Browse publications by year: 2018

Fulltext Material Characterization of a Magnetorheological Fluid Subjected to Long-Term Operation in Damper

Utami D, Ubaidillah, Mazlan SA, Imaduddin F, Nordin NA, Bahiuddin I, et al.

Materials (Basel), 2018 Nov 06;11(11).
PMID: 30404193 DOI: 10.3390/ma11112195

This paper investigates the field-dependent rheological properties of magnetorheological (MR) fluid used to fill in MR dampers after long-term cyclic operation. For testing purposes, a meandering MR valve was customized to create a double-ended MR damper in which MR fluid flowed inside the valve due to the magnetic flux density. The test was conducted for 170,000 cycles using a fatigue dynamic testing machine which has 20 mm of stroke length and 0.4 Hz of frequency. Firstly, the damping force was investigated as the number of operating cycles increased. Secondly, the change in viscosity of the MR fluid was identified as in-use thickening (IUT). Finally, the morphological observation of MR particles was undertaken before and after the long-term operation. From these tests, it was demonstrated that the damping force increased as the number of operating cycles increases, both when the damper is turn on (on-state) and off (off-state). It is also observed that the particle size and shape changed due to the long operation, showing irregular particles.

MeSH terms: Fatigue; Particle Size; Rheology; Viscosity; Stroke; Physical Phenomena; Mechanical Phenomena
Locomotor constraints favour the evolution of the human pygmy phenotype in tropical rainforests

Venkataraman VV, Yegian AK, Wallace IJ, Holowka NB, Tacey I, Gurven M, et al.

Proc Biol Sci, 2018 11 07;285(1890).
PMID: 30404871 DOI: 10.1098/rspb.2018.1492

The convergent evolution of the human pygmy phenotype in tropical rainforests is widely assumed to reflect adaptation in response to the distinct ecological challenges of this habitat (e.g. high levels of heat and humidity, high pathogen load, low food availability, and dense forest structure), yet few precise adaptive benefits of this phenotype have been proposed. Here, we describe and test a biomechanical model of how the rainforest environment can alter gait kinematics such that short stature is advantageous in dense habitats. We hypothesized that environmental constraints on step length in rainforests alter walking mechanics such that taller individuals are expected to walk more slowly due to their inability to achieve preferred step lengths in the rainforest. We tested predictions from this model with experimental field data from two short-statured populations that regularly forage in the rainforest: the Batek of Peninsular Malaysia and the Tsimane of the Bolivian Amazon. In accordance with model expectations, we found stature-dependent constraints on step length in the rainforest and concomitant reductions in walking speed that are expected to compromise foraging efficiency. These results provide the first evidence that the human pygmy phenotype is beneficial in terms of locomotor performance and highlight the value of applying laboratory-derived biomechanical models to field settings for testing evolutionary hypotheses.

MeSH terms: Adaptation, Biological*; Biomechanical Phenomena; Body Height*; Bolivia; Humans; Locomotion*; Malaysia; Male; Models, Biological; Phenotype*; Tropical Climate; Rainforest*
Fulltext Stability Evaluations of Different Types of Vegetable Oil-based Emulsions

Teh SS, Mah SH

J Oleo Sci, 2018;67(11):1381-1387.
PMID: 30404958 DOI: 10.5650/jos.ess18067

The study was aimed at evaluating the effects of vegetable oils on emulsion stability. Palm olein (POo), olive oil (OO), safflower oil (SAF), grape seed oil (GSO), soybean oil (SBO) and sunflower oil (SFO) with different degree of saturation levels were chosen as major ingredient of oil phases. All the emulsions were stored at 4℃, 27℃ and 40℃ for 35 days and subjected to all the stability tests, including temperature variation, centrifuge test, cycle test, pH and slip melting point. The results indicated that POo exhibited the highest stability, followed by SAF, OO, GSO, SFO and SBO. In addition, the results implied that the degree of saturation levels of vegetable oils does give significant effect on emulsion stability based on the centrifuge testing for an approximate 30% usage level of oil. The POo-based emulsion exhibited good emulsion stability throughout the experimental period indicated that POo could be a good carrier oil for various applications in cosmetic industry.

MeSH terms: Olive Oil/chemistry; Centrifugation; Cosmetics; Emulsions/chemistry*; Hydrogen-Ion Concentration; Plant Oils/chemistry*; Safflower Oil/chemistry; Soybean Oil/chemistry; Temperature; Transition Temperature; Grape Seed Extract/chemistry
Fulltext Synthesis and Optimization of Chitosan Nanoparticles Loaded with L-Ascorbic Acid and Thymoquinone

Othman N, Masarudin MJ, Kuen CY, Dasuan NA, Abdullah LC, Md Jamil SNA

Nanomaterials (Basel), 2018 Nov 07;8(11).
PMID: 30405074 DOI: 10.3390/nano8110920

The combination of compounds with different classes (hydrophobic and hydrophilic characters) in single chitosan carrier is a challenge due to the hydrophilicity of chitosan. Utilization of l-ascorbic acid (LAA) and thymoquinone (TQ) compounds as effective antioxidants is marred by poor bioavailability and uptake. Nanoparticles (NPs) solved the problem by functioning as a carrier for them because they have high surface areas for more efficient delivery and uptake by cells. This research, therefore, synthesized chitosan NPs (CNPs) containing LAA and TQ, CNP-LAA-TQ via ionic gelation routes as the preparation is non-toxic. They were characterized using electron microscopy, zetasizer, UV⁻VIS spectrophotometry, and infrared spectroscopy. The optimum CNP-LAA-TQ size produced was 141.5 ± 7.8 nm, with a polydispersity index (PDI) of 0.207 ± 0.013. The encapsulation efficiency of CNP-LAA-TQ was 22.8 ± 3.2% for LAA and 35.6 ± 3.6% for TQ. Combined hydrophilic LAA and hydrophobic TQ proved that a myriad of highly efficacious compounds with poor systemic uptake could be encapsulated together in NP systems to increase their pharmaceutical efficiency, indirectly contributing to the advancement of medical and pharmaceutical sectors.

MeSH terms: Antioxidants; Ascorbic Acid; Biological Availability; Gels; Microscopy, Electron; Spectrophotometry; Spectrum Analysis; Benzoquinones; Chitosan; Nanoparticles; Hydrophobic and Hydrophilic Interactions
Fulltext Transcriptomic and Genomic Approaches for Unravelling Candida albicans Biofilm Formation and Drug Resistance-An Update

Chong PP, Chin VK, Wong WF, Madhavan P, Yong VC, Looi CY

Genes (Basel), 2018 Nov 07;9(11).
PMID: 30405082 DOI: 10.3390/genes9110540

Candida albicans is an opportunistic fungal pathogen, which causes a plethora of superficial, as well as invasive, infections in humans. The ability of this fungus in switching from commensalism to active infection is attributed to its many virulence traits. Biofilm formation is a key process, which allows the fungus to adhere to and proliferate on medically implanted devices as well as host tissue and cause serious life-threatening infections. Biofilms are complex communities of filamentous and yeast cells surrounded by an extracellular matrix that confers an enhanced degree of resistance to antifungal drugs. Moreover, the extensive plasticity of the C. albicans genome has given this versatile fungus the added advantage of microevolution and adaptation to thrive within the unique environmental niches within the host. To combat these challenges in dealing with C. albicans infections, it is imperative that we target specifically the molecular pathways involved in biofilm formation as well as drug resistance. With the advent of the -omics era and whole genome sequencing platforms, novel pathways and genes involved in the pathogenesis of the fungus have been unraveled. Researchers have used a myriad of strategies including transcriptome analysis for C. albicans cells grown in different environments, whole genome sequencing of different strains, functional genomics approaches to identify critical regulatory genes, as well as comparative genomics analysis between C. albicans and its closely related, much less virulent relative, C. dubliniensis, in the quest to increase our understanding of the mechanisms underlying the success of C. albicans as a major fungal pathogen. This review attempts to summarize the most recent advancements in the field of biofilm and antifungal resistance research and offers suggestions for future directions in therapeutics development.

MeSH terms: Antifungal Agents; Candida albicans; Extracellular Matrix; Humans; Symbiosis; Virulence; Biofilms; Gene Expression Profiling; Genomics; Drug Resistance, Fungal
Fulltext Antioxidant and Oxidative Stress: A Mutual Interplay in Age-Related Diseases

Tan BL, Norhaizan ME, Liew WP, Sulaiman Rahman H

Front Pharmacol, 2018;9:1162.
PMID: 30405405 DOI: 10.3389/fphar.2018.01162

Aging is the progressive loss of organ and tissue function over time. Growing older is positively linked to cognitive and biological degeneration such as physical frailty, psychological impairment, and cognitive decline. Oxidative stress is considered as an imbalance between pro- and antioxidant species, which results in molecular and cellular damage. Oxidative stress plays a crucial role in the development of age-related diseases. Emerging research evidence has suggested that antioxidant can control the autoxidation by interrupting the propagation of free radicals or by inhibiting the formation of free radicals and subsequently reduce oxidative stress, improve immune function, and increase healthy longevity. Indeed, oxidation damage is highly dependent on the inherited or acquired defects in enzymes involved in the redox-mediated signaling pathways. Therefore, the role of molecules with antioxidant activity that promote healthy aging and counteract oxidative stress is worth to discuss further. Of particular interest in this article, we highlighted the molecular mechanisms of antioxidants involved in the prevention of age-related diseases. Taken together, a better understanding of the role of antioxidants involved in redox modulation of inflammation would provide a useful approach for potential interventions, and subsequently promoting healthy longevity.
AFOMP policy number 6: code of ethics for medical physicists in AFOMP Countries

Round WH, Ng KH, Rodriguez L, Thayalan K, Tang F, Srivastava R, et al.

Australas Phys Eng Sci Med, 2018 Dec;41(4):809-810.
PMID: 30406922 DOI: 10.1007/s13246-018-0708-x

This policy statement, which is the sixth of a series of documents prepared by the Asia-Oceania Federation of Organizations for Medical Physics (AFOMP) Professional Development Committee, gives guidance on how medical physicists in AFOMP countries should conduct themselves in an ethical manner in their professional practice (Ng et al. in Australas Phys Eng Sci Med 32:175-179, 2009; Round et al. in Australas Phys Eng Sci Med 33:7-10, 2010; Round et al. in Australas Phys Eng Sci Med 34:303-307, 2011; Round et al. in Australas Phys Eng Sci Med 35:393-398, 2012; Round et al. in Australas Phys Eng Sci Med 38:217-221, 2015). It was developed after the ethics policies and codes of conducts of several medical physics societies and other professional organisations were studied. The policy was adopted at the Annual General Meeting of AFOMP held in Jaipur, India, in November 2017.

MeSH terms: Humans; Codes of Ethics; Australasia
Evaluation of the Effectiveness of a 3-Year, Teacher-Led Healthy Lifestyle Program on Eating Behaviors Among Adolescents Living in Day School Hostels in Malaysia

Teng CY, Chin YS, Taib MNM, Chan YM

Food Nutr Bull, 2018 12;39(4):595-607.
PMID: 30407077 DOI: 10.1177/0379572118795358

BACKGROUND: Independence gained during adolescence may be associated with unhealthy eating behaviors. Although malnutrition among adolescents is evident, studies on eating behaviors among adolescents are scarce.
OBJECTIVE: To determine the effectiveness of a teacher-led Healthy Lifestyle Program on eating behaviors among adolescents in Malaysia.
METHODS: This was a cluster randomized controlled trial (conducted in 2012 to 2014), with 100 schools randomly selected from 721 schools, then assigned to 50 intervention schools and 50 control schools. A Healthy Eating and Be Active among Teens (HEBAT) module was developed for pretrained teachers to deliver a Healthy Lifestyle Program on eating behaviors among adolescents. Eating behaviors of the respondents was determined using Eating Behaviors Questionnaire. Linear Mixed Model analysis and χ2 test were used to determine within- and between-group effects of studied variables.
RESULTS: A total of 4277 respondents participated in this study, with 2635 samples involved in the final analysis, comprised of 921 intervention and 1714 control respondents. There were 32.4% (36.4%) males and 67.6% (63.6%) females in the intervention (control) group. Mean age was comparable between the groups (intervention = 12.98 years; control = 12.97 years). Majority of the respondents skipped meals at baseline (intervention = 74.7%; control = 79.5%). After the program, intervention respondents had higher consumption frequency of lunch, dinner, and mid-morning snack but a lower consumption frequency of late-evening snack and meal skipping behaviors than their control counterparts.
CONCLUSION: The teacher-led Healthy Lifestyle Program was effective in reducing meal-skipping behaviors among Malaysian adolescents.

MeSH terms: Adolescent; Adolescent Behavior*; Child; Female; Health Promotion/methods*; Humans; Malaysia; Male; Schools*; Healthy Diet/statistics & numerical data*
Fulltext Anti-EGFR anchored paclitaxel loaded PLGA nanoparticles for the treatment of triple negative breast cancer. In-vitro and in-vivo anticancer activities

Venugopal V, Krishnan S, Palanimuthu VR, Sankarankutty S, Kalaimani JK, Karupiah S, et al.

PLoS One, 2018;13(11):e0206109.
PMID: 30408068 DOI: 10.1371/journal.pone.0206109

The aim of the present study is to analyze the viability of anti-EGFR anchored immunonanoparticle (INP) bearing Paclitaxel (PTX) to specifically bind the EGFR protein on the TNBC cells. The NP was prepared by nanoprecipitation and characterized the particle size, charge, entrapment of drug and release of it. The anti-EGFR anchored and the integrity was confirmed by SDS-PAGE. Cytotoxicity and NPs cellular uptake was analyzed with MDA-MB-468 type cancer cells and the EGFR expression was confirmed by PCR, qualitatively and quantitatively. The in-vivo antitumor activity of INP was determined by using athymic mice model and targeting efficiency was measured by calculating the PTX accumulation in the tumor plasma. The prepared INP with the size of 336.3 nm and the charge of -3.48 mV showed sustained drug release upto 48 h. The INP showed significant reduction of cancer cell viability of 10.6% for 48 h with 93 fold higher PTX accumulation in the tumor plasma compared with NPs. Based on these reports, we recommend that anti-EGFR anchored PTX loaded NP may have the ability to target the TNBC cells and improve the therapeutic action and subsidize the side effects of PTX for the treatment of TNBC.

MeSH terms: Animals; Cell Survival/drug effects; Delayed-Action Preparations; Drug Carriers/administration & dosage; Drug Carriers/chemistry; Humans; Paclitaxel/administration & dosage*; Paclitaxel/chemistry; Xenograft Model Antitumor Assays; Cell Line, Tumor; Mice; Nanoparticles/administration & dosage*; Nanoparticles/chemistry; Triple Negative Breast Neoplasms/drug therapy*; Triple Negative Breast Neoplasms/pathology; ErbB Receptors/antagonists & inhibitors; ErbB Receptors/chemistry
Fulltext Recovery planning towards doubling wild tiger Panthera tigris numbers: Detailing 18 recovery sites from across the range

Harihar A, Chanchani P, Borah J, Crouthers RJ, Darman Y, Gray TNE, et al.

PLoS One, 2018;13(11):e0207114.
PMID: 30408090 DOI: 10.1371/journal.pone.0207114

With less than 3200 wild tigers in 2010, the heads of 13 tiger-range countries committed to doubling the global population of wild tigers by 2022. This goal represents the highest level of ambition and commitment required to turn the tide for tigers in the wild. Yet, ensuring efficient and targeted implementation of conservation actions alongside systematic monitoring of progress towards this goal requires that we set site-specific recovery targets and timelines that are ecologically realistic. In this study, we assess the recovery potential of 18 sites identified under WWF's Tigers Alive Initiative. We delineated recovery systems comprising a source, recovery site, and support region, which need to be managed synergistically to meet these targets. By using the best available data on tiger and prey numbers, and adapting existing species recovery frameworks, we show that these sites, which currently support 165 (118-277) tigers, have the potential to harbour 585 (454-739) individuals. This would constitute a 15% increase in the global population and represent over a three-fold increase within these specific sites, on an average. However, it may not be realistic to achieve this target by 2022, since tiger recovery in 15 of these 18 sites is contingent on the initial recovery of prey populations, which is a slow process. We conclude that while sustained conservation efforts can yield significant recoveries, it is critical that we commit our resources to achieving the biologically realistic targets for these sites even if the timelines are extended.

MeSH terms: Animals; Asia; Goals; Population Density; Predatory Behavior; Time Factors; Tigers*; Endangered Species*
Neighbourhood influences and its association with the mental health of adolescents in Kuala Lumpur, Malaysia

Zahir Izuan A, Shamsul Azhar S, Tan MKS, Syed-Sharizman SAR

Asian J Psychiatr, 2018 Dec;38:35-41.
PMID: 30408711 DOI: 10.1016/j.ajp.2018.10.018

BACKGROUND: Mental health problems are affecting more children and adolescents worldwide. Individual, family and school factors are often linked with mental health problems among adolescents.
AIM: To determine the neighbourhood factors influencing the prevalence of abnormal mental health status among adolescents in an urban population.
METHOD: A cross-sectional study was conducted among adolescents aged 13, 14 and 16 years old from thirteen secondary schools in Kuala Lumpur using validated questionnaires. A total of 567 adolescents participated in this study.
RESULTS: The prevalence of abnormal mental health status in this study was 4.4%. In multivariable analysis, female (OR = 1.79, 95%CI: 1.11-2.89), having divorced parents (OR = 3.53, 95%CI: 1.96-6.36), high educational stress (OR = 8.18, 95%CI: 4.25-15.75), medium educational stress (OR = 2.99, 95%CI: 1.53-5.83), whose house has been broken in before (OR = 2.02, 95%CI: 1.11-3.68) and living in a neighbourhood with low socioeconomic status (OR = 2.09, 95%CI: 1.23-3.56) were more likely to have abnormal mental health status.
CONCLUSIONS: Neighbourhood factors were found to be significant in determining adolescents' mental health status. The findings emphasize the importance of those in the public health sector to highlight these significant neighbourhood factors to the Ministry of Housing and Local Government. Swift action needs to be taken by the Ministry to provide solutions related to the neighbourhood factors and this can contribute to improvement in the adolescents' mental health.
Fulltext Risk of deterioration among general ward patients: nurses' ability in assessing early warning signs

Salizar Mohamed Ludin

Malaysian Journal of Medical Research, 2018;2(1):19-29.
MyJurnal

Background:The challenge of recognizing ward-based patients at risk of deterioration is discussed
frequently within the relevant literature. Nurses in particular hold the prime position to identify problems at
an early stage using systematic patient assessment. However, general ward nurses' perceived knowledge,
attitudes, and practice related to assessment of the risk of deterioration are not well understood. Failures to
recognize or act upon the deterioration of general ward patients has sometimes resulted in the implementation
of early warning scoring systems and Critical Care Outreach teams.

Aim: The study aim to explore general ward nurses' perceived knowledge, attitude, and practice (KAP) in
assessing patients at risk of deteriorating in general wards.

Method: ACross-sectional study design with Modified Early Warning Score questionnaire for general ward
nurses was done in one tertiary hospital in Malaysia in 2013 and 2014.

Results: General ward nurses perceived that they struggled with knowledge and attitude, but they feel they
performed good practice in assessing patients at risk for deterioration. Nevertheless, the study finding shows
otherwise. Only one respondent achieved 'grade B' (85%) and the remainder scored in the band 'grade F'
(very poor). The respondents' attitude was measured by their perception of their levels of confidence and
concern. The mean confidence level was greater than six out of 10 for all categories. The attitudes mean score
± SD was set at 42.02 ±7.76. The data showed that 51% (N=50) scored below mean core of 42.02. However,
participants' overall mean score ±SD for perceptions of practice (risk of deterioration assessment) was 90.27
± 21.87 (6.94+/-1.683). The majority of participants awarded themselves a score between eight and nine,
which is in the 'good' range for the scale (0-2 weak; 3-5 moderate; 6-8 good; 9-10 excellent). Those who
scored above it were classified as having a good attitude.

Conclusion: A need exists for general ward nurses to gain a knowledge foundation in detecting abnormality
to address lack of confidence, poor attitude and alertness, and concern.
Fulltext Knowledge, perceptions and barriers of blood donation among adults in Hospital Universiti Sains Malaysia

Chin, Chee Kee, Dariah Mohd Yusoff, Kueh, Yee Cheng

Malaysian Journal of Medical Research, 2018;2(1):1-9.
MyJurnal

Blood donation is important for lives saving and the need is unceasing. However, the shortage of blood supply
is a common issue. While the public is the main source of blood donation, it is unknown whether they are
aware about it. This study was carried out to determine the public's knowledge, perceptions and barriers
towards blood donation. Atotal of 384 male and female respondents were conveniently selected to participate
in this study. Data was collected through self-administered questionnaire and analyzed with SPSS software
version 22.0. Most of the respondents (60.9%) had never donated blood but their knowledge towards blood
donation was high (79.9%). Some misconceptions were indicated among respondents. Afraid of the needle
prick, pain or discomfort were the top barriers among non-donors respondents (45.3%). The majority of the
respondents believed that blood donation is a practice or selfless concern for the well-being of others (98.7%).
A significant relationship was indicated between age and level of education with status of blood donation
(p

MeSH terms: Awareness; Blood Donors; Educational Status; Fear; Female; Male; Pain; Perception; Surveys and Questionnaires; Software
Fulltext Foot reflexology therapy for non-specific low back pain condition : a protocol for a randomized controlled trial

Nor Dalila Marican, Rozita Hod, Nadiah Wan-Arfah, Azmi Hassan

Int J Public Health Res, 2018;8(1):933-938.
MyJurnal

Introduction Non-specific low back pain is one of the most common physical ailments
affecting millions of people worldwide. This condition constitutes a
significant public health problem and was listed as a prevalent health
complaint in most societies. Even though there are many anecdotal claims
for reflexology in the treatment of various conditions such as a migraine,
arthritis and multiple sclerosis, but very little clinical evidence exists for
reflexology on the management of low back pain per se. This study aims to
evaluate the effects of foot reflexology therapy as an adjunctive treatment to
the Malaysian low back pain standard care in relieving pain and promoting
health-related quality of life among people with non-specific low back pain.
Methods This is a parallel randomized controlled trial with pre and post-treatment
study design. The study setting for the intervention located at Penawar
Reflexology Center, Kuala Terengganu, Malaysia. A total of 100
participants with non-specific low back pain will be allocated to one of two
groups, using a randomization computer program of Research Randomizer.
The control group will receive low back pain standard care, while the
intervention group will receive standard care plus eight sessions of foot
reflexology therapy. The pain intensity and health-related quality of life
scores will be measured using Visual Analogue Scale and Euro-quality of
life scale respectively in both groups. The study was approved by the
Human Research Ethics Committee of University Sultan Zainal Abidin
(UHREC/2016/2/011). The study protocol was registered at
ClinicalTrials.gov, with the ID number of NCT02887430.
Measurements Outcome measures will be undertaken at pre-intervention (week 1), postintervention
(week 6) and follow-up (week 10).
Conclusions This will be the first trial to compare the foot reflexology therapy with
control group among people who medically diagnosed with non-specific low
back pain in Malaysia. The result of this study will contribute to better
management of this population, especially for Malaysia healthcare setting.

Study site: Penawar Reflexology Center, Kuala Terengganu, Malaysia

MeSH terms: Arthritis; Eugenol; Follow-Up Studies; Humans; Malaysia; Massage; Migraine Disorders; Multiple Sclerosis; Pain Measurement; Public Health; Quality of Life; Random Allocation; Software; Universities; Zinc Oxide; Outcome Assessment (Health Care); Low Back Pain; Ethics Committees, Research; Control Groups; Visual Analog Scale
Fulltext The level of knowledge, attitudes and practices towards the prevention of HIV/AIDS among young mothers. [Tahap pengetahuan, sikap dan amalan terhadap pencegahan HIV/AID dalam kalangan ibu muda.]

Norfazilah Ahmad, Mohd Rohaizat Hassan, Incham Manggat, Mohd Rizam Abdul Rahman, Hazlina Mohd Miskam, Sazman Wahab, et al.

Int J Public Health Res, 2018;8(1):913-923.
MyJurnal

Introduction The Acquired Immuno Deficiency Syndrome (AIDS) is caused by Human Immunodeficiency Virus (HIV) infection and a disease with high morbidity and mortality.Young mothers are sub-populations that are at high risk for HIV through sexual activity. In addition, information on the level of knowledge, attitude and practice among young mothers in Malaysia regarding HIV/AIDS prevention is still limited.Therefore, the objective of this study is to examine the level of knowledge, attitudes and practices towards the prevention of HIV/AIDS among young mothers and the factors that influence them.
Methods A cross-sectional study was conducted at a tertiary hospital in a city center among 147 young mothers aged 18-30 years old at the Post Natal and Obstetrics and Gynecology Ward (O & G). Data collection was conducted in April-November 2014 and the respondents' selection was based on simple random sampling. A questionnaire containing validated instruments was used in this study. Approval for conducting research has been obtained from the UKM Research Ethics Committee before the data collection procedure is implemented.
Results Majority of the young mothers have good knowledge (78.8%) and practice (71.2%) towards HIV/AIDS prevention. While more than half of them (56.7%) have positive attitude towards the prevention of HIV/AIDS. Living in the urban area and being married are significantly associated with having good knowledge and positive attitude towards HIV/AIDS prevention. While, mothers who are 5 years older compared to the younger ones and being married are significantly associated with having good practice towards HIV/AIDS prevention.
Conclusions The level of knowledge, attitudes and practices as well as the associated factors could be the baseline to formulate health intervention to prevent HIV/AIDS among this vulnerable group.

MeSH terms: Acquired Immunodeficiency Syndrome; Attitude; Cross-Sectional Studies; Female; Hospitals, University; Humans; Health Knowledge, Attitudes, Practice; Malaysia; Marriage; Mothers; Obstetrics; Surveys and Questionnaires; Sexual Behavior; HIV Infections; Tertiary Care Centers
Fulltext Prevalence of obesity and screening for diabetes among secondary school students

Edmund Yu, Wei Chang, Narwani Hussin, Marliana Abd Rahim, Sreevali, Muthuvadivelu, Chan, Wai Seong

Int J Public Health Res, 2018;8(1):907-912.
MyJurnal

Introduction There is an increasing trend of obesity in children and adolescent globally. The objectives of this study were to identify the prevalence of overweight and obesity among students from secondary schools and to determine the mean random blood sugar (RBS) for the overweight and obese students.
Methods This was a cross sectional study. Two secondary schools that were scheduled for visit by the School Health Team, Taiping in July 2016 were included. A standardized data collection sheet was used to collect the data. Overweight and obesity were defined based on WHO 2007 reference for BMI-for-age criteria. Random blood glucose was checked for overweight and obese students.
Results A total of 184 school students consented and participated. 128 (69.6%) were female and 90 (48.9%) were Malays. The mean weight and height were 56.21 kg and 1.61 m respectively with BMI of 21.49 kg/m2. Overall, the prevalence of obese and overweight were 12.5% and 10.9% respectively. Among the 4 BMI groups, there were no significant difference found in sex (p=0.849) and races (p=0.536). However, there was significant difference (p=0.042) in mean RBS for obese and overweight students between races. RBS readings among overweight and obese students were within normal range with mean of 5.95 (0.67) mmol/l (range between 4.60 – 7.70 mmol/l).
Conclusions The overall prevalence of overweight and obesity were comparable with other studies done in Malaysia. Nevertheless, there was no prevalence of Type II diabetes mellitus among them.
Fulltext Bone transport using semicircular Ilizarov ring fixator in the treatment of the infected nonunion of the humerus: a case report

Kamarul Izham Kamarudin, Then, Jun Wei, Yeoh, Ching Wooi, Ooi, Ying Jing, Chopra, S.

International e-Journal of Science, Medicine & Education, 2018;12(2):34-36.
MyJurnal

Bone transport using the Ilizarov technique has been
one of the most popular techniques in treating fracture
with significant bone defect. However, pain and joint
stiffness following Ilizarov fixation are few of the wellknown
complications. We report a case of a 23-year-old
gentleman with a closed left humeral diaphyseal fracture
following a traffic accident who underwent plating of the
left humerus which was later complicated with infected
nonunion. He was then treated with corticotomy and
bone lengthening using the semicircular Ilizarov ring
fixator. Good clinical and functional outcomes were
observed during transportation period (elbow flexion
10̊ to 90̊) with minimal complications.
Fulltext Surgical management of a mangled foot by a free vascularized fibular graft: a case report

Kow, Ren Yi, Aziah Abdul Aziz, Muhammad Firdaus Abas, Low, Chooi Leng, Akmal Azim Ahmad Alwi

International e-Journal of Science, Medicine & Education, 2018;12(2):30-33.
MyJurnal

The human foot serves as an important part to support
the body weight and accounts for the majority of our
movements. A mangled limb involves injury to at least
three out of four systems, namely the soft tissues, nerves,
blood supply and bone. While amputation is indicated in
some cases of mangled limb, with proper planning, limb
salvaging surgical management is also a viable option.
Special consideration to the skeletal stabilization, control
of infection, vascular status and soft tissue coverage is
paramount to the success of limb salvaging surgery. We
present a case of mangled limb which was successfully
treated with limb salvaging surgical management. Initial
debridement, Kirschner wires insertion and cross ankle
external fixation were used for skeletal stabilization. An
antibiotic spacer was inserted for local antibiotic and to
maintain the length left due to the loss of medial and
intermediate cuneiform bones. The anterior tibialis
artery and its venae comitantes were utilized for free
vascularized fibular graft to provide bony reconstruction
as well as soft tissue coverage for the mangled foot.

MeSH terms: Amputation; Ankle; Anti-Bacterial Agents; Arteries; Body Weight; Bone Wires; Debridement; Fibula; Foot; Humans; Tarsal Bones; Limb Salvage
Fulltext Femoral deformity correction and lengthening on nail with monorail external fixator : a case report

Mohd Bakrynizam Abu Bakar Siddiq, Kamarul Izham Kamarudin, Kamarul Al Haq, Suresh Chopr

International e-Journal of Science, Medicine & Education, 2018;12(2):26-29.
MyJurnal

Limb length discrepancy (LLD) is quite common.
Lower limb shortening is one of the causes of limb
length discrepancy. The common treatment that is
used is the llizarov technique for bone lengthening.
The new technique uses an intramedullary nail with
a monoplanar external fixator. Using this technique,
bone lengthening duration in patients can be reduced
and knee joint mobility can be improved without
jeopardizing bone regeneration. We report a case of a
27-year-old gentleman who had right femur shortening
from childhood and was referred to us for corrective
deformity. He underwent bone lengthening on the nail
which lenghthens and equalizes the leg while avoiding
stiffness and reduces joint mobility which leads to good
patient satisfaction outcome. The use of the external
fixator with intramedullary nailing to lengthen the
femur is one method that can reduce patient burden
mentally and physically. However although it has many
advantages we must watch out for the complications
during the regular visits to ensure good outcome.

MeSH terms: Bone Lengthening; Bone Regeneration; Femur; Fracture Fixation, Intramedullary; Humans; Knee Joint; Male; External Fixators; Patient Satisfaction; Lower Extremity
Fulltext A palatal swelling transpires out as a nasal B-cell Non-Hodgkin's Lymphom

Sunil Pazhayanur Venkateswaran, Rafiq Abdul Karim Vasiwala, Norfadzilah Mohd Yusof

International e-Journal of Science, Medicine & Education, 2018;12(2):22-25.
MyJurnal

Primary sinonasal Non-Hodgkin’s Lymphoma’s
(NHLs) are quite rare and emulate the presentation
of benign inflammatory diseases. It is challenging to
distinguish them morphologically and radiologically
from other malignant neoplasms.
We report a 37-year-old male patient who presented
with obstruction of the nasal passages, rhinorrhoea,
epistaxis, post nasal drip, facial swelling, orbital
symptoms and pyrexia. The mass was a nasal diffuse large
B-cell lymphoma confirmed by immunohistochemistry.
After the first cycle of chemotherapy was started, the
patient improved with resolution of the facial swelling,
pain and visual defects.
A high index of suspicion is required to differentiate
sinonasal lymphomas from other lesions.

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