Displaying all 15 publications

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  1. Ramasamy V, Nadarajah S
    J Family Med Prim Care, 2019 1 2;7(5):1083-1085.
    PMID: 30598962 DOI: 10.4103/jfmpc.jfmpc_47_18
    A foreign body in the nose is a common referral dealt by the otolaryngologist on daily basis. Here we report a case of a 5-year-old girl who was referred from a primary care center with complaints of left nasal blockage and epistaxis along with foul smelling brownish discharge for 1-day duration. Nasal endoscopic examination of the left side of the nose revealed an impacted button battery at the cartilaginous portion of the nasal septum.
  2. Mohamad I, Saniasaya J, Nadarajah S, Salmah WM
    Malays Fam Physician, 2019;14(1):53-55.
    PMID: 31289634
  3. Ng BW, Abdullah AF, Nadarajah S
    Malays Orthop J, 2017 Mar;11(1):57-59.
    PMID: 28435576 MyJurnal DOI: 10.5704/MOJ.1703.003
    Acromioclavicular joint (ACJ) dissociation is one of the common injuries affecting adults. The stability of ACJ largely depends on the integrity of acromioclavicular ligament, coracoclavicular ligament, capsule, trapezius muscle and deltoid muscle. The injury has been classified by Rockwood into six types and treatment options can be guided by the classification. TightRope fixation is one of the many surgical procedures available to address acromioclavicular joint separation. It consists of tensioning of a no. 5 Fibrewire suture secured at both ends to low-profile metallic buttons. Despite various advantages of using this technique, complications such as suture cut-out, clavicle fracture and suture failure have been documented. The author presents a case of a type III acromioclavicular joint dissociation treated with TightRope which suture cutout was noted intra-operatively. Decision to amend the fixation using a cut one-third tubular plate as an additional anchor for the metallic button on the clavicle was made. Patient's progress was evaluated using the University of California at Los Angeles Shoulder Score (UCLA Shoulder Score) and significant improvement was noted six months post operatively. We propose this technique as a solution to the encountered problem.
  4. Lim EH, Nadarajah S, Mohamad I
    Oman Med J, 2017 Sep;32(5):432-435.
    PMID: 29026477 DOI: 10.5001/omj.2017.81
    Sialolithiasis is the formation of calculi or sialoliths in the salivary gland. It is the most common benign condition of the salivary gland. Sialolithiasis can occur in all salivary glands. The submandibular gland is most commonly affected followed by the parotid gland. Calculi commonly measure less than 10 mm. Calculi of more than 15 mm are termed giant salivary gland calculi and are infrequently reported in the literature. Here, we report a case of unusually large submandibular gland calculus of 5 cm in greatest dimension which caused erosion of the oral cavity.
  5. Nadarajah S, Samsudin A, Ramli N, Tan CT, Mimiwati Z
    Optom Vis Sci, 2017 10;94(10):981-985.
    PMID: 28858045 DOI: 10.1097/OPX.0000000000001117
    SIGNIFICANCE: To our knowledge, this is the first time a study looking at the association between corneal hysteresis (CH) and obstructive sleep apnea syndrome (OSAS) severity has been reported. We provide evidence that CH is lower in OSAS and speculate on the possible causes.

    PURPOSE: The present study aims to look at the association between CH and severity of OSAS, and whether CH could be another link between OSAS and the development of glaucoma.

    METHODS: This was a cross-sectional, observational study at the University Malaya Medical Centre, Kuala Lumpur. Patients undergoing polysomnography for assessment of OSAS were recruited. We measured central corneal thickness (CCT) using optical biometry, and CH using ocular response analysis. Intraocular pressure (IOP) and Humphrey visual field (HVF) indices were also measured. The Apnea Hypopnea Index (AHI) divided patients into normal, mild, moderate, and severe OSAS categories. The normal and mild categories (47.9%) were then collectively called group 1, and the moderate and severe categories (52.1%) were called group 2. T tests, Pearson correlation tests, and general linear model analysis were performed, with P .05). CH correlated negatively with AHI (r = -0.229, P = .013) and positively with lowest oxygen saturation (r = 0.213, P = .022).

    CONCLUSIONS: CH is lower in moderate/severe OSAS than in normal/mild cases. This may be another link between OSAS and the development of glaucoma; further studies are indicated to determine the significance of this connection.

  6. Thevarajah MT, Nadarajah S, Chew YY, Chan PC
    Singapore Med J, 2008 Jun;49(6):454-7.
    PMID: 18581016
    We report the results of a laboratory evaluation of the BioRad Urinary Metanephrines Reagent Kit. The test was designed for the quantitative measurement of normetanephrine and metanephrine in urine by high performance liquid chromatography. The kit was evaluated in view of improving assay reliability and specificity as compared to the manual method based on cation exchange chromatography and spectrophotometry.
  7. Abu Bakar SA, Nadarajah S, Absl Kamarul Adzhar ZA, Mohamed I
    PLoS One, 2016;11(6):e0156537.
    PMID: 27272043 DOI: 10.1371/journal.pone.0156537
    In this paper, we introduce the R package gendist that computes the probability density function, the cumulative distribution function, the quantile function and generates random values for several generated probability distribution models including the mixture model, the composite model, the folded model, the skewed symmetric model and the arc tan model. These models are extensively used in the literature and the R functions provided here are flexible enough to accommodate various univariate distributions found in other R packages. We also show its applications in graphing, estimation, simulation and risk measurements.
  8. Goh TC, Bajuri MY, C Nadarajah S, Abdul Rashid AH, Baharuddin S, Zamri KS
    J Foot Ankle Res, 2020 Jun 16;13(1):36.
    PMID: 32546270 DOI: 10.1186/s13047-020-00406-y
    BACKGROUND: Diabetic foot infection is a worldwide health problem is commonly encountered in daily practice. This study was conducted to identify the microbiological profile and antibiotic sensitivity patterns of causative agents identified from diabetic foot infections (DFIs). In addition, the assessment included probable risk factors contributing to infection of ulcers that harbour multidrug-resistant organisms (MDROs) and their outcomes.

    METHODS: We carried out a prospective analysis based on the DFI samples collected from 2016 till 2018. Specimens were cultured with optimal techniques in addition to antibiotic susceptibility based on recommendations from The Clinical and Laboratory Standards Institute (CLSI). A total of 1040 pathogens were isolated with an average of 1.9 pathogens per lesion in 550 patients who were identified with having DFIs during this interval.

    RESULTS: A higher percentage of Gram-negative pathogens (54%) were identified as compared with Gram-positive pathogens (33%) or anaerobes (12%). A total of 85% of the patients were found to have polymicrobial infections. Pseudomonas aeruginosa (19%), Staphylococcus aureus (11%) and Bacteroides species (8%) appeared to be the predominant organisms isolated. In the management of Gram-positive bacteria, the most efficacious treatment was seen with the use of Vancomycin, while Imipenem and Amikacin proved to be effective in the treatment of Gram-negative bacteria.

    CONCLUSION: DFI's are common among Malaysians with diabetes, with a majority of cases displaying polymicrobial aetiology with multi-drug resistant isolates. The data obtained from this study will be valuable in aiding future empirical treatment guidelines in the treatment of DFIs. This study investigated the microbiology of DFIs and their resistance to antibiotics in patients with DFIs that were managed at a Tertiary Care Centre in Malaysia.

  9. Maruthamuthu T, Saniasiaya J, Mohamad I, Nadarajah S, Lazim NM, Wan Abdul Rahman WF
    Oman Med J, 2018 Jul;33(4):342-345.
    PMID: 30038735 DOI: 10.5001/omj.2018.62
    Parotid gland surgery can be challenging due to intricate relationship between the gland and facial nerve. Besides complete removal of the lesion, the main focus of surgery is centered on the facial nerve. Surgery can be technically demanding especially when the tumor is large or involves the deep lobe. We report a patient with a 30-year history of gigantic parotid mass, which initial fine-needle aspiration cytology reported as pleomorphic adenoma. The tumor, weighing 1.3 kg, was successfully resected with facial nerve preservation. Histopathological examination of the excised mass confirmed as carcinoma ex pleomorphic adenoma (CaExPA) of adenocarcinoma, not otherwise specified type. We describe the specific surgical and reconstruction techniques for successful removal of large parotid tumors with facial nerve preservation. To our knowledge, this is the heaviest CaExPA of the parotid gland in South-East Asian region.
  10. Chai-Lee T, Nadarajah S, Abdullah B, Mohamad I, Maruthamuthu T, Nadarajan C, et al.
    Int J Surg Case Rep, 2017;33:119-123.
    PMID: 28314224 DOI: 10.1016/j.ijscr.2017.02.051
    INTRODUCTION: The management of orbital abscesses in neonates and infants is very challenging. Surgical drainage of the abscess is aimed at removing the pus and preventing blindness. We describe a case of orbital abscess in an infant that was caused by methicillin-resistant Staphylococcus aureus and that was successfully drained with image-guided endoscopic surgery.

    PRESENTATION OF CASE: A 39-day-old infant presented with progressive right maxillary swelling complicated by methicillin-resistant Staphylococcus aureus orbital abscess. Tooth bud abscess was the most likely primary cause and a combination of intravenous antibiotics was initially prescribed. The collection of intra-orbital pus was removed using image-guided system-aided endoscopic surgical drainage.

    DISCUSSION: Prompt diagnosis and management are very crucial. Endoscopic drainage of these abscesses in children has been described. Image-guided drainage of the orbital abscess is a newer technique that has been reported in a teenager and in adult patients. This is the first reported case of endoscopic orbital drainage surgery in an infant. The procedure was performed successfully. This approach provides for better identification of the anatomical structures in a very young patient. Injuries to the medial rectus, globe and optic nerve can be avoided with this technique.

    CONCLUSION: Aggressive management of orbital abscesses in infants is mandatory. Image-guided endoscopic orbital drainage offers precise visualization and a safer technique in a relatively smaller orbit.

  11. Kandiah R, Aziz A, Nik Min NFA, Rahim MR, Zawawi N, Sayuti KA, et al.
    Malays J Pathol, 2021 Dec;43(3):457-461.
    PMID: 34958068
    Lichenoid uvula mass is an unusual entity and the clinicopathologic entities are important for the diagnosis. In this case report, we report an elderly lady presented with dysphagia and "hot potato voice" due to a lichenoid uvula mass. Apart from muffled voice, the other associated symptoms are dysphagia, sore throat, globus pharyngeus and snoring. She was a non-smoker, and not on any medications except for hypertension and dyslipidaemia. Apart from the enlarged uvula, other parts of the oral cavity, oropharynx and larynx were normal. She has no other signs such as cutaneous lesions. The mass was excised under general anaesthesia followed by resolution of symptoms. Awareness of this entity, the clinical and histopathological features should be highlighted to differentiate it from other diagnosis.
  12. Fung SK, Sundaraj K, Ahamed NU, Kiang LC, Nadarajah S, Sahayadhas A, et al.
    J Bodyw Mov Ther, 2014 Apr;18(2):220-7.
    PMID: 24725790 DOI: 10.1016/j.jbmt.2013.05.011
    Sports video tracking is a research topic that has attained increasing attention due to its high commercial potential. A number of sports, including tennis, soccer, gymnastics, running, golf, badminton and cricket have been utilised to display the novel ideas in sports motion tracking. The main challenge associated with this research concerns the extraction of a highly complex articulated motion from a video scene. Our research focuses on the development of a markerless human motion tracking system that tracks the major body parts of an athlete straight from a sports broadcast video. We proposed a hybrid tracking method, which consists of a combination of three algorithms (pyramidal Lucas-Kanade optical flow (LK), normalised correlation-based template matching and background subtraction), to track the golfer's head, body, hands, shoulders, knees and feet during a full swing. We then match, track and map the results onto a 2D articulated human stick model to represent the pose of the golfer over time. Our work was tested using two video broadcasts of a golfer, and we obtained satisfactory results. The current outcomes of this research can play an important role in enhancing the performance of a golfer, provide vital information to sports medicine practitioners by providing technically sound guidance on movements and should assist to diminish the risk of golfing injuries.
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