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Distribution of rats infected with Rickettsia tsutsugamushi (scrub typhus) in an edge habitat

Muul I, Chai KS

Southeast Asian J Trop Med Public Health, 1978 Dec;9(4):489-93.
PMID: 751214

No focalization of rats (Rattus tiomanicus and R. argentiventer) infected with Rickettsia tsutsugamushi could be discerned over a 500 m trapping transect at the border between a forest and lalang grass (Imperata cylindrica). R. tiomanicus appeared to occupy 250 m of the transect on the average and had periods during which infections were observed which averaged 97 days. Calulations indicated that more than 50% of individuals become infected over their life-time. The high rate of infection in this and other areas described in earlier publications and the habits of the rats suggest that infected mites are densely and widely dispersed in the areas studied in Malaysia.
Fulltext Combination of Pyridoxine and Thiamine Treatment in Bilateral Induced Ptosis in a Child: Case Report and Review of Literature

Chai KS, Norsarwany M, Shatriah I

Cureus, 2017 Aug 16;9(8):e1573.
PMID: 29057185 DOI: 10.7759/cureus.1573

Ptosis is a rare side effect of vincristine chemotherapy in patients treated for cancer. We report a case of a child with common B-cell acute lymphoblastic leukemia who developed bilateral moderate ptosis following the chemotherapy protocol of the United Kingdom Acute Lymphoblastic Leukemia (ALL) regimen A. The patient showed dramatic clinical improvement after a combination of oral pyridoxine and thiamine treatment. We provide a literature review of this uncommon presentation.
Fulltext Kingella kingae Keratitis in a Child with Underlying Vernal Keratoconjunctivitis

Nurul-Laila S, Chai KS, Liza-Sharmini AT, Shatriah I

Case Rep Ophthalmol Med, 2017;2017:1087821.
PMID: 28546880 DOI: 10.1155/2017/1087821

Kingella kingae had rarely been reported as a causative organism for corneal ulcer and had not been described before in vernal keratoconjunctivitis (VKC). Generally regarded as commensals of respiratory tract particularly in young children, it had however been isolated from the corneal ulcer scraping of both adult and children. We report a case of bacterial ulcer with isolation of Kingella kingae from the corneal scraping in a young child with underlying VKC.
Fulltext Double-Breasted Anterior Rectus Sheath Turnover Flap

Chung WY, Chai KS, Stephen D, Ranjit J

Cureus, 2023 Nov;15(11):e49302.
PMID: 38957194 DOI: 10.7759/cureus.49302

The management of the open abdomen follows wound management with temporary abdominal closure prior to definitive closure while concurrently managing patient nutrient and fluid losses. This case report describes the successful use of double-breasted anterior rectus sheath turnover (DART) flap for early open abdomen closure to facilitate oncological management. The patient is a 47-year-old female with uterine smooth muscle neoplasm whose laparotomy wound was complicated with abdominal wound dehiscence and intra-abdominal infection. The abdomen could be closed with no fistula formation, iatrogenic bowel perforations, or overlying skin necrosis, and a follow-up showed no hernia occurrence. In conclusion, the DART flap provides a simple and autologous option for early tension-free midline closure of the open abdomen with acceptable intra- and postoperative complications.
Fulltext A 20-year experience of immediate mandibular reconstruction using free fibula osteocutaneous flaps following ameloblastoma resection: Radical resection, outcomes, and recurrence

Chai KS, Omar FH, Mat Saad AZ, Wan Sulaiman WA, Halim AS

Arch Plast Surg, 2019 Sep;46(5):426-432.
PMID: 31550747 DOI: 10.5999/aps.2018.01487

BACKGROUND: The mandible is an important structure that is located in the lower third of the face. Large mandibular defects after tumor resection cause loss of its function. This study assessed the outcomes and tumor recurrence after immediate mandibular reconstruction using a free fibula osteocutaneous flap following radical resection of ameloblastoma.
METHODS: This is a retrospective non-randomized study of outcomes and tumor recurrence of all patients diagnosed with mandibular ameloblastoma from August 1997 until August 2017 (20 years) requiring free fibula osteocutaneous flap reconstruction at a single institution. The patients were identified through an electronic operative database; subsequently, their medical records and photo documentation were retrieved.
RESULTS: Twenty-seven patients were included in this study. Eighteen patients were male, while nine were female. The majority of the patients (48.1%) were in their third decade of life when they were diagnosed with ameloblastoma. All of them underwent radical resection of the tumor with a surgical margin of 2 cm (hemimandibulectomy in cases with a large tumor) and immediate mandibular reconstruction with a free fibula osteocutaneous flap. Two patients required revision of a vascular anastomosis due to venous thrombosis postoperatively, while one patient developed a flap recipient site infection. The flap success rate was 100%. There was no tumor recurrence during a mean follow-up period of 5.6 years.
CONCLUSIONS: Mandibular ameloblastoma should be treated with segmental mandibulectomy (with a surgical margin of 2 cm) to reduce the risk of recurrence. Subsequent mandibular and adjacent soft tissue defects should be reconstructed immediately with a free fibula osteocutaneous flap.
The Epidemiological Profile of Open Globe Injuries and Prognostic Factors in a Tertiary Care Centre

Ng HR, Chee SF, Chai KS, Chong MF, Mustapha M

Cureus, 2021 Jun;13(6):e15846.
PMID: 34327079 DOI: 10.7759/cureus.15846

Purpose To describe the epidemiology of open globe injuries and its prognostic factors from the perspectives of a tertiary care centre in northern Malaysia. Methods A retrospective study of open globe injuries in a period of three years between June 2017 and May 2020. Patients presenting with open globe injuries were identified and recruited from hospital census. Case records were retrieved and analysed after recruitment. Results A total of 114 patients with 118 open globe injuries were included in the study. Four patients had bilateral eye involvement. Men were found to have seven and a half times higher rate of ocular injuries than women. The predominant age group of ocular trauma presentation was in younger adults between the age of 21 and 30 years old. Work-related injuries account for almost half of the globe injuries (48.7%) followed by motor vehicle accident-related, domestic accident-related, and others. The significant factors related to the visual outcome are presenting visual acuity (VA), presence of relative afferent pupillary defect (RAPD) and vitreous loss. Conclusion The factors related to visual outcomes in this study may aid the clinician in determining the visual prognosis of ocular injuries. Young working males were the most susceptible group to sustain penetrating ocular injuries due to their job nature. Health education and safety at workplace are essential to reduce the occurrence of ocular injuries.
Fulltext Early outcomes of cleft and palatal width following anterior palate repair (vomerine flap) in infants with wide cleft lip and palate

Mat Saad AZ, Chai KS, Wan Sulaiman WA, Mat Johar SFN, Halim AS

Arch Plast Surg, 2019 Nov;46(6):518-524.
PMID: 31775204 DOI: 10.5999/aps.2019.00227

BACKGROUND: Anterior palatal repair performed during cleft lip repair using a vomerine flap may assist in recruiting additional soft tissue for subsequent completion of palatoplasty, especially in patients with a wide cleft. We present our early.
RESULTS: in the hope of triggering a re-evaluation of this technique regarding its advantages for maxillary growth through further studies of patients with a wide cleft.
METHODS: A retrospective analysis of patients with complete unilateral and bilateral cleft lip and palate was performed, including cleft and palatal measurements taken during initial surgery (lip repair together with anterior palate repair) and upon completion of palatoplasty.
RESULTS: In total, 14 patients were included in this study, of whom nine (63.3%) had unilateral cleft lip and palate and five (37.5%) had bilateral cleft. All patients had a wide cleft palate. Lip and anterior palate repair was done at a median age of 3 months, while completion of palatoplasty was done at a median age of 10.5 months. Measurements taken upon completion of palatoplasty showed significant cleft width reduction in the mid-palate and intertubercle regions; however, the palatal arch distances at nearby landmarks showed non-significant marginal changes.
CONCLUSIONS: Anterior palate repair using a vomerine flap significantly reduced the remaining cleft width, while the palatal width remained. Further research is warranted to explore the long-term effects of this technique in wide cleft patients in terms of facial growth.