1
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Ng KL, Tan SN, Huan N, Nasaruddin MZ, Othman N, Rahaman JAA. Utilizing medical thoracoscopy for the diagnosis of myelomatous pleural effusion: 2 case reports. Respirol Case Rep 2024; 12:e01333. [PMID: 38528948 PMCID: PMC10963134 DOI: 10.1002/rcr2.1333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 03/14/2024] [Indexed: 03/27/2024] Open
Abstract
Multiple myeloma (MM) is characterized by neoplastic proliferation of monoclonal antibody producing plasma cells. In clinical practice, pleural effusion is seen in up to 6% of MM patients, with many causative factors. Nevertheless, true myelomatous pleural effusion, defined as infiltration of the pleura by myeloma cells, is very rare. In this case report, we present two patients with biopsy proven myelomatous pleural effusion. The first patient developed myelomatous pleural effusion as initial presentation while the second patient's pleural effusion occurred during disease relapse. In both cases, prompt diagnosis via medical thoracoscopy (MT) followed by early commencement of myeloma specific chemotherapy led to clinical, biochemical, and radiological resolution and therefore were crucial steps in the management of myelomatous pleural effusion.
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Affiliation(s)
- Khai Lip Ng
- Department of MedicineMelaka HospitalMelakaMalaysia
- Department of PulmonologySerdang HospitalKajangMalaysia
| | - Sin Nee Tan
- Department of PulmonologySerdang HospitalKajangMalaysia
| | - Nai‐Chien Huan
- Department of Respiratory MedicineQueen Elizabeth HospitalKota KinabaluMalaysia
| | | | - Noriah Othman
- Department of PathologySerdang HospitalKajangMalaysia
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2
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Soo CI, Mak WW, Nasaruddin MZ, Ismail R, Ban AYL, Abdul Rahaman JA. Bronchial thermoplasty for severe asthmatics: a real-world clinical study from Malaysia. Singapore Med J 2024; 65:119-122. [PMID: 34617697 PMCID: PMC10942133 DOI: 10.11622/smedj.2021144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 08/09/2019] [Indexed: 11/18/2022]
Affiliation(s)
- Chun Ian Soo
- Division of Respiratory Medicine, Department of Internal Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Woh Wei Mak
- Department of Pulmonology, Serdang Hospital, Selangor, Malaysia
| | | | - Rosmadi Ismail
- Department of Pulmonology, Serdang Hospital, Selangor, Malaysia
| | - Andrea Yu-Lin Ban
- Pulmonology Unit, Department of Internal Medicine, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia
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3
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Daut UN, Faisal Thena MH, Hui‐Xin T, Nasaruddin MZ, Abdul Rahaman JA. Inflammatory endobronchial polyps unleashing recurrent pneumothorax: A case report. Respirol Case Rep 2024; 12:e01278. [PMID: 38239333 PMCID: PMC10794854 DOI: 10.1002/rcr2.1278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 12/15/2023] [Indexed: 01/22/2024] Open
Abstract
Inflammatory endobronchial polyps (IEPs) are rare benign lesions that originate from the bronchial mucosa. While pneumothorax is a well-known complication of various pulmonary conditions, its association with IEPs is exceedingly uncommon and poorly understood. This case report presents a unique and explosive encounter of a patient with an inflammatory endobronchial polyp who experienced a pneumothorax, shedding light on the clinical presentation, diagnostic challenges, and management strategies for this rare entity.
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Affiliation(s)
| | | | - Tan Hui‐Xin
- Pulmonology DepartmentHospital Sultan Idris Shah SerdangSerdangMalaysia
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4
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Kho SS, Lim KC, Muhammad NA, Nasaruddin MZ, Ismail I, Daut UM, Abdul Rahaman JA. Clinical and radiological outcomes of SARS-CoV-2 related organising pneumonia in COVID-19 survivors. Med J Malaysia 2023; 78:131-138. [PMID: 36988520] [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: 04/19/2023]
Abstract
INTRODUCTION COVID-19 patients frequently demonstrate radiological organising pneumonia (OP) pattern. The longterm outcome and treatment options for this group of patients remain uncertain. We aim to describe the clinical and radiological outcomes of patients with COVID-19-related OP and identify possible clinical factors associated with inferior radiological outcome. MATERIALS AND METHODS Post-COVID-19 clinic attendees, consisting of post-COVID-19 patients discharged from major hospitals in the state of Selangor during the third pandemic wave of COVID-19 in Malaysia, were enrolled in this retrospective study for 6 months. Physician-scored Modified Medical Research Council (mMRC), patient self-reported quality of life (EQ-VAS) score and follow-up CT scan were evaluated. RESULTS Our cohort comprised 131 patients, with a median age of 52 (IQR 39-60) years and median BMI of 29.40 (IQR 25.59-34.72). Majority (72.5%) had co-morbidities, and 97.7% had severe disease requiring supplementary oxygen support during the acute COVID-19 episode. 56.5% required intensive care; among which one-third were invasively ventilated. Median equivalent dose of methylprednisolone prescribed was 2.60 (IQR 1.29-5.18) mg/kg during admission, while the median prednisolone dose upon discharge was 0.64 (IQR 0.51-0.78) mg/kg. It was tapered over a median of 8.0 (IQR 5.8-9.0) weeks. Upon follow-up at 11 (IQR 8-15) weeks, one-third of patients remained symptomatic, with cough, fatigue and dyspnoea being the most reported symptoms. mMRC and EQ-VAS scores improved significantly (p<0.001) during follow-up. Repeat CT scans were done in 59.5% of patients, with 94.8% of them demonstrating improvement. In fact, 51.7% had complete radiological resolution. Intensive care admission and mechanical ventilation are among the factors which were associated with poorer radiological outcomes, p<0.05. CONCLUSION Approximately one-third of patients with SARSCoV- 2-related OP remained symptomatic at 3 months of follow-up. Majority demonstrated favourable radiological outcomes at 5-month reassessment, except those who required intensive care unit admission and mechanical ventilation.
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Affiliation(s)
- S S Kho
- Serdang Hospital, Department of Pulmonology, Selangor, Malaysia.
| | - K C Lim
- Serdang Hospital, Department of Medicine, Selangor, Division of Infectious Diseases, Malaysia
| | - N A Muhammad
- Serdang Hospital, Department of Pulmonology, Selangor, Malaysia
| | - M Z Nasaruddin
- Serdang Hospital, Department of Pulmonology, Selangor, Malaysia
| | - I Ismail
- Serdang Hospital, Department of Radiology, Selangor, Malaysia
| | - U M Daut
- Serdang Hospital, Department of Pulmonology, Selangor, Malaysia
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5
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Kho SS, Soo CI, Nasaruddin MZ, Ngan KW, Abdul Rahaman JA. Multimodal linear endobronchial ultrasound guided mediastinal lymph node biopsy in the diagnosis of isolated mediastinal lymphadenopathy. Proceedings of Singapore Healthcare 2022. [DOI: 10.1177/20101058221111655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Isolated mediastinal lymphadenopathy represents a common diagnostic dilemma whereby morphological analysis of tissue specimens are frequently needed to ascertain the diagnosis. Cryobiopsy by linear endobronchial ultrasound (EBUS) guidance had recently been described in literature. We described a multimodality biopsy approach of a case of isolated tuberculous mediastinal lymphadenitis in which we employed the 22-gauge transbronchial aspiration needle, mini-forceps and a flexible cryoprobe sequentially. We aim to highlight the novel technique of linear EBUS guided cryobiopsy in acquiring superior histological specimen from mediastinal lymphadenopathy for diagnosis purposes. We also compared the histopathological quality of the specimens acquired from these three different biopsy modalities.
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Affiliation(s)
- Sze Shyang Kho
- Pulmonology Department, Serdang Hospital, Ministry of Health Malaysia, Selangor, Malaysia
- Division of Respiratory Medicine, Department of Internal Medicine, Sarawak General Hospital, Ministry of Health Malaysia, Sarawak, Malaysia
| | - Chun Ian Soo
- Division of Respiratory Medicine, Department of Internal Medicine, University of Malaya Medical Center, Kuala Lumpur, Malaysia
| | - Mona Zaria Nasaruddin
- Pulmonology Department, Serdang Hospital, Ministry of Health Malaysia, Selangor, Malaysia
| | - Kah Wai Ngan
- Pathology Department, Serdang Hospital, Ministry of Health Malaysia, Selangor, Malaysia
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6
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Kho SS, Nasaruddin MZ, Rahaman JAA. Virtual Bronchoscopic Navigation Guided Recanalization of Chronic Total Post-Tuberculosis Bronchial Stenosis. Arch Bronconeumol 2022; 58:768-769. [DOI: 10.1016/j.arbres.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/03/2022] [Accepted: 05/08/2022] [Indexed: 12/01/2022]
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7
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Kho SS, Nyanti LE, Muhammad NA, Nasaruddin MZ, Abdul Rahaman JA. The more you give, the worse it gets. Breathe (Sheff) 2022; 17:210083. [PMID: 35035553 PMCID: PMC8753619 DOI: 10.1183/20734735.0083-2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 08/04/2021] [Indexed: 11/05/2022] Open
Abstract
Persistent tachypnoea despite resolution of bronchospasm in a patient with acute asthma exacerbation after administration of inhaled short acting β2-receptor agonist should alert the clinician to this potential diagnosis. https://bit.ly/385VU2Q.
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Affiliation(s)
- Sze Shyang Kho
- Pulmonology Unit, Serdang Hospital, Ministry of Health Malaysia, Selangor, Malaysia.,Division of Respiratory Medicine, Dept of Internal Medicine, Sarawak General Hospital, Ministry of Health Malaysia, Sarawak, Malaysia
| | - Larry Ellee Nyanti
- Division of Respiratory Medicine, Dept of Internal Medicine, Sarawak General Hospital, Ministry of Health Malaysia, Sarawak, Malaysia
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8
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Huan N, Ng KL, Nasaruddin MZ, Muhammad NA, Daut UN, Abdul Rahaman JA. Topical mitomycin-C as an adjuvant to multimodal endoscopic treatment for tracheobronchial stenosis secondary to endobronchial tuberculosis. Respirol Case Rep 2021; 9:e00711. [PMID: 33532074 PMCID: PMC7829630 DOI: 10.1002/rcr2.711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 12/29/2020] [Accepted: 01/05/2021] [Indexed: 12/02/2022] Open
Abstract
Tracheobronchial stenosis secondary to endobronchial tuberculosis (TSTB) is a rare but debilitating complication of endobronchial tuberculosis (EBTB). Topical mitomycin-C (TMC) has been successfully utilized to restore airway patency and to prevent recurrence of TSTB, although little is known about its exact efficacy. Here, we report the biggest case series to date involving seven patients who received TMC as part of multimodality endoscopic treatment for TSTB with varying levels of success. All patients presented with dyspnoea during or after treatment completion for pulmonary tuberculosis (PTB). Four patients had short-segment concentric membranous TSTB while two patients had concurrent bronchomalacia. Another one patient had a thick fibrotic band adjacent to luminal opening. We hypothesize that TMC is more efficacious in short membranous stenosis without concurrent bronchomalacia and/or thick fibrotic bands. More studies are needed to bridge the current gaps in knowledge regarding the optimal role and benefits of TMC for TSTB patients.
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Affiliation(s)
| | - Khai Lip Ng
- Department of PulmonologySerdang HospitalKajangMalaysia
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9
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Ng BH, Mohd Aminudin NH, Nasaruddin MZ, Abdul Rahaman JA. Successful drainage of complex haemoserous malignant pleural effusion with a single modified low-dose intrapleural alteplase and dornase alfa. BMJ Case Rep 2021; 14:14/2/e239702. [PMID: 33547099 PMCID: PMC7871233 DOI: 10.1136/bcr-2020-239702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Patients with symptomatic complex malignant pleural effusion (MPE) are frequently unfit for decortication and have a poorer prognosis. Septations can develop in MPE, which may lead to failure of complete drainage and pleural infection. Intrapleural fibrinolytic therapy (IPFT) is an alternative treatment. The use of IPFT in patients with anaemia and high risk for intrapleural bleeding is not well established. We report a successful drainage of complex haemoserous MPE with a single modified low-dose of intrapleural 5 mg of alteplase and 5 mg of dornase alfa in a patient with pre-existing anaemia with no significant risk of intrapleural bleeding.
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Affiliation(s)
- Boon Hau Ng
- Medical Department, Pusat Perubatan Universiti Kebangsaan Malaysia, Cheras, Wilayah Persekutuan Kuala Lumpur, Malaysia
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10
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Ng KL, Huan N, Nasaruddin MZ, Muhammad NA, Daut UN, Abdul Rahaman JA. Pulmonary mucormycosis masquerading as endobronchial tumour in an immunocompetent pregnant young lady. Respirol Case Rep 2021; 9:e00704. [PMID: 33364028 PMCID: PMC7756165 DOI: 10.1002/rcr2.704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 11/30/2020] [Accepted: 12/03/2020] [Indexed: 11/11/2022] Open
Abstract
Pulmonary mucormycosis is a rare but rapidly progressing and life-threatening fungal infection, usually affecting immunocompromised patients. We report a case of a previously healthy young lady who presented with prolonged cough, weight loss, and haemoptysis. Imaging showed left hilar mass with infiltration into the left main bronchus and concurrent mediastinal lymphadenopathy. Flexible bronchoscopy revealed an endobronchial mass occluding the left main bronchus. Tumour debulking was performed using rigid bronchoscopy with cryoprobe and snares. Histopathological examination revealed inflamed tissue with fungal organism. Fungal polymerase chain reaction (PCR) confirmed Rhizopus microsporus. She was treated with two weeks of intravenous amphotericin-B with complete clinical and radiological resolution.
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Affiliation(s)
- Khai Lip Ng
- Department of PulmonologySerdang HospitalKajangMalaysia
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11
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Huan NC, Ng KL, Tang JT, Kua HN, Daut UN, Muhammad NA, Nasaruddin MZ, Abdul Rahman JA. Interventional Pulmonology and COVID-19: Experience from a Malaysian Tertiary Hospital. Ann Acad Med Singap 2020; 49:1013-1017. [PMID: 33463660 DOI: 10.47102/annals-acadmedsg.2020364] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The ongoing pandemic of COVID-19 has presented multiple challenges to global healthcare services, dictating changes in almost every aspect of daily medical practice. Performing aerosol generating procedures (AGPs) in the field of interventional pulmonology can lead to profound formation of aerosols, leading to a high risk of infection among healthcare workers (HCWs). We share our experiences on performing AGPs in the midst of a COVID-19 pandemic by focusing on changes in AGP practices. In a pandemic, HCWs ought to adapt to the ever-changing situation and use available resources to provide the best possible healthcare to patients, ensure safety of staff, and continue medical education of future pulmonologists.
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12
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Huan N, Ng KL, Nasaruddin MZ, Muhammad NA, Daut UN, Abdul Rahaman JA. Conservative management of airway tear as a complication of silicone endobronchial stenting in bronchomalacia secondary to endobronchial tuberculosis. Respirol Case Rep 2020; 8:e00684. [PMID: 33194207 PMCID: PMC7644387 DOI: 10.1002/rcr2.684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/14/2020] [Accepted: 10/22/2020] [Indexed: 11/12/2022] Open
Abstract
Tracheobronchial stenosis due to tuberculosis (TSTB) is a potentially debilitating complication of endobronchial tuberculosis (EBTB). Endobronchial interventions including silicone stent insertion is an acceptable approach to improve quality of life among patients with TSTB. However, little is known about the optimal management strategy for patients with bronchomalacia secondary to EBTB (B-EBTB) and whether stent-related complication rates are higher among this group of patients. Herein, we report two patients with B-EBTB who unfortunately developed bronchial tear related to silicone endobronchial stenting. Both patients were successfully managed conservatively without the need for emergency open surgery. We hypothesize that endobronchial intervention might be more beneficial for patients with pure TSTB and might be riskier in cases of bronchomalacia with reduced airway thickness and loss of airway cartilaginous support. More future studies are needed to bridge the current gap in knowledge regarding the optimal management and role of endobronchial interventions among patients with B-EBTB.
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Affiliation(s)
| | - Khai Lip Ng
- Department of PulmonologySerdang HospitalKajangMalaysia
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13
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Marzuki NM, Jaeb MZM, Ban A, Ismail AI, Ali IAH, Razali NM, Samsudin A, Nasaruddin MZ, Rahman RA, Zim MAM, Kassim R, Lam YF, Tarekh NA, Ibrahim A, Kapse SV. Personalised management of Chronic Obstructive Pulmonary Disease (COPD): Malaysian consensus algorithm for appropriate use of inhaled corticosteroid (ICS) in COPD patients. Med J Malaysia 2020; 75:717-721. [PMID: 33219183] [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 Regarding the long-term safety issues with the use of inhaled corticosteroids (ICS) and the clinical predominance of dual bronchodilators in enhancing treatment outcomes in chronic obstructive pulmonary disease (COPD), ICS is no longer a "preferred therapy" according to the Global Initiative for Chronic Obstructive Lung Disease except on top of a dual bronchodilator. This has necessitated a change in the current therapy for many COPD patients. OBJECTIVE To determine a standardised algorithm to reassess and personalise the treatment COPD patients based on the available evidence. METHODS A consensus statement was agreed upon by a panel of pulmonologists in from 11 institutes in Malaysia whose members formed this consensus group. RESULTS According to the consensus, which was unanimously adopted, all COPD patients who are currently receiving an ICS-based treatment should be reassessed based on the presence of co-existence of asthma or high eosinophil counts and frequency of moderate or severe exacerbations in the previous 12 months. When that the patients meet any of the aforementioned criteria, then the patient can continue taking ICS-based therapy. However, if the patients do not meet the criteria, then the treatment of patients need to be personalised based on whether the patient is currently receiving long-acting beta-agonists (LABA)/ICS or triple therapy. CONCLUSION A flowchart of the consensus providing a guidance to Malaysian clinicians was elucidated based on evidences and international guidelines that identifies the right patients who should receive inhaled corticosteroids and enable to switch non ICS based therapies in patients less likely to benefit from such treatments.
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Affiliation(s)
- N M Marzuki
- Institut Perubatan Respiratori, Kuala Lumpur, Malaysia
| | - M Z M Jaeb
- Hospital Raja Perempuan Zainab II (HRPZ II), Department of Medicine, Kota Bharu, Kelantan, Malaysia
| | - A Ban
- Universiti Kebangsaan Malaysia Medical Centre, Department of Medicine, Kuala Lumpur, Malaysia
| | - A I Ismail
- Universiti Teknologi MARA, Faculty of Medicine, Selangor, Malaysia
| | - I A H Ali
- Hospital Pulau Pinang, Department of Respiratory Medicine, Pulau Pinang, Malaysia
| | - N M Razali
- Hospital Sultanah Nur Zahirah, Department of Respiratory Medicine, Kuala Terengganu, Terengganu, Malaysia
| | - A Samsudin
- Hospital Sultanah Nur Zahirah, Department of Respiratory Medicine, Kuala Terengganu, Terengganu, Malaysia
| | - M Z Nasaruddin
- Hospital Serdang, Department of Respiratory Medicine, Selangor, Malaysia
| | - R A Rahman
- Department of Respiratory Medicine, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia
| | - M A M Zim
- Universiti Teknologi MARA, Faculty of Medicine, UiTM Selayang campus, Selangor, Malaysia
| | - R Kassim
- Hospital Sultanah Bahiyah, Department of Respiratory Medicine, Alor Setar, Kedah, Malaysia
| | - Y F Lam
- Hospital Raja Permaisuri Bainun, Department of Respiratory Medicine, Ipoh, Perak, Malaysia
| | - N A Tarekh
- Department of Respiratory Medicine, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia
| | - A Ibrahim
- Hospital Tengku Ampuan Afzan, Department of Respiratory Medicine, Kuantan, Pahang, Malaysia
| | - S V Kapse
- Novartis Corporation (Malaysia) Sdn Bhd, Medical Affairs Department, Petaling Jaya, Selangor, Malaysia.
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14
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Mohammad N, Nasaruddin MZ, Ismail R, Abdul Rahaman JAB. Clinical vignette of bronchoscopic thermal vapour ablation: Malaysians’ first experience. Proceedings of Singapore Healthcare 2020. [DOI: 10.1177/2010105820957038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We report a case of severe emphysema with bullae in a patient who underwent the new technique of bronchoscopic lung volume reduction to the right upper lobe. He was symptomatic with breathlessness and frequent exacerbations. He was not deemed suitable for a surgical lung volume reduction or bullectomy due to a very low forced expiratory volume in one second (FEV1). Endobronchial valves were not considered due to the incomplete fissures. The case was carefully screened, and was discussed in a multidisciplinary meeting prior to the final decision. This was the first case in Malaysia of bronchoscopic thermal vapour ablation (BTVA) for severe advanced emphysema. Multiple experts were involved prior, during and after the procedure. Despite having a poor lung reserve, he came through the procedure successfully with no immediate complications. His serial spirometry showed a 50% improvement at six months compared to baseline. This case highlights the important role of a multidisciplinary meeting, expert opinion and the careful selection of which patients should undergo BTVA. The procedure should be carried out at a centre of excellence in order to achieve a successful procedure.
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Affiliation(s)
- Nurashikin Mohammad
- Internal Medicine Department, Universiti Sains Malaysia Health Campus, Malaysia
- Hospital Universiti Sains Malaysia, Malaysia
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15
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Abdul Wahid FS, Nasaruddin MZ, Mohd Idris MR, Tusimin M, Tumian NR, Abdullah Mahdy Z. Effects of preeclampsia on the yield of hematopoietic stem cells obtained from umbilical cord blood at delivery. J Obstet Gynaecol Res 2012; 38:490-7. [DOI: 10.1111/j.1447-0756.2011.01740.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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