Introduction Multiple drug therapy (MDT) was utilized for the treatment of Hansen’s disease in Sarawak since 1989. MDT Sungai Buloh and MDT Sarawak were the 2 major MDT regimens used. Hence, we aim to compare the outcomes of MDT Sungai Buloh and MDT Sarawak. Materials and Methods A retrospective review of 40 cases receiving MDT Sungai Buloh and MDT Sarawak from 1993 to 2006 was performed. Data regarding demographics and outcomes were collected and analysed. Primary outcome was cure and secondary outcomes were relapse, reactivation, death, leprosy reactions and deformities. Results There were no statistically significant differences in the primary outcome among patients on MDT Sungai Buloh and MDT Sarawak (p=0.41) after adjustment for surveillance rate. We noted that significantly more patients on MDT Sarawak (40.9%) were still under surveillance compared to MDT Sungai Buloh (5.6%, p=0.01). We also noted a higher rate of erythema nodosum leprosum (ENL) (16.7%) and deformities (22.2%) in patients receiving MDT Sungai Buloh compared to 9.1% ENL and 9.1% deformity rate among those on MDT Sarawak. However, this did not reach statistical significance. Other secondary outcomes were not significantly different between the two regimens. No recurrence was reported with the two treatment regimens. Subanalysis for multibacillary patients did not reveal any significant differences between the two regimens in the primary outcome of cure after adjustment for surveillance rate (p=0.35). Both ENL and deformity rates of 25% each for MDT Sungai Buloh were higher than the rate of 13.3% each for MDT Sarawak although they did not reach statistical significance. Analysis for paucibacillary patients did not show superiority of any one regimen. Conclusion Both the MDT Sungai Buloh and MDT Sarawak were effective in leprosy treatment. Selection of the best treatment regimens will depend on the cost effectiveness, ease of administration and duration of treatment that patients can tolerate.

To describe the sociodemographic profile, contraceptive practice, and awareness of HIV infection among unmarried post partum women in the biggest government hospital in Pahang. Methods: A cross sectional questionnaire-proforma-based study was conducted for one year duration from August 2010 until July 2011 by identifying and recruiting all the unmarried women upon admission for delivery. Basic information were obtained from the use of patients’ case notes, and further related and necessary information were obtained from a direct face-to-face interview based on a proforma. Results: A total of 121 unmarried women were identified and recruited. The age ranged from 13 to 36 years with a mean age of 21.6 years. 31.4% were teenagers. Only 16% of patients have tertiary education, and 2.5% never had any formal education. About one third of the women were smokers or ex-smokers, 7.5% had consumed alcohol, but none denied ever use of any recreational drugs. Almost 9% has prior history of being sexually assaulted. About three quarter of the women never used any contraceptive method. Majority of the patients (85.1%) were aware of HIV transmission risk; 75% never had any antenatal checkup or booked at late gestation (> 20 weeks); and 45.8% were not aware of any support groups for single mothers. Conclusion: Single unmarried women are associated with disadvantaged sociodemographic profile. Contraceptive practice was also very low despite significant awareness towards risk of HIV infection. Further follow up, support and care should be offered to these women.

OBJECTIVES: Glaucoma is an incurable eye disease and the second leading cause of blindness in the world. Until 2020, the number of patients of this disease is estimated to increase. This paper proposes a glaucoma detection method using statistical features and the k-nearest neighbor algorithm as the classifier. METHODS: We propose three statistical features, namely, the mean, smoothness and 3rd moment, which are extracted from images of the optic nerve head. These three features are obtained through feature extraction followed by feature selection using the correlation feature selection method. To classify those features, we apply the k-nearest neighbor algorithm as a classifier to perform glaucoma detection on fundus images. RESULTS: To evaluate the performance of the proposed method, 84 fundus images were used as experimental data consisting of 41 glaucoma image and 43 normal images. The performance of our proposed method was measured in terms of accuracy, and the overall result achieved in this work was 95.24%, respectively. CONCLUSIONS: This research showed that the proposed method using three statistics features achieves good performance for glaucoma detection.
Blindness ; Classification ; Eye Diseases ; Glaucoma ; Humans ; Methods ; Optic Disk ; Optic Nerve Diseases ; Retinal Degeneration

BACKGROUND: Recently, the pharmaceutical manufacturing industry has been growing rapidly in many countries in the world, including in Arab countries. Pharmaceuticals reach aquatic environments and are prevalent at small concentrations in wastewater from the drug manufacturing industry and hospitals. Such presence also occurs in domestic wastewater and results from the disposal of unused and expired medicines. Therefore, the objective of this study was to analyze and compare the quantity and quality of publications made by researchers in Arab countries on pharmaceutical wastewater. METHODS: To retrieve documents related to pharmaceutical wastewater, we used the Scopus database on November 21, 2015. All documents with terms related to pharmaceutical wastewater in the title or abstract were analysed. Results obtained from Arab countries were compared with those obtained from Turkey, Iran and Israel. RESULTS: Globally, a total of 6360 publications were retrieved while those from Arab countries, Iran, Turkey and Israel, were 179, 113, 96 and 54 publications respectively. The highest share of publications belonged to Kingdom of Saudi Arabia (KSA) with a total of 47 (26.2 %) publications, followed by Egypt (38; 21.2 %), Tunisia (17; 9.5 %) and Morocco (16; 8.9 %). The total number of citations was 1635, with a mean of 9.13 and a median (inter quartile range) of 3 (1.0–10.0). The study identified 87 (48.6 %) documents with 32 countries of international collaboration with Arab countries. It was noted that Arab researchers collaborated mainly with authors in Western Europe (54; 30.2 %), followed by authors from the Asiatic region (29; 16.2 %) and Northern America (15; 8.4 %). The most productive institution was King Saud University, KSA (13; 7.3 %), followed by the National Research Centre, Egypt (10; 7.3 %). CONCLUSIONS: This study showed that KSA has the largest share of productivity on pharmaceutical wastewater research. Bibliometric analysis demonstrated that research productivity, mainly from Arab countries in pharmaceutical wastewater research, was relatively lagging behind. More research effort is required for Arab countries to catch up with those of non-Arab Middle Easter countries on pharmaceutical wastewater research.
Arab World ; Arabs* ; Bibliometrics ; Cooperative Behavior ; Efficiency ; Egypt ; Europe ; Humans ; Iran ; Israel ; Middle East* ; Morocco ; North America ; Saudi Arabia ; Tunisia ; Turkey ; Waste Water*

Introduction: Proximal femur resection and endoprosthetic reconstruction is the preferred treatment for extensive bony destruction and pathological fractures. Due to the relatively high cost of endoprosthesis, we adopted the modified unipolar hemiarthroplasty (MUH) for reconstruction when the mode of treatment was for palliation. Materials and Methods:This is a retrospective case study of six patients, who had bone and multi-organs metastases with extensive proximal femur involvement with pathologic fractures who underwent resection and MUH reconstruction during the period 2013 to 2017. All patients were classified as Group B / C based on Scandinavian Sarcoma Group survival scoring, with estimated survival of maximum six months. The basic MUH construct consisted of AustinMoore prosthesis which was secured to a Küntscher nail using cerclage wire and cemented into the femoral canal. Subsequently, the whole length of the prosthesis which remained outside the canal was coated with cement. Results:The mean age was 61.8 years. The mean survival was 3.9 months, post-operation. There was no implant failure during patients’ life span; however, a third of the patients developed infection. Wheel chair ambulation was started immediately post-operation for all patients, and two patients progressed to walking frame ambulation. The total cost of each construct was below US$490 in comparison to long-stem hemiarthroplasty (roughly US$ 1700). Conclusion: Our aim was to alleviate pain, facilitate rehabilitation, ease nursing care and improve quality of life for metastatic bone disease patients until end of life. MUH for the treatment of pathological fracture in proximal femoral metastases is a feasible palliative surgical modality in resource-limited settings.

The NS2B/NS3 protease is crucial for the pathogenesis of the DENV. Therefore, the inhibition of this protease is considered to be the key strategy for the development of new antiviral drugs. In the present study, malabaricones C (3) and E (4), acylphenols from the fruits of Myristica cinnamomea King, have been respectively identified as moderate (27.33 ± 5.45 μM) and potent (7.55 ± 1.64 μM) DENV-2 NS2B/NS3 protease inhibitors, thus making this the first report on the DENV-2 NS2B/NS3 protease inhibitory activity of acylphenols. Based on the molecular docking studies, compounds 3 and 4 both have π-π interactions with Tyr161. While compound 3 has hydrogen bonding interactions with Gly151, Gly153 and Tyr161, compound 4 however, forms hydrogen bonds with Ser135, Asp129, Phe130 and Ile86 instead. The results from the present study suggests that malabaricones C (3) and E (4) could be employed as lead compounds for the development of new dengue antivirals from natural origin.