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Median nerve compression by gouty tophi: a case report

Raffael, I., Rajesh, S.

International Medical Journal Malaysia, 2015;14(1):87-91.
MyJurnal

We describe a case of median nerve compression by gouty tophi. This is a rare condition and presented with loss of function with paraesthesia of both hands in addition to multiple tophis. Surgery was chosen for immediate relief, where a debulking of left flexor digitorum superficialis with decompression of carpal tunnel was done and resulted in improvement of symptoms but became complicated due to inadequate physiotherapy.
Topographical anatomy of asterion by an innovative technique using transillumination and skiagram

Srijit D, Rajesh S, Vijay K

Chin Med J (Engl), 2007 Oct 5;120(19):1724-6.
PMID: 17935679
In vitro assessment of non-irritant microemulsified voriconazole hydrogel system

Raju Y P, N H, Chowdary V H, Nair RS, Basha D J, N T

Artif Cells Nanomed Biotechnol, 2017 Dec;45(8):1539-1547.
PMID: 27887040 DOI: 10.1080/21691401.2016.1260579

Research was aimed on microemulsion-based hydrogel for voriconazole. Oleic acid and isopropyl myristate as lipid phases; tween 20: tween 80 as surfactants and PEG600 as cosurfactant were selected to formulate voriconazole microemulsions. The promising microemulsions in terms of zeta potential, pH, viscosity, and drug release were selected and developed into hydrogels using carbopol 934. Resulting microemulsion-based hydrogel (MBH) of voriconazole were evaluated for in vitro diffusion and ex vivo permeation. Antifungal potentials of MBH were assessed against selected fungal strains. Optimal MBH formulations, O6 and O8 had displayed their antifungal potentials with enlarged zone of inhibition against selected fungal strains.
Fulltext Brown-Séquard Syndrome as a First Presentation of Multiple Sclerosis

Ralot TK, Singh R, Bafna C, Rajesh S, Singh S

Malays J Med Sci, 2017 Aug;24(4):106-110.
PMID: 28951696 DOI: 10.21315/mjms2017.24.4.13

A female patient aged 48 years presented with sub-acute onset of weakness in right upper and lower limb over the past one month and numbness over left side of body below neck level. Multiple sclerosis (MS) presenting as Brown-Séquard syndrome is very rare. We present a case of hemicord myelitis which presented as Brown-Séquard syndrome as a first manifestation, which was later diagnosed as MS during subsequent relapses.
Fulltext Dry Sliding Wear Studies on Sillimanite and B4C Reinforced Aluminium Hybrid Composites Fabricated by Vacuum Assisted Stir Casting Process

Pethuraj M, Uthayakumar M, Rajesh S, Abdul Majid MS, Rajakarunakaran S, Niemczewska-Wójcik M

Materials (Basel), 2022 Dec 27;16(1).
PMID: 36614597 DOI: 10.3390/ma16010259

This paper presents the results of studies to understand the influence of hybridisation on mechanical and tribological behaviour as well as dry sliding wear of aluminium metal matrix composites. Sillimanite and boron carbide (B4C) were used as primary and secondary reinforcements and pure aluminium was used as the matrix material. The composite was fabricated by using a vacuum assisted stir casting process. Different research instruments were used, including a scanning electron microscope with EDX spectrometer, a surface measurement device, a thermal image analyser, as well as a tribotester. The results show that tensile, impact strength and hardness of the hybridised composites are superior (a step ahead) than unreinforced and primary composites. The wear behaviour of the fabricated specimens was tested for the dry sliding wear behaviour under the load range of 10-50 N with the steps of 20 N for the sliding velocities 0.75, 1.5 and 2.25 m/s over a distance of 1000 m. The wear rate increased with load and decreased as the wt.% of reinforcement increased. The wear rate of the composite with 10 wt.% Al2SiO5 was approximately 44% lower than that of the composite with 5 wt.% Al2SiO5. The same dependence was noted for hybrid composite (5 wt.% Al2SiO5 + 5 wt.% B4C)-the wear rate was approximately 50.8% lower than that of the composite with 5 wt.% Al2SiO5 under the same test condition. The friction coefficient decreased as the weight percentage of the reinforcement (Al2SiO5 and B4C) increased due to the uniform distribution of the reinforcement on the surface of the composites. The main wear mechanism of the studied materials was abrasion wear. The wear mechanism of the composite had tribochemical type. It involved the oxidation and transfer of the material, which formed protective tribolayers ensuring an additional sliding process. The mechanism that played the main role in the wear process of the composites was a combination of abrasive, adhesive and oxidative wear.
Role of high resolution ultrasound in ulnar nerve neuropathy

Radhika S, Lee YL, Low SF, Fazalina MF, Sharifah Majedah IA, Suraya A, et al.

Med J Malaysia, 2015 Jun;70(3):158-61.
PMID: 26248778 MyJurnal

AIM: This study was conducted to measure the cross sectional area (CSA) of the ulnar nerve (UN) in the cubital tunnel and to evaluate the role of high-resolution ultrasonography in the diagnosis of ulnar nerve neuropathy (UNN).
MATERIALS AND METHODS: This was a cross sectional study with 64 arms from 32 patients (34 neuropathic, 30 nonneuropathic). Diagnosis was confirmed by nerve conduction study and electromyography. The ulnar nerves were evaluated with 15MHz small footprint linear array transducer. The ulnar nerve CSA was measured at three levels with arm extended: at medial epicondyle (ME), 5cm proximal and 5cm distal to ME. Results from the neuropathic and nonneuropathic arms were compared. Independent T-tests and Pearson correlation tests were used. P value of less than 0.05 was considered significant.
RESULTS: Mean CSA values for the UN at levels 5cm proximal to ME, ME and 5cm distal to ME were 0.055, 0.109, 0.045 cm(2) respectively in the neuropathic group and 0.049, 0.075, 0.042 cm2 respectively in the non-neuropathic group. The CSA of the UN at the ME level was significantly larger in the neuropathic group, with p value of 0.005. However, there was no statistical difference between the groups at 5cm proximal and distal to the ME, with p values of 0.10 and 0.35 respectively.
CONCLUSION: There is significant difference in CSA values of the UN at ME between the neuropathic and non-neuropathic groups with mean CSA value above the predetermined 0.10cm(2) cut-off point. High-resolution ultrasonography is therefore useful to diagnose and follow up cases of elbow UNN.
Genome-wide association study identifies five new susceptibility loci for primary angle closure glaucoma

Khor CC, Do T, Jia H, Nakano M, George R, Abu-Amero K, et al.

Nat Genet, 2016 May;48(5):556-62.
PMID: 27064256 DOI: 10.1038/ng.3540

Primary angle closure glaucoma (PACG) is a major cause of blindness worldwide. We conducted a genome-wide association study (GWAS) followed by replication in a combined total of 10,503 PACG cases and 29,567 controls drawn from 24 countries across Asia, Australia, Europe, North America, and South America. We observed significant evidence of disease association at five new genetic loci upon meta-analysis of all patient collections. These loci are at EPDR1 rs3816415 (odds ratio (OR) = 1.24, P = 5.94 × 10(-15)), CHAT rs1258267 (OR = 1.22, P = 2.85 × 10(-16)), GLIS3 rs736893 (OR = 1.18, P = 1.43 × 10(-14)), FERMT2 rs7494379 (OR = 1.14, P = 3.43 × 10(-11)), and DPM2-FAM102A rs3739821 (OR = 1.15, P = 8.32 × 10(-12)). We also confirmed significant association at three previously described loci (P < 5 × 10(-8) for each sentinel SNP at PLEKHA7, COL11A1, and PCMTD1-ST18), providing new insights into the biology of PACG.