Browse publications by year: 2006

  1. Choy YC
    Med. J. Malaysia, 2006 Dec;61(5):577-85.
    PMID: 17623959
    Critical incident monitoring in anaesthesia is an important tool for quality improvement and maintenance of high safety standards in anaesthetic services. It is now widely accepted as a useful quality improvement technique for reducing morbidity and mortality in anaesthesia and has become part of the many quality assurance programmes of many general hospitals under the Ministry of Health. Despite wide-spread reservations about its value, critical incident monitoring is a classical qualitative research technique which is particularly useful where problems are complex, contextual and influenced by the interaction of physical, psychological and social factors. Thus, it is well suited to be used in probing the complex factors behind human error and system failure. Human error has significant contributions to morbidities and mortalities in anaesthesia. Understanding the relationships between, errors, incidents and accidents is important for prevention and risk management to reduce harm to patients. Cardiac arrests in the operating theatre (OT) and prolonged stay in recovery, constituted the bulk of reported incidents. Cardiac arrests in OT resulted in significant mortality and involved mostly de-compensated patients and those with unstable cardiovascular functions, presenting for emergency operations. Prolonged-stay in the recovery extended period of observation for ill patients. Prolonged stay in recovery was justifiable in some cases, as these patients needed a longer period of post-operative observation until they were stable enough to return to the ward. The advantages of the relatively low cost, and the ability to provide a comprehensive body of detailed qualitative information, which can be used to develop strategies to prevent and manage existing problems and to plan further initiatives for patient safety makes critical incident monitoring a valuable tool in ensuring patient safety. The contribution of critical incident reporting to the issue of patient safety is far from clear and very difficult to study. Efforts to do so have tended to rely on incident reporting, the only practical approach when funding is limited. The heterogeneity of critically ill patients as a group means that huge study populations would be required if other research techniques were to be used. In the era of evidence-based medicine, anaesthetists are looking for alternative evidence-based solutions to problems that we have accepted traditionally when we cannot quantify for good practical reasons. In the quest for patient safety, investment should be made in reliable audit, detection and reporting systems. The growing recognition that human error usually result from a failure of a system rather than an individual should be fostered to allow more lessons to be learnt, an approach that has been successful in other, safety-critical industries. New technology has a great deal to offer and investment is warranted in novel fail-safe drug administration systems. Last but not the least the importance of simple and sensible changes and better education should be remembered.
    MeSH terms: Anesthesia/adverse effects*; Humans; Malaysia; Pilot Projects; Quality Assurance, Health Care/methods*; Systems Analysis; Task Performance and Analysis; Monitoring, Intraoperative*; Safety Management/methods*; Medical Errors/prevention & control*
  2. Lotfy M, Badra G, Burham W, Alenzi FQ, Bermejo-Martin JF, Bernardo D, et al.
    Br. J. Biomed. Sci., 2006 Jan;63(4):171-184.
    PMID: 28700882 DOI: 10.1080/09674845.2006.11732742
  3. Goh KL, Wong CH
    Gastroenterol Hepatol (N Y), 2006 Feb;2(2):118-123.
    PMID: 28286439
    Gastroesophageal reflux disease (GERD) has been reported to be uncommon among Asians. Although prevalence rates of reflux esophagitis and symptoms of GERD in Asian patients vary, most of the recently published studies have shown an increasing trend, likely due to better awareness and diagnosis as well as to a true increase in the prevalence of the disease. The exact reasons for this increase in prevalence are unclear but must be linked in some way to the dramatic socioeconomic development taking place in the region. Changes in dietary patterns and body mass index have been suggested as underlying reasons. On the other hand the high prevalence of Helicobacter pylori infection in Asia and its association with decreased acid secretion and a low prevalence of GERD have also been noted. Another interesting observation is differing rates of GERD among different Asian ethnic groups, indicating a possible genetic susceptibility to GERD. Diagnosis of GERD is usually based on symptoms; many Asian patients, however, do not understand the term "heartburn," as there is no equivalent term in the major Asian languages. Patients therefore describe their symptoms variously, such as chest discomfort or wind and soreness in the chest. Nonerosive reflux disease appears to be common among Asians. Atypical manifestations of GERD, including noncardiac chest pain, asthma, and laryngitis, appear to be common among Asian patients as well.
  4. Sivagnanam G, Saraswathi S, Rajasekaran A
    Med Educ Online, 2006 Dec;11(1):4610.
    PMID: 28253788 DOI: 10.3402/meo.v11i.4610
    Purpose - To assess an innovative tutoring program named 'Student-Led Objective Tutorial' (SLOT) among undergraduate medical students. Method - The program was conceptualized by the Pharmacology Unit of Faculty of Medicine and Health Sciences, Asian Institute of Medicine Science & Technology (AIMST), Malaysia and implemented in the middle of 2005. A cohort of 246 medical undergraduate students (spread across 5 consecutive batches) participated. Following a brief explanation on the purpose and nature of SLOT, each batch was divided into small groups and was given a reading assignment on 4 previously delivered lecture topics. Each group was asked to prepare 3-5 multiple choice questions (MCQs) of their own in PowerPoint format to be presented, in turns, to the whole class on the day of SLOT. The proceedings were facilitated by 2 lecturers. Student feedback on the efficacy and benefits were assessed through an anonymous self administered questionnaire. Results - About 76% (188) of the students favored SLOT. The acceptance rate of SLOT was higher among males. There was no significant difference between batches in their opinions on whether to pursue SLOT in future. The most prevalent positive comment was that SLOT enhanced learning skills, and the negative comment being, it consumed more time. Conclusions - SLOT is a novel tutorial method which can offset faculty shortage with advantages like enhanced interest among teachers and learners, uniform reach of content, opportunities for group learning, and involvement of visual aids as teaching-learning (T-L) method. SLOT unraveled the students' potential of peer tutoring both inside as well as outside the classroom. Consumer tutors (students) can be tapped as a resource for SLOT for all subjects and courses in healthcare teaching.
  5. Zulkhairi, A., Hasnah, B., Zaiton, Z., Jamaludin, M., Zanariyah, A., Khairul, K.A.K., et al.
    Malays J Nutr, 2006;12(2):213-220.
    Atherosclerosis, the cholesterol deposition in and around cells of the intimal layer of the aorta, has been recognized as one of the main causative factors for cardiovascular diseases. Intensive research has been carried out throughout the world but the precise atherogenesis has yet to be fully understood, though hypercholesterolaemia is considered to be the prime risk factor. The aim of the study was to evaluate the effect of high cholesterol diet consumption on the formation of atherosclerosis in vivo. Three groups of adultWhite New Zealand male rabbits (six animals per group) were used in this study. Except for one group which acted as a control (K), the other two groups were given 1% and 2% high cholesterol diet respectively for 10 weeks. At the end of the experiment, blood samples were taken from the marginal ear vein for plasma cholesterol estimation. The animals were sacrificed and the aorta was excised for histomorphometric analysis. The result shows that despite no significant differences in plasma cholesterol levels being observed between the groups treated with 1% and 2% cholesterol, high cholesterol consumption was able to induce hypercholesterolaemia significantly (p
    MeSH terms: Animals; Aorta; Cholesterol; Cholesterol, Dietary; Diet; Hypercholesterolemia; Male; New Zealand; Rabbits; Risk Factors; Tunica Intima; Atherosclerosis
  6. Sukardi, S., Yaakub, H., Ganabadi, S., Cheng, L.H.
    Malays J Nutr, 2006;12(2):201-211.
    L-arginine is an amino acid, which serves as the sole substrate for nitric oxide (NO) synthesis with the concomitant formation of L-citrulline in biologic system. NO has been demonstrated to be involved in smooth muscle relaxation and vasodilation, immune regulation and neurotransmission. It also has an important function as both intercellular and intracellular signals in many physiological systems, including the reproductive system where NO mediates penis erection. This study was undertaken to determine the effects of L-arginine on sperm motility, sperm count, and the nitric oxide level in the seminal plasma. Twelve sexually matured male rabbits (Oryctolagus cuniculus) were randomly divided into four groups with three rabbits each, which were control, low, medium, and high concentration groups. The treatment groups were force-fed with 100mg/kg, 200mg/kg, and 300mg/kg body weight of L-arginine for four weeks, whereas the control group was force-fed with water. Semen samples were collected every three days alternatively for a week before starting treatment and then after four weeks of treatment. Pre-treatment and post-treatment results were compared. Semen samples were collected using artificial vaginas from each group for sperm analysis such as sperm motility, sperm count and NO level in seminal plasma. Sperm motility and sperm count were analysed manually under microscope (twenty power objective), using a Makler counting chamber. NO levels in the seminal plasma were determined using Griess reaction. The results obtained from this study showed that oral consumption of L-arginine exerted a significant (p
    MeSH terms: Animals; Arginine; Biological Products; Body Weight; Citrulline; Female; Humans; Male; Muscle Relaxation; Synaptic Transmission; Nitric Oxide; Penis; Rabbits; Semen; Sperm Count; Sperm Motility; Spermatozoa; Vagina; Vasodilation; Water; Treatment Outcome; Control Groups; Semen Analysis
  7. Ng, T.K.W.
    Malays J Nutr, 2006;12(2):181-188.
    Omega-3 fatty acid nutrition is widely recognised as essential to health and general well-being. However, health professionals and the general public in Malaysia may lack knowledge on the sources or the amounts of these essential fat components in foods. This paper attempts to correct this scenario by identifying the potential sources of omega-3 fatty acids [a-linolenic acid (ALA), or eicosapentaenoic acid (EPA) + docosahexaenoic acid (DHA)] in the Malaysian diet and calculating the amounts of these “nutrients” provided per serving of a wide variety of foods. The information generated provides Malaysian health professionals and consumers with options in food choices or meal planning with the goal towards achieving the recommended nutrient intakes for omega-3 fatty acids. The findings in the present study revealed that the potential sources of omega-3 fatty acids in the Malaysian diet in decreasing order are: edible oils (ALA), fish and fish products (EPA+DHA), vegetables (ALA), meat and eggs (EPA+DHA), and milk/milk products (EPA+DHA). Edible oils which are exceptionally high in ALA such as flaxseed oil and perilla oil are presently unavailable at local retail outlets and supermarkets. However, consumers can still meet the recommended nutrient intakes (RNIs) for omega-3 fatty acids of 0.3 to 1.2% energy (equivalent to 0.67g-2.67g) by choosing a wellbalanced diet prepared preferably with a cooking oil blend containing ALA, and one or more servings daily from at least three of the following food groups: (i) fish (“jelawat”, “siakap”, sardines, tuna, mackerel, salmon)/seafoods (shrimps, crab)/meat, (ii) vegetables/soybean/ soybean-based products/beans and peas, (iii) omega-3 enriched/fortified foods (eg. “omega-3 eggs”), and (iv) ready-to-drink omega-3 milk preparations/soybean milk.
    MeSH terms: Animals; Cooking; Diet; Docosahexaenoic Acids; Fish Products; Food, Fortified; Goals; Linseed Oil; Malaysia; Milk; Plant Oils; Salmon; Soybeans; Tuna; Vegetables; Eicosapentaenoic Acid; Fatty Acids, Omega-3; Seafood; alpha-Linolenic Acid; Peas
  8. Noor-Aini, M.Y., Pon, L.W., Ong, F.B., Adeeb, N., Seri, S.S., Shamsuddin, K., et al.
    Malays J Nutr, 2006;12(2):125-146.
    Lifestyle has been shown to exert a major impact on the quality of life and health in mid-life women coping with menopausal changes. This study aimed to assess the efficacy of a lifestyle intervention package in improving nutritional knowledge and composition, dietary habits and related health status in mid-life women. Between Nov 1999 to Oct 2001, 360 disease free women, non users of HRT, aged 45 years and above with intact uterus were recruited into the study. The women were randomised into three groups - I (control), II (lifestyle intervention) and III (lifestyle intervention with HRT) respectively. After 12 months, 85.6% completed the study. The lifestyle intervention programme, well accepted by the participants, brought about an improved dietary composition, better eating habits, more exercise participation and increment in knowledge with concomitant improvement of the health status. The benefits observed were significant reduction in energy, fat and carbohydrate intake with increased intake of legumes; milk and cheese/yogurt; and reduction of tea and coffee. Body weight was reduced and more importantly preventing abdominal obesity in the intervention groups with HRT was more effective. Further adaptations of the dietary component with advice on obtaining micronutrients from local produce would contribute towards a more balanced diet in midlife women as dairy products were not popular and these women had low meat intake.
    MeSH terms: Animals; Carbohydrates; Cheese; Coffee; Diet; Female; Food Habits; Health Status; Humans; Fabaceae; Life Style; Meat; Milk; Quality of Life; Tea; Uterus; Yogurt; Micronutrients; Obesity, Abdominal
  9. Chia, Yoke Yin, Ton, So Ha
    Malays J Nutr, 2006;12(1):67-78.
    The objective of the study was to quantify and to profile the amino acids content in urine samples. The amino acids content in urine was determined in 162 individuals (62 young non-vegetarians aged 15-45 years, 24 elderly non-vegetarians aged 46-70 years, 40 young vegetarians and 36 elderly vegetarians) by high performance liquid chromatography (HPLC). The most common amino acids detected in the young and elderly individuals on vegetarian and non-vegetarian diets were phenylalanine, threonine, arginine and asparagine, while leucine, aspartic acid and alanine were not found in any urine samples in both groups. Isoleucine was not detected in the urine of vegetarians. The concentrations of the majority of essential amino acids were between 0.10 - 2.00 mgl24hrs except for histidine which had a range of 4.1 - 5.0 mgl24hrs. The concentrations of non-essential amino acids varied. Proline, glycine and tyrosine concentrations were between 0.10 - 1.00 mg/24hrs, while cysteine, glutamine, glutamic acid and cystine concentrations were between 11.0 - 21.0 mg124hrs. Asparagine and hydroxy-proline had a range of 0.10 - 5.00 mg/24hrs, while serine and arginine ranged between 31.0 - 50.0 mg124hrs. Isoleucine and serine were not detected in elderly vegetarians while histidine, glycine, glutamic acid and hydroxy-proline were not detected in elderly non-vegetarians. Isoleucine, glycine and hydroxy proline were detected in young non-vegetarians but not in young vegetarians. The levels of amino acids showed no significant statistical differences between young vegetarians and non-vegetarians as well as between elderly vegetarians and non-vegetarians. Phenylalanine, threonine and trypthophan were commonly detected in the lacto-ovo and lacto vegetarians, while valine, cysteine, arginine and asparagine were commonly detected in vegans. In conclusion, except for isoleucine, general differences were seen in urinary amino acid excretions between vegetarians and non-vegetarians even though the differences were statistically not significant. Therefore lacto-ovo diets could be nutritionally adequate as the nutrients were substituted by dairy or plant products.
    MeSH terms: Vegans; Alanine; Amino Acids; Amino Acids, Essential; Arginine; Asparagine; Aspartic Acid; Chromatography, High Pressure Liquid; Cysteine; Cystine; Diet; Dietary Proteins; Glutamine; Glycine; Histidine; Humans; Isoleucine; Leucine; Phenylalanine; Proline; Serine; Threonine; Tyrosine; Valine; Diet, Vegetarian; Glutamic Acid
  10. Siti Sabariah, B., Zalilah, M.S., Norlijah, O., Normah, H., Maznah, I., Laily, P., et al.
    Malays J Nutr, 2006;12(1):33-44.
    The objective of this paper is to report on the reliability and validity of a knowledge, attitude and practice instrument used among young primary school children. The instrument was developed as an evaluation tool in the HELIC study and consisted of 23 knowledge, 11 attitude and 10 practice items. A total of 335 Year 2 students from 4 randomly selected primary schools in Selangor and Wilayah Persekutuan participated in the HELIC study. Students were divided into small groups and an enumerator verbally administered the instrument to each group. Reliability for each construct (knowledge, attitude and practice) was estimated as item to total score correlation and internal consistency (Cronbach's alpha). Construct validity was determined through factor analysis and Pearson correlation. Results indicated that 3 attitude and 3 practice items did not correlate significantly to the total score (p>0.05). However, the deletion of these items did not significantly alter the Cronbach's alpha coefficients. Internal consistency was good for knowledge (a=0.68) but low for attitude (a=0.37) and practice (a=0.36) constructs. Based on factor analysis, 5 factor-solutions emerged for knowledge and 4 factor solutions for attitude and practice. Sufficient variance was obtained for the factors in knowledge (51.7%), attitude (51.2% and practice (51.0%). There were also significant positive correlations among the constructs ( ~ 4 . 0 1 ) . In conclusion, the instrument was valid and reliable, especially for the knowledge construct. Further improvements, particularly on the attitude and practice constructs, are needed in order for the instrument to be an effective assessment or evaluation tool in various settings.
    MeSH terms: Factor Analysis, Statistical; Schools; Students; Reproducibility of Results; Knowledge
  11. Foo LH, Khor GL, Tee, E. Siong ES, Prabakaran D
    Malays J Nutr, 2006;12(1):11-21.
    Dietary intakes and lifestyle habits during adolescence may predict the occurrence of obesity and other diet-related chronic diseases later in life. The purpose of this study was to determine dietary intake of adolescents in a fishing community in Tuaran District, Sabah. A total of 199 apparently healthy adolescents comprising 94 male and 105 female subjects were purposively selected for the study. The mean age of the subjects was 15.2 f 2.2 years with female subjects having a higher mean age of 15.7 f 2.4 years compared to the males (14.6 k1.8 years). The mean BMI of the subjects was 18.4 f 2.9 kg/m2 with females having a significantly higher BMI (18.9 f 2.8 kg/m2) than the males (17.8 f 3.0 kg/m2). Based on the WHO classification (WHO, 1995), 19.6% of the subjects could be classified as thin while 4.5% were at risk of overweight. Overall for both sexes, intake of energy and most nutrients were below the Malaysian recommended nutrient intake (RNI) levels for adolescents, with the exception of vitamin C and niacin. The male subjects showed higher mean intake for vitamin A, thiamine, niacin and vitamin C than the females. Calcium and iron intake ranked among the lowest levels, at 33.4% and 47.2% respectively of the RNI values for both sexes. The main sources of energy were rice, flour products and tubers while fish and seafood were the chief sources of protein. Majority of the subjects (84%) reported taking breakfast daily, which often consisted of fried noodles, fried banana, doughnuts and coffee. Consumption of snacks was popular and commonly consumed snacks were bread, biscuits, and fried banana. The present study revealed that 25.5% and 14.3% of the male and female adolescents respectively were thin, with majority of them consuming inadequate levels of energy and several key nutrients. The results underscore the need for adolescents to be targeted for nutrition and health education as they go through a period of marked physical, physiological and psychological changes.
    MeSH terms: Adolescent; Ascorbic Acid; Bread; Calcium; Chronic Disease; Coffee; Diet; Female; Flour; Health Education; Humans; Iron; Life Style; Malaysia; Male; Niacin; Obesity; Oryza; Thiamine; Vitamin A; Body Mass Index; Seafood; Musa; Overweight; Breakfast; Snacks
  12. Moy FM, Gan CY, Mohd Kassim SZ
    Malays J Nutr, 2006;12(1):1-10.
    Eating patterns such as eating frequency, skipping of breakfast, and frequency of meals eaten away from home might influence school-going children's nutritional status, which will then influence their health and academic performance. This article reports the findings of a survey on the eating patterns of the school children and adolescents in Kuala Lumpur. A total of 3620 school children studying in Primary 5, Secondary 2 and Secondary 4 were selected using multi-stage sampling. The students were surveyed using a pre-tested questionnaire while their weights and heights were measured in the field. It was found that 19.9% skipped at least one meal a day with the youngest group having the lowest prevalence. The most frequently missed meal is breakfast (12.6%) followed by lunch (6.7%) and dinner (4.4%). The school is an important provider of breakfast and lunch for the students. As the students' age increased, the prevalence of eating breakfast and lunch in school increased. The youngest age group had the highest prevalence of snacking and taking of nutritional supplements (p<0.05). Fast food and local hawker food were also consumed by about 60-70% of the students. Logistic regression analysis showed that skipping of breakfast is significantly associated with age, sex, BMI and taking of nutritional supplements. Promotion of healthy eating should be targeted at students in primary and secondary schools as they tend to depend on outside food.
    MeSH terms: Adolescent; Child; Child Nutritional Physiological Phenomena; China/ethnology; Cross-Sectional Studies; Feeding Behavior; Humans; India/ethnology; Malaysia; Malaysia/ethnology; Nutritional Status; Surveys and Questionnaires; Students; Prevalence; Meals; Breakfast; Lunch; Snacks
  13. Khalib, A.L., Ngan, H.U.
    Workplace bullying has drawn greater attention in the last one and half decades. Despite its recognition by many organizations and countries, it is still rife. Why is that so? Could it be that the root of the problem has not been addressed? Or, could it be due to difficulties and resistances in embarking preventive and control measures. In this paper, we will examine the possible causes of workplace bullying based on a proposed model. In depth discussion of the personal and organizational factors are made while the work group and societal factors are dealt with in brief. In summary, the root of workplace bullying is multi-factorial. Understanding the complexity and subtlety of workplace bullying is pertinent in the effort to prevent or curtail it.
    MeSH terms: Attention; Organizations; Paper; Tooth Root; Organizational Culture; Workplace; Bullying
  14. Zafir, M.M., Fazilah, M.H.
    Stres di tempat kerja terjadi apabila keperluan kerja tidak sepadan dengan kebolehan, sumber, dan kehendak pekerja. Ia boleh memberi kesan ke atas psikologi dan fisiologi manusia. Seseorang individu yang berasa tertekan dengan kerja yang dilakukan akan menunjukkan kemurungan yang berpanjangan. Apabila rasa tertekan, psikologi akan terganggu dan pekerja gagal membuat keputusan dengan baik. Situasi ini boleh menjejaskan prestasi kerja mereka dan menggugat produktiviti organisasi. Masalah paling dibimbangi adalah stres di tempat kerja boleh menyebabkan penyakit berbahaya seperti tekanan darah tinggi, sakit jantung dan melemahkan sistem pertahanan badan terhadap penyakit. Stres di tempat kerja juga boleh menyebabkan kemalangan di tempat kerja, peningkatan kos keselamatan dan kesihatan pekerjaan, gangguan trauma kumulatif, menjejaskan prestasi kerja serta mengganggu kehidupan sosial individu. Masalah keselamatan dan kesihatan pekerjaan akibat stres di tempat kerja seharusnya tidak diabaikan oleh organisasi kerana ia boleh menyebabkan sumber manusia sesebuah negara kehilangan daya saingnya. Sumber manusia yang berasa terancam akibat masalah keselamatan dan kesihatan akan gagal menggunakan sepenuhnya kreativiti mereka dan melakukan tugas pada tahap minimum. Fenomena ini seharusnya dibimbangi dalam persekitaran perniagaan masa kini yang sangat kompetitif. Di Malaysia, kajian yang berkaitan dengan stres seharusnya dipertingkatkan kerana kajian lepas terhadap stres di tempat kerja adalah tidak menyeluruh. Perkembangan ini sejajar dengan perubahan yang berlaku di persekitaran kerja seperti teknologi, sosial, ekonomi, undang-undang buruh dan seumpamanya. Kajian stres di tempat kerja perlu dijalankan kerana sumbangannya amat bernilai dalam menghasilkan sumber manusia yang lebih produktif dan berdaya saing.
    MeSH terms: Ataxia Telangiectasia; Malaysia; Methylglycosides
  15. Azmi, M.T., Emran, M.T.
    Background: Without any doubt, the combo of user ID and password are the most used authentication method in the computing and internet environment. However, due to the enormous number of accounts that require password authentication, users tend to develop bad habits in their password practices which in turn will put their account security at risk. With the increasing use of computing in health-care settings and the use of EMR in hospitals, such practices are a cause for concern.
    Methods: This is a cross-sectional study using self-administered questionnaires, investigating the practice of the respondents in keeping their passwords secure. Respondents in this survey are the undergraduate students of Faculty of Medicine, Universiti Kebangsaan Malaysia.
    Results: Among the findings are that 87.4% of the respondents used the same password for more than one account. If a user used the same password for several accounts, it might trigger a domino effect if any of the account passwords were compromised. A total of 98.9% of the respondents memorised their password only in their mind, without writing down the password anywhere. This may lead to using easily guessable passwords which may introduce additional security risk to their accounts. The majority of the respondents (96.6%) never or rarely change their passwords. The study also showed that 82.7% of the respondents used passwords which are 6-8 characters in length. Longer passwords are usually safer but harder to remember. The questionnaire also explored the users’ password combination style, whether they used numbers only or combination of numbers and alphabets or some other pattern. A total of 39.1% used letters only but 27.6% used combination of numbers only which is less secure. About 77% of the respondents used personal information such as their birthday date or a person’s name as part of their password.
    Conclusions: This habit may make their password guessable to people who are close to them. In conclusion, most medical students are not practising safe password conduct and they should be educated on this. If not, patients’ data confidentiality may be compromised in the future due to such practices.
    MeSH terms: Confidentiality; Cross-Sectional Studies; Faculty; Habits; Humans; Malaysia; Surveys and Questionnaires; Students, Medical; Writing; Internet
  16. Rozhan, S., Jamsiah, M., Rahimah, A., Ang, K.T.
    Background: The COMBI concept is a novel approach by the WHO to control communicable diseases which are influenced by community behaviour. The Ministry of Health is currently evaluating its use against dengue in selected areas throughout Malaysia. COMBI doctrine differs from previous dengue campaigns. It acknowledges that the factors contributing to dengue proliferation may differ between areas. Factors for a given area are analysed, then a single precise behavioural goal to overcome those problems is formulated. To inculcate this behavioural change, the target community is subjected to an intensive campaign using Integrated Marketing Communication techniques adapted from the advertisingindustry, particularly involving volunteers from the community itself.
    Methodology: In Selangor the pilot project was implemented in Section 3 and Section 4 of Bandar Baru Bangi, in the district of Hulu Langat. Here, Aedes breeding was found to occur mainly in water containers of semi permanent nature (eg. ‘kolah’, aquatic plant jars, flower pot bases etc). A total of 172 volunteers were recruited to disperse the message of “Suluh – Suluh, Basuh - Basuh” whilst distributing leaflets and flashlights to 2666 homes. Residents were instructed to illuminate such water containers twice weekly and scrub any containers found to contain larvae. The program commenced on 23/5/2004 and lasted 16 weeks.
    Results : During this period, the initial Aedes Index of 5 was reduced to 0.96 while combined cases of Dengue Fever / Dengue Haemorraghic Fever in Sections 3 and 4 reported to the Hulu Langat District Health Office also dropped to 1 (unconfirmed).
    Conclusion : The COMBI approach in Hulu Langat successfully demonstrated that correct problem identification synergized with community engagement can potentially reduce Aedes proliferationand dengue morbidity.
    MeSH terms: Aedes; Animals; Breeding; Communicable Diseases; Dengue; Goals; Larva; Malaysia; Pilot Projects; Volunteers; Water; Flowers; Marketing
  17. Dyah Pitaloka, S., Rizal, A.M.
    Background: A cross sectional study was carried out to identify the level and factors associated with patients’ satisfaction in antenatal clinic at Hospital Universiti Kebangsaan Malaysia.
    Methods: A total of 150 respondents were selected by using convenience sampling method. Data was collected via structured questionnaire with face to face interview. The obtained data was analyzed by using SPSS version 11.5.
    Results: Majority of the respondents were Malay (72%), while Chinese (18%) and Indian (10%).
    Age of the respondents around 19 to 40 years old with tertiary education level (50.7%) and most of them are working (76.4%). More than half of the respondents were satisfied with the service that they received (56.7%), while the others (43.3%) not satisfied. Generally, most of the respondents were satisfied with interpersonal aspects from the staff (62%), technical quality of the doctors (79.3%), efficacy (78%), availability (50.7%), and the financial aspect (70%). Meanwhile, the respondents were not satisfied with the several aspects i.e. accessibility (61.3%), convenience (51.3%), and continuity of care (81.3%). In bivariate analysis, the result of this study showed that there were only two factors significantly related with level of satisfaction (p
    MeSH terms: Continuity of Patient Care; Cross-Sectional Studies; Hospitals; Hospitals, University; Humans; Malaysia; Outpatient Clinics, Hospital; Personal Satisfaction; Physicians; Surveys and Questionnaires; Patient Satisfaction
  18. Rizal. A.M., Enna, M.H., Aljunid, S.M., Rohana, A.G., Soehardy, Z., Norella, C.T.K.
    Background: A randomised clinical trial was carried out to study the cost-effectiveness of continuous venovenous hemofiltration using high volume and standard volume.
    Methods: Study was done through interviews involving patients or their relatives and document review on patients’ treatment and progress note during the hemofiltration therapy in the Intensive Care Unit, Hospital University Kebangsaan Malaysia. Study also involved secondary data analysis and a structured questionnaire survey to assess the treatment and medical cost incurred by the hospital during the continuous venovenous hemofiltration therapy.
    Results: The result of this study showed that the continuous venovenous hemofiltration given at high volume 4-6 litres/hour is more cost effective than standard volume of 2 litres/hour. The Sequential Organ Failure Assessment (SOFA) score reduction in the high volume hemofiltration is 3.0 units over 24 hours. This reduction is higher than the standard volume hemofiltration which is only 0.5 unit over 24 hours.
    Conclusions: High volume hemofiltration is more cost effective than standard volume therapy, where only RM 5,552 compared to RM 23,512 is needed for every one unit of SOFA score reduction respectively.
    MeSH terms: Hemofiltration; Hospitals, University; Humans; Intensive Care Units; Malaysia; Universities; Organ Dysfunction Scores
  19. Che Abd Rahim Mohamed, Tee, Lee Theng, Zaharuddin Ahmad
    Natural radionuclides such as 210 Po and 210 Pb were analyzed in soft part of cockle (Anadara granosa) obtained from Kuala Selangor in the west coast Peninsular of Malaysia. The activity levels of both nuclides fluctuated within the size of cockles from 41.3 ± 2.5 Bq/kg to 114 ± 7 Bq/kg and 12.9 ± 1.7 Bq/kg to 96.8 ± 5.3 Bq/kg in dry weight (dwt) for 210 Po and 210 Pb, respectively. The level activity in wet weight (wwt) also varied from 8.60 ± 0.52 Bq/kg to 25.70 ± 1.63 Bq/kg and 2.47 ± 0.40 Bq/kg to 19.27 ± 1.05 Bq/kg for 210 Po and 210 Pb, respectively, probably related to the different of metabolic rate and growth of cockles. Activity ratio of 210 Po/ 210 Pb in dry weight also fluctuated from 0.93 to 6.41 with not related to the decay of 210 Pb.
    MeSH terms: Animals; Malaysia; Radioisotopes; Cardiidae; Arcidae; Biological Processes; Physiological Processes
  20. Nashriyah Mat, Mazleha Maskin, Abdul Khalik Wood, Zaini Hamzah
    Mineral elemental uptake by Colocasia esculenta growing in swamp agroecosystem was studied following 14, 18 or 28 months of field spraying (MAT, months after treatment) with herbicide Gramoxone ® (paraquat). In overall, Al (68226.67 + 24066.56 μg/g dw) was the major element in riverine alluvial swamp soil, followed by micronutrient Fe (22280.00 + 6328.87 μg/g dw).
    Concentration of macronutrient K (20733.33 + 7371.82 μg/g dw) was the highest in swamp taro leaf followed by macronutrient Ca (7050.00 + 3767.26 μg/g dw). In overall, the order of importance of the average mineral concentration in swamp taro leaf was K > Ca > Mn > Al > Na > Fe > Zn > Br > Co. However at 14 MAT, the order of importance of mineral content concentration in swamp taro leaf was K > Ca > Al > Na > Mn > Fe > Zn > Br > Co. At 18 MAT, the order of importance of mineral content concentration in swamp taro leaf was K > Ca > Mn > Al > Fe > Na > Zn > Br > Co. At 28 MAT, the order of importance of mineral content concentration in swamp taro leaf was K > Ca > Mn > Fe > Al > Zn > Na > Br > Co. In overall, the average order of importance of mineral elemental uptake or the soil plant transfer coefficient was Mn > K > Na > Zn > Co > Fe > Al; similar with the order at 28 MAT. However, at 14 MAT the order of importance of the soil plant transfer coefficient was different at Mn > K > Na > Co > Zn > Al > Fe.
    MeSH terms: Herbicides; Minerals; Paraquat; Soil; Trace Elements; Zinc; Plant Leaves; Micronutrients; Colocasia; Wetlands
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