Introduction: Staphylococcus aureus is the leading biofilmforming microorganisms in orthopaedic implant infections. The biofilms formed are difficult to eradicate and resistance to antibiotics. This current study aims to determine the effectiveness of povidone-iodine; an antiseptic solution in eradicating S. aureus biofilm on stainless steel alloy. In addition to the usual Colony-Forming Unit (CFU) used for verification, Scanning Electron Microscope (SEM) is used to validate the formation and eradication of the biofilms. Materials and methods: This is an in vitro study where the biofilm is formed by inoculating clinically isolated S. aureus, incubated for 24 hours onto stainless steel alloy 316L implants. The implants are then irrigated using povidoneiodine solution with varying concentrations (5 and 10%) and durations (30, 60, and 180 seconds). The anti-biofilm effect was evaluated using plating and SEM methods to confirm its effectiveness. The process is repeated after 24 hours of postirrigation reincubation to detect any rebound growth. Results: No biofilm seen after irrigation with povidoneiodine at 5% and 10% concentrations at 30, 60 and 180 seconds, respectively, in both CFU count and SEM. This result is replicated after 24 hours of reincubation, in assessing for rebound growth. Conclusion: Our study supports that a minimum of 5% povidone-iodine with a minimum irrigation time of 30 seconds are effective at eliminating S. aureus biofilm on stainless steel alloy implants. Both CFU count and SEM yield similar value in validating the presence of biofilm. Additionally, SEM allows visualisation of the morphology of the biofilm.

Dengue remains a public health threat that consumes a significant number of resources for its prevention and control. This systematic review aimed to solidify recent costing evidence in dengue management among South East Asian (SEA) countries. All studies conducted between 2010 and 2020 were retrieved using four international databases i.e. PubMed, Scopus, Web of Science, and Emerald Insight. The review was reported according to PRISMA guidelines. Quality assessments were done independently by two reviewers using a checklist adapted for the cost of illness studies. We identified 13 original articles representing several SEA countries. Among the common reported costing measure include total cost/ health expenditure; direct medical cost; direct non-medical cost; and indirect cost. The estimated total cost for dengue management varied between countries largely due to the difference in the total incidence of dengue cases. The estimated cost spent on dengue per capita GDP ranges from less than 0.001% to 0.1%, depending on the recorded number of dengue cases of the year. The majority of the articles focused on the economic burden from the perspective of treatment such as hospitalization and ambulatory care. In a nutshell, the economic burden of managing dengue infection is costly and the evidence suggests a steady increase in health expenditure with the growing number of dengue cases

Introduction: Patellar fractures were common and often challenging to manage, particularly in the elderly population. Achieving stable anatomic reduction and maintaining it throughout the perioperative period was crucial for restoring knee function, especially in patients with osteopenic bone. Materials and methods: This was a retrospective case series of geriatric patients who presented to our centre with closed transverse patellar fractures between 2022 and 2023. All fractures were classified as AO 34C1 under the Arbeitsgemeinschaft für Osteosynthesefragen (AO) classification and were considered fragility fractures, having resulted from a fall from standing height. Only patients aged over 60 years were included. All underwent open reduction and internal fixation using cannulated screws with suture tape augmentation. The Knee Society Score (KSS) was evaluated at four months post-operatively, and patients were followed for complications for up to one year. Results: Six cases met the inclusion criteria. The mean displacement was 19mm, and the average operative time was 45.17 minutes. The average time to radiographic union was 8.67 weeks. At a mean follow-up of 12.8 months, none of the patients required revision surgery or hardware removal. No patient reported issues related to implant prominence or pain during kneeling. The KSS at four months ranged from 87 to 97, with a mean score of 91. Conclusion: Cannulated screw fixation with suture tape augmentation appeared to be a safe and effective method for treating transverse patellar fractures in the elderly population, offering stable fixation and favourable functional outcomes.

During the coronavirus disease 2019 (COVID-19) pandemic, the worldwide medical education system was affected tremendously due to the suspension of clinical activities and lockdown to prevent the spread of the disease. The delivery of clinical training was modified to alternative methods including online classrooms, recorded video, use of simulated patients and hybrid teaching. Several institutions worldwide chose to postpone their scheduled examination, which requires physical attendance or opted for virtual examination. Malaysian centralised postgraduate orthopaedic exit examination was postponed in 2020 and later recommenced in 2021 with three different centres across the country: north, east and central Malaysia. This article describes the preparation and challenges faced in conducting a face-to-face clinical exit examination for postgraduate orthopaedic candidates in Universiti Putra Malaysia in May 2021, during the Conditional Movement Control Order phase. The examination was a success, and no outbreak of COVID-19 was reported from the event.

The increasing number of drug-resistant pathogens is a global issue and becoming worse because it has reduced the effectiveness of current antibiotics in the management of infectious diseases. Therefore, this situation highlights the urgency of an action plan to identify and develop novel and potent antimicrobials derived from natural resources. Therapeutic compounds from natural resources can offer novel, straightforward approaches against pathogenic bacteria with the least toxic manifestations and a low risk of acquiring resistance. Marine organisms and coastal plants receive much interest among researchers nowadays for developing new pharmaceuticals because they are rich in secondary metabolites that have various pharmacological effects, such as antibacterial, anti-cancer, antiviral, anti-inflammatory and others. This review's goal is to highlight the phytochemical components of marine organisms and coastal plants that might be accountable for their antibacterial properties that have been scientifically confirmed and can be potential aids in treating infectious diseases caused by multidrug resistant (MDR) bacteria in humans.

Breast and hepatic cancers are the leading incidences in the globe occurring of the human sufferings from various cancers. Snake venoms have been reported to provide effective therapeutic agents. The current study investigates the anticancer potency of Egyptian venoms snakes on two cells: breast cancer cells (MCF-7) and hepato-cancer cells (HepG2) (In vitro assay). The examined venoms were more potent on MCF-7 than HepG2 cells. Their inhibition % on MCF-7 ranged from 71.47 to 99.02% with medium inhibition concentrations (IC50s): 3.48, 3.60, 3.70, 4.33, and 4.49 μg/ml for venoms: Echis pyramid (E.H), Cerastes vipera (C.V), Naja haje (N.H), Echis coloratus (E.C), and Cerastes cerastes (C.C), respectively. The values of IC50s on HepG2 were 4.32, 17.77, 59.72, 63.75, and 217.90 μg/ml for toxins: E.C, E.P, C.V, C.C, and N.H, respectively. Some biomarkers were conducted to investigate the apoptotic effects of toxins into the cells. Increasing profiles of lactate dehydrogenase (LDH) activity and levels of glutathione content (GSH) and malodialdhyde (MDA) as well as repairment of DNA indicated such these actions. So, more reliable investigations on these venoms were needed to provide intelligent therapeutic agent for cancer treatment.

Purpose: This study aimed to describe the prevalence of vitamin D deficiency in Indonesian children and adolescents. Methods: This was a meta-analysis of prevalence using the Hartung-Knapp-Sidik-Jonkman method with a random effects model. A prediction interval was used to estimate true effects. We searched PubMed, MEDLINE, Cochrane Library, Science Direct, Google Scholar, and 3 Indonesian databases (Indonesian Scientific Journal Database, Neliti, and Indonesia One Search). We included cross-sectional or case-control studies that provided data on the prevalence of vitamin D deficiency. We excluded case reports, case series, cohort studies, or studies outside Indonesia. We computed point prevalence by dividing the number of children with hypovitaminosis D by the total number of subjects in that study. This review was registered with PROSPERO (International Prospective Register of Systematic Reviews) (CRD42022329814). Results: Of 1,397 manuscripts identified, 7 were included in this review. A total of 5,870 children were included in this meta-analysis, ranging in age from 6 months to 19 years. The prevalence of hypovitaminosis D in Indonesia was calculated as 33% (95% confidence interval [CI], 9–56) and was higher in females (60% [95% CI, 58–62]) than in males (40% [95% CI, 38–42]). Mean serum vitamin D level was 22.74 ng/mL (95% CI, 16.95–30.51) with a prediction interval of 15.96 ng/mL to 29.52 ng/mL. Conclusion Vitamin D deficiency is a public health emergency in Indonesia. Strategies to detect and treat vitamin D deficiency in Indonesian children and adolescents should be implemented immediately.

Microorganisms, such as spanning bacteria, archaea and fungi, were ubiquitous and played pivotal roles in shaping ecosystems. This review offered a comprehensive investigation into the multifaceted strategies employed by microorganisms to thrive and adapt within complex ecological niches. Key themes explored in this review encompassed microbial defence mechanisms, biofilm formation, quorum sensing and altruistic behaviours. Microbial defence mechanisms were scrutinized, with a focus on bacteriocin production. Despite the costs associated with production, bacteriocins served as potent weapons that selectively targeted closely related strains, reducing competition and conferring indirect benefits to the producer's genetic kin. Biofilm formation, a critical facet of microbial survival, was discussed in detail. These structured microbial communities encased in self-secreted extracellular matrices provided structural support and protection, demonstrating their significance in diverse ecological contexts. The review further delved into the evolutionary implications of quorum sensing and altruism within microbial communities. Quorum sensing, a mechanism that allowed population density-dependent communication and cooperation, was revealed as essential for microbial survival. In conclusion, this review enhanced our understanding of the intricate strategies microorganisms employed for survival, adaptation and competition in intricate ecosystems. By shedding light on these mechanisms, it advanced our comprehension of microbial community dynamics and their indispensable roles in diverse environments.

The study of transposable genetic elements, a cornerstone of molecular genetics, offers profound insights into the dynamic nature of genetic material. This exploration encompasses various types found in bacteria, including insertion sequences, composite and non-composite transposons. These elements are instrumental in shaping bacterial genomes by facilitating the movement of genetic information, driving evolution and contributing to genetic diversity. Understanding the mechanisms of transposition is essential for unravelling the intricate processes governing genetic rearrangements. Replicative and conservative transposition mechanisms, exemplified by the Tn3 family and phage Mu, illustrate the remarkable adaptability of these systems in reshaping genomes. However, it is the transposon Tn5 that steals the spotlight as a versatile molecular genetics tool. Tn5's transposition mechanism, characterized by precise control over gene expression, translational regulation, protein localization and the induction of conditional mutations, empowers researchers to dissect gene regulation intricacies with unprecedented accuracy. Transposable genetic elements, epitomized by Tn5, are indispensable instruments in molecular genetics. They allow researchers to navigate the intricate landscape of genetics, exploring gene regulation, protein function, and genetic diversity with unparalleled precision. These elements continue to be at the forefront of molecular genetics research, driving innovations that deepen our understanding of the fundamental mechanisms governing life's genetic code.

The expansion of healthcare services to serve as many people as possible has led to the decentralisation of laboratory testing. Many laboratory tests are now made available at district hospitals and rural health clinics for certain states or provinces. Consequently, there is a proliferation of laboratory tests, techniques, equipment, and other required commodities at the different medical laboratories. The lack of central governance has resulted in a widely-diverse and non-standardised laboratory services that may eventually affect the quality of healthcare delivery to patients. To ensure a high-quality and standardised healthcare delivery across a state or a province, it is important that the relevant stakeholders outline and implement the necessary strategies to establish a streamlined medical laboratory network. In this article, we discuss the significance of laboratory procurement consolidation and centralisation in the steering of the standardisation of laboratory operations leading to a high-quality and efficient chemical pathology services in a defined region.