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Biomedical subjects

A Abdullah

Publications and source records attributed to A Abdullah.

At least 19 recordsLinked to original sources
PubMed2006

Er:YAG laser resurfacing for inoperable medium-sized facial congenital melanocytic naevi in children.

Congenital melanocytic naevi (CMN) can cause significant psychosocial morbidity, especially if they are in visually exposed areas. The preferred treatment is surgical excision, though not all lesions are amenable to this because anatomical location may preclude aesthetic and functional reconstruction. Three children with inoperable facial CMN were treated with Er:YAG resurfacing under general anaesthetic. Two children were Fitzpatrick skin type II, and one child was skin type VI. Treatment was performed at 4-9-monthly intervals. The procedure achieved significant lightening and thinning in all three cases, without scarring or dyspigmentation. One child developed herpes simplex infection in the treated area on one occasion, which was managed with oral aciclovir, and did not lead to scarring or preclude further treatment. We conclude that Er:YAG laser resurfacing is effective for CMN, even in darker skin types. The incidence of side-effects is low, although repeated treatment is necessary.

Child↗
PubMed2006

Internal auditory canal stenosis in congenital sensorineural hearing loss.

OBJECTIVE: Sensorineural hearing loss (SNHL) due to internal auditory canal (IAC) stenosis with hypoplasia of the cochleovestibular nerve is a rare disorder. The diagnosis of the IAC stenosis requires both high resolution computed tomography scan (HRCT) and magnetic resonance imaging (MRI). METHODS: A retrospective review over 6 years in an academic tertiary referral center was performed. RESULTS: Six patients with congenital SNHL were diagnosed with congenital IAC stenosis. Four had unilateral and two had bilateral IAC stenosis after imaging. MRI showed hypoplastic vestibulocochlear nerve in all cases. CONCLUSIONS: This paper highlights the importance of imaging in diagnosing IAC stenosis and detecting the presence of cochleovestibular nerve in cases of congenital SNHL.

Child↗
PubMed2006

Severe adverse cutaneous reaction to insulin due to cresol sensitivity.

We present the case of an 80-year-old lady known to be sensitive to chlorocresol (4-chloro-3-methyl phenol) who developed severe erythrodermic exfoliative dermatitis with atypical features 2 weeks after commencing subcutaneous insulin. All medications except insulin were stopped, without major improvement. It was noted that the insulin contained m-cresol (m-methyl phenol) so a parabens-based insulin was substituted. There was a significant improvement in her clinical condition within 72 hr. Further patch and intradermal testing to the insulin and m-cresol was planned, but she developed a nosocomial infection and died. We hypothesize that the adverse cutaneous reaction was a systemic manifestation of cresol sensitivity, given the rapid clinical resolution on changing insulins and the previously demonstrated sensitivity to chlorocresol, particularly as cross-reactivity between different low molecular weight methyl phenols is documented. Local injection site reactions and systemic side-effects including nausea, diarrhoea and vomiting have previously been reported with cresol-containing insulins, although to our knowledge, this is the first reported case of a severe cutaneous reaction. It is important to be aware of m-cresol as a potential allergen, as it is contained in most commercially available insulins.

Aged, 80 and over↗
PubMed2006

The treatment of port-wine stains with the pulsed-dye laser at 2-week and 6-week intervals: a comparative study.

BACKGROUND: The pulsed-dye laser (PDL) is the treatment of choice for port-wine stains (PWS). Multiple treatments are usually necessary, with standard treatment intervals ranging between 6 and 12 weeks. However, there are no studies on the effect of treating PWS at different time intervals, and the ideal time interval between treatments has not yet been agreed. It is uncertain whether treatment is more effective if administered at shorter time intervals. OBJECTIVES: To establish whether the treatment of PWS with the variable pulse width 595-nm (V-beam) PDL at 2-week intervals achieves better results, with no difference in the complication rate, than treatment given at 6-week intervals. METHODS: We prospectively investigated 15 patients with PWS. Each patient had the whole PWS treated at initial visit. Half of the PWS was randomly allocated to be treated at 2 weeks and the other half at 6 weeks from initial visit. Both halves of the PWS thus were treated twice in total, once at the initial visit and the second treatment either at 2 weeks or 6 weeks from initial visit. At 12 weeks an observer blinded to treatment allocation clinically evaluated the results. The outcome measure was lightening of the PWS as measured with a reflectance spectrophotometer. Complications were recorded throughout the study period. RESULTS: Of the 15 patients, 13 completed the study. Three patients had two PWS each treated separately, giving a total of 16 treated PWS sites. In 11 sites (69%), the 2-week interval treatment resulted in greater reduction in reflectance than the 6-week interval treatment. Using the nonparametric Wilcoxon matched-pair signed rank test, the 2-week treatment interval site resulted in greater reduction in reflectance measurements compared with the 6-week treatment interval site (P < 0.01). This agreed closely with independent observer assessment judging that the 2-week treatment interval resulted in better lightening of the PWS than the 6-week treatment interval (P = 0.003). There were no adverse reactions from the treatments. CONCLUSIONS: Preliminary data suggest that a treatment interval of 2 weeks is well tolerated by patients and resulted in greater lightening of the PWS in the majority, compared with a standard 6-week interval. It also has the potential to reduce the total duration of a course of treatment significantly.

Adult↗
PubMed2006

Chromomycosis caused by Exophiala spinifera.

Chromomycosis is a chronic, localized infection of the cutaneous and subcutaneous tissues caused by dematiaceous fungi of several genera. It has distinctive clinical, pathological and mycological characteristics. Exophiala spinifera is a well-established aetiological agent of phaeohyphomycosis, but there are only two reported cases worldwide of this dematiaceous fungus causing chromomycosis. We report the first known case in the UK of E. spinifera causing chromomycosis.

Aged↗
PubMed2006

Newborn hearing screening: experience in a Malaysian hospital.

INTRODUCTION: This study aims to determine the prevalence of hearing loss among newborns delivered at Hospital Universiti Kebangsaan Malaysia and to evaluate the usefulness of our hearing screening protocol. METHODS: All infants born in the hospital over a nine-month period, between April to December 2003, were screened for hearing loss with a portable otoacoustic emission (OAE) before discharge. At the age of two months, a second OAE test was repeated on newborns who failed the initial test. Those who failed the second test were re-tested at three months of age. When these infants failed the third OAE test, a brainstem evoked response (BSER) test was performed. RESULTS: During the study period, 4,219 infants were born in the hospital, and 3,762 (89.2 percent) underwent OAE screening. 620 (19.7 percent) of them failed the first screening test, and 506 (81.6 percent) of them came for a second stage-screening test. In the third stage screening at three months of age, only 39 (65 percent) patients turned up. Of these, ten infants passed the OAE test and 29 failed. However, when these infants underwent BSER, 13 had normal BSER and 16 have abnormal BSER. The prevalence of hearing loss in this study was 0.42 percent (16/3,762). CONCLUSION: The large number of defaulters and false-positive results in this study suggest that this pilot hearing-screen programme requires fine-tuning to minimise these problems.

Audiometry, Evoked Response↗
PubMed2005

A pilot project on hospital-based universal newborn hearing screening: lessons learned.

OBJECTIVE: This paper reports the performance of a newly implemented hospital-based universal newborn hearing screening programme and the challenges to the effective implementation. METHODS: Data of 4437 babies screened from April 2003 to February 2004 at Hospital Universiti Kebangsaan Malaysia was analyzed to measure the performance of the newborn hearing screening programme. Quality indicators, which include the coverage rate, initial refer rate, return for follow-up rate, ages of diagnosis and intervention were calculated. Factors contributing to poor compliance for follow-up were examined through questionnaire survey of 341 parents who did not bring their babies for the initial screening follow-up. RESULTS: The findings of this study revealed unsatisfactory performance of the hearing screening programme compared to the Joint committee of Infant Hearing recommendation [Joint Committee on Infant Hearing Year 2000 Position Statement: Principles and Guidelines for Early Hearing Detection and Intervention Programs, Pediatrics 106 (4) (2000) 798-817]. The coverage rate, initial refer rate, and return for follow-up rate were 84.64, 11.97 and 56.97%, respectively. The average age of diagnosis was 3.56 months (S.D. 1.33). Only 1 of the 16 babies identified as having hearing loss through the screening programme has been fitted with hearing aids. Delay in coming to audiological certainty was one of the reasons hampering early intervention of these children. The commonly cited reasons for not returning for screening follow-up reflect the need to create public awareness of the importance of early diagnosis and intervention of hearing loss. CONCLUSIONS: The implementation of the present screening programme needs to be reviewed. Factors contributing to its unsatisfactory performance must be identified and steps must be taken to resolve them so that early identification and intervention of permanent congenital hearing loss can become a reality.

Continuity of Patient Care↗
PubMed2005

Study of patient-reported morbidity following V-beam pulsed-dye laser treatment of port wine stains.

The V-beam pulsed-dye laser (PDL) (595 nm) has gained popularity in the treatment of port wine stains (PWS). It uses longer pulse durations than the standard flashlamp-pumped pulsed-dye laser (FPDL) (585 nm) and has an in-built cooling system to protect the epidermis. This should, theoretically, reduce the treatment-associated side effects, including discomfort. The aim of this questionnaire-based study was to confirm the clinical impression that V-beam PDL is well tolerated. The results were compared with a historical group of 62 PWS patients treated with FPDL. Fifty-one patients took part in the current study. Only 35.7% (vs. 81% in the historical comparison group) required topical anaesthetic prior to laser treatment. A shortening in the duration of bruising (8 vs. 10 days) and of symptoms such as burning and tightness (3 vs. 10 days) was recorded. Lifestyle change after treatment was recorded by fewer patients (39 vs. 57%). We conclude that V-beam PDL is better tolerated than FPDL when used at therapeutic levels in patients with PWS.

Adolescent↗
PubMed2005

Sensitivity and specificity of portable transient otoacoustic emission (TEOAE) in newborn hearing screening.

Early identification and management of hearing impairment is very valuable. The goal standard measurement of hearing loss is by brainstem evoked response (BSER). This prospective study was conducted in Hospital University Kebangsaan Malaysia (HUKM) to determine the sensitivity and specificity of transient evoked otoacoustic emission (TEOAE) as a screening tool for hearing impairment from February 1999 to February 2000. One hundred and thirty-three newborns from postnatal ward and seventy-eight newborns from neonatal intensive care unit (NICU) were screened for possible hearing loss using portable TEOAE. This study showed that TEOAE is a very sensitive but moderately specific screening tool.

Cochlear Microphonic Potentials↗
PubMed2005

Cervical necrotizing fasciitis due to klebsiella.

Necrotizing fasciitis is an aggressive infection involving fascia and subcutaneous tissue thus causing infectious thrombosis of the nutrient vessels to the overlying skin ultimately leading to extensive necrosis. Although necrotizing fasciitis is common in the perineum, abdominal wall and extremities it is relatively uncommon in the head and neck region. This is a case report of a 65 year old female visiting from India who presented with diabetic ketoacidosis precipitated by cervical necrotizing fasciitis. Computed tomography imaging showed involvement of the left parapharyngeal space and there was soft tissue gas present. This patient subsequently underwent an emergency neck exploration and desloughing. Repeated pus culture studies isolated Klebsiella species as the sole pathogen. Our case illustrates that prompt diagnosis and treatment of cervical necrotizing fasciitis can ensure a good outcome.

Aged↗
PubMed2003

Preoperative high resolution CT and MR imaging in cochlear implantation.

INTRODUCTION: Accurate preoperative imaging of the temporal bone in patients receiving cochlear implants is important. High resolution computed tomography (HRCT) and magnetic resonance (MR) imaging are the 2 preoperative imaging modalities that provide critical information on abnormalities of the otic capsule, pneumatisation of the mastoid, middle ear abnormalities, cochlear ducts patency and presence of cochlear nerve. MATERIALS AND METHODS: The HRCT and MR imaging in 46 cochlear implant patients in our department were reviewed. RESULTS: Majority of our patients [34 patients (73.9%)] showed normal HRCT of the temporal bone; 5 (10.9%) patients had labyrinthitis ossificans, 2 (4.3%) had Mondini's abnormality and 2 (4.3%) had middle ear effusion. One patient each had high jugular bulb, hypoplasia of the internal auditory canal and single cochlear cavity, respectively. CONCLUSION: The above findings contribute significantly to our surgical decisions regarding candidacy for surgery, side selection and surgical technique in cochlear implantation.

Cochlear Diseases↗
PubMed2003

The different faces of facial nerve schwannomas.

Facial nerve schwannomas are rare benign tumors. The tumor can arise anywhere along the course of the facial nerve. The most common presentation for this tumor is a slowly progressive facial nerve paralysis. Sensorineural hearing loss (SNHL) and tinnitus are later symptoms. The symptoms and signs depend on the site of tumor along the nerve. We report three cases of facial nerve schwannomas with different clinical presentations. Appropriate management of a facial nerve schwannoma should be based on the site and extent of the tumor and status of the nerve function.

Adult↗
PubMed2001

Comparison of oestrus synchronisation programmes in dairy cattle using oestradiol benzoate, short-acting progesterone and cloprostenol, or buserelin and cloprostenol.

AIM: To evaluate the efficacy of a programme using oestradiol benzoate, progesterone and the prostaglandin-F2 (PG) analogue, cloprostenol, to synchronise oestrus and ovulation in dairy cows, compared with a programme using a gonadotropinreleasing hormone (GnRH) agonist, buserelin, and cloprostenol. METHODS: Twenty non-lactating dairy cows, at random stages of the oestrus cycle, were randomly assigned to 1 of 2 treatments. In Treatment 1 ( OPPG; n=10), cows were injected with 2 mg oestradiol benzoate intramuscularly (IM) plus 200 mg progesterone subcutaneously (SC) on Day 0, followed by 500 microg cloprostenol IM on Day 9 and 1 mg oestradiol benzoate on Day 10. In Treatment 2 (GPG; n=10), cows were injected with 10 microg buserelin IM on Day 0, 500 microg cloprostenol IM on Day 7 and 10 microg buserelin on Day 9. The ovaries of all cows were examined by ultrasonography, using an 8 MHz probe, from 5 days before the initial treatment until ovulation. Cows were observed for oestrus 3 times daily for 7 days after cloprostenol treatment. Blood samples were collected daily for determination of progesterone, and 6-hourly for 36 h after the second oestradiol or buserelin injection for the determination of follicle stimulating hormone (FSH) and luteinising hormone (LH) concentrations. RESULTS: The percentage of cows observed in oestrus was higher in the OPPG group than in the GPG group (100% vs 55.6%, p=0.018). Treatment with either short-acting progesterone plus oestradiol benzoate or buserelin was followed by atresia or ovulation of the dominant follicle. Emergence of a new follicular wave occurred earlier (p>0.001) in the GPG group (2.2+/-0.2 days) than in the OPPG group (3.6+/-0.2 days). There was no significant difference between treatment groups in the variation of time of follicular wave emergence or size of the largest follicles at either the time of initial treatment (10.8+/-1.4 mm vs 11.1+/-0.8 mm), cloprostenol treatment (13.8+/-0.7 mm vs 14.0+/-1.3 mm) or of ovulation (15.4+/-0.7 mm vs 17.6+/-1.1 mm; p=0.10). The LH surge occurred sooner after the second injection of buserelin (4.0+/-1.0 h) than after the second injection of oestradiol benzoate (22.8+/-1.2 h; p>0.001). The interval between the second injection of oestradiol benzoate or buserelin and ovulation did not differ significantly between treatment groups (1.7+/-0.3 days vs 1.6+/-0.2 days; p=0.69). CONCLUSIONS: The use of short-term progesterone treatment, combined with oestradiol benzoate for follicular wave synchronisation, and cloprostenol to cause lysis of residual luteal tissue, is a promising alternative to established methods of oestrus synchronisation in cows.

Journal Article↗