Five new species of Notosacantha are described from Borneo (Sabah): N. flaviventris Borowiec and Takizawa sp. nov. (also described from Sumatra), N. flavosuturata Świętojańska and Takizawa sp. nov., N. minuta Świętojańska and Takizawa sp. nov., N. obscuricornis Borowiec and Takizawa sp. nov. and N. ovoidea Borowiec and Świętojańska sp. nov. New records for nine other species, a check list and key to Bornean Notosacantha are given. Myrsinaceae and Myristicaceae are new host plant families for tortoise beetles and Ardisia elliptica Thunb., Ardisia sp., Embelia sp., Gironiema sp. (all Myrsinaceae) and Knema sp. (Myristicaceae) are new host plants for Notosacantha.
Natural radionuclides, such as (210)Po and (210)Pb were measured in the water samples collected from six stations at Kuala Selangor, Malaysia. Results for (210)Po and (210)Pb in dissolved and particulate phases have showed the difference in distribution and chemical behavior. The fluctuation activities of (210)Po and (210)Pb depend on wave action, geology and degree of fresh water input occurring at study areas and probably due to different sampling dates. The distribution coefficient, K(d), values of (210)Po and (210)Pb ranged from 2.0 x 10(3)lg(-1) to 265.15 x 10(5)lg(-1), and from 3.0 x 10(3)lg(-1) to 558.16 x 10(5)lg(-1), respectively. High K(d) values of (210)Po and (210)Pb indicated that a strong adsorption of (210)Po and (210)Pb onto suspended particles, and the sinking of both nuclides on the seabed at study locations were controlled by the characteristics of suspended particles.
The authors have characterised the genetic diversity of the bluetongue virus (BTV) RNA segments 3 and 10 from Indonesia, Malaysia and Australia. Analysis of RNA segment 3, which codes for the core protein VP3, showed conserved sequences in the previously defined Australasian topotype, but which further divided into four distinct clades or genotypes. Certain genotypes appeared to be geographically restricted while others were distributed widely throughout South-East Asia. Ongoing surveillance programmes in Australia have identified the movement of Indonesian genotypes into northern Australia and possible reassortment among them. Similarly, analysis of RNA segment 10, which codes for the non-structural protein NS3/3A, showed they were also conserved and grouped into five clades or genotypes, three Asian and two North American/South African.
The diversity and abundance of macroinvertebrate shredders were investigated in 52 forested streams (local scale) from nine catchments (regional scale) covering a large area of peninsular Malaysia. A total of 10,642 individuals of aquatic macroinvertebrates were collected, of which 18.22% were shredders. Biodiversity of shredders was described by alpha (αaverage), beta (β) and gamma diversity (γ) measures. We found high diversity and abundance of shredders in all catchments, represented by 1,939 individuals (range 6-115 and average per site of 37.29±3.48 SE) from 31 taxa with 2-13 taxa per site (αaverage=6.98±0.33 SE) and 10-15 taxa per catchment (γ=13.33±0.55 SE). At the local scale, water temperature, stream width, depth and altitude were correlated significantly with diversity (Adj-R2=0.205). Meanwhile, dissolved oxygen, stream velocity, water temperature, stream width and altitude were correlated to shredder abundance (Adj-R2=0.242). At regional scale, however, water temperature was correlated negatively with β and γ diversity (r2=0.161 and 0.237, respectively) as well as abundance of shredders (r2=0.235). Canopy cover was correlated positively with β diversity (r2=0.378) and abundance (r2=0.266), meanwhile altitude was correlated positively with β (quadratic: r2=0.175), γ diversity (quadratic: r2=0.848) as well as abundance (quadratic: r2=0.299). The present study is considered as the first report describing the biodiversity and abundance of shredders in forested headwater streams across a large spatial scale in peninsular Malaysia. We concluded that water temperature has a negative effect while altitude showed a positive relationship with diversity and abundance of shredders. However, it was difficult to detect an influence of canopy cover on shredder diversity.
Mesohabitat selection in fluvial fishes was studied in a small tropical stream of the Malay Peninsula. A total of 681 individuals representing 24 species were sampled at 45 stations within heterogeneous stream (ca. 1 km in length), in which water depth, water velocity, substrate size, and riparian canopy cover were measured as environmental variables. A canonical correspondence analysis (CCA) yielded a diagram that shows a specific mesohabitat selection of the fish assemblage, in which the species were plotted widely on the CCA1-CCA2 biplot. Generalized linear model also revealed a significant pattern of the mesohabitat selection of several species. Water velocity and substrate size mainly separated on CCA1, indicating variation of pool (deep, slow-flow section) and riffle (shallow, fast-flow section) structures is a primary factor of mesohabitat selection in the fluvial fish assemblage. The mean body weight of species significantly correlated with CCA1; larger species tended to inhabit pools, while small ones occupied riffles. The riparian canopy cover separated on CCA2. The trophic level of species significantly correlated with CCA2; herbivorous species (low trophic level) selected open sites without riparian cover, whereas omnivorous/carnivorous (middle-high trophic level) species preferred highly covered sites. In conclusion, our results suggest that mesohabitat selection is closely related to the species feeding habit, which is consistent with the results of previous studies.
Beta blockers provide both morbidity and mortality benefits for post-myocardial infarction (MI) patients. Despite this, beta blockers are still often underused or used at suboptimal dosages. This was a retrospective observational study with the objectives of estimating the proportion of post-MI patients who are receiving beta-blocker therapy in University Malaya Medical Centre (UMMC), assessing the number of them receiving beta blockers at optimal dosages and determining the factors associated with beta-blocker prescribing post-MI. Of 315 patient case notes reviewed, 77.5% were prescribed beta blockers. However, dosages were optimized in only 39.3% of patients. Reasons for not optimizing the dosages were typically not due to the presence of contraindications to beta blockers. Elderly (> 65 years old), ejection fraction (EF) < 40%, a history of cerebrovascular accident (CVA) or mild asthma, use of calcium channel blocker (CCB), digoxin or anti-asthmatic agents were all significantly associated with a reduced rate of beta-blocker prescribing post-MI. More effort should be placed in improving its use in specific patient populations. Initiatives to optimize the dosage of beta blockers to recommended dosages that matched those in clinical trials with proven mortality benefits will also need to be intensified.
Study site: University Malaya Medical Centre, Kuala Lumpur
Medications given via the intravenous (IV) route provide rapid drug delivery to the body. IV therapy is a complex process requiring proper drug preparation before administration to the patients. Therefore, errors occurring at any stage can cause harmful clinical outcomes to the patients, which may lead to morbidity and mortality. This was a prospective observational study with the objectives to determine whether medication errors occur in IV drug preparation and administration in Selayang Hospital, determining the associated factors and identifying the strategies in reducing these medication errors. 341 (97.7%) errors were identified during observation of total 349 IV drug preparations and administrations. The most common errors include the vial tap not swabbed during prepreparation and injecting bolus doses faster than the recommended administration rate. There was one incident of wrong drug attempted. Errors were significantly more likely to occur during administration time at 8.00am and when bolus drugs were given. Errors could be reduced by having proper guidelines on IV procedures, more common use of IV infusion control devices and by giving full concentration during the process. Awareness among the staff nurses and training needs should be addressed to reduce the rate of medication errors. Standard IV procedures should be abided and this needs the cooperation and active roles from all healthcare professionals as well as the staff nurses.
Study site: Hospital Selayang, Kuala Lumpur
Oesophageal atresia (EA) and tracheoesophageal fistula (TEF) is one of the congenital anomaly occurring in the newborns with the incidence of 1 in 2500 births seen worldwide. A retrospective review of newborns admitted to Hospital Sultanah Bahiyah (HSB) from 1st January 2000 to 31st December 2009 was done. The objective was to look at the influence of birth weight, time of surgical intervention, presence of other congenital anomaly and presence of preoperative pneumonia to the immediate outcome (mortality) of the surgery. There were 47 patients with oesophageal atresia, out of which 26 (55%) were males and 21 (45%) females. The distribution of patients by race were 34 Malays (72%), 9 Chinese (19%) and 4 Indians (9%). The birth weight of the babies range from 0.8 kg to 4.0 kg and there was a significant association with the outcome of the surgery (p< 0.05). Most of the babies (20) were operated within 24 hours of presentation but there was no significant association to the outcome. 23 (49%) of them were born with congenital malformation and there was a significant association with the outcome of the surgery (p<0.05). Based on the chest roentgenogram, 20 (43%) of them had pneumonia with significant association with the outcome (p<0.05). The mortality rate is 23% and the causes of death were pneumonia (36%), renal failure (18%), cardiac malformation (18%) and multiple congenital malformations (28%). The outcome of EA and TEF is determined mainly by birth weight, congenital malformations and presence of preoperative pneumonia in HSB.
AIM: This prospective, single-group, pre-post design trial was conducted to evaluate the effect of individualised Medical Nutrition Therapy intervention administered by a dietitian in individuals with type 2 diabetes mellitus on glycaemic control, metabolic parameters and dietary intake.
METHODS: Subjects (n=104; age=56.4 ±9.9 years; 37% male; years of diagnosis = 6.3 ±4.9 years) treated with diet and on a stabile dose of oral anti-diabetic agents were given dietary advice by a dietitian for a 12 week period. Individualised dietary advice was based on Malaysian Medical Nutrition Therapy for adults with type 2 diabetes mellitus. The primary outcome measure was glycaemic control (fructosamine and HbA1c level) and the secondary outcome included measures of anthropometry, blood pressure, lipid profile, insulin levels dietary intake and knowledge on nutrition.
RESULTS: At week 12, 100 subjects completed the study with a dropout rate of 3.8%. The post-Medical Nutrition Therapy results showed a significant reduction of fructosamine (311.5 ±50 to 297 ±44 umol/L; P< 0.001) and HbA1c (7.6 ±1.2 to 7.2 +1.1%, p<0.001) with pronounced reduction for subjects who had very high HbA1c levels of >9.3% at baseline. Waist circumference (90.7 ±10.2 to 89.1 ±9.8 cm, p<0.05), HDL-cholesterol (1.1 ±0.3 to 1.2 ±0.3 mmol/L, p<0.05), dietary intake and nutrition knowledge score (42 ±19 vs. 75 ±17%; p< 0.001) were significantly improved from the baseline.
CONCLUSIONS: Individualised Medical Nutrition Therapy administered by a dietitian resulted in favourable diabetes outcomes, which were more apparent for individuals with higher than optimal HbA1c levels at the start of the study.
A nationwide investigation was carried out to determine the current susceptibility status of Culex quinquefasciatus Say populations against four active ingredients representing four major insecticide classes: DDT, propoxur, malathion, and permethrin. Across 14 study sites, both larval and adult bioassays exhibited dissimilar trends in susceptibility. A correlation between propoxur and malathion resistance and between propoxur and permethrin resistance in larval bioassays was found. The results obtained from this study provide baseline information for vector control programs conducted by local authorities. The susceptibility status of this mosquito should be monitored from time to time to ensure the effectiveness of current vector control operations in Malaysia.
A comprehensive 8-yr survey of acarine ectoparasites (ticks and mites) of bats was carried out in 18 localities from 2002 to 2009. Most of the surveys were conducted during 14 national biodiversity scientific expeditions throughout Malaysia. The objective was to identify acarines of known public health importance from bats and thus determine whether there is any potential public health risk in Malaysia. Trapping of bats was conducted using Harp traps and Mist nets. In total, 1,579 individuals comprising of 6 families and 52 species of bats were examined alive. In general, 25.6% of the bats were infested with acarines. Infestation rates of ticks, mesostigmatid mites, and chiggers on bats examined were 0.4, 10.4, and 14.7%, respectively. Their prevalence and mean intensity were tabulated. Genera of ticks extracted were Amblyomma, Dermacentor, Ixodes, and Ornithodoros. Of these genera, only two species can be identified to species level and they are Amblyomma cordiferum and Ixodes simplex. In total, 8 genera and 15 species of mesostigmatid mites were found; the species were Ancystropus eonycteris, Ancystropus zeleborii, Echinonysus nasutus, Laelaps aingworthae, Laelaps nuttalli, Laelaps sanguisugus, Laelaps sculpturatus, Longolaelaps longulus, Longolaelaps whartonii, Meristaspis lateralis, Meristaspis macroglossi, Paraperiglischrus rhinolophinus, Spinturnix acuminatus, Spinturnix americanus, and Spinturnix bakeri. Chiggers on bats were represented by 12 genera and 6 species; the species identified were Gahrliepia fletcheri, Riedlinia lipoxena, Trombigastia cadei, Walchiella impar, Walchiella oudemansi, and Whartonia caobangensis. The study produced an up-to-date list of acarine ectoparasites of bats in Malaysia where a total of 38 genera and 47 species of acarines were listed. Findings of the study demonstrated that 5 genera and 1 species of acarines that may pose potential health risks, can be found on bats.
The study aims to investigate anatomy learning styles and strategies of Jordanian and Malaysian medical students at the Jordan University of Science and Technology.
Here, we report the draft genome sequences of four nosocomial methicillin-resistant Staphylococcus aureus strains (PPUKM-261-2009, PPUKM-332-2009, PPUKM-377-2009, and PPUKM-775-2009) isolated from a university teaching hospital in Malaysia. Three of the strains belong to sequence type 239 (ST239), which has been associated with sustained hospital epidemics worldwide.
This study is the first report to suggest a morphological phylogenetic framework for the seven varieties of Ficus deltoidea Jack (Ficus: Moraceae) from the Malay Peninsula of Malaysia. Several molecular-based classifications on the genus Ficus had been proposed, but neither had discussed the relationship between seven varieties of F. deltoidea to its allies nor within the varieties. The relationship between seven varieties of F. deltoidea is still debated due to the extreme morphological variabilities and ambiguous boundaries between taxa. Thus, the correct identification of these varieties is important as several morphological characters are variety-specific. To test the monophyly and further resolved the relationship in F. deltoidea, a morphological phylogenetic analysis was conducted based on herbarium specimens representing the seven varieties of F. deltoidea that were collected from the Malay Peninsula of Malaysia, by using related species of the genus Ficus; F. grossularioides, F. ischnopoda and F. oleifolia as the outgroups. Parsimony and neighbour-joining analyses indicated that F. deltoidea is monophyletic, in that the seven varieties of F. deltoidea nested into two clades; clade subspecies deltoidea (var. deltoidea, var. bilobata, var. angustifolia, var. kunstleri and var. trengganuensis) and clade subspecies motleyana (var. intermedia and var. motleyana).
Tacit knowledge of health-care experts is an important source of experiential know-how, yet due to various operational and technical reasons, such health-care knowledge is not entirely harnessed and put into professional practice. Emerging knowledge-management (KM) solutions suggest strategies to acquire the seemingly intractable and nonarticulated tacit knowledge of health-care experts. This paper presents a KM methodology, together with its computational implementation, to 1) acquire the tacit knowledge possessed by health-care experts; 2) represent the acquired tacit health-care knowledge in a computational formalism--i.e., clinical scenarios--that allows the reuse of stored knowledge to acquire tacit knowledge; and 3) crystallize the acquired tacit knowledge so that it is validated for health-care decision-support and medical education systems.