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Fulltext A preliminary report on the relationship between serum anti-thrombin III concentration in pre- and post-operative patients and in women on oral contraceptives

Ton SH, Lopez CG, Thiruselvam A, Lyou YT

Med J Malaysia, 1981 Dec;36(4):212-4.
PMID: 7334955

A T III values in patients undergoing surgery were found to be lower post-operatively but the fall in value was not significant while women on oral contraceptives were found to have similar AT III values as that of women not on oral contraceptives. The observed values are discussed.

Matched MeSH terms: Postoperative Period
Fulltext Neurological recovery following posterior decompression of spinal secondaries

Razak M, Sappani K

Med J Malaysia, 1998 Sep;53 Suppl A:6-11.
PMID: 10968177

This is a retrospective study comprising 45 patients who underwent decompressive laminectomy due to secondary malignancy in the spine. There were 31 males and 14 females. Two of them had no weakness, one was treated for radicular pain and the other for severe intractable back pain. Forty-three patients presented with weakness of the limb of which six patients were able to walk unaided, four with an aid, twenty four were unable to walk of which eleven of them were completely paralysed. Nineteen of the patients had urinary incontinence. Out of 10 patients in Frankel's D, 3 of them regained almost normal power post operatively and were able to walk without any aids at the time of discharge. There were 6 patients in Frankel's C and 2 improved. Of 17 patients in Frankel's B, 6 of them improved and were able to walk with walking aids. Only one out of ten patient from Frankel's A had showed an improvement. A total of three patients deteriorated post operatively and all of them presented with multiple level involvement. There was no change in the post operative status of the two patients who did not have weakness. Overall only 27% of the patient showed improvement following decompressive laminectomy.

Matched MeSH terms: Postoperative Period
Fulltext Secondary intraocular lens implantation in University Hospital, Kuala Lumpur

Jaais F

Med J Malaysia, 1998 Sep;53(3):272-6.
PMID: 10968165

Secondary intraocular lens implantation after cataract surgery done in University Hospital between 1983 to 1993 were reviewed. Thirty three patients (37 eyes) underwent secondary intraocular lens implantation during this period. Twenty four eyes had secondary anterior chamber lens implantation while 13 had posterior chamber lens implantation. There was no case of secondary posterior scleral fixation lens implantation. Visual acuity of 6/9 or better was seen in 25 of 37 eyes (67%) in the series. Eyes seeing as good or better than before secondary implantation procedure were noted in 34 of 37 eyes (92%). Vision of 6/9 or better was seen in 9 of 13 eyes (70%) with posterior chamber implants and 16 of 24 eyes in (67%) with anterior chamber lenses. Complications including bullous keratopathy, uveitis and glaucoma were seen with anterior chamber implants of the rigid type resulting in poorer visual acuity than before the secondary procedure.

Matched MeSH terms: Postoperative Period
Loss of consciousness following spinal anaesthesia for caesarean section

Chan YK, Gopinathan R, Rajendram R

Br J Anaesth, 2000 Sep;85(3):474-6.
PMID: 11103195

A healthy parturient under spinal anaesthesia for Caesarean section lost consciousness for an hour, 20 min after the intrathecal injection of 2 ml of 0.5% heavy bupivacaine. The patient was haemodynamically stable before losing consciousness. The differential diagnosis is discussed.

Matched MeSH terms: Postoperative Period
Fulltext Simple approach to the management of aseptic non-union of the shaft of long bones

Devnani AS

Singapore Med J, 2001 Jan;42(1):20-5.
PMID: 11361233

Internal fixation with a plate in the management of non-union for shaft of long bones has been condemned but the review of the literature does not provide such unequivocal evidence. Also there are certain situations where it is either technically not feasible or contraindicated to do closed intramedullary nailing. This study was done to see the outcome of plate-fixation for the treatment of non-union of the shaft of long bones.

Matched MeSH terms: Postoperative Period
Intravesical explosion during transurethral resection of the prostate

Dublin N, Razack AH, Loh CS

ANZ J Surg, 2001 Jun;71(6):384-5.
PMID: 11409027
Matched MeSH terms: Postoperative Period
Fulltext Reoperative thyroid surgery in hospital universiti sains malaysia

Tun M, Salekan K, Sain AH

Malays J Med Sci, 2003 Jan;10(1):86-9.
PMID: 23365506 MyJurnal

From 1996 to 2001, 393 thyroidectomies were performed and 25 (6.4%) patients underwent reoperative thyroid surgery at Hospital Universiti Sains Malaysia. All reoperated patients had undergone one prior thyroid operation. All were females with an average age of 39.1 years (18-61 years). The most frequent indication for reoperation was cancer in resected specimen of an originally misdiagnosed carcinoma treated by partial thyroid resection. Final histological diagnosis of 25 reoperations showed thyroid carcinoma in 22 (88%) cases and multinodular goiter in 3 cases. The overall interval between the initial and the reoperative procedures ranged from 3 weeks to 15 years. There was no post-operative mortality after reoperation. Post-operative complications were discovered in 5 patients, as 3 (12%) of whom had transient hypocalcaemia, one (4%) had wound breakdown and one (4%) had permanent recurrent laryngeal nerve palsy. Reoperative thyroid surgery is an uncommon operation with high complication rate.

Matched MeSH terms: Postoperative Period
Renal function following liver transplantation for unresectable hepatoblastoma

Lee WS, Grundy R, Milford DV, Taylor CM, de Ville de Goyet J, McKiernan PJ, et al.

Pediatr Transplant, 2003 Aug;7(4):270-6.
PMID: 12890004

Combination of cyclosporine (CsA) and tacrolimus immunosuppression post-liver transplantation (LT) and the chemotherapeutic drugs used to treat hepatoblastoma (HB), are nephrotoxic. We aimed to determine the severity and duration of nephrotoxicity in children following LT for unresectable HB. We reviewed all children undergoing LT for unresectable HB at the Liver Unit, Birmingham Children's Hospital, UK, from 1991 to July 2000. Thirty-six children undergoing LT for biliary atresia, matched for age and sex, were selected as controls to compare pre- and post-LT renal function. Renal function was determined by estimation of glomerular filtration rate (eGFR) derived from plasma creatinine using Schwartz's formula. Twelve children with HB (mean age of diagnosis 33 months) who underwent LT (mean age 47 months) and 36 controls (mean age of LT 34 months) were studied. CsA was the main immunosuppressive drug used in each group. The median eGFR before, and at 3, 6, 12, 24 and 36 months after LT in HB group was significantly lower than controls (93 vs. 152, 66 vs. 79, 62 vs. 86, 66 vs. 87, 64 vs. 94, 53 vs. 90 mL/min/1.73 m2, respectively; 0.01 < p < 0.03). The reductions in the median eGFR of both the HB group and controls before and at 36 months after LT were 49 and 41%, respectively. At 36 months after LT, there was a trend for partial recovery of the eGFR in the controls but not in the HB group. Children who underwent LT for unresectable HB had renal dysfunction before transplantation that persisted for 36 months after LT.

Matched MeSH terms: Postoperative Period
Study of viridans streptococci and Staphylococcus species in cleft lip and palate patients before and after surgery

Arief EM, Mohamed Z, Idris FM

Cleft Palate Craniofac J, 2005 May;42(3):277-9.
PMID: 15865462

OBJECTIVE: To determine the effect of surgery on types and colony count of Streptococcus and Staphylococcus species in cleft lip and palate (CLP) patients.
DESIGN: Saliva samples were collected after the morning meal by placing a sterile cotton swab in the vestibule of the oral cavity from cleft lip and palate patients immediately preoperative and 12 weeks postoperative. Normal children were examined as a control group. Samples were cultured; Staphylococcus and Streptococcus isolates were identified and quantified.
PATIENTS: Fifteen cleft lip and palate patients and 22 normal children, aged 3 to 39 months were examined.
RESULTS: Streptococcus mitis biovar 1, Streptococcus salivarius and Streptococcus oralis of the viridans group of streptococci were the most commonly found in normal children, as well as in cleft lip and palate children. In the cleft lip and palate group, mean streptococcal count was 32.41 (29.80) and 46.46 (42.80) in the pre- and postoperative periods, respectively; in the normal group, the count was 20.93 (27.93) and 49.92 (34.72) at 0 week and 12 weeks, respectively. Staphylococcus aureus was the most common Staphylococcus species found in CLP patients, representing 47.4% postoperatively. In the cleft lip and palate children, mean staphylococcal count was 5.34 (8.13) and 0.56 (0.92) in the pre- and postoperative periods, respectively; in normal children, the count was 0.82 (1.98) and 0.60 (2.55) at 0 and 12 weeks, respectively. The differences were statistically significant only for the staphylococcal count between pre- and postoperative periods in children with cleft lip and palate as tested by analysis of variance (p < .05).
CONCLUSIONS: Cleft lip and palate patients had more colonization by S. aureus compared with normal children, and the colony count decreased significantly following surgical repair of the cleft lip and palate.

Matched MeSH terms: Postoperative Period
Fulltext Functional outcome after major lower extremity amputation: a survey on lower extremity amputees

Wan Hazmy CH, Chia WY, Fong TS, Ganendra P

Med J Malaysia, 2006 Feb;61 Suppl A:3-9.
PMID: 17042220

The post-operatve course of amputees is poorly documented. This cross-sectional survey was unertaken to determine functional outcomes of 213 patients who had undergone either a below-knee or above-knee amputation from 2000 to 2002 in a state-hospital setting. The study comprises a self-constructed questionnaire and interview conducted by phone. Of the 213 amputees, 41 out of 61 documented telephone numbers of the patients were useful for contact. Only 30 amputees were available for the study as the remaining 11 had passed away. Included in the questionnaire was the modified Barthel Index, a measurement to assess the amputees' ability to carry out activities of daily living (ADL). It contains ten questions pertaining to ADL with a total score of 20 points. Two-thirds of the respondents (67%) use their prosthesis for less than six hours per day. The Barthel Index of 30 patients ranged from 9-20 (mean 17.7). However, the mean Barthel Index in those with and without prosthesis was 18.4 and 15.2 respectively, but this difference was not significant. Half of the respondents were unable to maintain their pre-amputation jobs, while the remaining 50% were still able to work. Forty seven percent of amputees took less than a year to return to their activities, while 33% took between one to two years. Regarding the adequacy of preamputation information provided by the doctors, 73% amputees responded in the affirmative, while 27% felt otherwise. Amputees were still facing substantial disabilities following major amputation of the lower limb. Although 80% of respondents surveyed own prosthesis, the full use of prosthesis is suboptimal due to prosthetic-related problems. Most amputees had a good functional outcome based on the modified Barthel Index. Some amputees were unhappy as they felt that they were insufficiently informed regarding post-amputation expectation prior to the amputation. Despite good support from family, the community support for amputees is still lacking.

Matched MeSH terms: Postoperative Period*
Fulltext Femoral overgrowth following plate fixation of the fractured femur in children

Sulaiman AR, Joehaimy J, Iskandar MA, Anwar Hau M, Ezane AM, Faisham WI

Singapore Med J, 2006 Aug;47(8):684-7.
PMID: 16865208

The purpose of this study is to determine the overgrowth phenomenon of the affected femur following plate fixation of femoral fractures in children.

Matched MeSH terms: Postoperative Period
Fulltext A comparative study of intravenous patient-controlled analgesia morphine and tramadol in patients undergoing major operation

Hadi MA, Kamaruljan HS, Saedah A, Abdullah NM

Med J Malaysia, 2006 Dec;61(5):570-6.
PMID: 17623958

The success of major surgery depends partly on providing effective post-operative pain relief, which can be commonly achieved by morphine administration via patient- controlled analgesic (PCA) system. Alternatively, tramadol which is a weak opioid analgesic, can be used for post operative pain relief. The purpose of this study was to evaluate the effectiveness of intravenous PCA tramadol in comparison with PCA morphine in term of analgesic properties, sedation and side effects. A randomized, double-blinded study was conducted on 160 ASA I and II patients who underwent major operations. Eighty of them received a loading dose of intravenous morphine 0.1 mg/kg followed by PCA morphine bolus of 1 mg (1 mg/ml) as required, while the other 80 patients received a loading dose of 2.5 mg/kg of intravenous tramadol followed by PCA infusion of 10 mg (10 mg/ml) as required. Patients were monitored for pain, sedation and side effects as well as respiratory rate, nausea, vomiting, pruritus, blood pressure and pulse rate. Patients were evaluated 30 minutes, 4 hours, 24 hours and 48 hours post operation. There were no differences in the demographic data between the two groups (p > 0.05). The overall mean pain score in tramadol group was 0.70 +/- 0.60 as compared to 0.75 +/- 0.67 for morphine group. The mean pain score for tramadol and morphine groups at 30 minutes, 4 hours, 24 hours and 48 hours post operation were 1.32 +/- 0.79, 104 +/- 0.79, 0.35 +/- 0.48, 0.09 +/- 0.33 and 1.35 +/- 0.99, 1.14 +/- 0.81, 0.40 +/- 0.54, 0.10 +/- 0.34 respectively. The overall mean sedation score in tramadol and morphine group was 0.39 +/- 0.44 as compared to 0.35 +/- 0.43 for morphine group. The mean sedation score for tramadol and morphine group at 30 minutes, 4 hours, 24 hours and 48 hours post operation were 0.90 +/- 0.74, 0.56 +/- 0.59, 0.075 +/- 0.27, 0.025 +/- 0.16 and 0.84 +/- 0.70, 0.46 +/- 0.64, 0.08 +/- 0.27, 0.01 +/- 0.11 respectively. There was no significant difference in the overall mean pain and sedation score between the two groups as well as for each duration assessed (p > 0.05). There were also no significant differences between the two groups with regard to the blood pressure and heart rate. The incidence of nausea, vomiting and pruritus were the same in the two groups. This study indicates that PCA tramadol is as equally effective as PCA morphine control following major surgery. The incidences of sedation, nausea or pruritus were the same in the two groups.

Matched MeSH terms: Postoperative Period
Fulltext Post-cardiac surgery patient satisfaction with quality nursing care at institute jantung negara (ijn)

Ho, Siew Eng, Gurbinder Kaur, Syed Rozaidi Wafa, Syed Zulkifli Syed Zakaria, Razali Omar

Medicine & Health, 2006;1(1):14-19.
MyJurnal

Quality nursing care has a great impact on patient satisfaction. Quality nursing care is perceived by the post cardiac surgery patient, as the degree of physical, emotional and spiritual needs that have to be fulfilled while hospitalisation. The objective of this study was to identify factors in quality nursing care that determine post cardiac patient satisfaction. This single cross-sectional descriptive study using ‘NURSQUAL’ instrument consisted of four elements; technical competence, information giving, assurance and empathy to measure patient satisfaction with quality nursing care. It consisted of four research questions with 33 items to measure the four elements. Between January to March 2005, 52 post cardiac surgery patients from Institute Jantung Negara (IJN), who fulfilled the inclusion criteria were recruited for this study. There was a significant difference between technical competence, information giving, assurance and empathy with patient satisfaction with p value < 0.05. The element of assurance made the strongest statistically significant unique contribution to the prediction of patient satisfaction with a p value < 0.05.

Matched MeSH terms: Postoperative Period
Fulltext Primary hyperparathyroidism with hungry bone syndrome - A Case Report

Norazmi, K., Khairul, A.J.

International Medical Journal Malaysia, 2007;6(2):1-7.
MyJurnal

Primary hyperparathyroidism with severe bone disease as a result of excessive parathyroid hormone ( PTH ) release and severe hypercalcaemia can lead to 'hungry bone syndrome' (HBS) post operatively. This is due to sudden cessation of PTH and drop in serum calcium. We reported a case a young man with primary hyperparathyriodism due to a single parathyroid adenoma with severe bone disease and post operatively developed hungry bone syndrome.

Matched MeSH terms: Postoperative Period
Fulltext Effectiveness of cataract surgery with intraocular lens implantation: a comparative study between extracapsular cataract extraction and phacoemulsification

Rizal, A.M., Muhammad, M., Aljunid, S.M., Normalina, M., Faridah Hanom, A., Chuah, K.L., et al.

Malaysian Journal of Community Health, 2007;13(1):32-37.
MyJurnal

Background: A randomised single blinded clinical trial comparing the effectiveness of two methods of cataract surgery with intraocular lens implantation: extracapsular cataract extraction (ECCE) and phacoemulsification (PEA) was carried out at Hospital Universiti Kebangsaan Malaysia (HUKM) between March 2000 and August 2001. Methods: The effectiveness of cataract surgery was assessed from the quality of life specifically for vision via Visual Function 14 (VF-14) preoperatively, one week, two months and six months after surgery. Results: The result showed that there was a significant increased in VF-14 scores after a week, two months and six months postoperation compared to the score before surgery for both techniques. However there was no significant difference in VF-14 scores when compared between ECCE and PEA. Conclusions: This study indicated that both techniques give equal benefit to cataract patients. Since effectiveness of cataract surgery with intraocular lens implantation is unrelated to operative procedures, less costly technique should be promoted.

Matched MeSH terms: Postoperative Period
Ethnic differences in pain perception and patient-controlled analgesia usage for postoperative pain

Tan EC, Lim Y, Teo YY, Goh R, Law HY, Sia AT

J Pain, 2008 Sep;9(9):849-55.
PMID: 18550441 DOI: 10.1016/j.jpain.2008.04.004

There are reports suggesting that sensitivity to and tolerance of both clinical and experimental pain differ among ethnic groups. We examined self-rated pain score and morphine usage in 1034 women who underwent elective lower cesarian section (LSCS) for their deliveries. Data on pain scores and amount of total morphine use according to patient-controlled analgesia were collected every 4 hours. Overall, lowest pain scores were recorded 12 hours after surgery and highest at 24 hours. Morphine consumption was highest within the first 4 hours and lowest between 12 and 16 hours. There were statistically significant ethnic group differences in pain scores (P = 1.7 x 10(-7)) and morphine usage (P = 2.8 x 10(-15)) between ethnic groups, with Indians having the highest mean pain score and using the highest amount of morphine. The ethnic differences in pain score and morphine self-administration persisted after controlling for age, body mass index, and duration of operation.

Matched MeSH terms: Postoperative Period
Fulltext Functional Outcome After Arthroscopic Rotator Cuff Repair - An Early Experience

Khoo, S.W., Khoo, S.M., Yeong, Y.K., Towil, B.

Malays Orthop J, 2009;3(2):29-32.
MyJurnal

According to recently reported outcome studies, functional outcomes after arthroscopic rotator cuff repair are reasonable and comparable to open or mini-open techniques. We report the functional outcomes after arthroscopic rotator cuff repair of 10 consecutive patients. The average age was 53.9(range 46-59) years. There was a significant improvement of the function of the shoulder when the preoperative scores were compared with those at the time of at least six months follow-up (range of 6 months to 18 months). With the UCLA rating scale, the average total score increased from preoperative 9.8 (range, 6-15) to postoperative 32.6 (range,23-35). With the use of ASES shoulder index, the average total score improved from 14.6 range, 1.6-35) to 92.3 (range,66.6 to 100). We concluded that arthroscopic rotator cuff repair is a treatment method in selective patients with symptomatic rotator cuff pathology to alleviate shoulder pain and improve function.

Matched MeSH terms: Postoperative Period
Fulltext Endoscopic Carpal Tunnel Release - A Prospective Study of Functional Outcome

Ravindran, T., Sara, T., Loh, Y.C.

Malays Orthop J, 2009;3(1):46-52.
MyJurnal

To evaluate the functional outcome of patients who underwent endoscopic carpal tunnel release (ECTR). This was a prospective study in 24 patients with idiopathic carpal tunnel syndrome undergoing ECTR. Patient assessment entailing both subjective and objective tests at intervals of two and six weeks, three, six and nine months and finally at one year postoperatively. Our assessment results showed overall improvement in symptoms. As early as two weeks post-operatively, there was a low incidence of pillar pain and scar tenderness, allowing patients to return to work early. There were no serious complications. ECTR can be effectively performed with a low perioperative and late postoperative rate of complications. This minimally invasive method can be an option of surgical treatment for patients with carpal tunnel syndrome, who intend to return to work soon after surgery.

Matched MeSH terms: Postoperative Period
Fulltext Young patients with colorectal cancer have poor survival in the first twenty months after operation and predictable survival in the medium and long-term: analysis of survival and prognostic markers

Chan KK, Dassanayake B, Deen R, Wickramarachchi RE, Kumarage SK, Samita S, et al.

World J Surg Oncol, 2010;8:82.
PMID: 20840793 DOI: 10.1186/1477-7819-8-82

This study compares clinico-pathological features in young (<40 years) and older patients (>50 years) with colorectal cancer, survival in the young and the influence of pre-operative clinical and histological factors on survival.

Matched MeSH terms: Postoperative Period
Fulltext Causative Factors for Femoral Pin Track Fractures inNavigated Total Knee Arthroplasty

Ewe, T.W., Chee, E.K., Chooi, Y.S., Ng, W.M.

Malays Orthop J, 2010;4(1):8-11.
MyJurnal

This retrospective radiographic analysis of 57 patients (62 knees) examined two possible factors involved in pin tract fractures of the femur due to navigated total knee arthroplasty (TKA): the angle of the tracker pin with respect to the lateral femoral cortex, and the distance between the tracker pin and the lateral joint line. Our findings demonstrate a relationship between postoperative pin tract induced stress fractures (3 patients), with pin tract angles exceeding 15Â°. Pin placement at a site more than 10cm from the lateral joint line, did not show any significant association with risk of fracture. These findings lead to enhanced understanding of the causative factors underlying pin track femoral fractures in TKAs.

Matched MeSH terms: Postoperative Period

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