Locked pubic symphysis is a rare form of pelvic injury that usually occurs after a lateral compression injury to
the pelvis, where the intact pubis is trapped behind the contralateral pubis. To the best of our knowledge, there
were 25 similar cases reported in the English literature since it was first described in 1952. We present a case
of locked pubic symphysis with a left iliac wing fracture and a left femur shaft fracture requiring open reduction
and internal fixation. We also reviewed previous reported cases of locked pubic symphysis and analysed the
pattern of presentation and guide to management of such injuries. We propose a classification system for
grading overlapping pubic symphysis that will provide a better guide to the management of such injuries.
: Halal industry is currently one of the fastest growing market segments in the world. With the emerging of IR4.0, the future growth of Halal industry and its sustainability can be affected by the advancement of technology. Technology has continuously assimilated in every aspect of our live from consumerization, commercialization, and industrialization to infrastructure. Even though many factors may have collectively contributed towards better understanding of Halal sustainability, this article focuses only on the technological aspects of Halal in the face of IR4.0. With this focus, four components of technology comprising of technoware, humanware, infoware, and orgaware are discussed. Although each components of technology have been fairly studied in the previous Halal literature, most of them were not specifically emphasized on the sustainability issues. From DCs point-of-view, a firm that is capable of managing the complexity in the components of technology will become more sustainable at Halal marketplace under dynamic environment. A framework is proposed to explain how the technology complexity together with the environmental factors (opportunities and threats of IR4.0) can be affecting Halal sustainability. This article has proposed the complexity in each components of technology will positively affect Halal sustainability. Accordingly, the opportunities of IR4.0 is proposed to have a positive direct and moderation effects on the relationships between technology complexity and Halal sustainability, whereas the threats of IR4.0 will have a negative direct and moderation effects on the relationships.
Polycystic ovarian syndrome (PCOS) is a heterogeneous endocrine disorder characterised by elevated levels of male hormones, acne and hirsutism. Hormonal imbalances in PCOS women can lead to immature eggs, anovulation and infertility. Plant extracts have been shown to improve PCOS however, there was a lack of systematic review on this topic. The aim of this paper was to review the plant extracts claimed to improve PCOS in the literature. In depth searches of the literature was carried out based on the Preferred Reporting Items for Systematic Review and Me- ta-analyses (PRISMA) guideline. A bibliographic search was performed on MEDLINE, Science Direct, Web of Science and Cochrane library databases using the following search terms; [‘Polycystic Ovarian Syndrome’ or ‘PCOS’] and [‘plant extracts’]. A total of 38 studies were included in the final review. 15 plant extracts hypothesised to reduce PCOS were identified; Chinese herbal medicine (n=22), Black Cohosh (n=2), Jatamansi (n=1), Tribulus (n=1), Kacip Fatimah (n=1), Fenugreek seed (n=2), Coconut tree flower (n=1), Maitake mushroom (n=1), Wood Betony (n=1), Cinnamon (n=2), Marjoran (n=1), Korean Red Ginseng (n=1), Hazelnut (n=1), Adlay (n=1) and Northern White Ce- dar (n=1). Three different models were used; randomised control trials (n=23), animal models (n=14) and non-ran- domised surveillance study (n=1). PCOS characteristics were improved with the used of plant extracts by improving insulin resistance, pregnancy outcomes and ovarian morphology. However, most of these researches are at the early stages. Further researches are needed to elucidate the mechanisms of these plant extracts in treating PCOS.
A new method of Standard Malaysian Rubber (SMR) process wastewater treatment was developed based on in situ hypochlorous acid generation. The hypochlorous acid was generated in an undivided electrolytic cell consisting of two sets of graphite as anode and stainless sheets as cathode. The generated hypochlorous acid served as an oxidizing agent to destroy the organic matter present in the SMR wastewater. For an influent COD concentration of 2960 mg/L at an initial pH 4.5+/-0.1, current density 74.5 mA/cm(2), sodium chloride content 3% and electrolysis period of 75 min, resulted in the following residual values pH 7.5, COD 87 mg/L, BOD(5) 60 mg/L, TOC 65 mg/L, total chlorine 146 mg/L, turbidity 7 NTU and temperature 48 degrees C, respectively. In the case of 2% sodium chloride as an electrolyte for the above said operating condition resulted in the following values namely: pH 7.2, COD 165 mg/L, BOD(5) 105 mg/L, TOC 120 mg/L, total chlorine 120 mg/L, turbidity 27 NTU and temperature 53 degrees C, respectively. The energy requirement were found to be 30 and 46 Wh/L, while treating 24 L of SMR wastewater at 2 and 3% sodium chloride concentration at a current density 74.5 mA/cm(2). The observed energy difference was due to the improved conductivity at high sodium chloride content.
Single-cell analysis has become the interest of a wide range of biological and biomedical engineering research. It could provide precise information on individual cells, leading to important knowledge regarding human diseases. To perform single-cell analysis, it is crucial to isolate the individual cells before further manipulation is carried out. Recently, microfluidic biochips have been widely used for cell trapping and single cell analysis, such as mechanical and electrical detection. This work focuses on developing a finite element simulation model of single-cell trapping system for any types of cells or particles based on the hydrodynamic flow resistance (Rh) manipulations in the main channel and trap channel to achieve successful trapping. Analysis is carried out using finite element ABAQUS-FEA™ software. A guideline to design and optimize single-cell trapping model is proposed and the example of a thorough optimization analysis is carried out using a yeast cell model. The results show the finite element model is able to trap a single cell inside the fluidic environment. Fluid's velocity profile and streamline plots for successful and unsuccessful single yeast cell trapping are presented according to the hydrodynamic concept. The single-cell trapping model can be a significant important guideline in designing a new chip for biomedical applications.
Cell adhesion is essential in cell communication and regulation, and is of fundamental importance in the development and maintenance of tissues. The mechanical interactions between a cell and its extracellular matrix (ECM) can influence and control cell behavior and function. The essential function of cell adhesion has created tremendous interests in developing methods for measuring and studying cell adhesion properties. The study of cell adhesion could be categorized into cell adhesion attachment and detachment events. The study of cell adhesion has been widely explored via both events for many important purposes in cellular biology, biomedical, and engineering fields. Cell adhesion attachment and detachment events could be further grouped into the cell population and single cell approach. Various techniques to measure cell adhesion have been applied to many fields of study in order to gain understanding of cell signaling pathways, biomaterial studies for implantable sensors, artificial bone and tooth replacement, the development of tissue-on-a-chip and organ-on-a-chip in tissue engineering, the effects of biochemical treatments and environmental stimuli to the cell adhesion, the potential of drug treatments, cancer metastasis study, and the determination of the adhesion properties of normal and cancerous cells. This review discussed the overview of the available methods to study cell adhesion through attachment and detachment events.
Surface electromyography (SEMG) signals can provide important information for prosthetic hand control application. In this study, time domain (TD) features were used in extracting information from the SEMG signal in determining hand motions and stages of contraction (start, middle and end). Data were collected from ten healthy subjects. Two muscles, which are flexor carpi ulnaris (FCU) and extensor carpi radialis (ECR) were assessed during three hand motions of wrist flexion (WF), wrist extension (WE) and co-contraction (CC). The SEMG signals were first segmented into 132.5 ms windows, full wave rectified and filtered with a 6 Hz low pass Butterworth filter. Five TD features of mean absolute value, variance, root mean square, integrated absolute value and waveform length were used for feature extraction and subsequently patterns were determined. It is concluded that the TD features that were used are able to differentiate hand motions. However, for the stages of contraction determination, although there were patterns observed, it is determined that the stages could not be properly be differentiated due to the variability of signal strengths between subjects.
Intranasal haemangioma is quite rare. This tumor may be confused with other intranasal vascular tumor such as juvenile nasopharyngeal angiofibroma (JNA), glomus tumors as well as other tumor such as angiosarcoma and leiomyoma. Juvenile nasopharyngeal angiofibroma is the most common vascular tumor encountered in nasal cavity. A definitive histology diagnosis pre-operatively is difficult to be obtained as the biopsy may lead into severe uncontrolled bleeding. The final diagnosis very much depends on histology after the tumor excision. Complete surgical resection of the tumor is the standard approach. In this report we describe our surgical management in approaching intranasal haemangioma endoscopically and this pathology can be considered as one of differential diagnosis for unilateral nasal mass.
The effect of metal cations, both nonhydrolyzable and hydrolyzable, on the zeta potential of palm olein emulsions stabilized by the nonionic emulsifier, polyoxyethylene nonyl phenyl ether, was investigated as a function of pH and cation concentrations, respectively. The oil drops were found to be negatively charged in the presence of simple mono- and divalent cations. Charge reversal of the oil drops was observed when hydrolyzable cations (Zn2+, Cu2+, Fe3+, and Al3+) were used and the behavior is strongly dependent on the type of cation, its concentration, and the pH of the dispersion. The results are discussed in terms of current theories of electrophoresis and adsorption-precipitation at interfaces. The chemical free energies of adsorption of the cations were calculated. Copyright 1999 Academic Press.
Chrome azurol S immobilised on XAD-2 has been used in this study as a reagent phase for the development of an optical fibre Al(III) sensor. Using a kinetic approach, this sensor was able to give a linear response in the Al(III) concentration range of 1.3 x 10(-5)-2.0 x 10(-4) M with a limit of detection of 1.0 x 10(-4) M. The optimum responses were obtained at pH 6.0 and when the solution was stirred. The sensor response was found to have a repeatability and reproducibility of 1.6% and 5.8%, respectively. The results obtained for Al(III) determination in aqueous sample were in good agreement with those obtained using graphite furnace-atomic absorption spectrometry.
Tuberculosis (TB) is an ancient disease dated back from ancient Greece time. Once rare in developed countries, now it has re-emerged due to immigration and secondary immunodeficiency. A 27-year-old lady had left knee pain for the past 4 years, went for knee diagnostic arthroscopy procedure, and diagnosed as pigmented villonodular synovitis (PVNS) of the left knee. Despite regular analgesics and physiotherapy, patient symptoms worsen. Two years after the initial treatment, the patient went for a further workout and diagnosed as knee tuberculosis, commenced on anti-TB treatment, the patient still left complicated with a stiff knee and fixed flexion deformity. Identification of knee tuberculosis during the initial phase is crucial as late diagnosis and treatment will leave the patient with debilitating complications.
Introduction: Low job satisfaction among healthcare workers may lead to high turnover intention, poor job perfor-mance, high absenteeism, and low patient satisfaction. Global and local needs for health workforce are increasing in trend to meet current health demands. Addressing job satisfaction of the healthcare workers is a practical way to uti-lise the available human resources optimally. The main aim of this study is to determine job satisfaction level and its associated factors among healthcare workers in health clinics under the Petaling District Health Office jurisdiction in Selangor, Malaysia. Methods: A cross-sectional study was conducted among healthcare workers in ten health clinics in Petaling District from April until May 2019. Simple random sampling method proportionate to the number of staffs from each health clinics was done. A structured self-administered questionnaire was used. Results: The response rate was 93%. Majority of the respondent were female (83%), married (82%), diploma holder (41%), nurses (33%) and working in health clinics with specialists (93%). The job satisfaction mean score for the studied population was 4.46 (SD = 0.72). Self-rated physical health and mental stress status were significantly associated with job satisfaction (p < 0.001). Conclusion: The job satisfaction level of the studied population was comparable to other local studies and higher than studies from Iran, Ethiopia and China. Extra attention should be given to healthcare workers with poor physical health and poor mental stress. More objective study on physical health and mental stress is required.
Let g be a finite group and s be a subset of g, where s does not include
the identity of g and is inverse closed. A cayley graph of a group g with respect to the
subset s is a graph, where its vertices are the elements of g and two vertices a and b
are connected if ab-1 is in the subset s. The energy of a cayley graph is the sum of all
absolute values of the eigenvalues of its adjacency matrix. In this paper, we consider a
specific subset s = {b, ab, . . . , An-1b} for dihedral groups of order 2n, where n 3 and find
the cayley graph with respect to the set. We also calculate the eigenvalues and compute
the energy of the respected cayley graphs. Finally, the generalization of the energy of the
respected cayley graphs is found.
Trawling is a method of catching fish in a large volume where fish net is pulled through water using one or two boats. Bottom trawling is where the nets are pulled over or close to seabed and can affect the subsea pipeline if found along the route. Therefore, the objective of this study was to determine the impact of pull-over to selected subsea pipelines in Sabah and Labuan waters. This study involved four oil and gas pipelines in Sabah and Labuan waters from the oil fields to shore terminals. The research started with obtaining data of the pipelines and specification of trawl gear in Sabah. Fishing trawler traffic data along the pipelines route was determined by AIS system and site observation to determine the density of the trawlers. Trawl gear pull-over load was calculated using DNV algorithm and the inputs were trawl gear specification ^and fishing trawl speed. The severity was based on pull-over load calculated and pipeline yield stress. Then frequency was based on AIS data and density of fishing trawl per area. Based on the comparison between trawl pull-over load and yield strength/stress, the effect of trawl board pull-over is considered as minor, which is the lowest in the severity index.
Achilles tendon is the strongest tendon in the body . Achilles tendon rupture is a debilitating ankle injury especially among the athletes. We would like to highlight an unusual case of acute dual-level injuries of the Achilles tendon. Case report: A 30-year-old footballer presented with left ankle injury during a football tournament. Examination revealed tenderness at posterior left heel, palpable gap at Achilles tendon region and positive Thompson test. Radiological assessment showed dual-level injuries of the Achilles tendon-proximally was a rupture at musculotendinous junction and distally was an avulsion calcaneal fracture. We performed a mini-open approach Achilles tendon reconstruction for this patient. First, we reconstructed the distal avulsion calcaneal fracture using double row anchor sutures technique. Next, we repaired the proximal ruptured Achilles tendon using percutaneous Achilles reconstruction system (PARS) from Arthrex. Postoperatively, patient was put on functional rehabilitation protocol. At present, patient recovers well and regains back the Achilles tendon function. In conclusion, segmental Achilles tendon injury is rare and its surgical treatment can be challenging and must be well-planned.
Snapping scapula syndrome is a condition with audible and palpable grating localized to the superomedial angle of the scapula associated with pain. The etiology is likely secondary to anomalous tissue between scapula and chest wall (e.g. bursitis, hooked superomedial angle scapula, Luschka tubercle, malunited rib/scapula fracture and osteochondroma). Case report: We present a case of a 17year-old gentleman, with chronic pain over bilateral upper scapula associated with grating sound upon shoulders movement. Examination revealed significant audible crepitus on bilateral scapula without restriction of shoulders motion. MRI showed no abnormal finding. An attempt for conservative approach including physical therapy and steroid/local anaesthesia injection has been unsuccessful. We subsequently performed an arthroscopic bursectomy and superomedial angle scapula decompression on the right scapula. There were inflammed bursa with fibrotic tissue and prominent superomedial angle of scapula observed during the surgery. Postoperatively, the symptom over right scapula completely resolved with good patient satisfaction. At present, patient is scheduled for the similar surgery on the remaining symptomatic left scapula. In conclusion, arthroscopic scapulothoracic bursectomy with superomedial angle scapula decompression is a reliable treatment for snapping scapula syndrome with predictably high rates of pain relief, patient satisfaction as well as improvement in functional outcomes.
Kajian ini telah dijalankan dengan menghasilkan dua sistem komposit iaitu komposit epoksi berpengisi montmorillonite (MMT) dengan dan tanpa cecair getah asli terepoksida (LENR) secara kaedah pencampuran in situ. Komposit telah di pra-matang pada tiga suhu iaitu pada suhu 30 °C, 50 °C atau 70 °C . Kedua dua sistem dimatang pada suhu 130 °C atau 140 °C. Ujian hentaman Izod dan ujian keliatan patah ke atas komposit yang dihasilkan menunjukkan peningkatan maksimum sebanyak 44% dengan penambahan MMT dan 29% peningkatan dengan penambahan getah asli terepoksida. Selain kandungan MMT, suhu pra matang 70 °C memberikan kesan yang ketara terhadap kekuatan hentaman dan keliatan patah sistem epoksi berpengisi MMT. Suhu pra-matang 50 °C merupakan suhu yang optimum dan berupaya memberikan kekuatan hentaman dan keliatan patah yang baik kepada sistem epoksi berpengisi MMT getah asli terepoksida. Suhu matang bagi kedua dua sistem tidak memberikan kesan yang ketara kepada sifat mekanikal kedua dua sistem komposit ini. Pemeriksaan mikrostruktur melalui mikroskop elektron transmisi menunjukkan MMT tertabur dengan susunan interkalasi. Peningkatan kandungan MMT melebihi 1 % berat menunjukkan kehadiran taktoid dan penggumpalan silikat.
The microstructural evolution of Sn-40Pb/Cu joints has been investigated under 125 o C thermal exposure conditions using single shear lap joints. A scanning electron microscope (SEM) was used to observe the morphology of the phases and energy dispersive x-ray (EDX) was used to estimate the elemental compositions of the phases. A double layer of Cu6Sn5 and Cu3Sn were observed. The Cu6Sn5 developed with a scalloped morphology, while the Cu3Sn always grew as a somewhat undulated planar layer in phase with the Cu6Sn5. The Cu6Sn5 layer began to transform from scallop shape to planar type after aging for 375 hours due to reduction in the interfacial energy. The intermetallic layers showed a linear dependence on the square root of aging time. The growth rate constant of the intermetallic compounds are estimated as 15.2 x 10 - 14 and 0.152 x 10 -14 cm 2 /s for Cu6Sn5 and Cu3Sn intermetallic, respectively.
This study was carried out to compare the rate of burn wound healing with the applications of the latex of Carica papaya Linn. (papaya) or of silver sulfadiazine cream (SSD). Partial and full thickness burn wound (2 cm x 2 cm) was induced on the dorsal part of anaesthetized rats by using heated metal plates. The rats were divided into three groups, i.e. untreated group and groups treated daily with SSD and papaya latex, respectively. A digital camera was used to take photographs of the burn wounds daily to monitor their healing. It was found that there was no significant difference in the healing time of papaya latex treated group compared to the SSD treated group. Papaya latex contained digestive enzymes which might clean burn wounds but might also cause wound bleeding in a few rats of the papaya latex group.