Publications by authors named "Nik Amin Sahid Nik Lah"

7 Publications

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Successful pregnancy in morbidly obese lady with polycystic ovary syndrome after bariatric surgery: A case report.

Int J Surg Case Rep 2021 Aug 24;85:106235. Epub 2021 Jul 24.

Department of Surgery, Faculty of Medicine and Science Health, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia. Electronic address:

Introduction: Obesity has been proven to have adverse effects on fertility and is one of the predisposing factors for delay in pregnancy even with the use of assisted reproductive technique. There are many pathways in which obesity can affect fertility such as anovulation, poor implantation and low-quality oocyte.

Case Presentation: We report a case of a 40-year-old lady with primary infertility for six years with underlying polycystic ovary syndrome (PCOS) and BMI 45.7 whom was successfully conceived twice following bariatric surgery procedure in which reduction of 70% of her BMI prior to bariatric surgery lead to her spontaneous conception without fertility intervention and successful live birth.

Clinical Discussion: Obese PCOS needs multidisciplinary approaches which include weight loss program such as dietary advice, exercise intervention as part of preliminary treatment prior to ovulation induction and counselling.

Conclusion: Bariatric surgery has been a mainstay treatment in patients with morbid obesity and those with BMI more than 35 associated with obesity related problems such as joint pain, hypertension or diabetes mellitus. Bariatric surgery such as laparoscopic sleeve gastrectomy should be considered more often in contrast to lifestyle modification for morbidly obese lady with PCOS and infertility prior to the use of standard ovulation induction regime for treating infertility.
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http://dx.doi.org/10.1016/j.ijscr.2021.106235DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8329476PMC
August 2021

A case of rectal cancers in teenager: A conundrum of genetics and clinical medicine.

Ann Med Surg (Lond) 2021 May 29;65:102353. Epub 2021 Apr 29.

Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Sabah, Malaysia.

Introduction: Signet cell carcinoma (SRCC)of the rectum is a rare subtype of the rectum cancer which accounts for only 0.8% of colorectal cancer in adolescents and young adults (AYAs) which spread aggressively to other organs and peritoneum.

Case Presentation: We present a case of 15-year-old boy from rural area, presented with chronic diarrhea and per rectal bleeding for 3 months. The diagnosis was determined by colonoscope which revealed a fungating mass identified at 10cm from anal verge. Histological examination confirmed diagnosis of signet ring cell adenocarcinoma. CT scan of the abdomen showed thickening involving the recto-sigmoid colon and rectal mass, without evidence of distant metastatic disease. The patient's carcinoembryonic antigen level was within the normal range. He underwent a colostomy and was subjected to neoadjuvant CCRT and surgery.

Discussion: This CASE highlights the importance and challenges in achieving early diagnosis and surgical intervention of signet-ring cell carcinoma in adolescents, as most cases are detected at an advanced stage coupled with the scarcity of information on these rarer subtypes which leads to a poor prognosis.

Conclusion: In managing Signet cell carcinoma of the colorectal, physician have to know that it has a poor prognosis in patients of any age. However, in young teenagers delayed diagnosis and treatment option are narrowed to palliative management. Genetic profiling of family members and similar environment population may be a key to early detection.
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http://dx.doi.org/10.1016/j.amsu.2021.102353DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8111589PMC
May 2021

Aggressive scalp and sternal lesion: A presentation of rare case of metastatic eccrine carcinoma.

Ann Med Surg (Lond) 2021 May 16;65:102322. Epub 2021 Apr 16.

Surgical Department, Faculty of Medicine & Health Sciences, University Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia.

Introduction: Ductal Eccrine carcinoma (DEC) is a rare primary cutaneous tumor that exhibits both squamous and adnexal ductal differentiation. Due to its rarity in clinical practice we present as case of DEC and a literature review on the latest management of this rare disease.

Case Presentation: We report a case 41 years old female presented with lesion on the scalp and sternal mass, increasing in size with itchiness and erythematous for 6 months duration. Further CECT scan of brain and neck shows features of malignant left frontal scalp lesion with poor plane with overlying skin and underlying skull bone and CECT of thorax shows a large, irregular heterogeneously enhancing mass with necrotic center noted at right hilar within superior segment of right lower lobe, encasing right middle and lower lobe bronchi. Wedge biopsy of scalp lesion showed an intradermal lesion extensively infiltrating by malignant gland accompanied by desmoplasia and the tumor cells are seen extending into the surgical margins suggestive of ductal eccrine carcinoma.Clinical Discussion:This case highlights the importance and challenges in achieving early diagnosis coupled with the scarcity of information on these leads to difficulty in managing this patient.

Conclusion: In managing Ductal Eccrine Carcinoma tumor, standard method of treatment for has not been established. However, wide surgical excision is the treatment of choice for localized lesions. Regarding prognosis, there is conflicting data published which we describe in this article.
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http://dx.doi.org/10.1016/j.amsu.2021.102322DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8091880PMC
May 2021

Challenges in electromyographic endotracheal tube (EMG ETT) placement via awake fibreoptic intubation during emergency thyroidectomy.

BMJ Case Rep 2021 May 13;14(5). Epub 2021 May 13.

Medicine Based Disciplines Department, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia

Recurrent laryngeal nerve (RLN) injury is one of the main complications of total thyroidectomy. If the injury is bilateral, total airway obstruction, aphonia and hoarseness of voice could be precipitated. Hence, it is wise for the operating surgeon to be guided by neural monitoring during thyroidectomy. We present a valuable experience handling a middle-aged man with a huge papillary thyroid carcinoma . He needed an urgent thyroidectomy due to obstructive symptoms. We highlight our intraoperative dexterity in handling his surgery in the context of continuous monitoring of RLN using electromyography.
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http://dx.doi.org/10.1136/bcr-2021-242286DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8126277PMC
May 2021

Re: Perforated descending colon adenocarcinoma manifesting as necrotizing fasciitis.

ANZ J Surg 2021 04;91(4):763-764

Department of Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.

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http://dx.doi.org/10.1111/ans.16536DOI Listing
April 2021

A clinically silent tumour of adrenal myelolipoma: A case report.

Int J Surg Case Rep 2020 1;72:63-65. Epub 2020 Jun 1.

Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia.

Introduction: Adrenal myelolipoma is a rare, non-functional, benign neoplasm which is constituted of mature haematopoietic elements and adipose tissues in various proportions. It is diagnosed accidentally and frequently with the widespread use of imaging modalities.

Presentation Of Case: We report a 63-year-old lady with incidental findings of adrenal tumour on computed tomography (CT) scan during a routine medical check-up. She underwent tumour resection in view of a large tumour of 7 cm in size.

Discussion: CT scan is sensitive to diagnose adrenal myelolipoma in view of its fat-laden property and useful to monitor the tumour progress. Even previously she opted for conservative management; the decision for surgery was made in view of enlarging tumour and risk of surrounding tissue compression.

Conclusion: With increased awareness, the detection rate of this tumour is improving, hence able to prevent the complications of a large tumour such as compression, bleeding and tumour necrosis.
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http://dx.doi.org/10.1016/j.ijscr.2020.05.056DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7283099PMC
June 2020

Intestinal knot in acute Meckel's diverticulitis.

BMJ Case Rep 2019 Nov 24;12(11). Epub 2019 Nov 24.

Department of Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.

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http://dx.doi.org/10.1136/bcr-2019-232611DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6887436PMC
November 2019
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