Methods: Eight subjects were instructed to clean the interproximal side of their posterior teeth using a toothpick. Each toothpick sample was kept for 0 days (as a control), 14 days, and 20 days. The purity and DNA concentration of each sample were determined through DNA examination. After determining the concentration and purity of DNA from each sample, electrophoresis of the AMG loci was performed for sex determination.
Results: This study showed that the average concentration of DNA on toothpicks ranged from 425.25 to 796.25 μg/ml, and the average purity of DNA ranged from 1.09 to 1.13 μg/ml. The AMG gene produces 112 and 116 base pair amplicons from the X and Y chromosomes.
Conclusion: Sex determination using DNA can be done using AMG loci, a protein found on the sex chromosomes (X and Y). The value of DNA concentration on toothpicks could be used to support forensic identification after 20 days at room temperature.
Methods: All patients admitted into our centre were screened for eligibility and those who underwent surgery from September 2016 to September 2017 had a D-dimer screening after surgery, followed by an ultrasound Doppler if the former was positive. The choice of anticoagulant therapy was not influenced by this study, and observation of the use was in keeping with usual practices in our centre was done.
Results: A total number of 331 patients were recruited in this study, however, after the inclusion and exclusion criteria had been met, 320 patients remained eligible, i.e. suitable for analysis. The mean age of our patients was 46 years, with 66% being male patients. A majority of the cases in this study were cranial related, with only 5% being spine surgeries. On the multivariate analysis, the Well's score and the number of days in bed remained statistically significant, after adjusting for age group, gender, ethnicity, type of central venous access and type of DVT prophylaxis with an adjusted odd's ratio, and a confidence interval of 95%, and P < 0.05 for each.
Conclusion: Well's scoring and number of days in bed were independent factors affecting the rate of DVT in patients undergoing neurosurgical procedures in our centre.
METHODS: Patients who were 10-80 years old and presented with a Graeb score of more than six were randomised into endoscopic washout and EVD treatment groups. A CT brain was repeated on each patient within 24 hours after surgery, and if a patient's Graeb score was still more than six, a repeat endoscopic washout was performed to clear the remaining clots. All patients were monitored for shunt dependency at two weeks and three months, and clinical outcomes were measured at six months after the procedure.
RESULTS: A total of 39 patients were recruited; 19 patients were randomised into the endoscopic washout group, and 20 were randomised into the EVD group. However, three patients in the endoscopic group refused that treatment and opted for EVD insertion. Patients treated with endoscopic washout had significantly less drainage dependency at two weeks (P < 0.005) and at three months (P < 0.004) as compared to patients in the external ventricular drainage group. The reduction in Graeb scores was also significantly greater in the endoscopic washout group (P < 0.001). However, the functional outcome at six months measured via a modified Rankin scale score was no different in the two groups of patients. The difference in the functional outcome of the patients was mainly dependent on the initial pathology, with those presenting with a thalamic bleed with IVH showing a poor functional outcome. This parameter was also influenced by the Glasgow Coma Scale (GCS) score on admission, with those patients with a score of 12 or less having a poor functional outcome (MRS 5-6) at three and six months after the surgery.
CONCLUSIONS: The use of neuroendoscopy in patients with a massive IVH significantly reduced drainage dependency. However, it did not alter the final functional outcome.
METHODS: We describe the clinical presentation, diagnostic work-up, management, and clinical course of a patient admitted with SMA syndrome who was subsequently found to have a hypothalamic germinoma.
RESULTS: An adolescent boy was admitted to the surgical ward with progressive weight loss over a 2 year period and postprandial vomiting. He was diagnosed with SMA syndrome based on evidence of proximal duodenal dilatation, extrinsic compression of the distal duodenum, and a narrowed aortomesenteric angle (16°). Investigations performed to exclude thyrotoxicosis unexpectedly revealed secondary hypothyroidism and further evaluation demonstrated evidence of pan-hypopituitarism. Psychiatric evaluation excluded anorexia nervosa and bulimia. Magnetic resonance imaging (MRI) of the brain revealed a heterogeneously enhancing hypothalamic lesion, but a normal pituitary gland. Hormone replacement with hydrocortisone, desmopressin, testosterone, and thyroxine resulted in weight gain and resolution of gastrointestinal symptoms. A transventricular endoscopic biopsy subsequently confirmed a hypothalamic germinoma and he was referred to an oncologist.
CONCLUSION: SMA syndrome secondary to severe weight loss is an uncommon cause of upper gastrointestinal obstruction. While there have been reports of poorly controlled diabetes mellitus and thyrotoxicosis manifesting as SMA syndrome, there are no published reports to date of SMA syndrome secondary to hypothalamic/pituitary disease. Management of SMA syndrome is conservative, as symptoms of intestinal obstruction resolve with weight gain following treatment of the underlying cause. Awareness of this uncommon presentation of endocrine cachexia/hypothalamic disease will prevent unnecessary laparotomies and a misdiagnosis of an eating disorder.
AIM: The aim of the present study was to determine sex of human mandible from morphology, morphometric measurements as well as discriminant function analysis from the CT scan.
MATERIALS AND METHODS: The present retrospective study comprised 79 subjects (48 males, 31 females), with age group between 18 and 74 years, and were obtained from the post mortem computed tomography data in the Hospital Kuala Lumpur. The parameters were divided into three morphologic and nine morphometric parameters, which were measured by using Osirix MD Software 3D Volume Rendering.
RESULTS: The Chi-square test showed that men were significantly association with square-shaped chin (92%), prominent muscle marking (85%) and everted gonial glare, whereas women had pointed chin (84%), less prominent muscle marking (90%) and inverted gonial glare (80%). All parameter measurements showed significantly greater values in males than in females by independent t-test (p< 0.01). By discriminant analysis, the classification accuracy was 78.5%, the sensitivity was 79.2% and the specificity was 77.4%. The discriminant function equation was formulated based on bigonial breath and condylar height, which were the best predictors.
CONCLUSION: In conclusion, the mandible could be distinguished according to the sex. The results of the study can be used for identification of damaged and/or unknown mandible in the Malaysian population.
METHODS: Geometric morphometric (GM) analysis of mandibles from 400 dental panoramic tomography (DPT) specimens was conducted. The MorphoJ program was used to perform generalized Procrustes analysis (GPA), Procrustes ANOVA, principal component analysis (PCA), discriminant function analysis (DFA), and canonical variate analysis (CVA). In the tpsDig2 program, the 27 landmarks were applied to the DPT radiographs. Variations in mandibular size and form were categorized into four age groups: group 1 (15-24 years), group 2 (25-34 years), group 3 (35-44 years), and group 4 (45-54 years).
RESULTS: The diversity in mandibular shape among the first eight principal components was 81%. Procrustes ANOVA revealed significant shape differences (P
METHODS: The extracts were assessed for the antimalarial potential using a malarial SYBR Green I fluorescence-based (MSF) assay, while the toxicity was screened by using brine shrimp lethality test (BSLT), haemolytic assay, and cytotoxicity assay against normal embryo fibroblast cell line (NIH/3T3) and normal kidney epithelial cell line (Vero).
RESULTS: The acetone extract showed the highest antimalarial activity (50% inhibitory concentration, IC50 = 5.85 ± 1.64 μg/mL), followed by the methanol extract (IC50 = 10.31 ± 1.90 μg/mL). Meanwhile, the ethanol and aqueous extracts displayed low antimalarial activity with IC50 values of 20.00 ± 1.57 and 30.95 μg/mL ± 1.27 μg/mL, respectively. The significant antimalarial activity was demonstrated in all extracts and artemisinin (P < 0.05). All extracts were non-toxic to brine shrimps (50% lethality concentration, LC50 > 1000 ppm). Furthermore, no occurrence of haemolysis (< 5%) was observed in normal erythrocytes when treated with all extracts compared to Triton X-100 that caused 100% haemolysis (P < 0.05). The acetone and methanol extracts were non-toxic to the normal cell lines and statistically significant to artemisinin (P < 0.05).
CONCLUSION: Taken together with satisfactory selectivity index (SI) values, the acetone and methanol extracts of Q. infectoria galls could serve as an alternative, promising and safe antimalarial agents.