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Improved stability of live attenuated vaccine gdhA derivative Pasteurella multocida B:2 by freeze drying method for use as animal vaccine

Oslan SNH, Halim M, Ramle NA, Saad MZ, Tan JS, Kapri MR, et al.

Cryobiology, 2017 12;79:1-8.
PMID: 29037980 DOI: 10.1016/j.cryobiol.2017.10.004

The efficacy of attenuated strain of gdhA derivative Pasteurella multocida B:2 mutant as a live vaccine to control haemorrhagic septicaemia (HS) disease in cattle and buffaloes has been demonstrated. In order to use P. multocida B:2 mutant as a commercial product, it is essential to optimise its formulation for high viability and stability of the live cells. The effectiveness of freeze-drying process using different protective agent formulations for improving cells viability was explored. Sugar and nitrogen compounds were used as protective agents in freeze-drying and the capability of these compounds in maintaining the viability of mutant P. multocida B:2 during subsequent storage was investigated. A complete loss in viability of freeze-dried mutant P. multocida B:2 was monthly observed until 6-12 months of storage at -30 °C, 4 °C and 27 °C when nitrogen compound or no protective agent was added. Trehalose and sucrose showed significantly high survival rate of 93-95% immediately after freeze-drying and the viability was retained during the subsequent storage at -30 °C and 4 °C. A smooth cell surface without any cell-wall damage was observed for the cells formulated with trehalose under scanning electron micrograph. This study presented a freeze-drying process generating a dried live attenuated vaccine formulation with high stability for commercial applications.
Occupational safety and health management in the construction industry: a review

Jaafar MH, Arifin K, Aiyub K, Razman MR, Ishak MIS, Samsurijan MS

Int J Occup Saf Ergon, 2018 Dec;24(4):493-506.
PMID: 28849991 DOI: 10.1080/10803548.2017.1366129

The construction industry plays a significant role in contributing to the economy and development globally. During the process of construction, various hazards coupled with the unique nature of the industry contribute to high fatality rates. This review refers to previous published studies and related Malaysian legislation documents. Four main elements consisting of human, worksite, management and external elements which cause occupational accidents and illnesses were identified. External and management elements are the underlying causes contributing to occupational safety and health (OSH), while human and worksite elements are more apparent causes of occupational accidents and illnesses. An effective OSH management approach is required to contain all hazards at construction sites. An approach to OSH management constructed by elements of policy, process, personnel and incentive developed in previous work is explored. Changes to the sub-elements according to previous studies and the related Malaysian legislation are also covered in this review.
Fulltext Dialysis Provision and Implications of Health Economics on Peritoneal Dialysis Utilization: A Review from a Malaysian Perspective

Abdul Manaf MR, Surendra NK, Abdul Gafor AH, Seong Hooi L, Bavanandan S

Int J Nephrol, 2017;2017:5819629.
PMID: 29225970 DOI: 10.1155/2017/5819629

End-stage renal disease (ESRD) is managed by either lifesaving hemodialysis (HD) and peritoneal dialysis (PD) or a kidney transplant. In Malaysia, the prevalence of dialysis-treated ESRD patients has shown an exponential growth from 504 per million population (pmp) in 2005 to 1155 pmp in 2014. There were 1046 pmp patients on HD and 109 pmp patients on PD in 2014. Kidney transplants are limited due to lack of donors. Malaysia adopts public-private financing model for dialysis. Majority of HD patients were treated in the private sector but almost all PD patients were treated in government facilities. Inequality in access to dialysis is visible within geographical regions where majority of HD centres are scattered around developed areas. The expenditure on dialysis has been escalating in recent years but economic evaluations of dialysis modalities are scarce. Evidence shows that health policies and reimbursement strategies influence dialysis provision. Increased uptake of PD can produce significant economic benefits and improve patients' access to dialysis. As a result, some countries implemented a PD-First or Favored Policy to expand PD use. Thus, a current comparative costs analysis of dialysis is strongly recommended to assist decision-makers to establish a more equitable and economically sustainable dialysis provision in the future.
Characterisation and immunosuppressive activity of human cartilage-derived mesenchymal stem cells

Sandrasaigaran P, Algraittee SJR, Ahmad AR, Vidyadaran S, Ramasamy R

Cytotechnology, 2018 Jun;70(3):1037-1050.
PMID: 29497876 DOI: 10.1007/s10616-017-0182-4

Mesenchymal stem cells (MSCs) exert potent immuno-regulatory activities on various immune cells and also differentiate into various mesodermal lineages besides retaining a distinct self-renewal ability. Such exclusive characteristics had enabled MSCs to be recognised as an ideal source for cell-based treatment in regenerative medicine and immunotherapy. Thus, considering MSCs for treating degenerative disease of organs with limited regenerative potential such as cartilage would serve as an ideal therapy. This study explored the feasibility of generating human cartilage-derived MSCs (hC-MSCs) from sports injured patients and characterised based on multipotent differentiation and immunosuppressive activities. Cartilage tissues harvested from a non-weight bearing region during an arthroscopy procedure were used to generate MSCs. Despite the classic morphology of fibroblast-like cells and a defined immunophenotyping, MSCs expressed early embryonic transcriptional markers (SOX2, REX1, OCT4 and NANOG) and differentiated into chondrocytes, adipocytes and osteocytes when induced accordingly. Upon co-culture with PHA-L activated T-cells, hC-MSCs suppressed the proliferation of the T-cells in a dose-dependent manner. Although, hC-MSCs did not alter the activation profile of T cells significantly, yet prevented the entering of activated T cells into S phase of the cell cycle by cell cycle arrest. The present study has strengthened the evidence of tissue-resident mesenchymal stem cells in human cartilage tissue. The endogenous MSCs could be an excellent tool in treating dysregulated immune response that associated with cartilage since hC-MSCs exerted both immunosuppressive and regenerative capabilities.
Fulltext Validation of the trauma mortality prediction scores from a Malaysian population

Tan JH, Tan HCL, Noh NAM, Mohamad Y, Alwi RI

Burns Trauma, 2017;5:37.
PMID: 29299483 DOI: 10.1186/s41038-017-0102-z

Background: Well-known trauma mortality prediction scores such as New Injury Severity Score (NISS), Revised Trauma Score (RTS), and Trauma and Injury Severity Score (TRISS) have been externally validated from high-income countries with established trauma databases. However, these scores were never used in Malaysian population. In this current study, we attempted to validate these scoring systems using our regional trauma surgery database.
Methods: A retrospective analysis of the regional Malaysian Trauma Surgery Database was performed over a period of 3 years from May 2011 to April 2014. NISS, RTS, Major Trauma Outcome Study (MTOS)-TRISS, and National Trauma Database (NTrD)-TRISS scores were recorded and calculated. Individual scoring system's performance in predicting trauma mortality was compared by calculating the area under the receiver operating characteristic (AUC) curve. Youden index and associated optimal cutoff values for each scoring system was calculated to predict mortality. The corresponding positive predictive value, negative predictive value, and accuracy of the cutoff values were calculated.
Results: A total of 2208 trauma patients (2004 blunt and 204 penetrating injuries) with mean age of 36 (SD = 16) years were included. There were 239 deaths with a corresponding mortality rate of 10.8%. The AUC calculated for the NISS, RTS, MTOS-TRISS, and NTrD-TRISS were 0.878, 0.802, 0.812, and 0.848, respectively. The NISS score with a cutoff value of 24, sensitivity of 86.6% and specificity of 74.3%, outperformed the rest (p
Biochemical and structural characterization of a novel cold-active esterase-like protein from the psychrophilic yeast Glaciozyma antarctica

Hashim NHF, Mahadi NM, Illias RM, Feroz SR, Abu Bakar FD, Murad AMA

Extremophiles, 2018 Jul;22(4):607-616.
PMID: 29556723 DOI: 10.1007/s00792-018-1021-z

Dienelactone hydrolase, an α/β hydrolase enzyme, catalyzes the hydrolysis of dienelactone to maleylacetate, an intermediate for the Krebs cycle. Genome sequencing of the psychrophilic yeast, Glaciozyma antarctica predicted a putative open reading frame (ORF) for dienelactone hydrolase (GaDlh) with 52% sequence similarity to that from Coniophora puteana. Phylogenetic tree analysis showed that GaDlh is closely related to other reported dienelactone hydrolases, and distantly related to other α/β hydrolases. Structural prediction using MODELLER 9.14 showed that GaDlh has the same α/β hydrolase fold as other dienelactone hydrolases and esterase/lipase enzymes, with a catalytic triad consisting of Cys-His-Asp and a G-x-C-x-G-G motif. Based on the predicted structure, GaDlh exhibits several characteristics of cold-adapted proteins such as glycine clustering in the binding pocket, reduced protein core hydrophobicity, and the absence of proline residues in loops. The putative ORF was amplified, cloned, and overexpressed in an Escherichia coli expression system. The recombinant protein was overexpressed as soluble proteins and was purified via Ni-NTA affinity chromatography. Biochemical characterization of GaDlh revealed that it has an optimal temperature at 10 °C and that it retained almost 90% of its residual activity when incubated for 90 min at 10 °C. The optimal pH was at pH 8.0 and it was stable between pH 5-9 when incubated for 60 min (more than 50% residual activity). Its Km value was 256 μM and its catalytic efficiency was 81.7 s-1. To our knowledge, this is the first report describing a novel cold-active dienelactone hydrolase-like protein.
13C-Urea Breath Test Accuracy for Helicobacter pylori Infection in the Asian Population: A Meta-Analysis

Abd Rahim MA, Johani FH, Shah SA, Hassan MR, Abdul Manaf MR

Ann Glob Health, 2019 Jul 24;85(1).
PMID: 31348624

BACKGROUND: Helicobacter pylori (H. pylori) infection is known to be associated with peptic ulcer and gastric cancer. Detection of H. pylori infection is a significant part of peptic ulcer and gastric cancer prevention and management. 13C-urea breath test (UBT) provides a good option for the pathogen detection due to its accuracy and safety.
OBJECTIVE: This review aims to evaluate the 13C-UBT diagnostic accuracy studies conducted among Asian population and validate its use for the Asian population.
METHODS: Original articles were systematically searched in PubMed, Scopus, and Google Scholar using the PICOS strategy by applying relevant keywords. Only studies published in English and conducted in Asia were included. Our search returned 276 articles. After assessment, 11 articles which answered our research question and met the criteria set for systematic review and meta-analysis were accepted. A total of 15 study protocols were extracted from the 11 accepted articles.
FINDINGS: Majority of the studies were conducted in Hong Kong (six), followed by Taiwan (five), Japan (two), and one each in Singapore and Israel. All studies had used histology as part of its gold standard of reference. All but one study was performed on adult populations. The summary estimate for sensitivity was 97% (95% CI: 96, 98%), and specificity was 96% (95% CI: 95, 97%), with significant heterogeneity between studies. Adjusting for the dose (50 mg) and breath sample collection time (20 minutes) had improved both accuracy estimates and significantly reduced heterogeneity.
CONCLUSION: This review supports the test-and-treat strategy for H. pylori infection management. Prevalence and cost-effectiveness studies are mandatory for health authorities to adopt this strategy into national policy.
Fulltext Emergency repair of blunt traumatic bronchus injury presenting with massive air leak

Chuah JS, Raymond Lim ZM, Lee EP, Tan JH, Mohamad Y, Alwi RI

Chin J Traumatol, 2022 Nov;25(6):392-394.
PMID: 35031204 DOI: 10.1016/j.cjtee.2021.12.007

Blunt traumatic tracheobronchial injury is rare, but can be potentially life-threatening. It accounts for only 0.5%-2% of all trauma cases. Patients may present with non-specific signs and symptoms, requiring a high index of suspicion with accurate diagnosis and prompt treatment. A 26-year-old female was brought into the emergency department after sustained a blunt trauma to the chest from a high impact motor vehicle accident. She presented with signs of respiratory distress and extensive subcutaneous emphysema from the chest up to the neck. Her airway was secured and chest drain was inserted for right sided pneumothorax. CT of the neck and thorax revealed a collapsed right middle lung lobe with a massive pneumothorax, raising the suspicion of a right middle lobe bronchus injury. Diagnosis was confirmed by bronchoscopy. In view of the difficulty in maintaining her ventilation and persistent pneumothorax with a massive air leak, immediate right thoracotomy via posterolateral approach was performed. The right middle lobar bronchus tear was repaired. There were no intra- or post-operative complications. She made an uneventful recovery. She was asymptomatic at her first month follow-up. A repeated chest X-ray showed expanded lungs. Details of the case including clinical presentation, imaging and management were discussed with an emphasis on the early uses of bronchoscopy in case of suspected blunt traumatic tracheobronchial injury. A review of the current literature of tracheobronchial injury management was presented.
A Meta-Analysis of eHealth Interventions on Ischaemic Heart Disease Health Outcomes

Megat Kamaruddin PSN, Mohammed Nawi A, Abdul Manaf MR, Yaman MN, Abd Malek AM

Glob Heart, 2023;18(1):12.
PMID: 36936248 DOI: 10.5334/gh.1173

BACKGROUND: Electronic Health (eHealth) interventions as a secondary prevention tool to empower patients' health in decision-making and behaviour.
OBJECTIVE: With the growing body of evidence supporting the use of eHealth interventions, the intention is to conduct a meta-analysis on various health outcomes of eHealth interventions among ischaemic heart disease (IHD) patients.
METHODS: Based on PRISMA guidelines, eligible studies were searched through databases of Web of Science, Scopus, PubMed, EBSCOHost, and SAGE (PROSPERO registration CRD42021290091). Inclusion criteria were English language and randomised controlled trials published between 2011 to 2021 exploring health outcomes that empower IHD patients with eHealth interventions. RevMan 5.4 was utilised for meta-analysis, sensitivity analysis, and risk of bias (RoB) assessment while GRADE software for generating findings of physical health outcomes. Non-physical health outcomes were analysed using SWiM (synthesis without meta-analysis) method.
RESULTS: This review included 10 studies, whereby, six studies with 895 participants' data were pooled for physical health outcomes. Overall, the RoB varied significantly across domains, with the majority was low risks, a substantial proportion of high risks and a sizeable proportion of unclear. With GRADE evidence of moderate to high quality, eHealth interventions improved low density lipoprotien (LDL) levels in IHD patients when compared to usual care after 12 months of interventions (SMD -0.26, 95% CI [-0.45, -0.06], I2 = 0%, p = 0.01). Significance appraisal in each domain of the non-physical health outcomes found significant findings for medication adherence, physical activity and dietary behaviour, while half of the non-significant findings were found for other behavioural outcomes, psychological and quality of life.
CONCLUSIONS: Electronic Health interventions are found effective at lowering LDL cholesterol in long-term but benefits remain inconclusive for other physical and non-physical health outcomes for IHD patients. Integrating sustainable patient empowerment strategies with the advancement of eHealth interventions by utilising appropriate frameworks is recommended for future research.
Fulltext Relationship between selenium and breast cancer: a case-control study in the Klang Valley

Suzana S, Cham BG, Ahmad Rohi G, Mohd Rizal R, Fairulnizal MN, Normah H, et al.

Singapore Med J, 2009 Mar;50(3):265-9.
PMID: 19352569

The purpose of this study was to assess the relationship between selenium status and intake among breast cancer patients from the Klang Valley.
Functional outcome and quality of life following treatment for post-traumatic osteomyelitis of long bones

Zayzan KR, Yusof NM, Sulong AF, Zakaria Z, Ab Rahman J

Singapore Med J, 2020 Dec 02.
PMID: 33264560 DOI: 10.11622/smedj.2020164

INTRODUCTION: The clinical outcomes and factors associated with treatment failure of post-traumatic osteomyelitis have been investigated by many studies. However, limb functionality and quality of life following treatment for this condition have not been thoroughly studied.
METHODS: This was a cross-sectional study that included 47 patients with post-traumatic osteomyelitis of the lower limb. Functional outcome was assessed using the Lower Extremity Functional Score (LEFS), and quality of life was assessed using the validated Malay version of Short Form-36 version 2.
RESULTS: Mean follow-up time was 4.6 (range 2.3-9.5) years. Median age was 44 years. Osteomyelitis was located in the tibia for 26 patients and in the femur for 21 patients. Osteomyelitis was consequent to internal infection in 38 patients and due to infected open fractures in nine patients. 42 (89.4%) patients had fracture union and control of infection. Bone defect was found to be a significant contributing factor for treatment failure (p = 0.008). The median LEFS for the success group was 65 when compared to 49 for the failure group. Although the success group showed better scores with regard to quality of life, the difference between the two groups was not statistically significant.
CONCLUSION: The success rate for post-traumatic osteomyelitis of the lower limb was high. The presence of a bone defect was associated with treatment failure. Successfully treated patients had significantly better functional outcomes than failed ones.
Self-management of osteoarthritis while waiting for total knee arthroplasty during the COVID-19 pandemic among older Malaysians

Mahdzir ANK, Mat S, Seow SR, Abdul Rani R, Che Hasan MK, Mohamad Yahaya NH

World J Clin Cases, 2023 Oct 16;11(29):7043-7052.
PMID: 37946758 DOI: 10.12998/wjcc.v11.i29.7043

BACKGROUND: The study sought to understand the self-management strategies used by patients during the postponement of their total knee arthroplasty (TKA) procedure, as well as the associations between the length of waiting time, pain, and physical frailty and function. The study focused on individuals aged 50 years and above, as they are known to be more vulnerable to the negative impacts of delayed elective surgery and rehabilitation. This study hypothesizes that delayed TKR due to coronavirus disease 2019 (COVID-19) will bear negative effect in self-management, pain, and physical frailty and function in older adults.
AIM: To investigate the effects of COVID-19 pandemic on self-management, pain, and physical function in older adults awaiting TKA in Malaysia.
METHODS: This cross-sectional study has the data of participants, who matched the criteria and scheduled for TKA for the first time, extracted from the TKA registry in the Department of Orthopaedics and Traumatology, Hospital Canselor Tuanku Mukhriz. Data on pain status, and self-management, physical frailty, and instrumental activities daily living were also collected. Multiple linear regression analysis with a significant level of 0.05 was used to identify the association between waiting time and pain on physical frailty and functional performance.
RESULTS: Out of 180 had deferred TKA, 50% of them aged 50 years old and above, 80% were women with ethnic distribution Malay (66%), Chinese (22%), Indian (10%), and others (2%) respectively. Ninety-two percent of the participants took medication to manage their pain during the waiting time, while 10% used herbs and traditional supplements, and 68% did exercises as part of their osteoarthritis (OA) self-management. Thirty-six participants were found to have physical frailty (strength, assistance with walking, rising from a chair, climbing stairs, and falls questionnaire score > 4) which accounted for 72%. Increased pain was associated with physical frailty with odds ratio, odds ratio (95% confidence interval): 1.46 (1.04-2.05). This association remained significant even after the adjustment according to age and self-management.
CONCLUSION: While deferring TKA during a pandemic is unavoidable, patient monitoring for OA treatment during the waiting period is important in reducing physical frailty, ensuring the older patients' independence.
Recent Advances of GFRP Composite Cross Arms in Energy Transmission Tower: A Short Review on Design Improvements and Mechanical Properties

Syamsir A, Ean LW, Asyraf MRM, Supian ABM, Madenci E, Özkılıç YO, et al.

Materials (Basel), 2023 Mar 30;16(7).
PMID: 37049072 DOI: 10.3390/ma16072778

Currently, pultruded glass fibre-reinforced polymer (pGFRP) composites have been extensively applied as cross-arm structures in latticed transmission towers. These materials were chosen for their high strength-to-weight ratio and lightweight characteristics. Nevertheless, several researchers have discovered that several existing composite cross arms can decline in performance, which leads to composite failure due to creep, torsional movement, buckling, moisture, significant temperature change, and other environmental factors. This leads to the composite structure experiencing a reduced service life. To resolve this problem, several researchers have proposed to implement composite cross arms with sleeve installation, an addition of bracing systems, and the inclusion of pGFRP composite beams with the core structure in order to have a sustainable composite structure. The aforementioned improvements in these composite structures provide superior performance under mechanical duress by having better stiffness, superiority in flexural behaviour, enhanced energy absorption, and improved load-carrying capacity. Even though there is a deficiency in the previous literature on this matter, several established works on the enhancement of composite cross-arm structures and beams have been applied. Thus, this review articles delivers on a state-of-the-art review on the design improvement and mechanical properties of composite cross-arm structures in experimental and computational simulation approaches.
Factors Influencing Despair, Self-blame, and Acceptance Among Parents of Children with Autism Spectrum Disorder (ASD): A Malaysian Perspective

Abd Latif MH, Wan Ismail WS, Abdul Manaf MR, Abdul Taib NI

J Autism Dev Disord, 2023 Nov 21.
PMID: 37987948 DOI: 10.1007/s10803-023-06155-8

PURPOSE: Accepting and adapting to the child's diagnosis of Autism Spectrum Disorder (ASD) can be challenging for parents. We aimed to assess domains of parental adjustment namely despair, self-blame, and acceptance among parents whose children were diagnosed with ASD.
METHODS: A cross-sectional study was conducted among 111 parents of children with autism who attended Child and Adolescent Psychiatry Unit (CAPU), in a university teaching hospital in Kuala Lumpur, Malaysia. Sociodemographic profiles of both parents and children were gathered. Parental adjustment focusing on parental self-blame, despair and acceptance were assessed using self-reported questionnaires namely Adjustment to the Diagnosis of Autism (ADA).
RESULTS: Higher level of despair was associated with parents who have medical illness (β = 0.214, p = 0.016) and children who received antipsychotic medications (β = 0.329, p
Fulltext Transient severe myocarditis and intraventricular thrombus associated with SARS-CoV-2 vaccination

Loch A, Siew KSW, Tan KL, Azman Bin Raja Aman RRAB

Singapore Med J, 2023 Jun;64(6):366-372.
PMID: 35509213 DOI: 10.11622/smedj.2022042
Fulltext An investigation to offer conclusive recommendations on suitable benefit/cost criteria-based normalization methods for TOPSIS

Krishnan AR, Hamid MR, Tanakinjal GH, Asli MF, Boniface B, Ghazali MF

MethodsX, 2023;10:102227.
PMID: 37333510 DOI: 10.1016/j.mex.2023.102227

Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) is a popular multi-criteria decision-making method that ranks the available alternatives by examining the ideal-positive and ideal-negative solutions for each decision criterion. The first step of using TOPSIS is to normalize the presence of incommensurable data in the decision matrix. There are several normalization methods, and the choice of these methods does affect TOPSIS results. As such, some efforts were made in the past to compare and recommend suitable normalization methods for TOPSIS. However, such studies merely compared a limited collection of normalization methods or used a noncomprehensive procedure to evaluate each method's suitability, leading to equivocal recommendations. This study, therefore, employed an alternate, comprehensive procedure to evaluate and recommend suitable benefit/cost criteria-based normalization methods for TOPSIS (out of ten methods extracted from past literature). The procedure was devised based on three evaluation metrics: the average Spearman's rank correlation, average Pearson correlation, and standard deviation metrics, combined with the Borda count technique.•The first study examined the suitability of ten benefit/cost criteria-based normalization methods over TOPSIS.•Users should combine the sum-based method and vector method into the TOPSIS application for safer decision-making.•The maximum method (version I) or Jüttler's-Körth's method has an identical effect on TOPSIS results.
Dosimetric assessment of Gadolinium-159 for hepatic radioembolization: Tomographic images and Monte Carlo simulation

Musa AS, Abdul Hadi MFR, Hashikin NAA, Ashour NI, Ying CK

Appl Radiat Isot, 2023 Sep;199:110916.
PMID: 37393764 DOI: 10.1016/j.apradiso.2023.110916

A common therapeutic radionuclide used in hepatic radioembolization is yttrium-90 (90Y). However, the absence of gamma emissions makes it difficult to verify the post-treatment distribution of 90Y microspheres. Gadolinium-159 (159Gd) has physical properties that are suitable for therapy and post-treatment imaging in hepatic radioembolization procedures. The current study is innovative for conducting a dosimetric investigation of the use of 159Gd in hepatic radioembolization by simulating tomographic images using the Geant4 application for tomographic emission (GATE) Monte Carlo (MC) simulation. For registration and segmentation, tomographic images of five patients with hepatocellular carcinoma (HCC) who had undergone transarterial radioembolization (TARE) therapy were processed using a 3D slicer. The tomographic images with 159Gd and 90Y separately were simulated using the GATE MC Package. The output of simulation (dose image) was uploaded to 3D slicer to compute the absorbed dose for each organ of interests. 159Gd were able to provide a recommended dose of 120 Gy to the tumour, with normal liver and lungs absorbed doses close to that of 90Y and less than the respective maximum permitted doses of 70 Gy and 30 Gy, respectively. Compared to 90Y, 159Gd requires higher administered activity approximately 4.92 times to achieve a tumour dose of 120 Gy. Thus; this research gives new insights into the use of 159Gd as a theranostic radioisotope, with the potential to be used as a90Y alternative for liver radioembolization.
Fulltext Influence of Woven Glass-Fibre Prepreg Orientation on the Flexural Properties of a Sustainable Composite Honeycomb Sandwich Panel for Structural Applications

Amir AL, Ishak MR, Yidris N, Zuhri MYM, Asyraf MRM, Zakaria SZS

Materials (Basel), 2023 Jul 15;16(14).
PMID: 37512295 DOI: 10.3390/ma16145021

Owing to the high potential application need in the aerospace and structural industry for honeycomb sandwich composite, the study on the flexural behaviour of sandwich composite structure has attracted attention in recent decades. The excellent bending behaviour of sandwich composite structures is based on their facesheet (FS) and core materials. This research studied the effect of woven glass-fibre prepreg orientation on the honeycomb sandwich panel. A three-point bending flexural test was done as per ASTM C393 standard by applying a 5 kN load on different orientation angles of woven glass-fibre prepreg honeycomb sandwich panel: α = 0°, 45° and 90°. The results show that most of the sandwich panel has almost the same failure mode during the three-point bending test. Additionally, the α = 0° orientation angle shows a higher maximum load prior to the first failure occurrence compared to others due to higher flexibility but lower stiffness. In addition, the woven glass-fibre prepreg orientation angle, α = 0°, has the maximum stress and flexural modulus, which directly depend upon the maximum load value obtained during the flexural test. In addition, the experimental results and analytical prediction for honeycomb sandwich deflection show good agreement. According to the result obtained, it is revealed that woven glass-fibre honeycomb sandwich panels with an α = 0° orientation is a good alternative compared to 45° and 90°, especially when better bending application is the main purpose. The final result of this research can be applied to enhance the properties of glass-fibre-reinforced polymer composite (GFRPC) cross-arm and enhance the existing cross-arm used in high transmission towers.
Fulltext Rare Case of Focal Gigantism of the Foot

Sellvam SA, Raghu S, Leong JF, Hafni F, Abdul Rani R

Cureus, 2023 Aug;15(8):e43173.
PMID: 37692627 DOI: 10.7759/cureus.43173

Macrodystrophia lipomatosa (MDL) is a rare congenital variant of focused gigantism that is non-hereditary. Typically, MDL presents with localized gigantism in either the hand or foot. In this case report, we present the unique instance of a 12-year-old girl who has experienced enlargement of the first and second toes on her right foot since birth. Plain radiographs and MRI findings revealed the accumulation of fatty tissue around the first and second toes, medial and lateral aspects of the first metatarsal, extending up to the medial plantar arch of the foot. To enhance foot functionality and alleviate any issues with wearing footwear, a successful reconstruction surgical intervention was performed. As a result, the patient can now wear shoes without any difficulties. MDL is a very uncommon kind of congenital localised gigantism, and surgical consultation is frequently performed for cosmetic reasons.
Fulltext Scaphoid Plate Osteosynthesis in Complex Fractures and Wrist Trauma: A Case Series

Liau CJ, Liew SK, Arsad SR, Muhammad Nawawi RF, Silvanathan JP

Cureus, 2023 Sep;15(9):e45067.
PMID: 37842372 DOI: 10.7759/cureus.45067

Introduction Treatment of scaphoid fracture is challenging due to its unique blood supply and geometry. Traditionally, a headless compression screw is the standard treatment for unstable scaphoid fracture. Some fractures are complex, for example, comminution with bone loss. A scaphoid plate is an option in these difficult fractures providing adequate rotational stability. Aim To share our experience in using scaphoid plates in complex wrist trauma and comminuted fractures. Method and material Complex wrist trauma involving scaphoid fractures that were comminuted and multi-fragmentary fractures treated with plate osteosynthesis were retrospectively reviewed between July 2019 and September 2021. Patient demographic data, preoperative radiographs, CT scans, pain, wrist range of motion, and fracture union rate to union were reviewed. Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH®) score was recorded at 1-year postoperative follow-up. Results Nine patients associated with complex wrist trauma were included in this case series. The mean follow-up was 2.5 years (13-30 months). The union rate was 100%. The mean arc of motion was 105° (95-110°). QuickDASH® score was 19.96 at 1-year postoperative follow-up. Four patients had good outcomes, four satisfactory, and one poor outcome. One hardware complication was observed which was the impingement of the plate proximally over the articular surface of the distal radius. Conclusion A scaphoid plate is a reliable option for treating complex and difficult fractures. It provides adequate stability, especially in comminution, bone loss, or multi-fragmentary fractures which are not amendable using other fixation methods. We recommend the expansion of plate osteosynthesis beyond scaphoid nonunion into complex wrist trauma.

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