Introduction: Acne vulgaris is a chronic inflammatory dermatosis caused by Propionibacterium acnes. Clinicians are constantly attempting to discover the best antibiotic regimes in treating acne vulgaris. This study compares two regimens in terms of efficacy, tolerability, compliance and recurrence rate to make recommendation on which is the best regime. Methods: An open-labelled prospective randomized investigator-blinded interventional study was carried on moderate acne vulgaris patients. Patients were assigned to treatment arm at enrolment followed by fol- low-up and maintenance visits. Demographic data were collected at enrolment and questionnaire enquiring acne condition, general health and quality of life impairment were filled at every visit followed by blinded dermatologist assessment. Antibiotic tablets were provided based on assigned arm until follow-up 3. Results: 26 mild acne vulgaris patients aged 17 to 29 years were recruited. Physician assessment based on GAGS and photo assessment analysis showed an overall significant change (p0.05) were found between regimens. Similarly, patient self-perceived assessment and CADI assessment also showed overall significant changes (p
Introduction: Urbanisation is a key determinant of population health. Malaysia’s exemplary economic growth in the early 1990s and the consequent development and urbanisation led to significant changes in health, lifestyle and quality of life. Rising expectations, changing demographics and nutrition and disease transitions were challenges synonymous to an increasingly urban Malaysia. As the Government targets optimal population health, this paper aims to explore one of the many challenges of urbanisation, namely the prevalence of non-communicable diseases or NCDs. For the purpose of this paper, NCD is proxied by Diabetes Mellitus. Methods: This study is based the 2015 National Health and Morbidity Survey, which is a cross-sectional population-based survey, involving 30,000 re- spondents. Given the binomial nature of the survey variables, the multinomial Probit model was employed using the STATA statistical software. Results: Generally, age, gender and race are significant in determining health outcomes. Socioeconomically, all three variables of income, education and employment are significant. For lifestyle factors, findings show that only the weight and physically active status have a role in determining health outcomes. Finally, the urban variable is also positive and significant. Conclusion: Findings show that the prevalence of Diabetes Melli- tus, is rising along with urbanisation and that there is a health penalty for the urban population and also for those who do not embrace healthy lifestyles. Additionally, other factors are equally important as urban health determinants, encompassing both the demographic and socioeconomic factors.
Introduction: Determination of learning needs is central for holistic patient education, to sustain behavior changes and to control patient’s risk factor. However, patients often sense that their learning needs are unmet and informa- tion provided was too general. Thus, this study aimed to determine the perceived learning needs and their level of importance among Coronary Artery Disease (CAD) patients. Methods: The current investigation is a descriptive, cross-sectional study for which all CAD patients were selected using the cencus method. The data was collected us- ing Cardiac Patients Learning Needs Inventory. The questionnaire was delivered to 140 CAD patients who had their follow-up in a cardiology clinic. The instrument is reliable with a Cronbach’s alpha coefficient of 0.96. The study design followed STROBE cross-sectional design process guideline. Results: Participants’ mean age was 58.96 ± 9.42 years. More than half of the participants were males (62.9%), employed (52.0%) and had attained secondary level education (69.3%). Around two-thirds (60.7%) of the patients perceived to have high learning needs. Gender and highest educational achievement were significantly associated with perceived learning needs. The most significant perceived learning needs were medication information, risk factors for CAD, information on diet, physical activity, anatomy and physiology, and other related information. Conclusion: This study has identified the important domains of learning needs among CAD patients. Findings from the present study will provide important input for future cardi- ac educational strategies to reduce the rate of hospital readmission and death.
Introduction: Scarcity of data found in regard to association of vitamin D level with bone mineral density (BMD). Our study aimed to determine the correlation of vitamin D with BMD and intact parathyroid hormone (iPTH) among healthy Malay adult. Methods: This cross-sectional study recruited 126 healthy Malay volunteers (aged 21–45 years old) from Kota Bharu, Malaysia. Serum total calcium, albumin, phosphorus, 25-hydroxyvitamin D (25(OH)D), and iPTH were measured. BMD was assessed with dual energy X-ray absorptiometry (DXA) scan over left hip (right hip in case of problem with left hip) and lumbar spine (L1 – L4 vertebrae). Results: The mean serum 25(OH)D was 38.91
± 14.07 nmol/L. Out of 126 study subjects, 104 subjects (82.5%) had insufficient level of vitamin D (< 50 nmol/L). Mean hip and lumbar BMD were 0.952 ± 0.145 g/cm2 and 1.006 ± 0.133 g/cm2 respectively. According to T-score, 93 subjects (73.8%) had normal T-score of -1, 33 subjects (26.2%) had osteopenia (T-score -2.5 to -1) and none had osteoporosis (T-score -2.5). Significant positive correlation between serum 25(OH)D and hip BMD (r = 0.234, p = 0.009) was observed, but no correlation was found between serum 25(OH)D and lumbar BMD. Meanwhile, significant inverse correlation between serum 25(OH)D and iPTH was observed (r = -0.324, p < 0.001). Conclusion: High prevalence of vitamin D insufficiency was observed among healthy Malay population, but majority had normal bone density. Nonetheless, serum 25(OH)D was positively correlated with BMD and inversely correlated with iPTH. Our findings support the role of vitamin D for maintaining bone health.
Introduction: Drug-resistance is a major hindrance to successful treatment of AML. Current predictive biomarkers are mainly genetic aberrations and insufficient in foretelling treatment outcome in all acute myeloid leukaemia (AML) due to its heterogeneous and aggressive nature. Proteins are stable and reliable. Secreted proteins in AML may have predictive or prognostic values for early intervention. Proteomic studies on AML are few and further investigations will benefit in selection of best markers. The aim of the study was to identify differentially expressed plasma proteins in AML with different treatment outcome. Methods: Two-dimensional electrophoresis (2-DE) technique was utilised to identify proteins differentially expressed in chemo-sensitive/chemo-resistant AML. Plasma and peripheral blood mononuclear cell (PBMC) lysate proteome analysis were performed on six chemo-resistant, four chemo-sensitive and six healthy controls and seven chemo-resistant, three chemo-sensitive and six healthy controls, respectively. Each experiment was conducted in duplicate or triplicate. Images were captured and protein spots detected by software. Differentially expressed protein spots were excised from gel and proteins were identified using LC/MS/MS. Proteins spots that were also detected in healthy controls were excluded. Results: Comparing mean % volume of each spot demonstrated significantly enhanced expression of apoliprotein-E (APO-E) and haptoglobin (HP) (p
Introduction: Diabetes-associated autoantibodies (DAA) is the hallmark of T1DM and LADA which are frequently tested in young diabetes patients. It was noted that up to 10-15% of patients with initial diagnosis of T2DM also exhibit DAA. Regardless of the classification, the presence of DAA suggests an underlying islet autoimmunity which lead to progressive pancreatic β-cell failure. There is limited data reported on DAA in young diabetes patients in Malaysia. This study aims to determine the frequency of DAA positivity and its association with demographic and clinical characteristics among this cohort. Methods: A retrospective study using secondary data obtained from Al- lergy and Immunology Research Centre, Institute for Medical Research, Malaysia. This study included 194 diabetes patients who were diagnosed before the age of 40 years old and tested for GADA, ICA, IA2A and IAA. Results: From 194 patients, 91 (46.9%) were positive for least one of the following DAA: ICA (79, 40.7%), GADA (61, 31.4%), IA2A (37, 19.1%) and IAA (9, 4.6%). Multiple positivity was higher (73.6%) compared to single positivity. Highest com- bination of double positivity was ICA+GADA (54, 59.3%) and triple positivity was ICA+GADA+IA2A (25, 27.5%). Simultaneous positivity of four autoantibodies was seen in only one (1.1%) patient. ICA, GADA and IA2A were asso- ciated with age group and ethnicity (all p < 0.001). Only IA2A was associated with gender (p = 0.012). Conclusions: GADA, ICA ad IA2A are more significant in young Malaysian diabetes patients. IAA has a very low frequency in this studied population.
Introduction: In Malaysia, herbal medicines are used for variety of reasons including health promotion and home remedies during pregnancy and postpartum with Manjakani (Quercus infectoria) as one of the most commonly consumed herbs. Herbal medicines consumption had been linked to heavy metals contamination and transfer from mother to infant and may affect infant’s growth and development. This study aims to (i) determine Manjakani consumption among postpartum mothers, (ii) quantify its heavy metals level, namely lead, cadmium, arsenic and chromium, and (iii) determine health risk associated with its consumption. Methods: A cross-sectional study involving 106 postpartum mothers was carried out in Kuala Lumpur. Six samples of Manjakani were sampled and extracted using microwave digester and analysed using Inductively coupled plasma mass spectrometry (ICP-MS). Non-carcinogenic health risks for herbal medicine consumption were calculated using Hazard Quotient (HQ). Results: Manjakani was consumed by 16% of mothers (n=17). Highest level of the metals was shown by chromium with mean concentration of 4210 ± 1910 ug/kg, followed by lead (170.8 ± 193.2), arsenic (39.3 ± 27.1) and cadmium (7.7 ± 0.76). There were no significant non-carcinogenic health risks with lead, arsenic, chromium and cadmium contamination (HQ < 1). Conclusion: Manjakani is consumed by mothers during confinement period. Heavy metals were quantified in Manjakani although no significant association was observed with socio-demographic characteristics and birth outcomes.
Introduction: Moringa oleifera Lam. is a miracle tree that has been widely utilised in folklore medicine due to its immense amount of phenolic constituents that could treat various ailments. Different techniques have been imple- mented to extract the phenolic but the parameters may not be optimised to further enhance the amount of phenolic extracted. Thus, the work aimed to enhance phenolic content and antioxidant activity of M. oleifera through RSM methodology, which is rapid and convenience. Methods: At first, antioxidant activity of different parts of M. oleifera (leaves, stem, pod and seed) were investigated. The plant part with the highest antioxidant activity was selected for the optimisation of extraction condition using RSM. In RSM, temperature (XA), extraction time (XB) and solid-liquid ratio (XC) were employed to study the effects on yield, total phenolics, flavonoids and antioxidant activity. Then, the optimum extraction condition obtained via RSM was utilised in LC-MS and HPLC analysis to determine the poten- tial bioactive constituents. Results: The leaves of M. oleifera displayed the highest antioxidant activity as compared to other plant parts. The optimum extraction condition obtained for the leaves extract was: temperature (XA): 82°C, extraction time (XB): 48 min and solid-liquid ratio (XC): 1:30 g/mL (w/v). Meanwhile, LC-MS revealed the presence of gallic acid, chlorogenic acid, quercetin, kaempferol and 3-O-glucoside kaempferol. HPLC analysis detected six compounds; gallic acid, epicatechin gallate, chlorogenic acid, myricetin, quercetin and kaempferol. Conclusion: The optimisation are promising to improve yield and antioxidant activity in M. oleifera as compared to non-conven- tional extractions.
Introduction: Aedes albopictus is known for its aggressiveness towards human and recently expanded to more coun- tries outside the native regions. Thus, the demographic parameters of Aedes albopictus are important to determine the characteristics of this species mosquitoes in terms of the reproduction rates and dispersal distance. Materials and Methods: This study, was performed using a Shah Alam strain of Aedes albopictus originally collected in twenty district areas of the central zone of Shah Alam. This research applies field work-study with a cross-sectional design to investigate the demographic parameters of Aedes albopictus. The demographic evaluation of Aedes albopictus was conducted under the control environment in insectarium. Results: Investigation on the demographic parameters of Aedes albopictus clearly showed that there is a significance different observed in the total number of mosquito eggs produced in both high and low incidence rate IR areas (p=0.03). In contrast, other parameters showed insignificant value between high and low IR areas. Conclusion: The key to control the mosquito vectors population is by tracking the vector’s life cycle including its survival. Therefore, the outcome of this study may provide as a baseline to esti- mate the dengue outbreak in the current episystem.
Introduction: Vibrio cholerae is a motile, Gram-negative curved rod belonging to the Vibrionaceae family. It is the causative agent of cholera. The acute diarrheal disease cholera causes about 120 000 casualties annually and has a significant effect on the health of young kids between the ages of 1 and 5. The main cause of death is due to resistance to antibiotics. As a result, new drug targets need to be identified immediately. The study’s goal is to identify Vibrio Cholerae’s putative drug target through an integrated approach to genomics and proteomics. Methods: Through this study, 2241 core protein sequence of Vibrio Cholerae were retrieved from the Panx tool. The sequence decreased to 173 druggable sequences by undergoing different phases of the process such as determining the non-homolo- gous sequence against human proteome by using the BlastP tool, identifying the essential genes by using the DEG database, and determining the sequence of virulent proteins by using Virulent prediction tool. Results: 11 potential drug targets were identified through molecular weight, and sub-cellular localization analysis. Conclusion: Through pan-genome analysis, we can able to find potential drug targets. This study also helps to identify the potential drug targets against Vibrio cholerae and to increase the efforts of drug and vaccine developments.
Introduction: Glucose-6-phosphate dehydrogenase (G6PD) deficiency causes red blood cell destruction due to oxi- dative stress. G6PD is essential for NADPH conversion; which is critical for glutathione reductase to prevent damage to cellular structures. In Malaysia, blood donors are not routinely screened for G6PD deficiency. We hypothesise that G6PD-deficient red blood cells are more likely to haemolyse during storage due to increased oxidative molecules. The objectives of this study were to determine the prevalence of G6PD deficiency among blood donors, describe their characteristics and to evaluate the effects of storage on G6PD-deficient donated blood. Methods: This study was conducted at selected mobile donation centres in Terengganu. Consented blood donors were screened for G6PD sta- tus using fluorescent spot tests (FST). G6PD enzyme activities were measured for donors who were G6PD deficient. Effects of storage on haemolysis from G6PD-deficient donors were compared with non G6PD-deficient group. Sixty ml of blood was collected from blood unit to transfer pouch for estimation of haemoglobin (Hb), plasma Hb, per- centage of haemolysis and plasma potassium. Serial sampling with a 7-day interval was done from Day 1 to Day 35. Statistical analysis was considered significant if p 0.05. Results: A total of 440 blood donors were screened and 12 male donors were found to be G6PD deficient by FST. Enzymatic activities were measured in 11 donors as one donor sample failed to be sent to the centre due to logistic problem. Their enzymatic activities ranged from 1.66-2.93 U/g Hb whereby 6 have severe deficiency and the other 5 were categorised as partial deficiency. Donors were asymp- tomatic for haemolytic episode. Serial sampling showed there was no significant difference of haemolytic parameters in blood units of G6PD-deficient donors as compared to control (p>0.05). Conclusion: Prevalence of G6PD blood donors in Terengganu mobile centres was 2.7%. G6PD enzyme activities did not correlate with clinical symptoms. Haemolytic parameters were not affected in blood units which were G6PD-deficient.
Introduction: Accelerants and fabrics are commonly used to spread fire attributable to their highly flammable prop- erties. Hence, having the ability to discriminate the different types of accelerants on various types of fabrics after fire and/or arson using the non-destructive Attenuated Total Reflectance-Fourier Transform Infrared (ATR-FTIR) spec- troscopy coupled with chemometric techniques appears forensically relevant. Methods: Six types of fabrics viz. cotton, wool, silk, rayon, satin, and polyester, were burnt completely with RON95 and RON97 gasoline as well as diesel. Subsequently, the samples were analyzed by ATR-FTIR spectroscopy followed by Principal Component Analysis (PCA) and Linear Discriminant Analysis (LDA) for discriminating the different types of accelerants on such burned fabrics. Results: RON95 showed the fastest rate of burning on all fabric types. Results also revealed that while wool had the slowest burning rate for all the three different accelerants, polyester, cotton, and satin demon- strated the highest rate of burning in RON95, RON97, and diesel, respectively. FTIR spectra revealed the presence of alkane, alcohol, alkene, alkyne, aromatic, and amine compounds for all fabrics. The two dimensional PCA (PC1 versus PC2) demonstrated 71% of variance and it was improved by cross-validation through the three dimensional LDA technique with correct classification of 77.8%. Conclusion: ATR-FTIR spectroscopy coupled with chemometric techniques had enabled identification of the functional groups, as well as statistically supported discrimination of the different accelerants, a matter of relevance in forensic fire and arson investigations.
Introduction: There are numerous studies on the therapeutic properties of Artocarpus heterophyllus. However, stud- ies on the aqueous extraction of A. heterophyllus leaves are limited. This present study was conducted to optimize the extraction conditions of A. heterophyllus leaves to yield the highest phenolic, flavonoids and antioxidant contents. Methods: Response surface methodology (RSM) was employed to obtain a higher phenolic extraction parameter(s) of A. heterophyllus leaves using Central Composite Design (CCD). The antioxidant activity was then determined via ABTS (2,29-azinobis (3 ethylbenzothiazoline-6-sulfonic acid)) and DPPH (2,2-Diphenyl-1-picrylhydrazyl) assay and analysis of the individual phenolics was performed by high performance liquid chromatography (HPLC). Results: The optimum extraction conditions with higher phenolics content and antioxidant activity was achieved at 81°C, 100 min and 40 mL/g sample with a good desirability value of 0.87. Under these optimized parameters, total phenolics and flavonoids were 174.48 ± 4.05 mg GAE/g sample and 21.44 ± 0.05 mg RE/g sample, respectively. Meanwhile, antioxidant activity via ABTS and DPPH assays were 90.88% ± 0.09 and 87.22% ± 0.62, respectively. Finally, under optimal extraction conditions revealed 4 compounds identified as chlorogenic acid, quercetin, rutin and kaempferol. Conclusion: The optimisation are promising to improve phenolic yield and antioxidant activity in A. heterophyllus leaves. It also proved that A. heterophyllus leaves can be used as an alternative natural antioxidant especially in medicinal applications since all identified compound possess significant biological activities for human health.
Introduction: Lean healthcare outcome is usually measured with multiple key performance metrics but there is a lack of tools that enabled efficiency assessment. This research aimed to assess the efficiency among lean public emergen- cy departments (ED) through Slack-Based Measure Data Envelopment Analysis (SBM-DEA) and evaluate the impact of lean on the efficiency in public emergency departments. Methods: A retrospective observational study design using data on the number of support staff, number of doctors, number of discharge, arrival to consultant and length of stay. Efficiency scores of 20 Malaysian public EDs were computed using SBM-DEA modelling and compared be- tween before and after lean implementation. Results: A total of 13 out of 20 public EDs exhibited improvement in ar- rival to consultant and length of stay upon lean implementation. However, only 9 out of the 13 public EDs have had an improvement in efficiency score. Conclusion: Lean healthcare demonstrated a positive impact on the efficiency level of some public EDs. The SBM-DEA model offers the benchmarking capability and slack elimination information that may complement the lean continuous improvement philosophy.
Introduction: Age-related macular degeneration (ARMD) is an ocular degenerative disorder that associated with impairment of central vision. Oxidative stress plays an important role in the pathogenesis of ARMD. The aim of this study was to determine the level of antioxidant enzymes (catalase and glutathione peroxidase) in tears among Malay ARMD patients. Methods: A cross sectional study was conducted between September 2015 and November 2017 among Malay ARMD patients. Schirmer paper was used to collect the tear samples. The level of catalase and glu- tathione peroxidase level in tears was evaluated using commercially available oxidative stress marker kits. Results: A total of 136 Malay ARMD patients were recruited into the study with 68 controls. Mean tear catalase and gluta- thione peroxidase levels were significantly lower in ARMD patients (1348.97 SD 109.11 µM and 453.87 SD 41.96 U/L respectively) as compared to the control group (1453.38 SD 38.87 µM and 502.28 SD 34.29 U/L respectively) (P
Introduction: FertiQoL questionnaire was developed and validated in 2011. It has been widely used and translated
into many languages to measure QoL among infertile individuals. The use of translated psychometric tools is often
subjected to cross-cultural variations. The objective of this study is to assess the psychometric properties of the
Malaysian FertiQoL. Methods: A study was conducted among attendees of a public infertility clinic. Demographic
details were collected and respondents answered the Malaysian FertiQoL. The questionnaire consists of 34 items.
Factor analysis and internal consistency were analysed using SPSS v24. Results: Data from 175 respondents were
analysed. Mean age is 32.1 ±3.8 SD with 56.6% female and 43.4% male. KMO index were 0.826 and significant
Bartlett’s test for sphericity. For Treatment domain, factor loadings for items T2 and T5 were < 0.32 but for all other
items were acceptable between 0.32 – 0.80 with no cross loadings and Cronbach alpha for environment (0.717)
and tolerability (0.660). For Core items, Q4, Q6 and Q14 loaded onto different domains and Q19 had poor factor
loading. All other items were acceptable. Cronbach alpha for specific domains were emotional (0.788) mind-body
(0.829), relational (0.639) and social (0.666). Cronbach alpha for emotional, relational, social improved to 0.857,
0.643 and 0.732 if Q4, Q6 and Q14 were omitted respectively. Conclusion: The study identified six items that affected the psychometric validity of the questionnaire and maybe explained by language or cross-cultural reasons.
However, the Malaysian FertiQoL can still be useful to measure QoL in those with infertility.
Introduction: The World Health Organization recommends evaluation of maternal satisfaction to improve quality of health care during childbirth. Dissatisfaction may lead to undesired outcomes such as unassisted homebirth and delay in seeking treatment. Determining the maternal satisfaction level and its associated factors may help to improve health care services and prevent negative implications to both mothers and infants. This study aimed to determine the maternal satisfaction towards intrapartum care of designated healthcare facilities and its associated factors among postnatal women. Methods: This was a cross-sectional study of postnatal women attended Klinik Kesihatan Salak from December 2017 to February 2018. Systematic random sampling with the ratio of 1:3 was applied to the eligible respondents. A self-administered questionnaire that include respondent’s socio-demographic characteristics and a validated 14-items Maternal Satisfaction with Hospital-based Intrapartum Care Scale was used. Data was analyzed using SPSS 23. Results: 274 respondents were recruited in this study. Overall, only 21.2% of respondents were sat- isfied with the intrapartum care given. The level of satisfaction was highest in interpersonal care domain (36.1%), followed by physical birth environment (34.3%) and the least satisfied was information and decision making domain (27.7%). Binary logistic regression showed that maternal satisfaction was significantly associated with place of birth (AOR (95% CI): 0.046 (0.183, 0.984)) and labour complications (AOR (95% CI): 3.387 (1.345, 8.528)). Conclusion: The overall maternal satisfaction towards intrapartum care was low and the information and decision-making do- main appeared to be the least satisfied. Maternal satisfaction was associated with place of birth and labour compli- cations. Therefore, health care providers should emphasize and improve the quality of services especially for this domain and to consider factor that contribute to dissatisfaction towards the intrapartum care.
Introduction: Short-term fasting may influence intraocular pressure (IOP) due to alteration of fluid (total body water;
TBW, and water intake) and fat (total body fat; TBF). This study aimed: i) to compare IOP values within and between,
fasting and non-fasting periods; and ii) to assess the association between IOP and, TBW and TBF. Methods: Thirty
healthy participants aged 21.8±1.1 years were assessed on two different periods (fasting vs. non-fasting). During each
period, the IOP, TBW and TBF values were assessed for four times (morning, afternoon, evening, late-evening). The
IOP was measured using AccuPen® tonopen, while TBW and TBF were assessed by using a Tanita body composition
analyser. Results: During fasting, the IOP value in the afternoon (14.53±2.33 mmHg) was significantly higher than in
the evening (12.43±2.73 mmHg, p=0.009) and late-evening (12.60±2.44 mmHg, p=0.003). No significant difference
in IOP was observed during non-fasting period. The mean of IOP in the evening was significantly lower during fasting
compared to non-fasting (12.43±2.73 mmHg vs 13.75±2.53 mmHg, p=0.044). The IOP and TBW were negatively
correlated (r=-0.268; p=0.011) during non-fasting and showed no association during fasting period. There was no
significant correlation between IOP and TBF during both fasting and non-fasting periods. Conclusion: IOP reduction
during short-term fasting, together with the no association with TBF and TBW suggested that IOP is an independent
factor that reduces during fasting in healthy population.
Introduction: Pesticides may influence the physicochemical properties of soil and the water quality parameters, which is vital in maintaining soil fertility and producing high quality crops. Objective: This study aims to determine the relationship between the concentration of pesticides, the physicochemical properties of the paddy soil samples and the water quality parameters of paddy water samples. Methods: A total of 72 soil and 72 water samples were collected in Tanjung Karang, Malaysia. The paddy soil and water were extracted using Quick, Easy, Cheap, Efficient, Rugged and Safe (QuEChERS) and solid phase extraction (SPE) techniques respectively. The concentrations of pesti- cides were analysed in ultra-high performance liquid chromatography tandem mass spectrometry (UHPLC-MS/MS). The relationship of the concentration of target pesticides and the paddy soil and water physicochemical properties were studied using Spearman correlation. Results: In paddy soil, the concentration of propiconazole shows moderate positive correlation with manganese (Mn) (r = 0.587) (p 0.01). Meanwhile buprofezin-total organic carbon (TOC) (r = -0.55) (p 0.01), imidacloprid-cation exchange capacity (CEC) (r = -0.519) (p 0.01), pymetrozine-sodium (Na) (r = -0.588) (p 0.01), and trifloxystrobin-calcium (Ca) (r = 0.566) (p 0.01) showed moderate negative correlation. Whereas in water, trifloxystrobin showed significant positive correlation with turbidity (r = 0.718) (p 0.01) and te- buconazole showed negative correlation to dissolved oxygen (DO) (r = 0.634) (p 0.01). Conclusion: The presence of pesticides in paddy field may influence the soil and water quality, thus regular monitoring of pesticides usage and nutrient management in soil is deemed important.
Introduction: Chronic musculoskeletal pain is a common disabling condition among older adults with the major- ity, remain undertreated. This study aimed to determine the uptake of non-pharmacological treatment for chronic musculoskeletal pain among older adults and the associated factors. Methods: A stratified sampling proportionate to size with individual clinics as the strata were used to recruit 276 respondents from six public health clinics in Petaling district, one of the most aged districts in the state of Selangor, Malaysia. Based on the proportion calculat- ed, eligible older adults were selected by systematic random sampling from the registration list. Data was collected using a pre-tested and validated questionnaire through a face-to-face interview with respondents. The questionnaire comprised of seven sections, namely, socio-demographic, comorbidity, depression, pain severity, treatment options, attitude towards chronic pain and chronic musculoskeletal pain. Inferential analysis was conducted using Chi- Square (X2) and Fisher’s Exact Tests. The P value of < 0.05 regarded as statistically significant. Results: A total of 242 (87.7%) of the respondents had chronic musculoskeletal pain, in which 235 (85.1%) were treated with non-pharma- cological treatments. The commonly used non-pharmacological treatments were exercise (67.8%), biological-based therapies (40.9%) and massage (33.7%). The uptake of non-pharmacological treatment for chronic musculoskeletal pain among older adults was significantly associated with the presence of diabetes. Conclusion: The findings re- vealed the remarkably high uptake of non-pharmacological treatment among older adults who experienced chronic musculoskeletal pain which was significantly associated with diabetes and the presence of other diseases like high blood pressure, osteoarthritis, back pain and rheumatic arthritis.