MyMedR

Association of loss of heterozygosity and PTEN gene abnormalities with paraclinical, clinical modalities and survival time of glioma patients in Malaysia

Abdullah JM, Farizan A, Asmarina K, Zainuddin N, Ghazali MM, Jaafar H, et al.

Asian J Surg, 2006 Oct;29(4):274-82.

PMID: 17098662

The pattern of allelic loss of heterozygosity (LOH) and PTEN mutations appear to be associated with the progression of gliomas leading to a decrement in the survival rate of patients. This present study was carried out to determine the LOH and PTEN mutational status in glioma patients and its association with patients' survival.

Persistence of cognitive deficits following paediatric head injury without professional rehabilitation in rural East Coast Malaysia

Abdullah JM, Kumaraswamy N, Awang N, Ghazali MM, Abdullah MR

Asian J Surg, 2005 Jul;28(3):163-7.

PMID: 16024307

To use data from a prospective, longitudinal study to determine whether psychomotor functions improve spontaneously during the first year following paediatric traumatic brain injury without modern rehabilitation facilities in a rural area of Malaysia.

Diagnostic cerebral angiography in spontaneous intracranial haemorrhage: a guide for developing countries

Abu Bakar I, Shuaib IL, Mohd Ariff AR, Naing NN, Abdullah JM

Asian J Surg, 2005 Jan;28(1):1-6.

PMID: 15691788

OBJECTIVE: Spontaneous intracranial haemorrhage constitutes 18-40% of all stroke cases. Indications for cerebral angiography to find underlying potentially treatable vascular abnormalities are not clear. This study determined which intracranial haemorrhage patients need cerebral angiography by correlating computed tomography (CT) findings, age and hypertension history with cerebral angiography findings.

METHODS: A total of 54 patients (8-79 years) with intracranial haemorrhage who underwent both CT examination and six-vessel cerebral angiography were studied over a 2-year period. Cerebral angiography was repeated within 6 weeks if the first angiogram was negative.

RESULTS: Angiography detected vascular lesions in 50% of cases (aneurysm 38.9% and arteriovenous malformation, AVM, 11.1%). In the aneurysm group, angiographic yield was 34.3% whereas in the AVM group, it was 37.9%. Subarachnoid haemorrhage (SAH) combined with other types of haemorrhage (such as intracerebral haemorrhage, ICH) was not significantly correlated with the likelihood of finding a vascular lesion, both aneurysm and AVM (p = 0.157). Age less than 50 years had significant correlation (p = 0.021) in the AVM group as well as in the aneurysm group (p < 0.001). A history of hypertension was associated with both aneurysm (p = 0.039) and AVM (p = 0.008). No patients with deep intracerebral haematoma had vascular lesions. The presence of an intravascular haemorrhage (IVH) had significant correlation with aneurysm (p = 0.008) but not AVM. There was no significant difference in mean age between patients with and without a vascular lesion (p = 0.134).

CONCLUSION: Cerebral angiography is justified in patients with ICH accompanied by pure SAH (p = 0.001). Other factors associated with finding a vascular lesion were a history of hypertension and the presence of IVH. Diagnostic cerebral angiography is indicated for patients with ICH and SAH and IVH with a history of hypertension, regardless of age.

Fulltext Surgical management of juvenile nasopharyngeal angiofibroma without angiographic embolization

Ahmad R, Ishlah W, Azilah N, Rahman JA

Asian J Surg, 2008 Oct;31(4):174-8.

PMID: 19010758 DOI: 10.1016/S1015-9584(08)60081-0

Juvenile nasopharyngeal angiofibroma (JNA) is a rare benign neoplasm that occurs almost exclusively in the nasopharynx of adolescent males. Surgery remains the primary treatment of choice. JNA has always presented a management challenge to surgeons because of its vascular nature, site of occurrence, and local tissue destruction. The surgical approaches are either standard open method which include external or intraoral incisions, or the recent advanced approach, i.e. via using the endonasal endoscope. It is widely accepted that the use of preoperative angiographic embolization reduces the occurrence of intraoperative bleeding and facilitates tumour removal. However, angiographic embolization is not available at all centres. The purpose of this article is to present our experience with five patients diagnosed with JNA who were resected without embolization, using various surgical approaches. Two tumours were removed via endonasal endoscopic surgery. None of the tumours were embolized prior to surgery. We highlight the preoperative evaluation of tumour extent, using both computed tomography (CT) and magnetic resonance angiography, and the importance of temporary clamping of the external carotid artery intraoperatively. Our results suggest that the latter procedure is a safe and effective means of facilitating surgery and reducing intraoperative bleeding.

Head injury from fan blades among children

Alias A, Krishnapillai R, Teng HW, Abd Latif AZ, Adnan JS

Asian J Surg, 2005 Jul;28(3):168-70.

PMID: 16024308

OBJECTIVE: Head injury caused by fan blades is rare among children. We analysed 14 cases of such injury and discuss the causes, type of injury and preventive measures.

METHODS: A retrospective analysis of 14 cases of children who were admitted to the Pediatric Neurosurgical Unit of Hospital Kuala Lumpur after sustaining head injuries caused by fan blades between January 2000 and December 2002 was performed.

RESULTS: The causes of fan-blade head injury included jumping on the upper bunk of a bunk-bed, climbing on a ladder, climbing up onto a table, and being lifted by an adult. Thirteen patients were injured by ceiling fans and one by falling onto an uncovered table fan. School-aged boys were the predominant victims. Mean patient age was 7.9 years (range, 1.0-12.2 years). There was a twin peak incidence of when the accidents occurred: just before lunch in the afternoon and bedtime at night. The types of injury were scalp lacerations, compound depressed fractures and multiple intracranial haemorrhages. Two patients had the complication of wound infection, and one of these patients developed cerebral spinal fluid leak. One patient died from severe head injuries.

CONCLUSION: Safety awareness among parents and caretakers are important as fan-blade head injury among children is preventable.

Fulltext The effect of sequential intermittent pneumatic compression of foot and calf on popliteal artery mean systolic blood flow in patients with intermittent claudication

Anthonysamy D, Azizi ZA, Tajri HM

Asian J Surg, 2012 Oct;35(4):131-5.

PMID: 23063083 DOI: 10.1016/j.asjsur.2012.06.005

To determine the effect of intermittent pneumatic foot and calf compression on popliteal artery mean systolic blood flow in patients with intermittent claudication. The secondary objective was to determine the change in blood flow with posture.

Fulltext Medial pectoral pedicle is a reliable landmark for axillary lymph node dissection

Aripin YM, Ibrahim N, Muhammad R

Asian J Surg, 2013 Oct;36(4):150-3.

PMID: 23726827 DOI: 10.1016/j.asjsur.2013.04.008

The anatomical orientation of structures in the axilla has not been well studied, although it is essential for a neat and safe dissection. The objective of this study was to determine the relations between neurovascular structures in the axilla as they were encountered during axillary lymph node dissection (ALND) for breast cancer.

Fulltext Surgical management of large desmoid tumour of the anterior abdominal wall

Arshad AR, Normala B

Asian J Surg, 2008 Apr;31(2):90-5.

PMID: 18490222 DOI: 10.1016/S1015-9584(08)60065-2

Desmoid tumours are uncommon. They are locally invasive and incomplete excision leads to recurrence, which can pose a significant management challenge. Patients therefore require effective treatment, which essentially entails tumour excision with a clear surgical margin. The resulting wide defect may lead to difficulty in closure of the anterior abdominal wall. We report our experience in treating large desmoid tumours of the anterior abdominal wall. Between January 2000 and December 2001, three patients with large desmoid tumour of the anterior abdominal wall were treated with wide excision, which included a 3-cm margin of uninvolved tissues. This led to a considerable abdominal wall defect. The peritoneal defect was closed as a separate layer, though under considerable tension, while the abdominal wall musculature defect was closed with a polypropylene mesh. All three patients recovered well with no immediate or late postoperative morbidity. Follow-up until December 2006 has not revealed any tumour recurrence or hernia development. Wide excision of an anterior abdominal wall desmoid tumour with a clear margin of 3 cm including the peritoneum should be considered when managing such tumours. Closure under tension of the peritoneum did not seem to produce any morbidity.

Liver abscess caused by tuberculosis and melioidosis

Azali HY, Norly S, Wong LM, Tan KS, Safian NM

Asian J Surg, 2007 Apr;30(2):138-40.

PMID: 17475585

We report an unusual co-existence of Burkholderia pseudomallei and acid fast bacilli in a young Malay gentleman with liver abscess. He was treated with antibiotics and surgical drainage. This phenomenon has not been reported in previous literature and the dilemma of its management is discussed.

Melioidosis and the vascular surgeon: Hospital Kuala Lumpur experience

Azizi ZA, Yahya M, Lee SK

Asian J Surg, 2005 Oct;28(4):309-11.

PMID: 16234087

Bacterial arteritis is relatively uncommon and management of this condition, which carries high morbidity and mortality, is difficult and time-consuming. Common organisms implicated include Salmonella and Staphylococcus. Arteritis as a result of infection by Burkholderia pseudomallei (formerly Pseudomonas pseudomallei) has been rarely reported in the English literature. This organism, which is endemic in our part of the world, is well known to cause a wide spectrum of septic conditions. A review of cases managed at Hospital Kuala Lumpur revealed that bacterial arteritis due to melioidosis is not such a rare entity. We share our experience in the management of this condition using three cases as examples.

Outcomes of pulmonary resection in pulmonary aspergilloma: A retrospective cohort study in a single tertiary-care hospital in Northern Thailand

Balasubbiah N, Saeteng S, Siwachat S, Thuropathum P, Tantraworasin A

Asian J Surg, 2024 Feb 22.

PMID: 38388261 DOI: 10.1016/j.asjsur.2024.02.003

BACKGROUND: To date, surgery is the best approach to maximize a cure for symptomatic aspergilloma, but this is not without risk of both morbidity and mortality. The aim of this study is to present the characteristics and outcomes of 77 patients diagnosed with aspergilloma who underwent surgery at Chiang Mai University Hospital (CMUH), and to identify risk factors for composite major postoperative complications (CMPC).

METHODS: This is an observational retrospective cohort study carried out at CMUH over a period of 11 years from January 1, 2010, to February 28, 2021. Patient characteristics and postoperative outcomes were studied. The primary outcomes were categorized into CMPC. Univariable and multivariable risk regression analysis were used to identify risk factors of CMPC, with risk ratio (RR) and 95% confidence intervals being calculated.

RESULTS: There were 77 patients included in this study; 27 patients identified as having CMPC and 55 patients as a non-CMPC group. From the multivariable analysis, a factor associated with CMPC included perioperative FFP transfusion (risk ratio (RR) 1.01,95 % CI 1.01-1.02) and preoperative angiogram embolization (RR 8.42, 95 % CI 1.44-49.06) whereas immediate extubation (RR 0.22, 95% CI 0.06-0.81) was less likely to be associated with CMPC. There was a trend of increased risk of CMPC in patients received perioperative blood transfusion, but the data did not reach statistical significance.

CONCLUSIONS: This study has identified a need for patient profiling before embarking on lung surgery for aspergilloma, to predict outcomes and allocate resources appropriately for safer surgery.

Fulltext Role of laparoscopy and ultrasound in the management of "impalpable testis" in children

Budianto IR, Tan HL, Kinoshita Y, Tamba RP, Leiri S, Taguchi T

Asian J Surg, 2014 Oct;37(4):200-4.

PMID: 24661449 DOI: 10.1016/j.asjsur.2014.01.013

Undescended testes is one of the most common congenital abnormalities in boys. In cases of impalpable testes, ultrasound is often used to find the testis, which frequently provides false-negative results. Recently, laparoscopy has become popular in the management of impalpable testes.

Chylous ascites after anterior resection for rectal carcinoma: a rare but significant incident

Chan KY, Teoh CM, Sukumar N

Asian J Surg, 2006 Jan;29(1):46-8.

PMID: 16428100

Chylous ascites specifically after anterior resection for rectal cancer has not been documented in the literature thus far. All previously reported postoperative chylous ascites developed in other types of malignancies and were diagnosed within a few days of surgery. However, the patient we report had symptoms 2 years after surgery. Intraoperatively, chylous ascites was found with multiple lymph node metastasis in the small bowel mesentery and retroperitoneal region. The rarity of chylous ascites after anterior resection in rectal carcinoma is documented and discussed.

Fulltext Inguinal hernia repair by surgical trainees at a Malaysian teaching hospital

Chan KY, Rohaizak M, Sukumar N, Shaharuddin S, Jasmi AY

Asian J Surg, 2004 Oct;27(4):306-12.

PMID: 15564185

To assess the outcome of inguinal hernia repaired by surgical trainees at Universiti Kebangsaan Malaysia Hospital.

Fulltext Total parathyroidectomy under local anaesthesia for renal hyperparathyroidism

Cheong YT, Taib NA, Normayah K, Hisham AN

Asian J Surg, 2009 Jan;32(1):51-4.

PMID: 19321403 DOI: 10.1016/S1015-9584(09)60009-9

Renal hyperparathyroidism with attendant osteodystrophy is a frequent and severe morbidity affecting the quality of life of end stage renal failure patients surviving on long-term renal replacement therapy. A small subgroup of these patients with severe cardiorespiratory dysfunction was deemed at very high risk for general anaesthesia (GA). We report on a series of total parathyroidectomy under local anaesthesia (LA) for these patients.

Fulltext Post-hemithyroidectomy hypothyroidism in non autoimmune thyroiditis patients: Incidence, risk factors and duration of follow up

Chong SS, Hoh SY, Huang SM

Asian J Surg, 2019 Nov;42(11):957-962.

PMID: 30987945 DOI: 10.1016/j.asjsur.2019.01.015

BACKGROUND: Hemithyroidectomy has a known but less predictable sequelae of hypothyroidism. Presence of anti-thyroid antibody is known, well studied risk factor. Other postulated risk factors include higher pre-operative TSH level and lower ratio of post-operative thyroid remnant to the patient's weight. We reviewed our data to address the above mentioned risk factors.

METHOD: This was a retrospective study done in National Cheng Kung University Hospital, Taiwan from 2015 to 2017. 125 patients underwent hemithyroidectomy, but 24 patients were excluded due to autoimmune thyroiditis, which was determined as the exclusion criteria. Standard panel of blood investigations were taken in each clinic visit before and after operation. A neck ultrasound was done 2 months post-operatively to assess the thyroid remnant. Chi-square test was used for categorical data analysis. Independent student t-test was used for continuous data with parametric distribution and Mann-Whitney U test for non parametric data. p 2.0 uIU/mL was a risk factor as Chi square test showed p

Aspiration of breast abscess under ultrasound guidance: outcome obtained and factors affecting success

Elagili F, Abdullah N, Fong L, Pei T

Asian J Surg, 2007 Jan;30(1):40-4.

PMID: 17337370

To assess ultrasonographically (US) guided needle aspiration of breast abscesses as an alternative to surgical incision and drainage.

Antrochoanal polyps: clinical presentation and the role of powered endoscopic polypectomy

Gendeh BS, Long YT, Misiran K

Asian J Surg, 2004 Jan;27(1):22-5.

PMID: 14719510

Antrochoanal polyps are a rare clinical entity. In this review of patients treated between January 1996 and September 2002, there were 18 cases of antrochoanal polyps. The mean age of patients was 20 years. Nasal obstruction was the most common symptom (17 cases, 94%), followed by rhinorrhoea (44%), epistaxis (33%), postnasal drip (28%), and snoring (22%). Chronic sinus was the most common associated rhinological finding (50%). Various surgical approaches were used: endoscopic polypectomy and middle meatal antrostomy in seven patients (38.9%), endoscopic polypectomy and inferior meatal antrostomy in three patients (16.7%) and Caldwell-Luc surgery in one patient (5.6%). No complications were noted in patients treated with powered instrumentation, including the three patients in whom combined transcanine approaches were used. We concluded that powered endoscopic polypectomy was safe and effective. It allowed a more complete dissection and may diminish the chance of recurrence.

Fulltext Prognostic factors in patients with colorectal cancer at Hospital Universiti Sains Malaysia

Ghazali AK, Musa KI, Naing NN, Mahmood Z

Asian J Surg, 2010 Jul;33(3):127-33.

PMID: 21163410 DOI: 10.1016/S1015-9584(10)60022-X

To determine the 5-year survival rate and prognostic factors for survival in patients with colorectal cancer treated at the Surgical Unit, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia.

Swordfish attack--death by penetrating head injury

Gooi BH, Khamizar W, Suhani MN

Asian J Surg, 2007 Apr;30(2):158-9.

PMID: 17475591

There have been very few reports of swordfish attacks on humans and none have resulted in death. Although there are no reports of unprovoked attacks on humans, swordfish can be very dangerous when provoked and they can jump and use their swords to pierce their target. We describe here an unusual case of death that resulted from intracranial penetrating injury caused by a swordfish.

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