Patient undergoes orthodontic treatment with fixed appliances have more plaque
retentive area compare to normal person. Therefore, this patient requires higher standard of oral
hygiene care. One of adjunctive cleaning device for oral hygiene care is water irrigator. There are
several types of water irrigator available in the market such as syringe type, electricity and battery
operated. However, the problem is the available water irrigators are expensive. (Copied from article).
Limb problem is a common complication for patients with diabetes. While the impact of diabetic limb problems
on physical health is well known, the psychological impact of the condition is still largely unknown. People with
diabetes with or without foot ulcers frequently suffer from major depressive disorder, and this is made worse
by the presence of limb complications. Furthermore, depression itself can have negative consequences on the
person’s diabetes. Hence, in caring for people with diabetic foot problem, the psychological sequelae must not
be overlooked but managed accordingly
Schwannomas are benign slow growing lesions arising from the Schwann cells that ensheath the axons of the peripheral, cranial and autonomic nervous systems. Intracranial schwannomas develop from the facial nerve much more rarely than from the vestibular or trigeminal nerves. Ancient schwannoma is an unusual histological variant of this rare disease. A 48 years old man who had recurrent facial nerve paralysis and right external auditory mass is presented in this case report.
The great potential of biodegradable polymers in orthopaedic surgery is
gradually being recognized. PLGA is one of the common polymers used. However, long
term outcomes, with regards to PLGA, are still not well documented. Hence, we
attempted to study the outcome of PLGA and also its combination with fibrin. (Copied from article).
Introduction: Knowledge, attitude as well as adoption of pharmacogenomics in clinical practice among the pharmacists and physicians in Malaysia have not been reported. This cross-sectional study explores various facets of the two professions as related to pharmacogenomics to determine the need and preferred method to improve education among them. This study also aims to identify the current state of pharmacogenomics practice in Malaysia to help identify barrier and solution to reap advantages from pharmacogenomics practices. Methods: A questionnaire consisting of 38 questions in five parts was adopted and validated. It explores the respondents’ characteristics, attitude, knowledge, adoption and education. It was distributed online to 1500 pharmacists and physicians over five months. Results: Pharmacists differed from the physicians in terms of attitude, knowledge, adoption and education. Overall, adoption rate of pharmacogenomics was found to be low but its anticipation for future adoption is high, and benefits were reported by healthcare professionals who have used the test in a clinical setting. Majority of respondents had poor to fair knowledge and nearly half have had no prior formal teaching on pharmacogenomics. Interest in the education is very high, and most of them preferred to learn pharmacogenomics via continuous professional education programs. Conclusion: Pharmacogenomics is a field that promises many benefits, but to reap these benefits require its implementation in clinical setting. Pharmacists and physicians need to be equipped with adequate knowledge and positive attitude towards pharmacogenomics.
Introduction: The corneal endothelium is made up of an extremely thin layer of non -regenerating cells essential in keeping the cornea clear. The purpose of this study was to quantify the corneal endothelial cells morphology, visual acuity (VA) and refractive error in patients having femtosecond laser-assisted cataract surgery (FLACS) and conventional phacoemulsification surgery (CPS). Methods: Clinical data from 56 eyes were included in this study. 28 eyes had FLACS surgery and another 28 eyes had CPS. Distance VA, refractive error, corneal thickness and endothelial cells morphology were evaluated pre-operatively and at 1 month follow up. Refractive error was determined subjectively and VA was taken using Snellen chart. Specular microscope was used to measure endothelial cells morphology and central corneal thickness. Mann Whitney test and Spearman correlation analysis were used to analyse the results. Results: There were no statistically significant difference in the mean endothelial cell density (p=0.24), mean central corneal thickness (p=0.68), mean coefficient of variance (p=0.19), mean hexagonality (p=0.44), VA (p=0.72) and postoperative refractive outcome (p=0.66) between both groups. The duration of surgery was noted to have no statistically significant difference between both groups (p=0.08), while the cumulative dissipated energy and torsional time showed a significant difference between groups (p=0.01 and p
Introduction: Our objectives are to identify the incidence of hypophosphatemia and the associated risk factors. We also want to establish intravenous replacement therapy that is effective for ICU patients. Methods: A prospective observational study assessing adults admitted to ICU in between March and May 2009. All patients without baseline phosphate level and renal failure were excluded. They were evaluated for the occurrence of common risk factors. Association with independent variables that includes age, gender and BMI were verified. Evaluation of IV replacement therapy was done in the treated patients. Results: From 50 patients that were reviewed, nine were excluded. There were 66% male and 34% female with mean age 46.88±17.89. The mean ICU stay was 8.00±6.41 days. The incidence of hypophosphatemia was 29% (n=12/41). Gender and
creatinine clearance was found to be significantly different between normophosphatemia and
hypophosphatemia patients. There was no significant association for each potential risk factor and the number of risk factors (≥3) with the incidence of hypophosphatemia. Multi-linear regression analysis showed that lactate, creatinine clearance and pH were significant predictors to the serum levels. A significant difference of mean serum phosphate was seen after repletion by total dose of 10, 20 and 40 mmols in the treatment subgroups. Conclusions: The incidence of hypophosphatemia in our ICU was high and comparable to previous studies. None of the commonly reported risk factors is associated with hypophosphatemia in this studied population. Among all significant correlated variables, only pH was found to be a significant predictor for serum phosphate. Baseline phosphate level may guide the initial replacement dose to prevent delay in normalization of serum levels.
The advancement in human stem cell research has promised a viable alternative treatment for a range of ‘incurable diseases’ such as neurological diseases. To date, several studies have documented substantial evidences on the therapeutic properties of stem cells in promoting repair in different diseases including common neurological disorders i.e. ischaemic stroke and spinal cord injury. However, the progress of stem cell research has been surrounded by ethical issues which largely due to the usage of human embryos as one of the sources. These embryonic stem cells which originally derived from human embryo of aborted foetus or already existing human embryonic stem cells (hESCs) lines, has sparked an intense moral and religious argument among people of various faith, including Muslim community. From the therapeutic point of view, amongst the currently available stem cells, hESCs show the greatest potential for the broadest range of cell replacement therapies and are regarded as the most commercially viable. This review focuses on the major ethical issues, particularly to Muslim community, related to human embryonic stem cells research with special emphasis on the moral status of the embryo and the beginning of life according to the Islamic ethics and rulings. In this paper, we also discuss some ethical positions towards embryonic stem cell research in the Islamic world, including official regulations existing in some Muslim countries. We examine the justification and the necessity on the usage of hESCs following the newly discovered Induced Pluripotent Stem Cells (IPSCs) in the laboratory. In addition, we supplement the discussions with the general views and positions from the other two Abrahamic religions i.e. Christianity and Judaism.
Introduction: The aim of this study was to determine the effects of gamat extract on pain behaviour and Fos like immunoreactivity (FLI) expression in the ventral posterolateral thalamus using the acute pain model. Materials & Methods: Fourteen Sprague-Dawley male rats (220-300 gram) were given intraplantar injection of 0.05ml formalin (1%) followed by intraperitoneal administration of either 4 mg/kg gamat extracts (Holothuria spp.) or saline (control). Behavioural changes were observed and rats were sacrificed 2 hours post-formalin injection. Immunohistochemistry testing was done on the brain sections. FLI was examined using a light microscope attached to an image analyser. The behaviour and FLI data were analysed using repeated measure analysis of variance and independent t-test respectively. Significance level was taken as p
Pain is infl uenced by multiple factors including personal experience, psychological, sociocultural and situational factors. Failure to recognise pain will lead to poor patient management and deleterious effect on the patients wellbeing. Assessing pain in paediatric and cognitively compromised patients remains a challenge. Pain assessment in these groups of patients depends on the observers assessment and studies have shown the discrepancy between the observers assessment and patients verbal report. A specifi c and accurate tool is required to assist in the pain assessment. Although there are assessment tools available using behaviour scoring system and physiological indicators, none of the tool demonstrates its superiority than the others. Biochemical indicators such as stress hormones are frequently measured and used in con-junction with verbal reports; however they are non specifi c to pain and are increased in infl ammation, haemodynamic and emotional changes. The association between immunological indicators e.g. IL-1 , IL-6, IL- 8 and clinical pain has been shown, however; the defi nite correlation of the changes in the indicators and the level of pain is still unclear and may require further investigation.
Critical size defects (CSD) in the long bones of New Zealand White rabbits (Oryctolagus cuniculus) have been used for years as an experimental model for investigation of the effectiveness of a new bone substitute material. There are varieties of protocols available in the literature. This technical note attempts to present an alternative surgical technique of a CSD in the New Zealand white rabbit tibia. Methods: Thirty-nine New Zealand White rabbits were used in this study. A CSD of approximately 4.5 mm (width) X 9.0 mm (length) was surgically drilled at the proximal tibial metaphysis, approximately 1 cm from the knee joint. The surrounding of soft tissue was repositioned and sutured layer by layer with bioabsorbable surgical suture. Two x-rays of anteroposterior and lateral were taken before assessed under computed tomography scan at 6, 12 and 24 weeks. Results: This alternative method created CSD with less bleeding from the muscle observed. No mortality or other surgical complications observed within 6 weeks, 12 weeks and 24 weeks following surgery. Conclusion: A simple and safe method for performing CSD was demonstrated and recommended as an alternative approach for surgery on New Zealand White rabbits.
A novel injectable calcium phosphate bone cement (osteopaste) has been
developed. Its potential application in orthopaedics as a filler of bone defects has been
studied. The biomaterial was composed of tetra-calcium phosphate (TTCP) and tricalcium
phosphate (TCP) powder. The aim of the present study was to evaluate the
healing process of osteopaste in rabbit tibia.(Copied from article).
Introduction: The metabolic syndrome comprises a collection of cardiovascular disease risks, which has been demonstrated to predict type 2 diabetes mellitus and cardiovascular disease. Metabolic syndrome is a crucial health concern in Malaysia, with a prevalence of about 42.5% in the general population based on the ‘Harmonized’ definition. The aim of this study was to ascertain the association between socioeconomic status among Malaysian government employees with metabolic syndrome, compared with those without metabolic syndrome. Furthermore, this study also aimed to ascertain the associated obesity indicators for metabolic syndrome among employees—explicitly body mass index, waist circumference, waist-to-hip ratio, body fat percentage, fat mass index, and waist-to-height ratio. Methods: This cross-sectional study was
undertaken at government agencies in Putrajaya, Malaysia, via multi-stage random sampling. A total of 675 government employees were randomly sampled from a list of 3,173 government employees working in five government agencies under five geographical areas. Data on socioeconomic status, anthropometric, biochemical, and clinical assessments were collected. Results: Employees who were males had higher metabolic syndrome prevalence compared to their counterparts (p=0.019). In addition, employees aged between 20 to younger than 30 years had lowest metabolic syndrome prevalence (p=0.002). The risk of having metabolic syndrome was almost 10 times more likely in men with a waist-to-hip ratio of ≥0.90 compared to men with a waist-to-hip ratio of
Cerebral Venous Thrombosis in patients with Evan’s Syndrome of autoimmune hemolytic anemia is rare. The
common neurological symptoms are headaches, vision loss, dyslexia without agraphia, motor aphasia,
unilateral upper limb weakness and papilloedema. We present a case report of a lady with a known case of
Evan’s Syndrome whom presented with severe anemia and unilateral right sided hemiparesis with right facial
weakness. Plain and Contrast enhanced CT brain showed bilateral high parietal white matter edema with
venous thrombosis in the right transverse and superior sagittal venous sinuses. At the time of the diagnosis,
she was in hematological remission.
Patient understanding and perception of diabetes control is important if clinicians were to allow diabetes patients to play a central role in management of their illness. We conducted a survey to see what diabetic patients generally thought of their understanding of disease and glycemic control; if these perceptions were accurate and related to complications.
One hundred and eight consecutive patients (mean age 52.7± 13 years, BMI 27±5.2 kg/m2, HbA1c 9.2±2.2 %) attending diabetes clinic participated including 63% women, 60% primary or no education, and 47% duration of diabetes >10 years. 54% claimed to have a good understanding although nearly half answered questions on diabetes management and targets wrongly. 32% perceived their glycemic control to be good and were found to have lower baseline HbA1c (p
This study aimed to examine five pillars of Islam and their relationship with physical and spiritual health. The five pillars of Islam are the foundation of Muslim life, considered mandatory by believers, and Muslims are required to observe them with utmost dedication. They are summarized as Shahadah, Salah, Zakat Saum, and Hajj. he first pillar of Islam, declaration of faith (Shahadah) includes the most important concept, which is the complete submission to the will of Allah (SWT) by obeying and believing in Him. Spirituality in general is defined as “religious belief or the spiritual quality of something”, “a search for the sacred”, “personal growth, or an encounter with one's own inner dimension”. The World Health Organization (WHO) mentions spiritual health as one of four dimensions to well-being; physical, mental, social, and spiritual”. Moreover, holistic nursing practice includes treating people as a whole and attending to a client’s physiological, psychological, and spiritual needs. Thus, this study intends to further explore the unitary aspect of Islam that infuse each of the pillars, and their effects on physical, spiritual well-being and nursing implications associated with it. Five pillars of Islam are discussed from the Quran, Alhadith, and Sunnah (the sayings and traditions of the Prophet) as baselines, and further additions from the knowledge of the Islamic scholars. And it is noted that our practices based on the five pillars of Islam have not only positive effects on physical but also spiritual health. This paper pointed out that while performing obligatory duties as stipulated by Islam, one could achieve spiritual enhancement as well as physical strength and well being.
Introduction: Laparoscopic fundoplication is performed for the management of symptomatic hiatus hernias and gastro-oesophageal reflux disease (GORD) refractory to medical therapy. We adopted the use of Gore Bio-A® for selected laparoscopic hiatus hernia repairs in 2011 and with this case series aimed to establish whether mesh augmentation affects symptomatic outcomes. Methods: A retrospective review of prospectively collected data from all laparoscopic fundoplications performed by a single surgeon between October 2011 and January 2013 was performed. Patient specific data were entered into a proforma and analysed using Microsoft ExcelTM. Patient reported outcomes were assessed with a system specific quality of life questionnaire (GORD-HRQL) both pre and post-operatively. Results: Twenty-three patients underwent laparoscopic fundoplication during the study period. Gore Bio-A® re-enforcement of the hiatal repair was used in 14 patients and was the preferred option for those with pre-operative evidence of a large hiatus hernia. Whilst overall there was a statistically significant difference between pre and post-operative scores (21 vs 0, p=
Medicinal plants become very important in our days for their therapeutic benefits to humankind. It sustains human health, and it is commonly known as herbal medicines since ancient times. Annona muricata is a heart-shaped fruit that is consumed raw or as the fruit juice in the tropical area. A. muricata is used in traditional and alternative medicine to treat different ailments such as diabetes, hypertension, respiratory and skin illness, inflammation and cancer. A. muricata contains essential anticancer agents named acetogenins that play the significant role in various cancer types. Acetogenins are strong nicotinamide adenine dinucleotide oxidase inhibitors of the cancer cell's mitochondrial membrane but showed neurotoxic effects in rats. Therefore, acetogenins need to be further investigated to determine the exact mechanisms of action, long-term safety, optimal dosage, and potential side effects. Given the extensive studies on A. muricata, this review focuses on the phytochemistry, medicinal uses, biological activities and the mechanisms of action for the fruit extracts and acetogenins, to stimulate further studies on the fruit pulp used for human consumption.
Introduction: To review the gestational age at diagnosis, method of diagnosis, pregnancy outcome and
maternal complications of prenatally diagnosed lethal foetal anomalies. Methods: Retrospective review of 25
women who had aborted or delivered foetuses with lethal anomalies in a tertiary hospital in 2011 based on
patient medical records. Results: There were a total of 10,088 deliveries, in which 25 (0.24%) women were
found to have conceived foetuses with lethal anomalies. All of them were diagnosed by prenatal ultrasound
and only 7 (28.0%) had both prenatal ultrasound and genetic study done. The women’s mean age was 29.9
years old. The mean gestational age at diagnosis of lethal foetal anomalies was 25.5 weeks (SD=12.5) and
mean gestational age at termination of pregnancy (TOP) or delivery was 28.5 weeks (SD=12.5). Seven (28%)
women had early counseling and TOP at the gestation of < 22 weeks. Beyond 22 weeks of gestation, eight
(32%) women had TOP and ten (40%) women had spontaneous delivery. Twenty (80%) women delivered or
aborted vaginally, three (12%) women with assisted breech delivery and two (8%) women with abdominal
delivery which were performed due to transverse foetal lie in labour and a failed induction, leading to
emergency hysterotomy complicated by hysterectomy due to intraoperative finding of ruptured uterus.
Overall, the associated post-partum adverse events included post-partum haemorrhage (12%), retained
placenta (12%), blood transfusion (8%), uterine rupture (4%) and endometritis (4%). Mean duration of hospital
stay was 6.6 days (SD 3.7 days). Conclusion: Late diagnosis of lethal foetal anomalies leads to various
maternal morbidities, in this case series , which could have been prevented if they were diagnosed and
terminated at early trimester. A new direction is needed in our local practice.
Introduction: Astrocytic gliomas are the most common and lethal intracranial brain tumours and rely on angiogenesis for the tumour development. Endothelial progenitor cells (EPCs) contribute to the angiogenesis of glioma tumour. Objectives: The study aimed to investigate the matured circulating endothelial cells population in the peripheral blood mononuclear cells (PBMCs) and its associations with tissue resident angiogenic cells in astrocytic glioma patients. Methods: A total of 22 astrocytic glioma patients were recruited from Hospital Universiti Sains Malaysia. Tumour were sliced and stained with CD133+ and VEGFA+ for angiogenic cells (n=22). The circulating (CD133-/VEGFR2+) matured endothelial cells in PBMCs (n=22) were quantified using FACS. The paired t-test and Pearson correlation test were used for the data analysis. Results: The angiogenic cells in brain tumour tissue were significantly higher compared to adjacent normal brain tissue (median 1.07±0.96% vs. median 0.69±0.68%; Wilcoxon signed rank test Z=-3.100; p=0.002). Positive correlation was found between the angiogenic cells of brain tumour tissue and adjacent normal brain tissue (Spearman’s rho correlation test, r=0.56; p=0.007). Significant positive correlation was found between matured endothelial cells in peripheral circulating systems and angiogenic cells in tumour of astrocytic glioma patients (Pearson correlation test, r=0.60, p=0.003).Conclusion:The findings of the study give support to the possible roles of EPCs in astrocytic glioma patients. Thus targeting tissue resident angiogenic cells and matured circulating endothelial cells by antiangiogenic treatment might be useful to prevent the tumour growth.