Displaying publications 81 - 100 of 188 in total

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  1. Ghazali Mat Nor, Nasruddin Jaafar
    Ann Dent, 1995;2(1):-.
    MyJurnal
    The mangement of vascular lesions such as haemangiomas frequently present difficult choices between various treatment modalities. Circumstances may limit the,number of options available for the surgeon. This article describes the circumstances, investigations, difficult choices, and eventual treatment of a case of a mandibular haemangioma. It is concluded that for a medium sized haemangioma such as in this case,in the absence of facilities to embolize it, surgical excision may be safely carned out provided that proper investigations and precautions have been conducted. An angiogram is of utmost important in determining the feeding vessels and is very important before any surgical procedure is attempted.
    Matched MeSH terms: Surgeons
  2. Arsad SR, Sem SH, Silvanathan JP, Muhammad Nawawi RF
    Cureus, 2020 Jan 22;12(1):e6735.
    PMID: 32140316 DOI: 10.7759/cureus.6735
    Dorsal dislocations of proximal interphalangeal joint with palmar lip fractures base of middle phalanx of fingers are rare, complex, and often a challenging injury to the treating hand surgeons especially in those chronic cases. Hemi-hamate arthroplasty is the preferred surgical option in treating chronic dorsal fracture-dislocations of the proximal interphalangeal joint. We report two cases with a chronic injury that have been treated with hemi-hamate arthroplasty. Range of motion, pinch and grip strengths, QuickDASH scores, complications, and radiological findings were recorded at follow-up. Good functional outcomes were observed in both patients without major complications. Hemi-hamate arthroplasty can be a reliable surgical treatment for chronic proximal interphalangeal joint fracture-dislocations.
    Matched MeSH terms: Surgeons
  3. Kosai NR, Rajan R
    Obes Surg, 2018 08;28(8):2572-2577.
    PMID: 29860561 DOI: 10.1007/s11695-018-3289-6
    Bariatric surgery has become a popular treatment modality for obesity in Malaysia. However, the absence of a standardized national registry has led to paucity of information pertaining to quantity and quality of bariatric surgery in Malaysia. In the absence of a national registry, a nationwide survey was conducted with the aim of establishing a fair estimate of case volume based on type of procedure and to identify the total number of surgeons performing those procedures at their respective centers from 1st January 2010 to 31st December 2016. For this purpose, a questionnaire was designed and distributed to bariatric surgeons throughout Malaysia. The data along with a brief narrative of the history and progress of bariatric surgery in Malaysia is presented in this report.
    Matched MeSH terms: Surgeons
  4. Voon K, Premnath N
    Med J Malaysia, 2020 11;75(6):762-763.
    PMID: 33219197
    COVID-19 has infected more than 10 million people worldwide and it has become one of the biggest challenges in the modern medical history. Wearing of face masks, social distancing, effective hand hygiene and the use of appropriate personal protective equipment are important in flattening the curve of the pandemic. The role of the surgeons in this battle against COVID-19 include curbing the spread of the disease, to protect and preserve the surgical workforce and to ensure the continuance of essential surgical services. We report our experience in dealing with the COVID-19 outbreak in a tertiary surgical centre in the Penang General Hospital in Northern Malaysia.
    Matched MeSH terms: Surgeons*
  5. Mohd Zain MR, Shamsuddin AM, Mamat AZ, Mokhtar AM, Ali S, Chen YC, et al.
    Front Pediatr, 2019;7:230.
    PMID: 31231625 DOI: 10.3389/fped.2019.00230
    Introduction: Pediatric cardiac surgical mission programs are deemed as common practice, especially in developing nations funded by international non-governmental organizations (NGOs). This article presents and discusses the results and strategies implemented by this partnership, aiming at achieving the autonomy of the local center by this collaboration. Materials and Methods: A retrospective review was conducted on patients with congenital heart disease who underwent surgical intervention from the beginning of the NGO collaboration (September 2015) until November 2018 in an existing cardiac center. In between those visits, any congenital heart disease patient with Risk Adjustment Congenital Heart Surgery (RACHS)-1 Category 1-3 would be discussed in a local multi-disciplinary meeting with regards to the feasibility of the surgery being performed by the local members. Results: A total of 60 operations were performed during the trips. Throughout the visit, 46% (28) of the operations were performed by the local surgeon, with or without assistance from the visiting surgeon. Between September 2015 and November 2018, 27 cases were also performed by the local team independently. For the 27 cases performed by the local team independently, the median age of the patient was 42 days (ranging from 14 days to 20 years old), with median body weight of 3.2 kg (ranging from 2.8 to 64 kg). Conclusion: Humanitarian pediatric cardiac surgical missions are safe to be done for the population in need. In order to achieve autonomy, continuous efforts by both teams are crucial, as the cooperation by the two parties ensures that the objectives are achieved.
    Matched MeSH terms: Surgeons
  6. 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
  7. Sharouny H, Omar RB
    Iran Red Crescent Med J, 2014 Dec;16(12):e17066.
    PMID: 25763237 DOI: 10.5812/ircmj.17066
    INTRODUCTION: Laryngeal stenosis has various causes and treatment options. Endoscopic resection of the stenotic part with CO2 laser is one of the treatment options of laryngotracheal stenosis. Keels are useful for preventing adhesion formation, restenosis and web formation, which may happen during the later stage. They can be put in place either via the endoscopic approach or through a micro thyroidotomy and are held in place with a heavy suture through cricothyroid and thyrohyoid membranes. They are left in place for two to four weeks, and then removed through the endoscopic approach under general anesthetics.

    CASE PRESENTATION: We report on a case of anterior glottis stenosis with keel aspiration for two weeks, after endoscopic CO2 laser resection of the stenotic section and keel placement. The patient was admitted to our center, where bronchoscopy was performed and the keel was removed. A new custom-made silastic keel was properly placed in raw areas and fixed to the skin with suture through the cricothyroid and thyrohyoid membranes. The keel was removed three weeks later.

    CONCLUSIONS: Endoscopic keel placement should be done with heavy suture through cricothyroid and thyrohyoid membranes. Surgeons should suture the keel to the anterior laryngeal wall with specially designed Lichtenberger's needle-carriers to prevent complications such as keel aspiration, adhesion formation and imposing a second trip under general anesthetics, which put the patient at increased risk. The false vocal cord microflaps, as biological keels and a relatively new method may replace silastic keel placement in the future.

    Matched MeSH terms: Surgeons
  8. 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
  9. 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
  10. 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
  11. Mohd S, Yusof N, Lai LL, Hossain MG, Ramalingam S, Hamid SSA, et al.
    BMC Med Educ, 2019 Jul 01;19(1):238.
    PMID: 31262281 DOI: 10.1186/s12909-019-1685-9
    BACKGROUND: Procurement of bone allograft must be performed by trained personnel. Improper handling and lack of knowledge during bone procurement will lead to contamination hence jeopardizing quality of the procured bones and expose bone recipients to risks of infection in post-operative phase. Bone procurement workshop is the fundamental training programme to enhance skill among personnel who has been or will be involved in bone procurement. This study evaluated the effectiveness of the workshop contents including teaching materials by assessing the knowledge on bone procurement among the participants before and after the workshop.

    METHODS: Bone procurement workshop was held for 2 days for doctors and paramedics. The knowledge on bone procurement was evaluated in pre- and post-assessments by answering self administration questionnaire before and after the workshop, respectively.

    RESULTS: A total of 50 participants comprised of doctors and paramedics attended the workshop however only 15 (55.6%) doctors and 12 (44.4%) paramedics completed the assessments. Overall, the mean total score for the post-assessment (61.4%) was significantly higher (p 

    Matched MeSH terms: Surgeons/education
  12. Henry Tan Chor Lip, Tan Jih Huei, Simon Jerome Vendargon
    MyJurnal
    Iatrogenic diaphragmatic entry following thoracic surgery is rare with only two cases reported till date. This case reports on a 46-year-old male with persistent pleural sepsis due to right empyema thoracis despite best medical ef- forts. Following a right thoracotomy and decortication, the right diaphragm was inadvertently incised due to dense adhesions between the diaphragm and thickened cortex. To our knowledge, this is the third case reported of iatro- genic diaphragmatic entry following thoracic surgery for empyema thoracis. The pearls from this case report is that any evidence of empyema thoracis involving the lower lobe on imaging should warn the surgeons to be aware of inadvertent entry into the peritoneal cavity, as the diaphragm can be adherent to the cortex trapping the lower lobe.

    Matched MeSH terms: Surgeons
  13. Tomar L, Govil G, Dhawan P
    Malays Orthop J, 2021 Mar;15(1):128-131.
    PMID: 33880160 DOI: 10.5704/MOJ.2103.020
    Salvage total hip arthroplasty (THA) may be required to manage femoral neck fracture implant failures, avascular necrosis and secondary hip arthritis. Cannulated cancellous screws can become stripped or incarcerated during the initial implantation and pose hardware removal issues. We present a novel technique for safe screw removal in a 62-year-old female patient with a painful right hip. She had undergone cancellous screw fixation for a fracture of the neck of femur ten years ago. There was avascular necrosis with screw cut out leading to secondary hip arthritis necessitating THA. Intra-operatively cannulated cancellous screw along the inferior femoral neck region was incarcerated. After posterior dislocation of the head, the neck was osteotomised, and the screw threads were exposed for possible extraction. However, the thickened femoral neck region with solid cortical bone prevented the screw disengagement in either direction. The screw along the femoral trochanter region was cut with a Harrington cutter and the remaining screw disengaged with careful removal of bony spicules and controlled anticlockwise rotations, to remove the screw in around fifteen minutes. Arthroplasty could be completed uneventfully thereafter. We could remove the screw while avoiding an iatrogenic fracture along the calcar region and excessive bone loss along the screw track. The femoral canal remained uncompromised. The anticipation of a difficult implant removal with a thorough understanding of the devices and techniques, is an invaluable asset to the operating surgeon. With a simple tool and novel technique in a difficult situation, we can save on operating time and minimise complications.
    Matched MeSH terms: Surgeons
  14. 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*
  15. Nayak SB, Vasudeva SK
    Morphologie, 2021 Apr 16.
    PMID: 33875370 DOI: 10.1016/j.morpho.2021.03.005
    The scrotum is supplied by ilioinguinal, genital branch of genitofemoral, perineal branch of the posterior cutaneous nerve of the thigh and the posterior scrotal branches of the pudendal nerve. We report an extremely rare innervation of the anterior part of the scrotum by the anterior division of the right obturator nerve. The genital branch of genitofemoral nerve did not reach the scrotum. The ilioinguinal nerve did not supply the scrotum. The anterior division of the obturator nerve gave a branch which ascended superomedially in the thigh, crossed superficial to the spermatic cord and communicated with the right ilioinguinal nerve. As it crossed the spermatic cord, it gave a scrotal branch which descended over the spermatic cord and ramified to supply the anterior part of the scrotum. Knowledge of this variation could be important to anaesthesiologists, urologists and surgeons in general.
    Matched MeSH terms: Surgeons
  16. Nazri Mohd Yusof
    MyJurnal
    Integration and islamisation (INI) programmes for undergraduate medical students have been practiced, reviewed and published in many journals. However, there is only a dearth of study on the implementation of such a programme for postgraduate clinical students. Hence, there is a need to examine such a programme because of the different learning environment and characteristic of the students. The aim of this paper is to examine the existing clinical postgraduate programme at IIUM and attempts to improve the INI curriculum. Method: The study employs an analytical method and important factors for the development of the curriculum are analysed to come out with the objective, content, teaching methodology and assessment method suitable for the program. Result: The study identified the important factors that determine the curriculum to be the needs of National Health Service, the mission of the university, the requirement of the professional body and characteristic of the students. The study proposes that the objective of the program is to produce holistic orthopaedic surgeons who understand the belief of Muslim patients and is able to facilitate them in their ibadah and daily life as a Muslims. This is achieved through offering a course which consists of 4 main subjects on the principles of shariah which include the element of Islamic worldview, fiqh ibadah, fiqh muamalah and Islamic moral values with emphasis on issues related to medicine. The teaching method proposed is having regular seminars which consist of presentations and discussion of important concept in Islamic fiqh and followed by case study on fiqh issues related to Medicine. Finally, the students should be assessed from the case write up which they are required to submit before they can sit for the final professional exam. Conclusion: This improved program enables students to complete their study without compromising their duties to provide services at their respective hospitals.
    Matched MeSH terms: Orthopedic Surgeons
  17. 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
  18. Chilmi MZ, Desnantyo AT, Widhiyanto L, Wirashada BC
    Malays Orthop J, 2020 Jul;14(2):145-148.
    PMID: 32983392 DOI: 10.5704/MOJ.2007.025
    In Indonesia, arthrodesis becomes a choice of treatment in the absence of ankle arthroplasty implants for young adults. Arthrodesis on ankle osteoarthritis (OA) often leads to functional impairment. Low tibiofibular osteotomy is an alternative and it has been known to be the preferable option for those in the productive-ages. A 22-year-old male with a previous history of a motorbike accident, operated eight years ago, came with persistent pain on the left ankle that has worsened over the years. Plain radiography with a tibial-ankle surface angle (TAS) of 74o (normally 88o-93o) indicated varus deformity. Osteotomy was performed on distal tibia above the syndesmotic joint, as well as on the middle third of fibula. Open wedge osteotomy of the tibia was corrected until the normal TAS angle was reached by fluoroscopy. Cortical allograft was used to fill the osteotomy gap. Instrumentation was performed using a clover leaf® plate with 6 screws insertion for fixation stability. All results were satisfactory. Twelve weeks post-operatively, the patient was performing activities normally. Four-month post-operative radiological evaluation showed fusion of graft and the angle of TAS of 89°. Post-operative functional assessment using the American Academy of Orthopaedic Surgeon (AAOS) Foot and Ankle Measurement (FAM) questionnaires showed significant improvement (pre 89, post 38).
    Matched MeSH terms: Orthopedic Surgeons
  19. 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
  20. Zainuddin AA, Grover SR, Soon CH, Nur Azurah AG, Mahdy ZA, Wu LL, et al.
    Front Pediatr, 2019;7:144.
    PMID: 31058121 DOI: 10.3389/fped.2019.00144
    Background: Girls born with congenital adrenal hyperplasia have virilized external genitalia. There is considerable debate regarding both the outcomes of feminizing genitoplasty and timing of the surgery in this population. Objective: To investigate outcomes of females 46,XX individuals with CAH in Malaysia, the surgical outcomes of feminizing genitoplasty (FG) and their attitudes toward surgery. Study Design: This is a cross-sectional study involving the two main tertiary centers in Malaysia. All 46,XX patients with CAH and raised female, who had undergone FG were identified and invited to participate. Data on socio-demographic, medical profiles, and attitudes toward surgery were collected. A standardized evaluation of the external genitalia was undertaken including the anatomic and cosmetic evaluation by independent gynecologists. Results: Of 61 individuals identified, 59 participated-consisting of children (n = 12), adolescents (n = 29) and adults (n = 18). All but one had classical CAH (98.3%) and had undergone FG (n = 55, 93.2%) with surgery mostly undertaken by pediatric surgeons trained in DSD work (n = 44, 74.6%). Complications overall were low (20.3%), with repeat surgery rate of 9.1%. External genital examination was performed in 38 participants. Overall 36.8% had absent clitoral glands and 39.5% had a persistent urogenital sinus and in 10.5%, no vaginal orifices were seen. Poor cosmetic outcomes were present in 42.1% with 55.3% recommended for further assessment under general anesthetic. Almost half participants did not venture an opinion on FG, those who did varied from having a positive attitude toward it (18 participants) to 3 opining that it should not be done, or avoided or delayed. From the participants, 35.5% preferred FG to be done early in life compared to 44.0% of the parents. Conclusions: The reoperation rates of the feminizing genitoplasty surgeries were low however due to the anatomic and cosmetic outcomes, reassessment of the external genitalia of these CAH patients may be required once they consider becoming sexually active as they may require further treatment. Many factors such as cultural sensitivities and access to medical treatment and late diagnoses have an impact on attitudes toward FG.
    Matched MeSH terms: Surgeons
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