This was a retrospective study of 177 patients above the age of 45 who were admitted to the Psychiatric Unit, University Hospital Petaling Jaya during the period October 1975 to October 1978. The available socio-demographic and clinical data from the case files were studied. The patients were divided into two groups - those with effective illnesses and those with non-affective illnesses. The differences in socio-demographic background and clinical symptomatology between the two groups and how the data compares with that in other studies was reported. The sick elderly person is an economic and psychological liagility to .his family and society. Absence of illness in the elderly not only fosters their continued independence but also improves the quality of their individual life. Though no definite correlations or conclusions could be arrived at, this study has sought to bring into awareness the necessity of delineating possible illness precipitating stress factors in the social and domestic environment of patients in later life.
COVID-19 infection is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which was declared a pandemic in 2020. Dengue fever (DF) is caused by the dengue virus (DENV) from the Flaviviridae family and is transmitted via the bite of the female Aedes aegypti mosquito. COVID-19 pneumonia and dengue fever coinfection is a relatively difficult diagnosis to be established considering the similarities in the clinical manifestation of both diseases. I hereby report an unusual case of dual diagnosis involving COVID-19 pneumonia and dengue fever (DF) on the same day of presentation to the hospital. A 62-year-old male presented to the emergency department with a fever of six days duration associated with chills, rigors, arthralgia, myalgia, and a generalized pinpoint rash over the chest and abdomen. He had contact with a worker who recently tested positive for COVID-19. However, his vital signs were stable with peripheral capillary oxygen saturation (SPO2) of 99% under room air. Laboratory investigations showed polycythemia, increased hematocrit levels, and thrombocytopenia. Liver function tests showed evidence of acute hepatitis. Otherwise, the basic metabolic panel and coagulation profile were normal. Viral screens for hepatitis B, hepatitis C, and human immunodeficiency virus (HIV) were negative. The posterior-anterior chest radiograph of the patient showed ground glass opacity in both middle and lower zones of the lungs, which is mostly peripheral with preservation of lung markings. The diagnosis was confirmed by a positive SARS-CoV-2 polymerase chain reaction (PCR) test with a cycle threshold (CT) value of 19.97 and positive immunoglobulin M (IgM) and immunoglobulin G (IgG) titers on the dengue serology panel on the same day of testing. Predisposing risk factors were chronic medical illnesses (type 2 diabetes mellitus, hypertension, and ischemic heart disease) and exposure to probable COVID-19-infected individuals. The patient fully recovered after treatment with oral paracetamol 1 g four times a day for five days and an intravenous drip of 0.9% sodium chloride for 24 hours.
Mortality rate due to heart diseases increases dramatically with age. Captopril is an angiotensin converting enzyme inhibitor (ACE) used effectively for the management of hypertension. Due to short elimination half-life of captopril the oral dose is very high. Captopril is prone to oxidation and it has been reported that the oxidation rate of captopril in skin tissues is considerably low when compared to intestinal tissues. All these factors make captopril an ideal drug candidate for transdermal delivery. In this research work an effort was made to formulate transdermal films of captopril by utilizing polyvinylpyrrolidone (PVP) and polyvinyl alcohol (PVA) as film formers and polyethylene glycol 400 (PEG400) as a plasticizer. Dimethyl sulfoxide (DMSO) and dimethylformamide (DMF) were used as permeation enhancers. Physicochemical parameters of the films such as appearance, thickness, weight variation and drug content were evaluated. The invitro permeation studies were carried out through excised human cadaver skin using Franz diffusion cells. The in-vitro permeation studies demonstrated that the film (P4) having the polymer ratio (PVP:PVA = 80:20) with DMSO (10%) resulted a promising drug release of 79.58% at 24 hours with a flux of 70.0 µg/cm(2)/hr. No signs of erythema or oedema were observed on the rabbit skin as a result of skin irritation study by Draize test. Based on the stability report it was confirmed that the films were physically and chemically stable, hence the prepared films are very well suited for transdermal application.
Regeneration of plantlets from shoot apex-derived callus and "calloid" cultures of a local taro [Colocasia esculenta var. antiquorum cv. Keladi Birah] cultivar, was expedited by treatment with high levels of spermine. The total time taken, from culture of primary shoot apices on modified Linsmaier and Skoog medium supplemented with trichlorophenoxyacetic acid and kinetin, to complete plantlet regeneration, was reduced by 2-16 weeks, when the callus and "calloid" cultures were treated with 0.01, 0.1 and 1 mM spermine. Furthermore, the number of plantlets produced per gram callus increased from 25 to 55. On media supplemented with arginine and ornithine, no callus was initiated from expiants and no plantlets differentiated from pre-established callus.
In vitro growth and multiplication of taro [Colocasia esculenta var. antiquorum cv. Keladi Birah] was improved considerably, when primary shoot apices were cultured on two modifications of Linsmaier and Skoog [1965] medium, containing 5.5 mg 1(-1) naphthaleneacetic acid and 0.2 mg 1(-1) kinetin or 1.85 mg 1(-1) naphthaleneacetic acid and 2 mg 1(-1) kinetin and supplemented with 10(-4) or 10(-3) mol·1(-1) of polyamine spermine or either of the precursors of polyamine putrescine-arginine and ornithine. Plantlets were regenerated directly from primary shoot apices, axillary buds and protocorm-like bodies [PLB]. Frequency of plantlet regeneration, rate of development and growth in height of main plantlets were enhanced by the addition of arginine and ornithine to the media. Secondary plantlet formation from axillary buds and PLB were promoted by spermine and arginine respectively.
A pseudoaneurysm, or false aneurysm, is a haematoma that is formed secondary to a leaking hole in an artery. This haematoma is contained by surrounding fascia. In contrast, a true aneurysm contains all three layers of vessel wall, namely intima. Pseudoaneurysms are scarce and can arise consequential of numerous iatrogenic influences, including but not limited to, blunt or penetrating trauma, orthopedic procedures like tibial nailing or ankle arthroscopy, and sports injury. A thorough history taking focusing on the recent history of trauma or instrumentation and clinical examination should raise the suspicion of a pseudoaneurysm. In doubtful cases, imaging modalities such as an ultrasound and doppler examination of the lower limb can be utilized to confirm the diagnosis. Our case was a 37-year-old gentleman presented with progressive swelling in the anterior aspect of his left leg for the past two weeks. The patient had a atypical presentation, with absence of classic signs of a pseudoaneurysm such as a pulsatile mass, absence distal pulses or a thrill or bruit. However, these injuries albeit rare can be sinister and prompt diagnosis is critical, so that pertinent treatment can be delivered. Our case highlights the importance of sonographic approaches for suspected vascular injuries.
This article illustrates a case of persistent trigeminal neuralgia in a medically compromised 65-year-old female who did not respond to pharmacotherapy. She had undergone several peripheral neurectomies as well as a failed right posterior fossa exploration that resulted in a cerebrospinal fluid leak. Persistent pain over the right external nasal area and right mental region was relieved for several hours after daily injections of bupivacaine. A trial of a single dose of 100 units of botulinum toxin type A (BOTOX) diluted in 2.5 mL saline was injected into the external nasal trigger zone (60 units) and to the mental nerve region (40 units). She achieved complete pain relief in the external nasal region for 5 months. Pain recurred and the site was again injected with 100 units of botulinum toxin type A (BOTOX). Pain relief at the mental region was partial. This was finally controlled with peripheral neurectomy. The patient was pain free with a maintenance dose of 200 mg carbamazepine daily for about 1 year, after which she elected to undergo stereotactic gamma knife radiosurgery when pain recurred at the external nasal region.
The authors selected 38 thin-layer-chromatography (TLC) systems described in the available literature published over the last 10 years and evaluated those systems with respect to their suitability for detection and identification of opiates in urine, opium and heroin, as well as adulterants in heroin. A total of 14 substances: 8 opiates (morphine, 6-monoacetylmorphine, diacetylmorphine, codeine, acetylcodeine, noscapine, papaverine and thebaine) and 6 adulterants (ephedrine, quinine, methadone, caffeine, cocaine and strychnine) were used as test samples for this research. Using laboratory-coated plates and pre-coated plates, 15 and 13 TLC systems, respectively, were found to be able to detect and identify morphine and codeine in urine without interference from the remaining 12 substances. For the detection of opiates in opium samples as well as opiates and adulterants in illicit heroin samples the TLC system: chloroform-n-hexane-triethylamine (9:9:4) which was developed by the National Drug Research Centre, Penang, Malaysia, was found to be most suitable on both laboratory-coated and pre-coated plates. In addition, the following two systems, one on laboratory-coated plates--hexane-chloroform-diethylamine (50:30:7)--and the other on pre-coated plates--benzene-dioxane-ethanol-ammonia (50:40:5:5; T-7)--were also found to be among most suitable TLC systems for the analysis of opiates in opium samples. The article also presents the relative cost of each of the 38 evaluated TLC systems.