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Fulltext Exudative retinal detachment and macular hole as a rare sequelae of central vein occlusion

Rathna, R., Mushawiahti, M., Bastion, M.L.C., Masdar, A., Ropilah, A.R.

Medicine & Health, 2018;13(1):243-250.
MyJurnal

Central retinal vein occlusion (CRVO) is uncommon among young patients. Among the young adults, CRVO tends to be more benign with good visual prognosis. Macular oedema secondary to retinal vein occlusion is a relatively common complication that is currently being treated with intravitreal anti vascular endothelial growth factor with good outcomes. Other complications include lamellar hole, vitreous hemorrhage and neovascular glaucoma. We report a case of central retinal vein occlusion in a young female who presented to us with the complaint of blurring of vision in the left eye for four months. Fundus examination showed hyperemic optic disc, dilated tortuous vein, extensive retinal hemorrhages with macular oedema and an inferior shallow exudative retinal detachment. One month later, intravitreal ranibizumab injection for her macular oedema, a full thickness macular hole developed with reduction of macular oedema. Four months later, the hole spontaneously closed but her macular oedema persisted. The possibility of rare complications like exudative retinal detachment and full thickness macular hole must be kept in mind to ensure early detection and effective management is provided to preserve vision.
Fulltext Listening to islamic praises (dzikr) is more effective in reducing perioperative anxiety levels when compared to nature-based sounds in muslim patients undergoing surgery under regional anaesthesia.

Samsudin A, Yahya N, Wan Mat WR, Masdar A, Liu CY, Izaham A

IIUM Medical Journal Malaysia, 2019;18(3):31-39.
MyJurnal

Many studies have investigated the effects of music on perioperative anxiety and its implication on anaesthetic practice, however there are limited number of studies reported for religious or spiritual intervention in this aspect. We investigated the effects of listening to Islamic praises (Dzikr) and nature-based sounds delivered via headphones as non-pharmacological interventions for perioperative anxiety.Materials and Methods: Sixty-three Muslim patients scheduled for elective lower limb surgery under regional anaesthesia were randomly assigned to listen to Dzikr (Group A), nature-based sounds (Group B) or given headphones without any sounds (Group C). Anxiety levels were assessed using a visual analogue scale for anxiety (VAS-A). Physiological responses (mean arterial pressure, heart rate and respiratory rate) as well as patients’ overall satisfaction level were documented.Results: Patients in Group A demonstrated statistically significant lower VAS-A scores compared to those in Group B and C at 30-minutes after skin incision (p=0.002 and p=0.001 respectively) and at the end of the surgery (p=0.028 andp
The patients' understanding on the status and role of anaesthesiologists

Budiman M, Izaham A, Abdul Manap N, Zainudin K, Kamaruzaman E, Masdar A, et al.

Clin Ter, 2015 Nov-Dec;166(6):227-35.
PMID: 26794808 DOI: 10.7417/CT.2015.1892

OBJECTIVES: To evaluate patients' understanding on the status and role of anaesthesiologists.
MATERIALS AND METHODS: This was a prospective, questionnaire-based cross-sectional study. The interview had three segments which questioned on (i) patients' knowledge of the qualification, training and role of anaesthesiologists, (ii) attitude of patients towards anaesthesia and anaesthesiologists and (iii) the demographic data of patients.
RESULTS: Of 384 patients interviewed, 59.4% had prior anaesthesia experience. Most patients (95.6%) knew that anaesthesiologists were medical doctors, but only 27.1% knew the duration of training required to attain this specialist qualification. Patients' awareness of the various anaesthetic responsibilities was 12.2% in managing labour pain, 25.5% in intensive care units, 49.2% in chronic pain and 99.5% in postoperative pain management. During surgery, 73.7% of patients knew that anaesthesiologists were monitoring their vital signs, but only 42.2% thought anaesthesiologists also treated medical problems intraoperatively. Most patients (95.1%) would like to meet their anaesthesiologists prior to the operation and 97.7% want them to inform all possible anaesthesia complications.
CONCLUSIONS: Our patients' understanding and awareness of the status and roles of anaesthesiologists are still limited and variable. This can be further improved with patient interaction and public education.
KEYWORDS: Anaesthesiologist; Attitudes; Patient’s knowledge; Patient’s perception; Survey
Fulltext [Combined spinal-epidural analgesia in labour: its effects on delivery outcome]

Singh SK, Yahya N, Misiran K, Masdar A, Nor NM, Yee LC

Rev Bras Anestesiol, 2016 May-Jun;66(3):259-64.
PMID: 26993410 DOI: 10.1016/j.bjan.2014.09.009

Combined spinal-epidural (CSE) has become an increasingly popular alternative to traditional labour epidural due to its rapid onset and reliable analgesia provided. This was a prospective, convenient sampling study to determine the effects of CSE analgesia on labour outcome.
Fulltext Combined spinal-epidural analgesia in labour: its effects on delivery outcome

Singh SK, Yahya N, Misiran K, Masdar A, Nor NM, Yee LC

Braz J Anesthesiol, 2016 May-Jun;66(3):259-64.
PMID: 27108822 DOI: 10.1016/j.bjane.2014.09.006

BACKGROUND AND OBJECTIVES: Combined spinal-epidural (CSE) has become an increasingly popular alternative to traditional labour epidural due to its rapid onset and reliable analgesia provided. This was a prospective, convenient sampling study to determine the effects of CSE analgesia on labour outcome.

METHODS: One hundred and ten healthy primigravida parturients with a singleton pregnancy of ≥37 weeks gestation and in the active phase of labour were studied. They were enrolled to the CSE (n=55) or Non-CSE (n=55) group based on whether they consented to CSE analgesia. Non-CSE parturients were offered other methods of labour analgesia. The duration of the first and second stage of labour, rate of instrumental vaginal delivery and emergency cesarean section, and Apgar scores were compared.

RESULTS: The mean duration of the first and second stage of labour was not significantly different between both groups. Instrumental delivery rates between the groups were not significantly different (CSE group, 11% versus Non-CSE group, 16%). The slightly higher incidence of cesarean section in the CSE group (16% versus 15% in the Non-CSE group) was not statistically significant. Neonatal outcome in terms of Apgar score of less than 7 at 1 and 5min was similar in both groups.

CONCLUSION: There were no significant differences in the duration of labour, rate of instrumental vaginal delivery and emergency cesarean section, and neonatal outcome in parturients who received compared to those who did not receive CSE for labour analgesia.
Fulltext Evaluating the Optimal Operating Table Height for ProSeal-LMA™ Insertion

Low SL, Masdar A, Md Nor N, Mohd Azidin A, Low HJ, Mohamad Mahdi SN

Int J Clin Pract, 2022;2022:5118362.
PMID: 36474553 DOI: 10.1155/2022/5118362

INTRODUCTION: ProSeal-Laryngeal Mask Airway™ (P-LMA™) is one of the commonly used laryngeal mask airways. Despite the proper insertion technique, suboptimal positioning and airway morbidity still occurs. This study explored the possibility of the operating table height position affecting successful P-LMA™ placement.
METHODS: A total of 138 patients aged between 18 and 65 years old with the American Society of Anesthesiologists (ASA) I or II status, who required general anaesthesia and had no contraindication towards the use of P-LMA™, were recruited. They were randomly positioned into three anatomical landmarks, which were umbilicus, lowest rib margin, and xiphoid. P-LMA™ was inserted following muscle paralysis, and the first successful placement was evaluated using positional and performance tests. Duration, ease of P-LMA™ insertion, and airway complications were compared.
RESULTS: Demographic and airway features were comparable among all groups. The P-LMA™ placement success rate improved when the table height was positioned at the lowest rib margin (p=0.002). All three positions were comparable in terms of duration, ease of insertion, and airway morbidities.
CONCLUSION: The lowest rib margin anatomical landmark can be used as a guide in achieving the optimal operating table height for successful P-LMA™ placement.