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Fulltext The effect of prehospital epinephrine in out-of-hospital cardiac arrest: a systematic review and meta-analysis

Teoh WY, Ng KT

Future Healthc J, 2019 Jun;6(Suppl 2):42.
PMID: 31572937 DOI: 10.7861/futurehosp.6-2s-s42
Fulltext A comparative study of first and third year student nurses' knowledge and attitudes on the elderly and ageing

Wan YC, Poi PJH

Med J Malaysia, 1997 Sep;52(3):238-43.
PMID: 10968092

A comparative study was carried out to assess Year I and Year III student nurses' attitudes and knowledge of the elderly. Significantly more Year I students disagreed that the elderly had a capacity to learn (chi 2 = 11.08, p = 0.0006). Year III students were significantly more likely to obtain information about the elderly from the mass media, agencies, and relatives but not from health personnel. Nearly all respondents (96.25%) in the study wanted to know more about the elderly. Only 3 of the 14 questions on ageing revealed significant differences in knowledge between the two groups. The basic course in gerontology should be expanded and revised to dispel erroneous attitudes, allow better understanding of the ageing process, and ensure entry-level competence in caring for older people.
The effect of intravenous magnesium on postoperative morphine consumption in noncardiac surgery: A systematic review and meta-analysis with trial sequential analysis

Ng KT, Yap JLL, Izham IN, Teoh WY, Kwok PE, Koh WJ

Eur J Anaesthesiol, 2020 Mar;37(3):212-223.
PMID: 31977626 DOI: 10.1097/EJA.0000000000001164

BACKGROUND: Several studies suggest that systemic magnesium reduces postoperative opioid consumption and the intensity of pain, but others report conflicting results. The efficacy and safety profile of intravenous magnesium in noncardiac surgery remain uncertain.
OBJECTIVES: The aim of this review was to investigate the effect of intravenous magnesium on the consumption of postoperative morphine in the first 24 h in adults undergoing noncardiac surgery.
DESIGN: Systematic review and meta-analysis with trial sequential analysis.
DATA SOURCES: MEDLINE, EMBASE, CENTRAL from their inception until January 2019.
ELIGIBILITY CRITERIA: All randomised clinical trials comparing intravenous magnesium versus placebo in noncardiac surgery were systematically searched in the databases. Observational studies, case reports, case series and nonsystematic reviews were excluded.
RESULTS: Fifty-one trials (n=3311) were included for quantitative meta-analysis. In comparison with placebo, postoperative morphine consumption at 24-h was significantly reduced in the magnesium group, with a mean difference [95% confidence interval (CI)] of -5.6 mg (-7.54 to -3.66, P
Fulltext New Paradigms for Virus Detection, Surveillance and Control of Zika Virus Vectors in the Settings of Southeast Asia

Vythilingam I, Sam JI, Chan YF, Khaw LT, Sulaiman WY

Front Microbiol, 2016;7:1452.
PMID: 27679623 DOI: 10.3389/fmicb.2016.01452

Zika virus (ZIKV) has now become a global public health concern. The vectors for ZIKV are Aedes aegypti and A. albopictus. Both these mosquitoes are predominant in Southeast Asia and are also responsible for the spread of other arboviral diseases like dengue virus and chikungunya virus. The incidence of dengue has been increasing over the years and this is of concern to public health workers. Simple laboratory tools for the detection of ZIKV is also lacking. In the absence of drugs and vaccine for these arboviral diseases, vector control is the main option for surveillance and control. Aedes larval surveys have been the hallmark of dengue control along with larviciding and fogging when cases are reported. However, we need new paradigms and options for control of these vectors. The current situation in Southeast Asia clearly proves that effective strategies for vector control need to be proactive and not reactive. This will be the way forward to control epidemics of these diseases inclusive of ZIKV until a vaccine becomes available.
Epidemiology, clinical characteristics, laboratory findings and severity of respiratory syncytial virus acute lower respiratory infection in Malaysian children, 2008-2013

Ng KF, Tan KK, Sam ZH, Ting GS, Gan WY

J Paediatr Child Health, 2017 Apr;53(4):399-407.
PMID: 27704652 DOI: 10.1111/jpc.13375

AIM: The aim of this study is to describe epidemiology, clinical features, laboratory data and severity of respiratory syncytial virus (RSV) acute lower respiratory infection (ALRI) in Malaysian children and to determine risk factors associated with prolonged hospital stay, paediatric intensive care unit (PICU) admission and mortality.
METHODS: Retrospective data on demographics, clinical presentation, outcomes and laboratory findings of 450 children admitted into Tuanku Jaafar Hospital in Seremban, Malaysia from 2008 to 2013 with documented diagnosis of RSV ALRI were collected and analysed.
RESULTS: Most admissions were children below 2 years old (85.8%; 386/450). Commonest symptoms were fever (84.2%; 379/450), cough (97.8%; 440/450) and rhinorrhea (83.6%; 376/450). The median age among febrile patients (n = 379) was 9.0 months with interquartile range (IQR) of 4.0-19.0 months whereas the median age among those who were apyrexial (n = 71) was 2 months with IQR of 1-6 months (P-value <0.001). 15.3% (69/450) needed intensive care and 1.6% (7/450) died. Young age, history of prematurity, chronic comorbidity and thrombocytosis were significantly associated with prolonged hospital stay, PICU admission and mortality.
CONCLUSIONS: Infants less than 6 months old with RSV ALRI tend to be afebrile at presentation. Younger age, history of prematurity, chronic comorbidity and thrombocytosis are predictors of severe RSV ALRI among Malaysian children. Case fatality rate for Malaysian children below 5 years of age with RSV ALRI in our centre is higher than what is seen in developed countries, suggesting that there is room for improvement.
Fulltext Evidence of Enriched, Hadean Mantle Reservoir from 4.2-4.0 Ga zircon xenocrysts from Paleoarchean TTGs of the Singhbhum Craton, Eastern India

Chaudhuri T, Wan Y, Mazumder R, Ma M, Liu D

Sci Rep, 2018 May 04;8(1):7069.
PMID: 29728630 DOI: 10.1038/s41598-018-25494-6

Sensitive High-Resolution Ion Microprobe (SHRIMP) U-Pb analyses of zircons from Paleoarchean (~3.4 Ga) tonalite-gneiss called the Older Metamorphic Tonalitic Gneiss (OMTG) from the Champua area of the Singhbhum Craton, India, reveal 4.24-4.03 Ga xenocrystic zircons, suggesting that the OMTG records the hitherto unknown oldest precursor of Hadean age reported in India. Hf isotopic analyses of the Hadean xenocrysts yield unradiogenic 176Hf/177Hfinitial compositions (0.27995 ± 0.0009 to 0.28001 ± 0.0007; ɛHf[t] = -2.5 to -5.2) indicating that an enriched reservoir existed during Hadean eon in the Singhbhum cratonic mantle. Time integrated ɛHf[t] compositional array of the Hadean xenocrysts indicates a mafic protolith with 176Lu/177Hf ratio of ∼0.019 that was reworked during ∼4.2-4.0 Ga. This also suggests that separation of such an enriched reservoir from chondritic mantle took place at 4.5 ± 0.19 Ga. However, more radiogenic yet subchondritic compositions of ∼3.67 Ga (average 176Hf/177Hfinitial 0.28024 ± 0.00007) and ~3.4 Ga zircons (average 176Hf/177Hfinitial = 0.28053 ± 0.00003) from the same OMTG samples and two other Paleoarchean TTGs dated at ~3.4 Ga and ~3.3 Ga (average 176Hf/177Hfinitial is 0.28057 ± 0.00008 and 0.28060 ± 0.00003), respectively, corroborate that the enriched Hadean reservoir subsequently underwent mixing with mantle-derived juvenile magma during the Eo-Paleoarchean.
A review of applied research on low-carbon urban design: based on scientific knowledge mapping

Wang G, Wan Y, Ding CJ, Liu X, Jiang Y

Environ Sci Pollut Res Int, 2023 Oct;30(47):103513-103533.
PMID: 37704820 DOI: 10.1007/s11356-023-29490-w

The construction of low-carbon cities is an essential component of sustainable urban development. However, there is a lack of a comprehensive low-carbon city design and evaluation system that incorporates "carbon sink accounting-remote sensing monitoring-numerical modelling-design and application" in an all-around linkage, multi-scale coupling, and localized effects. This paper utilizes the Citespace tool to evaluate low-carbon city design applications by analyzing literature in the Web of Science (WOS) core collection database. The results reveal that low-carbon cities undergo four stages: "measurement-implementation-regulation - management." The research themes are divided into three core clustering evolutionary pathways: "extension of carbon sink functions," "spatialisation of carbon sink systems," and "full-cycle, full-dimensional decarbonisation." Applications include "Utility studies of multi-scale carbon sink assessments," "Correlation analysis of carbon sink influencing factors," "Predictive characterisation of multiple planning scenarios," and "Spatial planning applications of urban sink enhancement." Future low-carbon city construction should incorporate intelligent algorithm technology in real-time to provide a strong design basis for multi-scale urban spatial design with the features of "high-precision accounting, full-cycle assessment and low-energy concept."
Fulltext Biochemical aspirin resistance in stroke patients - a cross-sectional single centre study

Azmin S, Sahathevan R, Rabani R, Nafisah WY, Tan HJ, Raymond AA, et al.

EXCLI J, 2013;12:907-15.
PMID: 27092036

BACKGROUND: Aspirin use is known to reduce the recurrence of stroke. However, the clinical response to aspirin has been mixed. The rate of stroke recurrence whilst on aspirin treatment is still unacceptably high. A plausible explanation for this may be resistance to the effects of aspirin. The causes of aspirin resistance are manifold and multi-factorial. We conducted a study to investigate the prevalence rate of biochemical aspirin resistance in a cohort of aspirin-naïve stroke patients. We also sought to determine the inherent factors that may predispose towards the development of aspirin resistance.
METHOD: This was a cross-sectional, observational study conducted on patients admitted to our centre with an acute stroke who were aspirin-naïve. The diagnosis of an acute stroke was confirmed by clinical history and brain imaging. Fifty consecutive patients were prospectively enrolled. Socio-demographic data were collected and baseline blood investigations were performed. Patients were tested for biochemical aspirin resistance using Multiplate platelet analyser (Dynabyte, Munich, Germany) after 5 doses of aspirin, corresponding to a total dose of 900 mg.
RESULTS: The median age of patients was 65.5 years and 54 % of patients were female. There were 11 smokers; of these 10 were male. Twenty-six (52 %) patients were Chinese, 21 (41 %) were Malay and 3 (6.0 %) were Indian. Aspirin resistance was present in 14 % of our patients. There was an inverse relationship between the presence of aspirin resistance and plasma HDL levels (r = -0.394; p = 0.005). There was no relationship observed between aspirin resistance and total cholesterol, triglycerides, LDL, HbA1c, ALT, ALP, urea and creatinine levels. There were no significant differences in demographic profiles or smoking status between the aspirin resistant and non-aspirin resistant groups. We did not find any link between ethnicity and aspirin resistance.
CONCLUSIONS: Our results indicate that a lower HDL level is associated with biochemical aspirin resistance. This may increase platelet aggregation and consequently increase the risk of a recurrent stroke. The clinical implications for aspirin resistance are far reaching. Any evidence that correctable factors may negatively influence the action of aspirin warrants further investigation. The prevalence rate of biochemical aspirin resistance in our study is comparable to the findings in other studies performed in an Asian population. Further research is required to determine how our findings translate into clinical aspirin resistance and stroke recurrence.
KEYWORDS: Asia; antiplatelet therapy; aspirin; aspirin resistance; developing countries; ischaemic stroke; risk factors
Fulltext Comparative study on waterborne parasites between Malaysia and Thailand: A new insight

Kumar T, Onichandran S, Lim YA, Sawangjaroen N, Ithoi I, Andiappan H, et al.

Am J Trop Med Hyg, 2014 Apr;90(4):682-9.
PMID: 24567315 DOI: 10.4269/ajtmh.13-0266

This study investigated the distribution of parasites as main contaminants in water environments of peninsular Malaysia (October 2011-December 2011) and the southeastern coast of Thailand (June 2012). Sixty-four water samples, 33 from Malaysia and 31 from Thailand, of various water types were examined according to U.S. Environmental Protection Agency guidelines. Drinking or household water types from both countries were free from parasitic contamination. The recreational/environmental (except a swimming pool in Malaysia) and effluent water types from these two countries were contaminated with waterborne parasites: Giardia (0.04-4 cysts/L), Cryptosporidium (0.06-2.33 oocysts/L), hookworm (6.67-350 ova/L), Ascaris (0.33-33.33 ova/L), and Schistosoma (9.25-13.33 ova/L). The most contaminated sites were recreational lake garden 3 in Malaysia and river 2 in Thailand. Higher concentrations of Giardia, Cryptosporidium, and hookworm were found in samples from Malaysia than in samples from Thailand. The presence of Giardia cysts showed a significant association with the presence of Cryptosporidium oocysts (P < 0.005).
Waterborne parasites and physico-chemical assessment of selected lakes in Malaysia

Onichandran S, Kumar T, Lim YA, Sawangjaroen N, Andiappan H, Salibay CC, et al.

Parasitol Res, 2013 Dec;112(12):4185-91.
PMID: 24046263 DOI: 10.1007/s00436-013-3610-1

The objective of this study was to assess the physico-chemical parameters and waterborne parasites in selected recreational lakes from Malaysia. Samples were collected from seven stations of Recreational Lake A (RL-A) and six stations of Recreational Lake B (RL-B). The samples were processed to detect the presence of Giardia spp. and Cryptosporidium spp. using immunomagnetic separation kit, helminth eggs or ova by bright field microscopy and Acanthamoeba spp. by cultivation in non-nutrient agar. Chemical parameters such as ammonia, chlorine, fluoride, nitrate and nitrite and physical parameters such as dissolved oxygen, electrical conductivity, pH, salinity, temperature and total dissolved solid were also measured. Both lakes were freshwater with salinity ranging from 0.05 to 0.09 ppt. Most stations of these lakes were contaminated with Cryptosporidium spp., Giardia spp., Ascaris spp. and hookworm. Schistosoma spp. was found in RL-B only, while Acanthamoeba spp. was found in all stations. Of all sampling sites, station 5 of RL-B is the most contaminated. Linear regression and correlation analysis revealed that Giardia spp. and Schistosoma spp. showed a significant negative correlation with turbidity (p
Tissue-specific and maturity-dependent distribution of pyridine alkaloids in Areca triandra

Wu J, Zhang H, Wang S, Yuan L, Grünhofer P, Schreiber L, et al.

J Plant Res, 2019 Jul;132(4):531-540.
PMID: 31127431 DOI: 10.1007/s10265-019-01115-9

Areca nuts (seeds of Areca catechu L.) are a traditional and popular masticatory in India, Bangladesh, Malaysia, certain parts of China, and some other countries. Four related pyridine alkaloids (arecoline, arecaidine, guvacoline, and guvacine) are considered being the main functional ingredients in areca nut. Until now, A. catechu is the only known species producing these alkaloids in the Arecaceae family. In the present study, we investigated alkaloid contents in 12 Arecaceae species and found that only Areca triandra Roxb. contained these pyridine alkaloids. We further analyzed in more detail tissue-specific and development-related distribution of these alkaloids in leaves, male and female flowers and fruits in different stages of maturity in A. triandra by ultra-performance liquid chromatography-quadrupole/time-of-flight mass spectrometry. Results revealed that the alkaloids were most abundant in young leaves, the pericarp of ripe fruits and the endosperm of unripe fruits in developmental stage 2. Abundance of the 4 different alkaloids in A. triandra fruits varied during maturation. Pericarps of ripe fruits had the highest arecaidine concentration (4.45 mg g-1) and the lowest guvacoline concentration (0.0175 mg g-1), whereas the endosperm of unripe fruits of developmental stage 2 contained the highest guvacoline concentration (3.39 mg g-1) and the lowest guvacine concentration (0.245 mg g-1). We conclude that A. triandra is useful in future as a further valuable source of Areca alkaloids.
Elder Abuse and Chronic Pain: Cross-Sectional and Longitudinal Results from the Preventing Elder Abuse and Neglect Initiative

Yunus RM, Hairi NN, Choo WY, Tan MP, Hairi F, Sooryanarayana R, et al.

J Am Geriatr Soc, 2018 07;66(6):1165-1171.
PMID: 29601084 DOI: 10.1111/jgs.15370

OBJECTIVES: To examine the cross-sectional and longitudinal relationships between elder abuse and neglect (EAN) and chronic pain in rural older Malaysians.
DESIGN: Two-year prospective cohort study.
SETTING: Kuala Pilah, a district in Negeri Sembilan approximately 100 km from the capital city, Kuala Lumpur.
PARTICIPANTS: Community-dwelling older adults aged 60 and older. Using a multistage cluster sampling strategy, 1,927 respondents were recruited and assessed at baseline, of whom 1,189 were re-assessed 2 years later.
MEASURES: EAN was determined using the modified Conflict Tactic Scale, and chronic pain was assessed through self-report using validated questions.
RESULTS: The prevalence of chronic pain was 20.4%. Cross-sectional results revealed 8 variables significantly associated with chronic pain-age, education, income, comorbidities, self-rated health, depression, gait speed, and EAN. Abused elderly adults were 1.52 times as likely to have chronic pain (odds ratio=1.52, 95% confidence interval (CI)=1.03-2.27), although longitudinal analyses showed no relationship between EAN and risk of chronic pain (risk ratio=1.14, 95% CI=0.81-1.60). This lack of causal link was consistent when comparing analysis with complete cases with that of imputed data.
CONCLUSION: Our findings indicate no temporal relationship between EAN and chronic pain but indicated cross-sectional associations between the two. This might indicate that, although EAN does not lead to chronic pain, individuals with greater physical limitations are more vulnerable to abuse. Our study also shows the importance of cohort design in determining causal relationships between EAN and potentially linked health outcomes.
Evidence for the Higgs Boson Decay to a Z Boson and a Photon at the LHC

Aad G, Abbott B, Abeling K, Abicht NJ, Abidi SH, Aboulhorma A, et al.

Phys Rev Lett, 2024 Jan 12;132(2):021803.
PMID: 38277607 DOI: 10.1103/PhysRevLett.132.021803

The first evidence for the Higgs boson decay to a Z boson and a photon is presented, with a statistical significance of 3.4 standard deviations. The result is derived from a combined analysis of the searches performed by the ATLAS and CMS Collaborations with proton-proton collision datasets collected at the CERN Large Hadron Collider (LHC) from 2015 to 2018. These correspond to integrated luminosities of around 140 fb^{-1} for each experiment, at a center-of-mass energy of 13 TeV. The measured signal yield is 2.2±0.7 times the standard model prediction, and agrees with the theoretical expectation within 1.9 standard deviations.

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