We present a case of a 27-year-old female with T2 DM who developed allergic reactions after commencement of insulin therapy. Trial with different types of insulin resulted in a series of allergic reactions ranging from urticarial rash to development of angioedema, bronchospasm and anaphylactic shock. She was successfully treated with a modified insulin desensitization protocol using rapid-acting insulin.
A 69-year-old female complained of intermittent left hip pain for the past 3 years. Biochemical tests revealed normal serum calcium and phosphorus with markedly raised alkaline phosphatase. MRI of the hip revealed extensive marrow signal abnormalities at the left pelvic bone, while CT of the thorax revealed a spiculated lung nodule at the left lower lung lobe. In order to diagnose either primary, metastatic bone tumour or Paget's disease of the bone (PDB), an open biopsy of the left iliac bone was performed. The histopathology of bone biopsy of the left iliac bone was consistent with PDB. A CT guided biopsy of the lung mass done later revealed adenocarcinoma of the lung. She had 18F-FDG PETCECT Scan for staging evaluation and result was suggestive of new bony metastases. Patient was started on IV Zoledronic acid for treatment of the PDB. In view of the stage 4 lung adenocarcinoma with bony metastases, patient was scheduled for palliative chemotherapy.
MeSH terms: Aged; Alkaline Phosphatase; Bone Marrow; Bone Neoplasms; Calcium; Female; Humans; Lung; Lung Neoplasms; Magnetic Resonance Imaging; Pain; Pelvic Bones; Phosphorus; Thorax; Tomography, X-Ray Computed; Fluorodeoxyglucose F18; Image-Guided Biopsy
A 58-year-old male presented with persistent severe headache, lethargy, decline libido and no neurological deficits. Besides quadruple anterior pituitary hormonal deficiencies, magnetic resonance imaging (MRI) demonstrated an enlarged ring-enhanced non-homogenous pituitary. Following hormonal replacement, these symptoms improved but empty sella evolved. The challenges of diagnosis and management were discussed. Awareness of the unclear etiology and uncertain clinical course of autoimmune hypophysitis in a man in this age group is essential for prompt and appropriate management.
An apparently well 27-year-old phenotypically male adult was seen at the endocrine clinic for gender assignment. Patient had been raised as a male and identifies as such. Abdominal CT scan showed a unilateral left adrenal mass and karyotyping revealed 46 XX female karyotype. She was diagnosed to have simple virilizing CAH and needed thorough counselling with subsequent management by a multidisciplinary team.
Urolithiasis considered as a disease condition that is neglected in terms of research because of its perceived low prevalence and possibly the seemingly good prognosis associated with it. However, in recent years, the prevalence of urolithiasis is increasing in both developed and developing countries and the disease is associated with significant burden and healthcare cost from patients’ caregivers, and society’s perspective. All healthcare providers (including pharmacists) have an important role to play in the management of this disease and it deserves more attention in terms of clinical practice and research. This review aims to provide a comprehensive understanding of patient satisfaction, from the aspect of defining satisfaction of patients, perceptions toward disease management, and a review of literature of satisfaction of patients with kidney stones and its magnitude in healthcare provided. The medical literature has many articles about urolithiasis management options. However, there have been no sufficient published studies discussing patient-reported outcomes of kidney stone management to evaluate their satisfaction, preferences, treatment expectations, and quality of life. Future studies are needed to spot the light on kidney stones patients’ preferences and reported outcomes.
MeSH terms: Developing Countries; Humans; Kidney Calculi; Motivation; Perception; Personal Satisfaction; Pharmacists; Prognosis; Quality of Life; Prevalence; Caregivers; Health Care Costs; Patient Satisfaction; Disease Management; Urolithiasis; Patient Preference; Patient Reported Outcome Measures
Emergence of various global health problems has widened the pharmacist’s job scope. An accessible resource for health and medication information as the pharmacist strengthen the existing public health system. Achievement of optimal patient outcomes involves community and clinical pharmacist safe and effective medication use. However, the public is still unaware of the pharmacist’s role in public and global health. This essay aims to identify pharmacist’s role in overcoming global health problems with a literature review. Pharmacists’ role change from public care provider to public care profession. The roles of pharmacists in health care team as primary care practitioners can be seen in their management of tropical and chronic diseases. With their evaluation skills and extensive knowledge of drugs. Pharmacists can provide the best medical advice to the patients besides promoting selftreatment on minor ailments. Furthermore, they also help in reducing the medical costs and optimising medications for the patients. The faith of the public in pharmacists on vaccination proves that they accept the involvement of pharmacists in healthcare provision. However, the public awareness towards pharmacists’ role should be improved.
MeSH terms: Chronic Disease; Community Pharmacy Services; Counseling; Delivery of Health Care; Pharmaceutical Preparations; Humans; Patient Care Team; Pharmacists; Primary Health Care; Public Health; Vaccination; Global Health
Although therapeutic drug monitoring (TDM) has been used in practice, conflicting data on its usefulness in the management of epilepsy have been reported. These results range from identifying no significant differences in patients’ clinical outcomes to determining TDM to be a cost-effective service. Thus, this study was conducted to evaluate the effectiveness of our pharmacist-managed TDM service in helping patients with epilepsy (PWE) to achieve seizure control. This was a retrospective observational study conducted in the TDM Unit of Hospital Keningau, Sabah. Pharmacist-prepared reports issued for 30 subjects with uncontrolled seizures in 2014 were analysed to determine the effectiveness of their recommendations. Effectiveness was measured based on the number of patients who achieved ≥ 50% reduction in seizure frequency and the number of patients with a threemonth seizure-free period. Overall, 80% of the pharmacists’ TDM recommendations were accepted by prescribers. Based on the data collected, 17 (56.67%) subjects had their seizure frequency decreased at least by half, while 11 (36.67%) subjects achieved total remission. However, there was no significant association between acceptance of recommendations and seizure control; although acceptance of pharmacist recommendations was associated with 1.4 times greater odds of achieving seizure control among PWE, this difference was not statistically significant. In conclusion, a pharmacist-managed TDM service was associated with an improvement in seizure control of more than 50% among PWE with unsatisfactory seizure control.
MeSH terms: Cost-Benefit Analysis; Data Collection; Epilepsy; Hospitals; Humans; Malaysia; Pharmacists; Retrospective Studies; Seizures; Drug Monitoring
Over the years, the rights of pharmacists as health care professionals have been a controversial topic in the medical field. Pharmacists worldwide have always been independent in being able to practice medicine in their own way and have been given exclusive dispensing rights to distribute drugs and medicines to patients. In Malaysia, however, this is not the case. The overwhelming opinion has been that pharmacists are losing their dispensing rights because doctors are earning more. The current study was carried out in view of recent debates regarding the implementation of a dispensary separation policy in Malaysia. The main objective of this study was to gain an understanding of the views of and challenges experienced by the public in regards to the implementation of this type of policy. The overall results of this study show that dispensing rights are still viewed with mixed feelings. Study subjects reported believing that pharmacists were capable of dispensing medication but that they lack the confidence to make changes within the existing system. When their conditions were not severe, respondents indicated that they preferred the old system where doctors prescribe them with medicine and they subsequently visit the pharmacy. In conclusion, the majority of interview participants were of the opinion that maintaining the current system would benefit them holistically. In this study, input from a total of 929 respondents was gathered via a structured survey conducted throughout Malaysia. The study findings were also supported by data obtained during interviews carried out with 350 informants regarding their views of the implementation of dispensary separation in Malaysia
Pharmacists play an important role in healthcare delivery. Over the years, their role has shifted from product-oriented to patient-oriented. This study aimed to assess the perceptions of the public towards the role of pharmacists and the willingness of the public to pay for pharmacist-provided dispensing services in Sabah. This was a questionnairebased, cross-sectional study conducted from September 2014 to June 2015 in three major cities in Sabah, namely, Kota Kinabalu, Sandakan and Tawau. The respondents were conveniently selected and interviewed based on a questionnaire to assess their perceptions of the role of pharmacists. A contingent valuation interview was then conducted to assess the respondents’ willingness to pay. A total of 647 respondents were interviewed. Of the respondents, 61.4% agreed that pharmacists knew more about their medications and side effects and how to use the medications than their doctors. However, more than half of the respondents (54.4%) perceived that the pharmacists’ role was only to supply medications and 66.6% of the respondents perceived that the pharmacist’s role was to follow doctors’ directions. Of the respondents, 89.0% appreciated and adhered to the counselling points provided by their pharmacists; 85.0% of the respondents hoped that pharmacists could play a greater role in healthcare in the future. Forty percent of the respondents agreed that community pharmacists were simply business people who sold products in their pharmacies. Finally, 55.3% of the respondents were willing to pay for pharmacist-provided dispensing services. The median (interquartile ranges [IQR]) amount that they were willing to pay was RM5.00 (IQR RM5.00). Respondents in this study showed variations in their views of the pharmacy profession. Nevertheless, more than half of the respondents valued pharmacist-provided dispensing services and were willing to pay RM5.00 for the services. To improve pharmacy practice, efforts should be undertaken to address the respondents’ misunderstandings about the pharmacy profession and to promote the roles of pharmacists to the general public.
MeSH terms: Cities; Counseling; Cross-Sectional Studies; Delivery of Health Care; Humans; Malaysia; Perception; Pharmaceutical Services; Pharmacies; Pharmacists; Pharmacy; Surveys and Questionnaires
Tomato (Solanum lycopersicon L.) fruit is rich in various nutrients, vitamins and health-promoting molecules. Fresh tomatoes are an important part of the Mediterranean gastronomy, and their consumption is thought to contribute substantially to the reduced incidence of some chronic diseases in the Mediterranean populations in comparison with those of other world areas. Unfortunately, tomato fruit is highly perishable, resulting in important economic losses and posing a challenge to storage, logistic and supply management. This review summarizes the current knowledge on some important health-promoting and eating quality traits of tomato fruits after harvest and highlights the existence of substantial cultivar-to-cultivar variation in the postharvest evolution of the considered traits according to maturity stage at harvest and in response to postharvest manipulations. It also suggests the need for adapting postharvest procedures to the characteristics of each particular genotype to preserve the optimal quality of the fresh product.
Kertas ini mengkaji sumbangan Ibn Abī Dunyā (208-281/894) dalam mengembangkan pemikiran tasawuf Islam dan peranannya dalam merumuskan falsafah kesufian yang diungkapkan oleh ahli-ahli sufi yang besar yang berkembang dengan meluas di abad ke 3 Hijrah. Penulisan dan karya-karya tasawuf yang dihasilkan oleh Ibn Abī Dunyā banyak memberikan pengaruh kepada perkembangan ilmu tasawuf di abad pertengahan dan pemikirannya dikutip oleh ulama sufi yang muktabar yang mengasaskan manhaj kesufian Islam yang utama seperti Imām al-Ghazālī, al-Qushayrī, al-Shādhilī, Ibn ‘Arabī, al-Sulamī, al-Kutubī, al-Birgivī dan sebagainya. Cetusan dan fikrah tasawuf yang digagaskannya dizahirkan dalam karya-karyanya yang monumental seperti Dhamm al-Dunyā, Dhamm al-Malāḥī, al-‘Uqūbāt, al-Jū‘, Makārim al-Akhlāq, al-Riqqah wa’l-Bukā’, al-Ṣabr, Iṣṭinā‘ al-Ma‘rūf, al-Muḥtaḍirīn, al-Mutamannīn, Ṣifat al-Nār dan sebagainya. Kertas ini akan menganalisis pemikiran dan sumbangannya yang signifikan ini dalam disiplin tasawuf dan melihat relevensinya dengan idealisme tasawuf moden.
Often people hear the expression 'women are made from the ribs of the prophet Adam' in religious lectures or writings related to women and girls. However, to what extent these truths must be analysed and clarified so that they can clear up misunderstandings and negative stereotypes about Muslim women as if they were second-class creations. This is because, most of the people feel that it is part of the essence of the Quran and the Hadith, even though it is taken from the scriptures that you have heard, but its source is not explained every time it is mentioned or written. Therefore, this paper aims to identify its source and focus its discussion on its content from a scientific perspective and in line with scientific findings on the issue. It is hoped that through a paper based on the study of libraries in two areas, the science of revelation and science can contribute knowledge that is beneficial to the community in general and the Islamic world in particular.
The involvement of women preachers in the field of preaching is also a major contributor to the process of delivering the preaching to the community. Thus, the importance of Islamic women's role in delivering the content of their preaching focused on aspects related to women and society based on the main sources of the Quran and the sunnah. Therefore, the objective of this study is to study the role of Muslim women in delivering the message of preaching to the community according to the Quranic perspective. This study uses qualitative method which is a documentary study which is accompanied by the arguments of the Quran, Hadith and the views of several commentators on the topic of the study. The study found that women play a very important role in communicating the message of faith such as issues of faith, sharia, morals and current issues of women and society based on the Quranic message. This is because the Muslim preacher's delivery is more personalized and influenced by a more feminine and family-oriented approach.
The recent increase in the number of videos available in cyberspace is due to the availability of multimedia devices, highly developed communication technologies, and low-cost storage devices. These videos are simply stored in databases through text annotation. Content-based video browsing and retrieval are inefficient due to the method used to store videos in databases. Video databases are large in size and contain voluminous information, and these characteristics emphasize the need for automated video structure analyses. Shot boundary detection (SBD) is considered a substantial process of video browsing and retrieval. SBD aims to detect transition and their boundaries between consecutive shots; hence, shots with rich information are used in the content-based video indexing and retrieval. This paper presents a review of an extensive set for SBD approaches and their development. The advantages and disadvantages of each approach are comprehensively explored. The developed algorithms are discussed, and challenges and recommendations are presented.
MeSH terms: Algorithms; Databases, Factual; Multimedia; Internet; Text Messaging
The problem of entropy generation analysis and natural convection in a nanofluid square cavity with a concentric solid insert and different temperature distributions is studied numerically by the finite difference method. An isothermal heater is placed on the bottom wall while isothermal cold sources are distributed along the top and side walls of the square cavity. The remainder of these walls are kept adiabatic. Water-based nanofluids with Al 2 O 3 nanoparticles are chosen for the investigation. The governing dimensionless parameters of this study are the nanoparticles volume fraction ( 0 ≤ ϕ ≤ 0.09 ), Rayleigh number ( 10 3 ≤ R a ≤ 10 6 ) , thermal conductivity ratio ( 0.44 ≤ K r ≤ 23.8 ) and length of the inner solid ( 0 ≤ D ≤ 0.7 ). Comparisons with previously experimental and numerical published works verify a very good agreement with the proposed numerical method. Numerical results are presented graphically in the form of streamlines, isotherms and local entropy generation as well as the local and average Nusselt numbers. The obtained results indicate that the thermal conductivity ratio and the inner solid size are excellent control parameters for an optimization of heat transfer and Bejan number within the fully heated and partially cooled square cavity.
Kidney image enhancement is challenging due to the unpredictable quality of MRI images, as well as the nature of kidney diseases. The focus of this work is on kidney images enhancement by proposing a new Local Fractional Entropy (LFE)-based model. The proposed model estimates the probability of pixels that represent edges based on the entropy of the neighboring pixels, which results in local fractional entropy. When there is a small change in the intensity values (indicating the presence of edge in the image), the local fractional entropy gives fine image details. Similarly, when no change in intensity values is present (indicating smooth texture), the LFE does not provide fine details, based on the fact that there is no edge information. Tests were conducted on a large dataset of different, poor-quality kidney images to show that the proposed model is useful and effective. A comparative study with the classical methods, coupled with the latest enhancement methods, shows that the proposed model outperforms the existing methods.
This numerical study considers the mixed convection and the inherent entropy generated in Al 2 O 3 -water nanofluid filling a cavity containing a rotating conductive cylinder. The vertical walls of the cavity are wavy and are cooled isothermally. The horizontal walls are thermally insulated, except for a heat source segment located at the bottom wall. The dimensionless governing equations subject to the selected boundary conditions are solved numerically using the Galerkin finite-element method. The study is accomplished by inspecting different ranges of the physical and geometrical parameters, namely, the Rayleigh number ( 10 3 ≤ R a ≤ 10 6 ), angular rotational velocity ( 0 ≤ Ω ≤ 750 ), number of undulations ( 0 ≤ N ≤ 4 ), volume fraction of Al 2 O 3 nanoparticles ( 0 ≤ ϕ ≤ 0.04 ), and the length of the heat source ( 0.2 ≤ H ≤ 0.8 ) . The results show that the rotation of the cylinder boosts the rate of heat exchange when the Rayleigh number is less than 5 × 10 5 . The number of undulations affects the average Nusselt number for a still cylinder. The rate of heat exchange increases with the volume fraction of the Al 2 O 3 nanoparticles and the length of the heater segment.
In this paper, we introduce a new, three-dimensional chaotic system with one stable equilibrium. This system is a multistable dynamic system in which the strange attractor is hidden. We investigate its dynamic properties through equilibrium analysis, a bifurcation diagram and Lyapunov exponents. Such multistable systems are important in engineering. We perform an entropy analysis, parameter estimation and circuit design using this new system to show its feasibility and ability to be used in engineering applications.
In this paper, we study Tsallis' fractional entropy (TFE) in a complex domain by applying the definition of the complex probability functions. We study the upper and lower bounds of TFE based on some special functions. Moreover, applications in complex neural networks (CNNs) are illustrated to recognize the accuracy of CNNs.
Sea cucumbers, blind cylindrical marine invertebrates that live in the ocean intertidal beds have more than thousand species available of varying morphology and colours throughout the world. Sea cucumbers have long been exploited in traditional treatment as a source of natural medicinal compounds. Various nutritional and therapeutic values have been linked to this invertebrate. These creatures have been eaten since ancient times and purported as the most commonly consumed echinoderms. Some important biological activities of sea cucumbers including anti-hypertension, anti-inflammatory, anti-cancer, anti-asthmatic, anti-bacterial and wound healing. Thus, this short review comes with the principal aim to cover the profile, taxonomy, together with nutritional and medicinal properties of sea cucumbers.