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  1. Fulltext Biomechanical Analysis of Crossed Pinning Construct in Supracondylar Fracture of Humerus: Does the Point of Crossing Matter?
    Hanim A, Wafiuddin M, Azfar MA, Awang MS, Nik Abdul Adel NA
    Cureus, 2021 Mar 22;13(3):e14043.
    PMID: 33898129 DOI: 10.7759/cureus.14043
    Introduction This appears to be the first biomechanical study that compares the stability of various locations of the crossing points in crossed pinning Kirschner wiring (K-wire) construct in treating pediatric supracondylar humerus fracture (SCHF). Additionally, this study compared the biomechanical stability between crossed pinning K-wire construct and the three-lateral divergent K-wire construct. Methods For the study purpose, 30 synthetic humerus bones were osteotomised at mid-olecranon fossa, anatomically reduced, and pinned using two 1.6-millimeter K-wires in five different constructs. A total of six samples were prepared for each construct and tested for extension, flexion, valgus, varus, internal rotation, and external rotation forces. Results As for crossed pinning K-wire construct, the center crossing point emerged as the stiffest construct in both linear and rotational forces, in comparison to the lateral crossing point, superior crossing, and medial crossing point Conclusion Based on this analysis, it is highly recommended that, if the crossed pinning construct is selected to treat supracondylar humerus fracture, the surgeon should aim for center crossing point as it is the most stable construct. Nevertheless, if lateral and superior crossing points are obtained during the initial attempt of fixation, the fixation may be accepted without revising the K-wire as the stability of these two constructs are comparable and portrayed no significant difference when compared to that of the center crossing point. Additionally, it is essential to avoid the medial crossing point as it is significantly less stable in terms of rotational force when compared to the center crossing point.
  2. Recent advances in hybrid wet scrubbing techniques for NOx and SO2 removal: State of the art and future research
    Sharif HMA, Mahmood N, Wang S, Hussain I, Hou YN, Yang LH, et al.
    Chemosphere, 2021 Jun;273:129695.
    PMID: 33524756 DOI: 10.1016/j.chemosphere.2021.129695
    Recently, the discharge of flue gas has become a global issue due to the rapid development in industrial and anthropogenic activities. Various dry and wet treatment approaches including conventional and hybrid hybrid wet scrubbing have been employing to combat against these toxic exhaust emissions. However, certain issues i.e., large energy consumption, generation of secondary pollutants, low regeneration of scrubbing liquid and high efficieny are hindering their practical applications on industrial level. Despite this, the hybrid wet scrubbing technique (advanced oxidation, ionic-liquids and solid engineered interface hybrid materials based techniques) is gaining great attention because of its low installation costs, simultaneous removal of multi-air pollutants and low energy requirements. However, the lack of understanding about the basic principles and fundamental requirements are great hurdles for its commercial scale application, which is aim of this review article. This review article highlights the recent developments, minimization of GHG, sustainable improvements for the regeneration of used catalyst via green and electron rich donors. It explains, various hybrid wet scrubbing techniques can perform well under mild condition with possible improvements such as development of stable, heterogeneous catalysts, fast and in-situ regeneration for large scale applications. Finally, it discussed recovery of resources i.e., N2O, NH3 and N2, the key challenges about several competitive side products and loss of catalytic activity over time to treat toxic gases via feasible solutions by hybrid wet scrubbing techniques.
  3. Fulltext A Hybrid Deep CNN Model for Abnormal Arrhythmia Detection Based on Cardiac ECG Signal
    Ullah A, Rehman SU, Tu S, Mehmood RM, Fawad, Ehatisham-Ul-Haq M
    Sensors (Basel), 2021 Feb 01;21(3).
    PMID: 33535397 DOI: 10.3390/s21030951
    Electrocardiogram (ECG) signals play a vital role in diagnosing and monitoring patients suffering from various cardiovascular diseases (CVDs). This research aims to develop a robust algorithm that can accurately classify the electrocardiogram signal even in the presence of environmental noise. A one-dimensional convolutional neural network (CNN) with two convolutional layers, two down-sampling layers, and a fully connected layer is proposed in this work. The same 1D data was transformed into two-dimensional (2D) images to improve the model's classification accuracy. Then, we applied the 2D CNN model consisting of input and output layers, three 2D-convolutional layers, three down-sampling layers, and a fully connected layer. The classification accuracy of 97.38% and 99.02% is achieved with the proposed 1D and 2D model when tested on the publicly available Massachusetts Institute of Technology-Beth Israel Hospital (MIT-BIH) arrhythmia database. Both proposed 1D and 2D CNN models outperformed the corresponding state-of-the-art classification algorithms for the same data, which validates the proposed models' effectiveness.
  4. Fulltext Unilateral neglect or alien hand syndrome? A diagnostic challenge
    Wan Yusoff WR, Hanafi MH, Ibrahim AH, Kassim NK, Suhaimi A
    J Taibah Univ Med Sci, 2021 Apr;16(2):288-291.
    PMID: 33897336 DOI: 10.1016/j.jtumed.2020.12.003
    Alien hand syndrome (AHS) is a rare post-stroke complication. Although the occurrence of AHS after stroke is rare, it can have a disabling impact on the lifestyle and career of the patients post stroke. It is difficult to distinguish AHS from the non-dominant hemispheric infarction with symptoms of hemianopia and left hemineglect, as patients with AHS can also have neglect as well as behaviour symptoms if the frontal lobe is involved. We report the case of a 62-year-old gentleman who was admitted to the rehabilitation ward and was treated for neglect and apraxia following right middle cerebral artery stroke. After further re-evaluation, the patient was diagnosed with AHS. Functionally, he improved and the symptoms disappeared four months after the stroke. In this case report, we highlight the features of AHS and provide a unique management approach.
  5. Fulltext BipD of Burkholderia pseudomallei: Structure, Functions, and Detection Methods
    Selvam K, Khalid MF, Mustaffa KMF, Harun A, Aziah I
    Microorganisms, 2021 Mar 30;9(4).
    PMID: 33808203 DOI: 10.3390/microorganisms9040711
    Melioidosis is a severe disease caused by Burkholderia pseudomallei (B. pseudomallei), a Gram-negative environmental bacterium. It is endemic in Southeast Asia and Northern Australia, but it is underreported in many other countries. The principal routes of entry for B. pseudomallei are skin penetration, inhalation, and ingestion. It mainly affects immunocompromised populations, especially patients with type 2 diabetes mellitus. The laboratory diagnosis of melioidosis is challenging due to its non-specific clinical manifestations, which mimic other severe infections. The culture method is considered an imperfect gold standard for the diagnosis of melioidosis due to its low sensitivity. Antibody detection has low sensitivity and specificity due to the high seropositivity among healthy people in endemic regions. Antigen detection using various proteins has been tested for the rapid determination of B. pseudomallei; however, it presents certain limitations in terms of its sensitivity and specificity. Therefore, this review aims to frame the present knowledge of a potential target known as the Burkholderia invasion protein D (BipD), including future directions for its detection using an aptamer-based sensor (aptasensor).
  6. The effect of multisensory-adapted dental environment on children's behavior toward dental treatment: A systematic review
    Ismail AF, Tengku Azmi TMA, Malek WMSWA, Mallineni SK
    J Indian Soc Pedod Prev Dent, 2021 4 23;39(1):2-8.
    PMID: 33885380 DOI: 10.4103/jisppd.jisppd_36_21
    Objective: The objective was to assess the effectiveness of multisensory-adapted environment on children's behavior toward dental treatment, specifically in special need children.

    Materials and Methods: The main health databases were selected such as SCOPUS, Medline, CINAHL, and Dentistry and Oral Sciences. A set of keywords was defined to identify the relevant article were (i.e., Snoezelen OR Multisensory OR sensory-adapted and Dentistry OR Oral). The articles were selected and extracted by two reviewers based on the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines and some predetermined exclusion criteria. Furthermore, the risk of bias assessment was done.

    Results: A total of 317 papers were selected at the first phase from SCOPUS (97 papers), Medline (108 papers), CINAHL (110 papers), and Dentistry and Oral Sciences (2 papers). After applying the inclusion and exclusion criteria and duplicated papers were removed, only four eligible papers were selected for final synthesis.

    Conclusions: Multisensory-adapted dental environment effectively improves oral health behavior among special needs children in terms of physiological changes, behaviors, pain, and sensory discomfort. Thus, the clinician may introduce this approach in their clinical settings.

  7. Fulltext Author Correction: Comparison of eight complete chloroplast genomes of the endangered Aquilaria tree species (Thymelaeaceae) and their phylogenetic relationships
    Hishamuddin MS, Lee SY, Ng WL, Ramlee SI, Lamasudin DU, Mohamed R
    Sci Rep, 2021 Apr 22;11(1):9160.
    PMID: 33888845 DOI: 10.1038/s41598-021-88638-1
  8. Chemical composition of three Malaysian Horsfieldia essential oils
    Salleh WMNHW, Shakri NM, Khamis S, Setzer WN, Nadri MH
    Nat Prod Res, 2020 Sep 14.
    PMID: 32927975 DOI: 10.1080/14786419.2020.1819274
    This study aims to assess the chemical compositions of the essential oils from three Horsfieldia species namely H. fulva Warb., H. sucosa Warb. and H. superba Warb., which are found in Malaysia. The essential oils were derived from the samples through hydrodistillation which were then characterised by gas chromatography (GC-FID) and gas chromatography-mass spectrometry (GC-MS). Based on the findings, the H. fulva, H. sucosa and H. superba essential oils represented 98.2%, 98.7% and 98.5% of the total oils, respectively. The major component of H. fulva oil was identified to be germacrene D (20.8%), H. sucosa oil mainly contained α-cadinol (17.5%), whereas H. superba oil was rich in δ-cadinene (18.2%). To the best of our knowledge, this is the first study of the composition of the essential oils from these selected Horsfieldia species.
  9. Molecular forces governing protein-protein interaction: Structure-function relationship of complexes protein in the food industry
    Alrosan M, Tan TC, Easa AM, Gammoh S, Alu'datt MH
    Crit Rev Food Sci Nutr, 2021 Jan 18.
    PMID: 33455424 DOI: 10.1080/10408398.2021.1871589
    The application of protein-protein interaction (PPI) has been widely used in various industries, such as food, nutraceutical, and pharmaceutical. A deeper understanding of PPI is needed, and the molecular forces governing proteins and their interaction must be explained. The design of new structures with improved functional properties, e.g., solubility, emulsion, and gelation, has been fueled by the development of structural and colloidal building blocks. In this review, the molecular forces of protein structures are discussed, followed by the relationship between molecular force and structure, ways of a bind of proteins together in solution or at the interface, and functional properties. A more detailed look is thus taken at the relationship between the various influencing factors on molecular forces involved in PPI. These factors include protein properties, such as types, concentration, and mixing ratio, and solvent conditions, such as ionic strength and pH. This review also summarizes methods tha1t are capable of identifying molecular forces in protein and PPI, as well as characterizing protein structure.
  10. On the indirect environmental outcomes of COVID-19: short-term revival with futuristic long-term implications
    Irfan M, Ahmad M, Fareed Z, Iqbal N, Sharif A, Wu H
    Int J Environ Health Res, 2021 Jan 15.
    PMID: 33448868 DOI: 10.1080/09603123.2021.1874888
    The aim of this study is to identify and highlight the positive and negative indirect environmental impacts of COVID-19, with a particular focus on the most affected economies (USA, China, Spain, and Italy). In this respect, the empirical and theoretical dimensions of the contents of those impacts are analyzed. Research findings reveal a significant relationship between contingency actions and positive indirect impacts such as air quality improvements, clean beaches, and the decline in environmental noise. Besides, negative indirect impacts also exist, such as the rise in waste level and curtailment in recycling, further threatening the physical spaces (land and water), besides air. It is expected that global businesses will revive in the near future (though slowly), but the reduction in greenhouse gas emissions during this short time span is not a sustainable way of environmental mitigation. Thus, long-term mitigation policies should be strengthened to cope with the undesirable deterioration of the environment. Research findings provide an up-to-date glimpse of the pandemic from the perspectives of current and future indirect environmental impacts and the post-pandemic situation. Finally, it is suggested to invent and prepare action plans to induce a sustainable economic and environmental future in the post-pandemic world scenario.
  11. Assessment of health risks and individuals' willingness to participate in drinking water management at flood-prone Pahang River Basin, Malaysia
    Alam L, Rahman LF, Ahmed MF, Bari MA, Masud MM, Mokhtar MB
    Environ Geochem Health, 2021 May;43(5):2049-2063.
    PMID: 33389458 DOI: 10.1007/s10653-020-00783-0
    Rivers, the main source of the domestic water supply in Malaysia, have been threatened by frequent flooding in recent years. This study aims to assess human health risks associated with exposure to concentrated heavy metals in a flood-prone region of Malaysia and investigate the affected individuals' willingness to participate in managing water resources. Hazard indices and cancer risks associated with water contamination by heavy metals have been assessed following the method prescribed by the US Environmental Protection Agency. Yearly data of heavy metal contamination (Cd, Cr, Pb, Zn, Fe), water quality parameters (DO, BOD, COD, pH), and climatic information (annual rainfall, annual temperature) have been collected from the Department of Environment and Meteorological Department of Malaysia, respectively. The inductively coupled plasma mass spectrometry technique has been used by the department of environment for analyzing heavy metal concentration in river water samples. In this study, data from a stratified random sample of households in the affected region were analyzed, using partial least squares structural equation modeling, to predict the link between individuals' perceptions and attitudes about water resources and their willingness to engage in water management program. The health risk estimation indicated that the hazard index values were below the acceptable limit, representing no non-carcinogenic risk to adults and children residing in the study area via oral intake and dermal adsorption of water. However, the calculated value for cancer risk signified possible carcinogenic risks associated with Pb and Cd. In general, contamination due to pollution and flooding tends to increase in the basin region, and appropriate management is needed. The results identified perceived water quality as a significant factor influencing people's attitudes toward involvement in water management programs. As in many developing countries, there is no legal provision guaranteeing public representation in water management in Malaysia. The conclusion discusses the importance of these for the literature and for informing future policy actions.
  12. Fulltext Microwave-assisted Preparation of Cross-linked Gelatin-Paracetamol Matrices: Optimization Using the D-optimal Design
    Kuang TK, Kang YB, Segarra I, Kanwal U, Ahsan M, Bukhari NI
    Turk J Pharm Sci, 2021 04 20;18(2):167-175.
    PMID: 33902255 DOI: 10.4274/tjps.galenos.2020.48902
    Objectives: This study was conducted to assess the effect of microwave heating on the preparation of paracetamol cross-linked gelatin matrices by using the design of experiment (DoE) approach and explore the influence of the duration of microwave irradiation, the concentrations of crosslinker, and the amount of sodium bicarbonate (salt) on paracetamol release. These parameters were also compared with those of the matrices prepared via conventional heating.

    Materials and Methods: Twenty gel matrices were prepared with different durations of microwave irradiation, amounts of maize, and concentrations of sodium bicarbonate as suggested by Design Expert (DX®). The percentage drug release, the coefficient of variance (CV) in release, and the mean dissolution time (MDT) were the properties explored in the designed experimentation.

    Results: Target responses were dependent on microwave irradiation time, cross-linker amount, and salt concentration. Classical and microwave heating did not demonstrate statistically significant difference in modifying the percentage of drug released from the matrices. However, the CVs of microwave-assisted formulations were lower than those of the gel matrices prepared via classical heating. Thus, microwave heating produced lesser variations in drug release. The optimized gel matrices demonstrated that the observed percentage of drug release, CV, and MDT were within the prediction interval generated by DX®. The release mechanism of the matrix formulations followed the Peppas-Korsmeyer anomalous transport model.

    Conclusion: The DoE-supported microwave-assisted approach could be applied to optimize the critical factors of drug release with less variation.

  13. Fulltext Performance analysis of noninvasive electrophysiological methods for the assessment of diabetic sensorimotor polyneuropathy in clinical research: a systematic review and meta-analysis with trial sequential analysis
    Haque F, Reaz MBI, Ali SHM, Arsad N, Chowdhury MEH
    Sci Rep, 2020 12 10;10(1):21770.
    PMID: 33303857 DOI: 10.1038/s41598-020-78787-0
    Despite the availability of various clinical trials that used different diagnostic methods to identify diabetic sensorimotor polyneuropathy (DSPN), no reliable studies that prove the associations among diagnostic parameters from two different methods are available. Statistically significant diagnostic parameters from various methods can help determine if two different methods can be incorporated together for diagnosing DSPN. In this study, a systematic review, meta-analysis, and trial sequential analysis (TSA) were performed to determine the associations among the different parameters from the most commonly used electrophysiological screening methods in clinical research for DSPN, namely, nerve conduction study (NCS), corneal confocal microscopy (CCM), and electromyography (EMG), for different experimental groups. Electronic databases (e.g., Web of Science, PubMed, and Google Scholar) were searched systematically for articles reporting different screening tools for diabetic peripheral neuropathy. A total of 22 studies involving 2394 participants (801 patients with DSPN, 702 controls, and 891 non-DSPN patients) were reviewed systematically. Meta-analysis was performed to determine statistical significance of difference among four NCS parameters, i.e., peroneal motor nerve conduction velocity, peroneal motor nerve amplitude, sural sensory nerve conduction velocity, and sural sensory nerve amplitude (all p 
  14. Fulltext Case Report-Staged brachytherapy achieving complete metabolic response in unresectable oligometastatic colorectal cancer to the liver
    Appalanaido GK, Bahajjaj SIBZ, Shukor SA, Ahmad MZ, Francis HCH
    Oxf Med Case Reports, 2021 Apr;2021(4):omab016.
    PMID: 33948189 DOI: 10.1093/omcr/omab016
    Liver is the most common site for metastasis from colorectal cancer (CRC). Non-surgical treatment options for oligometastatic CRC confined to the liver which represents an intermediate state in the metastatic cascade are fast expanding. Currently, several liver-directed local therapeutic options are available, such as hepatic arterial infusion (HAI) therapy, radio-frequency ablation (RFA), transarterial chemoembolization (TACE), stereotactic body radiotherapy and high dose rate brachytherapy (HDRBT). Many factors such as patient's fitness, liver function (LF), tumour size, location of the tumour in the liver and scheduling of systemic therapy need to be considered when selecting patients for surgery or local liver-directed therapy. This case report illustrates a successful local treatment with staged HDRBT for a large and unresectable, liver only oligometastatic disease from CRC. This patient underwent 4 cycles of chemotherapy (FOLFOX 4) followed by primary tumour resection and first stage of HDRBT to liver for a residual 14 cm tumour after the chemotherapy. After completing a further 4 cycles of chemotherapy with the same regimen, the tumour remained stable at 8 cm. She underwent a second stage of HDRBT to the same lesion and a repeat PET-CT scan done 8 weeks after the second HDRBT showed complete metabolic response. To our knowledge, this is the largest CRC metastatic liver lesion that has been successfully treated with HDRB.
  15. Fulltext CD89/CD35 Expression Ratio in Salivary Neutrophil as an Early Detection Marker for Severe Early Childhood Caries
    Luthfi M, Oki AS, Indrawati R, Rifai M, Dachlan YP, Razak FA
    Eur J Dent, 2020 Jul;14(3):386-392.
    PMID: 32645730 DOI: 10.1055/s-0040-1713704
    OBJECTIVES:  To analyze CD35/CD89 expression ratio on the surface of neutrophils as an early detection marker for S-ECC.

    MATERIALS AND METHODS:  Saliva was collected from 4- to 6-year-old kindergarten students. Salivary neutrophils were obtained by instructing the subjects to rinse their mouth with 1 mL of sterile 1.5% NaCl for 30 seconds before expectorating it into a sterile glass. The expression of CFSE+CD35+ and CFSE+CD89+was measured and analyzed using flow cytometry.

    RESULTS: The expression of CFSE+CD89+ in the caries-free group (2.46 ± 0.39) was significantly lower than that in the S-ECC group (3.41 ± 1.11), with a p-value of 0.0001, while the expression of CFSE+CD35+ in the caries-free group was (2.35 ± 0.56) compared with (1.54 ± 0.35) (p = 0.0001) in the S-ECC group.

    CONCLUSIONS:  The expression ratio of CFSE+CD89+ and CFSE+CD35+constitutes a marker for S-ECC.

  16. The use of salt-coating to improve textural, mechanical, cooking and sensory properties of air-dried yellow alkaline noodles
    Yeoh SY, Lubowa M, Tan TC, Murad M, Mat Easa A
    Food Chem, 2020 Dec 15;333:127425.
    PMID: 32683254 DOI: 10.1016/j.foodchem.2020.127425
    Zero-salted yellow alkaline noodles (YAN) were immersed in solutions of resistant starch HYLON™ VII (HC) or fruit coating Semperfresh™ (SC) containing a range of salt (NaCl) between 10 and 30% (w/v). The objective was to evaluate the effect of salt-coatings on the textural, handling, cooking, and sensory properties of YAN. Increasing salt in the coatings caused a reduction in optimum cooking time, cooking loss and increase in cooking yield. The mechanical and textural parameters, sensory hardness, springiness and overall sensory acceptability of the salt-coated noodles however decreased with increasing salt application. HC-Na10 and SC-Na10 showed the highest textural and mechanical parameters, sensory hardness and springiness. The differences in the parameters were attributed mainly to the water absorption properties of starch that was affected by salt application. Thus, the quality of salt-coated noodles was dependent mainly on the amounts of salt applied in the coatings rather than on the types of coatings used.
  17. Fulltext Pharmacokinetics of Free Oxytetracycline and Oxytetracycline Loaded Cockle Shell Calcium Carbonate-Based Nanoparticle in BALB/c Mice
    Idris SB, Abdul Kadir A, Abdullah JFF, Ramanoon SZ, Basit MA, Abubakar MZZA
    Front Vet Sci, 2020;7:270.
    PMID: 32613011 DOI: 10.3389/fvets.2020.00270
    The development and utilization of nano-antibiotics is currently gaining attention as a possible solution to antibiotic resistance. The aim of this study was therefore to determine the pharmacokinetics of free oxytetracycline (OTC) and oxytetracycline loaded cockle shell calcium carbonate-based nanoparticle (OTC-CNP) after a single dose of intraperitoneal (IP) administration in BALB/c mice. A total of 100 female BALB/c mice divided into two groups of equal number (n = 50) were administered with 10 mg/kg OTC and OTC-CNP, respectively. Blood samples were collected before and post-administration from both groups at time 0, 5, 10, 15, and 30 min and 1, 2, 6, 24, and 48 h, and OTC plasma concentration was quantified using a validated HPLC-UV method. The pharmacokinetic parameters were analyzed using a non-compartment model. The Cmax values of OTC in OTC-CNP and free OTC treated group were 64.99 and 23.53 μg/ml, respectively. OTC was detected up to 24 h in the OTC-CNP group as against 1 h in the free OTC group following intraperitoneal administration. In the OTC-CNP group, the plasma elimination rate of OTC was slower while the half-life, the area under the curve, and the volume of the distribution were increased. In conclusion, the pharmacokinetic profile of OTC in the OTC-CNP group differs significantly from that of free OTC. However, further studies are necessary to determine the antibacterial efficacy of OTC-CNP for the treatment of bacterial diseases.
  18. Phylogenetic Diversity of Burkholderia pseudomallei isolated from veterinary cases and the environments in Peninsular Malaysia
    Sadiq MA, Hassan L, Aziz SA, Zakaria Z, Musa HI, Amin MM, et al.
    Vet Anim Sci, 2018 Dec;6:21-28.
    PMID: 32734049 DOI: 10.1016/j.vas.2018.07.004
    This study was designed to determine the genotype and the phylogeny of Burkholderia pseudomallei isolated from veterinary cases and from the animal environments in Peninsular Malaysia. The Malaysian B. pseudomallei population were then compared to those found elsewhere. A total of 113 isolates from veterinary cases (35) and the environment (56 from soil and 22 from water) were characterized using multilocus sequence typing (MLST). Two novel alleles, allele 97 and 69 of the gene locus ace and lepA respectively were recovered. Isolates were resolved into 12 distinct sequence types (STs) out of which five were novel, namely ST1130, ST1131, ST1338, ST1339 and ST1367. The isolates from veterinary cases co-clustered with those from the environment. B. pseudomallei isolates in this study were highly clonal and have descended from a common ancestor clonal complex (CC) 48 found in Southeast Asia. This study shows that veterinary case isolates are often caused by similar STs, with similar populations found in the direct animal environment and those previously reported to cause human infections in Malaysia and elsewhere. Isolates of B. pseudomallei from human infections have been given more attention, with a comparatively lower focus on isolates from animals and the farm environment. This study highlighted the genotype and phylogeny of B. pseudomallei isolated from animals and the environment and their relations to the isolates from human cases reported in Malaysia and elsewhere. Most STs reported in this study, from veterinary cases and animal environment are similar to those previously reported as causing human infections in Malaysia and elsewhere. Therefore, even though direct zoonosis is uncommon, monitoring melioidosis occurrences in animals can provide insights on the bacterial strains infecting humans.
  19. Knowledge, Attitude, and Practice of General Population toward Complementary and Alternative Medicines in Relation to Health and Quality of Life in Sungai Petani, Malaysia
    Mohiuddin SG, Aziz S, Iqbal MZ, Naqvi AA, Ahmed R, Mahmoud MA, et al.
    J Pharm Bioallied Sci, 2020 01 29;12(1):57-63.
    PMID: 32801601 DOI: 10.4103/jpbs.JPBS_182_19
    Purpose: The demand of complementary and alternative medicine (CAM) has increased drastically over the past few decades. The perceptions about CAMs among general population are positive. However, the literature highlights that effectiveness and acceptance of alternative therapies among the general population is still a subject of debate.

    Materials and Methods: This is a cross-sectional study and the response along with demographic details was collected through a validated questionnaire; the results were analyzed by using a validated data collection tool. The results were concluded based on good, moderate, and poor responses, which were evaluated through data analysis by using the Statistical Package for the Social Sciences software version 20.0., SPSS Inc., Chicago, III, USA. A value of P < 0.05 was considered statistically significant.

    Results: In total, 182 (44.4%) of male and 228 (55.6%) of female respondents were selected for this study. Studies showed that a greater knowledge level was observed among female respondents (15.55 ± 2.7, P < 0.001). The selected Chinese population had relatively good knowledge (i.e., 15.63, P = 0.006). People practicing Buddhism had also good knowledge. Rural population had lesser family income and showed a good practice pattern and understanding (P = 0.006). The positive attitude was identified among women ( P < 0.001) with a mean score of 15.55 ± 2.7. Postgraduate participants were found to have diverse results with SD ± 6.23, and 77.1% had a good attitude. A statistically significant association was observed between religion and attitude of respondents (P < 0.001).

    Conclusion: Although a better practice was noticed in Malaysian population, more awareness is required and knowledge should be disseminated among the population to improve the overall health and quality of life in Malaysia.

  20. A finite element study: Finding the best configuration between unilateral, hybrid, and ilizarov in terms of biomechanical point of view
    Abd Aziz AU, Abdul Wahab AH, Abdul Rahim RA, Abdul Kadir MR, Ramlee MH
    Injury, 2020 Nov;51(11):2474-2478.
    PMID: 32798038 DOI: 10.1016/j.injury.2020.08.001
    In an open fracture, the external fixator is one of the definitive treatment options as it could provide the initial stabilisation of the fractured bone. Limited literature discussing on the biomechanical stability between unilateral, hybrid and Ilizarov configurations, principally in treating a femoral fracture. Thus, this study aims to analyse the biomechanical stability of different external fixators via the finite element method (FEM). The present study portrays that different configurations of fixators possess different biomechanical stability, hence leading to different healing rates and complication risks. For the methodology, three-dimensional models of three different external fixators were reconstructed where axial loads were applied on the proximal end of the femur, simulating the stance phase. From the results, the unilateral configuration provides better stability compared to the hybrid and Ilizarov, where it displaced the least with an average percentage difference of 50% for the fixator's frame and 23% for the bone. The unilateral configuration also produced the least interfragmentary movement (0.48 mm) as compared to hybrid (0.62 mm) and Ilizarov (0.61 mm) configurations. Besides, the strain and stress of the unilateral configuration were superior in terms of stability compared to the other two configurations. As a conclusion, the unilateral configuration had the best biomechanical stability as it was able to assist the bone healing process as well as minimising the risk of pin tract infection while treating a femoral fracture.
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