Multislice computed tomography (MSCT) is the imaging modality of choice in assessing clinically stable patients with blunt abdominal trauma. This study assessed the role of MSCT in the detection of intra abdominal injury caused by blunt trauma in our centre within a two-year-period (2008-2009). A total of 151 patients had MSCT abdomen for blunt abdominal trauma within this study period. Positive scan were seen in 126 patients (83.4%). Out of these positive scans, liver, spleen and renal injuries were seen in 42.1% (n=53), 34.9% (n=44) and 30.0% (n=34) of cases respectively. Laparotomies were performed in 45 patients. Out of these 45 laparotomies, 10 patients had surgically significant injuries that were missed on CT scan findings. The injuries were bowel perforation (n=4), serosal tear of bowel (n=1), mesenteric injuries with active haemorrhage (n=3), spleen injury (n=1) and liver injury (n=1).

INTRODUCTIONMaximal oxygen uptake, V&O2 peak, among athletes is an important foundation for all training programmes to enhance competition performance. In Singapore, the V& O2 peak of athletes is apparently not widely known. There is also controversy in the modelling or scaling of maximal oxygen uptake for differences in body size - the use of ratio-scaling remains common but allometric scaling is gaining acceptance as the method of choice.

MATERIALS AND METHODSOne hundred fifty-eight male (age, 21.7 +/- 4.9 years; body mass, 64.8 +/- 8.6 kg) and 28 female (age, 21.9 +/- 7.0 years; body mass, 53.0 +/- 7.0 kg) athletes completed a maximal treadmill run to volitional exhaustion, to determine VO2 peak.

RESULTSV& O2 peak in L/min of female athletes was 67.8% that of male athletes (2.53 +/- 0.29 vs. 3.73 +/- 0.53 L/min), and V& O2 peak in mL/kg BM1.0/min of female athletes was 83.4% of male athletes (48.4 +/- 7.2 vs. 58.0 +/- 6.9 mL/kg BM1.0/min). Ratio-scaling of V& O2 peak did not create a size-free variable and was unsuitable as a scaling method. Instead, V& O2 peak, that was independent of the effect of body mass in male and female athletes, was best described using 2 separate and allometrically-derived sex-specific regression equations; these were V& O2 peak = 2.23 BM0.67 for male athletes and V& O2 peak = 2.23 BM0.24 for female athletes.

Adolescent ; Adult ; Body Size ; Exercise Test ; Female ; Humans ; Male ; Models, Biological ; Monitoring, Physiologic ; methods ; Oxygen Consumption ; physiology ; Physical Fitness ; physiology ; Singapore ; Sports

The aim of this study was to determine the genotoxicity of a locally produced nanocomposite by Universiti Sains Malaysia, Malaysia using Comet assay. Stem cells from human exfoliated deciduous teeth (SHED) were treated with the nanocomposite at five different concentrations (0.006, 0.0125, 0.025, 0.05, and 0.1 mg/ml) along with concurrent negative (medium alone) and positive control (zinc sulfate heptahydrate) and incubated at 37°C for 24 hours in an incubator at 5% CO2. The tail moment was used to assess the extent of DNA damage. The tail moment for the group of SHED treated with nanocomposite (for all the five different concentrations) was not statistically significant as compared to the negative control, suggesting that the locally produced dental nanocomposite did not induce any DNA damage. Hence, it can be concluded that the locally produced nanocomposite is non-genotoxic on stem cells from human exfoliated deciduous teeth.

INTRODUCTIONThe present study aimed to obtain preliminary tympanometric data of young Malay adults and to compare the results between genders.

METHODS96 undergraduate students (49 males and 47 females), aged 19-25 (mean and standard deviation 21.14 +/- 1.31) years, participated in this study. Otoscopic examination, pure tone audiometry, qualitative tympanogram and ipsilateral acoustic reflex were measured to ensure a clear ear canal, normal hearing and normal middle ear function, prior to tympanometric measurement. As a result, a total of 154 ears (80 ears from males and 74 ears from females) were selected for further statistical analyses. The tympanometric parameters measured were peak compensated static acoustic admittance (Peak Y(tm)), tympanometric width (TW) and equivalent ear canal volume (V(ea)).

RESULTSThe results showed that the mean Peak Y(tm), V(ea) and TW for males were 0.81 mmhos, 1.48 cubic cm and 113.67 daPa, respectively. The mean Peak Y(tm), V(ea) and TW for females were 0.63 mmhos, 1.12 cubic cm and 98.04 daPa, respectively. Males were found to have significantly higher mean V(ea) and mean Peak Y(tm) than females. However no significant gender difference was observed in the mean TW.

CONCLUSIONThe current study suggests that young Malay adults may require gender-specific Peak Y(tm) and V(ea) values when implementing a quantitative approach in tympanogram interpretation.

Acoustic Impedance Tests ; methods ; Acoustics ; Audiometry ; methods ; Audiometry, Pure-Tone ; Ear Canal ; pathology ; Ethnic Groups ; Female ; Humans ; Malaysia ; Male ; Otoscopy ; methods ; Reference Values ; Sex Factors ; Young Adult

INTRODUCTIONThe aim of this study is to investigate the amount of water loss and percentage dehydration experienced during 1 hour of paddling on the kayak ergometer so as to help coaches and athletes tailor a suitable and adequate rehydration regime. Also, rehydration efficacy between water and a well established, commercially available sports drink (Gatorade, Quaker Oats company, USA) was investigated in this cross-over study.

MATERIALS AND METHODSTen national flatwater kayakers were monitored in a controlled setting while paddling the kayak ergometer for 1 hour at an intensity sustainable for long distance marathon. They rehydrated themselves ad libitum with provided beverage. Post-void towel-dried body mass was measured before and after the exercise with percentage dehydration calculated. Body core temperature (tympanic temperatures), ratings of perceived exertion and thirst index were monitored every 15 minutes. The amount of fluid consumed, urine output and urine specific gravity were obtained after exercise.

RESULTSThe results [mean +/- standard deviation (SD)] showed that kayakers underwent 1.10 +/- 0.52% dehydration while rehydrating with water as compared to 0.72 +/- 0.38% while rehydrating with Gatorade. Also, athletes on water rehydration had higher rating of perceived exertion (RPE) at the 30th and 60th minute mark of the exercise. Overall, athletes undergoing water rehydration lost significantly more body mass (0.70 +/- 0.39 kg) as compared to rehydrating with Gatorade (0.46 +/- 0.27).

CONCLUSIONAlthough the hydration efficacy of Gatorade proved superior to that of water, the athletes' hydration habits with either fluids did not provide adequate hydration. It is recommended that specific strategies be developed to address dehydration and rehydration issues of kayakers in Singapore.

Adult ; Beverages ; Competitive Behavior ; Cross-Over Studies ; Dehydration ; metabolism ; physiopathology ; Drinking ; Exercise ; physiology ; Female ; Fluid Therapy ; methods ; Humans ; Male ; Monitoring, Physiologic ; Physical Exertion ; physiology ; Ships ; Sports ; Water-Electrolyte Balance ; physiology

OBJECTIVETo evaluate the antitumor activity of Manilkara zapota (M. zapota) L. stem bark against Ehrlich ascites carcinoma (EAC) in Swiss albino mice.

METHODSThe in vivo antitumour activity of the ethyl acetate extract of stem bark of M. zapota L. (EASM) was evaluated at 50, 100 and 200 mg/kg bw against EAC using mean survival time. After administration of the extract of M. zapota, viable EAC cell count and body weight in the EAC tumour hosts were observed. The animal was also observed for improvement in the haematological parameters (e.g., heamoglobin content, red and white blood cells count and differential cell count) after EASM treatment.

RESULTSIntraperitoneal administration of EASM reduced viable EAC cells, increased the survival time, and restored altered haematological parameters. Significant efficacy was observed for EASM at 100 mg/kg dose (P<0.05).

CONCLUSIONSIt can be concluded that the ethyl acetate extract of stem bark of M. zapota L. possesses significant antitumour activity.

Animals ; Antineoplastic Agents ; isolation & purification ; therapeutic use ; Body Weight ; Carcinoma, Ehrlich Tumor ; drug therapy ; Cell Survival ; drug effects ; Disease Models, Animal ; Injections, Intraperitoneal ; Male ; Manilkara ; chemistry ; Mice ; Plant Bark ; chemistry ; Plant Extracts ; isolation & purification ; therapeutic use ; Survival Analysis ; Treatment Outcome

Aims: Camellia sinensis ( green t ea) is known for its therapeutic properties (anti - inflammatory, anti - oxidative and anti - ageing). The aim of this study was to determine the in vitro inhibitory activity of gree n tea extract on some odorous skin commensal bacteria. Methodology and results: Tea leaves were collected from MARDI Agro Technology Park, Cameron Highlands. A standardised protocol was used to obtain green tea extract. Aqueous green tea extracts were tes ted for antibacterial activity by well diffusion method. Minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) assays were performed by broth microdilution assays using green tea extract concen trations from 16 to 0.0313 mg/ mL . Green tea extract showed antibacterial activity against skin microbiota. The high antimicrobial effect was achieved against Micrococcus luteus with MIC and MBC of 0.125 and 0.25 mg/μL respectively, followed by Staphylococcus epidermidis with MIC and MBC o f 0.25 and 0.25 mg/μL respectively, Bacillus subtilis with MIC and MBC of 0.5 and 0.5 mg/μL respectively and lastly, Corynebacterium xerosis with MIC and MBC of 0.5 and 1.0 mg/μL respectively. Conclusion, significance and impact of study: The results obta ined from the study confirm the in vitro anti - microbial activity of green tea extracts against skin microbiota. The antibacterial effects of green tea against skin bacteria with its anti - oxidant and anti - aging properties will help in keeping skin healthy, fresh and reducing unpleasant odo rs .
Camellia sinensis

Introduction: The lack of evidence that proves the benefit of traditional and complementary medicines (T&CM) in treating chronic medical conditions does not deter its usage among patients worldwide. Prevalence of usage among post-stroke patients in Malaysia especially is unknown. This study aims to determine the prevalence, practice and perception of T&CM use among stroke survivors attending an outpatient rehabilitation program in a teaching hospital. Methods: A cross-sectional study was conducted among 104 post stroke patients attending an outpatient rehabilitation program. A structured self-administered questionnaire was used to collect data on sociodemographic and clinical profile of patients, as well as types of therapy used and perception on T&CM usage. Descriptive analysis was done, and bivariate analysis was used to determine associations between categorical data. Results: Mean age of patients was 62 years (SD 12.2), 54% were Chinese and 75% of the patients had ischaemic stroke. Mean age of T&CM users was younger compared to nonT&CM users (61 years vs. 66 years, p=0.04). Two-thirds (66%) of patients admitted to concurrent T&CM usage while attending conventional post stroke rehabilitation. Acupuncture (40.4%), massage (40.4%) and traditional Chinese medicine (11.5%) were the most common T&CM used. Positive perception was recorded in terms of ability of T&CM usage to relieve post stroke symptoms (68%), and it was safe to use because it was made from ‘natural sources'. Negative perception recorded: T&CM caused significant adverse effects (57.6%) and was not safe to be used in combination with other conventional medicines (62.5%). Conclusions: Concurrent T&CM usage among post-stroke patients attending structured outpatient rehabilitation program is widely practised especially acupuncture, massage and traditional Chinese medici
Complementary Therapies, Stroke

Congenital insensitivity to pain with anhidrosis is a rare autosomal recessive disorder presenting with loss of pain sensation, thermal sensation defects, and self-mutilating behavior. In the present study, we recruited two consanguineous pedigree showing pain insensitivity symptoms from Pakistan for clinical and molecular investigations. In family A, one female patient displayed classical CIPA symptoms along with microcephaly and severe intellectual disability. During course of the disease, her right foot was amputated and had remarkable dental degeneration and teeth shedding. In family B, one boy presented with classical symptoms of congenital insensitivity to pain with anhidrosis. Blood was collected from both families for molecular studies. Sequencing with the Ilumina Trusight One Sequencing Panel covering 4813 OMIM genes revealed a known homozygous mutation c.2084C>T; p.P695L of NTRK1 in family A and a novel truncated mutation c.2025C>G; p.Y681X in family B. Protein modeling analysis of both mutations (p.P695L and p.Y681X) predicted loss of the rigidity in tyrosine kinase domain of NTRK1 that led to conformational changes as well as deleterious effect on protein function. The known mutation was reported more than a decade ago in a family from Northern Israel and other non-sense mutation is newly identified. It is interested that most of NTRK1 mutations are associated with this domain. This is first ever report of NTRK1 variants in congenital insensitivity to pain with anhidrosis patients from Pakistan.
Pain Insensitivity, Congenital

Introduction: A dilemma arises when a bone graft or fracture fragment is accidentally dropped on the operation theatre floor and becomes contaminated. This study aimed to determine the efficacy of simple and readily available antiseptic solutions in disinfecting contaminated bones. Materials and methods: This experimental study involved 225 bone specimens prepared from discarded bone fragments during a series of 45 knee and hip arthroplasty surgeries. The bone fragments were cut into five identical cubes and were randomly assigned to either control (positive or negative), or experimental groups (0.5% chlorhexidine, 10% povidone-iodine or 70% alcohol). The control negative was to determine pre-contamination culture. All bone specimens, except the control negative group were uniformly contaminated by dropping on the operation theatre floor. Subsequently, the dropped bone specimens except for the control positive group, were disinfected by immersing in a respective antiseptic solution for 10 minutes, before transported to the microbiology laboratory for incubation. Results: The incidence of a positive culture from a dropped bone fragment was 86.5%. From the 37 specimens sent for each group, the incidence of positive culture was 5.4% (2 specimens) after being disinfected using chlorhexidine, 67.6% (25 specimens) using povidone-iodine and 81.1% (30 specimens) using alcohol. Simple logistic regression analysis demonstrated that chlorhexidine was significantly effective in disinfecting contaminated bones (p-value <0.001, odd ratio 0.009). Povidone-iodine and alcohol were not statistically significant (p-value 0.059 and 0.53, respectively). Organisms identified were Bacillus species and coagulase negative Staphylococcus. No gram-negative bacteria were isolated. Conclusion: A total of 0.5% chlorhexidine is effective and superior in disinfecting contaminated bones.