MyMedR

Association of ethnicity and acute kidney injury after cardiac surgery in a South East Asian population

Chew ST, Mar WM, Ti LK

Br J Anaesth, 2013 Mar;110(3):397-401.

BACKGROUND: Postoperative acute kidney injury (AKI) is a frequent and serious complication after cardiac surgery. Clinical factors alone have failed to accurately predict the incidence of AKI after cardiac surgery. Ethnicity has been shown to be a predictor of AKI in the Western population. We tested the hypothesis that ethnicity is an independent predictor of AKI in patients undergoing cardiac surgery in a South East Asian population.

METHODS: A total of 1756 consecutive patients undergoing cardiac surgery were prospectively recruited. Among them, data of 1639 patients met the criteria for analysis. There were 1182 Chinese, 195 Indian, and 262 Malay patients. The main outcome was postoperative AKI, defined as a 25% or greater increase in preoperative to a maximum postoperative serum creatinine level within 3 days after surgery.

RESULTS: Five hundred and seventy-nine patients (35.3%) developed AKI after cardiac surgery. Ethnicity was shown to be an independent predictor of AKI after cardiac surgery with Indians and Malays having a higher risk of developing AKI when compared with Chinese patients (odds ratio: Indian vs Chinese 1.44, Malay vs Chinese 1.51).

CONCLUSIONS: Indians and Malays have a higher risk of developing AKI after cardiac surgery than Chinese in a South East Asian population. Ethnicity was shown to be an independent predictor of AKI after cardiac surgery.

Fulltext Early Malaysian experience on the use of head and neck localizers in the precision radiotherapy of intra and extra cranial sites for first 28 cases

Zamzuri I, Idris NR, Mar W, Abdullah JM, Zakaria A, Biswal BM

Med J Malaysia, 2006 Dec;61(5):621-5.

PMID: 17623965 MyJurnal

Precision Radiotherapy at high doses require a fixed, referable target point. The frame system fulfills the required criteria by making the target point relocatable and fixed within a stereotactic space. Since December 2001, we have treated 28 central and peripheral nervous system lesions using either radiosurgery as a single high dose fraction or fractionated 3-dimensional conformal radiotherapy using a lower dose and a multi-leaf collimator. Various pathological lesions either benign or malignant were treated. Eighty six percent of our treated lesions showed growth restraint, preventing them from causing new symptoms with a median follow-up duration of 20.5 months. However, the true benefit from this technique would require a long-term follow-up to document the progress.

Fulltext The prognostic value of early follow-up computerized tomography of the brain in adult traumatic brain injury

Kiflie A, Alias NA, Abdul-Kareem MM, Mar W, Abdullah J, Naing NN

Med J Malaysia, 2006 Oct;61(4):466-73.

PMID: 17243525 MyJurnal

A total of 31 adult patients with moderate and severe head injury were assessed clinically on admission for Glasgow Coma Scale (GCS) and short test of mental status (STMS) on follow-up and compared to their initial and follow up CT scan. Good predictors were admission GCS, midline shift, volume of subdural haemorrhage in the initial CT scan of the brain as well as the presence of post-traumatic hydrocephalus, gliosis and site of gliosis in the follow-up CT scan. There was no direct correlation between the significant predictors on the first CT scan and the follow-up CT scan of the brain.

Fulltext Polymodal therapy for high grade gliomas: a case report of favourable outcomes following intraoperative radiation therapy

Zamzuri I, Rahman GI, Muzaimi M, Jafri AM, Nik Ruzman NI, Lutfi YA, et al.

Med J Malaysia, 2012 Feb;67(1):121-2.

PMID: 22582564 MyJurnal

High grade gliomas, frequently with their infiltrative nature, often make the outcome from neurosurgical intervention alone unsatisfactory. It is recognized that adjuvant radiochemotherapy approaches offer an improved prognosis. For these reasons, we opted for surgical debulking, intraoperative radiation therapy (IORT) in combination with whole brain irradiation therapy and chemotherapy (temozolamide cycles) in the management of a 42 year-old lady with Glioblastoma Multiforme (GBM). Her troublesome symptoms improved after 3 months of this polymodal therapy and remained independently functional for more than two years.

Intracerebral haematomas after deep brain stimulation surgery in a patient with Tourette syndrome and low factor XIIIA activity

Idris Z, Ghani AR, Mar W, Bhaskar S, Wan Hassan WN, Tharakan J, et al.

J Clin Neurosci, 2010 Oct;17(10):1343-4.

PMID: 20620064 DOI: 10.1016/j.jocn.2010.01.054

A 24-year-old male patient with refractory Tourette syndrome was treated with deep brain stimulation (DBS) and developed subsequent bilateral subcortical haematomas. Additional blood tests revealed abnormalities of plasma factor XIIIA and tryptophan levels, which may be associated with Tourette syndrome. Neurosurgeons who perform DBS surgery on patients with Tourette syndrome must be aware of possible disastrous complications resulting from factor XIIIA disorders of blood haemostasis. Routine screening for this condition is not typically performed prior to surgery in these patients.

Displaying all 5 publications