1.Proximal Tibia Bone Graft: An alternative Donor Source especially for Foot and Ankle Procedures
Jia TY ; Gurmeet S ; Asni A ; Ramanathan R
Malaysian Orthopaedic Journal 2015;9(1):14-17
Bone graft is essential in various orthopaedic procedures.
Among the many donor sites for harvesting autologous
bone graft, the iliac crest has been the most commonly used.
However, for foot and ankle procedures the proximal tibia
has gained popularity as an alternative donor site due to its
anatomic proximity to the primary surgical site. In this article
we evaluated the possible complications associated with
harvesting proximal tibia bone graft. Our study showed the
low incidence of morbidity in harvesting proximal tibia bone
graft, thereby providing a good alternative donor for foot
and ankle procedures.
Bone Transplantation
3.Extracranial Carotid Aneurysm Secondary to Takayasu Arteritis (TA): A Rare Complication
Irfan Mohamad ; Ikhwan Sani Mohamad ; Prahalad Ramanathan ; Win Mar@Salmah3
Malaysian Journal of Medicine and Health Sciences 2015;11(2):89-92
Extracranial aneurysms are a rare presentation accounting for only less than 5% of all peripheral artery
aneurysms. The left common carotid artery aneurysm is considered even rarer. We present a case of a
46-year-old gentleman who presented to casualty unit with a neck mass, stridor and acute respiratory
distress. Prior to this admission patient was being investigated for Takayasu arteritis (TA). Patient
was subsequently intubated due to respiratory compromise. A CT angiography of the thorax was done
showed a proximal left common carotid artery aneurysm with contained leakage of aneurysm with
severe compression of the trachea. Patient was subsequently transferred to the vascular team in National
Heart Institute for further management.
Aneurysm
4.Multiple Atraumatic Osteoporotic Vertebral Fractures in an Adolescent with Suprasellar Germinoma: A Case Report
CC Wong ; HF Phang ; ML Cheong ; Ramanathan Ramiah
Malaysian Orthopaedic Journal 2012;6(2):54-56
We present the case of a patient with multiple atraumatic
osteoporotic vertebral fractures in an adolescent with
suprasellar germinoma and also review of relevant literature. The patient suffered from a rare adolescent brain tumour with common complications which are often overlooked and give rise to significant morbidity. Suprasellar germinoma is an intracranial neoplasm, that in addition to its rarity, has variable clinical presentation. Despite appropriate treatment
and good outcome, tumour related morbidity is still of
concern for these patients.
5.A Case of Osteosarcoma Of The Maxilla-Challenges In Diagnosis And Management
N.I.H. Abdul Rahim ; N.A. Ngah ; A. Ramanathan ; T.George ; S.M. Ismail
Annals of Dentistry 2011;18(1):24-29
Osteosarcoma is a primary malignant neoplasm of the
bone. Osteosarcoma of the jaws especially those of
maxilla is rare. The diagnosis of osteosarcomas is
diff icult and challenging. In this case report we
highlight a rare case of osteosarcoma of the maxilla
in a 29 year old male patient which was highly
aggressive and was initially diagnosed as
rhabdomyosarcoma. This case highlights the difficulty
in diagnosing osteosarcoma merely from incisional
biopsy specimens which may not be representative of
the whole tumour. Limited clinical information at
incisional biopsy also adds to the difficulty in arriving
at the definitive diagnosis. We further discuss the
treatment modalities followed in this case.
6.Psychoses of Epilepsy in Pregnancy: A Case Report
Mario FAHED ; Seethalakshmi RAMANATHAN
Clinical Psychopharmacology and Neuroscience 2021;19(2):388-390
To discuss the unique relationship between psychosis and seizures in a young individual, who is also pregnant. Psychosis of epilepsy can present in multitude of ways, including pre-ictal, ictal, post-ictal, chronic interictal, and forced normalization psychosis.
7.Psychoses of Epilepsy in Pregnancy: A Case Report
Mario FAHED ; Seethalakshmi RAMANATHAN
Clinical Psychopharmacology and Neuroscience 2021;19(2):388-390
To discuss the unique relationship between psychosis and seizures in a young individual, who is also pregnant. Psychosis of epilepsy can present in multitude of ways, including pre-ictal, ictal, post-ictal, chronic interictal, and forced normalization psychosis.
8.Attitudes, barriers and facilitators to the conduct of research in government hospitals: a cross-sectional study among specialists in government hospitals, northern states of Malaysia
Teh Lei Choo ; Prema Muninathan ; Choy Mun Pung ; G.R. Letchuman Ramanathan
The Medical Journal of Malaysia 2017;72(1):26-31
Introduction: Specialists constitute a major ‘driving force’
and catalyst for growth of research in their speciality. A
clearer understanding is required as to what motivates their
participation in research as well as the barriers they faced.
This research aims to study the attitudes, barriers and
facilitators faced by specialists and to identify strategies to
promote and sustain research activities in their hospitals.
Methodology: A cross-sectional survey using selfadministered
questionnaires was conducted among all
specialists working in government specialist hospitals in the
northern states of Malaysia.
Results: Out of 733 questionnaires distributed, 467 were
returned giving a response rate of 63.7%. Ninety-nine
percent of the respondents believed that research benefits
patients while 93.3% think research helps in their
professional development. However, 34.8% think that under
their present working conditions, it is unlikely they will
participate in research. The major barriers identified were
lack of funds for research (81%); lack access to expertise,
software or statistical analysis (78.4%); interference with
daily work schedule (75.1%) and inconsistent manpower in
their department (74.2%). There are three barriers with
statistically significant difference between hospitals with
CRC compared to hospitals without CRC; lack of funds,
mentors and access to expertise, software or statistical
analysis. The demographic factors, attitudes and barriers
contributing to involvement in research also investigated.
The main facilitators for the conduct of research are
potential to benefit patients and potential for professional
development.
Conclusion: Taking note of the findings, the Ministry of
Health can implement appropriate strategies to improve
specialist participation in research.
Specialization
;
Attitude
9.P53/MDM2 co-expression correlates with the tumour differentiation in oral squamous cell carcinoma – A retrospective study and a systematic review.
Y.F. Choon ; A. Ramanathan ; H. Ali ; W.M.N. Ghani ; S.C. Cheong ; R.B. Zain
Annals of Dentistry 2011;18(1):8-17
Background: MDM2 and p53 are involved in a
negative feedback loop where p53 regulates MDM2 at
the transcriptional level. MDM2, in turn, downregulates
p53. This co-ordinated interaction between
these proteins is set to play an important role in the
regulation of cell cycle progression following DNA
damage to cells. The over-expression of both p53 and
MDM2 has been reported in various cancers. However
there are only few studies discussing the co-expression
of MDM2 with p53 in oral squamous cell carcinoma
Aim: The purpose of this study was to determine
the correlation of co-expression of p53, MDM2, and
Ki-67 proteins with clinico-pathological factors in oral
squamous cell carcinoma (OSCC) and to conduct a
systematic review of the co-expression of p53/MDM2.
Method: This is a retrospective descriptive study
and a systematic review. Formalin-fixed paraff inembedded
tissues from 45 OSCC cases were stained
by immunohistochemistry (IHC) for p53, MDM2, and
Ki-67 proteins.
Results: Immuno-reactivity for p53, MDM2, and
Ki-67 was seen in 75.6%, 97.8%, and 62.2% cases of
OSCC respectively. The co-expression of p53 and
MDM2 (p53/MDM2) was detected in 97.1%, however
there was no signif icant correlation between p53
and MDM2 expression. Notably, p53/MDM2 coexpression
was significantly associated with tumour
differentiation (p-value = 0.045). The Ki-67LI was not
signif icantly associated with neither MDM2 nor
p53/MDM2 co-expression (p-value = 0.268, 0.916
respectively).
Conclusion: The expression of MDM2 was not
signif icantly associated with p53 expression
suggesting that MDM2 expression is mediated by
p53-independent pathways or mutated p53 could not
induce the expression of MDM2 in this set of OSCCs.
The only clinico-pathological parameter that correlates
significantly with co-expression of p53/MDM2 is
tumour differentiation where it is suggestive that the
co-expression of these 2 proteins is indicative of
aggressive tumour behavior.