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Haemoglobin E in Malaya

LEHMAN H, SINGH RB

Nature, 1956 Sep 29;178(4535):695-6.
PMID: 13369502
A case report of Carnitine Palmitoyltransferase deficiency type II

Singh R, Rabi Atul Adawiyah M

Med J Malaysia, 2022 Jan;77(1):98-100.
PMID: 35087004

Carnitine Palmitoyltransferase deficiency type II (CPT II) is a rare metabolic disorder of fatty acid oxidation with an autosomal recessive mode of inheritance. The outcome is usually severe with most of the patients typically passing away in the newborn period. In this report, we share our experience in managing a case of CPT II in a one-day-old term female baby who was delivered at Hospital Sultan Abdul Halim.
Fulltext Haematological and plasma electrolyte changes after long distance running in high heat and humidity

Singh R, Sirisinghe RG

Singapore Med J, 1999 Feb;40(2):84-7.
PMID: 10414164

To investigate the acute effects of an 18 km run on the haematological and plasma electrolyte parameters, in recreational runners under conditions of high temperatures and humidity.
Rehydration with sodium-enriched coconut water after exercise-induced dehydration

Ismail I, Singh R, Sirisinghe RG

Southeast Asian J. Trop. Med. Public Health, 2007 Jul;38(4):769-85.
PMID: 17883020

This crossover study assessed the effectiveness of plain water (PW), sports drink (SD), fresh young coconut water (CW) and sodium-enriched fresh young coconut water (SCW) on whole body rehydration (R) and plasma volume (PV) restoration after exercise-induced dehydration. Ten healthy male subjects ran at 65% of VO2max in an environmental temperature of 32.06 +/- 0.02 degree C with a relative humidity (rh) of 53.32 +/- 0.17% for 90 minutes to lose 3% body weight (BW). During the 2-hour rehydration period, subjects drank, in randomized order, PW, SD, CW or SCW equivalent to 120% of BW lost in three boluses representing 50, 40 and 30% of the fluid lost at 0, 30, and 60 minutes, respectively. In all trials subjects were still somewhat dehydrated even after the 2-hour rehydration period. Indexes of percent rehydration with PW, SD, CW and SCW were 58 +/- 2, 68 +/- 2, 65+/- 2 and 69 +/- 1%, respectively, with significantly better rehydration with SD and SCW. The rehydration indexes for SD and SCW were significantly lower than PW (p < 0.01). PV was restored to euhydration levels after 2 hours of rehydration with SD, CW and SCW but not with PW. The plasma glucose concentration were significantly higher when SD, CW and SCW were ingested. SCW was similar in sweetness to CW and SD but caused less nausea and stomach upset compared to SD and PW. In conclusion, ingesting SCW was as good as ingesting a commercial sports drink for whole body rehydration after exercise-induced dehydration but with better fluid tolerance.
Tinea faciei mimicking lupus erythematosus

Singh R, Bharu K, Ghazali W, Bharu K, Nor M, Kerian K

Cutis, 1994 Jun;53(6):297-8.
PMID: 8070283

The authors describe a case of tinea faciei occurring in a sixteen-year-old boy. The rash was localized to the face and upper chest and resembled a typical photosensitive disorder, resulting in inappropriate treatment for six months. Results of a potassium hydroxide preparation and culture from the surface scale confirmed the clinical diagnosis.
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.
Temporal Patterns of Subjective Experiences and Self-Regulation during Ramadan Fasting among Elite Archers: A Qualitative Analysis

Roy J, Hamidan S, Singh R

Asian J Sports Med, 2011 Sep;2(3):195-204.
PMID: 22375239

Some major competitions (e.g. London Olympics, 2012) are scheduled during the Ramadan fasting month. Little attention has been given to explore the archers' performance related subjective experiences with a qualitative method. Therefore, this study addressed individual archers' subjective experiences within the framework of self-regulation during Ramadan.
Fulltext Gouty wrist arthritis causing carpal tunnel syndrome--a case report

Sikkandar MF, Sapuan J, Singh R, Abdullah S

Med J Malaysia, 2012 Jun;67(3):333-4.
PMID: 23082430

A 63 year old male with a history of gout and hypertension presented with carpal tunnel syndrome. He gave history of bilateral wrist pain associated with numbness over the median nerve distribution of the hand. Tinels sign and Phalens test were positive with no obvious thenar muscle wasting on examination. Tophaceous deposits in the flexor tendons and within the synovium of the wrist joint was seen during surgery and this established gout as the cause of median nerve entrapment in this patient.
Combination of sago and soy-protein supplementation during endurance cycling exercise and subsequent high-intensity endurance capacity

Ghosh AK, Rahaman AA, Singh R

Int J Sport Nutr Exerc Metab, 2010 Jun;20(3):216-23.
PMID: 20601739

The purpose of the study was to investigate whether a combination of sago and soy protein ingested during moderate-intensity cycling exercise can improve subsequent high-intensity endurance capacity compared with a carbohydrate in the form of sago and with a placebo. The participants were 8 male recreational cyclists with age, weight, and VO2max of 21.5 +/- 1.1 yr, 63.3 +/- 2.4 kg, and 39.9 +/- 1.1 ml . kg(-1) . min(-1), respectively. The design of the study was a randomized, double-blind placebo-controlled crossover comprising 60 min of exercise on a cycle ergometer at 60% VO2max followed by a time-to-exhaustion ride at 90% VO2max. The sago feeding provided 60 g of carbohydrate, and the sago-soy combination provided 52.5 g of carbohydrate and 15 g of protein, both at 20-min intervals during exercise. Times to exhaustion for the placebo, sago, and sago-soy supplementations were 4.09 +/- 1.28, 5.49 +/- 1.20, and 7.53 +/- 2.02 min, respectively. Sago-soy supplementation increased endurance by 84% (44-140%; p < .001) and by 37% (15-63%; p < .05) relative to placebo and sago, respectively. The plasma insulin response was elevated above that with placebo during sago and sago-soy supplementations. The authors conclude that a combination of sago and soy protein can delay fatigue during high-intensity cycling.
Minimum level of jumping exercise required to maintain exercise-induced bone gains in female rats

Ooi FK, Singh R, Singh HJ, Umemura Y

Osteoporos Int, 2009 Jun;20(6):963-72.
PMID: 18839049 DOI: 10.1007/s00198-008-0760-6

SUMMARY: This study determines the minimum level of exercise required to maintain 8 weeks of jumping exercise-induced bone gains in rats. It was found that the minimum level of exercise required for maintaining the different exercise-induced bone gains varied between 11% and 18% of the initial exercise intensity.
INTRODUCTION: This study ascertains the minimum level of follow-up exercise required to maintain bone gains induced by an 8-week jumping exercise in rats.
METHODS: Twelve groups of 12-week old rats (n = 10 rats per group) were given either no exercise for 8 (8S) or 32 weeks (32S), or received 8 weeks of standard training program (8STP) that consisted of 200 jumps per week, given at 40 jumps per day for 5 days per week, followed by 24 weeks of exercise at loads of either 40 or 20 or 10 jumps per day, for either 5, or 3, or 1 day/week. Bone mass, strength, and morphometric properties were measured in the right tibia. Data were analyzed using one-way analyses of variance.
RESULTS: Bone mass, strength, mid-shaft periosteal perimeter and cortical area were significantly (p < 0.05) higher in the rats given 8STP than that in the 8S group. The minimal level of exercise required to maintain the bone gains was 31, 36, 25, and 21 jumps per week for mass, strength, periosteal perimeter and cortical area, respectively.
CONCLUSIONS: Eight weeks of jumping exercise-induced bone gains could be maintained for a period of 24 weeks with follow-up exercise consisting of 11% to 18% of the initial exercise load.
Effects of palm vitamin e supplementation on exercise-induced oxidative stress and endurance performance in the heat

Keong CC, Singh HJ, Singh R

J Sports Sci Med, 2006;5(4):629-39.
PMID: 24357959

This study investigates the effects of tocotrienol-rich palm vitamin E supplementation on exercise-induced lipid peroxidation and endurance performance in the heat. In a double blind, cross-over study, eighteen healthy, male recreational athletes completed two endurance running trials, until exhaustion, on a motorized treadmill at 70% VO2max on two separate occasions following a 6-week supplementation regimen of either tocotrienol-rich palm vitamin E (E) or placebo (P). Both trials were conducted in the heat (31°C, 70% relative humidity). During the trials, rectal temperature (Trec), ratings of perceived exertion (RPE) and oxygen uptake (VO2) were recorded. Blood samples were collected for the determination of plasma volume changes (PVC), malondialdehyde (MDA), creatine kinase (CK), total antioxidant status (TAS) and vitamin E. After the supplementation regimen, serum alpha-tocopherol increased ~33% but serum concentrations of tocotrienols were negligible. No significant differences were evident in mean Trec, RPE, VO2 or in the time to exhaustion between the E-supplemented and the placebo- supplemented groups. Similarly, mean PVC, CK and TAS were also not different between the two groups. Resting plasma mean MDA concentration in the E-supplemented group was significantly lower than that in the placebo-supplemented group. At exhaustion, plasma mean MDA was higher than the resting values in both groups. Although tocotrienol-rich palm vitamin E supplementation decreased lipid peroxidation at rest and, to some extent, during exercise in the heat, as evident from the lower MDA levels, it however did not enhance endurance running performance or prevent exercise-induced muscle damage or influenced body core temperature or plasma volume changes during exercise in the heat. Key Pointsreduced lipid peroxidation at rest.did not enhance endurance running performance in the heat.did not prevent exercise-induced muscle damage as indicated by CK activity.
Changes in bone turnover markers and bone mass with reducing levels of jumping exercise regimens in female rats

Ooi FK, Singh R, Singh HJ

Asian J Sports Med, 2012 Dec;3(4):225-32.
PMID: 23342220

To date, little is known about the effects of a reduced level of jumping exercise regimens on bone turnover markers and mass. This study investigates the effects of different jumping exercise regimens with varying exercise loads on serum bone turnover markers and bone mass in female rats.
Anthropometric and physiological profiles of sepak takraw players

Jawis MN, Singh R, Singh HJ, Yassin MN

Br J Sports Med, 2005 Nov;39(11):825-9; discussion 825-9.
PMID: 16244191

OBJECTIVES: Anthropometric and physiological profiles of national sepak takraw players were determined.
METHODS: Thirty nine players, specialising in the three playing positions (tekong/server, feeder, and killer/spiker) were divided into three age categories of under 15 (U15), under 18 (U18), and under 23 (U23) years of age. Height, weight, percent body fat (%bf), maximum oxygen consumption (Vo(2max)), range of motion (ROM), back and leg strength, and heart rate, for the estimation of oxygen consumption during matches, were recorded. Statistical analysis was performed using one way ANOVA for independent measurements and data are presented as mean+/-standard deviation.
RESULTS: The U23 players were significantly taller and heavier with significantly better ROM of the neck, trunk, and ankle joints and back and leg strength than the U15 players. No significant difference was found in %bf between the three age categories. Mean maximum heart rate during exercise was significantly higher in the U15 group when compared to the U18 and U23 groups (p<0.05). Mean Vo2max was similar between the three groups. Estimated oxygen consumption during matches was 69.1%, 68.5%, and 56.4% of Vo2max in the killer, tekong, and the feeder groups, respectively.
CONCLUSIONS: The mean height, body weight, and cardiopulmonary capacities of the players were within the Malaysian population norms, but were somewhat lower than those of players of other court games from other countries. %bf was also lower in these players. This study provides the much needed anthropometric and physiological data of sepak takraw players for further development of this sport.
Decay of heat acclimation during exercise in cold and exposure to cold environment

Saat M, Sirisinghe RG, Singh R, Tochihara Y

Eur J Appl Physiol, 2005 Oct;95(4):313-20.
PMID: 16151840

Sixteen male students exercised for 14 days (1 h/day) in the heat for heat acclimation (HA). During deacclimation (DA) one group exercised in the cold (EXG, n=8) for 60 min/day (morning) and was exposed to the cold for another hour (afternoon) for 14 days. The other group was exposed to the cold (EPG, n=8) for 1 h each in the morning and afternoon (Ta: 18.0 degrees C, RH: 58%) over the same period. All returned to exercise in the heat for reacclimation (RA) for 10 days. Subjects were tested on days 1, 16, 21, 32, 36 and 44 on a bicycle ergometer for 60 min at 60% of VO(2max) in the heat (Ta: 31.1 degrees C, RH: 70%). Rectal temperature (T (re)) and heart rate (HR) at 40 min of exercise were used to determine the decay/gain of HA, which was calculated using the formula described by Pandolf et al. (Ergonomics, 20:399-408, 1977). After HA (day 16) T (re) and HR decreased significantly. During DA, EXG showed decay in T (re) of 24 and 35% and HR of 29 and 35% on days 21 and 32, respectively. For EPG the corresponding decay was of 2 and 9% for T (re) and 17 and 17% for HR. After 10 days of RA, EXG showed gains of 11% in T (re) and 12% in HR, while EPG showed gains of 47% in T (re) and 38% in HR. In conclusion, EXG had greater decay during DA and lower gains in RA compared to EPG. However, the differences between groups were significant only for T (re) after 4 days of DA.
Fulltext Spirometric studies in Malaysians between 13 and 69 years of age

Singh R, Singh HJ, Sirisinghe RG

Med J Malaysia, 1993 Jun;48(2):175-84.
PMID: 8350793

Spirometry was performed on 1,999 subjects (1,385 males and 614 females) ranging in age from 13 to 69 years and comprising of all the main races in Malaysia. They were divided into 6 age groups. Mean forced vital capacity (FVC) in the males and females was 3.49 +/- 0.02 L and 2.51 +/- 0.02 L respectively. Both FVC and FEV1 correlated negatively with age. Regression analysis on data between the ages of 20 to 69 years revealed an age-related decline in FVC of about 30 ml per year of life in the males and 22 ml per year in the females. Multiple stepwise regression of the data for the prediction of an individual's FVC above the age of 20 years gave an equation for the males: FVC = 0.0407 (height)-0.0296 (age)-2.343 L and for the females: FVC = 0.031 (height)-0.022 (age)-1.64 L. Predicted FVC values derived from equations based on other populations were considerably higher than the observed mean in this study, re-emphasizing the need to be cautious when applying formulae derived from one population to another. Grossly erroneous conclusions may be reached unless predicted equations for lung-function tests for a given population group are derived from studies based upon the same population group.
Physical and physiological profiles of Malaysian dragon boat rowers

Singh R, Singh HJ, Sirisinghe RG

Br J Sports Med, 1995 Mar;29(1):13-5.
PMID: 7788209

Maximal oxygen consumption (VO2max) and maximal workload attained (WLmax) were determined in 28 Malaysian dragon boat rowers who were exercised to exhaustion on an arm ergometer. Mean VO2max was 2.75 l min-1 at a mean WLmax of 195.5 W. Anaerobic endurance power of the arms, determined by cranking at 100 RPM at a workload of 400 W and the time taken to maintain the cadence until it fell to 75 RPM, was 34.9(+/- 2.3) s. Leg performance, as determined by standing long jump and vertical jump, was 140.0(+/- 4.5) kg m and 100.3(+/- 3.1) kg m s-1 respectively. Right hand grip strength was significantly (p < 0.001) greater than the left hand. Percentage body fat of the rowers was 11.8(+/- 0.6)%. These values represent the first measurements of their kind performed on dragon boat rowers in Malaysia.
Fulltext Spirometric volumes in Malaysian males

Singh R, Singh HJ, Sirisinghe RG

Southeast Asian J. Trop. Med. Public Health, 1994 Jun;25(2):341-8.
PMID: 7855654

Spirometry was performed on 1,485 male subjects ranging in age from 13 years to 78 years and comprising of all the main ethnic groups in Malaysia. They were divided into six age categories. Mean forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) were 3.45 +/- 0.02 and 3.10 +/- 0.02, respectively. Both FVC and FEV1 correlated negatively with age. Regression analysis revealed an age-related decline in FVC of 295 ml per decade of life. Multiple stepwise regression of the data for the prediction of an individual's FVC above the age of 20 years gave the equation FVC (1) = 0.0404 (height in cm)-0.0295 (age in years)-2.2892. Predicted FVC values derived from equations based on other populations were considerably higher than the observed mean in this study. This study therefore, reemphasises the need to be cautions when applying formulae derived from one population to another. Grossly erroneous conclusions may be reached unless predicted equations for lung-function tests for a given population group are derived from studies based upon the same population group.
Cardiopulmonary fitness in a sample of Malaysian population

Singh R, Singh HJ, Sirisinghe RG

Jpn. J. Physiol., 1989;39(4):475-85.
PMID: 2601189

Lung capacity and maximum oxygen uptake (VO2max) were measured directly in 167 healthy males, from all the main races in Malaysia. Their ages ranged from 13 to 59 years. They were divided into five age groups (A to E), ranging from the second to the sixth decade. Lung capacities were determined using a dry spirometer and VO2max was taken as the maximum rate of oxygen consumption during exhaustive exercise on a cycle ergometer. Mean forced vital capacity (FVC) was 3.3 +/- 0.5 l and it correlated negatively with age. Mean VO2max was 3.2 +/- 0.2 l.min-1 (56.8 +/- 3.5 ml.kg-1.min-1) in Group A (13-19 years) compared to 1.7 +/- 0.2 l.min-1 (28.9 +/- 2.9 ml.kg-1.min-1) in Group E (50-59 years). Regression analysis revealed an age-related decline in VO2max of 0.77 ml.kg-1.min-1.year-1. Multiple regression of the data gave the following equations for the prediction of an individual's VO2max: VO2max (l.min-1) = 1.99 + 0.035 (weight)-0.04 (age), VO2max (ml.kg-1.min-1) = 67.7-0.77 (age), where age is in years, weight in kg. In terms of VO2max as an index of cardiopulmonary performance. Malaysians have a relatively lower capacity when related to the Swedish norms or even to those of some Chilean workers. Malaysians were, however, within the average norms of the American Heart Association's recommendations. Age-related decline in VO2max was also somewhat higher in the Malaysians.
Forced vital capacity in Malaysian females

Singh R, Singh HJ, Sirisinghe RG

Jpn. J. Physiol., 1992;42(3):407-14.
PMID: 1434102

Spirometry was performed on 614 female subjects ranging in age from 13 to 69 years and comprising all the main races in Malaysia. They were divided into six age categories. Mean forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were 2.51 +/- 0.02 and 2.31 +/- 0.02l, respectively. Both FVC and FEV1 correlated negatively with age. Regression analysis revealed an age-related decline in FVC of 220 ml per decade of life. Multiple stepwise regression of the data for the prediction of an individual's FVC above the age of 20 years gave an equation: FVC(l) = 0.0312 (height)-0.022 (age)-1.64. Predicted FVC values derived from equations based on other populations were considerably higher than the observed mean in this study. Our study, therefore, reemphasizes the need to be cautious when applying formulae derived from one population to another. Grossly erroneous conclusions may be reached unless predicted equations for lung-function tests for a given population group are derived from studies based on the same population group.
Fulltext Porokeratosis: a report of three clinical variants

Singh R, Ghazali W, Nor M

Med J Malaysia, 1991 Mar;46(1):99-103.
PMID: 1836046

Three patients presenting with distinct clinical variants of porokeratosis are reported. This article discusses the etiology, classification and response to different modalities of treatment.

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