A total of 245 foreign workers was screened for various microbial and parasitic infections, as part of the pilot study on the health problems of foreign workers. The sample comprising of Indonesian and Bangladeshi workers, was selected on a non-probability basis from two sources, i.e. University Hospital and a private sector. This investigation revealed substantive number of workers with positive cases to some of the microbial and parasitic infections. KEYWORDS: Pilot study, infective agents, foreign workers
We describe the results of serology for parasitic infection of 698 foreign workers. The 698 foreign workers participated included 115 Indonesians, 387 Bangladeshis, 101 Burmese, 81 Pakistanis, 6 Indians, 3 Thais, 3 Filipinoes and 2 others. Blood samples were taken from these workers and eight tests (Amoebiasis, Echinococcosis, Filariasis (bm and wb), Leishmaniasis, Malaria, Schistosomiasis and Trypanosomiasis) were performed on serum separated from the blood. Among the 698 sera tested, 38.1% were found to be positive for at least one parasitic infection. The most common antibody detected in the positive sera was antibody for amoebiasis (28.1%), followed by malaria (26.9%), echinococcosis (18.1%) and schistosomiasis (11.6%). Other tests showed a low percentage of infection with leshmaniasis (6.5%), filariasis (Brugia malayi (3%) and Wuchereria bancrofti (1%)) and trypanosomiasis (1%).
A case of chronic fatigue syndrome (CFS) like illness was identified recently. Diagnosis CFS is commonly used in the western countries but not in Malaysia or other parts of Asia. It is probably because the diagnosis of neurasthenia has gradually disappeared especially in the United States and United Kingdom. Neurasthenia is dropped in the DSM-111 and DSM-1V but is still retained in the 10th International Classification of Disease. This paper is reporting the case and discussing the definition of chronic fatigue syndrome. (JUMMEC 2000; 2:103-104).
congenital deformity among paediatric patients. The outcome of starting clubfoot treatment early is very
promising. Patient retention throughout the treatment programme is challenging in Sarawak. In this study,
we explored the barriers that parents/caregivers face when seeking clubfoot treatment in Sarawak, Northwest
Borneo. A better understanding of the barriers will provide us with the information to formulate effective
programmes for clubfoot treatment in this region.
Methods: We conducted a questionnaire-based quantitative cross-sectional descriptive survey. We adapted
a set of closed-ended questionnaires originally designed by Kazibwe and Struthers in a study done in Uganda
in the year 2006.
Results: A total of 53 parents/caregivers of children with idiopathic clubfoot were recruited in this study, with
16 defaulter cases and 37 non-defaulter cases. We found 2 statistically significant barriers to clubfoot treatment
in Sarawak, with p-value < 0.05, namely the geographical factor (p = 0.019) and logistic factor (p = 0.017).
Conclusion: Barriers to clubfoot treatment that influence the compliance to treatment identified in this study
are long distance travel, logistics limitations, uncooperative patients during treatment, parents/caregivers
having other commitments, unsupportive family members, lack of understanding regarding clubfoot and its
treatment, inadequate specialists in clubfoot, traditional socio-cultural beliefs and practices and economic
constraints. Enhanced understanding in this matter will guide us in devising culturally admissible ways to
increase awareness in parents/caregivers regarding clubfoot and its treatment. A sustainable national clubfoot
program will be very beneficial in providing a holistic approach to tackle barriers to treatment in our country.
Introduction: Cyberbullying is a growing public health menace although research into the topic is very much lacking in Malaysia. This study aimed to determine the prevalence of cyberbullying among Malaysian adolescents and its association to gender, internet use pattern and offline bullying.
Methods: This study adopts a cross-sectional methodology among Malaysian adolescents’ (N=882, 13 to 14 years old) through both the dimensions of victimization and perpetration using the European Cyberbullying Intervention Project Questionnaire (ECIPQ).
Results: The result shows that if the period of the cyberbullying experience is confined to the past one month, the prevalence cyber-victimization and cyber-perpetration are 31.6% and 20.9% respectively. The prevalence however increased by more than 2-fold when it was extended to the past 3-months experience (73.7% and 64.2% respectively). Online harassment seems to dominate the prevalence of various types of cyberbullying in both cyber-victimization and cyber-perpetration dimensions (60.4% and 55.4% respectively). Both offline victims (AOR 2.40, p
Laparoscopic cholecystectomy, although is less invasive than open surgery, is not completely pain free. The use of local anaesthesia to relieve pain following this procedure is a common practice. However, it remains debatable whether a pre- or post-operative drug administration is more effective. Here, we investigated the role of preemptive local anaesthetic infiltration given pre- or post-incisional, in relieving the pain during laparoscopic surgery.
A randomized controlled trial was conducted with 96 patients receiving 0.5% Bupivacaine 100mg. Group A (n=48) received post-incisional skin infiltration whilst Group B (n=48) received pre-incisional infiltration. Incisional (somatic) and intra-abdominal (visceral) pain was assessed using Visual Analog Scale (VAS) at day 0, day 1 and day 7 post-operative days.
Baseline characteristics between the two groups were similar. Incisional pain was lower in Group B as compared to Group A at day 0 (P=0.03) and day 1 (P0.05).
Administration of pre-incisional local anaesthesia offers better pre-emptive pain relief measure than post-incisional administration by reducing somatic and visceral pain in laparoscopic gall bladder surgery.
Cryptococcus neoformans is an encapsulated fungal pathogen that causes severe disease primarily in
immunocompromised patients. Adherence and internalisation of microbial pathogens into host cells often
begin with engagement of microbes to the surface receptors of host. However, the mechanisms involved
remain poorly understood. In this study, we investigated the association of cell surface determinants of C.
neoformans with mammalian cells. Our results showed that treatment with trypsin, but not paraformaldehyde
or heat killing, could reduce host-cryptococci interaction, suggesting the involvement of cell surface proteins
(CSPs) of C. neoformans in the interaction. We extended our investigations to determine the roles of CSPs
during cryptococci-host cells interaction by extracting and conjugating CSPs of C. neoformans to latex beads.
Conjugation of CSPs with both encapsulated and acapsular C. neoformans increased the association of latex
beads with mammalian alveolar epithelial cells, alveolar macrophages and monocyte-derived macrophages.
Further examination on the actin organisation of the host cells implied the involvement of actin-dependent
phagocytosis in the internalisation of C. neoformans in CSP-conjugated latex beads. We hypothesised that
CSPs present on the cell wall of C. neoformans mediate the adherence and actin-dependent phagocytosis
of cryptococci by mammalian cells. Our results warrant further studies on the exact role of CSPs in the
pathogenesis of cryptococcosis.
Evidence suggests that breast cancer is taking the form of a chronic illness. This will add on to the present burden of managing chronic diseases in the healthcare delivery system. The burden of breast cancer being a chronic illness, calls for greater efforts to address the many neglected, physical-psycho-social and occupational functioning consequences. Timely efforts are needed to identify and implement interventions that are aim at improving the quality of life of women with breast cancer. At present, research evidence is highlighting that chronic diseases may best be managed using a self-management approach, and best treated by a balance of traditional medical care and the day-to-day practice of self-management skills. This paper presents the perspective of breast cancer as a chronic illness and its implication for rehabilitation and medical education. It is imperative that health professionals be made aware of these survivorship issues through medical education. The goals are to reduce the many disability risks, encourage patient-health provider communication and enhance partnership in care, within a timely, holistic therapeutic program to improve the quality of life of women with breast cancer.
Many researchers studies have shown that stressful life events, from the death of a loved one to the loss of a job, are linked to an increase in certain health problems, particularly heart disease, diabetes, and hypertension. Many people assume that stress leads to cancer as well. Evidence for this, however, is not clear. However, the significance of mind-body interactions in medicine is now increasingly being recognised.(Copied from article.)
Dengue is one of the highest occurring vector-borne diseases. It is caused by dengue viruses 1- 4. Currently, the disease is classified into dengue with or without warning signs and severe dengue based on WHO 2009 dengue classification. As of today, neither specific drugs nor commercial vaccine exist for dengue. The best treatment yet would be support, management and proper medical care. With no pathognomonic features that could differentiate it from other febrile illnesses, clinical diagnosis alone is insufficient. Yet, despite the current advances and existence of various laboratory diagnostic methods of dengue, a consensus singular method has not been established. There are several hypotheses or theories regarding the vaguely understood immunopathogenesis of dengue. Amongst these are the viral factors, host-immune factors and host-genetic factors. In addition to these, the occurrence of asymptomatic dengue has further complicated the disease. However, these individuals provide opportunities in the search for protective factors against dengue.
The undergraduate dental degree in Malaysia is regulated by the Malaysian Dental Council (MDC) (Standard of Undergraduate Competencies), Code of Professional Conduct of the Malaysian Dental Council, the Malaysian Qualification Framework 2.0 and the Malaysian Quality Agency (MQA) quality assurance documents. These primary documents emphasize the importance of professional ethics and law in dentistry as will be further detailed and discussed later. This study reflects on the need to integrate ethics, professionalism and law with sufficient coverage in terms of content and emphasis in the dental undergraduate curriculum. Literature and benchmarking practices are reviewed for a deeper reflection of the current needs in a professional dental ethics and law education course. The present study is primarily focused on regulatory requirements, legal cases and comparative literature to serve as a reference on how professional ethics and law courses may be conducted. As an incidental measure, a reflection as to how the course of study of professional ethics is delivered in a local university is considered in a selected local university’s undergraduate dental curriculum. The findings indicate that ethics professionalism and dental law is not given sufficient emphasis as it is included as one of the minor components within another overcrowded subject and the coverage of what is taught is limited in context. This paper is an invitation to all dental schools to review and reflect whether, given the emphasis on professional ethics, legal and regulatory compliance in the regulatory documents, it is adequately reflected in their dental curriculum. In this regard, some benchmarking references are done to suggest what such a course should cover, for consideration of the dental schools.
The objective of this study was to compare in-patient drug use patterns, costs, and outcomes associated with risperidone or olanzapine in a naturalistic clinical setting. Retrospective chart reviews of 92 patients with psychotic disorders were conducted at the University of Malaya Medical Centre (UMMC). Data was collected from patients who were hospitalized and for whom risperidone or olanzapine was the drug of first choice for long-term pharmacologic treatment. Proportion of patients for whom efficacy of the studied treatment could be established (as rated by the treating physician) was higher, but not significantly, with risperidone compared to olanzapine (p = 0.46). The average dose of the studied medication was 2.9 ± 1.0 mg/day for risperidone and 9.7 ± 2.4 mg/day for olanzapine. The total cost was significantly higher (p
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
Bisphosphonates are synthetic analogues of pyrophosphate. Their main pharmacological effect is to iuhibit bone resorption by a variety of mechanisms, not all of which are clearly understood. The activity of the bisphosphonates varies depending on the compound. In clinical trials, they have been shown to stop postmenopausal bone loss and increase bone density, with a concomitant reduction in fracture rate with some agents. This article reviews the currently known mechanisms of action of the bisphosphonates and the evidence that they are useful in the treatment of osteoporosis.
Screening for drugs of abused were conducted by using Gas chromatography-Mass spectrometry (GCMS) fitted with capillary column. Urine samples supplied by Centre of Inmigrant Studies, University of Malaya were processed upon arrival and screened for the following drugs. Amphetamines, methamphetamines, aphedrine, hydroxy-amphetamines, ecstasy, benzamphetamines, codeine, morphine, heroine, cocaine and diazepam. The analysis was done using Shimadzu QP5000 Gas chromatograph-mass spectrometer by selected ion monitoring with BPX35 column, 15 m length, 0.32 ID, helium gas as carrier and quadropole mass detector at 1.60 kV electron gain. Analysis were performed using selected ion monitoring (SIM) mode and quantitations were based on area under the curve of individual standards at various concentrations. The method is sensitive to nanogram levels and are able to detect the presence of these drugs in both urine and plasma. From this study (n-100), none of the urine were found positive for the drugs screened. The major problem encountered were adulterated with water based on the clearness and the colour of the urine. Based on this suspicion we would like to suggest that the testing be done on blood samples as this would be more confirmative and quantitative.
A survey of malnutrition and helminth infections among 268 pre-school children living in the Kuala Betis Orang Asli resttlement villages in Kelantan. The prevalence of helminth infections was 47.4% with Ascaris lumbricoides being the most common helminth (43.9%), followed by Trichuris trichiura (29.7%) and hookworm (6.3%). The prevalence of Ascaris lumbricoides and Trichuris trichiura infections increased with age, with the highest prevalence found in the 6-7 years age group. The overall prevalence of stunting, underweight and wasting were 61.7%, 60.4% and 17.5% respectively. Both stunting and underweight were significantly higher among the infected children. Factors associated with helminth infections in the pre-school children were older age group, poor water supply and households with more than 5 members. Rountine regular deworming is recommended based on the World Health Organisation recommendations for school children.
In vitro lymphocyte proliferative response of peripheral blood leucocytes (PBL) to purified Toxoplasma gondii antigen were evaluated by 3[H] methyl thymidine incorporation in patients acutely and chronically infected with Toxoplama gondii. PBL from three patients with acute sylnptonlatic toxoplaslnosis showed no response to T. gondii antigen during the emergence of anti-Toxoplasma 1gM antibodies and the response returned as the infection became chronic. Lymphocytes of twelve chronically-infected patients responded positively to the antigen. In all patients the lymphocyte proliferative response to the mitogen, Concanavalill A (Con A) was normal. Analysis of Toxoplasma proliferative response of PBL from a patient with acute toxoplasrnosis showed that CD8+ cells were responsible for induction of suppression while the response during the chronic infection was lnediated by CD4+ cells. In human toxoplasmosis there was antigen-specific lymphocyte unresponsiveness during the acute phase of the infection and it appears that the initnunesuppression was mediated by CD8+ cells. KEYWORDS: Toxoplasmosis-lymphocyte blastogenesis-antigen specific-CD4+, CD8+
Breast feeding has been actively encouraged in Malaysia in the last few years in all public hospitals. This study proposes to find out the prevalence of breast feeding in three villages in a rural community in Kedah, Malaysia. This was a cross sectional study on breastfeeding practices in Kubang Pasu, a district of Kedah. Majority of the mothers initiated breast feeding but exclusive breastfeeding was only 21% for four months and predominant breastfeeding was about 12.6%. The breastfeeding practice was more prevalent among women from the higher educational strata and higher income than those from the lower strata and lower income (p
Background: WHO has recommended that all countries apply the concept of Universal Health Coverage (UHC) in their commitment to ensure the health of their people. Although most ASEAN countries have implemented UHC, only 30% of them are considered successful. UHC considers three pillars for its implementation; all groups of people should be covered, at least the basic healthcare services are delivered, and that people could afford to access healthcare when in need. National health insurance had been set up by many countries as the approach to ensure that all citizens could obtain healthcare. However, in Indonesia, after several years of implementation, 33% of the population has yet to register while the 100% target was overdue in 2019.
Objective: To describe the progress towards UHC in Indonesia and determine the strategies used by other countries in ASEAN in achieving UHC.
Methods: Articles on UHC in ASEAN countries between the years 2014-2019 were searched according to PRISMA and reviewed. The articles were compiled using a series keyword in ResearchGate, ScientDirect, ProQuest, SAGE, and EmeraldInsight database. The studies included qualitative studies and written in English.
Results: There are various healthcare financial mechanisms that a country can implement. In 2014, Indonesia had developed a national health insurance known as JKM as its mechanism of financing healthcare towards achieving UHC. However, till date only 54% of her population had registered for JKM. There is no automatic registration via the national identity card and registration for NHIS is only done when there is a need to use the healthcare services.
Conclusion: The review demonstrates that policy implementation still needs to be monitored and evaluated. Recommendations are made for the medical professional association and the government.