Displaying publications 1 - 20 of 29 in total

  1. Thambidorai CR, Anuar Z
    J Indian Assoc Pediatr Surg, 2011 Jul;16(3):115-7.
    PMID: 21897576 DOI: 10.4103/0971-9261.83500
    This is a report on the use of magnetic resonance urography (MRU) in a 6-year-old girl who presented with urinary incontinence. She had a left duplex kidney with poorly functioning upper moiety and ectopic insertion of the dilated upper pole ureter. MRU has been shown to be superior to conventional imaging techniques in delineating poorly functioning moieties of duplex kidneys and ectopic ureters.
  2. Thambidorai CR, Khaleed A
    Pediatr Surg Int, 2008 Mar;24(3):371-4.
    PMID: 17492292
    Two patients with unilateral transverse testicular ectopia (TTE) without the persistence of Mullerian duct structures are described. Each presented with unilateral impalpable testis and a contralateral inguinal hernia. The diagnosis of unilateral TTE was made during laparoscopic evaluation for undescended testis. The first patient had unilateral TTE on the right side and the second on the left. In both patients, a long thin band resembling the round ligament of the uterus was seen extending from the region of the internal inguinal ring (IIR) on the side of the undescended testis to the opposite inguinal canal. In both patients, there was no patent processus vaginalis on the side of the undescended testis and on the contralateral side the internal rings were widely patent with large hernial sacs. In the second patient, the right vas was seen extending from the right IIR towards the right side of the pelvis. The right vas showed a short segment of discontinuity at the level of the right IIR while its proximal end extended into the left inguinal canal in close relation to the right spermatic vessels. The vasal anomaly was probably ischemic in origin, resulting from excessive mobility of the ectopic testis and its vas in TTE. Correlation of the current hypotheses on the embryology of TTE with the above mentioned laparoscopic findings is discussed.
  3. Hussain M, Thambidorai CR
    Med J Malaysia, 2000 Jun;55(2):271-2.
    PMID: 19839160
    A neurologically impaired child who had fundoplication and gastrostomy done for gastroesophageal at the age of three, presented two years later with intestinal obstruction. She underwent laparotomy and was found to have antegrade jejuno-jejunal intussusception. Intussusception is an unusual but recognised complication of gastrostomy tube placement.
  4. Thambidorai CR, Aman Fuad Y
    Singapore Med J, 2008 Dec;49(12):994-7.
    PMID: 19122949
    The place of laparoscopic appendicectomy in the management of complicated appendicitis remains unsettled with reports of a higher incidence of postoperative intraperitoneal abscess. Most studies on laparoscopic appendicectomy in children have been done in the Western population. This retrospective review was done to compare laparoscopic appendicectomy with open appendicectomy in children with complicated appendicitis in a hospital in Malaysia.
  5. Thambidorai CR, Raghu R, Zulfiqar A
    Pediatr Surg Int, 2008 Feb;24(2):161-5.
    PMID: 17985137
    Different criteria have been used in literature to describe the anterior ectopic anus (AEA) anomaly, resulting in uncertainty over its prevalence, association with constipation and definition of the indications for surgery. It has been recently proposed that the term AEA should be restricted to anomalies in which a normal appearing anal orifice is located in the perineum in a more anterior location than normal, with an anal canal of normal calibre that is shown by electrical stimulation to be surrounded by the voluntary external anal sphincter (EAS). We report about four infants, three females and one male, who presented with constipation and had an anteriorly located anal orifice of normal calibre. The anal position index measured clinically was less than 0.34 in all the female patients and 0.44 in the male patient. In preoperative magnetic resonance imaging (MRI), the EAS was distributed all around the circumference of the anal canal, including the ventral aspect of the anal canal, in all the patients. Preoperative MRI documentation of sphincter distribution is recommended for the diagnosis of AEA, as it would help in better definition of its association with constipation and the results of surgical management.
  6. Hamidah A, Thambidorai CR, Jamal R
    Med J Malaysia, 2005 Oct;60(4):517-9.
    PMID: 16570722
    We describe a patient with HbE-beta thalassaemia and chronic hepatitis C virus infection (genotype 1a) who was treated successfully with peginterferon alfa-2b and ribavirin, following failure to respond to standard interferon and ribavirin therapy. She had sustained virological response for nearly 24 months after completing peginterferon alfa-2b and ribavirin therapy. Transfusion requirements were significantly increased during combination therapy due to ribavirin-induced haemolysis. The adverse effects of interferon were well tolerated. Combination therapy with peginterferon alfa-2b and ribavirin maybe a feasible treatment option for a subset of thalassaemia/HCV infected non-responders to standard interferon-based therapy.
  7. Thambidorai CR, Imtiaz A, Nafiqudin M
    Med J Malaysia, 2005 Dec;60(5):653-4.
    PMID: 16515121
    An eight-year-old boy admitted for acute abdominal pain was diagnosed to have torsion of the spleen (TS) based on contrast enhanced computerised tomography (CECT) of the abdomen. CECT showed whorled appearance in the splenic hilum. Whorl sign' refers to the presence of a twisted splenic pedicle intermingled with fat, resulting in alternating circular bands of radiodensity and radiolucency and is considered diagnostic of TS. This is the fourth reported case of whorl sign in children with TS and the first from Malaysia.
  8. Hamidah A, Thambidorai CR, Jamal R
    PMID: 16124452
    We describe a patient with Evans syndrome (autoimmune hemolytic anemia and autoimmune thrombocytopenia) who was refractory to steroids and intravenous immunoglobulin. She responded to splenectomy and has remained in clinical remission for 3 years. In the majority of cases, splenectomy rarely induces a durable remission but it may be beneficial in a small group of patients, hence should be considered as alternative therapy in the management of these patients.
  9. 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.
  10. Visvanathan R, Thambidorai CR, Myint H
    Ann Acad Med Singap, 1992 Nov;21(6):830-2.
    PMID: 1338270
    Two patients, members of one family, with Peutz-Jeghers syndrome are described who underwent surgery for bowel obstruction. Both had multiple polyps in the gastrointestinal tract. Severe dysplasia and adenomatous change were present in two hamartomatous polyps adjacent to a stenosing colonic carcinoma in one patient and moderate dysplasia and adenomatous change were observed in two hamartomatous rectal polyps in his son. These changes support recent reports in the literature of progression towards neoplasia in these lesions.
  11. Faizah M, Kanaheswari Y, Thambidorai C, Zulfiqar M
    Biomed Imaging Interv J, 2011 Jan-Mar;7(1):e7.
    PMID: 21655116 MyJurnal DOI: 10.2349/biij.7.1.e7
    To compare echocontrast cystosonography (ECS) using in-vivo agitated saline with fluoroscopic micturating cystourethrography (MCU) in the detection and grading of vesicoureteric reflux (VUR).
  12. Thambidorai CR, Adbel LK, Zulfiqar A
    J Indian Assoc Pediatr Surg, 2010 Oct;15(4):137-8.
    PMID: 21170197 DOI: 10.4103/0971-9261.72438
    This is a report on the use of transperineal intraoperative ultrasound imaging in a case of Currarino's triad for the first time in the literature.
  13. Thambidorai CR, Wahab A, Hamzaini AH
    J Indian Assoc Pediatr Surg, 2008 Jul;13(3):115-7.
    PMID: 20011488 DOI: 10.4103/0971-9261.43820
    A 4-year-old girl with a solitary vascular anomaly of the mesentery presented with acute lower abdominal pain. Despite the use of ultrasound, computed tomography scan and image-guided core biopsies, the lesion was initially mistaken for an inflammatory intra-abdominal mass. The correct diagnosis was made at laparotomy. Solitary vascular anomaly of the mesentery is rare and its presentation as an acute abdomen has not been reported before.
  14. Thambidorai CR, Qureshi MA, Shukri J, Zulfiqar A
    Med J Malaysia, 2005 Jun;60(2):226-8.
    PMID: 16114166
    Posterior sagittal anorectoplasty (PSARP) is preferred by most pediatric surgeon and intermediate types of anorectal anomalies (ARA) in infants. In this report, we describe two girls who presented in their late teens with ARA and were treated by PSARP. Prior to this report, only two adult females with congenital rectovaginal fistulae treated by PSARP have been reported. Megarectum is a feature in late presentation of ARA and requires rectal tapering during PSARP. The functional outcome in late presentation of ARA is discussed.
  15. Thambidorai CR, Muin I, Razman J, Zulfiqar A
    Dis Colon Rectum, 2003 Jul;46(7):974-7.
    PMID: 12847376
    PURPOSE: Currarino triad, which comprises anorectal stenosis, anterior sacral defect, and a presacral mass, is an uncommon cause of constipation in children and adults. The presacral mass in this triad is most often caused by an anterior sacral meningocele, a teratoma, or an enterogenous cyst, but rarely may be caused by dual pathology. A neonate with Currarino triad and dual pathology in the presacral mass is described in this report.

    METHOD: A male Chinese neonate, who presented with abdominal distention and constipation on the second day of life, was found to have features of Currarino triad. Colostomy was done in the neonatal period, and the presacral mass was excised by posterior sagittal perineal approach at the age of six months.

    RESULTS: The excised presacral mass consisted of an anterior meningocele and a teratoma. The patient continued to have constipation during follow-up and required anorectoplasty to correct residual anorectal stenosis. At the time of this report the patient was three years old and growing normally with normal anorectal function.

    DISCUSSION: Of a total of about 200 cases of complete Currarino triad found in the literature, in only 22 patients did the presacral mass contain both meningocele and teratoma. The features of these 22 patients and the current views on the surgical management of Currarino triad are discussed.

  16. Jasmi AY, Thambidorai CR, Khairussalleh J
    Med J Malaysia, 2003 Aug;58(3):443-5.
    PMID: 14750388
    Gallstone disease is a common association in patients with haematological splenomegaly. When indicated, simultaneous splenectomy and cholecystectomy should be performed and traditionally this is accomplished by open surgery. We report a 17 year old thalassaemic girl with splenomegaly complicated by gallstone pancreatitis. We treated her with a combination of needlescopic cholecystectomy and laparoscopic splenectomy as well as delivering the huge spleen via a pfannenstiel incision to hide the scar. We believe this technique is an acceptable alternative mainly for rapid delivery of the spleen and to minimize visible scars hence improving cosmesis.
  17. Thambidorai CR, Arief H, Noor Afidah MS
    Singapore Med J, 2009 Dec;50(12):e412-4.
    PMID: 20087543
    Localised dilatation of a segment of the intestine without any macroscopically-identifiable cause is rare, and has been reported in association with omphalocoele in only 14 children up to 2006. In most of these cases, the segmental intestinal dilatation (SID) was either diagnosed incidentally, or due to presentation with partial or complete intestinal obstruction. We report, for the first time, a 37-week-old neonate with bowel perforation in SID associated with omphalocoele. In our case, a long thin vessel that resembled the mesodiverticular vessel of a Meckel's diverticulum was present in the dilated segment, supporting the view that SID and Meckel's diverticulum may be embryologically related.
  18. Rohana J, Boo NY, Thambidorai CR
    Singapore Med J, 2008 Feb;49(2):142-4.
    PMID: 18301842
    This prospective observational study was conducted to determine the outcome of newborns with congenital diaphragmatic hernia (CDH). They were managed with a protocol of gentle ventilation to avoid barotraumas, and inhaled nitric oxide (iNO) or intravenous magnesium sulphate for treatment of persistent pulmonary hypertension of newborns (PPHN).
  19. Zulfiqar MA, Noryati M, Hamzaini AH, Thambidorai CR
    Med J Malaysia, 2006 Jun;61(2):199-203.
    PMID: 16898311 MyJurnal
    The purpose of this study was to determine the effectiveness of pneumatic reduction of intussusception using equipment readily available in the hospital. Twenty-two children aged between four months and four years had pneumatic reduction of intussusception. The device used was assembled using (i) a hand-held pump attached to a pressure gauge, and (ii) a 3-way Foley's balloon catheter. There was a 73% success rate and there were no complications. The device used was effective and safe for the pneumatic reduction of intussusception.
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