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Ng BH, Low HJ, Nuratiqah NA, Faisal AH, Fairuz AS, Shahrir MS, Andrea YLB. A case series of pulmonary alveolar proteinosis: Response differently to whole lung lavage. Med J Malaysia 2022; 77:261-263. [PMID: 35338641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Pulmonary alveolar proteinosis (PAP) is a rare disease and its prognosis can be improved by whole lung lavage (WLL). Herein, we present three cases with idiopathic PAP treated successfully with either single or double WLL in the same setting. All three of them presented with exertional dyspnoea with radiographic findings of pulmonary infiltrates. They showed a marked clinical and physiologic improvement post WLL. Two of them were in remission. These three cases were diagnosed using different lung biopsy modalities, including video-assisted thoracoscopic lung biopsy, computed tomography-guided percutaneous transthoracic tru-cut needle lung biopsy, and transbronchial forceps lung biopsy (TBLB), respectively. The current cases have shown that TBLB may provide adequate diagnostic yield, and the invasive surgical lung biopsy may not be necessary to achieve a definitive diagnosis.
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Affiliation(s)
- B H Ng
- Pusat Perubatan Universiti Kebangsaan Malaysia, Department of Internal Medicine, Respiratory Unit, Malaysia
| | - H J Low
- Pusat Perubatan Universiti Kebangsaan Malaysia, Department of Anaesthesiology and Critical Care, Malaysia
| | - N A Nuratiqah
- Pusat Perubatan Universiti Kebangsaan Malaysia, Department of Internal Medicine, Respiratory Unit, Malaysia
| | - A H Faisal
- Pusat Perubatan Universiti Kebangsaan Malaysia, Department of Internal Medicine, Respiratory Unit, Malaysia
| | - A S Fairuz
- Pusat Perubatan Universiti Kebangsaan Malaysia, Department of Anaesthesiology and Critical Care, Malaysia
| | - M S Shahrir
- Pusat Perubatan Universiti Kebangsaan Malaysia, Department of Internal Medicine, Rheumatology Unit, Malaysia
| | - Y L B Andrea
- Pusat Perubatan Universiti Kebangsaan Malaysia, Department of Internal Medicine, Respiratory Unit, Malaysia
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Ng BH, Andrea YLB, Nuratiqah NA, Faisal AH, Low HJ. Clots in tuberculosis. Med J Malaysia 2021; 76:953-955. [PMID: 34806695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Tuberculosis (TB) is a common communicable disease. Active TB infection may be complicated by both venous and arterial thrombosis which are often under-recognised. We report two patients with incidental TB associated thrombosis involving different venous systems. Both responded to anticoagulant and anti-tuberculous therapy (ATT). Patients with tuberculosis are at risk of VTE and careful monitoring for venous thromboembolism (VTE) is needed during ATT. Our case illustrates the importance of having a high index of suspicion for silent VTE as it may complicate active TB infection.
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Affiliation(s)
- B H Ng
- Pusat Perubatan Universiti Kebangsaan Malaysia, Department of Internal Medicine, Respiratory Unit, Malaysia
| | - Y L B Andrea
- Pusat Perubatan Universiti Kebangsaan Malaysia, Department of Internal Medicine, Respiratory Unit, Malaysia.
| | - N A Nuratiqah
- Pusat Perubatan Universiti Kebangsaan Malaysia, Department of Internal Medicine, Respiratory Unit, Malaysia
| | - A H Faisal
- Pusat Perubatan Universiti Kebangsaan Malaysia, Department of Internal Medicine, Respiratory Unit, Malaysia
| | - H J Low
- Pusat Perubatan Universiti Kebangsaan Malaysia, Department of Anaesthesiology and Critical Care, Malaysia
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Hassan A, Latif MT, Soo CI, Faisal AH, Roslina AM, Ban Andrea YL, Hassan T. Corrigendum to "Short communication: Diagnosis of lung cancer increases during the annual southeast Asian haze periods" [Lung Cancer 113 (2017) 1-3]. Lung Cancer 2021; 154:229. [PMID: 33678457 DOI: 10.1016/j.lungcan.2021.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- A Hassan
- Respiratory Unit, Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, University Kebangsaan, 56000 Cheras, Malaysia; Department of Clinical Oncology, University Technology MARA, 40450 Shah Alam, Malaysia
| | - M T Latif
- School of Environmental and Natural Resource Sciences, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, Bangi 43600, Malaysia; Institute for Environment and Development (Lestari), Universiti Kebangsaan Malaysia, Bangi 43600, Malaysia
| | - C I Soo
- Respiratory Unit, Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, University Kebangsaan, 56000 Cheras, Malaysia
| | - A H Faisal
- Respiratory Unit, Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, University Kebangsaan, 56000 Cheras, Malaysia
| | - A M Roslina
- Respiratory Unit, Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, University Kebangsaan, 56000 Cheras, Malaysia
| | - Y L Ban Andrea
- Respiratory Unit, Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, University Kebangsaan, 56000 Cheras, Malaysia
| | - T Hassan
- Respiratory Unit, Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, University Kebangsaan, 56000 Cheras, Malaysia.
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Ng BH, Andrea YLB, Nuratiqah NA, Faisal AH, Soo CI, Najma K, Periyasamy P. COVID-19 detected from targeted contact tracing, attempting to see the pattern in random happenings: early lessons in Malaysia. Med J Malaysia 2020; 75:582-584. [PMID: 32918430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The world feels strange as we face what is for most of us our first ever pandemic. The number of newly diagnosed cases rises daily in many parts of the world, and we are faced with the reality that there are still many things to learn about this new disease. We share here our experience of treating our first 199 COVID-19 patients in the Hospital Canselor Tuanku Muhriz, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM).
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Affiliation(s)
- B H Ng
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Respiratory Unit, Kuala Lumpur, Malaysia
| | - Y L B Andrea
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Respiratory Unit, Kuala Lumpur, Malaysia.
| | - N A Nuratiqah
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Respiratory Unit, Kuala Lumpur, Malaysia
| | - A H Faisal
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Respiratory Unit, Kuala Lumpur, Malaysia
| | - C I Soo
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Respiratory Unit, Kuala Lumpur, Malaysia
| | - K Najma
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Infectious Disease Unit, Kuala Lumpur, Malaysia
| | - P Periyasamy
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Infectious Disease Unit, Kuala Lumpur, Malaysia
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Ng BH, Nuratiqah NA, Faisal AH, Soo CI, Low HJ, Najma K, Periyasamy P, Mustafa N, Andrea YLB. A descriptive study of the psychological experience of health care workers in close contact with a person with COVID-19. Med J Malaysia 2020; 75:485-489. [PMID: 32918414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND COVID-19 has the potential to affect the mental health of health care workers (HCWs). It is known that HCWs who serve as front-liners during the COVID-19 pandemic experience stress and have the fear of contracting the infection. Little is known of how being a positive contact affects HCWs. OBJECTIVE We examined the experience of HCWs who were quarantined following a close unprotected contact with a COVID-19 positive colleague and explore the psychological impact especially as the timing of the quarantine coincided with the Eid (annual Muslim festival) celebration in Malaysia. METHODS This was a cross-sectional on-line questionnaire study, involving HCWs exposed to a COVID-19 positive colleague in Universiti Kebangsaan Malaysia Medical Centre, a teaching hospital. Data on demographics, levels of depression, anxiety and stress using a validated depression, anxiety, and stress scale (DASS-21) questionnaire, aspects of quarantine, wearing of masks, hand hygiene practice and swab experience were collected. RESULTS Twenty-two HCWs participated. Eighteen (81.8%) were between 30-39 years and 17 (77.3%) were women. Majority 19 (86.3%) were Malays. There were twelve (54.5%) medical officers, 5 (22.7%) specialists and 5(22.7%) allied health staff. Eighteen out of 22 (81.8%) felt they were able to do home quarantine adequately. All tested negative with a mean (Standard Deviation) hour of contact of 2.56±2.38 hours. Eighteen reported their biggest concern was infecting their families. CONCLUSION HCWs undergoing contact swabbing and quarantine are vulnerable to depression, anxiety and stress. The ability of the HCW to adequately home quarantine should not be taken for granted. Psychological support should be offered to HCWs who are positive contacts.
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Affiliation(s)
- B H Ng
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Pulmonology Unit, Kuala Lumpur, Malaysia
| | - N A Nuratiqah
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Pulmonology Unit, Kuala Lumpur, Malaysia
| | - A H Faisal
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Pulmonology Unit, Kuala Lumpur, Malaysia
| | - C I Soo
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Pulmonology Unit, Kuala Lumpur, Malaysia
| | - H J Low
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Anaesthesiology and critical care, Kuala Lumpur, Malaysia
| | - K Najma
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Infectious Diseases Unit, Kuala Lumpur, Malaysia
| | - P Periyasamy
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Infectious Diseases Unit, Kuala Lumpur, Malaysia
| | - N Mustafa
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Endocrine Unit, Kuala Lumpur, Malaysia
| | - Y L B Andrea
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Pulmonology Unit, Kuala Lumpur, Malaysia.
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Ng BH, Nuratiqah NA, Andrea YLB, Faisal AH, Soo CI, Najma K, Shahizon MM, Isa AZ, Kamazuraman L, Yusuf AS, Abdul GH, Mustafa N, Nafisah WY, Azmin S, Khoo CS, Hemalatha M, Ching ZH, Low HJ, Periyasamy P. Lung computed tomography patterns of a cluster of asymptomatic young males with COVID-19 admitted to a teaching hospital in Kuala Lumpur. Med J Malaysia 2020; 75:368-371. [PMID: 32723996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND AND OBJECTIVE Coronavirus Disease 2019 (COVID- 19) was first reported in Malaysia in March 2020. We describe here the clinical characteristics and computed tomography (CT) patterns in asymptomatic young patients who had laboratory-confirmed COVID-19. METHODS This is a retrospective observational study where 25 male in-patients with laboratory-confirmed COVID-19 in Hospital Canselor Tuanku Muhriz. Demographics, clinical data and CT images of these patients were reviewed by 2 senior radiologists. RESULTS In total there were 25 patients (all males; mean age [±SD], 21.64±2.40 years; range, 18-27 years). Patients with abnormal chest CT showed a relatively low normal absolute lymphocytes count (median: 2.2 x 109/L) and absolute monocyte count (median: 0.5 x 109/L). Lactate dehydrogenase was elevated in 5 (20%) of the patients. The procalcitonin level was normal while elevated levels of alanine aminotransferase, total bilirubin, platelet and C-reactive protein were common. Baseline chest CT showed abnormalities in 6 patients. The distribution of the lesions were; upper lobe 3 (12%) lower lobe 3 (12%) with peripheral distribution 4 (16%). Of the 25 patients included, 4 (16%) had ground glass opacification (GGO), 1 (4%) had a small peripheral subpleural nodule, and 1 (4%) had a dense solitary granuloma. Four patients had typical CT features of COVID-19. CONCLUSION We found that the CT imaging showed peripheral GGO in our patients. They remained clinically stable with no deterioration of their respiratory symptoms suggesting stability in lung involvement. We postulate that rapid changes in CT imaging may not be present in young, asymptomatic, non-smoking COVID-19 patients. Thus the use of CT thoraxfor early diagnosis may be reserved for patients in the older agegroups, and not in younger patients.
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Affiliation(s)
- B H Ng
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Pulmonology Unit, Kuala Lumpur, Malaysia
| | - N A Nuratiqah
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Pulmonology Unit, Kuala Lumpur, Malaysia
| | - Y L B Andrea
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Pulmonology Unit, Kuala Lumpur, Malaysia.
| | - A H Faisal
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Pulmonology Unit, Kuala Lumpur, Malaysia
| | - C I Soo
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Pulmonology Unit, Kuala Lumpur, Malaysia
| | - K Najma
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Infectious Diseases Unit, Kuala Lumpur, Malaysia
| | - M M Shahizon
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Radiology, Kuala Lumpur, Malaysia
| | - A Z Isa
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Radiology, Kuala Lumpur, Malaysia
| | - L Kamazuraman
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Nephrology Unit, Kuala Lumpur, Malaysia
| | - A S Yusuf
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Nephrology Unit, Kuala Lumpur, Malaysia
| | - G H Abdul
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Nephrology Unit, Kuala Lumpur, Malaysia
| | - N Mustafa
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Endocrine Unit, Kuala Lumpur, Malaysia
| | - W Y Nafisah
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Neurology Unit, Kuala Lumpur, Malaysia
| | - S Azmin
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Neurology Unit, Kuala Lumpur, Malaysia
| | - C S Khoo
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Neurology Unit, Kuala Lumpur, Malaysia
| | - M Hemalatha
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Pulmonology Unit, Kuala Lumpur, Malaysia
| | - Z H Ching
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Pulmonology Unit, Kuala Lumpur, Malaysia
| | - H J Low
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Anaesthesiology and critical care, Kuala Lumpur, Malaysia
| | - P Periyasamy
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Internal Medicine, Infectious Diseases Unit, Kuala Lumpur, Malaysia
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