We sought to review the current practice of sedation and analgesia in intensive care units (ICUs) in Malaysian public hospitals. A questionnaire survey was designed and sent by mail to 40 public hospitals with ICU facility in Malaysia. The anaesthesiologists in charge of ICU were asked to complete the questionnaire. Thirty seven questionnaires were returned (92.5% response rate). Only 35% respondents routinely assess the degree of sedation. The Ramsay scale was used prevalently. A written protocol for sedation was available in only 14 centers (38%). Although 36 centers (95%) routinely adjust the degree of sedation according to patient's clinical progress, only 10 centers (14%) interrupt sedation on a daily basis. Most respondents agreed that the selection of agents for sedation depends on familiarity (97%), pharmacology (97%), the expected duration for sedation (92%), patient's clinical diagnosis (89%) and cost (73%). Midazolam (89%) and morphine (86%) were the most commonly used agents for sedation and analgesia, respectively. Only 14% respondents still frequently use neuromuscular blocking agents, mostly in head injury patients. Our survey showed similarity in the choice of sedative and analgesic agents in ICUs in Malaysian public hospitals comparable to international practice. Nevertheless, the standard of practice could still be improved by implementing the practice of sedation score assessment and daily interruption of sedative infusion as well as having a written protocol for sedation and analgesia.
A multi-wavelength laser comb is demonstrated using a nonlinear effect in a backward pumped Bismuth-based Erbium-doped fiber (Bi-EDF) for the first time. It uses a ring cavity resonator scheme containing a 215 cm long highly nonlinear Bi-EDF, optical isolators, polarisation controller and 10 dB output coupler. The laser generates more than 10 lines of optical comb with a line spacing of approximately 0.41 nm at 1615.5 nm region using 146 mW of 1480 nm pump power.
Extending the frying-life of oils is of commercial and economic importance. Due to this fact, assessment on the thermal stability of frying oils could provide considerable savings to the food processors. In this study, the physico-chemical properties of five palm products mainly palm oil, single-fractionated palm olein, double-fractionated palm olein, red palm olein and palm-based shortening during 80 hours of heating at 180 degrees C were investigated. Heating properties of these products were then compared with that of high oleic sunflower oil, which was used as reference oil. The indices applied in evaluating the quality changes of oils were free fatty acid, smoke point, p-anisidine value, tocols, polar and polymer compounds. Three palm products i.e. palm oil, single-fractionated palm olein and double-fractionated palm olein were identified to be the most stable in terms of lower formation of free fatty acid, polar and polymer compounds as well as preserving higher smoke point and tocols content compared to the other three oils. The low intensity of hydrolytic and oxidative changes due to prolonged heating, suggests that these palm products are inherently suitable for frying purposes.
Tidal variation in tropical coastal water plays an important role on physicochemical characteristics and nutrients concentration. Baseline measurements were made for nutrients concentration and physicochemical properties of coastal water, Port Dickson, Malaysia. pH, temperature, oxidation reduction potential, salinity and electrical conductivity have high values at high tides. Principal Components Analysis (PCA) was used to understand spatial variation of nutrients and physicochemical pattern of Port Dickson coastal water at high and low tide. Four principal components of PCA were extracted at low and high tides. Positively loaded nutrients with negative loadings of DO, pH and ORP in PCA outputs indicated nutrients contribution related with pollution sources. This study output will be a baseline frame for future studies in Port Dickson involving water and sediment samples. Water and sediment samples of future monitoring studies in Port Dickson coastal water will help in understanding of coastal water chemistry and pollution sources.
There is a strong association between depression and pain, which is influenced by various biological and psychological mechanisms. The objectives of this study were to assess the prevalence and severity of pain symptoms among patients with major depression; and to determine the correlation between pain with clinical variables, neurotic pathology and severity of depression.
We are reporting four cases of serious washing machine related injury that presented within a period of 5 months. All patients were young children with the mean age of 9 year-old and three had their dominant hand injured. The washing machines involved were the automatic top loader type and all injuries occurred during the spinning phase. Serious automatic washing machine injury is not uncommon in Malaysia. We feel that there is a need to improve the safety features especially during the spinning phase. The operating instructions and safety precautions on the washing machine should be displayed in different languages that can be understood well. Parents should also aware of the potential risks of this seemingly benign household appliance.
This paper puts forward a new automatic clustering algorithm based on Multi-Objective Particle Swarm Optimization and Simulated Annealing, "MOPSOSA". The proposed algorithm is capable of automatic clustering which is appropriate for partitioning datasets to a suitable number of clusters. MOPSOSA combines the features of the multi-objective based particle swarm optimization (PSO) and the Multi-Objective Simulated Annealing (MOSA). Three cluster validity indices were optimized simultaneously to establish the suitable number of clusters and the appropriate clustering for a dataset. The first cluster validity index is centred on Euclidean distance, the second on the point symmetry distance, and the last cluster validity index is based on short distance. A number of algorithms have been compared with the MOPSOSA algorithm in resolving clustering problems by determining the actual number of clusters and optimal clustering. Computational experiments were carried out to study fourteen artificial and five real life datasets.
The purpose of this study was to evaluate fermentation of milk in the presence of green tea (Camellia sinensis) with respect to changes in antioxidant activity, phenolic compounds and the growth of lactic acid bacteria. Pasteurized full fat cow's milk and starter culture were incubated at 41 °C in the presence of two different types of green tea extracts. The yogurts formed were refrigerated (4 °C) for further analysis. The total phenolic content was highest (p
To investigate the wound healing efficacy of two chitosan films, Chit-AA and Chit-LA, in comparison with a commercial preparation, Omiderm, using punch biopsy wounds in rats.
A study was carried out to determine the chemical composition of bulk precipitation, throughfall and stemflow in an urban forest in Kuala Lumpur, Malaysia. The mean weekly rainfall recorded during the period of study was 63.2 mm. Throughfall, stemflow and canopy interception of incident precipitation were 77.1%, 1.2% and 21.7% respectively. Bulk precipitation, througfall and stemflow were acidic, the pH recorded being 4.37, 4.71 and 4.15 respectively. In all cases the dominant ions were NO3, SO4, Cl, NH4, K, Ca and Na. Of the ions studied Ca, K, Cl, SO4, Mg and Mn showed net increases in passing through the forest canopy, while NH4, Na, NO3, Zn, H and Fe showed net retention. This study shows that the urban environment of Kuala Lumpur contributes considerable amounts of materials to the atmosphere, as reflected by the high ionic contents in bulk precipitation, throughfall and stemflow.
A series of chelating reagents, 1-phenyl-3-methyl-4-(2-fluorobenzoyl)-5-pyrazolone, 1-phenyl-3-methyl-4-(3-fluorobenzoyl)-5-pyrazolone and 1-phenyl-3-methyl-4-(4-fluorobenzoyl)-5-pyrazolone, has been synthesized. The extraction of Ln(III), (Ln = La, Eu and Lu) into chloroform with these reagents at 30 +/- 1 degrees has been studied. The composition of the complexes extracted has been determined by the slope method, and the extraction constants K(ex), were measured. The presence of the fluorine atom in the reagents does not make the K(ex), values much different from those obtained with the parent pyrazolone.
Cord blood from 8,975 babies delivered in Hospital Sultanah Aminah Johor Bahru over a period of eight months (1st August 1985 to 31st March 1986) were screened for G6PD deficiency. The overall incidence was 4.5% in Chinese, 3.5% in Malays and 1.5% in Indian babies. One hundred of these babies were observed in the nursery for seven days and their daily serum bilirubin recorded. The serum bilirubin peaked at 96 hours to a value of 12mg%. None of the babies in the nursery developed a serum bilirubin level of more than 15mg%. Six of the babies with G6PD deficiency that were sent home were readmitted with hyperbilirubinaemia that needed exchange transfusion.
The Cardiothoracic Department, General Hospital, Kuala Lumpur which was set up in April 1982, deals with a wide range of cardiac disease, general thoracic and also vascular cases. A total of 2,450 operations were performed from April 1982 to February 1987, and 79.3% of these were for cardiac cases (open and closed heart). This paper reports a review of the 1,110 consecutive open heart operations performed by the Department during the stated period.
The results of a 10-year study of intussusception seen in the General Hospital Kuala Lumpur is presented. Incidence among Indians was found to be the lowest in comparison to the other two major racial groups. In 63.5 percent of infants there was no pain. A large number of patients presented with diarrhoea (21.8 percent), constipation (31 percent) and abdominal distension. (43.7 percent). Overall mortality rate was high (14.4 percent). This could be attributed to late presentation (only 30.8 percent) of cases were seen within 24 hours of onset of symptoms) which also accounted for a higher resection rate. A high incidence of lead points (28.7 percent) was also seen. The usefulness of barium enema reduction in this country is discussed. Mainstay of management in the majority of cases is operation with adequate pre and postoperative care.
An interactive teaching tool that utilizes a game board strategy to facilitate the learning of statistics has been developed and employed. This study aims to determine the impact of the board game on the motivation of diploma students towards learning statistics. Data are collected from 7 respondents using a face to face interview. Responses are qualitatively analysed. Results show that respondents are generally positive about the effectiveness of the board game as a teaching tool to enhance le arning and understanding. More importantly, respondents have shown a change in attitude towards statistics and are more motivated to learn statistics under this innovative learning environment. Some suggestions for future research are outlined.
Objectives: To evaluate the impact of the clinical instructor communication on dental students’ clinical training in Faculty of Dentistry, Universiti Teknologi Mara (UiTM). Materials and Methods: A sample of 174 undergraduate clinical dental students were recruited to complete the Clinical Education Instructional Quality Questionnaire (ClinEd IQ) which consists of forty-five questions, forty-three multiple choice questions and two open-ended. The multiple-choice questions consist of 3 subscales which were measured on a six-point Likert Scale from “strongly disagree” to “strongly agree”. The open-ended responses were analysed using thematic analysis. This paper discusses the Subscale of interaction with clinical instructors and the open-ended responses. Results: The responses of 150 students were evaluated. The students rated their interaction with instructors with a mean score of 4.64 on a six -point scale. There was a significant difference between mean scores for each academic level with year five students’ score being highest. There were four areas of concern identified through the open-ended responses. Conclusion: While the quality of supervision in terms of interaction with clinical instructors is considered satisfactory and the students generally reported positive experiences, there is room for improvements especially regarding areas of concern.
This paper presents the dataset of undergraduates learning habits during and before the occurrence of pandemic COVID-19 under the scope of sociodemographic and psychological aspects. This dataset consists of four (4) main sections which are students' demographic, psychological disruption, students' learning habits and integration of online sessions with sustainability topics. A total of 37 variables were distributed via an online survey platform. The link of the online survey was circulated to the students using few social media platforms such as WhatsApp groups, Telegram, and faculties' Facebook starting from June 1 until June 31, 2020. There was a total of 668 respondents accompanied by consent were agreed to join the survey. This dataset can have an important role for research and education in identifying the impact on learning performance among the undergraduate students during COVID-19 pandemic based on different sociodemographic and psychological aspects.
Dental fluorosis incidence had been reported to be affecting children widely, especially in water-fluoridated ar-ea. As these children grow into young adults, perceived aesthetic problems arise mainly due to their concern with generalized mottled and stained teeth appearance. Fixed prosthodontics treatment involving single anterior tooth in patients with generalized fluorosis condition had been found challenging due to aesthetic restorability to blend with fluorosis condition. Clinical considerations: A simplified procedural direct chair-side technique of mimicking fluorosis condition onto anterior all-ceramic crowns are discussed in this paper. The mimicked fluoro-sis is reversible and has the opportunity to be adjusted according to the patient’s fluorosis condition thus hinder-ing the need to redo the crown in the future. Conclusions: The appearance of anterior all-ceramic crowns with direct chair-side staining technique provided blended and harmonized well with the dental fluorosis condition in both patients thus, giving natural looking smile.
GABAA receptors are the major inhibitory neurotransmitter receptor in the human brain. The receptors are assembled from combination of protein subunits in pentameric complex which may consist of α1-6, β1-3, γ1-3, ρ1-3, δ, ε, θ, or π subunits. There are a theoretical > 150,000 possible assemblies and arrangements of GABAA subunits, although only a few combinations have been found in human with the most dominant consists of 2α1, 2β2, and 1γ2 in a counterclockwise arrangement as seen from the synaptic cleft. The receptors also possess binding sites for various unrelated substances including benzodiazepines, barbiturates, and anesthetics. The α5-containing GABAARs only make up ≤ 5% of the entire receptor population, but up to 25% of the receptor subtype is located in the crucial learning and memory-associated area of the brain-the hippocampus, which has ignited myriads of hypotheses and theories in regard to its role. As well as exhibiting synaptic phasic inhibition, the α5-containing receptors are also extrasynaptic and mediate tonic inhibition with continuously occurring smaller amplitude. Studies on negative-allosteric modulators for reducing this tonic inhibition have been shown to enhance learning and memory in neurological disorders such as schizophrenia, Down syndrome, and autism with a possible alternative benzodiazepine binding site. Therefore, a few α5 subunit-specific compounds have been developed to address these pharmacological needs. With its small population, the α5-containing receptors could be the key and also the answer for many untreated cognitive dysfunctions and disorders.
Tocochromanols consisting of tocopherols and tocotrienols, is collectively known as vitamin E. Similarity in their structures, physical and chemical properties rendered the tocochromanols to be subject of chromatography interest. Supercritical fluid chromatography is a highly efficient tool for the separation and analysis of tocochromanols. Separation and analysis of tocochromanols using supercritical fluid chromatography had been carried out in the past using capillary or packed columns. Each of these techniques offer their own advantages and drawbacks. Besides being used for analysis, packed column supercritical fluid chromatography found applications as a purification and content enrichment tool. Emergence of new equipment and stationary phase technologies in recent years also helped in making supercritical fluid chromatography a highly efficient tool for the separation and analysis of tocochromanols. This paper gives an insight into the use of capillary and packed columns in supercritical fluid chromatography for the separation and/or analysis of tocochromanols. The types of stationary phase used, as well as chromatographic conditions are also discussed.