Primary dysmenorrhoea among reproductive-age women at Kuala Selangor health clinic: Prevalence and factors associated.

INTRODUCTION: Primary dysmenorrhoea (PD) is a frequent gynaecological condition in adolescents and adult women worldwide, affecting their daily activity and leading to a lower quality of life. The purpose of this study is to determine the prevalence, severity, and factors associated with PD among reproductive-age women at Kuala Selangor Health Clinic. MATERIALS AND METHODS: This cross-sectional study used systematic random sampling at the Kuala Selangor Health Clinic from 3rd July to 29th September 2017. This study included 213 women between the age of 18 and 35 years old. The questionnaires consist of sociodemographic, lifestyle activities, and menstrual history components with Numerical Rating Scale (NRS) for menstrual pain as well as the Pictorial Blood Assessment Chart (PBAC) to quantify the blood loss during menstruation. RESULTS: A total of 210 women participated in this study with a response rate of 98.6%. The prevalence of PD was 60.5% with 13.4%, 75.6%, and 11.0% for mild, moderate, and severe in intensity, respectively. Nulliparous (OR: 5.1, CI: 1.508, 17.277, p = 0.009), first-degree family history of dysmenorrhoea (OR: 4.431, CI: 1.727, 11,368, p = 0.002), heavy menstrual blood flow (OR: 11.6, CI: 2.849, 47.53, p <0.001), and lack of regular physical exercise (OR: 14.037, CI: 5.161, 38.183, p < 0.001) were found as the significant association for PD. Meanwhile, having a short menstruation reduces the risk of PD during menstruation (OR: 0.04, CI: 0.004, 0.391, p = 0.006). CONCLUSION: PD is prevalent among reproductive-age women. Physical exercise is a protective factor for PD, hence health care providers particularly those in primary care settings should regularly counsel and encourage women to be physically active.

Refractory Right Coronary Artery Spasm: A Case Report.

Herein, we report a case of severe coronary spasm during cardiac catheterization refractory to medical management. Although this condition is usually managed with vasodilating agents, our patient ultimately required placement of stents.

Balloon-assisted Tracking of Guide Extension Catheter: A Novel Technique to Retrieve a Carotid Embolic Protection Device.

Embolic protection devices are used to minimize the risk of stroke by preventing the migration of emboli during carotid artery stenting (CAS). After the successful conclusion of the CAS procedure, these devices are meant to be retrieved. Sometimes retrieval of the filter can be difficult. This difficulty in retrieval can be due to multiple factors such as incomplete stent expansion, stent fracture, vasospasm, and vessel tortuosity causing pseudostenoses. In this case report, an under-expanded proximal carotid stent strut contributed to the filter not being retrievable in spite of maneuvers to retrieve the filter. An innovative approach was used; a coronary guide extension catheter was used to enhance support and balloon-assisted tracking of the extension catheter then permitted advancement of the retrieval device and ultimate retrieval of the filter. This technique to retrieve a carotid filter has not been previously described in the literature.

The Effect Of Grasping The Steering Wheel While Positioning The Shoulder Closer To The Body

@#Discomfort and pain issue at the body part are common complaints reported by car drivers. It is due to driving task require physical demands and need to maintain and adapt several postures in a constrained space while controlling the car. Hence, this study aims to determine the pattern of shoulder activation muscle consisting of the Trapezius muscle in two different driving posture. Respondents were required to grasp the steering wheel at 8 and 4 hand position. The Surface Electromyography was used to get the reading for left muscle’s Trapezius Descendent (TD) at two different positions; i) closest distant from steering wheel and ii) far distant from the steering wheel. Then, Temporal Analysis was used to evaluate the pattern of the driving action. From the experiment, it shows the different value of muscle activation occurred while driving according to turning action. The far seated position depicted greater activation on driving action compared to the closer seated to the steering wheel. In conclusion, the driving posture effects the activation of shoulder and arm’s muscles as early as after 20 seconds of driving activity. Hence, choosing the correct driving posture allowed a comfortable driving environment for the driver.

W/M serrated osteotomy for infantile Blount's disease in Ghana: Short-term results.

PURPOSE: The W/M serrated high tibial osteotomy is a not frequently described surgical technique for simultaneously correcting the varus and torsional deformity in patients with Blount's disease. Without the need for internal fixation, this surgical treatment is well suited for developing countries. This study describes the short-term results of the bilateral and unilateral W/M serrated osteotomy in patients with infantile Blount's disease. METHODS: Between May 2008 and January 2013, 52 patients were treated with uni- (n = 22) or bi-lateral (n = 30) W/M serrated osteotomy of the proximal tibia due to a tibial varus deformity in two district hospitals in Ghana. Other causes than infantile Blount's disease were excluded from the analysis. Pre- and post-operative clinical and radiological measurements were done, and complications were monitored up to 12 weeks after surgery. RESULTS: Seventeen patients (five males, 12 females; mean age 4.9 [standard deviation: 2.10]) were included, which underwent a total of 25 W/M serrated osteotomies. The femorotibial angle was corrected from 34.1° ([mean] range: 6-68°) to - 7.1° ([mean] range: -28-5°). Only one patient had developed a wound infection, and all reached full consolidation. CONCLUSIONS: The W/M serrated osteotomy seems a profitable alternative technique for treating the varus and torsional deformity in patients with Blount's disease in the circumstances of developing countries. The short-term outcomes are good and promising with a low complication rate and good consolidation. Long-term follow-up results of these patients are needed to observe possible complications. LEVEL OF EVIDENCE: IV, therapeutic case series.

An electrochemical impedance spectroscopy (EIS) assay measuring the calcification inhibition capacity in biological fluids.

Pathological calcification of the cardiovascular system is one of the major causes of high mortality and morbidity in dialysis patients. The inhibition of ectopic calcification relies (I) on the formation of calciprotein particles (CPPs), nanospherical complexes of calcium phosphate mineral, fetuin-A and other acidic serum proteins, and (II) on the stabilization of calcium phosphate prenucleation clusters by fetuin-A monomers. In supersaturated serum, mineral ion aggregation leads to a change in the electrical impedance. In this work, we present a method based on electrochemical impedance spectroscopy (EIS) to establish an impedance trace of mineral ion clustering in vitro. In the presence of 20 µM of serum protein fetuin-A, a prototypic calcification inhibitor, we measured a change in impedance (Δ(R)) of 195.52 ± 27.78%Ω compared to 430.41 ± 11.36%Ω in inhibitor-free samples. We also identified a CPP-formation dependency on the actual content of ions and protein in the samples under investigation. Two-step ripening of CPP was also observed. The presented method may form the basis of a simple label-free bedside or online test to be used in routine clinical practice for estimating the calcification risk in serum.

Rapid disappearance of an endothelial ulceration in the left main coronary artery.

A case is presented of a 65-year-old male who presented with an acute anterior wall myocardial infarction. An initial coronary angiogram demonstrated an ulcerated atherosclerotic plaque in the left main coronary artery. After 48 h of aggressive medical therapy including a 2b3a glycoprotein blocking agent, repeat angiography demonstrated resolution of the ulcerated plaque. The process of atherosclerotic plaque rupture is of dynamic nature.

Synthesis of 1,2-unsaturated pyranosylphosphonate nucleosides from 3,4,6-tri-O-acetyl-D-glycal.

Ferrier rearrangement of 3,4,6-tri-O-acetyl-D-glucal (1) in the presence of triethylphosphite afforded the 2,3-unsaturated pyranose 2. Deacetylation and simultaneous migration of the double bond to 1,2-position in the sugar moiety was achieved by stirring in sodium ethoxide. Tosylation with one equivalent of tosyl chloride afforded 4. Nucleophile displacement of the tosylate of 4 with nucleobase in the presence of NaH/DMF followed by deprotection gave the desired 1,2-unsaturated pyranosylphosphonates 7a-c.

Clinical and radiological features of pseudomyxoma peritonei.

Pseudomyxoma peritonei is due to diffuse involvement of the peritoneal cavity with mucinous material. Four patients were found in two major general hospitals in Riyadh. All patients were male. Cardinal clinical features were abdominal distension, pain and weight loss. Computed tomography was helpful preoperatively. Laparoscopy or laparotomy were performed to arrive at a correct diagnosis.

Beta-endorphin and components of emotionality discriminate between physically active and sedentary men.

Differences between physically active and sedentary men were tested by profile comparison. The study identifies the relative importance of circulating beta-endorphin (BE), atherosclerotic disease risk (ADR) index, and selected components of emotionality in discriminating between physically active and sedentary men. The subjects were psychologically normal and medically healthy middle-aged men. Jogging activity was the subject classification criterion. The data were collected on selected physiological (treadmill), biochemical (blood collected from resting subjects), and psychological (Eysenck and MMPI) variables. The physical fitness score (PFS) was used as an index of fitness. Physically active men with a high PFS (n = 21), when compared to the sedentary men with a low PFS (n = 15), exhibited lower basal plasma BE, lower ADR, lower anxiety index (AI), and lower MMPI depression score (D). Canonical correlation analysis showed that PFS and BE in one set were correlated with D and neuroticism (NS) in another set of variables. Discriminant function analysis showed that the AI was the most powerful discriminator between the physically active and sedentary men, followed by BE and NS. Interestingly, BE and NS exhibited the same magnitude of discrimination power. The ADR exhibited less discrimination power, relative to AI, BE, and NS. In conclusion, the physically active men, compared to the sedentary men in this study, exhibited lower basal plasma BE, which appeared to be associated with less atherosclerotic disease risk, less neuroticism, less anxiety, and less depression.

Decreases in resting plasma beta-endorphin/-lipotropin after endurance training.

The purpose of the present study was to investigate changes in the resting plasma beta-endorphin/-lipotropin (beta E/beta-LPH) concentration that may occur with exercise training. A treatment group (N = 10) of previously sedentary, psychologically normal, and medically healthy middle-aged men trained for 4 months in a structured fitness program. The treatment group was compared with two age-matched groups: a jogger group (N = 10) and a sedentary group (N = 10). Venous blood was collected in the early morning after the subjects had been fasting for at least 12 h. The subjects were also resting at the time of blood collection. Resting plasma beta E/beta-LPH (measured by radioimmunoassay) decreased (P less than 0.05) following the 4 months of exercise training in the treatment group, from 11.01 +/- 1.62 (SE) to 7.22 +/- 0.99 pmol.1-1. The jogger and sedentary groups demonstrated no changes in the resting plasma beta E/beta-LPH concentration following the 4 months. Aerobic fitness, measured by the maximal oxygen uptake (VO2max), increased (P less than 0.01) from 36.56 +/- 2.58 (SE) to 44.85 +/- 1.34 ml.kg-1.min-1 in the treatment group after the 4 months of training. There were no changes in VO2max for either the jogger group or the sedentary group following the 4 months. In conclusion, beta E/beta-LPH in the plasma of resting middle-aged men appeared to be decreased after 4 months of aerobic training.

Effects of exercise on cardiovascular disease risk in women with NIDDM.

The effect of a 4-month exercise program on measures of cardiovascular disease (CHD) risk was observed in women (mean age = 59.2 +/- 3.9 years) of postmenopausal years with NIDDM, who demonstrated fair to normal control of blood glucose control. The women were randomly assigned to either an exercise (n = 5) or control (n = 5) group. Initially, both groups had a similar body mass index, resting heart rate and blood pressures, blood glucose and hemoglobin A1. After 4 months, the exercise group demonstrated a 32% increase (P less than 0.03) in both absolute and relative maximum oxygen uptake (VO2) while the control group remained unchanged. Significant differences were found between the exercisers and non-exercisers for absolute (F(1,8) 4.94, P = 0.057) and relative (F(1,8) 7.67, P = 0.024) maximum VO2 from pretest to posttest. Body weight (kg) and body fat (%) remained unchanged for both groups. Although total cholesterol was found to be reduced by 13% for the exercise group (P less than 0.03) and 11% for the controls (P less than 0.01), a 15% decrease (P less than 0.03) in high-density lipoprotein (HDL) was observed for the control group, only. Hence, a marked difference (P less than 0.03) in the risk ratio was observed between the exercise and control groups. These data suggest that physical exercise may play an important role in the maintenance of HDL mass and in the reduction of CHD risk factors in women of postmenopausal years with NIDDM.

Tumoral calcinosis: case reports from Saudi Arabia with a review of the literature.

Tumoral calcinosis is a rare disease mainly reported among blacks, especially from the tropical and sub-tropical regions of Africa. Hitherto, no reports of this disease entity have been reported from North Africa and the Arab Peninsula. This paper is therefore the first documentation of tumoral calcinosis in nine patients from the Arabian Peninsula; seven of whom are Saudis and two Yemenis. Peculiar osseous and joint changes co-existed in one of the cases. Moreover, there was a high incidence in the feet, in 75% of cases. One of the lesions was quite extensive. Reason for these changes are suggested.

Structural changes of the diaphragmatic peritoneum in patients with schistosomal hepatic fibrosis: its relation to ascites.

The histopathologic changes of the peritoneum of the hemidiaphragm were studied in 30 patients with schistosomal liver disease and compared with ten control subjects. The diaphragmatic peritoneum of patients with ascites was markedly thickened with infiltration of inflammatory cells and collagen bundles resembling the interstitial changes of peripheral lymphedema. Obliteration of diaphragmatic lymphatic stomata with restricted lymph flow as well as excess lymph formation from portal hypertension are both major factors in the magnitude and intractability of ascites associated with schistosomal hepatic fibrosis.

Impact of physical fitness on strategy development in decision-making tasks.

Data from 30 female subjects indicated that a 17.3% increase in a physical fitness index improved by 12% to 68% the information processing and decision-making capabilities of the subjects. The changes in physical fitness did not affect the performance on a variety of other tasks.

Serum lipids: interactions between age and moderate intensity exercise.

The purpose of this study was to examine relationships between age and selected serum lipids and lipoproteins in women before and after a physical fitness programme. Twenty females 27-59 years of age who had participated in the Purdue University Physical Fitness Programme were selected and placed into one of two groups: "junior" (mean age 34, all under 40 yrs) or "senior" (mean age 50, all over 43). A two way factorial design was used to study differences in serum triglycerides (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDLC), high density lipoprotein cholesterol (HDLC), and the risk ratios TC/HDLC and LDLC/HDLC associated with physical fitness and the eight month physical fitness programme. The ability of the biochemical variables to discriminate between the age groups was investigated using discriminant function analyses. The analyses of variance indicated that although the two age groups were matched on the basis of a multivariate physical fitness score (Ismail et al, 1965) the older group was heavier (p less than 0.05), and had higher systolic and pulse pressures (p less than 0.05). Both groups increased their physical fitness score from pre to post programme (p less than 0.01). No significant age related biochemical differences were noted in the univariate analyses; however, in the discriminant function analyses the biochemical variables significantly discriminated between the two groups before, but not after the programme. A decrease in serum triglycerides was observed in the more highly fit women in each age group. These findings suggest that moderate levels of physical activity may help to counteract some of the undesirable changes in the lipid profile associated with age.

Influence of catecholamine activity on the hierarchical relationships among physical fitness condition and selected personality characteristics.

Tested male Ss (N = 34) to determine how changes in the urinary excretion patterns of selected catecholamines and their metabolites affect the multivariate relationships involving variables that measure physical fitness condition and selected personality characteristics. Urine specimens were collected from each S after sleep and during occupational activities and analyzed for six catecholamine-related variables. Those measures were combined with six personality variables (MMPI) and a physical fitness score (Ismail Criterion), and subjected to first- and second-order factor analyses. The findings indicated an association between low physical fitness and high self-reported anxious depression during the occupational period, but not at rest. The changes in the factor structures were statistically mediated by changes in the concentrations of the biochemical variables across the collection periods. This suggests that the relationships between physical fitness and personality are augmented during catecholamine reactivity to occupational stress.

Relationships between urinary catecholamine metabolites, particularly MHPG, and selected personality and physical fitness characteristics in normal subjects.

Thirty-four normal male subjects were tested to determine the relationships between physical fitness condition (Ismail criterion), levels of self-reported depression (MMPI) and anxiety (Welsh criterion), and the urinary concentrations of 3-methoxy-4-hydroxyphenylglycol (MHPG), normetanephrine (NM), and metanephrine (M). Urinary samples were collected after sleep and during occupational activities to ascertain the effects of different psychosocial stimuli on the relationships among the variables. Univariately, urinary MHPG did not relate to physical fitness and was moderately related to depression (p less than or equal to 0.10) during the occupational period. Multivariate canonical correlational results revealed a significant (p less than or equal to 0.04) relationship between the biochemical and personality sets of variables during the occupational settings. MHPG was the most sensitive catecholamine metabolite for reflecting depressive conditions. The results suggest a biochemical reactivity syndrome involving MHPG that may relate to depressive personality characteristics.