Displaying all 15 publications

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  1. Saravanan S, Vivek AS
    Med J Malaysia, 2007 Dec;62(5):418-9.
    PMID: 18705481 MyJurnal
    This is to report on the use of growing endoprosthesis, also known as lengthening prosthesis in the management of four patients in the paedriatic age group in the Orthopaedic Oncolgy Unit at University Malaya Medical Centre. These are custom made prosthesis, designed and made in India based on measured roentrograms. The ages of these patients vary from 6 to 13 years old. These are cases of Osteosarcoma and Ewing's sarcoma around the knee. This is the first time these custom made prosthesis have ever been used in Malaysia. We feel that this is a feasible option for limb salvage in the treatment of primary bone tumours in growing children.
  2. Saravanan S, Zairul Anuar KB, Zulkefli A, Ramanathan R
    Med J Malaysia, 2014 Oct;69(5):216-8.
    PMID: 25638234 MyJurnal
    OBJECTIVE: The aim is to find rate of return to work of surgically treated thoracolumbar fracture patients and to know if back pain, compensation issues or neurological status influence this rate.

    METHODOLOGY: A retrospective cohort study analysing the patients with thoracolumbar fractures treated surgically from January 2008 till December 2009.

    RESULTS: Neurological status is the main factor deciding return to work in this group. Back pain and compensation related issues were not statistically significant in influencing return to work. 74% of patients in this group return to work.

    CONCLUSION: Return to work among the patients with thoracolumbar fracture, treated surgically, is mainly dependent on neurological status and not the compensation related issues or back pain.
  3. Goh JH, Saravanan S, Ng WM, Looi LM, Ali R
    Malays Orthop J, 2010;4(1):50-52.
    MyJurnal
    We report a case of a 21 years old female who presented with a history of anterior knee pain for previous 3 months. Pain was localized to the anteromedial aspect of the left knee and aggravated by flexion. Clinical examination revealed a 2x2cm painful lump on the anteromedial aspect of the left medial condyle with no effusion. Magnetic resonance imaging revealed an anterosuperior tear of the medial collateral ligament. The patient subsequently underwent left knee arthroscopic examination. Two yellowish pedunculated masses arising from the anteromedial portion of the synovium were discovered and completely excised. Histopathological examination of the excision biopsy revealed pigmented villonodular synovitis (PVNS) with marked central necrosis. One year post excision, she is well with no signs or symptoms of recurrence. This case highlights an uncommon cause of anterior knee pain. Localized PVNS typically presents with mechanical symptoms, however, pain could arise from pedicle torsion and necrosis.
  4. Gopinath V, Saravanan S, Al-Maleki AR, Ramesh M, Vadivelu J
    Biomed Pharmacother, 2018 Nov;107:96-108.
    PMID: 30086465 DOI: 10.1016/j.biopha.2018.07.136
    Natural polysaccharides are renewable with a high degree of biocompatibility, biodegradability, and ability to mimic the natural extracellular matrix (ECM) microenvironment. Comprehensive investigations of polysaccharides are essential for our fundamental understanding of exploiting its potential as bio-composite, nano-conjugate and in pharmaceutical sectors. Polysaccharides are considered to be superior to other polymers, for its ease in tailoring, bio-compatibility, bio-activity, homogeneity and bio-adhesive properties. The main focus of this review is to spotlight the new advancements and challenges concerned with surface modification, binding domains, biological interaction with the conjugate including stability, polydispersity, and biodegradability. In this review, we have limited our survey to three essential polysaccharides including cellulose, starch, and glycogen that are sourced from plants, microbes, and animals respectively are reviewed. We also present the polysaccharides which have been extensively modified with the various types of conjugates for combating last-ditch pharmaceutical challenges.
  5. Narayani SS, Saravanan S, Ravindran J, Ramasamy MS, Chitra J
    Int J Biol Macromol, 2019 Oct 01;138:618-628.
    PMID: 31344415 DOI: 10.1016/j.ijbiomac.2019.07.127
    Fucoidan is a marine sulfated polysaccharide, which is extracted from brown seaweed that has a wide range of bioactivities including anti-cancer properties. However, the underlying mechanism of fucoidan on its anti-cancer and apoptotic activity against colon cancer cell line Caco-2 remains to be elucidated. Hence, the present study evaluated the cytotoxicity, apoptotic and anti-cancer activity of fucoidan extracted from brown seaweed Sargassum cinereum against Caco-2 cell line. Cytotoxicity, morphological examination of nuclei, mitochondrial membrane potential, flow cytometry, reactive oxygen species (ROS) formation and detection of apoptotic efficacy of fucoidan were assessed by different assay protocols. Fucoidan inhibited growth of Caco-2 cells in a dose-dependent manner. IC50 concentration of fucoidan was found to be 250 μg/ml. AO/EB, Hoechst and Annexin V/PI staining confirmed the apoptosis induced by fucoidan in Caco-2 cells. Fucoidan was also found to increase ROS production and augment mitochondrial membrane permeability. The findings of the study suggest that fucoidan exerts potent anti-cancer and apoptotic effect on Caco-2 cells by enhancing ROS production. Thus, fucoidan may be used as a promising therapeutic regimen against various cancer cell types.
  6. Sundaramurthy SSR, Allen KE, Fletcher MA, Liew KF, Borhanuddin B, Ali M, et al.
    BMC Infect Dis, 2024 Jan 12;24(1):79.
    PMID: 38216882 DOI: 10.1186/s12879-023-08611-3
    BACKGROUND: Pneumococcal disease caused by Streptococcus pneumoniae is an important cause of morbidity and mortality across all ages, particularly in younger children and older adults. Here, we describe pneumococcal disease hospitalizations at Ministry of Health (MoH) facilities in Malaysia between 2013 and 2015.

    METHODS: This was a retrospective databases analysis. Tabular data from the Malaysian Health Data Warehouse (MyHDW) were used to identify microbiologically confirmed, pneumococcal disease hospitalizations and deaths during hospitalization, using hospital-assigned ICD-10 codes (i.e., classified as meningitis, pneumonia, or non-meningitis non-pneumonia). Case counts, mortality counts, and case fatality rates were reported by patient age group and by Malaysian geographic region.

    RESULTS: A total of 683 pneumococcal disease hospitalizations were identified from the analysis: 53 pneumococcal meningitis hospitalizations (5 deaths and 48 discharges), 413 pneumococcal pneumonia hospitalizations (24 deaths and 389 discharges), and 205 non-meningitis non-pneumonia pneumococcal disease hospitalizations (58 deaths and 147 discharges). Most hospitalizations occurred in children aged 

  7. Chan CY, Kwan MK, Saravanan S, Saw LB, Deepak AS
    Med J Malaysia, 2007 Mar;62(1):33-5.
    PMID: 17682567 MyJurnal
    Assessment of the curve flexibility is a crucial step in a surgeon's pre-operative planning for scoliosis surgery. Many techniques have been described. These include traction films, supine side bending films, push prone techniques, traction under general anaesthesia as well as fulcrum bending film. In this study, we studied the pre- and immediate post-operative radiographs of twenty eight adolescent idiopathic scoliosis (AIS) patients who were corrected using pedicle screw systems between January 2004 and August 2006. There were twenty two females and six male patients. The mean age of the patients were 17.5 years with a range of 12 to 38 years. Skeletal maturity of the patients was assessed by Risser's score. The majority was Risser 4 (15 cases, 53.6%). Based on King and Moe's classification, the most common curve was type 3 curve (15 cases, 53.6%). Among the twenty eight patients, twenty three patients underwent only posterior correction, while 5 patients underwent additional anterior release surgery. The mean pre-operative Cobb's angle for the posterior surgery group was 65.5 +/- 13.9 degrees and the mean post-operative Cobb's angle was 32.9 +/- 12.6 degrees. There was no difference between the mean correction estimated by fulcrum bending films (Fulcrum Flexibility) and the post- operative Correction Rate figures (44.2% vs. 49.9%). The mean Fulcrum Bending Correction Index (FBCI) in this group of patients is 112.8%. In the group of patients who underwent additional anterior release, their curves were noted to be larger and less flexible with the mean pre-operative Cobb's angle and Fulcrum Flexibility of 90.4 degrees +/- 9.3 degrees and 23.4% respectively. The Fulcrum Bending Correction Index (FBCI) for this group of patients was significantly higher than the posterior surgery group: i.e. 164.0% vs 112.8%. Thus, anterior release does help to improve the correction significantly. The fulcrum bending films give good pre-operative estimation of the amount of correction to be expected post-operatively. The fulcrum bending films can help to identify the curve types which might require anterior release in order to improve the scoliosis correction. Using the Fulcrum Bending Correction Index (FBCI) will also enable surgeons to quantify more accurately the amount of correction achieved by taking into account the inherent flexibility of the spine.
  8. Swathirajan CR, Vignesh R, Boobalan J, Solomon SS, Saravanan S, Balakrishnan P
    J Med Microbiol, 2017 Oct;66(10):1379-1382.
    PMID: 28901908 DOI: 10.1099/jmm.0.000514
    BACKGROUND: Sustainable suppression of HIV replication forms the basis of anti-retroviral therapy (ART) medication. Thus, reliable quantification of HIV viral load has become an essential factor to monitor the effectiveness of the ART. Longer turnaround-time (TAT), batch testing and technical skills are major drawbacks of standard real-time PCR assays.

    METHODS: The performance of the point-of-care Xpert HIV-1 viral load assay was evaluated against the Abbott RealTime PCR m2000rt system. A total of 96 plasma specimens ranging from 2.5 log10 copies ml-1 to 4.99 log10 copies ml-1 and proficiency testing panel specimens were used. Precision and accuracy were checked using the Pearson correlation co-efficient test and Bland-Altman analysis.

    RESULTS: Compared to the Abbott RealTime PCR, the Xpert HIV-1 viral load assay showed a good correlation (Pearson r=0.81; P<0.0001) with a mean difference of 0.27 log10 copies ml-1 (95 % CI, -0.41 to 0.96 log10 copies ml-1; sd, 0.35 log10 copies ml-1).

    CONCLUSION: Reliable and ease of testing individual specimens could make the Xpert HIV-1 viral load assay an efficient alternative method for ART monitoring in clinical management of HIV disease in resource-limited settings. The rapid test results (less than 2 h) could help in making an immediate clinical decision, which further strengthens patient care.

  9. Swathirajan CR, Vignesh R, Waldrop G, Shanmugasundaram U, Nandagopal P, Solomon SS, et al.
    Curr. HIV Res., 2018;16(4):302-314.
    PMID: 30543175 DOI: 10.2174/1570162X17666181212122607
    BACKGROUND: Anti-viral cytokine expressions by cytotoxic T-cells and lower activation rates have been reported to correlate with suppressed HIV replication in long-term non-progressors (LTNP). Immune mechanisms underlying disease non-progression in LTNP might vary with HIV-1 subtype and geographical locations.

    OBJECTIVE: This study evaluates cytokine expression and T-cells activation in relation to disease non-progression in LTNP.

    METHODS: HIV-1 Subtype C infected LTNP (n=20) and progressors (n=15) were enrolled and flowcytometry assays were performed to study HIV-specific CD8 T-cells expressing IL-2, IFN-γ, TNF-α and MIP-1β against gag and env peptides. CD4+ T-cell activation was evaluated by surface expression of HLADR and CD38.

    RESULTS: Proportions of cytokines studied did not differ significantly between LTNP and progressors, while contrasting correlations with disease progression markers were observed in LTNP. CD4+ T-cell activation rates were significantly lower in LTNP compared to progressors which indicate the potential role of T-cell activation rates in disease non-progression in LTNP.

    CONCLUSION: LTNP and progressors showed similar CD8+ T-cell responses, but final conclusions can be drawn only by comparing multiple immune factors in larger LTNP cohort with HIV-1 infected individuals at various levels of disease progression. A possible role of HIV-1 subtype variation and ethnic differences in addition to host-genetic and viral factors cannot be ruled out.

  10. Saravanan S, Shankar EM, Vignesh R, Ganesh PS, Sankar S, Velu V, et al.
    J Viral Hepat, 2024 Apr 05.
    PMID: 38578122 DOI: 10.1111/jvh.13928
    The current World Health Organization (WHO) Hepatitis Elimination Strategy suffers from lack of a target for diagnosing or expunging occult HBV infection. A sizable segment of the global population has an undetected HBV infection, particularly the high-risk populations and those residing in countries like India with intermediate endemicity. There is growing proof that people with hidden HBV infection can infect others, and that these infections are linked to serious chronic hepatic complications, especially hepatocellular carcinoma. Given the current diagnostic infrastructure in low-resource settings, the WHO 2030 objective of obliterating hepatitis B appears to be undeniably challenging to accomplish. Given the molecular basis of occult HBV infection strongly linked to intrahepatic persistence, patients may inexplicably harbour HBV genomes for a prolonged duration without displaying any pronounced clinical or biochemical signs of liver disease, and present histological signs of moderate degree necro-inflammation, diffuse fibrosis, and hence the international strategy to eradicate viral hepatitis warrants inclusion of occult HBV infection.
  11. Saravanan S, Sareen N, Abu-El-Rub E, Ashour H, Sequiera GL, Ammar HI, et al.
    Sci Rep, 2018 10 10;8(1):15069.
    PMID: 30305684 DOI: 10.1038/s41598-018-33144-0
    Abnormal conduction and improper electrical impulse propagation are common in heart after myocardial infarction (MI). The scar tissue is non-conductive therefore the electrical communication between adjacent cardiomyocytes is disrupted. In the current study, we synthesized and characterized a conductive biodegradable scaffold by incorporating graphene oxide gold nanosheets (GO-Au) into a clinically approved natural polymer chitosan (CS). Inclusion of GO-Au nanosheets in CS scaffold displayed two fold increase in electrical conductivity. The scaffold exhibited excellent porous architecture with desired swelling and controlled degradation properties. It also supported cell attachment and growth with no signs of discrete cytotoxicity. In a rat model of MI, in vivo as well as in isolated heart, the scaffold after 5 weeks of implantation showed a significant improvement in QRS interval which was associated with enhanced conduction velocity and contractility in the infarct zone by increasing connexin 43 levels. These results corroborate that implantation of novel conductive polymeric scaffold in the infarcted heart improved the cardiac contractility and restored ventricular function. Therefore, our approach may be useful in planning future strategies to construct clinically relevant conductive polymer patches for cardiac patients with conduction defects.
  12. Nandagopal P, Bhattacharya J, Srikrishnan AK, Goyal R, Ravichandran Swathirajan C, Patil S, et al.
    J Gen Virol, 2018 Mar;99(3):379-392.
    PMID: 29458681 DOI: 10.1099/jgv.0.001016
    Broadly neutralizing antibodies (bnAbs) have been considered to be potent therapeutic tools and potential vaccine candidates to enable protection against various clades of human immunodeficiency virus (HIV). The generation of bnAbs has been associated with enhanced exposure to antigen, high viral load and low CD4+ T cell counts, among other factors. However, only limited data are available on the generation of bnAbs in viraemic non-progressors that demonstrate moderate to high viraemia. Further, since HIV-1 subtype C viruses account for more than 50 % of global HIV infections, the identification of bnAbs with novel specificities is crucial to enable the development of potent tools to aid in HIV therapy and prevention. In the present study, we analysed and compared the neutralization potential of responses in 70 plasma samples isolated from ART-naïve HIV-1 subtype C-infected individuals with various disease progression profiles against a panel of 30 pseudoviruses. Among the seven samples that exhibited a neutralization breadth of ≥70 %, four were identified as 'elite neutralizers', and three of these were from viraemic non-progressors while the fourth was from a typical progressor. Analysis of the neutralization specificities revealed that none of the four elite neutralizers were reactive to epitopes in the membrane proximal external region (MPER), CD4-binding site and V1V2 or V3 glycan. However, two of the four elite neutralizers exhibited enhanced sensitivity towards viruses lacking N332 glycan, indicating high neutralization potency. Overall, our findings indicate that the identification of potent neutralization responses with distinct epitope specificities is possible from the as yet unexplored Indian population, which has a high prevalence of HIV-1 subtype C infection.
  13. Swathirajan CR, Nandagopal P, Vignesh R, Srikrishnan AK, Goyal R, Qureshi H, et al.
    Pathog Dis, 2019 06 01;77(4).
    PMID: 31505637 DOI: 10.1093/femspd/ftz044
    HIV-1 vaccine functioning relies on successful induction of broadly neutralizing antibodies (bNAbs). CXCR3- circulatory T-follicular helper (cTfh) cells are necessary for inducing B-cells for generating bNAbs. Recent studies have suggested that CXCR3+ Tfh cells might also influence bNAb production. Plasma samples from 34 ART-Naïve HIV-1 infected individuals [long-term nonprogressors (LTNP)-19; Progressors-13] were tested against a heterologous virus panel (n = 11) from subtypes A, B, C, G, AC, BC and AE. Frequencies of CXCR3+ and CXCR3- cTfh-like cells in peripheral circulation were studied using flow cytometry. LTNP showed significantly lower CXCR3+ and higher CXCR3- cTfh-like cell frequencies, while neutralization breadth was observed to be broader in progressors. A positive correlation was observed between bNAb breadth and potency with CXCR3+PD-1+ cTfh-like cells in LTNP. Based on neutralization breadth, 9 HIV-1 infected individuals were classified as 'top neutralizers' and 23 as 'low neutralizers' and they did not show any correlations with CXCR3+ and CXCR3- cTfh-like cells. These preliminary data suggest that CXCR3+ similar to CXCR3- might possess significant functional properties for driving B-cells to produce bNAbs. Hence, an HIV vaccine which is capable of optimal induction of CXCR3+ cTfh cells at germinal centers might confer superior protection against HIV.
  14. Selvavinayagam ST, Suvaithenamudhan S, Yong YK, Hemashree K, Rajeshkumar M, Kumaresan A, et al.
    J Med Virol, 2024 Feb;96(2):e29456.
    PMID: 38329187 DOI: 10.1002/jmv.29456
    A state-wide prospective longitudinal investigation of the genomic surveillance of the omicron B.1.1.529 SARS-CoV-2 variant and its sublineages in Tamil Nadu, India, was conducted between December 2021 and March 2023. The study aimed to elucidate their mutational patterns and their genetic interrelationship in the Indian population. The study identified several unique mutations at different time-points, which likely could attribute to the changing disease characteristics, transmission, and pathogenicity attributes of omicron variants. The study found that the omicron variant is highly competent in its mutating potentials, and that it continues to evolve in the general population, likely escaping from natural as well as vaccine-induced immune responses. Our findings suggest that continuous surveillance of viral variants at the global scenario is warranted to undertake intervention measures against potentially precarious SARS-CoV-2 variants and their evolution.
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