abid rajah - Academia.edu (original) (raw)

Papers by abid rajah

Research paper thumbnail of Eltanolone for induction of anaesthesia and to supplement nitrous oxide for minor gynaecological surgery

We have used eltanolone to induce anaesthesia and by intermittent injection to supplement nitrous... more We have used eltanolone to induce anaesthesia and by intermittent injection to supplement nitrous oxide during maintenance in 50 patients undergoing minor gynaecological surgery; opioids were not used. Induction of anaesthesia was remarkably trouble free and achieved with a single dose of 0.5 mg.kg−1 in 90% of patients. Pain on injection was not a feature. Satisfactory anaesthesia was achieved in 84% of patients; eight required addition ofisoflurane. There were minimal cardiovascular changes and apnoea on induction occurred in only one patient. Recovery times were acceptable.

Research paper thumbnail of Acute Lung Injury And Acute Respiratory Distress Syndrome: A Review Article

British Journal of Medical Practitioners, 2010

Acute lung injury is a syndrome with a diagnostic criteria base on hypoxaemia and a classical rad... more Acute lung injury is a syndrome with a diagnostic criteria base on hypoxaemia and a classical radiological appearance, with acute respiratory distress syndrome at the severe end of the disease spectrum. Its incidence is common, it is likely to exist outside the intensive care setting and therefore is a condition relevant to all clinicians. Genetically predisposed individuals are subject to environmental triggers which can be intra or extrapulmonary in nature. An inflammatory response causes damage to alveolar epithelial cells and vasculature, impairing gas exchange and can lead to multiple organ failure. Management centres around supportive care and treating the cause, but evidence supports use of low tidal volume ventilatory settings and conservative intravenous fluid strategies. Long term outcomes are related to neuromuscular, cognitive and psychological issues rather than pulmonary, and rehabilitation during recovery needs to focus on this. Acute Lung Injury (ALI) is a continuum ...

Research paper thumbnail of Non-barbiturate drugs for the induction and maintenance of anaesthesia

Intravenous induction of anaesthesia is now universally accepted, and the gold standard against w... more Intravenous induction of anaesthesia is now universally accepted, and the gold standard against which all drugs that are used for this purpose must be compared is thiopentone. This is despite early problems that occurred with this agent, which resulted from ignorance of its profound cardiorespiratory depressant effects, particularly when it was used as the sole anaesthetic. Even in more modern times it has been described as ~... perhaps the most dangerous drug available in modern medicine' (Dundee, 1979), yet it remains the most commonly used intravenous anaesthetic. Anaesthetists are fully aware of the properties of thiopentone and probably its most unique feature is its predictability. Indeed, apart from porphyria, it is true to say that there is a safe dose for everyone. Nevertheless, thiopentone has a number of drawbacks, and manufacturers continue to search for new agents. It is highly alkaline and extremely irritant if injected extravascularly or intra-arterially. Cardiorespiratory depression demands judicious use, especially in sick patients and in those with cardiovascular disease. It has no analgesic properties and actually increases sensitivity to somatic pain. Termination of its action is due to redistribution away from the brain, so that cumulation is a major problem on repeat administration and it is unsuitab'le for use by continuous infusion except when given by complicated computer-controlled systems in an exponential fashion. The delayed recovery to 'street' fitness is not acceptable for outpatient anaesthesia. Thiopentone also has a low therapeutic index. A number of non-barbiturate drugs have been introduced in an attempt to overcome the undesirable properties of thiopentone, but some have made only brief appearances. The eugenol derivative propanidid was associated with rapid recovery, but there was an unacceptable incidence of allergic reactions to its sotubilizing agent, Cremophor EL. Steroid anaesthetics have a high therapeutic index, but three have been withdrawn; hydroxydione because of a high incidence of thrombophlebitis, minaxolone as a result of problems related to long-term toxicological testing, and Althesin (alphaxalone/alphadolone), which had been described as approaching the ideal intravenous anaesthetic, because of problems with its vehicle, again Cremophor EL.

Research paper thumbnail of Eltanolone for induction of anaesthesia and to supplement nitrous oxide for minor gynaecological surgery

Anaesthesia, 2007

We have used eltanolone to induce anaesthesia and by intermittent injection to supplement nitrous... more We have used eltanolone to induce anaesthesia and by intermittent injection to supplement nitrous oxide during maintenance in 50 patients undergoing minor gynaecological surgery; opioids were not used. Induction of anaesthesia was remarkably trouble free and achieved with a single dose of 0.5 mg.kg-' in 90% of patients. Pain on injection was not a feature. Satisfactory anaesthesia was achieved in 84% of patients; eight required addition of isojlurane. There were minimal cardiovascular changes and apnoea on induction occurred in only one patient. Recovery times were acceptable.

Research paper thumbnail of The use of diazepam in chloroquine poisoning

Anaesthesia, 1990

A 39-year-oldpatient was found to be unconscious after having taken 2.5 g of chlojoquine. Treatme... more A 39-year-oldpatient was found to be unconscious after having taken 2.5 g of chlojoquine. Treatment consisted mainly ofgastric lavage and diazepam. Experimental and clinical evidence is presented to show that diazepam in varying doses signiJican fly decreases the mortality rate.

Research paper thumbnail of A problem with the TEC 5 vaporizer

Anaesthesia, 1992

ALEXANDER CD, WETCHLER BV, THOMPSON RE. Bupivacaine infiltration of the mesosalpinx in ambulatory... more ALEXANDER CD, WETCHLER BV, THOMPSON RE. Bupivacaine infiltration of the mesosalpinx in ambulatory surgical laparoscopic tubal sterilisation. Canadian Anaesthetbts ' Society

Research paper thumbnail of The use of high-dose intravenous immunoglobulins in Guillain-Barr� syndrome

Anaesthesia, 1992

A patient with severe Guillain-Barré syndrome responded to treatment with high-dose intravenous i... more A patient with severe Guillain-Barré syndrome responded to treatment with high-dose intravenous immunoglobulins. It is suggested, on the basis of recent case reports, that immunoglobulins may have an important rôle in the future treatment of this immune-mediated disease.

Research paper thumbnail of Eltanolone for induction of anaesthesia and to supplement nitrous oxide for minor gynaecological surgery

We have used eltanolone to induce anaesthesia and by intermittent injection to supplement nitrous... more We have used eltanolone to induce anaesthesia and by intermittent injection to supplement nitrous oxide during maintenance in 50 patients undergoing minor gynaecological surgery; opioids were not used. Induction of anaesthesia was remarkably trouble free and achieved with a single dose of 0.5 mg.kg−1 in 90% of patients. Pain on injection was not a feature. Satisfactory anaesthesia was achieved in 84% of patients; eight required addition ofisoflurane. There were minimal cardiovascular changes and apnoea on induction occurred in only one patient. Recovery times were acceptable.

Research paper thumbnail of Acute Lung Injury And Acute Respiratory Distress Syndrome: A Review Article

British Journal of Medical Practitioners, 2010

Acute lung injury is a syndrome with a diagnostic criteria base on hypoxaemia and a classical rad... more Acute lung injury is a syndrome with a diagnostic criteria base on hypoxaemia and a classical radiological appearance, with acute respiratory distress syndrome at the severe end of the disease spectrum. Its incidence is common, it is likely to exist outside the intensive care setting and therefore is a condition relevant to all clinicians. Genetically predisposed individuals are subject to environmental triggers which can be intra or extrapulmonary in nature. An inflammatory response causes damage to alveolar epithelial cells and vasculature, impairing gas exchange and can lead to multiple organ failure. Management centres around supportive care and treating the cause, but evidence supports use of low tidal volume ventilatory settings and conservative intravenous fluid strategies. Long term outcomes are related to neuromuscular, cognitive and psychological issues rather than pulmonary, and rehabilitation during recovery needs to focus on this. Acute Lung Injury (ALI) is a continuum ...

Research paper thumbnail of Non-barbiturate drugs for the induction and maintenance of anaesthesia

Intravenous induction of anaesthesia is now universally accepted, and the gold standard against w... more Intravenous induction of anaesthesia is now universally accepted, and the gold standard against which all drugs that are used for this purpose must be compared is thiopentone. This is despite early problems that occurred with this agent, which resulted from ignorance of its profound cardiorespiratory depressant effects, particularly when it was used as the sole anaesthetic. Even in more modern times it has been described as ~... perhaps the most dangerous drug available in modern medicine' (Dundee, 1979), yet it remains the most commonly used intravenous anaesthetic. Anaesthetists are fully aware of the properties of thiopentone and probably its most unique feature is its predictability. Indeed, apart from porphyria, it is true to say that there is a safe dose for everyone. Nevertheless, thiopentone has a number of drawbacks, and manufacturers continue to search for new agents. It is highly alkaline and extremely irritant if injected extravascularly or intra-arterially. Cardiorespiratory depression demands judicious use, especially in sick patients and in those with cardiovascular disease. It has no analgesic properties and actually increases sensitivity to somatic pain. Termination of its action is due to redistribution away from the brain, so that cumulation is a major problem on repeat administration and it is unsuitab'le for use by continuous infusion except when given by complicated computer-controlled systems in an exponential fashion. The delayed recovery to 'street' fitness is not acceptable for outpatient anaesthesia. Thiopentone also has a low therapeutic index. A number of non-barbiturate drugs have been introduced in an attempt to overcome the undesirable properties of thiopentone, but some have made only brief appearances. The eugenol derivative propanidid was associated with rapid recovery, but there was an unacceptable incidence of allergic reactions to its sotubilizing agent, Cremophor EL. Steroid anaesthetics have a high therapeutic index, but three have been withdrawn; hydroxydione because of a high incidence of thrombophlebitis, minaxolone as a result of problems related to long-term toxicological testing, and Althesin (alphaxalone/alphadolone), which had been described as approaching the ideal intravenous anaesthetic, because of problems with its vehicle, again Cremophor EL.

Research paper thumbnail of Eltanolone for induction of anaesthesia and to supplement nitrous oxide for minor gynaecological surgery

Anaesthesia, 2007

We have used eltanolone to induce anaesthesia and by intermittent injection to supplement nitrous... more We have used eltanolone to induce anaesthesia and by intermittent injection to supplement nitrous oxide during maintenance in 50 patients undergoing minor gynaecological surgery; opioids were not used. Induction of anaesthesia was remarkably trouble free and achieved with a single dose of 0.5 mg.kg-' in 90% of patients. Pain on injection was not a feature. Satisfactory anaesthesia was achieved in 84% of patients; eight required addition of isojlurane. There were minimal cardiovascular changes and apnoea on induction occurred in only one patient. Recovery times were acceptable.

Research paper thumbnail of The use of diazepam in chloroquine poisoning

Anaesthesia, 1990

A 39-year-oldpatient was found to be unconscious after having taken 2.5 g of chlojoquine. Treatme... more A 39-year-oldpatient was found to be unconscious after having taken 2.5 g of chlojoquine. Treatment consisted mainly ofgastric lavage and diazepam. Experimental and clinical evidence is presented to show that diazepam in varying doses signiJican fly decreases the mortality rate.

Research paper thumbnail of A problem with the TEC 5 vaporizer

Anaesthesia, 1992

ALEXANDER CD, WETCHLER BV, THOMPSON RE. Bupivacaine infiltration of the mesosalpinx in ambulatory... more ALEXANDER CD, WETCHLER BV, THOMPSON RE. Bupivacaine infiltration of the mesosalpinx in ambulatory surgical laparoscopic tubal sterilisation. Canadian Anaesthetbts ' Society

Research paper thumbnail of The use of high-dose intravenous immunoglobulins in Guillain-Barr� syndrome

Anaesthesia, 1992

A patient with severe Guillain-Barré syndrome responded to treatment with high-dose intravenous i... more A patient with severe Guillain-Barré syndrome responded to treatment with high-dose intravenous immunoglobulins. It is suggested, on the basis of recent case reports, that immunoglobulins may have an important rôle in the future treatment of this immune-mediated disease.