Review of continuous wound infusion compared to epidural analgesia for post-operative pain after laparotomy in hospital Sultanah Aminah Johor Bahru

Post-operative pain remains a major concern and managing it optimally is core responsibility for Acute Pain Service (APS). Studies to demonstrate clear benefit of one analgesia modality over another are limited. The aim of this study was to compare analgesic efficacy of epidural analgesia with a relatively new method of analgesia, continuous wound infusion (CWI) for post-operative pain management after laparotomy. Methods: A retrospective observational study was performed to evaluate post-operative pain, length of stay and rescue analgesia requirements of 177 patients who underwent laparotomy between the year 2020 and 2021 in Hospital Sultanah Aminah Johor Bahru. Data from perianaesthetic care records, Enhanced Recovery After Surgery (ERAS) Audit form and medical records were collected and analysed. Results: 85 patients received continuous epidural analgesia (CEA) and 92 patients received CWI. CEA group was better in pain control at rest (p=0.05) and on movement (P=0.007). CEA group also had higher percentage of patients with well controlled pain (pain score 4days) compared CWI. Conclusions: CEA significantly produced lower pain scores after laparotomy surgery compared to CWI. Nevertheless, CWI had as role as an alternative in patients whom epidural is contraindicated or not planned in advance, while providing shorter hospital stay

Habitat quality assessment in the Royal Belum rainforest, Malaysia using spatial analysis

Royal Belum rainforest contains various flora and fauna species, however, the assessment of habitat quality is still lacking. This study aims to develop the habitat quality zone in the Royal Belum rainforest. The downloaded Landsat 8 OLI/TIRS CI satellite images in the year 2020 from the United States Geological Survey (USGS) were processed using supervised classification and exported into vector data in ArcGis 10.8. Land use, normalized difference vegetation index (NDVI), buffer, and land structure were then analyzed. The result shows that the highest percentage and density of the land use of the Royal Belum rainforest is vegetation. Buffer zone analysis identifies the risky area for habitat in the range of 1km and 5km from the built-up area. The area within the buffer ring should be protected from building and construction to ensure habitat quality in that area can be maintained. This study will give a better understanding of land use and vegetation index assessment for future planning in the Royal Belum rainforest. Therefore, habitat quality assessment is an important tool that can help to identify areas of high-quality habitat that are crucial for the survival and reproduction of target species and to prioritize these areas for conservation and management

Differences in Attitude towards End-Of-Life Care among Haemodialysis Patients and their Family Members in Two Malaysian Hospitals

INTRODUCTION: End-of-life (EOL) care has become an important topic of discussion  in those with chronic illness, especially in End Stage Renal Disease (ESRD) patients on dialysis. This study explored attitudes towards the EOL care among haemodialysis patients and compared them with the patients’ family members. MATERIALS AND METHODS: The study was a cross-sectional descriptive study conducted in two tertiary hospitals in Malaysia. The data was collected by using a survey questionnaire from 164 participants which consisted of 82 pairs of patients and their relatives. RESULTS: ‘Patient’ and ‘family’ groups demonstrated differences in their preferences regarding EOL care options. Family members group favoured cardiopulmonary resuscitation (81.7% vs 41.4%) (p &lt;0.001), endotracheal intubation (80.5% vs 43.9%) (p = 0.989) and nasogastric tube feeding (87.8% vs 67%) (p = 0.001) more than patients themselves. The physician was the most nominated surrogate decision-maker by the patient (91.5%). Majority of the patients (57.3%) felt uncomfortable discussing EOL care options. There was significant correlation between duration of dialysis and patients’ EOL preferences where patients less than 5 years on haemodialysis favoured CPR (55.9% vs 31.3%; p = 0.026), intubation (55.9% vs 35.4%) and nasogastric tube feeding (82.3% vs 56.3%; p = 0.013) compared to patients who had been on haemodialysis for 5 years or longer. CONCLUSION: This study demonstrated significant differences between the attitudes of the patients and their relatives regarding EOL care preferences.  </jats:p

KANTHAN LIMESTONES

Source: https://youtu.be/0OV0Wbj_oM0?si=fFPFMBv9KZYp5I63 Kinta valley is famous for its limestones formation, which include beautiful white and cream-coloured marble rocks. These limestones formations, formed over millinea, are striking and known for their intricates pattern and textures. The limestone creates karts feature like caves and forms calcite crystals through reprecipitation. The marble extracted from this area is very popular because of its natural beauty and versatility in construction and design

BIOTITE GRANITE

Arose from Tampin, Negeri Sembilan, biotite granite is an igneous rock characterised by its mineral composition, primarily consisting of quartz, feldspar (including both potassium feldspar and plagioclase feldspar), and biotite (mica). Notably, its geological age can be traced back to the Late Triassic period (230 - 200 million years ago). The distinctive feature of biotite granite is the presence of biotite. Biotite is a dark-coloured mineral that imparts a dark appearance to the rock. The dark colour of biotite, combined with quartz and feldspar, gives biotite granite a mottled or speckled appearance, often with a combination of light and dark minerals. It exhibits a coarse-grained texture, with mineral grains visible to the naked eye. The coarse texture contributes to the durability of the rock. Biotite granite is popular in construction due to its robust nature and aesthetic appeal

SIMPANG PULAI MARBLE

Source: https://youtu.be/3MiWLSGPdeg?si=dodpriR33QGuQMOv Marble rock in Thematic 4 originates from Simpang Pulai , Kinta valley. These limestones deposit have evolved over millions of years by gradually accumulating marine sediments rich in calcium carbonate. The formation of this marble rock can be traced back to the Devonian period, spanning from approximately 419 million to 359 million years ago, reflecting the intricate natural processes that have shaped the Kinta Valley landscape

SUEVITE

Source: https://youtu.be/kMfWWeE2zMM?si=WriwolWXLJCVDMA Rock Type: Terrestrial and Metamorphic Rock Age: Quaternary (1.83 million years ago) Origin: Bukit Bunuh, Lenggong, Perak. Suevite is a type of brecciated rock composed of a mixture of materials, including polymic lithic breccia rock, quartzite impacted rock, impacted sedimentary rock impacted granite rock, and quartz or meta quartz impacted rock

PORPHYRITIC GRANITE

Porphyritic Granite originated from Tampin, Negeri Sembilan, a distinctive igneous rock dating back to the Late Triassic (230 - 200 million years ago). It can be characterised by its texture featuring larger crystals known as phenocrysts embedded within a finer-grained matrix called the groundmass. "Porphyritic" refers to the texture of the rock. In porphyritic granite, larger crystals, known as phenocrysts, are embedded within a finer-grained matrix called the groundmass. This contrast in grain size is a defining feature of porphyritic rocks

SERPENTINITE

Source : https://www.youtube.com/watch?v=wA0kGA8Ttxs Middle Miocene - Pliocene (13.82-2.58 million years ago) Serpentinite is a metamorphic rock that forms from the alternation of peridotite, a type of ultramafic rock formed in proximity to Sabah Crocker Range. This rock originated from Kampung Polumpung, Melangkap, Kota Belud Sabah, dated back to the Middle Miocene to the Pliocene period, between 13.82 and 2.58 million years ag

PEGMATITE

Source : https://www.youtube.com/watch?v=2HHQEnPfShM The quartzite from Gunung Jerai Area Kedah is a metamorphic rock and amongst the oldest rock in Malaysia. The Cambrian Age suggests that it was 540-485 million years ago as a sedimentary rock but had undergone the process of metamorphism to form quartzite. The metamorphism process transformed the quartzite into a hard and granular texture from pre-existing sedimentary rocks like sandstone