Primary thyroid lymphoma is uncommon and accounts for less than 2-5% of all thyroid malignancies. The aim of the present study was to review our experience and management of primary thyroid lymphoma and to discuss the diagnostic and therapeutic considerations.
In spite of major advances in oncology, the World Health Organization predicts that cancer incidence will double within the next two decades. Although it is well understood that cancer is a hyperproliferative disorder mediated through dysregulation of multiple cell signaling pathways, most cancer drug development remains focused on modulation of specific targets, mostly one at a time, with agents referred to as "targeted therapies," "smart drugs," or "magic bullets." How many cancer targets there are is not known, and how many targets must be attacked to control cancer growth is not well understood. Although more than 90% of cancer-linked deaths are due to metastasis of the tumor to vital organs, most drug targeting is focused on killing the primary tumor. Besides lacking specificity, the targeted drugs induce toxicity and side effects that sometimes are greater problems than the disease itself. Furthermore, the cost of some of these drugs is so high that most people cannot afford them. The present report describes the potential anticancer properties of curcumin, a component of the Indian spice turmeric (Curcuma longa), known for its safety and low cost. Curcumin can selectively modulate multiple cell signaling pathways linked to inflammation and to survival, growth, invasion, angiogenesis, and metastasis of cancer cells. More clinical trials of curcumin are needed to prove its usefulness in the cancer setting.
The main aim of the study is to provide an empirical analysis of quality management practice among Malaysian Ministry of Health hospital employees, ranging from medical specialists to health attendants.
Dysregulation of microRNAs (miRNAs) has been implicated in almost every known survival mechanisms utilized by cancer cells. One of such mechanisms, anoikis resistance, plays a pivotal role in enabling metastasis by allowing cancer cells to circumvent cell death induced by lack of attachment. Understanding how miRNAs regulate the various anoikis pathways has become the research question of increasing number of studies published in the past years. Through these studies, a growing list of miRNAs has been identified to be important players in promoting either anoikis or resistance to anoikis. In this review, we will be focusing on these miRNAs and how the findings from those studies can contribute to novel therapeutic strategies against cancer progression. We will be examining miRNAs that have been found to promote anoikis sensitivity in numerous cancer types followed by miRNAs that inhibit anoikis. In addition, we will also be taking a look at major signaling pathways involved in the action of the each of these miRNAs to gain a better understanding on how miRNAs regulate anoikis.
Charred human remains were found in the smoking ambers of a dying fire in an oil palm plantation in Selangor, Malaysia in the midnight of January 28, 2013. Investigations showed that palm fronds and rubber tires were used to light and sustain the blaze. At least four to five tires were estimated to be used based on the residual burnt metal wires at the site. The remains were brought to the Department of Forensic Medicine, Hospital Sungai Buloh, Selangor for post-mortem examination. Pre-autopsy imaging showed a fractured skull with presence of a bullet in the head. The body belonged to a male with unrecognizable facial features, pugilistic attitude, and reduced body size caused by fire damage with sparing of the posterior surface. A large fracture was present at the skull vault. An entry gunshot wound was observed on the left side of the body of mandible, which was associated with base of skull fracture. Heat-related fractures were also noted on the right side of the frontal bone. A projectile was retrieved from the right side of the occipital lobe. Further examination showed presence of soot and hyperaemic larynx, trachea, main bronchi, and oesophagus. Black spots measuring 1 to 2 mm were present on the surface and parenchyma of the heart, liver, pancreas and kidneys. Histopathology examination showed black particles within the vessels in the affected organs. We report this rare finding in a charred body and present a discussion based on published literature on this issue.
PURPOSE: The purpose of this paper is to advance healthcare service quality research using hierarchical component models.
DESIGN/METHODOLOGY/APPROACH: This study used a quantitative approach with cross-sectional design as a survey method, combining cluster and convenience sampling and partial least square structural equation modelling (PLS-SEM) to validate the research model and test the hypotheses.
FINDINGS: The study extends health service quality literature by showing that: patient satisfaction (PS) is dominant, significant and indirect determinant of behavioural compliance (BC); perceived service quality has the strongest effect on BC via PS.
RESEARCH LIMITATIONS/IMPLICATIONS: Only one hospital was evaluated.
PRACTICAL IMPLICATIONS: The study provides managers with a service quality model for conducting integrated service delivery systems analysis and design.
ORIGINALITY/VALUE: Overall, the study makes a significant contribution to healthcare organizations, better health outcomes for patients and better quality of life for the community.
KEYWORDS: Healthcare; Hierarchical perceived service quality; Population-based sampling
A total of 323 workers from 5 different occupational groups in the telecommunication industry were studied in this cross sectional study, which sought to determine the prevalence of Work Related Upper Limb Disorders (WRULD) in 5 occupational groups; operators using the Video Display Terminals, switchboard operators, clerks, data entry processors and the supervisors. WRULD was also studied with regard to factors such as sex, race, height, age, stress and the discomfort perceived due to the work station design. The possibility of WRULD was determined from a self-administered questionnaire and confirmed by history and physical examination. Psychological stress and the discomfort due to the workstation were measured from the questionnaire. The overall prevalence was found to be 31.2% and the prevalence among the various occupations differed with it being the highest in the switchboard operators and data processors and the lowest in the supervisors. The older workers and the female workers were found to have higher prevalences of WRULD. It was also found that a higher stress score and a higher score of discomfort perceived at the work station were associated with higher prevalences of WRULD.
A cross sectional study to determine the prevalence of hearing loss and hearing impairment was conducted on 286 male subjects from a rural area. The sample was chosen by using a simple random sampling method. Prevalence of symptoms of tinnitus, ear disease, ear drum perforation and infection of external auditory meatus was 19.0 per cent, 6.7 per cent, 3.5 per cent and 0.4 per cent respectively. Air conduction audiometry tests showed the prevalences of hearing impairment of the left, right and both ears (aged 15-30 years) were 5.9%, 8.8% and 0% respectively. The prevalence of hearing loss increased with age. The higher frequencies (> 4KHz) appeared to be more affected than the lower frequencies.
Partial least squares discriminant analysis (PLS-DA) is a well-known technique for feature extraction and discriminant analysis in chemometrics. Despite its popularity, it has been observed that PLS-DA does not automatically lead to extraction of relevant features. Feature learning and extraction depends on how well the discriminant subspace is captured. In this paper, discriminant subspace learning of chemical data is discussed from the perspective of PLS-DA and a recent extension of PLS-DA, which is known as the locality preserving partial least squares discriminant analysis (LPPLS-DA). The objective is twofold: (a) to introduce the LPPLS-DA algorithm to the chemometrics community and (b) to demonstrate the superior discrimination capabilities of LPPLS-DA and how it can be a powerful alternative to PLS-DA. Four chemical data sets are used: three spectroscopic data sets and one that contains compositional data. Comparative performances are measured based on discrimination and classification of these data sets. To compare the classification performances, the data samples are projected onto the PLS-DA and LPPLS-DA subspaces, and classification of the projected samples into one of the different groups (classes) is done using the nearest-neighbor classifier. We also compare the two techniques in data visualization (discrimination) task. The ability of LPPLS-DA to group samples from the same class while at the same time maximizing the between-class separation is clearly shown in our results. In comparison with PLS-DA, separation of data in the projected LPPLS-DA subspace is more well defined.
Objective: To evaluate the effect of type of viscosity and groove on surface detail reproduction of elastomeric impression materials. Methods: Two polyvinylsiloxane and polyether elastomeric impression materials were investigated. An aluminium cylindrical reference block with V- and U-shaped grooves of 1 mm and 2 mm in depth was machined using CAD-CAM system. Impressions of the block were taken to produce 35 master dies. Each die was immersed in distilled water for 5 minutes prior to impression making. Surface topography of the dies and impressions were captured using Alicona Imaging System. Mean difference in depth between the mas-ter dies and corresponding impressions’ grooves were analyzed. Results: Type of viscosities and groove showed significant main effects on surface detail (p < .01), but no significant interaction was observed between the two (p > .01). Express™ putty/light exhibited the lowest mean difference in depth for all grooves. The highest mean difference for U1 (38.3μm ± 21.55), U2 (52.96μm ± 30.39),V1 (45.02μm ± 34.82) and V2 (58.44μm ± 44.19) was obtained from Impregum medium, Aquasil medium, Impregum™ heavy/light and Impregum™ heavy/light groups respectively. Conclusion: Express putty/light-bodied material produced the best surface detail, and U-shaped groove showed superior detail reproduction.
Heterotopic interstitial pregnancy in natural conception is very rare. Definitive diagnosis is
made by systematic pelvic ultrasound. Simultaneous viable conception observed in both intraand extra-uterine is pathognomonic of heterotopic interstitial pregnancy. We report a 34-yearold woman primigravida at 10 weeks’ amenorrhoea who underwent evacuation of retained
product of conception for missed miscarriage. Intraoperatively, minimal product of conception
was retrieved. Bedside pelvic ultrasound showed cystic mass at right superolateral part of
uterine fundus suspicious of interstitial pregnancy. Cornual resection was performed via
laparotomy. Histopathological examination showed presence of product of conception and
interstitial pregnancy. Serum β-human chorionic gonadotropin dropped from 10,027 IU/l on day
one post-ERPC to 210 IU/l at day three post-cornual resection. This case report highlighted
the challenge in diagnosing heterotopic interstitial pregnancy conceived naturally. Timely
diagnosis may avert dire consequences of massive haemorrhage from ruptured uterine cornua
Lung cancer remains a major health problem with a low 5-year survival rate of patients. Recent studies have shown that dysregulation of microRNAs (miRNAs) are prevalent in lung cancer and these aberrations play a significant role in the progression of tumour progression. In the present study, bioinformatics analyses was employed to predict potential miR-608 targets, which are associated with signaling pathways involved in cancer. Luciferase reporter assay identified AKT2 as a novel target of miR-608, and suppression of its protein levels was validated through western blot analysis. Zebrafish embryos were microinjected with cells transfected with miR-608 to elucidate the role of miR-608 in vivo, and immunostained with antibodies to detect activated caspase-3. We present the first evidence that miR-608 behaves as a tumour suppressor in A549 and SK-LU-1 cells through the regulation of AKT2, suggesting that selective targeting of AKT2 via miR-608 may be developed as a potential therapeutic strategy for miRNA-based non-small cell lung cancer (NSCLC) therapy.
Oral cancer remains as a worldwide health issue. In Malaysia, oral neoplasm contributed about 10.6% death at the government hospitals. The significant consequences of delaying referral and poor prognosis of oral cancer was mainly due to the lack of knowledge among public. This study aims to determine the level of awareness and knowledge on oral cancer among students with non-medical background in Kepala Batas, Pulau Pinang, Malaysia. A cross sectional study using questionnaires were conducted among systematically randomly selected 275 non-medical background students aged 18 years old and above. The association of smoking habit with oral cancer awareness and knowledge was evaluated using chi-square test. Factors associated with the knowledge were determined at both univariable and multivariable levels using simple logistic and multiple logistic regression analyses respectively. Oral cancer awareness level was high among the students (85%) even though knowledge on early signs of oral cancer was low (19 years old has 1.96 time the odds compared to students aged ≤19 to have poor knowledge while Malay has 4.28 time the odds compared to Indian to have poor knowledge. Although smoking was observed as the most recognisable risk factor of oral cancer (82%), the smoking prevalence was relatively high (46.9%). The smokers in this study had low awareness and knowledge on oral cancer compared to the non-smoker. Hence, preventive measures adopting knowledge transfer should be proposed to enhance individual awareness and knowledge on oral cancer with Smoking cessation programme to help the smoker to quit smoking
Introduction: This study examined how waist circumference (WC) varied across sociodemographic characteristics of Malaysian adults using a nationally representative data. Methods: Data from the Malaysian Adult Nutrition Survey 2014 (n = 2696) was used. In the sample, 46.55% were males and 53.45% were females. The outcome variable was WC. Waist circumference was categorised into four ordinal outcomes: very low, low, high and very high. The ex- planatory variables were age, monthly individual income, education, gender, marital status, ethnicity, employment status and household location. Ordered probit models were utilised. Results: The majority of males had a low WC (54.66%), and only a small proportion had a very high WC (0.96%). Similarly, a high proportion of females had a low WC (55.59%), and only 1.94% had a very high WC. Younger males were more likely to have a high WC than their older counterparts. Males who had monthly income of RM2000-2999 or RM3000-3999 were more likely to have a high WC compared with those who had monthly income of RM999. Chinese and Indian males were more likely to have a high WC than Bumiputera males. For females, those who were married, widowed/divorced and Bu- miputera were likely to have a high WC. Conclusion: WC was associated with various sociodemographic profiles of males and females. In particular, there were positive associations between the likelihoods of having a high WC and younger age group, higher income, Chinese, Indian, and being married. Our findings provided policy makers with better information on formulating intervention measures.
Metal oxide particles have been studied by many researchers as potential catalysts for the production of biofuel. However, better understanding of catalysts preparation and characterisation are essential. A series of solid metal oxide catalysts were synthesised by chemical precipitation method using metal salt precursor such as magnesium nitrate hexahydrate, (Mg(NO3)2.6H2O), copper (II) nitrate tryhidrate (Cu(NO3)2.3H2O) and nickel nitrate hexahydrate, (Ni(NO3)2.6H2O ). The synthesised catalysts before and after calcination were further characterised using Thermal Gravity Analysis (TGA), Fourier Transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), N2 physisorption and Scanning Electron Microscope (SEM) analysis. Higher catalytic activity and higher production of biofuel may benefits from this higher surface area metal oxide catalysts synthesis by precipitation method in this work
Quality attributes of steamed bread without green banana flour (BF) (CON), substituted with 30%
BF (BBFI) and 30% BF + 8% gluten (BBFII) were determined. The green banana flour (BF) and the mixture of wheat flour (WF) substituted with 30% BF + 8% gluten (FBFII) was significantly highest in water holding capacity and oil holding capacities, respectively. Potassium, calcium and magnesium were significantly higher in BBFI and BBFII than CON. Significantly highest insoluble dietary fibre and total dietary fibre shown in BBFI. Steaming resulted significant reduction in resistant starch content in BBFI as compared with the dough of BBFI I. The specific volume of BBFII and CON showed significant different compared to the BBFI. The BBFII spread ratio was significantly highest and steamer spring lowest than CON. BBFII showed significantly highest in hardness and adhesiveness values but CON was significantly highest in cohesiveness, elasticity and chewiness. L and Hue values was shown highest in CON. BBFII indicated highest acceptability score than other samples.
Health services are considered to be of good quality if customers’ expectations and perceptions are well balanced. Determinants confirming customers’ expectations will lead to satisfaction, while factors disconfirming it will result in customers’ dissatisfaction, reduced compliance to physicians’ treatment and deterioration in overall disease management. A cross-sectional comparative study was carried out from September till October 2008 to determine population satisfaction with health services provided by the public health clinics in Selangor. A total of 3840 respondents from the urban Health Clinics (HCs) and 4768 respondents from rural HCs were selected applying multi-stage random sampling from 54 HCs in nine districts from Selangor. Self-administrated questionnaires formulated by adopting SERVQUAL method based on modified five dimensions plus four dimensions of Clinics Corporation were used . Results showed the proportion of satisfaction among the population towards services provided by the public HCs was high at 86.1%. From X2 bivariate analysis; satisfied respondents were significantly from Indian and Chinese ethnic community more than the Malays, more among the less educated, the older age category (more than 33 years old) and males’ were slightly more satisfied than females. Patients who visited HCs more than three times were more satisfied than one time visitors. Occupation, marital status and HCs urban-rural locality were not significantly associated with customers’ satisfaction level. All dimensions showed high satisfaction level especially on treatment outcome, except on health care workers (HCWs) caring and professionalism domains. Working as a team was slightly higher in the urban areas compared to rural area. Overall, the SERVQUAL score of all dimensions were higher among the urban respondents albeit not significant. Clients’ perceptions were generally higher than expectations reflecting the high satisfactions among clients at 86.1%. Much improvement needs to be put into training HCWs to be more caring and adapting a professional attitude towards clients. Clients’ satisfactions in the urban and rural HCs were almost equal and did not reflect a decrease of health services priority in the rural areas.
Sepsis causes high mortality and morbidity. Static lactate concentration and early lactate clearance are cited to be a predictor for sepsis survival. This study examined the clinical utility of static lactate concentration and early lactate clearance within the first six hours of admission in Emergency Department (ED) to predict 28-day mortality rate in sepsis patients. Patients who presented with sepsis, severe sepsis or septic shock and admitted to ED of Universiti Kebangsaan Malaysia Medical Centre were recruited. Blood lactate concentrations were measured upon admission (H0), at 1st hour (H1) and 6th hour (H6), respectively. Either standard treatment of sepsis or early goal directed therapy was initiated according to sepsis severity. A follow-up report was conducted at 28 days via telephone call, e-mail or case notes. Patients were later classified into survivor and non-survivor as final outcome. Static lactate concentration appeared to be significantly higher for non-survivor as compared to the survival group at H0, H1 and H6 (p
Food waste is a mixture of organic residues that affect fermentation process. Thus, appropriate parameters should be optimised to ensure high biomethane production. In this research, response surface methodology (RSM) was utilised for building models, evaluating the significance of several independent factors (pH, temperature, substrate concentration and inocula size) and determining optimum conditions for desirable responses (biomethane yield). The RSM and contour plots set the optimum working factors in order to accomplish the desired biomethane yield. Results suggest that biomethane yield can be increased when pH and temperature are increased. Thus, the main effects of parameters are pH and temperature.
In this article, five variables including type of substrates, sizes of substrates, mass ratio of spawn to substrates (SP/SS), temperature and pretreatment of substrates were used to model mycelium growth in Pleurotus sp. (oyster mushroom) cultivation by using agricultural wastes via two level factorial analysis. Two different substrates which were empty fruit bunch (EFB) and sugarcane bagasse (SB) were used. Analysis of Variance (ANOVA) for both mycelium extension rate (M) and nitrogen concentration in mycelium (N) showed that the confidence level was greater than 95% while p-value of both models were less than 0.05 which is significant. The coefficient of determination (R2) for both M and N were 0.8829 and 0.9819 respectively. From the experiment, the best condition to achieve maximum M (0.8 cm/day) and N (656 mg/L) was by using substrate B, 2.5 cm size of substrate, 1:14 for SP/SS, incubated at ambient temperature and application of steam treatment. The data showed that EFB can be used to replace sawdust as a media for the oyster mushroom cultivation. Data analysis was performed using Design Expert version 7.0.