Objective: To establish the antibacterial activity of lanthanides complexes with a tetradentate Schiff base ligand L. Methods: (N, N'-bis (1-naphthaldimine)-o-phenylenediamine) was prepared from the condensation of 2-hydroxy-1-naphthaldehyde with o-phenylenediamine in a molar ratio of 2:1. The antimicrobial activity of the resultant Ln (III) complexes was investigated using agar well diffusion and micro-broth dilution techniques; the latter was used to establish the minimum inhibitory concentrations for each compound investigated. Results: Most of Ln (III) complexes were found to exhibit antibacterial activities against a number of pathogenic bacteria with MICs ranging between 1.95-250.00 μg/mL. Staphylococcus aureus was the most susceptible bacterial species to [LaL(NO3)2(H2O)](NO3) complex while Shigella dysenteriae andEscherichia coli required a relatively higher MIC (250 μg/mL). The complexes La (III) and Pr (III) were effective inhibitors against Staphylococcus aureus, whereas Sm (III) complex was effective against Serratia marcescens. On the other hand, Gd (III), La (III) and Nd (III) were found to be more potent inhibitors against Pseudomonas aeruginosa than two of commonly used antibiotics. The remaining Ln (III) complexes showed no remarkable activity as compared to the two standard drugs used. Conclusions: Tetradentate Schiff base ligand L and its complexes could be a potential antibacterial compounds after further investigation.

Total thyroidectomy is increasingly accepted for the management of bilateral benign thyroid disorders. Postoperatively, patients require lifelong levothyroxine replacement therapy to avoid postoperative hypothyroidism, which besides the burden of compliance, has been proven to be associated with several long-term side effects. Heterotopic thyroid autotransplantation was proposed several decades ago to avoid the need for life-long postoperative replacement therapy with maintaining the autoregulatory mechanism of thyroxin production inside the body according to its needs. Available data regarding this topic in literature is relatively poor. Before applying thyroid autotransplantation on humans, several studies have been done on animals, where the autologous transplantations were found to be successful in almost all the cases, proved by follow up postoperative 8-week measurements of thyroid hormones and histopathological examination of the removed autografts. Regarding the clinical application, few trials have been done using cryopreserved in vivo, in vitro or immediately autotransplanted thyroid autografts. Satisfactory results were obtained, however, the number of these studies and the number of patients per each study was very low. Besides the study methodologies were not so consistent.
Animals ; Autografts* ; Compliance ; Follow-Up Studies ; Humans ; Hypothyroidism ; In Vitro Techniques ; Thyroid Gland* ; Thyroid Hormones ; Thyroidectomy ; Thyroxine ; Transplantation, Autologous* ; Transplantation, Heterotopic

Objective:To determine the prevalence, genetic relatedness, and pattern of antimicrobial susceptibility in methicillin-resistant Staphylococcus aureus (S. aureus) (MRSA) isolated from household dogs, farm dogs, and stray dogs, compared to isolates from their associated personnel.
Methods: MRSA was isolated from 250 nasal swabs (150 swabs from dogs and 100 swabs from humans). PCR assays were used to detect the presence of both the nuc and mecA genes, which confirmed the identity of S. aureus isolates and the presence of methicillin resistance, respectively. Disk diffusion was used to determine the antibiotic susceptibility against 15 antimicrobial agents along with an E-test that determined the minimum inhibitory concentration for oxacillin. Pulsed field gel electrophoresis was conducted to determine the genetic relatedness of MRSA isolates from dogs to those from associated and unassociated personnel.
Results:The prevalence of S. aureus in dogs and humans was 12.7%and 10.0%respectively, while the prevalence of MRSA isolates in dogs and humans was 5.3%and 5.0%, respectively. The prevalence of MRSA isolates in household dogs, farm dogs, and stray dogs was 7.8%, 4.7%, and 0.0%, respectively. MRSA isolates demonstrated a significantly higher rate of multi-resistance against three or more antimicrobial agents than methicillin-susceptible S. aureus (MSSA). Trimethoprim-sulphamethoxazole and chloramphenicol were the most effective antibiotics against all MRSA isolates. Pulsed field gel electrophoresis revealed a strong association between dog MRSA isolates and MRSA isolates from strongly associated personnel. Conclusions:MRSA is prevalent in house dogs, as well as in dog rearing centers and among their strongly associated personnel. A strong association was found between the MRSA isolates from dogs and those from humans who are in close contact. In addition, MRSA isolates showed a high rate of multi-resistance compared to MSSA isolates.

Objective: To elucidate the molecular mechanisms of the potent anti-obesity effect of Moringa oleifera Lam. (M. oleifera) ethanolic extract and to clarify the link between these mechanisms and the associated metabolic and vascular risks in the experimental model of visceral obesity. Methods: M. oleifera ethanolic extract was orally administered at 600 mg/kg body weight in obese female rats daily for 12 weeks. At the end of treatment, body weight was deter-mined, and the atherogenic index, coronary artery index, glucose level, insulin resistance status, liver and kidney functions were assessed. Also, the mRNA of leptin, adiponectin and resistin in visceral adipose tissue was determined by quantitative real time-PCR. Results: The results showed that M. oleifera extract down-regulated mRNA expression of leptin and resistin, while it up-regulated adiponectin gene expression in obese rats relative to untreated obese control counterparts. This amelioration of genes expression was paralleled by a reduction in body weight and improvement of the atherogenic index and coronary artery index, as well as glucose level and insulin resistance value without adverse effects on liver or kidney functions, versus the untreated obese control ones. Conclusions: It is reasonable to assume that the anti-obesity, anti-atherogenic and anti-diabetic properties of M. oleifera are mechanistically achieved via working directly on the adipokines of the visceral adipose tissue. Therefore, M. oleifera may be a good thera-peutic candidate for the symptoms of metabolic syndrome.

Purpose:Sepsis is a common acute life-threatening condition that emergency physicians routinely face.Diagnostic options within the Emergency Department (ED) are limited due to lack of infrastructure,consequently limiting the use of invasive hemodynamic monitoring or imaging tests.The mortality rate due to sepsis can be assessed via multiple scoring systems,for example,mortality in emergency department sepsis (MEDS) score and sepsis patient evaluation in the emergency department (SPEED) score,both of which quantify the variation of mortality rates according to clinical findings,laboratory data,or therapeutic interventions.This study aims to improve the management processes of sepsis patients by comparing SPEED score and MEDS score for predicting the 28-day mortality in cases of emergency sepsis.Methods:The study is a cross-sectional,prospective study including 61 sepsis patients in ED in Suez Canal University Hospital,Egypt,from August 2017 to June 2018.Patients were selected by two steps:(1) suspected septic patients presenting with at least one of the following abnormal clinical findings:(a) body temperature higher than 38℃ or lower than 36℃,(b) heart rate higher than 90 beats/min,(c) hyperventilation evidenced by respiratory rate higher than 20 breaths/min or PaCO2 lower than 32 mmHg,and (d) white blood cell count higher than 12,000/μL or lower than 4000/μL;(2) confirmed septic patients with at least a 2-point increase from the baseline total sequential organ failure assessment (SOFA) score following infection.Other inclusion criteria included adult patients with an age ≥18 years regardless of gender and those who had either systemic inflammatory response syndrome or suspected/confirmed infection.Patients were shortly follow-up for the 28-day mortality.Each patient was subject to SPEED score and MEDS score and then the results were compared to detect which of them was more effective in predicting outcome.The receiver operating characteristic curves were also done for MEDS and SPEED scores.Results:Among the 61 patients,41 died with the mortality rate of 67.2％.The mortality rate increased with a higher SPEED and MEDS scores.Both SPEED and MEDS scores revealed significant difference between the survivors and nonsurvivors (p =0.004 and p ＜ 0.001,respectively),indicating that both the two systems are effective in predicting the 28-day mortality of sepsis patients.Thereafter,the receiver operating characteristic curves were plotted,which showed that SPEED was better than the MEDS score when applied to the complete study population with an area under the curve being 0.87 (0.788-0.963) as compared with 0.75 (0.634-0.876) for MEDS.Logistic regression analysis revealed that the best fitting predictor of 28-day mortality for sepsis patients was the SPEED scoring system.For every one unit increase in SPEED score,the odds of 28-day mortality increased by 37％.Conclusion:SPEED score is more useful and accurate than MEDS score in predicting the 28-day mortality among sepsis patients.Therefore SPEED rather than MEDS should be more widely used in the ED for sepsis patients.

Purpose: This study aims to explore the feasibility and implications of Ramadan fasting for patients who have undergone laparoscopic sleeve gastrectomy (LSG), assessing impacts on hydration, nutrient intake, weight management, and gastrointestinal symptoms. Methods: A prospective online survey was conducted among 218 LSG patients and 83 control individuals with obesity who had not undergone surgery. Participants were surveyed before and after Ramadan, providing data on fasting practices, hunger and satiety levels, fluid and nutrient intake, and the occurrence of gastrointestinal symptoms. Statistical analysis was used to compare outcomes between fasting and non-fasting periods and between LSG patients and control participants. Results: A total of 70.2% of LSG patients completed the entire month of Ramadan fasting, with a significant correlation found between the duration post-surgery and the ability to fast. Fasting LSG patients reported decreased hunger, increased satiety, and significant reductions in fluid and nutrient intake during Ramadan. Weight loss was reported in 90.8% of fasting patients, with an average total weight loss of 7.2%. Gastrointestinal symptoms were mild and manageable. Conclusion The majority of LSG patients can successfully fast during Ramadan with appropriate precautions, including adequate fluid and protein intake. The study highlights the need for patient education and tailored nutritional guidance to ensure safe and effective fasting post-LSG. In order to fast for the entire month, patients may be advised to consider postponing surgery for a few months after Ramadan, avoid overeating during non-fasting hours, and ensure sufficient fluid consumption and protein intake during fasting.

Ergonomic is important in classroom. Sitting for protracted period in class may lead students to develop musculoskeletal disorders. Their physical health and performance in the class may increase by designing school furniture that match with human body. In Malaysia, there is a lack of ergonomic assessment for school environment especially in urban areas. The aim of this study is to determine the mismatch between the furniture dimension and anthropometric parameters among primary school children in Putrajaya. This is a cross-sectional study which involved 100, Year 1 and Year 6 primary school students randomly selected in Putrajaya. Five anthropometric measurements (popliteal height, buttock popliteal length, elbow height, shoulder height (sitting), hip breadth) as well as five furniture dimensions (seat height, seat depth, seat width, backrest height and seat to desk height) were measured. Instrument used is Martin type anthropometer set, SECA body meter, and SECA weighing scale. Calculation for determining mismatch between the furniture and anthropometric measures were calculated using a standard mismatch formula. There was 100% mismatch for seat height, seat depth, and seat to seat to desk height for Year 1. As for Year 6, mismatch was reported 100% for backrest height and seat to desk height. There were significance difference for parameters of popliteal height between Year 1 and Year 6 and between male and female of Year 1. There was a presence of mismatch between furniture dimension and children anthropometric measurement. Proposed dimension of furniture shows decrease in percentage of mismatch for the most parameter of anthropometric measurement.

Objective: : Chiari III malformations are extremely rare hindbrain malformations that are associated with a high early mortality rate, or severe neurologic deficits in the survivors. The treatment is early operative closure and cerebrospinal fluid diversion (CSF) shunting. Methods: : We operated on 15 patients by repair and excision between July 2014 till June 2020 and retrospective data collection was done. Only one patient doesn’t need ventriculoperitoneal (VP) shunt and the other 14 patients need a VP shunt. We described stepwise dissection and untethering of the cerebellum from the bony edge to regrowth and herniation of cerebellum again into this potential space and simple dural closure or repair with graft was done. Results: : We started with VP in eight patients (53%) and the other seven patients (46.7%) started with excision and then six patients need VP shunt later on because four patients developed CSF leak and two patients developed increased high intracranial tension. Only four patients (26.7%) needed a blood transfusion. Conclusion : There are variations in the outcome and not all cases of Chiari malformation III will die and severe developmental delay is not a must. Proper management and repair carry a good prognosis.

Numerous health issues can arise from improper domestic waste management. Uncollected wastes provide food and breeding sites for insect, bird and rodent which can expose the community to vector borne disease. Therefore, this study aims to investigate the community awareness towards domestic waste management. This study is a cross-sectional study conducted at Bandar Baru Sungai Buloh, Selangor, Malaysia. The questionnaire consists of five sections with a total of 57 questions. The questionnaire consists of four parts: Socio-demographic, knowledge, attitude and practice. The data were analysed using SPSS version 22.0. T-test, ANOVA test, Chi-squared test were used according to the type of variables and significance level will be taken at 95% or p-value of less than 0.05. A total of 355 respondents participated in this study. The mean age was 40.52 ±14.94. The majority of them were male (52.1%), Malay (71.0%), married (71.3%), with secondary educational (81%) and employed (41.1%). The majority of respondents mentioned that inappropriate waste management can cause dengue fever and leptospirosis (98.0%, 97.2%; respectively). Property type, education, occupation, ethnicity, religions and household income were significant influenced the knowledge of the participants towards domestic waste management. For attitude, gender, education, ethnicity, religion and income significantly influenced the attitude of the participants towards domestic waste management. For practice, ethnicity, religion and occupation were significantly influenced the practice of the participants towards domestic waste management. In conclusion, the community has moderate awareness of domestic waste management. Awareness of waste management should also be taught in school so that the next generation of people will have a better understanding and eventually have better practice in domestic waste management. It is also hoped that a carefully thought-out strategy can be developed to further improve the community awareness towards domestic waste management which will shed a new light on tackling this issue.
Waste Management ; Health ; Knowledge ; Attitude ; Practice ; general population

Background: and Purpose Repetitive transcranial magnetic stimulation (rTMS) of the cerebellar hemisphere represents a new option in treating essential tremor (ET) patients. We aimed to determine the efficacy of cerebellar rTMS in treating ET using different protocols regarding the number of sessions, exposure duration, and follow-up duration. Methods: A randomized sham-controlled trial was conducted, in which 45 recruit patients were randomly allocated to 2 groups. The first (active group) comprised 23 patients who were exposed to 12 sessions of active rTMS with 900 pulses of 1-Hz rTMS at 90% of the resting motor threshold daily on each side of the cerebellar hemispheres over 4 weeks. The second group (sham group) comprised 22 patients who were exposed to 12 sessions of sham rTMS. Both groups were reassessed at baseline and after 1 day, 1 month, 2 months, and 3 months using the Fahn-Tolosa-Marin tremor-rating scale (FTM). Results: Demographic characteristics did no differ between the two groups. There were significant reductions both in FTM subscores A and B and in the FTM total score in the active-rTMS group during the period of assessment and after 3 months (p=0.031 and 0.011, respectively).However, subscore C did not change significantly from baseline when assessed at 2 and 3 months (p=0.073 and 0.236, respectively). Furthermore, the global assessment score was significantly higher in the active-rTMS group (p>0.001). Conclusions Low-frequency rTMS over the cerebellar cortex for 1 month showed relative safety and long-lasting efficacy in patients with ET. Further large-sample clinical trials are needed that include different sites of stimulation and longer follow-ups.