The Sundaland species of the genus Dysphaea were studied using molecular and morphological methods. Four species are recognized: D. dimidiata Selys, D. lugens Selys, D. ulu spec. nov. (holotype ♂, from Borneo, Sarawak, Miri division, Upper Baram, Sungai Pejelai, Ulu Moh, 24 viii 2014; deposited in RMNH) and D. vanida spec. nov. (holotype ♂, from Thailand, Ranong province, Khlong Nakha, Khlong Bang Man, 12-13 v 1999; deposited in RMNH). The four species are described and illustrated for both sexes, with keys provided. The type specimens of the four Dysphaea taxa named by E. de Selys Longchamps, i.e. dimidiata, limbata, semilimbata and lugens, were studied and their taxonomic status is discussed. Lectotypes are designated for D. dimidiata and D. limbata. D. dimidiata is recorded from Palawan (the Philippines) for the first time. A molecular analysis using three markers (COI, 16S and 28S) is presented. This includes specimens of three Sundaland species of the genus (D. lugens missing) and two congeners from other regions (D. basi-tincta and D. gloriosa). Notes and photographs of the male holotype of D. walli Fraser (from Maymyo, Burma) are provided.
The species of Billaea Robineau-Desvoidy (Diptera, Tachinidae) from the eastern Palearctic and Oriental regions are revised. Ten described species are recognized, viz. B. atkinsoni (Baranov) (new records for Japan, Laos, Malaysia, Pakistan and Thailand), B. ficorum (Townsend), B. fortis (Rondani), B. impigra Kolomiets (new record for China), B. kolomyetzi Mesnil, B. malayana Malloch, B. morosa Mesnil, B. robusta Malloch, B. steini (Brauer et Bergenstamm) and B. triangulifera (Zetterstedt) and nine species are described as new to science, B. brevicauda Zhang et Shima sp. nov. (China), B. carinata Zhang et Shima sp. nov. (China), B. chinensis Zhang et Shima sp. nov. (China and Vietnam), B. flava Zhang et Wang sp. nov. (China), B. kurahashii Zhang et Shima sp. nov. (Laos and Thailand), B. micronychia Zhang et Shima sp. nov. (China and Japan; previously misidentified from China as B. irrorata (Meigen)), B. papei Zhang et Shima sp. nov. (Malaysia), B. setigera Zhang et Shima sp. nov. (China) and B. verticalis Shima et Zhang sp. nov. (China). Billaea fasciata (Townsend, 1928) is treated as a junior synonym of B. ficorum (Townsend, 1916), syn. nov. Billaea irrorata is no longer recorded from the eastern Palearctic. A key to 19 species of Billaea from the eastern Palearctic and Oriental regions and 101 figures of male terminalia, bodies, heads and abdomens are given.
An integrative taxonomic analysis is used to identify and describe two new species of the agamid genus Bronchocela (Kuhl) from Peninsular Malaysia: an upland species B. shenlong sp. nov. from Bukit Larut, Perak in the Bintang Mountain Range and Parit Falls, Cameron Highlands, Pahang in the Titiwangsa Mountain Range and an insular species, B. rayaensis sp. nov., from Pulau Langkawi, Kedah off the northwest coast on the border with Thailand. Both species are diagnosed from each other and all other species of Bronchocela on the basis of body shape, scale morphology, and color pattern. The analysis also demonstrates the remarkable genetic similarity of B. cristatella (Kuhl) throughout 1120 km of its range from northern Peninsular Malaysia to western Borneo despite its highly variable coloration and pattern. The two new species are appended to a rapidly growing list of newly described lizard species (60 to date) from Peninsular Malaysia tallied within the last decade.
An accessory to modern developing economies includes a shift from traditional, laborious lifestyles and cuisine to more sedentary careers, recreation and convenience-based foodstuffs. Similar changes in the developed western world have led to harmful health consequences. Minimization of this effect in current transitional cultures could be met by placing value on the maintenance of heritage-rich food. Vitally important to this is the preservation and dissemination of knowledge of these traditional foods. Here, we investigate the history and functionality of a traditional rice snack cooked in Nepenthes pitchers, one of the most iconic and recognizable plants in the rapidly growing economic environment of Southeast Asia.
OBJECTIVE: To identify the stress-prevalence and coping-strategies among University Kebangsaan Malaysia (UKM) medical students.
METHODS: This was an observational study conducted among 234 UKM first and third year medical students. Standardized questionnaire on stress and coping strategies was used. Stress data was related to subjective experiences on some positive and negative adjectives such as tense, relaxed etc. Positive adjectives were measured by sign "++" and "+" scoring "1" while stress-negative adjectives were measured by sign "?" and "-" scoring "0". Forty-eight coping items under task, emotion and avoidance strategies were measured using 5-point Likert-scale.
RESULTS: Overall stress-prevalence was 49%. Female and Malay respondents were more stressed. Significant differences of stress-level was observed between Malays and non Malays in first year (p=0.04) and in third year (p=0.01). Most common strategies used to cope stress was task-oriented while emotion oriented was least.
CONCLUSION: Stress-prevalence and stress-level in UKM medical students was high. Most of the respondents coped stress using task-oriented strategies. Stressor and its effective management must be ensured. Educational institutions should act as a creative designer of learning environment to get relieve from educational stressor.
KEYWORDS: Coping strategies; Medical students; Stress prevalence
The aim of this open label crossover study was to investigate the effects of Nigella sativa on reproductive health and metabolic profile of perimenopausal women in Rawang, Malaysia.
Introduction. The burden of tuberculosis is high in eastern Malaysia, and rates of Mycobacterium tuberculosis drug resistance are poorly defined. Our objectives were to determine M. tuberculosis susceptibility and document management after receipt of susceptibility results.
Methods. Prospective study of adult outpatients with smear-positive pulmonary tuberculosis (PTB) in Sabah, Malaysia. Additionally, hospital clinicians accessed the reference laboratory for clinical purposes during the study.
Results. 176 outpatients were enrolled; 173 provided sputum samples. Mycobacterial culture yielded M. tuberculosis in 159 (91.9%) and nontuberculous Mycobacterium (NTM) in three (1.7%). Among outpatients there were no instances of multidrug resistant M. tuberculosis (MDR-TB). Seven people (4.5%) had isoniazid resistance (INH-R); all were switched to an appropriate second-line regimen for varying durations (4.5-9 months). Median delay to commencement of the second-line regimen was 13 weeks. Among 15 inpatients with suspected TB, 2 had multidrug resistant TB (one extensively drug resistant), 2 had INH-R, and 4 had NTM.
Conclusions. Current community rates of MDR-TB in Sabah are low. However, INH-resistance poses challenges, and NTM is an important differential diagnosis in this setting, where smear microscopy is the usual diagnostic modality. To address INH-R management issues in our setting, we propose an algorithm for the treatment of isoniazid-resistant PTB.
Study site: Tuberculosis clinic, Klinik Kesihatan Luyang, Kota Kinabalu, Sabah, Malaysia
BACKGROUND: Pharmacists are considered medication experts but are underutilized and exist mainly at the periphery of the Malaysian primary health care team. Private general practitioners (GPs) in Malaysia are granted rights under the Poison Act 1952 to prescribe and dispense medications at their primary care clinics. As most consumers obtain their medications from their GPs, community pharmacists' involvement in ensuring safe use of medicines is limited. The integration of a pharmacist into private GP clinics has the potential to contribute to quality use of medicines. This study aims to explore health care consumers' views on the integration of pharmacists within private GP clinics in Malaysia.
METHODS: A purposive sample of health care consumers in Selangor and Kuala Lumpur, Malaysia, were invited to participate in focus groups and semi-structured interviews. Sessions were audio recorded and transcribed verbatim and thematically analyzed using NVivo 10.
RESULTS: A total of 24 health care consumers participated in two focus groups and six semi-structured interviews. Four major themes were identified: 1) pharmacists' role viewed mainly as supplying medications, 2) readiness to accept pharmacists in private GP clinics, 3) willingness to pay for pharmacy services, and 4) concerns about GPs' resistance to pharmacist integration. Consumers felt that a pharmacist integrated into a private GP clinic could offer potential benefits such as to provide trustworthy information on the use and potential side effects of medications and screening for medication misadventure. The potential increase in costs passed on to consumers and GPs' reluctance were perceived as barriers to integration.
CONCLUSION: This study provides insights into consumers' perspectives on the roles of pharmacists within private GP clinics in Malaysia. Consumers generally supported pharmacist integration into private primary health care clinics. However, for pharmacists to expand their capacity in providing integrated and collaborative primary care services to consumers, barriers to pharmacist integration need to be addressed.
KEYWORDS: Malaysia; general practitioners; health care consumer; pharmacist integration; private clinic
Defaulting is an important issue across all medical specialties, but much more so in cancer as delayed or incomplete treatment has been shown to result in worse clinical outcomes such as treatment resistance, disease progression as well as lower survival. Our objective was to identify psychosocial variables and characteristics associated with default among cancer patients. A total of 467 consecutive adult cancer patients attending the oncology clinic at a single academic medical centre completed the Hospital Anxiety and Depression Scale and reported their preference for psychological support at baseline, 4-6 weeks and 12-18 months follow-up. Default was defined as refusal, delay or discontinuation of treatment or visit, despite the ability to do so. A total of 159 of 467 (34.0%) cancer patients were defaulters. Of these 159 defaulters, 89 (56.0%) desired psychological support, compared to only 13 (4.2%) of 308 non-defaulters. Using a logistic regression, patients who were defaulters had 52 times higher odds (P = 0.001; 95% confidence interval 20.61-134.47) of desiring psychological support than non-defaulters after adjusting for covariates. These findings suggest that defaulters should be offered psychological support which may increase cancer treatment acceptance rates and improve survival.
Study site: Oncology clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
This study investigate the relationships between geomorphometric properties and the minimum low flow discharge of undisturbed drainage basins in the Taman Bukit Cahaya Seri Alam Forest Reserve, Peninsular Malaysia. The drainage basins selected were third-order basins so as to facilitate a common base for sampling and performing an unbiased statistical analyses. Three levels of relationships were observed in the study. Significant relationships existed between the geomorphometric properties as shown by the correlation network analysis; secondly, individual geomorphometric properties were observed to influence minimum flow discharge; and finally, the multiple regression model set up showed that minimum flow discharge (Q min) was dependent of basin area (AU), stream length (LS), maximum relief (Hmax), average relief (HAV) and stream frequency (SF). These findings further enforced other studies of this nature that drainage basins were dynamic and functional entities whose operations were governed by complex interrelationships occurring within the basins. Changes to any of the geomorphometric properties would influence their role as basin regulators thus influencing a change in basin response. In the case of the basin's minimum low flow, a change in any of the properties considered in the regression model influenced the "time to peak" of flow. A shorter time period would mean higher discharge, which is generally considered the prerequisite to flooding. This research also conclude that the role of geomorphometric properties to control the water supply within the stream through out the year even though during the drought and less precipitations months. Drainage basins are sensitive entities and any deteriorations involve will generate reciprocals and response to the water supply as well as the habitat within the areas.
To answer the question posed the terms of reference of local ethical committees as well as a few from overseas were reviewed. It was noted that these committees were established by various professional bodies and functioned independently. Guidelines for ethical practice and conduct were made available to the profession with compliance left to the individual doctor. Amongst the many ethical issues of concern both to the public and the profession was that of self regulation. It is being suggested that these concerns be addressed rather then set up a national body.
Fat remains a hot topic because of concerns over associations between consumption of fats and the incidence of some chronic conditions including coronary artery disease, diabetes, cancer and obesity. Dietary fats serve multiple purposes. The effects of dietary fats generally reflect the collective influences of multiple fatty acids in the diet or food. This presentation highlights some recent developments on the role of dietary fats and oils in health and disease. Debate continues over the role of dietary modification in coronary prevention by lipid lowering. The degree to which a recommended diet will result in health benefits for an individual is difficult to predict, because the outcome will depend on the influence of other factors such as a person's genetic constitution, level of physical activity and total diet composition. There can now be little doubt about the importance of genetic factors in the etiology of cardiovascular disease, diabetes, obesity and cancer. The importance of antioxidant status in the prevention of cardiovascular disease as well as many cancers is being increasingly recognised. It is now evident that not all saturated fatty acids are equally cholesterolemic. Recent accounts evaluating palm oil's effects on blood lipids and lipoproteins suggest that diets incorporating palm oil as the major dietary fat do not raise plasma total and LDL cholesterol levels to the extent expected from its fatty acid composition. Palm oil is endowed with a good mixture of natural antioxidants and together with its balanced composition of the different classes of fatty acids, makes it a safe, stable and versatile edible oil with many positive health and nutritional attributes. In recent times, adverse health concerns from the consumption of trans fatty acids arising from hydrogenation of oils and fats have been the subject of much discussion and controversy. Trans fatty acids when compared with cis fatty acids or unhydrogenated fats have been shown to lower serum HDL cholesterol, raise serum LDL cholesterol and when substituted for saturated fatty acids, increase lipoprotein Lp (a) level, an independent risk factor for the development of coronary heart disease. The idea of which foods, nutrients and supplements are "healthy" is often being amended as new scientific data is presented and then simplified for the consumers. What was once perceived as a healthy diet is often no longer considered as such and vice versa. Dietary recommendations have to change with time and the evidence available. Nutritional recommendations should encourage eating a great variety of nutrient sources within our food supply in moderation. Various lifestyle options to improve health should also be promoted.
Neopolystoma liewi sp. n. is described from the conjunctival cavity of the Malayan box turtle Cuora amboinensis (Daudin, 1802), in Peninsular Malaysia. This is the first record of Neopolystoma in Malaysia and the fourth polystomatid species described from C. amboinensis. Of the 27 Malayan box turtles examined, 8 were found to be infected. A maximum of 2 parasites per eye and 4 individuals per host was recorded. N. liewi sp. n. differs from all other members of the genus by possessing few and short genital spines and small marginal hooks. The oncomiracidium has 64 ciliated cells arranged symmetrically about the sagittal axis.