Lymphatic filariasis is endemic in Asia. The infections persist as a major cause of clinical morbidity and a significant impediment to socioeconomic development. Its prevalence is increasing world wide, largely because of rapid unplanned urbanization in many endemic areas. It is estimated that at least 120 million people are infected. In our study on foreign workers, a total of 241 day time blood samples were collected. The countries represented were Bangladesh (134), Indonesia (103), Pakistan (3) and Myanmar(1). The tests conducted on blood samples were thick blood film for microfilaria and thin blood film for malaria and quantitation of eosinophiles using the Giemsa stain. Out of the 241 blood samples tested, one was positive for Wuchereria bancrofti and one other was positive for malaria (Plasmodium falciparum) each from Bangladesh and Indonesia respectively. As for the blood eosinophiles, 39 (16.18%) blood samples showed high eosinophilia. Fifteen (6.22%) were from Banglandesh and 24 (9.96%) were from Indonesia. The Bangladeshi male who was positive for Witcherrria bamuofti also showed eosinophilia of 22%. We believe that some of these cases with high eosinophilia, may be positive for microfilaria. We may have missed some cases because of the methodology we chose. Lymphatic filariasis is endemic in Bangladesh and Indonesia. In Malaysia W. brancrofti, especially in the cities have been eliminated. However their vectors for the transmission of W. bancrofti is rampant in the cities. With the influx of immigrants with W. bancrofti and in relation to their occupational nature, W. bancrofti may eventually be introduced into the community and change the whole facet of the disease in Malaysia.
Reproductive health is "a state of complete, mental and social well-being in all matters relating to the reproductive system and to its functions and processes. Implicit in this is the right of men and women to be informed and to have access to safe, effective and affordable and acceptable methods of family planning of their choice, as well as other methods of their choice for regulation of fertility, which are not against the law, and the right of access to health-care services that enable women to go safely through pregnancy and childbirth." The survey on Health Problems of Migrant Workers included a section on Women's Health covering aspects of reproductive health. This was based on concerns over reproductive health needs of migrant women workers, particularly since the large majority are in the reproductive age-group, and the utilisation of government healthcare facilities. The latter has implications for the potential burden on public healthcare services in terms of resources and costs. Specifically, the Women's Health section included questions on pregnancy, place of delivery of last baby (born in Malaysia), postnatal care related to this delivery, and mode of payment. For those currently pregnant, questions were asked of sources of antenatal care, postnatal care and respective modes of payment for thsoe services. This section also included questions on current contraceptive practices, source of supplies, and mode of payment for contraceptive methods.
Sexual health is defined as part of reproductive health and includes healthy sexual development; equitable and responsible relationships and sexual fulfillment; and freedom from illness, disease, disability, violence and other harmful practices related to sexuality. For this project on Health Problems of Migrant Workers, a section on sexual health was incorporated based on a special concern over sexually transmitted diseases (STDs), and high-risk behaviours. Access to healthcare is recognised to be a problem with minority or marginalised groups, including adolescents and migrant populations, especially undocumented migrants. This exacerbates the issue of control and management of STDs. The Sexual Health section covered experience with sexual interourse, and a limited number of questions related to sex partners and condom use among those who are sexually experienced.
Introduction: Optimal humidity, temperature, improper handling and storage of rice will increase the likeliness of aflatoxin growth in the air. The most common and carcinogenic aflatoxin is Aflatoxin B1 (AFB1) that may cause lung cancer if inhaled. This study aims to associate the exposure of AFB1 in inhalable dust and its respiratory effects among rice millers.
Materials and Methods: This cross-sectional study utilised the purposive sampling method and recruited 76 rice millers as exposed subjects and 48 office workers as the control group. The total inhalable dust was collected using the filter-loaded air samplers for an eight working hours’ exposure. The subjects’ hands were swabbed with cotton pads wetted with 0.5 ml Phosphate buffered Saline Tween-20 solution post shift. The collected samples were analysed for AFB1 by using the ELISA kits. The questionnaire gathering information on sociodemographic, work data and respiratory symptoms were completed. The lung function test was performed for the pre- and post-shifts.
Results: The mean airborne AFB1 at the rice mill area and personal exposure were 2.22 ng/m3 ± 0.07 and 0.25 ng/m3 ± 0.24, respectively. The mean contamination level of AFB1 on hands was 0.25 ng/ml detected on two rice millers (2.3%) while non-detectable in non-exposed workers. The most complained symptoms among rice millers were wheezing and breathlessness (n = 6, 9.2%). There was a significant difference in the mean forced expiration volume (FEV1) for pre- and post-shifts between rice millers and the non-exposed workers, but no significant correlation between the mean AFB1 concentration and lung function. Age and work factors were confounders in lung function.
Conclusion: Despite no association being established in this study, the promotion of wearing suitable personal protective equipment (PPE) is highly recommended to prevent cumulative exposure among the rice millers.
The concept of primary health care (PHC) according to WHO has been implemented in Malaysia since 1978. The rural health centres which provide the primary health care have developed from about 47 in 1970 to about 772 in 1998. Since the implementation of the health centres there has been significant reduction in morbidity and mortality rates. However due to the emerging issues like changing demographic 'patterns, changing pattern of disease, and increasing demand from the public, the delivery of PHC is being reviewed. Newer programmes and review of the older programmes are being done to address the provision of PHC in the 21st century. The functions and roles of the existing staff in the health centres are being reviewed. This new concept is known as expanded scope of primary health care. The purpose of this paper is to explain the achievements in primary health care and the components of primary health care in the expanded scope.
Background: Strength of leg musculature is crucial to generate propulsive force during rowing. The purpose of this study was to determine the relationship of isokinetic dominant leg strength and 2 km time trial on stationary rowing ergometer among male national rowers.
Methods: Seventeen male national rowers were recruited for the study. Their hip and knee isokinetic strength were determined in the sagittal plane at 60°/s angular velocity. The relationship between the hip and knee strength, and 2 km time trial performance were evaluated using Pearson correlation.
Results: The national rowers completed the 2 km time trial duration in 7.20±0.39 minutes. The hamstring to quadriceps ratio (H:Q) was significantly correlated to 2 km time trial performance (r=-0.491, p=0.045). No other significant relationships between hip and knee isokinetic strength and 2 km time trial performance were observed.
Conclusion: Increased isokinetic knee strength ratio (H:Q) may enhance 2 km time trial performance among male national rowers. Other isokinetic variables of hip and knee isokinetic strength were not significantly related to 2 km time trial.
Phenytoin is commonly prescribed for the prophylaxis of seizures in neurosurgical patients. A phenytoininduced
serious adverse effect of thrombocytopenia has been reported in the literature. The concurrent
use of dexamethasone, another commonly prescribed drug in neurosurgical patients, has been reported to
aggravate this adverse haematological effect. We present a report of phenytoin-induced thrombocytopenia
in a patient concurrently prescribed with dexamethasone, after an intracerebral haemorrhage secondary to
a rupture of an arteriovenous malformation. The thrombocytopenia was noted after two weeks of phenytoin
medication. Phenytoin was immediately withheld, and seven units of random donor platelets were transfused.
A gradual resolution of thrombocytopenia was observed within a week.
Three urban public primary schools in the district of Petaling, Selangor were surveyed for obesity amongst the schoolchildren and factors related to it. The prevalence of obesity amongst primary schoolchildren, with the mean age of 8.91 years was 9.5%. In addition, it was more prevalent among the boys (p
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.
We report a case of a 59-year-old gentleman with complete left brachial plexus injury. He presented with
chronic pain over the dorsum of his left hand since the injury eight years ago. Medical treatment had been
optimised but the pain still persist. End-to-side nerve transfer was done involving superficial sensory radial
nerve and median nerve to alleviate the pain. The surgery was considered successful as the patient claimed
that the pain score had reduced a few weeks postoperatively. However, there was no sensory recovery and
functionally no improvement was observed.
Presence of a hypofunctioning pigmented adenoma are commonly asymptomatic and is usually only found during an autopsy. In contrast, hyperfunctioning pigmented adenoma is a rare clinical entity and in the majority of cases results in Cushing's syndrome. In this case study, we report a 66-year-old male who presented instead with the clinical and biochemical features of Conn's syndrome. On laparoscopic adrenalectomy, it was found that the tumour had a functioning black adenoma which does not usually present with Conn's syndrome but rather to that of a Cushing's. The intraoperative changes and histopathological findings are discussed.
Compression of the common bile duct by a stone impacted in the cystic duct is an uncommon cause of obstructive jaundice. We present a case study and review of the literature pertaining to the presentation, diagnosis, and surgical treatment of Mirizzi syndrome.
Introduction: The population of Malaysia is ageing rapidly. Due to the relatively greater incidence of noncommunicable diseases among older adults, polypharmacy is highly prevalent in this population. This polypharmacy along with other age-related factors increases the risk of drug-related problems to several folds. Currently, no study in Malaysia or even Asia has determined the type and nature of drug-related problems among non-institutionalised older adults. Therefore, this study aims to highlight common drug-related problems among community-dwelling older persons (≥ 65 years) with polypharmacy.
Materials and Methods: A cross-sectional exploratory study was carried out where in-depth home medication reviews were carried out by two pharmacists. Participants were recruited from geriatric and fall clinics of the University of Malaya Medical Centre located in the urban area of the Federal Territory of Malaysia. The total numbers of drug-related problems were classified using the Pharmaceutical Care Network Europe (PCNE) classification V9.0. Recommendations and referral letters were provided based on the pharmaceutical care issues identified.
Results: Thirty participants were recruited, among whom 178 drug-related problems were identified with a median value of six [range 1-11] drug-related problems per participant. The majority of problems were related to the effectiveness of prescribed treatment (69.1 %), followed by the possibility of adverse effects (28.7 %).
Conclusion: Home medication review identifies numerous medication-related issues and allows for patient education and detailed counselling in an informal and patient-friendly manner. Future studies to determine the longitudinal effect of home medication review on patient outcome, cost implications, and overall healthcare utilization are now indicated.
Antimicrobial peptides (AMPs) have gained increasing attention as a potential candidate in the development of novel antimicrobial agent. Designing AMPs with enhanced antimicrobial activity while reducing the cell toxicity level is desired especially against the antibiotic-resistant microbes. Various approaches towards the design of AMPs have been described and physicochemical properties of AMPs represent the primary factors determining the antimicrobial potency of AMPs. The most common parameters include net charge and hydrophobicity, which greatly influence the antimicrobial activity of AMPs. Moreover, certain amino acids would have critical importance in affecting the antimicrobial activity as well as cell cytotoxicity of AMPS. In this review, net charge, hydrophobicity, and specific amino acid residues were discussed as factors contributing to the antimicrobial activity of AMPs.
The plants of the genus Phyllanthus (Euphorbiaceae) are distributed in most tropical and subtropical regions of world. This plant has been long used as a traditional medicine to treat problems such as stomach, intestinal infections, kidney and urinary bladder disturbances, diabetes, and hepatitis B. There has been considerable interest in these plants in recent years. This review discusses the antiviral and anticancer aspects of Phyllanthus species. Scientific studies have demonstrated that extracts and purified isolated compounds (flavonoids, lignans, phenols, and terpenes) obtained from these plants possess antiviral effects against herpes simplex (HSV) and dengue virus infections (DENV). These observations are associated with the disruption of essential proteins needed during viral cycle, thus halting the viral replication. In addition, the Phyllanthus species have also been shown to exert inhibitory effects against selected cancers types. In these studies anti-proliferative, anti-metastatic, anti-angiogenic effects and induced apoptosis of human cancers cell lines were observed. These may be explained by the disruption of multiple survival pathways and differential protein expression. CONLCUSION:As a conclusion, tThe Phyllanthus plant possesses multiple medicinal properties, including antiviral and anticancer activities which may potentially be used as a medicinal source for many disease locally.
A cross-sectional study of 109 patients with Pseudomonas aeruginosa bacteremia from the University of Malaya Medical Centre (UMMC) in the years 2000 and 2001 was conducted to describe epidemiological features, underlying diseases, possible source of infection, early mortality among patients as well as the antibiotic susceptibility pattern of patients' isolates. Further analysis of the 87 patient records that were available revealed that the mean age was 48.5 years (SD ± 25.1). Fifty-two per cent of cases were male and 48% female. Seventy-nine per cent of infections were nosocomially acquired, 33% of bacteremias were polymicrobial, 47% of patients had a continuous bladder drainage catheter (CBD) in situ, 33% had a central venous catheter (CVL) present at the time of bacteremia and 30% were ventilated. Sixty-eight per cent of patients had an underlying immunosuppressed state and 26% had undergone surgery involving general anesthesia in the week prior to isolating P. aeruginosa. Among the 23 patients with early mortality, 61% were on inappropriate antimicrobials. Most of the patients' isolates were sensitive to imipenem (86%), ciprofloxacin (81%), ceftazidime (79%), gentamicin (78%) and cefoperazone (77%). Among the community acquired strains, however, there was 100% sensitivity to imipenem, ceftazidime, cefoperazone and ciprofloxacin.
Squamous cell carcinoma of the tongue is a highly malignant condition and results in high mortality and morbidity in patients despite its early detection (1). Early surgical interventions have been found to reduce mortality but in many reports, tongue reconstructions using live grafts have been found to reduce normal tongue function of speech, swallow and taste. In contrast, our report using free radial forearm flap (FRFF) to reconstruct the defect left over after a radical tongue resection in a 38-year-old gentleman with oral cancer has shown promising results. This type of reconstruction has left the patient with a functional and cosmetically acceptable tongue with minimal alteration in recognizable speech.