Displaying publications 21 - 37 of 37 in total

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  1. Nalliah S, Loh KY, Japaraj RP, Mukudan K
    J Matern Fetal Neonatal Med, 2009 Feb;22(2):129-36.
    PMID: 19197787 DOI: 10.1080/14767050802509520
    The 'Term Breech Trial' (TBT) results of 2001 have impacted on the mode of delivery of breech with a low threshold for caesarean delivery (CD) worldwide.
  2. Nalliah S, Pereira J, Lim ST, Jayasingam V, Phang GG
    MyJurnal
    In recent years, the internet has become an increasingly popular tool for people to obtain information due to the overwhelming availability of material. As internet access becomes more readily available, the newer generation of patients, medical students and doctors are starting to prefer the internet as a source of reference to acquire medical knowledge. The main objectives of this study were to determine the accuracy of using Google search in establishing a clinical diagnosis based on information provided from the New England Journal of Medicine (NEJM) and to determine the concordance rate of Google diagnosis with the actual diagnosis from NEJM.
  3. Naing C, Htet NH, Basavaraj AK, Nalliah S
    J Diabetes Metab Disord, 2018 Dec;17(2):333-343.
    PMID: 30918869 DOI: 10.1007/s40200-018-0349-3
    Background: This study aimed to synthesize evidence on the association between IL-10 gene (-819 C/T, -1082 A/G, -592 A/C) polymorphisms and the risk of developing diabetic nephropathy.

    Methods: A systematic literature search was done in health-related electronic databases. The search was limited to studies published in English until September 2017. We also checked the references of retrieved articles and relevant reviews for any additional studies. The methodological quality of the studies included in this review was assessed using the 'Scales for Quality Assessment'. The I2 test was used to quantify between-study heterogeneity. A value of I2 > 50% indicated substantial heterogeneity. For the pooled analysis, summary odds ratio (OR) and its 95% confidence interval (CI) in random effect model were used.

    Results: Eight case-control studies (1192 cases with diabetic nephropathy and 2399 controls) met the inclusion criteria. Three groups of people namely Africans, Asians and Caucasians were included in this review. There were significant protective effects of SNP -819 C/T in overall population (OR 0.32, 95% CI 0.26-0.4) and - 1082 A/G SNP in the Asian population (OR 0.64, 95% CI 0.47-0.86) on diabetic nephropathy in the recessive model. There was no significant effect of -592 A/C on diabetic nephropathy.

    Conclusion: The findings suggest the protective effects of -1082A/G and -819G/A polymorphisms on the risk of developing diabetic nephropathy in type 2 diabetes mellitus, especially in the Asian population. Well- designed, prospective studies with sufficient number of participants are recommended to substantiate these findings.

  4. Fazli Khalaf Z, Liow JW, Nalliah S, Foong ALS
    J Homosex, 2023 Jul 29;70(9):1763-1786.
    PMID: 35285780 DOI: 10.1080/00918369.2022.2042662
    A central tenet of the health professions is that of equitable access to health care. However, disparities in equitable healthcare provision continues to be a challenge in many societies due to prejudices against the LGBTQ community. This study was aimed at exploring the attitudes of medical students toward LGBTQ patients in Malaysia. A qualitative approach was adopted to seek depth of understanding of clinical year medical students' perceptions and attitudes toward LGBTQ patients. Data were collected in 2018 through individual interviews and focus group discussions with a total of 29 participants, using a semi-structured question guideline. Purposive sampling comprised representation from the three major ethnic groups in Malaysia. Thematic analysis using NVivo highlighted three main themes i.e., neutrality, in compliance with the Professional Code of Conduct; implicit biases and tolerance of an Odd Identity; explicit biases with prejudices and stereotyping. The lack of knowledge and understanding of the nature and issues of sexuality is problematic as found in this study. They are primarily biases and prejudices projected onto marginalized LGBTQ patients who must contend with multiple jeopardies in conservative societies such as in Malaysia. With some state policies framed around Islam the concern is with the belief among Malay/Islamic students for LGBTQ individuals to go through conversion 'therapies' to become cisgender and heterosexual.
  5. Saraswathy T, Nalliah S, Rosliza AM, Ramasamy S, Jalina K, Shahar HK, et al.
    BMC Med Educ, 2021 Sep 09;21(1):482.
    PMID: 34503488 DOI: 10.1186/s12909-021-02907-1
    BACKGROUND: This study aimed at determining the effectiveness of an innovative approach using interprofessional simulation scenarios (IPSS) in improving knowledge, attitude, and practice (KAP) of hospital-acquired infection control (HAIC) among health professionals.

    METHODS: The interventional study was conducted in a teaching hospital in Malaysia. Purposive sampling was used to recruit participants from surgical, intensive care, and other units. Thirty-six health professionals in the experimental and forty in the control group completed the study. All subjects participated in an interactive lecture and demonstrated four IPSS on HAIC i.e. (i) taking blood specimen (ii) bedsore dressing (iii) collecting sputum for acid-fast bacilli and (iv) intermittent bladder catheterization. Each team consisted of a doctor and a nurse. A self-administered questionnaire on KAP on HAIC was completed by respondents during the pre-, immediately and, post-intervention. An independent t-test was conducted to measure the significance between the experimental and control group.

    RESULTS: The mean scores for KAP among the experimental group increased following the intervention. Significant differences in scores were seen between the two groups post-intervention (p 

  6. Nalliah S, Fong JSH, Yi Thor AY, Lim OH
    Indian J Urol, 2019;35(2):147-155.
    PMID: 31000921 DOI: 10.4103/iju.IJU_378_18
    INTRODUCTION: The aim of this systematic review is to compare chemotherapeutic agents commonly used in treating recurrent urinary infection in nonpregnant women by their efficacy, tolerability, adverse effects, and cost employing network meta-analysis.

    MATERIALS AND METHODS: We used three online databases, i.e., PubMed, ScienceDirect, and Cochrane Central Registry of Clinical Trials. Randomized controlled trials (RCTs) on the use of prophylactic chemotherapeutic agents used in treating nonpregnant women with recurrent urinary tract infections (RUTIs) published between 2002 and 2016 were selected. Only published papers in English were assessed for study quality, and meta-analyses were performed using fixed-effects model with NetMetaXL.

    RESULTS: Six RCTs fulfilled the criteria. When all three variables, i.e., efficacy, adverse effects and cost were considered, nitrofurantoin 50 mg once daily for 6 months appears to rank high for prophylaxis against RUTI. When efficacy was the only factor, fosfomycin had the highest superiority compared to D-mannose, nitrofurantoin, estriol, trimethoprim-sulfamethoxazole, and cranberry juice, respectively. However, fosfomycin was also ranked highest by adverse events. When cost alone is considered, nitrofurantoin appeared the most cost-effective agent while placed third for efficacy alone.

    CONCLUSION: Selecting appropriate chemotherapeutic agents for RUTI will need to factor in effectiveness, adverse effects, and cost. While it is difficult to select an ideal drug, evaluation using network analysis may guide choice of medication for best practice.

  7. Jeevaratnam K, Nadarajah VD, Judson JP, Nalliah S, Abdullah MF
    PMID: 20920154 DOI: 10.1186/1471-2393-10-58
    Hypertensive disorders in pregnancy contributes to about 12% of maternal deaths in Malaysia and similarly worldwide. Early detection and adequate management are preventable strategies. Biochemical markers of abnormal angiogenesis would be more specific in early detection than routine blood pressure and proteinuria measurements. The aim of this study was to estimate maternal plasma PlGF and sFlt-1 levels in pregnant women with gestational hypertension at three intervals of pregnancy and correlate these biomarker levels with placental morphometry.
  8. Aznal SS, Meng FG, Nalliah S, Tay A, Chinniah K, Jamli MF
    Indian J Pathol Microbiol, 2012 Oct-Dec;55(4):450-5.
    PMID: 23455778 DOI: 10.4103/0377-4929.107778
    Pelvic organ prolapse (POP) is associated with menopause and changes in the proteins of the pelvic supporting system, but there is scant data on the precise alterations in Malaysian women.
  9. Thangarajoo S, Rosliza AM, Nalliah S, Karim J, Shohaimi S, Ramasamy S, et al.
    BMC Med Educ, 2021 Apr 26;21(1):243.
    PMID: 33902577 DOI: 10.1186/s12909-021-02610-1
    BACKGROUND: Interprofessional learning (IPL) is a key challenge in Malaysia in incorporating the current profession-specific medical education into the interprofessional learning curriculum. Safe practices would be enhanced with improved collaboration among the health professionals when they learn with, from, and about each other. The main objective of this study was to determine the significant differences in self-assessment, attitude, and perception of interprofessional learning among doctors and nurses in a teaching hospital in Klang Valley, Malaysia. The second objective was to determine if there is any significant difference in the selected demography factors, mean and total scores between doctors and nurses in self-assessment, attitude, and perceptions of IPL aspects.

    METHODS: A total of doctors (39) and nurses (37) were recruited for an interventional study on the interprofessional learning approach on hospital acquired infection control. The participants responded to the University of West England Interprofessional (UWEIP) questionnaire at baseline consisting of four dimensions in IPL aspects; Self-assessment on communication and teamwork skills (CTW), interprofessional learning (IPL), interprofessional interaction (IPI), and interprofessional relationship (IPR). The Cronbach alpha value for the total questionnaire was established at 0.79.

    RESULTS: The majority of doctors scored positive in CTW, IPL, IPR, and neutral in IPI. Nurses' also recorded the highest positive scores in CTW, IPL, and IPR, and neutral in IPI. Negative scores were found in CTW and IPI. A significant difference was revealed between doctors and nurses in IPL attitude; p = 0.024 and there was no significant difference in other dimensions (p > .05). Results also found a significant difference between participants' and non-participants of IPL training sessions; p = 0.009.

    CONCLUSIONS: This study revealed the infusion of interprofessional learning training among the health professionals displayed better self-assessments, attitudes, and perceptions towards collaborative practices.

  10. Nalliah S, Wg P, Masten Singh PK, Naidu P, Lim V, Ahamed AA
    Aust Fam Physician, 2017 Mar;46(3):139-144.
    PMID: 28260277
    BACKGROUND: Overactive bladder syndrome (OAB) is a common medical condition that causes significant distress and impact on the quality of life in women. Muscarinic receptor antagonists remain the mainstay of therapy, but they are limited by their efficacy and adverse effects. The objective of the article was to compare the clinical efficacy and tolerability of medications used to treat OAB in women through network meta-analysis.

    METHODS: Data from eligible studies of commonly prescribed pharmacological agents in the treatment of OAB in women were entered into Net-MetaXL after a literature search using two online databases (PubMed and Cochrane). Studies between 31 July 2000 and 31 July 2015 were included in this study.

    RESULTS: Five quantitative studies were eligible for analysis. The most efficacious drug to treat OAB in women appears to be solifenacin 10 mg once daily (OD), followed by oxybutynin 3 mg three times a day. However, solifenacin 10 mg OD caused more adverse effects that the other treatments.

    DISCUSSION: Our results are similar to those of another systematic review. When considering efficacy, tolerability and cost, solifenacin 5 mg once daily is the drug of choice as it is more efficacious, albeit with more adverse effects, than other treatments. If solifenacin is unsuitable, oxybutynin 3 mg TDS is recommended.
  11. Fernando HV, Chan LL, Dang N, Santhanes D, Banneheke H, Nalliah S, et al.
    Pharm Dev Technol, 2019 Mar;24(3):348-356.
    PMID: 29799300 DOI: 10.1080/10837450.2018.1481430
    Microporous polymeric matrices prepared from poly(ɛ-caprolactone) [PCL] were evaluated for controlled vaginal delivery of the antiprotozoal agent (tinidazole) in the treatment of the sexually transmitted infection, trichomoniasis. The matrices were produced by rapidly cooling co-solutions of PCL and tinidazole in acetone to -80 °C to induce crystallisation and hardening of the polymer. Tinidazole incorporation in the matrices increased from 1.4 to 3.9% (w/w), when the drug concentration in the starting PCL solution was raised from 10 to 20% (w/w), giving rise to drug loading efficiencies up to 20%. Rapid 'burst release' of 30% of the tinidazole content was recorded over 24 h when the PCL matrices were immersed in simulated vaginal fluid. Gradual drug release occurred over the next 6 days resulting in delivery of around 50% of the tinidazole load by day 7 with the released drug retaining antiprotozoal activity at levels almost 50% that of the 'non-formulated' drug in solution form. Basic modelling predicted that the concentration of tinidazole released into vaginal fluid in vivo from a PCL matrix in the form of an intravaginal ring would exceed the minimum inhibitory concentration against Trichomonas vaginalis. These findings recommend further investigation of PCL matrices as intravaginal devices for controlled delivery of antiprotozoal agents in the treatment and prevention of sexually transmitted infections.
  12. Wong ZY, Ou KQ, Prasad A, Say WX, Nalliah S
    Aust J Gen Pract, 2022 10;51(10):758-765.
    PMID: 36184858 DOI: 10.31128/AJGP-01-22-6288
    BACKGROUND AND OBJECTIVES: Nausea, vomiting and hyperemesis in early pregnancy are common in primary care, and hospital care is required in severe cases. The aim of this review is to appraise relevant clinical practice guidelines (CPGs) to manage hyperemesis gravidarum (HG) by using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) checklist.

    METHOD: A systematic search was conducted employing PubMed, Cochrane and ScienceDirect from inception until May 2021. The quality of four CPGs were evaluated by two appraisers independently using the AGREE II checklist.

    RESULTS: Four international CPGs that fulfilled the criteria were included in this review; all scored over 50% according to the AGREE II tool. Applying a modified categorisation standard, CPGs were considered as either 'recommended' or 'recommended with modifications'.

    DISCUSSION: The synthesis of all four CPGs suggested similar management strategies for HG, with minor differences. Medical practitioners could use the guiding principles of management on the basis of the needs of individual patients.

  13. Nalliah S, Chan SL, Ong CL, Suthan TH, Tan KC, She VN, et al.
    Singapore Med J, 2010 Apr;51(4):332-8.
    PMID: 20505913
    Internet search has been the main source for information and data mining in medical research. Its use by medical students has immensely contributed to learning activities. The main aim of the study was to determine the effectiveness of internet use by medical students during their initial years of clinical instruction in order to establish a diagnosis after being provided with the history and physical findings of a clinical problem.
  14. Akhilesh M, Mahalingam V, Nalliah S, Ali RM, Ganesalingam M, Haleagrahara N
    Biomed Rep, 2013 Mar;1(2):257-258.
    PMID: 24648931
    The aim of this study was to determine whether or not the increased levels of hypoxia-inducible factor-1α (HIF-1α) could be used to demonstrate failed placentation in pre-eclamptic mothers. Twenty pregnant females with (pre-eclampsia group) or without pre-eclampsia (control group) were included in the present study. Antenatal and post-delivery HIF-1α transcription factor levels were measured. A significant increase was observed in the HIF-1α levels in the pre- and post-natal pre-eclampsia mothers. The findings suggest that the levels of HIF-1α in the blood of mothers with pre-eclampsia decrease after delivery of the placenta. The results confirm that there is increased HIF-1α in pre-eclampsia and a steady increase in the levels of HIF-1α could be commensurate with the possibility of a patient developing pre-eclampsia at a later trimester.
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