Parotid tumours represent one of many groups of tumours in the field of
Otorhinolaryngology. However, a local demographical evaluation of parotid tumours and its annual incidences has never been undertaken. This study intends to review local demography in relation to incidence of parotid tumour seen in Otorhinolaryngology (ORL) clinic, Hospital Tuanku Ja’afar Seremban, Negeri Sembilan from the year 2007 till 2012. Methods: A retrospective demographical study on parotid cases seen in ORL clinic, Hospital Tuanku Ja’afar Seremban between 2007 till 2012 involving 56 cases. Data that was collected include patient details, facial nerve involvement on presentation, type of surgery performed, site of tumour, facial nerve injury post operation and final histopathological diagnosis. Results: An average of 10 cases per year was noted from 2007 to 2012. Male to female ratio was found to be 1.4:1. Age range of sample population were 9 to 79 years old with a mean age of 47 at time of diagnosis. Superficial lobe was found to be the most common tumour site (63%). Majority of cases consists of benign tumours in 51 out of 56 cases with Warthin’s tumour and Pleomorphic Adenoma being the most common histopathological finding. Post operative facial nerve injury were noted in 17 cases in which 13 cases were temporary while 4 others were permanent.
The 12- item General Health Questionnaire (GHQ-12) has been translated into many languages and widely used in different settings and countries. Its reliability and psychometric properties were extensively studied in many population groups which suggested that it measures psychological distress in multidimensional construct. Objective: The objective of this study was to assess the reliability and factor structure of the Bahasa Malaysia version of the GHQ-12 among university students attending a health program at a Malaysian public university. Method: The cross sectional survey was conducted on 306 undergraduate students aged between 18 to 27 years old who visited the booth set up for mental health screening at a health program. The screening was conducted using a self-administered, validated Bahasa Malaysia version of GHQ-12 questionnaire. Results: Using exploratory factor analysis, the Bahasa Malaysia version of GHQ-12 was found to have a three factor structures namely depressive symptoms, self-esteem and perceived abilities which accounted for 58% of the item variance. The overall Cronbach’s alpha coefficient of the scale was found to be high (0.84) with each factor having acceptable inter-item consistency ranging from 0.61 to 0.82. Conclusion: The findings of the study show that the Bahasa Malaysia version GHQ-12 is reliable and has good structural characteristics. It can assess a few domains of the psychological status of university students. It also helps in providing more information
on the domain which may become a focus target of intervention in the prevention of mental illness.
MeSH terms: Mental Disorders; Cross-Sectional Studies; Depression; Factor Analysis, Statistical; Humans; Language; Malaysia; Mental Health; Psychometrics; Surveys and Questionnaires; Self Concept; Stress, Psychological; Students; Translating; Universities; Reproducibility of Results; Population Groups
Background: Diabetic retinopathy (DR) is a microvascular complication of diabetes, which is a cause of visual impairment and blindness. Its development and progression have been linked to dyslipidaemia, although the link remains inconclusive.
Aim: This study aimed to determine the prevalence of dyslipidaemia among type 2 diabetic patients with DR in a tertiary setting and to determine the association between dyslipidaemia and DR severity.
Materials and methods: This was a cross sectional study using retrospective data of type 2 diabetic patients attending the opthalmology clinic of a tertiary centre from January 2007 to June 2014. Results of their fasting lipid profile and clinical data were retrieved from the hospital information system.
Results: A total of 178 patient’s data were collected. 120 (n=67.4%) patients had non-proliferative diabetic retinopathy (NDPR) with moderate NPDR being the most prevalent. Dyslipidaemia was noted in 151 (84.8%) of the patients. Patients had a combination of more than one abnormality in the lipid profile with increased LDL-cholesterol being the main abnormality. Dyslipidaemia was however, not significantly associated with DR severity.
Conclusion: Dyslipidaemia was highly prevalent in DR patients. The dyslipidaemia was however not associated with severity of DR.
Study site: Ophthalmology clinic, Hospital (?name), Malaysia
The information on job strain among crane operators in Malaysia is lacking. The aim of this study was to determine the prevalence and contributing factors of job strain among crane operators working in port container terminals. A cross sectional study was carried out at a port container terminal in Malaysia. Data was collected using validated self-administered questionnaires, which consisted of the Job Content Questionnaire (JCQ), and the Depression, Anxiety, and Stress Scale (DASS-21). All crane operators in the selected terminal participated in the study. Data was analyzed using SSPS version 19. Two-hundred- and-forty crane operators participated in the study.. The prevalence of job strain determined from the JCQ was 43.8%. Job strain was significantly associated with psychological job demand, decision latitude, anxiety, physical isometric loads and muscle ache. The prevalence of job strain in this study was high. There is an urgent need to recognize the existence of this problem among crane operators by their respective management. Implementation of comprehensive stress management programs are recommended to reduce job strain among these workers.
Obesity is a well-established risk factor for cardiovascular disease. The objective of
the study was to determine the prevalence of obesity and factors associated among secondary school students aged between 13 to 17 years at Slemani City Centre, Iraq. Methodology: A cross sectional study design was used. The calculated sample size was 1656. Probability proportional to size sampling technique was used to select the sample. A validated pretested questionnaire was used to collect the data. Weight and height were also taken. Data were analyzed using SPSS version 21. Chi-square test was used to determine an association between two categorical variables. Independent t-test was used to compare two means. Multiple logistic regression was used to determine the predictors for obesity. Results: The response rate was 92.54% and the overall mean age of the 1588 respondents was 15.42 (95% CI = 15.35, 15.49) years. The prevalence of overweight and obesity was 20.6% and 11.3% respectively. Variables significantly associated with overweight and obesity (age, monthly family income, education level of parents, body part satisfaction and body size perception) were entered into the logistic regression model. Multiple logistic regression analysis showed that the predictors for overweight and obesity were age, monthly family income, body part dissatisfaction and body size perception. Conclusion: The prevalence of overweight and obesity is high (20.6% and 11.3% respectively). The predictors of obesity among secondary school students aged between 13 to 17 years old at Slemani City Centre Kurdistan Region, Iraq were age, family income and body image dissatisfaction.
MeSH terms: Body Image; Body Weight; Cardiovascular Diseases; Cross-Sectional Studies; Humans; Iraq; Obesity; Parents; Personal Satisfaction; Surveys and Questionnaires; Risk Factors; Size Perception; Students; Prevalence; Chi-Square Distribution; Logistic Models; Sample Size; Human Body; Overweight
Thirty one Vibrio cholera isolates recovered from cholera outbreak in Bintulu, Sarawak (Malaysia) were detected with the presence of ctx gene by using specific PCR. These isolates were further characterized and differentiated by using the Enterobacterial Repetitive Intergenic Consensus PCR (ERIC-PCR) and BOX-PCR to determine their genomic fingerprints. The specific PCR result confirmed the identities of 27 isolates out of 31 as pathogenic V. cholerae. The ERIC-PCR generated several genetic profiles consisting of 4-6 bands with sizes in the range of 100 to 600 bp, while the BOX-PCR produced profiles numbering 2-7 bands in the sizes between 200 to 1000 bp. Based on the dendrogram generated from the DNA fingerprinting profiles (ERIC-PCR and BOX-PCR), all of the isolates can be divided into 2 main clusters that is further divided into 2 sub-clusters. The low genetic diversity of the isolates indicated the outbreak of V. cholerae in the study area was due to the contamination from a single or few sources of V. cholerae.
Peripheral vestibular disorder (PVD) is serious and common. Clinically, giving an accurate diagnosis of PVD can be challenging. Vestibular evoked myogenic potential (VEMP) is an objective test to evaluate the integrity of vestibular organs, particularly saccule and/or inferior vestibular nerve. This study was performed to determine the sensitivity and specificity of VEMP using different stimuli. Fourty normal and 65 PVD subjects who fulfilled the inclusion criteria were recruited. While sitting comfortably, VEMP waveforms were recorded with active electrode on sternocleidomastoid muscle and negative electrode on upper forehead. Tone bursts (500, 750 and 1000 Hz) were delivered via headphones at 90 dBnHL and 5/s presentation rate. VEMP parameters for each stimulus (amplitude and latency of P1 and N1 peak) were analyzed accordingly. Receiver operating characteristic (ROC) was performed to determine the sensitivity and specificity of VEMP at different test frequencies. N1 amplitude of 750 Hz stimulus produced the most ideal sensitivity (65% on right and 63% on left) and specificity (83% on right and 78% on left). The importance of using a few tone bursts in VEMP test in order to minimize the false negative in cases might be encountered in clinics as the certain tone burst had inadequate sensitivity in detecting PVD cases. The 750 Hz stimulus produced the most ideal VEMP with adequate values of sensitivity and specificity, at least in this study.
Introduction: Production of nitric oxide (NO) is one of the main responses elicited by a variety of
immune cells such as macrophages (e.g. microglia, resident macrophages of brain), during inflammation. Evaluation of NO levels in the inflammatory milieu is considered important to the understanding of the intensity of an immune response; and has been performed using different methods including the Griess assay. To assay NO in culture, an appropriate number of cells are stimulated into an inflammatory phenotype. Common stimuli include lipopolysaccharide (LPS), IFN-γ and TNF-α. However, overt stimulation could cause cell cytotoxicity therefore an ideal concentration of LPS should be used. Objective: To set-up a model of BV-2 cell activation that allows the assay of detectable levels of NO. Optimization of BV-2 microglia cell density and LPS concentrations after stimulation by bacterial lipopolysaccharide (LPS) for the Griess assay is demonstrated in this study. Methods: BV-2 microglia were cultured at different cell densities, and treated with LPS at three concentrations (1, 5, 10 μg/ml). NO production in culture supernatants were then measured at 18, 24, 48 and 72 hours. Moreover, methyl tetrazolium assay (MTT) was also performed to ensure that NO measurement is performed at no-cytotoxic concentrations of LPS. Results and Conclusions: NO production follows a temporal pattern. The density of 25000 cells/ well was the ideal seeding density for NO evaluation in BV-2 cells. BV-2 stimulation by LPS is dose dependent, and NO levels are increased proportional to the LPS concentration up to 1.0μg/ml, whereas the higher LPS concentrations are associated with decreased cell viability may be caused by the high toxic levels of LPS or NO. Although Griess assay has been commonly used by the scientists, however, optimization of its parameters on BV-2 cells will be useful for the experiments which will be performed on this particular cell line. The optimized pattern of Griess assay on BV-2 cells was achieved in this study, hence easier and more practical for the future scientists to perform Griess assay on BV-2 cells.
Medical students are future doctors who are trained to treat all kinds of diseases including people living with HIV/AIDS (PLWHA) without prejudice. Teaching basic scientific knowledge and technical skills is no longer adequate for today’s medical students. There is also a need for them to be provided with high personal and professional values. This study examined stigmatizing attitude towards people living with HIV/AIDS (PLWHA) among the medical students in a public medical school. The participants were stratified to preclinical-year (year 1 and year 2) and clinical-year (year 3 and year 4) medical students. Simple random sampling was carried out to select 170 participants from each category of students. Self-administered questionnaires captured socio-demographic data, HIV/AIDS knowledge and stigmatisation attitudes towards PLWHA. Multiple linear regression was used to assess the relationship between ethnic groups and stigmatization attitude. Three hundred and forty participants were recruited. Malay medical students who did not have previous encounter with PLWHA were associated with stigmatizing attitude towards HIV/AIDS patients, whereas clinical-year medical students who had no clinical encounter with PLWHA were more likely to feel uncomfortable with PLWHA. Malay ethnicity and medical students in clinical years who had not encounter a PLWHA were more likely to have stigmatizing attitude towards PLWHA.
Mental health is a growing concern in the field of occupational health globally due to its social, health, and economic implications on the individual and the community at large. As universities in Malaysia are advancing towards becoming world-class research universities, academicians are now faced with more pressures, making them more vulnerable to burnout. A cross sectional study was conducted among 194 randomly sampled academicians from a faculty of a public university. Data was collected using a self-administered questionnaire to assess the sociodemographic characteristics, occupational characteristics and burnout. Analysis was done using SPSS version 21. The response rate was 87.1%. The overall prevalence of burnout was 10.7% with significant associations between gender (χ2 = 4.61; p = 0.03), teaching experience (χ2 = 0.83; p = 0.02), job satisfaction (χ2 = 11.33; p = 0.001). Female academicians have a higher prevalence of burnout (14.3%). Academicians who have fewer years of teaching experience (
Public and private hospitals in Kuala Lumpur and Selangor were evaluated in terms of their accessibility for the physically disabled. The research hypotheses for this study included the following: (1) Both types of hospitals are accessible for the physically disabled as measured by specific criteria but (2) the degree of accessibility is higher in the case of private hospitals as compared to public hospitals. A total of 23 private hospitals and 11 public hospitals in Kuala Lumpur and Selangor were invited to participate in the study. The 5 private hospitals and 5 public hospitals that agreed were evaluated for adequacy of facilities for the physically-disabled. For this purpose, 13 specific criteria were assessed and scored for each hospital. These criteria were also grouped into 5 categories, namely, parking, toilet, door and lift, corridor and ramp. Scores were compared between each hospital and then aggregated and compared for private hospitals versus public hospitals. It was found that none of the 5 private hospitals and 5 public hospitals studied satisfied 100% of the criteria evaluated. Looking at each hospital individually, the overall scores range from 32% to 92% for the criteria set. Only 4 of the 10 hospitals in our sample achieved overall scores of 80% or higher in terms of the evaluation criteria we used. With the exception of availability of ramps where public hospitals scored slightly higher ,for most of the individual criterion, private hospitals scored higher than public hospitals. Looking at each criterion across all hospitals, the scores range from 59.2% (adequacy of parking) to 85% (adequacy of corridors). The median score obtained by private hospitals and by public hospitals for all 13 criteria were analysed for any difference. The difference between private hospitals and public hospitals is not statistically significant (Mann-Whitney U = 6.5, p-value = 0.099). There is no significant difference between Kuala Lumpur/Selangor private and public hospitals in terms of accessibility for physically disabled people. However, some hospitals are more accessible for the physically disabled than other hospitals. These findings indicate that there is room for improvement.
etrocaval ureter is a relatively rare anomaly where ureteric obstruction may occur as a result of ureter passes behind the inferior vena cava (IVC), hence, compressing it between the IVC and the vertebrae. We report 2 cases of retrocaval ureter with different presentations. One patient was managed surgically with minimally invasive approach and the other was managed conservatively.
This study was carried out to investigate the effects of noisy background on brain activation during a working memory task. Fourteen healthy male subjects underwent silent functional Magnetic Resonance Imaging (fMRI) scans while listening to words presented verbally against quiet (WIS) and noisy (WIN) backgrounds. The stimuli were binaurally presented to the subjects at 70 dB sound pressure level (SPL) in both conditions. Group results indicated significant (p < 0.001) bilateral widespread of brain activations in the primary auditory cortex, superior temporal gyrus, inferior frontal gyrus, supramarginal gyrus and inferior parietal lobes during WIS. Additional significant activation was observed in the middle cingulate cortex and anterior cingulate cortex during WIN, suggesting the involvement of cingulate cortex in working memory processing against a noisy background. The mean percentage of signal change in all regions was higher during WIN as compared to WIS. Right hemispheric predominance was observed for both conditions in primary auditory cortex and middle frontal gyrus and this could be attributed to the increased difficulty of the tasks. The results obtained from this study demonstrated that background noise increased task demand and difficulty. Task demand was found to play an important role in determining the activation magnitude in the brain areas during working memory task.
Automotive industry in Malaysia is one of the booming industries which encompass the design, development and manufacturing of motor vehicles. However, it has its own setback as the interaction between complex tools, machines, and instruments, coupled with humans as workers pose several health hazards. A cross-sectional study was conducted to determine the prevalence of musculoskeletal disorders (MSD) and the association with awkward posture among automotive assembly line workers. A simple random sampling method was adopted and data were collected based on Standardized Nordic Questionnaire (SNQ) and Rapid Upper Limb Assessment (RULA) method for analysing awkward posture. With a response rate of 83%, a total of 232 assembly line workers with at least one year job tenure participated in this study. The findings revealed that 78.4% of workers reported MSD while the highest percentage of complaints concerned the lower back (50.9%). Three factors were found to be significantly associated with MSD: age (χ2=5.61, p=0.018), job tenure (χ2= 8.26, p=0.004) and awkward posture (χ2= 65.37, p < 0.001). Logistic regression analysis indicated that significant risk factors for MSD symptoms were workers aged ≥ 25 years old (OR= 2.25, 95%CI 1.14-4.46) and those workers with equal and more than three years job tenure (OR= 2.44, 95%CI 1.04-5.63). In addition, workers in the very high and high RULA action level who were 69 times (OR = 69.38, 95%CI 14.51- 331.73) and 12 times (OR = 12.42, 95%CI 5.21-29.58), respectively, also had higher odds of complaints of MSD. The high prevalence of MSD shows that MSD symptoms is a significant problem among automotive assembly line workers while age, job tenure and awkward posture based on RULA action level are the significant factors for MSD. In particular, this study proves that the prevalence of MSD increases as the RULA action level and job tenure increases. Thus, this problem could be reduced by decreasing RULA action level through appropriate ergonomic workstation design and ergonomic training for workers.
MeSH terms: Back; Cross-Sectional Studies; Humans; Human Engineering; Industry; Malaysia; Musculoskeletal Diseases; Posture; Surveys and Questionnaires; Risk Factors; Prevalence; Logistic Models; Motor Vehicles; Upper Extremity
Dietary pattern analysis has emerged as important instruments to identify modifiable dietary risk factors for non-communicable diseases. The aim of this study was to determine the major dietary patterns among adolescents in Petaling District, Selangor and their associations with socio-demographic characteristics and obesity. An analytic cross- sectional study design was conducted in selected secondary schools in Petaling District. Sampling with probability proportionate to size was used and five schools were selected. Self-administered semi-quantitative food frequency questionnaire was used for data collection. Weight was measured with a digital bathroom scale (TANITA model) and height was measured using SECA body meter. Principal component factor analysis using varimax orthogonal transformation was used to identify the dietary patterns. Chi square was used to test for associations of dietary patterns with socio-demographic characteristics and obesity. Three major dietary patterns were identified: firstly, fruits and vegetables; secondly, sugar and fatand finally, meat and chicken which explained for 12.7%, 11.6% and 10.7% variation in food intake, respectively. There were significant associations between ethnicity, religion, family income, educational level of parents and the dietary patterns. However, there was no significant association between obesity and the dietary patterns. It may be more effective to describe a healthy diet using results of dietary pattern analysis in public health intervention, rather than describing single food items or nutrients. It is recommended that nutrition education programmes should be implemented in schools so as to prevent the development of obesity in the non-obese.
MeSH terms: Adolescent; Animals; Body Weight; Carbohydrates; Chickens; Cross-Sectional Studies; Demography; Diet; Factor Analysis, Statistical; Fruit; Humans; Meat; Obesity; Parents; Public Health; Surveys and Questionnaires; Risk Factors; Vegetables
The effect of loud noise to the army personnel is often identified when hearing loss had already developed. Acoustic trauma during shooting training can also lead to acute changes in the ear which is shown on otoscopic examination. This study was undertaken to determine the effectiveness of hearing protective device (earplug) on the prevalence of external ear changes amongst military personnel during shooting. This is a prospective cross sectional study that was conducted among 76 military personnel, who were divided into two groups: those with and without earplugs during shooting. Each participant underwent 3 otoscopic examinations: (a) pre-shooting, (b) immediate post-shooting (within 48 hours) and (c) 2 weeks after shooting. A total of 78 army personnel who were scheduled to undergo shooting training were otoscopically examined. Eighty three percent of them did not wear earplugs before. The percentage of inflammation of external auditory canal and tympanic membrane dullness increased tremendously among subjects from non–earplug group less than 48 hours post-shooting. Assessment after 2 weeks showed improvement in around 30% of the subjects. Loud noise has become an occupational hazard not only to the inner ear but it also predisposes the external and middle ear structures to some form of injury. Although improvement is seen after some period, a protective device such as an earplug should be recommended and the usage should be reinforced among the army personnel involved in shooting.
Peripheral blood (PB) CD34+ cells enumeration is currently the most reliable method to guide the timing of stem cell harvest. However, its usage is restricted by being technically challenging, costly, and time-consuming. Immature reticulocyte fraction (IRF) determination, which is simpler and cheaper and has a faster turn-around time, has been proposed for a similar purpose. The purpose of this study is to evaluate the value of IRF in guiding stem cell harvest and examine the correlation between IRF and PB CD34+ cells count. Daily pre-harvest tests, i.e. PB CD34+ cells and IRF from 21 patients scheduled for autologous PBSC transplant were assessed. Stem cells harvests were commenced when the PB CD34+ cell count were more than 10 cell/ul. A total of 205 pre-harvest tests were analysed. Following stem cell mobilisations, both the IRF and PB CD 34+ cell counts rose with a variable pattern. In this study, we observed that the IRF peaks preceded the PB CD34+ count by 2 days. On the day of stem cell harvest, all the peak IRF values were >0.3. The PB CD34+ cell counts correlated with the harvested stem cell yield, whereby r2 = 0.77, p < 0.021. In autologous stem cell mobilisation, we believe that IRF is a useful screening tool to predict the rise of the PB CD34+ cell counts as it is a simple, fast and less costly. An IRF of > 0.3 may be used as a cut-off value for the initiation of PB CD34+ quantification prior to stem cell harvest.
We are all aware that there has been a dramatic increase in the number of anterior cruciate ligament (ACL) reconstructions that are carried out here in Malaysia as well as around the world. The numbers of ACL injuries have undoubtedly increased over the years with greater participation of young adults in sporting activities. However it is not certain whether the increase in the numbers of reconstructions can be accounted for by the increasing numbers of ACL injuries. Without doubt commercial interests as well the influence of the biomedical companies have a role to play. In the past the rationale for surgical treatment of an ACL tear was that the ACL is vital for knee function and that in the long term ACL deficiency will lead to more injuries of the meniscus and more degeneration of the joint. This belief was prevalent because the natural history of an ACL deficient knee and the ultimate outcome of reconstruction of the ACL were both not known. However in recent years a substantial amount of research has been published, which has elucidated the natural history of ACL deficient knees as well as the long term outcome of reconstruction of the ACL.
Conventional chondrosarcomas rarely metastasize and it is extremely unusual to see multicentric- behaviour in malignant cartilage tumour. We report a 40 year old lady with presentation of two non-contiguous metachronous foci of low to intermediate grade of chondrosarcoma over left pelvic bone and right scalp respectively in the absence of pulmonary or visceral metastasis.
MeSH terms: Bone Neoplasms; Cartilage; Chondrosarcoma; Pelvic Bones; Scalp
The management of post-radiation wound breakdown over the posterior cervico thoracic region can be a challenging task for a surgeon. The aim of the treatment is to produce a well vascularized and a low tensile flap which will close a large defect. We describe the use of the lower trapezius flap to reconstruct the wound breakdown and to obtain stable tissue coverage in a patient with post- radiation necrosis. This flap minimizes the disruption of the scapula-thoracic function while preserving the range of movement over the shoulder. From the literature review, it was noted that the dorsal scapular artery (DSA) and transverse cervical artery (TCA) aid in the blood supply to the trapezius muscle and prevent local necrosis during rotation of the flap. The trapezius flap is widely accepted because of the minor donor site morbidity, large arc of rotation and adequate blood supply.