MyMedR

Displaying all 5 publications

Abstract:

Sort:

Fulltext Right posterior segmental hepatic duct: role of intraoperative cholangiogram to prevent extrahepatic biliary duct injuries

Ikhwan SM, Zamri Z, Hairol O, Razman J, Affirul C

International Medical Journal Malaysia, 2015;14(2):63-66.
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.
Fulltext Primary extraskeletal Ewing's sarcoma/primitive neuroectodermal tumour of breast

Ikhwan SM, Kenneth VK, Seoparjoo A, Zin AA

BMJ Case Rep, 2013 Jun 21;2013.
PMID: 23813511 DOI: 10.1136/bcr-2013-009584

Primary primitive neuroectodermal tumour (PNET) and extraskeletal Ewing's sarcoma belongs to the Ewing's family of tumours. Primary tumours arising from breast are very rare. There are only a few case reports published on primary extraskeletal Ewing's sarcoma and PNET arising from breast. We present an extremely rare case of an inoperable primary Ewing's sarcoma arising from left breast with contralateral breast, lymphatic and lung metastasis.
Elephant attack - A rare case of survival

Syahmi WM, Mafauzy MM, Baharuddin KA, Ikhwan SM, Sayuti KA, Mohd Shukruddeen S

Med J Malaysia, 2021 Sep;76(5):741-743.
PMID: 34508386

Conflict of human-wild elephant is not uncommon in Malaysia. Most of the human victims usually succumb to death due to internal organ injuries. Here we report a case of a woman who was the victim of an elephant attack and successfully survived to share our experience in managing this type of polytrauma.
Endoscopic sphincterotomy with balloon dilatation versus sphincterotomy alone for common bile duct stones removal: a randomised controlled trial

Ooi JS, Ikhwan SM, Azem Fathi MA, Leow VM, Syed Hassan AZ

Med J Malaysia, 2024 Mar;79(2):133-140.
PMID: 38553916

INTRODUCTION: Endoscopic sphincterotomy (EST) plus endoscopic papillary large balloon dilatation (EPLBD) has been reported as a valid alternative to EST alone in removing common bile duct (CBD) stone. The aim of this study is to compare efficacy, and safety of these two groups of patients in removing CBD stone in Hospital Universiti Sains Malaysia (HUSM).
MATERIALS AND METHODS: This is a prospective single centre randomised single blinded comparative study conducted in HUSM. The primary endpoints for this study are the overall complete stone clearance rate and complication rate, while the secondary outcome for this study are duration of procedure and rate of usage of adjunct methods. Objective data analysis is conducted using independent sample t-test and chi-squared test.
RESULTS: A total of 66 patients underwent endoscopic retrograde cholangiopancreatography (ERCP) for choledocholithiasis which is CBD stone. 34 patients were allocated to EST plus EPLBD arm (n=34), and 32 patients were in EST alone arm (n=32) using randomisation method. For intention to treat, patients from EST alone arm that unable to achieve complete stone clearance will be switched to EST plus EPLBD arm. The overall complete stone removal rate for both groups were comparable (EST plus EPLDB: 100% versus EST alone: 93.8%; p= 0.139). The two patients from EST alone group (6.2%) that unable to achieve complete stone clearance were converted to EST plus EPLBD group for intention to treat and able to achieve complete stone clearance by EST plus EPLBD. For procedural time, both arms are comparable as well (EST plus EPLDB: 15.8 minutes vs EST alone: 15.5 minutes; p= 0.860). Complications such as pancreatitis occurred in one patient in EST plus EPLBD arm (EST plus EPLDB: 2.9 % vs EST alone: 0 %; p= 0.328), and bleeding occurred in one patient in EST alone arm (EST plus EPLDB: 0 % vs EST alone: 3.1 %; p= 0.299) , but it is not statistically significant. No perforation or cholangitis complication occurred in both groups. No adjunct usage was observed in both groups.
CONCLUSION: In this study with limited sample size, both EST plus EPLBD and EST alone are effective and has comparable procedural time in removing CBD stone. Even though both methods are equally effective, EPLBD plus EST is an alternative solution if complete stone clearance is unable to achieve via EST alone.
Prospective diagnostic study on the use of narrow-band imaging on suspicious lesions during colonoscopy examination

Yaacob H, Ikhwan SM, Hashim MN, Syed Abd Aziz SH, Wan Zain WZ, Tuan Sharif SE, et al.

Asian J Endosc Surg, 2018 Nov;11(4):318-324.
PMID: 29424061 DOI: 10.1111/ases.12463

INTRODUCTION: Colonoscopy is the gold standard to detect colorectal neoplasm. Narrow-band imaging (NBI) has a good diagnostic accuracy to differentiate between neoplastic and non-neoplastic colorectal lesions. This study explores the diagnostic validity of NBI colonoscopy as well as its associated factors related to neoplastic and non-neoplastic colorectal lesions.
METHODS: This study enrolled 100 patients in a single-center tertiary teaching hospital. Patients presented for screening colonoscopy, and those with suspicious colorectal lesions were included in this study. During colonoscopy, the most suspicious lesion in each patient was analyzed using the NBI system based on Sano's classification. Each lesion was biopsied for histopathological analysis, the gold standard. Endoscopic images were captured electronically. The sensitivity, specificity, and diagnostic accuracy of NBI colonoscopy were assessed. Other associated factors related to neoplastic and non-neoplastic lesions were analyzed accordingly.
RESULTS: The sensitivity and specificity of the NBI were 88.2% and 71.9%, respectively. The area under the receiver-operator curve was 0.801, indicating that NBI has a good ability to differentiate between disease and non-disease. There are significant associations between histopathological examination outcomes and both presenting symptoms, especially weight loss, and lesion site, even after other variables were controlled (P