Introduction: Streptococcus pneumoniae is an important bacterial pathogen, causing respiratory infection. Penicillin resistance in S. pneumoniae is associated with alterations in the penicillin binding proteins, while resistance to macrolides is conferred either by the modification of the ribosomal target site or efflux mechanism. This study aimed to characterize S. pneumoniae and its antibiotic resistance genes using 2 sets of multiplex PCRs. Methods: A quintuplex and triplex PCR was used to characterize the pbp1A, ermB, gyrA, ply, and the mefE genes. Fifty-eight penicillin sensitive strains (PSSP), 36 penicillin intermediate strains (PISP) and 26 penicillin resistance strains (PRSP) were used. Results: Alteration in pbp1A was only observed in PISP and PRSP strains, while PCR amplification of the ermB or mefE was observed only in strains with reduced susceptibility to erythromycin. The assay was found to be sensitive as simulated blood cultures showed the lowest level of detection to be 10cfu. Conclusions: As predicted, the assay was able to differentiate penicillin susceptible from the non-susceptible strains based on the detection of the pbp1A gene, which correlated with the MIC value of the strains.
Hypertrophic cardiomyopathy (HCM) is a global disease affecting people of various ethnic origins and both genders. HCM is a genetic disorder with a wide range of symptoms, including the catastrophic presentation of sudden cardiac death. Proper diagnosis and treatment of this disorder can relieve symptoms and prolong life. Non-invasive imaging is essential in diagnosing HCM. We present a review to deliberate the potential use of cardiac magnetic resonance (CMR) imaging in HCM assessment and also identify the risk factors entailed with risk stratification of HCM based on Magnetic Resonance Imaging (MRI).
MeSH terms: Cardiomyopathy, Hypertrophic; Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy; Risk Factors; Death, Sudden, Cardiac
A 36-year-old man with underlying chronic lymphocytic leukemia had left arm swelling for a duration of 3 months. Clinically, the affected arm was swollen, erythematous and tender. Epicoccum nigrum was isolated from the culture of the tissue that was obtained intraoperatively. He was treated and responded to voriconazole therapy. To the best of our knowledge, this is the first case of intramuscular abscess as a result of E. nigrum infection in an immunocompromised patient.
Intramuscular shoulder angiomyolipomas are very rare. We report a case in a 22-year-old male with a well circumscribed lesion located on the back of the shoulder. This lesion, differs from renal angiomyolipoma in terms of non-association with tuberous sclerosis, circumscription and male predominance. Another characteristic feature is the absence of epithelioid cells. Differential diagnosis includes lipoma, angiolipoma, angioleiomyoma, hemangioma, myolipoma and liposarcoma. It is distinguished from the above mentioned entities by the presence of a combination of thick-walled blood vessels, smooth muscle and fat.
Delayed neuropsychiatric sequelae is an important condition which commonly occur during recovery from acute carbon monoxide poisoning. Typical presentation would be apathy, disorientation, amnesia, hypokinesia, bizarre behavior, insomnia and neurological manifestations such as gait disturbance, hypertonia and tremor. We report here a case of a man presented with delayed neuropsychiatric sequelae one month after the carbon monoxide poisoning in his suicidal attempt. He presented with the typical presentation and diagnosis confirmed with the MRI findings. His MRI showed abnormal signal in subcortical hemisphere white matter of both temporo-fronto-parietal-occipital regions along the insula and both globus pallidus. He was treated with Olanzapine, Fluvoxamine, Chlorpromazine and Levodopa and his condition slowly improved. It is important for clinicians to recognize the symptoms and risk factors to develop delayed neuropsychiatric sequelae in patients who previously had carbon monoxide poisoning.
Introduction: Little is known about anxiety symptoms among diabetic patients, especially among those who are living in rural areas in Malaysia. Thus, the aim of this paper is to investigate the prevalence of anxiety among diabetic patients and factors associated with anxiety in rural communities in Malaysia.
Methods: A cross-sectional study involving 464 diabetes mellitus patients in rural health districts and outpatient clinics in Malaysia was conducted. Each participant was interviewed using the Hospital Anxiety and Depression Scale.
Results: Respondents consisted of 193 (41.6%) males and 271 (58.4%) females. The mean age of participants was 59.65 ± 10.16 years and the mean duration of diabetes mellitus was 6.9 ± 6.3 years. Results indicate that 15% of the participants have anxiety symptoms. Multiple logistic regression analysis revealed that patients with history of ischemic heart disease and depression and those who were underweight have higher anxiety scores with adjusted OR 5.06 (95% CI 1.79 to 14.27), 27.71 (95% CI 14.23 to 53.98) and 14.6 (95% CI 2.49 to 84.82), respectively.
Conclusions: This study suggests that although the prevalence of anxiety among diabetics is low, primary care physician should be trained to identify high risk patients and to manage their condition in order to improve the clinical outcome.
MeSH terms: Adult; Ambulatory Care Facilities; Anxiety; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Humans; Malaysia; Rural Population; Prevalence
To determine the prevalence of depression and its relationship with health related quality of life among prostate cancer patients in tertiary medical centres, Kuala Lumpur.
The role of virgin coconut oil in the treatment of allergic rhinitis is controversial.
Thus, the aim of the present study is to determine the effects of virgin coconut oil ingestion, in
addition to standard medications, on allergic rhinitis. We also studied the side effects of
consumption of virgin coconut oil.
MeSH terms: Eating; Iatrogenic Disease; Plant Oils; Drug-Related Side Effects and Adverse Reactions; Rhinitis, Allergic
Tuberculous prostatitis is an uncommon form of tuberculosis infection. It is commonly seen in immunocompromised patients and in those of middle or advanced age. The diagnosis is often not straight forward due to the nature of its presentation. We report a case of tuberculous prostatitis in a young, healthy and immunocompetent patient, who initially presented with respiratory features, followed by episodes of seizures and testicular swelling. He was finally diagnosed with tuberculous prostatitis after prostatic biopsy. This case illustrates that in a high TB prevalence environment, when symptoms warrant, there should be a high clinical suspicion coupled with a thorough approach in order to arrive at a correct diagnosis of TB prostatitis.
Axillary malodor is caused by microbial biotransformation of non-smelling molecules present in apocrine secretions, into volatile odorous molecules. This study aimed to determine the antimicrobial activities of potassium aluminium salts (alum) against four malodor-producing axillary bacterial flora, as an alternative natural product for reducing axillary malodor.
Nurul Mahfuzah Ahmad Yani, Nur Zakirah Zahari, Nur Fatini Haziqah Abu Samah, Muhammad Ammar Faidhi Mohamed Azahar, Siti Munira Yasin, Mohd Shahril Ahmad Saman, et al.
Homelessness continues to exist in our country even though we hear of various initiatives that have been put in place to solve this ongoing issue. The objectives of this study are, first, to explore factors that lead to homelessness, second, to determine the associated medical conditions and third, to shed light on the views of homeless individuals regarding their future perspectives.
MeSH terms: Homeless Persons; Humans; Malaysia; Social Problems; Qualitative Research
Introduction: The study attempts to evaluate the students’ perception of pharmacology as a
subject, its usefulness in future practice, teaching methods currently used, and their patterns of
learning and preparing for exams. Methods: A structured, self-administered questionnaire was
distributed to second year medical students. Results: Of the 125 students who participated,
22.73 % considered pharmacology more important than any other subject. The students found
small group sessions most interesting followed by directed self-learning, computer aided
learning and lectures. Of those who responded, 79 and 66 % suggested to increase the small
group and directed-self-learning sessions respectively. Up to 40 % of the students felt that
pharmacology teaching must be through case-based discussions and 20 % requested for more
practical sessions. Conclusions: It appears that majority of students entering the medical
schools has little prior knowledge of pharmacology. While going through the preclinical years
they understood the importance of pharmacology and its application in future practice,
however, they tend to develop interest in one or other topics. Students prefer to have a greater
number of small group sessions as they feel that these sessions are most useful for learning.
Majority of the students tend to use both the textbooks and lecture notes and study regularly
for better performance in examinations. The students also preferred to have more case-based
learning sessions incorporated into the small group sessions.
KEYWORDS: Pharmacology teaching, student perception, teaching methodologies
To assess the agreement of the Scheimpflug camera system Pentacam with the optical low-coherence reflectometry (OLCR) device LENSTAR LS900 in measuring anterior segment biometry.
Introduction: Leprosy is a chronic granulomatous disease which also known as Hansen’s disease caused by Mycobacterium leprae. The social rights and health requirements should not be neglected among the remaining survivors. Although nutritional status and leprosy invasion has been studied in the past, there is still an unclear relationship between these two. The aim of this study was to assess the relationship between nutritional status and disability among the leprosy survivors.
sampling was conducted at Sungai Buloh, Selangor area from June 2014 to July 2014. The degree of disability was assessed using Barthel’s Index and the nutritional status assessment was assessed using Mini Nutritional Assessment. The data was analysed using SPSS version 20.
Results: A total of 73 patients were involved in the study (60.3% were male and 89.0% were Chinese). The prevalence of disability was 56.2% (95% CI: 44.5 – 67.8) with walking up-stair s the highest item that need help (50.7%). There were 9.6% malnourished and 49.3% were at risk of malnutrition. There was a negative strong correlation between Nutritional score and the Barthel’s index score (Spearman rho, ρ = -0.714, p < 0.001).
Conclusions: Measures must be taken to improve their nutritional status in order to increase their ability to be more independent particularly those who are very old. The degree of disability increases with malnutrition.
KEYWORDS: Functional dependence, nutritional status, leprosy
Existing structural components require strengthening after a certain period of time due to increases in service loads, errors in design, mechanical damage, and the need to extend the service period. Externally-bonded reinforcement (EBR) and near-surface mounted (NSM) reinforcement are two preferred strengthening approach. This paper presents a NSM technique incorporating NSM composites, namely steel and carbon fiber-reinforced polymer (CFRP) bars, as reinforcement. Experimental and analytical studies carried out to explore the performance of reinforced concrete (RC) members strengthened with the NSM composites. Analytical models were developed in predicting the maximum crack spacing and width, concrete cover separation failure loads, and deflection. A four-point bending test was applied on beams strengthened with different types and ratios of NSM reinforcement. The failure characteristics, yield, and ultimate capacities, deflection, strain, and cracking behavior of the beams were evaluated based on the experimental output. The test results indicate an increase in the cracking load of 69% and an increase in the ultimate load of 92% compared with the control beam. The predicted result from the analytical model shows good agreement with the experimental result, which ensures the competent implementation of the present NSM-steel and CFRP technique.
MeSH terms: Carbon; Carmustine; Polymers; Steel; Time Factors; Physical Phenomena
One of the approaches to prolong the service lifespan of polymeric material is the development of self-healing ability by means of embedded microcapsules containing a healing agent. In this work, poly(melamine-urea-formaldehyde) (PMUF) microcapsules containing a palm oil-based alkyd were produced by polymerization of melamine resin, urea and formaldehyde that encapsulated droplets of the suspended alkyd particles. A series of spherical and free-flowing microcapsules were obtained. The chemical properties of core and shell materials were characterized by Attenuated total reflection-Fourier transform infrared spectroscopy (ATR-FTIR) and proton nuclear magnetic resonance spectroscopy (¹H-NMR). Differential scanning calorimetry (DSC) analysis showed a glass transition around -15 °C due to the alkyd, and a melting temperature at around 200 °C due to the shell. Thermogravimetric analysis (TGA) results showed that the core and shell thermally degraded within the temperature range of 200⁻600 °C. Field emission scanning electron microscope (FESEM) examination of the ruptured microcapsule showed smooth inner and rough outer surfaces of the shell. Flexural strength and microhardness (Vickers) of the cured epoxy compound were not affected with the incorporation of 1%⁻3% of the microcapsules. The viability of the healing reactions was demonstrated by blending small amounts of alkyd with epoxy and hardener at different ratios. The blends could readily cure to non-sticky hard solids at room temperature and the reactions could be verified by ATR-FTIR.
Cadmium oxide semiconductor nanoparticles were produced using a water based mixture, incorporating cadmium nitrates, polyvinyl pyrrolidone (PVP), and calcination temperature. An X-ray diffraction (XRD) evaluation was conducted to determine the degree of crystallization of the semiconductor nanoparticles. In addition, scanning electron microscopy (SEM) was conducted to identify the morphological features of the nanoparticles. The typical particle sizes and particle dispersal were analyzed via the use of transmission electron microscopy (TEM). The findings provided further support for the XRD outcomes. To determine the composition phase, Fourier transform infrared spectroscopy (FT-IR) was conducted, as it indicated the existence of not only metal oxide ionic band in the selection of samples, but also the efficient removal of organic compounds following calcinations. The optical characteristics were demonstrated, so as to analyze the energy band gap via the use of a UV⁻Vis spectrophotometer. A reduced particle size resulted in diminution of the intensity of photoluminescence, was demonstrated by PL spectra. Plus, the magnetic characteristics were examined using an electron spin resonance (ESR) spectroscopy, which affirmed the existence of unpaired electrons.
The use of transparent polymers as an alternative to glass has become widespread. However, the direct exposure of these materials to climatic conditions of sunlight and heat decrease the lifetime cost of these products. The aim of this study was to minimize the harm caused by ultraviolet (UV) radiation exposure to transparent poly(methylmethacrylate) (PMMA), which usually leads to changes in the physical and chemical properties of these materials and reduced performance. This was achieved using environmentally friendly cellulose acetate butyrate (CAB). The optical, morphological, and thermal properties of CAB blended with transparent PMMA was studied using UV-VIS spectrophotometry, scanning electron microscopy, X-ray diffraction, dynamic mechanical analysis, and thermal gravimetric analysis. The results show that CAB was able to reduce the effects of UV radiation by making PMMA more transparent to UV light, thereby preventing the negative effects of trapped radiation within the compositional structure, while maintaining the amorphous structure of the blend. The results also show that CAB blended with PMMA led to some properties commensurate with the requirements of research in terms of a slight increase in the value of the modulus and the glass transition temperature for the PMMA/CAB blend.
Poly(phenyl-(4-(6-thiophen-3-yl-hexyloxy)-benzylidene)-amine) (P3TArH) was successfully synthesized and coated on the surface of Fe₃O₄ magnetic nanoparticles (MNPs). The nanocomposites were characterized by Fourier transform infra-red (FTIR), X-ray diffractometry (XRD), Brunauer-Emmett-Teller (BET) surface area analysis, analyzer transmission electron microscopy (TEM) and vibrating sample magnetometry (VSM). P3TArH-coated MNPs (MNP@P3TArH) showed higher capabilities for the extraction of commonly-used phthalates and were optimized for the magnetic-solid phase extraction (MSPE) of environmental samples. Separation and determination of the extracted phthalates, namely dimethyl phthalate (DMP), diethyl phthalate (DEP), dipropyl phthalate (DPP), dibutyl phthalate (DBP), butyl benzyl phthalate (BBP), dicyclohexyl phthalate (DCP), di-ethylhexyl phthalate (DEHP) and di-n-octyl phthalate (DNOP), were conducted by a gas chromatography-flame ionization detector (GC-FID). The best working conditions were as follows; sample at pH 7, 30 min extraction time, ethyl acetate as the elution solvent, 500-µL elution solvent volumes, 10 min desorption time, 10-mg adsorbent dosage, 20-mL sample loading volume and 15 g·L-1 concentration of NaCl. Under the optimized conditions, the analytical performances were determined with a linear range of 0.1⁻50 µg·L-1 and a limit of detection at 0.08⁻0.468 µg·L-1 for all of the analytes studied. The intra-day (n = 7) and inter-day (n = 3) relative standard deviations (RSD%) of three replicates were each demonstrated in the range of 3.7⁻4.9 and 3.0⁻5.0, respectively. The steadiness and reusability studies suggested that the MNP@P3TArH could be used up to five cycles. The proposed method was executed for the analysis of real water samples, namely commercial bottled mineral water and bottled fresh milk, whereby recoveries in the range of 68%⁻101% and RSD% lower than 7.7 were attained.
Nanocomposite polymer electrolyte membranes (NCPEMs) based on poly(acrylic acid)(PAA) and titania (TiO₂) are prepared by a solution casting technique. The ionic conductivity of NCPEMs increases with the weight ratio of TiO₂.The highest ionic conductivity of (8.36 ± 0.01) × 10-4 S·cm-1 is obtained with addition of 6 wt % of TiO₂ at ambient temperature. The complexation between PAA, LiTFSI and TiO₂ is discussed in Attenuated total reflectance-Fourier Transform Infrared (ATR-FTIR) studies. Electrical double layer capacitors (EDLCs) are fabricated using the filler-free polymer electrolyte or the most conducting NCPEM and carbon-based electrodes. The electrochemical performances of fabricated EDLCs are studied through cyclic voltammetry (CV) and galvanostatic charge-discharge studies. EDLC comprising NCPEM shows the specific capacitance of 28.56 F·g-1 (or equivalent to 29.54 mF·cm-2) with excellent electrochemical stability.