Knowledge and practices of radiation protection among Malaysian radiographers working in nuclear medicine: A preliminary study.

This study is aimed to determine knowledge and practices on radiation protection among radiographers in nuclear medicine department. A cross-sectional survey was conducted among radiographers in nuclear medicine departments in four health institutions in Malaysia. A set of questionnaires was distributed to 17 respondents using convenience sampling. Approximately more than 75% and 44% - 56% of the radiographers have good knowledge of radiation protection and frequent adherence to radiation protection practices, respectively. Levels of education and length of service were statistically correlated with radiation protection knowledge and practices attributes (p < 0.05), respectively. More training is necessary for knowledge and practice improvement.

Administration of tranexamic acid for victims of severe trauma within pre-hospital care ambulance services (PHCAS) in Malaysia.

INTRODUCTION: Trauma is a Global threat and the 5th highest cause of all-cause mortality in Malaysia caused predominantly due to road traffic accidents. Majority of trauma victims are young adults aged between 21-40 years old. In Malaysia, 24 out of 100,000 population die annually due to trauma, rating us amongst the highest in South East Asia. These alarming figures justify aggressive preventive and mitigation strategies. The aim of this paper is to promote the implementation of evidence-based interventions that will reduce the rate of preventable death because of trauma. Tranexamic acid is one of the few interventions in the early management of severe trauma with level-one evidence. Tranexamic acid has been proven to reduce all causes of mortality and mortality due to bleeding. Evidence proves that it is most effective when administered early, particularly within the 1st hour of trauma. This proposed guideline is formulated based upon quality evidence from multicentre studies, clinical practices in other countries and consideration of the local demographic factors with the intent of enabling an easy and simple pathway to administer tranexamic acid early in the care of the severely injured. CONCLUSION: The guideline highlights select pre-hospital criteria's and the methods for drug administration. The authors recognise that some variants may be present amongst certain institutions necessitating minor adaptations, nevertheless the core principles of advocating tranexamic acid early in the course of pre-hospital trauma should be adhered to.

Edge waves in poroelastic plate under plane stress conditions.

Employing Biot's theory, the problem of edge waves in poroelastic plate under plane stress conditions is studied for both a pervious and an impervious surface. The equations for plane stress conditions are derived and discussed. The particle trajectory is obtained, which is an elliptic. The frequency equation is discussed for symmetric and antisymmetric motions and results of special interest are shown.

Medically important solar ultraviolet A. Radiation measurements.

Results from a 6-year study of solar ultraviolet A (UVA) radiation measurements at the equatorial location of Penang (5 degrees N) are presented. On clear days, the diurnal flux reaches a very high dosage of about 3.0 x 10(-2) KWHM-2 around midday. The average daily total flux is in the range of 1.6 x 10(-1) KWHM-2 and does not change much seasonally. The high 83% cloud cover only reduces the incoming flux to about half. The radiation flux represents a lower limit of the incident UVA radiation applicable to much of the equatorial/tropical region.

A profile of primary hepatocellular carcinoma patients in the Gizan Area of Saudi Arabia.

Clinical, laboratory, and ultrasonographic features of 75 patients of primary hepatocellular carcinoma (PHC) living in the Gizan Area of Saudi Arabia and their follow-up, during a 2-year period, were characterized. Eighty-nine percent of the cases were defined histologically, whereas in the rest, ultrasonographic (US) evidence along with an alphafetoprotein (AFP) level exceeding 480 ng/ml were taken as the positive evidence for PHC. Eighty percent of the cases were male patients, with the peak incidence during the seventh decade. The most common clinical presentations were hepatic enlargement (91%), abdominal pain (76%), splenic enlargement (33%), and acites (33%), followed by bruit, fever, metastases, and varices. Alteration in a liver function test was manifest in 97% of the cases, AFP values greater than 480 ng/ml in 57%, and a hepatitis B virus surface antigen (HBsAg) positivity in 65% of the cases. There was no intersex variation in positivity for HBsAg, antibody to HBsAg (anti-HBs), antibody to hepatitis B virus core antigen (anti-HBc) among the 30 PHC cases studied. Positivity for HBsAg or the overall hepatitis B virus exposure in PHC cases was higher than the normal controls (P less than 0.001). In addition to histologic confirmation of PHC in 67 cases, there was histologic evidence of cirrhosis in 25%, or chronic active hepatitis in 19% of the cases. At the time of diagnosis, the average duration of the presenting illness was less than 2 months, while the mortality in the ensuing 2-month period was 73%. The average span of total illness in the vast majority of cases was 4 to 6 months. Two female patients (one with fibrolamellar carcinoma) however, survived for 2 years. Immunization against hepatitis B virus should be considered for all newborns in such hyperendemic communities. A continuous program should be started in such communities to screen and immunize all those yet unexposed to hepatitis B virus. The established HBsAg carriers should be periodically examined ultrasonographically along with an AFP estimation for initiating the chemotherapeutic and other measures against PHC in fairly early stages of malignancy.

Effects of propranolol and hydrocortisone pretreatment on radiation-induced myocardial injury in rats.

Earlier studies in our laboratory (23) showed evidence of dose-related acute injury to the myocardium after exposure of rats to ionizing radiation. Biochemical, histological, and electrocardiographic parameters were studied. In further continuation of this study, the effects of intervention by pretreatment with propranolol (10 mg/kg body weight) and hydrocortisone (10 mg/kg body weight) have been studied. The above drugs were administered to male albino rats weighing 150 to 200 g 30 min before exposure to 6000-rad single-dose gamma radiation over the precordial area. The parameters observed were cardiac glycogen, serum enzymes, lactate, pyruvate, blood sugar, adrenal ascorbic acid, and histology of the myocardium. The beneficial effects of this procedure are discussed.

Biochemical and pathological changes in the heart following bile duct ligation.

Biochemical, histological, and ECG changes were studied on the second, fifth, tenth, and fifteenth days after bile duct ligation in male albino rats. The biochemical parameters included serum bilirubin, free fatty acids (FFA), serum glutamic oxaloacetic transaminase, pyruvate, serum bilirubin, free fatty acids (FFA), serum glutamic oxaloacetic transaminase, pyruvate, and cardiac glycogen. Maximum increase in serum bilirubin was noted on the 5th day after ligation. Although it decreased on the 10th and 15th days, the level on the 15th day was higher than in normal level. Serum enzymes, FFA, and pyruvate also showed a maximum level on the 5th day after ligation, with the levels returning toward normal on the 10th and 15th days. Maximum depletion of cardiac glycogen was observed on the 5th day, coming back toward normal on the 10th and 15th days. ECG studies showed bradycardia, increase in PR and QT intervals, and arrhythmia in a few cases. Histology showed cloudy swelling and accumulation of bilirubin in the myocardium with a maximum change on the 5th day. The significance of recovery after the 5th day is discussed.

Effect of radiation on myocardial metabolism and structure.

The effects of gamma radiation on structure, function, and metabolism of rat heart were studied. The precordial region of male albino rats (weighing 150-200 g) was exposed to 4000, 6000, and 8000 rads of gamma rays, using a cesium-137. Seventy-two hours after exposure, ECG lead II was taken, and animals were killed. Blood, heart, and adrenals were collected for the study of serum lactic dehydrogenase (SLD), serum glutamic oxaloacetic transaminase (SGOT), serum lactate, cardiac glycogen, and adrenal ascorbic acid. Histopathology of the heart was done using eosine and hematoxyline stains. The structural, functional, and biochemical changes observed were directly proportional to the intensity of gamma radiation.

Systolic time intervals in chronic anemia.

Systolic time intervals were measured noninvasively in 12 healthy control subjects (hemoglobin 12 to 15 Gm. per cent) and 32 cases of chronic anemia without underlying cardiovascular disease. It was found that in mild anemia (hemoglobin above 7 Gm. per cent), where cardiac output is known to be normal, the systolic time intervals were also normal. In severe anemia (hemoglobin below 7 Gm. per cent), where cardiac output is known to be high, the systolic time intervals showed the pattern usually associated with high cardiac output, i.e., increased left ventricular ejection time (LVET) and decreased pre-ejection period (PEP) and PEP/LVET ratio, only when congestive failure was absent. In severe anemia with congestive failure, the LVET was decreased, and PEP and PEP/LVET ratio were increased--the pattern associated with impaired myocardial performance, even though cardiac output is known to be high in such cases also.

Effect of physical fitness on myocardial damage and circulation after myocardial necrosis.

The effect of physical training (conditioning) on myocardial circulation and myocardial damage has been evaluated in experimental myocardial necrosis in albino rats. Conditioning was done by making the animals swim in a tank of water, thermostatically controlled at 32 degrees +/- 1 degrees C, 60 minutes daily, six days a week, for eight weeks. Myocardial necrosis was produced by subcutaneous injection of isoproterenol, 85 mg/kg body weight, on two consecutive days. Investigations included ECG (lead II), SGOT, SGPT, SLDH, SCPK, histopathology of the heart, and myocardial Rubidium 84 uptake. It was observed that, in conditioned animals, elevation of serum enzymes was less, incidence of cardiac arrhythmia was lower, myocardial damage was less marked, and myocardial circulation was better after myocardial necrosis in comparison to unconditioned animals. Less myocardial damage and lower incidence of cardiac of cardiac arrhythmia are presumably associated with a better prognosis.

Myocardial metabolism at different environmental temperatures in experimental myocardial necrosis.

Although the effect of cold and heat stress on myocardial metabolisms has been widely studied, this parameter has not been investigated over a wide range of environmental temperatures after myocardial infarction. Since high as well as low temperatures are known to adversely affect the myocardium, changes in enviromental temperature are likely to be of great importance to patients suffering from acute coronary insult. Therefore, the myocardial metabolism was studied at different environmental temperatures in albino rats with isoproterenol-induced infarct-like myocardial necrosis. Male albino rats weighing 100 to 150 g were selected for the study. The investigations included ECG (lead II), histology, serum free fatty acids (FFA), serum triglycerides (TGS), cardiac noradrenaline, cardiac glycogen, and adrenal ascorbic acid, after the induction of myocardial necrosis. The biochemical changes were minimum between 10 and 15 degrees C while, at 4 degrees C, marked changes were observed. No significant change was seen in the serum triglycerides.

Effect of combination of stresses on myocardial metabolism.

The effect of hypoxia, exercise, and thermal stress on myocardial metabolism have been widely investigated, but little attention has been paid to studying the effects of a combination of these stress. The influence of hypoxia as modified by physical exertion (swimming) and cold stress was therefore studied. The parameters investigated included myocardial glycogen and noradrenaline, serum free fatty acid, adrenal ascorbic acid, and adrenal weight. It was observed that maximal stress was produced when hypoxia was combined with physical exertion. No suppression of cold-induced lipolysis by hypoxia was observed, in contrast to previously reported observations. Maximal depletion of cardiac blycogen and cardiac noradrenaline was noted in hypoxic exercise. Adrenal overactivity was not found to be related to any particular stress but was seen to be proportional to the severity of the stress applied.

Effect of conditioning on myocardial metabolism after myocardial infarction.

The present study was conducted to evaluate the effect of prior physical training on metabolic changes after isoproternol-induced myocardial infarction in albino rats. The evaluation was done in terms of serum transaminases (SGOT and SGPT), serum lactic dehydrogenase (LDH), serum creatine phosphokinase (CPK), cardiac glycogen, and cardiac noradrenaline. Male albino rats weighed 100-150 g were selected for the study. Physical training (conditioning) consisted in making the animals swim in a tank of water for 60 min daily on 6 days a week, for 8 weeks. Myocardial infarction was produced by subcutaneous injection of isoproterenol, 85 mg/kg body weight, on 2 consecutive days. There was significantly less elevation of SGOT, LDH and CPK in the conditioned group after myocardial infarction; the rise in SGPT was not significantly different in the two groups. A smaller rise of serum enzymes revealed less myocardial damage in the conditioned group; the rise in FFA was also less in the conditioned group, a more favorable situation for an ischemic myocardium. No significant difference was observed in cardiac glycogen and cardiac noradrenaline after isoproterenol-induced cardiac necrosis. The significance of these observations is discussed.