A 28-year-old G3P1+1 at 6 weeks period of amenorrhea with a previous Caesarean section presented with per vaginal bleeding. A cervical ectopic pregnancy was confirmed by a transvaginal scan. An intramuscular methotrexate was given followed by intracervical route due to poor decline of the serum βHCG. However, due to persistent increment of serum βHCG, an additional four doses of intramuscular methotrexate with folinic acid rescue were administered and she responded well to the regime. Unfortunately, following the last dose, she developed an episode of excessive per vaginal bleeding which required suction and curettage of the cervical canal. A Foley‘s catheter balloon was placed intracervically as a tamponade and the bleeding was successfully arrested.

g <3> ; Evaluation ; brushin ; Cellular aspects of

We present a case of a four-year-old boy who succumbed to diphtheria following incomplete course of immunisation, which included diphtheria vaccine. This case report focuses on the issues of parental refusal to vaccines and the development of "halal" vaccines for the prevention of infectious diseases.

The anti-malarial potential of different parts of Allophylus africanus P. Beauv and Tragia benthamii Baker were determined in vivo for suppressive, curative and cytotoxic activities in mice receiving 0.2 mL of a standard inoculum size of 1 × 10(7) infected erythrocytes of Plasmodium berghei (NK-65) intraperitoneally. The A. africanus extracts suppressed parasitaemia following administration to infected mice by 92.82%-97.81% on day 7 post-infection against 96.81% for chloroquine. The infected extract-treated animals had significantly moderate (P < 0.05) packed cell volume (PCV) compared with the infected, untreated animals. Phytochemical screening revealed a predominance of tannins, saponins, flavonoids and carbohydrates in all parts of A. africanus, and alkaloids instead of flavonoids in the extract of T. benthamii. The results suggest that the extract possesses considerable antimalarial activity. These results support further studies on A. africanus.
Animals ; Antimalarials ; administration & dosage ; chemistry ; Drug Evaluation, Preclinical ; Euphorbiaceae ; chemistry ; Female ; Humans ; Malaria ; drug therapy ; parasitology ; Male ; Mice ; Plant Extracts ; administration & dosage ; chemistry ; Plasmodium berghei ; drug effects ; Sapindaceae ; chemistry

Mastoid lymph node inflammation is a rare entity. Pathological conditions in the vicinity of the mastoid processes can be challenging for maxillofacial head-neck surgeons to address. We report a case of suppurative mastoid lymphadenitis in an 18-year-old Caucasian male. To our knowledge, there are no publications that highlight the clinical, ultrasonographic, intra-, and postoperative data for any pathologic process that presented as mastoiditis.

Early detection of a dengue outbreak is an important first step towards implementing effective dengue interventions resulting in reduced mortality and morbidity. A dengue mathematical model would be useful for the prediction of an outbreak and evaluation of control measures. However, such a model must be carefully parameterized and validated with epidemiological, ecological and entomological data. A field study was conducted to collect and analyse various parameters to model dengue transmission and outbreak. Dengueprone areas in Kuala Lumpur, Pahang, Kedah and Johor were chosen for this study. Ovitraps were placed outdoor and used to determine the effects of meteorological parameters on vector breeding. Vector population in each area was monitored weekly for 87 weeks. Weather stations, consisting of a temperature and relative humidity data logger and an automated rain gauge, were installed at key locations in each study site. Correlation and Autoregressive Distributed Lag (ADL) model were used to study the relationship among the variables. Previous week rainfall plays a significant role in increasing the mosquito population, followed by maximum humidity and temperature. The secondary data of rainfall, temperature and humidity provided by the meteorological department showed an insignificant relationship with the mosquito population compared to the primary data recorded by the researchers. A well fit model was obtained for each locality to be used as a predictive model to foretell possible outbreak.

A simple, accurate and sensitive high-performance liquid chromatography (HPLC) method was developed, validated and applied to the determination of either theophylline or paracetamol in milk-based samples. The method allowed drug quantification in fresh and powdered milk with a relatively short run time of analysis and it was also successfully applied to the quantification of the drugs in solid dosage forms intended for pediatric use. Moreover, the main significant advantages over other published works are the simplicity of the sample preparation, reduced assay time and sample loss. The method meets the International Conference on Harmonization guideline for analytical methods validation regarding specificity,linearity,accuracy,precision, specificity and robustness as required by health authorities and applied by industry while designing and marketing new drug products.The technique encompasses the separation of the analytes with a reverse phase C18column under isocratic conditions and UV detection at 272 nm and 243 nm,respectively,for theophylline and paracetamol. The lower limit of quantification for both drugs was determined as 0.2μg/mL and the between-batch accuracy was 99.7%.This HPLC method allows quantification of theophylline and paracetamol in milk matrices and it can be applied in the design,development and production of milk-based pediatric dosage forms.

No abstract available.
Adult ; Aged ; Child ; Female ; Herpes Genitalis/diagnosis* ; Human ; Infant, Newborn ; Keratitis, Dendritic/diagnosis* ; Male ; Middle Age ; Risk ; Support, U.S. Gov't, P.H.S.

OBJECTIVES: This study was intended to investigate the differences of job stressors between managers and low level employees among white-collar workers. Another objective of this study was to examine whether the effects of job stressors on mental health differ between the two groups. METHODS: Data was obtained from 204 managers and 251 low level employees who were employed in white-collar jobs. Fourteen job stressors and seven job stress variables were measured. RESULTS: Among the 14 job stressors, role overload, job insecurity, and work-family conflict were higher job stressors for the manager group whereas role conflict, work-aptitude incongruity, participation in decision making, and promotion problems were higher job stressors for the low level of employees. There were no differences in job stress scores between the two groups. However, differences in the effects of job stressors on job stress were found between the two groups. For the manager group, job insecurity, work-aptitude incongruity, and work-family conflict significantly affected in explanation of job stress whereas for the low level employees, role underload, peer satisfaction, and environmental problems significantly explaining the job stress variables. CONCLUSIONS: There were significant differences in job stressors between managers and low level employees among white-collar workers. Additionally there were differences in the effects of job stressors on job stress between the two groups.
Decision Making ; Mental Health

Although stress among nursing staff is common, adopting effective coping styles helps in minimizing the problem. The objectives of this study were to compare stress level among nursing staff working in the above disciplines, to identify common coping style used and to determine the relationship between stress and coping styles. This cross-sectional study involved 106 nursing staff who were universally sampled from psychiatric wards and emergency departments in two public hospitals in the Klang Valley. Self-rated questionnaires i.e. Stress Arousal Checklist (SACL) and Coping inventory for Stressful Situations (CISS) were used to assess stress levels and coping styles respectively. There was insignificant difference in terms of stress level between the two nursing staffs. Stress dimension of SACL between the psychiatry (6.53 + 3.18, p=0.372) and emergency (6.02 + 2.67, p=0.372) nursing staffs were insignificant. Arousal dimension of SACL was also insignificant between psychiatry (8.60 + 1.70, p=0.372) and emergency (9.19 + 1.61, p=0.07) nursing staff. Task coping was the most commonly used coping styles among the psychiatry (55.36 + 9.85) and emergency (57.73 + 9.87) nursing staff in this study. Stress dimension of SACL showed weak significant relationship with task coping (r=-0.313, p=0.001) and emotion coping (r=0.292, p=0.001). Arousal dimension of SACL was also found to have weak significant relationship with task coping (r=0.271, p=0.003) and emotion coping (r=-0.251, p=0.005). While nursing was found to be a stressful profession, a significant relationship between stress and coping styles allows intervention to enable better adaptation to the stressful working environment.