Non-governmental organizations (NGOs) are one of the important players during a pandemic, including the Islamic Medical Association of Malaysia (IMAM) Response and Relief Team (IMARET). During the coronavirus disease (COVID-19) pandemic, IMARET played a key role in assisting health relief efforts in Malaysia. We are sharing this experience as a medical NGO's response to the pandemic. This report presents data from the March 18 to June 10, 2020, retrieved from IMARET's database with approval from the Executive Committee and the IMARET COVID-19 Task Force. We report that IMARET's task force consists of 30 people, mostly medical doctors. Supplies distributed included personal protective equipment with other medical equipment, such as portable ultrasounds and ventilators. IMARET engaged with 33 collaborators and 92 partners and funders. There were 135 volunteers with the majority being medical volunteers. IMARET raised more than RM $3 million (US $740 000) garnering support from over 40 000 donors in 85 days. In conclusion, NGOs play a significant role that effectively enhance and complement the consolidated works by the authorities and public in the effort to overcome COVID-19 challenges.
Cardiovascular disease (CVD) has been the number one cause of death since the last three decades in Malaysia and diabetes mellitus and hypertension are considered as major risk factors. A study to reduce risk factors for cardiovascular diseases in the community (PIKOM) through education and lifestyle changes was undertaken. The study population was from four different areas in Peninsular Malaysia - Kota Bharu and Bachok in Kelantan ; Raub in Pahang; Gunung Besout in Perak and Felda Palong in Negri Sembilan. The subjects invited to participate in this study ware aged between 30 - 65 years, did not have any debilitating illnesses and no known history of diabetes mellitus, hypertension or cardiovascular disease. Subjects were asked to come to the local clinic in a fasting state and after physical examination, blood was taken for plasma glucose and lipids. Oral glucose tolerance test (OGTT) was then performed. A total of 4,121 subjects participated in the study. The proportion of subjects with diabetes mellitus was highest in Felda Palong area (20.3%) and lowest in Raub area (7.1%). The proportion of subjects with hypertension was also highest in Felda Palong area (38.6%) and lowest in Raub area (29.1%). This could be attributable to the subjects in Felda Palong having the highest mean Body Mass Index (BMI) and Waist-to-Hip Ratio (WHR). There were significant associations between diabetes and hypertension with age and obesity. Subjects with diabetes mellitus and hypertension also had the highest mean age, BMI, WHR and plasma cholesterol.In conclusion, the proportion of patients with risk factors for CVD was high and intervention studies through education and lifestyle changes were being carried out to see their effectiveness.
Gross domestic product (GDP) is an important indicator for determining a country's or region's economic status and development level, and it is closely linked to inflation, unemployment, and economic growth rates. These basic indicators can comprehensively and effectively reflect a country's or region's future economic development. The center of radial basis function neural network and smoothing factor to take a uniform distribution of the random radial basis function artificial neural network will be the focus of this study. This stochastic learning method is a useful addition to the existing methods for determining the center and smoothing factors of radial basis function neural networks, and it can also help the network more efficiently train. GDP forecasting is aided by the genetic algorithm radial basis neural network, which allows the government to make timely and effective macrocontrol plans based on the forecast trend of GDP in the region. This study uses the genetic algorithm radial basis, neural network model, to make judgments on the relationships contained in this sequence and compare and analyze the prediction effect and generalization ability of the model to verify the applicability of the genetic algorithm radial basis, neural network model, based on the modeling of historical data, which may contain linear and nonlinear relationships by itself, so this study uses the genetic algorithm radial basis, neural network model, to make, compare, and analyze judgments on the relationships contained in this sequence.
Grog is an additive material that plays important roles in ceramic making. It improves the fabrication process of green bodies as well as the physical properties of fired bodies. Few low-cost materials and wastes have found their application as grog in recent years, thus encouraging the replacement of commercial grogs with cost-saving materials. Coal fly ash, a combustion waste produced by coal-fired power plant, has the potential to be converted into grog owing to its small particle sizes and high content of silica and alumina. In this study, grog was derived from coal fly ash and mixed with kaolin clay to produce ceramics. Effects of the grog addition on the resultant ceramics were investigated. It was found that, to a certain extent, the grog addition reduced the firing shrinkage and increased the total porosity of the ceramics. The dimensional stability of the ceramics at a firing temperature of 1200 °C was also not noticeably affected by the grog. However, the grog addition in general had negative effects on the biaxial flexural strength and refractoriness of the ceramics.
Exercise has been suggested as the best and the most affordable way for managing blood pressure. The insertion/ deletion of angiotensin I-converting enzyme (ACE) I/D gene polymorphism had been reported to be linked with sev- eral diseases such as hypertension and diabetic nephropathy. Several studies showed that blood pressure response to exercise training for health management also vary among individuals with different genotypes of ACE I/D gene poly- morphism. A study of 9 months of endurance exercise training at 75 to 85 % of VO2max showed that the decrease of resting blood pressure in I allele carriers wass greater than D allele carriers. In contrast, other study discovered that adult women with D allele had greater reduction in resting blood pressure than those with I allele, following a 12-week combined aerobic and resistance exercise training. Despite the inconsistencies of some findings, it has remained unknown if the ACE I/D gene polymorphism would also influence blood pressure response to isometric handgrip training that had been found to be superior to the dynamic resistance exercise training in controlling and preventing high blood pressure. Thus, this article was to review the literature on ACE I/D gene polymorphism and blood pressure response to exercise training that could serve as the basis for future research to identify individuals who will lower resting blood pressure the most with exercise training program for health management.
Anti-N-methyl-d-aspartate receptor encephalitis is characterized by the clinical manifestation of neuropsychiatric symptoms, predominantly affecting young adults, and frequently associated with neoplasms. It is the second most common cause of autoimmune and paraneoplastic encephalitis. Early diagnosis is often missed, as patients are commonly diagnosed with psychiatric illnesses and are treated with antipsychotics - which rarely gives complete resolution of symptoms. Herein, we discuss a patient with mixed clinical, imaging, electroencephalogram, and laboratory findings, with an eventual diagnosis of anti-N-methyl-d-aspartate receptor encephalitis requiring immunotherapy and operative intervention.
Breast lesions are rare prepubescents. The majority of breast lesions in this age group are benign. The most common of these rare lesions is juvenile fibroadenoma, which accounts for only 0.5% of all fibroadenomas. It is uncommon to have a palpable lesion in juveniles as very small lesions show obvious asymmetry. Fibroadenomas can grow to a large size, and surgical intervention is cosmetically challenging, especially in achieving symmetry in a developing breast. A 12-year-old girl presented with right breast swelling associated with tenderness. The mass had initially been small on self-discovery 1 year previously and grew with time. There was no overlying skin changes or any significant risk factors for breast malignancy. Triple assessment showed features of fibroadenoma, but we were unable to rule out a phyllodes tumor. She subsequently underwent excision biopsy of the right breast lesion for symptomatic control and histopathology examination (HPE) of the lesion. The HPE report confirmed the diagnosis of fibroadenoma. The patient recovered well postoperatively with no complications. Juvenile breast lesions are rare, and it is a challenge to provide an adolescent with the best treatment in terms of clinical and psychological care. A surgical approach requires meticulous planning to ensure a fine balance between adequate resection and the best cosmetic outcome for a developing breast.
Recovery from chikungunya is previously considered universal and mortality due to the virus is rare and unusual. Findings from recent chikungunya outbreaks occurred in Reunion Island and India have since challenged the conventional view on the benign nature of the illness. Malaysia has experienced at least of 4 outbreaks of chikungunya since 1998. In the present on-going large outbreak due to chikungunya virus of Central/East African genotype, a previous healthy sixty six years gentleman without co-morbidity was noted to have severe systemic infection by the virus and involvement of his liver. He subsequently passed away due to cardiovascular collapse after 5 days of illness.
Ectopic pregnancy is an extra-uterine pregnancy and is a potentially life-threatening condition that can lead to death from intra-peritoneal hemorrhage. This case reports a rare occurrence of ruptured tubal pregnancy in which the patient presented early with abdominal pain and a negative urine pregnancy test but subsequently presented again with evidence of intra-peritoneal hemorrhage. A negative urine pregnancy test is often used to rule out pregnancy, but it is not 100% sensitive. Complete assessment is critical in this important diagnosis in order to plan for the appropriate emergency management.
Cases of penile siliconoma are unusual and less commonly present to medical practitioners. The siliconoma is a subsequence of injecting high viscous solution into the penis; commonly sillicone with the aim to enhance its size and performance. This case will look at a patient who developed penile siliconoma after a dubious penile implant injection gone wrong. It will also look at what surgical options are available to the unfortunate patients to ease their suffering. Physician should have a high index of suspicion on the use of such substances to enhance sexual perfor- mances in patients presenting with atypical penile swelling.
Diagnosing acute appendicitis in children can be difficult due to atypical presenting symptoms. While there are reported cases of acute appendicitis or appendiceal masses causing unilateral hydronephrosis, bilateral hydronephrosis as a complication of appendiceal mass is very rare. We report a case of a child who presented with cardinal symptomatology associated with the urogenital tract. Ultrasound (US) investigation showed a pelvic mass causing bilateral hydronephrosis. An initial diagnosis of a pelvic teratoma was made based on the US and computed tomography (CT) scan findings. The final diagnosis of an appendiceal mass causing bilateral hydronephrosis was established intraoperatively.
Diplopodia is a rare congenital disorder that has not been extensively discussed in textbooks, and case reports appear to be the main source of information. Although the exact cause of diplopodia remains unknown, the presence of extra digits as well as metatarsals and tarsals allows it to be differentiated from pedal polydactyly. Syndactyly refers to the congenital fusion of the digits. Concomitant bilateral syndactyly and diplopodia is extremely unusual, and in this report we describe a case of right diplopodia and left polydactyly combined with bilateral manual syndactyly in a 15-year-old girl who was ultimately treated with through-the-knee amputation. Radiological examination of the right leg revealed tibial hypoplasia and the right foot displayed 8 digits with corresponding metatarsals and tarsals, whereas the left leg revealed 2 extra digits on the medial aspect of the foot with corresponding metatarsal and tarsal bones. Anatomical dissection of the right foot revealed that it was divided into halves consisting of 8 toes with corresponding metatarsals and tarsals, as well as tibial hypoplasia and absence of the great toe. Diplopodia associated with tibial hypoplasia and syndactyly can be treated surgically, and the present case report details the clinical, radiological, and anatomical elements of this rare deformity.
Mass valuation of properties is important for purposes like property tax, price indices construction, and understanding market dynamics. There are several ways that the mass valuation can be carried out. This paper reviews the conventional MRA and several other advanced methods such as SAR, Kriging, GWR, and MWR. SAR and Kriging are good for modeling spatial dependence while GWR and MWR are good for modeling spatial heterogeneity. The difference between SAR and Kriging is the calculation of weights. Kriging weights are based on the spatial dependence or so called the semi-variogram analysis of the price data whereas the weights in SAR are based on the spatial contiguity between the sample data. MWR and GWR are special types of regression where study region is subdivided into local sections to increase the accuracy of prediction through neutralizing the heterogeneity of autocorrelations. MWR assigns equal weights for observations within a window while GWR uses distance decay functions. The merits and drawbacks of each method are discussed.
Cancer of uterine cervix is one of the most common cancers among women worldwide, second only to breast cancer in incidence and mortality. Industrialized countries have dramatically reduced the incidence of mortality from cervical cancer in the last 50 years through aggressive screening programs utilizing pelvic examinations and Papanicolaou (pap) smears. The main objective of the study was to determine the relationship between socio-demography, knowledge, attitude and practice regarding pap smear screening among female patients in Hospital Teluk Intan. There was statistically significant association between level of knowledge and practice (p
Mathematically, the human alimentary tract organs were simplified in the model structure as separate compartments with
pathways of transfer that are kinetically homogenous and equally distributed. The development of gastro-compartment
model follows the first order kinetics of differential equations to describe cadmium absorption, distribution and elimination
in the human digestive system. With the aid of in vitro DIN assay, an artificial gastric and gastrointestinal fluid were
prepared using water leach purification (WLP) residue as a sample that contained toxic metals cadmium. The Simulation,
Analysis and Modelling II (SAAM II) V2.1 software is employed to design models easily, simulate experiments quickly and
analyze data accurately. Based on the experimental inputs and fractional transfer rates parameter incorporated to the
gastro-compartment model, the concentration of cadmium against time profile curves were plotted as the model output.
The curve presented concentration of cadmium in both gastric and gastrointestinal fluid where initially absorption phase
(first hour) occurred followed by the distribution phase (second to third hours) and elimination process (third to fifth
hours). The concentration of cadmium obtained from the simulated model structures was in good agreement with the
fitted model predicted measurements as statistical t-test conducted showed the values were not significantly different.
Therefore, modeling approach with SAAM II software gave realistic and better estimation of cadmium dissolution into
the human gastrointestinal tract.
Heavy metal accumulation and depuration may alter the effectiveness of Meretrix meretrix as a biomonitoring organism for water quality assessment. Therefore, this study was conducted to evaluate the effects of heavy metal accumulation and depuration on M. meretrix, by immersing it in Copper (Cu), Zinc (Zn), and Lead (Pb)
solutions under laboratory conditions. The results showed that M. meretrix is able to accumulate Cu, Zn, and Pb at the rate of 0.99, 21.80, and 0.57 μg/g per day, respectively, and depurates at the rate of 0.42, 23.55, and 1.01 μg/g per day, respectively. These results indicate that M. meretrix could be effectively used as a biomonitoring organism for Cu because the accumulation rate is significantly (p ≤ 0.05) higher than the depuration rate. However, this was not the case for Zn because the accumulation rate was almost similar to the depuration rate, while for Pb, accumulation or depuration did not occur in M. meretrix.
The pro-poor growth and environmental sustainability are the twin agendas widely discussed in environmental science literature. The technology-embodied growth helps to attain both agendas through knowledge sharing and technology transfer, which trickle down to the poor income group and improve their living standards. Hence, the role of information and communication technologies (ICTs) is deemed crucial in boosting economic growth and is under deep consideration to establish its role in reducing poverty and environmental pollution. The current study examines the long-run relationship between ICTs, poverty reduction, and ecological degradation in Pakistan using time series data from 1975-2018. The short- and long-run parameter estimates were obtained through the Autoregressive Distributed Lag (ARDL) model for robust inferences. The results substantiate the inverted U-shaped Environmental Kuznets Curve relationship between income and emissions with a turning point at US$1000 in the short-run and US$800 in the long-run. The results confirmed the decisive intervention of ICTs factors in the poverty reduction, i.e., computer communications and mobile-telephone-broadband subscriptions support to reduce poverty incidence with the mediation of inbound FDI in a country. As far as income inequality is concerned, it shows that computer services support minimizing income inequality via a channel of high-technology exports in a country. The technology embodied emissions verified in the long-run, where mobile-telephone-broadband subscriptions increase carbon emissions. Finally, mobile-telephone-broadband subscriptions and inbound FDI both are significant contributors to amplify the country's economic growth. The results conclude that poverty reduction and environmental sustainability agenda are achieved by developing green ICT infrastructure in a country.
In this paper, a minibioreactor platform made of low cost polymers is presented. The minibioreactor prototype was designed
as an alternative solution for carrying out microbial fermentation experiments in laboratory. The minibioreactor prototype
has a working volume of 1.5 mL and was fabricated from poly(methylmethacrylate) (PMMA) and poly(dimethylsiloxane)
(PDMS) polymers. Cell density was measured online whilst agitation rates and the temperature of the reactor content
can be tightly controlled to desired set-point values. As proof-of-concept, various S. cerevisae fermentation experiments
were conducted. In every experiment, the minibioreactor operated stably for the entire length of operation which was
nearly 40 h with very minimal volume loss i.e. about 2.8 µL·h-1 at 37ºC. The minibioreactor has the maximum oxygen
transfer rate (OTR) of 16.6 mmol·L-1·h-1 under the agitation rate of 300 rpm. Under these conditions, cell specific growth
rate as high as 0.291 h-1 was obtained. The experimental data in the minibioreactor operation was also reproducible
using shake flask where similar growth profiles were attained under a similar growth conditions.