MyMedR

Fulltext Silent lacunar infarct with peduncular hallucinosis

Singh, J., Ahmad, N.

Malaysian Journal of Psychiatry, 2016;25(1):0-0.

MyJurnal

Objective: Lacunar infarct is a small infarct in the distal distribution of deep
penetrating vessels. A silent stroke is not associated with outward symptoms.
The objective of this report is to highlight a case of a silent young stroke
presenting with peduncular hallucinosis.

Methods: This gentleman was
thoroughly investigated and was found to have a lacunar infarct of the Pons
and Occipital Lobe. A further referral to Neurology thereafter; for an in
depth investigation into the cause of this silent young stroke.

Results:
Treatment with low dose antipsychotic resolved the complaints; while the
episode being transient.

Conclusion: Organic psychosis is responsive to
antidopaminergic agents, via action on the Ponto-Geniculo-Occipital
pathways.

The cardio-oesophageal angle--a quantitative radiological assessment

Singh G, Singh J

Med J Malaysia, 1978 Sep;33(1):10-2.

PMID: 750887

Parasites that cause problems in Malaysia: soil-transmitted helminths and malaria parasites

Singh B, Cox-Singh J

Trends Parasitol, 2001 Dec;17(12):597-600.

PMID: 11756045

Malaysia is a developing country with a range of parasitic infections. Indeed, soil-transmitted helminths and malaria parasites continue to have a significant impact on public health in Malaysia. In this article, the prevalence and distribution of these parasites, the problems associated with parasitic infections, the control measures taken to deal with these parasites and implications for the future will be discussed.

Plasmodium knowlesi - an emerging pathogen

Ahmed MA, Cox-Singh J

ISBT science series, 2015 Apr;10(Suppl 1):134-140.

PMID: 26029250

Ten years have passed since the publication of a large focus of Plasmodium knowlesi infections in the human population. The discovery was made during a molecular investigation of atypical P. malariae cases in the Kapit Health Division, Sarawak, Malaysian Borneo. Patients were more symptomatic with higher parasite counts than expected in P. malariae infections. The investigation found only P. knowlesi DNA present in patient blood samples. Morphological similarity had allowed P. knowlesi to masquerade as P. malariae during routine diagnostic microscopy for malaria. P. knowlesi, a malaria parasite of macaque monkeys, had entered the human population. The subsequent development of P. knowlesi species-specific PCR assays soon demonstrated that the entry was not confined to the Kapit Division but extended across island and mainland Southeast Asia. Relevant clinical descriptions and guidelines for the treatment and management of patents with P. knowlesi malaria were not available. Nor was it clear whether P. knowlesi had undergone a host switch event into the human population or if infections were zoonotic. The outputs of studies on P. knowlesi malaria during the past 10 years will be summarized, highlighting major findings within the context of pathophysiology, virulence, host switch events, treatment, control and importantly malaria elimination.

Fulltext Human infections with Plasmodium knowlesi--zoonotic malaria

Millar SB, Cox-Singh J

Clin Microbiol Infect, 2015 Jul;21(7):640-8.

PMID: 25843504 DOI: 10.1016/j.cmi.2015.03.017

In 2004 a large focus of Plasmodium knowlesi malaria was reported in the human population in Sarawak, Malaysian Borneo. Plasmodium knowlesi, a parasite of the South-East Asian macaques (Macaca fascicularis and Macaca nemestrina), had entered the human population. Plasmodium knowlesi is transmitted by the leucosphyrus group of Anopheline mosquitoes and transmission is largely zoonotic and restricted to the jungle setting. Humans entering jungle transmission sites are at risk. Since 2004, human cases of P. knowlesi have been continuously reported in local communities and in travellers returning from South East Asia. Plasmodium knowlesi is the most common type of indigenous malaria reported in Malaysia. Infections are most often uncomplicated but at least 10% of patients report with severe malaria and 1-2% of cases have a fatal outcome. Parasitaemia is positively associated with the clinical and laboratory markers of severe malaria. The current literature on P. knowlesi, including epidemiology, natural hosts and vectors, pathogenesis, clinical descriptions, treatment and diagnosis, is reviewed. There are many gaps in our understanding of this disease that are highlighted here with suggestions for further research to inform pre-emptive control measures that would be required to prevent a full emergence of this parasite into the human population.

Fulltext Whole lung tomography in the early detection and follow-up of lung secondaries following hydatidiform mole

Sivanesaratnam V, Singh J

Med J Malaysia, 1985 Dec;40(4):317-20.

PMID: 3842732

22 patients with proven hydatidiform molar pregnancy were subjected to whole lung tomography. By this technique, lung metastases were detected in four patients when plain chest radiographs had shown no secondaries. In a fifth patient additional nodules not observed on the plain radiographs were seen. The usefulness of this procedure as an adjunct to existing methods of following up of patients with metastatic trophoblastic disease is discussed.

Spontaneous extravasation of contrast medium associated with acute renal colic

Singh J, Young WB

Med J Malaysia, 1974 Jun;28(4):244-7.

PMID: 4279004

Some radiological observations on the practice of insertion of charm needles

Soo YS, Singh J

Med J Malaya, 1972 Sep;27(1):40-2.

PMID: 4264823

Paget's disease of bone (osteitis deformans) amongst the West Malaysians

Soo YS, Singh J

Australas Radiol, 1972 Jun;16(2):152-4.

PMID: 4635265

Some radiological observations on the practice of insertion of 'charm needles'

Soo YS, Singh J

Med J Malaysia, 1972 Sep;27(1):40-42.

PMID: 35158534

No abstract available.

Fulltext Knowlesi malaria: newly emergent and of public health importance?

Cox-Singh J, Singh B

Trends Parasitol, 2008 Sep;24(9):406-10.

PMID: 18678527 DOI: 10.1016/j.pt.2008.06.001

Several questions on public health impact have arisen from the discovery of a large focus of the simian malaria parasite, Plasmodium knowlesi, in the human population. P. knowlesi malaria is not newly emergent and was overlooked until molecular tools to distinguish between P. knowlesi and the morphologically similar Plasmodium malariae became available. Knowlesi malaria is a zoonosis that is widely distributed in Southeast Asia and can be fatal. Information on knowlesi malaria should be included in medical and public health guidelines to encourage the accurate diagnosis and treatment of patients, and monitor the incidence and distribution of cases. A complete emergence of P. knowlesi into the human population could be overwhelming and, although challenging, the prevention of this situation deserves serious consideration.

Fulltext Malaria in the Malaysian Army with particular reference to chemosuppressive use

Supramaniam V, Datta GC, Singam V, Singh J

Med J Malaysia, 1987 Mar;42(1):44-9.

PMID: 3323860

Malaria is the most important communicable disease in the field for the Malaysian soldier. His chief weapon is chemoprophylaxis. This was proguanil hydrochloride in the '50s, changed to Daraclor in 1962; since late 1985, Fansidar only is used. The incidence of malaria over the years has fluctuated widely and had its peak in 1977 at 29.7/1,000 soldiers and since then has shown a downward trend. Studies carried out to study the problem are noted briefly. Antimalarial discipline in the field, continued surveillance and integrated control measures in the base are emphasised in the fight against malaria.

Fulltext Penang cancer cases reported to the National Cancer Registry of Malaysia, 1987-1990: an epidemiological analysis

Chan CK, Singh J, Rasid BK, Devaraj T

Med J Malaysia, 1994 Jun;49(2):122-31.

PMID: 8090090

2,124 cases of cancer diagnosed and/or treated in Penang between 1987-1990 were reported to the National Cancer Registry of Malaysia by hospitals in Penang. 1,762 met the criteria for Penang incident cases first diagnosed between 1987-1990, and were the subjects on which all subsequent analyses were based. 85 per cent of case notifications were from Mount Miriam Hospital. Among males, all-site cancer incidence rates (age-standardised) were highest among Chinese, and lowest among Malays. Among females, the Indian female incidence rate was highest, higher than that of any other ethnic-gender sub-group. Site-specific cancer rates varied according to ethnicity and gender, but overall the four most frequent cancers reported from Penang were breast, lung, cervix and nasopharynx cancers. It needs to be emphasised that all these results are highly tentative since they are based on notified cancer occurrences and hence are very uncertain proxies for true cancer incidence. Based on incidence rates from the Singapore Cancer Registry (1978-1982), the expected number of incident cases in 1989 for Penang (Malays, Chinese and Indians combined) was 1,561. The number notified to the National Cancer Registry was 496. This underlines the tentative nature of this analysis of the returns for 1987-1990 from Penang.

Assessment of the association between three pfmdr1 point mutations and chloroquine resistance in vitro of Malaysian Plasmodium falciparum isolates

Cox-Singh J, Singh B, Alias A, Abdullah MS

Trans R Soc Trop Med Hyg, 1995 7 1;89(4):436-7.

PMID: 7570891

AIDS in Malaysia

Singh J, Che'Rus S, Chong S, Chong YK, Crofts N

AIDS, 1994;8 Suppl 2:S99-103.

PMID: 7857575

Fulltext Aids to diagnosis of nasopharyngeal carcinoma

Umapati P, Rajadurai P, Kook SC, Lekhraj R, Singh J

Med J Malaysia, 1988 Jun;43(2):109-16.

PMID: 3237126

Fulltext Diagnosis of thanatophoric dwarfism in utero

Afzal M, Singh J, Ong SK

Med J Malaysia, 1983 Mar;38(1):47-50.

PMID: 6633336

Thanatophoric dwarfism is a severe form of neonatal shortlimbed skeletal dysplasia. Most infants are stillborn or die soon after birth. This disorder has well defined radiological features which distinguish it from the other forms of neonatal dwarfism. We report two cases where short limbs were detected on sonography and a diagnosis was made on antenatal radiographs and fetography.

Increased sensitivity of malaria detection by nested polymerase chain reaction using simple sampling and DNA extraction

Cox-Singh J, Mahayet S, Abdullah MS, Singh B

Int J Parasitol, 1997 Dec;27(12):1575-7.

PMID: 9467744

Malaria remains a disease of underdeveloped and remote regions of the world. The application of polymerase chain reaction (PCR) technology to malaria epidemiology has the potential for increasing our knowledge and understanding of this disease. In order to study malaria in all geographical locations it is important that specimen collection and DNA extraction for PCR be kept simple. Here we report a method for extracting DNA from dried blood spots on filter paper which is capable of detecting one Plasmodium falciparum and two Plasmodium vivax parasites/microliter of whole blood by nested PCR without compromising the simplicity of specimen collection or DNA extraction.

Fulltext Pathological laughter associated with cerebral lupus: a case report

Singh J, Ahmad N, Chai YC

ASEAN Journal of Psychiatry, 2017;18(1):107-113.

MyJurnal

Objective: Pathological laughter, pseudobulbar affect or a myriad of its other synonyms, is a condition common secondary to neurological injury, presenting with uncontrolled laughing or crying, appearing to be mood-incongruent and significantly debilitating. The objective of this case report is to highlight a rare case of pathological laughter associated with Cerebral Lupus.
Methods: We report a case of a 27-year-old lady presenting with signs and symptoms of stroke with dysarthria progressing to aphasia and then pathological laughter, with an underlying poorly controlled Systemic Lupus Erythematosus, manifesting as Cerebral Lupus.
Results: An improvement in affect congruency followed by decreased frequency of outbreaks among bouts of pathological laughter.
Conclusion: The combination of Escitalopram and Topiramate is effective in the symptomatic treatment of Pathological Laughter.

Fulltext Single-stage "Fix and Flap" gives Good Outcomes in Grade 3B/C Open Tibial Fractures: A Prospective Study

Singh J, Dhillon MS, Dhatt SS

Malays Orthop J, 2020 Mar;14(1):61-73.

PMID: 32296484 DOI: 10.5704/MOJ.2003.010

Introduction: Grade 3B/C open tibial fractures with grossly contaminated degloving injuries have poor outcomes, with or without vascular injuries. Treatment decision oscillates between limb salvage and amputation. The standard protocol of repeated debridement and delayed wound cover is a challenge in developing countries due to overcrowded emergencies and limited operating room availability. We present results of our modified protocol involving primary stabilisation with external fixation and immediate wound cover as an aggressive modality of treatment.

Material and Methods: Thirty-three patients with severe open tibial shaft fractures were managed using a standardised protocol of emergent debridement, external fixation and immediate wound cover with free distant/local rotational muscle flaps and fasciocutaneous flaps, and with vascular repair in Grade 3C fractures. Intra-articular fractures were excluded. Patients were followed for a minimum of three years, with an assessment of clinical, radiological and functional outcomes.

Results: Wound cover was achieved with 24 distant free muscle flaps, four local rotational muscle flaps and five fasciocutaneous flaps. All fractures united with an average time to union of 40.3 weeks (16-88). Fifteen patients (45.4%) underwent only a single major surgery using primary definitive external fixation. Deep infection was seen in four patients (12.1%). Nineteen patients had excellent to good outcomes, six were fair, and eight were poor.

Conclusion: "Fix and Flap" in the same sitting, using immediate wound cover and external fixation, has given good results in our hands despite the delayed presentation, the neurovascular deficit and the degloving injury. This may be a better management strategy in overcrowded tertiary care centres of developing countries, with a single surgical procedure in almost half the cases.

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