Displaying all 15 publications

  1. Fadzullah NA, Kasthuri S, Basiron N
    Med J Malaysia, 2019 Oct;74(5):452-453.
    PMID: 31649230
    According to the Malaysian Department of Statistics motor vehicle accidents are the third leading cause of death in Malaysia and accounts for 7.4% of premature deaths in 2016. With the invention of the airbag, the number of serious injuries and fatalities have been reduced significantly. However, there has also been a corresponding increase in the number of injuries attributable to these devices. The patient narrated in this case report sustained a mixed dermal thickness burn over the upper limb as a result of an airbag deployment. She recovered without other life threatening injuries.
  2. Ali F, Safawi EB, Zakaria Z, Basiron N
    Clin Ter, 2013;164(5):413-5.
    PMID: 24217827 DOI: 10.7417/CT.2013.1605
    Entero-cutaneous fistula resulting from a locally invasive large bowel carcinoma is a difficult surgical challenge. En-bloc resection of the involved organs and the entero-cutaneous fistula tract with a healthy tissue margin will result in a composite abdominal wall defect that requires closure. Reconstructive surgical options include primary closure, components separation and the use of local, regional or free flaps with or without prosthetic mesh. We report a case of an abdominal enterocutaneous fistula secondary to a locally invasive sigmoid carcinoma, which was reconstructed with a pedicled antero-lateral thigh perforator (ALT) flap. To our knowledge, this is the first case of a malignant entero-cutaneous fistula, which was reconstructed with an ALT flap.
  3. Hisham A, Abd Latib M, Basiron N
    Case Rep Surg, 2017;2017:3491012.
    PMID: 28255494 DOI: 10.1155/2017/3491012
    Juvenile hypertrophy of the breast (JHB) is a rare and relentless disease affecting women in the peripubertal period. We present a 13-year-old girl with massive bilateral JHB, successfully treated with a breast reduction and free nipple graft technique. A total of 7300 grams of breast tissue had been removed, accounting for 14.9% of the patient's total body weight. Prophylactic hormonal therapy was not commenced. During the 5-year follow-up period, there was no recurrence and the patient remains satisfied with the aesthetic outcome. A recent meta-analysis study indicates that subcutaneous mastectomy is associated with reduced risk of recurrence, but it is more deforming and the aesthetic result is inferior to a reduction mammaplasty. In patients treated with the latter technique, some evidence exists suggesting that the use of a free nipple graft is associated with a less frequent risk of recurrence than a pedicle technique. This present case is unique as it demonstrates the clinical course of this patient at a considerably longer follow-up period than most reported studies. We adhered to the limited available evidence and highlight the long-term reliability of breast reduction with free nipple grafting as the first line surgical option in JHB, eliminating the need for repeated surgeries.
  4. Liang Yii RS, Chai SC, Zainal HM, Basiron N
    Jt Dis Relat Surg, 2022;33(3):673-679.
    PMID: 36345197 DOI: 10.52312/jdrs.2022.843
    Combined tendocutaneous defect of Achilles tendon remains a complex reconstructive challenge whereby both the soft tissue coverage and tendon reconstruction have to be considered to achieve a good functional and aesthetic outcome. A 14-year-old boy who sustained an open right calcaneum fracture (Gustilo-Anderson IIIB) with a transected Achilles tendon and huge skin defect from motorcycle wheel spoke injury was admitted. The Achilles tendon repair site broke down following initial surgical debridement and primary repair, resulting in a sizeable combined tendocutaneous defect. Simultaneous soft tissue coverage and tendon defect reconstruction using composite sensate free anterior lateral thigh (ALT) fasciocutaneous flap with vascularized fascia lata was performed subsequently. The vascularized fascia lata was tubularized to wrap the native proximal stump of Achilles tendon and secured using the modified Krakow suturing technique. The distal end of tubularized fascia lata was, then, secured by drilling across right calcaneum bone, passing the suture transosseously and screwed. He led an uneventful postoperative recovery with satisfactory functional and aesthetic outcomes at one year of follow-up. In conclusion, the present case demonstrates the reliability of this technique and its advantages over other flap choices in reconstruction of a huge combined tendocutaneous defect.
  5. Mat Johar F, Wan Sulaiman WA, Mat Saad AZ, Basiron N, Sahid NA
    Int J Surg Case Rep, 2020;72:202-206.
    PMID: 32544829 DOI: 10.1016/j.ijscr.2020.05.036
    INTRODUCTION: Blue Rubber Bleb Nevus Syndrome (BRBNS) also known as Bean's Syndrome is an atypical type of vascular malformation. To date, around 200 cases have been reported world-wide. In view of its low incidence rate, clinicians might misdiagnose and under treat. The key features of this syndrome are characterized by multiple cutaneous, soft tissue and gastrointestinal tract venous malformations.

    PRESENTATION OF CASE: We report the first case of Blue Rubber Bleb Nevus Syndrome in Malaysia, a 23 years old Malay girl who suffers from multiple cutaneous venous malformation and gastrointestinal bleeding episodes.

    DISCUSSION: The typical morbidity for this syndrome is symptomatic anemia due to secondary iron deficiency due to the gastrointestinal venous malformation bleeding. In managing the gastrointestinal bleeding, it mainly depends on the severity of gastrointestinal bleeding, some may resolve spontaneously, while the others may be needing blood transfusion, and some may require GIT resections. As for cutaneous lesions, normally it is innocuous depending on the region and size. Large or problematic cutaneous venous malformation might benefit from sclerotherapy or excision.

    CONCLUSION: Multidisciplinary approach is crucial in managing BRBNS case due to its complexity and the spectrum of multiple organ involvement to ensure the best outcome to the patient.

  6. Harun NH, Mydin RBSMN, Sreekantan S, Saharudin KA, Basiron N, Seeni A
    J Biomater Sci Polym Ed, 2020 10;31(14):1757-1769.
    PMID: 32498665 DOI: 10.1080/09205063.2020.1775759
    The emerging polymer nanocomposites have received industrial interests in diverse fields because of their added value in metal oxide-based nanocomposites, such as titanium (TiO2) and zinc oxide (ZnO). Linear low-density polyethylene (LLDPE)-based polymer has recently generated a huge market in the healthcare industry. TiO2 and ZnO are well known for their instant photocatalytic killing of hospital-acquired infections, especially multidrug-resistant (MDR) pathogens. This study investigated the actions of LLDPE/TiO2/ZnO (1:3) nanocomposites in different weight% against two representative MDR pathogens, namely, methicillin-resistant Staphylococcus aureus (MRSA) and Klebsiella pneumonia (K.pneumoniae). Antibacterial activities were quantified according to international standard guidelines of CLSI MO2-A11 (static condition) and ASTM E-2149 (dynamic condition). Preliminary observation via a scanning electron microscope revealed that LLDPE matrix with TiO2/ZnO nanocomposites changed the bacterial morphology and reduced the bacterial adherence and biofilm formation. Furthermore, a high ZnO weight ratio killed both types of pathogens. The bactericidal potential of the nanocomposite is highlighted by the enhancements in photocatalytic activity, zinc ion release and reactive species, and bacteriostatic/bactericidal activity against bacterial growth. This study provides new insights into the MDR-bactericidal potential of LLDPE with TiO2/ZnO nanocomposites for targeted healthcare applications.
  7. Azmi FP, Rahman NAA, Mazlan L, Basiron N, Imran FH
    Case Rep Surg, 2020;2020:1798543.
    PMID: 33381344 DOI: 10.1155/2020/1798543
    Mucinous adenocarcinoma of the perianal region is an oncologic rarity posing a diagnostic and therapeutic dilemma for treating oncologists. This is due to the low number of reported cases, compounded by the lack of definitive therapeutic guidelines. It accounts for 2% to 3% of all gastrointestinal malignancies and is historically known to arise from chronic anal fistulas and ischiorectal or perianal abscesses. We hereby report an interesting case of perianal mucinous adenocarcinoma in a 66-year-old male initially treated for a horseshoe abscess with complex fistulae. He presented with a 6-month history of a discharging growth in perianal region and painful defecation associated with occasional blood mixed stools. An incisional biopsy from the ulcer revealed mucinous adenocarcinoma. Contrast-enhanced computed tomography (CT) scan and magnetic resonance imaging (MRI) scan showed a localized perianal growth which involves the internal and external sphincter as well as suspicious involvement in the posterior aspect of the levator ani/puborectalis sling, which was further confirmed with colonoscopy (see figures). With no preset treatment protocol for this rare entity, he was managed with an abdominoperineal resection (APR) and vertical rectus abdominis myocutaneous flap (VRAM) tissue reconstruction. He had a turbulent postoperative period including intestinal obstruction secondary to internal herniation of bowel resulting in flap failure. The subsequent perineal wound was managed conservatively with advanced wound care and has since completely healed.
  8. 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.
  9. Syazni MA, Gendeh HS, Kosai NR, Ramzisham AR, Gendeh BS, Basiron NH, et al.
    Med J Malaysia, 2017 02;72(1):80-82.
    PMID: 28255152 MyJurnal
    Sternal metastasis from differentiated thyroid carcinoma (DTC) is rare and presents a conundrum for surgeons. We present a lady diagnosed with follicular thyroid carcinoma and sternal metastasis who underwent thyroidectomy, sternectomy and sternoplasty with titanium mesh and acrylic plate. She developed a surgical site infection, of which multiple conservative approaches were attempted. She eventually required removal of the implant. Closure of sternal defect was completed with bilateral pectoralis major advancement flaps. This article highlights a series of complications faced during the course of treatment and how they were managed in a tertiary healthcare centre.
  10. Basiron N, Sreekantan S, Kang LJ, Akil HM, Mydin RBSMN
    Polymers (Basel), 2020 Feb 09;12(2).
    PMID: 32050485 DOI: 10.3390/polym12020394
    The polyvinyl alcohol (PVA) and neem extract were grafted onto coupled oxides (3ZT-CO) via reflux process to stabilize the particles to form 3ZT-CO/PVA and 3ZT-CO/Neem. These were then incorporated into LLDPE by melt blending process to give LLDPE/3ZT-CO/PVA and LLDPE/3ZT-CO/Neem composites. The Neem and PVA stabilized particles showed high zeta potential and dispersed homogeneously in water. The stabilization process altered the shape of the particles due to plane growth along the (002) polar direction. The stabilizers acted as capping agents and initiated the one-dimensional growth. The alkyl chain groups from PVA increased the polarity of the LLDPE/3ZT-CO/PVA and played a dominant role in the water adsorption process to activate the photocatalytic activity. This was further enhanced by the homogeneous distribution of the particles and low degree of crystallinity (20.87%) of the LLDPE composites. LLDPE/3ZT-CO/PVA exhibited the highest photodegradation (93.95%), which was better than the non-stabilized particles. Therefore, the photocatalytic activity of a polymer composite can be enhanced by grafting PVA and neem onto couple oxides. The LLDPE/3ZT-CO/PVA composite was further used to treat textile effluent. The results showed the composite was able to remove dye color by 93.95% and to reduce biochemical oxygen demand (BOD) and chemical oxygen demand (COD) by 99.99%.
  11. Heng SSL, Ganandran T, Gan YH, Mat Zain MA, Basiron N, Wan Sulaiman WA
    J Plast Reconstr Aesthet Surg, 2023 Oct;85:187-192.
    PMID: 37499560 DOI: 10.1016/j.bjps.2023.07.008
    INTRODUCTION: Tessier cleft 7 are rare craniofacial clefts. Live-birth incidence varies from 1/80,000 to 1/300,000, with the incidence of 1 in 120 craniofacial clefts among Asians. Its clinical presentation varies widely in severity, thus, complicating diagnosis and contributing to the lack of consensus regarding its surgical management. The aim of this study is to describe clinical findings, types of Tessier cleft 7 soft tissue repair, and its outcomes in Kuala Lumpur Hospital.

    METHODS: This retrospective study reviewed records of children operated from January 2001 to July 2019. Data regarding concurrent congenital anomalies, complications, type of surgery, etc., were collected from outpatient records, operative notes, and clinical photographs.

    RESULTS: Twenty-eight children were treated, and 33 clefts (5 bilateral) were repaired. The male-to-female ratio was 1.3:1 (16 males and 12 females). Twenty-three patients had unilateral clefts (82.14%), with 14 right (60.86%) and 8 left (34.78%). Bilateral clefts were less common (17.86%). Twenty-three patients (82.14%) were Malay, 3 (10.71%) Chinese, 1 (3.57%) Indian, and 1 (3.57%) Cambodian. Eleven medical records were untraceable (discontinued due to duration of inactivity). There were 10 straight-line repairs, 5 Z-plasties, and 1 W-plasty performed; 3 cases did not detail the type of repair. One child required scar revision, and 1 had hypertrophic scarring requiring corticosteroid injection-no disturbances in speech or oral incompetency while eating were reported. Duration of follow-up ranged from 3 to 14 years.

    CONCLUSION: Our center has a higher rate of Tessier cleft 7 attendance. Straight-line cutaneous repairs combined with inferior vermilion mucosal flap can be used with low rates of complication and revision surgery.

  12. Dharmaraj B, Diong NC, Shamugam N, Sathiamurthy N, Mohd Zainal H, Chai SC, et al.
    Indian J Thorac Cardiovasc Surg, 2021 Jan;37(1):82-88.
    PMID: 33442211 DOI: 10.1007/s12055-020-00972-7
    Chest wall resection is defined as partial or full-thickness removal of the chest wall. Significant morbidity has been recorded, with documented respiratory failure as high as 27%. Medical records of all patients who had undergone chest wall resection and reconstruction were reviewed. Patients' demographics, length of surgery, reconstruction method, size of tumor and chest wall defect, histopathological result, complications, duration of post-operative antibiotics, and hospital stay were assessed. From 1 April 2017 to 30 April 2019, a total of 20 patients underwent chest wall reconstructive surgery. The median age was 57 years, with 12 females and 8 males. Fourteen patients (70%) had malignant disease and 6 patients (30%) had benign disease. Nine patients underwent rigid reconstruction (titanium mesh for sternum and titanium plates for ribs), 6 patients had non-rigid reconstruction (with polypropylene or composite mesh), and 5 patients had primary closure. Nine patients (45%) required closure with myocutaneous flap. Complications were noted in 70% of patients. Patients who underwent primary closure had minor complications. In total, 66.7% of patients who had closure with either fasciocutaneous or myocutaneous flaps had threatened flap necrosis. Two patients developed pneumonia and 3 patients (15%) had respiratory failure requiring tracheostomy and prolonged ventilation. There was 1 mortality (5%) in this series. In conclusion, chest wall resections involving large defects require prudent clinical judgment and multidisciplinary assessments in determining the choice of chest wall reconstruction to improve outcomes.
  13. Saharudin KA, Sreekantan S, Basiron N, Khor YL, Harun NH, S M N Mydin RB, et al.
    Polymers (Basel), 2018 Aug 06;10(8).
    PMID: 30960803 DOI: 10.3390/polym10080878
    Metal oxide-polymer nanocomposite has been proven to have selective bactericidal effects against the main and common pathogens (Gram-positive Staphylococcus aureus (S. aureus) and Gram-negative Escherichia coli (E. coli)) that can cause harmful infectious diseases. As such, this study looked into the prospect of using TiO₂/ZnO with linear low-density polyethylene (LLDPE) to inactivate S. aureus and E. coli. The physical, structural, chemical, mechanical, and antibacterial properties of the nanocomposite were investigated in detail in this paper. The production of reactive species, such as hydroxyl radicals (•OH), holes (h⁺), superoxide anion radicals (O₂•¯), and zinc ion (Zn2+), released from the nanocomposite were quantified to elucidate the underlying antibacterial mechanisms. LLDPE/25T75Z with TiO₂/ZnO (1:3) nanocomposite displayed the best performance that inactivated S. aureus and E. coli by 95% and 100%, respectively. The dominant reactive active species and the zinc ion release toward the superior antibacterial effect of nanocomposite are discussed. This work does not only offer depiction of the effective element required for antimicrobial biomedical appliances, but also the essential structural characteristics to enhance water uptake to expedite photocatalytic activity of LLDPE/metal oxide nanocomposite for long term application.
  14. Harun NH, Mydin RBSMN, Sreekantan S, Saharudin KA, Basiron N, Aris F, et al.
    ACS Omega, 2020 Jun 02;5(21):12027-12034.
    PMID: 32548381 DOI: 10.1021/acsomega.0c00213
    The surge of medical devices associated with nosocomial infection (NI) cases, especially by multidrug-resistant (MDR) bacterial strains, is one of the pressing issues of present health care systems. Metal oxide nanoparticles (MNPs) have become promising antibacterial agents against a wide range of bacterial strains. This work study is on the bactericidal capacity of heterogeneous TiO2/ZnO nanocomposites with different weight percentages and concentrations against common MDR and non-MDR bacterial strains. The profiles on disk diffusion, minimum inhibitory concentration, minimum bactericidal concentration, tolerance determination, time-kill, and biofilm inhibition assay were determined after 24 h of direct contact with the nanocomposite samples. Findings from this work revealed that the heterogeneous TiO2/ZnO nanocomposite with a 25T75Z weight ratio showed an optimal tolerance ratio against Gram-positive and -negative bacteria, indicating their bactericidal capacity. Further observation suggests that higher molar ratio of Zn2+ may possibly involve generation of active ion species that enhance bactericidal effect against Gram-positive bacterial strains, especially for the MDR strains. Nano-based technology using MNPs may provide a promising solution for the prevention and control of NIs. Further work on biocompatibility and cytotoxicity profiles of this nanocomposite are needed.
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