Foreword. M K Rajakumar
Introduction: The transformation of health care in Malaysia. p1. CHEE HENG LENG AND SIMON BARRACLOUGH
PART I: The state and the private sector in the financing and provision of health care. p17
1 The growth of corporate health care in Malaysia. p19. CHEE HENG LENG AND SIMON BARRACLOUGH
2 Regulating Malaysia’s private health care sector. p40. NIK ROSNAH WAN ABDULLAH
3 Rising health care costs: the contradictory responses of the Malaysian state. p59. PHUA KAI LIT
4 Malaysian health policy in comparative perspective. p72. M. RAMESH
5 The welfarist state under duress: global influences and local contingencies in Malaysia. p85. CHAN CHEE KHOON
6 Equity in Malaysian health care: an analysis of public health expenditures and health care facilities. p102. WEE CHONG HUI AND JOMO K.S.
PART II: People’s access to health care. p117
7 Health care for the Orang Asli: consequences of paternalism and non-recognition. p119. COLIN NICHOLAS AND ADELA BAER
8 Women’s access to health care services in Malaysia. p137. CHEE HENG LENG AND WONG YUT LIN
9 HIV/AIDS health care policy and practice in Malaysia. p154. HUANG MARY S.L. AND MOHD NASIR MOHD TAIB
10 Health care and long-term care issues for the elderly. p170. ONG FON SIM
11 Health care in Sarawak: model of a public system. p187. KHOO KHAY JIN
Epilogue: Civil society and health care policy in Malaysia. p208. CHEE HENG LENG AND SIMON BARRACLOUGH
MeSH terms: Aged; Delivery of Health Care; Economics; Health Expenditures; Health Policy; Health Services Accessibility; Malaysia; Rural Health; HIV Infections; Review; Health Care Costs; Private Sector; Public Sector; Healthcare Financing
Evaluation of: Jada SR, Lim R, Wong CI et al.: Role ofUGT1A1*6, UGT1A1*28 and ABCG2 c.421C>A polymorphisms in irinotecan-induced neutropenia in Asian cancer patients. Cancer Sci. 98(9), 1461-1467 (2007). The pharmacokinetics and toxicity of irinotecan vary widely among patients. This review focuses primarily on a study of the role of UGT1A1*6, UGT1A1*28, and ABCG2 421C>A in three Asian cancer patient populations treated with a 3-weekly regimen of irinotecan. In that study, a statistically significantly higher level of SN-38 and a relatively lower degree of glucuronidation occurred in patients with the UGT1A1*6 homozygote genotype than in patients with the reference genotype. The UGT1A1*6 allele was associated with an increased risk of severe neutropenia. In addition, the study of gene allele frequencies in three healthy Asian populations indicated that the allelic frequency of UGT1A1*6 was higher in the healthy Chinese subjects than in the Malaysian or Indian subjects. UGT1A1*28 and ABCG2 421C>A were not associated with the pharmacokinetics of SN-38 or the severity of neutropenia. In this evaluation, we put this study into the context of similar studies of irinogenetics (irinotecan pharmacogenetics) in Asians and discuss the application of UGT1A1 testing in Asian cancer patients treated with irinotecan-containing regimens.
During 2005, 764 children were brought to a large children's hospital in Ho Chi Minh City, Vietnam, with a diagnosis of hand, foot, and mouth disease. All enrolled children had specimens (vesicle fluid, stool, throat swab) collected for enterovirus isolation by cell culture. An enterovirus was isolated from 411 (53.8%) of the specimens: 173 (42.1%) isolates were identified as human enterovirus 71 (HEV71) and 214 (52.1%) as coxsackievirus A16. Of the identified HEV71 infections, 51 (29.5%) were complicated by acute neurologic disease and 3 (1.7%) were fatal. HEV71 was isolated throughout the year, with a period of higher prevalence in October-November. Phylogenetic analysis of 23 HEV71 isolates showed that during the first half of 2005, viruses belonging to 3 subgenogroups, C1, C4, and a previously undescribed subgenogroup, C5, cocirculated in southern Vietnam. In the second half of the year, viruses belonging to subgenogroup C5 predominated during a period of higher HEV71 activity.
MeSH terms: Adolescent; Animals; Cercopithecus aethiops; Child; Hand, Foot and Mouth Disease/epidemiology*; Hand, Foot and Mouth Disease/transmission; Hand, Foot and Mouth Disease/virology*; Humans; Phylogeny; Vero Cells; Vietnam/epidemiology; Reverse Transcriptase Polymerase Chain Reaction/methods; Enterovirus A, Human/genetics; Enterovirus A, Human/isolation & purification; Capsid Proteins/genetics; Cell Line, Tumor
The fabrication of an optical biosensor by using stacked films where 3-methyl-2-benzothiazolinone hydrazone (MBTH) was immobilized in a hybrid nafion/sol-gelsilicate film and laccase in a chitosan film for the detection of phenolic compounds wasdescribed. Quinone and/or phenoxy radical product from the enzymatic oxidation ofphenolic compounds was allowed to couple with MBTH to form a colored azo-dye productfor spectrophometric detection. The biosensor demonstrated a linear response to catecholconcentration range of 0.5-8.0 mM with detection limit of 0.33 mM and response time of10 min. The reproducibility of the fabricated biosensor was good with RSD value of 5.3 %(n = 8) and stable for at least 2 months. The use of the hybrid materials of nafion/sol-gelsilicate to immobilize laccase has altered the selectivity of the enzyme to various phenoliccompounds such as catechol, guaicol, o-cresol and m-cresol when compared to the non-immobilized enzyme. When immobilized in this hybrid film, the biosensor response onlyto catechol and not other phenolic compounds investigated. Immobilization in this hybridmaterial has enable the biosensor to be more selective to catechol compared with the non-immobilized enzyme. This shows that by a careful selection of different immobilizationmatrices, the selectivity of an enzyme can be modified to yield a biosensor with goodselectivity towards certain targeted analytes.
An optical urea biosensor was fabricated by stacking several layers of sol-gelfilms. The stacking of the sol-gel films allowed the immobilization of a Nile Bluechromoionophore (ETH 5294) and urease enzyme separately without the need of anychemical attachment procedure. The absorbance response of the biosensor was monitoredat 550 nm, i.e. the deprotonation of the chromoionophore. This multi-layer sol-gel filmformat enabled higher enzyme loading in the biosensor to be achieved. The urea opticalbiosensor constructed from three layers of sol-gel films that contained urease demonstrateda much wider linear response range of up to 100 mM urea when compared with biosensorsthat constructed from 1-2 layers of films. Analysis of urea in urine samples with thisoptical urea biosensor yielded results similar to that determined by a spectrophotometricmethod using the reagent p-dimethylaminobenzaldehyde (R² = 0.982, n = 6). The averagerecovery of urea from urine samples using this urea biosensor is approximately 103%.
Abductor pollicis longus (APL) muscle is known to exhibit different variations with respect to its attachments. Various studies have reported the splitting of the APL muscle. Comparative anatomical findings of split insertion of APL is commonly found in chimpanzees, gorillas and gibbons. In the present study, we describe an anomalous APL muscle, which originated from the posterior surface of the shaft of the radius and ulna and traversed a course deep to the extensor retinaculum. Interestingly, immediately after emerging form the deeper aspect of extensor retinaculum, the thin tendon of the APL muscle continued again as a muscular belly in relation to the dorsolateral part of the 1st metacarpal bone, to end as a tendon with its attachment to the base of the proximal phalanx. Such an unusual variation of APL with its attachment into proximal phalanx is a rare finding and may be of importance in altering the mechanics of the thumb during abduction. The clinical significance of such an anatomical variation of APL may be important during reconstructive surgeries involving thumb and also of academic interest.
Over two hundred bacteria were isolated from the halosphere, rhizosphere and endophyte of Malaysian maize plantation and screened for phytases activity. Thirty isolates with high detectable phytase activity were chosen for media optimization study and species identification. Ten types of bacterial phytase producers have been discovered in this study, which provides opportunity for characterization of new phytase(s) and various commercial and environmental applications. The majority of the bacterial isolates with high detectable phytase activity were of endophyte origin and 1.6% of the total isolates showed phytase activity of more than 1 U/ml. Most of the strains produced extra-cellular phytase and Staphylococcus lentus ASUIA 279 showed the highest phytase activity of 1.913 U/ml. All 30 species used in media optimization study exhibit favorable enzyme production when 1% rice bran was included in the growth media.
Mycelium-bound lipase (MBL) was prepared using a strain of Geotrichum candidum isolated from local soil. At the time of maximum lipase activity (54 h), the mycelia to which the lipase was bound were harvested by filtration and centrifugation. Dry MBL was prepared by lyophilizing the mycelia obtained. The yield of MBL was 3.66 g/l with a protein content of 44.11 mg/g. The lipase activity and specific lipase activity were 22.59 and 510 U/g protein, respectively. The moisture content of the MBL was 3.85%. The activity of free (extracellular) lipase in the culture supernatant (after removal of mycelia) was less than 0.2 U/ml. The MBL showed selectivity for oleic acid over palmitic acid during hydrolysis of palm olein, indicating that the lipase from G. candidum displayed high substrate selectivity for unsaturated fatty acid containing a cis-9 double bond, even in crude form. This unique specificity of MBL could be a direct, simple and inexpensive way in the fats and oil industry for the selective hydrolysis or transesterification of cis-9 fatty acid residues in natural triacylglycerols.
The fatty acid composition and trans fatty acids (TFA) contents of samples of five Malaysian cream crackers biscuit brands were determined by gas-liquid chromatography, using a 60 m Supelco SP2340 fused silica capillary column and flame ionization detection. The identities of the fatty acids were established by comparing their retention times with authentic standards from Supelco. The results were expressed as relative percentages. The total saturated fatty acids (SFA) in the samples ranged from 48.90% to 54.87% of total fatty acids. As for the polyunsaturated fatty acids (PUFA), the total PUFA in the samples ranged from 9.97% to 11.73% of total fatty acids. Total trans fatty acids (TFA) ranged from 0.17% to 0.77% of total fatty acids. The monotrans 18:2 tc or 18:2 ct isomer content ranged from 0.07% to 0.10% of total fatty acids and the ditrans 18:2 isomer (9t, 12t) was not detected. The results indicate that all the fat sources of the 5 sample crackers biscuit brands were palm oil based.
Salmonella enterica is one of the major causes of bacterial foodborne infection. The aims of this study were to determine the antibiotic resistance and the genetic diversity of Salmonella enterica isolated from street foods and clinical samples and to understand the correlation between the prevalence of serovars and genotypes with their source (street food and clinical samples) and geographic origin (Negeri Sembilan, Malacca and Selangor in Peninsular Malaysia). The enterobacterial repetitive intergenic consensus (ERIC) PCR analysis distinguished the Salmonella isolates into 19 ERIC types, with one untypable isolate. Dendrograms were specifically constructed for the S. Biafra and S. Typhi isolates. Identical or very similar ERIC types among the S. Biafra isolates from street food samples indicate transmission of the S. Biafra among the street foods, as well as possible cross-contamination of the street foods. In addition, the identical or very similar ERIC types among the S. Typhi isolates from human samples examined suggest possible similarity in their source of infection. All the twenty four isolates were resistant to rifampin and none were resistant to cefuroxime. Most isolates displayed multiple resistances. Dendrogram of antibiotic resistances produced six clusters, with similarity levels between 18.8% and 100%. Generally, street food and clinical isolates tend to cluster apart. Dendrogram to cluster the antibiotic groups showed that they could be grouped according to classes based on mode of inhibition. The findings suggest that street food contaminated with drug-resistant Salmonella enterica can be an important factor in the continuous emergence of antibiotic resistant Salmonella enterica.
Processed meat products, such as burgers, sausages, meatballs, salami and nuggets are currently popular with urban consumers. However, in general, they are high in cholesterol, total lipid and saturated fatty acids. Four beef burger formulations were prepared, each containing 15% fat from either beef fat (control), palm fat (PF), red PF or a blend of PF and red PF at a ratio of 1:1 at 15% fat. A rat assay was carried out to determine lipid profile, apparent digestibility (AD) and protein efficiency ratio (PER) of rats fed with beef burger diets containing palm based fats. Treatment with PF and red PF beef burger diets did not affect the total cholesterol concentration but resulted in higher HDL-cholesterol concentration in their blood serum. The rats fed with dried burger diets containing PF and red PF had higher AD value (90.0% and 89.3%, respectively) and was not significantly different (P < 0.05) compared to the group fed with dried burger containing beef fat (90.7) over the 10 days experimental diet period. PER values of all treatments except for casein were not significantly different (P < 0.05). There was also no difference (P < 0.05) in food intake and body weight gain between all rats fed with dried burger containing different types of palm based fats. In summary, the utilization of PF and red PF in beef burger increased the HDLcholesterol and had no effect on the concentration of total cholesterol in rat blood serum. Addition of palm based fats into beef burgers did not change AD and PER.
This study investigated the protein quality of two sets of Roselle seeds processed differently (dried and boiled). Twenty weanling Sprague Dawley rats were used to conduct the growth and nitrogen balance studies. Rats were fed with 10% (w/w) protein from dried (DS) and boiled (BS) Roselle seeds powder for 4 weeks. Casein was used in this study as a standard reference protein. There was a significantly higher (p < 0.05) food intake and weight gain by rats fed with BS compared with DS. In the growth study, there was no significant difference (p < 0.05) in protein efficiency ratio (PER) and net protein ratio (NPR) of BS compared to DS, but it was significantly different with casein (CD). PER value of rats fed with DS was significantly lower (p < 0.05) than casein. In the nitrogen balance study, true nitrogen absorption (TNA) and nitrogen balance (NB) of BS group was significantly higher (p < 0.05) than DS group. However, apparent digestibility (AD), true digestibility (TD) and biological value (BV) for both diets was not significantly different. This study showed that the protein quality of dried Roselle seeds was similar to the Roselle seeds boiled at 100oC for 30 minutes.
The objective of this project was to determine the physico-chemical and sensory characteristics of bread supplemented with four different levels (control, 5%, 10%, and 15%) of pumpkin flour. The physical (weight, loaf volume, specific volume and oven spring) and chemical (moisture, protein, fat, fibre and ash) attributes were determined in the raw pumpkin, pumpkin flour (PF), control and supplemented breads. Sensory attributes were conducted on the control and supplemented breads. Increasing the level of substitution from 5% to 15% pumpkin flour significantly (p
Polymerase chain reaction (PCR) technique was used to assay for the detection of specific genes in the genomes of the Aeromonas spp. isolated from environmental and shellfish sources, particularly aero and hlyA genes, responsible for aerolysin and hemolysin toxins production in this genus. The results showed that: (i) the 1500 bp amplicon of the hlyA gene was detected in 20/38 of the Aeromonas hydrophila, 13/38 of the A. caviae and 6/9 of the A. veronii biovar sobria isolates; (ii) the 690 bp amplicon of the aero gene was detected in 20/38 of A. hydrophila, 17/38 of A. caviae and 6/9 of A. veronii biovar sobria isolates; (iii) the nucleotide blast results of aerolysin gene sequences of the representative strains of A. hydrophila, A. caviae and A. veronii biovar sobria revealed a high homology of 94%, 95% and 95% with published sequences, respectively and ; (iv) the protein blast showed 97%, 94% and 96% homology when compared to the published sequences, respectively. The finding of A. hydrophila virulence genes in other members of the genus Aeromonas, may give a new perspective to the significance of these results. The method described here may be a useful detection tool to assist in further investigation of aero and hlyA genes in the genus Aeromonas, especially for food microbiologist.
This study was carried out to extract and compare the characteristic ability of globulins from cottonseed, alfalfa seed, pea seed, mung bean and French bean with cocoa seeds to produce cocoa-specific aroma precursors. The extracted globulins were compared through SDS PAGE, amino acid and oligopeptide profiles. A very low recovery was obtained during globulin extraction from different seeds ranging from 0.5% to 2.7%. Cottonseed produced the highest total protein (13.90 mg/g), followed by cocoa seed (11.91 mg/g), whereas alfalfa seed, mung bean, pea seed and French bean produced 7.86, 4.77, 4.59 and 3.89 mg/g respectively. Two distinctive bands of 51.1 and 33.0 kDa were observed for cocoa vicilin-class globulin (VCG) from SDS PAGE. More than three bands were shown for other seed globulins. Comparative HPLC analyses of the obtained peptide mixtures revealed different and complex patterns of predominantly hydrophobic peptides. A similar high content of amides (glutamic acids-glutamine, aspartic acid- asparagine and arginine) and low concentrations of lysine were observed in all seeds globulin.
Solvent-extracted Moringa oleifera seed oil was transesterified using immobilized lipase (Lipozyme IM 60) (Novozymes Bagsvaerd Denmark) at 1% (w/w) concentration, shaken at 60oC and 200 rpm for up to 24h. After transesterification, the oil was fractionated with acetone at -18oC and without acetone at 10oC to obtain two fractions, stearin and olein fractions. Incubation of the transesterified oil at 10oC for 24 h resulted in the formation of fat crystals, which settled at the bottom of the flask in sample transesterified for 24 h, while the control (0 h) sample became rather viscous with fat crystals in suspension. Transesterification resulted in a change in the triacylglycerol (TAG) profile of the oil, which in turn affected its solid fat content (SFC) and thermal behavior. The SFC value at 0oC after 24 h of reaction was 10.35% and significantly (P
The native sago starch exists as a compact crystalline structure and is not efficiently hydrolyzed by Raw Starch Degrading Enzyme (RSDE). In order to enhance its hydrolysability, the starch was treated with acid and heated below its gelatinization temperature, thus increasing the accessibility of the sago starch granule to enzymatic attack. Results showed that treatment of sago starch with acid at pH 2.0 and temperature 65oC for 2 hours greatly enhanced its conversion rate to glucose from 53.3% to 71.9%. It is clearly shown that high yield of glucose is produced during hydrolysis of acid-treated sago starch using the Raw Starch Degrading Enzyme from Acremonium sp. The difference between the acid-treated and untreated sago starch in this study could be due to the differences on the surface of the sago starch granule which may influence the accessibility and diffusion of enzyme into the starch during hydrolysis.
All living organisms including human beings in this biosphere are constantly exposed to a variety of xenobiotics. The enormous chemical load in the environment has been primarily through the modernization, industrialization and changes in lifestyle. The changing food habits to suit modern living pose a serious threat to a healthy life. Among others, consumption of soft drinks invariably forms a part of modern life. Mostly children and adolescents are the target groups vulnerable to frequent consumption, compromising the nutritious foods such as fruits, vegetables, milk and milk products. Logically, the quality of the soft drinks is determined by the type and quantity of chemicals present, including those present inherently in the water used for such preparations. The impact of soft drinks on human health has been a subject of in depth research. Consumption of soft drinks plays a major role in a variety of diseases like obesity, diabetes, dental and bone disorders and others, more so among children and adolescents. The toxic effects of soft drinks have gained much attention, due to the frequent scientific reports and media attention. The objective of this review is to provide a comprehensive scrutiny of the impact of soft drinks on health, as well as to suggest alternatives for a healthy life style.
This study was conducted on selected local herbs such as ulam raja (Cosmos caudatus), kesum (Polygonum minus), selom (Oenanthe javanica), pegaga (Centella asiatica) and curry leaves (Murraya koenigii) to investigate their antioxidative activities. The water extracts of the herbs were analysed for total phenolic content, reducing antioxidant power, ferric thiocyanate (FTC) and the thiobarbituric acid (TBA) test was also accried out. Polygonum minus showed the highest total phenolic content and reducing power among the herbs. Increasing the concentration of the extracts resulted in increased Fe3+ reducing antioxidant power for all the herbs. FTC and TBA tests on the extracts during seven days of storage showed that all the herbs extracts had the ability to reduce oxidation compared to the control (P < 0.05). From the FTC analysis, Murraya koenigii leaves was best in reducing the oxidation rate (67.67%) compared to the other herbs studied. Analysis of TBA showed that Centella asiatica extract had the highest antioxidant effect. However, both TBA and FTC analysis for these two herbs showed no significant difference (P >0.05) from Polygonum minus and butylated hydroxyanisole (BHT) a synthetic antioxidant. Correlation analysis showed positive correlations between amount of total phenolic content and reducing power (r = 0.75) and antioxidative activities (r = 0.58) in linoleic acid emulsion system. This shows that antioxidative activities of these Malaysian herbal plants especially Polygonum minus may be a potential source of natural antioxidants with similar characteristics to the synthetic antioxidant, BHT.
Three restriction enzymes were used in Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) using the mitochondrial cytochrome b region to establish a differential diagnosis which detect and discriminate between three meat species: pork, cow and chicken. DNA was extracted from samples containing meat of a single animal such as raw pork (Sus scrofa domesticus), chicken (Gallus gallus) and cow (Bos taurus) as well as mixed samples of two species of animals in different ratios. The amplified 359 base pairs (bp) portion of the mitochondrial cyt b gene from pure or mixed samples in different ratios was cut using three different restriction enzymes resulting in species specific restriction fragment length polymorphism (RFLP). This technique proved to be extremely reliable in detecting the presence of low levels of target DNA obtained from a 0.25 mg component in a particular mixed meat sample. This revealed the cyt b region as highly conserved and consequently a good molecular marker for diagnostic studies. Thus, this technique can be applied to food authentication for the identification of different species of animals in food products.
MeSH terms: Animals; Cattle; Chickens; Diagnosis, Differential; DNA; DNA Restriction Enzymes; Female; Meat; Polymorphism, Restriction Fragment Length; Swine; Polymerase Chain Reaction; Base Pairing; Sus scrofa; Cytochromes b; Genes, Mitochondrial