Introduction: Child abuse is an epidemic and in Malaysia, the numbers are rising. Statistic showed that 60% of the victims were below seven years old. Since most of them goes to preschool at this age, the role of childcare providers (CPs) in addressing this issue is crucial. However, previous data showed that referrals made by them to the author-ities was less than 1%. The objective of this study was to determine the knowledge and attitude of CPs in KEMAS preschools towards child abuse. Methods: This is a cross-sectional study involving CPs working in the KEMAS pre-schools in Kota Bharu and Tumpat, Kelantan, Malaysia, from April to June 2019. Results: From 218 respondents, 78% and 83% of them had good awareness on signs of neglect and physical abuse respectively compared to sexual abuse (64.6%). In terms of knowledge, 80% answered correctly about signs of abuse. However, only 18.8% an-swered correctly about sexual abuse. Moreover, 86.7% of CPs believed that they should be responsible to lodge a report, while only 6% of them objected. Although 76.1% were correct about the information to be prepared for reporting, only 4.6% of them realised that suspicions about a case would suffice to lodge a report. There were 94.5%, and 65.1% of CPs who correctly answered about the protection of the reporter under the law and its penalty respectively. But, only 26.6% of the CPs were correct about the category of mandated reporters according to the law. Conclusion: Although majority of CPs had good knowledge and awareness, there was still 26.6% who did not realise that they were mandated to report suspected cases. Therefore, educational programs need to be planned to increase awareness and knowledge on abuse and its legal aspects among CPs.
Introduction: Coated archwires improve aesthetics during orthodontic treatment. However, little is known regarding
their clinical benefit. This randomised controlled trial (RCT) compared the tooth alignment (TA), coating loss (CL),
colour change (∆E*), and patient perception of coated archwires with their controls. Details of ∆E* and perception were reported in the second part of the articles. Methods: This RCT was done at three centres. Participants
were randomised to receive one of four treatment interventions using 0.014” superelastic coated nickel-titanium
archwires from Orthocare, RMO, G&H, and conventional uncoated 3M Unitek® archwires. These archwires were
ligated during bonding and collected after eighth week and questionnaires were distributed to participants in the
experimental groups only. After removal, TA and CL were measured using Little’s Irregularity Index and Autodesk®
AutoCAD® software, respectively. At the time of this preliminary reporting, 84 participants had completed the trial. Two archwires fractured and were excluded. Therefore, 166 archwires (n = 166) were analysed. Results: Only
non-extraction cases showed statistically significant differences in TA change between all groups (p = 0.005) and
RMO showed significantly lowest mean of TA (1.5 mm). RMO and Orthocare showed significant TA change in the
upper and lower arches (p = 0.037, 0.048). CL was found to be insignificant for both extraction and non-extraction
cases (p >0.05). Comparison between upper and lower arches revealed no significant difference in TA and CL in all
groups (p >0.05). Conclusion: From this preliminary analysis, Orthocare provides better TA in non-extraction cases
despite highest percentage of coating loss.
Introduction: Coated archwires improve aesthetics because of the tooth-coloured appearance. However, colour change of the coated archwires have been reported in vitro. Nonetheless, little is known to what extent this colour change occurs clinically. This second part of the multi-centre, double-blind, randomised controlled trial evaluated the colour change (E*) of three coated archwires with their controls and patient perception. Methods: 84 patients who received treatment with upper and lower fixed appliance treatment were invited. Consented patients were randomised to receive one of four treatment interventions using 0.014” superelastic nickel-titanium archwires from
(1) Orthocare (2) RMO (3) G&H, and (4) 3M Unitek® uncoated. These archwires were ligated during bonding and collected after 8th week. After removal, the digital images of the archwires were assessed for colour change using Adobe® Photoshop® software, and the CIE L*a*b* system was used to calculate the ΔE* values. Patient perception was measured using oral aesthetic subjective impact scale (OASIS) questionnaire. Results: For colour change and patient perception assessment, 132 archwires from 66 participants who had been treated with aesthetic archwires were collected. Two fractured archwires were excluded. Initial analysis revealed all three aesthetic archwires groups showed significant mean of E* with the highest was found in Orthocare (23.9), and the lowest is G&H (16.8). Post hoc comparison revealed statistically significant mean of E* in Orthocare when compared with other groups (p
Introduction: Previous studies have found that unwed pregnant teenagers have a variety of psychological issues such as loss of self-confidence, emotional stress, fear, worry, anxiety, depression, and suicidal thoughts. In addition, the society’s negative perception has made these teenagers to be alienated and mocked by the community and also by their own family members. Thus, this research aims to identify the mental health state and also to deeply explore on these teenagers’ emotional and psychological conditions. Methods: This research adopts qualitative phenomeno- logical research design. Four residents of a Protection Centre in Johor Bahru have been selected through purposive sampling method. Semi-structured interviews were conducted and the data has been transcribed and analysed using thematic content analysis method. Results: Results obtained show that the teenagers’ mental health symptoms are at moderate to severe states. They also show signs of emotional disturbance such as depression, seclusion, difficulty in sleeping, lips dry, easy to sweat, uncontrolled emotion, no appetite, headache, anxiety or worry, negative thoughts and not energetic. Apart from these, they also experience unstable emotional and psychological situations such as sadness, anger, fear, shock, stress and guilt due to shaming their families. Conclusion: This study is expected to pro- vide an early explanation on mental health among Muslim unwed pregnant teenagers. Therefore, the appropriate methods to use in addressing their emotional and psychological states need to be explored.
Introduction: Schoolbag weight across different types of school and schoolbag content has not been
studied in Malaysia. This cross sectional survey determines the weight of schoolbags, its content and
occurrence of back pain among primary school children in different medium primary school in Kuala
Lumpur. Methods: Students’ body weight, and schoolbags weight were measured using a calibrated
scale. Schoolbag content was examined, and weighed according to necessary learning materials
or unnecessary materials. Back pain in the past one week was assessed using a self-administered
questionnaire, adapted from previous studies. Results: A total of 358 students (167 male, 191 female)
were enrolled, of which 119 were from National School (NS), 122 from Chinese Medium School (CMS)
and 117 from Tamil Medium School (TMS). The mean schoolbag weight was 4.55±1.62kg for NS,
8.53±1.94kg for CMS and 6.06±2.09kg for TMS, which was 11.7%, 22.0% and 16.6% of body weight,
respectively. The mean weight of unnecessary schoolbag content was 0.64(0.91)kg for NS, 2.18(1.49)kg for CMS and 1.96(1.56) for TMS students. Back pain was detected in 87.0% NS students, 68.0% CMS students and 66.7% TMS students. Significant association was found between occurrence of back pain and types of school ( 2=16.64,p=0.00). Conclusions: Students from all the three mediums primary school, in particular Chinese medium school carry school bag heavier than that generally recommended, with unnecessary materials weigh up to 2kg. The occurrence of back pain is high and this is associated with the types of school.
Objective: A baseline functional magnetic resonance imaging (fMRI) study was carried out on a healthy right-handed male subject to attain further insights into the basic neuronal control mechanisms of bimanual and unimanual movements of hand fingers, an area that is still not fully understood. Methods : The study used the basic unimanual and bimanual movements of the left- and right-hand fingers to stimulate neuronal activity in the cerebral cortices. The subject was instructed to sequentially press his fingers either unimanually (UNI) or bimanually (BIM), against the thumb in a consistent alternative manner during the functional scans. The data were analysed using the MATLAB and SPM2 software packages. Results : Brain activations obtained via the F-test indicate a larger activation area as compared to that obtained from the T-test. The results showed that, the activated brain regions due to the self-paced finger movements are the precentral and postcentral gyrii covering the primary motor, premotor and somatosensory primer areas. The activestate signal intensity was found to be significantly (p < 0.05) higher than that of the resting-state. For UNI, brain activation showed contra-laterality with a larger activation area and a higher signal intensity at the point of maximum intensity for the left-hand finger
movement (UNIleft) compared to the right-hand finger movement (UNIright). Small ipsilateral activations were observed during UNIright and UNIleft. For BIM, the activation was observed in both hemispheres with the right hemisphere showing a higher signal intensity and coverage. The results support the fact that for a right-handed person performing either UNI or BIM type of movement, the activated motor area on the right hemisphere of the brain (movement of the left hand fingers) experience a higher intensity and larger coverage of hemodynamic response compared to the left hemisphere of the brain (movement of the right hand fingers). Analyses performed on the activated regions of interest (ROI) by
comparing the unimanual and bimanual types of activations revealed that during BIM, there are voxels in the left hemisphere controlling the movement of the left hand fingers (BIMleft) and voxels in the right hemisphere controlling the movement of the right hand fingers (BIMright). The interactions observed in this study resemble the existence of interhemispheric connection between both hemispheres during BIM. Conclusion : Although this is a single subject study, the hemodynamic response and the neuronal control mechanism in the cerebral cortices based on the BOLD mechanism can be studied and evaluated using fMRI and SPM.
Pediatric ocular trauma; though the number is small, can lead to a devastating lifetime impact due to its risk of ambly- opia (if it occurs before the age of seven) and also loss of vision. We are reporting a case of a young 12-year-old-boy who was struck unintentionally by an arrow to the eye by another friend during sports activity. The arrow pierced the right eyebrow just below the orbital roof then perforated the globe from the superior orbit pointing downwards piercing the floor of the orbit fracturing the maxillary roof. Emergency scleral repair was done; however, there was no useful vision left. Arrow injury to the eye is a rare occurrence but leads to severe consequences given its high velocity and projectile in nature. The incidence is low and highly avoidable if precautionary measures are taken.
Despite increasing interest in in nutraceuticals and their potential health benefits, not much is known about bioavailability of most of these nutraceutical compounds. Although they are considered dietary supplements and are subjected to a limited form of regulation, there is, however, a need to improve the efficacy and safety of these nutraceuticals. Additional research which defines the pharmacology, stability and bioavailability of these products is expected to gain strength and may offer a better understanding of their applicability in the prevention of disease conditions. This article reviews some aspects of nutraceutical bioavailability with examples from our work on the absorption studies of minerals from spirulina (Arthrospira plantensis) and gamma-oryzanol from rice bran (Oryza sativa) extract which employed human colon carcinoma (Caco-2) cell line and in vivo bioassays using animal models. Bioavailability of iron from spirulina was compared with its common source FeS04. Using the in vitro digestion protocol in combination with Caco-2 cell culture system, spirulina showed a high iron bioavailability compared to FeS04. The presence of other dietary factors (calcium, ascorbic acid, zinc, tannin and caffeine) was found to be not as significant as ferrous sulphate in affecting the iron uptake from spirulina. In vivo study showed that the efficacy of iron repletion in anaemic rats was enhanced in groups fed either commercial or cultured spirulina with improved haematological parameters of iron status. Further work on the behaviour and distribution of radiolabelled iron from spirulina has shown that iron-59 retained in the GIT of mice was lower in spirulina group compared to FeS04. Bioavailability study of gamme oryzanol was similarly conducted using Caco-2 cell as in vitro system and rabbit as in vivo model with the application of different formulations of gamma oryzanol in comparison with the natural form. Both systems showed that gamma oryzanol in its natural oil was poorly absorbed. However, when converted to other formulations, gamma oryzanol bioavailability was greatly increased by as much as 200 and 33 times more from the emulsion and microspheres respectively. These findings suggest that the efficacy of nutraceuticals in particular plant derived products which contain many phytochemicals should be assessed in terms of not only their potential health benefits such as antioxidant action but also their bioavailability in order to provide a more wholesome picture of their potential.
Introduction: Inflammation is one of the major cause of cardiovascular disease, obesity, cancer and stroke. Many dietary compounds containing kernel oil or coconut oil with anti-inflammatory effect can delay the onset of these chronic diseases however the underlying mechanism is unclear. Methods: This study compares the effects of 5% virgin palm kernel oil (VPKO), virgin coconut oil (VCO) and refined, bleached, deodorized olive oil (RBDOO) on selected immune markers in healthy sprague dawley (SD) rats (n=16 per treatment) across 8 weeks. Sera were obtained for four major immunological analyses including cluster of differentiation 4 (CD 4), cluster of differentiation 8 (CD 8), interleukin 6 (IL 6), and c reactive protein (CRP). Results were expressed in mean ± standard error of the mean (mean±SE). Results: Eight weeks fat feeding had no significant difference in weight gain across treatments. Interestingly, we observe significant different on the concentration of CD 4 (p=0.001) with the lowest CD 4 level in rats fed with VPKO 3.87±0.65 ng/ml. The concentration of CD 8 in rats fed with VPKO 8.19±0.25 (p=0.001) ng/ml was comparable to VCO fed rats but was found lower than the control group, RBDOO fed rats. Lower T cell count (CD 4 or CD 8) indicates suppression in inflammation. IL-6 and CRP concentration in rat fed with VPKO 10.89±0.22 pg/ml and 118.39±7.13 ng/ml were slightly higher than that of VCO fed rats but were lower than RBDOO fed rats. Conclusion: We postulate that VPKO could be a potential supplement as an alternative to VCO for relieving inflammation and enhancing body immune system.
Laboratory workers exposed to diverse occupational exposures to accidents. Evidently, extant, yet very limited em- pirical underpinnings suggest that knowledge, practices and awareness of safety precautions are uncharacteristically poor among laboratory workers. As such, their demonstration of safety-related attitudes and practices have remained questionable. This paper, thus presents a systematic search of the literature on laboratory workers’ safety-related knowledge, attitudes, and practices. Specifically, literature published between 2007 and 2017 that characteristically attempted to evaluate knowledge, attitudes and practices among laboratory workers on Occupational Safety and Health were reviewed. Evidently, results from the review indicate poor knowledge, attitude and practice among the laboratory workers. It is critical that strategies be put in place by the management of the health facilities to institute and undertake activities in the form of training, improved safety management practices, organizational commitment and improved safety culture.
Bisphenol A (BPA) is a controversial plastics ingredient used mainly in the production of polycarbonate plastics (PC) and epoxy resins that widely used nowadays in food and drink packaging. Even though BPA is not involved in polyethylene terephthalate (PET) manufacturing, recent study had reported the present of BPA in PET water bottle. This study was conducted to investigate effects storage conditions on release of BPA from PC and PET bottled water as well as to assess health risks associated with consumption. Methods: Solid phase extraction (SPE) was used to extract the samples, followed by analysis using ultra high performance liquid chromatography with fluorescence detector (UHPLC-FLD). The possibility of developing chronic non-carcinogenic health risk among consumers of bottled water was evaluated using hazard quotient (HQ). Results: Results showed that BPA migrated from PC and PET water bottles at concentrations ranging from 9.13 to 257.67 ng/L and 11.53 ng/L to 269.87 ng/L respectively. Concentrations of BPA were higher in PET bottled water compared to PC bottled water across all storage conditions. Higher storage temperature and longer storage duration increased BPA concentrations in PC and PET bottled water. Concentrations of BPA in bottled water which were kept in a car and were exposed to sunlight were higher than control samples which were stored indoor at room temperature. Conclusion: No significant chronic non-carcinogenic health risks were calculated for daily ingestion of BPA-contaminated bottled water; calculated HQ was less than one.
Introduction: Evidently, stigma has potentially prompted the negative outcome in Tuberculosis (TB) control through delayed diagnosis and poor adherence to treatment. Amidst accelerating treatment interruption in Selangor, little attention is paid to the quantitative assessment of stigma, thus warrant further characterisation of TB stigma in ur-ban districts, Selangor. This study aimed to determine the predictors of internalised stigma among newly diagnosed PTB smear positive in urban districts, Selangor. Methods: A multi-centric longitudinal study recruited 345 newly diagnosed PTB smear positive patients who started TB treatment from November 2018 until June 2019. Baseline assessments utilised pre-tested self-administered questionnaire and standardised data collection form. Using IBM SPSS version 25.0, multiple linear regression was computed to determine the predictors. Results: The response rate was 84.7% with most of respondents were married and attained educational level up to secondary school. Other than low mean score of social support [mean (SD)=33.39(5.86)], the prominent findings were lacking knowledge of anti-TB side effect and wrongly perceived damaging effect of anti-TB drug to internal organ. The mean internalised stigma score was 24.88 (SD=4.70), which predicted by age, educational level (no formal education), employment status (retiree), alternative medicine practice, baseline symptoms score, perceived barrier, and social support, with entire group of variables significantly predicted TB stigma (F [9, 331] =21.476, p
Introduction: The vast majority of in vitro research on microglia are based on cells isolated from
neonatal animals (3-5 days of age). Studying microglia of adults has been limited by the lack of a suitable culture system that supports their growth. In this study, we describe a protocol for growing microglia of adults based on modifications of the technique for culturing microglia isolated from neonatal rats. Methods: Mixed glia isolated from adult rats (age range of 1 month to 3 years old) were seeded in
culture flasks coated with poly-L-lysine. Cells were maintained in DMEM media supplemented with
insulin-transferrin-selenium (ITS) and recombinant human macrophage colony-stimulating factor
(M-CSF). Mild trypsinisation was carried out to isolate microglia from mixed glia culture. Results:
Microglia cells of adult rats were successfully grown in vitro. For the expansion of adult microglia,
it was observed that coating the cell culture flasks with poly-L-lysine was crucial to encourage cell
adherence. The substitution of insulin in culture media with ITS was found to improve cell yield and
reduced the number of days required for culture from 28 days to 14 days. Addition of M-CSF to cell
culture medium, along with the improvisations described above provided the best adult microglia cell
yield (2.91 ± 0.56 x 106 cells) compared to the technique of replating cells (0.91 ± 0.65 x 106 cells;
p
The transwell migration assay is commonly used for assessing cell migration. It involves the enumeration of cells that
have migrated across a pore-containing membrane. We describe a randomised approach to quantifying migrated
cells and compare it to a conventional full cell count. We used ATP as a chemoattractant and automatic cell quantification performed on all fields (Full count; FC) or 10 randomly selected fields (Randomised count; RC). The two
methods were compared by evaluating standard deviations (SD), coefficient of variation (CV) and using the Bland-Altman analysis. The dispersion of data is higher with the RC approach (3.77-6.66% CV for control; 3.89-4.48% CV
for ATP-treated wells) compared to FC (0.27-0.46% CV for control; 0.05-0.09% CV for ATP-treated wells), but are
acceptable considering that the number of migrated cells are in the thousands. Both methods verified that an ATP
migration assay for BV2 microglia was established, demonstrating that the RC approach is reliable and comparable
to a full count.
Objective: Mesenchymal stem cells (MSC) are multipotent, non-haematopoietic stem cells that are
capable of differentiating into different varieties of mature cell types such as osteoblasts, chondrocytes, adipocytes, and myoblasts. There is abundant evidence showing that MSC not only affect the differentiation of haematopoietic progenitors, but also the function of mature cells like lymphocytes and neutrophils. However the effect of MSC on neutrophil function and its responses is not well studied. Therefore, this study was conducted to assess the effect of MSC on neutrophil nitric oxide production. Method: Neutrophils from heparanised venous blood were isolated using Ficoll-Hypaque density gradient centrifugation followed by Dextran sedimentation and red blood cell (RBC) lysis. Isolated neutrophils were on average of 97% purity as determined by morphologic analysis. MSC were generated from human bone marrow and characterised by immunophenotyping (monoclonal antibodies CD105, CD73 and CD34) using a flowcytometer. In order to test the effects of MSC on neutrophil function, isolated neutrophils were co-cultured in the presence or absence of MSC at different ratios for 24 and 48 hours. The amount of nitric oxide released was used as an indication of oxidative burst and measured using the Griess assay. Result: The results indicate that MSC neither elevate the NO level when cocultured with resting neutrophils nor alone. However MSC profoundly inhibit the secretion of nitric oxide in PMA stimulated neutrophils after 24hr of incubation. Conclusion: MSC exert an immunomodulatory effect on neutrophil by suppressing neutrophil oxidative burst in vitro.
Mitragyna speciosa (Korth.) or kratom is a native medicinal plant of Southeast Asia. Commonly used by hard labours in harsh working environment, the ingestion of brewed kratom decoction is reported to produce dose-dependent stimulant and opioid-like effects. Kratom is also regularly consumed as a pain killer and as traditional cure for common maladies such as fever and cough. However, it remains unknown whether regular consumption of kratom decoction is associated with brain abnormalities in regular users in traditional settings. Methods: A total of 14 subjects (7 regular kratom users and 7 non-kratom users) voluntarily participated in this cross-sectional study. Face-to-face interviews were conducted with kratom users to determine history of kratom use and later these respondents underwent brain magnetic resonance imaging (MRI). Results: There were no significant differences (p>0.05) in the intracranial volume (ICV), cortical volumes (frontal, parietal, temporal, occipital, or cingulate lobe), or subcortical volumes (striatum, hippocampus, or amygdala), as well as in the diffusion tensor imaging (DTI) metrics, fractional anisotropy (FA) and mean diffusivity (MD) between kratom users and the controls. Conclusion: This preliminary study showed long-term consumption of kratom decoction is not significantly associated with altered brain structures in regular kratom users in traditional settings. However, further study is needed to establish more data for kratom use and its effects.
Introduction: Kratom or (Mitragyna speciosa) leaves are consumed as a folk remedy and opioid substitute in the Southeast Asian region. There is still a lack of information about the long-term or toxic-causing effects of kratom use. Methods: A total of thirteen regular kratom users, with long-term (>20 twenty years) kratom use history were recruited for this cross-sectional pilot study. Respondents were required to undergo a blood-test and laboratory anaysis was conducted to determine the mitragynine content in an acquired street sample of kratom. Results: The regular, long- term consumption of brewed kratom decoction did not cause any significant alterations in haematological, kidney, liver, thyroid, inflammatory and gastrointestinal analytes in a cohort of kratom users who had no history of substance misuse. However, those who had a higher intake (>3 glasses per day) of kratom exhibited higher lipid values (except for HDL-cholesterol), and a moderate elevation of homocysteine level. Conclusion: Long-term (>20 years with a daily intake of 87.54mg of mitragynine) kratom consumption was not associated with altered biochemical levels, although prolonged and heavy use (>3 glasses daily) may result in cardiovascular risks. The latter finding, however, requires further investigation.
In order to accomplish a wide range of duties and responsibilities that may be done under unpleasant working con- ditions, prolonged standing posture is common with school teachers. Nevertheless, standing upright for a long time or otherwise regarded as prolonged standing frequently contributes to body pain and discomfort, muscle fatigue and even health problems such as musculoskeletal disorders (MSDs). The aim of this paper is to review MSDs arising from prolonged standing and spread information on existing ergonomic and non-ergonomic interventions to alleviate prolonged standing discomfort. Systematic review on prolonged standing school teachers with specific keywords were recognized to discover the appropriate studies and information in a systematic search. The informations in this review may be helpful to guide teacher, school management and researchers to implement the suitable interventions in order to minimise the health issue due to MSDs among school teachers.
Introduction: Zika virus infection is caused by flavivirus virus and spread by Aedes mosquitoes. Since first report-ed in 1947, it spread to various countries especially in the equatorial region including Malaysia. The infection is non-fatal to an adult. However, the major risk of its infection is towards unborn baby when the mother is infected. The vertical transmission to the foetus possess various risks include the teratogenic effect that may lead to elective abortion. Thus, the objectives of this review are to discover about Zika virus and its effect on pregnant women and to evaluate Islamic perspective about elective abortion of Zika virus-infected women. Methods: This review was done through reviewing evidence from the journals, books and reports. The data were reviewed thematically according to the objectives. Results: Studies shown that Zika virus may cause miscarriage, preterm birth, microcephaly and other malformation known as Congenital Zika syndrome. This leads to a demand for elective abortion which raised Islamic ethical issue if it is permissible. In Islam, abortion is extremely prohibited once the foetus reached 120-day of con-ception unless it causes harm to the mother’s life. But, if the foetus age is less than 120-day, abortion is permissible when the pregnancy affects the mother’s health. Abortion due to foetal microcephaly and congenital malformation is prohibited. Conclusion: Effort must be taken to prevent the spread of Zika virus to reduce the need for an elective abortion through an education Muslim community regarding elective abortion.
Spontaneous pneumothorax and pneumomediastinum is defined as presence of free air or gas in the pleural cav- ity and mediastinal structures respectively. Spontaneous pneumothorax seems to be associated with anatomical abnormalities such as subpleural blebs or bullae, however not for spontaneous pneumomediastinum which may developed without an apparent precipitating cause. Both usually may occur in young healthy adults without serious underlying lung disease. We report a case of spontaneous pneumothorax and pneumomediastinum after a trivial injury. He was initially presented with dyspnea after two weeks of initial trivial trauma. Chest radiograph showed left apical pneumothorax with pneumomediastinum with no evidence of rib fracture. His condition was deemed non-traumatic by surgical colleague, thus admitted to medical ward for observation and eventually discharged well.