Methods: A cross-sectional study was used. Totally, 427 samples of dissimilar Thai-Muslim healthy blood donors living in three southern border provinces were selected via simple random sampling (aged 17-65 years old) and donors found to be positive for infectious markers were excluded. All samples were analysed for JK*A and JK*B alleles using PCR-SSP. The Pearson's chi-squared and Fisher exact tests were used to compare the JK frequencies among southern Thai-Muslim with those among other populations previously reported.
Results: A total of 427 donors-315 males and 112 females, with a median age of 29 years (interquartile range: 18 years)-were analysed. A JK*A/JK*B genotype was the most common, and the JK*A and JK*B allele frequencies among the southern Thai-Muslims were 55.2% and 44.8%, respectively. Their frequencies significantly differed from those of the central Thai, Korean, Japanese, Brazilian-Japanese, Chinese, Filipino, Africans and American Natives populations (P < 0.05). Predicted JK phenotypes were compared with different groups of Malaysians. The Jk(a+b+) phenotype frequency among southern Thai-Muslims was significantly higher than that of Malaysian Malays and Indians (P < 0.05).
Conclusions: The JK*A and JK*B allele frequencies in a southern Thai-Muslim population were determined, which can be applied not only to solve problems in transfusion medicine but also to provide tools for genetic anthropology and population studies.
Methods: Forty-eight male Sprague Dawley rats were allocated into eight groups of six rats (n = 6): control, CP only (200 mg kg-1), AM only (100 mg kg-1, 300 mg kg-1 and 500 mg kg-1) and CP + AM (100 mg kg-1, 300 mg kg-1 and 500 mg kg-1). Animals were sacrificed after 63 days of treatment and the sperm from the caudal epididymis was taken for sperm analysis.
Results: The body and the reproductive organs weight, sperm count and motility did not differ between CP and other groups (P > 0.05). A significant increase (P < 0.05) in percentage of the dead and abnormal sperm were seen in the CP alone treated group compared to the control group. Co-administration of AM to the CP exposed rats significantly reduced the (P < 0.05) percentage of abnormal sperm as compared to the CP only group.
Conclusion: Overall, the present results represent the potential of AM to protect against CP induced reproductive toxicity.
Methods: This cross-sectional study included 222 STEMI patients admitted to two tertiary hospitals in Malaysia. By determining symptom-to-door time, the study population was categorised into two definitive treatment seeking groups: early (≤ 3 h) and delayed (> 3 h). Data was collected focusing on socio-demographical data, risk factors and comorbidities, clinical presentation, situational factors and action taken by patients.
Results: The mean age of our patients was 58.0 (SD = 11.9) years old, and the population consisted of 186 (83.8%) males and 36 (16.2%) females. Our study found that the median symptom-to-door time was 130.5 (IQR 240) min, with 64% of subjects arriving early and 36% arriving late. Pre-hospital delays were found to be significant among females (adj OR = 2.42; 95% CI: 1.02, 5.76; P = 0.046), patients with recurrence of similar clinical presentations (adj OR = 2.74; 95% CI: 1.37, 5.46; P = 0.004), patients experiencing atypical symptoms (adj OR = 2.64; 95% CI: 1.11, 6.31; P = 0.029) and patients who chose to have their first medical contact (FMC) for their symptoms with a general practitioner (adj OR = 2.80; 95% CI: 1.20, 6.56; P = 0.018). However, patients with hyperlipidaemia (adj OR = 0.46; 95% CI: 0.23, 0.93; P = 0.030), self-perceived cardiac symptoms (adj OR = 0.36; 95% CI: 0.17, 0.73; P = 0.005) and symptoms that began in public places (adj OR = 0.21; 95% CI: 0.06, 0.69; P = 0.010) tended to seek treatment earlier.
Conclusion: The symptom-to-door time among the Malaysian population is shorter in comparison to other developing countries. Nevertheless, identified, modifiable pre-hospital factors can be addressed to further shorten symptom-to-door time among STEMI patients.
Methods: A combination of top-down approach and activity-based costing was applied. The standard operating procedure (SOP) for CRC was developed for each stage according to national data and guidelines at the University of Malaya Medical Centre (UMMC). The unit cost was calculated and incorporated into the treatment pathway in order to obtain the total cost of managing a single CRC patient according to the stage of illness. The cost data were represented by means and standard deviation and the results were demonstrated by tabulation. All cost data are presented in Malaysian Ringgit (RM). The cost difference between early stage (Stage I) and late stage (Stage II-IV) was analysed using independent t-test.
Results: The cost per patient increased with stage of CRC, from RM13,672 (USD4,410.30) for stage I, to RM27,972 (USD9,023.20) for Stage IV. The early stage had statistically significant lower cost compared to late stage t(2) = -4.729, P = 0.042. The highest fraction of the cost was related to surgery for Stage I, but was superseded by oncology day care treatment for Stages II-IV. CRC is a costly illness. From a provider perspective, the highest cost was found in Stages III and IV. The early stages conserved more resources than did the advanced stages of cancer.
Conclusion: Early diagnosis and management of CRC, therefore, not only affects oncologic prognosis, but has implications for health care costs. This adds further justification to develop and implement CRC screening programmes in Malaysia.
Methods: This retrospective cohort study was conducted during one year and it involved 104 patients. Their records were reviewed and assessed. The causative agents and its sensitivity pattern were noted. The results were presented as descriptive statistic and analysed.
Results: A total of 133 microorganisms were isolated with 1.28 microorganisms per lesion. The microorganism isolated were 62% (n = 83) GN (Gram-negative) and 38% (n = 50) GP (Gram-positive). GN microorganisms include Pseudomonas spp (28%), Proteus spp (11%), Klebsiella spp (8%) and E. coli (4%). Staphylococcus aureus (54%) was predominant among GP, followed by Group B Streptococci (26%) and Enterococcus spp (6%). Thirty patients (28.8%) had polymicrobial infections. The association between the quantity of microorganisms and severity of DFI was significant. Among severe DFI cases, 77.8% with polymicrobial microorganisms underwent amputation compared to 33.3% with monomicrobial infection.
Conclusion: GN microorganisms were predominantly isolated from DFIs and remained sensitive to widely used agents. Polymicrobial infections were associated with DFI severity.
Methods: Fifty-seven participants were assessed for their demographics and functional ability relating to the requirement for walking devices, including the Timed Up and Go Test (TUGT) and lower limb loading during sit-to-stand (LLL-STS).
Results: Thirty-five participants (61%) used a walking device, particularly a standard walker, for daily walking. More than half of them (n = 23, 66%) had potential of walking progression (i.e., safely walk with a less-support device than the usual one). The ability of walking progression was significantly associated with a mild severity of injury, increased lower-limb muscle strength, decreased time to complete the TUGT, and, in particular, increased LLL-STS.
Conclusion: A large proportion of ambulatory individuals with SCI have the potential for walking progression, which may increase their level of independence and minimise the appearance of disability. Strategies to promote LLL-STS are important for this progression.
Methods: The original English version of the GCEQ underwent forward and backward translation into the Malay language. A cross-sectional study was conducted. The finalised Malay version was administered to 674 undergraduate students at the Health Campus of the Universiti Sains Malaysia (USM) with a mean age of 20.27 years (SD = 1.35 years). Confirmatory factor analysis (CFA) was conducted for the psychometric evaluation.
Results: The measurement model consisted of 20 observed items and five latent factors. CFA demonstrated adequate fit to the data: comparative fit index = 0.929; standardised root mean square residual = 0.052; root mean square error of approximation = 0.061 (90% CI = 0.056, 0.067). The composite reliability coefficients for the five latent factors ranged from 0.777 to 0.851. All the correlations between the factors were less than 0.85, so discriminant validity was achieved.
Conclusion: The findings suggested that the Malay version of the GCEQ is valid and reliable for assessing goal content in the exercise context of undergraduates at the Health Campus, USM.
Methods: This cross-sectional study included 50 patients with late-onset (≥ 32 weeks gestation) PE. Maternal serum was obtained before delivery, and placentas were obtained immediately after delivery. SEMA3B and CUL1 levels were evaluated by ELISA. Results were statistically analysed by Spearman correlation test, with a P < 0.05 considered statistically significant.
Results: While elevated serum SEMA3B levels significantly correlated with increased placental SEMA3B levels in late-onset PE (R = 0.620, P = 0.000), alteration of serum CUL1 levels did not correlate with alteration of placental CUL1.
Conclusion: Alteration of circulating maternal SEMA3B, but not CUL1, levels can potentially be used to monitor PE progression during pregnancy.
Methods: The participants were university students at USM's Health Campus, who were invited to volunteer and complete two measures: a demographic form, including the types of co-curricular activities in which the students chose to enrol (sports, uniform and art), and the Physical Activity and Leisure Motivation Scale (PALMS).
Results: A total of 588 university students (female = 79.1%, male = 20.9%) with a mean age of 19.77 (SD = 1.39) participated in the study. The results showed significant differences in the motives of affiliation (P < 0.001), appearance (P = 0.008) and physical condition (P = 0.010) across the types of co-curricular activities in which the students participated. The students who enrolled in sports generally showed higher motives of affiliation, appearance and physical condition for participating in PA than other types of co-curricular activities.
Conclusion: The study findings can provide further insights into the motives for participating in PA among health sciences students and encouragement for students to integrate PA into their daily routines.
Methods: The Malay adult-report version of the SDQ was administered to 495 parents and 432 teachers, respectively. At the same time, a newly translated Malay child-report version of the SDQ was also administered to 150 children aged 13 to 14 years old in this community study. W e measured internal reliability using Cronbach's Alpha for all reported data. Construct validity of the parent-report data was assessed using factor analysis. Confirmatory Factor Analysis (CFA) was also subsequently perform on parent-report data to explain the model fit indices of this questionnaire.
Result: Cronbach's Alpha was acceptable for all parent, teacher and child-report data with values of 0.74, 0.77 and 0.78, respectively. Factor analysis of the parent's report showed a five-factor solution, which was consistent with other psychometric evaluations of the SDQ in other languages. CFA showed good model fit of the original five factor model which consists of Emotional, Conduct, Hyperactivity, Peer problem and Pro-social scale.
Conclusion: This study shows that the psychometric properties of the Malay parent-report version of the SDQ were similar to other parent-report version of the SDQ questionnaires in other languages, although cross-cultural differences may still exist.
Methods: One hundred and fifty hard-working agricultural farmers from high-prevalence area for CKDu (Madawachchiya) were screened three times for proteinuria; 66 proteinuric and 21 non-proteinuric were identified as the baseline classification. Selected individuals were analysed further for creatinine, protein and cystatin C in urine and creatinine, cystatin C in serum. Urine protein-to-creatinine ratio (UP/UC) was calculated.
Results: Based on creatinine and cystatin C cut-off levels in serum, individuals were classified as high or normal. Diagnosis of two functional markers (creatinine and cystatin C) were evaluated using receiver operating characteristic (ROC) curve and in terms of sensitivity and specificity using UP/UC as the baseline. Creatinine and cystatin C-based eGFR (estimated Glomerular filtration rate) levels were calculated, and Pearson's correlation coefficient was determined between different eGFR measurements using UP/UC. Mean (SD) UP/UC ratio, serum creatinine, and serum cystatin C levels of the proteinuric subjects were 129.0 (18.4) mg/mmol, 1.35 (0.39) mg/dL, 1.69 (0.58) mg/L. For non-proteniuric individuals, the results were found to be 14.4 (2.28), 1.22 (0.40) mg/dL, 0.82 (0.25) mg/L. The ROC analysis showed excellent accuracy in using cystatin C for identifying proteinuric patients than creatinine area under the curve (AUC): 0.9675, P < 0.001). Cut-off points were identified as 1.015 mg/dL for serum creatinine and 0.930mg/L for cystatin C. Furthermore, cystatin C based Hoek formula showed the better correlation (0.635, P < 0.001) with UP/UC compared with creatinine based modification of diet in renal disease (MDRD) formula.
Conclusion: The study showed elevated serum cystatin C in patients with persisting proteinuria compared with non-responding serum creatinine. Moreover, cystatin C-based eGFR equations were more accurate to determine the kidney function than serum creatinine in proteinuric patients who are vulnerable for CKDu in high-prevalence areas.
Methods: A total of 51 M. tuberculosis acid fast bacilli (AFB) smear-positive sputum specimens were inoculated directly into drug-free and serial dilutions of drug-containing Middlebrook 7H9 broth media. With this direct resazurin micro plate assay (REMA) method, resazurin dye was used as a growth indicator in microplate wells. The minimum inhibitory concentrations (MIC) of isoniazid (INH) and rifampicin (RIF) were compared with those of the 'gold standard' absolute concentration method (ACM). The turnaround time (TAT) of the direct REMA and the ACM were also determined.
Results: At the selected cut-off points (INH: 0.0625 μg/mL; RIF: 0.125 μg/mL), good drug susceptibility test results were obtained for INH and RIF with an average sensitivity, specificity and accuracy of 90%, 100% and 97%, respectively, with a TAT of 15 days. The REMA method also correctly classified the resistant isolates with positive predictive values of 95% and negative predictive values of 98% for the two drugs.
Conclusions: The direct REMA was reliable in routine diagnostic laboratories for the drug susceptibility testing of M. tuberculosis and the rapid detection of multi-drug-resistant tuberculosis.
Methods: This cross-sectional study used the sequential exploratory type of mixed methods design in which quantitative data analysis was performed via survey-based questionnaires and qualitative study. For this purpose, we performed a thematic analysis of semi-structured interview questions that were administered to all participants using the self-interview technique.
Results: A majority of students were of the opinion that the process of making poster preparation acted as an opportunity to promote deep learning. Moreover, a majority expressed that making these presentations required teamwork, which gave them an insight into collaborative learning.
Conclusion: Our study revealed that poster presentations, when used effectively as an assignment, can facilitate a learner's critical and reflective thinking and promoting active learning. Previous generic guidelines for making posters were found to be an important step that led to a systematic scientific approach amongst learners as well as for integrating basic science and medical knowledge.
Methods: In this clinical trial study, 98 participants were randomly allocated to an HBM group (n = 48) and a control group (n = 50). The HBM group received an audiovisual compact disc (CD) that contained information about nutritional behaviour of colorectal cancer (CRC) prevention based on HBM that lasted 45 min. Both groups completed questionnaires regarding demographic factors, knowledge and HBM constructs, and a three-day dietary recall at the beginning of the study, 1 week after, and 3 months after the education. The outcome of this study was measured by the amount of food servings consumed and dietary micronutrient intake.
Results: At the baseline, there were no significant differences between groups regarding demographic factors. Findings showed that self-efficacy (P < 0.001), severity (P < 0.001), and benefits (P < 0.001) were perceived to be higher, and knowledge (P < 0.001) was increased in the HBM group compared to control group 3 months after education. There was a significant increase in fruit and vegetable (P < 0.001) and dairy (P = 0.001) intake and a significant decrease in red meat servings (P = 0.016) in the HBM group compared to the control group. Also, intake of vitamin D (P < 0.001), folate (P < 0.001), calcium (P = 0.008), and dietary fibre (P < 0.001) was increased in the HBM group compared to the control group 3 months after education.
Conclusion: Education plans based on HBM and implemented through multimedia can change nutritional beliefs and behaviours for the prevention of colorectal cancer.