Medication error has been identified as a major factor affecting patient safety. Many innovative efforts such as Computerised Physician Order Entry (CPOE), a Pharmacy Information System, automated dispensing machines and Point of Administration Systems have been carried out with the aim of improving medication safety. However, areas remain that require urgent attention. One main area will be the lack of continuity of care due to the breakdown of communication between multiple healthcare providers. Solutions may include consideration of "health smart cards" that carry vital patient medical information in the form of a "credit card" or use of the Malaysian identification card. However, costs and technical aspects associated with the implementation of this health smart card will be a significant barrier. Security and confidentiality, on the other hand, are expected to be of primary concern to patients. Challenges associated with the implementation of a health smart card might include physician buy-in for use in his or her everyday practice. Training and technical support should also be available to ensure the smooth implementation of this system. Despite these challenges, implementation of a health smart card moves us closer to seamless care in our country, thereby increasing the productivity and quality of healthcare.
A vascularized outer-table calvarial bone graft was used for repairing a Posnick type 2 traumatic orbito-frontal bone defect supported by the use of a calcium-based putty (Allomatrix) in a 7-year-old girl. Gaps between the donor and recipient sites were filled with Allomatrix containing demineralized bone matrix particles. Four years later there was a good cosmetic result using an artificial left eye.
The daily variations in the in situ CO(2) exchange of the reproductive organs of Durio zibethinus trees, growing in an experimental field at University Putra Malaysia (UPM), were examined at different growth stages. Reproductive organs emerged on the leafless portions of branches inside the crown. The photon flux densities (PFD) in the chambers used for the measurements were less than 100 mumol m(-2) s(-1) and were 40% of the PFD outside of the crown. The daytime net respiration rate and the nighttime dark respiration rate were higher at the time of flower initiation and during the mixed stages, when flower buds, flowers, and fruit coexist, than at the flower bud stage. The net respiration rate was lower than the daytime dark respiration rate at given temperatures, especially at the flower bud and fruit stages. Conversely, the net respiration rate was similar to the daytime dark respiration rate at the mixed stage. Photosynthetic CO(2) refixation reduced the daily respiratory loss by 17, 5, 0.3, and 24% at the flower bud, flower initiation, mixed, and fruit stages, respectively.
This cross-sectional study aimed to determine the prevalence, frequency, and intensity of parent-reported pain among non-verbal children with cerebral palsy (CP) and explore associations with medical, demographic, and parental psychosocial factors.
Osteoporotic drugs are used to prevent fragility fractures, but their role in fracture healing still remains unknown. Thus, alternative agents with suitable mode of delivery are needed to promote fracture healing. This study was performed to investigate the effects of direct deliveries of lovastatin and tocotrienol to fracture sites on ossification-related gene expression in fracture healing in a postmenopausal osteoporosis model. Forty-eight Sprague Dawley female rats were divided into six groups. Group I comprised the sham-operated rats, while Groups II-VI were ovariectomized rats. After 8 weeks, the right tibiae of all rats were fractured and stabilized. Group I and Group II were given two single injections of lovastatin and tocotrienol carriers. Group III was given an estrogen preparation at 64.5 µg/kg daily via oral gavages. Group IV was injected with lovastatin particles (750 µg/kg), while Group V was injected with tocotrienol particles (60 mg/kg). Group VI received two single injections of 750 µg/kg lovastatin particles and 60 mg/kg tocotrienol particles. After 4 weeks, the gene expressions were measured. Group VI showed significantly higher gene expressions of osteocalcin, BMP-2, VEGF-α, and RUNX-2 compared to Group II. In conclusion, combined treatment of lovastatin and tocotrienol upregulated the expression of genes related to fracture healing.
Evidence in crime scenes available in the form of biological stains which cannot be visualized during naked eye examination can be detected by imaging their fluorescence using a combination of excitation lights and suitable filters. These combinations selectively allow the passage of fluorescence light emitted from the targeted stains. However, interference from the fluorescence generated by many of the surface materials bearing the stains often renders it difficult to visualize the stains during forensic photography. This report describes the use of background correction algorithm (BCA) to enhance the visibility of seminal stain, a biological evidence that fluoresces. While earlier reports described the use of narrow band-pass filters for other fluorescing evidences, here, we utilize BCA to enhance images captured using commonly available colour filters, yellow, orange and red. Mean-based contrast adjustment was incorporated into BCA to adjust the background brightness for achieving similarity of images' background appearance, a crucial step for ensuring success while implementing BCA. Experiment results demonstrated the effectiveness of our proposed colour filters' approach using the improved BCA in enhancing the visibility of seminal stains in varying dilutions on selected surfaces.
This paper critically reviews the impacts of supplementing trace elements on the anaerobic digestion performance. The in-depth knowledge of trace elements as micronutrients and metalloenzyme components justifies trace element supplementation into the anaerobic digestion system. Most of the earlier studies reported that trace elements addition at (sub)optimum dosages had positive impacts mainly longer term on digester stability with greater organic matter degradation, low volatile fatty acids (VFA) concentration and higher biogas production. However, these positive impacts and element requirements are not fully understood, they are explained on a case to case basis because of the great variance of the anaerobic digestion operation. Iron (Fe), nickel (Ni) and cobalt (Co) are the most studied and desirable elements. The right combination of multi-elements supplementation can have greater positive impact. This measure is highly recommended, especially for the mono-digestion of micronutrient-deficient substrates. The future research should consider the aspect of trace element bioavailability.
Dengue is a climate-sensitive infectious disease. Climate-based dengue early warning may be a simple, low-cost, and effective tool for enhancing surveillance and control. Scientific studies on climate and dengue in local context form the basis for advancing the development of a climate-based early warning system. This study aims to review the current status of scientific studies in climate and dengue and the prospect or challenges of such research on a climate-based dengue early warning system in a dengue-endemic country, taking Malaysia as a case study.
Curcumin is more soluble in ethanol, dimethylsulfoxide, methanol and acetone than in water. In this study, nanocurcumin combined with 8 mT AC static magnetic field was used to enhance cellular uptake, bioavailability, and ultimate efficiency of curcumin against prostate cancer cell line (PC3), four bacteria strains (two Gram positive: Micrococcus luteus ATCC 9341, Staphylococcus aureus ATCC 29213 and two Gram negative: Escherichia coli ATCC 25922, Pseudomonas aeruginosa ATCC 27853), mammalian cell line (HEK) and human erythrocytes (RBC). The efficiency (E%) between IC50 of nanocurcumin combined with magnetic field (NANOCUR-MF) and control against PC3 was 35.93%, which is three times higher compared to curcumin combined with magnetic field (CUR-MF); i.e., 10.77%. However, their E% against HEK was not significant; 1.4% for NANOCUR-MF and 1.95% for CUR-MF. Moreover, depending in minimum bacterial concentration (MBC), the use of MF leads to a reduction of MBCs for all tested bacteria compared with control. The obtained results established the applicability of (MF) in enhancing cellular uptake for PC3 and tested bacteria strains by increasing the penetration of drug (nanocurcumin and parent curcumin) into cell with fixing mild cytotoxic profile for HEK and RBC.
Cell culture involves a complex of processes of cell isolation from their natural environment (in vivo) and subsequent growth in a controlled environmental artificial condition (in vitro). Cells from specific tissues or organs are cultured as short term or established cell lines which are widely used for research and diagnosis, most specially in the aspect of viral infection, because pathogenic viral isolation depends on the availability of permissible cell cultures. Cell culture provides the required setting for the detection and identification of numerous pathogens of humans, which is achieved via virus isolation in the cell culture as the "gold standard" for virus discovery. In this review, we summarized the views of researchers on the current role of cell culture technology in the diagnosis of human diseases. The technological advancement of recent years, starting with monoclonal antibody development to molecular techniques, provides an important approach for detecting presence of viral infection. They are also used as a baseline for establishing rapid tests for newly discovered pathogens. A combination of virus isolation in cell culture and molecular methods is still critical in identifying viruses that were previously unrecognized. Therefore, cell culture should be considered as a fundamental procedure in identifying suspected infectious viral agent.
This pilot study aims to assess Escherichia coli (E. coli) contamination and its perceived health risks among beachgoers in ten tropical beach sands along Port Dickson coastline (Malaysia). This study also aims to determine the relationship between perceived health symptoms and tropical beach sand exposure behavior. The concentration of E. coli in tropical beach sand ranged from 60cfu/100g to 4113cfu/100g. E. coli contamination was the highest at Tanjung Gemuk (4113±30cfu/100g) and the lowest at Tanjung Tuan (60±15cfu/100g); the high level of contamination could be due to the location of the former at the sewage outlet of nearby hotels. Skin symptoms were the most predominant among the health symptoms indicated by beachgoers. Exposure duration was significantly correlated with the perceived health symptoms among beachgoers in the beaches studied.
There is a lack of studies looking into religiosity and religious coping in cancer patient. In this cross-sectional study, we examined the religiosity using Duke University Religion Index, religious coping using Brief Religious Coping Scale, anxiety and depression based on Hospital Anxiety and Depression Scale among 200 cancer patients. The association between religiosity and religious coping with anxiety and depression was studied. The findings showed that subjects with anxiety or depression used more negative religious coping and had lower non-organization religiosity. Hence, measurements in reducing negative religious coping and encouraging religious activities could help to reduce psychological distress in cancer patients.
BACKGROUND: The attitudes of healthcare professionals towards HIV positive patients and high risk groups are central to the quality of care and therefore to the management of HIV/AIDS related stigma in health settings. Extant HIV/AIDS stigma scales that measure stigmatising attitudes towards people living with HIV/AIDS have been developed using scaling techniques such as principal component analysis. This approach has resulted in instruments that are often long. Mokken scale analysis is a nonparametric hierarchical scaling technique that can be used to develop unidimensional cumulative scales. This technique is advantageous over the other approaches; as the scales are usually shorter, while retaining acceptable psychometric properties. Moreover, Mokken scales also make no distributional assumptions about the underlying data, other than that the data are capable of being ordered by item and by person. In this study we aimed at developing a precise and concise measure of HIV/AIDS related stigma among health care professionals, using Mokken scale analysis.
METHODS: We carried out a cross sectional survey of healthcare students at the Monash University campuses in Malaysia and Australia. The survey consisted of demographic questions and an initial item pool of twenty five potential questions for inclusion in an HIV stigma scale.
RESULTS: We analysed the data using the mokken package in the R statistical environment providing a 9-item scale with high reliability, validity and acceptable psychometric properties, measuring and ranking the HIV/AIDS related stigmatising attitudes.
CONCLUSION: Mokken scaling procedure not only produced a comprehensive hierarchical scale that could accurately order a person along HIV/AIDS stigmatising attitude, but also demonstrated a unidimensional and reliable measurement tool which could be used in future studies. The principal component analysis confirmed the accuracy of the Mokken scale analysis in correctly detecting the unidimensionality of this scale. We recommend future works to study the generalisability of this scale in a new population.
Monocytic microparticles (mMP) are microparticles derived from human monocytes either under in vivo or in vitro conditions. The size of mMP is between 0.1 and 1.0 μm. Apart from the size range, mMPs are also identified based on phosphatidylserine and CD14 expression on their surface, though this is not always the case. Monocytic MP are critical players in inflammation, endothelial cell function, and blood coagulation. They exhibit dual function by either helping the progression of such conditions or limiting it, depending on certain factors. Furthermore, the numbers of mMP are elevated in some autoimmune diseases, infectious diseases, and metabolic disorders. However, it is unknown whether mMP play an active role in these diseases or are simply biomarkers. The mechanism of mMP modulation is yet to be identified. In this review, we highlight the mechanism of mMP formation and the roles that they play in inflammation, blood coagulation, and different disease settings.
A total of 40 marine mussel Perna viridis populations collected (2002-2009) from 20 geographical sites located in two busy shipping lanes namely the Straits of Malacca (10 sites; 16 populations) and the Straits of Johore (8 sites; 21 populations) and three populations (2 sites) on the east coast of Peninsular Malaysia, was determined for Cd, Cu, Fe, Ni, Pb and Zn concentrations. In comparison with the maximum permissible limits (MPLs) set by existing food safety guidelines, all metal concentrations found in all the mussel populations were lower than the prescribed MPLs. In terms of the provisional tolerable weekly intake prescribed by the Joint FAO/WHO Expert Committee on Food Additives (JECFA) and oral reference doses (ORDs) by the USEPA, all the studied metals (except for Pb) were unlikely to become the limiting factors or unlikely to pose a risk for the consumption of the mussel populations. The estimated daily intake (EDI) for average level mussel (ALM) and high level mussel (HLM) consumers of mussels was found to be lower than the ORD guidelines for Cd, Cu, Fe, Ni and Zn. Furthermore, the target hazard quotient (THQ) was found to be less than 1 for ALM consumers but higher than 1 for HLM consumers in some sites. Therefore, there were no potential human health risks to the ALM consumers of the mussels. However, for Pb THQ values, the Pb levels in some mussel populations could create a health risk problem. Present results indicate that the consumption amounts of mussels should be limited for minimizing potential health risks of heavy metals to the HLM consumers.
Background Curcumin (diferuloylmethane) is a polyphenol derived from the plant Curcuma longa, commonly called turmeric. Extensive research over the last 50 years has demonstrated that these polyphenols play an important role in the maintenance of health and prevention of diseases, in addition to its therapeutic benefits such as anti-tumor, anti-inflammatory, and anti-oxidant activities. Materials and methods This study is devoted to the enhancement of the solubility and bioavailability of curcumin nanoparticles prepared by a process based on a wet-milling technique and then examine in vitro against prostate cancer cell line 3 (PC3), human embryonic kidney cell line (HEK), human erythrocytes (red blood cells (RBCs)), and against fourth different bacterial strains two gram-positive (Micrococcus luteus ATCC 9341, Staphylococcus aureus ATCC 29213), two gram-negative (Escherichia coli ATCC 25922, Pseudomonas aeruginosa ATCC 27853). Results The cell viability curve, the half maximal inhibitory concentration (IC50), and the minimum bactericidal concentration (MBC) were evaluated. Nanocurcumin displayed significant activity against cancer cell line (PC3) and low toxicity against normal cells (HEK) compared with parent curcumin in favor of PC3 (P 0.05). On the other hand, the results demonstrate that, the MBCs of nanocurcumin were lower than curcumin for all different bacterial strains. Moreover, the selected gram-positive bacteria had higher sensitivity than the selected gram-negative bacteria for both curcumin and nanocurcumin. In conclusion, all these findings not only indicate that nanocurcumin safe compound has a potent ability as anti-cancer and antimicrobial activities, but also well justify the avail of using nanocurcumin as prostate cells PC3 anti-cancer, and antimicrobial agent for nanocurcumin are markedly improved by decreasing particle size to the nano-scale regime.
Polycyclic aromatic hydrocarbons (PAHs) are primarily formed as a result of thermal treatment of food, especially barbecuing or grilling. Contamination by PAHs is due to generation by direct pyrolysis of food nutrients and deposition from smoke produced through incomplete combustion of thermal agents. PAHs are ubiquitous compounds, well-known to be carcinogenic, which can reach the food in different ways. As an important human exposure pathway of contaminants, dietary intake of PAHs is of increasing concern for assessing cancer risk in the human body. In addition, the risks associated with consumption of barbecued meat may increase if consumers use cooking practices that enhance the concentrations of contaminants and their bioaccessibility. Since total PAHs always overestimate the actual amount that is available for absorption by the body, bioaccessibility of PAHs is to be preferred. Bioaccessibility of PAHs in food is the fraction of PAHs mobilized from food matrices during gastrointestinal digestion. An in vitro human digestion model was chosen for assessing the bioaccessibility of PAHs in food as it offers a simple, rapid, low cost alternative to human and animal studies; providing insights which may not be achievable in in vivo studies. Thus, this review aimed not only to provide an overview of general aspects of PAHs such as the formation, carcinogenicity, sources, occurrence, and factors affecting PAH concentrations, but also to enhance understanding of bioaccessibility assessment using an in vitro digestion model.
A neonate with cyanosis at birth was found to have a rare type of totally anomalous pulmonary venous connection. The pulmonary veins entered a confluence posterior to the left atrial wall, which drained into the right superior cavoatrial junction. There were no other major structural defects and no evidence of isomerism. Because of the severe cyanosis, and the restrictive nature of the interatrial communication, we performed balloon atrioseptostomy to improve oxygenation. We then achieved successful surgical repair when the baby was aged 7 months.