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Common bile duct perforation due to tuberculosis: a case report

Jarmin R, Alwi RI, Shaharuddin S, Salleh KM, Gunn A

Asian J Surg, 2004 Oct;27(4):342-4.
PMID: 15564193

A young man with HIV presented with biliary peritonitis secondary to spontaneous common bile duct perforation. Investigation revealed that the perforation was due to Mycobacterium tuberculosis. Tuberculosis of the bile duct is uncommon and usually presents with obstructive jaundice due to stricture. Bile duct perforation due to tuberculosis is extremely rare. Its management is discussed.
The synthesis of hydroxyapatite through the precipitation method

Shah RK, Fahmi MN, Mat AH, Zainal AA

Med J Malaysia, 2004 May;59 Suppl B:75-6.
PMID: 15468826

Hydroxyapatite (HA) has been earmarked as suitable for implantation within the human of its chemical makeup to human bone. In this paper, HA powders were synthesized via the precipitation method where phosphoric acid (H3PO4) was titrated into calcium hydroxide solution [Ca(OH)2]. Two parameters such as temperature and stirring rate were identified as factors that influenced the amount and purity of HA powder. Phase identification of the synthesized powder was done using X-Ray Diffraction (XRD). The results show that HA phase can be synthesized from this titration process of Ca(OH)2 and H3PO4 with yield amount of HA powder around 45 - 61 grams but with less than hundred percent purity. In order to study the effect of heat treatment to HA crystals structure, HA powder was calcined at 850 degrees C for 2 hours. It's found that the degree of crystallinity increases after calcination because of lattice expansion when the materials were heated at higher temperature
Effectiveness of Individualized Home-Based Exercise on Turning and Balance Performance Among Adults Older than 50 yrs: A Randomized Controlled Trial

Ashari A, Hamid TA, Hussain MR, Hill KD

Am J Phys Med Rehabil, 2016 May;95(5):355-65.
PMID: 26418489 DOI: 10.1097/PHM.0000000000000388

This study evaluated the effectiveness of an individualized home-based exercise program that included specific turning exercises in improving turning performance in adults identified as having unsteadiness during turning.
Fulltext Utilization of Bracing Arms as Additional Reinforcement in Pultruded Glass Fiber-Reinforced Polymer Composite Cross-Arms: Creep Experimental and Numerical Analyses

Asyraf MRM, Ishak MR, Sapuan SM, Yidris N

Polymers (Basel), 2021 Feb 19;13(4).
PMID: 33669491 DOI: 10.3390/polym13040620

The application of pultruded glass fiber-reinforced polymer composites (PGFRPCs) as a replacement for conventional wooden cross-arms in transmission towers is relatively new. Although numerous studies have conducted creep tests on coupon-scale PGFRPC cross-arms, none had performed creep analyses on full-scale PGFRPC cross-arms under actual working load conditions. Thus, this work proposed to study the influence of an additional bracing system on the creep responses of PGFRPC cross-arms in a 132 kV transmission tower. The creep behaviors and responses of the main members in current and braced PGFRPC cross-arm designs were compared and evaluated in a transmission tower under actual working conditions. These PGFRPC cross-arms were subjected to actual working loads mimicking the actual weight of electrical cables and insulators for a duration of 1000 h. The cross-arms were installed on a custom test rig in an open area to simulate the actual environment of tropical climate conditions. Further creep analysis was performed by using Findley and Burger models on the basis of experimental data to link instantaneous and extended (transient and viscoelastic) creep strains. The addition of braced arms to the structure reduced the total strain of a cross-arm's main member beams and improved elastic and viscous moduli. The addition of bracing arms improved the structural integrity and stiffness of the cross-arm structure. The findings of this study suggested that the use of a bracing system in cross-arm structures could prolong the structures' service life and subsequently reduce maintenance effort and cost for long-term applications in transmission towers.
Fulltext Pressure Sensor System for Customized Scoliosis Braces

Fuss FK, Ahmad A, Tan AM, Razman R, Weizman Y

Sensors (Basel), 2021 Feb 06;21(4).
PMID: 33562166 DOI: 10.3390/s21041153

Hard-shell thoracolumbar sacral orthoses (TLSOs) are used for treating idiopathic scoliosis, a deformation of the spine with a sideways curvature. The pressure required inside the TLSO for ideal corrective results remains unclear. Retrofitting TLSOs with commercially available pressure measurement systems is expensive and can only be performed in a laboratory. The aim of this study was to develop a cost-effective but accurate pressure sensor system for TLSOs. The sensor was built from a piezoresistive polymer, placed between two closed-cell foam liners, and evaluated with a material testing machine. Because foams are energy absorbers, the pressure-conductance curve was affected by hysteresis. The sensor was calibrated on a force plate with the transitions from loading to unloading used to establish the calibration curve. The root mean square error was 12% on average within the required pressure range of 0.01-0.13 MPa. The sensor reacted to the changing pressure during breathing and different activities when tested underneath a chest belt at different tensions. The peak pressure reached 0.135 MPa. The sensor was further tested inside the scoliosis brace during different activities. The measured pressure was 0.014-0.124 MPa. The results from this study enable cheaper and mobile systems to be used for clinical studies on the comfort and pressure of braces during daily activities.
Fulltext Crystal structure of (E)-4-meth-oxy-2-{[(5-methyl-pyridin-2-yl)imino]-meth-yl}phenol

Adam F, Arafath MA, Haque RA, Razali MR

Acta Crystallogr E Crystallogr Commun, 2015 Nov 1;71(Pt 11):o819.
PMID: 26594544 DOI: 10.1107/S2056989015018113

The mol-ecule of the title Schiff base compound, C14H14N2O2, displays an E conformation with respect the imine C=N double bond. The mol-ecule is approximately planar, with the dihedral angle formed by the planes of the pyridine and benzene rings being 5.72 (6)°. There is an intra-molecular hydrogen bond involving the phenolic H and imine N atoms.
Caudate lobe abscess: Challenging site with less invasive option of treatment: A case series

Supandi FN, Singh B, Roslan R, Husin I, Lee TS

Ann Hepatobiliary Pancreat Surg, 2021 Jun 30;25(Suppl 1):S240.
PMID: 34230345 DOI: 10.14701/ahbps.EP-39

Introduction: The rarity of caudate lobe abscess has made it difficult to outline a treatment algorithm for this pathology due to its anatomically challenging site. Caudate lobe abscesses also poses a risk of rupture, making its management more complicated. However, advances in imaging have made it possible for early detection and paradigm shift in its management from open surgery to non-operative intervention.
Methods: All patients with isolated caudate lobe abscess were selected retrospectively and diagnosis was confirmed by imaging. Patient in this case series underwent either percutaneous or endoscopic drainage and empirical antibiotic therapy alone.
Results: There are 5 patients in this case series, 3 of them underwent percutaneous drainage, 1 of them treated with antibiotic alone and another underwent endoscopic ultrasound (EUS)-guided drainage. All patients showed complete resolution of caudate lobe abscess without procedural complications.
Conclusions: The caudate lobe, which lies posterior to the hepatoduodenal ligament and anterior to the inferior vena cava exposes the patient to possible life-threatening complications when subjected to drainage via a percutaneous approach. EUS allows not only identification of intervening vessels which is the major reason for technical difficulty in percutaneous drainage, but excellent visualization of abscess cavities and the surrounding landmarks. In conclusion, non-surgical approach is our treatment of choice in management of caudate lobe liver abscess.
Fulltext Development of nanostructured lipid carrier (NLC) assisted with polysorbate nonionic surfactants as a carrier for l-ascorbic acid and Gold Tri.E 30

Eh Suk VR, Mohd Latif F, Teo YY, Misran M

J Food Sci Technol, 2020 Sep;57(9):3259-3266.
PMID: 32728274 DOI: 10.1007/s13197-020-04357-x

Lipid nanocarrier displays the advantages over conventional drug carriers as they are formulated with biodegradable and non-irritant lipids. However, the main drawbacks are the agglomeration of lipid particles, instability over storage, low drug loading, and the burst release of active ingredients. In this study, we investigated the effects of various polysorbate nonionic surfactants namely Tween 20, 40, 60, or 80 on the nanostructured lipid carrier (NLC). NLC incorporated with polysorbate nonionic surfactant was prepared by using high-pressure homogenization technique. The average size was reduced to 139.9 ± 15.8 nm in the presence of Tween 80 and remained stable in nano-size even incubated for 28 days. Encapsulation of l-ascorbic acid or Gold Tri.E 30 showed a high encapsulation efficiency of more than 75%, where the highest was Gold Tri.E in the presence of Tween 60 at 99.7%. In vitro release study showed that the release of both l-ascorbic acid and Gold Tri.E was significantly reduced in NLC with Tween as compared to bare active ingredients and NLC without Tween. In conclusion, the incorporation of Tween successfully produced a lipid nanocarrier that has the potential to be developed as a carrier of various active ingredients such as nutrients, extracts, and drugs.
Fulltext Pes anserine syndrome in post knee arthroplasty. A rare case report

Kamudin NAF, Rani RA, Yahaya NHM

J Clin Orthop Trauma, 2018 11 20;11(1):171-174.
PMID: 32002008 DOI: 10.1016/j.jcot.2018.11.007

Pes anserine syndrome is a cause of inferomedial knee pain. It occurs in patients with diabetes mellitus, osteoarthritis, rheumatoid arthritis and in overweight patients. It is a challenge to identify the causes of knee pain following knee replacement surgery. We present a case report of pes anserine syndrome in a 79-year-old female who had undergone knee arthroplasty 13 years prior. She was pain free until one year ago when her knee pain resurfaced without any symptoms of infection or history of trauma. She was successfully treated with a combination of stretching exercise and steroid local steroid injection. We want to highlight that such common condition as pes anserine syndrome, could occur in total knee arthroplasty, and should be considered as one of the possible diagnosis.
An unusual cause of subacute airway obstruction in a hemodialysis patient with brachio-cephalic arteriovenous fistula: A rare presentation of central venous occlusion

Hamzan MI, Hamid AR, Halim AS, Mat Saad AZ

Hemodial Int, 2020 04;24(2):E33-E36.
PMID: 32141217 DOI: 10.1111/hdi.12832

A young lady with an arteriovenous (AV) fistula on hemodialysis was referred for surgical management following a failed endovascular approach to relieve central venous occlusion. She had an obstructed left brachiocephalic vein with a history of numerous central vein catheter placements. Alternative routes for new arteriovenous fistula creation had been exhausted due to previous contralateral upper limb fistula rupture and ligation. To the best of our knowledge, no similar cases of airway obstruction in central venous occlusion occurring in hemodialysis patients with AV fistula have been reported. The importance of identifying the possible emergency red flags in hemodialysis patients with central venous occlusion is important to prevent unwanted consequences.
Fulltext Hemi-hamate Arthroplasty in Chronic Fracture-dislocation of Proximal Interphalangeal Joint of Fingers: A Report of Two Cases

Arsad SR, Sem SH, Silvanathan JP, Muhammad Nawawi RF

Cureus, 2020 Jan 22;12(1):e6735.
PMID: 32140316 DOI: 10.7759/cureus.6735

Dorsal dislocations of proximal interphalangeal joint with palmar lip fractures base of middle phalanx of fingers are rare, complex, and often a challenging injury to the treating hand surgeons especially in those chronic cases. Hemi-hamate arthroplasty is the preferred surgical option in treating chronic dorsal fracture-dislocations of the proximal interphalangeal joint. We report two cases with a chronic injury that have been treated with hemi-hamate arthroplasty. Range of motion, pinch and grip strengths, QuickDASH scores, complications, and radiological findings were recorded at follow-up. Good functional outcomes were observed in both patients without major complications. Hemi-hamate arthroplasty can be a reliable surgical treatment for chronic proximal interphalangeal joint fracture-dislocations.
Fulltext Radiation Safety in Emergency Medicine: Balancing the Benefits and Risks

Azman RR, Shah MNM, Ng KH

Korean J Radiol, 2019 03;20(3):399-404.
PMID: 30799570 DOI: 10.3348/kjr.2018.0416

The use of computed tomography (CT) in emergency departments has increased over several decades, as physicians increasingly depend on imaging for diagnoses. Patients and medical personnel are put at risk due to frequent exposure to and higher levels of radiation, with very little evidence of improvements in outcomes. Here, we explore why CT imaging has a tendency to be overused in emergency departments and the obstacles that medical personnel face in ensuring patient safety. The solution requires cooperation from all emergency care stakeholders as well as the continuous education of doctors on how CT scans help in particular cases.
Beating the odds: a rare case of supracardiac total anomalous pulmonary venous return (TAPVR) in an adult patient

Talib N, Sayuti KA, Abdullah MS, Mohd Zain MR

BMJ Case Rep, 2018 Mar 05;2018.
PMID: 29507009 DOI: 10.1136/bcr-2017-221074

Total anomalous pulmonary venous return (TAPVR) is a rare congenital heart defect, and patients are usually symptomatic at a very young age. Survival to adulthood without surgical correction is extremely rare. We report a 33-year-old woman with a heart murmur and a history of a successful pregnancy. Echocardiogram revealed a large atrial septal defect with suspicious pulmonary vein anomaly. Chest radiograph demonstrated classical 'snowman' configuration. Cardiac catheterisation was consistent with anomalous pulmonary venous drainage. Cardiac CT confirmed supracardiac TAPVR, whereby all the pulmonary veins drain into the anomalous vein and finally to the superior vena cava. She remained asymptomatic and underwent a successful surgical repair.
Plant polyphenols as green sunscreen ingredients: A systematic review

Ng SY, Eh Suk VR, Gew LT

J Cosmet Dermatol, 2022 Nov;21(11):5409-5444.
PMID: 35723888 DOI: 10.1111/jocd.15170

BACKGROUND: Excessive exposure to ultraviolet radiation has harmful effects on human skin. At present, synthetic and mineral types of sunscreens used to protect against these harmful damages have been reported to cause negative health and environmental effects. The studies involving characterization and isolation of phytoconstituents from natural botanical sources are important to discover their potential beneficial effects on sunscreen development AIM: This systematic review provides specific and compiled information on the photoprotective properties of natural botanical sources for sunscreen development. The efforts in research and innovation are essential to ensure the safety and sustainability of plant-based sunscreen products.
METHODS: In this review, a total of 35 articles were selected using the Scopus database based on the inclusion and exclusion criteria RESULT: The significant correlation between total phenolic content, total flavonoid content, antioxidant activities, and sun protection factor were shown in these studies which confirmed the potential benefits of natural plants in sunscreen development.
CONCLUSIONS: In addition, natural botanical sources also exhibit excellent anti-tyrosinase, anti-aging, and anti-inflammatory activities. However, the biological activities of plants were dependent on the solvents used for extraction.
Fulltext Impact of COVID-19 Pandemic on Healthcare Utilization among Patients with Type 2 Diabetes Mellitus: A Systematic Review

Amsah N, Md Isa Z, Ahmad N, Abdul Manaf MR

Int J Environ Res Public Health, 2023 Mar 04;20(5).
PMID: 36901588 DOI: 10.3390/ijerph20054577

As the COVID-19 pandemic continues, healthcare services have been grossly overwhelmed by the pandemic. Due to this circumstance, routine care for individuals with type 2 diabetes mellitus (T2DM) has been temporarily disrupted. The purpose of this systematic review was to summarize the evidence regarding the impact of the COVID-19 pandemic on healthcare utilization among patients with T2DM. A systematic search was conducted in the Web of Science, Scopus, and PubMed databases. The process of identifying the final articles followed the PRISMA guidelines. The inclusion criteria were articles published between 2020 and 2022, written in English, and studies focusing on the research question. Any proceedings and books were excluded. A total of fourteen articles relevant to the research question were extracted. Following that, the included articles were critically appraised using the Mixed Method Appraisal Tool (MMAT) and the Joanna Briggs Institute Critical Appraisal Tool to assess the quality of the studies. The findings were further classified into three themes: reduced healthcare utilization among T2DM patients in routine healthcare services, a surge of telemedicine usage, and delay in the delivery of healthcare services. The key messages include demands for monitoring the long-term effects of the missed care and that better preparedness is crucial for any pandemic in the future. A tight diagnostic workup at the community level and regular follow-ups are crucial in managing the impact of the pandemic among T2DM patients. Telemedicine should be on the agenda of the health system to maintain and complement healthcare services. Future research is warranted to determine effective strategies to deal with the impact of the pandemic on healthcare utilization and delivery among T2DM patients. A clear policy is essential and should be established.
Fulltext Test-retest reliability of the single leg stance on a Lafayette stability platform

Zaghlul N, Goh SL, Razman R, Danaee M, Chan CK

PLoS One, 2023;18(1):e0280361.
PMID: 36649257 DOI: 10.1371/journal.pone.0280361

The validity and reliability of the Lafayette stability platform are well-established for double leg testing. However, no evaluation of single leg (SL) stance on the platform was discovered yet. Therefore, this study aimed to investigate the reliability of conducting the SL stance on the Lafayette platform. Thirty-six healthy and active university students (age 23.2 ± 3.2 years; BMI 21.1 ± 3.1 kg/m2) were tested twice, one week apart (week 1; W1, week 2; W2). They stood on their dominant leg with eyes-open (EO) and eyes-closed (EC) in random order. Three successful trials of 20 seconds each were recorded. The duration during which the platform was maintained within 0° of tilt was referred to as time in balance (TIB). At all-time points, TIB was consistently longer in EO (EOW1: 17.02 ± 1.04s; EOW2: 17.32 ± 1.03s) compared to EC (ECW1: 11.55 ± 1.73s; ECW2: 13.08 ± 1.82s). A ±10 seconds difference was demonstrated in the Bland-Altman analysis in both EO and EC. Lower standard error of measurement (SEM) and coefficient of variation (CV) indicated consistent output. High intraclass correlation coefficient (ICC) values were seen between weeks (EO = 0.74; EC = 0.76) and within weeks (EOW1 = 0.79; EOW2 = 0.86; ECW1 = 0.71; ECW2 = 0.71). Although statistical measures (i.e., SEM, CV, and ICC) indicated good reliability of Lafayette for SL tasks, the wide agreement interval is yet to be clinically meaningful. Factors underlying the wide variation need to be identified before Lafayette is used for TIB assessment.
Fulltext Factors associated with anxiety and depression among type 2 diabetes outpatients in Malaysia: a descriptive cross-sectional single-centre study

Ganasegeran K, Renganathan P, Manaf RA, Al-Dubai SA

BMJ Open, 2014 Apr 23;4(4):e004794.
PMID: 24760351 DOI: 10.1136/bmjopen-2014-004794

OBJECTIVE: To determine the prevalence and factors associated with anxiety and depression among type 2 diabetes outpatients in Malaysia.
DESIGN: Descriptive, cross-sectional single-centre study with universal sampling of all patients with type 2 diabetes.
SETTING: Endocrinology clinic of medical outpatient department in a Malaysian public hospital.
PARTICIPANTS: All 169 patients with type 2 diabetes (men, n=99; women, n=70) aged between 18 and 90 years who acquired follow-up treatment from the endocrinology clinic in the month of September 2013.
MAIN OUTCOME MEASURES: The validated Hospital Anxiety and Depression Scale (HADS), sociodemographic characteristics and clinical health information from patient records.
RESULTS: Of the total 169 patients surveyed, anxiety and depression were found in 53 (31.4%) and 68 (40.3%), respectively. In multivariate analysis, age, ethnicity and ischaemic heart disease were significantly associated with anxiety, while age, ethnicity and monthly household income were significantly associated with depression.
CONCLUSIONS: Sociodemographics and clinical health factors were important correlates of anxiety and depression among patients with diabetes. Integrated psychological and medical care to boost self-determination and confidence in the management of diabetes would catalyse optimal health outcomes among patients with diabetes.
Fulltext Strategies for improving production performance of probiotic Pediococcus acidilactici viable cell by overcoming lactic acid inhibition

Othman M, Ariff AB, Wasoh H, Kapri MR, Halim M

AMB Express, 2017 Nov 27;7(1):215.
PMID: 29181600 DOI: 10.1186/s13568-017-0519-6

Lactic acid bacteria are industrially important microorganisms recognized for fermentative ability mostly in their probiotic benefits as well as lactic acid production for various applications. Fermentation conditions such as concentration of initial glucose in the culture, concentration of lactic acid accumulated in the culture, types of pH control strategy, types of aeration mode and different agitation speed had influenced the cultivation performance of batch fermentation of Pediococcus acidilactici. The maximum viable cell concentration obtained in constant fed-batch fermentation at a feeding rate of 0.015 L/h was 6.1 times higher with 1.6 times reduction in lactic acid accumulation compared to batch fermentation. Anion exchange resin, IRA 67 was found to have the highest selectivity towards lactic acid compared to other components studied. Fed-batch fermentation of P. acidilactici coupled with lactic acid removal system using IRA 67 resin showed 55.5 and 9.1 times of improvement in maximum viable cell concentration compared to fermentation without resin for batch and fed-batch mode respectively. The improvement of the P. acidilactici growth in the constant fed-batch fermentation indicated the use of minimal and simple process control equipment is an effective approach for reducing by-product inhibition. Further improvement in the cultivation performance of P. acidilactici in fed-bath fermentation with in situ addition of anion-exchange resin significantly helped to enhance the growth of P. acidilactici by reducing the inhibitory effect of lactic acid and thus increasing probiotic production.
Fulltext Lucent thoracic lesion in a newborn with respiratory distress

Mah SS, Azman RR, Md Shah MN

Paediatr Child Health, 2020 Feb;25(1):1-3.
PMID: 33390731 DOI: 10.1093/pch/pxz008
Fulltext Evaluation of Wound Closure Activity of Nigella sativa, Melastoma malabathricum, Pluchea indica, and Piper sarmentosum Extracts on Scratched Monolayer of Human Gingival Fibroblasts

Ab Rahman MR, Abdul Razak F, Mohd Bakri M

Evid Based Complement Alternat Med, 2014;2014:190342.
PMID: 25371695 DOI: 10.1155/2014/190342

Nigella sativa, Melastoma malabathricum, Pluchea indica, and Piper sarmentosum are common Asian traditional medicines to treat minor wounds. This study aimed to investigate the in vitro wound healing properties of aqueous extracts of these plants using human gingival fibroblast (HGF) monolayer as study model. DPPH scavenging activity of the extracts was evaluated and effect on HGF proliferation was determined. Their effect on HGF's function to synthesize collagen was indicated by the level of hydroxyproline produced and effect on wound healing activity was assessed using an in vitro scratch assay. The influence of the extracts on expression of bFGF and TGF-β was also determined. Results revealed all four extracts to exhibit low free radical scavenging activity. The extract from N. sativa (NSSE) compared to the others showed favourable enhancement of HGF proliferation with EC50 of 22.67 ± 3.06 µg/mL (P < 0.05) with accelerated wound closure activity despite its nonsignificant effect on collagen synthesis. In addition to the elevated level of bFGF by up to 15% at 100 µg/mL of NSSE, a slightly better effect was observed on the expression of TGF-β. NSSE thus showed that promising wound healing properties and data obtained may contribute towards validation of its traditional use for the healing of oral wounds.

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