INTRODUCTION: Despite the various methods described in producing platelet-rich plasma (PRP), it is well established that this biological product in its many preparations have been proven to enhance wound healing. However, very little have been known about the efficacy of these methods hence there is a lack of evidence in the superiority of one method over another. Thus, a study was conducted to compare these different protocols to determine which produces the highest concentration of platelets.
METHODS: Peripheral blood was obtained from 24 healthy volunteers. Four different protocols using similar 2 step centrifugation methods of preparing PRP were applied to an equal number of samples in this study. Platelet counts were performed on whole blood (without processing), PRP preparations and platelet-poor plasma (PPP).
RESULTS: All protocols produced higher amounts of platelet concentrates in PRP preparations than plasma. However, centrifugation at 150g for 10 minutes followed by another at 450g at 10 minutes produces significantly higher amount of platelets concentration (p<0.05)
CONCLUSION: Optimizing the protocols to produce PRP appears to be important in obtaining a maximal yield of platelet concentrate. Here the protocol described has shown to provide significant concentration yield over all others.
Keywords: platelet-rich-plasma, growth factors, centrifugal forces
In 1999, the Department of Social and Preventive Medicine set up its website on the Internet (http://ummc.med.uni.edu.my/sps/. Setting up the website was a whole new experience for the author and many new things were learnt along the way. This paper describes how the website was constructed, the problems, and solutions to all these problems. The experience of the author in setting up the SPM website may be useful to others wishing to set up their own department websites. KEYWORDS: Internet, SPM, website, web page
Achieving and maintaining good glycaemic control remains an important goal in the management of this common and prevalent disorder. Recent evidence from important megatrials, ACCORD, ADVANCE, VADT, UKPDS-10 year follow-up as well as the STENO-2 follow-up study, have cleared doubts concerning the benefits of targeting good glycaemic control. For the first time, we have the reassurance that macrovascular benefits can be realised from good glycaemic control. The legacy effect of prior good glucose control from the UKPDS-10 year follow-up, reinforces the results seen from the DCCT-EDIC (for Type 1 diabetes). The Intervention Phase of the UKPDS revealed benefits for reduction of microvascular complications, while it was only at the end of the Post-Trial Monitoring Phase where significant improvements in both micro and macrovascular outcomes were seen. The other three Trials assessing the effect of glycaemic control on cardiovascular outcomes, although largely negative for CV benefit, give valuable insight towards appropriate patient characteristics for which aggressive glucose control can and should be instituted. Individualising glycaemic targets, which has been the approach that many clinicians have been practising, has received new impetus albeit with clearer details. Getting to glycaemic goal early in the course of T2DM and Doing to Safely (Avoiding hypoglycaemia)are the key ingredients to successful management. The legacy of the memory of initial good metabolic/glycaemic control is investment in good health with benefits of reductions in both micro and more importantly, macrovascular disease, years later. Multifactorial interventions that include blood pressure, lipid lowering in addition to glucose control in these individuals with the Metabolic Syndrome result in more immediate beneficial additive effects on cardiovascular outcomes.
The aim of the study was to research the use of a simple neural network in diagnosing angina in patients complaining of chest pain. A total of 887 records were extracted from the electronic medical record system (EMR) in Selayang Hospital, Malaysia. Simple neural networks (simple perceptrons) were built and trained using a subset of 470 records with and without pre-processing using principal components analysis (PCA). These were subsequently tested on another subset of 417 records. Average sensitivity of 80.75% (95% CI 79.54%, 81.96%), specificity of 41.64% (95% CI 40.13%, 43.15%), PPV of 46.73% (95% CI 45.20%, 48.26%) and NPV of 77.39% (95% CI 76.11%, 78.67%) were achieved with the simple perceptron. When PCA pre-processing was used, the perceptrons had a sensitivity of 1.43% (95% CI 1.06%, 1.80%), specificity of 98.32% (95% CI 97.92%, 98.72%), PPV of 32.95% (95% CI 31.51%, 34.39%) and NPV of 61.33% (95% CI 59.84%, 62.82%). These results show that it is possible for a simple neural network to have respectable sensitivity and specificity levels for angina.
According to tradition, plants and herbs are potential cures for numerous illnesses. In recent decades, they have gained worldwide recognition as critical sources of new drugs, especially for cancer, and the focus on medicinal plant research has increased tremendously. Currently, research scientists attribute the occurrence of post-chemotherapy tumour exacerbation to the presence of cancer stem cells hidden in the bulk of the malignant tumour, forming a rare subpopulation that plays a major role in tumour re-initiation, progression and recurrence. There is increasing evidence of cancer stem cells in a wide array of tumours, and these cells could be the crucial target for future chemotherapy approaches. This review of the major plant-basedphy to chemicals with documented antagonistic activities against cancer stem cells, their molecular targets and the mechanisms involved, may serve as a guide for developing from the existing natural agents, more effective, and broader spectrum anti-cancer stem cell compounds with the potential for clinical application.
Over the years, the emphasis on research practices in healthcare has received more recognition than the emphasis on teaching practices. Also, in contrast to the strong focus on aligning care-giving practices with evidence of effectiveness; aligning educational practices with evidences of effectiveness has continued to be neglected. This creates a chasm that hinders the delivery of effective health practices. Many challenges in the current healthcare delivery system warrant a call for a revamp of health professionals' education, and for a greater focus in effective teaching, assessment and supervision. This paper highlights the current challenges in health professional education (as revealed by the Institute of Medicine, IOM, 2003). It focusses on five key issues for promoting teaching excellence, and supports the move for new lecturers to be educationally trained so that 'teaching for learning' becomes current, effective and enjoyable. More importantly, the vision for health professional education that "all health professionals are educated to deliver patient-centred-care as members of an interdisciplinary team, emphasising evidence-based practice, quality improvement approaches, and informatics" can be attained. This vision has important implication for medical lecturers as it means they have to be better educated to teach in order to be prepared to meet the demands of a reformed healthcare system.
Introduction: The population of Malaysia is ageing rapidly. Due to the relatively greater incidence of noncommunicable diseases among older adults, polypharmacy is highly prevalent in this population. This polypharmacy along with other age-related factors increases the risk of drug-related problems to several folds. Currently, no study in Malaysia or even Asia has determined the type and nature of drug-related problems among non-institutionalised older adults. Therefore, this study aims to highlight common drug-related problems among community-dwelling older persons (≥ 65 years) with polypharmacy.
Materials and Methods: A cross-sectional exploratory study was carried out where in-depth home medication reviews were carried out by two pharmacists. Participants were recruited from geriatric and fall clinics of the University of Malaya Medical Centre located in the urban area of the Federal Territory of Malaysia. The total numbers of drug-related problems were classified using the Pharmaceutical Care Network Europe (PCNE) classification V9.0. Recommendations and referral letters were provided based on the pharmaceutical care issues identified.
Results: Thirty participants were recruited, among whom 178 drug-related problems were identified with a median value of six [range 1-11] drug-related problems per participant. The majority of problems were related to the effectiveness of prescribed treatment (69.1 %), followed by the possibility of adverse effects (28.7 %).
Conclusion: Home medication review identifies numerous medication-related issues and allows for patient education and detailed counselling in an informal and patient-friendly manner. Future studies to determine the longitudinal effect of home medication review on patient outcome, cost implications, and overall healthcare utilization are now indicated.
The current volume of JUMMEC contains a wide spectrum of health topics highlighting the importance of controlling metabolic factors in diabetes, selection of heart failure patients for innovative treatment, early postoperative analgesia, testing of a translated screener for urinary tract problems, problems when commissioning a new operating theatre and breastfeeding issues.(Copied from article).
During the period from January 1992 up to the end of July 2001, the Burns Unit in King Khalid C Hospital treated 1735 cases of burns. The burns cases were of varying causes, age groups, degree, depth and extent. The formula used in lTeating these burns patients was a modification of Parkland fonnula. The fluid used was Ringer lactate solution. This fluid was administered for the first 3 days post burn until the general condilion of the palient was sfabilized. Early oral intake was encouraged in aU patients and was started as early as the second or the third day. Colloids were given by the end of the third or even the fourth day and according to the individual patients' needs. The results of this treatment regime significantly avoided renal complications and ensured patient rehydration. KEYWORDS; Major burns, fluids resuscitation
Objective: The aim of this study was to investigate scuba diving induced exercise response in novice divers as required in open water scuba diving certification.
Methods: Maximal cardiopulmonary exercise test (CPET) was performed in 30 novice divers before and within 24 hours after a standard scuba diving open water certification diving protocol of four open water dives.
Results: A significant increase in maximal oxygen consumption (VO2max) in mL·kg-1·min-1 after scuba diving training [25.84 (6.0) vs. 27.04 (7.0)] (p
This was a cross-sectional study which attempts to assess the effectiveness of the 18-hour lactation management course organised by Klang District Health Office for its health staff. The course was conducted for three days from 19 to 21 September, 2006 with a total of 18 hours, comprising 15 hours of lectures and three hours of supervised clinical experience. There were a total of 46 participants for the course. The pre- and post-test scores of the participants from the course were used for analysis. This study showed that the mean pre-test versus mean post-test scores were 12.63 and 19.87. The difference in the mean score was statistically significant (p < 0.001, 95%CI -8.285, -6.193). The difference was significant for the staff nurse, community nurse and assistant nurse but not for doctors. In conclusion, the 18-hour duration lactation management course was effective at improving the knowledge and skills on breastfeeding management for the health staff.
Empowering lay screeners, such as pre-school teachers, on vision screening is a cost-effective way to
ensure larger populations of children can be screened. Although the validity of lay screeners in conducting
vision screening were reported in several studies, none showed data concerning improvement of the level
of knowledge among lay screeners after completing vision screening training, which could indicate the
effectiveness of the training program. This study aimed to determine the level of knowledge of pre-school
teachers before and after attending a training program. Sixty pre-school teachers from Tabika and Taska KEMAS
were randomly selected. The Study Group (n = 30) was given theory and practical training on vision screening,
whereas the Control Group (n = 30) was only given brief verbal instructions on how to conduct the screening. A
theory test containing 15 questions related to the training modules were administered to both groups, before
and after their training/briefing respectively. The findings showed that the level of knowledge among preschool
teachers in the Study Group (73.24 ± 11.73%) was significantly higher than the Control Group (56.22
± 13.11%) (p < 0.01). There was also a significant improvement in the level of knowledge among pre-school
teachers in the Study Group after the training (p
Background: The rise in substance-use-related problems among Malaysian adolescents called for a study to
assess the efficacy of an anti-drug educational program to improve the knowledge, attitude and perception
(KAP) of Malaysian students regarding substance use.
Methods: This study involved 573 students from four Malaysian Chinese schools in Malacca. Each student
filled out a Likert-scale mandarin translated questionnaire (KAP-C) on substance use ( Pre-test). Following an
educational program on substance use, the KAP-C questionnaire was given again to the students, immediately
following the program (PT 1), and after a month (PT 2) and two months (PT3) of the programme.
Results: The students showed improvement in knowledge of the types of substance use in PT 1 (p
Nine local plant species were picked randomly and their aqueous extracts have been screened to know their effects on the phagocytic capability and intracellular killing of StapllylococclIs al/rellS bacteria by mouse peritoneal macrophages. Macrophage cultures were incubated with different concentration of each plant extracts forI hour. Among these aqueous extracts, Ageratum conyzoides and Malastoma melabathricum inhibited the phagocytic capability and intracellular killing of Stapllylococclls aureus compared with controls. Elicited (activated) cells have more phagocytic capability and intracellular killing than the resident (normal) macrophages. There were no differences in the viability of cells between treated cells (with extracts) and controls (without extracts). KEYWORDS: Aqueous plant extracts, murine macrophage, phagocytosis.
Many nation states, including Malaysia are undergoing development and modernization while modernization brings tremendous achievements related to social and economic wellbeing, on the other hand, it also brings along with it the various untoward effects on the nation. One of the main factors which have an impact on modernization seems to be the rapid changes in the demographic pattern. In the initial stage of modernization, mass migration of rural populations to the urban areas, has been on going in Malaysia since the seventies. In the early nineties, the robust economic development in Malaysia necessitated the import of foreign labour from the neighbouring countries in order to provide cheap labour in the labour intensive industries. This demographic changes, internal and foreign migration, parallels the economic progress of the host countries. According to the latest report from the Immigration Department, there are more than 1.2 million registered foreign workers (up to January 1998) in Malaysia. This figure may exceed 2 million if we take into consideration the illegal immigrants and this is a big proportion (about 10%) of foreign workers in which has Malaysia's population of approxiamtely 20 million. The presence of such a big number of foreign workers during less than a decade is not merely an immigration issue, but it is a major concern for the nation especially with respect to health care, housing and education. As the immigrant community is highly dynamic, the emerging and re-emerging infectious diseases are a great concern for Malaysia especially in formulating health policies for Malaysia currently and in the future.
Many nation states, including Malaysia are undergoing development and modernization brings tremendous achievements related to social and economic well-being, on the other hand, it also brings along with it the various untoward effects on the nation. One of the main factors which have an impact on modernization, mass migration of rural populations to the urban areas, has been on going in Malaysia since the seventies. In the early nineties, the robust economic development in Malaysia necessitated the import of foreign labour from the neighbouring countries in order to provide cheap labour in the labour intensive industries. This demographic changes, internal and foreign migration, parallels the economic progress of the host countries. According to the latest report from the Immigration Department, there are more than 1.2 million registered foreign workers (up to January 1998) in Malaysia. This figure may exceed 2 million if we take into consideration the illegal immigrants and this is a big proportion (about 10%) of foreign workers in which has Malaysia’s population of approximately 20 million. The presence of such a big number of foreign workers during less than a decade is not merely an immigration issue, but it is major concern for the nation especially with respect to health care, housing and education. As the immigrant community is highly dynamic, the emerging and re-emerging infectious diseases are a great concern for Malaysia especially in formulating health policies for Malaysia currently and in the future.
We report a case of a 59-year-old gentleman with complete left brachial plexus injury. He presented with
chronic pain over the dorsum of his left hand since the injury eight years ago. Medical treatment had been
optimised but the pain still persist. End-to-side nerve transfer was done involving superficial sensory radial
nerve and median nerve to alleviate the pain. The surgery was considered successful as the patient claimed
that the pain score had reduced a few weeks postoperatively. However, there was no sensory recovery and
functionally no improvement was observed.
Introduction: The health effects of inhaling rice dust contaminated with endotoxin include respiratory problems, asthma, chronic bronchitis and chronic obstructive pulmonary disease.Thus, this comparative cross-sectional study aims to associate the concentration of endotoxin levels in inhalable rice dust and the lung function decline among rice millers.
Materials and Methods: The endotoxin level in inhalable dust for both area and personal samplings were collected using 25 mm Glass Fiber (A) filter loaded in IOM samplers connected to a pump by tygon tubing. The pump was operated at 2.0 litres/min and clipped around the breathing zone of the rice millers for eight hours. The endotoxin concentrations were analysed using Limulus Amoebocyte Lysate Chromogenic Endpoint assay at 405 nm. Lung function tests were carried out using Spirometer (Pony FX), for both the rice millers and the non-exposed groups.
Results: Findings for the mean concentration of endotoxin for areas was 0.26(standard deviation (SD) = 0.12) EU/m3 whereas the mean personal inhalable endotoxin level among the rice millers was 0.29(SD = 0.15) EU/m3. Post-shift lung function tests for FEV1/FVC measured appeared lower among rice millers (54%) compared to non-exposed workers (62%), but not statistically significant (p = 0.313). However, there were significant correlations between endotoxin concentration and post-shift LFT parameters of measured FVC, FEV1 and PEFR (p < 0.05).
Conclusion: Despite the low level of endotoxin exposure, proper protective measures should be applied for rice millers for long term protection.