Subcutaneous Panniculitis-like T-cell Lymphoma: A Case Report of A Solved Conundrum

Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare primary cutaneous lymphoma which often be very complexed to be diagnosed. Here we reported a case of a 38-year-old lady with wax and wane course of left facial swelling associated with prolonged pyrexia of unknown origin, lethargy and prominent weight loss. Multiple investigations were conducted to reach to the conclusive diagnosis. Histopathological showed infiltration of neoplastic lymphoid cells within the adipocyte clusters with hyperchromatic nuclei, small nucleoli and scant cytoplasm. Immunohistochemical analysis were immunoreactive to CD3, CD8 & TIA and negative to CD20, CD4 & CD56. Based on clinical findings, histopathology report and immunohistochemical analysis, the patient diagnosed with SPTCL. Hence, any suspicious maxillofacial swelling without obvious sign of infection and trauma shall be investigated until a final diagnosis is reached

An Unusual Cause of Progressive Chest Deformity in A Child

Inflammatory myofibroblastic tumour (IMT) is a rare tumour with intermediate malignant potential and unclear aetiology. In most cases, the clinical presentation is non-specific. The liver and lung are the most common location for IMT in children, and mediastinum is an uncommon place. Symptoms vary depending on the location of IMT, thus making a definitive diagnosis to be even more difficult. Until the histological investigation can rule out IMT, it should be considered in the differential diagnosis of individuals with localised masses. We report here a case of an 8-year-old boy with rightsided chest pain and deformity before the diagnosis of mediastinal IMT was made through tissue biopsy

Designing and Validating a New Youth and Adolescent Sexual Knowledge Scale

INTRODUCTION: There is an increasing trend of premarital sexual experience and teenage pregnancies in Malaysia, coupled with a paucity of data regarding sexual practices amongst adolescents. Current available sexual knowledge scales that were reviewed were found unsuitable to be applied to the Malaysian population, due to a multitude of factors such cultural and religious sensitivity; explicit nature and contents; targeting specific populations; non-comprehensiveness. MATERIALS AND METHODS: The development of a new scale, Youth and Adolescent Sexual Knowledge Scale (YASKS) is divided into qualitative and quantitative stages. The qualitative stage involved extensive literature review of currently available and related scales and expert interviews (qualitative content validity) to identify the domains for sexual knowledge; item identification for each domain and language review. In the quantitative stage, the pretest of the pre-final version, and validation study were conducted among students from International Islamic University Malaysia, in Kuantan. RESULTS: Initial Exploratory Factor Analysis (EFA) revealed 11 factors with overall Cronbach alpha of 0.3, 95% CI (0.251,0.422) EFA was then repeated with two factors resulting in deletion of 19 items. Cronbach alpha significantly improved to 0.695% CI (0.548, 0.643), while the alpha for the two domains were 0.68, CI (0.637, 0.724) and 0.5, 95% CI (0.455,0.589). CONCLUSION: This study revealed a two-factor model with 12 items of the YASKS with acceptable psychometric properties. This scale is valid and reliable to measure sexual knowledge among youth and adolescents in Kuantan

Management of Deep Neck Infection with Descending Mediastinitis using Video-Assisted Thoracoscopic Surgery

Descending mediastinitis is defined as the spread of oropharyngeal or odontogenic infection into the mediastinum. It occurs uncommonly and has a high mortality rate. Prompt commencement of broad-spectrum antibiotics combined with surgical drainage is crucial to limit further spread of infection. We report a case of extensive deep neck infection in a 66-year-old female which rapidly progressed to the contralateral neck complicated by descending anterior mediastinitis. She underwent a combined transcervical and video-assisted thoracoscopic surgery (VATS) for drainage of abscess and was put on 3 weeks of intravenous antibiotics coupled with another 3 weeks of oral antibiotics. Deep neck infection with descending mediastinitis can be successfully treated with antibiotics and early surgical drainage via a combined transcervical and VATS approach

The Efficacy of Patient Controlled Analgesia for Acute Non Traumatic Abdominal Pain in Emergency Department

INTRODUCTION: Patient-Controlled Analgesia (PCA) is an intravenous selfadministration of small doses of opioids (such as morphine) using a programmable pump, The goal of PCA is to efficiently reduce patients’ pain at patient's preferred dose and schedule. Thus, we conducted a study to compare patient PCA morphine with intravenous bolus morphine for acute abdominal pain of non-traumatic origin in the emergency department (ED). MATERIALS AND METHODS: A randomised, non-blinded clinical trial was conducted in patients presented with severe acute non traumatic abdominal pain of less than 24 hours requiring opioid analgesic based on numerical pain score of more than seven at triage. The primary outcome was visual analogue pain score (VAS) recorded at 0, 30th, 60th and 120th minutes during the management in the ED and after admission to wards, and the secondary outcomes were total dosage of morphine used and degree of patient satisfaction. RESULTS: A total of 62 participants who fulfilled study criteria were randomized into PCA morphine group or bolus morphine group. The average amount of analgesic used for bolus morphine group was lower compared to PCA morphine (4.23 mg)(s.d 1.89 vs 5.29 mg)(s.d 2.16) (p=0.027). Despite of significant VAS score changes within group analysis, between group repeated measure ANOVA (RMA) VAS score analysis was not statistically significant. [Bolus group (6.7+2.03) compared to PCA group (5.83 + 2.38)](p=0.089). Patient satisfaction was statistically significant for the PCA group [PCA (1.65+0.709) compared to bolus group (2.23+0.920)](p=0.007). CONCLUSIONS: There was no significant difference in pain score reduction between PCA and intravenous bolus of morphine for the management of severe acute non traumatic abdominal pain in ED. However, PCA provided more patient satisfaction and should be considered as an alternative modality of acute pain management in ED

A Teenage Girl with Large Lung Mass

Extraskeletal Ewing Sarcoma is rarely reported. A fifteen-year-old girl presented with the right-sided pleuritic chest pain, shortness of breath, and productive cough with whitish sputum associated with poor oral intake. She subsequently underwent contrast-enhanced Computerized Tomography thorax, which showed lobulated heterogenous hypodensity occupying the entrance of the right superior pulmonary vein, extending to the left atrium

Is Cognitive Behaviour Therapy Effective for Borderline Personality Disorder : A Case Report and Review of Literature

Managing people with borderline personality disorder (BPD) is an arduous task due to the complexity of the condition. This paper describes the role of Cognitive Behaviour Therapy (CBT) in a patient diagnosed with BPD who has undergone a modified DBT skill group training. Despite receiving multiple interventions in the past, this patient had her bouts of struggles living with this illness which required a new approach to facilitate her recovery. A trial of a short-term, 12 session-ed treatment of mindfulness-based CBT was commenced. In this case report we describe the challenges and modifications which surpass during this session and literature review on the role of CBT on BPD.

Eruption Cyst of a Newborn and Review of the Management

Eruption cyst is a cyst associated with the unerupted tooth that is rarely found in a newborn or infant. We reported a case of a male infant who presented with an eruption cyst at birth in which has not caused any feeding or airway problem in him. A periodic monitoring was performed and spontaneous regression of the cystic lesion was observed within a month with the presence of a neonatal tooth .

A Scoping Review of Female Genital Mutilation and its Effects on Sexual Function and Sexual Satisfaction

The practice of female circumcision (FC), particularly female genital mutilation/cutting (FGM/C), has been controversial as it is regarded as physically and mentally harmful and violates human rights. The purpose of this study is to perform a scoping review aiming to evaluate and compare the effects of FC and FGM/C on the sexual function of the affected women, including the Google Scholar, EBSCO Discovery Service, PubMed, ProQuest Health & Medical Complete, and Wiley Online Library between the year 1999 to 2020. The following keywords were used: ‘Female Circumcision’, ‘Female Genital Mutilation, ‘Female Genital Cutting’, ‘Female Circumcision and Sexual Function’, and ‘Female Circumcision and Sexual Satisfaction. A total of 72 articles related to FC and sexual function or satisfaction were retrieved, and 30 articles met the inclusion criteria. Based on the analysis of the final 30 articles, most of the articles described the detrimental effects of FGM/C on sexual function and sexual satisfaction. However, future studiesMaround the less invasive types of FGM/C are required to better reflect on FGM/C on female health. FGM is detrimental to female sexual satisfaction. However, a different method of FC that is less invasive may provide different outcomes. Therefore, a comprehensive guideline on proper FC techniques is needed for education among medical practitioners to prevent any adverse effects on sexuality

Holistic Approach of Periodontitis Patient with Diabetes Mellitus: A Case Report

Diabetes mellitus (DM) is a common risk factor for patients with periodontal disease. Periodontitis patients with poor glycaemic control present with severe and advanced periodontal tissue destruction. A multidisciplinary approach between the periodontist and medical practitioner is clinically proven to maintain the patient's periodontal health and general well-being. This case report aims to raise the awareness and provide a basic guideline for medical and dental practitioners in identifying and managing periodontitis patients with undiagnosed DM particularly if patient is presented with recurrent periodontal abscess. A 34-year-old Malay lady presented with recurrent periodontal abscess and diagnosed with Periodontitis Stage III Grade C was treated holistically by the periodontist and a medical practitioner. The patient's compliance towards the periodontal treatment, routine medical check-ups, and medications has helped the patient achieved better periodontal health and controlled glycaemic level. Following her sixth periodontal re-evaluation in two years improvement in oral hygiene, resolution of gingival swelling and bleeding were seen after sequences of non-surgical, surgical periodontal treatment and patient’s compliance towards her medications and follow-up