Enhanced Surgical Techniques in Orthopedics: A Comprehensive Guide for Surgeons Based on Modification of the McFarland and Osborne Approach to the Hip.

INTRODUCTION: The implementation of various approaches in hip arthroplasties introduces distinct advantages and complications. Notably, widely adopted methods such as the posterior approach have been linked to elevated rates of posterior hip dislocations and iatrogenic sciatic nerve injuries, while the lateral approach has been associated with superior gluteal nerve injuries. In this study, we propose a refined modification of the McFarland and Osborne approach, aiming to amalgamate the most favorable aspects of prior modifications of the lateral approach to the hip. Additionally, our contribution extends to providing a comprehensive stepwise guide for the exposure and closure processes in cases of bipolar hemiarthroplasty or total hip replacement. This modification not only offers potential advantages to seasoned orthopedic surgeons but also serves as a valuable resource for young Turks venturing into hip surgeries. MATERIAL AND METHODS: 14 patients with femoral neck fractures underwent surgery using the modified McFarland and Osborne approach and were followed up for a period of six months. The functional outcome was analyzed by the Modified Mobility and Aids Scoring Matrix. RESULTS: Seven of the 14 patients attained pre-injury status with respect to the Mobility and Aids scoring matrix. six patients had a fall of 1, and one patient had a fall of 2, as compared to pre-injury status. CONCLUSION: Our research suggests that this method serves as a superior alternative to conventional approaches, demonstrating notable advantages in terms of dissection difficulty, reduced risk to neurovascular structures, and minimized post-operative hip dislocations. Additionally, it exhibits a favorable outcome, enabling a return to pre-injury levels of activity.

An Integrated Metabolomics Study on Antidiabetic Activity of Christia vespertilionis Leaves Extract Using Chemometric and Molecular Docking Analysis.

In disease treatment, the utilisation of medicinal plants has witnessed a discernible rise, driven by concerns over the adverse effects associated with synthetic drugs available in the market. Analyses of the plant Christia vespertilionis (L.f.) Bakh. F., indigenous to Malaysia, has suggested its antidiabetic property linked to α-glucosidase inhibition, but metabolites responsible for antidiabetic are unexplored. The metabolomics approaches and molecular docking simulations were integrated to identify the putative α-glucosidase inhibitors and their enzyme interaction. In this study, the crude leaves extracted from this plant were extracted using solvents of varying polarity, followed by gas and liquid chromatography coupled with mass spectrometry metabolomics. The highest inhibition activity in a mixture of n-hexane and ethyl acetate (1:1, v/v)) was observed. Six putative metabolites corresponding to antidiabetic activity were identified: palmitic acid (2), linolenic acid (4), 7-tetradecenal (5), aloeemodin-8-monoglucoside (14), bruceine I (15), and sanjidin B (16). The mechanism of action of all the identified compounds is competitive, mainly involving hydrophobic and hydrogen bonding interactions with the protein residues. Compounds 14, 15, and 16 exhibited strong binding capabilities with both enzyme crystal structures compared to the positive control, quercetin. The metabolites extracted from C. vespertilionis leaves have demonstrated promising antidiabetic effects. These antidiabetic compounds can potentially commercialise new drug candidates in managing diabetes conditions.

Shoulder Arthroplasty: A Bibliometric Analysis Using the Scopus Database.

Primary joint replacements are performed increasingly often worldwide, driven by an aging population, improvement in surgical techniques, and advancements in implant designs. While more attention has traditionally been focused on weight-bearing joints such as the hip and knee, shoulder replacement surgeries have gained increasing attention in recent years due to the population's demand for a better quality of life. Thus far, a comprehensive bibliometric analysis of shoulder arthroplasty-related publications using the Scopus database has not yet been conducted. This bibliometric analysis aims to fill this gap by reviewing the Scopus database from its inception until 2023 to examine the literature on shoulder arthroplasty. A total of 5300 publications meeting the selection criteria were included in this analysis. The turn of the century marked a significant turning point for the field of shoulder arthroplasty, with an increasing number of publications produced annually. This trend can be attributed to the improvement of implant designs, which have become more consistent and reliable over time. While the majority of articles were authored by researchers and clinicians from the United States of America (USA), publications by French authors had a higher scholarly impact in the field. There is a noticeable gap in research on shoulder arthroplasty in developing countries, possibly due to the prohibitively high cost of implants and the prioritization of other healthcare sectors. This bibliometric analysis, utilizing Scopus data, serves as a guiding light for researchers, clinicians, and policymakers, potentially fostering collaborative projects and guiding the development of future studies to further advance the field of shoulder arthroplasty, particularly in developing countries.

Profile of Amoebic vs Pyogenic Liver Abscess and Comparison of Demographical, Clinical, and Laboratory Profiles of these Patients From a Tertiary Care Center in Northern India.

Background and objective: Amoebic liver abscess (ALA) and pyogenic liver abscesses (PLA) are the most common causes of liver abscess in developing and developed countries, respectively. Although incidence of liver abscess is low, but mortality is high amongst the patients due to delayed diagnosis. The study was done to find out the prevalence of amoebic and PLA among patients of liver abscess. The clinical, personal, and demographical details were also evaluated to find out the risk factor(s) associated with ALA and PLA, respectively. Method: A retrospective study was conducted to find the prevalence of amoebic and PLA. Clinical, demographic, personal details were evaluated from hospital records. Laboratory parameters such as total leucocyte count, platelets, bilirubin, ESR (Erythrocyte Sedimentation Rate), hemoglobin, glycosylated hemoglobin (HbA1c), alkaline phosphate (ALP), Aspartate aminotransferase (SGOT/AST), Alanine aminotransferase (SGPT/ALT), serum albumin, bilirubin levels, and procalcitonin were recorded. The Ultrasonography (USG) findings regarding the size, location, volume, and number of abscesses were also analyzed. Results: Total of 107 patients of liver abscess were evaluated, and 61.6% of patients were of amoebic etiology, and 25.3% were of pyogenic etiology. Males of 20-60 years of age were predominantly affected with right upper quadrant pain and fever as the most common presentations. ALA patients were found to have solitary abscess in the right lobe involving 6th and 7th segments, with decreased hemoglobin, hyperbilirubinemia, elevated ALP and SGOT, with normal SGPT, and addiction to alcohol. PLA patients had increased HbA1c, increased PCT values, low serum albumin levels, and low platelet-to-white blood cell values. The most common bacteria causing PLA was Escherichia coli (n = 8) followed by Enterobacter cloacae (n = 5). Mortality was seen in 6 patients. Conclusion: Liver abscess is found to have relatively high mortality and morbidity. Therefore, early diagnosis is the only method to prevent mortality and morbidity in these patients. Since the presentation is very nonspecific, evaluation of certain risk factors and laboratory parameters can aid in the diagnosis.

A laudable strategy to manage bacterial panicle blight disease of rice using biocontrol agents.

Bacterial panicle blight (BPB) disease is a dreadful disease in rice-producing countries. Burkholderia glumae, a Gram-negative, rod-shaped, and flagellated bacterium was identified as the primary culprit for BPB disease. In 2019, the disease was reported in 18 countries, and to date, it has been spotted in 26 countries. Rice yield has been reduced by up to 75% worldwide due to this disease. Interestingly, the biocontrol strategy offers a promising alternative to manage BPB disease. This review summarizes the management status of BPB disease using biological control agents (BCA). Bacteria from the genera Bacillus, Burkholderia, Enterobacter, Pantoea, Pseudomonas, and Streptomyces have been examined as BCA under in vitro, glasshouse, and field conditions. Besides bacteria, bacteriophages have also been reported to reduce BPB pathogens under in vitro and glasshouse conditions. Here, the overview of the mechanisms of bacteria and bacteriophages in controlling BPB pathogens is addressed. The applications of BCA using various delivery methods could effectively manage BPB disease to benefit the agroecosystems and food security.

Fit-cardiopulmonary resuscitation approach in public mass cardiopulmonary resuscitation teaching: A randomized control trial.

OBJECTIVES: To improve public awareness and the rate of bystander cardiopulmonary resuscitation (CPR), a novel and exciting approach called fit-CPR that incorporates mass CPR with high-intensity physical activity into the beat of locally favoured music was proposed. This study was conducted to measure the effectiveness of fit-CPR compared to the standard classroom method (CCM). METHODS: Between 30th August to 29th November 2018, 129 participants from Syiah Kuala University, Banda Aceh, Indonesia, were randomized to learn CPR, either through fit-CPR or CCM protocol. All participants underwent pre, post, and 6-month retention tests. Each test had a 10-item questionnaire with CPR performance on a manikin that was assessed using a validated checklist. RESULTS: Sixty-one (47.3%) participants completed the fit-CPR while 68 (52.7%) completed the CCM. There was a significant improvement in knowledge, performance, and quality of CPR from pre, post, and 6-month retention tests (p<0.01) in both groups. On high-quality CPR, the fit-CPR and CCM groups obtained an increased score of 285.0% and 151%, respectively, p=0.014 between pre and immediate post-test. Knowledge scores between fit-CPR and CCM groups showed an increase of 79.5% and 111.2%, respectively, p=0.002. Fit-CPR was completed between 52.5-57.5 minutes, while CCM took 75 minutes. CONCLUSION: The fit-CPR demonstrated a comparable outcome to standard CPR when teaching to the mass public with less time spent.

Serum vitamin D levels among immunoglobulin A nephropathy patients and the associated parameters.

INTRODUCTION: Low serum 25-hydroxyvitamin D is associated with chronic kidney disease progression, and there are limited data on the vitamin D levels in patients with Immunoglobulin A nephropathy. This study was conducted to determine the level of 25-hydroxyvitamin D in a stable immunoglobulin A nephropathy patient and its association with other parameters. MATERIALS AND METHODS: We performed a cross-sectional study involving 70 patients with biopsy-proven immunoglobulin A nephropathy with a stable estimated glomerular filtration rate and urinary albuminuria. Their demographic profiles were documented, and blood samples were taken for serum 25-hydroxyvitamin D, highly sensitive C-reactive protein, urine albuminuria and other routine blood tests. RESULTS: We found nine patients (12.9%) had sufficient 25- hydroxyvitamin D [25(OH)D] levels of more than 30ng/mL and the rest of the patients; 61 (87.1%) had serum 25(OH)D levels below 30 ng/ml. Amongst those with low vitamin D, 38 (62.3%) had serum 25(OH)D between 15-30 ng/mL (insufficient), and the remaining 23 (37.7%) had serum 25(OH)D below 15 ng/ml (deficient). Their mean level of serum 25(OH)D was 19.92 ± 9.04 ng/mL with a serum creatinine of 106.23 ± 38.56 µmol/L and mean estimated glomerular filtration rate (eGFR) at 68.11± 27.65 mL/min/1.73 m2. There was no association between urinary albuminuria, highly sensitive C-reactive protein, estimated glomerular filtration rate or systolic blood pressure with serum 25(OH)D level. CONCLUSION: Low vitamin D (insufficiency and deficiency) are indeed prevalent in stable immunoglobulin A nephropathy patients. We found no correlation between the vitamin D levels with albuminuria, renal function and highly sensitive C-reactive.

Impact of Covid-19 on gastrointestinal cancer surgery: A National Survey.

PURPOSE: To understand the actual impact of the Covid-19 pandemic and frame the future strategies, we conducted a pan India survey to study the impact on the surgical management of gastrointestinal cancers. METHODS: A national multicentre survey in the form of a questionnaire from 16 tertiary care gastrointestinal oncology centres across India was conducted from January 2019 to June 2021 that was divided into a 15-month pre-Covid era and a similar period of active Covid pandemic era. RESULTS: There was significant disruption of services; 13 (81%) centres worked as dedicated Covid care centres and 43% reported suspension of essential care for more than 6 months. In active Covid phase, there was a 14.5% decrease in registrations and proportion of decrease was highest in the centres from South zone (22%). There was decrease in resections across all organ systems; maximum reduction was noted in hepatic resections (33%) followed by oesophageal and gastric resections (31 and 25% respectively). There was minimal decrease in colorectal resections (5%). A total of 584 (7.1%) patients had either active Covid-19 infection or developed infection in the post-operative period or had recovered from Covid-19 infection. Only 3 (18%) centres reported higher morbidity, while the rest of the centres reported similar or lower morbidity rates when compared to pre-Covid phase; however, 6 (37%) centres reported slightly higher mortality in the active Covid phase. CONCLUSION: Covid-19 pandemic resulted in significant reduction in new cancer registrations and elective gastrointestinal cancer surgeries. Perioperative morbidity remained similar despite 7.1% perioperative Covid 19 exposure.

Changes in the Tibial Strain After Proximal Fibular Osteotomy: A Biomechanical Cadaveric Study.

Total knee arthroplasty surgery is an increasingly common procedure for the treatment of uni- and tricompartmental knee osteoarthritis, particularly in advanced stages and in the older population. Its usage is being extended to younger patients, where implant longevity is of concern. In the younger age group, especially with early disease, other options merit consideration. On the other hand, it may not be possible for elderly patients with medical comorbidities to undergo joint replacement surgery. Proximal fibular osteotomy (PFO) has recently been advocated to treat medial knee osteoarthritis. Although there have been clinical reports showing promising outcomes, the biomechanical basis of this procedure is still unclear. We performed a cadaveric study to investigate the effect of PFO on proximal tibial strain. Eight unpaired cadaveric lower limb specimens were loaded in compression at 2 times body weight. Strain gauges were mounted on various sites on the proximal tibia and fibula. After PFO, there was a significant increase in the lateral tibial strain adjacent to the proximal tibiofibular joint (P<.05). There was moderate effect size reduction in the anteromedial tibial strain as well as moderate effect size increase in the posterior tibial strain. The strain reduction seen at the anteromedial tibia can offer a possible explanation for symptomatic relief after PFO. However, the increase in the lateral and posterior tibial strain raises concern about long-term accelerated wear in these regions. [Orthopedics. 2022;45(5):314-319.].

Synthesis, Characterization, and Photocatalytic Activities of Graphene Oxide/metal Oxides Nanocomposites: A Review.

Sustainable water processing techniques have been extensively investigated and are capable of improving water quality. Among the techniques, photocatalytic technology has shown great potential in recent years as a low cost, environmentally friendly and sustainable technology. However, the major challenge in the industrial development of photocatalyst technology is to develop an ideal photocatalyst which must have high photocatalytic activity, a large specific surface area, harvest sunlight and shows recyclability. Keeping these views, the present review highlighted the synthesis approaches of graphene/metal oxide nanocomposite, characterization techniques and their prominent applications in photocatalysis. Various parameters such as photocatalyst loading, structure of photocatalyst, temperature, pH, effect of oxidizing species and wavelength of light were addressed which could affect the rate of degradation. Moreover, the formation of intermediates during photo-oxidation of organic pollutants using these photocatalysts is also discussed. The analysis concluded with a synopsis of the importance of graphene-based materials in pollutant removal. Finally, a brief overview of the problems and future approaches in the field is also presented.

Unilateral opaque chest radiograph in paediatrics: A case series.

Pulmonary underdevelopment is a rare congenital disease which manifests as persistent hemithorax opacification at chest radiography. We present three patients with different types of pulmonary underdevelopment, their imaging features and associated anomalies. Case 1 is a premature neonate with persistent respiratory distress. Further imaging confirmed right pulmonary hypoplasia, associated with a patent foramen ovale, patent ductus arteriosus and vertebral anomalies. Case 2 is a 6-year-old child with corrected anorectal malformation, and recurrent pneumonia. Further imaging confirmed left pulmonary aplasia, associated with an aberrant right subclavian artery and vertebral anomaly. Case 3 is a full term neonate who developed excessive drooling of saliva and respiratory distress. Further imaging confirmed right pulmonary agenesis, associated with an atrial septal defect, patent ductus arteriosus and tracheo-oesophageal fistula. Pulmonary underdevelopment is classified into three types: hypoplasia, aplasia and agenesis. The majority of them have associated anomalies. This condition should be considered a differential diagnosis in paediatric patients with an opaque hemithorax on chest radiography.

Is there seasonal variation in gallstone related admissions in England?

BACKGROUND: Gallstone related pathology (GRP) accounts for a significant proportion of general surgery admissions. The aim of this study is to investigate if seasonal variation for GRP admissions exist in England allowing improved resource allocation and planning. METHODS: This multicentre retrospective cohort study included only emergency adult (≥18 years old) admissions to acute secondary care with ICD-10 codes associated with gallstones between 01/01/2010 to 31/12/2019 in England using Hospital Episode Statistics data. Seasons were defined according to United Kingdom Met Office. RESULTS: A total of 396 879 GRP related admissions were recorded during the specified period, accounting for 1.44% of all emergency admissions. Our study suggests a significant seasonal peak in Summer (n = 102 620) based cumulative admissions per season and a linear regression model (p < 0.001), followed by Autumn (n = 102 267), then Spring (n = 97 807) and finally Winter (n = 94 185). Spectral analysis confirmed there is seasonality in the emergency GRP admissions every 12 months. A forecasting model was shown to be reliable; all observed admissions for 2019 were within the 95% prediction intervals for each month for the proportion of emergency GRP admissions. CONCLUSION: Resource allocation towards the Summer months to target seasonal peaks in GRP should be considered.

A Rare Report of Clinical Lycanthropy in Obsessive-Compulsive and Related Disorders.

Lycanthropy is a rare variant of a delusional misidentification syndrome specifically reverse inter-metamorphosis where patients believe that they are experiencing transformation or have transformed into an animal. A case report of this phenomenon is discussed. We report the lycanthropy phenomenon of a 25-year-old male who believed himself to be transformed into a buffalo after bestiality along with developing obsessive-compulsive features. A case report along with a literature review forms the basis of discussion. Clinical lycanthropy has been reported with various neuropsychiatric conditions including primary psychotic and affective conditions, drug intoxication and withdrawal, cerebrovascular disease, traumatic brain injury, dementia, delirium, and seizures, but its association in the context of obsessive-compulsive and related disorders (OCRDs) is a very rare finding. A differential of OCRD should be given due importance and managed accordingly when dealing with lycanthropy, which may help in early identification and management.

Oil Palm Biomass Biorefinery for Sustainable Production of Renewable Materials.

Oil palm biomass is widely known for its potential as a renewable resource for various value-added products due to its lignocellulosic content and availability. Oil palm biomass biorefinery is an industry that comes with sociopolitical benefits through job opportunities, as well as potential environmental benefits. Many studies have been conducted on the technological advancements of oil-palm biomass-derived renewable materials, which are discussed comprehensively in this review. Recent technological developments have made it possible to bring new and innovative technologies to commercialization, such as compost, biocharcoal, biocomposites, and bioplastics.

Systemic lupus erythematosus among male patients in Malaysia: how are we different from other geographical regions?

BACKGROUND: Systemic lupus erythematosus (SLE) is an autoimmune disease which predominantly affects females. The disease characteristics in male SLE patients are reported to be distinct and may vary across ethnicities and geographical regions. OBJECTIVE: To determine and compare the clinical phenotype and organ damage between male and female patients with SLE in Malaysia. METHODOLOGY: This was a cross-sectional study involving SLE patients from Universiti Kebangsaan Malaysia Medical Centre from June 2016 until June 2017. Information on their socio-demographics and disease characteristics were obtained from the clinical records. Disease damage was assessed using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) damage index (SDI) scores. The disease characteristics, autoantibody profiles and organ damage were compared between male and female patients, and multivariable analysis using male sex as dependent variable was then performed. RESULTS: A total of 418 patients were recruited and a total of 59 (14.1%) patients were male. Male patients presented with lower SLE ACR criteria at initial presentation but a significantly higher number of them had renal involvement (lupus nephritis) (78.0% versus 63.8%, p = 0.04). Male patients had less musculoskeletal involvement (45.8% versus 63.0%, p = 0.02) and tended to have lesser mucocutaneous involvement. Immunologic profile revealed that a lower number of male patients had positive anti-Ro antibody (22.7% versus 44.7%, p = 0.04) and they tended to have positive lupus anticoagulant antibody (27.6% versus 14.3%, p = 0.06). Presence of organ damage (SDI score ≥ 1) was significantly higher among males (55.9% versus 39.6%, p = 0.02) with higher renal damage (25.4% versus 9.2%, p = 0.004) and cardiovascular event of ischaemic heart disease or stroke (20.3% versus 7.0%, p = 0.004). They were also inclined to develop damage much earlier as compared to female patients, 3 (interquartile range (IQR) 7.5) versus 5 (IQR 7) years, p = 0.08. The occurrence of disease damage was independently associated with male gender with odds ratio of 1.9 (95% confidence interval 1.1-3.5), p = 0.02. CONCLUSION: Male patients with SLE have more severe disease with renal damage and cardiovascular event.

Effects of moringa leaves (Moringa oleifera) extraction on quality changes and melanosis of giant freshwater prawn (Macrobrachium rosenbergii) during chilled storage.

An aqueous extraction of moringa (Moringa oleifera) leaves were prepared as the edible coats for keeping the quality of the giant freshwater prawn (Macrobrachium rosenbergii). In addition, the antioxidant properties and activity; total phenolic content (TPC), total flavonoid contents (TFC), free radical scavenging activity (DPPH), and ferric reducing antioxidant power (FRAP) of moringa leaves were also determined. The phenolic compounds and antioxidant properties in the moringa leaves are low; 16.14 mgGAEg-1 for TPC; 5.57 mgQEg-1 for TFC; 1.36 mgTEg-1 for DPPH; and 3.05 mgTEg-1 for FRAP. The experiment was further conducted by coating the M. rosenbergii with moringa leaves extraction before chilled storage at 4°C for 15 days. Moringa leaves extraction were effectively reduced the microflora count in M. rosenbergii (P<0.05). Total volatile basis nitrogen (TVB-N) value showed a significant (P<0.05) lower amount in treated samples compared to the controls. Melanosis were obvious in controls compared to the treated samples. After 15 days of chilled storage, the sensory properties; taste, texture and odour of treated samples were acceptable by the panelists. Biopreservation of moringa leaves extraction significantly benefits in keeping the quality of M. rosenbergii.

Crystal structure of (E)-2-[3-(tert-but-yl)-2-hy-droxy-benzyl-idene]-N-cyclo-hexyl-hydrazine-1-carbo-thio-amide.

In the title compound, C18H27N3OS, the cyclo-hexane ring has a chair conformation. The azomethine C=N double bond has an E configuration. The nearly planar hydrazinecarbo-thio-amide moiety and substituted benzene ring are twisted by 31.13 (5)° relative to each other. The amide moiety and the cyclo-hexane ring are almost perpendicular to each other; a similar conformation was previously observed in reported structures. In the crystal, mol-ecules are linked by N-H⋯S hydrogen bonds, forming inversion dimers with an R 2 2(8) ring motif.

Elucidating the Inhibitory Potential of Designed Peptides Against Amyloid Fibrillation and Amyloid Associated Cytotoxicity.

Inhibition of fibrillation process and disaggregation of mature fibrils using small peptide are the promising remedial strategies to combat neurodegenerative diseases. However, designing peptide-based drugs to target ß-sheet-rich amyloid has been a major challenge. The current work describes, for the first time, the amyloid inhibitory potential of the two short peptides (selected on the basis of predisposition of their amino acid residues toward ß-sheet formation) using combination of biophysical, imaging methods, and docking approaches. Results showed that peptides employed different mechanisms to inhibit the amyloid fibrillation. Furthermore, they were also effective in blocking the amyloid fibrillation pathway. In contrary to the insulin fibrillar mesh, significantly less fibrillar species appeared in the presence of peptides, as confirmed by transmission electron microscopy. Circular dichroism analysis indicated that although peptides did not stabilize the native state of insulin, they inhibited amyloid aggregation by reducing the formation of ß-sheet rich structures. Hemolytic assay revealed the non-hemolytic nature of the species formed when insulin was co-incubated with the peptides. Therefore, despite the inherent potential to form ß-sheet structure, these peptides inhibited the amyloid formation and potentially can be used as therapeutics for the treatment of amyloid-related diseases.

Delineating risk zones and evaluation of shelter centres for flood disaster management along the Pahang River Basin, Malaysia.

Shelter centres are important locations to safeguard people from helpless situations and are an integral part of disaster risk reduction (DRR), particularly for flood DRR. The establishment of shelter centres, and their design based on scientific assessment, is crucial. Yet, they are very much related to the geographic location, socio-economic conditions and the livelihoods of the affected communities. However, many parts of the developing world are still lagging behind in ensuring such scientific design. Considering the flood disaster in 2014 that affected the residents living along the Pahang River Basin, in this study we delineate the communities at risk and evaluate the existing shelter centres to determine how they reduce people's vulnerability to the risks associated with rural and urban landscapes. We used spatial analysis tools to delineate risk zones and to evaluate existing evacuation systems. A flood disaster risk map was produced to determine which communities are living with risks. Subsequently, the distribution of shelter centres examined whether they are able to support people living at the flood risk zones. These centres were also evaluated using a set of international guidelines for effective disaster shelters. This reveals that the number of shelter centres is not adequate. The designation and designing of shelter centres are not being done scientifically. The maps produced here have a lot of potential to support disaster management decisions, in particular site selection and the prioritisation of centres. The study concludes with a set of guidelines and recommendations for structural and non-structural measures, such as alternative livelihoods and the potential of ecotourism, which may improve the resilience among flood-affected communities; and the decision-making process for the overall flood DRR initiatives.