MyMedR

Factors influencing the egg production of Ascaris lumbricoides: relationship to weight, length and diameter of worms

Sinniah B, Subramaniam K

J Helminthol, 1991 Jun;65(2):141-7.

Fifty children aged 6 to 13 years and infected with Ascaris lumbricoides were selected for the study. The number of eggs laid daily by a female Ascaris increased with increase in its length, weight and diameter. Female worms became mature and started laying eggs when they reached a length of 118 mm. Adult female worms measuring 3.7 mm or more in diameter were found to be mature. The minimum weight of a worm producing eggs was 1.1 g. On average the number of eggs produced by the female decreased with increase in the worm load.

The effects of prenatal alcohol exposure on the morphological characteristics of spinal motoneurons

David P, Subramaniam K

Birth Defects Res. Part A Clin. Mol. Teratol., 2009 Sep;85(9):791-9.

PMID: 19452514 DOI: 10.1002/bdra.20593

Clinical studies and research in animals have established that alcohol consumption during pregnancy produces irreversible developmental anomalies. Deficits in fine motor performance are often noted in infants diagnosed with fetal alcohol syndrome. However, the effects of alcohol on the spinal motoneurons have not been examined. In this study, the morphometric alterations in spinal motoneurons were assessed as a result of prenatal alcohol exposure.

Prenatal alcohol exposure and early postnatal changes in the developing nerve-muscle system

David P, Subramaniam K

Birth Defects Res. Part A Clin. Mol. Teratol., 2005 Nov;73(11):897-903.

PMID: 16228975

Extensive research on prenatal alcohol exposure has proven the potent teratogenicity of this substance of abuse. Children born to alcoholic mothers are often diagnosed with fetal alcohol syndrome (FAS). Those afflicted with FAS often have muscle weakness, muscle wasting, and atrophy. This study assessed the effects of prenatal alcohol exposure on the developing rat neuromuscular system.

The rate of loss of maxillary anterior alveolar bone height in patients with leprosy

Subramaniam K, Marks SC, Seang Hoo Nah

Lepr Rev, 1983 Jun;54(2):119-27.

PMID: 6888141

Cellulitis in human brucellosis: An atypical presentation

Subramaniam K, Ali SU

Malays J Pathol, 2019 Dec;41(3):359-364.

PMID: 31901923

INTRODUCTION: Brucellosis is a zoonotic disease with variable clinical manifestations and atypical presentation in humans. Human brucellosis cases are not seen often in Malaysia.

CASE REPORT: This is a case report of 19 years old gentleman who presented with fever, lower limb redness, pain and swelling. He was initially treated as cellulitis. However, based on the recovery of Brucella melitensis from his blood culture, he was later diagnosed to have brucellosis. He had a history of consumption of fresh goat's milk and uncooked meat which could have been the possible modes of transmission. Brucella serology IgM and IgG were both positive, and anti-Brucella immunocapture agglutination test (BrucellaCapt) was also positive with a titer of 1:2560. He was treated with six weeks of oral doxycycline 100 mg twice daily and oral rifampin 450 mg twice daily.

DISCUSSION: This is a case of human brucellosis with atypical cutaneous involvement.

Thoracic aortic dissection. Death may not always be due to rupture with haemorrhage. Unusual complications which can be missed at autopsy

Subramaniam K, Sheppard MN

J Forensic Leg Med, 2018 Feb;54:127-129.

PMID: 29413954 DOI: 10.1016/j.jflm.2018.01.005

OBJECTIVES: Aortic dissection (AD) can be a challenging diagnosis. At autopsy, the aorta may not be dilated and intimal tears may be missed or found without obvious rupture or haemorrhage. We report our experience of AD at a tertiary referral centre with review of 32 cases and discuss 2 unusual complications.

METHODS/RESULTS: 32 cases of which 12 females and 20 male and 18 out of 32 cases were aged below 40. All of the cases were examined macroscopically and microscopically. 30 out of 32 cases (93%) died due to rupture associated with the AD. Two unusual complications were proximal extension of AD into left coronary artery (CA) with intramural haematoma blocking the vessel and AD involving the ostium of the right CA resulting in avulsion of the right CA from the aorta. Mode of death in both these cases were myocardial ischemia. Sections of the aorta in all cases confirmed extensive cystic medial degeneration with disorganisation, fragmentation and disappearance of the elastin fibres with increased collagen and smooth muscle nuclear degeneration.

CONCLUSION: Pathologists should be thorough when examining the aorta, the aortic valve and root in AD. When a rupture site cannot be found it is important to look for unusual complications involving the CAs. Histology plays an important role to corroborate the cause of death.

Fulltext Surgical removal of inverted papilloma: case report of endoscopic versus open excision

Prepageran N, Gopala K, Subramaniam KN

Med J Malaysia, 2002 Dec;57(4):493-5.

PMID: 12733177

We describe two cases of nasal inverted papilloma who had different management modalities. Although both were essentially of the same pathology, one underwent endoscopic excision while the other was treated with the more popular lateral rhinotomy and medial maxillectomy. We wish to highlight the different modalities of treatment available for inverted papilloma and a review of published results.

Re-innervation of muscles after nerve injury in neonates

Naidu MD, Subramaniam K, Vrbová G

Restor. Neurol. Neurosci., 1996 Jan 1;10(1):35-42.

PMID: 21551851 DOI: 10.3233/RNN-1996-10105

Three-day-old neonatal rats had their common peroneal nerve crushed 3 mm from the extensor digitorum longus (EDL) muscle. At periodic intervals of 7, 10, 14, 21 and 28 days following nerve injury the EDL muscles were removed, weighed, stained using the silver cholinesterase method and their muscle fibres counted. In these rats during the re-innervation process, the bands of Biingner were absent, some endplates disintegrated and a large proportion of the muscle fibres were lost. This study has shown that interruption of the normal nerve-muscle interaction during the neonatal period is highly detrimental to the subsequent growth and development of the muscle.

Anatomical variability of the frontal sinuses and their application in forensic identification

Nambiar P, Naidu MD, Subramaniam K

Clin Anat, 1999;12(1):16-9.

PMID: 9890725

The uniqueness of anatomical structures and their variations provides the basis for forensic identification of unknown deceased persons. Similar to fingerprints, each frontal sinus is so distinctive and unique that the chances of two individuals having the same morphology of the frontal sinuses is extremely remote. Radiographs, especially the occipitomental view commonly used in the assessment of paranasal pathology, provide excellent records of these sinuses. The case illustrated here is an application of the frontal sinus identification of a victim in a mass disaster.

Organization of common peroneal nerve motoneurones in the rat and monkey: a comparative study

Yeong SO, Subramaniam K, Vrbová G

Neuroreport, 1998 Apr 20;9(6):1085-8.

PMID: 9601672

The motoneurones with axons in the common peroneal nerve (CPN) of the rat and monkey were examined using retrograde labelling with horseradish peroxidase (HRP). In both species, the CPN motoneurone pool was localized in the dorsolateral part of the ventral horn of the spinal cord. In the rat, the labelled motoneurones were located between the L3 and L6 spinal segments whereas in the monkey, they extended from the caudal end of L4 to the L6 spinal segments. In both species the majority of the labelled neurones were located within the L5 segment. The mean number of the CPN motoneurones in the rat and monkey was 458 and 1148, respectively. A bimodal size distribution of motoneurones was found in both species.

Fulltext Clostridial aortitis causing ruptured dissecting aneurysm in a young adult female

Subramaniam K, Hasmi AH, Mahmood MS

Malays J Pathol, 2014 Dec;36(3):213-6.

PMID: 25500522 MyJurnal

Ruptured dissecting aortic aneurysm more commonly occur in men in the 40 to 70 age group, and most commonly is associated with atherosclerosis. Uncommon causes are previous heart surgery, connective tissue disorders and aortitis. Despite its rarity, Clostridium spp aortitis progresses very rapidly with a mortality rate of approximately 79% in adults, typically occurring within 48 hours of infection. We present a case of sudden death due to clostridial aortitis causing ruptured aortic dissection in an apparently healthy adult female, 7 weeks post-spontaneous vaginal delivery. This case highlights the pathology of aortic dissection and cystic media necrosis as presentations of clostridium spp infection in young female adult.

Ocular presentation of sphenoid mucocele

Prepageran N, Subramaniam KN, Krishnan GG, Raman R

Orbit, 2004 Mar;23(1):45-7.

PMID: 15513020

A sphenoid mucocele often presents late due to its deep-seated anatomical site. It has a varied presentation, due to its close relationship to the cavernous sinus and the base of the skull. It can present initially to the ophthalmologist with ocular complaints. In the present paper, the authors present two cases of sphenoid mucocele, one with an isolated third and one with an isolated sixth cranial nerve palsy.

Self-retaining ear speculum: Thudicum design

Raman R, Subramaniam KN, Dahalil MB

Otolaryngol Head Neck Surg, 1999 Jul;121(1):157.

PMID: 10388900

A longitudinal study of alveolar bone loss around maxillary central incisors in patients with leprosy in Malaysia

Subramaniam K, Nah SH, Marks SC

Lepr Rev, 1994 Jun;65(2):137-42.

PMID: 7968186

The loss of alveolar bone supporting the maxillary central incisors and the general periodontal conditions were evaluated after 14 years in the 12 patients remaining from an original group of 47 under treatment in Malaysia. Alveolar bone loss was minimal during this period even in the presence of periodontal inflammation. These data suggest that treatment protects patients with leprosy from alveolar bone loss and suggests that other skeletal deformities might respond similarly.

Relationship between the loss of maxillary anterior alveolar bone and the duration of untreated lepromatous leprosy in Malaysia

Nah SH, Marks SC, Subramaniam K

Lepr Rev, 1985 Mar;56(1):51-5.

PMID: 3990507

Sudden cardiac death in a young adult man due to spontaneous coronary artery dissection

Subramaniam K, Siew SF, Mahmood MS

Malays J Pathol, 2019 Apr;41(1):51-54.

PMID: 31025638

Spontaneous coronary artery dissection is a rare event and commonly associated with pregnancy and female gender. This condition can reduce or completely obstruct the blood flow to the heart, causing a myocardial ischaemia, abnormalities in heart rhythm or sudden death. We present a case of a 28-year-old Indian male with no previous medical illness who complained sudden onset of chest pain prior to his death. Autopsy revealed a left anterior descending coronary artery dissection associated with plaque rupture. The anterior wall of left ventricle showed contraction band necrosis. There was also atheroma present in the right coronary artery which was insignificant. Histologically, dissection was associated with atherosclerosis. There was no evidence of vasculitis. The cause of death was given as coronary artery dissection due to coronary artery atherosclerosis.

Fatty liver in a two days old neonate

Arivalagan P, Husain MS, Subramaniam K, Kaslan MRM

Med J Malaysia, 2019 Oct;74(5):454-455.

PMID: 31649231

Neonatal death due to inborn error of metabolism (IEM) is rare in Malaysia. We report a sudden neonate death just a few hours after being discharged from the hospital. The deceased was a two-day-old baby boy and was asymptomatic until his demise. He was fed with expressed breast milk and formula milk. Autopsy revealed fatty changes of the liver and an enlarged heart. Laboratory investigation confirmed very long chain Acyl-CoA dehydrogenase deficiency which resulted in his death. Autopsy of sudden unexpected death in neonate should include investigation for inborn error of metabolism. Fatty liver and enlarged heart could give a clue for the diagnosis.

Fulltext Test anxiety: state, trait and relationship with exam satisfaction

Ping LT, Subramaniam K, Krishnaswamy S

Malays J Med Sci, 2008 Apr;15(2):18-23.

PMID: 22589620

Test anxiety is defined as the reaction to stimuli that is associated with an individual's experience of testing or evaluating situations. This study aims to examine the fluctuation pattern of anxiety symptoms during a clinical examination and its relationship with underlying anxiety traits. Fourth year medical students of Penang Medical College undertaking the Ophthalmology clinical examination participated in this study. First phase of the survey, on anxiety symptoms was conducted immediately after the Ophthalmology clinical examination while the second phase, on pre-existing anxiety traits was conducted six weeks later with the aid of STAI instrument. Responses for both stages were combined and analyzed. Sixty-three of 122 students responded to both phases of the study, giving a response rate of 52%. All symptoms except trembling peaked 10 minutes before the exam begun showing a downward progression with no resurgence thereafter. Students with pre-existing anxiety traits had high anxiety scores 10 minutes into the examination and while with the examiners. Anticipatory anxiety is a source of concern and can effect performance and appropriate steps should be taken to help the students with this. A few other studies should be done to conclude.

Detection and molecular characterization of infectious spleen and kidney necrosis virus from major ornamental fish breeding states in Peninsular Malaysia

Subramaniam K, Shariff M, Omar AR, Hair-Bejo M, Ong BL

J Fish Dis, 2014 Jul;37(7):609-18.

PMID: 23952914 DOI: 10.1111/jfd.12152

'Gold standard' OIE reference PCR assay was utilized to detect the presence of infectious spleen and kidney necrosis virus (ISKNV) in freshwater ornamental fish from Malaysia. From total of 210 ornamental fish samples representing 14 species, ISKNV was detected in 36 samples representing 5 fish species. All positive cases did not show any clinical signs of ISKNV. Three restriction enzymes analyses showed that the fish were infected by identical strains of the same virus species within Megalocytivirus genus. Major capsid protein (MCP) genes of 10 ISKNV strains were sequenced and compared with 9 other reference nucleotide sequences acquired from GenBank. Sequence analysis of MCP gene showed that all strains detected in this study were closely related to the reference ISKNV with nucleotide sequence identity that was ranging from 99.8% to 100%. In addition, phylogenetic analysis of MCP gene revealed that viruses from genus Megalocytivirus can be divided into three genotypes: genotype 1 include reference ISKNV and all other strains that were detected in this study, genotype 2 include viruses closely related to red sea bream iridovirus (RSIV), and genotype 3 include viruses closely related turbot reddish body iridovirus (TRBIV).

Psychometric properties and osteoprotective behaviors among type 2 diabetic patients: osteoporosis self-efficacy scale Malay version (OSES-M)

Abdulameer SA, Syed Sulaiman SA, Hassali MA, Subramaniam K, Sahib MN

Osteoporos Int, 2013 Mar;24(3):929-40.

PMID: 22790611 DOI: 10.1007/s00198-012-2071-1

In type 2 diabetic patients (T2DM), only 22 % have normal bone mineral density and almost three quarters of the sample population had low self-efficacy towards osteoporosis. These results reflect the need for screening and educational programs to increase the awareness of T2DM towards osteoporosis.
INTRODUCTION: Our aim was to translate and examine the psychometric properties of the Malay version of the osteoporosis self-efficacy scale (OSES-M) among T2DM and to determine the best cut-off value with optimum sensitivity and specificity. In addition, to assess factors that affects diabetic patients' osteoporosis self-efficacy.
METHODS: A standard "forward-backward" procedure was used to translate the OSES into Malay language, which was then validated with a convenience sample of 250 T2DM. The sensitivity and specificity of the OSES-M was calculated using receiver operating characteristic curve analysis. Bivariate and multivariate approaches were used to examine multiple independent variables on each dependent variable.
RESULTS: The mean score of OSES-M was 731.74 ± 197.15. Fleiss' kappa, content validity ratio range, and content validity index were 0.99, 0.75-1, and 0.96, respectively. Two factors were extracted from exploratory factor analysis and were confirmed through confirmatory factor analysis. Internal consistency and test-retest reliability were 0.92 and 0.86, respectively. The optimum cut-off point of OSES-M to predict osteoporosis/osteopenia was 858. Regression analysis revealed that knowledge, health belief, and some demographic data had an impact on OSES-M.
CONCLUSIONS: The results show that the OSES-M is a reliable and valid instrument for measuring osteoporosis self-efficacy in the Malaysian clinical setting.

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