Papers by Abdul Rauf Ahmad
The Journal of Hand Surgery (Asian-Pacific Volume), 2019
Background: To compare outcomes of atraumatic hand surgeries using the WALANT technique versus in... more Background: To compare outcomes of atraumatic hand surgeries using the WALANT technique versus intravenous regional anesthesia or local anesthesia with tourniquet. Methods: We conducted a comprehensive literature search using PubMed, MEDLINE, Embase, and Cochrane Library from inception to October 2018. All randomized or quasi-randomized trials and cohort studies comparing WALANT procedure versus local anesthesia or intravenous regional anesthesia with tourniquet among atraumatic hand surgeries were included. Methodological quality and risk of bias of eligible studies were assessed by three independent reviewers. The random effects model was used due to both statistical and clinical heterogeneity among studies. Results: The search yielded 496 records, of which 9 studies were included in the systematic review. We were able to pool findings for operative time, post-operative pain scores, patient satisfaction, and complication rates. On the average, the WALANT group had longer operative...
Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology, Jan 5, 2015
Double disruptions of the superior suspensory shoulder complex, commonly referred to as 'floa... more Double disruptions of the superior suspensory shoulder complex, commonly referred to as 'floating shoulder' injuries, are ipsilateral midshaft clavicular and scapular neck/body fractures with a loss of bony attachment of the glenoid. The treatment of 'floating shoulder' injuries has been debated controversially for many years. The purpose of this study was to demonstrate the clinical and functional outcomes of patients with 'floating shoulder' injuries who underwent operative fixation of the clavicle fracture only. Between 2002 and 2010, 32 consecutive floating shoulder injuries were identified in skeletally mature patients at a level I trauma center and followed in a single private practice. Thirteen patients met the inclusion and exclusion criteria for this retrospective study with a minimum 12-month follow-up. Clavicle and scapular fractures were identified by Current Procedural Technology codes and classified based on Orthopaedic Trauma Association/Arbeit...
Journal of Hand Surgery Global Online, 2020
Purpose This study compared outcomes of plating distal radius (DR) fractures using wide-awake loc... more Purpose This study compared outcomes of plating distal radius (DR) fractures using wide-awake local anesthesia no tourniquet (WALANT) versus general anesthesia (GA). Methods From March 2018 to March 2019, 20 patients with DR fracture underwent plating using WALANT whereas 20 patients who underwent plating under GA were used as controls. Outcomes evaluated were pain control, waiting time for the operation, hemodynamic changes, blood loss, the occurrence of adverse effects of medications used in WALANT and GA, and the duration of postoperative stay. Results The WALANT group experienced a significantly shorter waiting time for surgery (6 vs 20 days; P Conclusions The WALANT approach is a viable alternative to GA for plating of DR fractures. Type of study/level of evidence Therapeutic III.
Foot & Ankle Surgery: Techniques, Reports & Cases, 2021
Techniques in Shoulder & Elbow Surgery, 2020
Isolated acromion fractures, although unusual, are not uncommon. Traditionally treated conservati... more Isolated acromion fractures, although unusual, are not uncommon. Traditionally treated conservatively, an improved understanding of shoulder biomechanics has extended the indications for surgical treatment. Surgical modalities described in the literature are plating, cortical lag screw, Kirschner wiring, and tension-band wiring. We describe a novel surgical technique for both fixation of an acute fracture or revision surgery of the base of acromion fracture. The technique involves the insertion of an intramedullary screw from the lateral tip of the acromion toward the tapered medial part of the scapular spine. This is supplemented by an anatomic locking reconstruction plating placed on the superior border of the acromion and scapular spine. We share an illustrated case of a 39-year-old woman, who successfully underwent a revision surgery with this technique and recovered well with excellent radiologic and functional outcomes. A long intramedullary screw provides good interfragmentary compression, 3-point fixation, and better bony purchases. A supplementary plate helps to resist rotational and muscular-pulling forces. In conclusion, intramedullary screw fixation, supplemented with plating, offers a viable surgical treatment for acromion fractures, and combined with a proper postoperative rehabilitation regime, it helps patients to achieve
Journal of Shoulder and Elbow Surgery, 2020
BACKGROUND Fixation of clavicle fractures has now become a more popular option as it provides bet... more BACKGROUND Fixation of clavicle fractures has now become a more popular option as it provides better outcome compared with conservative management. Wide-awake local anesthesia no tourniquet (WALANT) has been effectively used in plating of distal radius and olecranon fractures. This paper expands the usage of WALANT into the shoulder girdle, namely plating of the clavicle that has not been described. The operation is typically performed under general anesthesia. METHODS We report a case series of 16 patients who successfully underwent fixation of the clavicle under the wide-awake technique. The clavicle fractures were grouped under the AO Fracture Classification. The WALANT solution comprised 1% lidocaine, 1:100,000 epinephrine, and 10:1 sodium bicarbonate. A total of 40 mL was injected in each patient with 10 mL subcutaneously along the clavicle followed by 30 mL subperiosteally at multiple intervals and directions. RESULTS The Numerical Pain Rating Score was 0 during WALANT injection and during surgery except for 2 patients with Numerical Pain Rating Scores of 1 and 2, respectively, during reduction. CONCLUSION We conclude that clavicle plating under WALANT is a good alternative option of anesthesia.
Orthopaedic Journal of Sports Medicine, 2020
Objectives: Patients_with_traumatic_brain_or_spinal_cord injury are at risk of developing peri-ar... more Objectives: Patients_with_traumatic_brain_or_spinal_cord injury are at risk of developing peri-articular NHO most frequently affecting the hip; with resulting ankyloses and functional limitations1. Surgical excision aims to improve functional ability and facilitate nursing care2. It is technically challenging as NHO development maybe multi-focal and multi-directional around the joint involving important neuro-vascular structures2. Plain_radiographs often provide sub-optimal_information_required_for_surgical planning Methods: An_18-year-old_male_presented to us with pain and immobility of his right hip 18-months following a traumatic brain injury. The joint was completely ankylosed and he was unable to walk. Plain radiograph showed extensive NHO from medial aspect of right proximal femur to ischial tuberosity (Figure_1). A CT scan with 3D reconstruction more clearly defined the NHO as extending posteriorly from the greater trochanter to ipsilateral pubic ramus and ischial tuberosity ...
Current Orthopaedic Practice, 2020
INTRODUCTION Equinus is defined as the inability of the ankle to perform dorsiflextion for normal... more INTRODUCTION Equinus is defined as the inability of the ankle to perform dorsiflextion for normal gait which leads to lower limb compensation or pathology or both. It can be classified based on soft-tissue or osseous causes of joint restriction. Mild to moderate classification is normally related only to soft-tissue involvement, meanwhile in severe form, there is a combination of soft-tissue and osseous causes. There are multiple causes that lead to equinus deformity such as Charcot neuroarthropathy and necrotizing fasciitis from severe soft-tissue loss and scarring after debridement as well as biomechanical imbalance secondary to Achilles tendinopathy and tibiotalar exostoses formation. Many techniques of correction have been published, but the success rate varies. In severe forms of equinus deformity, standard procedures such as tendon transfer or tendon lengthening, open softtissue releases, and acute arthrodesis are not ideal in restoring the normal ankle joint attitude as they are often associated with more complications. This is a case report of a severe ankle equinovarus deformity caused by severe soft-tissue contractures secondary to necrotizing fasciitis that was treated with a six-axis Ortho-SUV external fixator (OSF) (S.H. Pitkar Orthotools Pvt. Ltd., Pune, India) followed by arthroscopic cartilage denudation and ankle arthrodesis. Patient informed consent was obtained for this report.
HAND, 2019
Introduction: Wide-awake local anesthesia and no tourniquet (WALANT) has come a long way. It has ... more Introduction: Wide-awake local anesthesia and no tourniquet (WALANT) has come a long way. It has been reported to be successful in the surgery of distal radius and ulna fractures. We report a case of olecranon fracture plating under WALANT. Methods: Surgery was performed with the patient fully conscious where tumescent anesthesia was injected into the surgical site without application of tourniquet 30 minutes before the first incision. Posterior approach to the elbow was used, and the fracture was fixed with anatomical locking plates. Results: The surgery was successfully completed without pain. The numerical pain rating score was 0 throughout the surgery. Conclusions: The use of WALANT for surgical fixation can be expanded beyond the hand and wrist. This is a safe and simple option for patients at high risk of general anesthesia, producing similar surgical outcomes without intraoperative and postoperative complications.
The Journal of hand surgery, 2018
Fractures of the distal radius are one of the most common types of injuries encountered in hand s... more Fractures of the distal radius are one of the most common types of injuries encountered in hand surgery. Plate osteosynthesis is recommended for unstable fractures. Because distal radius fracture fixation is usually performed under general or regional anesthesia with the use of a tourniquet, this exposes patients, especially elderly people with extensive comorbidities, to adverse effects commonly associated with these forms of anesthesia. As such, many of these patients are unable to undergo surgery in a timely manner until they are deemed medically fit for surgery or anesthesia, and some may still be treated nonsurgically. Injecting local anesthetic of lidocaine and epinephrine into the surgical field and without using a tourniquet is known to be advantageous for various surgical procedures of the hand. However, this approach, also known as wide-awake local anesthesia no tourniquet (WALANT), has not been used in the fixation of fractures beyond the wrist. Using the WALANT approach ...
Brazilian Journal of Chemical Engineering, 2010
Recent developments in nanotechnologies have helped to benchmark carbon nanotubes (CNTs) as one o... more Recent developments in nanotechnologies have helped to benchmark carbon nanotubes (CNTs) as one of the most studied nanomaterials. By taking advantages of CNTs extraordinary physical, chemical and electronic properties, a wide variety of applications has been proposed in various engineering fields. In this short review, the contribution of CNTs is addressed in terms of sustainable environment and green technologies perspective, such as waste water treatment, air pollution monitoring, biotechnologies, renewable energy technologies, supercapacitors and green nanocomposites. Consideration of CNTs for large scale application from the aspect of cost and potential hazards are also discussed. Based on the literature studied, CNTs pose a great potential as a promising material for application in various environmental fields.
Mammal Study, 2014
Small and highly degraded forest patches are usually scattered across oil palm plantation landsca... more Small and highly degraded forest patches are usually scattered across oil palm plantation landscapes and often exist as permanent features. By using a combination of camera-trapping and line-transect methods, we evaluated the usefulness of three such forest patches (< 30 ha) for terrestrial mammal species conservation in a mature oil palm plantation located near (< 1.7 km) a large continuous tract of logged forest in
Procedia - Social and Behavioral Sciences, 2010
UKM1 is a test developed in Malaysia to evaluate the level of intelligence of the students. This ... more UKM1 is a test developed in Malaysia to evaluate the level of intelligence of the students. This study aims at identifying the reliability and validity of the UKM1 using the item analysis method. A random sample of 773 students was selected from the local schools. The test was administered via on-line. The study confirms that UKM1 is a multidimensional test with three correlated dimensions which are Visual Spatial (VS), Verbal Linguistic (VL) and Logical Mathematics (LM).
PLoS ONE, 2012
Background: Home range is defined as the extent and location of the area covered annually by a wi... more Background: Home range is defined as the extent and location of the area covered annually by a wild animal in its natural habitat. Studies of African and Indian elephants in landscapes of largely open habitats have indicated that the sizes of the home range are determined not only by the food supplies and seasonal changes, but also by numerous other factors including availability of water sources, habitat loss and the existence of man-made barriers. The home range size for the Bornean elephant had never been investigated before. Methodology/Principal Findings: The first satellite tracking program to investigate the movement of wild Bornean elephants in Sabah was initiated in 2005. Five adult female elephants were immobilized and neck collars were fitted with tracking devices. The sizes of their home range and movement patterns were determined using location data gathered from a satellite tracking system and analyzed by using the Minimum Convex Polygon and Harmonic Mean methods. Home range size was estimated to be 250 to 400 km 2 in a non-fragmented forest and 600 km 2 in a fragmented forest. The ranging behavior was influenced by the size of the natural forest habitat and the availability of permanent water sources. The movement pattern was influenced by human disturbance and the need to move from one feeding site to another. Conclusions/Significance: Home range and movement rate were influenced by the degree of habitat fragmentation. Once habitat was cleared or converted, the availability of food plants and water sources were reduced, forcing the elephants to travel to adjacent forest areas. Therefore movement rate in fragmented forest was higher than in the non-fragmented forest. Finally, in fragmented habitat human and elephant conflict occurrences were likely to be higher, due to increased movement bringing elephants into contact more often with humans.
Oryx, 2013
The Sumatran rhinoceros Dicerorhinus sumatrensis is on the brink of extinction. Although habitat ... more The Sumatran rhinoceros Dicerorhinus sumatrensis is on the brink of extinction. Although habitat loss and poaching were the reasons of the decline, today's reproductive isolation is the main threat to the survival of the species. Genetic studies have played an important role in identifying conservation priorities, including for rhinoceroses. However, for a species such as the Sumatran rhinoceros, where time is of the essence in preventing extinction, to what extent should genetic and geographical distances be taken into account in deciding the most urgently needed conservation interventions? We propose that the populations of Sumatra and Borneo be considered as a single management unit.
Journal of Medical Entomology, 2013
A comprehensive 8-yr survey of acarine ectoparasites (ticks and mites) of bats was carried out in... more A comprehensive 8-yr survey of acarine ectoparasites (ticks and mites) of bats was carried out in 18 localities from 2002 to 2009. Most of the surveys were conducted during 14 national biodiversity scientiÞc expeditions throughout Malaysia. The objective was to identify acarines of known public health importance from bats and thus determine whether there is any potential public health risk in Malaysia. Trapping of bats was conducted using Harp traps and Mist nets. In total, 1,579 individuals comprising of 6 families and 52 species of bats were examined alive. In general, 25.6% of the bats were infested with acarines. Infestation rates of ticks, mesostigmatid mites, and chiggers on bats examined were 0.4, 10.4, and 14.7%, respectively. Their prevalence and mean intensity were tabulated. Genera of ticks extracted were Amblyomma, Dermacentor, Ixodes, and Ornithodoros. Of these genera, only two species can be identiÞed to species level and they are Amblyomma cordiferum and Ixodes simplex. In total, 8 genera and 15 species of mesostigmatid mites were found; the species were Ancystropus eonycteris, Ancystropus zeleborii, Echinonysus nasutus, Laelaps aingworthae, Laelaps nuttalli, Laelaps sanguisugus, Laelaps sculpturatus, Longolaelaps longulus, Longolaelaps whartonii, Meristaspis lateralis, Meristaspis macroglossi, Paraperiglischrus rhinolophinus, Spinturnix acuminatus, Spinturnix americanus, and Spinturnix bakeri. Chiggers on bats were represented by 12 genera and 6 species; the species identiÞed were Gahrliepia fletcheri, Riedlinia lipoxena, Trombigastia cadei, Walchiella impar, Walchiella oudemansi, and Whartonia caobangensis. The study produced an up-to-date list of acarine ectoparasites of bats in Malaysia where a total of 38 genera and 47 species of acarines were listed. Findings of the study demonstrated that 5 genera and 1 species of acarines that may pose potential health risks, can be found on bats.
International Journal of Primatology, 2010
Primates spend about half of their lives at sleeping sites, and their choice of sleeping sites ma... more Primates spend about half of their lives at sleeping sites, and their choice of sleeping sites may affect individual survival. We identified a total of 88 trees used by proboscis monkeys (Nasalis larvatus) as night sleeping sites on 16 nights from June to September 2008 in riverine, mangrove, and mixed mangrove-riverine forests along the Garama River, a tributary of the Klias River, in the west of Sabah, Malaysia. We recorded 11 variables for each tree, including the species, physical structure, distance from the riverbank, and connectivity with surrounding trees. We compared sleeping trees with 114 trees with ≥30 cm girth at breast height (GBH) located ≤50 m of the riverbank in 8 botanical plots (total 1 ha). Trees in the plots represented the general vegetation patterns of the study area. Choice of sleeping trees did not depend on the tree species. Although sleeping trees included trees ≤46 m from the river, those closer to riverbanks (5-35 m, n=76) were more likely to be used as sleeping sites. Compared to the available trees, sleeping trees had larger trunks (mean±SD=143.6±56.9 cm GBH), and were taller (mean±SD=34.3±8.1 m), with greater number (median=6; range=12) and larger (mean±SD=24.1±15.2 cm circumference) main branches. They were also located near to other trees, with overlapping branches, creating good arboreal connectivity. Choice of sleeping trees by proboscis monkeys is likely to be related to risks of predation and injury from falling, as well as ease of social interaction and efficiency of locomotion.
Biomedical Journal of Scientific & Technical Research, 2020
Orthopaedic Journal of Sports Medicine, 2020
Introduction: Triplane fracture is a traumatic ankle fracture seen in children 10-17 years of age... more Introduction: Triplane fracture is a traumatic ankle fracture seen in children 10-17 years of age. Name derives from the fact that the fracture exists in the frontal, lateral, and transverse planes and considered as transitional injuries because occur during the period of distal tibial physeal closure. It results from supinationexternal rotation injury, same as tillaux fracture. Report: We presented a case of 14 years old male with right ankle pain after fall with twisted position while running. Examination revealed tenderness on his right ankle, and radiograph showed Salter-Harris IV of tibial epiphysis. CT scan was performed to determine fracture configurations. Open reduction and internal fixation was done using posterolateral approach using T buttress plate 6 holes to fix the metaphysis fracture. Subsequently anterolateral incision was done to assess epiphysis fracture however fracture site not displaced thus lag screw was abandoned. Postoperatively, the ankle was protected in a...
Orthopaedic Journal of Sports Medicine, 2020
Dislocation of the intermediate cuneiform is a rare injury, and only a few cases have been report... more Dislocation of the intermediate cuneiform is a rare injury, and only a few cases have been reported .Cuneiforms dislocations have been treated in a variety of methods, ranging from open or closed reduction, without or with fixation such as Krischner wires or screws. Methods: A 24 years old female presented with right foot pain following fall from motorbike after got hit by a car from back. She related a history that her right foot was forced into torsion and plantarflexion at impact . On examination there was a bony protuberance on the dorsal surface, at cuneiform area . Radiograph showed dorsal dislocation of intermediate cuneiform. CT scan was performed and supported the radiographical findings. Manipulation under sedation was attempted, but was unsuccessful. Results: Patient was placed supine under spinal anesthesia . A dorsal incision was made centering over the protuberance proceeded distally up to the base of the second-metatarsal. The dislocated middle cuneiform was identifie...
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Papers by Abdul Rauf Ahmad