MyMedR

Anaesthetic management of a parturient with a mediastinal mass for caesarean delivery

Lee CY, Izaham A, Zainuddin K

Int J Obstet Anesth, 2013 Nov;22(4):356-8.

PMID: 23993805 DOI: 10.1016/j.ijoa.2013.03.017

Occupational radiation exposure to anesthetists from fluoroscopic projections during orthopedic operative procedures

Abas AA, Rahman RA, Yahya N, Kamaruzaman E, Zainuddin K, Manap NA

Clin Ter, 2014;165(4):e253-7.

PMID: 25203339 DOI: 10.7417/CT.2014.1739

The role of anesthetists during orthopedic fluoroscopic procedures exposes them to radiation. We conducted a prospective, descriptive study to estimate the radiation exposure to anesthetists during procedures over a six-month period in the orthopedic trauma operating theatres which had the most fluoroscopic usage.

Fulltext Ultrasound Probe Positions for Internal Jugular Vein Cannulation: A Prospective Study of Different Techniques

Kurien M, Teo R, Zainuddin K, Azidin AM, Izaham A, Budiman M, et al.

Clin Ter, 2021 Jul 05;172(4):278-283.

PMID: 34247211 DOI: 10.7417/CT.2021.2332

Objective: We compared sonoanatomy of the internal jugular vein (IJV) the high (HA), conventional (CA) and the medial oblique approach (MA) to identify the best approach and head position for IJV cannulation.

Materials & Methods: Total of 45 volunteers aged 18-65 years were included in this study. The degree of overlap in percentage, depth of IJV from skin, antero-posterior (AP) and transverse diameters (TD) of IJV were measured in real time with ultrasound (US). Measurements were taken in the HA, CA and MA in neutral and 30° head rotation on both the right and left side of the neck.

Results: The HA had lower percentage of overlap when compared to CA and MA in neutral and 30° head rotation (p= 0.002 to ≤0.001). The IJV was more shallow in the CA and MA. The AP and TD of the IJV were larger in the MA when compared to HA (p=<0.001) and CA (p =0.026 to < 0.001) and the right IJV has a larger AP and TD in all approaches.

Discussion: The HA had the least percentage of overlap compared to CA and MA, therefore the risk of accidental ICA puncture can be reduced. The apparent overlap seen in MA may not reflect the actual scenario because of the way the US beam cuts the vessel. The AP and TD of IJV were significantly increased in the MA, which would ease CVC.

Conclusion: We conclude and recommend the medial oblique probe position with 30° head rotation provides optimal real time sonographic parameters for US guided IJV cannulation.

Chest tube entrapment: a simple solution for technical error

Haron H, Baharudin MN, Ismail I, Zainuddin K, Abdul Rahman MR

Ann Thorac Surg, 2014 Jun;97(6):2166-7.

PMID: 24882295 DOI: 10.1016/j.athoracsur.2013.07.129

Unrecognized chest tube entrapment by surgical closure is a technical error. We present a rare case of chest tube entrapment that was successfully treated with a simple and safe solution in an elderly man after coronary artery bypass grafting (CABG). We visualized the suture using a small endoscope through the chest tube and incised it with the help of thoracoscopic scissors. The tube was then removed without the need for surgical exploration.

Fulltext Sound frequency spectra of snore in relation to the site of obstruction among snorers

Qualickuz Zanan NH, Azman M, Zainuddin K, Wan Puteh SE, Mohamed AS, Mat Baki M

Acta Otorhinolaryngol Ital, 2021 Aug;41(4):348-355.

PMID: 34533538 DOI: 10.14639/0392-100X-N1202

Objective: This study aimed to describe the sound frequency of snoring in relation to the site of upper airway vibration among snorers.

Methods: 383 snores from 40 participants who complained of snoring were digitally recorded during natural and induced sleep using a level III polysomnography monitor with a built-in microphone. During drug-induced sleep endoscopy (DISE), the real-time site of upper airway obstruction was assessed, and the sound frequency of snoring was recorded synchronously.

Results: The mean peak of snoring frequency for unilevel palatal, oropharynx and epiglottis obstruction were 522.5, 482.4 and 300.0 Hz, respectively. Most participants showed multilevel obstruction at the palate and oropharynx, in which the mean for bi-peak snoring frequency were 402.90 Hz and 1086.96 Hz, respectively. Severity of OSA was significantly associated with multilevel obstruction.

Conclusions: There was a significant association between the snoring sound frequency and site of unilevel obstruction. Palatal or oropharyngeal obstruction produced sound at mid-frequency range, while the epiglottis produced a low frequency range. Multilevel obstruction documented a bi-peak snoring frequency.

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