Introduction: The accuracy of image interpretations of CT and MRI studies is absolutely dependent on the quality of the images produced. Motion artifacts which result from the patients' movement during image acquisitions may lead to misinterpretation, wrong diagnosis or inconclusive examinations. In pediatric age groups, most of CT and MRI examinations require sedation or general anesthesia to achieve the degree of cooperation or immobilisation to complete the procedures successfully. Methods: The patients were randomly chosen among children, from newborn to 12 years of age who underwent sedation and general anesthesia for CT scan and and MRI in the University of Malaya Medical Centre between September 2001 and August 2003. The quality of MRI and CT images were evaluated by radiologists using a three-point scale: 1-no motion artifact; 2-minor motion artifacts and 3-major motion artifacts. Results: Among sedated children, 75.5% and 41% had good CT and MRI images respectively. In general, the anesthesia group, 100% had good CT images and 85.7% had good MRI images. Children who received sedation (33.5%) had severe motion artifacts whereas none of the anesthetised children had severe motion artifacts. Conclusion: General anesthesia is much better for good quality images in both MRI and CT examinations; however it is associated with a higher cost and longer hospital stay. Combination of oral chloral hydrate and intravenous midazolam was found to be the most effective sedative agent in terms of CT/MRI image quality.

Osteolytic disease of the bones have a myriad range of aetiology. One rare cause is Gorham’s disease or disappearing bone disease. This disease is a diagnosis by exclusion using correlation made with clinical presentation, radiological findings and histopathological confirmation. Although many different therapies have been advocated, none have been successful in fully controlling this disease. We present a case that was detected in a Chinese lady using diagnostic imaging, confirmed with computed tomography guided biopsy and successfully treated with joint reconstruction using endoprosthesis.
Osteolysis, Essential

Dengue is a serious mosquito borne disease common in tropical and sub-tropical countries including Malaysia. There is at present a lack of specific treatment and an effective tetravalent vaccine against dengue. The control of dengue depends solely on the suppression of the two most important vectors namely, Aedes aegypti and Ae albopictus. Despite intensive and extensive control efforts by health agencies, the disease continues to spread. This paper updates various innovations on control of dengue vectors. Gene-based sterile insect technique using the RIDL technology for both Aedes aegypti & Ae albopictus control has now been actively researched and field trials are pursued to evaluate the effectiveness of the technology. The release of Wolbachia-infected Ae aegypti is another dengue control innovation. The infected mosquito cannot support development of dengue virus and has shorter life span. Other innovations include: auto-dissemination of insect control agents using ovitrap, autocidal adult and larva trap, outdoor residual spraying, insecticidal paint and biocontrol agent. In other innovation, outbreak prediction capability is enhanced by developing model based on environmental data and analysis utilising neural network.

Exclusive breastfeeding (EBF) is very crucial for the health of infant as well as mother. However, the prevalence ofexclusive breastfeeding is very low especially among working mother. Since the prevalence of EBF might be influenced bythe level of knowledge on EBF, researcher comes to critical thinking to conduct this study to evaluate level of knowledgeon EBF among working mother. A cross sectional design study was carried out to determine knowledge level on exclusivebreastfeeding among working mother, and its relationship with demographic data in Hospital Canselor Tuanku Muhriz(HCTM). A total 283 respondents were recruited to participate in this study. The respondents’ knowledge level on exclusivebreastfeeding was identified using Kim & Chapman (2013) Questionnaire on Knowledge and Practice about ExclusiveBreastfeeding. The result showed that majority of the respondents (56.9%) had high knowledge on exclusive breastfeeding.For demographic data, factors such as age, level of education, and family income had shown a significant association (p< 0.05) with level of knowledge on exclusive breastfeeding. In conclusion, the level of knowledge of EBF was identifiedamong working mother, yet it has been influenced by mother’s sociodemographic background.

Acute ptosis due to preseptal cellulitis requires urgent medical attention, as the infection can extend posteriorly into the orbit, leading to significant visual and cerebral complications. We report a case of a 58-year-old woman with uncontrolled diabetes mellitus presenting with acute ptosis due to preseptal cellulitis. After initial resolution of fever with intravenous amoxicillin-clavulanate, she experienced a seizure due to cerebral abscess a week later and was treated with intravenous ceftriaxone. Preseptal cellulitis is usually treated on an outpatient basis with oral antibiotics, as it rarely extends posteriorly to cause cerebral complications. We wish to highlight the importance of admitting patients with preseptal cellulitis in patients with uncontrolled diabetes for intravenous antibiotics due to the potential for visual and cerebral complications.

In the practice of forensic entomology, the chronological age of the maggots retrieved from the cadaver is used to determine the minimum post-mortem interval (mPMI) i.e. minimum time of death. The conventional method of aging the maggots is based on measuring the growth rate of these maggots. Although effective, the constraint associated with conventional method necessitates the development of new age determination method, such as pteridine determination. Pteridine, a by-product of protein metabolism in insects is known to correlate with the age of a variety of dipterans. A number of studies were conducted on aging the adults of forensically important flies. In this study, pteridine was extracted from Chrysomya megacephala and Chrysomya rufifacies maggots of known age using established methods and determined by measuring the fluorescence at excitation of 330nm and the emissions between 350nm and 600nm. Results exhibited significant positive linear relationships between the pteridine accumulations and age of the fly immature. Pteridine determination is a potential new age determination tool that can be used to determine mPMI.

Aims: Maternal vaginal Group B Streptococcus (GBS) colonization is considered a risk factor for preterm delivery and, consequently, neonatal infections. Previous studies have portrayed the important roles of these virulence factors, including hemolytic pigment, hyaluronidase (HylB), serine-rich protein (Srr) and bacterial surface adhesion of GBS (BsaB) in mediating GBS colonization and intrauterine ascending infection, causing preterm delivery. This study aimed to investigate the association between mRNA expression of virulence genes in GBS isolates obtained from symptomatic pregnant women and preterm delivery. Methodology and results: GBS isolates were obtained from high vaginal swabs of 40 symptomatic pregnant women of gestational age of less than 37 weeks. RNA was extracted from these GBS isolates and RT-qPCR was performed to determine the relative mRNA expression of GBS virulence genes, including CylE (encode enzyme required for the biosynthesis of the hemolytic pigment), HylB, Srr-1 and BsaB. Socio-demographic details and obstetric history were not found to be associated with the delivery outcomes of these women. The GBS isolates from symptomatic pregnant women who delivered prematurely showed a higher expression of CylE gene and a trend towards an elevated expression of HylB gene compared to women with term delivery. Meanwhile the expression of both Srr-1 and BsaB genes was similar between symptomatic pregnant women who had term or preterm delivery. Conclusion, significance and impact of study The results suggest that following vaginal colonization, both CylE and HylB genes are likely to contribute to intrauterine ascending infection and inflammation, leading to preterm delivery in humans. These virulence factors may be targeted for the pre-clinical stages of vaccine development or therapeutic intervention.
Streptococcus agalactiae--isolation & ; purification ; Pregnant Women