Displaying publications 1 - 20 of 43 in total

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  1. Lichterman BL, Wong SN, Likhterman LB
    World Neurosurg, 2019 Aug;128:149-157.
    PMID: 31042604 DOI: 10.1016/j.wneu.2019.04.178
    The article is dedicated to the life and work of Dr. Roy Selby (1930-2002), an American neurosurgeon who founded neurosurgery in Malaysia. Dr. Selby stayed in Malaysia from July 1963 to May 1970. He opened the first neurosurgical department at the general hospital in Kuala Lumpur and established a training program under which Malaysian physicians and nurses were sent to neurosurgery centers in the United States and Canada. Some physicians came back and headed local neurosurgical units. On his return to the United States, Dr. Selby practiced neurosurgery until 1986, when he had to give it up due to the impact of progressive congestive heart failure. From 1986 to 1994, Dr. Selby taught graduate courses in the Department of Psychology at East Texas State University, Texarkana, Texas. He was a pioneer of spinal surgery and founded the Lumbar Spine Society. Dr. Selby was a world citizen neurosurgeon and advocated international standards of training in neurosurgery. From 1985 to 1994, he was chairman of the Archives Committee of the American Association of Neurological Surgeons. Dr. Selby serves as a model of a physician as a humanist.
    Matched MeSH terms: Neurosurgery/education; Neurosurgery/history*
  2. Sriram PR
    Asian J Neurosurg, 2017 11 9;12(4):766-768.
    PMID: 29114307 DOI: 10.4103/1793-5482.185055
    Primary orbital lymphoma is a rare entity with only 1% of extranodal lymphomas. They usually present to ophthalmologist and surgical reserved for biopsy or tissue diagnosis. We present a patient who was referred to neurosurgery for a rapid growing orbital lymphoma. It grows from a small nodule in the eyelid to a huge, aggressive, disfiguring lesion invading bone and dura with intracranial extension within 3 months. The patient was treated with total surgical excision followed by systemic chemotherapy.
    Matched MeSH terms: Neurosurgery
  3. Theophilus SC, Adnan JS
    Malays J Med Sci, 2011 Jan;18(1):30-7.
    PMID: 22135571
    BACKGROUND: A double-blind randomised control study was conducted on all patients who were admitted or referred to the Department of Neurosurgery, Sultanah Aminah Hospital, Johor Bahru, with a diagnosis of hydrocephalus where a ventriculoperitoneal shunt was indicated.
    METHODS: The period of study was from November 2005 to May 2007, and the follow-up period was 3 months after surgery. Randomisation was carried out in the operating room prior to the procedure. The scrub nurse selected a sealed envelope, which contained the assignment of each patient to 1 of 2 treatment groups: Group 1 patients were treated with topical methicillin, and Group 2 patients were not treated with topical methicillin. Prophylactic antibiotic, cefuroxime (25 mg/kg) was given intravenously at induction. Standard sterile operative technique was followed in preparing and draping the patients.
    RESULTS: A total of 90 patients were recruited in the study, and 13 (14.4%) patients developed an infection within 3 months post-operation. Group 1 had a 8.9% risk of infection, and Group 2 had a 20% risk; however, there was no statistically significant post-operative ventriculoperitoneal shunt (VPS) infection reduction with the use of topical methicillin in VPS surgery (P = 0.230). Multivariate analysis showed that only duration of surgery had a significant influence on the incidence of post-operative VPS infection in the non-methicillin group (P = 0.02). The non-methicillin group had an 8 times greater risk of developing post-operative VPS infection than the methicillin group if surgery lasted longer than 1 hour.
    CONCLUSION: Topical methicillin had no significance in the reduction of post-operative VPS infection.
    KEYWORDS: methicillin; neurosurgery; post-operative wound infection; topical administration; ventriculoperitoneal shunt
    Study site: Patient admitted or referred to Hospital Sultanah Aminah Johor Bahru, Johor, Malaysia
    Matched MeSH terms: Neurosurgery
  4. Chong SL, Khan UR, Santhanam I, Seo JS, Wang Q, Jamaluddin SF, et al.
    BMJ Open, 2017 Aug 18;7(8):e015759.
    PMID: 28821516 DOI: 10.1136/bmjopen-2016-015759
    OBJECTIVE: We aim to examine the mechanisms of head-injured children presenting to participating centres in the Pan Asian Trauma Outcomes Study (PATOS) and to evaluate the association between mechanism of injury and severe outcomes.

    DESIGN AND SETTING: We performed a retrospective review of medical records among emergency departments (EDs) of eight PATOS centres, from September 2014 - August 2015.

    PARTICIPANTS: We included children <16 years old who presented within 24 hours of head injury and were admitted for observation or required a computed tomography (CT) of the brain from the ED. We excluded children with known coagulopathies, neurological co-morbidities or prior neurosurgery. We reviewed the mechanism, intent, location and object involved in each injury, and the patients' physical findings on presentation.

    OUTCOMES: Primary outcomes were death, endotracheal intubation or neurosurgical intervention. Secondary outcomes included hospital and ED length of stay.

    RESULTS: 1438 children were analysed. 953 children (66.3%) were male and the median age was 5.0 years (IQR 1.0-10.0). Falls predominated especially among children younger than 2 years (82.9%), while road traffic injuries were more likely to occur among children 2 years and above compared with younger children (25.8% vs 11.1%). Centres from upper and lower middle-income countries were more likely to receive head injured children from road traffic collisions compared with those from high-income countries (51.4% and 40.9%, vs 10.9%, p<0.0001) and attended to a greater proportion of children with severe outcomes (58.2% and 28.4%, vs 3.6%, p<0.0001). After adjusting for age, gender, intent of injury and gross national income, traffic injuries (adjusted OR 2.183, 95% CI 1.448 to 3.293) were associated with severe outcomes, as compared with falls.

    CONCLUSIONS: Among children with head injuries, traffic injuries are independently associated with death, endotracheal intubation and neurosurgery. This collaboration among Asian centres holds potential for future prospective childhood injury surveillance.

    Matched MeSH terms: Neurosurgery
  5. Abdullah JM
    Malays J Med Sci, 2015 May-Jun;22(3):1-6.
    PMID: 26715890
    16 years have passed since the idea was mooted in 1999 by five neurosurgeons in the corridors of Hotel Perdana, Kota Bharu. They were Dato' Dr Johari Siregar Bin Adnan, Dato' Professor Dr Ahmad Zubaidi Abdul Latif , Dr Azmin Kass Bin Rosman, Dato' Dr Mohammed Saffari Bin Mohammed Haspani and Professor Dato' Dr Jafri Malin Abdullah. They initiated the beginning of the first programme in Neurosurgery in Malaysia. The rest is history.
    Matched MeSH terms: Neurosurgery
  6. Hassan MH, Hassan WMNW, Zaini RHM, Shukeri WFWM, Abidin HZ, Eu CS
    Malays J Med Sci, 2017 Oct;24(5):83-93.
    PMID: 29386975 MyJurnal DOI: 10.21315/mjms2017.24.5.9
    Background: Normal saline (NS) is a common fluid of choice in neurosurgery and neuro-intensive care unit (ICU), but it does not contain other electrolytes and has the potential to cause hyperchloremic metabolic acidosis with prolonged infusion. These problems may be reduced with the availability of balanced fluid (BF), which becomes a more physiological isotonic solution with the presence of complete electrolyte content. This study aimed to compare the changes in electrolytes and acid-base between NS and BF (Sterofundin® ISO) therapy for post-operative severe traumatic brain injury (TBI) patients in neuro-ICU.

    Methods: Sixty-six severe TBI patients who required emergency craniotomy or craniectomy and were planned for post-operative ventilation were randomised into NS (n = 33) and BF therapy groups (n = 33). The calculation of maintenance fluid given was based on the Holliday-Segar method. The electrolytes and acid-base parameters were assessed at an 8 h interval for 24 h. The data were analysed using repeated measures ANOVA.

    Results: The NS group showed a significant lower base excess (-3.20 versus -1.35, P = 0.049), lower bicarbonate level (22.03 versus 23.48 mmol/L, P = 0.031), and more hyperchloremia (115.12 versus 111.74 mmol/L, P < 0.001) and hypokalemia (3.36 versus 3.70 mmol/L, P < 0.001) than the BF group at 24 h of therapy. The BF group showed a significantly higher level of calcium (1.97 versus 1.79 mmol/L, P = 0.003) and magnesium (0.94 versus 0.80 mmol/L, P < 0.001) than the NS group at 24 h of fluid therapy. No significant differences were found in pH, pCO2, lactate, and sodium level.

    Conclusion: BF therapy showed better effects in maintaining higher electrolyte parameters and reducing the trend toward hyperchloremic metabolic acidosis than the NS therapy during prolonged fluid therapy for postoperative TBI patients.

    Matched MeSH terms: Neurosurgery
  7. Rethinasamy R, Alias A, Kandasamy R, Raffiq A, Looi MC, Hillda T
    Malays J Med Sci, 2019 Sep;26(5):139-147.
    PMID: 31728126 MyJurnal DOI: 10.21315/mjms2019.26.5.13
    Background: Neurosurgical patients are varied, encompassing cranial and spinal diseases and trauma, and are admitted under both elective and emergency settings. In all settings, neurosurgery patients are at risk of deep vein thrombosis. D-dimer and ultrasound Doppler have long been good screening and confirmatory tools for the diagnosis of deep vein thrombosis (DVT). We conducted a study to identify the factors associated with DVT among neurosurgical patients, and the overall rate of occurrence at our centre. We aimed to also compare our results to the incidence in similar studies elsewhere in which more judicious use of pharmacological prophylaxis was undertaken. We also included the Well's score to validate its usefulness in screening for DVT in our local setting.

    Methods: All patients admitted into our centre were screened for eligibility and those who underwent surgery from September 2016 to September 2017 had a D-dimer screening after surgery, followed by an ultrasound Doppler if the former was positive. The choice of anticoagulant therapy was not influenced by this study, and observation of the use was in keeping with usual practices in our centre was done.

    Results: A total number of 331 patients were recruited in this study, however, after the inclusion and exclusion criteria had been met, 320 patients remained eligible, i.e. suitable for analysis. The mean age of our patients was 46 years, with 66% being male patients. A majority of the cases in this study were cranial related, with only 5% being spine surgeries. On the multivariate analysis, the Well's score and the number of days in bed remained statistically significant, after adjusting for age group, gender, ethnicity, type of central venous access and type of DVT prophylaxis with an adjusted odd's ratio, and a confidence interval of 95%, and P < 0.05 for each.

    Conclusion: Well's scoring and number of days in bed were independent factors affecting the rate of DVT in patients undergoing neurosurgical procedures in our centre.

    Matched MeSH terms: Neurosurgery
  8. Othman AK, Udin N, Shab MS, Hamzah NA, Mat Azmi IS, Naing NN
    Med J Malaysia, 2020 11;75(6):705-709.
    PMID: 33219181
    INTRODUCTION: Brain tumour (BT) is a tremendous burden on patients, families as well as the surrounding communities, especially the healthcare services. It can be classified into either a benign slow growing tumour (non-cancerous) and malignant tumour (cancerous). The purpose of this study was to determine the incidence and pattern of brain tumour admitted to the Neurosurgery Department in Hospital Sultanah Nurzahirah (HSNZ), Terengganu, Malaysia.

    METHODS: This is a retrospective study of incidence and pattern of BT admitted to the Neurosurgery Department in HSNZ. Data was collected from the yearly census of BT registered from 2013 to 2018.

    RESULTS: A total number of 386 new cases of primary BT were registered. The number of cases of BT was found to be lowest among children (0 to 10 years old) with only 4.4% but at peak among elderly aged between 51 to 60 years old (26.2%). As for gender, males constituted about 44.5% (n=172) whereas females accounted for 55.5% (n= 214) of the cases. In total, meningioma was found to have the highest incidence (27.2%) followed by metastases brain tumour (18.1%) and glioma (17.4%).

    CONCLUSIONS: This study has shown that the incidence of BT was led by meningioma which had a high prevalence among the elderly population, followed by metastasis BT and gliomas.

    Matched MeSH terms: Neurosurgery
  9. Ghilan K, Mehmood A, Ahmed Z, Nahari A, Almalki MJ, Jabour AM, et al.
    Saudi J Biol Sci, 2021 Jan;28(1):643-650.
    PMID: 33424351 DOI: 10.1016/j.sjbs.2020.10.055
    Background: Efficiency remains one of the most important drivers of decision making in health care system. Fund allocators need to receive structured information about the cost healthcare services from hospitals for better decisions related to resource allocation and budgeting. The objective of the study was to estimate the unit cost for health services offered to inpatients in King Fahd Central hospital (KFCH) Jazan during the financial year 2018.

    Methods: We applied a retrospective approach using a top-down costing method to estimate the cost of health care services. Clinical and Administrative departments divided into cost centres, and the unit cost was calculated by dividing the total cost of final care cost centres into the total number of patients discharged in one year. The average cost of inpatient services was calculated based on the average cost of each ward and the number of patients treated.

    Results: The average cost per patient stayed in KFCH was SAR 19,034, with the highest cost of SAR 108,561 for patients in the Orthopedic ward. The average cost of the patient in the Surgery ward, Plastic surgery, Neurosurgery, Medical ward, Pediatric ward and Gynecology ward was SAR 33,033, SAR 29,425, SAR 23,444, SAR 20,450, SAR 9579 and SAR 8636 respectively.

    Conclusion: This study provides necessary information about the cost of health care services in a tertiary care setting. This information can be used as a primary tool and reference for further studies in other regions of the country. Hence, this data can help to provide a better understanding of tertiary hospital costing in the region to achieve the privatization objective.

    Matched MeSH terms: Neurosurgery
  10. Loewenthal J, Kenny PG, Seng YG
    Aust N Z J Surg, 1974 Jul;44(3):211-4.
    PMID: 4618111
    Matched MeSH terms: Neurosurgery/history*
  11. Waran V, Thillainathan R, Karuppiah R, Pickard JD
    World Neurosurg, 2022 01;157:135-142.
    PMID: 34687934 DOI: 10.1016/j.wneu.2021.10.112
    BACKGROUND: The provision of equitable and affordable health care has become increasingly challenging as advanced technology is introduced, particularly in developing countries. We explored the hypothesis that focused, small-scale mini-public-private partnerships have a potential role in providing equitable and affordable access to advanced technology for the benefit of all patients in developing nations, particularly middle-income countries.

    METHODS: A clinician-led financial plan was developed at the University of Malaya to create the Centre for Image Guidance and Minimally Invasive Therapy (CIGMIT) to provide an integrated platform for high-end care for Malaysian patients of all ages, both public and private, requiring complex neurosurgical and spinal procedures and stereotactic and intensity-modulated radiotherapy. The challenges faced during development of the plan were documented together with an audit of patient throughput and analyses of financial risk and return.

    RESULTS: CIGMIT opened in 2015. Patient throughput, both public and private, progressively increased in all facilities. In 2015-2019, 37,724 patients used the Centre's facilities. CIGMIT has become progressively more profitable for the University of Malaya, the public and private hospitals, and the investor. CIGMIT has weathered the challenges posed by coronavirus disease 19.

    CONCLUSIONS: Focused, small-scale mini-public-private partnerships have a potential role in providing advanced technology for the benefit of patients in developing nations, particularly middle-income countries, subject to an approach that balances equity of access between public and private health care systems with fair reward.

    Matched MeSH terms: Neurosurgery/organization & administration*
  12. Gendeh BS
    Indian J Otolaryngol Head Neck Surg, 2010 Sep;62(3):264-76.
    PMID: 23120724 DOI: 10.1007/s12070-010-0077-6
    Sinus surgery has the potential of allowing ENT surgeons to encroach the boundaries of our colleagues in ophthalmology and neurosurgery. The advent of nasal endoscope and lately powered instrumentation and computer-assisted navigational systems has avoided the use of the conventional and more radical approaches by the ENT surgeon for the treatment of inflammatory pathology or tumors of the orbit and skull base. As rhinologists have gained more experience in endoscopic surgery, more areas related to the orbit and the anterior skull base are accessible and surgery is safer.
    Matched MeSH terms: Neurosurgery
  13. Chee CP
    Neurosurgery, 1988 Apr;22(4):780-2.
    PMID: 3374793
    The author describes a new operative method for treating chronic recurrent subdural hematoma. The subdural pocket is exteriorized so that it is in continuity with the subgaleal space through a limited extradural pocket and an L-shaped linear craniectomy. This procedure has been carried out in two patients with recurrent chronic subdural hematoma, both of whom made complete recoveries despite initial recurrence of the subdural hematoma.
    Matched MeSH terms: Neurosurgery/methods
  14. Ng WP, Liew BS, Idris Z, Rosman AK
    Malays J Med Sci, 2017 Mar;24(2):78-86.
    PMID: 28894407 MyJurnal DOI: 10.21315/mjms2017.24.2.10
    BACKGROUND: High grade gliomas (HGGs) are locally invasive brain tumours that carry a dismal prognosis. Although complete resection increases median survival, the difficulty in reliably demonstrating the tumour border intraoperatively is a norm. The Department of Neurosurgery, Hospital Sungai Buloh is the first public hospital in Malaysia to overcome this problem by adopting fluorescence-guided (FG) surgery using 5-aminolevulinic acid (5-ALA).

    METHODS: A total of 74 patients with histologically proven HGGs treated between January 2008 and December 2014, who fulfilled the inclusion criteria, were enrolled. Kaplan-Meier survival estimates and Cox proportional hazard regression were used.

    RESULTS: Significant longer survival time (months) was observed in the FG group compared with the conventional group (12 months versus 8 months, P < 0.020). Even without adjuvant therapy, HGG patients from FG group survived longer than those from the conventional group (8 months versus 3 months, P = 0.006). No significant differences were seen in postoperative Karnofsky performance scale (KPS) between the groups at 6 weeks and 6 months after surgery compared to pre-operative KPS. Cox proportional hazard regression identified four independent predictors of survival: KPS > 80 (P = 0.010), histology (P < 0.001), surgical method (P < 0.001) and adjuvant therapy (P < 0.001).

    CONCLUSION: This study showed a significant clinical benefit for HGG patients in terms of overall survival using FG surgery as it did not result in worsening of post-operative function outcome when compared with the conventional surgical method. We advocate a further multicentered, randomised controlled trial to support these findings before FG surgery can be implemented as a standard surgical adjunct in local practice for the benefit of HGG patients.

    Matched MeSH terms: Neurosurgery
  15. Mehbodniya AH, Moghavvemi M, Narayanan V, Waran V
    World Neurosurg, 2019 Feb;122:e449-e454.
    PMID: 30347306 DOI: 10.1016/j.wneu.2018.10.069
    BACKGROUND: Navigation (image guidance) is an essential tool in modern neurosurgery, and most surgeons use an optical tracking system. Although the technology is accurate and reliable, one often is confronted by line of sight issues that interrupt the flow of an operation. There has been feedback on the matter, but the actual problem has not been accurately quantified, therefore making this the primary aim of this study. It is particularly important given that robotic technology is gradually making its way into neurosurgery and most of these devices depend on optical navigation when procedures are being conducted.

    METHODS: In this study, the frequency and causes of line of sight issues is assessed using recordings of Navigation probe locations and its synchronised video recordings.

    RESULTS: The mentioned experiment conducted for a series of 15 neurosurgical operations. This issue occured in all these surgeries except one. Maximum duration of issue presisting reached up to 56% of the navigation usage time.

    CONCLUSIONS: The arrangment of staff and equipment is a key factor in avoiding this issue.

    Matched MeSH terms: Neurosurgery
  16. Raffiq A, Abdullah JM, Haspani S, Adnan JS
    Malays J Med Sci, 2015 Dec;22(Spec Issue):5-8.
    PMID: 27006632 MyJurnal
    The development of neurosurgical services and training in Malaysia began in 1963, with the first centre established in its capital city at Hospital Kuala Lumpur, aimed to provide much needed neurosurgical services and training in the field of neurology and neurosurgery. This center subsequently expanded in 1975 with the establishment of the Tunku Abdul Rahman Neuroscience Institute (IKTAR); which integrated the three allied interdependent disciplines of neurosurgery, neurology and psychiatry. The establishment of this institute catalysed the rapid expansion of neurosurgical services in Malaysia and paved the way for development of comprehensive training for doctors, nurses, and paramedics. This culminated in the establishments of a local comprehensive neurosurgery training program for doctors in 2001; followed by a training program for nurses and paramedics in 2006. To date, there are more than 60 neurosurgeons providing expert care in 11 centers across Malaysia, along with trained personnel in the field of neurosciences.
    Matched MeSH terms: Neurosurgery
  17. Idris B, Sayuti S, Abdullah JM
    J Clin Neurosci, 2007 Feb;14(2):148-52.
    PMID: 17161289
    Universiti Sains Malaysia is the only institution in Malaysia which incorporates all fields of the neurosciences under one roof. The integration of basic and clinical neurosciences has made it possible for this institution to become an excellent academic and research centre. This article describes the history, academic contributions and scientific progress of neurosciences at Universiti Sains Malaysia.
    Matched MeSH terms: Neurosurgery/history*
  18. Wittayanakorn N, Nga VDW, Sobana M, Bahuri NFA, Baticulon RE
    World Neurosurg, 2020 12;144:e164-e177.
    PMID: 32805466 DOI: 10.1016/j.wneu.2020.08.073
    OBJECTIVE: Neurosurgery departments worldwide have been forced to restructure their training programs because of the coronavirus disease 2019 (COVID-19) pandemic. In this study, we describe the impact of COVID-19 on neurosurgical training in Southeast Asia.

    METHODS: We conducted an online survey among neurosurgery residents in Indonesia, Malaysia, Philippines, Singapore, and Thailand from May 22 to 31, 2020 using Google Forms. The 33-item questionnaire collected data on elective and emergency neurosurgical operations, ongoing learning activities, and health worker safety.

    RESULTS: A total of 298 of 470 neurosurgery residents completed the survey, equivalent to a 63% response rate. The decrease in elective neurosurgical operations in Indonesia and in the Philippines (median, 100% for both) was significantly greater compared with other countries (P < 0.001). For emergency operations, trainees in Indonesia and Malaysia had a significantly greater reduction in their caseload (median, 80% and 70%, respectively) compared with trainees in Singapore and Thailand (median, 20% and 50%, respectively; P < 0.001). Neurosurgery residents were most concerned about the decrease in their hands-on surgical experience, uncertainty in their career advancement, and occupational safety in the workplace. Most of the residents (n = 221, 74%) believed that the COVID-19 crisis will have a negative impact on their neurosurgical training overall.

    CONCLUSIONS: An effective national strategy to control COVID-19 is crucial to sustain neurosurgical training and to provide essential neurosurgical services. Training programs in Southeast Asia should consider developing online learning modules and setting up simulation laboratories to allow trainees to systematically acquire knowledge and develop practical skills during these challenging times.

    Matched MeSH terms: Neurosurgery/education*
  19. Baticulon RE, Nga VDW, Sobana M, Bahuri NFA, Wittayanakorn N
    World Neurosurg, 2021 Feb;146:427.
    PMID: 33607747 DOI: 10.1016/j.wneu.2020.11.056
    Matched MeSH terms: Neurosurgery*
  20. Waran V, Narayanan V, Karuppiah R, Pancharatnam D, Chandran H, Raman R, et al.
    J Surg Educ, 2014 Mar-Apr;71(2):193-7.
    PMID: 24602709 DOI: 10.1016/j.jsurg.2013.08.010
    The traditionally accepted form of training is direct supervision by an expert; however, modern trends in medicine have made this progressively more difficult to achieve. A 3-dimensional printer makes it possible to convert patients imaging data into accurate models, thus allowing the possibility to reproduce models with pathology. This enables a large number of trainees to be trained simultaneously using realistic models simulating actual neurosurgical procedures. The aim of this study was to assess the usefulness of these models in training surgeons to perform standard procedures that require complex techniques and equipment.
    Matched MeSH terms: Neurosurgery/education*
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