Fractures may occur after an episode of seizures. Although rare, with a high index
of suspicion and proper physical examination, delay of diagnosis and treatment
can be avoided. We report a case of near missed bilateral proximal humerus
fracture after an episode of generalized tonic-clonic seizure. A 58-year-old lady
with a background history of epilepsy complained of generalized body ache after
a generalized tonic-clonic seizure which happened few hours before presentation to our Emergency Department. On assessment, she was in pain and unable to
move all four limbs. After given analgesia, patient was reassessed whereby she
complained of bilateral shoulder stiffness and pain. Examination of the upper limbs
revealed restricted range of movement in all directions with no shoulder squaring.
X-ray showed bilateral proximal humerus fracture. Proximal humeral fractures
rarely occur by itself following seizures; they are almost always associated with
dislocation of the glenohumeral joint.
Eventration of the diaphragm is caused by weakened musculature of the diaphragm. This can occur in one or
both hemidiaphragms. Symptoms may be minimal and it is usually detected incidentally on chest radiograph
which would show an elevation of the diaphragm. We report and discuss a case of eventration of right
diaphragm in a patient presented with a lobulated lung mass on chest radiograph.
Hyperadrenocorticism is the excessive production of cortisol by the adrenal cortex. 15-20% of hyperadrenocorticism in dogs may be due to functional adrenal tumour. Here we present a case of functional adrenal tumour in a 10 years old Shih-Tzu Poodle mixed-breed dog that was presented to University Veterinary Hospital, Universiti Putra Malaysia. Physical examination findings include multiple cutaneous myiasis, a pendulous abdomen with comedones on the ventral thoracic region and thinning of the skin. Clinical signs shown were polyuria, polydipsia and polyphagia. Serum biochemistry result showed elevated alkaline phosphatase enzyme of 5 folds. Urinary specific gravity was minimally concentrated (1.015). Radiography showed generalised hepatomegaly. Meanwhile, ultrasonography showed unilateral enlargement of the right adrenal gland with mineralisation. Invasion of the right adrenal gland into the caudal vena cava was observed. A differentiation test (high-dose dexamethasone suppression test) was performed and a lack of suppression of the cortisol level was observed. Based on the appropriate clinical signs and physical examination findings, elevated alkaline phosphatase enzyme, minimally concentrated urinary specific gravity, generalised hepatomegaly, unilateral adrenal gland enlargement, and high-dose dexamethasone suppression test, a diagnosis of functional adrenal tumour was made.
Old intact male dogs are often predisposed to benign prostatic hyperplasia. Both hypertrophy and hyperplasia of prostate
gland occur due to hormonal influences. Clinical signs such as haematuria, stranguria and tenesmus are often associated with benign
prostatic hyperplasia. A seven year-old local breed intact male dog was presented with a primary complaint of haematuria and
stranguria. Diagnostic work-up conducted inclusive of complete blood count, serum biochemistry, urinalysis, abdominal radiograph,
cystourethrography and abdominal ultrasonography. The dog was diagnosed with cystic benign prostatic hyperplasia. Prostatic
omentalisation and castration were performed in this case.
Tuberculosis in children remains a public heath concern in Malaysia and other developing countries. Mycobacterium tuberculosis (TB) infection of the liver, known as hepatic TB, is an extra pulmonary manifestation of TB. Tuberculous bacilli can reach the liver via hematogenous dissemination through hepatic artery, or by local spread from the gastrointestinal tract via portal vein [1].(Copied from article)
This study aims to determine the mediating effects of coping strategies on the relationships between organizational support (supervisor and coworker support) and work-family conflict. A questionnaire survey approach was conducted with the purposive sampling. This study was contributed to 342 married employees from different organizations in the Luangprabang province, Laos. The gathered data was analyzed by employing the Structural Equation Modeling using SPSS Amos 21.0 software. The findings showed that organizational support (supervisor support and coworker support) was not significantly related to work-family conflict. Problemfocused coping was not significantly related to work-family conflict, whereas emotion-focused coping was significantly related to work-family conflict. This is one of the first studies to provide empirical evidence in terms of the mediating effects regarding coping strategies among married employees in Laos. The organizations should consider the coping strategies and the support from supervisors and colleagues in formulating strategies to minimize work-family conflict. Additionally, problem-focused coping is a more meaningful predictor of work-family conflict than emotion-focused coping. Providing the training of the comprehensive coping program to the employees could help them to be sensitive in coping work-family conflict. This study could serve as an important guideline to develop planning strategies in managing work and family role and promoting work-life balance among the employees.
There is a high incidence of 36% to 83% of respiratory dysfunction in patients with acute cervical spinal cord
injury. Complications arising from respiratory dysfunction remain one of the most common causes of morbidity
and mortality in the spinal cord injured population. Specialized pulmonary care and therapy can help individuals
with tetraplegia to maintain a stable respiratory status allowing active participation in active rehabilitation.
This would allow them to achieve rehabilitation goals of independent function and community reintegration.
Mechanical insufflation-exsufflation (MIE) therapy is an option for secretion management in individuals with
acute spinal cord injury. In this paper, we present our experience using MIE as an adjunct to management of
secretions in the spinal cord injured population at the University of Malaya Medical Centre.
Mild hyperkalaemia does not typically cause cardiac symptoms. However, for an elderly patient on atrio-ventricular (AV) nodal blocker, even mild hyperkalaemia may result in disastrous outcome. We report a case of persistent bradyarrythmia caused by iatrogenic hyperkalaemia in a patient who had concomitant use of AV nodal medication. An 81-year-old lady with multiple comorbidities and a long list of medications presented with symptomatic bradyarrhythmia. She, in fact, had two AV nodal blockers in her prescription, a beta-blocker and amiodarone. Her potassium level was found to be mildly elevated due to acute renal failure. She remained bradycardic despite initial treatment and was subsequently dependant on intravenous isoproterenol until her renal function improved. This case highlights the different threshold for manifestation of hyperkalaemic symptoms in a growing group of patients: elderly patients with multiple comorbidities and polypharmacy.
Keywords: bradyarrythmia, bradycardia, elderly, hyperkalaemia, polypharmacy
The Morel-Lavallee lesion is a rare soft tissue injury that occurs due to traumatic shearing force on skin surface causing separation of skin and subcutaneous tissue resulting in hematoma. This case report depicts a 22-year-old gentleman who was involved in a motor vehicle accident. He complained of pain and swelling over lower back. He was treated for soft tissue injury and admitted for pain control. One day post-trauma, he complained of increased swelling over the back. His hemoglobin dropped from 12.2g/dL to 10.7g/dL. Diagnosis of Morel-Lavallae lesion was made. Initially no surgical intervention was planned. However, in view of worsening of swelling, bedside aspiration was performed and subsequently a pigtail catheter was inserted to drain the hematoma. In total, 2.05 litre of liquefied hematoma was drained. Thus, Morel-Lavallee lesion is an uncommon soft tissue injury that can cause significant bleeding following trauma.
Keywords: degloving injuries, hematoma, trauma
The aim of this study was to assess the viability of coating collagen to Hydroxyapatite (HA) coated commercially pure Titanium (cpTi) samples. Five samples of cpTi were immersed in a simulated body fluid (Tas-SBF) after stages of gritting, sandblasting and acid etching. One sample was taken out after 3, 5 and 7 days of immersion in Tas-SBF respectively. The 7 days Tas-SBF coated sample was coated with collagen by physical adsorption method. Analysis was performed to study the surface roughness, morphology and elemental analysis of the coated surfaces.The equipment used wereAlicona, Scanning Electron Microscope (SEM), Energy-dispersive X-ray Spectroscopy (EDS) and Fourier Transform Infrared Spectroscopy (FTIR). Process of sand blasting and acid etching were able to produce desired morphology and surface roughness. The average surface roughness, Sa of sand blasted cpTi surface and acid etched cpTi were 2.17 ± 0.75 µm and 2.12 ± 0.15 µm respectively. Immersion in Tas-SBF produced a crystalline coating and morphology that were similar to bone-like apatite. Roughness value of cpTi after being immersed in SBF for 7 days was 2.23 ± 0.31 µm and the Ca/P ratio was 7.076. Collagen coated samples had the highest Sa value which was 3.91 ± 0.31 µm and the Ca/P ratio was 1.190. This study showed that it is possible to achieve apatite and collagen coating on a modified cpTi surface using physical adsorption method.
Radio propagation prediction simulation methods based on deterministic technique such as ray launching is extensively used to accomplish radio channel characterization. However, the superiority of the simulation depends on the number of rays launched and received. This paper presented the indoor three-dimensional (3D) Minimum Ray Launching Maximum Accuracy (MRLMA) technique, which is applicable for an efficient indoor radio wave propagation prediction. Utilizing the novel MRLMA technique in the simulation environment for ray lunching and tracing can drastically reduce the number of rays that need to be traced, and improve the efficiency of ray tracing. Implementation and justification of MRLMA presented in the paper. An indoor office 3D layouts are selected and simulations have been performed using the MRLMA and other reference techniques. Results showed that the indoor 3D MRLMA model is appropriate for wireless communications network systems design and optimization process with respect to efficiency, coverage, number of rays launching, number of rays received by the mobile station, and simulation time.
Formulation 2 (1 g w/w) was the most favourable and was chosen for further analyses to
compare its composition with that of a control (0 g w/w). Total phenolic content (TPC) of
the fresh noodles remained higher than that of the control even after cooking. However,
after cooking, the carbohydrate and protein contents showed significant increases. The
results showed that the lemuni-supplemented noodles have a longer shelf life compared to
the control. The colour parameters L* and a* also showed significant differences as the
lightness decreased, and the redness increased after the substitution. The L*, a* and b*
values decreased significantly after the noodles of both formulations were cooked. The
tensile strength, adhesiveness, and hardness of the lemuni noodles were significantly
higher than those of the control. Thus, the Vitex negundo Linn. leaf has the potential to
increase the health benefits of food products.
Writing ability is essential in second language (L2) learners’ educational and professional life.
However, experiencing writing apprehension can inhibit the L2 learners’ confidence (Daly, 1975). The
objective of this study was to investigate the writing apprehension levels of ESL pre-university learners
in writing argumentative composition. 320 pre-university learners from a local institution participated
in the study. Two instruments were employed in the study. The first was the Second Language Writing
Anxiety Inventory (SLWAI) and the other one was the Analytic Scale of Argumentative Writing
(ASAW). The findings revealed a moderate level of writing apprehension among the pre-university
learners in argumentative writing. Among the three Second Language Writing Apprehension (SLWA)
dimensions, avoidance behaviour obtained the highest mean score. As writing is one of the important
components tested in Malaysian University English Test (MUET), the findings of the present study
may become a platform for instructors to develop a better understanding about SLWA. Hence, it may
throw light on what educators can do to help these L2 learners cope with or eliminate writing
apprehension as it hampers the writing quality.
Aim: To investigate cigarette consumption patterns exhibited by non-smokers, occasional smokers, and daily smokers in Malaysia.
Subjects and methods: A sample of 4204 individuals from the 2011 Malaysian Global Adult Tobacco Survey is analyzed. A zero-inflated ordered probit model is used to accommodate the ordinal nature of smoking outcomes with excessive zero observations of non-smokers.
Results: Socio-demographic characteristics are closely associated with consumption patterns of non-smokers, occasional smokers, and daily smokers. Specifically, urbanites, government employees, and Malays exhibit greater tendencies to be daily smokers and lower propensities to be non-smokers than others. Education is a deterring factor in cigarette smoking as higher education up to the tertiary level raises the propensity of being a non-smoker by 8.16 percentage points. The role of ethnicity is highlighted as individuals of Malay and other ethnic backgrounds are more likely to smoke daily, while exhibiting lower propensities of being non-smokers. Males are more likely to engage in occasional or daily smoking than females. Employment in government or non-government sectors increases the probability of daily smoking.
Conclusions: Our results suggest the need to include measures to cope with internal or external cues among smokers with specific socio-demographic characteristics. Cessation interventions should focus on daily smokers in urban surroundings with low education levels and those of Malay ethnic origins. Anti-smoking measures in line with occasional smoking may include ameliorating the male attitude toward smoking and policies to prohibit workplace indulgence.
Study name: Global Adults Tobacco Survey (GATS-2011)
Samples of Y-Ba-Cu-O superconductor with nominal compositions of YBa2Cu3O7-d + x (weight %) Y2O3 (x = 0 - 15) were prepared by solid state reaction method using the Y2Cu2O5 and BaCuO2 precursors as the starting reagents. The X-ray diffraction (XRD) diffractograms for the doped samples (x> 0) show an additional non-superconducting Y2BaCuO5 (211) phase. The scanning electron microscope (SEM) micrographs show that the smaller Y2BaCuO5 grains are precipitated on the surface of the larger YBa2Cu3O7-d (YBCO) crystals. The grain size of the YBCO decreases with increasing yttria. The superconducting zero resistivity critical temperature (Tco) of the doped samples is very close to the Tco of the YBCO for x < 5, but it seems to be significantly decreasing for larger x. The transport critical current density (J) for x < 5 is enhanced due to magnetic flux pinning process by the 211 phase. However, Jc decreased for larger x due to the increase of weak links at the grain boundaries of the YBCO phase.
Sampel superkonduktor Y-Ba-Cu-O dengan komposisi nominal YBa2Cu3O7-d + x (% berat) Y2O3 (x = 0 -15) disediakan dengan kaedah tindakbalas keadaan pepejal menggunakan bahan pelopor Y2Cu2O5 dan BaCuO2 Difraktogram pembelauan sinar-X (XRD) bagi sampel yang didop (x > 0) menunjukkan wujudnya fasa tak mensuperkonduksi Y2BaCuO5 (211). Mikrograf mikroskop imbasan elektron (SEM) menunjukkan bahawa butiran Y2BaCuO5 yang lebih kecil itu termendap di atas permukaan hablur YBa2Cu3O7-d yang lebih besar. Saiz hablur YBCO mengecil dengan peningkatan yittria. Suhu genting kerintangan sifar (Tc) bagi sampel yang didop adalah hampir dengan Tco bagi YBCO untuk x<5, tetapi menurun dengan agak cepat untuk x yang lebih besar. Ketumpatan arus genting angkutan (J) untuk x < 5 meningkat jika dibandingkan dengan YBCO disebabkan oleh proses kepinan fluks magnet oleh fasa 211. Walau bagaimanapun, Jc menurun untuk x yang lebih tinggi kerana meningkatnya hubungan lemah pada sempadan butiran fasa YBCO.
The Sibling Inventory of Differential Experience (SIDE; Daniels & Plomin, 1985) is a self-report to assess children’s perception of parental differential treatment (PDT). Specifically, SIDE measures two specific constructs of PDT: control and affection. The present study applied both the traditional (twocorrelated-factor model) and novel (bifactor) modeling approaches to derive the most optimal measurement structure of the Chinese version of SIDE (SIDE-C). Respondents were 225 primary school students who have only one sibling in the family. Results showed that, while the two-correlated-factor model was acceptable, the bifactor model had a better fit. The bifactor model is preferable in terms of fit indices and the principle of parsimony. Additionally, Omega hierarchical coefficient supported the strength of the general factor over the specific factors of parental differential treatment. The findings not only shed light on the factorial validity of the SIDE-C but also suggest future studies to consider the roles of the general and specific factors of PDT.
A functional cookie formulation containing oligofructose, dietary fibre and lower calorie, fat and sugar contents than conventional cookies was optimized using Response Surface Methodology (RSM). Instant N-Oil II was used as a fat replacer, while Raftilose ®P95 was used as a sugar substitute with the addition of fructose to enhance sweetness. Selection of the optimal formulation was based on caloric content. An optimized formulation, V1, was obtained from the model Y = 4927.70 – 152.34X1 – 155.42X3 + 104.20X32 + 151.71X33 – 95.08X34, where Instant N-Oil II replaced 30% of butter and 24.4%, w/w (30.5g) fructose replaced 40.0%, w/w (50.0g) sucrose. Two additional optimized formulations, S1 and S2, were proposed which contained the same ingredients as V1, but both contained 19.0%, w/w (23.8g) Raftilose ®P95. Also, S2 had a higher fat replacement level (42%). A reference cookie prepared from a conventional recipe received significantly higher scores (P < 0.05) than the functional cookies V1, S1 and S2 in the sensory evaluation. However, when health benefits of the functional cookies were explained to the panel after the sensory evaluation had concluded, majority of the panelists stated that they would prefer S1, had they known of its health benefits. S1 contained 19.04% fat, 8.62% fructose and 0.74% sucrose, namely, significantly lower fat and sucrose levels and higher fructose content than the conventional cookie.
Polarization in antiferroelectric liquid crystals has two origins: The piezoelectric polarization which is of chiral origin and the flexoelectric polarization which originates in different orientation of tilts in neighboring layers. The flexoelectric polarization is perpendicular to the tilt direction only if the structure is uniformly helicoidally modulated. In structures like SmC*F11andSmC;12 the flexoelectric contribution might be significant and it can be non-parallel to the piezoelectric component. Hence it may deviates the direction of polarization from the perpendicular direction significantly. The angle formed by the polarization and the tilt is therefore general and as such the basic characteristic of the SmCG* phase can be recognized. It seems that this aspect was completely overlooked in the past. In this contribution we analyze the dependence of the polarization direction on the phase structures and on the values of piezoelectric and flexoelectric coefficients in the discrete phenomenological model.
The crab carapace is a waste which cannot be decomposed. This waste was used to
remove the Reactive Orange 16 (RO16) and Basic Blue 3 (BB3) from aqueous solution
at different operational parameters such as pH, mass load, the concentrations of dye and
the temperature. The crab collected was modified to obtain quaternized crab (QC) using
(3-chloro-2-hydroxypropyl) trimethylammonium chloride solution (C6H15Cl2NO, 65% w/w
in water). The pH of the dyes solution was varied from pH 4 to 10. The highest adsorption
percentage was achieved at pH 7 for both dyes. Increasing the QC mass for the adsorption
process had granted an increase of dyes removal percentage. The highest adsorption
percentage was achieved at 91.00% for RO16 and 29.40% for BB3 dyes with 7.5 g/L QC
used. However, the adsorption capacity of QC decreased with higher QC mass because the
dye molecules occupied on the surface and prevented other molecules to diffuse into the
QC. At higher concentration beyond 20 mg/L and 10 mg/L of RO16 and BB3, respectively,
the maximum adsorption was achieved at 2.5362 mg/g and 0.6812 mg/g. The adsorption of
both dyes by QC was best fitted using Langmuir isotherm model, explaining the adsorption
mainly occurred as a single layer on the surface of QC. Comparison to the results obtained
from the kinetic models, the adsorption was
chemisorption in nature. According to the
thermodynamic studies, the adsorption of
RO16 was an exothermic, while BB3 was
an endorthermic process.