The performance of ultrasound and upper gastrointestinal study in diagnosing malrotation in children, with or without volvulus.

Background: Rapid diagnosis is crucial for pediatric patients with midgut volvulus and malrotation to prevent serious complications. While the upper gastrointestinal study (UGIS) is the traditional method, the use of ultrasound (US) is gaining prominence.

Objectives: To assess the diagnostic sensitivity and specificity of US compared to UGIS for malrotation and midgut volvulus.

Sonographic evaluation of normal diaphragmatic thickness and excursion in Malaysia paediatric population: A single-institution cross-sectional study.

Introduction: Diaphragmatic dysfunction is often underdiagnosed as clinical presentation is non-specific and reference values for normal diaphragmatic excursion are inadequate. The rationale of this study is to provide a normal reference value of diaphragmatic excursion and thickness in Malaysia's paediatric population using M-mode sonography, as no previous local data are available to our knowledge.

Materials And Methods: A total of 119 healthy infants and children fulfilling our inclusion and exclusion criteria were recruited.

Case report: Kaposi hemangioendothelioma of the right upper limb with the Kasabach-Merritt phenomenon: A potentially lethal diagnostic challenge.

Kaposi hemangioendothelioma (KHE) is a rare vascular neoplasm that presents usually within the first year of life. Because of its rarity and complexity, there is often a delay in diagnosis. KHE could be associated with a life-threatening consumptive coagulopathy named the Kasabach-Merritt phenomenon (KMP).

Prophylactic Intraoperative Nasolacrimal Duct Intubation in Surgical Treatment of Facial Fractures-Is There a Role?

Nasolacrimal duct (NLD) damage is associated in the majority of type II and III naso-orbito-ethmoid (NOE) fractures. Our study aims to investigate the efficacy and safety of prophylactic NLD intubation in the setting of facial fractures, by comparing incidence of postoperative epiphora and wound infection. A retrospective matched control study was conducted on all patients with surgically treated facial fractures from 2008 to 2013 (  = 280) (IRB ref number: DSRB 2013/01198).

Retropharyngeal Abscess in a Neonate After Extravasation Injury: To Drain or not to Drain?

Neonatal retropharyngeal abscess (RPA) is a rare and life-threatening entity. Most of the cases are idiopathic in nature. We encountered a case of RPA in a newborn secondary to extravasation injury.

Distant recurrence of endometrial cancer more than 10 years after hysterectomy: a case report.

Objectives: Endometrial cancer is the sixth most common cancer among women and recurrence of after 10 years is extremely rare.

Case Presentation: We reported a comprehensive review of histopathology, investigations and treatment regarding a woman with distant recurrence of endometrial cancer to rectus abdominis muscle after 23 years from the primary surgery. Previous published literatures of similar case were included into the review analysis.

Disinfection capabilities of a 222 nm wavelength ultraviolet lighting device: a pilot study.

Objective: To demonstrate the efficacy of the SafeZone UVC (Ushio Inc., Japan) 222 nm ultraviolet C (UVC) light to reduce bacterial burden in pressure ulcers (PUs) in human patients. This research is the first human clinical trial using 222 nm UVC in eradicating bacteria in human wounds.

Sonographic nomogram of paediatric renal size in Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM).

Introduction: A person's childhood is an important period of growth, and also one's most vulnerable, as one can be exposed to various pathologies, for example those that could affect the growth of one's kidney. Asians are physiologically different from Caucasians, and the nomogram renal size obtained from a Western population (mostly of Caucasians) is not be suitable for representing Asian children. As such a nomogram on paediatric renal size derived from Malaysia is needed.

Uterine-conserving approach in ruptured intramyometrial ectopic pregnancy.

Intramyometrial ectopic pregnancy (IMEP) is a rare form of ectopic pregnancy. It is defined as a conceptus implanted within the myometrium and is completely surrounded by myometrium with clear separation from both the uterine cavity and tubes. IMEP possesses not only diagnostic but also therapeutic challenge.

Management Options and Outcome of Cerebral Arteriovenous Malformation in Pregnancy: Case Series.

Cerebral arteriovenous malformation (AVM) is a rare entity with an estimated prevalence of 0.01-0.05% in the general population.

Elevated serum CA 19-9 with adnexal mass: is it always an ovarian malignancy?

Endometriotic cysts a common benign gynaecological disease in women of reproductive age. We report an unusual case of ruptured endometrioma associated with increased CA 19-9. A 27-year-old woman presented with an acute abdomenal adnexal mass and elevated CA 19-9.

Imaging modalities for an uncommon inguinal scrotal pathology: A case report and literature review.

Inguinal scrotal swelling is a common presentation to surgical clinic with various differential diagnoses. In most circumstances, a good clinical assessment is sufficient to identify the diagnosis. Imaging is necessary when diagnostic difficulty was encountered.

One year survivor of metastatic renal cell carcinoma treated with pazopanib.

Tyrosine kinase inhibitor (TKI) and its side effects are well known. However, these are mainly descriptive, with pictorial data lacking. Here, in we report a case of metastatic renal cell carcinoma, treated with TKI, with classic side effects; supplemented with images that demonstrate the adverse effects of the drug.

Characteristics of Primary Care Physicians in Patient-centered Medical Home Practices: United States, 2013.

Objective-This report describes the characteristics of primary care physicians in patient-centered medical home (PCMH) practices and compares these characteristics with those of primary care physicians in non-PCMH practices. Methods-The data presented in this report were collected during the induction interview for the 2013 National Ambulatory Medical Care Survey, a national probability sample survey of nonfederal physicians who see patients in office settings in the United States. Analyses exclude anesthesiologists, radiologists, pathologists, and physicians in community health centers.

Expected Source of Payment at Emergency Department Visits for Adults Aged 18-64 for the United States and in the Five Most Populous States, 2012.

Data from the National Hospital Ambulatory Medical Care Survey, 2012 •In 2012, 33% of emergency department (ED) visits in the United States made by adults aged 18-64 had private insurance as the expected source of payment. This percentage was lower for Illinois than for the total United States. •In 2012, 21% of ED visits made by adults aged 18-64 had Medicaid as the expected source of payment.

Emergency Department Use in the Country's Five Most Populous States and the Total United States, 2012.

Data from the National Hospital Ambulatory Medical Care Survey, 2012 •In 2012, the emergency department (ED) visit rate in the United States was 42 visits per 100 persons. •The ED visit rate among the five most populous states ranged from 37 visits per 100 persons in New York to 49 visits per 100 persons in Texas. •The percentage of ED visits resulting in admission to the same hospital was higher in California (16%) and Florida (17%) than was observed nationally (11%).

Primary umbilical endometriosis successfully treated with dienogest.

Primary umbilical endometriosis (PUE) is a rare gynaecological disorder. A majority of the reported cases were treated with surgical excision as medical treatment had been found to be less successful. We reported a case of PUE successfully treated with dienogest without any profound side effects from the drug.

Nonresponse Bias in Estimates From the 2012 National Ambulatory Medical Care Survey.

Background: The National Ambulatory Medical Care Survey (NAMCS) is an annual, nationally representative sample survey of physicians and of visits to physicians. Two major changes were made to the 2012 NAMCS to support reliable state estimates. The sampling design changed from an area sample to a fivefold-larger list sample of physicians stratified by the nine U.

Toward a More Complete Picture of Outpatient, Office-Based Health Care in the U.S.

The healthcare system in the U.S., particularly outpatient, office-based care, has been shifting toward service delivery by advanced practice providers, particularly nurse practitioners (NPs) and physician assistants (PAs).

An Algorithm for the Management of Concomitant Maxillofacial, Laryngeal, and Cervical Spine Trauma.

Concomitant maxillofacial, laryngeal and cervical spine injuries may occur after high-energy accidents. Although this presentation is uncommon, the multiple injuries may compromise airway, breathing, circulation, and neurologic function. We identified 8 adult trauma patients admitted to the National University Hospital with the concomitant injuries.

Renal doppler assessment in differentiating obstructive from non-obstructive hydronephrosis in children.

Background: to determine the usefulness of Doppler ultrasound measurement of resistive index (RI) in differentiating obstructive from non-obstructive hydronephrosis in children.

Methods: From August 2011 to November 2012, renal Doppler assessments of the intra-renal renal arteries were performed on 16 children (19 kidneys) with congenital hydronephrosis. the independent t-test was used to assess for significant difference in RI values between those with obstructive hydronephrosis (6 kidneys) and those with non-obstructive hydronephrosis (13 kidneys) as determined by dynamic renal scintigraphy.

Adoption of Certified Electronic Health Record Systems and Electronic Information Sharing in Physician Offices: United States, 2013 and 2014.

Data from the 2014 National Electronic Health Records Survey. In 2014, 74.1% of office-based physicians had a certified electronic health record (EHR) system, up from 67.

State Variation in Preventive Care Visits, by Patient Characteristics, 2012.

Data from the National Ambulatory Medical Care Survey, 2012. In 2012, 61.4 preventive care visits were made to office-based physicians per 100 persons.

A Protocol to Reduce Interobserver Variability in the Computed Tomography Measurement of Orbital Floor Fractures.

Orbital fracture detection and size determination from computed tomography (CT) scans affect the decision to operate, the type of surgical implant used, and postoperative outcomes. However, the lack of standardization of radiological signs often leads to the false-positive detection of orbital fractures, while nonstandardized landmarks lead to inaccurate defect measurements. We aim to design a novel protocol for CT measurement of orbital floor fractures and evaluate the interobserver variability on CT scan images.

Variation in Physician Office Visit Rates by Patient Characteristics and State, 2012.

In 2012, 74% of children and adults with a usual place to visit listed a doctor's office as their usual place for care (1,2). This report examines the rate of physician office visits by patient age, sex, and state. Visits by adults with private insurance as their expected source of payment were also examined.