Ectodermal Dysplasia ; complications ; diagnostic imaging ; pathology ; Female ; Humans ; Hydrocephalus ; complications ; diagnostic imaging ; pathology ; Infant ; Polydactyly ; complications ; Tomography, X-Ray Computed

Kidney Failure, Acute ; Hospitals, General

A four-year-old Ibanese boy presented with subacute abdominal distension for two months duration. Ultrasound and computed tomography (CT) scan showed solid liver masses as well as bowel and intraperitoneal lesions. Initial diagnosis of intraperitoneal inflammatory process as in tuberculosis with non-liquefied liver abscess with differential diagnosis of neoplastic process was made. Liver biopsy and peritoneal fluid analysis revealed Burkitt’s lymphoma (BL). We aim to highlight the diagnostic challenge of BL in this young age group emphasizing on the ultrasound and CT features of intraabdominal BL. We would also want to stress the importance of early diagnosis of BL as it is known to be the most aggressive tumour within 24 hours yet to have good survival if early diagnosis was made.
Lymphoma ; Child

Introduction: We conducted this study to compare the specificity and sensitivity of the Ortolani and Barlow tests performed by dedicated examiners, and to ascertain the incidence of developmental dysplasia of the hip (DDH) in breech babies. Methods: A dedicated examiner underwent specific training and testing by a paediatric orthopaedic surgeon. Routine examiners were medical officers who had basic training in medical school and were briefly trained by their superiors. The dedicated examiner examined 170 babies. Thirty babies including 5 babies with positive tests (according to the dedicated examiner) were examined by a blinded routine examiner. Results of Ortolani and Barlow tests on 30 babies were compared with ultrasound examination by blinded radiologist. Results: Five babies had positive Ortolani and Barlow tests. The routine examiner did not detect positive Ortolani and Barlow tests. Conclusion: The incidence of positive Ortolani and Barlow tests among breech babies was 2.8%. Result of Ortolani and Barlow tests by dedicated hip screener were better than results performed by routine examiner.

Digital mammogram has become the most effective technique for early breast cancer detection modality. Digital mammogram takes an electronic image of the breast and stores it directly in a computer. The aim of this study is to develop an automated system for assisting the analysis of digital mammograms. Computer image processing techniques will be applied to enhance images and this is followed by segmentation of the region of interest (ROI). Subsequently, the textural features will be extracted from the ROI. The texture features will be used to classify the ROIs as either masses or non-masses. In this study normal breast images and breast image with masses used as the standard input to the proposed system are taken from Mammographic Image Analysis Society (MIAS) digital mammogram database. In MIAS database, masses are grouped into either spiculated, circumscribed or ill-defined. Additional information includes location of masses centres and radius of masses. The extraction of the textural features of ROIs is done by using gray level co-occurrence matrices (GLCM) which is constructed at four different directions for each ROI. The results show that the GLCM at 0º, 45º, 90º and 135º with a block size of 8X8 give significant texture information to identify between masses and non-masses tissues. Analysis of GLCM properties i.e. contrast, energy and homogeneity resulted in receiver operating characteristics (ROC) curve area of Az = 0.84 for Otsu’s method, 0.82 for thresholding method and Az = 0.7 for K-mean clustering. ROC curve area of 0.8-0.9 is rated as good results. The authors’ proposed method contains no complicated algorithm. The detection is based on a decision tree with five criterions to be analysed. This simplicity leads to less computational time. Thus, this approach is suitable for automated real-time breast cancer diagnosis system

The aim of this study was to examine the aspect of information disclosure by doctor-investigator during the process of obtaining informed consent in clinical trials. This research employed a mixed-method data collection that is library research and interview. A qualitative methodology and analysis were used in an open-ended, face-to-face interviews with 17 patient-subjects. The interview questions were based on information that needed to be disclosed to patient-subjects during the process of obtaining informed consent. Each interview took place in Kajang Hospital and National Heart Institute and lasted 25-30 minutes. Interviews were conducted in Bahasa Melayu and English. The interviews were tape-recorded, and the main points from the interviews were jotted down to ensure that all information was adequately gathered. Interviewed occurred in Kajang Hospital and National Heart Institute. The participants were patients who had been referred to the Kajang Hospital and National Heart Institute. They were recruited (8 from Kajang Hospital and 9 from National Heart Institute) by their own doctors to participate in a study to evaluate the safety and effectivenes of the investigational stent after been diagnosed with coronary artery disease and also in a study to investigate drug for antidepressant. respectively. The study revealed that doctor-investigators fail to disclose full information to patient-subjects. Instead, doctor-investigators only disclosed information which they thought were necessary for the patient-subjects to know. The study also showed that there were doctor-investigators who did not disclose information at all to the patient-subjects. This study implies that the aspect of information disclosure in the process of obtaining informed consent in clinical trials is rather poor and did not fulfill the criterion of good medical practice. A random monitoring task to be conducted by the research ethics commitees during the informed consent process is suggested.

Cervical cancer is the seventh most common cancer among women in Iraq. This study aimed to assess the factors influencing Pap smear practice among married primary school teachers in Diyala City, Iraq. A total of 222 teachers (aged 20 years to 63 years) residing in Diyala City were enrolled in a cross sectional study from 1st August till 30th September 2012. The sampling method was a self-administered survey using a multistage sampling technique. The prevalence of Pap smear practice was very low (12.6%). Relatives and friends were the main source of information about the Pap smear test for more than one third (41.9%) of the respondents. However, the medical doctor’s advice was the most important reason for undergoing a Pap smear test in more than two third (60.7%) of respondents. Only 32.4% of the teachers have good knowledge about cervical cancer and Pap smear test, but 76.1% of them showed a positive attitude toward learning about cervical cancer and Pap smear. Based on multiple logistic regression analysis results only the husband’s encouragement (p= 0.003, prevalence odds ratio [POR] = 0.256, 95%CI 0.10-0.63) was significantly associated with Pap smear practice. A more effective educational program is needed to educate Iraqi women about cervical cancer and screening tests, including Pap smear.
Papanicolaou Test

The objective s of the research are t o identify the noise sources and noise level exposure inside C130H aircraft ’s hangar ; to produce nois e mapp ing ; to identify hearing status of C 130H aircraft maintenance crews (MC) ; and suggesting the noise control measure that can be applied. A field survey on noise level by using a digital s ound level m eter and producin g noise mapping . A h earing test ing among 63 MC was carried out in Institute of Aviation Me dicine , Royal Malaysian Air Force ( RMAF ) . Reviewing the literature and a nalyzing some control measure s to be taken. Hearing test result shown 41.2% of the MC are having hearing impairment. The highest noise level at the central of the hanga r is 92.2 dB A ( day - time) and 94.2 dBA (night - time) when there is a C130H aircraft starting its engine at 50 meter s from the centr al of the hanga r, 95.3 dBA (day - time) and 97.3 dBA (night - time) when there is a C130H a ircraft Engine Ground Run at 150 meter s fr om the centra l of the hanga r. Besides, Auxiliary Power Unit is producing the highest nois e level which is 125.7 dBA (day - time) and 127.7 dBA (night - time) . The application of Personal Protective Equipment (PPE) is the very likely control measure to be taken while engin eering control is ve ry costly but can be considered. Since noise is recognized as a hazard, hearing protection as PPE will not be the ultimate solution as a control measure. Hence, the Engineering Control must be identified and studied to be implemented as an ultimate solution to control the noise hazard in long term duration.

The objectives of the research are to identify the noise sources and noise level exposure inside C130H aircraft’s hangar; to produce noise mapping; to identify hearing status of C130H aircraft maintenance crews (MC); and suggesting the noise control measure that can be applied. A field survey on noise level by using a digital sound level meter and producing noise mapping. A hearing testing among 63 MC was carried out in Institute of Aviation Medicine, Royal Malaysian Air Force (RMAF). Reviewing the literature and analyzing some control measures to be taken. Hearing test result shown 41.2% of the MC are having hearing impairment. The highest noise level at the central of the hangar is 92.2 dBA (day-time) and 94.2 dBA (night-time) when there is a C130H aircraft starting its engine at 50 meters from the central of the hangar, 95.3 dBA (day-time) and 97.3 dBA (night-time) when there is a C130H aircraft Engine Ground Run at 150 meters from the central of the hangar. Besides, Auxiliary Power Unit is producing the highest noise level which is 125.7 dBA (day-time) and 127.7 dBA (night-time). The application of Personal Protective Equipment (PPE) is the very likely control measure to be taken while engineering control is very costly but can be considered. Since noise is recognized as a hazard, hearing protection as PPE will not be the ultimate solution as a control measure. Hence, the Engineering Control must be identified and studied to be implemented as an ultimate solution to control the noise hazard in long term duration.
C130H aircraft ; maintenance crew ; noise exposure

Objective: Contrast-enhanced ultrasound has become increasingly utilised as an alternative imaging modality for the diagnosis of vesicoureteric reflux (VUR) in paediatric patients. The study objective is to evaluate the efficacy of contrast enhanced Voiding Urosonography (ce-VUS) compared with fluoroscopic micturating cystourethrography (MCU) in the detection of VUR. Methods: This prospective study was carried out between July 2011 and January 2013 on paediatric patients who underwent MCU. All consented patients would undergo ceVUS prior to MCU. We documented the epidemiology details, the number of Kidney-Ureter (K-U) unit studied, baseline renal and bladder sonogram, as well as presence of VUR on ce-VUR. The technique for ce-VUS was standardized using normal saline to fill the bladder prior to administration of SonoVue® (2.5 ml) to assess the kidney-ureter (K-U) unit. Dedicated contrast detection software was used to discern the presence of microbubbles in the pelvicaliceal system (PCS). The findings were then compared with MCU. Results: 27 paediatric patients were involved in the study [17 males (63%) and 10 females (37%)] involving 55 K-U units (one patient had a complete duplex system). MCU detected VUR in 10 K-U units while ce-VUS detected VUR in 8 out of the 10 K-U units. There were 2 false negative cases (both Grade 1) with ce-VUS. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of ce-VUS were 80%, 98%, 95%, 89% and 96%, respectively. Conclusion: ce-VUS is a sensitive and specific radiation-free alternative for the detection of VUR in the paediatric population.
Urinary Tract Infections