ABSTRACTS FOR INTERNATIONAL HEALTH AND MEDICAL SCIENCES CONFERENCE 2019 (IHMSC 2019)
Held at Taylor’s University Lakeside Campus, Subang Jaya, Selangor, Malaysia, 8-9th March, 2019
Introduction: Unsafe blood products cause transfusion-transmissible infections among blood receivers. The knowledge and perception of blood donors is important as it is associated with their donation behaviour and hence the safety of blood products. There was no previous study that assessed the knowledge and perception on blood safety issues among blood donors to date. The objective of this study was to assess the knowledge and perception of blood
donors on blood safety issues.
Methods: This was a pilot study conducted to pilot test the self-developed questionnaire by the researchers. The questionnaire was available in the Malay language. One-hundred-thirty donors at the National Blood Centre were recruited to complete the self-administered questionnaire. Health sciences professionals, medical students and non-Malaysians were excluded in this study.
Results: A total of 130 donors comprising of 70 males (53.8%) and 60 females (46.2%) responded. The mean age of the respondents is 32.48±8.86 years. Most of the respondents were Malay (55.4%), single (49.2%), working in private sector (46.9%) and regular donor (68.5%). More than half of the respondents did not know that dengue, Zika and mad-cow disease can be contracted through blood transfusion. Ten percent of the respondents answered that bisexual people are eligible to donate blood. 40.7% of the donors agreed to check their HIV status through blood donation. Majority of the donors (60.7%) agreed that the donors’ blood is safe if the screening test is negative. Whereas, 33.9% of the donors disagreed that they shall be responsible if their blood causes infection.
Conclusion: Several knowledge gaps and inappropriate perception among the respondents were identified and these might affect the safety of the blood products. Targeted measures should be taken to rectify donors’ knowledge and perception in order to minimise inappropriate blood donor behaviours and reduce unsafe blood products.
Introduction: About 18% of Malaysian Armed Forces (MAF) personnel are diagnosed with either hypertension, diabetes or coronary artery disease, while another 8% are obese. The rising prevalence necessitates intervention.
Methods: This is a single blinded randomized controlled trial among overweight and obese MAF personnel attending medical checkup in MAF hospital in Kuala Lumpur. An intervention module was developed to increase their physical activity level. Short version of International Physical Activity Questionnaire was used to assess physical activity in metabolic equivalent of task score (METs score), while blood pressure, body mass index (BMI), blood lipid profile and fasting blood sugar measurements were also obtained. These parameters were measured at baseline and again at 6 months. Generalized estimating equations (GEE) statistical test were applied to evaluate the effect of the intervention.
Results: Response rate was 100%. Most of participants were aged above 40 years, male, from Malay ethnic group, completed secondary education and had monthly income above RM 4000. Most of the respondents were obese and had moderate level of physical activity at baseline. All variables compared between groups at baseline showed no significant difference. At six months, after controlling for covariates, the significant difference was only in METs score. The odds of having high METs score in the intervention group after receiving intervention was nearly 3 times higher than those in the control group, after adjusting for interaction between time and group as well as other covari- ates (AOR = 2.908, 95% CI 1.323 – 6.391, P=0.008).
Conclusion: Intervention was effective in increasing physical activity among overweight and obese military personnel.
Study site: Malaysian Armed Forces Hospital, Kuala Lumpur, Malaysia
Introduction: Female Genital Cutting (FGC) is a sensitive issue as this topic is always associated with religion and culture in Malaysia. In the past, FGC is performed by the traditional midwives. However, this practice has been med-icalized nowadays. This study aimed to understand the reasons of performing FGC, the decision making, the practice and the future of FGC among rural community in Northern Malaysia. Methods: Focus group discussions (FGD) were conducted on three groups of young women aged 18-45, older women aged 45 and above and a group of married adult men. All of them were Malay Muslims who were conveniently selected from a rural village in Northern Malay-sia. A semi-structured interview guide was used to conduct the FGD focusing on the reasons, decision making, the practice and the future of FGC. Data was collected until saturation of information was achieved. These participants were chosen based on their willingness to take part in the discussion and also based on their personality of being talkative and able to give feedback to the questions. Results: The result of the interviews revealed that religion is the reason of practicing FGC. All of the participants from each FGD prefer to go to the doctor in the clinic compared to the traditional midwives. The men in this FGD mentioned that they rarely involved in the decision making of the FGC and only the mother or the grandmother to take the responsibility to decide. Conclusion: Generally, majority Malay Muslims community from the rural areas in Northern Malaysia believed that FGC is compulsory in Islam and they prefer to go to the doctors to perform FGC.
Benzene has been measured in indoor environments for many decades and has been identified to cause variety of health effects. Children spend most of their time indoors such as daycare centre, preschool and school, they are more likely to be exposed to indoor air pollutants. This paper was aimed to review the exposure to benzene among children within indoor environments from worldwide studies from 2003 to 2018. Based on 24 papers evaluated, 54% were conducted in primary schools. The highest concentration of benzene was found in preschools in China at 148.0 µg/m3. The benzene levels were found higher in indoors than outdoors for most of the studies. Active sampling techniques were used in 42% of studies that enable the determination of acute health effects on children during short-period of exposure time. Differences in sampling techniques and durations make it hard to compare the outcomes of the studies with health-effect guidelines. This review indicated a diversity of sampling approaches and techniques, pointing to the importance of establishment of standard method for collecting and reporting data.
Introduction: Acalypha indica is commonly referred to as “pokok kucing galak”. It is an herbaceous species that grow along the earth’s equator line, including the wet, temperate and tropical regions. Domestic cats experience the effect of this plant by reacting very favorably to the root. The first compilation of the ethnopharmacology and phytochemistry of the Acalypha plants was published. This genus is the fourth largest genus of the Euphorbiaceae family, with about 500 species. However, the review only represents about one third of the species from the Acalypha genus. Methods: Hence, this study is performed to obtain updates on the biochemistry of this plant, via literature search. Results: From the articles, almost every part of the plant, including the leaves, stems and roots, are used as traditional remedies. Local people consume the plant for therapeutic purposes such as anthelminthic, anti-ulcer, anti-bacteria, anti-microbial and wound healing. In homeopathy practice, it is used for asthma and bronchitis. Nevertheless,
there is still a potential risk of using A. indica. It was reported that this traditional medicine could induce Intravascular haemolysis in patients with a glucose-6-phosphate-dehydrogenase (G6PD) deficiency. Clinical evaluations of Acalypha extract could be utilized to justify the ethnomedicinal claims and for the safety of its therapeutic applications. Meanwhile, there is an increase in the phytochemical and chromatographic experiments of A. indica that could introduce the extract’s role in pharmaceutical, nutraceutical, zoology and veterinary fields. It contains secondary metabolites, including dihydroactinidiolide; a terpenoid, alkaloids, flavonoids and steroids, for example, brassicasterol. Conclusion: The finding of this review concludes that Acalypha is a natural source, worth to be further investigated. It is hoped that new biologically active constituents could be discovered, since only few Acalypha species were comprehensively studied.
Introduction: Estimation of gestational age (GA) is clinically crucial for managing pregnancy and assessing the foetal anatomy, growth and development. Transverse cerebellar diameter (TCD) has been reported as an accurate tool for dating the pregnancy. This study aimed to determine the accuracy of foetal TCD for dating the pregnancy and to con- struct a reference chart for GA of Yemeni foetuses. Methods: We conducted this prospective cross-sectional study among 400 Yemeni pregnant women between 18 and 40 weeks of gestation provided that they were with known last menstrual period and singleton normal pregnancies. Sonographic TCDs were measured for each foetus. The mean TCD was measured for gestational weeks separately, and a polynomial regression model was then used to predict the GA by TCD. Results: There was a robust correlation between GA and TCD (r = 0.995, p
Joint involvement is common in systemic lupus erythematosus (SLE) patients, however, screening for joint specific autoantibodies in patients is not routinely performed. This may be due to the lack of known antigens and available tissue. The rat musculoskeletal tissue may be a suitable source of antigen to detect arthritic autoantibodies.
Method: We tested plasma of SLE patients, with arthritis (N=9) and without arthritis (N=7) as well as plasma from normal individuals (N=7) on fresh sectioned tissue from rat plantar hind paw using indirect immunofluorescence method.
Results: Binding of autoantibodies to striation in skeletal muscle cells in the tissue was clearly demonstrable in all samples from SLE with arthritis but not on slides incubated with plasma from normal or SLE without arthritis.
Conclusion: Thus, rat plantar tissue may be suitable for detecting autoantibodies from SLE patients that may be involved in the pathogenesis of lupus arthritis.
Yolk Sac tumour (YST) of the nasal cavity is extremely rare with only less than five previously reported cases in the English literature. Due to its rarity, the diagnosis is not one that is considered at initial presentation until tissue biopsies are sent for histopathological examination. Serum α-fetoprotein levels aid in diagnosis and in monitoring progression of the tumour. Being a very uncommon tumour of germ cell origin presenting as localized disease in the nasal cavity, prognosis and survival rates are difficult to determine. We are reporting a rare yolk sac tumour case in an infant and the challenges encountered in its management.
Presently, there is no specific federal legislation governing articular cartilage tissue engineering (ACTE) experimenta- tion practices in Malaysia. However, there are related regulations and guidelines provided by government agencies to oversee and guide such practices. The rules and regulations provided in the documents have the essential aim of safeguarding public health through ensuring that non-clinical studies reach a certain quality, efficient and safe for hu- man use. There are themes identified when scrutinising relevant documents which includes, the need for authorised personnel and the establishment of facilities in conducting such experiments, the aspect of cell-scaffold construct development, the use of human materials, the aspect of biosafety, animal care and use during the experiments, and considerations on the impact on the environment. The individual laboratory or facility shall adopt and adapt these standards as deemed appropriate by the ACTE researchers to ensure that non-clinical studies are conducted in a proper and ethical manner.
Introduction: Most patients with malocclusion are given orthodontic leveling therapy with the aim of reducing the vertical discrepancy between teeth. This computational study aims to evaluate the degree of deformation of su- perelastic NiTi arch wire upon bending at different deflections in a bracket system. Methods: A three-dimensional finite-element model of a wire-bracket system was developed to simulate the bending behavior of superelastic NiTi arch wire in three-brackets configuration. A superelastic subroutine was integrated in the model to anticipate the superelastic behavior of the arch wire. The mid span of the arch wire was loaded to different extent of deflections, ranging from 1.0 to 4.0 mm. The mechanical deformation of the arch wires was accessed from three parameters, in specific the unloading force, the bending stress and the martensite fraction. Results: The superelastic wire deflected at 4.0 mm yielded smaller unloading force than the wire bent at 1.0 mm. The bending stress was highly localized at the wire curvature, with the stress magnitude increased from 465 MPa at 1.0 mm to 951 MPa at 4.0 mm deflection. The martensite volume consistently increased throughout the bending, with a fully transformed martensite was ob- served as early as 2.0 mm of deflection. The magnitude of bending stress and the volume of fully transformed mar- tensite increased gradually in relation to the wire deflection. Conclusion: The wire-bracket system induced localize wire deformation, hindering complete utilization of superelasticity during orthodontic treatment.
Introduction: Bladder cancer is associated with high risk of tumour recurrence and therapeutic resistance. Cancer stem cells (CSC) within a particular tumour are postulated to drive tumorigenesis and influence tumour behaviour. Recent studies have shown that Newcastle disease virus (NDV) is able to selectively kill and exert a strong oncolytic effect against various cancer types. However little is known about the oncolytic effect of NDV against CSC. In this study, the oncolytic effect of NDV against putative bladder CSC was examined. Methods: Putative bladder CSC was selectively grown in the form of 3D-spheroids from six different bladder cancer cell lines. The spheroid cells were characterised for their stemness properties to ensure that these cells truly represent CSC. This was conducted via the analysis of CSC associated genes and cell surface markers expression. Subsequently, the oncolytic effect of the wild-type NDV-AF2240 strain against the bladder cancer spheroids was investigated. Results: All the spheroids expressed significantly high levels of CSC-associated genes. Flow-cytometry analysis revealed that the expression pattern of the CSC-associated surface markers was different in the spheroid cells; suggesting heterogeneity in the expression signatures of these cells. The infection of spheroids with NDV showed that the NDV was able to target bladder cancer spheroids but there was a spectrum of response across the different spheroids. Intriguingly, NDV was able to persistently infect bladder cancer spheroids that were not sensitive towards NDV infection as the presence of NDV viral genes were detected in the spheroid cells. The NDV persistently infected bladder cancer spheroids were resistant to superinfection and developed an antiviral state by expressing low levels of interferon-beta (IFN-b). NDV persistency of infection affects the process of epithelial to mesenchymal transition (EMT) of cancer cells as the spheroid forming ability of an established NDV persistently infected bladder cancer cell line, EJ28-PI was shown to be impaired. The EJ28-PI cells expressed significantly high levels of the EN2 gene. Knockdown of the EN2 expression reduced the viability of EJ28-PI cells; suggesting a role for EN2 in mediating NDV persistency of infection in cancer cells. Conclusion: Bladder CSC gene expression signatures influence the efficacy of NDV-mediated oncolysis. Our current work is focused on identifying genes and signalling pathways that influence NDV-mediated oncolysis us-ing whole-transcriptomic sequencing. The findings of this study can potentially be used to enhance the efficacy of NDV-mediated oncolysis and accelerate the translation of NDV as an oncotherapeutic agent in the clinic.
Introduction: Cardiac rehabilitation is one of the secondary prevention programme to reduce morbidity and mortal- ity in cardiac patients. However, adherence towards this programme is still sub optimal. The objective of this study isto determine the perceived barriers on cardiac rehabilitation programme among cardiac patients and its association with the sociodemographiccharacteristics. Methods: A preliminary study using the Cardiac Rehabilitation Barrier Scale (CRBS) was conducted in a tertiary hospital among 40 patients. The CRBS tool was validated and tested for reliability.Convenience sampling method was used among those who have attended the cardiac rehabilitation pro- gramme. Ethical approval was obtained from the institution ethical committee. There were total of 22 items in the CRBS except for the last item (22nd) being an open-ended item to enable the patients to share their opinion on any other barriers towards attendance to cardiac rehabilitation programme. The 21 items assessed on patients’ opinion on the perceived barriers during their attendance to the cardiac rehabilitation programme in a form of Likert scale. Results: The overall mean (SD) score for the 21 items was 60.70 (8.77) showed that the patients were able to un- derstand gave their best options on the opinions towards CRBS. The highest mean on item 11 on ‘time constraints’ at 3.58 (0.75). Thus, the majority of the patients scored the item “time constraints’ as the highest perceived barrier during attendance in the cardiac rehabilitation programme. The association of the sociodemographic status had sig- nificance difference (p
Introduction: Sun exposure is a risk for skin cancer but is beneficial for multiple other diseases. Recommendations for photoprotection are well defined, guidelines for optimal sun exposure is not clear. We determined sun exposure in healthy adults, considering their skin phototype and amount of skin exposed. Methods: A cross sectional study was performed involving healthy adults working in a tertiary health facility. Fitzpatrick skin phototype quiz was used to determine skin phototype. Sun exposure was quantified as an index (SEI); body surface area exposed times duration of exposure. Results: We recruited 167 volunteers, 110(66%) women and 56(34%) men. Mean age was 29.77±6.58 years, 124(74.7%) were Malay, 27(16.3%) Chinese, 14(8.4%) Indians and 1(0.6%) of other ethnicity. Fitzpatrick skin phototypes were 30(18.1%) type III, 109(65.7%) type IV and 27(16.3%) type V. Exposed body surface area was 13.96±8.33% in males and 14.55±9.58% in females. The duration of sun exposure per week in males was 11.52±6.11hours and 10.71±5.75 hours in females. Mean SEI was 160 ±144. The SEI in females was 158 ±151, 164 ±130 in males, p value =0.81. There were no significant differences in SEI between gender and skin phototypes. Conclusion: SEI was very low in our study population due to limited body surface area exposed and duration of sun exposure. SEI was higher in darker skin and males, however these were not statistically significant.
Introduction: Tobacco smoking is a major public health concern worldwide as it is one of the major risk factors for non-communicable diseases leading to burden of adverse health effects in their later life. According to Global Adult Tobacco Survey Malaysia (2011), 43.9% of men, 1.0% of women, and 23.1% overall currently smoked tobacco. It is important to prevent smoking uptake and promote smoking cessation to reduce the impact of tobacco smoking. The constant monitoring of the magnitude of smoking and its influencing factors is crucial for effective planning of anti-smoking programs. This study aimed to determine the prevalence of smoking and its associated factors among male villagers in Kampung Barambangon, Kudat, Sabah. Methods: A cross-sectional study was conducted among male villagers aged 15 years and above in Kampung Barambangon, Kudat District, Sabah State. Non probability convenience sampling was employed. The study period was from March to April, 2019. Data collection was done by using pretested self-administered questionnaire and a total of 97 villagers were participated in the study. Chi-square test was used for statistical analysis. Results: The study revealed that the prevalence of smokers among male residents in Kampung Barambangon was 50.5% (95% CI: 48.6–52.1%). It was found that there were significant associations between smoking status and positive attitude towards smoking (p-value 0.001), having siblings who smoked (p value 0.001), having high percentage of friends who smoked (p-value 0.009) and high educational level (p-value 0.005). Conclusion: The prevalence of male smokers in Kampung Barambangon was higher than the national prevalence. The findings may help in understanding the magnitude of the smoking problem and its associated factors which can be used for effective tobacco control and intervention programs.
Introduction: Single parent families, especially, those headed by single mothers are becoming increasingly common around the world especially in Malaysia. Single mothers generally suffer from poorer mental health, job discrimina- tion, abuse and neglect. Hence, they often experience high anxiety, depression, and stress. This calls for research to empower their mental wellbeing. The present study examined the effectiveness of creative group counselling in increasing self-compassion, and decreasing depression, anxiety and stress among single mothers. Methods: A qua- si experimental pre-test post-test design was employed in the study. Research participants consisted of 36 single mothers placed in two experimental and two control groups. The instruments used were Self-Compassion Scale and Depression Anxiety and Stress Scale. A self-compassion module was developed that comprised creative therapeutic activities which was administered to the participants in the experimental groups via a 7-session group counselling programme. Participants in the control groups, on the other hand, took part in guidance activities. Semi structured in- terviews were also performed to gather feedback on the impact of the creative intervention from three single mothers. Results: Findings revealed that creative group counselling successfully increased the level of self-compassion among single mothers. Additionally, the depression, stress and anxiety scores of single mothers were lower after joining the group counselling programme. Furthermore, three themes emerged from the present study which are i) be kind to oneself; ii) mistakes are part of life; and iii) self-transformation. Conclusion: It is evident that the implementation of creative group counselling improves the mental wellbeing of single mothers.
A 64-year-old Malay gentleman alleged occupational injury when a malfunctioned metal hydraulic door hit on his face while unloading sand from his tipper-truck. Post-trauma, he complained of right eye (RE) pain and total loss of vision. On examination, noted RE visual acuity was unable to be assessed and left eye (LE) was 6/24 with pinhole 6/9. No eyeball could be seen in the right socket with superior orbital rim step deformity and left periorbital haema- toma. Computed tomography scan of the brain and orbit confirmed displaced right eye globe into the right anterior cranial fossa with right and left multiple orbital wall fractures. He then underwent successful right eye globe reposi- tioning. Traumatic orbital roof fracture is a rare condition. Repositioning of the eye globe was done to salvage the eye globe for a cosmetic reason and to avoid localised inflammatory reaction at the anterior cranial fossa.
In this paper, we report three cases of orbital rhabdomyosarcoma in different age groups with different histopathologic types. Case 1 is a 10-year old Malay boy who presented with painless proptosis of the left eye. Magnetic resonance imaging (MRI) showed soft tissue mass arising from the lateral rectus muscle. Tissue biopsy revealed rhabdomyosarcoma of embryonal type. Case 2 is a 32-year old Malay man who presented with a progressive left eye proptosis associated with pain and redness. Computed Tomography (CT) scan showed a retrobulbar mass extending medially in the left orbit. Meanwhile, biopsy showed rhabdomyosarcoma of pleomorphic type. Case 3 is a 67-year old Malay woman who presented with proptosis and fungating growth of left orbital region, epistaxis and nasal blockage. CT scan revealed an ill-defined mass filling up the left orbital cavity. Biopsy showed rhabdomyosarcoma of alveolar type. Rhabdomyosarcoma is the most common in childhood but it should be considered as a differential diagnosis of orbital tumours irrespective of age.
Automotive industry in Malaysia is one of the booming industries which encompass the design, development and manufacturing of motor vehicles. However, it has its own setback as the interaction between complex tools, machines, and instruments, coupled with humans as workers pose several health hazards. A cross-sectional study was conducted to determine the prevalence of musculoskeletal disorders (MSD) and the association with awkward posture among automotive assembly line workers. A simple random sampling method was adopted and data were collected based on Standardized Nordic Questionnaire (SNQ) and Rapid Upper Limb Assessment (RULA) method for analysing awkward posture. With a response rate of 83%, a total of 232 assembly line workers with at least one year job tenure participated in this study. The findings revealed that 78.4% of workers reported MSD while the highest percentage of complaints concerned the lower back (50.9%). Three factors were found to be significantly associated with MSD: age (χ2=5.61, p=0.018), job tenure (χ2= 8.26, p=0.004) and awkward posture (χ2= 65.37, p < 0.001). Logistic regression analysis indicated that significant risk factors for MSD symptoms were workers aged ≥ 25 years old (OR= 2.25, 95%CI 1.14-4.46) and those workers with equal and more than three years job tenure (OR= 2.44, 95%CI 1.04-5.63). In addition, workers in the very high and high RULA action level who were 69 times (OR = 69.38, 95%CI 14.51- 331.73) and 12 times (OR = 12.42, 95%CI 5.21-29.58), respectively, also had higher odds of complaints of MSD. The high prevalence of MSD shows that MSD symptoms is a significant problem among automotive assembly line workers while age, job tenure and awkward posture based on RULA action level are the significant factors for MSD. In particular, this study proves that the prevalence of MSD increases as the RULA action level and job tenure increases. Thus, this problem could be reduced by decreasing RULA action level through appropriate ergonomic workstation design and ergonomic training for workers.
Introduction: Sustained optimal adherence to antiretroviral therapy (ART) is required for long-term suppression of vi- ral replication. However, adherence level in Jos, Nigeria has been reported to be below optimal adherence, thus this study investigates the predictors of adherence to antiretroviral therapy among Human Immunodeficiency Virus (HIV) patients there. Methods: A validated and pretested questionnaire was used in this cross-sectional study to collect data on sociodemographic characteristics, duration of being on ART, alcohol consumption, presence of symptoms, drug type and disclosure status from 224 randomly selected adult HIV patients. Chi-square and binary logistics re- gression were used for data analysis. Level of significance was set at 0.05. Results: Only 14.3% of the respondents had optimal adherence. Adherence to ART is significantly associated with gender (p = 0.043), duration of ART use (p = 0.041), alcohol (p = 0.029), drug type (p = 0.001), and disclosure status (p = 0.004). Binary logistics regression reveals that females are 2.4 times more likely to have optimal adherence than males, patients on ART for over 10 years are 2.5 times more likely to have optimal adherence than those less than 10 years, and patients with disclosed HIV status are 3.3 times more likely to have optimal adherence than those who had not. Conclusion: Generally, the patients had suboptimal adherence. Being female, having longer duration on ART and disclosure status are predictors for optimal adherence. Intervention with emphasis on males and new patients on ART is recommended to educate on optimal adherence and motivate patients to disclose their status.
Introduction: Low job satisfaction among healthcare workers may lead to high turnover intention, poor job perfor-mance, high absenteeism, and low patient satisfaction. Global and local needs for health workforce are increasing in trend to meet current health demands. Addressing job satisfaction of the healthcare workers is a practical way to uti-lise the available human resources optimally. The main aim of this study is to determine job satisfaction level and its associated factors among healthcare workers in health clinics under the Petaling District Health Office jurisdiction in Selangor, Malaysia. Methods: A cross-sectional study was conducted among healthcare workers in ten health clinics in Petaling District from April until May 2019. Simple random sampling method proportionate to the number of staffs from each health clinics was done. A structured self-administered questionnaire was used. Results: The response rate was 93%. Majority of the respondent were female (83%), married (82%), diploma holder (41%), nurses (33%) and working in health clinics with specialists (93%). The job satisfaction mean score for the studied population was 4.46 (SD = 0.72). Self-rated physical health and mental stress status were significantly associated with job satisfaction (p < 0.001). Conclusion: The job satisfaction level of the studied population was comparable to other local studies and higher than studies from Iran, Ethiopia and China. Extra attention should be given to healthcare workers with poor physical health and poor mental stress. More objective study on physical health and mental stress is required.