A study was conducted at Greentown Health Clinic, Ipoh to assess and classify asthma by levels of control based on the Global Initiative for Asthma (GINA). The secondary objective was to identify those patients whose control was suboptimal. A total of 102 patients were included in this study based on random sampling between 25th April 2008 and 6th June 2008. Standard Asthma Control Questionnaires were used to classify asthma and levels of control. Baseline Peak Expiratory Flow Rate (PEFR) measurements and PEFR at audit visits were also recorded. All data were analysed using SPSS version 13. The study showed that only 39.2 % of the patients were classified as having controlled asthma, 34.3 % had asthma that was partly controlled and 26.5 % of the patients had uncontrolled asthma. Among those patients who had inadequate asthma control, more than half of them had nocturnal attacks and exacerbations. These findings demonstrate the need by the attending doctor to improve assessment of the patient’s control of asthma by actively questioning the patients and subsequently improving management to achieve optimal control of asthma.
Study site: Klinik Kesihatan Greentown, Ipoh, Perak, Malaysia
MeSH terms: Adult; Ambulatory Care Facilities; Asthma; China/ethnology; Cross-Sectional Studies; Female; Humans; India/ethnology; Malaysia; Malaysia/ethnology; Male; Medical Audit*; Peak Expiratory Flow Rate; Surveys and Questionnaires; Disease Management
Caregivers may experience the need for information, social support, a range of services and financial support in caring for children with disabilities. However, some of these needs are unmet. This study aims to determine the perceived unmet needs among caregivers of children with disabilities at the Community-based Rehabilitation centre (CBR). A cross-sectional study was carried out among a total of 337 caregivers, who were recruited from 12 CBR centres in Selangor. The unmet needs were assessed using Family Needs Survey (FNS) questionnaire, which included six subscales of needs such as need for information, social support, community services, explaining to others, financial support and family functioning. Caregivers identified the need for information that the child might receive in the future as their greatest need (94.4%) and the least was the need for getting more counseling or help in getting a job (16.3%). The mean score for the overall unmet needs was 18.67 (SD=7.623). Out of six subscales of FNS, the need for information had the highest rating which was 98.3%, followed by need for social support (93.4%), need for community services (84.0%), need for financial support (79.9%), need for family functioning (61.8%) and need for explaining to others (46.2%). The unmet needs varied within the subscales. Therefore, more effective intervention programs are needed in community-based rehabilitation centres to match or reduce those varied unmet needs in order to allow caregivers to provide better care for their children with disabilities.
MeSH terms: Child; Counseling; Cross-Sectional Studies; Financial Support; Humans; Malaysia; Surveys and Questionnaires; Rehabilitation Centers; Social Support; Social Welfare; Caregivers; Disabled Children
Cognitive Impairment is common in late life and may be due to the normal process of ageing, or associated with physical or mental disorder which contributes to a decrease in quality of life, neuropsychiatric symptoms, increased disability and increased healthcare cost. The aim of this study is to determine the prevalence of cognitive impairment among the elderly members in NACSCOM in Day Care Centres within the Klang Valley and its associated socio-demographic factors such as age, gender and educational level. This cross-sectional study was conducted on 101 members of NACSCOM in Day Care Centres of Damansara,Subang Jaya and Setapak using assisted questionnaires as the research tool. The questionnaire comprising of a total of 10 questions based on Elderly Cognitive Assessment Questionnaires (ECAQ), consisted of three parts, memory, orientation and recall. One correctly answered question earned the respondent one mark. The total score for ECAQ is 10 where respondents with scores of 5 and below were identified as having cognitive impairment. Data collected was analyzed using Chi-square test (SPSS version 18). The prevalence of cognitive impairment among the elderly members of NACSCOM in Day Care Centres within the Klang Valley was 4.0%. This study also showed that there was no statistically significant association between cognitive impairment and sociodemographic factors such as age, gender and education. Prevalence of cognitive impairment among the members of NACSCOM in Day Care Centres within the Klang Valley was found to be low. This could be attributed to the fact that members actively participated in activities organized by NACSCOM. The study also did not find any statistically significant association between cognitive impairment and age, gender and education.
MeSH terms: Aged; Cognition; Cognition Disorders; Cross-Sectional Studies; Day Care, Medical; Humans; Memory; Quality of Life; Surveys and Questionnaires; Geriatric Assessment; Prevalence; Health Care Costs
The maternal health status of Orang Asli women in Malaysia was noted to be lower as compared to other groups of population in the country. This study aimed to determine the level of knowledge, attitude and practice on antenatal care, which is a vital component of maternal health among the Orang Asli women in three Orang Asli villages in Jempol District, Negeri Sembilan. All women aged between 15 to 49 years old who had at least one antenatal experience were interviewed using a structured, pretested questionnaire. A total of 104 women were interviewed. Among them, 92.3% admitted attending antenatal clinic during their previous pregnancies while only 48.1% came early for their first check-up. About 70% of the women had history of home delivery and 44.2% had experienced at least one high risk pregnancy before. Study revealed that 44.2% (95% CI, 34.7 – 53.7%) of the women have good knowledge regarding antenatal care while 53.8% (95% CI, 44.3 – 63.1%) of them noted to have positive attitude regarding antenatal care. However, result showed that the level of knowledge regarding the importance of early antenatal care, screening test and complications of diabetes and hypertension in pregnancy were poor. In conclusion, the rate of home delivery and late antenatal booking was still high among the Orang Asli women and it is significantly associated with their attitude regarding antenatal care. These findings can be used to plan a customized health intervention program aiming to improve the maternal health practices and eventually improve the health status of the Orang Asli women
Study site: Orang Asli village, Jempol, Negeri Sembilan, Malaysia
MeSH terms: Maternal Health; Adult; Diabetes Mellitus; Female; Health Status; Health Surveys; Humans; Hypertension; Malaysia; Pregnancy; Prenatal Care; Surveys and Questionnaires; Rural Population; Pregnancy, High-Risk; Gravidity
Impact of health care on the population health has been measured in terms of morbidity and mortality but this measurement doesn’t distinguish between children, adults and the elderly. It does not also take into account the losses that occur because of handicap, pain, or other disability. Therefore, measures of population health which combine information on mortality and non-fatal healthboutcomes to represent the health of a particular population as a single number was introduced. QALYs and DALYs are both common outcome measures in economic evaluations of health interventions. QALYs is the comprehensive measure of health outcome because it can simultaneously capture gains from reduced morbidity (quality gains) and reduced mortality (quantity gains) and combine these into a single measure. DALYs is primarily a measure of disease burden where it combines losses from premature death and loss of healthy life resulting from disability. Although QALYs and DALYs are almost similar in their basic concept but there are few distinct differences which must be paid attention to in order to correctly utilize these measures.
Adolescents who overestimate the prevalence of smoking among their peers or other teens are at higher risk to take up smoking. The purpose of this study is to elucidate the factors which are related to adolescents’ overestimation of smoking. We surveyed form four (16 years old) students in Petaling District, Selangor. A sample was selected using two-stage stratified sampling, and data were collected using standardised, self-administered questionnaires. A response rate of 80.4% (n=1045/1298) was obtained, and a total of 943 students were included in the final analysis. About 73 percent (n=688/943) of the respondents overestimated the prevalence of smoking among their peers. The odds of overestimating increased as the number of close friends who smoke increased [Two close friends, OR=3.10(1.67-5.75), three close friends OR=10.81(4.44-26.3) and four-five close friends OR= 12.91(5.31-31.43)]. Those who had an elder brother who smoked (OR=1.95 (1.18-3.24)) and females [2.08(1.37-3.33) were more likely to overestimate peer smoking prevalence. Intervention programmes to correct the misperception of peer smoking prevalence are recommended, in addition to measures to modify the other factors that are amenable to intervention, so as to reduce the risk of smoking initiation among adolescents.
This study was conducted to determine the proportion and factors associated with periodontal disease among younger adult attended Al Fatah Dental Faculty in Libya. A cross sectional study with universal sampling methods was carried out from July 2010 until September 2010 among 70 Libyan subjects aged between 20-35 years. The data in this study was collected using self administrated questionnaire, followed by oral examination done by trained dentists. The results of this study showed that, the prevalence of periodontal disease in Libyan subjects was 75.7%. Gender, oral care habits, smoking were found significantly associated with presence of periodontal disease. Gingivitis has been found the most common types of periodontal disease (94%). High percentage of periodontal disease in this study was among men (87.9%) compared to women (69.9%). In conclusion, modifiable factors like changing lifestyle such as avoiding smoking and practicing oral care can be promoted to prevent periodontitis.
Molecular pathogenesis of chronic myeloid leukemia (CML) is well established and molecular
monitoring for patients with CML has become an important practice in the management of patients
on imatinib therapy. In the present study, we report the use of RQ-PCR method for detection of
BCR-ABL fusion gene for our CML cases. We performed a two-step RQ-PCR on bone marrow
aspirates or peripheral blood of 37 CML patients. Quantitative expression of BCR-ABL fusion
gene was carried out relative to the expression of a housekeeping gene as endogenous control to
compensate for uneven cell numbers, RNA quality, or variations in reverse transcription effi ciencies. Twenty-four of these patients were pre-treated with hydroxyurea or alpha interferon prior to the imatinib therapy. Their BCR-ABL fusion gene levels were monitored for 18 months. All samples processed were evaluable. The PCR amplifi cation effi ciency of the ABL gene is 90.5% (0.2158) and the BCR-ABL gene, 93.4% (0.1573).
On integration into the host cervical keratinocyte genome, human papillomavirus (HPV) E7 protein
binds pRB, releasing E2F from normally incompetent pRB-E2F complexes and allowing propagation
of G1-S transition by the E2F. p16 INK4a, a tumour suppressor protein, increases in reflex response to counter this. 29 histologically re-confi rmed low-grade squamous intraepithelial lesions (LSIL), 27 high-grade squamous intraepithelial lesions (HSIL) and 30 invasive cervical squamous carcinoma (SCC) were immunohistochemically stained for p16INK4a expression using the CINtec Histology Kit (REF 9511, mtm laboratories AG, Heidelberg, Germany) to re-affi rm the notion that integration of HPV occurs predominantly in SCC and possibly HSIL and less in LSIL and normal squamous epithelium (NSqE). Implicit was also the attempt to understand the role of E2F, as indicated by p16INK4a, in evolution of SCC from HSIL. No ethnic predilection was noted for LSIL, HSIL or SCC. Patients with SCC were signifi cantly older by about 14-years compared with HSIL (p
Since the discovery of the double-helical structure of DNA, genetic regulation of gene expression has been well elucidated. More recently, another equally, if not more, important scheme of regulation of gene expression, called epigenetics, has emerged to explain the many biological observations that traditional genetic mechanisms have failed to decipher. Epigenetics is a discipline of study on the biological consequences of cellular alterations that do not involve nucleotide changes, as opposed to genetic mutations. Epigenetic changes are reversible and may lead to loss or gain of biological functions. The three most reported mechanisms of epigenetic regulation of gene expression involve changes in: (i) chromatin remodelling, (ii) DNA methylation and (iii) microRNA (miRNA). More importantly, many of the elucidated epigenetic changes are linked to the pathogenesis of human diseases and cancers. In this mini review, core concepts and basic experimental approaches in the study of epigenetic regulation of gene expression are briefl y reviewed in relation to disease, with emphasis on cancer. This mini review also intends to highlight the fact that, besides genetics, epigenetics is now a discipline physicians and clinical research scientists can no longer ignore in their pursuit to understand disease and cancer and to develop new therapeutic strategies for treatment.
Per rectal bleeding is one of the most common presenting features reported in the surgical outpatient
clinic as well as emergency department. Although underlying causes for per rectal bleeding are
mainly surgical in nature, infective causes should not be forgotten. Infection by Entamoeba histolytica occurs worldwide but is more common in areas of poor sanitation and nutrition especially in the tropics. The infection may remain asymptomatic, however in invasive cases it may cause morbidity and mortality. We report two cases of adults presenting with per rectal bleeding where the diagnosis of amoebic colitis was made only upon histopathological examination.
A prospective study was carried out to evaluate the sensitivity of dengue NS1 antigen-capture ELISA in comparison with dengue virus isolation, conventional RT-PCR and real-time RT-PCR for laboratory confi rmation of acute dengue based on single-acute serum samples. Four primary healthcare centres were involved to recruit patients with clinical diagnosis of dengue illness. Patient’s demographic, epidemiological and clinical information were collected on a standardized data entry form and 5 ml of venous blood was collected upon consent. In the laboratory, six types of laboratory tests were performed on each of the collected acute serum sample. Of the 558 acute serum samples collected from 558 patients with clinical diagnosis of dengue from mid-August 2006 to March 2009, 174 serum samples were tested positive by the dengue NS1 antigen-capture ELISA, 77 by virus isolation, 92 by RT-PCR and 112 by real-time RT-PCR. A total of 190 serum samples were tested positive by either one or a combination of the four methods whereas, only 59 serum samples were tested positive by all four methods. Thus, based on singleacute serum samples, 190 of the 558 patients (34.1%) were laboratory-confi rmed acute dengue. The overall test sensitivity was 91.6%, 40.5%, 48.4% and 58.9% for dengue NS1 antigen-capture ELISA, virus isolation, conventional RT-PCR and real-time RT-PCR respectively. Statistically, dengue NS1 antigen-capture ELISA was the most sensitive and virus isolation was the least sensitive test for the laboratory confi rmation of acute dengue based on single-acute serum specimens. Real-time RT-PCR was signifi cantly more sensitive than the conventional RT-PCR.
Malaysia has adopted various strategies in developing its space sector. Indigenous space technologies would enable a sustainable growth of the space field and at the same time develop the strategic space technologies. Therefore, issues related to the current space research level are fundamentally crucial to be highlighted. Subsequently, the space focus areas can be derived in order to meet the expectations of the national and international space technology growth requirements, which are moving on to a stronger posture in R&D. In the absence of a strong R&D national space industry leadership, the Malaysian space sector remains in a traditional downstream mode of the world space technology supply chain ever since. The space technology supply chain can be divided into the ground segment and the space segment. This paper examines the current space research activities in Malaysia within the framework of the space technology supply chain. As a result, a preliminary gap in the overview of space research in Malaysia is established.
The effects of anticipated climate change and the potential impact on animal production are discussed in the context of varying biophysical features, agro-ecological zones (AEZs), ecosystems, land use, and responses in animal genetic diversity and production. The AEZs in Asia have great diversity in their links to food production in crop-animal small farm systems, the poverty complex and livelihoods of the poor. In these environments. climate change effects on animals were mediated through heat stress, water availability, quantity and quality of the available feed resources, type of production system and productivity. The responses to heat stress are tabulated and they vary according to species, breeds within-species, AEZs, physiological and nutritional status, genetic potential and multifunctionality. Among ruminant production systems, dairy production was especially vulnerable to heat stress. Interestingly in India, buffalo numbers owned largely by the landless and small farmers in the semi-arid and arid regions have grown twice as fast as the buffalo population in the irrigated areas. The implications and strategies to cope with climate change involve mitigation, adaptation and policy. The principal strategy is targetting to the reduce on in greenhouse gas (GHG) emission from the agricultural sector from enteric fermentation and manure, and ways to intensify C sequestration. An important link is that of breeding and conserving indigenous animal genetic resources as a means to mitigate climate change, with associated benefits to the trade of live animals and animal products. Improved integrated tree crops-ruminant systems are an important pathway to enhance C sequestration. The opportunities for research and development (R&D) are enormous and they would need policy support and large investments to provide improved understanding of ways to ensure sustainable animal production systems. Coping with the totality of the effects and impact of climate change constitutes the challenges for agricultural R&D and the improved livelihood of the resource-poor in the future.
Almost a half century after it was introduced, Wilks’ statistic has come into application in industrial manufacturing process variability monitoring. This is an important breakthrough in the way experts monitor the variability of manufacturing processes which is vital in modern industry. It leaves behind the traditional practice characterized by the use of sample size n which equals 1, if the process variability monitoring is based on individual observations and is greater than the number of variables p if one works with subgroup observations. The use of Wilks’ statistic allows us to work with n < p. This paper contains a review on process variability monitoring based on individual observations. First, some historical backgrounds of process variability monitoring in the general scheme was reviewed before it was revealed where the philosophy of Wilks’ statistic could be further interpreted. Subsequently it was indicated that the way to monitor the process variability depended on how the variability itself was measured. Finally, a new statistic for detecting the shift in variability based on individual observations was introduced and then a new control chart was proposed. The performance of the proposed chart as compared with Wilks chart, was quite promising. Therefore, some recommendations were given to better understand the history of manufacturing process variability.
MeSH terms: Commerce; Industry; Paper; Research Design; Sample Size
Reflex epilepsy is usually induced by external stimulation, photosensitive epilepsy being the most common. Epilepsy induced by auditory stimulation is rarely studied. There are no currently published magnetoencephalographic (MEG) studies demonstrating the initiation of epileptic neuronal discharges by repeated auditory stimulations in temporal lobe epilepsy (TLE) patients. We retrospectively studied one TLE patient who underwent a MEG study to localize her epileptic focus. Auditory, somatosensory, visual and motor evoked potential studies were performed during the MEG recording. A single dipole method calculated equivalent current dipoles to localize the epileptic source. The least-squares minimization method was used to obtain the optimal solution with goodness-of-fit of greater than 80%. Periodic lateralized epileptiform discharges (PLEDs) were recorded in the temporal region when repeated auditory stimulations were done. We postulated that neuronal cortical suppression occurred during repeated stimulations which provoked epileptiform discharges (PLEDs) without any physical symptoms or aura. It was concluded that repeated stimulations could facilitate epileptiform discharges in focal area/areas in certain subjects.
Lead-free solder paste printing processes account for the majority of assembly defects in the electronic manufacturing industry. In the stencil printing process, the solder paste must be able to withstand low and high shear rates which result in continuous structural breakdown and build-up. This study investigated the effect of the addition of nickel and platinum powders to the thixotropic behaviour of lead-free Sn/Ag/Cu solder pastes using the structural kinetic model. A hysteresis loop test and constant shear test were utilized to investigate the thixotropic behaviour of the pastes using parallel plate rheometry at 25ºC. In this study, the shear rates were increased from 0.01 s–1 to 10 s–1 and the second curve was a result of decreasing the shear rate from 10 s–1 to 0.01 s–1. For the constant shear test, the samples were subjected to five different shear rates of 0.01s–1, 0.1s–1, 1s–1, 10s–1 and 100s–1. The constant shear rate test was designed to study the structural breakdown and build-up of the paste materials. From this investigation, the hysteresis loop test was shown to be an effective test method to differentiate the extent of structural recovery in the solder pastes. All the pastes showed a high degree of shear thinning behaviour with time. This might be due to the agglomeration of particles in the flux that prohibited paste flow under low shear rate. The action of high shear rate would break the agglomerates into smaller pieces which facilitated the flow of pastes, thus viscosity was reduced at high shear rate.
A study to determine the impact of leachate from operating and closed landfills into the surface water and groundwater systems in the state of Selangor was conducted in the year 2009. Groundwater was a major source of water for various uses in Selangor, Malaysia and was especially important for industrial purposes. The presence of high numbers of landfill sites was seen to have increased the risk of groundwater contamination. There were 20 landfill sites in the state of Selangor and seven of them were still operating and 13 closed. The landfills are classified into four categories, which were: (a) landfills operating at critical stages without controls to prevent pollution into the environment; (b) open dumpsites that have the capacity to continue to accept waste but needed to be upgraded to manage leachate and gas; (c) landfills that were closed but no safety closure plan was carried out; and (d) engineered landfills with up to date technologies. As most of the landfills were built prior to 1989, they were not subjected to the Environmental Impact Assessment requirements, hence, they were being poorly managed and were badly sited. The non-engineered sites had no proper pollution controls such as cover materials, liner materials, groundwater monitoring wells, leachate collection ponds and treatment, and methane gas collection pipes. This study revealed that the surface water and groundwater at and nearby the landfill sites were contaminated at various levels due to the landfill sites and operation. A comparison between the current quality of surface water and groundwater with their respective standards and background levels was carried out to survey the trend of the contamination. However, the limited financial resources hindered a very thorough investigation and restricted the number of samples collected and parameters analysed.
MeSH terms: Malaysia; Methane; Surveys and Questionnaires; Water; Groundwater; Water Wells; Ponds; Waste Disposal Facilities
The functionalization of pristine CNTs is necessary for carbon nanotubes (CNTs) to be fully utilized, with the aim of increasing the nanotube reactivity and solubility in aqueous solutions. In this study, multi-walled carbon nanotubes (MWCNTs) were functionalized with a carboxylic group as this was an important step prior to application. The carboxylic group-functionalization was conducted through acid treatment, using sulphuric and nitric acids mixed at a ratio of 3:1 (v/v) and sonication for 30 min under different temperatures and time durations. The functionalization conditions of 50ºC x 5 h and 60ºC x 3 h were identified to be most suitable for introducing a carboxylic group onto the nanotube surfaces. The percentage of total weight loss due to the carboxylic group on the MWCNTs treated at 50ºC x 5 h and 60ºC x 3 h obtained from the thermogravimetric analysis was 13.26% and 13.76%, respectively. For both samples, peaks corresponding to the carboxylic group were identified in the FT-IR spectra. The changes in the morphology of the treated MWCNTs were also observed under SEM analysis.
Awareness and sensitivity on the subject of green technology are currently commanding the attention of the world in the light of rising energy costs and the threat of global warming. Many countries are now recognizing the benefits of researching into and using green technology to reduce their carbon and water footprints and to minimize waste. (Copied from article).