This paper discuss thermal comfort studies of an under air conditioning in hot and humid climate which at one of the higher institution in East Coast of Malaysia. Indoor thermal environment is important as it affects the health and productivity of building occupants. The paper reports on an experimental investigation of indoor thermal comfort characteristics under the control of air conditioning. Firstly, the well known Fanger’s thermal comfort model was simplified for the current experimental investigation. This is followed by reporting the experimental results of indoor thermal comfort characteristics under the control of temperature, with eight different of temperatures which are 22oC to 29oC. Finally, indoor thermal comfort was merely affected by the increment ventilation and outdoor climate. PMV value was higher when near from the window because of the effects of the wall radiations and the metabolic heat.
Synthesis of palm oil based-urethane acrylate (POBUA) resins was carried out by acrylation of epoxidizedpalm oil (EPOP) using acrylic acid in the presence of a catalyst and followed by isocyanation to obtainthe POBUA. Using the monomer as a diluent in the formulation, 4% of photoinitiator and incorporationof organoclay (1-5% wt), nanocomposites were obtained upon UV irradiation. The X-ray DiffractoryXRD study revealed that the nanocomposites obtained were of the exfoliation type. The presence ofthe clay improved the hardness and did not affect the thermal stability. Similarly, it increased the glasstransition temperature Tg but reduced the modulus as the clay content was increased. The improvementof the tensile strength was only obtained when the clay concentration was 5 phr.
The aim of this study was to assess the wear of tungsten carbide burs and round rotary diamond instruments through measurements of rake angle and visual observations respectively under a field emission scanning electron microscope. Sixty short and long head pear-shaped tungsten carbide burs and 18 round rotary diamond instruments that had been used to complete < 5, > 5 and > 10 cavity preparations (n=10/group) were selected from the 3rd and 4th year dental students, Faculty of Dentistry, University of Malaya. There were two control groups consisting of long and short tungsten carbide burs of ten each. Two-way ANOVA was used to analyse the rake angle data. The data from the two control groups were collectively analysed following multiple paired t-test (p>.05) which showed no significant difference between the two types of tungsten carbide bur (short and long head). The mean rake angle of the control group was significantly higher (p < .05) compared to the < 5, > 5 and > 10 cavity preparation groups. The rake angle of the > 10 cavity preparation group was significantly lower than the other two test groups (p < .05). Round rotary diamond instruments in the < 5 cavity preparation group showed intact diamond particles with distinct cutting facets comparable to the control group. However, diamonds instruments in the > 5 and > 10 cavity preparation groups showed blunt diamond particles. In conclusion, wear of tungsten carbide burs and round rotary diamond instruments were evident after repeated use. Wear was more pronounced when instruments were used to prepare more than ten cavities.
Hysterectomy is one of the most common non-obstetric surgical procedures performed on women. Little is known about the factors affecting decision making process regarding hysterectomy in Malaysia. The study aimed to explore factors affecting women decision regarding hysterectomy among Malaysian women. This study has enrolled 100 women eligible for hysterectomy in the department of general gynecology ward in the university of Malaya hospital, Malaysia. A structured questionnaire was administered by interview. Descriptive analysis was used to obtain the frequencies. Chi square test and simple logistic regression test were performed to assess the association between variables. The majority of participants aged 41-50 years (52%) and married (74%). Twenty seven out of 100 participants made their decision on the operation within one month while 73 women decided after one month. Some complications were only known by the minority of patients such as injury to ureter (47%), injury to nerve (8%), incision hernia (18%), vault prolapse (21 %), and deep vein thrombosis (43%). Most of women delay their decision on the surgery (73%). Factors associated significantly with decision were ethnicity, religion, knowledge on complication, discussion with spouse and doctor.. Cultural factors, opinion of husband and doctors and knowledge of the complication play an important role in the decision of women. It is important to provide suitable information and social support for patients to help them in their decision-making. Participation and support from spouses and doctors should also be encouraged.
Substantial studies reported musculoskeletal disorders among the working population in the developed country, however, a limited number of studies were conducted in Malaysia. The objective of this cross sectional study was to determine the physical activity risk factors for low back pain among automotive workers in Selangor. Modified Risk Factors Questionnaire (RFQ) was used to assess physical activity with the occurrence of low back pain. The significant physical activities associated with the 12 months point prevalence are lifting weight (
Objective: The smoking rate among patients with mental health problem is higher than in the general population. Effective pharmacotherapy to treat nicotine addiction is thus needed to reduce the morbidity and mortality associated with cigarette smoking among these patients. This article reviews the literature on the suitability of varenicline for smokers with mental health problems.
Methods: A search of the literature was conducted using PubMed from year 2001 to July 2009 using key words varenicline alone and varenicline and mental health. Articles chosen were narrowed to those published in English. The type of articles chosen included clinical trials, metaanalyses, case reports, and review articles.
Results: The search produced a total of 322 articles on varenicline and 14 articles on varenicline and mental health. Varenicline, a new drug for smoking cessation is an α4β2 partial agonist and partial antagonist at nicotinic acetylcholine receptor. As a partial agonist, varenicline relieves craving and withdrawal symptoms that occur during smoking abstinence and also reduce the rewarding effects of smoking in patients who relapse. However, at present, there is concern regarding the neuropsychiatric side effects such as aggressive behaviour, suicidal ideation, mania and depression associated with varenicline use in patients with mental health problems, but these reports did not show a causal-link or lack of link between these symptoms and varenicline.
Conclusion: Current available data support the effectiveness of varenicline to treat nicotine dependence. However its safety among smokers with mental health problems remains to be elucidated. At present, further safety assessment is needed in this patient population. Until new data is available regarding the safety of varenicline in these populations, psychiatrists and physicians prescribing this medication should be extra cautious and monitor for possible psychiatric side effects when prescribing this medication to patients with pre-existing psychiatric disorders or have vulnerability to psychoses.
Spatial and temporal variations in concentrations of several metals and isotopes in sediment cores from around Penang Island, an area with economically important biological resources off the northwest coast of peninsular Malaysia, are reported. Because of a typical, monazite rich mineralogy in surrounding drainage basins, sedimentary metal enrichment factors relative to global average materials, enrichment factors (EFs) of ˃1.0 do not always indicate significant anthropogenic metal inputs. Because of extensive metal solubilization in the hot, organic carbon rich area, EFs of < 1.0 may be observed for several metals despite significant anthropogenic contributions. Comparison of metal-Al relationships in Penang area surface sediments with those in nearby and presumed uncontaminated Strait of Malacca sediments more accurately correct for atypical regional solubilization and mineralogical effects than comparison to global average materials. Such comparisons show concentrations of Cd, Cu, Pb, Ni, Cr, As, Sb, Zn and V have changed by less than a factor of two by anthropogenic discharges. Sedimentary concentration profiles of Pb, Zn and Cu, ratioed to Sc to normalize for variations in grain size and mineralogy, have subsurface maxima suggestive of modest and recently reduced anthropogenic inputs. Mn, U, As and Sb have Sc-normalized concentration profiles clearly affected by diagenetic processes. Sc-normalized profiles of Cr, Th, Ce and Sm show only small changes with depth, confirming insignificant anthropogenic inputs and undetectable postdepositional diagenetic mobility.
Excess ²¹⁰Pb activities and fluxes in Penang area sediments are limited by supply of this radionuclide, in contrast to sediments of both the northwestern U.S.A. and Amazon continental shelves, where they are limited by particle scavenging reactions.²¹⁰Pb activities in sediments of
the shallow, dynamic Penang area often show erratic or unconvincing changes with depth that
cannot be reliably modeled by assuming steady state, constant deposition rate of particles of
uniform chemistry, mineralogy and initial unsupported ²¹⁰Pb, and that mixing is limited to a
recognizable surface layer and resemble a diffusive process.
Layered double hydroxide (LDH) with Mg/Al molar ratio of 4/1 (MAN-4) was synthesized by co-precipitation and followed by hydrothermal method. The compound was allowed to undergo ion exchange with K2HPO4 for 48 hours to produce MgAlHPO4 (MAHP-4). The solid produced was characterized using X-ray diffraction (XRD) and Fourier Transform Infrared spectroscopy (FTIR). Adsorption of copper solution by MAHP-4 was carried out using batch experiment by mixing the copper solution and the sorbent MAHP-4. The effects of
various parameters such as contact time, pH, adsorbent dosage and initial concentration were investigated. The optimum pH for copper removal was found to be 4 and the optimum time of copper removal was found at 4 hours. The isotherm data was analysed using model isotherm Langmuir with the correlation coefficient of 0.999 was recorded. The maximum adsorption capacity, Qo (mg/g) of 142.8 mg/g was also recorded from the Langmuir isotherm. The remaining copper solution was determined by using EDXRF (Energy Dispersive XRay Fluorescence spectrometry) model MiniPal 4 (PAN analytical). The results in this study indicate that MAHP-4 has potential as an effective adsorbent for removing copper from aqueous solution.
Recently, Malaysia has taken a positive step toward providing a better water quality by introducing more water quality parameters into its Water Quality Standard. With regard to the natural radionuclides that may present in the water, 3 parameters were introduced that is gross alpha, gross beta and radium which need to be measured and cannot exceed 0.1, 1.0 and 1.0 Bq/L respectively. This study was conducted to develop a more practical method in measuring these parameters in aqueous environmental samples. Besides having a lot of former tin mining areas, some part of Malaysia is located on the granitic rock which also contributes to a certain extent the amount of natural radionuclides such as uranium and thorium. For all we know these two radionuclides are the origin of other radionuclides being produced from their decay series. The State of Kelantan was chosen as the study area, where the water samples were collected from various part of the Kelantan River. 25 liters of samples were collected, acidify to pH 2 and filtered before the analysis. Measurement of these parameters was done using liquid scintillation counter (LSC). The LSC was set up to
the optimum discriminator level and counting was done using alpha-beta mode. The results show that gross alpha and beta can be measured using scintillation cocktail and radium and radon using extraction method. The results for gross alpha, gross beta, 222Ra and 226Ra are 0.39-6.42, 0.66-16.18, 0.40-4.65 and 0.05-0.56 Bq/L. MDA for gross alpha, gross beta and radium is 0.03, 0.08 and 0.00035 Bq/L respectively.
Objective: To delineate and differentiate between late subacute hemorrhage and intracranial lipomas in clinically available conventional and advanced MR sequences. Methods: Two cases of late subacute hemorrhage and two cases of intracranial lipoma were reviewed with CT scans and 3.0T scanner MRI. The sequences evaluated in MRI were T1-weighted (T1W) fast spin echo (FSE), T2-weighted (T2W) FSE, gradient echo T2*-weighted (GRE T2*W) images, diffusion weighted (DWI), apparent diffusion coefficient (ADC) and multivoxel spectroscopy. Results: Late subacute hemorrhage and intracranial lipoma have similar imaging features on T1W, T2W FSE with blooming artefact at the margins on GRE T2*W. However on GRE T2*W sequence, the central area of lipoma demonstrates low signal; while hemorrhage demonstrates high signal. In DWI, late subacute hemorrhage shows hyperintensity; while in lipoma there is loss of signal.
Conclusion: Awareness of the potential pitfalls in standard sequence are important, as these entities appear to have similar T1W/ T2W characteristic with blooming artefact on T2*W. Knowing the distinctive central signal intensity pattern on GRE T2W* and DWI is therefore essential to differentiate between these lesions as there are differences to their clinical management.
Geographical Information Systems (GIS) and three dimensional (3D) World Wide Web (WWW) applications usage are on the rise. The demand for online 3D terrain visualization for GIS data has increased. Current users demand for more complex data which have higher accuracy and realism. This is aided by the emergence of geo-browsers in the market which provide free service and also cater for the commercialized market. Other new technology driving the market is the use of software such as CityGML, Virtual Reality Markup Language (VRML)/ Entensive 3D (X3D), geoVRML, and Keyhole Markup Language (KML). These technologies also play an important role for this new era of online 3D terrain visualization. The aim of this paper is to implement the online 3D terrain visualization for GIS data by using VRML technology and launching the system into three different web servers. The data used for this system are contour data and high resolution satellite image (QUICKBIRD) for Universiti Putra Malaysia (UPM) area. Testing was done only for satellite image overlaid to 3D terrain data. The web servers used in this experiment were the Spatial Research Group Server in UPM, Universiti Utara Malaysia (UUM) web server, and ruzinoor.my web server. The comparison was based on the performance of web servers in terms of accessibility, uploading time, CPU usage, frame rate per second (fps), and number of users. The results from this experiment will be of help and guidance to the developers in finding the right web servers for the best performance on implementing online 3D terrain visualization for GIS data.
This research focuses on the ASTER DEM generation for visual and mathematical analysis of topography, landscapes and landforms, as well as modeling of surface processes of Central Alborz, Iran. ASTER DEM 15 m generated using tie points over the Central Alborz and Damavand volcano with 5671 m height from ASTER (Advanced Space borne Thermal Emission and Reflection Radiometer) satellite data using PCI Geomatica 9.1. Geomorphic parameters are useful to identify and describe geomorphologic forms and processes, which were extracted from ASTER DEM in GIS environment such as elevation, aspect, slope angle, vertical curvature, and tangential curvature. Although the elevation values are slightly low in altitudes above 5500 m asl., the ASTER DEM is useful in interpretation of the macro- and meso-relief, and provides the opportunity for mapping especially at medium scales (1:100,000 and 1:50,000). ASTER DEM has potential to be a best tool to study 3D model for to geomorphologic mapping and processes of glacial and per glacial forms above 4300 m asl.
Sepsis causes high mortality and morbidity. Static lactate concentration and early lactate clearance are cited to be a predictor for sepsis survival. This study examined the clinical utility of static lactate concentration and early lactate clearance within the first six hours of admission in Emergency Department (ED) to predict 28-day mortality rate in sepsis patients. Patients who presented with sepsis, severe sepsis or septic shock and admitted to ED of Universiti Kebangsaan Malaysia Medical Centre were recruited. Blood lactate concentrations were measured upon admission (H0), at 1st hour (H1) and 6th hour (H6), respectively. Either standard treatment of sepsis or early goal directed therapy was initiated according to sepsis severity. A follow-up report was conducted at 28 days via telephone call, e-mail or case notes. Patients were later classified into survivor and non-survivor as final outcome. Static lactate concentration appeared to be significantly higher for non-survivor as compared to the survival group at H0, H1 and H6 (p
Evaluation of the mechanical behaviour of restoration dental materials is essential to understand their performance under different load conditions and to estimate their durability under clinical oral function. Restorative materials and dental tissues like other materials by having specific mechanical properties, such as static strength (i.e. compressive strength, tensile strength, flexural strength) and dynamic strength (i.e. fatigue strength). The selection of proper mechanical test type depends on the goals that the study claims to define. On such basis, the mechanical test can be chosen correctly. Laboratory studies should be designed as replications of the clinical oral circumstances to measure the mechanical and physical properties of a material and any arbitrary choices in the design of the study may result in large variations of data.
Chronic periodontitis (CP) is an inflammatory disease of the supporting tissues of the teeth caused by specific microorganism. Hypertension is one of the major causes of cardiovascular disease whereas periodontitis has recently drawn increasing attention because of its potential relationship with cardiovascular disease. The objectives of this study were to determine the prevalence of the hypertension in CP patients as well as to evaluate the association between hypertension and severity of CP. One hundred and eighty five records of CP patients treated in Dental Clinic, Universiti Sains Malaysia Hospital (USM Hospital), Kelantan from 2010 until 2013 were retrieved and reviewed. The diagnosis of periodontal disease and the presence of hypertension were recorded. The severity of chronic periodontitis was classified into mild, moderate and severe according to the clinical attachment loss. The data was obtained and analyzed using SPSS version 20.0. Majority of the subjects were from Malay ethnic group (94.4%) at the age range between 41 and 61 years (67.8%). In conclusion, the prevalence of hypertension in chronic periodontitis patients was 12.2%. There was no significant association between hypertension and severity of CP (p=0.229).
Two species of plants, Andrographis paniculata and Euphorbia hirta were screened for antibacterial activities against three Gram positives and Gram negatives. The leaves from both plants were extracted by methanol extraction. The antibacterial activity was detected with spread plate well diffusion method. The extracts of both plants demonstrated inhibitory activity against both Gram negative and positives bacteria. Staphylococcus aureus, Bacillus subtilis, Streptococcus epidemidis, Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa. The minimum inhibitory concentration (MIC determination using micro dilution method showed that the A/tic of A. paniculata for the tested bacteria were 1.56 mg/ml (Staph. aureus), 3.13 mg/ml (Bacillus subtilis), 3.13 mg/ml (Strept. epidemidis), 1.56 mg/ml (Escherichia cob), 12.50 mg/ml (Klebsiella pneumoniae) and 3.13 mg/ml (Pseudomonas aeruginosa) respectively. The MIC value for E. hirta was 6.25 mg/ml (Staph. aureus) and 3.13 mg/ml (Bacillus subtilis), 3.13 mg/ml (Strept. Epidemidis), 3.13 mg/ml (Pseudomonas aeruginosa),12.5 mg/ml (Escherichia coli), and 6.25 mg/ml (Klebsiella pneumoniae). Both plants represent a potential for pharmaceutical and agricultural applications and are worthy of further study.
Kajian kes-kawalan ini dijalankan untuk mengkaji hubungan adipositi dan komposisi tubuh terhadap risiko kanser payudara di kalangan 70 orang wanita yang baru didiagnos kanser payudara dan 138 orang kawalan. Parameter antropometri yang merangkumi tinggi, berat, ukuran pinggang dan ukuran pinggul dan aras glukosa darah berpuasa serta tekanan darah diukur di kalangan subjek. Komposisi tubuh ditentukan menggunakan analisis bioimpedans (Maltron 906). Hasil kajian menunjukkan Indeks Jisim Tubuh (?T) kumpulan kes adalah 26.0 ± 4.8 kg/m2 dan 25.3 ± 4.5 kg/m2 bagi kumpulan kawalan (p > 0.05). Seramai 71% subjek dari kumpulan kes dan 40% subjek kumpulan kawalan mengalami obesiti abdominal (ukurlilit pinggang 80 cm) [OR = 3.4 (95% CI =1.7-6.9] (p < 0.05). Wanita pra menopaus berisiko sebanyak empat kali untuk mendapat kanser payudara dengan [Adjusted OR = 4.3 (95% CI = 1.8-10.3)]. Peratus lemak tubuh adalah tinggi di kalangan kes (36.4 ± 4.7%) berbanding kawalan 35.3 ± 4.4% tetapi perbezaan ini adalah tidak signifikan. Jisim Tubuh Tanpa Lemak ?TTL) menunjukkan nilai min 38.8 ± 5.7 kg bagi kawalan dan 38.9 ± 5.5 kg pada kes. Korelasi positif yang lemah ditunjukkan di antara umur dan IJT (r = 0.179, p = 0.010), ukuran pinggang (r = 0.218, p = 0.002), nisbah pinggang-pinggul (NPR) (r = 0.233, p = 0.001) dan peratus lemak tubuh (r = 0.330, p = 0.000). Kesimpulannya, obesiti abdominal meningkatkan risiko kanser payudara, terutama di kalangan wanita pra menopaus. Obesiti jenis ini dan peratus lemak tubuh adalah meningkat dengan pertambahan usia. Adalah penting bagi wanita untuk mengekalkan ukuran pinggang yang sihat melalui gaya hidup sihat bagi mengurangkan risiko kanser payudara.
Kajian garis pangkal pengimejan resonans magnet kefungsian (fMRI) telah dijalankan ke atas 2 orang subjek lelaki sihat dominan tangan kanan dan kiri. Kajian ini menggunakan gerakan jari tangan kanan dan kiri untuk merangsang aktiviti neuron di dalam korteks serebrum. Subjek diarahkan supaya menekan jari-jari pada ibu jari secara bergilir-gilir semasa imbasan fMRI dilakukan. Paradigma 5 kitar aktif-rehat digunakan dengan setiap kitar mengandungi satu blok aktif dan satu blok rehat dengan 10 siri pengukuran untuk setiap blok. Seratus isipadu imej fMRI bagi setiap subjek dianalisis menggunakan pekej perisian MatLab dan SPM2. Model linear am (GLM) digunakan untuk menganggar secara statistik parameter yang mencirikan model rangsangan hemodinamik bagi gerakan jari. Kesimpulan mengenai pengaktifan otak yang diperhatikan dijana secara statistik berasaskan teori medan rawak (RFT) Gaussian. Keputusan menunjukkan bahawa rantau otak yang aktif akibat gerakan jari adalah pada girus presentral merangkumi kawasan motor primer. Pengaktifan otak adalah secara kontralateral terhadap gerakan jari tangan kanan dan kiri. Keamatan isyarat keadaan aktif didapati lebih tinggi secara bererti (p < 0.001) daripada keamatan isyarat keadaan rehat. Bilangan voksel yang aktif didapati lebih tinggi pada hemisfera otak yang mengawal gerakan jari bagi tangan yang tidak dominan untuk kedua-dua subjek. Keputusan ini menyokong fakta bahawa kawasan pengaktifan motor pada hemisfera otak semasa gerakan jari tangan yang tidak dominan mengalami rangsangan hemodinamik yang lebih tinggi dan kawasan pengaktifan yang lebih luas berbanding dengan kawasan pengaktifan pada hemisfera otak yang mengawal gerakan jari bagi tangan yang dominan.
Aktiviti fizikal yang kerap seperti senaman mempunyai implikasi yang baik terhadap kehidupan seharian kita terutamanya dalam aspek kesihatan dan pengurusan stres. Kajian ini adalah bertujuan untuk mengkaji kesan program senaman aerobik dengan protokol yang ditetapkan ke atas aras penanda tekanan terpilih di kalangan pelajar universiti semasa musim peperiksaan akademik. Lapan belas (n=18) mahasiswa tidak terlatih, dipadankan dengan umur dan BMI, telah dibahagikan kepada 2 kumpulan iaitu kumpulan intervensi (n=10) dan kawalan (n=8). Kumpulan intervensi menjalani senaman jenis aerobik berintensiti sederhana (60-75% daripada kadar denyut jantung maksimum), 3 kali seminggu selama 40-50 minit untuk setiap sesi selama 6 minggu. Darah vena diambil pada sebelum program senaman bermula (M1) dan selepas program senaman berakhir (M2) iaitu dalam minggu pertama musim peperiksaan. Kecergasan kardiorespiratori dan status stres psikologi diukur sebelum kedua-dua sesi pengambilan darah. Analisis biokima dijalankan untuk melihat aras malondialdehid (MDA) plasma dan kortisol serum. Hasil kajian menunjukkan bahawa program senaman selama 6 minggu ini telah merangsang penurunan aras MDA yang signifikan (F=19.58, p=0.002) semasa minggu peperiksaan berbanding aras sebelum program senaman bermula. Kumpulan intervensi juga menunjukkan aras MDA yang lebih rendah (t=-0.42, p=0.001) berbanding kumpulan kawalan semasa menduduki minggu peperiksaan. Walaubagaimanapun, tiada perbezaan yang signifikan pada aras kortisol dalam kedua-dua kumpulan walaupun terdapat penurunan yang sedikit pada kumpulan intervensi semasa minggu peperiksaan. Kajian ini mencadangkan bahawa program senaman yang dijalankan mampu dijadikan sebagai strategi yang berkesan untuk membantu pelajar menghadapi stres terutamanya sewaktu sesi akademik yang memberatkan.
Introduction and Objectives: The intensive care unit (ICU) is an uncomfortable and stressful environment for patients. The use of adequate sedation and analgesia is important to reduce stress to patients. The aim of this study was to compare a relatively new sedative agent, dexmedetomidine to current sedative agent used, propofol in the provision of sedation and analgesia, their effects on haemodynamic and respiratory parameters and cost involved on post open heart surgery patients. Materials and Methods: A prospective, randomized single-blinded trial was conducted on post open heart surgery patients in the ICU of the Hospital Universiti Sains Malaysia (HUSM). Thirty two patients were randomized to dexmedetomidine or propofol groups. Analgesic requirement, haemodynamic and respiratory parameters, and extubation time were measured and compared. Mean rate of infusion to achieve adequate sedation were used to calculate the cost involved in the use of these two agents. Results: Patients sedated with dexmedetomidine required significantly lower dose of morphine compared to propofol [mean (sd): 12.80 (2.61) versus 15.86 (1.87) mg/kg/min, p=0.00]. Mean heart rate was also significantly lower in dexmedetomidine group compared to propofol group [mean (CI): 74.48 (70.38,78.59) versus 83.85 (79.61,88.09) per minutes, p=0.00]. However there were no significant differences in the other parameters between the two groups. Cost involved the use of dexmedetomidine was slightly higher compared to propofol (RM 9.57 versus RM8.94 per hour). Discussion and Conclusions: Dexmedetomidine is comparable to propofol in the provision of sedation, and its effect on haemodynamic and respiratory parameters. However it has added advantages in the provision of analgesia, and caused a significant reduction in heart rate. This is beneficial in these patients by reducing myocardial oxygen demand, and hence subsequent ischaemia and infarction. However, further larger studies are needed to evaluate the effect of dexmedetomidine on perioperative cardiac morbidity and mortality.