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.
Background: Those with increased dynamic knee valgus are vulnerable to increased risk of non-contact knee
injuries. However, studies on the top down kinetic chain of lower limb mechanics during dynamic motions
such as single leg squat (SLS) among trained males were scarce.
Objective: The objective of the study was to evaluate the relationship between isokinetic hip and knee strength
and frontal plane projection angle (FPPA) of the knee joint during SLS.
Methods: Thirty-two male junior athletes (twelve cyclists, ten runners and ten squash players) were screened
for excessive dynamic knee valgus (DKV) prior to participation. Only those within the normal value of DKV were
included. Their hip and knee isokinetic strength in sagittal plane were evaluated at 60º/s of angular velocity
for both legs using dynamometer. Two dimensional knee FPPA was evaluated during SLS at 60º of knee flexion.
Pearson correlation was evaluated between knee FPPA during SLS and isokinetic leg strength.
Results: Correlations between knee FPPA and hip and knee isokinetic strength were not statistically significant
except between knee flexion peak torque/body weight (r = -0.35, p = 0.05) and hamstring to quadriceps ratio
(r = -0.39, p = 0.03) of non-dominant leg.
Conclusions: Isokinetic hip and knee strength and knee FPPA during SLS was correlated only for non-dominant
leg during SLS among male junior athletes. DKV during SLS may be reduced through strengthening the muscles
around hip and knee joints.
Introduction: Attention is one of many cognitive functions; it plays a central role in the learning process. For this reason, our study aims to determine the impact of attentional abilities on academic performance among middle school learners in Middle Atlas of Morocco.
Methods: Data were collected from a sample of 137 middle school learners. For the assessment of attentional abilities, we performed the Trail Making Test (TMT) to estimate mental flexibility. Evaluation of selective attention was done through the Stroop Test and the measurement of sustained attention was achieved via the d2-R test.
Results: Our results revealed that the attentional abilities of learners in our samples are positively correlated with their academic performance and vice versa.
Conclusion: At the end of this study, it is important to establish a thorough diagnosis of attentional disorders to identify learners with attention problems in order to implement a remedial program so as to avoid the detrimental effects of these disorders on the academic performance of learners.
In the last three centuries, medicine has focused predominantly on the physical body as the source of disease, placing very little importance on the mind. However, the significance of mind-body interactions in medicine is now increasingly being recognised. True health must include both the physical body and the mind. This article traces our concepts of the relationship between mind and body since primitive times and explores its relevance to the maintenance of health.
The rapid aging of populations worldwide demands major changes across all aspects of health care for older persons. Geriatric medicine which is that branch of of medicine which is concerned with the clinical, preventive and rehabilitative aspects of care of older persons, has much to offer in relieving the suffering and increasing the disability free years they can enjoy. Recent advances in Geriatric Medicine based on well designed randomised trials and meta-analysis that are clinically significant to the practicing physician are reviewed in this article. KEYWORDS: Recent advances, Geriatric Medicine, Older persons.
Many tests are available for the diagnosis of H. pylori infection. Broadly they can be divided into invasive- endoscopy biopsy based tests and non-invasive tests. Of the endoscopy biopsy based tests the rapid urease tests (RUT) have been found to be the most convenient, accurate and inexpensive tests and they have therefore been recommended by several consensus panels and working parties as the test of choice during endoscopy. Several RUTS are available; some are commercial: CLO test, Pyloritek, Helicobacter urease test, H. yylori test and others- "homemade". We strongly recommend the "homemade" 1 min rapid urease test using an unbuffered solution as originally described by Arvind et al. This test has been shown to be easy to prepare, inexpensive and accurate on field-testing. Several factors affect the accuracy of the RUT. The larger the size of biopsy samples, the quicker is the postive reaction time. With the CLO test, warming the tests to 37'C has also been shown to hasten the reaction time. The effect of blood on the RUT poses an important problem in testing. It is vitally important to determine the H. yylori status in patients with bleeding peptic ulcers as the recurrence of bleeding has been shown to be markedly reduced or virtually abolished with H. yylori eradication. While the results of studies have not been entirely consistent, it is likely that presence of blood does reduce the sensitivity of the RUT. It is therefore sensible that in patients with bleeding ulcers, the RUT should not be the sole endoscopy biopsy test used and that samples should also be taken for histological examination.
We aimed to establish a method for quantitative analysis of mixed haematopoietic chimerism based on microchip electrophoresis of selected molecular markers following PCR amplification for accurate monitoring of graft status post-transplantation. A 12-year-old girl with relapsed acute lymphoblastic leukaemia who underwent allogeneic bone marrow transplantation had qualitative chimerism analysis using short tandem repeat markers at three time points following the procedure. Her archived DNA samples were then used to test the ability to correlate her clinical course with changes in the quantity of donor chimerism at the different time points. Quantitative chimerism analysis was performed on the Agilent 2100 bioanalyser and donor-recipient ratios were calculated from generated electropherograms. Complete donor chimerism (98%) was demonstrated three weeks post- transplantation. Decreasing amount of donor chimerism to 24% was shown after three months and this concurred with clinical relapse. Following a second transplant, full donor chimerism was reestablished where donor chimerism rose to 100%. High resolution microchip electrophoresis could be useful in predicting the occurrence of increasing recipient chimerism which may herald impending relapse in patients while the disease burden is still low. This investigational approach may provide useful information for clinicians to select appropriate intervention strategies to ensure successful transplantation.
There is a high incidence of 36% to 83% of respiratory dysfunction in patients with acute cervical spinal cord
injury. Complications arising from respiratory dysfunction remain one of the most common causes of morbidity
and mortality in the spinal cord injured population. Specialized pulmonary care and therapy can help individuals
with tetraplegia to maintain a stable respiratory status allowing active participation in active rehabilitation.
This would allow them to achieve rehabilitation goals of independent function and community reintegration.
Mechanical insufflation-exsufflation (MIE) therapy is an option for secretion management in individuals with
acute spinal cord injury. In this paper, we present our experience using MIE as an adjunct to management of
secretions in the spinal cord injured population at the University of Malaya Medical Centre.
Distress has become a major issue in cancer population. Patients may suffer from either physical,psychological distress or both. Cancer patients who are undergoing chemotherapy are more likely to experience psychological distress. This could be due to the negative effects of chemotherapy agents, the uncertainty of post-treatment, and the occurrence of psychosocial problems. As a result, the patient may experience a normal reaction such as sadness or may develop common psychiatric disorders such as depression and anxiety.
Malaysia has been swamped by migrant workers from nearby countries like Indonesia, Phillipine and also Bangladesh since 1980's. The main pulling forces which motivated them to migrate to Malaysia are better economy, political stability and religious freedom in Malaysia. Another way of classifying migration pattern is to divide it into push and pull migration or a combination of the two. Pull migrants are those who migrate to obtain better economic opportunity while push migrants are those who try to run away from being prosecuted or due to fear of political and religious suppression. Whatever the push and the pull factors, they are bound to encounter some acculturation challenges. This will inevitably produce certain psychological sequelae. Therefore, the main aim of this study is to determine the point prevalence of psychiatric morbidity experienced by the migrant population. The psychological impact of push and pull migrations is fundamentally distinct. There were significant numbers of migrants admitted to University Hospital psychiatric units who suffered from psychological distress and para suicide. The reasons for these problems are multi-faceted. Hence, another purpose of this study was to investigate factors which make them to be at risk of developing psychiatric morbidity. The findings of this study can be used as a basis for making recommendations to the government of the rationale to include psychological assessment as one of the important components in the pre-employment selection criteria.
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.
Osteoarthritis (OA) affects millions of people worldwide with its irreversible destruction of articular cartilage. Recently, the potential of using chondrogenic differentiated multipotent mesenchymal stromal cells (cMSCs) for OA treatment is being assessed. Preliminary clinical studies have been encouraging. However current studies have also demonstrated that cMSCs are not biochemically and biomechanically identical to native articular chondrocytes (ACs). Thus, there is an urgent need for the implementation of proteomic applications as proteomics involve protein identification, relative quantification of proteins and studies of post-translational modification which reveal novel regulating processes of complex mechanisms such as in chondrogenesis. A comprehensive understanding of chondrogenesis is essential for the establishment of an effective cMSC model to regenerate cartilage. In this article, we will review current proteomic studies on chondrogenesis, focusing on recent findings and the proteomic approaches utilised.
Objectives: Pancreatic cancer is an aggressive silent killer with a median survival of a few months. It is the
fourth leading cause of cancer death in the United States. The aim of this study was to evaluate the prognostic
factors affecting the survival of patients with adenocarcinoma of the pancreas in Malaysia.
Methods: This retrospective study examined 107 patients with adenocarcinoma of the pancreas from 2002
to 2012 at University Malaya Medical Centre. The factors evaluated were age, sex, race, smoking habits,
performance status, the presence of jaundice, pre-treatment CA 19.9 serum level, the location of a primary
tumour, tumour grade, tumour staging and intent of treatment.
Results: The median survival for the overall study population was 7.0 months (95% CI 5.1-8.8 months) with
1, 3, and 5-year survival rates of 30.8%, 8.4% and 3.7% respectively. The survival was 16.1 months (95% CI
7.7-24.4 months) for stage 1, 15.5 months (95% CI 8.1-22.8 months) for stage 2, 8.4 months (95% CI 6.1-10.8
months) for stage 3, and 3.8 months (95% CI 2.9-4.7 months) for stage 4. In multivariate analysis, independent
and unfavourable prognostic factors which retained significance were performance status, tumour stage and
treatment intent.
Conclusions: The biological characteristics are important as predictors of survival in patients with pancreatic
cancer. Longer survival is possible if the disease is identified in its early stages with good performance status.
Further development and evaluation of novel screening strategies need to be established to improve early
detection of this disease.
Problem-based learning (PBL) i s an educational reform that is now becoming a household word in higher education, particularly in medical schools. Many medical schools have implemented a full problem-based learning curriculum (PBLC) whiIe some have included PBL into selected units of the course in an otherwise conventional cumculum (embedded PBL) and others run their tutorials in a PBL manner within a modified conventional curriculum (hybrid curriculum). Yet there are others who claim that small components of PBL in a conventional curriculum are not PBL at all. Thus amateurs in the subject matter find difficulty in evaluating the logistics and outcome of these variations. This article focuses or, the general characteristics of PBL and how this learning method can help enhance independent learning and critical thinking, whether in a full, embedded or hybrid curriculum. The extent of PBL to be included and which of the three types is to be adopted depends on the objective of the undergraduate medical course as determined by the faculty, resources available, limitations, feedback on the existing curriculum and various other factors. KEYWORDS: Problem-based Learning (PBL); Embedded PBL; Hybrid PBL; New Integrated Curriculum (NIC).
Primary parotid lymphoma is uncommon and rarely suspected. In most cases, the disease would have disseminated at the time of diagnosis. We describe a case of primary non-Hodgkin’s lymphoma of the parotid gland which progressed to the central nervous system. Clinical history is of limited value in identifying this condition. Diagnostic imaging studies (CT or MRI) may indicate whether or not the mass is salivary in origin but do not help to confirm the diagnosis. In this case, it was deemed that FNA alone is incapable of determining the precise histological subtype for lymphoma, whilst a tru-cut biopsy demonstrated a more sensitive method of determining the diagnosis. The lessons learned from this case would prove useful for other health care providers to make an early diagnosis and hopefully manage more effectively if similar conditions appear in their practice. Performing the appropriate measures can help to not only improve the prognosis but may even avert the prospect of unnecessary surgery.
The objective of this study was to determine the prevalence of sleep disturbance with work characteristics among nurses in the Melaka Hospital, Malacca, Malaysia. This was a cross sectional study conducted in Melaka Hospital. Universal sampling was conducted and a Malay version of the Pittsburgh Sleep Quality Index (PSQI) questionnaire was used in data collection. Socio-demographic characteristics such as age, marital status, number of children and work characteristics such as type of work schedule and duration were also enquired. Factors associated with poor sleep quality were compared between those nurses with good sleep quality by using logistic regression. There were 607 nurses who completed the questionnaire with a response rate of 73.1%. There was a moderate prevalence (57.8%) of poor sleep quality (PSQI > 5) in all study subjects. The prevalence of sleep disturbance was more widespread among nurses who worked shifts (62.0%) compared to non-shift working nurses (41.5%) p
Bilharziasis is a tropical parasitic disease caused by different species of the genus Schistosoma. One species, S. haematobium, is widely spread in Sudan. There is a scarcity of information about S. haematobium infection among the fishermen in the country. Therefore, this study was designed to determine the prevalence of S. haematobium infection among fishermen, and the immune status among non-infected fishermen in two villages, El Hadib and Hawer-Ajowel at the White Nile state in Sudan. A cross-sectional survey was conducted among 119 fishermen in addition to 20 samples from non-endemic area which were included as a control group. Urine samples were examined by sedimentation method and faecal samples were examined by the Kato Katz method and formalin-ether concentration technique. Blood samples were examined for enumeration of IgE antibody and cytokines, interferon Gamma (IFN-γ), Tumor Necrosis Factor (TNF) and Interleukin10 (IL–10) levels using ELISA. The result of the study indicated that the overall prevalence of S. haematobium among the fishermen was 35 (29.41 %). Of the 35 positive participants, 23 (65.71 %) were infected for the first time, and 12 (34.29 %) for the second time (re-infection). Twenty-four candidates of the non-infected fishermen were included in the immunological study. The total IgE mean titer was 282.90 ±70.93 iu/ml, IFN-γ mean level was 9.62±4.60 pg/ml. TNF, 114.64±46.63 pg/ml and the IL–10 was 1.51±0.58 pg/ml. High prevalence of S. haematobium exists among fishermen and the non-infected fishermen from the endemic area showed high immune response similar to those exposed to the infection.