In this study, a chitosan co-polymer scaffold was prepared by mixing poly(vinyl alcohol) (PVA), NO, carboxymethyl chitosan (NOCC) and polyethylene glycol (PEG) solutions to obtain desirable properties for chondrocyte cultivation. Electron beam (e-beam) radiation was used to physically cross-link these polymers at different doses (30 kGy and 50 kGy). The co-polymers were then lyophilized to form macroporous three-dimensional (3-D) matrix. Scaffold morphology, porosity, swelling properties, biocompatibility, expression of glycosaminoglycan (GAG) and type II collagen following the seeding of primary chondrocytes were studied up to 28 days. The results demonstrate that irradiation of e-beam at 50 kGy increased scaffold porosity and pore sizes subsequently enhanced cell attachment and proliferation. Scanning electron microscopy and transmission electron microscopy revealed extensive interconnected microstructure of PVA-PEG-NOCC, demonstrated cellular activities on the scaffolds and their ability to maintain chondrocyte phenotype. In addition, the produced PVA-PEG-NOCC scaffolds showed superior swelling properties, and increased GAG and type II collagen secreted by the seeded chondrocytes. In conclusion, the results suggest that by adding NOCC and irradiation cross-linking at 50 kGy, the physical and biological properties of PVA-PEG blend can be further enhanced thereby making PVA-PEG-NOCC a potential scaffold for chondrocytes.
The radioprotective effect of Polyalthia longifolia was studied in mice. P. longifolia treatment showed improvement in mice survival compared to 100% mortality in the irradiated mice. Significant increases in hemoglobin concentration, and red blood cell, white blood cell and platelet counts were observed in the animals pretreated with leaf extract. Pre-irradiation administration of P. longifolia leaf extract also increased the CFU counts of the spleen colony and increased the relative spleen size. A dose-dependent decrease in lipid peroxidation levels was observed in the animals pretreated with P. longifolia. However, although the animals pretreated with P. longifolia exhibited a significant increase in superoxide dismutase and catalase activity, the values remained below normal in both liver and the intestine. Pre-irradiation administration of P. longifolia also resulted in the regeneration of the mucosal crypts and villi of the intestine. Moreover, pretreatment with P. longifolia leaf extract also showed restoration of the normal liver cell structure and a significant reduction in the elevated levels of ALT, AST and bilirubin. These results suggested the radioprotective ability of P. longifolia leaf extract, which is significant for future investigation for human applications in developing efficient, economically viable, non-toxic natural and clinically acceptable novel radioprotectors.
This is a case of a 62-year-old Indian man who was diagnosed with a rare type of lung
neuroendocrine tumour (NET) of atypical carcinoid (AC) subtype which comprises only 0.1%–
0.2% of pulmonary neoplasms. He initially presented to a private hospital in May 2018 with a
6-month history of chronic productive cough and haemoptysis. Chest X-Ray (CXR), CT scan,
bronchoscopy, biopsy and broncho-alveolar lavage were conducted. At this stage, imaging and
histopathological investigations were negative for malignancy. Diagnosis of bronchiectasis was
made and he was treated with antibiotic and tranexamic acid. Due to financial difficulties, his
care was transferred to a university respiratory clinic in June 2018. His condition was monitored
with CXR at every visit and treatment with tranexamic acid was continued for 6 months.
However, due to persistent haemoptysis, he presented to the university primary care clinic in
Dec 2018. Investigations were repeated in January 2019 where his CXR showed increased
opacity of the left retrocardiac region and CT scan revealed a left lower lobe endobronchial
mass causing collapse with mediastinal lymphadenopathy suggestive of malignancy.
Bronchoscopy, biopsy and histopathology confirmed the presence of NET. Although the Ki-67
index was low, the mitotic count, presence of necrosis and evidence of liver metastases
favoured the diagnosis of AC. A positron emission tomography Ga-68 DONATOC scan showed
evidence of somatostatin receptor avid known primary malignancy in the lungs with suspicions
of liver metastasis. He was subsequently referred to the oncology team and chemotherapy was
initiated. This case highlights the challenge in diagnosis and management of patients with AC.
Physicians ought to be vigilant and have a high index of suspicion in patients who present with
persistent symptoms on multiple visits. Early diagnosis of NET would prevent metastasis and
provide better prognosis. Continuous follow-up shared care between primary care and
secondary care physicians is also essential to provide ongoing psychosocial support for
patients with NET, especially those with metastatic disease
This article aims to report a case of a young female patient with anti-neutrophil cytoplasmic antibodies-associated vasculitis complicated with pulmonary renal syndrome, multiple relapses, and who later developed venous thromboembolism. Pulmonary renal syndrome is a well- recognized and lethal complication; however, incidence of venous thromboembolism has not been well-described. In this article, we described a 38-year-old Malay female patient admitted in 2008 with three-month history of peripheral neuropathy of lower limbs and right ankle ulcers. Initial inflammatory markers were high and perinuclear Anti-Neutrophil Cytoplasmic Antibodies were positive. She was diagnosed as anti-neutrophil cytoplasmic antibodies-associated vasculitis and started on intravenous methylprednisolone with methotrexate. She presented with relapse of skin vasculitis complicated with pulmonary renal syndrome after being stable for one year. She was intubated and proceeded with plasmapheresis and hemodialysis. She completed six cycles of cyclophosphamide. Renal biopsy revealed chronic changes consistent with end stage renal disease. She further relapsed in 2011 with nasal blockage, epistaxis, and nasal deviation. Chest X-ray revealed lung nodules. Prednisolone was increased, her symptoms settled, and she was discharged with azathioprine. She was readmitted at the end of the same year due to two-day history of right deep vein thrombosis and she later succumbed to methicillin-resistant Staphylococcus aureus sepsis.
A new isomers of thiourea derivatives, namely N-(4-chlorobutanoyl)-N'-(2-methylphenyl)-thiourea (1a), N-(4-chlorobutanoyl)-N'-(3-methylphenyl)thiourea (1b) and N-(4-chlorobutanoyl)-N'-(4-methylphenyl)thiourea (1c) have been synthesized by refluxing mixture of equimolar amounts of 4-chlorobutanoylisothiocyanate with 2, 3 or 4-toluidine, respectively. The three isomers were characterized by spectroscopic (UV/vis, FT-IR and NMR) and X-ray crystallography techniques. To investigate the isomerization effect on spectroscopic data, DFT and TD-DFT calculations have been carried out using five hybrid functionals (B3LYP, B3P86, CAM-B3LYP, M06-2X and PBE0) to predict UV/vis absorption bands (n→π∗ and π→π∗), (1)H and (13)C NMR chemical shifts, FT-IR vibration modes and X-ray parameters (bonds, bond angles and torsion angles) for 1a, 1b and 1c isomers. The results showed that the isomerization effect is significant on λ(MAX) absorption bands, while for IR and NMR the effect is negligible. In accordance with previous studies, B3LYP, B3P86 and PBE0 gave the most reliable to predict the excitation energies of thiourea derivatives.
Watermelon is a natural product that contains high level of antioxidants and may prevent oxidative damage in tissues due to free radical generation following an exposure to ionizing radiation. The present study aimed to investigate the radioprotective effects of watermelon (Citrullus lanatus (Thunb.) Matsum. and Nakai) juice against oxidative damage induced by low dose X-ray exposure in mice. Twelve adult male ICR mice were randomly divided into two groups consisting of radiation (Rx) and supplementation (Tx) groups. Rx received filtered tap water, while Tx was supplemented with 50% (v/v) watermelon juice for 28 days ad libitum prior to total body irradiation by 100 μGy X-ray on day 29. Brain, lung, and liver tissues were assessed for the levels of malondialdehyde (MDA), apurinic/apyrimidinic (AP) sites, glutathione (GSH), and superoxide dismutase (SOD) inhibition activities. Results showed significant reduction of MDA levels and AP sites formation of Tx compared to Rx (P < 0.05). Mice supplemented with 50% watermelon juice restore the intracellular antioxidant activities by significantly increased SOD inhibition activities and GSH levels compared to Rx. These findings may postulate that supplementation of 50% watermelon (Citrullus lanatus (Thunb.) Matsum. and Nakai) juice could modulate oxidative damage induced by low dose X-ray exposure.
Bone age assessment (BAA) of unknown people is one of the most important topics in clinical procedure for evaluation of biological maturity of children. BAA is performed usually by comparing an X-ray of left hand wrist with an atlas of known sample bones. Recently, BAA has gained remarkable ground from academia and medicine. Manual methods of BAA are time-consuming and prone to observer variability. This is a motivation for developing automated methods of BAA. However, there is considerable research on the automated assessment, much of which are still in the experimental stage. This survey provides taxonomy of automated BAA approaches and discusses the challenges. Finally, we present suggestions for future research.
In regard to thermoluminescence (TL) applied to dosimetry, in recent times a number of researchers have explored the role of optical fibers for radiation detection and measurement. Many of the studies have focused on the specific dopant concentration, the type of dopant and the fiber core diameter, all key dependencies in producing significant increase in the sensitivity of such fibers. At doses of less than 1 Gy none of these investigations have addressed the relationship between dose response and TL glow peak behavior of erbium (Er)-doped silica cylindrical fibers (CF). For x-rays obtained at accelerating potentials from 70 to 130 kVp, delivering doses of between 0.1 and 0.7 Gy, present study explores the issue of dose response, special attention being paid to determination of the kinetic parameters and dosimetric peak properties of Er-doped CF. The effect of dose response on the kinetic parameters of the glow peak has been compared against other fiber types, revealing previously misunderstood connections between kinetic parameters and radiation dose. Within the investigated dose range there was an absence of supralinearity of response of the Er-doped silica CF, instead sub-linear response being observed. Detailed examination of glow peak response and kinetic parameters has thus been shown to shed new light of the rarely acknowledged issue of the limitation of TL kinetic model and sub-linear dose response of Er-doped silica CF.
The National Clinical Practice Guideline in Tuberculosis (TB) was designed to improve the quality of tuberculosis care. However, it remains unknown whether primary care doctors adhere to it well. This audit aims to assess the quality of care in the process of TB contact tracing in a primary care setting. Methods: Data on TB contact tracing from 1st February 2013 to 15th February 2013 was obtained retrospectively from all medical records of diagnosed pulmonary TB in a public primary care clinic. All patients who fulfilled the inclusion and exclusion criteria were included in the study. Results: A total of 102 medical records of adult TB contacts were recruited. The median age of the TB contact was 34 (IQR=10) years and 65 % were male. Seventy two percent of the adult TB contact had a TBIS 10C3 form created, and 95% of the medical records were fully documented. History taking and physical examination were recorded on 97% and 99% of patients respectively during the first follow-up at the polyclinic. Eighty five percent and 100% of the patients had a chest-x-ray and sputum direct smear for acid-fast bacilli done respectively. The turn-up rate for the first, second, third and fourth visit was 100% to 32%, 10% and 2% respectively. Conclusion: The quality of care for adult TB contacts tracing in this clinical audit was found to be suboptimal. There is a difference between the current national guidelines and practice in the clinic. Certain measures to improve the quality of care for adult TB contact tracing
are urgently needed.
We report a rare case of sling shot injury that presented with a gunshot-like wound with preseptal cellulitis, in a toddler. An 11-month-old Malay child presented with a gunshot-like wound over the forehead following sling shot injury. On examination, he had a deep circular laceration wound over the forehead, measuring 2.0 cm in diameter, with minimal bleeding. There was no obvious foreign body seen inside the wound and no palpable foreign body surrounding the wound. The gunshot-like wound was associated with left preseptal cellulitis. A skull X-ray showed a white opaque foreign body in the left frontal bone. Computed tomography (CT) scan of orbit and brain revealed a left comminuted fracture of the left orbital roof, and left frontal brain contusion with prelesional edema. Wound exploration was performed and revealed a 0.5 cm unshattered marble embedded in the left frontal bone. The marble and bone fragments were removed. The left preseptal cellulitis responded well to intravenous antibiotic and topical antibiotic.
Syzygium campanulatum Korth is an equatorial, evergreen, aboriginal shrub of Malaysia. Conventionally it has been used as a stomachic. However, in the currently conducted study dimethyl cardamonin or 2',4'-dihydroxy-6'-methoxy-3',5'-dimethylchalcone (DMC) was isolated from S. campanulatum Korth, leaf extract. The structural characterization of DMC was carried out by making use of various techniques including UV, IR, NMR spectral followed by LC-MS, and X-ray crystallographic techniques. For determining the purity of compound, highly effective techniques including TLC, HPLC, and melting point were used. The cytotoxicity of DMC and three different extracts of S. campanulatum was evaluated against human colon cancer cell line (HT-29) by three different assays. DMC and ethanolic extract revealed potent and dose-dependent cytotoxic activity on the cancer cell line with IC50 12.6 and 90.1 µg/mL, respectively. Quite astonishingly to our knowledge, this is the very first report on S. campanulatum as being a rich source (3.5%) of DMC, X-ray crystallography, and anticancer activity on human colon cancer cells.
Formation of carbonate minerals by CO2 sequestration is a potential means to reduce atmospheric CO2 emissions. Vast amount of alkaline and alkali earth metals exist in silicate minerals that may be carbonated. Laboratory experiments carried out to study the dissolution rate in Pahang Sandstone, Malaysia, by CO2 injection at different flow rate in surficial condition. X-ray Powder Diffraction (XRD), Scanning Electron Microscope (SEM) with Energy Dispersive X-ray Spectroscopy (EDX), Atomic Absorption Spectroscopy (AAS) and weight losses measurement were performed to analyze the solid and liquid phase before and after the reaction process. The weight changes and mineral dissolution caused by CO2 injection for two hours CO2 bubbling and one week' aging were 0.28% and 18.74%, respectively. The average variation of concentrations of alkaline earth metals in solution varied from 22.62% for Ca(2+) to 17.42% for Mg(2+), with in between 16.18% observed for the alkali earth metal, potassium. Analysis of variance (ANOVA) test is performed to determine significant differences of the element concentration, including Ca, Mg, and K, before and after the reaction experiment. Such changes show that the deposition of alkali and alkaline earth metals and the dissolution of required elements in sandstone samples are enhanced by CO2 injection.
Myasthenia gravis (MG) is an autoantibody-mediated disorder affecting the neuromuscular junction causing characteristic fatigable muscle weakness. Though it can be associated with tumours of the thymus as well as thyroid disorders, it is rare for both to coexist. The exact prevalence of thyroid carcinoma in MG with thymoma is not known but only about a dozen cases have been reported in the literature. We report a case of a 38-year-old Myanmar lady who presented with weakness and breathlessness due to MG with neck swelling. On examination, she had fatigable proximal muscle weakness and thyroid enlargement with no obvious features of hyperthyroidism. Mediastinal widening and an enlarged thyroid gland were noted on her chest X-ray and chest CT. A subtotal thyroidectomy and thymectomy were done. The histology showed follicular carcinoma of the thyroid and benign thymoma. The majority of the reported cases of thyroid carcinoma in association with MG were papillary carcinoma. Follicular carcinoma thyroid associated with MG has not yet been reported in the literature.
In this work, zinc chromite (ZnCr2O4) nanostructures have been synthesized through co-precipitation method. The effect of various parameters such as alkaline agent, pH value, and capping agent type was investigated on purity, particle size and morphology of samples. It was found that particle size and morphology of the products could be greatly influenced via these parameters. The synthesized products were characterized by field emission scanning electron microscopy (FESEM), X-ray diffraction (XRD), fourier transform infrared (FT-IR) spectra, X-ray energy dispersive spectroscopy (EDS), photoluminescence (PL) spectroscopy, diffuse reflectance spectroscopy (DRS) and vibrating sample magnetometry (VSM). The superhydrophilicity of the calcined oxides was investigated by wetting experiments and a sessile drop technique which carried out at room temperature in air to determine the surface and interfacial interactions. Furthermore, the photocatalytic activity of ZnCr2O4 nanoparticles was confirmed by degradation of anionic dyes such as Eosin-Y and phenol red under UV light irradiation. The obtained ZnCr2O4 nanoparticles exhibit a paramagnetic behavior although bulk ZnCr2O4 is antiferromagnetic, this change in magnetic property can be ascribed to finite size effects.
We report a case of a 34-year-old lady with past history of asthma and pulmonary tuberculosis, who presented 5 weeks pregnant with acute dyspnea. Her chest X-ray showed left-sided complete lung collapse and concomitant right-sided pneumothorax. The pneumothorax was initially managed conservatively with a chest tube but due to its persistence despite suction, was subsequently changed to a Pneumostat(TM), with which she was later discharged. She had a normal echocardiography (ejection fraction [EF] 67%) at 5 weeks of gestation but developed pulmonary hypertension (EF 55%, pulmonary arterial pressure 40.7 mmHg) as the pregnancy progressed. She delivered a healthy baby at 35 weeks via elective lower section caesarean section with spinal anesthesia. We followed her up postnatally and noted the presence of left-sided pulmonary embolism, hypoplastic left lung, and left pulmonary artery. The management of this complex case involved a multidisciplinary effort between general medical, respiratory, obstetric, and cardiothoracic teams.
In this work, a novel electrochemical sensor was fabricated for determination of amoxicillin in bovine milk samples by decoration of carboxylated multi-walled carbon nanotubes (MWCNTs) with gold nanoparticles (AuNPs) using ethylenediamine (en) as a cross linker (AuNPs/en-MWCNTs). The constructed nanocomposite was homogenized in dimethylformamide and drop casted on screen printed electrode. Field emission scanning electron microscopy (FESEM), energy dispersive X-Ray (EDX), X-Ray diffraction (XRD) and cyclic voltammetry were used to characterize the synthesized nanocomposites. The results show that the synthesized nanocomposites induced a remarkable synergetic effect for the oxidation of amoxicillin. Effect of some parameters, including pH, buffer, scan rate, accumulation potential, accumulation time and amount of casted nanocomposites, on the sensitivity of fabricated sensor were optimized. Under the optimum conditions, there was two linear calibration ranges from 0.2-10 µM and 10-30 µM with equations of Ipa (µA) = 2.88C (µM) + 1.2017; r = 0.9939 and Ipa (µA) = 0.88C (µM) + 22.97; r = 0.9973, respectively. The limit of detection (LOD) and limit of quantitation (LOQ) were calculated as 0.015 µM and 0.149 µM, respectively. The fabricated electrochemical sensor was successfully applied for determination of Amoxicillin in bovine milk samples and all results compared with high performance liquid chromatography (HPLC) standard method.
Twenty-two (42 per cent) out of 52 patients admitted with severe bronchiolitis to our Paediatric Intensive Care Unit required ventilation. Risk factors associated with ventilation included a younger mean age, female sex, low birthweight, failure to thrive and the presence of an underlying illness. Ventilated patients were also more likely to have a higher respiratory distress assessment index (RDAI) score, pneumonic infiltration on chest X-ray, lower serum sodium and a positive respiratory syncytial virus isolation in the tracheal secretion.
The eminent aim for advance wound management is to provide a great impact on the quality of life. Therefore, an excellent strategy for an ideal wound dressing is being developed that eliminates certain drawbacks while promoting tissue regeneration for the prevention of bacterial invasion. The aim of this study is to develop a bilayer hybrid biomatrix of natural origin for wound dressing. The bilayer hybrid bioscaffold was fabricated by the combination of ovine tendon collagen type I and palm tree-based nanocellulose. The fabricated biomatrix was then post-cross-linked with 0.1% (w/v) genipin (GNP). The physical characteristics were evaluated based on the microstructure, pore size, porosity, and water uptake capacity followed by degradation behaviour and mechanical strength. Chemical analysis was performed using energy-dispersive X-ray spectroscopy (EDX), Fourier transform infrared spectrophotometry (FTIR), and X-ray diffraction (XRD). The results demonstrated a uniform interconnected porous structure with optimal pore size ranging between 90 and 140 μm, acceptable porosity (>70%), and highwater uptake capacity (>1500%). The biodegradation rate of the fabricated biomatrix was extended to 22 days. Further analysis with EDX identified the main elements of the bioscaffold, which contains carbon (C) 50.28%, nitrogen (N) 18.78%, and oxygen (O) 30.94% based on the atomic percentage. FTIR reported the functional groups of collagen type I (amide A: 3302 cm-1, amide B: 2926 cm-1, amide I: 1631 cm-1, amide II: 1547 cm-1, and amide III: 1237 cm-1) and nanocellulose (pyranose ring), thus confirming the presence of collagen and nanocellulose in the bilayer hybrid scaffold. The XRD demonstrated a smooth wavy wavelength that is consistent with the amorphous material and less crystallinity. The combination of nanocellulose with collagen demonstrated a positive effect with an increase of Young's modulus. In conclusion, the fabricated bilayer hybrid bioscaffold demonstrated optimum physicochemical and mechanical properties that are suitable for skin wound dressing.
Introduction: Varicella pneumonitis is a rare but lethal complication of varicella zoster infection. Case description:We report a case of a 42 year old gentleman who presented with fever, rash, cough and worsening shortness of breath after exposure to his daughter who just recovered from varicella zoster infection. He is an active smoker with no comorbidities. He presented on day 4 of illness with generalised vesicular eruption and respiratory examination revealed reduced vesicular breath sounds bilaterally. He was intubated in view of worsening respiratory distress and was transferred to ICU. Chest X-ray and ABG was suggestive of acute respiratory distress syndrome(ARDS). He was treated with IV Acyclovir and broad spectrum antibiotics in view of subsequent hospital acquired infection. He was discharged well after 3 weeks of hospitalisation. Discussion: Varicella zoster infection is caused by Human alpha-herpesvirus 3, one of eight herpes viruses known to infect humans. Diagnosis of varicella pneumonitis with ARDS was made on the basis of rash, respiratory symptoms and contact with a child who just recovered from varicella zoster infection and rapid worsening of radiological changes. The risk factor of developing severe pneumonitis can be attributed to active smoking. Conclusion: High degree of suspicion and timely diagnosis is crucial for a favourable outcome in a patient with this rare complication.