Public health developments in colonial Malaya: colonialism and the politics of prevention.

PubMed Central

Manderson, L

1999-01-01

In both African and Asian colonies until the late 19th century, colonial medicine operated pragmatically to meet the medical needs first of colonial officers and troops, immigrant settlers, and laborers responsible for economic development, then of indigenous populations when their ill health threatened the well-being of the expatriate population. Since the turn of the century, however, the consequences of colonial expansion and development for indigenous people's health had become increasingly apparent, and disease control and public health programs were expanded in this light. These programs increased government surveillance of populations at both community and household levels. As a consequence, colonial states extended institutional oversight and induced dependency through public health measures. Drawing on my own work on colonial Malaya, I illustrate developments in public health and their links to the moral logic of colonialism and its complementarity to the political economy. PMID:9987478

Hugh Alistair Reid OBE MD: investigation and treatment of snake bite.

PubMed

Hawgood, B J

1998-03-01

Alistair Reid was an outstanding clinician, epidemiologist and scientist. At the Penang General Hospital, Malaya, his careful observation of sea snake poisoning revealed that sea snake venoms were myotoxic in man leading to generalized rhabdomyolysis, and were not neurotoxic as observed in animals. In 1961, Reid founded and became the first Honorary Director of the Penang Institute of Snake and Venom Research. Effective treatment of sea snake poisoning required specific antivenom which was produced at the Commonwealth Serum Laboratories in Melbourne from Enhydrina schistosa venom supplied by the Institute. From the low frequency of envenoming following bites, Reid concluded that snakes on the defensive when biting man seldom injected much venom. He provided clinical guidelines to assess the degree of envenoming, and the correct dose of specific antivenom to be used in the treatment of snake bite in Malaya. Reid demonstrated that the non-clotting blood of patients bitten by the pit viper, Calloselasma rhodostoma [Ancistrodon rhodostoma] was due to venom-induced defibrination. From his clinical experience of these patients, Reid suggested that a defibrinating derivative of C. rhodostoma venom might have a useful role in the treatment of deep vein thrombosis. This led to Arvin (ancrod) being used clinically from 1968. After leaving Malaya in 1964, Alistair Reid joined the staff of the Liverpool School of Tropical Medicine, as Senior Lecturer. Enzyme-linked immunosorbent assay (ELISA) for detecting and quantifying snake venom and venom-antibody was developed at the Liverpool Venom Research Unit: this proved useful in the diagnosis of snake bite, in epidemiological studies of envenoming patterns, and in screening of antivenom potency. In 1977, Dr H. Alistair Reid became Head of the WHO Collaborative Centre for the Control of Antivenoms based at Liverpool.

Discovery and Characterization of Novel Signatures from the Ricinus communis L. (Castor Bean) Genome

DTIC Science & Technology

2006-11-01

mortar and pestle under liquid nitrogen, using Qiagen DNeasy Plant Maxi kits according to the manufacturer’s instructions, and quantified...Former Soviet Union India Iran Indonesia Israel Japan Jordan Malaya Pakistan Philippines Saudi Arabia Sri Lanka Syria Taiwan

CULTURAL FRONTIERS OF THE PEACE CORPS.

ERIC Educational Resources Information Center

TEXTOR, ROBERT B., ED.

THE PRESENT WORK CONTAINS ANALYSES OF PEACE CORPS PROGRAMS IN SELECTED HOST COUNTRIES (THE PHILIPPINES, MALAYA, THAILAND, PERU, BOLIVIA, AFGHANISTAN, SOMALIA, NIGERIA, TANGANYIKA, SIERRA LEONE, TUNISIA, MOROCCO, AND JAMAICA) WRITTEN BY AN AUTHORITY ON EACH COUNTRY. COVERAGE OF DOMESTIC OPERATIONS OF THE PEACE CORPS IS STRICTLY LIMITED TO WHAT IS…

Anisotropic transport of microalgae Chlorella vulgaris in microfluidic channel

NASA Astrophysics Data System (ADS)

Izzati Ishak, Nur; Muniandy, S. V.; Periasamy, Vengadesh; Ng, Fong-Lee; Phang, Siew-Moi

2017-08-01

Not Available Project supported by the Science Fund from the Ministry of Higher Education of Malaysia under the Fundamental Research Grant Scheme (Grant No. FRGS: FP057-2014A) and the Fund from the University of Malaya Research Grant (Grant No. UMRG: RP020A-14AFR).

Malaysian Students' Perceptions of Flipped Classroom: A Case Study

ERIC Educational Resources Information Center

Zainuddin, Zamzami; Attaran, Mohammad

2016-01-01

The purpose of this study was to evaluate a class in University of Malaya where flipped learning was applied, and to examine students' perceptions and feedback towards flipped classroom. Data were collected using both quantitative and qualitative methods, i.e. survey, focus group and individual interviews. The results indicated that most students…

Enhancing Employability through Industrial Training in the Malaysian Context

ERIC Educational Resources Information Center

Pillai, Stefanie; Khan, Mahmud H.; Ibrahim, Ida Syahirah; Raphael, Sharmane

2012-01-01

This study discusses the industrial training programme at the University of Malaya in Malaysia, specifically the issues that need to be addressed in order to enhance the employability skills of graduates. Findings from the feedback obtained from trainees and organizations in the 2008/2009 academic session were examined in terms of the extent to…

English in Malaysia

ERIC Educational Resources Information Center

Foo, Bernadette; Richards, Cynthia

2004-01-01

This article seeks to lay out the use and importance of English in Malaysia from the time when the British ruled what was then Malaya to the present moment. When the British came to colonize the country, they brought with them their culture, their language and their beliefs. They introduced the English language as the medium of instruction in the…

An Institution in Search of Excellence: Lessons Learnt

ERIC Educational Resources Information Center

Hashim, Fatimah; Awang, Halimah

2005-01-01

This is a report of the strategies adopted by the University of Malaya (UM), Malaysia, to address the issues and complexities involved in its search for excellence in teaching and learning, research and service. The story is told how the university sought accreditation through the International Standards Organisation (ISO) and how by uniting their…

Re-Inventing Counterinsurgency Doctrine: Why The United States Failed in Iraq and Afghanistan

DTIC Science & Technology

2016-02-16

5 Dr Richard Stubbs, 113-118. 6 John A. Nagl, Learning to Eat Soup With a Knife: Counterinsurgency Lessons From Malaya and Vietnam...Modern War in Theory and Practice. New York: The Penguin Press, 2014. Nagl, John A. Learning to Eat Soup With a Knife: Counterinsurgency Lessons From

Re-Inventing Counterinsurgency Doctrine: Why the United States Failed in Iraq and Afghanistan

DTIC Science & Technology

2016-01-08

5 Dr Richard Stubbs, 113-118. 6 John A. Nagl, Learning to Eat Soup With a Knife: Counterinsurgency Lessons From Malaya and Vietnam...Modern War in Theory and Practice. New York: The Penguin Press, 2014. Nagl, John A. Learning to Eat Soup With a Knife: Counterinsurgency Lessons From

Ethnicity and British Colonialism; The Rationale for Racially-Based Schools

ERIC Educational Resources Information Center

Whitehead, Clive

2005-01-01

This paper examines the rationale for ethnic schooling in former British colonial territories in East Africa and Southeast Asia. Critics, especially of British rule in Malaya and Singapore, have traditionally claimed that ethnic schools were established as part of a British political strategy of "divide et impera". An examination the…

Endoscopic Transsphenoidal Resection of Craniopharyngioma.

PubMed

Liew, Kong Yew; Narayanan, Prepageran; Waran, Vicknes

2018-02-01

Objectives  To demonstrate, step-by-step, the technique and efficacy of endoscopic transsphenoidal approach in resection of a suprasellar craniopharyngioma. Design  The video shows a step-by-step approach to the resection, covering the exposure, access, resection, and confirmation of resection and reconstruction. Setting  The surgery was performed in the University of Malaya Medical Centre, a tertiary referral center in the capital of Malaysia. Participants  Surgery was performed jointly by Professor Prepageran from the department of otorhinolaryngology and Professor Vicknes Waran from the division of neurosurgery. Both surgeons are from the University of Malaya. Video compilation, editing, and voice narration was done by Dr. Kong Yew Liew. Main Outcome Measures  Completeness of resection and avoidance of intra- and postoperative complications. Results  Based on intraoperative views and MRI findings, the tumor was completely resected with the patient suffering only transient diabetes insipidus. Conclusion  Central suprasellar tumors can be removed completely via an endoscopic transsphenoidal approach with minimal morbidity to the patient. The link to the video can be found at: https://youtu.be/ZNIHfk12cYg .

Anorogenic nature of magmatism in the Northern Baikal volcanic belt: Evidence from geochemical, geochronological (U-Pb), and isotopic (Pb, Nd) data

USGS Publications Warehouse

Neymark, L.A.; Larin, A.M.; Nemchin, A.A.; Ovchinnikova, G.V.; Rytsk, E. Yu

1998-01-01

The Northern Baikal volcanic belt has an age of 1.82-1.87 Ga and extends along the boundary between the Siberian Platform and the Baikal foldbelt. The volcanic belt is composed of volcanics of the Akitkan Group and granitic rocks of the Irel and Primorsk complexes. The geochemistry of the rocks points to the intraplate anorogenic nature of the belt. U-Pb zircon dating of the Chuya granitoids revealed that they are older (2020-2060 Ma) than the Northern Baikal volcanic belt and, thus, cannot be regarded as its component. Data on the Pb isotopic system of feldspars from the granitoids confirm the contemporaneity of all volcanic rocks of the belt except the volcanics of the upper portion of the Akitkan Group (Chaya Formation). Our data suggest its possibly younger (???1.3 Ga) age. The isotopic Nd and Pb compositions of the acid volcanic rocks provide evidence of the heterogeneity of their crustal protoliths. The volcanics of the Malaya Kosa Formation have ??Nd(T) = -6.1, ??2 = 9.36, and were most probably produced with the participation of the U-depleted lower continental crust of Archean age. Other rocks of the complex show ??Nd(T) from -0.1 to -2.4, ??2 = 9.78, and could have been formed by the recycling of the juvenile crust. The depletion of the Malaya Kosa volcanics in most LILEs and HFSEs compared with other acid igneous rocks of the belt possibly reflects compositional differences between the Late Archean and Early Proterozoic crustal sources. The basaltic rocks of the Malaya Kosa Formation (??Nd varies from -4.6 to -5.4) were produced by either the melting of the enriched lithospheric mantle or the contamination of derivatives of the depleted mantle by Early Archean lower crustal rocks, which are not exposed within the area. Copyright ?? 1998 by MAEe Cyrillic signK Hay??a/Interperiodica Publishing.

Recruitment and Financing of Candidates To Study Overseas: Its Implications for Australia.

ERIC Educational Resources Information Center

Smart, Don

Growing numbers of Malaysian students are going to Australia for overseas study. This paper begins with a discussion of Malaysia's New Economic Policy, whose provisions include a phasing out of English as the language of instruction in favor of Bahasa Malaya, the language of the indigenous Malay majority. This policy provides a background for the…

Transnational Governances in Higher Education: New Universities, Rhetorics, and Networks in Postwar Singapore

ERIC Educational Resources Information Center

Chou, Grace Ai-Ling

2015-01-01

At the close of World War II, Japan's ouster from Malaya led to the resumption of British control and a new outlook toward political independence. Higher education would play a central role in this complex transition, where the forces of decolonization and nation-building converged with drives toward both interethnic competition and multiethnic…

Stimulating Student Interest in Physiology: The Intermedical School Physiology Quiz

ERIC Educational Resources Information Center

Cheng, Hwee-Ming

2010-01-01

The Intermedical School Physiology Quiz (IMSPQ) was initiated in 2003 during the author's last sabbatical from the University of Malaya. At this inaugural event, there were just seven competing teams from Malaysian medical schools. The challenge trophy for the IMSPQ is named in honor of Prof. A. Raman, who was the first Malaysian Professor of…

Education in Thailand: From Old to New. World Education Monograph Series, Number Two.

ERIC Educational Resources Information Center

Servatamorn, Sirmsree

The history of educational development in Thailand shows a transition from early concern for religious and moral training toward the present emphasis on the practical development of individuals and society. Thai culture may have originated in Mongolia and has been strongly affected by its present cultural neighbors, Malaya, Cambodia, Laos, Burma,…

Comparing University Academic Performances of HSC Students at the Three Art-Based Faculties

ERIC Educational Resources Information Center

Ismail, Noor Azina; Othman, Azmah

2006-01-01

University Malaya enrolls students from all states in Malaysia as well as a small number of students from overseas. The objective of this paper is to investigate the effect of past performance on students at three faculties, namely, Faculty of Economics and Administration(FEA), Faculty of Business and Accounting(FBA) and Faculty of Arts and Social…

Misconceptions Highlighted among Medical Students in the Annual International Intermedical School Physiology Quiz

ERIC Educational Resources Information Center

Cheng, Hwee-Ming; Durairajanayagam, Damayanthi

2012-01-01

The annual Intermedical School Physiology Quiz (IMSPQ), initiated in 2003, is now an event that attracts a unique, large gathering of selected medical students from medical schools across the globe. The 8th IMSPQ, in 2010, hosted by the Department of Physiology, University of Malaya, in Kuala Lumpur, Malaysia, had 200 students representing 41…

Forming the Academic Profession in East Asia: A Comparative Analysis. East Asia: History, Politics, Sociology, Culture. A Routledge Series.

ERIC Educational Resources Information Center

Kim, Terri

This book is a comparative examination of the formation of the academic profession in Korea and Malaya, and later, South Korea, Malaysia, and Singapore, from colonial times. The analysis takes into account the connections and disconnections between the colonial and postcolonial periods in shaping the academic profession. The chapters are: (1)…

Singapore: Background and U.S. Relations

DTIC Science & Technology

2010-03-19

Address in August 2008, Lee announced some modest liberalizing measures, including a relaxation of censorship of political films and approval of peaceful...in its success. Singapore achieved home rule in 1959 and joined with Malaya, Sabah, and Sarawak to form the Federation of Malaysia in 1963...Singapore from Malaysia . Amid serious doubts about its viability, Singapore became a separate independent nation on August 9, 1965. SINGAPORE

Government Can Mount Effective Counter-Insurgency Programs against Marxist Oriented Revolutions.

DTIC Science & Technology

1983-09-01

supported financially by the very people whom these arms and personnel are subjugating.3 An added taxation on the people’s resources creates a number...repre- sented by college students). 8 As these productive individuals are removed from the economy the effective taxation increase on the remaining...Malaya against Communist insurgency forces. When the British were requested to assist the Malaysian government, they took over the government

Southeast Asia Report, No. 1371.

DTIC Science & Technology

1983-11-18

Malaysian military pressure, according to a rare joint communique issued by the two factions. The merger, agreed to after recent talks, was thought...copy of which was obtained exclusive- ly by the BANGKOK POST, says the talks were held recently in a jungle redoubt along the Thai- Malaysian border...Force for the suppression of guerrillas of the Communist Party of Malaya [CPM] along the Thai- Malaysian border, reported that, on 30 September at

Asian Universities' Collaboration for Advanced Environmental Engineering via Simultaneous Distant Learning Classes Using Video Playback

NASA Astrophysics Data System (ADS)

Araki, Mituhiko; Nakamura, Yuichi; Fujii, Shigeo; Tsuno, Hiroshi

Three international simultaneous lectures of the post graduate level in the field of environmental science and engineering are under preparation in Kyoto University. They are planned to be opened in three Asian universities (Tsinghua University in China, University of Malaya in Malaysia, and Kyoto University in Japan) as formal courses. The contents of the lectures, purpose of the project and technical problems are reported.

Threat Recognition and Response. Volume 2,

DTIC Science & Technology

1986-08-01

strongly anti-communist caretaker regime. Tunku Abdul Rahman, the Malay conservative anti-colonialist leader of the Alliance Party was invited to pay an...May 1961 Tunku Abdul Rahman, the new Prime Minister of Malaya, proposed a ’closer understanding’ with Britain and the peoples of Singapore, North...dispute. Senator Robert Kennedy met Sukarno in Tokyo in mid-January 1964, and later flew to Kuala Lumpur for discussions with Tunku Abdul Rahman. A

Applied Actant Network Theory: Toward the Automated Detection of Technoscientific Emergence from Full Text Publications and Patents (Open Access)

DTIC Science & Technology

2012-11-02

Applied Actant-Network Theory: Toward the Automated Detection of Technoscientific Emergence from Full-Text Publications and Patents David C...Brock**, Olga Babko-Malaya*, James Pustejovsky***, Patrick Thomas****, *BAE Systems Advanced Information Technologies, ** David C. Brock Consulting... Wojick , D. 2008. Population modeling of the emergence and development of scientific fields. Scientometrics, 75(3):495–518. Cook, T. D. and

The Worst Disaster: The Decisive Point and the Fall of Singapore

DTIC Science & Technology

2007-11-06

British territory of Malaya includes Singapore. In 1957, Malaysia became an independent state. In 1965, ore seceded from Malaysia . A.J Kennedy, A...repulsed? Per the leisurely pace of Singapore’s defense planning to date, it would certainly have been uncharacteristic of the entire Singapore... leisurely pace, Britain’s pre-WWII operational commanders were unable to compensate for a newly identified decisive point. Conversely, today’s

Yakov Abramovich Smorodinsky

NASA Astrophysics Data System (ADS)

Smorodinskaya, Noemi

2013-06-01

My father Yakov Abramovich Smorodinsky (Ya.A. hereafter) was born on December 30, 1917 in a small town of Malaya Vishera located about 100 miles south-east of St. Petersburg. His mother Roza Smorodinsky (Fitingof) originated from a big family. She married a young railroad engineer and a dance competition winner named Abram Smorodinsky, who died of typhus in 1921, when little Yakov was four years old. So, he was brought up solely by his mother...

Implementation of Clinical Quality Management for Rehabilitation in Malaysia.

PubMed

Engkasan, Julia Patrick; Stucki, Gerold; Ali, Sadeeq; Yusof, Yusniza Mohd; Hussain, Hafez; Latif, Lydia Abdul

2018-04-18

In February 2017, the World Health Organization (WHO) launched its historic "Rehabilitation 2030: A Call for Action". Scaling up rehabilitation in health systems requires concerted action across all 6 components of WHO's Health Systems Framework. For rehabilitation, information about functioning is essential, as it is required for effective rehabilitation at all levels of the health system. What is missing is a countrywide demonstration project involving the implementation of a clinical quality management system for the continuous improvement of rehabilitation, both at the level of clinical care for individual patients and at the level of rehabilitation service provision. Consequently, the Department of Rehabilitation Medicine at the University of Malaya and University Malaya Medical Centre, together with the Cheras Rehabilitation Hospital of the Ministry of Health, and the Social Security Organisation (SOCSO) Rehabilitation Centre in Malacca, Malaysia, initiated a project to develop a Malaysian-wide clinical quality management system for rehabilitation (CQM-R Malaysia). The objective of this paper is to describe CQM-R Malaysia. First, a conceptual description of a CQM-R based on the International Classification of Functioning, Disability and Health (ICF) is set out. The methods, results and conclusions of a situation analysis conducted in January 2017 are then reported. Finally, the building blocks and implementation action plan developed for CQM-R Malaysia are presented.

Dental Students’ Educational Environment and Perceived Stress: The University of Malaya Experience

PubMed Central

Myint, Kyaimon; See-Ziau, Hoe; Husain, Ruby; Ismail, Rosnah

2016-01-01

Background An equitable and positive learning environment fosters deep self-directed learning in students and, consequently, good practice in their profession. Although demotivating weaknesses may lead to repeated day-to-day stress with a cascade of deleterious consequences at both personal and professional levels, a possible relationship between these parameters has not been reported. This study was undertaken to determine the relationship between students’ perceptions of their educational environment and their stress levels. Methods Sixty-one first year students at the Dental Faculty, University of Malaya, Malaysia participated. The Dundee Ready Education Environment Measure (DREEM) was used to determine educational environment while self-rated perceived stress level was measured by the Depression Anxiety Stress Scale (DASS). Results Most students (62.39%) showed positive perceptions for the total and five domains of DREEM. The highest percentage was observed for “Students perception of learning” (64.04%) while the lowest was for “Students’ social self-perception” (60.32%). At the same time, 61% of students showed high perceived stress levels. However, this was not associated with their DREEM scores. Conclusion Although a positive perception of their educational environment was found, minor corrective measures need to be implemented. Furthermore, longitudinal studies on an annual basis would provide useful input for strategic planning purposes. PMID:27418869

The control of rabies in Malaya through compulsory mass vaccination of dogs.

PubMed

WELLS, C W

1954-01-01

A fulminating extension of rabies-which has been enzootic in northern Malaya since 1924-occurred in Kuala Lumpur in April 1952. The outbreak was suppressed by the compulsory mass vaccination of dogs, stringent legislation, and intensive stray-dog destruction. Similar measures are being employed in the current campaign, the aim of which is the complete eradication of the disease.From an average annual incidence of 112 confirmed canine cases prior to 1952-when a total of 198 cases was reported-the incidence fell to 15 cases (all in unvaccinated dogs) for the period January-November 1953, during the last 5(1/2) months of which no case in either animals or man was reported. It is considered that the extensive publicity campaign and strict enforcement of the control measures have contributed measurably to the present improved position.Statistics relating to confirmed cases in dogs previously vaccinated with (a) phenolized 20% brain-tissue suspension vaccine (buffalo origin) and (b) chicken-embryo vaccine (Flury strain) are quoted and their probable significance in favour of the latter under Malayan conditions is discussed. The hypothesis that the development of rabies may, in many instances, have been blocked by the vaccine is advanced.The plan for a pan-Federation compulsory vaccination campaign in 1954, to consolidate the 1952-3 improvements, is outlined.

Malaysia: Political Transition and Implications for U.S. Policy

DTIC Science & Technology

2003-10-21

shall be subject to a penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. 1...127,316 sq. miles (about the size of New Mexico) Capital: Kuala Lumpur Ethnic Groups: Bumiputeras 58% [ Malay 47%, Indigenous 11%], Chinese 24...British. The British added ethnic Chinese and Indians to the Malay and other indigenous populations of peninsular Malaya, Sabah, and Sarawak. The

JPRS Report East Asia Southeast Asia

DTIC Science & Technology

1987-07-08

funds to sustain the market, buying interest generated by the blue chips and investors’ longer-term view of the market occur at the same time, the bull...Yearend (MALAYA, 19 Jun 87) 62 Manila Stock Market Surges to Record Highs (Raul Mercelo; THE MANILA CHRONICLE, 18 Jun 87)... 63 - c - STAR...Reports Mixed Reactions to Investment Code (Chito Lozada; THE PHILIPPINE STAR, 12 Jun 87) 65 MANILA BULLETIN Hails Approval of Investment Code

Special Warfare: A Selected Bibliography.

DTIC Science & Technology

1983-10-01

G8234 1982) 31. Chaliand, Gerard. Revolution in the Third World: Myth and Prosnects. New York: Viking Pres, 1977. (D842 .C45) 32. Clutterbuck, Richard ...L. Guerrillas and Terrorists. London: Faber and Faber, 1977. (HV6431 .C61) 33. Clutterbuck, Richard L. The Long. Lona War: Counterinsurgency in Malaya...Boulder: Panther, 1965. (U240 D3) 39. Darnell, Richard J. Civic Action Program in the Armed Forces. Fort Belvoir: US Army Combat Developments Command

USSR Report, Military Affairs, Military History Journal, No. 4, April 1986

DTIC Science & Technology

1986-08-21

25 Oct 1944. On Cape Pikushev, in Malaya Volokovaya Bay , in Port of Linakhamari on Cape Ristiniyemi, in Suolavuono Bay , in Kobholmfjord, in...Holmengorfjord Tasks Assigned to Force Capturing port and coast of Tsemes Bay , helping units of 18th Army in liberating Novorossiysk To cut in...unexpected for the enemy, since it did not assume that the numerous launches and small boats concentrated in Gelendzhik Bay could quickly and covertly

Area Handbook Series: Singapore: A Country Study.

DTIC Science & Technology

1989-12-01

built to house 12,000 Asian work- ers, with cinemas , hospitals, churches, and seventeen soccer fields. Above-ground tanks held enough fuel for the...the Malaysian general election in April 1964. UMNO was unable to win any seats in the Singapore election, and PAP won only one seat on the penin...of Malaya, Singapore, Sabah, and Sarawak merged to form a Malaysian National Alliance Party. The follow- ing month, the PAP and four opposition

Better Lucky Than Good: A Theory of Unconventional Minds and the Power of Who

DTIC Science & Technology

2009-12-01

approach. Interestingly, the premise of Nagl’s book, Learning to Eat Soup with a Knife: Counterinsurgency Lessons from Malaya and Vietnam, is that only...insurgency between Hit and Baghdadi. He had operated a rural mosque and insurgents met there routinely to plan, pray , or hide. He had abandoned his...caricature of Sheriff Buford Pusser as portrayed in the semi-biopic movie Walking Tall. Why chance spoiling his image by potentially getting his nose

Conflict and Compromise in the Southern Philippines: The Case of Moro Identity.

DTIC Science & Technology

1998-06-01

imbedded in peninsular Malaya, on Java and on Sumatra. Islam was attractive to island leaders as it offered an alternative to the Hindu empire which had...unique not only in that its administrative make-up included a military governorship, but its size and population density also differentiated it from its...school system, administrative set-up, 68 Fowler, 54. 69 T.J.S. George, Revolt in Mindanao: The Rise of Mam in Philippine Politics ( Malaysia : Oxford

Selected Translations from Kommunist, Number 8, 1961.

DTIC Science & Technology

1961-07-21

and developing» There are hqw significant sectionä of a workuig C3äSS in India , •Indonesia and in the/majority of countries Of latin America, In... Pakistan , Thai- land,’Malaya, and the Philippines. In many others such as Tunisia, , Iibya,’Kenya, Iforocco and Liberia, the imperialist .countries haver... Pakistan whose rulers have linked the country to the -■- imperialist’military blocs. About 1c$ of Pakistanis budget is spent for military purposes

Irregular Pen and Limited Sword: PSYWAR, PSYOP, and MISO in Counterinsurgency

DTIC Science & Technology

2011-12-16

Forces Press, 1948), 3-5, 14-16; Leo J. Margolin, Paper Bullets: A Brief Story of Psychological Warfare in World War II (New York: Froben Press, 1946...Robert Thompson, Make for the Hills, Memories of Far Eastern Wars (London: Leo Cooper Ltd, 1989), 1-32, 41-70. 62Post Second World War, Malaya (now...communication ( LOCs ), recruiting efforts, and political viability. The first of the initiatives that contributed to the defeat of the PFLOAG was the

History of the Office of the Secretary of Defense. Volume 2. The Test of War, 1950-1953

DTIC Science & Technology

1988-01-01

alliance, and mutual assistance with Peking. In Malaya, the Philippines , and Indochina, widespread guerrilla warfare flared after World War II, with...Pacific ran through the Aleutians to Japan, the Ryukyu Islands, and the Philippines and that there could be no U.S. guarantee against aggression for... Philippines to Formosa to prevent any attack on or from that island, and that aid to French forces in Indochina be stepped up. * 29 Since the Joint

Addressing a silent killer - The International Conference on Betel Quid and Areca Nut

Cancer.gov

The Center for Global Health, National Cancer Institute, in coordination with the National Institute of Dental and Craniofacial Research , The University of Texas at MD Anderson Cancer Center, Oral Cancer Research Coordinating Center, University of Malaya, Taiwan Health Promotion Administration, Ministry of Health and Welfare, and with the generous support of the Malaysia Ministry of Health, hosted the International Conference on Betel Quid and Areca Nut in Kuala Lumpur Malaysia on April 27-28, 2016.

Two Sides of the Same COIN: A Comparative Analysis of American and British Counterinsurgency Approaches at the Turn of the Twentieth Century

DTIC Science & Technology

2013-12-10

hearts and minds.16 Additionally, he claimed the cooperation between the civilian, military, and police authorities through the Briggs Plan developed...Company, 1967), 76-77. 16Ibid., 176. 17For additional information on the Briggs plan see John J. McCuen, The Art of Counter- Revolutionary War (St...the British campaign in Malaya began as an enemy-focused operation targeting the insurgent forces under the Briggs Plan and then Sir Gerald Templar

British Joint Counter-Insurgency Doctrine - Chinese Whispers From the Past and a Doomed Future

DTIC Science & Technology

2010-04-01

Committee” system of governance and policing used in Malaya to that, which had already been tied and tested in India. 119 Michael Crawshaw , "Running a...years and claimed the lives of one   155 http://news.bbc.co.uk/2/hi/programmes/uk_confidential/1731567.stm. 156 Ibid. 157 Crawshaw : p14. 158... Crawshaw , Michael. "Running a Country: The British Colonial Experience and Its Relevance to Present-Day Concerns." The Defence Academy of the

British Air Power in Peripheral Conflict, 1919-1976

DTIC Science & Technology

1989-10-01

Northwest Frontier of Mohn Pimlott, "The British Army: The Dhofar Campaign, 1970-1975," in Ian F.W. Beckett and John Pimlott (eds.), Armed Forces and...Malaya, Singapore, Borneo, and even the Phil - ippines!5 In December 1962, an Indonesian-backed revolt was staged by the "secret army" of Brunei r...BIBLIOGRAPHY 121 Pimlott, John. "The British Army: The Dhofar Campaign, 1970-1975," in Ian F.W. Beckett and John Pimlott (eds.), Armed Forces and

Beyond Hearts and Minds: Evaluating U.S. Unconventional Warfare Doctrine

DTIC Science & Technology

2005-12-01

bottles, and even knives were thrust into their vaginas . Men had beer bottles thrust up their rectums, were dragged behind Land Rovers, whipped...Punjab during the late 1980’s and early 1990’s. Like Malaya, a myth has propagated that it was political reform (not the use of coercive violence...undermine efforts and recommends maintaining an aura of superiority over everyone but the top Sharifs. The myth that Lawrence was able to blend in with the

Malaysian Parasites 37: An Introduction to the Ecology of the Mosquitoes of the Lowland Dipterocarp Forest of Selangor, Malaya

DTIC Science & Technology

1960-01-01

introductory account jointly. The work at Ulu Gombak has been supplemented by collections in other forest areas of Selangor, chiefly Ulu Langat ...including those two species, but there is little information available on their ecology. ULU LANGAT FOREST RESERVE Situated due east of Kuala Lumpur (see...RESERVES These reserves have been visited only occasionally. Each is much less disturbed than either Ulu Gombak or Ulu Langat and this is reflected both

The Misapplication of the Malayan Counterinsurgency Model to the Strategic Hamlet Program

DTIC Science & Technology

2001-06-01

insurgency are Harry Miller’s A Short History of Malaysia and Anthony Short’s The Communist Insurrection in Malaya. The former gives a good account of...Hills: Memories of Far Eastern Wars (London: Leo Cooper Ltd., 1989), 79-80. 3 Mackay, 12. 23 4Wang Gungwu, Malaysia : A Survey (New York: Frederick A...system in which personal loyalty rather that performance was rewarded . By placing loyalists in key military and civilian posts, Diem sought to create a

Bottle feeding and ideology in colonial Malaya: the production of change.

PubMed

Manderson, L

1982-01-01

Considerable attention has been paid to the correlation between high infant morbidity and mortality rates and the increased incidence of bottle feeding. The shift from prolonged breast feeding to a mixed regime or the exclusive use of sweetened condensed milk or infant formula has been related to the promotional activities of milk companies, and typically has been presented as a relatively recent development in Third World countries. However, the marketing of tinned and powdered milk only partially explains the increased use of these products. In colonial Malaya, condensed milk was marketed from the late 19th century. Infant formula was available from the turn of the century and was widely advertised, first in the English-language press and later also in the vernacular presses. At the same time, other social and cultural factors served to discourage breast feeding. There were changes in ideas regarding ideal body weight for both women and infants, and regarding infant care and diet; these ideas were presented in the mass media. In addition, maternal and child health clinics, established in the 1920s to reduce the high infant mortality rate, both propagated popular beliefs about infant weight and supplied milk and educated women to artificially feed their infants. Industry, the media, and health services all promoted, if not always intentionally, bottle feeding rather than breast feeding. Bottle feeding as an ideal, if not a reality, was thus well established before the intensive promotion of milk products by multinational corporations that followed the political independence of the colony.

The Iraq War: Learning from the Past, Adapting to the Present, and Planning for the Future

DTIC Science & Technology

2007-02-01

derive a template for victory from any single campaign or national approach. 4 DEFINING TERMS A public fed a steady diet of suicide bombings and...appointment), Sir Gerald Templer, insisted that committees meet at least once a day, if only for “a whiskey and soda .”27 The system worked well in Malaya and...allowed the insurgency to take root, making it far more difficult to eradicate. Even when U.S. forces became aware of the danger , they had great

K-Ar age of the late Pleistocene eruption of Toba, north Sumatra

USGS Publications Warehouse

Ninkovich, D.; Shackleton, N.J.; Abdel-Monem, A. A.; Obradovich, J.D.; Izett, G.

1978-01-01

The late Pleistocene eruption of Toba is the largest magnitude explosive eruption documented from the Quaternary. K-Ar dating of the uppermost unit of the Toba Tuff gives an age of [~amp]sim; 75,000 yr. A chemically and petrographically equivalent ash layer in deep-sea cores helps calibrate the Stage 4-5 boundary of the standard oxygen isotope stratigraphy. A similar ash in Malaya that overlies finds of Tampan Palaeolithic tools indicates that they are older than 75,000 yr. ?? 1978 Nature Publishing Group.

The Experiences of Well-Being of Palliative Care Patients in Malaysia: A Thematic Analysis.

PubMed

Beng, Tan Seng; Chin, Loh Ee; Guan, Ng Chong; Ann, Yee Hway; Wu, Cathie; Kuan, Wong Sook; Jane, Lim Ee; Khee, Saw Shier; Meng, Christopher Boey Chiong

2015-08-01

A qualitative study was conducted with semistructured interviews to explore the experiences of well-being in 15 adult palliative care inpatients of University Malaya Medical Center, Kuala Lumpur, Malaysia. The results were thematically analyzed. Six basic themes were generated (1) positive attitude, (2) positive cognitions, (3) positive emotions, (4) positive engagement, (5) positive relationships, and (6) positive circumstances. The Seeds Model was conceptualized from the analysis. This model may inform the development of interventions in the enhancement of well-being of palliative care patients. © The Author(s) 2014.

The Genus Culex, Subgenus Eumelanomyia Theobald in Southeast Asia and Adjacent Areas

DTIC Science & Technology

1972-01-01

in Malaya and Singapore; by W. V. King, L. E. Rozeboom, K. L. Knight, J. Laffoon, E. S. Ross, F. E. Baisas, M. Delfinado, G . Alcasid and others in...with a small number of branches and hair g -VIII of abdomen placed near to the caudolateral angle. In the larva, the following characters are...3) and 3(2-3)b respectively; 6-I& IV usually double (l-3); 6-V, VI usually single (l-2); 2-VII always lateral to l-VII; 9-VII usually 6b(4-7); g

Examining the relationship between local extinction risk and position in range.

PubMed

Boakes, Elizabeth H; Isaac, Nicholas J B; Fuller, Richard A; Mace, Georgina M; McGowan, Philip J K

2018-02-01

Over half of globally threatened animal species have experienced rapid geographic range loss. Identifying the parts of species' distributions most vulnerable to local extinction would benefit conservation planning. However, previous studies give little consensus on whether ranges decline to the core or edge. We built on previous work by using empirical data to examine the position of recent local extinctions within species' geographic ranges, address range position as a continuum, and explore the influence of environmental factors. We aggregated point-locality data for 125 Galliform species from across the Palearctic and Indo-Malaya into equal-area half-degree grid cells and used a multispecies dynamic Bayesian occupancy model to estimate rates of local extinctions. Our model provides a novel approach to identify loss of populations from within species ranges. We investigated the relationship between extinction rates and distance from range edge by examining whether patterns were consistent across biogeographic realm and different categories of land use. In the Palearctic, local extinctions occurred closer to the range edge than range core in both unconverted and human-dominated landscapes. In Indo-Malaya, no pattern was found for unconverted landscapes, but in human-dominated landscapes extinctions tended to occur closer to the core than the edge. Our results suggest that local and regional factors override general spatial patterns of recent local extinction within species' ranges and highlight the difficulty of predicting the parts of a species' distribution most vulnerable to threat. © 2017 The Authors. Conservation Biology published by Wiley Periodicals, Inc. on behalf of Society for Conservation Biology.

Historical development of the renal histopathology services in Malaysia.

PubMed

Looi, Lai-Meng; Cheah, Phaik-Leng

2009-06-01

Western-style medicine was introduced to Malaya by the Portuguese, Dutch and British between the 1500s and 1800s. Although the earliest pathology laboratories were developed within hospitals towards the end of the 19th Century, histopathology emerged much later than the biochemistry and bacteriology services. The University Departments of Pathology were the pioneers of the renal histopathology diagnostic services. The Department of Pathology, University of Malaya (UM) received its first renal biopsy on 19 May 1968. Hospital Universiti Kebangsaan Malaysia (HUKM) and Hospital Universiti Sains Malaysia (HUSM) started their services in 1979 and 1987 respectively. It is notable that the early services in these University centres caterred for both the university hospitals and the Ministry of Health (MOH) until the mid-1990s when MOH began to develop its own services, pivoted on renal pathologists trained through Fellowship programmes. Currently, key centres in the MOH are Kuala Lumpur Hospital, Sultanah Aminah Hospital Johor Bahru and Malacca Hospital. With the inclusion of renal biopsy interpretation in the Master of Pathology programmes, basic renal histopathology services became widely available throughout the country from 2000. This subsequently filtered out to the private sector as more histopathologists embraced private practice. There is now active continuing professional development in renal histopathology through clinicopathological dicussions, seminars and workshops. Renal research on amyloid nephropathy, minimal change disease, IgA nephropathy, fibrillary glomerulonephritis, lupus nephritis and microwave technology have provided an insight into the patterns of renal pathology and changing criteria for biopsy. More recently, there has been increasing involvement of renal teams in clinical trials, particularly for lupus nephritis and renal transplant modulation.

Suicide and ethnicity in Malaysia.

PubMed

Murty, Om Prakash; Cheh, Lo Boon; Bakit, Pangie Anak; Hui, Foo Jhi; Ibrahim, Zarina Binti; Jusoh, Nazirah Binti

2008-03-01

This article highlights methods of ending life in different ethnic groups. This inference is drawn from analysis of data from suicidal cases from the University Malaya Medical Centre mortuary. This study also looked at sex, age, social, and employment factors. Kuala Lumpur has sizeable populations of Muslims, Chinese, Indians and Indonesian, etc. This study is based on 251 cases of suicide that were reported at the University Malaya Medical Centre from 2000 to 2004. Malaysia has a population of 22,662,365 people with 3 major ethnic groups: Malay (58%), Chinese (24%), and Indians (8%) with a minority of "others" (10%), which includes foreigners, Sabahan, and Sarawakian. This research found suicides of 164 male (65%) and 87 female (35%) victims. Their age ranged from 15 to 80 years. The age group from 21 to 30 had the highest total cases of suicide (83 of 251; 33.1%). Among ethnic groups highest rate of suicide was among Chinese with a total of 120 cases (120 of 251; 47.8%). As far as lone method of suicide is concerned, hangings accounted for the highest proportion of cases (108 of 251; 43%). Among ethnic groups, jumping from height was the commonest method used by Chinese (49 of 120; 41%), Malay (9 of 16; 56%), and others (15 of 28; 53.4%); whereas, hanging was the commonest method of committing suicide by Indians (49 of 87); Muslims showed the lowest cases of suicide (18 of 251; 7.2%). In poisoning group Indian was the highest ethnic group who used this method (20 of 37; 54.1%).

Descriptive epidemiology of colorectal cancer in University Malaya Medical Centre, 2001 to 2010.

PubMed

Magaji, Bello Arkilla; Moy, Foong Ming; Roslani, April Camilla; Law, Chee Wei

2014-01-01

Colorectal cancer is the second most frequent cancer in Malaysia. Nevertheless, there is little information on treatment and outcomes nationally. We aimed to determine the demographic, clinical and treatment characteristics of colorectal cancer patients treated at the University Malaya Medical Centre (UMMC) as part of a larger project on survival and quality of life outcomes. Medical records of 1,212 patients undergoing treatment in UMMC between January 2001 and December 2010 were reviewed. A retrospective-prospective cohort study design was used. Research tools included the National Cancer Patient Registration form. Statistical analysis included means, standard deviations (SD), proportions, chi square, t-test/ ANOVA. P-value significance was set at 0.05. The male: female ratio was 1.2:1. The mean age was 62.1 (SD12.4) years. Patients were predominantly Chinese (67%), then Malays (18%), Indians (13%) and others (2%). Malays were younger than Chinese and Indians (mean age 57 versus 62 versus 62 years, p<0.001). More females (56%) had colon cancers compared to males (44%) (p=0.022). Malays (57%) had more rectal cancer compared to Chinese (45%) and Indians (49%) (p=0.004). Dukes' stage data weres available in 67%, with Dukes' C and D accounting for 64%. Stage was not affected by age, gender, ethnicity or tumor site. Treatment modalities included surgery alone (40%), surgery and chemo/radiotherapy 32%, chemo and radiotherapy (8%) and others (20%). Significant ethnic differences in age and site distribution, if verified in population-based settings, would support implementation of preventive measures targeting those with the greatest need, at the right age.

How Can the U.S. Military Avoid Another 9/15?: An Analysis of the Inability of U.S. Military Leaders to Provide an Adequate Strategy for Responding to the 9/11 Attacks

DTIC Science & Technology

2007-12-01

Deputy Chief of Staff for Operations and Plans, Department of the Army (DSCOPS, DA). d. Conduct programs which bear directly on the Army in the field...response recommendation were all products of an educational system that focused on a Direct Approach. In his work, Learning to Eat Soup with a...79 Duggan, p 169. 80 John Nagl, Learning to Eat Soup with a Knife: Counterinsurgency Lessons from Malaya and Vietnam, Chicago: University of

Overview of breast cancer in Malaysian women: a problem with late diagnosis.

PubMed

Hisham, Abdullah N; Yip, Cheng-Har

2004-04-01

Breast cancer is the most common cancer among Malaysian women. There is a marked geographical difference in the worldwide incidence of breast cancer, with a higher incidence in developed countries compared to developing countries. From 1998 to 2001, new cases of breast cancer presenting to the breast clinics at Hospital Kuala Lumpur and University Malaya Medical Centre, Malaysia, were reviewed; the race, age and stage at presentation were analysed. Of 774 cases seen in Hospital Kuala Lumpur, only 5.2% (40/774) were impalpable breast cancers diagnosed on mammography. The prevalent age group was 40 to 49 years, and the median age was 50 years. The average size of the tumour was 5.4 cm in diameter. Malay women appear to have larger tumours and a later stage at presentation than other ethnic groups; 50% to 60% were in late stages (Stages 3 and 4). During the same period, 752 new cases of breast cancer were seen in the University Malaya Medical Centre. The average tumour size was 4.2 cm, and 30% to 40% were in late stages. The age incidence was similar. The delay in presentation of breast cancer was attributed to a strong belief in traditional medicine, the negative perception of the disease, poverty and poor education, coupled with fear and denial. A prospective, population-based study is required to determine the demographic pattern of breast cancer and the factors delaying presentation. These findings will have important implications in future programmes to promote the early detection of breast cancer, as well as in understanding geographical as well as racial variations in the incidence of breast cancer.

Functional status of acute stroke patients in University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia.

PubMed

Rameezan, B A R; Zaliha, O

2005-12-01

Stroke is a leading cause of death and disability in most developed countries and developing nations. Majority of the stroke survivors are left with significant physical and cognitive impairments. In addition to the improved acute stroke care, they often benefit from rehabilitation in improving their function. This was the first study done to document function for post stroke patients in Malaysia. It was prospective study conducted to document functional status of acute stroke patients upon admission, discharge and at 3 months post stroke. Assessment of functional status for these patients are based on their activities of daily living and ambulation i.e. self-care, sphincter control, mobility, locomotion, communication and social cognition. It is also aimed to describe their demographic and clinical characteristics. Correlation of functional status at 3 months post stroke with the initial severity of stroke was also explored. A total of fifty-one patients with acute stroke in University Malaya Medical Centre (UMMC) were recruited. The patient's age ranged from 38 to 83 years with a mean of 60.2 years. Thirty-six patients (71%) were first stroke sufferers and fifteen patients (29%) had recurrent stroke. At discharge from acute stay, 13% of patients were able to ambulate with aids and 87% needed assistance for ambulation in varying degrees. Eighty-two percent of patients showed improvement in overall function (both motor and cognition) at 3 months post stroke. Sixty percent of patients were independent in ambulation and 40% required assistance. Significant correlation was seen between the initial severity of stroke and functional status at 3 months post stroke. Functional status of patients with stroke has improved at 3 months post stroke. A comprehensive rehabilitation medicine programme should be incorporated into management of stroke patients to expedite functional recovery and improve patient's independence.

University of Malaya dental students' attitudes towards communication skills learning: implications for dental education.

PubMed

Nor, Nor Azlida M; Yusof, Zamros Y M; Shahidan, Mohd Noor F M

2011-12-01

The Ministry of Higher Education in Malaysia has called for the implementation of a soft skills module in all public universities in Malaysia. In response to this and as part of curriculum development efforts for a new integrated program for 2011, a study was undertaken to improve the University of Malaya (UM) Faculty of Dentistry's communication skills course. One of the study objectives was to investigate dental students' attitudes towards communication skills learning and the association between their attitudes and demographic and education-related characteristics. A cross-sectional survey--using a self-administered twenty-four-item adapted Communication Skills Attitude Scale (CSAS) that contained both positive (PAS) and negative (NAS) attitude subscales--was carried out targeting all final-year dental students at the UM and the Universiti Kebangsaan Malaysia (UKM). A total of 148 students completed the survey, yielding a response rate of 88.1 percent. Overall, UKM students had significantly more positive attitudes towards communication skills learning (PAS score: mean=48.69, SD=4.48, p<0.001) than UM students (mean=46.03, SD=4.22). There was no statistically significant difference in negative attitudes between the two groups. UKM students with more positive attitudes tended to be female (p<0.05). UM students with more negative attitudes perceived themselves as poor communicators (p<0.05), and UKM students with more negative attitudes tended to have poor English proficiency (p<0.05). This study found that both UM and UKM final-year dental students have positive and negative attitudes towards learning communication skills. These attitudes were significantly associated with certain background and education-related attributes. Outcomes of this study served as a valuable guide in strengthening the communication skills course for the UM's new, integrated dental curriculum.

The medical students' societies and medical students' publications.

PubMed

Lim, K H

2005-07-01

The rich corporate life of the medical student and the medical students' societies at our medical school (at the present National University of Singapore) is generally unappreciated by its graduates and regrettably, even more unknown to the medical student of today. The present generation of medical students of NUS do not know of their rich history. We have published documentation of student activities from the founding of the medical school in 1905 till the establishment of the then University of Malaya in 1950, reviewed herein. Materials presented after 1950 were gathered from personal communications from key players in the students' societies and from editors of the medical students' publications.

The dental identification of victims of an aircraft accident in Malaysia.

PubMed

Nambiar, P; Jalil, N; Singh, B

1997-02-01

On 15 September 1995 a Malaysian Airlines (MAS) Fokker 50 plane plunged while descending and crashed, killing thirty-four passengers aboard. The dental disaster victim identification team comprising dental surgeons from the Dental faculty, University of Malaya; Ministry of Health, Sabah; and the Malaysian Defence Forces played an active role in the identification process. Most of the bodies were badly mutilated, disfigured and severely incinerated. Problems were encountered due to inadequate facilities and space at the mortuary. Difficulties were also encountered during the procurement and deciphering of information from dental records. This disaster has however created greater awareness amongst Malaysians of the important role of forensic odontology in mass disasters.

Proposal: A Hybrid Dictionary Modelling Approach for Malay Tweet Normalization

NASA Astrophysics Data System (ADS)

Muhamad, Nor Azlizawati Binti; Idris, Norisma; Arshi Saloot, Mohammad

2017-02-01

Malay Twitter message presents a special deviation from the original language. Malay Tweet widely used currently by Twitter users, especially at Malaya archipelago. Thus, it is important to make a normalization system which can translated Malay Tweet language into the standard Malay language. Some researchers have conducted in natural language processing which mainly focuses on normalizing English Twitter messages, while few studies have been done for normalize Malay Tweets. This paper proposes an approach to normalize Malay Twitter messages based on hybrid dictionary modelling methods. This approach normalizes noisy Malay twitter messages such as colloquially language, novel words, and interjections into standard Malay language. This research will be used Language Model and N-grams model.

Ocular trauma injuries: a 1-year surveillance study in the University of Malaya Medical Centre, Malaysia. 2008.

PubMed

Soong, Terrence Kwong-Weng; Koh, Alan; Subrayan, Visvaraja; Loo, Angela Voon Pei

2011-12-01

To describe the epidemiology of ocular injuries presenting to the University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia. Prospective analysis of all ocular trauma injuries presenting to the Department of Ophthalmology in UMMC from 1 January 2008 to 31 December 2008. A total of 603 eyes of 546 patients were recruited for the study. All patients presenting to the department with ocular trauma injuries were assessed by an ophthalmologist. Data on the type and source of injury, demographic profile of the patients, and clinical presentation were documented using a uniform and validated datasheet. Among eye injury cases, 481 patients (88.1%) were male, with a male-to-female ratio of 7.4:1. Of the patients, 412 (75.5%) were Malaysian while the remaining 134 (24.5%) were of non-Malaysian nationality. The average age was 31.5 years (range 1-81 years). A total of 238 injured eyes (43.6%) were work-related. The common sources of eye trauma include the use of high-powered tools (30.8%), motor vehicle accident (23.1%), and domestic accidents (17.7%). Only six patients (2.5%) reported to having used eye protective device (EPD) at time of their work-related injuries. A major cause of preventable ocular injuries in Malaysia was work-related trauma. Ocular injuries can be reduced by the use of eye protection devices and the implementation of appropriate preventive strategies to address each risk factor. Effective training is an integral part of occupational safety and health, which should be made mandatory at the workplace. In addition, there should be a continual assessment of safety and health issues at the workplace. A long-term database of all ocular injuries in Malaysia is recommended, to aid research on a larger scale and the development of new preventive strategies for ocular injuries.

Many roads lead to Rome--is that true of the teaching and learning of pharmacology? Lessons from three medical schools in Malaysia.

PubMed

Sim, S M; Achike, F I; Geh, S L

2005-08-01

In Malaysia many new medical schools (both public and private) have been set up in the last 12 years. As a result of global changes and local adjustments made in medical training, cross-breeds of different medical curricula have produced a wide spectrum of teaching-learning methods in these medical schools. In this paper, we have selected three medical schools--two public (Universiti Malaya and Universiti Putra Malaysia) and one private (International Medical University) to illustrate different approaches in the teaching-learning of pharmacology that exist in Malaysia. How do these different teaching-learning approaches affect the students' interest and ability to "master" pharmacology and in turn to develop a good prescribing practice?

Outlier detection in a new half-circular distribution

NASA Astrophysics Data System (ADS)

Rambli, Adzhar; Mohamed, Ibrahim Bin; Shimizu, Kunio; Khalidin, Nurliza

2015-10-01

In this paper, we use a discordancy test based on spacing theory to detect outlier in a half-circular data. Up to now, numerous discordancy tests have been proposed to detect outlier in circular distributions which are defined in [0,2π). However, some circular data lie within just half of this range. Therefore, first we introduce a new half-circular distribution developed using the inverse stereographic projection technique on a gamma distributed variable. Then, we develop a new discordancy test to detect single or multiple outliers in the half-circular data based on the spacing theory. We show the practical value of the test by applying it to an eye data set obtained from a glaucoma clinic at the University of Malaya Medical Centre, Malaysia.

Pythons in Burma: Short-tailed python (Reptilia: Squamata)

USGS Publications Warehouse

Zug, George R.; Gotte, Steve W.; Jacobs, Jeremy F.

2011-01-01

Short-tailed pythons, Python curtus species group, occur predominantly in the Malayan Peninsula, Sumatra, and Borneo. The discovery of an adult female in Mon State, Myanmar, led to a review of the distribution of all group members (spot-mapping of all localities of confirmed occurrence) and an examination of morphological variation in P. brongersmai. The resulting maps demonstrate a limited occurrence of these pythons within peninsular Malaya, Sumatra, and Borneo with broad absences in these regions. Our small samples limit the recognition of regional differentiation in the morphology of P. brongersmai populations; however, the presence of unique traits in the Myanmar python and its strong allopatry indicate that it is a unique genetic lineage, and it is described as Python kyaiktiyo new species.

Challenges of Treating Childhood Medulloblastoma in a Country With Limited Resources: 20 Years of Experience at a Single Tertiary Center in Malaysia

PubMed Central

Abd-Ghafar, Sayyidatul; Ganesan, Dharmendra; Bustam Mainudin, Anita Zarina; Wong, Kum Thong; Ramli, Norlisah; Jawin, Vida; Lum, Su Han; Yap, Tsiao Yi; Bouffet, Eric; Qaddoumi, Ibrahim; Krishnan, Shekhar; Ariffin, Hany; Abdullah, Wan Ariffin

2017-01-01

Purpose Pediatric medulloblastoma (MB) treatment has evolved over the past few decades; however, treating children in countries with limited resources remains challenging. Until now, the literature regarding childhood MB in Malaysia has been nonexistent. Our objectives were to review the demographics and outcome of pediatric MB treated at the University Malaya Medical Center between January 1994 and December 2013 and describe the challenges encountered. Methods Fifty-one patients with childhood MB were seen at University Malaya Medical Center. Data from 43 patients were analyzed; eight patients were excluded because their families refused treatment after surgery. Results Headache and vomiting were the most common presenting symptoms, and the mean interval between symptom onset and diagnosis was 4 weeks. Fourteen patients presented with metastatic disease. Five-year progression-free survival (± SE) for patients ≥ 3 years old was 41.7% ± 14.2% (95% CI, 21.3% to 81.4%) in the high-risk group and 68.6% ± 18.6% (95% CI, 40.3% to 100%) in the average-risk group, and 5-year overall survival (± SE) in these two groups was 41.7% ± 14.2% (95% CI, 21.3% to 81.4%) and 58.3% ± 18.6% (95% CI, 31.3% to 100%), respectively. Children younger than 3 years old had 5-year progression-free and overall survival rates (± SE) of 47.6% ± 12.1% (95% CI, 28.9% to 78.4%) and 45.6% ± 11.7% (95% CI, 27.6% to 75.5%), respectively. Time to relapse ranged from 4 to 132 months. Most patients who experienced relapse died within 1 year. Febrile neutropenia, hearing loss, and endocrinopathy were the most common treatment-related complications. Conclusion The survival rate of childhood MB in Malaysia is inferior to that usually reported in the literature. We postulate that the following factors contribute to this difference: lack of a multidisciplinary neuro-oncology team, limited health care facilities, inconsistent risk assessment, insufficient data in the National Cancer Registry and pathology reports, inadequate long-term follow-up, and cultural beliefs leading to treatment abandonment. PMID:28717752

Challenges of Treating Childhood Medulloblastoma in a Country With Limited Resources: 20 Years of Experience at a Single Tertiary Center in Malaysia.

PubMed

Rajagopal, Revathi; Abd-Ghafar, Sayyidatul; Ganesan, Dharmendra; Bustam Mainudin, Anita Zarina; Wong, Kum Thong; Ramli, Norlisah; Jawin, Vida; Lum, Su Han; Yap, Tsiao Yi; Bouffet, Eric; Qaddoumi, Ibrahim; Krishnan, Shekhar; Ariffin, Hany; Abdullah, Wan Ariffin

2017-04-01

Pediatric medulloblastoma (MB) treatment has evolved over the past few decades; however, treating children in countries with limited resources remains challenging. Until now, the literature regarding childhood MB in Malaysia has been nonexistent. Our objectives were to review the demographics and outcome of pediatric MB treated at the University Malaya Medical Center between January 1994 and December 2013 and describe the challenges encountered. Fifty-one patients with childhood MB were seen at University Malaya Medical Center. Data from 43 patients were analyzed; eight patients were excluded because their families refused treatment after surgery. Headache and vomiting were the most common presenting symptoms, and the mean interval between symptom onset and diagnosis was 4 weeks. Fourteen patients presented with metastatic disease. Five-year progression-free survival (± SE) for patients ≥ 3 years old was 41.7% ± 14.2% (95% CI, 21.3% to 81.4%) in the high-risk group and 68.6% ± 18.6% (95% CI, 40.3% to 100%) in the average-risk group, and 5-year overall survival (± SE) in these two groups was 41.7% ± 14.2% (95% CI, 21.3% to 81.4%) and 58.3% ± 18.6% (95% CI, 31.3% to 100%), respectively. Children younger than 3 years old had 5-year progression-free and overall survival rates (± SE) of 47.6% ± 12.1% (95% CI, 28.9% to 78.4%) and 45.6% ± 11.7% (95% CI, 27.6% to 75.5%), respectively. Time to relapse ranged from 4 to 132 months. Most patients who experienced relapse died within 1 year. Febrile neutropenia, hearing loss, and endocrinopathy were the most common treatment-related complications. The survival rate of childhood MB in Malaysia is inferior to that usually reported in the literature. We postulate that the following factors contribute to this difference: lack of a multidisciplinary neuro-oncology team, limited health care facilities, inconsistent risk assessment, insufficient data in the National Cancer Registry and pathology reports, inadequate long-term follow-up, and cultural beliefs leading to treatment abandonment.

Real-time teleteaching in medical physics

PubMed Central

Woo, M; Ng, KH

2008-01-01

Medical physics is a relatively small professional community, usually with a scarcity of expertise that could greatly benefit students entering the field. However, the reach of the profession can span great geographical distances, making the training of students a difficult task. In addition to the requirement of training new students, the evolving field of medical physics, with its many emerging advanced techniques and technologies, could benefit greatly from ongoing continuing education as well as consultation with experts. Many continuing education courses and workshops are constantly being offered, including many web-based study courses and virtual libraries. However, one mode of education and communication that has not been widely used is the real-time interactive process. Video-based conferencing systems do exist, but these usually require a substantial amount of effort and cost to set up. The authors have been working on promoting the ever-expanding capability of the Internet to facilitate the education of medical physics to students entering the field. A pilot project has been carried out for six years and reported previously. The project is a collaboration between the Department of Medical Physics at the Toronto Odette Cancer Centre in Canada and the Department of Biomedical Imaging at the University of Malaya in Malaysia. Since 2001, medical physics graduate students at the University of Malaya have been taught by lecturers from Toronto every year, using the Internet as the main tool of communication. The pilot study explored the different methods that can be used to provide real-time interactive remote education, and delivered traditional classroom lectures as well as hands-on workshops. Another similar project was started in 2007 to offer real-time teaching to a class of medical physics students at Wuhan University in Hubei, China. There are new challenges as well as new opportunities associated with this project. By building an inventory of tools and experiences, the intent is to broaden the real-time teleteaching method to serve a wide community so that future students entering the field can have efficient access to high-quality education that will benefit the profession in the long term. PMID:21614306

Carboniferous paleogeographic, phytogeographic, and paleoclimatic reconstructions

USGS Publications Warehouse

Rowley, D.B.; Raymond, A.; Parrish, Judith T.; Lottes, A.L.; Scotese, C.R.; Ziegler, A.M.

1985-01-01

Two revised paleogeographic reconstructions of the Visean and Westphalian C-D stages are presented based on recent paleomagnetic, phytogeographic, stratigraphic, and tectonic data. These data change the positions of some continental blocks, and allow the definition of several new ones. The most important modifications that have been incorporated in these reconstructions are: (1) a proposed isthmus linking North America and Siberia across the Bering Strait; and (2) the separation of China and Southeast Asia in six major blocks, including South China, North China, Shan Thai-Malaya, Indochina, Qangtang, and Tarim blocks. Evidence is presented that suggests that at least the South China, Shan Thai-Malaya, and Qangtang blocks were derived from the northern margin of Gondwana. Multivariate statistical analysis of phytogeographic data from the middle and late Paleozoic allow definition of a number of different phytogeographic units for four time intervals: (1) the Early Devonian, (2) Tournaisian-early Visean, (3) Visean, and (4) late Visean-early Namurian A. Pre-late Visean-early Namurian A floral assemblages from South China show affinities with northern Gondwana floras suggesting a southerly position and provides additional support for our reconstruction of South China against the northern margin of Gondwana. There is a marked decrease in the diversity of phytogeographic units in the Namurian and younger Carboniferous. This correlates closely with the time of assembly of most of Pangaea. The general pattern of Carboniferous phytogeographic units corresponds well with global distribution of continents shown on our paleogeographic reconstructions. In addition, we have constructed paleoclimatic maps for the two Carboniferous time intervals. These maps stress the distribution of rainfall, as this should be strongly correlated with the floras. There is marked change in the rainfall patterns between the Visean and Westphalian C-D. This change corresponds with the closing of the Appalachian-Ouachita ocean between Laurussia and Gondwana, and reflects the removal of a low-latitude moisture source that probably gave rise to monsoonal conditions along the northern margin of Gondwana in the Visean and earlier times. As well, the presence of a substantial heat source at high elevation in the Late Carboniferous significantly influenced the distribution of climatic belts. ?? 1986.

Soft skills and dental education.

PubMed

Gonzalez, M A G; Abu Kasim, N H; Naimie, Z

2013-05-01

Soft skills and hard skills are essential in the practice of dentistry. While hard skills deal with technical proficiency, soft skills relate to a personal values and interpersonal skills that determine a person's ability to fit in a particular situation. These skills contribute to the success of organisations that deal face-to-face with clients. Effective soft skills benefit the dental practice. However, the teaching of soft skills remains a challenge to dental schools. This paper discusses the different soft skills, how they are taught and assessed and the issues that need to be addressed in their teaching and assessment. The use of the module by the Faculty of Dentistry, University of Malaya for development of soft skills for institutions of higher learning introduced by the Ministry of Higher Education, Malaysia. © 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.

Knowledge portal: a tool to capture university requirements

NASA Astrophysics Data System (ADS)

Mansourvar, Marjan; Binti Mohd Yasin, Norizan

2011-10-01

New technologies, especially, the Internet have made a huge impact on knowledge management and information dissemination in education. The web portal as a knowledge management system is very popular topics in many organizations including universities. Generally, a web portal defines as a gateway to online network accessible resources through the intranet, extranet or Internet. This study develops a knowledge portal for the students in the Faculty of Computer Science and Information Technology (FCSIT), University of Malaya (UM). The goals of this portal are to provide information for the students to help them to choose the right courses and major that are relevant to their intended future jobs or career in IT. A quantitative approach used as the selected method for this research. Quantitative method provides an easy and useful way to collect data from a large sample population.

Clinical oncology in Malaysia: 1914 to present

PubMed Central

2006-01-01

A narration of the development of staff, infrastructure and buildings in the various parts of the country is given in this paper. The role of universities and other institutions of learning, public health, palliative care, nuclear medicine and cancer registries is described together with the networking that has been developed between the government, non-governmental organisations and private hospitals. The training of skilled manpower and the commencement of the Master of Clinical Oncology in the University of Malaya is highlighted. Efforts taken to improve the various aspects of cancer control which includes prevention of cancer, early detection, treatment and palliative care are covered. It is vital to ensure that cancer care services must be accessible and affordable throughout the entire health system, from the primary care level up to the centres for tertiary care, throughout the whole country. PMID:21614216

Parkinson disease of ranking lawyer and legislator SJV Chelvanayakam: a hypothesis.

PubMed

Chelvanayakam, S J V

2003-12-01

SJV Chelvanayakam (1898-1977), a ranking civil lawyer and legislator, was probably the well known Parkinson disease victim in the 20th century Sri Lanka. He was born in Ipoh, Malaya, where his father had moved in the last decade of the 19th century for professional advancement. Ipoh was then an attractive location for migrants from China and the Indian subcontinent since it was in the Kinta valley--touted then, as the world's richest single tin field. Chelvanayakam was brought to Jaffna peninsula when he was aged four (in 1902 or 1903) by his mother, who returned to her native Tellipalai town partly due to indifferent health during her stay in Kinta region. In this communication, I present a hypothesis that organotin exposure as a foetus or during infancy at his place of birth is likely to have been a contributing factor to Chelvanayakam's Parkinsonism. It seems to fit the available circumstantial evidence.

Assessing bone banking activities at University of Malaya medical centre.

PubMed

Mohd, Suhaili; Samsuddin, Sharifah Mazni; Ramalingam, Saravana; Min, Ng Wuey; Yusof, Norimah; Zaman, T Kamarul; Mansor, Azura

2015-12-01

The main advantage of establishing in-house bone banks is its ability to readily provide allograft bones for local surgeries. Bone procurement activities of our university bone bank during the 10 years of operation were reviewed. Socio-demographic data of donors, types of bone procured, cases of rejected bones and types of allograft bones transplanted are presented. From 179 potential donors, 73 % were accepted with 213 procured bones. Femoral head was the common bone transplanted (45 %), as it was also the most common procured (82 %). Bones were rejected mainly due to non-technical reasons (83 %) rather than positive results of microbiological (13 %) and serological (4 %) tests. Comprehensive data could not be obtained for further analysis due to difficulties in retrieving information. Therefore, quality assurance system was improved to establish more systematic documentations, as the basis of good banking practice with process control hence allowing traceability.

Seroepidemiology of toxoplasmosis among HIV-infected patients and healthy blood donors.

PubMed

Nissapatorn, V; Kamarulzaman, A; Init, I; Tan, L H; Rohela, M; Norliza, A; Chan, L L; Latt, H M; Anuar, A Khairul; Quek, K F

2002-09-01

A cross-sectional study was carried out in University of Malaya Medical Centre, Kuala Lumpur. Blood samples from 100 HIV-infected patients and 203 Healthy Blood Donors (HBD) were collected and anti-Toxoplasma antibodies were detected by using conventional ELISA. The seroprevalence of toxoplasmosis in HIV/AIDS and Healthy Blood Donors were found to be 21% and 28.1% respectively. There was no significant association between the seroprevalence of toxoplasmosis and various possible risk factors i.e. contact with cat, consumption of undercooked meat and history of blood transfusion in both groups. No significant differences between Toxoplasma seroprevalence in HIV/AIDS and Healthy Blood Donors in association with presence of single or multiple risk factors were found. The mean CD4 count among HIV/AIDS patients in this study was 202.23 cell/cumm. There was no significant association between CD4 count and seropositivity for Toxoplasma antibodies in HIV/AIDS patients.

Application of amplified ribosomal DNA restriction analysis in identification of Acinetobacter baumannii from a tertiary teaching hospital, Malaysia.

PubMed

Kong, B H; Hanifah, Y A; Yusof, M Y; Thong, K L

2011-12-01

Acinetobacter baumannii, genomic species 3 and 13TU are being increasingly reported as the most important Acinetobacter species that cause infections in hospitalized patients. These Acinetobacter species are grouped in the Acinetobacter calcoaceticus- Acinetobacter baumannii (Acb) complex. Differentiation of the species in the Acb-complex is limited by phenotypic methods. Therefore, in this study, amplified ribosomal DNA restriction analysis (ARDRA) was applied to confirm the identity A. baumannii strains as well as to differentiate between the subspecies. One hundred and eighty-five strains from Intensive Care Unit, Universiti Malaya Medical Center (UMMC) were successfully identified as A. baumannii by ARDRA. Acinetobacter genomic species 13TU and 15TU were identified in 3 and 1 strains, respectively. ARDRA provides an accurate, rapid and definitive approach towards the identification of the species level in the genus Acinetobacter. This paper reports the first application ARDRA in genospecies identification of Acinetobacter in Malaysia.

Combined use of ribotyping, PFGE typing and IS431 typing in the discrimination of nosocomial strains of methicillin-resistant Staphylococcus aureus.

PubMed

Yoshida, T; Kondo, N; Hanifah, Y A; Hiramatsu, K

1997-01-01

We have previously reported the phenotypic characterization of methicillin-resistant Staphylococcus aureus (MRSA) clinical strains isolated in Malaya University Hospital in the period 1987 to 1989 using antibiogram, coagulase typing, plasmid profiles, and phage typing. Here, we report the analysis of the same strains with three genotyping methods; ribotyping, pulsed-field gel electrophoresis (PFGE) typing, and IS431 typing (a restriction enzyme fragment length polymorphism analysis using an IS431 probe). Ribotyping could discriminate 46 clinical MRSA strains into 5 ribotypes, PFGE typing into 22 types, and IS431 typing into 15 types. Since the differences of the three genotyping patterns from strain to strain were quite independent from one another, the combined use of the three genotyping methods could discriminate 46 strains into 39 genotypes. Thus, the powerful discriminatory ability of the combination was demonstrated.

Factorial validity and reliability of the Malaysian simplified Chinese version of Multidimensional Scale of Perceived Social Support (MSPSS-SCV) among a group of university students.

PubMed

Guan, Ng Chong; Seng, Loh Huai; Hway Ann, Anne Yee; Hui, Koh Ong

2015-03-01

This study was aimed at validating the simplified Chinese version of the Multidimensional Scale of Perceived Support (MSPSS-SCV) among a group of medical and dental students in University Malaya. Two hundred and two students who took part in this study were given the MSPSS-SCV, the Medical Outcome Study social support survey, the Malay version of the Beck Depression Inventory, the Malay version of the General Health Questionnaire, and the English version of the MSPSS. After 1 week, these students were again required to complete the MSPSS-SCV but with the item sequences shuffled. This scale displayed excellent internal consistency (Cronbach's α = .924), high test-retest reliability (.71), parallel form reliability (.92; Spearman's ρ, P < .01), and validity. In conclusion, the MSPSS-SCV demonstrated sound psychometric properties in measuring social support among a group of medical and dental students. It could therefore be used as a simple screening tool among young educated Malaysian adolescents. © 2013 APJPH.

Why do some people with type 2 diabetes who are using insulin have poor glycaemic control? A qualitative study

PubMed Central

Tong, Wen Ting; Vethakkan, Shireene Ratna; Ng, Chirk Jenn

2015-01-01

Objective To explore factors influencing poor glycaemic control in people with type 2 diabetes using insulin. Research design A qualitative method comprising in-depth individual interviews. A semistructured interview guide was used. The interviews were audiorecorded, transcribed verbatim and analysed using a thematic approach. Participants Seventeen people with type 2 diabetes using insulin with glycated haemoglobin (HbA1c) ≥9% for >1 year. Setting The Primary Care Clinic and Diabetes Clinic in the University of Malaya Medical Centre (UMMC), Malaysia. Results Data analysis uncovered four themes: lifestyle challenges in adhering to medical recommendations; psychosocial and emotional hurdles; treatment-related factors; lack of knowledge about and self-efficacy in diabetes self-care. Conclusions Factors that explain the poor glycaemic control in people with type 2 diabetes using insulin were identified. Healthcare providers could use these findings to address patients’ concerns during consultations and help to improve glycaemic control. PMID:25633285

The effects of diaphenylsulfone (DDS) against chloroquine-resistant Plasmodium falciparum*

PubMed Central

Degowin, Richard L.; Eppes, R. Bennett; Carson, Paul E.; Powell, Robin D.

1966-01-01

In view of the problems caused by the chloroquine-resistance of some strains of Plasmodium falciparum, the authors have investigated the effectiveness of diaphenylsulfone against two such resistant strains, from Malaya and Viet-Nam. They found that diaphenylsulfone given during acute attacks of malaria had a blood schizontocidal activity against the Malayan resistant strain but was not rapidly effective in terminating acute attacks in non-immune persons, and that, when the drug was given prophylactically in relatively small doses, it was substantially effective in preventing patency of mosquito-induced infection with the same strain. The protective effect of diaphenylsulfone is that of a clinical prophylactic or suppressive drug; it does not appear to be a true causal prophylactic. It was also found that the protective effect is vitiated by the concurrent administration of paraaminobenzoic acid. These studies indicate a need for further assessment of the antimalarial value of sulfones and sulfonamides, both alone and in combination with other drugs, for prevention and cure. PMID:5328901

Hospitalization of childhood rotavirus infection from Kuala Lumpur, Malaysia.

PubMed

Lee, W S; Veerasingam, P D; Goh, A Y T; Chua, K B

2003-01-01

To determine the epidemiology of rotavirus gastroenteritis in children admitted to an urban hospital in a developing country from South-East Asia. Retrospective review of cases of acute gastroenteritis admitted to the children's ward of the University of Malaya Medical Centre, Kuala Lumpur, Malaysia, between 1996 and 1999. During the study period, 333 cases (24%) of 1362 stool samples, obtained from children admitted with acute diarrhoea, were positive for rotavirus. Acute gastroenteritis constituted 8.2%, and rotavirus infection 1.6% of all the paediatric admissions each year. Of the 271 cases analysed, 72% of the affected population were less than 2 years of age. Peak incidence of admissions was between January to March, and September to October. Dehydration was common (92%) but electrolyte disturbances, lactose intolerance (5.2%), prolonged diarrhoea (2.6%) and cow's milk protein intolerance was uncommon. No deaths were recorded. Rotavirus infection was a common cause of childhood diarrhoea that required hospital admission in an urban setting in Malaysia.

The grotesque female in Malaysian poems: shaping the migrant's psyche.

PubMed

DMani, Sheba

2011-12-01

The works of Malaysian poet, Wong Phui Nam's Against the Wilderness (vii) China bride and Variations on a Birthday Theme (iv) Kali, illustrate a bride and a mother in terrifying images. Wong's stylistic form of representing the female body through startling images of inversion and degradation evoke feelings of unease. The suspension between the known and the unknown causes a bewildering reality verging on madness. Interpreted through the lens of the carnivalesque, specifically, the grotesque body, festive language and parody, I attempt to reconstruct the psyche of the Chinese migrant which underpins these poems. The migrant who arrived in Malaya during the colonial era in the early nineteenth century faced political and social struggles in adapting to a new land. In the poems, the migrant juxtaposes his position to a female and uses the female body as a site of contention to intensify the torment of the psyche and to reflect the despair of the Chinese in Malaysia.

Exploration momentum builds in offshore Indonesia

DOE Office of Scientific and Technical Information (OSTI.GOV)

Van Dyke, L.F.

1969-06-23

A base map shows where the major action is taking place in SE. Asian waters. Eight rigs are active in the Indonesian-Malaysian theater. Several companies or groups have plans in various stages of preliminary exploration, from running seismic surveys to charting exploration programs. The Indonesian Government appears willing to negotiate new production sharing agreements for blocks of open acreage. Malaya would also like to grant some new acreage. Only 3 companies have done significant drilling to date. Production in one wildcat, was estimated at about 2,480 bpd, but the well was lost due to mechanical problems. The second well alsomore » found some oil, but was not completed due to mechanical troubles. A third test is reported to have encountered the same productive limestones. A total of 3 dry holes have been drilled off S. Kalimantan. A discovery well, some 80 miles northeast of Djakarta, and about 18 miles off shore in the Java Sea, flowed 2,600 bpd.« less

Satisfaction of orthognathic surgical patients in a Malaysian population.

PubMed

Siow, K K; Ong, S T; Lian, C B; Ngeow, W C

2002-12-01

Thirty-one patients treated at the Faculty of Dentistry, University of Malaya, were assessed for their satisfaction following orthognathic surgery. The female to male ratio was 22:9 with an age range of 17 to 36. Almost all patients (97%) listed appearance as one of their rationales for surgery. More males (78%) than females (59%) wanted functional improvement, while more females (91%) than males (33%) hoped for improvement in self-confidence. All patients reported esthetic improvement while 68% each reported improvement in mastication and self-confidence. Slightly more than half (52%) chose esthetic improvement as the single most important factor resulting in satisfaction. Almost ninety percent of male patients claimed satisfaction with functional improvement, while 68% of those who found satisfaction in improved self-confidence were females. Eighty-seven percent rated their post-surgical changes as being well accepted by their family. The impact of these findings on the success of the surgery and the need to reinforce verbal communication with printed pamphlets are emphasized.

Comparison of psychotropic prescriptions between oncology and cardiology inpatients: result from a pharmacy database in a teaching hospital in Malaysia.

PubMed

Ng, Chong Guan; Mohamed, Salina; Wern, Tai Yi; Haris, Azwa; Zainal, Nor Zuraida; Sulaiman, Ahmad Hatim

2014-01-01

To examine the prescription rates in cancer patients of three common psychotropic drugs: anxiolytic/ hypnotic, antidepressant and antipsychotic. In this retrospective cohort study, data were extracted from the pharmacy database of University Malaya Medical Center (UMMC) responsible for dispensing records of patients stored in the pharmacy's Medication Management and Use System (Ascribe). We analyzed the use of psychotropics in patients from the oncology ward and cardiology from 2008 to 2012. Odds ratios (ORs) were adjusted for age, gender and ethnicity. A total of 3,345 oncology patients and 8,980 cardiology patients were included. Oncology patients were significantly more often prescribed psychotropic drugs (adjusted OR: anxiolytic/hypnotic=5.55 (CI: 4.64-6.63); antidepressants=6.08 (CI: 4.83-7.64) and antipsychotics=5.41 (CI: 4.17-7.02). Non-Malay female cancer patients were at significantly higher risk of anxiolytic/hypnotic use. Psychotropic drugs prescription is common in cancer patients. Anxiolytic/hypnotic prescription rates are significantly higher in non-Malay female patients in Malaysia.

Vertical distribution of Aedes mosquitoes in multiple storey buildings in Selangor and Kuala Lumpur, Malaysia.

PubMed

Lau, K W; Chen, C D; Lee, H L; Izzul, A A; Asri-Isa, M; Zulfadli, M; Sofian-Azirun, M

2013-03-01

The aim of the present study was to determine the vertical distribution and abundance of Aedes mosquitoes in multiple storey buildings in Selangor and Kuala Lumpur, Malaysia. Ovitrap surveillance was conducted for 4 continuous weeks in multiple storey buildings in 4 residential areas located in Selangor [Kg. Baiduri (KB)] and Kuala Lumpur [Student Hostel of University of Malaya (UM), Kg. Kerinchi (KK) and Hang Tuah (HT)]. The results implied that Aedes mosquitoes could be found from ground floor to highest floor of multiple storey buildings and data from different elevation did not show significant difference. Ovitrap index for UM, KB, HT and KK ranged from 0 - 29.17%, 0 - 55.56%, 8.33 - 83.33% and 0 - 91.17% respectively. Aedes aegypti and Aedes albopictus were found breeding in HT, KK and KB; while only Ae. albopictus was obtained from UM. The results indicate that the invasion of Aedes mosquitoes in high-rise apartments could facilitate the transmission of dengue virus and new approaches to vector control in this type of residential area should be developed.

Testing students' e-learning via Facebook through Bayesian structural equation modeling.

PubMed

Salarzadeh Jenatabadi, Hashem; Moghavvemi, Sedigheh; Wan Mohamed Radzi, Che Wan Jasimah Bt; Babashamsi, Parastoo; Arashi, Mohammad

2017-01-01

Learning is an intentional activity, with several factors affecting students' intention to use new learning technology. Researchers have investigated technology acceptance in different contexts by developing various theories/models and testing them by a number of means. Although most theories/models developed have been examined through regression or structural equation modeling, Bayesian analysis offers more accurate data analysis results. To address this gap, the unified theory of acceptance and technology use in the context of e-learning via Facebook are re-examined in this study using Bayesian analysis. The data (S1 Data) were collected from 170 students enrolled in a business statistics course at University of Malaya, Malaysia, and tested with the maximum likelihood and Bayesian approaches. The difference between the two methods' results indicates that performance expectancy and hedonic motivation are the strongest factors influencing the intention to use e-learning via Facebook. The Bayesian estimation model exhibited better data fit than the maximum likelihood estimator model. The results of the Bayesian and maximum likelihood estimator approaches are compared and the reasons for the result discrepancy are deliberated.

Breast cancer in a multi-ethnic Asian setting: results from the Singapore-Malaysia hospital-based breast cancer registry.

PubMed

Pathy, Nirmala Bhoo; Yip, Cheng Har; Taib, Nur Aishah; Hartman, Mikael; Saxena, Nakul; Iau, Philip; Bulgiba, Awang M; Lee, Soo Chin; Lim, Siew Eng; Wong, John E L; Verkooijen, Helena M

2011-04-01

Two hospital-based breast cancer databases (University Malaya Medical Center, Malaysia [n = 1513] and National University Hospital, Singapore [n = 2545]) were merged into a regional registry of breast cancer patients diagnosed between 1990 and 2007. A review of the data found 51% of patients diagnosed before the age of 50 years. and 72% percent of the women were Chinese followed by Malays (16%), Indians (8%), and other races (4%). Median tumor size at presentation was 26 mm and about 25% of patients presented with TNM stage III or IV disease. Most tumors were of ductal histology (87%). Fifty-seven percent of tumors were estrogen receptor positive and 40% were poorly differentiated. Of those patients who had surgery, 70% had mastectomy while 30% had breast conserving surgery. Overall, chemotherapy was administered to 56% of patients and hormonal treatment to 60%. Five-year overall survival was 82.5% in patients with TNM stage 0 to stage II cancer, and 30.2% in those with later stages. Copyright © 2011 Elsevier Ltd. All rights reserved.

Antibacterial and antifungal properties of human cerumen.

PubMed

Lum, C L; Jeyanthi, S; Prepageran, N; Vadivelu, J; Raman, R

2009-04-01

To assess the antibacterial and antifungal properties of human cerumen by studying its effect on the growth of Staphylococcus aureus, Esherichia coli, Pseudomonas aeruginosa and Candida albicans. Cerumen samples were collected from 75 normal, healthy subjects aged from seven to 80 years, without ear pathology, who attended the ear, nose and throat out-patient clinic of the University Malaya Medical Center from May 2006 to October 2006. Of these 75 samples, 31 had no growth when cultured on nutrient agar. Inhibition studies on these 31 samples were performed for Staphylococcus aureus (American Type Culture Collection (ATCC) 25923), Esherichia coli (ATCC 25922), Pseudomonas aeruginosa (ATCC 27853) and Candida albicans. Nutrient agar was used to conserve all three bacterial strains and Sabouraud dextrose agar was used for Candida albicans. A decrease in Staphylococcus aureus growth was observed for 27 of the 31 samples. All 31 samples induced decreased growth of Pseudomonas aeruginosa, while 29 induced decreased growth of Candida albicans. However, only four samples induced decreased growth of Escherichia coli. Cerumen was demonstrated to have potential antimicrobial effects on strains of Staphylococcus aureus, Pseudomonas aeruginosa and Candida albicans.

Stigma in mental illness: attitudes of medical students towards mental illness.

PubMed

Mas, A; Hatim, A

2002-12-01

Negative attitudes towards people with mental illness can be attributed to stigma. The objective of this study was to determine the attitudes of medical students towards mental illness by comparing those who have had contact with mental patients and those who have not. This study also assesses to what extent knowledge about mental illness can affect the students' attitude. A vignette and two dependent measures (social distance scale and dangerousness scale) were used to assess the attitudes of medical students towards mental illness. They comprised of 108 first year and 85 final year medical students in University of Malaya, Kuala Lumpur. The first year students didn't have any prior psychiatric training. The final year students who had knowledge and contact (undergone 8 weeks of clinical psychiatric training) were less stigmatizing toward mentally ill patients. There were no significant differences in the attitudes towards mentally ill patient among the first year students (no knowledge) regardless they had previous contact or not. Knowledge seems to have the effect in inculcating greater tolerance of mental illness. Contact by itself is not sufficient for attitude changes.

Late Vendian Complexes in the Structure of Metamorphic Basement of the Fore Range Zone, Greater Caucasus

NASA Astrophysics Data System (ADS)

Kamzolkin, V. A.; Latyshev, A. V.; Vidyapin, Yu. P.; Somin, M. L.; Smul'skaya, A. I.; Ivanov, S. D.

2018-05-01

The paper presents new data on the composition, age, and relationships (with host and overlying deposits) of intrusive rocks in the basement of the Fore Range zone (Greater Caucasus), in the Malaya Laba River Basin. The evolutionary features of intrusive units located within the Blyb metamorphic complex are described. It is shown for the first time that the lower levels of this complex are, in a structural sense, outcrops of the Late Vendian basement. The basement is composed of the Balkan Formation and a massif of quartz metadiorites that intrudes it; for the rocks of this massif, ages ranging from 549 ± 7.4 to 574.1 ± 6.7 Ma are obtained for three U-Pb datings by the SHRIMP-II method. The Herzyinan magmatic event is represented by a group of granodiorite intrusions penetrating the Blyb complex on a series of faults extending along its boundary with the Main Range zone. The obtained estimate for the U-Pb age of one of the intrusions (319 ± 3.8 Ma) corresponds to the end of the Serpukhovian stage of the Early Carboniferous.

Present status of malaria control in Asia

PubMed Central

Dy, F. J.

1954-01-01

The author summarizes the information given by 13 governments—Afghanistan, Burma, Ceylon, China, India, Indonesia, Malaya, Netherlands New Guinea, Philippines, Portuguese India, Sarawak, Thailand, and Viet Nam—on their existing and proposed malaria-control programmes in response to a questionnaire prepared by WHO for discussion at the First Asian Malaria Conference, which was held in Bangkok in September 1953. Although in late 1953 nearly 46.5 million of the 271 million people living in malarious regions were protected against the disease, more than 224 million others were still unprotected. It is noted that residual-insecticide spraying—the basis of most campaigns—has significantly reduced spleen- and parasite-rates; that the minor opposition to spraying initially encountered in some places quickly disappeared as the benefits became apparent; that malaria control has resulted in general improvements in public health and has promoted socio-economic development; that anopheline resistance to the insecticides used has not been observed; that ten governments voiced the need for indoctrination of public officials concerning malaria control; and that there is a trend among governments to make financial provision for long-term malaria-control schemes. PMID:13209318

Testing students’ e-learning via Facebook through Bayesian structural equation modeling

PubMed Central

Moghavvemi, Sedigheh; Wan Mohamed Radzi, Che Wan Jasimah Bt; Babashamsi, Parastoo; Arashi, Mohammad

2017-01-01

Learning is an intentional activity, with several factors affecting students’ intention to use new learning technology. Researchers have investigated technology acceptance in different contexts by developing various theories/models and testing them by a number of means. Although most theories/models developed have been examined through regression or structural equation modeling, Bayesian analysis offers more accurate data analysis results. To address this gap, the unified theory of acceptance and technology use in the context of e-learning via Facebook are re-examined in this study using Bayesian analysis. The data (S1 Data) were collected from 170 students enrolled in a business statistics course at University of Malaya, Malaysia, and tested with the maximum likelihood and Bayesian approaches. The difference between the two methods’ results indicates that performance expectancy and hedonic motivation are the strongest factors influencing the intention to use e-learning via Facebook. The Bayesian estimation model exhibited better data fit than the maximum likelihood estimator model. The results of the Bayesian and maximum likelihood estimator approaches are compared and the reasons for the result discrepancy are deliberated. PMID:28886019

Capecitabine pattern of usage, rate of febrile neutropaenia and treatment related death in asian cancer patients in clinical practice.

PubMed

Phua, Vincent Chee Ee; Wong, Wei Quan; Tan, Pei Lin; Bustam, Anita Zarina; Saad, Marniza; Alip, Adlinda; Wan Ishak, Wan Zamaniah

2015-01-01

Oral capecitabine is increasingly replacing intravenous 5-fluorouracil in many chemotherapy regimens. However, data on the risk of febrile neutropaenia (FN) and treatment related death (TRD) with the drug remain sparse outside of clinical trial settings despite its widespread usage. This study aimed to determine these rates in a large cohort of patients treated in the University of Malaya Medical Centre (UMMC). We reviewed the clinical notes of all patients prescribed with oral capecitabine chemotherapy for any tumour sites in University Malaya Medical Centre (UMMC) from 1st January 2009 till 31st June 2010. Information collected included patient demographics, histopathological features, treatment received including the different chemotherapy regimens and intent of treatment whether the chemotherapy was given for neoadjuvant, concurrent with radiation, adjuvant or palliative intent. The aim of this study is to establish the pattern of usage, FN and TRD rates with capecitabine in clinical practice outside of clinical trial setting. FN is defined as an oral temperature >38.5°or two consecutive readings of >38.0° for 2 hours and an absolute neutrophil count <0.5 x 109/L, or expected to fall below 0.5 x 109/L (de Naurois et al., 2010). Treatment related death was defined as death occurring during or within 30 days of last chemotherapy treatment. Between 1st January 2009 and 30th June 2010, 274 patients were treated with capecitabine chemotherapy in UMMC. The mean age was 58 years (range 22 to 82 years). Capecitabine was used in 14 different tumour sites with the colorectal site predominating with a total of 128 cases (46.7%), followed by breast cancer (35.8%). Capecitabine was most commonly used in the palliative setting accounting for 63.9% of the cases, followed by the adjuvant setting (19.7%). The most common regimen was single agent capecitabine with 129 cases (47.1%). The other common regimens were XELOX (21.5%) and ECX (10.2%). The main result of this study showed an overall FN rate of 2.2% (6/274). The overall TRD rate was 5.1% (14/274). The FN rate for the single agent capecitabine regimen was 1.6% (2/129) and the TRD rate was 5.4% (7/129). All the TRDs were with single agent capecitabine regimen were used for palliative intent. Oral capecitabine is used widely in clinical practice in a myriad of tumour sites and bears a low risk of febrile neutropaenia. However, capecitabine like any other intravenous chemotherapeutic agent carries a significant risk of treatment related death.

Leong, K.M. (Ed.). The Petroleum Geology and Resources of Malaysia ISBN 983-9738-10-0 . Petronas (Petroliam Nasional Berhad), Kualar Lumpur 2000, A4 size, 665 pages (U.S. $100 + postage (2.5 kg)), hyperlinkhttp://www.petronas.com.my

NASA Astrophysics Data System (ADS)

Murphy, Richard W.; Hutchison, Charles S.

2001-08-01

This 27-chapter volume is a comprehensive review of the petroleum geology of a significant Southeast Asian oil-producing country. The authors are predominantly from Petronas (20) with contributions by Shell (2) and the University of Malaya (1). The whole manuscript was reviewed by Dick Selley and coordinated by Leong Khee Meng. Foremost among the authors is Dr Mazlan Hj. Madon, whose byline is found on 14 chapters and whose guiding hand can be recognised throughout the book. In addition to in-house reports, Petronas has drawn on oil company work, resulting both from exploration activities on PSCs and from regional assessments, based on public domain and proprietary data. The companies involved include Esso, Shell, Mobil, Sun, Texaco, Conoco, Oxy, Triton, OPIC, Idemitsu, Nippon Oil, Elf, Hall-Houston and Western Mining. The volume is a remarkable tribute to the progress made by the Malaysian National Oil Company in the 25 years since the granting of its initial charter in 1974.

Prevalence of intestinal parasites among members of the public in Kuala Lumpur, Malaysia.

PubMed

Jamaiah, I; Rohela, M

2005-01-01

A total of 246 stool samples were collected from the public who participated in a Medical Fair held at the University Malaya Medical Center. The stools were examined for intestinal parasites using the formalin-ether concentration technique. The overall infection rate was 6.9% (17 out of 246), with Trichuris trichiura being the most common parasite (4.5%), followed by Ascaris lumbricoides (0.8%), Clonorchis sinensis (0.8%), hookworm (0.4%), and Entamoeba histolytica (0.4%). None of these participants showed any clinical symptoms. The highest infection rate was among the Chinese 7.7% (13 out of 169), followed by the Malays 7.0% (3 out of 43) and Indians 3.3% (1 out of 30). The highest infection rate was in the age group 16-30 years, which was 9% (6 out of 67). The two cases of clonorchiasis were from two Chinese women aged 28 and 66 years. The 28-year-old Chinese woman was born in Malaysia and had never left the country, while the older woman was also born in Malaysia but had visited Hong Kong as a tourist on two occasions. Both enjoyed eating raw fresh water fish with porridge.

Dental Fear among Medical and Dental Undergraduates

PubMed Central

Hakim, H.; Razak, I. A.

2014-01-01

Objective. To assess the prevalence and level of dental fear among health related undergraduates and to identify factors causing such fear using Kleinknecht's Dental Fear Survey (DFS) questionnaire. Methods. Kleinknecht's DFS questionnaire was used to assess dental fear and anxiety among the entire enrollment of the medical and dental undergraduates' of the University of Malaya. Results. Overall response rate was 82.2%. Dental students reported higher prevalence of dental fear (96.0% versus 90.4%). However, most of the fear encountered among dental students was in the low fear category as compared to their medical counterpart (69.2 versus 51.2%). Significantly more medical students cancelled dental appointment due to fear compared to dental students (P = 0.004). “Heart beats faster” and “muscle being tensed” were the top two physiological responses experienced by the respondents. “Drill” and “anesthetic needle” were the most fear provoking objects among respondents of both faculties. Conclusion. Dental fear and anxiety are a common problem encountered among medical and dental undergraduates who represent future health care professionals. Also, high level of dental fear and anxiety leads to the avoidance of the dental services. PMID:25386615

A retrospective review of methotrexate-induced hepatotoxicity among patients with psoriasis in a tertiary dermatology center in Malaysia.

PubMed

Ng, Lim Chui; Lee, Yin Yin; Lee, Chew Kek; Wong, Su-Ming

2013-01-01

Methotrexate (MTX) is a common and efficacious systemic agent used for the treatment of moderate to severe psoriasis. Nevertheless, its use is associated with the risk of hepatotoxicity. This study was performed to study the association of MTX dose with regards to hepatotoxicity as evidenced by deranged transaminases. This was a retrospective review of patients with psoriasis on MTX from 2000 to 2009 at the outpatient dermatology clinic, University Malaya Medical Centre (UMMC). We analyzed patients' demography, serial laboratory investigations, liver ultrasounds, and liver biopsies of patients on MTX. Sixty-six of 710 (9.30%) patients with psoriasis were prescribed MTX throughout the 10-year period. Among them 57.6% developed deranged transaminases, with six requiring MTX withdrawal due to hepatotoxicity. The mean cumulative dose of MTX at the detection of liver enzyme derangement was 552.3 ± 596.1 mg. A high proportion of patients on MTX had deranged transaminases. However, the number of serious events was low. We concluded from this study that the use of MTX is relatively safe in patients with moderate to severe psoriasis. © 2013 The International Society of Dermatology.

Comparison of susceptibility test methods to detect penicillin susceptibility in Streptococcus pneumoniae isolates.

PubMed

Mohd Nasir, Mohd Desa; Parasakthi, Navaratnam

2004-06-01

The increasing prevalence of penicillin-resistant Streptococuus pneumoniae urges for fast and accurate susceptibility testing methods. This study evaluated the comparability of three commonly used techniques; disk diffusion, E-test and agar dilution, to detect penicillin susceptibility in clinical isolates of S. pneumoniae. Fifty pneumococcal isolates, obtained from patients at the University of Malaya Medical Centre, were selected to include both penicillin-susceptible strains and those that had decreased susceptibility (resistant and intermediate) to penicillin. The minimum inhibitory concentration (MIC) values of penicillin to serve as the reference was determined by the agar dilution method in which, based on the MIC breakpoints recommended by the National Committee for Clinical Laboratory Standards (NCCLS), 27 strains had decreased susceptibility to penicillin with 17 strains resistant and 10 intermediate. Comparing to the agar dilution method, oxacillin disk diffusion test detected all strains with decreased penicillin susceptibility as such while E-test showed a close agreement of susceptibility (92%) of the isolates to penicillin. This confirmed that oxacillin is a good screening test for S. pneumoniae isolates with decreased susceptibility to penicillin while E-test is very reliable for rapid and accurate detection of penicillin susceptibility.

Systemic lupus erythematosus in the multiethnic Malaysian population: disease expression and ethnic differences revisited.

PubMed

Jasmin, R; Sockalingam, S; Cheah, T E; Goh, K J

2013-08-01

Ethnic differences in systemic lupus erythematosus (SLE) have been previously described in the multiethnic Malaysian population. However, there have since been many demographic and socioeconomic changes in the country. The aim of this study is to re-examine the clinical and immunological profiles of Malaysian SLE patients of different ethnic backgrounds. Consecutive follow-up patients at the University Malaya Medical Centre (UMMC) from July 2010 until March 2011 were included in the study. The most common clinical manifestations were malar rash (61.3%), arthritis (52.3%), haematological disease (51.6%), oral ulcers (51%) and renal disease (40.6%). Ethnic Indians had fewer malar and discoid rashes but were at higher risk of arthritis, serositis, renal and neuropsychiatric disease compared to Malays and Chinese Malaysians. Antiphospholipid syndrome (APS) was less common in Chinese. A longer duration of SLE correlated with a lower SLEDAI score. Overall, the spectrum disease expression was similar to the earlier Malaysian study but the frequency of the more severe disease manifestations, viz. renal, haematological, neuropsychiatric involvements and serositis, were lower. This study further emphasises differences primarily between ethnic Indians and the other races in Malaysia.

Thinking about thinking: changes in first-year medical students’ metacognition and its relation to performance

PubMed Central

Hong, Wei Han; Vadivelu, Jamunarani; Daniel, Esther Gnanamalar Sarojini; Sim, Joong Hiong

2015-01-01

Background Studies have shown the importance of metacognition in medical education. Metacognitive skills consist of two dimensions: knowledge of metacognition and regulation of metacognition. Aim This study hypothesizes that the knowledge and regulation of metacognition is significantly different at the beginning and end of the academic year, and a correlation exists between the two dimensions of metacognitive skills with academic performance. Methods The Metacognitive Skills Inventory comprising 52 Likert-scale items was administered to 159 first-year medical students at the University of Malaya. Students’ year-end results were used to measure their academic performance. Results A paired sample t-test indicated no significant difference for knowledge of metacognition at the beginning and end of the academic year. A paired sample t-test revealed significant difference for regulation of metacognition at the beginning and end of the academic year. A very strong correlation was found between the two dimensions of metacognition. The correlation between knowledge and regulation of metacognition with students’ academic result was moderate. Conclusions The improvement in students’ metacognitive regulation and the moderate correlation between knowledge and regulation of metacognition with academic performance at the end of the academic year indicate the probable positive influence of the teaching and learning activities in the medical program. PMID:26314338

Building a DNA barcode reference library for the true butterflies (Lepidoptera) of Peninsula Malaysia: what about the subspecies?

PubMed

Wilson, John-James; Sing, Kong-Wah; Sofian-Azirun, Mohd

2013-01-01

The objective of this study was to build a DNA barcode reference library for the true butterflies of Peninsula Malaysia and assess the value of attaching subspecies names to DNA barcode records. A new DNA barcode library was constructed with butterflies from the Museum of Zoology, University of Malaya collection. The library was analysed in conjunction with publicly available DNA barcodes from other Asia-Pacific localities to test the ability of the DNA barcodes to discriminate species and subspecies. Analyses confirmed the capacity of the new DNA barcode reference library to distinguish the vast majority of species (92%) and revealed that most subspecies possessed unique DNA barcodes (84%). In some cases conspecific subspecies exhibited genetic distances between their DNA barcodes that are typically seen between species, and these were often taxa that have previously been regarded as full species. Subspecies designations as shorthand for geographically and morphologically differentiated groups provide a useful heuristic for assessing how such groups correlate with clustering patterns of DNA barcodes, especially as the number of DNA barcodes per species in reference libraries increases. Our study demonstrates the value in attaching subspecies names to DNA barcode records as they can reveal a history of taxonomic concepts and expose important units of biodiversity.

Microbial cell preparation in enteral feeding in critically ill patients: A randomized, double-blind, placebo-controlled clinical trial.

PubMed

Malik, Ausama A; Rajandram, Retnagowri; Tah, Pei Chien; Hakumat-Rai, Vineya-Rai; Chin, Kin-Fah

2016-04-01

Gut failure is a common condition in critically ill patients in the intensive care unit (ICU). Enteral feeding is usually the first line of choice for nutrition support in critically ill patients. However, enteral feeding has its own set of complications such as alterations in gut transit time and composition of gut eco-culture. The primary aim of this study was to investigate the effect of microbial cell preparation on the return of gut function, white blood cell count, C-reactive protein levels, number of days on mechanical ventilation, and length of stay in ICU. A consecutive cohort of 60 patients admitted to the ICU in University Malaya Medical Centre requiring enteral feeding were prospectively randomized to receive either treatment (n = 30) or placebo (n = 30). Patients receiving enteral feeding supplemented with a course of treatment achieved a faster return of gut function and required shorter duration of mechanical ventilation and shorter length of stay in the ICU. However, inflammatory markers did not show any significant change in the pretreatment and posttreatment groups. Overall, it can be concluded that microbial cell preparation enhances gut function and the overall clinical outcome of critically ill patients receiving enteral feeding in the ICU. Copyright © 2015 Elsevier Inc. All rights reserved.

Organic composition of aerosol particulate matter during a haze episode in Kuala Lumpur, Malaysia

NASA Astrophysics Data System (ADS)

Radzi Bin Abas, M.; Rahman, Noorsaadah A.; Omar, Nasr Yousef M. J.; Maah, M. Jamil; Abu Samah, Azizan; Oros, Daniel R.; Otto, Angelika; Simoneit, Bernd R. T.

The solvent-extractable compounds of urban airborne particulate matter were analyzed to determine the distributions of homologous and biomarker tracers. Samples were collected by high-volume air filtration during the haze episode of 1997 around the University of Malaya campus near Petaling Jaya, a suburb of Kuala Lumpur, Malaysia. These results show that the samples contain n-alkanes, n-alkan-2-ones, n-alkanols, methyl n-alkanoates, n-alkyl nitriles, n-alkanals, n-alkanoic acids, levoglucosan, PAHs, and UCM as the dominant components, with minor amounts of terpenoids, glyceryl esters and sterols, all derived from natural biogenic sources (vascular plant wax), from burning of biomass, and from anthropogenic utilization of fossil fuel products (lubricating oil, vehicle emissions, etc.). Some compositional differences are observed in the samples and greater atmospheric concentrations were found for almost all organic components in the samples collected near a roadway. The results interpreted in terms of major sources are due to local build-up of organic contaminants from vehicular emissions, smoke from biomass burning, and natural background as a result of the atmospheric stability during the haze episodes. The organic components transported in from areas outside the region, assuming all smoke components are external to the city, amount to about 30% of the total organic particle burden.

Fibroadenomatoid mastopathy: another distractive breast lesion?

PubMed

Tan, P E; Looi, L M

1991-12-01

Although most anatomical pathologists have encountered breast lesions with the composite histological features of fibroadenoma (FA) and fibrocystic change (FC), referred to as fibroadenomatosis or fibroadenomatoid mastopathy (FAM), little is known about its prevalence or clinico-pathological significance. In a retrospective histological review of 400 consecutive breast lesions, among both East and West Malaysians, coded either as FA or FC in the files of the Department of Pathology, University of Malaya, we found 45 (11.3%) cases of FAM. Typically, FAM lesions showed fibroadenomatoid foci in a background of fibrocystic change. The finding of FAM among lesions coded as FC was higher (18.5%) than among FA (4%). The mean age of patients with FAM (32.1 years) was similar to FC (35.1 years) but significantly older than that of FA (26.1 years). The notion that FA and FC are lesions at two ends of a spectrum of growth disorder of breast related to oestrogen-progesterone interplay, and that FAM occupies a position intermediate between the two, may explain its morphological and age patterns, but remains speculative. It is hoped that increasing awareness of this condition will lead to better understanding of breast pathophysiology. Nevertheless, until its biological nature, histogenesis and malignant potential are more clearly understood, defining FAM as a distinct form of breast disease may not be meaningful to patient management.

A comparison of donor and control group quality of life.

PubMed

Tumin, Makmor; Abdul Talib Abdul Mutalib, Muzalwana; Mohd Satar, Nurulhuda; Abdullah, Nawi; Chong, Chin-Sieng; Ng, Kok-Peng; Lim, Soo-Kun

2014-03-03

Informed consent of prospective donors should include information about the quality of life (QoL) of existing donors, especially those within the relevant country. This study aimed to provide information on Malaysian organ donors' QoL relative to a control group. Using a shorter version of the SF-36, QoL of 80 donors from the University of Malaya Medical Center (UMMC), Malaysia was surveyed and compared to QoL of 80 selected healthy individuals. ANOVA and General Linear Model (GLM) procedure were each applied for the QoL comparison, which was based on gender and age. Donors recorded a better QoL relative to the control group. Comparison across gender revealed that differences are more obvious for males than females. Donor/control comparison across age groups reveals that donors aged 56 and above reported significantly better QoL in most domains relative to other age groups. Information on donor QoL should be made available to the public to present a comprehensive picture of the consequences of organ donation. Nonetheless, we also argue that, despite the merits of organ donation, caution is required before concluding that donors have better QoL because the present research outcomes may reflect a self-selection bias in which respondents only included donors engaging in regular follow-ups.

Heritage Landmark of the Royal Town of Klang: Balai Bomba Klang Selatan

NASA Astrophysics Data System (ADS)

Sulaiman, Normah; Powell, Robert

2017-10-01

The arrival of the British colony in Kuala Lumpur sparked a radical change in the town in terms of infrastructure and town planning. Due to the British Empire’s reign over Malaya in the advent of 20th century, the colonial architectural style has influenced a lot of important building in the royal town of Selangor. Some of the building is abandoned disrespect, disregard and it’s frightening. Many deemed historic buildings and structures disappears in exchange for modernity, which is a threat to the townscape and history. The local council of Klang aims to preserve clusters of colonial sights, place of worships, schools, and remnants of a fort that has shaped the town enabling people to be more appreciative towards it. Located in the heart of Klang town, the fire station sits next to another heritage trail icon, Raja Abdullah Warehouse. Without proper documentation and curation, the building significant will remain unknown and eventually disappear. The core of this paper will showcase the building design quality and its importance, as the first attempt to document the Balai Bomba Klang Selatan to assist in conserving its tangible and intangible qualities. The study aims to collate and document the tangible qualities of the fire station to complement the measured drawing exercise.

Building a DNA Barcode Reference Library for the True Butterflies (Lepidoptera) of Peninsula Malaysia: What about the Subspecies?

PubMed Central

Wilson, John-James; Sing, Kong-Wah; Sofian-Azirun, Mohd

2013-01-01

The objective of this study was to build a DNA barcode reference library for the true butterflies of Peninsula Malaysia and assess the value of attaching subspecies names to DNA barcode records. A new DNA barcode library was constructed with butterflies from the Museum of Zoology, University of Malaya collection. The library was analysed in conjunction with publicly available DNA barcodes from other Asia-Pacific localities to test the ability of the DNA barcodes to discriminate species and subspecies. Analyses confirmed the capacity of the new DNA barcode reference library to distinguish the vast majority of species (92%) and revealed that most subspecies possessed unique DNA barcodes (84%). In some cases conspecific subspecies exhibited genetic distances between their DNA barcodes that are typically seen between species, and these were often taxa that have previously been regarded as full species. Subspecies designations as shorthand for geographically and morphologically differentiated groups provide a useful heuristic for assessing how such groups correlate with clustering patterns of DNA barcodes, especially as the number of DNA barcodes per species in reference libraries increases. Our study demonstrates the value in attaching subspecies names to DNA barcode records as they can reveal a history of taxonomic concepts and expose important units of biodiversity. PMID:24282514

Psychometric Properties of the Malay Version of the Dutch Eating Behaviour Questionnaire (DEBQ) in a Sample of Malaysian Adults Attending a Health Care Facility.

PubMed

Subramaniam, Kavitha; Low, Wah Yun; Chinna, Karuthan; Chin, Kin Fah; Krishnaswamy, Saroja

2017-08-01

This study aims to investigate the psychometric properties of the Malay version of the Dutch Eating Behaviour Questionnaire (DEBQ) among Malaysian adults. The Malay version of the DEBQ instrument was administered to 398 outpatients (269 women and 129 men) at the University of Malaya Medical Centre (UMMC). Confirmatory Factor Analysis (CFA) was conducted to study the construct validity of the instrument. Composite reliability coefficient, Raykov's rho, was used to determine the internal consistency. The proposed three-factor structure for the DEBQ instrument was appropriate, although three items (Items 21, 14 and 27) showed problematic loadings with inappropriate model fit and were removed. The modified version had an appropriate model fit χ 2 /df = 2.129, TLI = 0.908, CFI = 0.918, RMSEA = 0.053 (90%CI = 0.048-0.058), close-fit P -value = 0.136 and satisfactory internal consistency of 0.914 for emotional eating scale, 0.819 for external eating scale and 0.856 for restrained eating scale. The Malay version of the DEBQ is a valid instrument to study eating behaviour traits among Malaysian adults. Further research is warranted to determine if Items 14 and 27 are appropriate for the Malaysian population.

Validation of the Malay version of the Amsterdam Preoperative Anxiety and Information Scale (APAIS).

PubMed

Mohd Fahmi, Z; Lai, L L; Loh, P S

2015-08-01

Preoperative anxiety is a significant problem worldwide that may affect patients' surgical outcome. By using a simple and reliable tool such as the Amsterdam Preoperative Anxiety and Information Scale (APAIS), anaesthesiologists would be able to assess preoperative anxiety adequately and accurately. The purpose of this study was to develop and validate the Malay version of APAIS (Malay-APAIS), and assess the factors associated with higher anxiety scores. The authors performed forward and backward translation of APAIS into Malay and then tested on 200 patients in the anaesthetic clinic of University Malaya Medical Centre. Psychometric analysis was performed with factor analysis, internal consistency and correlation with Spielberger's State-Trait Anxiety Inventory (STAI-state). A good correlation was shown with STAI-state (r = 0.59). Anxiety and need for information both emerged with high internal consistency (Cronbach's alpha 0.93 and 0.90 respectively). Female gender, surgery with a higher risk and need for information were found to be associated with higher anxiety scores. On the other hand, previous experience with surgery had lower need for information. The Malay-APAIS is a valid and reliable tool for the assessment of patients' preoperative anxiety and their need for information. By understanding and measuring patient's concerns objectively, the perioperative management will improve to a much higher standard of care.

Japanese Encephalitis in Malaysia: An Overview and Timeline.

PubMed

Kumar, Kiven; Arshad, Siti Suri; Selvarajah, Gayathri Thevi; Abu, Jalila; Toung, Ooi Peck; Abba, Yusuf; Yasmin, A R; Bande, Faruku; Sharma, Reuben; Ong, Bee Lee

2018-05-29

Japanese encephalitis (JE) is a vector-borne zoonotic disease caused by the Japanese encephalitis virus (JEV). It causes encephalitis in human and horses, and may lead to reproductive failure in sows. The first human encephalitis case in Malaya (now Malaysia) was reported during World War II in a British prison in 1942. Later, encephalitis was observed among race horses in Singapore. In 1951, the first JEV was isolated from the brain of an encephalitis patient. The true storyline of JE exposure among humans and animals has not been documented in Malaysia. In some places such as Sarawak, JEV has been isolated from mosquitoes before an outbreak in 1992. JE is an epidemic in Malaysia except Sarawak. There are four major outbreaks reported in Pulau Langkawi (1974), Penang (1988), Perak and Negeri Sembilan (1998-1999), and Sarawak (1992). JE is considered endemic only in Sarawak. Initially, both adults and children were victims of JE in Malaysia, however, according to the current reports; JE infection is only lethal to children in Malaysia. This paper describes a timeline of JE cases (background of each case) from first detection to current status, vaccination programs against JE, diagnostic methods used in hospitals and factors which may contribute to the transmission of JE among humans and animals in Malaysia. Copyright © 2018. Published by Elsevier B.V.

Thrombophilic mutations in pre-eclampsia and pregnancy-induced hypertension.

PubMed

Omar, Siti Z; Qvist, Rajes; Khaing, Si L; Muniandy, Sekaran; Bhalla, Sunil

2008-04-01

The aim of the present study was to determine the existence or prevalence of thrombophilic markers such as Factor V Leiden, prothrombin G20210A, protein S, protein C, activated protein C and anti-thrombin in pre-eclampsia and pregnancy-induced hypertensive patients. Blood samples were collected from a total number of 124 women at the maternity unit, University of Malaya Medical Center. These included 49 patients with pre-eclampsia, 63 patients with pregnancy-induced hypertension and 12 normal pregnant women. DNA was extracted from the blood samples. Factor V Leiden (Taq I) and prothrombin G20210A (Hind III) genotyping was done on polymerase chain reaction-restriction fragment length polymorphism. Anti-thrombin activity and the concentrations of protein C, protein S and activated protein C were measured using the IL Coagulation System (Hemosil). Of the 124 subjects, one pre-eclampsia patient was homozygous for Factor V Leiden mutation but prothrombin G20210A mutation was not present in any of the subjects. The subject with Factor V Leiden mutation also had a low activated protein C resistance and a low protein S concentration. Factor V Leiden mutation is present in the Asian population and may very well serve as one of the genetic factors responsible for pre-eclampsia and other adverse pregnancy outcomes.

The Banyan tree: overseas migrants from South Asia.

PubMed

Tinker, H

1979-10-01

The number of Indian emigrants throughout the years has made little or no population difference to the country. With the population of India, Pakistan, and Bangladesh totalling about 700 million in the mid 1970s, emigration is almost irrelevant. In 3 small nations, Mauritius, Fiji, and Guyana, Indians form the majority of the population. Present demographic trends point to the same majority in Trinidad. Indians also are an important group in Malaya, Singapore, and Ceylon, where they are more than 10% of the overall population. In other countries Indians form a small, minority population without political power. Almost all the overseas communities preserved the essential of the Hindu, Muslim, or Sikh religions which they took with them. In the Caribbean the Indian, or East Indian, has discarded his mother tongue after 3 or more generations in isolation. In South Africa only very old emigrants still speak their native tongue. Indian communities abroad often separate into Hindu and Muslim communities. British society uses the term "multi-racial" to describe the pluralistic cultures in its colonies, but British culture is not multiracial. The term has meaning only when applied to an urban area such as Singapore. In Singapore a multilingual policy is applied in order to make the multiracial ideal a reality.

Prevalence and associations of neuropathic pain in a cohort of multi-ethnic Asian low back pain patients.

PubMed

Kew, Yueting; Tan, Cheng-Yin; Ng, Chong-Jing; Thang, Sue-Sien; Tan, Leong-Hooi; Khoo, Yvonne Khaii; Lim, Jun-Ni; Ng, Jia-Hui; Chan, Chris Yin-Wei; Kwan, Mun-Keong; Goh, Khean-Jin

2017-04-01

The prevalence of neuropathic low back pain differs in different ethnic populations. The aims of the study are to determine its frequency and associations in a multi-ethnic cohort of Asian low back pain patients. This was a cross-sectional study of low back patients seen at the University of Malaya Medical Centre, Kuala Lumpur, Malaysia. Neuropathic low back pain patients were identified using the painDETECT questionnaire and compared with non-neuropathic (unclear or nociceptive) low back pain patients, in terms of socio-demographic and clinical factors, pain severity (numerical pain rating scale, NPRS), disability (Roland Morris Disability Questionnaire, RMDQ), as well as anxiety and depression (Hospital Anxiety and Depression Scale, HADS). Of 210 patients, 26 (12.4%) have neuropathic low back pain. Neuropathic pain is associated with non-Chinese ethnicity, higher body mass index and pain radiation below the knee. Patients with neuropathic pain have significantly higher NPRS and RMDQ scores, and there are more subjects with anxiety on HADS. However, there are no differences between the groups in age, gender, pain duration or underlying diagnosis of low back pain. The prevalence of neuropathic low back pain in a multi-ethnic Malaysian cohort is lower than previously reported in other populations with possible differences between ethnic groups. It is associated with greater pain severity, disability and anxiety.

From Undang-undang Melaka to federal constitution: the dynamics of multicultural Malaysia.

PubMed

Nor, Mohd Roslan Mohd; Abdullah, Ahmad Termizi; Ali, Abdul Karim

2016-01-01

Malaysia is a multicultural state comprising three main races: Malays, Chinese and Indians. The three main religions are Islam, Buddhism and Hinduism. Other religions such as Sikhism and Christianity are also practised. Muslims are the majority comprising 67 % of the population. This paper is qualitative in nature. It applies historical comparative method in presenting its data. The Undang - undang Melaka (Malacca Laws) was obtained from the monograph available at National Library of Malaysia under the name of Hukum Kanun Melaka. Analysis was done on selected examples from this document. This paper highlights that had there been no introduction to a common law system, Malaysia would have remained with its traditional laws influenced by Islam and its local customs as evident from Undang - undang Melaka (Malacca laws). The Undang - undang Melaka was practised from 1422 to 1444 and the law of the country was developed to accommodate the introduction of civil law during the colonial period. One of the unique aspects of multicultural Malaysia is the fact that it has a parallel legal system: sharia and civil law. This paper examines histo-cultural development of the Islamic law as practised in pre-independent Malaysia, as well as the coexistence between these two laws after the independence of Malaya in 1957. This paper concludes that Islamic law in Malaysia is confined to Muslim family matters, while civil law covers all other matters.

A comparison of smoking behaviour characteristics between Caucasian smokers in the United Kingdom and Malay smokers in Malaysia.

PubMed

Robson, Noorzurani; Bond, Alyson; Wolff, Kim

2013-01-01

There is evidence that smoking behaviour differs by ethnicity. This study aims to compare smoking behaviour characteristics between Caucasian and Malay smokers. A cross sectional survey, involving 175 smokers attending smoking cessation clinics at the Institute of Psychiatry, London, United Kingdom and University Malaya, Kuala Lumpur, Malaysia between May 2005 and February 2007. Data on demographics, smoking history, nicotine dependence and smoking behaviour were collected. All participants were males, mean age 30.7 ± 10.3 years. Caucasians initiated smoking significantly earlier (mean age 14.8 ± 2.8 years) (p = 0.001) and smoked regularly significantly earlier (mean age 17.3 ± 3.5) (p = 0.003) than Malays (mean starting age 16.9 ± 4.4 years and mean age regular use 19.5 ± 4.5 years), respectively. Caucasians smoked less for social integration than Malays (p = 0.03) but smoked more for regulation of negative affect than Malays (p = 0.008) and smoked more for hedonism than Malays (p < 0.001). Malays smoke as a means of socially integrating. This has important public health implications. Social reasons and the social environment play a role in smoking uptake, smoking maintenance and smoking cessation and this should be borne in mind for strategies planning to promote smoking cessation. Copyright © 2013 Elsevier Inc. All rights reserved.

Radiological study on newly developed composite corn advance lines in Malaysia

NASA Astrophysics Data System (ADS)

Adekunle Olatunji, Michael; Bemigho Uwatse, Onosohwo; Uddin Khandaker, Mayeen; Amin, Y. M.; Faruq, G.

2014-12-01

Owing to population growth, there has been high demand for food across the world, and hence, different agricultural activities such as use of phosphate fertilizers, recycling of organic matters, etc, have been deployed to increase crop yields. In Malaysia, a total of nine composite corn advance lines have been developed at the Institute of Biological Sciences, University of Malaya and are being grown under different conditions with a bid to meet the average daily human need for energy and fiber intake. To this end, the knowledge of radioactivity levels in these corn advance lines are of paramount importance for the estimation of possible radiological hazards due to its consumption. Hence, the radioactivity concentrations of 226Ra, 228Ra and 40K in the corn have been determined using HPGe γ-ray spectrometry. The activity concentrations in the corn ranged from 0.05 to 19.18 Bq kg-1 for 226Ra, from 0.10 to 3.22 Bq kg-1 for 228Ra and from 26.4 to 129 Bq kg-1 for 40K. In order to ascertain the radiological safety of the population regarding maize consumption, the daily intakes of these radionuclides as well as the annual effective dose were estimated. The total effective dose obtained due to the ingestion of radionuclides via maize consumption is 15.39 μSv y-1, which is less than the international recommendations.

Pediatric craniomaxillofacial injuries after road traffic crashes: characteristics of injuries and protective equipment use.

PubMed

Yunus, Siti Salmiah Mohd; Ngeow, Wei Cheong; Ramli, Roszalina

2015-09-01

A cross-sectional study to determine the pattern of craniomaxillofacial (CMF) injuries among children involved in road traffic crashes was performed. The association of protective equipment use with the CMF injuries was evaluated. Retrospective records of children treated in the University Malaya Medical Centre, Kuala Lumpur, Malaysia, after road traffic crashes between January 1, 2008 and December 31, 2012 were reviewed, and, after that, telephone interviews were made. Seventy-one children were included in this study. Fifty-two (73.6%) were involved in a motorcycle injury and 19 (23.4%) in a car crash. Their mean age was 6.02 years; SD, 3.46 (range between 0 to 13 years old). More male children were observed (52.1%) compared with females (47.9%). Thirty-nine point four percent of the children sustained CMF injuries, 33.8% body injuries, and 23.9% had both CMF and other body parts injuries. The highest injury severity score was 26, whereas the lowest was 0. Many children did not use protective equipment during traveling, 44.2% of children among motorcycle pillion riders, and 78.9% among car passengers. The association between helmet use and CMF injuries was shown to be statistically significant (P < .001). Craniomaxillofacial injuries could be prevented with the use of motorcycle helmet and seat belt. Copyright © 2015 Elsevier Inc. All rights reserved.

Attitudes of medical students towards euthanasia in a multicultural setting.

PubMed

Adchalingam, K; Kong, W H; Zakiah, M A; Zaini, M; Wong, Y L; Lang, C C

2005-03-01

A cross-sectional survey of 400 medical students of multicultural backgrounds at the University of Malaya was conducted to understand their attitudes towards euthanasia and factors related to medical decisions and ethical reasoning concerning the prolongation of life, the right to die and euthanasia. The student respondents completed self-administered questionnaires that comprised of twelve questions with multiple stems addressing personal perceptions, knowledge, attitudes, and decisions about euthanasia and the relief of suffering. The majority of respondents (52%) were for the withdrawal of active therapy in a patient suffering from a terminal painful disease while 48% of them were against it. Seventy-one percent of the students involved in the study were against the idea of active euthanasia i.e. the administration of a lethal injection. However, 27% of the respondents felt that there was a moral justification to assist patients to die. Thirty-two percent of the respondents favoured the legalization of euthanasia in Malaysia while 67% of them were strongly against it. The majority (61%) of respondents would not practice euthanasia as a doctor nor would they have performed on themselves if or when it became legal. The main issue surrounding euthanasia that concerned the respondents was the misuse of it by unethical practitioners and they felt that further debate on the matter was essential, both within the local and international communities.

Thermoluminescence Response of Ge-Doped Cylindrical-, Flat- and Photonic Crystal Silica-Fibres to Electron and Photon Radiation

PubMed Central

Entezam, A.; Khandaker, M. U.; Amin, Y. M.; Ung, N. M.; Bradley, D. A.; Maah, J.; Safari, M. J.; Moradi, F.

2016-01-01

Study has been made of the thermoluminescence (TL) response of silica-based Ge-doped cylindrical, flat and photonic crystal fibres (referred to herein as PCF-collapsed) to electron (6, 12 and 20 MeV) and photon (6, 10 MV) irradiation and 1.25 MeV γ-rays, for doses from 0.1 Gy to 100 Gy. The electron and photon irradiations were delivered through use of a Varian Model 2100C linear accelerator located at the University of Malaya Medical Centre and γ-rays delivered from a 60Co irradiator located at the Secondary Standard Dosimetry Laboratory (SSDL), Malaysian Nuclear Agency. Tailor-made to be of various dimensions and dopant concentrations (6–10% Ge), the fibres were observed to provide TL yield linear with radiation dose, reproducibility being within 1–5%, with insensitivity to energy and angular variation. The sensitivity dependency of both detectors with respect to field size follows the dependency of the output factors. For flat fibres exposed to 6 MV X-rays, the 6% Ge-doped fibre provided the greatest TL yield while PCF-collapsed showed a response 2.4 times greater than that of the 6% Ge-doped flat fibres. The response of cylindrical fibres increased with core size. The fibres offer uniform response, high spatial resolution and sensitivity, providing the basis of promising TL systems for radiotherapy applications. PMID:27149115

Lung cancer in patients younger than 40 years in a multiracial Asian country.

PubMed

Liam, C K; Lim, K H; Wong, C M

2000-12-01

This study aimed to determine whether the clinicopathological features of lung cancer in patients younger than 40 years differ from that of older patients in an Asian country. We undertook a review of the clinicopathological data of all patients with confirmed primary lung cancer at the Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia, from October 1991 to September 1999. Of the 580 patients with lung cancer, 36 (6.2%; 23 males, 13 females) were 21-39 years old at diagnosis. The percentage of people who had never smoked was higher among the younger patients (58.3% vs 19.1%, P < 0.001). Although adenocarcinoma was the most common cell type in both groups, its incidence was higher in the younger patients (24/36 (66.7%) vs 228/544 (41.9%), P = 0.007). The mean World Health Organization performance status at presentation was worse in the younger patients (2.4 vs 2, P = 0.007). In the case of non-small cell lung cancer, all the younger patients presented with either stage IIIb or metastatic disease compared to 77.2% of the older patients (P < 0.001). Younger lung cancer patients were more likely than older patients to have never smoked, to have adenocarcinoma, and to present with poorer performance status and with more advanced-stage non-small cell lung cancer.

Female labour force participation and fertility.

PubMed

Concepcion, M B

1974-01-01

The levels of labor force participation by women in selected Asian countries were recorded in a series of censuses taken over a period of years. These levels were less influenced than male employment levels by economic conditions and more influenced by cultural traits of the country. Postwar trends seem to have fallen in Korea, risen in Singapore and the Philippines, and remained steady in Japan, Malaya, and Thailand. The limitations of these data are mentioned. In Thailand and West Malaysia greater percentages of women worked in agricultural than non-agricultural employment; in the Philippines, where women did not work so much in agricultural pursuits, their jobs were still in traditional rather than in development industries. In the cities of Bangkok, Manila, and Kuala Lumpur, fertility was lower for working than for non-working women. In rural agricultural areas, the fertility of working women was minimally higher, probably due to economic need of lar ger families. It is concluded that urban life separates the employment and the family roles of working women, leading to lowered fertility; this does not occur in rural areas. The creation of new roles for women alternative or supplementary to marriage and motherhood would result in lowered fertility. In high fertility Asian countries, policies directed toward greater participation of women in non-agricultural work and great er exposure to an urban lifestyle might achieve fertility reductions.

Depression and Associated Factors in Patients with Type 2 Diabetes Mellitus.

PubMed

Hashim, N A; Ariaratnam, S; Salleh, M R; Said, M A; Sulaiman, A H

2016-06-01

To determine the prevalence of major depressive disorder and its association with socio-demographic and clinical factors in patients with type 2 diabetes mellitus. This was a cross-sectional study of patients with type 2 diabetes mellitus who attended the hospital-based primary care clinics at the University Malaya Medical Centre, Kuala Lumpur, Malaysia. The patients were interviewed using the Mini-International Neuropsychiatric Interview to diagnose depression based on the DSM-IV criteria. The socio-demographic and clinical data were obtained by interviewing the patients and subsequently verified against their respective case notes. A total of 204 patients were recruited. The prevalence of major depressive disorder was 15.7%. Major depressive disorder was significantly associated with younger age of patients (mean ± standard deviation, 57.8 ± 15.1 years, p = 0.04), younger age at diagnosis of diabetes mellitus (46.2 ± 13.0 years, p = 0.01), having secondary education (p = 0.02), and having a history of depression (p = 0.002). Multivariate analysis showed that current age (p = 0.04), duration of diabetes mellitus (p = 0.04), age at diagnosis of diabetes mellitus (p = 0.01), and secondary education (p = 0.01) were significant factors. The prevalence of major depressive disorder was high among patients with type 2 diabetes mellitus. Screening of patients with type 2 diabetes mellitus for depression should be performed periodically or routinely, especially in the primary care setting.

The UK-SEA-ME Psychosocial-Cultural Cancer Research Network: setting the stage for applied qualitative research on cancer health behaviour in southeast Asia and the Middle East.

PubMed

Lim, Jennifer N W

2011-01-01

Psychosocial and cultural factors influencing cancer health behaviour have not been systematically investigated outside the western culture, and qualitative research is the best approach for this type of social research. The research methods employed to study health problems in Asia predominantly are quantitative techniques. The set up of the first psychosocial cancer research network in Asia marks the beginning of a collaboration to promote and spearhead applied qualitative healthcare research in cancer in the UK, Southeast Asia and the Middle East. This paper sets out the rationale, objectives and mission for the UK-SEA-ME Psychosocial-Cultural Cancer Research Network. The UK-SEA-ME network is made up of collaborators from the University of Leeds (UK), the University of Malaya (Malaysia), the National University of Singapore (Singapore) and the University of United Arab Emirates (UAE). The network promotes applied qualitative research to investigate the psychosocial and cultural factors influencing delayed and late presentation and diagnosis for cancer (breast cancer) in partner countries, as well as advocating the use of the mixed-methods research approach. The network also offers knowledge transfer for capacity building within network universities. The mission of the network is to improve public awareness about the importance of early management and prevention of cancer through research in Asia.

"You still need to give her a token of appreciation": the meaning of the exchange of money in the sexual relationships of out-of-school adolescents in rural southwest Uganda.

PubMed

Nobelius, Ann-Maree; Kalina, Bessie; Pool, Robert; Whitworth, Jimmy; Chesters, Janice; Power, Robert

2010-09-01

This article challenges the pervasive assumption that exchanging gifts and money in adolescent sexual relationships is transactional. Data were derived from a multi-method, qualitative sexual health needs assessment of 31 out-of-school adolescents in rural southwest Uganda. Grounded theory analysis allows contextual meanings of exchange to emerge. Adolescents have developed gendered courting and exchange models that parallel marital relationships in this cultural context. Whereas exchange is considered transactional and immoral in some types of relationships, in adolescent relationships, it is not. Young women are not ashamed of, or stigmatized by, the exchange; they are proud of it. The exchange signifies several things: self-respect and a partner's willingness to wait for the relationships to become sexual and, therefore, that they are valued and respected by their partners. This demonstrates commitment from a partner, whose role is as a provider. To expect no gift or to have sex for pleasure are the hallmarks of the worst kind of woman-a malaya. "Need" is the only acceptable rationale for extramartial sex for any woman in this sexual value system. Interventions promoting longer courting and sustained support for one partner would encourage a delay in debut for young women and encourage greater monogamy in young men.

Racial variations in booking haemoglobin of primigravidae in Malaysia: a prospective study

PubMed Central

2013-01-01

Background Variations in racial haemoglobin had been previously described in multiple studies locally and abroad. This study was conducted to quantify the differences in haemoglobin of booking primigravidae amongst the three major races in Malaysia at the antenatal clinic of University Malaya Medical Centre, Kuala Lumpur. Findings One year prospective study of booking full blood count sample of primigravidae taken in one centre was conducted. Multiple comparative analyses of the booking haemoglobin were performed using the One-way ANOVA comparative mean test in each trimester. 622 primigravidae without any known history of haematological disorders were recruited into the study. The mean haemoglobin for the Indian race was the lowest compared to the two other races in the second and the third trimesters, and it was found to be statistically significant lower (p- value 0.001) than the Malay race in the second trimester. It was also found that the Indian race had a significantly higher incidence of moderate to severe anaemia (p- value: 0.029). The prevalence of anaemia in our study population is also significantly higher in the Indian population (p- value: 0.01). Conclusions The findings from this study have established that there is racial preponderance to anaemia in pregnancy. The Indian race is at a higher risk of having anaemia in pregnancy particularly in the second trimester. PMID:23634656

Geophysicists

NASA Astrophysics Data System (ADS)

William W. Fox, Jr., has been appointed director of the Cooperative Institute for Marine and Atmospheric Studies (CIMAS). He had been director of the Southeast Fisheries Center of the National Marine Fisheries Service since 1978. CIMAS was established in 1977 by the National Oceanic and Atmospheric Administration and the University of Miami.Seven of the 689 U.S. Fulbright Scholars for 1982-1983 are lecturing and conducting advanced research in geology in universities abroad. Brian Francis Farrell, a research assistant in planetary studies at Harvard University, is lecturing in oceanography at the University of Cambridge in England through June. William B. Fergusson, associate professor of civil engineering at Villanova University, will lecture in geology at the Kangwon National University in Korea until July. Ray Edward Ferrell, Jr., geology chairman at Louisiana State University in Baton Rouge, lectured and conducted research in marine geology at the University of Oslo in Norway. M. Allan Kays, professor of geology at the University of Oregon in Eugene, will conduct research in geology at the University of Copenhagen in Denmark through April. Richard Vernon McGehee, associate professor of health education at Southeastern Louisiana University (University Station campus), will be lecturing in geology at the University of Monrovia in Liberia through July. Bruce Warren Nelson, a professor of environmental studies at the University of Virginia in Charlottesville, will be lecturing in geology at the Universiti Malaya in Malaysia through April. Ronald Porter Willis, professor of geology at the University of Wisconsin—Eau Claire, will be lecturing in geology at the Seoul National University in Korea through July.

Academic standards and changing patterns of medical school admissions: a Malaysian study.

PubMed

Tan, C M

1990-07-01

Changing social demands made it necessary for the Medical Faculty of the University of Malaya to accommodate students with a wider range of academic experience than before. However, teachers sought to achieve comparable academic standards to those in the West by striving to maintain a close resemblance to the Western model of medical education in other respects. As a result teachers failed to adapt their teaching methods, assessment techniques and curriculum design to meet the educational needs of the students, thus compromising academic standards. Many students lack basic academic skills and do not know how to learn effectively. In order to help students overcome their learning difficulties innovative teaching was required during the first year at university, designed to foster the joint development of knowledge and basic skills. In the case of less well-prepared students who lack self-confidence, a caring and supportive learning environment is crucial to the achievement of meaningful learning. Lecturers needed to become facilitators of learning rather than transmitters of knowledge. However, teachers' objective to retain international recognition of the degree, which presumably reflected the importance of teaching, was not operationalized in terms of its incentive structure such that teachers were constrained not to try to fill the new roles demanded of them. It was assumed that academic distinction accrued through scientific research was essential for the achievement of academic excellence. However, under the prevailing circumstances the two aims were mutually exclusive and incompatible and teaching quality deteriorated.

Adult anthropometric measures and socio-demographic factors influencing age at menarche of university students in malaysia.

PubMed

Hossain, Md Golam; Wee, Ai-Sze; Ashaie, Maeirah; Kamarul, T

2013-09-01

Early onset of menarche has been shown to be associated with breast cancer and ischaemic heart disease. Studies on age at menarche of the Malaysian population are poorly documented. This study aimed to determine the influence of anthropometric and socio-demographic factors on the age at menarche of university students in Malaysia. Data were obtained in 2010-11 from 961 students between the ages of 18 and 25 years from the University of Malaya using stratified sampling, and multiple regression analysis was applied. Sixty-three per cent of students reached menarche at the age of 12 or 13 years, with the mean and median of age at menarche being 12.45 ± 1.17 and 12.01 years, respectively. Menarcheal age was positively associated with height (p<0.05) and negatively associated with BMI (p<0.001). Students from urban areas attained menarche earlier than those from rural areas (p<0.05). Students from small-sized families attained menarche earlier than those from larger families (p<0.05). First-born students experienced menarche earlier than those who were seventh-born or later. Obese and overweight students reached menarche earlier than students who were underweight or of normal weight (p<0.01). The variations in age at menarche among the Malaysian ethnic groups were statistically insignificant. The results suggest that heavier and first-born students from small families are more likely to attain menarche earlier than their counterparts.

Liver cirrhosis in Malaysia: peculiar epidemiology in a multiracial Asian country.

PubMed

Qua, Choon-Seng; Goh, Khean-Lee

2011-08-01

To determine the etiology of liver cirrhosis and risk factors for hepatocellular carcinoma (HCC) in a multiracial Asian population. Consecutive patients with liver cirrhosis presenting to outpatient clinics and inpatient service at the University of Malaya Medical Centre from 1 April 2006 to 31 May 2009 were included. A total of 460 patients were included in the study: 317 male patients (68.9%) and 143 female patients (31.1%), with a mean age of 58.8years (range: 15-87years). The major causes of cirrhosis were: chronic hepatitis B, n=212, 46.1%; chronic hepatitis C, n=85, 18.5%; cryptogenic, n=71, 15.4%; alcohol, n=58, 12.6% and autoimmune, n=9, 2.0%. Alcohol was the main etiology in Indians (51.1%) compared to Malay (0%) and Chinese (4.4%) (both P<0.001). Hepatitis B was the predominant etiology in Malay (47.9%) and Chinese (58.8%) compared to Indians (5.6%) (both P<0.001). Hepatitis C cirrhosis was highest in Malays (25.0%). 136 patients (29.6%) had concurrent HCC. Male sex (P<0.001), age>60years (P=0.014), hepatitis B (P<0.001), hepatitis C (P=0.006) and cryptogenic cause (P=0.002) were found to be independent risk factors for HCC. The etiology of cirrhosis has a peculiar pattern based on racial differences in alcohol intake and in the prevalence of hepatitis B. © 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.

A case-control study and meta-analysis confirm glucokinase regulatory gene rs780094 is a risk factor for gestational diabetes mellitus.

PubMed

Jamalpour, Sajad; Zain, Shamsul Mohd; Mosavat, Maryam; Mohamed, Zahurin; Omar, Siti Zawiah

2018-04-15

Although the influence of a common variant in the glucokinase regulatory gene (GCKR rs780094) in type 2 diabetes mellitus has been well documented, less data however, is available of its role in gestational diabetes mellitus (GDM). We carried out a case control study to assess the association between GCKR rs780094 and GDM in the Asian, and also a meta-analysis to further assess the strength of the association. Demographic, clinical and genotype data were determined for 1122 women (267 cases and 855 controls) recruited from the University of Malaya Medical Centre in the Klang Valley, Kuala Lumpur. Relevant articles were identified from Pubmed, Embase, MEDLINE, and Web of Science. Extraction of data was carried out and summary estimates of the association between rs780094 and GDM were examined. The frequency of risk allele C was significantly higher in the cases than controls (OR 1.34, 95% CI 1.09-1.66, P = 0.006). The C allele was also associated with increased level of random 2-hour fasting plasma glucose and pregravid body mass index. Meta-analysis further confirmed the association of the GCKR rs780094 with GDM (OR 1.32, 95% CI 1.14-1.52, P = 0.0001). This study strongly suggests that GCKR rs780094-C is associated with increased risk of GDM. Copyright © 2018 Elsevier B.V. All rights reserved.

Ocular Surface Disease in Glaucoma: Effect of Polypharmacy and Preservatives.

PubMed

Ramli, Norlina; Supramaniam, Gowri; Samsudin, Amir; Juana, Azida; Zahari, Mimiwati; Choo, May May

2015-09-01

To evaluate the prevalence of ocular surface disease (OSD) in glaucoma and nonglaucoma subjects using different clinical tests and to determine the effect of number of antiglaucoma medications and preservatives on OSD. This is a cross-sectional, case-comparison study at the Eye Clinic of the University of Malaya Medical Centre, Malaysia, between June 2012 and January 2013. Glaucoma subjects (n = 105) using topical antiglaucoma medications were compared with control subjects (n = 102) who were not on any topical medications. The presence of OSD was assessed using the tear film breakup time (TBUT) test, corneal staining, Schirmer test, and Ocular Surface Disease Index (OSDI) questionnaire grading. The prevalence of OSD varied from 37 to 91% in the glaucoma group, depending on the type of clinical test. More subjects in the glaucoma group had corneal staining (63% vs. 36%, p = 0.004), abnormal Schirmer tests (39% vs. 25%, p = 0.049), and moderate OSDI symptoms (17% vs. 7%, p = 0.028). The percentage with abnormal TBUT increased with higher numbers of topical medications and was high with both benzalkonium chloride-containing and preservative-free eye drops (90% and 94%, respectively, both p < 0.001). Benzalkonium chloride was associated with a nearly three times higher odds ratio of showing abnormal OSDI. Ocular surface disease is common in those using topical antiglaucoma medications. Abnormal TBUT is associated with increasing number of eye drops and benzalkonium chloride-containing eye drops, although this also occurs with the use of preservative-free eye drops.

Health-seeking behaviour among patients with faecal incontinence in a Malaysian academic setting.

PubMed

Roslani, A C; Ramakrishnan, R; Azmi, S

2017-12-01

Faecal incontinence (FI) is not a common presenting complaint in Malaysia, and little has been published on this topic. Since it is a treatable condition, a greater understanding of factors contributing to healthseeking behaviour is needed in order to plan effective provision of services. A survey of 1000 patients and accompanying relatives, visiting general surgical and obstetrics and gynaecology clinics for matters unrelated to FI, was conducted at University Malaya Medical Centre between January 2009 and February 2010. A follow-up regression analysis of the 83 patients who had FI, to identify factors associated with health-seeking behaviour, was performed. Variables identified through univariate analysis were subjected to multivariate analysis to determine independence. Reasons for not seeking treatment were also analysed. Only eight patients (9.6%) had sought medical treatment. On univariate analysis, the likelihood of seeking treatment was significantly higher among patients who had more severe symptoms (OR 30.0, p=0.002), had incontinence to liquid stool (OR 3.83, p=0.002) or when there was an alteration to lifestyle (OR: 17.34; p<0.001). Nevertheless, the only independently-associated variable was alteration in lifestyle. Common reasons given for not seeking treatment was that the condition did not affect patients' daily activities (88.0%), "social taboo" (5.3%) and "other" reasons (6.7%). Lifestyle alteration is the main driver of healthseeking behaviour in FI. However, the majority do not seek treatment. Greater public and physician-awareness on FI and available treatment options is needed.

Stress among parents of children with attention deficit hyperactivity disorder, a Malaysian experience.

PubMed

Narkunam, Neelaveni; Hashim, Aili Hanim; Sachdev, Manveen Kaur; Pillai, Subash K; Ng, Chong Guan

2014-06-01

Attention deficit hyperactivity disorder (ADHD) is a chronic debilitating illness with onset in early childhood. The objective of this study was to look at the impact of children with ADHD on their parents. All parents with children diagnosed as having ADHD attending the Psychiatry Adolescent and Child Unit, University Malaya were included in this study. Their parenting stress was assessed using the Parent Stress Index. A total of 95 parents participated in the study. The proportion of parents who reported significant stress in this study was much higher than in most studies (n = 69, 73%). Significant correlation was found between the severity of the child's disorder (Children's Global Assessment Scale [CGAS] score) and the parents' stress level (OR 0.16, 95% CI 0.05-0.51). Mothers were significantly more stressed than fathers (OR 0.16, 95% CI 0.05-0.51) and non-Malay parents more stressed than the Malay parents (OR 3.92, 95% CI 1.29-11.94). Parents with children older than 12 years of age were six times more stressed than parents with children younger than 12 years old (OR 6.47, 95% CI 1.55-27.01). Stressed parents acknowledged that having a child with ADHD was their biggest worry. Stress has marked consequences on any person and has important bearings on their mental health. Stress among parents needs be looked into when treating children with ADHD. Copyright © 2012 Wiley Publishing Asia Pty Ltd.

The prevalence of tongue lesions in Malaysian dental outpatients from the Klang Valley area.

PubMed

Koay, C L; Lim, J A; Siar, C H

2011-03-01

 To determine the prevalence of tongue lesions in Malaysian dental outpatients from the Klang Valley area.  A cross sectional study was conducted on 600 Malaysian outpatients (257 men, 343 women, mean age, 37.7 years) attending the Primary Dental Care Unit at the Faculty of Dentistry, University of Malaya. Demographic and medical data were recorded for all respondents.  One hundred eighty-one patients (30.2%) (81 men, 100 women, mean age 42.0 years) were diagnosed with at least one tongue lesion (n = 207) at the time of examination. Of these, 24 patients (4%) had two or more tongue lesions present synchronously. Seven different lesions were diagnosed: fissured tongue (13.8%), crenated tongue (7.8%), pigmented tongue (6.2%), geographic tongue (2.2%), ankyloglossia (1.7%), hairy tongue (1.0%) and median rhomboid glossitis (0.2%). Their racial prevalences were Malays (n = 65, 10.8%), Indians (n = 62, 10.3%), Chinese (n = 53, 8.8%) and other race (n = 1, 0.2%). A significant relationship was observed between crenated tongue and race; between four types of tongue lesions (fissured tongue, geographic tongue, crenated tongue and pigmented tongue) and age; and between fissured tongue and gender (P < 0.05). Distribution characteristics of tongue lesions in Malaysians are important as local reference data in the daily clinical practice. © 2010 John Wiley & Sons A/S.

Domestic violence management in Malaysia: A survey on the primary health care providers

PubMed Central

Othman, Sajaratulnisah; Mat Adenan, Noor Azmi

2008-01-01

Aim To assess the knowledge, attitudes and practices of primary health care providers regarding the identification and management of domestic violence in a hospital based primary health care setting. Method A survey of all clinicians and nursing staff of the outpatient, casualty and antenatal clinics in University Malaya Medical Centre using a self-administered questionnaire. Results Hundred and eight out of 188 available staff participated. Sixty-two percent of the clinicians and 66.9% of the nursing staff perceived the prevalence of domestic violence within their patients to be very rare or rare. Majority of the clinicians (68.9%) reported asking their patients regarding domestic violence 'at times' but 26.2% had never asked at all. Time factor, concern about offending the patient and unsure of how to ask were reported as barriers in asking for domestic violence by 66%, 52.5% and 32.8% of the clinicians respectively. Clinicians have different practices and levels of confidence within the management of domestic violence. Victim-blaming attitude exists in 28% of the clinicians and 51.1% of the nursing staff. Less than a third of the participants reported knowing of any written protocol for domestic violence management. Only 20% of the clinicians and 6.8% of the nursing staff had ever attended any educational program related to domestic violence. Conclusion Lack of positive attitude and positive practices among the staff towards domestic violence identification and management might be related to inadequate knowledge and inappropriate personal values regarding domestic violence. PMID:18973706

Impact of socio-economic class on colorectal cancer patient outcomes in Kuala Lumpur and Kuching, Malaysia.

PubMed

Kong, Chee-Kwan; Roslani, April Camilla; Law, Chee-Wei; Law, Suk-Chin Diana; Arumugam, Kulenthran

2010-01-01

Research over the past several decades has indicated that low socioeconomic class has a direct effect on health outcomes. In Malaysia, class distribution may differ with the region. The objective of this study was to compare the presentation and survival of colorectal cancer patients in two dissimilar cities, Kuala Lumpur and Kuching, Sarawak. All patients diagnosed with a malignancy of the colon or rectum in Sarawak General Hospital and University of Malaya Medical Center from 1st Jan 2000-31st Dec 2006 were recruited. Data on presentation, socio-economic class and survival were obtained. The survival duration was categorized into more than three years or three years and less. Testing for significance was performed using the chi-square test, with p values less than 0.05 considered statistically significant. A total of 565 patients in UMMC and 642 patients in SGH had a new diagnosis of colorectal carcinoma. Patients in Kuching had a longer duration of symptoms and more advanced stage at presentation, but this was not statistically significant. Lower socio-economic class was a significant factor for late and more advanced stage at diagnosis, as well as poorer three and five year survival rates. However, survival was lower for patients in Kuching compared to Kuala Lumpur, even after matching for socio-economic class. There is near-zero awareness of colorectal cancer screening in Malaysia. These findings support reaching out to communities of lower socioeconomic backgrounds to improve the colorectal cancer survival rates.

Utilization of the emergency department by older residents in Kuala Lumpur, Malaysia.

PubMed

Mohd Mokhtar, Mohd Amin; Pin, Tan Maw; Zakaria, Mohd Idzwan; Hairi, Noran Naqiah; Kamaruzzaman, Shahrul Bahiyah; Vyrn, Chin Ai; Hua, Philip Poi Jun

2015-08-01

To determine the pattern of utilization of emergency department (ED) services by older patients in Kuala Lumpur, Malaysia, compared with younger patients in the same setting. The sociodemographics, clinical characteristics and resource utilization of consecutive patients attending the adult ED at the University Malaya Medical Center were recorded during a typical week. A total of 1649 patients were included in the study; 422/1649 (25.6%) were aged ≥60 years and 1077 (74.4%) were aged <60 years. Older adult patients were more likely to be diagnosed with ischemic heart disease (12.6% vs 2.5%, P < 0.001), and more likely to require investigations such as electrocardiogram (68.1% vs 16.6%, P < 0.001) or chest X-rays (67.6% vs 24.0%, P < 0.001) than their younger counterparts. Logistic regression methods showed that older adults remained an independent predictor of hospital admission (OR 2.75, 95% CI 2.11-3.57). The ratio of older adult patients attending our ED over the proportion of older people in the general population was 26:6, which is far higher than reported in previous published studies carried out in other countries. Older ED attenders are also more likely to require investigations, procedures and hospital admissions. With the rapidly aging population in Malaysia, reconfiguration of resources will need to occur at a compatible rate in order to ensure that the healthcare needs of our older adults are met. © 2014 Japan Geriatrics Society.

Late presentation of esophageal cancer: observations in a multiracial South-East Asian population.

PubMed

Abdullah, Muhammad; Karim, Adil Abdel; Goh, Khean-Lee

2010-02-01

Esophageal cancer (ECA) is an important cancer in Malaysia. The aim of the study is to review the demographic data and clinical presentation of patients with ECA seen at the University of Malaya Medical Centre, Kuala Lumpur. Patients with histologically proven ECA were recruited for the study. Patients' case notes, endoscopy and operating theater records were reviewed. All cases were histologically confirmed. A total of 143 patients with ECA was diagnosed between 1998 and 2003. The mean age of the patients was 63.1 +/- 12.1 years with a male : female ratio of 1.8:1. Of these 50.3 percent were Indians, 32.9 percent, Chinese and 16.8 percent Malays. The overall hospital-based prevalence rates per 100 000 admissions according to races were: Malay; 23.5, Chinese; 57.4 and Indian; 134.1. The location of the tumors was: upper; 16 (11.2%) middle; 52 (36.4%) and lower; 75 (52.4%). The histological type of ECA were: squamous cell carcinomas; 113 (79.0%) and adenocarcinomas; 30 (21.0%). The ECA stage at diagnosis, was: II; 18 (12.6%), III; 23 (16.1%) and IV; 102 (71.3%). Only 24 (16.8%) patients underwent surgery and13 (9.1%) were considered curative. Overall 114 (79.7%) patients underwent palliative endoscopic stenting and six (4.2%) were given other palliative therapy including radiotherapy. Squamous cell cancer was the predominant type. ECA presents late in our patients and only a minority of patients underwent curative surgery.

Analysis of dental erosion induced by different beverages and validity of equipment for identifying early dental erosion, in vitro study.

PubMed

Jameel, Rafey Ahmad; Khan, Shah Salman; Abdul Rahim, Zubaidah Hj; Bakri, Marina Mohd; Siddiqui, Saima

2016-07-01

To understand early dental erosion induced by different beverages and the equipment for its detection. The study was conducted at the University Malaya Medical Centre, Kuala Lumpur, Malaysia, from June to September 2014, and comprised single-rooted, unpolished teeth divided into six groups. Electron micrographs and other baseline readings for further analyses were taken before and after the exposure to different beverages. The teeth were exposed to the beverages using a modified Nordini's artificial mouth model. The positioning of the teeth on the motorised stage of the equipment was standardised. Of the several beverages used, CocaCola had the lowest pH value of 2.53, while tap water had the highest pH of 5.4. Deionised distilled water, which was used as a reference, had a pH near to neutral /alkaline of 7.3. The fluoride content ranged between 9.38ppm in tea and 0.005ppm in orange juice. Teeth exposed to beverages with low pH and considerably high fluoride underwent slight remineralisation (roughness increase 8% from tea), while beverages with no fluoride content and low pH roughened the enamel surface (Coca Cola roughened upto 37%). Quantitative analyses of tooth erosion, micro-hardness, surface-roughness, and surface-height showed that all beverages exhibited positive erosive effect on the tooth enamel surface (p<0.005). CocaCola was found to be the most erosive agent among both hot and cold beverages (37%), while coffee was more erosive among the hot beverages (29%).

The accuracy and safety of fluoroscopically guided percutaneous pedicle screws in the lumbosacral junction and the lumbar spine: a review of 880 screws.

PubMed

Chiu, C K; Kwan, M K; Chan, C Y W; Schaefer, C; Hansen-Algenstaedt, N

2015-08-01

We undertook a retrospective study investigating the accuracy and safety of percutaneous pedicle screws placed under fluoroscopic guidance in the lumbosacral junction and lumbar spine. The CT scans of patients were chosen from two centres: European patients from University Medical Center Hamburg-Eppendorf, Germany, and Asian patients from the University of Malaya, Malaysia. Screw perforations were classified into grades 0, 1, 2 and 3. A total of 880 percutaneous pedicle screws from 203 patients were analysed: 614 screws from 144 European patients and 266 screws from 59 Asian patients. The mean age of the patients was 58.8 years (16 to 91) and there were 103 men and 100 women. The total rate of perforation was 9.9% (87 screws) with 7.4% grade 1, 2.0% grade 2 and 0.5% grade 3 perforations. The rate of perforation in Europeans was 10.4% and in Asians was 8.6%, with no significant difference between the two (p = 0.42). The rate of perforation was the highest in S1 (19.4%) followed by L5 (14.9%). The accuracy and safety of percutaneous pedicle screw placement are comparable to those cited in the literature for the open method of pedicle screw placement. Greater caution must be taken during the insertion of L5 and S1 percutaneous pedicle screws owing to their more angulated pedicles, the anatomical variations in their vertebral bodies and the morphology of the spinal canal at this location. ©2015 The British Editorial Society of Bone & Joint Surgery.

Characteristics of persons with spinal cord injury who drive in Malaysia and its barriers: a cross sectional study.

PubMed

Lee, Richard Chee Houw; Hasnan, Nazirah; Engkasan, Julia Patrick

2018-04-01

Cross sectional study. To determine the prevalence, characteristics of and barriers to driving among persons with a spinal cord injury (SCI). SCI Rehabilitation Clinic, University Malaya Medical Centre (UMMC). This is a questionnaire-based study on persons with SCI who attended the UMMC SCI Rehabilitation Clinic between June 2015 and November 2016. The questionnaire comprised demographic data, clinical characteristics, driving variables, Spinal Cord Independence Measure III, WHOQOL-BREF, and Craig Handicap Assessment and Reporting Technique Short Form. Malaysians aged greater than 18 years old with any etiology and levels of SCI, had no other physical disabilities and not suffering from progressive illness were recruited. A single investigator administered the questionnaire via face-to-face interviews. A total of 160 participants were included in this study. Overall, 37% of persons with SCI drove and owned a modified vehicle. Almost half of persons with paraplegia (47%) drove, but only 12% of tetraplegia did. A majority (93%) of those who drove aged below 60 years, and had higher level of independence in activity of daily living. More drivers (81%) compared to non-drivers (24%) were employed; drivers also reported better community reintegration and quality of life. Three commonest barriers to driving included medical reasons (38%), fear and lack of confidence (17%), and inability to afford vehicle modifications (13%). The percentage of persons with SCI driving post injury is low. Based on the findings of this study, more efforts are needed to motivate and facilitate persons with SCI to drive.

Hyphema due to blunt injury: a review of 118 patients

PubMed Central

Ulagantheran, V; Ahmad Fauzi, M S; Reddy, S C

2010-01-01

AIM To determine the causes, associated ocular findings and visual acuity on presentation, complications and visual outcome following treatment in patients of hyphema due to blunt injury METHODS A retrospective study was performed in 118 patients with hyphema due to blunt injury admitted in University of Malaya Medical Centre, Kuala Lumpur, Malaysia. The gender, age, race, cause of blunt injury resulting in hyphema, eye involved, vision at admission, other associated ophthalmological findings, complications and visual outcome were noted from the case records of patients. The data were analyzed using SPSS programme. RESULTS Males were more predominantly affected (93.2%). Two-thirds of patients (67.8%) were aged below 30 years. Sports related injury (38.1%) was the most common cause for hyphema. Hyphema disappeared within 5 days in 66.9% of patients. Iris injuries were very commonly associated in the form of mydriasis, sphincter tear and iridodialysis. Associated vitreous haemorrhage was noted in 11.9% of patients. During the hospital stay, secondary haemorrhage was observed in 3.4% of patients. The best corrected vision of 6/18 or better was noted in 85.4% of patients at the last follow-up. The follow-up of these subjects was very poor and thus the incidence of secondary glaucoma could not be established. Moderate blood staining of cornea occurred in 0.8% of patients. CONCLUSION Sports related injury is the most common cause of hyphema in Malaysia. Good visual recovery, without serious complications, is possible with appropriate and in-time treatment in hyphema patients due to blunt injury. PMID:22553571

Barriers faced by healthcare professionals when managing falls in older people in Kuala Lumpur, Malaysia: a qualitative study

PubMed Central

Loganathan, Annaletchumy; Ng, Chirk Jenn; Tan, Maw Pin; Low, Wah Yun

2015-01-01

Objective To explore the barriers faced by healthcare professionals (HCPs) in managing falls among older people (aged above 60 years) who have a high risk of falling. Research design The study used a qualitative methodology, comprising 10 in-depth interviews and two focus group discussions. A semistructured topic guide was used to facilitate the interviews, which were audio recorded, transcribed verbatim and checked for accuracy. Data were analysed thematically using WeftQDA software. Participants 20 HCPs who managed falls in older people. Setting This study was conducted at the Primary Care Clinic in the University Malaya Medical Centre (UMMC), Malaysia. Results Four categories of barriers emerged—these were related to perceived barriers for older people, HCPs’ barriers, lack of caregiver support and healthcare system barriers. HCPs perceived that older people normalised falls, felt stigmatised, were fatalistic, as well as in denial regarding falls-related advice. HCPs themselves trivialised falls and lacked the skills to manage falls. Rehabilitation was impeded by premature decisions to admit older people to nursing homes. Lastly, there was a lack of healthcare providers as well as a dearth of fall education and training on fall prevention for HCPs. Conclusions This study identified barriers that explain poor fall management in older people with a high risk of falls. The lack of structured fall prevention guidelines and insufficient training in fall management made HCPs unable to advise patients on how to prevent falls. The findings of this study warrant evidence-based structured fall prevention intervention targeted to patients as well as to HCPs. PMID:26546140

Estimates of economic burden of providing inpatient care in childhood rotavirus gastroenteritis from Malaysia.

PubMed

Lee, Way Seah; Poo, Muhammad Izzuddin; Nagaraj, Shyamala

2007-12-01

To estimate the cost of an episode of inpatient care and the economic burden of hospitalisation for childhood rotavirus gastroenteritis (GE) in Malaysia. A 12-month prospective, hospital-based study on children less than 14 years of age with rotavirus GE, admitted to University of Malaya Medical Centre, Kuala Lumpur, was conducted in 2002. Data on human resource expenditure, costs of investigations, treatment and consumables were collected. Published estimates on rotavirus disease incidence in Malaysia were searched. Economic burden of hospital care for rotavirus GE in Malaysia was estimated by multiplying the cost of each episode of hospital admission for rotavirus GE with national rotavirus incidence in Malaysia. In 2002, the per capita health expenditure by Malaysian Government was US$71.47. Rotavirus was positive in 85 (22%) of the 393 patients with acute GE admitted during the study period. The median cost of providing inpatient care for an episode of rotavirus GE was US$211.91 (range US$68.50-880.60). The estimated average cases of children hospitalised for rotavirus GE in Malaysia (1999-2000) was 8571 annually. The financial burden of providing inpatient care for rotavirus GE in Malaysian children was estimated to be US$1.8 million (range US$0.6 million-7.5 million) annually. The cost of providing inpatient care for childhood rotavirus GE in Malaysia was estimated to be US$1.8 million annually. The financial burden of rotavirus disease would be higher if cost of outpatient visits, non-medical and societal costs are included.

Heavy metals in human teeth dentine: A bio-indicator of metals exposure and environmental pollution.

PubMed

Asaduzzaman, Khandoker; Khandaker, Mayeen Uddin; Binti Baharudin, Nurul Atiqah; Amin, Yusoff Bin Mohd; Farook, Mohideen Salihu; Bradley, D A; Mahmoud, Okba

2017-06-01

With rapid urbanization and large-scale industrial activities, modern human populations are being increasingly subjected to chronic environmental heavy metal exposures. Elemental uptake in tooth dentine is a bioindicator, the uptake occurring during the formation and mineralization processes, stored to large extent over periods of many years. The uptake includes essential elements, most typically geogenic dietary sources, as well as non-essential elements arising through environmental insults. In this study, with the help of the Dental Faculty of the University of Malaya, a total of 50 separate human teeth were collected from dental patients of various ethnicity, age, gender, occupation, dietary habit, residency, etc. Analysis was conducted using inductively coupled plasma-mass spectrometry (ICP-MS), most samples indicating the presence of the following trace elements, placed in order of concentration, from least to greatest: As, Mn, Ba, Cu, Cr, Pb, Zn, Hg, Sb, Al, Sr, Sn. The concentrations have been observed to increase with age. Among the ethnic groups, the teeth of ethnic Chinese showed marginally greater metal concentrations than those of the Indians and Malays, the teeth dentine of females generally showing greater concentrations than that of males. Greater concentrations of Hg, Cu and Sn were found in molars while Pb, Sr, Sb and Zn were present in greater concentrations in incisors. With the elevated concentration levels of heavy metals in tooth dentine reflecting pollution from industrial emissions and urbanization, it is evident that human tooth dentine can provide chronological information on exposure, representing a reliable bio-indicator of environmental pollution. Copyright © 2017 Elsevier Ltd. All rights reserved.

Ethnic variation of genetic (idiopathic) generalized epilepsy in Malaysia.

PubMed

Lim, Kheng Seang; Ng, Ching Ching; Chan, Chung Kin; Foo, Wee Shean; Low, Joyce Siew Yong; Tan, Chong Tin

2017-02-01

Ethnic variation in epilepsy classification was reported in the Epilepsy Phenome/Genome Project. This study aimed to determine the ethnic variation in the prevalence of genetic (idiopathic) generalized epilepsy (GGE) and GGE with family history in a multi-ethnic Asian population in Malaysia. In this cross-sectional study, 392 patients with a clinical diagnosis of GGE were recruited in the neurology outpatient clinic, University of Malaya Medical Centre (UMMC), from January 2011 till April 2016. In our epilepsy cohort (n=2100), 18.7% were diagnosed to have GGE. Of those, 28.6% >(N=112) had family history of epilepsy with a mean age of seizure onset of 16.5 years old, and 42.0% had myoclonic seizures (N=47). The lifetime prevalence of epilepsy among first-degree relative of those with GGE and positive family history was 15.0%. Analysis according to ethnicity showed that Malaysian Chinese had the lowest percentage of GGE among those with epilepsy (12.3%), as compared with Indian and Malay (25.3% and 21.3%, p<0.001). In addition, 32.1% of these Indian patients with GGE had positive family history, which is more than the Malay (26.4%) and Chinese (27.5%) ethnic groups. Consanguineous marriage was noted in 5 Indian families with positive family history (9.6%). There was ethnic variation in the prevalence of GGE, whereby the Malaysian Chinese had the lowest percentage of GGE as compared with Indian and Malay. A substantial proportion of GGE had positive family history among the three ethnics groups. Copyright © 2016 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Risk of treatment related death and febrile neutropaenia with taxane-based adjuvant chemotherapy for breast cancer in a middle income country outside a clinical trial setting.

PubMed

Phua, Chee Ee; Bustam, Anita Zarina; Yusof, Mastura Md; Saad, Marniza; Yip, Cheng-Har; Taib, Nor Aishah; Ng, Char Hong; Teh, Yew Ching

2012-01-01

The risk of treatment-related death (TRD) and febrile neutropaenia (FN) with adjuvant taxane- based chemotherapy for early breast cancer is unknown in Malaysia despite its widespread usage in recent years. This study aims to determine these rates in patients treated in University Malaya Medical Centre (UMMC). Patients who were treated with adjuvant taxane-based chemotherapy for early breast cancer stages I, II or III from 2007-2011 in UMMC were identified from our UMMC Breast Cancer Registry. The TRD and FN rates were then determined retrospectively from medical records. TRD was defined as death occurring during or within 30 days of completing chemotherapy as a consequence of the chemotherapy treatment. FN was defined as an oral temperature >38.5°C or two consecutive readings of >38.0°C for 2 hours and an absolute neutrophil count <0.5x109/L, or expected to fall below 0.5x109/L. A total of 622 patients received adjuvant chemotherapy during this period. Of these patients 209 (33.6%) received taxane-based chemotherapy. 4 taxane-based regimens were used namely the FEC-D, TC, TAC and AC-PCX regimens. The commonest regimen employed was the FEC-D regimen accounting for 79.9% of the patients. The FN rate was 10% and there was no TRD. Adjuvant taxane-based chemotherapy in UMMC for early breast cancer has a FN rate of 10%. Primary prophylactic G-CSF should be considered for patients with any additional risk factor for FN.

The Predictive Accuracy of PREDICT: A Personalized Decision-Making Tool for Southeast Asian Women With Breast Cancer

PubMed Central

Wong, Hoong-Seam; Subramaniam, Shridevi; Alias, Zarifah; Taib, Nur Aishah; Ho, Gwo-Fuang; Ng, Char-Hong; Yip, Cheng-Har; Verkooijen, Helena M.; Hartman, Mikael; Bhoo-Pathy, Nirmala

2015-01-01

Abstract Web-based prognostication tools may provide a simple and economically feasible option to aid prognostication and selection of chemotherapy in early breast cancers. We validated PREDICT, a free online breast cancer prognostication and treatment benefit tool, in a resource-limited setting. All 1480 patients who underwent complete surgical treatment for stages I to III breast cancer from 1998 to 2006 were identified from the prospective breast cancer registry of University Malaya Medical Centre, Kuala Lumpur, Malaysia. Calibration was evaluated by comparing the model-predicted overall survival (OS) with patients’ actual OS. Model discrimination was tested using receiver-operating characteristic (ROC) analysis. Median age at diagnosis was 50 years. The median tumor size at presentation was 3 cm and 54% of patients had lymph node-negative disease. About 55% of women had estrogen receptor-positive breast cancer. Overall, the model-predicted 5 and 10-year OS was 86.3% and 77.5%, respectively, whereas the observed 5 and 10-year OS was 87.6% (difference: −1.3%) and 74.2% (difference: 3.3%), respectively; P values for goodness-of-fit test were 0.18 and 0.12, respectively. The program was accurate in most subgroups of patients, but significantly overestimated survival in patients aged <40 years, and in those receiving neoadjuvant chemotherapy. PREDICT performed well in terms of discrimination; areas under ROC curve were 0.78 (95% confidence interval [CI]: 0.74–0.81) and 0.73 (95% CI: 0.68–0.78) for 5 and 10-year OS, respectively. Based on its accurate performance in this study, PREDICT may be clinically useful in prognosticating women with breast cancer and personalizing breast cancer treatment in resource-limited settings. PMID:25715267

Genotype 3 is the predominant hepatitis C genotype in a multi-ethnic Asian population in Malaysia.

PubMed

Ho, Shiaw-Hooi; Ng, Kee-Peng; Kaur, Harvinder; Goh, Khean-Lee

2015-06-01

Genotypes of hepatitis C virus (HCV) are distributed differently across the world. There is a paucity of such data in a multi-ethnic Asian population like Malaysia. The objectives of this study were to determine the distribution of HCV genotypes between major ethnic groups and to ascertain their association with basic demographic variables like age and gender. This was a cross-sectional prospective study conducted from September 2007 to September 2013. Consecutive patients who were detected to have anti-HCV antibodies in the University of Malaya Medical Centre were included and tested for the presence of HCV RNA using Roche Cobas Amplicor Analyzer and HCV genotype using Roche single Linear Array HCV Genotyping strip. Five hundred and ninety-six subjects were found to have positive anti-HCV antibodies during this period of time. However, only 396 (66.4%) were HCV RNA positive and included in the final analysis. Our results showed that HCV genotype 3 was the predominant genotype with overall frequency of 61.9% followed by genotypes 1 (35.9%), 2 (1.8%) and 6 (0.5%). There was a slightly higher prevalence of HCV genotype 3 among the Malays when compared to the Chinese (P=0.043). No other statistical significant differences were observed in the distribution of HCV genotypes among the major ethnic groups. There was also no association between the predominant genotypes and basic demographic variables. In a multi-ethnic Asian society in Malaysia, genotype 3 is the predominant genotype among all the major ethnic groups with genotype 1 as the second commonest genotype. Both genotypes 2 and 6 are uncommon. Neither genotype 4 nor 5 was detected. There is no identification of HCV genotype according to ethnic origin, age and gender.

Factors contributing to hearing impairment in patients with cleft lip/palate in Malaysia: A prospective study of 346 ears.

PubMed

Cheong, Jack Pein; Soo, Siew Shuin; Manuel, Anura Michelle

2016-09-01

To determine the factors contributing towards hearing impairment in patients with cleft lip/palate. A prospective analysis was conducted on 173 patients (346 ears) with cleft lip and palate (CL/P) who presented to the combined cleft clinic at University Malaya Medical Centre (UMMC) over 12 months. The patients' hearing status was determined using otoacoustic emission (OAE), pure tone audiometry (PTA) and auditory brainstem response (ABR). These results were analysed against several parameters, which included age, gender, race, types of cleft pathology, impact and timing of repair surgery. The patients' age ranged from 1-26 years old. They comprised 30% with unilateral cleft lip and palate (UCLP), 28% with bilateral cleft lip and palate (BCLP), 28% with isolated cleft palate (ICP) and 14% with isolated cleft lip (ICL). Majority of the patients (68.2%) had normal otoscopic findings. Out of the 346 ears, 241 ears (70%) ears had passed the hearing tests. There was no significant relationship between patients' gender and ethnicity with their hearing status. The types of cleft pathology significantly influenced the outcome of PTA and ABR screening results (p < 0.001). There was no significant difference between the repaired and unrepaired cleft groups and the outcome of hearing tests. However, hearing improvement occurred when palatal repair was performed at the age of <1year old (OR = 2.37, CI 1.2 = 4.6, p = 0.01). Majority of the cleft patients had normal hearing (70%). Hearing threshold varied significantly between the different types of cleft pathology. Surgery conferred no significant impact on the hearing outcome unless surgery was performed at the age of <1 year old. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Association between glycemic control and antidiabetic drugs in type 2 diabetes mellitus patients with cardiovascular complications

PubMed Central

Huri, Hasniza Zaman; Ling, Doris Yew Hui; Ahmad, Wan Azman Wan

2015-01-01

Purpose Cardiovascular disease (CVD) is a macrovascular complication in patients with type 2 diabetes mellitus (T2DM). To date, glycemic control profiles of antidiabetic drugs in cardiovascular (CV) complications have not been clearly elucidated. Therefore, this study was conducted retrospectively to assess the association of antidiabetic drugs and glycemic control with CV profiles in T2DM patients. The association of concurrent medications and comorbidities with glycemic control was also investigated. Methods A total of 220 T2DM patients from the University of Malaya Medical Centre, Malaysia, who had at least one CV complication and who had been taking at least one antidiabetic drug for at least 3 months, were included. The associations of antidiabetics, cardiovascular diseases, laboratory parameters, concurrent medications, comorbidities, demographics, and clinical characteristics with glycemic control were investigated. Results Sulfonylureas in combination (P=0.002) and sulfonylurea monotherapy (P<0.001) were found to be associated with good glycemic control, whereas insulin in combination (P=0.051), and combination biguanides and insulin therapy (P=0.012) were found to be associated with poor glycemic control. Stroke (P=0.044) was the only type of CVD that seemed to be significantly associated with good glycemic control. Other factors such as benign prostatic hyperplasia (P=0.026), elderly patients (P=0.018), low-density lipoprotein cholesterol levels (P=0.021), and fasting plasma glucose (P<0.001) were found to be significantly correlated with good glycemic control. Conclusion Individualized treatment in T2DM patients with CVDs can be supported through a better understanding of the association between glycemic control and CV profiles in T2DM patients. PMID:26316711

Factors Associated with Health Care Professionals' Attitude Toward the Presumed Consent System.

PubMed

Tumin, Makmor; Tafran, Khaled; Satar, NurulHuda Mohd; Peng, Ng Kok; Manikam, Rishya; Yoong, Tang Li; Chan, Chong Mei

2018-05-16

This paper explores health care professionals' potential attitude toward organ donation if the presumed consent system were to be implemented in Malaysia, as well as factors associated with this attitude. We used self-administered questionnaires to investigate the attitude of 382 health care professionals from the University of Malaya Medical Center between January and February 2014. The responses were analyzed using logistic regression. Of the 382 respondents, 175 (45.8%) stated that they would officially object to organ donation if the presumed consent system were to be implemented, whereas the remaining 207 (54.2%) stated that they would not object. The logistic regression showed that health care professionals from the Malay ethnic group were more likely to object than those from Chinese (adjusted odds ratio of 0.342; P = .001) and Indian and other (adjusted odds ratio of 0.341; P = .003) ethnic groups. Health care professionals earning 3000 Malaysian Ringgit or below were more likely to object than those earning above 3000 Malaysian Ringgit (adjusted odds ratio of 1.919; P = .006). Moreover, respondents who were initially unwilling to donate organs, regardless of the donation system, were more likely to object under the presumed consent system than those who were initially willing to donate (adjusted odds ratio of 2.765; P < .001). Health care professionals in Malaysia have a relatively negative attitude toward the presumed consent system, which does not encourage the implementation of this system in the country at present. To pave the way for a successful implementation of the presumed consent system, efforts should be initiated to enhance the attitude of health care professionals toward this system. In particular, these efforts should at most target the health care professionals who are Malay, earn a low income, and have a negative default attitude toward deceased donation.

Malaysian dental graduates' competence in holistic care: what do graduates and employers think?

PubMed

Yusof, Zamros Y M; Jaafar, Nasruddin; Jallaludin, Raja-Latifah R; Abu-Hassan, Mohamed I; Razak, Ishak A

2010-12-01

The purpose of this study was to explore the University of Malaya (UM) dental graduates' competence in holistic care in real settings from the employers' and graduates' perspectives. A self-administered questionnaire consisting of ten domains was sent to thirty senior dental officers of the Ministry of Health (MOH) and 164 UM graduates. In this article, nineteen major competencies that best represent the graduates' competence in the provision of holistic care are discussed. Each competency was rated on a scale of 1 (very poor) to 4 (very good) and was categorized as "poor and of major concern" (if less than 60 percent of respondents scored good or very good), "satisfactory and of minor concern" (60-69 percent), or "excellent" (70 percent and above). One hundred and six out of 164 graduates (64.6 percent) and twenty-nine out of thirty employers (96.7 percent) responded. Overall, the employers rated the graduates lower than what the graduates rated themselves on all items. While the graduates felt they were excellent and satisfactory in sixteen out of nineteen items (84.2 percent), the employers felt they were poor in fourteen out of nineteen (73.7 percent). Both groups agreed that the graduates were excellent in communication, but poor in life-saving skills, obtaining patient's family and psychosocial histories, and recognizing signs and symptoms (not intraoral) indicating the presence of a systemic disease. In conclusion, although the graduates felt competent in the majority of the holistic care competencies, the employers had some reservations over such claims. Outcomes of the study led to recommendations to incorporate longer community-based learning hours, an improved behavioral science component, a module for special care patients, and multidepartmental collaborative teachings in the new integrated program aimed for implementation in 2011.

Factors Associated With Medical and Nursing Students' Willingness to Donate Organs.

PubMed

Tumin, Makmor; Tafran, Khaled; Tang, Li Yoong; Chong, Mei Chan; Mohd Jaafar, Noor Ismawati; Mohd Satar, NurulHuda; Abdullah, Nurhidayah

2016-03-01

Malaysia suffers from a chronic shortage of human organs for transplantation. Medical and nursing students (MaNS) are future health professionals and thus their attitude toward organ donation is vital for driving national donation rates. This study investigates MaNS' willingness to donate organs upon death and the factors influencing their willingness. A cross-sectional design was used with a sample of 500 students (264 medical and 236 nursing) at the University of Malaya. A self-administrated questionnaire was used. The responses were analyzed by using descriptive statistics and multiple logistic regression. Of all respondents, 278 (55.6%) were willing to donate organs upon death, while the remaining 222 (44.4%) were unwilling to donate. Only 44 (8.8%) had donor cards. The multiple logistic regression revealed that the minorities ethnic group was more willing to donate organs than Malay respondents (adjusted odds ratio [aOR] = 1.98, P = 0.010). In addition, medical students were more willing to donate than nursing students (aOR = 2.53, P = 0.000). Respondents who have a family member with a donor card were more willing to donate than respondents who do not (aOR = 3.48, P = 0.006). MaNS who believed that their religion permits deceased donation were more willing to donate than their counterparts (aOR = 4.96, P = 0.000). Household income and sex were not significant predictors of MaNS' willingness to donate organs upon death. MaNS have moderate willingness, but low commitment toward deceased organ donation. Strategies for improving MaNS' attitude should better educate them on organ donation, targeting the most the Malay and nursing students, and should consider the influence of family attitude and religious permissibility on MaNS' willingness.

Factors Associated With Medical and Nursing Students’ Willingness to Donate Organs

PubMed Central

Tumin, Makmor; Tafran, Khaled; Tang, Li Yoong; Chong, Mei Chan; Mohd Jaafar, Noor Ismawati; Mohd Satar, NurulHuda; Abdullah, Nurhidayah

2016-01-01

Abstract Malaysia suffers from a chronic shortage of human organs for transplantation. Medical and nursing students (MaNS) are future health professionals and thus their attitude toward organ donation is vital for driving national donation rates. This study investigates MaNS’ willingness to donate organs upon death and the factors influencing their willingness. A cross-sectional design was used with a sample of 500 students (264 medical and 236 nursing) at the University of Malaya. A self-administrated questionnaire was used. The responses were analyzed by using descriptive statistics and multiple logistic regression. Of all respondents, 278 (55.6%) were willing to donate organs upon death, while the remaining 222 (44.4%) were unwilling to donate. Only 44 (8.8%) had donor cards. The multiple logistic regression revealed that the minorities ethnic group was more willing to donate organs than Malay respondents (adjusted odds ratio [aOR] = 1.98, P = 0.010). In addition, medical students were more willing to donate than nursing students (aOR = 2.53, P = 0.000). Respondents who have a family member with a donor card were more willing to donate than respondents who do not (aOR = 3.48, P = 0.006). MaNS who believed that their religion permits deceased donation were more willing to donate than their counterparts (aOR = 4.96, P = 0.000). Household income and sex were not significant predictors of MaNS’ willingness to donate organs upon death. MaNS have moderate willingness, but low commitment toward deceased organ donation. Strategies for improving MaNS’ attitude should better educate them on organ donation, targeting the most the Malay and nursing students, and should consider the influence of family attitude and religious permissibility on MaNS’ willingness. PMID:27015207

Fatal lightning strikes in Malaysia.

PubMed

Murty, O P; Kian, Chong Kah; Ari Husin, Mohammed Husrul; Nanta Kumar, Ranjeev Kumar; Mohammed Yusuf, Wan Yuhana W

2009-09-01

Lightning strike is a natural phenomenon with potentially devastating effects and represents one of the important causes of deaths from environmental phenomena. Almost every organ system may be affected as lightning current passes through the human body taking the shortest pathways between the contact points. A 10 years retrospective study (1996-2005) was conducted at University Hospital Kuala Lumpur (20 cases) also including cases during last 3 years from Hospital Tengku Ampuan Rahimah, Klang (7 cases) from the autopsy reports at Forensic Pathology Units of these 2 hospitals. Both these hospitals are attached to University of Malaya. There were 27 fatal cases of lightning strike with male preponderance(92.59%) and male to female ratio of 12.5:1. Majority of victims of lightning strike were from the age group between 30 and 39 years old. Most of the victims were foreign workers. Indonesians workers contributed to 59.26% of overall cases. Majority of them were construction workers who attributed i.e.11 of 27 cases (40.74%). Most of the victims were brought in dead (37.04%). In majority of the cases the lightning incidence occurred in the evenings, with the frequency of 15 of 27 cases (62.5%). The month of December represented with the highest number of cases (5 cases of 23 cases); 2004 had the highest incidence of lightning strike which was 5 (19.23%). Lightning strike incidence occurred when victims had taken shelter (25.9%) under trees or shades. Lightning strike in open areas occurred in 10 of 27 cases (37.0%). Head and neck were the most commonly affected sites with the incidence of 77.78% and 74% respectively in all the victims. Only 29.63% of the cases presented with ear bleeding.

The predictive value of early molecular response in chronic myeloid leukaemia patients treated with imatinib in a single real-world medical centre in a developing country.

PubMed

Bee, Ping Chong; Sekaran, Veera; Ng, Richard Rui Jie; Kweh, Ting Yi; Gan, Gin Gin

2017-03-01

The prognosis of patients with chronic myeloid leukaemia (CML) has improved since the introduction of imatinib. However, patients who do not achieve complete cytogenetic response (CCyR) and major molecular response (MMR) have poorer prognosis. Recent clinical trials have demonstrated that early and deeper cytogenetic and molecular responses predict a better long-term outcome. This study aimed to analyse the relationship between early molecular response and clinical outcome in a real-life setting. This retrospective study included all patients with CML, in chronic or accelerated phase, who were treated with imatinib at University of Malaya Medical Centre, Malaysia. A total of 70 patients were analysed. The median follow-up duration was 74 months, and the cumulative percentages of patients with CCyR and MMR were 80.0% and 65.7%, respectively. Overall survival (OS) and event-free survival (EFS) at ten years were 94.3% and 92.9%, respectively. Patients who achieved CCyR and MMR had significantly better OS and EFS than those who did not. At six months, patients who had a BCR-ABL level ≤ 10% had significantly better OS and EFS than those who had a BCR-ABL level > 10%. The target milestone of CCyR at 12 months and MMR at 18 months showed no survival advantage in our patients. Our data showed that imatinib is still useful as first-line therapy. However, vigilant monitoring of patients who have a BCR-ABL level > 10% at six months of treatment should be implemented so that prompt action can be taken to provide the best outcome for these patients. Copyright: © Singapore Medical Association

Impact of non-surgical periodontal therapy on OHRQoL in an obese population, a randomised control trial.

PubMed

Basher, Samara S; Saub, R; Vaithilingam, R D; Safii, S H; Daher, Aqil M; Al-Bayaty, F H; Baharuddin, N A

2017-11-21

Oral Health Related Quality of Life (OHRQoL) is an important measure of disease and intervention outcomes. Chronic periodontitis (CP) is an inflammatory condition that is associated with obesity and adversely affects OHRQoL. Obese patients with CP incur a double burden of disease. In this article we aimed to explore the effect of Non-Surgical Periodontal Therapy (NSPT) on OHRQoL among obese participants with chronic periodontitis. This was a randomised control clinical trial at the Faculty of Dentistry, University of Malaya. A total of 66 obese patients with chronic periodontitis were randomly allocated into the treatment group (n=33) who received NSPT, while the control group (n=33) received no treatment. Four participants (2 from each group) were non-contactable 12 weeks post intervention. Therefore, their data were removed from the final analysis. The protocol involved questionnaires (characteristics and OHRQoL (Oral Health Impact Profile-14; OHIP-14)) and a clinical examination. The OHIP prevalence of impact (PI), overall mean OHIP severity score (SS) and mean OHIP Extent of Impact (EI) at baseline and at the 12-week follow up were almost similar between the two groups and statistically not significant at (p=0.618), (p=0.573), and (p=0.915), respectively. However, in a within-group comparison, OHIP PI, OHIP SS, and OHIP EI showed a significant improvement for both treatment and control groups and the p values were ((0.002), (0.008) for PI), ((0.006) and (0.004) for SS) and ((0.006) and (0.002) for EI) in-treatment and control groups, respectively. NSPT did not significantly affect the OHRQoL among those obese with CP. Regardless, NSPT, functional limitation and psychological discomfort domains had significantly improved. ( NCT02508415 ). Retrospectively registered on 2 nd of April 2015.

Using Rasch model to analyze the ability of pre-university students in vector

NASA Astrophysics Data System (ADS)

Ibrahim, Faridah Mohamed; Shariff, Asma Ahmad; Tahir, Rohayatimah Muhammad

2015-10-01

Evaluating students' performance only from overall examination marks does not give accurate evidence of their achievement on a particular subject. For a more detailed analysis, an instrument called Rasch Measurement Model (Rasch Model), widely used in education research, may be applied. Using the analysis map, the level of each student's ability and the level of the questions difficulty can be measured. This paper describes how the Rasch Model is used to evaluate students' achivement and performance in Vector, a subject taken by students enrolled in the Physical Science Program at the Centre for Foundation Studies in Science, University of Malaya. Usually, students' understanding of the subject and performance are assessed and examined at the end of the semester in the final examination, apart from continuous assessment done throughout the course. In order to evaluate the individual achievement and get a better and accurate evidence on the performance, 28 male and 28 female students' marks were taken randomly from the final examination results and analysed using the Rasch Model. Observation made from the map showed that more than half of the questions were categorized as difficult while the two most difficult questions could be answered correctly by 33.9% of the students. Results showed that the students performed very well and their achievement was above expectation. About 27% of the sudents could be considered as having very high ability in answering all the questions, with one student being able to answer well, obtaining perfect score. However, two students were found to be misfits since they were able to answer difficult questions but gave poor response to easy ones.

Association between 5HT2A polymorphism and selective serotonin re-uptake inhibitor (SSRI)-induced sexual desire disorder (SDD) among Malaysian women.

PubMed

Masiran, Ruziana; Sidi, Hatta; Mohamed, Zahurin; Mohamed Saini, Suriati; Nik Jaafar, Nik Ruzyanei

2013-04-01

SSRIs are known for their sexual side-effects with a variable rate of sexual dysfunction (SD). 5HT2A (rs6311) single nucleotide polymorphism (SNP) was found to have significant association with SD. The purpose of this study was to determine the prevalence of female SDD, its clinical correlates and association with 5HT2A (rs6311) SNP in patients with major depressive disorder (MDD) treated with SSRIs. This was a cross-sectional study. We evaluated 95 female outpatients with MDD treated with SSRIs who were in remission. Outcome measures were stratified by the presence or absence of SDD. A buccal swab was obtained from each patient and sent for genotyping in the Pharmacogenomics and Medical Biotechnology Laboratory of Universiti Malaya. The overall prevalence of female SD was 32.6%. The prevalence of female SDD was 62.1%. Those with arousal problem, lubrication problem, sexual satisfaction problem, orgasm problem and problematic marriage were more likely to have sexual desire disorder. The majority of participants who had sexual desire disorder had genotype TT (42.4%) but there was no significant association observed. After controlling for age, number of children, education level, SSRI type, lubrication problem, orgasm problem, satisfaction problem and marital problem, only arousal problem significantly enhanced the presence of sexual desire disorder by 8.5 times (odds ratio = 8.46, 95% confidence interval = 1.24-57.58; P = 0.018). This study showed that there was no significant association between SDD and the 5HT2A (rs6311) SNP. Arousal problem significantly enhanced the presence of sexual desire disorder. Copyright © 2013 Wiley Publishing Asia Pty Ltd.

Range-Wide Latitudinal and Elevational Temperature Gradients for the World's Terrestrial Birds: Implications under Global Climate Change

PubMed Central

La Sorte, Frank A.; Butchart, Stuart H. M.; Jetz, Walter; Böhning-Gaese, Katrin

2014-01-01

Species' geographical distributions are tracking latitudinal and elevational surface temperature gradients under global climate change. To evaluate the opportunities to track these gradients across space, we provide a first baseline assessment of the steepness of these gradients for the world's terrestrial birds. Within the breeding ranges of 9,014 bird species, we characterized the spatial gradients in temperature along latitude and elevation for all and a subset of bird species, respectively. We summarized these temperature gradients globally for threatened and non-threatened species and determined how their steepness varied based on species' geography (range size, shape, and orientation) and projected changes in temperature under climate change. Elevational temperature gradients were steepest for species in Africa, western North and South America, and central Asia and shallowest in Australasia, insular IndoMalaya, and the Neotropical lowlands. Latitudinal temperature gradients were steepest for extratropical species, especially in the Northern Hemisphere. Threatened species had shallower elevational gradients whereas latitudinal gradients differed little between threatened and non-threatened species. The strength of elevational gradients was positively correlated with projected changes in temperature. For latitudinal gradients, this relationship only held for extratropical species. The strength of latitudinal gradients was better predicted by species' geography, but primarily for extratropical species. Our findings suggest threatened species are associated with shallower elevational temperature gradients, whereas steep latitudinal gradients are most prevalent outside the tropics where fewer bird species occur year-round. Future modeling and mitigation efforts would benefit from the development of finer grain distributional data to ascertain how these gradients are structured within species' ranges, how and why these gradients vary among species, and the capacity of species to utilize these gradients under climate change. PMID:24852009

Changes in the oral health-related quality of life 24 h following insertion of fixed orthodontic appliances.

PubMed

Mansor, Noorhanizar; Saub, Roslan; Othman, Siti Adibah

2012-10-01

The objective of this study was to assess changes in the oral health-related quality of life (OHRQoL) among patients wearing fixed orthodontic appliances 24 h after insertion. Sixty patients aged between 14 and 24 years (29 males and 31 females; mean age, 17.8 years; SD 3.1 years) were recruited from the Postgraduate Clinic, Department of Children's Dentistry and Orthodontics, Faculty of Dentistry, University of Malaya. The oral health-related quality of life (OHRQoL) was measured before treatment and 24 h after insertion of the orthodontic appliance. The instrument used to measure OHRQoL was a modified self-administered short version of Malaysian Oral Health Impact Profile (OHIP-16[M]) questionnaire. The higher the score, the poorer is the OHRQoL. Overall score of OHRQoL increased significantly 24 h after insertion (mean 43.5±10.9) as compared to before insertion (mean 34.1±9.2) (P<0.001). Significant changes were found for the following items: Difficulties in chewing, bad breath, difficulties in pronunciation, discomfort in eating, ulcer, pain, avoidances of eating certain foods, difficulties in cleaning, embarrassment, avoid smiling, disturbed sleep, concentration affected, difficulty carrying out daily activities, and lack of self-confidence (P<0.05). Significant changes were also found in the mean difference of OHRQoL for gender (P<0.001). OHRQoL was found to deteriorate 24 h after insertion of fixed orthodontic appliances in almost all domains, with significant changes in gender. This information can be used as "informed consent", which might increase patient's compliance as they are aware of what to expect from initial orthodontic treatment.

Do Corticosteroids Still Have a Role in the Management of Third Molar Surgery?

PubMed

Ngeow, Wei Cheong; Lim, Daniel

2016-07-01

The use of corticosteroids to reduce the post-operative sequelae of lower third molar surgery, namely pain, swelling and trismus, has been well studied by many researchers over the past 6 decades. This study reviewed the reported outcome of corticosteroids used in controlling the above sequalae after third molar surgery. A PubMed, Medline, EMBASE and Google search was undertaken of all controlled clinical trials on the effects of corticosteroids on pain, swelling and trismus after lower third molar surgery. The review was limited to studies published over the last 10 years (2006-2015). Of the 46 initially retrieved articles, 34 were finally included. Eleven studies compared the effect of 2 similar (but different dose) or different group of corticosteroids. Thirty-one studies reported the effects of corticosteroids on all sequale, 2 reported the outcome on swelling and trismus and another 1 on swelling and pain only. In 16 of the studies, corticosteroid use resulted in significant reductions in pain after third molar removal. Twenty-two out of 29 studies reported reduced swelling against negative control while 18 out of 25 studies reported improved mouth opening. Fourteen studies reported the benefit of corticosteroids on all 3 sequelae, with 71.4% resulted from the use of methylprednisolone. Although there are some conflicting effects, the results of this analysis shows in general the benefits derived from short-term use of corticosteroids in relation to pain, swelling and trismus following third molar surgical extraction, with no side effects observed. This work was supported by the University of Malaya's High Impact Research grant UM.C/625/1/HIR/MOHE/05.

Psychometric Validation of the Bahasa Malaysia Version of the EORTC QLQ-CR29.

PubMed

Magaji, Bello Arkilla; Moy, Foong Ming; Roslani, April Camilla; Law, Chee Wei; Raduan, Farhana; Sagap, Ismail

2015-01-01

This study examined the psychometric properties of the Bahasa Malaysia (BM) version of the European Organization for Research and Treatment of Cancer (EORTC) Colorectal Cancer-specific Quality Of Life Questionnaire (QLQ-CR29). We studied 93 patients recruited from University Malaya and Universiti Kebangsaan Medical Centers, Kuala Lumpur, Malaysia using a self-administered method. Tools included QLQ-C30, QLQ-CR29 and Karnofsky Performance Scales (KPS). Statistical analyses included Cronbach's alpha, test-retest correlations, multi-traits scaling and known-groups comparisons. A p value ≤ 0.05 was considered significant. The internal consistency coefficients for body image, urinary frequency, blood and mucus and stool frequency scales were acceptable (Cronbach's alpha α ≥ 0.65). However, the coefficients were low for the blood and mucus and stool frequency scales in patients with a stoma bag (α = 0.46). Test-retest correlation coefficients were moderate to high (range: r = 0.51 to 1.00) for most of the scales except anxiety, urinary frequency, buttock pain, hair loss, stoma care related problems, and dyspareunia (r ≤ 0.49). Convergent and discriminant validities were achieved in all scales. Patients with a stoma reported significantly higher symptoms of blood and mucus in the stool, flatulence, faecal incontinence, sore skin, and embarrassment due to the frequent need to change the stoma bag (p < 0.05) compared to patients without stoma. None of the scales distinguished between patients based on the KPS scores. There were no overlaps between scales in the QLQ-C30 and QLQ-CR29 (r < 0.40). the BM version of the QLQ-CR29 indicated acceptable psychometric properties in most of the scales similar to original validation study. This questionnaire could be used to complement the QLQ-C30 in assessing HRQOL among BM speaking population with colorectal cancer.

Health-related quality of life among colorectal cancer patients in Malaysia: a study protocol

PubMed Central

2012-01-01

Background Colorectal cancer is a major public health problem in Malaysia. However, it is also one of the most treatable cancers, resulting in significant numbers of survivors. Therefore, the impact of surviving treatment for colorectal cancer on health related quality of life is important for the patients, clinicians and policy makers, and may differ in different cultures and populations. The aim of this study was to validate the Malaysian versions of the European Organization for Research and Treatment of Cancer quality of life instruments among colorectal cancers patients. Methods/design This is a cross sectional multi centre study. Three hospitals were included, the University of Malaya Medical Centre, the Universiti Kebangsaan Malaysia Medical Centre and Hospital Tuanku Jaafar Seremban. Malaysian citizens and permanent residence were studied and demographic and clinical information obtained from hospital records. The European Organization for Research and Treatment of Cancer Quality of life Core 30, colorectal cancer CR29, and the colorectal cancer liver metastasis LMC 21 were used and an observer assessment of performance obtained with the Karnofsky Performance Scale. Questionnaires were translated into three most commonly spoken languages in Malaysia (Bahasa Malaysia, Chinese and Tamil), then administered, scored and analyzed following the developers’ guidelines. Ethical approval was obtained from the participating centres. Tests of reliability and validity were performed to examine the validity of these instruments. Conclusion The result of pilot testing shows that the use of the Malaysian versions of EORTC QLQ C30, CR29 instruments is feasible in our sample of colorectal cancer patients. Instructions for completion as well as questions were well understood except the questions on the overall quality of life, overall health status and sexual activity. Thus we anticipate obtaining good psychometric properties for the instruments at the end of the study. PMID:22937765

Health-related quality of life among colorectal cancer patients in Malaysia: a study protocol.

PubMed

Magaji, Bello Arkilla; Moy, Foong Ming; Roslani, April Camilla; Sagap, Ismail; Zakaria, Jasiah; Blazeby, Jane M; Law, Chee Wei

2012-09-03

Colorectal cancer is a major public health problem in Malaysia. However, it is also one of the most treatable cancers, resulting in significant numbers of survivors. Therefore, the impact of surviving treatment for colorectal cancer on health related quality of life is important for the patients, clinicians and policy makers, and may differ in different cultures and populations. The aim of this study was to validate the Malaysian versions of the European Organization for Research and Treatment of Cancer quality of life instruments among colorectal cancers patients. This is a cross sectional multi centre study. Three hospitals were included, the University of Malaya Medical Centre, the Universiti Kebangsaan Malaysia Medical Centre and Hospital Tuanku Jaafar Seremban. Malaysian citizens and permanent residence were studied and demographic and clinical information obtained from hospital records. The European Organization for Research and Treatment of Cancer Quality of life Core 30, colorectal cancer CR29, and the colorectal cancer liver metastasis LMC 21 were used and an observer assessment of performance obtained with the Karnofsky Performance Scale. Questionnaires were translated into three most commonly spoken languages in Malaysia (Bahasa Malaysia, Chinese and Tamil), then administered, scored and analyzed following the developers' guidelines. Ethical approval was obtained from the participating centres. Tests of reliability and validity were performed to examine the validity of these instruments. The result of pilot testing shows that the use of the Malaysian versions of EORTC QLQ C30, CR29 instruments is feasible in our sample of colorectal cancer patients. Instructions for completion as well as questions were well understood except the questions on the overall quality of life, overall health status and sexual activity. Thus we anticipate obtaining good psychometric properties for the instruments at the end of the study.

Oral candidal species among smokers and non-smokers.

PubMed

Rasool, S; Siar, C H; Ng, K P

2005-11-01

To determine the various oral Candidal species among healthy Malaysian adults. Case-control study. This study was collaborated between the Department of Medical Microbiology, Faculty of Medicine and Department of Oral Pathology, Oral Medicine and Periodontology, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia, between September 2002 till January 2004. One hundred adults (50 smokers and 50 non-smokers), aged between 40 and 70 years were studied. Swabs and carbohydrate assimilation (Saboraud Dextrose Agar, Corn Meal Agar, API 20C AUX System) were performed. Specimens were collected from dorsum of the tongue, buccal mucosa and commissures (right and left each). Colony forms were established by positive colony forming units, on SDA medium (24-48 hours). Germ tube test for (true/pseudohyphae) growth was done on Corn Meal Agar Medium. Candida biotypes were evaluated by API 20C AUX system, which had a numerical 7 digit profile, added to evaluate a definite Candida species. Thirty-five percent of Malaysian adults harbored Candida intraorally. Candidal species identified among 100 subjects had C. albicans (27) 77%, C. glabrata (3) 8%, C. famata, C. tropicalis, C. krusei, C. lusitaniae and C. guilliermondii (1) 3% each. Thirty-three positive cases comprised of 35 species i.e. two cases had two species each. Fifty seven percent of these were smokers and 43% non-smokers. These included 40% Chinese, 36% Malays and 24% Indians. Species were, however, not specified according to intra-oral sites i.e. buccal, commissural mucosa and dorsum of tongue. On this series C. albicans is the most common species found in the oral cavity of Malaysian adults. It is equally frequent in smokers and non-smokers, but showed a predilection for the ethnic Chinese group.

The zoonotic flaviviruses of southern, south-eastern and eastern Asia, and Australasia: the potential for emergent viruses.

PubMed

Mackenzie, J S; Williams, D T

2009-08-01

The genus Flaviviridae comprises about 70 members, of which about 30 are found in southern, south-eastern and eastern Asia and Australasia. These include major pathogens such as Japanese encephalitis (JE), West Nile (WN), Murray Valley encephalitis (MVE), tick-borne encephalitis, Kyasanur Forest disease virus, and the dengue viruses. Other members are known to be associated with mild febrile disease in humans, or with no known disease. In addition, novel flaviviruses continue to be discovered, as demonstrated recently by New Mapoon virus in Australia, Sitiawan virus in Malaysia, and ThCAr virus in Thailand. About 19 of these viruses are mosquito-borne, six are tick-borne, and four have no known vector and represent isolates from rodents or bats. Evidence from phylogenetic studies suggest that JE, MVE and Alfuy viruses probably emerged in the Malaya-Indonesian region from an African progenitor virus, possibly a virus related to Usutu virus. WN virus, however, is believed to have emerged in Africa, and then dispersed through avian migration. Evidence suggests that there are at least seven genetic lineages of WN virus, of which lineage 1b spread to Australasia as Kunjin virus, lineages 1a and 5 spread to India, and lineage 6 spread to Malaysia. Indeed, flaviviruses have a propensity to spread and emerge in new geographic areas, and they represent a potential source for new disease emergence. Many of the factors associated with disease emergence are present in the region, such as changes in land use and deforestation, increasing population movement, urbanization, and increasing trade. Furthermore, because of their ecology and dependence on climate, there is a strong likelihood that global warming may significantly increase the potential for disease emergence and/or spread.

Seismic anisotropy beneath South China Sea: using SKS splitting to constrain mantle flow

NASA Astrophysics Data System (ADS)

Xue, M.; Le, K.; Yang, T.

2011-12-01

The evolution of South China Sea is under debate and several hypotheses have been proposed: (1) The collision of India plate and Eurasia plate; (2) the backward movement of the Pacific subduction plate; (3) mantle upwelling; and (4) combinations of above hypotheses. All these causal mechanisms emphasize the contributions of deep structures to the evolution of South China Sea. In this study we use earthquake data recorded by seismic stations surrounding South China Sea to constrain mantle flow beneath. To fill the vacancy of seismic data in Viet Nam, we deployed 4 seismic stations (VT01-VT04) in a roughly north - south orientation in Viet Nam in Nov. 2009. We combine the VT dataset with the AD and MY datasets from IRIS and select 81 events for SKS splitting analysis. Measurements were made at 11 stations using Wolfe and Silver (1998)'s multi-event stacking procedure. Our observed splitting directions in Vietnam are generally consistent with those of Bai et. al. (2009) . In northern Vietnam, the splitting times are around 1 sec and the fast directions are NWW-SEE, parallel to the absolute plate motion as well as the motion of the Earth surface, implying the crust and the mantle are coupled in this region and is moving as a result of the collision of India and China. While in southern Vietnam and Malaya, the fast directions are NE-SW, almost perpendicular to the absolute plate motion as well as the surface motion of Eurasia plate. However, the observed NE-SW is parallel to the subduction direction of the Australian plate, which might be caused by the mantle flow along NE-SW induced by the subduction.

Hand grip strength in the adult Malaysian population.

PubMed

Kamarul, T; Ahmad, T S; Loh, W Y C

2006-08-01

To measure the hand grip strength of Malaysians aged 18 to 65 years. Between January and April 2003, 412 subjects (200 women and 212 men) were recruited from staff, students, and visitors of the University of Malaya Medical Centre. Socioeconomic, general health, and lifestyle data were collected from each subject using a standard questionnaire. Weight and height were measured prior to testing. Standardised positioning and instructions based on several hand grip protocols were used. Data were collected using the LIDO kinetic work set. 93% of the subjects were right-hand dominant and 7% were left-hand dominant. Hand grip strength was significantly correlated with hand dominance, gender, occupation, height, and weight, but not body mass index. No significant differences in grip strength were noted with regard to race or level of income. Men were stronger than women in all age-groups, with a ratio of 1.75:1. In both right- and left-hand dominant groups, the dominant hand was consistently stronger than the non-dominant side, with a ratio of 1.12:1 in the right-hand dominant group and 1.05:1 in the left-hand dominant group. The strongest hand grip strength in the right-hand dominant group occurred in the age-group of 25 to 34 years; in the left-hand dominant group it was in the age-group of 18 to 24 years. In western populations, the mean grip strength can be as much as 1.5 times greater than in the Malaysian population. Data derived from western populations cannot be applied to a comparable Malaysian population. Gender, hand dominance, age, occupation, weight, and height must be considered when establishing normal values for grip strength.

Prediction of lymph node involvement in patients with breast tumors measuring 3-5 cm in a middle-income setting: the role of CancerMath.

PubMed

Pijnappel, E N; Bhoo-Pathy, N; Suniza, J; See, M H; Tan, G H; Yip, C H; Hartman, M; Taib, N A; Verkooijen, H M

2014-12-01

In settings with limited resources, sentinel lymph node biopsy (SNB) is only offered to breast cancer patients with small tumors and a low a priori risk of axillary metastases. We investigated whether CancerMath, a free online prediction tool for axillary lymph node involvement, is able to identify women at low risk of axillary lymph node metastases in Malaysian women with 3-5 cm tumors, with the aim to offer SNB in a targeted, cost-effective way. Women with non-metastatic breast cancers, measuring 3-5 cm were identified within the University Malaya Medical Centre (UMMC) breast cancer registry. We compared CancerMath-predicted probabilities of lymph node involvement between women with versus without lymph node metastases. The discriminative performance of CancerMath was tested using receiver operating characteristic (ROC) analysis. Out of 1,017 patients, 520 (51 %) had axillary involvement. Tumors of women with axillary involvement were more often estrogen-receptor positive, progesterone-receptor positive, and human epidermal growth factor receptor (HER)-2 positive. The mean CancerMath score was higher in women with axillary involvement than in those without (53.5 vs. 51.3, p = 0.001). In terms of discrimination, CancerMath performed poorly, with an area under the ROC curve of 0.553 (95 % confidence interval CI 0.518-0.588). Attempts to optimize the CancerMath model by adding ethnicity and HER2 to the model did not improve discriminatory performance. For Malaysian women with tumors measuring 3-5 cm, CancerMath is unable to accurately predict lymph node involvement and is therefore not helpful in the identification of women at low risk of node-positive disease who could benefit from SNB.

The predictive accuracy of PREDICT: a personalized decision-making tool for Southeast Asian women with breast cancer.

PubMed

Wong, Hoong-Seam; Subramaniam, Shridevi; Alias, Zarifah; Taib, Nur Aishah; Ho, Gwo-Fuang; Ng, Char-Hong; Yip, Cheng-Har; Verkooijen, Helena M; Hartman, Mikael; Bhoo-Pathy, Nirmala

2015-02-01

Web-based prognostication tools may provide a simple and economically feasible option to aid prognostication and selection of chemotherapy in early breast cancers. We validated PREDICT, a free online breast cancer prognostication and treatment benefit tool, in a resource-limited setting. All 1480 patients who underwent complete surgical treatment for stages I to III breast cancer from 1998 to 2006 were identified from the prospective breast cancer registry of University Malaya Medical Centre, Kuala Lumpur, Malaysia. Calibration was evaluated by comparing the model-predicted overall survival (OS) with patients' actual OS. Model discrimination was tested using receiver-operating characteristic (ROC) analysis. Median age at diagnosis was 50 years. The median tumor size at presentation was 3 cm and 54% of patients had lymph node-negative disease. About 55% of women had estrogen receptor-positive breast cancer. Overall, the model-predicted 5 and 10-year OS was 86.3% and 77.5%, respectively, whereas the observed 5 and 10-year OS was 87.6% (difference: -1.3%) and 74.2% (difference: 3.3%), respectively; P values for goodness-of-fit test were 0.18 and 0.12, respectively. The program was accurate in most subgroups of patients, but significantly overestimated survival in patients aged <40 years, and in those receiving neoadjuvant chemotherapy. PREDICT performed well in terms of discrimination; areas under ROC curve were 0.78 (95% confidence interval [CI]: 0.74-0.81) and 0.73 (95% CI: 0.68-0.78) for 5 and 10-year OS, respectively. Based on its accurate performance in this study, PREDICT may be clinically useful in prognosticating women with breast cancer and personalizing breast cancer treatment in resource-limited settings.

Clinical and autoantibody profile in systemic sclerosis: baseline characteristics from a West Malaysian cohort.

PubMed

Sujau, Ibrahim; Ng, Chin Teck; Sthaneshwar, Pavai; Sockalingam, Sargunan; Cheah, Tien Eang; Yahya, Fariz; Jasmin, Raja

2015-05-01

To evaluate the clinical and antibody profile of systemic sclerosis (SSc) in a Malaysian cohort. Consecutive patients with SSc in University Malaya Medical Centre from March to November 2012 were included in this study. In addition to clinical characterization, all subjects underwent autoantibody testing using Euroline immunoblot assay. The association between clinical features and autoantibody profile was evaluated. There were 31, predominantly Chinese (45.2%), subjects. Limited cutaneous disease was the most common subtype (71%). Raynaud's phenomenon was the most commonly observed feature (83.9%). Nine (29%) had esophageal dysmotility symptoms and 23 (74.2%), including all patients with diffuse SSc, had symptoms of gastro-esophageal reflux disease (GERD). Restrictive pattern on pulmonary function test and evidence of lung fibrosis were seen in more than 70% of patients. Echocardiographic evidence of pulmonary arterial hypertension was seen in 58.1%. Telangiectasia, calcinosis, digital ulcers, digital pulp loss or pitting were seen more commonly in the diffuse subtype. The two most prevalent autoantibodies were anti-Scl-70 and anti-Ro-52. The presence of anti-Scl-70 was significantly associated with restrictive lung disease (P = 0.05). Anti-Ro-52 was associated with control subjects with other autoimmune diseases (P = 0.043). The presence of anti-PM-Scl-75 was associated with overlap syndrome (P = 0.032). Patients with anticentromere antibodies were more likely to have vasculitic rash (P = 0.012). In Malaysia, SSc most commonly affects the Chinese. Limited cutaneous is more common than diffuse subtype. Features of CREST (calcinosis, Reynaud disease, esophageal dysmotility, sclerodactyly, telangiectasia) are more commonly observed in the diffuse cutaneous subgroup. Anti-Scl-70 and anti-Ro-52 antibodies are promising biomarkers for pulmonary involvement in SSc. © 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

Reliability and validity of the Malay Version of the Breast- Impact of Treatment Scale (MVBITS) in breast cancer women undergoing chemotherapy.

PubMed

Zainal, Nor Zuraida; Shuib, Norley; Bustam, Anita Zarina; Sabki, Zuraida Ahmad; Guan, Ng Chong

2013-01-01

Body image dissatisfaction among breast cancer survivors has been associated with psychological stress resultant from breast cancer and resultant surgery. This study aimed to examine the psychometric properties of the Malay Version of the Breast-Impact of Treatment Scale (MVBITS) and to investigate the associations of retained factors with the Hospital Anxiety and Depression Scale (HADS) and the Rosenberg Self-Esteem Scale (RSES). The MVBITS was 'forward-backward' translated from English to Malay and then administered to 70 female breast cancer patients who came to the Oncology Clinic of University Malaya Medical Centre, Kuala Lumpur, Malaysia to undergo chemotherapy. Principal component analysis (PCA) with varimax rotation was performed to explore the factor structure of the MVBITS. Associations of retained factors were estimated with reference to Spearman correlation coefficients. The internal consistency reliability of MVBITS was good (Cronbach's alpha 0.945) and showed temporal stability over a 3-week period. Principal component analysis suggested two factors termed as 'Intrusion' and 'Avoidance' domains. These factors explained 70.3% of the variance. Factor 1 comprised the effects of breast cancer treatment on the emotion and thought, while Factor 2 informed attempts to limit exposure of the body to self or others. The Factor 1 of MVBITS was positively correlated with total, depression and anxiety sub-scores of HADS. Factor 2 was positively correlated with total and anxiety sub-scores of HADS. MVBITS was also positively correlated with the RSES scores. The results showed that the Malay Version of Breast-Impact of Treatment Scale possesses satisfactory psychometric properties suggesting that this instrument is appropriate for assessment of body change stress among female breast cancer patients in Malaysia.

Clinical and electrophysiological characteristics of symmetric polyneuropathy in a cohort of systemic lupus erythematosus patients.

PubMed

Jasmin, R; Sockalingam, S; Ramanaidu, L P; Goh, K J

2015-03-01

Peripheral neuropathy in systemic lupus erythematosus (SLE) is heterogeneous and its commonest pattern is symmetrical polyneuropathy. The aim of this study was to describe the prevalence, clinical and electrophysiological features, disease associations and effects on function and quality of life of polyneuropathy in SLE patients, defined using combined clinical and electrophysiological diagnostic criteria. Consecutive SLE patients seen at the University of Malaya Medical Centre were included. Patients with medication and other disorders known to cause neuropathy were excluded. Demographic, clinical and laboratory data were obtained using a pre-defined questionnaire. Function and health-related quality of life was assessed using the modified Rankin scale and the SF-36 scores. Nerve conduction studies (NCS) were carried out in both upper and lower limbs. Polyneuropathy was defined as the presence of bilateral clinical symptoms and/or signs and bilateral abnormal NCS parameters. Of 150 patients, 23 (15.3%) had polyneuropathy. SLE-related polyneuropathy was mainly characterized by sensory symptoms of numbness/tingling and pain with mild signs of absent ankle reflexes and reduced pain sensation. Function was minimally affected and there were no differences in quality of life scores. NCS abnormalities suggested mild length-dependent axonal neuropathy, primarily in the distal lower limbs. Compared to those without polyneuropathy, SLE-related polyneuropathy patients were significantly older but had no other significant demographic or disease associations. SLE-related polyneuropathy is a chronic, axonal and predominantly sensory neuropathy, associated with older age. Its underlying pathogenetic mechanisms are unknown, although a possibility could be an increased susceptibility of peripheral nerves in SLE patients to effects of aging. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Variable outcome in infantile-onset inflammatory bowel disease in an Asian cohort

PubMed Central

Lee, Way Seah; Ng, Ruey Terng; Chan, Koon-Wing; Lau, Yu-Lung

2016-01-01

AIM Infantile-onset inflammatory bowel disease (IO-IBD) with the onset of disease before 12 mo of age, is a different disease entity from childhood IBD. We aimed to describe the clinical features, outcome and role of mutation in interleukin-10 (IL-10) and interleukin-10 receptors (IL-10R) in Asian children with IO-IBD. METHODS All cases of IO-IBD, defined as onset of disease before 12 mo of age, seen at University Malaya Medical Center, Malaysia were reviewed. We performed mutational analysis for IL10 and IL10R genes in patients with presenting clinical features of Crohn’s disease (CD). RESULTS Six [13%; CD = 3, ulcerative colitis (UC) = 2, IBD-unclassified (IBD-U) = 1] of the 48 children (CD = 25; UC = 23) with IBD have IO-IBD. At final review [median (range) duration of follow-up: 6.5 (3.0-20) years], three patients were in remission without immunosuppression [one each for post-colostomy (IBD-U), after standard immunosuppression (CD), and after total colectomy (UC)]. Three patients were on immunosuppression: one (UC) was in remission while two (both CD) had persistent disease. As compared with later-onset disease, IO-IBD were more likely to present with bloody diarrhea (100% vs 55%, P = 0.039) but were similar in terms of an associated autoimmune liver disease (0% vs 19%, P = 0.31), requiring biologics therapy (50% vs 36%, P = 0.40), surgery (50% vs 29%, P = 0.27), or achieving remission (50% vs 64%, P = 0.40). No mutations in either IL10 or IL10R in the three patients with CD and the only patient with IBD-U were identified. CONCLUSION The clinical features of IO-IBD in this Asian cohort of children who were negative for IL-10 or IL-10R mutations were variable. As compared to childhood IBD with onset of disease after 12 mo of age, IO-IBD achieved remission at a similar rate. PMID:28082818

Variable outcome in infantile-onset inflammatory bowel disease in an Asian cohort.

PubMed

Lee, Way Seah; Ng, Ruey Terng; Chan, Koon-Wing; Lau, Yu-Lung

2016-12-28

Infantile-onset inflammatory bowel disease (IO-IBD) with the onset of disease before 12 mo of age, is a different disease entity from childhood IBD. We aimed to describe the clinical features, outcome and role of mutation in interleukin-10 (IL-10) and interleukin-10 receptors (IL-10R) in Asian children with IO-IBD. All cases of IO-IBD, defined as onset of disease before 12 mo of age, seen at University Malaya Medical Center, Malaysia were reviewed. We performed mutational analysis for IL10 and IL10R genes in patients with presenting clinical features of Crohn's disease (CD). Six [13%; CD = 3, ulcerative colitis (UC) = 2, IBD-unclassified (IBD-U) = 1] of the 48 children (CD = 25; UC = 23) with IBD have IO-IBD. At final review [median (range) duration of follow-up: 6.5 (3.0-20) years], three patients were in remission without immunosuppression [one each for post-colostomy (IBD-U), after standard immunosuppression (CD), and after total colectomy (UC)]. Three patients were on immunosuppression: one (UC) was in remission while two (both CD) had persistent disease. As compared with later-onset disease, IO-IBD were more likely to present with bloody diarrhea (100% vs 55%, P = 0.039) but were similar in terms of an associated autoimmune liver disease (0% vs 19%, P = 0.31), requiring biologics therapy (50% vs 36%, P = 0.40), surgery (50% vs 29%, P = 0.27), or achieving remission (50% vs 64%, P = 0.40). No mutations in either IL10 or IL10R in the three patients with CD and the only patient with IBD-U were identified. The clinical features of IO-IBD in this Asian cohort of children who were negative for IL-10 or IL-10R mutations were variable. As compared to childhood IBD with onset of disease after 12 mo of age, IO-IBD achieved remission at a similar rate.

MDRD vs. CKD-EPI in comparison to 51Chromium EDTA: a cross sectional study of Malaysian CKD cohort.

PubMed

Jalalonmuhali, Maisarah; Lim, Soo Kun; Md Shah, Mohammad Nazri; Ng, Kok Peng

2017-12-13

Accurate measurement of renal function is important: however, radiolabelled gold standard measurement of GFR is highly expensive and can only be used on a very limited scale. We aim to compare the performance of Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equations in the multi-ethnic population attending University Malaya Medical Centre (UMMC). This is a cross-sectional study recruiting patients, who attend UMMC Nephrology clinics on voluntary basis. 51-Chromium EDTA ( 51 Cr-EDTA) plasma level was used to measure the reference GFR. The serum creatinine was determined by IDMS reference modified Jaffe kinetic assay (Cr Jaffe ). The predictive capabilities of MDRD and CKD-EPI based equations were calculated. Data was analysed using SPSS version 20 and correlation, bias, precision and accuracy were determined. A total of 113 subjects with mean age of 58.12 ± 14.76 years and BMI of 25.99 ± 4.29 kg/m 2 were recruited. The mean reference GFR was 66.98 ± 40.65 ml/min/1.73m 2 , while the estimated GFR based on MDRD and CKD-EPI formula were 62.17 ± 40.40, and 60.44 ± 34.59, respectively. Both MDRD and CKD-EPI were well-correlated with reference GFR (0.806 and 0.867 respectively) and statistically significant with p < 0.001. In the overall cohort, although MDRD had smaller bias than CKD-EPI (4.81 vs. 6.54), CKD-EPI was more precise (25.22 vs. 20.29) with higher accuracy within 30% of measured GFR (79.65 vs. 86.73%). The CKD-EPI equation appeared to be more precise and accurate than the MDRD equation in estimating GFR in our cohort of multi-ethnic populations in Malaysia.

Functional and Molecular Surveillance of Helicobacter pylori Antibiotic Resistance in Kuala Lumpur

PubMed Central

Teh, Xinsheng; Khosravi, Yalda; Lee, Woon Ching; Leow, Alex Hwong Ruey; Loke, Mun Fai; Vadivelu, Jamuna; Goh, Khean Lee

2014-01-01

Background Helicobacter pylori is the etiological agent for diseases ranging from chronic gastritis and peptic ulcer disease to gastric adenocarcinoma and primary gastric B-cell lymphoma. Emergence of resistance to antibiotics possesses a challenge to the effort to eradicate H. pylori using conventional antibiotic-based therapies. The molecular mechanisms that contribute to the resistance of these strains have yet to be identified and are important for understanding the evolutional pattern and selective pressure imposed by the environment. Methods and Findings H. pylori was isolated from 102 patients diagnosed with gastrointestinal diseases, who underwent endoscopy at University Malaya Medical Centre (UMMC). The isolates were tested for their susceptibility on eleven antibiotics using Etest. Based on susceptibility test, 32.3% of the isolates were found to have primary metronidazole resistance; followed by clarithromycin (6.8%) and fluoroquinolones (6.8%). To further investigate the resistant strains, mutational patterns of gene rdxA, frxA, gyrA, gyrB, and 23S rRNA were studied. Consistent with the previous reports, metronidazole resistance was prevalent in the local population. However, clarithromycin, fluoroquinolone and multi-drug resistance were shown to be emerging. Molecular patterns correlated well with phenotypic data. Interestingly, multi-drug resistant (MDR) strains were found to be associated with higher minimum inhibitory concentration (MIC) than their single-drug resistant (SDR) counterparts. Most importantly, clarithromycin-resistant strains were suggested to have a higher incidence for developing multi-drug resistance. Conclusion Data from this study highlighted the urgency to monitor closely the prevalence of antibiotic resistance in the Malaysian population; especially that of clarithromycin and multi-drug resistance. Further study is needed to understand the molecular association between clarithromycin resistance and multi-drug resistance in H. pylori. The report serves a reminder that a strict antibiotic usage policy is needed in Malaysia and other developing countries (especially those where H. pylori prevalence remained high). PMID:25003707

PERSONALITY TRAITS AND STRESS LEVELS AMONG SENIOR DENTAL STUDENTS: EVIDENCE FROM MALAYSIA AND SINGAPORE.

PubMed

Yusof, Zamros Y M; Hassan, Wan Nurazreena Wan; Razak, Ishak A; Hashim, Siti Marini N; Tahir, Mohd Khairul A M; Keng, Siong Beng

2016-11-01

This study aimed to evaluate the association between dental students’ personality traits and stress levels in relation to dental education programs among senior dental students in University Malaya (UM) in Malaysia and National University of Singapore (NUS). A cross-sectional survey using a self-administered questionnaire was conducted on UM and NUS senior dental students. The questionnaire comprised items on demographic background, the Big Five Inventory Personality Traits (BFIPT) test and a modified Dental Environment Stress (DES) scale. Rasch analysis was used to convert raw data to interval scores. Analyses were done by t-test, Pearson correlation, and Hierarchical regression statistics. The response rate was 100% (UM=132, NUS=76). Personality trait Agreeableness (mean=0.30) was significantly more prevalent among UM than NUS students (mean=0.15, p=0.016). In NUS, Neuroticism (mean=0.36) was significantly more prevalent than in UM (mean=0.14, p=0.002). The DES mean score was higher among NUS (mean=0.23) than UM students (mean=0.07). In UM, Neuroticism was significantly correlated with stress levels (r=0.338, p<0.001). In NUS, these were Neuroticism (r=0.278, p=0.015), Agreeableness (r=0.250, p=0.029) and Conscientiousness (r=-0.242, p=0.035) personality traits. The correlation was strongest for personality trait Neuroticism in both schools. Hierarchical regression analysis showed that gender and Neuroticism were significant predictors for students’ stress levels (p<0.05) with the latter exerting a bigger effect size (R2=0.18) than gender (R2=004). This study showed that gender and Neuroticism personality trait were significant predictors for stress levels among selected groups of dental students in Southeast Asia. Information on students’ personality may be useful in new students’ intake, stress management counseling and future program reviews.

Typhus-like Fevers of Unknown Ætiology, with Special Reference to the Malay States

PubMed Central

Fletcher, William

1930-01-01

Typhus exanthematicus, Rocky Mountain fever, and the tsutsugamushi disease have been classified in the “typhus group” by Megaw, as louse-typhus, tick-typhus, and mite-typhus. He has added a fourth-class, comprising typhus-like fevers, with unknown vectors. It is the diseases of this class with which this paper is concerned. Endemic typhus (Brill's disease) is very closely related to typhus fever; the Weil-Felix reaction is positive, typhus-like vascular lesions are present, and there is cross-immunity with typhus. In the exanthematic fever of Marseilles the relationship is more superficial; there is neither cross-immunity nor vascular lesion, and the Weil-Felix reaction is negative. Some, e.g., the scrub-typhus of Malaya (vector probably a mite), are more nearly related to tsutsugamushi than to typhus; others, e.g., Indian “tick-typhus” (vector probably a tick), to Rocky Mountain fever. All are non-contagious, non-epidemic, warm-weather diseases. They are unassociated with dirt, squalor, or lice, and are restricted to definite foci. Probably rodents or other animals are the reservoirs of the virus. On the question of identity with typhus, health authorities decide that notification is unnecessary; typhus introduced into America spreads, Brill's disease does not. These typhus-like diseases are not the same in all the countries where they occur. There are two main groups: (1) an urban group, more closely related to typhus, in which the Weil-Felix reaction is positive; (2) a rural group, more closely related to tsutsugamushi and Rocky Mountain fever, in which the Weil-Felix reaction is negative. There is a special non-indologenic strain of B. proteus, which is agglutinated in some of the fevers belonging to the second group. Tropical typhus in the Malay States: (1) urban form, or “shop-typhus,” resembling Brill's disease; (2) rural form or “scrub-typhus.” Peculiar association with oil-palms and coarse grass. PMID:19987538

Rapid response to methylphenidate as an add-on therapy to mirtazapine in the treatment of major depressive disorder in terminally ill cancer patients: a four-week, randomized, double-blinded, placebo-controlled study.

PubMed

Ng, Chong Guan; Boks, Marco P M; Roes, Kit C B; Zainal, Nor Zuraida; Sulaiman, Ahmad Hatim; Tan, Seng Beng; de Wit, Niek J

2014-04-01

This is a 4 week, randomized, double-blind, placebo-controlled study to examine the effects of methylphenidate as add-on therapy to mirtazapine compared to placebo for treatment of depression in terminally ill cancer patients. It involved 88 terminally ill cancer patients from University of Malaya Medical Centre, Kuala Lumpur, Malaysia. They were randomized and treated with either methylphenidate or placebo as add on to mirtazapine. The change in Montgomery-Åsberg Depression Rating Scale (MADRS) score from baseline to day 3 was analyzed by linear regression. Changes of MADRS and Clinical Global Impression-Severity Scale (CGI-S) over 28 days were analyzed using mixed model repeated measures (MMRM). Secondary analysis of MADRS response rates, defined as 50% or more reduction from baseline score. A significantly larger reduction of Montgomery-Åsberg Depression Rating Scale (MADRS) score in the methylphenidate group was observed from day 3 (B=4.14; 95% CI=1.83-6.45). Response rate (defined as 50% or more reduction from baseline MADRS score) in the methylphenidate treated group was superior from day 14. Improvement in Clinical Global Impression-Severity Scale (CGI-S) was greater in the methylphenidate treated group from day 3 until day 28. The drop-out rates were 52.3% in the methylphenidate group and 59.1% in the placebo group (relative risk=0.86, 95%CI=0.54-1.37) due to cancer progression. Nervous system adverse events were more common in methylphenidate treated subjects (20.5% vs 9.1%, p=0.13). In conclusions, methylphenidate as add on therapy to mirtazapine demonstrated an earlier antidepressant response in terminally ill cancer patients, although at an increased risk of the nervous system side effects. Copyright © 2014 Elsevier B.V. and ECNP. All rights reserved.

Exophytic oral verrucous hyperplasia: a new entity.

PubMed

Patil, Shankargouda; Warnakulasuriya, Saman; Raj, Thirumal; Sanketh, D S; Rao, Roopa S

2016-11-01

Exophytic oral verrucous hyperplasia (OVH) is a new entity described by an expert working group from South Asia. First reported in Taiwan, there are no reports so far from an Indian population. The aim was to use the microscopic features described by the expert group to differentiate OVH from other oral verruco-papillary lesions in an Indian archive. In a retrospective multicentre study, using pathology archives, 188 verruco-papillary lesions were retrieved from pathology archives. A proforma listing histopathological criteria for OVH based on published guidelines (Annals of Dentistry, University of Malaya, 2013) was used. Patients' demographic and clinical data were transcribed from patient charts. The Pearson chi-square test was used to determine associations between clinical and histopathological features. Of 188 oral verruco-papillary lesions that were evaluated, based on microscopic features the cases were reclassified as OVH (57), verrucous carcinoma (VC) (84), oral squamous cell carcinoma (16), and other verruco-papillary lesions (31). Both OVH (70%) and VC (60%) showed male predominance and commonly affected buccal mucosa (OVH 74% and VC 57%). Absence of downward growth of the hyperplastic epithelium into lamina propria when compared with the level of the basement membrane of the adjacent normal epithelium was a distinct feature in OVH. Keratin plugging, epithelial dysplasia and subepithelial lymphocytic infiltration were found to be significantly different (P < 0.05) in OVH versus VC. The sample size of other verruco-papillary lesions was insufficient for statistical comparison. Apart from the absence of an endophytic growth pattern in OVH, we noted the presence of dysplasia in OVH. This significant observation does institute a debate as to whether this enigmatic lesion could possibly be a precedent of oral squamous or verrucous carcinoma. We propose OVH is a distinct entity in our Indian population and should be considered in the classification of oral potentially malignant disorders. © 2015 Wiley Publishing Asia Pty Ltd.

New constraints on the formation and evolution of the Andaman Sea, a sedimented back arc spreading center in the South East Asia, from seismic reflection studies.

NASA Astrophysics Data System (ADS)

Jourdain, A.; Singh, S. C.; Klinger, Y.

2014-12-01

The Andaman Sea is an enigmatic feature in the Indian Ocean region. To the west, it is bounded by a near arc parallel Andaman subduction system and to the east by the Malaya Peninsula. It hosts volcanic provinces like Alcock and Sewell Rises and the Andaman Sea Spreading Center (ASSC) that connects the sliver strike-slip Sagaing Fault in the north with the Andaman Nicobar and Great Sumatra Faults in the south. The actual spreading center follows a succession of basins, starting by the spreading of the Mergui basin in the south-east, 32 Ma ago, that shifted to the actual position of the spreading closer to the subduction trench. Several hypotheses have been proposed for the formation of the Andaman Sea basins: (a) Pull-apart basin along the Sagaing-Sumatra fault system, driven by the collision-extrusion mechanism and/or by the slip-partitioning induced by the oblique subduction, (b) Back-arc spreading due to the subduction. There is a debate about the orientation of the present spreading/extension between the North-South motion along the strike-slip faults and the NW-SE opening of the ASSC. We have access to 7000 km of high-resolution deep seismic reflection data, and high-resolution bathymetry data, which we combine with relocated earthquake data to shed light upon the formation and evolution of the Andaman Sea Basin. The central basin contains up to 4 km thick sediments. The crustal thickness is about 5-8 km in the central basin and increases to 13-15 km beneath the Alcock and Sewell Rises, which are devoid of sediments. Here we show how both the collision and the subduction play a role in the position and orientation of the extension in the Andaman Sea Basin, and how they influence the accretion at the spreading center.

The prevalence of undernutrition upon hospitalization in children in a developing country: A single hospital study from Malaysia.

PubMed

Lee, Way-Seah; Ahmad, Zulfadly

2017-10-01

Undernourished children who require hospital care have a longer duration of hospitalization and respond poorly to modern medical therapy. The objective of the present study was to ascertain the nutritional status of children admitted to a pediatric tertiary center in Malaysia and the risk factors leading to undernutrition upon admission. In this cross-sectional, hospital-based study, anthropometric measurements [weight, length/height, mid-upper arm circumference (MUAC), triceps skinfold thickness were performed in 285 children aged from 3 months to 15 years who were admitted to University Malaya Medical Centre, Kuala Lumpur in November 2013. Acute (wasting) and chronic (stunting) undernutrition were defined as weight-for-height (WFH) and height-for-age (HFA) < -2 standard deviation (S.D.), respectively. Underweight was defined as weight-for-age < -2 S.D. For children aged between 1 and 5 years of age, World Health Organization definition for acute undernutrition (HFA < -2 S.D. and/or MUAC < 12.5 cm) was also noted. Upon admission, the prevalence rates of acute and chronic undernutrition were 11% (n = 32) and 14% (n = 41), respectively. In addition, 7% (n = 21) had an MUAC of < 12.5 cm, 15% had body-mass index < -2 S.D., and 7% (n = 21) had triceps skinfold thickness < -2 S.D., while 17% (n = 47) were underweight. Using the World Health Organization definition of acute undernutrition, an additional eight patients were noted to have acute undernutrition (n = 40, 14%). No significant risk factors associated with undernutrition were identified. The prevalence of undernutrition among children admitted to a tertiary hospital in Malaysia was 14%. Strategies for systematic screening and provision of nutritional support in children at risk of undernutrition as well as treatment of undernutrition in children requiring hospitalization are needed. Copyright © 2017. Published by Elsevier B.V.

Elder mistreatment in a community dwelling population: the Malaysian Elder Mistreatment Project (MAESTRO) cohort study protocol

PubMed Central

Choo, Wan Yuen; Hairi, Noran Naqiah; Sooryanarayana, Rajini; Yunus, Raudah Mohd; Hairi, Farizah Mohd; Ismail, Norliana; Kandiben, Shathanapriya; Mohd Ali, Zainudin; Ahmad, Sharifah Nor; Abdul Razak, Inayah; Othman, Sajaratulnisah; Tan, Maw Pin; Mydin, Fadzilah Hanum Mohd; Peramalah, Devi; Brownell, Patricia; Bulgiba, Awang

2016-01-01

Introduction Despite being now recognised as a global health concern, there is still an inadequate amount of research into elder mistreatment, especially in low and middle-income regions. The purpose of this paper is to report on the design and methodology of a population-based cohort study on elder mistreatment among the older Malaysian population. The study aims at gathering data and evidence to estimate the prevalence and incidence of elder mistreatment, identify its individual, familial and social determinants, and quantify its health consequences. Methods and analysis This is a community-based prospective cohort study using randomly selected households from the national census. A multistage sampling method was employed to obtain a total of 2496 older adults living in the rural Kuala Pilah district. The study is divided into two phases: cross-sectional study (baseline), and a longitudinal follow-up study at the third and fifth years. Elder mistreatment was measured using instrument derived from the previous literature and modified Conflict Tactic Scales. Outcomes of elder mistreatment include mortality, physical function, mental health, quality of life and health utilisation. Logistic regression models are used to examine the relationship between risk factors and abuse estimates. Cox proportional hazard regression will be used to estimate risk of mortality associated with abuse. Associated annual rate of hospitalisation and health visit frequency, and reporting of abuse, will be estimated using Poisson regression. Ethics and dissemination The study has been approved by the Medical Ethics Committee of the University of Malaya Medical Center (MEC Ref 902.2) and the Malaysian National Medical Research Register (NMRR-12-1444-11726). Written consent was obtained from all respondents prior to baseline assessment and subsequent follow-up. Findings will be disseminated to local stakeholders via forums with community leaders, and health and social welfare departments, and published in appropriate scientific journals and presented at conferences. PMID:27225651

Electrical stimulation-evoked contractions blunt orthostatic hypotension in sub-acute spinal cord-injured individuals: two clinical case studies.

PubMed

Hamzaid, N A; Tean, L T; Davis, G M; Suhaimi, A; Hasnan, N

2015-05-01

Prospective study of two cases. To describe the effects of electrical stimulation (ES) therapy in the 4-week management of two sub-acute spinal cord-injured (SCI) individuals (C7 American Spinal Injury Association Impairment Scale (AIS) B and T9 AIS (B)). University Malaya Medical Centre, Kuala Lumpur, Malaysia. A diagnostic tilt-table test was conducted to confirm the presence of orthostatic hypotension (OH) based on the current clinical definitions. Following initial assessment, subjects underwent 4 weeks of ES therapy 4 times weekly for 1 h per day. Post-tests tilt table challenge, both with and without ES on their rectus abdominis, quadriceps, hamstrings and gastrocnemius muscles, was conducted at the end of the study (week 5). Subjects' blood pressures (BP) and heart rates (HR) were recorded every minute during pre-test and post-tests. Orthostatic symptoms, as well as the maximum tolerance time that the subjects could withstand head up tilt at 60°, were recorded. Subject A improved his orthostatic symptoms, but did not recover from clinically defined OH based on the 20-min duration requirement. With concurrent ES therapy, 60° head up tilt BP was 89/62 mm Hg compared with baseline BP of 115/71 mm Hg. Subject B fully recovered from OH demonstrated by BP of 105/71 mm Hg during the 60° head up tilt compared with baseline BP of 124/77 mm Hg. Both patients demonstrated longer tolerance time during head up tilt with concomitant ES (subject A: pre-test 4 min, post-test without ES 6 min, post-test with ES 12 min; subject B: pre-test 4 min, post-test without ES 28 min, post-test with ES 60 min). Weekly ES therapy had positive effect on OH management in sub-acute SCI individuals.

Time trends in upper gastrointestinal diseases and Helicobacter pylori infection in a multiracial Asian population--a 20-year experience over three time periods.

PubMed

Leow, A H-R; Lim, Y-Y; Liew, W-C; Goh, K-L

2016-04-01

Marked epidemiological changes in upper gastrointestinal diseases and Helicobacter pylori infection have taken place in the Asian Pacific region. In particular, differences with respect to race in the multiracial Asian population in Malaysia have been important and interesting. A time trend study of upper gastrointestinal disease and H. pylori infection in three time periods: 1989-1990, 1999-2000 and 2009-2010 spanning a period of 20 years was carried out. Consecutive first time gastroscopies carried out on patients attending the University of Malaya Medical Center were studied. Diagnoses and H. pylori infection status were carefully recorded. A steady decline in prevalence of duodenal ulcer (DU) and gastric ulcer (GU) from 21.1% to 9.5% to 5.0% and from 11.9% to 9.4% to 9.9% while an increase in erosive oesophagitis (EO) from 2.0% to 8.4% to 9.5% (chi-square for trend; P < 0.001) for the periods 1989-1990, 1999-200 and 2009-2010 were observed. The overall prevalence of H. pylori had also decreased from 51.7% to 30.3% to 11.1% for the same periods of time. The proportion of H. pylori positive ulcers had also decreased: DU (90.1%-69.8%-28.9%) and GU (86.6-56.8%-18.9%) (P < 0.001). This was observed in Malays, Chinese and Indians but the difference over time was most marked in Malays. There was a steady decline in the proportion of patients with gastric and oesophageal cancers. Peptic ulcers have declined significantly over a 20-year period together with a decline in H. pylori infection. In contrast, a steady increase in erosive oesophagitis was observed. Gastric and oesophageal squamous cell cancers have declined to low levels. © 2016 John Wiley & Sons Ltd.

Non-alcoholic fatty liver disease in diabetics--prevalence and predictive factors in a multiracial hospital clinic population in Malaysia.

PubMed

Chan, Wah-Kheong; Tan, Alexander Tong-Boon; Vethakkan, Shireene Ratna; Tah, Pei-Chien; Vijayananthan, Anushya; Goh, Khean-Lee

2013-08-01

There is currently no published study comparing prevalence of non-alcoholic fatty liver disease (NAFLD) and associated factors among diabetics of different ethnicity in the Asia-Pacific region. Cross-sectional study of consecutive patients in the Diabetic Clinic in University of Malaya Medical Centre. The Global Physical Activity Questionnaire and a semiquantitative food-frequency questionnaire were used to assess physical activity and dietary intake, respectively. Diagnosis of NAFLD was ultrasound-based and following exclusion of significant alcohol intake. Data for 399 patients were analyzed (mean age 62.3 ± 10.5 years, 43.1% men). The racial distribution was Chinese 43.6%, Indian 33.1%, Malay 22.3%, and others 1.0%. The prevalence of NAFLD was 49.6%. On univariate analysis, factors associated with NAFLD were age < 65 years, race, obesity, central obesity, glycated hemoglobin ≥ 7.0%, and elevated serum alanine aminotransferase (ALT) and gamma-glutamyl transpeptidase levels. Patients with low physical activity were more likely to have NAFLD (odds ratio [OR] = 1.67, 95% confidence interval [CI] = 1.06-2.63, P = 0.020). The prevalence of NAFLD was highest among Malays (60.7%), followed by Indians (51.5%), and lowest among Chinese (42.0%) consistent with higher prevalence of central obesity and higher percentage calorie intake from fat in the former groups of patients. On multivariate analysis, independent factors associated with NAFLD were central obesity (OR = 2.20, 95% CI = 1.29-3.75, P = 0.004) and elevated serum ALT level (OR = 1.98, 95% CI = 1.21-3.25, P = 0.007). NAFLD was seen in half of a cohort of diabetic patients and was independently associated with central obesity and elevated serum ALT level. Prevalence of NAFLD was different and paralleled the difference in prevalence of central obesity and in percentage calorie intake from fat among the different ethnic groups. © 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

Trend and impact of international collaboration in clinical medicine papers published in Malaysia.

PubMed

Low, Wah Yun; Ng, Kwan Hoong; Kabir, M A; Koh, Ai Peng; Sinnasamy, Janaki

2014-01-01

Research collaboration is the way forward in order to improve quality and impact of its research findings. International research collaboration has resulted in international co-authorship in scientific communications and publications. This study highlights the collaborating research and authorship trend in clinical medicine in Malaysia from 2001 to 2010. Malaysian-based author affiliation in the Web of Science (Science Citation Index Expanded) and clinical medicine journals ( n  = 999) and articles ( n  = 3951) as of 30th Oct 2011 were downloaded. Types of document analyzed were articles and reviews, and impact factors (IF) in the 2010 Journal Citation Report Science Edition were taken to access the quality of the articles. The number of publications in clinical medicine increased from 4.5 % ( n  = 178) in 2001 to 23.9 % ( n  = 944) in 2010. The top three contributors in the subject categories are Pharmacology and Pharmacy (13.9 %), General and Internal Medicine (13.6 %) and Tropical Medicine (7.3 %). By journal tier system: Tier 1 (18.7 %, n  = 738), Tier 2 (22.5 %, n  = 888), Tier 3 (29.6 %, n  = 1170), Tier 4 (27.2 %, n  = 1074), and journals without IF (2.1 %, n  = 81). University of Malaya was the most productive. Local collaborators accounted for 60.3 % and international collaborations 39.7 %. Articles with international collaborations appeared in journals with higher journal IFs than those without international collaboration. They were also cited more significantly than articles without international collaborations. Citations, impact factor and journal tiers were significantly associated with international collaboration in Malaysia's clinical medicine publications. Malaysia has achieved a significant number of ISI publications in clinical medicine participation in international collaboration.

Sedimentation in the Lena river delta and adjacent part of the Laptev Sea

NASA Astrophysics Data System (ADS)

Charkin, A.; Dudarev, O.; Semiletov, I.; Vonk, J.; Sanchez-Garcia, L.; Gustafsson, Ö.; Andersson, P.; Shakhova, N.

2009-04-01

Any attempt to understand the effects of the Arctic Ocean on global change or the effect of global change on the Arctic Ocean requires a thorough understanding of coastal processes. The major transport of freshwater, dissolved and solid materials into the Arctic ocean is determined by riverine discharge and coastal erosion from Eurasia . The Lena River drains almost 3 mill. km2 of the vast Siberian hinterland (which is now under strong warming impact), and discharge up to 720 km3 per year, making it the second largest river draining into the Arctic Ocean. Thus, it is extremely important to perform a base-line study in the key area of the near-shore Arctic ocean which integrates Lena River discharge, which is a product o permafrost degradation in the Lena watershed, and off-shore export of eroded material, which is mostly induced by retreatment of the coastal ice-complex. Since 1999, the Buor-Khaya Gulf was chosen for detailed investigation by Laboratory of the Arctic Research (LAR) of the Pacific Oceanological Institute as a key area which accepts both eroded carbon and solid discharge from the Bykovsky and Bol'shay/Malaya Trofimovsky channels of the Lena delta. The intention of this report is to present a first comprehensive interpretation of the modern depositional environment in the Lena river delta and Buor-Khaya Gulf considering all the geochemical data obtained both in the International Siberian Shelf Study2008 (ISSS-08) and 11 previous summertime and wintertime LAR expeditions (1999-2007), accomplished in cooperation with the International Arctic Research Center of the University Alaska Fairbanks. Set of samples was studied in cooperation with the Stockholm University and Swedish Museum of Natural History. Detailed transects and maps of the particulate material distribution, particulate organic carbon (POC) and nitrogen (PON) as well as CN stable isotopes in both suspended particles and underlying surface sediment, and its sizing are discussed in connection with changing hydrometeorological conditions with a special emphasis on the area surrounding Muostakh Island, which exhibits rates of coastal erosion up to 15-20 m during couple summertime weeks.

Nutritional Status of Breast Cancer Survivors 1 Year after Diagnosis: A Preliminary Analysis from the Malaysian Breast Cancer Survivorship Cohort Study.

PubMed

Majid, Hazreen Abd; Keow, Low Phei; Islam, Tania; Su, Tin Tin; Cantwell, Marie; Taib, Nur Aishah

2018-04-01

Lifestyle factors, such as diet, body weight, and physical activity, are linked to better survival after breast cancer (BC) diagnosis. A high percentage of the Malaysian population is overweight or obese. In addition, studies have shown a disparity in survival among Malaysian women compared with other higher-income countries. The Malaysian Breast Cancer Survivorship Cohort (MyBCC) study aims to study lifestyle factors that affect survival in BC survivors. These are the preliminary findings on the nutritional status of Malaysian BC survivors. Our aim was to evaluate the nutritional status of BC survivors at 1 year after diagnosis. This was a cross-sectional study of 194 participants from the MyBCC study, recruited within 1 year of their diagnosis. Participants completed a 3-day food diary. Malaysian women (aged 18 years and older) who were newly diagnosed with primary BC, managed at the University Malaya Medical Center, and able to converse either in Malay, English, or Mandarin were included. Dietary intake and prevalence of overweight or obesity among participants 1 year after diagnosis were measured. Student's t test and analysis of variance or its equivalent nonparametric test were used for association in continuous variables. About 66% (n=129) of participants were overweight or obese and >45% (n=86) had high body fat percentage 1 year after diagnosis. The participants' diets were low in fiber (median=8.7 g/day; interquartile range=7.2 g/day) and calcium (median=458 mg/day; interquartile range=252 mg/day). Ethnicity and educational attainment contributed to the differences in dietary intake among participants. Higher saturated fat and lower fiber intake were observed among Malay participants compared with other ethnic groups. Overweight and obesity were highly prevalent among BC survivors and suboptimal dietary intake was observed. Provision of an individualized medical nutrition therapy by a qualified dietitian is crucial as part of comprehensive BC survivorship care. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Study on incidence of needle stick injury and factors associated with this problem among medical students.

PubMed

Norsayani, Mohamad Yaakob; Noor Hassim, Ismail

2003-05-01

Medical students face the threat of needle stick injury with the consequent risk of acquiring blood-borne infection by pathogens such as HIV, Hepatitis B and Hepatitis C while performing their clinical activities in the hospitals. A cross-sectional study was conducted among 417 final year medical students from Universiti Kebangsaan Malaysia (UKM), University Malaya (UM) and Universiti Putra Malaysia (UPM). The aims of the study were to determine the incidence of cases and episodes of needle stick injury among them in the past year. This study was also done to find out the factors that might be associated with the occurrence of this problem. The factors were sociodemographic factors, duration of exposure, level of knowledge of blood-borne diseases and Universal Precaution, perception of risk of blood-borne diseases and level of practice of Universal Precaution. The incidence of needle stick injury among medical students was 14.1% (59 cases). The total number of episodes of needle stick injury was 87 and the incidence of episodes among respondents was high i.e. 20.9%. The highest incidence of episodes of needle stick injury occurred in Obstetric & Gynaecology postings, followed by Medicine and Surgery. For clinical procedures, venepuncture had the highest incidence followed by setting up drips and giving parenteral injections. The results showed the students who had needle stick injury (cases) had lower scores in the practice of Universal Precautions than non-cases (p<0.05). There was a significant association between the level of practice of Universal Precautions and the number of episodes of needle stick injury, i.e. the higher the score for the practice of Universal Precautions, the lower the number of episodes (beta=-2.03 x 10(-2), p<0.05). This study showed that medical students are at risk of needle stick injury and blood-borne infections during their clinical activities while performing procedures on patients especially for those who were poor at practising Universal Precautions. Therefore some preventive measures should be taken by the management of the universities and medical students to avoid the occurrence of these problems.

Source profiling of arsenic and heavy metals in the Selangor River basin and their maternal and cord blood levels in Selangor State, Malaysia.

PubMed

Sakai, Nobumitsu; Alsaad, Zohour; Thuong, Nguyen Thi; Shiota, Kenji; Yoneda, Minoru; Ali Mohd, Mustafa

2017-10-01

Arsenic and 5 heavy metals (nickel, copper, zinc, cadmium and lead) were quantitated in surface water (n = 18) and soil/ore samples (n = 45) collected from 5 land uses (oil palm converted from forest, oil palm in peat swamp, bare land, quarry and forest) in the Selangor River basin by inductively coupled plasma mass spectrometry (ICP-MS). Geographic information system (GIS) was used as a spatial analytical tool to classify 4 land uses (forest, agriculture/peat, urban and bare land) from a satellite image taken by Landsat 8. Source profiling of the 6 elements was conducted to identify their occurrence, their distribution and the pollution source associated with the land use. The concentrations of arsenic, cadmium and lead were also analyzed in maternal blood (n = 99) and cord blood (n = 87) specimens from 136 pregnant women collected at the University of Malaya Medical Center for elucidating maternal exposure as well as maternal-to-fetal transfer. The source profiling identified that nickel and zinc were discharged from sewage and/or industrial effluents, and that lead was discharged from mining sites. Arsenic showed a site-specific pollution in tin-tungsten deposit areas, and the pollution source could be associated with arsenopyrite. The maternal blood levels of arsenic (0.82 ± 0.61 μg/dL), cadmium (0.15 ± 0.2 μg/dL) and lead (2.6 ± 2.1 μg/dL) were not significantly high compared to their acute toxicity levels, but could have attributable risks of chronic toxicity. Those in cord blood were significantly decreased in cadmium (0.06 ± 0.07 μg/dL) and lead (0.99 ± 1.2 μg/dL) but were equivalent in arsenic (0.82 ± 1.1 μg/dL) because of the different kinetics of maternal-to-fetal transfer. Copyright © 2017 Elsevier Ltd. All rights reserved.

Phyllodes tumours of the breast: retrospective analysis of a University Hospital's experience.

PubMed

Toh, Y F; Cheah, P L; Looi, L M; Teoh, K H; Tan, P H

2016-04-01

Taking cognizance of the purported variation of phyllodes tumours in Asians compared with Western populations, this study looked at phyllodes tumours of the breast diagnosed at the Department of Pathology, University of Malaya Medical Centre over an 8-year period with regards to patient profiles, tumour parameters, treatment offered and outcome. Sixty-four new cases of phyllodes tumour were diagnosed during the period, however only 30 (21 benign, 4 borderline and 5 malignant) finally qualified for entry into the study. These were followed-up for 4-102 months (average = 41.7 months). Thirteen cases (8 benign, 3 borderline, 2 malignant) were Chinese, 9 (all benign) Malay, 7 (4 benign, 1 borderline, 2 malignant) Indian and 1 (malignant) Indonesian. Prevalence of benign versus combined borderline and malignant phyllodes showed a marginally significant difference (p=0.049) between the Malays and Chinese. Patients' ages ranged from 21-70 years with a mean of 44.9 years with no significant difference in age between benign, borderline or malignant phyllodes tumours. Except for benign phyllodes tumours (mean size = 5.8 cm) being significantly smaller at presentation compared with borderline (mean size = 12.5 cm) and malignant (mean size = 15.8 cm) (p<0.05) tumours, history of previous pregnancy, breast feeding, hormonal contraception and tumour laterality did not differ between the three categories. Family history of breast cancer was noted in 2 cases of benign phyllodes. Local excision was performed in 17 benign, 2 borderline and 3 malignant tumours and mastectomy in 4 benign, 2 borderline and 2 malignant tumours. Surgical clearance was not properly recorded in 10 benign phyllodes tumours. Six benign and all 4 borderline and 5 malignant tumours had clearances of <10 mm. Two benign tumours recurred locally at 15 and 49 months after local excision, however information regarding surgical clearance was not available in both cases. One patient with a malignant tumour developed a radiologically-diagnosed lung nodule 26 months after mastectomy, was given a course of radiotherapy and remained well 8-months following identification of the lung nodule.

Impact of Time Since Last Childbirth on Survival of Women with Premenopausal and Postmenopausal Breast Cancers.

PubMed

Balakrishnan, Nanthini; Teo, Soo-Hwang; Sinnadurai, Siamala; Bhoo Pathy, Nanthini Thevi; See, Mee-Hoong; Taib, Nur Aishah; Yip, Cheng-Har; Bhoo Pathy, Nirmala

2017-11-01

Reproductive factors are associated with risk of breast cancer, but the association with breast cancer survival is less well known. Previous studies have reported conflicting results on the association between time since last childbirth and breast cancer survival. We determined the association between time since last childbirth (LCB) and survival of women with premenopausal and postmenopausal breast cancers in Malaysia. A historical cohort of 986 premenopausal, and 1123 postmenopausal, parous breast cancer patients diagnosed from 2001 to 2012 in University Malaya Medical Centre were included in the analyses. Time since LCB was categorized into quintiles. Multivariable Cox regression was used to determine whether time since LCB was associated with survival following breast cancer, adjusting for demographic, tumor, and treatment characteristics. Premenopausal breast cancer patients with the most recent childbirth (LCB quintile 1) were younger, more likely to present with unfavorable prognostic profiles and had the lowest 5-year overall survival (OS) (66.9; 95% CI 60.2-73.6%), compared to women with longer duration since LCB (quintile 2 thru 5). In univariable analysis, time since LCB was inversely associated with risk of mortality and the hazard ratio for LCB quintile 2, 3, 4, and 5 versus quintile 1 were 0.53 (95% CI 0.36-0.77), 0.49 (95% CI 0.33-0.75), 0.61 (95% CI 0.43-0.85), and 0.64 (95% CI 0.44-0.93), respectively; P trend  = 0.016. However, this association was attenuated substantially following adjustment for age at diagnosis and other prognostic factors. Similarly, postmenopausal breast cancer patients with the most recent childbirth were also more likely to present with unfavorable disease profiles. Compared to postmenopausal breast cancer patients in LCB quintile 1, patients in quintile 5 had a higher risk of mortality. This association was not significant following multivariable adjustment. Time since LCB is not independently associated with survival in premenopausal or postmenopausal breast cancers. The apparent increase in risks of mortality in premenopausal breast cancer patients with a recent childbirth, and postmenopausal patients with longer duration since LCB, appear to be largely explained by their age at diagnosis.

Elder mistreatment in a community dwelling population: the Malaysian Elder Mistreatment Project (MAESTRO) cohort study protocol.

PubMed

Choo, Wan Yuen; Hairi, Noran Naqiah; Sooryanarayana, Rajini; Yunus, Raudah Mohd; Hairi, Farizah Mohd; Ismail, Norliana; Kandiben, Shathanapriya; Mohd Ali, Zainudin; Ahmad, Sharifah Nor; Abdul Razak, Inayah; Othman, Sajaratulnisah; Tan, Maw Pin; Mydin, Fadzilah Hanum Mohd; Peramalah, Devi; Brownell, Patricia; Bulgiba, Awang

2016-05-25

Despite being now recognised as a global health concern, there is still an inadequate amount of research into elder mistreatment, especially in low and middle-income regions. The purpose of this paper is to report on the design and methodology of a population-based cohort study on elder mistreatment among the older Malaysian population. The study aims at gathering data and evidence to estimate the prevalence and incidence of elder mistreatment, identify its individual, familial and social determinants, and quantify its health consequences. This is a community-based prospective cohort study using randomly selected households from the national census. A multistage sampling method was employed to obtain a total of 2496 older adults living in the rural Kuala Pilah district. The study is divided into two phases: cross-sectional study (baseline), and a longitudinal follow-up study at the third and fifth years. Elder mistreatment was measured using instrument derived from the previous literature and modified Conflict Tactic Scales. Outcomes of elder mistreatment include mortality, physical function, mental health, quality of life and health utilisation. Logistic regression models are used to examine the relationship between risk factors and abuse estimates. Cox proportional hazard regression will be used to estimate risk of mortality associated with abuse. Associated annual rate of hospitalisation and health visit frequency, and reporting of abuse, will be estimated using Poisson regression. The study has been approved by the Medical Ethics Committee of the University of Malaya Medical Center (MEC Ref 902.2) and the Malaysian National Medical Research Register (NMRR-12-1444-11726). Written consent was obtained from all respondents prior to baseline assessment and subsequent follow-up. Findings will be disseminated to local stakeholders via forums with community leaders, and health and social welfare departments, and published in appropriate scientific journals and presented at conferences. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Generic atorvastatin is as effective as the brand-name drug (LIPITOR®) in lowering cholesterol levels: a cross-sectional retrospective cohort study.

PubMed

Loch, Alexander; Bewersdorf, Jan Philipp; Kofink, Daniel; Ismail, Dzafir; Abidin, Imran Zainal; Veriah, Ramesh Singh

2017-07-17

In a world of ever increasing health care costs, generic drugs represent a major opportunity to ensure access to essential medicines for people who otherwise would be unable to afford them. However, some clinicians and patients are still questioning the safety and effectiveness of generic formulations compared to the proprietary drugs necessitating further systematic research analyzing the generic drugs' efficacy. Our objective was to compare the lipid lowering effects of generic and branded atorvastatin. This cross-sectional, retrospective cohort study was conducted at the University of Malaya Medical Centre from 1 May 2013 until 30 May 2013. We analyzed the lipid profiles (total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides) of 629 patients before and at least 3 months after switching them from proprietary atorvastatin (Lipitor ® ) to generic atorvastatin (atorvastatin calcium from Ranbaxy Laboratories, Inc.). We also investigated if there was any difference in the effectiveness of both atorvastatin formulations in various ethnic groups. 266 patients were included in this study. When comparing the median values we found no statistically significant differences (Wilcoxon signed-rank test; p < 0.05) between proprietary and generic atorvastatin in lowering total cholesterol (4.60 mmol/l pre-transition vs. 4.50 mmol/l post-transition; p = 0.583), LDL-cholesterol (2.42 mmol/l vs. 2.41 mmol/l; p = 0.923) and triglycerides (1.50 mmol/l vs. 1.50 mmol/l; p = 0.513). While there was a statistically significant (p = 0.009) difference in HDL-cholesterol levels favouring proprietary atorvastatin, the extent of this change (1.26 mmol/l vs. 1.25 mmol/l) was deemed not to be clinically relevant. There was no statistically significant difference when analyzing the effects on various ethnic groups. Substituting proprietary atorvastatin for its generic formulation atorvastatin calcium does not result in a less effective management of hyperlipidemia. Our findings lend support to the approach of lowering health care costs by switching patients from branded drugs to their less expensive generic analogues.

Short-term clinical outcome of orthosis alone vs combination of orthosis, nerve, and tendon gliding exercises and ultrasound therapy for treatment of carpal tunnel syndrome.

PubMed

Sim, Sze En; Gunasagaran, Jayaletchumi; Goh, Khean-Jin; Ahmad, Tunku Sara

2018-02-07

Prospective randomized study. Carpal tunnel syndrome (CTS) has been described as the most common compression neuropathy. Many modalities exist for conservative treatment. Efficacy of each modality has been described in the literature. However, the effectiveness of combination of these modalities is not well established. The purpose of this study is to assess the short-term clinical outcome of conservative treatment for CTS comparing orthosis alone with combination of orthosis, nerve/tendon gliding exercises, and ultrasound therapy. Forty-one patients who presented to Upper Limb Reconstructive and Microsurgery Clinic, University Malaya Medical Centre with CTS and positive electrodiagnostic study were recruited. Fifteen patients had bilateral CTS. Fifty-six wrists were equally randomized to orthosis alone and a combined therapy of orthosis, nerve/tendon gliding exercise, and ultrasound therapy. All patients were required to complete the Boston Carpal Tunnel Questionnaire during the first visit and 2 months after treatment. Both the orthosis and combined therapy groups showed a significant improvement in symptoms and function after treatment. The mean difference of symptoms in the orthosis group was 0.53; 95% confidence interval [CI]: 0.23-0.83 (P = .001) and in the combined therapy group was 0.48; 95% CI: 0.24-0.72 (P < .001). Mean difference of function in the orthosis group was 0.59; 95% CI: 0.28-0.91 (P = .001) and combined group was 0.69; 95% CI: 0.49-0.89 (P < .001). However, there was no significant difference in symptom severity and functional status scores between the groups. Our findings support other findings where orthosis and exercises improved symptom severity and functional status scores, however, there was no significant difference between orthosis alone and combined treatment. Patients who underwent conservative management for CTS showed improvement in symptoms and function. However, the combination of orthosis, nerve/tendon gliding exercises, and ultrasound therapy did not offer additional benefit compared to orthosis alone. Copyright © 2018 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Prevalence of serum celiac antibodies in a multiracial Asian population--a first study in the young Asian adult population of Malaysia.

PubMed

Yap, Theresa Wan-Chen; Chan, Weng-Kai; Leow, Alex Hwong-Ruey; Azmi, Ahmad Najib; Loke, Mun-Fai; Vadivelu, Jamuna; Goh, Khean-Lee

2015-01-01

Celiac disease (CD) is an immune-mediated disorder induced by the ingestion of gluten in genetically susceptible persons. The prevalence of CD in Malaysia is unknown. We aim to determine the seroprevalence of CD antibodies and also investigate the correlation between H. pylori infection and CD in the young and healthy multiracial Malaysian population. Healthy young adult volunteers between the ages of 18-30 years were consecutively recruited from June 2012 to May 2014 at the University of Malaya Medical Centre (UMMC), Kuala Lumpur. Serum samples from all the participants were tested for anti-gliadin antibody immunoglobulin A/immunoglobulin G (IgA/IgG) and anti-tissue transglutaminase antibody (tTG) IgA/IgG. Samples positive for both anti-gliadin and anti-tTG were further validated for anti-human endomysial IgA antibodies (EmA). Serological diagnosis of CD was made when anti-gliadin, anti-tTG and anti-EmA were positive. 562 qualified participants with mean age 24 ± 2.4 years old were recruited into our study. CD was found in 7 participants where most of them were asymptomatic and unaware of their CD status. The median of anti-gliadin and anti-tTG IgA/IgG value was 38.2 U/ml (interquartile range, 28.3-60.4 U/ml) and 49.2 U/ml (interquartile range, 41.1-65.9 U/ml), respectively. Seroprevalence of CD antibodies was 1.9% (6 out of 324) in female while only 0.4% (1 out of 238) in male. Seroprevalence among Malay was 0.8% (2 of 236), Chinese was 1.7% (3 of 177) and Indian was 1.3% (2 of 149). Overall, seroprevalence of CD antibodies in healthy asymptomatic adults in the Malaysian population was 1.25% (95% CI, 0.78%-1.72%). No significant relationship was discovered between CD and H. pylori infection. The seroprevalence of CD antibodies in healthy young adults in the Malaysian population was 1.25% (1 in 100). CD is underdiagnosed and it could be a much greater problem in Malaysia than previously thought.

Complementary and alternative medicine use amongst Malaysian orthopaedic oncology patients.

PubMed

Dhanoa, Amreeta; Yong, Tze Lek; Yeap, Stephanie Jin Leng; Lee, Isaac Shi Zhung; Singh, Vivek Ajit

2014-10-17

Although studies have shown that a large proportion of cancer patients use CAM, no study on CAM use amongst orthopaedic oncology patients has been published. Therefore, this study aims to determine the prevalence, characteristics and factors associated with CAM use amongst orthopaedic oncology patients. All consecutive consenting patients/parents who presented at the Orthopaedic Oncology Clinic, University Malaya Medical Centre (1st January to 31st December 2013) were interviewed using a structured questionnaire. Overall, one hundred sixty-eight of the 274 patients recruited (61.3%) had used CAM at some time during their current illness. The prevalence of CAM used was 68% (123/181) for patients with malignant tumours and 48.4% (45/93) for patients with benign tumours. The most popular CAMs were biological-based therapies (90.5%), followed by mind-body techniques (40.5%). The most frequently used biological therapies were mega/multivitamins (31%), snakehead (Chana striatus) (28%) and sea cucumber (Stichopus horrens) (18%); whereas prayers (31%) and holy water (13%) dominated the mind-body category. Common reasons for CAM use were to improve physical well-being (60.1%), try out everything that would help (59.5%) and to enhance wound-healing (39.3%). Independent predictors for CAM use in multivariate analysis were paediatric patients [OR 2.46; 95% CI 0.99-6.06; p = 0.05], malignant tumours [OR 1.90; 95% CI 1.12-3.25; p = 0.018] and patients who underwent surgery [OR 2.06; 95% CI 1.15-3.69; p = 0.015]. Majority patients started taking CAMs following suggestions from family members (53%) and friends (49%). Sixty-six percent of patients felt they actually benefitted from CAM and 83.3% were satisfied/very satisfied. Only 5 patients reported side-effects. Majority of CAM users planned to continue CAM use or recommend it to others. However, only 31.5% of patients disclosed their CAM usage to their doctors. This survey revealed a high prevalence of CAM usage amongst orthopaedic oncology patients, with majority patients expressing satisfaction towards CAM. Oncologists should proactively ask patients about CAM to prevent potential adverse effects, as most patients do not share this information with them.

Link between the northward extension of Great Sumatra Fault and continental rifting in the Andaman Sea: new results from seismic reflection studies

NASA Astrophysics Data System (ADS)

Singh, S. C.; Moeremans, R. E.; McArdle, J.; Johansen, K.

2012-12-01

The Great Sumatra Fault (GSF) traverses the main land Sumatra from Sunda Strait in the southeast to Banda Aceh in the northwest for about 1900 km, and defines the present day plate boundary between the Sunda Plate in the north and Burmese Sliver Plate in the south. It is formed due to the oblique subduction of the Indo-Australian Plate beneath the Sunda Plate. It has been well studied on land but is poorly studied north of Banda Aceh in the Andaman Sea. Its study is further complicated by the presence of volcanic arc in its vicinity and its interaction with the West Andaman Fault (WAF) further north. Here we present deep seismic reflection images along the northward extension of the GSF over 700 km until it joins the Andaman Spreading Centre and interpret these images in the light of earthquake, gravity and bathymetry data. We find that the GSF has two strands between Banda Aceh and Nicobar Island: a transpression in the south and a deep narrow active rift basin in the north dotted with volcanoes in the center, suggesting that the volcanic arc is coincident with the rifting. Further north of Nicobar Island, an active strike-slip fault cuts through a deep rifted basin until its intersection with Andaman Sea Spreading Centre. The volcanic arc lies just east of the basin. The western margin of this basin seems to be a rifted continental margin, tilted westward flooring the Andaman-Nicobar forearc basin, which was once a part of Malaya Peninsula, suggesting that a significant parts of the Andaman-Nicobar forearc system is underlain by the Sunda continental crust. The Andaman-Nicobar forearc basin is bounded in the west by backthrusts, similar to the West Andaman and Mentawai faults bounding the Aceh and Mentawai forearc basins in the south. The cluster of seismicity after the 2004 great Andaman-Sumatra earthquake just north of Nicobar Island coincides with the intersection of two NW-SE and N-S trending strike-slip fault systems. Some of hypocentre of these earthquakes lie in the mantle down to 30 km depth, which along with the presence of volcanic arc just 15 km east of these faults, suggest that there is no generic link between the strike-slip fault and volcanic arc.

Technial Programme Committee

NASA Astrophysics Data System (ADS)

2014-06-01

Chairpersons Dr Dinesh Sathyamoorthy, Science & Technology Research Institute for Defence (STRIDE), Ministry of Defence, Malaysia Associate Professor Sr Dr Abdul Rashid Mohamed Shariff, Universiti Putra Malaysia (UPM), Malaysia Dr Ahmad Fikri Abdullah, Universiti Putra Malaysia (UPM), Malaysia Dr Farrah Melissa Muharram, Universiti Putra Malaysia (UPM), Malaysia Members Professor Dr Li Jing, Beijing Normal University, China Professor Dr Iyyanki Muralikrishna, Administrative Staff College of India (ASCI), India Professor Dr Alias Abdul Rahman, Universiti Teknologi Malaysia (UTM), Malaysia Professor Dr Ismat Mohamed El Hassan, King Saud University, Saudi Arabia Professor Dr George Miliaresis, Open University of Cyprus, Cyprus Professor Dr Christine Pohl, Universiti Teknologi Malaysia (UTM), Malaysia Professor Dr Mahender Kotha, Goa University, India Associate Professor Dr Paolo Gamba, University of Pavia, Italy Associate Professor Dr Behara Seshadri Daya Sagar, Indian Statistical Institute (ISI), India Associate Professor Sr Ranjit Singh, Infrastructure University Kuala Lumpur (IUKL), Malaysia Associate Professor Dr Abdul Nasir Matori, Universiti Teknologi Petronas (UTP), Malaysia Associate Dr Lucian Dragut, West University of Timişoara, Romania Associate Professor Dr Saied Pirasteh, Islamic Azad University, Iran Associate Professor Dr Peter Yuen, Cranfield University, United Kingdom Associate Professor Dr Lim Hwee San, Universiti Sains Malaysia (USM), Malaysia Associate Professor Dr Wayan Suparta, Universiti Kebangsaan Malaysia (UKM), Malaysia Associate Professor Dr Tuong Thuy Vu, The University of Nottingham Malaysia Campus, Malaysia Associate Professor Dr Maged Mahmoud Marghany, Universiti Teknologi Malaysia (UTM), Malaysia Associate Professor Dr Rami Al-Ruzouq, University of Sharjah, UAE Associate Professor Dr Biswajeet Pradhan, Universiti Putra Malaysia (UPM), Malaysia Associate Professor Dr Helmi Zulhaidi Mohd Shafri, Universiti Putra Malaysia (UPM), Malaysia Associate Professor Dr Benny Peter, Universiti Teknologi Malaysia (UTM), Malaysia Associate Professor Dr Norzailawati Mohd Nor, International Islamic University Malaysia (IIUM), Malaysia Dr Josée Lévesque, Defence Research and Development Canada (DRDC), Canada Dr Ali Ariapour, Islamic Azad University, Iran Dr Zulkiflee Abd Latif, Universiti Teknologi MARA (UiTM), Malaysia Dr Lim Tien Sze, Multimedia University (MMU), Malaysia Dr Ruzinoor Che Mat, Universiti Utara Malaysia (UUM), Malaysia Dr Eran Sadek Said Md Sadek, Universiti Teknologi MARA (UiTM), Malaysia Dr Siti Khairunniza Bejo, Universiti Putra Malaysia (UPM) Dr Ramin Nourqolipour, National Organization of Forest, Range and Watershed Manage Sr Mohktar Azizi Mohd Din, Universiti Malaya Col (Rt) Frederic Hernoust, Magelli Marzieh Mokarram, University of Isf Mohd Fadhil Abuhan, Royal Malaysian Police, Malaysia

Direct short-term effects of EBP teaching: change in knowledge, not in attitude; a cross-cultural comparison among students from European and Asian medical schools

PubMed Central

Widyahening, Indah S.; van der Heijden, Geert J.M.G.; Moy, Foong Ming; van der Graaf, Yolanda; Sastroasmoro, Sudigdo; Bulgiba, Awang

2012-01-01

Introduction We report about the direct short-term effects of a Clinical Epidemiology and Evidence-based Medicine (CE-EBM) module on the knowledge, attitude, and behavior of students in the University Medical Center Utrecht (UMCU), Universitas Indonesia (UI), and University of Malaya (UM). Methods We used an adapted version of a 26-item validated questionnaire, including four subscales: knowledge, attitude, behavior, and future use of evidence-based practice (EBP). The four components were compared among the students in the three medical schools before the module using one-way ANOVA. At the end of the module, we measured only knowledge and attitudes. We computed Cronbach's α to assess the reliability of the responses in our population. To assess the change in knowledge and attitudes, we used the paired t-test in the comparison of scores before and after the module. Results In total, 526 students (224 UI, 202 UM, and 100 UMCU) completed the questionnaires. In the three medical schools, Cronbach's α for the pre-module total score and the four subscale scores always exceeded 0.62. UMCU students achieved the highest pre-module scores in all subscales compared to UI and UM with the comparison of average (SD) score as the following: knowledge 5.04 (0.4) vs. 4.73 (0.69) and 4.24 (0.74), p<0.001; attitude 4.52 (0.64) vs. 3.85 (0.68) and 3.55 (0.63), p<0.001; behavior 2.62 (0.55) vs. 2.35 (0.71) and 2.39 (0.92), p=0.016; and future use of EBP 4.32 (0.59) vs. 4.08 (0.62) and 3.7 (0.71), p<0.01. The CE-EBM module increased the knowledge of the UMCU (from average 5.04±0.4 to 5.35±0.51; p<0.001) and UM students (from average 4.24±0.74 to 4.53±0.72; p<0.001) but not UI. The post-module scores for attitude did not change in the three medical schools. Conclusion EBP teaching had direct short-term effects on knowledge, not on attitude. Differences in pre-module scores are most likely related to differences in the system and infrastructure of both medical schools and their curriculum. PMID:23121993

Direct short-term effects of EBP teaching: change in knowledge, not in attitude; a cross-cultural comparison among students from European and Asian medical schools.

PubMed

Widyahening, Indah S; van der Heijden, Geert J M G; Moy, Foong Ming; van der Graaf, Yolanda; Sastroasmoro, Sudigdo; Bulgiba, Awang

2012-10-31

We report about the direct short-term effects of a Clinical Epidemiology and Evidence-based Medicine (CE-EBM) module on the knowledge, attitude, and behavior of students in the University Medical Center Utrecht (UMCU), Universitas Indonesia (UI), and University of Malaya (UM). We used an adapted version of a 26-item validated questionnaire, including four subscales: knowledge, attitude, behavior, and future use of evidence-based practice (EBP). The four components were compared among the students in the three medical schools before the module using one-way ANOVA. At the end of the module, we measured only knowledge and attitudes. We computed Cronbach's α to assess the reliability of the responses in our population. To assess the change in knowledge and attitudes, we used the paired t-test in the comparison of scores before and after the module. In total, 526 students (224 UI, 202 UM, and 100 UMCU) completed the questionnaires. In the three medical schools, Cronbach's α for the pre-module total score and the four subscale scores always exceeded 0.62. UMCU students achieved the highest pre-module scores in all subscales compared to UI and UM with the comparison of average (SD) score as the following: knowledge 5.04 (0.4) vs. 4.73 (0.69) and 4.24 (0.74), p<0.001; attitude 4.52 (0.64) vs. 3.85 (0.68) and 3.55 (0.63), p<0.001; behavior 2.62 (0.55) vs. 2.35 (0.71) and 2.39 (0.92), p=0.016; and future use of EBP 4.32 (0.59) vs. 4.08 (0.62) and 3.7 (0.71), p<0.01. The CE-EBM module increased the knowledge of the UMCU (from average 5.04±0.4 to 5.35±0.51; p<0.001) and UM students (from average 4.24±0.74 to 4.53±0.72; p<0.001) but not UI. The post-module scores for attitude did not change in the three medical schools. EBP teaching had direct short-term effects on knowledge, not on attitude. Differences in pre-module scores are most likely related to differences in the system and infrastructure of both medical schools and their curriculum.

Prevalence of Serum Celiac Antibodies in a Multiracial Asian Population-A First Study in the Young Asian Adult Population of Malaysia

PubMed Central

Yap, Theresa Wan-Chen; Chan, Weng-Kai; Leow, Alex Hwong-Ruey; Azmi, Ahmad Najib; Loke, Mun-Fai; Vadivelu, Jamuna; Goh, Khean-Lee

2015-01-01

Background Celiac disease (CD) is an immune-mediated disorder induced by the ingestion of gluten in genetically susceptible persons. The prevalence of CD in Malaysia is unknown. We aim to determine the seroprevalence of CD antibodies and also investigate the correlation between H. pylori infection and CD in the young and healthy multiracial Malaysian population. Methods Healthy young adult volunteers between the ages of 18–30 years were consecutively recruited from June 2012 to May 2014 at the University of Malaya Medical Centre (UMMC), Kuala Lumpur. Serum samples from all the participants were tested for anti-gliadin antibody immunoglobulin A/immunoglobulin G (IgA/IgG) and anti-tissue transglutaminase antibody (tTG) IgA/IgG. Samples positive for both anti-gliadin and anti-tTG were further validated for anti-human endomysial IgA antibodies (EmA). Serological diagnosis of CD was made when anti-gliadin, anti-tTG and anti-EmA were positive. Results 562 qualified participants with mean age 24 ± 2.4 years old were recruited into our study. CD was found in 7 participants where most of them were asymptomatic and unaware of their CD status. The median of anti-gliadin and anti-tTG IgA/IgG value was 38.2 U/ml (interquartile range, 28.3–60.4 U/ml) and 49.2 U/ml (interquartile range, 41.1–65.9 U/ml), respectively. Seroprevalence of CD antibodies was 1.9% (6 out of 324) in female while only 0.4% (1 out of 238) in male. Seroprevalence among Malay was 0.8% (2 of 236), Chinese was 1.7% (3 of 177) and Indian was 1.3% (2 of 149). Overall, seroprevalence of CD antibodies in healthy asymptomatic adults in the Malaysian population was 1.25% (95% CI, 0.78%-1.72%). No significant relationship was discovered between CD and H. pylori infection. Conclusions The seroprevalence of CD antibodies in healthy young adults in the Malaysian population was 1.25% (1 in 100). CD is underdiagnosed and it could be a much greater problem in Malaysia than previously thought. PMID:25799401

Beyond Critical Congenital Heart Disease: Newborn Screening Using Pulse Oximetry for Neonatal Sepsis and Respiratory Diseases in a Middle-Income Country.

PubMed

Jawin, Vida; Ang, Hak-Lee; Omar, Asma; Thong, Meow-Keong

2015-01-01

Studies on pulse oximetry screening for neonatal sepsis and respiratory disease in a middle-income country are lacking. Newborn screening for critical congenital heart disease (CCHD) using pulse oximetry is an effective and life-saving strategy in developed countries. While most studies have reported false-positive results during CCHD screening, they have not elaborated on the detected disease types. We studied the effectiveness and outcomes of pulse oximetry newborn screening for non-cardiac hypoxemic diseases such as neonatal sepsis, respiratory diseases, and CCHD in a middle-income country. In a pilot study performed at the University Malaya Medical Centre (UMMC), Malaysia, all apparently healthy term newborns, delivered at UMMC were screened pre-discharge using pulse oximetry. Echocardiography was performed for newborns that had positive screening results on two separate occasions, 1-h apart. Newborns with normal echocardiograms were evaluated and treated for other non-cardiac diseases. Fifteen of 5247 term newborns had positive screening results. The median age at screening was 20 h. Thirteen newborns (0.24%) had significant non-cardiac diseases: sepsis (n = 2) and respiratory diseases (n = 11) that required hospitalization and treatment. The remaining two newborns with normal antenatal ultrasonograms had positive screening test and confirmed to have CCHD. Another 18 newborns with negative screening test were later admitted for treatment of sepsis (n = 16) and penumonia (n = 2). All newborns were treated and alive at the end of the study. The sensitivity and specificity of pulse oximetry screening for non-cardiac diseases were 42% and 99.9% respectively, and 100% and 99.7% for CCHD, respectively. Routine pulse oximetry screening test was effective in identifying newborns with CCHD and other hypoxemia illnesses, which may led to potential life-threatening condition. This study showed that the expanded use of pulse oximetry has immediate implications for low- and middle-income countries contemplating strategies to reduce neonatal mortality and morbidity. ASD, atrial septal defect; CCHD, critical congenital heart disease; CRP, C-reactive protein; CXR, chest radiographs; NDI, neurodevelopment impairment; PPHN, persistent pulmonary hypertension of the newborn; PDA, patent ductus arteriosus; PFO, patent foramen ovale; TGA, transposition of great artery; TTN, transient tachypnoea of the newborn; VSD, ventricular septal defect.

Interdisciplinary and inter-institutional differences in learning preferences among Malaysian medical and health sciences students.

PubMed

Wong, Rebecca S Y; Siow, Heng Loke; Kumarasamy, Vinoth; Shaherah Fadhlullah Suhaimi, Nazrila

2017-10-01

The learner-centred approach in medical and health sciences education makes the study of learning preferences relevant and important. This study aimed to investigate the interdisciplinary, inter-institutional, gender and racial differences in the preferred learning styles among Malaysian medical and health sciences students in three Malaysian universities, namely SEGi University (SEGi), University of Malaya (UM) and Universiti Tunku Abdul Rahman (UTAR). It also investigated the differences in the preferred learning styles of these students between high achievers and non-high achievers. This cross-sectional study was carried out on medical and health sciences students from three Malaysian universities following the approval of the Research and Ethics Committee, SEGi University. Purposive sampling was used and the preferred learning styles were assessed using the VARK questionnaire. The questionnaire was validated prior to its use. Three disciplines (medicine, pharmacy and dentistry) were chosen based on their entry criteria and some similarities in their course structure. The three participating universities were Malaysian universities with a home-grown undergraduate entry medical program and students from a diverse cultural and socioeconomic background. The data were analysed using the Statistical Package for the Social Sciences (SPSS) software, version 22. VARK subscale scores were expressed as mean+standard deviation. Comparisons of the means were carried out using t-test or ANOVA. A p value of <0.05 was considered as statistically significant, and <0.001 as highly significant. Both statistically significant interdisciplinary and inter-institutional differences in learning preferences were observed. Out of the 337 students, a majority of the participants were unimodal learners ( n =263, 78.04%). The most common type of learners was the reading/writing type ( n =92, 27.30%) while the kinesthetic subscale ( M =6.98, SD =2.85) had the highest mean score. Female students ( M =6.86, SD =2.86) scored significantly higher than male students ( M =6.08, SD =2.41; t (249), p =0.014) in the auditory subscale, whereas Chinese students ( M =5.87, SD =2.65) scored significantly higher than Malay students ( M =4.70, SD =2.87; p =0.04) in the visual subscale. However, the mean VARK subscale scores did not differ significantly between high achievers and non-high achievers ( p >0.05). This study gives an insight into the learner characteristics of more than one medical school in Malaysia. Such multi-institutional studies are lacking in the published literature and this study gives a better representation of the current situation in the learning preferences among medical students in Malaysia.

Effect of Modified Otago Exercises on Postural Balance, Fear of Falling, and Fall Risk in Older Fallers With Knee Osteoarthritis and Impaired Gait and Balance: A Secondary Analysis.

PubMed

Mat, Sumaiyah; Ng, Chin Teck; Tan, Pey June; Ramli, Norlisah; Fadzli, Farhana; Rozalli, Faizatul Izza; Mazlan, Mazlina; Hill, Keith D; Tan, Maw Pin

2018-03-01

Osteoarthritis (OA) is considered an established risk factor for falls. Published studies evaluating secondary falls prevention strategies among individuals with OA are limited. To evaluate the effect of a personalized home-based exercise program to improve postural balance, fear of falling, and falls risk in older fallers with knee OA and gait and balance problems. Randomized controlled trial. University of Malaya Medical Centre. Fallers who had both radiological OA and a Timed Up and Go (TUG) score of over 13.5 seconds. Postural sway (composite sway) was quantified with the Modified Clinical Test of Sensory Interaction on Balance (mCTSIB) under 4 different sensory conditions: eyes open on firm surface, eyes closed on firm surface, eyes open on unstable foam surface, and eyes closed on unstable foam surface. Participants were asked to stand upright and to attempt to hold their position for 10 seconds for each test condition. The average reading for all conditions were calculated. Participants randomized to the intervention arm received a home-based modified Otago Exercise Program (OEP) as part of a multifactorial intervention, whereas control participants received general health advice and conventional treatment. This was a secondary subgroup analysis from an original randomized controlled trial, the Malaysian Falls Assessment and Intervention Trial (MyFAIT) (trial registration number: ISRCTN11674947). Posturography using a long force plate balance platform (Balancemaster, NeuroCom, USA), the Knee injury and Osteoarthritis Outcome Score (KOOS) and the short-form Falls Efficacy Scale-International (short FES-I) were assessed at baseline and 6 months. Results of 41 fallers with radiological evidence of OA and impaired TUG (intervention, 17; control, 24) were available for the final analysis. Between-group analysis revealed significant improvements in the Modified Clinical Test of Sensory Interaction on Balance (mCTSIB), Limits of Stability (LOS), and short FES-I scores by the intervention group compared to the control group at 6 months. No significant difference in time to first fall or in fall-free survival between the intervention and control groups was found. Home-based balance and strength exercises benefited older fallers with OA and gait and balance disorders by improving postural control, with no observable trend in reduction of fall recurrence. Our findings will now inform a future, adequately powered, randomized controlled study using fall events as definitive outcomes. I. Copyright © 2018 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Automated classification of tropical shrub species: a hybrid of leaf shape and machine learning approach

PubMed Central

Murat, Miraemiliana; Abu, Arpah; Yap, Hwa Jen; Yong, Kien-Thai

2017-01-01

Plants play a crucial role in foodstuff, medicine, industry, and environmental protection. The skill of recognising plants is very important in some applications, including conservation of endangered species and rehabilitation of lands after mining activities. However, it is a difficult task to identify plant species because it requires specialized knowledge. Developing an automated classification system for plant species is necessary and valuable since it can help specialists as well as the public in identifying plant species easily. Shape descriptors were applied on the myDAUN dataset that contains 45 tropical shrub species collected from the University of Malaya (UM), Malaysia. Based on literature review, this is the first study in the development of tropical shrub species image dataset and classification using a hybrid of leaf shape and machine learning approach. Four types of shape descriptors were used in this study namely morphological shape descriptors (MSD), Histogram of Oriented Gradients (HOG), Hu invariant moments (Hu) and Zernike moments (ZM). Single descriptor, as well as the combination of hybrid descriptors were tested and compared. The tropical shrub species are classified using six different classifiers, which are artificial neural network (ANN), random forest (RF), support vector machine (SVM), k-nearest neighbour (k-NN), linear discriminant analysis (LDA) and directed acyclic graph multiclass least squares twin support vector machine (DAG MLSTSVM). In addition, three types of feature selection methods were tested in the myDAUN dataset, Relief, Correlation-based feature selection (CFS) and Pearson’s coefficient correlation (PCC). The well-known Flavia dataset and Swedish Leaf dataset were used as the validation dataset on the proposed methods. The results showed that the hybrid of all descriptors of ANN outperformed the other classifiers with an average classification accuracy of 98.23% for the myDAUN dataset, 95.25% for the Flavia dataset and 99.89% for the Swedish Leaf dataset. In addition, the Relief feature selection method achieved the highest classification accuracy of 98.13% after 80 (or 60%) of the original features were reduced, from 133 to 53 descriptors in the myDAUN dataset with the reduction in computational time. Subsequently, the hybridisation of four descriptors gave the best results compared to others. It is proven that the combination MSD and HOG were good enough for tropical shrubs species classification. Hu and ZM descriptors also improved the accuracy in tropical shrubs species classification in terms of invariant to translation, rotation and scale. ANN outperformed the others for tropical shrub species classification in this study. Feature selection methods can be used in the classification of tropical shrub species, as the comparable results could be obtained with the reduced descriptors and reduced in computational time and cost. PMID:28924506

Genotypic and Phenotypic Detection of AmpC β-lactamases in Enterobacter spp. Isolated from a Teaching Hospital in Malaysia.

PubMed

Mohd Khari, Fatin Izzati; Karunakaran, Rina; Rosli, Roshalina; Tee Tay, Sun

2016-01-01

The objective of this study was to determine the occurrence of chromosomal and plasmid-mediated β-lactamases (AmpC) genes in a collection of Malaysian isolates of Enterobacter species. Several phenotypic tests for detection of AmpC production of Enterobacter spp. were evaluated and the agreements between tests were determined. Antimicrobial susceptibility profiles for 117 Enterobacter clinical isolates obtained from the Medical Microbiology Diagnostic Laboratory, University Malaya Medical Centre, Malaysia, from November 2012-February 2014 were determined in accordance to CLSI guidelines. AmpC genes were detected using a multiplex PCR assay targeting the MIR/ACT gene (closely related to chromosomal EBC family gene) and other plasmid-mediated genes, including DHA, MOX, CMY, ACC, and FOX. The AmpC β-lactamase production of the isolates was assessed using cefoxitin disk screening test, D69C AmpC detection set, cefoxitin-cloxacillin double disk synergy test (CC-DDS) and AmpC induction test. Among the Enterobacter isolates in this study, 39.3% were resistant to cefotaxime and ceftriaxone and 23.9% were resistant to ceftazidime. Ten (8.5%) of the isolates were resistant to cefepime, and one isolate was resistant to meropenem. Chromosomal EBC family gene was amplified from 36 (47.4%) E. cloacae and three (25%) E. asburiae. A novel blaDHA type plasmid-mediated AmpC gene was identified for the first time from an E. cloacae isolate. AmpC β-lactamase production was detected in 99 (89.2%) of 111 potential AmpC β-lactamase producers (positive in cefoxitin disk screening) using D69C AmpC detection set. The detection rates were lower with CC-DDS (80.2%) and AmpC induction tests (50.5%). There was low agreement between the D69C AmpC detection set and the other two phenotypic tests. Of the 40 isolates with AmpC genes detected in this study, 87.5%, 77.5% and 50.0% of these isolates were positive by the D69C AmpC detection set, CC-DDS and AmpC induction tests, respectively. Besides MIR/ACT gene, a novel plasmid-mediated AmpC gene belonging to the DHA-type was identified in this study. Low agreement was noted between the D69C AmpC detection set and two other phenotypic tests for detection of AmpC production in Enterobacter spp. As plasmid-mediated genes may serve as the reservoir for the emergence of antibiotic resistance in a clinical setting, surveillance and infection control measures are necessary to limit the spread of these genes in the hospital.

Automated classification of tropical shrub species: a hybrid of leaf shape and machine learning approach.

PubMed

Murat, Miraemiliana; Chang, Siow-Wee; Abu, Arpah; Yap, Hwa Jen; Yong, Kien-Thai

2017-01-01

Plants play a crucial role in foodstuff, medicine, industry, and environmental protection. The skill of recognising plants is very important in some applications, including conservation of endangered species and rehabilitation of lands after mining activities. However, it is a difficult task to identify plant species because it requires specialized knowledge. Developing an automated classification system for plant species is necessary and valuable since it can help specialists as well as the public in identifying plant species easily. Shape descriptors were applied on the myDAUN dataset that contains 45 tropical shrub species collected from the University of Malaya (UM), Malaysia. Based on literature review, this is the first study in the development of tropical shrub species image dataset and classification using a hybrid of leaf shape and machine learning approach. Four types of shape descriptors were used in this study namely morphological shape descriptors (MSD), Histogram of Oriented Gradients (HOG), Hu invariant moments (Hu) and Zernike moments (ZM). Single descriptor, as well as the combination of hybrid descriptors were tested and compared. The tropical shrub species are classified using six different classifiers, which are artificial neural network (ANN), random forest (RF), support vector machine (SVM), k-nearest neighbour (k-NN), linear discriminant analysis (LDA) and directed acyclic graph multiclass least squares twin support vector machine (DAG MLSTSVM). In addition, three types of feature selection methods were tested in the myDAUN dataset, Relief, Correlation-based feature selection (CFS) and Pearson's coefficient correlation (PCC). The well-known Flavia dataset and Swedish Leaf dataset were used as the validation dataset on the proposed methods. The results showed that the hybrid of all descriptors of ANN outperformed the other classifiers with an average classification accuracy of 98.23% for the myDAUN dataset, 95.25% for the Flavia dataset and 99.89% for the Swedish Leaf dataset. In addition, the Relief feature selection method achieved the highest classification accuracy of 98.13% after 80 (or 60%) of the original features were reduced, from 133 to 53 descriptors in the myDAUN dataset with the reduction in computational time. Subsequently, the hybridisation of four descriptors gave the best results compared to others. It is proven that the combination MSD and HOG were good enough for tropical shrubs species classification. Hu and ZM descriptors also improved the accuracy in tropical shrubs species classification in terms of invariant to translation, rotation and scale. ANN outperformed the others for tropical shrub species classification in this study. Feature selection methods can be used in the classification of tropical shrub species, as the comparable results could be obtained with the reduced descriptors and reduced in computational time and cost.

[Taxonomy and evolution of the genus Pratylenchoides (Nematoda: Pratylenchidae)].

PubMed

Ryss, A Iu

2007-01-01

The amended diagnosis of the genus Pratylenchoides and list of its valid species with synonyms are given. All the efficient diagnostic characters are listed. Modern taxonomic standard for the description of Pratylenchoides species is proposed; it may be used also in taxonomic databases. Tabular and text keys for all species of the genus are given. Five following groups are considered within the genus Pratylenchoides. The group arenicola differs from other groups in the primitive adanal bursa type; the groups magnicauda, crenicauda, ritteri, and megalobatus differ from each other in the position of cardium along the body axis in relation to the pharyngeal gland nuclei, pharynx types are named according to the stages of its evolution from the primitive tylenchoid pharynx (cardium situated posteriorly) to the advanced hoplolaimoid one (cardium situated anteriorly). Diagnoses and species compositions of the groups are given. Basing on the matrix of species characters, the dendrogram has been generated for all species of Pratylenchoides and for all characters (UPGMA, distance, mean character difference, random, characters ordered). Taking in view that the PAUP software gives equal weights to all characters, including the most important ones which define the prognostic species groups, the separate dendrograms for each prognostic species group were generated using the same above mentioned tree parameters. On the base of the records of Pratylenchoides species the matrices of plant host ranges, geographic distribution, and preferred soil-climatic conditions were developed. The dendrograms of the faunal similarities were generated using these matrices, with conclusions on a possible origin and evolution of the genus. The genus evolved from the flood lands with swampy soils and prevalence of dicotyledons (herbaceous Lamiaceae and woody Salicaceae families) to the forest mainland communities with balanced humidity and predominance of herbaceous Poaceae and Fabaceae with woody Fagaceae, Betulaceae, and Oleaceae. The leading factor of the evolutional adaptation to soil-climatic conditions was the factor of humidity, but its significance gradually decreased with the host change to more advanced plant taxa adapted to the communities with more dry balanced humidity. The genus took its origin on the south shores of Laurasia in the Cainozoe. Later, when Hindistant and Arabian Peninsula joined with Laurasia creating the Himalayas barrier, the Pratylenchoides spp. distributed by two branches: the northern one moved into Central Asia, East Europe and North America, and the south branch came into Indo-Malaya, West Asia and the north of Africa. The remnants of the ancient species groups remain in West Europe and East Asia. In the North America the genus gave an origin to its sister genus Apratylenchoides, which spread to the south up to Antarctica; another advanced branch spread in the North America reaching Alaska.

Genotypic and Phenotypic Detection of AmpC β-lactamases in Enterobacter spp. Isolated from a Teaching Hospital in Malaysia

PubMed Central

Mohd Khari, Fatin Izzati; Karunakaran, Rina; Rosli, Roshalina; Tee Tay, Sun

2016-01-01

Objectives The objective of this study was to determine the occurrence of chromosomal and plasmid-mediated β-lactamases (AmpC) genes in a collection of Malaysian isolates of Enterobacter species. Several phenotypic tests for detection of AmpC production of Enterobacter spp. were evaluated and the agreements between tests were determined. Methods Antimicrobial susceptibility profiles for 117 Enterobacter clinical isolates obtained from the Medical Microbiology Diagnostic Laboratory, University Malaya Medical Centre, Malaysia, from November 2012—February 2014 were determined in accordance to CLSI guidelines. AmpC genes were detected using a multiplex PCR assay targeting the MIR/ACT gene (closely related to chromosomal EBC family gene) and other plasmid-mediated genes, including DHA, MOX, CMY, ACC, and FOX. The AmpC β-lactamase production of the isolates was assessed using cefoxitin disk screening test, D69C AmpC detection set, cefoxitin-cloxacillin double disk synergy test (CC-DDS) and AmpC induction test. Results Among the Enterobacter isolates in this study, 39.3% were resistant to cefotaxime and ceftriaxone and 23.9% were resistant to ceftazidime. Ten (8.5%) of the isolates were resistant to cefepime, and one isolate was resistant to meropenem. Chromosomal EBC family gene was amplified from 36 (47.4%) E. cloacae and three (25%) E. asburiae. A novel blaDHA type plasmid-mediated AmpC gene was identified for the first time from an E. cloacae isolate. AmpC β-lactamase production was detected in 99 (89.2%) of 111 potential AmpC β-lactamase producers (positive in cefoxitin disk screening) using D69C AmpC detection set. The detection rates were lower with CC-DDS (80.2%) and AmpC induction tests (50.5%). There was low agreement between the D69C AmpC detection set and the other two phenotypic tests. Of the 40 isolates with AmpC genes detected in this study, 87.5%, 77.5% and 50.0% of these isolates were positive by the D69C AmpC detection set, CC-DDS and AmpC induction tests, respectively. Conclusions Besides MIR/ACT gene, a novel plasmid-mediated AmpC gene belonging to the DHA-type was identified in this study. Low agreement was noted between the D69C AmpC detection set and two other phenotypic tests for detection of AmpC production in Enterobacter spp. As plasmid-mediated genes may serve as the reservoir for the emergence of antibiotic resistance in a clinical setting, surveillance and infection control measures are necessary to limit the spread of these genes in the hospital. PMID:26963619

Relapse to opioid use in opioid-dependent individuals released from compulsory drug detention centres compared with those from voluntary methadone treatment centres in Malaysia: a two-arm, prospective observational study

PubMed Central

Wegman, Martin P; Altice, Frederick L; Kaur, Sangeeth; Rajandaran, Vanesa; Osornprasop, Sutayut; Wilson, David; Wilson, David P; Kamarulzaman, Adeeba

2017-01-01

Summary Background Detention of people who use drugs into compulsory drug detention centres (CDDCs) is common throughout East and Southeast Asia. Evidence-based pharmacological therapies for treating substance use disorders, such as opioid agonist treatments with methadone, are generally unavailable in these settings. We used a unique opportunity where CDDCs coexisted with voluntary drug treatment centres (VTCs) providing methadone in Malaysia to compare the timing and occurrence of opioid relapse (measured using urine drug testing) in individuals transitioning from CDDCs versus methadone maintenance in VTCs. Methods We did a parallel, two-arm, prospective observational study of opioid-dependent individuals aged 18 years and older who were treated in Malaysia in the Klang Valley in two settings: CDDCs and VTCs. We used sequential sampling to recruit individuals. Assessed individuals in CDDCs were required to participate in services such as counselling sessions and manual labour. Assessed individuals in VTCs could voluntarily access many of the components available in CDDCs, in addition to methadone therapy. We undertook urinary drug tests and behavioural interviews to assess individuals at baseline and at 1, 3, 6, 9, and 12 months post-release. The primary outcome was time to opioid relapse post-release in the community confirmed by urinary drug testing in individuals who had undergone baseline interviewing and at least one urine drug test (our analytic sample). Relapse rates between the groups were compared using time-to-event methods. This study is registered at ClinicalTrials.gov (NCT02698098). Findings Between July 17, 2012, and August 21, 2014, we screened 168 CDDC attendees and 113 VTC inpatients; of these, 89 from CDDCs and 95 from VTCs were included in our analytic sample. The baseline characteristics of the two groups were similar. In unadjusted analyses, CDDC participants had significantly more rapid relapse to opioid use post-release compared with VTC participants (median time to relapse 31 days [IQR 26–32] vs 352 days [256–unestimable], log rank test, p<0·0001). VTC participants had an 84% (95% CI 75–90) decreased risk of opioid relapse after adjustment for control variables and inverse propensity of treatment weights. Time-varying effect modelling revealed the largest hazard ratio reduction, at 91% (95% CI 83–96), occurs during the first 50 days in the community. Interpretation Opioid-dependent individuals in CDDCs are significantly more likely to relapse to opioid use after release, and sooner, than those treated with evidence-based treatments such as methadone, suggesting that CDDCs have no role in the treatment of opioid-use disorders. Funding The World Bank Group, Doris Duke Charitable Foundation, National Institute on Drug Abuse, Australian National Health & Medical Research Council, National Institute of Mental Health, and the University of Malaya-Malaysian Ministry of Higher Education High Impact Research Grant. PMID:27964869

Relapse to opioid use in opioid-dependent individuals released from compulsory drug detention centres compared with those from voluntary methadone treatment centres in Malaysia: a two-arm, prospective observational study.

PubMed

Wegman, Martin P; Altice, Frederick L; Kaur, Sangeeth; Rajandaran, Vanesa; Osornprasop, Sutayut; Wilson, David; Wilson, David P; Kamarulzaman, Adeeba

2017-02-01

Detention of people who use drugs into compulsory drug detention centres (CDDCs) is common throughout East and Southeast Asia. Evidence-based pharmacological therapies for treating substance use disorders, such as opioid agonist treatments with methadone, are generally unavailable in these settings. We used a unique opportunity where CDDCs coexisted with voluntary drug treatment centres (VTCs) providing methadone in Malaysia to compare the timing and occurrence of opioid relapse (measured using urine drug testing) in individuals transitioning from CDDCs versus methadone maintenance in VTCs. We did a parallel, two-arm, prospective observational study of opioid-dependent individuals aged 18 years and older who were treated in Malaysia in the Klang Valley in two settings: CDDCs and VTCs. We used sequential sampling to recruit individuals. Assessed individuals in CDDCs were required to participate in services such as counselling sessions and manual labour. Assessed individuals in VTCs could voluntarily access many of the components available in CDDCs, in addition to methadone therapy. We undertook urinary drug tests and behavioural interviews to assess individuals at baseline and at 1, 3, 6, 9, and 12 months post-release. The primary outcome was time to opioid relapse post-release in the community confirmed by urinary drug testing in individuals who had undergone baseline interviewing and at least one urine drug test (our analytic sample). Relapse rates between the groups were compared using time-to-event methods. This study is registered at ClinicalTrials.gov (NCT02698098). Between July 17, 2012, and August 21, 2014, we screened 168 CDDC attendees and 113 VTC inpatients; of these, 89 from CDDCs and 95 from VTCs were included in our analytic sample. The baseline characteristics of the two groups were similar. In unadjusted analyses, CDDC participants had significantly more rapid relapse to opioid use post-release compared with VTC participants (median time to relapse 31 days [IQR 26-32] vs 352 days [256-unestimable], log rank test, p<0·0001). VTC participants had an 84% (95% CI 75-90) decreased risk of opioid relapse after adjustment for control variables and inverse propensity of treatment weights. Time-varying effect modelling revealed the largest hazard ratio reduction, at 91% (95% CI 83-96), occurs during the first 50 days in the community. Opioid-dependent individuals in CDDCs are significantly more likely to relapse to opioid use after release, and sooner, than those treated with evidence-based treatments such as methadone, suggesting that CDDCs have no role in the treatment of opioid-use disorders. The World Bank Group, Doris Duke Charitable Foundation, National Institute on Drug Abuse, Australian National Health & Medical Research Council, National Institute of Mental Health, and the University of Malaya-Malaysian Ministry of Higher Education High Impact Research Grant. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND license. Published by Elsevier Ltd.. All rights reserved.

[Main evolution lines of plant parasitic nematodes of the order Aphelenchida siddiqi, 1980].

PubMed

Ryss, A Iu

2007-01-01

Phylogenic models for each aphelenchid family and phylogeny of the order Aphelenchida as a whole were developed on the base of detailed comparative morphological and bionomical analysis of the order. Bionomical and morphological characters having a phylogenetic significance were selected. Classification proposed by Hunt, 1993 was used as the starting-point of the study. Life cycles and their evolution in Aphelenchida were analyzed on the base of phylogenetic trees. It is concluded, that aphelenchid ancestors combined mycophagy, plant parasitic, and partly predaceous feeding. Relations of the primitive Aphelenchida with their symbionts developed from the spots of the fungal organic matter decomposition in the "nema- tode-fungi" associations, followed by a transition to the temporary endoparasitic habit omitting ectoparasitism. With a complication of the nematodes' life cycles, the insect vector (detritophagous or pollinator) transformed into the real insect host of the parasitic nematode in the 2-host life cycle (with the plant and insect hosts) or in the obligate 1-host entomoparasitic life cycle of the aphelenchid nematodes. Specialization of the aphelenchid life cycles to insect vectors followed two main ways. In the first way, the resistant to unfavorable environmental conditions nematode juveniles, known already for the primitive aphelenchids transformed into dispersal juveniles, and later into parasitic juveniles. In the second evolution line the dispersal function were laid on inseminated but non-gravid (not egg-producing) females. Both above-mentioned trends of parasitic specialization were arisen independently in different phylogenetic lines of the Aphelenchida. In each line of the parasitic development in different nematode families, the highly specialized ectoparasites, as well as endoparasites on insects, were formed. In the evolution of life cycle of parasitic nematodes, a tendency to decrease the body size took place. The function of dispersion shifted to more junior juvenile stage (the first line of specialization), or body sizes of non-gravid females and males copulated with the latter become smaller (second specialization line, till the development of dwarf males and location of the males and small inseminated non-gravid females in the uterus of gravid nematode female). The hypothetic fundamental model of the parasitic cycles' specialization in the order Aphelenchida was developed, basing on the comparison of known life cycles in different phylogenetic lines within aphelenchid families. The conception of the geographic origin and historic dispersal of the order Aphelenchida was proposed. The origin of the superfamily Aphelenchoidoidea and order Aphelenchida as a whole probably took place in eastern areas of Gondwana (parts of which are recently Hindustan, Indo-Malaya, Australia and Antarctica), presumably in the Devonian period. When the Gondwana and Laurasia paleocontinents were joined into Pangea in Carbon period, aphelenchids dispersed in the Laurasian part of Pangea. Endemism of the advanced entomophilic ectoparasitic Acugutturidae indicates on the secondary hotbed of speciation in Caribbean area. Development of the anhydrobiotic adaptations in the Aphelenchida promoted their successful invasion in the cold regions of Holarctic. Another important adaptations was the transformation of the initially resistant nematode life cycle phase into the dispersal phases vectored by insects.

Survival rates and predictors of survival among colorectal cancer patients in a Malaysian tertiary hospital.

PubMed

Magaji, Bello Arkilla; Moy, Foong Ming; Roslani, April Camilla; Law, Chee Wei

2017-05-18

Colorectal cancer is the third most commonly diagnosed malignancy and the fourth leading cause of cancer-related death globally. It is the second most common cancer among both males and females in Malaysia. The economic burden of colorectal cancer is likely to increase over time owing to its current trend and aging population. Cancer survival analysis is an essential indicator for early detection and improvement in cancer treatment. However, there was a scarcity of studies concerning survival of colorectal cancer patients as well as its predictors. Therefore, we aimed to determine the 1-, 3- and 5-year survival rates, compare survival rates among ethnic groups and determine the predictors of survival among colorectal cancer patients. This was an ambidirectional cohort study conducted at the University Malaya Medical Centre (UMMC) in Kuala Lumpur, Malaysia. All Malaysian citizens or permanent residents with histologically confirmed diagnosis of colorectal cancer seen at UMMC from 1 January 2001 to 31 December 2010 were included in the study. Demographic and clinical characteristics were extracted from the medical records. Patients were followed-up until death or censored at the end of the study (31st December 2010). Censored patients' vital status (whether alive or dead) were cross checked with the National Registration Department. Survival analyses at 1-, 3- and 5-year intervals were performed using the Kaplan-Meier method. Log-rank test was used to compare the survival rates, while Cox proportional hazard regression analysis was carried out to determine the predictors of 5-year colorectal cancer survival. Among 1212 patients, the median survival for colorectal, colon and rectal cancers were 42.0, 42.0 and 41.0 months respectively; while the 1-, 3-, and 5-year relative survival rates ranged from 73.8 to 76.0%, 52.1 to 53.7% and 40.4 to 45.4% respectively. The Chinese patients had the lowest 5-year survival compared to Malay and Indian patients. Based on the 814 patients with data on their Duke's staging, independent predictors of poor colorectal cancer (5-year) survival were male sex (Hazard Ratio [HR]: 1.41; 95% CI: 1.12, 1.76), Chinese ethnicity (HR: 1.41; 95% CI: 1.07,1.85), elevated (≥ 5.1 ng/ml) pre-operative carcino-embryonic antigen (CEA) level (HR: 2.13; 95% CI: 1.60, 2.83), Duke's stage C (HR: 1.68; 95% CI: 1.28, 2.21), Duke's stage D (HR: 4.61; 95% CI: 3.39, 6.28) and emergency surgery (HR: 1.52; 95% CI: 1.07, 2.15). The survival rates of colorectal cancer among our patients were comparable with those of some Asian countries but lower than those found in more developed countries. Males and patients from the Chinese ethnic group had lower survival rates compared to their counterparts. More advanced staging and late presentation were important predictors of colorectal cancer survival. Health education programs targeting high risk groups and emphasizing the importance of screening and early diagnosis, as well as the recognition of symptoms and risk factors should be implemented. A nationwide colorectal cancer screening program should be designed and implemented to increase early detection and improve survival outcomes.

Stars Just Got Bigger - A 300 Solar Mass Star Uncovered

NASA Astrophysics Data System (ADS)

2010-07-01

Using a combination of instruments on ESO's Very Large Telescope, astronomers have discovered the most massive stars to date, one weighing at birth more than 300 times the mass of the Sun, or twice as much as the currently accepted limit of 150 solar masses. The existence of these monsters - millions of times more luminous than the Sun, losing weight through very powerful winds - may provide an answer to the question "how massive can stars be?" A team of astronomers led by Paul Crowther, Professor of Astrophysics at the University of Sheffield, has used ESO's Very Large Telescope (VLT), as well as archival data from the NASA/ESA Hubble Space Telescope, to study two young clusters of stars, NGC 3603 and RMC 136a in detail. NGC 3603 is a cosmic factory where stars form frantically from the nebula's extended clouds of gas and dust, located 22 000 light-years away from the Sun (eso1005). RMC 136a (more often known as R136) is another cluster of young, massive and hot stars, which is located inside the Tarantula Nebula, in one of our neighbouring galaxies, the Large Magellanic Cloud, 165 000 light-years away (eso0613). The team found several stars with surface temperatures over 40 000 degrees, more than seven times hotter than our Sun, and a few tens of times larger and several million times brighter. Comparisons with models imply that several of these stars were born with masses in excess of 150 solar masses. The star R136a1, found in the R136 cluster, is the most massive star ever found, with a current mass of about 265 solar masses and with a birthweight of as much as 320 times that of the Sun. In NGC 3603, the astronomers could also directly measure the masses of two stars that belong to a double star system [1], as a validation of the models used. The stars A1, B and C in this cluster have estimated masses at birth above or close to 150 solar masses. Very massive stars produce very powerful outflows. "Unlike humans, these stars are born heavy and lose weight as they age," says Paul Crowther. "Being a little over a million years old, the most extreme star R136a1 is already 'middle-aged' and has undergone an intense weight loss programme, shedding a fifth of its initial mass over that time, or more than fifty solar masses." If R136a1 replaced the Sun in our Solar System, it would outshine the Sun by as much as the Sun currently outshines the full Moon. "Its high mass would reduce the length of the Earth's year to three weeks, and it would bathe the Earth in incredibly intense ultraviolet radiation, rendering life on our planet impossible," says Raphael Hirschi from Keele University, who belongs to the team. These super heavyweight stars are extremely rare, forming solely within the densest star clusters. Distinguishing the individual stars - which has now been achieved for the first time - requires the exquisite resolving power of the VLT's infrared instruments [2]. The team also estimated the maximum possible mass for the stars within these clusters and the relative number of the most massive ones. "The smallest stars are limited to more than about eighty times more than Jupiter, below which they are 'failed stars' or brown dwarfs," says team member Olivier Schnurr from the Astrophysikalisches Institut Potsdam. "Our new finding supports the previous view that there is also an upper limit to how big stars can get, although it raises the limit by a factor of two, to about 300 solar masses." Within R136, only four stars weighed more than 150 solar masses at birth, yet they account for nearly half of the wind and radiation power of the entire cluster, comprising approximately 100 000 stars in total. R136a1 alone energises its surroundings by more than a factor of fifty compared to the Orion Nebula cluster, the closest region of massive star formation to Earth. Understanding how high mass stars form is puzzling enough, due to their very short lives and powerful winds, so that the identification of such extreme cases as R136a1 raises the challenge to theorists still further. "Either they were born so big or smaller stars merged together to produce them," explains Crowther. Stars between about 8 and 150 solar masses explode at the end of their short lives as supernovae, leaving behind exotic remnants, either neutron stars or black holes. Having now established the existence of stars weighing between 150 and 300 solar masses, the astronomers' findings raise the prospect of the existence of exceptionally bright, "pair instability supernovae" that completely blow themselves apart, failing to leave behind any remnant and dispersing up to ten solar masses of iron into their surroundings. A few candidates for such explosions have already been proposed in recent years. Not only is R136a1 the most massive star ever found, but it also has the highest luminosity too, close to 10 million times greater than the Sun. "Owing to the rarity of these monsters, I think it is unlikely that this new record will be broken any time soon," concludes Crowther. Notes [1] The star A1 in NGC 3603 is a double star, with an orbital period of 3.77 days. The two stars in the system have, respectively, 120 and 92 times the mass of the Sun, which means that they have formed as stars weighing, respectively, 148 and 106 solar masses. [2] The team used the SINFONI, ISAAC and MAD instruments, all attached to ESO's Very Large Telescope at Paranal, Chile. [3] (note added on 26 July 2010) The "bigger" in the title does not imply that these stars are the biggest observed. Such stars, called red supergiants, can have radii up to about a thousand solar radii, while R136a1, which is blue, is about 35 times as large as the Sun. However, R136a1 is the star with the greatest mass known to date. More information This work is presented in an article published in the Monthly Notices of the Royal Astronomical Society ("The R136 star cluster hosts several stars whose individual masses greatly exceed the accepted 150 Msun stellar mass limit", by P. Crowther et al.). The team is composed of Paul A. Crowther, Richard J. Parker, and Simon P. Goodwin (University of Sheffield, UK), Olivier Schnurr (University of Sheffield and Astrophysikalisches Institut Potsdam, Germany), Raphael Hirschi (Keele University, UK), and Norhasliza Yusof and Hasan Abu Kassim (University of Malaya, Malaysia). ESO, the European Southern Observatory, is the foremost intergovernmental astronomy organisation in Europe and the world's most productive astronomical observatory. It is supported by 14 countries: Austria, Belgium, the Czech Republic, Denmark, France, Finland, Germany, Italy, the Netherlands, Portugal, Spain, Sweden, Switzerland and the United Kingdom. ESO carries out an ambitious programme focused on the design, construction and operation of powerful ground-based observing facilities enabling astronomers to make important scientific discoveries. ESO also plays a leading role in promoting and organising cooperation in astronomical research. ESO operates three unique world-class observing sites in Chile: La Silla, Paranal and Chajnantor. At Paranal, ESO operates the Very Large Telescope, the world's most advanced visible-light astronomical observatory and VISTA, the world's largest survey telescope. ESO is the European partner of a revolutionary astronomical telescope ALMA, the largest astronomical project in existence. ESO is currently planning a 42-metre European Extremely Large optical/near-infrared Telescope, the E-ELT, which will become "the world's biggest eye on the sky".