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.

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.

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

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.

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.

Medical implants are normally used in clinical practice to treat most orthopaedics situations involving bone fractures, deformities, dislocation, and lengthening. It should be noted that specific measures regarding biomechanical and biomaterial characteristics are required for a successful post-surgery procedure. Biomechanical evaluations on the medical implants could be performed by utilising computer and engineering technology. One of them is in silico studies using finite element method that could be simulated in high-performance computer. However, various assumptions are required in computer simulation, such as the constraints on data input and computer resources. This review paper discusses current approaches of constructing a finite element model of human bone with specific material properties for upper limb such as the shoulder joint, humerus, elbow joint, radius and wrist joint. Previous related literatures were reviewed from selected keywords and search engines. To narrow the literature search in this study, inclusion and exclusion criteria of the literature searching were applied. We looked at the current level of knowledge in this field and offered recommendations for future study. In conclusion, studies from previous literature have demonstrated several ways for developing mathematical models and simulating medical implants.

Introduction: Obesity has been linked to coronary artery disease, type II diabetes, metabolic syndrome, stroke, and cancer. Pomegranate (Punica granatum; PG) has been used extensively in folk medicine for several therapeutic purposes. The goal of this study is to investigate the anti-obesity effect of PG peel and pulp methanolic extracts in highfat diet (HFD)-induced Sprague-Dawley rats. Methods: The animals were separated into 7 groups namely Normal control group (normal diet); HFD-induced only as negative control group, and positive control group (HFD-induced + orlistat); treatment group included HFD-induced + peel 125 mg/kg, HFD-induced +peel 250 mg/kg, HFD-induced + pulp 125 mg/kg and HFD-induced + pulp 250 mg/kg. Results: It was observed that methanolic extract of peel and pulp PG 250 mg/kg showed low increment of body weight with a reduction in weight of liver, visceral fat, and subcutaneous fat. Compared to the negative control group, total cholesterol, triglyceride, and low-density lipoprotein levels were shown to be lowered for PG peel and pulp groups also showed higher values in high-density lipoprotein. Conclusion: PG reduced obesity-related markers in blood, liver, and adipose tissue and inhibited obesity caused by a high-fat diet probably because of its antioxidant properties.