This study was aimed to determine the efficiency of synthetic protein-free media in spermatozoa washing, preparation
and retention of the activity of washed spermatozoa over short periods in vitro. Normozoospermic semen samples (n =
71) were equally apportioned and washed using synthetic protein-free medium (PFM), minimum essential medium + HSA
(MEM) or commercial protein-containing medium (CPC). Washed spermatozoa were cultured in vitro using PFM, MEM or
CPC media and held for 24 hrs at 4°C, 15°C, 22°C or 37°C. Spermatozoa activity was evaluated at 0 hr, 4 to 7 hrs and
24 hrs post-wash. The effects of PFM on spermatozoa motility, vitality, membrane integrity and DNA fragmentation level
were not significantly different from that of MEM and CPC media at 0 hr, 4 to 7 hrs and 24 hrs post-wash in vitro. Synthetic
PFM, MEM and CPC retained spermatozoa activity highest when specimen were held at 22°C and it was significantly higher
(p < 0.05) than that at 37°C after 24 hrs incubation in vitro. However, no significant changes (p > 0.05) were noted
in spermatozoa DNA fragmentation (SDF) levels when specimen were held at 22°C or 37°C at 4 to 7 hrs and also after
24 hrs post-wash in vitro in all media. The use of synthetic PFM as an alternative to the commercial protein-containing
media in human spermatozoa washing and preparation procedure for an efficient and safer (Assisted Reproduction
Technology) ART outcome. Spermatozoa activity can be successfully retained at room temperature post-wash over short
periods; spermatozoa may lose viability rapidly if held for long hours at 37°C in all media.
Awareness, involvement and training in dysphagia management are essential to ensure that patients are appropriately
assessed for dysphagia and provided with intervention. The study aimed to identify levels of awareness, involvement and
training of medical officers in dysphagia management. A total of 51 medical officers from the family medicine, medical,
otorhinolaryngology, surgery, and neurosurgery departments in Hospital Universiti Sains Malaysia participated in the
study. Levels of awareness, involvement and training of medical officers in dysphagia management were reported using
descriptive analysis. Results indicate that medical officers lacked awareness and training in dysphagia management.
Referral rates to speech-language pathologists for dysphagia management were low with 58.4% of medical officers having
had seldom or never referred patients. The results provide valuable information for addressing dysphagia management
in the hospital.
Programmes in the Health Sciences are less pursued by students compared to competative programmes such as medicine,
pharmacy, and dentistry. This study aimed to investigate the perception of Form Five students towards a career in Health
Sciences in four dimensions including characteristics that are considered as “important” in the selection of a career
choice, the level of knowledge in professions within the field of Health Sciences, students’ perception towards a career in
the field of Health Sciences and their possible career choice in the field of Health Sciences. This is a cross-sectional study
that included 188 students from 10 secondary schools around Kuala Lumpur. The results showed that the respondents
prioritized career characteristics that provided “job satisfaction”(97.8%), “job security” (96.8%), “interesting” (95.2%),
“helping other people” (92.4%), “doing something good for society” (92.1%) and “high salary” (88.6%). Respondents
also reported high level of knowledge for the profession of Medicine (93.1%), Pharmacy (84.0%), Dentistry (76.6%),
Nursing (74.8%) and Forensic Science (71.3%). Respondents knew the least about Speech-Language Therapy (28.0%),
Audiology (27.0%) and Occupational Therapy (19.3%) professions. Differences in terms of gender and ethnicity were also
identified through this study. Respondents’ perception towards the professions were influenced by the level of familiarity,
ethnicity and gender. Respondents were found to be less familiar and have misperception towards less-known professions,
and this affect respondents’ consideration to pursue these professions as careers.
Health care services are not often accessible and available for all people in one country due to multiple reasons such as the geographical barrier, affordability, etc. The aim of this study was to analyse willingness to pay (WTP) for healthcare services user fees among Malaysian population and determine its’ influencing factors. Structured interviews were conducted involving 774 households in 4 states represents Peninsular Malaysia. Validated questionnaires with open ended, followed by bidding games were applied to elicit maximum amount of WTP. The study was analysed descriptively and with multivariate regression method to adjust for potential confounding factors. More than half of respondents WTP more than current fee for the government clinic outpatient registration fee with mean MYR3.76 (SD2.71). Majority of respondents not WTP more than usual for private clinic simple outpatient treatment charges with the mean MYR38.76 (SD5.45). Factors that were found to have significant associations with WTP for both government and private clinic were income and having health insurance. Community willing to pay for healthcare services user fees and charges but at certain amount. The healthcare services user fees and charges can be increased up to community WTP level to avoid from catastrophic expenditure.
Exclusive breastfeeding (EBF) is very crucial for the health of infant as well as mother. However, the prevalence of
exclusive breastfeeding is very low especially among working mother. Since the prevalence of EBF might be influenced by
the level of knowledge on EBF, researcher comes to critical thinking to conduct this study to evaluate level of knowledge
on EBF among working mother. A cross sectional design study was carried out to determine knowledge level on exclusive
breastfeeding among working mother, and its relationship with demographic data in Hospital Canselor Tuanku Muhriz
(HCTM). A total 283 respondents were recruited to participate in this study. The respondents’ knowledge level on exclusive
breastfeeding was identified using Kim & Chapman (2013) Questionnaire on Knowledge and Practice about Exclusive
Breastfeeding. The result showed that majority of the respondents (56.9%) had high knowledge on exclusive breastfeeding.
For demographic data, factors such as age, level of education, and family income had shown a significant association (p
< 0.05) with level of knowledge on exclusive breastfeeding. In conclusion, the level of knowledge of EBF was identified
among working mother, yet it has been influenced by mother’s sociodemographic background
Loss of teeth can affect masticatory efficiency in older adults. This may result in avoidance or modifications in food
choices and lead to lower intake of important nutrients among older individuals. The aim of this study was to determine
the association between tooth loss and body mass index, BMI, among older adults in Kuala Pilah, Negeri Sembilan. A
cross-sectional study was carried out on 428 older adults aged 50 years and above from selected villages in district of
Kuala Pilah. Respondents were interviewed to collect information on their demographic characteristics. Number of tooth
loss was determined through oral assessment, followed by anthropometric assessment to calculate the BMI of respondents.
Findings showed that majority of the respondents were overweight and obese, 40.4% and 19.9% respectively, while only
a small proportion was underweight, 3.9%. The proportion of edentulism (total tooth loss) was 18.3% and majority of
the older adults had lost more than 12 teeth (77.1%) and less than 4 pairs of occluding posterior teeth (86.0%). Total
and partial tooth loss was found to be not significantly associated with BMI. In relation to the arrangement of teeth,
older adults with reduced number of posterior occluding pairs of teeth were more likely to experience unsatisfactory
BMI (OR = 3.61, 95% CI: 1.48, 8.76). This may suggest that functional arrangement of the tooth in the oral cavity is more
important than the number of tooth loss alone. Thus, maintaining an optimum number of teeth for chewing is essential
for maintenance of ideal BMI.
Occupational injury is an issue that needs to be considered in reducing the problems of disability and death in the
workplace. Healthy and high-productivity workers are one of the important factors that are important to the economic
growth of a country. This study aims to identify the trend of disability for employees covered by the Employment Injury
Scheme under the Social Security Organization Malaysia (SOCSO) for the years 2009-2013. Based on the descriptive
analysis, 80% of the total numbers of workers who suffer injury or death in the workplace are male employees. In
addition, workers aged 25 and above are more prone to injury and death associated with work. The results showed that
socio-demographic factors such as gender and age, as well as level of disability are several important factors that need
to be considered in identifying the trend of disability among employees.
Hope leads to lower depression and anxiety and is associated with improved quality of life of cancer patients. In this
study, Hope Scale (HS) was translated into Malay, and the psychometric properties of the Malay version of the Hope
Scale were investigated among Malaysian cancer patients. Concurrent translation and back translation of the original
English version of the Hope Scale were performed, and the Malay version was administered to 195 cancer patients
with different cancer diagnoses at baseline assessment and 2 months later at follow-up. The Hope Scale (Malay) total
score (Cronbach’s α = 0.72; intraclass correlation coefficient (ICC) = 0.67) and its domains (Cronbach’s α [pathway] =
0.7; Cronbach’s α [agency] = 0.7; ICC[Pathway] = 0.64; ICC[Agency] = 0.70) demonstrated acceptable internal consistencies and
test-retest reliability. Convergent and discriminant validities were also achieved by the Hope Scale (Malay). The Hope
Scale (Malay) demonstrated construct validity, as confirmatory factor analysis demonstrated that the items in the Hope
Scale (Malay) best fit into two domains, which was true for the original English version. The Hope Scale (Malay) had
acceptable psychometric properties and thus is suitable for assessing hope in Malaysian cancer patients.
Knowledge of normal anatomy and physiology of swallowing is fundamental in the identification of individuals with or
at risk for swallowing disorders. Learning anatomy and physiology however, is not an easy task thus, computer-assisted
learning (CAL) approaches have been incorporated into the learning of the topics to enhance understanding. Although
evidence exists on the benefits of using CAL in education, more studies are necessary in the field of swallowing. While
courseware for the learning of anatomy and physiology of swallowing exist, they are not comprehensive. Therefore, this
study aimed to develop a comprehensive CAL courseware for anatomy and physiology of swallowing. The current study
used a designed-based research following the ADDIE (analysis, design, development, implementation, and evaluation)
model to create a multimedia courseware, incorporating the use of text, still images, animations, audio narrations,
and presented on a simple graphical user interface. The courseware was evaluated by 27 undergraduate students in
terms of its usefulness, ease of use, and users’ satisfaction. Results indicate that the participants were satisfied with the
courseware and that they perceived the courseware as useful, easy to learn and easy to use. The study represents an
initiative to investigate the use of CAL in the subject and to establish the basis for further work which includes assessment
on the learning outcomes from the usage of the CAL courseware. It is hoped that the use of this courseware in teaching
and learning of anatomy and physiology of swallowing can enhance students’ knowledge and understanding of the area
efficiently and effectively.
One hundred seventy-one patients suffering from chronic renal diseases at Kuala Lumpur Hospital participated in a crosssectional study with purposive sampling to ascertain prevalence rates of Cryptosporidium parvum (C. parvum), Giardia
intestinalis (G. intestinalis), Blastocystis hominis (B. hominis) and Strongyloides stercoralis (S. stercoralis). The patients
were divided into 2 groups: post-transplant group (138 patients) and pre-transplant group (33 patients). In this study, the
parasite infection is linked to the aspects of race, gender, renal patient’s group and the postrenal transplantation period.
Immunofluorescence staining was performed on fecal slides for the detection of C. parvum oocysts and G. intestinalis cysts.
Sand charcoal culture technique was also used to detect the presence of S. strongyloides in fecal samples. The findings
showed that the prevalence of C. parvum, G. intestinalis dan B. hominis among post-transplant patients was 18.1%,
10.9% and 22.5%, respectively but none of the pretransplant patient was infected. Meanwhile, both patient groups were
free of S. stercoralis infection. Furthermore, there was no significant association between post-transplantation period
and pattern in prevalence of the studied parasites, however, it was noted that the prevalence rates of C. parvum and G.
intestinalis had declined after 6 months post transplantati
Inhibition of xanthine oxidase (XO) activity is an effective therapeutic approach for the treatment of diseases such as gout and hyperuricemia. Additionally, the use of XO inhibitors can further be extended to injury treatments such as ischemic reperfusion in various organs such as heart, liver and kidney. In this study, 7 aurone compounds were synthesized and tested on XO and compared with the positive control allopurinol. Compound 5e was identified as the most potent compound and was able to inhibit half of XO activity at 33.23 μM followed by compounds 5f and 5d at 210.22 μM and 302.0 μM, respectively. Finally, molecular docking
The importance of nontechnical skills among healthcare professionals is gaining widespread recognition as critical
elements complementing technical skills that are used to improve patients’ safety. These skills are typically acquired
through simulation training which has emerged as an effective way to complement clinical training. Effective simulation
requires structure and effective debriefing methods to enhance its learning outcome. In previous literature, evidence of the
effectiveness of healthcare simulation was available but studies evaluating debriefing method(s) remain sparse. In this
paper, the effectiveness of debriefing methods in eight studies on the acquisition of nontechnical skills among healthcare
professionals is reviewed. Articles published from 1st January 2016 across three different databases were referred to. The
results of the review show a statistically significant improvement in the performance of nontechnical and technical skills
across different professionals through various methods of debriefing. Nontechnical skills such as teamwork, effective
communication, decision-making, and situational awareness have improved significantly. In addition, integration of
realism in simulation learning has begun to emerge as an effective technique of providing a real world experience.
However, there was lack of detailed information on the length and type of debriefing conducted in the studies. These
methods clearly require further research since the key to successful simulation learning is through debriefing which is
the heart of simulation.
In the search for universal vaccine candidates for the prevention of avian influenza, the non-structural (NS)-1 protein of avian influenza virus (AIV) H5N1 has shown promising potential for its ability to effectively stimulate the host immunity. This study was aimed to produce a bacterial expression plasmid using pRSET B vector to harbour the NS1 gene of AIV H5N1 (A/Chicken/Malaysia/5858/2004 (H5N1)) for protein expression in Escherichia coli (E. coli). The NS1 gene (687 bp) was initially amplified by polymerase chain reaction (PCR) and then cloned into a pGEM-T Easy TA vector. The NS1 gene was released from pGEM-T-NS1 using EcoRI and XhoI restriction enzymes (RE). The pRSET B vector was also linearized using the same RE. The digested NS1 gene and linearized pRSET B were ligated using T4 DNA ligase to form the expression plasmid, pRSET B-NS1. The NS1 gene sequence in pRSET B-NS1 was confirmed by DNA sequencing. To prepare recombinant bacterial cells for protein expression in the future, pRSET B-NS1 was transformed into E. coli strain BL21 (DE3) by heat-shock. Colonies bearing the recombinant plasmid were screened using PCR. The DNA sequencing analysis revealed that the NS1 gene sequence was 97% homologous to that of AIV H5N1 A/Chicken/Malaysia/5858/2004 (H5N1). These results indicated that the NS1 gene of influenza A/Chicken/Malaysia/5858/2004 (H5N1) was successfully amplified and cloned into a pRSET B vector. Bacterial colonies carrying pRSET B-NS1 can be used for the synthesis of NS1-based influenza vaccine in the future and thereby aid in the prevention of avian influenza.
Studies on the potential effect of EMF exposure on permeability of the blood-brain barrier (BBB) in humans are virtually absent. This study was conducted to study the effect of EMF exposure on pericytes in brain tissues and its effect on oxidative stress level in the blood through total protein and malondialdehyde (MDA). About 16 male rats (Wistar) were used and divided into two groups which were negative control and treatment group. In negative control group, the animals were placed in a solenoid without any EMF exposure for 3 hours daily for 5 days. In the treatment group, the animals were placed in a solenoid with 0.3 mT EMF exposure for the same time duration. On day 3 and day 5, animals were sacrificed and the brain was removed for histological examination while on day 1, day 3 and day 5, the blood was collected for biochemistry analysis. Histological observation showed the presence of morphological changes in the brain tissues of rats that exposed to EMF. Statistical analysis showed that there is no significant decrease in total protein (p>0.05) between negative control group and treatment group. Meanwhile, MDA level in blood showed a significant increase in treatment group (p
Cheiloscopy is recognized as a tool for personal identification due to its strength in criminalistics. In this study, the lip print of Malaysian Chinese population in Klang Valley was used for gender determination using lipstick-cellophane technique. 412 subjects (203 males and 209 females) were selected conveniently. Lipstick was first applied on the lips and the lip print was lifted using cellophane tape prior to pasting them onto a plain A4 paper and analysis using magnifying glass. Six topography areas of lip prints were classified using Suzuki and Tsuchihashi’s classification, including upper left, upper middle, upper right, lower right, lower middle and lower left. Chi-square test showed that all lip sections were significantly different from each other (p < 0.05). Type II was the dominant pattern in four lip sections for both genders: upper left (male 81.3%, female 57.4%), upper right (male 71.9%, female 42.9%), lower left (male 98.0%, female 90.0%) and lower right (male 96.1%, female 86.1%). Type IV was the dominant pattern for both middle part of the lips; upper middle (male 56.2%, female 50.7%) and lower middle (male 62.6%, female 50.2%). The results showed that gender can be differentiated based on lip print patterns. This finding suggested that cheiloscopy could be used in aiding personal identification for forensic investigation.
The objective of this study is to examine the impact of the casemix reimbursement on the hospital revenue at three selected hospitals (Type B, C and D) reimbursed using 602 groups from 14,749 cases. The results of the study showed that the hospitals received 32.4% higher income when reimbursed with Indonesia Case Bases Groups (INA-CBG) as compared to fee-for-service. Type D hospitals is the biggest gainer with 81.0% increased in income followed by Type B hospital that obtained 34.7% higher revenue. In conclusion, the use of INA-CBG as a prospective payment method has benefitted the hospitals by the increase in the revenues. It is hope that additional resources gained in this programme will allow the hospitals to provide optimum care to the population. It is recommended that the JKA management will use the INA-CBG casemix data to monitor the performance of the hospitals to ensure that quality and efficiency of the services provided to the population is continuously maintained.
This review paper aims to present an overview of the development of blood substitute particularly red blood cell substitute or artificial oxygen carrier. Knowledge on human blood inspired from the understanding of human blood circulation system. Ibn Nafis was first to describe that blood flow through respiratory system before entering the heart. This finding denied the claim that tiny pores present within the septum of the heart. Then, William Harvey further described human cardiovascular system in detail and contributed to better understanding on the roles of blood in body. Several blood transfusions were attempted using blood collected from human, animal and other blood substitutes such as milk before the practice was banned for almost 150 years in Europe. Major discoveries on blood group and antibody reaction have made blood transfusion safer. However, several issues and challenges have re-triggered the exploration to develop red cell substitutes. Two approaches have been taken to develop the red blood cell substitute which are classified into biological and chemical based oxygen carriers. The earliest efforts have been on haemoglobin based oxygen carrier (HBOC) and perfluorocarbon (PFC) while the recent developement are on polymer-based oxygen carrier and in-vitro stem cell derived red blood cell.
The purpose of this study was to evaluate the image quality and diagnostic accuracy of coronary computed tomography angiography (CCTA) using 640-slice scanner. Advancement of multidetector computed tomography (MDCT) technology with higher spatial, temporal resolution, and increasing detector array have improved the image quality and diagnostic accuracy of CCTA. A total of 25 patients (12 men and 13 women) underwent CCTA examination was chosen and data was acquired by 640-slice scanner. All 16 segments of coronary arteries were evaluated by two reviewers using a 4-likert scale for qualitative assessment. In quantitative assessment, the evaluation of 4 main coronary arteries were analysed in terms of signal intensity (SI), image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). All 25 patients with a mean age of 52.88 ± 14.75 years old and body mass index (BMI) of 24.24 ± 3.28 kg/m2 were analysed. In qualitative assessment, from the total of 400 segments, 379 segments (95%) had diagnostic value while 21 segments did not have diagnostic value, which means 5% artefact was detected. In quantitative assessment, there was no statistical differences in gender, race, and BMI (p>0.05). Overall evaluation showed that higher SI at the left main artery (LM) at 393.7 ± 47.19. Image noise was higher at right coronary artery (RCA) at 39.01 ± 13.97. SNR and CNR showed higher at left anterior descending (LAD) with 12.73 ± 5.17 and LM 9.14 ± 4.2, respectively. In conclusion, this study indicates that 640-slice MDCT has higher diagnostic value in CCTA examination with 95% vessel visibility with 5% artefact detection.
The incidence of falls among older adults can be caused by nutritional, health status, physical and environmental factors. The objective of this study was to develop and evaluate the contents in a booklet on nutrition and falls prevention among older adults as a nutritional education material for falls prevention. In Phase I, market survey in bookstore, website search and need assessment among 30 respondents using a questionnaire was conducted. Results from Phase I were used to form a 32-page A5 size booklet that includes information on nutrients related to bone health, recommendations of high protein and calcium menus, ideal exercise and tips to avoid falls in older adults. The content validity of the booklet was conducted among six health professionals to assess the suitability and understanding in Phase II. The content of the booklet (Phase III) was then evaluated among 24 respondents aged 60 years and above. From the need assessment in Phase I, majority of respondents chose 7 to 9 for the score of each questions which indicates the need for all information to be included in the booklet. For Phase II, criteria with highest average score were composition and typography with a score of 60%. For Phase III, most respondents chose “good” for all the criteria stated except for pictures (satisfactory), while 62.5% of respondents stated that they were satisfied with the information contents in the booklet. In conclusion, this booklet can be used as one of the strategies for nutrition education in the prevention of falls among older adults.
The present study examines the factors affecting fruit and vegetable (FV) consumption in Malaysia. A nationally representative data that consists of a large sample size is used. Hence, the findings can provide inferential information. The present study uses secondary data from the Malaysian Household Expenditure Survey 2009/2010. The survey was carried out using a two-stage stratified sampling. The first stage was based on Enumeration Blocks, while the second stage was based on Living Quarters. A lognormal hurdle model is used to estimate the consumption decision and amount decision of FV across ethnic groups. The results suggest that household size, income, gender, marital status, age and education play significant roles in FV consumption. The probability of consuming FV and amount spent increase with household size (p