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11 results on '"Manisekar Subramaniam"'

1. Surgical outcomes of gallbladder cancer: the OMEGA retrospective, multicentre, international cohort studyResearch in context

Author

Anita Balakrishnan, Petros Barmpounakis, Nikolaos Demiris, Asif Jah, Harry V.M. Spiers, Shibojit Talukder, Jack L. Martin, Paul Gibbs, Simon J.F. Harper, Emmanuel L. Huguet, Vasilis Kosmoliaptsis, Siong S. Liau, Raaj K. Praseedom, Bristi Basu, Xavier de Aretxabala, Javier Lendoire, Shishir Maithel, Alejandro Branes, Bodil Andersson, Alejandro Serrablo, Volkan Adsay, Tomoyuki Abe, Moh'd Abu Hilal, Maria del Mar Achalandabaso Boira, Mustapha Adham, Mohamed Adam, Maryam Ahmad, Bilal Al-Sarireh, Maite Albiol, Nassir Alhaboob, Adnan Alseidi, Houssem Ammar, Akshay Anand, Pantelis Antonakis, Veronica Araya, Stanley W. Ashley, Georgi Atanasov, Fabio Ausania, Ricardo Balestri, Abhirup Banerjee, Simon Banting, Giedrius Barauskas, Fabian Bartsch, Andrea Belli, Simona Beretta, Frederik Berrevoet, Gerardo Blanco Fernandez, Louisa Bolm, Mathieu Bonal, Emre Bozkurt, Andries E. Braat, Luke Bradshaw, Lyle Burdine, Matthew Byrne, Maria Caceres, Maria Jesus Castro Santiago, Benjamin Chan, Lynn Chong, Ahmet Çoker, Maria Conde Rodriguez, Daniel Croagh, Alyn Crutchley, Carmen Cutolo, Mathieu D'Hondt, Daniel D'Souza, Freek Daams, Raffaele Dalla Valle, José Davide, Mario de Bellis, Marieke de Boer, Celine de Meyere, Philip de Reuver, Matthew Dixon, Panagiotis Dorovinis, Gabriela Echeverría Bauer, Maria Eduarda, Hasan Eker, Joris Erdmann, Mert Erkan, Evangelos Felekouras, Emanuele Felli, Eduardo Fernandes, Eduardo Figueroa Rivera, Andras Fulop, Daniel Galun, Michael Gerhards, Poya Ghorbani, Fabio Giannone, Luis Gil, Emmanouil Giorgakis, Mario Giuffrida, Felice Giuliante, Ioannis Gkekas, Miguel Gomez Bravo, Bas Groot Koerkamp, Oscar Guevara, Alfredo Guglielmi, Aiste Gulla, Rahul Gupta, Amit Gupta, Marta Gutiérrez, Abu Bakar Hafeez Bhatti, Jeroen Hagendoorn, Zain Hajee, Abdul Rahman Hakeem, Hytham Hamid, Sayed Hassen, Stefan Heinrich, Ryota Higuchi, Daniel Hoffman, David Holroyd, Daniel Hughes, Arpad Ivanecz, Satheesh Iype, Isabel Jaen Torrejimeno, Shantanu Joglekar, Robert Jones, Klaus Kaczirek, Harsh Kanhere, Ambareen Kausar, Zhanyi Kee, Jessica Keilson, Jorg Kleef, Johannes Klose, Brett Knowles, Jun Kit Koong, Nagappan Kumar, Supreeth Kunnuru, Paleswan Joshi Lakhey, Andrea Laurenzi, Yeong Sing Lee, Felipe Leon, Voon Meng Leow, Jean-Baptiste Lequeu, Mickael Lesurtel, Elisabeth Lo, Stefan Löb, Elizabeth Lockie, Peter Lodge, Dolores López Garnica, Victor Lopez Lopez, Linda Lundgren, Nikolaos Machairas, Dhiresh Maharjan, Deep Malde, Guillaume Martel, Julie Martin, Michele Mazzola, Arianeb Mehrabi, Ricardo Memeo, Flavio Milana, George Molina, Leah Monette, Haluk Morgul, Dimitrios Moris, Antonios Morsi-Yeroyannis, Nicholas Mowbray, Francesk Mulita, Edoardo Maria Muttillo, Malith Nandasena, Pueya Rashid Nashidengo, Arash Nickkholgh, Colin Byron Noel, Masayuki Ohtsuka, Arturs Ozolins, Sanjay Pandanaboyana, Nikolaos Pararas, Alessandro Parente, June Peng, Arkaitz Perfecto Valero, Julie Perinel, Konstatinos Perivoliotis, Teresa Perra, Patrick Pessaux, Natalie Petruch, Gaetano Piccolo, Laszlo Piros, Alberto Porcu, Viswakumar Prabakaran, Raj Prasad, Mikel Prieto Calvo, Florian Primavesi, Eva Maria Pueyo Periz, Alberto Quaglia, Jose M. Ramia Angel, Ashwin Rammohan, Francisco Razionale, Ricardo Robles Campos, Manas Roy, Sophie Rozwadowski, Luis Ruffolo, Natalia Ruiz, Andrea Ruzzenante, Lily Saadat, Mohamed Amine Said, Edoardo Saladino, Gabriel Saliba, Per Sandstrom, Carlo Alberto Schena, Anthony Scholer, Cristoph Schwartz, Lorenzo Serafini, Pablo Serrano, Deepak Sharma, Aali Sheen, Vishwanath Siddagangaiah, Michael Silva, Saurabh Singh, Ajith Siriwardena, Michal Skalski, Mante Smig, Faris Soliman, Donzília Sousa Silva, Ernesto Sparrelid, Parthi Srinivasan, Malin Sternby Eilard, Oliver Strobel, Urban Stupan, Miguel Angel Suarez-Munoz, Manisekar Subramaniam, Teiichi Sugiura, Robert Sutcliffe, Hilko Swank, Lillian Taylor, Prabin Bikram Thapa, Catherine The, Asara Thepbunchonchai, Caman Thieu, Navneet Tiwari, Guido Torzilli, Chutwichai Tovikkai, Blaz Trotovsek, Savvas Tsaramanidis, Georgios Tsoulfas, Katsuhiko Uesaka, Garzali Umar, Lucio Urbani, Michail Vailas, Ronald van Dam, Peter van de Boezem, Stijn van Laarhoven, Tomas Vanagas, Mike Van Dooren, Manon Viannet, Luca Vigano, Aarathi Vijayashanker, Celia Villodre, Toshifumi Wakai, Aklile Workneh, Li Xu, Masakazu Yamamoto, Zhiying Yang, Robert Young, and Marko Zivanovic

Subjects
Gallbladder cancer, Liver resection, Surgical outcomes, Cholangiocarcinoma, Medicine (General), R5-920
Abstract

Summary: Background: Gallbladder cancer (GBC) is rare but aggressive. The extent of surgical intervention for different GBC stages is non-uniform, ranging from cholecystectomy alone to extended resections including major hepatectomy, resection of adjacent organs and routine extrahepatic bile duct resection (EBDR). Robust evidence here is lacking, however, and survival benefit poorly defined. This study assesses factors associated with recurrence-free survival (RFS), overall survival (OS) and morbidity and mortality following GBC surgery in high income countries (HIC) and low and middle income countries (LMIC). Methods: The multicentre, retrospective Operative Management of Gallbladder Cancer (OMEGA) cohort study included all patients who underwent GBC resection across 133 centres between 1st January 2010 and 31st December 2020. Regression analyses assessed factors associated with OS, RFS and morbidity. Findings: On multivariable analysis of all 3676 patients, wedge resection and segment IVb/V resection failed to improve RFS (HR 1.04 [0.84–1.29], p = 0.711 and HR 1.18 [0.95–1.46], p = 0.13 respectively) or OS (HR 0.96 [0.79–1.17], p = 0.67 and HR 1.48 [1.16–1.88], p = 0.49 respectively), while major hepatectomy was associated with worse RFS (HR 1.33 [1.02–1.74], p = 0.037) and OS (HR 1.26 [1.03–1.53], p = 0.022). Furthermore, EBDR (OR 2.86 [2.3–3.52], p

Published
2023
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2. Prediction of hepatocellular carcinoma risk in patients with type-2 diabetes using supervised machine learning classification model

Author

Noor Atika Azit, Shahnorbanun Sahran, Voon Meng Leow, Manisekar Subramaniam, Suryati Mokhtar, and Azmawati Mohammed Nawi

Subjects
Hepatocellular carcinoma, Diabetes, Risk prediction, Machine learning, Support vector machine, Science (General), Q1-390, Social sciences (General), H1-99
Abstract

Background: Hepatocellular carcinoma (HCC) among type-2 diabetes (T2D) patients is an increasing burden to diabetes management. This study aims to develop and select the best machine learning (ML) classification model for predicting HCC in T2D for HCC early detection. Methods: A case-control study was conducted utilising computerised medical records in two hepatobiliary centres. The predictors were chosen using multiple logistic regression. IBM SPSS Modeler® was used to assess the discriminative performance of support vector machine (SVM), logistic regression (LR), artificial neural network (ANN), chi-square automatic interaction detection (CHAID), and their ensembles. Results: Subjects (N = 424) were split into 60% training (n = 248) and 40% testing (n = 176) groups. The independent predictors identified were race, viral hepatitis, abdominal pain/discomfort, unintentional weight loss, statins, alcohol consumption, non-alcoholic fatty liver, platelet 129 IU/L, and alanine transaminase ≥25 IU/L. The performances of all models differed significantly (Cochran’s Q-test,p = 0.001) but not between the ensembled and SVM model (McNemar test, p = 0.687). SVM model was selected as the best model due to its simplicity, high accuracy (85.28%), and high AUC (0.914). A web-based application was developed using the best model’s algorithm for HCC prediction. Conclusions: If further validation studies confirm these results, the SVM model’s application potentially augments early HCC detection in T2D patients.

Published
2022
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3. Risk factors of hepatocellular carcinoma in type 2 diabetes patients: A two-centre study in a developing country

Author

Noor Atika Azit, Shahnorbanun Sahran, Leow Voon Meng, Manisekar Subramaniam, Suryati Mokhtar, and Azmawati Mohammed Nawi

Subjects
Medicine, Science
Abstract

Type 2 diabetes mellitus (T2DM) is increasingly known as a risk factor of hepatocellular carcinoma (HCC). In this study, we determined the risk factors associated with HCC in T2DM patients. This was a matched case-control study conducted at two hepatobiliary referral centres in a developing country. Patients’ sociodemographic, clinical, and biochemical characteristics between 1 January 2012 and 30 June 2018 were extracted from the electronic medical records and analysed using multivariate logistic regression analysis. A total of 212 case-control pairs were included. Significant risk factors included Chinese and Malay ethnicities that interacted with viral hepatitis (adjusted odds ratio [AOR] = 11.77, 95% confidence interval [CI]: 1.39–99.79) and (AOR = 37.94, 95% CI: 3.92–367.61) respectively, weight loss (AOR = 5.28, 95% CI: 2.29–12.19), abdominal pain/ discomfort (AOR = 6.73, 95% CI: 3.34–13.34), alcohol (AOR = 4.08, 95% CI: 1.81–9.22), fatty liver (AOR = 3.29, 95% CI: 1.40–7.76), low platelet (AOR = 4.03, 95% CI:1.90–8.55), raised alanine transaminase (AOR = 2.11, 95% CI: 1.16–3.86). and alkaline phosphatase (ALP) levels (AOR = 2.17, 95% CI: 1.17–4.00). Statins reduced the risk of HCC by 63% (AOR = 0.37, 95% CI: 0.21–0.65). The identification of these factors aids the risk stratification for HCC among T2DM patients for early detection and decision-making in patient management in the primary care setting.

Published
2021

6. Massive upper gastrointestinal bleeding: a rare complication of cholecystoduodenal fistula

Author

Manisekar Subramaniam, Dinesh Kumar Vadioaloo, Voon Meng Leow, and Guo Hou Loo

Subjects
0301 basic medicine, Male, medicine.medical_specialty, Biliary Fistula, Fistula, medicine.medical_treatment, 030105 genetics & heredity, Cystic artery, Biliary disease, 03 medical and health sciences, 0302 clinical medicine, Rare Disease, Laparotomy, medicine.artery, medicine, Intestinal Fistula, Humans, Duodenal Diseases, Duodenal Perforation, Aged, business.industry, Gallbladder, Biliary fistula, General Medicine, medicine.disease, Surgery, medicine.anatomical_structure, Upper gastrointestinal bleeding, business, Gastrointestinal Hemorrhage, 030217 neurology & neurosurgery
Abstract

A biliary fistula which may occur spontaneously or after surgery, is an abnormal communication from the biliary system to an organ, cavity or free surface. Spontaneous biliary-enteric fistula is a rare complication of gallbladder pathology, with over 90% of them secondary to cholelithiasis. Approximately 6% are due to perforating peptic ulcers. Symptoms of biliary-enteric fistula varies widely and usually non-specific, mimicking any chronic biliary disease. Cholecystoduodenal fistula causing severe upper gastrointestinal (UGI) bleed is very rare. Bleeding cholecystoduodenal fistula commonly requires surgical resection of the fistula and repair of the duodenal perforation. We describe the case of a previously healthy older patient who initially presented with symptoms suggestive of UGI bleeding. Bleeding could not be controlled endoscopically. When a laparotomy was performed, a cholecystoduodenal fistula was discovered and bleeding was noted to originate from the superficial branch of cystic artery.

Published
2019

7. Use of aerosol protective barrier in a patient with impending cholangitis and unknown COVID-19 status undergoing emergency ERCP during COVID-19 pandemic

Author

Ikhwan Sani Mohamad, Voon Meng Leow, and Manisekar Subramaniam

Subjects
Adult, 2019-20 coronavirus outbreak, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Cholangitis, Pneumonia, Viral, GI-stents, TB and other respiratory infections, Emergency treatment, pancreas and biliary tract, Protective barrier, Betacoronavirus, 03 medical and health sciences, 0302 clinical medicine, Pandemic, medicine, Humans, 030212 general & internal medicine, endoscopy, Intensive care medicine, Pandemics, Personal Protective Equipment, Personal protective equipment, Aerosols, Cholangiopancreatography, Endoscopic Retrograde, medicine.diagnostic_test, SARS-CoV-2, business.industry, COVID-19, General Medicine, Endoscopy, Female, Innovations in Treatment, 030211 gastroenterology & hepatology, Coronavirus Infections, Emergency Service, Hospital, business, bird flu
Abstract

WHO declared worldwide outbreak of COVID-19 a pandemic on 11 March 2020. Healthcare authorities have temporarily stopped all elective surgical and endoscopy procedures. Nevertheless, there is a subset of patients who require emergency treatment such as aerosol-generating procedures. Herein, we would like to discuss the management of a patient diagnosed with impending biliary sepsis during COVID-19 outbreak. The highlight of the discussion is mainly concerning the advantages of concurrent use of aerosol protective barrier in addition to personal protective equipment practice, necessary precautions to be taken during endoscopy retrograde cholangiopancreatography and handling of the patient preprocedure and postprocedure.

Published
2020
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8. Non Operative Management of Blunt Pancreatic Trauma

Author

Jasjit Singh Nijhar, Dinesh Kumar Vadioaloo, Manisekar Subramaniam, Yu Hang Wai, and Leow Voon Meng

Subjects
medicine.medical_specialty, Blunt, Hepatology, Pancreatic trauma, business.industry, Gastroenterology, medicine, business, Surgery
Published
2019
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11. Large lipoma of the spermatic cord presenting as post-operative recurrent hernia in a middle aged gentleman: a case report

Author

Manisekar Subramaniam and Ravindran Vashu

Subjects
Medicine(all), medicine.medical_specialty, Recurrent Hernia, business.industry, education, General Medicine, Lipoma, Left inguinal hernia, medicine.disease, Spermatic cord, humanities, Surgery, body regions, stomatognathic diseases, medicine.anatomical_structure, surgical procedures, operative, Case report, medicine, Post operative, business, Clinical scenario
Abstract

A gentleman who presented with a left inguinal hernia was operated and treated by hernioplasty. After a few years he presented with a clinical scenario of recurrent hernia. During surgery the lump was found to be a large lipoma that was not documented and found during the first operation.

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