MyMedR

How do surgeons weather the storm of COVID-19 pandemic?

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.

Fulltext Pulmonary resection for metastatic breast cancer

Gooi BH, Premnath N, Manjit S

Med J Malaysia, 2004 Mar;59(1):112-4.

PMID: 15535346

The management of pulmonary metastasis from breast carcinoma is challenging and often consists of palliation of symptoms. Surgical resection of pulmonary metastasis is considered inappropriate in view of the disseminated nature of the disease and limited life expectancy. It can however be a worthwhile option if imaging, including bone scans rule out metastatic disease in other part of the body. We report a patient with pulmonary metastasis from breast carcinoma who was successfully treated with pulmonary wedge resection of the metastatic lesion.

Fulltext Pitfall in diagnostic trauma laparoscopy

Yeap BH, Premnath N, Manjit S

Med J Malaysia, 2005 Mar;60(1):89-90.

PMID: 16250287

The resurging interest in diagnostic laparoscopy has witnessed its increasing application in trauma surgery. Such unbridled enthusiasm has at times overlooked its shortcoming in the diagnosis and management of certain in abdominal injuries. We report and discuss one such conspicuous limitation and advocate that the use laparoscopy in abdominal trauma should be tempered with caution.

Fulltext Thoracoscopic sympathectomy for primary palmar hyperhydrosis: the Penang Hospital experience

Gooi BH, Manjit S, Premnath N

Med J Malaysia, 2002 Mar;57(1):66-9.

PMID: 14569720 MyJurnal

Background: Primary palmar hyperhidrosis is a functionally and socially disabling condition. The choice of treatment is controversial.
Objective: To examine the clinical presentation of primary palmar hyperhidrosis and the results of treatment with thoracoscopic sympathectomy in a local setting.
Materials and Methods: A retrospective study of 7 patients involving 10 sympathectomies between October 1997 and October 2000 was undertaken.
Results: The duration of anaesthesia ranged from 55 to 130 minutes with the majority being 1 hour. The immediate results were good, with all operated limbs dry soon after operation. There was no mortality or serious morbidity in this study. All were satisfied with the results of surgery.
Conclusions: Primary palmar hyperhidrosis is not uncommon but rather underdiagnosed. Thoracoscopic sympathectomy is an effective treatment with minimal complications.

Fulltext Thoracoplasty with acrylic plate-marlex mesh combination following near total resection of sternum: a case of chondrosarcoma of sternum

Premnath N, Lo HL, Cheong YT, Manjit S

Med J Malaysia, 2002 Sep;57(3):368-70.

PMID: 12440279

Removal of the whole sternum for malignant tumours results in a large defect, causing severe deformity and possible paradoxical movements of the chest wall. The reconstruction of the resultant large defect of the chest wall is often complex and difficult. Commonly used materials include rib autograft, steel strus acrylic plate and various synthetic meshes such as Goretex or Marlex mesh, with a myocutaneous flap for coverage. A case of a 48-year-old man with sternal chondrosarcoma successfully treated with thoracoplasty using acrylic plate-marlex mesh combination following near total resection of sternum is reported.

A dedifferentiated large posterior mediastinal liposarcoma - An incidental finding successfully resected

Narasimman S, Jasjit SN, Navarasi SR, Premnath N

Med J Malaysia, 2016 08;71(4):201-202.

PMID: 27770120

This is a case of a posterior mediastinal mass in an asymptomatic gentleman, which was resected successfully and he has been disease free for more than a year of follow up. The histopathology findings happen to be a rare occurrence.

Are we reaping what we sow? Gender diversity in surgery: a survey of medical students

Cronin C, Lucas M, McCarthy A, Boland F, Varadarajan R, Premnath N, et al.

Postgrad Med J, 2019 Mar;95(1121):119-124.

PMID: 30975724 DOI: 10.1136/postgradmedj-2018-136136

BACKGROUND: A survey of medical students from the Royal College of Surgeons in Ireland (RCSI) at Dublin, Perdana and Penang in Malaysia was undertaken in an attempt to explore attitudes towards a career in surgery and document potential differences between male and female students' perceptions of a surgical career.

METHOD: A hyperlink to an online, anonymised questionnaire was distributed to medical students in 3rd, 4th and final year at three RCSI campuses. Basic descriptive statistics were used to describe the responses to individual questions and appropriate statistical tests used to compare male and female responses to questions.

RESULTS: A total of 464 completed questionnaires were analysed. Almost 40% (n=185) were male and 60% (n=279) were female. Males were significantly more influenced by remuneration than females (p<0.001) towards a choice of surgical career. Females were significantly more influenced in their choice of surgical career by part-time work (p<0.001), parental leave (p<0.001), working hours (p<0.001) and length of residency (p=0.003). During surgical attachments, females were significantly more likely to admit feeling intimidated than males (p=0.002) and males more likely to report feeling confident (p<0.001). Ninety-six per cent of students felt they would be more likely to pursue a career in which they had identified a positive role model, with female medical students three times more likely to have identified a female role model than males.

CONCLUSION: According to our study, preference for a career in surgery declines with advancing years in medical school for both males and females. Medical students report high levels of feeling intimidated or ignored during their surgical placements, and enthusiasm for surgery reduces during medical school with exposure to this. These findings, along with the importance of role modelling, add further urgency to the need to address factors which make surgery less appealing to female medical graduates.

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