Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) are a group of uncommon diseases. Given its rarity and multisystem clinical presentation which are usually serious and potentially fatal, prompt recognition and early treatment are of utmost importance. We report a case of AAV that presented with digital infarcts, cutaneous vasculitis, rapidly progressive glomerulonephritis, mononeuritis multiplex, eosinophilia and positive myeloperoxidase (MPO)-ANCA antibody. Apart from renal damage, there was complete recovery in other systems following intravenous cyclophosphamide and high-dose glucocorticoids albeit the response was delayed. This response obviates the need for second-line therapy with newer agent such as rituximab (anti-CD20 monoclonal antibody). We would also like to highlight that this is the first case of AAV that is associated with autoimmune thyroid disease to be reported from Malaysia.
Recent progress with tailored growth and post-process sorting enables carbon nanotube (CNT) assemblies with predominantly metallic or semi-conducting concentrations. Cryogenic and microwave measurements performed here show transport dimensionality and overall order increasing with increasing metallic concentration, even in atmospheric doping conditions. By 120 GHz, the conductivity of predominantly semi-conducting assemblies grew to 400% its DC value at an increasing growth rate, while other concentrations a growth rate that tapered off. A generalized Drude model fits to the different frequency dependent behaviors and yields useful quality control parameters such as plasma frequency, mean free path, and degree of localization. As one of the first demonstrations of waveguides fabricated from this material, sorted CNTs from both as-made and post-process sources were inserted into sections of practical micro-strip. With both sources, sorted CNT micro-strip increasingly outperformed the unsorted with increasing frequency-- illustrating that sorted CNT assemblies will be important for high frequency applications.
Ultrasound imaging is a very essential technique in medical diagnosis due to its being safe, economical and non-invasive nature. Despite its popularity, the US images, however, are corrupted with speckle noise, which reduces US images qualities, hampering image interpretation and processing stage. Hence, there are many efforts made by researches to formulate various despeckling methods for speckle reduction in US images.
To assess the impact of incremental modifications of treatment planning and delivery technique, as well as patient anatomical factors, on late gastrointestinal toxicity using data from the TROG 03.04 RADAR prostate radiotherapy trial.
This cross sectional survey was conducted to determine the support in making Penang UNESCO World Heritage Site (GTWHS) smoke free and to determine the influence of tolerance towards smoking on this support. This is the first phase in making Penang, Malaysia a smoke free state. A multistage sampling process was done to select a sample of respondents to represent the population of GTWHS. Attitude towards smoking was assessed using tolerance as a proxy. A total of 3,268 members of the community participated in the survey. A big majority (n = 2969; 90.9%) of the respondents supported the initiative. Support was lowest among the owners and residents/tenants, higher age groups, the Chinese, men, respondents who had poor knowledge of the places gazetted as smoke free, and respondents with poor knowledge of the health effects on smokers and on passive smokers. The odds (both adjusted and unadjusted) of not supporting the initiative was high among those tolerant to smoking in public areas. Tolerance towards smoking was associated with 80.3% risk of non-support in the respondents who were tolerant to smoking and a 57.2% risk in the population. Health promotion and education concerning the harm of tobacco smoke in Malaysia, which has mainly targeted smokers, must change. Health education concerning the risks of second hand smoke must also be given to non-smokers and efforts should be made to denormalize smoking.
The role of anesthetists during orthopedic fluoroscopic procedures exposes them to radiation. We conducted a prospective, descriptive study to estimate the radiation exposure to anesthetists during procedures over a six-month period in the orthopedic trauma operating theatres which had the most fluoroscopic usage.
Acute pain service (APS) ensures provision of effective and safe postoperative pain relief. The following cases describe a potentially fatal error in managing patients who receive epidural analgesia postoperatively.
Electromagnetic (EM) waves transmitted by Horizontal Electric Dipole (HED) source to detect contrasts in subsurface resistivity termed Seabed Logging (SBL) is now an established method for hydrocarbon exploration. However, currently used EM wave detectors for SBL have several challenges including the sensitivity and its bulk size. This work exploits the benefit of superconductor technology in developing a magnetometer termed Superconducting Quantum Interference Device (SQUID) which can potentially be used for SBL. A SQUID magnetometer was fabricated using hexagon shape-niobium wire with YBa2Cu37O, (YBCO) as a barrier. The YBa2Cu37O, samples were synthesized by sol-gel method and were sintered using a furnace and conventional microwave oven. The YBCO gel was dried at 120 degrees C in air for 72 hours. It was then ground and divided into 12 parts. Four samples were sintered at 750 degrees C, 850 degrees C, 900 degrees C, and 950 degrees C for 12 hours in a furnace to find the optimum temperature. The other eight samples were sintered in a microwave with 1100 Watt (W) with a different sintering time, 5, 15, 45 minutes, 1 hour, 1 hour 15 minutes, 1 hour 30 minutes, 1 hour 45 minutes and 2 hours. A DEWAR container was designed and fabricated using fiberglass material. It was filled with liquid nitrogen (LN2) to ensure the superconducting state of the magnetometer. XRD results showed that the optimum sintering temperature for the formation of orthorhombic Y-123 phase was at 950 degrees C with the crystallite size of 67 nm. The morphology results from Field Emission Scanning Electron Microscopy (FESEM) showed that the grains had formed a rod shape with an average diameter of 60 nm. The fabricated SQUID magnetometer was able to show an increment of approximately 249% in the intensity of the EM waves when the source receiver offset was one meter apart.
Magnetic nanoparticles in the hollow region of carbon nanotubes have attraction due to their changing physical electrical and magnetic properties. Nickel zinc ferrite plays an important role in many applications due to its superior magnetic properties. Ni0.8Zn0.2Fe2O4 single crystals were encapsulated in multiwall carbon nanotubes (MWCNTs). The magnetic nano crystals were prepared using a sol-gel self combustion method at the sintering temperature of 750 degrees C and were characterized by XRD, FESEM, TEM and VSM. Initial permeability, Q-factor and relative loss factor were measured by impedance vector network analyzer. XRD patterns were used for the phase identification. FESEM images show morphology and dimensions of the grains of Ni0.8Zn0.2Fe2O4 single crystals and Ni0.8Zn0.2Fe2O4 single crystals in MWCNTs. TEM images were used to investigate single crystal and encapsulation of Ni0.8Zn0.2Fe2O4 single crystals in the MWCNTs. VSM results confirmed super paramagnetic behaviour of encapsulated Ni0.8Zn0.2Fe2O4 single crystals. It was also attributed that encapsulated Ni0.8Zn0.2Fe2O4 single crystals in MWCNTs showed a higher initial permeability (51.608), Q-factor (67.069), and low loss factor (0.0002) as compared to Ni0.8Zn0.2Fe2O4 single crystals. The new encapsulated Ni0.8Zn0.2Fe2O4 single crystals in the MWCNTs may have potential applications in electronic and medical industries.
In seabed logging the magnitude of electromagnetic (EM) waves for the detection of a hydrocarbon reservoir in the marine environment is very important. Having a strong EM source for exploration target 4000 m below the sea floor is a very challenging task. A new carbon nanotubes (CNT) fibres/aluminium based EM transmitter is developed and NiZn ferrite as magnetic feeders was used in a scaled tank to evaluate the presence of oil. Resistive scaled tank experiments with a scale factor of 2000 were carried out. X-ray Diffraction (XRD), Raman Spectroscopy and Field Emission Scanning Electron Microscope (FESEM) were done to characterize the synthesized magnetic feeders. Single phase Ni0.76Mg0.04Zn0.2Fe2O4, obtained by the sol-gel method and sintered at 700 degrees C in air, has a [311] major peak. FESEM results show nanoparticles with average diameters of 17-45 nm. Samples which have a high Q-factor (approximately 50) was used as magnetic feeders for the EM transmitter. The magnitude of the EM waves of this new EM transmitter increases up to 400%. A curve fitting method using MATLAB software was done to evaluate the performance of the new EM transmitter. The correlation value with CNT fibres/aluminium-NiZnFe2O4 base transmitter shows a 152.5% increase of the magnetic field strength in the presence of oil. Modelling of the scale tank which replicates the marine environment was done using the Finite Element Method (FEM). In conclusion, FEM was able to delineate the presence of oil with greater magnitude of E-field (16.89%) and the B field (4.20%) due to the new EM transmitter.
We report a rare case of an 18 year old girl with Sturge-Weber syndrome, she had extensive facial port wine stains, right bupthalmos and advanced glaucoma involving both eyes. She underwent right eye glaucoma drainage device surgery under general anaesthesia, and had a difficult intubation due to extensive angiomatous like soft tissue swelling at her upper airway. This report highlights the importance of being aware of the need for continuous follow-up in Sturge-Weber syndrome patients as this syndrome can lead to blindness due to advance glaucoma and the awareness of possible difficult intubation for this group of patients.
The sol-gel method was carried out to synthesize nanosized Yttrium Iron Garnet (YIG). The nanomaterials with ferrite structure were heat-treated at different temperatures from 500 to 1000 °C. The phase identification, morphology and functional groups of the prepared samples were characterized by powder X-ray diffraction (PXRD), scanning electron microscopy (SEM) and Fourier transform infrared spectroscopy (FT-IR), respectively. The YIG ferrite nanopowder was composited with polyvinylidene fluoride (PVDF) by a solution casting method. The magnitudes of reflection and transmission coefficients of PVDF/YIG containing 6, 10 and 13% YIG, respectively, were measured using rectangular waveguide in conjunction with a microwave vector network analyzer (VNA) in X-band frequencies. The results indicate that the presence of YIG in polymer composites causes an increase in reflection coefficient and decrease in transmission coefficient of the polymer.
Aluminum substituted yttrium iron garnet nano particles with compositional variation of Y(3.0-x) A1(x)Fe5O12, where x = 0.0, 0.5, 1.0, 1.5, 2.0, 2.5 and 3.0 were prepared using sol gel technique. The X-ray diffraction results showed that the best garnet phase appeared when the sintering temperature was 800 degrees C. Nano-crystalline particles with high purity and sizes ranging from 20 to 100 nm were obtained. It was found that the aluminum substitution had resulted in a sharp fall of the d-spacing when x = 2, which we speculated is due to the preference of the aluminum atoms to the smaller tetrahedron and octahedron sites instead of the much larger dodecahedron site. High resolution transmission electron microscope (HRTEM) and electron diffraction (ED) patterns showed single crystal nanoparticles were obtained from this method. The magnetic measurement gave moderate values of initial permeability; the highest value of 5.3 was shown by sample Y3Fe5O12 at more than 100 MHz which was attributed to the morphology of the microstructure which appeared to be homogeneous. This had resulted in an easy movement of domain walls. The substitution of aluminum for yttrium is speculated to cause a cubic to rhombodedral structural change and had weakened the super-exchange interactions thus a fall of real permeability was observed. This might have created a strain in the sub-lattices and had subsequently caused a shift of resonance frequencies to more than 1.8 GHz when x > 0.5.
This is our initial response towards preparation of nano-inductors garnet for high operating frequencies strontium iron garnet (Sr3Fe5O12) denoted as SrIG and yttrium iron garnet (Y3Fe5O12) denoted as YIG. The garnet nano crystals were prepared by novel sol-gel technique. The phase and crystal structure of the prepared samples were identified by using X-ray diffraction analysis. SEM images were done to reveal the surface morphology of the samples. Raman spectra was taken for yttrium iron garnet (Y3Fe5O12). The magnetic properties of the samples namely initial permeability (micro), relative loss factor (RLF) and quality factor (Q-Factor) were done by using LCR meter. From the XRD profile, both of the Y3Fe5O12 and Sr3Fe5O12 samples showed single phase garnet and crystallization had completely occurred at 900 degrees C for the SrIG and 950 degrees C for the YIG samples. The YIG sample showed extremely low RLF value (0.0082) and high density 4.623 g/cm3. Interesting however is the high Q factor (20-60) shown by the Sr3Fe5O12 sample from 20-100 MHz. This high performance magnetic property is attributed to the homogenous and cubical-like microstructure. The YIG particles were used as magnetic feeder for EM transmitter. It was observed that YIG magnetic feeder with the EM transmitter gave 39% higher magnetic field than without YIG magnetic feeder.
The capability of carbon nanotubes (CNTs) to adsorb lead (Pb) in aqueous solution was investigated. Batch mode adsorption experiment was conducted to determine the effects of pH, agitation speed, CNTs dosage and contact time. The removal of Pb(II) reached maximum value 85% or 83% at pH 5 or 40 mg/L of CNTs, respectively. Higher correlation coefficients from Langmuir isotherm model indicates the strong adsorptions of Pb(II) on the surface of CNTs (adsorption capacity Xm = 102.04 mg/g). The results indicates that the highest percentage removal of Pb (96.03%) can be achieved at pH 5, 40 mg/L of CNTs, contact time 80 min, and agitation speed 50 r/min.
Background: The high prevalence and impacts of orofacial pain (OFP) have caused major sufferings to individuals and society. The purpose of the study was to investigate the problems and impacts of OFP among a group of Malaysian aborigines. The objectives were to determine (i) the prevalence, aetiology, duration, severity, types and persistence of OFP during the past 3 months preceding the study; (ii) its associated impact on daily performance; and (iii) the measures taken for pain relief.
Methods: This is a cross sectional study carried out in Kuala Lipis, Pahang involving 6 villages of Orang Asli Bateq and Semai. Study sample was chosen using convenient sampling including adults aged 16 years and above. Participants were invited for an interview using structured questionnaire followed by clinical examination. Data analysis was carried out using SPSS ver12.
Results: Response rate was low at 20% (n = 140). Over one-quarter (26.4%) of the sample experienced OFP in the previous 3 months. Toothache was found to be the main aetiology (83.3%) followed by gingival pain (18.9%), temporomandibular joint (10.8%) and facial pain (8.1%). Mean duration of pain was 9.8 days for toothache, 162.4 days for gingival pain, 7.3 days for TMJ and 5.7 days for facial pain. Of those who had OFP, over half rated the pain as moderate (37.8%) and severe (29.7%) and most of the pain was ‘intermittent’ in nature (81.1%). Over half (62.2%) admitted the pain had disappeared during the interview. In terms of pain relief, 56.8% of the sample used traditional medicine. The pain had impacted on the chewing ability (70.3%, p=0.01), ability to sleep at night (73.0%, p<0.001), levels of anxiety (70.3%), ability to perform daily chores (33.3%) and social life (35.1%) of the Orang Asli sample.
Conclusion: This study suggests the prevalence of OFP was high among the Orang Asli sample, which imposed considerable physical and psychological impacts on daily life.
Key words: orofacial pain; impacts; quality of life; Malaysian aborigines
Ambulatory or day care surgery is still in its infancy in this part of the world. Our newly built university affiliated hospital started its Day Surgery Centre in February 1998. It is the first multidisciplinary ambulatory surgery centre in a teaching hospital in the country. It caters for Orthopaedic surgery, Urology, Plastic surgery, Otorhinolaryngology, General surgery, Paediatric surgery and Ophthalmology. We have done 2,604 cases and our unanticipated admission rate is less than 2%. There has been no major morbidity or mortality. The problems of setting up a multidisciplinary ambulatory centre in a teaching hospital are discussed.
High performance liquid chromatography (HPLC) with phenylisothiocyanate (PITC) is recently used for confirming the diagnosis of inborn errors of metabolism (IEM) especially amino acid disorders in Malaysian children. The method of HPLC used is a precolumn derivatization of amino acids with phenylisothiocyanate and is separated by reversed phase chromatography using 3.9 x 300 mm free amino acid columns and is detected by a UV/Vis detector. The samples are obtained from cases suspected of inborn errors of metabolism, especially of amino acid disorders, which are detected clinically by pediatricians. Initially, samples from patients suspected of inborn errors of metabolism, either urine or serum, are run on one-dimensional thin layer chromatography and supplementary chemical tests to detect the abnormal bands and associated abnormalities respectively. Positive samples are further run on HPLC to determine the specific amino acids abnormality. An examples of a case of maple syrup urine disease is discussed, based on the thin layer chromatography findings and HPLC findings.