A case of Tracheoesophageal Fistula (TOF) was presented where the blind upper esophageal pouch was mistakenly intubated; in spite of this, adequate lung ventilation was possible for more than one hour. This was only noticed by the surgeon upon incision of the lower end of the pouch.
Poly(4,4'-diphenylene diphenylvinylene) was synthesised from 4,4' dibenzoylbiphenyl with TiCl4 and zinc dust as the catalyst and reducing agent respectively in THF. 4,4' -Dibenzoylbiphenyl was prepared via Friedel-Crafts reaction with benzoylchloride and biphenyl as starting materials. The cataÂlyst used was anhydrous AlCl3 Elemental analysis, GCMS chromatogram, FTIR spectrum and melting point measurement indicated that 4,4'Âdibenzoylbiphenyl was obtained with 100% purity. The polymer was successÂfully obtained with mass recovery of 72%. Glass transition, Tg and degradaÂtion, temperature, Td found were 196°C and 465°C, respectively. Number average molecular weight and weight average molecular weight found were 7,400 g/mol and 15,500 g/mol as measured by using gel permeation chromaÂtography. Conductivity of the pristine polymer was 8.3 x 10-11 Scm-I, whereas maximum conductivity found for LiCLO4 and iodine doped samples were 1.7 x 10-7 Scm-1 (2007 fold increase) and 5.5 x 10-9 Scm-1 (66 fold increase) with 18.75% and 37.50% of optimum doping contents respectively.
Poli(4,4'-difenilena difenilvinilena) telah disintesis daripada 4,4'Â-dibenzoilbifenil menggunakan TiCl4 dan serbuk zink masing-masing sebagai mangkin dan agen penurun di dalam THF. 4,4'-Dibenzoilbijenil telah disediakan melalui tindak balas Friedel-Crafts daripada benzoilklorida dan bijenil sebagai bahan mula dan AlCl3 kontang sebagai mangkin. Analisis unsur, kromatogram GCMS, spektrum FTIR dan penentuan takat lebur menunjukkan sebatian 4,4' -dibenzoilbifenil telah berjaya diperolehi dengan ketulenan 100%. Polimer telah berjaya disintesis dengan pengumpulan semula bahan sebanyak 72%. Suhu peralihan kaca, Tg dan suhu penguraian terma, Td bagi polimer masing-masing adalah 196°C dan 465°C. Kromatografi penelapan gel menunjukkan polimer yang dihasilkan mempunyai jisim molekul purata nombor dan jisim molekul purata berat masing-masing adalah 7,400 g/mol dan 15,500 g/mol. Kekonduksian polimer asal adalah 8.3 x 10-11 Scm-1, manakala kekonduksian maksimum polimer terdop LiClO4 dan iodin masing-masing adalah 1.7 x 10-7 Scm-I (peningkatan sebanyak 2007 kali ganda) dan 5.5 x 10-9 Scm-1 (peningkatan sebanyak 66 kali ganda) dengan kandungan agen pendop optimum sebanyak 18. 75% dan 37.50%.
Adunan polietilena berketumpatan rendah (LDPE)/getah asli cecair (LNR) dalam komposisi 100LDPE/0LNR, 70LDPE/30LNR, 60LDPE/40LNR dan 40LDPE/60LNR telah dihasilkan melalui penyebaran emulsi LDPE dan LNR.. LNR diperolehi melalui tindak balas pemekaan fotokimia ke atas getah asli (NR) dan emulsi LNR disediakan dengan menggunakan natrium dodesil sulfat (SDS) sebagai agen pengemulsi dan 1-heksanol sebagai ko-pengemulsi. Emulsi LDPE dihasilkan dengan cara yang sama menggunakan larutan LDPE dalam karbon tetraklorida, SDS dan 1-heksanol. Adunan LDPE/LNR disediakan melalui pencampuran emulsi LNR dan LDPE. Sifat mekanik adunan LDPE/LNR dianalisis melalui ujian regangan, hentaman dan kekerasan. Sifat mekanik optimum diperhatikan bagi adunan dengan komposisi 60LDPE/40LNR yang memberi nilai tegasan dan terikan yang maksimum. Suhu peralihan kaca, Tg, seperti yang diperolehi daripada analisis kalorimetri imbasan pembezaan (DSC) menunjukkan adunan yang dihasilkan adalah homogen. Kajian morfologi yang dilakukan dengan menggunakan mikroskop imbasan elektron (SEM) juga menunjukkan kehomogenan adunan yang dihasilkan.
The first carpometacarpal (CMC) joint, located at the base of the thumb and formed by the junction between the first metacarpal and trapezium, is a common site for osteoarthritis of the hand. The shape of both the first metacarpal and trapezium contributes to the intrinsic bony stability of the joint, and variability in the morphology of both these bones can affect the joint's function. The objectives of this study were to quantify the morphological variation in the complete metacarpal and trapezium and determine any correlation between anatomical features of these two components of the first CMC joint. A multi-object statistical shape modelling pipeline, consisting of scaling, hierarchical rigid registration, non-rigid registration and projection pursuit principal component analysis, was implemented. Four anatomical measures were quantified from the shape model, namely the first metacarpal articular tilt and torsion angles and the trapezium length and width. Variations in the first metacarpal articular tilt angle (- 6.3°
To examine the effects of short duration stress management training (SMT) on self-perceived depression, anxiety and stress in male automotive assembly workers, 118 male automotive workers from Pekan, Pahang (n = 60, mean age = 40.0 years, SD = 6.67) and Kota Bharu, Kelantan (n = 58, mean age = 38.1 years, SD = 5.86) were assigned to experimental and control group, respectively. A SMT program consisting of aerobic exercise, stress management manual, video session, lecture, question and answer session, and pamphlet and poster session were conducted in the experimental group. A validated short-form Malay version of the Depression Anxiety Stress Scales (DASS-21) were self-administered before and after the intervention program in the experimental and control group and their time and group interaction effects were examined using the repeated measure ANOVA test. Results indicated that the mean (SD) scores for DASS-Depression (p = 0.036) and DASS-Anxiety (p = 0.011) were significantly decreased, respectively, after the intervention program in the experimental group as compared to the control group (significant time-group interaction effects). No similar effect was observed for the mean (SD) scores for DASS-Stress (p = 0.104). However, the mean (SD) scores for subscales of DASS-Depression (Dysphoria, p = 0.01), DASS-Anxiety (Subjective Anxiety, p = 0.007, Situational Anxiety, p = 0.048), and DASS-Stress (Nervous Arousal, p = 0.018, Easily Upset, p = 0.047) showed significant time and group interaction effects. These findings suggest that short duration SMT is effective in reducing some aspects of self-perceived depression, anxiety and stress in male automotive workers.
Like many other parts of the globe, in Malaysia, construction industry has a vital support to
the national economy, even though statistics indicates that, at the same time, it is an extremely
risky profession due to high accident rate. In addition, current evidences suggest that, in
general, safety in Sarawak construction industries lack attention. As, human behavior is regarded
as the principal component that contributes to accidents in this industry, this study
intends to explore existing barriers in development and maintaining safety performance behavior
as well as possible coping strategies. A qualitative analysis of in-depth interview (N=4)
among different levels of professions within industries in Kuching, Sarawak reveals that,
price sensitive subcontracting, short-term projects, irregular cash flow, dependency on larger
companies, less managerial and supervisory engagement, and priority on progress alone create
obstacles for safety behavior. On the other hand, possibly, the challenges can be managed
through integration of safety into contracts as compliance, associated disbursement, and introducing
incentives.
Molecularly imprinted polymer (MIP) based on acrylate monomer was prepared at 80°C for 5 hours using p-xylene and ethylene glycol dimethacrylate (EGDMA) as a template and crosslinking agent respectively. The polymer obtained was washed with a mixture of acetic acid and methanol (1:4) and dried in the vacuum oven at 80°C. FTIR spectrum showed that all the templates were leached out from polymer during excessive washing and drying stage. The rebinding test result showed that the MIP was bonded with the analyte in the presence of organic solvents as shown by FTIR spectroscopy. The SEM micrograph showed that non-imprinted polymer (NIP) had no cavity as compared to MIP.
PEG at compositions of 10, 15 and 20 g were added into the initial formulation of hydrogel L, which was composed of
6 g low molecular weight chitosan (LMC) and 14 g poly (vinyl pyrrolidone) in 100 g of 2% lactic acid. The mixtures
were moulded and exposed to γ radiation at 7 kGy. The hydrogels obtained were characterized in term of gel fraction,
swelling property, syneresis effect, FTIR, XRD and cross section morphology. The results indicated PEG reduces almost
27% crosslinking density of the LMC-PVP hydrogel yet increased hydrogel’s water holding capacity from 450% and 480%
to 750% and 650% in phosphate buffer solution (PBS) at pH5.5 and pH7.0, respectively. Also PEG enhanced the ability
of LMC-PVP hydrogel to retain its moisture from dehydration at body temperature. The morphological study showed PEG
developed thick pores wall and reduced the pores size of the hydrogels’ network.
Recently, there is a heightened level of awareness towards energy efficiency in highperformance data centers both to reduce environmental pollution and save cost. Such data centers consume massive amount of energy for processing huge computational requirements from users. These supercomputers demand a constant supply of electricity to be available 24/7 for both its core computing functions as well as cooling the data center. Previously, researchers had introduced various strategies for achieving energy efficiency. However, in order to achieve a truly effective energy management, factors that influence energy usages must also be taken into consideration. The failure to manage such factors leads to excessive energy consumption. In this work, we shall focus on factors relevant to running the operation of high-performance data centers. We reconstructed and analyzed such factors or attributes based on the universally accepted Reduce, Reuse and Recycle Concept (3R). We recategorized energy attributes of the existing Energy Efficient Data Center Frameworks (EEDCFs) to be aligned with 3R. Then, we developed energy-saving algorithms in response to the concept. Our framework was then measured according to the performance metrics namely power usage effectiveness (PUE), energy reuse effectiveness (ERE) and carbon usage effectiveness (CUE) against variability size of data center. The simulation results of our EEDCF showed that better energy saving is achieved in comparison to the existing EEDCFs. This signifies that the application of the 3R concept in energy consumption yielded a promising result as a platform for other researchers to explore more on energy renewal initiatives and embrace it for future application.
Several studies on job stress have been conducted among nurses, teachers, clerks, lecturers, laboratory technicians, petroleum and automotive workers and the calculated prevalences ranged from 20-35%; associated factors identified include high job demand, low job control and poor social support. Thus, the aim of the present study was to determine the prevalence and associated factors of stress in dental healthcare workers of an institution of higher learning in Kelantan. A cross-sectional study of the prevalence and associated factors of stress in 54 dental healthcare workers of an institution of higher learning in Kelantan [response rate of 63.5 percent] was conducted in March 2006. The Malay version of the validated Depression, Anxiety and Stress Scale and Karasek’s Job Content Questionnaire were used as research instruments in this study. Informed consents were obtained from all participants. The prevalence of stress was 22.2%. One (1.9%) staff member experienced severe stress whilst 20.4% experienced mild to moderate stress. After controlling for age, sex, marital status and duration of work, psychological job demand (adj. b 0.61, 95% CI 0.21, 1.00, p=0.003), toxic exposures (adj. b 1.41, 95% CI 0.47, 2.35, p=0.004) and overtime work (adj. b 5.67, 95% CI - 1.18, 10.16, p=0.015) were directly associated with reported stress in dental healthcare workers. High psychological job demand, increased toxic exposures at work and increased overtime work were significantly associated with stress in dental healthcare workers. These findings can be used to guide preventive measures to reduce stress in dental healthcare settings.
The sample size calculation for a prevalence only needs a simple formula. However, there are a number of practical issues in selecting values for the parameters required in the formula. Several practical issues are addressed and appropriate recommendations are given. The paper also suggests the application of a software calculator that checks the normal approximation assumption and incorporates finite population correction in the sample size calculation.
To examine the reliability and construct validity of the Malay Version of the Depression Anxiety Stress Scales (DASS), a validation study was conducted in 184 automotive assembly workers. The internal consistency and construct validity were assessed using Cronbach's alpha coefficient
and exploratory factor analysis. The Cronbach's alpha coefficients for DASS-Depression, DASS-Anxiety and DASS-Stress were 0.91, 0.88 and j 0.89, respectively, indicating satisfactory internal consistency Exploratory factor analysis showed three meaningful common factors that could
explain the three theoretical constructs of this instrument. These results suggested that the Malay version DASS is reliable and valid for assessing, the self perceived depression, anxiety and stress among Malaysian automotive workers.
Study site: Two automotive assembly plants, Pahang, Malaysia
The development and application of advanced materials i.e. nanomaterials are important for the technology revolution and economic progress of the country. However, the potential health risk arising from nanomaterials become a major concern. Given the fact that both particulate and molecular identity of nanomaterials is responsible for the biological effects, the effects of nanomaterial exposure cannot be predicted based on the current understanding of their bulk properties. The lack of nanomaterials data for safety assessment become a major challenge to implement safe work practice at nanomaterials related industries. To resolve the aforementioned problem, a conceptual framework for hazard assessment of nanomaterials is presented in this study. Bayesian Network (BN) is used to support hazard assessment according to the guideline issued by the Department of Occupational Safety and Health (DOSH) Malaysia. The understanding of the hazard is crucial to encourage the development of an action plan to ensure the safety aspect while processing and handling nanomaterials.
An ionic liquid, 1-n-butyl-3-methylimidazolium chloride (BmimCl) was blended with urea at 1:1 mole ratio to create a BmimCl/Urea mixture. The agarose/talc composite films containing the BmimCl/Urea mixture were then acquired through a gelation method. The weight ratio of agarose and talc was fixed at 4:1, while the content of BmimCl/Urea was varied from 0 to 10 wt % relative to the overall weight of the composite films. The tensile stress and modulus results showed the optimum BmimCl/Urea content in the composite film lies at 8 wt %. The talc particles are embedded in the agarose matrix and there are no pullouts for the composite films containing BmimCl/Urea as demonstrated by SEM micrographs. The addition of BmimCl/Urea increased the glass transition temperature of the composite films, however, the thermal decomposition temperature decreased drastically. FTIR and FT-Raman spectra indicated the existence of interaction between agarose and talc, which improves their interfacial adhesion. As a conclusion, a BmimCl/Urea mixture can be utilized as a coupling agent for agarose/talc composite films.
Many published studies that examined the effect of lead exposure on neurobehavioral performances were conducted in confined manufacturing environment with low to moderate blood lead levels as a marker of exposure. This study was conducted in a general environmental setting with very low exposure intensity and blood lead levels. The objective of the study was to determine the effect of very low blood lead levels (below 10 μg/dl) on the neurobehavioral performances of policemen in Kota Bharu, Kelantan. The study, conducted between August 25(th) and October 20(th) 2001, was cross-sectional in design and comprised of 89 policemen working in Kota Bharu district. The lead concentration of venous blood was determined using graphite furnace absorption spectrometer. We assessed neurobehavioral performances using the WHO Neurobehavioral Core Test Battery (NCTB). The mean blood lead concentration was 2.5 + 1.0 mg/dl. Among the seven tests performed, the positive effect of blood lead on Benton visual retention was not significant after controlling for the confounding effect of smoke-dose. This study suggested that very low blood lead levels have no significant effects on the neurobehavioral performances. Therefore, more studies with blood lead levels below the recommended environmental limit of 10 mg/dl, as recommended by Centers for Disease Control (CDC), be conducted in order to justify that limit.
CYP2D6 polymorphisms show large geographical and interethnic differences. Variations in CYP2D6 activity may impact upon a patient's pain level and may contribute to interindividual variations in the response to opioids. This paper reviews the evidence on how CYP2D6 polymorphisms might influence pain sensitivity and clinical response to codeine and tramadol. For example, it is shown that (1) CYP2D6 poor metabolizers (PMs) may be less efficient at synthesizing endogenous morphine compared with other metabolizers. In contrast, ultra-rapid metabolizers (UMs) may be more efficient than other metabolizers at synthesizing endogenous morphine, thus strengthening endogenous pain modulation. Additionally, for codeine and tramadol that are bioactivated by CYP2D6, PMs may undergo no metabolite formation, leading to inadequate analgesia. Conversely, UMs may experience quicker analgesic effects but be prone to higher mu-opioid-related toxicity. The literature suggested the potential usefulness of the determination of CYP2D6 polymorphisms in elucidating serious adverse events and in preventing subsequent inappropriate selection or doses of codeine and tramadol. Notably, even though many studies investigated a possible role of the CYP2D6 polymorphisms on pain sensitivity, pharmacokinetics and pharmacodynamics of these drugs, the results of analgesia and adverse effects are conflicting. More studies are required to demonstrate genetically determined unresponsiveness and risk of developing serious adverse events for patients with pain and these should involve larger numbers of patients in different population types.
Diagnostic imaging methods are normally required to make the preoperative diagnosis of adult intussusception. Furthermore, it helps to define the location and nature of the associated mass as lead point if present. Lipoma may appear as lesion of fat attenuation expressed in Hounsfield unit on CT scan.
Acute disseminated encephalomyelitis (ADEM) complicating dengue infection is still exceedingly rare even in endemic countries such as Malaysia. Here we report two such cases, the first in an elderly female patient and the second in a young man. Both presented with encephalopathy, brainstem involvement and worsening upper and lower limb weakness. Initial magnetic resonance imaging (MRI) of the brain was normal in the first case. Serum for dengue Ig M and NS-1 was positive in both cases. Cerebrospinal fluid (CSF) showed pleocytosis in both with Dengue IgM and NS-1 positive in the second case but not done in the first. MRI brain showed changes of perpendicular subcortical palisading white matter, callosal and brainstem disease mimicking multiple sclerosis (MS) in both patients though in the former case there was a lag between the onset of clinical symptoms and MRI changes which was only clarified on reimaging. The temporal evolution and duration of the clinical symptoms, CSF changes and neuroimaging were more suggestive of Dengue ADEM rather than an encephalitis though initially the first case began as dengue encephalitis. Furthermore in dengue encephalitis neuroimaging is usually normal or rarely edema, haemorrhage, brainstem, thalamic or focal lesions are seen. Therefore, early recognition of ADEM as a sequelae of dengue infection with neuroimaging mimicking MS and repeat imaging helped in identifying these two cases. Treatment with intravenous steroids followed by maintenance oral steroids produced good outcome in both patients.
The JCQ has been shown to be a valid and reliable instrument to assess job stress in many occupational settings worldwide. In Malaysia, both the English and validated Malay versions have been employed in studies of medical professionals and laboratory technicians, respectively. The present study assessed the reliability and construct validity of the Malay version of the JCQ among automotive workers in Malaysia. Fifty workers of a major automotive manufacturer in Kota Bharu, Kelantan consented to participate in the study and were administered the Malay version of the JCQ. Translation (English-Malay) and back translation (Malay-English) of the JCQ was made to ensure the face validity of the questionnaire. Reliability was determined using Cronbach's alpha for internal consistency, whilst construct validity was assessed using exploratory factor analysis (principal component with varimax rotation). The results indicate that the Cronbach's alpha coefficients were acceptable for decision latitude (job control or decision authority) (0.74) and social support (0.79); however, it was slightly lower for psychological job demand (0.61). Exploratory factor analysis showed 3 meaningful common factors that could explain the 3 theoretical dimensions or constructs of Karasek's demand-control-social support model. In conclusion, the results of the validation study suggested that the JCQ scales are reliable and valid for assessing job stress in a population working in the automotive industry. Further analyses are necessary to evaluate the stability and concurrent validity of the JCQ.