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Fulltext Perspectives and Consensus among International Orthopaedic Surgeons during Initial and Mid-lockdown Phases of Coronavirus Disease

Jerome JTJ, Mercier F, Mudgal CS, Arenas-Prat J, Vinagre G, Goorens CK, et al.

J Hand Microsurg, 2020 Dec;12(3):135-162.
PMID: 33408440 DOI: 10.1055/s-0040-1713964

With a lot of uncertainty, unclear, and frequently changing management protocols, COVID-19 has significantly impacted the orthopaedic surgical practice during this pandemic crisis. Surgeons around the world needed closed introspection, contemplation, and prospective consensual recommendations for safe surgical practice and prevention of viral contamination. One hundred orthopaedic surgeons from 50 countries were sent a Google online form with a questionnaire explicating protocols for admission, surgeries, discharge, follow-up, relevant information affecting their surgical practices, difficulties faced, and many more important issues that happened during and after the lockdown. Ten surgeons critically construed and interpreted the data to form rationale guidelines and recommendations. Of the total, hand and microsurgery surgeons (52%), trauma surgeons (32%), joint replacement surgeons (20%), and arthroscopy surgeons (14%) actively participated in the survey. Surgeons from national public health care/government college hospitals (44%) and private/semiprivate practitioners (54%) were involved in the study. Countries had lockdown started as early as January 3, 2020 with the implementation of partial or complete lifting of lockdown in few countries while writing this article. Surgeons (58%) did not stop their surgical practice or clinics but preferred only emergency cases during the lockdown. Most of the surgeons (49%) had three-fourths reduction in their total patients turn-up and the remaining cases were managed by conservative (54%) methods. There was a 50 to 75% reduction in the number of surgeries. Surgeons did perform emergency procedures without COVID-19 tests but preferred reverse transcription polymerase chain reaction (RT-PCR; 77%) and computed tomography (CT) scan chest (12%) tests for all elective surgical cases. Open fracture and emergency procedures (60%) and distal radius (55%) fractures were the most commonly performed surgeries. Surgeons preferred full personal protection equipment kits (69%) with a respirator (N95/FFP3), but in the case of unavailability, they used surgical masks and normal gowns. Regional/local anesthesia (70%) remained their choice for surgery to prevent the aerosolized risk of contaminations. Essential surgical follow-up with limited persons and visits was encouraged by 70% of the surgeons, whereas teleconsultation and telerehabilitation by 30% of the surgeons. Despite the protective equipment, one-third of the surgeons were afraid of getting infected and 56% feared of infecting their near and dear ones. Orthopaedic surgeons in private practice did face 50 to 75% financial loss and have to furlough 25% staff and 50% paramedical persons. Orthopaedics meetings were cancelled, and virtual meetings have become the preferred mode of sharing the knowledge and experiences avoiding human contacts. Staying at home, reading, and writing manuscripts became more interesting and an interesting lifestyle change is seen among the surgeons. Unanimously and without any doubt all accepted the fact that COVID-19 pandemic has reached an unprecedented level where personal hygiene, hand washing, social distancing, and safe surgical practices are the viable antidotes, and they have all slowly integrated these practices into their lives. Strict adherence to local authority recommendations and guidelines, uniform and standardized norms for admission, inpatient, and discharge, mandatory RT-PCR tests before surgery and in selective cases with CT scan chest, optimizing and regularizing the surgeries, avoiding and delaying nonemergency surgeries and follow-up protocols, use of teleconsultations cautiously, and working in close association with the World Health Organization and national health care systems will provide a conducive and safe working environment for orthopaedic surgeons and their fraternity and also will prevent the resurgence of COVID-19.
Reliability and validity of MicroScribe-3DXL system in comparison with radiographic cephalometric system: Angular measurements

Barmou MM, Hussain SF, Abu Hassan MI

Int Orthod, 2018 06;16(2):314-327.
PMID: 29673688 DOI: 10.1016/j.ortho.2018.03.005

AIM: The aim of the study was to assess the reliability and validity of cephalometric variables from MicroScribe-3DXL.
MATERIALS AND METHODS: Seven cephalometric variables (facial angle, ANB, maxillary depth, U1/FH, FMA, IMPA, FMIA) were measured by a dentist in 60 Malay subjects (30 males and 30 females) with class I occlusion and balanced face. Two standard images were taken for each subject with conventional cephalometric radiography and MicroScribe-3DXL. All the images were traced and analysed. SPSS version 2.0 was used for statistical analysis with P-value was set at P<0.05.
RESULTS: The results revealed a significant statistic difference in four measurements (U1/FH, FMA, IMPA, FMIA) with P-value range (0.00 to 0.03). The difference in the measurements was considered clinically acceptable. The overall reliability of MicroScribe-3DXL was 92.7% and its validity was 91.8%.
CONCLUSION: The MicroScribe-3DXL is reliable and valid to most of the cephalometric variables with the advantages of saving time and cost. This is a promising device to assist in diverse areas in dental practice and research.
Comparison of the load at fracture of Turkom-Cera to Procera AllCeram and In-Ceram all-ceramic restorations

AL-Makramani BM, Razak AA, Abu-Hassan MI

J Prosthodont, 2009 Aug;18(6):484-8.
PMID: 19694015

PURPOSE: This study investigated the occlusal fracture resistance of Turkom-Cerafused alumina compared to Procera AllCeram and In-Ceram all-ceramic restorations.
MATERIALS AND METHODS: Sixmaster dies were duplicated from the prepared maxillary first premolar tooth using nonprecious metal alloy (Wiron 99). Ten copings of 0.6 mm thickness were fabricated from each type of ceramic, for a total of thirty copings. Two master dies were used for each group, and each of them was used to lute five copings. All groups were cemented with resin luting cement Panavia F according to manufacturer's instructions and received a static load of 5 kg during cementation. After 24 hours of distilled water storage at 37 degrees C, the copings were vertically compressed using a universal testing machine at a crosshead speed of 1 mm/min.
RESULTS: The results of the present study showed the following mean loads at fracture: Turkom-Cera (2184 +/- 164 N), In-Ceram (2042 +/- 200 N), and Procera AllCeram (1954 +/- 211 N). ANOVA and Scheffe's post hoc test showed that the mean load at fracture of Turkom-Cera was significantly different from Procera AllCeram (p < 0.05). Scheffe's post hoc test showed no significant difference between the mean load at fracture of Turkom-Cera and In-Ceram or between the mean load at fracture of In-Ceram and Procera AllCeram.
CONCLUSION: Because Turkom-Cera demonstrated equal to or higher loads at fracture than currently accepted all-ceramic materials, it would seem to be acceptable for fabrication of anterior and posterior ceramic crowns.
Effect of luting cements on the compressive strength of Turkom-Cera all-ceramic copings

Al-Makramani BM, Razak AA, Abu-Hassan MI

J Contemp Dent Pract, 2008;9(2):33-40.
PMID: 18264523

The objective of this study is to investigate the effect of different luting agents on the fracture strength of Turkom-Cera all-ceramic copings.
General dental practitioners' views on early childhood caries and timing of the first dental visit in Selangor, Malaysia

Hussein AS, Schroth RJ, Abu-Hassan MI

Asia Pac J Public Health, 2015 Mar;27(2):NP2326-38.
PMID: 23420056 DOI: 10.1177/1010539513475645

This survey evaluated the knowledge, attitudes, and practices of general dental practitioners (GDPs) in Selangor regarding early childhood caries (ECC) prevention and the recommended timing of a child's first dental visit. A questionnaire was mailed to 521 licensed GDPs. Descriptive statistics were used, and bivariate and logistic regression analyses were performed. The response rate was 52.6%. Although 89.8% mentioned counseling parents and caregivers, only 44.2% were familiar with anticipatory guidance. Whereas 98.2% agreed that early examinations are important to prevent ECC, only 51.8% were aware of the recommendation for a first visit by 12 months of age. GDPs who recommended early dental visits were significantly more likely to be recent graduates, more familiar with professional guidelines, and less likely to be deterred by a child's crying or behavior. In conclusion, GDPs in Selangor are aware about the importance of early dental visits in ECC prevention. However, a considerable number of them are still not aware of the recommendation that children must first visit the dentist by 12 months of age. Furthermore, some of their current practices in ECC management and prevention do not match professional recommendations.
Fulltext The effectiveness of iron education through a mobile application on donor return after deferral for low hemoglobin

Hasan MI, Noordin SS, Hami R, Ishak N, Achuthan A

Blood Transfus, 2022 Nov;20(6):446-453.
PMID: 35848625 DOI: 10.2450/2022.0018-22

BACKGROUND: Low hemoglobin level is a common cause of donor deferral and results in a huge loss of the donor pool. This study aimed to evaluate the effectiveness of a mobile application as an educational tool to enhance donor return and improve hemoglobin levels after deferral.
MATERIALS AND METHODS: This was an interventional study involving 382 blood donors who were deferred for low hemoglobin. The donors were divided equally into two groups: a control group and the intervention group. The control group received standard management for low hemoglobin deferral, which includes a short counseling session and a 1-month course of oral iron therapy. The intervention group used a mobile application in addition to standard management. The primary endpoint was the number of blood donors who returned during the 7 months of follow-up. The secondary endpoints were the hemoglobin increment at the first visit after the donors' deferral.
RESULTS: The return rate was higher in the intervention group, with 81.2% of the donors returning in the 7 months of follow-up compared to 66% of the control group (p<0.001). Male and female donors had mean hemoglobin increments of 1.0 g/dL and 0.7 g/dL, respectively, in the intervention group, compared to decrements of 0.2 g/dL and 0.4 g/dL, respectively, in the control group (p<0.001). Multivariable analysis showed a significant association between intervention method, education level and donation status on donor return (p=0.015, p<0.001, and p<0.001, respectively).
DISCUSSION: Higher return rate and greater hemoglobin increase in the interventional group could be attributed to features in the mobile application. Repeat donors had the highest odds of returning to donate, followed by those with a tertiary level of education, and those given the mobile application. This study showed that a mobile application was effective in enhancing donor return and increasing hemoglobin level among deferred blood donors on their first return.
Fulltext Effect of Luting Cements On the Bond Strength to Turkom-Cera All-Ceramic Material

Al-Makramani BMA, Razak AAA, Abu-Hassan MI, Al-Sanabani FA, Albakri FM

Open Access Maced J Med Sci, 2018 Mar 15;6(3):548-553.
PMID: 29610618 DOI: 10.3889/oamjms.2018.111

BACKGROUND: The selection of the appropriate luting cement is a key factor for achieving a strong bond between prepared teeth and dental restorations.
AIM: To evaluate the shear bond strength of Zinc phosphate cement Elite, glass ionomer cement Fuji I, resin-modified glass ionomer cement Fuji Plus and resin luting cement Panavia-F to Turkom-Cera all-ceramic material.
MATERIALS AND METHODS: Turkom-Cera was used to form discs 10mm in diameter and 3 mm in thickness (n = 40). The ceramic discs were wet ground, air - particle abraded with 50 - μm aluminium oxide particles and randomly divided into four groups (n = 10). The luting cement was bonded to Turkom-Cera discs as per manufacturer instructions. The shear bond strengths were determined using the universal testing machine at a crosshead speed of 0.5 mm/min. The data were analysed using the tests One Way ANOVA, the nonparametric Kruskal - Wallis test and Mann - Whitney Post hoc test.
RESULTS: The shear bond strength of the Elite, Fuji I, Fuji Plus and Panavia F groups were: 0.92 ± 0.42, 2.04 ± 0.78, 4.37 ± 1.18, and 16.42 ± 3.38 MPa, respectively. There was the statistically significant difference between the four luting cement tested (p < 0.05).
CONCLUSION: the phosphate-containing resin cement Panavia-F exhibited shear bond strength value significantly higher than all materials tested.
Effect of Surface Treatments on the Bond Strength to Turkom-Cera All-ceramic Material

Razak AA, Abu-Hassan MI, Al-Makramani BM, Al-Sanabani FA, Al-Shami IZ, Almansour HM

J Contemp Dent Pract, 2016 Nov 01;17(11):920-925.
PMID: 27965501

AIM: The aim of this study was to evaluate the effect of surface treatments on shear bond strength (SBS) of Turkom-Cera (Turkom-Ceramic (M) Sdn. Bhd., Puchong, Malaysia) all-ceramic material cemented with resin cement Panavia-F (Kuraray Medical Inc., Okayama, Japan).
MATERIALS AND METHODS: Forty Turkom-Cera ceramic disks (10 mm × 3 mm) were prepared and randomly divided into four groups. The disks were wet ground to 1000-grit and subjected to four surface treatments: (1) No treatment (Control), (2) sandblasting, (3) silane application, and (4) sandblasting + silane. The four groups of 10 specimens each were bonded with Panavia-F resin cement according to manufacturer's recommendations. The SBS was determined using the universal testing machine (Instron) at 0.5 mm/min crosshead speed. Failure modes were recorded and a qualitative micromorphologic examination of different surface treatments was performed. The data were analyzed using the one-way analysis of variance (ANOVA) and Tukey honestly significant difference (HSD) tests.
RESULTS: The SBS of the control, sandblasting, silane, and sandblasting + silane groups were: 10.8 ± 1.5, 16.4 ± 3.4, 16.2 ± 2.5, and 19.1 ± 2.4 MPa respectively. According to the Tukey HSD test, only the mean SBS of the control group was significantly different from the other three groups. There was no significant difference between sandblasting, silane, and sandblasting + silane groups.
CONCLUSION: In this study, the three surface treatments used improved the bond strength of resin cement to Turkom-Cera disks.
CLINICAL SIGNIFICANCE: The surface treatments used in this study appeared to be suitable methods for the cementation of glass infiltrated all-ceramic restorations.
Surgical and functional outcomes of cochlear implantation in post-lingual and cross-over patients: First 5-year review of the National Ministry of Health Malaysia cochlear implant programme

Philip Rajan D, Siti Sabzah MH, Zulkiflee S, Tengku Mohamed I, Kumareysh Vijay V, Iskandar H, et al.

Med J Malaysia, 2018 12;73(6):393-396.
PMID: 30647210

INTRODUCTION: There has been a paradigm shift in the management of acquired sensory neural deafness in the past 30years. This is due to the emergence of implantable hearing devices such as the cochlear implant. The objective of this study is to identify surgical and functional outcomes of post-lingual and cross-over patients implanted with a cochlear implant under the National Ministry of Heath Cochlear Implant (CI) Program between 2009-2013.
MATERIALS AND METHODS: We retrospectively reviewed all postlingual and cross-over recipients of cochlear implants under the National Ministry of Heath CI Programme from 2009 to 2013. The outcomes measured were surgical complications and functional outcome. Surgical complications were divided into major and minor complications. Functional outcomes were measured using Categorical Auditory Performances (CAP) scale.
RESULTS: A total of 41 post-lingual and 15 cross-over patients were implanted between 2009 and 2013. The age of implantees ranged from 3.6 years to 63.2 years old. There were two major complications (3.6%), one is a case of electrode migration at three months post implantation, and six months post second implantation. Another was a case of device failure at about one-year post implantation. Both patients were reimplanted in the same ear. There was no minor complication. The CAP score for both groups (overall) showed significant improvement with 96.4% achieved CAP score of five and above at 24 months after implantation (p<0.001). The CAP score showed marked improvement at the first 6 months post implantation and continued to improve with time in both groups.
CONCLUSION: The Malaysian National Ministry of Health Cochlear implant (CI) Program between 2009-2013 has been a successful programme with good surgical and functional outcomes among the post lingual and cross-over patients.
Consumers' views on generic medicines: a review of the literature

Hassali MA, Shafie AA, Jamshed S, Ibrahim MI, Awaisu A

Int J Pharm Pract, 2009 Apr;17(2):79-88.
PMID: 20214255

OBJECTIVES: To review the literature on consumers' knowledge, attitudes and opinions of the use of generic medicines.
METHOD: A narrative review of studies conducted from 1970 to 2008 on consumers perceptions and views towards generic medicines was performed. An extensive literature search was undertaken using indexing services available at the authors' institution library. The following keywords were used for the search: brand, generic, multisource, medications, medicines, drugs, pharmaceuticals and consumers, customers, and patients. Electronic databases searched were Medline, Inside Web, ISI Web of Knowledge, Science Direct, Springer Link, JSTOR, Proquest, Ebsco Host and Google Scholar. These electronic databases were searched for full text papers published in English from 1970 to October 2008.
KEY FINDINGS: Twenty studies were identified. Eleven were from the USA, four were from Europe, two were from Canada and one each was from Australia, Brazil and Malaysia. In general, consumers showed mixed reactions towards the use of generic medicines. This was evident from the divergence of views observed by country development level, consumers' socioeconomic characteristics, drug product characteristics, pharmaceutical reimbursement system, policy environment, contact with health care professionals, past experience with medications, and knowledge of the seriousness of a medical condition.
CONCLUSIONS: Patient confidence and knowledge pertaining to generic medicines use have increased over the past four decades, especially in developed countries. Mass educational efforts, financial incentives, and greater communication among patients and health care professionals were seen as major drivers to the uptake of generic medicines among consumers.
Compliance with legal requirements at community pharmacies: a cross sectional study from Pakistan

Hussain A, Ibrahim MI, Baber ZU

Int J Pharm Pract, 2012 Jun;20(3):183-90.
PMID: 22554161 DOI: 10.1111/j.2042-7174.2011.00178.x

The study evaluated the compliance of community pharmacies with legal requirements as laid down by the drug regulatory framework in Pakistan.
Fulltext Inducible T7 RNA Polymerase-mediated Multigene Expression System, pMGX

Hassan MI, McSorley FR, Hotta K, Boddy CN

J Vis Exp, 2017 06 27.
PMID: 28715370 DOI: 10.3791/55187

Co-expression of multiple proteins is increasingly essential for synthetic biology, studying protein-protein complexes, and characterizing and harnessing biosynthetic pathways. In this manuscript, the use of a highly effective system for the construction of multigene synthetic operons under the control of an inducible T7 RNA polymerase is described. This system allows many genes to be expressed simultaneously from one plasmid. Here, a set of four related vectors, pMGX-A, pMGX-hisA, pMGX-K, and pMGX-hisK, with either the ampicillin or kanamycin resistance selectable marker (A and K) and either possessing or lacking an N-terminal hexahistidine tag (his) are disclosed. Detailed protocols for the construction of synthetic operons using this vector system are provided along with the corresponding data, showing that a pMGX-based system containing five genes can be readily constructed and used to produce all five encoded proteins in Escherichia coli. This system and protocol enables researchers to routinely express complex multi-component modules and pathways in E. coli.
A rapid micro quantification method of paracetamol in suppositories using differential scanning calorimetry

Noordin MI, Chung LY

Drug Dev Ind Pharm, 2004;30(9):925-30.
PMID: 15554216

This study adopts Differential Scanning Calorimetry (DSC) to analyze the thermal properties of samples (2.5-4.0 mg) from the tip, middle, and base sections of individual paracetamol suppositories, which were sampled carefully using a stainless steel scalpel. The contents of paracetamol present in the samples obtained from these sections were determined from the enthalpies of fusion of paracetamol and expressed as % w/w paracetamol to allow comparison of the amount of paracetamol found in each section. The tip, middle, and base sections contained 10.1+/-0.2%, 10.1+/-0.2%, and 10.3+/-0.2% w/w paracetamol, and are statistically similar (One-way anova; p>0.05). This indicates that the preparation technique adopted produces high quality suppositories in terms of content uniformity. The contents of paracetamol in the 120-mg paracetamol suppositories determined by DSC and UV spectrophotometry were statistically equivalent (Students's t-test; p>0.05), 120.8+/-2.6 mg and 120.8+/-1.5 mg, respectively, making DSC a clear alternative method for the measurement of content of drug in suppositories. The main advantages of the method are that samples of only 2.5-4.0 mg are required and the procedure does not require an extraction process, which allows for the analysis to be completed rapidly. In addition, it is highly sensitive and reproducible, with the lower detection limit at 4.0% w/w paracetamol, which is about 2.5 times lower than the content of paracetamol (10% w/w) present in our 120-mg paracetamol suppositories and commercial paracetamol suppositories, which contained about 125 mg paracetamol. Therefore, this method is particularly suited for determination of content uniformity in individual suppositories in quality control (QC) and in process quality control (PQC).
A comparison of different standard-setting methods for professional qualifying dental examination

Abd-Rahman ANA, Baharuddin IH, Abu-Hassan MI, Davies SJ

J Dent Educ, 2021 Jul;85(7):1210-1216.
PMID: 33792052 DOI: 10.1002/jdd.12600

BACKGROUND: The outcome of assessments is determined by the standard-setting method used. Standard setting is the process of deciding what is good enough. A cutoff score of 50% was commonly used in dental schools in Malaysia. This study aims to compare the conventional, norm-referenced, and modified-Angoff standard-setting methods.
METHODS: The norm-referenced method of standard setting was applied to the real scores of 40 final-year dental students on a multiple-choice question (MCQ), a short answer question (SAQ), and an objective structured clinical examination (OSCE). A panel of 10 judges set the standard using the modified-Angoff method for the same paper in one sitting. One judge set the passing score of 10 OSCE questions after 2 weeks. A comparison of the grades and pass/fail rates derived from the absolute standard, norm-referenced, and modified-Angoff methods was made. The intra-rater and inter-rater reliabilities of the modified-Angoff method were assessed.
RESULTS: The passing rate for the absolute standard was 100% (40/40), for the norm-referenced method it was 62.5% (25/40), and for the modified-Angoff method it was 80% (32/40). The modified-Angoff method had good inter-rater reliability of 0.876 and excellent test-retest reliability of 0.941.
CONCLUSION: There were significant differences in the outcomes of these three standard-setting methods, as shown by the difference in the proportion of candidates who passed and failed the assessment. The modified-Angoff method was found to have good reliability for use with a professional qualifying dental examination.
Fulltext Subxiphoid uniportal lobectomy

ElSaegh MMM, Ismail NA, Mydin MI, Nardini M, Dunning J

J Vis Surg, 2017;3:24.
PMID: 29078587 DOI: 10.21037/jovs.2016.12.05

Video-assisted thoracic surgery (VATS) surgery has seen an evolution from multiple ports to uniportal and finally subxiphoid uniportal recently. In traditional VATS surgery, the instruments and the thoracoscope enter the thoracic cavity through two to four operating ports on the lateral chest wall, which can cause chronic pain and chest wall numbness. However single-portal VATS surgery could potentially cause similar problems as the port is placed in between the ribs. In March 2015 Liu et al. reported a VATS bilateral pulmonary metastasectomy and right middle lobectomy via a subxiphoid uniportal technique. The advantage of the uniportal subxiphoid approach is the ability to use different size of instruments and freedom of movement as there is no limitation by the ribs. Post-operative pain typically experienced due to bruising of the intercostal nerves is also avoided in this approach. Shanghai Pulmonary hospital has taken VATS surgery to the next level with subxiphoid uniportal VATS (SVATS) lung resection, whereby this method is performed in large volumes of cases. Here we describe our experience of a uniportal subxiphoid VATS right middle lobectomy using the Shanghai technique, the first in the UK. A uniportal sub-xiphoid lobectomy was performed on a 62-year-old lifelong smoker male patient with a histological diagnosis of right middle lobe adenocarcinoma, measuring 1.5 cm and radiological staging of T1aN0M0. We have been performing microlobectomies in our institution (with the utility port placed in the subxiphoid region) which is technically similar to this approach. This is the first subxiphoid uniportal lobectomy performed in the UK. The operation was done successfully and the patient was discharged home 2 days later without any complications.
Assessment of burnout, resilience, and thriving among academic health professionals: findings from an international study

Nahas ARF, Elnaem MH, Mubarak N, Khatwa MA, Barakat M, Faller E, et al.

Front Public Health, 2024;12:1366612.
PMID: 38645445 DOI: 10.3389/fpubh.2024.1366612

INTRODUCTION: Burnout, resilience, and thriving significantly impact academics, particularly in health professions, where responsibilities are extensive. This study aimed to explore these constructs among academic health professionals, examining sociodemographic and work-related factors influencing these outcomes.
METHODS: A cross-sectional study was conducted among academic health professionals via web-based professional networks from August 2022 to February 2023. Validated tools were used, and descriptive and inferential statistics were applied.
RESULTS: 505 participants were included, predominantly female (63%), with a mean age of 38.15 ± 9.6 years. High burnout was reported by 10.9%, 13.7% experienced exhaustion, and 6.3% were disengaged. Resilience and thriving were moderate at 59.2 and 51.9%, respectively. Age correlated negatively with burnout (r = -0.131, p = 0.003) but positively with resilience (r = 0.178, p
Fulltext Coconut oil and cholesterol as challenge agents to induce hyperlipidemia and atherosclerosis in hamster animal model

Syarifah-Noratiqah, S.B., Zulfarina, M.S., 'Atiqah, A., Qodriyah, H.M.S., Naina-Mohamed, I., Fairus, S.

Medicine & Health, 2018;13(1):29-48.
MyJurnal

Hyperlipidemia is a condition of high lipid levels in the plasma and often linked with the deposition of lipid droplets in the aorta which initiate the progression of atherosclerosis. Atherosclerosis is a common cardiovascular disorder initiated by the formation of foams cells in the vascular wall which leads to turbulent blood flow, injury to the endothelial layer and subsequent vascular thrombosis. Since the early 1980’s, Golden-Syrian hamsters have been widely used as an animal model in the research of hyperlipidemia and atherosclerosis. The use of hamsters in the hyperlipidemic and atherosclerotic model is due to their lipoprotein profile that is closer to human setting, sensitive to high-fat high-cholesterol (HFHC) diet and a suitable rodent model. Atherosclerosis can be induced in hamsters through dietary challenge with HFHC diet. Over the decades, coconut oil (CNO) was commonly used as the source of fat in the diet design of high saturated fatty acids (SFA) composition. In this review, we summarized published literature with designs involving CNO plus cholesterol-induced hyperlipidemia, atherosclerosis or both. The factors that may influence the ability of CNO and cholesterol combination to induce hyperlipidemia such as the period of dietary intervention, hamster strains and the dietary amount were evaluated and summarized.
Fulltext Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Burstein R, Henry NJ, Collison ML, Marczak LB, Sligar A, Watson S, et al.

Nature, 2019 Oct;574(7778):353-358.
PMID: 31619795 DOI: 10.1038/s41586-019-1545-0

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2-to end preventable child deaths by 2030-we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000-2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations.
Fulltext Biomechanics in Removable Partial Dentures: A Literature Review of FEA-Based Studies

Mousa MA, Abdullah JY, Jamayet NB, El-Anwar MI, Ganji KK, Alam MK, et al.

Biomed Res Int, 2021;2021:5699962.
PMID: 34485518 DOI: 10.1155/2021/5699962

The present study was aimed at reviewing the studies that used finite element analysis (FEA) to estimate the biomechanical stress arising in removable partial dentures (RPDs) and how to optimize it. A literature survey was conducted for the English full-text articles, which used only FEA to estimate the stress developed in RPDs from Jan 2000 to May 2021. In RPDs, the retaining and supporting structures are subjected to dynamic loads during insertion and removal of the prosthesis as well as during function. The majority of stresses in free-end saddle (FES) RPDs are concentrated in the shoulder of the clasp, the horizontal curvature of the gingival approaching clasp, and the part of the major connector next to terminal abutments. Clasps fabricated from flexible materials were beneficial to eliminate the stress in the abutment, while rigid materials were preferred for major connectors to eliminate the displacement of the prosthesis. In implant-assisted RPD, the implant receive the majority of the load, thereby reducing the stress on the abutment and reducing the displacement of the prosthesis. The amount of stress in the implant decreases with zero or minimal angulation, using long and wide implants, and when the implants are placed in the first molar area.
Impact of Ramadan fasting on disease activity in patients with multiple sclerosis: a multicenter study

Hassan A, Merghany N, Ouchkat F, Regragui W, Kedah H, Hamdy SM, et al.

Nutr Neurosci, 2021 Nov 28.
PMID: 34842062 DOI: 10.1080/1028415X.2021.2006955

BACKGROUND: The safety of Ramadan fasting for Muslim patients suffering from multiple sclerosis (MS) is still a matter of debate. This work aimed to study the clinical course of MS during Ramadan fasting and to clarify the predictors of relapses and symptoms exacerbation.
METHODS: This retrospective study included 153 Muslim patients with MS. Data related to the disease course before Ramadan were obtained from patients' files, whereas data related to the disease activity during Ramadan, were collected from patients over the two months following Ramadan.
RESULTS: Patients with MS who experienced relapses, exacerbation of symptoms and development of new symptoms during Ramadan had a statistically significant longer disease duration compared to those who did not experience (P < 0.001, <0.001, 0.01 respectively). Also, patients who experienced relapses, exacerbation of symptoms and development of new symptoms during Ramadan had a statistically significant higher expanded disability status scale (EDSS) compared to those who did not experience (P <0.001, <0.001,0.01, respectively). The occurrence of relapses, exacerbation of symptoms and development of new symptoms during Ramadan, were significantly higher in patients who experienced relapses in the preceding year compared to those who did not (P= 0.002, 0.002, 0.01, respectively). Binary logistic regression revealed that each score elevation of EDSS increased the odds of relapse during Ramadan by 1.02 (P-value = 0.04). Also, each month's increase in disease duration increased the odds of relapse during Ramadan by 1.87 (P-value = 0.046).
CONCLUSION: High EDSS and long disease duration are independent predictors of relapse during Ramadan.

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