Methods: Patients with severe kyphoscoliosis having coronal Cobb angle >90° were applied with modified halo-pelvic Ilizarov distraction assembly preoperatively. The modified assembly consisted of a pelvic component and halo ring, and distraction was given at the rate of 2–3 mm/day for 6–12 weeks. Complete clinical assessments along with pulmonary function tests were performed, and scoliosis series X-ray images were assessed for coronal and sagittal Cobb angle and other spinopelvic parameters before applying the assembly and during 2 years of follow-up. Results: Thirty-four patients (age, 9–27 years; male/female ratio of 18:16) were included. The coronal and sagittal Cobb angles were 116°±16.2° and 84°±28.3°, respectively. Correction rates obtained through modified halo-pelvic assembly were nearly 52% (p=0.001) in coronal and 40% (p=0.001) in sagittal Cobb angles, with improvement in height (p=0.001). Apical vertebral translation and coronal balance were also improved significantly (p=0.001). Further improvements in all the parameters were obtained after definitive surgery, with improvements in the forced expiratory volume in 1 second (p =0.002) and forced vital capacity (p=0.001). Conclusions Our modified halo-pelvic Ilizarov distraction assembly can achieve good correction in severe spinal deformities without significant risk to neurology, has fewer complications, and promotes good patient compliance.

Good collateral circulation flow is a promising outcome for ischemic stroke patients. Collateral circulation is the vessels that flow in parallel to each other, perfusing the same target tissue. Different patients are shown to have different statuses of collateral. Good collateral circulation is expected to give significantly better clinical outcomes for stroke patients including acute stroke patients who underwent thrombectomy. Modern multimodal imaging techniques have encouraged neuroradiology to assess collateral flow. This paper presents the basic overview of CBCT technology and compares the usefulness of Cone Beam Computed Tomography (CBCT), Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) based on working principles, performance, cost and applications. In addition, the overview of collateral circulation and its characteristics will be discussed. In assessing collateral circulation, improvement of acquisition techniques and algorithm CBCT provides fast delineation of detail vasculature and improves spatial resolution. It is a three-dimensional (3D) imaging modality to investigate collateral flow. For ischemic stroke patients with clinical symptoms, CBCT improves the image quality for the assessment of collateral circulation in the brain. Precise evaluation of collateral circulation from the images will support the decision-making for suitable acute stroke treatment, benefiting both the patient and doctor.

Aims: Insect pests are one of the major constraints of oil palm production in Malaysia. However, synthetic chemical insecticides are the most common method for its control, despite their negative effects on non-target organisms and the development of resistance. Therefore, the present study is aimed to identify novel indigenous isolates of entomopathogenic fungi (EPF) in oil palm soil as part of integrated pest management (IPM) of oil palm insect pests. Methodology and results: The potential of EPF were isolated from the soil collected from the oil palm plantation in UPM using a mealworm beetle larva (Tenebrio molitor) as an insect bait. Seven Metarhizium anisopliae and two Purpureocillium lilacinum isolates were identified by morphological characterization (macroscopic and microscopic observation) and molecular identification using internal transcribed spacer (ITS) region (ITS region amplification). Conclusion, significance and impact of study To our knowledge, this is the first time P. lilacinum has been found in the soil of an oil palm plantation or any other host in Malaysia. Furthermore, both of the isolates M. anisopliae and P. lilacinum may be potentially considered as biological control candidates for major insect pests in oil palm.
Entomophthorales--genetics ; Palm Oil ; Insecticides

Major Depressive Disorder (MDD) is substantially higher in people seeking Methadone Maintenance Therapy (MMT) as compared to the normal population. Erectile Dysfunction (ED) is one of the side effects of Methadone Maintenance Therapy (MMT) which is rarely explored as it is regarded as a sensitive topic. This study aims to determine the prevalence of MDD and its association with ED among MMT clients. A cross-sectional study was conducted involving 160 subjects who attended the Methadone outpatient clinic. The clients were given Patient Health Questionnaire-9 to screen for depressive symptoms and MINI International Neuropsychiatric Interview to diagnose MDD. ED was diagnosed using the 5-item International Index of Erectile Function. The results showed the prevalence of depression in clients on MMT was 30.6% and the prevalence of ED was 72.5%. On multivariate analyses, there were significant associations between ED with depression (P<0.05). Smoking also was found to be contributed to depression. Sociodemographic factors, comorbid medical illnesses, and illicit substance use were found to have no associations with depression. Therefore, given the prevalence of MDD and ED in MMT clients was high, routine assessment of depressive symptoms and sexual function in clients on methadone should be done to minimize their negative impact on the clients

ABSTRACT Coronavirus disease 2019 (COVID-19) which caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV2) is the prevailing global health issue at this time, spreading rapidly despite various containment efforts. It is first reported in Wuhan, China in December 2019 and the total number of cases has reached 7,064,230 with 404,585 total deaths globally to date (June 7, 2020). SARS-CoV-2 is reported closely related to SARS-CoV and MERS-CoV, the virus causes only mild symptoms in the majority of cases. However, it can progress to pneumonia and acute respiratory distress syndrome (ARDS), eventually leading to multiple organ dysfunction, the major cause of mortality among affected patients. The primary modes of transmission include droplet and contact infection, and possibly respiratory aerosols in settings where aerosol-generating procedures (AGPs) occur. Diagnosis mainly relies on detecting the viral RNA in nasopharyngeal and oropharyngeal specimens, combined with imaging techniques such as chest X-ray and computerized tomography (CT) scan. Currently, no empirical therapy or vaccine is available yet for the virus, and supportive measures remain the mainstay of treatment. Information about the virus is being updated every day. This review article summarizes the current knowledge surrounding the outbreak, including epidemiology, virological facts, pathogenesis, clinical findings, diagnostic criteria, and currently available therapeutics and vaccines, with a special emphasis on Middle Eastern countries including Saudi Arabia.
SARS-CoV-2 ; COVID-19--epidemiology

In July 2010 Universiti Kebangsaan Malaysia (UKM) and Niigata University (NU) signed a memorandum of agreement to continue collaboration in joint planning and implementation of education, research and practice services in the field of medicine. Since then several undergraduate and postgraduate students including academic staffs have been visiting NU and UKM as part of their learning experience. This collaboration is also a good opportunity for Doctor of Public Health (DRPH) postgraduate candidates to gain experience on the practice of public health in handling public health issues, planning the healthcare facilities, delivering a quality public health services, enforcing public health policies/regulations and finally learn about the health systems in general at other countries especially from developed country like Japan. The learning experience will help student to evaluate the difference of practice of public health in different countries based on their culture, availability of resources, disease trend and other factors influence the practice of public health.
Delivery of Health Care ; ethnology ; Public Health ; Health Knowledge, Attitudes, Practice ; Japan

Background: This study was performed to compare the oxidative quality of repeatedly heated palm and soybean oils, which were used to fry keropok lekors and potato chips. Method: A kilogramme of keropok lekors or potato chips was fried in 2.5 L of palm or soybean oil at 180 °C for 10 minutes. The frying process was repeated once and four times to obtain twice-heated and five-times-heated oils. The peroxide value and fatty acid composition of the oils were measured. Results: Frequent heating significantly increased the peroxide values in both oils, with the five-times-heated oils having the highest peroxide values [five-times-heated palm: 14.26 ± 0.41 and 11.29 ± 0.58 meq/kg vs fresh: 2.13 ± 0.00, F (3,12) = 346.80, P < 0.001; five-times-heated soybean: 16.95 ± 0.39 and 12.90 ± 0.21 meq/kg vs fresh: 2.53 ± 0.00 oils, F (3,12) = 1755, P < 0.001, when used to fry keropok lekors and potato chips, respectively]. Overall, both oils showed significantly higher peroxide values when keropok lekors were fried in them compared with when potato chips were fried. In general, the heated soybean oil had significantly higher peroxide values than the heated palm oil. Fatty acid composition in the oils remained mostly unaltered by the heating frequency. Conclusion: Keropok lekors, when used as the frying material, increased the peroxide values of the palm and soybean oils. Fatty acid composition was not much affected by the frequency of frying or the fried item used.