Local wisdom in wound treatment practice in Tengger tribe farmers.

INTRODUCTION: Farmers have a high risk of injury either due to the use of agricultural tools, or chemicals, or the geographical conditions of the agricultural area. This study aimed to describe the use of local wisdom in the practice of wound treatment among Tengger tribal farmers in Indonesia. MATERIALS AND METHODS: This qualitative study used accidental sampling, conducted in the agricultural land of Ngadisari Village, Sukapura District, Probolinggo Regency, East Java for 3 weeks in November 2020. This study involved all farmers who were working on the land at the time of the study (n=30). The questionnaires consist of demographic, wound characteristics and wound treatment processes. RESULTS: The practice of wound treatment for the Tengger Tribe farmers is divided into two stages, namely the initial wound stage (stopping bleeding) using gums of medical plants and the wound healing stage, which is divided into treatment for the outer body using mashed leaf herbs and for the inner body using herbs that function to increase body stamina. CONCLUSION: The local wisdom Tengger ethnic-based wound treatment uses whatever is in nature to stop the bleeding and increase the wound healing process.

Towards Higher Oil Yield and Quality of Essential Oil Extracted from Aquilaria malaccensis Wood via the Subcritical Technique.

A method that delivers a high yield and excellent quality of essential oil, which retains most of its value-added compounds, and undergoes least change after the extraction process, is greatly sought after. Although chemical free methods are acceptable, they call for an extensive processing time, while the yield and quality from these methods are often disappointing. This work utilizes subcritical water technology to address these issues. In this undertaking, essential oil was extracted from Aquilaria malaccensis wood by way of subcritical conditions, and characterized through gas chromatography/mass spectroscopy (GC/MS). Optimization through response surface methodology revealed temperature to be the most critical factor for the extraction process, while the optimum conditions for temperature, sample-to-solvent ratio, and time for subcritical water extraction was revealed as 225 °C, 0.2 gr/mL, and 17 min, respectively. The subcritical water extraction technique involves two simultaneous processes, which are based on good fitting to the two-site kinetic and second order model. In comparison to the hydrodistillation method, GC/MS results indicated that the quality of A. malaccensis' wood oils, derived through the subcritical water technique, are of significantly better quality, while containing many constructive value-added compounds, such as furfural and guaiacol, which are useful for the production of pesticides and medicines. Pore size, functional groups, and morphology analysis revealed the occurrence of substantial damage to the samples, which facilitated an improved extraction of bio-products. In comparison to conventional methods, the use of the subcritical method not only involves a shorter processing time, but also delivers a higher oil yield and quality.

Study on the incidence of adverse events during intra-hospital transfer of critical care patients from emergency department.

INTRODUCTION: Emergency department (ED) plays a main role in the initial management of patients who are critically ill. These patients require intra-hospital transfer for continuation of care. Adverse events can occur during this short duration and the distance of intra -hospital transfer. The aims of this study were to determine the incidence of adverse events during intrahospital transfer from ED and to determine the factors associated. METHODOLOGY: This was a cross-sectional observational study done from November 2017 until December 2017 at ED Hospital Sultan Abdul Halim (HSAH), a 650-bedded tertiary hospital in the state of Kedah. All patients that were triaged to red zone, age 18 years and above, and involved in intra-hospital transfer to critical coronary unit, intensive care unit and wards were included. All cases were documented in proforma by the accompanying staff. RESULTS: Among the 170 critically ill patients, only 29 patients (17.1%) experienced adverse events during intra-hospital transfer. The adverse events seen were hypotension (12.4%), desaturation (3.5%) and dislodged peripheral line (2.4%). Cardiorespiratory related diagnosis was the commonest presentation. Intra-hospital transfer during morning shift and evening shift has 79.5% (b=-1.59, OR=0.21, 95% CI: 0.06, 0.69, p=0.011) and 75.6% ((b=-1.41, OR=0.24, 95% CI: 0.08, 0.73, p=0.012) lesser odds of experiencing adverse events compare to night shift. Patients with vasopressor/inotropes had 9 times higher odds of experiencing adverse events during transportation, compared to patients with no vasopressor/inotropes (b=2.27, OR=9.70, 95% CI: 3.39, 27.72, p<0.001). CONCLUSIONS: Critical care patients who are involved in intrahospital transfer were at risk of adverse events such as hypotension, desaturation and dislodge peripheral line. Risk identification and maintaining level of care is important to minimize the adverse events during transfer. Patients had higher rates of adverse events if they were transferred during night shifts and on inotropic/vasopressor support.

An Obstructed Malignant Inflammatory Myofibroblastic Tumour of the Rectum.

Inflammatory myofibroblastic tumour is rare but more common in children. It shows an immunophenotypic features of myofibroblastic differentiation, hence bearing neoplastic potential. The diagnosis is challenging especially if it involves rectum. Surgical resection is the mainstay of treatment if clinically obstructed. A 65-year-old gentleman presented with intestinal obstruction, which then followed by a hartmann's procedure. Final diagnosis is a rare case of inflammatory myofibroblastic tumour of the rectum. We discuss its genetic involvement with a literature review.

Estimation of ochratoxin A in poultry feed and its ingredients with special reference to temperature conditions.

1. The present study was designed to analyse ochratoxin A (OTA) in poultry feed samples (mixed types) along with different poultry feed ingredients collected from different farms and market of Lahore, Pakistan. 2. The whole year (2012-2013) was divided into three sub-periods depending upon environmental conditions, that is, July-October (hot and humid), November-February (winter) and March-June (moderate). During each sub-period 120 samples were collected for each feed and each ingredient constituting a total of 840 samples (120x7 of feed and feed ingredients in each sub-period). 3. The results of this study indicated that the incidence of OTA-positive samples was highest in July-October followed by that during March-June while the incidence was minimum during November-February. Similarly, the largest number of samples was below the maximum tolerable level (MTL) during November-February followed by March-June while the least number of samples was below MTL during hot weather (July-October). 4. This is the first elaborative study regarding the levels of OTA in poultry feed and its ingredients collected from Lahore, Pakistan.

Ameliorative effects of L-carnitine and vitamin E (α-tocopherol) on haematological and serum biochemical parameters in White Leghorn cockerels given ochratoxin A contaminated feed.

1. L-carnitine is a quaternary ammonium compound biologically synthesised from the amino acids methionine and lysine while vitamin E (α-tocopherol) is an important antioxidant. The objective of the present study was to evaluate the ameliorative effects of L-carnitine and vitamin E upon haematological and serum biochemical parameters in ochratoxin A intoxicated birds. 2. Day-old White Leghorn cockerels were acclimatised for 2 d, divided in 12 groups with 20 birds in each group. From d 3 of age, they were given different combinations of ochratoxin A (1.0 and 2.0 mg/kg), L-carnitine (1 g/kg) and vitamin E (200 mg/kg) in feed. Haematological (erythrocyte count, leucocyte count, haemoglobin concentration and haematocrit percentage) and serum biochemical parameters (serum urea, creatinine, albumin, total proteins and alanine aminotransferase) were evaluated. 3. Results confirmed that L-carnitine and vitamin E given alone or combined with 1.0 mg/kg ochratoxin A ameliorated toxin induced alterations in haematological and serum biochemical parameters. This amelioration, however, did not occur when ochratoxin of 2.0 mg/kg was given. 4. L-carnitine and vitamin E in combination have the ability to ameliorate ochratoxin altered haematological and serum biochemical parameters. However, the optimum ratio of L-carnitine + vitamin E, to be used to assure such mitigation of ochratoxin A altered changes in haematological and serum biochemical parameters in cockerels, has yet to be determined. The combination used in this study was indeed sufficient to ameliorate the alterations induced by ochratoxin A up to 1.0 mg/kg feed.

The effect of layering structures on mechanical and thermal properties of hybrid bacterial cellulose/Kevlar reinforced epoxy composites.

The effect of layering structures on mechanical and thermal hybrid bacterial cellulose (BC) sheet/Kevlar reinforced epoxy composites was investigated. The BC sheet was extracted from Nata de Coco and used as green reinforcement material hybrid with Kevlar reinforced epoxy composites. The BC/Kevlar reinforced epoxy composite was fabricated by using hand lay-up technique equipped with vacuum bagging system and the BC sheets and Kevlar layers were laminated into different layered structures. The performance of the hybrid BC/Kevlar reinforced epoxy composites was characterized through tensile test and low velocity impact according to ASTM D3039 and ASTM D7136, respectively. The thermal performance of the hybrid composites was characterized by using dynamic mechanical analysis (DMA) test. Tensile test on BC sheet composites with Kevlar and epoxy demonstrated that the addition of BC sheet in BC/Kevlar could not withstand the tensor stress by reducing the tensile stress and Young's modulus. The one layer of Kevlar which was replaced with three to six BC sheets had increased the ability to absorb impact force. The storage modulus (E') and Tan δ were significantly dependent on the number of BC sheets and its layering structure. The highest value of E' was observed when BC sheets were arranged alternately with the Kevlar layers. Different damage mechanisms associated with the number of BC sheets and its layered-structure suggested that the BC sheet was functioning as an impact energy absorber as well as strengthening fibers. This study will upsurge interest in BC reinforced composites and the development of new ideas in automotive, marine and bullet applications.

Periodontal health status of children and adolescents with diabetes mellitus: a systematic review and meta-analysis.

Diabetes mellitus (DM) is a complex metabolic disease characterized by hyperglycaemia resulted from defects in insulin secretion or action, or both. Various studies have reported on the bidirectional relationship between DM and periodontal disease. A systematic search of the literature was performed in several databases, EBSCO Medline Complete, PubMed, Science Direct and a manual search for articles from 2000 until 2019. Literature that fulfilled the inclusion criteria were identified, and data measuring plaque index (PI), gingival index (GI), clinical attachment loss (CAL) and periodontal probing depth (PPD) were extracted and subjected to Random-effects meta-analysis. From 947 titles and abstracts screened, 11 articles were included for meta-analysis. It was found that PI, GI, CAL and PPD were significantly higher in DM children than in non-DM children according to the Standardized Mean different (SMD) and 95% confidence intervals (CI) (SMD 0.54, 95% CI 0.20-0.87, P = 0.002; SMD 0.63, 95% CI 0.39-0.87, P < 0.001; SMD 0.79, 95% CI 0.52-1.05, P < 0.001, SMD 0.67, 95% CI 0.23-1.11, P = 0.003, respectively). The meta-analysis showed significant differences in PI, GI, PD and CAL between the two groups, favouring non-DM children. Therefore, early detection of DM children with periodontal disease is crucial to prevent periodontal disease.

Via-less electromagnetic band-gap-enabled antenna based on textile material for wearable applications.

A compact fabric antenna structure integrated with electromagnetic bandgap structures (EBGs) covering the desired frequency spectrum between 2.36 GHz and 2.40 GHz for Medical Body-Area Networks (MBANs), is introduced. The needs of flexible system applications, the antenna is preferably low-profile, compact, directive, and robust to the human body's loading effect have to be satisfied. The EBGs are attractive solutions for such requirements and provide efficient performance. In contrast to earlier documented EBG backed antenna designs, the proposed EBG behaved as shielding from the antenna to the human body, reduced the size, and acted as a radiator. The EBGs reduce the frequency detuning due to the human body and decrease the back radiation, improving the antenna efficiency. The proposed antenna system has an overall dimension of 46×46×2.4 mm3. The computed and experimental results achieved a gain of 7.2 dBi, a Front to Back Ratio (FBR) of 12.2 dB, and an efficiency of 74.8%, respectively. The Specific Absorption Rate (SAR) demonstrates a reduction of more than 95% compared to the antenna without EBGs. Moreover, the antenna performance robustness to human body loading and bending is also studied experimentally. Hence, the integrated antenna-EBG is a suitable candidate for many wearable applications, including healthcare devices and related applications.

Assessment of dispersion of airborne particles of oral/nasal fluid by high flow nasal cannula therapy.

BACKGROUND: Nasal High Flow (NHF) therapy delivers flows of heated humidified gases up to 60 LPM (litres per minute) via a nasal cannula. Particles of oral/nasal fluid released by patients undergoing NHF therapy may pose a cross-infection risk, which is a potential concern for treating COVID-19 patients. METHODS: Liquid particles within the exhaled breath of healthy participants were measured with two protocols: (1) high speed camera imaging and counting exhaled particles under high magnification (6 participants) and (2) measuring the deposition of a chemical marker (riboflavin-5-monophosphate) at a distance of 100 and 500 mm on filter papers through which air was drawn (10 participants). The filter papers were assayed with HPLC. Breathing conditions tested included quiet (resting) breathing and vigorous breathing (which here means nasal snorting, voluntary coughing and voluntary sneezing). Unsupported (natural) breathing and NHF at 30 and 60 LPM were compared. RESULTS: Imaging: During quiet breathing, no particles were recorded with unsupported breathing or 30 LPM NHF (detection limit for single particles 33 µm). Particles were detected from 2 of 6 participants at 60 LPM quiet breathing at approximately 10% of the rate caused by unsupported vigorous breathing. Unsupported vigorous breathing released the greatest numbers of particles. Vigorous breathing with NHF at 60 LPM, released half the number of particles compared to vigorous breathing without NHF.Chemical marker tests: No oral/nasal fluid was detected in quiet breathing without NHF (detection limit 0.28 µL/m3). In quiet breathing with NHF at 60 LPM, small quantities were detected in 4 out of 29 quiet breathing tests, not exceeding 17 µL/m3. Vigorous breathing released 200-1000 times more fluid than the quiet breathing with NHF. The quantities detected in vigorous breathing were similar whether using NHF or not. CONCLUSION: During quiet breathing, 60 LPM NHF therapy may cause oral/nasal fluid to be released as particles, at levels of tens of µL per cubic metre of air. Vigorous breathing (snort, cough or sneeze) releases 200 to 1000 times more oral/nasal fluid than quiet breathing (p < 0.001 with both imaging and chemical marker methods). During vigorous breathing, 60 LPM NHF therapy caused no statistically significant difference in the quantity of oral/nasal fluid released compared to unsupported breathing. NHF use does not increase the risk of dispersing infectious aerosols above the risk of unsupported vigorous breathing. Standard infection prevention and control measures should apply when dealing with a patient who has an acute respiratory infection, independent of which, if any, respiratory support is being used. CLINICAL TRIAL REGISTRATION: ACTRN12614000924651.

Cochlear nerve canal stenosis and associated semicircular canal abnormalities in paediatric sensorineural hearing loss: a single centre study.

OBJECTIVE: This study aimed to evaluate the association between cochlear nerve canal dimensions and semicircular canal abnormalities and to determine the distribution of bony labyrinth anomalies in patients with cochlear nerve canal stenosis. METHOD: This was a retrospective study in which high-resolution computed tomography images of paediatric patients with severe-to-profound sensorineural hearing loss were reviewed. A cochlear nerve canal diameter of 1.5 mm or less in the axial plane was classified as stenotic. Semicircular canals and other bony labyrinth morphology and abnormality were evaluated. RESULTS: Cochlear nerve canal stenosis was detected in 65 out of 265 ears (24 per cent). Of the 65 ears, 17 ears had abnormal semicircular canals (26 per cent). Significant correlation was demonstrated between cochlear nerve canal stenosis and semicircular canal abnormalities (p < 0.01). Incomplete partition type II was the most common accompanying abnormality of cochlear nerve canal stenosis (15 out of 65, 23 per cent). CONCLUSION: Cochlear nerve canal stenosis is statistically associated with semicircular canal abnormalities. Whenever a cochlear nerve canal stenosis is present in a patient with sensorineural hearing loss, the semicircular canal should be scrutinised for presence of abnormalities.

Taeniasis and neurocysticercosis among Malaysians.

Taeniasis, endemic in Southeast Asia, is caused by Taenia saginata (for beef) or Taenia solium and Taenia asiatica (for pork). T. solium also causes cysticercosis which can affect various organs. Taeniasis and cysticercosis cases are rarely reported in Malaysia. We report here two separate cases of beef taeniasis, and an interesting case of neurocysticercosis in a Malay Muslim. The taeniasis cases involved a Malaysian Chinese and a native Sabahan. Proglottids were recovered from them, and identification of the tapeworm done either from the microscopic examination of the egg or using PCR-based molecular diagnosis. Upon confirmation of taeniasis, both cases were given praziquantel and had been asymptomatic since. The neurocysticercosis case involving a Muslim who presented with seizure, was confirmed by histopathological examination of tissue sections taken from craniotomy excision of the brain lesion. He was given one month course of albendazole 400 mg bid and dexamethasone, and had been well and seizure free since. The two cases of taeniasis documented here had acquired the disease through eating raw or undercooked contaminated beef. For the neurocyticercosis case, it is suspected that he might have acquired the infection in one of his travels through human to human transmission via contaminated food or water consumption, given that Malaysia is not T. solium endemic area. Lastly praziquantel is an effective drug for beef taeniasis, while a combination of albendazole and dexamethasone work well for neurocysticercosis.

[Role of 24 hour intraesophageal pH monitoring in diagnosis of gastroesophageal reflux and assessment of drug effectiveness]. / Znachenie sutochnogo monitorirovaniia vnutripishchevodnogo pH v diagnostike gastroézofageal'noi refliuksnoi bolezni i otsemke éffektivnosti lekarstvennykh preparatov.

58 patients with gastroesophageal reflux (GER) and 18 patients with chronic gastroduodenitis (CGD) were examined using 24-h monitoring of intraesophageal pH. GER patients exhibited changes in all the readings of 24-h pH-gram of the esophagus which strongly correlated with severity of clinical symptoms (heartburn, metasternal pain), reflux-esophagitis (endoscopical picture), data of esophagotonocimography. 24-h monitoring of intraesophageal pH provided an adequate estimation of the drugs used to treat GER. As to effect on intraesophageal pH, domperidon had no effect, famotidine had a moderate positive effect, omeprasol returned pH to normal.

Effect of physical pretreatment on dilute acid hydrolysis of water hyacinth (Eichhornia crassipes).

Effects of different physical pretreatments on water hyacinth for dilute acid hydrolysis process (121 ± 3 °C, 5% H(2)SO(4), 60 min) were comparatively investigated. Untreated sample had produced 24.69 mg sugar/g dry matter. Steaming (121 ± 3 °C) and boiling (100 ± 3 °C) for 30 min had provided 35.9% and 52.4% higher sugar yield than untreated sample, respectively. The highest sugar yield (132.96 mg sugar/g dry matter) in ultrasonication was obtained at 20 min irradiation using 100% power. The highest sugar production (155.13 mg sugar/g dry matter) was obtained from pulverized samples. Hydrolysis time was reduced when using samples pretreated by drying, mechanical comminution and ultrasonication. In most methods, prolonging the pretreatment period was ineffective and led to sugar degradations. Morphology inspection and thermal analysis had provided evidences of structure disruption that led to higher sugar recovery in hydrolysis process.

Rare complications of pyogenic liver abscess.

Pyogenic liver abscess (PLA) is still associated with significant morbidity and mortality. With advances in imaging, most cases are now diagnosed early and effectively treated. However, complications, although considered rare, may still occur. We report three cases of PLA that were associated with rare and significant complications. Two patients had an abscess rupture that resulted in pyopericardium in one patient and sub-diaphragmatic abscess in the other. Another patient with Klebsiella pneumoniae PLA had bilateral endophthalmitis that resulted in blindness. Death secondary to overwhelming sepsis occurred in the patient with Escherichia coli-related pyopericardium. Delay in diagnosis contributed to the complications in two of the patients.

Elevated serum CA 19-9 in association with Hashimoto thyroiditis.

Tumour markers are widely used in clinical practice. Elevated tumour markers can be observed in both malignant and benign conditions. Therefore, it is important for clinicians to be aware of the association of tumour markers with various disorders so that unnecessary investigations can be avoided without missing the malignant disorders. A 58-year-old woman who presented with weight loss and elevated carbohydrate antigen 19-9 (CA19-9) was referred to our hospital for evaluation and was subsequently diagnosed with Hashimoto thyroiditis. Investigations for underlying malignancy were negative. The CA19-9 level normalised subsequently, with restoration of the euthyroid state.