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  1. Yeap TB, Teah MK, Zenian S
    BMJ Case Rep, 2021 Mar 04;14(3).
    PMID: 33664045 DOI: 10.1136/bcr-2021-241916
    Jehovah's Witnesses (JW) is a branch of Christianity which was founded in 1872. However, their beliefs differ from other Christians in many ways. Majority of JW believe that it is against the teaching of God should they receive blood transfusion, while minority think receiving own blood or others is acceptable. These vast beliefs should always be respected by all medical practitioners to avoid medicolegal implications. The differing beliefs about blood transfusion is certainly a huge challenge to the surgeons and anesthesiologists, especially dealing with major surgeries. Thus, effective surgical and anaesthetic techniques are focused to minimise blood loss to avoid unnecessary blood transfusion. We report a JW patient who successfully underwent an emergency endoscopic transsphenoidal surgery secondary to pituitary apoplexy; highlighting our intraoperative acute hypervolaemic haemodilution technique to reduce blood loss.
  2. Teah MK, Chan GK, Wong MTF, Yeap TB
    BMJ Case Rep, 2021 Jan 08;14(1).
    PMID: 33419751 DOI: 10.1136/bcr-2020-238318
    Prolonged exposure to benzodiazepines (BDZ) may contribute towards physical dependence, which is manifested by iatrogenic Benzodiazepine Withdrawal Syndrome (BWS), a condition often underdiagnosed. Current evidence recommends precluding BDZ infusion as sedation in the intensive care unit to avoid possible withdrawal and delirium issues. Administration of dexmedetomidine should be considered to facilitate weaning in patients with BWS.
  3. Teah MK, Chu YM, Shanmuganathan SD, Yeap TB
    BMJ Case Rep, 2020 Dec 09;13(12).
    PMID: 33298493 DOI: 10.1136/bcr-2020-237764
    Intubations are important live saving skills to maintain adequate ventilation and oxygenation. Common indications include impending upper airway obstruction, respiratory failure and impaired conscious level. Oral myiasis is an infrequently found disease which is characterised by ectoparasitic infestation of body tissues by fly maggots.We present a case report and share valuable experiences on a patient with massive airway myiasis causing upper airway obstruction which require emergency intubation.
  4. Teah MK, Liew EHR, Wong MTF, Yeap TB
    BMJ Case Rep, 2021 Feb 19;14(2).
    PMID: 33608338 DOI: 10.1136/bcr-2020-238600
    Awake fibreoptic intubation (AFOI) is an established modality in patients with anticipated difficulty with tracheal intubation. This case demonstrates that with careful and meticulous preparations, AFOI can lead to improved airway management and excellent patient outcomes. A 38-year-old woman presented with severe trismus secondary to odentogenous abscess was identified preoperatively as having a potential difficult airway. AFOI was performed successfully using combined Spray-As-You-Go and dexmedetomidine technique.
  5. Yeap TB, Teah MK, Thevarajah S, Azerai S
    BMJ Case Rep, 2021 Mar 25;14(3).
    PMID: 33766970 DOI: 10.1136/bcr-2020-241176
    Wolff-Parkinson-White (WPW) syndrome is an extremely rare congenital cardiac conduction disorder. It is due to an aberrant pathway between the atrium and ventricle. This manuscript entails a man with an underlying WPW who was posted for an elective orchidectomy. We discussed the important perioperative precautions to prevent the precipitation of acute cardiac events.
  6. Yeap TB, Teah MK, Ramly AKM, Bong CP
    BMJ Case Rep, 2021 Apr 09;14(4).
    PMID: 33837036 DOI: 10.1136/bcr-2021-242118
    Anaesthesia for patients with huge mediastinal mass is very challenging due to the cardiorespiratory embarrassment that may occur. We present a patient with this condition, which was complicated by total airway obstruction, intraoperatively. We discuss the importance of patient positioning and the role of spontaneous ventilation.
  7. Yeap TB, Teah MK, Quay YJJ, Wong MTF
    BMJ Case Rep, 2021 Jan 28;14(1).
    PMID: 33509897 DOI: 10.1136/bcr-2020-241008
    Acute stridor is often an airway emergency. We present a valuable experience handling an elderly woman who was initially treated as COVID-19 positive during the pandemic in November 2020. She needed an urgent tracheostomy due to nasopharyngeal (NP) diffuse large B-cell lymphoma causing acute airway obstruction. Fortunately, 1 hour later, her NP swab real-time PCR test result returned as SARS-CoV-2 negative. This interesting article depicts the importance of adequate preparations when handling potentially infectious patients with anticipated difficult airway and the perioperative issues associated with it.
  8. Teah MK, Yap KY, Ismail AJ, Yeap TB
    BMJ Case Rep, 2021 Feb 17;14(2).
    PMID: 33597165 DOI: 10.1136/bcr-2020-241148
    Placement of a double-lumen tube to achieve one lung ventilation is an aerosol-generating procedure. Performing it on a patient with COVID-19 will put healthcare workers at high risk of contracting the disease. We herein report a case of its use in a patient with traumatic diaphragmatic rupture, who was also suspected to have COVID-19. This article aims to highlight the issues, it presented and ways to address them as well as the perioperative impact of personal protective equipment.
  9. Lo SY, Teah MK, Ho YZ, Yeap TB
    BMJ Case Rep, 2021 Feb 05;14(2).
    PMID: 33547110 DOI: 10.1136/bcr-2020-241189
    A young man presented to our centre needing an urgent debridement of his postcraniotomy wound due to massive myiasis during the COVID-19 pandemic in October 2020. Prior to the surgery, his nasopharyngeal swab real-time PCR test result was unknown. One day later, it returned as SARS-CoV-2 positive. All healthcare workers who were involved in the patient management avoided cross infection as they wore appropriate personal protective equipment. This article depicts the importance of adequate preparations when handling potentially infectious patients and the perioperative issues associated with it.
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