BACKGROUND:There is a controversy in the clinical anterior cruciate ligament reconstruction using autologous hamstring tendon or tendon alograft. OBJECTIVE:To compare the clinical results of anterior cruciate ligament reconstruction with tendon alograft and autograft. METHODS: Totaly 123 patients with injured anterior cruciate ligament received anterior cruciate ligament reconstruction and they were divided into two groups: 63 cases in autograft group and 60 cases in alograft group. The postoperative effects were assessed by the Lysholm score and Lachman test. RESULTS AND CONCLUSION: Al the patients were folowed for more than 8 months. After anterior cruciate ligament reconstruction, the stability of the knee joint, Lysholm scores and Lachman test results were al improved significantly in the two groups; while there was no difference between the two groups at the last folow-up (P > 0.05). The clinical outcomes of anterior cruciate ligament reconstruction with alograft and autograft are almost similar; therefore, surgeons should select ideal graft according to the patient’s condition and surgeon’s experience.

The bioefficacy of Piper aduncum L. essential oil formulated in aerosol cans was evaluated against Aedes aegypti and Aedes albopictus in a simulated room. The aerosol spray test was based on the Malaysian test standard for aerosol (MS 1221:1991UDC 632.982.2 modified from WHO 2009 methodology) and examined the knockdown effect within 20 minutes of exposure. Mortality rate after 24 hour of holding period was also determined. A commercial aerosol spray (0.09% prallethrin 0.05% d-phenothrin) was also tested as a comparison. Our results showed that the knockdown effect of the commercial aerosol spray and P. aduncum essential oil spray (8% and 10% concentrations) was significantly higher in Ae. albopictus adult females, when compared with that of Ae. aegypti adult females (P<0.05). There was a significant difference in knockdown between commercial aerosol spray and essential oil spray for both Aedes spp. (P<0.05). The essential oil induced significantly higher mortality in Ae. aegypti (80%) than in Ae. albopictus (71.6%) (P<0.05). The commercial aerosol spray caused 97.7% and 86.5% mortality against Ae. aegypti and Ae. albopictus respectively (P<0.05). Based on these data, P. aduncum essential oil has the potential to be used as an aerosol spray against Aedes spp.

This study explored the efficacy of Toxorhynchites splendens, predator of Aedes albopictus as a biocontrol agent. There was a negative correlation between Ae. albopictus larval population and Tx. splendens larval population in ovitraps (r= -0.287, R2=0.0821). The correlation is higher between the mean number of Ae. albopictus larvae per ovitrap and the number of Tx. splendens larvae in an ovitrap (r=-0.987, R2=0.9737). Larvae of Tx. splendens were observed to co-exist with larvae of Ae. albopictus and Culex fuscocephala in the ovitraps placed in the study area. The existence of Tx. splendens larvae in the study area coincides with their habit, preferring to breed in bamboo stumps. A total of 480 ovitraps were inspected for 30-week study period and 281 ovitraps were positive with Ae. albopictus larvae respectively. There was a significant difference between numbers of ovitrap positive for Ae. albopictus larvae with number of Tx. splendens larvae in the ovitraps (ANOVA, F(4,475) 2.655, p< 0.05). Of 281 ovitraps positive with Ae. albopictus larvae, 255 ovitraps contained only one Tx. splendens larva each. Only one ovitrap contained four, the most number of Tx. splendens larvae (p< 0.05). Thus, Tx. splendens could be utilised as an alternative for dengue vector control programme.

Hepatitis complicating typhoid fever has been previously reported widely. Occurrence of acute renal failure and hepatitis together is extremely rare. A case report of complicated acute renal failure and hepatitis in a typhoid patient is reported and discussed.
Hepatitis ; Typhoid Fever ; Kidney Failure, Acute ; Case Report ; occurrence

Phantom limb pain may reduce ambulation and mobility in amputees, resulting in diminished quality of life. We conducted a prospective study to compare the perioperative analgesic use of intravenous morphine infusion in 27 patients (Group A) and intramuscular diclofenac sodium in 28 patients (Group B) in patients undergoing lower limb amputation. All patients underwent amputation under spinal anaesthesia and reported a Modified Verbal Numerical Pain Score of less than two prior to the procedure. Presence of phantom pain was assessed on the first, second, third and seventh day as well as at the third month and sixth month post-operatively. Twelve (44 %) patients from group A and 21 patients (75 %) from group B developed phantom limb pain following amputation, a statistically significant difference between groups (p<0.05). We conclude that intravenous morphine infusion is more effective than intramuscular diclofenac sodium in preventing the occurrence of phantom limb pain following amputation.

Patients with cubitus varus deformity secondary to malunited supracondylar fracture are at risk for lateral humeral condylar (LHC) fracture. This report describes a child presenting with preexisting malunion of supracondylar fracture presenting along with nonunion of a LHC fracture following a recent injury. The patient underwent resection osteotomy of the metaphyseal proximal fragment of the fracture surface, reduction of the displaced LHC fragment and screw fixation. This procedure corrected the cubitus varus and treated the nonunion of the lateral condyle thus avoiding a supracondylar osteotomy procedure. Treatment resulted in solid union, good range of motion and no avascular necrosis.

Reduction of a malunited femoral diaphyseal fracture can be achieved by osteotomy and immediate internal fixation or gradual skeletal traction followed by delayed internal fixation. We retrospectively reviewed 27 patients with malunited and shortened femur. Nine patients with mean shortening of 4.7 cm (2.5 10.0) underwent acute one stage reduction and gained 2.5 to 5.0 cm length. Eighteen patients with mean shortening of 5.3 cm (3.5 to 9.0) underwent twostage reduction and gained 2.0 to 5.0 cm length. Ther

To determine the current practices of private practitioners for the management of STIs in Pulau Pinang, Malaysia, evaluation of pharmacotherapy for STIs in private clinics and to ascertain the management of STIs compared to standard guidelines. Methods: Data was collected by self-administered questionnaire for private practitioners, which gathered information on their socio-demographic as well as practice characteristics. Descriptive statistical analysis was performed by using SPSS for Windows version 13.0. Results: Data was collected from 78 practitioners. Most of the treatment choices mentioned for the treatment of gonorrhea were inconsistent with the guidelines. About 51.2% of practitioners did not screen their patients for HIV/AIDS. Majority of private practitioners counseled their patients about HIV/AIDS on an irregular basis. A high percentage of 59% did not inform health authorities about STI cases and 32.1% mentioned that they did not use any guidelines. Conclusions: Management of STIs by private practitioners with respect to selection of antibiotics, patient counseling and case notification leaves a lot to be desired. Current management practices can adversely impact on HIV/AIDS transmission in the country. Interventions are needed to improve the management practices of private practitioners.

Background: There is a need to identify the knowledge that mothers have about breastfeeding to help promote it. Therefore, it is important to develop a valid and reliable questionnaire to provide useful and comparable data about breastfeeding knowledge. The objectives of this study were to determine the reliability and validity of a Malay version of a questionnaire assessing breastfeeding knowledge and describe the breastfeeding knowledge level among respondents. Methods: A cross-sectional study was conducted from 1 January to 31 May 2008 among female staff working at the Universiti Sains Malaysia Health Campus. A self-administered questionnaire containing 53 items assessing breastfeeding knowledge was given to respondents. The questions were adapted and modified from a breastfeeding questionnaire developed by a team of Hospital Universiti Sains Malaysia paediatric nurses. Exploratory factor analysis, internal consistency reliability, and descriptive analysis of respondents’ knowledge were conducted. Results: A total of 252 female staff participated in the study. Factor analysis constructed 10 domains of knowledge and excluded 6 items, leaving 47 items in the final questionnaire. Cronbach’s alpha of the final questionnaire was 0.77. Respondents’ lowest knowledge was on the practical aspects of breastfeeding. Conclusion: The questionnaire is reliable and valid to assess the breastfeeding knowledge of Malaysian women.

Objective: To evaluate the cytotoxic activity of wood extracts of Lunasia amara Blanco (L. amara) and to perform further phytochemical standardization.
Methods: The wood extracts of L. amara were assessed for cytotoxic activity by in vitro tetrazolium bromide (MTT) method against two human cancer cell lines, cervical cancer cells (HeLa) and breast cancer cells (T47D). Thin layer chromatography, Dragendorf, acetic anhydride-sulfuric acid and ferric chloride were used to detect alkaloids, steroids and polyphenols, respectively. Furthermore, quantitative determination of total alkaloid by ultra fast liquid chromatography-photodiode array detection using lunacrine as a marker compound was performed as well.
Results: The ethyl acetate extract exhibited higher cell-growth inhibition than methanol and n-hexane extracts on HeLa and T47D cancer line cells with the IC50 of 71.15 and 79.04 mg/mL, respectively. Total alkaloid in ethyl acetate extract was counted as (10.46 ± 0.28)%(w/w), while lunacrine determined by ultra fast liquid chromatography-photodiode array detection method was found to be (3.55 ± 0.26)%(w/w).
Conclusions: The high total alkaloid and lunacrine concentration on the extract confirm the potential cytotoxic property of ethyl acetate wood extract of L. amara.