Hypertension is a major risk factor for cardiovascular diseases which is one of the leading causes of death worldwide. Piper sarmentosum(PS) has been widely used in traditional medicine with proven antihypertensive and antioxidant effects. This study aims to evaluate the antihypertensive potential of PS aqueous extract (PSAE) and to investigate the factors modulating nitric oxide (NO) production through its anti-oxidant activities. Methods:PS leaves were extracted with distilled water, freeze-dried and examined to quantify their antioxidant activities through 2,2-diphenyl-1-picrylhydrazyl and ferric reducing ability plasma test. The antihypertensive effect of PSAE in spontaneous hypertensive rats (SHR) was evaluated using four different groups (n=6); C (negative control), K (PSAE 500mg/kg), P (3 mg/kg perindopril) and M (PSAE 500 mg/kg + 1.5 mg/kg perindopril). PSAE and other treatments were given via oral gavage for 28 days. The blood pressure (BP) was determined using the non-invasive BP monitoring tail cuff technique and recorded weekly. SHR’s blood was collected to determine the serum NO level using Griess assay. Asymmetric dimethylarginine (ADMA) and arginine levels were determined using high performance liquid chromatography. Results:The extract showed good in-vitro antioxidant activities and a significant reduction in both systolic and diastolic BP compared to control group. They were also a decrease in plasma ADMA and an increase in serum NO level. Meanwhile, arginine level does not change significantly. Conclusion:High in-vitro antioxidant activities in PSAE enhances the clearance of ADMA that leads to an increase in serum NO production hence ameliorating the blood pressure of SHR.
This study was conducted to evaluate the susceptibility of microorganisms involved in early infection of open fractures in orthopaedics to current prophylactic antibiotics practice and determine the association of various parameters related to the causative organism, patient, injury and management to the resistance of such microorganisms. Methods: This is a retrospective study that reviewed cases collected from the surgical operations record from January 2015 to December 2017 in Hospital Tengku Ampuan Afzan, Kuantan. A total of 179 cases were collected with 110 cases fulfilling the proposed inclusion / exclusion criteria. They all underwent routine debridement followed by culture and sensitivity. Previous clinical records were traced to identify the various risk factors for infection and evaluate these against the resistance of the microorganisms to prophylactic antimicrobial drugs. Results: Admission to the intensive care unit, blood transfusion, antibiotic regime and duration, fracture grade, injury severity score and duration of admission were all significantly associated with resistance of microorganism. The study also demonstrated the predominance of Gram-negative microorganisms constituting 65.9% of isolates. Gram-negative microorganisms were seen more in higher fracture grades and Injury Severity Scale, and longer duration of admission and antibiotic treatment. The overall susceptibility of microorganisms to antibiotics was also demonstrated with up to 68.6% resistance to cefuroxime and 36.9% to Gentamicin. Staphylococcus aureus and MRSA were the commonest Gram-positive organisms while Pseudomonas and Acinetobacter spp. the commonest Gram-negatives. Conclusion: Admission to Intensive Care Unit, blood transfusion, antibiotic regime and duration, fracture grade, injury severity score and duration of antibiotics have a significant positive predictive value to the development of resistance of microorganisms. The shift to predominantly Gram-negative microorganisms indicate an urgency to modify management of open fracture to achieve optimal results. This will also prevent the emergence of new multi-drug resistance microorganism which is already a worldwide public health problem.
Many new objective tests to assess the function of specific structures of the vestibular organ are currently adopted in vestibular clinics. One of the objective assessments include the video head impulse test (vHIT) where gain & velocity responses of eye relative to the head movements are recorded using an infrared camera. Methods: Thirty normal hearing subjects age between 18 to 25 years old participated in this study. At least ten Lateral, Left Anterior Right Posterior (LARP), and Right Anterior Left Posterior (RALP) responses were recorded for each participant by making small and rapid unpredictable head movements. Results: The average velocity gain for Lateral responses at 40 ms, 60 ms and 80 ms were 1.05 ± 0.003, 1.03 ± 0.002 and 1.01 ± 0.003 respectively. The LARP average velocity regression were 1.01 ± 0.24 for Left Anterior and 1.05 ± 0.25 for Right Posterior, with an average gain asymmetry of 5.13%. The RALP average velocity regression were 1.08 ± 0.31 for Right Anterior and 1.12 ± 0.30 for Left Posterior, with an average gain asymmetry of 5.87%. One sample T-test were conducted to compare Lateral responses to a previous study by Mossman et al. (2015) where significant differences in velocity gain at 60 ms and 80 ms between studies were found where, t (59) = 5.56, p
Thyroid disorders are among common medical conditions encountered in clinical practice. However, the disease burden among Malaysian population has not been established. This study was aimed to determine the prevalence of goitre and its associated factors among adult population in Peninsular Malaysia. Materials and Methods: A cross-sectional study was performed in 5 pre-assigned regions in Peninsular Malaysia. Participants’ sociodemographic profile and medical history were recorded. Physical examinations were done looking for abnormalities of the thyroid gland and signs of thyroid dysfunctions. The diagnosis of goitre was made by palpation and corroborated by the repeat examination by another investigator. The World Health Organization (WHO) goitre grading system was used. Fifteen millilitre of blood were withdrawn and analysed at a central laboratory. Results: Among 2190 respondents, the prevalence of goitre was 9.3%. Goitre was associated with positive anti-thyroperoxidase and anti-thyroglobulin antibodies. Females were at higher risk of goitre (adjusted OR = 2.4; 95% CI 1.6–3.5; p
Pre-hypertension, a classification of blood pressure ranging from 120–139 mm Hg systolic and/or 80–89 mm Hg diastolic, has been introduced to identify those high-risk group of developing hypertension to implement early intervention to halt disease progression. This study determines the prevalence of pre-hypertension and its determinants among undergraduate preclinical medical students in Malaysia.
Materials & Methods: This was a cross-sectional study conducted among 158 registered second year medical students at one research university in central Malaysia from January to April 2018.
Results: The prevalence of pre-hypertension was 20.6% among undergraduate preclinical medical students. The most respondent was female (69.9%), Malay ethnic (50.6%) who had normal body mass index (67.3%), no depression (79.5%), no anxiety (60.3%), no stress (68.6%), low physical activity level (44.9%), never smoked (95.5%), and never consumed alcohol (87.8%). Some respondents had positive family history of hypertension (43.6%) and diabetes mellitus (31.4%). After adjusted for all variables, gender (AOR=14.45, 95% CI 5.58-37.43) and depression status (AOR=6.37, 95% CI 1.29-31.49) were significantly associated with pre-hypertension.
Conclusion: The prevalence of pre-hypertension among preclinical medical students was lower compared to other country, predicted by gender and depression status. However, further comprehensive multicentered studies in Malaysia with larger sample size is recommended to get more precise results in identifying determinants for pre-hypertension so that early intervention could be implemented nationwide.
MeSH terms: Anxiety; Cross-Sectional Studies; Depression; Female; Humans; Malaysia; Malaysia/ethnology; Male; Stress, Psychological; Students, Medical*; Body Mass Index; Prevalence; Young Adult; Prehypertension*
Factory and Machinery Act (Noise Exposure) Regulation 1989 (FMA [Noise] 1989) has been implemented in Malaysia for nearly 30 years, but noise-induced hearing loss (NIHL) cases is still rising. Fault tree analysis is a top-down approach to analyzing incidences of 'failures', starting with establishing the single top event that will eventually cause NIHL, followed by identification of the contributing factors to the top event which are the immediate or basic events. Through its visual, structural and deductive approach; FTA is able to depict the temporal sequence of events and their interactions in a formal and logical hierarchy. Materials and Methods: Employees with permanent standard threshold shifts (PSTS) underwent further assessment confirming the presence of NIHL. A single common fault tree was constructed based on six cases of PSTS. The top event is the PSTS. Intermediate and basic events were identified and mapped with relevance to the provisions in the FMA (noise) 1989 indicating how failed control measures have resulted in the PSTS cases.Results: The constructed fault tree with its branches illustrated how breach or non-compliance of FMA (Noise) 1989 resulted in the eventual top event (NIHL). Conclusion: FTA provides a standardized perspective of errors within the system in preventing NIHL.
Innovation is not just an individual study by a company or an entrepreneur, but it has to be in a larger system that enables innovation. There is a need, therefore to study the external and internal factors that influence the output of technological innovation. The goal of this study was to identify the factor that influence of the performance in technology innovation defined from several researchers. The role of innovation as a critical factor influencing a company’s business creativity and competitiveness make it essential to growth of productivity and productivity of the industry. Various studies of innovation is identified as helping companies open new markets and gain competitive advantage succeeded in increasing market share and achieving sustainable competitiveness.
Shape recognition is an important aspect in Computer Vision. From the point of view of different object recognition problem has been solved and some of the modifications in the method of recognition is still ongoing. This is the main reason that the identification form used in applications with a large number of major challenges, including sound, degradations. In this paper a number of forms of identification methods have been defined from which researchers can get an idea for an efficient technique modified.
The practices of conventional methods for maintenance management in Kolej Universiti Islam Melaka (KUIM) faced many issues due to poor service delivery, inadequate finance, and poor maintenance plan and maintenance backlogs. The purpose of this study is to improve the conventional method practices which tend to be ineffective in KUIM. The selected KUIM is based on conventional method practices and its major problems, attempt to implement computerised technology and the willingness of staff to share their experiences. The responses from semi-structured interview with engineer and assistant engineer were recorded using video camera and transcribed verbatim. The overall findings of this research indicated; poor service delivery, inadequate financial, poor maintenance planning and maintenance backlogs. There is also need to overcome less man power competencies of maintenance management practices which existed KUIM. In addition, the study also found that the KUIM still use conventional maintenance management processes in managing hostel facility condition. The proposed solutions are intended to be used for maintenance management practices at KUIM in order to provide high-quality of hostel facility with safe and healthy environments.
This cross-sectional study aims to determine the provision of foods according to NOVA classifications (an ultra-processed classification), to assess contribution of sodium and added sugar availability in each of NOVA food groups, and to evaluate nutritional status as well as to determine the relationship between sodium, added sugar availability of each NOVA foods groups and nutritional status among adults in Terengganu. Materials and methods:About 200 respondents aged between 18 and 59 years old from Kuala Nerus, Terengganu were recruited. Their dietary intake from two days of 24-hour dietary recall underwent NOVA classification and analyzed through Nutritionist Pro. All respondents had their blood pressure and fasting blood glucose taken. Spearman’s rank correlation was used to evaluate the relationship between sodium and added sugar each of NOVA food groups and the nutritional status. Results:The total energy intake of the respondents was 1818 kcal +375.05 per day. The energy contribution of ultra-processed group was 24%. The sodium and added sugar contribution of ultra-processed group were 26% and 63%, respectively. The mean blood pressure and median of blood glucose were normal at 114/79 mmHg and 5.3 mmol/L, respectively. No significant correlation was found between sodium, added sugar availability of each NOVA food groups and nutritional status at p
The Eurycoma longifolia (EL) root aqueous extract has long been used as an enhancer of male sexual performance. However, data from previous studies in both human males and experimental male animals on the testosterone level in those given the EL extract orally were at best insufficiently conclusive. Materials and Method Sixty-four healthy adult male Sprague Dawley rats were acclimatized, and randomized into six test groups and one control group. All rats where given either the aqueous ELextract or distilled water via metal gavage needle. The first three test groups received the low (50mg/kg bw), medium (100mg/kg bw) and high (200mg/kg bw) doses respectively of the EL daily for 15 days only. The second three test groups continued receiving the same daily treatment doses for 30 days. The controls were given distilled water only. At the end of each of the study period, blood samples were collected via cardiac puncture and the rats were euthanized. The testicles were obtained, weighed, and processed for histological examination. Results The sera testosterone levels were higher in animals which received the medium and high doses for both treatment duration. Rats which received medium and high oral doses of ELshowed an increase of spermatogenesis and mature spermatozoa. ConclusionThe optimal enhancing effect on sera testosterone levels and testicular spermatogenesis of EL treatment in adult male rats was observed with the medium dose of 100mg/kg bw given once daily for both 15 and 30 days.
Many studies have investigated the effects of music on perioperative anxiety and its implication on anaesthetic practice, however there are limited number of studies reported for religious or spiritual intervention in this aspect. We investigated the effects of listening to Islamic praises (Dzikr) and nature-based sounds delivered via headphones as non-pharmacological interventions for perioperative anxiety.Materials and Methods: Sixty-three Muslim patients scheduled for elective lower limb surgery under regional anaesthesia were randomly assigned to listen to Dzikr (Group A), nature-based sounds (Group B) or given headphones without any sounds (Group C). Anxiety levels were assessed using a visual analogue scale for anxiety (VAS-A). Physiological responses (mean arterial pressure, heart rate and respiratory rate) as well as patients’ overall satisfaction level were documented.Results: Patients in Group A demonstrated statistically significant lower VAS-A scores compared to those in Group B and C at 30-minutes after skin incision (p=0.002 and p=0.001 respectively) and at the end of the surgery (p=0.028 andp
Occult HCV infection has a predilection for specific populations such as haemodialysis (HD) patients.The exact natural course, epidemiology, pathogenesis and clinical importance of OCI are unknown. We investigated the existence of OCI among local patients undergoing routine HD at a referral hospital in Pahang, Malaysia. Methods:Serum andperipheral blood mononuclear cells (PMBCs) were collected from peripheral venous blood samples of seropositive (anti-HCV positive) and seronegative (anti-HCV negative) HD patients as well as healthy individuals (negative control group). Inclusion criteria for the seronegative patients included elevated liver enzymes. Both conventional PCR and strand-specific PCR were used to detect the viral RNA and to indicate active viral replication in PBMCs respectively. Direct DNA sequencing was done to confirm the viral HCV RNA and their genotypes. Results:In the majority (90-100%) of seropositive chronic hepatitis C patients, viral RNA was detected in both serum and PMBCs . Meanwhile, out of 22 seronegative patients, 6 (27%) showed active viral replication in PBMCs but no detectable viral RNA presence in the serum. None of the negative control group had detectable viral RNA. All seronegative patients with OCI were infected with HCV genotype 3 and two of them (2/6) had a slight elevation of their liver enzymes. Conclusion:Seronegative OCI does exist among local hemodialysis patients, with normal or persistently abnormal liver enzyme values. Further investigation is needed to study the mode of viral transmission and clinical significance of OCI in HD setting.
The increasing trend of Chronic Kidney Disease (CKD) prevalence in Indonesia is a public health concern as it increases mortality, morbidity and burden of disease that has great implication on the health economic. In addition, CKD patients who are more likely to undergo hemodialysis is commonly associated with psychological problems such as depression, anxiety and stress and these have added more to the disease burden. Immediate measures such as progressive muscle relaxation (PMR) to reduce the psychological symptoms is of great importance before the symptoms progress into psychiatric disorders. The study was aimed to evaluate the effectiveness of PMR in reducing symptoms of depression, anxiety and stress among patients undergoing hemodialysis. It was a quasi-experimental, pretest-posttest control study that recruited 60 eligible respondents who underwent hemodialysis and was randomly allocated into intervention and wait-list control groups. Respondents in the intervention group performed PMR twice a day for two weeks. Mean scores of depression, anxiety and stress of respondents were examined before and after intervention using Depression, Anxiety and Stress Scale–21 questionnaire (DASS-21). Results showed that mean scores of depression, anxiety and stress differed significantly before and after intervention between groups and within the intervention group (p
Depression and anxiety are common complications associated with traumatic brain injury (TBI) patients but screening tools which are validated to assess these complications in the TBI population are scarce. This study investigated the validity of the Malay version of Hospital Anxiety and Depression Scale (HADS) to screen for depression and anxiety among Malaysian TBI patients. Materials and Methods: This cross-sectional study recruited 101 TBI patients in which they were administered the Malay version of HADS and the Structured Clinical Interview for Diagnostic and Statistical Manual for Mental Disorder 4thEdition (DSM-IV) for Axis I Disorders (SCID-I) (as comparison tool). Internal consistency (Cronbach’s α) and concurrent validity (using receiver operating characteristics) of the Malay version of HADS were evaluated. Results: The total Malay version of HADS score and its anxiety subscale exhibited good internal consistency of 0.80 and 0.78 respectively, but the internal consistency of its depressive subscale was low at 0.57. The depressive subscale of the Malay version of HADS exhibited high area under the curve (AUC) of 0.86, specificity of 82%, sensitivity of 76% and negative predictive value of 91% but its positive predictive value was 58%, at cut-off point of 8/9. While the anxiety subscale also demonstrated high AUC of 0.88, specificity of 71%, sensitivity of 93% and negative predictive value of 98% its positive predictive value was only 34%. Conclusion: The Malay version of HADS is a valid screening tool for depression and anxiety among Malaysian TBI population.
An unhealthy dietary practice as a result of environmental and societal changes is increasingly exposed to adults. These unhealthy practices lead to an increased cardiometabolic risk, and obese adults are at a higher risk as compared to normal-weight adults. The best strategy to promote healthy lifestyle practices among Malaysian obese adult is still fragmented. Materials and Methods: A single-centre randomised controlled trial was carried out to determine the effect of the lifestyle modification intervention (LMI) with the motivational construct, in comparison to the current standard LMI on the dietary macronutrient intake among obese adults. The dietary macronutrient intake and changes in body weight were assessed at baseline and after six months. Seventy-nine participants completed the study. Results: Our finding showed that six months of LMI with motivational construct resulted in a higher reduction of total fat and cholesterol from the dietary intake as compared to the control. In addition, the participants in the intervention group had a significant body weight loss after six months (-1.97 kg, 95% CI: -0.324, 1.360, t(39) = 3.397, p= 0.002). Conclusion: This study demonstrates that the intervention had a meaningful impact on improving the dietary macronutrient intake, which is beneficial to support body weight loss in obese adults. Future trials with additional nutritional biomarkers are needed to extend these findings.
Orlistat is a widely used drug in treating obesity as it promotes weight reduction. The aim of this study was to determine the protective effects of orlistat (10 mg/kg/day) on cardiovascular parameters and oxidative stress biomarkers in high-fat diet (HFD)-induced obese rats. Methods:Twenty-four male rats Sprague Dawley rats were divided into three groups and fed with normal diet (N), HFD and HFD with orlistat (HFD+O). Orlistat was administered daily by oral gavage and after six weeks, all rats were sacrificed. Results:Administration of orlistat along with HFD (HFD+O) has brought significant decreases in Lee obesity index and LDL level compared to HFD group. Activities of cardiac superoxide dismutase (SOD), glutathione peroxidase (GPx) and catalase (CAT) were significantly higher, whereas level of oxidised LDL was significantly lower in HFD+O group compared to HFD group. HFD group had significantly higher necrotic patch area in myocardium while minimal histological changes were seen in HFD+O group. Conclusion:This study may suggest that administration of orlistat at 10 mg/kg/day for 6 weeks may have protective effects against the changes on Lee obesity index, lipid profiles, cardiac oxidative stress biomarkers and histology of myocardium in HFD-induced obese rats possibly through its hypolipidaemic and antioxidant actions.
The relevance of Information and Communication Technology (ICT) in the field of Technical Vocational Education and Training (TVET) cannot be overemphasized in community studies. The era of work is changing constantly like ICT, thus creating more challenges for workers in the face of the current globalization in the 21st century and the University responsible for its provision. Although many studies explain and demonstrate the extent to which ICT is applied to different educational disciplines, the literature on effective ICT integration in the field of Technical Education and Training (TVET) is limited and requires further exploration to highlight the level of TVET requirements for ICT integration. Therefore, this paper attempts to add to the ICT integration in TVET by making it clear; the need for effective ICT integration in TVET, the factors that influence effective ICT integration in TVET, the overview of the challenges for effective ICT integration in TVET. This paper proposes for the planning and management of ICT resources on TVET.
SOX9, a members of SOX family, plays a significant roles in developmental processes during embryogenesis, including brain tissue. Few studies have shown that SOX9has been involved in tumourigenesis of several types of cancer including brain tumour. However, such studies are still lacking in the Malaysian population. The aim of this study was to determine SOX9expression level in several types of brain tumours in East Coast Malaysia. Materials and Methods: Five formalin-fixed pariffin-embedded brain tumour samples of Malay descendants were sectioned by using microtome. RNA extraction was performed with slight modification by adding Trizol during tissue lysis. The RNA was converted to cDNA using reverse transcription technique before SOX9expression was detected using RT q-PCR assay in brain tumours normalized to non-neoplastic brain tissues. Results: Overall results displayed that SOX9gene in all samples were up-regulated. SOX9overexpression was found in both high and low grade glioma (anaplastic and pilocytic astrocytoma respectively). This is consistence with both low grade (benign) and atypical meningioma. Secondary brain tumour also showed up-regulation when compared to normal brain tissue. Conclusion: Up-regulation in SOX9expression in selected brain tumours in Malay patients revealed its significant roles in brain tumourigenesis. Functional studies should be carried out to observe the SOX9functions and mechanism whether they should reflect their diverse roles in Malaysia population.
Zamzam water is blessed water originated from Mecca and is believed by Muslims to have the ability to cure illness. This ability to cure illness is due to the fact that zamzam water has higher concentration of minerals especially sodium, calcium and magnesium which play a vital role. Sodium is reported to be involved in the regulation of the Mu-Opioid Receptor, which indirectly leads to the production of cAMP. Hence, this current study was carried out to investigate the synergistic effects of zamzam water and methadone combination on cAMP levels in human primary glioblastoma cell line (U-87 MG) after chronic morphine administration. Materials and Methods:The time course and concentration of morphine on U-87 MG cell line was determined. The U-87 MG cell line was incubated with morphine (25 μL/mL) for 24h, to make the cell dependent on morphine and later treated with different combinations of 3.2 mL of zamzam water and methadone (5, 10, 25 μL/mL). The levels of cAMP was determined using the enzyme-linked immunosorbent assay kit. Results:The result revealed that 3.2 mL of zamzam water incubated with 10 μl/mL of methadone significantly prevented the overshoot production of cAMP level (p