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  1. Ramasamy S, Yu SM
    At the contemporary workplace, employees are expecting non-tangible resources on top of economic benefits, which suggests the importance of psychological contract. However, studies to date are inclined to focus on outcomes of psychological contract. Given that psychological contract is a perception and involves fulfilment of obligations, employees’ grit and the ability of utilisation of emotion in facilitating cognitive processes might influence psychological contract. The aim of this paper is to examine the relationship between grit and psychological contract with emotional utilisation acting as the mediator in the relationship. Therefore, a cross-sectional survey was conducted. Data were collected from 194 university staff using three measures: Psychological Contract Inventory, Short Grit Scale, and Assessing Emotions Scale. Correlation was conducted to examine the relationships between the three constructs. Regression analysis was conducted using SPSS 23 to test for mediation effect of emotional utilisation. The results revealed that grit and utilisation of emotion had significant relationships with psychological contract respectively, and grit was also significantly related to utilisation of emotion. Moreover, utilisation of emotion mediated the relationship between grit and psychological contract. The findings provide implications for employers to take into account of grit and utilisation of emotion in addressing psychological contract of employees.
  2. Ramasamy S, Kiew LV, Chung LY
    Molecules, 2014 Feb 24;19(2):2588-601.
    PMID: 24566323 DOI: 10.3390/molecules19022588
    Bacopa monnieri and the constituents of this plant, especially bacosides, possess various neuropharmacological properties. Like drugs, some herbal extracts and the constituents of their extracts alter cytochrome P450 (CYP) enzymes, causing potential herb-drug interactions. The effects of Bacopa monnieri standardized extract and the bacosides from the extract on five major CYP isoforms in vitro were analyzed using a luminescent CYP recombinant human enzyme assay. B. monnieri extract exhibited non-competitive inhibition of CYP2C19 (IC50/Ki = 23.67/9.5 µg/mL), CYP2C9 (36.49/12.5 µg/mL), CYP1A2 (52.20/25.1 µg/mL); competitive inhibition of CYP3A4 (83.95/14.5 µg/mL) and weak inhibition of CYP2D6 (IC50 = 2061.50 µg/mL). However, the bacosides showed negligible inhibition of the same isoforms. B. monnieri, which is orally administered, has a higher concentration in the gut than the liver; therefore, this herb could exhibit stronger inhibition of intestinal CYPs than hepatic CYPs. At an estimated gut concentration of 600 µg/mL (based on a daily dosage of 300 mg/day), B. monnieri reduced the catalytic activities of CYP3A4, CYP2C9 and CYP2C19 to less than 10% compared to the total activity (without inhibitor = 100%). These findings suggest that B. monnieri extract could contribute to herb-drug interactions when orally co-administered with drugs metabolized by CYP1A2, CYP3A4, CYP2C9 and CYP2C19.
  3. Subramanian P, Ramasamy S, Ng KH, Chinna K, Rosli R
    Int J Nurs Pract, 2016 Jun;22(3):232-8.
    PMID: 25355297 DOI: 10.1111/ijn.12363
    Alleviating acute pain and providing pain relief are central to caring for surgical patients as pain can lead to many adverse medical consequences. This study aimed to explore patients' experience of pain and satisfaction with postoperative pain control. A cross-sectional survey was carried out among 107 respondents who had undergone abdominal surgery in the surgical ward of an urban hospital using the Revised American Pain Society's Patient Outcome and Satisfaction Survey Questionnaires (APS-POQ-R). Data were analysed using descriptive statistics and chi-square test. Chi-square test showed significant association between race (P = 0.038), education level (P ≤ 0.001), previous operation status (P = 0.032) and operation status (P ≤ 0.001). Further analysis on nominal regression, association between dissatisfaction with factors of operation status (46.09 (95% CI 7.456, 284.947)) and previous operation status (13.38 (95% CI 1.39, 128.74)) was found to be significant. Moderate to high levels of pain intensity in the last 24 h after surgery, as well as moderate to high rates of pain-related interference with care activities were most reported. Pain still remains an issue among surgical patients, and effective pain management and health education are needed to manage pain more effectively after surgery.
  4. Ramasamy S, Abdul Wahab N, Zainal Abidin N, Manickam S, Zakaria Z
    PLoS One, 2012;7(4):e34793.
    PMID: 22536331 DOI: 10.1371/journal.pone.0034793
    Phyllanthus watsonii Airy Shaw is an endemic plant found in Peninsular Malaysia. Although there are numerous reports on the anti cancer properties of other Phyllanthus species, published information on the cytotoxicity of P. watsonii are very limited. The present study was carried out with bioassay-guided fractionation approach to evaluate the cytotoxicity and apoptosis induction capability of the P. watsonii extracts and fractions on human gynecologic (SKOV-3 and Ca Ski) and colon (HT-29) cancer cells. P. watsonii extracts exhibited strong cytotoxicity on all the cancer cells studied with IC(50) values of ≤ 20.0 µg/mL. Hexane extract of P. watsonii was further subjected to bioassay-guided fractionation and yielded 10 fractions (PW-1→PW-10). PW-4→PW-8 portrayed stronger cytotoxic activity and was further subjected to bioassay-guided fractionation and resulted with 8 sub-fractions (PPWH-1→PPWH-8). PPWH-7 possessed greatest cytotoxicity (IC(50) values ranged from 0.66-0.83 µg/mL) and was selective on the cancer cells studied. LC-MS/MS analysis of PPWH-7 revealed the presence of ellagic acid, geranic acid, glochidone, betulin, phyllanthin and sterol glucoside. Marked morphological changes, ladder-like appearance of DNA and increment in caspase-3 activity indicating apoptosis were clearly observed in both human gynecologic and colon cancer cells treated with P. watsonii especially with PPWH-7. The study also indicated that P. watsonii extracts arrested cell cycle at different growth phases in SKOV-3, Ca Ski and HT-29 cells. Cytotoxic and apoptotic potential of the endemic P. watsonii was investigated for the first time by bioassay-guided approach. These results demonstrated that P. watsonii selectively inhibits the growth of SKOV-3, Ca Ski and HT-29 cells through apoptosis induction and cell cycle modulation. Hence, P. watsonii has the potential to be further exploited for the discovery and development of new anti cancer drugs.
  5. Ramasamy S, Abdul Wahab N, Zainal Abidin N, Manickam S
    Exp. Toxicol. Pathol., 2013 Mar;65(3):341-9.
    PMID: 22217449 DOI: 10.1016/j.etp.2011.11.005
    Species of Phyllanthus have traditionally been used for hundreds of years for treating many ailments including diabetes, anemia, bronchitis and hepatitis. The present study aims to investigate the cytotoxic and apoptotic effects of methanol (PWM), hexane (PWH) and ethyl acetate (PWE) extracts from the leaves of the endemic plant Phyllanthus watsonii Airy Shaw (Phyllanthaceae) on MCF-7 human breast cancer cells. We observed that the PWM, PWH and PWE extracts were cytotoxic and selectively inhibited the growth and proliferation of MCF-7 cells compared to untreated control in a dose dependent manner with an IC(50) of 12.7 ± 4.65, 7.9 ± 0.60 and 7.7 ± 0.29 μg/ml, respectively. However, the extracts were not toxic at these concentrations to normal human lung fibroblast MRC-5 cells. Cell death induced by PWM, PWH and PWE extracts were mainly due to apoptosis which was characterized by apoptotic morphological changes and a nuclear DNA fragmentation. Caspase-3 activation following P. watsonii extracts treatment was also evident for apoptotic cell death which was preceded by an S phase cell cycle perturbation. The results suggested that the cytotoxic activity of P. watsonii extracts was related to an early event of cell cycle perturbation and a later event of apoptosis. Hence, P. watsonii displays potential to be further exploited in the discovery and development of new anticancer agents.
  6. Ramasamy SP, Chandrasekaran S, Jayakumar CR, Mallick AS
    Singapore Med J, 1992 Apr;33(2):196-7.
    PMID: 1621130
    A 27-year-old gravida two para one mother delivered a term male baby by caesarean section. The baby was referred for enlarged head. This neonate with large head was found to have Porencephalic cyst with dilated Triventricular system. There was a posterior fossa cyst communicating with fourth ventricle. A diagnosis of Dandy Walker Cyst with Porencephaly was made. Ventriculo-Peritoneal shunt was done on the ninth day of life. The baby had an uneventful postoperative period and was subsequently discharged.
  7. Yusof Z, Ramasamy S, Mahmood NZ, Yaacob JS
    Molecules, 2018 Jun 04;23(6).
    PMID: 29867000 DOI: 10.3390/molecules23061345
    This project studied the effect of vermicompost application on the composition of bioactive anthocyanin and phenolic compounds, and the antioxidant activity of Clinacanthus nutans. The correlation between the bioactive constituents and antioxidant capacity was also evaluated. In this project, a field study was conducted using a randomized complete block design (RCBD) with four treatment groups, including control plants (CC), plants supplied with chemical fertilizer (CF), plants supplied with vermicompost (VC), and plants supplied with mixed fertilizer (MF). The leaves of C. nutans from all treatment groups were harvested, subjected to solvent extraction, and used for quantification of total anthocyanin content (TAC), total phenolic content (TPC), and total flavonoid content (TFC). The initial antioxidant activity of the extracts was evaluated using 2,2-Diphenyl-1-picrylhydrazyl (DPPH) and 2,2'-azinobis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) assays, as well as after two and four weeks of storage at -20 °C and 4 °C. Data analysis showed that CC plants contained the highest TAC (2180.14 ± 338.43 µg/g dry weight) and TFC (276.25 ± 3.09 mg QE/g dry weight). On the other hand, CF plants showed the highest TPC (181.53 ± 35.58 mg GAE/g dry weight). Moreover, we found that CC plants had the highest antioxidant potential against DPPH radicals whereas MF plants showed the lowest antioxidant potential. After four weeks of extract storage at -20 °C and 4 °C, the TPC, TFC, TAC, and antioxidant potential of the extracts decreased. Extracts from VC showed the lowest percentage of total phenolic and total flavonoid loss after extract storage at -20 °C and 4 °C compared with other plant extracts. At this juncture, it could be deduced that the application of vermicompost had little effect on the expression of phenolics, flavonoids, or anthocyanin in C. nutans. However, the extract from plants treated with vermicompost (VC and MF) showed better stability compared with CC and CF after extract storage at different temperatures.
  8. Foong AL, Sow CF, Ramasamy S, Yap PS
    Int J Med Educ, 2019 Jan 25;10:1-8.
    PMID: 30685752 DOI: 10.5116/ijme.5c30.988d
    Objectives: This study was aimed at determining whether the pre-tertiary education system and ethnicity have any association with the attitudes of medical undergraduates towards communication skills. It also sought to determine if attitudes should have any relationship with communication skills assessment outcomes.

    Methods: A cross-section survey design was performed with 323 participants from two cohorts of medical undergraduates, i.e., first-year (n = 153) and second-year students (n = 170) who completed the Communication Skills Attitude Scale. Participants comprised of the main ethnic groups in Malaysia, i.e., Malays, Chinese and Indians, from different language medium pre-tertiary education backgrounds. Attitude measurements were compared with OSCE outcomes.

    Results: There was a significant difference in Negative Attitude Scale between pre-tertiary education system with attitudes towards communication skills (F (3, 319) = 7.79, p = .001), but no significant difference with Positive Attitude Scale (F (3, 319) = 0.43, p = .649). There was no significant difference between ethnicity and attitudes towards communication skills with PAS (F (2, 320) = 0.66, p = .519) and NAS (F (2, 320) = 1.24, p = .291). Students from Chinese medium education system had stronger negative attitudes with a mean score of 14.7 (n = 56, SD = 3.6) for primary school levels and 15.9 (n = 17, SD = 3.0) for secondary school levels, compared with others. There was no significant prediction of student's attitudes towards assessments outcomes.

    Conclusions: Preliminary findings from the small data pool suggest indicative relationships requiring further studies with more participants and proportionate pre-tertiary education system backgrounds.

  9. Saraswathy T, Nalliah S, Rosliza AM, Ramasamy S, Jalina K, Shahar HK, et al.
    BMC Med Educ, 2021 Sep 09;21(1):482.
    PMID: 34503488 DOI: 10.1186/s12909-021-02907-1
    BACKGROUND: This study aimed at determining the effectiveness of an innovative approach using interprofessional simulation scenarios (IPSS) in improving knowledge, attitude, and practice (KAP) of hospital-acquired infection control (HAIC) among health professionals.

    METHODS: The interventional study was conducted in a teaching hospital in Malaysia. Purposive sampling was used to recruit participants from surgical, intensive care, and other units. Thirty-six health professionals in the experimental and forty in the control group completed the study. All subjects participated in an interactive lecture and demonstrated four IPSS on HAIC i.e. (i) taking blood specimen (ii) bedsore dressing (iii) collecting sputum for acid-fast bacilli and (iv) intermittent bladder catheterization. Each team consisted of a doctor and a nurse. A self-administered questionnaire on KAP on HAIC was completed by respondents during the pre-, immediately and, post-intervention. An independent t-test was conducted to measure the significance between the experimental and control group.

    RESULTS: The mean scores for KAP among the experimental group increased following the intervention. Significant differences in scores were seen between the two groups post-intervention (p 

  10. Subramaniam S, Rahmat J, Rahman NA, Ramasamy S, Bhoo-Pathy N, Pin GP, et al.
    Asian Pac J Cancer Prev, 2014;15(18):7863-7.
    PMID: 25292078
    BACKGROUND: Retinoblastoma is a rare type of cancer that usually develops in early childhood. If left untreated it can cause blindness and even death. The aim of this study is to determine sociodemographic and clinical features of retinoblastoma patients and also to determine the treatment pattern and outcome in Malaysia.

    MATERIALS AND METHODS: Data for this study were retrieved from the Retinoblastoma Registry of the National Eye Database (NED) in Malaysia. Hospital Kuala Lumpur, Hospital Umum Kuching, Sarawak and Hospital Queen Elizabeth, Kota Kinabalu were the major source data providers for this study. Data collected in the registry cover demography, clinical presentation, modes of treatment, outcomes and complications.

    RESULTS: The study group consisted of 119 patients (162 eyes) diagnosed with retinoblastoma between 2004 and 2012. There were 68 male (57.1%) and 51 (42.9%) female. The median age at presentation was 22 months. A majority of patients were Malays (54.6%), followed by Chinese (18, 5%), Indians (8.4%), and indigenous races (15.9%). Seventy six (63.8%) patients had unilateral involvement whereas 43 patients had bilateral disease (36.1%). It was found that most children presented with leukocoria (110 patients), followed by strabismus (19), and protopsis (12). Among the 76 with unilateral involvement (76 eyes), enucleation was performed for a majority (79%). More than half of these patients had extraocular extension. Of the 40 who received chemotherapy, 95% were given drugs systemically. Furthermore, in 43 patients with bilateral involvement (86 eyes), 35 (41%) eyes were enucleated and 17 (49%) showed extraocular extension. Seventy-two percent of these patients received systemic chemotherapy. The patients were followed up 1 year after diagnosis, whereby 66 were found to be alive and 4 dead. Sixteen patients defaulted treatment and were lost to follow-up, whereas follow-up data were not available in 33 patients.

    CONCLUSIONS: Patients with retinoblastoma in this middle-income Asian setting are presenting at late stages. As a result, a high proportion of patients warrant aggressive management such as enucleation. We also showed that a high number of patients default follow-up. Therefore, reduction in refusal or delay to initial treatment, and follow-up should be emphasized in order to improve the survival rates of retinoblastoma in this part of the world.
  11. Lim JS, Singh O, Ramasamy RD, Ramasamy S, Subramanian K, Lee EJ, et al.
    Drug Metab. Pharmacokinet., 2010;25(6):616-23.
    PMID: 20930417
    CYP1A2 play an important role in the metabolism of many carcinogens and clinically important drugs. CYP1A2 activity has been found to be influenced by the presence of polymorphic variants which were reported to display wide interethnic variation. This study investigates the frequency distribution and linkage disequilibrium patterns of CYP1A2 genetic polymorphisms, and characterize their haplotype structures in three healthy Asian populations in Singapore (Chinese, Malay, and Indian). The entire CYP1A2 gene was screened in 126 healthy subjects from all three ethnic groups (N=42 each). A total of 25 polymorphisms was identified, of which nine were novel. The polymorphisms, -2467delT and -163C>A were detected at high frequencies in all Asian ethnic groups. Significant interethnic differences were observed in the genotypic frequency distribution of IVS2-99G>A (P<0.01) and 1548C>T (P=0.05) across the three ethnic groups while -163C>A (P=0.02) was found to differ between Chinese and Malays. Haplotype analyses revealed four to six major haplotypes in each ethnic population which accounted for more than 60% of the cumulative haplotype frequencies. Future studies should be done to investigate the functional roles of these haplotypes.
  12. Ramasamy S, Chin SP, Sukumaran SD, Buckle MJ, Kiew LV, Chung LY
    PLoS One, 2015;10(5):e0126565.
    PMID: 25965066 DOI: 10.1371/journal.pone.0126565
    Bacopa monnieri has been used in Ayurvedic medicine to improve memory and cognition. The active constituent responsible for its pharmacological effects is bacoside A, a mixture of dammarane-type triterpenoid saponins containing sugar chains linked to a steroid aglycone skeleton. Triterpenoid saponins have been reported to be transformed in vivo to metabolites that give better biological activity and pharmacokinetic characteristics. Thus, the activities of the parent compounds (bacosides), aglycones (jujubogenin and pseudojujubogenin) and their derivatives (ebelin lactone and bacogenin A1) were compared using a combination of in silico and in vitro screening methods. The compounds were docked into 5-HT1A, 5-HT2A, D1, D2, M1 receptors and acetylcholinesterase (AChE) using AutoDock and their central nervous system (CNS) drug-like properties were determined using Discovery Studio molecular properties and ADMET descriptors. The compounds were screened in vitro using radioligand receptor binding and AChE inhibition assays. In silico studies showed that the parent bacosides were not able to dock into the chosen CNS targets and had poor molecular properties as a CNS drug. In contrast, the aglycones and their derivatives showed better binding affinity and good CNS drug-like properties, were well absorbed through the intestines and had good blood brain barrier (BBB) penetration. Among the compounds tested in vitro, ebelin lactone showed binding affinity towards M1 (Ki = 0.45 μM) and 5-HT2A (4.21 μM) receptors. Bacoside A and bacopaside X (9.06 μM) showed binding affinity towards the D1 receptor. None of the compounds showed any inhibitory activity against AChE. Since the stimulation of M1 and 5-HT2A receptors has been implicated in memory and cognition and ebelin lactone was shown to have the strongest binding energy, highest BBB penetration and binding affinity towards M1 and 5-HT2A receptors, we suggest that B. monnieri constituents may be transformed in vivo to the active form before exerting their pharmacological activity.
  13. Poh KW, Wai YZ, Rahmat J, Shunmugam M, Alagaratnam J, Ramasamy S
    Int J Ophthalmol, 2017;10(3):488-490.
    PMID: 28393045 DOI: 10.18240/ijo.2017.03.26
  14. Chew FLM, Thavaratnam LK, Shukor INC, Ramasamy S, Rahmat J, Reidpath DD, et al.
    Med J Malaysia, 2018 02;73(1):25-30.
    PMID: 29531199 MyJurnal
    INTRODUCTION: Little is known regarding the extent of visual impairment amongst pre-school children in Malaysia.

    OBJECTIVE: To determine the prevalence of visual impairment and amblyopia in Malaysian preschool children.

    METHODOLOGY: A cross-sectional, population-based study was conducted on children aged four to six years from 51 participating kindergartens in the district of Segamat, Johor, Malaysia from 20 March 2016 to 6 April 2016. All subjects had initial eye screening consisting of LogMar visual acuity, orthoptics examination and Spot vision screener assessment. Subjects who failed the initial eye screening were invited for a formal eye assessment consisting of cycloplegic refraction and a comprehensive ocular examination. Definitions of visual impairment and amblyopia were based on the Multi-Ethnic Pediatric Eye Disease Study criteria.

    RESULTS: A total of 1287 children were recruited. Mean subject age was 5.03 (SD:0.77) and males represented 52.3% of subjects. Subjects by ethnicity were Malay (54.8%), Chinese (27.7%), Indian (15.6%) and Orang Asli (1.9%). Formal eye assessment was required for 221 subjects and 88.8% required ophthalmic intervention. Refractive error, representing 95.4% of diagnosed ocular disorders, comprised of astigmatism (84%), myopia (9%) and hypermetropia (6.9%). With-the-rule astigmatism was present in 93.4% of the subjects with astigmatism. Visual impairment was present in 12.5% of our subjects, with 61% having bilateral visual impairment. Of the subjects with visual impairment, 59.1% had moderate visual impairment. The prevalence of amblyopia was 7.53%, and 66% of the amblyopic subjects had bilateral amblyopia.

    CONCLUSION: Our study highlights an urgent need for initiation of preschool vision screening in Malaysia.

  15. Chew FLM, Qurut SE, Hassan I, Lim ST, Ramasamy S, Rahmat J
    Med J Malaysia, 2019 02;74(1):15-19.
    PMID: 30846656
    INTRODUCTION: Paediatric cataract surgery is challenging with reported post-operative visual acuity (VA) of 0.3LogMar or better varying between 33% to 68% of patients.

    OBJECTIVE: The aim is to document the post-operative refraction, VA and complications of non-traumatic pediatric cataract surgery performed in a tertiary referral center in Malaysia.

    METHODOLOGY: This retrospective study reviewed case notes of all consecutive patients aged 12 years and below who underwent cataract surgery from January 2010 to December 2015. Patients were recruited if they had a minimum of six months post-operative follow-up. Exclusion criteria included traumatic cataract, central nervous system abnormalities, incomplete medical records or pre-existing ocular pathology. Subjects were divided into two groups based on refraction at one month. Subjects with refraction within 1- dioptre of the targeted spherical equivalent were in the success group and the rest were in the failure group.

    RESULTS: A total of 111 subjects were recruited (65 subjects in success group and 46 subjects in the failure group). Mean age at surgery was 33.14 (SD: 33.47) months. The success group had significantly longer axial length (p:0.0045, CI: 0.566-0.994, OR: 0.750). At final review, 44.1%(49/111) subjects had visual acuity of 0.3LogMar or better. The success group had better final mean VA in comparison to the failure group (p:0.034, CI:1.079-7.224, OR: 2.791).

    CONCLUSION: The outcome of non-traumatic paediatric cataract surgery was acceptable with 58.6% achieved targeted refractive correction at 1-month post-operative period. Longer axial length was associated with better refractive outcome. Capsule related complications was the most common intra-operative complication.

  16. Thangarajoo S, Rosliza AM, Nalliah S, Karim J, Shohaimi S, Ramasamy S, et al.
    BMC Med Educ, 2021 Apr 26;21(1):243.
    PMID: 33902577 DOI: 10.1186/s12909-021-02610-1
    BACKGROUND: Interprofessional learning (IPL) is a key challenge in Malaysia in incorporating the current profession-specific medical education into the interprofessional learning curriculum. Safe practices would be enhanced with improved collaboration among the health professionals when they learn with, from, and about each other. The main objective of this study was to determine the significant differences in self-assessment, attitude, and perception of interprofessional learning among doctors and nurses in a teaching hospital in Klang Valley, Malaysia. The second objective was to determine if there is any significant difference in the selected demography factors, mean and total scores between doctors and nurses in self-assessment, attitude, and perceptions of IPL aspects.

    METHODS: A total of doctors (39) and nurses (37) were recruited for an interventional study on the interprofessional learning approach on hospital acquired infection control. The participants responded to the University of West England Interprofessional (UWEIP) questionnaire at baseline consisting of four dimensions in IPL aspects; Self-assessment on communication and teamwork skills (CTW), interprofessional learning (IPL), interprofessional interaction (IPI), and interprofessional relationship (IPR). The Cronbach alpha value for the total questionnaire was established at 0.79.

    RESULTS: The majority of doctors scored positive in CTW, IPL, IPR, and neutral in IPI. Nurses' also recorded the highest positive scores in CTW, IPL, and IPR, and neutral in IPI. Negative scores were found in CTW and IPI. A significant difference was revealed between doctors and nurses in IPL attitude; p = 0.024 and there was no significant difference in other dimensions (p > .05). Results also found a significant difference between participants' and non-participants of IPL training sessions; p = 0.009.

    CONCLUSIONS: This study revealed the infusion of interprofessional learning training among the health professionals displayed better self-assessments, attitudes, and perceptions towards collaborative practices.

  17. Mohd Khalid MK, Yakob Y, Md Yasin R, Wee Teik K, Siew CG, Rahmat J, et al.
    Mol. Vis., 2015;21:1185-90.
    PMID: 26539030
    The availability of molecular genetic testing for retinoblastoma (RB) in Malaysia has enabled patients with a heritable predisposition to the disease to be identified, which thus improves the clinical management of these patients and their families. In this paper, we presented our strategy for performing molecular genetic testing of the RB1 gene and the findings from our first 2 years of starting this service.
  18. Teow Kheng Leong K, Abu Kassim SNA, Sidhu JK, Zohari Z, Sivalingam T, Ramasamy S, et al.
    BMC Ophthalmol, 2021 Mar 09;21(1):128.
    PMID: 33750348 DOI: 10.1186/s12886-021-01882-x
    BACKGROUND: The current practice for new-born eye examination by an Ophthalmologist in Malaysian hospitals is limited to only preterm new-borns, syndromic or ill infants. Healthy term new-borns are usually discharged without a thorough eye examination. This study is aimed at determining the proportion and types of ocular abnormalities detected in purportedly healthy term new-borns.

    METHOD: This cross-sectional study is comprised of 203 participants, all purportedly healthy term new-born infants from the Obstetrics and Gynaecology ward at Hospital Kuala Lumpur over a 6 months period. The examination list includes external eye examination, red reflex test, and fundus imaging using a wide-field digital retinal imaging system (Phoenix Clinical ICON Paediatric Retinal Camera) by a trained Investigator. The pathologies detected were documented. The results were compared and correlated with similar studies published in the literature previously.

    RESULTS: Total ocular abnormalities were detected in 34% of the infants. The most common finding was retinal haemorrhage in 29.6% of the infants, of which 53.3% occurred bilaterally. Spontaneous vaginal delivery (SVD) remained the greatest risk factor which has nearly 3.5 times higher risk of new-borns developing retinal haemorrhage compared to Lower Segment Caesarean Section (LSCS). There was a 6% increased likelihood of developing retinal haemorrhage for every 1-min increment in the duration of 2nd stage of labour.

    CONCLUSION: Universal eye screening for all new-borns using a wide-field digital imaging system is realistically possible, safe, and useful in detecting posterior segment disorders. The most common abnormality detected is retinal haemorrhage.

  19. Chan JY, Li H, Singh O, Mahajan A, Ramasamy S, Subramaniyan K, et al.
    Urol Oncol, 2013 Nov;31(8):1553-60.
    PMID: 22561070 DOI: 10.1016/j.urolonc.2012.02.009
    OBJECTIVES: Recently, several genome-wide association studies have demonstrated a cumulative association of 5 polymorphic variants in chromosomes 8q24 and 17q with prostate cancer (CaP) risk in Caucasians, particularly those harboring aggressive clinicopathologic characteristics. The purpose of this study was to evaluate the influence of these variants on CaP susceptibility in Singaporean Asian men.
    MATERIALS AND METHODS: We performed a case-control study in 289 Chinese CaP patients and 412 healthy subjects (144 Chinese, 134 Malays, and 134 Indians), and examined the association of the 5 single nucleotide polymorphisms (SNPs) with CaP.
    RESULTS: In the healthy subjects, rs16901979 A-allele frequency was highest amongst Chinese (0.32) compared with Malays (0.13; P < 0.0001) or Indians (0.09; P < 0.0001); rs6983267 G-allele was highest in Indians (0.51) compared with Chinese (0.42; P = 0.041) or Malays (0.43; P = 0.077); whereas rs1859962 G-allele frequency was highest amongst Indians (0.56) compared with Chinese (0.40; P = 0.0002) or Malays (0.38; P < 0.0001). Individuals with the rs4430796 TT genotype were at increased CaP risk in the Chinese via a recessive model (odds ratios (OR) = 1.56, 95% CI = 1.04-2.33). Significant associations were observed for rs4430796 TT with Gleason scores of ≥ 7 (OR = 1.76, 95% CI = 1.14-2.73) and prostate-specific antigen (PSA) levels of ≥ 10 ng/ml at diagnosis (OR = 1.63, 95% CI = 1.01-2.63), as well as for rs6983267 GG with stage 3-4 CaPs (OR = 1.91, 95% CI = 1.01-3.61). A cumulative gene interaction influence on disease risk, which approximately doubled for individuals with at least 2 susceptibility genotypes, was also identified (OR = 2.18, 95% CI = 1.10-4.32).
    CONCLUSIONS: This exploratory analysis suggests that the 5 genetic variants previously described may contribute to prostate cancer risk in Singaporean men.
    KEYWORDS: Cancer; Ethnicity; Gleason; Pharmacogenetics; Polymorphism; Prostate
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