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A randomized controlled trial of trigger finger release under digital anesthesia with (WALANT) and without adrenaline

Mohd Rashid MZ, Sapuan J, Abdullah S

J Orthop Surg (Hong Kong), 2019 3 12;27(1):2309499019833002.
PMID: 30852960 DOI: 10.1177/2309499019833002

BACKGROUND:: Trigger finger release utilizing wide-awake local anesthesia no tourniquet (WALANT) usage in extremity surgery is not widely used in our setting due to the possibility of necrosis. Usage of a tourniquet is generally acceptable for providing surgical field hemostasis. We evaluate hemostasis score, surgical field visibility, onset and duration of anesthesia, pain score, and the duration of surgery and potential side effects of WALANT.
METHODS:: Eighty-six patients scheduled for trigger finger release between July 2016 and December 2017 were randomized into a control group (1% lignocaine and 8.4% sodium bicarbonate with arm tourniquet; given 10 min prior to procedure) and an intervention group (1% lignocaine, 1:100,000 of adrenaline and 8.4% sodium bicarbonate; given 30 min prior to procedure), with a total of 4 ml of solution injected around the A1 pulley. The onset of anesthesia and pain score upon injection of the first 1 ml were recorded. After the procedure, the surgeon rated for the hemostasis score (1-10: 1 as no bleeding and 10 being profuse bleeding). Duration of surgery and return of sensation were recorded.
RESULTS:: Hemostasis score was grouped into visibility score as 1-3: good, 4-6: moderate, and 7-10: poor. The intervention group (with adrenaline) had a 74% of good surgical field visibility compared to 44% from the controlled group (without adrenaline; p < 0.05). Duration of anesthesia was longer in the intervention group (with adrenaline), with a 2.77-h difference.
CONCLUSION:: WALANT provides excellent surgical field visibility and is safe and on par with conventional methods but without the usage of a tourniquet and its associated discomfort.
Fulltext Osteoradionecrosis in Subaxial Cervical Spine - a Rare and Devastating Complication: A Case Report

Rashid MZ, Ariffin MH, Rhani SA, Baharudin A, Ibrahim K

Malays Orthop J, 2017 Nov;11(3):53-55.
PMID: 29326769 MyJurnal DOI: 10.5704/MOJ.1711.005

Osteoradionecrosis, a rare complication of radiation therapy, is a slow progression disease which affects the surrounding structures of spinal components. It essentially weakens the soft tissue and bony configuration and can cause nerve impingement or cord compression. We describe a patient who underwent radiotherapy for thyroid cancer and presented with cervical kyphosis with anterolisthesis of C3/C4 and C4/C5 some 32 years later. We explore the role of anterior and posterior fusion, as well as hyperbaric oxygen therapy in promoting healing.
Occurrence and potential human health risk of pharmaceutical residues in drinking water from Putrajaya (Malaysia)

Praveena SM, Mohd Rashid MZ, Mohd Nasir FA, Sze Yee W, Aris AZ

Ecotoxicol Environ Saf, 2019 Sep 30;180:549-556.
PMID: 31128553 DOI: 10.1016/j.ecoenv.2019.05.051

Occurrence of pharmaceutical residues in drinking water has been widely reported in countries that have registered steady economic growth. This can exert concerns among the general consumers, prompting them to explore the potential human health risks associated with continuous exposure to pharmaceuticals. However, such an occurrence is rarely reported in developing or under-developed countries. To give more contexts, this study looked at the presence of nine pharmaceutical residues in drinking water (amoxicillin, caffeine, chloramphenicol, ciprofloxacin, dexamethasone, diclofenac, nitrofurazone, sulfamethoxazole, and triclosan) at Putrajaya residential area in Malaysia. Additionally, the potential health risks associated with contaminated drinking water were investigated. This study has found the presence of pharmaceutical residue concentrations up to 0.38 ng/L, with the highest concentration of caffeine (0.38 ng/L) and the lowest concentration of diclofenac (0.14 ng/L). In comparison, all the nine pharmaceutical residues were substantially lower than previously reported studies. In general, Hazard Quotient (HQ) values indicated that low potential health hazards were present for all age groups. Nevertheless, quantitative occurrences of pharmaceutical residues in drinking water will help guide future toxicological studies to examine other chronic effects, while canvassing for proper framework to look into the water risk management and regulation in Malaysia.
Composition and biting activity of Anopheles (Diptera: Culicidae) attracted to human bait in a malaria endemic village in peninsular Malaysia near the Thailand border

Hassan AA, Rahman WA, Rashid MZ, Shahrem MR, Adanan CR

J Vector Ecol, 2001 Jun;26(1):70-5.
PMID: 11469187

Nine species of Anopheles mosquitoes were collected biting humans indoors and outdoors in a malaria endemic village in northern Peninsular Malaysia. Outdoor biting was higher than that observed indoors. Biting of An. maculatus was observed throughout the night. Peak indoor biting occurred at 2130 h while outdoor biting was higher after midnight. Outdoor biting of Anopheles barbirostris and An. sinensis was observed throughout the night with several peaks after the second half of the night. Outdoor biting activities of An. kochi and An. philippinensis were primarily active after dusk and steadily declined after 2130 h.
The distribution of common Anopheles mosquitoes in northwestern Peninsular Malaysia

Abu Hassan A, Rahman WA, Salmah MR, Rashid MZ, Jaal Z, Adanan CR, et al.

J Vector Ecol, 1997 Dec;22(2):109-14.
PMID: 9491360

Using cow-baited net traps in the coastal and hilly areas of northern peninsular Malaysia, 21 species of Anopheles mosquitoes were found. The distribution of common Anopheles is presented. The composition of the anopheline mosquito fauna was more diversified in the coastal areas than in the hilly areas. The displacement of Anopheles sundaicus by Anopheles subpictus and the disappearance of Anopheles hackeri in the coastal area were noted.