Modeling of hemoglobin in dengue fever and dengue hemorrhagic fever using bioelectrical impedance

This paper describes a model for predicting hemoglobin (Hb) by using bioelectrical impedance analysis (BIA) in dengue patients in the Hospital Universiti Kebangsaan Malaysia (HUKM). Bioelectrical impedance measurements were conducted on 83 (47 males and 36 females) serologically confirmed dengue fever (DF) and dengue hemorrhagic fever (DHF) patients during their hospitalization. The predictive equation for Hb was derived using multivariate analysis. We investigated all the parameters in BIA, patients' symptom and demographic data. In this developed model, four predictors (reactance (Xc), sex, weight and vomiting) were found to be the best predictive factors for modeling Hb in dengue patients. However, the model can only explain approximately 42 of the variation in Hb status, thus single frequency bio-impedance stand-alone technique is insufficient to monitor Hb for the DF and DHF patients. Further investigation using multi-frequency BIA is recommended in modeling Hb to achieve the most parsimonious model

Anatomical variations of median nerve formation, distribution and possible communication with other nerves in preserved human cadavers

Formation, distribution and possible communication of the median nerve are essential to know in treatment and surgeries of various conditions of injuries e.g. repair or reconstruction of the median nerve post traumatic accident. In the present study, 44 upper limbs were dissected. Root forming the median nerve, the median nerve in relation with the axillary artery and communication of the median nerve with other nerves were noted

Predictors of breast cancer screening uptake: a pre intervention community survey in Malaysia

Introduction: Despite health education efforts to educate women on breast cancer and breast cancer screening modalities, the incidence of breast cancer and presentation at an advanced stage are still a problem in Malaysia. Objectives: To determine factors associated with the uptake of breast cancer screening among women in the general population. Methods: This pre-intervention survey was conducted in a suburban district. All households were approached and women aged 20 to 60 years old were interviewed with pre-tested guided questionnaires. Variables collected included socio-demographic characteristics, knowledge on breast cancer and screening practice of breast cancer. Univariate and multivariate analysis were performed. Results: 41.5 of a total of 381 respondents scored above average; the mean knowledge score on causes and risks factors of breast cancer was 3.41 out of 5 (SD1.609). 58.5 had ever practiced BSE with half of them performing it at regular monthly intervals. Uptake of CBE by nurses and by doctors was 40.7 and 37.3, respectively. Mammogram uptake was 14.6. Significant predictors of BSE were good knowledge of breast cancer (OR=2.654, 95 CI: 1.033-6.816), being married (OR=2.213, 95 CI: 1.201-4.076) and attending CBE (OR=1.729, 95 CI: 1.122-2.665). Significant predictors for CBE included being married (OR=2.161, 95 CI: 1.174-3.979), good knowledge of breast cancer (OR=2.286, 95 CI: 1.012-5.161), and social support for breast cancer screening (OR=2.312, 95 CI: 1.245-4.293). Women who had CBE were more likely to undergo mammographic screening of the breast (OR=5.744, 95 CI: 2.112-15.623), p<0.005. Conclusion: CBE attendance is a strong factor in promoting BSE and mammography, educating women on the importance of breast cancer screening and on how to conduct BSE. The currently opportunistic conduct of CBE should be extended to active calling of women for CBE

The predictive accuracy of PREDICT: A personalized decision-making tool for southeast Asian women with breast cancer

10.1097/MD.0000000000000593Medicine (United States)948e59

The Effect of Different Binder Compositions in Fabricating Silica Foam (SiO2) Via Replication Method / N.A.Nazaruddin...[et al.]

Ceramic foams or reticulated porous ceramic are form highly porous ceramic with closed, fully open and partially interconnected structure of porosity and wide range of application of the catalyst, electrical conductivity, refractory insulation of furnaces, filtration, adsorption and separation. There are various conventional method in fabrication silica foam such as direct forming, steam heating, freeze casting method and polymeric sponge method which is also well-known also as replication method. In this study, silica foam was fabricated using a 55wt. % of silica powder with different binder compositions of polyethylene glycol (PEG) and carboxymethyl cellulose (CMC) via replication method. The present work focuses in the effect of three variable compositions of PEG and CMC at high sintering temperature of 1250ºC in producing silica foams. The polyurethane foam (PU) acts as the template for slurry from silica powder compounds and mixed together with binders and distilled water. All samples are immersed into the SiO2 slurry and dried at a temperature of 100ºC for 24 hours. The green bodies of foams were further sintered at temperature of 1250ºC. The morphological analyses depicted that the size of the silica foam pores were in the range of 259.15μm to 559.83μm. It was found that the density of silica foam in the range of 0.4953 g/cm3 to 0.7170 g/ cm3. Whereas, the result of porosity percentage obtained from 61.38 % to 71.9 %. Density and porosity analysis shows that the density of foams increased with decreased porosity of the silica foam. Mechanical properties analysis with compressive strength give a result in a range of 0.1310 N/mm2 to 0.2329 N/mm2 respectively. Thus, the replication method adopted for the SiO2 foam fabrication was proven a success

Symptom Experiences and Coping Strategies among Multi-ethnic Solid Tumor Patients Undergoing Chemotherapy in Malaysia

Background: This study was performed to assess patient symptoms prevalence, frequency and severity, as well as distress and coping strategies used, and to identify the relationships between coping strategies and psychological and physical symptoms distress and demographic data of cancer patients. This cross-sectional descriptive study involved a total of 268 cancer patients with various types of cancer and chemotherapy identified in the oncology unit of an urban tertiary hospital. Materials and Methods: Data were collected using questionnaires (demographic questionnaire, Medical characteristics, Memorial Symptom Assessment Scale (MSAS) and Brief COPE scales and analyzed for demographic, and disease-related variable effects on symptom prevalence, severity, distress and coping strategies. Results: Symptom prevalence was relatively high and ranged from 14.9% for swelling of arms and legs to 88.1% for lack of energy. This latter was the highest rated symptom in the study. The level of distress was found to be low in three domains. Problem-focused coping strategies were found to be more commonly employed compared to emotion-focused strategies, demonstrating significant associations with sex, age group, educational levels and race. However, there was a positive correlation between emotion-focused strategies and physical and psychological distress, indicating that patients would choose emotion-focused strategies when symptom distress increased. Conclusions: These findings demonstrate that high symptom prevalence rates and coping strategies used render an improvement in current nursing management. Therefore development of symptoms management groups, encouraging the use of self-care diaries and enhancing the quality of psychooncology services provided are to be recommended

Survival analysis of Malaysian women with breast cancer: results from the University of Malaya Medical Centre

The overall survival in our centre was low. Recognizing factors that affect prognosis of breast cancer patients in Malaysia may improve delivery of health care to at-risk groups by strategizing interventions as survival depends on early detection and effective treatment

Delays in time to primary treatment after a diagnosis of breast cancer: does it impact survival?

Objective. Treatment delays in breast cancer are generally thought to affect prognosis but the impact on survival remains unclear. Indicators for breast cancer care include time to primary treatment. The purpose of this study was to evaluate whether time to primary treatment (TPT) in breast cancer impacts survival. Method. A total of 648 breast cancer patients treated in the University Malaya Medical Center (UMMC), Malaysia between 2004 and 2005 were included in the study. TPT was calculated from the date of pathological diagnosis to the date of primary treatment. Mortality data was obtained from the National Registry of Births and Deaths. Last date of follow-up was November 2010. Results. Median TPT was 18 days. Majority 508 (69.1) of the patients received treatment within 30 days after diagnosis. The majority was surgically treated. Ethnicity (p = 0.002) and stage at presentation (p = 0.007) were significantly associated with delayed TPT. Malay ethnicity had delayed TPT compared to the Chinese; Hazard Ratio (HR) 1.9 (Confidence Interval (CI) 1.237, 2.987). Delayed TPT did not affect overall survival on univariate and multivariate analyses. Conclusion. Time to primary treatment after a diagnosis of breast cancer had no impact on overall survival. Further studies on care before diagnosis are important in drawing up meaningful quality indicators. (c) 2012 Elsevier Inc. All rights reserved

Total Parathyroidectomy Under Local Anaesthesia for Renal Hyperparathyroidism

Renal hyperparathyroidism with attendant osteodystrophy is a frequent and severe morbidity affecting the quality of life of end stage renal failure patients surviving on long-term renal replacement therapy. A small subgroup of these patients with severe cardiorespiratory dysfunction was deemed at very high risk for general anaesthesia (GA). We report on a series of total parathyroidectomy under local anaesthesia (LA) for these patients. Methodology: A total of 32 consecutive patients with severe cardiorespiratory dysfunction who underwent total parathyroidectomy under LA over a period of 7 years were prospectively accrued in this study. The patient characteristics, the operative outcome and the feasibility to surgery under LA were analyzed. Results: Sixteen of the patients (50%) had severe restrictive lung disease as a result of renal osteodystrophy and the other 16 patients had poor cardiac status. Histopathological examination confirmed 23 (71.9%) patients had four glands removed and seven (21.9%) patients had three glands removed. Two patients had only two glands removed and had recurrent hypercalcaemia. However, all patients reported symptomatic improvement. The post-operative complications were minimal; one patient had acute coronary syndrome and wound haematoma and another patient had wound haematoma which necessitated exploration under LA. A further patient developed congestive heart failure requiring treatment in the coronary care unit. Conclusion: Total parathyroidectomy can be performed safely and successfully under LA. We believe surgery under LA would be the most appropriate option for selected, high-risk patients to minimise the risk of GA