MyMedR

Fulltext Do-It-Yourself Surgical Simulation Kits: One Academic Medical Center's Response to the COVID-19 Pandemic in Malaysia

Nah SA, Singaravel S, Sanmugam A

Acad Med, 2021 Jan 01;96(1):e3.

PMID: 33003042 DOI: 10.1097/ACM.0000000000003786

Matched MeSH terms: Surgical Procedures, Operative/methods*

Neonatal tumours in Malaysia: a call for heightened awareness

Yeap BH, Zahari Z

Pediatr Surg Int, 2010 Feb;26(2):207-12.

PMID: 19943053 DOI: 10.1007/s00383-009-2523-7

Neonatal neoplasms are rare tumours notorious for their atypical presentation and unpredictable behaviour. Their optimal treatment remains uncertain, a dilemma compounded by the deleterious effects of adjuvant chemo- or radiotherapy during this vulnerable period of growth. This paper examined the relatively high incidence of these tumours and its impact on paediatric surgery in Malaysia.

Matched MeSH terms: Surgical Procedures, Operative/methods*

Fulltext Surgical experience with cardiac tumours at the General Hospital, Kuala Lumpur

Awang Y, Sallehuddin A

Med J Malaysia, 1991 Mar;46(1):28-34.

PMID: 1836035

Fifteen patients underwent surgery for cardiac tumours in General Hospital Kuala Lumpur between October 1984 and June 1989. Twelve of the patients had cardiac myxomas and underwent excision under cardiopulmonary bypass. Two patients had sarcoma, of which one was excised. The other was inoperable. Another patient had a metastalic malignant melanoma which was inoperable. Of the patients 10 were female and five male. Their ages ranged from 16 to 60 years. All were symptomatic and the commonest mode of presentation was exertional dyspnoea and palpitations. Two presented with cerebral embolisation. The three patients with malignant tumours had constitutional symptoms at the time of surgery. All patients had echocardiography pre-operatively to confirm the diagnosis of cardiac tumour. Only one patient underwent preoperative cardiac catheterisation and angiography. The surgical approach in all patients was through a median sternotomy and all except one were operated under cardiopulmonary bypass. There was no intraoperative embolisation. There was one perioperative death. Fourteen patients were followed up for periods ranging from one to 44 months. Three patients with malignant cardiac tumours died. One had recurrence of myxoma 21 months after the initial surgery. We conclude that excision of cardiac myxomas carry a very small risk following which patients have good prognosis. Malignant tumours carry a bad prognosis. From our experience, we conclude that echocardiography is an extremely accurate tool in the diagnosis of cardiac tumours.

Matched MeSH terms: Surgical Procedures, Operative/methods

Tension enterothorax

Wong PS, Vendargon SJ

Asian Cardiovasc Thorac Ann, 2003 Dec;11(4):375.

PMID: 14681107

Matched MeSH terms: Surgical Procedures, Operative/methods

Intestinal knotting: A case report and brief literature review

Sohail M, Alyson T, Sim SK, Nik Azim NA

Med J Malaysia, 2020 09;75(5):606-608.

PMID: 32918439

Ileo-ileal knotting is a rare cause of intestinal obstruction. In this condition, one bowel loop makes a knot with an adjacent bowel loop, resulting in mechanical obstruction and even gangrene of the bowel. We present a case of a young girl with ileo-ileal knotting resulting in a closed-loop obstruction and gangrene of the small bowel loop. This is a difficult condition to diagnose; a high index of suspicion and early surgical intervention are essential to reduce morbidity and mortality.

Matched MeSH terms: Surgical Procedures, Operative/methods

Prospective randomized clinical trial on suction elastic band ligator versus forceps ligator in the treatment of haemorrhoids

Ramzisham AR, Sagap I, Nadeson S, Ali IM, Hasni MJ

Asian J Surg, 2005 Oct;28(4):241-5.

PMID: 16234072

This prospective randomized clinical trial was undertaken to compare the use of a single-operator vacuum suction ligator and the traditional forceps ligator in terms of pain perception following the procedure, intra-procedure bleeding and other complications.

Matched MeSH terms: Surgical Procedures, Operative/methods*

Fulltext Abdominal aortic aneurysm--a plea for early elective excision (aneurysmectomy)

Leong YP

Med J Malaysia, 1991 Mar;46(1):51-8.

PMID: 1836038

Though peripheral arterial disease is not as common as in the Western countries, abdominal aorit aneurysm (AAA) is the most frequent arterial problem in Malaysia. A prospective study was made of 100 consecutive patients who presented with AAA to the author between January 1986 to September 1988 (31 months' period). There were 88 males and 12 females. The age range was 47-90 years, mean = 68.7. All the major ethnic rates were equally affected. The sizes of the AAA were documented by ultrasonography and the diameters ranged from 3-10 centimetres, mean = 5.8. Aneurysmectomy was performed on 58 patients, 17 of which were emergencies for ruptured AAA. The operative mortality for elective surgery was 2 percent, but that for emergency surgery was 47 percent. Ten patients refused surgery and 28 were not offered an operation. The true incidence of AAA is likely to be much higher than the number of patients referred for treatment. Many cases are not diagnosed or referred for treatment. Many cases of ruptured AAA died at home or in peripheral hospitals without a diagnosis being made. It is estimated that an AAA is present in 17,000 persons in Peninsular Malaysia. The risk of elective surgery is significantly lower than that of emergency. The overall mortality for ruptured AAA is even higher at about 99 percent. Furthermore, AAA is a benign disease and after surgery the patients return to their normal life expectancy. It is recommended that patients with AAA of five centimetres or more should be advised surgery if premature death is to be avoided.

Matched MeSH terms: Surgical Procedures, Operative/methods

Fulltext Complete congenital third branchial fistula: does the theoretical course apply?

Aneeza WH, Mazita A, Marina MB, Razif MY

Singapore Med J, 2010 Jul;51(7):e122-5.

PMID: 20730387

The course of a third branchial fistula is derived from its embryological origin, in accordance with the branchial apparatus theory. Treatment of this condition requires complete removal of the tract in order to avoid recurrence; however, this can pose a risk to the surrounding structures. We report the case of a complete third branchial fistula as well as a literature review on its theoretical course and management.

Matched MeSH terms: Surgical Procedures, Operative/methods

Cemento-ossifying fibroma of the maxilla

Al-Shaham AA, Samher AA

J Plast Surg Hand Surg, 2010 Dec;44(6):318-21.

PMID: 21446812 DOI: 10.3109/02844311003683713

Despite the fact that cemento-ossifying fibromas of the maxilla may be quite large and locally aggressive, en-bloc excision is achieved by gentle blunt dissection, with the whole tumour mass peeled out from the adjacent structures. Until recently different fibro-osseous tumours that contained cementum were classified together as "cementomas". In 1992 The World Health Organization adopted a new classification that included these fibromas as benign osseous tumours. While such tumours of the mandible are common, those of the maxilla are rare. They are growth products of periodontal membrane remnant. The triggering mechanism in the formation of cementum outside the periodontal membrane remains unclear. We present a 35-year-old woman who had a giant expanding lobular mass in the right maxilla of 5 years duration. She had visual disturbances and nasal obstruction, and was treated successfully by surgical en-bloc resection of the tumour through an infraorbital transverse incision. The differential diagnosis included fibrous dysplasia, osteoid osteoma, osteoblastoma, chronic sclerosing osteomyelitis, ameloblastoma, squamous cell carcinoma of the maxillary sinus, calcifying epithelial odontogenic tumour (Pindborg tumour) and calcifying odontogenic cyst (Gorlin cyst). Histopathological examination confirmed a cemento-ossifying fibroma.

Matched MeSH terms: Surgical Procedures, Operative/methods

Pilot study assessing the direct medical cost of treating patients with cancer in Kenya; findings and implications for the future

Atieno OM, Opanga S, Martin A, Kurdi A, Godman B

J Med Econ, 2018 Sep;21(9):878-887.

PMID: 29860920 DOI: 10.1080/13696998.2018.1484372

BACKGROUND: Currently the majority of cancer deaths occur in low- and middle-income countries, where there are appreciable funding concerns. In Kenya, most patients currently pay out of pocket for treatment, and those who are insured are generally not covered for the full costs of treatment. This places a considerable burden on households if family members develop cancer. However, the actual cost of cancer treatment in Kenya is unknown. Such an analysis is essential to better allocate resources as Kenya strives towards universal healthcare.

OBJECTIVES: To evaluate the economic burden of treating cancer patients.

METHOD: Descriptive cross-sectional cost of illness study in the leading teaching and referral hospital in Kenya, with data collected from the hospital files of sampled adult patients for treatment during 2016.

RESULTS: In total, 412 patient files were reviewed, of which 63.4% (n = 261) were female and 36.6% (n = 151) male. The cost of cancer care is highly dependent on the modality. Most reviewed patients had surgery, chemotherapy and palliative care. The cost of cancer therapy varied with the type of cancer. Patients on chemotherapy alone cost an average of KES 138,207 (USD 1364.3); while those treated with surgery cost an average of KES 128,207 (1265.6), and those on radiotherapy KES 119,036 (1175.1). Some patients had a combination of all three, costing, on average, KES 333,462 (3291.8) per patient during the year.

CONCLUSION: The cost of cancer treatment in Kenya depends on the type of cancer, the modality, cost of medicines and the type of inpatient admission. The greatest contributors are currently the cost of medicines and inpatient admissions. This pilot study can inform future initiatives among the government as well as private and public insurance companies to increase available resources, and better allocate available resources, to more effectively treat patients with cancer in Kenya. The authors will be monitoring developments and conducting further research.

Matched MeSH terms: Surgical Procedures, Operative/methods

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