Problems faced by Malaysians during the Movement Control Order and Conditional Movement Control Order: A cross-sectional study.

INTRODUCTION: The COVID-19 pandemic had caused Malaysia to introduce a lockdown approach for the first time that was due to an outbreak of infectious disease. This was bound to create certain problems as it disrupts Malaysians' daily routine and way of life. MATERIALS AND METHODS: A cross-sectional study to identify the problems faced by Malaysian Social Media Users during the Movement Control Order (MCO) and Conditional Movement Control Order (CMCO) was conducted. An online survey that assessed the knowledge, attitude, and practice of COVID-19 was shared via social media. RESULTS: The response of the attitude module from the participants during MCO (n=2073) and CMCO (n=2720) were analysed. Chi-squared and Fisher's Exact Test showed that the male, unmarried, young (<40 years old), and employed participants were the most affected (p<0.05) when responding to a list of major problems faced during MCO/CMCO - 'Emotional difficulty being confined', 'Did not get paid due to missing work', 'Unable to communicate with family members who were not there', 'Unable to get food or water', 'Unable to get regular medical care or prescriptions', and 'There were no problems for me during MCO/CMCO'. CONCLUSION: The problems that were faced by these groups need to be addressed for better public health interventions and policies to win against the war on the ongoing COVID- 19 pandemic.

Garlic, green tea and turmeric extracts-mediated green synthesis of silver nanoparticles: Phytochemical, antioxidant and in vitro cytotoxicity studies.

Phyto-synthesis of silver nanoparticles (AgNPs) was achieved using aqueous garlic, green tea and turmeric extracts, and characterized by different spectroscopic techniques. Phytochemical analysis revealed the presence of rich amount of biochemicals in these extracts, which serve as reducing and capping agents for converting silver nitrate into AgNPs. FT IR spectroscopy confirmed the role of biomolecules in the bioreduction and efficient stabilization of AgNPs. UV-Vis DRS spectra showed a band around 450 nm characteristics of AgNPs. XRD patterns revealed the crystalline nature of the synthesized AgNPs with fcc structure. SEM and TEM analysis revealed the spherical shape of the synthesized AgNPs with an average particle size of 8 nm. EDX analysis confirmed the purity of the synthesized AgNPs with a strong signal at 3.2 keV. The antioxidant activity was assessed by ABTS, DPPH, p-NDA, H2O2 and DMSO scavenging assays, in which the AgNPs synthesized using green method showed remarkable activity with respect to the standard antioxidants ascorbic acid and rutin. In vitro cytotoxicity activity was tested on four cancer cell lines such as human breast adenocarcinoma (MCF-7), cervical (HeLa), epithelioma (Hep-2) and lung (A549) along with one normal human dermal fibroblasts (NHDF) cell line. The AgNPs synthesized using turmeric extract exhibits excellent antioxidant and cytotoxicity activity compared to that synthesized using other extracts.

The role of post-operative radiographs in predicting risk of flexor pollicis longus tendon rupture after volar plate fixation of distal radius fractures - a case control study.

BACKGROUND AND AIM: Volar plating of distal radius fractures is one of the common procedures performed in trauma surgery. Flexor pollicis longus (FPL) rupture has been described as complication following volar plating of distal radius fractures. The aim of our study was to investigate the possible relation between parameters measured on post-operative radiographs and the occurrence of FPL ruptures. MATERIALS AND METHODS: This was a case control study. The post-operative radiographs of 11 FPL rupture, and 22 non-FPL rupture patients were reviewed with respect to fracture reduction and plate position and the various parameters were calculated by five independent people. Logistic regression was used to examine the importance of the variables. RESULTS: We identified two significant factors to predict FPL rupture after volar plating of distal radial fractures. These were radial tilt and plate distance from the joint line. The odds ratio of ruptures was 0.74 (95% CI 0.57-0.95) for every degree of radial tilt <25° and 0.50 (95% CI 0.28-0.88) for every millimetre that the distal end of the plate was away from the volar lip of the distal radius at the wrist joint. CONCLUSION: Post-operative radiographs could help us predict FPL rupture after distal radius volar plating. The findings also highlight the need for good fracture reduction and thoughtful placement of the volar plate intraoperatively to minimise the risk of FPL tendon rupture.

Prospective evaluation of systolic arterial pressure control with a phenylephrine infusion regimen during spinal anaesthesia for caesarean section.

BACKGROUND: Hypotension and nausea occur frequently during spinal anaesthesia for caesarean section. The aim of this evaluation was to assess systolic arterial pressure control with our routine prophylactic intravenous phenylephrine infusion regimen. We audited a local standard for an incidence of hypotension of ≤ 25% during the first 15 min of anaesthesia. METHODS: One hundred healthy women undergoing elective caesarean section were assessed. Following intravenous preload with 10 mL/kg Hartmann's solution, 0.5% hyperbaric bupivacaine 2.8 mL combined with diamorphine 400 µg was given intrathecally in the sitting position. Intravenous phenylephrine was then started at 67 µg/min (the maximum rate). Systolic arterial pressure was recorded every 2 min. The infusion was titrated, according to local guidelines, to maintain systolic arterial pressure close to baseline. RESULTS: The median dose of phenylephrine given by infusion was 1000 [interquartile range 670-1000]µg, with 51 patients not requiring any change to the infusion rate. Eleven patients (11%, 95% CI 6-19) developed hypotension, defined as a systolic arterial pressure <80% of baseline. A further four patients were given a bolus of phenylephrine for suspected hypotension. The incidence of hypotension or suspected hypotension was therefore 15% (95% CI 9-24). Thirteen patients (13%, 95% CI 7-21) developed nausea. No patient vomited. CONCLUSIONS: Our routine phenylephrine infusion regimen was effective at minimizing hypotension and nausea during relatively high-dose spinal anaesthesia. This was achieved with a low intervention rate, in conjunction with a 2-min rather than a 1-min non-invasive blood pressure cycle time and a relatively low volume of intravenous fluid.