Factors associated with different types of hip fractures among elderly patients a tertiary hospital in Pahang: A retrospective cross-sectional study.

INTRODUCTION: Hip fractures, predominantly due to decreased bone density and falls, significantly impact elderly health, disproportionately affecting women and placing a strain on healthcare resources. This study aims to conduct an indepth epidemiological analysis of hip fracture incidence among the elderly in Pahang, Malaysia, to inform better healthcare strategies. MATERIALS AND METHODS: In this retrospective study, medical records of patients admitted with hip fractures between 2019 and 2021 at Hospital Sultan Haji Ahmad Shah (HoSHAS) in Pahang were analyzed. Data on sociodemographic characteristics, nature of trauma, fracture types, and comorbidities were collected and examined using descriptive and inferential statistics. RESULTS: Among 3856 Orthopaedic Department admissions at HoSHAS (2019-2021), 296 hip fracture cases were identified, predominantly in women (71.3%), Malay ethnicity (75.3%), and aged 71-80 (38.5%). Intertrochanteric femur fractures were prevalent (62.8%). Unintentional falls accounted for 94.9% of cases. Logistic regression showed age and gender as significant predictors of femoral neck fractures. Specifically, Chinese seniors were 1.96 times more likely, and women over 65 were 1.95 times more likely to suffer these fractures. Notably, the absence of comorbidities increased the risk by 3.41 times (p < 0.05). CONCLUSION: With increased longevity among Malaysian citizen, the number of hip fracture cases are growing and leading to other health-related problems such as disability, depression, and cardiovascular. Various preventive interventions for osteoporosis and falls should be implemented to reduce the incidence of hip fractures among older adults.

Q-switched ytterbium-doped fiber laser based on evanescent field interaction with lutetium oxide.

We demonstrated lutetium oxide (${\textrm{Lu}_2}{\textrm{O}_3}$Lu2O3) deposited onto D-shaped fiber producing Q-switched ytterbium-doped fiber laser (YDFL) with an operating wavelength of 1037 nm. D-shaped fiber ${\textrm{Lu}_2}{\textrm{O}_3}$Lu2O3 as a saturable absorber (SA) was prepared using a polishing-wheel technique by polishing 2 times to establish an excellent evanescent field interaction between material and light on the surface of the polished region. The SA was deployed into a YDFL to generate Q-switching. The proposed D-shaped fiber ${\textrm{Lu}_2}{\textrm{O}_3}$Lu2O3 initiated pulses as short as 3.6 µs, with the highest repetition rate of 65.8 kHz. Stability of the SA is proven, as it produced stable pulses within the pump power of 99 to 133 mW with an SNR of 62.13 dB. Q-switched YDFL generates pulses with an output power of 0.93 to 1.99 mW and pulse energy of 17 to 30 nJ. We obtained a laser cavity with the optical-to-optical efficiency of 3.33%, which was the highest among D-shaped fiber-deposited SA materials in YDFL. Therefore, ${\textrm{Lu}_2}{\textrm{O}_3}$Lu2O3 deposited onto D-shaped fiber can be deployed as an SA in YDFL for a portable Q-switched laser source.

Are Boys Ready for Human Papillomavirus Vaccine? A National Study of Boys in Malaysia.

BACKGROUND: The aim of this study was to investigate factors associated with the willingness of boys to accept the human papillomavirus (HPV) vaccine. METHODS: A nationwide cross-sectional survey among Secondary One male students in Malaysia. RESULTS: Among 2823 respondents, knowledge about HPV infection and the HPV vaccine was extremely poor. The mean total knowledge score was only 3.17 (SD ± 2.14), out of a possible score of 10. The majority of respondents were unaware that vaccinating boys can help protect girls against HPV infection (81.6%), and HPV is a sexually transmitted infection (70.1%). Many had the misconception that only females get HPV (78.9%). In multivariable analysis, the factors associated with the intention to receive the HPV vaccination were: agreeing boys need to be vaccinated against HPV infection (odds ratio [OR], 2.05; 95% confidence interval [CI], 1.57-2.68), perceiving their parents might allow them to get the HPV vaccine (OR, 1.66; 95% CI, 1.18-2.34), perceived susceptibility to HPV infection (OR, 1.63; 95% CI, 1.06-2.52), and attending a rural school (OR, 1.49; 95% CI, 1.14-1.95). CONCLUSIONS: Public health educational programs that are focused and tailored on parents consenting to HPV vaccination for boys at a young age can be useful in improving HPV vaccination rates among boys. There is also a pressing need to educate boys about the benefits of HPV vaccination in males and about HPV disease susceptibility to facilitate adoption of the HPV vaccine by young adults in the future.

Influence of Corynebacterium pseudotuberculosis infection on level of acute phase proteins in goats.

BACKGROUND: Goat caseous lymphadenitis (CLA) is a chronic disease caused by Corynebacterium pseudotuberculosis. However, there is paucity of data about goat's acute phase response during the course of CLA. This study was conducted to investigate the response of acute phase proteins, mainly haptoglobin (Hp), serum amyloid A (SAA) and the negative acute phase response, especially albumin after an experimental challenge of C. pseudotuberculosis and phospholipase D (PLD) in Cross bred Boer goats. RESULTS: Serum Hp concentration in goats challenged with C. pseudotuberculosis (inoculated with 1x10(9) cfu subcutaneously) showed a significant increase, 5 fold in males (0.98 ± 0.12 mg/ml) and 3 fold in females (0.66 ± 0.12 mg/ml) compared to the control (0.2 ± 0.02 mg/ml). Challenge with PLD (1 ml/20 kg body weight intravenously) also showed significant increase, 4 fold in males and females (0.89 ± 0.11 mg/ml; 0.82 ± 0.12 mg/ml) respectively compared to the control (0.2 ± 0.02 mg/ml). Albumin concentration showed a significant decrease in both treated groups compared to the control. There were no significant changes in SAA concentration between challenged and control goats. CONCLUSIONS: There was a significant response by Hp to C. pseudotuberculosis infection and PLD challenge. This was supported by the early acute response in which Hp was detected before CLA lesions were developed. Therefore, it concluded that C. pseudotuberculosis and PLD can influence the level of acute phase proteins in goats.

Assessment of blood changes post-challenge with Corynebacterium pseudotuberculosis and its exotoxin (phospholipase D): A comprehensive study in goat.

AIM: There is very little information regarding blood changes during the challenge of phospholipase D (PLD) in goats. Therefore, this experiment was conducted to study the changes in blood after the challenge with Corynebacterium pseudotuberculosis and its exotoxin, PLD to fill in the gap of caseous lymphadenitis (CLA) research. MATERIALS AND METHODS: Twenty-six crossbred Boer goats aged 12-14 months were divided into 3 groups; the first group n=6 was inoculated with 1 ml phosphate buffered solution s.c. as the control. The second group n=10 was inoculated with C. pseudotuberculosis 1 × 10(9) cfu s.c. The third group n=10 was intravenous injected with PLD 1 ml/20 kg body weight. Serial blood collections were done at 1 h, 3 h, 5 h, 8 h, and 12 h then every 24 h post-inoculation for the first 30 days of the experiment. Subsequently, the blood collection continued twice a week till the end of the experiment (90 days post-challenge). RESULTS: Both C. pseudotuberculosis and PLD treated groups showed significant changes (p<0.05) in red blood cell count, hemoglobin (Hb), packed cell volume, mean corpuscular volume, mean corpuscular Hb concentration, white blood cell count, neutrophils, lymphocytes, monocytes, eosinophils, basophils, globulin, and total plasma proteins. Similarly, both treated groups showed significant changes (p<0.05) in alanine transaminase, alkaline phosphatase, aspartate transaminase, total bilirubin, calcium concentration, creatine phosphokinase, creatinine, gamma-glutamyl transpeptidase, urea concentration, lactate dehydrogenase, prothrombin time, and activated partial thromboplastin time. CONCLUSION: It concluded that C. pseudotuberculosis and PLD have a negative impact on the goat's health in general reflected by all those changes recorded in the hemogram, leukogram, and the blood chemistry.

Polymorphism of ITPA 94C>A and risk of adverse effects among patients with acute lymphoblastic leukaemia treated with 6-mercaptopurine.

WHAT IS KNOWN AND OBJECTIVE: Genetic polymorphisms of thiopurine S-methyltransferase (TPMT) and inosine triphosphate pyrophosphohydrolase (ITPA 94C>A) contribute to variable responses, including fatal adverse effects, among subjects treated with 6-mercaptopurine (6-MP). Our objectives were to investigate the distribution of specific TPMT and ITPA genotypes in healthy subjects and patients with acute lymphoblastic leukaemia (ALL) from the three main ethnic groups (Malays, Chinese and Indians) in Malaysia and the association of the polymorphisms with adverse effects of 6-MP. METHODS: Patients with ALL and healthy controls were recruited and genotyped for genetic variants of TPMT and ITPA 94C>A. The relationship between genotypes and clinical outcomes was investigated. RESULTS AND DISCUSSION: Acute lymphoblastic leukaemia patients with allele ITPA 94A were more likely to develop fever and liver toxicity with 6-MP. The prevalence of TPMT variants was low and this makes it unlikely that testing for them would be useful in our populations. Only patients heterozygous for TPMT*3C were detected. WHAT IS NEW AND CONCLUSION: Our results suggest that ITPA 94C>A testing, but not TPMT testing, may help in minimizing the adverse effects of 6-MP in Malaysian patients. However, whether this is true in clinical practice requires a larger study and formal randomized controlled evaluation.

Heterogeneity of the CYP2D6 gene among Malays in Malaysia.

BACKGROUND: Although Malays shared an origin with Chinese, their evolution saw substantial divergences. Phenotyping studies suggested that they differed in CYP2D6 polymorphism, with higher PM prevalence but lesser right-shift for debrisoquine MRs. OBJECTIVE: To study the genotype distribution of CYP2D6 among the Malays in Malaysia. METHOD: We obtained DNA from 107 Malays and used PCR to determine common CYP2D6 alleles. RESULT: CYP2D6*1 occurred at a frequency of 36.0%, duplicated gene, 0.93%, CYP2D6*4, 2.8%, CYP2D6*5, 5.1%, CYP2D6*9, 3.3%, CYP2D6*10, 49.5% and CYP2D6*17, 0.5%. The findings of CYP2D6*17 and CYP2D6*9 were novel for Asia. The frequency for CYP2D6*10 was lower than in other Asian races. The most frequent genotypes were CYP2D6*1/*10 at 39.3%. Two subjects had genotypes that predicted PM phenotype, 35% showed genotypes that predicted intermediate metabolizers and one subject had a genotype that predicted ultra-rapid metabolism. CONCLUSION: The genetic polymorphism of CYP2D6 in Malays is different from Chinese and Far Eastern races. They may be intermediate between East Asians and Caucasians in CYP2D6 activity. Further study in relation to the evolution of races and disease prevalence may help to identify the contributions of the polymorphism in alleged susceptibility to diseases apart from delineating its contributions to ethnic differences in the pharmacology of CYP2D6 drugs.