Trivial Indirect Trauma Causing Recurrent Bilateral Quadriceps Tendon Rupture in End Stage Renal Failure Patient: A Case Report.

Recurrent bilateral quadriceps tendon rupture in a young patient is a very rare incident. The underlying medical condition is always present and may have contributed to this injury. We report a recurrent bilateral quadricep tendon rupture in a 28-year-old man with underlying end-stage renal failure that occurred 10 months after the first repair. Injuries were indirect and trivial during the first and second events. Surgical repair was performed with similar technique for both incidents and he was advised to exercise extreme cautions after the second repair. He could return to his daily activities with no further recurrence at 30 months follow-up.

Trivial Indirect Trauma Causing Recurrent Bilateral Quadriceps Tendon Rupture in End Stage Renal Failure Patient: A Case Report

@#Recurrent bilateral quadriceps tendon rupture in a young patient is a very rare incident. The underlying medical condition is always present and may have contributed to this injury. We report a recurrent bilateral quadricep tendon rupture in a 28-year-old man with underlying end-stage renal failure that occurred 10 months after the first repair. Injuries were indirect and trivial during the first and second events. Surgical repair was performed with similar technique for both incidents and he was advised to exercise extreme cautions after the second repair. He could return to his daily activities with no further recurrence at 30 months follow-up.

The Brain-Derived Neurotrophic Factor (BDNF) gene Val66Met (rs6265) polymorphism and stress among preclinical medical students in Malaysia.

OBJECTIVE: This study aimed to determine the allelic and genotypic association of the Val66Met (rs6265) polymorphism in the BDNF gene with stress levels in preclinical medical students of Universiti Sultan Zainal Abidin (UniSZA), Terengganu, Malaysia. METHODS: In this cross-sectional study, we recruited all 122 preclinical medical students. The validated depression anxiety stress scales-21 (DASS-21) questionnaire was distributed and blood samples were collected from each subject for DNA extraction. Genotyping analysis of the BDNF gene (Val66Met) polymorphism was performed via an optimised polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. RESULTS: A total of 105 subjects agreed to participate in this study. Indian students were found to more likely have the Val/Val genotype, whereas Malay students were more likely to have the Met/Met genotype (p = 0.027). Individuals carrying any one of the three BDNF genotypes (Val/Val, Val/Met and Met/Met) differed significantly from each other in terms of their perception of stress (p = 0.010); students carrying the Val/Val genotype (M = 10.6) perceived significantly lower stress than students carrying the Val/Met (M = 14) and Met/Met (M = 15.1) genotypes. CONCLUSION: In our study, the Met-allele was associated with higher stress levels. To the best of our knowledge, this is the first study investigating this stress-related gene in medical students. The findings from this study should trigger more investigators to focus on the impact of stress on genetically predisposed medical students.

Molecular orbitals of delocalized electron clouds in neuronal domains.

We have further developed the two-brains hypothesis as a form of complementarity (or complementary relationship) of endogenously induced weak magnetic fields in the electromagnetic brain. The locally induced magnetic field between electron magnetic dipole moments of delocalized electron clouds in neuronal domains is complementary to the exogenous electromagnetic waves created by the oscillating molecular dipoles in the electro-ionic brain. In this paper, we mathematically model the operation of the electromagnetic grid, especially in regard to the functional role of atomic orbitals of dipole-bound delocalized electrons. A quantum molecular dynamic approach under quantum equilibrium conditions is taken to illustrate phase differences between quasi-free electrons tethered to an oscillating molecular core. We use a simplified version of the many-body problem to analytically solve the macro-quantum wave equation (equivalent to the Kohn-Sham equation). The resultant solution for the mechanical angular momentum can be used to approximate the molecular orbital of the dipole-bound delocalized electrons. In addition to non-adiabatic motion of the molecular core, 'guidance waves' may contribute to the delocalized macro-quantum wave functions in generating nonlocal phase correlations. The intrinsic magnetic properties of the origins of the endogenous electromagnetic field are considered to be a nested hierarchy of electromagnetic fields that may also include electromagnetic patterns in three-dimensional space. The coupling between the two-brains may involve an 'anticipatory affect' based on the conceptualization of anticipation as potentiality, arising either from the macro-quantum potential energy or from the electrostatic effects of residual charges in the quantum and classical subsystems of the two-brains that occurs through partitioning of the potential energy of the combined quantum molecular dynamic system.

Theorizing how the brain encodes consciousness based on negentropic entanglement.

The physicality of subjectivity is explained through a theoretical conceptualization of guidance waves informing meaning in negentropically entangled non-electrolytic brain regions. Subjectivity manifests its influence at the microscopic scale of matter originating from de Broglie 'hidden' thermodynamics as action of guidance waves. The preconscious experienceability of subjectivity is associated with a nested hierarchy of microprocesses, which are actualized as a continuum of patterns of discrete atomic microfeels (or "qualia"). The mechanism is suggested to be through negentropic entanglement of hierarchical thermodynamic transfer of information as thermo-qubits originating from nonpolarized regions of actin-binding proteinaceous structures of nonsynaptic spines. The resultant continuous stream of intrinsic information entails a negentropic action (or experiential flow of thermo-quantum internal energy that results in a negentropic force) which is encoded through the non-zero real component of the mean approximation of the negentropic force as a 'consciousness code'. Consciousness consisting of two major subprocesses: (1) preconscious experienceability and (2) conscious experience. Both are encapsulated by nonreductive physicalism and panexperiential materialism. The subprocess (1) governing "subjectivity" carries many microprocesses leading to the actualization of discrete atomic microfeels by the 'consciousness code'. These atomic microfeels constitute internal energy that results in the transfer intrinsic information in terms of thermo-qubits. These thermo-qubits are realized as thermal entropy and sensed by subprocess (2) governing "self-awareness" in conscious experience.

Development of an Amperometric Glucose Biosensor Based on the Immobilization of Glucose Oxidase on the Se-MCM-41 Mesoporous Composite.

A new bioenzymatic glucose biosensor for selective and sensitive detection of glucose was developed by the immobilization of glucose oxidase (GOD) onto selenium nanoparticle-mesoporous silica composite (MCM-41) matrix and then prepared as a carbon paste electrode (CPE). Cyclic voltammetry was employed to probe the catalytic behavior of the biosensor. A linear calibration plot is obtained over a wide concentration range of glucose from 1 × 10-5 to 2 × 10-3 M. Under optimal conditions, the biosensor exhibits high sensitivity (0.34 µA·mM-1), low detection limit (1 × 10-4 M), high affinity to glucose (Km = 0.02 mM), and also good reproducibility (R.S.D. 2.8%, n=10) and a stability of about ten days when stored dry at +4°C. Besides, the effects of pH value, scan rate, mediator effects on the glucose current, and electroactive interference of the biosensor were also discussed. As a result, the biosensor exhibited an excellent electrocatalytic response to glucose as well as unique stability and reproducibility.

Controlled Release of Lysozyme from Double-Walled Poly(Lactide-Co-Glycolide) (PLGA) Microspheres.

Double-walled microspheres based on poly(lactide-co-glycolide) (PLGA) are potential delivery systems for reducing a very high initial burst release of encapsulated protein and peptide drugs. In this study, double-walled microspheres made of glucose core, hydroxyl-terminated poly(lactide-co-glycolide) (Glu-PLGA), and carboxyl-terminated PLGA were fabricated using a modified water-in-oil-in-oil-in-water (w1/o/o/w2) emulsion solvent evaporation technique for the controlled release of a model protein, lysozyme. Microspheres size, morphology, encapsulation efficiency, lysozyme in vitro release profiles, bioactivity, and structural integrity, were evaluated. Scanning electron microscopy (SEM) images revealed that double-walled microspheres comprising of Glu-PLGA and PLGA with a mass ratio of 1:1 have a spherical shape and smooth surfaces. A statistically significant increase in the encapsulation efficiency (82.52% ± 3.28%) was achieved when 1% (w/v) polyvinyl alcohol (PVA) and 2.5% (w/v) trehalose were incorporated in the internal and external aqueous phase, respectively, during emulsification. Double-walled microspheres prepared together with excipients (PVA and trehalose) showed a better control release of lysozyme. The released lysozyme was fully bioactive, and its structural integrity was slightly affected during microspheres fabrication and in vitro release studies. Therefore, double-walled microspheres made of Glu-PLGA and PLGA together with excipients (PVA and trehalose) provide a controlled and sustained release for lysozyme.

The association of shift work and hypertension among male factory workers in Kota Bharu, Kelantan, Malaysia.

Shift work associated with various health problems and there is concern that shift workers are at higher risk to develop hypertension. A cross-sectional study was conducted from December 2003 to May 2004 to compare the prevalence of hypertension and to examine the relationship between shift work and hypertension among 148 randomly selected male workers from one of the factories in Kota Bharu, Kelantan. Information on psychosocial and life-style factors, anthropometric and blood pressure measurements, and fasting blood sugar and lipid profiles analyses were obtained. The prevalence of hypertension was significantly higher among shift workers (22.4%) compared to day workers (4.2%), with p-value of 0.001. Shift work was significantly associated with hypertension (adjusted odds ratio 9.1; 95% CI 1.4-56.7).

Lipid disorders among male factory shift workers in Kota Bharu, Kelantan.

Shift work is associated with various health problems and there is concern that shift workers are at higher risk to develop dyslipidaemia. A cross-sectional study was conducted from December 2003 to May 2004 to compare the prevalence of dyslipidaemia (hypercholesterolaemia, hypertriglyceridaemia, hyper-LDL and hypo-HDL-cholesterolaemia) and to examine the relationship between shift work and dyslipidaemia among 148 randomly selected male workers from one of the factories in Kota Bharu, Kelantan. Information on psychosocial and life-style factors, anthropometric and blood pressure measurement, fasting blood sugar and lipid profiles analyses were obtained. In multiple variable analysis, the presence of any abnormalities in the lipid profiles was regarded as having dyslipidaemia. The prevalence of hypercholesterolaemia (47.4%) and hypertriglyceridaemia (42.1%) were significantly higher among shift workers compared to day workers with p-value of 0.014 and 0.044 respectively. There was no significant different in the prevalence of hyper-LDL and hypo-HDL-cholesterolaemia and shift work was not significantly associated with dyslipidaemia, OR(adj) = 1.27; 95% CI 0.63-2.57.

Factors associated with adult poisoning in northern Malaysia: a case-control study.

Data on adult risk factors associated with drug or chemical poisonings in Malaysia are scarce. The objective of the study was to identify possible risk factors associated with adult admissions to the Penang General Hospital (PGH) due to chemical poisoning and/or drug overdose. The present study was a case-control study, conducted over 18 weeks. One hundred acutely poisoned adult patients admitted to PGH during the period from September 2003 to February 2004 were considered as cases. Two hundred patients admitted to the same medical wards for other illnesses, during the same period, were matched for age and gender with the poisoned cases and thus selected as controls. McNemar test and binary logistic were used for univariate analysis and logistic regression analysis for multivariate analyses. The odds ratio (OR) and its 95% confidence interval (95% CI) were calculated for each predictor variable. Positive histories of psychiatric illness and previous poisoning, problems in boy/girl friend relationships, family problems, marital problems, Indian ethnicity, Chinese ethnicity, living in rented houses and living in a household with less than five people were significant risk factors associated with adult admissions due to poisoning.

Job dissatisfaction in lecturers in School of Medical Sciences Universiti Sains Malaysia and Faculty of Medicine Universiti Kebangsaan Malaysia.

Job dissatisfaction in doctors and teachers is known to have direct consequences on the quality of service and teaching for patients and students respectively. A cross-sectional study to assess dissatisfaction in lecturers of School of Medical Sciences, Universiti Sains Malaysia (USM) and Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM) was undertaken between August 2001 and May 2002. The original English version of the Job Content Questionnaire (CQ) version 1.7 (revised 1997) by Robert Karasek was self-administered to 73 (response rate 58.4%) and 80 (response rate 41.7%) lecturers in the medical faculties of USM and UKM, respectively. The prevalence of job dissatisfaction in USM and UKM lecturers were 42.6% and 42.9%, respectively; the difference was not significant (p>0.05). Risk factors of job dissatisfaction in USM lecturers were decision authority (p<0.001) and psychological job demand (p<0.001). Significant risk factors of job dissatisfaction in UKM lecturers were skill discretion (p<0.01) and psychological job demand (p<0.001). We conclude that psychological job demand was a risk factor of job dissatisfaction in both USM and UKM lecturers; in USM, decision authority was protective, while in UKM, skill discretion was protective against job dissatisfaction.

Prevalence and associated factors of job-related depression in laboratory technicians in Hospital Universiti Sains Malaysia (HUSM) and Ministry of Health Malaysia (MOH) Hospitals in Kelantan.

Karasek's job strain model postulates that workers chronically exposed to adverse psychosocial work environment (high strain job)--high psychological job demands and low job control, including poor social support, increased physical demand and hazardous work condition--will eventually develop both physical illnesses such as cardiovascular diseases and psychological disorders such as depression. In order to determine the prevalence and associated factors of job-related depression, a cross-sectional study was conducted among laboratory technicians in Hospital Universiti Sains Malaysia (HUSM) and Kementerian Kesihatan Malaysia (KKM) Hospitals in Kelantan between September 2001 and February 2002. One hundred and two laboratory technicians in HUSM and 79 laboratory technicians in 7 KKM Hospitals were selected; 84/102 (82.4%) in HUSM and 71/79 (89.9%) in KKM Hospitals responded. Data was collected using self-administered questionnaires of the validated Malay version of the Job Content Questionnaire (JCQ) originally developed by Robert Karasek. Results indicated that the prevalence of high job strain in laboratory technicians in HUSM and KKM hospitals was 33.3% (28/84) and 26.8% (19/71), respectively (p>0.05). Significantly higher proportion (59.5%) (50/84) of laboratory technicians in HUSM compared to those in KKM Hospitals (39.4%) (28/71) (p = 0.016) experienced job-related depression. Significant associated factors of job-related depression were low social support (HUSM: adjusted OR 4.7, 95% CI 1.2-18.8; KKM: adjusted OR 14.8, 95%CI 2.4-89.3), high psychological demand (HUSM: adjusted OR 3.0, 95%CI 1.0-8.8), and low decision authority (KKM: adjusted OR 9.7, 95%CI 1.0-91.1). We conclude that strengthening the social support network (supervisors' and coworkers' support), reducing psychological job demand, and increasing decision-making authority of laboratory technicians may go a long way towards reducing job-related depression.

A study of job strain and dissatisfaction among lecturers in the School of Medical Sciences Universiti Sains Malaysia.

Job stress has now become one of the most significant health and safety issues in the workplace and one of the least understood areas of organizational cost. A cross-sectional study to assess job strain and dissatisfaction in lecturers of the School of Medical Sciences, Universiti Sains Malaysia (USM) was undertaken between August 2001 and May 2002. The original English version of the Job Content Questionnaire (JCQ) version 1.7 (revised 1997) by Robert Karasek was self-administered to 73 (response rate 58.4%) lecturers in School of Medical Sciences USM. The prevalence of job strain (defined by low decision latitude and high psychological demands) in USM was 23.3%. The risk factors of job strain in the lecturers were psychological stressors (adjusted OR 1.2, 95% CI 1.0, 1.4), created skill (adjusted OR 0.4, 95% CI 0.2, 0.8) and working in clinical-based departments (adjusted OR 18.7, 95% CI 1.6, 22.7). The prevalence of job dissatisfaction was 42.6%. Associated factors of job dissatisfaction in USM lecturers were decision authority (p < 0.001) and psychological job demand (p < 0.001). We conclude that psychological stressors and created skill were non-protective and protective, respectively, against job strain in USM lecturers. Clinical-based lecturers experienced higher job strain compared to non-clinical-based lecturers. Psychological job demand was strongly associated with job dissatisfaction, and decision authority was protective against job dissatisfaction.

Prevalence and risk factors of job strain among laboratory technicians in Hospital Universiti Sains Malaysia.

INTRODUCTION: Several sources of job stress exist. Some of these stressors are intrinsic to the job, while some are related to psychosocial and other factors. METHODS: A cross-sectional study of the prevalence and risk factors of job strain in 84 laboratory technicians in Hospital Universiti Sains Malaysia (HUSM) (response rate 82.4 percent) was conducted between September 2001 and February 2002. A Malay version of the validated Karasek's Job Content Questionnaire was used as the research instrument in this study. There were five scales in the questionnaire. Two scales were used to define job strain, namely: decision latitude and psychological demands. RESULTS: The prevalence of high job strain in laboratory technicians in HUSM was 33.3 percent. Job insecurity (adjusted OR 2.4; 95 percent CI 1.2-5.7), physical exertion (adjusted OR 1.7; 95 percent CI 1.1-2.9), and total psychological stressors (adjusted OR 3.6; 95 percent CI 1.8-7.1) were significantly associated with job strain. CONCLUSION: A high proportion of laboratory technicians in HUSM experienced high job strain and psychosocial factors in the workplace posed significant risks of job strain in these workers.

Job strain and its associated factors among lecturers in the School of Medical Sciences, Universiti Sains Malaysia and Faculty of Medicine, Universiti Kebangsaan Malaysia.

A cross-sectional study to assess job strain and its associated factors among lecturers of the School of Medical Sciences, Universiti Sains Malaysia (USM) and Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM) was undertaken between August 2001 and May 2002. The original English version of the Job Content Questionnaire (JCQ) version 1.7 (revised 1997) by Robert Karasek based on the Job Strain Model was self-administered to 73 (response rate 58.4%) and 80 (response rate 41.7%) lecturers in the medical faculties of USM and UKM respectively. The prevalence of job strain (defined by low decision latitude and high psychological demand) in USM and UKM was 23.3% and 17.5%, respectively; the difference was not significant (p 2 0.05). Analysis showed that the associated factors of job strain in USM lecturers were psychological stressors (adjusted OR 1.2, 95% CI: 1.0, 1.4), created skill (adjusted OR 0.4, 95% CI: 0.2, 0.8), working in clinical-based departments (adjusted OR 18.9, 95% CI: 1.6, 22.7). The risk factors of job strain in UKM lecturers were created skill (adjusted OR 0.3, 95% CI: 0.1, 0.9), psychological stressors (adjusted OR 1.2, 95% CI: 1.0, 1.5) and co-worker support (adjusted OR 0.3, 95% CI: 0.1, 0.9). We conclude psychological stressors and created skill were nonprotective and protective, respectively, against job strain in both USM and UKM lecturers.

Risk factors of job-related depression in laboratory technicians in Hospital Universiti Sains Malaysia (HUSM) and Kementerian Kesihatan Malaysia (KKM) hospitals in Kelantan.

A cross-sectional study was conducted to determine the risk factors of job-related depression in laboratory technicians in Hospital Universiti Sains Malaysia (HUSM) and Kementerian Kesihatan Malaysia (KKM) Hospitals in Kelantan, between September 2001 and February 2002. One hundred and two laboratory technicians from HUSM and 79 from KKM Hospitals were selected and 84 (82.4%) from HUSM and 71 (89.9%) from KKM Hospitals were recruited as study subjects. Data were collected by self-administered questionnaire using the validated Malay version of the Job Content Questionnaire (JCQ), originally developed by Robert Karasek. The results indicated significant associations between the risk factors of job-related depression, and low social support, and high psychological demands (OR 3.0, 95% CI 1.1-8.8) in laboratory technicians in HUSM. However, for laboratory technicians in KKM Hospitals, the significant association was between job-related depression, and low social support and low decision authority (OR 9.7, 95% CI 1.1-91.1). Low social support was highly associated with job-related depression in laboratory technicians in HUSM and KKM Hospitals. We, therefore, conclude that low social support positively predicted depression in laboratory technicians in HUSM and KKM Hospitals. In addition, high psychological demands also significantly predicted depression in laboratory technicians in HUSM; however, for laboratory technicians in KKM Hospitals, low decision authority was the significant predictor of depression.