Differences in systolic blood pressure reading between arms are common but could signal trouble if the discrepancy is significant. Early detection of aortic dissection could invariably determine patient's survivability. Hence, a high index of suspicion with prompt diagnostic imaging is vital for accurate diagnosis.
Meckel's diverticulitis or Meckel's associated pathology frequently presents in childhood with gastrointestinal bleeding. It is rarely seen in adults. It is a congenital abnormality that commonly goes undetected. We present a case of a perforated Meckel's diverticulum due to fishbone ingestion in an elderly gentleman. The aim of this case report is to highlight the rare presentation of a perforation in a Meckel's diverticulum due to an extrinsic pathology and to outline diagnostic and management options in cases of Meckel's diverticulum.
INTRODUCTION: Dental care has remained as an unmet need for people living with HIV/AIDS (PLWHAs). Dental students are considered as future healthcare workforce and having beliefs which are discriminating may have negative attitudes towards providing care to these individuals (Azodo et al., 2010). The study aimed to assess the ethical beliefs and attitudes of dental students towards PLWHAs for providing care.
METHODS: It is a descriptive correlational and cross sectional study. Nine public and private dental schools in Malaysia participated in the study. Data was collected using a validated self-administered questionnaire.
RESULTS: A total of 481 dental students participated in this study, yielding response rate of 78%. Majority of the participants (74%) believed that patients' HIV status should be disclosed to patients' sexual partner without permission. Approximately 60% of the participants reported that rooms/beds of HIV patients should be clearly marked. Regarding patient disease status 28% of the students reported that it is appropriate to test a patient for HIV/AIDS without patient's permission. Only Fifty five percent of the students expressed the willingness to treat HIV patients and 49% reported to held fear of getting infected while treating patients with HIV/AIDS. Sixty four percent of the participants reported to be more comfortable giving care to non-HIV patients than HIV-positive patients.
CONCLUSION: Dental students' ethical beliefs about HIV/AIDS were not consistent with the ethical principles as stated in the code of ethics and they held negative attitudes towards PLWHAs. Ethical beliefs were found to be a determinant that may influence future attitudes of these students towards individuals with HIV/AIDS when providing care.
Large, intact areas of tropical peatland are highly threatened at a global scale by the expansion of commercial agriculture and other forms of economic development. Conserving peatlands on a landscape scale, with their hydrology intact, is of international conservation importance to preserve their distinctive biodiversity and ecosystem services and maintain their resilience to future environmental change. We explored threats to and opportunities for conserving remaining intact tropical peatlands; thus, we excluded peatlands of Indonesia and Malaysia, where extensive deforestation, drainage, and conversion to plantations means conservation in this region can protect only small fragments of the original ecosystem. We focused on a case study, the Pastaza-Marañón Foreland Basin (PMFB) in Peru, which is among the largest known intact tropical peatland landscapes in the world and is representative of peatland vulnerability. Maintenance of the hydrological conditions critical for carbon storage and ecosystem function of peatlands is, in the PMFB, primarily threatened by expansion of commercial agriculture linked to new transport infrastructure that is facilitating access to remote areas. There remain opportunities in the PMFB and elsewhere to develop alternative, more sustainable land-use practices. Although some of the peatlands in the PMFB fall within existing legally protected areas, this protection does not include the most carbon-dense (domed pole forest) areas. New carbon-based conservation instruments (e.g., REDD+, Green Climate Fund), developing markets for sustainable peatland products, transferring land title to local communities, and expanding protected areas offer pathways to increased protection for intact tropical peatlands in Amazonia and elsewhere, such as those in New Guinea and Central Africa which remain, for the moment, broadly beyond the frontier of commercial development.
Purpose of this study to be conducted is to identify the risk factor of low back pain amongst port crane operator and to improve the health management program in the company. The objectives of this study are to evaluate the major group of port crane operator that having low back pain problem, to analyse the risk factors that associated to low back pain problem (WBV, Awkward prolonged sitting and shift work-psychological) , individual characteristics (sport activity or hobby), to analyse the associated rate operator’s absence from work (medical leave) and low back pain problem and to propose the basic ergonomic assessment checklist for management to investigate health incident cases and fit-to-work (ergonomics) screening checklist for new recruitment. A survey research design through the distribution of the questionnaire and interview & field observation will
be used for research methodology. The population of this study consists of port crane operatorsRubber Tyred Gantry Operator (RTG). Questionnaire method used to collect all relevant information from correspondence. Interview also will be conducted to gain further details information. Data were analyzed with the usage of Statistical Package for the Social Sciences (SPSS) to make the process of analysis easier. As result, firstly, the study shown that there are association of risk factor for working posture and years of exposure with Low back Pain. The null hypothesis was rejected and there is probability that these risk factors have influence the low back pain. It was also concluded that the null hypothesis was accepted which means there are no correlation of risk factors for heavy physical works, previous job experience, previous accident with low back pain problem. Thirdly, the study
shown there are no correlation of rate operator’s absence from work (medical leave) with low back pain problem as the null hypothesis was accepted with p value <0.05
Keywords: Port, Low Back Pain, Ergonomics, Occupational Safety & Health, Rubber tyre gantry, Back Pain
Simulation-based medical education enables knowledge, skills and attitudes to be taught in a safe,
realistic manner. Flipped classroom teaching encourages self-learning. Emergency medicine exposes
students to diverse group of patients and physicians’ decision making. This study aims to determine
students’ perception on knowledge, skills and confidence after combined flipped classroom and
simulated teaching. Two cohorts of Semester 7 students Group 1 (n = 120) and Group 2 (n = 78)
completed a 5-point Likert scale questionnaire. Group 1 completed the questionnaire after a lapse
of six months while Group 2 at the end the posting. Responses from both cohorts were compared
using the Mann-Whitney U test. Of 198 (Groups 1 and 2) students, 91.41% (n = 181) felt the
simulated sessions helped better understand care of emergency patients. The sessions helped identify
knowledge gaps (89.90%; n = 178), improve knowledge and understanding of oxygen therapy devices
(85.35%; n = 169), and airway equipment (90.91%; n = 180). They prepared better for the flipped
classroom teaching than traditional sessions (80.81%; n = 160). They felt that their communication
skills (82.32%; n = 163) and confidence (63.64%; n = 126) improved. Significant differences noted
to questions (p = 0.006, p = 0.005, p = 0.041 respectively) targeting knowledge on oxygen therapy
devices, confidence, and identification of gaps in knowledge respectively. Combined simulation and
flipped classroom teaching was well received by students though this requires more preparation.
Hevea brasiliensis is one of the popular industrial crops in Malaysia better known as rubber tree belongs to the family Euphorbiaceace. From more than 12 species of Hevea, only Hevea brasiliensis is economically exploited because the milky latex extracted from the tree is the primary source of natural rubber. As in other crops, various plant physiological conditions and pathogenic diseases influence rubber production. Brown bast is one of the most serious threats to natural rubber production. In general, high-yielding clones of rubber tree are often considered to be more susceptible to this physiological disorder also commonly termed Tapping Panel Dryness (TPD). It is estimated that brown bast leads to approximately 15-20% decrease in yield. There is no known cure for brown bast yet. However, many plantation practices manage brown bast in rubber by giving tapping rest and changing tapping panel. Hence, this review condenses the causal of brown bast, symptoms of diseases and also control of brown bast affected Hevea tree.
Annual air temperature data obtained from twenty-two meteorological stations across Malaysia are modeled using multiple regression. A correlation test was conducted to find statistical relationship between each of the dependent variables: annual maximum and annual average air temperature and predictor variables: longitude, latitude, elevation and wind speed. Regression models using least square estimation method were developed relating the dependent variables to independent variables and the adequacy of the models is determined by the coefficient of determination. The result shows that the longitude and wind speed factors have a significant influence on the annual air temperature in Malaysia.
The indoor and outdoor radon concentrations in Cameron Highlands (Peninsular Malaysia) and Ranau (East Malaysia) were measured. The measurements were carried out using passive method based on CR-39 solid state nuclear track detector (SSNTD) (for indoor measurements in Cameron Highlands) and active method using continuous radon/thoron progeny monitor (for indoor and outdoor measurements in Ranau and outdoor measurements in Cameron Highlands). The mean indoor radon concentrations in Cameron Highlands and Ranau were 50 Bqm-3 and 1.5 Bqm-3, respectively. The mean indoor radon concentration in Cameron Highlands was slightly higher compare to the world average. The maximum value recorded was 97 Bqm-3 which is almost similar to WHO reference level. The mean outdoor radon concentrations in Cameron Highlands and Ranau were 7.4 Bqm-3and 1.7 Bqm-3, respectively. The outdoor concentrations were low and comparable to world outdoor average.
The synchronous firefly genus Pteroptyx Olivier is reassessed from morphological, molecular, and habitat perspectives in Malaysia, and includes some reliably associated females described from morphological features and internal female reproductive anatomy. Phylogenetic analyses using combined morphological and molecular data (where available) for 158 taxa supported all the major features of the existing taxonomic categories within the Indopacific Luciolinae. They revealed a distinct Pteroptyx clade as a morphologically variable genus with Poluninius selangoriensis Ballantyne being newly synonymised with Luciola testacea Motschulsky, the type species, which is redescribed from the type series. Pteroptyx gelasina Ballantyne was shown to be distinct and three of the four morphological subdivisions within Pteroptyx malaccae (Gorham) considered useful. A new species Pt. balingiana Jusoh sp. nov. is described from Sarawak. A second specimen of Pt. gombakia Ballantyne is described and figured. Some females were reliably associated with identified males by molecular data, but investigation of their morphology showed consistent features that were for the most part not useful for species delineation, which still relies on association with the males and colour patterns. All females investigated had bursa plates.Habitat details for most Pteroptyx revealed an association with a riparian environment likely to support mangroves but not necessarily an obligatory association with mangroves or any particular species. Pteroptyx galbina Jusoh was found up to 30 km from the sea, and Pt. bearni Olivier displays in a variety of flowering plants alongside rivers, including mangroves.Keys to species and diagnoses of all species with coloured plates are given.
This revision focuses on the genus Calleida Latreille, 1824 (in the widest sense) in the Oriental Region, previously treated as genus or subgenus Callidiola Jeannel, 1949. In the present contribution, as first part of a series of revisions of the Asiatic Calleida species, we define nine species groups including all known Asiatic species, based on external features and morphological characters of male and female genitalia. A key for the identification of all nine species groups is provided, along with diagnostic characters, included species, geographical distribution, and brief discussion on monophyly and relationships for each species group. In particular, the present contribution deals with species of six small species groups, including eleven species in total, for which keys to all known species, descriptions, distribution maps, habitus images and genitalia illustrations are provided.Five new species are described: Calleida gressittiana Casale Shi, sp. n. (type locality: Kinabalu, Sabah, Borneo), Calleida puncticollis Shi Casale, sp. n. (type locality: Zigui, Hubei), Calleida jelineki Casale Shi, sp. n. (type locality: Coimbatore, India), Calleida viet Casale Shi, sp. n. (type locality: Vung Tau, Vietnam), Calleida borneensis Shi Casale, sp. n. (type locality: Sabah, Borneo). Lectotypes for five taxa are designated. One synonymy is newly proposed: Calleida lieftincki Louwerens junior synonym of Calleida corporaali Andrewes, syn. nov.
It is hard to identify the local Malay identity in a design context compared to other cultural oriented design in several countries. This paper tries to uncover how designers interpret local identity embodied agent based on local items influences and understood and the influence of incremental, radical design that changes respective to preceding designs. A descriptive study through the literature reviews focusses on a type of artefact initiated through cultural-oriented design. Based on the preliminary study, a sampling taken from the Chinese, Indian, Japanese or European consistently apply the same fundamental understanding in regards to the culture-oriented design. From the same point of view, teapot seems to be used as one of the dominant artefact indicating the design preferences. This research will benefit both the academia and the industry and identify significant identity based on the local context and become an embodied agent to give impact in establishing the state-of-the-art of brand, the identity of local design, establish new trademark towards generating domestic, international economy and promote the nation worldwide throughout design platform.
Human hemoglobin of G-Makassar variant has been reported very rarely with Beta Thalassemia. In year 1969 Hb GMakassar was first identified in Makassar, Sulawesi (Celebes), Republic of Indonesia. The disease was first published in 1969 and 33 years later it has been reported at a family of Thailand origin. We report a 45-yearold Malay man who was investigated for anemia and thrombocytopenia then diagnosed with Hb G-Makassar. This finding describes as a new Hemoglobin GMakassar discovered in Malaysia after 14 years diagnosed in Thailand.
Introduction: The increasing burden of Non-Communicable Diseases and their prevalence has led Ministry of Health (MOH) Malaysia to introduce a community empowerment program “Komuniti Sihat, Perkasa Negara” acronymed as KOSPEN in July 2013. Thirty thousand community health volunteers have been trained nationwide up to May 2015.
Objective: To identify the factors associated with knowledge on KOSPEN and its implementation among community health volunteers in Kulim District.
Methods: A cross-sectional study based on simple random sampling was conducted among community health volunteers Kulim District. Volunteers participated in this study were 194. Data collected using self-administered questionnaire. All data collected were analysed using IBM SPSS version 22 involving descriptive and inferential statistics with significance level set at 0.05.
Results: The study found that level of knowledge on KOSPEN is associated with employment status (p=0.02) and awareness level (p<0.001) among the community health volunteers. The level of implementation is associated with age (p=0.025), education level (p=0.007) and employment status (p=0.017) of the community health volunteers. Employment status (aOR=2.133, 95% CI=1.056-4.306, p=0.035) and awareness level (aOR=6.119, 95% CI=2.701-13.867 p<0.001) were predictors of level of knowledge on KOSPEN. Level of implementation of KOSPEN by the community health volunteers could be predicted by education level (aOR=4.085, 95% CI=1.299-12.851 p=0.016).
Conclusion: Generally the KOSPEN volunteers had good knowledge on KOSPEN and implementation of KOSPEN program. However, there are still misconceptions among the KOSPEN volunteers regarding their functions and role. Therefore it is important to empower the volunteers with awareness on their roles, functions and good knowledge.
BACKGROUND: Elder abuse and neglect (EAN) is a growing public health problem, and numerous adverse health effects of abuse in late life have been documented. Little is known, however, about the impact of elder abuse on sleep quality. This study examines the longitudinal relationship between EAN and sleep quality.
METHODS: This was a 2-year prospective cohort study involving 1927 older adults in a rural Malaysian district, Kuala Pilah. A multi-stage cluster sampling strategy was employed. After 2 years, 1189 respondents were re-assessed. EAN was determined using the modified Conflict Tactic Scale, while sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI).
RESULTS: The prevalence of elder abuse was 8.1% (95% CI:6.9,9.3). Longitudinal analysis using generalized estimating equations showed that elder abuse contributed to higher PSQI scores (B:0.49, 95% CI:0.17,0.58). Sub-analyses demonstrated that psychological abuse and neglect had significant longitudinal relationships with increase of PSQI scores, while other subtypes did not.
CONCLUSION: Abuse in late life, particularly psychological abuse and neglect, result in greater PSQI scores. Even though this may imply decline in sleep quality, our findings were not considered clinically significant as they did not exceed the clinical cut-off score of five. Nevertheless, sleep quality is an important determinant of health and a predictor of mortality among older adults; thus, understanding its relationship with abuse is useful to health care providers and policy-makers in improving health services and upgrading preventive measures.
As a possible implementation of a low-power wide-area network (LPWAN), Long Range (LoRa) technology is considered to be the future wireless communication standard for the Internet of Things (IoT) as it offers competitive features, such as a long communication range, low cost, and reduced power consumption, which make it an optimum alternative to the current wireless sensor networks and conventional cellular technologies. However, the limited bandwidth available for physical layer modulation in LoRa makes it unsuitable for high bit rate data transfer from devices like image sensors. In this paper, we propose a new method for mangrove forest monitoring in Malaysia, wherein we transfer image sensor data over the LoRa physical layer (PHY) in a node-to-node network model. In implementing this method, we produce a novel scheme for overcoming the bandwidth limitation of LoRa. With this scheme the images, which requires high data rate to transfer, collected by the sensor are encrypted as hexadecimal data and then split into packets for transfer via the LoRa physical layer (PHY). To assess the quality of images transferred using this scheme, we measured the packet loss rate, peak signal-to-noise ratio (PSNR), and structural similarity (SSIM) index of each image. These measurements verify the proposed scheme for image transmission, and support the industrial and academic trend which promotes LoRa as the future solution for IoT infrastructure.
Introduction: Nicotine cravings and withdrawal symptoms are associated with higher rates of relapse. It has been shown that combining behavioral therapy and pharmacotherapy leads to a higher long-term abstinence rate in those who quit smoking. Al-Quran recitation has been proven to reduce anxiety among athletes before tournaments and pulse and heart rates among patients awaiting cardiac operations. As most of the patients who wish to stop smoking experience high-anxiety states, we postulate that Al-Quran recitation will also able to reduce craving among smokers attempting to quit smoking.
Methods: Fifty smokers from an outpatient clinic were randomly assigned to control and intervention groups. They were taught different ways of coping with smoking urges, i.e., counseling using the 12'M' method (control group) versus Al-Quran recitation (intervention group). They met for four consecutive weeks of counselling and to fill out a withdrawal scale. Carbon monoxide (CO) levels were tested at baseline and at week 4. At week 12, the number of cigarettes smoked was measured again. The decrease in the number of cigarettes considered to be clinically significant for the calculation of sample size was based on expert opinion.
Results: The reduction in the number of cigarettes smoked was 7 cigarettes in the counselling group and 9 cigarettes in Al-Quran recitation group over 12 weeks duration. There was a statistically significant difference in the number of cigarettes smoked between the groups. There was also a statistically significant difference in the change in cravings between the groups at week 4 (p-value = 0.005). However, the difference in the changes in CO levels between the two groups was not statistically significant.
Conclusion: Al-Quran recitation produced a statistically significant reduction in the number of cigarettes smoked at week 12 and a significant change in cravings at week 4 among smokers attempting to quit. Difference in smoking abstinence rates was not measured in this study.
A new species of firefly (Coleoptera: Lampyridae) Pygoluciola dunguna Nada sp. nov. is described from males and reliably associated females, collected mainly from lowland dipterocarp forests of Peninsular Malaysia at elevations below 300 m a.s.l. This species is found to be terrestrial, flying at low heights between 10-15 m above ground in between the herbaceous plants. Males are intermediate between the two types of Pygoluciola Wittmer known until now. A list of species, and a key to males and known females of Pygoluciola is given. The female bursa has paired elongate hook like bursa plates.
Preputial calculus is a relative surgical rarity. It usually happens in elderly men with poor hygiene and uncircumcised penis complicated with phimosis. In the paediatric group, it is usually secondary to phimosis and other urologic and/or neurologic anomalies. Surgical treatment is the mainstay of treatment. Herein, we report a 27-year-old gentleman with preputial stone presented with obstructive uropathy and was successfully treated with surgical intervention. To the best of our knowledge, this is the first reported case of the largest preputial stone in Malaysia.
Lane Change Assistance (LCA) system in cars can potentially mitigate blind spot related crashes; but its effectiveness
largely depends on driver acceptance and proper use. Although still in early stages, the volume of cars equipped with
LCA system is expected torise in the near future as the technology has been considered in the New Car Assessment
Program for Southeast Asian Countries (ASEAN NCAP) 2017 Rating Scheme. Therefore, this study is initiated to assess
user acceptance of and experience with LCA-equipped cars. Self-administered questionnaires were distributed to
owners of LCA-equipped cars at selected service centres in the Klang Valley from November 2016 to February 2017.
From a total of 276 valid responses, results revealed that most owners greatly considered LCA system when
purchasing their cars and agreed that the systems had positively altered their driving behaviours i.e. regularly using
the turn signal and checking the side mirrors. Nevertheless, about 20% of the respondents stated theirannoyance and
distraction by the LCA systems due to unnecessary warnings from various sources, aside from getting too many
warnings during traffic congestion. The study findings provide some practical implications that can aid the industry
and relevant stakeholders in gauging the issue and actual situations concerning the use of LCA system in Malaysia.