1.Mycotic bronchial artery aneurysmal rupture in the early stage of lung abscess: A case report
Mohd Alkaf Ab Latip ; Syed Rasul Syed Hamid ; Abdul Rahman Ismail
The Medical Journal of Malaysia 2016;71(2):96-97
Symptomatic bronchial artery aneurysm warrants urgent
intervention. It has a known association with pulmonary
infection caused by Staphylococcus aureus. We hereby
report an elderly lady with a ruptured left superior bronchial
artery mycotic aneurysm. She was in the early stages of
treatment for a left lung abscess. She had multiple episodes
of haemoptysis following which she underwent a left lower
lobectomy. Presentation of lung abscess with a concurrent
ruptured mycotic aneurysm warrants early surgical
intervention and can be curative as seen in this case.
Staphylococcus aureus
2.Coronary artery bypass graft surgery in a young female with systemic lupus erythematosus and its operative challenges: A case report
Gurpreet Singh ; Simon Jerome Vendargon ; Syed Rasul Syed Hamid
The Medical Journal of Malaysia 2019;74(6):549-550
We understand that autoimmune disorders such as
Systemic Lupus Erythematosus increases the likelihood of
developing coronary heart disease. However, its
implications on patients undergoing cardiac surgery is not
well understood. Here we present a female patient with SLE
who developed coronary artery disease at a young age and
underwent coronary artery bypass graft surgery. As SLE is
associated with vasculitis, we wanted to understand
regarding the choice of conduit as well as its long term
patency. Also whether percutaneous angioplasty has a role
to play in patients with SLE.
3.Incentive spirometry inspiratory capacity changes and predictors after open heart surgery: a 5-day prospective study
Leela T. Narayanan ; Syed Rasul G. Syed Hamid
The Medical Journal of Malaysia 2020;75(3):226-234
Introduction: Incentive spirometry (IS) is commonly used for
increasing postoperative IS inspiratory capacity (ISIC) after
open heart surgery (OHS). However, little is known about the
serial changes in ISIC and their predictive factors.
Objective: The aim of this study is to identify the
postoperative ISIC changes relative to preoperative ISIC
after OHS, and determine their predictors, including patient
characteristics factors and IS performance parameters such
as inspiration volumes (ISv) and frequencies (ISf).
Methods: This is a prospective study with blinding
procedures involving 95 OHS patients, aged 52.8±11.5 years,
whose ISIC was measured preoperatively (PreopISIC) until
fifth postoperative day (POD), while ISv and ISf monitored
with an electronic device from POD1-POD4. Regression
models were used to identify predictors of POD1 ISIC, POD2-
POD5 ISIC increments, and the odds of attaining PreopISIC
by POD5.
Results: The ISIC reduced to 41% on POD1, increasing
thereafter to 57%, 75%, 91%, and 106% from POD2-POD5
respectively. Higher PreopISIC (B=-0.01) significantly
predicted lower POD1 ISIC, and, together with
hyperlipedemia (B=11.52), which significantly predicted
higher POD1 ISIC, explained 13% of variance. ISv at relative
percentages of PreopISIC from POD1-POD4 (BPOD1=0.60,
BPOD2=0.56, BPOD3=0.49, BPOD4=0.50) significantly predicted
ISIC of subsequent PODs with variances at 23%, 24%, 17%
and 25% respectively, but no association was elicited for ISf.
IS performance findings facilitated proposal of a
postoperative IS therapy target guideline. Higher ISv
(B=0.05) also increased odds of patients recovering to
preoperative ISIC on POD5 while higher PreopISIC (B=-
0.002), pain (B=-0.72) and being of Indian race (B=-1.73)
decreased its odds.
Conclusion: ISv appears integral to IS therapy efficacy after
OHS and the proposed therapy targets need further
verification through randomized controlled trials.
4.Case series of haemothorax secondary to avulsed bullae vessel
Qin Jian Low ; Zuraida Hatta ; Seng Wee Cheo ; Syed Rasul Bin G. Syed Hamid ; Kee San Goh
The Medical Journal of Malaysia 2019;74(5):431-432
Haemothorax refer to the bleeding in the pleural space. It is
commonly due to iatrogenic, blunt or penetrating chest
trauma. Non-traumatic haemothorax is a rare entity that can
potentially lead to life threatening complications. The initial
management of both traumatic and non-traumatic
haemothorax includes resuscitation and stabilisation of the
patient. We would like to present two cases of non-traumatic
haemothorax secondary to an avulsed bullae vessel.