MyMedR

Fulltext Factitious disorder: a case study of fictitious illness

Subramaniam M

Med J Malaysia, 1987 Jun;42(2):129-31.

A case of fictitious illness in a young Malaysian Indian male is reported and its relation to the more usual presentation of factitious disorders is discussed. Pathogenesis of this condition and its management are also suggested. Factitious disorders present not uncommonly in this country and it is important for the general duty medical officer and primary care physician to be familiar with this condition.

The Gilles de la Tourette syndrome

Subramaniam M

Med J Malaya, 1966 Sep;21(1):95-6.

PMID: 4224886

Migration and schizophrenia--a review and case report

Subramaniam M

Med J Malaysia, 1964 Dec;19:134-9.

PMID: 14279236

Pharmacotherapy in psychotic disorders

SUBRAMANIAM M

Med J Malaya, 1962 Sep;17:25-36.

PMID: 13979040

Failure of clonidine in tardive dystonia: implications for nosology

Adityanjee, Singh S, Subramaniam M

Biol Psychiatry, 1989 Jun;26(2):199-202.

PMID: 2567611

Behaviour therapy

Subramaniam M, Asirdas S

Med J Malaya, 1965 Sep;20(1):39-41.

PMID: 4221410

Fulltext Large lipoma of the spermatic cord presenting as post-operative recurrent hernia in a middle aged gentleman: a case report

Vashu R, Subramaniam M

Cases J, 2009;2:8500.

PMID: 19918377 DOI: 10.4076/1757-1626-2-8500

A gentleman who presented with a left inguinal hernia was operated and treated by hernioplasty. After a few years he presented with a clinical scenario of recurrent hernia. During surgery the lump was found to be a large lipoma that was not documented and found during the first operation.

Psychiatric morbidity and HIV in female drug dependants in Malaysia

Varma S, Wai B, Singh S, Subramaniam M

Eur. Psychiatry, 1998 Dec;13(8):431-3.

PMID: 19698662 DOI: 10.1016/S0924-9338(99)80693-2

Female drug dependants (n = 171) and controls (n = 1137) were studied to search for psychiatric morbidity in them. The psychiatric morbidity was found to be 36.3% and 6.9%, respectively. The most common psychiatric disorder found was dysthymic disorder followed by adjustment disorder, anxiety disorder and borderline personality disorder. The diagnosis was significantly dependent on the type of drug used (P < 0.001) and HIV seropositivtty status of the patients (P = 0.04). The findings highlight the relationship of the psychiatric morbidity to the HIV status and female drug users.

Sporadic koro and marital dysharmony

Adityanjee, Zain AM, Subramaniam M

Psychopathology, 1991;24(1):49-52.

PMID: 2023985 DOI: 10.1159/000284697

A case of Koro is described in a Malaysian Chinese man in the setting of martial dysharmony and sexual rejection. A distinction is suggested between the epidemic form of Koro and the Koro symptom occurring sporadically. Existence of the sporadic Koro syndrome is discussed and a unified classificatory system is proposed.

Association between household food access insecurity and nutritional status indicators among children aged <5 years in Nepal: results from a national, cross-sectional household survey

Sreeramareddy CT, Ramakrishnareddy N, Subramaniam M

Public Health Nutr, 2015 Nov;18(16):2906-14.

PMID: 25435296 DOI: 10.1017/S1368980014002729

OBJECTIVE: To examine the association between household food insecurity score and Z-scores of childhood nutritional status indicators.

DESIGN: Population-based, cross-sectional survey, Nepal Demographic and Health Survey 2011.

SETTING: A nationally representative sample of 11 085 households selected by a two-stage, stratified cluster sampling design to interview eligible men and women.

SUBJECTS: Children (n 2591) aged 0-60 months in a sub-sample of households selected for men's interview.

RESULTS: Prevalence of moderate and severe household food insecurity was 23·2% and 19·0%, respectively, for children aged 0-60 months. Weighted prevalence rates for stunting (height-for-age Z-score (HAZ)

Religious--sociocultural psychotherapy in patients with anxiety and depression

Razali SM, Hasanah CI, Aminah K, Subramaniam M

Aust N Z J Psychiatry, 1998 Dec;32(6):867-72.

PMID: 10084352

To show the effectiveness of incorporating religious-sociocultural components in the management of patients with generalised anxiety disorders and major depression who have strong religious and cultural backgrounds as compared with a normal psychotherapeutic approach.

Eating disorders in Hong Kong

Goh SE, Ong SB, Subramaniam M

Br J Psychiatry, 1993 Feb;162:276-7.

PMID: 8435714

Temporary remission of tardive dystonia following electroconvulsive therapy

Adityanjee, Jayaswal SK, Chan TM, Subramaniam M

Br J Psychiatry, 1990 Mar;156:433-5.

PMID: 2346849

An improvement in tardive dystonia in a patient who had received ECT for a schizophrenic psychosis is reported. The improvement suggests that the pathophysiology of tardive dystonia may involve neurotransmitter receptor changes similar to those seen in schizophrenia.

Fulltext Use of aerosol protective barrier in a patient with impending cholangitis and unknown COVID-19 status undergoing emergency ERCP during COVID-19 pandemic

Leow VM, Mohamad IS, Subramaniam M

BMJ Case Rep, 2020 Jul 16;13(7).

PMID: 32675132 DOI: 10.1136/bcr-2020-236918

WHO declared worldwide outbreak of COVID-19 a pandemic on 11 March 2020. Healthcare authorities have temporarily stopped all elective surgical and endoscopy procedures. Nevertheless, there is a subset of patients who require emergency treatment such as aerosol-generating procedures. Herein, we would like to discuss the management of a patient diagnosed with impending biliary sepsis during COVID-19 outbreak. The highlight of the discussion is mainly concerning the advantages of concurrent use of aerosol protective barrier in addition to personal protective equipment practice, necessary precautions to be taken during endoscopy retrograde cholangiopancreatography and handling of the patient preprocedure and postprocedure.

Smoking and nicotine dependence in Singapore: findings from a cross-sectional epidemiological study

Picco L, Subramaniam M, Abdin E, Vaingankar JA, Chong SA

Ann Acad Med Singap, 2012 Aug;41(8):325-34.

PMID: 23010809

INTRODUCTION: Smoking is one of the leading preventable causes of death throughout the world and can lead to nicotine dependence, particularly when initiated at a young age. This paper describes the prevalence of smoking and nicotine dependence in the adult Singapore resident population, whilst also exploring rates among the major ethnic groups (Chinese, Malay and Indian), different education levels and those with chronic psychiatric and physical comorbidities.

MATERIAL AND METHODS: The Singapore Mental Health Study (SMHS) is a cross-sectional epidemiological study that was conducted between December 2009 and December 2010. Information on smoking status was assessed using the Composite International Diagnostic Interview version 3.0 (CIDI 3.0) and the Fagerstrom Test for Nicotine Dependence measured nicotine dependence. Socio-demographic information was also collected.

RESULTS: In total, 6616 respondents participated in the SMHS giving a response rate of 75.9%. We found that 16% of the population were current smokers and 4.5% had nicotine dependence. Current smokers were more likely to be younger (18 to 34 years old), males, Malay and have lower education, whilst males had a 4.6 times higher risk of nicotine dependence to that of females. The prevalence of nicotine dependence was also higher in those with alcohol abuse and those experiencing chronic pain.

CONCLUSION: The results from this study highlight the important differences in the prevalence of smoking and nicotine dependence among different age groups, gender and ethnicity in Singapore and are important for developing future health policies and targeted preventive strategies.

The prevalence and impact of major depressive disorder among Chinese, Malays and Indians in an Asian multi-racial population

Chong SA, Vaingankar J, Abdin E, Subramaniam M

J Affect Disord, 2012 Apr;138(1-2):128-36.

PMID: 22209269 DOI: 10.1016/j.jad.2011.11.038

Reports of rates of depression among different Asian ethnic groups within the same country using standardized assessments are rare in the extant literature.

Aggression in Asian patients with first-episode psychosis

Verma S, Poon LY, Subramaniam M, Chong SA

Int J Soc Psychiatry, 2005 Dec;51(4):365-71.

PMID: 16400911

The aims of this study were to examine the prevalence and severity of aggression in patients with first-episode psychosis and to identify the association between aggression and sociodemographic and clinical factors.

Fulltext Massive upper gastrointestinal bleeding: a rare complication of cholecystoduodenal fistula

Vadioaloo DK, Loo GH, Leow VM, Subramaniam M

BMJ Case Rep, 2019 May 10;12(5).

PMID: 31079042 DOI: 10.1136/bcr-2018-228654

A biliary fistula which may occur spontaneously or after surgery, is an abnormal communication from the biliary system to an organ, cavity or free surface. Spontaneous biliary-enteric fistula is a rare complication of gallbladder pathology, with over 90% of them secondary to cholelithiasis. Approximately 6% are due to perforating peptic ulcers. Symptoms of biliary-enteric fistula varies widely and usually non-specific, mimicking any chronic biliary disease. Cholecystoduodenal fistula causing severe upper gastrointestinal (UGI) bleed is very rare. Bleeding cholecystoduodenal fistula commonly requires surgical resection of the fistula and repair of the duodenal perforation. We describe the case of a previously healthy older patient who initially presented with symptoms suggestive of UGI bleeding. Bleeding could not be controlled endoscopically. When a laparotomy was performed, a cholecystoduodenal fistula was discovered and bleeding was noted to originate from the superficial branch of cystic artery.

First-episode psychosis and vocational outcomes: A predictive model

Chua YC, Abdin E, Tang C, Subramaniam M, Verma S

Schizophr Res, 2019 09;211:63-68.

PMID: 31327504 DOI: 10.1016/j.schres.2019.07.009

Most studies on predictors of vocational outcomes are cross-sectional and results are varied. This study aimed to examine the vocational rates of patients with first-episode psychosis (FEP), identify factors predicting a lack of engagement in age-appropriate roles, and evaluate the predictive ability of a model with baseline sociodemographic information and 2-year symptom and functioning trajectories on vocational outcomes. The Singapore Early Psychosis Intervention Program (EPIP) has maintained a standing database on patient clinico-demographic information. The primary outcome, vocational status, was operationalized as "meaningfully employed", that is, being gainfully employed or engaged in an age-appropriate role, and "unemployed". Using logistic regression, the predictive ability of the proposed model was evaluated. Vocational data was available for 1177 patients accepted into EPIP between 2001 and 2012. At the end of two years in the service, 829 (70.4%) patients were meaningfully employed and 348 (29.6%) patients were unemployed. The binary logistic regression model on the prediction of 2-year vocational outcomes yielded an AUC of 0.759 (SE = 0.016, p-value 

Temporal gene expression profiling of maslinic acid-treated Raji cells

Lau WM, Subramaniam M, Goh HH, Lim YM

Mol Omics, 2021 04 19;17(2):252-259.

PMID: 33346776 DOI: 10.1039/d0mo00168f

Maslinic acid is a novel phytochemical reported to target multiple signaling pathways. A complete gene expression profile was therefore constructed to illustrate the anti-tumourigenesis effects of maslinic acid in Raji cells across five time-points. Microarray analysis was used to identify genes that were differentially expressed in maslinic acid treated Raji cells at 0, 4, 8, 12, 24 and 48 h. Extracted RNA was hybridized using the AffymetrixGeneChip to obtain expression profiles. A total of 109 genes were found to be significantly expressed over a period of 48 hours. By 12 hours, maslinic acid regulates the majority of genes involved in the cell cycle, p53 and NF-κB signaling pathways. At the same time, XAF1, APAF1, SESN3, and TP53BP2 were evidently up-regulated, while oncogenes, FAIM, CD27, and RRM2B, were down-regulated by at least 2-fold. In conclusion, maslinic acid shows an hourly progression of gene expression in Raji cells.

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