MyMedR

Fulltext Intractable epistaxis secondary to a post-traumatic pseudoaneurysm

Mann GS, Philip R, Balachandran A

Med J Malaysia, 2005 Aug;60(3):367-9.

Epistaxis is a common problem encountered in clinical practice. It is usually self-limiting and is usually controlled with conservative measures such as nasal compression or ice-packs. Occasionally nasal packing is required. It is rarely severe enough that surgical intervention is warranted. The following report illustrates a patient who presented to us with a rare cause of life-threatening epistaxis that is, a post-traumatic pseudoaneurysm who finally required surgical intervention to control the bleeding.

Otorhinolaryngology services at a district hospital in Sabah, Malaysia during the COVID-19 Pandemic

Mann GS, Rajan P, Sawali H

Med J Malaysia, 2021 08;76(Suppl 4):39-41.

PMID: 34558557

No abstract provided.

Our experience in tracheostomy for COVID positive patients in Hospital Tawau: A case series

Luqman Afiq MI, Mann GS

Med J Malaysia, 2021 08;76(Suppl 4):60-62.

PMID: 34558563

The Coronavirus Disease (COVID-19) pandemic has led to an increase in the number of critically ill patients requiring intensive care unit admissions and mechanical ventilation. The sequential effect is that these patients may then require a tracheostomy. Tracheostomy guidelines were established to help minimise the risk of viral transmission to the personnel performing the procedure. Safety measures regarding preoperative planning, surgical technique and nursing care are important to minimise the risk of transmission to medical personnel. We describe our experience in conducting tracheostomies for two COVID-19 patients at a referral centre in Sabah, Malaysia.

Postoperative Outcomes After Tympanoplasty for Active Versus Inactive Otitis Media Patients With Tympanic Membrane Perforation: A Systematic Review and Meta-Analysis

Wong ZY, Park YS, Mann GS

Otol Neurotol, 2023 Aug 01;44(7):643-650.

PMID: 37400232 DOI: 10.1097/MAO.0000000000003940

OBJECTIVES: To compare postoperative tympanoplasty outcomes between active versus inactive otitis media (OM) patients with tympanic membrane perforation.

DATABASES REVIEWED: Medline via PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, and Google Scholar for studies published from inception to March 1, 2023.

METHODS: Studies of 15- to 60-year-old patients undergoing microscopic/endoscopic myringoplasty using underlay/overlay technique with reported postoperative mean hearing gain and graft uptake were included. Studies requiring simultaneous surgical procedures, reporting patients with comorbidities and with non-English full text articles were excluded. Articles were independently screened by two researchers with data extracted according to a predetermined proforma in Microsoft Excel. Cochrane risk-of-bias assessment was used for risk of bias evaluation of randomized studies and Risk of Bias in Nonrandomized Studies of Interventions for nonrandomized studies. Similar studies were pooled for meta-analysis using the inverse variance random effects model to calculate the mean difference and corresponding 95% confidence interval (CI) for mean hearing gain and DerSimonian and Laird random effects model for graft uptake.

RESULTS: Thirty-three studies comprising 2,373 patients met the inclusion/exclusion criteria, seven were pooled for meta-analysis. Included articles showed inactive OM patients have higher average postoperative mean hearing gain of 10.84 dB and graft uptake of 88.7% compared to active OM patients (9.15 dB and 84.2%). Meta-analysis of mean hearing gain (MD, -0.76 dB; 95% CI, -2.11 to 0.60; p = 0.27, moderate certainty) and graft uptake (OD, 0.61; 95% CI, 0.34-1.09; p = 0.10, moderate certainty) have an overall p value >0.05.

CONCLUSION: There were no statistically significant differences in postoperative mean hearing gain and graft uptake between active and inactive OM patients undergoing tympanoplasty. Hence, tympanoplasty procedures should not be postponed solely because of patients' preoperative ear discharge status.

Intravenous neck injections in a drug abuser resulting in infection of a laryngocele

Jahendran J, Sani A, Rajan P, Mann GS, Appoo B

Asian J Surg, 2005 Jan;28(1):41-4.

PMID: 15691797

A pyolaryngocele is an uncommon complication of a laryngocele that has become infected. We present a case of a pyolaryngocele that was probably due to repeated injections in the neck veins. The pathogenesis, clinical features and management are discussed in detail.

Exploring the knowledge of nasopharyngeal carcinoma among medical doctors at primary health care level in Perak state, Malaysia

Balachandran R, Philip R, Avatar S, Simon R, Mann GS, Benedict CT, et al.

Eur Arch Otorhinolaryngol, 2012 Feb;269(2):649-58.

PMID: 21691719 DOI: 10.1007/s00405-011-1665-0

Nasopharyngeal carcinoma (NPC) is among the commonest cancers in Malaysia. The prognosis for NPC like most other head and neck cancer is dependent on its staging. Majority of patients in Malaysia at the time of diagnosis are either at stage III or IV (27 and 47%, respectively). The lack of knowledge among primary care medical doctors regarding NPC may contribute to this delay in diagnosis. The aim of this study was to assess the knowledge of the primary care doctors in the state of Perak on the various aspects of NPC. The doctors at the primary care level in the state of Perak were recruited to take part in this study on a voluntary basis. A total number of 154 out of 198 doctors participated in this survey. They were given a questionnaire to fill in to test their knowledge on different aspects of NPC and its treatment. The overall respondents' score was poor with a score of 67.5% on all sections. The doctors appear to be able to identify common presenting features of NPC with a mean score of 85.3% but for the uncommon presentations of NPC, the scores were poorer with 61.8%. In addition, 54.1% of the participants answered that they would refer a patient with symptoms suspicious of NPC after a period of 1 month from the onset of symptom. However, only 34% would refer within 2 weeks. Based on the results of this study, the authors feel that it is clear that the doctors posted in the primary care hospitals and clinics appear to have inadequate knowledge to diagnose and refer patients with suspected NPC. As early diagnosis can often lead to a better prognostic outcome, steps must be taken to raise the awareness among these doctors.

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