A 37-year-old woman presented with a short history of fever and bilateral lower limb
weakness. She also had impaired sensory function up to T4 spine level and lax anal tone.
Laboratory investigations confirmed dengue infection with mild thrombocytopenia. MRI of the
spine showed a spinal subarachnoid haemorrhage from the level of T4 till T9. Despite
medical and surgical interventions, her lower limb weakness persists. A high index of
suspicion is needed to recognise dengue-related neurological complications. This diagnosis
should be considered in any patients from dengue endemic areas presenting with acute
febrile illness with atypical neurological manifestations.
MeSH terms: Adult; Dengue; Female; Fever; Humans; Magnetic Resonance Imaging; Nervous System Diseases; Sensation; Spine; Subarachnoid Hemorrhage; Thrombocytopenia; Lower Extremity
We report a case of a 13-year-old boy who presented with acute onset of generalised erythematous skin and patchy areas of pustules for one week duration. He was well until one month ago when he started having small scaly plaques on his scalp and extensors of his legs. During the acute episode, he also had joint pain and bilateral conjunctivitis. Skin biopsy confirmed pustular psoriasis. He developed leucocytosis and transaminitis during the acute phase of the pustular eruption while on acitretin, which was then withheld. Subsequently, treatment with oral cyclosporine induced remission of his skin and joint disease. The case is hereby reported because of rarity of presentation and clinical features. Oral cyclosporine should be considered in patients with generalised pustular psoriasis complicated with transaminitis.
In Part 1, we took us through the path of the early implementation of the traditional medical curriculum. Although it worked in the early stages of medical education in Malaysia, it was deemed necessary to continually evaluate the curriculum to ensure that it meets the needs of national development and to keep pace with global trends. What were the triggers that initiated the global trend of curricular change in the 1970’s? (Copied from article).
A mathematical model for the reaction-diffusion equation is developed to describe the nutrient release profiles and degradation of poly(lactic acid) (PLA)-coated controlled-release fertilizer. A multi-diffusion model that consists of coupled partial differential equations is used to study the diffusion and chemical reaction (autocatalytic degradation) simultaneously. The model is solved using an analytical-numerical method. Firstly, the model equation is transformed using the Laplace transformation as the Laplace transform cannot be inverted analytically. Numerical inversion of the Laplace transform is used by employing the Zakian method. The solution is useful in predicting the nutrient release profiles at various diffusivity, concentration of extraction medium, and reaction rates. It also helps in explaining the transformation of autocatalytic concentration in the coating material for various reaction rates, times of reaction, and reaction-multi diffusion. The solution is also applicable to the other biodegradable polymer-coated controlled-release fertilizers.
Extensive employment of biomaterials in the areas of biomedical and microbiological applications is considered to be of prime importance. As expected, oil based polymer materials were gradually replaced by natural or synthetic biopolymers due to their well-known intrinsic characteristics such as biodegradability, non-toxicity and biocompatibility. Literature on this subject was found to be expanding, especially in the areas of biomedical and microbiological applications. Introduction of porosity into a biomaterial broadens the scope of applications. In addition, increased porosity can have a beneficial effect for the applications which exploit their exceptional ability of loading, retaining and releasing of fluids. Different applications require a unique set of pore characteristics in the biopolymer matrix. Various pore morphologies have different characteristics and contribute different performances to the biopolymer matrix. Fabrication methods for bio-based porous materials more related to the choice of material. By choosing the appropriate combination of fabrication technique and biomaterial employment, one can obtain tunable pore characteristic to fulfill the requirements of desired application. In our previous review, we described the literature related to biopolymers and fabrication techniques of porous materials. This paper we will focus on the biomedical and microbiological applications of bio-based porous materials.
Non-isocyanate polyurethane (NIPU) was prepared from Jatropha curcas oil (JCO) and its alkyd resin via curing with different diamines. The isocyanate-free approach is a green chemistry route, wherein carbon dioxide conversion plays a major role in NIPU preparation. Catalytic carbon dioxide fixation can be achieved through carbonation of epoxidized derivatives of JCO. In this study, 1,3-diaminopropane (DM) and isophorone diamine (IPDA) were used as curing agents separately. Cyclic carbonate conversion was catalyzed by tetrabutylammonium bromide. After epoxy conversion, carbonated JCO (CJCO) and carbonated alkyd resin (CC-AR) with carbonate contents of 24.9 and 20.2 wt %, respectively, were obtained. The molecular weight of CJCO and CC-AR were determined by gel permeation chromatography. JCO carbonates were cured with different amine contents. CJCO was blended with different weight ratios of CC-AR to improve its characteristics. The cured NIPU film was characterized by spectroscopic techniques, differential scanning calorimetry, and a universal testing machine. Field emission scanning electron microscopy was used to analyze the morphology of the NIPU film before and after solvent treatment. The solvent effects on the NIPU film interfacial surface were investigated with water, 30% ethanol, methyl ethyl ketone, 10% HCl, 10% NaCl, and 5% NaOH. NIPU based on CCJO and CC-AR (ratio of 1:3) with IPDA crosslink exhibits high glass transition temperature (44 °C), better solvent and chemical resistance, and Young's modulus (680 MPa) compared with the blend crosslinked with DM. Thus, this study showed that the presence of CC-AR in CJCO-based NIPU can improve the thermomechanical and chemical resistance performance of the NIPU film via a green technology approach.
The objective of this work is to characterize and investigate the blood compatibility of polyurethane (PU)/mustard oil composites fabricated using electrospinning technique. The fabricated scaffold was characterized using scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR), atomic force microscopy (AFM), thermogravimetric analysis (TGA) and contact angle measurements. The activated partial thromboplastin time (APPT), prothrombin time (PT) and the hemolytic assay were done to investigate the blood compatibility of the developed composites. The SEM results revealed that the fiber diameter of the composites (761 ± 123 nm) was reduced compared to pristine PU control. The interaction between PU and mustard oil was confirmed by FTIR as evident through the shifting of peaks. The fabricated composites depicted hydrophobic behavior as insinuated by the increase in contact angle measurements. PU/mustard composites displayed improved crystallinity as confirmed by TGA. Atomic force micrographs suggested that developed PU/mustard oil composites showed an increase in the surface roughness (Ra) compared to pure PU. The Ra of pure PU was observed to be 723 nm but for the fabricated PU/mustard oil composite the Ra was found to be 1298 nm (Ra). The hemolytic index value for pure PU and fabricated composites was observed to be 2.73% and 1.15% indicating that developed composites showed a non-hemolytic behavior signifying the safety of the composites with red blood cells. Hence the newly developed composites with improved physicochemical and blood compatibility properties may be considered as a potential candidate for fabricating cardiac patches and grafts.
Reinforced concrete (RC) structures require strengthening for numerous factors, such as increased load, modification of the structural systems, structural upgrade or errors in the design and construction stages. The side near-surface mounted (SNSM) strengthening technique with glass fiber-reinforced polymer (GFRP) bars is a relatively new emerging technique for enhancing the flexural capacities of existing RC elements. Nine RC rectangular beams were flexurally strengthened with this technique and tested under four-point bending loads until failure. The main goal of this study is to optimize the structural capacity of the RC beams by varying the amount of strengthening reinforcement and bond length. The experimental test results showed that strengthening with SNSM GFRP bars significantly enhanced the flexural responses of the specimens compared with the control specimen. The first cracking and ultimate loads, energy absorption capacities, ductility and stiffness were remarkably enhanced by the SNSM technique. It was also confirmed that the bond length of the strengthened reinforcement greatly influences the energy absorption capacities, ductility and stiffness. The effect of the bond length on these properties is more significant compared to the amount of strengthening reinforcement.
A renewable resource, epoxidized jatropha oil (EJO), was used as a green plasticizer and added to poly(lactic acid) (PLA). EJO was compounded into PLA at different contents. The addition of 3 wt % EJO to the PLA demonstrates significant improvement in flexibility, which leads to a percentage increase of about 7000% in elongation at break. This tensile result was confirmed by surface morphology analysis with clear proof of plastic deformation in EJO-plasticized PLA. EJO imparts a good heat stabilization effect. Thermal stability of PLA was enhanced upon addition of EJO, which is due to their good interaction and plasticizer dispersion within the PLA matrix. This EJO-plasticized PLA has wide applications in various industries, such as packaging of food and non-food products.
MeSH terms: Drug Packaging; Hot Temperature; Plasticizers; Plastics; Polyesters; Product Packaging; Jatropha
A halloysite nanotubes⁻polyvinyl alcohol⁻polyvinylpyrrolidone (HNTs⁻PVA⁻PVP) composite has been investigated for a quite long time aiming at improving the physico⁻chemical characterization of HNTs. In this work, HNTs⁻PVA⁻PVP composite were prepared based on a unique procedure characterized by crosslinking two polymers with HNTs. The composite of two polymers were modified by treating HNTs with phosphoric acid (H₃PO₄) and by using malonic acid (MA) as a crosslinker. The composite was also treated by adding the dispersion agent sodium dodecyl sulfate (SDS). The HNTs⁻PVA⁻PVP composite shows better characteristics regarding agglomeration when HNTs is treated in advance by H₃PO₄. Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), transmission electron microscopy (TEM), field emission scanning electron microscopy (FESEM), brunauer⁻emmett⁻teller (BET), size distribution, and atomic force microscopy (AFM) are used to characterize the physio-chemical properties of the composite. FTIR shows additional peaks at 2924.29, 1455.7, and 682.4 cm-1 compared to the neat HNTs due to adding MA. Despite that, the XRD spectra do not show a significant difference, the decrease in peak intensity could be attributed to the addition of semi-crystalline PVA and the amorphous PVP. The images taken by TEM and FESEM show the possible effects of MA on the morphology and internal feature of HNTs⁻PVA⁻PVP composite treated by MA by showing the deformation of the matrix. The BET surface area increased to 121.1 m²/g compared to the neat HNTs at 59.1 m²/g. This result, the second highest recorded result, is considered a breakthrough in enhancing the properties of HNTs⁻PVA⁻PVP composite, and treatment by MA crosslinking may attribute to the size and the number of the pores. The results from these techniques clearly showed that a significant change has occurred for treated HNTs⁻PVA⁻PVP composite where MA was added. The characterization of HNTs⁻PVA⁻PVP composite with and without treating HNTs and using crosslinker may lead to a better understanding of this new composites as a precursor to possible applications in the dentistry field.
In this study, reduced graphene oxide (RGO)/polymethyl methacrylate (PMMA) nanocomposites were prepared by employing in situ polymerization and solution blending methods. In terms of mechanical properties, RGO loading increased the Young's modulus but decreased the elongation at break for RGO/PMMA nanocomposites. Tensile strength for solution blended RGO/PMMA nanocomposites increased after adding 0.5 wt % RGO, which was attributed to the good dispersion of RGO in the nanocomposites as evidenced from SEM and TEM. Solar energy conversion efficiency measurement results showed that the optimum concentration of RGO in the RGO/PMMA nanocomposites was found to be 1.0 wt % in order to achieve the maximum solar energy conversion efficiency of 25%. In the present study, the solution blended nanocomposites exhibited better overall properties than in situ polymerized nanocomposites owing to the better dispersion of RGO in solution blending. These findings would contribute to future work in search of higher conversion efficiency using nanocomposites.
Discovery and use of biocompatible polymers offers great promise in the pharmaceutical field, particularly in drug delivery systems. Disulphide bonds, which commonly occur in peptides and proteins and have been used as drug-glutathione conjugates, are reductively cleaved in the colon. The intrinsic stability of a disulphide relative to thiol groups is determined by the redox potential of the environment. The objective of this study was to synthesise a trimesic acid-based disulphide cross-linked polymer that could potentially be used for targeted delivery to the colon. The monomer was synthesised by an amide coupling reaction between trimesic acid and (triphenylmethyl) thioethylamine using a two-step synthesis method. The s-trityl group was removed using a cocktail of trifluoroacetic acid and triethylsilane to expose the thiols in preparation for further polymerisation. The resulting polymers (P10, P15, P21, P25, and P51, generated using different molar ratios) were reduced after 1.5 h of reduction time. Scanning electron microscopy images of the polymers showed spherical, loose, or tight patterns depending on the molar ratio of polymerisation. These polymers also exhibited efficient dissolution under various gastrointestinal conditions. Of the five polymers tested, P10 and P15 appeared to be promising drug delivery vehicles for poorly soluble drugs, due to the hydrophobic nature of the polymers.
Halloysite nanotubes (HNTs)-polyester nanocomposites with four different concentrations were produced using solution casting technique and the biodegradation effect of short-term seawater exposure (120 h) was studied. Monolithic polyester was observed to have the highest seawater absorption with 1.37%. At 0.3 wt % HNTs reinforcement, the seawater absorption dropped significantly to the lowest value of 0.77% due to increase of liquid diffusion path. For samples tested in dry conditions, the Tg, storage modulus, tensile properties and flexural properties were improved. The highest improvement of Tg was from 79.3 to 82.4 °C (increase 3.1 °C) in the case of 0.3 wt % HNTs. This can be associated with the exfoliated HNTs particles, which restrict the mobility of polymer chains and thus raised the Tg. After seawater exposure, the Tg, storage modulus, tensile properties and flexural properties of polyester and its nanocomposites were decreased. The Young's modulus of 0.3 wt % HNTs-polyester dropped 20% while monolithic polyester dropped up to 24% compared to their values in dry condition. Apart from that, 29% flexural modulus reduction was observed, which was 18% higher than monolithic polyester. In contrast, fracture toughness and surface roughness increased due to plasticization effect. The presence of various microbial communities caused gradual biodegradation on the microstructure of the polyester matrix as also evidently shown by SEM images.
The aim was to explore the utilization of oil palm mesocarp fiber (OPMF) as a source for the production of cellulose nanocrystals (CNC). OPMF was first treated with alkali and then bleached before the production of CNC by acid hydrolysis (H₂SO₄). The produced materials were characterized using Fourier transform infrared (FTIR) spectroscopy, X-ray diffraction (XRD), thermogravimetric analysis (TGA), a scanning electron microscope (SEM) and a transmission electron microscope (TEM). It was proven that acid hydrolysis can increase the crystallinity of bleached OPMF and reduce the dimension of cellulose to nano scale. Changes in the peaks of the FTIR spectrum at 2852 (C-H stretching), 1732 (C=O stretching) and 1234 cm-1 (C-O stretching) indicated that the alkali treatment completely removed hemicelluloses and lignin from the fiber surface. This can be seen from the thermogram obtained from the TGA characterization. Morphological characterization clearly showed the formation of rod-shaped CNCs. The promising results prove that OPMF is a valuable source for the production of CNC.
The viscosity of four new polymers was investigated for the effect of aging at high temperature, with varying degrees of salinity and hardness. The four sulfonated based polyacrylamide co-polymers were FLOCOMB C7035; AN132 VHM; SUPERPUSHER SAV55; and THERMOASSOCIATIF copolymers. All polymer samples were aged at 80 °C for varying times (from zero to at least 90 days) with and without isobutyl alcohol (IBA) as an antioxidant. To see the effect of divalent ions on the polymer solution viscosity, parallel experiments were performed in a mixture of CaCl₂-NaCl of the same ionic strength as 5 wt % NaCl. The polymers without IBA showed severe viscosity reduction after aging for 90 days in both types of preparation (5 wt % NaCl or CaCl₂-NaCl). In the presence of IBA, viscosity was increased when aging time was increased for 5 wt % NaCl. In CaCl₂-NaCl, on the other hand, a viscosity reduction was observed as aging time was increased. This behavior was observed for all polymers except AN132 VHM.
Valvular dysfunction as the prominent reason of heart failure may causes morbidity and mortality around the world. The inability of human body to regenerate the defected heart valves necessitates the development of the artificial prosthesis to be replaced. Besides, the lack of capacity to grow, repair or remodel of an artificial valves and biological difficulty such as infection or inflammation make the development of tissue engineering heart valve (TEHV) concept. This research presented the use of compound of poly-l-lactic acid (PLLA), thermoplastic polyurethane (TPU) and maghemite nanoparticle (γ-Fe₂O₃) as the potential biomaterials to develop three-dimensional (3D) aortic heart valve scaffold. Electrospinning was used for fabricating the 3D scaffold. The steepest ascent followed by the response surface methodology was used to optimize the electrospinning parameters involved in terms of elastic modulus. The structural and porosity properties of fabricated scaffold were characterized using FE-SEM and liquid displacement technique, respectively. The 3D scaffold was then seeded with aortic smooth muscle cells (AOSMCs) and biological behavior in terms of cell attachment and proliferation during 34 days of incubation was characterized using MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay and confocal laser microscopy. Furthermore, the mechanical properties in terms of elastic modulus and stiffness were investigated after cell seeding through macro-indentation test. The analysis indicated the formation of ultrafine quality of nanofibers with diameter distribution of 178 ± 45 nm and 90.72% porosity. In terms of cell proliferation, the results exhibited desirable proliferation (109.32 ± 3.22% compared to the control) of cells over the 3D scaffold in 34 days of incubation. The elastic modulus and stiffness index after cell seeding were founded to be 22.78 ± 2.12 MPa and 1490.9 ± 12 Nmm², respectively. Overall, the fabricated 3D scaffold exhibits desirable structural, biological and mechanical properties and has the potential to be used in vivo.
The aim was to explore the utilization of tea leaf waste fibers (TLWF) as a source for the production of cellulose nanocrystals (CNC). TLWF was first treated with alkaline, followed by bleaching before being hydrolyzed with concentrated sulfuric acid. The materials attained after each step of chemical treatments were characterized and their chemical compositions were studied. The structure analysis was examined by Fourier transform infrared (FTIR) spectroscopy and X-ray diffraction (XRD). From FTIR analysis, two peaks at 1716 and 1207 cm-1-which represent C=O stretching and C⁻O stretching, respectively-disappeared in the spectra after the alkaline and bleaching treatments indicated that hemicellulose and lignin were almost entirely discarded from the fiber. The surface morphology of TLWF before and after chemical treatments was investigated by scanning electron microscopy (SEM) while the dimension of CNC was determined by transmission electron microscopy (TEM). The extraction of CNC increased the surface roughness and the crystallinity index of fiber from 41.5% to 83.1%. Morphological characterization from TEM revealed the appearance of needle-like shaped CNCs with average diameter of 7.97 nm. The promising results from all the analyses justify TLWF as a principal source of natural materials which can produce CNC.
This research aims to test four new polymers for their stability under high salinity/high hardness conditions for their possible use in polymer flooding to improve oil recovery from hydrocarbon reservoirs. The four sulfonated based polyacrylamide co-polymers were FLOCOMB C7035; SUPERPUSHER SAV55; THERMOASSOCIATIF; and AN132 VHM which are basically sulfonated polyacrylamide copolymers of AM (acrylamide) with AMPS (2-Acrylamido-2-Methylpropane Sulfonate). AN132 VHM has a molecular weight of 9⁻11 million Daltons with 32 mol % degree of sulfonation. SUPERPUSHER SAV55 mainly has about 35 mol % sulfonation degree and a molecular weight of 9⁻11 million Daltons. FLOCOMB C7035, in addition, has undergone post-hydrolysis step to increase polydispersity and molecular weight above 18 million Daltons but it has a sulfonation degree much lower than 32 mol %. THERMOASSOCIATIF has a molecular weight lower than 12 million Daltons and a medium sulfonation degree of around 32 mol %, and also contains LCST (lower critical solution temperature) type block, which is responsible for its thermoassociative characteristics. This paper discusses the rheological behavior of these polymers in aqueous solutions (100⁻4500 ppm) with NaCl (0.1⁻10 wt %) measured at 25 °C. The effect of hardness was investigated by preparing a CaCl₂-NaCl solution of same ionic strength as the 5 wt % of NaCl. In summary, it can be concluded that the rheological behavior of the newly modified co-polymers was in general agreement to the existing polymers, except that THERMOASSOCIATIF polymers showed unique behavior, which could possibly make them a better candidate for enhanced oil recovery (EOR) application in high salinity conditions. The other three polymers, on the other hand, are better candidates for EOR applications in reservoirs containing high divalent ions. These results are expected to be helpful in selecting and screening the polymers for an EOR application.
Background On August 24, 2011, 31 US-bound refugees from Kuala Lumpur, Malaysia (KL) arrived in Los Angeles. One of them was diagnosed with measles post-arrival. He exposed others during a flight, and persons in the community while disembarking and seeking medical care. As a result, 9 cases of measles were identified. Methods We estimated costs of response to this outbreak and conducted a comparative cost analysis examining what might have happened had all US-bound refugees been vaccinated before leaving Malaysia. Results State-by-state costs differed and variously included vaccination, hospitalization, medical visits, and contact tracing with costs ranging from $621 to $35,115. The total of domestic and IOM Malaysia reported costs for US-bound refugees were $137,505 [range: $134,531 - $142,777 from a sensitivity analysis]. Had all US-bound refugees been vaccinated while in Malaysia, it would have cost approximately $19,646 and could have prevented 8 measles cases. Conclusion A vaccination program for US-bound refugees, supporting a complete vaccination for US-bound refugees, could improve refugees' health, reduce importations of vaccine-preventable diseases in the United States, and avert measles response activities and costs.
MeSH terms: Adolescent; Costs and Cost Analysis; Disease Outbreaks/economics; Disease Outbreaks/prevention & control; Female; Humans; Malaysia/epidemiology; Male; Measles/economics*; Measles/epidemiology; Measles/prevention & control; Measles/transmission; Measles Vaccine/economics; Refugees*; United States; Vaccination/economics; Los Angeles/epidemiology; Immunization Programs/economics; Young Adult; Airports; Air Travel*