To investigate crown development patterns, branch architecture, branch-level light interception, and leaf and branch dynamics were studied in saplings of a plagiotropically branching tree species, Polyalthia jenkinsii Hk. f. & Thoms. (Annonaceae) in a Malaysian rain forest. Lengths of branches and parts of the branches lacking leaves ('bare' branches) were smaller in upper branches than in lower branches within crowns, whereas lengths of 'leafy' parts and the number of leaves per branch were larger in intermediate than in upper and lower branches. Maximum diffuse light absorption (DLA) of individual leaves was not related to sapling height or branch position within crowns, whereas minimum DLA was lower in tall saplings. Accordingly, branch-level light interception was higher in intermediate than in upper and lower branches. The leaf production rate was higher and leaf loss rate was smaller in upper than in intermediate and lower branches. Moreover, the branch production rate of new first-order branches was larger in the upper crowns. Thus, leaf and branch dynamics do not correspond to branch-level light interception in the different canopy zones. As a result of architectural constraints, branches at different vertical positions experience predictable light microenvironments in plagiotropic species. Accordingly, this pattern of carbon allocation among branches might be particularly important for growth and crown development in plagiotropic species.
A shared experience in Health and Education are essential ingredients of nationhood. In healthcare, it is constructive to think in terms of the characteristics of a healthcare system that a substantial majority of our people would be enthusiastic to claim ownership. It is useful to think in terms of the elements of a 'charter for health for all Malaysians towards 2020' a) Healthcare for all Malaysians, that is equitable, accessible, and comprehensive. b) Care of quality given with courtesy and respect for patients and their families, with no financial barriers at the time of need. c) A commitment to healthcare of a quality that is appropriate to a Malaysia as a developed country by the Year 2020. Each Five-Year Plan should move in that direction, guided by extensive consultation with the community on priorities and preferences. We have to overcome the 'colonial hangover' that still leaves its mark. Health investment is still concentrated in the capital city, Kuala Lumpur, and in other cities. It is a hospital-centred system. The colonial hierarchy persists with its apex in the Capital city. Government servants are separated from other citizens in access to healthcare. Finally, health has low budget priority. However, there is good reason for optimism. A remarkable consensus has emerged between health professionals and government experts on the shape of a future health system for Malaysia. This is a considerable achievement, in contrasts to the bitter divisions that have characterised changes in other countries. There is still a long road ahead, so it is most important that the leaders of the Malaysian community make clear their preferences and priorities. The Ministry of Health speaks of a 'transformation' of the health system, and advises the medical profession to prepare for radical changes in their behaviour, and in the delivery and funding of healthcare. Four strands of change can be discerned. One, all the professions of health will have to provide evidence of competency, and must learn to monitor the quality of service they provide. Second, the great divide between public and private sector will end, and we have to find ways to integrate our services. Third, a Health Financing Authority may be established, providing hope to all Malaysians that their basic health needs will be met. As citizens, we have the duty to ask that there will be no 'privatisation' of the Health Financing Authority, or of the health facilities of the Ministry of Health. There is a fourth change, arising from our entry into the World Trade Organisation (WTO). Foreign investors will demand access to Malaysian markets, under a so-called 'Globalisation'. All professions will be affected. More serious is the danger of commercialised health care that will damage the health of the less well-off in our country, and raise the cost of health for all of us. Health and education are most important concerns for all of us, yet it strange that as citizens we have contributed so little to shaping the sort of health system that we want for our families and for ourselves. I hope that this meeting is a new beginning.
MeSH terms: Health Services*; Malaysia; Primary Health Care*
A cross-sectional comparative study was conducted to determine the nutritional status among physically active groups in Kota Bharu. The study population comprised 83 adult male athletes from 8 different types of sports (athlete group), 80 active men who exercised a minimum of 30 min per day for at least 3 times per week (exercise group), and 80 inactive men (sedentary group). All the respondents were aged between 18 to 44 years. Measurements taken from the respondents were anthropometric measurements, systolic (SBP) and diastolic (DBP) blood pressure, and serum total cholesterol (TC). The results showed that the combined prevalence of pre-obese (BMI 25.0-29.9) and obese (BMI Â¡Ã30.0) was 21.7% in athletes, 29.9% in exercise group, and 47.5% in sedentary group. The mean (Â± SD) percentage of body fat in athletes was 15.7 Â± 5.4%, which was lower compared to the exercise (18.9 Â± 5.5%) and sedentary (20.6 Â± 5.8%) groups. The incidence of waist-to-hip ratio above 0.9 in athlete, exercise and sedentary groups was 9.6%, 18.7% and 31.3%, respectively. The incidence of hypertension (SBP Â¡Ã140 and/or DBP Â¡Ã90 mmHg) was 13.2% in athletes, 17.5% in exercise group and 42.5% in the sedentary group. The TC values showed that the prevalence of â€œhigh riskâ€ individuals (TC Â¡Ã6.20 mmol/l) was also lower in athletes (20.5%), compared to the exercise (36.2%) and sedentary (47.5%) groups. The study revealed that individuals who are actively involved in physical activity, particularly in sport activities have better nutritional status compared to sedentary people. However, the nutritional status in the athlete and exercise groups was still unsatisfactory. The incidence of poor health status related to over nutrition in the active groups was rather high and needs attention from health professionals. Further studies are needed to determine nutritional practices among physically active groups.
As consumer interest in organically grown vegetables is increasing in Malaysia, there is a need to answer whether the vegetables are more nutritious than those conventionally grown. This study investigates commercially available vegetables grown organically and conventionally, purchased from retailers to analyse Ã¢-carotene, vitamin C and riboflavin contents. Five types of green vegetables were selected, namely Chinese mustard (sawi) (Brassica juncea), Chinese kale (kailan) (Brassica alboglabra), lettuce (daun salad) (Lactuca sativa), spinach (bayam putih) (Amaranthus viridis) and swamp cabbage (kangkung) (Ipomoea aquatica). For vitamin analysis, a reverse-phase high performance liquid chromatography was used to identify and quantify Î²-carotene, vitamin C and riboflavin. The findings showed that not all of the organically grown vegetables were higher in vitamins than that conventionally grown. This study found that only swamp cabbage grown organically was highest in Î²-carotene , vitamin C and riboflavin contents among the entire samples studied. The various nutrients in organically grown vegetables need to be analysed for the generation of a database on nutritional value which is important for future research.
Ambulatory blood pressure monitoring (ABPM) devices are increasingly being used in the assessment of hypertension. The purpose of the study was to investigate patientâ€™s diurnal BP variation and to further determine the differences of BP readings between male and female patients and the effects of age in patients who attended the clinic with essential hypertension. In addition, evidence of relationship between the parameters recorded by 24-hour ABPM was also investigated. This study was conducted in an outpatient specialist clinic. Two indices were used to demonstrate the diurnal BP variation. Firstly, the diurnal systolic blood pressure (SBP) and diastolic blood pressure (DBP) variations which were calculated as night / day BP ratio for SBP and DBP respectively. Anyone scoring less than 100% were categorised as dippers. Secondly, nocturnal falls in SBP and DBP were calculated as (awake SBP-sleep SBP)/awake SBP x 100 and (awake DBP-sleep DBP)/awake DBP x 100 respectively. The results showed that there was no significant difference in the mean BP between male and female patients. In general, the study sample were categorised as dippers and non dippers. There were more male dippers than female dippers. Finally correlation analysis revealed that age is related to SBP variables whilst night HR showed positive correlation with night time BP. It is concluded that ABPM was shown to be a useful tool to analyse the variation and prevalence of cardiovascular risk markers in hypertensive patients and can easily be done in an outpatient set-up.
Aim: To reevaluate the psychometric characteristics of the Malay version of the Edinburgh Postnatal Depression Scale among a sample of postpartum Malay women attending the Bakar Bata Health Center in Alor Setar, Kedah, North West of Peninsular Malaysia. Materials and methods: 64 women between 4 to 12 weeks postpartum were recruited for there validation study. They were given questionnaires on socio-demography, the 21-item Malay version of the Beck Depression Inventory II (BDI-II) and the 10-item Malay version of the Edinburgh Postnatal Depression Scale (EPDS). All the participants were later interviewed using the Hamilton Depression Rating Scale (HDRS-17) and the Composite International Diagnostic Interview (CIDI). All diagnoses were made based on the Tenth Edition of the International Classification of Diseases (ICD-10) Results: 9 women (14.1%) were diagnosed to have significant depression (7 mild depressive episodes and 2 moderate epressive episodes according to ICD-10). EPDS was found to have good internal consistency (Cronbach alpha =0.86) and split half reliability (Spearman split half coefficient = 0.83). The instrument also showed satisfactory discriminant and concurrent validity as evidenced by the statistically significant difference in EPDS scores between the depressed group and their nondepressed counterparts (Mann Whitney U test: 2 tailed p value
MeSH terms: Demography; Depression; Depressive Disorder; Female; Humans; Malaysia; Psychiatric Status Rating Scales; Psychometrics; Surveys and Questionnaires; Reproducibility of Results; Statistics, Nonparametric; Depression, Postpartum; International Classification of Diseases; Postpartum Period
Quality of life measures are designed to enable patientsâ€™ perspectives on the impact of health and healthcare interventions on their lives to be assessed and taken into account in clinical decision-making and research. This paper discusses some approaches, methodological as well as interpretative issues of health related quality of life research.
MeSH terms: Clinical Decision-Making; Paper; Quality of Life; Research
The characteristics of foveal suppression (FS) in fixation disparity (FD) due to visual stress were investigated and their relationshipâ€™s between, age, symptoms, and the effect of temporary elimination of FD using prisms on the degree of the FS were analysed. Forty-five presbyopic subjects (15 without FD and 30 with stress related FD) participated in the study. The subjects underwent comprehensive optometric examination prior to the study. Their FS and FD were measured. The FD was later corrected with ophthalmic prisms, the power of which was equally divided between the eyes, and the FS was later verified. Age and FS had no significant correlation for subjects without FD (Spearmanâ€™s rs = 0.17, p = 0.55,NS) and in subjects with FD (rs = 2.49, p = 0.19, NS), respectively. Correlation between the degree of FS and FD was weak (rs=0.38, p=0.07), however the magnitude of FD significantly increased with age (r=0.27, p=0.04). Subjects with FD had significantly larger degree of FS compared with subjects without FD (Wilcoxonâ€™s Z =-0.25, p=0.01). There was no significant difference in the magnitudes of FD (t = -0.38, p=0.07) and in their degrees of FS (Mann-Whitney U = 1.5, p=0.71) between subjects with and without symptoms. Correcting the FD with prisms generally reduced the degree of FS (Wilcoxonâ€™s Z =1.96, p=0.04), however, significant change in FS only occured in subjects with symptoms (Z=-1.97, p=0.03), but was not significant in subjects without symptoms (Z=-0.70, p=0.48).
Road accident is â€˜a global tragedyâ€™ with ever-rising trend. The goal of this article includes review of the causes and nature of accidents, statistical data regarding road accidents and the economical impact. 1.17 million deaths occur each year worldwide due to road accidents 70 % of which occur in developing countries. 65% of deaths involve pedestrians, 35 % of which are children. Estimates suggest that 23-34 million people are injured worldwide every year in road crashes - a value almost twice that previously estimated. It is estimated that more than 200 U.S. citizens die each year due to road accidents abroad. Every year in Europe, more than 50,000 peoples are killed in road accidents, and more than 150,000 remain disabled. It is a sad fact that the total number of road accidents in Malaysia exceeded 223,000 in 1999. On the average, 16 persons died from these road accidents, every single day in 1999. Lack of attention, reckless driving, lack of proper protection, speeding, bad personal habits, social and behavioral misconduct and inconsiderate drivers of larger vehicles are some of the problems that cause accidents. In Malaysia, motorcycle fatal accidents (60%) warrant a high degree of concern. Young children and senior citizens are found to be in the vulnerable age group. In Malaysia, in 1999 alone, general insurers paid RM1.67 billion or an average of RM4.6 million a day on motor claims. It is now recognized that road traffic accidents represent a major public health problem, because of the high number of victims involved and because of the seriousness of the consequences for themselves and for their families.
Diabetes mellitus is the commonest cause of neuropathy worldwide. Diabetic neuropathy (DN) develops in about 4-10% of diabetic patients after 5 years and in 15% after 20 years.Four main mechanisms have been postulated to underlie the pathogenesis of DN. Diabetic neuropathy can be divided into symmetrical and asymmetrical neuropathies. Diabetic Autonomic Neuropathy (DAN) parallels the severity of DSN, and affects primarily the cardiovascular, gastrointestinal, genitourinary and integumentary systems. The cornerstone of treatment of diabetic neuropathy is optimization of glycaemic control. Future treatments for diabetic neuropathy should address the underlying pathogenesis.
MeSH terms: Blood Glucose; Diabetic Neuropathies; Humans; Integumentary System
Major sporting events in Asia are commonly staged in hot environments where the average daytime temperature is generally 29-31Â°C with the average relative humidity ranging from 80-95%. Exercise capacity and exercise performance are reduced when the ambient temperature is high and it has major implications for competitors as well as for spectators and officials. Prolonged exercise leads to progressive water and electrolyte loss from the body as sweat is secreted to promote heat loss. The rate of sweating depends on many factors and increases in proportion to work rate and environmental temperature and humidity. Sweat rates are highly variable and can exceed 2L.h-1 for prolonged periods in high heat. Since dehydration will impair exercise capacity and can pose a risk to health, the intake of fluid during exercise to offset sweat losses is important. Carbohydrate-electrolyte fluid ingestion during exercise has the dual role of providing a source of carbohydrate fuel to supplement the bodyâ€™s limited stores and of supplying water and electrolytes to replace the losses incurred by sweating. The composition of the drinks to be taken will be influenced by the relative importance of the need to supply fuel and water which, is in turn depends on the intensity and duration of exercise activity, the ambient temperature and humidity. Carbohydrate-electrolyte solutions appear to be more effective in improving performance than plain water. There is no advantage to fluid intake during exercise of less than 30-minute duration. Complete restoration of fluid balance after exercise is an important part of the recovery process and becomes even more important in hot, humid conditions. If a second bout of exercise has to be performed after a elatively short interval, the speed of rehydration becomes of crucial importance. Rehydration after exercise requires not only replacement of volume losses, but also replacement of some electrolytes, primarily sodium. Studies show that rehydration after exercise can be achieved only if sweat electrolyte losses as well as water are replaced. Drinks with low sodium content are ineffective at rehydration and they will only reduce the stimulus to drink. Addition of small amount of carbohydrate to the rehydrating drinks may improve the rate of intestinal uptake of sodium and water and will improve palatability. The volume of the rehydration beverage consumed should be greater than the volume of sweat lost to provide the ongoing obligatory urine losses and palatability of the beverage is a major issue when a large volume of fluid has to be consumed.
MeSH terms: Asia; Beverages; Body Temperature Regulation; Carbohydrates; Dehydration; Drinking; Fluid Therapy; Hot Temperature; Humidity; Sodium; Sweat; Sweating; Temperature; Water; Water-Electrolyte Balance
Solitary plasmacytoma of the head and neck is a rare disease entity. Its description in the literature consist of some case reports. Solitary plasmacytoma presenting with exophthalmos are rare. We report a case of intracranial solitary plasmacytoma in an elderly lady with involvement of the right orbitocranial region presenting with severe exophthalmos. The tumour was debulked and radiotherapy was given.
Newcastle disease virus (NDV) is one of the most economically important avian virus which affects the poultry industry worldwide. Although NDV is being very actively studied in Malaysia, there are still no studies on its potential as an anticancer agent, a new approach to treating cancer known as virotherapy. Currently, a collaborative research is being undertaken between Universiti Putra Malaysia (UPM), Universiti Sains Malaysia (USM) and Majlis Kanser Nasional (MAKNA) in characterising various local NDV isolates as anticancer agent. This paper describes an overview of the research that have been carried out worldwide in the use of NDV for cancer treatment and also some of our findings in characterising local NDVs with oncolytic properties.
The purpose of this study was to investigate the relationship between heterophoria and refractive error. Thirty-six subjects (11 myopes, 25 emmetropes) participated in this study. Heterophoria was measured with the Free-Space Phoria Card at five different viewing distances (25cm, 33cm, 50cm, 100cm and 300cm). Regardless of the types of heterophoria, the amount of heterophoria reduced towards orthophoric position with increasing viewing distance. Emmetropes and myopes did not show any significant difference in the degree of heterophoria at different viewing distances (F = 0.30, p>0.05) or in the type of heterophoria (c2 = 2, p>0.05).Thirty-six optometry students, aged from 19 to 24 years, participated in this study. All subjects had complete optometric examination within the last two years and did not show any clinical signs of accommodative, fusion, stereopsis or strabismic problems. Written consents were obtained prior to examination. Eleven (8 females, 3 males) of them were myopes (spherical range: -0.25DS to â€“ 10.00DS; cylindrical range: -0.25DC to â€“0.75DC). Twenty-five (14 females, 11 males) of them were emmetropes (Refraction range: plano - +1.00DS). The majority (10 out of 11) of our myopic subjects. In general, exophores (69%) were most common in this study. Regardless of the type of heterophoria, the amount of heterophoria decreased towards orthophoric position with increasing viewing distances. Our finding are also consistent with the report of fixation disparity at different viewing distance (24).viewing distance. We too report an exo-shift of the heterophoria with decreasing viewing distance 97% of our subjects. One subject however showed an eso-shift for closer distance.
In this study, we examined the effects of acute ingestion of a herbal drink (H) or a coloured water placebo (P) on physiological responses and performance during cycling exercise. Eight healthy and trained male young cyclists (age: 16.0Â±0.5years) exercised on a cycle ergometer at 72.0Â±0.8% of the maximal oxygen consumption (VO2max) until exhaustion in a room maintained at 23.9Â±0.2 oC and 64.2Â±1.6% relative humidity on two occasions, 1-week apart. During each exercise bout, subjects received 3ml.kg-1 body weight of H or P every 20 minutes in a doubleblind randomised study design. There was no significant difference between H and P trials in the total work time to exhaustion (84.5Â±5.1 and 82.3Â±5.6 min respectively). Changes in heart rate, oxygen consumption, plasma glucose concentrations, plasma lactate concentrations, rectal temperature, respiratory exchange ratio and energy expenditure were similar with both type of drinks. Loss of plasma volume was also similar with both drinks. Herbal drink elicited similar physiological responses, thermoregularity responses and exercise performances during endurance cycling when compared to the placebo ingestion. Thus, it can be concluded that the ingredient in the herbal drink did not provide any added advantage to cycling endurance performance. In both the herbal (H) drink and placebo (P) trials, time taken for exhaustion to occur were similar, and they were 84.5 Â± 5.1 min and 82.3 Â± 5.6 min respectively (p>0.05). The total volume of fluid consumed during exercise was also similar in both drinks, 751.0Â± 49.6 ml and 727.6 Â± 42.7 ml in the H and P trials respectively. As a result of exercise, subjectsâ€™ body weight decreased 0.7 Â± 0.2 kg (2.6 Â± 0.5%) and 0.8 Â± 0.2 kg (2.8 Â± 0.5%) in the H and P trials respectively, and these values were corrected for the fluid ingested during cycling. The decrease in body weight as expressed both in kg and percentage change of body weight with P did not differ statistically from H. Similar hemoglobin concentrations and hematocrit were noted at each time point during the H trial when compared with P trial. The percentage change of plasma volume relative to the preexercise level is shown in Figure 1. Plasma volume declined significantly (p
MeSH terms: Blood Glucose; Body Temperature; Body Weight; Energy Metabolism; Heart Rate; Hematocrit; Hemoglobins; Humidity; Male; Oxygen Consumption; Plasma Volume; Temperature; Water; Exercise; Lactic Acid
The pharmacodynamics of propranolol were studied in 12 cirrhotic Malay patients. Fifteen healthy Malay volunteers were selected and several clinical parameters were obtained. The effects of three doses of propranolol in reducing the heart rate (HR) of these patients were observed to be significantly different. These differences were seen at dosing of 10 mg vs 20 mg and 10 mg vs 30 mg (P
Prostate cancer is not common in south-east asia and in particular there are only scarce reports on the characteristics of Malaysian men with prostate cancer. A retrospective study where all prostate specimens sent to the pathology department during the period 1st January 1996 to 30th June 1998 were reviewed. A total of 131 prostate specimens were reviewed and these consisted of prostatectomy specimens, transurethral resection specimens and trucut biopsy specimens. Only 114 patientsâ€™ case notes were evaluated. Data reviewed were age, race, presenting symptoms, clinical findings and prostate-specific antigen (PSA) level. Overall incidence of carcinoma of the prostate was 19.0%. The incidence of carcinoma of the prostate with serum prostate-specific antigen (PSA) of 4.1 to 20.0 ng/ml was only 10% and 60.5% of patients had evidence of subclinical histological prostatitis. The mean age of men with carcinoma of the prostate was 71.3 years and there was no differences in the incidence of carcinoma of the prostate among the 3 major ethnic groups (Malays, Chinese and Indian). About three-quarter of the patients with carcinoma of the prostate presented with lower urinary tract symptoms, a third had haematuria and about a tenth of patients presented with urinary retention. The majority of patients presented with metastatic disease (66.7%) with a mean PSA of 1476.8 ng/ml. A significant proportion of men with prostatic diseases attending the University of Malaya Medical Center had prostate cancer (19.0%). A small proportion of men with serum PSA in the range of 4.1 to 20.0 ng/ml had prostate cancer and this is thought to be due to the background histological prostatitis. The majority of patients presented late.
The truth often hurts, but only by knowing the truth can proper solutions be found. It has long been recognised that adequate epidemiological data is crucial for the planning and development of cancer programmes. In the First Report of the National Cancer Registry, 26,089 cases were registered among the population in Peninsular Malaysia. Taking into account the estimated 10,656 unregistered cases and the 3750 cases registered in Sabah and Sarawak, the total number of new cancer patients in Malaysia in 2002 would be approximately 40 500. This means that the cumulative lifetime risk of getting cancer was 1 in 4 in Malaysia, a fact which hit the headlines in many of the daily newspapers of the country. Cancer is indeed a serious national health problem. Correlating these registry findings with existing findings from studies on lifestyles, presentation of disease, diagnostic tests, interventions in cancer prevention, treatment, palliation and rehabilitation will be the way to go in defining and refining the strategy against cancer in this country.
MeSH terms: Delivery of Health Care; Diagnostic Tests, Routine; Humans; Life Style; Malaysia; Medicine; Neoplasms; Palliative Care; Registries