MyMedR

Fulltext Ultrasound in the diagnosis of splenic abscess. Case report

Sivalingam S

Med J Malaysia, 1988 Dec;43(4):338-9.

Tetralogy of Fallot correction with transannular patch reconstruction in a patient with an anomalous right coronary artery and an unusual course of the right ventricular branch

Gonzalez SA, Sivalingam S

Indian J Thorac Cardiovasc Surg, 2021 May;37(3):329-333.

PMID: 33967425 DOI: 10.1007/s12055-020-01074-0

Anomalous coronary arteries occur in as many as 12% of patients with tetralogy of Fallot (TOF). In patients with this condition, pulmonary hypoplasia can be prohibitive in performing a valve-sparing repair, subsequently resulting in various techniques to preserve the anomalous coronary artery. The management strategy is often complex in such a situation. We report on a case of TOF with an anomalous right coronary artery crossing the right ventricular outflow tract, with an unusual course of the right ventricular (RV) branch, which precluded placement of a valved conduit. In this case, we performed a successful repair with mobilization of the anomalous coronary artery and reconstruction of the right ventricular outflow tract with a limited transannular patch.

Strategy for ventricular septal defect closure after prior gastric pull-through

Sivalingam S, Krishnasamy S, Yakub MA

Asian Cardiovasc Thorac Ann, 2015 Jun;23(5):612-4.

PMID: 24962807 DOI: 10.1177/0218492314540667

A 9-year-old boy was referred with a perimembranous ventricular septal defect. At birth, he had undergone a right thoracotomy with ligation of a tracheoesophageal fistula, cervical esophagostomy, and feeding gastrostomy. At 2 years of age, he had gastric tube reconstruction with a pull-through retrosternally, anterior to the heart, and an end-to-end esophagogastric anastomosis. Via a right anterolateral thoracotomy through the previous scar, the entire gastric tube was mobilized away from the sternum to facilitate a median sternotomy. With the patient supine, a median sternotomy was performed without difficulty, and the ventricular septal defect was closed under cardiopulmonary bypass.

Persistent valve of systemic venous sinus: a cause of neonatal cyanosis

Qureshi AU, Latiff HA, Sivalingam S

Cardiol Young, 2014 Aug;24(4):756-9.

PMID: 24016801 DOI: 10.1017/S1047951113001200

Incomplete involution of valve of systemic venous sinus can present across a spectrum of anatomical lesions ranging from eustachian valve to division of right atrium (cor triatriatum dexter) with overlapping features. We present the case of a neonate presenting with cyanosis, having persistent valve of systemic venous sinus with anatomical details of the redundant tissue in right atrium suggesting an intermediate form between Chiari network and division of right atrium.

Medical radiation exposures for diagnostic radiology in Malaysia

Ng KH, Abdullah BJ, Sivalingam S

Health Phys, 1999 Jul;77(1):33-6.

PMID: 10376539

The medical radiation usage for diagnostic radiology in Malaysia (a Level II country) for 1990-1994 is reported, enabling a comparison to be made for the first time with the United Nations Scientific Committee on the Effects of Atomic Radiation Report. In 1994, the number of physicians, radiologists, x-ray units, and x-ray examinations per 1,000 population was 0.45, 0.005, 0.065, and 183, respectively. (Level I countries had averages of 2.6, 0.072, 0.35, and 860, respectively). In 1994, a total of 3.6 million x-ray examinations were performed; the annual effective dose per capita to the population was 0.05 mSv, and the collective effective dose was 1,000 person-Sv. Chest examinations contributed 63% of the total. Almost all examinations experienced increasing frequency from 1990 to 1994 except for barium studies, cholecystography, and intravenous urography (-23%, -36%, -51%). These decreases are related to the increasing use of ultrasound and greater availability of fiberoptic endoscopy. Notable increases during the same period were observed in computed tomography (161%), cardiac procedures (190%), and mammography (240%). In order to progress from Level II to Level I status Malaysia needs to expand and upgrade radiological service in tandem with the health care development of the country.

Fulltext X-ray based radiological procedures in Malaysia--1990-1994

Ng KH, Abdullah BJJ, Rassiah P, Sivalingam S

Med J Malaysia, 1999 Jun;54(2):185-91.

PMID: 10972028

X-ray based radiological procedure statistics and trend in Malaysia for 1990-1994 is reported; this information allows comparisons to be made with the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) Report. Additionally it is essential information for health care planners and providers. Malaysia is categorised as a health care level II country based on the UNSCEAR definition. In 1994, the number of physicians, radiologists, x-ray units and x-ray examinations per 1000 population was 0.45, 0.005, 0.065 and 183 respectively. 3.6 million x-ray examinations were performed in 1994, with chest radiography being the commonest study (63%). Information on x-ray examinations, number of hospitals and x-ray units is reported for the Ministry of Health, private practice and teaching hospitals. Examination frequency increased in computed tomography (161%), cardiac procedures (190%), and mammography (240%); while a decrease in barium studies (-23%), cholecystography (-36%), and intravenous urography (-51%) was noted. There is a potential and need to expand and upgrade radiological services.

Fulltext Renal papillary necrosis in Ipoh

Segasothy M, Thyaparan A, Sivalingam S, Kamal A, Vijaya Kumar R

Med J Malaysia, 1986 Mar;41(1):19-23.

PMID: 3796342

594 intravenous urograms done at the General Hospital, Ipoh, from January 1981 to March 1985 were reviewed for renal papillary necrosis (RPN). 11 cases (1.8%) of RPN were detected. Of these three were due to diabetes mellitus;eight were due to analgesic nephropathy. There was an equal incidence
in males and females, contrary to the experience in the West and Australia. RPN was observed mainly in the older age groups. Five of the 11 cases of RPN presented as renal colic.

Circumflex aorta: An uncharted territory

Haranal M, Srimurugan B, Sivalingam S

Asian Cardiovasc Thorac Ann, 2021 May 06.

PMID: 33957784 DOI: 10.1177/02184923211015092

BACKGROUND: Vascular rings are aortic arch anomalies with a spectrum of manifestations ranging from asymptomatic lesions detected incidentally to an acute presentation secondary to tracheo-esophageal compression. Circumflex retro-esophageal aortic arch is an extreme form of true vascular ring. It remains an uncharted territory to many surgeons.

METHODS: A comprehensive search of peer reviewed journals was completed based on the key words, "Circumflex aorta," "Circumflex retro-esophageal aorta" and "circumflex arch" using Google scholar, Scholars Portal Journals and PubMed. The reference section for each article found was searched to obtain additional articles. Literature on the circumflex aorta was reviewed starting from the embryogenesis to the latest management strategies.

RESULTS: Right circumflex aorta is more prevalent compared to left circumflex aorta. It can occur in isolation or in association with other intracardiac lesions. Mainly presents in children, however reported in adults too. The presentation may vary from asymptomatic lesion to acute respiratory distress secondary to airway compression. Computerized tomography (CT) and magnetic resonance imaging (MRI) are important tools in delineating the vascular anatomy. Aortic uncrossing is the definitive procedure. However, the role of concomitant tracheobronchopexy is emerging. Native tissue-to-tissue anastomosis is commonly preferred, but cases of extra-anatomic grafts are reported.

CONCLUSION: Circumflex aorta is amenable to complete repair. Preoperative delineation of anatomy is important for successful surgical outcome. Division of the retro-esophageal segment is crucial in relieving the compressive symptoms. In addition, tracheobronchopexy is helpful in addressing residual tracheomalacia but this accounts for a high-risk surgery.

Asymptomatic Balanced Double Aortic Arch Associated With Tetralogy of Fallot

Haranal M, Abdul Latiff HB, Sivalingam S

World J Pediatr Congenit Heart Surg, 2020 01;11(1):130-132.

PMID: 31835984 DOI: 10.1177/2150135119885889

Coexistence of asymptomatic balanced double aortic arch with tetralogy of Fallot (TOF) is extremely rare and represents a surgical dilemma in decision-making due to the lack of consensus on the management of this subset of patients. We report a case of asymptomatic balanced double aortic arch coexistent with TOF in a two-year-old girl.

Modified Tran Viet-Neveux technique of truncus arteriosus repair

Haranal M, Latiff HA, Sivalingam S

Asian Cardiovasc Thorac Ann, 2021 Jul;29(6):563-564.

PMID: 33653150 DOI: 10.1177/0218492321998503

Fulltext Aortic valve neocuspidization for aortic regurgitation associated with ventricular septal defect

Sivalingam S, Haranal M, Pathan IH

Interact Cardiovasc Thorac Surg, 2022 Jan 18;34(2):315-321.

PMID: 34499736 DOI: 10.1093/icvts/ivab239

OBJECTIVES: Different methods of aortic valve repair have been described in the literature for aortic regurgitation (AR) associated with doubly committed subarterial ventricular septal defects. Our goal was to present our experience with aortic valve reconstruction of a single leaflet using the aortic valve neocuspidization technique in this subset of patients.

METHODS: It is a retrospective review of 7 patients with doubly committed subarterial ventricular septal defects with significant (>moderate) AR who underwent the single-leaflet neocuspidization technique of aortic valve reconstruction from January 2016 to January 2019. Data were collected from medical records. All patients had thorough 2-dimensional echocardiographic assessment preoperatively and during the follow-up period. Primary end points were freedom from postoperative AR and freedom from reoperation and all-cause mortality within the follow-up period with secondary end points of freedom from thromboembolism and infective endocarditis.

RESULTS: Out of 7 patients, 6 were male and 1 was female. There were no perioperative deaths. The mean follow-up period was 2.6 ± 0.8 years. No deaths occurred during the follow-up period. At the latest follow-up examination, only 2 patients showed mild AR and were asymptomatic. There was no documented event of infective endocarditis or thromboembolism during the follow-up period.

CONCLUSIONS: The aortic leaflet neocuspidization procedure for the aortic valve is a relatively new concept. Availability of a template makes it an easily reproducible valve repair in paediatric patients with a single-leaflet abnormality. This technique preserves the remaining 2 normal leaflets, thus promoting the growth potential while maintaining near normal aortic root complex dynamics.

Explantation of the Venus P-valve: a first in-human experience

Saram SJ, Leong MC, Sivalingam S

Interact Cardiovasc Thorac Surg, 2021 10 04;33(4):671.

PMID: 34606583 DOI: 10.1093/icvts/ivab129

Fulltext Stenting of right ventricular outflow tract in Tetralogy of Fallot with subarterial ventricular septal defect: A word of caution

Lee J, Sivalingam S, Alwi M

Ann Pediatr Cardiol, 2017 9 21;10(3):281-283.

PMID: 28928615 DOI: 10.4103/apc.APC_168_16

We report a case of Tetralogy of Fallot with severe cyanosis who underwent a successful right ventricular outflow tract stenting. Follow-up echocardiography revealed moderate aortic regurgitation due to the impingement of the stent on the aortic valve. The patient underwent successful surgical correction at which time the stent was removed completely with a resolution of the aortic regurgitation.

Fulltext Total anomalous origin of the coronary arteries from the right pulmonary artery

Haranal M, Srimurugan B, Sivalingam S

Indian J Thorac Cardiovasc Surg, 2022 Mar;38(2):231-234.

PMID: 35221566 DOI: 10.1007/s12055-021-01274-2

Fulltext Renal papillary necrosis in the east coast of Peninsular Malaysia

Segasothy M, Kamal A, Das D, Naidu RR, Sivalingam S

Singapore Med J, 1990 Jun;31(3):250-2.

PMID: 2392703

Six hundred and one intravenous Urograms (IVU) done at the General Hospital, Kuala Trengganu from 1981 to 1985 were reviewed retrospectively for Renal Papillary Necrosis (RPN). It was found that 1.3% of IVUs had RPN. There was a higher incidence of RPN amongst males as compared to females. RPN occurred more commonly in the younger age groups.

An uncommon mediastinal cyst with a rare neurologic consequence

Sivalingam S, Qureshi AU, Chern LM, Latiff HA

Ann Thorac Surg, 2014 Apr;97(4):e93-5.

PMID: 24694456 DOI: 10.1016/j.athoracsur.2013.12.060

Enteric cysts are uncommon posterior mediastinal cysts, usually presenting with respiratory symptoms in infancy. We present a rare case of posterior mediastinal enteric cyst extending from below the diaphragm and perforating into the left atrium, causing a thromboembolic cerebral infarct in a 5-year-old boy.

Aneurysmal dilatation without distal obstruction: a rare complication of valved bovine jugular vein conduit

Qureshi AU, Abbaker AE, Sivalingam S, Latiff HA

World J Pediatr Congenit Heart Surg, 2014 Apr;5(2):348-51.

PMID: 24668992 DOI: 10.1177/2150135113509819

Valved bovine jugular vein (Contegra) conduit is considered a suitable choice for pediatric population with congenital heart defect requiring right ventricle to main pulmonary artery connection. Intermediate follow-up studies have shown the propensity of developing distal conduit stenosis and valve thrombosis. We present a rare case of aneurysmal dilatation of the conduit leading to valve failure requiring conduit explantation.

Hook wire localization for testis sparing surgery

Ong TA, Yaakup NA, Sivalingam S, Razack AH

Urology, 2013 Apr;81(4):904-7.

PMID: 23537760 DOI: 10.1016/j.urology.2012.10.077

To describe a novel technique for localizing small testicular mass during testicular-sparing surgery (TSS).

Right Ventricular Perforation Caused by a Pacing Catheter Two Weeks After Insertion in a Neonate With Congenital Atrioventricular Block

Ota N, Suzuki R, Latiff HA, Sivalingam S

Ann Thorac Surg, 2015 Oct;100(4):1471.

PMID: 26434454 DOI: 10.1016/j.athoracsur.2015.06.084

Single-nucleotide polymorphisms of the interleukin-18 gene promoter region in rheumatoid arthritis patients: protective effect of AA genotype

Sivalingam SP, Yoon KH, Koh DR, Fong KY

Tissue Antigens, 2003 Dec;62(6):498-504.

PMID: 14617033 DOI: 10.1046/j.1399-0039.2003.00137.x

Rheumatoid arthritis (RA) is a chronic arthritic condition that can lead to deformities and disabilities. Although numerous studies reported the association of human leukocyte antigen (HLA)-DRB1*04 and RA, other genes, e.g. cytokines genes, may contribute towards disease susceptibility. Interleukin-18 (IL-18) is a proinflammatory cytokine postulated to play a role in the acute and chronic inflammatory phases of RA. The IL-18 protein expression seems to be regulated by two single-nucleotide polymorphisms (SNPs) located at positions -607 and -137 in the promoter region of the gene. It is postulated that specific alleles may be associated with susceptibility to the development of RA. In the present study, we described the IL-18 gene promoter region genotypes and combined genotypes (-607/-137) in 106 RA patients and 273 unrelated healthy controls to evaluate the contributions of these alleles to RA predisposition in Chinese, Malays, and Indians. The genotyping were performed using sequence-specific polymerase chain reactions. Rheumatoid factors were assayed by enzyme-linked immunosorbent assay. Biodata were obtained through chart review. The controls had significantly higher frequency of AA genotype at position -607 when compared to RA patients. No significant differences were observed in the distribution of either allelic or genotypic frequencies at position -137. There was no association between the genotypes and the presence of rheumatoid factors. This study did not find evidence of a genetic susceptibility factor but demonstrated the novel finding that the AA genotype at position -607 is associated with a protective effect against development of RA in Chinese individuals. This protection may be mediated through inhibition of cyclic (Adenosine 3', 5'-cyclic monophosphate) AMP-responsive element (CRE)-binding protein by the disruption of the CRE consensus sequence.

Displaying publications 1 - 20 of 52 in total