Prominent bactericidal characteristics of silver-copper nanocomposites produced via pulse laser ablation.

This paper reports the characterization and antibacterial performance evaluation of some spherical and stable crystalline silver (Ag)/copper (Cu) nanocomposites (Ag-CuNCs) prepared in deionized water (DIW) using pulse laser ablation in liquid (PLAL) method. The influence of various laser fluences (LFs) on the structural, morphological, optical and antibacterial properties of these NCs were determined. The UV-Vis absorbance of these NCs at 403 nm and 595 nm was gradually increased accompanied by a blue shift. XRD patterns disclosed the nucleation of highly crystalline Ag-CuNCs with their face centered cubic lattice structure. TEM images showed the existence of spherical NCs with size range of 3-20 nm and lattice fringe spacing of approximately 0.145 nm. EDX profiles of Ag-CuNCs indicated their high purity. The antibacterial effectiveness of the Ag-CuNCs was evaluated by the inhibition zone diameter (IZD) and optical density (OD600) tests against Gram-negative (Escherichia coli) and Gram-positive (Staphylococcus aureus) bacteria. The proposed NCs revealed the IZD values in the range of 22-26 mm and 20-25 mm when tested against E. coli and S. aureus bacteria, respectively. The Ag-CuNCs prepared at LF of 14.15 J/cm2 revealed the best bactericidal activity. It is established that by controlling the laser fluence the bactericidal effectiveness of the Ag-CuNCs can be tuned.

Computed Tomographic Study of Occipital Thickness in Ethnic Malays.

Introduction: Occipitocervical fusion is performed to address craniocervical and atlantoaxial instability. A screw of at least 8mm is needed for biomechanical stability. Occipital thickness of Malay ethnicity is unknown, and this study presents the optimal screw placement positions for occiput screw in this population. This was a retrospective cross-sectional study of 100 Malays who underwent computed tomography (CT) scan for brain assessment. To measure the occipital bone thickness of Malay ethnicity at the area of common screw placement for occipitocervical fusion. The subject's data was obtained from the institutional database with consent from the administrations and the patients. None of the patients had any head and neck pathology. Materials and methods: The subject's data was obtained from the institutional database with consent from the administrations and the patients. None of the patients had any head and neck pathology. Computed tomography (CT) of 100 Malay patients who underwent head and neck CT were analysed, based on our inclusion and exclusion criteria. Measurements were taken using a specialised viewer software where 55 points were measured, followed a grid with 10mm distance using external occipital protuberance (EOP) as the reference point. Results: There were 57 males and 43 females of Malay ethnicity with a mean age of 36.7 years analysed in this study. The EOP was the thickest bone of the occiput which measured 16.15mm. There was an area of at least 8mm thickness up to 20mm on either side of the EOP, and at level 10mm inferior to the EOP. There is thickness of at least 8mm, up to 30mm inferior to the EOP at the midline. The males have significantly thicker bone especially along the midline compared to females. Conclusion: Screws of at least 8mm can be safely inserted in the Malay population at 20mm on either side of the EOP at the level 10mm inferior to the EOP and up to 30mm inferior to the EOP at the midline.

Femoral Neck Non-union Treated using Compression Screw with or without Gluteus Medius Trochanteric Flap: A Case Series of Ten patients.

Non-union is a challenging complication following a femoral neck fracture. Inability to achieve anatomical reduction and compression over the fracture leads to non-union. We reported a 10-case series of femoral neck non-union treated with sliding compression screw and anti-rotational screw with or without gluteus medius local trochanteric flap. When compression could not be achieved and a gap was present over the non-union site, a gluteus medius trochanteric flap was used to enhance the union. Surgeries were performed as a single-stage procedure through the Watson Jones approach. The initial implants were removed, followed by fracture reduction, during which the varus deformity was corrected, and the neck length was preserved as much as possible. Patients were advised for strict non-weight bearing until the presence of trabecular bone crossing the fracture on the radiographs. Union was achieved at three months in all cases. Patients undergoing surgery without trochanteric flap had normal abduction strength, and the neck length was maintained. All cases had no significant loss of function. Patients with trochanteric myo-osseous flap had neck shortening with weak abductors with MRC grade 4. Two out of 10 cases developed avascular necrosis of the femoral head before intervention. One case progressed to collapse of the femoral head requiring implant removal. This and the femoral neck shortening, caused this patient to have weak abductors and a positive Trendelenburg gait. We observed that delayed surgery leads to neck shortening and fracture gap requiring trochanteric myo-osseous flap to achieve union.

Acute compartment syndrome of the forearm: A case report of radius fracture with concomitant brachial artery transaction.

Acute compartment syndrome (ACS) is a surgical emergency that requires timely recognition and early management for a good outcome. We report a case of a 71- year-old male seen at the Emergency Department of Universiti Sains Malaysia (USM), Malaysia, on anticoagulant therapy for valvular atrial fibrillation, who had sustained a closed fracture of the left distal end radius following a fall. Examination of the left upper limb showed deformity and tenderness over the left wrist, associated with swelling and a tense anterior compartment with blisters formation and rapid expansion of hematoma at the cubital fossa away from the fracture site. Both radial and brachial pulses were absent and confirmed with the absence of a doppler signal over the brachial and radial artery and CT angiography of the left upper limb showed there was a vascular injury of the brachial artery. Fasciotomy of the left upper limb and revascularization of the left brachial artery was done. Intraoperative findings showed a tight anterior compartment with muscle bulging upon compartment release with a complete cut of the left distal brachial artery. The primary end-to-end vascular anastomosis was done and distal circulation was restored. The distal end radius fracture was treated conservatively. The patient underwent split skin grafting of the left forearm after 6 weeks post-injury and went home well. It is critical to recognize a concomitant vascular injury in fracture-related ACS as the clinical feature may overlap. Failure in detection of concomitant vascular injury may lead to emergency fasciotomy without vascular exploration and repair.

Displaced Physeal and Metaphyseal Fractures of Distal Radius in Children. Can Wire Fixation Achieve Better Outcome at Skeletal Maturity than Cast Alone?

INTRODUCTION: Redisplacement following fracture reduction is a known sequela during the casting period in children treated for distal radius fracture. Kirschner wire pinning can be alternatively used to maintain the reduction during fracture healing. This study was conducted to compare the outcomes at skeletal maturity of distal radius fractures in children treated with a cast alone or together with a Kirschner wire transfixation. MATERIAL AND METHODS: This was a retrospective study involving 57 children with metaphyseal and physeal fractures of the distal radius. There were 30 patients with metaphyseal fractures, 19 were casted, and 11 were wire transfixed. There were 27 patients with physeal fractures, 19 were treated with a cast alone, and the remaining eight underwent pinning with Kirschner wires. All were evaluated clinically, and radiologically, and their overall outcome assessed according to the scoring system, at or after skeletal maturity, at the mean follow-up of 6.5 years (3.0 to 9.0 years). RESULTS: In the metaphysis group, patients treated with wire fixation had a restriction in wrist palmar flexion (p=0.04) compared with patients treated with a cast. There was no radiological difference between cast and wire fixation in the metaphysis group. In the physis group, restriction of motion was found in both dorsiflexion (p=0.04) and palmar flexion (p=0.01) in patients treated with wire fixation. There was a statistically significant difference in radial inclination (p=0.01) and dorsal tilt (p=0.03) between cast and wire fixation in physis group with a more increased radial inclination in wire fixation and a more dorsal tilt in patients treated with a cast. All patients were pain-free except one (5.3%) in the physis group who had only mild pain. Overall outcomes at skeletal maturity were excellent and good in all patients. Grip strength showed no statistical difference in all groups. Complications of wire fixation included radial physeal arrests, pin site infection and numbness. CONCLUSION: Cast and wire fixation showed excellent and good outcomes at skeletal maturity in children with previous distal radius fracture involving both metaphysis and physis. We would recommend that children who are still having at least two years of growth remaining be treated with a cast alone following a reduction unless there is a persistent unacceptable reduction warranting a wire fixation. The site of the fracture and the type of treatment have no influence on the grip strength at skeletal maturity.

Oligomycins as inhibitors of K-Ras plasma membrane localisation.

Frequently present in pancreatic, colorectal and non-small cell lung carcinomas, oncogenic mutant K-Ras must be localised to the plasma membrane (PM) to be functional. Inhibitors of K-Ras PM localisation are therefore putative cancer chemotherapeutics. By screening a microbial extract library in a high content cell-based assay we detected the rare oligomycin class of Streptomyces polyketides as inhibitors of K-Ras PM localisation. Cultivation and fractionation of three unique oligomycin producing Streptomyces strains yielded oligomycins A-E (1-5) and 21-hydroxy-oligomycin A (6), together with the new 21-hydroxy-oligomycin C (7) and 40-hydroxy-oligomycin B (8). Structures for 1-8 were assigned by detailed spectroscopic analysis. Cancer cell viability screening confirmed 1-8 were cytotoxic to human colorectal carcinoma cells (IC50 > 3 µM), and were inhibitors of the ABC transporter efflux pump P-glycoprotein (P-gp), with 5 being comparable in potency to the positive control verapamil. Significantly, oligomycins 1-8 proved to be exceptionally potent inhibitors of K-Ras PM localisation (Emax 0.67-0.75 with an IC50 ~ 1.5-14 nM).

A cross-cultural test of the validity of occupational therapy assessments with patients with schizophrenia.

The validity and use of psychosocial assessments in occupational therapy are ongoing concerns (Moyer, 1984) and were the focus of this study. Fifty African patients with schizophrenia and 10 nondysfunctional African volunteers took an an assessment battery that included the Schroeder, Block, Campbell Adult Psychiatric Sensory Integration Evaluation (SBC) (Schroeder, Block, Trottier, & Stowell, 1978), a daily activity, work, and leisure activity interview based on the Model of Human Occupation (Kielhofner, 1985), and a culture-specific test of functional performance. Data on subjects' psychiatric histories and demographics were collected. Rationale for the assessments used, methods for devising the functional assessment, methods and procedures for data collection, and analysis are presented. A stronger relationship was found to exist between subjects' performances on the SBC and the functional activity test than between interviews based on the Model of Human Occupation and the functional activity test, both for patients and for the whole sample. All assessments were found to differentiate between patients and nonpatients, although the SBC was the best discriminator. Among psychiatric history variables, the strongest relationships were between measures of seriousness of illness and both the SBC and functional activity assessment. The most effective way to measure performance dysfunction and seriousness of illness in persons with schizophrenia was to measure the underlying sensorimotor impairment or to use a culture-specific test of functional performance.

The effect of lactose supplementation and source on feed intake and production characteristics of laying hens.

Three experiments involving a total of 550 laying hens were conducted to study the effects of low level lactose feeding on the egg production characteristics of laying hens. The specific purposes were to determine if lactose influenced calcium utilization and feed intake and if there were any important interactions between lactose and calcium. There was a consistent significant improvement in egg shell breaking strength as a result of lactose supplementation. One percent dietary lactose appeared to be adequate to achieve this improvement. The addition of 2 or 3% lactose did not result in any greater improvement than 1%. There were no consistent influences of lactose, lactose source, or calcium level on feed intake or any of the other variables examined in the three experiments. As was expected, 61-week-old hens laid significantly fewer and larger eggs with weaker shells than 47-week-old hens. There were four statistically significant interaction effects: lactose level X calcium level on egg production; lactose level X calcium level on egg shell strength; and age X lactose level on egg shell strength. Even though these effects were statistically significant, it is questionable whether or not they are of practical importance in feeding laying hens.