MyMedR

Displaying all 7 publications

Abstract:

Sort:

Fulltext A Rare Occurrence of Craniopharyngioma Causing Visual Disturbance in Pregnancy

Wai Wye NH, Naffi AA, Othman O, Bastion MC

Cureus, 2021 Oct;13(10):e18700.
PMID: 34790457 DOI: 10.7759/cureus.18700

Craniopharyngioma is a rare and benign sellar and suprasellar region tumour. It rarely manifests during pregnancy. We report a 32-year-old primigravida at 19 weeks of gestation with a craniopharyngioma, presenting with visual disturbances during pregnancy. Her vision was 6/9 OD and counting fingers OS with a relative afferent pupillary defect in the left eye. Fundi were normal bilaterally. Visual field testing showed a nasal field defect OD and generalized depression OS. Brain magnetic resonance imaging revealed a suprasellar tumour with chiasmatic compression. Craniotomy and excision of the tumour were done at 20 weeks of gestation. Histopathological examination was consistent with craniopharyngioma. Postoperatively, mother and foetus were stable. Vision improved from counting fingers to 6/6 OS and remained at 6/9 OD. Subsequently, she delivered a healthy baby at term. Such rare and difficult cases warrant close multidisciplinary cooperation pre- and post-operatively to attain optimal outcomes for both mother and baby. By optimizing the patient's medical condition, risks of complications may be reduced. A poor pre-operative vision should also not deter surgical intervention as a proven good visual outcome is achievable.
Fulltext Bilateral Open Globe Injury Secondary to the King of Fruits: Durian Fall

Lee J, Che Hamzah J, Mohd Khialdin S, Naffi AA

Cureus, 2023 May;15(5):e39153.
PMID: 37332448 DOI: 10.7759/cureus.39153

We report a case of bilateral open globe injury that resulted from a durian fruit falling on a 62-year-old woman's unprotected face during durian picking in her orchard. On presentation, the bilateral vision was light perception. The right eye sustained a curvilinear corneal laceration with expelled intraocular content. Meanwhile, the left eye sustained a corneoscleral laceration with expelled uvea and retina. Additionally, the right upper lid margin was lacerated. Emergency wound exploration, primary toilet, and suturing were performed on bilateral eyes. Preoperatively, she received intramuscular anti-tetanus toxoid and intravenous ciprofloxacin. Intravitreal ceftazidime and vancomycin were given intraoperatively as endophthalmitis prophylaxis. Postoperatively, the vision remained as light perception. There were no signs of endophthalmitis in both eyes. Although traumatic globe injury due to durian is uncommon, individuals should wear protective gear while in a durian orchard to avoid such unprecedented accidents. Prompt yet scrupulous action should be taken to save the globe and further possible complications.
Fulltext Determination of Factors Influencing the Health Belief Model (HBM) and Adherence to Intravitreal Anti-vascular Endothelial Growth Factor (VEGF) Among Patients With Diabetic Macular Edema (DME)

Ting Yih Ling J, Mohd Zain A, Naffi AA, Mustapha M, Wan Abdul Halim WH

Cureus, 2023 Feb;15(2):e34669.
PMID: 36909105 DOI: 10.7759/cureus.34669

Background Diabetic macular edema (DME) is becoming one of the leading causes of blindness worldwide with a significant impact on quality of life. The effectiveness of intravitreal (IVT) anti-vascular endothelial growth factor (VEGF) therapy has been established by clinical trials and has become the treatment of choice in the majority of DME patients in reducing macular edema and improving visual acuity. Frequent drop-out and discontinuation of treatment are major issues. Lack of compliance can lead to worsening outcomes and be a burden to patients and the healthcare system. Purpose The purpose of this study is to assess multiple factors that affect adherence to IVT anti-VEGF treatment among patients with DME, including socioeconomic causes and the Health Belief Model (HBM) domains, in addition to exploring the relationship between them. Methods This cross-sectional study was conducted among DME patients in Hospital Canselor Tuanku Muhriz, Kuala Lumpur, Malaysia, from December 2020 to June 2021. We identified eligible patients using a retrospective chart review of clinical findings and optical coherence tomography (OCT) findings. Included subjects were of Malaysian nationality, aged 18 years and above, who were initiated or re-initiated IVT anti-VEGF treatment regime and on follow-up for at least six months from initial injection from January 2019 onwards. A translated and validated self-administered questionnaire was given to the respondents. Data were analyzed using IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, New York, United States). Demographics of the patient were summarized using descriptive statistics, independent sample t-test was used to compare the difference in components of the HBM questionnaire. Linear regression was further used to explore the relationship between patients' demographics and the HBM component. Results A total of 141 patients participated in this study, of whom 56.2% patients were adherent to treatment. The majority were aged 60 years and above (56.7%), male (52.5%), Malay (38.9%), and married (71.6%). There was a significant statistical difference in patients who were adherent to treatment, in terms of life entourage (p=0.004, Fisher Exact test). HBM domains that influenced adherence to treatment included perceived severity, perceived barriers, perceived benefits, cues to action, and self-efficacy (p<0.05, independent sample t-test). Further, multiple logistic regression tests on sociodemographic factors and HBM domains after eliminating confounding factors narrowed down the significant variables to perceived susceptibility (p= 0.023), perceived benefits (p< 0.001), and self-efficacy (p< 0.001). Conclusion Patients' adherence to IVT anti-VEGF is influenced by perceived susceptibility to complications from DME, perceived benefits to the treatment, and self-efficacy.
Fulltext Usage of topical insulin for the treatment of diabetic keratopathy, including corneal epithelial defects

Leong CY, Naffi AA, Wan Abdul Halim WH, Bastion MC

World J Diabetes, 2023 Jun 15;14(6):930-938.
PMID: 37383598 DOI: 10.4239/wjd.v14.i6.930

BACKGROUND: Diabetic keratopathy (DK) occurs in 46%-64% of patients with diabetes and requires serious attention. In patients with diabetes, the healing of corneal epithelial defects or ulcers takes longer than in patients without diabetes. Insulin is an effective factor in wound healing. The ability of systemic insulin to rapidly heal burn wounds has been reported for nearly a century, but only a few studies have been performed on the effects of topical insulin (TI) on the eye. Treatment with TI is effective in treating DK.
AIM: To review clinical and experimental animal studies providing evidence for the efficacy of TI to heal corneal wounds.
METHODS: National and international databases, including PubMed and Scopus, were searched using relevant keywords, and additional manual searches were conducted to assess the effectiveness of TI application on corneal wound healing. Journal articles published from January 1, 2000 to December 1, 2022 were examined. The relevancy of the identified citations was checked against predetermined eligibility standards, and relevant articles were extracted and reviewed.
RESULTS: A total of eight articles were found relevant to be discussed in this review, including four animal studies and four clinical studies. According to the studies conducted, TI is effective for corneal re-epithelialization in patients with diabetes based on corneal wound size and healing rate.
CONCLUSION: Available animal and clinical studies have shown that TI promotes corneal wound healing by several mechanisms. The use of TI was not associated with adverse effects in any of the published cases. Further studies are needed to enhance our knowledge and understanding of TI in the healing of DK.
Fulltext A Case Series of Eye Removal Surgeries: Five Years of Experience at a Tertiary Eye Care Centre in Malaysia

Wangdi L, Wai Wye NH, Meng Hsien Y, Naffi AA, Bastion MC

Cureus, 2024 Aug;16(8):e65986.
PMID: 39221292 DOI: 10.7759/cureus.65986

BACKGROUND: Eye removal surgeries, also called anophthalmic surgeries, are usually performed for a painful blinded eye due to various underlying causes. In this case review, we intended to study the indications, the types of anophthalmic surgeries, and post-operative complications related to eye removal surgeries.
METHOD: Five years of retrospective case review of surgical eye removals was conducted from 1st June 2018 to 31st May 2023 at Hospital Canselor Tuanku Muhriz (HCTM), University of Kebangsaan Malaysia (UKM). Medical record files were used to analyse the age, gender, affected eye, types of surgeries, and indications of the eye removal surgery.
RESULTS: Fourteen eyes underwent anophthalmic surgeries inclusive of evisceration (78.57%, n = 11), enucleation (14.29%, n = 2), and exenteration (7.14%, n = 1). Among the evisceration group, 63.64% (n = 7) were due to endophthalmitis, 27.27% (n = 3) were due to ocular trauma, and 9.09% (n = 1) were done for a painful blind due to neovascular glaucoma. Two enucleation surgeries were performed for retinoblastoma and one exenteration for orbital metastatic malignancy.
CONCLUSION: The preferred choice of anophthalmic surgery was in favour of evisceration, especially when the underlying causes were due to benign conditions. The most common indications of anophthalmic surgeries were endophthalmitis, trauma, and malignancies. Enucleation and exenteration were performed mainly for the blinded eye due to the intraocular malignancies and malignancy with an extraocular spread. A fairly lesser number of anophthalmic surgeries over the five years could imply an improvement in the conservative management approach of a painful blinded eye.
Bilateral intermediate uveitis in a healthy teenager with the multisystem inflammatory syndrome in children secondary to COVID-19 infection

Sim AYC, Naffi AA, Fai TS, Kori N, Zaidi WAW, Periyasamy P, et al.

J Med Virol, 2022 Apr;94(4):1269-1271.
PMID: 34897747 DOI: 10.1002/jmv.27521
Evaluation of Three-Dimensional Heads up Ophthalmic Surgery Demonstration From the Perspective of Surgeons and Postgraduate Trainees

Cheng TC, Yahya MFN, Mohd Naffi AA, Othman O, Seng Fai T, Yong MH, et al.

J Craniofac Surg, 2021 Oct 01;32(7):2285-2291.
PMID: 33770023 DOI: 10.1097/SCS.0000000000007645

BACKGROUND: To evaluate the satisfaction of surgeons and trainees with three-dimensional (3D) ophthalmic surgery during a demonstration compared to traditional surgery.
METHODS: This validated questionnaire-based study was conducted over 1-month during which Ngenuity 3D surgery was demonstrated. All surgeons and trainees exposed were recruited to complete a questionnaire comprising visualization, physical, ease of use, teaching and learning, and overall satisfaction.
RESULTS: All 7 surgeons and 33 postgraduate students responded. Surgeons reported no significant difference except overall (P = 0.047, paired t-test). Postgraduate trainees reported significantly better experience with 3D for illumination (P = 0.008), manoeuvrability (P = 0.01), glare (P = 0.037), eye strain (P = 0.008), neck and upper back strain (P = 0.000), lower back pain (P = 0.019), communication (P = 0.002), comfortable environment (P = 0.001), sharing of knowledge (P = 0.000), and overall (P = 0.009).
CONCLUSIONS: During early experience, surgeons and trainees reported better satisfaction with 3D overall. Trainees had better satisfaction with 3D in various subcomponents of visualization, physical, ease of use, and education.