Lifestyle and eating habits of bank employees in Mozambique / Estilo de vida y hábitos alimenticios de banqueros em Mozambique / Estilo de vida e hábitos alimentares de bancários em Moçambique

Objective: to evaluate the lifestyle and eating habits of bank workers in Mozambique. Method: a cross-sectional study with a quantitative approach, with 32 employees from three bank branches, selected through convenience sampling, in 2021. A food frequency questionnaire and a lifestyle questionnaire were applied. Descriptive statistics were employed for data treatment using SPSS v.25, presenting the data as absolute and relative frequencies. Results: in terms of lifestyle, 65.6% of participants were physically active, 100% were non-smokers, and 40.6% preferred fruits and vegetables instead of sweet and savory foods. Regarding food consumption frequency, the bread and equivalents group had the highest daily intake, with French bread (44%) being the most consumed, followed by the fruit and vegetable group with lettuce leading consumption (44%). The third group was meat and equivalents with the most consumed food in that category being fried egg (28%). The least consumed food group was oils and sauces with the most consumed in the category being salad dressings (19%). Conclusion: more healthy lifestyles and eating habits were evidenced.

Validity, Reliability and Responsiveness of the Malay Shoulder Pain and Disability Index (M-SPADI) for Patients with Shoulder Pain

@#Introduction: The purpose of this study is to determine the validity, reliability, and responsiveness of the Malay Shoulder Pain and Disability Index (M-SPADI) in Malay speakers suffering from shoulder pain. Materials and methods: The M-SPADI, the Numerical Rating Scale (NRS), and measurements of shoulder active range of motion (AROM) were completed by 140 patients with shoulder pain (68 with rotator cuff pathology and 72 with other shoulder pathology). Thirty-four patients were retested for test-retest reliability with M-SPADI after an average of 9.2 days. M-SPADI was performed on twenty-one individuals three months after completing treatment for rotator cuff disorders to assess response. Results: The results of exploratory factor analysis revealed a bidimensional structure for M-SPADI. M-SPADI disability score was significantly greater in patients with rotator cuff pathologies (median = 31.87, IQR 82.50) than in patients with other shoulder pathologies (median = 20.00, IQR 23.84). In multi-group factor analysis, measurement invariance revealed no significant difference between the two groups (p>0.05). There was a significant positive correlation between M-SPADI and NRS (Pain = 0.86, Disability = 0.75, Total = 0.82, p=0.005), and a significant negative correlation between M-SPADI and shoulder AROM (Pain = -0.34 to -0.67, Disability =-0.44 to -0.73, Total =- 0.43 to -0.72, p=0.005). M-SPADI had a high degree of internal consistency (Cronbach's 0.92 for pain and 0.95 for disability). Test-retest reliability was moderate to excellent (ICC Pain = 0.84, ICC Disability = 0.78, ICC Total = 0.81, p=0.001), and the smallest detectable change ranges (Pain = 8.74, Disability = 3.21, Total = 3.83) were less than the minimal detectable change ranges (Pain = 21.57, Disability = 6.82, Total = 8.79). The area under the receiver operating characteristic curve (AUC) for M-SPADI was greater than 0.90 (Pain = 0.99, Disability = 0.94, Total = 0.96). Conclusion: The M-SPADI has established construct validity, internal consistency, test-retest reliability, and responsiveness. The M-SPADI is a reliable and valid instrument for evaluating shoulder pain among Malayspeaking individuals. In addition, the M-SPADI disability subscale may be useful for monitoring functional score changes in patients with rotator cuff pathology.

Prevalence of Dental Fluorosis and Its Associated Factors After Cessation of Water Fluoridation

@#Introduction: Water fluoridation (WF) was ceased in the state of Pahang, Malaysia, in July 2012. Any changes in fluoride exposure during childhood can influence the development of fluorosis. Thus, this study aimed to compare the prevalence of fluorosis between WF-ceased and WF-continued areas in Malaysia, and its associated factors among 7 and 12-year-old children. Methods: A cross-sectional study was conducted among children in WF-ceased and WF areas (n=1211). The 12-year-olds in WF-ceased areas were exposed to WF between 4.5 to 6.5 years before cessation, and it was hypothesised they would have similar fluorosis prevalence as their counterparts who lived in WF areas. The 7-year olds were born during the cessation period. Examination of fluorosis was performed by a calibrated dentist using Dean’s criteria and a parental questionnaire was utilised to collect information about demographics and exposure to fluoride. Results: Fluorosis prevalence (Dean’s≥2) was significantly lower among children in WF-ceased areas than WF areas (p< 0.001). Intra-area comparison indicated that the 12-year olds have higher prevalence of fluorosis than the 7-year-olds, except for anterior fluorosis scores among those in WF areas. The majority of fluorosis cases were very mild in both areas. Simple logistic regression indicated that duration of exposure to WF, age, mother’s income and education, age started toothbrushing with toothpaste, and frequency of toothbrushing were associated with fluorosis. Conclusions: Fluorosis prevalence decreased following water fluoridation cessation. The null hypothesis that 12-year-olds in both areas would have similar prevalence of fluorosis was rejected. Several factors were associated with fluorosis.

Validity and Reliability of the Malay Version of the Identification of Functional Ankle Instability (IdFAI-M) Questionnaire among Malaysian University Athletes

@#Introduction: This study was designed to produce a validated and reliable Malay version of the Identification of Functional Ankle Instability (IdFAI-M) questionnaire. Materials and method: The cross-cultural adaptation was conducted based on standard guidelines to produce the Malay version of the Identification of Functional Ankle Instability (IdFAI-M) questionnaire. The reliability and validity testing were then performed among one hundred and twenty-three physically active University of Malaya students. Among them, twenty-two students also participated in the second return of the questionnaire over a two-week interval, which was then evaluated for test-retest reliability testing. Results: The content validity for item-level (I-CVI) and Kappa values for all items were more than 0.7, respectively and the all scales-level (S-CVI) values were 0.983 (consistency), 0.967 (representativeness), 1.00 (relevance) and 0.983 (clarity). The questionnaire also demonstrated excellent reliability with an intraclass correlation coefficient (ICC2.1) above 0.850 for all items. It was observed that outer loading of most items were more than the minimum acceptable value (0.7). Fornell-Larcker criterion demonstrate all values for each reflective construct was larger than the correlations with other constructs, indicating discriminant. The cross-loading values of each item has shown a weak correlation with all other constructs, except for the one to which it was theoretically associated. Conclusions: The Malay version of the IdFAI (IdFAI-M) is a reliable and valid instrument that can be readily utilised to subjectively assess ankle instability.

Dimensions of Pathophysiology of COVID 19 on the Body Systems and Its Implication for Investigations, Treatment and Further Studies

Introduction:The 2019–20 coronavirus pandemic is a continuing pandemic of coronavirus disease 2019 (COVID-19), result in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). By May 27th, 2020, over 5.61million people have been infected with COVID 19 across the globe in over 200 countries with more than 350,000 deaths. So far more than 2.3million people have recoveredfrom the COVID 19 pandemic.Objective:To review literatures associated withvarious pathophysiology on the body systems identified and published so as to guide effective management of patient with COVID 19. To highlight some pathological dimensions of the systems significantly affected by COVID 19 to identify gaps for the enhancement of further studies Methodology:The LILACS-BIREME, SCIELO, PUBMED, ACADEMIA, SCIENCE DOMAIN databases and some textbooks were accessed for the study. Scientific papers published in English between January and May, 2020 on the pathophysiology of COVID 19 were reviewed. A total of 89 reports published between 1stJanuary 2020 to 29thMay 2020 were identified and reviewed. Sixty-sevenpublications meeting the inclusion criterion on COVID 19 pathophysiology were selected for this review. Finally, an analysis was conducted and the papers were assessed in agreement with the study objectives.Results andDiscussion:The review has discovered different pathophysiological changes on about sevenbody systems namely respiratory, cardiovascular, hematological, nervous, urinary, digestive and reproductive systems.Conclusion:There are a lot of pathophysiological dimensions that have devastating effect on the body systems which may need immediate investigations, treatmentand further studies.

Biological and Comorbidity as Risk Factors for COVID 19 High Morbidity and Mortality among the Aged Population and Its Implications for Public Health Education and Research in Ghana

Introduction:The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been found to be the cause of this current pandemic of corona virusinfection (COVID 19), (World Health Organization (WHO) 2020). It is of interest to note that Wuhan, which is located in the Hubei province of China, was the first community within which this outbreak was first identified in December 2019. There is high morbidity and mortality among the elderly patients with COVID-19 than the young and middle-aged patients. Again, most of the morbidity and mortality have comorbid conditions (presence of more than one disease in one person) from 1 to 3 in addition to COVID 19 and most of these conditions are age related.Objective:The aim of this work is to describe changes in biological processes in aged population in relation to the presence of a possible comorbidity vis-à-vis COVID 19. To review publications and other studies associated with biological changes in the ageing process as well as identifying some specific comorbidity among the aged. To develop an appropriate health educational programs to protect the aged population on COVID 19. To develop an educational strategy on COVID 19 for the aged and the general public.Methodology:The LILACS-BIREME, SCIELO, PUBMED, ACADEMIA, SCIENCE DOMAIN databases and some textbooks were consulted for the study. Scientific papers published English between January and March, 2020 on the subject of COVID 19 among the aged were selected for inclusion. A total 65 of studies published between January 1st, 2020 to March 30th, 2020 and some textbooks on Anatomy and Physiology were identified and evaluated. Twenty-seven (27) articles meeting the inclusion criterion (COVID 19 among the aged) were selected for this review. Finally, an analysis was conducted and the papers were assessed in agreement with the study objectives. Results andDiscussion:The studies reviewed discovered a high prevalence and mortality of COVID 19 among the aged with comorbidity due to deterioration in ageing process in Respiratory and the Immune systems. Conclusion:It is recommended that some further research be done locally on COVID 19 to increase the knowledge on this subject in Ghana. It is also recommended that an appropriate health educational strategy be developed to create awareness among the aged.

Demographic study of brain tumour in a neurosurgical department in Terengganu, Malaysia

@#patients, families as well as the surrounding communities,especially the healthcare services. It can be classified intoeither a benign slow growing tumour (non-cancerous) andmalignant tumour (cancerous). The purpose of this studywas to determine the incidence and pattern of brain tumouradmitted to the Neurosurgery Department in HospitalSultanah Nurzahirah (HSNZ), Terengganu, Malaysia.Methods: This is a retrospective study of incidence andpattern of BT admitted to the Neurosurgery Department inHSNZ. Data was collected from the yearly census of BTregistered from 2013 to 2018.Results: A total number of 386 new cases of primary BT wereregistered. The number of cases of BT was found to belowest among children (0 to 10 years old) with only 4.4% butat peak among elderly aged between 51 to 60 years old(26.2%). As for gender, males constituted about 44.5%(n=172) whereas females accounted for 55.5% (n= 214) of thecases. In total, meningioma was found to have the highestincidence (27.2%) followed by metastases brain tumour(18.1%) and glioma (17.4%). Conclusions: This study has shown that the incidence of BTwas led by meningioma which had a high prevalence amongthe elderly population, followed by metastasis BT andgliomas.

Image Quality of Coronary CT Angiography (CCTA) using 640-slice Scanner: Qualitative and Quantitative Assessments of Coronary Arteries Visibility (Kualiti Imej Tomografi Berkomputer Angiografi Koronari Menggunakan Mesin Pengimbas 640 Hirisan: Penilaian Kualitatif dan Kuantitatif ke atas Keterlihatan Arteri Koronari) / Jurnal Sains Kesihatan Malaysia

@#The purpose of this study was to evaluate the image quality and diagnostic accuracy of coronary computed tomography angiography (CCTA) using 640-slice scanner. Advancement of multidetector computed tomography (MDCT) technology with higher spatial, temporal resolution, and increasing detector array have improved the image quality and diagnostic accuracy of CCTA. A total of 25 patients (12 men and 13 women) underwent CCTA examination was chosen and data was acquired by 640-slice scanner. All 16 segments of coronary arteries were evaluated by two reviewers using a 4-likert scale for qualitative assessment. In quantitative assessment, the evaluation of 4 main coronary arteries were analysed in terms of signal intensity (SI), image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). All 25 patients with a mean age of 52.88 ± 14.75 years old and body mass index (BMI) of 24.24 ± 3.28 kg/m2 were analysed. In qualitative assessment, from the total of 400 segments, 379 segments (95%) had diagnostic value while 21 segments did not have diagnostic value, which means 5% artefact was detected. In quantitative assessment, there was no statistical differences in gender, race, and BMI (p>0.05). Overall evaluation showed that higher SI at the left main artery (LM) at 393.7 ± 47.19. Image noise was higher at right coronary artery (RCA) at 39.01 ± 13.97. SNR and CNR showed higher at left anterior descending (LAD) with 12.73 ± 5.17 and LM 9.14 ± 4.2, respectively. In conclusion, this study indicates that 640-slice MDCT has higher diagnostic value in CCTA examination with 95% vessel visibility with 5% artefact detection.

Radiation Dose Comparison in CT Thorax, CT Abdomen and CT Thorax-Abdomen-Pelvis (TAP) Using 640-and 160-Slice Computed Tomography (CT) Scanners (Perbandingan Dos Sinaran dalam Pemeriksaan Tomografi Berkomputer (CT) Toraksik, Abdomen dan Toraksik-Abdomen-Pelvis (TAP) antara 640 dan 160 Hirisan) / Jurnal Sains Kesihatan Malaysia

@#This study was carried out to compare the effective dose, size specific dose estimation (SSDE) and scan length between genders and between CT scanner with different slice number. A total of 245 set data of radiation dose and scan length for CT scanning procedure involving thorax, abdomen and pelvis regions were obtained retrospectively for comparisons. 111 patients (60 males and 51 females) were scanned using 160-slices CT scanner while 134 patients (71 males and 63 females) were scanned using 640-slices CT scanner. Generally, there were no significant differences in the radiation dose and scan length among genders. However, differences for SSDE in CT thorax and CT thorax-abdomen-pelvis (TAP) protocols exist whereby in CT thorax protocol, 640-slices CT scanner had a significantly higher value of SSDE (9.06±2.67 mGy) than that in 160-slices CT scanner (7.82±1.33 mGy). Similarly to the CT TAP protocol, whereby 640-slices CT scanner had a significantly lower value in SSDE (9.17±1.59 mGy) than that in 160-slices CT scanner (10.76±3.72 mGy). In conclusion, there was no significant difference in the radiation dose and scan length between genders but significant difference was only observed in SSDE due to the presence of body size variation among the study population especially in different CT scanners.

Incidence of Football and Futsal Injuries Among Youth in Malaysian Games 2018

@#Introduction: Football and futsal were the main sports in the Malaysian Games. However, they were associated with a risk of injury. The purpose of the study was to analyse the incidence, circumstances, and characteristics of football and futsal injuries during the Malaysian Games of 2018. Materials and method: During the tournament, 14 teams participated in men's football, 12 teams in men's futsal and 11 teams in women's futsal. The biannual event involved athletes aged under 21 years. A medical report form used by FIFA Medical Assessment and Research Centre (F-Marc), was provided to the physiotherapists and team doctors of all the teams to report all injuries after each match. Results: The response rate was 84.62% in football and 59.76% in futsal. A total of 48 injuries were reported from 26 football matches, equivalent to 64.64 injuries per 1000 match hours (95%CI 46.35 to 82.93). In futsal, a total of 48 injuries from 41 matches were reported, equivalent to 292.42 injuries per 1000 match hours (95% CI 209.7 to 375.14). The rate of injury in women futsal players was higher compared to men: 358.21 versus 247.04 injuries per 1000 match hours (p=0.224). Futsal recorded higher injuries per 1000 match hours than football (p<0.001). Conclusion: The rate of severe injury in futsal and football recorded in the study as compared to previous studies gave rise to serious concerns. Hence, there was an urgent need to pay more attention to injury prevention strategies.

ANTHROPOMETRIC CHARACTERISTICS OF MALAYSIAN COMPETITIVE POWERLIFTERS WITH PHYSICAL DISABILITIES

@#Background: Studies on the anthropometric, physical and physiological characteristics among Malaysian Paralympic powerlifters are limited. This study examined the sociodemographic, clinical information and anthropometric physical parameters of Paralympic powerlifters in Malaysia.Methods: A cross-sectional study was conducted during a Powerlifting Workshop and National Championship in 2016. A structured questionnaire was used to collect data on powerlifters’ sociodemographic, sports participation history and medical information. All participants underwent a structured physical medical examination and anthropometric assessments. Results: Fifty-two powerlifters participated in this study. Mean age of participants was 24.50±SD8.25 year. The majority of the participants were men (82.7%) and most had spinal cord injury (34.6%) or amputation of the lower limb (26.9%). Most of the powerlifters competed at district and state level championships and 42.3% had represented Malaysia at international competitions. Women powerlifters had a significantly higher amount of body fat compared to men (35.61% vs 19.80%; p=0.003). Male power-lifters had significantly longer arm and forearm length (30.10±IQR3.00 cm vs 23.00±IQR2.13 cm; p=0.020). A significantly positive relationship was found between age, experience, weight, BMI, LBM, arm circumferences (relaxed and tensed) and the powerlifter’s best lift. Age, experience, body weight, BMI, lean body mass, body fat, hip circumference and arm circumferences (relaxed and tensed) met the criteria for inclusion in a multivariate model. Years of experience and non-dominant arm circumference (tensed) were significant predictors of best lifts among powerlifters. Conclusion: In conclusion, assessment of anthropometric measures could be useful in monitoring athletes’ progress with training and have a role in the talent identification program for Paralympic powerlifters

Genes Biomarkers In Autism: Brain Development And Function

Myasthenia gravis is an autoimmune disorder that places patients in debilitating condition. It currently affects 14 to 20 per 100,000 population. Its pathogenesis involves the destruction of acetylcholine receptor by antibodies pro-duced by lymphocytes in the thymus gland. Symptoms could vary from impair extraocular muscles to generalized weakness. The antibodies have also been reported to affect other muscle structure within the body such as cardio-myocytes, leading to arrhythmia episodes which could be fatal. This review is a student project and involves the as-sessment of myasthenia gravis and the interplay between thymoma and thymomectomy.

The Effectiveness Of A Navigation System For Ambulance Service In Kuala Lumpur, Malaysia

@#The response and transport intervals of an ambulance dispatch are affected by various factors. The present ambulance system relies on the driver’s experience, knowledge of local road map and estimations of directions. These may contribute to delays, misdirection and inefficient utilization of resources. The objectives of this study were to assess the effects of GPS navigation device on the response and transport time intervals of an ambulance service operating in urban setting. This was a three-month experimental study involving simulated ambulance dispatch based in a hospital. A total of 50 simulated cycles were constructed. Travel time, arrival time and distance were documented from each cycle. The median actual response time using map and GPS navigation device was 11.82 min and 10.47 min respectively. The median actual transport time using map and GPS navigation device was 11.00 min and 10.74 min respectively. The differences in response time and transport time between map and GPS navigation were not statistically significant (p= 0.215 and p=0.710). The application of GPS reduced the error value between estimated and actual response time by 8.73%. It also reduced the mean error value between estimated and actual transport time by 1.42%. The result shows that the GPS navigation device allowed for more accurate travel time estimation and its application in an urban setting such as Kuala Lumpur has the potential to reduce ambulance response time.

The Effectiveness of a Navigation System for Ambulance Service in Kuala Lumpur, Malaysia

The response and transport intervals of an ambulance dispatch are affected by various factors. The present ambulance system relies on the driver’s experience, knowledge of local road map and estimations of directions. These may contribute to delays, misdirection and inefficient utilization of resources. The objectives of this study were to assess the effects of GPS navigation device on the response and transport time intervals of an ambulance service operating in urban setting. This was a three-month experimental study involving simulated ambulance dispatch based in a hospital. A total of 50 simulated cycles were constructed. Travel time, arrival time and distance were documented from each cycle. The median actual response time using map and GPS navigation device was 11.82 min and 10.47 min respectively. The median actual transport time using map and GPS navigation device was 11.00 min and 10.74 min respectively. The differences in response time and transport time between map and GPS navigation were not statistically significant (p= 0.215 and p=0.710). The application of GPS reduced the error value between estimated and actual response time by 8.73%. It also reduced the mean error value between estimated and actual transport time by 1.42%. The result shows that the GPS navigation device allowed for more accurate travel time estimation and its application in an urban setting such as Kuala Lumpur has the potential to reduce ambulance response time.

Prehypertension and hypertension in medical students of northern border university in Arar, Saudi Arabia

Aim of the work: hypertension is the commonest cardiovascular disorder. Prehypertension in adolescents and young adults is a risk factor for developing hypertension in later years of life. The objective of this study was to determine the prevalence rate and risk factor associated with prehypertension and hypertension in the medical students of Northern Border University in Arar city, Saudi Arabia

Methods: this crosssectional study included 232 students. The study subjects were selected by systematic random sampling method. This study included 232 medical students [136 male and 96 female]. The study period was from 1 March to 31 May 2017. Students were given a predesigned and pretested questionnaire to collect the relevant data

Results: Fifty [52.1%] of females and 58.8% of males were pre-hypertensive and 1.5% from males were hypertensive. Family history of hypertension was positive in 66.7% of hypertensive or prehypertensive students [P<0.05], 18.2% were obese [P<0.05], 9.1% of hypertensive or pre-hypertensive students were diabetic [P>0.05], 31.8% were smokers [P>0.05], 10.6% were drug addicts [P>0.05], 18.2% only performing muscular exercise [P>0.05], 62.1% consume >5g salt /day [P<0.05]and 40.9% of them spent 2-5 hours in front of TV, Computer or mobile [P>0.05]

Conclusion: in medical students of the Northern Border University, 52.1% of females and 58.8% of males were pre-hypertensive and 1.5% of males were hypertensive. Risk factors included obesity, family history, sedentary life and excess salt intake. So health-care providers should recognize the increased risk of prehypertension and hypertension and should seek to identify and manage the modifiable risk factors in those students

Variation in morphology of soft palate using cone-beam computed tomography in Sakaka population

Objective: The aim of the present study was to investigate the variation in morphology of soft palate in age groups and gender using CBCT in Sakaka population

Study design: The study sample consisted of 240 CBCT scans aged between 15 and 45 years. The velar morphology on CBCT was examined and grouped into six types. The results obtained were subjected to statistical analysis to find out the association between variants of the soft palate with gender and different age groups

Results: The most frequent type of soft palate was Rat tail shaped. [46.25%] followed by Leaf shape, 18.75% Butt shape, 13.33% and Handle shape, 10%. S-shape7.5% and Crook shape, was 4.1%. There was no significant difference between Males and Females

Conclusions: The knowledge of a varied spectrum of velar morphology and the variants of the soft palate assist in the better understanding of the velopharyngeal closure and craniofacial anomalies

study of the interaction between H. pylori mice passage strains and gastric epithelial cells

Helicobacter pylori [H. pylori] infections are very serious health problem that are further worsened by increasing/developing resistance to the current antibiotics. Therefore, new therapeutic agents are needed for H. pylori eradication. Use of a CD46 derived peptide [P3] as bactericidal agent against H. pylori has shown high activity rate in vivo and this study examines the changes in H. pylori features in response to effect of P3 treatment.AGS cells were infected with H. pylori wild type strain 67:21 and its mice passage strains [P3 treated and untreated strains] and further examined using immunoblotting assay, FACS and Urease activity analysis. Comparatively we found increased level of Urease alpha subunit A [UreA] and alkyl hydroperoxide reductase C [AhpC] proteins for P3 treated strain of H. pylori than its wild type or untreated strain after infection of AGS cells. Conclusion These results suggest that there might be a high rate of adherence to host cells for the P3 treated passage strain than untreated or wild type strain. Our findings also indicate that either adhesins are being changed or H. pylori interaction to the host cells is affected after P3 treatment

Impact of virtual reality games on psychological well-being and upper limb performance in adults with physical disabilities: A pilot study

Introduction: There is limited information regarding the effects of interactive virtual reality (VR) games on psychological and physical well-being among adults with physical disabilities. We aimed to examine the impact of VR games on psychological well-being, upper limb motor function and reaction time in adults with physical disabilities. Methods: Fifteen participants completed the intervention using Wii VR games in this pilot study. Depressive, Anxiety and Stress Scales (DASS) and Capabilities of Upper Extremity (CUE) questionnaires were used to measure psychological well-being and upper limb motor function respectively. Upper limb reaction time was measured using reaction time test. Results: Results showed that there was a significant difference (p<0.05) in DASS questionnaire and average reaction time score after intervention. Conclusion: There is a potential for using interactive VR games as an exercise tool to improve psychological wellbeing and upper limb reaction time among adults with disabilities.

Damage control resuscitation: A case of thoraco abdominal impalement

Damage Control Resuscitation and Surgery is the concept of controlled hypotension, haemostatic resuscitation and abbreviated surgical procedures following severe trauma; the practice of which has resulted in improved mortality and morbidity. We describe a rare case of thoraco-abdominal impalement successfully managed based on the concept of Damage Control Resuscitation.

Anti N-Methyl-D-Aspartate Receptor Encephalitis with Ovarian Teratoma: A Dilemma in Diagnosis

We report a rare case of altered mental status in a young patient with immature ovarian teratoma. A 22-year-old woman presented with seizures, hallucination, amnesia and orofacial dyskinesia. Examination and investigation revealed an ovarian massand asalphing-oophorectomy was performed. The histopathological examination result showed an immature teratoma grade 2 with thepresence of immature primitive glial tissue. Her CSF N-Methyl-DAspartic acid receptor (Anti-NMDAR) antibodytest was positive. N-Methyl-D-Aspartic acid receptor antibody associated limbic encephalitis is an autoimmune antibody-mediated neuropsychiatric disorder. Resection of the tumour and immunotherapy resulted in full recovery.