Failure analysis was performed to investigate the failure of the femur fixation plate which was previously fixed on the femur of a girl. Radiography, metallography, fractography and mechanical testing were conducted in this study. The results show that the failure was due to the formation of notches on the femur plate. These notches act as stress raisers from where the cracks start to propagate. Finally fracture occurred on the femur plate and subsequently, the plate failed.
*Bone Plates ; Bone Screws ; *Equipment Failure Analysis ; Femur/radiography ; Femur/*surgery ; Fracture Fixation, Internal/*instrumentation ; *Stainless Steel ; Surface Properties

Objective: To isolate compounds from K. pinnata and elucidate their structures and to explore preliminary antioxidant, antimicrobial, cytotoxic and thombolytic activities of extractives of the plant. Methods: The methanol extract of whole plant of K. pinnata has been subjected to different chromatographic separation and purification processes to isolate the secondary metabolites. The structures of the isolated compounds have been elucidated by extensive NMR studies. The free radical scavenging activity of the crude extract and its different Kupchan fractions were determined on stable radical DPPH. In vitro antimicrobial activity was determined by the disk diffusion method. Cytotoxicity screening has been performed against Artemia salina. Total phenolics content, membrane stabilizing activity and thombolytic activities were assessed by following established protocol. Results: The isolated compounds were identified as glut-5(6)-en-3-one, taraxerone, 3β-friedelanol, β-amyrin-3-acetate, 3,5,7,3',5'-pentahydroxyflavone and β-sitosterol. The chloroform soluble fraction showed potent antioxidant activity of (IC50=80.0 μg/mL) and significant cytotoxicity, while the crude extract demonstrated noticeable total polyphenol content (149.24 mg of GAE/gm of extractive), moderate membrane stabilizing activity and inhibition of clot lysis of blood. Conclusions: The obtained results rationalize the folkloric use of the plant and can be further investigated to isolate the active compounds responsible for the biological activities.

Pregnant women are at higher risk of transmitting the infections to their foetus. This prompted the “Prevention of Mother to Child Transmission (PMTCT) Program” in Malaysia since 1998. The objective of this cross sectional study was to determine the knowledge, attitude and practice (KAP) of pregnant mothers in the west of Sabah towards HIV/AIDS and its influencing factors. Data were obtained through self administered questionnaires. Results showed that only 32.2% of the respondents have good knowledge compared to 67.8% who had poor knowledge (p <0.001) of HIV/AIDS. Majority of them (56.4%) have good attitude and practice towards HIV/AIDS compared to the remaining poor attitude and practice respondent (44.4%) (p<0.001). Radio/TV (90.2%) and reading materials (83.9%) were the main sources of obtaining information. Main influencing factors for having good knowledge towards HIV/AIDS were women aged < 30 years old, have high education, who perceived on having good knowledge towards HIV/AIDS and received health education from health staffs. Mean while, influencing factors for having good attitude and practice towards HIV/AIDS were women having high education and received health education from health staffs. Therefore, implementation of PMCTC must be reviewed regularly to ensure the program reach its targets.

?AlM: To evaluate the effect of different methods in managing punctual and canalicular stenosis as a complication of viral conjunctivitis.
?METHODS: A retrospective cohort study, including 35 cases of punctal stenosis post-viral conjunctivitis. Cases were diagnosed clinically and treated after 4wk of complete remission from epidemic keratoconjunctivitis. Patients were treated with mechanical dilatation, insertion of perforated silicon punctual plugs or the use of Mini-Monoka stent.
?RESULTS: Six out of 35 ( 17. 14%) had a satisfactory outcome by punctal dilatation alone. Punctal dilatation with insertion of perforated punctal plugs was done in 20 cases ( 57. 14%). Nine cases ( 25. 71%) had punctal dilatation with Mini - Monoka tube insertion. Disease severity and the use of Mini-Monoka silicon tube did not correlate with bilateral eye involvement or involvement of both upper and lower punctum.
?CONCLUSlON: Management of punctal occlusion post viral conjunctivitis may be treated easily using perforated punctal plugs. Silicon intubation with Mini-Monoka might be needed to manage resistant cases.

Anatomy ; history ; France ; General Surgery ; history ; History, 17th Century ; History, 18th Century ; Humans

Driving activity has become more important as this medium being practical, it is also cheaper and faster in connecting human from one to another place. However, in some occurrence, it can cause accidents as they become fatigued while driving. Driver fatigue is one of the top contributors to the road accidents and can be dangerous as other road safety issues such as drink driving. Worst is, there are no laws regulating driver fatigue. Therefore, the main purpose of this study is to develop the regression model of apsychophysical factor for drivers’ fatigue which can predict the relationship between the process input parameters and output responses. The study was participated by ten subjects. The heart rate was taken and recorded using heart rate monitor. Design Expert 8.0.6 software was used for the regression analysis. The modeling validation runs werewithin the 90% prediction intervals of the developed model and the residual errors were less than 10%. The R 2 value is 0.9400 whichmeans that the linear regression line passed exactly through all points. The significant parameters that influenced the heart rate were also identified.The parameters are time exposure, type of road, and gender.
Psychophysical ; fatigue ; regression modeling ; heart rate

Background and Objective: Neuromyelitis optica (NMO) shares certain features with multiple sclerosis (MS). Similar phenotypes, wide spectrum and the differential prevalence of NMO among ethnic backgrounds pose diagnostic challenges. NMO-IgG antibodies are specific biomarker for NMO and facilitate its differentiation from other demyelinating diseases. This study aimed to assess the frequency of NMO and NMO-IgG seropositivity in Saudi patients with demyelinating diseases of the central nervous system. Methods: One hundred and four patients from neurology database at King Abdulaziz Medical City, Riyadh underwent clinical and laboratory examination, neuroimaging and NMO-IgG antibodies screening. Results: The mean age at presentation was 32 (±9) years and there was an excess of females (female:male – 3:1). The mean duration of illness was 4.6 (±3.2) years. During the illness, 48.1% of patients had clinical evidence of spinal cord involvement, 29.8% had optic neuritis and 14.4% had both features. A large majority (75.8%) of brain lesions fulfilled MRI criteria for MS and 17% had lesions extending over ≥3 vertebral segments. NMO-IgG antibodies were present in only one patient – a frequency of 0.96% in our study cohort. Conclusion: Prevalence of NMO and NMO-IgG seropositivity is rare in Saudis with demyelinating diseases of the central nervous system. Hence, routine NMO-IgG testing is likely to have a low diagnostic yield

Introduction: Gestational diabetes (GDM) has significant maternal and foetal implications. screening allows active interventions which significantly improves pregnancy outcomes. Despite World Health Organization (WHO), FIGO and National Institute of clinical Excellence (NIcE) recommendations for universal screening especially among high risk population; Malaysia currently adopts a selective risk based screening for GDM. Objective: the objective is to audit the effectiveness of the current practice of selective risk based screening in detection of GDM in Malaysia. Methodology: this is a retrospective cohort study based on the National Obstetric Registry (NOR) which comprises of 14 major tertiary hospitals in Malaysia. the study period was from 1st January 2011 till 31st December 2012 and a total of 22,044 patients with GDM were analysed. Logistic regression analysis was used to calculate the crude odd ratio. Results: the incidence of GDM in Malaysia is 8.4%. Maternal age of ≥25, booking bMI ≥27kg/m2, booking weight ≥80kg and previous hypertension are non-significant risk of developing GDM in Malaysia. Parity 5 and more was only associated with an odds-ratio of 1.02 (95% confidence Interval: 0.90-1.17) as compared to parity below 5. the association of women with previous stillbirth with GDM was not significant. conclusion: current risk based screening for GDM based on maternal age, booking bMI, weight and hypertension is inappropriate. An ideal screening tool should precede disease complications, which is the novel objective of screening. Universal screening for GDM in Malaysia may be a more accurate measure, especially with regards to reducing maternal and foetal complications.
Diabetes, Gestational

Osteoporosis and osteopenia can affect patients undergoing arthroplasty of the hip, which is typically recommended for patients with severe osteoarthritis or elderly patients with a femoral neck fracture. Preoperative screening for this type of bone loss could be helpful to patients and prevent poor outcomes due to the rate of underdiagnosis of osteoporosis, which can reach 73% in patients undergoing hip arthroplasty. Complications associated with low bone mineral density include periprosthetic fractures as well as an increased revision rate. Although the benefit of antiresorptive medications postoperatively has been demonstrated, when administered preoperatively, worse outcomes were reported compared to its non-usage. Surgical management is as important as pre-medication. According to general recommendations, cemented implants provide greater benefit in osteoporotic patients. However, when using cementless implants, ribbed stems, straight tapered stems, stems with medial calcar contact, and titanium-composed stems can be used to prevent periprosthetic loss of bone mineral density; however, they should not be placed in a varus position. These stems can also be coated with zoledronate and other products.

Osteoporosis and osteopenia can affect patients undergoing arthroplasty of the hip, which is typically recommended for patients with severe osteoarthritis or elderly patients with a femoral neck fracture. Preoperative screening for this type of bone loss could be helpful to patients and prevent poor outcomes due to the rate of underdiagnosis of osteoporosis, which can reach 73% in patients undergoing hip arthroplasty. Complications associated with low bone mineral density include periprosthetic fractures as well as an increased revision rate. Although the benefit of antiresorptive medications postoperatively has been demonstrated, when administered preoperatively, worse outcomes were reported compared to its non-usage. Surgical management is as important as pre-medication. According to general recommendations, cemented implants provide greater benefit in osteoporotic patients. However, when using cementless implants, ribbed stems, straight tapered stems, stems with medial calcar contact, and titanium-composed stems can be used to prevent periprosthetic loss of bone mineral density; however, they should not be placed in a varus position. These stems can also be coated with zoledronate and other products.