The issue of antibiotic resistance has been around ever since the first antibiotic penicillin was introduced to the world. It continues to rise, becoming a major problem across the globe and Malaysia is no exception. Hospital is a critical component of the antibiotic resistance problem worldwide. The problems of antibiotic resistance are typically magnified in a hospital setting due to the common variables in the hospital environment that favour its development. These include a combination of highly susceptible patients, intensive and prolonged antibiotic use, and crossinfection resulting in nosocomial infections with highly resistant bacterial pathogens such as multi-resistant gram-negative rods, vancomycin resistant enterococci (VRE) and methicillinresistant Staphylococcus aureus (MRSA) as well as resistant fungal infections. Transmission of highly resistant bacteria from patient to patient within the hospital environment amplifies the problem of antibiotic resistance and may result in the infection of patients who are not receiving antibiotics. Transmission of antibiotic-resistant strains from hospital personnel to patients or vice versa may also occur. What are the available strategies and what works best in managing antibiotic resistance in the hospital? This review will highlight the seriousness of the resistance problem and identify actions that address it especially in the context of improving the problem in Malaysian hospitals.
: Reconstruction of the primary defect following resection of primary tumour is part of
the surgical treatment of head and neck cancer.The present paper reports a case of reconstruction
of medium size through and through defect of the cheek with the transverse platysma
myocutaneous flap combined with the temporalis flap. (Copied from article).
A Poisson model typically is assumed for count data, but when there are so many zeroes in the response variable, because of overdispersion, a negative binomial regression is suggested as a count regression instead of Poisson regression. In this paper, a zero-inflated negative binomial regression model with right truncation count data was developed. In this model, we considered a response variable and one or more than one explanatory variables. The estimation of regression
parameters using the maximum likelihood method was discussed and the goodness-of-fit for the regression model was examined. We studied the effects of truncation in terms of parameters estimation, their standard errors and the goodnessof-fit statistics via real data. The results showed a better fit by using a truncated zero-inflated negative binomial regression model when the response variable has many zeros and it was right truncated.
A preliminary survey on sixty-nine 7 to 12 year old Temuan tribe school children living some 30 kilometers from Kuala Lumpur was conducted. The examinations were carried out using a chair-table set up with natural daylight as the source of light. The DMF index of klein, Palmer and Knutson was used to assess the dental caries status. In spite of low fluoride content in their water supply, the findings revealed a generally low prevalence of caries experience (DMFT 1.26). The highest DMFT was in the 11 year olds. The relationship between these findings and their possible causes are discussed.
Acacia mangium, a fast growing tree is widely planted in Malaysia. Converting Acacia wood into nanocellulose could create new value added products for forest-based industry. Nanocrystalline cellulose (NCC) was prepared from Acacia mangium wood pulp via 64wt% sulfuric acid hydrolysis. Prior to acid hydrolysis, Acacia mangium was subjected to pulping followed by bleaching in order to remove non-cellulosic fragments. Acid hydrolysis was carried out on bleached pulp to produce the needle-like NCC with 79% crystallinity and aspect ratio of 26. The resulting NCC was mixed with PVA as a reinforcement material. Incorporation of 2% NCC improved the tensile of the NCC-PVA film by 30%.
The COVID-19 pandemic resulted in more than 4.3 million confirmed cases and more than 2,90,000 deaths worldwide. It has also given rise to fears of an imminent economic crisis and recession. Social distance, self-isolation, and travel restrictions have led to a reduction in the workforce across all economical sectors and have led to a loss of many jobs. Schools have closed down, and the need for commodities and manufactured goods has decreased. On the other hand, the need for medical supplies has increased significantly. The food sector is also facing increased demand as a result of panic buying and storing food products. In response to this global outbreak, we summarize the socioeconomic effects of COVID-19 on the various aspects of the world economy. In Malaysia, the COVID-19 epidemic has checked the resilience of the agriculture sector. Especially the Malaysian paddy industry as country imports 30% of its overall consumption from different parts of the world. The real price of rice triplicating for the consumers, which was alarming for nations in this pandemic situation. The Government of Malaysia introduced the National Agrofood Policy 2011-2020 (NAP4) in 2010 as a guidance document for the implementation of agricultural sector development programs and projects in Malaysia. The NAP4 's 10-year term is to be finished by the end of 2020. Several sectors demonstrate substantial success after approximately 8 years of introduction, while the other classes often lag behind the goal and progress quite slowly. Agricultural sector performance is affected by many problems and challenges. In acknowledgment of the poor success of this field, the Ministry of Agriculture and Agri-Based Industry has launched new approaches, policies, and programs that can change the agricultural sector more rapidly. The new direction is aimed at ensuring national food security and boosting farm and revenues. The authorized government agency needs to revise the policy formulation where Malaysia needs to set stages to revolutionize and modernize the rice farming to address the problem faced by the paddy sector in this pandemic situation to adopt GF. In this study, the researcher focuses on the improvisation of the policy to increase the paddy production sustainably.
The purpose of this study was to investigate the relationship of biochemical (enzymes) and nutritional components in the selected honey samples from Malaysia. The relationship is important to estimate the quality of honey based on the concentration of these nutritious components. Such a study is limited for honey samples from tropical countries with heavy rainfall throughout the year.
BACKGROUND: A double-blind randomised control study was conducted on all patients who were admitted or referred to the Department of Neurosurgery, Sultanah Aminah Hospital, Johor Bahru, with a diagnosis of hydrocephalus where a ventriculoperitoneal shunt was indicated.
METHODS: The period of study was from November 2005 to May 2007, and the follow-up period was 3 months after surgery. Randomisation was carried out in the operating room prior to the procedure. The scrub nurse selected a sealed envelope, which contained the assignment of each patient to 1 of 2 treatment groups: Group 1 patients were treated with topical methicillin, and Group 2 patients were not treated with topical methicillin. Prophylactic antibiotic, cefuroxime (25 mg/kg) was given intravenously at induction. Standard sterile operative technique was followed in preparing and draping the patients.
RESULTS: A total of 90 patients were recruited in the study, and 13 (14.4%) patients developed an infection within 3 months post-operation. Group 1 had a 8.9% risk of infection, and Group 2 had a 20% risk; however, there was no statistically significant post-operative ventriculoperitoneal shunt (VPS) infection reduction with the use of topical methicillin in VPS surgery (P = 0.230). Multivariate analysis showed that only duration of surgery had a significant influence on the incidence of post-operative VPS infection in the non-methicillin group (P = 0.02). The non-methicillin group had an 8 times greater risk of developing post-operative VPS infection than the methicillin group if surgery lasted longer than 1 hour.
CONCLUSION: Topical methicillin had no significance in the reduction of post-operative VPS infection.
KEYWORDS: methicillin; neurosurgery; post-operative wound infection; topical administration; ventriculoperitoneal shunt
Study site: Patient admitted or referred to Hospital Sultanah Aminah Johor Bahru, Johor, Malaysia
Trauma patients presented to emergency department usually come with spinal immobilization device as a precaution and initial pre-management care by emergency medical personnel. These types of patients are at higher risk for suspected cervical fractures and internal injuries. The use of cervical collar raises some issues on radiation dose to the patient and image quality.
Therefore, the use of cervical collar in routine trauma patients is questioned by researchers. The
purpose of this paper was to investigate the effect of cervical collar on entrance surface dose, exit surface dose and image quality. Methods: Siemens Multix Top CR System and Kyoto Kagaku PBU-50 Body Phantom was used. The phantom was positioned supine on the table couch and was exposed with and without cervical collar. An Anteroposterior (AP) Axial cervical projection was performed and the phantom was also exposed with and without Automatic Exposure Control (AEC) to study the effects on radiation dose and image quality. The dose reading was recorded in all exposures and compared. Images obtained were analyzed for Signal to Noise Ratio (SNR). Results: Lower entrance dose was recorded with cervical collar when the AEC was disabled during the exposure and the results were vice versa when the AEC was enabled. Higher exit dose was calculated when cervical collar was applied to the phantom. Greater signal to noise ratio (SNR) was observed with cervical collar. Conclusions: This study concluded that cervical collar adds to exit dose and without any impact on image quality. The entrance surface dose recorded with cervical collar and AEC disabled was lower compared to when it was removed. However, the entrance surface dose recorded with cervical collar and the AEC enabled was higher compared to when it was removed.
The distribution and abundance of zooplankton species of Harapan and Aman
Lakes were investigated in relation to physical parameters and chlorophyll-a content. Both
lakes were characterised by the occurrence of algal bloom problem. The composition of
zooplankton was collected at monthly intervals from November 2013 to February 2014.
The total number of taxa in Harapan and Aman Lakes were 23 and 27, respectively.
Rotifera was the highest abundance group represent 64% of the total species recorded
followed by Copepoda (29%) and Cladocera (7%). Three dominant zooplankton that been
recorded in both the lakes are Brachionus forficula, Brachionus nilsoni, and Trichocerca
sp. High abundance of these species indicates that the lakes are eutrophic water bodies.
Overall, zooplankton species distribution and abundance in the study sites are influenced
by various environmental factors such as water transparency and chlorophyll-a content.
Occupational health hazards as a result to exposure to mineral dust containing silica has been established long time ago in occupational health history. Its effects on lung function and symptom was evaluated in a cross sectional studied among 49 small enterprise pottery workers in the county of Sayong clustered in 3 villages. Respiratory symptoms and lung function was evaluated using MRC respiratory questionnaire 86 and standard spirometry performed. The prevalence of chronic cough, phlegm and chest tightness was 24.5%, 16% and16% respectively. There was no significant decrement in lung function parameters from the predicted normal value with the mean predicted FVC; FEV1 and FEV1/FVC ratio was 85.32%, 83.87% and 99.22 respectively. The relationship between lung symptoms and lung function parameters was evaluated and the result was not significant.
Aim: The objective of the present study was to assess the validity and reliability of Malay version of the QOLLTI-F questionnaire.
Methods: A total of 80 Malay caregivers of cancer patients in an outpatient oncology clinic were enrolled in this study. A translated QOLLTI-F questionnaire of 16 items was used in order to assess their quality of life. Demographic characteristics were recorded. Both face and content validity of the translated version were carried out by professionals and the construct validity of the questionnaire was assessed by exploratory factor analysis.
Results: Exploratory factor analysis led to the extraction of seven factors and this was consistent with the English version. Cronbach Alpha coefficient showed good consistency of the questions within the sub-scales (Cronbach's alpha > 0.7).
Conclusion: This study was confined to a Malay population, and the analyses were potentially limited by a small sample size .Nevertheless, the translated questionnaire demonstrated valid and reliable psychometric properties when administered to Malay caregivers. Future studies are needed to see if this instrument can fit other samples in different settings and populations.
Study site: Oncology clinic, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
Nanofluid has become one of the interesting topics for engineers working for decades to
develop more efficient heat transfer in different applications. Nanorefrigerant, as a combination of
nanoparticles and refrigerant, is a new concept that has been recently investigated by number of
researchers. Electricity consumption usually varies from one sector to another. Generally, residential
sector is one of the biggest electricity consumers in Malaysia. Based on the literature, 26.3% of
electricity consumption in the residential sector in Malaysia is allocated to refrigerator–freezers.
Protein antigen-i parasit ikan C. irritans berpotensi tinggi digunakan sebagai calon dalam pembangunan vaksin komersial terhadap C. irritans. Walau bagaimanapun, kewujudan variasi pada antigen-i serotip C. irritans yang berbeza mempengaruhi tahap perlindungan yang bakal diberikan terhadap varians C. irritans yang berbeza apabila antigen-i digunakan sebagai vaksin. Kajian ini dijalankan untuk membandingkan jujukan pelbagai antigen-i pencilan C. irritans di Malaysia berbanding antigen-i pencilan C. irritans yang pernah dilaporkan. Perbandingan filogenetik dijalankan untuk meramalkan potensi protein tersebut dalam usaha membangunkan calon serodiagnostik dan pemvaksinan terhadap pencilan C. irritans yang berlainan. Penjajaran jujukan berbilang bagi jujukan asid amino antigen-i dilakukan dengan perisian CLUSTALX dan analisis filogenetik antigen-i dilakukan menggunakan kaedah parsimoni maksimum (MP) dan kaedah Bayes. Sembilan transkrip unik (TU) C. irritans yang mempunyai padanan signifikan dengan antigen-i di pangkalan data protein NCBI didapati mempunyai peratus kesamaan antara 41% hingga 71%. Kedua-dua pohon MP dan Bayesian yang dijana menunjukkan varians antigen-i cn56 and cn57 terkelompok bersama dalam satu kumpulan manakala varians antigen-i yang lain terbahagi kepada dua kumpulan berasingan dan pengkelompokan ini disokong oleh kehadiran asid amino yang terpulihara dalam kumpulan masing-masing. Kajian lanjutan boleh dilakukan untuk mengenal pasti varians antigen-i yang sesuai sebagai calon serodiagnosis dan juga dapat memberi perlindungan silang terhadap pelbagai pencilan C. irritans di serata dunia.
Long-distance running has gathered some momentum among health-conscious participants. However, some
studies have revealed association between long-distance running and development of acute kidney injury.
Although the impact usually lasts only for a few days after the event, some participants have been admitted for
severe acute kidney injury, the minority of which require dialysis treatment. The mechanisms underlying the
injury may include dehydration, development of rhabdomyolysis, heat stroke and concomitant use of NSAIDS.
Unfortunately, there is no long-term follow-up study to determine the long-term effect on kidney function.
Acute hyponatremia may develop in a significant proportion of long-distance runners. Majority of them were
asymptomatic but a few fatal cases which were supposedly due to cerebral oedema have been reported.
Excessive intake of hypotonic drinks, excessive sweating and secretion of non-osmotic antidiuretic hormone
have been postulated to be the causes of hyponatremia. This mini review will discuss the pathophysiology of
the development of acute kidney injury and hyponatremia. It will also discuss the prevention and treatment
of both conditions.
The research on damages of structures that are supported by deep foundations has been quite intensive in the past decade. Kinematic interaction in soil-pile interaction is evaluated based on the p-y curve approach. Existing p-y curves have considered the effects of relative density on soil-pile interaction in sandy soil. The roughness influence of the surface wall pile on p-y curves has not been emphasized sufficiently. The presented study was performed to develop a series of p-y curves for single piles through comprehensive experimental investigations. Modification factors were studied, namely, the effects of relative density and roughness of the wall surface of pile. The model tests were subjected to lateral load in Johor Bahru sand. The new p-y curves were evaluated based on the experimental data and were compared to the existing p-y curves. The soil-pile reaction for various relative density (from 30% to 75%) was increased in the range of 40-95% for a smooth pile at a small displacement and 90% at a large displacement. For rough pile, the ratio of dense to loose relative density soil-pile reaction was from 2.0 to 3.0 at a small to large displacement. Direct comparison of the developed p-y curve shows significant differences in the magnitude and shapes with the existing load-transfer curves. Good comparison with the experimental and design studies demonstrates the multidisciplinary applications of the present method.
Grouped and single pile behavior differs owing to the impacts of the pile-to-pile interaction. Ultimate lateral resistance and lateral subgrade modulus within a pile group are known as the key parameters in the soil-pile interaction phenomenon. In this study, a series of experimental investigation was carried out on single and group pile subjected to monotonic lateral loadings. Experimental investigations were conducted on twelve model pile groups of configurations 1 × 2, 1 × 3, 2 × 2, 3 × 3, and 3 × 2 for embedded length-to-diameter ratio l/d = 32 into loose and dense sand, spacing from 3 to 6 pile diameter, in parallel and series arrangement. The tests were performed in dry sand from Johor Bahru, Malaysia. To reconstruct the sand samples, the new designed apparatus, Mobile Pluviator, was adopted. The ultimate lateral load is increased 53% in increasing of s/d from 3 to 6 owing to effects of sand relative density. An increasing of the number of piles in-group decreases the group efficiency owing to the increasing of overlapped stress zones and active wedges. A ratio of s/d more than 6d is large enough to eliminate the pile-to-pile interaction and the group effects. It may be more in the loose sand.
Studies have shown that differences between children with and without handwriting difficulties lie not only in the written product (static data) but also in dynamic data of handwriting process. Since writing system varies among countries and individuals, this study was conducted to determine the feasibility of using quantitative outcome measures of children's drawing to identify children who are at risk of handwriting difficulties. A sample of 143 first graders of a normal primary school was investigated regarding their handwriting ability. The children were divided into two groups: test and control. Ten children from test group and 40 children from control group were individually tested for their Visual Motor Integration skills. Analysis on dynamic data indicated significant differences between the two groups in temporal and spatial measures of the drawing task performance. Thus, kinematic analysis of children's drawing is feasible to provide performance characteristic of handwriting ability, supporting its use in screening for handwriting difficulty.
Two traditional fermented food 'tapai' (fermented tapioca) and 'tempoyak' (fermented durian flesh), chilli puree and fresh goat's milk were used as sources for the isolation of lactic acid bacteria (LAB). A total of 126 isolates were obtained and by sequential screening for catalase activity and Gram-staining, 55 were determined to be LAB out of which 16 were established to be homofermentative by the gel plug test. Seven isolates were identified by use of the API 50CHL kit and two lactobacilli strains and one lactococci strain were selected to study their growth and lactic acid production profiles in a time course experiment. The lactobacilli strains, both isolated from 'tapai', produced higher amounts of cells and lactic acid from glucose as compared to the lactococci strain isolated from fresh goat's milk.