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Fulltext Intracranial germinoma – a case report

Subha, S.T., Puaviappan, P., Ramesh, N., Dass, Dipak B

Malaysian Journal of Medicine and Health Sciences, 2013;9(1):81-82.
MyJurnal

Intracranial germinomas belong to the class of germ cell tumors which are relatively rare intracranial tumors. Early recognition of this neoplasm is vital as germinomas are highly radiosensitive and effective/ early radiation therapy can result in relatively favourable overall prognosis. In this article we describe a 19 years old man who presented with pituitary tumor in the suprasellar region for which transsphenoidal decompression and biopsy was done. The histopathological examination confirmed it to be germinoma and he underwent craniospinal radiotherapy.
Fulltext Functional outcome of microsurgical clipping compared to endovascular coiling

Premananda RM, Ramesh N, Hillol KP

Med J Malaysia, 2012 Dec;67(6):585-90.
PMID: 23770950 MyJurnal

Endovascular coiling has been used increasingly as an alternative to neurosurgical clipping for treating subarachnoid hemorrhage secondary to aneurysm rupture. In a retrospective cohort review on the treatment methods of aneurysm rupture in Hospital Kuala Lumpur over the period of five years (2005-2009) a total of 268 patients were treated. These patients were broadly categorized into two groups based on their treatment mode for ruptured aneurysms. Statistical analysis was determined using Chi- Square tests to study these associations. In our study, 67.5% of patients presented with Good World Federation of Neurosurgical Societies (WFNS) grade (WFNS1-2) while 32.5% patients presented with Poor WFNS prior to intervention. In our outcome, it was noted that 60.4% had good functional outcome (mRS grade 0-2) as compared to 39.6% patients who had poor mRS(modified rankin scale) outcome (mRS 3-6). In the good WFNS group, 76% of patients in clipping group had a good mRS outcome while, 86.5% patients in coiling group had good mRS outcome (p=0.114). In poor WFNS presentation, it was noted that in 77.3% patients in clipping group, had poor mRS outcome. Similarly with poor WFNS presentation, 83.3% of patient in coiling group had poor outcome. (p=1.00). Hence when we control the WFNS group, there was no significant association between treatment group (clipping and coiling) and mRS outcome at 6 months. The outcome of patient is determined by initial clinical presentation (WFNS grade) and influenced by requirement of Extraventricular drain (EVD) in presence of hydrocephalus, CSF infection and pneumonia. Therefore the decision regarding treatment option needs to be individualized based on the presentation of the patient.
Fulltext National Trauma Database (NTrD)--improving trauma care: first year report

Sabariah FJ, Ramesh N, Mahathar AW

Med J Malaysia, 2008 Sep;63 Suppl C:45-9.
PMID: 19227673

The first Malaysian National Trauma Database was launched in May 2006 with five tertiary referral centres to determine the fundamental data on major trauma, subsequently to evaluate the major trauma management and to come up with guidelines for improved trauma care. A prospective study, using standardized and validated questionnaires, was carried out from May 2006 till April 2007 for all cases admitted and referred to the participating hospitals. During the one year period, 123,916 trauma patients were registered, of which 933 (0.75%) were classified as major trauma. Patients with blunt injury made up for 83.9% of cases and RTA accounted for 72.6% of injuries with 64.9% involving motorcyclist and pillion rider. 42.8% had severe head injury with an admission Glasgow Coma Scale (GCS) of 3-8 and the Revised Trauma Score (RTS) of 5-6 were recorded in 28.8% of patients. The distribution of Injury Severity Score (ISS) showed that 42.9% of cases were in the range of 16-24. Only 1.9% and 6.3% of the patients were reviewed by the Emergency Physician and Surgeon respectively. Patients with admission systolic blood pressure of less than 90 mmHg had a death rate of 54.6%. Patients with severe head injury (GCS < 9), 45.1% died while 79% patients with moderate head injury survived. There were more survivors within the higher RTS range compared to the lower RTS. Patients with direct admission accounted for 52.3% of survivors and there were 61.7% survivors for referred cases. In conclusion, NTrD first report has successfully demonstrated its significance in giving essential data on major trauma in Malaysia, however further expansion of the study may reflect more comprehensive trauma database in this country.
Fulltext Honey, Propolis, and Royal Jelly: A Comprehensive Review of Their Biological Actions and Health Benefits

Pasupuleti VR, Sammugam L, Ramesh N, Gan SH

Oxid Med Cell Longev, 2017;2017:1259510.
PMID: 28814983 DOI: 10.1155/2017/1259510

BACKGROUND: There are several health benefits that honeybee products such as honey, propolis, and royal jelly claim toward various types of diseases in addition to being food.
SCOPE AND APPROACH: In this paper, the effects of honey, propolis, and royal jelly on different metabolic diseases, cancers, and other diseases have been reviewed. The modes of actions of these products have also been illustrated for purposes of better understanding.
KEY FINDINGS AND CONCLUSIONS: An overview of honey, propolis, and royal jelly and their biological potentials was highlighted. The potential health benefits of honey, such as microbial inhibition, wound healing, and its effects on other diseases, are described. Propolis has been reported to have various health benefits related to gastrointestinal disorders, allergies, and gynecological, oral, and dermatological problems. Royal jelly is well known for its protective effects on reproductive health, neurodegenerative disorders, wound healing, and aging. Nevertheless, the exact mechanisms of action of honey, propolis, and royal jelly on the abovementioned diseases and activities have not been not fully elucidated, and further research is warranted to explain their exact contributions.
Bacteriology and antimicrobial susceptibility of ENT infections in a tropical hospital

Chew YK, Cheong JP, Ramesh N, Noorafidah MD, Brito-Mutunayagam S, Khir A, et al.

Ear Nose Throat J, 2014 Jun;93(6):E5-8.
PMID: 24932831

We conducted a retrospective observational study to determine the spectrum and antibiotic sensitivity pattern of organisms isolated in otorhinolaryngologic (ORL) infections. We reviewed the laboratory culture and sensitivity records of 4,909 patients-2,773 males (56.5%) and 2,136 females (43.5%), aged 2 to 90 years (mean: 45.3 ± 12.6)-who had been seen at two government hospitals in Malaysia. Of this group, 4,332 patients had a respiratory tract infection (88.2%), 206 had an ear infection (4.2%), 188 had a deep neck infection (3.8%), and 183 had an oropharyngeal infection (3.7%). The most common isolated organisms were Klebsiella spp, Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus, methicillin-susceptible S aureus, coagulase-negative S aureus, and Acinetobacter baumannii. We also identified the antimicrobial susceptibility of these organisms. We conclude that since the spectrum of causative pathogens in some infections differs between tropical and nontropical areas of the world, tropical hospitals should not completely adopt the antibiotic guidelines for ORL infections that have been recommended for hospitals in nontropical regions. We hope that our review and analysis of local data will help practitioners in Malaysia develop an appropriate prescribing policy with respect to ORL pathogens and antimicrobial susceptibility. The goal is to reduce the morbidity and mortality associated with these infections.
Fulltext Sleep Disturbances among Caregivers of Home-Isolated and Hospitalized COVID-19 Patients: A Multi-National Cross-Sectional Study

Turabi N, Tomar SP, Anyagwa OE, Durganaudu H, Ishwarya V, Kivan H, et al.

Indian J Community Med, 2023;48(5):676-683.
PMID: 37970177 DOI: 10.4103/ijcm.ijcm_690_22

BACKGROUND: Since the coronavirus (COVID-19) pandemic began, several studies were published on the possible prevention and treatment of the disease caused by severe acute respiratory syndrome coronavirus (SARSCoV-2), and its complications. However, one aspect that was overlooked is the impact on the mental health of the caregivers of COVID-19 patients. The current study endeavors to investigate sleep quality disturbances in the caregivers of COVID-19 patients in different countries.
MATERIAL AND METHODS: This cross-sectional multi-center study was performed between August 1, 2021, and August 30, 2022, across 11 countries. A total of 2411 responses meeting the inclusion criteria (being a family member or caregiver involved in patient care) were collected. The sleep quality was assessed using the self-reported Pittsburgh Sleep Quality Index (PSQI) 12. Total scores ranged from 0 to 21. A ≥5 indicated poor sleep quality with 89.6% sensitivity and 86.5% specificity.
RESULTS: A total of 2411 responses meeting the inclusion criteria showed that mean PSQI scores (P = 0.3604) were higher in caregivers of hospitalized patients than in patients isolated at home. Approximately 62.4% of caregivers reported sleep quality problems while caring for their patients.
CONCLUSION: The results showed that the majority of caregivers of patients with COVID-19 reported disturbances in sleep quality and impaired sleep was more common among caregivers of hospitalized patients, perhaps because hospitalization is associated with a more severe course of the disease. There is a pressing need to take measures to improve the mental health of these caregivers. There should be treatment programs set up to reverse sleep disturbances in this population sufficiently.