Displaying all 19 publications

  1. Zamri Z, Harunarashid, Das S, Ramzisham AR
    Clin Ter, 2010;161(5):457-8.
    PMID: 20964103
    Ureteritis cystica is a rare, benign, proliferative condition. We report the case of a 51-year-old female who complained of dysuria and frequency for the last 10 years. The symptoms, however, increased in severity and frequency over the past one year. Urine culture and sensitivity showed presence of Escherichia Coli which was sensitive to augmentin and ciproflaxocin. The urinary tract ultrasonography and intravenous urography revealed bladder diverticula with multiple small, smooth well defects with sharp borders that protruded into the lumen along the proximal and mid left ureter. This finding was later confirmed by retrograde pyelogram. She was treated and currently is on long term antibiotic therapy. The diagnostic features and management of ureteritis cystic is being discussed in detail.
  2. Ramzisham AR, Thambidorai CR
    Pediatr Surg Int, 2005 Jun;21(6):478-81.
    PMID: 15902476
    A rare case of a newborn male with a perineal hamartoma, accessory scrotum, anorectal anomaly, hypospadias, and bifid scrotum is reported, with discussion of its embryological significance. Only three other cases with such a combination of anomalies have been reported in the English literature.
  3. Tan GH, Harunarashid H, Das S, Goh YH, Ramzisham AR
    Clin Ter, 2010;161(6):533-4.
    PMID: 21181082
    An internal hernia through the mesosalpinx is a rare condition which is often overlooked. We report the case of a 65-year-old lady who presented with features of small bowel obstruction. At laparotomy, a gangrenous ileum was found to have herniated through a defect in the right mesosalpinx. We discuss this rare cause of a small bowel obstruction and its diagnostic dilemma.
  4. Rosliza G, Hairulfaizi H, Joanna OS, Zamrin DM, Ramzisham AR
    Med J Malaysia, 2010 Jun;65(2):146-7.
    PMID: 23756801
    We present a rare case of a multifocal sclerosing haemangioma of the lung in a 49-year-old lady. A left pneumonectomy with complete excision of the tumour seems to be the curative treatment. The recent literature on this unusual presentation is reviewed.
  5. Ramzisham AR, Somasundaram S, Nasir ZM, Ali F, Das S
    Clin Ter, 2010;161(5):453-5.
    PMID: 20949243
    For the management of a full-thickness scalp avulsion injury, thorough wound debridement and immediate primary revascularization or a split-thickness skin graft may be necessary. Graft failure may be common situation thereby predisposing the individuals to unnecessary multiple operations. In the recent times, the use of omental graft has gained much popularity. In the present study, we describe an interesting case of chronic non healing scalp ulcer in a young woman who eventually underwent a free omental flap reconstruction with split-thickness skin graft and had satisfactory outcome.
  6. Ooi JS, Ramzisham AR, Zamrin MD
    Asian Cardiovasc Thorac Ann, 2009 Aug;17(4):368-72.
    PMID: 19713332 DOI: 10.1177/0218492309338101
    The aim of this study was to compare 6% hydroxyethyl starch 130/0.4 with 4% succinylated gelatin for priming the cardiopulmonary bypass circuit and as volume replacement in patients undergoing coronary artery bypass, in terms of postoperative bleeding, blood transfusion requirements, renal function, and outcome after surgery. Forty-five patients received 6% hydroxyethyl starch 130/0.4 (Voluven) and another 45 were given 4% succinylated gelatin (Gelofusine) as the priming solution for the cardiopulmonary bypass circuit as well as for volume replacement. Postoperative bleeding was quantified from the hourly chest drainage in the first 4 h and at 24 h postoperatively. The baseline characteristics of both groups were similar. In the hydroxyethyl starch group, the total amount of colloid used was 1.9 +/- 1.0 L, while the gelatin group had 2.0 +/- 0.7 L. There was no significant difference in hourly chest drainage between groups. Blood transfusion requirements, estimated glomerular filtration rate, extubation time, intensive care unit and hospital stay were similar in both groups. It was concluded that 6% hydroxyethyl starch 130/0.4 is a safe alternative colloid for priming the cardiopulmonary bypass circuit and volume replacement in patients undergoing coronary artery bypass surgery.
  7. Ngoo KS, Ramzisham AR, Joanna OS, Zamrin DM
    Med J Malaysia, 2008 Mar;63(1):61-2.
    PMID: 18935737 MyJurnal
    A middle-aged lady presented with a three-month history of chronic cough. After a long and extensive investigation, CT thorax revealed collapse consolidation of the right lower lung lobe and bronchoscopy showed a polypoidal tumour within the involved bronchus. Thoracotomy and segmental lung resection revealed a peanut in the airways of the fibrotic and infected lung tissue. In view of the rarity of the food particle aspiration in a healthy adult, the delay in presentation and diagnosis in our patient, we would like to highlight this particular case. A high index of suspicion of FBA is necessary to avoid unnecessary anxiety, extensive investigations and overzealous treatment as well as to promote lung conservation.
  8. Dharmaraj B, Kosai NR, Gendeh H, Ramzisham AR, Das S
    Clin Ter, 2016;167(3):67-71.
    PMID: 27424505 DOI: 10.7417/CT.2016.1928
    BACKGROUND: Hyperhidrosis is an excessive sweating disorder affecting quality of life. Endoscopic thoracic sympathectomy (ETS), introduced by Kux in 1951, is currently the gold standard surgical treatment for primary hyperhidrosis. 75% of patients with primary hyperhidrosis have seen improvement in quality of life within 30 days after surgery. Compensatory hyperhidrosis and pneumothorax (up to 75%) have been reported in patients after surgery. This study evaluates the functional status, self- esteem, compensatory hyperhidrosis and quality of life among patient with primary hyperhidrosis before and after undergoing ETS.
    METHOD: Fifty (n=50) patients between the ages 18 to 30, with primary hyperhidrosis were recruited. Patients answered the quality of life questionnaire and Rosenberg self-esteem questionnaire prior to surgery and 30 days post surgery on follow up. Any post-operative complications were documented. Telephone interviews were held for patients who were unable to attend the clinics for follow-up.
    RESULTS: Forty six patients (92%) had symptomatic relieve within 30 days of surgery. The incidence of compensatory sweating was 78% (39 patients), with 6 patients developing severe hyperhidrosis. Two patients who did not experience symptomatic relieve, developed compensatory hyperhidrosis. Pneumothorax was documented in 8 patients (16%), with 6 patients requiring chest tubes. Significant improvement in quality of life and self-esteem was seen among patients after surgery.
    CONCLUSIONS: ETS has shown to significantly improve the quality of life and self-esteem of patients with primary hyperhidrosis within 30 days of surgery. However, the rate of compensatory hyperhidrosis still remains high (78%) which requires a long term evaluation.
    KEYWORDS: Hyperhyrosis; Quality of life; Thoracoscopic Symphatectomy
  9. Tan SN, Gendeh HS, Gendeh BS, Ramzisham AR
    Indian J Otolaryngol Head Neck Surg, 2019 Nov;71(Suppl 3):1683-1686.
    PMID: 31763224 DOI: 10.1007/s12070-015-0918-4
    Hemangioma is a disease of head and neck commonly, but its presence in the nasal cavity or sinus is rare. It is a form of benign tumour of vascular origin consisting of predominantly blood vessels. It can be categorized into capillary, cavernous and mixed type in accordance to its histopathology features. Retrospectively, we reviewed five cases of nasal hemangioma presenting at University Kebangsaan Malaysia Medical Center (UKMMC) between September 2007 and May 2015. Information on the patients age, gender, ethnicity, clinical symptoms, imaging findings (if available), treatment modalities were collected retrospectively for analysis. Five patients were analysed. Females were more affected than male with ratio of 4:1. All patients presented with unilateral lobular capillary hemangioma of the nasal cavity with 60 % (3/5) of the lesions on the right side and 40 % (2/5) on the left side. The common symptoms at presentation were epitaxis and nasal obstruction (5/5, 100 %), followed by rhinorrhea (3/5, 60 %) and facial pain (1/5, 20 %). All the patients underwent a surgical excision of the hemangioma. The five patients had no recurrence on subsequent follow ups. Computed tomography of paranasal sinuses can be performed to exclude bony erosions. Endoscopic sinus haemangioma excision provide good visualisation and better outcomes. In conclusion, nasal hemangioma should always be differential diagnosis for nasal lesions and surgical excision is still the preferred first line treatment.
  10. Chai FY, Ishamuddin IM, Hairulfaizi H, Joanna SM, Ramzisham AR
    Clin Ter, 2012;163(2):125-7.
    PMID: 22555827
    The best management of asymptomatic carotid artery disease in patient who needs coronary bypass remains controversial. We report the neurological outcome of four patients with asymptomatic unilateral significant carotid artery disease who underwent conventional coronary bypass without carotid revascularization. Our review highlighted the risk of perioperative stroke is not increased despite carotid revascularization was not performed. Asymptomatic carotid artery disease is not the cause for cerebral infarct but soft aortic atheroma encountered during surgery is the main culprit.
  11. Ramzisham AR, Arief H, Ngoo KS, Zamrin DM, Joanna OS
    Clin Ter, 2011;162(6):553-4.
    PMID: 22262328
    Acute aortic dissection is a life-threatening condition, warranting prompt diagnosis and treatment. Management of which incorporates multidisciplinary expertise from the medical, surgical and intensive care. If left untreated, the mortality rate of acute aortic disease exceeds 50% within 48 hours and 80% within two weeks, with a 5-year survival rate of 19%. The most common cause of death in untreated acute aortic dissection, regardless of aetiology, is aortic rupture. We would like to share our successful experience of cases at the two extreme ages of acute aortic dissection. Literature review with their pathogenesis are discussed.
  12. Ishamuddin IM, Zamrin DM, Joanna OS, Ramzisham AR, Hairolfaizi H
    Clin Ter, 2011;162(6):527-31.
    PMID: 22262322
    The safety, feasibility and post-operative outcome are the main concern in Off-pump Coronary artery bypass graft (OPCAB) surgery as compared to conventional technique especially in multi-vessels coronary artery disease.
  13. Izham IN, Zamrin DM, Joanna OS, Ramzisham AR, Hairolfaizi H, Ishamuddin IM, et al.
    Clin Ter, 2011;162(6):521-5.
    PMID: 22262321
    The effect of the duration of ischaemic myocardial time to left ventricular ejection fraction (LVEF) after valve replacement surgery has been attributed. This study aims to look at the correlation between myocardial ischaemic time and changes LVEF post valve replacement surgery up to 6 months period.
  14. Aini IF, Zamrin DM, Joanna OS, Hairulfaizi H, Ramzisham AR
    Clin Ter, 2010;161(5):459-60.
    PMID: 20949244
    The incidence of primary hyperhidrosis ranges between 2-5%. This condition is more common than previously thought of and has been linked to a familial predisposition. It is socially disabling to the affected individuals. In the current era of minimally invasive surgery, the video assisted thoracoscopic sympathectomy has become the definitive treatment with minimal complications. We report on a case of two siblings with primary hyperhidrosis that was treated successfully at our institution with the aim to share our experience and attract awareness among medical practitioners of the availability of a cure for this condition.
  15. Ramzisham AR, Raflis AR, Khairulasri MG, Ooi Su Min J, Fikri AM, Zamrin MD
    Asian Cardiovasc Thorac Ann, 2009 Dec;17(6):587-91.
    PMID: 20026533 DOI: 10.1177/0218492309348948
    Sternal dehiscence is a rare but devastating complication following median sternotomy for cardiac surgery. The optimal technique for sternal closure is unclear. We conducted this prospective randomized trial to compare the incidence of sternal dehiscence after figure-of-8 and simple interrupted suturing in patients undergoing coronary artery bypass grafting. Between January 2007 and June 2008, 98 patients had figure-of-8 suturing and 97 had interrupted sutures. The mean age of the patients was 60.9 +/- 7.6 years. The overall sternal dehiscence rate was 8%; 7 cases in the in figure-of-8 group and 9 in the interrupted group. Thirteen patients had no wound infection and healed with conservative treatment. Only 3 patients had sternal dehiscence with infection: 2 with simple interrupted closure and 1 with figure-of-8 sternal closure. There was no significant difference in rates of sternal dehiscence between the 2 groups. It was concluded that figure-of-8 sternal suturing is equally effective as simple interrupted suturing in preventing sternal dehiscence.
  16. Ramzisham AR, Johann KF, Talal AR, Joanna OS, Zamrin DM
    Med J Malaysia, 2007 Dec;62(5):416-7.
    PMID: 18705480 MyJurnal
    A 23 year old female with a past history of a lung abscess diagnosed at the age of 13 years presented with recurrent episodes of productive cough. Chest radiograph and a high resolution CT scan of the thorax led to the diagnosis of a left lower lobe lung abscess. She underwent a successful thoracotomy and a left lower lobe lobectomy. Histopathological examination revealed the diagnosis of an infected congenital bronchogenic cyst. The recent literature on this is reviewed.
  17. Ramzisham AR, Sagap I, Nadeson S, Ali IM, Hasni MJ
    Asian J Surg, 2005 Oct;28(4):241-5.
    PMID: 16234072
    This prospective randomized clinical trial was undertaken to compare the use of a single-operator vacuum suction ligator and the traditional forceps ligator in terms of pain perception following the procedure, intra-procedure bleeding and other complications.
  18. Hafez P, Chowdhury SR, Jose S, Law JX, Ruszymah BHI, Mohd Ramzisham AR, et al.
    Cardiovasc Eng Technol, 2018 09;9(3):529-538.
    PMID: 29948837 DOI: 10.1007/s13239-018-0368-8
    Developing experimental models to study ischemic heart disease is necessary for understanding of biological mechanisms to improve the therapeutic approaches for restoring cardiomyocytes function following injury. The aim of this study was to develop an in vitro hypoxic/re-oxygenation model of ischemia using primary human cardiomyocytes (HCM) and define subsequent cytotoxic effects. HCM were cultured in serum and glucose free medium in hypoxic condition with 1% O2 ranging from 30 min to 12 h. The optimal hypoxic exposure time was determined using Hypoxia Inducible Factor 1α (HIF-1α) as the hypoxic marker. Subsequently, the cells were moved to normoxic condition for 3, 6 and 9 h to replicate the re-oxygenation phase. Optimal period of hypoxic/re-oxygenation was determined based on 50% mitochondrial injury via 3-(4,5-dimethylthiazol-2-Yl)-2,5-diphenyltetrazolium bromide assay and cytotoxicity via lactate dehydrogenase (LDH) assay. It was found that the number of cells expressing HIF-1α increased with hypoxic time and 3 h was sufficient to stimulate the expression of this marker in all the cells. Upon re-oxygenation, mitochondrial activity reduced significantly whereas the cytotoxicity increased significantly with time. Six hours of re-oxygenation was optimal to induce reversible cell injury. The injury became irreversible after 9 h as indicated by > 60% LDH leakage compared to the control group cultured in normal condition. Under optimized hypoxic reoxygenation experimental conditions, mesenchymal stem cells formed nanotube with ischemic HCM and facilitated transfer of mitochondria suggesting the feasibility of using this as a model system to study molecular mechanisms of myocardial injury and rescue.
  19. 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.
Related Terms
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links