Publications by authors named "Manohar Arumugam"

13 Publications

  • Page 1 of 1

Acrometastases: The nasty alter ego of fingertip infections.

Malays Fam Physician 2021 Jul 3;16(2):86-89. Epub 2021 Jun 3.

MBBS (UM) MS Ortho (UM), Consultant Orthopaedic, Hand & Microsurgeon, Hand and Microsurgery Division, Department of Orthopaedic Surgery, Universiti Putra Malaysia.

Fingertip infections are commonly diagnosed in primary care. There is a serious condition, acrometastases, that is often mistaken for these infections. Acrometastases are defined as metastases located distal to the elbow or knee. We present a case of a malignant phyllodes tumour with acrometastases to the distal phalanx of the left middle finger that was misdiagnosed as a fingertip infection on 2 separate occasions, highlighting the need for vigilance regarding acrometastases.
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http://dx.doi.org/10.51866/cr1059DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8346759PMC
July 2021

Dietary Acid Load and Its Interaction with IGF1 (rs35767 and rs7136446) and IL6 (rs1800796) Polymorphisms on Metabolic Traits among Postmenopausal Women.

Nutrients 2021 Jun 23;13(7). Epub 2021 Jun 23.

Department of Orthopedics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), Serdang 43400, Malaysia.

The objective of this study was to explore the effects of dietary acid load (DAL) and IGF1 and IL6 gene polymorphisms and their potential diet-gene interactions on metabolic traits. A total of 211 community-dwelling postmenopausal women were recruited. DAL was estimated using potential renal acid load (PRAL). Blood was drawn for biochemical parameters and DNA was extracted and Agena MassARRAY was used for genotyping analysis to identify the signalling of IGF1 (rs35767 and rs7136446) and IL6 (rs1800796) polymorphisms. Interactions between diet and genetic polymorphisms were assessed using regression analysis. The result showed that DAL was positively associated with fasting blood glucose (FBG) (β = 0.147, < 0.05) and there was significant interaction effect between DAL and IL6 with systolic blood pressure (SBP) (β = 0.19, = 0.041). In conclusion, these findings did not support the interaction effects between DAL and IGF1 and IL6 single nucleotide polymorphisms (rs35767, rs7136446, and rs1800796) on metabolic traits, except for SBP. Besides, higher DAL was associated with higher FBG, allowing us to postulate that high DAL is a potential risk factor for diabetes.
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http://dx.doi.org/10.3390/nu13072161DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8308464PMC
June 2021

No Interaction Effect between Interleukin-6 Polymorphisms and Acid Ash Diet with Bone Resorption Marker in Postmenopausal Women.

Int J Environ Res Public Health 2021 01 19;18(2). Epub 2021 Jan 19.

Department of Orthopedics, Faculty of Medicine and Health Sciences, University Putra Malaysia (UPM), UPM Serdang, Seri Kembangan 43400, Selangor, Malaysia.

Background: Evidence is growing that a high-acid diet might accelerate the rate of bone loss, and gene polymorphisms such as Interleukin 6 () -174G/C and -572G/C are related to bone deterioration. However, no study of the interaction between diet and polymorphisms has been conducted among Asians. Thus, the objective of this study was to determine whether IL6 gene polymorphisms modified the association between dietary acidity and the rate of bone resorption.

Methods: This cross-sectional study recruited 203 postmenopausal women (age ranged from 51 to 85 years old) in community settings. The dietary intakes of the participants were assessed using a validated interviewer-administered semi-quantitative food frequency questionnaire (FFQ), while dietary acid load (DAL) was estimated using net endogenous acid production (NEAP). Agena MassARRAY genotyping analysis and serum collagen type 1 cross-linked C-telopeptide (CTX1) were used to identify the genotype and as a bone resorption marker, respectively. The interactions between diet and single-nucleotide polymorphisms (SNPs) were assessed using linear regressions.

Results: A total of 203 healthy postmenopausal women aged between 51 and 85 years participated in this study. The mean BMI of the participants was 24.3 kg/m. In -174 G/C, all the participants carried the GG genotype, while the C allele was absent. Approximately 40% of the participants had a high dietary acid load. Dietary acid load (B = 0.15, = 0.031) and the -572 CC genotype group (B = 0.14, = 0.044) were positively associated with a higher bone resorption. However, there was no moderating effect of the genetic polymorphism on the relationship between and acid ash diet and bone resorption markers among the postmenopausal women ( = 0.79).

Conclusion: High consumption of an acid ash diet and the -572 C allele seem to attribute to high bone resorption among postmenopausal women. However, our finding does not support the interaction effect of dietary acidity and (-174G/C and -572G/C) polymorphisms on the rate of bone resorption. Taken together, these results have given scientific research other candidate genes to focus on which may interact with DAL on bone resorption, to enhance planning for preventing or delaying the onset of osteoporosis among postmenopausal women.
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http://dx.doi.org/10.3390/ijerph18020827DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7835771PMC
January 2021

Bone single-photon emission computed tomography/computed tomography in cancer care in the past decade: a systematic review and meta-analysis as well as recommendations for further work.

Nucl Med Commun 2021 Jan;42(1):9-20

Department of Nuclear Medicine, The Royal Liverpool and Broadgreen University Hospitals, NHS Trust, Liverpool, UK.

Skeletal whole-body scintigraphy (WBS), although widely used as a sensitive tool for detecting metastatic bone disease in oncology cases, has relatively low specificity. Indeterminate bone lesions (IBLs) detected by WBS cause a diagnostic dilemma, which hampers further management plans. In the advent of hybrid imaging, single-photon emission computed tomography/computed tomography (SPECT/CT) has been gaining popularity as a tool to improve the characterisation of IBLs detected by WBS. As yet, there has not been a systematic review to objectively evaluate the diagnostic capabilities of SPECT/CT in this area. We conducted a systematic review of relevant electronic databases up to 30 August 2020. The outcomes of interest were the reporting of SPECT/CT to identify benign and malignant IBLs and the calculation of the sensitivity and specificity of the index test, based on histopathological examination or clinical and imaging follow-up as the reference standard. After the risk of bias and eligibility assessment, 12 articles were identified and synthesised in the meta-analysis. The pooled sensitivity and specificity of SPECT/CT for diagnosing IBLs are 93.0% [95% confidence interval (CI) 0.91-0.95] and 96.0% (95% CI 0.94-0.97), respectively. There was heterogeneity of the articles due to variable imaging protocols, duration of follow-up and scoring methods for interpreting the SPECT/CT results. The heterogeneity poses a challenge for accurate interpretation of the true diagnostic capability of SPECT/CT. In conclusion, targeted SPECT/CT improves the specificity of diagnosing bone metastases, but efforts need to be made to standardise the thresholds for SPECT/CT, methodology, as well as harmonising the reporting and interpretation criteria. We also make some recommendations for future works.
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http://dx.doi.org/10.1097/MNM.0000000000001306DOI Listing
January 2021

Effectiveness of Health-Led Cognitive Behavioral-Based Group Therapy on Pain, Functional Disability and Psychological Outcomes among Knee Osteoarthritis Patients in Malaysia.

Int J Environ Res Public Health 2020 08 26;17(17). Epub 2020 Aug 26.

Faculty of Allied Health Sciences, Cyberjaya University College of Medical Sciences, Cyberjaya 63000, Malaysia.

Background: Psychosocial interventions for patients with osteoarthritis (OA) of the knee to reduce pain and improve physical and psychological functioning are still lacking in Malaysia.

Methods: A parallel-group unblinded randomized controlled trial involving 300 patients was conducted in two hospital orthopedics clinics in Malaysia. Patients were randomly assigned to receive cognitive behavioral-based group therapy ( = 150) or no further intervention ( = 150). The primary outcome was the change from baseline in knee pain as determined by the Knee injury and Osteoarthritis Outcome Score (KOOS) at 6 months. The data collected were analyzed by covariate-adjusted mixed design repeated measures analysis of variance. All analyses were performed under the terms of intention-to-treat.

Results: At 6 months, mean change from baseline in the KOOS knee pain score was 0.6 points (95% CI -1.73 to 2.94) in the control group and 8.9 points (95% CI 6.62 to 11.23) (denoting less knee pain intensity) in the intervention group (significant treatment effect < 0.0001). Patients treated with such an approach also experienced significant improvement in functional ability when performing activities of daily living and had improved ability to cope with depression, anxiety and pain catastrophizing.

Conclusion: The intervention module delivered by healthcare professionals had a sustained effect on knee OA pain and functionality over 6 months, thereby leading to an overall improvement in psychological well-being, thus benefitting most of the Malaysian knee OA patients.
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http://dx.doi.org/10.3390/ijerph17176179DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7503685PMC
August 2020

High body fat percentage and low consumption of dairy products were associated with vitamin D inadequacy among older women in Malaysia.

PLoS One 2020 13;15(2):e0228803. Epub 2020 Feb 13.

Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.

Background: Serum vitamin D insufficiency is a public health issue, especially among older women. Sun exposure is fundamental in the production of vitamin D, but older women have less optimal sun exposure. Therefore, factors such as body composition and diet become more essential in sustaining sufficient serum levels of vitamin D. The objective of the current study is to determine factors contributing towards serum vitamin D insufficiency among 214 older women.

Methods: The respondents had their body weight, height, waist circumference and body fat percentage measured, as well as interviewed for their socio-demographic characteristics, sun exposure and dietary intake. Fasting blood samples were obtained from the respondents to measure their serum 25-hydroxyvitamin D [25(OH)D] concentration.

Results: There were 82.7% (95% CI: 77.6%, 87.8%) of the respondents that had serum vitamin D insufficiency (< 50 nmol/L) with an average of 37.4 ± 14.3nmol/L. In stepwise multiple linear regression, high percentage of body fat (ß = -0.211, p <0.01) and low consumption of milk and dairy products (ß = 0.135, p <0.05) were the main contributors towards insufficient serum vitamin D levels, but not socio-demographic characteristics, other anthropometric indices, sun exposure and diet quality.

Conclusion: Older women with high body fat percentage and low dairy product consumption were more likely to have serum vitamin D insufficiency. Older women should ensure their body fat percentage is within a healthy range and consume more milk and dairy products in preventing serum vitamin D insufficiency.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0228803PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7018013PMC
May 2020

Prevalence of Absence of Palmaris Longus and Its Association with Gender, Hand Dominance and Absence of FDS Tendon to Little Finger Among Malay Population.

J Hand Surg Asian Pac Vol 2017 Dec;22(4):484-489

† Department of Orthopaedic Surgery, Faculty of Medicine and Health Sciences, University Putra Malaysia, Malaysia.

Background: Palmaris Longus is being widely used in reconstructive, plastic and cosmetic surgeries due to its long tendon. It is the most readily available source for tendon grafting. The objective of this study was to determine the prevalence of absence of Palmaris Longus and its association with gender, hand dominance and absence of FDS (flexor digitorum superficialis) tendon to little finger among Malay population.

Methods: An analytical cross sectional study design was used and a self-administered proforma was distributed for data collection. 1239 Malay secondary school children in Putrajaya were tested for absence of Palmaris Longus using Schaffer's test. 4 additional tests namely Thompson's test, Mishra's test I, Mishra's test II and Pushpakumar's 'two-finger sign' method were used to confirm its absence in respondents with negative Schaffer's test. Function of Flexor Digitorum Superficialis tendon to little finger was determined by flexing PIP of little finger while hyperextend the other fingers.

Results: The prevalence of absence of Palmaris Longus was 11.7%. Left side absence of Palmaris Longus was much common. There was a significant association between absence of Palmaris Longus with gender in which female had higher prevalence of absence of Palmaris Longus than male.

Conclusions: In conclusion, the prevalence of absence of Palmaris Longus in Malay population was lower than Indian but higher than Chinese population. Females had higher prevalence of absence of Palmaris Longus and no association can be found with hand dominance and absence of Flexor Digitorum Superficialis tendon to little finger.
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http://dx.doi.org/10.1142/S021881041750054XDOI Listing
December 2017

Office Exercise Training to Reduce and Prevent the Occurrence of Musculoskeletal Disorders among Office Workers: A Hypothesis.

Malays J Med Sci 2016 Jul 30;23(4):54-8. Epub 2016 Jun 30.

Department of Pathology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia.

Pain in specific areas of the body (including the lower back, neck, and shoulders) due to extended periods of sitting and inactivity is the most widespread musculoskeletal disorder worldwide and has consequences that are both socio-economic and personal. This condition is particularly prevalent in industrialised countries, affecting roughly 70% to 80% of adults at some point in their lives; approximately 1% of the U.S. population is chronically disabled by this type of pain disorder. A practical way to reduce the prevalence of musculoskeletal pain among office workers would have a significant positive impact. More work is required to develop a package of exercises designed to prevent and treat musculoskeletal pain in office workers. Such a package would be preferable to pharmacological treatments, which can have undesirable side effects. The main objective of this package would be to increase the flexibility and strength of trunk muscles in order to decrease the soreness, pain, and degree of discomfort. In this article, we introduce our proposed package of exercises, which are based on guidelines issued bythe American College of Sports Medicine.
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http://dx.doi.org/10.21315/mjms2016.23.4.7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5025063PMC
July 2016

Comparative reliability of different instruments used to measure the severity of musculoskeletal disorders in office workers.

Work 2016 Jun;54(3):753-8

Department of Pathology, Faculty of Medicine and Health Sciences, University Putra Malaysia, Malaysia.

Background: The accuracy of instruments such as questionnaires and the goniometer are critical for measuring the severity of musculoskeletal disorders among office workers.

Objective: To determine the reliability of the Cornell questionnaire, goniometer and Borg questionnaire, which are commonly used instruments to assess the severity of musculoskeletal disorders in office workers.

Methods: One hundred twenty healthy office workers, body mass: 87.1 ± 10.3 (kg), age: 27 ± 5.1 (years), height: 1.78 ± 0.16 (m), (mean ± SD), who had at least 1 year of experience in office working, were chosen randomly. A plastic goniometer (30" height) was used three times to measure the range of motion in the neck, hip, knee and shoulder area, with a period of one hour between measurements to evaluate the test-retest accuracy. The Cornell questionnaire was used to measure the severity of musculoskeletal disorders and the Borg scale was used to measure perceived exertion. The questionnaires were filled out twice with a gap of 2 weeks between measurements.

Results: The Inter-class Correlation Co-efficient (ICC) indicated that all instrument sub-scales showed high levels of repeatability. The ICC coefficient was (0.805-0.954, p <0.001) for the Borg scale, (0.785-0.978, p <0.001) for the goniometer and (0.883-0.975, p <0.001) for the Cornell questionnaire.

Conclusions: The Cornell questionnaire, goniometer and Borg questionnaire all exhibit high reliability when used for the evaluation of the severity of musculoskeletal disorders in office workers.
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http://dx.doi.org/10.3233/WOR-162313DOI Listing
June 2016

Package of Office Exercise Training as a New Idea for Office Workers.

Iran J Public Health 2016 Apr;45(4):544-5

Unit of Enhancements Academic Performance, University Malaya, Malaysia.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4888186PMC
April 2016

The Bahasa Melayu version of Cornell Musculoskeletal Discomfort Questionnaire (CMDQ): Reliability and validity study in Malaysia.

Work 2016 Mar;54(1):171-8

Department of Pathology, Faculty of Medicine and Health Sciences, University Putra Malaysia, Serdang, Selangor, Malaysia.

Background: The Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) was developed to assess the level of musculoskeletal discomfort among office workers related to their ergonomic situation.

Objective: The primary objective of this initial study is to analyze the validity and dependability of the Malay translation of the Cornell Musculoskeletal Discomfort Questionnaire.

Methods: The questionnaire was self-administered two times, with an interval of two weeks in order to evaluate the accuracy of the original findings with a retest. The study involved 115 participants.

Results: The range of Cronbach Alpha coefficient showed a considerable consistency of the items for each sub-scale (Cronbach's a > 0.95). The range of Kappa coefficients was between (ICC = 0.690-0.949, p < 0.001), (ICC = 0.801-0.979, p < 0.001) and (ICC = 0.778-0.944, p < 0.001) for frequency, severity and interference scales.

Conclusions: This research, introduced the Malay-language version of the CMDQ (CMDQ-M) as the first formal validation of the CMDQ, and confirmed a high reliability and validity for the evaluation of musculoskeletal discomfort among the study population.
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http://dx.doi.org/10.3233/WOR-162269DOI Listing
March 2016

Using Design of Experiments Methods for Assessing Peak Contact Pressure to Material Properties of Soft Tissue in Human Knee.

J Med Eng 2013 8;2013:891759. Epub 2013 Sep 8.

Department of Mechanical and Manufacturing Engineering, Universiti Putra Malaysia, 43400 Selangor, Malaysia.

Contact pressure in the knee joint is a key element in the mechanisms of knee pain and osteoarthritis. Assessing the contact pressure in tibiofemoral joint is a challenging mechanical problem due to uncertainty in material properties. In this study, a sensitivity analysis of tibiofemoral peak contact pressure to the material properties of the soft tissue was carried out through fractional factorial and Box-Behnken designs. The cartilage was modeled as linear elastic material, and in addition to its elastic modulus, interaction effects of soft tissue material properties were added compared to previous research. The results indicated that elastic modulus of the cartilage is the most effective factor. Interaction effects of axial/radial modulus with elastic modulus of cartilage, circumferential and axial/radial moduli of meniscus were other influential factors. Furthermore this study showed how design of experiment methods can help designers to reduce the number of finite element analyses and to better interpret the results.
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http://dx.doi.org/10.1155/2013/891759DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4782665PMC
March 2016

Chronic nonhealing ulcer of the right thumb with multiple subcutaneous nodules.

Orthopedics 2008 Jul;31(7):710

Department of Orthopedic Surgery, Faculty of Medicine and Health Science, Universiti Putra Malaysia Jalan Puchong, 43400, Serdang, Selangor, Malaysia.

A 60-year-old man presented with a 3-month history of nonhealing ulcer over the tip of his right thumb. The ulcer started as a blister over the tip of the thumb that later ruptured and spread proximally to cover the whole pulp area of the thumb. There was no history of trauma, fever, weight loss, or loss of appetite. He is a pensioner and an avid gardener. He has a few cats as pets. The patient initially presented to a private orthopedic surgeon with a nonhealing ulcer of the right thumb. Multiple debridements were unsuccessful in ameliorating the ulcer. Three months after the onset of the initial lesion, multiple painless erythematous nodules had developed on his right arm, and one on the right thigh. All routine blood investigations were nondiagnostic. Swab culture from the ulcer failed to grow any organism and a course of antibiotics did not resolve the problem. Cultures of the biopsy specimen using Sabouraud's dextrose agar and potato carrot medium grew dark brown plaques that microscopically appeared to be branching hyphae. A diagnosis of sporotrichosis of the right upper limb was made and the patient was started on antifungal treatment immediately (T. Itraconazole [Sporanox] 200 mg BD). One month after commencement of antifungal treatment, the ulcer began to dry up and at 3 months all the lesions including the one on the right thigh had healed.
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July 2008
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