Displaying publications 61 - 80 of 188 in total

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  1. Pazarci O, Torun Y, Ozturk A, Oztemur Z
    Malays Orthop J, 2020 Jul;14(2):83-89.
    PMID: 32983381 DOI: 10.5704/MOJ.2007.016
    Introduction: The performance of the drilling process depends on the characteristics of the drilling equipment and surgeon's skill. To our knowledge, no research has focused on multi-parameter analysis of the dynamic behaviour of drills during the drilling process. This study aimed to characterise the physical changes and effects of different drills attached to a robotic arm during drilling of artificial bones in a standardised experimental setup.

    Material and Methods: Drilling processes using three brands of drills attached to a robotic arm were compared in terms of thrust force, vibration, noise level, speed deviation, and temperature. A standardised experimental setup was constructed, and measurement data were analysed statistically. Identical artificial bones were drilled 10 times with each drill.

    Results: Thrust force measurements, which varied through the cortex and medulla, showed expressive differences for each drill for maximum and mean values (p<0.001). Meaningful differences were obtained for mean vibration values and noise level (p<0.001). Speed variation measurements in drilling showed conspicuous differences with confident statistics (p<0.001). Induced temperature values were measured statistically for Drill 1, Drill 2, and Drill 3 as 78.38±11.49°C, 78.11±7.79°C, and 89.77±7.79°C, respectively.

    Conclusion: Thrust force and drill bit temperature were strongly correlated for each drill. Vibration values and noise level, which also had an influential relationship, were in the acceptable range for all experiments. Both thrust force and speed deviation information could be used to detect the drill bit status in the bone while drilling.

    Matched MeSH terms: Surgeons
  2. Al-Abdullah KI, Lim CP, Najdovski Z, Yassin W
    Int J Med Robot, 2019 Jun;15(3):e1989.
    PMID: 30721570 DOI: 10.1002/rcs.1989
    BACKGROUND: This paper presents a model-based bone milling state identification method that provides intraoperative bone quality information during robotic bone milling. The method helps surgeons identify bone layer transitions during bone milling.

    METHODS: On the basis of a series of bone milling experiments with commercial artificial bones, an artificial neural network force model is developed to estimate the milling force of different bone densities as a function of the milling feed rate and spindle speed. The model estimations are used to identify the bone density at the cutting zone by comparing the actual milling force with the estimated one.

    RESULTS: The verification experiments indicate the ability of the proposed method to distinguish between one cortical and two cancellous bone densities.

    CONCLUSIONS: The significance of the proposed method is that it can be used to discriminate a set of different bone density layers for a range of the milling feed rate and spindle speed.

    Matched MeSH terms: Surgeons
  3. Misron, L.H., Misron, K., Misron, S.N.F.
    MyJurnal
    Sleep disorder including insomnia is one of the complications of general anaesthesia. It is not uncommon and it is temporary but majority remains unnoticed and untreated. The effect of insomnia ranges from mild to severe, influencing both physical and mental health. Surgeon and anaesthetist need to identify this complication so that an appropriate treatment can be delivered. In complicated case, psychiatrist involvement is crucial. The treatment is symptomatic and temporary. We reported a case of distressful sleep disorder as a sequelae of general anaesthesia for mastoidectomy surgery. Subsequently after symptomatic treatment, he recovered completely and regained his normal sleep pattern.
    Matched MeSH terms: Surgeons
  4. Mejabi JO, Sergeenko OM, Ryabykh SO
    Malays Orthop J, 2019 Mar;13(1):49-53.
    PMID: 31001385 DOI: 10.5704/MOJ.1903.010
    Severe rigid neuromuscular scoliosis is a major challenge to the spine surgeon due to the possibilities of neurological sequelae from acute correction of the deformity. Halo gravity traction has been considered as a way of reducing the deformity before correction to prevent neurological complications. Three female patients with severe neuromuscular scoliosis aged seven to 13 years with main coronal Cobb angle of 95°-128° and Kyphotic Cobb of 47°-118° having ≤35% flexibility on traction, had between 18 to 23 days of 16 hour/day of halo gravity traction and night time supine traction with 4kg weight for 7-8 hours. They had 28.9% and 18.5% of main coronal and kyphotic Cobb angle correction post-traction respectively. All had posterior instrumentation and post-operatively, they had correction of main coronal Cobb angle of 29°-58° and kyphotic Cobb angle of 30°-77° with no neurological complication. Halo gravity traction is therefore a viable option for reducing post-operative neurological complication in rigid severe scoliosis.
    Matched MeSH terms: Surgeons
  5. Mohamed-Haflah NH, Abdullah S, Abdul-Rani R
    Malays Orthop J, 2021 Mar;15(1):16-20.
    PMID: 33880143 DOI: 10.5704/MOJ.2103.003
    The Coronavirus (COVID-19) pandemic and institution of the Movement Control Order (MCO) had resulted in the cancellation of a major orthopaedic exam in April 2020. The exam is known as the Malaysian Orthopaedic Specialist Committee (OSC) Part I Examinations. It is similar to the British Royal Colleges of Surgeons Membership (MRCS) exams and held twice annually in April and October. There are up to 200 candidates involved. With implementation of new guidelines and standard operating procedures (SOP), the OSC Part I exam was successfully held by Universiti Kebangsaan Malaysia (UKM) from 5th-9th October 2020. Here we highlight the challenges we faced whilst coordinating a major exam at a national level during the COVID-19 pandemic with recommendations for future exams.
    Matched MeSH terms: Surgeons
  6. Hanim A, Wafiuddin M, Azfar MA, Awang MS, Nik Abdul Adel NA
    Cureus, 2021 Mar 22;13(3):e14043.
    PMID: 33898129 DOI: 10.7759/cureus.14043
    Introduction This appears to be the first biomechanical study that compares the stability of various locations of the crossing points in crossed pinning Kirschner wiring (K-wire) construct in treating pediatric supracondylar humerus fracture (SCHF). Additionally, this study compared the biomechanical stability between crossed pinning K-wire construct and the three-lateral divergent K-wire construct. Methods For the study purpose, 30 synthetic humerus bones were osteotomised at mid-olecranon fossa, anatomically reduced, and pinned using two 1.6-millimeter K-wires in five different constructs. A total of six samples were prepared for each construct and tested for extension, flexion, valgus, varus, internal rotation, and external rotation forces. Results As for crossed pinning K-wire construct, the center crossing point emerged as the stiffest construct in both linear and rotational forces, in comparison to the lateral crossing point, superior crossing, and medial crossing point Conclusion Based on this analysis, it is highly recommended that, if the crossed pinning construct is selected to treat supracondylar humerus fracture, the surgeon should aim for center crossing point as it is the most stable construct. Nevertheless, if lateral and superior crossing points are obtained during the initial attempt of fixation, the fixation may be accepted without revising the K-wire as the stability of these two constructs are comparable and portrayed no significant difference when compared to that of the center crossing point. Additionally, it is essential to avoid the medial crossing point as it is significantly less stable in terms of rotational force when compared to the center crossing point.
    Matched MeSH terms: Surgeons
  7. Ngeow, W.C., Ong, S.T.
    Malaysian Dental Journal, 2008;29(2):84-93.
    MyJurnal
    The primary obligation and ultimate responsibility of a dental surgeon is not only to restore aesthetic and function, but also to relieve pain which originates from dental pathology or surgical procedures performed. Post operative dental pain is mainly of inflammatory origin. Common traditional oral analgesics, namely salicylates, paracetamol and non-steroidal anti-inflammatory drugs have been the drugs of choice, but are increasingly being superseded by newer designer analgesics, the cyclooxygenase-2 (COX-2) inhibitors. This article reviews the advantages and disadvantages of prescribing common traditional oral analgesics as well as exploring the potential use of COX-2 inhibitors as an alternative to these analgesics for the control of post operative pain in dentistry.
    Matched MeSH terms: Surgeons
  8. Taran S, Yusof AH, Yusof MI
    Malays Orthop J, 2015 Nov;9(3):75-77.
    PMID: 28611918 MyJurnal DOI: 10.5704/MOJ.1511.015
    Upper cervical chordoma (UCC) is rare condition and poses unique challenges to surgeons. Even though transoral approach is commonly employed, a minimally invasive technique has not been established. We report a 44-year old Malay lady who presented with a 1 month history of insidious onset of progressive neck pain without neurological symptoms. She was diagnosed to have an axial (C2) chordoma. Intralesional resection of the tumour was performed transorally using the Destandau endoscopic system (Storz, Germany). Satisfactory intralesional excision of the tumour was achieved. She had a posterior fixation of C1-C4 prior to that. Her symptoms improved postoperatively and there were no complications noted. She underwent adjuvant radiotherapy to minimize local recurrence. Endoscopic excision of UCC via the transoral approach is a safe option as it provides an excellent magnified view and ease of resection while minimizing the operative morbidity.
    Matched MeSH terms: Surgeons
  9. Mazita, A., Zahirrudin, Z., Saim, L., Asma, A.
    Medicine & Health, 2010;5(2):86-92.
    MyJurnal
    Facial nerve schwannoma is a rare slow growing benign tumour which arises from the Schwann cell of the neurilemma. A retrospective review of 6 patients who had been diagnosed with facial nerve schwannoma between 1998 and 2008 was conducted. There was equal distribution of male and female patients. The mean age was 42 years (range 19 to 66 years). The tumour originated in the internal auditory canal (2 patients), intra-temporal (3 patients) and intraparotid (1 patient) segments of the facial nerve. All tumours were successfully removed and facial nerve continuity was pre-served in 2 cases. The presenting symptoms of facial nerve schwannoma are non specific and dependent on the site of tumour origin. It is a great mimicker of other lesions that can present at the same location. The surgeon should have a high index of suspicion when patients present with progressive facial nerve palsy. Patients should always be counselled regarding risk of facial paralysis because the diagnosis of facial nerve schwannoma is often confirmed intra-operatively.
    Matched MeSH terms: Surgeons
  10. Abdullah, A., Shaharudin, M.H., Amin, M., Marhaban, J.A., Awang, M.A., Zulfiqar, M.A., et al.
    Medicine & Health, 2006;1(1):61-66.
    MyJurnal
    Evidence of ossification was previously considered a relative contraindication to cochlear implantation. It was considered difficult or impossible to achieve safe electrode insertion because of bony obstruction. Either the electrodes or the inner ear structures could be damaged. Moreover, obstructed scala tympani could limit the number of electrodes that can be inserted. The efficacy of the electrical stimulation was also questioned, as a higher current would be needed on an ossified cochlea. Finally, the neural survival in ossified cochlea is unknown. This may complicate the surgical procedure and affect the long-term outcome. However, depending on the experience of the surgeon, cochlear implantation has been attempted even in grossly ossified cochlea. Here we illustrate that cochlear implantation is safe in labyrinthitis ossificans.
    Matched MeSH terms: Surgeons
  11. Chan, H. Z., Wang, C. S., Azuhairy, A., Hau, A., Zulkiflee, O.
    Malays Orthop J, 2014;8(1):79-81.
    MyJurnal
    Primary sacral tumours are rare, therefore experience of managing their associated complications are very limited. Effective surgical treatment of pelvic chondrosarcoma remains a major challenge for orthopaedic surgeons, due to the complex anatomic structure of the pelvis, the lack of defined compartment borders, the close vicinity to vital structures, and the risk of jeopardizing pelvic structural stability. We report a rare case of a giant sacral chondrosarcoma (100cm x 80cm) in an elderly male who successfully underwent tumour resection with good functional outcome and recovery. Long term follow up is essential in view of the possibility of local tumour recurrence.
    Matched MeSH terms: Surgeons
  12. Ariffin, M. H., Selvyn Lloyd, Rhani, S. A., Kamalnizat, Baharudin, A.
    Malays Orthop J, 2014;8(2):40-42.
    MyJurnal
    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 post- radiation 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
  13. Saw, A.
    Malays Orthop J, 2007;1(2):1-2.
    MyJurnal
    Musculoskeletal tumour is much less common compared to tumours of epithelial origin. Most of these tumours are benign, with only about 1% malignant in nature. A general orthopaedic surgeon may only come across a malignant primary bone or soft tissue tumour a few times in his entire medical career. The current recommendation is for these conditions to be investigated and treated in centres with musculoskeletal oncology service. Careful clinical evaluation with appropriate plain radiography can provide adequate information for definitive diagnosis and treatment for most cases, especially the benign tumours. For some other cases, further investigations will be necessary. Magnetic resonance imaging (MRI) can provide excellent details on anatomical location of a tumour and delineate vital structures that may have been distorted by the lesion. For primary malignant tumours, computerized tomography scanning is still the gold standard for evaluation of pulmonary metastasis, and bone scan can allow early detection of distant metastasis to other bones. Whole body MRI has recently been recommended for tumour staging but the potential benefit for musculoskeletal tumour is not that convincing. PET may be very helpful for follow up detection of tumour recurrence but its role in diagnosis and staging of musculoskeletal tumours is still being evaluated...
    Matched MeSH terms: Surgeons
  14. Ghazali, N., Ismail, S.M., Abdul Rahman, Z.A.
    Ann Dent, 2001;8(1):-.
    MyJurnal
    Mental nerve neuropathy is an important presenting complaint that may be encountered by dental surgeons in their daily practise. There are various pathological processes that could bring about this symptom, ranging. from simple dental cause to vague, life threatening diseases. We present three cases of mental paraesthesia of different aetiologies. A literature review on mental nerve neuropathy related to malignancies and infection is discussed. The importance of a thorough chair side history taking, clinical examination and relevant investigations are emphasised in a suggested clinical approach to obtaining the diagnosis of a numb chin.
    Matched MeSH terms: Surgeons
  15. Leonar, J.H., Siti Salmiah, M.D., Das, S., Ayiesah, H.R.
    MyJurnal
    Arthroscopic sub acromial debridement surgery with acromioplasty is one of the shoulder surgeries performed to treat chronic shoulder pain. This surgical procedure is usually indicated in sub acromial impingement syndrome of shoulder, degenerative rotator cuff tears, severe functional limitation of shoulder joint and often surgery was performed in cases where all the conservative management had failed in the treatment of chronic shoulder pain. Even though the patient would be referred for early rehabilitation, post operative management of this surgical condition is highly challenging. Movement of the shoulder joint is often related with scapulo-thoracic joint, acromio-clavicular joint and sternoclavicular joint and the shoulder movements are governed by various different muscular forces from these joints. Failure to understand this biomechanical complexity of shoulder joint during post operative rehabilitation results in failure of the surgical outcome and might cause severe functional limitation with recurrent shoulder pain. Often in clinical practice, greater emphasis is given to achieve and regain movements in shoulder joint at the expense of the joint stability. However, inadequate scapular stability might further predispose the shoulder joint to excessive loading and results in repetitive injuries leading to chronic shoulder pain. This might affect the surgical and clinical outcome of the acromioplasty and result in surgical failure. Hence, surgeons and clinicians need to understand the biomechanical contributions in the post operative rehabilitation of the shoulder joint. The present case report emphasises the biomechanical model of post operative rehabilitation of a patient who had arthroscopic sub acromial debridement with acromioplasty.
    Matched MeSH terms: Surgeons
  16. Ikhwan SM, Zamri Z, Hairol O, Razman J, Affirul C
    MyJurnal
    Extrahepatic bile ducts constitute a significant anatomic site for surgeons when performing hepatobiliary
    operations from minor procedure such as cholecystectomy to major operation such as hepatectomy. The
    challenges for surgeon in performing such cases increase when congenital variance of biliary tree occurs which
    may lead to unintentional bile duct injuries. We reported a case of a lady who presented with obstructive
    jaundice secondary to huge distal common bile duct stone. The presence of right posterior segmental hepatic
    duct, which rarely occurs, was discovered during intraoperative cholangiogram before common bile duct
    exploration. The operation was successful without incidence of biliary duct injury.
    Matched MeSH terms: Surgeons
  17. Michael A, Narasimman S, Jasjit Singh N
    Med J Malaysia, 2018 04;73(2):110-111.
    PMID: 29703875 MyJurnal
    Intra-abdominal heterotopic ossification usually develops after abdominal surgery and can cause complications such as bowel obstruction and even intestinal perforation. Bisphosphonates, NSAIDs and even local radiation is used as prophylaxis or treatment. Surgeons must consider heterotopic ossification and its complications as a differential when managing complex polytrauma patients with suspicious radiographic densities.
    Matched MeSH terms: Surgeons
  18. Razman, J.
    MyJurnal
    Surgical training worldwide has been reformed from
    the since 19th century until the present era. It started as
    a trade which eventually was transformed into a
    profession that acquires skills and knowledge. The
    apprenticeship model was introduced amongst the
    Western surgeons as the standard approached for
    surgical training. The surgery was learned through
    direct observation without any formal and structured
    education. William S Halstead had introduced the new
    approach of training the surgeons in America
    following his landmark lecture at Yale University in
    1904 (1). His principle was based on direct the
    German Surgical training which emphasized on basic
    sciences in the curriculum and Sir William Ossler
    concepts of bedside rounds. This has lead to the
    development of Halsted principals of surgical training
    which included intense and repetitive exposure in
    managing surgical patients under the supervision of
    skilled surgeons, acquiring the knowledge of scientific
    basis of surgical diseases and as the surgical trainee
    received enhanced responsibility and independence
    with each advancing year (2). Since then, Halsted
    principle of surgical training has become the
    foundation of most established surgical training
    worldwide. The principles have been expanded and
    upgraded and since then six cores competencies have
    been identified for the surgical residents to achieve
    and master during the training course (3). There were
    medical knowledge, patient care, interpersonal and
    communication skills, professionalism, practice-based
    learning and improvement and system based practice.
    From the Malaysia perspective, surgical training was
    done through the overseas Royal colleges after the
    independence in 1957. The local programme started in
    1982 through the initiative of local universities that
    initially offered surgical training programme in
    General surgery, Orthopedics and otorhinolaryngology
    (4). Since then through the collaborations of Ministry
    of Health and other professional bodies various
    surgical training programme has been established to
    provide training opportunities which will eventually
    serving the nation. The subcommittee of the National
    Conjoint Board for General Surgery was the
    consultative body to oversee and manage the
    implementation of the surgical training. Since the
    establishment, the subcommittee was responsible in
    streamlined the training curriculum for all the
    universities that offered the course, centralized and
    standardized the intake of the trainees, coordinating
    the national exit examination and advising new
    application for graduate training in general surgery.
    The important milestone of the subcommittee was the
    task given to develop the national surgical
    postgraduate curriculum for the doctors who are
    interested in becoming a surgeon in the country. The
    curriculum is being developed to create a pathway for
    surgical training from the internship until subspecialty
    training. The development encompasses the
    governance, the curriculum development, the training
    process and learning outcome according to the latest
    evidence based on post graduate training. The
    programme should be the foundation in producing well
    trained surgeons towards 2050 through TN50.
    Matched MeSH terms: Surgeons
  19. Adlin Dasima, A.K., Nadia Hanom, I., Siti Aznida, A.K., Rusnaini, M.K., Mohd Fahmi, Z., Mohd Nazir, M.S., et al.
    MyJurnal
    This is our first experience in providing general anaesthesia for robotic-assisted thyroidectomy (RAT). It is rather a
    new experience for our anaesthetic team and few issues should be addressed. The conduct of RAT must be fully
    understood and familiarized as it may present with few challenges for the anaesthesiologists. The key point of
    success during this learning curve period is the importance of teamwork between the anaesthesiologists and the
    operating surgeons. The specific anaesthetic challenges include limited access to the patient post-docking of the
    robot, the need of extra precautions of the anaesthetic circuit and IV line connections, a vigilant anaesthesiologists
    and options for postoperative pain relief.
    Matched MeSH terms: Surgeons
  20. Nasir Mohd Nizlan, Azfar Rizal Ahmad, Hisham Abdul Rashid, Paisal Hussin, Che Hamzah Fahrudin, Abdullah Arifaizad, et al.
    MyJurnal
    Introduction: Degenerative disorder involving the acromioclavicular
    joint (ACJ) is quite common especially in the elderly.
    One of the surgical modalities of treatment of this disorder is the
    Mumford Procedure. Arthroscopic approach is preferred due to
    its reduced morbidity and faster post-operative recovery. One
    method utilizes the anteromedial and Neviaser portals, which
    allow direct and better visualization of the ACJ from the
    subacromial space. However, the dangers that may arise from
    incision and insertion of instruments through these portals are
    not fully understood. This cadaveric study was carried out to
    investigate the dangers that can arise from utilization of these
    portals and which structures are at risk during this procedure.
    Methods: Arthroscopic Mumford procedures were performed
    on 5 cadaver shoulders by a single surgeon utilizing the
    anteromedial and Neviaser portals. After marking each portals
    with methylene blue, dissection of nearby structures were
    carried out immediately after each procedure was completed.
    Important structures (subclavian artery as well as brachial plexus
    and its branches) were identified and the nearest measurements
    were made from each portal edges to these structures. Results:
    The anteromedial portal was noted to be closest to the
    suprascapular nerve (SSN) at 2.91 cm, while the Neviaser portal
    was noted to be closest also to the SSN at 1.60 cm. The
    suprascapular nerve was the structure most at risk during the
    Mumford procedure. The anteromedial portal was noted to be
    the most risky portal to utilize compared to the Neviaser portal.
    Conclusion: Extra precaution needs to be given to the
    anteromedial portal while performing an arthroscopic distal
    clavicle resection in view of the risk of injuring the
    suprascapular nerve of the affected limb.
    Matched MeSH terms: Surgeons
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