Quality Assessment Of Alternative Patent Fingerprint Method Using Alcohol Gel And Thermal Paper / Jurnal Sains Kesihatan Malaysia

@#Fingerprints are unique structures made up of a combination of friction ridges. Due to the individual characteristics of fingerprints, it is used commonly used for identification. Traditionally, patent fingerprints are obtained using an ink pad. Unfortunately, the print takes time to dry on paper and sometimes the fingerprint will leave streaks on a finger and nearby surfaces. Alcohol gel and thermal paper could address this problem as the alcohol component in gel is a weak acid that can reacts with the leuco dyes present on thermal paper. Hence forth, this study intends to find an alternative method of obtaining patent fingerprints using various combinations of alcohol gels and thermal papers. Six donors were requested to deposit their fingerprints on different types of thermal paper using different brands of alcohol gel hand sanitisers. Quality scores based on CAST’s grading scheme were used to determine the fingerprint quality using various combinations of thermal paper and hand sanitisers. The result showed that patent fingerprints developed using hand sanitiser and thermal paper were of lower quality than the standard (ink pad). Combination of alcohol-based hand sanitiser, which consists of 70% alcohol concentration and ATM receipt paper was found to be able to produce the best quality fingerprint among the studied combinations. Despite this result, it still indicates that fingerprints using an ink pad is still the best method to record a fingerprint.

Prevalence and Susceptibility of Staphylococcus aureus Nasal Carriage Strains Isolated from Haemodialysis Patients

@#Introduction: Staphylococcus aureus is part of the normal human flora that can commonly be found on the skin and mucous membranes of the nasal area. However, in immunosuppressed patients such as those with kidney failures, colonization can potentially lead to infection. There is a concern of increasing antibiotic resistance in S. aureus. This study aimed to determine the prevalence of S. aureus nasal colonization and its antimicrobial susceptibility among haemodialysis-dependent populations. Methods: A cross-sectional study at the Nephrology Unit, Hospital Canselori Tuanku Mukhriz (HCTM) was conducted among haemodialysis-dependent patients between February 2017 to February 2018. Nasal swabs were obtained and cultured on mannitol salt agar. S. aureus isolates were identified by gram staining, tube coagulase and Deoxyribonuclease (DNase). Cefoxitin disc (30 µg) were used to identified the presence of MRSA (methicillin-resistance S. aureus). The S. aureus colonies were further tested against six antibiotics using Kirby Bauer disc diffusion. Result: A total of 134 patients were recruited. S. aureus isolates were detected from 27 patients (20.1%). All S. aureus were phenotypically identified as methicillin-sensitive S. aureus (MSSA) based on the cefoxitin disc. Teicoplanin and linezolid were the most effective with 100% susceptibility. S. aureus exhibited a high resistance rate towards erythromycin (29.6%). No MRSA was isolated in this study. Conclusion: This study highlighted the high prevalence of S. aureus nasal colonization in haemodialysis patients. Teicoplanin and linezolid were found to be the most effective antibiotics against isolated S. aureus.

A Study from a Highly Populated Country : Risk Factors Associated with Lower Back Pain in Middle-Aged Adults

Objective@#: Low back pain (LBP) is a global health problem that affects the productivity of the patients. Several factors such as individual, occupational, and psychosocial factors increase the risk of LBP. However, only a few studies investigated those factors, especially in middle adulthood in Indonesia. Indonesia is a country with a young population that has been rapidly developing in recent years. This study was conducted to find out the factors associated with LBP in middle adulthood. @*Methods@#: This study is a cross-sectional observational analytic study using a convenience sampling method with a total sample of 3005 respondents. Data were collected using a questionnaire which was then analyzed using the chi-square test, Kolmogorovsmirnov, Spearman’s Rank, and logistic regression test. @*Results@#: From the result of this study, it was found that the 12-month prevalence of LBP in middle-aged adults was 44,29%. Female (odds ratio [OR], 1.3; 95% confidence interval [Cl], 1.098–1.545; p=0.002), lack of physical exercises (OR, 0.87; 95% Cl, 0.794–0.959; p=0.005), high body mass index (OR, 1.09; 95% Cl, 1.009–1.187; p=0.002), stress level (OR, 1.26; 95% Cl, 1.088–1.458; p=0.002), and years of work experience (OR, 1.1; 95% Cl, 1.001–1.225; p=0.047) were determined as risk factors that significantly associated with LBP. @*Conclusion@#: LBP is quite common among middle-aged adults in Indonesia. Female gender, higher body mass index, lack of physical activity, stress level, and years of work experience were all potential risk factors for LBP in middle-aged adults. Middle-aged adults in Indonesia should be aware of LBP and avoid disabilities by identifying risk factors that may worsen LBP in the future.

Combination of polymyxin B and Aquilaria malaccensis extract enhanced the killing and inhibited the growth of Acinetobacter baumannii and Klebsiella pneumoniae

Aims@#Polymyxins are an important last-line treatment for infections caused by multidrug-resistant Gram-negative bacteria. Nonetheless, the emergence of polymyxin-resistance and the limiting of polymyxin monotherapy urgently demands its optimisation. Aquilaria malaccensis (Agarwood) has been widely used as traditional medicine. Many parts of the plant including leaves exhibit a considerable in vitro antibacterial activity against microbial pathogens. Exploiting A. malaccensis in combination with polymyxins provides a novel strategy in fighting antimicrobial resistance. The objective of this study was to evaluate the combination effects of A. malaccensis extract with polymyxins against Acinetobacter baumannii and Klebsiella pneumoniae.@*Methodology and results@#In vitro time-kill studies and GC-MS analysis were performed to evaluate the bacterial killing of polymyxin B and extract combination and analyse chemical compounds of the extract, respectively. The combination of polymyxin B (1 mg/L) and A. malaccensis extract (32 mg/mL and 64 mg/mL) treatments exhibited enhanced bacterial killing compared to polymyxin B alone at 4 h and 24 h. Combination treatments also inhibited the bacterial growth of both A. baumannii and K. pneumoniae observed throughout the 24 h. More than sixty compounds including phytol, 9,12-octadecadienal, fatty acid, alkanes and terpenoids were putatively identified as the compounds that likely contributed to the antibacterial activity.@*Conclusion, significance and impact of study@#This study was the first to report the potential application of A. malaccensis extract in combination with polymyxin B in treatment against A. baumannii and K. pneumoniae and can be further investigated and optimized for the treatment of bacterial infectious diseases.

A review: Antimicrobial activity and toxicity analysis of the peel of banana, pomegranate, papaya, and citrus fruits (lemon and orange)

ABSTRACT@#Fruits have nutrients and health-promoting compounds and usually fruits are eaten fresh with minimally processed. To meet rising demand, the production and processing of horticultural crops of fruits have grown massively in response to the population and changing dietary habits. It is rarely known that some fruit wastes, including peel, actually have their own advantages to humans as well as industry. In fact, these fruit wastes, including fruit peel, should be handled and used to minimise the environmental impacts. The functional properties of the peel of banana, pomegranate, papaya, and citrus fruits such as lemon and orange can beneficially help in the production of new health products and in food industries. Antimicrobial compounds in fruit peel play an important role in inhibiting the microbial growth, specifically pathogenic microorganisms such as Escherichia coli, Bacillus aureus, Campylobacter, Salmonella, and Staphylococcus aureus. The antimicrobial compounds present in the fruit peel are typically secondary metabolites consisting, in particular, of phenolic compounds, steroids and alkaloids, which give certain functional effects on human health. It has been reported that every fruit peel has its own antimicrobial compounds which are responsible for inhibiting microbial growth. These fruit peel, despite their beneficial effects, have also been shown to have toxicity effects on their consumption depending on the amount of doses used in the implementation. This review covers physiological properties, chemical properties, antimicrobial activity, and the toxicity analysis of the fruit peels from banana, pomegranate, papaya, and citrus fruits.

Hedgehog signalling molecule, SMO is a poor prognostic marker in bladder cancer

@#Introduction: Hedgehog (HH) pathway is an important signalling cascade for growth and patterning during embryonic development. Constitutive activation of Hedgehog pathway can be found in various types of malignancies including medulloblastoma, basal cell carcinoma, gastrointestinal, breast, pancreatic, prostate cancer and leukaemia. Little is known about the expression and role of Hedgehog signalling in bladder cancer. Materials and Methods: The purpose of this study was to investigate the immunohistochemical expression of SMO in 112 bladder cancer cases and determine their association with demographic and clinicopathological parameters. Bladder cancer tissues were obtained from the Hospital Kuala Lumpur. Results: SMO was expressed in the cytoplasm of all cases of bladder cancer. 6 cases (5.4%) showed low expression, while 106 cases (94.6%) showed high expression. Positive expression of SMO protein was correlated with a few variables which include grade and stage of tumour, lymph node metastasis and distant metastasis. SMO expression showed statistically significant association with higher grade (p=0.001) and higher stage (p=0.042) of bladder cancer. SMO expression also showed borderline association with lymph node metastasis (p=0.056). Conclusion: These findings indicate that SMO expression may be a poor prognostic marker in bladder cancer.

Diagnostic dilemmas in fulminating sub-acute sclerosing pan-encephalitis (SSPE) with atypical presentation

@#Subacute sclerosing panencephalitis (SSPE) is a progressive, fatal disease of the central nervous system caused by a persistent measles virus in the brain. It is clinically characterized by insidious onset of intellectual deterioration and behavioral changes followed by myoclonic jerks and eventually complete neurologic deterioration. In about 10% of patients, the clinical manifestations of SSPE are not typical and that may cause a delay in the diagnosis. We report here 3 cases of SSPE with atypical presentations. Bilateral vision loss, hemiparesis, ataxia and acute encephalopathy with focal seizures were respectively the presenting symptoms at the onset of disease. The typical periodic EEG complexes in two patients and positive CSF measles IgG antibody led to the diagnosis of SSPE.

A Case Of Maxillary Sinus Carcinoma: An Occult Aggressive Entity

Carcinoma of the maxillary sinus is a rare aggressive entity. Squamous cell carcinoma of maxillary sinus has the highest incidence among the tumors developing within the sinonasal compartment and has one of the worst outcomes in comparison with other head and neck tumors. Management of these tumors often presents an uphill task to clinicians. In the present case, the patient presented with a swelling in the left cheek region with a history of trauma and altered sensation and no other signs and symptoms. Based on the history and clinical examination, a provisional diagnosis of infraorbital fracture was given. Further, radiographic and histopathological evaluation was done which leads to the final diagnosis of squamous cell carcinoma of the left maxillary sinus. As oral physicians, we come across diseases of the maxillary sinus; thereby, complete assessment of any pathology of the sinuses may help in early diagnosis of this deadly disease

Evaluation of in-vitro apoptosis induction, cytotoxic activity of Hymenodictyon excelsum (Roxb) Wall in Dalton’s lymphoma ascites (DLA) and Lung fibroblast - Mouse L929 cell lines.

The purpose of present study was to investigate the methanolic bark extract of Hymenodictyon excelsum (Roxb) Wall for its apoptosis, cytotoxic activities. Induction of apoptosis was carried out on L-929 cell line. The cytotoxic activity was evaluated by MTT assay against lung fibroblast (L-929) cell line and trypan blue dye exclusion assay on dalton’s lymphoma ascites (DLA) cells. Morphological changes and DNA fragmentation were found upon incubation with extract. The extract was found to be cytotoxic towards L-929 cells in 72 h MTT assay and concentration required for 50% cell death was 3.85μg/ml. Thus from the present investigation it can be concluded that the methanolic bark extract of Hymenodictyon excelsum (Roxb) exhibited apoptosis induction and cytotoxic activities.

Unruptured ectopic pregnancy is still uncommon in our setup

To analyze the frequency of ectopic pregnancy, treatment modalities, maternal outcome and why the unruptured ectopic pregnancy is presented less frequently in our set up. Cross sectional descriptive study. This study was conducted at the Department of OBGYN PUMHS Nawabshah from January 2008 to December 2010. All the patients who have a clinical suspicion for ectopic pregnancy or diagnosed by ultrasonography included in the study. Verbal interviews were taken in the post operative period for assessment of educational and socio economic status of patient along with the behavior of the referring authority. Patients' records were reviewed for clinico surgical finding and maternal outcome. Eighty eight [88] women were presented with ectopic pregnancy out of 13286 deliveries at PUMHS Hospital Nawabshah during 03 years study period making a frequency of 0.66%. No risk factor identified in 58[65.9%] of cases. 56[63.63%] patients presented in acute way. Regarding treatment modalities 86[97.72%] patients underwent laparotomy amongst them salpingectomy was performed in 50[56.81%], salpingo-oophorectomy in 28[31.81%], milking of tube were carried out in 03[3.40%] patients and complete tubal abortion was found in 05[5.86%] patients. 02 patients with unruptured ectopic pregnancy were selected for medical treatment, 01 was successful and other failed and treated by salpingectomy. Maternal outcome was satisfactory; no maternal death was found in the study group. Blood transfusion was required in 100% of patients [1-4 pints]. Regarding the aspect of why we are not receiving the patients with unruptured ectopic pregnancy, we found that > 90% of our patients belong to poor socioeconomic group and uneducated. Remaining patients belong to middle social class and were able to write their name. We found it an important factor in starting late antenatal care. We also assessed the behavior of referring authority as well as in our out- patient department; urine for the P.T was the preferable method of diagnosing first trimester pregnancy. Ultrasound was only advocated once patients presented with acute symptoms of ectopic pregnancy. The detection of unruptured ectopic pregnancy is almost nil in our setup due to late reporting to hospital by women when pregnant and inability of the health care providers to suspect it when faced with early pregnancy problems of lower abdominal pain and irregular vaginal bleeding. A change in the health professional behavior, provision of beta HCG estimation and transvaginal ultrasound in public sector hospitals are the modalities to improve the detection of unruptured ectopic pregnancy

Early pregnancy complications and risk factors

To determine the underlying risk factors in early pregnancy complication and outcome. Case series study. This study was conducted in the Department of Obstetrics and Gynaecology at Peoples Medical College Hospital Nawabshah from January 2010 to December 2010. all the women with first trimester pregnancy with different complications were included in this study, while those women with uneventful first trimester were excluded. The included women were registered on pre-designed proforma studied variable including demographic details, gestational period, type of complication, risk factor treatment and outcome. The data was examined in terms of mean and percentage with a confidence interval of 95%. Analysis was done on SPSS version 10. out of 661 total early pregnancy admissions, 309 [46-74%] patients had different early pregnancy of complication. Their mean age was 29.22 +/- 6.22 years. Commonest complications found were abortion in 206 [66.66%] cases. The underlying risk factors found in miscarriage were antiphospholipid syndrome in 8 [3.88%] cases, diabetes mellitus in 35 [16.99%] cases. Hypertension in 50 [24.27%] cases, PCOS in 15 [7.28%] cases and infection in 10 [4.85%] cases. 60 [61.22%] cases were treated by minor surgical procedures and 38 [38.77%] cases treated with conservative medical therapy. Outcome were anaemia in 245 [79.28%] cases, psychological upset in 189 [61.16%], infection in 131 [42.39%] and coagulopathy in 17 [5.50%] cases. Miscarriage was found as the most frequent early pregnancy complication and the most frequent risk factor was hypertension. Outcome included anaemia, psychological upset and infection

Use of misoprostol for induction of labour in unfavourable cervix

Objective of this study was to determine the maternal and fetal outcome after induction of labour with misoprostol in term pregnancies with unripened cervix. Experimental study. Non probability convenient, in the labour ward of Nawabshah medical college hospital Sindh, Pakistan from 6th April 2008 to 5th Dec 2008. Total 114 patients were induced with misoprostol who had singleton pregnancy of more than 36 weeks with cephalic presentation, reactive CTG and unfavorable cervix [Bishop Score <4]. Sampling strategy was non probability convenient sampling. However, patients with previous cesarean section, parity >4, nonreactive CTG, any contraindication to induction of labour and bishop score > 4 were excluded from the study. After taking an informed consent, patients were given 100mcg misoprostol in posterior fornix of vagina every 6 hour till 3 doses or initiation of labour. Labour was recorded on partogram. Maternal and fetal outcome were recorded on a self designed proforma. Majority of patients i.e. 63 [55.26%] belonged to age group of 23-30 years. Eighty seven [76.31%] patients who received induction were primigravida while 27 [23.68%] patients were P2-P4. Thirty six [31.57%] patients required single dose of misoprostol, 54 [47.36%] patients required two doses while 24 [21%] patients required three doses. Out of all these 114 patients, labour was successfully completed in 93 [81.57%] patients. While cesarean section was done in 21 [18.42%] patients. About 48 [42.10%] patients were delivered in 8 to 9 hours. Uterine hyper stimulation was seen in 9 [7.89%] patients. Apgar score was less than 7 in six [5.26%] newborns. Misoprostol is safe for induction of labour with an unfavorable cervix. The results were satisfying with minimal complications

Role of uterovaginal packing in postpartum hemorrhage

Objective: To find out the safety and efficacy of uterovaginal packing in postpartum hemorrhage in terms of complications and success to arrest bleeding

Place and Duration of Study: This study was conducted at Department of Obstetric and Gynecology Nawabshah Medical College Hospital, Sindh-Pakistan from 2[nd] January 2008 to 4[th] August 2009

Patients and Methods: In this prospective interventional study all patients presenting with postpartum hemorrhage who did not responded to medical treatment, placenta previa or coagulation failure, following vaginal delivery or cesarean section, were included. Multiparous women were also included in the study if they expressed strong desire to conserve uterus. Cases of ruptured uterus, perineal trauma, cervical trauma and vaginal trauma were excluded from this study. Frequencies and proportions of complications were calculated along with rate of successful cessation of bleeding. Data were analysed by SPSS version 11

Results: During study period 138 patients of postpartum hemorrhage underwent uterovaginal packing. Uterine atony unresponsive to oxytocics was the commonest cause of postpartum hemorrhages [n=88, 63.76%] followed by coagulopathy in 25 [18.11%]. Uterovaginal packing was successful in 89.14% patients. Post-insertion morbidity included fever more than 100[degree sign] F in 25 [18.11%] and episotomy wound infection in 9 [6.52%] patients

Conclusion: Results of this study show that uterovaginal packing is effective in arresting the bleeding. Uterovaginal packing still retains an important role in emergency obstetrics

Emergency obstetric hysterectomy frequency and maternal outcome

To review the frequency, indications and maternal outcome of emergency obstetric hysterectomy. Descriptive study. In obstetrics and gynecology department of Nawabshah Medical College Hospital Sindh from 2nd May 2005 to 31st April 2008. During the study period total 3089 patients were delivered. Out of these, 37 patients underwent cesarean hysterectomy. Records of all the patients were analyzed. The parameter analyzed were age, parity, social status, booking status, indication for operation, operative notes, maternal outcome, complications and postoperative status. Mortality register was also checked for the causes of maternal deaths. During the study period, there were 3089 deliveries. Amongst these 37 had emergency obstetric hysterectomies giving rise to a frequency of 11.9 / 1000 cases. Regarding parity, 23[62.1%] were multiparous, 12 [32.4%] patients were grand multiparous and 2 [5.4%] patients were primiparous. Commonest indication of emergency obstetric hysterectomy was postpartum hemorrhage due to uterine atony which was seen in 13[35.1%] cases, followed by ruptured uterus in 11[29.7%] cases, placenta previa in 6[16.2%] cases, and couveliar uterus in 5 [13.5%] cases and placenta accreta in 2 [5.4%] cases. Commonest maternal complications were urinary tract infection in 6[16.2%] patients followed by DIC in 5[13.5%] patients. Maternal mortality was seen in 2[5.4%] patients. In our study frequency of emergency obstetric hysterectomy was high. Most common indication was rupture uterus, post partum hemorrhage due to atony uterus and placental causes. After UTI, disseminated intravascular coagulation was most common complication seen. 2patients were expired. Sever Emergency obstetric hysterectomy when performed in selected cases at an appropriate time helps in bringing down maternal mortality

Evaluation of relaxant effect of Levcromakalim on oxytocin induced contraction of isolated Rat uterus

To observe the relaxant effect of Levcromakalim [a Potassium Channel Opener] on the Oxytocin induced contractions of the non-pregnant, isolated rat uterus. This study was carried out in the Department of Pharmacology, Shaikh Zayed, Post Graduate Medical Institute, Lahore. The Female non-pregnant albino rats [Sprague dawley strain], weighing approximately 150 to 200g were included in the study. The living animals were injected with Diethylstilbestrol [0.1 mg/kg], intramuscularly, 24 hrs before the experiments to make the uterus more sensitive to the effect of Oxytocin. The animals were then sacrificed, the uterus of each animal was dissected out and the isolated uterus was placed in the tissue organ bath, containing Dejalon`s solution which was aerated with 100% oxygen and the temperature of the system was maintained at 32[degree sign]C. First, the normal activity of the isolated uterus was recorded and then the effect of Oxytocin [contractions] was observed. The dose of Oxytocin [1-5micro g] was required to produce sub-maximal contractions of the uterus. Later on Levcromakalim [a potassium channel opener] relaxant effect was observed. The dose of Levcromakalim [1-5 micro g] was required to reduce 50% uterine contractions produced by Oxytocin. The concentration [dose] of Oxytocin required to produced the sub-maximal contractions of the rat uterus was [Mean +/- SEM] 4.360 +/- 0.644ng. The dose of Levcromakalim required to decrease 50% contractions of the uterus induced by Oxytocin was [Mean +/- SEM] 3.041 +/- 0.364micro g. The study proved that Levcromakalim [a Potassium Channel Opener] is a relaxant of the rat uterus and it can be clinically used in Dysmenorrhea and Pre-mature labour in humans

Renal failure - a dreadful complication seen in patients with abruptio placentae

In a clinical study in the department of Obstetrics and Gynaecology at People's Medical College Nawabshah from 15th April 2000 till 30thAPril 2003, it was noted that 1662 patients got admitted in the maternity ward, amongst whom 340 [21%] patients came with the complaint of antepartum haemorrhage out of which 110 [7%] patients were found to have abruptio placentae. Amongst whom, in 72 [65%] patients the abruptio was severe enough to cause intra uterine death of the fetus and 15 [14%] patients developed acute renal failure. Five patients died due to the additive effects of various complications. 13 [12%] patients needed peritoneal dialysis out of them 7 patients subsequently improved and 3 patients required kidney transplantation and were referred to Karachi. Early diagnosis and quicker treatment saved the rest of the patients from developing dreadful complications