Displaying publications 1 - 20 of 193 in total

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  1. Zheng YL, Norafizah MN, Rosli MS, Marlina MN, Maslina M, Nora Nurlinda Z, et al.
    MyJurnal
    Introduction: Critically-ill patients are commonly fed with EN via open system (OS) or closed system (CS). Several studies showed that patients on CS had received greater volume of EN compared to OS.
    Objective: As there was no study conducted in Malaysia, hence this study is conducted to compare the energy and protein adequacy of both systems.
    Methodology: This cohort prospective study was conducted in GICU (OS) and NICU/NHDW (CS) in Hospital Kuala Lumpur. Patients aged ≥18 years and fed by feeding pump in OS were included. Patients who were moribund or not given EN were excluded. Patients’ demographic data and disease severity score were collected on day 1 in ICU and followed for 5 days until decease or discharge. Adequacy was determined by percentage of energy/protein received from requirements.
    Results: Fifty-five patients were included (25 OS and 30 CS) with mean aged 45.41±17.46 years old, 78.2% male and 65.5% Malay. The mean SAPS II, SOFA score and ICU LOS were 46.47±10.65, 8.60±3.64 and 9.24±7.91 days respectively. The ICU mortality was 20%. EN was started about 2.56±2.89 days after ICU admission and the mean adequacy of energy was 74.56±32.23%, while protein adequacy was and 69.15±35.78%. Compared with the CS, OS were significantly older than CS (51 years old vs 42.5 years old; p=0.035) and had a higher SOFA score (10 vs 7.5; p= 0.014). No difference in ICU LOS and mortality between group were found. Energy (45.64% vs 96.71%; p<0.001) and protein adequacy (38.78% vs 94.12%; p<0.001) were significantly higher in the CS than the OS.
    Conclusion: CS as compared with OS may improve nutritional adequacy as CS delivered more 108% energy and 141% protein than OS. The difference in adequacy might be attributed to these factors; feeding method used in the system, patients’ characteristics and condition rather than the feeding system itself.
    Keywords: enteral nutrition, critically-ill patients, open system, closed system, adequacy
  2. Zaw Lin, Nor Amalina Emran, Yun, Mei Lai, Myo Thura Zaw
    MyJurnal
    Out of bacteria which cause food –borne infections, enterohemorrhagic Escherichia coli (EHEC) is
    well known to be pathogen causing serious outbreaks. The first outbreak of EHEC infection occurred
    in 1982 was due to ingestion of hamburger at restaurant. A rare Escherichia coli serotype, 0157:H7
    was isolated at that time and the following outbreaks were mostly due to this serotype. However, O26,
    O111 and O104 were also responsible for EHEC outbreaks. Enterohemorrhagic E. coli is an important
    food and water-borne pathogen. Verotoxins (VTs) produced by this pathogen causes painful
    hemorrhagic colitis along with major complications of hemolytic uremic syndrome (HUS). The
    morbidity and significantly high mortality and enormous economic loss are problematic to the health
    care administrators and EHEC infection is a serious public health issue. Another factor which makes
    it high transmissibility is the low infectious dose. The German O104:H4 epidemic was caused by the
    pathogen carrying a combination of virulence genes derived from two well-known pathogens, EHEC
    and enteroaggregative E. coli (EAEC). There is a possibility that two mobile DNA elements can occur
    again in this versatile pathogen. In this article, some aspects of EHEC infections which were
    established but not well known to the medical personals were explained to get understanding of why
    this infection should not be overlooked and should be under surveillance.
  3. Zarkasi KA, Ramli NZ, Mohamed K, Palasuberniam P, D’ Souza UJA
    MyJurnal
    Malaysia has high prevalence of general and central obesity which can be signified by measurements of BMI and waist circumference respectively. Both parameters are established risk factors and predictors for non-communicable diseases including diabetes and hypertension. A health screening programme was conducted in a rural district of Sabah, Malaysia where a total of 42 participants were examined for weight, height, BMI, waist circumference, systolic and diastolic blood pressure, pulse rate and capillary blood glucose. Mean age of the participants was 52.4 ± 14.9 years old. General obesity based on BMI was 42.9% while central obesity based on waist circumference was 26.2%. Proportion for hypertension and hyperglycaemia were equal at 33.3%. BMI was strongly correlated to waist circumference (r = 0.873, p < 0.001). Moreover, both BMI and waist circumference were independently correlated with systolic blood pressure (r = 0.418, p = 0.006 and r = 0.383, p = 0.012 respectively). Finally, systolic blood pressure was directly correlated with weight of the participants (r = 0.350, p = 0.023). These findings were found to be closely similar and comparable to currently available epidemiological data.
  4. Zainal Adwin Zainal Abidin, Hazwan Zaini, Firdaus Hayati, Nornazirah Azizan, Aizat Tamlikha
    MyJurnal
    Obscure gastrointestinal bleeding is a surgical enigma of disastrous proportions. Patient’s haemodynamic status often dictates the path of management ranging from endoscopy, embolization and/or surgery. Minority of the cases has failed to identify the exact source of bleeding during endoscopic and imaging techniques. Emergency surgery is warranted in hypovolaemic shock which has failed to respond to fluid and blood resuscitation. We present a 72-year-old male with an obscure upper gastrointestinal bleeding due to ruptured cystic artery pseudoaneurysm and illustrate the rarity of the presentation with successful management.
  5. Z. Chin, Abraham
    MyJurnal
    Since the 1970s, people’s understanding of life has gradually deepened into the basic material nucleic acid and protein levels of life. The life sciences have entered the era of “molecules†and produced a large number of new and interdisciplinary subjects. An important direction has had a major and profound impact on the development of epidemiology itself and on disease control.
  6. Yun, Mei Lai, Myo, Thura Zaw, Nor Amalina Emran, Lin, Zaw
    MyJurnal
    Escherichia coli sequence type 131 (ST131) carries multiple drug resistance (MDR) genes as well as virulence genes. Drug resistant characteristics give a management problem to health care personnel. Four MDR Escherichia coli ST131 H30-Rx subclones were identified among 80 Uropathogenic E. coli (UPEC) isolates by using 4 allelic-specific Polymerase Chain Reactions (PCR) in two hospitals of Kota Kinabalu, Sabah, Malaysia. There is emergence of multidrug resistant E. coli in Kota Kinabalu.
  7. Yun, Mei Lai, Myo, Thura Zaw, Tin, Sabai Aung, Tin, Win, Lin, Zaw
    MyJurnal
    The three plasmid borne alternative dihydropteroate synthetase (DHPS) genes namely sul1, sul2 and sul3 genes were heterologous in amino acid sequence and have about 40 – 50% identity. However, they have same DHPS activity with disc diffusion zone size of 6 mm with suphamethoxazole disc in our previous study. Sul1, sul2 and sul3 genes were observed in sulphamethoxazole resistant uropathogenic Escherichia coli (UPEC). In this study, all the three genes were cloned into E. coli host and minimum inhibitory concentration (MIC) was investigated for each sul gene to compare the activities of sul genes. The MIC values of E.coli containing sul2, sul1 and sul3 genes inserted recombinant plasmid were observed to have 18.5 mg/ml, 18 mg/ml and 17.5 mg/ml respectively as mean value of five experimental results. Although comparable MICs were obtained as a result, the MIC value was highest in E. coli carrying sul2 gene indicating that this DHPS enzyme activity of sul2 was strongest among three sul genes.
  8. Yeap, Boon Tat, Yeoh, Boon Seng, Rajesh Kumar Muniandy
    MyJurnal
    Anaphylactic reaction towards antibiotics is common during anaesthesia. It may present as bronchospasm, hypotension, desaturation, or urticarial. However it is uncommon for anaphylaxis reaction to present only as supraventricular tachycardia (SVT). This is a rare interesting case report on a 23-year-old healthy man whose anaesthetic categorization is American Society of Anaesthesiologist (ASA) 1, developed supraventricular tachycardia (SVT) towards intravenous cefuroxime, peri operatively. His condition resolved with carotid sinus massage. No pharmacological interventions were used. His skin prick intradermal tests showed allergies towards cefuroxime, cefazoline and cefoperazone. The patient subsequently underwent.
  9. Yahya AN, Sit JA, Raman S
    MyJurnal
    The success of cataract surgery is accessed by the improvement in visual acuity and accuracy of the post-operation refractive outcome against the pre-operation refractive target. Hence, the benchmark of 85% of patients achieving a final spherical equivalent within 1D of the desired target is used to monitor the refractive outcome. Meanwhile, the unaided visual acuity threshold of 6/12 after cataract operation is chosen as a yardstick because it allows patients to perform instrumental activities of daily living (IADL) independently without relying on spectacles.
  10. Wynn, Aye Aye, Myint, Ohnmar, Mya, Nang Khin
    MyJurnal
    Apoptosis is a programmed cell death which occurs following a variety of stimuli. Physiologically the process is important for morphogenesis of organs and homeostasis of different types of cells. Apoptotic cell death is responsible for a variety of pathologic states such as elimination of cell death in mutated cells, infected cells, tumour cells and transplant rejection well as the pathological atrophy. In this review, there is discussion about the control of apoptosis, detection methods of apoptosis, its association with infectious and non-communicable diseases. Intracellular microorganisms survive through inhibition of host cell apoptosis as well as they destroy the parenchymal cells causing impaired functions. It plays important role in tumourigenesis. There are possible therapeutic roles of drugs that modify apoptosis in human diseases.
  11. Wynn AA, Myint O
    MyJurnal
    Malaria is a major health problem in various parts of the world especially affecting the tropical countries. It affects the vital organs causing severe complicated malaria. Clinical syndromes like severe cerebral anaemia, coagulation abnormalities, respiratory distress and severe anaemia can increase the mortality of malaria infected cases. Variation in individual susceptibility and severity and type of clinical presentations of malaria raises the need for study of both the parasite and host immune reactions as well as the contribution of inflammatory cytokines in malaria pathogenesis. This study explored the immunopathological basis and advances of severe malaria and their importance in pathogenesis of malaria and its complications. Previous and ongoing studies indicate that changes in endothelium during the sequestration of parasites in organs causes disruption of endothelial barrier function leading to serious effects of malaria. Parasite and host factors contribute to disturbance of cytokine regulation and escape of parasites from the immune system of the host. Immunopathological changes and dysregulation of cytokine production play central role in pathogenesis and disease severity in malaria.
  12. Wong, Kwong Hui, Hanisah Mohd Siddiq, Nur Fadzlina Abu Seman, Krisnaah, Padmanathan, Mohd Amiruddin Mohd Kassim, Geveney, Yukin, et al.
    MyJurnal
    Obesity is a prevailing health issue and has been recognized as a threat in public health worldwide.
    Rural setting is no longer a barrier to the epidemic of obesity as previously thought. This crosssectional
    study aimed to determine the risk factors and associated co-morbidities of obesity among
    adults aged 18 and above in rural community of Kudat, Sabah. 28.2% of respondents were found to be
    obese with female predominance (54.9%). Older age, formally educated, ever-drinkers and high
    systolic blood pressure were associated with obesity. Various forms of interventions should also
    involve the rural area to close the disparity of health.
  13. Wong, Jackson Sing Ann, Yew, Hoe Tung
    MyJurnal
    In this modern and fast-moving world, elderly’s safety and security have become an important issue. According to the World Population Prospects of the United Nations 2015, there is 12.3 per cent population aged 60 and above globally and it is the fastest growing population at a rate of 3.26 per cent per year. In order to reduce the worries about the elderly living alone at home, Elderly Monitoring System is required for continuous monitoring. “Fall†is one of the critical incidents for the elderly living alone as it causes serious injuries. A fall detection system using global system for mobile communication can help to reduce the time of unaware of their next of kin.
  14. William, W., Newati Wid
    MyJurnal
    Disposal of shrimp shell waste is gradually increasing throughout the years due to the constant growing of cultured shrimp production at the local area which in turn increases the bio-waste of shrimp shell. Shrimp shell waste contains valuable components such as protein and chitin. Chitin can be found at the outer surface of shrimp shell, while chitosan can be derived from chitin. Chitosan is a valuable natural polymer as it holds major potentials for industrial applications. However, the poor quality of chitosan has restricted its potential in applications and this is due to the difficulties in maintaining its degree of deacetylation, solubility, and ash content. Hence, several factors such as the temperature for deacetylation treatment, concentration of alkaline solution, ratio of chitin to alkaline solution, and few other factors are important to produce a good quality of chitosan.
  15. Valentine J G, Diane C, Chua Y W
    MyJurnal
    Men who have sex with men (MSM) is one of the key populations affected by HIV epidemic with infection rates exceeding five percentages. Due to a strict and prohibitive socio-cultural and legal environment, male-to-male sexual practices are often misunderstood and highly stigmatised, thus creating barriers for MSM to access HIV prevention, treatment, care and support services.
  16. Umi Izzatti Saedon, Nicholas Pang Tze Ping, Loo, Jiann Lin
    MyJurnal
    Inaccessibility to clinical supervision is an issue faced by solo clinical psychologist practitioners. Combination use of web-based instant messaging and video call application were tried by 28 clinical psychologists in conducting a peer-led group tele-supervision to address ethical dilemmas, discuss case management, provide technical instruction, explore resistance and analyse countertransference, provide emotional support, and share knowledge and updated guidelines. Despite facing challenges including difficulty in face-to-face session scheduling, limited time for in-depth discussion, internet connection issues, and documentation dilemma, we believe it has potential to influence supervision practice for clinicians working in isolation in rural or remote locations.
  17. Tin Tin Aye, Yusolf Ibrahim, Daw Khin Saw Naing, Than Myint, Muhammad Hj. Jical
    MyJurnal
    Antenatal (AN) care is vital for all pregnant women and for reduction of maternal mortality and morbidity. AN care knowledge and specific AN care practices are some of the crucial components of what determines effective AN care. In developing nations, the health of pregnant women can be even more sensitive to these factors. Objectives of this study was to assess the antenatal (AN) care practice and pregnancy outcome of ever-married women aged 18 to 49 years old having at least one pregnancy experience ,residing in kampongs of Sikuati area, Kudat between March to December 2015. Cross–sectional descriptive study, non-probability convenient sampling method was used and 150 eligible participants were interviewed through face to face by trained interviewers using a semi-structured questionnaire and their knowledge of AN care, their AN care practices and outcomes and complications of their pregnancies were recorded. 99% of all the women received AN care, and 64% of the women received essential AN care practice (AN visit of minimum 4 times). The study revealed that overall knowledge amongst the women with good knowledge was 48% and low knowledge was 52%. Despite this, it was found that low knowledge of AN care was associated with essential AN care practice. Additionally, AN care practices, assessed through timing of first AN care visit and frequency of visits, was not significantly associated with pregnancy complications. Despite these results, outcomes were good and all complications were properly and successfully addressed. This may reflect the effectiveness of current programs in place promoting importance of AN care and delivery practices. Maintenance of current programs with targeted interventions to address low knowledge level and the low level of compliance with essential AN care completed are recommended..
  18. Thidar AM, Myint TT, Naing DKS, Mustapha ZA
    MyJurnal
    Learning anatomy is the basic and essential component of medical study when students start to learn in medical career. Since five hundred years ago, the human cadaver has been used as the silent mentor for students in learning anatomy. Later, pre-dissected specimens were used in addition to hands-on dissection of human cadaver. Current advances promote the use of anatomical models as well as plastinated specimens. This study focused on analyzing the preference of students towards different learning modalities available for anatomy teaching. It was conducted on first year medical students at the Faculty of Medicine and Health Sciences, University Malaysia Sabah (FPSK, UMS). A total of 76 students (27 males and 49 females) participated in this study. Out of 76 students, 57 (75%) students preferred using human cadaver for anatomy learning. Four students (5.3%) opted for plastinated
    specimen while 15 students (19.7%) chose the plastic model. Knowledge gained in learning Anatomy was said to be easier from cadaver (67.1%), followed by plastinated specimen (35.5%) and plastic models (52.6%). In the present study, 97.4% responded that plastic model was easier to apply their knowledge in objective structured practical examinations. The present study found that using cadaver was still favoured by medical students. Further studies are required to determine the preference between hands-on cadaveric dissections versus pre-dissected specimens.
  19. Teo, Chiang Hoon, Tuan Hairulnizam Tuan Kamaruzaman, Sarimah binti Abdullah
    MyJurnal
    Occupation-related fatigue and sleep loss are common among shift workers in the emergency department (ED), who deliver round-the-clock critical care service to patients. These factors affect their performance and impose an unnecessary hazard to patients, while also endangering themselves.
  20. Teo, Carolyn Ai Li, Mohd Idzham Zainal, Francis, Jessica Olivia, Lee, Kah Seng, Lee, Kristine Sheh Fuen, Liew, Jerry Ee Siung
    MyJurnal
    Widespread over-prescription of proton pump inhibitors (PPIs) without an appropriate indication has financial and potentially adverse clinical consequences.
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