Displaying publications 21 - 40 of 186 in total

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  1. Shahrun Niza AS, Nani Harlina ML, Razrim R, Ussof Eskaandar MH, Rohaizak M
    MyJurnal
    A surgeon’s experience plays an important role in breast conserving surgery (BCS). The common conception is that, the more junior is the operating surgeon, the surgical margin will be wider or closer to the tumour edge. Thus the aim of this study is to look into the adequacy of surgical margin performed by different level of surgeons’ experience in patients whom underwent wide local excision (WLE) and hook-wire localization (HWL) in our surgical unit. The surgical experience of the operating surgeon and their surgical margins will be analyzed. This is a retrospective study from January 2000 to December 2012. Eighty-eight patients with early breast cancer underwent WLE and HWL by 3 different groups of surgeons (breast surgeons, junior surgeons and surgical registrars) were included. The surgical margins were analyzed for involved-margin, closed-margin or excessed-margin.The incidence of involved-margin, closed-margin and excessed-margin is the lowest among breast surgeons compared to other groups. However, the results were not statistically significant. The incidence of involved surgical margin is significantly higher within junior surgeons for HWL compared to the breast surgeons. The incidence of involved, closed or excessed surgical margin were lowest when performed by breast surgeon but not significantly different between the three groups. However, for HWL the breast surgeons significantly better compared to the other groups.
    Matched MeSH terms: Surgeons
  2. Sivananthan, K., Drabu, K.J.
    Malays Orthop J, 2009;3(1):42-45.
    MyJurnal
    The number of hip replacement procedures in the United States is expected to increase four-fold by 2030. Younger patients, those under 65 years old, are expected to account for 53% of hip replacements in 2030, compared to 44% in 2005. As midterm review results are becoming available worldwide now, the problem that perplexes surgeons is the alteration of limb length which has been an ancillary goal of Total Hip Replacements. The lack of modularity in neck lengths and offsets in resurfacing arthroplasty clearly limits the change in limb lengths achievable for the hip. The goal of this study is to scrutinize the various parameters that affect implant seating in resurfacing arthroplasty and to determine the alteration of limb length achievable during surgery.
    Matched MeSH terms: Surgeons
  3. Ariffuddin I, Arman Zaharil MS, Wan Azman WS, Ahmad Sukari H
    Med J Malaysia, 2018 04;73(2):112-113.
    PMID: 29703876 MyJurnal
    High failure rate for recurrent palatal fistulas closure pose a great challenge to plastic surgeons. Tongue and facial artery musculomucosal (FAMM) flaps are the more commonly used flaps for closure of these recurrent fistulas. We report a case of a formerly inset FAMM flap to effectively close a previously repaired oronasal fistula.
    Matched MeSH terms: Surgeons
  4. Nazri Mohd Yusof
    MyJurnal
    Gastrocnemius flap is the workhorse for wound coverage in the proximal
    tibia. It can be perform by general orthopaedic surgeon because it is done without the
    need of microscopic instrumentation. Its coverage can be extended to cover the knee
    and midshaft of tibia when skin overlying it is included in the flap. (Copied from article).
    Matched MeSH terms: Orthopedic Surgeons
  5. Saad-Ilyas M, Zehra U, Khan UU, Mohammad I, Muhammad R, Aziz A
    Malays Orthop J, 2021 Mar;15(1):72-78.
    PMID: 33880151 DOI: 10.5704/MOJ.2103.011
    Introduction: The study aimed to target the current practices of the orthopaedic community in outpatient (OPD), emergency (ER) and surgical services (OT) during COVID-19.

    Material and method: This study surveyed 303 orthopaedic surgeons from all over Pakistan. The survey had 30 questions targeting the setup of outpatient, emergency and operation services in orthopaedic departments of different hospitals in Pakistan.

    Result: A total of 302 surgeons were included from 53 cities all over Pakistan. Between 35-48% of the respondents reported lack of availability of standard operating procedures in OPD, ER and in OT. Majority of the respondents noted that their OPD and surgical practice had been affected to some degree and 69% of the surgeons were only doing trauma surgery. This trend was higher in younger consultants of less than 45 years of age (p<0.001). Almost two-third of the surgeons, mostly senior (p=0.03) were using surgical masks as the only protective measure during various practices of OPD, ER and OT, while most of the setups were not assessing patients even for signs and symptoms of COVID. Almost 89% of the orthopaedic community is facing definite to mild stress during this pandemic and this has significantly affected the senior surgeons (p=0.01).

    Conclusion: Our study highlighted that COVID-19 has resulted in marked changes to the practices of the majority of Pakistani orthopaedic surgeons. Despite a sharp upsurge in the number of cases and mortality due to COVID-19, guidelines were still lacking at most of the settings and a substantial percentage of the orthopaedic community were not following adequate safety measures while attending to patients.

    Matched MeSH terms: Surgeons; Orthopedic Surgeons
  6. Jain VK, Upadhyaya GK, Iyengar KP, Patralekh MK, Lal H, Vaishya R
    Malays Orthop J, 2021 Mar;15(1):55-62.
    PMID: 33880149 DOI: 10.5704/MOJ.2103.009
    Introduction: The social lockdown measures imposed to contain the COVID-19 pandemic, have had profound effects on the healthcare systems across the world and India has been no exception to it. The study was aimed to evaluate the impact of COVID-19 on orthopaedic practice in India during the lockdown period and assess the preparedness of orthopaedic surgeons for resuming clinical practice after the initial lockdown was lifted.

    Materials and Methods: An online survey of 35 questions was conducted to evaluate impact on (i) general orthopaedic practice (ii) hospital protocols (iii) out-patient practice (iv) surgical practice (v) personal protective equipment (PPE) use and (vi) post-lockdown preparedness.

    Results: A total number of 588 practising orthopaedic surgeons from India completed the survey. Majority (88.3%) found severe impact (>50%) on trauma surgery and non-trauma surgery with significant reduction in out -patient attendance compared to corresponding time in 2019. There were significant changes made in individual hospital protocols (91.7 %). Appropriate required PPE was available in majority of the hospitals (74.3%). No remodelling or upgrading of the existing operating theatre infrastructure was done by most surgeons (89.5%).

    Conclusion: This pan India survey of orthopaedic surgeons has indicated that COVID-19 has had a profound impact on their outpatient and surgical trauma and non-trauma practice, due to the lockdown and resulted in significant changes to hospital protocols. Preparedness to resume clinical and surgical practice was associated with anxiety in two-thirds of the respondents. Majority of the orthopaedic practitioners felt that they would continue to conduct pre-operative COVID-19 screening and use PPE even after the lockdown is over.

    Matched MeSH terms: Surgeons; Orthopedic Surgeons
  7. Pasternak JD, Imisairi AH, Rinkes IHMB, Kruijff S
    World J Surg, 2020 08;44(8):2667-2668.
    PMID: 32424458 DOI: 10.1007/s00268-020-05583-2
    Matched MeSH terms: Surgeons/education*
  8. Tan K, Kwek E
    Malays Orthop J, 2020 Mar;14(1):24-27.
    PMID: 32296478 DOI: 10.5704/MOJ.2003.004
    Introduction: Orthopaedic surgeons are significantly predisposed to musculoskeletal injury, and these injuries can have negative effects on surgeon function and patient outcomes. While this phenomenon has been studied in the non-Asian population of surgeons, no study has been carried out in the local or regional Asian setting. The aim of this study was to determine the prevalence, characteristics and associations of occupational injuries in orthopaedic surgeons and residents, and to assess its functional impact.

    Materials and Methods: The Nordic Musculoskeletal Questionnaire was sent out to all orthopaedic consultants and residents at two institutions in Singapore, via an email link to an online survey. Separately, further questions on symptom description, severity and treatment were surveyed. Additional information like age, gender, height and weight were obtained as well.

    Results: A total of 87.5% respondents have at least one injury. Neck symptoms (66.1%) were the most prevalent, and back symptoms had the highest median severity score (4.5/10). The 74.1% of these injuries were reported as directly attributable to work. Age was found to be associated with an increase in the total number of anatomical areas affected (p = 0.016). A seated operating position was associated with more severe back pain (p = 0.040).

    Conclusion: There is a high prevalence of occupational injuries sustained in our population of orthopaedic surgeons. Neck symptoms, followed by back and wrist symptoms, were the predominant symptoms in our population. Targeted ergonomic interventions may be considered to prevent specific musculoskeletal injuries in our population of orthopaedic surgeons.

    Matched MeSH terms: Surgeons; Orthopedic Surgeons
  9. Abu-Hammad S, Elsayed SA, Nourwali I, Abu-Hammad O, Sghaireen M, Abouzaid BH, et al.
    J Craniomaxillofac Surg, 2020 Apr;48(4):458-462.
    PMID: 32184074 DOI: 10.1016/j.jcms.2020.02.023
    OBJECTIVES: This study aimed to explore gender differences on career satisfaction among oral and maxillofacial surgeons (OMFS) and to compare their views on female gender representation in leadership and mentorship positions.

    METHODS: A questionnaire was distributed among a sample of female and male OMFS surgeons in Egypt, Jordan and Saudi Arabia. Data were statistically analyzed to calculate significant differences between gender groups.

    RESULTS: A total of 110 (70 males and 40 females) or (18.7%) of a total of 587 (OMFS) surgeons in the three countries participated. Respondents had a mean age of: 39.2 ± 9.0 years (range = 25-60 years). Significantly more males (60) than females (24) indicated satisfaction with their careers (P = 0.008), and significantly more males (66) than females (23) thought that OMFS is the right specialty for them (P 

    Matched MeSH terms: Oral and Maxillofacial Surgeons*
  10. Chung WH, Mihara Y, Chiu CK, Hasan MS, Chan CYW, Kwan MK
    Clin Spine Surg, 2022 Feb 01;35(1):18-23.
    PMID: 33979103 DOI: 10.1097/BSD.0000000000001186
    STUDY DESIGN: This was a retrospective study.

    SUMMARY OF BACKGROUND DATA: Prolonged operation duration in adolescent idiopathic scoliosis (AIS) surgery was associated with increased perioperative complications. However, the factors affecting operation duration in AIS surgery were unknown.

    OBJECTIVE: The aim of the study was to investigate the factors affecting operation duration in posterior spinal fusion (PSF) surgery using a dual attending surgeon strategy among Lenke 1 and 2 AIS patients.

    METHODS: In all, 260 AIS patients with Lenke 1 and 2 curves who underwent PSF were retrospectively reviewed. Preoperative and intraoperative factors affecting operation duration such as age, sex, height, weight, body mass index, Risser grade, Lenke subtypes, number of fusion level, number of screws, screw density, wound length, upper and lowest instrumented vertebrae level, preoperative Cobb angle, and flexibility of the major curve were assessed using univariate and multivariate linear regression analyses. Independent factors were determined when P-value <0.05.

    RESULTS: The mean operation duration was 122.2±28.6 minutes. Significant independent factors affecting operation duration in PSF among Lenke 1 and 2 AIS patients were Lenke 2 subtypes (β=8.86, P=0.008), number of screws (β=7.01, P<0.001), wound length (β=1.14, P=0.009), and flexibility of the major curve (β=-0.25, P=0.005). The overall model fit was R2=0.525. Operation duration can be predicted using the formula: (8.86×Lenke subtypes)+(7.01×number of screws)+(1.14×wound length)-(0.25×flexibility)-0.54, where Lenke 2=1 and Lenke 1=0.

    CONCLUSION: The factors affecting operation duration in PSF among Lenke 1 and 2 AIS patients were Lenke 2 curves, number of screws, wound length, and curve flexibility. The knowledge of these factors enables the spinal deformity surgeons to plan and estimate the operation duration before AIS surgery.

    Matched MeSH terms: Surgeons*
  11. 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.

    Matched MeSH terms: Surgeons*
  12. Sharouny H, Narayanan P
    Iran Red Crescent Med J, 2015 Jan;17(1):e17104.
    PMID: 25763256 DOI: 10.5812/ircmj.17104
    INTRODUCTION: Frontal sinus mucoceles are the commonest among all paranasal mucoceles. With introduction of functional endoscopic sinus surgery, surgeons prefer endoscopic management of sinus mucoceles, but lesions that appear in the lateral part of the frontal sinus can be difficult to access and often need external approaches.

    CASE PRESENTATION: We described a lateral frontal sinus mucocele with intra-orbital extension, which was successfully managed by endoscopic sinus surgery.

    CONCLUSIONS: Endoscopic sinus surgery is the treatment of choice in most frontal sinus mucoceles including lateral frontal mucoceles.

    Matched MeSH terms: Surgeons
  13. Wijesuriya LI
    Malays Fam Physician, 2007;2(3):106-9.
    PMID: 25606095 MyJurnal
    Acute appendicitis has been known as a disease entity for well over a century but a confident diagnosis before surgery in all patients suspected of the condition is still not possible. Timely diagnosis is essential to minimise morbidity due to possible perforation of the inflamed organ in the event treatment is delayed; so much so that surgeons often preferred to operate at the slightest suspicion of the diagnosis in the past. This resulted in the removal of many normal appendixes. When the diagnosis of appendicitis is clear from the history and clinical examination, then no further investigation is necessary and prompt surgical treatment is appropriate. Where there is doubt about the diagnosis however it is advisable to resort to imaging studies such as abdominal ultrasound or computed tomography to clear such suspicions before subjecting the patient to an appendicectomy. These studies would also help avoid delays in surgery in deserving patients.
    Matched MeSH terms: Surgeons
  14. Ling JL, Teo SH, Mohamed Al-Fayyadh MZ, Mohamed Ali MR, Ng WM
    Arthroscopy, 2019 02;35(2):596-604.
    PMID: 30611592 DOI: 10.1016/j.arthro.2018.08.038
    PURPOSE: To assess the effectiveness of a low-cost self-made arthroscopic camera (LAC) in basic arthroscopic skills training compared with a commercial arthroscopic camera (CAC).

    METHODS: One hundred fifty-three orthopaedic residents were recruited and randomly assigned to either the LAC or CAC. They were allocated 2 practice sessions, with 20 minutes each, to practice 4 given arthroscopic tasks: task 1, transferring objects; task 2, stacking objects; task 3, probing numbers; and task 4, stretching rubber bands. The time taken for participants to complete the given tasks was recorded in 3 separate tests; before practice, immediately after practice, and after a period of 3 months. A comparison of the time taken between both groups to complete the given tasks in each test was measured as the primary outcome.

    RESULTS: Significant improvements in time completion were seen in the post-practice test for both groups in all given arthroscopic tasks, each with P < .001. However, there was no significant difference between the groups for task 1 (P = .743), task 2 (P = .940), task 3 (P = .932), task 4 (P = .929), and total (P = .944). The outcomes of the tests (before practice, after practice, and at 3 months) according to repeated measures analysis of variance did not differ significantly between the groups in task 1 (P = .475), task 2 (P = .558), task 3 (P = .850), task 4 (P = .965), and total (P = .865).

    CONCLUSIONS: The LAC is equally as effective as the CAC in basic arthroscopic skills training with the advantage of being cost-effective.

    CLINICAL RELEVANCE: In view of the scarcity in commercial arthroscopic devices for trainees, this low-cost device, which trainees can personally own and use, may provide a less expensive and easily available way for trainees to improve their arthroscopic skills. This might also cultivate more interest in arthroscopic surgery among junior surgeons.

    Matched MeSH terms: Surgeons
  15. Ong, A.H.
    Ann Dent, 1997;4(1):-.
    MyJurnal
    The palatal root of the first permanent molar is the most commonly deflected root into the maxillary sinus during extraction. A rational approach to the surgical removal of a root from the antrum is important. Some surgeons prefer the alveolar approach while others prefer the Caldwell-Luc operation. A case is presented where the palatal root tip of the left upper first molar was removed from the maxillary sinus by the Caldwell-Luc approach with simultaneous closure of the oro-antral fistula resulting from dental extraction. A fibreoptic light probe was used. The advantages and disadvantages as well as how to avoid the common complications of this surgical technique are discussed. A good result was achieved with successful removal of the root and no loss of sensibility of the teeth and/or gum for this case.
    Matched MeSH terms: Surgeons
  16. Choong C, Shalimar A, Jamari S
    Malays Orthop J, 2015 Nov;9(3):52-54.
    PMID: 28611911 MyJurnal DOI: 10.5704/MOJ.1511.017
    Brachial plexus injuries with intact yet flail limb presents with problems of persistent neuropathic pain and recurrent shoulder dislocations, that render the flail limb a damn nuisance. As treating surgeons, we are faced with the dilemma of offering treatment options, bearing in mind the patient's functional status and expectations. We present a case of a 55-year old housewife with complete brachial plexus injury begging for surgical amputation of her flail limb, 6 years post-injury. Here we discuss the outcome of transhumeral amputation and the possibility of offering early rather than delayed amputations in this group of patients.
    Matched MeSH terms: Surgeons
  17. Anuar R, Gooi SG, Zulkiflee O
    Malays Orthop J, 2015 Nov;9(3):71-74.
    PMID: 28611917 MyJurnal DOI: 10.5704/MOJ.1511.019
    The supracondylar humerus fracture (SCHF) in children is common and can be complicated with nerve injury either primarily immediate post-trauma or secondarily posttreatment. The concept of neurapraxic nerve injury makes most surgeons choose to 'watch and see' the nerve recovery before deciding second surgery if the nerve does not recover. We report three cases of nerve injury in SCHF, all of which underwent nerve exploration for different reasons. Early reduction in the Casualty is important to release the nerve tension before transferring the patient to the operation room. If close reduction fails, we proceed to explore the nerve together with open reduction of the fracture. In iatrogenic nerve injury, we recommend nerve exploration to determine the surgical procedure that is causing the injury. Primary nerve exploration will allow early assessment of the injured nerve and minimize subsequent surgery.
    Matched MeSH terms: Surgeons
  18. Koh PS, Chan SC
    J Nat Sci Biol Med, 2017 Jan-Jun;8(1):4-10.
    PMID: 28250667 DOI: 10.4103/0976-9668.198356
    Adult-to-adult living donor liver transplantation (LDLT) is widely accepted today with good outcomes and safety reported worldwide for both donor and recipient. Nonetheless, it remained a highly demanding technical and complex surgery if undertaken. The last two decades have seen an increased in adult-to-adult LDLT following our first report of right lobe LDLT in overcoming graft size limitation in adults. In this article, we discussed the operative techniques and challenges of adult right lobe LDLT incorporating the middle hepatic vein, which is practiced in our center for the recipient operation. The various issues and challenges faced by the transplant surgeon in ensuring good recipient outcome are explored and discussed here as well. Hence, it is important to understand that a successful recipient operation is dependent of multifactorial events starting at the preoperative stage of planning, understanding the intraoperative technical challenges and the physiology of flow modulation that goes hand-in-hand with the operation. Therefore, one needs to arm oneself with all the possible knowledge in overcoming these technical challenges and the ability to be flexible and adaptable during LDLT by tailoring the needs of each patient individually.
    Matched MeSH terms: Surgeons
  19. Roslan EJ, Kelly EG, Zain MA, Basiron NH, Imran FH
    Med J Malaysia, 2017 02;72(1):85-87.
    PMID: 28255154 MyJurnal
    Breast reconstructive surgery has evolved tremendously since its inception. Following tumour clearance surgery, physical restoration with breast reconstruction is an important aspect of physical and emotional rehabilitation. Various methods have been described to suit patients demand for the best aesthetic outcome. Surgeon's preference, experience and practicality of differing procedures must be considered. We describe a simultaneous bilateral breast reconstruction with free deep inferior epigastric (DIEP) flap and pedicled transverse rectus abdominis musculocutaneous (TRAM) flap immediately post mastectomies for bilateral breast cancers. The surgery described has resulted in a reasonable technical ease, acceptable flap and abdominal morbidity and good aesthetic outcome.
    Matched MeSH terms: Surgeons
  20. Amran, A.R., Azlin Saat, Cheung, H.S.
    MyJurnal
    Invasive Lobular Carcinoma of the breast is less common than Invasive Ductal Carcinoma and the presentation can be different from other types of breast carcinomas. It can present as diffuse swelling or thickening of breast rather than a mass. Sometimes, it can present as metastatic deposits from a very small primary breast lesion. These make the diagnosis of this type of breast carcinoma difficult and challenging for the radiologist and surgeon. We describe a case of Invasive Lobular Carcinoma of the breast, which presented with a left sterno-chondral metastasis and discuss the imaging findings and treatment of this condition.
    Matched MeSH terms: Surgeons
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