Browse publications by year: 2016

  1. Ameerah Adeelah, M.A., Kanit, T.D., Hatta, S.
    Medicine & Health, 2016;11(1):87-91.
    MyJurnal
    Vaginismus is a sexual dysfunction which results from vaginal musculature spasm
    and makes the penetration almost impossible. It is commonly associated with
    significant emotional distress. On several occasions, fear of pain during sexual
    intercourse may perpetuate the sexual dysfunction. We report a case of primary
    vaginismus that was associated with psychiatric squeale of anxiety and depression
    psychopathology. It suggests that psychological problems related to a mentalhealth
    problem in vaginismus should be dealt adequately for a holistic approach.
    A combination of behavioural, psychological and pharmacological treatment is
    important to ensure a good prognosis outcome.
  2. Loo, J.L., Farah Deena, A.S., Hatta, S.
    Medicine & Health, 2016;11(1):83-86.
    MyJurnal
    A case of rapid stabilization using electroconvulsive therapy (ECT) for a major
    depressive disordered (MDD) patient with life-threatening low body mass index
    (BMI) is reported. This case report focuses on a 55-year-old Malay housewife with
    underlying hyperthyroidism in a euthyroid state who presented with MDD with
    mood congruent psychotic features, which were precipitated by the death of her
    husband. Her BMI was only 11 kg/m2
    due to severe anorexia, and she was highly
    suicidal. Peripheral total parenteral nutrition was started and ECT was commenced
    for rapid stabilization on top of tablet escitalopram 15 mg nocte. Full remission was achieved after nine ECTs and steady healthy weight gain was achieved throughout
    admission. The patient was discharged at BMI of 13 kg/m2
    with good appetite. ECT
    was safe for very low BMI MDD patient.
  3. Tan, C.E., Tong, S.F., Zuhra, H., Aida, J.
    Medicine & Health, 2016;11(1):72-82.
    MyJurnal
    The Hypoglycaemia Symptom Rating Questionnaire (HypoSRQ) is potentially
    useful for local research on hypoglycaemia. However, it requires adaptation and
    validation in local settings. This study reports the process and results of cross-cultural
    adaptation and linguistic validation of HypoSRQ for Malay and English versions in
    our local setting. The HypoSRQ underwent forward and backward translation and
    adaptation with support from professional translators and a clinical psychologist.
    Cognitive debriefing was done among patients with Type 1 and Type 2 diabetes
    mellitus from varying sociodemographic backgrounds. Discussion was done
    together with the original developers of the HypoSRQ to decide on the best version
    for local use. The finalised versions were proofread and formatted with the help
    of Health Psychology Research. Cognitive debriefing for Malay version involved 7
    patients and for the English version5 patients. Direct literal translation into Malay
    language was unsuitable due to technical terms which were difficult for laypersons
    to understand. Amendments were made based on findings from the cognitive
    debriefing process. Participants found the questionnaire fairly easy to understand.
    The HypoSRQ-My (Malay) and HypoSRQ-EMy (English) is easily understood by
    local participants. These tools may undergo psychometric evaluation for future
    use in local settings.
  4. Ho, S.E., Ho, Christopher C.K., Zainah, M., Indra, Jaafar, M.Z., Choy, Y.C., et al.
    Medicine & Health, 2016;11(1):62-71.
    MyJurnal
    Patient-controlled analgesia (PCA) via an infusion pump enables patient to
    administer their own analgesia. The aim of this study was to evaluate the effect
    of an educational programme in managing post-operative pain and satisfaction
    on PCA following orthopedic surgery. A pre-test and post-test interventional study
    design with implementation of patient education programme on PCA was provided
    to 54 respondents. The control group received conventional PCA briefing from
    the Acute Pain Service protocol. Pain intensity was measured at 2 hrs, 6 hrs and
    24 hrs following surgery and pre-test and post-test of the Revised American Pain
    Society Patient Outcome Questionnaire (APS-POQ-R) was administered. There
    was difference in respondents’ level of pain score among the study respondents’
    medians for control group at 2 hrs, 6 hrs and 24 hrs following surgery and they were
    7.00 (IQR=3.00), 5.00 (IQR=2.00) and 3.00 (IQR=2.00); intervention group at 2 hrs,
    6 hrs and 24 hrs following surgery were 6.00 (IQR=2.00), 3.00 (IQR=1.00) and
    1.00 (IQR=1.00) respectively. There were significant differences in median of pain
    score between intervention and control group at 2 (U=142.0, p
  5. Syuhada, O., Shalini, P., Lim, W.K., Ammar, A., Suria Hayati, M.P., Aneeza Khairiyah, W.H., et al.
    Medicine & Health, 2016;11(1):56-61.
    MyJurnal
    Eosinophil-type nasal polyp (NP) is common in Western population. This aim of
    this study was to determine the histology type of NP among different Malaysian
    ethnic groups. A total of 122 chronic rhinosinusitis with nasal polyposis (CRSwNP)
    patients were retrospectively enrolled and demographic data was recorded. The
    histological slides were retrieved. The number of eosinophils and non-eosinophils
    were counted and average number of inflammatory cells for each high power
    field was calculated. Eosinophil-predominant was seen in 32.8% of patients and
    67.2% was non-eosinophil-predominant. Phenotypes of NP significantly showed an association with ethnicity (x² = 8.322; p < 0.05). A total of 78.9% of Chinese
    nasal polyps showed non-eosinophil predominant, while Malay and Indian nasal
    polyps revealed 71.9% and 40.7% of non-eosinophilic phenotype, respectively.
    Our study showed that Malaysian population had a non-eosinophilic phenotype
    of nasal polyps. There was a significant association in Malaysian ethnicity with the
    highest percentage in Chinese population.
  6. Bala Krishnian, M., Ahmad Khaldun, I., Johar, M.J., Ismail, M.S., Hamidah, Y.
    Medicine & Health, 2016;11(1):47-55.
    MyJurnal
    Information technology use in healthcare education has become a popular
    medium of instruction. One of the medium of instruction is video assisted learning
    (VAL). The use of VAL as an instructional method in the teaching and learning of emergency skills is not new. However, there are lack of studies on the perception of
    using this method in learning emergency skills. This qualitative study involved four
    focused discussion groups following a VAL instruction on emergency skills. A total
    of 20 paramedics were divided into four groups. They were involved in a focussed
    discussion after a VAL instruction session. Findings reveal that the paramedics
    perceived three major themes which were categorized as : i) advantages of video
    as teaching tool, ii) barrier in using video as a teaching tool; and iii) suggestions on
    using video as teaching tool. The findings indicate that the paramedics perceived
    VAL as a potential tool for learning emergency skills. However, they suggested the
    language of instruction should be in their mother tongue for better understanding.
    This implies that using English language has disadvantage in technology enhanced
    learning for better understanding.
  7. Ismail, A.K., Md Jawi, M.I., Mohd Salleh, N.I., Hamdan, N.A., Md Jamal, S., Shah, S.A., et al.
    Medicine & Health, 2016;11(1):38-46.
    MyJurnal
    Out-of-hospital cardiac arrest (OHCA) patients require immediate cardiopulmonary
    resuscitation (CPR). Early initiation of CPR and defibrillation before arrival at
    Emergency Department (ED) increases the chance of survival from sudden cardiac
    arrest. The main objective of this study was to identify the factors that influenced
    the outcome of early cardiopulmonary resuscitation (CPR) in out-of-hospital cardiac
    arrest (OHCA) patients managed at the ED of Universiti Kebangsaan Malaysia
    Medical Centre (UKMMC). The second objective was to determine the incidence
    of CPR initiated by the public prior to ambulance arrival. The present study was a
    one-year cross-sectional study. The OHCA patients were identified from the ED
    resuscitation logbook. Patients’ medical records were used to obtain details of the
    resuscitation. Factors recorded included: aetiology of arrest, initiation of on-scene
    CPR, use of automated external defibrillators (AEDs), mode of transportation and
    the incidence of return of spontaneous circulation (ROSC) in the ED. Categorical
    data was analysed using chi-square and Fisher exact tests. Nine patients out of 98
    had early CPR. Three patients achieved ROSC. Gender was significantly associated
    with ROSC (p-value=0.015). More patients who received early CPR achieved ROSC
    compared to those who received late CPR. The provision of early CPR and usage
    of AEDs by the public is still low. Female gender had a positive influence on ROSC.
    Efforts are required to increase the awareness and involvement of the public in
    initiating early CPR prior to the arrival of ambulance service.
  8. Ismail, A.K., Mohamad Ali, S., Che' Man, Z.
    Medicine & Health, 2016;11(1):29-37.
    MyJurnal
    Patients who self-discharge against medical advice (DAMA) are susceptible to life-threatening consequences. By understanding the factors associated with DAMA, healthcare centres can build strategies to assist patients to receive optimal medical care and prevent unfavourable outcome. The objective of this study was to determine the factors associated with DAMA from the Emergency Department (ED) of Universiti Kebangsaan Malaysia Medical Centre (UKMMC). This was a prospective unmatched case control study conducted over a 4-month period. For every DAMA episode, two patients who were admitted on the same day were randomly selected as control. Following patient consent, data was collected using a standardized questionnaire. Patients were contacted by the investigator for information regarding hospitalization within two weeks of DAMA. Ninety three patients were recruited; 31 DAMA patients and 62 admitted patients. Payment method was significantly associated with DAMA (OR 3.17 95% CI 1.29-7.98; p=0.01). The likelihood of self-paying patients to take DAMA was three times higher than those who had a guarantor letter from their employer or insurance provider. Other factors which influence DAMA were family obligations (OR 4.08 95% CI 1.09-15.26; p = 0.03) and work problems (OR 3.83 95% CI 1.13-12.94; p=0.03). A total of 19.4% of DAMA patients left following symptomatic pain relief. A total of 80.6% DAMA patients were admitted to hospital within two weeks of the DAMA episode. Payment method significantly influences DAMA. Payment planning, social welfare services, non-governmental organization funds and the introduction of a national health policy scheme may aid hospital payment, alleviate financial limitation of patients and reduce DAMA episodes.
    MeSH terms: Emergency Service, Hospital; Hospitals, University; Humans; Malaysia; Case-Control Studies
  9. Nik Muhamad NA, Kwong LJ
    Medicine & Health, 2016;11(1):22-28.
    MyJurnal
    The objectives were to identify factors associated with early revisit of adult patients with acute asthma exarcebation discharged from the Emergency Department (ED). It was a retrospective cohort study with patients aged 12 years or more within a period of 1 month and who were treated for acute asthma and discharged from the ED of Sarawak General Hospital. A total of 397 patients fulfilled sampling criteria and out of this number, 13.9% had revisit to the ED within 2 weeks. In all of these revisit cases, 9.1% were actually admitted. Prescription rate of oral corticosteroid was found to be low (24.9%) and abscond rate was high (25.1%). Patients who absconded from the ED and their concurrent infection were associated with early ED revisit.
    MeSH terms: Asthma*; Emergency Service, Hospital; Hospitals, General; Humans; Malaysia; Retrospective Studies; Cohort Studies
  10. Zainah, M., Sasikala, M., Nurfarieza, M.A., Ho, S.E.
    Medicine & Health, 2016;11(1):11-21.
    MyJurnal
    Fulfillment of the family needs for the critically ill patient in Critical Care Unit
    should be met by healthcare providers to improve patient’s quality of life. The
    purpose of this study was to identify the needs of family members of critically ill
    patients in a Critical Care Unit. A cross-sectional study was conducted on 109
    family members of patient hospitalized at the Intensive Care Unit and Coronary
    Care Units of Universiti Kebangsaan Malaysia Medical Centre (UKMMC). The
    modified Critical Care Family Needs Inventory (CCFNI) comprised of 5 domains of
    family member’s needs: Information, Proximity, Assurance, Comfort and Support.
    The findings showed that assurance and information needs were the highest with
    (3.77 ± 0.306); (3.62 ± 0.379), proximity need (3.60 ± 0.415), support need (3.57
    ± 0.477) and comfort need (3.55 ± 0.586), respectively. There was significant
    relationship between respondent’s relationship with family needs of proximity
    (p = 0.013). This study indicated that there were significant association between
    respondent’s monthly income and family needs of comfort and support, (p = 0.033)
    and (p = 0.004). There was also significant association between the gender with
    comfort need (p = 0.013). In this study, it was observed that information, proximity,
    assurance, comfort and support were opinioned as their requirements during
    hospitalization. Hence, it assists in coping while being admitted to Intensive Care
    Unit and Coronary Care Unit of UKMMC. An educational package and updating
    patient’s information should be emphasized to enhance the family needs of critically
    ill patient in the critical care settings.
  11. Nik Muhamad, N.A., Ismail, A.K., Kaharuddin, H., Miao Ching, H., Qamarul Ariffin, S., Syazwani Azwa, S., et al.
    Medicine & Health, 2016;11(1):2-10.
    MyJurnal
    Midazolam is one of the most commonly used drugs for sedation in Emergency Department (ED). This was a retrospective study conducted on 380 patients from December 2012 to May 2014 in ED of Universiti Kebangsaan Malaysia Medical Centre (UKMMC). The objective was to elicit the frequency of side effects and correlation to various factors i.e. socio-demography, co-morbidities, age groups and underlying illnesses. Out of 380 patients, 35 patients experienced side effects (20 patients with midazolam alone, 15 patients with combination of drugs). The average age was 42 years and the average dose of midazolam was 3.5mg. The most common other drug combined was fentanyl. The overall complication rate for midazolam was 5.3%. The most common side effect recorded was excessive somnolence (1.6%). Other side effects included local skin reactions (1.1%), vomiting (0.8%), headache (0.8%) and hypotension (0.5%). There was no significant association between the socio-demographic factors and drugs combination with the side effects of midazolam on patients. It was concluded that midazolam was a safe drug due to absence of any life-threatening side effects. There are possibilities that most side effects recorded could be caused by other comfounding factors e.g. underlying injuries or disease and combination with other drugs.
    MeSH terms: Emergency Service, Hospital; Hospitals, University; Humans; Malaysia; Midazolam*; Retrospective Studies; Drug-Related Side Effects and Adverse Reactions*
  12. Hui YW, Narayanan K, Dykes GA
    Water Environ Res, 2016 Nov 01;88(11):2040-2046.
    PMID: 26704787 DOI: 10.2175/106143016X14504669767292
      The effect of physical shearing on the attachment of six Pseudomonas aeruginosa strains and six Burkholderia cepacia strains to glass, stainless steel, polystyrene and Teflon® was determined. A significant (p < 0.05) decrease in hydrophobicity was apparent for all P. aeruginosa strains (17-36%) and B. cepacia, MS 5 (20%) after shearing. A significant (p < 0.05) decrease in attachment of some P. aeruginosa (0.2-0.5 log CFU/cm2) and B. cepacia (0.2-0.4 log CFU/cm2) strains to some surface types was apparent after shearing. Significant (p < 0.05) correlation was observed for both numbers of flagellated cells and hydrophobicity against attachment to glass, stainless steel and polystyrene for P. aeruginosa while only hydrophobicity showed significant correlation against the same surfaces for B. cepacia. Scanning electron microscopy and protein analysis showed that shearing removed surface proteins from the cells and may have led to the observed changes in hydrophobicity and attachment to abiotic surfaces.
    MeSH terms: Cell Count; Glass; Membrane Proteins; Microscopy, Electron, Scanning; Polystyrenes; Polytetrafluoroethylene; Pseudomonas aeruginosa; Stainless Steel; Burkholderia cepacia; Hydrophobic and Hydrophilic Interactions
  13. See WYN, Sumugam K, Subrayan V
    Allergy Rhinol (Providence), 2016 Jan 01;7(4):223-226.
    PMID: 28683249 DOI: 10.2500/ar.2016.7.0178
    BACKGROUND: To report an unusual case of compressive optic neuropathy secondary to a large onodi air cell.
    METHOD: Case report.
    RESULTS: A 50 year-old gentlemen presented to the eye clinic with left eye painless loss of vision for one day. Visual acuity was counting finger in the left eye with a positive relative afferent pupillary defect (RAPD). Dilated left fundus examination revealed a pale optic disc. A computed tomography of orbit and brain showed a large left sphenoid sinus with onodi-cell-like projection on the left superior margin of left optic canal impinging on the left optic nerve. He was referred to the otorhinolaryngology team and subsequently underwent left optic nerve decompression. Post-operatively, his left visual acuity improved to 6/60 with reversal of RAPD.
    CONCLUSION: There are many causes of optic neuropathy and compressive optic neuropathy due to large onodi air cell is uncommon. Acute unilateral loss of vision heralds from a multitude of sinister causes and junior residents should be vigilant that onodi air cell pneumotisation could be one of them.
    MeSH terms: Hospitals; Humans; Malaysia; Outpatient Clinics, Hospital
  14. Shakib MN, Moghavvemi M, Mahadi WN
    PLoS One, 2016;11(12):e0168013.
    PMID: 27992466 DOI: 10.1371/journal.pone.0168013
    In this paper, a new compact wideband monopole antenna is presented for wireless communication applications. This antenna comprises of a new radiating patch, a new arc-shaped strip, microstrip feed line, and a notched ground plane. The proposed radiating patch is combined with a rectangular and semi-circular patch and is integrated with a partial ground plane to provide a wide impedance bandwidth. The new arc-shaped strip between the radiating patch and microstrip feed line creates an extra surface on the patch, which helps further widen the bandwidth. Inserting one step notch on the ground plane further enhances the bandwidth. The antenna has a compact size of 16×20×1.6mm3. The measured result indicated that the antenna achieves a 127% bandwidth at VSWR≤2, ranging from 4.9GHz to 22.1GHz. Stable radiation patterns with acceptable gain are achieved. Also, a measured bandwidth of 107.7% at VSWR≤1.5 (5.1-17GHz) is obtained, which is suitable for UWB outdoor propagation. This antenna is compatible with a good number of wireless standards, including UWB band, Wimax 5.4 GHz band, MVDDS (12.2-12.7GHz), and close range radar and satellite communication in the X-band (8-12GHz), and Ku band (12-18GHz).
    MeSH terms: Calibration; Communication*; Radar/instrumentation*; Electric Impedance; Wireless Technology/instrumentation*; Electromagnetic Radiation
  15. Samsiah A, Othman N, Jamshed S, Hassali MA
    PLoS One, 2016;11(12):e0166114.
    PMID: 27906960 DOI: 10.1371/journal.pone.0166114
    OBJECTIVE: To explore and understand participants' perceptions and attitudes towards the reporting of medication errors (MEs).

    METHODS: A qualitative study using in-depth interviews of 31 healthcare practitioners from nine publicly funded, primary care clinics in three states in peninsular Malaysia was conducted for this study. The participants included family medicine specialists, doctors, pharmacists, pharmacist assistants, nurses and assistant medical officers. The interviews were audiotaped and transcribed verbatim. Analysis of the data was guided by the framework approach.

    RESULTS: Six themes and 28 codes were identified. Despite the availability of a reporting system, most of the participants agreed that MEs were underreported. The nature of the error plays an important role in determining the reporting. The reporting system, organisational factors, provider factors, reporter's burden and benefit of reporting also were identified.

    CONCLUSIONS: Healthcare practitioners in primary care clinics understood the importance of reporting MEs to improve patient safety. Their perceptions and attitudes towards reporting of MEs were influenced by many factors which affect the decision-making process of whether or not to report. Although the process is complex, it primarily is determined by the severity of the outcome of the errors. The participants voluntarily report the errors if they are familiar with the reporting system, what error to report, when to report and what form to use.

    MeSH terms: Attitude of Health Personnel*; Female; Humans; Malaysia; Male; Medication Errors*; Nurses/psychology; Pharmacists/psychology; Physicians/psychology; Primary Health Care; Primary Care Nursing*; Patient Safety
  16. Adeyemi IR, Razak SA, Salleh M, Venter HS
    PLoS One, 2016;11(12):e0166930.
    PMID: 27918593 DOI: 10.1371/journal.pone.0166930
    Comprehension of the statistical and structural mechanisms governing human dynamics in online interaction plays a pivotal role in online user identification, online profile development, and recommender systems. However, building a characteristic model of human dynamics on the Internet involves a complete analysis of the variations in human activity patterns, which is a complex process. This complexity is inherent in human dynamics and has not been extensively studied to reveal the structural composition of human behavior. A typical method of anatomizing such a complex system is viewing all independent interconnectivity that constitutes the complexity. An examination of the various dimensions of human communication pattern in online interactions is presented in this paper. The study employed reliable server-side web data from 31 known users to explore characteristics of human-driven communications. Various machine-learning techniques were explored. The results revealed that each individual exhibited a relatively consistent, unique behavioral signature and that the logistic regression model and model tree can be used to accurately distinguish online users. These results are applicable to one-to-one online user identification processes, insider misuse investigation processes, and online profiling in various areas.
    MeSH terms: Communication*; Computers; Humans; Identification (Psychology)*; Social Support; Internet*
  17. Lee XW, Mat-Isa MN, Mohd-Elias NA, Aizat-Juhari MA, Goh HH, Dear PH, et al.
    PLoS One, 2016;11(12):e0167958.
    PMID: 27977777 DOI: 10.1371/journal.pone.0167958
    Rafflesia is a biologically enigmatic species that is very rare in occurrence and possesses an extraordinary morphology. This parasitic plant produces a gigantic flower up to one metre in diameter with no leaves, stem or roots. However, little is known about the floral biology of this species especially at the molecular level. In an effort to address this issue, we have generated and characterised the transcriptome of the Rafflesia cantleyi flower, and performed a comparison with the transcriptome of its floral bud to predict genes that are expressed and regulated during flower development. Approximately 40 million sequencing reads were generated and assembled de novo into 18,053 transcripts with an average length of 641 bp. Of these, more than 79% of the transcripts had significant matches to annotated sequences in the public protein database. A total of 11,756 and 7,891 transcripts were assigned to Gene Ontology categories and clusters of orthologous groups respectively. In addition, 6,019 transcripts could be mapped to 129 pathways in Kyoto Encyclopaedia of Genes and Genomes Pathway database. Digital abundance analysis identified 52 transcripts with very high expression in the flower transcriptome of R. cantleyi. Subsequently, analysis of differential expression between developing flower and the floral bud revealed a set of 105 transcripts with potential role in flower development. Our work presents a deep transcriptome resource analysis for the developing flower of R. cantleyi. Genes potentially involved in the growth and development of the R. cantleyi flower were identified and provide insights into biological processes that occur during flower development.
    MeSH terms: Gene Expression Regulation, Plant/genetics; Angiosperms/genetics*; Gene Expression Profiling; Flowers/genetics*; Transcriptome/genetics*
  18. Chan SW, Ismail Z, Sumintono B
    PLoS One, 2016;11(11):e0163846.
    PMID: 27812091 DOI: 10.1371/journal.pone.0163846
    Based on a synthesis of literature, earlier studies, analyses and observations on high school students, this study developed an initial framework for assessing students' statistical reasoning about descriptive statistics. Framework descriptors were established across five levels of statistical reasoning and four key constructs. The former consisted of idiosyncratic reasoning, verbal reasoning, transitional reasoning, procedural reasoning, and integrated process reasoning. The latter include describing data, organizing and reducing data, representing data, and analyzing and interpreting data. In contrast to earlier studies, this initial framework formulated a complete and coherent statistical reasoning framework. A statistical reasoning assessment tool was then constructed from this initial framework. The tool was administered to 10 tenth-grade students in a task-based interview. The initial framework was refined, and the statistical reasoning assessment tool was revised. The ten students then participated in the second task-based interview, and the data obtained were used to validate the framework. The findings showed that the students' statistical reasoning levels were consistent across the four constructs, and this result confirmed the framework's cohesion. Developed to contribute to statistics education, this newly developed statistical reasoning framework provides a guide for planning learning goals and designing instruction and assessments.
    MeSH terms: Educational Measurement/methods*; Humans; Statistics as Topic*; Students*; Thinking*
  19. Lim YJ, Rosita J, Chieng JY, Hazizi AS
    PLoS One, 2016;11(12):e0167243.
    PMID: 27997551 DOI: 10.1371/journal.pone.0167243
    BACKGROUND AND AIMS: Functional constipation is very common with heterogeneous symptoms that have substantial impact on patient quality of life as well as medical resources which are rarely reported as life-threatening. The aim of this study is to examine the prevalence and symptoms characteristic of functional constipation (FC) by using Rome III diagnostic criteria among tertiary education students with an intention to introduce treatment in the future.

    METHODS: Demographic, socio-economics characteristics and symptoms of FC using the Rome III criteria were sought using a questionnaire administered to Malaysian students in a tertiary education setting. Other data obtained were the general health status, lifestyle factors and anthropometric measurements. Using a simple random sampling method, a total of 1662 students were recruited in the study with a response rate of 95.0%. Sampled data are presented as frequency and percentage and stratified accordingly into categories for Chi-square analysis.

    RESULTS: The prevalence of functional constipation among the students was 16.2%, with a significantly higher prevalence among women (17.4%) than men (12.5%). Hard or lumpy stool, incomplete evacuation, anorectal obstruction and straining were reported as the commonest symptoms experienced. Type 3 was the most frequent stool consistency experienced among the constipated individuals (35.2%). Only 4.4% of individuals reported having less than three defecations per week. Using univariable analysis, FC was significantly associated with sex (odds ratio: 1.48, 95% CI: 1.06-2.06) and age group (odds ratio: 1.34, 95% CI: 1.01-1.79) with P value < 0.05 significance level. In multivariate logistic regression analysis, only sex was found significantly associated with FC (adjusted odds ratio: 1.53, 95% CI: 1.08-2.17, P < 0.05).

    CONCLUSIONS: Based on the prevalence rate, constipation is a common problem among tertiary education students (16.2%), with significantly more prevalence among the female respondents. Early detection of symptoms and further intervention studies focusing on treatment recommendation in improving the symptoms are essential.

    MeSH terms: Adolescent; Adult; Aged; Female; Humans; Malaysia/epidemiology; Male; Middle Aged; Surveys and Questionnaires*; Sex Factors; Students*; Prevalence; Symptom Assessment*
  20. Su-Huan K, Fahmi MR, Abidin CZA, Soon-An O
    Water Environ Res, 2016 Nov 01;88(11):2047-2058.
    PMID: 28661323 DOI: 10.2175/106143016X14733681695285
      Advanced oxidation processes (AOPs) are of special interest in treating landfill leachate as they are the most promising procedures to degrade recalcitrant compounds and improve the biodegradability of wastewater. This paper aims to refresh the information base of AOPs and to discover the research gaps of AOPs in landfill leachate treatment. A brief overview of mechanisms involving in AOPs including ozone-based AOPs, hydrogen peroxide-based AOPs and persulfate-based AOPs are presented, and the parameters affecting AOPs are elaborated. Particularly, the advancement of AOPs in landfill leachate treatment is compared and discussed. Landfill leachate characterization prior to method selection and method optimization prior to treatment are necessary, as the performance and practicability of AOPs are influenced by leachate matrixes and treatment cost. More studies concerning the scavenging effects of leachate matrixes towards AOPs, as well as the persulfate-based AOPs in landfill leachate treatment, are necessary in the future.
    MeSH terms: Biodegradation, Environmental; Hydrogen Peroxide; Oxidation-Reduction; Ozone; Trenbolone Acetate; Water Pollutants, Chemical; Health Care Costs; Waste Water
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