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Fulltext Multiple magnet ingestion: The attractive hazardst

Othman MY, Singaravel S

Med J Malaysia, 2016 Aug;71(4):211-212.
PMID: 27770124

Foreign body ingestion among children is common and most usually pass through the gastrointestinal tract without requiring any intervention. Magnets, however, pose a greater threat especially when more than one are ingested. We report a case of multiple bowel perforation secondary to ingestion of magnetic beads in a 3-year-old.
Fulltext Biliary complications post liver resection for pediatric liver tumors

Othman MY, Teh KH, Zahari Z

World J Pediatr Surg, 2023;6(3):e000589.
PMID: 37441088 DOI: 10.1136/wjps-2023-000589

OBJECTIVE: To review biliary complications following liver resection for liver tumors in children and their associated risk factors.
METHODS: Retrospectively, we reviewed children who underwent liver resection for liver tumors from 2010 to 2019. Demographic data, operative details, types of complications, interventions and outcomes were studied.
RESULTS: Eighty-six out of 108 liver resections were included in this study. The median age of patients was 1.8 years old, and 55% were male. The majority (95%) were malignant tumors, of which 87% were hepatoblastoma (n=71). The most common procedure performed was extended right hepatectomy (37%, n=32). Twelve (14%) patients had primary biliary complications: nine bile leakages and three biliary obstructions. Six cases of bile leakage were treated non-operatively with drainage only; however, one developed bilothorax. Three bile leakages underwent early operative intervention. Four patients underwent biliary reconstruction. Biliary complications were not significantly associated with age, sex, ethnicity or pathology of the tumor. Ten of them (83%) developed following extended hepatectomies (five right, five left), in which the left side had a higher rate of complications (63% vs 16%). None of the central hepatectomies had biliary complications. Biliary complication rates were significantly higher among those who had segmentectomy 1 (p=0.023).
CONCLUSIONS: Biliary complication is a significant morbidity following liver resection in children. Surgery is eventually required for complicated bile leakage and primary biliary strictures. Follow-up is mandatory since secondary biliary complications may occur after the initial resolution of bile leakage. The groups at high risk of developing biliary complications are extended left hepatectomies and segmentectomy 1.
Diagnostic dilemma and challenges in management: Hirschsprung's disease, anal stenosis and reduced interstitial cells of Cajal enteric mesenchymopathy

Chan EEH, Merchant K, Othman MY, Laksmi NK

BMJ Case Rep, 2023 Apr 25;16(4).
PMID: 37185243 DOI: 10.1136/bcr-2022-252484

Hirschsprung's disease (HD) is one of the most well-known gastrointestinal motility disorders. Diagnosis and management of other lesser-known motility disorders are often challenging and tedious. We describe a teenager who was severely constipated from birth and needed intensive care admissions for life-threatening enterocolitis. She also had concomitant anal stenosis. Several rectal biopsies were unable to yield a conclusive diagnosis. Surgical level of resection had to be identified based on the motility of the bowel as determined by transit studies using oral ingestion of a milk feed labelled with Technetium-99m colloid. After completion of all operative stages, histopathological examination of the excised specimens concluded that she had short-segment HD associated with reduced interstitial cells of Cajal in the large bowel. She is currently continent, evacuating voluntarily approximately four times a day and is relieved of all her symptoms.
Fulltext Pediatric Solid Tumor Care and Multidisciplinary Tumor Boards in Low- and Middle-Income Countries in Southeast Asia

Othman MY, Blair S, Nah SA, Ariffin H, Assanasen C, Soh SY, et al.

JCO Glob Oncol, 2020 08;6:1328-1345.
PMID: 32886560 DOI: 10.1200/GO.20.00284

PURPOSE: Pediatric solid tumors require coordinated multidisciplinary specialist care. However, expertise and resources to conduct multidisciplinary tumor boards (MDTBs) are lacking in low- and middle-income countries (LMICs). We aimed to profile the landscape of pediatric solid tumor care and practices and perceptions on MDTBs among pediatric solid tumor units (PSTUs) in Southeast Asian LMICs.
METHODS: Using online surveys, availability of specialty manpower and MDTBs among PSTUs was first determined. From the subset of PSTUs with MDTBs, one pediatric surgeon and one pediatric oncologist from each center were queried using 5-point Likert scale questions adapted from published questionnaires.
RESULTS: In 37 (80.4%) of 46 identified PSTUs, availability of pediatric-trained specialists was as follows: oncologists, 94.6%; surgeons, 91.9%; radiologists, 54.1%; pathologists, 40.5%; radiation oncologists, 29.7%; nuclear medicine physicians, 13.5%; and nurses, 81.1%. Availability of pediatric-trained surgeons, radiologists, and pathologists was significantly associated with the existence of MDTBs (P = .037, .005, and .022, respectively). Among 43 (89.6%) of 48 respondents from 24 PSTUs with MDTBs, 90.5% of oncologists reported > 50% oncology-dedicated workload versus 22.7% of surgeons. Views on benefits and barriers did not significantly differ between oncologists and surgeons. The majority agreed that MDTBs helped to improve accuracy of treatment recommendations and team competence. Complex cases, insufficient radiology and pathology preparation, and need for supplementary investigations were the top barriers.
CONCLUSION: This first known profile of pediatric solid tumor care in Southeast Asia found that availability of pediatric-trained subspecialists was a significant prerequisite for pediatric MDTBs in this region. Most PSTUs lacked pediatric-trained pathologists and radiologists. Correspondingly, gaps in radiographic and pathologic diagnoses were the most common limitations for MDTBs. Greater emphasis on holistic multidisciplinary subspecialty development is needed to advance pediatric solid tumor care in Southeast Asia.
Fulltext Sociocultural factors affecting drive for muscularity among male college students in Malaysia

Sai A, Furusawa T, Othman MY, Tomojiri D, Wan Zaini WFZ, Tan CSY, et al.

Heliyon, 2020 Jul;6(7):e04414.
PMID: 32743089 DOI: 10.1016/j.heliyon.2020.e04414

Compared with females, little research on muscularity and the sociocultural influences on this domain has been conducted with males in non-Western societies. The current study explored these sociocultural predictors of drive for muscularity among Malaysian male college students, specifically in terms of ethnicity and exposure to media (i.e., Internet and social media). In total, 166 male college students from two universities in Kuala Lumpur were asked to rate the questionnaires as to muscularity-oriented attitudes and behaviours. Multivariable general linear model analyses revealed that being Chinese was a strong predictor of muscularity-oriented attitudes and behaviours. In addition, modern media, particularly, Internet use and the number of followers on Instagram, was found to significantly predict males' drive for muscularity. Overall findings suggest that males of particular ethnic groups may be at higher risk for negative body image compared to the other ethnic populations and modern media use may accelerate drive for muscularity, which may also in turn place males at higher risk for excess muscularity-oriented thoughts and behaviours.
Gastrointestinal and oncologic outcomes of pediatric gastrointestinal lymphoma following upfront resection or biopsy of bowel masses

Othman MY, Halepota HF, Le Linn Y, Lee YT, Chang KTE, Ahamed SH, et al.

Pediatr Surg Int, 2021 Aug;37(8):1049-1059.
PMID: 33963920 DOI: 10.1007/s00383-021-04915-0

PURPOSE: Complete upfront resection of pediatric gastrointestinal lymphomas is recommended over biopsy whenever feasible, but either approach may have adverse sequelae. We sought to compare gastrointestinal and oncological outcomes of pediatric gastrointestinal lymphomas who underwent attempted upfront resection or biopsy of the presenting bowel mass.
METHODS: We retrospectively reviewed charts of children with gastrointestinal lymphomas treated on LMB89 and LMB96 protocols from 2000 to 2019 who underwent upfront gastrointestinal surgery, and compared resection and biopsy groups.
RESULTS: Of 33 children with abdominal lymphomas, 20 had upfront gastrointestinal surgery-10 each had resection or biopsy. Patients with attempted upfront resections had fewer postoperative gastrointestinal complications compared to biopsies (10% vs. 60%, p = 0.057), but longer time to chemotherapy initiation (median 11.5 vs. 4.5 days, p