A Review on Finite Element Modelling and Simulation for Upper Limb of Human Bone and Implant

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

Stress Distribution and Stability Evaluation of Difference Number of Screws for Treating Tibia Transverse Fracture: Analysis on Patient-Specific Data

@#Introduction: Screws placement may influence the stress distribution and stability of the plate and bone. Implant failures are normally happened in clinical practise when inappropriate number of screws is implemented. Therefore, intensive investigations are needed to provide additional quantitative data on the use of different number of screws. Therefore, this study was conducted to investigate the biomechanical performance of different number of screws configurations on Locking compression plate (LCP) assembly when treating transverse fractures of the tibia bone. Methods: Finite element method was used to simulate tibia bone fracture treated with LCP in standing phase simulation. To accomplish this, a three-dimensional tibia model was reconstructed using CT dataset images. 11 holes of LCP and 36mm of locking screws were developed using SolidWorks software. From this study, there are three models in total have been developed with different number of screws and screw placements. A diaphysis transverse tibia fracture of 4 mm was constructed. Results: In terms of stress distribution, all configurations provide sufficient stress and do not exceeding the yield strength of that material. Conclusion: In conclusion, eight numbers of screws were the optimum configurations in order to provide ideal stability to the bone with displacement of 0.37 mm and 0.91 mm at plate and bone, respectively.

Kinematics and Comfortability Analysis of Orthosis for Patients Associated With Anterior Cruciate Ligament Injury: Hinge Versus Sleeve

@#Introduction: Every month, Sports National Institute (ISN) in Malaysia received around 3 to 4 cases associated with anterior cruciate ligament (ACL) injury involving athletes in hockey, kick volleyball and netball. Knee orthosis is one of treatment method and has been shown to support lower limb joint mechanics, which may protect the ACL injury for becoming worst. In this paper, an investigation was conducted to evaluate the performance of existing knee orthosis for treating ACL injury. Methods: Ten participants which have been grouped into two; six ACL patients (Group 1) and four healthy subjects (Group 2), where they took part in two bracing conditions; 1) with hinge (Brace 1) and 2) sleeve with bilateral hinges (Brace 2). A non-braced condition was included as a baseline measure. Three-dimensional kinematics data were used to calculate knee joint motions. Results: From the findings of ACL subjects, the knee flexion in non-braced condition (49.9°) has high value than others two braces, in which Brace 1 (40.9°) is less value than Brace 2 (44.6°). This shows the Brace 2 have higher degree of freedom than Brace 1. Other than that, the comfortability assessment found that Brace 2 is the most favourable options by participants in terms of less slippage and comfortless condition. Conclusion: In conclusion, the Brace 2 give best performance during dynamic balance activity in individuals who benefit from high degree of freedom and less slippage issue.

Patient-Specific Design of Passive Prosthetic Leg for Transtibial Amputee: Analysis Between Two Different Designs

@#Introduction: Amputee patients are usually utilized prosthetic leg for daily activities such as walking, climbing, and running. However, the current prosthetic leg that available from the market often associated with poor comfortability due to its conventional way of socket manufacturing. Therefore, this research aims to build custom-made passive transtibial prosthetic legs and to evaluate the aspects of biomechanical analysis. Methods: The residual leg of a subject was scanned using the Sense three-dimensional scanner. By referring to scanned residual leg model, two design of prosthetic legs which are the low-cost solid ankle cushion heel (SACH) foot (D1), and the high-cost flex foot (D2), were developed by using computer aided software (CAD), SolidWorks and Meshmixer. Each of the components were then meshed with triangle edge length of 5 mm in 3-Matic software. Marc.Mentat software was used to simulate the midstance phase of a gait cycle where an axial load of 350 N was applied. Results: The overall maximum stress of the D1 (190.2 MPa) was higher than D2 (38.47 MPa). In addition, socket and pylon in D1 showed tendency to yield because the maximum stress is higher than yield stress of respective materials. In displacement analysis, D2 showed higher overall displacement than D1 because the flex foot has higher flexibility. Conclusion: From overall result, prosthetic leg of D2 is better in biomechanical strength as compared with the D1 because it can withstand the loading from subject’s weight without showing any sign of yield.

Finite Element Modelling and Simulation for Lower Limb of Human Bone: A Review

@#Most orthopaedic cases that involved with bone fracture are normally treated with medical implants. To be noticed that some precautions in terms of biomechanical and biomaterial properties are necessary for a successful post-surgery process. The biomechanical evaluation of implants could be carried out using computing and engineering technologies. However, in the computer simulation, some assumptions are needed as the limitations on computer resources and data input. This review focuses on the current method of developing the finite element model for patients with specific values of material properties for lower limb part such as hip, knee and ankle joint. Previous literature was reviewed from which keywords and search engines were identified. In this review, inclusion and exclusion criteria were used to limit the literature search. We reviewed the state-of-the-art in this area and provide recommendations for future research. In conclusion, the previous published reports illustrated different methods to develop numerical models.

Knowledge and attitude of nurses towards diabetic foot care in a secondary health care centre in Malaysia

@#Introduction: Nurses play a vital role in the care and prevention of ulcers in patients with diabetic foot. Patient education, prevention of ulcers and rehabilitation are some of the vital aspects that nurses provide on a daily basis. Thus, good knowledge and attitude of nurses towards diabetic foot ulcers and its care will ensure better patient care. Objectives: The aim is to study the level of knowledge and attitude of nurses towards diabetic foot ulcers and its care in Hospital Segamat, Malaysia. Methods: A validated questionnaire was used between February 2019 to May 2019 covering area such as demography, predisposing factors of ulcer formation, characteristics of ulcers, complications of ulcers, and attitude towards diabetic foot care. Results: A total of 101 nurses took part and 57% of the participants scored poorly in the knowledge section of the questionnaire. In all 72% had scored poorly when asked regarding complications of diabetic foot ulcers; 49.5% of the nurses had positive attitude towards diabetic foot care; and 79.3% thought that care for diabetic foot ulcer is timeconsuming. Majority of them think that their colleagues are the main source of information. All demographic variables were deemed to be confounders with the knowledge and attitude of nurses towards diabetic foot ulcers and its care. Conclusions: Nurses in this centre had poor knowledge towards diabetic foot ulcers and its care. None of the variable studied were correlated with the level know knowledge. Good or poor knowledge of nurses does not correspond equally to good or poor attitude towards diabetic foot ulcers care. More frequent formal training of diabetic foot care would be needed to ensure better knowledge.

Spatial-Temporal Pattern of Mosquito-Borne Disease Occurrence Based on Epidemiological Data: A Case Study from Terengganu

@#Introduction: The trend of several mosquito-borne diseases in Malaysia has shown an increasing pattern over the past few years despite close monitoring and continuous control initiatives by public health authority. The objective of this study is to determine the spatial and temporal epidemiology of mosquito-borne disease in Terengganu from the year 2009 to 2018. Terengganu has been selected because it is geographically unique and experiences two monsoon seasons per year. Methods: Weekly surveillance data of mosquito-borne diseases which include dengue fever, malaria, filariasis, Japanese Encephalitis (JE) and chikungunya from 2009 to 2018 were collected from the Terengganu State Health Department. The variables included in the dataset mainly comprises of disease onset, diagnosis, case category, area (district) and site of onset. The data has been monitored spatial and temporal in which to explore the distribution pattern of the disease. The annual average for each type of mosquito-borne disease was determined using time-series and is further analysed by using geographical information system (GIS) tools to form spatial statistical analysis. Results: Results indicate that the temporal distribution of the mosquito-borne disease in Terengganu increases slightly despite a fluctuating pattern from the year 2009 to 2018 and there are between each type of mosquito-borne disease. Spatial analysis showed different stratification between seasons as well as the areas that are more susceptible to each disease. Conclusion: The results obtained in this present study through spatial and temporal analysis revealed that mosquito-borne diseases show a dynamic pattern in distribution. It can be concluded that the occurrence of the diseases depends on the geographical area and the weather within the region. This study provides public health authorities with a comprehensive assessment that will be useful for surveillance and monitoring, as well as for predicting and managing mosquito-borne disease outbreaks effectively

Industrially relevant cellulase production by indigenous thermophilic Bacillus licheniformis TLW-3 strain: Isolation-molecular identification and enzyme yield optimization

Cellulases are the third largest single industrial bio-robots. These enzymes are employed in industries like pharmaceutical, textile, food processing, paper recycling and detergent manufacturing. In order to produce broadly diversified cellulases, microbes [both bacteria and fungi] have been exploited. Different ecological niches have already been explored for the isolation of cellulolytic microbes. However, there have been no remarkable reports viz a viz to the hot oven ash [for cellulolytic bacterial flora]. In this regard, a Bacillus strainTLW-3 was isolated and selected for CMCase production and optimization. The strain was identified as B. licheniformis TLW-3 through 16S rDNA sequencing that was submitted to Gen Bank with accession numberKY440432. The isolate growth and CMCase production conditions were optimized to get the maximum CMCase yield. The highest growth and maximum CMCase production by B. licheniformis TLW-3 were recorded at pH 7 and 50?C, after the incubation period of 72 [hour] at 150rpm. Studies on the various nitrogen and carbon sources on CMCase production showed that the medium having 1% peptone, 0.5% yeast extract and 1% CMC can significantly enhance the enzymatic yield as compared to other [studied] sources. EDTA, Tween-20 and Tween-80 acted as inhibitors for the enzyme production. The present study holds the conviction that the [reported] organism could directly be applied to produce industrial thermophilic CMCase

Development and validation of liquid chromatographic method for quantitative determination of Loxoprofen in mobile phase and in human plasma

A Simple, sensitive and accurate high-performance liquid chromatographic [HPLC] method for effective and specific analysis of Loxoprofen [LXP] in the mobile phase and human plasma was developed. Effective chromatographic separation was attained on a Mediterranea Sea C18 column [250×4.6mm, 5um] with mobile phase containing acetonitrile and 0.01 M NaH2PO4 buffer [55: 45] by adjusting pH 6.5 with sodium dihydrogen phosphate buffer at a flow rate of 1ml/ min. Calibration ranges from 0.1ppm to 10 ppm with a coefficient of relation value [R2=0.999] by using a linear regression method and lower limit of quantification was 0.1ppm. The current method showed inter-day and intra-day accuracy and precision within the range of +/- 10%. % RSD was found to be less than 5 %. Analytical recovery was more than 90% which confirmed the reliability of current method. The proposed method was found appropriate for assessment of LXP in pharmacokinetic and bioequivalence study

ex vivo up-take of levamisole molecules by cestode [Monezia expensa] of goat [Capra hirsa] and its detection through RP-HPLC

Detection of various molecules of drugs remained a prime issue especially in tissues of animals, humans and in their target parasites. The cestode/tapeworms pose a dilemma because of their weird body composition and uptake pattern of nutrients and medicines especially through absorption by tegument. We selected levamisole; thought to be potent antiparasitic/ ani-cestodal drug. The uptake of levamisole [LEV] through cestodeal tissues is studied through HPCL in this paper. High performance liquid chromatography technique has been utilized to know the uptake of levamisole in tissues of cestodes of Goat [Monezia expensa] in small ruminants. The drug was exposed to M. expensa by in vitro till its death or a parasite ceases its movement. The tissue/ part of proglattids of the M. expensa were homogenized with some modifications and levamisole extraction was performed with liquid phase extraction method. The evaporation of solvent was done and the residual cestodal tissues were cleaned by solid phase. After the solid phase extraction method, the recovery of drug, detection and quantification of levamisole from cestodal tissues was determined through Reverse Phase Column High Performance Liquid Chromatography [RP-HPLC]. Levamisole [LEV] molecules assay was obtained on a C18 reverse-phase [20um, 6mm x 150mm] column at flow rate of 1ml/min using acetonitrile and ammonium acetate as mobile phase and UV detection was done at 254nm. The development of method of Levamisole [LEV] detection from cestodal tissues by HPLC in vitro samples has been demonstrated first time in Pakistan, which can provide the solution of parasitic control and provide in sight in to the uptake of anti cestodal drugs either against human or livestock parasites

Chronic obstructive pulmonary disease, its new drug treatments and strategies: a review

COPD is a complicated disease. Current available treatments are just for symptomatic relief and they cannot reverse the damages to lungs tissues due to alveolar destruction in COPD. Research is being conducted to evaluate new treatments and strategies to find specific treatments to minimize the symptoms of COPD. A new mixture of herbal medicine i.e AKL1 has emerged and thought to cure COPD symptoms especially cough related quality of life of COPD patients. Although, the results have showed no significant difference as compared to placebo but researchers recommend further evaluation in a large population [COPD Patients] group. Another medicine Roflumilast, a phosphodiesterase 4 inhibitor, was also found to be effective to treat COPD under specific recommendations with further research needed. Finally another medicine Indacaterol, a novel, once-daily [o.d] inhaled long-acting beta2-agonist proved to be effective clinically to treat COPD related broncho-constriction and also increasing the COPD patient's compliance by reducing the number of doses as compared to other conventional inhaled bronchodilators such as Albuterol

Improvised laparostomy pack to manage laparostomy for injuries due to improvised explosive devices [IEDs]

Splinters of improvised explosive devices [IEDs] cause multiple intestinal perforations and random pattern visceral injuries causing contamination of peritoneal cavity. This necessitates multiple peritoneal toilets and relook surgeries. Surgical management is to perform laparostomy to avoid life threatening complication, like abdominal compartment syndrome and fulminant sepsis. "Peshawar pack" is a three-layer temporary abdominal dressing pack for managing laparostomy. It is prepared in operation room and applied on patients with ease. Patients with abdominal injuries due to blasts of IEDs, managed with Peshawar pack during June 2014 to June 2016, were studied to determine the effectiveness and practical utility of Peshawar pack. Data was analysed by SPSS version 22. Total numbers, means +SD and frequencies with percentages were described. In fifty-five patients selected for the study, effective drainage of peritoneal cavity and control of peritoneal sepsis was achieved in all cases. Mobilisation out of bed was possible in 38 cases [70%] within 3-5 days and evisceration during mobilisation occurred in 02 cases [3.6%]. There was no case of iatrogenic gut injury. Complete fascial closure in staged manner was achieved in 53 cases [96%]. Peshawar pack is a simple, practical, and effective method for laparostomy care in abdominal injuries due to blast of IEDs

Improvised laparostomy pack to manage laparostomy for injuries due to improvised explosive devices [ieds]

causing contamination of peritoneal cavity. This necessitates multiple peritoneal toilets and relook surgeries. Surgical management is to perform laparostomy to avoid life threatening complication, like abdominal compartment syndrome and fulminant sepsis. "Peshawar pack" is a three-layer temporary abdominal dressing pack for managing laparostomy. It is prepared in operation room and applied on patients with ease. Patients with abdominal injuries due to blasts of IEDs, managed with Peshawar pack during June 2014 to June 2016, were studied to determine the effectiveness and practical utility of Peshawar pack. Data was analysed by SPSS version 22. Total numbers, means +SD and frequencies with percentages were described. In fifty-five patients selected for the study, effective drainage of peritoneal cavity and control f peritoneal sepsis was achieved in all cases. Mobilisation out of bed was possible in 38 cases [70%] within 3-5 days and evisceration during mobilisation occurred in 02 cases [3.6%]. There was no case of iatrogenic gut injury. Complete fascial closure in staged manner was achieved in 53 cases [96%]. Peshawar pack is a simple, practical, and effective method for laparostomy care in abdominal injuries due to blast of IEDs

Role of Pre-Synaptic NMDA Receptors in the Modulation of Inhibitory Synaptic Transmission in Sensory-Motor and Visual Cortical Pyramidal Neurons in Brain Slices of Young Epileptic Mice

Background: Previous studies from animal models have shown that pre-synapticNMDA receptors (preNMDARs) are present in the cortex, but the role of inhibition mediated bypreNMDARs during epileptogenesis remains unclear. In this study, we wanted to observe thechanges in GABAergic inhibition through preNMDARs in sensory-motor and visual corticalpyramidal neurons after pilocarpine-induced status epilepticus.Methods: Using a pilocarpine-induced epileptic mouse model, sensory-motor and visualcortical slices were prepared, and the whole-cell patch clamp technique was used to recordspontaneous inhibitory post-synaptic currents (sIPSCs).Results: The primary finding was that the mean amplitude of sIPSC from the sensorymotorcortex increased significantly in epileptic mice when the recording pipette contained MK-801 compared to control mice, whereas the mean sIPSC frequency was not significantly different,indicating that post-synaptic mechanisms are involved. However, there was no significant presynapticinhibition through preNMDARs in the acute brain slices from pilocarpine-inducedepileptic mice.Conclusion: In the acute case of epilepsy, a compensatory mechanism of post-synapticinhibition, possibly from ambient GABA, was observed through changes in the amplitude withoutsignificant changes in the frequency of sIPSC compared to control mice. The role of preNMDARmediatedinhibition in epileptogenesis during the chronic condition or in the juvenile stagewarrants further investigation.

Metal complexes of isonicotinylhydrazide and their antitubercular activity

The development and spreading of Multi Drug Resistant TB strains is hampering endeavours for the control and administration of tuberculosis [TB]. The expansion episodes of multi-medication safe strains of Mycobacterium tuberculosis against first and second line antituberculosis drugs on one side and the unfavourable effects of these drugs on the other side has led the enthusiasm of researcher towards the synthesis of metal complexes of various medication. This approach is born with the expectation of finding new antituberculous operators without or least reactions as well as being active against the resistant strains of Mycobacterium tuberculosis. This study concentrates on the screening of five metal complexes of isoniazid [INH] against five Mycobacterium tuberculosis strains. These strains have been confirmed by WHO being active and even proliferating safely even in the presence of pyrazinamide, isoniazid [INH], ethambutol and rifampicin. In this work INH was taken as reference medication. All synthesized complexes and INH were subjected for a month and a half in BACTEC MGIT 960 technique. INH and its Fe [II] complex restrained the development of all bacterial strains for merely two weeks, while the Fe[III], Cu[II], Co [II] and Mn [II] complexes repressed the development five strains for three weeks. Conclusively, the strains utilized in this study were discovered to be more susceptible to the later four complexes than the ligand [INH] drug and its Fe [II] complex. Furthermore, elemental analysis and atomic absorption of all complexes were conducted for the determination of metal to ligand ratio

Clinicopathological features associated to MiRNA-195 expression in patients with breast cancer: Evidence of a potential biomarker

Background and Objective: MiRNAs are a systematic class of small non-coding RNAs with impending role; tumor biomarkers. Our objective was to identify the level of expression of Mir-195 in patients with brea cancer along with its correlation with clinicopathologic features

Methods: A total of 209 females in which 139 historically diagnosed breast cancer [BC] cases and] healthy controls matched for age, their relative clinical and histopathological findings were recorded fro their laboratory reports and hospital record of the patients. Plasma was used for extraction of total l" and cDNA was prepared by using both miR-195 stem loop RT primers and gene specific antisense prime while U6 IT was used as control. Quantitative real-time PCR [qRT-PCR] for miR-195 expression status w< performed and amplification [down regulation] was recorded

Results: Of 139 samples the expression of miR-195 was down regulated in 72.6% cases and the remains 27.3% cases behaved same as 70 healthy or normal controls. Significant correlation of low miR-15 expression with higher differentiation grade, lymph node metastasis and clinical stage was found

Conclusion: Significant correlation between miR-195 expression and some Clinicopathological feature were recognized. MiR-195 could be used as potential non-invasive, molecular biomarker for early detectio of breast cancer

Intralesional versus oral chloroquine in cutaneous leishmaniasis: comparison of outcome, duration of treatment and total dose of drug

Objective: to compare intralesional versus oral chloroquine in cutaneous leishmaniasis and determine the cure rate, duration of treatment, and total dose of drug

Study Design: Randomized controlled study

Place and Duration of Study: department of Dermatology, Sheikh Zayed Medical College/Hospital, Rahim Yar Khan, from November 2013 to June 2014

Methodology: consecutive 86 patients of cutaneous leishmaniasis, with single to multiple lesions of various sizes were enrolled and divided randomly into group A and B for the purpose of intralesional and oral chloroquine administration, respectively to compare the effect of the two routes on duration of treatment and total dose of the drug. SPSS version 16 was used for data analysis after data entry into it. Quantitative variables like, duration, cost and total dose of treatment were calculated as mean and standard deviation and compared by using T-test. P-value of less than 0.05 was taken as significant

Results: cure rate was 100% in both groups towards the end of treatment. Mean duration of treatment was 9.17 +/- 3 weeks in intralesional [A] group as against 11.37 +/- 3 weeks in oral [B] group [p = 0.0028]. Mean total dose of the drug given to each patient in group A was 5.8 +/- 0.5 gm and in group B, it was 19.2 +/- 1.5 gm, which is significantly higher [p < 0.001]. The total cost of treatment in group A was Rs. 90 +/- 8 and in group B it was Rs. 91 +/- 1 [p=0.446]

Conclusion: duration of treatment is significantly shorter and total dose is lesser with intralesional compared to oral chloroquine in treatment of cutaneous leishmaniasis