The objective of this study is to examine the impact of the casemix reimbursement on the hospital revenue at three selected hospitals (Type B, C and D) reimbursed using 602 groups from 14,749 cases. The results of the study showed that the hospitals received 32.4% higher income when reimbursed with Indonesia Case Bases Groups (INA-CBG) as compared to fee-for-service. Type D hospitals is the biggest gainer with 81.0% increased in income followed by Type B hospital that obtained 34.7% higher revenue. In conclusion, the use of INA-CBG as a prospective payment method has benefitted the hospitals by the increase in the revenues. It is hope that additional resources gained in this programme will allow the hospitals to provide optimum care to the population. It is recommended that the JKA management will use the INA-CBG casemix data to monitor the performance of the hospitals to ensure that quality and efficiency of the services provided to the population is continuously maintained.
Four new species of semiterrestrial gecarcinucid crabs are described from limestone and sandstone habitats in southwestern Sarawak, Malaysia: Terrathelphusa aglaia n. sp., T. cerina n. sp., T. kundong n. sp., and T. mas n. sp. The taxonomy of T. kuchingensis (Nobili, 1901) is discussed, its precise identity ascertained from fresh material, and its actual distribution determined. This increases the number of Terrathelphusa species in Borneo to eight.
In this study, the selenium enriched peanuts and the different solubility proteins extracted from them were investigated. The dried defatted selenium enriched peanuts (SeP) powder (0.3147 μg/g) had a 2.5-fold higher mean total selenium concentration than general peanuts (GP) power (0.1233 μg/g). The SeP had higher concentration of selenium, manganese and zinc than that of GP, but less calcium. The rate of extraction of protein was 23.39% for peanuts and alkali soluble protein was the main component of protein in SeP, which accounted for 92.82% of total soluble protein and combined selenium was 77.33% of total selenium protein. In different forms of proteins from SeP, the WSePr due to higher concentration of selenium had higher DPPH free-radical scavenging activity, higher reducing activity and longer induction time than other proteins.
It is important to assess indoor air quality in school classrooms where the air quality may significantly influence school children's health and performance. This study aims to determine the concentrations of PM2.5 and dust chemical compositions in indoor and outdoor school classroom located in Kuala Lumpur City Centre. The PM2.5 concentration was measured from 19th September 2017-16th February 2018 using an optical PM2.5 sensor. Indoor and outdoor dust was also collected from the school classrooms and ion and trace metal concentrations were analysed using ion chromatography (IC) and inductively couple plasma-mass spectrometry (ICP-MS) respectively. This study showed that the average indoor and outdoor 24 h PM2.5 was 11.2 ± 0.45 µg m-3 and 11.4 ± 0.44 µg m-3 respectively. The 8 h PM2.5 concentration ranged between 3.2 and 28 µg m-3 for indoor and 3.2 and 19 µg m-3 for outdoor classrooms. The highest ion concentration in indoor dust was Ca2+ with an average concentration of 38.5 ± 35.0 µg g-1 while for outdoor dust SO42- recorded the highest ion concentration with an average concentration of 30.6 ± 9.37 µg g-1. Dominant trace metals in both indoor and outdoor dust were Al, Fe and Zn. Principle component analysis-multiple linear regression (PCA-MLR) demonstrated that the major source of indoor dust was road dust (69%), while soil dominated the outdoor dust (74%). Health risk assessment showed that the hazard quotient (HQ) value for non-carcinogenic trace metals was
Platelet-associated complications including thrombosis, thrombocytopenia, and hemorrhage are commonly observed during various inflammatory diseases such as sepsis, inflammatory bowel disease, and psoriasis. Despite the reported evidence on numerous mechanisms/molecules that may contribute to the dysfunction of platelets, the primary mechanisms that underpin platelet-associated complications during inflammatory diseases are not fully established. Here, we report the discovery of formyl peptide receptor 2, FPR2/ALX, in platelets and its primary role in the development of platelet-associated complications via ligation with its ligand, LL37. LL37 acts as a powerful endogenous antimicrobial peptide, but it also regulates innate immune responses. We demonstrate the impact of LL37 in the modulation of platelet reactivity, hemostasis, and thrombosis. LL37 activates a range of platelet functions, enhances thrombus formation, and shortens the tail bleeding time in mice. By utilizing a pharmacological inhibitor and Fpr2/3 (an ortholog of human FPR2/ALX)-deficient mice, the functional dependence of LL37 on FPR2/ALX was determined. Because the level of LL37 is increased in numerous inflammatory diseases, these results point toward a critical role for LL37 and FPR2/ALX in the development of platelet-related complications in such diseases. Hence, a better understanding of the clinical relevance of LL37 and FPR2/ALX in diverse pathophysiological settings will pave the way for the development of improved therapeutic strategies for a range of thromboinflammatory diseases.
The advantage of cooking cannot be summarized just as the better food digestion. Some investigations showed the effect of cooking on reduction of food anti-nutrients such as oxalate. This study was aimed to determine the effect of cooking on oxalate content and its negative effects on calcium availability in eight Malaysian soy-based dishes. Since there is few data which examined the effects of cooking on food oxalate content globally, thus this study was designed as the first in Malaysia. Oxalate in this research was analyzed by using enzymatic methods, while calcium content was determined by using Atomic Absorption Spectrophotometer. The oxalate concentration was in the range of 6.43-19.40 mg/100 g for whole cooked samples, 9.03-11.90 mg/100 g for raw soy products, and 4.36-7.99 mg/100 g for cooked ones. There were 5 out of 12 samples containing oxalate, which was significantly lower (p < 0.05) in cooked products compared to the raw ones. The rest of the samples were also lower in oxalate but not significantly different (p > 0.05). Oxalate in raw/cooked fermented soy products (tempeh) was slightly lower compared to the non-fermented ones. However, there was no significant difference (p > 0.05) in oxalate amount between fermented and non-fermented soy products. As Oxalate/Calcium ratio was below 1, oxalate did not have an effect on availability of calcium in the studied samples. Optimal cooking and food processing might be effective in reducing oxalate content in soy products. There is a need for more investigations about the effect of cooking on soy products to confirm the present results.
A chemical modifier (acrylic acid) was used to improve the thermal properties of polypropylene/ ethylene propylene diene terpolymer/calcium carbonate (PP/EPDM/CaCO3) composites. Treated
and untreated PP/EPDM composites were filled by CaCO3 at 0, 20 and 40% wt. The composites
were prepared using Z-blade mixer machine at 180oC and 50 rpm of rotor speed. Thermogravimetric
analysis (TGA) and differential scanning calorimetry (DSC) methods were used to analyze the thermal properties of the composites. Thermogravimetric analysis indicated that the total weight loss of PP/EPDM/CaCO3 composites decreased with the increasing filler loading for the treated and untreated composites. Meanwhile, the presence of acrylic acid was found to have increased the thermal stability and crystallinity of PP/EPDM/CaCO3
.
AIM OF THE STUDY: Postmenopausal osteoporosis is mainly treated with estrogen replacement therapy (ERT). However, ERT causes side effects, mainly breast cancer, uterine cancer and thromboembolic problems. Labisia pumila var. arata (LPva), a herb with phytoestrogenic effects has the potential to be used as an alternative agent to ERT. This study was conducted to determine the effects of LPva on bone biochemical markers and bone calcium content in ovariectomised rats.
MATERIALS AND METHODS: Thirty two Wistar rats were divided into 4 groups, with 8 rats in each group. The first group was sham operated (Sham), the second group was ovariectomised (OVX), the third (LPva) and fourth group (ERT) were also ovariectomised and given LPva 17.5 mg/kg and Premarin(®) 64.5 μg/kg, respectively. Blood samples were taken before and after treatment to measure osteocalcin and C-terminal telopeptide of type 1 collagen levels using ELISA while the fifth lumbar bone samples were taken to measure bone calcium content using the Atomic Absorption Spectrophotometer (AAS).
RESULTS: The osteocalcin levels were significantly higher in both the LPva and ERT groups compared to the OVX group. The CTX levels were significantly lower in both the LPva and ERT groups compared to the OVX group. However, only the ERT group had significantly higher bone calcium level compared to the OVX group.
CONCLUSION: The supplementation of 17.5 mg/kg of LPva to ovariectomised rats for 8 weeks was able to prevent the changes in bone biochemical markers but failed to prevent the bone calcium loss induced by ovariectomy.
Cosmos caudatus (ulam raja) contains high mineral content and possesses high antioxidant activity which may be beneficial in bone disorder such as postmenopausal osteoporosis. The effects of C. caudatus on bone metabolism biomarkers in ovariectomized rats were studied. 48 Sprague-Dawley rats aged three months were divided into 6 groups. One group of rats was sham-operated while the remaining rats were ovariectomized. The ovariectomized rats were further divided into 5 groups: the control, three groups force-fed with C. caudatus at the doses of 100mg/kg, 200mg/kg or 300mg/kg and another group supplemented with calcium 1% ad libitum. Treatments were given 6 days per week for a period of eight weeks. Blood samples were collected twice; before and after treatment. Parameters measured were bone resorbing cytokine; interleukin-1 and the bone biomarkers; osteocalcin and pyridinoline. Serum IL-1 and pyridinoline levels were significantly increased in ovariectomized rats. Supplementation of C. caudatus was able to prevent the increase of IL-1 and pyridinoline in ovariectomized rats. Besides that, C. caudatus showed the same effect as calcium 1% on biochemical parameters of bone metabolism in ovariectomized rats. In conclusion, Cosmos caudatus was as effective as calcium in preventing the increase in bone resorption in ovariectomized rats.
In this work, potato slices were exposed to different doses of UV-C irradiation (i.e. 2.28, 6.84, 11.41, and 13.68 kJ m(-2)) with or without pretreatment [i.e. ascorbic acid and calcium chloride (AACCl) dip] and stored at 4 ± 1 °C. Changes in enzymatic activities of polyphenol oxidase (PPO), peroxidase (POD) and phenylalanine ammonia lyase (PAL), as well as total phenolic content (TPC) were investigated after 0, 3, 7 and 10 days of storage. Results showed that untreated and UV-C treated potato slices at 13.68 kJ m(-2) dosage level showed significantly higher PPO, POD and PAL activities. Conversely, untreated potato slices showed the lowest TPC during storage period. Potato slices subjected to AACCl dip plus UV-C at 6.84 kJ m(-2) produced lower PPO, POD and PAL activities, as well as maintained a high TPC during storage.
Six weed species (Leptochola chinensis, Echinochloa crus-galli, Echinochloa colona, Jussiaea linifolia, Oryza sativa (weedy rice) and Cyperus iria) were tested for their salt tolerant traits in terms of chlorophyll, proline and mineral nutrients accumulation against different salinity levels (0, 4, 8, 16, 24, 32, and 40 dS m(-1)). Chlorophyll a, b and total chlorophyll content, proline and mineral nutrients accumulation were determined. Salt stress showed prominent effect on all the parameters investigated and there were significant variations between the all weed species. Chlorophyll content, K+, Ca(2+) and Mg(2+) ions in both shoots and roots significantly decreased; while proline and Na+ accumulation significantly increased with increasing salinity up to 40 dS m(-1). In terms of overall performance, Cyperus iria and E. crus-galliwere relatively more tolerant; E. colona and J. linifolia were tolerant; L. chinensis and O. sativa L were salt sensitive, respectively.
Dietary studies often report low calcium intake amongst post-menopausal Malaysian women and calcium deficiency has been implicated as part of the etiology of age-related bone loss leading to osteoporosis. Therefore, the objective of this study was to examine the effectiveness of high calcium skimmed milk (Anlene Gold, New Zealand Milk, Wellington, New Zealand) to reduce bone loss in Chinese postmenopausal women. Two hundred subjects aged 55-65 years and who were more than 5 years postmenopausal were randomized to a milk group and control group. The milk group consumed 50 g of high calcium skimmed milk powder daily, which contained 1200 mg calcium (taken as two glasses of milk a day). The control group continued with their usual diet. Using repeated measures ANCOVA, the milk supplement was found to significantly reduce the percentage of bone loss at the total body compared to the control group at 24 months (control -1.04%, milk -0.13%; P<0.001). At the lumbar spine, the percentage of bone loss in the control group was significantly higher (-0.90%) when compared to the milk (-0.13%) supplemented group at 24 months (P<0.05). Similarly, milk supplementation reduced the percentage of bone loss at the femoral neck (control -1.21%, milk 0.51%) (P<0.01) and total hip (control -2.17%, milk -0.50%) (P<0.01). The supplemented group did not experience any significant weight gain over the 24 months. The serum 25-hydroxy vitamin D level improved significantly (P<0.01) from 69.1 +/- 16.1 nmol/l at baseline to 86.4 +/- 22.0 nmol/l at 24 months in the milk group. In conclusion, ingestion of high calcium skimmed milk was effective in reducing the rate of bone loss at clinically important lumbar spine and hip sites in postmenopausal Chinese women in Malaysia. Supplementing with milk had additional benefits of improving the serum 25-hydroxy vitamin D status of the subjects.
Matched MeSH terms: Calcium, Dietary/administration & dosage; Calcium, Dietary/therapeutic use
Standard renal clearance techniques were used to compare the effects of intravenous infusions of L-arginine, D-lysine and glycine on urinary calcium excretion in the rat. A significant calciuric response was evident following the infusion of all three amino acids in all the animals. The maximal effect was evident in rats receiving L-arginine. The mechanism for the increased urinary calcium excretion in rats infused with L-arginine and D-lysine appeared more due to a decreased fractional reabsorption of this cation as no significant changes in the glomerular filtration rate (GFR) were evident in these two groups. The calciuria in rats receiving glycine appears due to increased filtered load secondary to the increased GFR, suggesting that the mechanism for calciuria evident following protein ingestion or amino acid infusion may vary and may be dependent upon the amino acid ingested or infused.
Acid sulfate soil characterized by pyrite (FeS2) which produces high acidity (soil pH < 3.5) and release high amount of Al3+ and Fe2+. Application of 4 t ha-1 Ground Magnesium Limestone (GML), is a common rate used for acid sulfate soil by the rice farmers in Malaysia. Therefore, this study was conducted to evaluate the integral effect of ground magnesium limestone (GML) and calcium silicate and to determine the optimal combination on acid sulfate soils in Malaysia. The acid sulfate soils were incubated under the submerged condition for 120 days with GML (0, 2, 4, 6 t ha-1) in combination with calcium silicate (0, 1, 2, 3 t ha-1) arranged in a Completely Randomized Design (CRD). The soil was sampled after 30, 60, 90 and 120 days of incubation and analyzed for soil pH, exchangeable Al, Ca, Mg, K and available Si. A total of 2 out of 16 combinations met the desired soil requirement for rice cultivation. The desired chemical soil characteristics for rice cultivation are soil pH > 4, exchangeable Al < 2 cmolc Kg-1, exchangeable Ca > 2 cmolc kg-1, exchangeable Mg > 1 cmolc kg-1 and Si content > 43 mg kg-1. The combinations are i) 2 t ha-1 calcium silicate + 2 t ha-1 GML, and ii) 3 t ha-1 calcium silicate + 2 t ha-1 GML, respectively. These combination rates met the desired requirement of soil chemical characteristics for rice cultivation. Soil acidity was reduced by a gradual release of Ca2+ and SiO32- from calcium silicate continuously filling the exchange sites and reducing the potential of extra (free) H+ availability in the soil system. Combination of calcium silicate and GML, shows the ameliorative effect with; i) release of Ca, ii) binding of Al3+ making it inert Al-hydroxides and, iii) bind H+ to produce water molecules.
A modified outdoor large-scale nutrient recycling system was developed to compost organic sludge and aimed to recover clean nitrogen for the cultivation of high-value-added microalgae. This study investigated the effect of calcium hydroxide addition on enhancing NH3 recovery in a pilot-scale reactor self-heated by metabolic heat of microorganisms during thermophilic composting of dewatered cow dung. 350 kg-ww of compost was prepared at the ratio of 5: 14: 1 (dewatered cowdung: rice husk: compost-seed) in a 4 m3 cylindrical rotary drum composting reactor for 14 days of aerated composting. High compost temperature up to 67 °C was observed from day 1 of composting, proving that thermophilic composting was achieved through the self-heating process. The temperature of compost increases as microbial activity increases and temperature decreases as organic matter decreases. The high CO2 evolution rate on day 0-2 (0.02-0.08 mol/min) indicated that microorganisms are most active in degrading organic matter. The increasing conversion of carbon demonstrated that organic carbon was degraded by microbial activity and emitted as CO2. The nitrogen mass balance revealed that adding calcium hydroxide to the compost and increasing the aeration rate on day 3 volatilized 9.83 % of the remaining ammonium ions in the compost, thereby improving the ammonia recovery. Moreover, Geobacillus was found to be the most dominant bacteria under elevated temperature that functions in the hydrolysis of non-dissolved nitrogen for better NH3 recovery. The presented results show that by thermophilic composting 1 ton-ds of dewatered cowdung for NH3 recovery, up to 11.54 kg-ds of microalgae can be produced.
In this study, the effect of beverages (Coke TM, Sprite™, Ribena™, Chrysanthemum tea and mineral water) on the demineralisation of the enamel surface was investigated. Demineralisation was determined by the rate of calcium released from the enamel surface on exposure to the beverages. Calcium was determined using the EDTA titration method. The pH of these beverages was measured using a pH meter and found to be in the acidic range (2.43 to 5.79) while mineral water which served as a control has a pH of 7.00. Ii was found that the rate of calcium released from Coke™(0.76 J..lg/min) showed a significant mean difference from Sprite™ (0.38 J..lg/min), Chrysanthemum tea (0.10 J..lg/min) and mineral water (0.00 J..lg/min)at p< .05, but was however not significantly different from Ribena™. Likewise, Chrysanthemum tea and mineral water also showed statistically no significant mean difference in the released of calcium during the study period. The results obtained in this study indicated that beverages with low pH may pose detrimental effect on the enamel surface which could have clinical implication, especially in people with salivary gland dysfunction or low salivary flow.
The massive growth of construction industry especially in the developing countries results in extensive quarrying activities which ultimately would lead to the depletion of natural resources. Apart from extensive extraction of the natural granite from the earth for concrete production, marble production industry is also majorly contributing to the quarrying activities. In addition, high volume of waste is generated by the marble production industry as 70% of marble is wasted during the production such as quarrying, cutting, processing and others which is environmental unfriendly. In a way to achieve sustainable construction, the present study is to utilise the waste marble in replacing the coarse aggregate in concrete production. The engineering performance including workability, compressive strength, ultrasonic pulse velocity (UPV) and chloride penetration were analysed. The raw waste marble obtained from the industry were crushed and sieved into maximum size 20 mm and used to replace the coarse aggregate at the level of 20%, 40%, 60%, 80% and 100% respectively. Results show that 60% of the replacement level has yield to optimum result by achieving the highest compressive strength and UPV at approximate 5% higher than the control. Meanwhile, the effect on chloride penetration resistance is more significant, i.e. approximate 19% better than the control. However, increasing the replacement level of waste marble has no significant effect on workability, although an increasing trend was observed.
Osteoporosis in elderly men is becoming an important health issue with the aging society. Elderly men with androgen deficiency are exposed to osteoporosis and can be treated with testosterone replacement. In this study, Eurycoma longifolia (EL), a plant with androgenic effects, was supplemented to an androgen-deficient osteoporotic aged rat as alternative to testosterone. Aged 12 months old Sprague-Dawley rats were divided into groups of normal control (NC), sham-operated (SO), orchidectomised-control (OrxC), orchidectomised and supplemented with EL (Orx + El) and orchidectomised and given testosterone (Orx + T). After 6 weeks of treatment, serum osteocalcin, serum terminal C-telopeptide Type 1 collagen (CTX) and the fourth lumbar bone calcium were measured. There were no significant differences in the osteocalcin levels before and after treatment in all the groups. The CTX levels were also similar for all the groups before treatment. However, after treatment, orchidectomy had caused significant elevation of CTX compared to normal control rats. Testosterone replacements in orchidectomised rats were able to prevent the rise of CTX. Orchidectomy had also reduced the bone calcium level compared to normal control rats. Both testosterone replacement and EL supplementation to orchidectomised rats were able to maintain the bone calcium level, with the former showing better effects. As a conclusion, EL prevented bone calcium loss in orchidectomised rats and therefore has the potential to be used as an alternative treatment for androgen deficient osteoporosis.
Lithium, the lightest natural-occurring alkali metal with an atomic number of three, stabilizes the mood to prevent episodes of acute manic and depression. Multiple lines of evidence point to lithium as an anti-suicidal, anti-viral, anti-cancer, immunomodulatory, neuroprotective and osteoprotective agent. This review article provides a comprehensive review of studies investigating the bone-enhancing effects of lithium and its possible underlying molecular mechanisms. Most of the animal experimental studies reported the beneficial effects of lithium in defective bones but not in healthy bones. In humans, the effects of lithium on bones remain heterogeneous. Mechanistically, lithium promotes osteoblastic activities by activating canonical Wingless (Wnt)/beta (β)-catenin, phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) and bone morphogenetic protein-2 (BMP-2) transduction pathways but suppresses osteoclastic activities by inhibiting the receptor activator of nuclear factor-kappa B (RANK)/receptor activator of nuclear factor-kappa B ligand (RANKL)/osteoprotegerin (OPG) system, nuclear factor-kappa B (NF-κB), mitogen-activated protein kinase (MAPK), and calcium signaling cascades. In conclusion, lithium confers protection to the skeleton but its clinical utility awaits further validation from human clinical trials.
Catecholaminergic polymorphic ventricular tachycardia (CPVT) predisposes to ventricular arrhythmia due to altered Ca(2+) homeostasis and can arise from ryanodine receptor (RyR2) mutations including RyR2-P2328S. Previous reports established that homozygotic murine RyR2-P2328S (RyR2 (S/S)) hearts show an atrial arrhythmic phenotype associated with reduced action potential (AP) conduction velocity and sodium channel (Nav1.5) expression. We now relate ventricular arrhythmogenicity and slowed AP conduction in RyR2 (S/S) hearts to connexin-43 (Cx43) and Nav1.5 expression and Na(+) current (I Na). Stimulation protocols applying extrasystolic S2 stimulation following 8 Hz S1 pacing at progressively decremented S1S2 intervals confirmed an arrhythmic tendency despite unchanged ventricular effective refractory periods (VERPs) in Langendorff-perfused RyR2 (S/S) hearts. Dynamic pacing imposing S1 stimuli then demonstrated that progressive reductions of basic cycle lengths (BCLs) produced greater reductions in conduction velocity at equivalent BCLs and diastolic intervals in RyR2 (S/S) than WT, but comparable changes in AP durations (APD90) and their alternans. Western blot analyses demonstrated that Cx43 protein expression in whole ventricles was similar, but Nav1.5 expression in both whole tissue and membrane fractions were significantly reduced in RyR2 (S/S) compared to wild-type (WT). Loose patch-clamp studies similarly demonstrated reduced I Na in RyR2 (S/S) ventricles. We thus attribute arrhythmogenesis in RyR2 (S/S) ventricles resulting from arrhythmic substrate produced by reduced conduction velocity to downregulated Nav1.5 reducing I Na, despite normal determinants of repolarization and passive conduction. The measured changes were quantitatively compatible with earlier predictions of linear relationships between conduction velocity and the peak I Na of the AP but nonlinear relationships between peak I Na and maximum Na(+) permeability.