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Malaysian Family Physician , 2008,
Abstract: Cardiovascular disease (CVD) risk is a continuum across blood pressure. The term prehypertension was introduced because it is now recognized that blood pressure readings between what is deemed optimal and hypertension is associated with increased CVD risk. The prevalence of prehypertension is high and the progression to hypertension is also high. Prehypertension is also commonly associated with other CVD risk factors namely dyslipidaemia, dysgylcaemia and overweight/obesity. Eighty-five percent of prehypertensives have one other or more CVD risk factor compared to normotensives. A recent study has shown a reduction in the development of hypertension from prehypertension with the use of an angiotensin receptor blocker. Unfortunately to date, the impact of treatment of prehypertension on CVD outcome is still unknown except in those with high CVD risk like diabetes or established CVD. However this does not mean nothing can be done for those with prehypertension. The aim of managing prehypertension is to lower the BP, prevent progression to hypertension and to prevent BP related CVD deaths. Lifestyle changes can reduce BP and this by itself can lower CVD risk. Until more evidence about other modalities of treatment become available this is a sensible and cost-effective way to manage prehypertension.
Malaysian Family Physician , 2008,
Extensive Mongolian Spots with Autosomal Dominant Inheritance
Beeregowda YC,Naveen Kumar,Manjunatha YC
Iranian Journal of Pediatrics , 2012,
Abstract: Background: Mongolian spots are benign skin markings at birth which fade and disappear as the child grows.Often persistent extensive Mongolian spots are associated with inborn error of metabolism. We report thirteen people of the single family manifested with extensive Mongolian spots showing autosomal dominantinheritance.Case Presentation: A one day old female child, product of second degree consanguineous marriage, born bynormal vaginal delivery with history of meconium stained amniotic fluid and birth asphyxia. On examination the child showed extensive bluish discoloration of the body involving trunk and extremities in both anterior and posterior aspects associated with bluish discoloration of the tongue. A detailed family history revealedmost of the family members manifested with extensive bluish discoloration of the body soon after birth which faded in the first few years of life and completely disappeared by puberty. Thus it was diagnosed to be extensive Mongolian spots with an autosomal dominant inheritance.Conclusion: Knowledge about the natural history of extensive ongolian spots, their inheritance and association with certain metabolic diseases mainly IEM and Mucopolysaccharidosis aids in the diagnosis and in order to improve the patient’s prognosis.
Comparison of the air-Q ILA and the LMA-Fastrach in airway management during general anaesthesia
EU Neoh, YC Choy
Southern African Journal of Anaesthesia and Analgesia , 2012,
Abstract: One hundred and sixty patients aged between 20-60 years with ASA physical status I-II, undergoing elective surgery under general anaesthesia, were enrolled into this prospective, randomised, double-blinded study to compare the success rate of tracheal intubation between the air-Q intubating laryngeal airway (ILA) and the laryngeal mask airway (LMA)-Fastrach (80 patients in each group). The degree of mouth opening, occurrence of coughing, laryngospasm, ease of insertion, adequacy of ventilation, and number of attempts were recorded during the insertion of the air-Q ILA and the LMA-Fastrach . Tracheal intubation via the supraglottic airway devices was then performed, and cricoid manipulation, ease of insertion and number of attempts, were noted. Postoperatively, the degree to which patients had a sore throat using visual analogue scale (VAS), hoarseness of voice and blood on the air-Q ILA and the LMA-Fastrach were recorded. In terms of ease of insertion, there was no statistically significant difference between the insertion of the air-Q ILA and the LMA-Fastrach . However, in terms of ease of tracheal intubation, the LMA-Fastrach group was superior (p-value = 0.001) in terms of external cricoid manipulation requirement, ease of intubation, and the number of attempts (p-value = 0.009). The success of blind intubation, with up to three attempts, was 77 (97.47%) and 60 (75%) patients, in the LMA-Fastrach and air-Q ILA groups, respectively. In conclusion, there was no statistical difference between the air-Q ILA and the LMA-Fastrach in terms of ease of insertion, incidence of adverse response, and adequacy of ventilation. However, tracheal intubation was superior using the LMAFastrach , rather than the air-Q ILA.
Whole body vibration therapy in fracture prevention among adults with chronic disease
Marco YC Pang
World Journal of Orthopedics , 2010, DOI: 10.5312/wjo.v1.i1.20
Abstract: Due to various physical impairments, individuals with chronic diseases often live a sedentary lifestyle, which leads to physical de-conditioning. The associated muscle weakness, functional decline and bone loss also render these individuals highly susceptible to falls and fragility fractures. There is an urgent need to search for safe and effective intervention strategies to prevent fragility fractures by modifying the fall-related risk factors and enhancing bone health. Whole body vibration (WBV) therapy has gained popularity in rehabilitation in recent years. In this type of treatment, mechanical vibration is delivered to the body while the individual is standing on an oscillating platform. As mechanical loading is one of the most powerful stimuli to induce osteogenesis, it is proposed that the mechanical stress applied to the human skeleton in WBV therapy might be beneficial for enhancing bone mass. Additionally, the vibratory signals also constitute a form of sensory stimulation and can induce reflex muscle activation, which could potentially induce therapeutic effects on muscle strength and important sensorimotor functions such as postural control. Increasing research evidence suggests that WBV is effective in enhancing hip bone mineral density, muscle strength and balance ability in elderly patients, and could have potential for individuals with chronic diseases, who often cannot tolerate vigorous impact or resistance exercise training. This article aims to discuss the potential role of WBV therapy in the prevention of fragility fractures among people with chronic diseases.
Decompos t on of elast c constant tensor nto orthogonal parts
Din kal, YC Akg z
International Journal of Engineering, Science and Technology , 2010,
Abstract: In this paper, we have elaborated on the decomposition methods such as irreducible decomposition, orthonormal tensor basis, harmonic and spectral decomposition for elastic constant tensor. Irreducible decomposition and orthonormal tensor basis methods are developed by using the results of existing theories in the literature. As examples to each decomposition method, we give results for the decomposition of elastic constant tensor in triclinic symmetry as well as materials with isotropic and transversely isotropic symmetry. Numerical examples serve to illustrate and verify each of the four decomposition methods. These examples are used to compare the decomposition methods explicitly. As a result of comparison process, it is stated that the spectral method is a non-linear invariant decomposition method that yields non-linear orthogonal parts contrary to the other three methods which are linear invariant decomposition methods. It is also shown that total scalar (isotropic) part is decomposed into two physically meaningful orthogonal parts by irreducible decomposition, orthonormal tensor basis and spectral methods. While in harmonic decomposition method, decomposition of total scalar part is not orthogonal. We propose that it is possible to make these parts orthogonal to each other. International Journal of Engineering, Science and Technology, Vol. 2, No. 6, 2010, pp. 22-46
Triple fixed-sign solutions in modelling a system with Hermite boundary conditions
Wong Patricia JY,Soh YC
Journal of Inequalities and Applications , 2005,
Abstract: We consider the following system of differential equations , , together with Hermite boundary conditions , , , , where , for , and . By using different fixed point theorems, we offer criteria for the existence of three solutions of the system which are of "prescribed signs" on the interval .
Comparison of coplanar and noncoplanar intensity-modulated radiation therapy and helical tomotherapy for hepatocellular carcinoma
Chen-Hsi Hsieh, Chia-Yuan Liu, Pei-Wei Shueng, Ngot-Swan Chong, Chih-Jen Chen, Ming-Jen Chen, Ching-Chung Lin, Tsang-En Wang, Shee-Chan Lin, Hung-Chi Tai, Hui-Ju Tien, Kuo-Hsin Chen, Li-Ying Wang, Yen-Ping Hsieh, David YC Huang, Yu-Jen Chen
Radiation Oncology , 2010, DOI: 10.1186/1748-717x-5-40
Abstract: Nine patients with unresectable HCC and PVT underwent step and shoot coplanar IMRT with intent to deliver 46 - 54 Gy to the tumor and portal vein. The volume of liver received 30Gy was set to keep less than 30% of whole normal liver (V30 < 30%). The mean dose to at least one side of kidney was kept below 23 Gy, and 50 Gy as for stomach. The maximum dose was kept below 47 Gy for spinal cord. Several parameters including mean hepatic dose, percent volume of normal liver with radiation dose at X Gy (Vx), uniformity index, conformal index, and doses to organs at risk were evaluated from the dose-volume histogram.HT provided better uniformity for the planning-target volume dose coverage than both IMRT techniques. The noncoplanar IMRT technique reduces the V10 to normal liver with a statistically significant level as compared to HT. The constraints for the liver in the V30 for coplanar IMRT vs. noncoplanar IMRT vs. HT could be reconsidered as 21% vs. 17% vs. 17%, respectively. When delivering 50 Gy and 60-66 Gy to the tumor bed, the constraints of mean dose to the normal liver could be less than 20 Gy and 25 Gy, respectively.Noncoplanar IMRT and HT are potential techniques of radiation therapy for HCC patients with PVT. Constraints for the liver in IMRT and HT could be stricter than for 3DCRT.Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide [1] and is the third most common cause of cancer mortality in the recent year [2]. The 5-year survival rate of individuals with liver cancer reported by the American Cancer Society in the United States is less than 10% despite aggressive conventional therapy. In addition, comparing 1991 and 2005, liver cancer is not only one of the three cancers with an increasing death rate, but also the fastest growing death rate (27%) in the United States [3]. Portal vein thrombosis (PVT) is a common complication in patients with advanced-stage HCC, occurring in 20%-80% of these patients [4-6]. PVT may alter the correc
Synthesis of New 1,3-Disubstituted-2,3-dihydro-1H-naphth[1,2e][1,3]oxazines
Zuhal Turgut,Emel Pelit,Adem K?ycü
Molecules , 2007, DOI: 10.3390/12030345
Abstract: 1,3-Disubstituted-2,3-dihydro-1H-naphth[1,2-e][1,3]oxazines were prepared through the ring-closurereactions of the aminobenzylnaphthols with substituted aryl-andheteroarylaldehydes.
Novel phytoandrogens and lipidic augmenters from Eucommia ulmoides
Victor YC Ong, Benny KH Tan
BMC Complementary and Alternative Medicine , 2007, DOI: 10.1186/1472-6882-7-3
Abstract: The extracts of E. ulmoides were tested using in-vitro reporter gene bioassays and in-vivo animal studies. Key compounds responsible for the steroidogenic effects were isolated and identified using solid phase extraction (SPE), high performance liquid chromatography (HPLC), thin layer chromatography (TLC), gas chromatography-mass spectroscopy (GC-MS), electron spray ionisation-mass spectroscopy (ESI-MS) and nuclear magnetic resonance (NMR).The following bioactivities of E. ulmoides were found: (1) a phenomenal tripartite synergism exists between the sex steroid receptors (androgen and estrogen receptors), their cognate steroidal ligands and lipidic augmenters isolated from E. ulmoides, (2) phytoandrogenic activity of E. ulmoides was mediated by plant triterpenoids binding cognately to the androgen receptor (AR) ligand binding domain.In addition to well-known phytoestrogens, the existence of phytoandrogens is reported in this study. Furthermore, a form of tripartite synergism between sex steroid receptors, sex hormones and plant-derived lipids is described for the first time. This could have contrasting clinical applications for hypogonadal- and hyperlipidaemic-related disorders.The androgen receptor (AR) plays a pivotal role in human (both male and female) physiology such as skeletal muscle development, bone density, fertility and sex drive [1,2]. The α and β estrogen receptors (ERs), likewise, have fundamental impact on the sex hormone-mediated physiological milieu. Conversely, over-active sex steroid (androgen and estrogen) receptors have been linked to increased risks of hormone-sensitive tumours such as prostate and breast cancers. Availability and binding of cognate ligands to the ligand binding domain (LBD) of the sex steroid receptors are required for the proportionate expression of specific genes responsible for such sex hormone-mediated processes [3,4].Vegetative foods such as the legumes, particularly soybean (Glycine max), contain phytoestrogens that modu
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