OBJECTIVES: Determination of the psychosocial status and assessment of the level of satisfaction in Malaysian cleft palate patients and their parents.
DESIGN: Cross-sectional study.
PARTICIPANTS AND METHODS: Sixty cleft lip and palate patients (12 to 17 years of age) from Hospital Universiti Sains Malaysia and their parents were selected. The questionnaires used were the Child Interview Schedule, the Parents Interview Schedule, and the Cleft Evaluation Profile (CEP), administered via individual interviews.
RESULTS: Patients were teased because of their clefts and felt their self-confidence was affected by the cleft condition. They were frequently teased about cleft-related features such as speech, teeth, and lip appearance. Parents also reported that their children were being teased because of their clefts and that their children's self-confidence was affected by the clefts. Both showed a significant level of satisfaction with the treatment provided by the cleft team. There was no significant difference between the responses of the patients and their parents. The features that were found to be most important for the patients and their parents, in decreasing order of priority, were teeth, nose, lips, and speech.
CONCLUSIONS: Cleft lip and/or palate patients were teased because of their clefts, and it affected their self-confidence. The Cleft Evaluation Profile is a reliable and useful tool to assess patients' level of satisfaction with treatment received for cleft lip and/or palate and can identify the types of cleft-related features that are most important for the patients.
The message that health care providers caring for patients with breast cancer would like to put forth, is that, not only early detection is crucial but early treatment too is important in ensuring survival. This paper examines the pattern of presentation at a single institution over a 10-year period from 1995 to 2005. In Malaysia, education outreach programmes are ongoing, with contributions not only from the public sector, but also private enterprise. Articles on breast cancer in local newspapers and women magazines and television are quite commonplace. However are our women getting the right message? Now is an appropriate time to bring the stakeholders together to formulate a way to reach all women in Malaysia, not excluding the fact that we are from different races, different education levels and backgrounds requiring differing ways of delivering health promotion messages. To answer the question of why women present late, we prospectively studied 25 women who presented with locally advanced disease. A quantitative, quasi-qualitative study was embarked upon, as a prelude to a more detailed study. Reasons for presenting late were recorded. We also looked at the pattern of presentation of breast lumps in women to our breast clinic in UMMC and in the surgical clinic in Hospital Kota Bharu, in the smaller capital of the state of Kelantan, in 2003. There is hope for the future, the government being a socially responsible one is currently making efforts towards mammographic screening in Malaysia. However understanding of the disease, acceptance of medical treatment and providing resources is imperative to ensure that health behaviour exhibited by our women is not self-destructive but self-preserving. Women are an integral part of not only the nation's workforce but the lifeline of the family - hopefully in the next decade we will see great improvement in the survival of Malaysian women with breast cancer.
MeSH terms: Breast Neoplasms/epidemiology*; Breast Neoplasms/psychology*; Clinical Trials as Topic; Female; Health Education*; Health Planning Guidelines; Health Resources; Humans; Malaysia/epidemiology; Mammography; Prospective Studies
A flow injection analysis (FIA) procedure for the determination of anisidine value (AV) in palm olein using a triiodide detector is described. Undiluted oil sample and chloramine-T reagent were added to a reaction chamber, and reaction was accelerated by applying a short vortex action (typically for 30 s). After allowing the emulsified oil phase to be separated from the aqueous phase (bottom layer), an aliquot of the aqueous phase (containing unreacted chloramine-T) was aspirated into a carrier stream that contained I(-) where the chloramine-T oxidized the I- to form I3(-) which was finally detected by a flow-through triiodide potentiometric detector. Variables that affect the FIA signals such as size of the reaction chamber, oil and reagent flow rates, chloramine-T concentration, vortex time, time for phase separation, carrier stream pH and injected volume were studied. The optimized FIA procedure is linear over 1.0-23.0 AV. The method exhibits good repeatabililty (R.S.D. of +/-3.16% (n = 4) for the determination of 5.0 AV) and a sampling rate of 40 samples per hour was achieved. Good correlation (r2 = 0.996 (n = 4)) between the proposed method and the manual American Oil Chemists' Society procedure was found when applied to the determination of twenty different types of palm olein samples.
House crows (Corvus splendens) in Selangor, Malaysia were examined for the presence of Campylobacter species, Salmonella species, Mycoplasma gallisepticum and Mycoplasma synoviae by serology, culture and pcr. For the detection of Campylobacter and Salmonella species swabs were taken either from the intestine or cloaca. For the detection of mycoplasmas, swabs were taken either from the choanal cleft or trachea for culture and pcr and serum samples were tested by the rapid serum agglutination (rsa) and monoclonal antibody-blocking elisa (mbelisa) for antibodies to M gallisepticum and M synoviae. For campylobacter, 25.3 per cent of the crows were positive by culture, and the species identified were Campylobacter jejuni and Campylobacter coli. No Salmonella species were isolated. Four of 24 swabs were positive for M gallisepticum dna but none gave positive results for M synoviae dna. No M gallisepticum or M synoviae antibodies were detected by rsa but 60 per cent of the sera gave positive reactions for M gallisepticum and 13 per cent gave positive reactions for M synoviae by mbelisa.
INTRODUCTION: Medical talks, newsletter circulars, scientific meetings and conferences, and interaction with members of the pharmaceutical industry, have become convenient means of carrying out continuing medical education (CME) for many busy doctors.
MATERIALS AND METHODS: To study the perceived importance of these various CME activities, a self-completed posted questionnaire survey was conducted among registered practitioners of a densely populated urban state in Malaysia.
RESULTS: Of the 172 respondents [male, 77%; hospital-based, 37%; general practitioner (GP), 55%; private practice, 70%; respondent rate of 19.5%], most preferred local conferences and endorsements by local experts to their foreign counterparts. Meetings or conferences sponsored by the pharmaceutical industry were ranked similarly with those without such links, while the reputation of the pharmaceutical firms was of foremost importance. Among GPs (n = 95) and non-GPs (n = 77), medical society newsletters were rated significantly higher by GPs while overseas conferences were rated higher by non-GPs.
CONCLUSION: Our findings provide an important first look at this under-explored area among Malaysian doctors and described a high degree of acceptance for the involvement of the pharmaceutical industry in CME activities.
MeSH terms: Adult; Attitude of Health Personnel*; Congresses as Topic/statistics & numerical data; Education, Medical, Continuing/methods*; Family Practice/education*; Family Practice/standards; Female; Humans; Malaysia; Male; Middle Aged; Periodicals as Topic/statistics & numerical data; Surveys and Questionnaires; Societies, Medical; Evidence-Based Medicine/education*; Health Care Surveys
Experimental data indicate that destructive oxidative events reach their peak within the first 24 h after trauma in head injury (HI) and that brain damage occurring due to this impact can be the cause of death or irreversible permanent disabilities in affected patients.
MeSH terms: Adult; Antioxidants/analysis; Erythrocytes/metabolism*; Female; Glutathione/blood; Craniocerebral Trauma/blood; Craniocerebral Trauma/complications; Craniocerebral Trauma/diagnosis*; Craniocerebral Trauma/mortality; Humans; Male; Nervous System Diseases/diagnosis; Nervous System Diseases/etiology; Oxidation-Reduction; Predictive Value of Tests*; Severity of Illness Index; Superoxide Dismutase/blood; Lipid Peroxidation; Case-Control Studies; Thiobarbituric Acid Reactive Substances/analysis
To determine the risk factors associated with complain of low back pain. A cross sectional study was done from June 2004 until August 2005. Seven hundred and sixty commercial vehicle drivers from 11 bus companies in central, northern and eastern regions in Malaysia participated in this study. Modified Nordic questionnaire was used to determine the prevalence of low back pain; Maestro human vibration meter was used to measure the personal R.M.S values of lateral, anterior-posterior and vertical axes. Modified Owas was used to assess the awkward posture of the driver torso namely, bending forward movement, leaning, sitting straight and twisting. Profile of Mood States (POMS) was used to evaluate the mood states of bus drivers with complain of low back pain. A high prevalence of low back pain (60.4%) among Malaysian commercial vehicle drivers was found. Logistic regression analysis controlling for age, income, education level and non occupational activities revealed that the following factors were related to low back pain: Tension-anxiety [1.080, 95% CI 1.041-1.121], depression dejection [1.047, 95% CI 1.023-1.072], anger-hostility [1.053, 95% CI 1.027-1.081], fatigue [1.132, 95% CI 1.089-1.177] and confusion [1.114, 95% CI 1.061-1.169] of POMS, length of employment [1.001, 95% CI 1.0-1.003], steering wheel adjustment [1.521, 95% CI 1.101-2.101], perception of exposing to vibration [1.943, 95% CI 1.389-2.719]. In conclusion, combinations of risks lead to high increase of low back pain complain among Malaysian bus drivers.
MeSH terms: Adult; Cross-Sectional Studies; Humans; Irritable Mood/physiology; Malaysia/epidemiology; Middle Aged; Occupational Diseases/etiology; Occupational Diseases/epidemiology*; Occupational Diseases/psychology; Pain Measurement; Posture/physiology; Surveys and Questionnaires; Risk Factors; Stress, Psychological/epidemiology; Vibration/adverse effects; Prevalence; Low Back Pain/etiology; Low Back Pain/epidemiology*; Low Back Pain/psychology; Risk Assessment; Motor Vehicles*; Torque
Malaysia's global, regional and bilateral international health relations are surveyed against the historical backdrop of the country's foreign policy. Malaysia has always participated in multilateral agencies, most notably the World Health Organization, as such agencies are part of the longstanding fabric of "good international citizenship". The threats of infectious diseases to human health and economic activity have caused an intensification and an organizational formalization of Malaysian health diplomacy, both regionally and bilaterally. Such diplomacy has also established a basis for developing a wider set of cooperative relationships that go beyond responding to the threat of pandemics. As Malaysia approaches "developed" status, its health sector is becoming increasingly integrated into the global economy through joint research and development ventures and transnational investment. At the same time, it will have the technological, financial and human resources to play an expanded altruistic role in global and regional health.
MeSH terms: Altruism; Communicable Diseases/epidemiology; Health Policy*; Health Status; Humans; Human Rights; International Cooperation*; Malaysia; Public Policy; Global Health; World Health Organization/organization & administration; Public Health Practice
Inactivation of the retinoblastoma (pRB) pathway is a common event in oral squamous cell carcinoma particularly through the aberrant expression of the components within this pathway. This study examines the alterations of molecules within the pRB pathway by looking at the presence of homozygous deletions in p16(INK4A) and the expression patterns of pRB, cyclin D1 and CDK4, as well as the presence of human papillomavirus (HPV) in our samples. In our study, 5/20 samples demonstrated deletions of p16(INK4A) exon 1alpha. pRB overexpression was found in 20/20 samples, the expression was mainly observed in all layers of the epithelia, particularly in the basal layer where cells are actively dividing and aberrant pRB expression was found in 12/20 samples. Cyclin D1 and CDK4 overexpression was detected in 6/20 and 2/20 samples respectively in comparison to hyperplasias where both proteins were either not expressed or expressed at minimal levels (<10%). Strikingly, HPV was found to be present in all of our samples, suggesting that HPV plays a significant role in driving oral carcinogenesis. Notably, 17/20 of our samples showed more than one alteration in the pRB pathway, however, we did not find any significant relationship between the presence of HPV, homozygous deletion of p16(INK4A) and overexpression of pRB, cyclin D1 and CDK4. Collectively, this data demonstrates that alterations in the pRB pathway are a common event and involve the aberration of more than one molecule within the pathway. Furthermore, the involvement of HPV in all our samples suggests that HPV infection may play an important role in oral carcinogenesis.
Probucol is a clinically used cholesterol-lowering drug, with pronounced antioxidant properties. We have reported previously, that dietary supplementation of probucol enhances NAD(P)H:quinone reductase (Iqbal M, Okada S (2003) Pharmacol Toxicol 93:259-263) and inhibits Fe-NTA induced lipid peroxidation and DNA damage in vitro (Iqbal M, Sharma SD, Oakada (2004) Redox Rep 9:167-172). Further to this, in the present study, we evaluated the modulatory effect of probucol on iron nitrilotriacetae (Fe-NTA) dependent renal carcinogenesis, hyperproliferative response and oxidative stress. In Fe-NTA alone treated group, a 20% renal cell tumor incidence was recorded whereas, in N-diethylnitrosamine (DEN)-initiated and Fe-NTA promoted animals, the percentage tumor incidence was increased to 70% as compared with untreated controls. No tumor incidence was recorded in DEN-initiated, nonpromoted group. Diet supplemented with 1.0% probucol fed prior to, during and after Fe-NTA treatment in DEN-initiated animals afforded >65% protection in renal cell tumor incidence. Probucol fed diet pretreatment also resulted a significant and dose dependent inhibition of Fe-NTA induced renal ornithine decarboxylase (ODC) activity. In oxidative stress studies, Fe-NTA alone treatment enhanced lipid peroxidation, accompanied by a decrease in the level of GSH, activities of antioxidants and phase II metabolizing enzymes in kidney concomitant with histolopathological changes. These changes were significantly and dose-dependently alleviated by probucol fed diet. From this data, it can be concluded that probucol can modulates toxic and tumor promoting effects of Fe-NTA and can serve as a potent chemopreventive agent to suppress oxidant induced tissue injury and carcinogenesis, in addition to being a cholesterol lowering and anti-atherogenic drug.
The volume of patient monitoring video acquired in hospitals is very huge and hence there is a need for better compression of the same for effective storage and transmission. This paper presents a new motion segmentation technique, which improves the compression of patient monitoring video. The proposed motion segmentation technique makes use of a binary mask, which is obtained by thresholding the standard deviation values of the pixels along the temporal axis. Two compression methods, which make use of the proposed motion segmentation technique, are presented. The first method uses MPEG-4 coder and 9/7-biorthogonal wavelet for compressing the moving and stationary portions of the video respectively. The second method uses 5/3-biorthogonal wavelet for compressing both the moving and the stationary portions of the video. The performances of these compression algorithms are evaluated in terms of PSNR and bitrate. From the experimental results, it is found that the proposed motion technique improves the performance of the MPEG-4 coder. Among the two compression methods presented, the MPEG-4 based method performs better for bitrates less than 767 Kbps whereas for bitrates above 767 Kbps the performance of the wavelet based method is found superior.
New conjugate vaccine for Streptococcus pneumoniae has been introduced in Malaysia recently. Information on infection due to S. pneumoniae in Malaysian children is scarce. We conducted a retrospective chart review of childhood invasive pneumococcal disease (IPD) presented to a single centre in Malaysia.
MeSH terms: Academic Medical Centers*; Child; Child, Preschool; Humans; Infant; Malaysia; Medical Audit; Pneumococcal Infections/physiopathology*; Retrospective Studies; Streptococcus pneumoniae/pathogenicity*
P-glycoprotein (PgP) is the most extensively studied ATP-binding cassette (ABC) coded by MDR1 gene. To date, 29 single nucleotide polymorphisms (SNPs) have been identified; but only SNP C3435T has been correlated with intestinal PgP expression levels and shown to influence the absorption of orally taken drugs that are PgP substrates. Individuals homozygous for the T allele have more than fourfold lower PgP expression compared with C/C individuals. We developed a one step primer based allele specific PCR method to detect SNP at C3435T to investigate the distribution of this genotype in the local population.
MeSH terms: Alleles; Base Sequence; DNA/genetics; DNA/chemistry; Female; Gene Frequency; Genotype; Humans; Malaysia; Male; Molecular Sequence Data; Polymorphism, Genetic*; Genetic Variation; Reproducibility of Results; Polymerase Chain Reaction/methods*; Sequence Analysis, DNA; P-Glycoprotein/genetics*; European Continental Ancestry Group/ethnology; European Continental Ancestry Group/genetics; Asian Continental Ancestry Group/ethnology; Asian Continental Ancestry Group/genetics
The aim of this study was to evaluate the effect of a synbiotic containing Lactobacillus acidophilus ATCC 4962, fructooligosaccharide, inulin and mannitol on plasma lipid profiles and erythrocyte membrane properties in hypercholesterolaemic pigs on high- and low-fat diets. Twenty-four white male Landrace pigs were randomly allocated to four treatment groups for 8 weeks (n 6). Treatment factors were the supplementation of synbiotic (with and without) and dietary fat (5 and 15 %). The supplementation of synbiotic reduced plasma total cholesterol (P = 0.001), TAG (P = 0.002) and LDL-cholesterol (P = 0.045) for both dietary fats. A higher concentration of esterified-cholesterol in HDL of pigs supplemented with synbiotic than the control regardless of dietary fat (P = 0.036) indicated that cholesterol was reduced in the form of cholesteryl esters. Reduced concentration of cholesteryl esters (P < 0.001) and increased concentration of TAG (P = 0.042) in LDL of pigs on synbiotic suggested that LDL-cholesterol was reduced via the hydrolysis of smaller and denser LDL particles. The erythrocytes of pigs without any synbiotic showed more prevalence of spur cells than those given the synbiotic, as supported by the higher cholesterol: phospholipid ratio in erythrocytes (P = 0.001). Also, membrane fluidity and rigidity were improved as supported by the decreased fluorescence anisotropies in the Hb-free erythrocyte membrane of pigs given synbiotic (P < 0.001). The administration of the synbiotic reduced plasma TAG, total cholesterol and LDL-cholesterol in hypercholesterolaemic pigs, possibly in the form of cholesteryl esters, via the interrelated pathways of lipid transporters (VLDL, LDL and HDL). The synbiotic also reduced deformation of erythrocytes via improved membrane fluidity and permeability.
This study is a result of an analysis of free and conjugated phytoestrogens daidzein, genistein, daidzin, genistin and coumesterol in human cord blood plasma using LCMS. Cord blood was collected from urban and rural populations of Malaysia (n=300) to establish a simple preliminary database on the levels of the analyzed compounds in the collected samples. The study also aimed to look at the levels of phytoestrogens in babies during birth as this may have a profound effect on the developmental process. The sample clean up was carried out by solid-phase extraction using C18 column and passed through DEAE sephadex gel before analysis by LCMS. The mean concentrations of total phytoestrogens were daidzein (1.4+/-2.9 ng/ml), genistein (3.7+/-2.8 ng/ml), daidzin (3.5+/-3.1 ng/ml), genistin (19.5+/-4.2 ng/ml) and coumesterol (3.3+/-3.3 ng/ml). Distribution of phytoestrogen was found to be higher in samples collected from rural areas compared to that of urban areas.