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Mohd Khairi MD, Shahrjerdi B, Ramiza RR, Normastura R. The association of allergy and chronic suppurative otitis media: A study in a tropical country. Med J Malaysia 2019; 74:205-208. [PMID: 31256174] [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: 06/09/2023]
Abstract
OBJECTIVE Chronic suppurative otitis media (CSOM) usually begins as a spontaneous perforation of tympanic membrane due to an acute infection of the middle ear. This study was aimed to evaluate the association between allergy and CSOM. METHODS A case-control study was carried out among patients with CSOM (cases) and controls were those with no ear pathology. The presence of CSOM was made through a medical history and otoscopic examination. Allergen testing was done by the skin prick test. RESULTS In all 124 subjects were recruited in this study with equal number of the cases and controls. The commonest positive reaction in the skin prick test in both groups was to house dust mites. Among CSOM cases, half (50%) of them had an allergy to Blomia tropicalis and 48.4% to Dermatophagoides while in the control group, 27.4% to Dermatophagoides and 25.8% to B. tropicalis. There were significant associations between CSOM and allergy to B. tropicalis (p=0.005), Dermatophagoides (p=0.016) and Felis domesticus (p=0.040). The prevalence of allergy at 95% confidence interval (95%CI) in CSOM and control groups were demonstrated as 59.7% (95%CI: 47.5, 71.9) and 30.6 % (95%CI: 19.1, 42.1) respectively. There was a significant association between allergy and CSOM (p=0.001). CONCLUSION Indoor allergens are the most prevalent in our environment and therefore good control may difficult to achieve. The hypersensitivity states of the subject are likely to have a role in the pathogenesis of CSOM especially in the tropical countries where allergy occurs perennially.
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Affiliation(s)
- M D Mohd Khairi
- Universiti Sains Malaysia, School of Medical Sciences, Department of Otorhinolaryngology, Health Campus, Kota Bharu, Kelantan, Malaysia.
| | - B Shahrjerdi
- Universiti Sains Malaysia, School of Medical Sciences, Department of Otorhinolaryngology, Health Campus, Kota Bharu, Kelantan, Malaysia
| | - R R Ramiza
- Universiti Sains Malaysia, School of Medical Sciences, Department of Otorhinolaryngology, Health Campus, Kota Bharu, Kelantan, Malaysia
| | - R Normastura
- Universiti Sains Malaysia, School of Dental Sciences, Health Campus, Kota Bharu, Kelantan, Malaysia
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Yatiee SL, Mohd Khairi MD, Md Salzihan MS, Ikmal HB. Intradermal Naevi of External Auditory Canal: Unusual location with a unique presentation. Med J Malaysia 2018; 73:121-122. [PMID: 29703880] [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: 06/08/2023]
Abstract
The incidence of intradermal nevus in the external auditory canal is uncommon. We herein are describing a case of 60-year-old lady who presented with foreign body sensation in the right external ear canal (EAC) with mild discomfort and ear bleed during ear picking. Otoscopic examination revealed hyperpigmented mass on the floor of the outer two third of EAC. Complete excisional biopsy of the mass resulted in histopathology findings of intradermal nevus. Despite the fact that the disease is not alarming, the possibilities of benign melanocytic nevi transformation into malignant lesions such as melanoma need to be ruled out.
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Affiliation(s)
- S L Yatiee
- Universiti Sains Malaysia, School of Medical Sciences, Department of Otorhinolaryngology, Health Campus, Kubang Kerian, Kelantan, Malaysia.
| | - M D Mohd Khairi
- Universiti Sains Malaysia, School of Medical Sciences, Department of Otorhinolaryngology, Health Campus, Kubang Kerian, Kelantan, Malaysia
| | - M S Md Salzihan
- Universiti Sains Malaysia, School of Medical Sciences, Department of Pathology, Health Campus, Kubang Kerian, Kelantan, Malaysia
| | - H B Ikmal
- Universiti Sains Malaysia, School of Medical Sciences, Department of Pathology, Health Campus, Kubang Kerian, Kelantan, Malaysia
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Rosdan S, Basheer L, Mohd Khairi MD. Clinical Characteristic of Vertigo in Children. Med J Malaysia 2015; 70:220-223. [PMID: 26358017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Maternal mortality and morbidity from eclampsia continues to be seen around the globe. Local Key Performance Index on recurrence of eclamptic fits did not meet targets, thus this raised the issue whether the care provided adhered to the standard management for eclampsia. METHODS This clinical audit was conducted to assess and improve the quality of the service being offered to patient, particularly in managing eclampsia cases. It was conducted according to the audit cycle. It begins with the development of 12 standardized criteria for eclampsia management. First audit was conducted by retrospectively reviewing eclampsia cases from year 2008 till 2012. Strategies for changes were formulated and implemented following the results of the first audit. Second audit was conducted six months after the changes. RESULTS The overall incidence rate of eclampsia was 9.17 per 10,000 deliveries. A first seizure occurred during the antepartum period in 52.9% of cases (n=27), intrapartum in 24% (n=11) and postpartum in 21% of cases (n=13). Suboptimal care was mainly on delay of activation of Red Alert system and no treatment for uncontrolled blood pressure. Several strategies were implemented, mainly on improving working knowledge of the staffs and reengineering hospital Red Alert system. Positive achievements observed during the second audit, shown by a reduction in the number of patients with recurrence eclamptic fits and perinatal mortality rate. CONCLUSION Conducting an audit is essential to evaluate local performance against the standardized criteria. Improvement can be achieved with inexpensive solutions and attainable within a short period of time.
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Affiliation(s)
- S Rosdan
- Universiti Sains Malaysia, School of Medical Sciences, Department of Otorhinolaryngology, Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia.
| | - L Basheer
- Universiti Sains Malaysia, School of Medical Sciences, Department of Otorhinolaryngology, Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia
| | - M D Mohd Khairi
- Universiti Sains Malaysia, School of Medical Sciences, Department of Otorhinolaryngology, Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia
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Maryam YK, Mohd Khairi MD, Asmah Hanim H. Myxoid Neurofibromas of the External Ear Canal: A Case Report. Med J Malaysia 2015; 70:102-103. [PMID: 26162387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Myxoid neurofibroma is benign tumours of perineural cell origin that arise from elements in the peripheral nervous system. We report a case of a 60-year-old female patient presented with history of right ear mass which was slowly growing. Her primary complaint was cosmetic deformity but hearing loss was also present. The mass was excised and histologically revealed a myxoid neurofibroma. To the authors' knowledge, this is the first time that a myxoid neurofibroma arising from external auditory canal is reported. It should be included in the differential diagnosis of a mass originating from this location.
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Affiliation(s)
- Y K Maryam
- Health Campus Universiti Sains Malaysia, School of Medical Sciences, Department of Otorhinolaryngology-Head & Neck Surgery, Jalan Raja Perempuan Zainab 2, Kota Bharu, Kelantan 16150, Malaysia.
| | - M D Mohd Khairi
- Health Campus Universiti Sains Malaysia, School of Medical Sciences, Department of Otorhinolaryngology-Head & Neck Surgery, Jalan Raja Perempuan Zainab 2, Kota Bharu, Kelantan 16150, Malaysia
| | - H Asmah Hanim
- Health Campus Universiti Sains Malaysia, School of Medical Sciences, Department of Pathology, Jalan Raja Perempuan Zainab 2, Kota Bharu, Kelantan 16150, Malaysia
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Khairunnisak M, Mohd Khairi MD. Congenital mastoid cholesteatoma presenting as a mass obstructing external auditory canal. Med J Malaysia 2014; 69:277-278. [PMID: 25934960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
We describe the clinical presentation, investigation and management of an eventually fatal case of hypercalcemic crisis due to primary hyperparathyridism (PHPT). A 60 year-old lady with history of urolithiasis presented with worsening generalized bone pain, spinal scoliosis and a limp. Laboratory data showed hypercalcemia and raised alkaline phosphatase. Left hip x-ray revealed a subcapital femoral neck fracture. Intact parathyroid hormone was elevated, 187.6 pmol/L (1.6 - 6.9) and ultrasound showed an enlarged right parathyroid gland. Despite initial reduction of serum calcium with saline infusion and multiple doses of intravenous pamidronate, her calcium increased to 4.14 mmol/L a week following application of Buck's traction for persistent left hip pain. She succumbed eventually with serum calcium peaking at 6.28 mmol/L despite multiple therapeutic interventions.
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Affiliation(s)
- M Khairunnisak
- Sarawak General Hospital, Medical Department, Jalan Hospital, 93586 Kuching, Sarawak, Malaysia.
| | - M D Mohd Khairi
- Sarawak General Hospital, Medical Department, Jalan Hospital, 93586 Kuching, Sarawak, Malaysia
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Izny Hafiz Z, Rosdan S, Mohd Khairi MD. Coblation tonsillectomy versus dissection tonsillectomy: a comparison of intraoperative time, intraoperative blood loss and post-operative pain. Med J Malaysia 2014; 69:74-78. [PMID: 25241816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The objective of this study was to compare the intraoperative time, intraoperative blood loss and post operative pain between coblation tonsillectomy and cold tonsillectomy in the same patient. A prospective single blind control trial was carried out on 34 patients whom underwent tonsillectomy. The patients with known bleeding disorder, history of unilateral peritonsillar abscess and unilateral tonsillar hypertrophy were excluded. Operations were done by a single surgeon using cold dissection tonsillectomy in one side while coblation tonsillectomy in the other. Intraoperative time, intraoperative blood loss and post operative pain during the first 3 days were compared between the two methods. Results showed that the intraoperative time was significantly shorter (p<0.001) and intraoperative blood loss was significantly lesser (p<0.001) in coblation tonsillectomy as compared to cold tonsillectomy. Post operative pain score was significantly less at 6 hours post operation (p<0.001) in coblation tonsillectomy as compared to cold tonsillectomy. However, there were no differences in the post operative pain scores on day 1, 2 and 3. In conclusion, coblation tonsillectomy does have superiority in improving intraoperative efficiency in term of intraoperative time and bleeding compared to cold dissection tonsillectomy. The patient will benefit with minimal post operative pain in the immediate post surgery duration.
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Affiliation(s)
- Z Izny Hafiz
- Universiti Sains Malaysia, Otorhinolaryngology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Jalan Raja Perempuan Zainab 2, Kota Bharu, Kelantan 16150, Malaysia.
| | - S Rosdan
- Universiti Sains Malaysia, Otorhinolaryngology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Jalan Raja Perempuan Zainab 2, Kota Bharu, Kelantan 16150, Malaysia
| | - M D Mohd Khairi
- Universiti Sains Malaysia, Otorhinolaryngology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Jalan Raja Perempuan Zainab 2, Kota Bharu, Kelantan 16150, Malaysia
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Mohd Khairi MD, Ramiza Ramza R. Cholesterol granuloma in a post-mastoidectomy for cholesteatoma. Med J Malaysia 2012; 67:217-218. [PMID: 22822649] [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: 06/01/2023]
Abstract
Cholesterol granuloma is a histological term used to describe the foreign body reaction towards cholesterol crystals causing granuloma. We report a case of cholesterol granuloma in a patient who presented with a mass in her ear after 6 years of mastoidectomy. The diagnosis has been confirmed by MRI and postoperative findings. The difference between cholesterol granuloma and the other entities especially cholesteatoma and meningoencephalic herniation must be made in view of its implications and surgical management of each lesion.
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Affiliation(s)
- M D Mohd Khairi
- Department of Otorhinolaryngology, School of Medical Sciences, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia.
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Wong CY, Khairi MDM, Mohamed SA, Irfan M. Dural tear post mastoidectomy repaired with Dura Gen. Med J Malaysia 2010; 65:307-308. [PMID: 21901952] [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: 05/31/2023]
Abstract
Dural exposure may occur during the course of thinning the tegmen tympani and tegmen mastoideum in mastoid procedure. If large area of dura is exposed or lacerated, cerebrospinal fluid and brain herniation may enter the mastoid cavity. We report a case of a patient with injured dura mater and tegmen mastoideum during mastoidectomy for chronic suppurative otitis media with cholesteatoma managed by using DuraGen. The dura mater and tegmen defect healed totally showing the success of the procedure. A collagen matrix like DuraGen is an option for repairing dural tear in mastoid region.
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Affiliation(s)
- C Y Wong
- USM, Institution: Department of Otorhinolaryngology, School of Medical Sciences, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia
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Mohd Khairi MD, Normastura AR, Wan Zaharah AW. Auditory neuropathy: three cases among a group with sensorineural hearing loss. Singapore Med J 2009; 50:e324-e325. [PMID: 19787161] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The prevalence of auditory neuropathy is not known, although the majority of cases are felt to lie within the population of neonatal intensive care unit graduates. We report three cases of auditory neuropathy, out of 211 children with sensorineural hearing loss, seen at our audiology clinic from April 1, 1999 to December 31, 2003. Two patients did not have a risk factor for hearing impairment. Screening policies based solely on transient evoked otoacoustic emissions testing will not detect auditory neuropathy effectively, and may falsely reassure parents and professionals unaware of this condition.
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Affiliation(s)
- M D Mohd Khairi
- Department of Otorhinolaryngology-Head & Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kota Bharu 16150, Malaysia.
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Normastura AR, Mohd Khairi MD, Azizah Y, Nizam A, Samsuddin AR, Naing L. Speech disorders in operated cleft lip and palate children in Northeast Malaysia. Med J Malaysia 2008; 63:21-25. [PMID: 18935726] [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: 05/26/2023]
Abstract
The aim of this study was to determine the prevalence and association of speech disorders among operated cleft lip and palate children (CLP) in Northeast Malaysia. A comparative cross sectional study was performed on 98 operated CLP and 109 non-cleft subjects that aged between 3- 12-years-old. Data collection was done clinically and also by recording speech samples of each subject from both groups using a portable cassette recorder. Results showed that the prevalence of speech abnormality was 61.2% (95% CI: 51.41-71.04) and the risk of having speech abnormality was 174.5 times (95% CI: 23.04, 1320.67; P value < 0.001) in CLP children compared to non-cleft children. Therefore it was found that children with appropriately repaired CLP in Northeast Malaysia failed to have normal speech.
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Affiliation(s)
- A R Normastura
- School of Dental Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan.
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Khairi MDM, Din S, Shahid H, Normastura AR. Hearing screening of infants in Neonatal Unit, Hospital Universiti Sains Malaysia using transient evoked otoacoustic emissions. J Laryngol Otol 2006; 119:678-83. [PMID: 16156907 DOI: 10.1258/0022215054798014] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The objective of this prospective study was to report on the prevalence of hearing impairment in the neonatal unit population. From 15 February 2000 to 15 March 2000 and from 15 February 2001 to 15 May 2001, 401 neonates were screened using transient evoked otoacoustic emissions (TEOAE) followed by second-stage screening of those infants who failed the initial test. Eight (2 per cent) infants failed one ear and 23 (5.74 per cent) infants failed both ears, adding up to 7.74 per cent planned for second-stage screening. Five out of 22 infants who came for the follow up failed the screening, resulting in a prevalence of hearing impairment of 1 per cent (95 per cent confidence interval [95% CI]: 0.0–2.0). Craniofacial malformations, very low birth weight, ototoxic medication, stigmata/syndromes associated with hearing loss and hyperbilirubinaemia at the level of exchange tranfusion were identified to be independent significant risk factors for hearing impairment, while poor Apgar scores and mechanical ventilation of more than five days were not. In conclusion, hearing screening in high-risk neonates revealed a total of 1 per cent with hearing loss. The changes in the risk profile indicate improved perinatal handling in a neonatal population at risk for hearing disorders.
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Affiliation(s)
- M D Mohd Khairi
- Department of Otorhinolaryngology-Head & Neck Surgery, Universiti Sains Malaysia, Health Campus, Kelantan, Malaysia.
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