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ABSTRACT Purpose To investigate the dynamic changes in ACVS on SWIs in patients who underwent reperfusion therapy and evaluate their association with neurological and radiological improvement Materials and Methods All patients treated for acute ischemic stroke between June 2020 and June 2022, in a single tertiary centre (Hospital Sultan Abdul Aziz Shah) who underwent reperfusion therapy and MRI imaging were retrospectively identified based on clinical and radiology reports. Expected Results This study hypothesizes an improvement in ACVS is expected to correlate with favourable neurological outcomes (MRS at 3 months and NIHSS score) and radiological outcome (DWI / ASPECT scores and Modified Mori score). Conversely, a worsening of ACVS is anticipated to be associated with unfavourable neurological and radiological outcomes. Conclusion Asymmetrical Cortical Vein Signs (ACVS) can serve as a valuable predictor of neurological and radiological outcomes in patients with large and distal vessel occlusion after reperfusion therapy Keywords: ACVS (The Asymmetrical cortical vein sign), Ischemic penumbra , Large vessel occlusion (LVO), Distal vessel occlusion (DVO)

MYSIR’s Abstracts 11. EP10: SUBGLOTTIC STENOSIS IN CHILDREN: SERIAL CASES OF CHILDREN UNDER 2 YEARS OLD 2. EP11: BRONCHOSCOPIC MANAGEMENT OF MALIGNANT DISTAL AIRWAY OBSTRUCTION WITH SELF EXPANDING METALLIC Y STENTS – CASE SERIES 3. EP12: NEBULIZED CIPROFLOXACIN/DEXAMETHASONE (CD) IN CONGENITAL TRACHEAL STENOSIS POST SLIDE TRACHEOPLASTY 4. EP13: EXPERIENCE WITH DRY MEDICAL THORACOSCOPY VIA VERESS NEEDLE: A CASE SERIES ANALYSIS

MYSIR's Abstracts 3 1. EP07: CASE OF REFRACTORY AND RECURRENT RADIAL ANEURYSMAL BONE CYST TREATED WITH TRANS-ARTERIAL EMBOLISATION AND PERCUTANEOUS SCLEROTHERAPY – OUR EXPERIENCE 2. EP08: ANGIOEMBOLISATION OF CREMASTERIC ARTERY FOR SCROTAL HAEMATOMA FOLLOWING HERNIAL REPAIR 3. EP09: EMBOLIZATION OF A HIGHLY VASCULAR CERVICAL SPINE TUMOUR AND IMAGING ASSESMENT PRIOR TO SURGERY 4. EP10: PRE-OPERATIVE EMBOLIZATION OF ANGIOSARCOMA OF THE HEAD: A CASE REPORT 5. EP11: PSEUDOMYXOMA PERITONEI MIMICKING RUPTURED LIVER ARTERIOVENOUS MALFORMATION – AN UNCOMMON PRESENTATION OF A HIGH GRADE LIVER SARCOMA 6. EP12: RUPTURED CYSTIC ARTERY PSEUDOANEURYSM AS A COMPLICATION OF ACUTE CALCULOUS CHOLECYSTITIS – A CASE REPORT

1. ABERRATION IN VARIATION: DECEPTION BY A CTA OCCULT BLEEDING VARIANT
 2. ATYPICAL MULTICENTRIC EXTRA COMPARTMENTAL AND METACHRONOUS GIANT CELL TUMOR RECURRENCE
 3. A RARE CASE OF PARARENAL MALAKOPLAKIA
 4. A CASE OF ERDHEIM CHESTER DISEASE WITH MULTISYSTEM INVOLVEMENT
 5. EXTRAOSSEOUS EWING’S SARCOMA INVOLVING VAS DEFERENS: A CASE REPORT

Lipiodol (also known as ethiodized oil) is an iodinated poppy seed oil first synthesized in 1901 for therapeutic purposes. The use of lipiodol in lymphangiography in later date has gain popularity as this agent tend to retain in the lymphatic system as opposed to other iodinated hydrosoluble contrast media that diffuse out of lymphatic system rapidly. Over the course of several days and weeks, the iodine within the lipiodol is released by enzymatic cleavage and the fat molecules are degraded. In our case, there is retention of lipiodol in the left axilla which showed as group of round calcifications in Mammogram. This has raised the suspicion of talcum powder usage for the reporting radiologist without revisiting the past surgical and medical procedure. Even though lipiodol washout is a time-dependant process, it can retain in our body or site of injection as long as few years as evidenced in our case.

Background: Pleuroscopy is one of the investigation modalities available for further evaluation of exudative pleural effusion. Aims of this study is to determine the diagnostic yield and common cause for pleural effusion that underwent pleuroscopy in Respiratory department, Hospital Sultanah Bahiyah .Methods: This is a retrospective descriptive analysis study of 106 patient who underwent pleuroscopy in Hospital Sultanah Bahiyah between July 2014 till Dec 2016. Hospital Sultanah Bahiyah is the only centre doing this procedure in North Malaysia.Result: Biopsy were done in 91% of the cases with diagnostic yield of up to 97%. Most common finding were malignancy (55%) with adenocarcinoma being the commonest subtype. Second commonest finding are granulomatous inflammation (19%) which is not surprising given our burden of tuberculosis. Majority of our patient were male (58%) with mean age of 60 years old. With regard to safety only one case develop complication where the patient develops re-expansion pulmonary oedema with no procedure related mortality.Conclusion: Pleuroscopy is a very safe procedure. Despite the high Tuberculosis burden in Malaysia the most common cause for exudative pleural effusion were due to malignancy, hence pleuroscopy should be consider in all cases of exudative pleural effusion.