MyMedR

Parapharyngeal space melioidosis in a diabetic

Elango S, Sivakumaran S

J Laryngol Otol, 1991 Jul;105(7):582-3.

Pseudomonas pseudomallei, a gram negative organism causing melioidosis, is found in tropical and subtropical regions. It may manifest as a pulmonary lesion, osteomyelitis, soft tissue abscesses, abscesses in various organs or in septicaemic form. Melioidosis of the parapharyngeal space has not been reported so far. A case of melioidosis of the parapharyngeal space which was successfully treated by drainage and prolonged antibiotic therapy is reported here. Melioidosis should be suspected in severe forms of deep neck space infection, especially if the patient comes from an endemic area.

Fulltext Prevalence of sexually transmitted diseases among female drug abusers in Malaysia

Isa AR, Sivakumaran S

Med J Malaysia, 1993 Jun;48(2):124-8.

PMID: 8350786

The prevalence of sexually transmitted diseases (STD) among female drug abusers was determined by screening 130 new inmates of a rehabilitation centre. The majority of the subjects (77.7%) were self-confessed sex workers. A high prevalence of syphilis (50.8%), hepatitis B (52.2%), moniliasis (23.8%) and trichomoniasis (19.2%) were noted. Gonorrhoea vaginitis was seen in 8.5%, which was low compared to previous studies. Six subjects were seropositive for human immunodeficiency virus (HIV), with 5 of them admitting to needle sharing and working as prostitutes. More than half of them harboured 2 or more STD. A rich reservoir of STD was seen among the drug abusers. With more evidence now available concerning the ease of HIV transmission associated with ulcerative STD, a stage could be set for greater heterosexual HIV transmission. As part of the rehabilitation process, female drug abusers need a thorough screening for STD followed by aggressive treatment regimens.

Intestinal helminthiasis and abdominal symptoms in adults

Mahendra Raj S, Sivakumaran S, Vijayakumari S

Trop Gastroenterol, 1991 Jan-Mar;12(1):21-4.

PMID: 2058006

In a study to test the association between soil transmitted intestinal helminthiasis and abdominal symptoms in a non-paediatric age group, 242 randomly selected patients (137 males, 105 females, median age 45 years) were asked specific questions pertaining to abdominal symptoms at the time of admission to the adult medical wards. Stool examination on all patients revealed a round worm prevalence rate of 21%. A larger proportion of stool positive female patients were symptomatic than stool negative females (68% vs 30%, p = 0.04). There was no significant difference in symptoms between stool positive and stool negative male patients (34.6% vs 31%, p = 0.91). The results suggested an association between intestinal nematode infection and abdominal symptoms in females but not in males.

Intracranial suppuration caused by Micrococcus luteus

Selladurai BM, Sivakumaran S, Aiyar S, Mohamad AR

Br J Neurosurg, 1993;7(2):205-7.

PMID: 8098607

Micrococcus spp. are commensal organisms colonizing the body surfaces of humans. In a few instances these organisms have been reported to colonize ventricular shunts. We report a patient, with no overt evidence of immunosuppression, in whom Micrococcus luteus was responsible for intracranial suppuration at multiple sites.

Does ascariasis, trichuriasis and hookworm infection predispose to non-specific abdominal symptoms among adults in endemic areas?

Raj SM, Anteson R, Sivakumaran S, Abdullah MR, Low HC

Trop Doct, 1994 Apr;24(2):88-9.

PMID: 8009635

Do ascariasis, trichuriasis and hookworm infections predispose to non-specific abdominal symptoms among adults in endemic areas?

Raj SM, Anteson R, Sivakumaran S, Abdullah MR, Low HC

Trop Doct, 1993 Oct;23(4):166-7.

PMID: 8273160

Risk of stroke and other adverse outcomes in patients with perioperative atrial fibrillation 1 year after non-cardiac surgery

Conen D, Alonso-Coello P, Douketis J, Chan MTV, Kurz A, Sigamani A, et al.

Eur Heart J, 2020 02 01;41(5):645-651.

PMID: 31237939 DOI: 10.1093/eurheartj/ehz431

AIMS: To determine the 1-year risk of stroke and other adverse outcomes in patients with a new diagnosis of perioperative atrial fibrillation (POAF) after non-cardiac surgery.

METHODS AND RESULTS: The PeriOperative ISchemic Evaluation (POISE)-1 trial evaluated the effects of metoprolol vs. placebo in 8351 patients, and POISE-2 compared the effect of aspirin vs. placebo, and clonidine vs. placebo in 10 010 patients. These trials included patients with, or at risk of, cardiovascular disease who were undergoing non-cardiac surgery. For the purpose of this study, we combined the POISE datasets, excluding 244 patients who were in atrial fibrillation (AF) at the time of randomization. Perioperative atrial fibrillation was defined as new AF that occurred within 30 days after surgery. Our primary outcome was the incidence of stroke at 1 year of follow-up; secondary outcomes were mortality and myocardial infarction (MI). We compared outcomes among patients with and without POAF using multivariable adjusted Cox proportional hazards models. Among 18 117 patients (mean age 69 years, 57.4% male), 404 had POAF (2.2%). The stroke incidence 1 year after surgery was 5.58 vs. 1.54 per 100 patient-years in patients with and without POAF, adjusted hazard ratio (aHR) 3.43, 95% confidence interval (CI) 2.00-5.90; P

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