Introduction: In several studies it was described that ineffective communication during patient handover between the hospital departments or during shift-to-shift transfer result in discontinuity of care, inappropriate treatment, and potential risks of injury for patients. The patient handover is a professional responsibility and accountability related to nursing care. SBAR (Situation - Background - Assessment – Recommendation) method as part of the international pa- tient safety goals(IPSGs) was developed to improve communication breakdown. Knowledge and attitude are essential factors associated with the implementation of patient handover, yet limited research was done on this. The purpose of this study was to examine the relationship between nurse knowledge and attitude toward a patient handover. Meth- ods: A cross-sectional approach was applied in this study. A total of 61 nurses consisting of the head nurse, and team leaders participated in sampling technique done by simple random sampling method from the hospital database. Data collection used a structured questionnaire with a good result of validity and reliability. Univariate and bivariate test were used for data analyzing with Statistical Package for the Social Science (SPSS) Version 18. Results: There is a relationship between nurses' knowledge and attitude toward patient handover with OR 5.280 (1.063-26.227); OR 5.333 (1.351-21.062), respectively and statistically significant (p
Introduction: Rapid ongoing industrialisation particularly in developing countries has triggered an
increased risk of occupational noise-related disease occurrence. Machinery and work tasks in metal fabrication
processes may produce high noise levels that can be harmful to hearing. This study aimed to investigate the
workers’ exposure to noise at a fabrication plant and their perceptions toward hearing loss symptoms and its association.
Methods: This study was conducted at a Heating, Ventilating and Air Conditioning fabrication plant in Johor.
With a 31% response rate, 50 respondents who were selected using purposive sampling answered a
questionnaire regarding demographic background, noise exposure and perceived hearing loss symptoms. Noise
measurements were also conducted among 30 of them based on the concept of sampling the maximum
risky workers. The noise was measured using a sound level meter IEC 60651 Class 2. Minimum (Lmin)
and maximum (Lmax) sound pressure levels were measured for 5-minute and repeated for three exposure
periods (morning, afternoon, evening). Results: 68% and 32% of the workers were 20-30 years old and had
been employed for 3-5 years, respectively. Average noise exposure level observed was 63.3-101.5 dBA. 25%
of the workers reported that they were sometimes experienced the symptoms of hearing loss. These include
difficulty in understanding conversation and ringing in the ear. However, noise exposure and hearing loss
symptoms were not significantly associated. Conclusion: The study findings suggest that the workers have a risk
of developing hearing loss. Intervention programme and enforcement on hearing protection of the workforce
are highly recommended.
Magnetic resonance imaging is gaining importance in the diagnosis of nerve and muscular disorders. The ability of magnetic resonance imaging to delineate the different muscles and the nerve in any plane has made the differentiation between the changes of neuropathy, denervation, and nerve entrapment possible. Although findings on magnetic resonance imaging are non-specific, their use, coupled with clinical symptoms and electromyographic findings, allow an accurate diagnosis to be made without resorting to invasive biopsies.
Immunoglobulin G, A and M levels were determined in paired maternal and cord sera of premature, full term and postmature newborns of urban dwelling Chinese, Indian, Malay and full term newborn of the forest dwelling Orang Asli (Malaysian aborigines). The mean serum IgC level in the full term Orang Asli newborns (1254±441 mg per 100 mil is comparable to that of the Indians (1211±282 mg per 100 ml) and Malays (1169±286 mg per 100 ml) but these levels are higher than those of the Chinese
newborns (1092±270 mg per 100 ml). Statistical analysis indicates a significant dependence of cord serum IgG level on maternal serum IgG level in the . Chinese, Indians and Malays. In addition, in Indians the cord serum IgG was significantly dependent at 5% level on the gestation age. The fetomaternal serum IgG level ratios at term were equal to or just less than one. The cord serum IgM levels of the Chinese, Indian, Malay and Orang Asli newborns at term were 11.6.±. 6.5, 12.5.±. 7.3, 10.9.±. 5.8 and
16.7±6.9 mg per 100 ml respectively. Statistical analysis showed absence of correlation between cord serum IgM level and birthweight, gestation age or maternal serum IgM level in Chinese and Malays. In Indians the cord sera IgM level showed a dependence on the birthweight. Immunoglobulin A was present in 34.6%, 40.5%, 31.6% and 62.5% of full term Chinese, Indian, Malay and Orang Asli newborns respectively. These observations are discussed in relation to the immunoglobulin levels observed in populations residing in temperate and other tropical regions.
83 Malays with HbE beta-thalassaemia who were not transfusion dependent were investigated. 79 persons showed no beta0 formation indicating the predominant gene in Malays with HbE beta-thalassaemia was beta0. HbF assays showed levels that were similar to transfusion dependent patients. Further studies are necessary to determine the presence of the alpha, (alpha+) gene Interacting with HbE and beta0 to produce the milder phenotype of HbE beta-thalassaemla.
Foreign body granuloma is a reaction to either a biodegradable substance or inert material. In a breast cancer patient who had undergone an excision or mastectomy with axillary clearance, a foreign body granuloma in the axilla may be misinterpreted as an axillary lymph node. We report our experience with a case of cotton-ball granuloma of the axilla in a breast cancer patient, which mimics a lymph node radiologically from the CT scan, mammogram and ultrasonography. Following biopsy and excision, the mass was diagnosed histologically as a foreign body granuloma.
We hereby present a case of planned complex suicide. In this case study, we report a teen-aged girl who committed suicide by strangulating herself, and subsequently fell from the 13th floor of a housing apartment. The planned complex suicide was substantiated by the presence of a suicide note and a photograph captured in a mobile handset. To the best of our knowledge, it is the first case involving self-strangulation and fall from height, in which the photograph was stored in the handset. This is to further emphasize that objects like mobile handsets can be important in determining the cause and manner of death. The available evidence at the site of incident should be explored meticulously in order to arrive at a proper conclusion.
The EQ-5D is a quality of life instrument that measures five dimensions of health. This study investigated the reliability and validity of its use in the Malaysian dialysis population. Test-retest reliability, convergent and discriminant validity were assessed. Responses of 86 subjects who completed both surveys were used in analysis. Test-retest reliability using Cohen's kappa was acceptable in four out of five dimensions, with the exception of self-care. Convergent validity was present. Discriminant validity was found in only two out of six hypotheses tested. In conclusion, the EQ-5D has potential in this population but further study is required.
The single emulsion or single screen system is usually reserved for mammography since its use in general radiography is limited. The purpose of this study is to compare the mammographic film-screen combination (MFC) and the standard film-screen combination (SFC) in terms of fracture and soft tissue injuries detection. PATIENTS, METHODS AND MATERIALS: In this prospective study, 41 patients from Accident and Emergency suspected of having injury in the hands, wrists, ankles and feet regions were radiographed using both MFC and SFC. These were compared in terms of image quality, presence of fractures and soft tissue injuries. The two different film-screen combinations were also compared in terms of detection of bony fragments, film characteristics such as film speed, contrast and spatial resolution, dose and cost.
Ten solvents were used to extract phytochemicals from the peel of Carica papaya cv. Sekaki/
Hong Kong to evaluate antibacterial activities and determine chemical composition of Carica
papaya cv. Sekaki/Hong Kong seeds. The antibacterial activities of ten solvent extracts were
tested against 14 microorganisms vis Shigella sonnei, Salmonella typhimurium, Escherichia
coli, Salmonella enteritidis, Vibrio vulnificus, Vibrio parahaemolyticus, Proteus mirabilis,
Staphylococcus aureus, Bacillus cereus, Listeria monocytogenes, Corynebacterium diphtheria,
Clostridium perfringens, Streptococcus pneumoniae and Bacillus subtilis using disk diffusion
test (DDT). The Carica papaya seed of ACN and MeOH extracts inhibited 11 microorganisms,
indicating their broad spectrum activity. The disk diffusion test exhibited moderate and clear
inhibition on C. diphtheria, S. pneumonia, B. subtilis and C. perfringens. MeOH extract
inhibited S. enteritidis, V. vulnificus, P. mirabilis and B. cereus with the lowest MIC at 11.25
mg/mL each, thus was chosen as the best extract. The hierarchy of extract potency can be
ranked as MeOH > acetone > ACN > CHCL3 > hexane > DE = PE > EtOH > DCM based
on clear and moderate inhibition and the lowest MIC. TPC and TFC of the extracts ranged
between 4.83 to 22.59 mg GAE/g DW and 1.32 (water) and 17.15 mg QE/g DW respectively.
The GC/MS analysis of MeOH extract identified potential antibacterial compounds such as
isothiocyanatomethyl benzene, 9-octadecenoic acid, hexadecanoic acid and β-sitosterol. The
Carica papaya seed cv. Sekaki/ Hong Kong possessed significant antibacterial activities when
extracted by different solvents in particular MeOH solvent.
Introduction: Smoking is a well-known cause of oral disease and oral cancer. Several dysplastic cytological changes occur before the appearance of the clinical lesion. This study aimed to investigate the cytopathological effects of smoking in clinically normal oral mucosa of cigarette smokers.
Materials and Methods: A total of 40 cigarette smokers and 40 nonsmokers (control group) were included in this study. All participants had clinically normal oral mucosa. Oral smears were obtained from the side of the tongue and floor of the mouth using a Cytobrush. The smears were stained by Papanicolaou stain and examined under light microscope for inflammation, hyperkeratinization and dysplasia.
Results: There was a significantly higher rate(p<0.005) of inflammation 63%, hyperkeratiniztion 62% and mild dysplasia 26% among smokers than non-smokers where the rates were 35%, 12% and 2% respectively.
Conclusion: Smoking causes significant cytopathological changes in normal oral mucosa, the detection of which is important to prevent progression into carcinoma. The procedure is fast, painless and inexpensive.
KEYWORDS: Papanicolaou stain, brush biopsy, cigarette smokers, dysplasia, oral mucosa
The present study was carried out to investigate the composition of species and species diversity at Compartment 28A in the Ulu Muda Forest Reserve (UMFR), located in north-west of Peninsular Malaysia. The area covered was one ha. Stems with diameter at breast height (dbh)as ≥ 1 cm were enumerated, identified and their height measured. The importance value index (IVI) was estimated to show which species have the highest value, since species density was also estimated. We recorded 722 species from 81 genera belonging to 42 families. The highest IVI was recorded for Macaranga hosei (42.40). It was also the highest in stand density (33 individuals / 4.43 %) in one ha. Species from Euphorbiaceae were represented at the highest level, with 11 genera (about 210 individuals). The total above-ground biomass (TAGB) in one ha using three different modifications from Kato et al. (190.3 t/ha), Kueh and Lim (2522.8 t/ha) and Lim (174.7 t/ha) were noted from family Dipterocarpaceae.
In this study, we investigated the conductivity enhancement of calix[8]arene-multi-walled CNTs (MWCNTs) thin film.
Two types of calix[8]arenes were used, which were 5,11,17,23,29,35,41,47-p-tert-butyl-49,50,51,52,53,54,55,56-
oktakis[(carboxy)-pentoxy] -calix[8]arene (C[8]1) and 49,50,51,52,53,54,55,56 -octahydroxycalix[8]arene (C[8]2).
The monolayer properties of these two types of calix[8]arene on water subphase were examined. Later, the thin films
were fabricated by combining different ratios of each types of calix[8]arene with MWCNTs using spin coating deposition
technique. Then, the developed thin films were characterized using surface potential meter and four point probe. Thin
films of C[8]2 with hydroxyl groups at lower rims demonstrated higher surface potential and conductivity as compared
to the thin films of C[8]1 with upper rims of tert-butyl groups and lower rims of carboxyl groups. These results indicated
that the conductivity of calixarene thin films can be enhanced by MWCNTs through simple spin coating technique.
Tropical forests are highly diverse and provide a great deal of economic value. They play an important role in providing goods and services which contribute to long-term social benefits in local communities. This study was carried out to examine the tree composition and estimate its economic value of timber resources in a lowland coastal forest. Four one ha plots were established in Pasir Tengkorak Forest Reserve in Langkawi, Kedah and the subplots measuring 10 × 10 m were established in each plot. All trees greater than 1 cm DBH (diameter at breast height) were identified and the parameters measured included tree height and diameter. The species diversity indices obtained for all four plots were relatively high. The Simpson’s index of diversity ranges from 0.946 to 0.969, while the Shannon-Weiner index (H’) ranges from 3.808 to 5.616. The Simpson’s measure of evenness (1/D) ranges from 0.239 to 0.563 suggesting that species evenness in the four ha plots were low. Stumpage value of timber in the study area was quite high with average value of RM33,600.46 per ha. Regression analysis showed that the relationship between stumpage value and species diversity was significant at the 5% level.
The present work aimed to determine the best formulation of mixed drink made from red cabbage and roselle extracts. Six mixed drink formulations were prepared based on different ratios of red cabbage to roselle extracts: F1 (30:20); F2 (35:15), F3 (40:10); F4 (20:30); F5 (15:35) and F6 (25:25). Samples were prepared by pasteurising the mixed drinks with the pre-determined amount of ingredients at 90°C for 5 sec. The pH of roselle extract (2.06 ± 0.02) was found to be more acidic as compared to red cabbage extract (6.38 ± 0.03). This contributed to the low pH in mixed drink formulations (2.68-3.48). Total titratable acidity (TTA) (0.44-0.89% malic acid w/v) and total anthocyanin content (247.99-339.77 mg cyanidin-3-glucoside/L) were shown to increase significantly with increasing roselle extract concentration. Similarly, total soluble solids (TSS) (12.23-12.83°brix) was found to increase significantly with higher ratio of red cabbage extract due to high TSS content (7.67 ± 0.08°brix) in the extract as compared to roselle extract (4.63 ± 0.09°brix). There were significant differences among all the samples in L*, a* and b* values. Mixed drink formulations that contained higher concentration of red cabbage extract were lighter and redder in colour. Significant differences were observed in sweetness, sourness, taste and overall acceptability of drinks, with F3 yielding the highest mean scores for all attributes. Mean score of sensory attributes of the mixed drinks were related to physicochemical properties. Mean scores of all sensory attributes had negative correlation with TTA. Sweetness mean score was positively correlated to the L* value, sourness mean score was positively correlated with pH, L* and a* values but negatively correlated with b* value, and colour mean score had positive correlation with a* value. Therefore, it can be concluded that panellists preferred less sour drinks, which were lighter and redder in colour.β-carotene onto the PKSAC in a model system but yielded the highest desorption efficiency.
Introduction: Preparation of herbal mixtures from the traditional knowledge has been used for over centuries to im- prove and maintain health condition. Nonetheless, lack of scientific evaluations on regard to their bioactive metab- olites as a mixture and their pharmacological effects have yet to be reported. Therefore, the objectives of this study are 1) to determine the effect of processing techniques (blending and juicing) on extracting polyphenols and 2) to determine the effect ratio of honey in herbal mixture (containing ginger, garlic, honey, apple cider vinegar, and lem- on juice). Methods: Raw ingredients such as garlic, ginger, lemon and apple cider (1:1:1:1) were used as the base for this herbal mixture. The base was either blended using a blender or juiced using a juicer. The mixture was simmered (85oC - 100oC) until reduced to half of the initial volume and cooled down before being added with honey in 1:1 (rA) or 1:3 (rB) ratio. The mixtures were tested for pH, total phenolic, total flavonoid content and alpha glucosidase inhibitory activities. Results: Both of juiced samples in both honey ratio (rA and rB) have lower acidity compared to blended samples. Total phenolic content (TPC) and total flavonoid content (TFC) also showed significantly high- er levels (p
Clonal disorders of LGL may either be CD3+ CD56- or CD3- CD56+ phenotype and these have been designated as T-cell leukaemia (T-LGL) or natural killer cell (NK)-LGL leukaemia respectively. Clonality is usually demonstrated by clonal rearrangement of T-cell receptor gene rearrangement or identified by flowcytometry analysis. Most patients with T-LGL will have an indolent course. In this report we described an aggressiveness of disease in a patient with clonal CD3+ LGL leukaemia whose cells also co-expressed CD56 diagnosed by flowcytometry. The patient responded well to interrupt ALL standard risk protocol however succumbed to her disease while waiting for upfront stem cell transplant. This case highlights on both the classical laboratory findings of rare entity of disease as well as a review of the literature pertaining particularly on its management.
A 42-year-old Malay gentleman presented with progressive painless blurring of vision on his left eye associated with ocular ache, redness and increasing proptosis. Examination revealed presence of relative afferent papillary defect with visual acuity of counting finger, and 6/6 on the right eye. Extraocular muscle movement of the left eye was restricted to ten percent in all directions. Computed tomography (CT) and magnetic resonance imaging (MRI) showed enhancing mass occupying the left orbital apex. Diagnosis of optic nerve sheath meningioma was made, and patient subsequently went for radiotherapy. His symptoms subsided completely, until he presented with similar visual complains, and fullness of the upper lid two years later. A repeated MRI showed enlargement of superior and lateral recti muscles with extension to lacrimal gland region. Biopsy of the lacrimal gland revealed inflammatory cells consistent of inflammatory pseudotumor. High dose systemic steroid was instituted, followed by slow tapering of oral steroid. His symptoms completely resolved, and latest visual acuity was 6/9, with no recurrence, to date.