1.Assessment of dental age estimation using dentinal translucency in ground sections of single rooted teeth: a digital image analysis
Abelene Maria DURAND ; Madhu NARAYAN ; Raghavendhar KARTHIK ; Rajkumar KRISHNAN ; Narasimhan SRINIVASAN ; Dinesh KUMAR
Anatomy & Cell Biology 2024;57(2):271-277
Human dentition is unique to individuals and helps in identification of individuals in forensic odontology. This study proposes to study the manually ground sections of single rooted teeth using digital methods for dental age estimation.To assess the dentinal translucency from the scanned digital images of manually ground section of teeth using commercially available image edition software. Corroborating the root dentinal translucency length and region of interest (ROI) of translucency zone in pixels (as a marker of dental age) with the chronological age of the subject, as stratified by different age groups. Twenty single-rooted extracted teeth from 20 patients each from 6 groups divided as per age. Manual sectioning of the teeth followed by scanning the sections was done. Root area in pixels and ROI of translucency zone were measured.From the observed values, translucency length percentage (TLP) and percentage of ROI in pixels (TPP) was calculated and tabulated. Pearson’s correlation coefficients were obtained for age with TLP and TPP. Positive correlation existed between age and TLP and also between age and TPP. With the obtained data, multilinear regression equations for specific age groups based on 10-year intervals were derived. By a step-down analysis method, age was estimated with an average error of around ±7.9 years. This study gives a novel method for age-estimation that can be applied in real-time forensic sciences.
2.Morphometric evaluation of great vein of Galen and its clinical implications
Grace Suganya. S ; Ariharan. K ; Raveendranath VEERAMANI ; Dinesh Kumar. V ; Nagarajan KRISHNAN
Anatomy & Cell Biology 2023;56(1):32-38
The Galenic venous system plays a vital role in the drainage of blood from deeper parts of the brain. This venous system is contributed by many major veins. These veins are located closer to the pineal gland making the surgical approach in this region difficult. Any accidental injury or occlusion of the vein of Galen could lead to devasting results. Thus, studying the dimensions of the vein of Galen is more important. Hence, we aimed to evaluate the morphometry and trajectory to the vein of Galen. About 100 computed tomographic venography records were evaluated and the length, diameter of vein of Galen, angle between straight sinus and vein of Galen and distance from internal occipital protuberance and roof of fourth ventricle to vein of Galen were studied. The mean length and diameter of vein of Galen were 9.8±2.7 and 4.08±1.04 respectively. The mean angle between straight sinus and vein of Galen was 64.2°. The mean distance between external occipital protuberance and roof of fourth ventricle to vein of Galen were 52±6.9 and 33.3±4.5 respectively. No significant morphometric differences were observed between the age groups as well as between the sexs. The results obtained from this study may be helpful for the neurosurgeons in better understanding of the anatomy of the Galenic venous system and to adopt a safe surgical approach to improve the efficacy of the surgeries of the pineal gland and also in the region of vein of Galen.
3.The Awareness, Practice and Perception of InstrumentAssisted Soft Tissue Mobilization (IASTM) among Malaysian Physiotherapists
Mah Saw Jo ; Vinosh Kumar Purushothaman ; Ambusam Subramaniam ; Rajkumar Krishnan Vasanthi
Malaysian Journal of Medicine and Health Sciences 2023;19(No.1):135-139
Introduction: Instrument-assisted soft tissue mobilization (IASTM) is a relatively recent method that has been shown
to help reduce muscular tension, increase flexibility and prevent tissue adhesion. Nevertheless, there is a paucity of
awareness and knowledge about the benefits of IASTM, especially following injury rehabilitation, despite its many
advantages. The study aimed to investigate the awareness, practice and perception of instrument- assisted soft tissue
mobilization (IASTM) among Malaysian physiotherapists (PTs). Methods: The cross-sectional study included 133 PTs
who answered an online questionnaire via a google link on their awareness and perception of IASTM in their practice. The Google link was given to the participants through email and the official Malaysian Physiotherapy (MPA) social media group. Results: Majority of the respondents (73.7%) are aware of IASTM technique. Despite being aware
on IASTM, 74.4% of respondents reported not practicing the technique. Furthermore, 73.7% of respondents stated
that the main reason they don’t practice is because fingers have better force adjustment than IASTM. Over 80% of
respondents revealed that practicing IASTM can save energy and convenient during myofascial release. Moreover,
82.7 % of respondents stated that one of the benefits of IASTM for PTs is that it helps alleviate stress on fingers and
wrists during soft tissue mobilization. Beyond 55% of respondents stated that they will incorporate IASTM in practice
in near future. Conclusion: According to the findings, the majority of Malaysian physiotherapists are aware of the
IASTM. However, fewer than half of respondents declined to incorporate it into their future practice due to the PTs
preference for feeling the patient’s muscle texture. More emphasis can be given to the IASTM techniques among the
PTs as the participants have mentioned that IASTM has better force exertion and saves energy when applying soft
tissue massage.
4.Limb Salvage Surgery in a Rare Case of Recurrent Parosteal Osteosarcoma with Vascular Graft Thrombosis
Gaurav Ravi KUMAR ; Chandra Kumar KRISHNAN ; Krishna MURALIDHARAN ; Shirley SUNDERSINGH ; Karthigaiselvi MURUGESAN ; Anand RAJA
Vascular Specialist International 2023;39(4):33-
Recurrent parosteal sarcomas with vascular involvement are rare and present unique challenges in their diagnosis and management. We report the case of a 21-year-old woman with parosteal osteosarcoma of the left distal femur, encasing the popliteal vessels. En bloc transarticular resection of the distal femur and popliteal vessels was performed, followed by reconstruction using a modular prosthesis and a saphenous vein autograft for both the artery and vein. On the 1st postoperative day, the patient developed an arterial thrombus requiring reintervention with a jump polytetrafluoroethylene (PTFE) graft. Histopathology confirmed parosteal osteosarcoma.After a disease-free survival of 41 months, the patient experienced local recurrence involving the PTFE graft, leading to graft compression, erosion, and subsequent thrombosis. Despite these complications, limb salvage was possible due to adequate collateral blood supply. This case highlights the feasibility of limb salvage surgery in select cases of parosteal osteosarcoma with vascular involvement.
7.Do Medical Students Know, Bother About, And Practise Preventive Measures In Malaysia?
Md Mizanur Rahman ; Mohaamad Shaah ; Yuggesh Kumar ; Sumeetha Marimuthu ; Mithrra Sundaram ; Shaundari Muniandy ; Mahanagaraani Yogeswaran ; Shamilaa Bala Krishnan Muthiah
Malaysian Journal of Public Health Medicine 2020;20(2):197-206
Since December 2019, a novel coronavirus disease (COVID-19) creates a global threat. Medical students are more susceptible to be infected by the virus. This study aimed to assess COVID-19 related knowledge, attitude towards COVID-19, and preventive behaviours against COVID-19 among medical students within the first month of the onset of the outbreak in Malaysia. We collect data from medical students using an online Google survey form. Out of 696 students, 467 responded to the questionnaire. The analysis revealed that the mean percentage of knowledge was (85.04), attitude (84.12), and preventive practice (77.75) respectively. Hierarchical multiple linear regression analysis revealed that living with family (p<0.01) and knowledge of COVID-19 (p<0.001) appeared to be important predictors of attitude toward COVID-19. However, gender (p<0.001), living status (p<0.001), frequency of travel during movement control order (p<0.01), attitude towards COVID-19 (p<0.001) have appeared significant predictors for preventive practice against COVID-19. But knowledge of COVID-19 had no impact on preventive practice against COVID-19 (p>0.05). We found a high level of COVID-19 related knowledge, attitude, and preventive practice against COVID-19 among medical students. A sustained knowledge, attitude, and preventive behavioural strategy could play an ingredient in upholding the student’s learning and practice against any disease like COVID-19.
8.Identification of Pedicle Screw Pullout Load Paths for Osteoporotic Vertebrae
Venkatesh KRISHNAN ; Vicky VARGHESE ; Gurunathan Saravana KUMAR ; Narayan YOGANANDAN
Asian Spine Journal 2020;14(3):273-279
Results:
Pullout strength decreased by 36% when the size of the revision screw was increased by 1 mm, while it increased by 35% when the size of the revision screw was increased by 2 mm compared to the index screw value. While the morphologies of the load paths were similar in all cases, they differ between the two groups: the larger screw responded with generally elevated stiffer path than the smaller screw, suggesting that revision surgery using a larger screw has more purchase along the inserted body-pedicle axis.
Conclusions
A larger screw enhances strength and increases biomechanical stability in revision surgeries, although the final surgical decision is made by the clinician, which includes the patient’s anatomy and associated characteristics.
9.Efficacy of Nasobiliary Tubes and Biliary Stents in Management of Patients with Bile Leak after Liver Transplantation: A Systematic Review
Ali RAZA ; Anam OMER ; Sara IQBAL ; Vineet GUDSOORKAR ; Pramoda KODURU ; Kumar KRISHNAN
Clinical Endoscopy 2019;52(2):159-167
BACKGROUND/AIMS: Bile leak is one of the most common complications of liver transplantation. The treatment options for bile leaks include conservative management, surgical re-intervention, percutaneous drainage and endoscopic drainage. We aimed to perform a systematic review to identify the efficacy of endoscopic treatment in the resolution of post-transplant bile leaks. METHODS: Two independent reviewers performed systematic literature search in PubMed, ISI Web of Science, grey literature and relevant references in May 2017. Human studies in English with documented post-liver transplant bile leaks were included. RESULTS: Thirty-four studies were included in the final analysis. The pooled efficacy of biliary stents for the resolution of post-transplant bile leaks was 82.43% compared with 87.15% efficacy of nasobiliary tubes. The efficacy of biliary stents was lower for anastomotic leaks (69.23%) compared to T-tube (90.9%) or cut-surface/ cystic duct stump related leaks (92.8%). Similarly, the efficacy of nasobiliary tube was also lower for anastomotic leaks (58.33%) compared to T-tube or cut-surface related leaks (100%). CONCLUSIONS: In this systematic review, the overall efficacy was 82.43% in biliary stent group, and 87.15% in nasobiliary tube group. Both biliary stent and nasobiliary tube were more effective in managing non-anastomotic leaks compared to anastomotic leaks.
Anastomotic Leak
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Bile
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Biliary Fistula
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Cystic Duct
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Drainage
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Humans
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Liver Transplantation
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Liver
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Stents
10.Extraction and characterisation of proteins from a Malaysian Isolate of Magnaporthe grisea
Hari Kumar Krishnan ; Kalaivani Nadarajah ; Ilakiya Sharanee Kumar ; Vaanee Sangappilai
Malaysian Journal of Microbiology 2018;14(6):519-533
Aims:
Rice blast, a disease caused by the fungus Magnaporthe grisea is one of the serious diseases of rice in the world. The main objective of this study is to isolate and characterise the proteins extracted from the rice blast fungus, M. grisea 7.6.
Methodology and results:
Through comparative 2-D analyses of the crude protein extracts obtained from this fungus, we were able to identify 88 protein spots through MALDI-TOF. These proteins were then classified into 8 functional groups through the Pfam and KEGG databases into hypothetical, transferases, energy and carbon metabolism, oxidoreductases, molecular chaperone, hydrolases, structural organisation and kinases. The individual protein’s functions were then identified and their possible role in pathogenesis, virulence and proliferation of M. grisea 7.6 were predicted.
Conclusion, significance and impact of study
Through the assays conducted, we were able to identify some proteins and pathways that could be targeted in developing fungicides and used in future mutagenesis studies.


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