In early 2001, Nadi IT (the IT department of the UMMC) migrated the UMMC leased line from its old 64 kbps line 10 the 34 Mbps University of Malaya leased line. The migration was a new leuning experience for Nadi IT and many lessons were learnt along the way. This paper describes the ideOll behind the migration process, the reason (or the migration, problems and solutions 10 aU these problems as well as the benefits derived from the migration. The experience of this process m~y be useful to others wishing 10 improve IT facilities without resorting to expensive solutions. KEYWORDS: Internet, leased line, migration
INTRODUCTION: Although the Feldenkrais method of rehabilitating chronic obstructive pulmonary disease (COPD) patients have been suggested, its use among practitioners is not widespread owing to preference of the more familiar standard program presently available. Several advantageous of the Feldenkrais Method have been suggested which includes improving the efficiency of movement, posture and, breathing. However how this compares to the standard rehabilitation protocol or pulmonary rehabilitation program (PRP) have not been previously demonstrated. The present study was thus conducted to compare the effectiveness of the Feldenkrais Method to the standard PRP using Borg score and 6 minute walked distance (6MWD) as outcome measurement tools.
RESULTS: There were 17 subjects in the Feldenkrais group (FG) and 19 subjects in the pulmonary group (PG), both of which received therapy for 8 weeks and assessed before and after receiving therapy. There were no improvements observed in the Borg score for the FG (after and before; 6.06+ 1.09 vs. 6.00+0.94). However, improvements in the PG group could be seen (after and before; 3.58+ 1.17 vs. 5.84 +1.01). Improvements in the 6MWD was observed in both groups with no significance differences noted (FG vs. PG; 379+129m vs. 374+80m).
CONCLUSION: The Feldenkrais method does not offer any advantage over the present PRP and in fact the latter offers better improvement in terms of the Borg score. However in view of the small study sample, further study would be needed before a final conclusion can be made.
Study site: Respiratory clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Problem-based learning (PBL) i s an educational reform that is now becoming a household word in higher education, particularly in medical schools. Many medical schools have implemented a full problem-based learning curriculum (PBLC) whiIe some have included PBL into selected units of the course in an otherwise conventional cumculum (embedded PBL) and others run their tutorials in a PBL manner within a modified conventional curriculum (hybrid curriculum). Yet there are others who claim that small components of PBL in a conventional curriculum are not PBL at all. Thus amateurs in the subject matter find difficulty in evaluating the logistics and outcome of these variations. This article focuses or, the general characteristics of PBL and how this learning method can help enhance independent learning and critical thinking, whether in a full, embedded or hybrid curriculum. The extent of PBL to be included and which of the three types is to be adopted depends on the objective of the undergraduate medical course as determined by the faculty, resources available, limitations, feedback on the existing curriculum and various other factors. KEYWORDS: Problem-based Learning (PBL); Embedded PBL; Hybrid PBL; New Integrated Curriculum (NIC).
The undergraduate dental degree in Malaysia is regulated by the Malaysian Dental Council (MDC) (Standard of Undergraduate Competencies), Code of Professional Conduct of the Malaysian Dental Council, the Malaysian Qualification Framework 2.0 and the Malaysian Quality Agency (MQA) quality assurance documents. These primary documents emphasize the importance of professional ethics and law in dentistry as will be further detailed and discussed later. This study reflects on the need to integrate ethics, professionalism and law with sufficient coverage in terms of content and emphasis in the dental undergraduate curriculum. Literature and benchmarking practices are reviewed for a deeper reflection of the current needs in a professional dental ethics and law education course. The present study is primarily focused on regulatory requirements, legal cases and comparative literature to serve as a reference on how professional ethics and law courses may be conducted. As an incidental measure, a reflection as to how the course of study of professional ethics is delivered in a local university is considered in a selected local university’s undergraduate dental curriculum. The findings indicate that ethics professionalism and dental law is not given sufficient emphasis as it is included as one of the minor components within another overcrowded subject and the coverage of what is taught is limited in context. This paper is an invitation to all dental schools to review and reflect whether, given the emphasis on professional ethics, legal and regulatory compliance in the regulatory documents, it is adequately reflected in their dental curriculum. In this regard, some benchmarking references are done to suggest what such a course should cover, for consideration of the dental schools.
With the increasing ease of travel and the passage of peoples between counkies there is a need to ensure that the recipient country is not burdened by the need for care of ilniiiigrant with health problems as well as the increased risk posed to the local population froni exposure to conun~unicabled isease. To assess the chest radiographs of a selected group of inun~igrantsto ascertain the presence of abnormalities especially the presence of tuberculosis. A total of 250 imniigrants were prospectively evaluated by a PA chest radiograph. The chest radiograph was evaluated by two radiologists for the presence of abnormalities of the heart, lungs, mediastinum and bony rib cage. There were 112 Indonesians, 133 Bangladeshis, one Myanmar, three Pakistanis and one others. Males made-up 222 while there were 28 females. The chest radiograph was diagnostic in all cases. There were 13 cases with enlarged hearts but with no evidence of heart failure. There was only a single inlmigrant who had evidence of active TB though there were 6 others who had evidence of old disease. There was evidence of other infections in five. With regard to the mediastinuni there was a single case with enlarged hila probably secondary to increased cardiac output. There were 21 patients with scoliosis of the spine and two with abnormaIities of the ribs. Even though there was a single case with evidence of TB from this pilot study, from unreported data from the UMMC, there were 15,16 and 23 immigrants treated for TB for 1994,1995 and 1996 respectively. This was mainly seen in the Indonesians followed by the Bangladeshis and Myanmar. We attribute this discrepancy to the biased salnpie in this study where probably only the healthy were seen while those who were not well did not want to participate in this study. In addition, this may also be due to the small sample used in this study. We feel that screening of the immigrants out in the field may be able to detect cases of active TB. As for the large hearts we feel that in the absence of any cardiac symptoms and other radiological changes these are probably due to the increased workload on the heart from physical activities. This is a recognised presentation. The changes in the mediastinum and bony rib cage are probably not very significant.
A survey was done to assess the chest radiographs of a selected group of immigrants. The objective is to ascertain the rpesence of abnormalities especially the presence of tuberculosis. Five hundred and eleven (511) chest radiographs (PA view) were evaluated. majority of the chest radiographs were normal, except for 2 cases of hilar lymphadenopathy, 4 cases of scoliosis and cervical rib, an old case of fracture of the clavicle and a case of cardiomegaly. Only 2 cases of TB were detected.
The study aimed at government efforts in making maternal and child healthcare services more available to
rural women, many of whom who still seek care from traditional practitioners during the postpartum period
after childbirth. In this research, we explored the role of traditional practitioners, such as Traditional Birth
Attendants (TBAs), herbalists and spiritualists, in traditional maternity care and the implications for the health
of the expectant mother, foetus or baby. This qualitative inquiry used purposive sampling and snowballing to
select the respondents in their various localities. It was observed that the traditional practitioners performed
both spiritual and medical roles during pregnancy and childbirth.
In the study, we discovered that both mothers and babies were exposed to health risks, as administration
of the herbal medicines and assistance at deliveries were carried out under unhygienic conditions. The
techniques used in labour management were not in compliance with the recommendations of the World
Health Organisation. The stages of maternity were characterised with the application of herbal concoctions
with spirituality attached.
The study recommends re-examination of mediating socio-cultural factors to professional health care. There
is a need for the Ghana Health Service to ensure the efficacy and safety of herbal drugs as well as to monitor
the production and application of such medicines.
In the last three centuries, medicine has focused predominantly on the physical body as the source of disease, placing very little importance on the mind. However, the significance of mind-body interactions in medicine is now increasingly being recognised. True health must include both the physical body and the mind. This article traces our concepts of the relationship between mind and body since primitive times and explores its relevance to the maintenance of health.
Introduction: Attention is one of many cognitive functions; it plays a central role in the learning process. For this reason, our study aims to determine the impact of attentional abilities on academic performance among middle school learners in Middle Atlas of Morocco.
Methods: Data were collected from a sample of 137 middle school learners. For the assessment of attentional abilities, we performed the Trail Making Test (TMT) to estimate mental flexibility. Evaluation of selective attention was done through the Stroop Test and the measurement of sustained attention was achieved via the d2-R test.
Results: Our results revealed that the attentional abilities of learners in our samples are positively correlated with their academic performance and vice versa.
Conclusion: At the end of this study, it is important to establish a thorough diagnosis of attentional disorders to identify learners with attention problems in order to implement a remedial program so as to avoid the detrimental effects of these disorders on the academic performance of learners.
The aim of the study was to research the use of a simple neural network in diagnosing angina in patients complaining of chest pain. A total of 887 records were extracted from the electronic medical record system (EMR) in Selayang Hospital, Malaysia. Simple neural networks (simple perceptrons) were built and trained using a subset of 470 records with and without pre-processing using principal components analysis (PCA). These were subsequently tested on another subset of 417 records. Average sensitivity of 80.75% (95% CI 79.54%, 81.96%), specificity of 41.64% (95% CI 40.13%, 43.15%), PPV of 46.73% (95% CI 45.20%, 48.26%) and NPV of 77.39% (95% CI 76.11%, 78.67%) were achieved with the simple perceptron. When PCA pre-processing was used, the perceptrons had a sensitivity of 1.43% (95% CI 1.06%, 1.80%), specificity of 98.32% (95% CI 97.92%, 98.72%), PPV of 32.95% (95% CI 31.51%, 34.39%) and NPV of 61.33% (95% CI 59.84%, 62.82%). These results show that it is possible for a simple neural network to have respectable sensitivity and specificity levels for angina.
A case of an unusual foreign body aspiration in a child was managed T&ently. The mainstay in treahnen! is urgent extraction of the aspirated foreign body via a bronchoscope under general anaesthesia. A thoracotomy may sometimes be required when endoscopic retrieval fails, as illustrated by this case. She had an increased hospital Slay of 16 days, was ventilated for 8 days and her most serious complication was septic shock from which she recovered. KEYWORDS: Foreign body aspiration, children.
The use of steroid therapy and its treatment impact on children hospitalised with viral croup between 1994-1998 were reviewed by comparing 30 patients who received steroid therapy with 65 patients who did not. There was no difference in the socio-demographic and clinical profile between the two groups. The hospital stay (2.8 ± 1.3 vs 3.5 ± 1.2 days, p = 0.02) and duration of documented stridor (1.3 ±0.5 vs 2.8 ± 1.0 days, p = 0.001) were shorter for patients who received steroid therapy although they appeared to have more severe respiratory distress. There were no complications associated with steroid therapy use. Despite reluctance in administering steroid therapy for viral croup, patients who received the treatment had a shorter hospital stay and duration of stridor. KEYWORDS: Croup, steroid therapy, hospital stay.
To determine the impact of the haze on asthma symptomatology in children with chronic asthma on inhaled prophylaxis. The study was prospective and collected information on asthma symptoms from children attending the asthma clinic. A comparison of peak expiratory flow rate (PEFR) measurements before and during the haze was performed for children above 7 years. A total of 97 children were included into the study. Forty (41%) children complained of an increase in nocturnal cough (55%) followed by nasal symptoms (40%), daytime cough (40%), nocturnal wheeze (25%) and daytime wheeze (18%). About half of the children who had increased symptomatology during the haze had to limit outdoor activities. In the 43 children in whom PEFR studies were available, 29 (67%) of them had a fall in the PEFR. However, children with no increase in asthma symptomatology showed a similar fall in PEFR measurement when compared to children with increased asthma symptomatology. The haze appeared to be detrimental to the well being of some children with chronic asthma despite being on inhaled prophylaxis.
Study site: Asthma clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
An alarming increase in the prevalence of depression has been found among Malaysian young adults which necessitates responsiveness. This study sought to better understand the subjective personal growth experience in terms of the processes among young adults recovering from major depressive disorder (MDD). A qualitative, transcendental phenomenological design was adopted by collecting data through in-depth, semi-structured interviews, audio recordings, interview transcripts and documents. Nine Malaysian young adults with MDD (Mean age=28) who reported being in recovery from MDD for at least one year were recruited from local mental health settings through purposive sampling. Data analysis involved Colaizzi’s eight-step method. The findings revealed eight personal growth processes themes: revealing the struggles, self-discovery and personal strength, personal responsibility, readiness for change, hope, redefining the meaning, forgiveness, and acceptance. Noticeably, each theme was interconnected to facilitate personal growth among major depressive young adults. The implications for mental health psychotherapy practice and future research were discussed.
Tyrosinase is a key enzyme that catalyzes melanogenesis in human skin. It oxidizes tyrosine to L-3,4-dihydroxyphenylalanine (L-DOPA) and subsequently to dopachrome, which further polymerizes to melanin pigments. Therefore finding an effective tyrosinase inhibitor, either from synthetic or natural sources, is not only useful as skin whitening agents in cosmetic application, but also beneficial in treating melanin-related disorders. The present study reports of the optimized and validated results of a cell-based tyrosinase assay using B16F10 murine melanoma cell line, which produces melanin pigments and has been used extensively in antimelanogenesis studies. The optimization studies involved 3 parameters (1) optimal seeding cell number per well for total protein extraction; (2) optimal dopachrome formation from enzymatic reaction between total protein (tyrosinase source) and L-DOPA (substrate); and (3) optimal incubation period after the addition of substrate. The present study demonstrates that using seeding cell number of 2 × 105 cells/well, total protein of 40 μg, L-Dopa of 5 mM,and at an incubation period of 1 hour at 37°C provided the optimal response on cultured melanoma cells. Kojic acid, a standard tyrosinase inhibitor, was used as a positive control in the optimized cell-based tyrosinase assay to validate the usefulness of the assay. CONCLUSION: The use of the mentioned protocol is sensitive to determine changes in melanoma cells as the result of tyrosine inhibitors.
Steroids remain an important component of maintenance immunosuppression after renal transplantation. Their anti-inflammatory action is partly due to the sequestration of CD4+ lymphocytes in the reticuloendothelial system. Steroids bind to intracellular receptors and the resulting steroid-receptor complex alters the transcription of cytokines by binding to glucocorticoid response elements on DNA. Transcription factors whose actions are altered by glucocorticoids include activating protein-1 (AP-1) and nuclear factor-B (NF-B). The main cytokines whose production by antigen-presenting cells is inhibited by steroids are interleukin-1 (IL-1), required for helper T-cell activation, and IL-6, required for B-cell activation. Other pro-inflammatory cytokines such as interferon gamma and tumour necrosis factor are also inhibited. This multiplicity of immunosuppressive actions is not fully replicated by other immunosuppressants. However, there are concerns about the long-term side effects of steroids. This review will examine the attempts at steroid withdrawal or steroid avoidance in renal transplant patients.
The objective of the present study is to investigate the impact of socio-demographic factors on the acquisition of health information on Non-Communicable Diseases (NCDs) among Malaysian adults. A robust analysis was conducted on cross-sectional survey data obtained from 398 respondents in Penang (Malaysia) between August to October 2010. An ordered probit model was applied to examine the factors affecting the scale of health information. The results suggest that old individuals, rural dwellers, having chronic disease and history of serious family illnesses are 0.19%, 2.39%, 2.2% and 2.71% less likely to acquire poor health information on NCDs than others, whereas Malays, Chinese, males and those of low educated are 8.76%, 6.22%, 2.94% and 21.62% more likely to acquire poor health information on NCDs than others. Based on these findings, several intervention measures toward increasing the health knowledge among the population are recommended, which include the use of language-based mass media to advertise the information on diseases, designing health awareness campaigns in urban areas and introducing more basic health related subjects and courses into primary and secondary schools.