Introduction : Despite the number of information generated by researchers, cardiovascular diseases problem has not clearly declined and perhaps in certain situation it is gradually increasing, affecting people who are previously at low risk. There is a tendency to believe that favourable outcomes can always be expected once intervention activities, like exercise promotion, are carried out, but practical experience gives rise to serious doubt.
Methods : A greater understanding of the socialization mechanisms operating in the adoption of physical activity in CVD control and allow specific exercise prescriptions for communitybased prevention and control is important. This paper highlighted the author’s feeling about controlling chronic diseases by mean of community intervention.
Results : This analysis has strongly believed that the important impetus of any community intervention approach should be oriented in the form of “from people to people”.
Conclusion : More emphasis needs to be placed on effective management and parameters for assessment of its management success.
Researchers all over the world have continuously contributed knowledge on common human cancers and its related risks. Despite these mountains of information, the trend of cancer problems has not significantly declined and perhaps in certain occasion, it gradually increased affecting those who are previously known to be less risky'. Cancer is still identified to be one of the top leading killer worldwide and is also the main source of psychosocial burden of the community particularly to the caregiver' Its problems are expected to be further increased as human beings are constantly modified and manipulated by unpredictable and dynamic human activities and globalization phenomena. Furthermore, the current advances in cancer therapy and others clinical interventions are not always guaranteed of a permanent cure, improve survival or prognosis, sustainable compliances, prolonging life and improving quality of life, thus the mortality and its associated biological and management complications are still prevalence. (Copied from article).
Traumatic cervical epidural hematoma is a rare disease in the pediatric population. It requires a high level of suspicion in children who presents with acute neurological deficit after trauma. Magnetic resonance imaging (MRI) is required to confirm the diagnosis. Early surgical intervention is recommended to have the best neurological outcome. We report a case of a traumatic cervical epidural hematoma in a toddler with complete paraplegia, which partially recovered after decompressive surgery. We would like to emphasize the importance of high suspicion for this condition and the need for an urgent MRI to confirm the diagnosis.
As physical abilities and health decline with age, older adults tend to lose their driving abilities, which affects their mobility. As mobility is important to older adults' wellbeing, there is a need to explore alternative modes of transportation to increase their ability to actively participate in society. Hence, this paper aims to understand the characteristics of private chauffeuring and companionship services for older adults, and to assess their possible effects on older adults' wellbeing. We gathered the views of transport operators, government agencies, and city councils that offer private chauffeuring and companionship services for older adults. We frame the model of private chauffeuring and companionship services as alternative mobility for older adults and outline a conceptual framework for its possible effects on their wellbeing. The underlying mobility characteristics were availability, accessibility, safety, and affordability-all of which influence wellbeing. The study found that the private chauffeuring and companionship model for older adults includes an additional model of government-to-consumer services in addition to the existing peer-to-peer and business-to-consumer services. While the services are available, the services provided are not standardized, with different operators offering different services and prices, and limiting certain geographical areas. Transport operators perceived that the services they offer promote older adults' physical and mental health, improve their social participation in the community, and empower them in making their travel decisions. The findings of the paper provide insights for policy makers for future planning of alternative transportation for older adults to enhance their mobility.
Depression is a frequent companion of stroke. It is associated with a degree of functional impairment that might adversely affect rehabilitation. A study was carried out to determine the rate of self-reported depression at admission and after six months, and the associated factors, in patients with stroke who were referred for rehabilitation. A multiple binary logistic regression was used to determine the associated factors at six months. Depression was recorded in 45% of patients at admission and in 39% at six months after the stroke. Patients who were employed, those who were depressed at admission, those who did not return to work and those who did not return to driving six months after stroke, were significantly associated with depression.
Mid-aortic syndrome (MAS) is a rare clinical entity that is
characterized by coarctation involving the distal thoracic and/or
abdominal aorta and its major branches accounting for 0.5–2%
of all cases of coarctation of the aorta (1). Renovascular
hypertension can be a significant sequelae - it is the main
symptomatic presentation of this disease among children and
adolescents. We describe a 9-year-old girl who presents with
recurrent abdominal pain and symptomatic hypertension. Due to
significant left ventricular systolic dysfunction and uncontrolled
hypertension, percutaneous balloon angioplasty was performed
to treat the coarctation. To our knowledge, this is the first
reported case of MAS in Malaysia. This case report highlights
the clinical presentation, the role of computed tomography
angiogram (CTA) in the diagnosis and current options in the
management of MAS.
Coexistence of asymptomatic balanced double aortic arch with tetralogy of Fallot (TOF) is extremely rare and represents a surgical dilemma in decision-making due to the lack of consensus on the management of this subset of patients. We report a case of asymptomatic balanced double aortic arch coexistent with TOF in a two-year-old girl.
There is a scarcity in both epidemiological studies and forecast models on the impact of air pollution on respiratory allergic responses in Malaysia. The quantification of baseline allows for an understanding of the severity of the impact and target areas for intervention. High-quality forecasts not only provide information for the assessment of potential outcomes but also the dissemination of public health warnings, such as the application of mobile-based early warning systems. There is a need for a data repository system that facilitates research on such studies. However, a call for more evidence should not put a pause on actions and future plans that will help reduce pollution emission and exposure to air pollutants as there are sufficient evidence to indicate that air pollutants impact health.
Inborn errors of immunity (IEI) (also known as primary immunodeficiencies) is an umbrella term for a growing group of over 450 different disorders that are characterized by defects in some of the components of the immune system. IEI are chronic diseases of genetic origin that render individuals suffering from them susceptible to infections. The mainstay of treatments for most patients with IEI, that is, predominantly antibody deficiencies is immunoglobulin replacement therapy (IRT), which is commonly delivered intravenously. Immunoglobulin (IG) therapy contains antibodies to compensate for the defective immune system's inability to produce them. Individuals with IEI need IRT regularly throughout their lives to help combat infections and prevent organ damage. Without IRT, they are in danger of suffering from morbidity, poor quality of life, and reduced life expectancy. In the last 20 years, the use of IG preparation has tripled and this is partly attributed to the growing awareness and improved diagnoses of IEI cases. IG preparations are also used for the treatment of other medical conditions including secondary immunodeficiencies and autoimmune diseases. As IG is derived from human plasma, there are concerns about the availability of supply, particularly to treat life-threatening conditions that cannot be improved with other medications. It is estimated that 75% to 80% of IEI patients do not have access to adequate IG therapy throughout the world. This concern of supply and other challenges faced by patients with IEI in Malaysia are described from the patients' perspective.
The pig-tailed macaque, Macaca nemestrina, which is distributed in Peninsular Malaysia, Thailand, Borneo, and Sumatra, has been the subject of unstable and changing taxonomic entity in the M. nemestrina group. This species is involved with a human-macaque conflict in Malaysia and at the same time played an important role in the ethnozoological culture of Malaysian. Even so, comprehensive phylogenetic, population genetics and biogeographical analysis of M. nemestrina in Malaysia are non-existent after decades of intensive research on the genus itself. Thus, we conducted the first comprehensive genetic study of M. nemestrina in Malaysia, based on three mitochondrial loci-Cytochrome b (567 bp), D-loop (398 bp), and COI (577 bp)-from 27 individuals representing Malaysia, plus an additional 26 sequences of Southeast Asian macaques from Genbank. Comparative biogeographical analysis in this study supports the positions of M. nemestrina in M. nemestrina groups as opposed to the silenus or Sulawesi groups. Results from this study also indicate that Bornean populations are the first extant lineages to separate from the other examined lineages of M. nemestrina, M. leonina, M. pagensis, and M. siberu in Southeast Asia. Molecular clock analysis suggested that M. nemestrina arrived in the Malay Peninsula about 0.32 million years ago (MYA). Our results indicate that the population of pig-tailed macaque from Perak (west Peninsular Malaysia) differs genetically based on all phylogenetic and population genetic analyses. Morphologically, Perak's pig-tailed macaque shows brighter coloration than M. n. nemestrina. Thus, we proposed a new subspecies for Perak's pig-tailed macaque as Macaca nemestrina perakensis distributed in the state of Perak, Peninsular Malaysia. This research helps resolve the taxonomic position and population genetics of pig-tailed macaque in Malaysia, which contribute directly to conservation and management of the species in Malaysia.
As a small-although growing-journal based in Malaysia, the Malaysian Journal of Medical Sciences (MJMS) has faced several challenges in the past, such as promoting our journal as well as making sure our article bank does not go empty. However, we strive to improve ourselves by taking all means necessary to increase the quantity and, most importantly, quality of our publications, as well as to increase our journal's visibility and citability. This editorial will focus on MJMS statistics throughout 2011-where MJMS turned 18-as well as future plans for our journal.
We report here a case of severe iron deficiency anaemia resulting from prolonged exclusive milk diet without any iron supplementation. The patient was a 1112 year old boy, the only child of a factory worker, who was breasffed until 4 months of age followed by exclusive feeding by non-fortifiedformula. He presented with severe iron deficiency anaemia with haemoglobin of4 .0g% and required blood trans-fusion. Iron and.vitamin supplements were given and cereals were slowly introduced. He responded very well to the treatment with satis-factory weight gain and improvement of anaemia. (Copied from article).
This study targeted two candidate genes from the best known regulator of blood pressure; the rennin angiotensin system; the ACE gene I/D polymorphism and the angiotensinogen M235T polymorphism. The study aimed to determine the genotypes trend between two different populations; the primary hypertensive patients, and the normal populations. 126 subjects were involved in this study (86 primary hypertensive patients and 40 normal individuals). All demographic factors were considered and analyzed. Insertion/deletion polymorphisms of the ACE gene were determined by an assay based on the polymerase chain reaction (PCR). Polymorphism analysis using PCR-RFLP procedure was used to identify the missense mutation M235T of the AGT gene. All significant data was collected using standardized case report form. The association of the different genotypes and the subjects’ condition was analyzed using the chi squared and odds ratio analyses. In the pooled analysis of both groups, it was shown that the polymorphisms in these genes were significantly associated with the incidence of primary hypertension, p<0.05. Results also showed that the D allele of the ACE gene may be associated with increased risk of primary hypertension (p<0.05, O.R: 3.0 [C.I: 1.25 – 5.35]). The angiotensinogen M235T polymorphism also showed a significant result; the T allele is associated with increased risk of primary hypertension (p<0.05, O.R: 2.56[C.I: 1.55 – 5.28]). This knowledge of the candidate genes of rennin angiotensin system has rendered it possible to show that gene polymorphism in symphony leads to the individual risk of primary hypertension.
Keywords: ACE, M235T, rennin, hypertension
Study site: University Kebangsaan Malaysia Medical Center and International Medical University Cardiology Clinic
Workplace bullying has drawn greater attention in the last one and half decades. Despite its recognition by many organizations and countries, it is still rife. Why is that so? Could it be that the root of the problem has not been addressed? Or, could it be due to difficulties and resistances in embarking preventive and control measures. In this paper, we will examine the possible causes of workplace bullying based on a proposed model. In depth discussion of the personal and organizational factors are made while the work group and societal factors are dealt with in brief. In summary, the root of workplace bullying is multi-factorial. Understanding the complexity and subtlety of workplace bullying is pertinent in the effort to prevent or curtail it.
Rheumatic mitral stenosis is prevalent in this part of the world and it gives rise to wide array of manifestations. However, hoarseness of voice secondary to recurrent laryngeal nerve paralysis (Ortner's syndrome) is an uncommon manifestation. This case illustrates an uncommon presentation in a common disease. A 29-year-old lady presented with a 2-year history of hoarseness of voice. Physical examination revealed a mid-diastolic murmur and left vocal cord paralysis. Echocardiography confirmed mitral stenosis with pulmonary hypertension. She underwent percutaneous mitral balloon valvotomy in 1991 with return of normal speech after a few months. The recurrent laryngeal nerve paralysis is mainly due to the compression by an enlarged pulmonary artery as initially thought. This complication is rarely seen nowadays due to greater awareness of the disease and earlier intervention. With the advent of percutaneous transvenous mitral valvotomy in the nineties, effective non-surgical intervention is plausible.
We describe a 5-year-old girl who had sudden onset difficulty in walking after 3 days of febrile illness. In the emergency department her creatine kinase level was elevated but urine myoglobin was normal. She was diagnosed as having benign acute childhood myositis. Because of poor oral intake and dehydration, she was admitted to the pediatric ward. The next day she had a petechial rash over the antecubital fossa, and dengue IgM back was positive. She was treated conservatively and recovered uneventfully. Despite dengue fever being endemic in Malaysia, this is the first case report of myositis following dengue infection in Malaysia.
Postpartum depression is one of the major depressions experienced by women during three months after giving birth to their babies. The symptoms of this type of depression cannot be taken lightly as it affects not only the women but also the development of the babies, family harmony and functioning and can in fact harm themselves and other individuals in their surrounding. Thus, this research was conducted to identify the influence of parental stress towards postpartum depression. A total of 181 women participated in this study and they were from two groups namely married and unmarried women who just gave birth. Two instruments were used and they were the Postpartum Depression Screening Scale and the Parental Stress Index Short Form. Results obtained showed that parental stress and its dimensions were significantly correlated with postpartum depression. In addition, maternal stress and difficult child characteristics were significant predictors of postpartum depression. Findings also showed that there were significant differences of parental stress and its dimensions between married and unmarried women who just gave birth. These findings imply the importance of coping with parental stress to prevent women from experiencing postpartum depression.
Keywords Postpartum Depression · Parental Stress · Child Characteristics · Regression