Introduction: With the increasing number of international students joining various universities worldwide, including Malaysia, acculturative stress resulting from their attempts to adjust to the cultures of host countries is one of the most challenging issues affecting their life in general and academic life in particular. The purpose of this study is to determine the level of acculturative stress and intention to dropout among new postgraduate international students in public universities, Malaysia. Methods: a cross-sectional study was conducted among 522 new international post-graduate students joining Malaysian public universities on their first semester. A multistage sampling method was adapted, and data were collected via self-administered questionnaire by using a validated questionnaire. Results: Out of the overall number of 522 respondents, (68.60%) of them were males while (31.40%) were females, the mean age of respondents was 28.95 ±5.91 years. The majority of the participants 60.54% (326) were single, whereas those who are married students represented 205 (39.3%). This study showed that 410 (78.5%) of the new postgraduate international students experienced a moderate level of acculturative stress with a median value of 107.00, while 63 (12.1 %) high level of stress and 49 (4.9 %) experience low level of acculturative stress .Consequently224 ,42.1 % of the participants students they have intention to dropout from the university for any reason , while 298 (57.1 % ) they don’t have any intention to dropout from the university Conclusions: This study showed the importance of educational intervention program among new international postgraduate students towards adapting to the Malaysian culture, in relation with increasing their cultural knowledge and interaction with host nationals and to reduce their acculturative stress and their intention to dropout from the university.
Introduction: Alzheimer disease (AD) is the most widely recognised neurodegenerative disorder in the ageing population, characterised by progressive neuronal loss. The enhanced level of acetylcholine (ACh) in the human brain is another measure of identifying the progression of the disease. Increased acetylcholinesterase (AChE) level plays a fundamental role in the hydrolysis of Ach which worsens the cognitive function. Though there are several medications or drugs currently used in treating AD, their clinical implications remains debatable due to its adverse effects. Methods: In this study, the combined nutraceutical effect of natural plant compounds, piperine and curcumin were evaluated for acetylcholinesterase inhibitory assay using Ellman colourimetric method. Results: Results obtained from the study revealed that combined effects of natural plant compounds showed promising acetylcholinesterase inhibition activity with an IC50 of 104.1 ± 0.08 µg/mL compared to individually treated compounds, i.e., IC50 of curcumin = 134.5 ± 0.05 µg/mL and IC50 of piperine = 62.81 ± 0.00 µg/mL. Conclusion: The results suggest that the natural plant compounds taken in combination act as natural acetylcholinesterase inhibitors, and could be beneficial in the treatment of AD.
Introduction: Acute abdomen in an elderly, especially in the right iliac fossa, is usually the common symptom that needs a precise surgical assessment with acute appendicitis being a common cause. Rarely, other conditions can mimic this presentation such as acute caecal diverticulitis.1 We describe a rare case of right iliac fossa pain in a 72- year old male which mimicked an acute appendicitis. The ability to recognize such condition is very important as its management is different at various stages. The objective of this case report is to increase awareness of this condition to ensure it is appropriately treated when encountered unexpectedly. Methods and Results: A 72-year old man was admitted with the complaint of right iliac fossa pain for 5 days. A pre-operative clinical diagnosis of acute appendicitis was made. The patient underwent an emergency laparotomy where an inflammatory mass in the caecum was found. A right hemicolectomy was performed as there was a suspicion of underlying malignancy. His histopathology report showed a single inflammatory diverticular mass. Acute caecal diverticulitis has a higher incidence in the Asian descent. In Western countries, more than 80% of all diverticula occur in the left sided colon, whereas the incidence of right-sided diverticular disease in Oriental countries can be up to 75%. The pre-operative diagnosis of right caecal diverticulitis is usually challenging to the surgeons, if without radiological imaging. Ultrasonography (USG) and computed tomography (CT) are the important investigations for the diagnosis with their specific findings. The ability to recognize the condition is very important as its management is different at various stages. The morbidity and mortality can be improved by earlier detection and proper management. Conclusion: Acute caecal diverticulitis should be considered in the differential diagnosis in elderly with right iliac fossa pain. The surgical approach can be range from a simple diverticulectomy to a more complex right hemicolectomy. The decision making should always be tailored to the severity of the condition of the patient.
Haemophilia A is an inherited bleeding disorder, commonly involve soft tissues and joints. Gastrointestinal tract
bleeding, are not uncommon but seldom highlighted. A 23-year-old male with underlying severe haemophilia A was
presented with a generalised abdominal pain for 2 days, abdominal distension, diarrhoea and vomiting. He did not
have any trauma to the abdomen. Abdominal examination revealed generalized tenderness with sign of guarding
on palpation. Laboratory investigations revealed isolated, prolonged activated partial thromboplastin time (APTT)
with normal total white blood cell count and haemoglobin level. In view of acute abdomen, which was not resolved
by conservative treatment, an emergency laparotomy was done with FVIII concentrate and recombinant factor VII
(rFVII) coverage. Intraoperative findings noted patchy gangrenous spots of about 30 cm in length in the small bowel.
Histopathology examination revealed an evidence of haemorrhage within the submucosal and intramuscularis layer
from the resected specimen. This case highlighted the possibility of gastrointestinal bleeding without prior trauma,
which can be presented as acute abdomen in severe haemophilia patient.
Introduction: Acute gastroenteritis (AGE) is one of the frequent causes of hospitalization in children under the age of five, particularly in a rural setting. This study was conducted to determine the epidemiology of acute gastroenteritis in indigenous children admitted to a rural district hospital in Sarawak. Methods: A retrospective review of indigenous paediatrics cases of acute gastroenteritis
admitted to the ward of Serian District Hospital, a rural district hospital in Sarawak, between the years
2006-2007. The data was collected from the patients’ case notes, obtained with permission from the
hospital management. Data was entered and analyzed using SPSS version 16. Results: During the study period, 234 indigenous children with acute gastroenteritis were admitted with the highest prevalence in 2006 (53.4%). The findings showed higher prevalence was found in children aged 3 years and below (76.5%) and male (56.4%) The minimum duration of hospital stay is 1 day, and the maximum stay is 5 days. The clinical findings showed that the majority of the cases presented with vomiting, diarrhea, dry mouth and tongue, sunken eye, with the majority (76%) reported having mild dehydration. The most common treatment used is oral rehydration solutions (85.4%), followed by intravenous bolus or drip (82.3%), paracetamol (79%) and antibiotic (36.2%). Peak incidence of admissions was between November to January. About 38.5% of the AGE cases admitted were found to be underweight (weight for- age below -2SD). Conclusion: The findings indicated children aged 3 years and below are the most vulnerable to AGE and malnutrition could be one of the predisposing factors. The peak incidence during the raining season at the end of the year indicated a possible relationship between AGE and seasonal type of virus infection. Prevention in the form of proper hygiene at the household level probably will prove to be useful.
Acute necrotizing encephalopathy of childhood (ANEC) is a rare condition which is important for clinicians to recognize as it has a high mortality rate and can result in significant neurological morbidities. It presents as acute encephalopathy with radiological findings of symmetrical brain lesions in bilateral thalami, putamen, brain stem teg- mentum, internal capsule, periventricular white matter and cerebellar medulla. Intravenous methylprednisolone is the mainstay of treatment. Immunoglobulin therapy and therapeutic hypothermia may be used as adjunctive therapy in cases with severe clinical and neuroradiological presentation. We present a case of severe ANEC and discuss the clinical manifestations, neuroimaging and management options.
Introduction: Thymoquinone (TQ), a bioactive compound from Nigella sativa is known for its various medicinal properties. Due to the low solubility of TQ, nanostructured lipid carrier (NLC) has been used as a delivery system to improve its efficacy. Nevertheless, the effect of TQ-NLC when administered intravenously is unclear. This study investigated the acute toxicity profile of intravenous administration of TQ-NLC in an in vivo model. Methods: Twelve female Sprague dawley rats were assigned randomly into two groups (n=6); a control and a treatment group that received normal saline and 25 mg/kg TQ-NLC, respectively, via intravenous injection. The rats were observed for 14 days for any alterations to their usual physical conditions such as behaviour and mortality, body weight, food intake, organ-to-body weight ratio, and haematological, biochemical and histopathological profile. Results: There were no significant changes (p>0.05) in the body weight, food intake, organ-to-body weight ratio, and haematological, bio- chemical and histopathological profile between TQ-NLC treatment and the control group. However, inflammation was observed at the site of injection on the rat’s tail. Conclusion: Intravenous administration of TQ-NLC (25 mg/kg) did not exert acute toxic effect in female Sprague dawley rats. The data can be used as a basis to further develop TQ- NLC as a potential therapeutic drug.
Introduction: Identification of remains recovered at advanced stages of decomposition can be problematic due to the lack of physical evidence. Nonetheless, human dentition is least susceptible to decomposition and as such carry a significant value in personal identification of decomposed remains. Demirjian’s method of age estimation was developed specifically for children with developing dentition. In this article, a method on adapting the Demirjian’s method for Malay ethnic-specific age estimation using the third molar development is presented. Methods: Orthop- antomograms of Malay subjects aged 18 to 25 were obtained from UiTM Sungai Buloh. Total of 318 samples were taken, comprising of 123 and 195 images from male and female subjects. Development of right and left mandibular third molar was classified according to the eight stages of development as illustrated in Demirjian’s method. Data obtained were subjected to statistical analysis such as descriptive statistics and analysis of variance. The intra- and inter-gender variation between left and right mandibular third molar was evaluated using independent student t-test and analysis of variance, respectively. Results: Intra-gender comparison analysis revealed a significant difference in the female and male with a p-value of 0.000 and 0.003, respectively. Regression equation to estimate age based on third molar development were formulated according to dental age and maturity score. Conclusion: The Demirjian’s method was successfully adapted for age estimation of individuals of Malay ethnicity. These findings can help with victim identification in cases of poor skeletal framework recovery and highly decomposed remains.
Introduction: Consistent condom use can reduce the rate of transmission of STD/HIV. Condom self-efficacy is an important determinant of consistent condom use. The Condom Use Self-Efficacy Scale (CUSES) assesses the individ- ual's confidence and expectations to obtain, use, dispose and negotiate use of condom with their sexual partners. This study aimed to adapt, translate and determine the validity and reliability of CUSES Malay version among STD/ HIV patients in a primary care clinic. Methods: This was a cross sectional validation study conducted among STD/ HIV patients in a primary care clinic. The CUSES Malay version underwent content validation (calculation of I-CVI), forward and backward translation, face validation and field testing for psychometric analysis. Psychometric analysis used included Principal Axis Factoring with direct oblimin rotation, internal consistency reliability (Cronbach's α) and test-retest reliability analyses (Intraclass Correlation (ICC)). Results: A total of 168 participants were enrolled into this study (99% response rate). In content validation, all items were retained as the I-CVI were >1.00. Feedback from face validation resulted in simpler phrases of some items. One item (B2) was removed due to poor factor loading of
Introduction: Adherence towards childhood immunization (completeness and timeliness), with consideration of age-dependent-seroconversion, is the basis for children protection. Despite high global and national immunization coverage, vaccine preventable diseases’ are rising. This study aimed to determine adherence (completeness and timeliness) towards different vaccines of childhood immunization and associated factors among mothers of under five children. Methods: Cross-sectional study design was conducted at a health clinic in Seremban. Total of 320 mothers of under five children attending child health clinic selected via systematic random sampling. Data collection was via validated self-administered questionnaires and proforma, analysed using SPSS version 22. Associations between categorical variables determined by chi-square tests. Results: Consented respondents were 314; resulting in response rate of 98.1%. Adherence (completeness) was 98.09% but only 56.5% - 97.1% of respondents adhered in terms of timeliness. Types of transportation was significantly associated with adherence (completeness), p=0.041. Employment status was significantly associated with adherence (timeliness) towards BCG (p=0.008), Hepatitis B dose one (p=0.018) and dose two (p=0.040) vaccines. Education level was significantly associated with adherence (timeliness) towards DTaP/IPV/HiB dose four (p=0.019). Maternal age and usage of government clinic were significantly associated with adherence (timeliness) of MMR dose one, p=0.030 and p=0.017 respectively. Conclusion: Adherence (completeness) was high but varying adherence towards vaccine timeliness. Transportation types associated with completeness. Employment status associated with BCG, first and second doses of Hepatitis B vaccines’ timeliness. Education level associated with fourth dose of DTaP/IPV/HiB. Maternal age and usage of government clinic associated with timeliness of first dose MMR.
Advanced parental age is a risk factor for chromosomal abnormalities in their offspring. Trisomy X or Triple X syn- drome has previously been reported with advanced maternal age. Here we report two (2) cases of Trisomy X with paternal age as risk factor. Generally, Trisomy X individuals show variable physical and psychological manifesta- tions. However, both cases reported here have advanced paternal age as a risk factor; 55 years old (46 years old at conception) for Case 1 with patient having right eye squint, beaked nose, Posterior Misalignment Type Ventricular Septal Defect (PMVSD) and small Patent Ductus Arteriosus (PDA) with failure to thrive and 49 years old (45 years old at conception) for Case 2 with speech delay and protruding tongue. In view of that, advanced paternal age could possibly contribute the accumulation of de novo mutations in germ line mosaicism.
The Family Health Programme in Malaysia started off with a humble beginning in the 1920s by the introduction of midwifery legislation under the Straits Settlement Ordinance and the Federal Malay states Midwifery Enactment. Institutionalisation of nursing training took placed in the 1940s while the rural health services for pregnant women and children were established in the 1950’s. In 1967, the school health program was initiated, followed by the de-livery of the school health services in 1972. The Ministry of Health (MoH) set up a Maternal and Child Health unit within the MoH organisation in 1974 to oversee the maternal, child and school health activities. In 1996, the Family Health Development Division was established with the prenatal, adolescent, adult, people with disability and nu-trition health services were incorporated into the family health activities. Subsequently, the age-group wellness and population genetic screening were introduced in year 2000. The family health programme has embraced the public health approach as its building blocks. Throughout the years, individual patient care has advanced the most through the improvement of standards and quality of services within the health clinics. Plateauing of maternal mortality ratio and under-5 mortality rate, increasing trend of non-communicable diseases, remerging of communicable diseases, urbanisation and globalization, and increasing ageing population are new challenges in the delivery of family health services to the community. In order to cater for these challenges, it is crucial to recognise the population health as one of the main component in the family health programmes. Transformation in the scope of new family and popu-lation health is needed to improve the delivery of family programme beyond the boundary of MoH facilities.
Introduction: The prevalence of children with autism spectrum disorder is increasing each year. Intervention pro- grammes towards improving the occupational needs such as daily activities of these children are limited. This study aimed to collect opinions from advisory panel for the content validation of the three developed intervention pro- grammes to be implemented among children with autism spectrum disorder aged between 6 to 12 years. The inter- vention programmes are; i) self-regulated learning, ii) sensory integration intervention and iii) activity-based interven- tion. Methods: A cross-sectional study was conducted. Twenty occupational therapists with more than three years’ experience working with children with autism spectrum disorders were recruited as advisory panel members. Re- searchers-developed questionnaire was used. The questionnaire consists of nine to eleven items. Each item consists of a five-point Likert scale for quantitative responses and open-ended questions for qualitative responses. Results: Advisory panel ratings of ‘Good’ to ‘Excellent’ was reported across most items in all three intervention programmes. Overall results suggested that the intervention programmes content was rated to be suitable for children with autism spectrum disorder. Constructive comments were adopted to clarify the activities and structure of the intervention programmes. Final development of the intervention programmes is presented. Conclusion: This study provides con- fidence for the interventions to be incorporated into the future randomised controlled trial.
Introduction: Due to rapid industrialization and urbanization, abundant industrial effluents are discharged into the environment. Concerns have been raised on dye manufacturing and textile industries due to the detrimental effects of effluents containing dye discharged. Hence, this study aims to examine the adsorption of a common synthetic dye using Agaricales (Gilled Mushrooms) as biosorbents. Method: Among the
5 species of Agaricales cultivated in the screening experiment, Pleurotus ostreatus (Oyster Mushroom) and Pleurotus eryngii (King Oyster Mushroom) were found to have relatively higher growth rates of 86.17% and 77.97% respectively. Pleurotus ostreatus was selected for recultivation with addition of 50 ppm of Remazol Brilliant Blue R dye to examine its ability to remove the dye. Pleurotus ostreatus showed rapid decolorizing ability within 3 days of cultivation with Ramazol Brilliant Blue R. Therefore, batch analysis was subsequently conducted by varying the experimental parameters. Results: AFrom the batch analysis, Pleurotus ostreatus achieved the highest dye decolorization in cultivation medium of pH 2, 0.1 mL surfactant, 0 mg/L of sodium chloride and with 8 plugs of biosorbent. Adsorption isotherm studies were also conducted. The adsorption data fitted Jovanovic isotherm the most with highest R2 value of 0.9949 compared to Langmuir, Freundlich and Harkin-Jura isotherms. Conclusion: This study shows the potential of Agaricales, particularly Pleurotus ostreatus as biosorbent of synthetic dye due to its high growth rate and efficiency of synthetic dye removal.
Introduction: Musculoskeletal Disorder (MSD) is an injury that affects the movement of human body systems such as muscles, tendons, ligaments, nerves, blood vessels, and others. The prevalence of MSDs in Indonesia is 11.9% based on diagnosis and 24.7% based on symptoms. MSDs prevalence is 31.2% based on employment among farm- ers, fishermen, and workers. Methods: The design of this study has been included in observational research using a quantitative approach with Cross-Sectional study. Results: MSDs can appear based on gender, age, educational status, and non-medical supporting professions. Older workers tend to be at risk of developing MSDs complaints. Conclusion: To reduce the risk of complaints, work facilities such as ergonomic chairs and tables can be provided along with extension of work intervals. Workers must take advantage of good rest periods. There is no relationship between work tenure and MSDs complaints. If the working period is long, then it can cause boredom and the endur- ance of muscles as well as bones physically.
Introduction: Adolescent aggression has become a serious public health problem with the escalating juvenile cases and violence among secondary school students by inflicting harm to others. The objective of this study was to deter-mine the biopsychosocial predictors of adolescent aggression among Form Four students in Hulu Langat. Methods: Cross-sectional study was conducted by proportionate population sampling method among Form Four students from all public secondary schools in Hulu Langat. Pre-tested questionnaires distributed to measure students’ ag-gression, demographic (ethnicity, family income), biological (sex, head injury, nutritional deficiency, breakfast skip-ping), psychological (attitude towards aggression, normative beliefs to aggression, personality trait, and emotional intelligence), and social factors (family environment, single parent status, domestic violence, peer deviant affiliation, alcohol, smoking, and substance abuse). Data was analysed using multivariate analysis to determine the significant predictors. Results: 480 students from four randomly selected schools participated in the study with response rate of 96.5%. The median aggression score was low, which was 23.00 (IQR=12.00). From simple linear regression, 15 factors had significant relationship with adolescent aggression. The predictors of adolescent aggression were lower family income, Malay ethnicity, nutritional deficiency, attitude towards aggression, and peer deviant affiliation (F [8, 244] =15.980, p-value
Clonal disorders of LGL may either be CD3+ CD56- or CD3- CD56+ phenotype and these have been designated as T-cell leukaemia (T-LGL) or natural killer cell (NK)-LGL leukaemia respectively. Clonality is usually demonstrated by clonal rearrangement of T-cell receptor gene rearrangement or identified by flowcytometry analysis. Most patients with T-LGL will have an indolent course. In this report we described an aggressiveness of disease in a patient with clonal CD3+ LGL leukaemia whose cells also co-expressed CD56 diagnosed by flowcytometry. The patient responded well to interrupt ALL standard risk protocol however succumbed to her disease while waiting for upfront stem cell transplant. This case highlights on both the classical laboratory findings of rare entity of disease as well as a review of the literature pertaining particularly on its management.
Air pollutants that possessed genotoxic properties have the potential to induce genetic damage. Micronuclei (MN) frequency is used as an indicator for identifying potential genotoxic exposures. A comparative cross-sectional study was carried out among primary school children in a petrochemical industrial area (N=111, Kemaman) and a rural (N=65, Dungun) area in Terengganu. Methods: Validated questionnaires were distributed to obtain the respondents’ socio-demographic data, previous exposure and reported respiratory illness. The frequency of micronuclei was assessed in collected buccal mucosa samples of children. The air monitoring was also carried out at 6 selected schools. Results: Results from the statistical analysis carried out showed significant differences with p=0.001 for all parameters assessed between areas, which included ultrafine particles, UFP (z = -4.842), PM2.5 (z = -10.392), PM10 (z= -11.074) NO2 (z = -11.868), SO2 (z = -5.667), relative humidity (z = -5.587). The MN frequency was statistically significant with PM2.5 (χ2= 17.78, p=0.001) and PM10 (χ2= 15.429, p =0.001). The statistical analysis also showed a significant association between UFP and coughing (PR=2.965, 95% CI=1.069-8.225). The multiple logistic regression analysis showed that the main pollutants influencing MN frequencies were UFP and NO2 with UFP (PR=1.877, 95%CI= 1.174-3.002) and NO2 (PR=1.008, 95%CI= 1.001-1.015). Conclusion: This study demonstrated that exposure to air pollutants may increase the risk of respiratory illness and may induce MN formation among children.
Introduction: For “smart health” Internet-of-Things (IoT) applications, substrate integrated waveguide (SIW) is a promising component to construct a wearable microwave device. For its efficacy in wearable devices, minimizing signal losses in terms of return and transition losses in SIW is of paramount importance. To enhance its performance, this paper presents the characterization of air-filled SIW transition losses for the SIW microwave device. Method: To investigate the effect of transition length on losses, the full-wave analysis of an air-filled SIW with different lengths of the taper transition was presented. For the analysis, the linear taper is designed for the Roger RT/Duroid 6002 substrate and utilized in the Ka-band frequencies. Result: From the full-wave analysis results, the length of the tran- sition taper can be reduced considerably while achieving a wide-bandwidth characteristic of return loss better than 20 GHz. The results also show that the transmission loss can be reliably reduced while reducing the size of the SIW component. Conclusion: The findings may contribute to the development of the compact design of wearable micro- wave devices having a comparable performance with the conventional waveguide.
Introduction: Transfusion Medicine is an evolving filed which integrates multidisciplinary science in providing safe blood and blood products for patients. With an increasing demand for Transfusion Medicine training in Malaysia, a formal survey is needed to evaluate the postgraduate Transfusion Medicine programme offered by Advanced Med- ical and Dental Institute, Universiti Sains Malaysia to identify areas of deficiency based on the alumni experiences. Methods: An English language survey form was developed specifically to assess the programme contents (overall contents, learning experience in each year, and support in research), the alumni perception on soft-skills gained during the study, and the outcome of the programme. The survey forms were distributed to all alumni between March 2018 and October 2018 via e-mail or hand-delivered. Results: The survey response rate was 79% (37 of 47). A ma- jority (97%) of the transfusion medicine specialists (TMS) in this study reported that the course offered in the program was relevant to their current job. The learning experience which includes course content, student’s placement, facili- ties, and support in research) were rated between satisfactory and good. Communicating effectively through speaking was the highest reported soft-skill gained during the programme, whereas communicating effectively in writing was the lowest soft-skill gained. On the programme outcome, all TMS agreed that this programme will produce qualified and well trained specialists for current working market. Conclusion: Some improvement in the programme contents and teaching activities are needed to equip the future TMS for the nation.