Phossy Jaw Disease and Correlation with White Phosphorus Bombing in Israel-Gaza War

Phosphorus necrosis of the jaw, commonly called “phossy jaw”, was a really horrible overwhelmingly disease, discovered by Workers in match factories in the 19th century developed oral abscesses in their mouths, leading to facial disfigurement and sometimes fatal brain damage. The gums developed an eerie greenish white 'glow' in the dark. Disease itself depends on an influence which the fumes of phosphoric acid, when they get dissolved in the saliva, are able to exert directly within the mouth to affect the jaw bones

What influences the rise and fall of health research disciplines? Insights from a mixed-method investigation of occupational epidemiological research in the UK

Introduction Occupational Epidemiology (OE) has played a vital role in producing improvements in the working population’s health. Nonetheless, anecdotal evidence indicates that OE in the UK is facing many challenges and the research workforce, funding, and output in this area are declining. This study aims to: investigate the nature and evolution of these key contributors to success; identify the external social, political, economic and any other factors which frame and contextualise these challenges and the facilitators; use this contextualisation to explain and evaluate how and why the identified challenges and facilitators influenced the OE field development compared to other similar fields; and explore how far they may explain the ebb and flow of research activity in OE in comparison with other health disciplines. Methods A sequential, mixed-method approach was undertaken in four phases. These included interviews with key UK-based OE researchers; a survey of UK-based OE researchers to test out themes that emerged from the first phase; a bibliometric analysis comparing trends and characteristics of UK-based OE published studies with those in public health epidemiology (PHE); and a documentary review of annual reports of three health research funding bodies including: the Medical Research Council, the Cancer Research Campaign, and the Health and Safety Commission. Results The lack of human and financial resources was found to be of utmost concern to the OE community, which increased over time and negatively affected researchers’ abilities to conduct further and higher quality studies. The bibliometric study revealed that the number of PHE publications and researchers increased substantially while the numbers for OE remained fairly constant. Furthermore, it was found that in PHE much higher levels of collaboration and adoption of newer methods such as the use of molecular and genetic techniques were applied. Widening research collaboration and the adoption of newer methods were encouraged by funding bodies because both are perceived to contribute to research efficiency and commercialisation of research ideas. These have been adopted more widely by other fields, thus helping them to develop and improve their status, which was not the case for OE. Furthermore, fewer influential representatives from the field of OE were found within funding bodies, which had played a major role in directing resources to research within health fields and hence influencing their development. Conclusions Social, economic, and political factors such as the exclusion of occupational health (OH) from the National Health Service, deindustrialisation, and neoliberal government policies within public and higher education institutions particularly that focus on economic contribution of science, and research auditing and efficiency, most likely, have the greatest influence on funding decisions of research in OH and other health disciplines. These issues have significantly instigated obscurity of OH and hence OE within the agendas of both the government and the funding bodies. Henceforward, the development of the OE field has become adversely affected compared to other health research fields. Finally, this thesis confirms that the rise and fall of a particular health research field is heavily influenced by specific past and contemporary social, economic and political factors. Engaging in social, economic and political matters, being open to new advances in research, and optimising networking opportunities with other disciplines, key researchers, policy-makers and other pertinent stakeholders and institutions may potentially facilitate progress in OE and other health research fields

Compliance of audit requirements by public listed companies in Malaysia capital markets

Purpose - In recent years, the corporate governance has become a subject of concern by many stakeholders and emphasis has been laid on the roles of Audit Committees to ensure the quality of financial reporting and compliance of audit requirements by the public listed companies (PLCs).Over the years poor corporate governance (CG) has been widely and frequently reported as a major factor that led to the 1997 Asian crisis, and numerous organisations have claimed that it was the main cause indeed (Nam, 2004).The World Bank claimed that poor CG within the Eastern Asian countries is attributed to a lack of an effective board of directors, inadequate internal control, unreliable financial statements, absence of sufficient information, poor compliance, and a lack of effective audit system (World Bank, 1998).The challenges mentioned have led to huge losses and poorly estimated liabilities.However, the regulatory bodies in charge of monitoring as well as controlling the affairs have failed to identify these weaknesses and to put in corrective measures.Malaysia was also hard hit by the Asian economic crisis that impacted the region in 1997.Corporate sector weaknesses and poor CG were considered important causes of the crisis (Khatri, Leruth & Piesse, 2002).The companies affected were in financial distress and had to seek protection under a winding up/bankruptcy protection.According Abdul Rahman et al (2007), as a result of the advents of the meltdown, the government of Malaysia saw the need to keep the standard of CG in all companies to regain and re-secure investors’ interest and confidence.As a result, the Malaysian Code of Corporate Governance (MCCG) is introduced (HLFC, 2000) and the Bursa Malaysia strengthen their Listing Requirements and best practice efforts is been practised in PLCs.One of the principles in the MCCG, Bursa Malaysia Listing Requirements is concerning the requirements of audit practises among the PLCs.In light of the above discussion, this paper focuses on the issue of compliance of audit requirements by the PLCs in Malaysia Capital Markets

The application of disclosure law, principles and requirements of corporate governance among public listed companies in Malaysia

Weakness in corporate governance and lack of disclosure are considered as causes of the Asian Economic Crisis in 1997-98. As a consequence, investors have demanded improvements in corporate governance practices as a guideline for companies to disclose accurate information. The Malaysian Code of Corporate Governance has consistently been revised to illustrate the guidelines towards best practices on the processes being adopted by companies in their operations to achieve the best governance framework. As most of the principles in the Code are largely derived from developed countries, it is timely to explore whether the principles influence disclosure of listed companies. The aim of this study is to investigate the application of disclosure law, principles and requirements among public listed companies in Malaysia. Qualitative data were collected from companies’ annual reports (representing 30% of 742 companies) from the period of 2012-2015, interviews, legislations and laws, etc. Analytical, comparative and content analysis approach were employed in analysing the law and policy, corporate governance principles and best practice of disclosure requirements among public listed companies. The findings of this study are as follows: firstly, the current laws in Malaysia are sufficient to govern corporate disclosure, but they are dispersed in more than one act/ laws or legislative system, some of which can be found in the Capital Market and Services Act 2007 and others in Companies Act 2016; secondly, public listed companies have applied the principles of the corporate governance; thirdly, the Public Listed Companies have partially reported the best practice of the companies in their annual report. The study recommends that the disclosure principles and laws should be made compulsory for every public listed company. Bursa Malaysia should also stipulate clear and full provisions that specify the disclosure of information through the companies’ annual reports and general corporate information to help investors to make good and timely decisions

The clinical impact of oral iron treatment for anaemia in pregnancy in accordance with current guidance: a prospective cohort study in a maternity unit in the Midlands of England

Background: Iron deficiency anaemia is a common disorder affecting up to 30% of pregnant women. Treatment guidelines for iron deficiency anaemia in pregnancy exist, which if adopted, may reduce the associated risks of maternal and fetal morbidity and mortality. However, multiple factors may impair adherence and absorption of oral iron, limiting the success of this first-line treatment. Methods: To document the effectiveness of national (British Society of Haematology) guidelines for the treatment of iron deficiency anaemia (IDA) in pregnancy, with a focus on use of oral iron, we carried out a prospective cohort study. Aims were to assess the response, side effect and adherence to treatment and predictability of response using routine clinical and laboratory data. The study population consisted of pregnant women diagnosed with anaemia. Women were offered follow-up through a dedicated anaemia clinic in a secondary care maternity unit serving a multi-ethnic population in the midlands of England. First line treatment was ferrous sulphate 200 mg three time a day as recommended in earlier national guidelines. The response was assessed 2 to 4 weeks later by measuring the haemoglobin (Hb) concentration. A response was defined in 2 ways; (i) a 10 g/L increase in Hb; and (ii) a 10 g/L increase in Hb and/or gestationally adjusted threshold of the Hb. Education and advice were provided to women, with on-going follow-up at clinic appointments including an assessment of side effects. Following a response with oral iron, treatment was continued for a further 3 months when the women were again reviewed. Results: The overall rate of haematological response to a first course of oral iron was 36.5% (10 g/L increase in Hb) and 55.2% (incorporating gestational threshold in Hb). The response rates at the completion of follow up, post-delivery, were 70.5% and 88.5% respectively. Responders to oral iron had lower median Hb at diagnosis (95 g/L) compared to non-responders (100 g/L). The responders median Hb was 113 g/l versus 103 g/L for non-responders at first follow-up and was Hb 122 g/L versus 110 g/L, respectively, at the end of the study visit 5. There is a statistically significant difference between responders and non-responders for the change in haemoglobin from baseline to visit 5 (p = 0.017). Non-responders reported more side effects than responders (95% versus 85%). Conclusion: Oral iron treatment for IDA in pregnancy as advocated in national guidelines is challenging to deliver, even in the setting of a specialist anaemia clinic. The findings have implications for guideline recommendations and implementation, and identify research opportunities for diagnosing IDA in pregnancy, optimising the pathways of iron treatment

Stapler-Less Uniportal Video-Assisted Thoracoscopic Surgery: Case Series and Review of the Literature

Background: With the world's trend towards minimally invasive surgical techniques, video-assisted thoracoscopic surgery (VATS) is now a well-established technique worldwide. Mechanical stapling is routinely employed for bronchial and pulmonary vasculature sealing and ligation during anatomical lung resection. The use of staplers is associated with high operating costs, bleeding, reopening and infections. This high stapler cost affected the spread and use of VATS in less developed countries where staplers can’t be afforded. In this study, we demonstrate the feasibility and outcomes from the first case series of uniportal VATS lobectomies and segmentectomies without the use of a stapler

Challenges to and facilitators of occupational epidemiology research in the UK

This study investigated the challenges and facilitators of occupational epidemiology (OE) research in the UK, and evaluated the impact of these challenges. Semi-structured in-depth interviews with leading UK-based OE researchers, and a survey of UK-based OE researchers were conducted. Seven leading researchers were interviewed, and there were 54 survey respondents. Key reported challenges for OE were diminishing resources during recent decades, influenced by social, economic and political drivers, and changing fashions in research policy. Consequently, the community is getting smaller and less influential. These challenges may have negatively affected OE research, causing it to fail to keep pace with recent methodological development and impacting its output of high-quality research. Better communication with, and support from other researchers and relevant policy and funding stakeholders was identified as the main facilitators to OE research. Many diseases were initially discovered in workplaces, as these make exceptionally good study populations to accurately assess exposures. Due to the decline of manufacturing industry, there is a perception that occupational diseases are now a thing of the past. Nevertheless, new occupational exposures remain under-evaluated and the UK has become reliant on overseas epidemiology. This has been exacerbated by the decline in the academic occupational medicine base. Maintaining UK-based OE research is hence necessary for the future development of occupational health services and policies for the UK workforce

Systolic Inter-Arm Blood Pressure Difference and Estimated Glomerular Filtration Rate in Type 2 Diabetic Patients in Palestine: a cross-sectional study

The Palestinian society's rates of Diabetes Mellitus are among the highest worldwide rates. One of the common diabetes complications is diabetic chronic kidney disease. Diabetic chronic kidney disease is associated with inter-arm blood pressure difference, defined as a ⩾10mmHg difference in systolic blood pressure between the right and left arms as a predictor. Several studies have shown that inter-arm blood pressure difference is related to an increased risk of death and vascular problems in patients with type-2 diabetes mellitus

Systolic inter-arm blood pressure difference and estimated glomerular filtration rate in type 2 diabetic patients in Palestine: a cross-sectional study

Objectives: this study aimed to investigate the association between systolic inter-arm blood pressure difference (iaBPD) and the estimated glomerular filtration rate (eGFR), as well as chronic kidney disease (cKD), in patients with type 2 diabetes mellitus (t2DM).Patients and methods: this cross-sectional study included 189 Palestinians diagnosed with t2DM. Data were collected through personal interviews, medical records and three separate blood pressure measurements from both arms. Patients were stratified in two ways: based on systolic iaBPD ≥15 mmhg and the presence of cKD, indicated by an eGFR of <60 ml/min/1.73 m2 over a three months period. We used simple and multiple linear regression analyses to clarify the association between systolic iaBPD (mmhg) and eGFR and to identify independent predictors for eGFR.Results: the mean age was 61.3 years, with a female percentage of 57.7%. the prevalence of systolic iaBPD ≥15 mmhg and cKD was 27.5% and 30.2%, respectively. among patients with eGFR <60 ml/min/1.73 m2, the median systolic iaBPD was 12.5 mmhg (interquartile range (iQR), 13.5 mmhg), whereas in patients with eGFR ≥60 ml/min/1.73 m2, it was 7.5 mmhg (iQR, 9.8 mmhg) with a significant difference (p = .021). the results of the multiple linear regression model did not reveal an independent association between systolic iaBPD and eGFR, with an unstandardized coefficient (B) of −0.257 (95% confidence interval (ci), −0.623 to 0.109; p = .167). however, older age (B, −0.886; 95% ci, −1.281 to −0.49; p < .001), hypertension (B, −12.715; 95% ci, −22.553 to −2.878; p = .012) and a longer duration of DM (B, −0.642; 95% ci, −1.10 to −0.174; p = .007) were significantly and negatively associated with eGFR.Conclusions: systolic iaBPD did not exhibit an independent association with eGFR in t2DM patients. however, older age, a previous history of hypertension, and a longer duration of DM were all significantly associated with lower eGFR.The authors thank each of Baraah Farun, Peter Bael, aya siaj, aseel Nassar, alhareth amro, Yahya abu Jwaid, Bayan awad, adan Rabayah, Basel Zaben, Natalie Khamashta, Mo’men alashwas, anas Barabrah, anas toqan, Mohammad shehadeh and Raya amer for their assistance in the data collection for this project