The use of lipase in hydrophilic solvent is usually hampered by inactivation. The solvent stability of a recombinant solvent stable lipase isolated from thermostable Bacillus sp. strain 42 (Lip 42), in DMSO and methanol were studied at different solvent-water compositions. The enzymatic activities were retained in up to 45% v/v solvent compositions. The near-UV CD spectra indicated that tertiary structures were perturbed at 60% v/v and above. Far-UV CD in methanol indicated the secondary structure in Lip 42 was retained throughout all solvent compositions. Fluorescence studies indicated formations of molten globules in solvent compositions of 60% v/v and above. The enzyme was able to retain its secondary structures in the presence of methanol; however, there was a general reduction in beta-sheet and an increase in alpha-helix contents. The H-bonding arrangements triggered in methanol and DMSO, respectively, caused different forms of tertiary structure perturbations on Lip 42, despite both showing partial denaturation with molten globule formations.
Consumption of probiotics has been associated with decreased risk of colon cancer and reported to have antimutagenic/ anti-carcinogenic properties. One possible mechanism for this effect involves physical binding of the mutagenic compounds, such as heterocyclic amines (HCAs), to the bacteria. Therefore, the objective of this study was to examine the binding capacity of bifidobacterial strains of human origin on mutagenic heterocyclic amines which are suspected to play a role in human cancers. In vitro binding of the mutagens Trp-p-2, IQ, MeIQx, 7,8DiMeIQx and PhIP by three bacterial strains in two media of different pH was analysed using high performance liquid chromatography. Bifidobacterium pseudocatenulatum G4 showed the highest decrease in the total HCAs content, followed by Bifidobacterium longum, and Escherichia coli. pH affects binding capacity; the highest binding was obtained at pH 6.8. Gram-positive tested strains were found to be consistently more effective than the gram-negative strain. There were significant decreases in the amount of HCAs in the presence of different cell concentrations of B. pseudocatenulatum G4; the highest decrease was detected at the concentration of 10(10) cfu/ml. The results showed that HCAs were able to bind with all bacterial strains tested in vitro, thus it may be possible to decrease their absorption by human intestine and increase their elimination via faeces.
The purpose of this study was to investigate the prevalence of body part symptoms and sources of injury/discomfort among workers in a car tyre service centre. Questionnaire survey and interview session were used to identify the level of body discomfort areas and sources of injury or discomfort. From questionnaire survey findings, 12 of respondents have body discomfort in the neck (66.7%%), shoulder (83.3%), elbow/forearm (75%), hand/wrist (91.7%), knee (58.3%), lower leg (75%), ankle/foot (33%) and lower back (30%). The main sources of injury/discomfort in the workplace were poor body posture (75%), bending the back (75%), highly repetitive motions (75%), lifting heavy objects (83.3%), the long-term standing (66.7%), long-term squatting (58.3%), bending the neck (66.7%) and high hand force (58.3%). About 50% reported that poor workplace design also contributed to injury while 41.7% mentioned the use of hand tools. To address modifying the ergonomic hazards, engineering controls and administrative controls can be used. The study will be useful to ergonomists, researchers, consultants, workshop managers, maintenance workers and others concerned with identifying body part symptoms and sources of injury/discomfort at the workplace.
Objective: To describe the association between childhood adversity and depression in adult depressed patients in a Malaysian population.
Methods: Fifty-two patients, who met the criteria for major depressive disorder or dysthymia according to the Structured Clinical Interview based on the revised 3rd edition of the Diagnostic and Statistical Manual of Mental Disorders, were used as cases and compared with 52 controls matched for age and sex. Cases and controls were assessed using a sexual and physical abuse questionnaire and a Parental Bonding Instrument.
Results: There was a positive relationship between childhood abuse in general and childhood physical abuse with adult depressive disorder in particular. Nearly a quarter (23%) of depressed patients reported being abused in childhood compared with none in the control group. There was no significant association between childhood loss and depression in adulthood. Low level of parental care during childhood was significantly correlated with adult depressive disorder.
Conclusion: Clinicians should assiduously seek a history of childhood adversities in adult patients with depression. This information can influence clinical management by way of implementing secondary preventive measures. In all depressed patients, mental health professionals also need to look out for their poor attachment with parents during childhood. This may enable interventions directed at parenting skills and improved attachment relationships with their own children. These types of interventions together
with pharmacotherapy may provide the optimal approach to the management of depression in adults and help prevent the cycle of depression perpetuating itself in the next generation.
Key words: Child abuse; Depression; Maternal behavior
The influence of two different stocking densities (0.20 m2/animal and 0.40 m2/animal) in transit under the hot, humid tropical conditions on heat shock protein (hsp) 70 induction was investigated in 60 Boer does. The animals were road transported for 3 h and the control group was kept under normal conditions in the farm. Irrespective of stocking density, transportation significantly increased hsp 70 densities (P < 0.05) in the kidneys. The hsp 70 response in the kidneys was more profound compared with those of heart tissues. Higher stocking density was more stressful to the goats based on hsp 70 expression. These results suggest that, irrespective of stocking density, transportation under hot, humid tropical conditions evoked hsp 70 reactions.
Study period: 1 February 2008 till 1 August 2008
Study participants: 110 type 2 diabetes patients, 40% male, 96% malay
Study design: Cross-sectional study
Questionnaire: Beck depression inventory II (BDI-II) in Malay version
Prevalence of depression: 22%
Study site: Outpatient clinic, Hospital Sik, Kedah, Malaysia
Mental foramen is an opening of the mental canal onto the lateral surface of the mandible. In this pilot radiographical study, in Malay population the effects of ageing towards the location and visibility of the mental foramen were determined. Most of the mental foramina were found to be located inferior to the apex of the second premolar. Non-visibility of the foramen was greatly increased in patients aged 50 years and above (Pearson Chi-square; p = 0.00). This finding may provide a guide to dental surgeries in Malay patients of different age groups.
Any foreign body in the paranasal sinuses can cause chronic complications. It is therefore important to remove these foreign bodies meticulously. Various approaches are available to accomplish this. This article is a case report of a patient who had gutta-percha as a foreign body in left maxillary sinus, after a gutta-percha point had been used to trace a sinus to confirm that it was an oroantral fistula. Traditional surgical approaches to the maxillary sinus require invasive techniques, such as radical antrostomy and the Caldwell-Luc approach. These may result in further complications and morbidity. The gutta-percha point in this case report was removed endoscopically in an otolaryngology clinic with local anaesthesia using a sublabial antroscopy. There is only one case reported in the dental literature regarding the endoscopically-assisted technique for removal of displaced gutta-percha using the sublabial antroscopy approach (Yura S, Ohga N, Ooi K, Izumiyama Y. Procedure of endoscopic removal of a gutta-percha point in maxillary sinus mucosa by ultrathin arthroscope.
Study site: ENT clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Primary gastrointestinal (GIT) lymphoma constitutes only 5 - 10% of all gastrointestinal tumours. The optimal therapy for these lymphomas is poorly defined and still controversial. We present our experience in the treatment and outcome of primary GIT lymphomas in UKM Medical Center, Malaysia. A retrospective review of all patients with primary GIT lymphoma from the year 2002 until 2007 was done. Our series has shown that primary GIT lymphoma is a rare disease as it comprises only 6.5% of all lymphomas treated in this institution. We had a female predominance of this disease with a large majority at an advanced stage of the disease. There was equal distribution involving stomach, small and large intestines. The incidence of primary GIT lymphomas was 6.5% with a female predominance. The majority had advanced diseases (stage III and IV) with equal distribution involving the stomach, small and large intestines. The most common histological variant was diffuse large B cell lymphoma (66%). Most (83%) patients with intestinal lymphoma had surgical resection and adjuvant chemotherapy. All patients with gastric lymphomas had chemotherapy alone. The mortality rate was 22% predominantly in younger patients with aggressive histology subtypes and advanced disease.
Onodi cell is a posterior ethmoid air cell that pneumatizes into the sphenoid sinus, It is an important entity for clinicians when performing endoscopic sinus surgery (EES) because it encroaches into the optic nerve and internal carotid artery. CT-scans are the road map for ESS to prevent damage to structures mentioned above. Its prevalence in Malaysia is unknown.
A cross-sectional study on organizational factors that influences job stress was carried out among Medical Laboratory Technologists (MLT) in Klang Valley's Hospitals. There were three organizational factors that were measured, interpersonal factor, job condition and career development. A total of 249 respondents participated in this study, 126 were from the private hospitals and 123 from the government hospitals. The prevalence of stress was found higher in the private hospitals with the percentage of 16.7% compared to the government hospitals of 15.4%. All three organizational factors were significantly associated with job stress (interpersonal factor p <0.001, job condition p<0.001 and career development p < 0.001). Management team in hospitals as well as the laboratory managers should introduce stress prevention programmes to assist MLTs in stress management.
Chronic rhinosinusitis (CRS) remains a prevalent disease and a major cause of morbidity for many patients and functional endoscopic sinus surgery (FESS) is the gold standard for the treatment of CRS. Many factors contribute to the development of CRS, among others nasal anatomic variation. The authors aim to study the association of concha bullosa and deviated nasal septum with CRS patients requiring FESS amongst the diversified multiethnic Malaysian race. The records of 137 patients with CRS who had undergone FESS between March 2002 and October 2006 at the Department of Otorhinolaryngology, Head and Neck Surgery of the Hospital Universiti Kebangsaan Malaysia (HUKM), Kuala Lumpur were retrospectively reviewed. The data revealed that deviated nasal septum (DNS) and concha bullosa (CB) were the two commonest anatomical variations in the nasal cavity. In this study, CB was statistically significant amongst the females and in the Chinese and Indian ethnic groups. DNS is also prevalent but has no significant statistical relationship with sex, age, ethnic group in the local context. CB and DNS are coincidental variations and this study disprove that DNS is associated with CB in its development and pathogenesis of CRS. The mere presence of both these conditions also does not predispose the patients to CRS in the adjacent paranasal sinuses.
BACKGROUND: Psoriasis is a complex chronic inflammatory skin disease with a worldwide distribution.
OBJECTIVE: To determine the prevalence of psoriasis according to age, gender and ethnicity among outpatients attending the dermatology clinic in Hospital Tengku Ampuan Rahimah, Klang Malaysia.
STUDY POPULATION: All outpatients attending the specialist clinic of the dermatology department in Hospital Tengku Ampuan Rahimah, Klang, Malaysia from January 2003 to December 2005.
METHODS: This is a retrospective descriptive study of all outpatients who attended the specialist clinic from January 2003 to December 2005 and diagnosed for psoriasis. The study population consisted of patients of all ages, both gender and different ethnic groups (Malay, Chinese, Indians and foreign workers) living in the Klang Valley and the surrounding areas.
RESULTS: A total of 5607 patients were examined during a period of three years and 9.5% were found to be suffering with psoriasis. It was more common in males (11.6%) than in females (7.2%). Patients within the 40-60 year age group had the highest (17.2%) rate and were lower in the younger age group including those aged over 60 years (8.1%). With regards to ethnicity, it was more common in Indians followed by Malays, Chinese and migrant foreign workers respectively. The study indicates that psoriasis is common in Malaysia and its distribution varies with age, ethnicity and gender.
Study site: dermatology department in Hospital Tengku Ampuan Rahimah,
Arterial stiffness is an index of vascular health; normal pregnancy is associated with reduced arterial stiffness. This cross sectional study compared arterial stiffness in older (≥35 years) and the younger (≤34 years) age groups of pregnant women. Arterial stiffness was assessed noninvasively in 66 pregnant women between 23 - 32 weeks gestation (41 women ≤ 34 years, 25 women ≥ 35 years) using the parameters pulse wave analysis and pulse wave velocity. Blood pressure (BP), body mass index (BMI), serum total cholesterol (TC) and fasting blood glucose (FBS) were also recorded. Mean ages of the younger and older age groups were 27.6±0.62 and 39.3±0.58 years; no significant difference was seen between the groups in their BMI, TC, FBS, SBP, DBP and gestational age. The older age group of women have increased arterial stiffness (augmentation index 19.4±1.9% vs 13.2±1.6%, p=0.015) and aortic stiffness (pulse wave velocity 8.7±0.3 vs 7.7±0.2 m/s, p=0.004) compared to the younger women. Linear regression analysis showed a positive significant correlation between age and augmentation index (R=0.278, p=0.026), and pulse wave velocity (R=0.350, p=0.004). We conclude that older pregnant women has increased arterial stiffness compared to a younger age group of pregnant women suggesting that vascular changes due to ageing occurs in pregnancy despite cardiovascular adaptations occurring in pregnancy.
MeSH terms: Blood Pressure; Cross-Sectional Studies; Female; Humans; Pregnancy; Body Mass Index; Vascular Stiffness*; Pulse Wave Analysis*
Full field digital mammography (FFDM) has been progressively introduced in medical centers in recent years. However, it is questionable which exposure parameters are suitable in order to reduce the glandular breast doses as they are related to induced carcinogenesis. The goal of this study was to compare the average glandular doses (AGD) and image quality of three FFDM systems namely Siemens Mammomat NovationDR, Hologic Lorad Selenia and General Electric Senographe Essential using a Figure of Merit. A Computerized Imaging Reference Systems (CIRS) tissue equivalent breast phantom which consists of phototimer compensation plate with different thickness and glandularity was exposed in fully automatic exposure control mode in the cranio-caudal projection similar to clinical settings. Thermoluminescent dosimeter 100H (TLD- 100H) was used to measure the entrance surface air kerma (ESAK), the AGD was calculated using European protocol whilst the image quality was assessed quantitatively by measuring the contrast to noise ratio (CNR) value. The obtained values were used to calculate the Figure of Merit (FOM) to analyze the effectiveness of the system. Repeated Measures ANOVA analysis showed that there is a significant difference (p<0.05) in the mean value of AGD and CNR between the three FFDM systems. Hologic Lorad Selenia system contrbuted the highest AGD value while General Electric Senographe Essential had the highest CNR and FOM value. In conclusion, this study may provide an objective criterion during the selection of a mammography unit by using the figure of merit for screening or diagnostic purpose.
This article describes the completed suicide patterns which occurred in the Timur Laut district of Penang Island, Malaysia. In a prospective cohort study over the three years period (2007-2009) there were 138 cases of suicide deaths. The number of suicide deaths for the year 2007, 2008 and 2009 were 45, 41 and 52 deaths, respectively. Majority of the suicide deaths were by jumping from height (47.1%), followed by hanging (34.1%) and by drowning (10.9%). The male victims outnumbered females in a 3 : 1 ratio.
Rotavirus vaccine is available as an optional vaccine in Malaysia. The counselling of optional vaccines is considered an integral part of the health services offered in a private paediatric clinic. While ensuring that all babies are up-todate with their compulsory immunization, counselling of optional vaccines like the rotavirus vaccine could give parents the choice to make an informed decision on the acceptance of this vaccine. Over a period of two years, we counselled the parents regarding diarrhoea caused by rotavirus disease and the rotavirus vaccine. In this study, the factors that were significantly associated with the acceptance of the rotavirus vaccine were the gender of the baby, the mother's age, the mother's occupation, the mode of payment for the vaccine, the number of previous visits to the clinic by the parents, the number of counselling sessions given to the parents and the pre-counselling awareness or knowledge of rotavirus disease and rotavirus vaccine. It is hoped that these findings may assist busy clinicians in their continuous efforts to provide health education and vaccination counselling to the parents of their patients.
This study was done to evaluate various DNA and RNA extractions from archival FFPE tissues. A total of 30 FFPE blocks from the years of 2004 to 2006 were assessed with each modified and adapted method. Extraction protocols evaluated include the modified enzymatic extraction method (Method A), Chelex-100 extraction method (Method B), heat-induced retrieval in alkaline solution extraction method (Methods C and D) and one commercial FFPE DNA Extraction kit (Qiagen, Crawley, UK). For RNA extraction, 2 extraction protocols were evaluated including the enzymatic extraction method (Method 1), and Chelex-100 RNA extraction method (Method 2). Results show that the modified enzymatic extraction method (Method A) is an efficient DNA extraction protocol, while for RNA extraction, the enzymatic method (Method 1) and the Chelex-100 RNA extraction method (Method 2) are equally efficient RNA extraction protocols.
Adult-onset dermatomyositis has been found to be associated with underlying malignancies in up to 40% of patients. The aims of this study were to determine the demographic profile, the underlying cancer and outcome in patients with dermatomyositis. This was a retrospective review of 38 patients with dermatomyositis seen over a 12-year period in the Department of Dermatology, Kuala Lumpur Hospital. Of these, 18 (47.4%) had an associated underlying malignancy. The male to female ratio was 2:1. Ten patients (55.6%) were Chinese. The youngest patient encountered was 32 years old. Nasopharyngeal carcinoma (61.1%) was the most common malignancy in our study population. Tumour markers were not useful as the initial screening for malignancies. Thorough screening for malignancy is imperative in adult dermatomyositis especially those above 40 years old.