A total of 78 samples comprising different types of street foods, sold in different locations in Malaysia, were examined for the presence of Enterobacter cloacae. E. cloacae contamination was recorded in 9% of the samples examined. Tests for susceptibility to 12 different antibiotics showed that all were resistant to six or more antibiotics, but susceptible to chloramphenicol and gentamicin. Plasmids of four different sizes were detected from the three plasmid positive isolates. RAPD analysis using four primers yielded completely different banding patterns for all E. cloacae studied. In Malaysia, no published information on street foods in the epidemiological investigation of E.cloacae related disease is available. However, their occurrences have provided compelling evidence that the risk of disease transmission caused by E. cloacae through street foods is moderate.
MeSH terms: Animals; Anti-Bacterial Agents; Chloramphenicol; Cloaca; Gentamicins; Malaysia; Plasmids; Enterobacter cloacae; DNA Primers; Random Amplified Polymorphic DNA Technique
Sensory attributes of four different palm sugars were related to gas chromatography/mass spectrometry (GC/MS) analysis using partial least squares regression (PLS). The sweet caramel and burnt-like sensory attributes were strongly associated with 2-furfural and 2-furan methanol volatile compounds. The sensory scores for roasty and nutty were also associated with the GC/MS ratings for roasty and nutty-like aroma by its highest scores obtained from 2-ethyl-5-methyl pyrazine, 2,5-dimethyl pyrazine and 2,3-dimethyl pyrazine volatile compounds along the PC1 dimension. PLS analysis did not show correlation for the character impact compound furaneol, 2-ethyl-3,5-dimethyl pyrazine (EDMP) and 2,3-diethyl-5-methyl pyrazine (DEMP), which are perceived to be responsible for the sweet caramel-like and roasty/nutty attributes of palm sugars, respectively. This lack of relationship could partially be explained by covariance among the sensory ratings for the samples.
Cocoa pod borer (Conopomorpha cramerella (Snellen)) is the main fatal pest that destroys cocoa plantations in South East Asia, mainly in Indonesia and Malaysia. Infested cocoa beans stick to each other, the pulp become hard and normal fermentation process to produce flavour precursors cannot be done. This research aimed to utilize the infested cocoa beans as a source of phenolic compounds. Extraction of phenolic compounds was carried out for three infestation levels regarded as low, medium and heavy. Parameters of study were bean size, shell content, fat content, total polyphenol and antioxidant activity. Results of the study showed that the increase in cocoa pod borer infestation significantly decreased cocoa bean size, fat content and total polyphenol; but shell content was increased. Antioxidant activity of the extracted polyphenol was not significantly affected by the infestation. The results clearly indicate that cocoa beans infested by cocoa pod borer can potentially to be used as a source of phenolic compounds for natural antioxidant uses.
The introduction of new agricultural commodities and products derived from modernbiotechnology may have an impact on human and animal health, the environment and economiesof countries. As more Genetically Modified Organisms (GMO) enter markets worldwide, themonitoring of GMOs is being preferred for obvious reasons such as determination of seed purity,verification of non-GMO status of agricultural crops and fulfilling GMO labeling provisions, tomention a few. Numerous GMO analytical methods which include screening, identification andquantification have been developed to reliably determine the presence and/or amount of GMOin agricultural commodities, in raw agricultural materials and in processed and refined ingredients.The detection of GMOs relies on the detection of transgenic DNA or protein material. For routineanalysis, a good sample preparation technique should reproducibly generate DNA/protein ofsufficient quality, purity and yield while minimizing the effects of inhibition andcontamination.
The key sample preparation steps include homogenization, pretreatment, extraction andpurification. Due to the fact that analytical laboratories receive samples that are often processedand refined, the quality and quantity of transgenic target analyte (e.g. protein and DNA) frequentlychallenge the sensitivity of any detection method. With the development of GMO analysistechniques, the Polymerase Chain Reaction (PCR) technique has been the mainstay for GMOdetection, and the real-time PCR is the most effective and important method for GMOquantification. The choice of target sequence; for example a promoter, a terminator, a gene, or ajunction between two of these elements, is the single most important factor controlling the specificity of the PCR method. Recent developments include event-specific methods, particularlyuseful for identification and quantification of GM content. Although PCR technology has obvious
limitations, the potentially high degree of sensitivity and specificity explains why PCR in its various
formats, is currently the leading analytical technology employed in GMO analysis. Comparatively, immunoassays are becoming attractive tools for rapid field monitoring for the integrity of agricultural commodities in identity preservation systems, whereby non-specialised personnel can employ them in cost-effective manner. This review discusses various popular extraction methodologies and summarises the current status of the most widely used and easily applicable GMO analysis technologies in laboratories, namely the PCR and immunoassay technologies.
The aim of this study was to investigate the acute (one-day treatment) effect of a methanol extract of
Orthosiphon stamineus, Benth on glutathione-S-transferase (GST) activity in streptozotocin (STZ)-induced diabetic young male and female Sprague Dawley (SD) rats. The methanol extract of O. stamineus was administered orally (5, 31.25, 125 and 500 mg/kg) to diabetic rats, and the effect on GST activity was measured by the method of Habig et al. (1974). No lethality and no significant changes in body weight and water intake were observed in the treated group as compared to the control group. A significant increase in the activity of GST was observed in the liver S-9 cytosolic fraction of diabetic male SD rats treated with 125 mg/kg (P < 0.01) and 500 mg/kg (P < 0.01) of the methanol extract O. stamineus. Administration of 500 mg/kg (P < 0.01) of the methanol extract of O. stamineus to diabetic female SD rats increased GST activity when compared to the control group. This study indicates that the methanol extract of O. stamineus could affect the activity of GST in rat liver and the effect seen was dose-dependent.
The objective of this research was to formulate an aerosol concentrate containing haruan (Channa
striatus) water extract that would produce a thin film when sprayed onto a wound and could be used for wound dressing. The aerosol concentrates were formulated with various polymer and plasticiser mixtures and tested in dispersion systems. The polymers evaluated were hydroxypropyl methylcellulose (HPMC), carboxymethylcellulose sodium (CMC Sodium), acacia, tragacanth, chitosan, gelatine and gelatine (bloom 151–160), all at concentrations of 2%. The plasticisers evaluated were polyethylene glycol (PEG) 400 and 4000, glycerine, propylene glycol, and triacetin. Films were prepared from film-forming dispersions by casting techniques. Film-forming dispersions were characterised in terms of pH, density, surface tension, rheological properties, particle size distribution, and tackiness. Based on these evaluations, HPMC was chosen as the best polymer. It produced a film with the expected qualities and was easy to reproduce in the form of dispersions or as thin transparent films. Glycerine was judged as the most appropriate plasticiser because it produced the concentrate having the desired qualities and properties expected from an aerosol concentrate.
Individualising a drug dosage regimen is more appropriate if it is based on pharmacokinetics data derived from local populations. In this study, we estimated valproic acid (VPA) and carbamazepine (CBZ) clearances in the Malaysian population from routinely collected therapeutic drug monitoring (TDM) data. We also evaluated the effects of gender, age, weight and concurrent antiepileptic drug (AED) therapy on VPA and CBZ clearance. Data was collected retrospectively from TDM forms of adult patients. Apparent drug clearance was estimated based on the standard steady state clearance equation. Mann-Whitney and KruskalWallis tests were used to evaluate gender and therapy differences, while Spearman’s Rank correlation was used to determine the associations of age and weight with clearance. One hundred thirty-two samples for VPA and 67 for CBZ were included in the analysis. Patients’ ages ranged from 15 to 72 years old. Mean VPA and CBZ clearances were found to be 0.36 l/kg/d and 1.60 l/kg/d, respectively. VPA clearance correlated positively but poorly with weight. Our results showed significant differences in (i) VPA clearance among male and female patients and (ii) VPA clearance between monotherapy and combination therapy. These findings provide a guide to initiate maintenance doses of VPA and CBZ in our local patients. Awareness of factors influencing drug clearance should help to optimise patients’ dosing regimens.
MeSH terms: Adult; Anticonvulsants; Body Weights and Measures; Carbamazepine; Clinical Protocols; Combined Modality Therapy; Female; Humans; Male; Retrospective Studies; Valproic Acid; Drug Monitoring
The International Pharmaceutical Federation (FIP) adopted a set of Good Pharmacy Practice (GPP) guidelines in 1993 and recommended that the regulatory bodies of individual countries should adapt the guidelines in accordance with their resources. The Malaysian Pharmaceutical Society (MPS) introduced its benchmarking guidelines (BMG) in 2003 as a means to raise the professional standards of the community pharmacy practice in Malaysia. Therefore, this study aimed to determine the extent to which community pharmacies have adopted the BMG. A cross-sectional study was conducted using mail questionnaires, which were posted to all community pharmacies in Malaysia. A total of 371 questionnaires (29.2%) were returned. Only 51.0% of the respondents were aware of the BMG. The extent of compliance with the guidelines was 62.6+21.1% (mean + standard deviation), with a median of 65%. The type and ownership of the community pharmacies were significantly associated with compliance with certain aspects of the guidelines. The main problem in complying with the BMG was financial constraint, and this problem was more likely to occur with independent than with chain pharmacies. However, the respondents generally agreed that most aspects of the BMG could be achieved in less than five years. Since the level of awareness among community pharmacists regarding the BMG is low, the MPS should promote or publicise the BMG further. The BMG should be reviewed before being used as part of the criteria for the accreditation of community pharmacies, as proposed by the MPS to further improve the quality and standards of community pharmacies in Malaysia.
MeSH terms: Accreditation; Cross-Sectional Studies; Malaysia; Ownership; Pharmaceutical Services; Pharmacies; Pharmacists; Pharmacy; Postal Service; Surveys and Questionnaires; Societies, Pharmaceutical; Benchmarking
The appropriateness of sampling times and indications for monitoring of serum drug concentrations for the purpose of therapeutic drug monitoring (TDM) were evaluated at three hospitals on the east coast of Malaysia. Appropriateness criteria for indication and sampling were adapted from previously published criteria and with input from local TDM pharmacists. Six drugs were chosen, namely gentamicin, digoxin, carbamazepine, phenobarbital, phenytoin, and valproic acid. A total of 265 TDM requests were evaluated. Appropriateness of the indication for TDM ranged from 77.4% to 82%, while that for sampling ranged from 34.2% to 62.1%. There were no significant differences between the three hospitals in both categories of appropriateness. Among different drug groups, the percentage of appropriate indication was found to be highest with antiepileptic drugs. Antiepileptic drugs, however, had the lowest rate of appropriate sampling. Overall, findings from the three hospitals showed very encouraging results with almost 80% of the requests considered as appropriately indicated. However, the percentage of appropriateness of sampling was lower, and thus may require further investigation.
Introduction : A cross sectional study was conducted among married women in Kg. Sasapan Kelubi, Hulu Langat, Selangor, Malaysia. The objective of the study was to identify the prevalence of Pap Smear practice and it`s influencing factors.
Methodology : Universal sampling was conducted from door to door to all married women who agreed to be involved in this study. Guided questionnaire was used as the main instrument in this study. The data was analyzed using SPSS version 12.0.
Result : A total of 154 respondents gave their feedback. Mean age in this study was 23.3±4.4.years. Only 66 respondents (42.9%) have had the pap smear with only 6 respondents (3.9%) practiced as per recommended schedule. The reasons for the respondents never practicing pap smear were no knowledge (n=46,52.3%), scared (n=22, 42.5%), shyness (n=21,23.9%), no free time(n-6,6.8%), unconcerned (n=3,3.4%), no female doctors (n= 6,6.8%), not bother, health clinic too far and high cost (n=1,1.1%). The only factor that showed significant association with pap smear practice was the score of knowledge about smear whereby respondents who underwent pap smear showed higher score compared to those respondents who never underwent pap smear.
Conclusion : The study showed that more efforts is required to improve knowledge and awareness among married women in rural area in order to overcome the knowledge gap, wrong perception and other reasons that prevent acceptance pap smear practice among them.
Keywords : married women, pap smear practice, rural area, Malaysia
Background: Somalia is a country that still practices Female Genital Mutilation (FGM). Female genital mutilation (FGM) constitutes all procedures, which involve partial or total removal of the external female genitalia or other injury to the female genital organs whether for cultural or any other nontherapeutic reasons.
Methodology: A cross-sectional community based study was conducted among males and females above 18 years of age attending the Out Patient Clinic and Mother & Child Clinic of Elder District, Rural Hospital Galgadud Region, Somalia in June 2006 using a structured questionnaire to access the respondents’ knowledge, attitude and practice.
Results: Four hundred respondents were interviewed and male respondents were noted to be more knowledgeable than their female counterparts (p 0.004) and so does respondents with formal education (p <0.001) and had occupation (p <0.001). Majority of the female respondents (97.1%) favors the practices of FGM and reasons such as to protect virginity (p <0.001), increase marital opportunity (p <0.001) and religious recommendations (p <0.001) were noted to be the important
factors in the continuation of FGM. All of the female respondents have had some form of FGM, giving the prevalence rate of 100% with 64.1% underwent the procedure at between the age of 5-10 years old and the commonest form of FGM were infibulations. Mother (69.4%) was the important decision maker for these women.
Conclusion: Aggressive education programme should be introduced targeting the women in this community. They should be well informed on the complication of FGM and its health effects. Providing clinics will help to alleviate some of the complications related to FGM. Law on protecting women from these practices should be introduced and enforced.
Key Words: female genital mutilation, knowledge, attitude, practice
Study site: Clinic of Elder District, Rural Hospital Galgadud Region, Somalia
Background: Nowadays, most medical laboratories in Malaysia practice occupational safety and health based on standard operating procedure and sometimes ad-hoc characteristic limited to only internal use. The level of compliance of the national occupational safety and health management system (OSHMS) guidelines among medical laboratories in Malaysia is still largely unexplored.
Methods: This study was carried out on 34 medical laboratories consisting of 17 public medical laboratories and 17 private medical laboratories in Klang Valley using self-administered questionnaire based on guideline of OSHMS6. This study covered 112 medical laboratories units including pathology chemistry (18), microbiology (20), virology (7), histopathology (16), cytopathology (17), hematology (19) and 15 multi discipline medical laboratories.
Results: This study showed the level of compliance to the national OSHMS guideline among medical laboratories who are MS ISO 15189:2004 accredited & have a higher scores (p
MeSH terms: Environmental Health; Hematology; Hospital Units; Malaysia; Patients' Rooms; Surveys and Questionnaires; Occupational Health
Background: The occupationally acquired accident and injuries in Malaysian medical laboratories are still largely unexplored prior to this survey. Some of these questions are attempted in this survey and act as source of reference for the number and accident injuries in medical laboratories in the area of Klang Valley and also in Malaysia.
Methods : This survey was carried out based on recordable cases throughout the calendar year of 2001 to 2005 from 3 main medical laboratories of Hospital Kuala Lumpur (HKL), Hospital Universiti Kebangsaan Malaysia (HUKM) and Pusat Perubatan Universiti Malaya (PPUM).
Results : The average annual incident rate for this three medical laboratories is 2.05/100 full time equivalent (FTE) employees. The annual incident rate in individual medical laboratory is 2.04/100 FTE (HKL), 2.07/100 FTE (HUKM) and 2.04/100 FTE (PPUM) employees, respectively. The most common injury that is 25.3% of the total cases reported was due to cuts by sharp objects and the second most common injury was exposure to biohazard and chemical substances which constitutes 19.9% of the total cases. . Needle prick injury (16.8%), fire (8.4%), fall/slip (6.3%) and gases leak and locked in cold room were reported as one case each.
Conclusion : The average incident rate from this study is remarkably similar compared with the incident injury rate reported by BLS (2006) which is 2.1/100 FTE in the average size of medical laboratory and diagnostic. Besides this incident rate of injury and illness as a comparison, it also can be used as a benchmark to evaluate the safety performance among medical laboratories in Malaysia.
Objective :This study was performed to determine changes in diet and lifestyle among breast cancer survivors in Malaysia.
Methods :This was a qualitative study done on fifteen survivors (8 Malays and 7 non-Malays) obtained from the Oncology and Surgery Department, National University of Malaysia Hospital. The study was conducted using a semi-structured interview format. The data obtained were sorted into various categories via content analysis.
Results :Majority of breast cancer survivors increased their fruit and vegetable intake following diagnosis. Some non-Malays changed to vegetarian whereas all the Malays remained on the same dietary pattern. As far as exercise was concerned, all Malays did not exercise before diagnosis, but did so after diagnosis, whereas most of non- Malays did not exercise either before or after diagnosis.
Conclusion : Some changes were noticed in dietary and lifestyle behaviors after diagnosis among some survivors. The differences were due to their different cultural and religious backgrounds.
MeSH terms: Vegetarians; Breast Neoplasms; Diet; Food Habits; Fruit; Life Style; Malaysia; Vegetables; Survivors
Introduction: This study seeks to identify the socio-demographic and behavioral characteristics of smokers (aged 18 and above), thus develop a predicting model for tobacco abstinence receiving cessation services for tobacco dependence at the Smoking Cessation Clinics (SCC) in government Primary Health Centers in Malaysia. These predictors would improve the effectiveness and efficiency of these clinics.
Methods : Smokers who sought smoking cessation therapy at the SCCs from 1st January 2004 to 31st
December 2004 were chosen randomly from clinic’s registries, and 254 smokers were recruited from 8 clinics chosen through stratified random sampling. Data analyses were performed with SPSS 12.0. 17.3% of smokers attending SCCs were able to quit smoking for at least six months.
Results : Factors significantly contributing to quitting success were elderly smokers (above 40 years old), smoked for more than 15 years, smoked less than ten sticks per day, had a previous history of quitting attempt, self referral to the clinic, high confidence level, attended SCC at least four times, each counseling session lasted for at least 30 minutes and were satisfied with the clinic service. In logistic regression model, smokers aged 40 years and above were 6.7 times more successful to quit, high level of confidence were nine times more successful, smoked more than ten sticks per day were ten times less successful, self referred smokers were ten times more successful and attending for at least 30 minutes counseling session were 12 times more successful.
Conclusion : This study concludes that more concerted effort is needed to approach various groups of target population and SCCs clinic services need to be improved.
MeSH terms: Aged; Ambulatory Care Facilities; Counseling; Cross-Sectional Studies; Health Services Needs and Demand; Humans; Malaysia; Referral and Consultation; Smoking; Tobacco; Tobacco Use Disorder; Logistic Models; Smoking Cessation
Introduction : The aim of this study was to determine the prevalence and the pattern of falls in community dwelling older people attending a primary care clinic in Kuala Lumpur, Malaysia.
Methods : A cross sectional study was conducted in an urban primary care clinic. Participants aged 60 years and older were included in the study. A structured questionnaire, assessing socio-demographic variables, medical and falls history was administered by one investigator over a 3-month period in 2004.
Results : A total of 151 respondents participated in this study with a response rate of 72%. The prevalence of falls was 47.0% over the previous 12-months period. Fifty-seven percent reported experiencing recurrent falls. Majority (61%) of falls occurred in the home and the two most common places were the bathroom (27%) and stairs (27%). Sixty-one percent of older people who fell, sustained an injury and most sought medical attention.
Conclusion : In conclusion, falls are common amongst older people attending this primary care clinic. It occurred commonly in the home in the bathroom and near stairs. However, a larger local community study is warranted to determine the prevalence and risk factors for falls in Malaysia.
Study site: primary care clinic in Kuala Lumpur, Malaysia
MeSH terms: Accidental Falls; Adult; Aged; Ambulatory Care Facilities; China/ethnology; Cross-Sectional Studies; Family Characteristics; Female; Hospitals, University; Humans; India/ethnology; Malaysia; Malaysia/ethnology; Male; Outpatient Clinics, Hospital; Primary Health Care; Surveys and Questionnaires; Residence Characteristics; Risk Factors; Prevalence; Independent Living
Introduction : Economic evaluations can provide “value-for money” information to those making decisions about the allocation of limited health care resources. In particular, economic evaluations can be used to identify interventions that are worth providing and those that are not. Furthermore, evaluations can be used with other approaches to help set priorities, such as program-budgeting marginal-analysis.
Methodology : Compile and systematically describe from the publications, articles and reports on economic evaluation in healthcare decision making.
Result : A high quality economic evaluation should provide decision makers with information that is useful, relevant, and timely. In addition, evaluations should be based on rigorous analytical methods, be balanced and impartial (credible), and be transparent and accessible to the reader. There are many situations where economic evaluations can assist decision makers: decisions by various levels of government or administrative bodies (e.g., regional health authorities, hospitals, drug plans) to fund a program, service or technology, pricing decisions by government regulators and technology manufacturers, clinical practice guidelines, priorities for research funding by governments and researchbased firms, post-marketing surveillance and updates of economic information based on the use of the technology in the “real world” (which can then be used to inform one of the other types of decisions).
Conclusion: This requires that decision makers take a broad view of the impact of a technology, and decision that are more explicit and transparent. The ultimate test of an evaluation is whether it leads to better decision in the presence of uncertainty, and results in the more efficient and effective use of resources.
Introduction: To determine association between occupational stress and personality characteristics among nurses at Maternal and Child Health Clinic in the state of Malacca, emphasizing on type of personality and personal perception of stress.
Methods : A cross sectional study was conducted among 152 nurses of Maternal and Child Health Clinics in Malacca using self administered questionnaires and selected via multistage sampling.
Results : This study showed that a total of 28.3% of the nurses were found to be stressed. Almost half (41.2%) of those who perceived that they were stressed were likely to be really stressed (p = 0.004). Therefore those who perceived themselves to be stressed should be referred for stress evaluation and further management if necessary. However selfperception of stress cannot be used as a screening tool for stress due to its lack of sensitivity (56.8%) and poor Positive Predictive Value (41.2%). Majority of the nurses were of Guardians Personality Type (98%) and 72.4% of them had extrovert trait. However there were no significant associations between stress with personality type or characteristic, most probably due to the preponderance of one personality type or characteristic. Other studied variables such as socio-demographic factors (age, gender, ethnicity, religion, marital status, educational level, body mass index, type of work place, position, duration of service and poverty level) and social factors (placement, chronic medical illness, chronic care taker, smoking status and alcohol drinker) were suggestive of an association between them and stress but were not statistically significant.
Conclusion : There is no association between occupational stress and personal characteristics among nurses in Malacca.
MeSH terms: Child Health; Alcohol Drinking; Alcohols; Ambulatory Care Facilities; Child; Cross-Sectional Studies; Humans; Malaysia; Nurses; Personality; Surveys and Questionnaires; Smoking; Body Mass Index; Workplace; Marital Status
Introduction : Stillbirth is one of the important adverse pregnancy outcomes that has been used as a health indicator for the measurement of the health status of a country especially for its obstetric care management. However, the aetiology of the occurrence of the stillbirth was commonly difficult to identify because of limitations in the classification system.
Methods : A review of existing, available information published up to January 2007 on stillbirths in Malaysia was used to obtain the basic background on the determinant factors of stillbirths. Results : Malaysia, which is a fast developing country, reported a stillbirth rate in the range of 4 to 5 per 1000 births. Almost 30- 40% were recorded as normally formed macerated stillbirths. This was based on a rapid reporting system of perinatal deaths using the modified version of the Wigglesworth’s pathophysiology classification. Those of extreme maternal age (less than 19 years and more than 35 years), those reside in rural areas, of the ‘Bumiputera’ and Indian ethnic groups were at higher risk of stillbirth. On detailed analysis it was seen that the risks of having a normally formed macerated stillbirth increased among those who had a preterm delivery and hypertension. Stillbirth rates were also higher in those with shorter gestational age and in those with parity between 2 and 5. No other factors related to stillbirth were found in this review.
Conclusion : This is a review based on existing published data which has a lot of limitation when it comes to analysing other important factors that might be related with the risk of the stillbirth. However, extreme maternal age and mothers from rural areas are the two factors that were persistently found in almost all literature. When these factors are combined with signs of pre term delivery, they indicate that close monitoring needs to be done.
Introduction : Johor Bahru has one of the highest rates of dengue disease in this country in spite of the implementation of COMBI (Communication for Behavioural Impact) in 2001.
Methods : To identify factors contributing to this problem, a case control study was conducted, focusing on risk factors such as the weather (rainfall and temperature), environment and sociodemography. Cases were selected from confirmed dengue cases from January to June, 2006. Controls were selected from patients who had no past history of having dengue illness from Health Clinics in Johore Bahru. Both case group and control group were matched by age and sex. All risk factors were analysed using SPSS version 11.5.
Results : Results from time-series analysis indicated that the cases of dengue illness were related to changes in the minimum temperature (r =-0.149; p
MeSH terms: Ambulatory Care Facilities; China/ethnology; Dengue; Humans; India/ethnology; Malaysia; Malaysia/ethnology; Risk Factors; Temperature; Weather; Case-Control Studies; Control Groups