MyMedR

Fulltext Evaluation of the severity and monitoring the progress of treatment of idiopathic congenital Talipes Equinovarus by Ponseti method

Vignesh, R., Theingi, M.M., Soe, San, Ooi, P.C., Ma, Nwet

Asian Journal of Medicine and Health Sciences, 2019;2(1):38-46.

MyJurnal

Introduction: Congenital talipes equinovarus (CTEV), commonly known as the ‘club foot’ is a developmental disorder of the lower limb that is related with socioeconomic difficulties. Ponseti method is considered as the most popular and successful method of treatment for CTEV children. This study was aimed to evaluate the severity and monitoring the progress of initial treatment of CTEV children.

Materials and methods: Forty two patients with 58 idiopathic CTEV feet treated at a hospital outpatient clinic from January 2017 to February 2018 were included in the study. Ponseti method and Pirani score system were used and the results were calculated after wearing brace for three months duration at the end of serial casting.

Results: The patients in the study were in the age range of 14 days to 12 months. The mean number of changing of casting was 7.2 times. Casts were changed 1.9 times more in the severe cases than mild cases. Thirty six (85.7%) cases needed percutaneous tenotomy. There was no need to perform tenotomy for the mild cases. The initial achievement rate was 90.5 % and there were 9.5 % relapsed cases because of incorrect wearing of the brace. Statistically significant score differences were seen before and after treatment (P-value

Fulltext Genotyping of Toxoplasma gondii isolates from wild boars in Peninsular Malaysia

Puvanesuaran VR, Noordin R, Balakrishnan V

PLoS One, 2013;8(4):e61730.

PMID: 23613920 DOI: 10.1371/journal.pone.0061730

Toxoplasma gondii is a parasitic protozoan that infects nearly one-third of the world population. The present study was done to isolate and genotype T. gondii from wild boar from forests of Pahang, Malaysia. A total of 30 wild boars' blood, heads and hearts were obtained for this study and 30 (100.0%) were found to be seropositive when assayed with modified agglutination test (MAT ≥ 6). The positive samples were inoculated into mice and T. gondii was only isolated from samples that had strong seropositivity (MAT ≥ 1:24).The isolates were subjected to PCR-RFLP analysis and all the Peninsular Malaysia isolates of T. gondii are of clonal type I.

Isolation and genotyping of Toxoplasma gondii from free-range ducks in Malaysia

Puvanesuaran VR, Noordin R, Balakrishnan V

Avian Dis, 2013 Mar;57(1):128-32.

PMID: 23678741

Toxoplasma gondii is a parasitic protozoan that infects nearly one-third of humans. The present study was performed to isolate and genotype T. gondii from free-range ducks in Malaysia. Sera, heads, and hearts from 205 ducks were obtained from four states in Peninsular Malaysia, and 30 (14.63%) sera were found to be seropositive when assayed with the modified agglutination test (MAT > or = 1:6). All the positive samples were inoculated into mice, and T. gondii was successfully isolated from four individual duck samples (1.95%), which were initially found to be strongly seropositive (MAT > or = 1:24). The isolates were subjected to PCR-RFLP analysis, and two T. gondii strains were identified: type I and type II. This is the first reported study on the genetic characterization of T. gondii isolates from free-range farm animals in Southeast Asia.

Fulltext Thalidomide as a Potential HIV Latency Reversal Agent: Is It the Right Time to Forget the Ancestral Sins?

Vignesh R, Shankar EM

EBioMedicine, 2017 Oct;24:20-21.

PMID: 28865747 DOI: 10.1016/j.ebiom.2017.08.025

A Tête-à-tête with ChatGPT on the impact of artificial intelligence in medical education

Vignesh R, Pradeep P, Balakrishnan P

Med J Malaysia, 2023 Jul;78(4):547-549.

PMID: 37518931

Chat Generative Pre-Trained Transformer (ChatGPT) is an artificial intelligence (AI) language model developed by OpenAI. It is trained to process vast amounts of text and engage in human-like conversational interaction with users. Being accessible by all, it is widely used and its capabilities range from language translation, summarising long texts and creative writing. This article explores the potential role of ChatGPT in medical education and the possible concerns about the misuse of this technology through a conversation with ChatGPT itself via text prompts. The implications of this technology in medical education as told by ChatGPT are interesting and seemingly helpful for both the students and the tutors. However, this could be a double-edged sword considering the risks of compromised students' integrity and concerns of over-reliance. This also calls for counter strategies and policies in place to mitigate these risks.

Recent advances on T-cell exhaustion in malaria infection

Shankar EM, Vignesh R, Dash AP

Med Microbiol Immunol, 2018 Aug;207(3-4):167-174.

PMID: 29936565 DOI: 10.1007/s00430-018-0547-0

T-cell exhaustion reportedly leads to dysfunctional immune responses of antigen-specific T cells. Investigations have revealed that T cells expand into functionally defective phenotypes with poor recall/memory abilities to parasitic antigens. The exploitation of co-inhibitory pathways represent a highly viable area of translational research that has very well been utilized against certain cancerous conditions. Malaria, at times, evolve into a sustained chronic state where T cells express several co-inhibitory molecules (negative immune checkpoints) facilitating parasite escape and sub-optimal protective responses. Experimental evidence suggests that blockade of co-inhibitory molecules on T cells in malaria could result in the sustenance of protective responses together with dramatic parasite clearance. The role of several co-inhibitory molecules in malaria infection largely remain unclear, and here we discussed the potential applicability of co-inhibitory molecules in the management of malaria with a view to harness protective host responses against chronic disease and associated consequences.

Fulltext Could Nutraceutical Approaches Possibly Attenuate the Cytokine Storm in COVID-19 Patients?

Vignesh R, Velu V, Sureban SM

Front Cell Infect Microbiol, 2021;11:667733.

PMID: 33968808 DOI: 10.3389/fcimb.2021.667733

Fulltext Updates on Dengue Vaccine and Antiviral: Where Are We Heading?

Norshidah H, Vignesh R, Lai NS

Molecules, 2021 Nov 09;26(22).

PMID: 34833860 DOI: 10.3390/molecules26226768

Approximately 100-400 million people from more than 100 countries in the tropical and subtropical world are affected by dengue infections. Recent scientific breakthroughs have brought new insights into novel strategies for the production of dengue antivirals and vaccines. The search for specific dengue inhibitors is expanding, and the mechanisms for evaluating the efficacy of novel drugs are currently established, allowing for expedited translation into human trials. Furthermore, in the aftermath of the only FDA-approved vaccine, Dengvaxia, a safer and more effective dengue vaccine candidate is making its way through the clinical trials. Until an effective antiviral therapy and licensed vaccine are available, disease monitoring and vector population control will be the mainstays of dengue prevention. In this article, we highlighted recent advances made in the perspectives of efforts made recently, in dengue vaccine development and dengue antiviral drug.

Fulltext Infectious risk assessment of unsafe handling practices and management of clinical solid waste

Hossain MS, Rahman NN, Balakrishnan V, Puvanesuaran VR, Sarker MZ, Kadir MO

Int J Environ Res Public Health, 2013 Jan 31;10(2):556-67.

PMID: 23435587 DOI: 10.3390/ijerph10020556

The present study was undertaken to determine the bacterial agents present in various clinical solid wastes, general waste and clinical sharp waste. The waste was collected from different wards/units in a healthcare facility in Penang Island, Malaysia. The presence of bacterial agents in clinical and general waste was determined using the conventional bacteria identification methods. Several pathogenic bacteria including opportunistic bacterial agent such as Pseudomonas aeruginosa, Salmonella spp., Klebsiella pneumoniae, Serratia marcescens, Acinetobacter baumannii, Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecalis, Streptococcus pyogenes were detected in clinical solid wastes. The presence of specific pathogenic bacterial strains in clinical sharp waste was determined using 16s rDNA analysis. In this study, several nosocomial pathogenic bacteria strains of Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Lysinibacillus sphaericus, Serratia marcescens, and Staphylococcus aureus were detected in clinical sharp waste. The present study suggests that waste generated from healthcare facilities should be sterilized at the point of generation in order to eliminate nosocomial infections from the general waste or either of the clinical wastes.

High prevalence of poor sleep quality among secondary school students in Malaysia

Vignesh R, Ganesh SS, Vengata Subramani M, Ravindran M, Abdul Karim RH

Med J Malaysia, 2018 12;73(6):444.

PMID: 30647230

No abstract provided.

Fulltext Is Herd Immunity Against SARS-CoV-2 a Silver Lining?

Vignesh R, Shankar EM, Velu V, Thyagarajan SP

Front Immunol, 2020;11:586781.

PMID: 33101320 DOI: 10.3389/fimmu.2020.586781

Fulltext Recent advances in HIV diagnostics: Point-of-care CD4 + T-cell count & viral load assays

Balakrishnan P, Saravanan S, Vignesh R, Shankar EM

Indian J Med Res, 2023 Nov 01;158(5&6):447-450.

PMID: 38063301 DOI: 10.4103/ijmr.ijmr_1616_23

Fulltext Chromogenic agar medium for rapid detection of extended-spectrum β-lactamases and Klebsiella pneumoniae carbapenemases producing bacteria from human immunodeficiency virus patients

Rameshkumar MR, Vignesh R, Swathirajan CR, Balakrishnan P, Arunagirinathan N

J Res Med Sci, 2015 Dec;20(12):1219-20.

PMID: 26958061 DOI: 10.4103/1735-1995.172994

Fulltext Performance of urinalysis tests in screening for significant bacteriuria among human immunodeficiency virus-infected subjects in South India

Vignesh R, Swathirajan CR, Solomon SS, Solomon S, Balakrishnan P

J Res Med Sci, 2017;22:77.

PMID: 28717374 DOI: 10.4103/jrms.JRMS_567_16

Fulltext Recent advances targeting innate immunity-mediated therapies against HIV-1 infection

Shankar EM, Velu V, Vignesh R, Vijayaraghavalu S, Rukumani DV, Sabet NS

Microbiol. Immunol., 2012 Aug;56(8):497-505.

PMID: 22900503 DOI: 10.1111/j.1348-0421.2012.00485.x

Early defence mechanisms of innate immunity respond rapidly to infection against HIV-1 in the genital mucosa. Additionally, innate immunity optimises effective adaptive immune responses against persistent HIV infection. Recent research has highlighted the intrinsic roles of apolipoprotein B mRNA-editing, enzyme-catalytic, polypeptide-like 3G, tripartite motif-containing protein 5, tetherin, sterile α-motif and histidine/aspartic acid domain-containing protein 1 in restricting HIV-1 replication. Likewise, certain endogenously secreted antimicrobial peptides, namely α/β/θ-defensins, lactoferrins, secretory leukocyte protease inhibitor, trappin-2/elafin and macrophage inflammatory protein-3α are reportedly protective. Whilst certain factors directly inhibit HIV, others can be permissive. Interferon-λ3 exerts an anti-HIV function by activating Janus kinase-signal transducer and activator of transcription-mediated innate responses. Morphine has been found to impair intracellular innate immunity, contributing to HIV establishment in macrophages. Interestingly, protegrin-1 could be used therapeutically to inhibit early HIV-1 establishment. Moreover, chloroquine inhibits plasmacytoid dendritic cell activation and improves effective T-cell responses. This minireview summarizes the recently identified targets for innate immunity-mediated therapies and outlines the challenges that lie ahead in improving treatment of HIV infection.

Fulltext Retrospective Analysis of Antibiotic Resistance in Streptococcus spp. from HIV Patients (2012-2017) from Southern India

Swathirajan CR, Rameshkumar MR, Solomon SS, Vignesh R, Balakrishnan P

Adv Biomed Res, 2019;8:1.

PMID: 30775343 DOI: 10.4103/abr.abr_185_18

Performance of point-of-care Xpert HIV-1 plasma viral load assay at a tertiary HIV care centre in Southern India

Swathirajan CR, Vignesh R, Boobalan J, Solomon SS, Saravanan S, Balakrishnan P

J Med Microbiol, 2017 Oct;66(10):1379-1382.

PMID: 28901908 DOI: 10.1099/jmm.0.000514

BACKGROUND: Sustainable suppression of HIV replication forms the basis of anti-retroviral therapy (ART) medication. Thus, reliable quantification of HIV viral load has become an essential factor to monitor the effectiveness of the ART. Longer turnaround-time (TAT), batch testing and technical skills are major drawbacks of standard real-time PCR assays.

METHODS: The performance of the point-of-care Xpert HIV-1 viral load assay was evaluated against the Abbott RealTime PCR m2000rt system. A total of 96 plasma specimens ranging from 2.5 log10 copies ml-1 to 4.99 log10 copies ml-1 and proficiency testing panel specimens were used. Precision and accuracy were checked using the Pearson correlation co-efficient test and Bland-Altman analysis.

RESULTS: Compared to the Abbott RealTime PCR, the Xpert HIV-1 viral load assay showed a good correlation (Pearson r=0.81; P<0.0001) with a mean difference of 0.27 log10 copies ml-1 (95 % CI, -0.41 to 0.96 log10 copies ml-1; sd, 0.35 log10 copies ml-1).

CONCLUSION: Reliable and ease of testing individual specimens could make the Xpert HIV-1 viral load assay an efficient alternative method for ART monitoring in clinical management of HIV disease in resource-limited settings. The rapid test results (less than 2 h) could help in making an immediate clinical decision, which further strengthens patient care.

Changing drug resistance profile in Pseudomonas aeruginosa infection among HIV patients from 2010-2017: A retrospective study

Swathirajan CR, Rameshkumar MR, Solomon SS, Vignesh R, Balakrishnan P

J Glob Antimicrob Resist, 2019 03;16:274-277.

PMID: 30389636 DOI: 10.1016/j.jgar.2018.10.019

OBJECTIVES: Pseudomonas aeruginosa is an important aetiological agent causing pneumonia, urinary tract infections and bacteraemia. High antibiotic use in nosocomial settings and for immunocompromised conditions results in increasing multidrug resistance. This study analysed the antimicrobial resistance profile of P. aeruginosa isolates in an HIV setting.

METHODS: A total of 7386 clinical specimens were collected from HIV patients attending YRG CARE from 2010-2017. P. aeruginosa isolated from clinical specimens were identified conventionally, and antimicrobial susceptibility testing was performed by the Kirby-Bauer disk diffusion method.

RESULTS: A total of 260 P. aeruginosa strains were isolated, with 165 P. aeruginosa (63.5%) being isolated from hospitalised patients. A higher incidence of P. aeruginosa infection (25.8%) was observed in 2017, and most of the P. aeruginosa were isolated from sputum specimens (57.3%). A high level of resistance was noted to ceftazidime (49.6%), followed by ticarcillin (41.5%). Imipenem and meropenem resistance was observed in 15.0% and 16.9% of P. aeruginosa isolates, respectively. A high rate of imipenem resistance was noted in 2016 (46.2%) and a high rate of meropenem resistance was noted in 2017 (20.5%). An increasing resistance rate of P. aeruginosa was observed against aztreonam, cefepime, levofloxacin, meropenem, piperacillin, piperacillin/tazobactam, ticarcillin and tobramycin from 2010 to 2017.

CONCLUSION: A constant increase in drug-resistant P. aeruginosa isolates from HIV patients was observed from 2010 to 2017. Findings from this study urge the need for periodical monitoring and surveillance of the P. aeruginosa resistance profile, especially in hospitalised and immunocompromised patients in resource-limited settings.

Fulltext Tuberculosis-Associated Immune Reconstitution Inflammatory Syndrome-An Extempore Game of Misfiring with Defense Arsenals

Vignesh R, Balakrishnan P, Tan HY, Yong YK, Velu V, Larsson M, et al.

Pathogens, 2023 Jan 29;12(2).

PMID: 36839482 DOI: 10.3390/pathogens12020210

The lethal combination involving TB and HIV, known as "syndemic" diseases, synergistically act upon one another to magnify the disease burden. Individuals on anti-retroviral therapy (ART) are at risk of developing TB-associated immune reconstitution inflammatory syndrome (TB-IRIS). The underlying inflammatory complication includes the rapid restoration of immune responses following ART, eventually leading to exaggerated inflammatory responses to MTB antigens. TB-IRIS continues to be a cause of morbidity and mortality among HIV/TB coinfected patients initiating ART, and although a significant quantum of knowledge has been acquired on the pathogenesis of IRIS, the underlying pathomechanisms and identification of a sensitive and specific diagnostic marker still remain a grey area of investigation. Here, we reviewed the latest research developments into IRIS immunopathogenesis, and outlined the modalities to prevent and manage strategies for better clinical and diagnostic outcomes for IRIS.

Fulltext Assessing the potential of NS2B/NS3 protease inhibitors biomarker in curbing dengue virus infections: In silico vs. In vitro approach

Norshidah H, Leow CH, Ezleen KE, Wahab HA, Vignesh R, Rasul A, et al.

Front Cell Infect Microbiol, 2023;13:1061937.

PMID: 36864886 DOI: 10.3389/fcimb.2023.1061937

An increase in the occurrence of viral infectious diseases is a global concern for human health. According to a WHO report, dengue virus (DENV) is one of the most common viral diseases affecting approximately 400 million people annually, with worsening symptoms in nearly 1% of cases. Both academic and industrial researchers have conducted numerous studies on viral epidemiology, virus structure and function, source and route of infection, treatment targets, vaccines, and drugs. The development of CYD-TDV or Dengvaxia® vaccine has been a major milestone in dengue treatment. However, evidence has shown that vaccines have some drawbacks and limitations. Therefore, researchers are developing dengue antivirals to curb infections. DENV NS2B/NS3 protease is a DENV enzyme essential for replication and virus assembly, making it an interesting antiviral target. For faster hit and lead recognition of DENV targets, methods to screen large number of molecules at lower costs are essential. Similarly, an integrated and multidisciplinary approach involving in silico screening and confirmation of biological activity is required. In this review, we discuss recent strategies for searching for novel DENV NS2B/NS3 protease inhibitors from the in silico and in vitro perspectives, either by applying one of the approaches or by integrating both. Therefore, we hope that our review will encourage researchers to integrate the best strategies and encourage further developments in this area.

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