A Study of Carotid Intima Media Thickness Among Thalassemia Patient in HUSM

Thalassemia patient lifespan nowadays has been increased significantly compared to previously due to the advancement of medical treatment and better healthcare system. As a result, more transfusion-related complications are seen, and one of the rising trends is the thromboembolic complication. Studies has shown that ultrasound measurement of carotid intima-media thickness (CIMT) can be used as a surrogate marker for future cardiovascular event and is recommended to be done in thalassemia patient as early diagnostic tool and for vascular risk stratification

The impact of different types of orthodontic appliances and its location in producing CT scan artefacts

Fixed orthodontic appliances can produce metal artefacts in CT images which may degrade the diagnostic image quality. The study aimed to evaluate the artefacts based on the types and location of the metallic and non-metallic orthodontic brackets. This is an in-vitro cross-sectional study. Four different types of orthodontic brackets (stainless steel, titanium, monocrystalline, and polycrystalline ceramic bracket) were bonded consecutively in four different locations of the cadaveric skull. All scans were performed by a single operator using the same CT machine followed by a standard scanning protocol. Artefact intensity for all data sets was quantified by calculating the standard deviation (SD) of the grey values within the dataset by following a standard method. The One-way ANOVA Bonferroni test was used for the data analysis. The mean artefact score of the stainless steel bracket was significantly (p < 0.001) high in comparison with other types of the orthodontic brackets. Besides, the mean artefact score was significantly (p=0.002) low when orthodontic brackets were placed unilaterally. Stainless steel brackets produced a significant amount of noise in CT images which can degrade the diagnostic image quality. Thus, the polycrystalline ceramic bracket can be a better alternative of stainless steel brackets for patient need frequent CT scan

Clinical profile and outcome of children who underwent micturating cystourethrogram : A tertiary hospital experience

Micturating cystourethrogram (MCUG) is the gold standard test for the diagnosis of vesicoureteric reflux (VUR). The study aims to establish the association between the presence of VUR and renal outcomes. Methods: A cross-sectional retrospective study was conducted in children who were referred for MCUG at a tertiary centre over a 10-year period. Baseline characteristic data and the results of renal ultrasound, MCUG, with renal function were compiled and analysed. Fisher Exact test was used to compare between the grade of VUR and renal outcomes. Simple and multiple logistic regressions were used to examine the risk factors that may contribute to the development of VUR. Results: There were 136 children included in total. Forty-five had VUR, (31 [68%] high-grade, 14 [32%] low-grade, respectively). One third (33.3%) were surgically treated, 29 (64.4%) developed chronic kidney disease (CKD), and 18 (40%) developed renal scarring. Children with urinary tract infection (UTI) and hydroureter have 4.19 and 3.40 times the odds of developing VUR, respectively. Conclusion: The presence of hydroureter from ultrasound is a strong indicator of underlying VUR and justifies the rationale of requesting for MCUG, especially for those with recurrent UTI. However, this study failed to demonstrate significant association between the presence of VUR and complications of renal scarring and CKD

Relationship between volume of leukoaraiosis spot and degree of tissue damage: a quantitative diffusion tensor imaging study

Diffusion tensor imaging (DTI) offers parameter indices, namely, mean diffusivity (MD) and fractional anisotropy (FA). Leukoaraiosis is a brain white matter hyperintensity as observed on fluid-attenuated inversion recovery (FLAIR) images. In this study, we attempt to assess leukoaraiosis at its specific spot using a new parameter, namely, lesion-to-normal appearing white matter ratio (LNR). LNR was then used to investigate the relationship between the volume of leukoaraiosis spot and the degree of tissue damage. This study involved 49 leukoaraiosis subjects who altogether contributed to 274 leukoaraiosis spots. The MD, FA, and volume were measured at each spot. LNR was calculated by comparing the MD values of the spot with those of the surrounding normal-appearing white matter (NAWM). The correlation between MD, FA, and LNR with leukoaraiosis volume was then analysed. The leukoaraiosis tissues generally exhibited higher MD (103.97 ± 12.32 × 10-5 mm2/s) and lower FA (0.31 ± 0.08) values than the NAWM tissues (79.30 ± 4.76 × 10-5 mm2/s and 0.41 ± 0.09, respectively). LNR values were found to range from 0.04 to 1.63. The results showed an insignificant association between the leukoaraiosis volume and LNR [r = −.055, p = .368], whereas a very weak association was shown with MD [r = −.196,p =.001] and FA [r = .268, p < .001]. The volume of the leukoaraiosis spot does not necessarily indicate the degree of tissue damage. By using LNR instead of MD, an accurate analysis was performed since the variability of MD for NAWM surrounding the lesion is taken into account

Primary aggressive osteosarcoma of sphenoid bone

Osteosarcoma is a malignant intra-osseous neoplasm producing osteoid. Osteosarcoma of the skull is very rare and it usually involves the cranial vault. The occurrence in the skull base is extremely rare. We report a case of primary osteosarcoma in 59-year-old lady, occur in left sphenoid wing with intracranial and intranasal extension manifesting as left facial pain, headache and left epistaxis. She underwent radiotherapy as the surgical resection of the tumour is not feasible due to the critical extent of the tumour. We describe the clinical, radiological and histopathological findings of the case

Primary aggressive osteosarcoma of sphenoid bone

Osteosarcoma is a malignant intra-osseous neoplasm producing osteoid. Osteosarcoma of the skull is very rare and it usually involves the cranial vault. The occurrence in the skull base is extremely rare. We report a case of primary osteosarcoma in 59-year-old lady, occur in left sphenoid wing with intracranial and intranasal extension manifesting as left facial pain, headache and left epistaxis. She underwent radiotherapy as the surgical resection of the tumour is not feasible due to the critical extent of the tumour. We describe the clinical, radiological and histopathological findings of the case

Haemostasis and Inflammatory Parameters as Potential Diagnostic Biomarkers for VTE in Trauma-Immobilized Patients

Venous thromboembolism (VTE), which encompasses deep venous thrombosis (DVT) and pulmonary embolism (PE), is a major public health concern due to its high incidences of morbidity and mortality. Patients who have experienced trauma with prolonged immobilization are at an increased risk of developing VTE. Plasma D-dimer levels have been known to be elevated in trauma patients, and they were closely correlated with the number of fractures. In other words, plasma D-dimer levels cannot be used as the only indicator of VTE in trauma cases. Given the limitations, further study is needed to explore other potential biomarkers for diagnosing VTE. To date, various established and novel VTE biomarkers have been studied in terms of their potential for predicting VTE, diagnostic performance, and improving clinical therapy for VTE. Therefore, this review aims to provide information regarding classic and essential haemostasis (including prothrombin time (PT), activated partial thromboplastin time (aPTT), D-dimer, fibrinogen, thrombin generation, protein C, protein S, antithrombin, tissue factor pathway inhibitor, and platelet count) and inflammatory biomarkers (C-reactive protein, erythrocyte sedimentation rate, and soluble P-selectin) as potential diagnostic biomarkers that can predict the risk of VTE development among trauma patients with prolonged immobilization. Thus, further advancement in risk stratification using these biomarkers would allow for a better diagnosis of patients with VTE, especially in areas with limited resources