This work aims to shed light in the fabrication of poly(3-hydroxybutyrate-co-44%-4-hydroxybutyrate)[P(3HB-co-44%4HB)]/chitosan-based silver nanocomposite material using different contents of silver nanoparticle (SNP); 1-9 wt%. Two approaches were applied in the fabrication; namely solvent casting and chemical crosslinking via glutaraldehyde (GA). A detailed characterization was conducted in order to yield information regarding the nanocomposite material. X-ray diffraction analysis exhibited the nature of the three components that exist in the nanocomposite films: P(3HB-co-4HB), chitosan, and SNP. In term of mechanical properties, tensile strength, and elongation at break were significantly improved up to 125% and 22%, respectively with the impregnation of the SNP. The melting temperature of the nanocomposite materials was increased whereas their thermal stability was slightly changed. Scanning electron microscopy images revealed that incorporation of 9 wt% of SNP caused agglomeration but the surface roughness of the material was significantly improved with the loading. Staphylococcus aureus and Escherichia coli were completely inhibited by the nanocomposite films with 7 and 9 wt% of SNP, respectively. On the other hand, degradation of the nanocomposite materials outweighed the degradation of the pure copolymer. These bioactive and biodegradable materials stand a good chance to serve the vast need of biomedical applications namely management and care of wound as wound dressing.
Ocular toxoplasmosis is the leading cause of infectious retinochoroiditis in both adults and children. It is caused by the obligate intracellular parasite, Toxoplasma gondii. It is a common cause of posterior uveitis and focal retinitis, typically seen in immunocompetent individuals as a primary infection or in immunocompromised individuals as reactivation of latent infection. Here, we report a rare case of a 29-year-old immunocompetent female presenting with gradual, painless diminution of vision in the left eye associated with headache for over one month. She had a history of hypertension but no other significant medical history. On ocular examination anterior segment was unremarkable and fundus examination of left eye showed "Headlight in fog appearance" suggestive of vitritis. Serological evaluation revealed positive for Toxoplasma IgG antibodies. The patient was treated with cotrimoxazole, oral prednisolone, and topical steroids for 4-6 weeks. Following treatment, her visual acuity improved to 6/6 in left eye. This case highlights the importance of considering ocular toxoplasmosis in the differential diagnosis of unilateral vitritis, even in immunocompetent patients.
Ischemic heart disease is a leading cause of morbidity and mortality in Malaysia. Management strategies for this disease have changed dramatically. This article, based on discussions of real cases, reviews current treatment methods for various patient subsets, with acute myocardial ischemia.
The development of a non-thermal plasma jet with a capillary configuration working at atmospheric pressure is reported
in this paper. The plasma jet is powered by a power source with frequency of several kilohertz. The working gas is
argon. The plasma obtained has been characterized by optical emission spectroscopic measurements and electrical
measurements of the discharge using voltage and current probes. The electron temperature has been estimated by using
the modified Boltzmann plot method utilizing the Ar 4p-4s transition. The electron temperatures at various positions
along the plasma jet length have been obtained and it is found that the electron temperature decreases at position further
from orifice. The electron density has been estimated from current and voltage measurements using the power balance
method. The effects of gas flow rate, applied voltage and frequency on the characteristics of the plasma jet have also been
investigated. The applications of the atmospheric pressure plasma jet (APPJ) developed to modify the surface properties
of Polyethyleneterephthalate (PET) and polycarbonate (PC) have been tested. Our results showed that the atmospheric
pressure non-thermal plasma jet can be effectively used to enhance the surface wettability and surface energy of the
PET and PC. The plasma jet has also been tested for inactivation of prokaryotic cells (Escherichia coli, Staphylococcus
aureus). In the case of E. coli, better than 4 log10 reduction can be achieved. The effect of plasma jet on the pH of cell
culture medium has suggested that the plasma species, particularly the electrons, are solely responsible for the effect
of inactivation of living cells.
Six cooling towers and eleven sources of potable water in a university campus in Kuala Lumpur were surveyed for the presence of legionellae. One nonmedical building cooling tower and three hot water systems from one ward of the hospital tested positive for Legionella, two of which contained Legionella pneumophila serogroup 1. The identification of Legionella was based on isolation, immunofluorescence and polymerase chain reaction (PCR).
The concentrations of Cd, As, Pb, Se, Fe, Mn, Zn, and Cu in acid-digested onion samples
were determined by inductively coupled plasma mass spectrometry, and the corresponding
elemental profiles were evaluated by using chemometric techniques. Results from principal
component analysis and hierarchical cluster analysis revealed that the spatial variations were
highly associated with As, Se, Pb, Zn, and Cd, which advocated dominance of the site related
impacts over colour variant of the onions. Such variation pattern could be partly attributed to
the consequences of industrialisation and/or urbanisation. From the safety assessment data,
concentrations of hazardous elements such as As, Cd, and Pb, were found beyond the World
Health Organisation and Food and Agricultural Organisation permissible levels, but within the
Malaysian regulatory limits except for Pb. The presence of elevated levels of toxic elements
beyond the reference limits in the onion varieties could be of health concern if ingested.
Primary sacral tumours are rare, therefore experience of managing their associated complications are very limited. Effective surgical treatment of pelvic chondrosarcoma remains a major challenge for orthopaedic surgeons, due to the complex anatomic structure of the pelvis, the lack of defined compartment borders, the close vicinity to vital structures, and the risk of jeopardizing pelvic structural stability. We report a rare case of a giant sacral chondrosarcoma (100cm x 80cm) in an elderly male who successfully underwent tumour resection with good functional outcome and recovery. Long term follow up is essential in view of the possibility of local tumour recurrence.
The Malaysian skincare industry is growing rapidly with a vast number of new sunscreens being produced annually. Inadequate skincare regulations and lack of enforcement have resulted in the overrating of sunscreens’ quality. The objectives of this study were to evaluate the efficacy and safety of the local and international sunscreens and to determine the effects of adding concentrated antioxidants into them. Three local and three internationally manufactured sunscreens were tested for the in vitro Ultraviolet A protection factor (UVAPF), Sun Protection Factor (SPF) and photostability. The creams were spread onto roughened polymethylmethacrylate plates where the absorbance was measured using a spectrophotometer before and after two hours of sunlight irradiation. The procedure was repeated combining available concentrated vitamin C and E creams. International sunscreens were found to have more accurate SPF labels (p=0.009) while local sunscreens were found to be more photostable (p=0.003). However, both sunscreens had inadequate UVAPF (p=0.471). Vitamin C enhanced the SPF values (p= 0.04) of both groups of sunscreens while vitamin E enhanced their photostability (p=0.000). Interestingly, combining vitamins C and E rich creams with the sunscreens had no effect on the SPF and UVAPF values as compared to the use of a single vitamin. More importantly, the combination of vitamins decreased the photostability (p=0.002) of sunscreens as compared to the addition of vitamin E alone. In conclusion, photoprotection is best achieved when sunscreens are used together with creams containing either vitamin C or E alone.
This article describes the approach towards a sensitivity study of wind flow and pollutant
dispersion in an idealized street canyon with tree plantings under thermal atmospheric conditions
using computational fluid dynamics (CFD). First, validation studies were performed to determine the
best turbulence model for the simulation of wind flow under thermal atmospheric conditions against
the previous experimental wind tunnel data. The results of the numerical simulation indicate that
large eddy simulation (LES) can accurately predict the wind flow structure at different thermal
intensities and different locations of heated wall. Finally, detailed descriptions of future research are
presented at the end of this article.
Numerical studies are conducted on turbulent incompressible flow over 2D backwardfacing
step in order to investigate the performance of three different turbulence models (standard k-e,
realizable k-e and SST k-ω) in predicting the region of separation and reattachment behind the edge
of the step. Current solutions of Reynolds number (Re= 13200) and expansion ratio (H: H2=1:3) are
compared with experimental measurements. Among the turbulence models, SST k-ω and standard k-e exhibited good agreement with the experimental results.
BACKGROUND: Low rate of adherence was found strongly associated with patients' beliefs across the studies about chronic diseases with hypertension. A crucial move is needed to bridge the gap between appropriate assessment tools and local hypertensive patients' medication adherence.
OBJECTIVE: To produce a translated version in Malay language of Beliefs about Medicines Questionnaire (BMQ) that was "conceptually equivalent" to the original English version for use in local clinical practice and research.
METHODS: The forward translation process was conducted by two independent professional translators and back translation was done by two other independent translators. A reliability analysis was conducted on 238 conveniently selected hypertensive patients. Intraclass correlation coefficient (ICC) was used to assess test-retest reliability for the randomly selected 40 patients in a period of 2 weeks. Discriminant validity was tested through Necessity-Concerns differential, BMQ subscales, and other parameters.
RESULTS: The overall Cronbach alpha for the internal consistency was good (0.860). The subscales of the BMQ demonstrated adequate internal consistency, with Cronbach alpha value of 0.759 for Specific-Necessity, 0.762 for Specific Concern, 0.624 for General-Overuse, and 0.756 for General-Harm. The ICC was excellent (0.922). Discriminant validity revealed that BMQ Specific-Necessity score was significantly inversely correlated with the systolic blood pressure level. Systolic and diastolic blood pressure levels (P = 0.038; P = 0.05) were reported to be significantly correlated with the Necessity-Concerns differential, with Necessity score equal or exceeding Concerns score.
CONCLUSIONS: The Malay-translated version of BMQ is a reliable and valid tool to assess patient belief about medication, especially medication adherence among the hypertensive patients in Malaysia.
Steroid-induced glaucoma is the most serious complication of the injudicious use of steroids, particularly among children affected by allergic conjunctivitis. This condition is steroid-dependent, and children are commonly being prescribed topical anti-inflammatories, including topical steroids, by general practitioners. Furthermore, topical steroids are also available over the counter, and this availability contributes to overuse without proper monitoring by an ophthalmologist. We present a series of five cases illustrating the devastating effect of unmonitored, long-term use of steroids among children for vernal keratoconjunctivitis. The medications were prescribed initially by general ophthalmologists and were continually bought over the counter by parents. At the presentation to our center, these patients were already compromised visually, exhibiting glaucomatous optic disc changes and high intraocular pressure. The series highlights the optic nerve damage resulting in irreversible visual compromises among children on long-term, topical steroids and the importance of regular monitoring with a low threshold for ophthalmologist referral.
Congenital humeroradial synostosis can occur as an isolated clinical entity or as part of a syndrome. Bilateral elbow fixed flexion deformity is very incapacitating and challenging to treat. Here we present the case of a boy with fixed flexion deformity of both elbows due bilateral humeroradial synostosis. Other characteristic features of multiple synostoses syndrome were also present in this child, his elder brother and mother. We elected to improve the position of the right elbow by adapting the modified French osteotomy described by Bellemore et al.
Distal oesophageal spasm is a rare condition that affects the motility of the oesophagus. It can be diagnosed by highresolution oesophageal manometry and the diagnosis is supported by other modalities such as barium swallow and esophagogastroduodenoscopy examinations. Treatment options include pharmacological therapy, endoscopy and surgical interventions. We described a case of distal oesophageal spasm in an elderly patient who presented with chronic dyspepsia.
The Malaysian government has committed to 'Fast Tracking the HIV Response' to achieve UNAIDS 2030 targets to end AIDS. The epidemic is concentrated among key populations and has shifted from people who inject drugs to HIV infection through sexual transmission among men who have sex with men, sex workers and transgender people. The aim of this scoping review was to examine social and behavioural research published since 2005 that can inform understanding of each stage of the 90:90:90 treatment cascade (as proposed by UNAIDS), including HIV risk behaviours and testing practices that precede entry. We found a concentration of studies related to predictors or correlates of HIV infections (mostly among men who have sex with men) and a shortfall in literature pertaining to sex workers or transgender people. While several studies examined factors associated with HIV testing, only one examined uptake of antiretroviral therapy and two explored issues of treatment adherence. No study examined broader care and support of people living with HIV. To scale-up effective programmes and apprise investment to achieve the ambitious targets set-out in the Malaysian National HIV/AIDS Strategic Plan, a combination of comprehensive strategic information and evidence generated through primary research is critical.