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Maternal blood : potential use in prenatal screening and diagnostics

Karuppiah, Thilakavathy, Jammal Ahmad Essa, Rozita Rosli

Buletin Persatuan Genetik Malaysia, 2002;8(1):0-0.
MyJurnal

Smaller family size and advancing parental age have increased the demand for prenatal diagnosis.
Prenatal cytogenetic diagnoses currently used, such as amniocentesis and chorionic villus
sampling, are usually not preferred by the expectant couples due to the risk imposed on the mother and child. High false positive rates (5%) of current non-invasive screening methods, such as serum analysts or ultrasound, cause a large number of unnecessary invasive practices to be performed, which apart from the associated risk, place considerable psychological distress on the couples
involved (Wald et al., 1999). (Copied from article).
Distribution of heavy metals in the dissolved and suspended phase of the sea-surface microlayer, seawater column and in sediments of Singapore's coastal environment

Cuong DT, Karuppiah S, Obbard JP

Environ Monit Assess, 2008 Mar;138(1-3):255-72.
PMID: 17562200

Concentrations of heavy metals were determined in the water column (including the sea-surface microlayer, subsurface, mid-depth and bottom water) and sediments from Singapore's coastal environment. The concentration ranges for As, Cd, Cr, Cu, Ni, Pb and Zn in the seawater dissolved phase (DP) were 0.34-2.04, 0.013-0.109, 0.07-0.35, 0.23-1.16, 0.28-0.78, 0.009-0.062 and 0.97-3.66 microg L(-1) respectively. The ranges for Cd, Cr, Cu, Ni, Pb and Zn in the suspended particulate matter (SPM) were 0.16-0.73, 6.72-53.93, 12.87-118.29, 4.34-60.71, 1.10-6.08 and 43.09-370.49 microg g(-1), respectively. Heavy metal concentrations in sediments ranged between 0.054-0.217, 37.48-50.52, 6.30-21.01, 13.27-26.59, 24.14-37.28 and 48.20-62.36 microg g(-1) for Cd, Cr, Cu, Ni, Pb and Zn, respectively. The lowest concentrations of metals in the DP and SPM were most frequently found in the subsurface water while the highest concentrations were mostly observed in the SML and bottom water. Overall, heavy metals in both the dissolved and particulate fractions have depth profiles that show a decreasing trend of concentrations from the subsurface to the bottom water, indicating that the prevalence of metals is linked to the marine biological cycle. In comparison to data from Greece, Malaysia and USA, the levels of metals in the DP are considered to be low in Singapore. Higher concentrations of particulate metals were reported for the Northern Adriatic Sea and the Rhine/Meuse estuary in the Netherlands compared to values reported in this study. The marine sediments in Singapore are not heavily contaminated when compared to metal levels in marine sediments from other countries such as Thailand, Japan, Korea, Spain and China.
Socioeconomic correlates of iodine status among school children in Sarawak, Malaysia

Wah-Yun Low, Siti Norazah Zulkifli, Rajeswari Karuppiah

Asia Pac J Public Health, 2002;14(2):110-7.
PMID: 12862416 DOI: 10.1177/101053950201400210

Iodine deficiency is recognized as a public health problem. This paper assesses iodine status by socioeconomic factors in school children in Sarawak, East Malaysia. Kuching, Bau and Simunjan districts were chosen based on advice from the Sarawak's Medical and Health Authority. 803 school children, aged eight years, were selected from 19 schools via proportionate systematic sampling. About half the proportion of the school children were from Kuching, 24% from Simunjan and 22% from Bau. Almost all were equally distributed by sex. By mother's race, almost half were Malays, followed by Bidayuh, Iban, Chinese and other races. Mean urinary iodine concentration was 3.36 microg/ 100ml, mean creatinine level was 111.10 mg/100ml and mean creatinine/iodine ratio was 39.45 microg/ gram. Four female children (0.5%) were found to have enlarged thyroid. Urinary iodine levels were significantly different by district, mother's race and household income. It was highest in Kuching, among children with Malay mothers, and with household incomes more than RM500 per month. Conversely, it was lowest in Bau, among children of Iban/Dayak and Chinese mothers, and incomes of RM500 or less per month. Based on the WHO/UNICEF/ICCIDD classification, the Sarawak school children in the present study fall into the moderate IDD category. The low prevalence of goitre is a positive finding indicating that iodine deficiency is corrected over time.
Fulltext Does prolonged standing at work among teachers associated with Musculoskeletal Disorders (MSDs)?

Ayuni Nabilah Alias, Karmegam Karuppiah, Vivien How, Velu Perumal

Malaysian Journal of Medicine and Health Sciences, 2020;16(2):281-289.
MyJurnal

In order to accomplish a wide range of duties and responsibilities that may be done under unpleasant working con- ditions, prolonged standing posture is common with school teachers. Nevertheless, standing upright for a long time or otherwise regarded as prolonged standing frequently contributes to body pain and discomfort, muscle fatigue and even health problems such as musculoskeletal disorders (MSDs). The aim of this paper is to review MSDs arising from prolonged standing and spread information on existing ergonomic and non-ergonomic interventions to alleviate prolonged standing discomfort. Systematic review on prolonged standing school teachers with specific keywords were recognized to discover the appropriate studies and information in a systematic search. The informations in this review may be helpful to guide teacher, school management and researchers to implement the suitable interventions in order to minimise the health issue due to MSDs among school teachers.
Fulltext Evaluation the discomfort level for students Polytechnic Kuching Sarawak sitting on chairs

Mahmood Ali, Mohd Sapuan Salit, Karmegam Karuppiah, Abu Saleh Ahmed

Malaysian Journal of Public Health Medicine, 2016;16(10):0-0.
MyJurnal

This study was conducted to evaluate the discomfort level of students from the Polytechnic Kuching Sarawak while they were sitting on chairs. Polytechnic Kuching students (n=500) completed a set of questionnaires utilizing a survey form which showed the body chart discomfort using Borg’s CR-10 Scale. The students was asked to identify body areas experiencing discomfort and to rate this discomfort using score rating groups (0 to 5) where score 0-1.99 = No discomfort (1), score2.00-3.99 =Discomfort (2) and score 4.00-5.00 = Very uncomfortable (3).The evaluation of seating discomfort levels showed acceptable levels for the students and possible outstanding problems. Students were asked to rank over an order 10 statements about comfort and choose three responses which gave the most consistent equal interval scale. The results showed that the main response of discomfort indicated the students felt cramped, stiff, numb, sore and tender muscle, unbearable pain, barely comfortable and uncomfortable. This project was identified to evaluate the comfort level for classrooms chairs of polytechnic students. Overall, there was a significant discomfort level for the students whilst sitting on chairs and a possible solution put forward is to design a new type of classroom chair made of natural fibre reinforced composite.
Utility of multimaterial 3D printers in creating models with pathological entities to enhance the training experience of neurosurgeons

Waran V, Narayanan V, Karuppiah R, Owen SL, Aziz T

J. Neurosurg., 2014 Feb;120(2):489-92.
PMID: 24321044 DOI: 10.3171/2013.11.JNS131066

The advent of multimaterial 3D printers allows the creation of neurosurgical models of a more realistic nature, mimicking real tissues. The authors used the latest generation of 3D printer to create a model, with an inbuilt pathological entity, of varying consistency and density. Using this model the authors were able to take trainees through the basic steps, from navigation and planning of skin flap to performing initial steps in a craniotomy and simple tumor excision. As the technology advances, models of this nature may be able to supplement the training of neurosurgeons in a simulated operating theater environment, thus improving the training experience.
Chitosan-based tyrosinase optical phenol biosensor employing hybrid nafion/sol-gel silicate for MBTH immobilization

Abdullah J, Ahmad M, Heng LY, Karuppiah N, Sidek H

Talanta, 2006 Oct 15;70(3):527-32.
PMID: 18970803 DOI: 10.1016/j.talanta.2005.12.061

The development of an optical biosensor based on immobilization of 3-methyl-2-benzothiazolinone hydrazone (MBTH) in hybrid nafion/sol-gel silicate film and tyrosinase in chitosan film for the detection of phenolic compounds has been described. Tyrosinase was immobilized in chitosan film deposited on the hybrid nafion/sol-gel silicate film containing MBTH. The enzymatic oxidation product of phenolic compounds were stabilized through formation of adduct with MBTH to produce a maroon color adduct. The color intensity of adduct was found to increase proportionally with the increase of the substrate concentrations after 5min exposure. The linearity of the biosensor towards phenol, catechol and m-cresol were in the respective concentration range of 0.5-7.0, 0.5-10.0 and 1.0-13.0mg/L with detection limit of 0.18, 0.23 and 0.43mg/L, respectively. The biosensor shows a good stability for at least 3 months.
Stacked films immobilization of MBTH in nafion/sol-gel silicate and horseradish peroxidase in chitosan for the determination of phenolic compounds

Abdullah J, Ahmad M, Heng LY, Karuppiah N, Sidek H

Anal Bioanal Chem, 2006 Nov;386(5):1285-92.
PMID: 17031625

The stacked-film immobilization of 3-methyl-2-benzothiazolinone hydrazone (MBTH) in hybrid nafion/sol-gel silicate film and horseradish peroxidase (HRP) in chitosan, performed in order to allow the determination of phenolic compounds, was investigated via an optical method. The stacked films were deposited onto a microscope glass slide by a spin-coating technique. The quinone or free radical product formed by the enzymatic reactions of phenolic compounds interacts with MBTH to form azo-dye products, which can be measured spectrophotometrically at a wavelength of 500 nm. The color intensity of the product was found to increase in proportion to the phenolic concentration after 5 min of exposure. The response of the biosensor was linear over concentration ranges of 0.025-0.500, 0.010-0.070 and 0.050-0.300 mM for guaiacol, resorcinol and o-cresol, respectively, and gave detection limits of 0.010, 0.005 and 0.012 mM. The sensor exhibited good sensitivity and stability for at least two months.
Fulltext Narrative Review of Infection Control Knowledge and Attitude among Healthcare Workers

AlJohani A, Karuppiah K, Al Mutairi A, Al Mutair A

J Epidemiol Glob Health, 2021 03;11(1):20-25.
PMID: 33605115 DOI: 10.2991/jegh.k.201101.001

BACKGROUND: Infection is one of the major threats to Healthcare Workers (HCW) worldwide. It exposes HCW to more than 20 kinds of blood-borne pathogen infections, especially the most severe cases, namely Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), and Human Immunodeficiency Virus (HIV). The impact of infection about HCWs' health, clinical burden, national economic burden, and humanistic burden suggests the importance of further investigation and discussion on this topic.
AIMS: This paper aimed to discuss literature on infection control knowledge and attitudes among HCWs and potential factors contributing to infection control.
METHOD: For this narrative review Proquest, Medline, and Up To Date have been utilized to search articles about infection control knowledge and attitudes among healthcare workers and potential factors contributing to infection control. The search was narrowed to article between 2000 and 2018. A total of 400 materials were initially identified to be potentially relevant for the review. A total of 28 articles were included, and they were found to match the inclusion criteria.
RESULTS: Results from the reviewed studies showed that there was a high-level knowledge in terms of precautionary measures and compliance with needle safety precautions while staff attitude achieved above average. Weak positive correlation was found between staff attitude and precautionary measures, while moderate positive correlation was found between precautionary measures and compliance with needle safety precautions. Only precautionary measures were found to significantly influence compliance with needle safety precautions, in which higher precautionary measures, resulted in higher compliance with needle safety precautions.
The utilisation of 3D printing in paediatric neurosurgery

Karuppiah R, Munusamy T, Bahuri NFA, Waran V

Childs Nerv Syst, 2021 05;37(5):1479-1484.
PMID: 33735402 DOI: 10.1007/s00381-021-05123-w

3D printing technology has evolved over the years and there is a growing interest in its application in paediatric neurosurgery. Modern 3D printers have enabled the development of patient-specific 3D models that provide a realistic representation of complex anatomies and will aid in planning complex procedures. Paediatric neurosurgical operations are challenging and hands-on training is restricted. Surgical simulation training with biomodel has provided a new paradigm for trainees to master their surgical skills before encountering similar scenarios in real-life environment. This paper reviews the aspects of 3D printing for preoperative planning and simulation-based surgical training in paediatric neurosurgery.
Fulltext Equitable Access to State-of-the-Art Medical Technology-a Malaysian Mini-Public-Private Partnership Case Study

Waran V, Thillainathan R, Karuppiah R, Pickard JD

World Neurosurg, 2022 01;157:135-142.
PMID: 34687934 DOI: 10.1016/j.wneu.2021.10.112

BACKGROUND: The provision of equitable and affordable health care has become increasingly challenging as advanced technology is introduced, particularly in developing countries. We explored the hypothesis that focused, small-scale mini-public-private partnerships have a potential role in providing equitable and affordable access to advanced technology for the benefit of all patients in developing nations, particularly middle-income countries.
METHODS: A clinician-led financial plan was developed at the University of Malaya to create the Centre for Image Guidance and Minimally Invasive Therapy (CIGMIT) to provide an integrated platform for high-end care for Malaysian patients of all ages, both public and private, requiring complex neurosurgical and spinal procedures and stereotactic and intensity-modulated radiotherapy. The challenges faced during development of the plan were documented together with an audit of patient throughput and analyses of financial risk and return.
RESULTS: CIGMIT opened in 2015. Patient throughput, both public and private, progressively increased in all facilities. In 2015-2019, 37,724 patients used the Centre's facilities. CIGMIT has become progressively more profitable for the University of Malaya, the public and private hospitals, and the investor. CIGMIT has weathered the challenges posed by coronavirus disease 19.
CONCLUSIONS: Focused, small-scale mini-public-private partnerships have a potential role in providing advanced technology for the benefit of patients in developing nations, particularly middle-income countries, subject to an approach that balances equity of access between public and private health care systems with fair reward.
Fulltext [Intractable intraoperative brain herniation secondary to tension pneumocephalus: a rare life-threatening complication during drainage of subdural empyema]

Foo LL, Chaw SH, Chan L, Ganesan D, Karuppiah R

Rev Bras Anestesiol, 2016 09 28;67(6):655-658.
PMID: 27692367 DOI: 10.1016/j.bjan.2015.09.006

Tension pneumocephalus is rare but has been well documented following trauma and neurosurgical procedures. It is a surgical emergency as it can lead to neurological deterioration, brainstem herniation and death. Unlike previous cases where tension pneumocephalus developed postoperatively, we describe a case of intraoperative tension pneumocephalus leading to sudden, massive open brain herniation out of the craniotomy site. The possible causative factors are outlined. It is imperative to rapidly identify possible causes of acute intraoperative brain herniation, including tension pneumocephalus, and institute appropriate measures to minimize neurological damage.
An Optical Biosensor based on Immobilization of Laccase and MBTH in Stacked Films for the Detection of Catechol

Abdullah J, Ahmad M, Heng LY, Karuppiah N, Sidek H

Sensors (Basel), 2007 Oct 11;7(10):2238-2250.
PMID: 28903224 DOI: 10.3390/s7102238

The fabrication of an optical biosensor by using stacked films where 3-methyl-2-benzothiazolinone hydrazone (MBTH) was immobilized in a hybrid nafion/sol-gelsilicate film and laccase in a chitosan film for the detection of phenolic compounds wasdescribed. Quinone and/or phenoxy radical product from the enzymatic oxidation ofphenolic compounds was allowed to couple with MBTH to form a colored azo-dye productfor spectrophometric detection. The biosensor demonstrated a linear response to catecholconcentration range of 0.5-8.0 mM with detection limit of 0.33 mM and response time of10 min. The reproducibility of the fabricated biosensor was good with RSD value of 5.3 %(n = 8) and stable for at least 2 months. The use of the hybrid materials of nafion/sol-gelsilicate to immobilize laccase has altered the selectivity of the enzyme to various phenoliccompounds such as catechol, guaicol, o-cresol and m-cresol when compared to the non-immobilized enzyme. When immobilized in this hybrid film, the biosensor response onlyto catechol and not other phenolic compounds investigated. Immobilization in this hybridmaterial has enable the biosensor to be more selective to catechol compared with the non-immobilized enzyme. This shows that by a careful selection of different immobilizationmatrices, the selectivity of an enzyme can be modified to yield a biosensor with goodselectivity towards certain targeted analytes.
Exploring SOD1 Gene for the Detection of Fetal Down Syndrome

Thilakavathy K, Rozita R, Baskaran TP

J Prenat Med, 2008 Jul;2(3):36-9.
PMID: 22439026

Fetal cells and circulating cellfree fetal DNA increases in the maternal circulation in women carrying trisomy 21 fetus.
A plethora of human pluripotent stem cells

Gao L, Thilakavathy K, Nordin N

Cell Biol Int, 2013 Sep;37(9):875-87.
PMID: 23619972 DOI: 10.1002/cbin.10120

At the early stages of mammalian development, a number of developmentally plastic cells appear that possess the ability to give rise to all of the differentiated cell types normally derived from the three primary germ layers - unique character known as pluripotency. To date, embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs) have been shown to be truly pluripotent. However, recent studies have revealed a variety of other cells that demonstrate pluripotentiality, including very small embryonic-like stem cells (VSELs), amniotic fluid stem cells (AFSCs), marrow-isolated adult multilineage inducible cells (MIAMI) and multipotent adult precursor cells (MAPCs). This review summarises key features of these six kinds of pluripotent and potentially pluripotent stem cells (ESCs, iPSCs, VSELs, AFSCs, MIAMI and MAPCs) and the evidence for their pluripotency properties.
Fulltext Muscle discomfort in prolonged standing among industrial workers

Adriana Abdul Aziz, Karmegam Karuppiah, Velu Perumal, Shamsul Bahri Mohd Tamrin, Enoch Kumar Perimal, Sivasankar S.

Malaysian Journal of Medicine and Health Sciences, 2019;15(103):90-92.
MyJurnal

Prolonged standing has been identified as one of the risk factors which is associated with occupational injuries. Therefore, the primary aim for this study is to determine the association between prolonged standing and muscle dis- comfort among workers who have to stand for long periods of time. A total of 74 respondents were given and asked to complete a self-administered Borg’s Scale questionnaire. After that, the completed questionnaire was analysed using statistical analysis. This study highlighted the correlation between height, weight and age of the respondents with muscle discomfort following exposure to prolonged standing. Besides that, the association between prolonged standing and muscle discomfort also will be highlighted. In short, the prevalence of leg muscle discomfort was higher compared to the muscle discomfort experienced by the other body parts.
Fulltext Ergonomic interventions: comparisons between footrest and anti-fatigue mat in reducing lower leg muscle discomforts during prolonged standing

Noreen Adila Omar, Karmegam Karuppiah, Vivien How, Enoch Kumar Perimal, Sivasankar S., Kulanthayan K. C. Mani

Malaysian Journal of Medicine and Health Sciences, 2019;15(103):116-119.
MyJurnal

Ergonomics is a science focusing on the study of human fit, decreasing human fatigue and discomfort through the design of new product. Prevention related to workers injury and illness such as muscle discomfort is part of the main goals in ergonomics interventions. Thus, this present study investigates the effectiveness of ergonomic interventions such as footrest and floor conditions in reducing workers lower leg muscle discomforts during prolonged standing. The main objective of this study was to determine and compare the lower leg muscles discomfort (exertion percent- age (%)) of Gastrocnemius and Tibialis Anterior among the respondents using the two ergonomic interventions (foot- rest and anti-fatigue mat). About 60 healthy subjects were recruited to stand for 2 hours (120 minutes) while using the two interventions in different session with one week interval between each test session. During standing, lower leg muscle discomfort of Gastrocnemius and Tibialis Anterior muscles were continuously monitored. Changes in lower leg muscle discomforts over standing time were measured using the surface Electromyography (sEMG). In this study, the sEMG readings showed that the percentage of exertion (%) were increasing with time (within 120 minutes) on muscles for both legs with the usage of the interventions (footrest and anti-fatigue mat). However, the percentage of exertion (%) from the sEMG readings were lower compared to previous studies. The independent t-test was used to find the mean changes on exertion percentage (%) between each muscles of both legs for the two interventions. Results found that there were significant exertion percentage at certain time with 15 minutes time period within the 120 minutes standing. This study showed that the ergonomic interventions (anti-fatigue mat and footrest) gives a low number of exertion percentage (%), showing a reduced muscle discomfort to the lower leg muscles compared to previous studies and interventions. In comparisons with footrest, this study showed that anti-fatigue mat is more applicable for the assembly workers in the industrial factory. The data produced by the comparisons between the two interventions can be useful especially to the Department of Occupational Safety and Health Malaysia (DOSH) in enhancing the safety and wellbeing of industrial workers in Malaysia.
Fulltext Humidity controlling material development from diatomite, waste glass and cockle shell powder: an experimental study

Huong Pei Zam, Emilia Zainal Abidin, Karmegam Karuppiah, Mohd Sapuan Salit

Malaysian Journal of Medicine and Health Sciences, 2019;15(204):99-105.
MyJurnal

Introduction: Innovative ways of balancing indoor relative humidity without compensate for the optimal working environment is crucial as excessive dampness is a risk factor for health symptoms among people and deteriorate building performance. This study examines the potential of fabricating humidity controlling material by sintering a mixture of diatomite, waste glass and cockle shell powder. Moisture sorption isotherms, moisture buffer values, pore structure, surface morphology and flexural strength of the final products were determined. Methods: Mixture of diatomite, powdered waste glass and cockle shell powder is mixed at different ratio, pressed and sintered at 1100°C for 20 minutes. The final products were examined using nitrogen gas adsorption-desorption and scanning electron microscopy for mesoporous and morphology properties. The moisture adsorption-desorption performances of the samples were tested using desiccator method while the flexural strength is tested using universal testing machine. Results: The sintered products have specific surface area from 5.744 m2/g to 14.765 m2/g and have pore size from 39.5-67.7 nm. The best product, manufactured by mixing 60% diatomite, 30% waste glass and 10% cockle shell powder, showed a good moisture buffer value (MBV: 1.3 g/m2 %RH) and flexural strength of 8.23 ± 1.8 MPa satisfy the standard of those commercial porous ceramics. Conclusion: Usage of waste glass and cockle shell powder in development of humidity control material helped in the waste reduction. The humidity control material produced can regulate indoor humidity without additional energy consumption. The superior products show excellent charac- teristics and highly promising for various construction applications.
Fulltext Determination of polycyclic aromatic hydrocarbons in human blood samples using solid phase extraction and gas chromatography mass spectrometry- a review

Samer Al-Battawi, Yu Bin Ho, Mohd Talib Latif, Vivien How, Karuppiah Thilakavathy

Malaysian Journal of Medicine and Health Sciences, 2019;15(204):165-169.
MyJurnal

Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous pollutants with toxic effects and adverse health impacts on general population. Several methods of extraction had been applied to extract PAHs from human blood samples such as solid phase extraction (SPE). The SPE represents one of the most common techniques for extraction and clean-up procedures as it needs low quantity of solvents with less manual efforts. Similarly, various analytical instruments like gas chromatography coupled to mass spectrometry (GC-MS) was used to measure the PAHs levels. Gas chromatog- raphy is a simple, fast, and very efficient method for solvents and small organic molecules. This review provides an overview of the measured concentrations of PAHs in human blood samples through the application of SPE and GC- MS during the last ten years. While these studies used various solvents, their application of SPE method and GC-MS revealed rewarding results about the determination of PAHs levels in the human samples.
Fulltext Musculoskeletal disorders and its association with self- reported productivity: a cross-sectional study among public office-workers in Putrajaya, Malaysia

Ayman Albeeli, Shamsul Bahri Mohd Tamrin, Ng Yee Guan, Karmegam Karuppiah

Malaysian Journal of Medicine and Health Sciences, 2020;16(4):272-279.
MyJurnal

Introduction: Prevalence of musculoskeletal disorders (MSDs) among office workers found to be high worldwide, leading to considerable economic impacts and health issues. The relationship between MSDs and productivity loss is widely recognized. This study investigates the possible relationships between the self-reported musculoskeletal dis- orders and productivity in term of absenteeism/presenteeism and self-evaluated productivity levels during presentee- ism time among office workers. Methods: Cross-sectional study was carried among office workers (n=398) in three public sector organizations in Putrajaya. Socio-demographic and productivity data were determined using self-ad- ministered general questionnaire whereas prevalence of MSDs evaluated using Cornell Musculoskeletal Disorders Questionnaire (CMDQ). Results: This study found that prevalence of MSDs symptoms among office workers in any body parts is high (83.7%), low-back pain reported the highest (58.5%) whereas thighs pain reported less prevalent MSDs symptoms (25.4%) among participants. Also, the results showed a significant association between prevalence of MSDs and productivity loss in regard with presenteeism (p

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