Introduction: Iontophoresis of vasoactive substances such as acetylcholine (ACh) and sodium nitroprusside (SNP) combined with Laser Doppler fluximetry (LDF) is a non-invasive tool used to determine microvascular endothelial function. This study aims to test the effect of sodium chloride on
non-specific vasodilatation when used as a vehicle in the process of iontophoresis. This study also aims to define the number of current pulses needed to get the maximum effect during iontophoresis with ACh and SNP using low current strength. Methods: The experiment was conducted in five healthy females. Baseline skin perfusion was taken before administration of seven current pulses. Current strength of 0.007 mA and current density of 0.01 mA/cm2 were used. Acetylcholine was used to assess endothelial dependent vasodilatation, while SNP was used to assess endothelial independent vasodilatation. The mean skin perfusion (AU) responses to the iontophoresis of ACh at the anodal and SNP at the cathode leads were recorded. Sodium chloride (0.9%) was used as a vehicle to obtain concentration of 1% for both ACh and SNP. Iontophoresis of pure vehicle (NaCl) was conducted on a separate day to observe the effect of vehicle only on the iontophoresis process at both anode and cathode. Results: Iontophoresis of NaCl showed no significant increase in perfusion compared to baseline at both anode and cathode. Significant increases in skin perfusion were observed with SNP and ACh; a plateau of ACh was reached from the 3rd pulse onwards; while the plateau of SNP was reached from the 4th pulse onwards. Conclusion: NaCl could be used as a vehicle for Ach and SNP during iontophoresis as it did not cause non-specific vasodilatation. Using five current pulses are adequate for iontophoresis of ACh and SNP to assess microvascular endothelial function.
Nitrate is required to maintain the growth and metabolism of plant and animals. Nevertheless, in excess amount such as polluted water, its concentration can be harmful to living organisms such as microalgae. Recently, studies on microalgae response towards nutrient fluctuation are usually limited to lipid accumulation for the production of biofuels, disregarding the other potential of microalgae to be used in wastewater treatments and as source of important metabolites. Our study therefore captures the need to investigate overall metabolite changes via NMR spectroscopy approach coupled with multivariate data to understand the complex molecular process under high (4X) and low (1/4X) concentrations of nitrate ([Formula: see text]). NMR spectra with the aid of chemometric analysis revealed contrasting metabolites makeup under abundance and limited nitrate treatment. By using NMR technique, 43 types of metabolites and 8 types of fatty acid chains were detected. Nevertheless, only 20 key changes were observed and 16 were down regulated in limited nitrate condition. This paper has demonstrated the feasibility of NMR-based metabolomics approach to study the physiological impact of changing environment such as pollution to the implications for growth and productivity of microalgae population.
A study was conducted among out-patients attending the Melaka Tengah Health Clinic to determine their compliance status towards antihypertensive, antidiabetic and antiasthmatic drugs. A total of 585 patients were enrolled in this study. Assessment of compliance was carried out using pill-counting and house-to-house interviews 14 days from the date of medication dispensed at the counter. The noncompliance rate among the 464 successfully interviewed patients was 56%. The mean noncompliance percentage was 78.0 +/- 43.1% (range: -10.0-314.3%). Among the four variables of compliance studied, race was not seen as a determinant of compliance. The older age group and those taking two or more drugs were statistically significant to be a noncomplier. Females were highly likely not to comply with drug therapy. Patients who conform to their refill dates were not really drug compliers. Forgetting to take their drugs and inability to read instructions on drug labels were the main reasons given. Underdosing was more common than overdosing, with an estimated cost of RM20,261.00 of unused medications per year.
Study site: Klinik Kesihatan Melaka Tengah, Melaka, Malaysia
During the initial phase of the coronavirus disease 2019 (COVID-19) pandemic, there was a critical need to create a valid and reliable screening and surveillance for university staff and students. Consequently, 11 medical experts participated in this cross-sectional study to judge three risk categories of either low, medium, or high, for all 1536 possible combinations of 11 key COVID-19 predictors. The independent experts' judgement on each combination was recorded via a novel dashboard-based rating method which presented combinations of these predictors in a dynamic display within Microsoft Excel. The validated instrument also incorporated an innovative algorithm-derived deduction for efficient rating tasks. The results of the study revealed an ordinal-weighted agreement coefficient of 0.81 (0.79 to 0.82, p-value < 0.001) that reached a substantial class of inferential benchmarking. Meanwhile, on average, the novel algorithm eliminated 76.0% of rating tasks by deducing risk categories based on experts' ratings for prior combinations. As a result, this study reported a valid, complete, practical, and efficient method for COVID-19 health screening via a reliable combinatorial-based experts' judgement. The new method to risk assessment may also prove applicable for wider fields of practice whenever a high-stakes decision-making relies on experts' agreement on combinations of important criteria.
The influence of sonoluminescence transesterification on biodiesel physicochemical properties was investigated and the results were compared to those of traditional mechanical stirring. This study was conducted to identify the mechanistic features of ultrasonication by coupling statistical analysis of the experiments into the simulation of cavitation bubble. Different combinations of operational variables were employed for alkali-catalysis transesterification of palm oil. The experimental results showed that transesterification with ultrasound irradiation could change the biodiesel density by about 0.3kg/m(3); the viscosity by 0.12mm(2)/s; the pour point by about 1-2°C and the flash point by 5°C compared to the traditional method. Furthermore, 93.84% of yield with alcohol to oil molar ratio of 6:1 could be achieved through ultrasound assisted transesterification within only 20min. However, only 89.09% of reaction yield was obtained by traditional macro mixing/heating under the same condition. Based on the simulated oscillation velocity value, the cavitation phenomenon significantly contributed to generation of fine micro emulsion and was able to overcome mass transfer restriction. It was found that the sonoluminescence bubbles reached the temperature of 758-713K, pressure of 235.5-159.55bar, oscillation velocity of 3.5-6.5cm/s, and equilibrium radius of 17.9-13.7 times greater than its initial size under the ambient temperature of 50-64°C at the moment of collapse. This showed that the sonoluminescence bubbles were in the condition in which the decomposition phenomena were activated and the reaction rate was accelerated together with a change in the biodiesel properties.
This clinical case report details the clinical sequence of a 78-year-old male receiving prosthetic rehabilitation using an implant-supported screwretained fixed partial denture. Despite the limitations imposed, the aesthetic and functional demands of the patient were fulfilled by this prosthetic rehabilitation. The importance of detailed prosthetic planning and evaluation prior to implant surgery is essential, therefore ideally, it should be done by the same operator or a team of operators working together. Problems can arise when the construction of the prosthesis is performed by other people who are not involved in the planning stage.
Methicillin-resistant Staphylococcus aureus (MRSA) infection is important among vas-cular surgical patients. Its effect can be devastating resulting in limb amputation and mortality. We performed a retrospective patients record analysis to determine the pat-tern of MRSA infection among vascular surgical patients in Hospital Kuala Lumpur from January 2005 to December 2007. We also attempted to identify the factors asso-ciated with poor clinical outcome after such infection. There were 999 patients who underwent vascular surgeries in HKL within the analysis period. Of these 24 patients (2.4%) were detected to have MRSA surgical site infection. The infection was commoner among cigarette smokers, patients with diabetes melitus and those who had previous vascular surgery. Most infections occurred in the emergency surgery category and manifested as wound breakdown. Fifty-four percent of the infected pa-tients ended with graft removal, amputations or death. MRSA infection complicating vascular surgery resulted in poor clinical outcome. This serious threat requires intensi-fied preventive measures.
Mangrove-dwelling microalgae are well adapted to frequent encounters of salinity fluctuations across their various growth phases but are lesser studied. The current study explored the adaptive changes (in terms of biomass, oil content and fatty acid composition) of mangrove-isolated C. vulgaris UMT-M1 cultured under different salinity levels (5, 10, 15, 20, 30 ppt). The highest total oil content was recorded in cultures at 15 ppt salinity (63.5% of dry weight) with uncompromised biomass productivity, thus highlighting the 'trigger-threshold' for oil accumulation in C. vulgaris UMT-M1. Subsequently, C. vulgaris UMT-M1 was further assessed across different growth phases under 15 ppt. The various short, medium and long-chain fatty acids (particularly C20:0), coupled with a high level of C18:3n3 PUFA reported at early exponential phase represents their physiological importance during rapid cell growth. Accumulation of C18:1 and C18:2 at stationary growth phase across all salinities was seen as cells accumulating substrate for C18:3n3 should the cells anticipate a move from stationary phase into new growth phase. This study sheds some light on the possibility of 'triggered' oil accumulation with uninterrupted growth and the participation of various fatty acid types upon salinity mitigation in a mangrove-dwelling microalgae.
Lichenoid uvula mass is an unusual entity and the clinicopathologic entities are important for the diagnosis. In this case report, we report an elderly lady presented with dysphagia and "hot potato voice" due to a lichenoid uvula mass. Apart from muffled voice, the other associated symptoms are dysphagia, sore throat, globus pharyngeus and snoring. She was a non-smoker, and not on any medications except for hypertension and dyslipidaemia. Apart from the enlarged uvula, other parts of the oral cavity, oropharynx and larynx were normal. She has no other signs such as cutaneous lesions. The mass was excised under general anaesthesia followed by resolution of symptoms. Awareness of this entity, the clinical and histopathological features should be highlighted to differentiate it from other diagnosis.
Influenza-like illnesses (ILI) were defined as a triad of cough, sore throat and fever. The aim of this study is to determine the changes in knowledge, perceptions and practices towards preventive measures of succumbing to ILI before and after hajj among Malaysian hajj pilgrims.Methodology: An open-labeled randomized control trial study performed on five hundred Malaysian hajj pilgrims in the year 2013. After validated pre-hajj questionnaires completed, 250 subjects were given health education, benzalkonium-based handrub and demonstration of the handrub usage together with pamphlets and labelled as an intervention group. Another 250 subjects from another flight batch were given the same questionnaires without health education with unmedicated hand lotion as a control group. The knowledge, perception, practices and compliances to the handrub practice in both groups were compared with the pre-hajj results. Results: No significant difference between pre and post hajj knowledge and practice among hajj pilgrims in intervention group. Pre hajj perception score [ M (IQR) = 30 (5.00), Z= -2.441, p < 0.05 ] is much higher compared to post hajj perception [ M (IQR) = 29 (6.00), Z = -2.441, p < O.O5 ]. No significant difference between pre and post hajj knowledge, perception and practices among hajj pilgrims in control group. Hand hygiene compliance was not improved with provision of health education and free handrub supply. Conclusion: No significant changes in knowledge, perceptions and practices of Malaysian hajj pilgrims pre and post-hajj in both groups. Provision of handrub did not improved hajj pilgrims compliance.
The role of caretakers at day-care centers has become more imperative in promoting oral health care in children since many new mothers opt to work outside their homes, leaving their children at day-care centers. The aim of this study is to assess the knowledge, attitude and practice of oral health promoting factors among secondary caretakers of children attending day-care centers.
Although a vital test, blood culture is often plagued with the problem of contamination and false results, especially in a chaotic emergency department setting. The objectives of this pilot study is to find out the level of understanding among healthcare staffs in emergency department, Hospital Universiti Sains Malaysia (HUSM) regarding good blood culture sampling practice.
Kimura disease presents as benign lesion and is commonly present among the Asian population. It
is a disease with a favourable prognosis and a peak age of onset in the third decade. It is a chronic
inflammatory disorder of unknown etiology that involves the lymph nodes and subcutaneous
tissues of the head and neck region. We report a case of a 15-year-old boy with multiple Kimura
lymphadenopathies involving the left posterior auricular region as well as the anterior and posterior
triangles of the neck.
Kimura disease presents as benign lesion and is commonly present among the Asian population. It is a disease with a favourable prognosis and a peak age of onset in the third decade. It is a chronic inflammatory disorder of unknown etiology that involves the lymph nodes and subcutaneous tissues of the head and neck region. We report a case of a 15-year-old boy with multiple Kimura lymphadenopathies involving the left posterior auricular region as well as the anterior and posterior triangles of the neck.
Four species of synanthropic flies were trapped in downtown Kuala Lumpur: Chrysomya megacephala, Chrysomya rufifacies, Musca domestica, and Musca sorbens. Burkholderia pseudomallei, the organism causing melioidosis, was the dominant bacteria isolated from Chrysomya megacephala. Klebsiella oxytoca, commonly associated with nosocomial infections, was commonly isolated from Chrysomya megacephala, Musca domestica, and Musca sorbens. Aeromonas hydrophila, the bacteria causing gastroenteritis, was predominantly isolated from Chrysomya megacephala and also from Musca domestica and Musca sorbens. A total of 18 bacterial species was isolated from the synanthropic flies trapped. Burkholderia pseudomallei had been reported for the first time.
The leaf extract of Tamarindus indica L. (T. indica) had been reported to possess high phenolic content and showed high antioxidant activities. In this study, the effects of the antioxidant-rich leaf extract of the T. indica on lipid peroxidation, antioxidant enzyme activities, H2O2-induced ROS production and gene expression patterns were investigated in liver HepG2 cells. Lipid peroxidation and ROS production were inhibited and the activity of antioxidant enzymes superoxide dismutase, catalase and glutathione peroxidase was enhanced when the cells were treated with the antioxidant-rich leaf extract. cDNA microarray analysis revealed that 207 genes were significantly regulated by at least 1.5-fold (p < 0.05) in cells treated with the antioxidant-rich leaf extract. The expression of KNG1, SERPINC1, SERPIND1, SERPINE1, FGG, FGA, MVK, DHCR24, CYP24A1, ALDH6A1, EPHX1 and LEAP2 were amongst the highly regulated. When the significantly regulated genes were analyzed using Ingenuity Pathway Analysis software, "Lipid Metabolism, Small Molecule Biochemistry, Hematological Disease" was the top biological network affected by the leaf extract, with a score of 36. The top predicted canonical pathway affected by the leaf extract was the coagulation system (P < 2.80 × 10(-6)) followed by the superpathway of cholesterol biosynthesis (P < 2.17 × 10(-4)), intrinsic prothrombin pathway (P < 2.92 × 10(-4)), Immune Protection/Antimicrobial Response (P < 2.28 × 10(-3)) and xenobiotic metabolism signaling (P < 2.41 × 10(-3)). The antioxidant-rich leaf extract of T. indica also altered the expression of proteins that are involved in the Coagulation System and the Intrinsic Prothrombin Activation Pathway (KNG1, SERPINE1, FGG), Superpathway of Cholesterol Biosynthesis (MVK), Immune protection/antimicrobial response (IFNGR1, LEAP2, ANXA3 and MX1) and Xenobiotic Metabolism Signaling (ALDH6A1, ADH6). In conclusion, the antioxidant-rich leaf extract of T. indica inhibited lipid peroxidation and ROS production, enhanced antioxidant enzyme activities and significantly regulated the expression of genes and proteins involved with consequential impact on the coagulation system, cholesterol biosynthesis, xenobiotic metabolism signaling and antimicrobial response.
In this study, the effects of limited and excess nitrate on biomass, lipid production, and fatty acid profile in Messastrum gracile SE-MC4 were determined. The expression of fatty acid desaturase genes, namely stearoyl-ACP desaturase (SAD), omega-6 fatty acid desaturase (ω-6 FAD), omega-3 fatty acid desaturase isoform 1 (ω-3 FADi1), and omega-3 fatty acid desaturase isoform 2 (ω-3 FADi2) was also assessed. It was found that nitrate limitation generally increased the total oil, α-linolenic acid (C18:3n3) and total polyunsaturated fatty acid (PUFA) contents in M. gracile. The reduction of nitrate concentration from 1.76 to 0.11 mM increased the total oil content significantly from 32.5 to 41.85% (dry weight). Palmitic (C16:0) and oleic (C18:1) acids as the predominant fatty acids in this microalgae constituted between 82 and 87% of the total oil content and were relatively consistent throughout all nitrate concentrations tested. The expression of SAD, ω-6 FAD, and ω-3 FADi2 genes increased under nitrate limitation, especially at 0.11 mM nitrate. The ω-3 FADi1 demonstrated a binary up-regulation pattern of expression under both nitrate-deficient (0.11 mM) and -excess (3.55 mM) conditions. Thus, findings from this study suggested that limited or excess nitrate could be used as part of a cultivation strategy to increase oil and PUFA content following media optimisation and more efficient culture methodology. Data obtained from the expression of desaturase genes would provide valuable insights into their roles under excess and limited nitrate conditions in M. gracile, potentially paving the way for future genetic modifications.