1.Brain and Spinal Tumour
Chin Hwee Goh ; Yeow Yen Lu ; Bik Liang Lau ; Jacqueline Oy Leng Wong ; Hock Keong Lee ; Donald Ngian San Liew ; Albert Sii Hieng Wong
The Medical Journal of Malaysia 2014;69(6):261-267
This study reviewed the epidemiology of brain and spinal
tumours in Sarawak from January 2009 till December 2012.
The crude incidence of brain tumour in Sarawak was 4.6 per
100,000 population/year with cumulative rate 0.5%.
Meningioma was the most common brain tumour (32.3%)
and followed by astrocytoma (19.4%). Only brain metastases
showed a rising trend and cases were doubled in 4 years.
This accounted for 15.4% and lung carcinoma was the
commonest primary. Others tumour load were consistent.
Primitive neuroectodermal tumour (PNET) and astrocytoma
were common in paediatrics (60%). We encountered more
primary spinal tumour rather than spinal metastases.
Intradural schwannoma was the commonest and frequently
located at thoracic level. The current healthcare system in
Sarawak enables a more consolidate data collection to
reflect accurate brain tumours incidence. This advantage
allows subsequent future survival outcome research and
benchmarking for healthcare resource planning.
2.Comparing the outcome of monitored anaesthesia care and local anaesthesia for carpal tunnel syndrome surgery by neurosurgeons
Goh Chin Hwee ; Lau Bik Liang ; Teong Sook Yee ; Law Wan Chung ; Tan Peter Chee Seong ; Ravindran Vashu ; Liew Donald Ngian San ; Wong Albert Sii Hieng
The Medical Journal of Malaysia 2019;74(6):499-503
Introduction: Carpal tunnel syndrome (CTS) is the
commonest median nerve entrapment neuropathy of the
hand, up to 90% of all nerve compression syndromes. The
disease is often treated with conservative measures or
surgery. The senior author initially intended to treat his own
neurosurgical patients concurrently diagnosed with carpal
tunnel syndrome in 2014, subsequently, he began to pick up
more referrals from the primary healthcare group over the
years. This has led to the setup of a peripheral and spine
clinic to act as a hub of referrals. Objective: Department of
Neurosurgery Sarawak aimed to evaluate the surgical
outcome of carpal tunnel release done over five years.
Methods: The carpal tunnel surgeries were done under local
anaesthesia (LA) given by neurosurgeons (Bupivacaine
0.5% or Lignocaine 2%). Monitored anaesthesia care (MAC)
was later introduced by our hospital neuroanaesthetist in
the beginning of 2018 (Target-controlled infusion propofol
and boluses of fentanyl). We looked into our first 17 cases
and compared these to the two anaesthesia techniques (LA
versus MAC + LA) in terms of patient’s pain score based on
visual analogue scale (VAS).
Results: Result showed MAC provided excellent pain control
during and immediately after the surgery. None experienced
anaesthesia complications. There was no difference in pain
control at post-operation one month. Both techniques had
equal good clinical outcome during patients’ clinic follow
up.
Conclusion: Neurosurgeons provide alternative route for
CTS patients to receive surgical treatment. Being a
designated pain free hospital, anaesthetist collaboration in
carpal tunnel surgery is an added value and improves
patients overall experience and satisfaction.
3.Psychological symptoms among healthcare workers handling COVID-19 patients
Sim Sze Kiat ; Lau Bik Liang ; Siti Rosnaini Zaila Ramli ; Nur Hazira Abdul Muti ; Nur Muzfirah Aniqah Abdul Rahman ; Jevitha Panicker Balachandran ; Alya Syafiqah Hamzah
The Medical Journal of Malaysia 2021;76(2):138-144
Introduction: Healthcare workers serve as the frontliners
against the coronavirus 2019 disease (COVID-19) and this
puts them most at risk of infection as they attend to
numerous patients with unknown status. This study aimed
to examine stress, anxiety, and depression among
healthcare workers caring for COVID-19 patients in Sarawak
General Hospital (SGH), Malaysia.
Materials and Methods: This cross-sectional observational
study conducted in SGH during the pandemic with an online
self-administered questionnaire composed of two parts, the
socio-demographic characteristics, and the Depression
Anxiety Stress Scale (DASS).
Results: A total of 105 healthcare workers responded to this
study. A questionnaire in both Bahasa Melayu and English
was used. The findings showed that all healthcare workers
had mild anxiety, with the majority experiencing mild stress
(57.1%), and almost half of the respondents experiencing
mild depression (41%). Female subjects had a significant
higher mean score in anxiety level and stress level
compared to male subjects (10.0±3.20 vs. 8.6±2.93, p<0.05;
14.1±4.76 vs. 10.7±3.70, p<0.05, respectively). Staff who were
transferred from other units to handle COVID-19 cases
experienced more psychological symptoms. There were
significant correlations between the depression, anxiety and
stress levels among the healthcare workers and the number
of children they had (r=0.739, p=0.001; r=0.642, p=0.001; r=1,
p =0.001 respectively). However, the stress level among the
healthcare workers was reversely correlated with their years
of working experience (r=-0.199, p=0.042).
Conclusion: This study identified some socio-demographic
factors associated with increased levels of stress, anxiety
and depression among the healthcare workers during
pandemic, which may lay ground for future interventions.