Epilepsy is the most common neurological disorder in pregnancy. The effects of epilepsy include congenital abnormalities which are increased 2-3 fold. The babies born suffer from haemorrhagic disease of newborn. Preconception management and folic acid supplementation is important in optimizing outcome. With close monitoring and proper management, more than 90% of mothers have no complications throughout their pregnancy. Hormonal contraception dosage need to be increased due to the enzyme inducing nature of the anti epileptics drugs.
Antithyroid drugs, radioiodine and surgery are lhe three modalities of treatment for Graves' hyperthyroidism. The treatment strategy depends on a clear understanding of the relative advantages and disadvantages of each mode of treatment as well as the individual patient's preference. Recent studies favour the use of high dose antithyroid drugs with thyroxine supplementation to induce a higher rate of remission. Radioiodine is likely to be favoured as the definitive form of treatment. Surgery still has a place particularly for young female patients with large goitres. Keywords: Antithyroid drugs, radioiodine, thyroidectomy.
Introduction: Drug abuse is a prevalent issue in Malaysia, and a constant struggle to eradicate even among substance abusers who have received prior rehabilitation. Drug abuse has also been known to affect the quality of life of an individual, due to the stigma it carries. This research emphasized on studying the life quality of relapsed and first-time substance abusers in rehabilitation centres including their tendency towards aggression. Methods: A cross-sectional study was conducted to evaluate the current inpatients in Cure & Care Rehabilitation Centres (CCRC) in Peninsular Malaysia. Primary data was acquired using a self-administered questionnaire consisting of socio-demographic (Part A), quality of life (Part B) and aggression related questions (Part C). 417 individuals were selected through purposive sampling from five different centres. A statistical analysis was conducted using independent t-test, single linear re- gression and Kruskal-Wallis using SPSS version 25.0. Results: An analysis of the data presented no significant asso- ciation between quality of life and tendency of aggression among relapsed and first time substance abusers (p>0.05). Based on the analysis and the outcome, age influences the level of aggression (p=0.018) while quality of life is af- fected by education level (p=0.017). Marital status is a factor that affects both the level of aggression (p=0.015) and quality of life (p=0.043). Conclusion: The findings may contribute to law enforcements in reducing violent crimes committed by drug abusers and rehabilitation efforts by rehabilitation centres, by establishing demographic profiles in relation to quality of life and aggression.
Strongyloides stercoralis is an intestinal nematode which is endemic in tropical and subtropical countries. The global prevalence of Strongyloides is unknown. Strongyloidiasis is found more frequently in the socioeconomically disadvantaged, in institutionalized populations, and in rural areas. The spectrum of disease varies. It may cause asymptomatic infection, mild eosinophilia or hyperinfection syndrome in the most severe form. Here we reported a case of Strongyloides hyperinfection syndrome in an immunosuppressed patient. This patient is a 54-year-old man with myasthenia gravis on long term azathioprine and prednisolone. He presented with fever associated with diarrhoea and was in septic shock. His blood culture was positive forKlebsiella pneumoniae.Strongyloides stercoralis larvae were detected in his sputum and stool sample. He was diagnosed to have Strongyloides hyperinfection and was treated with subcutaneous ivermectin. He recovered well. Our case demonstrated the association of Strongyloideshyperinfection with superimposed gram-negative sepsis as a consequence of prolonged immunosuppression. A high index of suspicion is needed in approaching patient with risk factors of hyperinfection syndrome.
Kajian ini dilaksanakan untuk membandingkan keberkesanan analgesia pre-emptif intravena magnesium sulfat menggunakan dos yang berbeza terhadap kesan pengawalan kesakitan berikutan pembedahan ginekologi. Seramai 56 orang pesakit dengan Indeks Jisim Badan (BMI)
This study aimed to assess the concentrations of cadmium (Cd), nickel (Ni) and lead (Pb) in the tissues of fish collected from the lower reach of the Kelantan River, Malaysia. Fishes were collected using gill nets during the dry and wet seasons. A total of 78 individual fish were caught and comprised 6 families, 11 genera and 13 species. The dorsal muscle was analysed using a graphite furnace Atomic Absorption Spectrometer (AAS). The mean concentration of Cd in Chitala chitala (0.076 mg/kg) was above the critical limit values of the European Commission (EC), World Health Organization (WHO) and Food and Agriculture Organization (FAO). The mean concentrations of Cd in Barbonymus gonionatus and Tachysurus maculatus were already at the level of concern, whereas the other species were approaching the limits of permissible levels. No fish samples were found to have a Ni level higher than the permissible limit of 0.5-0.6 mg/kg set by the WHO (1985). Osteochilus hasseltii (0.169 mg/kg) and T. maculatus (0.156 mg/kg) showed high Pb concentrations. The concentrations of heavy metals were found to be elevated in the wet season (p<0.05). Omnivorous fish were detected with elevated concentrations of Cd and Ni, whereas carnivorous fish had the highest concentration of Pb. The concentrations of Cd and Pb in fish tissues were positively correlated with fish weight (p<0.05). This study determined that the fish species caught in the Kelantan River were contaminated with non-essential metals (Cd, Ni and Pb). Nevertheless, the heavy metal concentration in the fish tissues, with the exception of C. chitala, O. hasseltii and T. maculatus, did not exceed the EC, FAO, Malaysian Food Act (MFA) or WHO guidelines.
The influence of the cool and warm temperatures on early life development and
survival of tropical oyster, Crassostrea iredalei was studied. D-hinged larvae (day 1 larvae)
were reared to three different temperatures (20°C, 27°C, and 34°C) for nine days. Oyster
larvae reared in temperature 27°C, acted as control (ambient temperature). The highest
survival rate occurred when the larvae were reared in 20°C and 27°C. Larvae reared at
34°C exhibited reduced survival but increase in the growth rate. The growth rate in larvae
reared in high temperature (34°C) was significantly higher compared to larvae reared in
20°C and 27°C (p
Lycopene and total phenolics of pink guava puree industry by-products (refiner, siever and decanter)
were evaluated after steam blanching at selected temperatures and times. Lycopene content was in the order of decanter > siever > refiner (7.3, 6.3 and 1.5 mg/100 g, respectively), and the content of total phenolics was in the order of refiner > siever > decanter (4434.1, 2881.3 and 1529.3 mg GAE/100 g, respectively). Regression coefficients for temperatures (x1) and times (x2) from multiple linear regression models of siever and decanter showed significant (p
A study was conducted to determine personal hygiene knowledge among 25 food handlers at 12 selected primary schools in Klang Valley area, Selangor, Malaysia. A qualitative approach using in-depth interviews was employed and respondents were selected by a convenience sampling. The results showed that the respondents had basic knowledge on personal hygiene practices, mainly on hand washing (30.7%) and glove use (18.7%). The food handlers (90%) practiced various good hand washing practices, with only 36% did not practice washing hands after eating or drinking. Most respondents (>70%) practiced glove use, however more than 50% did not wash hands with every glove change, change gloves when change type of products and after preparing raw material. The study showed that the food handlers have basic knowledge one good personal hygiene practices. However, some discrepancies were revealed in the proper hand washing procedure. This study recommended good hand washing procedure to be reiterated among the food handlers. There is also an immediate need for continuous training among food handlers regarding good personal hygiene practices.
The Combined Cleft Clinic at the University Hospital, Kuala Lumpur was organised in 1992. The team consists of Plastic Surgeon, Orthodontists, Speech therapist, Ear, Nose and Throat Surgeon, Audiologist, medical officers and the nurses. We attend the clinic on a regular basis. Specialists from other medical and dental disciplines as well as the members of the Cleft Lip and Palate Association of Malaysia (CLAPAM) do occasionally participate in this set-up.The team members formulate treatment plans for each cleft patient, monitor the patient's growth and development and manage the patient at different stages according to the individual needs. To date, the idea of team approach and an establishment of a centre towards management of cleft patients seem to be the most ideal as the patients are benefiting total treatment and care from various specialists from only one place. The experience of University Hospital as a centre for cleft patients is discussed.
Objective: Medical housemanship training has always been regarded as a highly stressful environment to doctors. This article described findings on stress, stressors and coping strategies among house officers in a Malaysian hospital. Methods: A cross-sectional study was conducted on house officers in a Malaysian hospital. The 12 items General Health Questionnaire (GHQ-12), General Stressors Questionnaire (GSQ) and Brief COPE inventory were administered to measure perceived stress, sources of stress and coping strategies among house officers respectively. Data was analysed using SPSS version 12. Results: Forty two house officers participated in this study. This study found that approximately 31% of the house officers were in distress. The top five stressors were fears of making mistakes that can lead to serious consequences, work overload, working with uncooperative colleagues, doing
work that mentally straining and feeling of being underpaid. The most frequent coping strategies used by house officers were religion, acceptance and self-distraction. Conclusion: This study found that there was a high percentage of distressed house officers. It also found that major stressors were related to performance pressure. The main coping strategy used by house officer was emotion-focused coping.
We present an algorithm to reduce the number of slices from 2D contour cross sections. The main aim of the algorithm is to filter less significant slices while preserving an acceptable level of output quality and keeping the computational cost to reconstruct surface(s) at a minimal level. This research is motivated mainly by two factors; first 2D cross sections data is often huge in size and high in precisions – the computational cost to reconstruct surface(s) from them is closely related to the size and complexity of this data. Second, we can trades visual fidelity with speed of computations if we can remove visually insignificant data from the original dataset which may contains redundant information. In our algorithm we use the number of contour points on a pair of slices to calculate the distance between them. Selection to retain/reject a slice is based on the value of distance compared against a threshold value. Optimal threshold value is derived to produce set of slices that collectively represent the feature of the dataset. We tested our algorithm over six different set of data, varying in complexities and sizes. The results show slice reduction rate depends on the complexity of the dataset, where highest reduction percentage is achieved for objects with lots of constant local variations. Our derived optimal thresholds seem to be able to produce the right set of slices with the potential of creating surface(s) that traded off the accuracy and speed requirements.
Cassava starch was used as feedstock for production of bioethanol by Saccharomyces cerevisiae. The cassava starch was hydrolyzed using commercial α-amylase and glucoamylase enzymes followed by a batch ethanol fermentation process using saccharified starch slurry. By using 110 g/L of reducing sugar from saccharified starch slurry, the ethanol yield was promising with maximum ethanol concentration of 20.6 g/L recorded after 55 hours of cultivation process. Three different models - the Logistic model, Luedeking-Piret-like equation and Gompertz equation - were used to characterize and explain the cell growth, reducing sugar consumption and production formation, respectively. The kinetic parameters were estimated by fitting the experimental data to the proposed models using non-linear regression analysis. The correlation coefficient r2 values for the Logistic model, Luedeking-Piret-like equation and the Gompertz equation were 0.994, 0.996 and 0.990, respectively. The high correlation coefficient values indicate that the proposed models were able to describe the ethanol fermentation process.
The safety of simultaneous bilateral total knee arthroplasty (TKA) remains controversial. The objective of the current study was to investigate perioperative morbidity and mortality rates within 30 days of simultaneous bilateral TKA. A detailed analysis of medical, surgical and anaesthesia records of 183 consecutive patients who underwent total knee arthroplasty between 2002 and 2006 was performed. The mean age of the patients was 67.6 years old. More than 80% had one or more co-morbidities, but none of them had ASA score greater than class 2. The mean hospital stay was 10 days, and the mean surgical time 156 minutes. Less than half of the patients (42.6%) required blood transfusion. The rate of perimorbidity was 15.3 % and there was no mortality in this series. We believe that simultaneous bilateral total knee arthroplasty is a safe and cost effective option for our patients, provided that patients are selected and informed appropriately.
Our continuing interest in anthraquinones from the Guttiferae family has led us to look at the genus Cratoxylum. A detailed chemical study on Cratoxylum aborescens resulted in the isolation of three anthraquinones, namely 1,8-dihydroxy-3-methoxy-6-methylanthraquinone (1), vismiaquinone (2) and vismione (3). These compounds were identified using 1D and 2D NMR spectroscopy. This is the first report on the chemistry of Cratoxylum aborescens.
The main objective of the present study was to investigate the effects of the frying media and storage time on the fatty acid composition (FAC) and iodine value (IV) of deep-fat fried potato chips. The frying experiment was conducted at 180ºC for five consecutive days. Six frying media were considered as the main treatments: refined, bleached, deodorized (RBD) palm olein (A), canola oil (C), RBD palm olein/sesame oil (AB, 1:1 w/w), RBD palm olein/canola oil (AC, 1:1, w/w), sesame oil/canola oil (BC, 1:1, w/w), and RBD palm olein/sesame oil/canola oil (ABC, 1:1:1, w/w/w). The initial degrees of unsaturation of the consumed oils, A, C, AB, AC, BC, and ABC, were 58.6, 94.0, 68.0, 72.2, 87.7, and 75.8 (g/100 g), respectively. The fatty acid analysis showed that there was a decrease in both the linolenic acid (C18:3) and linoleic acid (C18:2) contents, whereas the palmitic acid (C16:0) increased with a prolonged frying time. The chemical analysis showed that there was a significant (p < 0.05) difference in terms of the IV for each frying oil during the five consecutive days of frying (day 0 to 5). Oil C had the least stability in terms of deep-fat frying due to a high level of unsaturated fatty acids. Conversely, oil AC had the best stability due to the smallest reduction of the C18:2/C16:0 ratio and the IV.
The effect of ribose-induced Maillard reaction on the physical and mechanical properties of gelatin films was investigated. Bovine gelatin solution (5 g/100 mL) containing glycerol and sorbitol (1:1) was mixed with 20% (R20), 40% ribose (R40), or 40% sucrose (S40) (weight % is based on gelatin dry weight) followed by heating (90ºC, 2 h) and oven drying to produce dried gelatin films. R20 and R40 films were brownish in color with lower light transparency, while CF (control film; without sugars) and S40 were colorless and had higher transparency. Tensile strength and Young Modulus values of the films were in the order; CF > R20 > R40 > S40, while elongation at break was in the order; R40 > S40 > R20 > CF. Water solubility and swelling percentages of the films were in the order; CF > S40 > R20 > R40, indicating the occurrence of insoluble “Maillard complexes” within R20 and R40 films. R20 and R40 films showed maximum light absorption at wavelength of 200 − 350 nm, whilst S40 and CF showed maximum absorbance at 200 − 250 nm. The addition of ribose yielded gelatin films with increased protection against UV light, even though the presence of sugars might had disrupted the inter connection of junction zones and decrease in mechanical properties. Occurrence of the Maillard reaction within R20 and R40 films could be the main reason for differences in physical and mechanical properties of films containing ribose that were formed from heated film-forming solutions.
In this study, pineapple cannery waste materials were used as substrate for the microbial production of vanillic acid and vanillin by Aspergillus niger I-1472 and Pycnoporus cinnabarinus MUCL 39533. Biotransformation of ferulic acid from pineapple waste by A. niger I-1472 to vanillic acid was optimized using Response Surface Methodology (RSM). A central composite rotatable design was used to allocate treatment combinations and factors tested for their influence on vanillic acid production were inoculum size, yeast extract concentration, diammonium tartrate concentration and initial medium pH. The amount of vanillic acid produced was used as the response for the fermentation study and was assumed to be under the influence of the four factors tested. The estimated conditions for optimal vanillic acid production were inoculum size, 3.08 ×105 CFU mL-1; yeast extract, 0.37 gL-1; diammonium tartrate, 3.88 gL-1 and initial pH, 4.3. Subsequent biotransformation of vanillic acid by P. cinnabarinus MUCL 39533 to vanillin was enhanced with the addition of resin. Under these optimal conditions, 141.00 mgL-1 of vanillin was produced from 5 g of pineapple cannery waste.
Phorid flies play an important role in forensic cases and can cause myiasis in humans. Studies on phorid flies species diversity are still limited in Malaysia. This research was carried out to collect information about species and frequency distribution of phorid flies as to provide more information on their roles in forensic and medical entomology. Bait trap was used with 100 g beef liver as baits. The species of the flies were identified using identification keys from Disney as well as Brown and Oliver. There were 449 phorid flies found in Kepong, Kuala Lumpur including Megaselia scalaris, Megaselia spiracularis, Megaselia sp. and phorid flies of genus X. Female phorid flies (98.89%) were found more prone to be trapped compared to male phorid flies (1.11%). Most phorid flies trapped in Kepong, Kuala Lumpur were from genus Megaselia and consisted of female flies. A total of five species of phorid flies probably new to science were also discovered. This study showed that Megaselia flies were found indoors rather than in open spaces. This was corresponding to their discoveries among the decomposing corpse found inside premises.
Many studies have shown that probiotic strains added to a number of probiotic products are not compatible to that of
claimed. It is thus of note to validate probiotic strains added to probiotic products. In this study, three probiotic drinks,
A, B and C, were cultured on MRS agar and the number of bacterial colonies was enumerated. The bacterial counts
recovered from A (9.3 ± 6.9 log CFU/ml) and C (9.0 ± 6.9 log CFU/ml) were signifi cantly higher than B (5.2 ± 3.5 log
CFU/ml) and achieved the minimal amount recommended for probiotic bacteria. All of the isolates appeared as gram
positive rods microscopically and were proven to be catalase negative. However, there were only A1, A2, B4 and C1 that
were highly tolerant to the gastrointestinal pH 3 to 6. The four isolates produced and secreted antimicrobial substances
which inhibited the growth of Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus). C1 showed the greatest
growth inhibition by forming 17.50-mm and 17.85-mm inhibition zones against E. coli and S. aureus, respectively. The
16s rDNA sequencing and phylogenetic analysis were performed to further identify the twelve isolates. The twelve isolates
were found to be Lactobacillus (L.), particularly L. casei and L. paracasei. However, the bacteria isolated from drink B
were incompatible to the labelled ones. In conclusion, probiotic drinks are possible to contain different bacterial counts
and probiotic strains from the labelled ones. These differences might affect health benefi ts rendered by probiotic strains
to consumers.