Effects of cultural practice under different habitats, of well-managed monoculture plantation and growing wild under rubber trees, were studied in Aquilaria malaccensis (Karas) leaves. This study was carried out on Karas growing in these two habitats each from Lipis, Pahang and Sepang, Selangor areas in Malaysia; under the control and induced treatments. The parameters studied include wet and dry weight of 50 matured leaves, iron and zinc elemental contents in leaf, iron and zinc uptakes from soil, and leaf and soil moisture contents. Iron and zinc were analysed in Karas leaves and soil by using Instrumental Neutron Activation Analysis (INAA) technique.
Field investigation on the operation of an industrial fluidized bed paddy dryer of 25 t/h capacity available in a processing complex of Padiberas Nasional Berhad (BERNAS) of Malaysia was carried out to assess its drying characteristics, energy consumption and quality of product during two paddy harvesting seasons. A grain drying simulation model was used to predict dryer performance which can be used as a basis for improving drying operations. For the first season (August-September), average drying rate was found to be 538 kg moisture/h to reduce moisture content (mc) from 36.98± 0.89% dry basis (db) to 27.58±0.79% (db) at 100-120°C of drying air temperature with a feed rate (capacity) of 7.75 t/h. In the second season (February-March), average drying rate was found to be 435 kg moisture/h to reduce mc from 28.14 ±0.68% (db) to 22.54 ± 0.69% (db) at 78-90°C drying air temperature with a feed rate of 9.5 t/h. The thermal and electrical energy consumptions were obtained as 7.57 and 0.97 MJ/kg water removed, respectively, for the first season, while 5.92 and 1.2 MJ/kg water removed for the second season. Higher head rice yield and whiteness and lower milling recovery were achieved during the first season than the second season at acceptable milling degree and transparency. Meanwhile, simulation results indicated that the dryer performed better in terms of increased drying capacity during the second than the first season; the dryer could be operated at 150°C to achieve almost double throughput capacity up to 20 t/h for the second season, while for the first season, high mc hindered the capacity to be at or below 7.75 t/h even when using higher a temperature of 160°C to reduce moisture to the desired final moisture of 24-25% (db). Proportion of slower vehicles based on users' opinion poll
Chronic obstructive pulmonary disease (COPD) patients are reported to have cardiovascular instability which leads to greater limitation for activities there by leads to poor quality of life. Physical training proved to be one of the moderators of these limitations. However, uncertainty prevails among the protocol and duration. The present study investigated the effect of physical training on blood pressure, heart rate and Rate pressure Product (RPP) among COPD patients. A total of thirty COPD patients aged between 40 to 55 years were recruited for the study based on the inclusion and exclusion criteria and were assigned in to experimental group (15 patients) and control group (15 patients). The mean difference of blood pressure, heart rate and RPP were analyzed using paired t-test. There was significant difference between the pre and post test values of all parameters between experimental and control group with p< 0.05. Diastolic blood pressure showed to be less significant compared to the systolic blood pressure. This showed that specifically designed physical improved the cardiovascular fitness among COPD patients.
Estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) immunohistochemistry are important markers in the management of patient with breast carcinoma. In this study, we determine the concordance rate of ER, PR and HER2 immunohistochemistry markers between core needle biopsy (CNB) and excisional biopsy (EB) of breast carcinoma in patients of Universiti Kebangsaan Malaysia Medical Centre (UKMMC) from January 2002 until December 2012. A total of 93 female patients with CNB and subsequent EB were included in this retrospective descriptive study. Immunohistochemistry is used to determine ER, PR and HER2. ER and PR was graded using Allred score (0 to 8) while HER2 was scored from 0 to 3+. The markers between these two biopsies were compared to determine the concordance rate. In ER and PR, 93 samples were compared. ER was concordant in 80 cases (86.0%) and 13 cases (14.0%) was discordant. PR was concordant in 82 cases (88.2%) and discordant in 11 cases (11.8%). In HER2, 87 samples were compared and 62 cases (71.3%) were concordant while 25 cases (28.7%) were discordant. Concordance between CNB and EB was high for ER and PR. However, concordance rate for HER2 immunohistochemistry was less consistent. Overall, immunohistochemical analyses of CNB reflect the tumour marker status of the excised specimen.
Keywords: breast carcinoma, core needle biopsy, estrogen receptor, progesterone receptor, HER2
Light intensity output is one of the determinants for adequate curing of visible light-cured materials. The aim of this survey was to evaluate the light intensity outputs (LIOs) of light curing units (LCUs) in dental clinics of Hospital Universiti Sains Malaysia (HUSM) and School of Dental Sciences, Universiti Sains Malaysia (USM). The respective LIOs of all functioning Quartz Tungsten Halogen (QTH) and Light Emitting Diode (LED) LCUs were tested using two light radiometers. For cordless LED LCUs, the testing procedure was done in situ and after being fully charged. Statistical analysis using Kruskal Wallis and Wilcoxon signed ranks tests were performed to compare the LIOs between groups and between the LIOs of in situ and post-charged cordless LED LCUs, respectively. The level of significance was set at 0.05 (p
Chronic periodontitis (CP) is an inflammatory disease of the supporting tissues of the teeth caused by specific microorganism. Hypertension is one of the major causes of cardiovascular disease whereas periodontitis has recently drawn increasing attention because of its potential relationship with cardiovascular disease. The objectives of this study were to determine the prevalence of the hypertension in CP patients as well as to evaluate the association between hypertension and severity of CP. One hundred and eighty five records of CP patients treated in Dental Clinic, Universiti Sains Malaysia Hospital (USM Hospital), Kelantan from 2010 until 2013 were retrieved and reviewed. The diagnosis of periodontal disease and the presence of hypertension were recorded. The severity of chronic periodontitis was classified into mild, moderate and severe according to the clinical attachment loss. The data was obtained and analyzed using SPSS version 20.0. Majority of the subjects were from Malay ethnic group (94.4%) at the age range between 41 and 61 years (67.8%). In conclusion, the prevalence of hypertension in chronic periodontitis patients was 12.2%. There was no significant association between hypertension and severity of CP (p=0.229).
The objective of this survey was to evaluate the knowledge of final year dental and medical students of Universiti Sains Malaysia concerning epidemiology, aetiology, clinical aspects, prevention, early detection and treatment of oral cancer and oral potentially malignant disorders (OPMD). A pre-tested, self-administered questionnaire with 36 questions was used. Forty five dental students and 147 medical students participated in the study. Dental students were relatively better informed than their medical colleagues concerning most issues addressed in the questionnaire. Yet, in some areas of knowledge, the dental students did not differ significantly from their medical colleagues. Only a small proportion of both groups of students expressed confidence in their knowledge and skills in oral cancer prevention and detection. This study revealed areas of deficiency in the awareness of these students concerning oral cancer and OPMD. It points to a necessity to strengthen these aspects of medical and dental undergraduate curricula.
While the prevalence of visually impaired children constitutes a small portion of the visually impaired population, it is important to determine whether the low vision services available are utilised by these children. This is important as previous studies have shown that children have a very high rate of successful low vision device use compared to adults. This was a cross sectional retrospective study. Fifty nine low vision clinic children records were evaluated. The results showed that 25.4% of the children were categorised as with moderate low vision, 30.5% with severe low vision and 40.7% were categorised as blind. The major causes of low vision were congenital cataract, congenital nystagmus, congenital glaucoma, macular degeneration and retinitis pigmentosa. Low vision rehabilitation for near work using magnifiers improved the vision of 30.5% of the low vision children. This finding suggests that 1/3 of low vision children could benefit from low vision rehabilitation. The low vision devices most commonly prescribed to the children in this study were stand magnifiers, hand-held magnifiers and spectacles. This study illustrates the key role of optometrists in the management of visual impairment in Malaysian children. It would appear that the establishment of low vision services in government hospitals using trained optometrists is a cost effective method of service delivery. Therefore more low vision children would have access to proper low vision rehabilitation and through that rehabilitation, their quality of life can be improved.
Key words: children, low vision
Study site: Klinik Penglihatan Terhad Pusat Perubatana, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
Malnutrition is common among pediatric oncology patients. Factors contributing to malnutrition include physiological abnormalities, response to the tumors and side effects of the treatment. A pilot study was carried out to determine the nutritional status of 17 pediatric oncology patients aged 4 to 12 years old in Hospital Universiti Kebangsaan Malaysia, Kuala Lumpur. The
nutritional status was assessed via anthropometric measurements and dietary intake through 3 days repeatitive 24 hours diet recall with subjects and their carers. Biochemical profiles (serum albumin and hemoglobin) were reviewed from the medical record. Through anthropometry measurements, weight and height were used to calculate Z-scores and further determine the percentile weight-for-age, height-for-age using NCHS percentile charts (WHO 1983). Frisancho’s standards (1981) were used to define malnutrition based on MUACfor- age. Underweight as determined using z scores below -2 for weight-for-age was observed in 70.6% of the subjects. Whilst, 76.5% of the subjects were classified as stunted (z score < –2) for height-for-age. Based on MUAC-for-age percentile, the sign of severe malnutrition category (<5 percentile) was observed in 35.3% of the subject and 23.6% of the subject were in the moderate malnutrition (>5 – <10 percentile). About 70.6% of the subject had low haemoglobin (< 11 g/dl) and 29.4% of the subject were hypoalbuminemia (< 35 g/dl) . Total macronutrient intake was assessed and compared with the individual requirement (Seashore 1984) for energy and protein intake were satisfactory, except for subjects in age group 10 – 12 years who achieved only 70% of the individuals requirements. As a conclusion, although food intake of the subjects was satisfactory but chronic malnutrition was prevalent. Early recognition of malnutrition is essential in order to plan for a nutritional intervention and further enhancing the quality of life.
Key words: Nutritional status, pediatric oncology, anthropometric, dietary intake, biochemical profile.
Patient waiting time was introduced to orthodontic clinics in 2009 as a Key Performance Indicator (KPI) in the Ministry of Health Malaysia (MOH) as a measure of client satisfaction. A cross-sectional pilot study was carried out in 2009 in all four main government orthodontic clinics in Selangor. The objectives were to measure patient actual waiting time and evaluate conformance to this KPI. The sample comprised of 5,286 patients; 9.2% from Tanjung Karang, 37.1% Kajang, 29.3% Klang and 24.4% Shah Alam. There were 33.8% punctual, 44.2% early and 21.9% late patients. The mean actual waiting time (AWT) in Selangor was 30 min (SD 24.7); shortest in Tanjung Karang (16.5min, SD 15.3) and longest in Shah Alam (47.9min, SD29.6). AWT was 21.9 min (SD 17.4) for patients punctual for appointments, 40.3 min (SD 40.3) for early patients and 21.9min (SD19.8) for late patients respectively. Although the mean AWT was long for early patients, 20% of them were seen earlier than their appointment time. All four clinics complied with the MOH KPI performance target (>50%) with a mean compliance of 87.5% for Selangor. There is statistically significant difference in punctuality of patients in different clinics (p
The study aimed to explore the perceptions towards health promotion activities among population of Penang Island,
Malaysia. The study was designed as a questionnaire based cross sectional analysis. General public from the district of
Jelutong, located in the state of Penang, Malaysia was conveniently approached for the study. Descriptive statistics
were used to ascertain demographic characteristics where as inferential statistics were employed to measure the
extent of association among study variables. Out of 480 respondents, a response rate of 82.7% was achieved. The study
cohort was dominated by females (63.0%) and majority of the participants belonged to Malay ethnicity (88.1%). One
hundred and seventy two (43.3%) never attended a health promotional campaign and mentioned lack of time and
transport as potential barriers. Among those who attended such activities, one third was satisfied with the benefits of
health campaigns. Approximately 90% of the participants demanded accessible locations, common language as mode of
communication and complete medical checkups with professional advice at health promotional campaigns. General
public can encouraged to participate in the health promotion activities by considering their priorities before designing
a health promotion program. This will help in targeting and achieving the goal “health for all”.
Worldwide maternal mortality rate had reduced tremendously including Malaysia. At the 2000 Millenium Summit, eight Millenium Development Goals (MDGs) were established with target for the year 2015. Three years remained until the deadline to achieve MDG5, which comprised of two targets and one being reducing the maternal mortality ratio by 75%.This review compared the trend of maternal mortality and its causes in our centre to the national data. The national data had shown a reduction from 44 to 27.6 in 100,000 live births in1991 and 2008 respectively. The subsequent rate had stabilized for the past seven years. In contrast the UKM Medical Centre (UKMMC) data in the past 15 years had not been stable. The target of MDG5 seemed to be achievable by our country but may require longer time as we have yet to find ways to overcome medical care inadequacy in remote areas.
Dengue virus infection has been endemic in Malaysia and in the region for decades and the disease caused by the virus has led to increased morbidity and mortality each year. Dengue is now endemic in more than 110 countries worldwide with two-fifths of the world's population at risk. Dengue fever is a flu-like illness and clinical features vary with the age of the patient. Dengue haemorrhagic fever on the other hand, is characterized by high fever, haemorrhagic phenomena and in severe cases, circulatory failure. There is no specific treatment for dengue fever but careful clinical management frequently saves the lives of these patients. Vaccine development has been difficult as protection against one or two dengue viruses could actually increase the risk of more serious diseases. At present, the only method of preventing dengue is to combat the vector mosquitoes. Dengue is diagnosed by viral isolation and or serology. Current methods, some in-house and others commercial, are far from satisfactory. My laboratory has developed, evaluated and validated tests for dengue that now enable detection on the first day of illness in most cases. At the same time an important aspect of dengue prevention is protection. To this end, we have been investigating the various immune parameters such as T-cells, cytokines and antibody neutralizing activities to show that specific immune responses do occur in a selected Malaysian population which are HLA restricted, cytokine mediated and directed specifically at certain regions of the virus.
The information on job strain among crane operators in Malaysia is lacking. The aim of this study was to determine the prevalence and contributing factors of job strain among crane operators working in port container terminals. A cross sectional study was carried out at a port container terminal in Malaysia. Data was collected using validated self-administered questionnaires, which consisted of the Job Content Questionnaire (JCQ), and the Depression, Anxiety, and Stress Scale (DASS-21). All crane operators in the selected terminal participated in the study. Data was analyzed using SSPS version 19. Two-hundred- and-forty crane operators participated in the study.. The prevalence of job strain determined from the JCQ was 43.8%. Job strain was significantly associated with psychological job demand, decision latitude, anxiety, physical isometric loads and muscle ache. The prevalence of job strain in this study was high. There is an urgent need to recognize the existence of this problem among crane operators by their respective management. Implementation of comprehensive stress management programs are recommended to reduce job strain among these workers.
Thirty one Vibrio cholera isolates recovered from cholera outbreak in Bintulu, Sarawak (Malaysia) were detected with the presence of ctx gene by using specific PCR. These isolates were further characterized and differentiated by using the Enterobacterial Repetitive Intergenic Consensus PCR (ERIC-PCR) and BOX-PCR to determine their genomic fingerprints. The specific PCR result confirmed the identities of 27 isolates out of 31 as pathogenic V. cholerae. The ERIC-PCR generated several genetic profiles consisting of 4-6 bands with sizes in the range of 100 to 600 bp, while the BOX-PCR produced profiles numbering 2-7 bands in the sizes between 200 to 1000 bp. Based on the dendrogram generated from the DNA fingerprinting profiles (ERIC-PCR and BOX-PCR), all of the isolates can be divided into 2 main clusters that is further divided into 2 sub-clusters. The low genetic diversity of the isolates indicated the outbreak of V. cholerae in the study area was due to the contamination from a single or few sources of V. cholerae.
Solitary adrenal metastasis is a rare presentation in breast cancer and it presents the clinician with a difficult therapeutic dilemma as there are no existing guidelines for optimal management. On literature review, we only found one published case report of solitary adrenal metastasis from infiltrating ductal carcinoma of the breast. Here we present a case of a 75 year-old lady who presented with a right breast lump which was subsequently confirmed to be infiltrating ductal carcinoma. She underwent a right mastectomy and axillary clearance. Computerised tomography (CT) staging revealed a solitary adrenal metastasis. She was treated with aromatase inhibitors and her tumour markers which were initially raised has now normalised.
The incidence of cancer in Malaysia is rising alarmingly and newly qualified doctors will be expected
to be competent in the basic management of cancer patients. However, the opportunity to gain experience in oncology management will remain limited unless these students are stationed in an oncology unit which is solely dedicated to the treatment of such patients. Therefore, it is essential that undergraduate medical school training equips students with a sound knowledgebase, so that they can confidently manage basic oncological conditions appropriately. With the many private and local medical universities across the country, it is important that oncology training be standardized
and reflective of the local resources available, and government health policies. As a result, having a
standardized curriculum would help create a framework whereby competencies in cancer management would be accurately assessed.
A review of current information related to the likely incidences of thyroid diseases in the aged population of Malaysia, raising issues such as the need for further epidemiological studies of iodine intake in relation to thyroid diseases within different geographical regions and population subtypes, the need for general country-wide iodization of salt, and the screening of elderly Malaysians for so-called “occult” thyroid diseases.
Background: The transition from high school to a university is a significant milestone in every student’s life. Stress experienced by students can have a detrimental effect on their academic performance. Social support has generally been found to promote psychological well-being, as well as to buffer the effects of stress. Method: The study was conducted in one of the Universities in Malaysia. The study questionnaire was designed to include questions regarding socio-demographic aspects and stress of the students; in addition, the Multidimensional Scale of Perceived Social Support scale (MSPSS) that was developed by Zimet was administered. The main aim of this study is to investigate the relationship between Perceived Social Support, Stress and Gender differences among University Students. Results: In this study only a small group of the students scored very low on the Perceived social support scale. A low significant inverse correlation was found between MSPSS and stress. Male students’ experienced greater stress than female students’. Female students had a better perception of social support from their families compared to male students. Conclusion: The fact that, as the level of social support increase the level of stress decrease clearly shows that social support acts as a buffer to stress.
Introduction Clinical guidelines recommend the use of a single antipsychotic drug at standard doses. In clinical practise high-dose and combined antipsychotics are common. Methods A clinical audit of antipsychotic prescribing for patients in a forensic ward in a Malaysian hospital was undertaken using Prescribing Observatory for Mental Health-UK (POMH) standards and compared to POMH data. Results The level of high dose prescribing between Malaysian and the UK was comparable. There were low levels of the use of ‘as required’ (PRN) medication in Malaysia compared to the UK. The use of combined prescribing was more common in Malaysia. Discussion Levels of high dose antipsychotic prescribing are unsatisfactory across both jurisdictions. Specific quality improvements in Malaysia need to centre on the use of combination antipsychotics.