MyMedR

Neurosurgery in developing countries--a Malaysian-American viewpoint

Sundaresan N

Surg Neurol, 1984 Sep;22(3):316-7.

Matched MeSH terms: Neurosurgery*

Fulltext In Reply to the Letter to the Editor Regarding "Impact of COVID-19 on Neurosurgical Training in Southeast Asia"

Baticulon RE, Nga VDW, Sobana M, Bahuri NFA, Wittayanakorn N

World Neurosurg, 2021 Feb;146:427.

PMID: 33607747 DOI: 10.1016/j.wneu.2020.11.056

Matched MeSH terms: Neurosurgery*

Letter: Addressing Neurosurgery Research and Data Access Gaps in War-Inflicted Nations

Adebusoye FT, Awuah WA, Swaminathan N, Ghosh S, Wellington J, Abdul-Rahman T, et al.

Neurosurgery, 2023 Aug 01;93(2):e30-e31.

PMID: 37192472 DOI: 10.1227/neu.0000000000002527

Matched MeSH terms: Neurosurgery*

A Humanist Neurosurgeon: A Legacy of Dr. Roy Selby

Lichterman BL, Wong SN, Likhterman LB

World Neurosurg, 2019 Aug;128:149-157.

PMID: 31042604 DOI: 10.1016/j.wneu.2019.04.178

The article is dedicated to the life and work of Dr. Roy Selby (1930-2002), an American neurosurgeon who founded neurosurgery in Malaysia. Dr. Selby stayed in Malaysia from July 1963 to May 1970. He opened the first neurosurgical department at the general hospital in Kuala Lumpur and established a training program under which Malaysian physicians and nurses were sent to neurosurgery centers in the United States and Canada. Some physicians came back and headed local neurosurgical units. On his return to the United States, Dr. Selby practiced neurosurgery until 1986, when he had to give it up due to the impact of progressive congestive heart failure. From 1986 to 1994, Dr. Selby taught graduate courses in the Department of Psychology at East Texas State University, Texarkana, Texas. He was a pioneer of spinal surgery and founded the Lumbar Spine Society. Dr. Selby was a world citizen neurosurgeon and advocated international standards of training in neurosurgery. From 1985 to 1994, he was chairman of the Archives Committee of the American Association of Neurological Surgeons. Dr. Selby serves as a model of a physician as a humanist.

Matched MeSH terms: Neurosurgery/education; Neurosurgery/history*

NeuroVerse: neurosurgery in the era of Metaverse and other technological breakthroughs

Kundu M, Ng JC, Awuah WA, Huang H, Yarlagadda R, Mehta A, et al.

Postgrad Med J, 2023 May 22;99(1170):240-243.

PMID: 36892407 DOI: 10.1093/postmj/qgad002

The tremendous evolution in modern technology has led to a paradigm shift in neurosurgery. The latest advancements such as augmented reality, virtual reality, and mobile applications have been incorporated into neurosurgical practice. NeuroVerse, representing the application of the metaverse in neurosurgery, brings enormous potential to neurology and neurosurgery. Implementation of NeuroVerse could potentially elevate neurosurgical and interventional procedures, enhance medical visits and patient care, and reshape neurosurgical training. However, it is also vital to consider the challenges that may be associated with its implementation, such as privacy issues, cybersecurity breaches, ethical concerns, and widening of existing healthcare inequalities. NeuroVerse adds phenomenal dimensions to the neurosurgical environment for patients, doctors, and trainees, and represents an incomparable advancement in the delivery of medicine. Therefore, more research is needed to encourage widespread use of the metaverse in healthcare, particularly focusing on the areas of morality and credibility. Although the metaverse is expected to expand rapidly during and after the COVID-19 pandemic, it remains to be seen whether it represents an emerging technology that will revolutionize our society and healthcare or simply an immature condition of the future.

Matched MeSH terms: Neurosurgery*

The molecular landscape of neurological disorders: insights from single-cell RNA sequencing in neurology and neurosurgery

Awuah WA, Ahluwalia A, Ghosh S, Roy S, Tan JK, Adebusoye FT, et al.

Eur J Med Res, 2023 Nov 16;28(1):529.

PMID: 37974227 DOI: 10.1186/s40001-023-01504-w

Single-cell ribonucleic acid sequencing (scRNA-seq) has emerged as a transformative technology in neurological and neurosurgical research, revolutionising our comprehension of complex neurological disorders. In brain tumours, scRNA-seq has provided valuable insights into cancer heterogeneity, the tumour microenvironment, treatment resistance, and invasion patterns. It has also elucidated the brain tri-lineage cancer hierarchy and addressed limitations of current models. Neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease, and amyotrophic lateral sclerosis have been molecularly subtyped, dysregulated pathways have been identified, and potential therapeutic targets have been revealed using scRNA-seq. In epilepsy, scRNA-seq has explored the cellular and molecular heterogeneity underlying the condition, uncovering unique glial subpopulations and dysregulation of the immune system. ScRNA-seq has characterised distinct cellular constituents and responses to spinal cord injury in spinal cord diseases, as well as provided molecular signatures of various cell types and identified interactions involved in vascular remodelling. Furthermore, scRNA-seq has shed light on the molecular complexities of cerebrovascular diseases, such as stroke, providing insights into specific genes, cell-specific expression patterns, and potential therapeutic interventions. This review highlights the potential of scRNA-seq in guiding precision medicine approaches, identifying clinical biomarkers, and facilitating therapeutic discovery. However, challenges related to data analysis, standardisation, sample acquisition, scalability, and cost-effectiveness need to be addressed. Despite these challenges, scRNA-seq has the potential to transform clinical practice in neurological and neurosurgical research by providing personalised insights and improving patient outcomes.

Matched MeSH terms: Neurosurgery*

Tailoring teleconsultation to meet the current needs of neurosurgical services: a multimodality oriented neurosurgical consultation

Narenthiranathan NR, Adnan JS, Haspani MS

Stud Health Technol Inform, 2010;161:112-21.

PMID: 21191164

Teleconsultation in Neurosurgery was introduced in Malaysia in 2006 with the aims of enhancing quality services in the field of Neurosurgery. The present teleconsultation system is equipped with user friendly features which allow physicians to send and neurosurgeons to gain access to patient data in a swift and effective manner. In the past, teleconsultation in neurosurgery was tied with teleradiology, however we have now developed a multimodality system to cater specifically for neurosurgery. In Malaysia, the teleconsultation service is gaining momentum as evidenced by the large volume of cases channeled through this system. 944 cases within a span of 4 months were recorded on the system. 54.5% of the cases were trauma, 33.2% stroke, 6.1% intracranial tumours, 2% of cases were of spinal pathology, 2% pediatric anomalies and 2.2% intracranial infections. 50.2% of the referrals were after regular working hours reflecting the need for dedicated teleneurosurgery consultative services and the ability to review referrals outside of hospitals. Only 36% of cases needed emergency transfers and 9.9% of the cases were managed remotely at distant hospitals. Another 9.4% of the cases were either transferred electively or brought to the clinic for consultation. The above findings emphasise the importance of teleconsultation as a means to provide wide medical coverage within the region.

Matched MeSH terms: Neurosurgery*

Exteriorization of the subdural pocket for chronic recurrent subdural hematoma

Chee CP

Neurosurgery, 1988 Apr;22(4):780-2.

PMID: 3374793

The author describes a new operative method for treating chronic recurrent subdural hematoma. The subdural pocket is exteriorized so that it is in continuity with the subgaleal space through a limited extradural pocket and an L-shaped linear craniectomy. This procedure has been carried out in two patients with recurrent chronic subdural hematoma, both of whom made complete recoveries despite initial recurrence of the subdural hematoma.

Matched MeSH terms: Neurosurgery/methods

Douglas Miller

Loewenthal J, Kenny PG, Seng YG

Aust N Z J Surg, 1974 Jul;44(3):211-4.

PMID: 4618111

Matched MeSH terms: Neurosurgery/history*

Neurosurgery certification in member societies of the World Federation of Neurosurgical Societies: Asia

Gasco J, Braun JD, McCutcheon IE, Black PM

World Neurosurg, 2011 Mar-Apr;75(3-4):325-34.

PMID: 21600456 DOI: 10.1016/j.wneu.2011.01.001

To objectively compare the complexity and diversity of the certification process in neurological surgery in member societies of the World Federation of Neurosurgical Societies.

Matched MeSH terms: Neurosurgery/education; Neurosurgery/standards*; Neurosurgery/statistics & numerical data

Fulltext A Rare Case of Aggressive, Huge Primary Orbital Lymphoma with Intracranial Extension and Bone Invasion

Sriram PR

Asian J Neurosurg, 2017 11 9;12(4):766-768.

PMID: 29114307 DOI: 10.4103/1793-5482.185055

Primary orbital lymphoma is a rare entity with only 1% of extranodal lymphomas. They usually present to ophthalmologist and surgical reserved for biopsy or tissue diagnosis. We present a patient who was referred to neurosurgery for a rapid growing orbital lymphoma. It grows from a small nodule in the eyelid to a huge, aggressive, disfiguring lesion invading bone and dura with intracranial extension within 3 months. The patient was treated with total surgical excision followed by systemic chemotherapy.

Matched MeSH terms: Neurosurgery

Fulltext Ain't No Neuroscience Mountain High Enough: Experiences of a Neurogardener

Abdullah JM

Malays J Med Sci, 2015 May-Jun;22(3):1-6.

PMID: 26715890

16 years have passed since the idea was mooted in 1999 by five neurosurgeons in the corridors of Hotel Perdana, Kota Bharu. They were Dato' Dr Johari Siregar Bin Adnan, Dato' Professor Dr Ahmad Zubaidi Abdul Latif , Dr Azmin Kass Bin Rosman, Dato' Dr Mohammed Saffari Bin Mohammed Haspani and Professor Dato' Dr Jafri Malin Abdullah. They initiated the beginning of the first programme in Neurosurgery in Malaysia. The rest is history.

Matched MeSH terms: Neurosurgery

Injecting realism in surgical training-initial simulation experience with custom 3D models

Waran V, Narayanan V, Karuppiah R, Pancharatnam D, Chandran H, Raman R, et al.

J Surg Educ, 2014 Mar-Apr;71(2):193-7.

PMID: 24602709 DOI: 10.1016/j.jsurg.2013.08.010

The traditionally accepted form of training is direct supervision by an expert; however, modern trends in medicine have made this progressively more difficult to achieve. A 3-dimensional printer makes it possible to convert patients imaging data into accurate models, thus allowing the possibility to reproduce models with pathology. This enables a large number of trainees to be trained simultaneously using realistic models simulating actual neurosurgical procedures. The aim of this study was to assess the usefulness of these models in training surgeons to perform standard procedures that require complex techniques and equipment.

Matched MeSH terms: Neurosurgery/education*

History of neurosciences at the School of Medical Sciences, Universiti Sains Malaysia

Idris B, Sayuti S, Abdullah JM

J Clin Neurosci, 2007 Feb;14(2):148-52.

PMID: 17161289

Universiti Sains Malaysia is the only institution in Malaysia which incorporates all fields of the neurosciences under one roof. The integration of basic and clinical neurosciences has made it possible for this institution to become an excellent academic and research centre. This article describes the history, academic contributions and scientific progress of neurosciences at Universiti Sains Malaysia.

Matched MeSH terms: Neurosurgery/history*

Fulltext Equitable Access to State-of-the-Art Medical Technology-a Malaysian Mini-Public-Private Partnership Case Study

Waran V, Thillainathan R, Karuppiah R, Pickard JD

World Neurosurg, 2022 01;157:135-142.

PMID: 34687934 DOI: 10.1016/j.wneu.2021.10.112

BACKGROUND: The provision of equitable and affordable health care has become increasingly challenging as advanced technology is introduced, particularly in developing countries. We explored the hypothesis that focused, small-scale mini-public-private partnerships have a potential role in providing equitable and affordable access to advanced technology for the benefit of all patients in developing nations, particularly middle-income countries.

METHODS: A clinician-led financial plan was developed at the University of Malaya to create the Centre for Image Guidance and Minimally Invasive Therapy (CIGMIT) to provide an integrated platform for high-end care for Malaysian patients of all ages, both public and private, requiring complex neurosurgical and spinal procedures and stereotactic and intensity-modulated radiotherapy. The challenges faced during development of the plan were documented together with an audit of patient throughput and analyses of financial risk and return.

RESULTS: CIGMIT opened in 2015. Patient throughput, both public and private, progressively increased in all facilities. In 2015-2019, 37,724 patients used the Centre's facilities. CIGMIT has become progressively more profitable for the University of Malaya, the public and private hospitals, and the investor. CIGMIT has weathered the challenges posed by coronavirus disease 19.

CONCLUSIONS: Focused, small-scale mini-public-private partnerships have a potential role in providing advanced technology for the benefit of patients in developing nations, particularly middle-income countries, subject to an approach that balances equity of access between public and private health care systems with fair reward.

Matched MeSH terms: Neurosurgery/organization & administration*

Frequency and Causes of Line of Sight Issues During Neurosurgical Procedures Using Optical Image-Guided Systems

Mehbodniya AH, Moghavvemi M, Narayanan V, Waran V

World Neurosurg, 2019 Feb;122:e449-e454.

PMID: 30347306 DOI: 10.1016/j.wneu.2018.10.069

BACKGROUND: Navigation (image guidance) is an essential tool in modern neurosurgery, and most surgeons use an optical tracking system. Although the technology is accurate and reliable, one often is confronted by line of sight issues that interrupt the flow of an operation. There has been feedback on the matter, but the actual problem has not been accurately quantified, therefore making this the primary aim of this study. It is particularly important given that robotic technology is gradually making its way into neurosurgery and most of these devices depend on optical navigation when procedures are being conducted.

METHODS: In this study, the frequency and causes of line of sight issues is assessed using recordings of Navigation probe locations and its synchronised video recordings.

RESULTS: The mentioned experiment conducted for a series of 15 neurosurgical operations. This issue occured in all these surgeries except one. Maximum duration of issue presisting reached up to 56% of the navigation usage time.

CONCLUSIONS: The arrangment of staff and equipment is a key factor in avoiding this issue.

Matched MeSH terms: Neurosurgery

Utility of multimaterial 3D printers in creating models with pathological entities to enhance the training experience of neurosurgeons

Waran V, Narayanan V, Karuppiah R, Owen SL, Aziz T

J. Neurosurg., 2014 Feb;120(2):489-92.

PMID: 24321044 DOI: 10.3171/2013.11.JNS131066

The advent of multimaterial 3D printers allows the creation of neurosurgical models of a more realistic nature, mimicking real tissues. The authors used the latest generation of 3D printer to create a model, with an inbuilt pathological entity, of varying consistency and density. Using this model the authors were able to take trainees through the basic steps, from navigation and planning of skin flap to performing initial steps in a craniotomy and simple tumor excision. As the technology advances, models of this nature may be able to supplement the training of neurosurgeons in a simulated operating theater environment, thus improving the training experience.

Matched MeSH terms: Neurosurgery/education*; Neurosurgery/methods*

Telemedicine in neurosurgery using international digital telephone services between Japan and Malaysia--technical note

Houkin K, Fukuhara S, Selladurai BM, Zurin AA, Ishak M, Kuroda S, et al.

Neurol. Med. Chir. (Tokyo), 1999 Oct;39(11):773-7; discussion 777-8.

PMID: 10598447

A new image transmission and teleconference system using international digital telephone services was established between Japan and Malaysia. This new system consists of an ordinary personal computer, image scanner, and terminal adapter for digital telephone lines. The quality of images transferred using this system was high enough for diagnosis and discussion except for images such as radiographs requiring huge data transfer. Transmission of one image took approximately 20 seconds. The cost performance was almost equal to the conventional mailing system. The most remarkable advantage of this new system is the high quality of transferred images, the cost and time performance, and security of the medical information. New communication systems using international digital networks including the internet may allow re-distribution of medical resources between advanced countries and developing countries in neurosurgery.

Matched MeSH terms: Neurosurgery/economics; Neurosurgery/trends*

Fulltext Neuropsychological profile at three months post injury in patients with traumatic brain injury

Ali R, Wahab S, Abdul Rahman AH

Sains Malaysiana, 2013;42(3):403-408.

This study looked into the rate and pattern of neuropsychological impairment in patients with traumatic brain injury patients at three months post injury. Forty patients attending the neurosurgery outpatient clinic were included in the study. Benton visual retention test (BVRT), rey auditory verbal learning test (RAVLT), digit span test, trail making test (TMT) and mini mental state examination (MMSE) were used for assessment. Forty five percent (n=18) sustained moderate to severe head injury. Twenty five percent (n=10) have abnormal MMSE result. Forty two and a half percent (n=17) have abnormal BVRT result. Seventy five percent (n=30) have abnormal RAVLT result while 35% (n=14) have abnormal digit span test result. Seventy seven and a half percent (n=31) have at least one neurological deficit. There was significant association between severity of head injury (GCS score) and neuropsychological deficit. This study highlights the point that in post head injury patients, there are high occurrences of cognitive dysfunction. MMSE and GCS play a significant and important role in assessing cognitive dysfunction. Severity of head injury as determined by GCS scores also influence the outcome in patients with head injury

Matched MeSH terms: Neurosurgery

Fulltext Extended applications of endoscopic sinus surgery and its reference to cranial base and pituitary fossa

Gendeh BS

Indian J Otolaryngol Head Neck Surg, 2010 Sep;62(3):264-76.

PMID: 23120724 DOI: 10.1007/s12070-010-0077-6

Sinus surgery has the potential of allowing ENT surgeons to encroach the boundaries of our colleagues in ophthalmology and neurosurgery. The advent of nasal endoscope and lately powered instrumentation and computer-assisted navigational systems has avoided the use of the conventional and more radical approaches by the ENT surgeon for the treatment of inflammatory pathology or tumors of the orbit and skull base. As rhinologists have gained more experience in endoscopic surgery, more areas related to the orbit and the anterior skull base are accessible and surgery is safer.

Matched MeSH terms: Neurosurgery

Displaying publications 1 - 20 of 43 in total