This is a cross-sectional study which investigated the association between non-exclusive breastfeeding and maternal, paternal, obstetric and infant factors. Data on maternal, paternal, obstetric and infant factors were collected through face-to-face interview using a structured questionnaire from 498 mothers with four-week-old infants who attended government clinics in Klang district between 17 and 28 July 2006. The prevalence of non-exclusive breastfeeding at four weeks was 45.8%. Factors significantly associated with non-exclusive breastfeeding at four weeks included Indian ethnic mother (OR = 4.06), working mother (OR = 3.55), mother from high household income (OR = 1.90), mother who smokes (OR = 7.27), primiparous (OR = 1.97), infant not sharing a bed with mother (OR = 1.75) and infant born prematurely (OR = 7.69). Identification of risk factors should assist in targeting women who are at increased risk of non-exclusive breastfeeding.

This was a cross-sectional study which attempts to assess the effectiveness of the 18- hour lactation management course organised by Klang District Health Office for its health staff. The course was conducted for three days from 19 to 21 September, 2006 with a total of 18 hours, comprising 15 hours of lectures and three hours of supervised clinical experience. There were a total of 46 participants for the course. The pre- and post-test scores of the participants from the course were used for analysis. This study showed that the mean pre-test versus mean post-test scores were 12.63 and 19.87. The difference in the mean score was statistically significant (p < 0.001, 95%CI -8.285, -6.193). The difference was significant for the staff nurse, community nurse and assistant nurse but not for doctors. In conclusion, the 18-hour duration lactation management course was effective at improving the knowledge and skills on breastfeeding management for the health staff.

The JXA area of the AVF is often best treated as a unit, and JXA stenting achieves good short and medium term patency rates. Ultrasonography follows up enable us to pick up problematic fistula but it reduces Primary patency rate. Long term result of JXA stenting need to be followed up.

Introduction: The aims of this study were to determine the proximate composition, functional properties and antioxidant activity of pumpkin seeds and rind. Besides, the effects of dietary fibre in pumpkin seeds and rinds on bread qualities and properties were evaluated. Methods: Formulations for bread substituted with 0%, 5% and 10% pumpkin seed and rind, respectively were produced. Sensory evaluation of the prepared bread samples for such attributes as appearance, aroma, flavour, texture and overall acceptability was undertaken. The physical properties of the bread samples, including dough expansion, loaf volume, crumb colour and bread texture, were determined. Proximate analysis and determination of antioxidant activity of the bread samples were also conducted. Results: Crude fibre of the pumpkin seeds and pumpkin rinds was high at 31.48% and 14.83%, respectively. The total phenolic compound (TPC) and DPPH radical scavenging activity for the pumpkin rinds were 38.60 mg GAE/ 100 g dry weight and 69.38%, respectively, which were higher than those of pumpkin seeds. A 5% level of pumpkin rind bread gave the best overall acceptability and sensory attributes, followed by 5% pumpkin seed bread. Total dietary fibre, total phenolic compound and DPPH radical scavenging activity in breads substituted with 5% pumpkin seed and 5% pumpkin rind flour were higher than the values in control bread. Conclusion: Pumpkin seeds and rinds can be used as dietary fibre sources in bakery.

An infected pre-auricular sinus presenting as a post-auricular swelling is commonly misdiagnosed as an infected dermoid or sebaceous cyst. It may even mimic a mastoid abscess leading to further unwarranted investigations and interventions. We present a case of a 25-year-old Malay man who was initially diagnosed with recurrent infected dermoid cyst. At presentation, a right post-auricular inflamed swelling was noted with an overlying old incision and drainage scar. An auricular pit was found at the crus of helix. Using a blunt probe inserted along the sinus tract pus was drained without the need for further surgical incision. Six weeks after the acute episode, patient underwent excision of the pre-auricular sinus with no evidence of recurrence at three months follow up. Awareness by the attending physician of this ‘variant type’ of pre-auricular sinus at patient’s first presentation may negate the need for unnecessary incision and drainage which may subsequently impact the outcome of surgical excision and reduce the risk of recurrence.

Introduction: In order to overcome the stability problems of oils and fats, synthetic antioxidants such as butylated hydroxyanisole (BHA), butylated hydroxytoluene (BHT) and tert-butyl hydroquinone (TBHQ) have widespread use as food additives in many countries. Recent reports reveal that these compounds may be implicated in many health risks, including cancer and carcinogenesis. Hence, there is a move towards the use of natural antioxidants of plant origin to replace these synthetic antioxidants. Methods: In this study, roselle seed oil (RSO) and extract (RSE) were mixed with sunflower oil, respectively to monitor degradation rate and investigate antioxidant activity during accelerated storage. Results: The antioxidant activity was found to stabilise sunflower oil of various samples and in the order of RSE>RSO>tocopherol>sunflower oil. The total percentage increased after 5 days of storage period in free fatty acid (FFA), peroxide value (PV) and anisidine value (AV). Total oxidation value (TOx) of sunflower oil supplemented with 1500 ppm RSE was 33.3%, 47.7%, 14.5%, and 45.5%, respectively. While the total percentage increased under different analysis methods, sunflower oil supplemented with 5% RSO was 17.2%, 60.4%, 36.2% and 59.0% in the order of FFA, PV, AV and TOTOX. Both RSO and RSE were found to be more effective in stabilisation of sunflower oil compared to tocopherol. Total phenolic content of RSE was 46.40 ± 1.51 mg GAE/100g of oil while RSO was 12.51 ± 0.15 mg GAE/100g of oil. Conclusion: The data indicates that roselle seed oil and seed extract are rich in phenolics and antioxidant activities and may be a potential source of natural antioxidants.

Patients with extensive malignancies involving the femur often require total femoral replacement when their limbs can be salvaged. Reported series are small and involve heterogeneity of tumours. We present nine patients with osteosarcomas of the femur treated at our institution between 2003 and 2010 with a mean follow-up of 27 (6 to 56) months. Their ages ranged from 9 to 17 (mean 14 years). They had large volume tumours (mean 911 cm3 ) and presented late with a mean of 5.5 months from the onset of symptoms to definitive treatment. All patients underwent resection and total femur replacement. Six patients have died and two are alive with good function at the time of this report. One was lost to follow-up. These patients require a high level of treatment care and have a guarded prognosis
Osteosarcoma

The sintering behaviour of synthesized HA powder that was calcined at various temperatures ranging from 700 degrees C to 1000 degrees C was investigated in terms of phase stability, bulk density, Young's modulus and Vickers hardness. The calcination treatment resulted in higher crystallinity of the starting HA powder. Decomposition of HA phase to form secondary phases was not observed in all the calcined powders. The results also indicated that powder calcination (up to 900 degrees C) prior to sintering has negligible effect on the sinterability of the HA compacts. However, powder calcined at 1000 degrees C was found to be detrimental to the properties of sintered hydroxyapatite bioceramics.