1059 PHYSICAL ACTIVITY AMONG OLDER PEOPLE ADMITTED TO A UNIVERSITY HOSPITAL IN MALAYSIA

Introduction

Physical inactivity is prevalent among hospitalised older people and is associated with poor outcomes. This study aims to determine activity levels in a Malaysian university hospital.

Method

Direct observation of patients admitted to the geriatric medicine ward over 2 weeks between the hours of 8 am-8 pm was performed. Data was collated onto an observation diary which was piloted, and changes made iteratively. A taxonomy of inpatient activity and healthcare staff interaction was created. Observer training was done to ensure familiarity and consistency in the recording. Data was presented descriptively and comparison made between weekday/weekend. Minutes of activity time per-hour (mins/hr) was use to report findings.

Results

Ninety-one patients were observed over 1918.8 hours (weekday, 1579.67 hours; weekends, 363.87 hours). The observed median (Q1,Q3) was 15.1 (9.4, 30.1) hours per-patient. 32.6 minutes per day on average was spent upright, with the rest spent either sitting or lying down. 78.9% of patients’ time was spent doing nothing. Patients’ position was different between weekdays vs weekends, lying, 35.7 vs 40.8 mins/hr; sitting, 23.3 vs 18.2 mins/hr; and standing, 1.1 vs 1.0 mins/hr. Patients spent significantly less proportion of time active at the weekends (weekdays, 28.3% vs weekends, 19.9%). When individual activities were analysed, patients were doing less walking (weekend, 0.4 vs weekday, 0.01 mins/hr, p = 0.01) therapy-supervised exercise (1.1 vs 0.02 mins/hr, p < 0.01), and nursing care (0.6 vs 0.1 mins/hr, p < 0.01) over the weekend. There was also less doctor interaction (weekday, 1.1 vs 0.5 mins/hr, p = 0.04) and no therapist interaction at the weekend. Nursing input was unchanged.

Conclusion

Older people admitted to a university hospital in Malaysia were very inactive. There was further reduction in activity levels and healthcare interaction at the weekend. Maintaining physical activity during hospitalisation is required to ensure best possible recovery from their acute illness.

A Cost-Effective Alternative for Lateral Femoral Wall Perforation in Anterior Cruciate Ligament (ACL) Reconstruction: A Case Report

Lateral femoral wall perforation is a rare intra-operative complication in anterior cruciate ligament (ACL) reconstruction surgery. However, it can be challenging to manage if it occurs. We share our experience on lateral femoral wall perforation managed by a large fragment washer. A 25-year-old man with right ACL injury presented with knee instability despite physiotherapy. Anterior drawer test (ADT) and Lachman test were grade 3, glide on pivot shift was positive. During ACL reconstruction, the lateral femoral wall was perforated. Due to unavailability of the rescue endobutton and budget constraint, we passed the endobutton through a washer and allowed it to sit on the washer over the lateral femoral wall. ADT and Lachman test on post-operative 6, 12 and 24 weeks were grade 1, with a negative pivot shift test. Lysholm knee score improved from 69 pre-operatively to 98 post-operatively. Conventionally, lateral femoral wall perforation can be managed by rescue endobutton, or screw and washer post technique. As this complication is rare, the rescue endobutton may not be available at all times, and the cost of the implant is also another important factor to consider. A washer can be used as an alternative technique to manage lateral femoral wall perforation in ACL reconstruction as it is not only cost-effective but also provides stable fixation with good functional outcome.

Structure in nitrate glasses: Raman spectra of TlNO3-Cd(NO3)2 glass and mixed crystal

The Raman spectra of the equimolar mixture of Cd(NO3)2 and TlNO3 in the glassy and crystalline states have been measured over a range of temperatures. The alternative interpretations of the results in terms of distinct anion sites or a continuum of cation distributions are examined. Strong similarities between the spectra of the crystalline and glassy states indicate that three anion sites predominate. In two of these, the environment is dominated by either cadmium ions or thallium ions, whereas the third appears to have a mixture of the two cations.

Raman spectra of hydrated cadmium nitrate in the glassy and crystalline state

Raman spectra for polycrystalline samples of Cd(NO3)2.4H2O and Cd(NO3)2.12H2O are reported at room temperature and at 80 K. The spectra are compared with the spectrum of the anhydrous salt. The nitrate ion has an almost regular bidentate binding to the cadmium ion in Cd(NO3)2.4H2O, and this is used, with the spectral data, to test the conclusions from normal coordinate calculations.The Raman spectrum of Cd(NO3)2.4H2O. in the glassy state is reported, and it is found that the main features of the corresponding crystal are present in the glass. There are some additional features more characteristic of solution spectra which can be associated with disorder in the amorphous phase.

Raman spectrum of cadmium nitrate

The Raman spectra of Cd(NO3)2,4H2O and anhydrous Cd(NO3)2 are reported. The spectrum of Cd(NO3)2,4H2O is compatible with the known crystal structure Fdd2. The spectrum of the anhydrous salt is complex and indicates that the 16 NO3- ions are on four sites with different potential energy environments and each site is occupied by four NO3- ions. The centrosymmetric space group Pbcm is favoured to the non- centrosymmetric space group Pca21. Multiple-site splitting, site- symmetry splitting and correlation-field splitting are used to explain the complex band structures.

Vibrational spectra of alkali chlorates and nitrites in crystalline and molten states

The infrared and Raman spectra of NaClO3 and NaNO2 are reported in crystalline and molten states. The Raman spectra of melts of LiClO3, KClO3, AgClO3, and KKO2 are also reported. The melts all show well-developed lattice-like vibrations which are quite distinct from the crystalline vibrations both in energy and intensity. The spectra are interpreted on the basis of a lattice-like structure in the melt.

Vibrational spectra of anhydrous lithium perchlorate in crystalline and molten states

Anhydrous lithium perchlorate has been examined in the crystalline and molten state by infrared and Raman spectroscopy. In the crystalline phase all degenerate modes are split but the Raman and infrared spectra are essentially identical in the internal frequency region. In the molten state the spectra are more simple but no coincidences exist between infrared and Raman spectra. The spectra are interpreted in terms of a crystalline symmetry perturbation for both the solid and molten salts. The symmetry of the perturbing field is shown to change in going from the solid to the melt. An explanation of the melt spectra in terms of contact ion pairs is considered and dismissed. Observed vibrational frequencies and assignments are given.