Rheumatoid arthritis (RA) is a well and widely recognized cause of carpal tunnel syndrome (CTS). In the rheumatoid wrist, synovial expansion, joint erosions and ligamentous laxity result in compression of the median nerve due to increased intracarpal pressure. We evaluated the published studies to determine the prevalence of CTS and the characteristics of the median nerve in RA and its association with clinical parameters such as disease activity, disease duration and seropositivity. A total of 13 studies met the eligibility criteria. Pooled data from 8 studies with random selection of RA patients revealed that 86 out of 1561 (5.5%) subjects had CTS. Subclinical CTS, on the other hand, had a pooled prevalence of 14.0% (30/215). The cross sectional area of the median nerve of the RA patients without CTS were similar to the healthy controls. The vast majority of the studies (8/13) disclosed no significant relationship between the median nerve findings and the clinical or laboratory parameters in RA. The link between RA and the median nerve abnormalities has been overemphasized throughout the literature. The prevalence of CTS in RA is similar to the general population without any correlation between the median nerve characteristics and the clinical parameters of RA.
Goat milk is a highly nutritious and an ideal wholesome food. Today, an increase in demand by
consumers is witnessed towards consuming goat milk, mainly owed to their rich nutraceutical
value. In this study, novel goat milk bar was developed by incorporating rose flower extracts
as an added ingredient (concentration level: 0, 5, 10, 15 and 20%), and by using two different
types of natural sweeteners (cane sugar and palm sugar). The nutrition bars were evaluated
for proximate composition, texture properties and sensory qualities. Results obtained were
encouraging and the new goat milk based nutritional bar formulation with added rose extracts
certainly paves way for future commercial exploitation of the product. Goat milk, owing to its
rich nutraceutical value, and rose extracts owing to the dual functions of a natural antioxidant
and antimicrobial agent, can be beneficial for extending the shelf life of this novel product
under room or refrigerated temperatures, thus attracting better markets.
In this study, toxicological safety (mutagenicity) and therapeutic potential (antimutagenicity)
of water extract of Centella asiatica Linn., were evaluated using the Allium cepa assay. The
mitotic index (MI) at 6.25% concentration of the extract decreased significantly from 3.13% to
2.05% after 24 h and 48 h, respectively, however, the MI increased significantly by 60% and
400% at 12.5% and 50.0% concentrations, respectively. There was total arrest of cell division
at 100% concentration after 24 h and 48 h of onion’s roots exposure to the water extract.
The chromosomal aberrations (CA) induced by the extract were not significantly different
from the negative control (p ≥ 0.05) at the tested concentrations. The mutagenic activity of
cyclophosphamide was significantly suppressed above 50% at the tested concentrations. These
results suggest non-genotoxic effect, and antimutagenic potency of water extract of C. asiatica
in A. cepa cells, being desirable characteristics of anticancer therapeutics.
Seaweeds are marine macro algae that can be found attach to the bottom shallow coastal waters.
There are three major groups of seaweeds namely brown (Phaeophyta), red (Rhodophyta) and
green (Chlorophyta). One of the edible red seaweeds is Eucheuma cottonii. Red seaweeds have
been found of consisted several potential pharmaceutical uses such as antitumor, antiviral,
anticoagulant and immunomodulation functions. In This study, heavy metals content of E.
cottonii was determined by ICP-OES. Methanol was used as solvent for extraction. The
phenolic content of the extract was determined by Follin-Ciocalteau method and results were
expressed as gallic acid equivalents. The antioxidant activity was determined by DPPH assay.
Besides, anti-tyrosinase activity was investigated tyrosinase and L-DOPA with kojic acid as
positive control. For element test, three elements were detected (Ar, Fe and Zn). The phenolic
contents (3.40±0.013 mg GAE/g extract) and antioxidant activity (38.82±0.99 mg/mL) were
lower compared to other plants but E. cottonii shows a good tyrosinase enzyme inhibition
which achieved average 234.33μg/mL in 50% inhibition tyrosinase concentration (IC50). E.
cottonii could be the potential source of natural anti-tyrosinase.
Algal have attracted attention from biomedical scientists as they are a valuable natural
source of secondary metabolites that exhibit antioxidant activities. In this study, singlefactor
experiments were conducted to investigate the best extraction conditions (ethanol
concentration, solid-to-solvent ratio, extraction temperature and extraction time) in extracting
antioxidant compounds and capacities from four species of seaweeds (Sargassum polycystum,
Eucheuma denticulatum , Kappaphycus alvarezzi variance Buaya and Kappaphycus alvarezzi
variance Giant) from Sabah. Total phenolic content (TPC) and total flavonoid content (TFC)
assays were used to determine the phenolic and flavonoid concentrations, respectively, while
2,2-azinobis-3-ethylbenzothiazoline-6-sulfonic acid (ABTS) and 2,2-diphenyl-1-picylhydrazyl
(DPPH) radical scavenging capacity assays were used to evaluate the antioxidant capacities of
all seaweed extracts. Results showed that extraction parameters had significant effect (p < 0.05)
on the antioxidant compounds and antioxidant capacities of seaweed. Sargassum polycystum
portrayed the most antioxidant compounds (37.41 ± 0.01 mg GAE/g DW and 4.54 ± 0.02 mg
CE/g DW) and capacities (2.00 ± 0.01 μmol TEAC/g DW and 0.84 ± 0.01 μmol TEAC/g DW)
amongst four species of seaweed.
This study aimed to determine total antioxidant and antioxidant activity of selected local varieties
of lettuce (Lactuca sativa L.). Five varieties (iceberg, butterhead, romaine, green coral and
red coral) were subjected to DPPH radical scavenging activity and ferric reducing antioxidant
power assay (FRAP) assays for determination of antioxidant activity. Total phenolic content
and total flavonoid content were determined as total antioxidant. The EC50 values obtained from
the DPPH radical scavenging assay ranged from 303.56 to 4485.41 μg/ml. The red coral lettuce
had the lowest EC50 value indicating it possesses the highest antioxidant activity among the
varieties. This variety also showed the highest FRAP value compared with the other varieties,
where the values ranged from 48.05 to 2135.82 mM Fe2+/100 g fresh weight. Total phenolic
content of samples ranged from 4.85 to 76.05 mg gallic acid equivalent/100 g fresh weight,
with the red coral lettuce had the highest value. Total flavonoid content of the lettuce samples
ranged from 2.28 to 21.96 mg quercetin equivalent/100 g fresh weight, and were significantly
different (p
Realizing the huge potential of e-learning in casemix education and since there was no e-learning program on casemix and clinical coding available globally. International Centre for Case-mix and Clinical Coding (ITCC) proposed to establish a universal case-mix education programs through providing an e-learning program (ELP) for case-mix and clinical coding and evaluate its success. The aim of this study is to describe the process of development of e-learning program for casemix system and clinical coding. The introduction of course about casemix and clinical coding was redesigned for elearning program by applying ADDIE model (refer to Analysis, Design, Development, Implementation, and Evaluation).A total number of 57 learners attended to the course from around the world (40 different countries). The mean age of subjects was 34.70±8.66 years. Regarding profession, the largest percentiles (40.4%) of e-learners were belonging to academic sector and healthcare sector. All of the participants felt satisfied or very satisfied with the program. There was a significant difference between pre-test and post-test for e-learners knowledge score at the 0.05 alpha levels. The findings of the evaluation of the case-mix e-learning program indicated that e-learners found the educational performances of the case-mix online program to be satisfactory. With the advent of modern computer networking systems, organizations can employ these systems to enhance learning and performance improvement of case mix system.
Cardiovascular disease (CVD) is the leading cause of death in Malaysia and many parts of the world. Potentially modifiable risk factors for CVD include diabetes mellitus, hypertension, abdominal obesity, smoking and psychosocial stress. Over the last several decades, efforts to prevent or treat CVD risk factors have resulted in significantly lower rates of CVD-related mortality. However, many patients have never achieved adequate control of CVD risk factors despite them being identified. The aims of this study were to measure the prevalence of cardiovascular diseases and to determine its associated factors. A cross sectional study was carried out in a rural area of Malaysia from March 2011 to November 2011 on 1489 respondents aged 18 and above who were selected via convenient sampling. The survey was conducted via a face-to-face interview using a standardized self administered questionnaire. Prevalence of cardiovascular disease identified was 72 cases (4.8%). Overall, the prevalence of modifiable risk factors were predominant compared to non modifiable, with abdominal obesity (51.2%) hypertension (39.5%) and psychosocial stress (33.8%) being among the highest. However, the prevalence of other modifiable risk factors was relatively low with smoking (25.2%), and diabetes mellitus (10.9%) respectively. Respondent with diabetes mellitus and hypertension were 4 times more likely to have cardiovascular disease and those who are obese had associated 2.5risks towards cardiovascular disease. Therefore, community health intervention measures should be mobilized,specifically on prevention and control of lifestyle-related risk factors.
MeSH terms: Adult; Cause of Death; Cross-Sectional Studies; Diabetes Mellitus; Humans; Hypertension; Life Style; Malaysia; Obesity; Surveys and Questionnaires; Risk Factors; Smoking; Prevalence; Obesity, Abdominal
Lower back, neck and shoulder pain are the most prevalent musculoskeletal problems affecting office workers worldwide, and they have both personal and socioeconomic consequences as well. Several hypotheses regarding the underlying mechanisms and the maintenance behind office work-related musculoskeletal disorders have been presented. There is some evidence, based on epidemiological studies as well as studies upon smaller groups of subjects, that individuals who sit and work for a long time not only show cognitive impairment at the workplace, but also suffer from poorer and fragmented daytime sleep, in addition to increased risks of developing various psychological, physiological and medical impairments and musculoskeletal disorders. The related physical mechanisms behind musculoskeletal disorders are discussed in the context of new findings. The main causes, as well as varying levels in severity of musculoskeletal disorders,not to mentionthe link between such disorders in the neck, shoulder and lower back regions and physical activity among office workers are also stated. The main objective of this review paper is to conduct a systematic review to identify musculoskeletal disorders and how these disorders are
correlated with physical activity among office workers. The results of this review indicate that the musculoskeletal disorder is a critical issue among office workers and the main cause is related to the absence of physical activity as well as the subjects’ sedentary lifestyle. As a practical message, regular physical activity can be effective in the prevention and decrease of physical discomfort among office workers who suffer from musculoskeletal pain.
MeSH terms: Adult; Humans; Motor Activity*; Review; Musculoskeletal Pain*
The association between nutrition and cancer in general had been a controversial issue between scientists in the last
three decades, because some argued that there is a relationship and some nutrients can help in preventing cancer
occurrence, although this has not been a consistent finding by other studies. Studies were identified through a
systematic review of literature available on PubMed in between 1st January 2010 to 31st December 2013. We
included all studies that assessed nutrition or diet with occurrence or mortality of breast cancer. Out of 42 articles,
we included 8 articles in our screening and discussion. Among these 8 studies, there were 2 case-controls, 3 cohort
and 3 randomized control trials (RCT) studies. Although most studies reported that nutrition isassociated with
decreased risk, some reported the contrary,whereas others reported no relation. It was demonstrated a conflict
between the included papers in regards of the association between nutrition and breast cancer. These finding needs
to be re-evaluated in future studies.
The prevalence of occupational stress among academician is increasing in developed and developing countries. The job is not only to teach, but also involve in doing research, publications, consultation and administrative work. This study aims to assess the prevalence of occupational stress among academic staff in a research university and to investigate the association and correlation between stress and job factors which are career development, research, teaching and interpersonal relationship. One research university in Malaysia was selected randomly. A cross-sectional study was conducted and the respondents were recruited by using a randomized stratified sampling method. A total of 380 self-administered and validated Depression, Anxiety and Stress Scale-21 (DASS-21) and Stress Sources Questionnaires (SSQ) were distributed among academic staff between March to May 2012. The statistical analyses used were χ2, independent–t test and Pearson Correlation. Response rate was 81.1%. Stress prevalence was 22.1%. All socio-demographic factors showed no association with stress except ethnic group. Teaching, research and career development had significant association with stress among academic staff (p<0.05). Overall result showed career development, that include university condition and required publications for promotion were the greatest source of stress among the academicians. Occupational stress showed positive linear relationship to career development, research and teaching. There was a fair positive relationship between occupational stress and career development, research and teaching. It is recommended to organize continuous stress assessment program to identify and evaluate the current level of stress at the university level. This data could be a foundation for implementing prevention and control measures to reduce stress in the workplace.
Keywords: academic staff, lecturer, occupational stress, research, teaching, career development, interpersonal relationship, research university, job stress
Patients with chronic heart failure suffer from undesirable effects in their daily activities. Effective self-care management in conjunction with social support gives improved the wellbeing of patients with chronic heart failure. This study determines social support and self-care management among patients with chronic heart failure. A cross-sectional study was conducted at the Cardiology Clinic in Hospital Serdang, Selangor from April 2014 to June 2014. A questionnaire consisting of demographic characteristics, MOS Social Survey and Self-Care Heart Failure Index (SCHFI) was distributed to a total of 113 respondents. The results show moderately high level of social support (3.51±0.89) and level of self-care management (160.49±44.39). For instance, social support and self-care management were not statistically significant with the demographic characteristics (p>0.05). There was a positive correlation between social support and self-care management (r=0.263, p<0.05) and the findings suggest that social support should be considered a predictor in self-care management of patients with chronic heart failure.
Keywords: social support, self-care management, patient(s), chronic heart failure
Study site: Cardiology Clinic in Hospital Serdang, Selango
This cross sectional study investigated the test –retest reliability of the Malay Version Job Content
Questionnaire (M- JCQ) among electricity linemen. The M-JCQquestionnaire was administered to 10
electricity linemen working in private sub-contract company. The data were collected at two occasions
with one week interval of time between each sessions. Intraclass Correlation Coefficient (ICC) and Bland
Altman plot were used to analyze the reliability of the M-JCQ. The ICC for the ‘psychological demand’,
‘decision latitude’, ‘work related social support’ and ‘job insecurity’ scale were 0.96, 0.52, 0.99 and 0.55
respectively. The Bland Altman plot indicated that the tests and retest score for all the four scales had an
acceptable agreement. These findings indicated that the M- JCQ is reliable and consistent for assessing
work related psychosocial risk factors among electricity linemen.
Hepatitis B virus (HBV) infection is an upcoming public health problem in Malaysia. This study analysed the
trend of Hepatitis B (HB) cases from 2003 to 2012 and project the cases for an 18-year period (2013–2030).
Based on the national data of annual reported cases and the Malaysian population projections (2010–2040),
trend/regression lines were fitted to analyse the trend and estimated HB incidence. The number of HB
cases decreased for six consecutive years and began to increase from 2010 onwards. During the 10-year
period (2003–2012), the highest number of HB cases was reported in Sabah, followed by Pahang and
Wilayah Persekutuan; the lowest was reported in Perlis. The exponential curve shows a decrease of HB
cases by an average of 6.3%. However, the polynomial curve shows fluctuations in the trend, with a higher
degree of R-square (0.8655). Most states appear to be at moderate vulnerability to HBV infection (Kedah,
Perak, Negeri Sembilan, Terengganu, Sabah, and Sarawak), except for Melaka, Wilayah Persekutuan, and
Selangor, which were at high risk of HB incidences. Overall, the estimated HB cases indicate that the
number of cases and the incidence rates will increase in the future in all states, except for Penang. As the
estimated HB cases and incidence rates show an increasing pattern, the government should strengthen
their strategies in the management of HB and take preventive measures such as educating the public
through awareness programmes, conducting compulsory blood screening, and sustaining the Expanded
Programme on Immunization effectively.
Diagnosis-related group (DRG) system is patient classification system designed to produce limited number of classes
which are relatively similar in terms of resource consumption and clinical characteristics. The aim of this study was to
assess the level of knowledge, attitude and practice (KAP) of Turkish health care providers toward DRG system
implemented in Turkey.A total of 238 healthcare providers were randomly selected from two urbanand one rural hospital
in Turkey.A questionnaire was used for data collection; contacting 32 items (10 items about knowledge, 12 items about
attitude and 10 items about the practice) and its validity and reliability were confirmed. Data analysis was performed
using chi-square and multivariate logistic regression.In this study,only one third of healthcare providers showed good
knowledge (35.7%) and good practice (37.4%) about DRG system,compared to 54.2% of them showed good attitude.There
was significant difference between age, gender, occupation groups and whether the respondents have attended a
workshop for DRG system in terms of KAP (p > 0.05).These results indicated the need for further actions to implement
DRG system in terms of creation of suitable environment and increasing awareness among healthcare providers,
especially male, medical doctors, nurses, elderly, and those who have never attended a workshop, in addition to regular
review to ensure the program would reach its targets.
MeSH terms: Aged; Attitude; Diagnosis-Related Groups; Health Personnel; Hospitals, Rural; Humans; Male; Occupations; Physicians; Surveys and Questionnaires; Turkey; Reproducibility of Results; Logistic Models
A concern in breast cancer involves changes in weight which may adversely affect the prognosis of patients. This
study intended to evaluate weight changed uring chemotherapy and its association with prognostic outcome
measured as event-free survival (EFS)among breast cancer patients. A total of63 women diagnosed with breast cancer
and have been treated by anthracycline-based chemotherapy between 2005 and 2011were included.A weight change
(WC) was calculated based on relative percentage of weight changes from baseline to post-chemotherapy and
categorized into either weight change (WC >5%) or stable (±5% WC).Survival probabilities were estimated using the
Kaplan-Meier (SPSS 20). Upon treatment completion, 42.9% of the women experienced weight changes. A small
weight reduction was observed (61.1 ± 11.6kg to 60.2 ± 11.9kg; -0.8 ± 4.0kg; p=0.106). The median EFS of women who
experienced weight change was shorter (median 61.0 months) compared to those who maintained their weight
(median 89.0 months) (p=0.044). In this study, weight changes during breast cancer chemotherapy were associated
with poorer prognosis in comparison to women who maintained their weight.
Fungi are important natural product sources that have enormous potential for the production of novel compounds for use in pharmacology, agricultural applications and industry. Compared with other natural sources such as plants, fungi are highly diverse but understudied. However, research on Cladosporium cladosporioides revealed the existence of bioactive products such as p-methylbenzoic acid, ergosterol peroxide (EP) and calphostin C as well as enzymes including pectin methylesterase (PME), polygalacturonase (PG) and chlorpyrifos hydrolase. p-Methylbenzoic acid has ability to synthesise 1,5-benzodiazepine and its derivatives, polyethylene terephthalate and eicosapentaenoic acid. EP has anticancer, antiangiogenic, antibacterial, anti-oxidative and immunosuppressive properties. Calphostin C inhibits protein kinase C (PKC) by inactivating both PKC-epsilon and PKC-alpha. In addition, calphostin C stimulates apoptosis in WEHI-231 cells and vascular smooth muscle cells. Based on the stimulation of endoplasmic reticulum stress in some types of cancer, calphostin C has also been evaluated as a potential photodynamic therapeutic agent. Methylesterase (PME) and PG have garnered attention because of their usage in the food processing industry and significant physiological function in plants. Chlorpyrifos, a human, animal and plant toxin, can be degraded and eliminated by chlorpyrifos hydrolase.
Enzymatic catalysis is considered to be among the most environmental friendly processes for the synthesis of fine chemicals. In this study, lipase from Thermomyces lanuginosus (Lecitase Ultra™) was used to catalyze the synthesis of flavor esters, i.e., methyl butanoate and methyl benzoate by esterification of the acids with methanol in a microfluidic system. Maximum reaction rates of 195 and 115 mM min(-1) corresponding to catalytic efficiencies (k cat/K M) of 0.30 and 0.24 min(-1) mM(-1) as well as yield conversion of 54 and 41 % were observed in methyl butanoate and methyl benzoate synthesis, respectively. Catalytic turnover (k cat) was higher for methyl butanoate synthesis. Rate of synthesis and yield decreased with increasing flow rates. For both esters, increase in microfluidic flow rate resulted in increased advective transport over molecular diffusion and reaction rate, thus lower conversion. In microfluidic synthesis using T. lanuginosus lipase, the following reaction conditions were 40 °C, flow rate 0.1 mL min(-1), and 123 U g(-1) enzyme loading found to be the optimum operating limits. The work demonstrated the application of enzyme(s) in a microreactor system for the synthesis of industrially important esters.
Lignocellulosic biomasses, exhibit resistance to enzymatic hydrolysis due to the presence of lignin and hemicellulose. Ionic liquids proved their applicability in lignin degradation, however, ionic liquid removal has to be performed to proceed to hydrolysis. Therefore, this study reports an in situ hydrolysis of empty fruit bunches (EFB) that combined an ionic liquid (IL) pretreatment and enzymatic hydrolysis. For enzyme production, palm kernel cake (PKC) was used as the primary media for microbial cellulase (PKC-Cel) from Trichoderma reesei (RUTC30). The obtained enzyme exhibited a promising stability in several ionic liquids. Among few, in choline acetate [Cho]OAc, PKC-Cel retained 63.16 % of the initial activity after 6 h and lost only 10 % of its activity in 10 % IL/buffer mixture. Upon the confirmation of the PKC-Cel stability, EFB was subjected to IL-pretreatment followed by hydrolysis in a single step without further removal of the IL. The findings revealed that choline acetate [Cho]OAc and choline butyrate [Cho]Bu were among the best ILs used in the study since 0.332 ± 0.05 g glucose/g and 0.565 ± 0.08 g total reducing sugar/g EFB were obtained after 24 h of enzymatic hydrolysis. Compared to the untreated EFB, the amount of reducing sugar obtained after enzymatic hydrolysis increased by three-fold in the case of [Cho]OAc and [Cho]Bu, two-fold with [EMIM]OAc and phosphate-based ILs whereas the lowest concentration was obtained in [TBPH]OAc. Pretreatment of EFB with [Cho]OAc and [Cho]Bu showed significant differences in the morphology of EFB samples when observed with SEM. Analysis of the lignin, hemicellulose and hemicellulose showed that the total lignin content from the raw EFB was reduced from 37.8 ± 0.6 to 25.81 ± 0.35 % (w/w) upon employment of [Cho]OAc in the compatible system. The PKC-Cel from T. reesei (RUTC30) exhibited promising characteristics that need to be investigated further towards a single-step process for bioethanol production.
The biggest agricultural sector that contributes to the Malaysian economy is the oil palm industry. The effluent generated during the production of crude palm oil known as palm oil mill effluent (POME). POME undergoes anaerobic treatment that requires long retention time and produces large amount of methane that consequently contributes to global warming. In this study, an isolated bacteria was selected based on its ability to degrade kraft lignin (KL) and identified as Ochrobactrum sp. The bacteria were able to treat POME (from anaerobic pond) under the aerobic condition without addition of nutrient, resulting in a significant chemical oxygen demand (COD) removal of 71 %, removal rate of 1385 mg/l/day, and 12.3 times higher than that of the ponding system. It has also resulted in 60 % removal of ammoniacal nitrogen and 55 % of total polyphenolic after 6-day treatment period with the detection of lignocellulolytic enzymes.