19672 research outputs found
Sort by
Establishing the cut off values of androgen markers in the assessment of polycystic ovarian syndrome
No full textIntroduction: Hyperandrogenism remains as one of the key features in Polycystic Ovarian Syndrome (PCOS) and can be assessed clinically or determined by biochemical assays. Hirsutism is the most common clinical manifestation of hyperandrogenism. The clinical assessment is subjected to wide variability due to poor interobserver agreement and multiple population factors such as ethnic variation, cosmetic procedures and genetic trait. The difficulty in resolving the androgen excess biochemically is due to a lack of consensus as to which serum androgen should be measured for the diagnosis of PCOS. The aim of the study was to compare and establish the diagnostic cut off value for different androgen biomarker for the diagnosis of PCOS. Materials and Methods: A total of 312 patients classified to PCOS (n = 164) and non PCOS (n = 148) cohorts were selected from the Laboratory Information System (LIS) based on serum total testosterone (TT) and sex hormone binding globulin (SHBG) from the period of 1st April 2015 to 31st March 2016. PCOS was diagnosed based on Rotterdam criteria. Clinical hyperandrogenism and ultrasound polycystic ovarian morphology were obtained from the clinical records. The other relevant biochemical results such as serum luteinizing hormone (LH), follicle stimulating hormone (FSH) and albumin were also obtained from LIS. Free androgen index (FAI), calculated free testosterone (cFT) and calculated bioavailable testosterone (cBT) were calculated for these patients. Receiver Operating Characteristic (ROC) curve analysis were performed for serum TT, SHBG, FAI, cFT, cBT and LH: FSH ratio to determine the best marker to diagnose PCOS. Results: All the androgen parameters (except SHBG) were significantly higher in PCOS patients than in control (p<0.0001). The highest area under curve (AUC) curve was found for cBT followed by cFT and FAI. TT and LH: FSH ratio recorded a lower AUC and the lowest AUC was seen for SHBG. cBT at a cut off value of 0.86 nmol/L had the highest specificity, 83% and positive likelihood ratio (LR) at 3.79. This is followed by FAI at a cut off value of 7.1% with specificity at 82% and cFT at a cut off value of 0.8 pmol/L with specificity at 80%. All three calculated androgen indices (FAI, cFT and cBT) showed good correlation with each other. Furthermore, cFT, FAI and calculated BT were shown to be more specific with higher positive likelihood ratio than measured androgen markers. Conclusions: Based on our study, the calculated testosterone indices such as FAI, cBT and cFT are useful markers to distinguish PCOS from non-PCOS. Owing to ease of calculation, FAI can be incorporated in LIS and can be reported with TT and SHBG. This will be helpful for clinician to diagnose hyperandrogenism in PCOS
Mandibulotomy: an analysis of its morbidities
No full textThe mandibulotomy is a procedure that was developed to improve access in tumour resection. This study aimed to investigate the complications associated with mandibulotomy and analyze factors that could affect the risks of developing these complications. The hospital records of all patients who underwent a mandibulotomy as part of their tumour ablative surgery at two major centres in Malaysia were reviewed retrospectively. Demographic, clinical, and complications data were recorded and analyzed. Early postoperative complications occurred in 46.5% of the patients and post-radiation therapy complications in 16.1%. Wound dehiscence (27.9%) and inferior alveolar nerve injury (25.6%) were the common early postoperative complications. Dental injuries (9.7%) and plate exposure/infection (9.7%) were the common post-radiation therapy complications. Furthermore, inferior alveolar nerve injury and early abscess formation were significantly associated with the site of the mandibulotomy. The T-stage of a tumour but not the site of mandibulotomy was significantly associated with tumour margin clearance. Mandibulotomy does pose an added risk of complications for a patient undergoing tumour surgery. The benefits of mandibulotomy in terms of gaining margin clearance could not be proven in this study. The site of mandibulotomy appears to increase the risk of developing an inferior alveolar nerve injury
Determination of Optimal Freshwater Prawn Farming Site Locations using GIS and Multicriteria Evaluation
No full textMustafa, F.-B. and Bwadi, B.E., 2018. Determination of optimal freshwater prawn farming site locations using GIS and multicriteria evaluation. In: Ashraf, M.A. and Chowdhury, A.J.K. (eds.), Coastal Ecosystem Responses to Human and Climatic Changes throughout Asia. Site suitability selection is an essential condition for attaining maximum use of any land resources. Inadequate information about factors that influence the production of giant freshwater prawn has contributed to the low production in many regions. This study was to determine the best giant freshwater prawn farming site using the multicriteria evaluation (MCE) and GIS methods in the Negeri Sembilan state of Peninsular Malaysia. The analytic hierarchy process (AHP) pairwise comparison matrix was used to determine the weights for the physicochemical factors of water, soil, and infrastructure used in the analysis. The factor maps were generated through the data stored in the ArcGIS 10.1 environment. The present land-use map of the area was created from the shape-file map of the prawn farming areas. The results revealed that 18% of the area presently being used was most suitable areas, 49% was moderately suitable, and 33% was not suitable. The potential area for prawn farming is 441,421.56 ha; of which, only 441.80 ha (1%) have been under farming. The results of model verification showed that the suitability map was 100% consistent with the current farms in the study area when compared. GIS and AHP methodologies were found to be effective for site suitability selection for prawn farming. The results of the study can be useful for decision making about prawn farming in the study area
Classification of forensic autopsy reports through conceptual graph-based document representation model
No full textText categorization has been used extensively in recent years to classify plain-text clinical reports. This study employs text categorization techniques for the classification of open narrative forensic autopsy reports. One of the key steps in text classification is document representation. In document representation, a clinical report is transformed into a format that is suitable for classification. The traditional document representation technique for text categorization is the bag-of-words (BoW) technique. In this study, the traditional BoW technique is ineffective in classifying forensic autopsy reports because it merely extracts frequent but discriminative features from clinical reports. Moreover, this technique fails to capture word inversion, as well as word-level synonymy and polysemy, when classifying autopsy reports. Hence, the BoW technique suffers from low accuracy and low robustness unless it is improved with contextual and application-specific information. To overcome the aforementioned limitations of the BoW technique, this research aims to develop an effective conceptual graph-based document representation (CGDR) technique to classify 1500 forensic autopsy reports from four (4) manners of death (MoD) and sixteen (16) causes of death (CoD). Term-based and Systematized Nomenclature of Medicine–Clinical Terms (SNOMED CT) based conceptual features were extracted and represented through graphs. These features were then used to train a two-level text classifier. The first level classifier was responsible for predicting MoD. In addition, the second level classifier was responsible for predicting CoD using the proposed conceptual graph-based document representation technique. To demonstrate the significance of the proposed technique, its results were compared with those of six (6) state-of-the-art document representation techniques. Lastly, this study compared the effects of one-level classification and two-level classification on the experimental results. The experimental results indicated that the CGDR technique achieved 12% to 15% improvement in accuracy compared with fully automated document representation baseline techniques. Moreover, two-level classification obtained better results compared with one-level classification. The promising results of the proposed conceptual graph-based document representation technique suggest that pathologists can adopt the proposed system as their basis for second opinion, thereby supporting them in effectively determining CoD
Taxonomic revision of the genus Poropuntius (Teleostei: Cyprinidae) in Peninsular Malaysia
No full textUp to three nominal species of the cyprinid fish genus Poropuntius (i.e. P. deauratus [Valenciennes in Cuvier & Valenciennes 1842], P. normani [Smith 1931], and P. smedleyi [de Beaufort 1933]) have been reported to occur in Peninsular Malaysian freshwater ecosystems. However, low morphological differentiation among species of Poropuntius causes confusion and it is still unknown how many valid species of Poropuntius occur in this region. The goal of this study is to review the taxonomic status of Poropuntius in Peninsular Malaysia by using morphological and molecular characters. Principal Component Analysis (PCA) on a morphometric dataset including 281 specimens of Poropuntius from Peninsular Malaysia and P. normani from Thailand (type locality) failed to identify non-overlapping clusters within sampled specimens. A phylogenetic tree based on cytochrome oxidase subunit I (COI) showed intraspecific levels of genetic differentiation within Poropuntius of Peninsular Malaysia and the specimens of P. normani from Thailand form a monophyletic group. Our results strongly support the presence of only one species of Poropuntius in Peninsular Malaysia, P. normani. We demonstrate that P. smedleyi described from Johor, southern Peninsular Malaysia, is a junior synonym of P. normani. The previous reports of the presence of P. deauratus in Peninsular Malaysia are doubtful because this species was described from Vietnam where, in all evidence, it is endemic
The hypolipidemic effects of Tamarindus indica fruit pulp extract in normal and diet‐induced hypercholesterolemic hamsters are associated with altered levels of serum proteins
No full textThe hypolipidemic effects of Tamarindus indica fruit pulp extract (Ti-FPE) have been earlier reported but the underlying molecular mechanisms are still uncertain. In this study, hamsters fed with Ti-FPE, both in the absence and presence of high-cholesterol diet, were shown to have significantly reduced levels of serum triglyceride, LDL-C and total cholesterol. The Ti-FPE-fed non-hypercholesterolemic hamsters also showed significant enhanced levels of serum apolipoprotein A1, antithrombin III, transferrin and vitamin D binding protein. In diet-induced hypercholesterolemic hamsters, apolipoprotein A1, antithrombin III and transferrin, which were relatively low in levels, became significantly enhanced when the hamsters were fed with Ti-FPE. These Ti-FPE-fed hypercholesterolemic hamsters also showed significant higher levels of serum vitamin D binding protein. When the different treated groups of hamsters were analyzed for the levels of the four serum proteins by ELISA, similar altered abundance were detected. Ingenuity Pathway Analysis of the Ti-FPE modulated serum proteins singled out “Lipid metabolism, molecular transport, small molecule biochemistry” as the top network. Our results suggest that the hypolipidemic effects of Ti-FPE are associated with alterations of serum proteins that are known to be cardioprotective and involved in the metabolism of lipids. The MS data have been deposited to the ProteomeXchange Consortium with the dataset identifier PXD010232
Importance of Proactive Malaria Case Surveillance and Management in Malaysia
No full textAlthough Plasmodium vivax infections in Malaysia are usually imported, a significant autochthonous outbreak of vivax malaria was detected in a remote indigenous (Orang Asli) settlement located in northern peninsular Malaysia. Between November 2016 and April 2017, 164 cases of P. vivax infection were detected. Although 83.5% of the vivax cases were identified through passive case detection and contact screening during the first 7 weeks, subsequent mass blood screening (combination of rapid diagnostic tests, blood films, and polymerase chain reaction [PCR]) of the entire settlement (N = 3,757) revealed another 27 P. vivax infections, 19 of which were asymptomatic. The mapped data from this active case detection program was used to direct control efforts resulting in the successful control of the outbreak in this region. This report highlights the importance of proactive case surveillance and timely management of malaria control in Malaysia as it nears malaria elimination
Hepatopulmonary Syndrome and Portopulmonary Hypertension in Children: Recent Advances in Diagnosis and Management
No full textElectrospun PMMA polymer blend nanofibrous membrane: electrospinability, surface morphology and mechanical response
No full textThe present work focuses on the electrospinning ability, the evaluation of resulting surface morphology and mechanical response of PMMA polymer blend nanofibrous membranes. For this purpose, electrospinning ability of PMMA polymer blend is firstly investigated by exploring various set of electrospinning parameters. From the evaluation of surface morphology of the resulting electrospun membranes, the optimum parameters are identified. Using these optimum parameters, tensile specimens are subsequently produced. Three deformation modes are considered: monotonic tensile test, cyclic test with increasing maximum strain and cyclic-relaxation test. Morphological analysis shows that the optimized tensile specimens are initially isotropic on the plane. The mechanical test results highlight the strong inelastic responses of the materials, which include inelastic strain and time-dependent behavior characterized by stress relaxation. Finally, in situ tensile test outcomes suggest that strain-induced fiber re-orientation took place
Irrigation Management Based on Reservoir Operation with an Improved Weed Algorithm
No full textWater scarcity is a serious problem throughout the world. One critical part of this problem is supplying sufficient water to meet irrigation demands for agricultural production. The present study introduced an improved weed algorithm for reservoir operation with the aim of decreasing irrigation deficits. The Aswan High Dam, one of the most important dams in Egypt, was selected for this study to supply irrigation demands. The improved weed algorithm (IWA) had developed local search ability so that the exploration ability for the IWA increased and it could escape from local optima. Three inflows (low, medium and high) to the reservoir were considered for the downstream demands. For example, the average solution for the IWA at high inflow was 0.985 while it was 1.037, 1.040, 1.115 and 1.121 for the weed algorithm (WA), bat algorithm (BA), improved particle swarm optimization algorithm (IPSOA) and genetic algorithm (GA). This meant that the IWA decreased the objective function for high inflow by 5.01%, 5.20%, 11.65% and 12% compared to the WA, BA, IPSOA and GA, respectively. The computational time for the IWA at high inflow was 22 s, which was 12%, 18%, 24% and 29% lower than the WA, BA, IPSOA and GA, respectively. Results indicated that the IWA could meet the demands at all three inflows. The reliability index for the IWA for the three inflows was greater than the WA, BA, IPSOA and GA, meaning that the released water based on IWA could well supply the downstream demands. Thus, the improved weed algorithm is suggested for solving complex problems in water resources management