The QICKD study protocol: a cluster randomised trial to compare quality improvement interventions to lower systolic BP in chronic kidney disease (CKD) in primary care.

Background: Chronic kidney disease (CKD) is a relatively newly recognised but common long-term condition affecting 5 to 10% of the population. Effective management of CKD, with emphasis on strict blood pressure (BP) control, reduces cardiovascular risk and slows the progression of CKD. There is currently an unprecedented rise in referral to specialist renal services, which are often located in tertiary centres, inconvenient for patients, and wasteful of resources.

Scalarane-based sesterterpenoid RCE-protease inhibitors isolated from the Indonesian marine sponge Carteriospongia foliascens.

Two new 20,24-bishomo-25-norscalaranes, compounds 1 and 2, and two new and two known 20,24-bishomoscalaranes, compounds 3-6, have been isolated from the Indonesian marine sponge Carteriospongia foliascens. The structures of 1-6 were determined by spectroscopic analysis. Compounds 1 and 3-6 inhibit RCE-protease activity.

Photooxidation of water by NiTiO3 deposited from single source precursor [Ni2Ti2(OEt)2(micro-OEt)6(acac)4] by AACVD.

A single-source heterobimetallic complex Ni2Ti2(OEt)2(mu-OEt)6(acac)4 (1) (acac=2,4-pentanedionate), having a low decomposition temperature and sufficient solubility in organic solvents, was synthesized by simple chemical techniques in high yield and analyzed by melting point, FTIR, single crystal X-ray analysis and thermal analysis. The TGA analysis proved that complex (1) underwent facile thermal decomposition at 500 degrees C to give NiTiO3 residue. In-house designed aerosol assisted chemical vapor deposition equipment was used to deposit high quality thin films of NiTiO3 on a SnO2 coated conducting glass substrate at 500 degrees C.

Neuropsychological assessment in epilepsy surgery - preliminary experience in a rural tertiary care hospital in north East malaysia.

We present our preliminary experience in neuropsychological testing in epilepsy surgery patients to demonstrate how these tests contributed to decide the laterality of epileptic focus, and to assess the effect of surgery on patient's cognitive function and quality of life. Preoperative neuropsychological tests consisting of Wechsler Adult Intelligence Scale-III (WAIS) for IQ, Wechsler Memory Scale-III (WMS) for memory and patients' quality of life (QOLIE 31) were administered to refractory epilepsy patients under evaluation for surgical treatment. These tests were repeated one year after surgery and we studied any changes in trends.

1-(4-Bromo-phen-yl)-1-(4-nitro-benzo-yl)thio-urea.

The title compound, C(14)H(10)BrN(3)O(3)S, crystallizes as two concomitant polymorphs that differ in colour (one yellow and one colourless). Only the structure of the colourless form could be determined. The mol-ecule exists in the thio-amide form with an intra-molecular N-H⋯O=C hydrogen bond across the thio-urea system.

Leukocyte adhesion defect.

Leukocyte adhesion defect (LAD) is a rare, autosomal recessive primary immunodeficiency disorder of phagocytes, in which there is defective aggregation at the site of infection due to the absence of surface integrins. Diagnosis is based primarily on flowcytometric analysis of neutrophils for the surface expression of CD11, CD18 and CD15s. We describe here a case of a 7-months-old boy who presented with a characteristic history of recurrent infections, marked leukocytosis and delayed separation of umbilical cord.

Daily Energy Intake from Meals and Afternoon Snacks: Findings from the Malaysian Adults Nutrition Survey (MANS).

Meal and snack patterns are associated with energy and nutrient intakes and consequently health and nutritional status. The aim of this paper is to describe the percentage of daily energy intake from meals and afternoon snack among Malaysian adults. The study included a representative sample of adults aged 18-59 years (n=7349) from a nationwide Food Consumption Survey conducted by the Ministry of Health.

Energy and Nutrient Intakes: Findings from the Malaysian Adult Nutrition Survey (MANS).

Nutrition surveys based on a representative sample of the Malaysian adult population have hitherto not been reported. In 2003, the Ministry of Health, Malaysia, conducted the Malaysian Adult Nutrition Survey (MANS), the first and largest nutrition survey in the country which aimed to provide detailed quantitative information on nutritional status, food and nutrient intakes, and physical activity pattern on a nationwide representative sample of adult subjects between the ages of 18 and 59 years. The survey covered four zones in Peninsular Malaysia (Central, Southern, Northern and East Coast), Sabah and Sarawak.

Single source heterobimetallic precursors for the deposition of Cu-Ti mixed metal oxide thin films.

Heterobimetallic molecular precursors [Ti(4)(dmae)(6)(mu-OH)(mu-O)(6)Cu(6)(benzoate)(9)] (1) and [Ti(4)(dmae)(6)(mu-OH)(mu-O)(6)Cu(6)(2-methylbenzoate)(9)] (2) were prepared by the interaction of Ti(dmae)(4) [dmae=N,N-dimethylaminoethanolate] with Cu(benzoate)(2).2H(2)O for (2) and Cu(2-methylbenzoate)(2).2H(2)O for (2), respectively, in dry toluene, for selective deposition of Cu/Ti oxide thin films for possible technological applications.

Hematometrocolpos associated with common cloacal anomaly.

A rare case of hematometrocolpos is presented in a 14 years old female with known common cloacal malformation. It presented as a slowly growing tender pelvic mass. Ultrasound and CT scan of the pelvis revealed vagina and uterus filled with blood.

Transdiaphragmatic rupture of huge hepatic hydatid cyst with formation of bronchopleural fistula.

A case of right sided transdiaphragmatic rupture of hepatic hydatid cyst into the right hemithorax is presented. Computed Tomography (CT) scan showed a large hydatid cyst replacing the right lobe of liver and causing complete collapse of right lung secondary to the transdiaphragmatic rupture. Per-operatively, a bronchopleural fistula was also identified and repaired.

Nerve conduction study of healthy Asian Malays: the influence of age on median, ulnar, and sural nerves.

Background: Nerve conduction study is essential in the diagnosis of focal neuropathies and diffuse polyneuropathies. There are many factors that can affect nerve conduction velocity, and age is one of them. Most of the many studies of this effect, and the values from them, were on Caucasian subjects.

Heterobimetallic molecular cages for the deposition of Cu/Ti and Cu/Zn mixed-metal oxides.

Heterobimetallic molecular precursors [Ti4(dmae)6(mu-OH)(mu-O)6Cu6(OAc)9.H2O] (1) and [Zn7(OAc)10(mu-OH)6Cu5(dmae)4Cl4] (2) for the deposition of metal oxide thin films of Cu6Ti4O12 (Cu3TiO4, TiO2) and Cu5Zn7O12 (ZnO, CuO) were prepared by the interaction of Ti(dmae)4 with Cu(OAc)2.2H2O for 1 and tetrameric (N,N-dimethylamino)ethanolatocopper(II) chloride, [(dmae)CuCl]4 [where dmae = (N,N-dimethylamino)ethanolate] with Zn(OAc)2.

Extracorporeal shockwave lithotripsy versus ureteroscopy for 5- to 10-mm stones in the proximal ureter: Prospective effectiveness patient-preference trial.

Background: To establish the best treatment modality in our hospitals for patients with proximal-ureteral calculi 5 to 10 mm, we compared the treatment outcome in those who underwent primary ureteroscopy (URS) with that in patients who underwent primary in-situ SWL. The primary endpoints were stone-free rates at 3 weeks and 3 months and the subjective patient experience.

Patients And Methods: The study was a prospective patient-preference trial.

Not fun in the sun: playground safety in a heatwave.

Two patients with severe palmar burns sustained from hot playground equipment during a heatwave are presented here, with a review of the management of palmar burn injuries.

Synthesis of isostructural cage complexes of copper with cobalt and nickel for deposition of mixed ceramic oxide materials.

Heterobimetallic molecular precursors [Co2(acac)2mu-OH)2Cu4(dmae)4Cl4] (2) and [Ni2(acac)2(mu-OH)2Cu4(dmae)4Cl4] (3) [dmaeH = N,N-dimethylaminoethanol and acac = 2,4-pentanedionate] for the deposition of mixed oxide thin films were prepared by the interaction of tetrameric N,N-dimethylaminoethanolato copper(II) chloride, [Cu(dmae)Cl]4 (1) with M(acac)2.xH2O, [M = Co, Ni] in toluene. Both heterobimetallic cage complexes were characterized by melting point, elemental analysis, FT-IR spectroscopy, mass spectrometry, magnetometery, and single-crystal X-ray diffraction.

Nerve conduction study among healthy malays. The influence of age, height and body mass index on median, ulnar, common peroneal and sural nerves.

Nerve conduction study is essential in the diagnosis of focal neuropathies and diffuse polyneuropathies. Age, height and body mass index (BMI) can affect nerve velocities as reported by previous studies. We studied the effect of these factors on median, ulnar, common peroneal and sural nerves among healthy Malay subjects.

The effect of local anaesthetic cream (EMLA) applied with an occlusive dressing on skin thickness. Does it matter?

EMLA cream is used in plastic surgery as a topical anaesthetic to harvest split skin grafts. It has been observed that the skin appears pale and oedematous after the application of EMLA. The aim our study was to determine the effect of EMLA with an occlusive dressing on skin thickness using a high frequency ultrasound.

Umbilical varix presenting as an incarcerated umbilical hernia--a costly mistake if not recognised.

Incarcerated umbilical hernias commonly present as emergencies. Often they are diagnosed clinically and repaired surgically. In the case reported here, surgery could have been complicated by a major haemorrhage.

Preliminary report on spiegelberg pre and post-operative monitoring of severe head-injured patients who received decompressive craniectomy.

The monitoring of craniospinal compliance is uncommonly used clinically despite it's value. The Spiegelberg compliance monitor calculates intracranial compliance (C = deltaV/deltaP) from a moving average of small ICP perturbations (deltaP) resulting from a sequence of up to 200 pulses of added volume (deltaV = 0.1 ml, total V = 0.

Assault cases in Maiduguri metropolis: A comparative study of police and accident and emergency units' records.

Background: Information on the incidence of assault cases such as armed robbery, fights and house burglaries in most Nigerian cities are usually based on data collected from police records with little or no attempt to tap medical sources of information.

Objective: The aim of this study was therefore to compare the rate of recording of assault cases in the Maiduguri metropolitan area by the police at the Maiduguri central police station and the Accident and Emergency unit (A and E) of the University of Maiduguri Teaching Hospital. Possible reasons why assault victims report or do not report to the police before seeking for treatment was also investigated.

Synthesis and structural characterization of a new heterobimetallic coordination complex of barium and cobalt for use as a precursor for chemical vapor deposition.

Ba(dmae)2 (dmaeH=N,N-dimethylaminoethanol, C4H11NO) reacts with Co(acac)2 (acac=2,4-pentanedionate) to produce the trinuclear coordination complex [Ba2Co(acac)4(dmae)3(dmaeH)] in an 85% yield. Spectroscopic and single-crystal X-ray diffraction experiments indicate that the complex possesses a structure in which two barium atoms and a cobalt atom are bridged by acac and dmae groups. The barium centers are eight and nine coordinate with BaO7N and BaO7N2 coordination spheres while the cobalt is a more regular CoO5N octahedron.

Penetrating arrow injuries of the maxillofacial region.

We operated on four civilian patients who had unusual penetrating maxillofacial injuries that resulted from assault with arrows. The patients were fully conscious at the time of presentation. Recovery was uneventful in three, but one died.