Displaying publications 1 - 20 of 393 in total

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  1. Teh BT, Wan Azman WA, Thuraisingham S, Choy AM, Tan KH, Jesudason P, et al.
    JUMMEC, 1999;4:26-33.
    Activation of the synlpathetic nervous system (SNS) and renin-angiotensin system (RAS) plays a pivotal role in the pathophysiology and progression of the disease in chronic heart failure (CHF). Blocking the activation of the RAS with angiotensin converting enzyme inhibitors not only improves sylnptonls but also prolongs life in symptomatic CHF. Does a similar analogy hold true for the use of ß-blockers in CHF? Evidence from a number of small trials and several recent large prospective trials show that b-blockers may improve ventricular function and symptoms in CHF. In a combination of trials investigating the use of carvedilol (an α, and ß-blocker) in congestive heart failure a mortality benefit appears to be evident. There are still a number of key questions that relnaill unanswered regarding the tolerability, patient type and stage of CHF in which ß-blockers should be advocated. Several large scale trials are in progress to answer some of these questions and also to add further information regarding its efficacy and impact on survival. KEYWORDS: Beta-adrenoreceptor antagonist, congestive heart failure.
  2. Prasad U, Pua KC
    JUMMEC, 1999;4:39-42.
    100 consecutivnee wly diagnosed patients with nasopharyngeal carcinoma (NPC) since January 1994 were the subjects for studying various factors related to the delay in the confirmation of the diagnosis. 79 of them were ttlales and the peak age of incidence was the 5th decade. 92% of them were Chinese, 7% Malay and 1% Indian. 76% were agriculture worker or labourers with 66% having either no formal education (16%) or only primary level education (50%). For 50% of patients neck swelling was the first symptom, 26% had nasal symptoms, 12% ear symptoms and 11% hads symptoms due to intracranial extension of tumour. As many as 80% were at UICC Stage IV at the time of diagnosis. While the median delay, on the part of patients, in consulting a doctor was 2.5 days, the median delay on the part of the doctors to confirm the diagnosis of NPC was as long as 127 days, which was particularly worse when the patients presented with ear symptoms (266 days) followed by those with neck swelling (94 days). For those patients who were required to undergo more than one nasopharyngoscopy and biopsy the median doctor's delay was 144 days. Since 82% of patients had consulted general practitioners who remained the first-line health-service provider, it is suggested that their level of awareness with regards to NPC be significantly raised so that the delay on their part be greatly minimized. KEYWORDS: Nasopharyngeal carciuotna, delay in diagnosis, patient's delay, doctor's delay.
  3. Init I, Prummongkol S, Gan CC, Nissapatorn V, Khairul Anuar A
    JUMMEC, 2002;7:142-146.
    One (1) anti-Blastocystis serum from a monkey naturally infected with isolate M12 and four (4) hyperimmune sera raised in inbred Balb/c mice against crude antigens of two Blastocystis isolates (C and KPI). one each of Entamoeba histolytica (HK9) and Giardia lamblia (7404) were used to react with several homologous and heterologous Blastocystis isolates, E. histofytica, G. lambfia, Endolimax nana and Bac-4 (Escherichia coli isolated from culture medium of a B. hominis isolate KPl). All anti-Blastocystis sera did not show cross-reactivity with E. histolytica and G. lamblia by western blotting. Similarly, anti-E. histolytica and anti-G. lamblia sera also did not react against all Blastocystis isolates tested, even though these three protozoa are known to produce diarrhoea in humans. Polyclonal sera raised against antigen prepared from xenic culture of Blastocystis produced a smear reaction on the immunoblot, while antibodies raised against antigens prepared from axenic culture (isolate C) gave prominent reaction bands. This may be due to the purity of the immunogen used in inducing the immune response. The cross-reactions of sera from mice immunised with the xenic B. hominis isolates may also due to antibodies against E. coli. Anti-Blastocystis serum from monkey's with natural infection showed several prominent reaction bands together with a smear at above 40 kD were most probably induced by the excretory-secretory antigens of the parasite. A variety of reaction patterns were obtained with these anti-sera and the antigens from different Blastocystis isolates. These may be reflects from differences in antigenic components from various strains of this parasite. KEYWORDS: lJIastocysfis, polycional antibodies, immunoblot, experimental animals
  4. Faizah Abdul Karim, Zamros Yuzadi Mohd Yusof, Nor Azlida Mohd Nor
    JUMMEC, 2020;23(2):76-91.
    MyJurnal
    Information regarding water fluoridation (WF) in Malaysia has been substantially documented, but is scattered in various government publications and may be lost to the stakeholders. This paper is a review of water fluoridation in Malaysia and its effect on oral health: a history of WF in Malaysia, the current policy, the evidence of its effectiveness, the challenges and the future directions. A search for relevant physical and electronic documents of WF in Malaysia resulted in the identification of 70 documents for review. WF was gazetted as national policy with an optimal fluoride level of 0.7 parts-per-million (ppm) in 1972, with a reduction of the level to 0.5 ppm in 2005. Evidence showed that WF effectively reduced population dental caries while fluorosis was not a prevalent public health concern. Strong collaboration between stakeholders and the extensive network of piped water supplies resulted in 80% of the population receiving WF in 2013. However, the coverage was reduced to 74.1% in 2018, largely due to the cessation of WF in Pahang. The key challenges in WF included a lack of funding, weak legislation, use of reverse osmosis water filtration system, difficulty to maintaining an optimal level of fluoride in the water, and lack of local data on the impact of WF cessation on oral health, and its cost-effectiveness. This review will provide dental health professionals with scientific evidence on WF and oral health in Malaysia and assist them in answering relevant questions about WF raised by the public.
  5. Yaakob, Z.H., Syed Tamin, S., Nik Zainal, N.H., Chee, K.H., Chong, W.P., Hashim, N.E., et al.
    JUMMEC, 2009;12(2):57-62.
    MyJurnal
    Current selection guideline for CRT uses broad QRS duration (>120 ms) as a marker for ventricular dyssynchrony. However, more recent data supports mechanical marker specifically measured by Tissue Doppler Imaging (TDI) as a better criterion to predict response to CRT. Sixty seven patients with significant left ventricular dysfunction (EF less than 40%) and narrow QRS complex were prospectively enrolled. They underwent Tissue Doppler Imaging (TDI) study to evaluate intraventricular mechanical dyssynchrony. Dyssynchrony index which is defined as standard deviation of time to peak systolic velocity in twelve ventricular segments was measured. A value greater than 32.6 is taken to reflect significant ventricular dyssynchrony. Overall 38 patients (56.7%) demonstrated significant dyssynchrony. There was no significant correlation between QRS duration and the Ts-SD-12 (r = 0.14, p = 0.11). Ventricular mechanical dyssynchrony is common in patients with normal QRS duration. Therefore, QRS duration alone will miss a substantial proportion of suitable patients for CRT and therefore deny them this adjunct therapy. We propose echocardiographic parameters, specifically TDI, to be included in patient selection criteria for CRT.
  6. Fong, Chng Saun, Nasrin Aghamohammadi, Ramakreshnan, Logaraj, Nik Meriam Sulaiman
    JUMMEC, 2020;23(101):3-11.
    MyJurnal
    Background: There are rising concerns for the deterioration of outdoor thermal comfort (OTC) level as it influences the health and well-being of sensitive and vulnerable urban communities such as school children. However, the understanding of OTC among school children in an urban setting has been poorly highlighted in existing literature.

    Methods: A cross-sectional quantitative study was conducted among secondary school students in a selected area within Greater Kuala Lumpur (GKL) so as to understand their thermal perception towards the urban outdoor environment. A clustered random sampling was used to gather a total of 236 students for this study. Meteorological data were collected concurrently with the questionnaire survey which was conducted during the peak urban heating hours (0800 – 2000) from July 2018 to January 2019.

    Results: The secondary school students in the selected study area felt hot (n=120, 51%) and experienced little discomfort (n=144, 61%). If given a choice, 76% (n=179) of the students preferred a cooler environment although 56% (n=132) accepted the current thermal environment. Findings based on the on-site meteorological observations revealed that the students were constantly exposed to a mean of 32.7°C Physiological Equivalent Temperature (PET) while the expected neutral temperature was found to be 25.1°C PET.

    Conclusion: Based on these outcomes, it can be deduced that the students in this study showed traits of thermal acclimatization. Future studies should be conducted to identify the influence of other confounding factors, such as gender, ethnicity, and clothing variations among the secondary school students so as to ensure that the students are able to better adapt to the deteriorating OTC levels in urban outdoor spaces.
  7. Nor Azmawati Husain, Jamilah Mohamad
    JUMMEC, 2020;23(101):41-51.
    MyJurnal
    Background: TheJob Demand – Resource Model (JD-R) is a job-stress model that focuses on assessing the effect of the employees’ health-related outcomes, and their performances due to stress induced by their job demands, and job resources. Different occupations possess different combinations of specific job-related demands, and job resources. The Copenhagen Psychosocial Questionnaire (COPSOQ) is an established self-reported tool that has been widely used to measure general job demands through the JD-R model. In contrast, the BDJD-24 is a model that was developed to assess the specific job demands of the bus drivers’ job demands.

    Objective: This study aims to measure the validity and reliability of the job demand questionnaire by applying it on the taxi drivers of Malaysia so as to assess their safety performance (safety motivation and safety compliance).

    Method: A sample of 33 (N = 333) taxi drivers from the Klang Valley, Malaysia was recruited. Participants completed the questionnaire in the native language (Malay). To examine the psychometric properties of the COPSOQ and BDJD-24, we used the Exploratory Factor Analysis (EFA) derived from SPSS, and then confirmed it with the Confirmatory Factor Analysis (CFA) derived from AMOS.

    Results: The internal consistency was found to be acceptable, between 0.71 to 0.84. The CFA revealed that the taxi drivers’ job demands, as proposed, had a 5-dimensional influence. The five demands (i.e. emotional, hiding emotion, sensory, time, and safety) were clearly distinguished in the factor analysis. The KMO was adequate, at 0.78, and the variance for the 5-factor structure was 51.97%. The CFA also confirmed the correlation among these demands.

    Discussion: It is found that the COPSOQ and the BDJD-24 measurement were both reliable and valid for measuring the taxi drivers’ job demands. However, the general vs. specific job demands hypothesis, as proposed by the JD-R model, was not supported. The general job demands (emotional demands) were found to be more strongly associated with safety motivation, and safety compliance. The practical implications and limitations of the present study are further discussed in the paper.
  8. Amnah, A.B., Bulgiba, A., Omar, R.
    JUMMEC, 2015;18(2):1-7.
    MyJurnal
    We conducted a multi-institutional case study to identify the issues associated with the adoption of information and communication technology (ICT) in five private care hospitals in the Kingdom of Saudi Arabia. We conducted interviews with 37 respondents primarily comprising IT professionals.
    We found that there were three determinants of behavioural intentions in this case study: organisation objectives, facilitating conditions and social influence where there are no effects of performance expectancy or effort expectancy. In all five cases, none of the moderators (age, gender, experience and voluntariness) in the original united theory of acceptance and use of technology model were considered critically important by IT professionals. In the present paper, all qualitative elements such as themes, patterns and overarching in the data were analysed to reach a conclusion. In addition, the various perspectives of using ICT are discussed.
  9. Pathmanathan R
    JUMMEC, 1996;1:4-6.
  10. Goh EML, Chow SK, Yeap SS
    JUMMEC, 2002;7(2):86-91.
    Osteoarthritis is the most common joint disorder in the human population. It is characterized by the destruction of articular cartilage and the overgrowth of marginal and subchondral bone. The commonest weight bearing joint affected is that of the knee, affecting over one third of people over Ihe age of 65 years. This article reviews the recent principles of non surgical management of osteoarthritis. This is divided into non drug management such as primary prevention, physiotherapy, occupational therapy and patient education. Drug management will include the use of different types of analgesics. viscosupplementation as well as joint injection. KEY WORDS: Osteoarthritis, management
  11. Kulenthran, A.
    JUMMEC, 2009;12(1):1-2.
    MyJurnal
    The present issue brings a diverse yet interesting array of research, but they all have a common thread-they answer to a clinical problem raised. The topics span human sexuality, diagnostic challenges, sports medicine, nosocomial infections, screening for neonatal infections, statistical analysis and fine-tuning the art of anaesthesia.(Copied from article).
  12. Shariffuddin, I.I., Hasan, M.S., Chong, T.H., Kwan, M.K., Chan, Y.K.
    JUMMEC, 2016;19(1):1-6.
    MyJurnal
    Background:
    Prevention of hypothermia in patients undergoing major posterior approach spinal surgery can be difficult, as a
    large body surface is exposed to the cold environment of the operating theatre. We compared the efficacy of a
    new under-body forced-air warming blanket with that of a resistive heating blanket in preventing hypothermia.
    Methods:
    Sixty patients undergoing major posterior approach spinal surgery lasting for more than 2 hours were randomly
    assigned to warming with a full under-body forced-air warming blanket or three segments of resistive heating
    blankets, both set at 42°C. The ambient temperature was kept near 20°C. Nasopharyngeal, rectal and axillary
    temperatures were measured at regular intervals. Changes in core temperature (average of nasopharyngeal
    and rectal) over time were compared by the independent t-test.
    Results:
    The characteristics of the patients were comparable. The baseline core temperature was 36.36 ±0.38°C in the
    forced-air group and 36.27 ± 0.46°C in the resistive heating group. During the first hour, the core temperature
    decreased similarly from baseline in both groups. From 100 minutes after induction until the end of the surgery,
    core temperature rose in both groups. At the end of surgery, the core temperature was increased by 0.08
    ± 0.09°C from baseline in the forced-air group but decreased by 0.40 ±0.04°C from baseline in the resistive
    heating group. The difference in the change of the core temperature, at the end of the surgery, between the
    two groups is statistically significant (P
  13. Jayalakshmi P, Wong NW, Malik AK, Goh KL
    JUMMEC, 1996;1(2):39-42.
    A review of all colonic biopsies received by the Department of Pathology during a 8-year period revealed 41 cases of ulcerative colitis (UC). The diagnosis was based on histological and clinical features. The age range of patients was between 14 - 76 years with a median age of 35.4 years. The disease was more prevalent among Indians. The common presenting sysmptoms were diarrhoea (100%) and haematochezia (83%). The extent of colonic involvement varied. Twelve patients (29.2%) had pancolitis and 8 (19.5%) had proctitis.Extraintestinal manifestations were rare and only one patient had pyoderma gangrenosum. One patient developed multifocal colorectal cancer 10 years after the inial diagnosis of UC and died 2 years later due to metastases. Histology plays an important role in the diagnosis and management of patients with UC. We noted a good correlation between clinical and pathological features. The most recent colonic biopsy showed features of chronic UC with activity in 34 cases and features of remission in 4 cases.
  14. Vijaynanthan, A., Nawawi, O., Abdullah, B.J.J.
    JUMMEC, 2017;20(2):8-12.
    MyJurnal
    In the current study, we report a new technique to place a tunnelled peripherally inserted central catheter
    (PICC) at the upper arm of patient under real-time ultrasound-guided venipuncture using disposal equipment
    provided within a standard PICC set. The tunnelling of the PICC required an extra time of 5 minutes but was
    well tolerated by all patients involved in the study. The tunnelled PICC was applied on 50 patients and the
    infection rate as well its catheter dwell time were compared to another 50 patients with conventional PICC.
    The rate of patients who developed infection decreased from 34% for conventional PICC to 16% in tunnelled
    PICC patients. The central line-associated blood stream infections rate was also decreased from 4.4 per 1000
    catheter-days for conventional PICC to 1.3 per 1000 catheter-days for tunnelled PICC. The mean time to infection
    development for tunnelled PICC (24 days) was longer than those observed with conventional PICC (19 days).
    Tunnelled PICC has also increased the mean catheter dwell time from 27 days (for conventional PICC) to 47
    days. Tunnelling a PICC has the potential to reduce the infection rate while increase the catheter dwell time.
  15. Tan SY, Hawkins PN, Pepys MB
    JUMMEC, 1998;3:54-55.
    Familial amyloid polyneuropathy is most commonly associated with variant plasma transthyretin (TTR) although it has been described in association with variant apolipoprotein A1 and gelsolin. More than 40 TTR variants, all consisting of single amino acid substitutions diskibuted widely along the length of the 127 residue TTR subunit have now been described. We report here a novel TTR variant, Glu18, in a Colombian woman with TTR amyloidosis.
  16. Nusee, Z., Naidu, A., Ranjudham, S.N., Ismail, H.
    JUMMEC, 2011;14(1):10-20.
    MyJurnal
    The use of transobturator tape (TOT) for the treatment of stress urinary incontinence (SUI) has gained popularity since it was introduced in 2001. Only few studies have reported that TOT is superior in safety and efficacy when compared to tension free vaginal tape (TVT). This case-series study was conducted to investigate the safety and efficacy of the TOT procedure in patients at Ipoh Hospital. A cross sectional study on patients who underwent TOT procedures from Jan 2006 to Jun 2008 was conducted. Patients were followed-up 1 month, 3 month, 12 month and annually thereafter. Data were retrieved from patients‟ records based on the standard pre-operative assessment sheet and follow up record. Interviews were then made via telecommunication to assess the patients‟ progression and satisfaction using a validated questionnaire. Fifty-two subjects (n=52) were recruited. The mean age was 54.2 ± 10.6 years with the median follow up time of 19 months. Majority of cases (n=46; 88.5%) had concomitant pelvic organ prolapse (POP), while only 2 (3.8%) had an isolated stress urinary incontinence (SUI). Pre-operatively, only 16 patients (30.8%) were diagnosed with mixed urinary incontinence (MUI) and 24 patients (46.2%) had over active bladder symptoms (OAB) which include increased frequency and urgency. The objective cure rate for SUI was 42 (80.7%), 3 (5.8%) failed while 7 (13.5%) improved. Complications were limited to minor conditions and was only observed in four patients: one case (1.9%) of acute urinary retention, three (5.7%) had prolonged indwelling catheter more than 3 days and one (1.9%) each for mesh erosion, hematoma, urinary tract infection (UTI) and wound infection. Cure rate for MUI, frequency and urgency were 37.4%, 70.8% and 54.2% respectively. De novo urgency was noted in three (n=3: 5.7%) cases while (n=3: 5.7%) required revision of the tape. Forty-nine women (n=49: 94.2%) were satisfied with the procedure. TOT procedures significantly improve OAB symptoms with high patient‟s acceptance rate and no serious operative complication.
  17. Mahadeva S, Goh KL
    JUMMEC, 2001;6:12-19.
  18. Pillay Y, Goh KL
    JUMMEC, 2014;17(2):12-13.
    MyJurnal
    Salivary gland swelling is a rare complication of upper endoscopy with less than twelve cases reported in the literature. The swelling is usually transient in nature, with complete resolution in a few hours .While all the major paired salivary glands have been implicated, the exact aetiology remains obscure. In this case report, a sixty one year old female presents with unilateral swelling of the right parotid gland immediately following an upper endoscopy. There was complete resolution of the pneumoparotid with no neurological sequelae.
  19. Zarin Ikmal ZZ, Wan Azman WA, Asma O, Mazeni A
    JUMMEC, 2000;5:45-47.
    Six patients underwent transcatheter closure of patent ductus arteriosus (PDA) using either conventional Gianturco coils or the Amplatzer Ductal Occluder (ADO) device. All patients were females with a median age of 23.3 (range 4 to 26 years). The mean PDA size measured on the lateral aortogram was 3.81mm (range 2.3-5.831nm). Complete closure of the PDA was achieved in all patients. KEYWORDS: Patent ductus arteriosus, transcatheter device closure
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