Comparison of continuous preperitoneal infiltration versus patient controlled analgesia for pain control in elective colorectal surgery.

Background: Post-operative analgesia is crucial in enhanced recovery after surgery and to minimize post-operative complications. There remains data paucity on the efficacy of preperitoneal analgesia (PPA) compared to patient-controlled analgesia (PCA). This study aims to examine the efficacy of preperitoneal infusion as analgesia following elective colorectal surgery.

Outcomes of traumatic extremity vascular injuries from a Malaysian level 1 trauma center.

Background: In Malaysia, management of traumatic vascular injuries is at the discretion of the treating surgeon (trauma or vascular surgery). This study was conducted to report on the epidemiology, mechanism of injury and outcomes of vascular injuries managed in a regional level 1 trauma center.

Methods: This is a retrospective cohort study of all patients treated for traumatic extremity vascular injuries from January 2018 to December 2020.

Predictors of Mortality and Outcomes of Ventilated Patients Managed in a Resource-Limited Acute Surgical Ward.

Background: Acute care surgery is an important component of health care in the developed nations. However, in Malaysia, acute care surgery is yet to be recognized as a specific subspecialty service. Due to high demands of limited ICU beds, some patients have to be ventilated in the wards.

Intrauterine contraceptive device embedded in bladder wall with calculus formation removed successfully with open surgery.

An Intrauterine contraceptive devices (IUCD) is commonly inserted by the primary health care physician. It can migrate into pelvic or abdominal organs. When a pregnancy occurs following an insertion of an IUCD, there should be a high suspicion of uterine perforation or possible migration.

Older age and duration of exposure to type 2 diabetes in selective screening of asymptomatic carotid artery stenosis for primary stroke prevention-A single institution experience.

Aims: To evaluate the incidence and risk factors for carotid artery stenosis amongst asymptomatic type 2 diabetes from a single Malaysian tertiary institution.

Methods: This is a prospective cross-sectional study of asymptomatic type 2 diabetics selected from the outpatient ophthalmology and endocrine clinics for carotid duplex ultrasound scanning performed by a single radiologist. The duplex ultrasound criteria were based on the North American Symptomatic Carotid Endarterectomy Trial (NASCET) classification of carotid artery stenosis.

Clinical Audit of Urosepsis Treated in a Malaysian Surgery Unit.

This is a retrospective audit of all patients admitted to the surgical unit for urosepsis from June 2014 to June 2015 at the General Surgery Unit of Hospital Sultan Ismail, Malaysia. Demographics, comorbidities, presenting symptoms, length of stay (LOS), mortality, and associated risk factors were recorded. There were 35 patients treated for urosepsis with a male preponderance of 21/35 patients.

Pulmonary artery catheter entrapment after mitral valve surgery and the use of transesophageal echocardiography to accurately determine the site of entrapment.

The prevalence of pulmonary artery catheter (PAC) entrapment in open-heart surgery is scarce with a prevalence rate of 0.065%. Challenges in managing such cases lie particularly in choosing the modalities (chest roentgenogram, fluoroscopy, and transesophageal echocardiography) to accurately identify the anatomic location and cause of entrapment.

A Rare Presentation of Anterior Mediastinal Teratoma Mimicking Valvular Heart Disease with A Systolic Murmur.

Extrinsic pulmonary artery stenosis caused by anterior mediastinum teratoma presenting with an ejection systolic murmur is a rare phenomenon. Till date, 15 cases have been reported (inclusive of this case) in the English literatures. Herein we report a 20 year old female with extrinsic pulmonary artery stenosis because of compression by an anterior mediastinal teratoma with a loud ejection systolic murmur.

Major tracheobronchial injuries: Management of two rare cases.

Tracheobronchial injuries are uncommon and a high level of suspicion is needed for immediate diagnosis and prompt treatment. In this case series, two rare cases of tracheobronchial injuries is described showing variable clinical presentations with different levels of injury. Our first case was seen in a 20 years old male whom had a direct impact on the neck and presented with upper tracheal injury.

Prognostic predictors of early mortality from exsanguination in adult trauma: a Malaysian trauma center experience.

Background: Trauma mortality due to exsanguination is the second most common cause of death. The objective of this study is to investigate the predictors for early death from exsanguination.

Methods: A prognostic study was done to identify predictors of early mortality due to exsanguination.

Case report of a high voltage electrical injury and review of the indications for early fasciotomy in limb salvage of an electrically injured limb.

Electrical injuries make up a relatively small portion of burn injuries. Safety measures in place on domestic electricity supply have reduced the occurrence of high voltage electrical injuries. We present the case of a young man who sustained a high voltage electrical injury on all four limbs.