The diaphyseal tibia fracture is best treated with intramedullary nail but in some cases where the nail is not applicable, plate fixation will be the next option of fixation. The extensile anterior approach is normally used for conventional compression plate fixation in tibia shaft fractures. The extensive surgical dissection may devitalizes the bony fragments and interfere with the fracture union as well as soft tissue healing. Minimally Invasive Plate Osteosynthesis (MIPO) provides good preservation of blood supply and fracture hematoma at the fracture site thus promotes biological bone healing. The use of indirect reduction techniques and small skin incisions to introduce the plate is technically demanding and requires fluoroscopy exposures throughout the surgery, being some of its drawbacks. We recommend MIPO for conventional compression plate fixation in tibial shaft fractures in view of the reduced surgical trauma to the surrounding soft tissue and good functional outcome.
Surgical Fixation Devices ; Tibial Fractures

A 41-year-old Indonesian lady, non-diabetic, immune-competent, presented with complaints of painless swelling at the lower end of the neck, increasing in size for the past two months. There was history of cough with scanty expectoration for the past one year with insignificant loss of appetite and weight. Local examination showed a 4.5 cm × 6 cm fluctuating non-tender swelling with erythematous overlying skin but no draining point (Panel). On general examination there is no clubbing or lymphadenopathy. Respiratory examination revealed few crepitations over the right infra-clavicular area. Rest of the systemic examination is unremarkable. Her blood investigations showed elevated erythrocyte sedimentation rate (ESR) of 46 mm/hr. Full blood count, liver profiles and renal functions were all normal. A chest radiography was taken. Q: What is the diagnosis? Answer: refer to page 113

(Refer to page 99) Answer: Tubercular cold abscess The patient’s chest radiography is shown in panel showing right upper zone consolidation. Sputum examination were all negative. Bronchoscopy showed a mass partially obstructing the anterior segment of right upper lobe bronchus. Biopsy revealed multiple multinucleated granulomas and Langhans giant cells with areas of caseation and Acid Fast Bacilli (AFB) on Zeil-Neelsen staining. The patient responded to anti-tubercular treatment (ATT).

We investigated the immunogenicity of recombinant rMSP1 (rPbMSP1) that was generated from Plasmodium berghei. The rPbMSP1 formulated in alum was found to be immunogenic which induced high levels of specific anti-rPbMSP1 antibody. The IgG2a response predominated over IgG1 during the challenge infection in the vaccinated mice. Mice vaccinated with rPbMSP1 in alum mounted significant protective immunity against challenge infection (P < 0.01). On day 121 after the booster, three out of ten mice immunized with rPbMSP1 in PBS survived parasite infection (P < 0.05) and eight out of ten mice vaccinated with r MSP1 in alum did (P < 0.01). Hence, immunization with MSP1 in alum obviously has conferred protective effects, which prevented death from P. berghei lethal infection in mice (P < 0.01). These observations provide an excellent model for clinical assessment of this formulation in human subjects.
aluminum sulfate ; Laboratory mice ; upper case pea ; Infection as complication of medical care ; protect

The bioefficacy of nine commercial formulations of temephos against Aedes aegypti, Aedes albopictus and Culex quinquefasciatus larvae were evaluated in the laboratory. WHO larval bioassay with operational dosage of temephos at 1 mg/L was performed. The larval mortality was recorded every 5 minutes until complete mortality was achieved. All formulations of temephos exhibited various toxicity level against Ae. aegypti, Ae. albopictus and Cx. quinquefasciatus. Generally, larvae of Cx. quinquefasciatus was susceptible to all formulations of temephos, followed by Ae. aegypti and Ae. albopictus.

The enucleation of the eye due to variety of causes such as trauma, tumor and severe eye disease or infection has resulted to permanent defect of sight and aesthetic. Defects of the eye may include removal of a part of or the entire orbit which has affected patient’s psychology. Restoring the defect with pre-fabricated or custom-made ocular prosthesis will restore aesthetics and improves patient’s social confidence. This is a case report of construction a custom-made; hand painted iris of ocular prosthesis on a patient with missing left eye due to trauma using modified impression method. The case describes the process of constructing the custom-made ocular prosthesis with modification of impression technique to improve accuracy and fitting. It is aim to highlight the importance of custom-made prosthesis as compared to pre-fabricated ocular prosthesis on its property, fitting to eye socket, hygiene and aesthetic satisfaction.

Introduction: Food is a necessity for students. Yet, students’ food expenditure is anticipated to be restrained by their financial status. This cross-sectional study aims to determine the prevalence of food insecurity and its determinants among university students attending public universities in Peninsular Malaysia. Methods: Multistage random sampling was used to select respondents from public universities in Peninsular Malaysia. A total of 427 undergraduate students completed a selfadministered questionnaire at four randomly selected universities (Universiti Utara Malaysia, Universiti Kebangsaan Malaysia, Universiti Malaysia Pahang and Universiti Teknologi Malaysia). The questionnaire consisted of information concerning demographic and socioeconomic backgrounds, food security status, eating behaviour, financial literacy, and financial problem among university students. Frequency, chi-square, and logistic regression were used to analyse the variables. Results: Mean age of the respondents was 21.6 years, and 60.9% were found to be food insecure. Gender (χ2=5.415), origin (χ2=3.871), number of siblings (χ2=4.521), financial problem (χ2=42.364), and regular breakfast intake (χ2=5.654) were associated with food security status (p<0.05). Male respondents had 1.5 times (AOR=1.547, 95% CI: 1.006-2.380) the risk of having low food security status. Those with higher financial problems (AOR=3.575, 95% CI: 2.332-5.481) were 3.5 times more likely to be food insecure. Conclusion: The prevalence of food insecurity among public university students in Peninsular Malaysia was significantly high. Thus, intervention studies should focus on students with financial problems. Moreover, establishing a better system for an on campus food pantry or food bank is needed to counter the high prevalence of food insecurity among university students.

Introduction: Hypercholesterolemia has been proven as a main pathogenic trigger for pathogenesis of atherosclerosis. Atherosclerosis characterised by chronic inflammatory process and increased expression of inflammatory markers. In this study; Trihoney (a combination of three types of natural honey namely: Trigona, mellifera, and Dorsata) was investigated for its anti-inflammatory effect in hypercholesterolemic atherosclerotic rabbits. Methods: Thirty male New Zealand white rabbits (NZW) were grouped into: normal diet (C), normal diet with 0.6g/kg/day of Trihoney (C+H), 1% cholesterol diet (HCD), 1% cholesterol diet with 0.6g/kg/day of Trihoney (HCD+H), and 1% cholesterol diet with 2mg/kg/day of atorvastatin (HCD+At.). After 12 weeks of starting the experiment, animals were sacrificed and serum analysed for homocysteine and pro-atherogenic inflammatory markers such as: interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumour necrosis factor-α (TNF-α). Fasting serum glucose was analysed to assess glycaemic status. Results: Trihoney treated group showed significantly lower (p<0.05) serum IL-1β and IL-6 compared to the HCD group. Trihoney supplementation resulted in significant (p<0.001) reduction of serum TNF-α compared to HCD group. Experimental group HCD had serum homocysteine level comparable to that of the control groups without any significant difference despite little increase in the mean value. Trihoney treated group had serum homocysteine comparable to the controls. All experimental groups showed fasting serum glucose comparable to the control. Conclusion: This study showed that Trihoney has an anti-inflammatory function and may be used as an adjuvant to statins for management of atherosclerotic cardiovascular diseases even in diabetic subjects.

Introduction: Various phantom with varied materials has been proposed to replace the human body. Besides, there is always a demand to use the local material as a phantom material, which is readily available and inexpensive. Wood is usually preferred because it is multifunction, environmentally friendly, low in toxic, inexpensive, as well as easy to use and prepare. Previous studies have found that Rhizophora spp. is a suitable natural source material and has been suggested due to its comparable dosimetric properties to commercial phantom. Methods: In this study, fabricated Rhizophora spp. particleboards phantom was opted as a solid-equivalent phantom medium at low energy photon beams using Gafchromic film x-ray quality assurance 2 (XRQA2). Additionally, the characteristics of XRQA2 film in the diagnostic energy range were generated. Results: Interestingly, the density of the fabricated Rhizophora spp particleboards was observed to have the same density with the water equivalent material (ρ= 1.00 g.cm-3) and has shown to have loosened agreement with PDD of water phantom at approximately 25% of the dose error. Also, further analysis using XRQA 2 film showed that energy was independent at different ranges. Conclusion: The analysis of fabricated Rhizophora spp particleboards undertaken here has extended our knowledge of the possibility of manufacturing cost-effective water equivalent phantom by using binder-less particleboard from Rhizophora spp. Therefore, a definite need for smaller interspacing particles should be considered to elevate the potential of Rhizophora spp particle boards as water equivalent materials.

Ovitrap surveillance was carried out in fifteen localities encompassing foggingfree and dengue risk areas in West Malaysia to determine on the dispersal and prevalence of single and co-breeding of mosquito larvae particularly Aedes. Ovitraps were sited randomly indoors and outdoors within human settlements in all study areas. All the localities exhibited positive ovitraps with single breeding of Ae. albopictus that ranged between 64.29% and 100.00%. These findings indicated Ae. albopictus as the predominant container-breeding species in all study areas. The co-breeding of Ae. aegypti with Ae. albopictus larvae (34 ovitraps), Ae. albopictus with Culex quinquefasciatus larvae (32 ovitraps) as well as Cx. quinquefasciatus with Armigeres subalbatus larvae (1 ovitrap) were also detected in certain study localities. Interestingly, co-breeding of Ae. albopictus with Ar. subalbatus larvae as well as Ae. albopictus with Uranotaenia sp. larvae in Malaysia is reported for the first time in the present study. Better understanding of the co-breeding scenario involving different species of mosquito larvae is needed to ensure the efficacy of vector control actions to be conducted.