Obstructive sleep apnoea hypopnoea syndrome (OSAHS) is a common cause of breathing-related sleep disorder, causing excessive daytime sleepiness. Common clinical features of OSAHS include snoring, fragmented sleep, daytime somnolence and fatigue. This article aims to provide a comprehensive review of the condition, including its management.

Purpose: To evaluate the demography, aetiology, type and outcome of paediatric ocular trauma in tertiary centre in Malaysia. Method: We retrospectively studied 118 eyes from 117 patients over a period of 36 months (January 2006 to December 2008). All ocular injuries in patients aged 12 and below seen in the Ophthalmology Department for the first time were included in this study. Results: Mean age of patients was 6.1±3.0 years. 68 cases (58.2%) occurred in pre-school children, whereas 49 (41.9%) in school-aged children. Boys accounted for 65.8% of cases. There was no predilection for either right or the left eye. 47% of cases (56 patients) occurred in Malay. Most of the injuries took place at home when the children were alone (p<0.05). Sharp objects were the commonest cause (45 cases, 38.1%). The majority of cases (103, 87.3%) were considered preventable. The frequency of open and closed globe injury was similar. Hyphema was more common in closed globe injury compared to open globe injury (p<0.05). Other associated injuries such as cataract, vitreous hemorrhage and retinal hemorrhage are similar between the two groups. Visual outcome is generally poor with only 34 eyes (28.8%) had no visual impairment. Conclusion: Ocular trauma in children is an important cause of visual loss. Most cases occurred at home and were preventable. Prevention through education is the best approach.

Objective: A cross-sectional study was conducted in Malaysia with the objectives of determining the prevalence of smoking in Malaysia, reasons for starting to smoke, age first started to smoke, duration of smoking and to determine the relationship between smoking and age, sex,race, education level, peer influence and parental smoking status. Methods:All residents aged 18 years and above from selected households were included in this study. A standardised pre-tested structured questionnaire was used in this study. Results: The results showed that the overall mean age of the 17.246 respondents was 38.8 (95% CI=38.5-39.2) years with a range of 18-100 years. The majority were Malays (55.5%) followed by Chinese (21.2%) and Indians (11.2%). The age , sex and ethnicity adjusted prevalence of ever and current smokers were 32.0% and 24.9% respectively. The prevalence of ever and current smokers for males was 59.3% and 47.2% respectively. For the females,the prevalence of ever and current smokers was 4.8% and 2.7% respectively. The highest ethnicity adjusted prevalence of current smokers was in Malays (28.9%) followed by the Chinese (18.7%). The lowest prevalence was amongst the Indians (16.8%). The highest prevalence of current smokers was found in Kelantan (30.2%), Terengganu (29.7%), Pahang (28.7%) and Kedah (26.9%); the lowest prevalence was in Kuala Lumpur, Federal Territory (20.4%). The overall mean initiation age of current smokers was 19.2 years (95% CI=19.1. 19.4 years). The mean initiation age of male current smokers was significantly lower (18.9 years) compared to female current smokers(24.1 years). The mean duartion of smoking amongst the current smokers was 18.6 years .Males smoked significantly more cigarettes than the females (p<0.001). Discussion: Multivirate logistic regression analysis showed that smoking was significantly associated with age, sex, ethnicity, educational level and peer and family influence.

No abstract available.

The occurrence of severe lead (Pb) poisoning has risen in certain countries. There is increasing evidence that chronic lead exposure disturbs the prooxidant: antioxidant balance in the brain tissue and alters brain histology. The present study observed the antioxidant effect of tocotrienol-rich fraction (TRF) on brain tissues of the experimental rats following lead poisoning. Eighteen (n=18) male Sprague-Dawley rats, 6-weeks old, were randomly divided into control (CTRL) group and experimental groups; fed with 0.2% w/v lead acetate, as PB2 group; and fed with 0.2% w/v lead acetate and daily TRF supplementation (200 mg/kg body weight) as PB2T group. The experiment was conducted for 30 days. At the end of the study, the brain tissues were harvested and histopathological changes of the hippocampal region were observed. Biochemical findings such as brain lead, TRF and malondialdehyde (MDA) levels, and erythrocyte superoxide dismutase (SOD) activity were determined. It was observed that atypical apoptotic-like and disorganized neurons were present in the hippocampal region of the untreated PB2 group compared to PB2T group. Biochemical parameters showed a significant decrease (p < 0.05) in brain lead level in PB2T compared to PB. Even though no significant difference (p > 0.05) was obtained for MDA level, there was a significant increase (p < 0.05) in the erythrocyte SOD activity in PB2T compared to PB2 and CTRL. Supplementation with TRF improved histopathological changes in the brain tissues caused by lead exposure in drinking water by reducing lead accumulation in the brain of experimental rats.
Lead Poisoning

Autologous chondrocyte implantation (ACI) is a widely accepted procedure for the treatment of large, fullthickness chondral defects involving various joints, but its use in developing countries is limited because of high cost and failure rates due to limited resources and support systems. Five patients (age <45 years) with focal cartilage defects received ACI at University of Malaya from 2006 to 2007 and followed up for 36 months. The average presubjective Knee Evaluation Forms (IKDC) improved from 38.44±6.29 to 25.6±8.04 postoperatively, the Oxford Knee Score (OKS) went from 25.6±8.04 to 13.96±1.63 and the American Knee Society Score (AKSS) improved from 80±14.33 to 92.96±5.82 post-operatively. Thus improvements were seen in the IKDC and AKSS score but not in the OKS. Magnetic resonance images showed the presence of cartilage tissue filling in the lateral and medial patellar facet and medial femoral condyle in three patients. Failures were seen in two patients, both with patellar defects and over the age of 36 years. Treatment with autologous chondrocyte implantation for focal cartilage defect in lateral and medial patellar facet and medial femoral condyle showed early improvement which was maintained at 3 yrs follow-up. ACI provided satisfactory outcome in focal cartilage defects involving the femoral condyle.
Chondrocytes

The aim of this work was to study radiation and the effects of temperature on conductivity properties of polyvinyl alcohol (PVA)-based potassium hydroxide (KOH) and propylene carbonate (PC), where the ionic conduction preferentially occurs in the amorphous phase by free radicals ions through gamma-irradiation. Alkaline composite polymer electrolyte (ACPE) consisting of PVA, KOH and PC of different concentration ratios were prepared by solvent-casting technique. The ACPE were irradiated with different doses from 5 kGy up to 200 kGy. The conductivity properties of the electrolyte films were measured at different frequencies in the range 20 Hz to 1 MHz using LCR meter. The results showed that the conductivity properties were dependent on the radiation dose, temperature and the concentration of the polymer blends.
Radiation ; asparaginase/prednisone/vincristine ; Personal Computers ; Temperature ; Concentration

Background: The best course of action for massive irreparable rotator cuff tears (MIRCTs) is not universally agreed upon. Numerous surgical techniques have been discussed. The implantation of a biodegradable spacer into the subacromial area has been documented since 2012 by several authors. The implantation method is touted as being simpler, repeatable, and less invasive than other solutions that are now available. The purpose of this systematic review and meta-analysis, being the first of its kind, was to evaluate the literature to see the efficacy of InSpace balloon (ISB) implantation in the management of MIRCTs. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, and with 2 researchers assessing and analyzing each study separately, an extensive electronic search of the literature was conducted in the PubMed database from 1961 until July 27, 2022. Results: Fourteen studies were included in this systematic review and three in the meta-analysis. Eleven out of fourteen studies favored ISB use for MIRCTs, while only three were against its use. All spacers were arthroscopically implanted in the subacromial space. Three studies were included in the meta-analysis. The differences in the compared outcomes were statistically insignificant. Conclusions A controversy about the use of ISB remains in patients with MIRCTs. Both good and bad outcomes were reported.However, the majority of patients had good clinical outcomes across several grading scales, radiographic evidence of improved impingement, and self-report that they would redo the procedure in hindsight. To draw more solid conclusions and have statistically significant results in the meta-analysis, more randomized controlled trials and comparative studies comparing this device to other treatments are needed.

A series of new 2,5-disubstituted-1,3,4-oxadiazole derivatives (5a-j and 6a-j) have been designed and synthesized in four-steps. Sixteen compounds among the twenty compounds are reported for the first time. The compounds were characterized and confirmed by the FTIR, 1D- and 2D-NMR and HRMS analyses, and were tested against Mycobacterium smegmatis and Mycobacterium tuberculosis H37Ra. Compound 5d was the most active against M. smegmatis with MIC value of 25 µM, and exhibited cidal activity with MBC of 68 µM, respectively. The time-kill assay showed the good killing rate at 77% with the combination of isoniazid (INH). In addition, checkboard assay confirmed the interaction of compound 5d was categorised as additive. Docking simulation has been performed to position 5d into the pantothenate synthetase active site with binding free energy value –8.6 kcal mol-1. It also occupied the same active site as that of standard native ligand with similar interactions, which clearly indicate their potential as pantothenate synthetase inhibitor.

Background: and Purpose Randomized trials proved the benefits of mechanical thrombectomy (MT) for select patients with large vessel occlusion (LVO) within 24 hours of last-known-well (LKW). Recent data suggest that LVO patients may benefit from MT beyond 24 hours. This study reports the safety and outcomes of MT beyond 24 hours of LKW compared to standard medical therapy (SMT). Methods: This is a retrospective analysis of LVO patients presented to 11 comprehensive stroke centers in the United States beyond 24 hours from LKW between January 2015 and December 2021. We assessed 90-day outcomes using the modified Rankin Scale (mRS). Results: Of 334 patients presented with LVO beyond 24 hours, 64% received MT and 36% received SMT only. Patients who received MT were older (67±15 vs. 64±15 years, P=0.047) and had a higher baseline National Institutes of Health Stroke Scale (NIHSS; 16±7 vs.10±9, P<0.001). Successful recanalization (modified thrombolysis in cerebral infarction score 2b-3) was achieved in 83%, and 5.6% had symptomatic intracranial hemorrhage compared to 2.5% in the SMT group (P=0.19). MT was associated with mRS 0–2 at 90 days (adjusted odds ratio [aOR] 5.73, P=0.026), less mortality (34% vs. 63%, P<0.001), and better discharge NIHSS (P<0.001) compared to SMT in patients with baseline NIHSS ≥6. This treatment benefit remained after matching both groups. Age (aOR 0.94, P<0.001), baseline NIHSS (aOR 0.91, P=0.017), Alberta Stroke Program Early Computed Tomography (ASPECTS) score ≥8 (aOR 3.06, P=0.041), and collaterals scores (aOR 1.41, P=0.027) were associated with 90-day functional independence. Conclusion In patients with salvageable brain tissue, MT for LVO beyond 24 hours appears to improve outcomes compared to SMT, especially in patients with severe strokes. Patients’ age, ASPECTS, collaterals, and baseline NIHSS score should be considered before discounting MT merely based on LKW.