Silver (Ag) particles have sparked considerable interest in industry and academia, particularly for health and medical applications. Here, we present the “green” and simple synthesis of an Ag particle-based silicone (Si) thin film for medical device applications. Drop-casting and peel-off techniques were used to create an Si thin film containing 10–50% (v/v) of Ag particles. Electro impedance spectroscopy (EIS), X-ray diffraction analysis (XRD), scanning electron microscopy (SEM), energy dispersive X-ray (EDX), and tensile tests were used to demonstrate the electrical conductivity, crystallinity, morphology-elemental, and mechanical properties, respectively. The oriented crystalline structure and excellent electronic migration explained the highest conductivity value (1.40 × 10⁻⁵ S cm⁻¹) of the 50% Ag–Si thin film. The findings regarding the evolution of the conductive network were supported by the diameter and distribution of Ag particles in the Si film. However, the larger size of the Ag particles in the Si film resulted in a lower tensile stress of 68.23% and an elongation rate of 68.25% compared to the pristine Si film. The antibacterial activity of the Ag–Si film against methicillin-resistant Staphylococcus aureus (MRSA), Bacillus cereus (B. cereus), Klebsiella pneumoniae (K. pneumoniae), and Pseudomonas aeruginosa (P. aeruginosa) was investigated. These findings support Si–Ag thin films’ ability to avoid infection in any medical device application.

Symptomatic giant ganglioneuromas with mediastinal compression are rare, complicating its management with significant morbidity and mortality risks. A meticulous multidisciplinary preoperative planning is pivotal in ensuring success. We describe a case of a 30-year-old man with a giant posterior mediastinal mass with compression and displacement of the mediastinal structures. Biopsy confirmed a ganglioneuroma and patient underwent excision. Surgery was challenging in view of the size and adherence to the local structures. Haemodynamic instabilities were encountered necessitating a pre-emptive femoral-femoral cannulation for CPB. A piece-meal debulking of the tumour was performed, complicated with massive haemorrhage requiring autologous blood transfusion using an intraoperative blood salvage device. The patient recovered and was discharged home well at Day 8. A thorough pre-operative planning involving a multidisciplinary approach, an understanding of the surgical anatomy as well as anticipating impending complications is of paramount importance in the management of this particular case.

The COVID-19 pandemic has brought global health services to a standstill. National healthcare systems and medical staffing in many countries have reached crisis levels due to the phenomenal outbreak. Healthcare resources have been strained to meet the unprecedented numbers of patient admissions with a significant amount of funding and manpower being channelled towards tackling this global pandemic. Despite the rollout of vaccinations, the development of new viral strains has now presented a new challenge. With the inevitable conversion of tertiary public hospitals to specialized COVID-19 centres with ‘Full Covid Status’ and the mobilization of its doctors from all specialities to care for these patients, the non–COVID-19 patients are becoming more neglected. The lack of elective surgeries performed and non-emergent admissions due to the unavailability of beds and personnel to care for this group of patients are concerning. As most of the focus and resources are now aimed at COVID-19 patients, the need to forge collaborations and cooperation between hospitals, agencies and healthcare systems are pertinent to ensure the provision of quality treatment for those suffering from non–COVID-19 diseases. To highlight this effort in Malaysia, we would like to present 2 case studies of non–COVID-19 patients undergoing elective surgeries through intergovernmental ministerial collaborations and a public–private partnership.

Percutaneous central vein catheterization is commonly performed to access venous circulation for various clinical indications. However, unintentional arterial puncture may occur which can result in catastrophic complications. We report a case of an inadvertent right brachiocephalic artery cannulation in a 77-year-old lady planned for haemodialysis via a percutaneous internal jugular vein vascular access performed under ultrasound guidance. As an intravascular stent is not favourable in view of the close proximity of the right common carotid artery to the site of puncture as well as the risk of massive bleeding upon simple removal of the catheter, an open surgical removal via a median sternotomy was performed. Acquiring the competency in procedural skills, an understanding of the surgical anatomy and anticipating impending complications are of paramount importance in preventing as well as in mitigating the above complication.