Aging/*physiology ; *Biocompatible Materials ; Bone Regeneration/physiology ; Bone Remodeling/physiology ; Facial Bones/physiopathology ; Facial Bones/*surgery ; Maxillofacial Development/*physiology ; *Prostheses and Implants

Distant metastasis is a common sequelae of stage III colorectal adenocarcinoma. Liver and lungs are the most common sites for distant metastases, but, metastases to extremities are very rare. We report a case of rectosigmoid adenocarcinoma, which metastasizes to left first metacarpal bone, which is the first occurrence in our experience. The investigations and management of the patient are discussed.

Intraoperative active warming in daycare surgery may be least popular compared to major elective surgeries due to the lesser risk of perioperative hypothermia. This prospective, single blind, randomized, controlled trial in daycare breast lumpectomy was done to evaluate the routine use of intraoperative forced-air warmer in the presence of other warming modalities in prevention of perioperative hypothermia. Fifty patients were randomized into two groups; Group 1 received forced-air warmer and Group 2 received a standard cotton thermal blanket. Both groups received circulating-water mattress. Intraoperatively, all patients received pre-warmed intravenous fluid with an in-line warmer. Ear and ambient temperature was recorded using infrared ear thermometer and digital thermo-hygrometer respectively. Measurement was done before induction, every 15 minutes intraoperatively, upon arrival in recovery room and 30 mins later, postoperatively. All patients were normothermic prior to induction of anaesthesia. During the initial half an hour post-induction, both groups mean core temperature decreased at approximately 0.5˚C. Both showed no statistical difference in mean core temperature (0.04 ˚C) within the initial half an hour. The next half an hour, both groups had approximately 0.2˚C decrement but this time, Group 2 had a slightly higher mean core temperature than Group 1 which maintained until the end of surgery. Overall, within the initial one hour postinduction of GA, there was a drop of 0.7˚C and 0.6°C in Group 1 and Group 2 respectively, however the difference in final mean core temperature between the two groups was 0.05°C and it was not statistically significant (p value < 0.05). None of the patients experienced intraoperative hypothermia (< 36˚C) and all remained in the normothermic range with no shivering or sense of feeling cold, postoperatively. The results of the present study found no significant difference in the changes of final core temperature with or without the usage of intraoperative forced-air warmer in the presence of other warming measures in daycare breast lumpectomy.
Mastectomy, Segmental

Communicable Diseases, Emerging/epidemiology/prevention & control ; Developing Countries ; Disease Outbreaks/prevention & control ; Gastrointestinal Diseases/*epidemiology/prevention & control ; Humans ; Hygiene ; Papua New Guinea/epidemiology ; *Public Health ; Sanitation ; Water Supply

Cholera is a severe diarrhoeal illness caused by infection with the bacterium Vibrio cholerae. From July 2009 to late 2011 Papua New Guinea (PNG) experienced thefirst outbreak of cholera ever reported in this country. During this time > 15,000 cases of cholera were reported, resulting in approximately 500 deaths. The origin of this outbreak is unknown, but considering the remote location of the initial outbreak an infected international traveller is unlikely to be the source. In this paper we review the characteristics of the PNG cholera outbreak and discuss the ongoing threat of cholera to the country and the region.
Cholera/*epidemiology ; *Disease Outbreaks ; Female ; Humans ; Male ; Papua New Guinea/epidemiology ; Risk Factors

Respiratory infections are a major health burden for the people of Papua New Guinea (PNG) who are positive for human immunodeficiency virus (HIV). In the face of an ongoing HIV epidemic, little is known about the epidemiology and aetiology of respiratory infections in people living with HIV in PNG. In this article we provide an overview of the most important respiratory pathogens in HIV-positive people globally, focusing primarily on adults. Particular attention is given to respiratory viruses, bacterial pathogens such as Streptococcus pneumoniae and Mycobacterium tuberculosis, and Pneumocystis jiroveci. In doing so we highlight the need for a better understanding of the aetiology of respiratory infections in HIV-positive people in PNG. A study is underway that aims to determine the aetiology of common infectious illnesses in HIV-positive people in PNG, focusing on respiratory infections, diarrhoeal diseases and febrile illness. The results of this study should guide future prevention, diagnostic and treatment strategies.

A nasopharyngeal (Tornwaldt’s) cyst is uncommon. It is often asymptomotic; however it may cause problem if it too big becomes. We present a case of a 24-year-old Malay girl who had been a habitual snorer for years but was unaware of the significance of her problem. Opportunities for an earlier referral and assessment were missed since we were not aware of her history despite previous related but non-specific consultations at our primary healthcare centre. She was referred to us a few years later when her nasopharyngeal cyst became infected. After a course of antibiotics, she proceeded with an endoscopic resection of the nasopharyngeal cyst. A follow-up visit six months later did not reveal a recurrence. This case highlights the importance of a good history for the diagnosis of a nasopharyngeal cyst.

Children who are born in a community with insufficient micronutrients, particularly iodine in remote rural areas are associated with low intellectual functions and mental retardation. The aim of this cross-sectional study is to determine the mental performance of the schoolchildren in Bario, a highland settlement of the Kelabit people in the district of Baram, Sarawak and to determine its correlation with the availability of iodine in the environment, as well as other micronutrients such as selenium, copper and manganese. A total of 25 schoolchildren in Bario age ranging from 7 to 12 years old participated in the study. Mental performance of the schoolchildren were tested using TONI-2 (Test of Nonverbal Intelligence--second edition), a cognitive ability measures with a response format which eliminates language and reduces motoric and cultural factors. The iodine levels from several wells, soils and salt found in Bario were determined using HPLC (software version 3.05.01) whilst serum levels of selenium, copper and manganese were measured using Graphite Furnace Atomic Absorption Spectrophotometer (GFAAS). The results showed that the median and mode scores of intelligence quotient for Bario were 82 and 75, respectively, whilst median and mode scores of intelligence percentile were 11.0 and 5.0, respectively. The maximum score achieved were at the average level with the quotient score between 90-110. It was found that salt produced from one of the wells in Bario contained high quantity of iodine. Based on standards established by the Trace Elements Laboratory, Roben Institute, University of Surrey, United Kingdom, schoolchildren in Bario are having sufficient blood levels of copper and a high selenium and manganese levels. Despite the remoteness of the study area, the schoolchildren in Bario, Sarawak showed higher mental performance compared to other isolated areas. This is probably correlated with the high micronutrients availability, particularly iodine, found naturally in Bario.
Cross-Sectional Studies ; Iodine/*blood ; Malaysia ; *Mental Processes ; Micronutrients/*blood ; Soil/*analysis ; Water/*analysis