MyMedR

Branula used as T-tube introducer for middle-ear effusion

Raman R, Rahmat O

J Laryngol Otol, 2008 Jun;122(6):635.

PMID: 18036281 DOI: 10.1017/S002221510700120X

Objective: We report a method of inserting a T-tube.
Method: A 14-G branula and a T-tube are used.
Results: This method was found to be simple and required few instruments.
Conclusions: To the best of our knowledge, this method has not previously been reported

Matched MeSH terms: Surgical Instruments*

Approach to surgery in the middle ear without the need for an aural speculum

Raman R

Ear Nose Throat J, 1999 Apr;78(4):306-7.

PMID: 10224707

This article describes a new approach to permeatal surgery in the middle ear that does not require the use of an aural speculum.

Matched MeSH terms: Surgical Instruments

Fulltext A Technique for Removal of Forearm Dynamic Compression Plate with Stripped Screws: A Report of Three Cases

Lee, C.K., Kwan, M.K., Chua, Y.P.

Malays Orthop J, 2009;3(1):85-87.

MyJurnal

Removal of plates is a procedure commonly performed by orthopaedic surgeons and stripped screws are probably the most common problem encountered during this procedure. Stripped screws are caused by slippage between the screwdriver and the screw. Due to the inherent difficulty in removing such screws, surgeons should be knowledgeable in techniques for their removal and should be equipped with the proper instruments to expedite the procedure. There are few published articles about such techniques. This report describes a technique for removal of plates with stripped screws. The tip of a stripped screw is approached from the far cortex and then reamed with a trephine reamer in the direction of the screw until both cortices are cleared. The plate is then removed with stripped screws attached. All the removals utilizing this technique to date have been successful with no complications, and this method is safe, efficient and technically easy to learn.

Matched MeSH terms: Surgical Instruments

Fulltext Performance of transbronchial cryobiopsy in eccentrically and adjacently orientated radial endobronchial ultrasound lesions

Kho SS, Chan SK, Yong MC, Tie ST

ERJ Open Res, 2019 Oct;5(4).

PMID: 31649952 DOI: 10.1183/23120541.00135-2019

Background: Radial endobronchial ultrasound (R-EBUS) is an effective technique in the diagnosis of peripheral pulmonary lesions (PPL). However, lesion orientation with regards to the radial probe remains an important factor for effective biopsy. "Within" orientation was associated with significantly higher diagnostic yield. Cryobiopsy is a novel technique in obtaining larger tissue samples with the frozen tip allowing biopsy in a 360° direction, thus potentially achieving more effective biopsy in eccentrically and adjacently orientated lesions. We aimed to evaluate the performance and safety of transbronchial cryobiopsy versus forceps biopsy in eccentrically and adjacently orientated R-EBUS lesions.

Methods: Retrospective review of R-EBUS transbronchial biopsy for PPL over 17 months.

Results: 114 R-EBUS scans were included for analysis during the study period. Forceps biopsy was performed in 76 (66.7%) cases and cryobiopsy in 38 (33.3%) cases. Baseline demographics and lesion characteristics did not differ between the two groups. Median (interquartile range) lesion size was 3.48 (2.63-4.51) cm. Overall, 41.2% of lesions were of eccentric orientation and 15.8% adjacent orientation; only 43% were concentric in orientation. Overall diagnostic yield was 67.5% (77 out of 114). Orientation remained an important factor affecting diagnostic yield. Transbronchial cryobiopsy significantly increased the diagnostic yield in eccentrically and adjacently orientated lesions to 75.0% (18 out of 24), compared to 48.8% (20 out of 41) obtained via forceps biopsy (p<0.05); but not in concentric lesions. Cryobiopsy was associated with more mild and moderate bleeding complications compared to the forceps biopsy group.

Conclusions: Transbronchial cryobiopsy under R-EBUS guidance is a safe procedure which potentially increases diagnostic yield in eccentrically and adjacently orientated PPLs.

Matched MeSH terms: Surgical Instruments

Experiences with Filshie clip sterilization

Puraviappan AP, Hamid Arshat A

Adv Contracept, 1987 Mar;3(1):13-7.

PMID: 3630815

Between June 1980 and April 1986 796 cases of female sterilization were performed in a private clinic in Malaysia using Mark IVa and Mark VI Filshie clips. There was one failure. Technical failure, surgical difficulties and complications were minimal.

Matched MeSH terms: Surgical Instruments*

Fulltext A visual tutorial on the synthesis of gold nanoparticles

Low A, Bansal V

Biomed Imaging Interv J, 2010 01 01;6(1):e9.

PMID: 21611068 DOI: 10.2349/biij.6.1.e9

Many papers have been written on the synthesis of gold nanoparticles but very few included pictures of the process, and none of them used video to show the whole process of synthesis. This paper records the process of synthesis of gold nanoparticles using video clips. Every process from cleaning of glassware, an important step in the synthesis of metallic nanoparticles, to the dialysis process is shown. It also includes the preparation of aqua regia and the actual synthesis of gold nanoparticles. In some papers, the dialysis process was omitted, but in this paper, it is included to complete the whole process as it is being used for purification.

Matched MeSH terms: Surgical Instruments

Fulltext Characteristics and Outcomes of Patients with Anterior Circulation Intracranial Aneurysm Managed with Clipping in Hospital Sungai Buloh

Ab Ghani A, Nayan SA, Kandasamy R, Rosman AK, Ghani AR

Malays J Med Sci, 2016 Nov;23(6):113-117.

PMID: 28090185 MyJurnal DOI: 10.21315/mjms2016.23.6.12

The annual incidence of intracranial aneurysm in Malaysia is estimated to be 1.1-1.7 per 100,000 population based on a study done conducted in 1988. Since then, little epidemiological research has been conducted in Malaysia, and the real incidence is therefore probably unreported despite advancements in the diagnosis and treatment of this disorder. Intracranial aneurysm may be treated by microsurgical clipping or embolisation depending on its location and the surgeon's preference. This study aims to report the characteristics and outcomes of patients with a clipped anterior circulation aneurysm in Hospital Sungai Buloh.

Matched MeSH terms: Surgical Instruments

Mini open carpal tunnel release using Knifelight: evaluation of the safety and effectiveness of using a single wrist incision (cadaveric study)

Teh KK, Ng ES, Choon DS

J Hand Surg Eur Vol, 2009 Aug;34(4):506-10.

PMID: 19675032 DOI: 10.1177/1753193409100962

This cadaveric study evaluates the margin of safety and technical efficacy of mini open carpal tunnel release performed using Knifelight (Stryker Instruments) through a transverse 1 cm wrist incision. A single investigator released 32 wrists in 17 cadavers. The wrists were then explored to assess the completeness of release and damage to vital structures including the superficial palmar arch, palmar cutaneous branch and recurrent branch of the median nerve. All the releases were complete and no injury to the median nerve and other structures were observed. The mean distance of the recurrent motor branch to the ligamentous divisions was 5.7 +/- 2.4 mm, superficial palmar arch was 8.7 +/- 3.1 mm and palmar cutaneous branch to the ligamentous division was 7.2 +/- 2.4 mm. The mean length of the transverse carpal ligament was 29.3 +/- 3.7 mm. Guyon's canal was preserved in all cases.

Matched MeSH terms: Surgical Instruments*

Grommet insertion using a branula

Raman R, Rahmat O

J Laryngol Otol, 2008 Jul;122(7):735-6.

PMID: 18346289 DOI: 10.1017/S0022215108001928

To develop an easy method of performing myringotomy and grommet insertion, using minimal instruments.
Methods: An ear speculum and a branula were used.
Results: This method was found to be useful.
Conclusion: An easy method of performing myringotomy and grommet insertion is proposed.
Key words: Middle Ear Ventilation; Grommet Insertion; Otitis Media With Effusion

Matched MeSH terms: Surgical Instruments*

Nasal septal clamp

Raman R, Dahalil MB

Otolaryngol Head Neck Surg, 2000 Dec;123(6):750.

PMID: 11112973

Matched MeSH terms: Surgical Instruments*

Novel use of a Leyla-Yasargil retractor as an endoscope holder during endoscopic sinus surgery

Raman R, Prepageran N

Ear Nose Throat J, 2004 Apr;83(4):270.

PMID: 15147098

The authors describe a novel way of fashioning an endoscope holder from a common retractor and an ear speculum. Using such a device during endoscopic sinus surgery leaves both of the surgeon's hands free to manipulate the instruments.

Matched MeSH terms: Surgical Instruments*

Fulltext Speculum versus digital insertion of Foley catheter for induction of labor in Nulliparas with unripe cervix: a randomized controlled trial

Chia HM, Tan PC, Tan SP, Hamdan M, Omar SZ

BMC Pregnancy Childbirth, 2020 May 29;20(1):330.

PMID: 32471369 DOI: 10.1186/s12884-020-03029-0

BACKGROUND: Induction of labor (IoL) is an increasingly common obstetric procedure. Foley catheter IoL is recommended by WHO. It is associated with the lowest rate of uterine hyperstimulation syndrome and similar duration to delivery and vaginal delivery rate compared to other methods. Insertion is typically via speculum but digital insertion has been reported to be faster, better tolerated and with similar universal insertion success compared to speculum insertion in a mixed population of nulliparas and multiparas. Transcervical procedure is more challenging in nulliparas and when the cervix is unripe. We evaluated the ease and tolerability of digital compared to speculum insertion of Foley catheter for induction of labor in nulliparas with unripe cervixes.

METHODS: A randomized trial was performed in a university hospital in Malaysia. Participants were nulliparas at term with unripe cervixes (Bishop Score ≤ 5) admitted for IoL who were randomized to digital or speculum-aided transcervical Foley catheter insertion in lithotomy position. Primary outcomes were insertion duration, pain score [11-point Visual Numerical Rating Scale (VNRS)], and failure. All primary outcomes were recorded after the first insertion.

RESULTS: Data from 86 participants were analysed. Insertion duration (with standard deviation) was 2.72 ± 1.85 vs. 2.25 ± 0.55 min p = 0.12, pain score (VNRS) median [interquartile range] 3.5 [2-5] vs. 3 [2-5] p = 0.72 and failure 2/42 (5%) vs. 0/44 (0%) p = 0.24 for digital vs speculum respectively. There was no significant difference found between the two groups for all three primary outcomes. Induction to delivery 30.7 ± 9.4 vs 29.6 ± 11.5 h p = 0.64, Cesarean section 25/60 (64%) vs 28/64 (60%) RR 0.9 95% CI p = 0.7 and maternal satisfaction VNRS score with the birth process 7 [IQR 6-8] vs 7 [7-8] p = 0.97 for digital vs. speculum arms respectively. Other labor, delivery and neonatal secondary outcomes were not significantly different.

CONCLUSION: Digital and speculum insertion in nulliparas with unripe cervixes had similar insertion performance. As digital insertion required less equipment and consumables, it could be the preferred insertion method for the equally adept and the insertion technique to train towards.

TRIAL REGISTRATION: This trial was registered with ISRCTN registration number 13804902 on 15 November 2017.

Matched MeSH terms: Surgical Instruments*

Closure of the patent ductus arteriosus with a Ligaclip through a minithoracotomy

Majid AA

Chest, 1993 May;103(5):1512-4.

PMID: 8486035 DOI: 10.1378/chest.103.5.1512

This article describes a technique which allows the patent ductus arteriosus (PDA) to be closed through a minithoracotomy. It combines a simple method of inducing atelectasis with Ligaclip closure of the PDA through a subaxillary incision. It was used successfully in 11 children and adolescents.

Matched MeSH terms: Surgical Instruments*

Filshie clip sterilization -- single puncture laparoscopic approach (a preliminary report)

Ismail MT, Arshat H, Halim AJ

Malays J Reprod Health, 1988 Dec;6(2):90-6.

PMID: 12342172

PIP: In 1986, single puncture laparoscopic application of the Filshie clip was introduced into Malaysia's National Population and Family Development Board's female sterilization program for an evaluation. A total of 42 female sterilizations were performed by this method between June 1986 and December 1986. Laparoscopy was performed on an outpatient basis under local anesthesia. In 37 cases, the sterilization was interval. Filshie clips were successfully applied to the fallopian tubes of 40 women; in the remaining 2 cases, the latching mechanism jammed and Falope rings were used instead. The average time from application of 1st clip to skin closure was 10 minutes. During clip application, technical problems (faulty applicator, clip fell into the pelvic cavity, failure of latching mechanism) were encountered in 4 cases and surgical difficulties (poor visualization, hydrosalpinx, and tubal adhesions) occurred in 10 cases. In general, complications were minimal: 1 patient developed cynosis after anesyhesia (Pethidine) injection, the omentum was torn during introduction of the trocar in another, and a 3rd patient developed thrombophlebitis at the intravenous site. Only 1 pregnancy was recorded during the follow-up period; this occurred 15 months postoperatively and was intrauterine. Given the facts that this procedure is easy to learn, fast and simple, associated with no more complications than other laparoscopic procedures, and is cosmetically more acceptable to women, its more widespread application is recommended.

Matched MeSH terms: Surgical Instruments*

Results of group-circumcision of Muslim boys in Malaysia with a new type of disposable clamp

Schmitz RF, Abu Bakar MH, Omar ZH, Kamalanathan S, Schulpen TW, van der Werken C

Trop Doct, 2001 Jul;31(3):152-4.

PMID: 11444337

This study evaluates the safety and results of surgery usingTaraKlamp Circumcision Device during a group circumcision. Atotal of 64 circumcisions of Muslim boys were performed by Medical Assistants supervised by Medical Doctors in a hall in Kuala Lumpur, Malaysia. A new type disposable clamp was used, which was removed 4 days after the operation. No major complications occurred and the boys experienced in general mild pain postoperatively. Mostly good cosmetic results were obtained and 90% of the parents would recommend this new clamp to others. Group circumcisions withTaraKlamp Circumcision Device (Kuala Lumpur, Malaysia) are safe, although proper patient selection and adequate training in using the device are mandatory.

Matched MeSH terms: Surgical Instruments

Fulltext Severe Orbital Myiasis Caused by Chrysomya bezziana: A Case Report

Ng YS, Gan YK, Tupang L

Turk J Ophthalmol, 2021 Feb 25;51(1):62-65.

PMID: 33631919 DOI: 10.4274/tjo.galenos.2020.00225

An 88-year-old woman was brought to the hospital immediately after her neighbours noticed that she was bleeding from her right eye. On examination, her right eye was phthisic with maggot infestation of her right orbit. Over a hundred live maggots were extracted using forceps. Computed tomography scan revealed the infestation was confined to the right orbit. The patient underwent exenteration of the right orbit under general anaesthesia. The species was identified by an entomologist as Chrysomya bezziana, which has aggressive larvae that eat living tissue. This case report demonstrates that orbital myiasis caused by C. bezziana poses a very real risk of intracranial invasion as they feed on living tissues. Adjacent tissue destruction can be very rapid and definitive treatment involves urgent removal of its larvae via surgical debridement. To our knowledge, we are reporting the first case of orbital myiasis from a patient in Malaysia. Therefore, our case report may be helpful in the management of similar case of orbital myiasis.

Matched MeSH terms: Surgical Instruments

Fulltext Design and development of 3d face mask clips for hijab

Ahmad Sofian, Shminan, Rehman, Ullah Khan, Wan Norizan, Wan Hashim, Iswandy, Jamaludin

Journal of Cognitive Sciences & Human Development, 2020;6(2):52-62.

MyJurnal

The world has suffered from a critical shortage of Personal Protective Equipment (PPE) (Riva et al., 2007) during the pandemic of Covid-19 for medical staffs, the front liners. Like the whole world, Malaysia also imposed the stay-at-home and Movement Control Order (MCO) to break the chain of infections and flatten the curve of cases. The supply of PPE became a challenge during the lock down. There have been joined efforts from various parties stepping up, with different ways to help the production process of these key equipment but mostly focus on PPTs for male. Another challenge was face mask for Muslim lady health workers who wear hijab. This paper is about how to overcome these challenges and designed a novel face mask clip for hijab, using 3D printing. The face mask clip is for wearing a mask over hijab and is designed by generating a 3D digital file using computer-aided design (Hourcade, Bullock-Rest, & Hansen, 2012) software. Then the 3D design was converted to Standard Tessellation Language (STL) format, for the use of 3D printing systems. Then the design was split into layers for precise printing. The clips were tested by the staff in faculty of Cognitive Sciences and Human Development, Universiti Malaysia Sarawak. Feedbacks were collected by an online survey using the modified System Usability Scale. The participants reported that the clips are very comfortable and easy to use.

Matched MeSH terms: Surgical Instruments

Fulltext A Rare Incidence of Breakage of tip of Micropituitary Forceps during Percutaneous Discectomy - How to Remove it: A Case Report

Sureisen M, Tan BB, Teo YY, Wong CC

Malays Orthop J, 2015 Nov;9(3):58-60.

PMID: 28611913 MyJurnal DOI: 10.5704/MOJ.1511.009

Breakage of the tip of the micropituitary forceps during spine surgery is a rare occurrence. Retrieval of the broken tip could be a challenge in minimally invasive surgeries due to limitation of access and retrieval instruments. We describe our experience in handling such a situation during percutaneous radiofrequency discectomy. The removal was attempted, without converting into open surgery, by utilising percutaneous endoscopic lumbar discectomy working cannula and guided by image intensifier. We were able to remove the fragment without any significant morbidity to the patient. This technique for removal has not been reported previously in the literature.

Matched MeSH terms: Surgical Instruments

Fulltext Faculty development: mini-CEX as workplace-based assessment

Shahid Hassan

Education in Medicine Journal, 2011;3(1):12-21.

MyJurnal

Background: Competence-based curriculum has become the need of medical education to meet the objectives of institutions aiming to produce skilled physicians. To achieve the optimal competence and performance of graduates a number of traditional evaluation exercises have been practiced. Some of these e.g. OSCE although meet the acceptable standard of reliability and validity is the assessment done in a controlled environment. This leaves the room for performance-based assessment in real clinical situation such as mini clinical evaluation exercise (Mini-CEX). To practice and meet the challenges of Mini-CEX it is vital to undertake faculty development program with a comprehensively chalked down Mini-CEX protocol and its objectives to achieve the intended outcome. Objective: To undertake faculty development on Mini-CEX for its feasibility and acceptability as a method of formative assessment to evaluate the clinical competence of trainees in postgraduate program of Otolaryngology and Head-Neck Surgery. Method: 25 trainees from the four classes of master of surgery program of 2009 in Otolaryngology and Head-Neck Surgery (ORL-HNS) undertook Mini-CEX encounters and assessed by 9 supervisors in a 12-week period of study. Faculty development program was carried out through prior lectures deliberating on background, concept and procedure of Mini-CEX followed by demonstrations using video clip of Mini-CEX encounter recorded in own clinical environment. Students were also exposed to similar settings to take up the Mini-CEX encounter without any hesitation. Trainees were assessed in outpatient clinical setting. Program was evaluated for its feasibility and acceptability with respect to patient’s factors, clinical attributes, supervisor and trainee’s performance and their reported level of satisfaction.
Result: Faculty development and trainees orientation in Min-CEX was achieved as feasible and acceptable. Higher rating of satisfaction was reported by majority assessors and trainees as they found Mini-CEX acceptable for formative assessment. Among clinical skills highest rating was received in physical examination and lowest rating in therapeutic skills. Conclusion: A motivated faculty and organized approach towards a comprehensive knowledge on Mini-CEX for its background communication, demonstration of procedure and method to complete the rating forms is the useful guide to adopt Mini-CEX. The faculty and trainees in department of ORL-HNS found Mini-CEX as feasible and acceptable assessment tool to monitor educational activity of postgraduate program through performance-based evaluation in a real clinical situation.

Matched MeSH terms: Surgical Instruments

Fulltext Plastron osteotomy in the management of fishing hook ingestion in a Malayan box turtle (Cuora ambonensis)

Azlan, C.A., Cheah, E.H.C., Lam, J.L., Mohd Jefri, N., Saw, M.H., Noorshimah, R.

Jurnal Veterinar Malaysia, 2015;27(1):12-15.

MyJurnal

An adult male Malayan box turtle was diagnosed with foreign body obstruction of fishing hook. Upon presentation, the animal
had pale mucous membrane and fishing line protruding out from the oral cavity. Diagnosis of foreign body ingestion was based on
plain radiograph where the fishing hook was evidenced on the lateral and ventrodorsal radiographic view. Plastron osteotomy
surgical removal was performed after endoscopy guided forcep removal failed. Procedures were carried out under the injectable
anesthesia using a combination of ketamine and xylazine hydrochloride. Antibiotic, anti-inflammatory and parenteral fluid therapy
was given pre and post-surgically as medical treatment and stabilisation.

Matched MeSH terms: Surgical Instruments

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