Tooth restoration is a common, routine procedure among dentists but still has its own difficulties especially for posterior teeth. As it is a straightforward procedure, some dentists are not aware of the difficulties that may contribute in reducing the longevity of the filling. The aim of the study is to determine the difficulties encountered during and after placement of restorative materials in deep cavities. Materials and methods:Standardized questionnaires were divided randomly among general private dental practitioners in Kuala Lumpur. Chi-square test was used to determine any significant factors associated with difficulties of material placement. Results:This study showed that the most frequent difficulties encountered among practitioners were to obtain good moisture control (39.0%). No significant association was found between obtaining good moisture control and year of clinical experience (p= 0.286) and also place of graduation with the manipulation of the materials (p= 0.542). Conclusion:Dental practitioners claimed that it was difficult to obtain good moisture control in placement of posterior restoration. Thus, it is an obligation of dental practitioners to practice proper isolation and good manipulation of materials on posterior restoration.
Oxidative stress induced by excessive and unopposed levels of reactive oxygen species in male reproductive system results in impaired sperm quality, fertilization capacity and poor embryo development. Our goal is to assess the potential effects of Aquilaria malaccensis(AM) leaves, a plant with strong antioxidant property on early embryo development in vitroand embryo quality following fertilization with cyclophosphamide (CP) exposed rat sperm. Materials and Methods:Twenty four male Sprague Dawley rats were allocated into eight groups of three rats (n = 3): control, CP only (200 mg/kg), AM only (100 mg/kg, 300 mg/kg and 500 mg/kg) and CP + AM (100 mg/kg, 300 mg/kg and 500 mg/kg). Animals were sacrificed after 63 days of treatment and sperm from caudal epididymis were taken for in vitrofertilization (IVF) with oocytes from untreated female. Fertilization, embryo division and embryo morphology were examined at 8 and 48 hours post insemination and compared between groups. Statistical evaluations were performed using Chi-Square test and Fisher’s exact test and p-value
Hypertension is the most prevalent risk factor of cardiovascular diseases in Malaysia. 17.3% of hypertension cases in Malaysia is attributed to adults aged 18 to 39 years. Psychosocial distress is a possible risk factor for elevated blood pressure in young adults, and cortisol could be the mediating factor. The aim of this study is to evaluate the mediating role of cortisol in hypertension and psychosocial distress in young adults. Methods and materials:A comparative cross-sectional study was conducted in 240 young adults aged 18 to 45 years. The body mass index, waist circumference and blood pressure parameters were recorded. Serum cortisol, creatinine, fasting blood glucose and lipid profile were measured following acute mental stress test. Psychosocial distress was assessed using the DASS-21 questionnaire. Results:Mean (standard deviation) values for SBP, DBP, MAP were 126.0(16.3), 84.1(12.2) and 98.1(13.1) mmHg respectively. Anxiety was significantly associated with systolic blood pressure (β=0.644), diastolic blood pressure (β=0.454) and mean arterial pressure (β=0.516) after adjusting for sex, age and cortisol. However, it was not mediated by cortisol. Depression and stress were not found to have any effect on blood pressure of the young adults studied. Conclusion:The data suggest that there is no elevated risk for psychosocial distress and hypertension that cortisol poses in young adults.
Preclinical studies have reported that Murraya koenigiileaves (MKL) could enhance memory. MKL is also known for its antioxidant activity. The current study was to assess the possible neuroprotective potential of MKL methanolic extract in a two vessel occlusion (2VO) rat model of partial global cerebral ischaemia. Methods:Rats were divided into memory and learning groups. Each group was subdivided into sham control, untreated 2VO and MKL-treated 2VO subgroups. The Morris water maze test was implemented to assess the rats’ cognitive function postoperatively. Brain samples were histopathologically examined for viable neurons within the CA1 hippocampal region. Results: Water maze test findings showed that MKL positively improved memory and learning impairments. However, this improvement in memory test for the treated group was still significantly inferior to that of the healthy control group. Additionally, MKL treated group exhibited insignificant difference in the number of viable hippocampal CA1 pyramidal neurons from that of the untreated 2VO group, whereas both MKL treated and untreated 2VO groups showed significantly less viable neurons when compared with the control group. Conclusion: MKL extract modestly improved memory without providing substantial neuroprotective action to the hippocampal neurons in rats with chronic partial global cerebral ischaemia.
Methicillin-resistant Staphylococcus aureusis globally a major public health threat. Resistance to methicillin originates from a modified protein (PBP2a) encoded by the mecAgene. The PVLgene as an important virulence factor increases the pathogenicity of MRSA. Epidemiology and characteristics of MRSA differ in different geographical regions. This study was conducted to characterize and determine the antibiotic susceptibility profile of MRSA strains isolated from patients in Hospital Tengku Ampuan Afzan, Pahang, Malaysia and to detect the presence of the mecAand PVLgenes in the isolates. Materials and methods: In this study a total of 36 isolates of MRSA have been collected during a period of three months (1stFebruary –30thApril 2018). The susceptibility pattern of the isolates to ten different commonly used antibiotics were determined and the target genes were addressed by real-time PCR experiment. Results: Based on the identifying criteria, 44.4% of the isolates were CA-MRSA, and 55.5% were HA-MRSA. Resistance to oxacillin, cefoxitin and penicillin was 100%, gentamicin 88.8%, erythromycin 33.3%, tetracycline 77.7%, trimethoprim-sulfamethoxazole 61.1%, clindamycin 13.8%, chloramphenicol 11.1%, but no resistant strain of vancomycin was detected. Most of the isolates were resistant to more than three groups of antibiotics. Real-time PCR revealed that all the isolates were mecApositive and 4 isolates were PVL-positive. PVL-positive strains were CA-MRSA and susceptible to clindamycin. Conclusion: The study confirms multi-drug resistant MRSA in the study area, and shows that resistance to methicillin is mecAmediated. PVLcarrier strains were present and related to CA-MRSA strains of the isolates.
Myeloproliferative neoplasm (MPN) is a group of myeloid disorders which leads to erythrocytosis, thrombocytosis and leucocytosis. MPN with BCR-ABL positive is chronic myeloid leukaemia (CML) while BCR-ABL negative MPN includes polycythaemia Vera (PV), essential thrombocytemia (ET) and primary myelofibrosis (PMF). One of the major criteria for diagnosis of BCR-ABL negative MPN is the presence of JAK2-V617F mutation which is positive in 95% of PV and around 60% of ET and MF. Beside peripheral blood specimen, formalin-fixed paraffin-embedded (FFPE) marrow specimen can be used for detection of this mutation. Unfortunately, FFPE produces low quality DNA that put a challenge for successful amplification of DNA. We aimed to evaluate the utility of High Resolution Melting (HRM) analysis for detection of JAK2-V617F mutation in FFPE specimen from MPN cases. Materials andMethods:This study is a descriptive cross-sectional study. Forty FFPE marrow specimens were retrieved from the years 2014-2016. Bio-Rad Precision Melt Analysis software was used for analysis of HRM data. Allele-specific PCR was done for validation of results. Positive samples were subjected to Sanger sequencing. Results:JAK2-V617F mutation was positive in 13 out of 40 MPN cases. Level of agreement between HRM and AS-PCR was 97.5%. Conclusion:HRM is a rapid and powerful diagnostic assay which is suitable for detection of JAK2-V617F mutation in FFPE marrow specimen.
Hypertensive Disorders of Pregnancy (HDP) is an independent risk factor of cardiovascular (CVS) disease with endothelial dysfunction postulated to be the pathophysiology. Endothelin-1 (ET-1), a potent vasoconstrictor, has been identified as a pivotal mediator in HDP. Disturbances in nitric oxide (NO) bioavailability found in endothelial dysfunction may increase susceptibility to cardiovascular diseases such as hypertension. The study aims to determine serial ET-1 and NO levels in patients with HDP and its role in persistent endothelial dysfunction. Materials and Methods: Thirty-six pregnant women from the following categories (i) normal pregnant women (Control) (ii) chronic hypertension during pregnancy (CH) and (iii) pregnancy induced hypertension (PIH) participated in this study. Blood pressure indices measurements and sample collection were done at antepartum (32 weeks) and postpartum (8 weeks and 12 weeks). ET-1 and serum NO were measured using the Human ET-1 (Endothelin-1) ELISA Kit and Nitric Oxide (total) detection kit respectively. Results: Serum ET-1 was significantly higher in patients with CH (55.3 pg/ml) and PIH (35.6 pg/ml) compared to Control (11.8 pg/ml) during antenatal until 3 months postpartum (CH 38.3pg/ml, PIH 29.5 pg/ml, Control 1.9 pg/ml). This was accompanied by significantly lower levels of serum NO in HDP patients. Conclusion: Persistently higher than normal levels of ET-1 and lower than normal levels of NO up to 3 months postpartum in patients with history of HDP indicate presence of persistent endothelial dysfunction despite BP normalisation in PIH patients. Long term NO/ET-1 imbalance may account for the increased CVS disease risk.
Soil-transmitted helminth (STH) infections by Ascaris lumbricoides, Trichuris trichiuraand hookworms still persist in rural and urban areas of developing communities. Recent studies in Malaysia focused on Orang Asli communities and none in the hospital settings. This study aimed to investigate the prevalence and associated risk factors for STH among children admitted to Paediatric ward of the Hospital Tengku Ampuan Afzan (HTAA). Materials and Methods: This study was conducted among 135 (78 males, 57 females) patients in HTAA from December 2017 to May 2018. Faecal samples were examined using wet smear, Kato-Katz, Harada-Mori and sedimentation techniques. Demographic data and hygiene practice information were collected using a pre-tested questionnaire. Results: The overall prevalence of STH was 5.9% (A.lumbricoides 5.2%, T.trichiura0.7%, and hookworms 0.7%). Prevalence among males was 3.8% and females 8.8%. Majority (95.6%) were Malays. Chi square analysis showed that factors significantly associated with STH infections are household monthly income (p
Modern-day Malacca is a vibrant old city with a unique historical and cultural background from being the capital of a powerful Malay kingdom before the colonial era, as well as subsequent Portuguese, Dutch and British rule. The city centre was listed by UNESCO as a World Heritage Site in July 2008, many tourists come to Malacca to visit historical sites and tourism, so homestay facilities need to be available to their families Homestay a stay at a residence by a traveller and especially by a visiting foreign student who is hosted by a local family. In this study, propose a smart digital door lock system for homestay system. A digital door lock system is equipment that uses the digital information such as a secret code, semi-conductors, smart card, and finger prints as the method for authentication instead of the legacy key system. In proposed system, a ZigBee module is embedded in digital door lock and the door lock acts as a central main controller of the overall homestay system. A door lock system proposed here consists of RFID reader for user authentication, touch LCD, motor module for opening and closing of the door, sensor modules for detecting the condition inside the house, communication module, and control module for controlling other modules. Status of individual ZigBee module can be monitored and controlled by the centralized controller, digital door lock. As the door lock is the first and last thing people come across in entering and leaving the homestay respectively, the homestay automation function in digital door lock system enables user to conveniently control and monitor homestay environment and condition all at once before entering or leaving the house stay. Furthermore, it also allows users to remotely monitor the condition inside the house through Internet or any other public network.
This study aimed to determine the level of knowledge and compliance with eye care in related to vision complications within the community. Quantitative methods with cross-sectional survey design were applied using simple randomized sampling method. Modified questionnaires from the National Eye Institute Visual Functioning Questionnaire Version 2000 Recorded were distributed to (how many) participants and the data were analyzed using SPSS. Results showed that the level of knowledge and adherence to practices are highly related to eye care , while the complications of sighting in diabetic patients are relatively low. In conclusion, this study have shown that although knowledge levels and adherence to eye care practices are at a high level, eye complications due to diabetes still occured. Therefore,more holistic approach should be given attention to increase awareness of the complications of vision that can lead to blindness as well as more comprehensive diabetes complications so that the severity of complications can be controlled and prevented.
Lignin is a complex phenylpropanoid polymer which present between the cell-wall of plant cells and the second largest biomass after cellulose. This structural component is important in plant as they provide physical strength imparting stiffness to the plant cells that enables the plant to transport water and solutes through the treachery elements in plant vasculature system. In pulp and paper industry, delignification is an important step to produce high quality of fiber for paper making. Nevertheless, hindrance from lignin recalcitrant has make pulping process inefficient in both chemical and mechanical methods. This has resulted in pulping process to use more chemicals, high energy consumption and releasing pollutants to the environments. A greener technology or enzyme-based processing might be one of the alternative to improve pulping process. Researchers have been studied to remove lignin using enzymes produced by isolated microorganism from the gut of wood feeding insects or soil. This paper will provide a review on lignin and previous studies about lignin degradation using enzymes such as lignin peroxidase, manganese peroxidase, versatile peroxidase, dye-decolorizing peroxidase and laccase. The discussion in this paper is focused on issues pertaining the efficiency of using enzymes to degrade lignin which also known as bio-delignification. Also, the challenges in implementing bio-based method for pulping process is mentioned in this paper.
Statistics is one of the most important quantitative subjects in higher education. However, statistics subject is unappealing to many average students with varying background. Traditional teaching method of statistics which tend to emphasize on rote learning and heavy calculations can cause students to have negative perception thus stir anxiety towards statistics learning. Therefore, to address all these negative perceptions, it is important for educators to make a significant improvement in their teaching approach to make learning more dynamic, meaningful and inspiring. This study is aimed primarily to highlight the factors of a research instrument used to evaluate the implementation of a developed interactive learning tool namely XRace game board in providing active learning. An exploratory factor analysis suggested that out of 33 variables evaluated, there are six domains which account for 71.78% of the total variance which considerably reduce the complexity of the data set with 28.82% loss of information. Kaiser-Meyer-Olkin value is 0.895 and Bartlett's test p-value=0.000 < 0.05 indicate factor analysis is feasible for this data set. There is no item removed since the communalities values are all above moderate (min=0.583, max=0.837). The principal component analysis with Varimax rotation method revealed six domains in term of Motivation, Novelty, Fun learning, Commercialization, Product features and Eco friendly. The results suggested that these six important domains were considered in the evaluation of the learning tool and the possibility of utilizing it in teaching any difficult courses in an interesting and engaging way without loss of rigor.
Total thyroidectomy or at least hemithyroidectomy is routinely performed alongside total laryngectomy in patients with advanced carcinoma of the larynx. Life-threatening hypocalcaemia and hypothyroidism are common sequelae especially with adjuvant radiation. The study aims to determine the incidence of microscopic thyroid gland invasion and challenge the idea of routine thyroidectomy in advanced carcinoma of the larynx. Materials and Methods:This study was a retrospective observational study. It was done in two tertiary centres in Malaysia between 2003 and 2013 for a total duration of 11 years. A total of 72 patients were included in this study. Data from medical records, operative notes, and histopathological reports were collected and analysed. Results: Three patients (4.2%) had the presence of microscopic thyroid gland invasion. There were no significant associations between microscopic thyroid gland invasion and tumour subsites, histological types of a tumour nor T staging (p>0.05) Conclusion: The incidence of microscopic thyroid gland invasion in advance carcinoma of the larynx is low, disavowing routine thyroidectomy. Limitations: Some factors such as cartilage invasion on CT imaging and central lymph node treatment were not considered due to limitations in case documentation.
Post-menopausal osteoporosis is the most common type of osteoporosis, which occurs due to a deficiency of oestrogen following menopause. Considering the adverse effects of oestrogen replacement therapy, natural products may serve to replace the current conventional treatment. Ficus carica (FC) which is commonly known as fig may have a potential in treating post-menopausal osteoporosis due to their abundance of important minerals and bioactive compounds such as phenolic, flavonoid and anthocyanins. This study aimed to evaluate the effects of FC on bone metabolism of ovariectomized rats. Materials and Methods:Fifty-six female Spraque-Dawley rats were randomly divided into seven groups; SHAM operated (SHAM), ovariectomized control (OVX), ovariectomized + 64.5 μg/kg oestrogen (ERT), ovariectomized + 50 mg/kg aqueous extract of FC(AQ50), ovariectomized + 100 mg/kg aqueous extract of FC (AQ100), ovariectomized + 50 mg/kg raw FC (RW50), and ovariectomized + 100 mg/kg raw FC (RW100). After eight weeks of treatments, rats were euthanized and femurs were dissected out to measure bone osteocalcin, C-telopeptide of type 1 collagen and bone estrogen level. Results:RW50 and RW100 showed an increasing trend in osteocalcin levels and also oestrogen level, but no significant difference between all groups. RW50 and RW100 also showed significantly reduced C-telopeptide of type 1 collagen levels compared to OVX group. Conclusion:These findings suggested that raw FC at the doses of 50 mg/kg and 100 mg/kg have potential to improve bone in treating post-menopausal osteoporosis. However, this need to be confirmed with higher doses.
Management of disturbed wounds, large skin defects and the areas where skin tension precludes wound closure is of high clinical importance. Healing in wounds occurs through epithelization and contraction processes (second-intentions healing) that may result in certain undesirable complications including keloid and formation of a fragile epithelial layer.Materials and methods: 27 white New Zealand rabbit included in this study divided into 3 groups; one group of 9 rabbits received Flaxseed gel topically for three time intervals (1, 7, and 14 days); a second group received Fucidin cream as positive control, while a third group has not received any treatment as negative control, Skin elasticity measurements were performed using the DermaLab system. Results: Throughout the study, skin elasticity was significantly greater in Flaxseed group than in others. Flaxseed decrease elasticity value from (3.46 ± 2.05). Hence, Young's modulus of skin elasticity in flaxseed group was (2.46 ± 1.02) after 14 days (p = 0.003), while no significant differences were evident in both Fucidin group (1.16 ± 0.77) and non-treated group (1.86 ± 1.40) (p = 0.019), accordingly flaxseed extract more reproducible than other groups demonstrating comparable efficacy in skin elasticity and distensibility.Conclusions: This study showed the therapeutic effect of flaxseed on biologic tissue. Elasticity evaluation demonstrated increased density and firmness in the network of collagen fibers in the dermis and subcutis during wound healing process promise in generating therapeutic gel to be used in wound healing process.
Edinburgh Postpartum Depression Scale (EPDS) is a tool used to assess the risk of postpartum depression (PPD). In this study we determined the reliability and validity of the Malay version of EPDS when administered at two different time points in the postpartum period. Materials and Methods:This cross-sectional study design was carried out between May and September 2017 at three government primary healthcare clinics located in Batang Padang district, a suburban area of Perak state in Peninsular Malaysia. We recruited a total of 89 women; 41 women were in the early postpartum period (1-30 days) and 48 women were in the late postpartum period (31-120 days). Cronbach's alpha coefficient, inter-item correlation, and corrected item-total correlation were used to assess the internal consistency. The concurrent validity was assessed using Spearman’s correlation. The data were analyzed using SPSS version 20 and R 3.4.2. Results:The Cronbach’s alpha for the first and second group was 0.78 and 0.62, respectively, which indicated satisfactory reliability. At both time periods, removing Item 2 from the scale resulted in a significant increase in Cronbach’s alpha (to 0.847 and 0.709, respectively). As expected, the EPDS scores correlated moderately with the BDI-II scores (1−30 days: Spearman's rho = 0.65, p< 0.01; 31−120 days: Spearman's rho = 0.73, p< 0.01). Conclusion:The Malay version of the EPDS is a reliable screening instrument for detecting postpartum depression. It showed reasonability and feasibility and can be used in postpartum clinical settings or for assessing intervention effects in research studies. Furthermore, as our results indicated, removing Item 2 from the Malay version would increase the internal consistency of the EPDS.
Evidence has shown an increase in paediatric hypertension globally and this could give rise to increase prevalence of adult hypertension. The purpose of this paper was to determine the prevalence of hypertension among adolescents in Malaysia as well as the association between hypertension and lifestyle factors selected based on published literature. Methods:Adolescents aged 13-17 years old were selected randomly from two secondary schools to have their blood pressure measured. Their lifestyle information was obtained through completed bilingual questionnaires based on validated instruments, as well as anthropometry measurements. The relationship between hypertension and lifestyle factors was determined through statistical analysis. Results:A total of 273 students were included in the study with 120 (44%) males and 153 (56%) females. The prevalence of hypertension was 24.5% among the respondents with the highest being recorded among Malays (28.7%). Generally, hypertension was associated with an increased Body Mass Index (BMI) (AOR=4.053, 95%CI=1.677-9.795, p=0.002) and waist circumference (WC) (AOR=2.918, 95%CI=1.171-7.269, p=0.021) in all respondents. Similar associations were noted in females (BMI: AOR=7.707, 95%CI=2.043-29.072, p=0.003; WC: AOR=3.690, 95%CI=1.011-13.464, p=0.048) but not in males. Conclusion: Hypertension recorded high prevalence among Malaysian adolescents in our study. The strong association between elevated body weight, BMI and WC with hypertension may require further study to evaluate the need for screening.
Mak nyahs are locally known male-to-female transgenders in Malaysia. In Western countries, medicalization of transgenderism allows strictly selected patients to undergo sex reassignment surgery. However, a standardized treatment system is not yet available in Malaysia. A number of mak nyahs underwent sex reassignment surgery at their own will. This study aimed to explore mak nyahs’ knowledge and perception on sex reassignment surgery. Materials and Methods:A qualitative research was carried out from 13thJuly 2016 till 31st August 2016 among 8 adult mak nyahs in Kuantan, Pahang. Snowball sampling was used. Participants who gave verbal consent were interviewed individually and in focus groups. Data obtained was transcribed and used as the primary data source. Results: All informants were Malays and Muslims. They generally had some knowledge about the standard procedures and risks in sex reassignment surgery. All informants expressed their desire to have the surgery, but chose not to. Reasons discouraging them from having the surgery were: i) religion, ii) forbiddance from family, iii) fear of regret, iv) death from surgery, and v) the lack of necessity. Factors driving them to have the surgery: i) more income from sex work, ii) pressure from sex clients, iii) securing a stable relationship, iv) self-satisfaction, and v) hope for a better future. Conclusion: Religion seemed to be the main reason refraining them from undertaking the surgery. Counselling mak nyahs should include the advantages and disadvantages of sexual reassignment surgery. Islamic religious preaching is very important to help reduce high risk behaviours, as well as teaching mak nyahs to cope with challenges in adult life. Further research is necessary to show association between religious knowledge and successful rehabilitation of the mak nyahs’ community.
Exclusive breastfeeding is recommended as the optimal method of infant feeding for the first six months, but the rate remains low in many countries, including Malaysia. It is important to understand barriers preventing exclusive breastfeeding, to enable tackling these issues and thereby improving maternal and child health. This study aims to do this by exploring the knowledge, attitudes and behaviours of mothers towards breastfeeding in Sarawak, Malaysia. Material and Methods: Qualitative methods were employed, using semi-structured interviews with an interpreter, conducted in Sarawak General Hospital between 16thApril and 11thMay 2012. Convenience sampling was used to recruit participants from the maternity wards. Interviews were conducted using a topic guide, were audio-recorded and transcribed verbatim. Analysis was based on conventional content analysis, with codes and themes developing from the interviews. Results: Analysis of the 17 interviews identified five major themes; (1) positive attitudes towards breastfeeding, (2) lack of knowledge relating to exclusive breastfeeding, (3) fear of insufficient milk, (4) methods to improve awareness and knowledge of breastfeeding, (5) improvements in the workplace. There is a lack of knowledge amongst mothers in Malaysia regarding breastfeeding, causing anxiety and early discontinuation of breastfeeding. Methods to improve education of mothers and healthcare staff have been suggested, as well as improvements to encourage breastfeeding in the workplace. Conclusion: Focused education for new mothers and widespread community education may help improve breastfeeding continuation rates. The provision of workplace facilities and flexible working hours for new mothers may help overcome physical barriers preventing breastfeeding continuation once back at work
The demand for enzyme as biocatalyst is increasing for biotechnological based industry. This is due to their ability to catalyze specific biochemical reactions and able to generate products that have significant commercial value. Some of these enzymatic reactions cannot be replicated using conventional organic synthesis process. On the other hand, insects have evolved and established various enzymatic pathways that are not only important for their survival but also valuable. Therefore, scientists and engineers are searching a way to utilize insect’s enzyme for industrial processing as an alternative for greener technology. A high-level idea about how the biological systems work, evolve and interconnect in nature is essential in order to put the application into the industry. A new field of innovation to increase performance and reliability, discoveries are in turn solving some of technology’s greatest challenges as the demand for cleaner and greener technology is rising. This paper will review on the application of insect’s enzyme as a biocatalyst in the field of biopharmaceutical, agricultural, food and pulp and paper industry.