Severe calciphylaxis secondary to end stage renal failure: a case report

Calciphylaxis is a vascular calcification disease causing skin necrosis which contributes to high morbidity and mortality. Its exact pathogenesis is currently unknown but is commonly associated with chronic renal failure, hypercalcemia, hyperphosphatemia, secondary hyperparathyroidism and a variety of hypercoagulable state. It is relatively rare but may occur in 1-4% of patients with End Stage Renal Failure (ESRF). We are reporting a case of young lady with underlying ESRF presented with vascular and skin calciphylaxis

We care Sdn. Bhd. / Owais Qarni Qusham …[et al.]

We Care Sdn. Bhd. is a company that concern about the demand and needs of Malaysians especially to old folks and disable person. Therefore, we provide an easier medical transportation for them to use it everywhere they want. Besides that, we would make sure that the quality of the product will reach the expectation of the society with the good quality. Furthermore, we will make some upgrading in our product and others. We are not just looking for profits but we want to help people especially help our own country. With our product, we will provide the facility and also service to people. Our upgrade product will give better satisfaction to customers. It also can increase our country income by the tax that we pay and can also be an attractive to tourist with our service product. Moreover, we will create another job to citizen in Malaysia. We had decided to start our business at No. 10 Jalan Tun Teja 35/15, Alam Impian, 40470 Shah Alam, Selangor. The reasons we chose this location because the location was near the private and public hospitals, pharmacies and also residential area such as apartments and houses. So we think that this area is suitable for our product to invent in market

Retrospective identification of bacterial depository revealed that Streptococcus iniae was responsible for some of the streptococcosis cases in cultured red tilapia in Malaysia since 2006

This paper reports the identification of Streptococcus iniae from a large collection of isolates previously identified as Streptococcus sp., Lactococcus lactis subsp. lactis or Leuconostoc sp. A total of 204 bacterial isolates recovered either from the brain, eye, or kidney of red tilapias in previous disease outbreaks and disease monitoring in Malaysia from 2006 to 2008 were used. PCR identification revealed that 34 (16.7%) of the isolates were confirmed as S. iniae. Our records showed that S. iniae-infected fish exhibited lethargy, exophthalmia, and erratic swimming patterns. Pathological lesions including generalised congestion of the internal organs, splenic infarction with soft and oedematous brain. Histopathological examination revealed multifocal encephalitis as one of the major findings. However, 44% and 26.5% of the tilapias from which S. iniae was isolated did not manifest any clinical sign and pathological lesion, respectively. This study revealed that S. iniae was responsible for streptococcosis in cultured red tilapia in Malaysia since 2006

Mood booster / Abdul Jalil Mohammad Ali...[et al.]

Everyday life can no longer be imagined without fragrances and scented products. Humans have tempted to have perfumes or fragrances, which emulates nature's pleasant smells. Perfumes today are being made and used in different ways than in previous centuries. Perfumes are being manufactured more and more frequently with synthetic chemicals rather than natural oils. Less concentrated forms of perfume are also becoming increasingly popular. Combined, these factors decrease the cost of the scents, encouraging more widespread and frequent, often daily use. Using perfumes to heal, make people feel good and improve relationships between the sexes are the new frontiers being explored by the industry. The sense of smell is considered a right brain activity which rules emotions, memory, and creativity. The smelling oils and fragrances to cure physical and emotional problems is called aromatherapy can help to balance hormonal and body energy. The theory behind aromatherapy states that using essential oils helps bolster the immune system when inhaled or applied topically. Smelling sweet smells also affects one's mood and can be used as a form of psychotherapy. Thus, a new technology must be applied to make home fragrance a much more efficient use by having as many type of perfume you can store and at the same time you can mix it up to decide which smell suits the environment. Therefore, our company, MEWANGI Enterprise has introduced a product which is Mood Booster which the fragrance can be controlled by the tip of our finger

A Food Frequency Questionnaire for Hemodialysis Patients in Bangladesh (BDHD-FFQ): Development and Validation

Diet is a recognized risk factor and cornerstone for chronic kidney disease (CKD) management; however, a tool to assess dietary intake among Bangladeshi dialysis patients is scarce. This study aims to validate a prototype Bangladeshi Hemodialysis Food Frequency Questionnaire (BDHD-FFQ) against 3-day dietary recall (3DDR) and corresponding serum biomarkers. Nutrients of interest were energy, macronutrients, potassium, phosphate, iron, sodium and calcium. The BDHD-FFQ, comprising 132 food items, was developed from 606 24-h recalls and had undergone face and content validation. Comprehensive facets of relative validity were ascertained using six statistical tests (correlation coefficient, percent difference, paired t-test, cross-quartiles classification, weighted kappa, and Bland-Altman analysis). Overall, the BDHD-FFQ showed acceptable to good correlations (p 0.05). Cross-quartile classification indicated that <10% of patients were incorrectly classified. Weighted kappa statistics showed agreement with all but iron. Bland-Altman analysis showed positive mean differences were observed for all nutrients when compared to 3DDR, whilst energy, carbohydrates, fat, iron, sodium, and potassium had percentage data points within the limit of agreement (mean ± 1.96 SD), above 95%. In summary, the BDHD-FFQ demonstrated an acceptable relative validity for most of the nutrients as four out of the six statistical tests fulfilled the cut-off standard in assessing dietary intake of CKD patients in Bangladesh

Habitual dietary patterns of patients on hemodialysis indicate nutritional risk

Objective: This study aimed to (i) determine habitual dietary patterns of Malaysian patients on hemodialysis (HD) and (ii) examine their association with nutritional status. Methods: An à posteriori approach examined 3-day dietary recalls of 382 multiethnic Malaysian patients on HD, leading to short-listing of 31 food groups. Dietary patterns were derived through principal component analysis. Sociodemographic and lifestyle characteristics together with nutritional parameters were examined for associations with specific dietary patterns. Results: Four dietary patterns emerged, namely, “Home Food,” “Eating Out (EO)-Rice,” “EO-Sugar sweetened beverages,” and “EO-Noodle.” Younger patients, male gender, Malay, and patients with working status were more likely to follow “EO-Rice” and “EO-Sugar sweetened beverages” patterns, while Chinese patients were more likely to consume “EO-Noodle” pattern (all P values < .05). The EO frequency was directly associated with “EO-Rice” (P = .030), “EO-Sugar sweetened beverages” (P = .040), and “EO-Noodle” (P = .001) patterns. The highest tertile of the “Home Food” pattern related to higher handgrip strength (T3 = 21.3 ± 0.74 vs. 18.0 ± 0.73 kg, P = .006), higher serum albumin (T3 = 3.99 ± 0.04 vs. T1 = 3.84 ± 0.04 g/dL, P = .027), and lower Malnutrition-Inflammation Score (T3 = 4.9 ± 0.36 vs. T1 = 6.4 ± 0.34, P = .010), along with lower Diet Monotony Index (T3 = 29.0 ± 1.1 vs. T1 = 33.0 ± 1.0, P = .030). while “EO-Rice” and “EO-Sugar sweetened beverage” patterns were associated only with higher energy intake (all P values < .001). Conclusions: These results indicated that a home-based diet inclusive of healthy food choices was associated with better nutritional status in this HD population

Dietary fatty acid intake in hemodialysis patients and associations with circulating fatty acid profiles: a cross-sectional study

Objectives: The aims of this study were threefold: first, to assess the dietary fatty acid (FA) intake and blood FA status in Malaysian patients on hemodialysis (HD); second, to examine the association between dietary FA intakes and blood FA profiles in patients on HD; and third, to determine whether blood FAs could serve as a biomarker of dietary fat intake quality in these patients. Methods: Using 3 d of dietary records, FA intakes of 333 recruited patients were calculated using a food database built from laboratory analyses of commonly consumed Malaysian foods. Plasma triacylglycerol (TG) and erythrocyte FAs were determined by gas chromatography. Results: High dietary saturated fatty acid (SFA) and monounsaturated fatty acid (MUFA) consumption trends were observed. Patients on HD also reported low dietary ω-3 and ω-6 polyunsaturated fatty acid (PUFA) consumptions and low levels of TG and erythrocyte FAs. TG and dietary FAs were significantly associated respective to total PUFA, total ω-6 PUFA, 18:2 ω-6, total ω-3 PUFA, 18:3 ω-3, 22:6 ω-3, and trans 18:2 isomers (P < 0.05). Contrarily, only dietary total ω-3 PUFA and 22:6 ω-3 were significantly associated with erythrocyte FAs (P < 0.01). The highest tertile of fish and shellfish consumption reflected a significantly higher proportion of TG 22:6 ω-3. Dietary SFAs were directly associated with TG and erythrocyte MUFA, whereas dietary PUFAs were not. Conclusion: TG and erythrocyte FAs serve as biomarkers of dietary PUFA intake in patients on HD. Elevation of circulating MUFA may be attributed to inadequate intake of PUFAs

Association of ultrasound-derived metrics of the quadriceps muscle with protein energy wasting in hemodialysis patients: a multicenter cross-sectional study

This study aimed to assess muscle wasting and risk of protein energy wasting (PEW) in hemodialysis (HD) patients using an ultrasound (US) imaging method. PEW was identified using the ISRNM criteria in 351 HD patients. Quadriceps muscle thickness of rectus femoris (RF) and vastus intermedius (VI) muscles and cross-sectional area (CSA) of the RF muscle (RFCSA) were measured using US and compared with other physical measures. Associations of US indices with PEW were determined by logistic regression. Irrespective of gender, PEW vs. non-PEW patients had smaller RF, VI muscles, and RFCSA (all p < 0.001). US muscle sites (all p < 0.001) discriminated PEW from non-PEW patients, but the RFCSA compared to bio-impedance spectroscopy had a greater area under the curve (AUC, 0.686 vs. 0.581), sensitivity (72.8% vs. 65.8%), and specificity (55.6% vs. 53.9%). AUC of the RFCSA was greatest for PEW risk in men (0.74, 95% CI: 0.66–0.82) and women (0.80, 95% CI: 0.70–0.90) (both p < 0.001). Gender-specific RFCSA values (men < 6.00 cm2; women < 4.47 cm2) indicated HD patients with smaller RFCSA were 8 times more likely to have PEW (AOR = 8.63, 95% CI: 4.80–15.50, p < 0.001). The US approach enabled discrimination of muscle wasting in HD patients with PEW. The RFCSA was identified as the best US site with gender-specific RFCSA values to associate with PEW risk, suggesting potential diagnostic criteria for muscle wasting

Prospect Mapping Of Reservoir Z, Maari-Manaia Field, Taranaki Basin, New Zealand

This project is conducted to identify and map prospect Z of the Maari-Manaia field that can be encountered in the Moki Formation reservoir, which is a turbidite sand sediment. Seismic interpretation was conducted on the Maari 3D SEG-Y data, using the Maari-1 and Maari-2 well data as reference. The well data were used to identify the Moki formation top at the well location and the sand units in the formation. Seismic-to-well tie were conducted to identify seismic reflection which corresponds to the Moki formation top. The Moki formation top was then mapped from the 3D seismic volume using Petrel E&P software. Volumetric calculation was done using probabilistic method to estimate the volume of the oil reserve in the prospect

Development and validation of food frequency questionnaire for urban hemodialysis population in selected dialysis centres at the Klang Valley, Malaysia

Dietary assessment among hemodialysis population plays a crucial role in evaluating the quality of patients’ dietary intake. Adequate dietary intake will prevent malnutrition thus decrease the mortality rate among the population. A rapid and reliable tool that can be appropriately applied to quantify macronutrients and micronutrients consumed by Malaysian hemodialysis population is lacking. Therefore, the aim of this study is to develop and validate a food frequency questionnaire (FFQ) applicable to assess dietary intake for urban hemodialysis population in Malaysia. This study was divided into three phases: Phase I was the development of the FFQ whilst Phase II and Phase III provided for the validation of the FFQ. In Phase I, three days dietary recall (3DDR) from 388 subjects in the ‘Nutrition Status and Lifestyle Assessment in Hemodialysis Population, Malaysia’ study was selected based on inclusion criteria, and were used to construct a food item list using the Block’s method. A food nutrient database was then built inclusive of macro- and micronutrients. In Phase II, face validation (n=10) and content validation (n=10) were carried out. The final FFQ consisted of 123 food items. In Phase III, relative validation was then carried out with 121 subjects selected through consecutive sampling method [Malay=64%, Chinese=23% and Indian=13%; female=45%, male=55%; mean age=53±12 years; blood pressure=155/83, Malnutrition Inflammation Score ≥ 6 (Malnourished=24%)]. Anthropometry, biochemical profiles and dietary assessment for these subjects were assessed. The face validation of the FFQ indicated most food groups were well understood by lay persons and nutrition experts with the exception for ‘cooked rice’ groups (p<0.05). Mean time to complete the FFQ was 42±5 minutes. The mean difference for absolute intakes of total energy, carbohydrate, protein, total fat, sodium, potassium, phosphate, calcium and iron assessed by 3DDR and FFQ were significant (p<0.01). There was a significant correlation between FFQ and 3DDR assessments when comparing absolute intakes for total energy, carbohydrate, protein, total fat, sodium, potassium, phosphate, calcium and iron with correlations ranging from 0.35-0.47 (p<0.01). Cross-quartile classification indicated 70% to 82% subjects were classified into same or adjacent quartiles and 3.3% to 7.4% subjects were grossly misclassified when comparing absolute intakes assessed by FFQ and 3DDR. Bland-Altman plots showed more than 90% of subjects were scattered within the limit of agreement for all the nutrients between FFQ and 3DDR. This FFQ was developed appropriate to assess dietary intake of urban Malaysian hemodialysis population. The FFQ is suitable to be applied in nutritional epidemiological studies to assess populations’ diets contribute to malnutrition or any other health conditions