Vertebrobasilar Dolichoectasia (VBD) is a condition characterized by abnormal elongation, dilatation and tortuosity of the vertebrobasilar system. It is usually asymptomatic but rarely, it can present with cranial nerve compression symptoms. We present a case of simultaneous trigeminal neuralgia and hypoglossal nerve palsy due to compression by VBD. Neuroimaging plays an important role in diagnosing this condition so that further treatment can be provided.
Bilharziasis is a tropical parasitic disease caused by different species of the genus Schistosoma. One species, S. haematobium, is widely spread in Sudan. There is a scarcity of information about S. haematobium infection among the fishermen in the country. Therefore, this study was designed to determine the prevalence of S. haematobium infection among fishermen, and the immune status among non-infected fishermen in two villages, El Hadib and Hawer-Ajowel at the White Nile state in Sudan. A cross-sectional survey was conducted among 119 fishermen in addition to 20 samples from non-endemic area which were included as a control group. Urine samples were examined by sedimentation method and faecal samples were examined by the Kato Katz method and formalin-ether concentration technique. Blood samples were examined for enumeration of IgE antibody and cytokines, interferon Gamma (IFN-γ), Tumor Necrosis Factor (TNF) and Interleukin10 (IL–10) levels using ELISA. The result of the study indicated that the overall prevalence of S. haematobium among the fishermen was 35 (29.41 %). Of the 35 positive participants, 23 (65.71 %) were infected for the first time, and 12 (34.29 %) for the second time (re-infection). Twenty-four candidates of the non-infected fishermen were included in the immunological study. The total IgE mean titer was 282.90 ±70.93 iu/ml, IFN-γ mean level was 9.62±4.60 pg/ml. TNF, 114.64±46.63 pg/ml and the IL–10 was 1.51±0.58 pg/ml. High prevalence of S. haematobium exists among fishermen and the non-infected fishermen from the endemic area showed high immune response similar to those exposed to the infection.
The COVID-19 pandemic resulted in 5 consecutive Movement Control Orders (MCOs) in Malaysia in an attempt to flatten the epidemiological curve, with a reduction of cases. This study aims to use statistical analysis to assess whether the decisive public health interventions in the MCO were efficacious. Three statistical tests were employed: Mann-Kendall trend analysis; one way between groups ANOVA; and Pearson correlation test. Results demonstrated significant differences between the second block, MCO 3-5, compared to MCO 1-2. Johor and Selangor states experienced significant increase in early MCO, whereas Sarawak and Selangor states experienced significant decrease by MCO 3-5. The northern border states of Kedah, Perlis and Kelantan, had caseloads stabilised to zero by MCO 4/MCO 5. This study demonstrates that the MCO was effective within the target of twice the two-week incubation period of COVID-19, with cases from community transmission and importation through the air and southern land borders. Selangor and Sarawak had higher cases in early MCO due to situational factors. In conclusion, MCO has been efficacious, with different states attaining different levels of case reduction due to individualised reasons.
The sudden surge in the number of healthcare utilizations compels the hospital to plan for its future needs. Several time-series projections of Covid-19 were conducted to forecast the disease burden and resources utilization through simple predictive analytics. The projections revealed a rapid increase in the number of cases and patient in care at the hospital. It was estimated that the number of patients in care to range from 62 to 81 and 89 to 121 patients daily in the second and third phase of movement control order respectively. It was estimated that more than 100,000 plastic aprons, 80,000 sterile and non-sterile isolation gowns, 40,000 masks N95 and face shields, 30,000 gloves and nearly 17,000 bottles of hand sanitizers are needed until late May. Hence, a simple mathematical algorithm is a helpful tool to manage hospital resources during the pandemic.
Reverse transcriptase polymerase chain reaction (RT-PCR) assays for coronavirus disease 2019 (COVID-19) should be interpreted with clinical, epidemiological history and exposure risk to avoid misdiagnosis. We report a cruise-ship worker with significant travelling history, presented with acute respiratory symptoms and radiographic evidence of viral pneumonia. Initial RNA-dependent RNA polymerase (RdRp) gene confirmatory assay was negative. Use of a more robust RT-PCR assay detected ORF1ab, N and S genes for COVID-19, and the diagnosis was supported by an IgM and IgG positive COVID-19 serology. Subsequent follow up samples which reported inconsistencies in detecting RdRp gene also raise the concern of reliability of RdRp gene as the confirmatory assay for diagnosis of COVID-19. Patient later had prolonged viral shedding beyond serological recovery, with a negative viral culture reflecting non-infectivity.
Cardiorespiratory fitness (CRF) refers to the capacity of the circulatory and respiratory systems to supply oxygen to skeletal muscle mitochondria for energy production needed during physical activity. CRF is an important marker of physical and mental health and academic achievement in youth. However, only 40% of US youth are currently believed to have healthy CRF. In this statement, we review the physiological principles that determine CRF, the tools that are available to assess CRF, the modifiable and nonmodifiable factors influencing CRF, the association of CRF with markers of health in otherwise healthy youth, and the temporal trends in CRF both in the United States and internationally. Development of a cost-effective CRF measurement process that could readily be incorporated into office visits and in field settings to screen all youth periodically could help identify those at increased risk.
MeSH terms: Adolescent; American Heart Association*; Humans; Mental Health*; United States; Exercise*; Cardiorespiratory Fitness*
Endless industrial development and growing society occasionally create an enormous volume of wastewater, which leads to some issues on wastewater treatment. Existing conventional screening processes have various limitations and drawbacks. Therefore, this study investigated the use of a combination of non-corrosive stainless steel wool and a permanent magnet to increase magnetic gradient, hence reducing suspended matter in sewage through turbidity test. An approach for optimizing the reduction of suspended matter through turbidity analysis was conducted using central composite design (CCD) under response surface methodology (RSM). Three critical independent variables, such as magnet strength, circulation time, and steel wool, and turbidity removal as the response, were further studied to analyze their interaction effects. As a result, an optimal value of turbidity removal was found at 90.3% under the specified optimum conditions of magnet strength of 245 mT, 116 g of non-corrosive stainless steel wool, and 16 h of circulation time. Statistical analysis had shown that the magnet strength, circulation time, and steel wool significantly affected the turbidity removal performance. Furthermore, design of experiment was significantly verified by a small range of error between predicted and actual data. Consequently, a higher gradient of magnetic separation was proven to effectively remove suspended matter using inexpensive non-corrosive stainless steel wool without using magnetic adsorbent. Thus, the suggested approach was found to be cost-effective and environmentally friendly for sewage treatment.
The study aimed at using satellite remote sensing in identifying the land-use changes that have occurred in Lafia, Nigeria within the past 35 years, especially in relation to the current and the predicted future invasion of a fern (Pneumatopteris afra). Landsat satellite images OLI/TIRS, ETM+ and TM within the interval of 15 years from 1985 to 2020 were used for the extraction of land-use. Six broad classification systems were used to classify the land-use changes by employing a supervised classification technique. In 1985, the bare land dominated the land-use having an area of 69156 ha while the wetland was the least having an area of 3412 ha. However, in 2020, the built-up area has dominated the land-use of Lafia with an area of 144645 ha (52.21%) while the wetland still remained the least with area of 1477 ha. This is obviously due to the geometric increase in the urbanization of this city. There was a consistent loss of the forests from 1985 to 2020 with an annual rate of loss of 0.46%. This resulted in a loss of 44329 ha of forests in 2020 out of the 47643 ha in 1985. This approximately leads to a total loss of 172,732,045 USD of forest products. The current invasion of Pneumatopteris afra in Lafia was found to fall within the shrub and grasses land-use class. This indicates that the landsat satellite could not detect the wetlands where the plant dominated due to its massive covering. This study calls for immediate conservation of the remaining forests and wetlands in Lafia to prevent further encroachments and invasion by plants.
Food distribution and diversity is a significant factor that determines the habitat and site selection of avian species. Its effects on the health, reproduction, survival rate, diversity indices, population structure and home range of avian species. In wetland ecosystem, bird home range and population structure is influenced by richness and diversity of food resources and availability of suitable foraging sites. The aim of the study was to ascertain the food variety of Lesser Whistling Duck – Dendrocygna javanica in Paya Indah Wetland Reserve (PIWR). A scan method was employed from strategic places or blinds using a spotting scope and binocular to determine the food selection and density by Distance sampling point count method. Food items were categorised into the aquatic plants (AP), aquatic invertebrates (AIV), aquatic vertebrates (AV), terrestrial plants (TP), terrestrial vertebrates (TV) and terrestrial invertebrates (TIV). Distance analysis indicated that PIWR harboured 3.88 ± 0.00 birds per ha (n = 188 individuals). In addition, the results revealed that higher bird relative abundance of Lesser Whistling Duck concentrated in the shallow of Belibis lake that was rich in submerged and emergent vegetation (Eleocharis dulcis, Philydrum lanuginosum, Utricularia vulgaris, and Potamogeton perfoliatus). Kruskal–Wallis H test showed that food items were significantly different. Lesser Whistling Duck showed strong correlationship with AIV (r2 = 1.00, P < 0.05) and negative relationship with water TP (r2 = –0.061, P< 0.05). The regression model highlighted that Lesser Whistling Duck significantly preferred aquatic invertebrates, r2 = –0.686±0.68; P
Aortic dissection (AD) is a rare cardiovascular emergency with a high rate of mortality. Most patients present with typical signs and symptoms of AD. However, atypical presentation increases risk of delay in diagnosis and treatment. Patients may present with syncope, seizures or other neurological symptoms which may deceive the diagnosis of AD. Dissection can be in the acute or chronic phase, but there has been no documentation of an acute dissection which occurs in a chronic dissection. We hereby to report a case of an acute on chronic thoraco-abdominal dissection.
Epidermal cyst is the most common type of cyst to occur in subcutaneous tissue. It is usually small, asymptomatic, and solitary in lesion. When the size is greater than 5 cm, it is classified as a giant epidermal cyst. If the size is big, it may sometimes mimic a soft tissue sarcoma, hence requiring further evaluation with imaging or histopathological studies. We report a case series of two patients whom presented with a huge swelling at different body regions, involving gluteal and chest. Both patients underwent different modes of imaging to delineate the anatomical extent of the lesion. Excision biopsy was done and the histopathological report confirmed epidermal cyst with no malignancy. The purpose of this case series is to describe the rare occurrence of giant epidermal cyst and to elaborate the methods of approach to arrive at the diagnosis.
Wound management is important as it helps to promote healing without microbial infection. Euphorbia hirta, a species of Euphorbiaceae family, also known as Ara tanah among Malaysians, is traditionally used to promote wound healing where its poultice is applied to the sores on the legs, bruises and wounds. Several reported pharmacological properties including antioxidant, antimicrobial, antidiabetic, anti-anaphylactic activities have been reported on this plant. The aim of this review was to evaluate the wound healing effects of E. hirta. Information involving only in vivo studies on wound healing effect of E. hirta was searched using electronic databases. The electronic databases include PubMed, Google Scholar, Ovid, CENTRAL, LILACS, and ClinicalTrials.gov from year 1962 to 2020. A total of five out of 70 studies were included and assessment was made. All included articles studied different wound models in rats. All showed significant wound healing activity with different mechanism of action for incision, excision and dead space wound. Quality assessment of the included studies suggested that experimental animal study design can be improved. It can be concluded that E. hirta displayed potential as a wound healing agent in vivo studies although further research on structure-activity relationship of compounds responsible for the wound healing effect and toxicological studies before it can proceed to clinical studies.
Information regarding water fluoridation (WF) in Malaysia has been substantially documented, but is scattered in various government publications and may be lost to the stakeholders. This paper is a review of water fluoridation in Malaysia and its effect on oral health: a history of WF in Malaysia, the current policy, the evidence of its effectiveness, the challenges and the future directions. A search for relevant physical and electronic documents of WF in Malaysia resulted in the identification of 70 documents for review. WF was gazetted as national policy with an optimal fluoride level of 0.7 parts-per-million (ppm) in 1972, with a reduction of the level to 0.5 ppm in 2005. Evidence showed that WF effectively reduced population dental caries while fluorosis was not a prevalent public health concern. Strong collaboration between stakeholders and the extensive network of piped water supplies resulted in 80% of the population receiving WF in 2013. However, the coverage was reduced to 74.1% in 2018, largely due to the cessation of WF in Pahang. The key challenges in WF included a lack of funding, weak legislation, use of reverse osmosis water filtration system, difficulty to maintaining an optimal level of fluoride in the water, and lack of local data on the impact of WF cessation on oral health, and its cost-effectiveness. This review will provide dental health professionals with scientific evidence on WF and oral health in Malaysia and assist them in answering relevant questions about WF raised by the public.
The undergraduate dental degree in Malaysia is regulated by the Malaysian Dental Council (MDC) (Standard of Undergraduate Competencies), Code of Professional Conduct of the Malaysian Dental Council, the Malaysian Qualification Framework 2.0 and the Malaysian Quality Agency (MQA) quality assurance documents. These primary documents emphasize the importance of professional ethics and law in dentistry as will be further detailed and discussed later. This study reflects on the need to integrate ethics, professionalism and law with sufficient coverage in terms of content and emphasis in the dental undergraduate curriculum. Literature and benchmarking practices are reviewed for a deeper reflection of the current needs in a professional dental ethics and law education course. The present study is primarily focused on regulatory requirements, legal cases and comparative literature to serve as a reference on how professional ethics and law courses may be conducted. As an incidental measure, a reflection as to how the course of study of professional ethics is delivered in a local university is considered in a selected local university’s undergraduate dental curriculum. The findings indicate that ethics professionalism and dental law is not given sufficient emphasis as it is included as one of the minor components within another overcrowded subject and the coverage of what is taught is limited in context. This paper is an invitation to all dental schools to review and reflect whether, given the emphasis on professional ethics, legal and regulatory compliance in the regulatory documents, it is adequately reflected in their dental curriculum. In this regard, some benchmarking references are done to suggest what such a course should cover, for consideration of the dental schools.
Introduction: Dental anxiety is a common problem faced by dental practitioners worldwide. Generally, the management of dental anxiety can be classified as pharmacological and non-pharmacological approaches, in multiple studies and reports available on this subject.
Aims and objectives: This paper will provide a general overview of the pharmacological and nonpharmacological strategies in the management of dental anxiety, supported by dental literature. This would help dental practitioners understand the benefits and limitations of the different methods of treating their anxious patients.
Methodology: This is a narrative review and a summary of the different approaches and methods available in the management of dental anxiety. Relevant articles were searched from the online databases of PubMed, ScienceDirect, and Google Scholar, and the keywords used to identify the papers were ‘Dental Anxiety’, ‘Pharmacological’, and ‘Non-pharmacological’.
Conclusion: Appropriate management of dental anxiety is crucial to ensure a successful dental procedure. The choice of the anxiety management must be based on the complete understanding of the particular patient, identifying the source of anxiety, and working hand-in-hand with the patient for better oral health care.
Studies have found the association between hypercholesterolemia with oxidative stress and atherogenesis. Atherosclerosis has become one of the leading causes of mortality among industrial countries due to abnormal cholesterol metabolism, inflammation of arterial wall and build-up of atherosclerotic plaque. This disease has been recently linked with alpha lipoic acid (ALA), a mitochondrial compound with antioxidative effects in water- and fat-soluble mediums, in both oxidized and reduced forms: lipoic acid (LA) and dihydrolipoic acid (DHLA), respectively. This article provides a comprehensive review of the development and progression of atherosclerosis and the roles and regulations of ALA as a potent antioxidant against atherosclerosis.
According to tradition, plants and herbs are potential cures for numerous illnesses. In recent decades, they have gained worldwide recognition as critical sources of new drugs, especially for cancer, and the focus on medicinal plant research has increased tremendously. Currently, research scientists attribute the occurrence of post-chemotherapy tumour exacerbation to the presence of cancer stem cells hidden in the bulk of the malignant tumour, forming a rare subpopulation that plays a major role in tumour re-initiation, progression and recurrence. There is increasing evidence of cancer stem cells in a wide array of tumours, and these cells could be the crucial target for future chemotherapy approaches. This review of the major plant-basedphy to chemicals with documented antagonistic activities against cancer stem cells, their molecular targets and the mechanisms involved, may serve as a guide for developing from the existing natural agents, more effective, and broader spectrum anti-cancer stem cell compounds with the potential for clinical application.
Fibroblast growth factor 2 (FGF-2) is a multifunctional protein that has major roles in wound healing, tissue repair, and regeneration. This therapeutic protein is widely used for burn treatment because it can stimulate cell proliferation and differentiation, angiogenesis, and extracellular matrix remodeling. In this study, we developed a simple method using a controlled heated brass rod to create a homogenous third-degree burn murine model and evaluated the treatment using recombinant human FGF-2 (rhFGF-2). The results indicated that the wound area was 0.83 ± 0.05 cm2 and wound depth was 573.42 ± 147.82 μm. Mice treated with rhFGF-2 showed higher rates of wound closure, granulation tissue formation, angiogenesis, and re-epithelialization than that of phosphate-buffered saline (PBS)-treated group. In conclusion, our lab-made rhFGF-2 could be a potentially therapeutic protein for burn treatment as well as a bioequivalent drug for other commercial applications using FGF-2.
Congenital heart disease (CHD) is the result of a complicated interplay between genetic and non-genetic, or “environmental,” factors acting on the foetus and one of those environmental factors is maternal hyperglycemia. Maternal diabetes has teratogenic effects on the evolution of the foetal cardiovascular system; as a consequence, cardiovascular malformations are the most common anomalies in infants of diabetic mothers with transposition of the great arteries, tricuspid atresia and truncus arteriosus being some of the common cardiac malformations encountered. Thus, it is important to perform a detailed heart examination at autopsy of perinatal deaths in order to ascertain related anomalies. We present a case of stillbirth in a woman with Type 1 Diabetes mellitus on insulin therapy who claims she was unaware about her pregnancy.
Background: Strength of leg musculature is crucial to generate propulsive force during rowing. The purpose of this study was to determine the relationship of isokinetic dominant leg strength and 2 km time trial on stationary rowing ergometer among male national rowers.
Methods: Seventeen male national rowers were recruited for the study. Their hip and knee isokinetic strength were determined in the sagittal plane at 60°/s angular velocity. The relationship between the hip and knee strength, and 2 km time trial performance were evaluated using Pearson correlation.
Results: The national rowers completed the 2 km time trial duration in 7.20±0.39 minutes. The hamstring to quadriceps ratio (H:Q) was significantly correlated to 2 km time trial performance (r=-0.491, p=0.045). No other significant relationships between hip and knee isokinetic strength and 2 km time trial performance were observed.
Conclusion: Increased isokinetic knee strength ratio (H:Q) may enhance 2 km time trial performance among male national rowers. Other isokinetic variables of hip and knee isokinetic strength were not significantly related to 2 km time trial.