Introduction: Usage of smartphones have increased rapidly because of its importance in our daily life. This led to an increase in incidence of ocular problems among smartphone users. This research was conducted to determine the effect of smartphone usage on accommodation status. Methods: A cross-sectional study was conducted among young adults aged 19 to 30 years old in Management and Science University, Shah Alam. All subjects were asked to use smartphone for 20 minutes. The symptoms and accommodation status were evaluated before and after the smartphone usage. Results: Total subjects showed the mean age of 23.60 ± 2.77 years, 50% (n = 20) were males and 50% (n = 20) were females. The mean smartphone usage per day was 8.60 ± 2.80) hours. After 20 minutes of smartphone usage, subjects complained of tired eyes (92.50%), dry eyes (90.00%), blurred vision (87.50%), and headache (82.50%). Paired t-test showed significant reduction in amplitude of accommodation, monocularly from 9.9 ± 1.9 D to 8.76 ± 2.50 D (p = 0.00), and binocularly from 12.01 ± 1.95 D to 10.96 ± 2.16 D (p = 0.00); monoc- ular accommodative facility from 13.93 ± 3.13 cpm to 11.10 ± 4.32 cpm (p = 0.00) and binocular accommodative facility from 12.70 ± 3.57 cpm to 9.70 ± 4.21 cpm (p = 0.00); positive relative accommodation from -2.72 ± 0.87 D to -2.13 ± 1.28 D (p = 0.00) and increase in lag of accommodation from 0.4 ± 0.26 D to 0.93 ± 0.48 D (p = 0.00). Conclusion: This study shows that there were significance changes on accommodation status after 20 minutes of smartphone usage which can lead to weakness of accommodation.
Sterilisation is an essential step in the reprocessing of reusable dental instruments including burs that have become contaminated, or potentially contaminated. Transmission of disease or infection may happen as an effect of improper sterilisation of the reused instruments. Dental burs are one of the essential tools in any conservative dental procedures, which undergo multiple sterilisation cycles before being discarded. However, repeated sterilisation process is associated with the reduction in cutting efficiency of a bur that is potentially due to corrosion. Thus, this study aims to compare the effect of two sterilisation methods on cutting efficiency of a diamond bur that is commonly used in dental procedures. Methods: 30 fissure diamond burs were randomly divided into three sterilisation groups: Group A (dry heat), B (steam under pressure) and C (control). Each bur was used to cut teeth for 45 seconds for ten cycles. Between cuts, the burs underwent sterilisation based on their sterilisation groups. Amount of cutting weight was measured after each cut. Results: This study shows that no significant difference (p>0.05) in the cutting efficiency of the burs following sterilisation of Groups A and B. However, there is a significant mean difference (p
Objective: Mesenchymal stem cells (MSC) are multipotent, non-haematopoietic stem cells that are
capable of differentiating into different varieties of mature cell types such as osteoblasts, chondrocytes, adipocytes, and myoblasts. There is abundant evidence showing that MSC not only affect the differentiation of haematopoietic progenitors, but also the function of mature cells like lymphocytes and neutrophils. However the effect of MSC on neutrophil function and its responses is not well studied. Therefore, this study was conducted to assess the effect of MSC on neutrophil nitric oxide production. Method: Neutrophils from heparanised venous blood were isolated using Ficoll-Hypaque density gradient centrifugation followed by Dextran sedimentation and red blood cell (RBC) lysis. Isolated neutrophils were on average of 97% purity as determined by morphologic analysis. MSC were generated from human bone marrow and characterised by immunophenotyping (monoclonal antibodies CD105, CD73 and CD34) using a flowcytometer. In order to test the effects of MSC on neutrophil function, isolated neutrophils were co-cultured in the presence or absence of MSC at different ratios for 24 and 48 hours. The amount of nitric oxide released was used as an indication of oxidative burst and measured using the Griess assay. Result: The results indicate that MSC neither elevate the NO level when cocultured with resting neutrophils nor alone. However MSC profoundly inhibit the secretion of nitric oxide in PMA stimulated neutrophils after 24hr of incubation. Conclusion: MSC exert an immunomodulatory effect on neutrophil by suppressing neutrophil oxidative burst in vitro.
Introduction: Type 2 diabetes is increasing at an alarming rate worldwide. One of the leading factors to this condition is obesity. Low glycemic index (GI) and glycemic load (GL) diets have been proposed as lifestyle changes to address obesity, however, there is a lack of consensus on the optimal approach for weight loss, glycemic control and improving insulin sensitivity. In addition, the outcome of these diets are equivocal, with some studies suggesting beneficial outcomes and others suggesting otherwise. Furthermore, discrepant study designs have led to divergent conclusions. In order to provide a comprehensive overview of the low GI and low GL diets, a systematic review of literature on relevant observational studies and randomised control trials was performed on these databases:- The Cochrane Library, Medline, PubMed, Embase, Cinahl and Web of Science. Methods: The review was conducted based on the methodological standards for the conduct and reporting of Cochrane intervention reviews, Version 1.07, November 2018. Population, Intervention, Comparison and Outcomes (PICO) tool was used as the organising framework to define key elements of the review question. Results: Pertinent outcome variables include body weight, insulin resistance, HbA1c, fasting serum glucose, BMI, waist-to-hip ratio, triglyceride, HDL and LDL cholesterol. Our current understanding of these diets has been complicated by the reports that were based on different study designs and study populations. This review defines the issues, gaps in the research, study design, and evidence that is needed to inform practice, policy making and future research. There is also a dearth of information on the effect of low GI and GL diets on the Asian populations, specifically on improving insulin resistance. High carbohydrate diets are a mainstay of Asian societies. Conclusion: As cases of obesity and type 2 diabetes surge, there is an urgent need for research on low GI and GL dietary modifications among the Asian populations.
Introduction: Colour stability of the material is an essential factor that contributes to the selection of a flexible den- ture material. Staining effects on the denture may result in unattractive appearance, the dissatisfaction of the wearer, and limited usage period of the denture. This study aims to identify the colour stability of the Valplast flexible denture material using three types of beverages. Methods: A total of 32 disc-shaped flexible resin materials (20 +/- 0.1 mm in diameter and thickness 3 +/- 0.1 mm) were prepared based on the manufacturer instructions. The samples were randomly divided into 4 groups of immersion: distilled water (control), coffee solution, tea solution and red wine. The samples were left in the specified immersion solution for up to 60 days. Colour changes were measured after 1, 3, 7, 14, 21, 30, 45 and 60 days of immersion. Results: The samples immersed in coffee solution changed from S1 to S2, whereas samples in tea solution changed from S1 to S3. Additionally, samples in red wine changed from S1 to S4, as observed using the Valplast colour tone guide. The highest reflection measured using spectroscopy was 65.146 at 385.19 nm of the control samples, whereas the lowest reflection was 1.974 at the wavelength of 385.97 nm on the samples immersed in the red wine. Conclusion: The most significant difference can be observed in the red wine group, followed by samples in tea and coffee solutions. Moreover, increasing the immersion period causes increasing staining effect of the denture.
Introduction: In recent years, the variation in total fertility rate (TFR) has sparked public interest for demographic concerns on the global population shift towards an older age structure. This study aims to investigate the determi-nants of total fertility rate among Brunei, Indonesia, Malaysia and Philippines East Asian Growth Area (BIMP-EAGA) region. Methods: Our empirical study consists of data collected from the United Nations Development Report of the UNDP, World Development Indicators (WDI) of the World Bank and World Health Organization (WHO) report 2018. We investigated the socio-economic determinants of fertility rate by analyzing a panel data set consisting of 28 years from 1990-2017 of the four countries. A statistical and econometric software EViews version 10 (HIS Global Inc., Irvine, CA, USA) were used to run a Pearson’s Correlation and a multiple regression analysis by panel least squares method. To investigate the determinants of TFR we have selected five socio- economic factors, these are- Infant mortality rate (IMR), Gross National Income Per Capita, PPP (GNI), Human Development Index (HDI), percentage of population living in urban areas (URB) and lastly Female Labor Force Participation Rate (FLP). Results:Pearson’s correlation showed that a statistically significant negative relationship exists between TFR and the 3 vari-ables- GNI, URB and HDI. A statistically strong positive relationship exists between IMR and TFR. However, our results from the empirical multiple regression model indicates that there is a statistically significant negative relation-ship exists between TFR and two of the independent variables GNI and FLP. Conclusion: The results of present study showed that an increase in the national income and female labor participation rate in the workforce could result in a decrease in total fertility rate. These findings may have implications for countries national policy for planning, development and resource allocation.
Human cartilage contains multipotent stem cells, namely mesenchymal stem cells (MSCs) which are progenitors of connective tissue that play homeostatic and reparative roles. Although the major constituent cells in the cartilage are chondrocytes, they possess a limited regenerative ability, and as a result, spontaneous cartilage repair by chondro- cytes leads to the synthesis of fibrocartilage. Similarly, MSCs derived from articular cartilage of osteoarthritis patients have demonstrated inadequacy in cartilage repair. The role of MSCs in the pathophysiology of osteoarthritis (OA) is not entirely understood, whether the inflammatory milieu associated with OA joints affects the reparative properties of MSCs or the inherent defects of OA cartilage-derived MSCs impair the proper execution of the required immu- nosuppressive and reparative functions. Therefore, the current review explores the biological characteristics and features of MSCs derived from physiological state and OA condition with the aim of identifying how OA affects MSC functions as well as the role of MSCs in the pathophysiology of OA.
Introduction: One of the known factors that hindered smoking cessation is nicotine dependence. Measurement of the nicotine dependence is important to better understand cigarette smoking addiction dependence and ways to overcome it. Among methods of nicotine dependence measurement are self-reported Fagerstrom Test for Nicotine Dependence (FTND) and biochemical assessment such as saliva cotinine. Biochemical assessment can be used to measure the accuracy of the self-reported measurement of nicotine dependence. Objective: To explore the correlation between the FTND and the saliva cotinine of the smokers in three different timeline. Methods: A total of 61 male smokers who currently smoke cigarette on daily basis were recruited. The study used the one-group pretest-posttest study design and the data were collected three times. The self-reported measurement were measured by using FTND and the biochemical assessment measured by using saliva cotinine from Saliva Bio oral swab (SOS) with the sensitivity of 0.15ng/ml. Data analysis was conducted by using Pearson correlation. Results: There was a significant association between the FTND score and saliva cotinine level of the smokers at baseline, second and third data collection (p=0.014, p=0.003, p
Introduction: The Environment of Care (EoC) is less being the highlight as one of the important components in hospi-tal administration. The EoC is the interface between the patient and the organisation and it provides both a practical and safe area in which to provide patient care. The study aims to determine the correlation between the environment of care, patient satisfaction and willingness to recommend. Methods: This was a cross-sectional study conducted in one of the teaching hospitals in Malaysia. A Malay validated Hospital Consumer Assessment of Healthcare Provider and System (HCAHPS) questionnaire was used. The multistage sampling was applied. 13 wards represent medical, surgical and O&G based wards were selected randomly. Systematic random sampling method was used for pa-tient selection. Number of samples for each ward was calculated proportionately based on the average number of discharge patient monthly. The global rating item in HCAHPS was used to determine satisfaction level. Data was collected and analysed using SPSS version 22.0. Results: 547 respondents were involved in the study with 61.6% of them were female. Majority of respondents were young adult less than 60 years old. 36.9% of the respondents had positive experience with cleanliness of the ward meanwhile 26.7% had positive experience with quietness of the ward. 57.6% of the respondents were satisfied with the services and 64.5% were willing to recommend the hos-pital to others. There was a significant correlation between environment of care, satisfaction level and willingness to recommend. Conclusion: The healthcare facility needs to concentrate on creating a positive experience on EoC component as this can influence satisfaction level and willingness to recommend the hospital.
Introduction: Unequal retinal image size (RIS) or aniseikonia is usually related with anisometropia. Higher dif- ferences of RIS may manifest symptoms such as dizziness, headache or disorientation. In worst case might cause suppression that leads to amblyopia. Current study aims to evaluate the consistency of aniseikonia measurement in Smart Optometry smartphone application among myopic, hyperopic, and astigmatic simulated anisometropia and real anisometropia groups. Methods: Fifteen real anisometropes (refractive error; -0.50 until -6.00 diopters; D) and fifteen emmetropes (refractive error: -0.25 until +0.50D) were recruited. Real anisometropes wore their habitual spectacle correction while each emmetropes were fitted using soft contact lenses of +4.00DS, -4.00DS and -4.00DC with base curve 8.6 and total diameter 14.2mm in random order to mimic myopic-, hyperopic- and astigmat- ic-anisometropia before testing. Participants with any ocular disease and binocular vision problem were excluded. The consistency of aniseikonia measurement was determined in two visits, separated by at least 24-hour interval. Three repetitive measurements were taken in each visit. Results: Independent t-test and paired t-test showed that real and simulated anisometropia gave insignificant aniseikonia percentage, p>0.05. ICC findings revealed moder- ate-to-good agreement for all simulated and real groups. Bland Altman analysis between two visits exhibited good agreement among all simulated group; myopic (mean difference 0.2047; 95%CI:-1.1386-1.549), hyperopic (mean difference 0.2200; 95%CI:-0.9286-1.3686) and astigmatic (mean difference 0.2533; 95%CI:-0.7114-1.2180). Real anisometropes demonstrated good agreement with bias value of 0.2247(95%CI:-0.9162-1.3656) using Bland Altman plot. Conclusion: Smart Optometry application provides consistent measurement of aniseikonia regardless any types of anisometropia.
Introduction: The increased use of mobile phones has increased the mobile base stations (MBS) deployment. While understanding of radiation protection is growing among the public, questions regarding early-life exposure to ra- diofrequency radiation (RFR) from MBS in children are of importance as to whether it will raise the chances of developing chronic diseases during adulthood. Taking into account the sitting location of MBS, the purpose of this study is to evaluate the chromosomal DNA damage in buccal mucosal cells between school children exposed to RFR emitted from base station antennas. Method: This is a comparative cross-sectional study in which two group of school children were sampled i.e. exposed groups are children whose school located near MBS (200 meters); un- exposed groups are children whose school located distant far from the MBS (>200 meters). Digital RF Analyzer was used to measure RFR at the school surrounding. Buccal mucosa cells from the oral cavity were sampled to examine the level of micronuclei (MN) frequencies. Results: This study found that the densities of the RFR energy differed in range. Although all measurements showed the RFR reading below the acceptable exposure level, there were still sig- nificant variations at each location assessed. Statistically, the MN frequency is significantly different when compared to the exposed and non-exposed group. Conclusion: To understand the mechanism of health effects from exposure to low-level RFR emited from MBS, further study should consider environmental factors influencing MBS sitting on RFR emission, as well as examining the health effects into molecular levels.
Introduction: Airway management is one of the most important steps in emergency patient care, and it is part of the core content of emergency training programme in nursing. Besides, learning in the real clinical area on artificial air- way management is almost impossible due to the complexity of clinical conditions and non-uniform treatment algo- rithms that make the training strategies even more difficult to develop. This study was to evaluate the effectiveness of the simulation airway management training programme developed for the final year nursing students. Methods: This was a quasi-experimental with convenience sampling technique approach used. Students were exposed with the Intensive simulation of airway management technique which includes BLS, oropharyngeal measure and insertion, high flow O2 administration, interpret ECG, use of defib and understanding role of arrest team during emergency. The questionnaire on confident level was given before and after the simulation of airway management. Results: The results showed significant different in the mean score of pre-tests and post-tests (CI95% (-0.53414, -0.09586), t= -3.009, df = 19, p
Introduction: The purpose of the present study was to investigate exploratory factor analysis of the
Beck Anxiety Inventory (BAI) and reports its reliability and validity in Malaysia. Method: One thousand
and ninety participants from four different samples (namely students, general population, medical and
psychiatric patients) completed the Malay version of Beck Anxiety Inventory, as well as additional
questionnaires such as Fear Questionnaire, Anxiety Sensitivity Index, Depression Anxiety Stress Scale, and Catastrophic Cognition Questionnaire. Results: Exploratory factor analysis revealed a three factor solution and accounted for 48.01% of the total variance. The three-factor structure appeared to be; subjective anxiety, autonomic, and neurophysiology. The Cronbach alpha coefficients (α) ranged from 0.66 to 0.89 with satisfactory overall alpha value (.91). Evidence was also found acceptable concurrent validity of the BAI-Malay (range between r=.22 to r=.67). Conclusion: This study shows that the BAIMalay is a reliable and valid instrument to measure symptoms of anxiety in the Malay population
and can be used in research and clinical service in Malaysia. However, replication of study by using
confirmatory factor analysis and application of the instrument among anxiety patients worth of further
investigation.
Background: Prolonged exposure of heavy metals in the respirable particulate matter (PM10) from municipal solid waste (MSW) landfills may affect children health. Objective: To investigate the association of reported respiratory symptom with heavy metals in PM10, with heavy metals in fingernails among children residing close to MSW landfills. Methods: Two groups of children age 7 to 12 years old were involved in this cross-sectional study. Those residing within 3 km radius from a landfill were the exposed group and those residing more than 3 km radius as the unexposed group. Questionnaires adapted from American Thoracic Society were applied in the survey. Fingernails were used as biomarker. Ten heavy metals elements in PM and fingernail samples were analysed using inductively coupled plasma mass spectrometry (ICP-MS). Results: The cadmium, chromium, copper, manganese, nickel and lead concentrations in PM around the MSW landfills and residential areas exceeded the Canada and USEPA standard permissible limit. Heavy metals in fingernails (p
Introduction: Smoking is a common risk factor for periodontal disease and other chronic diseases. This study was conducted to determine the prevalence of smoking among army personnel and its association with periodontal health status. Methods: A cross-sectional study was carried out among randomly selected 233 army personnel in 8th Brigade Infantry, Kelantan. A face validated self-administered Bahasa Malaysia questionnaire was used for data col- lection. Periodontal examination was done using Community Periodontal Index (CPI) and coded as ‘0’ for healthy; ‘1’ for bleeding observation; ‘2’ for detection of calculus; ‘3’ for probing of 4-5mm pocketing and ‘4’ for probing of 6mm or more pocketing. Results: All respondents (n=233) were male, the majority (92.7%) Malays, not married (60.5%) with the mean (SD) age of 25.8 (5.06) years. The prevalence of smoking among army personnel was 76.0% (95% CI: 70.4, 81.5). Almost all (97.4%) have some degree of periodontal disease. The non-smoker, ex-smoker and smoker groups were highest for having calculus with a percentage of 40.5%, 57.1%, and 57.1%, respectively. No significant association was found between smoking status (ever-smoker and non-smoker) and periodontal pocketing (CPI 0-2 and CPI 3-4) (p=0.960). However, the ever-smokers (93.2%) significantly higher percentage for the need of invasive treatment (CPI >2) compared to the non-smokers (76.2%) (p=0.002). Conclusion: The prevalence of smok- ing among army personnel in North-East Malaysia was high, with most of them have some degree of periodontal disease. Smoking cessation intervention should be strategized in the military community to reduce the burden of care for chronic diseases.
Introduction: Studies found that low sleep quality (SQ) is associated with many factors such as health, quality of life (QOL), work or academic performance and co-curriculum activities. Hence, improvement to maintain SQ to en- hance students’ QOL is important. Approximately 43% of Malaysian were unaware of their sleep problem and how it affects their physical and mental health, especially among the younger generation. The study aims to investigate the association between SQ and QOL among undergraduate students in UTAR Sungai Long Campus. Method: A cross-sectional study among 256 undergraduate students recruited by purposive sampling was conducted. The Pitts- burgh Sleep Quality Index (PSQI) and the World Health Organization Quality of Life Instruments (WHOQOL-BREF) were administered to evaluate SQ and QOL, respectively. Self-reported demographic data were collected with a structured sociodemographic profile. Associations were evaluated using Spearman’s correlation coefficient, Chi- square test and independence t-test. The level of significance was p< 0.05. Result: Results showed more than one half of students had poor SQ (F=137, 53.5%) and poor QOL (F= 159, 62.1%). All seven PSQI components were significantly associated with at least one QOL domain. Sleep disturbances, sleep latency and daytime dysfunction were correlated with all four QOL domains which are physical health, psychological, social relationships, and envi- ronment. Among the sociodemographic variables, only time travelled from place of stay to campus was associated to SQ (p = 0.04). However, there was no significant association between SQ and the selected sociodemographic vari- ables such as gender, working part-time job, and travel distance from place of stay to campus. Conclusion: Overall, the results from this study showed one half of students suffered from poor SQ and QOL. SQ among undergraduate students is vital in developing good QOL.
Introduction:Staphylococcus aureus is a Gram-positive staphylococci that form biofilms. Bacteria that dwell in bio-films tend to be highly resistant towards the action of antibiotics. S. aureus is a main cause of infections in the oral cavity such as angular cheilitis, endodontic infections, osteomyelitis of the jaw, parotitis and oral mucositis. Previous studies reported that S. aureus also spread to the other parts of the body through the circulatory system, which may lead to chronic infections. Hence the search for new antibacterial agents remains high and needs urgent attention to treat this problem. Plants offer a rich source of antimicrobial agents and bioactive compounds. In this study, aque-ous oil palm leaf extracts (OPLE) has been used as an alternative antibacterial agent against oral infections mainly caused by Staphylococcus aureus. Many studies report the potential use of oil palm leaf extracts in treating bacterial infections such as Escherichia coli, Salmonella sp., Staphylococcus aureus (isolated from other part of the body), Pseudomonas aeruginosa and Bacillus sp. Although previous studies have documented the antimicrobial properties of oil palm leaf extracts, to date no study has been reported on the effect of oil palm leaf extract on oral microbes. Methods: The agar diffusion method, minimum inhibitory concentration (MIC) and minimal bactericidal concen-tration (MBC) assay were conducted in order to observe the antibacterial activity of aqueous oil palm leaf extract. The crystal violet assay was used to determine the anti-biofilm activity of the extracts. Chlorhexidine and deionised distilled water were used as the positive and negative control respectively. For agar diffusion method, the diameter of inhibition zone was measured. Results: The inhibition zone of the tested bacteria was observed between 0-20mm. The MIC and MBC assay were used to know the lowest concentrations of the extract that inhibit the growth and killed the tested bacteria respectively. The MIC and MBC values for the tested bacteria were observed between 0-7.813mg/mL. While for anti-biofilm assays, OPLE aqueous extract acts as a potent anti-biofilm agent with dual actions, pre-venting and eradicating the biofilm of the tested bacteria. Conclusion: In conclusion, the tested plant extracts could serve as alternative natural antibacterial and anti-biofilm agent against oral infections.
Introduction: An arteriovenous malformation (AVM) is an abnormal collection of blood vessels in which arterial blood flows directly into the draining vein without the normal interposed capillaries. The Spetzler-Martin grading system has been widely accepted worldwide to estimate the pretreatment risks and predict the outcome of patients with intracranial AVM. In Malaysia, we still do not have the baseline data of this grading system. Methods: A total of 33 patients from a tertiary referral hospital diagnosed with intracranial AVM based on neuroimaging findings over a 4-year period were studied. Medical
records were traced and neuroimaging findings were analysed. The AVMs were graded according to the Spetzler-Martin grading system and Fisher’s exact test was used to assess statistical difference between the grades of the AVM and management plan for the patients. Results: Four patients were graded as Grade 1, 9 patients as Grade II, 10 patients as Grade III, 6 patients as Grade IV and 4 patients as Grade V. Ten patients were treated conservatively; six patients underwent surgery and embolisation respectively. Four patients underwent radiosurgery and a combination of embolisation while surgery and radiosurgery were given to 5 patients and 2 patients respectively. Statistically significant difference (p=0.016) was found between the Spetzler-Martin grading system and the management of intracranial AVMs. Conclusion: The management decision was not made based on the
grading of the AVMs. It is recommended that all AVM patients be routinely graded according to this system prior to treatment.
We describe our technique of single-bundle PCL reconstruction using a bony femoral press-fit system. 9 patients un- derwent PCL reconstruction using our pressfit system. The surgical procedure is described in detail. Post-operatively, 5 patients were available for assessment and review. Four patients gave a final Lysholm score of 92 – 100%. Three patients gave a Hospital for Special Surgery (HSS) score of excellent, one fair and one poor. Two patients gave a re- duced Tegner activity score post-operatively while the other three gave a similar score post-operatively. Assessment using KT-1000 revealed four patients with a side-to-side difference of less than 3 mm (average side-to-side difference,1.87 mm), while one patient exhibited a side-to-side difference of 5.8 mm. We believe that our technique enhances tunnel healing through usage of a bone-plug fixation and provides a cheap alternative for graft fixation on the femoral side in PCL reconstruction.
Introduction: Discrepancies of nicotine content labelling of e-liquid products has been reported and it may
have existed to circumvent legal requirements that imposes restrictions on the sale of nicotine-containing
products in the market. Mandatory labelling requirement of e-liquid products is still pending in Malaysia.
This case study aimed to examine labelling discrepancies of e-liquid refill products declared as nicotine-free
sold in e-commerce platform in Malaysia. Methods: A total of 10 Malaysian-made e-liquid refill samples
were purchased via a popular e-commerce platform available to Malaysian. The e-liquid refills were
specifically chosen because it was declared to contain zero-nicotine. Nicotine concentrations were
measured using a Gas-chromatography with flame-ionisation detector (GC-FID). Results: About 80% (n = 8)
of the purchased e-liquid samples were contained nicotine despite being declared as nicotine-free.
The average nicotine levels were 1.092 (0.989) mg/mL. Conclusion: This case study confirmed the
presence of labelling discrepancies which non-comply with the existing Malaysian Poison Act.
Such non-compliance will contribute to the sale of unrestricted nicotine products. As a result, it will increase
addiction among novice smokers because e-liquid refills declared as “nicotine free” contained nicotine.
Implementation of stringent legal requirement on the nicotine content of local e-liquid products is
urgently needed as it will support the accomplishment of Malaysian Tobacco Endgame.