Parasitic worm infections, particularly by soil-transmitted helminths (STHs), are considered a public
health concern affecting millions of children in developing countries around the world. In Malaysia,
various prevalence studies have been carried out since 1970s among children from diverse population
ranging from the remote aboriginal communities in the Peninsular Malaysia to the rural interior tribes of
Sarawak. However, the number of worm infection studies in Malaysia is still limited particularly in East
Malaysia but overall, more studies should be conducted presently compared to 20 years ago. Focusing
mainly on STHs, we reviewed the prevalence and intensity of worm infection among children between
East Malaysia and West Malaysia, particularly from rural and urban settings.
Organ transplant has become a main stream important medical procedure commonly used in hospitals. However, for organ transplant programme to be successful, it heavily relies on the public to voluntarily register for organ procurement. Effort to promote awareness and register public as organ donors has been ongoing, but public response to commit and register as donors has been lukewarm. Arguably, healthcare personnel and nurses are in a key position to educate and advocate for organ donation but often, ironically healthcare personal themselves are reluctant or unwilling to commit as organ donors. Thus, in the context of student nurses in Universiti Malaysia Sabah (UMS), the question arises, what is their stance and views regarding organ donation.
Introduction: Vision is an important requirement for learning and plays a critical role in the development of a child during the first three years of life. Little is known regarding the extent of visual impairment amongst preschool children in Sabah.
Objective: To determine visual status among preschool children in Kota Kinabalu and to determine prevalence of refractive error among children who were referred by the programme.
Methodology: A retrospective cohort study of clinical records was conducted at Department of Ophthalmology, Hospital Queen Elizabeth, Kota Kinabalu, Sabah from May to September 2017. Criteria for failed vision were VA 6/12 (0.3 LogMar) or worse. All records of referred children were selected for prevalence of refractive error. Data collected include basic demographic data, visual acuity and refractive error. Myopia was defined as spherical equivalent (SE) ≥−1.00 DS, hyperopia SE ≥+3.00 DS and astigmatism ≥−1.50 DC.
Results: A total of 192 children age 4 to 6 years old were screened, comprised of 102 (53.1%) male and 90 (46.9%) female (mean age: 5.81 ± 0.41 years). Of the 192 students, 39 (20.3%) of them failed vision screening. Among the 39 children, only 17 children came for further eye assessment. Twelve (70.6%) of them had a binocular visual impairment (VI) while 5 (29.4%) children had monocular VI. Six years old children were found to have VI more compared to other age groups (n= 14, 82.4%) and majority of this age group having binocular VI (n=10, 83.3%). Mean SE was −0.60 ± 0.94. Astigmatism is the commonest type of refractive error found with a prevalence of 41.4% followed by myopia, 27.6%.
Conclusion: This study was the first attempt to investigate the visual status among preschool in Kota Kinabalu. As most children were found with astigmatism, early detection of significant refractive error could help to minimize the effect of VI.
Posterior capsular rupture (PCR) is a common and serious complication of cataract surgery. It complicates the process of inserting posterior chamber intraocular lens and affects the visual outcome. This study is a review on visual acuity of patients that had PCR during cataract surgery in Hospital Melaka, risk factors of PCR, and factors that cause poor visual outcome. The record of all patients that had PCR during cataract surgery from 1 January 2014 till 31 March 2017 was traced using National Eye Database (NED) and the patients’ folders were reviewed retrospectively. Data collected was demographic data, type of cataract surgery, status of surgeon, underlying ocular diseases, risks factors for PCR, postoperative visual acuity, and factors that cause poor visual outcome. There were 238 eyes that had PCR during cataract surgery, from 126 (53%) female and 112 (47%) male patients. The mean age was 66.62 years old, ranging from 9 to 87 years old. Major risk factors identified were hard cataract, polar cataract, uncooperative patients, extended continuous capsulorhexis, subluxated lens, myopia, vitrectomised eyes, and poor pupil dilatation. From 153 cases that had no pre-existing ocular diseases, 119 (78%) cases had normal vision (best corrected visual acuity – BCVA) two months after surgery, 10 (7%) cases had moderate visual impairment, and four (2%) cases had severe visual impairment. Causes of BCVA poorer than 6/18 were high astigmatism, CMO, and prolonged inflammation. Cataract surgery, even complicated by PCR, is compatible with good visual outcome if the complications are managed promptly.
Contralateral hyperhidrosis from the cardiovascular accident has been infrequently described in the stroke literature. The clinical significance and pathogenesis are yet well understood. This is a case of a 60-year-old man who developed excessive sweating of the paralyzed side with a pure division along the midline of the body secondary to a subcortical stroke, which region is supplied by branches of middle cerebral artery territory known as deep perforating lenticulostriate. To the best of our knowledge, a precise clinicoanatomic correlation between hyperhidrosis and subcortical stroke has not been widely reported. In this review, we summarize the existing literature of post-stroke hyperhidrosis to evaluate the correlation between clinical manifestation and its neuroanatomical location. According to the location of the infarction and clinical features, it can be concluded that both tracks en route through the ipsilateral internal capsule, after originating in the opercular cortex before crossing the brain stem and terminal connections with the contralateral thoracic spinal cord. Therefore, the phenomenon of hyperhidrosis in anterior circulation stroke might be postulated as due to the disruption of the sympathoinhibitory pathway that controls sweat glands, similarly like posterior circulation stroke.
As general population of obese patients in Malaysia rapidly increases, more obese patients are requiring anaesthesia for various operative procedures. Obesity is associated with anatomical and physiological differences and co-morbidities that influence on the choices of anaesthesia care. A surgical case with general anaesthesia is used as a basis of discussion. A 37-year-old female, history of untreated hypertension and gastrooesophageal reflux disease (GORD), BMI of 41 admitted for laparoscopic cholecystectomy for symptomatic cholelithiasis under general anaesthesia. She presented with pain at the upper right abdomen and associated with bloated abdomen, nausea and vomiting after intake of meals. General anaesthesia and right ultrasound-guided transversus abdominis plane (TAP) block for abdominal wall blocks via subcostal approach was performed. Operation was removal gallstones in the common bile duct via laparoscopic approach. Post-operation patient was extubated successfully. She was prescribed paracetamol 1g 4 hourly and started on fentanyl patient-controlled analgesia (PCA) for next 2 days. In this case report, there is the description of the application of TAP block which when used in obese abdominal surgical procedure, can provide excellent postoperative pain relief, early mobilization and recovery.
As in other parts of the world, the practice of traditional healing has been part of the local healthcare system for most of the indigenous ethnic groups, since time immemorial. Using descriptive research format, this study looked into the practice of a traditional medicine practitioner in one of the villages of Kota Marudu in Sabah, Malaysia. The practitioner comes from the Dusun Tagahas subethnic group which is one of the numerous ethnic groups in Sabah. The large number of ethnic group in Sabah has made the research of ethnomedicine rather challenging. The practitioner acquired knowledge of traditional healing and treatment which is mainly herbal medicines alluded with some spiritual aspects. He used many herbal preparations in various forms and applications. Similar to the other traditional medicine practitioners, his knowledge and skill regarding his practice are impressive but the practitioner is unable to explain on the mechanism of how the therapy works. Generally their philosophy rests on the notion that disease responds to right medicine but not explanation. There is an urgent need to capture all the knowledge and skill possessed by traditional medicine practitioners, who generally belong to an ageing and fading population, especially those live in remote and hard to reach areas. Scientific research should be conducted to help traditional medicine healers and herbalists to understand their practices before they suffer the consequences of inexorable extinction.
Escherichia coli (E. coli) is one of the most frequent causes of many bacterial infections especially
gastroenteritis in developing countries. It is also used as an indicator for faecal pollution in the
surveillance of bacteriological quality of drinking water. This study was conducted to determine the
survival of E. coli in water at room temperature (27oC). E. coli which is cultured in Lactose Peptone Broth
was inoculated into 8 bottles each containing 10 millilitres of distilled water. They were kept at 27oC.
Starting from the day 1, ten-fold dilutions were made from each bottle number and E. coli count was
done from each dilutions by using pour plate method. The colony forming unit/ millilitre (CFU/ml) was
calculated. The same procedure was carried out from bottles number 2 to 8 from day 2 to day 8
consecutively. CFU/ml of E. coli in dilution 10-5was markedly decreased from 3.9 x 106
in day 1to 0 in
day 8. The findings suggest that if the water is contaminated with low number of E. coli, it can be
eliminated by keeping water at room temperature for only few days.
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.
Prenatal exposure to chronic stress during critical periods of foetal development produces depression, attention and learning deficits, hormonal imbalances and affects the brain. The effect of prenatal restraint-stress on the postnatal developmental milestones, anthropometric measurements, and the body, brain and adrenal gland weights of the pups were examined and compared with the unrestrained control and the restrained group under the pyramid at postnatal day 10 and 21. Pregnant rats were restrained (9h/day) from gestation day 7 until parturition. Results showed significant delay in the milestones by one day in the restraint control (RC) compared to the unrestrained normal control (NC), while pups of the restrained pyramid (RP) group did not show the delay. Significant decreases in the anthropometric measurements, body and brain weights in RC group were observed at both postnatal days, while the RP group results matched with the NC group. Significant increase in the adrenal weights was found in the RC group compared to NC group and not the RP group. Results suggest prenatal restraint-stress definitely hampers the developmental milestones, anthropometric measurements, and body and brain weights of the young offspring. Results suggest, pyramid environment counteracts and protects the deleterious effects of chronic prenatal stress.
Obesity has become a global health issue, not to mention Malaysia, which topped over the list of countries in Asia. On World Health Day in 2019, the World Health Organization (WHO) announced that 64% of the male population and 65% of the female population in Malaysia are either obese or overweight1. The ringing of alarm is tremendously loud in the silence. Depending on each of us, this can be an issue that we laugh over or a kind but severe urge for us to take a step backwards, observe, and self-reflect.
It is important to prepare the nursing students to be confident and able to interact with the patients,
colleagues, doctors and other staff because the nature of nursing work included a high degree of personal
and group interaction. Continuous communication and interaction in nursing work are some of the
important factors for self-esteem among nurses. Self-esteem affects the relationship between job roles and
job satisfaction as well as the link between work performance and work roles conflict. The objective of this
study is to examine the effects of low self-esteem on clinical performance among first year nursing students
at private nursing college in Kota Kinabalu, Sabah. A descriptive qualitative study was conducted among
10 first year nursing students in one of the private nursing college. Data was collected through one to one
interviews using semi-structured questions. The interview question was structured based on observation
and literature review. The design is ideal because it facilitate the collection of data from a small number of
participants through personal interview. The collected data was transcribed into verbatim and analysed by
identifying the themes via coding and categorization. The results showed there are two main themes
emerged from the study: Defensive behavior and poor communication as the effects of low self-esteem on
the students’ clinical performance. As conclusion from this study, defensive behavior and poor
communication and are the obvious effects of low self-esteem among the first year nursing students in a
private nursing college. This study revealed the needs to equip the students with more conducive learning
environment facilitate suitable motivational and mentoring approaches and practice good communication
skills. Future research suggested, extends the study to the public nursing college for outcomes comparison
and evaluation.
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.
Non-communicable diseases are the leading causes of mortality and morbidity worldwide. Non-communicable diseases (NCDs) kill 40 million people each year and accounts for 70% of all deaths globally. NCDs were previously considered to only affect high-income countries. However, they now account for a very large burden in terms of both death rates and disability in low- and middle-income countries. Also, age standardized mortality rates from NCDs are greater in these countries as compared to high-income countries. By 2020, it is predicted that these diseases will be causing 7 out of every 10 deaths in developing countries. NCDs also have potentially serious socioeconomic implications through increasing individual and household impoverishment thereby hindering social and economic development. This article is an effort to determine the magnitude and consequences of this expeditiously growing public health problem of NCDs through published literature.
Approximately 50% patients with psychotic illnesses on antipsychotic drugs have an increased risk of obesity. This study aimed to determine changes in body weight, body fat percentage and lipid profiles and to stress the importance of early nutrition intervention in the management of psychotic illness patient treated with antipsychotic drugs. This is a prospective longitudinal study conducted for 3 months in Hospital Mesra Bukit Padang, Kota Kinabalu, Sabah. A total of 150 patients with Diagnostic and Statistical Manual IV (DSM-IV) diagnosis of psychotic illness (either Olanzapine or Risperidone only at any dosage) first started or restarted after a treatment gap of at least 6 months were recruited. Weight, height and body fat percentage were measured using Bioelectrical Impedance Analysis (BIA) (Model Omron HBF-375) and blood fasting lipid test were taken from the point of starting medication for 12 weeks. Data were analysed using repeated measures of ANOVA for statistical method. All variables showed significant mean differences (p < 0.05) in increasing pattern throughout the 12 weeks of treatment. However, the total cholesterol of risperidone patients had no significant mean difference from initial to week 6 (p = 0.282). It was proven that there was increase in body weight, body fat percentage and lipid profiles among patients on olanzapine and risperidone. The limitation of this study might relate to the drugs’ dosage and method used in assessing the body composition. It is suggested that early nutrition intervention is needed to control unnecessary gain of weight, body fat and lipid profiles in the management of patient with psychotic illnesses.
The population of Malaysia is estimated in 2018 to be around 32.04 million and 23.5% of the population resides in rural areas. The Ministry of Health has provided healthcare services to the rural areas with the access of modern healthcare facilities based on the two-tier healthcare system. In remote areas, mobile health clinic is the extension of healthcare service by the nearest static health clinic. However, most of the remote areas only covered by a community clinic or Klinik Desa which is limited for mother and child healthcare. There is demand from the people in remote areas for static health clinic or Klinik Kesihatan. Objectives: This study is to evaluate and compare the effectiveness between two health services in remote areas applied in Sabah. This study also determines which type of health services that able to worth the service to people in remote areas. Methods: This is a descriptive study. Data was taken from HMIS report (Per PL 206) under Sabah State Health Department. The data analysed by using Microsoft Excel. Results: This study was conducted based from the data obtained in 2015 till 2017 for the number of patients attended to static health clinics and mobile health clinics on selected remote areas. For example, Jambongan Health Clinic only have an average of 10 – 15 patients per day while the Mobile Health Clinic team under Beluran Health District which covers the adjacent remote areas of Jambongan Island have more than 20 patients per day on a single visit. Another example is from Terian Health Clinic in Penampang, which only have an average of 5 – 10 patients per day. However, on the mobile health team on a single visit to the village next to Terian which is Kg. Buayan, the average patients attended for the service is mo re than 20 patients. Conclusion: From the study, it was noted that people in remote areas prefer the mobile health service to visit their villages. This can be due to financial issue and limitation of transportation service to the nearest static clinic. The density of population and the development of the rural areas play important roles for the healthcare service to be effective in remote areas.
Telomeres are specialized DNA complexes found at the end of all chromosomes. Human, as a member of eukaryotic cells, requires telomeres to maintain the length and the stability of chromosomes. Telomeres lose their non-coding DNA sequence to protect the genetic information on the chromosomes. Shortening of telomeres occurs in most somatic cells after sufficient cell division in a human lifetime. Normal haemopoietic cells or stem cells possess telomerase enzyme to restore telomeres and allow further replication. Telomere dysfunction is the origin of several degenerative disorders and also predispose to cancer. Roles of telomere in carcinogenesis and ageing related disorders are reviewed.
Since the COVID-19 pandemic, Taiwan reported a total of 776 cases of COVID-19 (Dong et al., 2020) in comparison with its neighbouring countries, Japan and the Philippines which reported 210,769 and 465,724 cases of COVID-19 respectively, until 24 December 2020. Looking at the curve of the COVID-19 pandemic among various countries, Taiwan had indeed distinguished herself and stood out considering her well-contained COVID-19 infection despite it being a widespread infection in other countries.
Chest radiography, or chest X-ray (CXR), is not only an important tool for triaging and screening for pulmonary tuberculosis (TB) but is also useful in aiding diagnosis when pulmonary TB cannot be confirmed bacteriologically. Sabah is a state with high TB burden with the incidence rate of 124/100,000 population in 2015. Access to chest radiography is limited in many settings in Sabah. In 2016, the TB and Leprosy Control Unit of Sabah State Health Department started systematic screening for TB with the help of a mobile digital X-ray unit.
Synovial Sarcoma is a rare malignancy. It presents in adolescents and young adults. It occurs in soft tissue
of extremities usually near to the large joints, heart, lung, mediastinum, head and neck. A 23-year-old
female presented with a big hard fixed swelling in right supraclavicular region for 15 years. X-Ray chest
posterior-anterior view presented Homogenous opacity in upper lobe of right lung. USG of neck showed
large heterogeneous lobulated almost avascular solid mass in right side of root of neck and anterior upper
mediastinum may be associated with Schwannoma/ paraganglioma/soft tissue sarcoma. Spindle cell
lesion was reported by FNAC. MRI showed large slightly lobulated mass along right side of root of neck
and right side of superior mediastinum. A large soft tissue density mass along right side of neck and
superior mediastinum was found in CT scan. Surgical excision was done successfully. Histopathological
examination revealed spindle cell tumor favoring synovial sarcoma in the neck tissue and metastatic
spindle cell tumor in the lung lesion.