Thrombosis is one of the causes of morbidity and mortality in women of reproductive age group. Thrombosis at unusual sites may pose diagnostic and management dilemma for health care personnel. Teamwork and good communication provide the best modalities for maximum benefits to patients. Here with, we presented a case series of thrombosis at unusual sites seen and managed in our clinic.
A 35 year-old Malay lady presented with left hemiparesis while she was on oestrogen based combined contraception pills (C-OCP). Imaging studies showed extensive venous thrombosis with bilateral acute cortical infarct. Thrombophilia screening of antiphospholipid syndrome were negative. She was put on anticoagulant and stopped 2 years after the incident.
A 40 year-old Malay lady presented with abdominal discomfort, lethargy and massive splenomegaly. Bone marrow and trephine examination revealed primary myelofibrosis with positive JAK2617F. Imaging study showed chronic portal vein thrombosis with portal vein hypertension, complicated by gastro-oesophageal varices. She was put on hydroxyurea and later started on ruxolitinib with banding done over her gastro-oesophageal varices.
A 26 year-old Malay lady presented with serositis, mouth ulcer and anaemia symptoms. Laboratory studies were positive for systemic lupus erythematosus and negative for antiphospholipid study. Imaging study showed long segment thrombosis of right internal jugular vein with surrounding subcutaneous oedema. She is currently stable on anticoagulants and steroid. Teamwork and holistic approach is practiced in the investigation and management to provide maximum benefits for patients.
Osteolytic disease of the bones have a myriad range of aetiology. One rare cause is Gorham’s disease
or disappearing bone disease. This disease is a diagnosis by exclusion using correlation made with
clinical presentation, radiological findings and histopathological confirmation. Although many different
therapies have been advocated, none have been successful in fully controlling this disease. We present a
case that was detected in a Chinese lady using diagnostic imaging, confirmed with computed tomography
guided biopsy and successfully treated with joint reconstruction using endoprosthesis.
Mesenchymal stem cells (MSCs) hold a great therapeutic potential for regenerative
medicine and tissue engineering due to inherent immunomodulatory and reparative properties. Hence,
it necessitates a readily available supplyof MSCs to meet the clinical demands adequately. Although,
a human placenta can produce MSCs, the in vitro culture-mediated cellular senescence often affect the
quality of cell product. Thus, the current study has explored the feasibility of basic fibroblast growth
factor (bFGF) to enhance the growth of placenta-derived MSCs (PLC-MSCs). Methods:The basic
fibroblast growth factor (bFGF) was supplemented to optimise the growth of MSCs. The effects of
bFGF on morphology, growth kinetics and cytokine secretion of PLC-MSCs were assessed. Results:
The bFGF supplementation increased the proliferation of PLC-MSCs in a dose-dependent manner and
40 ng/ml showed a high trophism effect on PLC-MSC’s growth. In the presence of bFGF, PLC-MSCs
acquired a small and well-defined morphology that reflect an active proliferative status. BFGF has
induced PLC-MSCs to achieve a shorter doubling time (45 hrs) as compared to the non-supplemented
PLC-MSCs culture (81 hrs). Furthermore, bFGF impelled PLC-MSCs into cell cycle machinery where
a substantial fraction of cells was driven to S and G2/M phases. Amongst, 36 screened cytokines, bFGF
had only altered the secretion of IL-8, IL-6, TNFR1, MMP3 and VEGF. Conclusion:The present study
showed that bFGF supplementation promotes the growth of PLC-MSCs without significantly deviating
from the standard criteria of MSCs. Thus, bFGF could be considered as a potential mitogen to facilitate
the large-scale production of PLC-MSCs.
This paper describes the process of quantifying the qualitative data in discovering the requirement of designing a
glucose sensor for diabetic patients. A participatory design approach was conducted among stakeholders which
include project managers, developers and users in early phases. Early phase of the design requires a problem
gathering and identifying pain points. The goals and objectives of the designing the product by project members
were evaluated. Users’ expectation was then validated with the stakeholder’s goals. The results showed that there
was a contradiction of goals and need among team members and medical practitioners. The findings provide a
literature on a case study of an industry practice and useful methods to be applied to capture hidden needs and
requirements when designing healthcare products.
Posture is one of the most important factor that need to be considered in any postural analysis. Awkward, extreme,
and repetitive postures can increase the risk of musculoskeletal disorders (MSDs). As observational methods are more
widely used than instrumentation-based methods to assess postural problems, this study reviews and assesses the
scientific literature of observational methods and focused on pen and paper based specifically. In order to identify the
published methods, a list of English or Malay articles dating as far back as 1990 was compiled from PubMed, Science
Direct and Google Scholar. The keywords were ergo*, posture*, method*, observational*, postural problems*, pen and
paper*, posture analysis*, indirect* and macro-ergo*. In addition, a secondary search was also performed using
bibliography of retrieved articles so that additional papers for conducting review and evaluations can be collected. A
total of 121 articles that assessed postural problems in working activities were found. However, after intensive
screening process only 6 articles were selected to be further analyzed. Posture of upper arms/shoulder, lower arms/
elbow, wrist, neck, back/trunk and leg were highlighted in this study. The limitations and the strengths of the
published pen and paper based observational method focusing on those postures were also discussed. The finding of
this review will benefit researchers in the process of understanding unsafe posture in workplace. It could also provide
to researcher on how to improve the current pen and paper based observational method for assessing postural
problems.
The study of driver posture and comfort in driver workspace is important in vehicle package design especially in two
different type of vehicle, sedan and Multi-Purpose Vehicle (MPV). Due to different seat position in the driver
workspace, investigation of driver accommodation in relations to driver anthropometry is essential to ensure its
meet the ergonomic quality. Therefore, this research is to investigate the preferred driving posture of Malaysian
driver in both sedan and MPV type of car. Sixty two subjects (32 males and 30 females) aged between 17–60 years old
were selected to simulate the comfortable driving posture using mock-ups of sedan car and MPV. Measurements
based on SAE J1100 vehicle package design geometry were carried out for each subject. Result shows slight
differences in the range of posture angle between the two types of vehicles, the posture joint angle in MPV is
slightly smaller as compared to those of sedan car. The range postural angles for Malaysian driver population also is
slightly smaller compare to Caucasian people especially on lower body portion such as knee angle, hip angle and
ankle angle. These angles are due to the body stature and body segment length in which the population of Malaysia
have shorter thighs and legs than those in Europe and America.
Teachers face one of the highest demands of any professional group to use their voices at work. Thus, they are at
higher risk of developing voice disorder than the general population. The consequences of voice disorder may have
impact on teacher’s social and professional life as well as their mental, physical and emotional state and their
ability to communicate. Objectives of this study are to determine the prevalence of voice disorder and the
relationship between voice disorder with associated risk factors such as teaching activities and lifestyle factors
among primary school teachers in Bintulu, Sarawak. A cross sectional study was conducted based on random sample
of 4 primary schools in Bintulu, Sarawak between January-March 2014. A total of 100 full-time primary school
teachers were invited to participate in the study. Data were collected through a self-administered questionnaire
addressing the prevalence of voice disorder and potential risk factors. Descriptive analysis and chi-square test was
used to measure the relationship between voice disorder and associated risk factors. The response rate for this study
was 78% (78/100). The study found that the prevalence of voice disorder among primary school teachers in Bintulu,
Sarawak was 13%. Chi-square test results revealed that factors significantly associated with voice disorder (p
Extensive research has been carried out over the years to determine the maximum acceptable weight that a worker is capable of lifting in a given situation among the Occidental populations in the Europe and US. At present, there is a scarcity of studies in which lifting frequency is used as the measuring variable, especially in developing countries such as Malaysia. Therefore, the objective of this study is to determine the effects of lifting loads on the maximum acceptable frequency limit (MAFL), physiological response (muscle activity) and rating of perceived exertion (RPE) for asymmetric lifting and lowering tasks of Malaysian males.Ten male subjects are recruited in this study and they perform asymmetric lifting and lowering tasks repetitively for 30 minutes. Two lifting loads are considered (1) 1 kg and (2) 5 kg. Each of the subjects adjusts his frequency of lifting using a psychophysical approach. The subjects are instructed to perform the lifting and lowering task as fast as they could over duration of 30 minutes without exhausting themselves or becoming overheated. Electromyography (EMG) signals are recorded from four muscles (Right Erector Spinae (RES), Left Erector Spinae (LES), Right Trapezius p Descendenz (RTD) and Left Trapezius p Descendenz (LTD) and analysed in terms of the normalized MVC during asymmetric lifting and lowering tasks. The ratings of perceived exertion (RPE) for four body parts (arms, lower back, shoulders and entire body) are also collected after the subjects have completed the lifting and lowering task. The mean frequency of the lifting and lowering task obtained from the experiment is 13.41 and 9.66 times/minute for a lifting load of 1 and 5 kg, respectively. The results of the independent sample t-test show that load has a statistically significant effect on the maximum acceptable frequency limit (p < 0.05). However, it is found that even though there is an increase in muscle activity and RPE with an increase in lifting load, there is no significant difference in the overall mean muscle activity and RPE (p > 0.05). The percentage decrease in the maximum acceptable frequency for Malaysian males is higher than the Occidental populations for both of the loads investigated in this study.
MeSH terms: Back; Developing Countries; Electromyography; Europe; Physical Exertion; Malaysia; Male; Perception; Psychophysics; Shoulder; Lifting; Human Body; Superficial Back Muscles
This study was done to determine the relationship between indoor air quality and Sick Building Syndrome (SBS) among students in Retrofitting Building (Building A) located in Kuala Lumpur and Purposed-built Building (Building B) located in Selangor. A cross sectional study was conducted among student from selected buildings with the total number of 130 respondents. Modified questionnaire based on Indoor Air Quality and Work Symptoms Survey, NIOSH, Indoor Environmental Quality Survey, 1991 was used to record the number of students experienced SBS. Measurement of indoor air quality was performed using instruments recommended by the IAQ Code of Practice, Department of Occupational Safety and Health, Malaysia. There was a significantly higher number of occupants experienced SBS in Building A (60 of 65 respondents) compared to Building B (50 of 65 respondents) (Χ2= 4.127, p = 0.042). It was also found that there is a significant difference between the numbers of respondents having SBS between Building A and Building B (p < 0.045). Building A had higher CO2, bacteria, fungi, and UFP significantly as compared to Building B. However, only CO was significantly higher in Building B compared to Building A. It is suggested thatregular maintenance of both buildings is compulsory as ventilation played an important role in maintaining good indoor air quality in a building.
The number of people above 60 years of age will increases due to the growth of the population in the first half of the 21st century, particularly in Malaysia. This has led to the growing number of older drivers which is often unavoidable as driving is a necessary task that not only achieves mobility but also shows a sign of independence and improves self-esteem, which are essential towards effecting the lifestyle. This paper briefly looks at common elderly related visual impairment, reviews design approaches and tools that tackle or include these issues in the design process and further outlines new research needs. It is the intention of this paper to steer the research direction of the development of future design approach and tools that would enhance the capabilities of designers to be well prepared to cater for inclusive design for the elderly, more specifically for visual impairments issues.
Marine debris is widely distributed at the coastal area of the global oceans; however, shipborne garbage source studies are still lacking to document the pollution in Malaysia Territorial Water. Thus, this study has adopted a standard method of beach marine debris survey at five beaches and inspected 115 vessels to assess the type and amount of debris from shipping source stranded on the beach. This study found that vessel visiting Malaysian ports observed the MARPOL 73/78 Annex V requirements; however, identified objects from shipping activity (1.3%; 2 items/km) found on the beaches indicate that there are vessels disposing of garbage illegally at sea. Therefore, there is a need to promote the use of biodegradable material and introduce environmental education to increase awareness on the vessel.
The activity concentrations of naturally occurring radionuclides (226)Ra, (232)Th, and (40)K were determined in 30 agricultural and virgin soil samples randomly collected from Kedah, north of Malaysia, at a fertile soil depth of 0-30 cm. Gamma-ray spectrometry was applied using high-purity germanium (HPGe) gamma-ray detector and a PC-based MCA. The mean radioactivity concentrations of (226)Ra, (232)Th, and (40)K were found to be 102.08 ± 3.96, 133.96 ± 2.92, and 325.87 ± 9.83 Bq kg(-1), respectively, in agricultural soils and 65.24 ± 2.00, 83.39 ± 2.27, and 136.98 ± 9.76 Bq kg(-1), respectively, in virgin soils. The radioactivity concentrations in agricultural soils are higher than those in virgin soils and compared with those reported in other countries. The mean values of radium equivalent activity (Raeq), absorbed dose rates D (nGy h(-1)), annual effective dose equivalent, and external hazard index (Hex) are 458.785 Bq kg(-1), 141.62 nGy h(-1), and 0.169 mSv y(-1), respectively, in agricultural soils and 214.293 Bq kg(-1), 87.47 nGy h(-1), and 0.106 mSv y(-1), respectively, in virgin soils, with average Hex of 0.525. Results were discussed and compared with those reported in similar studies and with internationally recommended values.
A lipase producer psychrophilic microorganism isolated from Arctic sample was
studied. The genomic DNA of the isolate was extracted using modified CTAB method.
Identification of the isolate by morphological and 16S rRNA sequence analysis revealed
that the isolate is closely related to Arthrobacter gangotriensis (97% similarity).
A. gangotriensis was determined as positive lipase producer based on the plate screening
using specific and sensitive plate assay of Rhodamine B. The PCR result using
Arthrobacter sp.’s full lipase gene sequence as the template primers emphasised a
possible lipase gene at 900 bp band size. The gene is further cloned in a suitable vector
system for expression of lipase.
We report on the cloning of the lipase gene from Bacillus licheniformis IBRLCHS2
and the expression of the recombinant lipase. DNA sequencing analysis of the
cloned lipase gene showed that it shares 99% identity with the lipase gene from
B. licheniformis ATCC 14580 and belongs to subfamily 1.4 of true lipases based on amino
acid sequence alignment of various Bacillus lipases. The 612 bp lipase gene was then
cloned into the pET-15b(+) expression vector and the construct was transformed into
E. coli BL21 (DE3) for bulk expression of the lipase. Expression was analysed by SDSPAGE
where the lipase was found to have a molecular weight of about 23 kDa.
Throughout the cryopreservation process, plants were exposed to a series of
abiotic stresses such as desiccation and osmotic pressure due to highly concentrated
vitrification solution. Abiotic stress stimulates the production of reactive oxygen species
(ROS) which include hydrogen peroxide, superoxide radicals, and singlet oxygen. Higher
production of ROS may lead to oxidative stress which contributes to the major injuries in
cryopreserved explants. Antioxidant enzymes in plant such as ascorbate peroxidase
(APX) can protect plants from cell damage by scavenging the free radicals. This study was
determined based on APX enzyme activity of Aranda Broga Blue orchid’s protocorm-like
bodies (PLBs) in response to PVS2 (Plant Vitrification Solution 2) cryopreservation
treatments at different stages. PLBs that were precultured at 0.25 M sucrose for 3 days
were subjected to vitrification cryopreservation method. Results obtained showed that the
highest APX activity was achieved at PVS2 cryoprotectant treatment prior liquid nitrogen
(LN) storage. This phenomenon indicating that accumulation of osmotic and dehydrating
stress throughout the cryopreservation treatment resulted in oxidative burst which in turn
leads to higher APX activity in order to control the excess production of ROS. To
conclude, PVS2 treatment was revealed as the most detrimental step throughout
cryopreservation treatment. Thus, this research also suggested that exogenous
antioxidant such as ascorbic acid can be added throughout cryopreservation procedure
especially at PVS2 treatment in the future experiments to aid in regrowth of cryopreserved
explants by reducing oxidative stress.
Spheroids have been shown to recapitulate the tumour in vivo with properties
such as the tumour microenvironment, concentration gradients, and tumour phenotype. As
such, it can serve as a platform for determining the growth and invasion behaviour pattern
of the cancer cells as well as be utilised for drug sensitivity assays; capable of exhibiting
results that are closer to what is observed in vivo compared to two-dimensional (2D) cell
culture assays. This study focused on establishing a three-dimensional (3D) cell culture
model using the Nasopharyngeal Carcinoma (NPC) cell line, HK1 and analysing its growth
and invasion phenotypes. The spheroids will also serve as a model to elucidate their
sensitivity to the chemotherapeutic drug, Flavopiridol. The liquid overlay method was
employed to generate the spheroids which was embedded in bovine collagen I matrix for
growth and invasion phenotypes observation. The HK1 cells formed compact spheroids
within 72 hours. Our observation from the 3 days experiments revealed that the spheroids
gradually grew and invaded into the collagen matrix, showing that the HK1 spheroids are
capable of growth and invasion. Progressing from these experiments, the HK1 spheroids
were employed to perform a drug sensitivity assay using the chemotherapeutic drug,
Flavopiridol. The drug had a dose-dependent inhibition on spheroid growth and invasion.
To understand the effects of fish predator’s kairomones on Aedes mosquitoes’
oviposition, we established an experiment using gravid Aedes females. Kairomones
concentrations were established using Hampala macrolepidota. One individual fish was
placed inside containers with varying water levels (1 L, 5 L, and 10 L of water). The fish
were kept in the containers for 24 hours and were removed immediately at the start of
each trial in order to have the kairomones remnants. Twenty gravid adult females of
Aedes aegypti and Aedes albopictus were allowed to lay eggs on oviposition site with
various treatments: (1) control without any kairomones; (2) kairomone remnant in 1 L of
water; (3) kairomone remnant in 5 L of water; and (4) kairomone remnant in 10 L of water.
There are significant differences between the numbers of eggs laid by both Aedes species
for each different treatment (F = 9.131, df = 16, p
MeSH terms: Aedes; Animals; Cyprinidae; Eggs; Female; Oviposition; Pheromones; Water
The influence of the cool and warm temperatures on early life development and
survival of tropical oyster, Crassostrea iredalei was studied. D-hinged larvae (day 1 larvae)
were reared to three different temperatures (20°C, 27°C, and 34°C) for nine days. Oyster
larvae reared in temperature 27°C, acted as control (ambient temperature). The highest
survival rate occurred when the larvae were reared in 20°C and 27°C. Larvae reared at
34°C exhibited reduced survival but increase in the growth rate. The growth rate in larvae
reared in high temperature (34°C) was significantly higher compared to larvae reared in
20°C and 27°C (p
Paederus fuscipes Curtis is a nocturnal insect. The attractiveness of artificial
light sources from residential premises eventually causes the risk of severe dermatitis
effect, once Paederus is in contact with human skin. The objective of this study is to
investigate whether the light and height factors of residential buildings and its’ association
to rice cultivation phases are primary reasons for P. fuscipes’s mass dispersal into human
residential areas. The study site was located in residential premises that were built
adjacent to rice field areas (≈ 32–60 m and 164 m) north of the rice field located in Teluk
Air Tawar, mainland of Pulau Pinang. Overall, both light sources and rice cultivation
phases caused a significant effect for P. fuscipes beetles dispersal flight to invade human
settlements. More P. fuscipes were captured near the bright light source with the highest
number of beetles found during harvesting stage. Whereas, significantly higher number of
P. fuscipes were captured at level 2 and 3 compared to ground and level 1 of the
apartment building and P. fuscipes was also found significantly affected by the rice
cultivation phases at different elevation levels. This indicates that bright light sources and
higher elevation levels are the main factors in attracting P. fuscipes beetles to disperse
and causes infestations in residential areas. This finding could create awareness among
the public on P. fuscipes dispersal pattern.
Coral reefs in the northern region of the Straits of Malacca have a diverse group
of octocorals growing on its bed. The octocorals identified in this study are from islands
along the Straits. In this study, 23 specimens were identified, belonging to 4 sub-orders,
which have been subdivided into 8 families. From these 8 families, 15 different genera
have been identified. The identification process for this research was conducted based on
five important keys; the external form and colouration, polyps or colonial and fundamental
structure of colonies, monomorphic or dimorphic, the arrangement of polyps, and the
arrangement of sclerites.