MyMedR

Morphine-sparing effect of ketoprofen after abdominal surgery

Rao AS, Cardosa M, Inbasegaran K

Anaesth Intensive Care, 2000 Feb;28(1):22-6.

In a double-blind, placebo-controlled clinical trial (power of 80% to detect a 30% reduction in morphine consumption, P < 0.05), we have determined that the administration of two doses of intravenous ketoprofen 100 mg, one at the end of surgery and the second 12 hours postoperatively, was associated with a significant reduction in morphine consumption at eight (P = 0.028), 12 (P = 0.013) and 24 hours (P = 0.013) but not four hours (P = 0.065) postoperatively, as compared to placebo, when assessed by patient-controlled analgesia. There was no difference between the groups in pain scores or in the incidence of nausea and vomiting. One patient in the placebo group suffered from excessive sedation while one patient from the ketoprofen group suffered from transient oliguric renal failure. There were no other adverse effects. The results of this study show that ketoprofen does provide a morphine-sparing effect in the management of postoperative pain after abdominal surgery.

Fulltext Audit on tracheostomies performed at the General Intensive Care Unit, Kuala Lumpur Hospital

Rao AS, Mansor L, Inbasegaran K

Med J Malaysia, 2003 Jun;58(2):213-7.

PMID: 14569741 MyJurnal

During a 6-month period from October 2000 to March 2001, we analysed the indications, methods, waiting period and complications following a tracheostomy at the General Intensive Care Unit (GIGU) of Hospital Kuala Lumpur. There were 49 tracheostomies performed during this period. Thirty of them were performed in the GICU using the percutaneous dilatational method while 19 were performed electively in the Operating Theatre (OT) by the ear, nose and throat (ENT) surgeons. The main indications for a tracheostomy were prolonged mechanical ventilation and airway protection for patients with a poor Glasgow Coma Scale. The average waiting time for a tracheostomy after a decision was made to perform one was 1.34 +/- 0.72 days for a percutaneous tracheostomy and 3.72 +/- 2.52 days for a surgical tracheostomy. This difference was statistically significant (p < 0.001). There was excessive bleeding in 3 patients in the percutaneous tracheostomy group and 1 patient in the surgical tracheostomy group. Percutaneous tracheostomy is now the main method of tracheostomy at the GICU in Hospital Kuala Lumpur. Haemorrhage is the most significant complication of this procedure. However the overall complication rate is comparable with that of a surgical tracheostomy.

Fulltext Optimal size selection of laryngeal mask airway in Malaysian female adult population

Rao AS, Yew AEG, Inbasegaran K

Med J Malaysia, 2003 Dec;58(5):717-22.

PMID: 15190658 MyJurnal

The summary of various studies done looking at size selection of the laryngeal mask airway (LMA) in adults is that, selection based on sex is appropriate, and that both sizes 4 or 5 are adequate for adult females. However, in our local population these sizes may be too large especially the size 5 for adult females.

Fulltext Letter to the Editor regarding "Treatment of displaced fractures of the patella: Tension band wiring technique with the one-end or both-ends K-wire bending fixation method"

Sinha NK, Bhardwaj A, Rao AS

J Orthop Surg (Hong Kong), 2021 6 9;29(3):23094990211015501.

PMID: 34100330 DOI: 10.1177/23094990211015501

Fulltext Rare Presentation of a Rare Disease (Erdheim-Chester disease): A Case Report

Koh T, Fadli M, Vijaya Kumar S, Rao AS

Malays Orthop J, 2012 Nov;6(3):69-71.

PMID: 25279065 MyJurnal DOI: 10.5704/MOJ.1207.020

Erdheim-Chester disease (ECD) was first reported by J. Erdheim and W. Chester, in 1930. There are less than 250 reported cases till date. We report a case of ECD in a 16- year-old Malay male, who initially presented with elusive anemic symptoms with more specific symptoms of bony pain, cardiorespiratory and hepatic involvement evolving as the disease progressed.

Letter to the Editor: Minimally invasive plate osteosynthesis for proximal humeral fractures

Sinha N, Rao BS, Trivedy PD, Rao AS

J Orthop Surg (Hong Kong), 2016 04;24(1):139.

PMID: 27122535

Fulltext Production of gymnemic acid depends on medium, explants, PGRs, color lights, temperature, photoperiod, and sucrose sources in batch culture of Gymnema sylvestre

Ahmed AB, Rao AS, Rao MV, Taha RM

ScientificWorldJournal, 2012;2012:897867.

PMID: 22629221 DOI: 10.1100/2012/897867

Gymnema sylvestre (R.Br.) is an important diabetic medicinal plant which yields pharmaceutically active compounds called gymnemic acid (GA). The present study describes callus induction and the subsequent batch culture optimization and GA quantification determined by linearity, precision, accuracy, and recovery. Best callus induction of GA was noticed in MS medium combined with 2,4-D (1.5 mg/L) and KN (0.5 mg/L). Evaluation and isolation of GA from the calluses derived from different plant parts, namely, leaf, stem and petioles have been done in the present case for the first time. Factors such as light, temperature, sucrose, and photoperiod were studied to observe their effect on GA production. Temperature conditions completely inhibited GA production. Out of the different sucrose concentrations tested, the highest yield (35.4 mg/g d.w) was found at 5% sucrose followed by 12 h photoperiod (26.86 mg/g d.w). Maximum GA production (58.28 mg/g d.w) was observed in blue light. The results showed that physical and chemical factors greatly influence the production of GA in callus cultures of G. sylvestre. The factors optimized for in vitro production of GA during the present study can successfully be employed for their large-scale production in bioreactors.

Fulltext Abnormal muscle in the anterior compartment of the forearm: a case report

Rodrigues V, Nayak SB, Rao MK, Vollala V, Somayaji N, Rao AS

Cases J, 2009;2:9125.

PMID: 20062702 DOI: 10.1186/1757-1626-2-9125

During routine dissection for the undergraduate medical students, we encountered an unusual, additional muscle in the anterior compartment of the forearm. This muscle took origin from the anterior surface of the radius in common with the flexor digitorum superficialis muscle. It had a tendon of origin and a tendon of insertion. Its fleshy radial belly and the tendon of insertion, crossed superficial to the median nerve. The muscle was inserted partly to the flexor retinaculum and partly to the undersurface of palmar aponeurosis. The observations made by us in the present case will supplement our knowledge of variations of the muscles in this region which could be useful for hand surgeons as it could possibly compress the median nerve because of its close relationship to it.

Fulltext An international, multi-institution survey of the use of EUS in the diagnosis of pancreatic cystic lesions

Ge N, Brugge WR, Saxena P, Sahai A, Adler DG, Giovannini M, et al.

Endosc Ultrasound, 2019 9 26;8(6):418-427.

PMID: 31552915 DOI: 10.4103/eus.eus_61_19

Background and Objectives: Currently, pancreatic cystic lesions (PCLs) are recognized with increasing frequency and have become a more common finding in clinical practice. EUS is challenging in the diagnosis of PCLs and evidence-based decisions are lacking in its application. This study aimed to develop strong recommendations for the use of EUS in the diagnosis of PCLs, based on the experience of experts in the field.

Methods: A survey regarding the practice of EUS in the evaluation of PCLs was drafted by the committee member of the International Society of EUS Task Force (ISEUS-TF). It was disseminated to experts of EUS who were also members of the ISEUS-TF. In some cases, percentage agreement with some statements was calculated; in others, the options with the greatest numbers of responses were summarized.

Results: Fifteen questions were extracted and disseminated among 60 experts for the survey. Fifty-three experts completed the survey within the specified time frame. The average volume of EUS cases at the experts' institutions is 988.5 cases per year.

Conclusion: Despite the limitations of EUS alone in the morphologic diagnosis of PCLs, the results of the survey indicate that EUS-guided fine-needle aspiration is widely expected to become a more valuable method.

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