Hyperkalemia measurement between Blood Gas Analyser and Main Laboratory Biochemistry Analyser.

INTRODUCTION: Potassium level is measured for patients with high risk of hyperkalemia in the emergency department (ED) using both blood gas analyser (BGA) and biochemistry analyser (BCA). The study was conducted to evaluate the correlation and agreement of potassium measurement between BGA and BCA. MATERIALS AND METHODS: This is a prospective cross-sectional study on the data obtained from Hospital Universiti Sains Malaysia (Hospital USM) from Jun 2018 until May 2019. Blood samples were taken via a single prick from venous blood and sent separately using 1ml heparinised syringe and were analysed immediately in ED using BGA (Radiometer, ABL800 FLEX, Denmark) and another sample was sent to the central laboratory of Hospital USM and analysed by BCA (Architect, C8000, USA). Only patients who had potassium levels ≥5.0mmol/L on blood gas results were included. A total of 173 sample pairs were included. The correlation and agreement were evaluated using Passing and Bablok regression, Linear Regression and Bland-Altman test. RESULT: Of the 173 sample pairs, the median of potassium level based on BGA and BCA were 5.50mmol/L (IQR: 1.00) and 5.90mmol/L (IQR: 0.95) respectively. There was significant correlation between two measurements (p<0.001, r: 0.36). The agreement between the two measurements showed within acceptable mean difference which was 0.27 mmol/L with 95% limit of agreement were 1.21mmol/L to 1.73mmol/L. CONCLUSION: The result of blood gas can be used as a guide for initial treatment of hyperkalaemia in critical cases where time is of the essence. However, BCA result is still the definitive value.

Accessing Driving Posture Among Elderly Taxi Drivers In Malaysian Using RULA And QEC Approach

@#An elderly community may continue to serve their services to other jobs after retirement particularly in light works in accordance to their ability which can support the household income in such a challenging world. One of the professions that they could alternatively get involved is by being a taxi driver. Hence, the characteristic of elderly taxi driver is crucial to understand, primarily due to the ageing process which makes them more vulnerable towards injury. Sitting which is the working posture of a taxi driver should be properly done to avoid injuries among the elders. Improper seating posture is potentially unhealthy and considered as one of the major contributing factors for several musculoskeletal disorders (MSD) such as pain in the lower back part and shoulder. Due to increased exposures to seating posture inside the car, the proper sitting adjustment has become an important issue that demands adequate ergonomic interventions. A cross-sectional study was conducted with elderly taxi drivers using a self-administered questionnaire. It included questions on social-demographic data, Rapid Upper Limb Assessment (RULA) and Quick Exposure Check (QEC). Purposive method sampling is used according to these inclusive criteria; age 60 years old and above, self-driving taxi more than 1 year, no disabilities and registered with Ministry of Transport (MOT). Total of 443 respondents participated in the study. SPSS software version 20.0 to analyze data and RULA and QEC form was used. More than half elderly taxi driver used budget car (57.6%) type of taxi and most of elderly taxi drivers were smoking (66.0%). More than half respondents (70.0%) having felt back pain for the past 12 months and 75.4% feeling back pain the last seven days. 94.8% elderly taxi drivers complained of feeling low back pain. QEC showed higher score - neck (20.8%) and back body part (6.5%) and other factors at high score - driving (86.4%) and vibration (45.6%). RULA analysis body score at value score 7 (23.5%)- required immediate improvement and value score 5/6 (61.9%) - required investigation and needed to improve soon. Inappropriate seating posture among elderly taxi drivers may cause discomfort towards developing MSD. The implication of low awareness on ergonomics education could reflect quality lifestyle and health among elderly taxi drivers in Malaysia.

Evaluation of exposure of pemphigus vulgaris patients to Mycobacterium tuberculosis and Aspergillus fumigatus.

The purpose of this study was to screen pemphigus vulgaris (PV) (autoimmune bullous skin disease) for the presence of immunoglobulin G against Mycobacterium tuberculosis and Aspergillus fumigatus. The sera of 60 PV patients and 28 controls were screened for the presence of immunoglobulin G against M. tuberculosis and A. fumigatus by enzyme-linked immune-sorbent assay. Forty patients were females and 20 were males. The range of IgG against M. tuberculosis was from 0.9 to 152.6 (median = 2.95) in the patients and was from 0 to 2.2 (median = 1.6) in the controls. Seven (11.7 %) patients and none of the controls exceeded the cut-off value. Four patients were on systemic steroids and azathioprine and three did not receive treatment before. The results showed that PV patients had significantly more IgG against M. tuberculosis than the controls; the p value was 0.006. The range of IgG against A. fumigatus was from 1.3 to 76.3 (median = 4.9) in the patients and was from 1 to 105.3 (median = 5.25) in the controls. Six (10 %) patients and eight (28.6 %) controls exceeded the cut-off value. The six patients were on systemic steroids and azathioprine. No significant difference was detected between PV patients and controls regarding exposure to A. fumigatus; the p value was 0.308. PV patients showed significantly more exposure to the M. tuberculosis than the controls. This suggests that M. tuberculosis may contribute to the pathogenesis of PV.

Cryptococcal Meningitis Presenting as a Complication in HIV-infected Children: A Case Series From Sub-Saharan Africa.

Cryptococcal meningitis is a leading infectious disease worldwide as a result of the high burden of HIV and AIDS, although its cumulative incidence is very low in children compared with that in adults. Very few studies involving the disease in children have been reported including sub-Saharan Africa, with the highest prevalence of HIV-infected children in the world. We summarize 5 cases of children diagnosed with cryptococcal meningitis at a tertiary hospital in Harare, Zimbabwe, between October 1, 2013, and September 30, 2014.

Aerosol droplet optical trap loading using surface acoustic wave nebulization.

We demonstrate the use of surface acoustic wave nebulization (SAWN) to load optical traps. We show that the droplets sizes produced can be tuned by altering the RF frequency applied to the devices, which leads to more control over the sizes of trapped particles. Typically the size distribution of the liquid aerosols delivered using SAWN is smaller than via a standard commercial nebulization device. The ability to trap a range of liquids or small solid particles, not readily accessible using other ultrasonic devices, is also demonstrated both in optical tweezers and dual beam fiber traps.

Gastric mucormycosis.

A case of gastric mucormycosis proven on culture and histologic examination and successfully treated with resectional surgery and Amphotericin B is described.

Age-dependent variations in the camel lens crystallins.

1. Water-soluble crystallins from cortex and nucleus of both young and adult camel lenses were fractionated by gel filtration into high molecular weight aggregate (HMW-aggregate), alpha-low, beta-high, beta-low, gamma-high and gamma-low protein fractions. 2. Crystallins were characterized by SDS-polyacrylamide gel electrophoresis (SDS-PAGE) and isoelectric focusing (IEF). Changes related to age and lens parts were compared. 3. The major changes in crystallin distribution included an increase in HMW-aggregate (alpha-high), beta-high, and gamma, and a decrease in alpha-low and beta-low, when comparing lenses in the direction of the nucleus and in the direction of increasing age. 4. Similar changes were detected comparing either cortex and nucleus of the same lens or whole lenses of different age.

Horner's syndrome and tuberculosis. A case report.

Horner's syndrome and recurrent laryngeal palsy are rare complications of cervical tuberculous lymphadenopathy. A case, which mimicked malignant disease, is reported.

Multiple liver abscesses caused by Yersinia enterocolitica. A case report.

Yersinia enterocolitica is an important cause of multiple liver abscesses in iron-overloaded or debilitated patients. The condition has a high mortality rate and causes diagnostic and therapeutic problems. The successful management of an iron-overloaded patient presenting with jaundice and chronic renal failure is described.