Periodontal health status of children and adolescents with diabetes mellitus: a systematic review and meta-analysis.

Diabetes mellitus (DM) is a complex metabolic disease characterized by hyperglycaemia resulted from defects in insulin secretion or action, or both. Various studies have reported on the bidirectional relationship between DM and periodontal disease. A systematic search of the literature was performed in several databases, EBSCO Medline Complete, PubMed, Science Direct and a manual search for articles from 2000 until 2019. Literature that fulfilled the inclusion criteria were identified, and data measuring plaque index (PI), gingival index (GI), clinical attachment loss (CAL) and periodontal probing depth (PPD) were extracted and subjected to Random-effects meta-analysis. From 947 titles and abstracts screened, 11 articles were included for meta-analysis. It was found that PI, GI, CAL and PPD were significantly higher in DM children than in non-DM children according to the Standardized Mean different (SMD) and 95% confidence intervals (CI) (SMD 0.54, 95% CI 0.20-0.87, P = 0.002; SMD 0.63, 95% CI 0.39-0.87, P < 0.001; SMD 0.79, 95% CI 0.52-1.05, P < 0.001, SMD 0.67, 95% CI 0.23-1.11, P = 0.003, respectively). The meta-analysis showed significant differences in PI, GI, PD and CAL between the two groups, favouring non-DM children. Therefore, early detection of DM children with periodontal disease is crucial to prevent periodontal disease.

Towards Higher Oil Yield and Quality of Essential Oil Extracted from Aquilaria malaccensis Wood via the Subcritical Technique.

A method that delivers a high yield and excellent quality of essential oil, which retains most of its value-added compounds, and undergoes least change after the extraction process, is greatly sought after. Although chemical free methods are acceptable, they call for an extensive processing time, while the yield and quality from these methods are often disappointing. This work utilizes subcritical water technology to address these issues. In this undertaking, essential oil was extracted from Aquilaria malaccensis wood by way of subcritical conditions, and characterized through gas chromatography/mass spectroscopy (GC/MS). Optimization through response surface methodology revealed temperature to be the most critical factor for the extraction process, while the optimum conditions for temperature, sample-to-solvent ratio, and time for subcritical water extraction was revealed as 225 °C, 0.2 gr/mL, and 17 min, respectively. The subcritical water extraction technique involves two simultaneous processes, which are based on good fitting to the two-site kinetic and second order model. In comparison to the hydrodistillation method, GC/MS results indicated that the quality of A. malaccensis' wood oils, derived through the subcritical water technique, are of significantly better quality, while containing many constructive value-added compounds, such as furfural and guaiacol, which are useful for the production of pesticides and medicines. Pore size, functional groups, and morphology analysis revealed the occurrence of substantial damage to the samples, which facilitated an improved extraction of bio-products. In comparison to conventional methods, the use of the subcritical method not only involves a shorter processing time, but also delivers a higher oil yield and quality.

Study on the incidence of adverse events during intra-hospital transfer of critical care patients from emergency department.

INTRODUCTION: Emergency department (ED) plays a main role in the initial management of patients who are critically ill. These patients require intra-hospital transfer for continuation of care. Adverse events can occur during this short duration and the distance of intra -hospital transfer. The aims of this study were to determine the incidence of adverse events during intrahospital transfer from ED and to determine the factors associated. METHODOLOGY: This was a cross-sectional observational study done from November 2017 until December 2017 at ED Hospital Sultan Abdul Halim (HSAH), a 650-bedded tertiary hospital in the state of Kedah. All patients that were triaged to red zone, age 18 years and above, and involved in intra-hospital transfer to critical coronary unit, intensive care unit and wards were included. All cases were documented in proforma by the accompanying staff. RESULTS: Among the 170 critically ill patients, only 29 patients (17.1%) experienced adverse events during intra-hospital transfer. The adverse events seen were hypotension (12.4%), desaturation (3.5%) and dislodged peripheral line (2.4%). Cardiorespiratory related diagnosis was the commonest presentation. Intra-hospital transfer during morning shift and evening shift has 79.5% (b=-1.59, OR=0.21, 95% CI: 0.06, 0.69, p=0.011) and 75.6% ((b=-1.41, OR=0.24, 95% CI: 0.08, 0.73, p=0.012) lesser odds of experiencing adverse events compare to night shift. Patients with vasopressor/inotropes had 9 times higher odds of experiencing adverse events during transportation, compared to patients with no vasopressor/inotropes (b=2.27, OR=9.70, 95% CI: 3.39, 27.72, p<0.001). CONCLUSIONS: Critical care patients who are involved in intrahospital transfer were at risk of adverse events such as hypotension, desaturation and dislodge peripheral line. Risk identification and maintaining level of care is important to minimize the adverse events during transfer. Patients had higher rates of adverse events if they were transferred during night shifts and on inotropic/vasopressor support.

An Obstructed Malignant Inflammatory Myofibroblastic Tumour of the Rectum.

Inflammatory myofibroblastic tumour is rare but more common in children. It shows an immunophenotypic features of myofibroblastic differentiation, hence bearing neoplastic potential. The diagnosis is challenging especially if it involves rectum. Surgical resection is the mainstay of treatment if clinically obstructed. A 65-year-old gentleman presented with intestinal obstruction, which then followed by a hartmann's procedure. Final diagnosis is a rare case of inflammatory myofibroblastic tumour of the rectum. We discuss its genetic involvement with a literature review.

Effect of physical pretreatment on dilute acid hydrolysis of water hyacinth (Eichhornia crassipes).

Effects of different physical pretreatments on water hyacinth for dilute acid hydrolysis process (121 ± 3 °C, 5% H(2)SO(4), 60 min) were comparatively investigated. Untreated sample had produced 24.69 mg sugar/g dry matter. Steaming (121 ± 3 °C) and boiling (100 ± 3 °C) for 30 min had provided 35.9% and 52.4% higher sugar yield than untreated sample, respectively. The highest sugar yield (132.96 mg sugar/g dry matter) in ultrasonication was obtained at 20 min irradiation using 100% power. The highest sugar production (155.13 mg sugar/g dry matter) was obtained from pulverized samples. Hydrolysis time was reduced when using samples pretreated by drying, mechanical comminution and ultrasonication. In most methods, prolonging the pretreatment period was ineffective and led to sugar degradations. Morphology inspection and thermal analysis had provided evidences of structure disruption that led to higher sugar recovery in hydrolysis process.

Rare complications of pyogenic liver abscess.

Pyogenic liver abscess (PLA) is still associated with significant morbidity and mortality. With advances in imaging, most cases are now diagnosed early and effectively treated. However, complications, although considered rare, may still occur. We report three cases of PLA that were associated with rare and significant complications. Two patients had an abscess rupture that resulted in pyopericardium in one patient and sub-diaphragmatic abscess in the other. Another patient with Klebsiella pneumoniae PLA had bilateral endophthalmitis that resulted in blindness. Death secondary to overwhelming sepsis occurred in the patient with Escherichia coli-related pyopericardium. Delay in diagnosis contributed to the complications in two of the patients.

Elevated serum CA 19-9 in association with Hashimoto thyroiditis.

Tumour markers are widely used in clinical practice. Elevated tumour markers can be observed in both malignant and benign conditions. Therefore, it is important for clinicians to be aware of the association of tumour markers with various disorders so that unnecessary investigations can be avoided without missing the malignant disorders. A 58-year-old woman who presented with weight loss and elevated carbohydrate antigen 19-9 (CA19-9) was referred to our hospital for evaluation and was subsequently diagnosed with Hashimoto thyroiditis. Investigations for underlying malignancy were negative. The CA19-9 level normalised subsequently, with restoration of the euthyroid state.