Central Corneal Thickness and Intraocular Pressure in Children with Type 1 Diabetes Mellitus

Purpose@#The aim of this study is to determine the mean central corneal thickness (CCT) and mean intraocular pressure (IOP) in children with type 1 diabetes mellitus (T1DM) and to determine the relationship between CCT and IOP on the one hand and age, sex, retinopathy hemoglobin A1c (HbA1c), and duration of diabetes on the other. @*Methods@#This is a case-control, hospital-based study conducted at Hospital Universiti Sains Malaysia between January and November 2022. Thirty-eight children with T1DM were recruited as cases, and 38 healthy children were recruited as controls. The cases and controls then underwent ophthalmic examination, IOP measurement, and CCT measurement using optical coherence tomography (OCT) of the right eye. The IOP measurements were adjusted for CCT for further analysis. @*Results@#The means of CCT and IOP values were significantly higher in the T1DM group than in the control group (all p = 0.02). The mean CCT was 542.18 ± 20.40 μm in the T1DM group, and 529.52 ± 26.17 μm in the control group. The mean IOP was 14.68 ± 1.98 mmHg in the T1DM group, and 13.52 ± 1.66 mmHg in the control group. The mean HbA1c was 10.68% ± 2.49% in the T1DM group. Age and duration of DM were found to have a significant association with CCT in children with T1DM. The duration of DM was also found to be significantly associated with the IOP. Sex and HbA1c levels were found to have no significant relationship with either CCT or IOP. @*Conclusions@#Children with T1DM have significantly higher CCT and IOP than the average child. The duration of DM is a significant factor that impacts both CCT and IOP. In addition, age is another factor that affects CCT in children with T1DM.

Prevalence and risk factors associated with overweight and obesity in age group between 8 to 19 years in North India, a school based cross-sectional study

Background:The objective of this study was to observe association of demographic, lifestyle factors and Socio cultural and economic factors among children抯 and adolescents with overweight and obesity.Methods:Our study was cross sectional study, carried out in age group between 8 to 19 years of age from June to October 2019 in nine schools of district Baramulla, Jammu and Kashmir, North India. Body mass index (weight in kg/height in m2) was assessed to identify participants with (overweight/obese), CDC sex and age specific growth charts were used for assessment. Structured questionnaire was usedto collect information regarding socio-demographics and respondent抯 exposure to various risk factors.Results:In our study, among 354 participants study showed that 44.1% were boys and 55.9% were girls. Among these15.5% were overweight and 5.9% were obese in females, while as 7.9% were overweight and 2.5% were obese in males, thus showing female preponderance. Besides this physical activity, consumption of junk/fast foods along with watching TV and video games along with mother education and occupation were significantly associated with overweight and obesity in children抯 and adolescents.Conclusions:Having overweight parents along with limited exercise and Sedentary activities along with physical inactivity compounded by erratic eating habits with overweight parents are main risk factors leading to overweight and obesity in school going children抯 and adolescents in north Kashmir, India.

Etiology and clinical spectrumofacuteundifferentiated fever illness in patients in atertiary care hospital Sheri Kashmir institute of medicalscience Soura, Jammu and Kashmir

Background:Current study aimed at s to delineate the etiology and clinical parameters associated with AUFIpresenting toemergency department in atertiary care hospital.Methods:This wasa prospectivehospital based study carried out atemergency medicine, SKIMS hospital, SouraKashmir, IndiaJuly2017 toaugust 2018. Patients with acute undifferentiated fever were enrolled. Descriptive statistics were calculated in terms of mean盨D for continuous variables like age of the patients and duration of fever, Frequency and percentage were used to analyse categorical variables such as causes of fever and gender, while as descriptive analysis was calculated in terms of mean盨D for continuous variables like ageof the patients and duration of fever.Results:Totalnumbers of patients included were 174, among these 112 (64.3%) were males and 62 (35.6%) were females. Most patientswere diagnosedenteric fever (N=59, 33.9%)followed byUTI (N=25, 14.3%) dengue (N=12, 6.8%) and malaria (N=8, 4.5%)while rest of cases were associated with other viral illnesses (N=70, 40.5%)based on clinicalbasisand inconclusive laboratory results.Conclusions:Enteric fever was found to be the most commoncause of acute undifferentiated fever followed by dengue andother viral illnesses, althoughcauses and clinic spectrumof AUFI is varied.

Prediction of Relapse Among Individuals Undergoing Methadone Maintenance Therapy in Johor Bahru Health District

@#Introduction: Increase in the number of opioids seized in the recent year may indicate increased opioid use in Malaysia. In counteracting opioid abuse, Methadone Maintenance Therapy (MMT) was introduced in Malaysia but relapse following MMT has become an important issue. This study aimed to determine the prevalence and patient factors that served as predictors of opioid relapse among MMT patients. Method: A cross-sectional study involving 159 MMT patients who have reached dose stabilization (eight weeks at a constant dose of methadone) was conducted in Johor Bahru Health District. The dependent variable was opioid relapse, while the independent variables include socio-demographic characteristics, MMT history, crime history, cognitive and interpersonal factors, and social-environment influence. Face-to-face interviews using structured questionnaires and secondary data collection using data collection sheets were done. Multiple logistic regression was used to determine the predictors. Significant level set at alpha less than 5%. Result: The response rate was 86.9% with majority of them were Malay, male, and Muslim. The prevalence of opioid relapse was 11.9%. Those who were non-polydrug users (AOR=3.701, 95%CI=1.182, 11.587, p=0.025), classified as having moderate (AOR=5.869, 95%CI=1.524, 22.595, p=0.010) and high (AOR=5.952, 95%CI=1.000, 35.445, p=0.050) relapse risk response after given hypothetical situation whether respondent been offered drug or not, were more likely to have relapsed. Respondents with higher cognitive and behavioral problem-solving response scores were less likely to have relapsed (AOR=0.949, 95%CI=0.909, 0.991, p=0.008). Conclusion: About 1 in 5 MMT clients had relapsed after they reach dose stabilization. The predictors of opioid relapse were non-polydrug users, having moderate to high relapse risk, and cognitive and behavioral problem-solving responses.

Degree of conversion and water sorption of self-adhesive and conventional flowable composites: an in vitro study

Aim: Self-adhesive flowable composite resins have been recently introduced to the market. Degree of conversion (DC) and water sorption (WS) are two important parameters affecting the properties of restorative materials. This study aimed to assess the DC and WS of a self-adhesive flowable composite resin in comparison with two conventional flowable composite resins. Methods: Vertise Flow (VF) self-adhesive and Tetric-N Flow (TF) and Grandio Flow (GF) conventional flowable composites were evaluated in this in vitro, experimental study. The DC (n=3) was determined by attenuated total reflectance-Fourier transform infrared spectroscopy (ATR-FTIR). The WS (n=7) was measured after 7 days of immersion in artificial saliva accordingto ISO 4049specifications. Data were analyzed by one-way ANOVA and a post-hoc test (p<0.05). Results: VF showed the highest DC percentage (84.3%) followed by GF (72.79%) and TF (68.7%). The latter two had no significant difference (p=0.8). WS was the highest in VF (55.2 µg/mm3), and the two conventional flowable composites had a significant difference in WS (19.5 µg/mm3 in TF and 11 µg/mm3 in GF; p<0.001). Conclusions: Flowable composite resins had significant differences in DC and WS, and VF demonstrated the highest DC and WS

Callus Induction and Synthetic Seed Development in Draceana sanderiana Sanderex Mast: Lucky Bamboo

The study was carried out for callus induction and synthetic seed development from the shoot tips of Draceana sanderiana sander ex Mast. The shoot tips were subjected to different concentrations (0.25, 0.5 &1.0 mg/l) of 2,4-D on MS medium. The research findings revealed that the 2,4-D at concentrations of 0.25 mg/l was more suited for the profuse callus formation. The friable and light yellow callus was induced within 2 weeks of culture at 0.25 mg/l of 2,4-D on MS medium as compared to the other two concentrations of 2,4-D i.e.; 0.5 and 1.0 mg/l. Similarly the effect of sodium alginate and calcium chloride percentage on synthetic seed formation was observed, it was found that somatic embryos formed from shoot tips via callus kept in 2.5% sodium alginate and 100 milli molar CaCl2 produced synthetic seeds with firm spherical beads. The study leads to the formation of synthetic seeds of Draceana sanderiana which can be used for the conservation of germplasm through cryopreservation and the micro propagation of the said plant species.

Reference ranges for D-dimer levels in Malaysian women in the three trimesters of pregnancy

@#Introduction: Plasma D-dimer levels rise progressively during pregnancy, so one cannot apply normal reference ranges, or the usual cut-off value (500ng/mL), for the exclusion of venous thromboembolism (VTE), in pregnant women. This study was carried out in pregnant Malaysian women in order to build applicable reference ranges for D-dimer. Materials and Methods: A cross-sectional study was conducted to measure D-dimer in healthy pregnant women, and a non-pregnant control group, using the quantitative HaemosIL D-dimer HS500 assay. Reference ranges were derived using CLSI ‘Robust’ methods, and differences between group medians were tested using the Kruskal-Wallis and Mann-Whitney U tests. Results: Plasma D-dimer levels were measured in 92 pregnant women (distributed across the three trimesters)and 31 control women. The medians (and reference ranges) in ng/mL were: control 265 (<799); first trimester 481 (<1070); second trimester 1073 (357–1748); 3rd trimester 1533 (771–2410). There were significant differences between the D-dimer levels of each group and each of the other groups (P<0.001). Conclusions: Reference ranges for D-dimer in pregnant Malaysian women have been establised by this study. Whether these ranges can be used to determine cut-off levels for the exclusion of VTE at different stages of pregnancy is doubtful, as the levels rise continuously through pregnancy, and some very high outlying values occur in apparently normal near-term pregnancy.

Wound infection after laparoscopic cholecystectomy

Background: Surgeons are regularly not involved in the post discharge care of patients after uncomplicated laparoscopic cholecystectomy. The purpose of the current study was to document the symptomatic recovery of patients following laparoscopic cholecystectomy, because this has a bearing on the planning of a postoperative care package

Methods: The study was designed as a postoperative telephone questionnaire survey and was carried out prospectively between June2016 and February2017 in King Abdulaziz Hospital, KSA

Results: The study cohort comprised 51 patients who all completed the study. Postoperatively, only 3% of the patients had postoperative nausea/vomiting lasting >/=2 days. Pain was symptomatic in 12% of patients. Port-site wounds were a source of significant symptoms in 69% of the patients. Postoperative reviews by a nurse and primary-care doctor were necessary in 76% and 34% patients, respectively, with a combined average of 3.1 reviews per patient. Less than 4% of patients believed that they would benefit from a surgeon's review 6 weeks after LC. Median time taken to return to routine preoperative activity after surgery was 21 days [IQR, 16 to 33], which was affected by the degree of activity undertaken, wound-related symptoms persisting for >/=3 weeks, planned follow-up clinic appointment, and discharge as an outpatient

Conclusion: Wound-related symptoms are common after LC, require substantial input from the community health service in their management, and may delay return to preoperative routine

Outcome of extra-articular distal humerus fractures fixed by single column extra-articular distal humerus locking compression plate using triceps sparing postero-lateral approach

Objective: To determine the time to radiological union and final functional outcome of fixation of extraarticular distal humeral fractures with extra-artricular distal humerus locking plate

Methods: This prospective study was conducted from March 2014 to February 2018 and included extraarticular distal humeral fractures managed by operative fixation using extra-articular distal humerus locking plate. All the fractures were approached using lateral para-tricepetal approach of Gervin, and stabilized with extra-articular distal humerus locking plate with or without lag screws. Time to radiological union was assessed in the follow up and at the final follow up functional outcome was evaluated using Mayo Performance Elbow Score [MEPS]. Complications and need for any additional procedures was also recorded

Results: A total of 20 patients with mean age of 36.5 years and an average follow up of 17 months were included. The mean time to radiological union was 17.4 weeks [12 to 36 weeks] which included one delayed union that required bone grafting. The mean flexion at elbow was 127o with only one patient having flexion extension arc movement of less than 100o at the final follow up. The average MEPS at final follow up was 94.7+/-8 with 19 patients having excellent and good results

Conclusion: Use of extra-articular distal humeral locking plate using lateral para-tricepetal approach in extraarticular distal humeral fractures allows stable fixation of the fracture to allow early return to function with minimal soft tissue dissection and excellent final functional results and minimum complications

Assessment of Level of Knowledge on Gingival and Periodontal Diseases among Patients Attending Klinik Pergigian, Melaka-Manipal Medical College, Malaysia

Periodontal disease, including gingivitis and periodontitis, is considered to be one of the most common diseases among population and, if left untreated, can lead to tooth loss. The disease affects subjects in all age groups but is more common in adult population. Periodontal and gingival disease is a silent disease. The chronic, most prevalent form of periodontitis progresses in a slow to moderate manner and does not exhibit any clear symptoms especially in their early stage, however, it may include period of rapid destruction. Although this disease is not lifethreatening, it is an important public health problem because of its high prevalence, public demand, and its impact on individuals and society in terms of pain, discomfort, social and functional limitations and handicap, and the effect on quality of life. Besides that, the financial impact on the individual and community is very high especially in our fast developing country as the resource for such treatment is still imported from overseas. Also, a bidirectional link has been established between periodontal disease and systemic status in patients. Thus, the purpose of the present study was to explore perceptions of periodontal health and illness and to examine attitudes and beliefs regarding prevention of gum diseases among Malaysian population.

Provider Costs Of Treating Dementia Among The Elderly In Government Hospitals Of Malaysia

@#he increased use of health care services by elderly has placed greater pressure to an already strained health care resources. Thus, an accurate economic cost estimation for specific age-related diseases like dementia is essential. The objectives of this project are to estimate costs of treating patient dementia among Malaysian elderly in the hospital settings. Two types of data were collected: Hospital costing data (using costing template) and patient clinical data (using questionaire). The cost analysis for hospital setting was carried out using a step-down costing methodology. The costing template was used to organize costing data into three levels of cost centers in hospitals: overhead cost centers (e.g. administration, consumables, maintenance), intermediate cost centers (e.g. pharmacy, radiology), and final cost centers (all wards and clinics). In estimating the cost for each cost center, both capital cost (building, equipment and furniture cost) and recurrent cost (staff salary and recurrent cost except salary) were combined. Information on activities which reflects the workload such as discharges, inpatient days, number of visit, floor space etc., are gathered to determine an appropriate allocation factor. In addition, for each final cost center, the fully allocated costs are then divided by the total unit of in-patient days to obtain the cost of providing services on a per-patient per-day of stay basis, referred as unit cost. The unit cost is finally multiplied with the individual patient’s length of stay to obtain the cost of care per patient per admission. All these steps were simplified by using the Clinical Cost Modeling Software Version 3.0 (CCM Ver. 3.0). The mean cost of dementia cases per episode of care was RM 12,806 (SD=10,389) with the length of stay of 14.3 (SD=9.9) days per admission. The top three components of cost for the treatment of dementia were the ward services 8,040 (SD=7,512), 62.78% of the total cost, followed by the pharmacy 1,312(SD=1,098), 10.25% of the total cost and Intensive Care Unit 979 (SD=961), 7.64% of the total cost. A multivariable analysis using multiple linear regressions showed that factors which significantly influence (p<0.05) the treatment costs of dementia cases were the length of stay (p<0.001), followed by age (p=0.001), case type severe (p=0.005) and study location (p=0.032). However, the factor length of stay is the tremendous parameter. In conclusion, data collection from selected hospitals as well as patient level data from medical record unit were successfully used to estimate the provider costs of hospital for the elderly with dementia disease. Results from the project will enable an assessment on the economic impact and consequences of cognitive impairment in an aged population. A cost quantification and distributive mapping of the burden of care can assist in policy implementation through targeted intervention for at-risk groups, which will translate into savings by means of delayed onset or progression of dementia.

Assessment of knowledge, attitude and practice toward acne vulgaris among community in Jeddah City, 2016

Background: acne vulgaris is the most common skin condition seen by the dermatologists. It is a chronic inflammatory disease of pilosebaceous unit characterized by seborrhea, comedones, papules, pustules, nodules, cysts and in some cases scars and keloids, which persist for rest of the life

Objectives: the present work aimed at evaluating the level of awareness, Attitude and Practice toward acne vulgaris in Jeddah city

Methods: a cross sectional analytical questionnaire based study was carried out among the general population in Jeddah city. This study started in the year [2016] and composed of 461 subjects. The mean age of citizens was 28, 82. To assess citizens' demographic factors and beliefs about acne vulgaris, consenting citizens completed an anonymous online questionnaire. The data was entered and analyzed using SPSS version 20

Results: The sample is consisted of 65, 8% women and 34, 2% men. Among the respondents 7, 7% reported suffering from acne vulgaris and 13, 6% confirmed having a history of acne vulgaris illness in their family. The results of the study showed that 153 [34, 8%] subjects had weak knowledge related to the disease, 260 [59, 1%] subjects had average level of knowledge while only 27 [6, 1%] subjects had good knowledge regarding acne vulgaris. There was a statistical significant association between gender, educational level and the level of awareness about acne vulgaris

Conclusion: acne vulgaris is a disease that is potentially controllable but that cannot be cured. Education still be important overall the treatment of the patients

Relapse of Cutaneous Fungal Infection in Healthy Individuals - A Rising Concern.

Background: Superficial fungal infections are among the most common skin diseases, affecting millions of people throughout the world. These infections, which occur in both healthy and immunocompromised persons, are caused by dermatophytes, yeasts and nondermatophyte molds. Effective treatment can reduce the duration of symptoms in patients with superficial fungal infections. Unfortunately, there is a strong tendency for fungal infections to recur in many people even after effective clearing with medication. Aims and Objectives: To study the relapse of cutaneous fungal infection in healthy people. Materials and Methods: 160 patients with a history of relapse of fungal infections who came to the out-patient department of this tertiary care hospital within 6 months period were studied in detail regarding patient characteristics, demographic details and line of management. Results: Relapse of cutaneous fungal infection occurs most commonly in adults greater than 30 years (75%). There was a definite family history of fungal infections (15.6%) in patients coming with history of relapse. Tinea cruris (34.38%) was the most common site to come with history of relapse followed by onychomycosis (15.6%). Relapse occurred in 38.75% of the cases treated with terbinafine as this was the most common drug used. Conclusion: Regardless of the drug taken there were cases of relapse in cases of cutaneous fungal infection even in healthy individuals.

[Assessment of non-pylori helicobacter species in stray dog's stomach as a potential reservoir for human infections]

Backgrounds and Objectives: Helicobacter is a genus of Gram-negative bacteria with a characteristic helix shape. Today, a large number of non -H. pylori Helicobacter species in a wide variety of animals and humans have been described. Except helicobacter pylori, Non-pylori Helicobacter species has also been associated with some gastric problems such as gastritis, peptic ulceration and Mucosa-Associated Lymphoid Tissue [MALT] lymphoma in the human. However, due to the lack of sufficient researches on this subject in Iran, the main purpose of this study is scrutiny of these microorganisms on human health and the prevalence of Non-pylori Helicobacters in stray dogs as a reservoir for these microorganisms in Iran

Materials and Methods: In this study, 55 healthy stray dogs [randomly] were used. For evaluation of the general health condition of the dogs, 0.5ml of blood collected from the cephalic vein and evaluated after staining. The dogs were anesthetized and samples were collected from stomach by gastroscopy. Infection confirmed by a positive urease test and studied by Giemsa staining and using light microscopic routs

Results and Conclusions: In gastric samples, non-pylori helicobacter spp., have been observed. 87.5% of samples were positive for urease test. In light microscopic studies [we observed some spiral gram negative bacteria with 2-7 coils], 80% of samples were positive. Therefore the prevalence of helicobacter can vary from 80 to 87.5% in stray dogs. Among the investigated specimens, 25 specimens were contaminated along with several species of Helicobacter. It should be noted that, it is not possible to identify the species by using light microscopy

Repair of post polypectomy colonic perforation by Endoclip: a case report / Reparo de perfuração de cólon pós-polipectomia por Endoclip: relato de caso

A 73-year-old woman was admitted to evaluate for iron deficiency anemia, increased serum creatinine, and ascites. Her colonoscopy revealed a polyp at the junction of sigmoid and descending colon, and after polypectomy, a 6 mm colonic perforation was seen. The perforation was detected by radiography and CT scan; and beside conservative management and antibiotics, her perforation was closed by using Endoclip. The patient was observed and discharged from hospital without any surgery 5 days later, and in follow-up there was no problem regarding perforation. (AU)

Mulher, 73 anos, internada para avaliação para anemia ferropriva, com aumento da creatinina sérica e ascite. A colonoscopia revelou um pólipo na junção dos colos sigmoide e descendente e, em seguida à polipectomia, foi observada uma perfuração de 6 mm no cólon, comprovada por radiografias e tomografia computadorizada. Além do tratamento conservador e da antibioticoterapia, a perfuração foi ocluída com Endoclip. A paciente ficou sob observação e recebeu alta do hospital sem qualquer cirurgia 5 dias mais tarde. Durante o seguimento, não foram observados problemas com relação à perfuração. (AU)

Optimization of buffalo [bubalus bubalis] embryonic stem cell culture system

In order to retain an undifferentiated pluripotent state, embryonic stem [ES] cells have to be cultured on feeder cell layers. However, use of feeder layers limits stem cell research, since experimental data may result from a combined ES cell and feeder cell response to various stimuli. In this experimental study, a buffalo ES cell line was established from in vitro derived blastocysts and characterized by the Alkaline phosphatase [AP] and immunoflourescence staining of various pluripotency markers. We examined the effect of various factors like fibroblast growth factor 2 [FGF-2], leukemia inhibitory factor [LIF] and Y-27632 to support the growth and maintenance of bubaline ES cells on gelatin coated dishes, in order to establish feeder free culture systems. We also analyzed the effect of feeder-conditioned media on stem cell growth in gelatin based cultures both in the presence as well as in the absence of the growth factors. The results showed that Y-27632, in the presence of FGF-2 and LIF, resulted in higher colony growth and increased expression of Nanog gene. Feeder-Conditioned Medium resulted in a significant increase in growth of buffalo ES cells on gelatin coated plates, however, feeder layer based cultures produced better results than gelatin based cultures. Feeder layers from buffalo fetal fibroblast cells can support buffalo ES cells for more than two years. We developed a feeder free culture system that can maintain buffalo ES cells in the short term, as well as feeder layer based culture that can support the long term maintenance of buffalo ES cells

Evaluation of medicinal value of Epimedium datum on the basis of pharmacologically active constituents, Icariin and Icariside-II

Epimedium L. is well known medicinal genus of Chinese pharmacopoeia. Various species are ethno-botanically used against diseases of eye and kidney, impotence, asthma, arthritis and hypertension; besides being used as analeptic, expectorant, antibacterial, hypoglycemic, vasodilator and refrigerant. Recent studies have attributed most of these medicinal properties to its flavonoid glycosides, especially Icariin which is the major pharmacologically active constituent. Icariin has been found to possess effective aphrodisiac, antioxidant, immunomodulatory, hepatoprotective, cardioprotective, vasodilatory, antidepressant and anti-osteoporosis activities. Icariside-II, another active constituent, has cytotoxic and cytostatic effects on 6 cancer cell-lines, and immunosuppressive effects on allograft rejection. In this present study, Epimedium elatum Morr. and Decne., the only species of this genus growing in Indian subcontinent, has been investigated for its medicinal value by determining the content of pharmacologically active constituents, Icariin and Icariside-II, by HPLC method. HPLC analysis of alcohol extract of its shade dried parts was performed with reverse phase C-18 column. The mobile phase for Icariin was acetonitrile-water in gradient mode; while for Icariside-II, it was methanol-water. The effluent was monitored at 270nm. The results have revealed an appreciable content of Icariin and Icariside-II in its aerial and underground parts; the content being higher in populations growing at higher altitudes. The substantial presence of pharmacologically active constituents, Icariin and Icariside-II, in this species of Epimedium, signifies its value as a medicinal plant

tem Cell and Cloning Research in Farm Animals: A Special Focus on Buffalo.

Embryonic stem (ES) cell lines constitute a special class of cell lines derived from the inner cell masses of preimplantation embryos. They are special owing to their unique capability of self renewal and differentiation and propagation in culture for indefinite periods of time. Unlike cancerous cells, they maintain stable chromosomal content and have potential to differentiate into any of the 200 cell type, under appropriate culture conditions. Embryonic stem cell research has gained a tremendous momentum owing to their promises and hopes in regenerative medicine, stem cell therapy, biopharming, and usefulness as in vitro models for studying embryonic development and differentiation. ES cell research in farm animals provides strong incentives for precise genetic manipulation for better health, increased disease resistance, increased milk production and desired composition, increased growth rate with improved carcass composition, enhanced reproductive performance and prolificacy. The potential benefits of using ES cells as donor cells in somatic cell nuclear transfer would boost transgenic animal production. However, with all the promises and hopes, need for more rigorous research and evidence-based therapy is the need of the time, before we could successfully embark on exploitation of ES cells in regenerative medicine. In the current review, establishment, characterization, applications and future challenges of farm animal ES cells are discussed in detail with a special focus on bubaline ES cell lines.

Effectiveness of pulse oximetry screening for congenital heart disease in asymptomatic new-borns.

Background: Congenital Cardio-Vascular Malformations (CCVMs) are relatively common with a prevalence of 5-10 in every 1000 live births. CCVM represents a new-born condition that would be ideally suited to a screening program if simple and reliable methods were available. Pulse oximetry has been proposed as a screening method for the detection of congenital heart defects. Methods: Hospital based prospective non-randomized study conducted over a period of one year at the department of pediatrics in G.B. Panth hospital (Neonatology) and L.D. hospital (Neonatology). A total of 1200 asymptomatic new-borns attending G.B. Panth, neonatology/L.D. neonatology were screened with pulse oximetry. Oximetric screening for CCVM was performed by obtaining a single determination of postductal saturation at >24 hours. All new-borns underwent additional evaluation by echocardiography. Results: Out of 1200 newborns screened three had postductal saturation ≤95%. Echocardiography revealed TGA (transposition of great vessels) in one; TA (truncus arteriosus) in other and third one had structurally normal heart on echocardiography. There was one false negative screen (found in the inpatient records of G.B. Panth hospital). The sensitivity, specificity, positive predictive value and negative predictive value of pulse oximetry in screening for CCVM in asymptomatic new-borns was found to be 66.67%, 99.9%, 66.67% and 99.9% respectively. Conclusion: This screening test is simple, non-invasive and inexpensive. The sensitivity, specificity, and predictive value in this population were satisfactory, indicating that screening should be applied to larger populations, particularly in developing countries where lower rates of detection result in increased CCVM prevalence in asymptomatic new-borns.

Development Of Clinical Pathway For Mild Cognitive Impairment And Dementia To Quantify Cost Of Age-Related Cognitive Disorders In Malaysia

As the Malaysian population ages, the burden of age-related cognitive disorders such as dementia and Alzheimer’s disease will increase concomitantly. This is one of the sub-study under a research project titled by quantify the cost of age-related cognitive impairment in Malaysia, which was undertaken to develop a clinical pathway for Mild Cognitive Impairment (MCI) and Dementia. The clinical pathway (CP) will be used to support the costing studies of MCI and Dementia. An expert group discussion (EGD) was conducted among selected experts from six (6) government hospitals from different states of Malaysia, Ministry of Health, and United Nations University, International Institute for Global Health, UKM and UPM. The expert group includes psychiatrist specialists and public health medicine specialists. A total of 15 participants took part in the EGD. The group was presented with the different approach in managing MCI and Dementia. Finally, the group came to the consensus agreement on the most appropriate and efficient ways of managing the two conditions. In the EGD, an operational definition for MCI and Dementia was agreed upon and a pathway was developed for the usual practice in the Malaysian health system. A typical case used, as a reference is a 60-year-old patient referred to a memory clinic with complaint of “forgetfulness”. After three outpatient visits in the clinic, the diagnosis of MCI and Dementia could be clinically established. The clinical pathways covered all active clinical and non-clinical management of the patient over a period of one year. The experts identified the additional resources required to manage these patients for the whole spectrum of lifetime based on the expected life expectancy. The Clinical pathway (CP) for MCI and Dementia was successfully developed in EGD with strong support from practitioners in the health system. The findings will help the researchers to identify all-important clinical activities and interventions that will be included in the costing study.