Biopolymeric corneal lenticules by digital light processing based bioprinting: a dynamic substitute for corneal transplant

Digital light processing (DLP) technology has gained significant attention for its ability to construct intricate structures for various applications in tissue modeling and regeneration. In this study, we aimed to design corneal lenticules using DLP bioprinting technology, utilizing dual network bioinks to mimic the characteristics of the human cornea. The bioink was prepared using methacrylated hyaluronic acid and methacrylated gelatin, where ruthenium salt and sodium persulfate were included for mediating photo-crosslinking while tartrazine was used as a photoabsorber. The bioprinted lenticules were optically transparent (85.45% ± 0.14%), exhibited adhesive strength (58.67 ± 17.5 kPa), and compressive modulus (535.42 ± 29.05 kPa) sufficient for supporting corneal tissue integration and regeneration. Puncture resistance tests and drag force analysis further confirmed the excellent mechanical performance of the lenticules enabling their application as potential corneal implants. Additionally, the lenticules demonstrated outstanding support for re-epithelialization and stromal regeneration when assessed with human corneal stromal cells. We generated implant ready corneal lenticules while optimizing bioink and bioprinting parameters, providing valuable solution for individuals suffering from various corneal defects and waiting for corneal transplants.

Analyzing and Comparing Omicron Lineage Variants Protein–Protein Interaction Network Using Centrality Measure

The Worldwide spread of the Omicron lineage variants has now been confirmed. It is crucial to understand the process of cellular life and to discover new drugs need to identify the important proteins in a protein interaction network (PPIN). PPINs are often represented by graphs in bioinformatics, which describe cell processes. There are some proteins that have significant influences on these tissues, and which play a crucial role in regulating them. The discovery of new drugs is aided by the study of significant proteins. These significant proteins can be found by reducing the graph and using graph analysis. Studies examining protein interactions in the Omicron lineage (B.1.1.529) and its variants (BA.5, BA.4, BA.3, BA.2, BA.1.1, BA.1) are not yet available. Studying Omicron has been intended to find a significant protein. 68 nodes represent 68 proteins and 52 edges represent the relationship among the protein in the network. A few centrality measures are computed namely page rank centrality (PRC), degree centrality (DC), closeness centrality (CC), and betweenness centrality (BC) together with node degree and Local clustering coefficient (LCC). We also discover 18 network clusters using Markov clustering. 8 significant proteins (candidate gene of Omicron lineage variants) were detected among the 68 proteins, including AHSG, KCNK1, KCNQ1, MAPT, NR1H4, PSMC2, PTPN11 and, UBE21 which scored the highest among the Omicron proteins. It is found that in the variant of Omicron protein-protein interaction networks, the MAPT protein's impact is the most significant.

Clustering based secure error report fault tolerant routing in mobile adhoc networks

A Mobile Ad-hoc Network (MANET) is a self-constructed network consisting of spatially distributed nodes that cooperatively arrange themselves without any centralized manager or fixed based stations. In MANET, the nodes are deployed in a dynamic scenario, so, the nodes may fail as a result of energy depletion, hardware failure, communication link errors, and malicious attacks. Therefore, it is necessary to design energy-efficient fault-tolerant algorithms and protocols for MANETs. Since the development of Mobile Ad-hoc networks was originally motivated by military applications, such as battlefield surveillance and healthcare applications it is required to have a fast recovery mechanism to overcome the fault condition. In this research work, a fault-tolerant Routing mechanism is designed and implemented to address the fault conditions such as node failure, link failure, and critical battery issues called Fault tolerant cluster based AODV with Error Reporting Routing (CAODVERR) protocol, and to improve the stability of the MANET. Also, an Error reporting mechanism has been incorporated with the Ad-hoc On-Demand Distance Vector (AODV) routing protocol.

Non Dysraphic Intramedullary Spinal Cord Lipoma

Among all intramedullary spinal cord lesions, intramedullary spinal cord lipomas account less than 1%. Non-dysraphic intramedullary lipoma is very rare. It is most commonly seen in cervicodorsal region followed by cervico bulbar, lumbar and sometimes multiple. Here we present a 17-year-old female who underwent MRI due to upper dorsal pain followed by progressive bilateral lower limb weakness which showed intramedullary lesion extending from T1-T9, involving eight vertebral segments with distal syrinx and features suggestive of lipoma. Patient underwent surgical decompression of lipoma. Patient had an uneventful post-operative period. Diagnosis confirmed by histopathology.

Hybrid cumulative approach for localization of nodes with adaptive threshold gradient feature on energy minimization using federated learning

Purpose

Localization of the nodes is crucial for gaining access of different nodes which would provision in extreme areas where networks are unreachable. The feature of localization of nodes has become a significant study where multiple features on distance model are implicated on predictive and heuristic model for each set of localization parameters that govern the design on energy minimization with proposed adaptive threshold gradient feature (ATGF) model. A received signal strength indicator (RSSI) model with node estimated features is implicated with localization problem and enhanced with hybrid cumulative approach (HCA) algorithm for node optimizations with distance predicting.

Design/methodology/approach

Using a theoretical or empirical signal propagation model, the RSSI (known transmitting power) is converted to distance, the received power (measured at the receiving node) is converted to distance and the distance is converted to RSSI (known receiving power). As a result, the approximate distance between the transceiver node and the receiver may be determined by measuring the intensity of the received signal. After acquiring information on the distance between the anchor node and the unknown node, the location of the unknown node may be determined using either the trilateral technique or the maximum probability estimate approach, depending on the circumstances using federated learning.

Findings

Improvisation of localization for wireless sensor network has become one of the prime design features for estimating the different conditional changes externally and internally. One such feature of improvement is observed in this paper, via HCA where each feature of localization is depicted with machine learning algorithms imparting the energy reduction problem for each newer localized nodes in Section 5. All affected parametric features on energy levels and localization problem for newer and extinct nodes are implicated with hybrid cumulative approach as in Section 4. The proposed algorithm (HCA with AGTF) has implicated with significant change in energy levels of nodes which are generated newly and which are non-active for a stipulated time which are mentioned and tabulated in figures and tables in Section 6.

Originality/value

Localization of the nodes is crucial for gaining access of different nodes which would provision in extreme areas where networks are unreachable. The feature of localization of nodes has become a significant study where multiple features on distance model are implicated on predictive and heuristic model for each set of localization parameters that govern the design on energy minimization with proposed ATGF model. An RSSI model with node estimated features is implicated with localization problem and enhanced with HCA algorithm for node optimizations with distance predicting.

Increased classical monocyte subsets in South Asians compared to White Caucasians at risk for coronary atherosclerosis

Background

South Asians (SA) have an increased prevalence of coronary artery disease (CAD) and myocardial infarction compared with age- and sex-adjusted White Caucasians (WC). The mechanism for this increased risk is poorly understood. While classical CD14++CD16- monocytes act as independent predictors of cardiovascular disease, differences in the distribution of monocyte subsets between SA and WC have not been established.

Purpose

We aimed to determine if differences exist in monocyte subsets between SA and WC at risk for CAD.

Methods

Our cohort consisted of 119 consecutively enrolled patients (59 SA, 60 WC) at intermediate or higher risk for CAD by the INTERHEART score using self-reported history and physical exam. A single blood sample was collected prospectively for the purpose of monocyte analysis. Flow cytometry using dual colour fluorescence (CD14, CD16) within the monocyte gate was used to identify monocyte subsets (classical, intermediate and non-classical) by staff blinded to the individuals' characteristics.

Variables were compared using Mann-Whitney U test and Chi-squared test, as appropriate. Eta coefficient was calculated to analyze the relationship between ethnicity and proportion of monocyte subsets. Eta squared values were calculated to assess the impact of ethnicity on monocyte subset proportions.

Results

The SA group consisted of 64% males with a mean age of 54 (± 9), while the WC group consisted of 55% males with a mean age of 59 (± 7). Both groups had similar body mass index, rates of hypertension, dyslipidemia and family history of premature CAD. Compared to WC, SA had higher prevalence of diabetes (36% vs. 13%, p=0.005) and hemoglobin A1C levels (6.0±1.1% vs. 5.6±0.6%, p<0.001). SA patients had a higher proportion (85.3±10.7% vs. 81.4±11.0%, p=0.009) and total level (449.0±180.4 vs. 388±127.4, p=0.010) of classical CD14++CD16- monocytes compared to WC. There was no difference between the two groups in the proportion of intermediate CD14++CD16+ and non-classical CD14+CD16++ monocytes. There was no association between diabetes and the proportion of monocyte subsets. Ethnicity had a moderate association with the proportion of classical CD14++CD16- monocytes (Eta coefficient = 0.525) with a large effect size (Eta squared = 27.5%). The association of ethnicity with intermediate CD14++CD16+ and non-classical CD14+CD16++ monocytes was either weak or negligible with minimal to no effect size.

Conclusion

In patients with substantive risk for CAD, SA had a significantly higher proportion and level of classical CD14++CD16- monocytes compared to WC. Our findings provide a novel insight into the potential mechanism of increased CAD susceptibility amongst SA compared to WC. Future studies are needed to determine whether these ethnic differences in the distribution of monocyte subsets can predict susceptibility to developing CAD and suffering atherothrombotic events.

Funding Acknowledgement

Type of funding sources: Public Institution(s). Main funding source(s): Cardiology Academic Practice Plan grant at the University of British Columbia

Intelligent energy-aware multiple quality of service restraints based secured optimal routing protocol with dynamic mobility estimation for wireless sensor networks

This research work confronts a sender-based responsive and novel protocol named “Intelligent Energy-Aware Multiple restraints Secured Optimal Routing (IEAMSOR)” protocol for WSNs. In order to deal with the various emerges like packet routing, node mobility, and energy optimization as well as energy balancing in WSNs. The proposed protocol accounts for the basic QoS restraints such as Delay, HopCount and Energy Level for each link of ‘n’ number of routes and predicts the best optimal path among these in-between sender and receiver nodes throughout the route discovery process. It also assures the energy level of each node existing on the route during the route reply process. It incorporates the modified mobility prediction approach in order to estimate the stableness of link failure time for every link of each path during the route reply process. The main objective of this work to achieve the energy balancing among the nodes is achieved through fuzzy rules based node’s trust classification is introduced and based on this energy weight of each node is adjusted according to their trustworthiness. It accomplishes the path sustainment process when the link among the two nodes goes down. Moreover, the proposed model has been given careful attention for selecting additional substitute routes throughout link failure. The experimental results have seemed that the IEAMSOR protocol performs better than the existing traditional protocols.

Human Cadaveric Donor Cornea Derived Extra Cellular Matrix Microparticles for Minimally Invasive Healing/Regeneration of Corneal Wounds

Biological materials derived from extracellular matrix (ECM) proteins have garnered interest as their composition is very similar to that of native tissue. Herein, we report the use of human cornea derived decellularized ECM (dECM) microparticles dispersed in human fibrin sealant as an accessible therapeutic alternative for corneal anterior stromal reconstruction. dECM microparticles had good particle size distribution (≤10 µm) and retained the majority of corneal ECM components found in native tissue. Fibrin-dECM hydrogels exhibited compressive modulus of 70.83 ± 9.17 kPa matching that of native tissue, maximum burst pressure of 34.3 ± 3.7 kPa, and demonstrated a short crosslinking time of ~17 min. The fibrin-dECM hydrogels were found to be biodegradable, cytocompatible, non-mutagenic, non-sensitive, non-irritant, and supported the growth and maintained the phenotype of encapsulated human corneal stem cells (hCSCs) in vitro. In a rabbit model of anterior lamellar keratectomy, fibrin-dECM bio-adhesives promoted corneal re-epithelialization within 14 days, induced stromal tissue repair, and displayed integration with corneal tissues in vivo. Overall, our results suggest that the incorporation of cornea tissue-derived ECM microparticles in fibrin hydrogels is non-toxic, safe, and shows tremendous promise as a minimally invasive therapeutic approach for the treatment of superficial corneal epithelial wounds and anterior stromal injuries.

Tracking of Wearable IoT Devices Through WAP Using Intelligent Rule-Based Location Aware Approach

Usage of the internet is increasing in the daily life of humans due to the need for speedy task completion for their daily services. Most of the living time is spent in some indoor environment which provides WiFi which is the basic need of internet connectivity using Wireless Access Points (WAP). Nowadays, most of the devices are IoT-based ones, which connect with the outer world through the access points in the existing environment. The wearable IoT devices may be misplaced somewhere and we need a specific scenario which helps to identify the misplaced mobile devices based on access points where they are connected by their unique identity such as MAC address. Most of the time, unrestricted WiFi access provided in the public environment is used by the end-user. In that scenario, the tracking of misplaced mobile devices is creating an issue when the WiFi is in switch-off mode. This paper proposes a technique for tracking a mobile device by using a location-aware approach with KNN and intelligent rules by tracking the channel accessed by the user to find the misplaced path by examining the device connected WAP positions.

Artificial Neural Network based SVPWM for Five Level Cascaded H-bridge Inverter fed Grid connected PV System

An Artificial Neural Network (ANN) based Space Vector Pulse Width Modulation (SVPWM) for five level cascaded H-bridge inverter (CHBI) fed grid connected photovoltaic (PV) system. The multilevel inverter topologies are offers better performance compare conventional two level inverter like reduced total harmonic distortion, less electromagnetic interferences and voltage stresses across switches are low. The ANN based SVPWM generates the switching pulses for cascaded H-bridge inverter; it improves the accuracy in reference vectors tuning and identification, which leads to improve the inverter output voltage, better utilization of dc-link voltage and controlled output current. The ANN control makes the implementation of SVPWM becomes simple and minimizes the intricacy in tracking reference vector and calculation of switching time; it is suitable for any type of non-linear systems. This proposed system is energized using PV system and it is boosted using dc-dc boost converter, and the output of CHBI is synchronized with grid connected system using coupled inductor. The simulation and experimental results of ANN based SVPWM for CHBI is verified using simulink-matlab and DSP processor.

CuWO₄ Nanoparticles: Investigation of Dielectric, Electrochemical Behaviour and Photodegradation of Pharmaceutical Waste

The hydrothermally synthesized CuWO₄ nanoparticles (NPs) were characterized with different analysis such as X-ray diffraction (XRD), Scanning Electron Microscopy (SEM), High Resolution Transmission Electron Microscopy (HRTEM), Energy Dispersive X-ray Spectroscopy (EDX), Cyclic Voltammetry (CV), UV-Visible and Photoluminescence (PL) analysis. The prepared CuWO₄ NPs were examined with Electrochemical Impedance Spectroscopy (EIS). SEM images show that CuWO₄ NPs are highly spherical shaped morphology and porous in nature. The optical band gap of prepared CuWO₄ NPs is found to be 2.12 eV. Photodegradation of diclofenac sodium (DFS) (medical waste) in the aqueous medium with CuWO₄ NPs under visible light irradiation shows 98% degradation. The CuWO₄ NPs was stable up to 5th cycle it can be used as a reusable photocatalyst for the DFS degradation. The electrical conductivity and dielectric properties of the CuWO₄ NPs at room temperature is analyzed by EIS studies. The bulk conductivity value of the prepared nanoparticles is 1.477×10^-5 S/cm at room temperature. The conductivity of CuWO₄ NPs is found to be due to electrons movement. The CuWO₄ NPs shows higher photocatalytic and electrocatalytic activity for decomposition of DFS and methanol electro-oxidation in alkaline medium respectively.

UV-A Light Driven Activated Charcoal Supported Bi₂O₃-ZnO Nanocomposites; Hydrothermal Synthesis and Their Enhanced Photocatalytic and Self Cleaning Applications

The Activated Charcoal supported Bi₂O₃-ZnO (AC-BZ) nanocomposite is successfully synthesized by simple and efficient hydrothermal followed by thermal decomposition method. The addition of Activated charcoal into the Bi₂O₃-ZnO matrices increases the active sites and shows efficient catalytic activity upon the degradation of azo dyes, Rhodamine-B (Rh-B) and Trypan Blue (TB). Prepared photocatalysts further prove its ability by the way of structure and absorption capacity. For understanding the efficiency of photocatalyst, it was characterized by X-ray diffraction (XRD), Field Emission Scanning Electron Microscopy (FE-SEM), Field Emission Transmission Electron Microscopy (FE-TEM), High Resolution Transmission Electron Microscopy (HR-TEM), Diffused Reflectance Spectroscopy (UV-DRS), Photo Luminescense spectroscopy (PL) and N₂ adsorption- desorption isotherms (BET). The FESEM images of the activated charcoal supported Bi₂O₃-ZnO show a nanocomposite structure and reveal that most of particles have hexagonal and spherical type in nano range. Absorption range and band gap energy were examined by UV-DRS techniques, which indicate the photogenerated electrons and holes are responsible for better photocatalytic activity. The prepared AC-BZ nanocomposite has maximum efficiency at pH 7, and it shows enhanced degradation efficiency up to four cycles which proves reusability of the catalyst. The obtained catalyst shows higher efficiency in self cleaning property by forming maximum degree of contact angle when compared with pure ZnO and Bi₂O₃-ZnO. This work may provide new strategy for eco-friendly and cost effective photocatalysts for various applications.

Parents' perceptions of tele-audiological testing in a rural hearing screening program in South India

INTRODUCTION

Tele-diagnostic audiological testing in a hearing screening program for infants and young children is a novel practice, and this study is the first to explore its application in a rural community. It is important to understand parental perceptions and confidence when introducing a new process such as tele-audiological diagnostic testing in rural areas.

METHOD

A questionnaire with 17 rater-administered items was designed to elicit comments concerning the quality of tele-hearing testing and video-conferencing, access to tele-hearing testing, and parents' attitudes regarding tele-hearing testing in the village. The questionnaire was administered by an audiologist not involved in tele-diagnostic testing to avoid bias.

RESULTS

Parents perceived tele-hearing testing as equal in quality to in-person testing. Technical factors such as good video-conferencing quality and logistical factors such as ease of access due to reasonable travel time to testing facility could have influenced these perceptions.

CONCLUSIONS

While these results show tele-hearing testing is an acceptable alternative, occasional poor signal quality should be addressed prior to large-scale implementation.

Effect of Melatonin on Glutamate: BDNF Signaling in the Cerebral Cortex of Polychlorinated Biphenyls (PCBs)-Exposed Adult Male Rats

Various epidemiological survey suggests that the central nervous system is the target for many environmental contaminants. One among them is Aroclor 1254, a mixture of polychlorinated biphenyls (PCBs) which explore a spectrum of biochemical and neurotoxic responses in humans and laboratory animals. Learning and motor coordination deficits are the profound effects of PCBs which may be related to cerebral dysfunction. The aim of the study is to elicit the protective effect of melatonin (Mel), a potent, blood brain permeable antioxidant against the effect of Aroclor 1254 on the signaling of glutamate-principal excitatory neurotransmitter and brain derived neurotrophic factor (BDNF) in the cerebral cortex of adult rats which plays a key role in brain functions. Adult male Wistar rats were grouped into four and treated intraperitonealy (i.p) Group I with corn oil (Control), Group II with PCBs (2 mg/kg/bwt), Group III with PCBs + Mel (2 mg/kg/bwt + 5 mg/kg/bwt) and Group IV with Mel (5 mg/kg/bwt). The protein expression of glutamate signaling molecules and mRNA expressions of GLAST, BDNF signaling molecules were analyzed. The results suggest that simultaneous melatonin treatment significantly attenuated the NMDA receptor mediated glutamate excitotoxicity and protects the inhibition of BDNF signaling caused by PCBs exposure in cerebral cortex of adult male rats. Schematic pathway illustrating the proposed mechanism by which melatonin protects against A1254 mediated glutamate induced neurodegeneration in the cerebral cortex of adult male rats. PCBs induced neurodegeneration is caused by the overactivation of NMDAR, followed by the activation of voltage dependent calcium channels leading to the increase in intracellular Ca(2+) that stimulates calpain. Calpain inturn inhibits the PKA α and neurtrophin BDNF, its receptor and downstream signaling MAPK pathway leading to neurodegeneration. Melatonin had scavenged the ROS produced by PCBS and decreased the NMDAR expression which inturn protected the cells from neurodegeneration.

Melatonin attenuates polychlorinated biphenyls induced apoptosis in the neuronal cells of cerebral cortex and cerebellum of adult male rats--in vivo

Polychlorinated biphenyls (PCBs) are widespread persistent environmental contaminants that display a complex spectrum of toxicological properties, including neurotoxicity. Studies have shown that PCBs increase oxidative stress in brain, leading to apoptosis. The progressive loss of neurons in cerebral cortex and cerebellum, leads to various neurodegenerative diseases. Hence the present study is designed to determine PCBs toxicity toward neuronal cells and whether it could be inhibited by potent antioxidant melatonin. Four groups of adult male Wistar rats were treated for 30 days with corn oil, PCBs, PCBs+Mel and Melatonin, respectively. After treatment period the rats were euthanized and the brain was dissected to isolate cerebral cortex and cerebellum. The neuronal cells alone were then separated from the isolated brain regions, to detect the mRNA levels of apoptotic and neurofilament gene, a neuronal specific marker. Our results suggests that PCBs induces apoptosis in neuronal cells which is subsided by the anti apoptotic effect of melatonin.

Anti-cancer activity of quercetin in neuroblastoma: an in vitro approach

Neuroblastoma is a neuroendocrine tumour derived from neural crest cells and it remains a major therapeutic challenge in pediatric oncology. As response rates to chemotherapy are low, surgery remains the only effective treatment but since many tumors have metastasized at the time of diagnosis, curative surgery is rarely achieved. Consequently, a substantial need for new therapeutic options emerges. Quercetin a flavonoid, has been reported to lower the risk of several cancers. This study was designed to investigate its effects on apoptosis induction in the N2a, a mouse neuroblastoma cell line. The cell viability was determined by dimethyl thiazolyl tetrazolium bromide assay and diamidino-2-phenylindole staining was performed to confirm the apoptosis. The gene expression of bcl-w, p53, p27 and protein expression of caspases (3 and 9), bax, cytochrome-c were studied. This in vitro outcome suggests that quercetin can be used as a potent anti-cancer drug in future.

Polychlorinated biphenyls impair blood–brain barrier integrity via disruption of tight junction proteins in cerebrum, cerebellum and hippocampus of female Wistar rats

Polychlorinated biphenyls (PCBs) comprise a ubiquitous class of toxic substances associated with carcinogenic and tumor-promoting effects as well as neurotoxic properties. Reactive oxygen species, which is produced from PCBs, alters blood–brain barrier (BBB) integrity, which is paralleled by cytoskeletal rearrangements and redistribution and disappearance of tight junction proteins (TJPs) like claudin-5 and occludin. Quercetin, a potent antioxidant present in onion and other vegetables, appears to protect brain cells against oxidative stress, a tissue-damaging process associated with Alzheimer’s and other neurodegenerative disorders. The aim of this study is to analyze the role of quercetin on oxidative stress markers and transcription of transmembrane and cytoplasmic accessory TJPs on cerebrum, cerebellum and hippocampus of female rats exposed to PCBs. Rats were divided into the following four groups. Group I: received only vehicle (corn oil) intraperitoneally (i.p.); group II: received Aroclor 1254 at a dose of 2 mg/kg body weight (bwt)/day (i.p); group III: received Aroclor 1254 (i.p.) and simultaneously quercetin 50 mg/kg bwt/day through gavage and group IV: received quercetin alone gavage. From the experiment, the levels of hydrogen peroxide, lipid peroxidation and thiobarbituric acid reactive substances were observed to increase significantly in cerebrum, cerebellum and hippocampus as 50%, 25% and 20%, respectively, after exposure to PCB, and the messenger RNA expression of TJP in rats exposed to PCBs is decreased and is retrieved to the normal level simultaneously in quercetin-treated rats. Hence, quercetin can be used as a preventive medicine to PCBs exposure and prevents neurodegenerative disorders.

Comparison study between reamed and unreamed nailing of closed femoral fractures

Intramedullary nailing is an accepted procedures for femoral fractures gives uniformly good results. Various methods of intramedullary fixation have been practiced in the past. Recently intramedullary fixation without reaming has come into vogue. Preservation of the endosteal blood supply, less blood loss and quicker union have been the alleged benefits of not reaming the medullary canal. This study is a prospective randomised study conducted to compare intramedullary nail fixation of closed femoral fractures with and without a reaming procedure to assess the validity of the above assumptions. One hundred and two consecutive cases of skeletally mature patients with closed fracture of femoral shaft were randomised into two groups, i.e. Reamed (52) and Unreamed (50). The average follow-up was 36 weeks (range 28-86 weeks). Average time taken for various stages of the operation and total operating time were longer in the reamed group (109.9 min vs 78.6 min) and the blood loss was also increased (320 mls vs. 190 mls). Bridging and callus formation were seen to occur earlier in the reamed group compared to the unreamed enabling the patients in the reamed group to return to normal functions earlier. Limb length discrepancy and rotational alignment measured clinically and with CT scan did not however show any significant difference between the two methods. Nails used in this study group were notably of a smaller diameter and of shorter length when compared to those used in the western population highlighting the difference in the femur in the Asian population. Complications were notably more in the unreamed group where these were screw breakage (3/50) delayed unions (9/50) and non-unions (4/50). In the reamed group however there were only delayed union (2/50) and all fractures eventually united without any implant failure. We conclude that closed, reamed, antegrade insertion of an intramedullary nail is the treatment of choice in femoral shaft fractures, especially those involving the distal 1/3. The unreamed procedure should be reserved for certain exceptions, such as in polytrauma, where a shorter operative time and less blood loss is desired.

An audit of the Scoliosis Service at Hospital Kuala Lumpur

This is a study of patients referred to the Scoliosis Service of Hospital Kuala Lumpur. Three hundred and thirty five (335) consecutive patients who were seen between 1985 and 2000 were reviewed to determine the presentation of scoliosis, the treatment received and the compliance to follow up. Data were determined by measuring the frontal spinal radiographs. Two hundred and ninety eight (298) patients met inclusion criteria. Idiopathic scoliosis accounted for 203 patients (68.1%), 31 (10.4%) were neuromuscular scoliosis; and 44 (14.8%) had congenital scoliosis. Twenty-five point five percent of patients had surgery, 10.4% were treated with brace, while the remaining 69.1% of patients were observed, or had no treatment at all. Congenital scoliosis patients had better compliance compared to idiopathic or neuromuscular scoliosis patients.

The natural history of scoliosis: curve progression of untreated curves of different aetiology, with early (mean 2 year) follow up in surgically treated curves

We studied the curve progression of untreated curves presenting to the Scoliosis Service of Hospital Kuala Lumpur. One hundred and fifty-two (152) patients were included in this study. The median rate of curve progression of idiopathic scoliosis curves was 7.03 degrees per year, for neuromuscular scoliosis curves was 17.39 degrees per year; and congenital scoliosis curves were 3.67 degrees per year. These rates are similar to the reported rates in the literature. Data for sixty-one (61) surgically treated patients were reviewed to determine the early curve correction of the curves of different aetiology. The mean age of surgery was 14.15 years old, the mean preoperative curve size was 71.61 degrees; and the mean postoperative curve size was 43.78 degrees. The mean duration of follow up after surgery was 2.44 years. The revision and removal of instrumentation rate was 8.3%.

Predictive factors in the evolution of neural deficit in tuberculosis of the spine

This study was conducted to determine the factors involved in predicting the onset of paraplegia in tuberculosis of the spine. A cross-sectional, case control review of 85 cases of spinal tuberculosis was conducted at the National Tuberculosis Centre in Kuala Lumpur. Sixty-nine of these cases were normal neurologically, whilst 16 cases experienced neural deficit. The data was analysed using backward logistic regression and Fishers exact probability test. The factors studied included symptoms and signs of spinal tuberculosis, common investigations for tuberculosis, and physical factors of the disease. Only the erythrocyte sedimentation rate (ESR) showed a significant difference between the neural deficit and neurologically normal groups. This suggests that the ESR may be a factor in predicting evolution of paraplegia in spinal tuberculosis. In addition, it was noted that a low proportion of patients had positive sputum smear results and bacterial culture growth for mycobacterium tuberculosis suggesting these tests are of limited value for tuberculosis of the spine.

Effect of unilateral motor cortex ablation on activity of choline acetyltransferase and levels of amino acid transmitter candidates in the spinal cord of adult monkeys

Evidence that L-glutamate is a neurotransmitter of corticofugal fibers was sought by measuring changes in several biochemical markers of neurotransmitter function in discrete regions of spinal cord after ablation of sensorimotor cortex in monkeys. One and five weeks after unilateral cortical ablation, samples from six areas of spinal cord (ventral, lateral and dorsal regions of the left and right sides) were analysed for choline acetyltransferase (ChAT) activity and contents of amino acid transmitter candidates-glutamic acid (Glu), aspartic acid (Asp), glycine (Gly), taurine (Tau) and gamma-aminobutyric acid (GABA). During one to five weeks after unilateral cortical ablation of the monkey, prolonged hemiplegia in the contralateral side was observed. Histological examination of the spinal cord 5 weeks after unilateral (left) cortical ablation showed no apparent change in either control (ipsilateral, left) or affected (contralateral, right) sides of the cord as examined by the Klüver-Barrera method. The ChAT activity as a cholinergic marker was scarcely changed in any region of either left (control) or right (affected) side of the spinal cord at one and five weeks after unilateral (left side) ablation of the motor cortex. Amino acid levels in each region of the spinal cord were not significantly changed one week after unilateral ablation of the motor cortex. However, a significant decrease of Glu content was observed in the lateral column of the affected (right) side compared to the control (left) side of cervical and lumbar cord five weeks after cortical ablation of the left motor area. No concomitant alterations of other amino acids were detected.(ABSTRACT TRUNCATED AT 250 WORDS)