Squamous cell carcinoma in burn scars: report of three cases

Introduction: Squamous cell carcinoma (SCC) is a malignant tumour of epidermal keratinocytes. SCC may arise in chronically inflamed lesions such as burn scars and chronic ulcers. Here, we report three cases of SCC arising from pre-existing burn scars. Cases presentation: Case 1: A 63-year-old lady presented with a four-months duration of progressive skin tumour over right shoulder scar. She had burn injury over the right shoulder for more than 50 years. She underwent wide local excision of the mass and the histopathological examination (HPE) reported as well-differentiated SCC. Case 2: A 53-year-old gentleman presented with a one-year history of skin growth over left shin. He had burn injury over left lower limb since the age of 10. He underwent left above-knee amputation (AKA) and HPE reported as well-differentiated SCC. Case 3: A 31-year-old man presented with non-healing ulcers over bilateral ankles. He sustained burn injury over bilateral upper and lower limbs at the age of 11. He underwent right AKA and HPE reported as well differentiated SCC. Discussion: Malignant transformation from burn is usually slow. This type of SCC is aggressive and associated with poor prognosis. Conclusion: SCC can complicate long-standing burn scars; therefore, follow-up is recommended to look for malignant changes

Systematic review on role of miRNAs in acute Myocardial Infarction of young adults

Acute myocardial infarction (AMI) is the leading cause of death worldwide. In Malaysia, people are getting AMI at younger age compared to well-developed countries. The role of microRNA (miRNA) in pathogenesis of AMI is not well elucidated and its involvement in young population has not been studied. The systematic review performedusing available electronic databases and also previous reviews. The databases were broad search and began with the generic terms to identify search terms that were relevant. Databases including PubMed, Science Direct and Medline were searched between January 2010 and December 2020 for this systematic review. A total of 97 articles found. Only 1 article showed that the research was done in young AMI population. 13 miRNAs were found to be upregulated and 16 downregulated in young acute coronary syndrome (ACS) patient, which included both ST elevation myocardial infarction (STEMI) and non-ST elevation myocardial infarction (NSTEMI). miRNA 183-5p was significantly upregulated in ACS patients with NSTEMI whereas miRNA 134-5p, miRNA 15a-5p and let 7i-5p weresignificantly downregulated in patients with STEMI compared to healthy control. Plasma miRNA 183-5p, miRNA 134-5p, miRNA 15a-5p and let 7i-5p were dysregulated in STEMI and NSTEMI where they can potentially be used to discriminate the two ACS forms in future study

Systematic review on role of miRNAs In AMI of young adults

Acute myocardial infarction (AMI) is the leading cause of death worldwide. In Malaysia, people are getting AMI at younger age compared to well-developed countries. The role of microRNA (miRNA) in pathogenesis of AMI is not well elucidated and its involvement in young population has not been studied. The systematic review performed using available electronic databases and also previous reviews. The databases were broad search and began with the generic terms to identify search terms that were relevant. Databases including PubMed, Science Direct and Medline were searched between January 2010 and December 2020 for this systematic review. A total of 97 articles found. Only 1 article showed that the research was done in young AMI population. 13 miRNAs were found to be upregulated and 16 downregulated in young acute coronary syndrome (ACS) patient, which included both ST elevation myocardial infarction (STEMI) and non-ST elevation myocardial infarction (NSTEMI). miRNA 183-5p was significantly upregulated in ACS patients with NSTEMI whereas miRNA 134-5p, miRNA 15a-5p and let 7i-5p were significantly downregulated in patients with STEMI compared to healthy control. Plasma miRNA 183-5p, miRNA 134-5p, miRNA 15a-5p and let 7i-5p were dysregulated in STEMI and NSTEMI where they can potentially be used to discriminate the two ACS forms in future study

Improved quality of healed wounds with topical application of Eurycoma Longifolia Jack root extract hydrogel

INTRODUCTION:Collagen is the key component of the extracellular matrix that plays a critical role in the strength and quality of the healed wound. Eurycoma longifoliaJack root extract (TA) has been documented as an anti-inflammatory, antioxidant, and antimicrobial agent that may improve the quality of healed wounds. The objective of this study is to investigate the effect of topical application of TA hydrogel on the quality of the healed skin in rats. MATERIALS AND METHODS: Twenty male Sprague Dawley rats were grouped into 4 groups: Negative control, Hydrocyn®aqua gel positive control, vehicle (Xanthan) hydrogel, and Eurycoma longifolia Jack (TA) hydrogel. Treatments were applied twice daily starting on wounding day until day 21. An excisional wound was created on the back of 20 rats. Tissue samples of the healed skin were collected for histological examination by measuring the epidermal and dermal thicknesses and evaluating the collagen fibre quality by VVG stain. RESULTS:The TA hydrogel grouphad the thickest newly formed epidermis compared with the other experimental groups. For the dermal thickness, compared with the vehicle (xanthan) hydrogel group, TA hydrogel, and Hydrocyn aqua® gel positive control groups showed significantly increased thickness withpvalues 0.020 and 0.045, respectively. Histologically TA hydrogel group showed a significant increase in mixed-oriented collagen fibres, and fascicular collagen bundles and showed profound collagen density. CONCLUSION: TA hydrogel improved the quality of healed skin by increasing the epidermal/dermal thicknesses and enhancing the quality of newly produced collagen fibres. It can be considered a promising and effective wound-healing agen

Synchronous spindle cell Sarcoma of Sternum and left breast invasive Carcinoma: a case report

The sternum is a critical structure of anterior chest wall but is an uncommon site for neoplastic involvement. Speedy diagnosis and treatment of sternal neoplasia is prudent to prevent circulatory collapse from mass effect to the mediastinum. When a new sternal mass is encountered, whether it is believed to be primary or secondary; malignancy needs to be considered until proven otherwise since primary sternal tumour is more frequently malignant than benign. Sternal chondrosarcoma is the most common; followed by myeloma, lymphoma and osteosarcoma. Spindle cell sarcoma of the sternum is very rare, while invasive breast carcinoma remains the most common form of breast cancer. However, synchronous occurrence of sternal spindle cell sarcoma and invasive breast carcinoma is extraordinary. Contrastingly, in the setting of a highly suspicious breast mass encountered with a concurrent sternal mass, skeletal metastasis to the sternum is usually the first differential diagnosis to consider though this is also uncommon. We report a 62-year-old lady with underlying diabetes mellitus and hypertension, presented with a hard central chest wall swelling for 4- months duration, described as increasing in size. Further clinical examination revealed a hard, immobile sternal mass. Incidentally a small left breast lump was also palpable, whereby subsequent mammogram and breast sonography depicted as a BIRADS 5 mass. Histopathological examination of the sternal mass biopsy depicted a spindle cell sarcoma; while that of the left breast biopsy revealed an invasive carcinoma. Patient underwent left mastectomy, axillary clearance, sternal tumour resection and chest wall reconstruction

Pulmonary phaehyphomycosis in retroviral disease patient

Pulmonary phaeohyphomycosis is a rare infection in the lung caused by black fungi containing a cytoplasmic melanin-like pigment. A 42-year-old man with underlying retroviral disease on HAART was investigated for having constitutional symptoms. Despite undetectable viral load and a high CD4 count, he was found to have unexplained significant loss of weight and appetite over a period of 6 months. Clinical examination revealed a cachexic man with multiple inguinal lymphadenopathies. Excisional biopsy of the inguinal lymph node revealed reactive follicular hyperplasia. CT Thorax, Abdomen and Pelvis was arranged to look for occult malignancy or infection and he was found to have multiple non-enhancing subcentimeter lung nodules mainly at the lateral segment of the right middle lobe of his lung. The largest nodule measured about 0.8 x 1.5 x 0.5 (AP x W x CC), with some nodules having an irregular margin with no extension into the adjacent bronchi. Bronchoscopy was done and demonstrated a black patch at the right intermedius, lateral segment of the middle lobe which did not disappear upon bronchial flush or wash. Histopathological examination found focal areas of blackish pigment and the bronchial alveolar lavage sent for fungal culture grew Cladosporium species. The patient was treated with oral Itraconazole with marked clinical improvement. This case highlights an unusual black fungi infection in the lung that stands out not only for its rarity and it's responsiveness to treatment, but also the susceptibility of an RVD positive patient to this infection despite having suppressed viral load and normal CD4 count

Trihoney ameliorates hypercholesterolemia-induced epididymal histopathological changes in male rabbits

Hypercholesterolemia has been linked to weight change and histopathological alteration of male reproductive organs. The epididymis was suggested to be an early target of lipid-related infertility and can be dramatically affected by excess intake of a high cholesterol diet. On the other hand, the interest has been increased towards the use of honey as a prophylactic and therapeutic agent for various diseases. Therefore, the purpose of this study is to investigate the effects of Trihoney (a mixture of Trigona, Mellifera and Tualang) on epididymal weight change and histopathological alterations in hypercholesterolemic male rabbits and compare its effects with atorvastatin. Forty-eight mature male New Zealand white rabbits were divided into 6 groups. Two groups received standard rabbit pellet with 0 and 0.6 g/kg/day of Trihoney respectively while the other four groups received 1% cholesterol diet with 0, 0.3, 0.6 g/kg/day of Trihoney, and 2 mg/kg/day of atorvastatin. After 12 weeks, the rabbits were sacrificed and the epididymides were harvested for evaluation of weight and histopathological changes. Administration of 1% cholesterol diet either alone or in combination with atorvastatin caused a significant reduction in the epididymal weight and epididymal atrophy. Supplementation of Trihoney particularly at the dose of 0.6 g/kg/day improved epididymal weight, regained the normal architecture of the epididymal histology and increased the number of mature sperm inside the tubules of the epididymis. Based on these results, Trihoney exhibited its potential health benefit as a protective agent against epididymal weight reduction and histopathological alterations in hypercholesterolemic rabbits. © 2020, University of Malaya. All rights reserved

Chronic post-partum changes of mesenteric arteries in Nω-Nitro-L-arginine methyl ester hydrochloride (L-NAME)- induced hypertension in pregnant rats model.

Introduction: Women with history of hypertensive disorders of pregnancy (HDP) have four-fold increased risk to develop cardiovascular diseases later in life. It has been postulated that the transient increase in blood pressure (BP) during pregnancy leads to ongoing endothelial dysfunction even though BP is normalized during postpartum. A balanced production of endothelin-1 (ET-1) and nitric oxide (NO) is important for BP regulation. This study aims to investigate the chronic postpartum effects of hypertension during pregnancy on the mesenteric arteries. Materials and method: 24 female Sprague-Dawley (SD) rats were assigned to four groups (n=6). Hypertension was successfully induced in the treated groups given 125mg/kg/day of L-NAME. All groups were sacrificed at Day 30 postpartum. Histopathological study of mesenteric arteries and ELISA analyses were done to measure ET-1 and NO levels. Results: The endothelial cells were seen as a single squamous cell with flatten nucleus. No obvious abnormalities were observed in the treatment groups. The media to luminal ratio did not show significant alteration in the treatment groups. The endothelial cells number to length ratio remains the same across the groups. In addition, the concentration of ET-1 and NO were not significantly different in the treatment groups. Conclusion: Based on the current studies, there is no evidence that demonstrate abnormal changes to the endothelium and tunica media of the resistance artery in long-term duration following HDP. However, further investigation of its potential chronic effect warrants a deeper analysis at the endothelial receptors and alteration at ultrastructure level

Red cell antibody screening: a single centre experience

The Transfusion Unit of International Islamic University Medical Centre (IIUM MC) performs screening for red cell antibodies for all patients who are to be or might be transfused with red cell components. There are two types of red cell antibodies, the alloantibodies and autoantibodies. While the red cell autoantibodies are produced against self-antigen, the alloantibodies are the results of sensitization through transfusion or pregnancies. These antibodies are implicated in haemolytic transfusion reactions. This retrospective study examines the prevalence of red cell antibodies among patients of IIUM MC. Materials and Methods: All group cross matching and group screen and hold testing performed in IIUM MC from January 2017 to June 2018 were reviewed. Results: In total, samples of 3,712 patients were subjected to antibody screening using gel card. Twelve patients (0.32%) had positive antibody screening tests. The age ranged from 17 to 77 years. Nine (75%) patients were females. Four patients had positivity with Screening Cell I, one patient with Screening Cell II and III respectively. In the remaining patients (6/12) the antibody screening was positive for both Screening Cell I and II. In nine patients (0.24%) alloantibodies were identified, with six exhibiting multiple antibodies. The alloantibodies identified include anti-Le(a), anti-Le(b), anti-Kp(a), anti-C, anti-c, anti-E and anti-e. In three patients autoantibodies with no specificities were detected. Conclusion: Although the prevalence of red cell antibodies, specifically the alloantibodies is lower compared to other studies, the finding further reiterates the need to screen for unexpected red cell antibodies prior to red cell transfusion

Protective effect of Trihoney against Hypercholesterolemia-induced abnormalities in sperm quality parameters.

A growing body of evidence has linked hypercholesterolemia with a reduction in the sperm count and motility coupled with an increase in the sperm morphological abnormalities. It affects spermatogenesis, sperm cytoskeleton, epididymal sperm maturation and the sperm fertilizing capacity. Due to claim of various side effects associated with current medical treatment, there have been a growing interest of the public toward the use of herbal medicine. Hence, the aim of this study was to investigate the protective effects of a novel Trihoney on sperm parameters of hypercholesterolemic rabbits