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Earnings among people with spinal cord injury

Ramakrishnan K, Loh SY, Omar Z

Spinal Cord, 2011 Sep;49(9):986-9.
PMID: 21556013 DOI: 10.1038/sc.2011.47

Secondary analysis of cross-sectional data.
Return to work after spinal cord injury: factors related to time to first job

Ramakrishnan K, Mazlan M, Julia PE, Abdul Latif L

Spinal Cord, 2011 Aug;49(8):924-7.
PMID: 21383761 DOI: 10.1038/sc.2011.16

STUDY DESIGN: Cross-sectional survey.
OBJECTIVES: To investigate factors related to length of time between spinal cord injury (SCI) onset and start of first post-injury employment.
SETTING: Persons living with SCI in the community who are members of a disability support organization.
METHODS: Participants were randomly selected from the membership list of a non-governmental voluntary organization. They met the following four criteria: traumatic SCI, minimum of 15 years of age at the time of survey, a minimum of 2 years after SCI and had been employed for some time since SCI. The main outcome measure was time (in years) from injury onset to beginning first post-injury job.
RESULTS: Participants averaged 4.9 years (s.d. 5.1) from the time of SCI to their first post-injury job, with a range of 3 months to 20 years. Fifty percent of the participants who eventually returned to work had done so by 4 years. Return to pre-injury employer and employment were associated with early return, whereas having less years in education and being older at the time of injury were associated with longer time to return to work.
CONCLUSION: Rehabilitation team need to consider return to employment as a realistic goal even many years after SCI. Perhaps a focus on returning more people to their pre-injury employer and employment with added focus and input from rehabilitation team for those with lower education status and older age at time of injury might expedite the process of reintegration.
Return to work after spinal cord injury in Malaysia

Ramakrishnan K, Chung TY, Hasnan N, Abdullah SJ

Spinal Cord, 2011 Jul;49(7):812-6.
PMID: 21221119 DOI: 10.1038/sc.2010.186

STUDY DESIGN: Cross-sectional survey.
OBJECTIVES: To determine the employment outcomes of persons with spinal cord injury (SCI) and to investigate the impact of various demographic, injury-related and work-related variables on these outcomes.
SETTING: People living with SCI in Malaysia who are members of a disability support organization.
METHODS: A total of 84 members of the Malaysian Spinal Injury Association, who have had traumatic SCI for at least 2 years and were between 15 and 64 years of age at the time of study, were interviewed through phone using a questionnaire to identify the association between demographic, injury-related and work-related variables and employment outcomes.
RESULTS: The return to work rate in this study was 57.1% (employed at the time of study). The overall employment rate after SCI was 76.2% (worked at some point after injury). Those who were younger at time of injury (<20 years of age), able to drive a modified vehicle, independent in personal care and mobility were positively related to being employed. On the other hand, being hospitalized in the preceding 1 year and receiving financial incentives were negatively related to employment.
CONCLUSION: Functional independence, especially ability to drive, was strongly associated with return to work and should be one of the priority goals of comprehensive rehabilitation of persons with SCI. The negative impact of recent hospitalization as well as financial compensation needs to be probed further.
Fulltext Unilateral ankle dorsiflexor spasticity: an uncommon, disabling complication of transverse myelitis

Mazlan M, Hamzah N, Ramakrishnan K

Arch Med Sci, 2012 Nov 9;8(5):939-41.
PMID: 23185208 DOI: 10.5114/aoms.2012.28594
Cyclospora sp causing diarrhea in man

Sinniah B, Rajeswari B, Johari S, Ramakrishnan K, Yusoff SW, Rohela M

Southeast Asian J. Trop. Med. Public Health, 1994 Mar;25(1):221-3.
PMID: 7825021
Field's stain--a rapid staining method for Acanthamoeba spp

Pirehma M, Suresh K, Sivanandam S, Anuar AK, Ramakrishnan K, Kumar GS

Parasitol Res, 1999 Oct;85(10):791-3.
PMID: 10494803

Acanthamoeba sp. is a free-living amoeba known to cause chronic central nervous system infection or eye infection in humans. Many cases remain undetected for want of a good detection system. We report for the first time a rapid staining method to facilitate the identification of Acanthamoeba sp. using the modified Field's staining technique. A. castellanii, which was used in the present experiment, is maintained in our laboratory in mycological peptone medium (Gibco). The cultures were pooled together and smears were made on glass slides for staining purposes. Different types of stains such as Field's stain, modified Field's stain, Wright's stain, Giemsa stain, Ziehl-Neelsen stain, and trichrome stain were used to determine the best stain for the identification of this amoeba. The concentration of various stains and the duration of staining were varied to provide the best color and contrast for each stain. Acanthamoeba was also obtained from the brain of experimentally infected mice and was stained with various stains as mentioned above to determine the best stain for use in identifying the presence of this parasite in experimentally infected animals. The modified Field's stain gives a very good color contrast as compared with other stains. Furthermore, it takes only 20 s to be carried out using the least number of reagents, making it suitable for both laboratory and field use.
Irregular shedding of Blastocystis hominis

Vennila GD, Suresh Kumar G, Khairul Anuar A, Rajah S, Saminathan R, Sivanandan S, et al.

Parasitol Res, 1999 Feb;85(2):162-4.
PMID: 9934969

The shedding pattern of the protozoan parasite, Blastocystis hominis, is investigated in man and in experimental animal infections. The shedding pattern of the vacuolar and cystic forms of Blastocystis hominis in infected individuals have been shown in the present study to be irregular. The study shows that there is marked fluctuation in the shedding of the parasite from day to day, varying from as high as 17 to 0 per x40 microscopic field. The cystic stages when estimated in 8 Blastocystis-infected individuals ranged from as high as 7.4x10(5) cysts per gram of stool to 0. The shedding of cystic and vacuolar forms observed over a period of 20 days in experimentally-infected Wistar rats were not only shown to be irregular but the amount varied from host to host. The study has important diagnostic implications in that the stool samples must be collected more than once from patients showing clinical signs and symptoms to eliminate the cause of it to Blastocystis. The study also shows that there are asymptomatic individuals who pass a large amount of cysts as such individuals should be treated to prevent transmission to others.
Fulltext COVID-19 impact: Customised economic stimulus package recommender system using machine learning techniques

Kannan R, Wang IZW, Ong HB, Ramakrishnan K, Alamsyah A

F1000Res, 2021 09 16;10:932.
PMID: 34925768 DOI: 10.12688/f1000research.72976.2

Background: The Malaysian government reacted to the pandemic's economic effect with the Prihatin Rakyat Economic Stimulus Package (ESP) to cushion the novel coronavirus 2019 (COVID-19) impact on households. The ESP consists of cash assistance, utility discount, moratorium, Employee Provident Fund (EPF) cash withdrawals, credit guarantee scheme and wage subsidies. A survey carried out by the Department of Statistics Malaysia (DOSM) shows that households prefer different types of financial assistance. These preferences forge the need to effectively customise ESPs to manage the economic burden among low-income households. In this study, a recommender system for such ESPs was designed by leveraging data analytics and machine learning techniques. Methods: This study used a dataset from DOSM titled "Effects of COVID-19 on the Economy and Individual - Round 2," collected from April 10 to April 24, 2020. Cross-Industry Standard Process for Data Mining was followed to develop machine learning models to classify ESP receivers according to their preferred subsidies types. Four machine learning techniques-Decision Tree, Gradient Boosted Tree, Random Forest and Naïve Bayes-were used to build the predictive models for each moratorium, utility discount and EPF and Private Remuneration Scheme (PRS) cash withdrawals subsidies. The best predictive model was selected based on F-score metrics. Results: Among the four machine learning techniques, Gradient Boosted Tree outperformed the rest. This technique predicted the following: moratorium preferences with 93.8% sensitivity, 82.1% precision and 87.6% F-score; utilities discount with 86% sensitivity, 82.1% precision and 84% F-score; and EPF and PRS with 83.6% sensitivity, 81.2% precision and 82.4% F-score. Households that prefer moratorium subsidies did not favour other financial aids except for cash assistance. Conclusion: Findings present machine learning models that can predict individual household preferences from ESP. These models can be used to design customised ESPs that can effectively manage the financial burden of low-income households.
Sweat gland morphology and physiology in diabetes, neuropathy, and nephropathy: a review

Singaram S, Ramakrishnan K, Selvam J, Senthil M, Narayanamurthy V

Arch Physiol Biochem, 2024 Aug;130(4):437-451.
PMID: 36063413 DOI: 10.1080/13813455.2022.2114499

Context: Sweat glands (SGs) play a vital role in thermal regulation. The function and structure are altered during the different pathological conditions.Objective: These alterations are studied through three techniques: biopsy, sweat analytes and electrical activity of SG.Methods: The morphological study of SG through biopsy and various techniques involved in quantifying sweat analytes is focussed on here. Electrical activities of SG in diabetes, neuropathy and nephropathy cases are also discussed, highlighting their limitations and future scope.Results and Conclusion: The result of this review identified three areas of the knowledge gap. The first is wearable sensors to correlate pathological conditions. Secondly, there is no device to look for its structure and quantify its associated function. Finally, therapeutic applications of SG are explored, especially for renal failure. With these aspects, this paper provides information collection and correlates SG with pathologies related to diabetes. Hence this could help researchers develop suitable technologies for the gaps identified.
Fulltext Job characteristics of a Malaysian bank's anti-money laundering system and its employees' job satisfaction

Kannan R, Reddiar Y, Ramakrishnan K, Eastaff MS, Ramesh S

F1000Res, 2021;10:1052.
PMID: 36225238 DOI: 10.12688/f1000research.73234.2

Background: Banks and financial institutions are vulnerable to money laundering (ML) as a result of crime proceeds infiltrating banks in the form of significant cash deposits. Improved financial crime compliance processes and systems enable anti-ML (AML) analysts to devote considerable time and effort to case investigation and process quality work, thereby lowering financial risks by reporting suspicious activity in a timely and effective manner. This study uses Job Characteristics Theory (JCT) to evaluate the AML system through the job satisfaction and motivation of its users. The purpose of this study is to determine how satisfied AML personnel are with their jobs and how motivated they are to work with the system. Methods: This cross-sectional study used JCT to investigate the important elements impacting employee satisfaction with the AML system. The five core dimensions of the job characteristics were measured using a job diagnostic survey. The respondents were employees working in the AML department of a Malaysian bank, and the sample group was chosen using a purposive sampling approach. A total of 100 acceptable replies were gathered and analysed using various statistical approaches. A motivating potential score was generated for each employee based on five main job characteristics. Results: Findings revealed that five core job characteristics, namely, skill diversity, task identity, task importance, autonomy and feedback, positively influence the AML system employees' job satisfaction. However, skill variety and autonomy are found to be low, which are reflected in the poor motivating potential score. Conclusion: This study examined the characteristics of the AML system and its users' job satisfaction. Findings revealed that task significance is the most widely recognised characteristic, followed by feedback and task identity. However, there is a lack of skill variety and autonomy, which must be addressed to improve employee satisfaction with the AML system.
Blastocystis in animal handlers

Rajah Salim H, Suresh Kumar G, Vellayan S, Mak JW, Khairul Anuar A, Init I, et al.

Parasitol Res, 1999 Dec;85(12):1032-3.
PMID: 10599928

The present study investigated whether people working closely with animals were at higher risk of getting infected with Blastocystis hominis. The prevalence of the parasite was determined in two population groups, i.e., animal handlers and normal healthy individuals who did not work with animals. In all, 105 stool samples were collected from animal handlers from 2 local research institutions, a local zoo, and a local abattoir and 163 stool samples were collected from normal healthy individuals residing in high-rise flats in the city. The in vitro culture method used in the study detected that 41% of 105 animal handlers and 17% of 163 flat-dwellers in the city were positive for Blastocystis. This statistically significant finding (P = 0.0000313) shows that people who work closely with animals do stand at risk of acquiring Blastocystis infection.
Long-term nasogastric tube feeding in elderly stroke patients--an assessment of nutritional adequacy and attitudes to gastrostomy feeding in Asians

Zaherah Mohamed Shah F, Suraiya HS, Poi PJ, Tan KS, Lai PS, Ramakrishnan K, et al.

J Nutr Health Aging, 2012 Aug;16(8):701-6.
PMID: 23076512 DOI: 10.1007/s12603-012-0027-y

BACKGROUND: Gastrostomy feeding is superior to long-term nasogastric (NG) feeding in patients with dysphagic stroke, but this practice remains uncommon in Asia. We sought to examine the nutritional adequacy of patients on long term NG feeding and identify barriers to gastrostomy feeding in these patients.
METHODOLOGY: A prospective comparison of subjective global assessment (SGA), and anthropometry (mid-arm muscle circumference, MAMC; triceps skinfold thickness, TST) between elderly stroke patients on long-term NG feeding and matched controls was performed. Selected clinicians and carers of patients were interviewed to assess their knowledge and attitudes to gastrostomy feeding.
RESULTS: 140 patients (70 NG, 70 oral) were recruited between September 2010 and February 2011. Nutritional status was poorer in the NG compared to the oral group (SGA grade C 38.6% NG vs 0% oral, p<0.001; TST males 10.7 + 3.7 mm NG vs 15.4 + 4.6 mm oral, p<0.001; MAMCmales 187.9 + 40.4 mm NG vs 228.7 + 31.8 mm oral, p<0.001). 45 (64.3%) patients on long-term NG feeding reported complications, mainly consisting of dislodgement (50.5%), aspiration of feed content (8.6%) and trauma from insertion (4.3%). Among 20 clinicians from relevant speciliaties who were interviewed, only 11 (55%) clinicians would routinely recommend a PEG. All neurologists (100%) would recommend a PEG, whilst the response was mixed among non-neurologists. Among carers, lack of information (47.1%) was the commonest reason stated for not choosing a PEG.
CONCLUSION: Elderly patients with stroke on long term NG feeding have a poor nutritional status. Lack of recommendation by clinicians appears to be a major barrier to PEG feeding in these patients.