Displaying publications 1 - 20 of 182 in total

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  1. Rather than responding to the past, shape the future instead
    Kaur S
    Am J Bioeth, 2015;15(6):61-3.
    PMID: 26030504 DOI: 10.1080/15265161.2015.1028668
  2. Blue deficiency in patients with diabetes mellitus without retinopathy - its clinical implications
    Kaur S
    Sains Malaysiana, 1996;25(2):41-49.
    This study was conducted for 3 main purposes: 1) to determine if there was blue colour deficiency amongst diabetes mellitus (IDDM and NIDDM) patients without retinopathy, 2) to determine if the Dl5 test could be used to detect any colour vision defects amongst diabetics without retinopathy (all previous workers have used FM 100-Hue), and 3) to assess the performance of diabetics without retinopathy in detecting correct colour changes with the urine strip test. Thirty eight non-insulin dependent diabetes mellitus (NIDDM) and 30 insulin-dependent diabetes mellitus (IDDM) patients without retinopathy participated in this study. A control group of 23 normal subjects were also included in the study. Dl5 colour vision test was performed under daylight conditions. Colour dependent urine glucose test (Glukotest) was also performed on all subjects. The study showed that 47.1% of diabetics (47.4% NIDDM and 46.7% IDDM patients) without retinopathy had a blue colour deficiency. Amongst the diabetics with a blue colour deficiency, 25% of diabetics (22% of NIDDM and 28.6% of IDDM patients) failed to accurately match the strip colour with the comparison chart on the bottle.
    Kajian ini dilakukan untuk 3 tujuan: I) untuk menentukan samada terdapat gangguan penglihatan warna biru dalam pesakit diabetes mellitus (IDDM dan NIDDM) tanpa retinopati, 2) untuk menentukan samada ujian penglihatan warna Dl5 boleh digunakan untuk mengesan defek penglihatan warna dalam pesakit diabetes tanpa retinopati (kesemua kajian terdahulu menggunakan ujian FM 100-Hue). dan 3) untuk menilaikan prestasi pesakit diabetik tanpa retinopati dalam mengesan perubahan warna yang betul dengan menggunakan ujian strip urin. Tiga puluh lapan pesakit dengan non-insulin dependent diabetes (NIDDM) dan 30 pesakit dengan insulin dependent diabetes (IDDM) tanpa retinopati menyertai kajian ini. Kumpulan kawalan mengandungi 23 orang subjek yang normal juga terlibat di dalam kajian ini. Ujian penglihatan warna Dl5 dilakukan di bawah cahaya daylight. Ujian glukos urin berasaskan warna (Glukotest) dilakukan ke atas semua subjek. Kajian menunjukkan 47.1% pesakit diabetes (47.4% pesakit NIDDM dan 46.7% pesakit IDDM) tanpa retinopati mengalami defisiensi warna biru. Dalam kumpulan diabetik dengan defisiensi warna biru, 25% pesakit diabetes (22.2% adalah pesakit NIDDM dan 28.6% adalah pesakit IDDM) gagal untuk memadankan dengan tepat warna strip dengan carta perbandingan warna di atas botol.
  3. How IRBs make decisions: should we worry if they disagree?
    Kaur S
    J Med Ethics, 2013 Apr;39(4):230.
    PMID: 23077337 DOI: 10.1136/medethics-2012-100965
  4. Fulltext The Immediate Term Effect Of Chewing Commercially Available Meswak (Salvadora Persica) On Levels Of Calcium, Chloride, Phosphate And Thiocyanate In Whole Saliva.
    Kaur, S., Abdul Jalil, R., Akmar, S.L.
    Ann Dent, 2004;11(1):-.
    MyJurnal
    The objective of this study was to determine the effect of chewing commercially available meswak may have on levels of calcium, chloride, phosphate and thiocyanate in stimulated whole saliva. A total of 20 subjects participated in the investigation. They were distributed into two groups. Those in group A (10 individuals) were asked to first chew on a cotton roll (sized #1) followed by the chewing of an equivalent sized 5mm piece of commercially available meswak. Subjects in group B (10 individuals) did the same but, chewed on cotton roll (sized #2) followed by the chewing of an equivalent sized 10mm piece of commercially available meswak. After following a specified chewing protocol, samples of stimulated whole saliva were collected into a graduated tube at the end of every chewing regime. Calcium, chloride, phosphate and thiocyanate analysis were carried out using colour titration and spectrophotometer. Results from this investigation indicated that commercially available meswak chewing sticks apart from containing high amounts of calcium and chloride may possibly release phosphate and thiocyanate into whole saliva. These findings suggest that the commercially available meswak used as chewing sticks may have the potential of releasing substances into saliva that could influence the state of oral health. Further studies have to be carried out to ascertain the therapeutic benefits of chewing commercially available meswak.
  5. The coronavirus pandemic in Malaysia: A commentary
    Kaur S
    Psychol Trauma, 2020 Jul;12(5):482-484.
    PMID: 32584114 DOI: 10.1037/tra0000897
    As of mid-May 2020, it has been 5 months since the 1st case of coronavirus was detected in Malaysia. Thus far, 113 deaths have been reported. Several effective measures have been taken by the government under a partial lockdown or movement control order to contain the spread of the virus, which have led to the flattening of the curve. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
  6. Historic day for Malaysian consumers
    Kaur SR
    Health Millions, 1993 Apr;1(2):7-9.
    PMID: 12286471
  7. Recognising patients' rights: patchy progress
    Kaur S, Herxheimer A
    Lancet, 1994 Jan 15;343(8890):132.
    PMID: 7904000
  8. Fulltext Various ways of continuous intraocular pressure monitoring in glaucoma patients: a narrative review
    Ramakrishnan, G., Che Hamzah, J., Sharanjeet-Kaur S.
    Medicine & Health, 2019;14(2):17-29.
    MyJurnal
    Glaucoma is a group of neurodegenerative disease linked with imbalance in the aqueous humor flow due to resistance in the aqueous drainage system. This increases the intraocular pressure (IOP), which causes damage to the optic nerve head and leads to irreversible blindness. As IOP is the only treatable risk factor for glaucoma, its 24 hours biorhythm need to be understood before managing it. Monitoring IOP is a critically important part in the management of glaucoma. Various approach and technology have been initiated and on-going for a frequent, round-the-clock IOP measurement to determine the IOP peaks and fluctuations. We review the current innovative approach and its importance as well as discussing the shortcomings of each method to obtain the 24 hour IOP profile.
  9. Ethical considerations in clinical trials: a critique of the ICH-GCP guideline
    Kaur S, Choy CY
    Dev World Bioeth, 2014 Apr;14(1):20-8.
    PMID: 23170779 DOI: 10.1111/dewb.12004
    This article examines issues relating to ethics decision-making in clinical trials. The overriding concern is to ensure that the well being and the interests of human subjects are adequately safeguarded. In this respect, this article will embark on a critical analysis of the ICH-GCP Guideline. The purpose of such an undertaking is to highlight areas of concern and the shortcomings of the existing ICH-GCP Guideline. Particular emphasis is made on how ethics committees perform their duties and responsibilities in line with the principles outlined in the ICH-GCP Guideline. This article will draw attention to the need for a new approach to addressing the weaknesses of the ICH-GCP Guideline in its present form.
  10. Towards a balanced approach to identifying conflicts of interest faced by institutional review boards
    Kaur S, Balan S
    Theor Med Bioeth, 2015 Oct;36(5):341-61.
    PMID: 26438122 DOI: 10.1007/s11017-015-9339-3
    The welfare and protection of human subjects is critical to the integrity of clinical investigation and research. Institutional review boards (IRBs) were thus set up to be impartial reviewers of research protocols in clinical research. Their main role is to stand between the investigator and her human subjects in order to ensure that the welfare of human subjects are protected. While there is much literature on the conflicts of interest (CIs) faced by investigators and researchers in clinical investigations, an area that is less explored is CIs that may affect members of IRBs during the institutional ethics review of clinical investigations. This article examines the notion of CIs in clinical research and attempts to develop a framework for a clearer and more balanced approach to identifying CIs that may influence members of IRBs and impede their independence. It will also apply the proposed framework to demonstrate how IRBs possess, or at least may appear to possess, forms of financial CIs and non-financial CIs. The proper identification and management of these CIs is critical to preserving the integrity of clinical investigations and achieving the primary aim of human subjects protection.
  11. Confidentiality and death
    Ong BB, Kaur S
    Malays J Pathol, 1997 Dec;19(2):111-4.
    PMID: 10879250
    The duty of confidentiality in the normal doctor-patient relationship is well recognized. However, the duty of confidentiality between the pathologist who performs the autopsy and the requesting authorities and the next-of-kin is not as clearly spelt out. This article discusses the problems faced by the pathologist with regards to hospital and medico-legal autopsies in Malaysia. A proposed ethical guideline is included on how to deal with peculiar issues regarding confidentiality and the pathologist.
  12. Fulltext Ameliorative effect of gallic acid in paclitaxel-induced neuropathic pain in mice
    Kaur S, Muthuraman A
    Toxicol Rep, 2019;6:505-513.
    PMID: 31211096 DOI: 10.1016/j.toxrep.2019.06.001
    The present study has been investigated the role of gallic acid (GA) in paclitaxel-induced neuropathic pain. The neuropathic pain was developed with paclitaxel (PT: 2 mg/kg, i.p.) administration in mice. GA (20 and 40 mg/kg) and pregabalin (PreG: 5 mg/kg) were administered intravenously for 10 consecutive days. The neuralgic sensations were investigated by assessing various pain tests like acetone drop, pinprick, plantar, tail flick, and tail pinch test. Mice pain behaviors were evaluated on 0, 4th, 8th, 12th and 16th days. The levels of sciatic nerve thiobarbituric acid reactive substances (TBARS), reduced glutathione (GSH), superoxide anion, calcium, myeloperoxidase (MPO), and TNF-α were estimated. Treatment of GA and PreG attenuate PT induced thermal &mechanical hyperalgesia and allodynia symptoms along with the reduction of TBARS, total calcium, TNF-α, superoxide anion, and MPO activity levels; and decreased GSH level. Therefore, it has been concluded that GA has potential neuroprotective actions against PT induced neuropathic pain due to it's anti-oxidant, anti-inflammation and regulation of intracellular calcium ion concentration.
  13. Fulltext Colour vision of workers in the plastics industry
    Kaur S, Mursyid A, Ariffin AE
    Journal of Occupational Safety and Health, 2004;1(1):25-30.
    MyJurnal
    A study was undertaken to determine the effect of polyethylene and polystyrene used in the manufacture of plastic items on colour perception. Colour vision was assessed using the Ishihara plates, panel 015 test and the Farnsworth Munsell 100-Hue test. Two factories were chosen at random. One factory (referred here as factory A) used virgin resin in pellet form (polyethylene) in the manufacturing of plastic containers to store consumer edible oil. The other factory (referred as factory B) used polystyrene to make plastic bags. A total of 39 healthy employees from factory A (mean age 26.4 :t 8.2 years) and 40 healthy employees from factory B (mean age 26.8 :t 9.6 years) were recruited in this study. A control group of 27 normal healthy subjects (mean age 27.4 :t 4.3 years) who were employees of UKM with no occupational involvement with petroleum derivatives were also recruited in this study and they performed the same colour vision tests. All subjects passed the Ishihara plates test showing that none of the subjects (employees of factory A and B, and control subjects) had a congenital red-green defect. All control subjects passed all of the colour vision tests whilst some employees of factories A and B failed the 015 and FM100 Hue tests. For employees from factory A results from the 015 test showed that 7 (17.9%) had a tritan (blue-yellow) type of defect and 1 (2.6%) had a complex type of defect. The FM 100 Hue results of factory A employees showed that 51.3% (n=20) had a complex type of defect. Total error scores (TES) calculated from the FM 100 Hue test revealed that employees from factory A had a statistically significant higher mean TES of 65.13:!: 48.31 compared to that of control subjects with a mean TES of 31.26:!: 14.93. For employees in factory B, 10 employees (25.0%) had a tritan (blue-yellow) type of defect and 2 (5.0%) had a complex type of defect. Results of the FM 100 Hue test showed that 4 employees (1.0%) had a tritan type of defect whereas 22 (55.0%) had a complex type of defect. Mean total error scores (TES) calculated from the FM 100 Hue test revealed that employees from factory B had a statistically significant higher mean TES of 71.54 :t 54.63 compared with that of control subjects with a mean TES of 31.26 :t. 14.93

    The above results show that employees of the plastic factories studies are associated with a higher risk of acquiring colour vision defects as compared to normal subjects who are not engaged in the plastic manufacturing industry. This may have an implication towards the future retinal health of employees in petrod1emical-based industries.
  14. Symptomatic spinal epidural lipomatosis after a single local epidural steroid injection
    Tok CH, Kaur S, Gangi A
    Cardiovasc Intervent Radiol, 2011 Feb;34 Suppl 2:S250-5.
    PMID: 20859631 DOI: 10.1007/s00270-010-9982-z
    Spinal epidural lipomatosis is a rare disorder that can manifest with progressive neurological deficits. It is characterized by abnormal accumulation of unencapsulated epidural fat commonly associated with the administration of exogenous steroids associated with a variety of systemic diseases, endocrinopathies, and Cushing syndrome (Fogel et al. Spine J 5:202-211, 2005). Occasionally, spinal epidural lipomatosis may occur in patients not exposed to steroids or in patients with endocrinopathies, primarily in obese individuals (Fogel et al. Spine J 5:202-211, 2005). However, spinal lumbar epidural lipomatosis resulting from local steroid injection has rarely been reported. We report the case of a 45-year-old diabetic man with claudication that was probably due to symptomatic lumbar spinal lipomatosis resulting from a single local epidural steroid injection.
  15. The use of objective structured self-assessment and peer-feedback (OSSP) for learning communication skills: evaluation using a controlled trial
    Perera J, Mohamadou G, Kaur S
    Adv Health Sci Educ Theory Pract, 2010 May;15(2):185-93.
    PMID: 19757129 DOI: 10.1007/s10459-009-9191-1
    Feedback is essential to guide students towards expected performance goals. The usefulness of teacher feedback on improving communication skills (CS) has been well documented. It has been proposed that self-assessment and peer-feedback has an equally important role to play in enhancing learning. This is the focus of this study. Objectively structured self-assessment and peer feedback (OSSP) was incorporated into small group CS teaching sessions of a group of semester one medical students who were learning CS for the first time, to minimise the influence of previous educational interventions. A control group matched for academic performance, gender and age was used to enable parallel evaluation of the innovation. A reflective log containing closed and open ended questions was used for OSSP. Facilitators and simulated patients provided feedback to students in both groups during CS learning as per routine practice. Student perceptions on OSSP and acceptability as a learning method were explored using a questionnaire. CS were assessed in both groups using objective structured clinical examination (OSCE) as per routine practice and assessors were blinded as to which group the student belonged. Mean total score and scores for specific areas of interview skills were significantly higher in the experimental group. Analysis of the questionnaire data showed that students gained fresh insights into specific areas such as empathy, addressing patients' concerns and interview style during OSSP which clearly corroborated the specific differences in scores. The free text comments were highly encouraging as to acceptability of OSSP, in spite of 67% being never exposed to formal self- and peer-assessment during pre-university studies. OSSP promotes effective CS learning and learner acceptability is high.
  16. Biosorption and bioreduction of Cr(VI) by locally isolated Cr-resistant bacteria
    Zakaria ZA, Aruleswaran N, Kaur S, Ahmad WA
    Water Sci Technol, 2007;56(8):117-23.
    PMID: 17978439
    Cr(VI) biosorption and bioreduction ability of locally isolated Cr-resistant bacteria was investigated using the shake-flask technique. A mixture of S. epidermidis and B. cereus showed the highest minimum inhibitory concentration (MIC) level at 750 mg/L Cr(VI) followed by S. aureus and Bacillus sp. of 250 mg/L, and A. haemolyticus of 70 mg/L. From the Langmuir adsorption isotherm, the treatment of cells with heat-acid resulted in the highest amount of Cr(VI) adsorped (78.25 mg/g dry wt. for S. epidermidis) compared to heat-acetone (67.93 mg/g dry wt. Bacillus sp.), heat only (36.05 mg/g dry wt. S. epidermidis) or untreated cells (45.40 mg/g dry wt. S. epidermidis and B. cereus). FTIR analysis showed the involvement of amine groups in Cr(VI) adsorption. In the bioreduction study, A. haemolyticus was able to completely reduce Cr(VI) up to 50 mg/L.
  17. Fulltext Patient Isolation during Infectious Disease Outbreaks: Arguments for Physical Family Presence
    Voo TC, Lederman Z, Kaur S
    Public Health Ethics, 2020 Jul;13(2):133-142.
    PMID: 33294029 DOI: 10.1093/phe/phaa024
    This article argues that outbreak preparedness and response should implement a 'family presence' policy for infected patients in isolation that includes the option of physical visits and care within the isolation facility under some conditions. While such a 'physical family presence' (PFP) policy could increase infections during an outbreak and may raise moral dilemmas, we argue that it is ethically justified based on the least infringement principle and the need to minimize the harms and burdens of isolation as a restrictive measure. Categorical prohibition of PFP during the course of an outbreak or epidemic is likely to result in unnecessary harms to patients and families, and violate values such as the moral commitments of families to care for each other. Supporting the option of PFP under particular circumstances, on the other hand, will least infringe these moral considerations. An additional reason for a family presence policy is that it may facilitate voluntary cooperation with isolation and other restrictive measures. We provide an analysis of these considerations for supporting modes of family presence during an outbreak emergency, before defending the riskier option of PFP in the isolation facility from plausible objections and concerns.
  18. A comparison study on hindfoot correction, Achilles tendon length and thickness between clubfoot patients treated with percutaneous Achilles tendon tenotomy versus casting alone using Ponseti method
    Chandirasegaran S, Gunalan R, Aik S, Kaur S
    J Orthop Surg (Hong Kong), 2019 4 6;27(2):2309499019839126.
    PMID: 30947613 DOI: 10.1177/2309499019839126
    PURPOSE:: To compare the hindfoot correction using clinical and ultrasonography assessment in clubfoot patients undergoing Achilles tendon tenotomy with patients corrected with casting alone.

    METHOD:: A prospective observational study on idiopathic clubfoot patients less than 3 months old. Clinical assessment was done using hindfoot Pirani score and measurement of ankle dorsiflexion. Serial ultrasonography was done to measure the length and thickness of the Achilles tendon pre-hindfoot correction, 3 and 6 weeks post-hindfoot correction. Independent t-test was used to analyse the increase in ankle dorsiflexion, improvement in length and thickness of Achilles tendon between the two groups. Mann-Whitney U test was used to analyse the improvement in hindfoot Pirani score. Pearson correlation test was used for correlation in between clinical severity and ultrasonography assessment.

    RESULTS:: Twenty-three patients with bilateral clubfoot and four with unilateral clubfoot were recruited with a total of 50 clubfeet. Each group consists of 25 feet with a mean age of 2 months. Marked improvement in hindfoot correction was noted in tenotomy group compared to non-tenotomy group as evidenced by significant increase in Achilles tendon length, ankle dorsiflexion and improvement of hindfoot Pirani score. No significant difference in Achilles tendon thickness was noted between the two groups. Positive correlation was demonstrated between increase in Achilles tendon length and increase in ankle dorsiflexion as well as improvement in hindfoot Pirani score.

    CONCLUSION:: We would like to propose Achilles tendon tenotomy in all clubfoot patients as it is concretely evident that superior hindfoot correction was achieved in tenotomy group.

  19. Heredity factor in myopia development among a sample in Klang Valley, Malaysia
    Kaur S, Ramli NI, Narayanasamy S
    Chin Med J (Engl), 2012 Oct;125(19):3522-5.
    PMID: 23044317
    Development of myopia among young children is often contributed to the refractive status of the parents. This study was conducted to determine whether myopia can be inherited across the generation among a sample in the Klang Valley. Three generations involved are: G1 (grandparents), G2 (parents) and G3 (children).
  20. Fulltext Distribution of Refractive Errors among Healthy Infants and Young Children between the Age of 6 to 36 Months in Kuala Lumpur, Malaysia-A Pilot Study
    Yahya AN, Sharanjeet-Kaur S, Akhir SM
    Int J Environ Res Public Health, 2019 11 27;16(23).
    PMID: 31783494 DOI: 10.3390/ijerph16234730
    Uncorrected refractive error, especially myopia, in young children can cause permanent visual impairment in later life. However, data on the normative development of refractive error in this age group is limited, especially in Malaysia. The aim of this study was to determine the distribution of refractive error in a sample of infants and young children between the ages of 6 to 36 months in a prospective, cross-sectional study. Cycloplegic retinoscopy was conducted on both eyes of 151 children of mean age 18.09 ± 7.95 months. Mean spherical equivalent refractive error for the right and left eyes was +0.85 ± 0.97D and +0.86 ± 0.98D, respectively. The highest prevalence of refractive error was astigmatism (26%), followed by hyperopia (12.7%), myopia (1.3%) and anisometropia (0.7%). There was a reduction of hyperopic refractive error with increasing age. Myopia was seen to emerge at age 24 months. In conclusion, the prevalence of astigmatism and hyperopia in infants and young children was high, but that of myopia and anisometropia was low. There was a significant reduction in hyperopic refractive error towards emmetropia with increasing age. It is recommended that vision screening be conducted early to correct significant refractive error that may cause disruption to clear vision.
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