Displaying publications 41 - 60 of 188 in total

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  1. 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
  2. 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
  3. Dhillon KS
    Malays Orthop J, 2015;9(1):47-59.
    MyJurnal
    Conflicts of interest in medicine has created deep concerns about the integrity of medicine and raised doubts about the trustworthiness of the medical professional. New stories of conflict of interest in medicine have become a commonplace. The interactions between the medical professional and the biomedical device as well as the pharmaceutical industry has become so pervasive that the primary interest of the medical professional in protecting and promoting the welfare of the patient has been compromised. The professional judgement and actions have been influenced by secondary interests, the major fungible and quantifiable being financial interest. The industry influence not only affects the way we practice orthopaedics but also affects medical education and peer review publications. Peer review publications have been shown to exaggerate benefits of the industry products while at the same time downplaying the risks. These conflicts of interest in orthopaedic surgery are particularly common in spinal and joint replacement surgery where joint replacement has been described as a ‘fashion trade’. The introduction of new products appears to be an uncontrolled experiment which has been hijacked by large corporations. This article explores the unhealthy pervasive interaction between the orthopaedic surgeon and the medical devices as well as the pharmaceutical industry. It highlights how the biomedical and the pharmaceutical industry dominate all aspects of the healthcare system. With its wealth and political clout, its influence is present everywhere, from the use of devices and drugs, research, publications, trials, education and even formulation of CGPs.
    Matched MeSH terms: Surgeons
  4. Lee BH, Ho SW, Kau CY
    Malays Orthop J, 2018 Mar;12(1):54-56.
    PMID: 29725516 DOI: 10.5704/MOJ.1803.013
    Surgical fixation of hip fractures in patients with below knee amputation is challenging due to the difficulty in obtaining optimal traction for reduction of the fracture. Surgeons may face difficulty in positioning such patients on the traction table due to the absence of the foot and distal lower limb. There are several techniques described to overcome this technical difficulty. In this case report, we present a case of a 64-year old gentleman with bilateral below knee amputation presenting with a comminuted right intertrochanteric fracture. We highlight a simple and effective method of applying skin traction to obtain adequate reduction for hip fracture fixation.
    Matched MeSH terms: Surgeons
  5. Ahmad Faidzal Othman, Mohamad NorHisham, Azmi Abdul Rahman
    MyJurnal
    Symptomatic arterial pseudoaneurysm is not an uncommon emergent
    vascular case presenting to a tertiary hospital. These are mainly associated with
    infection, iatrogenic puncture or trauma. The resultant morbidity, limb loss and
    mortality present a challenge to the surgeons managing these cases. (Copied from article).
    Matched MeSH terms: Surgeons
  6. 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: Surgeons
  7. Gunasagaran J, Rasid RJ, Mappiare S, Devarajooh C, Ahmad TS
    Malays Orthop J, 2018 Jul;12(2):37-41.
    PMID: 30112127 MyJurnal DOI: 10.5704/MOJ.1807.007
    Introduction: Microsurgery is a subspecialised field which requires high technical skill. Laboratory training offers good opportunity for novice surgeons to learn and repetitively practise their skills prior to hands-on clinical practice. Commonly, the training programme consists of models in a stepwise increase in fidelity: from latex sheet to anaesthetised rat. We introduce microgrids model as a daily warm up procedure in a 5-day basic microsurgery course. The purpose of this study is to evaluate the correlation between microgrids colouring under magnification with microsuturing proficiency among novice surgeons. Materials and Methods: Participants were required to fill in microgrids under magnification everyday during their 5-day training as a starter test. The number of completely filled in microgrids in 20 seconds was recorded. A simulated cut on latex sheet was sutured and the time taken to apply five sutures was recorded. The sutures were evaluated with modified Global Rating Scale (GRS). Data was analysed with SPSS. Results: There was a statistically significant correlation between the number of microgrids coloured and the time taken to apply five sutures (p<0.01). An increase in number of microgrids coloured was significantly associated with the increase in quality of the suturing technique (p< 0.01). During the 5-day basic microsurgery skills training for novice surgeons, microsuturing skill improvement correlated with microgrid colouring. Conclusion: Microgrids colouring reflected microsuturing proficiency. It is an inexpensive, readily available, and simple model of 'warm up' for hand dexterity. The microgrids model can function as a starter test for initial training and a quick screening measure to assess microsurgical skill.
    Matched MeSH terms: Surgeons
  8. Abdullah SN, Abdullah B
    Cureus, 2020 May 15;12(5):e8132.
    PMID: 32550052 DOI: 10.7759/cureus.8132
    During endoscopic sinus and skull base surgeries, surgical landmarks are routinely used to guide surgeons navigating in the narrow corridor of the sinonasal region. Risk of complications is higher in difficult cases when there is excessive bleeding or alteration of the normal anatomical landmarks by tumour. An additional landmark is advantageous to prevent complications and serves as a guide. We present a case of supreme turbinate found incidentally during an endoscopic transsphenoidal surgery. Not much is known about the role of supreme turbinate. When it is present, the sphenoid ostium is located medial to its posteroinferior attachment, and behind its vertical part. Hence, the identification of this structure serves as an additional landmark besides superior turbinate during surgery.
    Matched MeSH terms: Surgeons
  9. Rao M, Ashwini LS, Somayaji SN, Mishra S, Guru A, Rao A
    Oman Med J, 2011 Nov;26(6):e027.
    PMID: 28861181 DOI: 10.5001/omj.2011.120
    Variation in the origin of long flexor tendons in the anterior compartment of forearm is common. During routine cadaveric dissection at Melaka Manipal Medical College (Manipal Campus), we observed a separate muscle belly and tendon of flexor digitorum superficialis (FDS) to the fifth digit in the right upper limb of a 60 year-old male cadaver. The anomalous muscle belly originated from the common flexor tendon from the medial epicondyle of the humerus and continued as a thin tendon at the middle of the forearm to get inserted into the middle phalanx of the fifth digit. This can be considered as a case of split flexor digitorum superficialis. Such muscle variations and knowledge of their frequency, appearance, and location can be helpful for surgeons.
    Matched MeSH terms: Surgeons
  10. Perumall VV, Sellamuthu P, Harun R, Zenian MS
    Asian J Neurosurg, 2015 Jan-Mar;10(1):1-4.
    PMID: 25767567 DOI: 10.4103/1793-5482.151500
    Healthcare costs continue to rise every day as the demand outgrows the supply of surgeons. The application of telephone consultation for immediate management is needed as most neurosurgeons are technology orientated. This enables a specialist at a remote mobile site to receive the necessary information and reduce transmission time, from the second the patient is seen till the management is obtained.
    Matched MeSH terms: Neurosurgeons; Surgeons
  11. Ab Ghani A, Nayan SA, Kandasamy R, Rosman AK, Ghani AR
    Malays J Med Sci, 2016 Nov;23(6):113-117.
    PMID: 28090185 MyJurnal DOI: 10.21315/mjms2016.23.6.12
    The annual incidence of intracranial aneurysm in Malaysia is estimated to be 1.1-1.7 per 100,000 population based on a study done conducted in 1988. Since then, little epidemiological research has been conducted in Malaysia, and the real incidence is therefore probably unreported despite advancements in the diagnosis and treatment of this disorder. Intracranial aneurysm may be treated by microsurgical clipping or embolisation depending on its location and the surgeon's preference. This study aims to report the characteristics and outcomes of patients with a clipped anterior circulation aneurysm in Hospital Sungai Buloh.
    Matched MeSH terms: Surgeons
  12. Watters DA, McCaig E, Nagra S, Kevau I
    Br J Surg, 2019 01;106(2):e53-e61.
    PMID: 30620072 DOI: 10.1002/bjs.11057
    BACKGROUND: There is a surgical workforce shortage in Papua New Guinea (PNG), the Pacific and Timor Leste. Previously, Pacific Island specialists who trained overseas tended to migrate.

    METHODS: A narrative review was undertaken of the training programmes delivered through the University of Papua New Guinea and Fiji National University's Fiji School of Medicine, and support provided through Australian Aid and the Royal Australasian College of Surgeons (RACS), including scholarships and visiting medical teams.

    RESULTS: The Fiji School of Medicine MMed programme, which commenced in 1998, has 39 surgical graduates. Sixteen of 22 Fijians, nine of ten Solomon Islanders and four of five in Vanuatu currently reside and/or work in-country. Surgical training in PNG began in 1975, and now has 104 general surgical graduates, 11 of whom originate from the Pacific Islands or Timor Leste. The PNG retention rate of local graduates is 97 per cent, with 80 per cent working in the public sector. Twenty-two surgeons have also undertaken subspecialty training. Timor Leste has trained eight surgical specialists in PNG, Fiji, Indonesia or Malaysia. All have returned to work in-country. The RACS has managed Australian Aid programmes, providing pro bono visiting medical teams to support service delivery and, increasingly, capacity building in the region. The RACS has funded scholarships and international travel grants to further train or sustain the surgical specialists.

    CONCLUSION: The local MMed programmes have been highly successful in retaining specialists in the region. Partnerships with Australian Aid and RACS have been effective in ensuring localization of the faculty and ongoing professional development.

    Matched MeSH terms: Surgeons/education*; Surgeons/statistics & numerical data
  13. Chan CYW, Chong JSL, Lee SY, Ch'ng PY, Chung WH, Chiu CK, et al.
    Spine (Phila Pa 1976), 2020 Dec 01;45(23):1661-1667.
    PMID: 32756286 DOI: 10.1097/BRS.0000000000003641
    STUDY DESIGN: Prospective study.

    OBJECTIVE: To determine the parents'/patients' perception on the informed consent process prior to posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS) patients.

    SUMMARY OF BACKGROUND DATA: Understanding parents/patients perspective on the process is important in order to achieve the goal of consent and prevent medico-legal implications.

    METHODS: Fifty AIS patients operated between August 2019 and November 2019 were prospectively recruited. Parents'/patients' perceptions on three sections were evaluated: the process of the informed consent, specific operative risk which they were most concerned with and the accountability of surgeons for the surgical risks. These data were ranked and scored using a 5-point Likert Scale. Preferences were reported in mean and standard deviation. Differences in terms of preferences were studied using One-way analysis of variance (ANOVA) analysis and deemed significant when P 

    Matched MeSH terms: Surgeons/psychology*; Surgeons/standards
  14. Ariffin M, Lloyd S, Rhani S, Kamalnizat, Baharudin A
    Malays Orthop J, 2014 Jul;8(2):40-2.
    PMID: 25279091 DOI: 10.5704/MOJ.1407.001
    The management of post-radiation wound breakdown over the posterior cervico thoracic region can be a challenging task for a surgeon. The aim of the treatment is to produce a well vascularized and a low tensile flap which will close a large defect. We describe the use of the lower trapezius flap to reconstruct the wound breakdown and to obtain stable tissue coverage in a patient with postradiation necrosis. This flap minimizes the disruption of the scapula-thoracic function while preserving the range of movement over the shoulder. From the literature review, it was noted that the dorsal scapular artery (DSA) and transverse cervical artery (TCA) aid in the blood supply to the trapezius muscle and prevent local necrosis during rotation of the flap. The trapezius flap is widely accepted because of the minor donor site morbidity, large arc of rotation and adequate blood supply.
    Matched MeSH terms: Surgeons
  15. Ng HK, Yaakub A, Ong LB
    Malays Fam Physician, 2014;9(3):42-8.
    PMID: 26425305 MyJurnal
    Full thickness macular hole is an eye disease, which can cause permanent visual impairment. Current advancement in vitreoretinal surgery has high success rates in repairing them, leading to a significant visual improvement, especially if patient presents early. In this article, three cases of idiopathic full thickness macular hole with different visual outcomes have been presented. All cases were referred by the primary care practitioners and had undergone macular hole surgery with the same vitreoretinal surgeon. The visual outcome was best in the patient who had the earliest presentation and referral. Early detection and referral of these patients is vital so that early surgical intervention can be carried out to improve their vision.
    Matched MeSH terms: Surgeons
  16. Anusha B, Baharudin A, Philip R, Harvinder S, Shaffie BM, Ramiza RR
    Surg Radiol Anat, 2015 Dec;37(10):1183-90.
    PMID: 25990686 DOI: 10.1007/s00276-015-1494-8
    Failure of a surgeon to understand the local variations of the anatomical landmarks of the sphenoid sinus is a potential risk factor to cause damage to the optic nerve (ON) or internal carotid artery (ICA) that lies on the walls of the sphenoid sinus. The aim of this study was to identify the anatomical variants of the sphenoid sinus and its related surrounding structures among the Southeast Asian (SEA) population, based on computed tomography (CT) scans.
    Matched MeSH terms: Surgeons
  17. Rasappan K, Oh J
    Malays Orthop J, 2020 Nov;14(3):1-3.
    PMID: 33403055 DOI: 10.5704/MOJ.2011.001
    As the COVID-19 pandemic ravages the whole world, the frontline clinicians are tirelessly fighting to contain and manage the disastrous effects of the virus from their communities. Stress, despair, fear, physical and psychological burn out, decreased work out put and lowered morale are some side effects this endless battle has had on the frontline healthcare worker. Although there have been many accounts of surgeons working in the frontline, there have only been few reflections on this ongoing battle from the junior clinician's point of view. In this article, we feature the perspectives of young residents from the orthopaedic unit at the epicenter of the COVID-19 fight in Singapore. We highlight the thoughts, fears, emotions, morale, motivating factors and reflections of junior clinicians while they work at frontlines. Fear in a dangerous new environment and amidst uncertainty is natural. However, a doctor's call of duty goes far above fear.
    Matched MeSH terms: Surgeons
  18. Chung WH, Tan RL, Chiu CK, Kwan MK, Chan C
    Malays Orthop J, 2020 Nov;14(3):170-173.
    PMID: 33403080 DOI: 10.5704/MOJ.2011.027
    Delayed post-operative spinal epidural haematoma (DPSEH) is diagnosed when the onset of symptoms is more than three days from the index surgery. DPSEH is a rare but serious complication of spinal surgery. Missed diagnosis will result in irreversible neurological deficit which may lead to permanent disabilities. We report two cases of DPSEH who presented with worsening neurological deficit four days after the index surgery. Magnetic resonance imaging (MRI) showed the presence of an epidural haematoma compressing the spinal cord. Surgical evacuation of haematoma were performed for both patients. Both patients experienced neurological improvement. Surgeons should have high index of suspicion to identify delayed onset of spinal epidural haematoma (SEH) and timely intervention should be taken to avoid irreversible neurological damage.
    Matched MeSH terms: Surgeons
  19. Gafoor AM, Reynu R, Kirubakaran M, Vimal Kumar V, Nik Ritza NM, Tikfun G, et al.
    Med J Malaysia, 2021 03;76(2):229-232.
    PMID: 33742633
    The rise in obesity has fuelled the current debate of its classification as a disease. Contrary to just being a medical condition or a risk factor for other diseases, obesity is a complex disease with multifaceted aetiology as well as its own disabling capacities, pathophysiology, and comorbidities. The problem of obesity in Malaysia is serious and calls for active intervention by all stakeholders ranging from government agencies to insurers and healthcare providers. To aid efforts to curb obesity, this consensus statement for bariatric surgery provides a basis for inclusion and exclusion criteria as well as the types of procedures accepted as the norm in Malaysia. This consensus statement was initiated by the Society of Endoscopic and Laparoscopic Surgeons of Malaysia and was collaborated with representatives from the Ministry of Health Malaysia.
    Matched MeSH terms: Surgeons
  20. Ramos AC, Chevallier JM, Mahawar K, Brown W, Kow L, White KP, et al.
    Obes Surg, 2020 May;30(5):1625-1634.
    PMID: 32152841 DOI: 10.1007/s11695-020-04519-y
    BACKGROUND: One-anastomosis gastric bypass (OAGB-MGB) is currently the third performed primary bariatric surgical procedure worldwide. However, the procedure is hampered by numerous controversies and there is considerable variability in surgical technique, patient selection, and pre- and postoperative care among the surgeons performing this procedure. This paper reports the results of a modified Delphi consensus study organized by the International Federation for Surgery of Obesity and Metabolic Disorders (IFSO).

    METHODS: Fifty-two internationally recognized bariatric experts from 28 countries convened for voting on 90 consensus statements over two rounds to identify those on which consensus could be reached. Inter-voter agreement of ≥ 70% was considered consensus, with voting participation ≥ 80% considered a robust vote.

    RESULTS: At least 70% consensus was achieved for 65 of the 90 questions (72.2% of the items), 61 during the first round of voting and an additional four in the second round. Where consensus was reached on a binary agree/disagree or yes/no item, there was agreement with the statement presented in 53 of 56 instances (94.6%). Where consensus was reached on a statement where options favorable versus unfavorable to OAGB-MGB were provided, including statements in which OAGB-MGB was compared to another procedure, the response option favorable to OAGB-MGB was selected in 13 of 23 instances (56.5%).

    CONCLUSION: Although there is general agreement that the OAGB-MGB is an effective and usually safe option for the management of patients with obesity or severe obesity, numerous areas of non-consensus remain in its use. Further empirical data are needed.

    Matched MeSH terms: Surgeons
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