What is needed to promote physical activity in a secondary school? a qualitative study / O que é necessário para promover a atividade física em uma escola de ensino médio? um estudo qualitativo / ¿qué se necesita para promover la actividad física en una escuela secundaria? un estudio cualitativo

Interventions are required to modify physical activity behaviours in adolescents, and in this regard, education-based actions seem to be effective. The aim of this study was to explore the beliefs and perceptions of the context stakeholders with respect to adolescents' health behaviours, as well as intervention programmes to gain insight into the setting where the implementation of an intervention is required. Three focus groups were created with twenty-two participants (nine adolescents, four parents, six teachers, and three local politicians). The educational context, in collaboration with the community, was perceived as a setting with high a potential for physical activity promotion. Engagement and coordination of all stakeholders were considered necessary for a tailored intervention, in addition to programme institutionalization to ensure sustainability. Multilevel intervention with a whole-school and community approach is key to increasing physical activity levels among adolescents. (AU)

São necessárias intervenções para modificar os comportamentos de atividade física dos adolescentes e, nesse sentido, as ações baseadas na educação nas escolas parecem ser eficazes. O objetivo deste estudo foi explorar as crenças e percepções das partes interessadas do contexto em relação aos comportamentos de saúde dos adolescentes, bem como aos programas de intervenção para obter uma visão do ambiente em que uma intervenção deseja ser implementada. Foram criados três grupos focais com vinte e dois participantes (nove adolescentes, quatro pais, seis professores e três políticos locais). O contexto educativo, em colaboração com a comunidade, foi percebido como um ambiente com um alto potencial para a promoção da atividade física. O compromisso e a coordenação de todas as partes interessadas foram considerados necessários para uma intervenção personalizada, bem como a institucionalização do programa para garantir a sustentabilidade. A intervenção multinível com uma abordagem de toda a escola e da comunidade é fundamental para aumentar os níveis de atividade física entre os adolescentes. (AU)

Se necesitan intervenciones para modificar los comportamientos de actividad física en adolescentes y, en este sentido, las iniciativas desde la educación parecen ser efectivas. El objetivo de este estudio fue explorar las creencias y percepciones de las partes interesadas del contexto en relación con los comportamientos de salud de los adolescentes y los programas de intervención para conocer mejor el entorno en el que se quiere aplicar una intervención. Se crearon tres grupos focales con veintidós participantes (nueve adolescentes, cuatro padres, seis docentes y tres políticos locales). El contexto educativo, en colaboración con la comunidad, fue percibido como un ambiente con un alto potencial para la promoción de la actividad física. Se consideró necesario el compromiso y la coordinación de todas las partes interesadas para una intervención personalizada, así como la institucionalización del programa para garantizar la sostenibilidad. La intervención multinivel con un enfoque de toda la escuela y la comunidad es clave para aumentar los niveles de actividad física entre los adolescentes. (AU)

Oral Healthcare Services Delivered During COVID-19 Lockdown: A Report from Eastern Mediterranean Region

ABSTRACT Objective: To describe oral healthcare services administered during the lockdown in the Eastern Mediterranean region and to investigate the role of socio-professional characteristics of dental practitioners or their self-reported COVID-19 infection. Material and Methods: A questionnaire was distributed to dental practitioners in all healthcare sectors in Jordan, Egypt, and Saudi Arabia. Results: There was a total of 335 participants, with the majority being females (N=225, 67.2%) and general practitioners (N=202, 60.3%). Cellulitis was the most common emergency encountered (N=108). The most common urgent procedures were for pulpitis, abscesses, and pericoronitis (N=191, 130, and 95, respectively). Country-specific significant associations were pulpitis in Egypt and Jordan, broken symptomatic teeth in Jordan, and biopsy in Egypt (p<0.05). The Ministry of Health was significantly associated with the management of dental infections, avulsion, and orthodontic emergencies, while university hospitals were significantly associated with advanced restorative procedures (p<0.05). Male practitioners performed significantly more procedures, particularly surgical emergencies (p<0.05). Conclusion: Dental infections were the most common complaints among dental patients during lockdown. Countryand sector-specific dental procedures are detected. Male gender seems to play a determinant role in performing a higher number of procedures, particularly for surgical emergencies (AU).

Lower Limb Muscle Fatigue Alters Spatiotemporal Gait Parameters and Turning Difficulty Characteristics in Parkinson’s Disease

Objective@#To determine the effects of lower limb muscle fatigue on spatiotemporal gait parameters and turning difficulty characteristics during the extended Timed Up and Go (extended TUG) test in individuals with different severity stages of Parkinson’s disease (PD). @*Methods@#Forty individuals with PD, classified as Hoehn and Yahr (H&Y) stages 2 and 3 participated in this pre- and post-experimental study design. The participants performed a continuous sit-to-stand task from a chair based on 30 cycles/min set-up to induce lower limb muscle fatigue. They performed extended TUG test immediately before and after completing the fatigue protocol. Spatiotemporal gait parameters and turning difficulty characteristics were recorded using two GoPro® Hero 4 Silver cameras. Data were subjected to a repeated-measure ANOVA. @*Results@#Individuals with PD experience significant changes in spatiotemporal gait parameters, specifically stride velocity and length, under conditions of lower limb muscle fatigue (p=0.001). These changes were more pronounced in individuals with PD in the H&Y stage 3 group. Additionally, both PD groups exhibited difficulty with turning, requiring more than five steps to complete a 180° turn and taking more than 3 seconds to accomplish it. @*Conclusion@#These findings highlight the impact of muscle fatigue on gait performance in PD and suggest that individuals in later stages of the disease may be particularly affected. Further research is needed to explore interventions that can mitigate these gait impairments and improve mobility in individuals with PD.

Papillary cystadenoma of the epididymis

ABSTRACT Background Papillary cystadenoma is a rare benign neoplasm of the epididymis. It may occur sporadically or in association with von Hippel-Lindau disease (VHLD). Papillary cystadenoma of the epididymis (PCE) is a benign mimic of metastatic clear cell renal cell carcinoma (CCRCC) given their histologic similarities. Case presentation Herein, we present the case of a 40-year-old man with a four-year history of microhematuria and a recently detected right paratesticular mass. A testicular sonogram revealed a hypoechoic, hypervascular solid mass in the right epididymal head treated by surgical excision. Histopathological examination demonstrated a 1.1 cm papillary cystadenoma of the epididymis. Genetic testing performed later showed no signs of VHLD. However, heterozygous mutations in three genes - CASR, POT1, and RAD51D - were found which have never been reported in PCE before. Conclusions Papillary cystadenoma of the epididymis should always be considered in the differential diagnosis of epididymal lesions, especially those that are cystic. The mainstay of treatment remains surgical excision, which provides an excellent prognosis.

Hepatoprotective effect of date palm fruit extract against doxorubicin intoxication in Wistar rats: In vivo and in silico studies

Objective: To investigate the prophylactic efficacy of date palm fruit extract against doxorubicin-induced hepatotoxicity in Wistar albino rats. Methods: The rats were equally and randomly assigned to 6 groups: group 1 (untreated control), group 2 and 3 given daily oral administration of prophylactic aqueous extract of date palm fruit at 0.75 and 1.5 mg/kg body weight, respectively, and group 4, 5 and 6 intraperitoneally injected with doxorubicin at 15 mg/kg on day 30. Rats in group 5 and 6 received daily oral administration of aqueous extract of date palm fruit at 0.75 and 1.5 mg/kg body weight, respectively, for 30 d. The phytochemicals identified by GC-MS analysis were analyzed using in silico study. Antioxidant enzymes, liver enzymatic, biochemical parameters and histopathological analysis were determined to evaluate hepatoprotective activity of date extract. Results: Aqueous extract of date palm fruit significantly mitigated doxorubicin-induced changes in activities of liver enzymes, reduced reactive oxygen species levels, and suppressed lipid peroxidation and DNA damage. Moreover, aqueous extract of date palm fruit reduced doxorubicin-induced hepatic lesions. Molecular docking studies showed that most compounds of aqueous extract of date palm fruit identified via GC-MS had good interaction with proteins of human pregnane X receptor, oxygenase-1, and CYP2C9. Conclusions: The aqueous extract of date palm fruit mitigates doxorubicin-mediated DNA damage and hepatotoxicity, and restores normal liver function and may be a promising agent against the deleterious effects of doxorubicin.

Handgrip Strength Assessment and Its Associated Factors among Hospitalized Elderly in Klang Valley Hospitals

@#Introduction: Handgrip strength is a crucial biomarker of aging. Poor handgrip strength among hospitalized elderly increases the risk of health complications leading to a higher risk of hospital readmissions and mortality. This study aimed to determine handgrip strength among hospitalized elderly in Klang Valley hospitals alongside its associated factors. Methods: A total of 57 subjects were recruited for this study. Face-to-face interviews and physical assessments were conducted to obtain data on sociodemographic factors, medical background, anthropometry assessments and biochemical markers level. Dietary intake was obtained through two days of 24-hour dietary recall while tools such as Global Oral Health Assessment Index (GOHAI) and Mini Nutrition Assessment- Short Form (MNA-SF) were used to assess perception towards oral health and malnutrition risk, respectively. Reference value from the Asian Working Group of Sarcopenia (2014) was used to compare handgrip strength. Results: 94.7% of the subjects were found to have low handgrip strength with a mean value of 8.28 + 6.92 kg/force. Factors including age (r=- 0.370, p=0.005), educational level (r=0.471, p=<0.0005), perception towards oral health (r=0.370, p=0.005) and energy intake (r=0.367, p=0.005) were significantly associated with handgrip strength. Meanwhile, other variables were not significantly associated. Conclusion: The majority of the subjects had poor handgrip strength. Factors such as age, educational level, perception towards oral health and energy intake were significantly associated with handgrip strength while the rest were non-significantly associated. Thus, more research and intervention strategies should be done to improve handgrip strength among hospitalized elderly to achieve a healthy aging nation.

Complete Androgen Insensitivity Syndrome: Diagnosis and Psychological Impact in Two Adolescents, A Case Report

@#This case report illustrates two cases of complete androgen insensitivity syndrome (CAIS) which is a rare form of sexual development disorder. Both presented with primary amenorrhea at the age of 18 and 19 years old. The hormonal profiles ruled out hypothyroidism, hyperprolactinemia, and primary ovarian failure. Magnetic resonance imaging of both patients showed the absence of uterus, fallopian tubes, ovaries, but the presence of proximal 1/3rd of the vagina. There is a single testis in the left inguinal region with unknown status of spermatogenesis. Women with CAIS are vulnerable to various psychological conditions caused by the appalling fact of being genotypically male when they have been raised female all their life. The gender confusion, reproductive issues, and how others perceive them require sensitive support. Hence, accentuate the need to explore and address the emotional, psychological, and psychiatric vulnerabilities, religious and spiritual beliefs in issues of relationships, infertility, and conception.

The cagA, cagE, vacA, dupA and iceA1 genes of Helicobacter pylori in Sudanese gastritis patients: Distribution and relationship with clinical outcomes and histological alterations

Aims@#Helicobacter pylori is a gastrointestinal bacterium that causes peptic ulcers and stomach cancer in nearly half of the world’s population. Many virulence factors influence the outcome of H. pylori related disorders. The purpose of this study was to see if there was a relationship between H. pylori virulence factors and histological and endoscopic findings in stomach biopsy specimens from Sudanese gastritis patients.@*Methodology and results@#In the period between March 2018 and January 2020, a total of 290 gastric biopsies were taken from patients in Khartoum State hospitals. Histopathology and polymerase chain reaction (PCR) assays were performed on all specimens. Histological investigation revealed H. pylori in 103/290 (35.5%) samples, while PCR revealed H. pylori 16S rRNA positivity in 88/290 (30.3%) samples. Eighty-eight positive PCR specimens were subjected to PCR for genotypic detection of cagA, cagE, vacA, dupA and iceA1 genes. All of strains were vacA positive 100% (88/88) followed by dupA 50.0% (44/88), cagA 40.9% (36/88), cagE gene 38.6% (34/88) and iceA1 gene was detected in only 15.9% (14/88). The vacA s1/m1 68.2% (60/88) was the most prevalent vacA subtype.@*Conclusion, significance and impact of study@#Helicobacter pylori virulence genes were widespread and diversified in Sudanese gastritis patients. Helicobacter pylori cagA and iceA1 were significantly in association with gastric mucosa inflammation degree, whereas the dupA gene was found to be associated with the clinical outcomes.

Autoimmune Haemolytic Anaemia: A cross sectional study in a Tertiary Haematological Centre (Anemia Hemolitik Autoimun: Kajian Keratan Lintang di Pusat Hemotologi Tertier) / Jurnal Sains Kesihatan Malaysia

@#Autoimmune haemolytic anaemia (AIHA) is a group of disorders wherein autoantibody causes decompensated acquired haemolysis. There has been no epidemiological study of autoimmune haemolytic anaemia (AIHA) in Malaysia. This study retrospectively analysed the epidemiology of AIHA including Evan’s Syndrome in a Tertiary Haematology Centre in Malaysia. Patients diagnosed with AIHA and Evan’s Syndrome at 18 years old and above between 1 January 1994 to 1 October 2020 at the out-patient Haematology Clinic of Hospital Raja Permaisuri Bainun, Ipoh were selected. Patients’ information was retrieved from the outpatient clinic records. A total of 71 patients were included of which predominantly female. The mean age for both genders were comparable. Ethnic stratification revealed AIHA was higher in Malays followed by Chinese and Indian. Warm AIHA was most prevalent at 40.8%, compared to cold AIHA and Evan’s Syndrome (both 23.9%), and mixed AIHA (11.3%). Primary was more common than secondary AIHA followed by Evan’s Syndrome. Approximately half of the secondary AIHA and secondary Evan’s Syndrome were due to SLE. Overall, 67.6% of patients received corticosteroid only and 28.2% combined with immunosuppressant. Individuals at higher age and females have higher risk of developing AIHA and Evan’s Syndrome. The highest prevalence was seen among the Malay ethnic. Primary warm AIHA is the most common type and majority of Evan’s syndrome are secondary to autoimmune diseases.

Hepatoprotective effect of date palm fruit extract against doxorubicin intoxication in Wistar rats: In vivo and in silico studies

Objective: To investigate the prophylactic efficacy of date palm fruit extract against doxorubicin-induced hepatotoxicity in Wistar albino rats. Methods: The rats were equally and randomly assigned to 6 groups: group 1 (untreated control), group 2 and 3 given daily oral administration of prophylactic aqueous extract of date palm fruit at 0.75 and 1.5 mg/kg body weight, respectively, and group 4, 5 and 6 intraperitoneally injected with doxorubicin at 15 mg/kg on day 30. Rats in group 5 and 6 received daily oral administration of aqueous extract of date palm fruit at 0.75 and 1.5 mg/kg body weight, respectively, for 30 d. The phytochemicals identified by GC-MS analysis were analyzed using in silico study. Antioxidant enzymes, liver enzymatic, biochemical parameters and histopathological analysis were determined to evaluate hepatoprotective activity of date extract. Results: Aqueous extract of date palm fruit significantly mitigated doxorubicin-induced changes in activities of liver enzymes, reduced reactive oxygen species levels, and suppressed lipid peroxidation and DNA damage. Moreover, aqueous extract of date palm fruit reduced doxorubicin-induced hepatic lesions. Molecular docking studies showed that most compounds of aqueous extract of date palm fruit identified via GC-MS had good interaction with proteins of human pregnane X receptor, oxygenase-1, and CYP2C9. Conclusions: The aqueous extract of date palm fruit mitigates doxorubicin-mediated DNA damage and hepatotoxicity, and restores normal liver function and may be a promising agent against the deleterious effects of doxorubicin.

Endoscopic assisted transoral approach with palatal splitting for a giant retropharyngeal schwannoma: a challenging case

Retropharyngeal schwannoma is rare. To the best of our knowledge, only 18 cases have been published in the English literature. Complete surgical excision is the treatment of choice for schwannomas. Transoral approaches have been applied for smaller lesions, and external cervical approaches are preferred for larger and more complex lesions. In this report, we present a case of large retropharyngeal schwannoma that was excised using an endoscopic-assisted transoral approach with palatal splitting. Postoperative functional and oncologic outcomes were satisfactory with no reported intraoperative/postoperative complications.

Effects of Paraplegia Fitness Integrated Training on Physical Function and Exercise Self-Efficacy and Adherence Among Individuals With Spinal Cord Injury

Objective@#To determine the effects of the Paraplegia Fitness Integrated Training (PARAFiT) program, which is an integrated graded physical exercise and health education program for individuals with spinal cord injury (SCI). @*Methods@#This nonrandomized single-blind study included 44 participants, who were assigned to either an intervention (PARAFiT) group or an active control (conventional physiotherapy) group. The intervention group underwent the PARAFiT program (8 weeks), which consisted of circuit-based interval training, progressive upper limb resistance training, and health education sessions. During the unsupervised period, the intervention group continuously underwent health education program once a month for 2 months (8 weeks). Repeated-measures analysis of variance was used for the analysis. @*Results@#The intervention group presented with a higher level of physical activity than did the control group; however, the difference was not significant (p=0.36). Additionally, the intervention group presented with better exercise self-efficacy and cardiorespiratory fitness and stronger bilateral shoulder muscle and handgrip than did the control group (all p<0.05). Exercise adherence was higher in the intervention group than in the control group during both the supervised (80% vs. 75%) and unsupervised (40% vs. 20%) periods. @*Conclusion@#The PARAFiT program enhanced the level of physical activity, exercise self-efficacy, physical fitness, and exercise adherence among the patients with SCI. Future studies should incorporate guidelines for home-based exercises and regular monitoring to promote long-term adherence to exercise and physical activity among individuals with SCI.

Assessment of Quality of Life for Scheuermann’s Kyphosis Patients with Cobb’s Angle 50°–65° Treated Conservatively or Surgically in North Jordan: A Prospective Comparative Study

Background@#Scheuermann’s disease is the most common cause of hyperkyphosis of the thoracic spine during the adolescence period. It causes neck and lower back pain, restriction of lung expansion, traction of the spinal cord, increased vulnerability to vertebral fracture, and a hump. Patients with curves 60°. The purpose of this prospective cohort study was to assess the quality of life and functional changes in conservatively or surgically treated Scheuermann’s disease patients with a curve size of 50°–65° in north Jordan. @*Methods@#Sixty-three adolescent patients with Scheuermann’s kyphosis (aged between 10 and 18 years) were treated at our hospital between January 2014 and August 2018. All patients were investigated clinically, radiologically (Cobb’s angle), and functionally (Oswestry Disability Index [ODI], Scoliosis Research Society 22 revision [SRS-22r] questionnaire, and pulmonary function test [PFT]) preand post-treatment (final follow-up). Patients were randomly selected for treatment method (conservative versus surgical). @*Results@#There were 31 patients (mean age, 15.48 ± 2.50 years) and 32 patients (mean age, 16.19 ± 1.51 years) treated conservatively and surgically, respectively. Mean ± standard deviation of ODI, SRS-22r, and Cobb’s angle of the surgical group improved from 16.8% ± 14.3%, 3.5 ± 0.5, and 58.75° ± 3.59°, respectively, pre-surgery to 13.4% ± 10.8%, 4.2 ± 0.5, and 41.53° ± 3.94°, respectively, post-surgery, while those of the conservative group became worse from 12.6% ± 13.4%, 3.9 ± 0.7, and 56.1° ± 3.3°, respectively, to 20.1% ± 13.6%, 3.5 ± 0.7, and 58.8° ± 5.8°, respectively. The surgical group showed better improvement in all scores than the conservative group (p < 0.05), as well as in PFT. @*Conclusions@#Surgical treatment of Scheuermann’s kyphosis with curves of 50°–65° resulted in better QOL, Cobb’s angle, and PFT than conservative treatment. This was because of lower patient cooperation in the conservative management group, which made the curve less flexible for exercises and bracing.

Metabolic bone disease in children and adolescent patients with ulcerative colitis

Abstract Objective: Metabolic bone disease concerns a broad spectrum of conditions related to reduced bone density. Metabolic bone disease has been linked to chronic inflammatory diseases, such as ulcerative colitis. This study examines the prevalence of metabolic bone disease in ulcerative colitis patients and explores possible clinical predictors. Method: The authors performed a retrospective study involving children and adolescents with confirmed ulcerative colitis between January 2013 and December 2018. Bone density was evaluated through a dual-energy X-ray absorptiometry scan of the spine and total body. Osteoporosis was defined as a bone mineral density Z-score of <−2 and osteopenia as a Z-score of between −1.0 and −2. Results: A total of 37 patients were included in this analysis, with a mean age of 13.4 ± 3.9 years and a mean duration of illness of 2.1 ± 2.4 years. Using lumbar spine Z-scores and total body Z-scores, osteoporosis and osteopenia were identified by dual-energy X-ray absorptiometry scan measurements in 11 patients (29.7%) and 15 patients (40.5%), and in ten patients (27%) and 13 patients (35%), respectively. Lumbar spine Z-scores were significantly positively associated with male gender (B = 2.02; p = 0.0001), and negatively associated with the presence of extraintestinal manifestations (B = −1.51, p = 0.009) and the use of biologics (B = −1.33, p = 0.004). However, total body Z-scores were positively associated with body mass index Z-scores (B = 0.26, p = 0.004) and duration of illness in years (B = 0.35, p = 0.003). Conclusions: Metabolic bone disease is very common in this cohort of Saudi Arabian children and adolescents with ulcerative colitis and its occurrence appears to increase in female patients who suffer from extraintestinal manifestations.

Evaluation of fracture resistance of zirconia monolithic restorations: an in vitro study / Avaliação da resistência à fratura de restaurações monolíticas de zircônia: um estudo in vitro

Objective: was to evaluate fracture resistance of zirconia monolithic restorations after aging procedures. Material and methods: Monolithic translucent zirconia 3-unit FPDs were fabricated using Cerec inLab CAD/CAM system on 2 stainless steel dies with a uniform 120 degrees circumferential deep chamfer finish line of 1 mm width. FPDs were divided into 2 groups, first group (Group A) was subjected to aging procedures in an autoclave at hydrothermal conditions 134 oC /2 bars for 5 hours. Second group (Group B) was not subjected to any aging procedures (control group). All specimens of each group were loaded compressively in a universal testing machine at cross head speed 0.5 mm/min until fracture occurred. The percentage of monoclinic (m) phase was detected by XRD device. Scanning electron microscope (SEM) was used to examine the fractured surfaces for Aged TZI (Group A) and Non-aged TZI (Group B). Student's t-test was used to compare between fracture resistances of both groups. The significance level was set at P ≤ 0.05. Results: The fracture resistance mean (SD) values of non-aged TZI (Group B) was 2406.9 ± 306.8 N which showed statistically significantly higher than that of aged group (Group A) which was 1964.5 ± 234.5 N. The percentage of monoclinic (m) phase detected by XRD device software in non-aged TZI (Group B) was nearly 0 weight % and in aged TZI (Group A) was about 42 weight %. Conclusions:Accelerated artificial aging decreases the fracture resistance of monolithic TZI FPDs. (AU)

Objetivo: Foi avaliar a resistencia à fratura de restaurações de zircônia monolítica após procedimentos de envelhecimento.Material e Métodos: 3 unidades de FPDs de zircônia monolítica translucida foram fabricadas utilizando o sistema Cerec inLab CAD/CAM com 2 matrizes de aço inoxidável com uma linha de acabamento de chanfro profundo circunferencial de 120 graus de largura de 1 mm. As FPDs foram divididos em dois grupos, primeiro grupo (Grupo A) foi submetido a procedimentos de envelhecimento em autoclave em condições hidrotérmicas de 134 °C /2 bars por 5 horas. O segundo grupo (Grupo B) não foi submetido a nenhum processo de envelhecimento (grupo controle). Todos os espécimes de cada grupo foram carregados compressivamente em uma maquina de teste universal na velocidade de 0.5 mm/min até a fratura ocorrer. A porcentagem da fase monoclínica (m) foi detectada pelo dispositivo XRD. O microscópio eletrônico de varredura (MEV) foi utilizado para examinar as superfícies fraturadas para TZI envelhecido (Grupo A) e TZI não envelhecido (Grupo B). O teste t de estudantes foi usado para comparar as resistências à fraturas de ambos os grupos. O nível de significância foi estabelecido em P ≤ 0.05. Resultados: Os valores médios de resistência à fratura (SD) do TZI não envelhecido (Grupo B) foi 2406.9±306.8 N, o qual se mostrou estatisticamente significativamente maior do que o grupo envelhecido (Grupo A), que foi 1964.5±234.5 N. A porcentagem da fase monoclínica (m) detectada pelo software do dispositivo XRD em TZI não envelhecido (Grupo B) foi próximo de 0% em peso e em TZI envelhecido (Grupo A) foi cerca de 42% em peso. Conclusão: O envelhecimento artificial acelerado diminui a resistência à fratura de FPDs TZI monolítico (AU)

Intraosseous meningioma mimicking osteosarcoma

Background Predominantly intraosseous meningiomas are rare entities that include true primary intraosseous meningiomas (PIM), as well as meningiomas that may show extensive bone involvement, such as en plaque meningiomas. Different hypotheses have been proposed to decipher the origin of PIMs, such as ectopic arachnoid cap cell entrapment during birth or after trauma. Surgical resection is the treatment of choice of such lesions. Case presentation We present a case of a 65-year-old man with an enlarging mass in the parieto-occipital region that grew slowly and progressively over 13 years, following head trauma during a motor vehicle accident. One year prior to presentation, he started experiencing daily holocranial headaches and blurry vision. CT and MRI studies revealed a permeative midline calvarial lesion measuring 14 cm in greatest dimension with extensive periosteal reaction, extension into the subcutaneous soft tissues, subjacent dural thickening and intracranial extension with invasion of the superior sagittal sinus. The favored pre-operative clinical diagnosis was osteosarcoma. The abnormal calvarium was excised and histopathological examination confirmed the diagnosis of a predominantly intraosseous calvarial meningioma, WHO grade I. Conclusions The present case highlights the importance of histopathologic diagnosis in guiding therapeutic decisions and reiterates the necessity of considering PIM or meningiomas with extensive intraosseous component in the differential diagnosis of calvarial masses, even when imaging suggests a neoplasm with aggressive behavior, such as osteosarcoma.

Health Impact Assessment as a Planning and Decision-making Tool

@#Health impact assessment (HIA) is a versatile planning and decision-making tool that has been applied in many situations but more so in environmental impact assessment (EIA). In many developed and developing countries, many development activities and projects are now subjected to EIA. HIA in urban planning although limited, is now being increasingly applied, whereby the planning of a city including its transportation system and corridors can have significant health implications on city dwellers. This paper discusses the usefulness of HIA as an impact assessment tool in various applications including in urban planning. The International Finance Corporation (IFC) has introduced a comprehensive HIA which includes health risk assessment (HRA). Environmental HRA is a standardized characterization of potential negative health impacts resulting from human exposures to dangerous agents or circumstances within the environment. HIA as a planning and decision-making tool will become more universal in its applications.

Allelic Diversity of the Hemochromatosis Gene (HFE) in Malays, Chinese and Indians

@#Introduction: Hereditary hemochromatosis (HH) is an autosomal recessive disorder that causes accumulation of iron in circulating blood and organs. The disease is associated with H63D, S65C and C282Y variants of the haemochromatosis (HFE) gene and, if not treated can cause organ damage and may prove fatal. The main objectives of the present survey were to screen these genetic variants and establish risk profiles for developing HH in Malays, Chinese and Indians. Methods: A total of two hundred and twenty-two unrelated and healthy individuals together representing Malay, Chinese and Indian ethnicities in Malaysia were scored for the H63D, S65C and C282Y variants using a polymerase chain reaction-restriction fragment length polymorphism technique. Results: There are clear differences in H63D, S65C and C282Y allele and genotype frequency distributions between Malays, Chinese and Indians. In particular, H63D is more common in Chinese (5.19%) and Indians (7.29%), while S65C is more common in Malays (1.03%) and Chinese (1.04%). In addition, a susceptibility genotype for HH (the compound heterozygote for C282Y and H63D) was only detected in Indians (0.02%). Conclusion: Overall, our study is the first to provide data on the prevalence of H63D, S65C, and C282Y genetic variants and HH risk profiles for Malays, Chinese and Indians.

Barriers to Physical Activity and Exercise Amongst Persons With Physical Disability in a Government-funded Teaching Hospital, Kuala Lumpur

@#Introduction: Physical inactivity is common among persons with disabilities (PWDs), thereby leading to harmful secondary complications. Therefore, this cross-sectional study aimed to identify the barriers to physical activity and exercise amongst PWDs in Malaysia. Methods: A total of 102 adults (age 15–65 years) with physical disabilities were recruited from a government-funded hospital. The participants completed the ‘Barriers to Physical Exercise and Disability’ questionnaire via interview by telephone calls or a one-to-one approach. Results: Most participants (90.2%) were interested in engaging in exercise programs. However, the mean concern index score was 2.83 ± 1.35. The majority of the respondents identified five major barriers. These barriers include health concerns (36.3%), transport barriers (36.3%), lack of energy and motivation (36.3%, 31.4%), and exercise program costs (23.54%). Conclusion: Many participants were interested in beginning an exercise program despite the barriers. This observation shows that if the barrier is eliminated, then, this community would be able to participate in an exercise program regularly. Results from the study can inspire health care providers to devise strategies for the promotion of physical activity participation and long-term adherence between PWDs.

Combination Effect of Tamoxifen and Ascorbic Acid Treatment on Breast Cancer Cells (MCF-7) and Cervical Cancer Cells (HeLa) Kesan Rawatan Kombinasi Tamoksifen dan Asid Askorbik ke atas Sel Kanser Payudara (MCF-7) dan Sel Kanser Serviks / Jurnal Sains Kesihatan Malaysia

@#Breast cancer and cervical cancer are among the leading causes of death among women in the world. Even though chemotherapy is available as cancer treatment, the development of drug resistance in both cancer cells has reduced the efficacy of chemotherapeutic drugs in such treatment. The current study was aimed to evaluate the cell viability of human breast cancer cells, MCF-7, and cervical cancer cells, HeLa upon the combination treatment of ascorbic acid and tamoxifen. The cell viability was measured using the MTT assay, with an incubation period of 72 hours in a humidified CO2 incubator. The concentrations of tamoxifen and ascorbic acid that reduced 50% of the cell population (IC50) were determined from the dose-response curve. The IC50 concentration was used to determine the cell viability in the treated cells. CompuSyn software was used to evaluate the combined effects towards both cells upon treatment and the results were calculated as combination index (CI). The data were analyzed using GraphPad Prism (version 7). Statistical analysis was performed using an independent t-test. The IC50 values of tamoxifen and ascorbic acid on MCF-7 cells were 14.53 µg/ml and 15.8 µg/ml respectively, while the IC50 values of tamoxifen and ascorbic acid on HeLa cells were 11.09 µg/ml and 202.3 µg/ml respectively. The combination of tamoxifen and ascorbic acid exerted a greater growth reduction percentage in both cells compared to tamoxifen alone. The results indicated that ascorbic acid synergizes the cytotoxic effect of tamoxifen at lower concentrations towards MCF-7 cells with a CI less than 1. However, the combination of tamoxifen and ascorbic acid exerted an antagonistic effect in HeLa cells, with a CI more than 1.