1.Therapeutic and Tectonic Penetrating Keratoplasty- All in One
Ng WL ; Umi Kalthum MN ; Jemaima CH ; Then KY
Journal of Surgical Academia 2015;5(1):79-81
A middle-aged gentleman with history of left penetrating keratoplatsy presented with left eye perforated corneal graft
secondary to infective keratitis. The affected eye was blind from absolute steroid-induced glaucoma. In view of
expected poor graft survival in a blind eye, globe removal was offered. However, the patient refused the treatment
and request for another corneal graft. This case highlights both the possibility of good outcome of cornea graft in
such a case, and also illustrates that patient’s autonomy to refuse treatment option outweighs beneficence.
Blindness
2.Frontal Mucocele Masked as Upper Lid Abcess- A Case Report
Ng WL ; Umi Kalthum MN ; Jemaima CH ; Norshamsiah MD
Journal of Surgical Academia 2016;6(1):43-45
Frontal mucocele is not commonly masked as upper lid abscess.A 72-year-old Chinese man with underlying
hyperthyroidism complained of left upper eyelid swelling of 6 months duration. The swelling had persisted and
worsen when intravenous antibiotic was changed oral type. Visual acuity on presentation was hand motion and
reverse relative afferent pupillary defect was present. Because the swelling was large and resulted in mechanical
ptosis and ophthalmoplegia, a CT imaging was performed, which showed huge left frontal mucocele eroding the
supereromedial orbital rim. The left globe was displaced inferolaterally but there was no extension into brain
parenchyma. Fundus examination showed pale optic disc with dull macula. Old laser marks were seen at peripheral
fundus. Referral to ortholaryngologist was made and endoscopic sinus surgery and evacuation of mucopyocoele was
done. Culture and sensitivity of the fluid showed no organism. He recovered well postoperatively with additional two
weeks of antibiotics. We highlight the necessity of surgical drainage of mucocele, following a course of antibiotic.
Mucocele
5.FIXATION STABILITY OF OBLIQUE WIRE IN ILIZAROV EXTERNAL FIXATOR
Ng WL ; Rukmanikanthan S ; Saw A
Malaysian Orthopaedic Journal 2019;13(Supplement A):19-
6.Minimally Invasive versus Conventional Open Surgery for Fixation of Spinal Fracture in Ankylosed Spine
Chung WH ; Ng WL ; Chiu CK ; Chan CYW ; Kwan MK
Malaysian Orthopaedic Journal 2020;14(No.3):22-31
Introduction: This was a retrospective study aimed to
investigate the perioperative outcomes of long construct
minimally invasive spinal stabilisation (MISt) using
percutaneous pedicle screws (PPS) versus conventional open
spinal surgery in the treatment of spinal fracture in
ankylosing spondylitis (AS) and diffuse idiopathic skeletal
hyperostosis (DISH).
Material and Methods: Twenty-one patients with AS and
DISH who were surgically treated between 2009 and 2017
were recruited. Outcomes of interest included operative time,
intra-operative blood loss, complications, duration of
hospital stay and fracture union rate.
Results: Mean age was 69.2 ± 9.9 years. Seven patients had
AS and 14 patients had DISH. 17 patients sustained AO type
B3 fracture and 4 patients had type B1 fracture. Spinal
trauma among these patients mostly involved thoracic spine
(61.9%), followed by lumbar (28.6%) and cervical spine
(9.5%). MISt using PPS was performed in 14 patients
(66.7%) whereas open surgery in 7 patients (33.3%). Mean
number of instrumentation level was 7.9 ± 1.6. Mean
operative time in MISt and open group was 179.3 ± 42.3
minutes and 253.6 ± 98.7 minutes, respectively (p=0.028).
Mean intra-operative blood loss in MISt and open group was
185.7 ± 86.4ml and 885.7 ± 338.8ml, respectively (p<0.001).
Complications and union rate were comparable between both
groups.
Conclusion: MISt using PPS lowers the operative time and
reduces intra-operative blood loss in vertebral fractures in
ankylosed disorders. However, it does not reduce the
perioperative complication rate due to the premorbid status
of the patients. There was no significant difference in the
union rate between MISt and open surgery.
7.Best practices on immunomodulators and biologic agents for ulcerative colitis and Crohn's disease in Asia
Choon Jin OOI ; Ida HILMI ; Rupa BANERJEE ; Sai Wei CHUAH ; Siew Chien NG ; Shu Chen WEI ; Govind K MAKHARIA ; Pises PISESPONGSA ; Min Hu CHEN ; Zhi Hua RAN ; Byong Duk YE ; Dong Il PARK ; Khoon Lin LING ; David ONG ; Vineet AHUJA ; Khean Lee GOH ; Jose SOLLANO ; Wee Chian LIM ; Wai Keung LEUNG ; Raja Affendi Raja ALI ; Deng Chyang WU ; Evan ONG ; Nazri MUSTAFFA ; Julajak LIMSRIVILAI ; Tadakazu HISAMATSU ; Suk Kyun YANG ; Qin OUYANG ; Richard GEARY ; Janaka H DE SILVA ; Rungsun RERKNIMITR ; Marcellus SIMADIBRATA ; Murdani ABDULLAH ; Rupert WL LEONG ;
Intestinal Research 2019;17(3):285-310
The Asia-Pacific Working Group on inflammatory bowel disease (IBD) was established in Cebu, Philippines, under the auspices of the Asian Pacific Association of Gastroenterology with the goal of improving IBD care in Asia. This consensus is carried out in collaboration with Asian Organization for Crohn's and Colitis. With biologic agents and biosimilars becoming more established, it is necessary to conduct a review on existing literature and establish a consensus on when and how to introduce biologic agents and biosimilars in the conjunction with conventional treatments for ulcerative colitis (UC) and Crohn's disease (CD) in Asia. These statements also address how pharmacogenetics influence the treatments of UC and CD and provide guidance on response monitoring and strategies to restore loss of response. Finally, the review includes statements on how to manage treatment alongside possible hepatitis B and tuberculosis infections, both common in Asia. These statements have been prepared and voted upon by members of IBD workgroup employing the modified Delphi process. These statements do not intend to be all-encompassing and future revisions are likely as new data continue to emerge.
Adalimumab
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Asia
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Asian Continental Ancestry Group
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Biological Factors
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Biosimilar Pharmaceuticals
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Colitis
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Colitis, Ulcerative
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Consensus
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Cooperative Behavior
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Crohn Disease
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Gastroenterology
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Hepatitis B
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Humans
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Immunologic Factors
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Inflammatory Bowel Diseases
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Infliximab
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Pharmacogenetics
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Philippines
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Practice Guidelines as Topic
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Tuberculosis
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Ulcer