Accurate diagnosis of human filarial infections still remains a problem for clinicians and co-ordinators of filariasis control programs. Diagnosis of filariasis is based on parasitological, histopathological, clinical and immunological approaches. No significant advances have been made for the first three approaches although some refinements in their use and interpretation of results have occurred. For the immunological approach, intradermal tests and antibody detection assays using crude parasite extracts generally lack specificity and/or sensitivity to discriminate between past and present filarial infections in humans. Antigen detection assays would therefore provide a more accurate indication of active filarial infections. Several monoclonal antibodies to various stages of lymphatic filarial parasites have been developed and appear potentially useful for filarial antigen detection.
Introduction: Diabetes mellitus (DM) is one of the top diseases that lead public health concern in Malaysia. It was believed to rise in number up to 4.5 million on cases by year 2020 based on the current figure. Momordica charantia Linn (MC), a climber belonging to family Cucurbitaceae, is well known in treating diabetic-related conditions. In earlier studies related to the hypoglycemic properties of MC mainly utilized the crude extract, which contain a mixture of bioactives (charantins, insulin-like peptides and alkaloids). Till now, there is no conclusive result on the major bioactives that play role in the hypoglycemic effect of MC and research regarding the charantin purification was not well established. Hence, the objectives of this study were to purify the charantin from MC and to characterize the purified charantin before further subjected to in vivo hypoglycemic study. Methods: The crude was first extracted from MC using ethanol as solvent via Soxhlet extraction following by a series of purification steps via washing, centrifugation, and C-18 cartridges. Results: The HPLC analysis showed that the charantin of purified extract after passing out from the cartridge exuded at 12.50 min with a concentration of 500 ppm, which is relatively 20 times higher than the crude extract (25 ppm). The structural properties of purified charantin were studied using FTIR and it showed strong peaks of carboxylic acids (2884 nm), alcohols (1023 nm) and diethyl ether (1114 nm) as compared
with the standard. The compound was reconfirmed in LC-MS analysis. The result displayed mass spectrum in positive mode indicates the presence of similar compound in the purified extract and standard charantin, as presented by ion m/z = 300. Conclusion: The charantin was successfully purified from MC and can act as a potent plant-based hypoglycemic agent for diabetes.
A clinical study was undertaken of new diabetics seen at a general medical unit in Singapore. Over a period of 12 months, there were seventy-five cases of which 38 (50.7%) were Chinese, 15 (20%) Malays and 22 (29.3%) Indians. Male patients were twice as common as female patients. The majority of patients (61.3%) were in the 5th and 6th decade and only 23 (30.7%) were obese. Oral sulphonylurea and dieting provided effective control in 80.6% of the patients, and only 9% of patients required insulin. Ketosis was present in only 6 cases and was easily controlled with appropriate treatment. Other clinical features are presented and discussed.
The scapula is a flat, triangular bone overlying the posterior chest wall and forming the posterior aspect of the shoulder girdle. To the best of our knowledge, there is no previous description of a notch of the medial aspect of the superior border of the scapula in the literature. The imaging findings of a supero-medial scapula border notch mimicking a bone tumour are presented in this case report.
The role of bioregeneration process in renewing the adsorbent surface for further adsorption of organics during simultaneous adsorption and biodegradation processes has been well recognized. The extent of bioregeneration of powdered activated carbon (PAC) as an adsorbent loaded with phenol, p-methylphenol, p-ethylphenol and p-isopropylphenol, respectively, in the simultaneous adsorption and biodegradation processes were quantitatively determined using oxygen uptake as a measure of substrate consumption. Bioregeneration phenomenon was also evaluated in the simultaneous adsorption and biodegradation processes under sequencing batch reactor (SBR) operation to treat synthetic wastewater containing 1200 mg l(-1) phenol and p-methylphenol, respectively. The SBR systems were operated with FILL, REACT, SETTLE, DRAW and IDLE periods in the ratio of 4:6:1:0.75:0.25 for a cycle time of 12 h. The results show that the percentage of desorption from loaded PAC decreased in the order phenol>p-methylphenol>p-ethylphenol>p-isopropylphenol. For the treatment of phenol and p-methylphenol in the SBR reactors, respectively, the simultaneous adsorption and biodegradation processes were able to produce a consistent effluent quality of COD < or = 100 mg l(-1) when the applied PAC dosage was 0.115 and 0.143 g PAC per cycle, respectively. When no further PAC was added, the treatment performance deteriorated to that of the case without PAC addition after 68 and 48 cycles of SBR operation, respectively, for phenol and p-methylphenol. This observation is consistent with the greater extent of bioregeneration for phenol-loaded PAC as compared to p-methylphenol-loaded PAC.
The speciation patterns of Cu, Cd, Zn, Pb, Fe and Mn in sediment samples under anoxic and oxidized conditions were investigated using three-stage, four-stage and five-stage sequential extraction schemes. All the extraction schemes identify the non-residual metal among three basic operationally-defined host fractions, namely, exchangeable, reducible and organic/sulfide bound. The anoxic sediment samples were found to have been oxidized during the extraction stage for the reducible fraction under the three-stage and four-stage schemes and the moderately reducible fraction under the five-stage scheme despite the maintenance of an oxygen-free environment. This artifact has resulted in an over-representation of the reducible fraction and an under-representation of the organic/sulfide fraction in the heavy metal speciation patterns of anoxic sediment samples. For Cd, Zn and Pb which had > 70% associated with the acid volatile sulfide in the organic/sulfide fraction, this artifact has resulted in the observation of a decrease in the reducible fraction and, in some cases, an increase in the organic/sulfide fraction upon oxidation of the anoxic sediment samples.
The objective of this study is to investigate the potential of the activated rice husk to be used as an alternative adsorbent to powdered activated carbon (PAC) in the simultaneous adsorption and biodegradation processes under sequencing batch reactor (SBR) operation to treat synthetic wastewater containing phenol, p-methylphenol, p-ethylphenol and p-isopropylphenol. The rice husk (PRH) was activated by pyrolysis at 600 degrees C for 5 hours in a nitrogen atmosphere. Using the Langmuir model, the limiting adsorption capacities of PRH for the phenols were found to vary from 0.015-0.05 of those of PAC. The SBR reactors with and without adsorbent addition were operated with fill, react, settle, draw and idle periods in the ratio of 4:6:1:0.76:0.25 for a cycle time of 12 hours. For phenolic wastewater containing, 1,200 mg/L phenol, 1,200 mg/L p-methylphenol, 800 mg/L p-ethylphenol and 660 mg/L p-isopropylphenol, it was found that the biodegradation process alone was unable to produce effluent of quality which would satisfy the discharge standards of COD < or = 100 mg/L and phenol concentration < or = 1 mg/L. The addition of PAC in the ratio of PAC/phenolic compound at 0.095 g/g for phenol, 0.119 g/g for p-methylpheol, 0.179 g/g for p-ethylphenol and 0.220 g/g for p-isopropylphenol, can improve the effluent quality to satisfy the discharge standards. Equivalent treatment performance was achieved with the use of PRH at dosages of 2-3 times higher than those of PAC for all the phenolic wastewater studied. The increased adsorption capacity of PRH shown in the treatment indicates bioregeneration of the adsorbed surface during the treatment process.
A method for securing closed suction drains in the neck is described where it serves to prevent leakage, slippage and accidental removal. This method involves passing a stay suture through the most proximal holes of the drain and suturing it to the skin and an overlying short length of the tube externally. Drains secured in this manner can be left in the wound for up to fourteen days with no associated complications from our experience in sixty-two patients following head and neck surgery.
The Juru River flows through largely urbanized areas and is grossly polluted by domestic wastes and discharges from pig farms. Other than carrying highly polluting organic materials, these wastes are also contaminated with heavy metals. To ascertain the extent of heavy metal pollution in the river, total and non-residual concentrations of Cu, Pb, Zn, Mn and Fe in sediment samples collected along the river were determined. The results indicate that both the total and non-residual metal concentrations in sediments can successfully be used to identify heavy metal pollution sources. The speciation of Zn, Mn and Fe in the sediment samples were investigated using a sequential leaching technique which identifies the elements among six operationally defined host fractions: (1) exchangeable, (2) carbonate and surface-associated, (3) easily reducible, (4) moderately reducible, (5) bound to organic matter and sulphides and (6) residual. The results indicate that Zn is mainly associated with the reducible fractions. Zn and Fe found in the moderately reducible fraction are significantly correlated, indicating that iron oxides is the preferred host phase by Zn.
The chemoprophylactic use of diethylcarbamazine citrate at total oral doses of 15--180 mg/kg body weight was tested against subperiodic Brugia malayi infection in the leaf monkey (Presbytis melalophos). A total dose of 45 mg/kg body weight given over 9 days killed all developing infective larvae. Similarly, a total dose of 35 mg/kg body weight given over 7 days killed all fourth stage larvae. The minimum effective dose that prevents infection would be 5 mg/kg body weight daily for 7 days every month.
Georgetown of Penang, an old city, is noted for its narrow streets. The existing traffic dispersal system is utterly inadequate to cope with the ever increasing number of cars and motorcycles on the road. The principal objective of this study is to build prediction models of CO to be employed as one of the planning tools in the future design of Penang urban traffic dispersal system. This study involves the monitoring of kerbside CO levels at selected sites and the fitting of hourly-averaged CO data to linear regression models incorporating the residual effect of CO emission due to traffic in the earlier periods and also different categories of vehicles. The best overall regression model appears to be the one based upon the total traffic count of motorcycles. This can be accounted for by the fact that the traffic counts of motorcycles and cars are highly correlated in most cases and that the emissions of CO from motorcycles are more readily detected as they travel closer to the kerb. The inclusion of residual CO in the models significantly improves the correlation coefficient from about 0.4 to about 0.7.
Miscarriage is one of the most common complications in pregnancy. There is emerging evidence that psychological impact following miscarriage is not unusual. Understanding the magnitude of psychological morbidity is important in the management of miscarriage. The main objective of this study was to compare the mean Hospital Anxiety and Depression Scale (HADS) score between women with miscarriage and women with successful pregnancy and to determine the sociodemographic factor and clinical characteristic that are associated with anxiety and depression. A descriptive case control study was conducted in a teaching hospital, over a period of 12-months (from October 2014 till September 2015). A total of 65 women were recruited with 32 women as the study group (miscarriage) and another 33 women as the control group (women with successful pregnancy). Mean HADS-anxiety score was higher in the study group compared to control group although it was not statistically significant (6.53 ± 3.427 vs 5.73 ± 2.875, p=0.309). Mean HADS-depression score was higher in the control group (4.34 ± 2.695 vs 4.45 ± 3.073, p=0.878). Women with maternal age more than 35 years and history of previous miscarriage had a higher tendency of anxiety and depression with higher mean HADS score. There was no association between other sociodemographic data and clinical characteristic with risk of anxiety and depression. As conclusion, there was no significant difference in women with miscarriage as compared to those with successful pregnancies, although older women with history of miscarriage had a preponderance to both disorders.
Keywords: anxiety, depression, miscarriage, morbidity, psychological
Type-2 diabetes mellitus (T2DM) patients who were on gliclazide co-administered with metformin were changed to pre-combined glibenclamide-metformin tablets in the Endocrine Clinic, Penang Hospital. We conducted a retrospective study to evaluate the differences in glycaemic control and treatment cost following the change. Eighty patients (60% females) with a mean age of 55 years old were studied. Mean glycosylated haemoglobin (HbAlc) reduction was -0.92% (p<0.01) and -0.83% (p<0.01) after three and six months respectively. Patients with baseline HbA1c > or =8% had greater reduction in mean HbA1c (-1.36%) after six months. The treatment cost per month was reduced by 45% at 3 months (p<0.01)) and 44% at 6 months (p<0.01). The change to pre-combined glibenclamide-metformin tablets resulted in significant improvement in glycaemia and reduction in treatment cost.
BACKGROUND: Mohs micrographic surgery (MMS) provides a combination of high cure rate and tissue conservation. Epidemiologic factors and changes in techniques may affect the way MMS is performed.
OBJECTIVE: We sought to evaluate changes over time in the type of patients and skin cancers that are treated using MMS, and the repairs used to close the defects.
METHODS: We conducted a retrospective study on patients treated with MMS at the Skin and Cancer Foundation Australia, Westmead, in 1997 against those treated in 2007. Patient demographics (age, sex), pathology of tumor, anatomic site of the tumor, preoperative tumor size, postoperative defect size, and repair method were analyzed.
RESULTS: There was a 260% increase in the number of procedures (596 in 1997 vs 1587 in 2007). The 2007 cohort was a little older (62 vs 64 years), but there were no differences in sex, anatomic site, rate of basal/squamous cell carcinoma, squamous cell carcinoma histologic subtypes, or preoperative tumor size. However, there were fewer superficial basal cell carcinomas, and the postoperative defect size was smaller in 2007 (P < .0001). There was also a decrease in the use of grafts and second-intention healing to close the defects and an increase in the number of side-to-side closures (P < .0001).
LIMITATIONS: Retrospective study at one institution is a limitation.
CONCLUSION: Although tumor size and the percentage of tumors in each anatomic site did not change over 10 years, the size of the defect created after MMS has become smaller. This reduction in defect size may explain why more defects are now repaired by side-to-side closure and flap repairs whereas fewer defects are repaired by skin grafting.
The objective of this research was to evaluate the treatment ofp-nitrophenol (PNP) as a sole organic carbon source using a sequencing batch reactor (SBR) with the addition of adsorbent. Two types of adsorbents, namely powdered activated carbon (PAC) and pyrolysed rice husk (PRH) were used in this study. Two identical SBRs, each with a working volume of 10 L, were operated with fill, react, settle, draw and idle periods in the ratio of 2:8:1:0.75:0.25 for a cycle time of 12 h. The results showed that, without the addition of adsorbent, increasing the influent PNP concentration to 200 mg/L resulted in the deterioration of chemical oxygen demand (COD) removal efficiency and PNP removal efficiency in the SBRs. Improvement in the performance of the SBR was observed with the addition of PAC. When the dosage of 1.0 g PAC/cycle was applied, COD removal of 95% and almost complete removal of PNP were achieved at the influent PNP concentration of 300 mg/L. The kinetic study showed that the rates of COD and PNP removal can be described by the first-order kinetics. The enhancement of performance in the PAC-supplemented SBR was postulated to be due to the initial adsorption of PNP by the freshly added and the bioregenerated PAC, thus reducing the inhibition on the microorganisms. The PRH was found to be ineffective because of its relatively low adsorption capacity for PNP, compared with that of PAC.
The bioregeneration efficiencies of powdered activated carbon (PAC) and pyrolyzed rice husk loaded with phenol and p-nitrophenol were quantified by oxygen uptake measurements using the respirometry technique in two approaches: (i) simultaneous adsorption and biodegradation and (ii) sequential adsorption and biodegradation. It was found that the applicability of the simultaneous adsorption and biodegradation approach was constrained by the requirement of adsorption preceding biodegradation in order to determine the initial adsorbent loading accurately. The sequential adsorption and biodegradation approach provides a good estimate of the upper limit of the bioregeneration efficiency for the loaded adsorbent in the simultaneous adsorption and biodegradation processes. The results showed that the mean bioregeneration efficiencies for PAC loaded with phenol and p-nitrophenol, respectively, obtained using the two approaches were in good agreement.
A kinetic model consisting of first-order desorption and biodegradation processes was developed to describe the bioregeneration of phenol- and p-nitrophenol-loaded powdered activated carbon (PAC) and pyrolyzed rice husk (PRH), respectively. Different dosages of PAC and PRH were loaded with phenol or p-nitrophenol by contacting with the respective phenolic compound at various concentrations. The kinetic model was used to fit the phenol or p-nitrophenol concentration data in the bulk solution during the bioregeneration process to determine the rate constants of desorption, k(d), and biodegradation, k. The results showed that the kinetic model fitted relatively well (R(2)>0.9) to the experimental data for the phenol- and p-nitrophenol-loaded PAC as well as p-nitrophenol-loaded PRH. Comparison of the values of k(d) and k shows that k is much greater than k(d). This indicates clearly that the desorption process is the rate-determining step in bioregeneration and k(d) can be used to characterize the rate of bioregeneration. The trend of the variation of the k(d) values with the dosages of PAC or PRH used suggests that higher rate of bioregeneration can be achieved under non-excess adsorbent dosage condition.