MyMedR

MCR-1 Gene Encoded Colistin-Resistant Escherichia coli in Raw Chicken Meat and Bean Sprouts in Malaysia

Aklilu E, Raman K

Int J Microbiol, 2020;2020:8853582.

PMID: 32774381 DOI: 10.1155/2020/8853582

This study was conducted to detect the presence of colistin-resistant Escherichia coli (E. coli) in raw chicken meat and bean sprouts collected from local markets and to determine the antimicrobial resistance patterns of the E. coli isolates. A total of 100 samples, comprised of 50 raw chicken meat and 50 bean sprouts, were collected and processed. Kirby-Bauer method was used to determine the antimicrobial resistance patterns, and PCR amplification was used to detect E. coli species-specific and colistin resistance (mcr-1 and mcr-2) genes. The results showed that 52.1% (12/23) of the E. coli isolated from raw chicken meat were positive for the colistin resistance encoding gene, mcr-1, whereas all the E. coli isolates from bean sprouts were negative for colistin resistance encoding genes. The findings show that chicken meat contaminated with colistin-resistant E. coli may pose public health risk to the consumers. Hence, prudent usage of antibiotics and hygienic handling of food items helps to prevent and combat the risks of spreading of colistin-resistant E. coli and the public health risks it may pose. More comprehensive and large-scale studies focusing on all the possible sources of colistin-resistant E. coli are recommended.

A rare complication of endoscopic cystgastrostomy

Lee J, Sachithanandan S, Raman K

Gastroenterology, 2011 Nov;141(5):e1-2.

PMID: 21946349 DOI: 10.1053/j.gastro.2010.07.062

Neuroendocrine tumor in choledochal cyst--case report and review of literature

Dahiya D, Raman K, Singh H

Pol Przegl Chir, 2011 Nov;83(11):627-9.

PMID: 22246096 DOI: 10.2478/v10035-011-0099-0

The report presents a rare case of carcinoid tumor in a 17 year female who presented with epigastric pain of one week duration. She was diagnosed to have type I choledochal cyst on abdominal ultrasound and MRI. She underwent total excision of choledochal cyst with roux-en-Y hepaticojejunostomy. Histopathological examination revealed a neuroendocrine tumor within choledochal cyst which was immunoreactive for Chromogranin A. Patient is well at 6 months of follow up. These tumors are characteristically slow-growing, therefore awareness of its presence preoperatively can facilitate optimal management by performing surgical resection with negative margins which offers the best chance of long-term survival.

Increase number of mitochondrion-like organelle in symptomatic Blastocystis subtype 3 due to metronidazole treatment

Raman K, Kumar S, Chye TT

Parasitol Res, 2016 Jan;115(1):391-6.

PMID: 26481491 DOI: 10.1007/s00436-015-4760-0

Blastocystis sp., an intestinal organism is known to cause diarrhea with metronidazole regarded as the first line of treatment despite reports of its resistance. The conflicting reports of variation in drug treatment have been ascribed to subtype differences. The present study evaluated in vitro responses due to metronidazole on ST3 isolated from three symptomatic and asymptomatic patients, respectively. Symptomatic isolates were obtained from clinical patients who showed symptoms such as diarrhea and abdominal bloating. Asymptomatic isolates from a stool survey carried out in a rural area. These patients had no other pathogens other than Blastocystis. Ultrastructural studies using transmission electron microscopy (TEM) and scanning electron microscopy (SEM) revealed drug-treated ST3 from symptomatic patients were irregular and amoebic with surface showing high-convoluted folding when treated with metronidazole. These organisms had higher number of mitochondrion-like organelle (MLO) with prominent cristae. However, the drug-treated ST3 from asymptomatic persons remained spherical in shape. Asymptomatic ST3 showed increase in the size of its central body with the MLO located at the periphery.

Cystic pheochromocytoma mimicking a malignant pancreatic cyst

Lee J, Raman K, Sachithanandan S

Gastrointest Endosc, 2011 Sep;74(3):712-3.

PMID: 21111418 DOI: 10.1016/j.gie.2010.09.027

Pancreatic hemangioma mimicking a malignant pancreatic cyst

Lee J, Raman K, Sachithanandan S

Gastrointest Endosc, 2011 Jan;73(1):174-6.

PMID: 20932519 DOI: 10.1016/j.gie.2010.07.038

Fulltext Outcomes of early versus delayed cholecystectomy in patients with mild to moderate acute biliary pancreatitis: A randomized prospective study

Jee SL, Jarmin R, Lim KF, Raman K

Asian J Surg, 2018 Jan;41(1):47-54.

PMID: 27530927 DOI: 10.1016/j.asjsur.2016.07.010

BACKGROUND: In patients with acute biliary pancreatitis (ABP), cholecystectomy is mandatory to prevent further biliary events, but the precise timing of cholecystectomy for mild to moderate disease remain a subject of ongoing debate. The aim of this study is to assess the outcomes of early versus delayed cholecystectomy. We hypothesize that early cholecystectomy as compared to delayed cholecystectomy reduces recurrent biliary events without a higher peri-operative complication rate.

METHODS: Patients with mild to moderate ABP were prospectively randomized to either an early cholecystectomy versus a delayed cholecystectomy group. Recurrent biliary events, peri-operative complications, conversion rate, length of surgery and total hospital length of stay between the two groups were evaluated.

RESULTS: A total of 72 patients were enrolled at a single public hospital. Of them, 38 were randomized to the early group and 34 patients to the delayed group. There were no differences regarding peri-operative complications (7.78% vs 11.76%; p = 0.700), conversion rate to open surgery (10.53% vs 11.76%; p = 1.000) and duration of surgery performed (80 vs 85 minutes, p = 0.752). Nevertheless, a greater rate of recurrent biliary events was found in the delayed group (44.12% vs 0%; p ≤ 0.0001) and the hospital length of stay was longer in the delayed group (9 vs 8 days, p = 0.002).

CONCLUSION: In mild to moderate ABP, early laparoscopic cholecystectomy reduces the risk of recurrent biliary events without an increase in operative difficulty or perioperative morbidity.

Computed tomography analysis of the anterior ethmoid genu of the frontal recess in non-diseased sinuses

Raman K, Govindaraju R, James K, Abu Bakar MZ, Patil N, Shah MN

J Laryngol Otol, 2023 Feb;137(2):169-173.

PMID: 34924062 DOI: 10.1017/S0022215121004175

OBJECTIVE: Knowledge of anatomical variations of the frontal recess and frontal sinus and recognition of endoscopic landmarks are vital for safe and effective endoscopic sinus surgery. This study revisited an anatomical landmark in the frontal recess that could serve as a guide to the frontal sinus.

METHOD: Prevalence of the anterior ethmoid genu, its morphology and its relationship with the frontal sinus drainage pathway was assessed. Computed tomography scans with multiplanar reconstruction were used to study non-diseased sinonasal complexes.

RESULTS: The anterior ethmoidal genu was present in all 102 anatomical sides studied, independent of age, gender and race. Its position was within the frontal sinus drainage pathway, and the drainage pathway was medial to it in 98 of 102 cases. The anterior ethmoidal genu sometimes extended laterally and formed a recess bounded by the lamina papyracea laterally, by the uncinate process anteriorly and by the bulla ethmoidalis posteriorly. Distance of the anterior ethmoidal genu to frontal ostia can be determined by the height of the posterior wall of the agger nasi cell rather than its volume or other dimensions.

CONCLUSION: This study confirmed that the anterior ethmoidal genu is a constant anatomical structure positioned within frontal sinus drainage pathway. The description of anterior ethmoidal genu found in this study explained the anatomical connection between the agger nasi cell, uncinate process and bulla ethmoidalis and its structural organisation.

Fulltext High lipid storage in vacoular forms of subtype 6 Blastocystis sp. in ostrich

Chandrasekaran H, Govind SK, Panchadcharam C, Bathmanaban P, Raman K, Thergarajan G

Parasit Vectors, 2014;7:469.

PMID: 25358755 DOI: 10.1186/s13071-014-0469-7

Blastocystis sp., a widely prevalent intestinal protozoan parasite is found in a wide range of animals, including humans. The possibility of zoonotic transmission to human from birds especially ostriches led us to investigate on the cross infectivity of Blastocystis sp. isolated from the ostrich feces as well as the phenotypic and subtype characteristics. There is a need to investigate this especially with the rising number of ostrich farms due to the growing global ostrich industry.

Fulltext Management of bleeding pseudoaneurysm of gastroduodenal artery secondary to chronic pancreatitis

Leow VM, Siam F, Kannan S, Sari Baharudin M, Raman K, Singh H

Med J Malaysia, 2013 Jun;68(3):271-2.

PMID: 23749023 MyJurnal

A bleeding pseudoaneurysm of the peripancreatic artery can present with massive upper gastrointestinal hemorrhage. History of pancreatitis and urgent imaging are crucial in the making of the diagnosis. Here, we report a patient with alcoholic chronic pancreatitis presented with ruptured pseudoaneurysm of gastroduodenal artery (GDA). He was treated with percutaneous angiographic embolisation.

Fulltext Extraneural metastasis of meningeal haemangiopericytoma to the liver

Yusoff AR, Mokhtar S, Raman K, Singh H, Shabery NAM

Turk J Gastroenterol, 2019 09;30(9):848-850.

PMID: 31530530 DOI: 10.5152/tjg.2019.18454

Liver Transplantation in Malaysia: Needs, Obstacles, and Opportunities

Khan JF, Shah DM, Sivapakiam S, Mokhtar S, Subramaniam M, Raman K, et al.

Transplantation, 2021 Dec 01;105(12):2507-2512.

PMID: 34818304 DOI: 10.1097/TP.0000000000003591

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