Surgical evacuation has long been the standard treatment for hemothorax. However, some patients are not suitable candidates for surgery. Intrapleural fibrinolytic therapy (IPFT) has recently emerged as an effective alternative for managing retained hemothorax. This case report describes two patients with retained hemothorax who were unfit for surgery and were successfully treated with IPFT at our centre. Both patients were deemed unsuitable for surgery due to comorbidities and their overall functional status. They received three cycles of IPFT, each consisting of 2.5 mg of alteplase. This treatment effectively evacuated the retained hemothorax, achieving complete radiological resolution without immediate or delayed complications up to 3 months post-discharge.
Dehalogenase E (DehE) is a non-stereospecific enzyme produced by the soil bacterium, Rhizobium sp. RC1. Till now, the catalytic mechanism of DehE remains unclear although several literature concerning its structure and function are available. Since DehE is non-stereospecific, the enzyme was hypothesized to follow a 'direct attack mechanism' for the catalytic breakdown of a haloacid. For a molecular insight, the DehE modelled structure was docked in silico with the substrate 2-chloropropionic acid (2CP) in the active site. The ideal position of DehE residues that allowed a direct attack mechanism was then assessed via molecular dynamics (MD) simulation. It was revealed that the essential catalytic water was hydrogen bonded to the 'water-bearer', Asn114, at a relatively constant distance of ∼2.0 Å after 50 ns. The same water molecule was also closely sited to the catalytic Asp189 at an average distance of ∼2.0 Å, signifying the imperative role of the latter to initiate proton abstraction for water activation. This reaction was crucial to promote a direct attack on the α-carbon of 2CP to eject the halide ion. The water molecule was oriented favourably towards the α-carbon of 2CP at an angle of ∼75°, mirrored by the formation of stable enzyme-substrate orientations throughout the simulation. The data therefore substantiated that the degradation of a haloacid by DehE followed a 'direct attack mechanism'. Hence, this study offers valuable information into future advancements in the engineering of haloacid dehalogenases with improved activity and selectivity, as well as functionality in solvents other than water.
Efficacy of a β-1,4-glucosidase from Trichoderma harzianum T12 (ThBglT12) in disrupting the cell wall of the phytopathogenic fungus M. phaseolina (Macrophomina phaseolina) was studied, as the underlying molecular mechanisms of cell wall recognition remains elusive. In this study, the binding location identified by a consensus of residues predicted by COACH tool, blind docking, and multiple sequence alignment revealed that molecular recognition by ThBglT12 occurred through interactions between the α-1,3-glucan, β-1,3-glucan, β-1,3/1,4-glucan, and chitin components of M. phaseolina, with corresponding binding energies of -7.4, -7.6, -7.5 and -7.8 kcal/mol. The residue consensus verified the participation of Glu172, Tyr304, Trp345, Glu373, Glu430, and Trp431 in the active site pocket of ThBglT12 to bind the ligands, of which Trp345 was the common interacting residue. Root mean square deviation (RMSD), root mean square fluctuation (RMSF), total energy, and minimum distance calculation from molecular dynamics (MD) simulation further confirmed the stability and the closeness of the binding ligands into the ThBglT12 active site pocket. The h-bond occupancy by Glu373 and Trp431 instated the role of the nucleophile for substrate recognition and specificity, crucial for cleaving the β-1,4 linkage. Further investigation showed that the proximity of Glu373 to the anomeric carbon of β-1,3/1,4-glucan (3.5 Å) and chitin (5.5 Å) indicates the nucleophiles' readiness to form enzyme-substrate intermediates. Plus, the neighboring water molecule appeared to be correctly positioned and oriented towards the anomeric carbon to hydrolyze the β-1,3/1,4-glucan and chitin, in less than 4.0 Å. In a nutshell, the study verified that the ThBglT12 is a good alternative fungicide to inhibit the growth of M. phaseolina.Communicated by Ramaswamy H. Sarma.
Free radical scavenging activity of 21 tropical plant extracts was evaluated using 1,1-diphenyl-2-picrylhydrazyl assay (DPPH). Total phenolic compounds and flavonoids were determined using Folin-Ciocalteu and HPLC, respectively. Results of the study revealed that all the plants tested exhibited excellent antioxidant activity with IC(50) in the range of 21.3 to 89.6 microg/mL. The most potent activity was demonstrated by Cosmos caudatus (21.3 microg/mL) and Piper betle (23.0 microg/mL) that are not significantly different than that of -tocopherol or BHA. L. inermis extract was found to consist of the highest concentration of phenolics, catechin, epicatechin, and naringenin. High content of quercetin, myricetin, and kaempferol were identified in Vitex negundo, Centella asiatica, and Sesbania grandiflora extracts, respectively. Luteolin and apigenin, on the other hand, were found in Premna cordifolia and Kaempferia galanga extracts. Strong correlation (R = 0.8613) between total phenolic compounds and total flavonoids (R = 0.8430) and that of antioxidant activity of the extracts were observed. The study revealed that phenolic, in particular flavonoids, may be the main contributors to the antioxidant activity exhibited by the plants.
Two hundred strains of Klebsiella species isolated from clinical specimens over a four-month period were biotyped as Klebsiella aerogenes (173 strains), Klebsiella ozaenae (15 strains), Klebsiella edwardsii (5 strains), Klebsiella atlantae (2 strains) and Klebsiella oxytoca (1 strain). Klebsiella aerogenes and Klebsiella ozaenae were more resistant towards antibiotics when compared with other species. Colonial morphology on eosin methylene blue agar (Oxoid) was not found useful for differentiations of Klebsiella biotypes.
High production costs of biosurfactants are mainly caused by the usage of the expensive substrate and long fermentation period which undermines their potential in bioremediation processes, food, and cosmetic industries even though they, owing to the biodegradability, lower toxicity, and raise specificity traits. One way to circumvent this is to improvise the formulation of biosurfactant-production medium by using cheaper substrate. A culture medium utilizing palm fatty acid distillate (PFAD), a palm oil refinery by-product, was first developed through one-factor-at-a-time (OFAT) technique and further refined by means of the statistical design method of factorial and response surface modeling to enhance the biosurfactant production from Pseudomonas sp. LM19. The results shows that, the optimized culture medium containing: 1.148% (v/v) PFAD; 4.054 g/L KH2PO4; 1.30 g/L yeast extract; 0.023 g/L sodium-EDTA; 1.057 g/L MgSO4·7H2O; 0.75 g/L K2HPO4; 0.20 g/L CaCl2·2H2O; 0.080 g/L FeCl3·6H2O gave the maximum biosurfactant productivity. This study demonstrated that the cell concentration and biosurfactant productivity could reach up to 8.5 × 109 CFU/mL and 0.346 g/L/day, respectively after seven days of growth, which were comparable to the values predicted by an RSM regression model, i.e., 8.4 × 109 CFU/mL and 0.347 g/L/day, respectively. Eleven rhamnolipid congeners were detected, in which dirhamnolipid accounted for 58% and monorhamnolipid was 42%. All in all, manipulation of palm oil by-products proved to be a feasible substrate for increasing the biosurfactant production about 3.55-fold as shown in this study.
Fertility preservation is significant for oncology patients to maintain their ability to start a family when they are ready. Onco-fertility, as a discipline, exists at the intersection of oncology and reproductive medicine that safeguards and expands the fertility options for cancer survivors, by facilitating early intervention and suitable treatment with favourable outcomes. Successful fertility preservation requires a comprehensive networking among the gynaecologists, oncologists, pathologists, imaging and other specialists, involved in diagnosing and treating cancer in the reproductive age group. There are several ways in which fertility can be preserved, like role of gonadotrophin releasing hormone analogues, in vitro maturation, and cryopreservation.
Surfactants are compounds that can reduce the surface tension between two different phases or the interfacial tension of the liquid between water and oil, possessing both hydrophilic and hydrophobic moieties. Biosurfactants have traits that have proven to be advantageous over synthetic surfactants, but these compounds do not compete economically with synthetic surfactants. Different alternatives increase the yield of biosurfactants; development of an economical production process and the usage of cheaper substrates during process have been employed. One of the solutions relies on the suitable formulation of a production medium by including alternative raw materials sourced from agro-wastes, hydrocarbons, or by-products of a process might help in boosting the biosurfactant production. Since the nutritional factors required will be different among microorganisms, the establishment of a suitable formulation for biosurfactant production will be challenging. The present review describes various nutrients and elements considered in the formulation of a production medium with an approach focusing on the macronutrient (carbon, nitrogen source, and C/N ratio), minerals, vitamins, metabolic regulators, and salinity levels which may aid in the study of biosurfactant production in the future.
This study looked into the rate and pattern of neuropsychological impairment in patients with traumatic brain injury patients at three months post injury. Forty patients attending the neurosurgery outpatient clinic were included in the study. Benton visual retention test (BVRT), rey auditory verbal learning test (RAVLT), digit span test, trail making test (TMT) and mini mental state examination (MMSE) were used for assessment. Forty five percent (n=18) sustained moderate to severe head injury. Twenty five percent (n=10) have abnormal MMSE result. Forty two and a half percent (n=17) have abnormal BVRT result. Seventy five percent (n=30) have abnormal RAVLT result while 35% (n=14) have abnormal digit span test result. Seventy seven and a half percent (n=31) have at least one neurological deficit. There was significant association between severity of head injury (GCS score) and neuropsychological deficit. This study highlights the point that in post head injury patients, there are high occurrences of cognitive dysfunction. MMSE and GCS play a significant and important role in assessing cognitive dysfunction. Severity of head injury as determined by GCS scores also influence the outcome in patients with head injury
Safer sex provision, including contraception information and services, should be made available to adolescents regardless of their marital status in strategies to reduce the incidence of unintended teenage pregnancies and the spread of STIs. In Malaysia, this information is still not being delivered formally to adolescents even though unintended teenage pregnancies and the practice of "baby dumping" are serious public health issues. The aims of this article are to describe the Malaysian context in terms of the need for comprehensive sexual and reproductive health information and treatment for unmarried adolescents. The article presents the key aspects of Malaysian society and the potential influence on the provision and delivery of sexual and reproductive health information and treatment to unmarried Malaysian adolescents that can be a reference for healthcare professionals especially school health nurses. The article also describes the establishment of sheltered homes, baby hatches and unregulated adoption processes as the initiatives being taken to address the issue of unintended teenage pregnancies. This article suggests that the policy and laws that require parental consent for accessing the services need to be reviewed and revised to ensure that specific services are available to adolescents in a safe environment that maintains confidentiality.
In all-ceramic systems, a high incidence of veneer chip-off has been reported in clinical studies. Coefficient of thermal expansion (CTE) behaviour is one of the factors that may increase residual stress in the interface and influence the veneer/core bond strength. Therefore, this study aimed to evaluate the effect of sodalite zeolite-infiltration on the CTE behaviour and bond strength of different all-ceramic prostheses. The case-study groups were synthesized sodalite zeolite-infiltrated alumina (IA-SOD) and synthesized sodalite zeolite-infiltrated zirconia-toughened alumina (ZTA) (IZ-SOD), while the control groups were glass-infiltrated alumina (IA-glass) and glass-infiltrated ZTA (IZ-glass). Forty cylindrical-shaped samples measuring 5 mm in diameter and 10 mm in height were tested for CTE using a thermo-mechanical analyser machine, and forty disc-shaped ceramic samples measuring 12 mm in diameter and 1.2 ± 0.2 mm in thickness were prepared using specially designed stainless steel split mould and veneered by cylinder-shaped (2 mm high × 2 mm diameter) low-fusing porcelain (Vita VM7). The veneer/core samples were sintered and tested for shear bond strength using a high precision universal testing machine. Scanning electron microscope, stereo microscope, atomic force microscope, and energy-dispersive X-ray spectroscopy were used to investigate the structural characteristics of samples at the fracture surface. The collected data were analyzed with a one-way ANOVA and Tukey HSD test (α=.05). IZ-SOD revealed highest CTE and shear bond strength values, while the IA-glass revealed the lowest values than the other groups. There was no significant difference in CTE and bond strength among IZ-SOD, IA-SOD and IZ-glass samples (p>0.05). The experimental SOD zeolite-infiltrated samples revealed higher CTE mismatch and bond strength along with a more favourable mode of failure than did the commercial glass-infiltrated samples. Sandblast technique is considered as effective conditioning procedure for enhancing the surface roughness of SOD zeolite-infiltrated frameworks which subsequently improving the bond strength.
Whole blood samples from patients with various forms of alpha- and beta- thalassaemia were incubated with 14C-Leucine to determine the relative rates of production of the alpha and beta chains by their reticulocytes. The labelled globin chains were fractionated by CM-Cellulose Chromatography in 8M Urea and the incorporated activity determined. The relative rates of synthesis of alpha and beta chains in some cases of alpha and beta- thalassaemia were established and the chain synthetic ratios were compared with similar ratios in normal individuals. The results show that it is possible to identify from the relative rates of in-vitro synthesis of the alpha and beta chains, the presence of the common thalassaemia slates in particular beta-thal trait, beta-thal homozygotes, Hb H disease and alpha0-thal trait. The presence of transfused blood does not affect the result. This study indicates that an abnormal alpha/beta chain synthesis ratio is useful in defining alpha and beta-thalassaemia variants.
Objectives. Fournier's gangrene (FG), though rare, is a life-threatening extensive fulminant infection of the genitals, perineum, or abdominal wall caused by a mixture of aerobic and anaerobic micro-organisms. Early and aggressive surgical debridement of the necrotic tissue and complete antibiotic coverage are the gold standards in treating FG. The purpose of our study was to assess the role of MEBO (moist exposed burn ointment) in topical treatment of the wound secondary to surgical debridement. Methods. Eleven patients (age range, 40-75 yr; mean, 55 yr) were admitted to the clinical facilities of the Department of Urology at Al Sabah Hospital, Kuwait, suffering from Fournier's gangrene, in the 31-month period between January 2004 and July 2006. All these patients were treated with broad-spectrum triple antimicrobial therapy as well as extensive debridement of necrotic tissue. The resultant wounds were treated with MEBO in six randomly selected patients and with a placebo in the remaining five patients. Results. The duration of hospital stay was reduced by 41.7% in the MEBO-treated group (30.0 vs 51.5 days) and pain control of pain was faster, which could be attributed to the faster control of infection and wound healing in this group. Conclusion. A combination of appropriate antibiotic coverage and aggressive surgical therapy is mandatory for the treatment of FG. MEBO promotes the healing of the resulting, quite extensive wound, reducing pain and controlling infection. It is a also a cost-effective therapy as it accelerates healing and reduces hospital stay by 41.7%.
Evidence for compression, or minimization of code length, has been found across biological systems from genomes to human language and music. Two linguistic laws-Menzerath's Law (which states that longer sequences consist of shorter constituents) and Zipf's Law of abbreviation (a negative relationship between signal length and frequency of use)-are predictions of compression. It has been proposed that compression is a universal in animal communication, but there have been mixed results, particularly in reference to Zipf's Law of abbreviation. Like songbirds, male gibbons (Hylobates muelleri) engage in long solo bouts with unique combinations of notes which combine into phrases. We found strong support for Menzerath's Law as the longer a phrase, the shorter the notes. To identify phrase types, we used state-of-the-art affinity propagation clustering, and were able to predict phrase types using support vector machines with a mean accuracy of 74%. Based on unsupervised phrase type classification, we did not find support for Zipf's Law of abbreviation. Our results indicate that adherence to linguistic laws in male gibbon solos depends on the unit of analysis. We conclude that principles of compression are applicable outside of human language, but may act differently across levels of organization in biological systems.
From 1996 to 2001, 393 thyroidectomies were performed and 25 (6.4%) patients underwent reoperative thyroid surgery at Hospital Universiti Sains Malaysia. All reoperated patients had undergone one prior thyroid operation. All were females with an average age of 39.1 years (18-61 years). The most frequent indication for reoperation was cancer in resected specimen of an originally misdiagnosed carcinoma treated by partial thyroid resection. Final histological diagnosis of 25 reoperations showed thyroid carcinoma in 22 (88%) cases and multinodular goiter in 3 cases. The overall interval between the initial and the reoperative procedures ranged from 3 weeks to 15 years. There was no post-operative mortality after reoperation. Post-operative complications were discovered in 5 patients, as 3 (12%) of whom had transient hypocalcaemia, one (4%) had wound breakdown and one (4%) had permanent recurrent laryngeal nerve palsy. Reoperative thyroid surgery is an uncommon operation with high complication rate.
Acute urinary retention (AUR) is one of the most serious complications of benign prostatic hypertrophy. This study was done to predict the outcome of trial of voiding without catheter (TWOC) in patients with AUR with intravesical prostatic protrusion (IPP) detected on transabdominal ultrasound. Other factors such as prostatic volume and patient's age were also assessed.
Tujuan kajian ini adalah untuk mengenal pasti kesan rawatan suhu yang berbeza terhadap kebioaktifan wolastonit
yang disintesis menggunakan teknik sol gel. Abu sekam padi dan batu kapur digunakan sebagai bahan awalan untuk
menghasilkan wolastonit. Nisbah campuran kalsium oksida dan silika dioksida CaO/SiO2 ditentukan pada 55:45 dan
dimasukkan ke dalam autoklaf pada suhu 135°C dengan tekanan 0.26 MPa selama 8 jam. Campuran serbuk CaO dan
SiO2 tersebut disinter pada suhu yang berbeza (1150°C dan 1250°C) dan diuji sifat kebioaktifan secara rendaman
dalam larutan cecair badan tersimulasi (SBF) selama 1,3,5,7 dan 14 hari secara in vitro. Sifat fizikal dan kebioaktifan
wolastonit sebelum dan selepas direndam dalam larutan SBF dan beberapa pencirian telah dijalankan menggunakan
teknik analisis XRD, FESEM, EDX dan FTIR. Campuran serbuk CaO-SiO2 yang telah diautoklaf dan disinter pada suhu
1250°C menghasilkan puncak tunggal pseudowolastonit. Ujian kebioaktifan menunjukkan lapisan amorfus kalsium
fosfat (ACP) dengan julat nisbah Ca/P 1.9-1.51 terbentuk lebih pantas pada sampel wolastonit yang disinter pada suhu
1250°C berbanding pembentukan ACP pada sampel tersinter 1150°C.
The purpose of this study was to examine the impact of aging on economic growth. The study used dynamic growth model and employed Autoregressive Distributed Lag (ARDL) approach for the period of 1980 to 2011. Three proxies for aging are used namely fertility rate, life expectancy and old dependency ratio. However, only fertility rate is detected to have a long run cointegration. The major finding of this study showed that a reduction of fertility rate lead to higher economic growth. This implied that even though Malaysia will face aging society by 2020, the economic growth is still stable and can increase by investing more on human capital.
The first visibility of the dawn occurs at a definite angle of the sun depression, Do
which is used to calculate the fajr
(dawn) prayer time. Dawn observations were carried out using Digital Single-lens Reflex (DSLR) camera in the period
from February to December 2017 at several locations in both Malaysia and Indonesia (Lat. between 2.0° - 7.0° N,
Long. 95.0°-106.0°E). Within the observational period, 64 days of the dawn luminance at horizon were recorded with
backgrounds of both sea and land. The purpose of these observations was to determine the sun depression angle Do
at the first moment when the dawn is seen using a DSLR camera. The results indicated that Do
can be determined using
a DSLR camera. The value of Do
is between -14.5° and -18.5° with a mean value of -16.67° and standard deviation of
0.9992. This suggests that the new sun depression angle Do
for dawn prayer is -17.0°.