Common microorganisms causing onychomycosis in tropical climate

Onychomycosis is the infection of nail apparatus by dermatophytes, yeasts or non-dermatophyte moulds and is responsible for 50% of all nail disorders. A five year retrospective study was conducted at Universiti Kebangsaan Malaysia to identify the common pathogens responsible for onychomycosis and to describe the epidemiology of the affected patients. A total of 278 abnormal nails were cultured, out of which 231 were positive for fungus. Females constituted 50.2% (n=116) while males 49.8% (n=115). The majority (51.9%, n=120) were between ages 50-69 years. The Malay ethnic group was most commonly affected (44.2%, n=102) followed by Chinese (33.8%, n=78), Indians (18.2%, n=42) and other ethnic groups (3.8%, n=9). The most common fungal element isolated was non-dermatophyte moulds (45.4%, n=105) followed by yeast (34.6%, n=80) and dermatophytes (1.3%, n=3). Aspergillus spp. was the commonest (59.8%,n=81) non-dermatophyte mould, while Candida spp. was the commonest yeast (74.3%, n=89) isolated. In this study, non-dermatophyte moulds are the most common microorganisms implicated to cause onychomysosis. Treatment for non-dermatophyte mould is challenging as the current available antifungal agents are more effective against dermatophytes and yeasts

Towards Surgical Robots:Understanding Interaction Challenges in Knee Surgery

Knee arthroscopy is a very common elective surgery, which is performed globally. Research has stated that there are currently several issues surrounding this surgery which reveal surgeons are frustrated with their instruments, cause unintended damage, and have high levels of cognitive and physical demands. The aim of this research is to explore in greater detail what is actually occurring during surgery and gain insights from the knee surgeons to illuminate the current frailties entangled with knee arthroscopy. This research consists of a field study observing four consultant orthopaedic knee surgeons performing knee arthroscopies, of which a total of 15 surgeries were video-recorded. Cards were created based on the analysis of the videos, which were then used to prompt further reflection in interviews with two of the four knee surgeons. From this study we endeavour to explore how knee surgeons currently employ instruments during knee surgery and the challenges that they experience. Our findings focus on a surgeon's perspective on the following challenges: (1) instrument limitations, (2) limited visibility, and (3) physical and cognitive pressures. Based on these limitations, we explore how current robotic surgical platforms could be introduced as a first step towards designing surgical robots for knee arthroscopy, that will result in more desirable patient outcomes as well as greater satisfaction for the knee surgeons