Displaying publications 41 - 60 of 62 in total

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  1. Raman S, Teoh T, Nagaraj S
    Int J Gynaecol Obstet, 1996 Aug;54(2):143-7.
    PMID: 9236312
    OBJECTIVES: To study whether there are any differences in growth of the femoral and humeral length between the three major ethnic groups in Malaysia viz Malays, Chinese and Indians. The effect on fetal growth by gender of the baby and parity of the mother was also studied.

    METHODS: The setting was the University of Kuala Lumpur. Thirty-four Malay, 35 Chinese and 34 Indian normal pregnant middle-class women were studied longitudinally by monthly ultrasound scans for 18 to 38 weeks of gestation. The data were subjected to regression analysis; the quadratic curve was found to be the most adequate. Dummy variables were used to determine any effects by gender, parity as well as ethnicity on the length of limb growth. There was no difference in birth weights of the three ethnic groups studied, nor in gender or parity.

    RESULTS: There were found to be significant differences in limb lengths of the Indians (longer) when compared with the Malays and Chinese. Parity seems to affect only Indians in whom the multiparous fetuses have shorter limb lengths than the primaparous. There appears to be no effect by gender.

    CONCLUSION: There appear to be definite differences in growth of limb length between the different Malaysian ethnic groups and this should be taken into account when growth charts are used and when fetal weight formulas are calculated using limb lengths. The limitation of this study was that the numbers of subjects studied were small. Larger studies will be able to confirm or refute the findings.

  2. Raman S, Chan LL, Chang KW, Rachagan SP
    Med J Malaysia, 1992 Sep;47(3):228-30.
    PMID: 1491650
    A case of intestinal obstruction due to ileal atresia where the diagnosis was made prenatally by ultrasound is presented. Close monitoring of the fetus was done ultrasonographically to look for any evidence of meconium peritonitis. The baby was delivered preterm but weighed 3.3 kg. Laparotomy and enterostomy was done and the baby is currently well.
  3. Raman S, Ramanujam T, Lim CT
    J Obstet Gynaecol Res, 1996 Aug;22(4):375-8.
    PMID: 8870422
    Extensive haemangioma with platelet consumption (Kasabach-Merritt syndrome) is rare. The lesion is usually a single cutaneous cavernous haemangioma similar to that found in our patient. Multiple superficial strawberry naevi were also seen all over the rest of the body. This condition was diagnosed antenatally in this patient with the use of colour Doppler. There is one recent report where the thrombocytopaenia was diagnosed by cordocentesis. Unfortunately the baby developed heart failure with intractable coagulopathy and died 2 days later.
  4. Raman S, Shahla A
    Aust N Z J Obstet Gynaecol, 1992 May;32(2):117-9.
    PMID: 1520194
    A prospective study of temperature drop in 141 normal term newborn infants delivered vaginally at the labour ward, University Hospital, Kuala Lumpur were studied. The effect of various manoeuvres on the temperature drop were also studied. They were randomized into 3 study groups, 63 cases where the babies were wiped with dry cloth alone, 37 cases where the babies were put into a plastic bag immediately after birth and lastly 41 cases where the babies were wiped with dry cloth and then inserted into a plastic bag. There was significant temperature drop in all the 3 groups maximum in the first 15 minutes and the fall continued for 1 hour after delivery (p less than 0.001). This shows that in an air-conditioned labour ward in a tropical country the temperature fall in newborn infants can be significant. This study also showed that plastic is a poor insulator against significant temperature drop.
  5. Raman S, Rachagan SP, Boopalan P, Jeyarani S
    Med J Malaysia, 1986 Dec;41(4):361-4.
    PMID: 3312976
    A case of infantile polycystic kidneys diagnosed prenatally by ultrasound is presented here. This condition was confirmed at post-mortem following delivery of the child. The clinical and pathological features of this inheritable disease is discussed.
  6. Raman S, Rachagan SP
    Med J Malaysia, 1983 Mar;38(1):57-8.
    PMID: 6633338
    A case of hypertensive encephalopathy in eclampsia is described. Complete recovery from the neurological deficits took three and a half weeks.
  7. Raman S, Sivanesaratnam V
    Med J Malaysia, 1982 Mar;37(1):76-7.
    PMID: 6889674
    A case of perforation of the uterus by the Multiload CU250 Device is described. To date no perforation of the uterus by this device has been reported. The device was successfully removed under laparoscopic control.
  8. Raman S, Samuel D, Suresh K
    Aust N Z J Obstet Gynaecol, 1991 Aug;31(3):217-20.
    PMID: 1804081
    In this study 24 patients who had conventional erect lateral X-ray pelvimetry had a CT pelvimetry done after delivery to complete the pelvimetry views. The erect lateral pelvimetry was read independently by a Consultant Radiologist, Consultant Obstetrician and a Medical Officer training in Obstetrics and Gynaecology. Using CT pelvimetry as the 'gold standard' (as the error of measurement was known with the machine used) the 3 readings were compared. There was no statistical difference in the values suggesting that X-ray pelvimetry is comparable to CT pelvimetry. However CT pelvimetry is preferred, if available, because of the lower dose of radiation involved, more comfort for the patient and shorter time in performing the procedure. Measurements done are easily read directly from the CT console.
  9. Raman S, Rachagan SP, Lim CT
    J Clin Ultrasound, 1991 Sep;19(7):434-7.
    PMID: 1658071
  10. Raman S, Kuppuvelumani P, Menaka H
    Med J Malaysia, 1991 Mar;46(1):110-3.
    PMID: 1836033
    The relevant investigations and management of a case of alpha-thalassaemia major suspected antenatally is discussed. The value of ultrasonically guided cordocentesis in the definite diagnosis of this condition is emphasised in the management of this pregnancy. We believe that this is the first time such a procedure has been done in this country.
  11. Raman S, Tai C, Neoh HS
    Med J Malaysia, 1991 Dec;46(4):314-9.
    PMID: 1840438
  12. Raman S, Sivanesaratnam V, Sinnathuray TA
    Med J Malaysia, 1981 Sep;36(3):151-4.
    PMID: 7199110
  13. Raman S, Tai CW, Le Marsney R, Schibler A, Gibbons K, Schlapbach LJ
    Pediatr Crit Care Med, 2020 09;21(9):811-819.
    PMID: 32516223 DOI: 10.1097/PCC.0000000000002411
    OBJECTIVES: Up to 37% of children admitted to the PICU develop acute kidney injury as defined by Kidney Disease: Improving Global Outcomes criteria. We describe the prevalence of acute kidney injury in a mixed pediatric intensive care cohort using this criteria. As tools to stratify patients at risk of acute kidney injury on PICU admission are lacking, we explored the variables at admission and day 1 that might predict the development of acute kidney injury.

    DESIGN: Single-center retrospective observational study.

    SETTING: Thirty-six-bed surgical/medical tertiary PICU.

    PATIENTS: Children from birth to less than or equal to 16 years old admitted between 2015 and 2018.

    INTERVENTIONS: None.

    MEASUREMENTS AND MAIN RESULTS: Clinical data were extracted from the PICU clinical information system. Patients with baseline creatinine at admission greater than 20 micromol/L above the calculated normal creatinine level were classified as "high risk of acute kidney injury." Models were created to predict acute kidney injury at admission and on day 1. Out of the 7,505 children admitted during the study period, 738 patients (9.8%) were classified as high risk of acute kidney injury at admission and 690 (9.2%) developed acute kidney injury during PICU admission. Compared to Kidney Disease: Improving Global Outcomes criteria as the reference standard, high risk of acute kidney injury had a lower sensitivity and higher specificity compared with renal angina index greater than or equal to 8 on day 1. For the admission model, the adjusted odds ratio of developing acute kidney injury for high risk of acute kidney injury was 4.2 (95% CI, 3.3-5.2). The adjusted odds ratio in the noncardiac cohort for high risk of acute kidney injury was 7.3 (95% CI, 5.5-9.7). For the day 1 model, odds ratios for high risk of acute kidney injury and renal angina index greater than or equal to 8 were 3.3 (95% CI, 2.6-4.2) and 3.1 (95% CI, 2.4-3.8), respectively.

    CONCLUSIONS: The relationship between high risk of acute kidney injury and acute kidney injury needs further evaluation. High risk of acute kidney injury performed better in the noncardiac cohort.

  14. Raman S, Shafie AA, Abraham MT, Shim CK, Maling TH, Rajendran S, et al.
    PLoS One, 2021;16(5):e0251760.
    PMID: 33984051 DOI: 10.1371/journal.pone.0251760
    Oral cancer has been recognized as a significant challenge to healthcare. In Malaysia, numerous patients frequently present with later stages of cancers to the highly subsidized public healthcare facilities. Such a trend contributes to a substantial social and economic burden. This study aims to determine the cost of treating oral potentially malignant disorders (OPMD) and oral cancer from a public healthcare provider's perspective. Medical records from two tertiary public hospitals were systematically abstracted to identify events and resources consumed retrospectively from August 2019 to January 2020. The cost accrued was used to estimate annual initial and maintenance costs via two different methods- inverse probability weighting (IPW) and unweighted average. A total of 86 OPMD and 148 oral cancer cases were included. The initial phase mean unadjusted cost was USD 2,861 (SD = 2,548) in OPMD and USD 38,762 (SD = 12,770) for the treatment of cancer. Further annual estimate of initial phase cost based on IPW method for OPMD, early and late-stage cancer was USD 3,561 (SD = 4,154), USD 32,530 (SD = 12,658) and USD 44,304 (SD = 16,240) respectively. Overall cost of late-stage cancer was significantly higher than early-stage by USD 11,740; 95% CI [6,853 to 16,695]; p< 0.001. Higher surgical care and personnel cost predominantly contributed to the larger expenditure. In contrast, no significant difference was identified between both cancer stages in the maintenance phase, USD 700; 95% CI [-1,142 to 2,541]; p = 0.457. A crude comparison of IPW estimate with unweighted average displayed a significant difference in the initial phase, with the latter being continuously higher across all groups. IPW method was shown to be able to use data more efficiently by adjusting cost according to survival and follow-up. While cost is not a primary consideration in treatment recommendations, our analysis demonstrates the potential economic benefit of investing in preventive medicine and early detection.
  15. Raman S, Mahmood S, Hilles AR, Javed MN, Azmana M, Al-Japairai KAS
    Curr Drug Metab, 2020;21(9):649-660.
    PMID: 32384025 DOI: 10.2174/1389200221666200508074348
    BACKGROUND: Blood-brain barrier (BBB) plays a most hindering role in drug delivery to the brain. Recent research comes out with the nanoparticles approach, is continuously working towards improving the delivery to the brain. Currently, polymeric nanoparticle is extensively involved in many therapies for spatial and temporal targeted areas delivery.

    METHODS: We did a non-systematic review, and the literature was searched in Google, Science Direct and PubMed. An overview is provided for the formulation of polymeric nanoparticles using different methods, effect of surface modification on the nanoparticle properties with types of polymeric nanoparticles and preparation methods. An account of different nanomedicine employed with therapeutic agent to cross the BBB alone with biodistribution of the drugs.

    RESULTS: We found that various types of polymeric nanoparticle systems are available and they prosper in delivering the therapeutic amount of the drug to the targeted area. The effect of physicochemical properties on nanoformulation includes change in their size, shape, elasticity, surface charge and hydrophobicity. Surface modification of polymers or nanocarriers is also vital in the formulation of nanoparticles to enhance targeting efficiency to the brain.

    CONCLUSION: More standardized methods for the preparation of nanoparticles and to assess the relationship of surface modification on drug delivery. While the preparation and its output like drug loading, particle size, and charge, permeation is always conflicted, so it requires more attention for the acceptance of nanoparticles for brain delivery.

  16. Sirimewan D, Bazli M, Raman S, Mohandes SR, Kineber AF, Arashpour M
    J Environ Manage, 2024 Feb;351:119908.
    PMID: 38169254 DOI: 10.1016/j.jenvman.2023.119908
    The construction industry generates a substantial volume of solid waste, often destinated for landfills, causing significant environmental pollution. Waste recycling is decisive in managing waste yet challenging due to labor-intensive sorting processes and the diverse forms of waste. Deep learning (DL) models have made remarkable strides in automating domestic waste recognition and sorting. However, the application of DL models to recognize the waste derived from construction, renovation, and demolition (CRD) activities remains limited due to the context-specific studies conducted in previous research. This paper aims to realistically capture the complexity of waste streams in the CRD context. The study encompasses collecting and annotating CRD waste images in real-world, uncontrolled environments. It then evaluates the performance of state-of-the-art DL models for automatically recognizing CRD waste in-the-wild. Several pre-trained networks are utilized to perform effectual feature extraction and transfer learning during DL model training. The results demonstrated that DL models, whether integrated with larger or lightweight backbone networks can recognize the composition of CRD waste streams in-the-wild which is useful for automated waste sorting. The outcome of the study emphasized the applicability of DL models in recognizing and sorting solid waste across various industrial domains, thereby contributing to resource recovery and encouraging environmental management efforts.
  17. Sit JA, Raman S, Yahya AN
    Malays J Med Sci, 2021 Oct;28(5):94-101.
    PMID: 35115891 DOI: 10.21315/mjms2021.28.5.9
    Background: A good refractive outcome after cataract surgery indicates adequate clinical service provision. Precise immersion biometry is critical to achieve the desired refractive outcome. While the immersion biometry results are good in the tertiary settings, it is of interest to explore the refractive outcome of cataract surgeries in a rural facility using the same technique.

    Methods: A retrospective cross-sectional review was conducted on medical records of all cataract surgeries carried out in Hospital Keningau, Sabah. This study used all patients' medical records who had been assessed using immersion biometry pre-operatively, underwent phacoemulsification cataract surgery besides attending a post-operative refraction session within 90 days from the operation date. Clinical details were recorded in the form of standard proformas and analysed. The refractive outcome was evaluated using spherical equivalence (SE) and best-corrected visual acuity (BCVA). The percentage of cases with post-operative SE within ±1.00 diopter (D) and BCVA of '6/12 or better' were determined. The association between demographic factors and surgical-related factors with post-operative SE was evaluated using Fisher's exact test.

    Results: Of 140 cataract surgeries, 113 fulfilled the inclusion criteria. The average patient age was 66.3 (SD = 10.9) years old. The technique was proven to replicate a good outcome of 84.1% of cases with post-operative SE within ±1.00 D while 90.3% of the cases achieved BCVA of '6/12 or better'. Age and ethnicity were found to be associated with post-operative SE.

    Conclusion: The study proves the reproducibility of good refractive outcome in a rural facility using immersion biometry. The findings provide a benchmark for performance surveillance in rural facilities.

  18. Sivanesaratnam V, Singh A, Rachagan SP, Raman S
    Med J Aust, 1986 Apr 14;144(8):411, 413-4.
    PMID: 3959969
    During the 10-year period 1974-1983, 68 patients with intraperitoneal haemorrhage as a result of the rupture of a corpus luteum were managed at the University Hospital, Kuala Lumpur, Malaysia. Most of the patients were aged between 18 and 35 years. In 63% of the patients the rupture occurred between the 14th and the 35th day of the menstrual cycle, and 10 patients had intraperitoneal bleeding severe enough (450-1500 mL) to require blood transfusion. The condition is often confused with other surgical emergencies such as appendicitis and ectopic pregnancy. An increased awareness of the problem in women of reproductive age and the use of laparoscopy, when indicated, will allow a more conservative approach to be adopted for those patients with minimal bleeding. The performance of an appendicectomy in the presence of blood in the peritoneal cavity did not appear to increase morbidity in those patients with a preoperative diagnosis of "appendicitis".
  19. Soh EBS, Raman S, Chia PMK
    Med J Malaysia, 1998 Sep;53(3):280-3.
    PMID: 10968167
    A gravid patient with fetal supraventricular tachycardia is presented. A review of this rare condition and the present recommended mode of therapy are discussed.
  20. Tai CW, Gibbons K, Schibler A, Schlapbach LJ, Raman S
    J Nephrol, 2021 Jun 02.
    PMID: 34076880 DOI: 10.1007/s40620-021-01071-5
    BACKGROUND: Acute kidney injury (AKI) is a major cause of morbidity and mortality in critically ill children. The aim of this paper was to describe the prevalence and course of AKI in critically ill children and to compare different AKI classification criteria.

    METHODS: We conducted a retrospective observational study in our multi-disciplinary Pediatric Intensive Care Unit (ICU) from January 2015 to December 2018. All patients from birth to 16 years of age who were admitted to the pediatric ICU were included. The Kidney Disease Improving Global Outcomes (KDIGO) definition was considered as the reference standard. We compared the incidence data assessed by KDIGO, pediatric risk, injury, failure, loss of kidney function and end- stage renal disease (pRIFLE) and pediatric reference change value optimised for AKI (pROCK).

    RESULTS: Out of 7505 patients, 9.2% developed AKI by KDIGO criteria. The majority (59.8%) presented with stage 1 AKI. Recovery from AKI was observed in 70.4% of patients within 7 days from diagnosis. Both pRIFLE and pROCK were less sensitive compared to KDIGO criteria for the classification of AKI. Patients who met all three-KDIGO, pRIFLE and pROCK criteria had a high mortality rate (35.0%).

    CONCLUSION: Close to one in ten patients admitted to the pediatric ICU met AKI criteria according to KDIGO. In about 30% of patients, AKI persisted beyond 7 days. Follow-up of patients with persistent kidney function reduction at hospital discharge is needed to reveal the long-term morbidity due to AKI in the pediatric ICU.

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