Primary squamous cell carcinoma of the rectum: a case report

Squamous cell carcinoma of the rectum is a very rare malignancy. In the literature, the incidence has been reported as 0.25 to 0.1 per 10000 colorectal carcinomas. Due to its rarity, the treatment and behavior of this tumor have only been discussed in case reports. As a result, several theories regarding their pathogenesis have been proposed. We will describe our experience in managing this rare malignancy in a 69-year-old man who presented with altered bowel habit. Surgery remains the mainstay of treatment. Issues regarding additional treatment have been presented in the literature. The rarity of this tumour also raises issues regarding criteria for diagnosis which we will try to highlight and discuss

Bonding properties and performance of multi-layered kenaf board

Kenaf (Hibiscus cannabinus) has recently been introduced to the Malaysian bio-composite industry. Based on their basic properties, both the bast fibres and core material of kenaf are distinctly different. While bast fibres are stiffer and low in wettability, the core material of kenaf is weaker and has excellent absorbing properties. This study evaluated the properties of kenaf board made from a combination of bast fibres and core material. The bast fibres were separated first from the core, followed by pre-treatment with NaOH, then combing until the fibres became loose. The properties of kenaf board were tested using MS standards 1787: 2005. An analysis of variance was carried out to study the effects of resin types and bast to core proportion on the boards. The buffering capacity study revealed that kenaf bast, kenaf core and rubberwood behaved similarly in alkali but differently in an acidic condition. Both the kenaf bast and core were relatively less stable in acid compared with rubberwood. Due to its morphological characteristics, the kenaf core inner surface exhibited higher wettability than the outer surface. There was significant interaction between resin type and the proportion of bast:core at p < 0.01. Generally, boards made from 100% kenaf core and bonded with urea formaldehyde (UF) resin had superior performance. The mechanical properties [modulus of elasticity (MOE), modulus of rupture (MOR), internal bond (IB)] of the boards were significantly influenced by the amount of bast fibre in the board––the higher the amount, the poorer the strengths. This effect, however, was reversed for thickness swelling (TS). Only UF-bonded kenaf-based boards had comparable water absorption (WA) property to that of the control (100% rubberwood). The incorporation of low molecular weight phenol formaldehyde (LPF) resin in the fibres had mixed effects on board properties. The effects varied based on the resin used; it improved the MOE and MOR of the board but not the IB, TS and WA when used with UF resin. It improved the IB only when used with melamine urea formaldehyde (MUF) resin. The best performance was given by boards made from 100% kenaf core irrespective of the type of resin used. All kenaf boards in this study had higher MOR than that of 100% rubberwood. Insufficient curing of LPF resin was identified as the main factor for the poor performance of LPF-bonded boards

Treatment and outcome of lower gastrointestinal bleeding: an observational multicentre study in East Coast region of Peninsular Malaysia

OBJECTIVE The objective of this study is to determine the type of treatment and its patients’ outcome with new onset of LGIB in the East Coast of Peninsular Malaysia. METHOD This was a cross-sectional study conducted at hospitals in the East Coast region of Peninsular Malaysia. Observational data were collected from patients with a new onset of non-traumatic LGIB. The patient was observed from beginning of treatment until discharged from the hospital to study its outcome. This study commenced from September 2019 until September 2020. RESULT 54 patients with LGIB were recruited. Male was reported to be more common than female to have lower gastrointestinal bleeding (40.7% vs 59.3%). The incidence of LGIB is most common at the age of 65 years and above (35.2%). The most common cause of LGIB is haemorrhoid. 8 patients from the study came with massive bleeding. 27 patients underwent colonoscopy. 64% of the patients were treated conservatively. 47 patients (87%) were resolved upon the same admission and 7 patients (12.9%) had a recurrence. 2 patients died due to sepsis which was non-bleeding related. The amount of blood transfusion ranges from 0-18 pints of packed cells. The bivariate analysis revealed that there was no statistical significance in the findings. CONCLUSION LGIB is common among Malay, males aged more than 65 years old. The common cause of bleeding is haemorrhoid and most patients were treated conservatively. The majority of bleeding was resolved and rarely caused morbidit

Gracilis muscles as neoanal spinchter for faecal incontinence

Faecal incontinence is a debilitating chronic clinical condition which may affect the patient and care givers. Modality of treatment is based on severity of the symptoms as well as the anatomical defect itself, availability of resources and expertise. We describe a modified technique of dynamic graciloplasty as neoanal sphincter for the treatment severe faecal incontinence who has failed previous over lapping sphincteroplasty. In our modified version, instead of using implanted intramuscular electrodes and subcutaneous neurostimulator to provide continuous stimulation, the patient will undergo an external stimulation on the nerve of transplanted gracilis periodically and concurrent biofeedback therapy. We believe the technique is relatively easy to learn and very cost effective without any electrodes or neurostimulator related complication

Clinical dilemma-management of low rectal cancer in a Jehovah’s Witness

Jehovah’s Witness followers pose a clinical dilemma to the medical practitioners due to their religious belief of an absolute prohibition of blood transfusion under any circumstances. We present a case of Jehovah’s Witness follower who underwent an ultra-low anterior resection for rectal cancer after neo-adjuvant chemo-radiotherapy. The challenges in the perioperative management are highlighted and managed accordingly

Solving One-Predator Two-Prey System by using Adomian Decomposition Method / Wan Khairiyah Hulaini Wan Ramli... [et. al]

In this paper, a mathematical model of one-predator two-prey system is discussed. This model is derived from predator-prey Lotka-Volterra model by adding another population of prey into the system. The model derived is a nonlinear system of ODEs. So the approach to this model is different from the linear system of ODEs. With reference to that, Adomian Decomposition Method (ADM) is one of the semi-analytical approaches being applied in this paper to solve the system. The approximate solution is made until four terms. The solution obtained is analyzed graphically

Adaptive Multi-state Millimeter Wave Cell Selection Scheme for 5G communication

Millimeter wave bands have been introduced as one of the most promising solutions to alleviate the spectrum secrecy in the upcoming future cellular technology (5G) due the enormous amount of raw bandwidth available in these bands. However, the inherent propagation characteristics of mmWave frequencies could impose new challenges i.e. higher path loss, atmospheric absorption, and rain attenuation which in turn increase the outage probability and hence, degrading the overall system performance. Therefore, in this paper, a novel flexible scheme is proposed namely Adaptive Multi-State MmWave Cell Selection (AMSMC-S) through adopting three classes of mmWave base stations, able to operate at various mmWave carrier frequencies (73, 38 and 28 GHz). Two mmWave cellular Grid-Based cell deployment scenarios have been implemented with two inter-site-distances 200 m and 300 m, corresponding to target area of (2.1 km2) and (2.2 km2). The maximum SINR value at the user equipment (UE) is taken in to consideration to enrich the mobile user experience. Numerical results show an improvement of overall system performance, where the outage probability reduced significantly to zero while maintaining an acceptable performance of the 5G systems with approximately more than 50% of the mobile stations with more than 1Gbps data rate.