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Shisha (waterpipe) smoking initiation among youth in Malaysia and global perspective: a scoping review (2006-2015)

Singh SK, Enzhong L, Reidpath DD, Allotey P

Public Health, 2017 Mar;144:78-85.
PMID: 28274388 DOI: 10.1016/j.puhe.2016.11.022

OBJECTIVE: To explore the initiating factors of waterpipe tobacco smoking (WTS) among youth.

STUDY DESIGN: The analytic framework for this scoping review was performed using the methodology outlined by Arksey and O'Malley, which includes identification of the research question, study selection, charting the data, collating, summarizing and reporting the results that were primarily guided by the research question; 'what is known about the initiation of shisha smoking among youth?'

METHODS: Electronic databases such as Cochrane, MEDLINE and PsycINFO were used to search for relevant articles. Articles included were all in English and published within the year of 2006 to 2015. Inclusion criteria; i) age range of 10 to 29 years; ii) examined the reasons why youth started or tried WTS; iii) in full text. Therefore, 26 articles were included in this scoping review.

RESULTS: This review has identified and classified the initiating factors of WTS among youth in four subtopics: individual factors, interpersonal influences, cigarettes and alcohol use, and media influences. Individual factors and interpersonal influences played an important role in initiation factors of WTS among youth.

CONCLUSION: This study concludes that public health professionals within the Southeast Asia region need to promote innovative preventive measures through peer-to-peer led interventions that are also easily assessable on social media platforms. The public health messages need to address the misconceptions of risk associated to WTS use.
Fulltext Predicting Quadruple Semitendinosus Graft Size for Anterior Cruciate Ligament Reconstruction by Patient Anthropometric Variables: A Cohort Study of 280 Cases

Singhal D, Kanodia N, Singh R, Singh SK, Agrawal S

Malays Orthop J, 2021 Nov;15(3):71-77.
PMID: 34966498 DOI: 10.5704/MOJ.2111.011

Introduction: Pre-operative identification of patients with inadequate hamstring graft for anterior cruciate ligament reconstruction is still a subject of interest. The purpose of this study is to correlate dimension of a harvested dimensions graft with patient physical anthropometric variables.
Materials and methods: This cohort study included 280 patients (male = 226, female = 54) scheduled for primary anterior cruciate ligament (ACL) reconstruction. Interrelationships between quadruple semitendinosus (ST) graft and anthropometric parameters (age, sex, height, weight, and BMI) were assessed using Pearson Correlation test and regression analysis. Difference among gender was analysed using Mann Whitney and t test. The observed graft diameter was also compared with the literature using Bland - Altman plot.
Results: Mean age of cohort was 29 years (range, 17-50 years), mean height was 1.69m (range, 1.6-1.9m), mean weight was 75 kg (range, 50-116kg) and mean BMI was 26kg/m2 (range 16.65-40.40kg/m2). Mean quadruple length of harvested ST graft was 7cm (7.1±0.6 cm, range, 5.6-8.8cm) and mean diameter was 8mm (8.2±0.8mm, range, 6.5-10mm). Only height and weight were significantly correlated with graft length and diameter in both sex (p value <0.05). Female, compared to male, had significantly smaller (p<0.0001) and thinner graft (p<0.0001). There was a strong agreement between the literature and our observed graft diameter, but with an overestimated graft diameter in 18.5% of the cases.
Conclusion: Among anthropometric parameter, only height and weight had moderate positive correlation with graft diameter. Males had longer and wider ST graft in contrast to age-matched female group.
Fulltext Conception of Saviour Siblings: Religious Views in Malaysia

Kuek CY, A/P Gurmukh Singh SK

Asian Bioeth Rev, 2022 Oct;14(4):363-377.
PMID: 36203711 DOI: 10.1007/s41649-022-00216-3

The advancement of human reproductive technology has made it possible for parents with a child affected by a haematological disorder to select and bring into being, a prospective child who can act as a matched stem cell donor. This can be done through the use of preimplantation genetic diagnosis (PGD) coupled with human leukocyte antigen (HLA) typing (PGD-HLA typing), or HLA tying as a standalone procedure, where a healthy embryo, which is an HLA match to the existing sick sibling, is chosen for implantation. The creation of such a sibling (saviour sibling) is normally taken as a last resort when there is no related or unrelated matched donor. While the conception of a saviour sibling may serve as a reliable and realistic treatment option for the ailing child, it also poses new moral questions that challenge a religiously pluralistic society such as Malaysia. The use of PGD-HLA typing may be controversial as it involves creating a life to save a life, selection of compatible human embryos and destruction of the unselected embryos. At present, there is no legal framework regulating the conception of saviour siblings. The development of ethically sound and appropriate local laws and policies should consider the views of religious communities, especially when it involves a controversial subject such as the conception of saviour siblings. This article seeks to explore the perceptions of religious scholars and representatives of the major religions professed and practised in Malaysia, namely Islam, Buddhism, Christianity and Hinduism, through qualitative interviews.
Nurse-led intervention on knowledge, attitude and beliefs towards acute coronary syndrome

Darsin Singh SK, Ahmad A, Rahmat N, Hmwe NTT

Nurs Crit Care, 2018 Jul;23(4):186-191.
PMID: 27071369 DOI: 10.1111/nicc.12240

BACKGROUND: Coronary heart disease has emerged as a number one killer in Malaysia and globally. Much of the morbidity and mortality in acute coronary syndrome patients is because of patients not recognizing their symptoms which contributes to delay in seeking early treatment.
AIM: The aim of this study is to evaluate the effectiveness of a nurse-led health education programme on knowledge, attitude and beliefs of coronary patients towards the responses to acute coronary syndrome and the association with patients' characteristics.
METHODS: A single-group quasi-experimental design took place in a tertiary hospital. A total of 60 coronary patients were recruited to this study. The knowledge, attitude and beliefs towards acute coronary syndrome (ACS) were evaluated at baseline and after 1 month of giving education intervention.
RESULTS: Knowledge, attitude and beliefs about ACS increased significantly from baseline to 1 month after intervention. Level of attitude was associated with gender, educational level and employment status.
CONCLUSIONS: The findings of this study suggest that an education program conducted by a nurse improved patients' level of knowledge, attitudes and beliefs in response to ACS symptoms at 1 month compared to baseline, but whether they are sustained for a longer period is unclear. Improving the responses towards ACS might reduce decision delay in symptom interpretation and seeking early treatment.
RELEVANCE TO CLINICAL PRACTICE: Nurse-led interventions have imparted positive outcomes in response to ACS symptoms among coronary patients. Therefore, nurses should take the initiative in educating patients to minimize delay in symptom interpretation and seeking early treatment.
Identification of hub glycogenes and their nsSNP analysis from mouse RNA-Seq data

Firoz A, Malik A, Singh SK, Jha V, Ali A

Gene, 2015 Dec 15;574(2):235-46.
PMID: 26260015 DOI: 10.1016/j.gene.2015.08.012

Glycogenes regulate a large number of biological processes such as cancer and development. In this work, we created an interaction network of 923 glycogenes to detect potential hubs from different mouse tissues using RNA-Seq data. DAVID functional cluster analysis revealed enrichment of immune response, glycoprotein and cholesterol metabolic processes. We also explored nsSNPs that may modify the expression and function of identified hubs using computational methods. We observe that the number of nsSNPs predicted by any two methods to affect protein function is 4, 7 and 2 for FLT1, NID2 and TNFRSF1B. Residues in the native and mutant proteins were analyzed for solvent accessibility and secondary structure change. Analysis of hubs can help in determining their degree of conservation and understanding their functions in biological processes. The nsSNPs proposed in this work may be further targeted through experimental methods for understanding structural and functional relationships of hub mutants.
Fulltext Distant entanglement via photon hopping in a coupled cavity magnomechanical system

Sohail A, Peng JX, Hidki A, Khalid M, Singh SK

Sci Rep, 2023 Dec 09;13(1):21840.
PMID: 38071389 DOI: 10.1038/s41598-023-48825-8

We theoretically propose a scheme to generate distant bipartite entanglement between various subsystems in coupled magnomechanical systems where both the microwave cavities are coupled through single photon hopping coupling strength Γ. Each cavity contains a magnon mode and phonon mode and this gives six excitation modes in our model Hamiltonian which are cavity-1 photons, cavity-2 photons, magnon and phonon in cavity-1, and magnon and phonon in cavity-2. We found that significant bipartite entanglement exists between indirectly coupled subsystems in coupled microwave cavities for an appropriate set of parameters regime. Moreover, we also obtain suitable cavity and magnon detuning parameters for a significant distant bipartite entanglement in different bipartitions. In addition, it can be seen that a single photon hopping parameter significantly affects both the degree as well as the transfer of quantum entanglement between various bipartitions. Hence, our present study related to coupled microwave cavity magnomechanical configuration will open new perspectives in coherent control of various quantum correlations including quantum state transfer among macroscopic quantum systems.
Fulltext Assessment of predictive models for chlorophyll-a concentration of a tropical lake

Malek S, Syed Ahmad SM, Singh SK, Milow P, Salleh A

BMC Bioinformatics, 2011;12 Suppl 13:S12.
PMID: 22372859 DOI: 10.1186/1471-2105-12-S13-S12

This study assesses four predictive ecological models; Fuzzy Logic (FL), Recurrent Artificial Neural Network (RANN), Hybrid Evolutionary Algorithm (HEA) and multiple linear regressions (MLR) to forecast chlorophyll- a concentration using limnological data from 2001 through 2004 of unstratified shallow, oligotrophic to mesotrophic tropical Putrajaya Lake (Malaysia). Performances of the models are assessed using Root Mean Square Error (RMSE), correlation coefficient (r), and Area under the Receiving Operating Characteristic (ROC) curve (AUC). Chlorophyll-a have been used to estimate algal biomass in aquatic ecosystem as it is common in most algae. Algal biomass indicates of the trophic status of a water body. Chlorophyll- a therefore, is an effective indicator for monitoring eutrophication which is a common problem of lakes and reservoirs all over the world. Assessments of these predictive models are necessary towards developing a reliable algorithm to estimate chlorophyll- a concentration for eutrophication management of tropical lakes.
Fulltext [Combined spinal-epidural analgesia in labour: its effects on delivery outcome]

Singh SK, Yahya N, Misiran K, Masdar A, Nor NM, Yee LC

Rev Bras Anestesiol, 2016 May-Jun;66(3):259-64.
PMID: 26993410 DOI: 10.1016/j.bjan.2014.09.009

Combined spinal-epidural (CSE) has become an increasingly popular alternative to traditional labour epidural due to its rapid onset and reliable analgesia provided. This was a prospective, convenient sampling study to determine the effects of CSE analgesia on labour outcome.
Fulltext A systems biology approach towards the identification of candidate therapeutic genes and potential biomarkers for Parkinson's disease

Sakharkar MK, Kashmir Singh SK, Rajamanickam K, Mohamed Essa M, Yang J, Chidambaram SB

PLoS One, 2019;14(9):e0220995.
PMID: 31487305 DOI: 10.1371/journal.pone.0220995

Parkinson's disease (PD) is an irreversible and incurable multigenic neurodegenerative disorder. It involves progressive loss of mid brain dopaminergic neurons in the substantia nigra pars compacta (SN). We compared brain gene expression profiles with those from the peripheral blood cells of a separate sample of PD patients to identify disease-associated genes. Here, we demonstrate the use of gene expression profiling of brain and blood for detecting valid targets and identifying early PD biomarkers. Implementing this systematic approach, we discovered putative PD risk genes in brain, delineated biological processes and molecular functions that may be particularly disrupted in PD and also identified several putative PD biomarkers in blood. 20 of the differentially expressed genes in SN were also found to be differentially expressed in the blood. Further application of this methodology to other brain regions and neurological disorders should facilitate the discovery of highly reliable and reproducible candidate risk genes and biomarkers for PD. The identification of valid peripheral biomarkers for PD may ultimately facilitate early identification, intervention, and prevention efforts as well.
Fulltext Emerging prospects of vitamin D3 in metabolic syndrome: A proof of concept (POC) approach targeting inflammation

Singh Y, Gupta G, Gilhotra RM, Singh SK, Prasher P, Krishnan A, et al.

EXCLI J, 2020;19:1512-1516.
PMID: 33312109 DOI: 10.17179/excli2020-2964
Applications and practice of advanced drug delivery systems for targeting Toll-like receptors in pulmonary diseases

Chan Y, Prasher P, Löbenberg R, Gupta G, Singh SK, Oliver BG, et al.

Nanomedicine (Lond), 2021 04;16(10):783-786.
PMID: 33733817 DOI: 10.2217/nnm-2021-0056
Recent update on barbiturate in relation to brain disorder

Pathak S, Gupta G, Thangavelu L, Singh SK, Dua K, Chellappan DK, et al.

EXCLI J, 2021;20:1028-1032.
PMID: 34267614 DOI: 10.17179/excli2021-3687
Educational intervention on delirium assessment using confusion assessment method-ICU (CAM-ICU) in a general intensive care unit

Ramoo V, Abu H, Rai V, Surat Singh SK, Baharudin AA, Danaee M, et al.

J Clin Nurs, 2018 Nov;27(21-22):4028-4039.
PMID: 29775510 DOI: 10.1111/jocn.14525

AIMS AND OBJECTIVES: To assess intensive care unit nurses' knowledge of intensive care unit delirium and delirium assessment before and after an educational intervention. In addition, nurses' perception on the usefulness of a delirium assessment tool and barriers against delirium assessment were assessed as secondary objectives.
BACKGROUND: Early identification of delirium in intensive care units is crucial for patient care. Hence, nurses require adequate knowledge to enable appropriate evaluation of delirium using standardised practice and assessment tools.
DESIGN: This study, performed in Malaysia, used a single-group pretest-posttest study design to assess the effect of educational interventions and hands-on practices on nurses' knowledge of intensive care unit delirium and delirium assessment.
METHODS: Sixty-one nurses participated in educational intervention sessions, including classroom learning, demonstrations and hands-on practices on the Confusion Assessment Method-Intensive Care Unit. Data were collected using self-administered questionnaires for the pre- and postintervention assessments. Analysis to determine the effect of the educational intervention consisted of the repeated-measures analysis of covariance.
RESULTS: There were significant differences in the knowledge scores pre- and postintervention, after controlling for demographic characteristics. The two most common perceived barriers to the adoption of the intensive care unit delirium assessment tool were "physicians did not use nurses' delirium assessment in decision-making" and "difficult to interpret delirium in intubated patients".
CONCLUSIONS: Educational intervention and hands-on practices increased nurses' knowledge of delirium assessment. Teaching and interprofessional involvements are essential for a successful implementation of intensive care unit delirium assessment practice.
RELEVANCE TO CLINICAL PRACTICE: This study supports existing evidences, indicating that education and training could increase nurses' knowledge of delirium and delirium assessment. Improving nurses' knowledge could potentially lead to better delirium management practice and improve ICU patient care. Thus, continuous efforts to improve and sustain nurses' knowledge become relevant in ICU settings.
Spectrum of Multimodality Findings in Post-surgical Breast Cancer Imaging

Ramli Hamid MT, Rahmat K, Hamid SA, Kirat Singh SK, Hooi TG

Curr Med Imaging Rev, 2019;15(9):866-872.
PMID: 32008533 DOI: 10.2174/1573405614666180627101520

BACKGROUND: Breast cancer is the commonest cancer affecting Malaysian women, accounting for an estimated 30% of all new cancer diagnosed annually. Improvements in breast cancer management have increased the breast cancer survival rate in Malaysia. Clinical and radiological surveillance of the treated breast is vital, as early detection of recurrence improves patient's survival rate.
DISCUSSION: As surgery and radiotherapy alter the appearance of the breasts, distinguishing between recurrence and benign post-surgical changes can be challenging radiologically due to overlapping features. Despite this, differentiation between these two entities is usually possible by recognizing characteristic features of post-treatment sequelae and the evolution of the appearance of the conservatively treated breast by comparing interval findings on serial studies.
CONCLUSION: This pictorial review aims to describe the typical and unusual features of post-treated breasts in the multimodality imaging workup of an established breast care centre in a teaching hospital in Malaysia.
Fulltext Predicting sustainable arsenic mitigation using machine learning techniques

Singh SK, Taylor RW, Pradhan B, Shirzadi A, Pham BT

Ecotoxicol Environ Saf, 2022 Feb 01;232:113271.
PMID: 35121252 DOI: 10.1016/j.ecoenv.2022.113271

This study evaluates state-of-the-art machine learning models in predicting the most sustainable arsenic mitigation preference. A Gaussian distribution-based Naïve Bayes (NB) classifier scored the highest Area Under the Curve (AUC) of the Receiver Operating Characteristic curve (0.82), followed by Nu Support Vector Classification (0.80), and K-Neighbors (0.79). Ensemble classifiers scored higher than 70% AUC, with Random Forest being the top performer (0.77), and Decision Tree model ranked fourth with an AUC of 0.77. The multilayer perceptron model also achieved high performance (AUC=0.75). Most linear classifiers underperformed, with the Ridge classifier at the top (AUC=0.73) and perceptron at the bottom (AUC=0.57). A Bernoulli distribution-based Naïve Bayes classifier was the poorest model (AUC=0.50). The Gaussian NB was also the most robust ML model with the slightest variation of Kappa score on training (0.58) and test data (0.64). The results suggest that nonlinear or ensemble classifiers could more accurately understand the complex relationships of socio-environmental data and help develop accurate and robust prediction models of sustainable arsenic mitigation. Furthermore, Gaussian NB is the best option when data is scarce.
Fulltext Overcoming drug delivery barriers and challenges in topical therapy of atopic dermatitis: A nanotechnological perspective

Hemrajani C, Negi P, Parashar A, Gupta G, Jha NK, Singh SK, et al.

Biomed Pharmacother, 2022 Mar;147:112633.
PMID: 35030434 DOI: 10.1016/j.biopha.2022.112633

Atopic dermatitis (AD) is an inflammatory disorder centered around loss of epidermal barrier function, and T helper 2 (Th2) immune responses. The current understanding of disease heterogeneity and complexity, limits the rational use of existing topical, systemic therapeutic agents, but paves way for development of advanced therapeutic agents. Additionally, advanced nanocarriers that deliver therapeutics to target cells, seem to offer a promising strategy, to overcome intrinsic limitations and challenges of conventional, and traditional drug delivery systems. Ever-evolving understanding of molecular target sites and complex pathophysiology, adverse effects of current therapeutic options, inefficient disease recapitulation by existing animal models are some of the challenges that we face. Also, despite limited success in market translatibility, nanocarriers have demonstrated excellent preclinical results and have been extensively studied for AD. Detailed research on behavior of nanocarriers in different patients and tailored therapy to account for phenotypic variability of the disease are the new research avenues that we look forward to.
Fulltext Combined spinal-epidural analgesia in labour: its effects on delivery outcome

Singh SK, Yahya N, Misiran K, Masdar A, Nor NM, Yee LC

Braz J Anesthesiol, 2016 May-Jun;66(3):259-64.
PMID: 27108822 DOI: 10.1016/j.bjane.2014.09.006

BACKGROUND AND OBJECTIVES: Combined spinal-epidural (CSE) has become an increasingly popular alternative to traditional labour epidural due to its rapid onset and reliable analgesia provided. This was a prospective, convenient sampling study to determine the effects of CSE analgesia on labour outcome.

METHODS: One hundred and ten healthy primigravida parturients with a singleton pregnancy of ≥37 weeks gestation and in the active phase of labour were studied. They were enrolled to the CSE (n=55) or Non-CSE (n=55) group based on whether they consented to CSE analgesia. Non-CSE parturients were offered other methods of labour analgesia. The duration of the first and second stage of labour, rate of instrumental vaginal delivery and emergency cesarean section, and Apgar scores were compared.

RESULTS: The mean duration of the first and second stage of labour was not significantly different between both groups. Instrumental delivery rates between the groups were not significantly different (CSE group, 11% versus Non-CSE group, 16%). The slightly higher incidence of cesarean section in the CSE group (16% versus 15% in the Non-CSE group) was not statistically significant. Neonatal outcome in terms of Apgar score of less than 7 at 1 and 5min was similar in both groups.

CONCLUSION: There were no significant differences in the duration of labour, rate of instrumental vaginal delivery and emergency cesarean section, and neonatal outcome in parturients who received compared to those who did not receive CSE for labour analgesia.
Can dextran-based nanoparticles mitigate inflammatory lung diseases?

Prasher P, Sharma M, R Wich P, Jha NK, Singh SK, Chellappan DK, et al.

Future Med Chem, 2021 12;13(23):2027-2031.
PMID: 34596425 DOI: 10.4155/fmc-2021-0218
Fulltext Emerging cases of mucormycosis under COVID-19 pandemic in India: Misuse of antibiotics

Gupta G, S R, Singh Y, Thangavelu L, Singh SK, Dureja H, et al.

Drug Dev Res, 2021 11;82(7):880-882.
PMID: 34323298 DOI: 10.1002/ddr.21862

COVID-19's second wave had a significant impact on India, on May 7, 2021, the largest daily recorded case count was a little more than 4 million, and it has since fallen. Although the number of new cases reported has dropped, during the third week of May 2021, India accounted for about 45% of new cases identified globally and around 34% of deaths. As India maintains its present level of stability, a new urgent threat has emerged in the form of coronavirus-associated mucormycosis. Mucormycosis, an acute and deadly fungal infection caused by Mucorales-related fungal species, is a fungal emergency with a particularly aggressive propensity for contiguous spread, associated with a poor prognosis if not properly and immediately identified, and treated. Mucormycosis, sometimes referred to as the "black fungus," has increased more rapidly in India during the second wave of COVID-19 than during the first wave, with at least 14,872 cases as of May 28, 2021. Uncontrolled diabetic mellitus (DM) and other immunosuppressive diseases such as neutropenia and corticosteroid treatment have traditionally been identified as risk factors for mucormycosis. Therefore, the use of glucocorticoids or high doses of glucocorticoids in mild COVID-19 cases (without hypoxemia) should be avoided. In addition, drugs that target the immune pathway, such as tocilizumab, are not recommended without clear benefits.
Nanomedicine and medicinal plants: Emerging symbiosis in managing lung diseases and associated infections

Paudel KR, De Rubis G, Panth N, Singh SK, Chellappan DK, Hansbro PM, et al.

EXCLI J, 2022;21:1299-1303.
PMID: 36483911 DOI: 10.17179/excli2022-5376

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