Introduction: Job satisfaction is the positive and negative feelings of the direction of the job provides the workers of the physical, psychological and social benefits compared to what this worker expects, which will have a significant impact on the level of work performance and productivity of work. This study aims to determine the level of job satisfaction of health workers and identify the type of constraints affecting the health workers and determining the importance of incentives that would raise the level of job satisfaction. Methods: A cross-sectional study conducted for the period from October 2017 to April 2018 in four general hospitals in Al- Najaf province. A number of 670 respondents were selected randomly. A self-administrated questionnaire in the Arabic Language was used to collect information after verifying its reliability. Results: This study found that 56.4% have a positive level of job satisfaction and the rest of the respondents believe that there are signs of constraints affecting health workers. On the other hand, there is a significant correlation between the age group and financial & moral support, there is a significant correla- tion between financial & moral support and job relationships, and between human resources and job relationships. Conclusion: there are more than half of the respondents were satisfied with their jobs and 56.1% of respondents were known about constraints affecting the health workers. Finally, 55.1% of respondents were familiar with the incentives that would raise the job satisfaction level.
Introduction: Multiple myeloma (MM) is characterized by genomic instability and cytogenetic abnormalities (CAs). The variation in rates of treatment response and overall survival is thought to arise from multiple genomic events that result in tumour development and progression. This study investigated CAs among the newly diagnosed MM (NDMM) patients at diagnosis and during follow-up and subsequently to assess their prognostic significance. Meth- ods: This is a prospective cohort study where bone marrow (BM) samples of 16 NDMM patients were collected at diagnosis and during follow up and subjected to conventional cytogenetic analysis (CCA) and interphase fluores- cence in situ hybridization (iFISH) analyses using standard procedures. Spectral karyotyping was performed on a selected patient who showed complex karyotype (CK) pattern on CCA. Results: Clonal abnormalities were identified in 56.3% of analysis by karyotyping and 68.8% by combination of karyotyping and iFISH. CCA showed normal diploid, hypodiploid and hyperdiploid karyotypes, whereas iFISH analysis could detect various IGH translocations involving 14q32 region, del(13q14) and del(17p13). Significant associations were observed between patients with complex karyotypes and abnormal karyotypes. Patients who had a CK or showed an abnormal CCA and iFISH results were associated with worse survival (p=0.011 and p=0.034 respectively). Structural abnormalities were found to be more common among hyperdiploid MM patients (p=0.001). Cytogenetic evolution was seen in the follow-up of BM cytogenetics. Conclusion: Karyotyping and iFISH are valuable assets in detecting prognostically relevant genomic abnormalities. The presence of cytogenetic evolution demonstrated the value of cytogenetics in monitoring treatment response and in management of MM.
Introduction: Aberrant expression of E-cadherin has shown to have correlation with advanced disease of prostate cancer. In this study, we evaluated the potential of E-cadherin as a prostate cancer prognostic marker and determined its correlation with patient outcomes. Method: 46 prostate cancer specimens in the form of paraffin-embedded tissue blocks were retrieved from the Histopathology Unit, Department of Pathology, Hospital Kuala Lumpur. The expres- sion patterns of E-cadherin were determined by immunohistochemistry staining. The E-cadherin expression was evaluated and scored as positive (3+) and negative or loss of expression (2+ and 1+). The correlations of E-cadherin expression with patient outcomes which included biochemical failure, disease-free, metastasis and local recurrence were determined. Correlations of E-cadherin expression with the currently used traditional clinicopathological pa- rameters were also evaluated. Results: There were significant correlations between E-cadherin expression with bio- chemical failure (p=0.005) and local recurrence (p=0.003). However, there were no significant correlations between E-cadherin expression with disease-free (p=0.864) and tumour metastasis (p=0.430). Comparing the correlation of E-cadherin expression with the traditional clinicopathological parameters, there were significant correlations be- tween E-cadherin expression with pathological staging (p=0.001), Gleason score (p=0.004) and perineural invasion (p=0.001). However, there was no significant correlation between E-cadherin expression with positive tumour mar- gin (p=0.320). Conclusion: These results support the potential use of E-cadherin as a prognostic tool for prostate cancer as well as an additional marker along the currently available traditional clinicopathological parameters.
Introduction: Nonvalvular atrial fibrillation is a common cause of cardioembolic stroke which accounts around 50% of all cardioembolic emboli. Oral anticoagulants remain the main choice of stroke prevention in patients with atrial fibrillation. Our study is aimed to determine the safety (absence or presence of bleeding events) and efficacy (absence or presence of ischemic stroke occurrence) of dabigatran versus warfarin for stroke prevention in patients with nonvalvular atrial fibrillation. Methods: A retrospective audit study was conducted based on past data obtained from Electronic Hospital Information System (EHIS) records in Serdang Hospital. Our sample was 150 patients with nonvalvular atrial fibrillation who were at risk of getting stroke and being prescribed with oral anticoagulants either warfarin or dabigatran from the year 2013 until 2019. Results: Our study showed that there was lesser occurrence of ischemic stroke in patients from dabigatran group (1.3%) as compared to those in warfarin group (2.7%). There were also almost 2 times lesser bleeding events in dabigatran group (6.7%) as compared to those in warfarin group (14.7%). The median of CHA2DS2-VASc Score in warfarin sampled patients (median=3+/-1) was lower than dabig- atran sampled patients (median=4+/-1). Conclusion: Both warfarin and dabigatran are effective in preventing stroke for patients with nonvalvular atrial fibrillation. However, dabigatran is associated with lesser bleeding events with lower incidence of major bleeds compared to warfarin.
Introduction: With the expanding need of nutrients to support fetal growth during pregnancy, pregnant women are recommended to take dietary supplements. However, the intake of these supplements in Malaysia are not much re- ported. We aimed to determine the awareness, attitude and behaviour among pregnant women related to intake of di- etary supplements during pregnancy and associated factors. Methods: A cross-sectional survey was conducted among pregnant women attending Obstetrics and Gynecology Specialist Clinic at Penang General Hospital between April and June 2018. Convenience sampling was used, and data was collected using a self-administered questionnaire. Awareness, attitude and behaviour were reported as frequency and percentages, and logistic regression was used to report associated factors. Analyses were performed using SPSS Statistics (Version 22). Results: A total of 273 respon- dents completed the questionnaires. While the awareness level on the role of dietary supplements during pregnancy is high (87.9%, n=240), only half of the respondents had a good attitude (53.5%, n=146) and had been taking essential supplements during pregnancy (49.1%, n=134). Having health problem was inversely associated with a good attitude towards the use of dietary supplements (OR=0.52, 95% CI 0.31-0.88), while respondents with a good awareness and a good attitude were more likely to consume dietary supplements (OR: 6.51, 95% CI 2.42 – 17.55, OR: 2.07, 95% CI 1.26 – 3.41, respectively). Conclusion: While the awareness level on the role of dietary supplements during pregnancy is high, only half of the respondents had a good attitude towards its intake and had been taking essential supplements during pregnancy.
The global COVID-19 pandemic has radically change the higher education landscape that caused closures of all education institutions in adherence to social distancing. It has forced the education sector to adopt online teaching and learning, and reminded educators that a flexible and robust education system is needed as the future is unpredictable. This paper focuses on educator’s viewpoint in adapting and adopting online teaching and learning, highlights the challenges experienced and the ways to overcome it that could serve as a reference for other educators to assimilate in similar circumstances. This paper also explores and discusses the benefit brought by these changes to higher education and the way forward in progressing, revolutionising and sustaining quality online teaching and learning where globalised, borderless and seamless teaching and learning with technology may become “the new normal” in higher education.
Background: Fermentable carbohydrates or FODMAPs (Fermentable Oligo-, Di-, Monosaccharides, and Polyols) are short-chained, poorly absorbed carbohydrates which trigger gastrointestinal symptoms causing pain, bloating, distension, diarrhea, and constipation in Irritable Bowel Syndrome (IBS) patients. This debilitating condition has an impact on the quality of life of patients. In addition, due to lack of dietary intervention, it can result in food restriction to alleviate symptoms as patients avoid a wide variety of food and beverages. Objective: To compare FODMAP and nutrient intake, food avoidance behavior and quality of life in 2 long standing patients with IBS. Methods: Patients were selected on the basis of being diagnosed with IBS by a gastroenterologist. A 24-hour dietary recall with multiple pass method was used to assess intake. FODMAP intake was determined using published data. Symptom severity and quality of life was measured using a validated questionnaire. Meanwhile, food avoidance was assessed using a dietary trigger piloted questionnaire. Results: Two female Chinese patients with severe gastrointestinal symptoms were selected for this case series. Patient 1 was a 75-year-old female presenting with constipation-predominant IBS and patient 2 was a 61-year-old presenting with diarrhea-predominant IBS. Patient 1 had a higher energy intake: 2198 kcal, and FODMAP intake 10.6g/d, compared to patient 2 with an energy and FODMAP intake of 1800 kcal and 3.6g/d respectively. Both patients avoided a wide of range of food groups including cereals and grains, animal products, dairy and spicy foods. They also reported reduced scores for quality of life. Conclusion: Both patients had low intake of calcium as a result of food avoidance. This highlights the importance of appropriate and timely dietary intervention to this group of patients, to promote improved symptom management without compromising nutrient intake.
Massive elimination efforts have been done to control the malaria disease caused by the emergence of the fifth human malaria parasite known as Plasmodium knowlesi. Early detection of the parasite is important in treating malaria infection. Microscopic examination of Giemsa-stained thick and thin blood films is the gold standard for laboratory malaria diagnosis, while rapid diagnostic tests (RDTs), polymerase chain reaction (PCR) and loop-mediated isothermal amplification (LAMP) are significant diagnostic techniques to detect acute infection. However, these methods have several limitations in which it could delay the treatment. The potential of lab-on-chip (LOC) as a point-of-care diagnostic tool for malaria fulfils the requirement of limitations where it is able to produce early detection of malaria infection. This review discusses advantages and disadvantages of malaria diagnostic methods as well as new approaches that could be used for high speed, sensitive and reliable malaria detection to prevent the disease from causing severe complications and even fatal if left untreated.
Ophiocordyceps sinensis is one of the most sought-after medicinal fungi used to treat various medical conditions such as respiratory diseases, liver and kidney dysfunctions. In China, it is widely used for alleviation of frequent urination where patients treated with O. sinensis have shown improvement in nocturia, which is the most common symptom of overactive bladder (OAB). Many studies have reported its anticancer, anti-inflammatory, anti-oxidative, hypoglycaemic and vasorelaxation properties. These properties are attributable to the presence of bioactive components such as polysaccharides, proteins and nucleosides. This mini-review highlights the medicinal potential of O. sinensis in alleviating OAB, which is a debilitating condition with a profound impact on the quality of life in a high proportion of older people. Four possible mechanisms of action of O. sinensis are suggested. Firstly, the relaxation of bladder smooth muscle through calcium dynamic, production of nitric acid (NO) and adenosine triphosphate (ATP). A second mechanism proposed is through the suppression of micturition reflex. The unequivocal properties of O. sinensis as anti-inflammatory and anti-oxidant, are two other plausible explanations, as both chronic inflammation and accumulation of oxidative stress molecules are associated with OAB exacerbation. With the recent success in cultivation of O. sinensis and the positive results from toxicity studies, a better understanding of its pharmacological actions can be further substantiated, including its use for relieving OAB.
Rapid and accurate identification of microorganisms can be of great value for clinical management. For many fastidious and slow-growing microorganisms, the conventional method used for detection is time-consuming, costly and labour-intensive. Hence, the development of new and improved microbial identification methods are necessary to overcome this bottleneck. Current trend has shifted towards the use of new molecular technologies in genomics and proteomics for bacterial identification and characterization. This mini review will focus on summarizing different types of genotypic and proteomics identification methods, as well as bioinformatics tools used for rapid identification and characterization of microorganisms from various specimens.
Introduction: Kratom or (Mitragyna speciosa) leaves are consumed as a folk remedy and opioid substitute in the Southeast Asian region. There is still a lack of information about the long-term or toxic-causing effects of kratom use. Methods: A total of thirteen regular kratom users, with long-term (>20 twenty years) kratom use history were recruited for this cross-sectional pilot study. Respondents were required to undergo a blood-test and laboratory anaysis was conducted to determine the mitragynine content in an acquired street sample of kratom. Results: The regular, long- term consumption of brewed kratom decoction did not cause any significant alterations in haematological, kidney, liver, thyroid, inflammatory and gastrointestinal analytes in a cohort of kratom users who had no history of substance misuse. However, those who had a higher intake (>3 glasses per day) of kratom exhibited higher lipid values (except for HDL-cholesterol), and a moderate elevation of homocysteine level. Conclusion: Long-term (>20 years with a daily intake of 87.54mg of mitragynine) kratom consumption was not associated with altered biochemical levels, although prolonged and heavy use (>3 glasses daily) may result in cardiovascular risks. The latter finding, however, requires further investigation.
Introduction: Most research has primarily focused on the influence of patients' beliefs on medication adherence in non-aboriginal populations. This study compared medication beliefs among aboriginal and non-aboriginal patients with hypertension and/or diabetes mellitus, predictors of medication beliefs, and their impact on medication adher- ence. Methods: A prospective cohort study was conducted using the Beliefs about Medicines Questionnaire-Specific on a randomly selected sample of 38 patients for each group. Medication adherence was measured by pill counts and prescription refill history. Results: Over half of the aboriginal and non-aboriginal patients believed that the med- ications are necessary for their health. In particular, aboriginal patients had higher necessity score (mean 21.32, SD 2.90) than non-aboriginal patients (mean 19.45, SD 3.68, p
Introduction: Soil-transmitted helminths (STHs) are considered one of the neglected parasitic diseases that cause ma- jor health problems and other related complications. The aim of this study was to determine the prevalence of STHs and anaemia among school children of little-known refugee communities in Malaysia. Methods: A cross-sectional study was conducted among 148 refugee school children in the Klang Valley, Malaysia, from 2017 to 2019. Data were collected using a questionnaire, in addition to haemoglobin testing while faecal samples were screened for STHs eggs using the formalin-ether concentration technique. Results: The result showed that the prevalence of STHs in this study was 37.2%. Trichuris trichiura infection was the most prevalent (46.4%) followed by Ascaris lumbri- coides (44.9%) and hookworms (8.7%). About 37.8 % of the respondents were found to be anaemic. Binary logistic regression showed significant infection with STHs complicated with anaemia (AOR: 3.67, 95 % CI 1.595-8.5). Con- clusion: The evidence from this study suggests proper and strategic interventions to reduce morbidity. An alternative and efficient system is needed to provide the schoolchildren with basic care for sanitation and health provision. It is recommended that voluntary clinics provided by non-government organisations focus on counselling and advice on personal hygiene of the children.
Introduction: Dengue fever is caused by the dengue virus that is transmitted via Aedes mosquitoes. The lifecycle of Aedes mosquitoes is affected by the local climate (rainfall) which influences dengue transmission. Sabah is one of the states that is laden with a high incidence rate of dengue in Malaysia and the condition seems to have worsened with sudden, multiple outbreaks occurring in the year 2016. Methods: An ecological analysis was conducted in Keningau, Sabah to analyse dengue case patterns and distribution over a 5-year period and to exhibit the correlation between rainfall, larval indices, dengue incidences, and outbreaks. Results: Significant cross-correlation analysis (CCF) was discovered between rainfall and Aedes index at lag number 5 with a correlation coefficient of 0.151 (±0.063) as well as between rainfall and Breteau Index at lag number 5 with a correlation coefficient of 0.143 (±0.063). However, no significant cross-correlation analysis was found between Aedes index and dengue incidences. Associations were also seen between larval indices and outbreak cases. Conclusion: This study showed an increase of Aedes and Breteau Indices to susceptibility level five weeks after rainfall which increases the risk of dengue transmission.
Introduction: Consistent condom use can reduce the rate of transmission of STD/HIV. Condom self-efficacy is an important determinant of consistent condom use. The Condom Use Self-Efficacy Scale (CUSES) assesses the individ- ual's confidence and expectations to obtain, use, dispose and negotiate use of condom with their sexual partners. This study aimed to adapt, translate and determine the validity and reliability of CUSES Malay version among STD/ HIV patients in a primary care clinic. Methods: This was a cross sectional validation study conducted among STD/ HIV patients in a primary care clinic. The CUSES Malay version underwent content validation (calculation of I-CVI), forward and backward translation, face validation and field testing for psychometric analysis. Psychometric analysis used included Principal Axis Factoring with direct oblimin rotation, internal consistency reliability (Cronbach's α) and test-retest reliability analyses (Intraclass Correlation (ICC)). Results: A total of 168 participants were enrolled into this study (99% response rate). In content validation, all items were retained as the I-CVI were >1.00. Feedback from face validation resulted in simpler phrases of some items. One item (B2) was removed due to poor factor loading of
Introduction: The objective of this study was to assess parental acceptance and factors that influenced their per- ceptions towards the use of dental therapists in providing treatment to children in private dental practice settings. Methods: A cross-sectional study was conducted on randomly selected parents of 11-year-old schoolchildren in Se- langor using a self-administered structured questionnaire. The survey consisted of three sections: socio-demographic characteristics, dental service utilisation and parental acceptance towards dental therapists in providing seven types of preventive and operative dental procedures. Results: The response rate was 83.1%. Overall, most parents regarded dental therapists providing dental care to their children in private dental care settings as acceptable, particularly on preventive treatment, namely ‘seeking advice on oral hygiene care' (87.8%) and ‘applying topical fluoride' (83.2%). In the multivariate analysis, younger parents and those who had preferences over private sectors were most likely to accept at least four dental procedures to be rendered to their children by dental therapists. Overall, respondents who were younger (OR = 1.40, 95% CI = 1.62, 1.92), lived in urban locality (OR = 1.77, 95% CI = 1.28, 2.45) and had a recent dental visit (OR = 1.51; 95% CI = 1.10, 2.07) were more likely to have an overall positive perceptions towards dental therapists. Conclusion: Most parents regarded dental therapists providing care to their children in private dental settings as acceptable and this was associated with their age, place of residence and past dental experiences.
Introduction: A growing evidence supported that variation of sweet taste perception, mediated by TAS1Rs gene variants could lead to excess sweetened food and beverages intake and also obesity. However, obesity development may also alter individuals' taste sensitivity and perception. Thus, it is best to further investigate whether or not the individuals' sweet taste sensitivity and acceptance are associated with variation in TAS1R2 gene and Body Mass Index (BMI) status. Methods: This comparison cross sectional study comprised of 88 obese and 92 non-obese subjects aged 20-45. All the subjects were genotyped for TAS1R2 gene variant at rs12033832 using polymerase chain reaction – restriction fragment length polymorphism (PCR-RFLP). Suprathreshold sensitivity for sweet taste was assessed using general Labeled Magnitude Scales. Intensity rating and hedonic test were carried out on 2 food samples (tea drink and rose flavoured agar) to examine subject's intensity rating and liking at different sugar contents. Results: Our re- sults showed that rs12033832 of TAS1R2 gene is associated with sweet taste perception among obese and non-obese subjects. No interaction effect between BMI status and TAS1R2 gene variant (rs12022832) was found on sweet taste measures. Overall, non-obese subjects with AA genotype on rs12033832 had the highest sweet taste sensitivity and dislike high sugar content products the most. The effect was reverse among the obese subjects with GG homozygous. Conclusion: These findings suggest that TAS1R2 gene variation plays an important role in sweet taste perception among individuals and may have nutritional implications and obesity.
Background: Potassium (K+) is the essential micronutrient and major intracellular fluid cation which involves in various cellular metabolism activities, maintaining fluid and electrolyte balance. Measurement of blood concentration in a medical laboratory has often encountered disturbances such as hemolysis, which may lead to the elevation in measurement and affects the medical diagnosis and treatment of the patient, conceivably fatal. Hemolysis can be decided using hemolysis index (H-index) through automation. Methods: In this study, H-index and concentration of fifty hospitalized patients (n=50) hemolysed blood samples were measured and correlated. Freezing-and-thaw method was used to hemolyse the blood samples. Different concentrations were diluted and analyzed using COBAS 8000 biochemistry analyser. Data were collected and analyzed using SPSS version 25. Results: Our findings showed significant mean differences, 0.001 (p ≤ 0.05) and strong positive linear relationship between two variables (H-index and ) (r=0.764, p ≤ 0.05). By applying calculated linear equation [y = 0.0048x + 5.146, = 0.5838], critical value of 6.0 mmol/l gives H-index of 178, H-index above 178 is suggested to be critical. Discussion and Conclusion: Concentration increases in proportion to H-index. A greater degree of hemolysis causes more ions to be released into extracellular fluid, respectively. In conclusion, when H-index less than 178 in measurement and there is no analytical significance bias generated, the result is acceptable, whilst H-index with analyte variation between clinically significant bias range can be released with a comment regarding the potential of data alteration. Meanwhile, result with H-index exceeding the cut-offs should be suppressed and recollection of sample is required.
Introduction: Increased demand and low blood supply have been a critical issue in many countries, including Malaysia. This issue occurs due to a lack of awareness towards the importance of blood donation. Therefore, this study aims to evaluate the level of knowledge, attitude and practice towards blood donation among undergraduate students of the Faculty of Health Sciences (FSK), Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur. Methods: This cross-sectional study was conducted on undergraduate students of the Faculty of Health Sciences (FSK), Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, which is comprised of 9 programmes: Biomedical Science, Optometry, Nutrition Science, Dietetics, Audiology, Speech Science, Physiotherapy, Occupational Therapy and Environmental Health. The respondents were recruited by a stratified random sampling technique with an informed consent. Questionnaire that consisted of four sections, namely: (A) sociodemographic characteristics, (B) knowledge on blood donation, (C) attitude towards blood donation and (D) practice of blood donation were distributed and a total of 274 responses were obtained for further evaluation. The significance values were set as P < 0.05. Results: Our research findings showed that the majority of students had a good level of knowledge (99.6%) and attitude (95.3%) about blood donation but most of them demonstrated a poor practice (59.1%). As for genders, female students had a better level of knowledge and attitude than males, but male students committed better practice towards blood donation than females. However, there were no significant differences between gender and programme of study as the respondents shared a similar background in health-related courses. Conclusion: A majority of the students had a good level of knowledge and attitude, but they are poor in practice. More campaigns need to be conducted to create awareness on the importance of blood donation.
Background: The main mechanism of fenitrothion (FNT) toxicity is by inhibiting the acetylcholinesterase enzyme, though studies have shown that FNT might also develop other toxicological manifestations, including oxidative stress. However, the kidney functions as well as oxidative stress status after repeated exposure to FNT is not well documented. Objective: The present study was conducted to evaluate the kidney functions and oxidative stress status after exposure to low doses of FNT. Materials and Methods: 24 male Sprague-Dawley rats were divided randomly into three groups (n = 8/group): control, which received 1 mg/ml corn oil; FNT 10, which received 10 mg/kg (BW) FNT; and FNT20 which received 20 mg/kg (BW) FNT. The corn oil and FNT were fed orally for 28 consecutive days. At the end of the study, the blood was taken, and the kidney was obtained for biochemistry evaluation and histological observation. Results: The AChE activity was significantly inhibited in the FNT20 group (p≤0.05) compared to the control group and FNT10 and the rats exhibited the signs and symptoms of toxicity such as lacrimation, piloerection, hypoactivity, and tremor. Plasma creatinine and BUN levels showed a significant increase (p≤0.05) in FNT treated groups, but the superoxide dismutase and glutathione level were significantly reduced (p≤0.05). The malondialdehyde and protein carbonyl level were elevated significantly (p≤0.05) in FNT treated groups. Histopathological observation revealed morphological changes, including atrophy of the glomerulus and presence of non-amyloid substances in FNT treated groups. Conclusion: Even at the dose that did not inhibit the AChE activity, FNT was found to reduce the renal function and induce oxidative damage on the kidney of male Sprague Dawley rats.