Introduction: Zika virus is mainly transmitted to human through bite of an infected Aedes species mosquito. It was reported that the transmission also occurs by blood transfusion, sexual intercourse and from mother to foetus. The World Health Organization (WHO) had declared Zika infection outbreak as Public Health Emergency of Internation-al Concern (PHEIC) in February 2016. Since December 2016, total of eight Zika cases had been reported to Ministry of Health, Malaysia (MOH). Since there is no available vaccine and specific treatment for the Zika virus infection, the preventive practices against Zika virus infection is the only defense and method to curb the infection. The ob-jective of this study is to determine predictors of preventive practices towards Zika virus infection among patients attending health clinics in Seremban. Methods: A cross-sectional study was done in selected public health clinics in Seremban, involving 874 respondents recruited by simple random sampling method. Primary data was collected using self-administered questionnaires in English and Bahasa Malaysia. Descriptive and analytical statistics were performed using SPSS version 22.0. Results: Majority of the respondents were female (57.2%), below 40 years old (62.5%), Malay (83.1%), Muslim (83.8%), married (86.2%) and had secondary school education (51.8%), working (64.9%) with monthly household income of
Introduction: Workers in health sector are exposed 5 times more workplace violence as compared to workers in other sectors. Their consequences can range from mild to severe, affecting the victim, quality of services and orga-nization. The objective is to evaluate the effectiveness of educational intervention on workplace violence among healthcare workers in health clinics. Methods: This study is a single blinded cluster randomized trial to see the ef-fectiveness of education intervention on coping with workplace violence involving 10 cluster clinics with total 82 respondents in each control and intervention group. Data was collected using pretested questionnaire at baseline, 1-month and 6-months post intervention. The analysis used were descriptive, compared mean at baseline, repeated measures of variance and Mixed Model. Results: Response rate 94% at 1-month due to loss to follow up. Majority of the respondents were female (82.3%), and Malays (83.5%). The prevalence of workplace violence was 27.4% and mostly involved psychological violence (95.6%). There were no significant different between control and interven-tion group characteristic at baseline. Repeated measures MANOVA test was conducted to test intervention effect on dependent variables. The results until 1-month time showed significant difference between intervention and control group on combination of the dependent variables over time in coping (F(1,162)=9.51, p=0.002, and η2=0.06), knowledge (F(1,162)=10.47, p=0.001, and η2=0.061) and confidence (F(1,162)=15.65, p
Introduction: This study aimed to investigate the relationships between parental effort to control the child’s food intake among primary school children with parents’ ‘control’, ‘restriction’ and ‘reward’ on limiting children to eat unhealthy foods. Methods: Data were collected among 485 primary school children and their parents. Questionnaire for Obesity survey among primary school children was used to document on the child’s daily food intake for one week. Results: All predictor variables are significant at the p
Head and neck cancers have been reported to have high immune infiltration scores, and clinical benefits of the anti-PD1 checkpoint inhibitor have been demonstrated in recurrent and metastatic cancers. Recent genetic signa-tures of the immune compartment have provided insights to delineate immune-active and -exhausted subtypes, to understand the immune status of OSCC patients that could further drive the development of novel immunotherapies. Vaccination with tumour-associated antigens is an approach to improve tumour recognition which could result in the eradication of cancer cells. Here, I would describe our efforts in developing antigen-specific vaccines for head and neck cancer. Using the B6.Cg-Tg(HLA-A/H2-D)2Enge/J mice bearing established tumours overexpressing the tumour antigens, we demonstrated that the vaccine delayed tumour growth, and in combination with anti-PD1, completely eliminated the tumour. The vaccine increased the expression of PD1 in T cells, and vaccinated animals showed increased antigen-specific responses by the ELISPOT assay. In summary, our data show that antigen-specific vaccine works synergistically with anti-PD1 and could be a promising therapeutic agent for head and neck cancer.
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.
Introduction: This is a proto-type product which is based on Frankincense essential oil and hydrosol. Methods: Three oleo gum resin species, namely; Boswellia carterii (BC), Boswellia frereana (BF), and Commiphora myrrha (CM) of Burceraceae family were extracted for their essential oil by hydro-distillation. They were screened for their poten-tial of anti-cariogenic activity by in-vitro experimental study of two main bacterial species (Streptococcus mutans and Lactobacillus spp), which are considered the main cause of dental and mouth diseases. Results: Methanol and acetone extracts of the three plants inhibited the growth of the bacteria. However, BF-methanol extract shows the greatest inhibition followed by BC and CM respectively. Hence, the obtained result encourages proceeding further thorough investigation to benefit the positive outcomes of these plant extracts in terms of introducing new potential antimicrobial formulations, such as mouth wash which can be used for mouth cleansing and protection from the diseases such as mouth ulcers, gingivitis, sinusitis, glandular fever and brucellosis as well as dental caries. This result can be converted to Boswellia Mouthwash Essential Oil (BosMEO) and Boswellia Mouthwash Hydrosol (BosMoHy) based products. This new plant extract product can be exploited for further research for its potential used as moth infection natural treatments such as mouth ulcers, gingivitis, sinusitis, glandular fever, brucellosis as well as respi-ratory problem. It is free of synthetic chemicals, organic, natural, plant based, and halal with no major health side effects. Conclusion: Plant-based product which is free from synthetic chemicals and with minimal side effects will satisfy its quality efficiency.
The effects of poor air quality are a serious issue in urban areas, wherever most people live and work. Precise moni- toring of air quality in real-time is crucial to enable prompt and fitting resolutions for outdoor workers and the public. This study is meant to provide information and to understand current knowledge on the use of mobile wireless sensor network for outdoor air pollution assessments and monitoring. A search of the literature was carried out using an appropriate query for the search of papers across various databases. Majority of the previous studies researched have reported that mobile wireless sensors are versatile and could be applied in exposure assessments and monitoring of outdoor air quality. The reviewed articles proved that mobile wireless sensors are a practical device that can effec- tively detect air pollution and will facilitate to boost the protection of the community, personal health care as well as environmental monitoring.
Introduction: Malaysian traffic police are always working on the public roads to alleviate traffic congestion and therefore exposed them to the polluted air every day. In particular, polluted air containing PM2.5 is dangerous to their respiratory health as they can penetrate deep into the lungs, leading to bronchitis, lung cancer and many more. Hence, this research examined the relationship of personal exposure level to PM2.5 with respiratory symptoms among traffic policemen in Kuala Lumpur and Johor Bahru. Methods: 134 participants among traffic policemen were agreed to participate in this study. They were requested to complete a questionnaire regarding the sociodemographic back- ground and respiratory health information. The questionnaire was adopted from International Union Against Tuber- culosis Lung Diseases (1986). Personal exposure level of PM2.5 was measured using an air pump with 5.0µm pore size PVC filter. Results: The mean exposure level of PM2.5 among traffic policemen was 28.69 µg/m3. It was found that some of them possess respiratory symptoms (Coughing 33.6%, Phlegm 25.4%, Wheezing 14.9% and Shortness of breath 32.1%). There was significant association detected at p-value < 0.05 in coughing. Despite, there was no significant association in other symptoms such as phlegm, wheezing and shortness of breath. Conclusions: Traffic police were exposed to a relatively high level of PM2.5 (12.4 µg/m3 to 55.3 µg/m3) and showed symptoms of respi- ratory effects. Therefore, recognition of the risks connected with occupational lung disease and exposure monitoring must be a high priority. This baseline data can serve as a reference to the top management of traffic police officers in order to develop an occupational safety and health guideline for police officers as required by Occupational Safety and Health Act (OSHA, Act 514 1994).
Discomfort measurement has usually been attempted by asking the participants to rate the scale of their discomfort which commonly termed as a subjective scale. Various studies had conducted the discomfort level on vehicle seat by using Visual Analogue Scale (VAS) and Likert scale. VAS is a tool that use to measure a discomfort or characteristics in range across a continuum of values. Meanwhile, Likert-scale is a tool consist of items that require respondents to rate their degrees of comfort or discomfort with various declarative statements. Thus, the purpose of this study is to review, discuss and compare between the VAS and Likert scale used on the development and assessment of sitting discomfort survey in seat vehicles. The literature on various topics related to questionnaire development on discomfort in seat vehicle were collected from electronic databases. Four high-quality studies were eligible and met the inclusion and exclusion criteria. Overall, there is no evidence and conclusion that neither visual analogue scale nor Likert scale are better to one another. Therefore, it can be concluded that either of this scale still applicable for the ergonomic research application as both of this scale have their own pros and cons.
Prolonged standing has been identified as one of the risk factors which is associated with occupational injuries. Therefore, the primary aim for this study is to determine the association between prolonged standing and muscle dis- comfort among workers who have to stand for long periods of time. A total of 74 respondents were given and asked to complete a self-administered Borg’s Scale questionnaire. After that, the completed questionnaire was analysed using statistical analysis. This study highlighted the correlation between height, weight and age of the respondents with muscle discomfort following exposure to prolonged standing. Besides that, the association between prolonged standing and muscle discomfort also will be highlighted. In short, the prevalence of leg muscle discomfort was higher compared to the muscle discomfort experienced by the other body parts.
We report a rare case of Ochrobactrum anthropi bacteremia in a previously healthy young man who was admitted for severe dengue. O. anthropi is a rarely encountered Gram negative organism which is resistant to commonly used beta-lactam antibiotics. This organism is usually interpreted as a contaminant as it is ubiquitous in the environment. Isolation of this organism upon admission suggested a community-acquired infection. He had persistent bacteremia and had to be treated with a prolonged course of meropenem and ciprofloxacin. This case report highlights the importance of early diagnosis and prompt treatment of this otherwise contaminant as previous reports showed this organism can be an opportunistic pathogen which may lead to severe infection.
Scimitar syndrome is a rare congenital heart defect occurring in 1 to 3 per 100,000 live births. This is a case of a 26 years old lady presenting with episodic fainting spells since the age of 18 years old. She was initially diagnosed with epilepsy until a referral to our centre found a soft splitting of the second heart sound and multiple premature ventricular complexes on ECG. The computed tomography of the pulmonary artery confirmed the diagnosis if Scim- itar syndrome in the presence of anomalous single right pulmonary vein draining into infra-diaphragmatic systemic venous circulation. A corrective open-heart surgery to re-implant the pulmonary vein was performed with excellent clinical outcomes. Therefore, it is crucial for clinicians to embody high index of suspicion of congenital anomaly even in adults presenting with indefinite clinical symptoms. This report also represents the first published case of adult Scimitar syndrome from Malaysia.
Introduction: The prevalence of diabetes mellitus (DM) in Malaysia is drastically increasing. Subjects with DM are
more likely to have deranged liver function tests (LFT). This study aimed to determine the prevalence of abnormal liver enzymes [(alanine aminotransferase (ALT) and alkaline phosphatase (ALP)] and its associated factors among type
2 DM (T2DM) subjects visiting a referral diabetic clinic in a tertiary government hospital. Methods: This retrospective, cross-sectional study included electronic data of 300 T2DM subjects ≥18 years old in the outpatient specialist
clinic from January 2011 to December 2014. Statistical analysis was performed using SPSS version 22. Results: The
study population at large included Malays, of age >60 years with comparable gender percentage. Most subjects had
long-standing DM, poor glycaemic control and were on treatment. The prevalence of abnormal ALT and ALP was
27.3% and 13%; with 90.2% and 97.4% having mild ALT and ALP elevations, respectively. Significant associations
noted for age, body mass index (BMI) and duration of T2DM for ALT whereas for ALP, anti-diabetic medication was
significant between groups of normal and abnormal levels. Deranged liver enzymes were associated significantly
with dyslipidaemia. Conclusion: Our study on the crude prevalence of raised liver enzymes may help identify T2DM
patients at increased risk of non-alcoholic fatty liver disease (NAFLD). Modification of metabolic risk factors, such
as weight loss, control of dyslipidaemia rather than just tighter glycaemic control should be emphasised to reduce
morbidity and mortality. Liver enzymes remain a simple and non- invasive marker of liver pathology in daily medical
practice.
Introduction: Acute gastroenteritis (AGE) is one of the frequent causes of hospitalization in children under the age of five, particularly in a rural setting. This study was conducted to determine the epidemiology of acute gastroenteritis in indigenous children admitted to a rural district hospital in Sarawak. Methods: A retrospective review of indigenous paediatrics cases of acute gastroenteritis
admitted to the ward of Serian District Hospital, a rural district hospital in Sarawak, between the years
2006-2007. The data was collected from the patients’ case notes, obtained with permission from the
hospital management. Data was entered and analyzed using SPSS version 16. Results: During the study period, 234 indigenous children with acute gastroenteritis were admitted with the highest prevalence in 2006 (53.4%). The findings showed higher prevalence was found in children aged 3 years and below (76.5%) and male (56.4%) The minimum duration of hospital stay is 1 day, and the maximum stay is 5 days. The clinical findings showed that the majority of the cases presented with vomiting, diarrhea, dry mouth and tongue, sunken eye, with the majority (76%) reported having mild dehydration. The most common treatment used is oral rehydration solutions (85.4%), followed by intravenous bolus or drip (82.3%), paracetamol (79%) and antibiotic (36.2%). Peak incidence of admissions was between November to January. About 38.5% of the AGE cases admitted were found to be underweight (weight for- age below -2SD). Conclusion: The findings indicated children aged 3 years and below are the most vulnerable to AGE and malnutrition could be one of the predisposing factors. The peak incidence during the raining season at the end of the year indicated a possible relationship between AGE and seasonal type of virus infection. Prevention in the form of proper hygiene at the household level probably will prove to be useful.
Hepatitis B virus (HBV) infection is one of the major public health problems in Malaysia. It remains the most common permanent deferral among blood donors. In Malaysia, the national vaccination programme has been introduced since 1989 to prevent HBV transmission. The objective of this study is to determine the prevalence and associated risk factors of HBV infection among first-time blood donors after the implementation of the national hepatitis B vaccination programme. Methods: This is a retrospective cohort study involving tracing of the database of National Blood Centre Malaysia. The record of first-time blood donors who had donated between 1st January 2010 and 31st December 2015 and were screened HBV positive was reviewed and analysed. Results: There were 376,737 first-time donors who had donated blood and 575 of them screened positive for HBV. The overall prevalence of seropositive for hepatitis B was 0.15%. The prevalence was higher at 0.23% among donors born before the year 1989 (pre-vaccination era) compared to 0.05% among donors born in and after the year 1989 (post-vaccination era). Perinatal transmission was found to have 15 times higher odds of developing HBV infection as compared to those who had the combination of risk factors among those born after the year 1989 (adjusted OR=14.95, 95% CI 1.80=124.01). Conclusion: The implementation of the national vaccination programme reduced the prevalence of hepatitis B among donors who received vaccination at birth compared to those who did not.
Introduction: Inadequate mixing during the blood collection process might affect the quality of platelet concentrates (PCs). Currently, two different mixing methods are used during whole blood collection: manual mixing and mixing using an automated blood collection mixer. However, the cost between manual and automated blood collection mixer differed largely and pose a dilemma for a blood transfusion service. The objective of this study was to evaluate PCs quality using either manual mixing or automated procedure. Methods: This was a cross-sectional study conduct- ed at the Advanced Medical and Dental Institute, Universiti Sains Malaysia. Thirty eligible participants aged 20 to 45 were included in this study, and a unit of 450 mL whole blood was collected from each participant. Fifteen units of whole blood were mixed by an automated blood collection mixer and the other 15 units were mixed using the man- ual mixing. All PCs were produced from platelet-rich plasma and stored at 20–24°C for 5 days. Quality parameters such as platelet count, leucocyte count, and pH were measured for each PCs on day 1 and day 5. Results: Platelet count on day 1 was significantly higher than on day 5 (p = 0.01) for both mixing methods. There was no statistically significant difference in any of the PCs quality parameters between the two types of mixing methods at either day 1 or day 5 of storage (p > 0.05). Conclusion: Comparable PCs quality is achieved from both manual mixing and auto- mated procedures.
Introduction: Clinical and sharp bins are commonly found in clinical settings. The usage of these bins is vital to ensure that health care facilities remain hygienic, free from any microbial transmissions and incidences of needle stick injuries. ‘oQ-Ba’ is a Japanese phrase that means bin. In real clinical settings, it is difficult to gather all bins at once while performing procedure due to limitations of space, frequency and mobility of bins. Therefore, ‘oQ-Ba’ the Universal Bins Trolley is developed to improve the waste management practice and increase the efficiency and effectivity of care delivery. Methods: A total of 40 respondents comprised of staffs from Emergency and Trauma De- partment and Haemodialysis Unit at Serian District Hospital were selected to use “oQ-Ba” the Universal Bins Trolley. They were given self-administered questionnaires pre and post-trials whichcomposed of ‘yes’ or ‘no’ answers to ob- tain feedbacks on the effectiveness of this project. Descriptive statistics include frequencies, means and percentages were used to analyze the data using the SPSS version 22. Results: The staffs found that the prototype helps to ensure the availability of the three bins as the bins are all attached together under one compartment. The staffs also found that the prototype is more convenient compared to the existing waste bins because of its mobility and unique design which consumed little amount of space. Conclusion: ‘oQ-Ba’ the Universal Bins Trolley provides handful of benefits to medical practitioners as it can ensure the availability of the three bins during a procedure.
Introduction: Cancer is one of the main causes of mortality globally and the incidence has been rising over the years. Studies have shown that miRNAs have the potential as cancer biomarkers. The miR-130a has been reported to be upregulated in several types of cancer, which indicate the important roles of miR-130a in cancer development and metastasis. The aim of this study is to identify potential target genes and to predict the regulatory function of miR- 130a-3p and 5p in cancer. Methods: Three bioinformatics platforms namely miRWalk, the Database for annotations, visualization and integrated discovery (DAVID) Gene Functional Classification Tool and miRanda-miRSVR analysis tools were used to identify possible interaction between miR-130a and its target. Protein-protein interaction (PPI) network for the predicted target genes was then constructed. Results: The analyses have identified nine predicted target genes for miR-130a-3p (RAPGEF4, SOS2, NRP1, RPS6KB1, MET, IL15, ACVR1, RYR2 and ITPR1), and ten for miR-130a-5p (BCL11A, SPOPL, NLK, PPARGC1A, POU4F2, CPEB4, ST18, RSBN1L, ELF5 and ARID4B), that might
play an important role in the development of cancer. Findings from this report suggest that miR-130a may involves in controlling cancer related genes; MET, ACVR1 and BCL11A. miR-130a-3p may regulates MET which involves in apoptosis and metastasis, and ACVR1 which involves in metastasis and angiogenesis. miR-130a-5p may regulates BCL11A which involves in apoptosis, proliferation and tumorigenesis. Conclusion: This study has highlighted the molecular interaction of miR-130a with associated genes and pathways, suggesting therapeutic potential of miR- 130a as personalised targeted therapy for cancer.
Introduction: The demand for commercial gluten-free food products are increasing due to rising prevalence of lifestyle-related diseases. The market growth is forecasted to increase in numbers. However, to date nutritional com- parison of gluten-free and gluten-containing food products is not done extensively in Malaysia. Therefore, this study aimed to investigate the nutritional composition and cost per 100 g between gluten-free and gluten-containing food products in selected grocery stores in Kuala Lumpur. Methods: A total of 106 food products comprising of gluten-free food products (n=41) and gluten-containing food products (n=65) were determined and compared for its nutritional composition and cost per 100 g. The products were obtained from 4 main grocery stores in Kuala Lumpur that supply gluten-free food products. The differences in nutritional composition and cost between both products were analysed by using independent samples t-test. Results: The results showed no difference in energy content between both prod- ucts. Across the food products, 15 % of gluten-free food products showed higher carbohydrate content compared to its counterparts. Protein content in gluten-free products was 63 % lower than gluten-containing products. Among all gluten-free food products included in this study, only lasagne sheet has lower content of dietary fibre compared to its counterparts. The cost for majority of gluten-free food products was significantly higher, which was two- to four- fold higher compared to gluten-containing products. Conclusion: This study indicated that gluten-free food products showed no nutritional advantage especially in its macronutrients, hence, avoidance of gluten for healthy population may not be beneficial and rather costly.
Introduction: Secure attachment to parents prevents adolescents from externalizing behaviours especially in developing countries. The aim of this study was to identify the contributors to parental attachment in a developing society. Methodology: This cross sectional study was performed on urban secondary students (aged between 13 and 17 years) based on multistage sampling in Pasir Gudang District, Johor, Malaysia. The depression, anxiety and stress (DASS-21) and Inventory of parent and peer attachment (IPPA) questionnaires were used along with a questionnaire for demographic information. Analysis of covariance (ANCOVA) was used to identify the main effect of study parameters on IPPA scores for father and mother. Results: A total of 2980 students (46.9% male and 53.1% female) participated in this study. Mean and SD for age was 14.39±1.28. Depression score and school form had a significant main effect on both paternal and maternal attachment (p