MyMedR

Fulltext Psychological Health of Surgeons in a Time of COVID-19: A Global Survey

Tan YQ, Wang Z, Yap QV, Chan YH, Ho RC, Hamid ARAH, et al.

Ann Surg, 2023 Jan 01;277(1):50-56.

PMID: 33491983 DOI: 10.1097/SLA.0000000000004775

OBJECTIVE: To assess the degree of psychological impact among surgical providers during the COVID-19 pandemic.

SUMMARY OF BACKGROUND DATA: The COVID-19 pandemic has extensively impacted global healthcare systems. We hypothesized that the degree of psychological impact would be higher for surgical providers deployed for COVID-19 work, certain surgical specialties, and for those who knew of someone diagnosed with, or who died, of COVID-19.

METHODS: We conducted a global web-based survey to investigate the psychological impact of COVID-19. The primary outcomes were the depression anxiety stress scale-21 and Impact of Event Scale-Revised scores.

RESULTS: A total of 4283 participants from 101 countries responded. 32.8%, 30.8%, 25.9%, and 24.0% screened positive for depression, anxiety, stress, and PTSD respectively. Respondents who knew someone who died of COVID-19 were more likely to screen positive for depression, anxiety, stress, and PTSD (OR 1.3, 1.6, 1.4, 1.7 respectively, all P < 0.05). Respondents who knew of someone diagnosed with COVID-19 were more likely to screen positive for depression, stress, and PTSD (OR 1.2, 1.2, and 1.3 respectively, all P < 0.05). Surgical specialties that operated in the head and neck region had higher psychological distress among its surgeons. Deployment for COVID- 19-related work was not associated with increased psychological distress.

CONCLUSIONS: The COVID-19 pandemic may have a mental health legacy outlasting its course. The long-term impact of this ongoing traumatic event underscores the importance of longitudinal mental health care for healthcare personnel, with particular attention to those who know of someone diagnosed with, or who died of COVID-19.

Fulltext Consensus statement from the international consensus meeting on post-traumatic cranioplasty

Iaccarino C, Kolias A, Adelson PD, Rubiano AM, Viaroli E, Buki A, et al.

Acta Neurochir (Wien), 2021 02;163(2):423-440.

PMID: 33354733 DOI: 10.1007/s00701-020-04663-5

BACKGROUND: Due to the lack of high-quality evidence which has hindered the development of evidence-based guidelines, there is a need to provide general guidance on cranioplasty (CP) following traumatic brain injury (TBI), as well as identify areas of ongoing uncertainty via a consensus-based approach.

METHODS: The international consensus meeting on post-traumatic CP was held during the International Conference on Recent Advances in Neurotraumatology (ICRAN), in Naples, Italy, in June 2018. This meeting was endorsed by the Neurotrauma Committee of the World Federation of Neurosurgical Societies (WFNS), the NIHR Global Health Research Group on Neurotrauma, and several other neurotrauma organizations. Discussions and voting were organized around 5 pre-specified themes: (1) indications and technique, (2) materials, (3) timing, (4) hydrocephalus, and (5) paediatric CP.

RESULTS: The participants discussed published evidence on each topic and proposed consensus statements, which were subject to ratification using anonymous real-time voting. Statements required an agreement threshold of more than 70% for inclusion in the final recommendations.

CONCLUSIONS: This document is the first set of practical consensus-based clinical recommendations on post-traumatic CP, focusing on timing, materials, complications, and surgical procedures. Future research directions are also presented.

Fulltext Antibody-drug conjugates: the paradigm shifts in the targeted cancer therapy

Aggarwal D, Yang J, Salam MA, Sengupta S, Al-Amin MY, Mustafa S, et al.

Front Immunol, 2023;14:1203073.

PMID: 37671162 DOI: 10.3389/fimmu.2023.1203073

Cancer is one of the deadliest diseases, causing million of deaths each year globally. Conventional anti-cancer therapies are non-targeted and have systemic toxicities limiting their versatile applications in many cancers. So, there is an unmet need for more specific therapeutic options that will be effective as well as free from toxicities. Antibody-drug conjugates (ADCs) are suitable alternatives with the right potential and improved therapeutic index for cancer therapy. The ADCs are highly precise new class of biopharmaceutical products that covalently linked a monoclonal antibody (mAb) (binds explicitly to a tumor-associated surface antigen) with a customized cytotoxic drug (kills cancer cells) and tied via a chemical linker (releases the drug). Due to its precise design, it brings about the target cell killing sparing the normal counterpart and free from the toxicities of conventional chemotherapy. It has never been so easy to develop potential ADCs for successful therapeutic usage. With relentless efforts, it took almost a century for scientists to advance the formula and design ADCs for its current clinical applications. Until now, several ADCs have passed successfully through preclinical and clinical trials and because of proven efficacy, a few are approved by the FDA to treat various cancer types. Even though ADCs posed some shortcomings like adverse effects and resistance at various stages of development, with continuous efforts most of these limitations are addressed and overcome to improve their efficacy. In this review, the basics of ADCs, physical and chemical properties, the evolution of design, limitations, and future potentials are discussed.

Fulltext The role of hospital environment in transmissions of multidrug-resistant gram-negative organisms

Chia PY, Sengupta S, Kukreja A, S L Ponnampalavanar S, Ng OT, Marimuthu K

Antimicrob Resist Infect Control, 2020 02 11;9(1):29.

PMID: 32046775 DOI: 10.1186/s13756-020-0685-1

Infections by multidrug-resistant (MDR) Gram-negative organisms (GN) are associated with a high mortality rate and present an increasing challenge to the healthcare system worldwide. In recent years, increasing evidence supports the association between the healthcare environment and transmission of MDRGN to patients and healthcare workers. To better understand the role of the environment in transmission and acquisition of MDRGN, we conducted a utilitarian review based on literature published from 2014 until 2019.

Rates of pin site infection during distraction osteogenesis based on monthly observations: a pilot study

Saw A, Chua YP, Hossain G, Sengupta S

J Orthop Surg (Hong Kong), 2012 Aug;20(2):181-4.

PMID: 22933675

To assess the monthly rates of infection of individual pin sites in 7 patients during distraction osteogenesis.

Acromioclavicular joint dislocation: a comparative biomechanical study of the palmaris-longus tendon graft reconstruction with other augmentative methods in cadaveric models

Luis GE, Yong CK, Singh DA, Sengupta S, Choon DS

J Orthop Surg Res, 2007;2:22.

PMID: 18042292

Acromioclavicular injuries are common in sports medicine. Surgical intervention is generally advocated for chronic instability of Rockwood grade III and more severe injuries. Various methods of coracoclavicular ligament reconstruction and augmentation have been described. The objective of this study is to compare the biomechanical properties of a novel palmaris-longus tendon reconstruction with those of the native AC+CC ligaments, the modified Weaver-Dunn reconstruction, the ACJ capsuloligamentous complex repair, screw and clavicle hook plate augmentation.

Fulltext Resection arthrodesis for primary bone tumour about the knee

Kwan MK, Ng ES, Penafort R, Saw A, Sengupta S

Med J Malaysia, 2005 Jul;60 Suppl C:66-71.

PMID: 16381287 MyJurnal

Bone defect following en bloc resection of primary bone tumor around the knee can be reconstructed by allograft or prothesis or combination of both. Resection-arthrodesis is an alternative option for young vigorous patients facing circumstances of financial constrain or limited supply of allograft. This study was undertaken to determine the outcome and complications associated with resection-arthrodesis of 22 primary bone tumors (13 giant cell tumors and 9 osteosarcomas) around the knee treated between 1990 and 2003 at the University Malaya Medical Center. The mean follow-up was 6 years (range 1-13 years). hree patients with osteosarcoma died of lung metastasis, 3 required above knee amputation and 2 defaulted follow-up. Local complications of the procedure include infection in 8 cases (36.4%), non-union 7 (31.8%) and mal-union. Of 14 patients who returned for final evaluation, 79.8% had satisfactory outcomes according to the Musculoskeletal Tumor Society grading system. In conclusion, resection-arthrodesis of the knee is a viable treatment option for selected patients with primary bone tumor around the knee, and good functional outcome can be expected in the presence of short-term local complications.

Giant cell tumour of bone with late presentation: review of treatment and outcome

Ng ES, Saw A, Sengupta S, Nazarina AR, Path M

J Orthop Surg (Hong Kong), 2002 Dec;10(2):120-8.

PMID: 12493923

To review cases of giant cell tumour of bone or osteoclastoma managed at the University Malaya Medical Center, University of Malaya, Kuala Lumpur, from January 1990 to December 1999.

Fulltext Pattern of rheumatoid arthritis in West Malaysia

Toh BH, Sengupta S, Ang AH, White JC, Lau KS

Ann Rheum Dis, 1973 Mar;32(2):151-6.

PMID: 4120913 DOI: 10.1136/ard.32.2.151

In West Malaysia RA appears to be less common than in temperate climates, but more common than in tropical Africa; furthermore, the incidence of gout and SLE is comparable. The clinical manifestations of RA are milder than those seen in more temperate climates. Subcutaneous rheumatoid nodules have not been observed. Positive serological tests for RF are significantly higher than in the general Malaysian population, but still lower than those reported for patients with RA in temperate climates. Of the three main ethnic groups, the highest incidence of positive results is found in the Chinese.
Study site: Arthritis Clinic, University Hospital, Kuala Lumpur (University Malaya Medical Centre, UMMC, Kuala Lumpur, Malaysia)

Fulltext A simple practical protocol for care of metal-skin interface of external fixation

Saw A, Chan CK, Penafort R, Sengupta S

Med J Malaysia, 2006 Feb;61 Suppl A:62-5.

PMID: 17042233

Patients treated with external fixation for limb reconsturciton or fracture stabilization equire regular and prolongedperiod of pin-tract care involving frequent visits to clinic and dressing traditionally carried out by trained nurses or medical assistants. A simple method of do-it-yourself dressing was introduced in our institution and this study was undertaken to evaluate the effectiveness of the protocol. Sixty patients (40 trauma-related problems and 20 congenital or developmental disorders) were enrolled into the study. Following application of external fixation, the patients and/or their caretakers were taught on how to do pin-site dressing using normal saline or drinking water as cleansing solution on daily basis. Patients were discharged on the second or third post-operative day and were followed-up every two weeks for an average 182 days (range 66 to 379 days) with special attention on identifying pin-tract infection. A simple grading system for pin-tract infections was proposed. Of 40 patients with trauma-related problems. 65% were post-traumatic infections. There were 788 metal-skin interfaces (239 half-pin fixations and 549 tensioned wire fixations. A total 143 metal-skin interface infections (18.1%) involving half-pin sites (41.3%) and tensioned wire sites (58.7%) was noted. Majority were grade I infections (79.7%), 18.8% grade II and only 1.4% grade III. Most infections (81%)were caused by Staphylococcus aureus. Grade I infections were successfully treated with frequent dressing, grade II by adjunctive oral antibiotic but grade III infections required removal of fixator. All eventually healed. Do yourself non-sterile dressing of metal-skin interfaces is a cost-effective method of pin-site care with a low infection rate. The infections were sucessfully treated using guidelines according to the proposed classification of pin-tract infections.

Fulltext A rare case of chondrosarcoma of the clavicle

Amalourde A, Vinayaga P, Naveed N, Jamal A, Looi LM, Sengupta S

Med J Malaysia, 2004 Dec;59 Suppl F:60-2.

PMID: 15941166 MyJurnal

Although all types of tumour and tumour-like conditions have been described to occur in the clavicle, they only contribute to less then 0.5% of all skeletal tumours. The incidence of primary chondrosarcoma of the clavicle is extremely rare. To our knowledge it has not been reported in Malaysia. We would like to highlight the possibility of chondrosarcoma as a differential diagnosis for a clavicular lesion.

Delayed management of fracture of the lateral humeral condyle in children

Dhillon KS, Sengupta S, Singh BJ

Acta Orthop Scand, 1988 Aug;59(4):419-24.

PMID: 3421080

Thirty-nine displaced fractures of the lateral humeral condyle in children were followed for an average of 5 (2-5) years. The results were evaluated from functional and cosmetic aspects. Patients treated within 2 weeks by open reduction and internal fixation did well. Those operated on after 6 weeks did not do better than nonoperated on cases. Complications included cubitus varus and valgus deformities, osteonecrosis, nonunion and malunion, and loss of motion. We recommend that patients presenting late be left alone and any sequelae evaluated at a late stage.

The pathology of tumour and "tumour-like" lesions of bone in the University Hospital, Kuala Lumpur

Peh SC, Cheah PL, Sengupta S

Malays J Pathol, 1988 Aug;10:45-50.

PMID: 3252076

Histomorphometric changes in the vessel wall at the site of amputation in diabetic patients--do they influence healing of the stump?

Naidu SV, Sengupta S

J Orthop Surg (Hong Kong), 2005 Apr;13(1):3-7.

PMID: 15872394

To predict healing of the stump by assessing the microscopic vascular changes at the amputation site.

Fulltext Supracondylar fractures of the humerus in children--an epidemiological study of 132 consecutive cases

Chai KK, Aik S, Sengupta S

Med J Malaysia, 2000 Sep;55 Suppl C:39-43.

PMID: 11200043

132 consecutive cases of supracondylar fractures of the humerus admitted between July, 1997 and February, 1999 were included in a prospective study. There were 93 boys and 39 girls. The age ranges from one to 14 years old. The non-dominant arm was more often injured. Ethnic Malay constituted the majority. Accidents mainly occurred at home with a peak between 4 pm and 8 pm. Majority was presented within 24 hours of injury. Type III fracture with distal fragment in extension predominated. Nerve injuries occurred in 9 cases in which median nerve was the most commonly affected. There was only one open fracture and it was complicated by absent radial pulse and median nerve injury.

Fulltext A freak accidental injury to the spinal cord

Koh KB, Vaikunthan R, Sengupta S

Med J Malaysia, 1988 Sep;43(3):246-9.

PMID: 3241584

Fulltext Necrotising fasciitis: a life-threatening complication of acupuncture in a patient with diabetes mellitus

Saw A, Kwan MK, Sengupta S

Singapore Med J, 2004 Apr;45(4):180-2.

PMID: 15094988

Acupuncture is used for some conditions as an alternative to medication or surgical intervention. Several complications had been reported, and they are generally due to physical injury by the needle or transmission of diseases. We report a case of life-threatening necrotising fasciitis that developed after acupuncture treatment for osteoarthritis of the knee in a 55-year-old diabetic woman. She presented with multiple discharging sinuses over the right knee. As the patient did not respond to intravenous antibiotics, extensive debridement was performed. She made a good recovery. Since many old diabetic patients with degenerative joint diseases may consider this mode of treatment, guidelines on cleanliness and sterility of this procedure should be developed and practiced.

Comparison of two methods of percutaneous pin fixation in displaced supracondylar fractures of the humerus in children

Foead A, Penafort R, Saw A, Sengupta S

J Orthop Surg (Hong Kong), 2004 Jun;12(1):76-82.

PMID: 15237126

To conduct a prospective randomised controlled study to compare the stability and risk of nerve injury between fractures treated by medial-lateral pin fixation and those treated by 2-lateral pin fixation.

Dislocation of cervico-thoracic spine with no neurological deficit--a case report

Saw A, Sengupta S

Injury, 2001 Jun;32(5):430-2.

PMID: 11382432

Fulltext Limb reconstruction surgery with external fixators--university hospital experience

Aik S, Sengupta S

Med J Malaysia, 2000 Sep;55 Suppl C:86-92.

PMID: 11200049

We are describing 21 limb reconstruction procedures performed in 18 patients with the use of external fixators from 1996 to 1998. The average age of patients was 21, ranging from 1 to 50 years old. Indications for surgery included short limb, non-union, pseudoarthrosis and bone or soft tissue deformities. Average length obtained for cases of limb lengthening was 6 cm. All the seven clubfoot deformities in five children were fully corrected. Equinus deformity recurred in one foot and was treated with supramalleolar osteotomy. Out of the seven cases with infected nonunion and bone loss, three failed to achieve union and required additional bone grafting procedures. One patient with unilateral external fixator for the correction of tibia shortening developed valgus deformity.

Displaying publications 1 - 20 of 26 in total