Congenital diaphragmatic hernia (CDH) is rare in adults. We report a 24 year old woman presenting with shortness of breath, chest pain and nausea after the birth of her first baby. Clinical examination, plain radiography and a CT scan revealed herniation of abdominal contents into her left chest. Via a midline laparotomy, the contents were reduced and the defect repaired, using a mesh. She remains symptom-free three years since her surgery and even after a second childbirth. A brief review of the literature reporting adult diaphragmatic hernia of congenital origin accompanies this case report. We conclude that symptomatic CDH in adults usually presents as an emergency with gastrointestinal and occasionally respiratory complications. Early diagnosis and repair is essential to avoid subsequent morbidity and mortality.
The cause and effect relationship between acute pancreatitis and primary hyperparathyroidism (pHPT) still evokes controversy. Our paper reviews the debate in the medical literature. In this controversy we add a case of a 49-year old non-alcoholic man presenting with recurrent attacks of acute pancreatitis. His raised serum calcium was realized rather late. Eventually, high intact parathyroid hormone levels led to open neck exploration and finding of a solitary parathyroid adenoma. Post-surgery, serum calcium returned to normal and abdominal symptoms disappeared. The case report and the accompanying literature review support our belief, that acute pancreatitis is one of the symptoms of pHPT often caused by a parathyroid adenoma and curable by its excision.
This study aim to evaluate antimicrobial efficacy of sodium hypochlorite (NaOCl) and ozonated water against Enterococci faecalis biofilm. The bacterial biofilm was exposed to 2.62%, 1.31% NaOCl and 0.1 ppm ozonated water over a range of time periods. The presence of viable cells was determined by enumeration of colony forming units (CFU). All experiments were repeated four times (n=4). The effectiveness of the agents was compared using nonparametric Kruskal- Wallis test. The result revealed that 2.62% of NaOCl can completely kill E. faecalis biofilm in 15 minutes whereas 1.31 % NaOCl required a longer time to produce such effect. 0.1 ppm ozonated, however, did not exhibit any antimicrobial effect within the period of time tested. From this study, it can be concluded that 0.1 ppm ozonated water was not comparable with 2.62% and 1.31% NaOCl in antimicrobial efficacy against E. faecalis biofilm.
The paper examines the propagation direction and speed of large scale travelling ionospheric disturbances (LSTIDs) obtained from GPS observations of extreme geomagnetic storms during the 23rd solar cycle; these are the October 2003 and November 2003 geomagnetic storms. In the analysis, the time delay between total electron content (TEC) structures at Scott Base station (SBA) (Lat. –77.85º, Long. 166.76º), McMurdo (McM4), (Lat. –77.84º, Long. 166.95º), Davis (DAV1), (Lat. –68.58º, Long. 77.97º) and Casey station (CAS1) (Lat. –66.28º, Long. 110.52º) GPS stations as well as the distance between these stations were employed in the analysis. The measurements during the October 2003 storm showed obvious time delay between the TEC enhancement occurrences at SBA/MCM4, DAV1 and CAS1 stations. The time delay indicated a movement of the ionospheric structures from higher to lower latitudes in a velocity ranging between 0.8 km/s – 1.2 km/s. The first sudden TEC enhancement was observed at SBA/McM4 (Lat. –75.84º) followed by CAS1 station (Lat. –66.28º) and the final TEC enhancement was seen at DAV1 station (Lat. –68.58º) with TEC magnitude decreasing while moving from higher to lower latitudes. One important observation was that although the latitude of the CAS1 station was lower than the DAV1 station, the TEC enhancement was firstly seen at the CAS1 station due to the shorter distance between SBA and CAS1 compared with the distance between SBA and CAS1 of about 500 km. The TEC measurements during the November 2003 storm showed an opposite propagation direction (i.e. poleward direction from lower to higher latitudes) which was seen with a velocity ranging between 0.3 km/s – 0.4 km/s. As similar response was observed using vertical TEC measurements obtained from individual PRN satellites but with higher velocity ranges (1.2 km/s – 2.4 km/s during October
and 0.5 km/s – 0.7 km/s during November). The equatorward or poleward expansion of LSTIDs during the October and November 2003 storms was probably caused by the disturbances in the neutral temperature which occurred close to the dayside convection throat or due to the neutral wind oscillation induced by atmospheric gravity waves launched from the aurora region.
Background: Majority of root canal treatment in Malaysia was provided by general dental practitioner. The purpose of this study was to evaluate the knowledge and practice (canal’s preparation, use of materials) by them. Methods: A questionnaire was structured and distributed to 120 registered general dental practitioners in selected areas in Perak, Johor and Klang Valley regarding the provision of root canal therapy in their practices. The questionnaires were hand delivered and collected after 1 to 2 weeks. Results: Reply rate was 95% (n=114). The result demonstrated that 62% respondents indicated that they performed the root canal therapy (RCT) themselves. Out of these only 26% included molars in the treatment. Three quarters of them (77%) used step-back technique and 54% used stainless steel instruments to prepare the canals. The majority of the respondents (69%) used calcium hydroxide as intracanal medicaments. Only 30% used rubber dam for isolation whereas the rest used cotton rolls. The numbers of routine radiographs taken were two for anterior teeth and three for molar. Half of the respondents indicated that they usually completed the RCT for the anterior tooth within two visits whereas three visits were needed for the molar tooth. The results were analyzed descriptively. Conclusions: This study indicates that most of the general dental practitioners’ do not comply with quality standards guidelines such as use of rubber dam as isolation. Cotton roll was the most popular isolation method. In spite of this, most of the respondents tend to update their knowledge and practices with current techniques and materials.
Purpose of the study: The objective of this study was to investigate the existence of the golden proportion between the width of the maxillary anterior teeth of undergraduate dental students at University of Malaya. Materials and method: Standardised photographs of 100 dental students’ smiles displaying only the lips and the teeth were captured. The images were transferred to a personal computer and the width of the maxillary anterior teeth was measured using an Image
Analyzer (Leiqa QWin). Calculations were made according to the Theory of Golden Proportion. The
data were statistically analysed using paired student T-test (α
Drought forecasting with a long lead time is essential for early warning systems and risk management strategies. The use of machine learning algorithms has been proven to be beneficial in forecasting droughts. However, forecasting at long lead times remains a challenge due to the effects of climate change and the complexities involved in drought assessment. The rise of deep learning techniques can solve this issue, and the present work aims to use a stacked long short-term memory (LSTM) architecture to forecast a commonly used drought measure, namely, the Standard Precipitation Evaporation Index. The model was then applied to the New South Wales region of Australia, with hydrometeorological and climatic variables as predictors. The multivariate interpolated grid of the Climatic Research Unit was used to compute the index at monthly scales, with meteorological variables as predictors. The architecture was trained using data from the period of 1901-2000 and tested on data from the period of 2001-2018. The results were then forecasted at lead times ranging from 1 month to 12 months. The forecasted results were analysed in terms of drought characteristics, such as drought intensity, drought onset, spatial extent and number of drought months, to elucidate how these characteristics improve the understanding of drought forecasting. The drought intensity forecasting capability of the model used two statistical metrics, namely, the coefficient of determination (R2) and root-mean-square error. The variation in the number of drought months was examined using the threat score technique. The results of this study showed that the stacked LSTM model can forecast effectively at short-term and long-term lead times. Such findings will be essential for government agencies and can be further tested to understand the forecasting capability of the presented architecture at shorter temporal scales, which can range from days to weeks.
The aim of the present research work has focused on investigating the effect of cellulose nanofibers (CNFs) and nano clays (montmorillonite (MMT) & organoclay (OMMT)) at 0.75Wt % on the performance of kenaf/epoxy composites. Mechanical (tensile and flexural) and thermal properties of composites in terms of morphology, thermal stability, weight loss, and dynamic mechanical properties were analyzed. The obtained results revealed that the integration of stiff CNFs as filler enhanced the mechanical and thermal properties, storage and loss modulus while a considerable decrease in Tan δ was realized compared to kenaf/epoxy composites. Enhancement in the properties was observed for OMMT and CNFs composites compared to MMT/kenaf/epoxy composites, which is attributed to the uniform filler distribution and interfacial adhesion between CNFs, OMMT, kenaf and epoxy matrix. The obtained results revealed that OMMT and CNFs based kenaf/epoxy composites can be an efficient alternative for construction applications.
A case of gangrene of the penis, rarely seen at our University Hospital is reported. Urolithiasis, urinary tract infection, infected piles and anaemia were found to be associated with the condition. Because of rapid spread of the gangrene, partial amputation was required in this reported case.
A case of non-fatal strangulation of the neck by rigging lines of a parachute during military training is presented. It is an unusual but potentially life-threatening injury. Probable factors leading to such injury are discussed.
The NADI program (pulse in Malay) was initially launched as a pilot project in 1980 in Kuala Lumpur, Malaysia. It utilized an integrated approach involving both the government and the private sectors. By sharing resources and expertise, and by working together, the government and the people can achieve national development faster and with better results. The agencies work through a multi-level supportive structure, at the head of which is the steering committee. The NADI teams at the field level are the focal points of services from the various agencies. Members of NADI teams also work with urban poor families as well as health groups, parents-teachers associations, and other similar groups. The policy and planning functions are carried out by the steering committee, the 5 area action committees and the community action committees, while the implementation function is carried out by the area program managers and NADI teams. The chairman of each area action committee is the head of the branch office of city hall. Using intestinal parasite control as the entry point, the NADI Integrated Family Development Program has greatly helped in expanding inter-agency cooperation and exchange of experiences by a coordinated, effective and efficient resource-mobilization. The program was later expanded to other parts of the country including the industrial and estate sectors. Services provided by NADI include: comprehensive health services to promote maternal and child health; adequate water supply, proper waste disposal, construction of latrines and providing electricity; and initiating community and family development such as community education, preschool education, vocational training, family counseling and building special facilities for recreational and educational purposes.
Objective: Mesenchymal stem cells (MSC) are multipotent, non-haematopoietic stem cells that are
capable of differentiating into different varieties of mature cell types such as osteoblasts, chondrocytes, adipocytes, and myoblasts. There is abundant evidence showing that MSC not only affect the differentiation of haematopoietic progenitors, but also the function of mature cells like lymphocytes and neutrophils. However the effect of MSC on neutrophil function and its responses is not well studied. Therefore, this study was conducted to assess the effect of MSC on neutrophil nitric oxide production. Method: Neutrophils from heparanised venous blood were isolated using Ficoll-Hypaque density gradient centrifugation followed by Dextran sedimentation and red blood cell (RBC) lysis. Isolated neutrophils were on average of 97% purity as determined by morphologic analysis. MSC were generated from human bone marrow and characterised by immunophenotyping (monoclonal antibodies CD105, CD73 and CD34) using a flowcytometer. In order to test the effects of MSC on neutrophil function, isolated neutrophils were co-cultured in the presence or absence of MSC at different ratios for 24 and 48 hours. The amount of nitric oxide released was used as an indication of oxidative burst and measured using the Griess assay. Result: The results indicate that MSC neither elevate the NO level when cocultured with resting neutrophils nor alone. However MSC profoundly inhibit the secretion of nitric oxide in PMA stimulated neutrophils after 24hr of incubation. Conclusion: MSC exert an immunomodulatory effect on neutrophil by suppressing neutrophil oxidative burst in vitro.
There is no report in the English literature on the criteria for neuroablation or neuroaugmentation for the treatment of Parkinson's disease in a developing country like Malaysia. A prospective study of patients with Parkinson's disease from the north-eastern peninsular Malaysia was done to assess their suitability of surgery. Age, race, duration of illness and dementia were considered important factors towards the success of such surgical procedures. A mathematical model is suggested for future cases deemed to be suitable for neuroaugmentative or ablative surgery.
Termite nests have long been suggested to be good indicators of groundwater but only a few studies are available to demonstrate the relationship between the two. This study therefore aims at investigating the most favourable spots for locating groundwater structures on a small parcel of land with conspicuous termite activity. To achieve this, geophysical soundings using the renowned vertical electrical sounding (VES) technique was carried out on the gridded study area. A total of nine VESs with one at the foot of a termitarium were conducted. The VES results were interpreted and assessed via two different techniques: (1) physical evaluation as performed by drillers in the field and (2) integration of primary and secondary geoelectrical parameters in a geographic information system (GIS). The result of the physical evaluation indicated a clear case of subjectivity in the interpretation but was consistent with the choice of VES points 1 and 6 (termitarium location) as being the most prospective points to be considered for drilling. Similarly, the integration of the geoelectrical parameters led to the mapping of the most prospective groundwater portion of the study area with the termitarium chiefly in the center of the most suitable region. This shows that termitaria are valuable landscape features that can be employed as biomarkers in the search of groundwater.
Field surveys of ectoparasites on rodents and scandents were conducted in four localities of wildlife reserves in Peninsular Malaysia from October 2008 to November 2009. A total of 16 animals comprising 5 species of hosts were caught and examined for ectoparasites. The hosts examined were Maxomys rajah, Maxomys whiteheadi, Leopoldamys sabanus, Lariscus insignis and Tupaia glis. Of these hosts, 9 genera, consisting of 14 species of ectoparasites were extracted. Three species of ticks (Ixodidae), 7 species of mesostigmatid mites (Laelaptidae), 3 species of chiggers (Trombiculidae) and 1 species of listrophorid mites (Listrophoriidae) were identified. The infestation rate of ectoparasites observed ranged from 12.5% to 62.5%. Among the ectoparasites found, Ixodes granulatus and Leptotrombidium deliense are of known medical importance.
Recent advances in microfluidic systems, particularly in the Micro Total Analysis System (μTAS) or Lab On a Chip (LOC), drive the current analysis tools and equipment towards miniaturization, rapid at-line testing and mobility. The state-of-the-art microfluidic technology targets a wider range but smaller volumes of analytes, making the analytical procedure relatively easier and faster. This trend together with faster electronics and modern instrumentation systems will make real-time and in situ analysis a definite possibility. This review focuses on microchip capillary electrophoresis with amperometric detection (MCE-AD) for the detection of DNA and other electroactive analytes. The problems associated with the microchip design, in particular the choice of materials and the configuration of electrodes are discussed thoroughly and solutions are proposed. Significant developments in the related areas are also covered and reviewed critically.
Tungsten-loaded TiO(2) photocatalyst has been successfully prepared and characterized. TEM analysis showed that the photocatalysts were nanosize with the tungsten species forming layers of coverage on the surface of TiO(2), but not in clustered form. This was confirmed by XRD and FT-Raman analyses where tungsten species were well dispersed at lower loading (<6.5 mol%), but were in crystalline WO(3) at higher loadings (>12 mol%). In addition, loading with tungsten could stabilize the anatase phase from transforming into inactive rutile phase and did not shift the optical absorption to the visible region as shown by DRUV-vis analysis. PZC value of TiO(2) was found at 6.4, but the presence of tungsten at 6.5 mol% WO(3), decreased the PZC value to 3. Tungsten-loaded TiO(2) was superior to unmodified TiO(2) with 2-fold increase in degradation rate of methylene blue, and equally effective for the degradation of different class of dyes such as methyl violet and methyl orange at 1 mol% WO(3) loading.