There has been, and is still, concern about the high elastic modulus of Ti alloys compared to bone. Any reduction in the Young's modulus value of the implant is expected to enhance stress redistribution to the adjacent bone tissues, minimize stress shielding and eventually prolong device lifetime. Dynamic Monte Carlo simulation is used to predict the gradual reduction in Young's modulus values between the bulk of Ti alloys and the modified surface layers due to Ca ion implantation. The simulation can be used as a screening step when applying new alloys and/or coatings.
seconds ; Alloys ; Ions ; simulation ; Young

We report a rare case of left axillary artery injury associated with anterior dislocation of the left shoulder in a 25 yrs old male as a result of a road traffic accident. The shoulder dislocation was reduced. A left upper limb angiogram showed an obstructed left axillary artery. The obstructed segment was surgically reconstructed with a Dacron graft. Six months post operation in follow up, he was found to have good left shoulder function and no neurovascular deficit. This is an injury that could have been easily missed without a simple clinical examination.
Shoulder ; Arteries ; Adenohypophyseal Diseases ; Injury inflicted to the body by an external force ; Nerve injury, NOS

Life expectancy from birth is increasing dramatically. Due to this increase, the population of elderly people will increase. Consequently, geriatric related illnesses will increase leading to increased necessity to build up comprehensive and coordinated cost effective health care services appropriate for elderly people. Frailty is not a disease, but rather considered as a syndrome requiring comprehensive and multidisciplinary care approach. It is a prevalent reversible pathological transitional stage between healthy aging and disability. Frailty is associated significantly with increased health care utilization, mortality, and comorbidities such falls, hospitalizations, physical dependence, and poor perception of health. The aim of this review is to compile existing literature on the economic cost of frailty syndrome among elderly people in the recent years. Search queries were constructed to look for articles related to the economic cost of frailty in the electronic databases available at the National University of Malaysia library for articles published between the years 2011 and 2019. The accessed electronic database included New England journal of medicine, Science Direct, SCOPUS, BMJ, Cochrane, and Wiley Online Library. Articles included in this review when they were original research, participants were defined as frail elderly, manuscripts written in English language, and involved clearly described measures of frailty cost. Among the literature, twenty one articles were found to satisfy the inclusion criteria of the review process. The cost of care for frail elderly was ranging from US $ 8,620 to 29,910 per patient per year. The cost of health care was ranging from US $ 2,540 to 221,400. The health care cost was accounting for 40% to 76% of the total care cost. Hospitalization cost was the highest, it was ranging from US $ 806 to 152,726. Outpatient cost was ranging from US $ 200 to 18,000. Medications cost was ranging from US $ 7 to 3,434 per frail elderly patient per year. Home help cost was ranging from US $ 804 to 19,728 per frail elderly patient per year. In conclusion, frailty is a costly syndrome. It can be considered as a cost effective target for health promoting interventions to contain future elderly cost.

Epidermoid cyst is a common benign cutaneous swelling frequently encountered in surgical practice. It usually presents as a painless lump frequently occurring in hairbearing areas of the body particularly the scalp, scrotum, neck, shoulder and back. Giant epidermoid cysts commonly occur in hairy areas such as the scalp. We present here the case of a rare occurrence of a giant epidermoid cyst in the less hairy area of the right upper thigh mimicking a soft tissue sarcoma. Steps are highlighted for the management of this unusual cyst.

We report a case of a non-pulsatile groin swelling in a 38 years old male drug addict without the typical clinical signs of an aneurysm. Ultrasound revealed a left femoral artery pseudo-aneurysm. He was surgically treated and the vessels were ligated without revascularisation.
Swelling ; groin <1> ; Aneurysm ; Drug addict ; Aspects of signs

Aedes aegypti (= Stegomyia aegypti) mosquito is a world vector of important arboviral diseases like dengue and Rift Valley fever. Despite its wide distribution in the western and southern regions of Saudi Arabia, where dengue outbreaks have occurred, its ecology is largely unknown. In this study we report on the main life table developmental attributes of a laboratory colony of Ae. aegypti reared from field-collected larvae from Madinah Province, west of Saudi Arabia. Females were maintained on daily blood meal and sugar. The female fecundity was ~62 eggs/female at an overall rate of 72% hatchability. The mean time needed for eggs to hatch into larvae was 4.5 d. The mean pupation time (P50) was 11.53 days (d). The proportion of immature survivorships were 0.69 for 1(st) larva to pupa (P/I), 0.98 for pupa to adult (A/P) and an overall 0.67 for 1(st) larva to adult (A/I). Males emerged faster than females with mean emergence time (E50) of 12.83 and 15.31 d, respectively. The average developmental velocity (V) showed that males (V= 0.081) developed faster than females (V= 0.068). The male/female sex ratio at adult emergence was 0.48, and insignificantly different from the 1:1 ratio. The adult mean life expectancy at emergence (eo) was 17.14 d for females compared to 9.59 d for males. The net reproductive rate (Ro) was 101.04 and the intrinsic rate of increase (rm) was 0.15 with a mean generation time (G) of 30.7 d. The instantaneous mean of birth (B) and death rate (D) were 0.30 and 0.15, respectively, with rm/B of 0.529 and B/D of 2.281. Compared to other Ae. aegypti strains from different geographic and ecological settings, the Saudi strain had a relatively low colonization potential. This is the first report on life table characteristics for Ae. aegypti from the Arabian Peninsula, and provides base-line information for wider studies on its natural populations. This is particularly important for understanding its population dynamics in relation to dengue transmission and control under regional conditions.

Aims: Variation in the traditional growth medium conditions to enhance the production of lipids, carbohydrates, protein and the free amino acids content of three cyanobacterial species. Methodology and Results: Three species of cyanobacteria (Anabaena laxa, Anabaena fertilissima and Nostoc muscorum) were collected from the culture collection of Soils, Water and Environment Research Institute, Agriculture Research Center, Giza, Egypt, to investigate their biochemical composition under different growth conditions, using BG110 (nitrogen free) as growth medium. These conditions were represented by control medium, static glucose medium with (1%, w/v), aerated medium (aerated by bubbling technique depending on CO2 normally existed in air with a concentration of 0.03%), molasses medium (0.7%, v/v) and aerated medium enriched with glucose (1%, w/v). Lipid content, total carbohydrates, soluble proteins and free amino acids were determined at the previous conditions. Glucose at 0.7% (w/v) was the most favorable for lipid production in A. laxa, where it exhibited the highest lipid content (427 μg/g fresh wt.). Increasing molasses concentration up to 0.7% (v/v) produced an increase in lipid contents of the tested cyanobacterial strains. The highest lipid content of both N. muscorum (366.2 μg/g fresh wt.) and A. laxa (357.4 μg/g fresh wt.) were recorded at molasses concentrations of 0.1 and 0.7% (v/v), respectively. A. laxa expressed high significant values for both proteins (31.6 μg/mL) and free amino acids (40.5 mg/g dry wt.) after 6 days of incubation period under aerated enriched glucose condition (1%, w/v). Also, at the same growth conditions, A. fertilissima exhibited high significant values for carbohydrates at 4th day (876.8 mg/g dry wt.). Conclusion, significance and impact of study: Aerated enriched glucose medium (1%, w/v) was the best growth medium condition used in the present study.

Eleven fungal strains were tested for their ability to produce brown and reddish brown textile dyes using H-acid (1- naphthol-8-amino-3, 6-disulfonic acid) as a dye precursor in the fermentation medium. All tested fungal strains exhibited high ability to produce dyes varying in both dye color (brown to reddish brown) and fastness properties to washing, perspiration and UV light. The produced dyes were subjected to further analysis for quantitative determination of dye components for investigation of their inter-relations as well as their role in dye color and stability.

OBJECTIVE: Mini-transforaminal lumbar interbody fusion (Mini-TLIF) and other minimally invasive approaches introduced for the purpose of treating lumbar degenerative disc disease and instability are achieving high success and safety rates as the conventional approaches. Moreover, it has less soft tissue damage, minimal blood loss, and less hospital stay. METHODS: A prospective study was conducted from 2012 to 2014 on 28 patients who were subjected to Mini-open TLIF combined with transpedicular screw fixation for spondylolisthesis and degenerative disc disease. Two paramedian approaches were done, 4 cm for each, to insert the pedicular screws, along with inserting unilateral TLIF cage with autologous bone graft. Decompression was done either unilateral or bilateral according to the patient side of radiculopathy. Sixteen patients (57.2%) were diagnosed with degenerative spondylolisthesis, 7 patients (25%) were diagnosed with isthmic type spondylolisthesis, and 5 patients (17.8%) were diagnosed with degenerative disc disease, 2 of them(7.1%) had previous operations at the same level. Twenty patients (71.4%) were operated at the L4/5 level, and 8 patients (28.6%) at the L5/S1 level. RESULTS: All patients were able to ambulate the next day of surgery. The mean estimated blood loss was 251.79mL. The average hospital stay was 4.14 days. The average follow-up was 9 months. The mean visual analog scale was 1.86 at discharge, 1.68 after 3 months, and 1.38 after 6 months. After 6 months of the operation, MacNab's criteria were good in 23 patients and excellent in 5 patients. We had one case with transient weakness, 2 cases of screw malposition without clinical manifestations, and one case of infection. CONCLUSION: Mini-TLIF approach is an efficient and safe approach for treating instability and degenerative diseases of the lumbar spine. The clinical outcome is encouraging and it may be an operation of choice for lumbar spinal fusion in selected patients.
Decompression ; Follow-Up Studies ; Humans ; Length of Stay ; Prospective Studies ; Radiculopathy ; Spinal Fusion ; Spine ; Spondylolisthesis ; Transplants ; Visual Analog Scale

Objective: To investigate the combined effect of extracorporeal shockwave therapy (ESWT) and integrated neuromuscular inhibition (INI) on myofascial trigger points in the upper trapezius. Methods: Sixty subjects aged 18–24 years old with active myofascial trigger points in the upper trapezius were studied. Participants were assigned randomly to either group A who received ESWT one session/week, group B who received INI three sessions/week, or group C who received ESWT in addition to INI. All groups completed 4 weeks of intervention. The following main outcome measures were evaluated at baseline and after 4 weeks of intervention: pain intensity, functional disability, pressure pain threshold (PPT), sympathetic skin response (SSR), and neuromuscular junction response (NMJR). Results: Within-group analysis revealed a significant decline in visual analog scale (VAS), Arabic neck disability index (ANDI), and NMJR and incline in PPT and SSR latency post-intervention (p<0.001). Multiple comparison analysis showed a substantial difference between the groups, while the major changes favored group C (p<0.05). Conclusion Combined treatment with ESWT and INI for treating myofascial trigger points in the upper trapezius is more effective than using only one of the two approaches in terms of clinical, functional, and neurophysiological aspects.