Most Read Articles
Prof. Cheuk-Chun Szeto, Dr. Winston W. S. Fung, 25 Jan 2018
A 65-year-old lady with a background of type 2 diabetes, hyperlipidaemia and chronic immune thrombocytopenia presented to us with a 2-week history of generalized malaise and myalgia. Shortly after the onset of myalgia, she was noted to have reduced urine output and the urine was described as dark in colour. Her regular medications included prednisolone, danazol, simvastatin, metformin, and human insulin. Upon further questioning, the patient admitted that her compliance to simvastatin and danazol used to be poor. However, she recently started to take both medications regularly after repeated education.
26 Dec 2017
Supplementation with omega-3 fatty acids in combination with rosuvastatin may yield significant reductions in triglycerides and nonhigh-density lipoprotein (HDL) cholesterol as compared with rosuvastatin monotherapy, according to data from the ROMANTIC (rosuvastatin-omacor in residual hypertriglyceridemia) trial.
Jairia Dela Cruz, 26 Jun 2018
The monoclonal antibody denosumab is safe and effective for use in patients on glucocorticoids and at risk of developing fractures, with a recent study showing that the drug performs better than risedronate in increasing bone mineral density (BMD).
Pearl Toh, 20 Mar 2018
Not only does treatment with the PCSK9* inhibitor alirocumab reduces cardiovascular (CV) events along with plunges in LDL-C levels, it was also associated with a reduced risk of all-cause mortality compared with placebo in patient with a recent acute coronary syndrome (ACS) and persistently high cholesterol despite maximal statin therapy, according to top-line results from the ODYSSEY** Outcomes trial.

Adjuvant low-dose intrathecal meperidine cuts incidence of spinal shivering

17 Nov 2017
The opioid epidemic in the US has presented a complicated moral dilemma to doctors when treating potential drug abusers.

Adjuvant intrathecal meperidine in low doses is effective for preventing anaesthesia-associated spinal shivering and reduces the need for rescue analgesics, according to a new meta-analysis.

Pooled data from 21 randomized controlled trials (RCTs), corresponding to 1,535 subjects, showed that adjuvant low-dose meperidine significantly reduced the incidence of shivering compared with controls (risk ratio [RR], 0.31; 95 percent CI, 0.24 to 0.40; p<0.00001). Moreover, relative risk reduction (RRR) was calculated to be 66.1 percent while the absolute RR (ARR) was 29.2 percent.

The effect of adjuvant low-dose intrathecal meperidine on shivering incidence, based on the four-level intensity scale, was examined in 15 RCTs corresponding to 1,198 patients. A meta-analysis of these trials found a preventive effect for grade I (RR, 0.62; 0.41 to 0.94; p=0.02) and II (RR, 0.35; 0.23 to 0.53; p<0.00001) shivering.

The risks for grade III (RR, 0.26; 0.16 to 0.41; p<0.00001) and IV (RR, 0.15; 0.08 to 0.28; p<0.00001) shivering were likewise reduced by the meperidine intervention.

Compared with controls, those who received the meperidine intervention also had a significantly reduced need for intraoperative rescue analgesics (RR, 0.27; 0.12 to 0.64; p=0.003), with RRR and ARR of 73.3 and 10.6 percent, respectively.

In contrast, adjuvant low-dose intrathecal meperidine significantly increased the risk of nausea (RR, 1.84; 1.29 to 2.64; p=0.0009) and vomiting (RR, 2.23; 1.23 to 4.02; p=0.008), but only moderately statistically increased the incidence of pruritus (RR, 2.31; 0.94 to 5.70; p=0.07).

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Most Read Articles
Prof. Cheuk-Chun Szeto, Dr. Winston W. S. Fung, 25 Jan 2018
A 65-year-old lady with a background of type 2 diabetes, hyperlipidaemia and chronic immune thrombocytopenia presented to us with a 2-week history of generalized malaise and myalgia. Shortly after the onset of myalgia, she was noted to have reduced urine output and the urine was described as dark in colour. Her regular medications included prednisolone, danazol, simvastatin, metformin, and human insulin. Upon further questioning, the patient admitted that her compliance to simvastatin and danazol used to be poor. However, she recently started to take both medications regularly after repeated education.
26 Dec 2017
Supplementation with omega-3 fatty acids in combination with rosuvastatin may yield significant reductions in triglycerides and nonhigh-density lipoprotein (HDL) cholesterol as compared with rosuvastatin monotherapy, according to data from the ROMANTIC (rosuvastatin-omacor in residual hypertriglyceridemia) trial.
Jairia Dela Cruz, 26 Jun 2018
The monoclonal antibody denosumab is safe and effective for use in patients on glucocorticoids and at risk of developing fractures, with a recent study showing that the drug performs better than risedronate in increasing bone mineral density (BMD).
Pearl Toh, 20 Mar 2018
Not only does treatment with the PCSK9* inhibitor alirocumab reduces cardiovascular (CV) events along with plunges in LDL-C levels, it was also associated with a reduced risk of all-cause mortality compared with placebo in patient with a recent acute coronary syndrome (ACS) and persistently high cholesterol despite maximal statin therapy, according to top-line results from the ODYSSEY** Outcomes trial.