Displaying all 17 publications

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  1. Kareem BA, Sofiyan M, Subramanian S
    Med J Malaysia, 2000 Sep;55(3):376-8.
    PMID: 11200721
    Dysphagia due to osteophytes in a young person is uncommon. We present a rare case of Forestier's disease causing dysphagia in a young lady without other bony involvement. The osteophytes were surgically removed and her symptoms resolved completely.
  2. Shanmugasundaram K, Subramanian S, Vedam V, Kumar V
    Case Rep Pathol, 2016;2016:9154309.
    PMID: 28078158 DOI: 10.1155/2016/9154309
    Carcinoma arising primarily from the jaw is a locally aggressive lesion with poor prognosis. Primary intraosseous carcinoma (PIOC) lesion develops either de novo remnants of odontogenic epithelium, odontogenic cyst/tumor, epithelium remnants, or/and salivary gland residues. We describe very interesting case of primary intraosseous carcinoma of mandible. This extensive lesion was sent for oncological opinion and further management. Due to the uncertainty of diagnostic criteria of PIOC, only few cases of this lesion with a typical presentation have been reported. This article presents a case of primary intraosseous carcinoma with a unique appearance and detailed review stating its clinicopathological correlation.
  3. Razak A, Patil PH, Sahota JS, Subramanian S
    J. Thorac. Cardiovasc. Surg., 2010 Mar;139(3):e27-8.
    PMID: 19660304 DOI: 10.1016/j.jtcvs.2008.08.042
  4. Balakrishnan R, Abdul-Razak HA, Jaspal S, Subramanian S, Shaharyar AM
    Med J Malaysia, 2008 Dec;63(5):413-4.
    PMID: 19803304 MyJurnal
    Haemangiopericytoma (HPC) is a rare vascular tumor arising from the pericytes of Zimmermann and is characterized by its unpredictable and variable biological behavior. These tumors are common in the trunk and the extremities and less than 16% of the cases occur in the head & neck region. Its occurrence in the oral cavity and pharynx is uncommon. We report an extremely rare case of haemangiopericytoma of the oropharynx arising from the tonsillo-lingual sulcus as a pedunculated mass, which was successfully excised perorally after a preliminary tracheostomy. No recurrence has been noted on a follow-up of more than six years.
  5. Subramanian S, Lekhraj Rampal GR, Wong EFM, Mastura S, Razi A
    Med J Malaysia, 2005 Dec;60(5):535-9.
    PMID: 16515102
    Sinusitis is an important cause of morbidity and one of the major sources of income loss. Anatomical variations of the nose have been reported to predispose to sinusitis. These variations include concha bullosa, nasal septal deviation and oversized bulla. The aim of this study was to determine the proportion and the distribution of concha bullosa in patients with chronic sinusitis and to determine the relationship between concha bullosa and age, sex, ethnicity. A cross-sectional study was conducted at the Department of Ear, Nose and Throat in Kuala Lumpur Hospital (HKL). Data was collected retrospectively using a pretested proforma. All patients who underwent Sino nasal surgery between January 1999 and December 2000 and whose preoperative CT scans were available were included in the study. The CT scans were reviewed. Analysis was carried out using Statistical Package for Social Sciences. Out of 146 patients who underwent sinonasal surgery between January 1999 and December 2000, 101 (69.2% preoperative CT scans of these patients were available and these were reviewed. The proportion of patients with concha bullosa was 49.5%. The results showed that there was significant relationship between presence of concha bullosa and age and sex. The overall mean age of patient with concha bullosa was 35.7 years (95% CI 12.1-39.3) and ranged from 11-years to 56-years. The mean age of respondents with concha bullosa was significantly lower than patients without concha bullosa 41.98 (95% CI 37.6-46.3; t-test = 2.221; df=99; p < 0.05). Concha bullosa was significantly more in females (66.0%) compared to males (chi2 = 4.465, df=1, p < 0.05). There was no significant relationship between presence of concha bullosa and ethnicity.
  6. Marimuthu K, Gunaselvam P, Aminur Rahman M, Xavier R, Arockiaraj J, Subramanian S, et al.
    Eur Rev Med Pharmacol Sci, 2015 May;19(10):1895-9.
    PMID: 26044237
    Sea urchin gonad is considered as a highly prized delicacy in several countries. It is also rich in valuable bioactive compounds including polyunsaturated fatty acids (PUFAs) and β-carotene. This study was undertaken to examine the antimicrobial properties of the ovary extract from sea urchin Diadema setosum against selected Gram-negative and Gram-positive bacteria.
  7. Chow KW, Ting HC, Yap YP, Yee KC, Purushotaman A, Subramanian S, et al.
    Int J Dermatol, 1998 Jun;37(6):446-8.
    PMID: 9646134
  8. Subramanian S, Patil SS, Ponnusamy S, Hasamnis AA, Loh KY, Santosh N
    Indian J Public Health, 2019 9 26;63(3):220-226.
    PMID: 31552852 DOI: 10.4103/ijph.IJPH_278_18
    Background: Whole-grain consumption is associated with several health benefits. Little is known, however, about whole-grain consumption patterns in medical students in Malaysia.

    Objectives: The study was conducted to assess whole-grain intake pattern and factors influencing intake among Malaysian medical students.

    Methods: A cross-sectional study investigating whole-grain intake among 151 medical students in a private medical university in Malaysia was conducted from January to June 2018. A self-administered questionnaire was used to assess sociodemographic variables, the whole-grain intake pattern and the knowledge and attitudes toward whole-grain intake. Data were analyzed using IBM SPSS software. Chi-square test and multivariable logistic regression were used.

    Results: The prevalence of reported whole-grain intake in the past 3 months was 51%. Chinese ethnicity, readiness to adhere to Malaysian food pyramid, and self-preparation of food, and eating at home were significantly associated with whole-grain consumption. However, the primary determinants of food choice such as education, knowledge, and affordability did not seem to influence whole-grain consumption. Whole-grain consumption is relatively low among Malaysian medical students. Cultural background and self-belief influence this practice despite being from the medical fraternity.

    Conclusions: Efforts are needed to bridge the knowledge-practice gap by assessing the barriers to whole-grain consumption to design effective initiatives to promote an increase in whole-grain consumption.

  9. Sankari T, Subramanian S, Hoti SL, Pani SP, Jambulingam P, Das PK
    Parasitol Res, 2021 Jan;120(1):311-319.
    PMID: 33146778 DOI: 10.1007/s00436-020-06950-7
    DEC or ivermectin (IVM) in combination with albendazole (ALB) has been the recommended strategy of the Global Programme to Eliminate Lymphatic Filariasis (GPELF) since 2000. Despite effective population coverage (> 65%) with several rounds of MDA with DEC or combination of DEC plus ALB, microfilariae persist in few individuals and they continue to be the source of infection for transmitting LF. We report an individual's variability in response to DEC by defining the response as complete absence of microfilaria (mf) (post-treatment mf count = 0) and non-response as presence of mf (post-treatment mf count ≥ 1). We analyzed follow-up data on individual's response to treatment from two randomized clinical trials in which 46 microfilaremic individuals were treated with single-dose DEC (6 mg/kg body weight). They were classified into low, medium, and high mf density categories based on their pre-treatment mf counts. Of the 46 individuals, 65.2% have not responded throughout the 12-month post-treatment period. Application of a logistic regression model with fixed (age, gender, mf density, post-treatment time, and their interactions) and random (individual's response over time) effects indicated that treatment response is independent of age, gender, and time. The overall treatment response increases in low and decreases in high mf density categories. Furthermore, the estimates for the random coefficients model showed that there is a greater variability in response between individuals over post-treatment time. The results substantiate that individual variation in response to DEC exists which indicate the importance of studying the parasite as well as host genetic factors associated with DEC action.
  10. Thekkeparambil Chandrabose S, Sriram S, Subramanian S, Cheng S, Ong WK, Rozen S, et al.
    Stem Cell Res Ther, 2018 03 20;9(1):68.
    PMID: 29559008 DOI: 10.1186/s13287-018-0796-2
    BACKGROUND: While a shift towards non-viral and animal component-free methods of generating induced pluripotent stem (iPS) cells is preferred for safer clinical applications, there is still a shortage of reliable cell sources and protocols for efficient reprogramming.

    METHODS: Here, we show a robust episomal and xeno-free reprogramming strategy for human iPS generation from dental pulp stem cells (DPSCs) which renders good efficiency (0.19%) over a short time frame (13-18 days).

    RESULTS: The robustness of DPSCs as starting cells for iPS induction is found due to their exceptional inherent stemness properties, developmental origin from neural crest cells, specification for tissue commitment, and differentiation capability. To investigate the epigenetic basis for the high reprogramming efficiency of DPSCs, we performed genome-wide DNA methylation analysis and found that the epigenetic signature of DPSCs associated with pluripotent, developmental, and ecto-mesenchymal genes is relatively close to that of iPS and embryonic stem (ES) cells. Among these genes, it is found that overexpression of PAX9 and knockdown of HERV-FRD improved the efficiencies of iPS generation.

    CONCLUSION: In conclusion, our study provides underlying epigenetic mechanisms that establish a robust platform for efficient generation of iPS cells from DPSCs, facilitating industrial and clinical use of iPS technology for therapeutic needs.

  11. Sheta A, Thaher T, Surani SR, Turabieh H, Braik M, Too J, et al.
    Diagnostics (Basel), 2023 Jul 20;13(14).
    PMID: 37510161 DOI: 10.3390/diagnostics13142417
    Obstructive sleep apnea (OSA) is a prevalent sleep disorder that affects approximately 3-7% of males and 2-5% of females. In the United States alone, 50-70 million adults suffer from various sleep disorders. OSA is characterized by recurrent episodes of breathing cessation during sleep, thereby leading to adverse effects such as daytime sleepiness, cognitive impairment, and reduced concentration. It also contributes to an increased risk of cardiovascular conditions and adversely impacts patient overall quality of life. As a result, numerous researchers have focused on developing automated detection models to identify OSA and address these limitations effectively and accurately. This study explored the potential benefits of utilizing machine learning methods based on demographic information for diagnosing the OSA syndrome. We gathered a comprehensive dataset from the Torr Sleep Center in Corpus Christi, Texas, USA. The dataset comprises 31 features, including demographic characteristics such as race, age, sex, BMI, Epworth score, M. Friedman tongue position, snoring, and more. We devised a novel process encompassing pre-processing, data grouping, feature selection, and machine learning classification methods to achieve the research objectives. The classification methods employed in this study encompass decision tree (DT), naive Bayes (NB), k-nearest neighbor (kNN), support vector machine (SVM), linear discriminant analysis (LDA), logistic regression (LR), and subspace discriminant (Ensemble) classifiers. Through rigorous experimentation, the results indicated the superior performance of the optimized kNN and SVM classifiers for accurately classifying sleep apnea. Moreover, significant enhancements in model accuracy were observed when utilizing the selected demographic variables and employing data grouping techniques. For instance, the accuracy percentage demonstrated an approximate improvement of 4.5%, 5%, and 10% with the feature selection approach when applied to the grouped data of Caucasians, females, and individuals aged 50 or below, respectively. Furthermore, a comparison with prior studies confirmed that effective data grouping and proper feature selection yielded superior performance in OSA detection when combined with an appropriate classification method. Overall, the findings of this research highlight the importance of leveraging demographic information, employing proper feature selection techniques, and utilizing optimized classification models for accurate and efficient OSA diagnosis.
  12. Markandan K, Tiong YW, Sankaran R, Subramanian S, Markandan UD, Chaudhary V, et al.
    PMID: 36243900 DOI: 10.1080/02648725.2022.2127070
    Infectious outbreaks are the foremost global public health concern, challenging the current healthcare system, which claims millions of lives annually. The most crucial way to control an infectious outbreak is by early detection through point-of-care (POC) diagnostics. POC diagnostics are highly advantageous owing to the prompt diagnosis, which is economical, simple and highly efficient with remote access capabilities. In particular, utilization of nanomaterials to architect POC devices has enabled highly integrated and portable (compact) devices with enhanced efficiency. As such, this review will detail the factors influencing the emergence of infectious diseases and methods for fast and accurate detection, thus elucidating the underlying factors of these infections. Furthermore, it comprehensively highlights the importance of different nanomaterials in POCs to detect nucleic acid, whole pathogens, proteins and antibody detection systems. Finally, we summarize findings reported on nanomaterials based on advanced POCs such as lab-on-chip, lab-on-disc-devices, point-of-action and hospital-on-chip. To this end, we discuss the challenges, potential solutions, prospects of integrating internet-of-things, artificial intelligence, 5G communications and data clouding to achieve intelligent POCs.
  13. Sriram S, Kang NY, Subramanian S, Nandi T, Sudhagar S, Xing Q, et al.
    Stem Cell Res Ther, 2021 02 05;12(1):113.
    PMID: 33546754 DOI: 10.1186/s13287-021-02171-6
    BACKGROUND: Despite recent rapid progress in method development and biological understanding of induced pluripotent stem (iPS) cells, there has been a relative shortage of tools that monitor the early reprogramming process into human iPS cells.

    METHODS: We screened the in-house built fluorescent library compounds that specifically bind human iPS cells. After tertiary screening, the selected probe was analyzed for its ability to detect reprogramming cells in the time-dependent manner using high-content imaging analysis. The probe was compared with conventional dyes in different reprogramming methods, cell types, and cell culture conditions. Cell sorting was performed with the fluorescent probe to analyze the early reprogramming cells for their pluripotent characteristics and genome-wide gene expression signatures by RNA-seq. Finally, the candidate reprogramming factor identified was investigated for its ability to modulate reprogramming efficiency.

    RESULTS: We identified a novel BODIPY-derived fluorescent probe, BDL-E5, which detects live human iPS cells at the early reprogramming stage. BDL-E5 can recognize authentic reprogramming cells around 7 days before iPS colonies are formed and stained positive with conventional pluripotent markers. Cell sorting of reprogrammed cells with BDL-E5 allowed generation of an increased number and higher quality of iPS cells. RNA sequencing analysis of BDL-E5-positive versus negative cells revealed early reprogramming patterns of gene expression, which notably included CREB1. Reprogramming efficiency was significantly increased by overexpression of CREB1 and decreased by knockdown of CREB1.

    CONCLUSION: Collectively, BDL-E5 offers a valuable tool for delineating the early reprogramming pathway and clinically applicable commercial production of human iPS cells.

  14. Subramanian S, Duraipandian C, Alsayari A, Ramachawolran G, Wong LS, Sekar M, et al.
    Front Pharmacol, 2023;14:1096905.
    PMID: 36817128 DOI: 10.3389/fphar.2023.1096905
    Background: Dodonaea viscosa Jacq. (D. viscosa) belongs to the family of Sapindaceae, commonly known as "Sinatha," and is used as a traditional medicine for treating wounds due to its high flavonoids content. However, to date there is no experimental evidence on its flavonoid-rich fraction of D. viscosa formulation as an agent for healing wounds. Objective: The present study aimed to evaluate the wound healing effect of ethyl acetate fraction of D. viscosa leaves on dermal wounds. Methods: The ethyl acetate fraction was produced from a water-ethanol extract of D. viscosa leaves and was quantitatively evaluated using the HPLC technique. The in-vivo wound healing ability of the ethyl acetate fraction of D. viscosa ointment (DVFO, 2.5%w/w and 5%w/w) was investigated in Sprague-Dawley rats utilizing an incision and excision paradigm with povidone-iodine ointment (5% w/w) as a control. The percentage of wound closure, hydroxyproline and hexosamine concentrations, tensile strength and epithelialization duration were measured. Subsequently, histopathology analysis of skin samples as well as western blots were performed for collagen type 3 (COL3A1), basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF). Results: The ethyl acetate fraction of D. viscosa revealed flavonoids with high concentrations of quercetin (6.46% w/w) and kaempferol (0.132% w/w). Compared to the control group, the DVFO (2.5% and 5.0% w/w) significantly accelerated wound healing in both models, as demonstrated by quicker wound contraction, epithelialization, elevated hydroxyproline levels and increased tensile strength. Histopathological investigations also revealed that DVFO treatment improved wound healing by re-epithelialization, collagen formation and vascularization of damaged skin samples. Western blot analysis further demonstrated an up-regulation of COL3A, vascular endothelial growth factor and bFGF protein in wound granulation tissue of the DVFO-treated group (p < 0.01). Conclusion: It is concluded that flavonoid-rich D. viscosa ethyl acetate fraction promotes wound healing by up-regulating the expressions of COL3A, VEGF and bFGF protein in wound granulation tissue. However, extensive clinical and pre-clinical research on the flavonoid-rich fraction of D. viscosa is needed to determine its significant impact in the healing of human wounds.
  15. Naito R, Leong DP, Bangdiwala SI, McKee M, Subramanian SV, Rangarajan S, et al.
    BMJ Glob Health, 2021 03;6(3).
    PMID: 33753400 DOI: 10.1136/bmjgh-2020-004124
    OBJECTIVE: To examine the association between social isolation and mortality and incident diseases in middle-aged adults in urban and rural communities from high-income, middle-income and low-income countries.

    DESIGN: Population-based prospective observational study.

    SETTING: Urban and rural communities in 20 high income, middle income and low income.

    PARTICIPANTS: 119 894 community-dwelling middle-aged adults.

    MAIN OUTCOME MEASURES: Associations of social isolation with mortality, cardiovascular death, non-cardiovascular death and incident diseases.

    RESULTS: Social isolation was more common in middle-income and high-income countries compared with low-income countries, in urban areas than rural areas, in older individuals and among women, those with less education and the unemployed. It was more frequent among smokers and those with a poorer diet. Social isolation was associated with greater risk of mortality (HR of 1.26, 95% CI: 1.17 to 1.36), incident stroke (HR: 1.23, 95% CI: 1.07 to 1.40), cardiovascular disease (HR: 1.15, 95% CI: 1.05 to 1.25) and pneumonia (HR: 1.22, 95% CI: 1.09 to 1.37), but not cancer. The associations between social isolation and mortality were observed in populations in high-income, middle-income and low-income countries (HR (95% CI): 1.69 (1.32 to 2.17), 1.27 (1.15 to 1.40) and 1.47 (1.25 to 1.73), respectively, interaction p=0.02). The HR associated with social isolation was greater in men than women and in younger than older individuals. Mediation analyses for the association between social isolation and mortality showed that unhealthy behaviours and comorbidities may account for about one-fifth of the association.

    CONCLUSION: Social isolation is associated with increased risk of mortality in countries at different economic levels. The increasing share of older people in populations in many countries argues for targeted strategies to mitigate its adverse effects.

  16. Palafox B, McKee M, Balabanova D, AlHabib KF, Avezum AJ, Bahonar A, et al.
    Int J Equity Health, 2016 12 08;15(1):199.
    PMID: 27931255
    BACKGROUND: Effective policies to control hypertension require an understanding of its distribution in the population and the barriers people face along the pathway from detection through to treatment and control. One key factor is household wealth, which may enable or limit a household's ability to access health care services and adequately control such a chronic condition. This study aims to describe the scale and patterns of wealth-related inequalities in the awareness, treatment and control of hypertension in 21 countries using baseline data from the Prospective Urban and Rural Epidemiology study.

    METHODS: A cross-section of 163,397 adults aged 35 to 70 years were recruited from 661 urban and rural communities in selected low-, middle- and high-income countries (complete data for this analysis from 151,619 participants). Using blood pressure measurements, self-reported health and household data, concentration indices adjusted for age, sex and urban-rural location, we estimate the magnitude of wealth-related inequalities in the levels of hypertension awareness, treatment, and control in each of the 21 country samples.

    RESULTS: Overall, the magnitude of wealth-related inequalities in hypertension awareness, treatment, and control was observed to be higher in poorer than in richer countries. In poorer countries, levels of hypertension awareness and treatment tended to be higher among wealthier households; while a similar pro-rich distribution was observed for hypertension control in countries at all levels of economic development. In some countries, hypertension awareness was greater among the poor (Sweden, Argentina, Poland), as was treatment (Sweden, Poland) and control (Sweden).

    CONCLUSION: Inequality in hypertension management outcomes decreased as countries became richer, but the considerable variation in patterns of wealth-related inequality - even among countries at similar levels of economic development - underscores the importance of health systems in improving hypertension management for all. These findings show that some, but not all, countries, including those with limited resources, have been able to achieve more equitable management of hypertension; and strategies must be tailored to national contexts to achieve optimal impact at population level.

  17. Malaspinas AS, Westaway MC, Muller C, Sousa VC, Lao O, Alves I, et al.
    Nature, 2016 Oct 13;538(7624):207-214.
    PMID: 27654914 DOI: 10.1038/nature18299
    The population history of Aboriginal Australians remains largely uncharacterized. Here we generate high-coverage genomes for 83 Aboriginal Australians (speakers of Pama-Nyungan languages) and 25 Papuans from the New Guinea Highlands. We find that Papuan and Aboriginal Australian ancestors diversified 25-40 thousand years ago (kya), suggesting pre-Holocene population structure in the ancient continent of Sahul (Australia, New Guinea and Tasmania). However, all of the studied Aboriginal Australians descend from a single founding population that differentiated ~10-32 kya. We infer a population expansion in northeast Australia during the Holocene epoch (past 10,000 years) associated with limited gene flow from this region to the rest of Australia, consistent with the spread of the Pama-Nyungan languages. We estimate that Aboriginal Australians and Papuans diverged from Eurasians 51-72 kya, following a single out-of-Africa dispersal, and subsequently admixed with archaic populations. Finally, we report evidence of selection in Aboriginal Australians potentially associated with living in the desert.
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