Bone health among older persons in medical clinic: A clinical audit.

Osteoporosis is commonly underdiagnosed and undertreated. We performed a clinical audit to assess the risk factors and clinical care for osteoporosis among older persons who attended medical clinic during a 4-week period in August 2013. There was a total of 128 patients with a mean age of 73.1±5.8 years, and 20.3%. had a history of fall. Fracture Risk Assessment Tool (FRAX) scores assessment showed 14.2% and 68.8% had a 10-year risk of major osteoporotic and hip fractures respectively. Only 6.3% underwent Dual-energy X-ray absorptiometry (DXA) and 73.4% did not receive any preventive treatment for osteoporosis. Older persons attending medical clinic at high risk of osteoporosis fractures did not receive appropriate screening and treatment. There is a need to improve the suboptimal care for bone health among older persons.

Thrombotic thrombocytopenic purpura-like syndrome associated with arcanobacterium pyogenes endocarditis in a post-transplant patient: A case report.

Systemic Arcanobacterium pyogenes is a rare bacterial infection in humans.1The diagnosis of thrombotic thrombocytopenic purpura (TTP)-like syndrome and infective endocarditis (IE) is often elusive. We report a case of TTP-like syndrome associated with A. pyogenes endocarditis in a post-allogenic transplant patient.

Antiphospholipid syndrome in Sarawak: real world experience in a developing country.

We performed a cross-sectional study of all antiphospholipid syndrome (APS) patients during an 8-year period (2006-2013) to describe the clinical features, serology profiles, treatment regimes, and outcomes in our center. There were a total of 59 patients in our study with the female to male ratio of 9:1. They have a mean age of 41.6 ± 12.1 years and a mean duration of illness of 38.4 ± 68.5 months. The majority of patients presented with vascular thrombosis (69.5 %) with equal arterial and venous involvements. Twenty-six patients (44.1 %) presented with obstetric complications with recurrent abortions (32.2 %) as the main manifestation. Most patients were on daily warfarin doses of 2-6 mg (91.0 %) with target INR of 2-3. There was neither recurrent thrombosis nor bleeding complications documented. There were 80 % live births following treatment in our patients.

Minimising oil droplet size using ultrasonic emulsification.

The efficient production of nanoemulsions, with oil droplet sizes of less than 100nm would facilitate the inclusion of oil soluble bio-active agents into a range of water based foods. Small droplet sizes lead to transparent emulsions so that product appearance is not altered by the addition of an oil phase. In this paper, we demonstrate that it is possible to create remarkably small transparent O/W nanoemulsions with average diameters as low as 40nm from sunflower oil. This is achieved using ultrasound or high shear homogenization and a surfactant/co-surfactant/oil system that is well optimised. The minimum droplet size of 40nm, was only obtained when both droplet deformability (surfactant design) and the applied shear (equipment geometry) were optimal. The time required to achieve the minimum droplet size was also clearly affected by the equipment configuration. Results at atmospheric pressure fitted an expected exponential relationship with the total energy density. However, we found that this relationship changes when an overpressure of up to 400kPa is applied to the sonication vessel, leading to more efficient emulsion production. Oil stability is unaffected by the sonication process.