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Fulltext Clinical manifestation and risk factors of tuberculosis infection in Malaysia: case study of a community clinic

Shanmuganathan R, Subramaniam ID

Glob J Health Sci, 2015;7(4):110-20.
PMID: 25946947 DOI: 10.5539/gjhs.v7n4p110

INTRODUCTION: The main aim of this study was to describe the clinical manifestation of tuberculosis infection cases in Malaysia and to determine the individual risk factors for their occurrence.
METHODOLOGY: The study adopted a quantitative research approach with use of descriptive statistical approach. The study setting was a community clinic which treats walk in patients who are mainly living and working in the surrounding areas. The study was conducted for a period of one year. All tuberculosis patients who sought treatment in the clinic during the time were included in this study. The total number of cases was 40. Data was collected from the medical records of the tuberculosis patients. The risk factors selected for investigation were demographic characteristics of age and sex, personal habits such as smoking, drug use and alcohol and presence of diseases such as human immunodeficiency virus positive (HIV+), diabetes mellitus, cancer, cyanotic heart disease, renal failure and steroid use.
RESULTS: Patients in the age group ranging from 41 to 50 years had the highest incidence of the infection. Smoking appears to be the most important risk factor for contracting followed by drug abuse, HIV+ infection and diabetes mellitus.
CONCLUSIONS: People with diseases such as diabetes mellitus and HIV that are high risk factors for TB should be screened for TB so that early detection and intervention is possible. Educational programs should be carried out to create awareness among the at risk groups.
Examining the Relationship between Psychosocial Work Factors and Musculoskeletal Discomfort among Computer Users in Malaysia

Zakerian S, Subramaniam I

Iran J Public Health, 2011;40(1):72-9.
PMID: 23113058

BACKGROUND: With computers rapidly carving a niche in virtually every nook and crevice of today's fast-paced society, musculoskeletal disorders are becoming more prevalent among computer users, which comprise a wide spectrum of the Malaysian population, including office workers. While extant literature depicts extensive research on musculoskeletal disorders in general, the five dimensions of psychosocial work factors (job demands, job contentment, job control, computer-related problems and social interaction) attributed to work-related musculoskeletal disorders have been neglected. This study examines the aforementioned elements in detail, pertaining to their relationship with musculoskeletal disorders, focusing in particular, on 120 office workers at Malaysian public sector organizations, whose jobs require intensive computer usage.
METHODS: Research was conducted between March and July 2009 in public service organizations in Malaysia. This study was conducted via a survey utilizing self-complete questionnaires and diary. The relationship between psychosocial work factors and musculoskeletal discomfort was ascertained through regression analyses, which revealed that some factors were more important than others were.
RESULTS: The results indicate a significant relationship among psychosocial work factors and musculoskeletal discomfort among computer users. Several of these factors such as job control, computer-related problem and social interaction of psychosocial work factors are found to be more important than others in musculoskeletal discomfort.
CONCLUSION: With computer usage on the rise among users, the prevalence of musculoskeletal discomfort could lead to unnecessary disabilities, hence, the vital need for greater attention to be given on this aspect in the work place, to alleviate to some extent, potential problems in future.
The relationship between psychosocial work factors, work stress and computer-related musculoskeletal discomforts among computer users in Malaysia

Zakerian SA, Subramaniam ID

Int J Occup Saf Ergon, 2009;15(4):425-34.
PMID: 20003776

Increasing numbers of workers use computer for work. So, especially among office workers, there is a high risk of musculoskeletal discomforts. This study examined the associations among 3 factors, psychosocial work factors, work stress and musculoskeletal discomforts. These associations were examined via a questionnaire survey on 30 office workers (at a university in Malaysia), whose jobs required an extensive use of computers. The questionnaire was distributed and collected daily for 20 days. While the results indicated a significant relationship among psychosocial work factors, work stress and musculoskeletal discomfort, 3 psychosocial work factors were found to be more important than others in both work stress and musculoskeletal discomfort: job demands, negative social interaction and computer-related problems. To further develop study design, it is necessary to investigate industrial and other workers who have experienced musculoskeletal discomforts and work stress.
Fulltext Cognitive stress changes the attributes of the three heads of the triceps brachii during muscle fatigue

Hussain J, Sundaraj K, Subramaniam ID

PLoS One, 2020;15(1):e0228089.
PMID: 31999750 DOI: 10.1371/journal.pone.0228089

INTRODUCTION: Cognitive stress (CS) changes the peripheral attributes of a muscle, but its effect on multi-head muscles has not been investigated. The objective of the current research was to investigate the impact of CS on the three heads of the triceps brachii (TB) muscle.
METHODS: Twenty-five young and healthy university students performed a triceps push-down exercise at 45% one repetition maximum (1RM) with and without CS until task failure, and the rate of fatigue (ROF), endurance time (ET) and number of repetitions (NR) for both exercises were analyzed. In addition, the first and last six repetitions of each exercise were considered non-fatiguing (NF) and fatiguing (Fa), respectively, and the root mean square (RMS), mean power frequency (MPF) and median frequency (MDF) for each exercise repetition were evaluated.
RESULTS: The lateral and long head showed significant differences (P<0.05) in the ROF between the two exercises, and all the heads showed significant (P<0.05) differences in the RMS between the two exercises under NF conditions. Only the long head showed a significant difference (P<0.05) in the MPF and MDF between the two exercises. CS increases the ET (24.74%) and NR (27%) of the exercise. The three heads showed significant differences (P<0.05) in the RMS, MPF and MDF under all exercise conditions.
CONCLUSION: A lower ROF was obtained with CS. In addition, the RMS was found to be better approximator of CS, whereas MPF and MDF were more resistant to the effect of CS. The results showed that the three heads worked independently under all conditions, and the non-synergist and synergist head pairs showed similar behavior under Fa conditions. The findings from this study provide additional insights regarding the functioning of each TB head.
Fulltext Assessment of muscle activity using electrical stimulation and mechanomyography: a systematic review

Uwamahoro R, Sundaraj K, Subramaniam ID

Biomed Eng Online, 2021 Jan 03;20(1):1.
PMID: 33390158 DOI: 10.1186/s12938-020-00840-w

This research has proved that mechanomyographic (MMG) signals can be used for evaluating muscle performance. Stimulation of the lost physiological functions of a muscle using an electrical signal has been determined crucial in clinical and experimental settings in which voluntary contraction fails in stimulating specific muscles. Previous studies have already indicated that characterizing contractile properties of muscles using MMG through neuromuscular electrical stimulation (NMES) showed excellent reliability. Thus, this review highlights the use of MMG signals on evaluating skeletal muscles under electrical stimulation. In total, 336 original articles were identified from the Scopus and SpringerLink electronic databases using search keywords for studies published between 2000 and 2020, and their eligibility for inclusion in this review has been screened using various inclusion criteria. After screening, 62 studies remained for analysis, with two additional articles from the bibliography, were categorized into the following: (1) fatigue, (2) torque, (3) force, (4) stiffness, (5) electrode development, (6) reliability of MMG and NMES approaches, and (7) validation of these techniques in clinical monitoring. This review has found that MMG through NMES provides feature factors for muscle activity assessment, highlighting standardized electromyostimulation and MMG parameters from different experimental protocols. Despite the evidence of mathematical computations in quantifying MMG along with NMES, the requirement of the processing speed, and fluctuation of MMG signals influence the technique to be prone to errors. Interestingly, although this review does not focus on machine learning, there are only few studies that have adopted it as an alternative to statistical analysis in the assessment of muscle fatigue, torque, and force. The results confirm the need for further investigation on the use of sophisticated computations of features of MMG signals from electrically stimulated muscles in muscle function assessment and assistive technology such as prosthetics control.
Analysis of fatigue in the three heads of the triceps brachii during isometric contractions at various effort levels

Hussain J, Sundaraj K, Subramaniam ID, Lam CK

J Musculoskelet Neuronal Interact, 2019 09 01;19(3):276-285.
PMID: 31475934

OBJECTIVE: The objective of this study was to investigate fatigue in the three heads of the triceps brachii (TB) muscle using surface electromyography (sEMG) obtained at 30%, 45% and 60% of maximal voluntary contraction (MVC).
METHODS: Twenty-five subjects performed isometric elbow extension until failure, and the rate of fatigue (ROF), time to fatigue (TTF) and normalized TTF (NTTF) were statistically analysed. Subsequently, the behaviour of root-mean-square (RMS), mean-power frequency (MPF) and median-power frequency (MDF) under pre-, onset- and post-fatigue conditions were compared.
RESULTS: The findings indicated that, among the heads, ROF was statistically significant at 30% and 45% MVC (P<0.05) but TTF and NTTF at all intensities was statistically insignificant (P>0.05). For every head, only TTF was statistically significant (P<0.05) at different intensities. MPF and MDF under pre-, onset- and post-fatigue conditions were statistically significant (P<0.05) among the heads at all intensities, whereas RMS showed no such behaviour.
CONCLUSION: The investigated parameters reveal that the three heads of TB act independently before fatigue onset and appear to work in union after fatigue. Synergist head pairs exhibit similar spectral and temporal behaviour in contrast to the non-synergist TB head pair. We find spectral parameters to be more specific predictors of fatigue.
Fulltext Muscle Fatigue in the Three Heads of Triceps Brachii During Intensity and Speed Variations of Triceps Push-Down Exercise

Hussain J, Sundaraj K, Subramaniam ID, Lam CK

Front Physiol, 2020;11:112.
PMID: 32153422 DOI: 10.3389/fphys.2020.00112

The objective of this study was to investigate the effects of changes in exercise intensity and speed on the three heads of the triceps brachii (TB) during triceps push-down exercise until task failure. Twenty-five subjects performed triceps push-down exercise at three different intensities (30, 45, and 60% 1RM) and speeds (slow, medium, and fast) until failure, and surface electromyography (sEMG) signals were recorded from the lateral, long and medial heads of the TB. The endurance time (ET), number of repetitions (NR) and rate of fatigue (ROF) were analyzed. Subsequently, the root-mean-square (RMS), mean power frequency (MPF) and median frequency (MDF) under no-fatigue (NF) and fatigue (Fa) conditions were statistically compared. The findings reveal that ROF increases with increase in the intensity and speed, and the opposite were obtained for the ET. The ROF in the three heads were comparable for all intensities and speeds. The ROF showed a significant difference (P < 0.05) among the three intensities and speeds for all heads. The three heads showed significantly different (P < 0.05) MPF and MDF values for all the performed exercises under both conditions, whereas the RMS values were significantly different only under Fa conditions. The current observations suggest that exercise intensity and speed affect the ROF while changes in intensity do not affect the MPF and MDF under Fa conditions. The behavior of the spectral parameters indicate that the three heads do not work in unison under any of the conditions. Changes in the speed of triceps push-down exercise affects the lateral and long heads, but changes in the exercise intensity affected the attributes of all heads to a greater extent.