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Fulltext The craniotomy box: an innovative method of containing hazardous aerosols generated during skull saw use in autopsy on a COVID-19 body

Hasmi AH, Khoo LS, Koo ZP, Suriani MUA, Hamdan AN, Yaro SWM, et al.

Forensic Sci Med Pathol, 2020 09;16(3):477-480.
PMID: 32500339 DOI: 10.1007/s12024-020-00270-z

During a disease pandemic, there is still a requirement to perform postmortem examinations within the context of legal considerations. The management of the dead from COVID-19 should not impede the medicolegal investigation of the death where required by the authorities and legislation but additional health and safety precautions should be adopted for the necessary postmortem procedures. The authors have therefore used the craniotomy box in an innovative way to enable a safe alternative for skull and brain removal procedures on suspected or confirmed COVID-19 bodies. The craniotomy box technique was tested on a confirmed COVID-19 positive body where a full postmortem examination was performed by a team of highly trained personnel in a negative pressure Biosafety Level 3 (BSL-3) autopsy suite in the National Institute of Forensic Medicine (IPFN) Malaysia. This craniotomy box is a custom-made transparent plastic box with five walls but without a floor. Two circular holes were made in one wall for the placement of arms in order to perform the skull opening procedure. A swab to detect the presence of the SARS-CoV-2 virus was taken from the interior surface of the craniotomy box after the procedure. The result from the test using real-time reverse transcriptase polymerase chain reaction (rRT-PCR) proved that an additional barrier provided respiratory protection by containing the aerosols generated from the skull opening procedure. This innovation ensures procedures performed inside this craniotomy box are safe for postmortem personnel performing high risk autopsies during pandemics.

Matched MeSH terms: Protective Clothing
New Zealand Malayan war veterans' exposure to dibutylphthalate is associated with an increased incidence of cryptorchidism, hypospadias and breast cancer in their children

Carran M, Shaw IC

N Z Med J, 2012;125(1358):52-63.
PMID: 22864157

It is well known that the endocrine-disrupting chemical (EDC) dibutylphthalate (DBP) inhibits testosterone synthesis and can lead to feminisation in male laboratory animals. Moreover, it has long been speculated that human exposure would result in the similar effects, but this is difficult to study because specific human exposure cohorts are rare. We report increases in the incidences of hypospadias (p<0.05), cryptorchidism (p<0.05) and breast cancer (p<0.05) in the children of New Zealand soldiers who served in Malaya (1948-1960) and were exposed to DBP applied daily to their clothing as an acaricide to prevent tick-transmitted bush typhus. In addition, we modelled absorption of DBP from the soldiers' clothing and using published data for skin absorption, and calculated a large theoretical absorbed dose of 64 mg/kg body weight/day which is similar to DBP's lowest observed adverse effect level (LOAEL) of 50 mg/kg body weight/day and thus indicates a biological effect is possible. This is the first report of a multigenerational developmental effect following DBP exposure in human males.

Matched MeSH terms: Clothing
Definitions, attitudes, and management practices in relation to diarrhea during enteral nutrition: a survey of patients, nurses, and dietitians

Majid HA, Emery PW, Whelan K

Nutr Clin Pract, 2012 Apr;27(2):252-60.
PMID: 22223668 DOI: 10.1177/0884533611431986

Diarrhea is a common complication in patients receiving enteral nutrition (EN), and understanding this problem among patients and healthcare professionals is required. The aim of the study was to investigate patients', nurses', and dietitians' definitions of diarrhea during EN, the attitudes of nurses and patients toward it, and the management practices of nurses and dietitians in response to diarrhea during EN.

Matched MeSH terms: Clothing
Anti-oviposition activities of used sock media against a dengue vector: prospects of eco-friendly control and solutions to pollution

Dieng H, Satho T, Abang F, Miake F, Ghani IA, Latip NA, et al.

Environ Sci Pollut Res Int, 2017 Sep;24(26):21375-21385.
PMID: 28744676 DOI: 10.1007/s11356-017-9624-y

Yearly, huge amounts of sock refuse are discarded into the environment. Socks contain many molecules, and worn ones, which are rich in smell-causing bacteria, have a strong influence on animals' behaviors. But the impacts of sock odor on the oviposition behavior of dengue vectors are unknown. We assessed whether Aedes albopictus changes its oviposition activity in response to the presence of used socks extract (USEx) in potential breeding grounds, using choice and no-choice bioassays (NCB). When furnished even chances to oviposit in two sites holding USEx and two others containing water (control), Ae. albopictus deposited significantly less eggs in USEx than in water sites. A similar pattern of oviposition preference was also observed when there were more oviposition options in water. When there were greater oviposition opportunities in USEx sites, Ae. albopictus oviposited preferentially in water. Females laid significantly more eggs during the NCB involving water than USEx. Also, significantly more mature eggs were retained by females in the NCB with USEx than in that with water. These observations strongly suggest the presence of molecules with either repellent or deterrent activities against Ae. albopictus females and provide an impetus to advocate the integration of used socks in dengue control programs. Such applications could be a realistic end-of-life recourse to reroute this waste from landfills.

Matched MeSH terms: Clothing
Glove-based approach to online signature verification

Kamel NS, Sayeed S, Ellis GA

IEEE Trans Pattern Anal Mach Intell, 2008 Jun;30(6):1109-13.
PMID: 18421114 DOI: 10.1109/TPAMI.2008.32

Utilizing the multiple degrees of freedom offered by the data glove for each finger and the hand, a novel on-line signature verification system using the Singular Value Decomposition (SVD) numerical tool for signature classification and verification is presented. The proposed technique is based on the Singular Value Decomposition in finding r singular vectors sensing the maximal energy of glove data matrix A, called principal subspace, so the effective dimensionality of A can be reduced. Having modeled the data glove signature through its r-principal subspace, signature authentication is performed by finding the angles between the different subspaces. A demonstration of the data glove is presented as an effective high-bandwidth data entry device for signature verification. This SVD-based signature verification technique is tested and its performance is shown to be able to recognize forgery signatures with a false acceptance rate of less than 1.2%.

Matched MeSH terms: Clothing*
Vitamin D status and its associated factors of free living Malay adults in a tropical country, Malaysia

Moy FM

J. Photochem. Photobiol. B, Biol., 2011 Sep 02;104(3):444-8.
PMID: 21636288 DOI: 10.1016/j.jphotobiol.2011.05.002

Vitamin D status is influenced by sun exposure, geographic latitude, daily outdoor activities, body surface exposed to sunlight and dietary intakes. Malaysia, is sunny all year round. However, the vitamin D status of this population especially among the healthy and free living adults is not known. Therefore a study of vitamin D status and associated factors was initiated among an existing Malay cohort in Kuala Lumpur. A total of 380 subjects were sampled to have their vitamin D status assessed using 25-hydroxyvitamin D (25(OH)D). A short questionnaire enquiring socio-demographic characteristics, exposure to sunlight and clothing style was administered. Their mean age was 48.5±5.2years and the mean 25(OH)D for males and females were 56.2±18.9nmol/L and 36.2±13.4nmol/L respectively. There were significant positive correlation for sun exposure score (r=0.27, p<0.001) and negative correlation for sun protection score (r=-0.41, p<0.001) with 25(OH)D levels. In the logistic regression model, females (OR=2.93; 95% CI: 1.17, 7.31), BMI (1.1; 1.03, 1.20) and sun exposure score (0.998; 0.996, 0.999) were significantly associated with vitamin D status as represented by 25(OH)D levels. Our findings show that obesity, lifestyle behaviours and clothing style are directly associated with our participants especially females' low vitamin D status.

Matched MeSH terms: Clothing
Assessment of urinary cotinine as a marker of nicotine absorption from tobacco leaves: a study on tobacco farmers in Malaysia

Onuki M, Yokoyama K, Kimura K, Sato H, Nordin RB, Naing L, et al.

J Occup Health, 2003 May;45(3):140-5.
PMID: 14646288

To assess dermal absorption of nicotine from tobacco leaves in relation to Green Tobacco Sickness (GTS), urinary cotinine concentrations were measured in 80 male tobacco-growing farmers and in 40 healthy males (controls) who did not handle wet tobacco leaves in Kelantan, Malaysia. Among non-smokers, urinary cotinine levels in farmers were significantly higher than those of controls; farmers with urinary cotinine of 50 ng/ml/m2 or above showed eye symptoms more frequently than those below this level (p<0.05). Farmers who did not wear protective equipment had subjective symptoms more frequently than those who used the equipment (p<0.05); some of these symptoms were seen more frequently in organophosphate (Tamaron) users than in non-users. As tobacco farmers evidence a risk of nicotine poisoning from tobacco leaves, assessment including GTS together with effects of pesticides will be necessary.

Matched MeSH terms: Protective Clothing
Fulltext Traditional and Novel Adiposity Indicators and Pancreatic Cancer Risk: Findings from the UK Women's Cohort Study

Shyam S, Greenwood D, Mai CW, Tan SS, Mohd Yusof BN, Moy FM, et al.

Cancers (Basel), 2021 Mar 02;13(5).
PMID: 33801191 DOI: 10.3390/cancers13051036

(1) Background: We studied the association of both conventional (BMI, waist and hip circumference and waist-hip ratio) and novel (UK clothing sizes) obesity indices with pancreatic cancer risk in the UK women's cohort study (UKWCS). (2) Methods: The UKWCS recruited 35,792 women from England, Wales and Scotland from 1995 to 1998. Cancer diagnosis and death information were obtained from the National Health Service (NHS) Central Register. Cox's proportional hazards regression was used to evaluate the association between baseline obesity indicators and pancreatic cancer risk. (3) Results: This analysis included 35,364 participants with a median follow-up of 19.3 years. During the 654,566 person-years follow up, there were 136 incident pancreatic cancer cases. After adjustments for age, smoking, education and physical activity, each centimetre increase in hip circumference (HR: 1.03, 95% CI: 1.01-1.05, p = 0.009) and each size increase in skirt size (HR: 1.12, 95% CI: 1.02-1.23, p = 0.041) at baseline increased pancreatic cancer risk. Baseline BMI became a significant predictor of pancreatic cancer risk (HR: 1.04, 95% CI: 1.00-1.08, p = 0.050) when latent pancreatic cancer cases were removed. Only baseline hip circumference was associated with pancreatic cancer risk (HR: 1.03, 95% CI: 1.00-1.05, p = 0.017) when participants with diabetes at baseline were excluded to control for reverse causality. (4) Conclusion: Hip circumference and skirt size were significant predictors of pancreatic cancer risk in the primary analysis. Thus, hip circumference is useful to assess body shape relationships. Additionally, standard skirt sizes offer an economical and objective alternative to conventional obesity indices for evaluating pancreatic cancer risk in women.

Matched MeSH terms: Clothing
Fulltext Does the attire of a primary care physician affect patients' perceptions and their levels of trust in the doctor?

Zahrina AZ, Haymond P, Rosanna P, Ho R, Rajini AR, Low BT, et al.

Malays Fam Physician, 2018;13(3):3-11.
PMID: 30800227

INTRODUCTION: With increasing evidence of disease transmission through doctors' white coats, many countries have discouraged doctors from wearing their white coats during consultations. However, there have been limited studies about patients' preferences concerning doctors' attire in Malaysia. This study, therefore, aimed to investigate patients' perceptions of doctors' attire before and after the disclosure of information about the infection risk associated with white coats.
METHOD: This cross-sectional study was conducted from 1st June 2015 to 31st July 2015 at three different primary care settings (government, private, and university primary care clinics) using a self-administered questionnaire. A 1:5 systematic random sampling method was employed to select the participants. The respondents were shown photographs of male and female doctors in four different types of attire and asked to rate their level of confidence and trust in and ease with doctors in each type of attire. Subsequently, the respondents were informed of the risk of white coat-carried infections, and their responses were reevaluated. Data analysis was completed using SPSS Version 24.0. Associations of categorical data were assessed using the Chi-Square test, while the overall change in perceptions after the disclosure of additional information was examined using the McNemar test. Results with p-values < 0.05 were considered statistically significant.
RESULTS: A total of 299 respondents completed the questionnaire. Most of the respondents had more confidence and trust in the male (62.5%) and female (59.2%) doctors wearing white coats. A high proportion of the respondents from the government clinic (70.5%) felt more confidence in male doctors dressed in white coats (p-value = 0.018). In terms of ethnicity, male doctors in white coats were highly favored by Malays (61.0%), followed by the Chinese (41.2%) and Indians (38%) (p = 0.005). A similar preference was observed for the female doctors, whereby the highest number of Malays (60.3%), followed by the Chinese (41.2%) and Indians (40.0%) (p = 0.006), had a preference for female doctors wearing white coats. Only 21.9% of the initial 71.9% of patients who preferred white coats maintained their preference (p < 0.001) after learning of the risk of microbial contamination associated with white coats.
CONCLUSION: Most patients preferred that primary care doctors wear white coats. Nevertheless, that perception changed after they were informed about the infection risk associated with white coats.

Matched MeSH terms: Clothing
Fulltext Influence of vitamin D binding protein polymorphism, demographics and lifestyle factors on vitamin D status of healthy Malaysian pregnant women

Lee SS, Ling KH, Tusimin M, Subramaniam R, Rahim KF, Loh SP

BMC Pregnancy Childbirth, 2020 Nov 23;20(1):714.
PMID: 33228578 DOI: 10.1186/s12884-020-03397-7

BACKGROUND: Vitamin D deficiency (VDD) has been related to vitamin D binding protein (GC) gene polymorphism, demographics and lifestyle factors in different populations. However, previous studies only focused on demographic and lifestyle factors or genetic factors alone. Therefore, this cross-sectional study aimed to assess the association between GC gene polymorphism, demographics and lifestyle factors with VDD among Malaysian pregnant women.
METHOD: Information on demographic characteristics, dietary vitamin D intake from supplement and food, time spent outdoors, skin type and clothing were collected using a questionnaire. Plasma total 25-hydroxyvitamin D (25OHD) levels were measured using an Ultra-High-Performance Liquid Chromatography (UHPLC). Maternal GC single nucleotide polymorphisms (SNPs) (rs4588 and rs7041) were determined using restriction fragment length polymorphism (RFLP) technique.
RESULTS: Results showed that 50.2% of pregnant women were vitamin D deficient (25OHD

Matched MeSH terms: Clothing
Fulltext Attitude towards sex: study of secondary schoolchildren in Selangor state

Maha, A., Azhar, M. Z., Sherina, M. S., Sharmili, V., Rampal, L., Abdah, A., et al.

Malaysian Journal of Medicine and Health Sciences, 2010;6(1):33-61.
MyJurnal

Introduction: HIV/AIDS is one of the leading health problems worldwide. There is an increasing rate among the ages between 13 to 49 years old. School based intervention is an important component of community-based interventions for HIV/AIDS and is the best stage to promote abstinence which is best maintained among those not sexually experienced. Objectives: This study was carried out to determine attitude towards sex among secondary school children in Selangor state. Methods: A cross-sectional study design was used. Four out of nine districts in Selangor state were selected at random. Students were divided according to gender, academic performance (good or poor) with no behavioural problems
and students with evidence of behaviour problems (at risk). Results: Out of 149 students, the majority (56.4%) were females. The majority of students did not think sex should be discussed in depth and do not speak to parents, teachers, religious teachers, counselors, relatives, doctors or nurses but speak to friends regarding sex. More than half watch pornography. A significantly higher percentage of male students in the weak and at-risk group admit to thinking of intimacy (hugging and kissing) with the opposite gender. A higher number of these students would try sex out of curiosity, for fun, because it was difficult to say ‘no’ to and that they would like it. A significantly higher percentage will try sex because they did not want to hurt their girlfriends’ feeling by saying ‘no’. While the majority of students think intimacy will end in sex, a significantly higher percentage of male at-risk students think just talking with the opposite gender will end in sex. The majority of male students responded feeling attracted to the picture of a girl in sexy clothing but a significantly higher percentage of at-risk students also felt attracted to the picture of a girl properly attired. A significantly higher percentage of male at-risk students say parents do not say sex before marriage is wrong and a significantly higher percentage of
male students of weak and at-risk groups say girlfriends say sex before marriage is okay. A significantly higher percentage of weak and at-risk students speak to doctors regarding sex and think sex should be discussed in depth. Conclusion: Weak and at-risk male students appeared to have a more vulnerable attitude towards sex. This may predispose them to risky sexual behaviours leading to HIV/AIDS. Poor academic performance and behaviour problems may not be different as potential sexual risk predictors. The information obtained will be useful in designing intervention programmes in the prevention of HIV/AIDS.

Matched MeSH terms: Clothing
Fulltext A Rejang river rash

Lim JL

Malays Fam Physician, 2014;9(1):33-34.
PMID: 25606297 MyJurnal

A 30-year-old Iban woman presented to a rural primary healthcare clinic located along the Batang Rejang in Sarawak. She had a 2-day history of rash, which started over her trunk and later spread to her face and limbs. What started out as individual erythematous maculopapular spots later coalesced to form larger raised blotches. The rash was extremely pruritic and affected her sleep, and hence her visit. The rash was preceded by high grade, persistent fever that was temporarily relieved by paracetamol. She also complained of malaise, arthralgia and myalgia. Her appetite had been poor since the onset of the fever. She lived in a long house at the edge of the jungle. Although she did not have a history of going into the jungle to forage, she went regularly to the river to wash clothes. Clinically, she appeared lethargic and had bilateral conjunctival injection. Her left anterior cervical lymph nodes were palpable. There were erythematous macules measuring 5 to 15 mm distributed over her whole body but predominantly over the chest and abdominal region (Figure 1). An unusual skin lesion was discovered at the right hypochondriac region. This lesion resembled a cigarette burn with a necrotic centre (Figure 2). There was no evidence of hepato-splenomegaly. Examination of the other systems was unremarkable. On further questioning, the patient admitted being bitten by a ‘kutu babi’ or mite 3 days before the onset of her fever.

Matched MeSH terms: Clothing
Fulltext Risk factors of vitamin D deficiency among 15-year-old adolescents participating in the Malaysian Health and Adolescents Longitudinal Research Team Study (MyHeARTs)

Quah SW, Abdul Majid H, Al-Sadat N, Yahya A, Su TT, Jalaludin MY

PLoS One, 2018;13(7):e0200736.
PMID: 30024934 DOI: 10.1371/journal.pone.0200736

BACKGROUND: This study is to determine the prevalence and risk factors of vitamin D deficiency (vitamin D ≤ 50 nmol/L) among 15-year-old Malaysian adolescents. By identifying potential risk factors, prevention strategies and interventions can be carried out to improve the vitamin D status in adolescents.
METHODS AND FINDINGS: Stratified random sampling design was used to select adolescents from 15 urban and rural secondary schools in Selangor, Perak and Kuala Lumpur, Malaysia. Data collection was carried out from 1st April 2014 to 30th June 2014. Information regarding socio-demographic characteristics, sun exposure and sun protective behaviours, clinical data and environmental factors were collected. Blood for total vitamin D was sampled. Descriptive and multivariate logistic regressions were performed. Total 1061 participants were analyzed (62% were female; mean age 15.1 ± 0.4 years). The prevalence of vitamin D deficiency was 33%. Mean vitamin D was lower in female (53 ± 15 nmol), obese (body fat percentage (≥25%m; ≥33.8%f) (56 ± 16 nmol/L), Malays (58 ± 18 nmol/L) and Indians (58 ± 15 nmol/L). In multivariate analysis, female (OR = 5.5; 95% CI: 3.4-7.5), Malay (OR = 3.2; 95% CI: 1.3-8.0), Indian (OR = 4.3; 95% CI: 1.6-12.0) and those always wearing long sleeve (OR = 2.4; 95% CI: 1.1-5.4) were more likely to have vitamin D deficiency. For female participants, ethnicity {Malays (OR = 6.7; 95% CI: 2.0-18.5), Indian (OR = 4.5; 95% CI: 1.8-19.3)} was an important risk factors. Cloud cover, school residence, skin pigmentation, sun-exposure and sun-protective behaviours were not significant risk factors. The limitation of this study was recall bias as it relied on self-reported on the sun exposure and protective behaviours. The diet factors were not included in this analysis.
CONCLUSIONS: The prevalence of Vitamin D deficiency among Malaysian adolescents was considerable. Gender, ethnicity and clothing style were important risk factors.

Matched MeSH terms: Clothing
Fulltext Major epidemiological factors associated with leptospirosis in Malaysia

Garba B, Bahaman AR, Bejo SK, Zakaria Z, Mutalib AR, Bande F

Acta Trop, 2018 Feb;178:242-247.
PMID: 29217379 DOI: 10.1016/j.actatropica.2017.12.010

INTRODUCTION: Leptospirosis is a zoonotic disease caused by a diverse pathogenic leptospira species and serovars. The disease is transmitted directly following contact with infected urine and other body fluids or indirectly after contact with water or soil contaminated with infected urine.
OBJECTIVES: While a wide range of domestic and wild animals are known to be reservoirs of the disease, occupation, international travel and recreation are beginning to assume a center stage in the transmission of the disease. The objective of this study is to review available literatures to determine the extent to which these aforementioned risk factors aid the transmission, increase incidence and outbreak of leptospirosis in Malaysia.
STUDY DESIGN: The review was conducted based on prevalence, incidence, and outbreak cases of leptospirosis among human and susceptible animals predisposed to several of the risk factors identified in Malaysia.
METHODS: Literature searchers and reviews were conducted based on articles published in citation index journals, Malaysian ministry of health reports, periodicals as well as reliable newspapers articles and online media platforms. In each case, the newspapers and online media reports were supported by press briefings by officials of the ministry of health and other agencies responsible.
RESULTS: The disease is endemic in Malaysia, and this was attributed to the large number of reservoir animals, suitable humid and moist environment for proliferation as well as abundant forest resources. Over 30 different serovars have been detected in Malaysia in different domestic and wild animal species. This, in addition to the frequency of flooding which has increased in recent years, and has helped increase the risk of human exposure. Occupation, recreation, flooding and rodent population were all identified as an important source and cause of the disease within the study population.
CONCLUSION: There is an urgent need for the government and other stakeholders to intensify efforts to control the spread of the disease, especially as it greatly affect human health and the tourism industry which is an important component of the Malaysian economy. The risk of infection can be minimized by creating awareness on the source and mode of transmission of the disease, including the use of protective clothing and avoiding swimming in contaminated waters. Moreover, improved diagnostics can also help reduce the suffering and mortalities that follow infection after exposure to infection source.

Matched MeSH terms: Protective Clothing
Fulltext Associations of clothing size, adiposity and weight change with risk of postmenopausal breast cancer in the UK Women's Cohort Study (UKWCS)

Moy FM, Greenwood DC, Cade JE

BMJ Open, 2018 Sep 28;8(9):e022599.
PMID: 30269068 DOI: 10.1136/bmjopen-2018-022599

OBJECTIVES: Breast cancer is associated with overweight and obesity after menopause. However, clothing size as a proxy of adiposity in predicting postmenopausal breast cancer is not widely studied. We aimed to explore the relationships between postmenopausal breast cancer risk with adipose indicators (including clothing sizes) and weight change over adulthood.
DESIGN: Prospective cohort study.
SETTING: England, Wales and Scotland.
PARTICIPANTS: 17 781 postmenopausal women from the UK Women's Cohort Study.
PRIMARY OUTCOME MEASURE: Incident cases of malignant breast cancers (International Classification of Diseases (ICD) 9 code 174 and ICD 10 code C50).
RESULTS: From 282 277 person-years follow-up, there were 946 incident breast cancer cases with an incidence rate of 3.35 per 1000 women. Body mass index (HR: 1.04; 95% CI: 1.02 to 1.07), blouse size (HR: 1.10; 1.03 to 1.18), waist circumference (HR: 1.07; 1.01 to 1.14) and skirt size (HR: 1.14;1.06 to 1.22) had positive associations with postmenopausal breast cancer after adjustment for potential confounders. Increased weight over adulthood (HR: 1.02; 1.01 to 1.03) was also associated with increased risk for postmenopausal breast cancer.
CONCLUSIONS: Blouse and skirt sizes can be used as adipose indicators in predicting postmenopausal breast cancer. Maintaining healthy body weight over adulthood is an effective measure in the prevention of postmenopausal breast cancer.

Matched MeSH terms: Clothing
Waist belt and central obesity cause partial hiatus hernia and short-segment acid reflux in asymptomatic volunteers

Lee YY, Wirz AA, Whiting JG, Robertson EV, Smith D, Weir A, et al.

Gut, 2014 Jul;63(7):1053-60.
PMID: 24064007 DOI: 10.1136/gutjnl-2013-305803

OBJECTIVE: There is a high incidence of inflammation and metaplasia at the gastro-oesophageal junction (GOJ) in asymptomatic volunteers. Additionally, the majority of patients with GOJ adenocarcinomas have no history of reflux symptoms. We report the effects of waist belt and increased waist circumference (WC) on the physiology of the GOJ in asymptomatic volunteers.
DESIGN: 12 subjects with normal and 12 with increased WC, matched for age and gender were examined fasted and following a meal and with waist belts on and off. A magnet was clipped to the squamo-columnar junction (SCJ). Combined assembly of magnet-locator probe, 12-channel pH catheter and 36-channel manometer was passed.
RESULTS: The waist belt and increased WC were each associated with proximal displacement of SCJ within the diaphragmatic hiatus (relative to upper border of lower oesophageal sphincter (LOS), peak LOS pressure point and pressure inversion point, and PIP (all p<0.05). The magnitude of proximal migration of SCJ during transient LOS relaxations was reduced by 1.6-2.6 cm with belt on versus off (p=0.01) and in obese versus non-obese (p=0.04), consistent with its resting position being already proximally displaced. The waist belt, but not increased WC, was associated with increased LOS pressure (vs intragastric pressure) and movement of pH transition point closer to SCJ. At 5 cm above upper border LOS, the mean % time pH <4 was <4% in all studied groups. Acid exposure 0.5-1.5 cm above SCJ was increased, with versus without, belt (p=0.02) and was most marked in obese subjects with belt.
CONCLUSIONS: Our findings indicate that in asymptomatic volunteers, waist belt and central obesity cause partial hiatus herniation and short-segment acid reflux. This provides a plausible explanation for the high incidence of inflammation and metaplasia and occurrence of neoplasia at the GOJ in subjects without a history of reflux symptoms.

Matched MeSH terms: Clothing/adverse effects*
Effects of pressure garment on spasticity and function of the arm in the early stages after stroke: a randomized controlled trial

Ooi HK, Chai SC, Kadar M

Clin Rehabil, 2020 Apr;34(4):515-523.
PMID: 32037862 DOI: 10.1177/0269215520905050

OBJECTIVE: To investigate the effects of pressure (Lycra) garment on the spasticity and function of the arm in the early stages after stroke.
DESIGN: A randomized controlled trial.
SETTING: Occupational therapy unit of a public hospital.
SUBJECTS: A total of 46 adults with stroke.
INTERVENTION: After random assignment, for six weeks, both intervention group and control group received a 2 hour/week conventional occupational therapy program, with the intervention group receiving an extra 6 hour/day pressure garment application (long glove).
MAIN MEASURES: Modified Modified Ashworth Scale, Disabilities of Arm, Shoulder and Hand Outcome Measure, and Jebsen-Taylor Hand Function Test. Eligibility measures: Mini Mental State Examination and Modified Modified Ashworth Scale. Assessments were performed at baseline and six weeks postintervention.
RESULTS: There were 21 participants with the mean age of 51.19 (8.28) years in the intervention group and 22 participants with the mean (SD) age of 52.82 (8.71) years in the control group. The intervention group had median (interquartile range (IQR)) post-stroke duration of 1 (1) month, while for the control group, they were 2 (2) months. There was no difference in spasticity, and both perceived and actual arm functions between the groups at six weeks after baseline.
CONCLUSION: Wearing a pressure garment on the arm for 6 hours daily had no effect in controlling spasticity or on improving arm function in the early stages after stroke.

Matched MeSH terms: Clothing*
Personal antimosquito measures plus proguanil for malaria prophylaxis in southern Malaysia

Henderson A, Rixom JA

Trans R Soc Trop Med Hyg, 1986;80(6):981-2.
PMID: 3603647

During the early months of 1985 and 1986, 408 non-immune British soldiers undertook training in the jungles north of Kota Tinggi, in southern Malaysia. In this geographical location, where malaria transmission is now light, a combination of strict personal antimosquito measures plus proguanil 200 mg daily produced effective, safe protection, with only a single case of vivax malaria occurring. Given the limited malaria risk, however, the results of this study should be extrapolated only with caution to other areas of Malaysia.

Matched MeSH terms: Clothing
Fulltext Occupationally Acquired Plasmodium knowlesi Malaria in Brunei Darussalam

Koh GJ, Ismail PK, Koh D

Saf Health Work, 2019 Mar;10(1):122-124.
PMID: 30949391 DOI: 10.1016/j.shaw.2018.09.002

Simian malaria is a zoonotic disease caused by Plasmodium knowlesi infection. The common natural reservoir of the parasite is the macaque monkey and the vector is the Anopheles mosquito. Human cases of P. knowlesi infection has been reported in all South East Asian countries in the last decade, and it is currently the most common type of malaria seen in Malaysia and Brunei. Between 2007-2017, 73 cases of P. knowlesi infection were notified and confirmed to the Ministry of Health in Brunei. Of these, 15 cases (21%) were documented as work-related, and 28 other cases (38%) were classified as probably related to work (due to incomplete history). The occupations of those with probable and confirmed work related infections were border patrol officers, Armed Forces and security personnel, Department of Forestry officers, boatmen and researchers. The remaining cases classified as most likely not related to work were possibly acquired via peri-domestic transmission. The risk of this zoonotic infection extends to tourists and overseas visitors who have to travel to the jungle in the course of their work. It can be minimised with the recommended use of prophylaxis for those going on duty into the jungles, application of mosquito/insect repellants, and use of repellant impregnated uniforms and bed nets in jungle camp sites.

Matched MeSH terms: Clothing
Fulltext Student, Teacher, and School Counselor Perceptions of National School Uniforms in Malaysia

Woo JM, Tam CL, Bonn GB, Tagg B

Front Psychol, 2020;11:1871.
PMID: 32849098 DOI: 10.3389/fpsyg.2020.01871

The national school uniform remained a requirement for all primary and secondary school students in Malaysia since its first introduction by the British missionaries in the nineteenth century. Although it is commonly thought that wearing uniforms improve cohesion among students, little research has been done to investigate the perception of national school uniforms and perceived cohesion among Malaysian students. The aim of the current study is to explore the experiences of former students, teachers and school counselors in relation to Malaysia's national school uniform policy, their influence on student life, and their relationship to school and national cohesion. Three studies were conducted. In Study 1, Malaysian secondary school graduates (N = 192) completed a self-report questionnaire with close and open-ended questions. In Study 2 and study 3, secondary school teachers (N = 10) and school counselors (N = 6) participated in semi-structured interviews, respectively. Although students felt the uniforms were unattractive, they had neutral to somewhat positive feelings about them overall. They did not report greater school cohesion or national identity related to uniforms but did report that uniforms lessened the importance of socioeconomic and other differences. Teachers and counselors reported similar views; they did not perceive much influence on national or school identity but did see advantages in terms of discipline and the lessening of student inequality. Generally, teachers and counselors were in favor of school uniforms but some suggested that uniform designs could be more culturally inclusive, particularly in regard to Muslim and non-Muslim students. Limitations of using non-representative sampling and future direction for Malaysian school uniforms were discussed. This study highlights the important characteristics that should be taken into consideration by educators and policymakers for future improvement of the national school uniform policy in Malaysia.

Matched MeSH terms: Clothing

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