Background: Stenotrophomonas maltophilia has emerged as an important nosocomial pathogen, capable of causing a wide spectrum of infections. Treatment is difficult because it is resistant to many antimicrobial agents, thus reducing the treatment options. The aims of this study were to describe the antimicrobial susceptibility patterns and synergistic effect of selected antimicrobial combinations against S. maltophilia isolates. Methods: This was a descriptive cross-sectional study undertaken in the Hospital Universiti Sains Malaysia from April 2011 to March 2012. S. maltophilia isolated from various clinical specimens were included in the study. Antimicrobial susceptibility testing was done using the epsilometer test (E-test) and interpreted according to the guidelines of the Clinical and Laboratory Standards Institute. In the synergy test, the isolates were tested against six different antimicrobial combinations. Results: In total, 84 S. maltophilia isolates were collected and analysed. According to the E-test, the antimicrobial susceptibility of trimethoprim-sulfamethoxazole (TMP-SMX), tigecycline, and ciprofloxacin was 100%, 91.1%, and 88.9% respectively. The antimicrobial combination of TMP-SMX and ceftazidime showed the highest synergistic effect. Conclusion: TMP-SMX remains the antimicrobial of choice to treat S. maltophilia infection. TMP-SMX and ceftazidime was the most effective combination in vitro.

Defatted dabai peel contains a high amount of anthocyanin. Anthocyanins are known to prevent several types of disease, including cardiovascular-related complications. This study aimed to describe the effects of different doses of defatted dabai peel extract by histopathological analyses on lesions in the liver, kidney, heart and aorta. Histopathology methods were applied to determine the protective effects of defatted dabai peel extracts against hypercholesterolemia-induced oxidative damages to animal organs. Haematoxylin and eosin staining was applied for histopathology examination for liver, kidney, heart and aorta. Data showed that a high dose of defatted dabai extract (3000 mg per day) applied to hypercholesterolemic rabbits for eight weeks had mild protective effect, especially reducing the severity of hepatic fibrosis and steatosis of the renal medulla. The high dose of extract supplementation also reduced inflammation of aorta and formation of atherosclerosis plaque in the cell wall of right ventricle of the heart. The high dose of defatted dabai peel extract could be a protective agent against oxidative stress.
Anthocyanins

This study was conducted to examine the effect of malathion on the development of Chrysomya megacephala. A total of 12 adult Sprague-Dawley rats was divided into 4 groups. Each animal in the 4 groups was given orally 0 (control), 10, 25 and 50ml/kg body weight of malathion, respectively. Chrysomya megacephala larvae were then allowed to grow on the liver of carcass. Larvae development was estimated by means of weight and length, time of adult emergence and survival rate. Results indicated that for the first 6 to 30 hours, larvae from control group developed more rapidly than larvae feeding on tissue containing malathion. However, the 3 doses of malathion did not exhibit significant impact on larvae length and weight. The time required for adult emergence was significantly greater for malathion-treated colony which was 10 days compared to 7 days in control colony. Control larvae of C. megacephala had higher survival rate compared to larvae exposed to the three different doses of malathion. Analysis of the tissues indicated that all rats and fly samples were positive for malathion. Malathion concentration was highest in liver. It was concluded that the presence of malathion altered the development rate of C. megacephala and thus disrupted normal postmortem interval estimation.
Malathion ; Chrysomya megacephala ; development aspects ; Adult ; Carbon ion

We report a case of open fracture of the clavicle with subclavian artery and vein laceration and perforation of the parietal pleural below the first rib that caused massive haemothorax. Emergency thoracotomy and exploration followed by repair of both vessels were able to salvage the patient and the extremity.

Cardio-pulmonary Resuscitation (CPR) is important and should be mastered by House Officers (HO). House officers who have just completed their studies are assigned to acute medical and surgical wards. If a patient in the ward has a cardiac arrest (CA), these doctors are usually the first to attend. Therefore an HO must be confident with CPR skills. They must be competent in performing CPR. The authors assessed 26 new HOs from Universiti Kebangsaan Malaysia Hospital (HUKM) with respect to their self-perception about CPR skills, confidence level in performing CPR and knowledge in performing CPR. Knowledge was assessed by a questionnaire. We found that 16 of 26 (61.5%) assessed themselves to have inadequate knowledge and 46.2% had no confidence in performing CPR. The mean score of the written test was 5.7 ± 1.8. Seven out of 26 (27.0%) HOs had incorrect hand placement position for CPR. Only 4 and 9 out of 26 HOs had their sternal paddle and cardiac apex paddle positions correctly placed respectively. In conclusion, knowledge, perception of skills and confidence levels of HOs on CPR are inadequate and need further assessment and improvement. Medical schools need to review their CPR curriculum in order to prepare HOs adequately to work in emergency situations.

Studies were initiated for two consecutive years to find out the effect of time of transplanting and seedlings hill(-1) on the productivity of rice in Dera Ismail Khan district of North West Frontier Province (NWFP), Pakistan. The experiment was laid out in a randomized complete block design with split plot arrangements. Main plots consisted of four transplanting dates viz. 20th and 27th of June and 4th and 11th of July while sub-plots contained 1, 2, 3 or 4 seedlings hill(-1). Among transplanting dates, June 20th planted crop gave highest paddy yield and net return with 1 seedling hill(-1). It explains that the use of more seedlings hill(-1) not only adds to cost but is also a mere wastage of natural resources. Based on research findings, we conclude that the use of 1 seedling hill(-1) is most appropriate for timely sowing otherwise 4 seedlings hill(-1) should be used to compensate for the yield gap in late transplanted rice.
Agriculture ; methods ; Oryza ; growth & development ; Pakistan ; Seasons ; Seeds ; growth & development ; Temperature

Background: Statins are a class of potent drugs that can be used to reduce cholesterol, especially low-density lipoprotein cholesterol (LDL-C). However, their effectiveness is limited if adherence to treatment is poor. The objectives of the study are to estimate the proportion of diabetic patient who has achieved LDL-C goal and to determine the association of LDL-C achievement with socio demographic factors and statin therapy adherence Methods: This is a cross-sectional study involving 234 patients with type 2 diabetes mellitus (T2DM) and dyslipidaemia attending an outpatient clinic in a hospital in Kelantan. Interviews and self-administered questionnaires were used to determine their sociodemographic and clinical characteristics. Adherence to therapy was assessed using the Medication Compliance Questionnaire (MCQ). The associations between the achievement of LDL targets and sociodemographic/clinical factors, including adherence, were analysed with simple logistic regression. Results: About 37.6% of patients achieved their LDL-C target. The percentage of patients who adhered to statin use was 98.3%, and 20.5% of these patients reported full adherence. There was no significant association between achievement of LDL-C targets with adherence or any other sociodemographic factors, such as age, gender and educational or economic status (all P-value < 0.05). Conclusion: Despite a high level of adherence, the majority of patients failed to achieve LDL-C targets. More concerted efforts are needed to improve this.

Peer-reviewed articles on the usage of mobile applications in the management of diabetes were reviewed. Studies using mobile device applications for diabetes interventions published between January 2007 and March 2013 were included in this review. Studies related to the developmental processes of the mobile applications were excluded. The characteristics of these studies and the outcomes of the methods used in the management of diabetes were gathered. We retrieved a total of 372 articles from ACM Digital library, PubMed and Proquest Medical Library. After applying the inclusion and exclusion criteria, 8 articles were eligible for further review. Most of the studies included in this review showed the effectiveness of mobile applications in diabetes management. Their major contribution comes from feedback functions of the systems that assist participants in the self-monitoring of their blood glucose and dietary intake. However, the majority of the studies showed the limited use of the mobile phone as a tool to input information into systems which would in turn convey a reminder message to the patient. In conclusion, with its features of portability and convenience, mobile application used in the management of diabetes has the potential to improve glycaemic control, resulting in significant clinical and financial benefits.
Diabetes Mellitus

Objective:To determine the larval habitats of mosquito fauna and possible impact of land use/land cover changes on the epidemiology of mosquito-borne diseases in Osogbo metropolis, Southwestern, Nigeria.
Methods: All accessible larval habitats were surveyed between May and September, 2011 in Osogbo metropolis while Land Use/ Land cover of the city was analyzed using 2 Lansat Multispectral Scanner satellite imagery of SPOT 1986 and LANDSAT TM 2009.
Results:A total of six species namely, Aedes aegypti, Aedes albopictus, Aedes vittatus, Anopheles gambiae complex, Culex quinquefasciatus and Eretmapodite chrysogaster were encountered during the study. The occurrence and contribution of disused tyres was significantly higher (P<0.05) than the other habitats encountered, while there were no significant differences in the contribution of gutters/run-offs, septic tanks/drums, ground pools/open drains and discarded containers to the breeding of mosquitoes (P>0.05). The accessible land use/land covered of the study area between 1986 and 2009 showed that the wet land coverage and settlement area increased from 0.19 to 9.09 hectare and 1.00 to 2.01 hectare respectively while the forest area decreased from 60.18 to 50.14 hectare.
Conclusion: The contribution of the habitats coupled with the increasing rate of flooded environment which could provide ample breeding sites for mosquitoes call for sustained environmental sanitation and management in Osogbo metropolis.

Road transport is the movement of passengers or goods on the road. To date, issues concerning the safety of students and school institutions have continued to attract public attention. The recent spate of incidents insideand outside the school compoundhas brought the issue of children safety into our attention. These include the escalating number of road casualties. This study was conducted to observe road hazard outside the school compound and analyse the safety risksfaced by school children by using the risk matrix. The risks are calculated to include likelihood and severity of hazard as identified in the Guideline of HIRARC 2008. The area selected was the East Coast state of Peninsular Malaysia, with over 111 schools randomly selected in Kelantan. Results werethen analysed and six highlighted hazards were discussed. The results show that the main road posed the highest risk due to speeding vehicles. These vehicles failed to slow down when approaching the school area. The school administrationmustenhance the safety of the staff, students, and public while in the school area. In conclusion, road safety awareness must be instilledamong teachers, students, parents and road users alike.
hazard ; road transport ; school ; children ; teacher ; safety ; hazard identification, risk analysis