Publications by authors named "Zainab Abdul Ghaffar"

2 Publications

  • Page 1 of 1

Brachytherapy of tongue carcinoma in a patient with difficult airway: anesthetic considerations.

J Contemp Brachytherapy 2018 Dec 28;10(6):573-576. Epub 2018 Dec 28.

Section of Surgery and Anesthesia, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Penang.

The practice of brachytherapy in unresectable tongue carcinoma is gaining popularity. However, this procedure poses specific anesthetic challenges, particularly challenges of airway sharing and a higher rate of difficult airway. We report a 74-year-old chronic smoker, chronic alcoholic with history of stroke, who had undergone brachytherapy for tongue carcinoma. Apart from a huge tongue tumor, he had an epiglottic mass but refused elective tracheostomy. This had led to a few critical states throughout the process of treatment, including a metabolic crisis due to thiamine deficiency and difficult airway crisis. To our best knowledge, there have been no reported case on a patient with vocal cord mass undergoing tongue brachytherapy. We hope sharing of this experience may aid the management of similar patients in future.
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http://dx.doi.org/10.5114/jcb.2018.79856DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6335561PMC
December 2018

Recombinant activated factor VII (rFVIIa) in refractory haemorrhage for non-haemophiliacs: an eleven-year single-centre experience.

BMC Hematol 2018 23;18:34. Epub 2018 Nov 23.

1Regenerative Medicine Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, 13200 Kepala Batas, PNG Malaysia.

Background: Massive bleeding is one of the commonest salvageable causes of death. The search for an ideal haemostatic agent during massive bleeding is still ongoing. One of the novel haemostatic medications is recombinant activated factor VII (rFVIIa). To date, the usage of rFVIIa during massive haemorrhage among non-haemophiliac patients remains off-label. The aim of this study is to report our experience in using rFVIIa to treat refractory bleeding.

Methods: Medical records of all patients treated with rFVIIa for massive bleeding over an eleven-year period in a single institution were recorded. Treatment indications, 24-h and 30-day mortality, changes in transfusion needs and coagulation profiles after rFVIIa administration were analysed.

Results: rFVIIa were administered in 76 patients. Of these, 41 (53.9%) were non-surgical bleeding, followed by 22 patients (28.9%) with trauma, other surgery bleedings in 9 patients (11.8%) and 4 patients (5.4%) with peripartum haemorrhage. Total survival rate was 78.9% within 24 h and 44.7% over 30 days. Among all these patients who had received rFVIIa due to life-threatening haemorrhage, blood and blood product requirements were significantly reduced ( < 0.001), and the coagulation profiles improved significantly ( < 0.05). Two patients with preexisting thromboembolism were given rFVIIa due to intractable bleeding, both survived. No thromboembolic events were reported after the administration of rFVIIa.

Conclusions: rFVIIa significantly improved coagulation parameters and reduced blood product requirements during refractory haemorrhage. Additionally, usage of rFVIIa in trauma and peripartum haemorrhage patients yield better outcomes than other groups of patients. However, the overall mortality rate remained high.
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http://dx.doi.org/10.1186/s12878-018-0126-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6251212PMC
November 2018
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