Rupture of one or more cardiac chambers following domestic blunt chest trauma is rare. A positive outcome depends on high level of suspicion and early surgical intervention. We report here an interesting case of a ruptured right atrial appendage in a four year old boy following a blunt crushing injury to the chest and abdomen by a heavy porcelain sink which was successfully repaired. Therefore, accurate diagnosis is very important for appropriate management.

INTRODUCTIONThe purpose of the study was to examine the determinants of self-reported disability - MODQ (Modified Oswestry Low Back Pain Disability Questionnaire) in patients with low back pain (LBP); and to examine the level of FABQ (Fear-Avoidance Belief Questionnaires) scores in an ambulatory clinical population referred to physiotherapy management. We believe that identifying potentially modifiable determinants of disability in patients with LBP provides an opportunity to broaden the strategies to reduce its socioeconomic burden.

MATERIALS AND METHODSA retrospective study was designed to be conducted in the physiotherapy department of a local hospital. The data were taken from standard examination of patients [n = 162, female 15.4%, male 84.6%, age mean = 30.6 years [standard deviation (SD), 11.4; range, 17 to 68)] presenting to the department with acute or chronic LBP. The data included physical examination of back, self-reported disability by MODQ, fear-avoidance beliefs by FABQ, pain intensity and demographic information.

RESULTSThe final model generated by hierarchical regression analysis revealed that MODQ scores included self-reported symptom aggravation with all movements, pain medication usage, average straight leg raise (SLR), pain intensity, and Fear-Avoidance Belief Questionnaire-Work (FABQ-W). Overall, these variables account for approximately 40% of variance. The mediational analysis indicated that the relationship between the FABQ-W and MODQ scores may be partially mediated by pain intensity, average SLR values and pain medication usage.

CONCLUSIONIn this correlational study of physical impairments, psychosocial factors and self-reported disability, disability was driven primarily by measures of pain and fear-avoidance beliefs. Because the FABQ is a simple and useful clinical tool, we suggest that physicians and physiotherapists alike should make it a routine attempt to characterise the fear-avoidance beliefs of patients with LBP.

Adolescent ; Adult ; Aged ; Disability Evaluation ; Fear ; psychology ; Female ; Health Knowledge, Attitudes, Practice ; Health Status Indicators ; Health Surveys ; Humans ; Low Back Pain ; physiopathology ; psychology ; Male ; Middle Aged ; Pain Measurement ; Retrospective Studies ; Surveys and Questionnaires ; Work Capacity Evaluation

Humans ; Male ; Practice Guidelines as Topic ; Prostatectomy ; standards ; Prostatic Neoplasms ; surgery

Objective: To study the occurrence of insects fauna obtained in a semi forested area in Malaysia using the carcass of the monkey Macaca fascicularis, Raffles, and to compared the wave of insect succession collected from the carcass placed outdoor and indoor. Methods:The outdoor and indoor studies were conducted at a location of 3o17’57.86”N, 101o47’00.78”E. The euthanized monkeys were placed indoor and outdor. The insect seccession visited the carcass, the envirenmental temperature and relative humidity were recorded. Results:The main insects attracted to specific stages of decomposition were mainly members of Diptera and Coleoptera. There was a delay of fly arrival by two days in indoor carcass. Nocturnal oviposition behaviour was not observed in this study. The flies left the carcass during the twilight zone as noted during a 3 days observation period in outdoor study. The dipteran species found outdoor and indoor were similar but more diverse coleopteran species was found indoor. Conclusions:Information and evidence from this study can be used to improve the estimation of the post mortem interval in forensic cases.

INTRODUCTIONMental illnesses are not only a growing public health concern but also a major social and economic issue affecting individuals and families throughout the world. The prevalence of mental disorders, the extent of disability caused by these disorders, and services utilisation of these patients has been well studied in developed countries. The aim of this study was to establish the prevalence of select mental disorders and their associated sociodemographic correlates in the adult Singapore resident population.

MATERIALS AND METHODSThis was a cross-sectional, populationbased, epidemiological study of adult Singapore residents aged 18 years and above. The subjects were randomly selected using a disproportionate stratified sampling method. The diagnoses of selected mental disorders including major depressive disorder (MDD), dysthymia, bipolar (bipolar I & II) disorders, generalised anxiety disorder (GAD), obsessive compulsive disorder (OCD), alcohol abuse and alcohol dependence were established using the Composite International Diagnostic Interview, which is a fully structured diagnostic instrument that assesses lifetime and 12-month prevalence of mental disorders.

RESULTSAmong the 6616 respondents (response rate of 75.9%), 12.0% had at least one lifetime affective, anxiety, or alcohol use disorders. The lifetime prevalence of MDD was 5.8% and that of bipolar disorder was 1.2%. The combined lifetime prevalence of the 2 anxiety disorders, GAD and OCD was 3.6%, with the latter being more common than GAD (0.9% and 3.0% respectively). The lifetime prevalence of alcohol abuse and dependence were found to be 3.1% and 0.5% respectively. Age, gender, ethnicity, marital status and chronic physical illnesses were all significant correlates of mental disorders.

CONCLUSIONThe identified associated factors would help guide resource allocation, policy formulation and programme development in Singapore.

Adolescent ; Adult ; Aged ; China ; ethnology ; Cross-Sectional Studies ; Female ; Health Surveys ; Humans ; India ; ethnology ; Malaysia ; ethnology ; Male ; Mental Disorders ; classification ; diagnosis ; epidemiology ; ethnology ; Middle Aged ; Risk Assessment ; Singapore ; epidemiology ; Young Adult

No abstract available.
Chorea ; Creutzfeldt-Jakob Syndrome

Objective: Converging evidence suggests that intestinal inflammation is involved in the pathogenesis of neurodegenerative diseases. Previous studies on fecal calprotectin in Parkinson’s disease (PD) were limited by small sample sizes, and literature regarding intestinal inflammation in multiple system atrophy (MSA) is very scarce. We investigated the levels of fecal calprotectin, a marker of intestinal inflammation, in PD and MSA. Methods: We recruited 169 subjects (71 PD, 38 MSA, and 60 age-similar nonneurological controls). Clinico-demographic data were collected. PD and MSA were subtyped and the severity assessed using the MDS-UPDRS and UMSARS, respectively. Fecal calprotectin and blood immune markers were analyzed. Results: Compared to controls (median: 35.7 [IQR: 114.2] μg/g), fecal calprotectin was significantly elevated in PD (median: 95.6 [IQR: 162.1] μg/g, p = 0.003) and even higher in MSA (median: 129.5 [IQR: 373.8] μg/g, p = 0.002). A significant interaction effect with age was observed; between-group differences were significant only in older subjects (i.e., ≥ 61 years) and became more apparent with increasing age. A total of 28.9% of MSA and 18.3% of PD patients had highly abnormal fecal calprotectin levels (≥ 250 μg/g); however, this difference was only significant for MSA compared to controls. Fecal calprotectin correlated moderately with selected blood immune markers in PD, but not with clinical features of PD or MSA. Conclusions Elevated fecal calprotectin suggests a role for intestinal inflammation in PD and MSA. A more complete understanding of gut immune alterations could open up new avenues of research and treatment for these debilitating diseases.