Incidental radiological findings of susuk in the orofacial region

Susuk, or charm needles, are inserted and worn subcutaneously in the face and other parts of the body, as they are believed to enhance beauty and youth, and for many other reasons such as treatment of headache, aches and pains in the joints, back or abdomen. The practice of inserting susuk is a traditional belief, genuinely cultural and superstitious, and common in the south-east Asian region. We present 13 cases of susuk, which was found incidentally on the radiographs as the patients came for various types of treatment at our centre.     

The Effect of Polyethylene Glycol Addition on Wettability and Optical Properties of GO/TiO2 Thin Film

Modification has been made to TiO₂ thin film to improve the wettability and the absorption of light. The sol-gel spin coating method was successfully used to synthesize GO/TiO₂ thin films using a titanium (IV) isopropoxide (TTIP) as a precursor. Different amounts of polyethylene glycol (PEG) (20 to 100 mg) were added into the parent sol solution to improve the optical properties and wettability of the GO/TiO₂ thin film. The effect of different amounts of PEG was characterized using X-ray diffraction (XRD) for the phase composition, scanning electron microscopy (SEM) for microstructure observation, atomic force microscopy (AFM) for the surface topography, ultraviolet–visible spectrophotometry (UV-VIS) for the optical properties and wettability of the thin films by measuring the water contact angle. The XRD analysis showed the amorphous phase. The SEM and AFM images revealed that the particles were less agglomerated and surface roughness increases from 1.21 × 10² to 2.63 × 10² nm when the amount of PEG increased. The wettability analysis results show that the water contact angle of the thin film decreased to 27.52° with the increase of PEG to 80 mg which indicated that the thin film has hydrophilic properties. The optical properties also improved significantly, where the light absorbance wavelength became wider and the band gap was reduced from 3.31 to 2.82 eV with the presence of PEG.     

Coronary bypass surgery in patients aged 70 years and over: mortality, morbidity, length of stay and hospital cost

The objective of this investigation was to compare the outcome of isolated coronary artery bypass grafting surgery in patients > or = 70 years with those < 70. The cardiac surgery database of the Institute was used to obtain the characteristics of patients undergoing coronary artery bypass grafting between January 2000 and September 2001. The patients were divided into those > or = 70 years of age and those < 70 years old. A Parsonnet risk score was determined for each patient for the analysis of mortality, length of stay and hospital charges. During the study period, 1594 cases of isolated coronary artery bypass grafting were carried out. 184 (11.5%) cases were performed in the older group. The 30-day mortality for patients aged 70 and over was 7 (3.3%) out of 184 while that of patients < 70 years of age was 47 (3.8%) out of 1410 (p < 0.740). The overall hospital mortality was 10 (5.4%) of 184 and 53 (3.8%) of 1410 (p < 0.272) respectively. Apart from a higher incidence of wound infection in elderly patients, the frequency of other major complications was comparable in both groups. The average length of postoperative stay for the elderly patients was 10.4 +/- 0.9 days compared to 8.7 +/- 0.2 days for the younger group (p < 0.049). The mean hospital charge in patients > or = 70 was RM 25,160.38 +/- 1656.75 whereas for patients < 70, it was RM 21,801.47 +/- 308.91 (p < 0.048). This study supports the continued performance of coronary artery bypass grafting in patients > or = 70 years. Advanced age alone should not deter a cardiac surgeon from offering such a potentially beneficial intervention.     

Effectiveness of biopesticides against brown planthopper (Nilaparvata lugens) in paddy cultivation

The brown planthopper (BPH) causes serious damage to rice by sucking rice sap, ovipositing in rice tissues, and transmitting a number of rice diseases during its long-distance migration that severely affect the productivity of paddy. Thus, the aim of this study is to investigate the effectiveness of biopesticides against BPH population. BV500WS is used at the early stage of paddy cultivation for growth enhancement meanwhile BV612EC is used a week after the liberation of BPH for crop protection. Three conditions were adopted as follows which are T1 where the paddy was sprayed using BV500WS and BV612EC to study the effectiveness of both types of biopesticides, T2 where the paddy was sprayed using BV500WS only and C1 where the paddy was cultivated without any pesticide application as control. BPH was released twice on day 46 and 59 of paddy cultivation. Reduction of BPH population with up to 100% mortality rate was observed with the application of two types of biopesticides at T1 resulting in the highest number of remaining tillers with 68.56%. Although severely affected by BPH, T2 was able to has comparable number of remaining tillers as C1 which was 46.24% and 49.65% respectively. These results showed that two types of biopesticides were more effective in reducing BPH compared to one type of biopesticide.     

Patients’ willingness to pay for their drugs in primary care clinics in an urbanized setting in Malaysia: a guide on drug charges implementation

Background

Malaysia is an upper middle income country that provides subsidized healthcare to ensure universal coverage to its citizens. The challenge of escalating health care cost occurs in most countries, including Malaysia due to increase in disease prevalence, which induced an escalation in drug expenditure. In 2009, the Ministry of Health has allocated up to Malaysian Ringgit (MYR) 1.402 billion (approximately USD 390 million) on subsidised drugs. This study was conducted to measure patients’ willingness to pay (WTP) for treatment of chronic condition or acute illnesses, in an urbanized population.

Methods

A cross-sectional study, through face-to-face interview was conducted in an urban state in 2012–2013. Systematic random sampling of 324 patients was selected from a list of patients attending ten public primary cares with Family Medicine Specialist service. Patients were asked using a bidding technique of maximum amount (in MYR) if they are WTP for chronic or acute illnesses.

Results

Patients are mostly young, female, of lower education and lower income. A total of 234 respondents (72.2%) were not willing to pay for drug charges. WTP for drugs either for chronic or acute illness were at low at median of MYR10 per visit (USD 3.8). Bivariate analysis showed that lower numbers of dependent children (≤3), higher personal and household income are associated with WTP. Multivariate analysis showed only number of dependent children (≤3) as significant (p = 0.009; 95% CI 1.27–5.44) predictor to drugs’ WTP.

Conclusion

The result indicates that primary care patients have low WTP for drugs, either for chronic condition or acute illness. Citizens are comfortable in the comfort zone whereby health services are highly subsidized through universal coverage. Hence, there is a resistance to pay for drugs.

     

Ventricular enlargement in multiple sclerosis: a comparison of three-dimensional and linear MRI estimates

Atrophy of central white matter is related to irreversible clinical disability in multiple sclerosis (MS) and ventricular enlargement may be a sensitive marker of this tissue loss. Therapeutic trials in MS have provided MRI data for investigation of cerebral atrophy in MS. These studies use almost exclusively two-dimensional (2-D) images, which may be limited in the assessment of three-dimensional (3-D) structures. We used 3-D MRI data to estimate ventricular volumes in 40 patients with MS and 10 healthy controls, to look at associations with clinical disability and the stage of the disease. We then compared simple linear measures of ventricular size from conventional 2-D images, with 3-D volume estimates to establish the best available linear indices of ventricular volume. Mean ventricular volumes were increased in the patients and significantly larger in the more disabled patients. The estimated volume of the third ventricle obtained from 3-D MRI showed the strongest association with the clinical stage of the disease, duration of symptoms and levels of disability. Finally, we confirmed that in patients with MS accurate data on ventricular size can be obtained from 2-D images by two simple and convenient linear measures, the width of the third ventricle and of the anterior horn of the lateral ventricle. Received: 17 April 2000 Accepted: 25 August 2000     

Computed and conventional chest radiography: A comparison of image quality and radiation dose

The aim of this study was to compare the image quality and entrance skin dose (ESD) for film‐screen and computed chest radiography. Analysis of the image quality and dose on chest radiography was carried out on a conventional X‐ray unit using film‐screen, storage phosphor plates and selenium drum direct chest radiography. For each receptor, ESD was measured in 60 patients using thermoluminescent dosemeters. Images were printed on 35 × 43 cm films. Image quality was assessed subjectively by evaluation of anatomic features and estimation of the image quality, following the guidelines established by the protocols of the Commission of the European Communities. There was no statistically significant difference noted between the computed and conventional images (Wilcoxon rank sum test, P > 0.05). Imaging of the mediastinum and peripheral lung structures were better visualized with the storage phosphor and selenium drum technique than with the film‐screen combination. The patients’ mean ESD for chest radiography using the storage phosphor, film‐screen combination and selenium drum was 0.20, 0.20 and 0.25 mGy, respectively, with no statistically significant difference with P > 0.05 (χ² tests).     

Transformational characteristics of ground-level ozone during high particulate events in urban area of Malaysia

Observations of ground-level ozone (O₃), nitric oxide (NO), nitrogen dioxide (NO₂), particulate matter (PM₁₀) and meteorological parameter (temperature, relative humidity and wind speed) fluctuations during high particulate event (HPE) and non-HPE in Malaysia have been conducted for 2 years (2013 and 2014). The study focuses on urban areas, namely, Shah Alam, Petaling Jaya and Bandaraya Melaka. The diurnal variations of ground-level O₃ concentration were higher during HPE than those during non-HPE in all urban areas. The concentration of O₃ fluctuated more in 2014 than 2013 due to the higher incidences of HPE. Temperature and wind speed fluctuated with higher PM₁₀, NO₂ and NO concentrations during HPE than those during non-HPE in all urban sites. Relative humidity was lower during HPE than that during non-HPE. Positive correlations were found between PM₁₀ and ozone during HPE for Shah Alam and Petaling Jaya with 0.81 and 0.79, respectively. Meanwhile, negative correlation (??0.76) was recorded for Bandaraya Melaka. The non-HPE correlation of PM₁₀ and O₃ showed negative values for all locations except Petaling Jaya (0.02). Temperature and wind speed shows a strong positive correlation with ozone for all locations during HPE and non-HPE with the highest at Shah Alam (0.97). Inverse relationships were found between relative humidity and O₃, in which the highest was for Shah Alam (??0.96) in 2013 and Shah Alam (??0.97) and Bandaraya Melaka (??0.97) in 2014. The result of the ozone best-fit equation obtained an R² of 0.6730. The study parameters had a significant positive relationship with the ozone predictions during HPE.