Microperforate hymen is a rare vaginal anomaly that is usually reported in childhood due to recurrent urogenital infections. Unlike imperforate hymen where the presenting complaints are classical due to complete vaginal obstruction, the less profound and varied presentation of microperforate hymen may go unnoticed. We report a case of a 39-year-old, with a background history of amenorrhea, who presented with acute abdomen suggestive of tubo-ovarian abscess, and was finally diagnosed to have microperforate hymen. She underwent hymenectomy to correct the anomaly. To our knowledge, this is the oldest age of presentation of a congenital form of microperforate hymen. A high index of suspicion and early detection of microperforate hymen and properly timed intervention is essential to prevent acute symptoms and long term detrimental sequalae to women’s reproductive and psychosexual health.
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.
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)
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.
Pennisetum purpureum Schumach. is a weed that is currently spreading rapidly to many parts of the world particularly tropical countries. The abundance of P. purpureum in Malaysia is presently a serious problem. A study was conducted to investigate and evaluate the potential allelopathic effects of P. purpureum on Eleusine indica L. Gaertn. using the aqueous leaf extract and plant debris incorporated into the soil. Low concentrations of the P. purpureum aqueous extract (2%) and debris incorporated into the soil (25/500 g) inhibited germination and seedling growth of the bioassay species (E. indica) by >80%. The responses of the bioassay species to the aqueous extract and debris-incorporated soil were concentration dependent. The aqueous extract had higher total phenolic content compared to that from the debris incorporated soil, indicating the presence of certain phytotoxic compounds in the leaf debris and leaf extracts.
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.
Pasteurized shell eggs are eggs that have been thermally treated to eliminate harmful bacteria, however the treatment may also denature some of the egg white proteins. In this study the degree of denaturation and functional properties (emulsifying, foaming, and gelling properties) of egg white obtained from pasteurized eggs (EWP) were compared with those of unpasteurized eggs (EWUP). Data from differential scanning calorimeter showed that the EWP (ovotransferin, lysozyme, and ovalbumin) denatured at lower temperatures and required lower denaturation enthalpies than EWUP, indicating a partial loss of protein structure during the pasteurization process in the pasteurized eggs. The emulsion and foam stability formed from EWP were significantly (P < 0.05) lower than those of EWUP, however the EWP formed stronger gels than EWUP. To assess suitability of EWP as a cake ingredient, angel food cake was prepared using both egg whites. As compared to EWUP-cake, EWP-cake was significantly (P < 0.05) lower in volume, cohesiveness and springiness values, but significantly (P < 0.05) higher in hardness, gumminess and chewiness. Overall, the sensory panelists gave significantly (P < 0.05) higher scores for angel food cake prepared with EWUP. The differences in functional properties of egg white proteins and the quality of cake were due mainly to the higher levels of denaturation attained by EWP as a result of the pasteurization process.
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.
Omega-3 long-chain polyunsaturated fatty acids (n-3 LC-PUFA) have many health benefits to human. Increasing evidence have shown that climate change reduces the availability of plankton n-3 LC-PUFA to primary consumers which potentially reduces the availability of n-3 LC-PUFA to human. Since marine bivalves are an important source of n-3 LC-PUFA for human beings, and bivalve aquaculture completely depends on phytoplankton in ambient water as food, it is important to understand the impact of climate change on the lipid nutritional quality of bivalves. In this study, fatty acid profile of different bivalves (mussels, oysters, clams, scallops and cockles) from different regions (tropical, subtropical and temperate) and time (before 1990, 1991-1995, 1996-2000, 2001-2005, 2006-2010, 2011-2015, 2016-2020) were extracted from published literature to calculate various lipid nutritional quality indicators. The results of this study revealed that the effects of global warming and declines in aragonite saturation state on the lipid content and lipid indices of bivalves are highly dependent on the geographical region and bivalves. In general, global warming has the largest negative impact on the lipid content and indices of temperate bivalves, including decreasing the PUFA/SFA, EPA + DHA and n-3/n-6. However, global warming has a much smaller negative impact on lipid content and lipid indices in other regions. The declines of aragonite saturation state in seawater promotes the accumulation of lipid content in tropical and subtropical bivalves, but it compromised the PUFA/SFA, EPA + DHA and n-3/n-6 of bivalves in all regions. The findings of this study not only fill the knowledge gap of the impact of climate change on the lipid nutritional quality of bivalves, but also provide guidance for the establishment of bivalve aquaculture and fisheries management plans to mitigate the impact of climate change.
Fourier transform infrared (FT-IR) spectroscopic studies have been undertaken to investigate the interactions among components in a system of hexanoyl chitosan-lithium trifluoromethanesulfonate (LiCF(3)SO(3))-diethyl carbonate (DEC)/ethylene carbonate (EC). LiCF(3)SO(3) interacts with the hexanoyl chitosan to form a hexanoyl chitosan-salt complex that results in the shifting of the N(COR)(2), CONHR and OCOR bands to lower wavenumbers. Interactions between EC and DEC with LiCF(3)SO(3) has been noted and discussed. Evidence of interaction between EC and DEC has been obtained experimentally. Studies on polymer-plasticizer spectra suggested that there is no interaction between the polymer host and plasticizers. Competition between plasticizer and polymer on associating with Li(+) ions was observed from the spectral data for gel polymer electrolytes. The obtained spectroscopic data has been correlated with the conductivity performance of hexanoyl chitosan-based polymer electrolytes.
We describe the clinical presentation, investigation and management of an eventually fatal case of hypercalcemic crisis due to primary hyperparathyridism (PHPT). A 60 year-old lady with history of urolithiasis presented with worsening generalized bone pain, spinal scoliosis and a limp. Laboratory data showed hypercalcemia and raised alkaline phosphatase. Left hip x-ray revealed a subcapital femoral neck fracture. Intact parathyroid hormone was elevated, 187.6 pmol/L (1.6 – 6.9) and ultrasound showed an enlarged right parathyroid gland. Despite initial reduction of serum calcium with saline infusion and multiple doses of intravenous pamidronate, her calcium increased to 4.14 mmol/L a week following application of Buck’s traction for persistent left hip pain. She succumbed eventually with serum calcium peaking at 6.28 mmol/L despite multiple therapeutic interventions.
KEY WORDS: Primary hyperparathyroidism, hypercalcemic crisis, pathological fracture, urolithiasis
Fibreoptic intubation has been established as a major advance in the management of difficult or failed intubation in the awake patient. If necessary, it may be performed under general anaesthesia with either spontaneous or controlled ventilation. This should be considered early in the management of failed intubation, before multiple attempts with other techniques lead to haemorrhage and oedema in the airway. We describe here selected case reports to illustrate this in 8 different situations. This is followed by a brief review of the technique and indications of fibreoptic intubation.
From January 1980 to August 1992, there were 125 deaths occurring in the operating theatre at the University Hospital Kuala Lumpur. Out of these 125, six were judged to have been mainly 'due to anaesthesia.' In the same time period, there were a total of 155,000 anaesthetics given in the hospital. This gives an anaesthetic death rate (in the operating theatre) of six out of 155,000 or 0.39:10,000.
Modern anaesthesia carries a definite although small risk. The risk from general and regional anaesthesia is reviewed, the causes explored, and preventive strategies discussed. Although anaesthesia may never be 100% safe, a knowledge of the risk and causes enables us to work towards this goal.
Overweight and obesity have become a serious health issue in worldwide and Malaysia is no exception. In view that obesity is one of the leading causes of non-communicable diseases, this systematic review aimed to explore whether Malaysian are getting fatter (overweight or obesity) and rounder (abdominal obesity). Searches of the published literature were conducted using 3 databases including EMBASE, MEDLINE, and PubMed. These were limited to cross-sectional or cohort studies in Malaysia. The databases provided the prevalence of overweight, obesity, and abdominal obesity among 15 years old and above Malaysian population from 2009 to 2015. In total, 47 articles were included in this review. Findings exhibit that the prevalence rates of overweight, obesity, and abdominal obesity range from 9.5% to 43.5%, 1.77% to 26.4% and 11.4% to 57.4%, respectively. Overweight is more predominant among males. However, obesity and abdominal obesity are more predominant among females. This means that more females are getting fatter and “rounder” as compared to males in Malaysia. The findings imply a lack of intervention programmes based on proper randomized controlled trials which are needed to adequately address the problem of obesity in Malaysia.
Introduction: In Malaysia, herbal medicines are used for variety of reasons including health promotion and home remedies during pregnancy and postpartum with Manjakani (Quercus infectoria) as one of the most commonly consumed herbs. Herbal medicines consumption had been linked to heavy metals contamination and transfer from mother to infant and may affect infant’s growth and development. This study aims to (i) determine Manjakani consumption among postpartum mothers, (ii) quantify its heavy metals level, namely lead, cadmium, arsenic and chromium, and (iii) determine health risk associated with its consumption. Methods: A cross-sectional study involving 106 postpartum mothers was carried out in Kuala Lumpur. Six samples of Manjakani were sampled and extracted using microwave digester and analysed using Inductively coupled plasma mass spectrometry (ICP-MS). Non-carcinogenic health risks for herbal medicine consumption were calculated using Hazard Quotient (HQ). Results: Manjakani was consumed by 16% of mothers (n=17). Highest level of the metals was shown by chromium with mean concentration of 4210 ± 1910 ug/kg, followed by lead (170.8 ± 193.2), arsenic (39.3 ± 27.1) and cadmium (7.7 ± 0.76). There were no significant non-carcinogenic health risks with lead, arsenic, chromium and cadmium contamination (HQ < 1). Conclusion: Manjakani is consumed by mothers during confinement period. Heavy metals were quantified in Manjakani although no significant association was observed with socio-demographic characteristics and birth outcomes.