Introduction: Iron deficiency (ID) has recently been identified as a threat to patients with heart failure with reduced ejection fraction (HFrEF). This study was conducted to determine the occurrence of ID among HFrEF patients in a Malaysian tertiary hospital and its correlation between left ventricular ejection fraction (LVEF). Methods: Stable patients with LVEF less than 45% were included. Demographic data, LVEF (Simpsons) and cardiac functional status were studied, along with full blood count and iron profile. Results: 81 patients with a mean LVEF of 33.6% were recruited. 43.2% of them were NYHA class II patients, followed by 38.3% class III, 13.6% class I and 4.9% class IV patients. About 2/5 of the study population were anaemic, and of those, 48.5% were iron deficient. Majority of these anaemic patients (87.5%) had an absolute iron deficiency. Pearson’s statistical analysis showed positive correlation between ejection fraction and serum ferritin (r=0.624, p< 0.001), serum iron (r= 0.302, p
Introduction: One of the known factors that hindered smoking cessation is nicotine dependence. Measurement of the nicotine dependence is important to better understand cigarette smoking addiction dependence and ways to overcome it. Among methods of nicotine dependence measurement are self-reported Fagerstrom Test for Nicotine Dependence (FTND) and biochemical assessment such as saliva cotinine. Biochemical assessment can be used to measure the accuracy of the self-reported measurement of nicotine dependence. Objective: To explore the correlation between the FTND and the saliva cotinine of the smokers in three different timeline. Methods: A total of 61 male smokers who currently smoke cigarette on daily basis were recruited. The study used the one-group pretest-posttest study design and the data were collected three times. The self-reported measurement were measured by using FTND and the biochemical assessment measured by using saliva cotinine from Saliva Bio oral swab (SOS) with the sensitivity of 0.15ng/ml. Data analysis was conducted by using Pearson correlation. Results: There was a significant association between the FTND score and saliva cotinine level of the smokers at baseline, second and third data collection (p=0.014, p=0.003, p
Introduction: The role of dietary intake on maternal glucose is uncertain. This study described the dietary charac- teristics of women with gestational diabetes mellitus (GDM) and examined the differences in dietary characteristics based on GDM diagnosis. Methods: This study recruited GDM women (n =45; age =31.1±5.1 years old) from health clinics in Seremban. Dietary intake, glycemic index (GI) and glycemic load (GL) were assessed using a semi-quanti- tative food frequency questionnaire (SFFQ) during first and second trimester of pregnancy. GDM diagnosis was made at 28 weeks gestation with the following cut-off for FPG 5.1 or 2hPG 7.8 mmol/L following oral glucose toler- ance test. Results: Women with GDM had a reasonable intake of protein and fat but consumed high-carbohydrate at second trimester and high-sugar diet at both trimesters. Fibre, iron and calcium from the food sources did not meet the recommended nutrient intakes for pregnancy. About 75.6% (n = 34) GDM women had high 2hPG (9.3 ± 1.5 mmol/L) with a normal FPG (4.7 ± 0.7 mmol/L). While dietary characteristics were not significantly different, women with a higher 2hPG tended to take a higher proportion of protein at first trimester and a higher dietary GI, serving of rice, and sugars and creamer at second trimester than high FPG. Conclusion: Suboptimal maternal nutrition in women with GDM are of particular concern. Dietary characteristics of women with high fasting and 2-hour glucose were comparable but not optimal. The needs of tailored nutritional intervention are evident in women known to be at high risk of GDM.
Introduction: Family planning practice is important among the high-risk mothers. Thus, the knowledge, attitude and practice of family planning among health care workers are very important in influencing the use of contraception among them. The objective of this study was to determine level of knowledge, attitudes and practices related to contraception among doctors and nurses in Petaling District, Selangor, Malaysia. Methods: A cross-sectional study involving 300 doctors and nurses working in the Maternal and Child Health Unit from six large public health clin-ics in Petaling district was conducted in May 2019. A self-administered questionnaire was used for data collection. Results: A total of 109 doctors and 149 nurses participated in this study. The response rate was 86%. The median duration of service in KKM and working in MCH were 9 years (IQR 6.0) and 3 years (IQR 6.0) respectively. Majority (74%) had attended CME on family planning. The mean score of knowledge was 9.0 (out of 13) (SD 1.899). In terms of attitude, 51.6% would often suggest family planning to relatives or friends. Three common perceived barriers for effective counselling on family planning were too many patients (94.5%), time constraint (91.7%) and inadequate knowledge on contraception (60.4%). Common preferred methods of contraception among users were hormonal method (33.1%), followed by barrier (condom) method (29.5%). Medical officers had better knowledge score as compared to nurses (p
Obesity is a well-established risk factor for cardiovascular disease. The objective of
the study was to determine the prevalence of obesity and factors associated among secondary school students aged between 13 to 17 years at Slemani City Centre, Iraq. Methodology: A cross sectional study design was used. The calculated sample size was 1656. Probability proportional to size sampling technique was used to select the sample. A validated pretested questionnaire was used to collect the data. Weight and height were also taken. Data were analyzed using SPSS version 21. Chi-square test was used to determine an association between two categorical variables. Independent t-test was used to compare two means. Multiple logistic regression was used to determine the predictors for obesity. Results: The response rate was 92.54% and the overall mean age of the 1588 respondents was 15.42 (95% CI = 15.35, 15.49) years. The prevalence of overweight and obesity was 20.6% and 11.3% respectively. Variables significantly associated with overweight and obesity (age, monthly family income, education level of parents, body part satisfaction and body size perception) were entered into the logistic regression model. Multiple logistic regression analysis showed that the predictors for overweight and obesity were age, monthly family income, body part dissatisfaction and body size perception. Conclusion: The prevalence of overweight and obesity is high (20.6% and 11.3% respectively). The predictors of obesity among secondary school students aged between 13 to 17 years old at Slemani City Centre Kurdistan Region, Iraq were age, family income and body image dissatisfaction.
Plasmodium knowlesi has been discovered as the fifth species causing malaria in humans. It is a major public health problem in South East Asia especially in Borneo. We report a case of pericardial effusion that rapidly progressing to cardiac tamponade, an atypical presentation of P. knowlesi malaria. Our patient had no underlying known medical illness, presented with high grade fever with chills and rigors, epigastric pain, nausea, vomiting and with poor oral intake. Initial bedside cardiac ultrasound showed minimal pericardial effusion. Within a few hours, she became hypotensive, deteriorated rapidly despite fluid resuscitation requiring mechanical ventilation and inotropic sup- port. Bedside cardiac ultrasound showed cardiac tamponade and pericardiocentesis was done. We highlight the importance of having high level of suspicion for this atypical presentation of cardiac tamponade when a patient is hypotensive in P. knowlesi infection. Prompt diagnosis and management may prevent potentially fatal complication.
Azadirachta indica (neem) has been used for a long time in agricultural and alternative medicine. Neem
had been proved effective against certain fungi that could infect human body. This pilot study aims to
demonstrate the antifungal effect of Malaysian neem leaf extracts on the pathogenic fungi in otomycosis,
Aspergillus niger and Candida albicans. This is a laboratory-controlled prospective study conducted at
Universiti Sains Malaysia. The powder form of Malaysian neem leaf was prepared. Ethanol and aqueous
extracts of the neem leaf was diluted with sterile water to establish five different concentrations of 50 g/
ml, 25 g/ml, 12.5 g/ml, 6.25 g/ml and 3.125g/ml. The extract was tested on Sabouraud Dextrose Agar
suspended with Candida albicans and Aspergillus niger respectively. Well diffusion method was used
and zone of inhibition was measured. Growth of the fungi was inhibited in both alcohol and aqueous
extract concentrations. The minimum inhibitory concentration (MIC) of Malaysian neem aqueous extract
against Candida albicans was 11.91 g/ml, neem ethanol extract against Candida albicans was 5.16 g/
ml, neem aqueous extract against Aspergillus niger was 7.73 g/ml and neem ethanol extract against
Aspergillus niger was 9.25 g/ml. Statistical analysis showed that the antifungal activity of Candida
albicans is better in alcohol neem than aqueous extract (p
Peripheral vestibular disorder (PVD) is serious and common. Clinically, giving an accurate diagnosis of PVD can be challenging. Vestibular evoked myogenic potential (VEMP) is an objective test to evaluate the integrity of vestibular organs, particularly saccule and/or inferior vestibular nerve. This study was performed to determine the sensitivity and specificity of VEMP using different stimuli. Fourty normal and 65 PVD subjects who fulfilled the inclusion criteria were recruited. While sitting comfortably, VEMP waveforms were recorded with active electrode on sternocleidomastoid muscle and negative electrode on upper forehead. Tone bursts (500, 750 and 1000 Hz) were delivered via headphones at 90 dBnHL and 5/s presentation rate. VEMP parameters for each stimulus (amplitude and latency of P1 and N1 peak) were analyzed accordingly. Receiver operating characteristic (ROC) was performed to determine the sensitivity and specificity of VEMP at different test frequencies. N1 amplitude of 750 Hz stimulus produced the most ideal sensitivity (65% on right and 63% on left) and specificity (83% on right and 78% on left). The importance of using a few tone bursts in VEMP test in order to minimize the false negative in cases might be encountered in clinics as the certain tone burst had inadequate sensitivity in detecting PVD cases. The 750 Hz stimulus produced the most ideal VEMP with adequate values of sensitivity and specificity, at least in this study.
Introduction: Group B Streptococcus (GBS), infection and recurrence in newborns and pregnant women can lead to
chronic medical illness resulting in significant morbidity, and mortality. Pathogenesis of GBS may be due to reasons
such as activation of the immune system, followed by the production of inflammatory markers and toxic components
by immune cells including macrophages. Methods: The studies on invasive and colonizing GBS strains inoculated
either with peripheral or brain macrophages, the expression of nitric oxide (NO), cell viability, and CD40 were
also measured by Griess assay, methyl tetrazolium assay (MTT), and flow cytometry, respectively. Furthermore, the
clinical manifestations of the selected patients were also assessed for this study. Results: Outcome of inflammatory
markers studies, after GBS inoculation indicated that, invasive GBS strains induced higher inflammatory markers
in comparison to colonizing GBS strains. Furthermore, patients’ clinical data showed that patients with invasive
GBS infections had severe condition unlike among patients with colonizing GBS strains. The fatality rate in patients
with invasive GBS strain were 30.8% while there was no death among carriers. Conclusion: This study, aimed to
understand the immune response to GBS, and strengthen the knowledge on GBS pathogenesis. It was concluded
that invasive GBS strains not only showed higher expression of inflammatory markers on immune cells but also had
higher pathogenesis effect in comparison to colonizing GBS strains.
The Rohingya is a group of refugees from Myanmar who have been residing in Malaysia since the 1980s. At present, there is no published information on health and nutritional status of refugee children
in Malaysia. This study was conducted to assess nutritional status of the Rohingya children aged
6 months to 12 years old (N=87) and to determine the associations between nutritional status with
socio-demographic, dietary diversity and health (birth weight, immunization and childhood illness)
variables. Children were measured for weight and height while their guardians were interviewed for
socio-demographic, dietary diversity and health information. About 27.5% of the Rohingya children
were underweight, 11.5% stunted, 16.1% thin and 12.6% at risk of overweight and overweight. The
percentage of children with low birth weight (< 2.5 kg) and no immunization was 17.8% and 11.5%,
respectively. Fever (67.8%) and flu (62.1%) were the most common childhood illnesses reported in
previous month with 44-75% of the children with these illnesses did not receive any medical treatment.
The mean dietary diversity score was 8.9+3.2 out of a possible 14, with a higher score indicating a
more diverse diet. There were significant correlations between frequency of immunization received
by the children with weight-for-age-z score (rs=0.27, p
Carpanenamase-producing Enterobacteriaceae (CPE) has emerged as a threat to hospitalized patients. Phenotypic test such as Modified hodge test was less sensitive and specific especially to detect blaNDM-1 which is the most predominant genotype in this region. Nucleic acid amplification technology offers improved specificity and sensitivity. Failed amplification due to the presence of inhibitors is a limitation. In this study, we tried to use previous method described by Villumseen et al with some modification using another DNA extraction kit. Methods: Ten mls of sterile whole blood taken from nearly expired blood bag from blood bank was spiked with 200 μl of 0.5mcFarland bacterial suspension from thirty-six confirmed isolates of blaNDM-1 carbapenamase-producing Klebsiella pneumoniae in an aerobic Bactec Plus and incubated until the growth was detected. The blood specimen was subjected to DNA extraction method using Macherey-Nachel, Nucleospin® Blood QuickPure followed with multiplex PCR. Results: Out of the 36 isolates, 12 isolates revealed blaNDM-1 , 9 isolates revealed blaNDM-1 and blaOXA-48, 7 isolates revealed blaNDM-1, blaVIM and blaKPC genotypes that were amplified at cycle threshold of less than 30. Another 8 isolates could not pick up any genotypes possibly due to pipetting error as all the internal control were amplified. Eight true negative gram negative isolates underwent same procedure and none amplified at a cycle threshold less than 30. Conclusion: This modified method was proved to give a high yield of CPE genotypes with the cycle threshold was set at less than or equal to 30 and able to overcome the presence of PCR inhibitors.
Percentage of haemolysis is widely used as a quality parameter to assess red blood cell viability in blood banking. In certain blood banks, serum potassium level is used due to the unavailability of the former test. The relationship between these two tests, however, is still unclear. The objective of this study is to determine the association between haemolysis measured using two different methods for quality control. Methods: A total of forty-four samples of packed red cell in citrate-phosphate-dextrose with optisol were randomly selected from donation drives. Nine millilitres of blood was collected weekly starting from day-2 of storage, followed by day-7, 14, 21, 28, 35 and 42 for assessment of red blood cell haemolysis by measuring serum potassium level and percentage of haemolysis.Results: These two parameters were correlated significantly with a positive moderate linear relationship on day 7, 21 and 28 with r = 0.393, 0.448 and 0.425, respectively and p-values less than 0.01. The linear regression analysis showed there was a significant regression equation which could be used to predict the serum potassium level from the percentage of haemolysis. Conclusion: There were significant increases in the percentage of haemolysis and serum potassium level in the packed red cell units with storage. The serum potassium level would be able to be predicted from the percentage of haemolysis using the regression equations on day 7, 21 and 28. The serum potassium measurement could be used as an alternative test to the percentage of haemolysis before issuing blood.
Introduction: Immune response against viral infections and tumors not only requires the recruitment of immune cells but also cytokines. Cytokine dysregulation is associated with inflammatory diseases such as cancer, autoimmune diseases, infections and allergy. Intake of fruit and vegetables are known not only to reduce inflammation but may also provide protection against various diseases. Methods: Effects of selected fruits and herbs on cytokines profile of IL-8, IL-1β, IL-6, IL-10, TNF and IL-12p70 were examined using the CBA flow cytometric assay. Peripheral blood mononuclear cells (PBMC) obtained from blood samples of twelve healthy subjects aged 20 to 30 years [males = 6 and females = 6] were treated with papaya, mata kucing, dang shen and pu-erh tea, respectively, for 6 and 48 hours at various concentrations. In vivo effects was further tested on healthy volunteers [males = 2, females = 4] by 2-days consumption of papaya following 2-days washout period without papaya. The diet of volunteers was controlled with fixed meals. Results:In vitro results after 6 hours of culture showed that papaya-treated PBMC significantly increased IL-8, IL-1β and IL-6 but reduced IL-10. Mata kucing-treated PBMC significantly increased IL-8 but reduced IL-6 while pu-erh tea significantly reduced IL-8, IL-1β, IL-6 and TNF. Cytokine analysis for dang shen-treated PBMC was only conducted at 48 hours. After 48 hours, papaya extract significantly reduced IL-8, IL-6 (8000 μg/ml), IL-10 and TNF. Significant increase of IL-6 was observed at 4000 and 16000 μg/ml. Mata kucing extract significantly increased IL-1β, IL-6 but reduced TNF. Significant increase of TNF was observed at 16000 μg/ml. Dang shen and pu-erh tea reduced IL-8, IL-1β, IL-6, IL-10 and TNF. However, in vivo papaya consumption did not show any significant changes and levels were low. Conclusion: This study showed fruits such as papaya and mata kucing had both stimulatory and inhibitory effect on various pro-inflammatory cytokines while effect of herbs such as dang shen and pu-erh tea were inhibitory. Immunomodulatory studies of natural food such as fruits and herbs may provide better understanding and subsequently improve management of inflammatory diseases.
Introduction: Tuberculosis (TB), commonly caused by Mycobacterium tuberculosis (Mtb), is one of the ten leading causes of death worldwide. The gold standard, microbiological culture for detection and differentiation of mycobac-teria are time-consuming and laborious. The use of fast, easy and sensitive nucleic acid amplification tests (NAATs) for diagnosis of TB remains challenging because there is a high degree of homology within Mtb complex (MTBC) members and absence of target genes in the genome of some strains. This study aimed to identify new candidate genetic marker and to design specific primers to detect Mtb using in silico methods. Methods: Using Basic Local Alignment Search Tool (BLAST) program, Mtb H37Rv chromosome reference genome sequence was mapped with other MTBC members and a single nucleotide polymorphism (SNP) at Rv1970 was found to be specific only for Mtb strains. Mismatch amplification mutation assay (MAMA) combine with polymerase chain reaction (PCR) was used as an alternative method to detect the point mutation. MAMA primers targeting the SNP were designed using Primer-BLAST and the PCR assay was optimized via Taguchi method. Results: The assay amplified a 112 bp gene fragment and was able to detect all Mtb strains, but not the other MTBC members and non-tuberculous Mycobacte-ria. The detection limit of the assay was 60 pg/μl. Conclusion: Bioinformatics has provided predictive identification of many new target markers. The designed primers were found to be highly specific at single-gene target resolution for detection of Mtb.
Introduction: The increased use of mobile phones has increased the mobile base stations (MBS) deployment. While understanding of radiation protection is growing among the public, questions regarding early-life exposure to ra- diofrequency radiation (RFR) from MBS in children are of importance as to whether it will raise the chances of developing chronic diseases during adulthood. Taking into account the sitting location of MBS, the purpose of this study is to evaluate the chromosomal DNA damage in buccal mucosal cells between school children exposed to RFR emitted from base station antennas. Method: This is a comparative cross-sectional study in which two group of school children were sampled i.e. exposed groups are children whose school located near MBS (200 meters); un- exposed groups are children whose school located distant far from the MBS (>200 meters). Digital RF Analyzer was used to measure RFR at the school surrounding. Buccal mucosa cells from the oral cavity were sampled to examine the level of micronuclei (MN) frequencies. Results: This study found that the densities of the RFR energy differed in range. Although all measurements showed the RFR reading below the acceptable exposure level, there were still sig- nificant variations at each location assessed. Statistically, the MN frequency is significantly different when compared to the exposed and non-exposed group. Conclusion: To understand the mechanism of health effects from exposure to low-level RFR emited from MBS, further study should consider environmental factors influencing MBS sitting on RFR emission, as well as examining the health effects into molecular levels.
Introduction: The advancement of technology and an ecological shift in the creative media industry requires manag- ers and TV production workers to adapt to changes to ensure their well-being. Recent development shows a growing concern for the mental, physical and social health of creative media workers that demands a more in-depth inves- tigation. Studies have found that those working in television production are facing long hours of work, poor pay, isolation and insecurity. However, there is little empirical research undertaken on those who work in the Malaysian creative media industry, especially Malay Muslims. Studies of media workers in Malaysia are mostly concerned with news production and the impact of reporting and journalistic challenges. The purpose of this study is to explore how Malay Muslim creative media workers manage and negotiate their mental health and well-being issues. Methods: By employing a phenomenological approach, interviews were conducted with seven participants, exploring their experience in the creative media industry. Results: The study found four emergent themes: (a) passion and commit- ment for creative endeavours, (b) work culture, (c) issue on work-life balance, and (d) role of religion. Discussion: This study is an attempt towards understanding the mental health of those working in the creative and entertainment realms in Malaysia. Based on the findings, implication for practitioners and future studies are discussed.
Introduction: Teachers play a vital role in identifying students with dyslexia. The acquisition of this knowledge will help teachers to classify students who are at risk of dyslexia. The objective of this study is to identify the level of teachers’ knowledge about dyslexia that comprises of its general knowledge, diagnosis, symptoms and treatments. A cross sectional study was done upon 138 preschool teachers. This research was conducted by using ‘Knowledge and Beliefs about Developmental Dyslexia’ questionnaire, which consists of 36 items with 3 Likert scale questions. Findings revealed that the level of general knowledge possessed by the pre-school teachers was relatively different based on the construct even though they have respectively received the Diploma in Early Childhood Education. On the same hand, most of the respondents were found to be having higher understanding on the general knowledge about dyslexia compared to their understanding on the symptoms, diagnosis and the treatments.
Introduction: The objective of the study is to identify the relationship between knowledge and the practice of mental training skill during competitions which requires the athletes to gain control and boost their confidence. The study significantly states that knowledge and the practice of mental training skill during competitions are able to increase the athletes’ ability to control their state of mind and raise their confidence. Methods: 115 students of Malaysian Sport School, Pahang Malaysia participated in the study. One set of Likert scale questionnaire, which consists of five parts is used as the study instrument. The study instrument is based on the Competitive State Anxiety Inventory (CSAI- 2), Test of Performance Strategies (TOPS) and Mental Toughness Questionnaire (MTQ-48). Results: The research findings demonstrate an average level of knowledge on mental training skill with reference to the athletes’ control of their mental state and their confidence. However, the significant relationship between the knowledge and the prac- tice of mental training skill with regards to the athletes’ mind control and confidence during competitions shows a highly positive and moderate relationship. Conclusion: Healthy mental training skill helps improve the athletes’ per- sonality during competition. Apart from prioritising on the physical element in training applied in the competitions, the main elements which become the athletes’ source of mental strength, level of control and confidence are able to overcome the mental challenges.
Introduction: According to PDRM statistic, in average, 100 babies are dumped every year, in Malaysia. The stig-ma of having babies out of wedlock, feeling of desperation and lack of support are some reasons why babies were dumped at the unimaginable places. Even if they were found and saved, these babies will be placed and raised at institutions. This will lead to the negative effects of institutionalisation as they do not receive appropriate adult care and attention which is crucial in developing their potential. OrphanCare Foundation advocates and provides services that ensure babies and children who are in institutions and those whose lives are at risk grow up in the care of a loving family. Methods: OrpahnCare Foundation provides a safe haven for babies that are being abandoned through baby hatch centres, finding a family for these babies through a legal adoption programme, and deinstitutionalisation (DI) i.e. removing all children currently in institutions, to family based care. Results: Since 2010, OrphanCare Foun-dation has saved a total of 369 babies and successfully arranged for the adoption of 221 babies. Forty even children were taken out from institutions and brought home to their families. Conclusion: The best place for a child to grow up is in the love and care of a family. They will receive personalised guidance, support and love that they need to develop to their full potential.