MyMedR

Splenectomy in idiopathic thrombocytopaenic purpura

Singh N

Med J Malaysia, 1974 Jun;28(4):257-9.

Fulltext Patient health education--an experiment

Singh N

Med J Malaysia, 1980 Jun;34(4):343-6.

PMID: 7219260

A' brief' of an attempt in integration of health education of patients as a part and parcel of treatment and management in hospitals in Kelantan is outlined. The methodology used in the context of local situation is described, problems and short-comings highlighted, and a few suggestions made including recommendations for further such trial efforts in other hospitals in the country.

Some observations of the typhoid outbreak in Sungai Padang, Perlis

Singh N, Menon V

Med J Malaysia, 1975 Dec;30(2):93-7.

PMID: 1228388

"Catapres in the management of hypertension"

Singh N, Menon V

Med J Malaysia, 1975 Mar;30(3):209-13.

PMID: 1160681

Assessing the role of anti-viper serum in the management of viper bites

Singh N, Menon V

Med J Malaysia, 1973 Sep;28(1):47-9.

PMID: 4273785

LABORATORY CONTROL OF ANTICOAGULANT THERAPY

LAU KS, SINGH N

Med J Malaysia, 1963 Dec;18:107-15.

PMID: 14117278

Mesenteric bones: Intra-abdominal heterotopic ossification

Michael A, Narasimman S, Jasjit Singh N

Med J Malaysia, 2018 04;73(2):110-111.

PMID: 29703875 MyJurnal

Intra-abdominal heterotopic ossification usually develops after abdominal surgery and can cause complications such as bowel obstruction and even intestinal perforation. Bisphosphonates, NSAIDs and even local radiation is used as prophylaxis or treatment. Surgeons must consider heterotopic ossification and its complications as a differential when managing complex polytrauma patients with suspicious radiographic densities.

Fulltext Subungual Glomus Tumours: Is Magnetic Resonance Imaging or Ultrasound Necessary for Diagnosis?

Pandey CR, Singh N, Tamang B

Malays Orthop J, 2017 Mar;11(1):47-51.

PMID: 28435574 DOI: 10.5704/MOJ.1703.020

INTRODUCTION: Diagnosis of subungual glomus tumour is mostly based on detailed history and clinical examination. Recently, Magnetic Resonance Imaging (MRI) and Ultrasound have been proposed as the imaging modality to confirm the clinical diagnosis and in planning the surgical management of these tumours. However, these imaging modalities are not routinely available in rural setting and also are expensive. Due to these limitations, we set out to establish that diagnosis and management of these rare tumours can be based solely on a battery of clinical tests and history taking.

MATERIALS AND METHODS: Retrospectively, we reviewed nine cases of glomus tumour. A clinical evaluation proforma was developed on the basis of clinical history and specific clinical test for diagnosis of these tumours. All the cases were evaluated and treated surgically by a single surgeon with a specific technique. Post-operatively, diagnosis was confirmed by histopathological examination.

RESULTS: Females (77.78%) were predominantly affected in this series and the tumours commonly occurred in the right hand (66.66%). Spontaneous pain, cold sensitivity test and Love's Pin test was positive in all cases (100%). Hildreth's test was positive in 88.89%. In none of the cases the tumours recurred during minimum follow-up of one year. In all cases, histopathological examination confirmed the preoperative diagnosis of glomus tumours.

CONCLUSION: Diagnosis of glomus tumours can be made clinically based on history taking and clinical examination. Magnetic Resonance Imaging and Ultrasound are not necessary for diagnosis and management of typical subungual tumours.

Fulltext Scranton Type V Osteochondral Defects of Talus: Does one-stage Arthroscopic Debridement, Microfracture and Plasma Rich in Growth Factor cause the Healing of Cyst and Cessation of Progression to Osteoarthritis?

Singh N, Pandey CR, Tamang B, Singh R

Malays Orthop J, 2020 Jul;14(2):64-71.

PMID: 32983379 DOI: 10.5704/MOJ.2007.014

Introduction: The study was conducted to evaluate the efficacy of arthroscopic debridement, microfracture and plasma rich in growth factor (PRGF) injection in the management of type V (Scranton) osteochondral lesions of talus and its role in healing the subchondral cyst and cessation of progression of ankle osteoarthritis.

Material and Methods: This is a prospective case series conducted on patients who were diagnosed with type V osteochondral lesions of talus. All the cases were treated with arthroscopic debridement, microfracture, and PRGF injections. The patients were evaluated for the healing of subchondral cysts and progression of osteoarthritis with radiography (plain radiographs and computerised tomography Scan). Also, the patients' outcome was evaluated with Quadruple Visual Analogue Scale, Ankle Range of Motion, Foot and Ankle Disability Index, Foot and Ankle Outcome Instrument and a Satisfaction Questionnaire.

Results: Five male patients underwent arthroscopic debridement, microfracture and PRGF injection for type V osteochondral lesion of talus. The mean age of patients was 27.4 years (19-47 years). All the patients gave history of minor twisting injury. Subchondral cyst healing was achieved in all patients by six months post-surgery. However, four out of five patients had developed early osteoarthritic changes of the ankle by their last follow-up [mean follow-up 29 months (ranged 15-36 months)]. Despite arthritic changes, all the patients reported 'Good' to 'Excellent' results on satisfaction questionnaire and Foot and Ankle Disability Index and could perform their day to day activities including sports.

Conclusion: Arthroscopic debridement, microfracture, and PRGF causes healing of the subchondral cyst but does not cause cessation of progression to osteoarthritis of ankle in type V osteochondral defects of talus. However, despite progress to osteoarthritis, patient satisfaction post-procedure is good to excellent at short-term follow-up.

Bilateral orbital cellulitis due to Neisseria gonorrhoeae and Staphylococcus aureus: a previously unreported case

Raja NS, Singh NN

J Med Microbiol, 2005 Jun;54(Pt 6):609-611.

PMID: 15888472 DOI: 10.1099/jmm.0.46031-0

Cellulitis of the orbit is a common cause of proptosis in children, and also frequently arises in the elderly and the immunocompromised. The condition is characterized by infection and swelling of the soft tissues lining the eye socket, pushing the eye ball outwards and causing severe pain, redness, discharge of pus and some degree of blurred vision. There is a small risk of infection spreading to the meninges of the brain and causing meningitis. This paper reports the case of an adult in whom polymicrobial bilateral orbital cellulitis had developed due to Staphylococcus aureus and Neisseria gonorrhoeae infection. N. gonorrhoeae infections are acquired by sexual contact. Although the infection may disseminate to a variety of tissues, it usually affects the mucous membranes of the urethra in males and the endocervix and urethra in females. To the authors' knowledge this is the first report of polymicrobial bilateral orbital cellulitis due to S. aureus and N. gonorrhoeae in medical literature.

Fulltext Formulation development and optimization of sustained release matrix tablet of Itopride HCl by response surface methodology and its evaluation of release kinetics

Bose A, Wong TW, Singh N

Saudi Pharm J, 2013 Apr;21(2):201-13.

PMID: 23960836 DOI: 10.1016/j.jsps.2012.03.006

The objective of this present investigation was to develop and formulate sustained release (SR) matrix tablets of Itopride HCl, by using different polymer combinations and fillers, to optimize by Central Composite Design response surface methodology for different drug release variables and to evaluate drug release pattern of the optimized product. Sustained release matrix tablets of various combinations were prepared with cellulose-based polymers: hydroxy propyl methyl cellulose (HPMC) and polyvinyl pyrolidine (pvp) and lactose as fillers. Study of pre-compression and post-compression parameters facilitated the screening of a formulation with best characteristics that underwent here optimization study by response surface methodology (Central Composite Design). The optimized tablet was further subjected to scanning electron microscopy to reveal its release pattern. The in vitro study revealed that combining of HPMC K100M (24.65 MG) with pvp(20 mg)and use of LACTOSE as filler sustained the action more than 12 h. The developed sustained release matrix tablet of improved efficacy can perform therapeutically better than a conventional tablet.

Fulltext Melioidosis: an emerging infectious disease

Raja NS, Ahmed MZ, Singh NN

J Postgrad Med, 2005 Apr-Jun;51(2):140-5.

PMID: 16006713

Infectious diseases account for a third of all the deaths in the developing world. Achievements in understanding the basic microbiology, pathogenesis, host defenses and expanded epidemiology of infectious diseases have resulted in better management and reduced mortality. However, an emerging infectious disease, melioidosis, is becoming endemic in the tropical regions of the world and is spreading to non-endemic areas. This article highlights the current understanding of melioidosis including advances in diagnosis, treatment and prevention. Better understanding of melioidosis is essential, as it is life-threatening and if untreated, patients can succumb to it. Our sources include a literature review, information from international consensus meetings on melioidosis and ongoing discussions within the medical and scientific community.

Oliva vidua fulminans, a marine mollusc, responsible for five fatal cases of neurotoxic food poisoning in Sabah, Malaysia

Kan SK, Singh N, Chan MK

Trans R Soc Trop Med Hyg, 1986;80(1):64-5.

PMID: 3727000

This is the first report in which a marine mollusc, Oliva vidua fulminans (olives), generally not known to be poisonous, was responsible for death in five children after consuming boiled olives with tamarind. The onset of symptoms was rapid 10 to 20 min after consumption of the olives. Signs and symptoms included nausea, vomiting, abdominal pain, tingling sensation around the lips, numbness around the mouth, drowsiness, lethargy and generalized weakness with paraesthesia in the limbs. The five deaths occurred within 3 to 4 hours after eating the poisoned olives and resulted from respiratory failure. Left-over olives from the affected household and freshly collected live olives had a toxicity of 14,200 mouse units (M.U.) and 15,000 M.U. per 100 g meat respectively. No other common chemical poison and organophosphorus insecticides were detected. The neurotoxic agent was acid and heat stable and was toxic at pH less than 4. Its action was similar to that of paralytic shellfish poisoning which was caused by toxins from certain dinoflagellates.

A new species of genus Nishada Moore, 1878 (Lepidoptera, Erebidae, Arctiinae) from India

Joshi R, Kirti JS, Singh N

Zootaxa, 2016 Oct 28;4179(1):128-132.

PMID: 27811698 DOI: 10.11646/zootaxa.4179.1.10

Genus Nishada Moore (1878) was proposed as a monotypic genus, under subfamily Lithosiinae, family Lithosiidae (now Lithosiini), including only Nishada flabrifera Moore (1878) from Calcutta (now as Kolkata), India. The genus is distributed from China to India, Thailand, Malaysia and up to Australia. The Indian fauna of Nishada is reported from North-East Himalayas, West Bengal (Kolkata) and South India. Members of this genus are unmarked, yellow to brown with short and broad wings. Genus Nishada has been taxonomically dealt by many authors but awaits thorough revision.

HISTORY: Hampson (1900) included a total of ten species: Nishada niveola Hampson, 1900, Nishada syntomioides (Walker, 1862), Nishada impervia (Walker, 1865), Nishada marginalis (Felder 1875), Nishada tula Swinhoe, 1900, Nishada nodicornis (Walker 1862), Nishada rotundipennis (Walker 1862), Nishada flabrifera Moore, 1878, Nishada sambara (Moore 1859) and Nishada xantholoma (Snellen 1879). Swinhoe (1902) and Hampson (1911) then described two new species, Nishada melanistis and Nishada brunneipennis, respectively, followed by Rothschild (1912, 1913) who described a further seven new species, Nishada brunnea, Nishada flavens, Nishada testacea, Nishada griseoflava, Nishada fuscofascia, Nishada louisiadensis and Nishada aurantiaca, bringing the total to 19 species. Strand (1922) catalogued only 13 of these species in Nishada, transferring N. brunnea and N. fuscofascia to genus Scoliacma Meyrick (1886); N. testacea, N.griseoflava and N. louisiadensis Rothschild to Eilema Hübner (1819) and synonymising N. flavens with N. sambara. Next, Matsumura (1927) described N. formosibia, followed by two more species, N. aureocincta Debauche, 1938 and N. benjaminea Roepke, 1946. Holloway (2001) synonymised N. nodicornis with N. rotundipennis and added the description of a new subspecies, Nishada chilomorpha adunca Holloway, 2001 from Borneo, indicating a distributional range as far as North East India. The nominotypical subspecies, N. c. chilomorpha was suggested to be restricted to its type locality of Java. Bucsek (2012) added Nishada cameronensis, Dubatolov & Bucsek (2013) described Nishada schintlmeisteri and Bucsek (2016) described Nishada temenggora. So, at present, Nishada comprises19 species, of which three are known from India (Singh et al. 2014). Herein, we describe one further species, Nishada pseudochilomorpha Joshi & Singh sp. nov., from Jatinga (Assam, India). In addition, new distributional records are reported for N. flabrifera.

Fulltext Status of insecticide resistance in An. culicifacies in Gadchiroli (Maharashtra) India

Chand G, Behera P, Bang A, Singh N

Pathog Glob Health, 2017 Oct;111(7):362-366.

PMID: 28971738 DOI: 10.1080/20477724.2017.1378836

An. culicifacies is the major vector of malaria in tribal community and tribal dominated areas in India. Development of resistance to insecticides is the major challenge to curb the transmission. Gadchiroli (Maharashtra) is a tribal district in central India where incidence of malaria increased from 2012 to 2015 despite indoor space spray with synthetic pyrethroids. To determine the susceptibility status of An. culicifacies against commonly used insecticides in public health program in Gadchiroli. standard WHO method and test kit were used. The insecticide impregnated papers were procured from vector control unit Malaysia. An. culicifacies found resistance to three major groups of pesticides i.e. organochlorine (DDT 4%), organophosphorous (Malathion 5%) and pyrethroids (Cyfluthrin 0.15%, Deltametherin 0.05% and Lambdacyhalothrin 0.05%). The susceptibility status in Permethrin 0.75% needs further confirmation. Development of resistance to different insecticides of varied groups is an adverse finding for the elimination of malaria, explaining the recent increase in malaria incidence in Gadchiroli. The phenomenon further needs to be studied in different locations and the susceptibility needs to test against other insecticides. The findings may have significant implications to the choice of insecticides in the malaria control program in tribal areas.

Attenuation of Nerve Agent Induced Neurodegenerative and Neuroinflammatory Changes in Rats with New Combination Treatment of Galantamine, Atropine and Midazolam

Singh N, Golime R, Kumar A, Roy T

Mol Neurobiol, 2025 Jan;62(1):461-474.

PMID: 38867111 DOI: 10.1007/s12035-024-04294-2

Acute nerve agent exposure can kill a person within minutes or produce multiple neurotoxic effects and subsequent brain damage with potential long-term adverse outcomes. Recent abuse of nerve-agents on Syrian civilians, during Japan terrorist attacks, and personal assassinations in the UK, and Malaysia indicate their potential threat to world population. Existing nerve agent antidotes offer only incomplete protection especially, if the treatment is delayed. To develop the effective drugs, it is advantageous to elucidate the underlying mechanisms of nerve agent-induced multiple neurological impairments. This study aimed to investigate the molecular basis of neuroinflammation during nerve agent toxicity with focus on inflammasome-associated proteins and neurodegeneration. In rats, NOD-like receptor family pyrin domain containing 3 (NLRP3), and glial fibrillary acidic protein (GFAP) immunoreactivity levels were considerably increased in the hippocampus, piriform cortex, and amygdala areas after single subcutaneous soman exposure (90 µg/kg-1). Western analysis indicated a notable increase in the neuroinflammatory indicator proteins, high mobility group box 1 (HMGB1) and inducible nitric oxide synthase (iNOS) levels. The presence of fluorojade-C-stained degenerating neurons in distinct rat brain areas is indicating the neurodegeneration during nerve agent toxicity. Pre-treatment with galantamine (3 mg/kg, - 30 min) followed by post-treatment of atropine (10 mg/kg, i.m.) and midazolam (5 mg/kg, i.m.), has completely protected animals from death induced by supra-lethal dose of soman (2XLD50) and reduced the neuroinflammatory and neurodegenerative changes. Results highlight that this new prophylactic and therapeutic drug combination might be an effective treatment option for soldiers deployed in conflict areas and first responders dealing with accidental/deliberate release of nerve agents.

Fulltext Candida sake--a rare cause of fungal endocarditis

Anuradha S, Agarwal SK, Prakash A, Singh NP, Kaur R

Med J Malaysia, 2008 Mar;63(1):75-6.

PMID: 18935744

Fulltext Successful pregnancy in untreated limited Wegener's granulomatosis

Sahni V, Agarwal SK, Singh NP, Sikdar S, Yadav A, Wadhwa A, et al.

Med J Malaysia, 2005 Oct;60(4):492-4.

PMID: 16570714

A thirty four year old female presented with upper and lower respiratory symptoms in the third trimester of pregnancy. After the delivery of a healthy baby, the symptoms progressed to involve multiple organ systems and eventually a diagnosis of limited Wegener's Granulomatosis (Carrington-Liebow syndrome) was made. The extremely rare combination of WG and pregnancy, especially the onset of disease in late pregnancy is discussed. The successful outcome of pregnancy even without treatment of WG is the highlight of the case.

Evaluation of a rapid test for the detection of antibodies to human immunodeficiency virus type 1 and 2

Ng KP, Saw TL, Baki A, He J, Singh N, Lyles CM

Int J STD AIDS, 1999 Jun;10(6):401-4.

PMID: 10414883

Hema-Strip HIV-1/2 is a one-step rapid test for the detection of anti-HIV-1/2 antibodies in whole blood. The test requires no expensive equipment and the results are available within 10-15 min. Using 72 known HIV-1 positive samples and 780 high-risk prisoners, the sensitivity and specificity of Hema-Strip HIV-1/2 was found to be comparable to microparticle enzyme immunoassay (MEIA). The data also indicated that Hema-Strip HIV-1/2 is an effective alternate testing system to conventional ELISA where the use of ELISA is not suitable and the result of the HIV testing is needed urgently.

Fulltext Extensive crescent formation in idiopathic membranous glomerulonephritis. A case report

Cheong IK, Chong SM, Singh N, Suleiman AB

Med J Malaysia, 1981 Mar;36(1):8-10.

PMID: 7321940

We report this 21 years old Indian male with the nephrotic syndrome due to membranous nephropathy who later developed numerous epithelial crescents leading to a rapid loss of renal function. The pathogenesis of the crescentic transformation in this type of glomerulopathy is discussed.

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