MyMedR

Fulltext Nocardia infection of the mastoid in an immunocompromised patient

Subha ST, Raman R

Med J Malaysia, 2004 Dec;59(5):688-9.

PMID: 15889577

A rare case of Nocardia infection of mastoid is presented in an immunocompromised patient.

Closure of a pharyngocutaneous fistula using a sternomastoid muscle flap

Raman R, Arumainathan UD

Can J Plast Surg, 2005;13(1):49.

PMID: 24223005

Presented here is a case of a pharyngocutaneous fistula which was closed primarily using a sternomastoid muscle flap, without skin coverage, thus obviating the need for a three-layered closure. Providing an intermediate cover was sufficient for the closure because the mucosal lining on the inside and the cutaneous covering on the outside grew using the muscle for support.

Fulltext Oropharyngeal flora changes in patients with head and neck malignancy post radiotherapy

Muthu K, Raman R, Gopalakrishnan G

Med J Malaysia, 2004 Dec;59(5):585-90.

PMID: 15889559

Radiotherapy has been recognized as a valuable modality of treatment in the management of head and neck cancers. It can have a direct bactericidal effect on the normal flora of the oropharynx. The objective of this study is to determine the changes in the oropharyngeal flora after external beam radiation. This prospective non randomized control study was performed to aid in identification of organisms involved in sepsis, as well as aid in choosing appropriate antibiotics for surgical procedures in irradiated patient. Forty patients with various head and neck malignancy and thirty control patients were selected. Oropharyngeal swabs were taken prior to radiotherapy, at the end and one month after radiotherapy. A single swab was taken from the control group. A full bacteriological analysis was performed. There was a statistically significant decrease in Alpha Hemolytic Streptococci and Neisseria species post radiotherapy. B Proteus and Candida Albicans showed a statistical significant increase in patients with head and neck cancer post radiotherapy. These changes remained even one month after radiotherapy.

Tracheostomy in patients with cervical rib: a note of caution

Prepageran N, Raman R

Ear Nose Throat J, 2003 Aug;82(8):626-7.

PMID: 14503102

Cervical rib is a congenital phenomenon that usually occurs in association with upper-limb neurovascular symptoms. The presence of a cervical rib displaces the great vessels that cross the thoracic outlet superiorly and proceed into the neck. We report an unusual case of iatrogenic hemorrhage during a tracheostomy in a patient whose right subclavian artery had been displaced by a cervical rib. Our aim is to alert surgeons to the hidden risks of this phenomenon.

Adjustable length tracheostomy tube for the morbidly obese and thick neck patient: a prototype

Lim PV, Raman R

Otolaryngol Head Neck Surg, 2001 Jan;124(1):56-7.

PMID: 11228454

Nasal septal clamp

Raman R, Dahalil MB

Otolaryngol Head Neck Surg, 2000 Dec;123(6):750.

PMID: 11112973

Preoperative estimation of resectable trachea by the cervical approach in surgery for tracheal stenosis

Raman R, Jalaluddin MA

Thorac Cardiovasc Surg, 1998 Feb;46(1):43-4.

PMID: 9554049

Fulltext Microscopically diagnosed head and neck cancers in the University Hospital, Kuala Lumpur

Jayalakshmi P, Pathmanathan R, Raman R, Prasad U

Med J Malaysia, 1989 Mar;44(1):58-63.

PMID: 2626114

A retrospective study of 1000 cases of microscopically diagnosed head and neck cancers in the University Hospital, Kuala Lumpur was done. Head and neck neoplasms comprise 7.1% of all tumours diagnosed in this Hospital and the commonest sites of involvement are the nasopharynx (29.1%), cervical lymph nodes (22.6%), oral cavity (10.2%), thyroid (8.2%) and skin (6.5%). Histologically, 87% of tumours are epithelial in nature. The results of this study show that nasopharyngeal carcinoma is commonest in Chinese males, while oral and laryngeal malignancies occur more frequently in Indians.

Novel use of a Leyla-Yasargil retractor as an endoscope holder during endoscopic sinus surgery

Raman R, Prepageran N

Ear Nose Throat J, 2004 Apr;83(4):270.

PMID: 15147098

The authors describe a novel way of fashioning an endoscope holder from a common retractor and an ear speculum. Using such a device during endoscopic sinus surgery leaves both of the surgeon's hands free to manipulate the instruments.

Fulltext Effects of temperature changes on nasal patency

Yogeetha R, Raman R, Quek KF

Singapore Med J, 2007 Apr;48(4):304-6.

PMID: 17384876

This study aims to assess the difference in nasal patency and resistance to temperature changes objectively and subjectively.

Fulltext Visual analog scale in hearing loss

Bokari S, Prepageran N, Raman R

Indian J Otolaryngol Head Neck Surg, 2010 Jan;62(1):40-3.

PMID: 23120679 DOI: 10.1007/s12070-010-0004-x

OBJECTIVE: To determine if visual analog scale (VAS) that has been used to measure magnitude of internal states such as pain, mood and various functional capabilities can be applied for patients with hearing loss.

MATERIALS AND METHODS: One hundred and sixty patients, aged 12-80 years with unilateral hearing loss were studied using a VAS (1-10) and pure tone audiometry (PTA) of responses to 500, 1,000 and 2,000 Hz to determine degree and type of hearing loss. The results of both were compared to determine if VAS can be used in measuring hearing loss.

RESULTS: Patients with mild, moderate hearing loss correlate well with corresponding VAS but other degrees of hearing loss (severe and profound) have poor correlation. The best correlation between PTA and VAS were found in conductive type of hearing loss.

CONCLUSION: This study suggest that there may be a role for VAS in mild and moderate hearing loss. This may be more applicable in rural setting as a screening procedure when audiometry is not available and can enhance clinical hearing assessment especially in mild-to-moderate conductive hearing loss.

Fulltext "High frequency presbycusis"-is there an earlier onset?

Arvin B, Prepageran N, Raman R

Indian J Otolaryngol Head Neck Surg, 2013 Dec;65(Suppl 3):480-4.

PMID: 24427701 DOI: 10.1007/s12070-011-0356-x

The objective of this study is to determine whether presbycusis occurs much earlier than previously believed if the high frequency (above 8 kHz) are included. Tertiary referral center (a teaching University). This is a cross-sectional observational study. Healthy adults from 20 to 49 years of age who had essentially normal hearing were included into the study. They were subjected to high frequency pure tone audiometry (until 16 kHz). Participants were grouped based on age ranges of 10 years (e.g., 20-29, 30-39, and 40-49) and the presence of symmetrical high frequency sensor neural hearing loss were documented. There is a significant presence of symmetrical high frequency sensor neural hearing loss (not attributed to any known risk factors) as early as from the age group of 40 to 49 years. Seven of 43 participants (16%) from age group of 20 to 29 years and 12 of 24 participants (50%) from age group of 30 to 39 years had significant high frequency hearing loss. High frequency hearing loss (high frequency Presbycusis) may occur much earlier than previously believed.

Keratosis Obturans: A Disease of the Tropics?

Chong AW, Raman R

Indian J Otolaryngol Head Neck Surg, 2017 Sep;69(3):291-295.

PMID: 28929057 DOI: 10.1007/s12070-017-1071-z

Keratosis obturans appears to be an obscure and relatively uncommon entity, even in literature search of journals and reference texts, so much so that there is not even any prevalence or incidence statistics available. However, the condition did not appear to be as uncommon based on our clinical observations. We have managed to obtain 64 patients representing 67 ears with keratosis obturans in our study period of about 18 months with a pattern of occurrence during this period. Humid weather seemed to play a role in the frequency of its appearance during certain period in our observation. There also appears to be a correlation between the severity of symptoms (predominantly pain and hearing loss) and the presenting appearance of the condition, i.e., presence or absence of granulation tissue, as well as that the degree of difficulty in exenteration of the keratosis obturans (matrix and content) depending on the expansion of the bony canal. Our figures showed the majority of the patients are females and young individuals, the majority of them occur unilaterally. The condition also appear to stop short of involving the tympanic membrane with only the bony canal being expanded with the surrounding oedema creating an apparent "canal stenosis".

Astaxanthin production by freshwater microalgae Chlorella sorokiniana and marine microalgae Tetraselmis sp

Raman R, Mohamad SE

Pak J Biol Sci, 2012 Dec 15;15(24):1182-6.

PMID: 23755409

There are numerous commercial applications of microalgae nowadays owing to their vast biotechnological and economical potential. Indisputably, astaxanthin is one of the high value product synthesized by microalgae and is achieving commercial success. Astaxanthin is a keto-carotenoid pigment found in many aquatic animals including microalgae. Astaxanthin cannot be synthesized by animals and provided in the diet is compulsory. In this study, the production of astaxanthin by the freshwater microalgae Chlorella sorokiniana and marine microalgae Tetraselmis sp. were studied. The relationship between growth and astaxanthin production by marine and freshwater microalgae cultivated under various carbon sources and concentrations, environmental conditions and nitrate concentrations was investigated in this study. Inorganic carbon source and low nitrate concentration favored the growth and production of astaxanthin by the marine microalgae Tetraselmis sp. and the freshwater microalgae Chlorella sorokiniana. Outdoor cultivation enhanced the growth of microalgae, while indoor cultivation promoted the formation of astaxanthin. The results indicated that supplementation of light, inorganic carbon and nitrate could be effectively manipulated to enhance the production of astaxanthin by both microalgae studied.

Hormonal changes causing rhinitis in pregnancy among Malaysian women

Indirani B, Raman R, Omar SZ

J Laryngol Otol, 2013 Sep;127(9):876-81.

PMID: 23954035 DOI: 10.1017/S0022215113001692

To investigate the aetiology of rhinitis occurring in pregnancy, by (1) describing the relationship between pregnancy rhinitis and serum oestrogen, progesterone, placental growth hormone and insulin-like growth factor, and (2) assessing the prevalence of pregnancy rhinitis among Malaysian women.

Comparison of the efficacy between oral rinse, oral gargle, and oral spray

Teh CSL, Raman R

J Prim Care Community Health, 2012 Apr 1;3(2):80-2.

PMID: 23803449 DOI: 10.1177/2150131911417185

INTRODUCTION AND AIMS: Patients with sore throats are often treated with oral gargles or oral sprays. Some may rinse instead of gargle, leading to unsatisfactory outcome. The authors studied the efficacy of oral rinses, gargles, and sprays and the effect of Friedman palate position on the outcome.
METHODS: Ten subjects used specially prepared solutions to rinse, gargle, and then spray their oral cavities at 2-hour intervals. The blue dye indicated the areas stained by the solution, which were scored.
RESULTS: Although there was no difference in reaching the oropharynx between the gargles and sprays, they were both better than were the oral rinses (P < .001). The difference in Friedman palate position did not have an effect on the efficacy of the different modalities.
CONCLUSION: Oral gargles and sprays have been shown to be significantly better than are oral rinses if the oropharynx is the targeted site, and the size of the oral airway does not impede their efficacy.
KEYWORDS: Friedman palate position; drug administration; oropharynx

Modified Mitchellson endoscope holder

Raman R, Dahalil MB, Prepageran N

J Laryngol Otol, 2008 Apr;122(4):414-5.

PMID: 17625036

Mitchellson's ear speculum holder has been modified to act as an endoscope holder, in order to be used in endoscopic surgery of the nose or ear.

Fulltext Glomus tympanicum: a report of two cases

Subha ST, Raman R, Prepageran N

Med J Malaysia, 2005 Mar;60(1):106-8.

PMID: 16250293

Two cases of glomus tympanium tumor of the middle ear stage 'type A' according to Fisch classification, are presented due to their rarity in this part of the world. These tumors were excised by end aural tympanotomy approach and there has been no recurrence in both patients to date.

Tonsillectomy without headlights: a unique solution

Prepageran N, Omar R, Raman R

Ear Nose Throat J, 2005 Sep;84(9):564.

PMID: 16261756

The tick Ixodida: an unusual foreign body in the ear

Alazzawi S, Omar R, Raman R

Trop Doct, 2016 Jan;46(1):62-3.

PMID: 26130704 DOI: 10.1177/0049475515592494

We report a patient with a hard tick in her left ear, adherent to the tympanic membrane.

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