Barefootodom6183

Kimura disease (KD) is a rare benign chronic inflammatory disease that presents as a nodule mostly involving deep subcutaneous tissue of the head and neck region with frequent regional lymphadenopathy and peripheral blood eosinophilia. KD shares some clinical and histopathological similarity with angiolymphoid hyperplasia with eosinophilia (ALHE). Consequently, KD and ALHE were once considered variants of the same disease spectrum. We present here rare cases of Kimura disease and ALHE involving the eyelid and lacrimal gland and discuss their differential features.A 68-year-old female presented with a 1-month history of lower back pain with right-sided radiculopathy and numbness. She was diagnosed with lumbar spondylosis and treated conservatively with analgesia and physiotherapy. Imaging showed multiple susuk, a metal alloy, in the lower back region and other regions of the body. The patient had undergone traditional medicine consultation 10 years earlier when the susuk was inserted in the lower back as talisman. The practice of the insertion of susuk is popular in rural East Malaysia and Indonesia. These foreign bodies act as possible causes of chronic inflammation and granuloma formation. In addition, the localised heighten peril upon imaging. This report suggests that the insertion of multiple susuk as talisman carries risk to safety of patients when imaging, and this practice complicates the management of musculoskeletal disorders.Accidental swallowing of objects commonly occurs among children and most of the objects pass through the gastrointestinal tract and out with the stool without any complications. However, recent reports have shown that there is an increasing occurrence of accidental ingestion of hijab pins among young hijab-wearing Muslim women or "hijabi". We highlight one such case, in which a young lady accidentally swallowed a pin that she was holding between her lips while she was styling her hijab. The pin was not successfully retrieved via endoscopy but was fortunately excreted spontaneously without any serious complications.OBJECTIVE A systemic steroid is known to have a potential to recover hearing after idiopathic sudden sensorineural hearing loss (ISSHL). However, lately many centres have introduced the use of intratympanic (IT) steroid therapy as an option. We reviewed our experience in the treatment of patients with ISSHL looking at the overall success of using systemic steroid, IT steroid injections as salvage therapy and primary IT steroid injection. METHODS A retrospective study was conducted on 20 patients who had suffered from ISSHL from January 1, 2012, to December 31, 2017. ISSHL is defined as a rapid decline in hearing over three days or less affecting three or more frequencies by 30dB or greater. Comparison between the mode of steroid therapies and improvement in patients was done. At least 15dB improvement in pure tone audiogram (PTA) was considered as successful therapeutic intervention. Selitrectinib datasheet RESULTS Twenty male and female patients who fit the inclusion and exclusion criteria were included. The mean age of the patients was 41.4 years with a range from 13 to 72 years. Ninety percent patients presented with unilateral ISSHL involvement. Eight ears of patients who received systemic steroid therapy alone had improved hearings (75%). Out of seven ears from six patients who received salvage therapy, four ears (57.1 %) had improvement in PTA. Seven ears showed improvement in PTA from a total of eight patients who primarily received IT injections. CONCLUSIONS IT steroid therapy promises a favourable outcome in the improvement of the hearing, as compared to systemic steroid administration. Its usage is recommended not only for salvage therapy but should be used as primary treatment especially in those with co- morbidities.INTRODUCTION Doctors play an important role to assess and manage pain. Failing to do so properly, pain will affect the quality of life and increase the length of hospital stay for patients. In Queen Elizabeth Hospital (QEH), Kota Kinabalu, Sabah, pain assessment and management programs have been conducted on a regular basis. However, there has been no studies to assess the effectiveness of these programs. METHODOLOGY This is a cross-sectional study to assess the knowledge and attitude on pain assessment and management among medical officers at QEH. A universal sampling technique was used, to represent medical officers from major clinical departments. The Knowledge and Attitudes Survey Regarding Pain (KASRP) questionnaire was used for this study. RESULTS A total of 278 questionnaires were distributed to medical officers. The study sample consisted of 125 females (44.9%), and 153 males (55.1%). The age group of the participants ranged from 25 to 41 years old. A 116 respondents scored less than 60% on the knowledge of pain (41.7%). These findings show there was a deficit in their knowledge and attitude about pain. There was also a difference of scores between genders, where the male doctors performed better than the female doctors. There was a difference between scores among doctors from different departments. The highest mean score was from the department of Anaesthesia (80.2%). There was also a difference regarding pain knowledge based on the years of working as a doctor, where the highest passing rate was from doctors working for more than five years. CONCLUSION This study demonstrated that there is a lack of knowledge and attitude on pain assessment and management among QEH medical officers who responded to this study. This will support the plan on a more aggressive and continuous education programme to improve pain assessment and management among doctors in QEH.OBJECTIVE To identify regions of the brain affected during cognitive working memory during tasks to assess attention, planning and decision making among military aviation personnel who have chronic intermittent exposure to high altitude environment. METHOD A case-control study was conducted in the Universiti Putra Malaysia among eight military personnel, four of whom had chronic intermittent exposure to high altitude training. They were divided into two groups, chronic intermittent exposure group (CE) (n=4) and a control group (n=4). They underwent a task-based functional magnetic resonance imaging (fMRI) that utilised spatial working memory task to objectively evaluate the neural activation in response to the Tower of London paradigm. Each correct answer was given a score of one and the maximum achievable score was 100%. RESULTS A consecutive dichotomised group of CE (4/8) and control (4/8) of age-matched military aviation personnel with a mean age of 37.23±5.52 years; showed significant activation in the right middle frontal gyrus (MFG).