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Fulltext Femoral Stem Subsidence and its Associated Factors after Cementless Bipolar Hemiarthroplasty in Geriatric Patients

Gema A, Irianto KA, Setiawati R

Malays Orthop J, 2021 Mar;15(1):63-71.
PMID: 33880150 DOI: 10.5704/MOJ.2103.010

Introduction: Early femoral stem subsidence has been a concern as a predictor of the beginning of implant loosening, especially on cementless hip arthroplasty implants. This study aimed to determine the factors that affect femoral stem subsidence and outcome following hemiarthroplasty in the geriatric population.
Materials and Methods: This is a retrospective study of 179 patients who underwent cementless bipolar hemiarthroplasty during the 2011-2019 period at an orthopaedic and traumatology hospital. Data on the patient's demography, pre-operative American Society Anaesthesiologist (ASA) score, body mass index (BMI), canal flare index (CFI), Dorr classification, and stem alignment were obtained. The primary outcomes were post-operative femoral stem subsidence, post-operative pain, and functional outcome using Harris Hip Score (HHS). Statistical analysis was conducted to identify risk factors associated with the primary outcome.
Results: The mean femoral stem subsidence was 2.16 ±3.4 mm. The mean post-operative Visual Analog Score (VAS) on follow-up was 1.38 ± 1. Mean HHS on follow-up was 85.28±10.3. American Society Anaesthesiologist score 3 (p = 0.011, OR = 2.77) and varus alignment (p=0.039, OR = 6.963) were related to worse stem subsidence. Otherwise, neutral alignment (p = 0.045 and OR = 0.405) gave protection against femoral stem subsidence. The female gender (p = 0.014, OR 2.53) was associated with postoperative pain onset. Neutral alignment had significant relationship with functional outcomes (p = 0.01; OR 0.33).
Conclusion: A higher ASA score and varus stem alignment were related to a higher risk of femoral stem subsidence. Meanwhile, neutral stem alignment had a protective effect on the femoral stem subsidence and outcome.
Allelic variants of acidic proline-rich proteins observed in Japanese, Chinese, and Malays

Shintani M, Minaguchi K, Suzuki K, Lim KA

Biochem Genet, 1990 Apr;28(3-4):173-84.
PMID: 2383244

Three new variants of acidic proline-rich proteins (At, Au, Aw) were found in human parotid saliva by isoelectric focusing and basic gel electrophoresis. Electrophoretic comparison of the purified proteins and their tryptic peptides suggested minor charge and size differences from other acidic PRPs. Genetic and biochemical studies indicate that the At and Aw proteins are allelic products of the PRH1 locus. Gene frequencies of the At productive allele (PRH1(6)) in Japanese, Chinese, and Malays were 0.008, 0.012, and 0.004, respectively. The Au protein was also found in Japanese (2 in 746 samples), Chinese (1 in 215 samples), and Malays (1 in 220 samples), however, the Aw protein was found only in one Japanese (n = 746). These three proteins were not found in 106 Indian subjects.
Fulltext Body mass index and nutritional status of adults in two rural villages in northern malaysia

Narayan KA, Khan AR

Malays J Nutr, 2007 Mar;13(1):9-17.
PMID: 22692185 MyJurnal

There has been a change in the lifestyles of populations, including reduced physical activity and consumption of foods high in calories. Overweight and obesity are now replacing the more traditional public health concerns such as under-nutrition and infectious diseases as some of the most significant contributors to ill health. Determination of the body mass index (BMI) profile and nutritional status of adults of two rural coastal villages in Northern Malaysia was part of a community diagnosis in a community survey. Height and weight were measured and BMI calculated. Blood pressure was measured using a manual sphygmomanometer according to WHO guidelines. A standardised questionnaire was used to interview the villagers concerning their health. Out of the total population, 504 were above 20 years of age. Data was available for 441 persons for analysis. There were 210 (47.6%) males and 231 (52.4%) females. The prevalence of underweight was 9.8% (n=43), overweight 25.9% (n=114) and obesity 17% (n=75). The problem of over-nutrition was significantly higher among females, especially housewives. (p< 0.05). Those in ages 41-70 years were the majority with problems of over-nutrition (p=<0.05). More than half (52.9%; n=39) of those who were obese had hypertension (p=<0.05). Results show that a higher number of women especially housewives were obese and more than half of those obese subjects had hypertension. A more thorough nutritional profile using waist, hip and body fat measurement as well as an assessment of the dietary intake and activity regime of these villagers is needed. Interventions need to be carried out before more serious complications of obesity become rooted in this community.
Dental caries among day creche children in Singapore

Goh SW, Lim KA

Dent J Malaysia Singapore, 1971 Apr;11(1):13-5.
PMID: 4256479
Particle swarm-based and neuro-based FOPID controllers for a Twin Rotor System with improved tracking performance and energy reduction

Norsahperi NMH, Danapalasingam KA

ISA Trans, 2020 Jul;102:230-244.
PMID: 32169293 DOI: 10.1016/j.isatra.2020.03.001

This paper examines two approaches in tuning fractional order proportional-integral-differential (FOPID) control named as neuro-based FOPID (NNFOPID) and particle swarm-based FOPID (PSOFOPID) for pitch control of a Twin Rotor Aerodynamic System (TRAS). For the neuro-based FOPID control, the innovations are the modification of output equation in the artificial neural network and the implementation of the Rectified Linear Unit (ReLU) activation function. The advantages of the proposed approach are a lighter network and the ability to tune more practical controller parameters without a deep knowledge of the system to achieve a satisfying pitch tracking response. As for the particle swarm-based FOPID control, the application of PSO with spreading factor algorithm is extended for tuning the FOPID controller gains and the innovation here is a new procedure in setting the initial search range. The important advantages of this proposed swarm-based algorithm are the avoidance of being trapped in local optima and reduction of the search area respectively. The performances of the proposed controllers are proven by extensive simulations and experimental verifications based on five standard criteria: square-wave characteristics, reference to disturbance ratio, evaluation time, energy consumption of the control signal and tracking performance. The performances of the proposed controllers are compared against an optimised PID control in three system conditions, namely Case I) without coupling effect and wind disturbance, Case II) with coupling effect only and Case III) with wind disturbance only. Together, this study finds that NNFOPID control offers an accurate system positioning by a 34% reduction in steady-state error with the lowest energy consumption and minimum evaluation time in Case II. In terms of the tracking performance and robustness for Case II, the superiority of PSOFOPID control is confirmed by a 27% reduction in the tracking error and the lowest oscillation value. The experimental results also validate the robustness and energy consumption of both controllers in Case III. It is envisaged that the proposed control designs can be very useful in tuning FOPID controller gains for high performance, low energy, and robust aerodynamics systems.
Fulltext CFD study on NACA 4415 airfoil implementing spherical and sinusoidal Tubercle Leading Edge

Aftab SMA, Ahmad KA

PLoS One, 2017;12(8):e0183456.
PMID: 28850622 DOI: 10.1371/journal.pone.0183456

The Humpback whale tubercles have been studied for more than a decade. Tubercle Leading Edge (TLE) effectively reduces the separation bubble size and helps in delaying stall. They are very effective in case of low Reynolds number flows. The current Computational Fluid Dynamics (CFD) study is on NACA 4415 airfoil, at a Reynolds number 120,000. Two TLE shapes are tested on NACA 4415 airfoil. The tubercle designs implemented on the airfoil are sinusoidal and spherical. A parametric study is also carried out considering three amplitudes (0.025c, 0.05c and 0.075c), the wavelength (0.25c) is fixed. Structured mesh is utilized to generate grid and Transition SST turbulence model is used to capture the flow physics. Results clearly show spherical tubercles outperform sinusoidal tubercles. Furthermore experimental study considering spherical TLE is carried out at Reynolds number 200,000. The experimental results show that spherical TLE improve performance compared to clean airfoil.
Fulltext Student perceptions regarding the usefulness of explicit discussion of "Structure of the Observed Learning Outcome" taxonomy

Prakash ES, Narayan KA, Sethuraman KR

Adv Physiol Educ, 2010 Sep;34(3):145-9.
PMID: 20826769 DOI: 10.1152/advan.00026.2010

One method of grading responses of the descriptive type is by using Structure of Observed Learning Outcomes (SOLO) taxonomy. The basis of this study was the expectation that if students were oriented to SOLO taxonomy, it would provide them an opportunity to understand some of the factors that teachers consider while grading descriptive responses and possibly develop strategies to improve scores. We first sampled the perceptions of 68 second-year undergraduate medical students doing the Respiratory System course regarding the usefulness of explicit discussion of SOLO taxonomy. Subsequently, in a distinct cohort of 20 second-year medical students doing the Central Nervous System course, we sought to determine whether explicit illustration of SOLO taxonomy combined with some advice on better answering descriptive test questions (to an experimental group) resulted in better student scores in a continuous assessment test compared with providing advice for better answering test questions but without any reference to SOLO taxonomy (the control group). Student ratings of the clarity of the presentation on SOLO taxonomy appeared satisfactory to the authors, as was student understanding of our presentation. The majority of participants indicated that knowledge of SOLO taxonomy would help them study and prepare better answers for questions of the descriptive type. Although scores in the experimental and control group were comparable, this experience nonetheless provided us with the motivation to orient students to SOLO taxonomy early on in the medical program and further research factors that affect students' development of strategies based on knowledge of SOLO taxonomy.
Fulltext Prevalence of undetected cognitive impairment and depression in residents of an elderly care home

Al-Jawad M, Rashid AK, Narayan KA

Med J Malaysia, 2007 Dec;62(5):375-9.
PMID: 18705469 MyJurnal

The elderly population in Malaysia is growing rapidly. Some of the most vulnerable are in residential care. Research is needed into the characteristics of this population to aid clinicians and policy makers in addressing the needs of this group. This observational, cross-sectional study aims to determine prevalence of undetected cognitive impairment and depression in elderly care home residents in Malaysia. One hundred and sixty-seven people over 60 years of age living in a state run residential home were interviewed. Validated assessment tools were used to measure dependency, cognitive impairment and depression. The prevalence of probable dementia is 36.5%, with increasing prevalence with age and level of dependence. Prevalence of depression is 67.0% (major depression 13.2%), with more depression in males and in the Indian population. None of the identified cases had been previously investigated or treated for dementia or depression.
Coral--polyhydroxybutrate composite scaffold for tissue engineering: prefabrication properties

Al-Salihi KA, Samsudin AR

Med J Malaysia, 2004 May;59 Suppl B:202-3.
PMID: 15468888

In this study the surface properties of two particulate coral and polyhydroxybutrate (PHB) were studied in order to characterize them prior to use in composite production. Coral powder and PHB particle were evaluated using scanning electron microscopy and confocal laser scanning microscopy, to measure surface porosity and pores size. The results showed that coral powder has multiple pleomorphic micropores cross each others give appearance of micro-interconnectivity. Some pore reached to 18 microm with an average porosity of 70%. PHB revealed multiple different size pores extended to the depth, with an average some times reach 25 microm and porosity 45%. These findings demonstrate that both coral and PHB have excellent pores size and porosity that facilitate bone in growth, vascular invasion and bone development. We believe that incorporation of coral powder into PHB will make an excellent composite scaffold for tissue engineering.
Bone marrow mesenchymal stem cells differentiation and proliferation on the surface of coral implant

Al-Salihi KA, Samsudin AR

Med J Malaysia, 2004 May;59 Suppl B:45-6.
PMID: 15468811

This study was designed to evaluate the ability of natural coral implant to provide an environment for marrow cells to differentiate into osteoblasts and function suitable for mineralized tissue formation. DNA content, alkaline phosptatase (ALP) activity, calcium (Ca) content and mineralized nodules, were measured at day 3, day 7 and day 14, in rat bone marrow stromal cells cultured with coral discs glass discs, while cells alone and coral disc alone were cultured as control. DNA content, ALP activity, Ca content measurements showed no difference between coral, glass and cells groups at 3 day which were higher than control (coral disc alone), but there were higher measurement at day 7 and 14 in the cell cultured on coral than on glass discs, control cells and control coral discs. Mineralized nodules formation (both in area and number) was more predominant on the coral surface than in control groups. These results showed that natural coral implant provided excellent and favorable situation for marrow cell to differentiate to osteoblasts, lead to large amount of mineralized tissue formation on coral surface. This in vitro result could explain the rapid bone bonding of coral in vivo.
Identification from a bitemark in a wad of chewing gum

Nambiar P, Carson G, Taylor JA, Brown KA

J Forensic Odontostomatol, 2001 Jun;19(1):5-8.
PMID: 11494677

A wad of used chewing gum recovered from the scene of a burglary contained impressions of human teeth. Casts of these impressions displayed unique morphological characteristics which were found to show concordance with corresponding features present on casts of the posterior teeth of a suspect.
The anti-idiotype vaccines for immunotherapy

Bhattacharya-Chatterjee M, Chatterjee SK, Foon KA

Curr. Opin. Mol. Ther., 2001 Feb;3(1):63-9.
PMID: 11249733

Certain anti-idiotypic antibodies that bind to the antigen-combining sites of antibodies can effectively mimic the three-dimensional structures and functions of the external antigens and can be used as surrogate antigens for active specific immunotherapy. Extensive studies in animal models have demonstrated the efficacy of these vaccines for triggering the immune system to induce specific and protective immunity against bacterial, viral and parasitic infections as well as tumors. Several monoclonal anti-idiotype antibodies that mimic distinct human tumor-associated antigens have been developed and characterized. Encouraging results have been obtained in recent clinical trials using these anti-idiotype antibodies as vaccines. In this article, we will review the current literature and discuss the potential of this novel therapeutic approach for various human cancers.
Seedlings of Neuwiedia (Orchidaceae subfamily Apostasioideae) have typical orchidaceous mycotrophic protocorms

Kristiansen KA, Rasmussen FN, Rasmussen HN

Am J Bot, 2001 May;88(5):956-9.
PMID: 11353721

Naturally occurring seedlings of Neuwiedia veratrifolia were found in three localities in Sabah, Borneo, Malaysia. Seedlings consisted of an irregular oblong protocorm and a terminal leafy rooted shoot. Protocorms contained mycotrophic tissue of the kind typical of orchid mycorrhiza (tolypophagy). This finding demonstrates an important synapomorphy between Neuwiedia and other orchids and strongly supports the monophyly of Orchidaceae in the broad sense, including apostasiod orchids.
Comparison of E-test with agar dilution methods in testing susceptibility of N. gonorrhoeae to azithromycin

Yasin RM, Suan KA, Meng CY

Sex Transm Dis, 1997 May;24(5):257-60.
PMID: 9153733

BACKGROUND AND OBJECTIVES: The antimicrobial susceptibility pattern of Neisseria gonorrhoeae varies from one country to another and may also change with time. To monitor these variations and changes, it is desirable to have a method that is simple and reproducible. This study was undertaken to determine the in vitro susceptibility of N. gonorrhoeae to azithromycin and to assess the reliability of results obtained using E-test methodology for determination of the minimum inhibitory concentration (MIC) of azithromycin.
STUDY DESIGN: The MICs for 135 clinical isolates of N. gonorrhoeae were determined by a modified Kirby-Bauer method recommended by the National Committee for Clinical Laboratory Standards against penicillin, cefuroxime, ceftriaxone, norfloxacin, tetracycline, kanamycin, spectinomycin, and azithromycin. The MIC of azithromycin was determined by both the E-test and agar dilution method. All tests were done simultaneously.
RESULTS: The MIC of azithromycin to all 135 isolates ranged from 0.078 to 0.25 microgram/ml with the agar dilution method and from 0.016 to 0.50 microgram/ml with the E-test. The MIC50 and MIC90 of azithromycin were 0.064 microgram/ml and 0.125 microgram/ml, respectively, by the agar dilution method, whereas they are slightly higher by the E-test method. Seventy-six of the isolates were beta-lactamase producers and 69 were high-level tetracycline-resistant N. gonorrhoeae. There was no difference in the MIC50 and MIC90 of azithromycin in these groups of isolates. The percentage agreement within the acceptable +/-1 log2 dilution difference between MICs obtained by E-test and those obtained by the agar dilution method was 97.8%.
CONCLUSIONS: Azithromycin has a very good in vitro antigonococcal activity, and the E-test is a reliable method to determine the MIC of azithromycin against N. gonorrhoeae.
Fulltext Aerodigestive amyloidosis presenting as acute asthma

Sreetharan SS, Prepageran N, Razak A, Valuyeetham KA

Med J Malaysia, 2003 Jun;58(2):290-3.
PMID: 14569753

Aerodigestive amyloidosis is a rare disorder characterized by fibrillar protein deposition in the aerodigestive tree. We present a case of a 19-year-old Chinese gentleman whose diagnosis was initially missed as he presented with features suggestive of severe bronchial asthma and was intubated and ventilated. He subsequently presented 2 years later with severe stridor and required emergency tracheostomy. Current literature is reviewed for the histopathology, common clinical features, radiological findings and treatment options for aerodigestive amyloidosis.
Cross-sectional Study on Assessment of First-pass Success of Video Laryngoscope Intubation in General Anesthesia Patients

Selina F, Talha KA, Maw K, Aung T, Ahmed F, Solaiman M

Mymensingh Med J, 2021 Jan;30(1):123-127.
PMID: 33397862

Traditional Direct laryngoscope (DL) has been used by anesthesiologist during intubation for general anesthesia patients for more than a century. Video laryngoscope (VL) helps in better visualization of laryngeal orifice during intubation and reduces intubation time. This was a cross sectional study conducted in two Asian Hospitals Queen Elizabeth II hospital of Kotakinabalu, Malaysia and King Faisal Hospital Taif of Saudi Arabia to assess the first-pass success of video laryngoscope and to compare with direct laryngoscope from July 2015 to December 2017. Random lottery technique was applied for sampling. Participants of both groups (VL and DL) were enrolled by simple lottery method. Total 146 patients were enrolled with a set inclusion criterion. Mallampati class, mouth opening, thyromental distance and mobility of atlantooccipital junction were set as predictors of first-pass success. The first-pass success was 98.7% in mallampati II patients and 92.8% in mallampati III patients. Average success rate was 95.75%. The mean success rate of VL and DL was compared and was found VL had a significantly better first-pass success rate than DL (p<0.05).
Fulltext Urinary incontinence among urban and rural community dwelling older women: prevalence, risk factors and quality of life

Murukesu RR, Singh DKA, Shahar S

BMC Public Health, 2019 Jun 13;19(Suppl 4):529.
PMID: 31196015 DOI: 10.1186/s12889-019-6870-6

BACKGROUND: Urinary incontinence (UI) is known to be more prevalent among women and is associated with decline in quality of life. The aim of our study was to investigate the prevalence, risk factors of urinary incontinence and its impact on quality of life among community dwelling older women living in urban and rural populations.
METHODS: This study was conducted based on secondary data analysed from the third phase of the longitudinal study "Neuroprotective Model for Health Longevity among Malaysian Elderly" (LRGS TUA). Stratification of urban and rural study areas were in accordance to that determined by the Department of Statistics. A total of 814 community dwelling older women (53% urban, 47% rural), aged 60 years and above, across four states within Peninsular Malaysia were included in this analysis. Interview-based questionnaires were used to obtain respondents' sociodemographic details and clinical characteristics. The Timed Up and Go test and Handgrip Strength tests were used to assess physical function. Urinary incontinence was self-reported, and quality of life of those with incontinence was assessed using the King's Health Questionnaire (KHQ).
RESULTS: Prevalence of urinary incontinence was 16% and 23% among older women living in urban and rural areas, respectively. Ethnicity was significantly associated with incontinence among older women in both urban and rural population (p
Parasite speciation within or between host species?--phylogenetic evidence from site-specific polystome monogeneans

Littlewood DT, Rohde K, Clough KA

Int J Parasitol, 1997 Nov;27(11):1289-97.
PMID: 9421713

Partial nuclear 28S ribosomal RNA and mitochondrial cytochrome c oxidase subunit I (COI) gene sequences (953 and 385 nucleotides, respectively) of one fish monogenean (outgroup) and six polystome monogeneans (four Polystomoides spp. from the oral cavities and urinary bladders of freshwater turtles in Australia and Malaya, two Neopolystoma spp. from the urinary bladder and conjunctival sac of a freshwater turtle in Australia) were used to examine the question of whether congeneric species infecting different sites in the same host species have speciated in that host by adapting to different sites, or whether species infecting a particular site in one host have given rise to species infecting the same site in different hosts. Results show unequivocally that congeneric species infecting the same site, even of host species belonging to different suborders and occurring on different continents, are more closely related than congeneric species infecting different sites of the same host species. This is interpreted as meaning that speciation has not occurred in one host. Morphological evolution of polystomes has been very slow: few differences between species and even genera have evolved over a period of at least 150 Myr, and this is matched by low substitution rates of nucleotides, and the ambiguous position of species of different genera, depending on whether COI or 28S rDNA sequences are used.
Fulltext Platelet Rich Plasma Injection for Soft Tissue Musculoskeletal Pain

Irianto KA, Bakri AH, Kloping NA

Malays Orthop J, 2021 Jul;15(2):96-100.
PMID: 34429828 DOI: 10.5704/MOJ.2107.014

Introduction: Treating soft tissue injuries can be a challenge for physicians as it can be overlooked which can lead to more problems. In recent studies, the use of Platelet Rich Plasma (PRP) has been gaining popularity for soft tissue injuries because of its benefits and minimal side effects. This study aims to evaluate the effect of PRP injection on various musculoskeletal soft tissues inflammation.
Material and Methods: This is a retrospective study of patients with soft tissue injury who underwent PRP therapy between 2015 and 2018 at an orthopaedic and traumatology hospital. The study collected demographic data including the type of soft tissue injury and Visual Analog Scale (VAS) before and after the PRP injection. Those data were statistically analysed to identify the significance of PRP.
Results: Seventy-six patients were included, predominantly female, middle aged (40-69 years old) and class one obesity. Most of the complaints (61.8%) were in the lower extremity region. Pain improvements measured with mean VAS score were observed in both acute (3.06±1.28 to 0.8±0.65) and chronic (4±1.75 to 0.97±0.62) cases. There was a significant decrease of VAS score before and after the PRP injection (p < 0.000).
Conclusion: PRP injection is able to alleviate both acute and chronic pain in soft tissue injuries without additional analgesic.
Fulltext Unmet needs for contraception in married women in a tribal area of India

Patil SS, Abdul Rashid K, Narayan KA

Malaysian Journal of Public Health Medicine, 2010;10(2):44-51.
MyJurnal

Background and Objectives: Unmet need for contraception is the gap between women's reproductive intentions and their contraceptive behavior. This community based interventional study was carried out to determine the unmet needs for contraception, the reasons for this and to assess the impact of interventional measures on acceptance of contraception.
Subjects and Methods: This study was conducted in 52 villages in the state of Maharashtra, India, among 363 married women selected by cluster sampling. Data was collected using an interview guide. An intervention was done for the women who had an unmet need and an assessment of the change was done subsequently. Data was analyzed by using SPSS.
Results The prevalence of contraceptive usage was 59.2% and the prevalence of unmet need for contraception was 44% (160). The unmet need for spacing births was 53.8%, 38.7% for limiting births and 7.5% women were dissatisfied with the current contraceptive method. The reasons ranged from side effects to contraceptives to source of obtaining contraceptives. Age of the respondents, education and number of living children showed statistically significant association with unmet needs. Post intervention, the contraceptive prevalence rate increased significantly 85.7% and there was a significant reduction in the unmet needs for spacing and limiting births, equally there was a significant reduction of dissatisfaction with using contraception.
Conclusion: Improvement in the use of contraception and addressing the unmet need for contraception requires community involvement and ongoing, sustained efforts by health workers to ensure quality care to the beneficiaries.

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