With the development of mobile computing, the focus of the marketing media has shifted from traditional media to social media. We are no longer solely reliant on the newspapers, radio and television for marketing. In fact, people are inclined to go online on social media every day. One of the popular social media today is WeChat. As a mobile app, WeChat has been widely used for social networking and business purposes. Due to the lack of literature in developing effective strategies in using WeChat in marketing, the present study serves as a groundwork to explore the subject matter in Malaysia. This study investigated the strategies on how to use WeChat as a marketing tool to create awareness of self-branding, which leads to enhanced relationships and increased sales. To conduct this research, qualitative method which involved observations and interviews was used to gather the data. Observations in WeChat groups and WeChat Moments were carried out. Thirty interviews were conducted to elicit the ideas or beliefs from WeChat users who are micro e-marketers. All the data collection was subsequently analysed using content analysis. Results indicated that effective WeChat marketing strategies are composed of four main aspects and they are labelled as WeChat followers strategy, WeChat self-branding strategy, WeChat Moments strategy and WeChat groups marketing strategy. This exploratory study contributes a fundamental knowledge about strategies of using WeChat marketing to address why people buy from you and not others. The research results provided insights into how WeChat can be used as a platform to establish, keep and satisfy the customers; create job opportunities for society and overall, bring welfare to the nation.
Chronic Lymphocytic Leukaemia (CLL) is a common type of leukaemia in persons of predominantly European descent but is rare in the Asian population. Disparities in CLL incidence among people of Asian and European descent may be related to the genetic make-up of the two different populations. Hypermethylation event might be one of the silencing mechanisms that inactivate the tumour suppressor genes in CLL. The aim of this study was to determine the hypermethylation status of p16INK4aand p15INK4bamong CLL patients and normal individuals. Materials & Methods: A total of 25 CLL patients and 25 normal individuals were recruited for this study and their genomic DNA were extracted from the peripheral blood. The hypermethylation status of p16INK4aand p15INK4bweredetermined using Methylation Specific-PCR (MS-PCR) whereas DNA sequencing method was applied to selected samples for validation of the MS-PCR results. We also evaluated the association between hypermethylation of these genes with the clinical and demographic characteristics of each group of subjects. Results: Among the CLL patients, p15INK4bpartial-methylation occurred in 6 (24%) subjects while methylation occurred in 1 (4%) subject. All the remaining patients were unmethylated at p15INK4b. All the samples showed unmethylation at p16INK4a. Statistically significant associations were found between p15INK4bhypermethylation with the presence of CLL (p=0.01) and with race (p=0.02). Conclusion: Further study using a larger sample size is warranted to explore the significance of DNA methylation incidenceamong the CLL patients of the Malaysian population. Hence, we suggest that hypermethylation at p15INK4bhas a huge influence that kick-starts CLL disease among Malaysians and MS-PCR technique is applicable to be used in methylation study.
Currently, there is a lack of clinically feasible and reliable method for discriminating outcome in sepsis. We aimed to derive a new bioscore for predicting mortality in critically ill patients with sepsis using a combination of biomarkers and clinical indexes. Materials and Methods: This was a secondary analysis from a prospective study involving 159 patients with sepsis admitted to an intensive care unit (ICU). Data for key variables considered for possible inclusion in the score were collected, which included: age, sex, source of admission, comorbidities, microorganism, bacteraemia, site of infection, septic shock status, baseline Simplified Acute Physiological Score II, Sequential Organ Failure Assessment (SOFA) score (total and organ sub-scores), C-reactive protein, procalcitonin and interleukin-6 (IL-6). Approximate quintiles of each variable were given points as per the strength of their association with 30-day mortality. Results:In accordance with the statistical significance in the logistic regression analysis, the final score utilised candidate variables of age, central nervous system and liver SOFA sub-scores and IL-6. The bioscore predicted 30-day mortality with a very good performance [area under the receiver operating characteristic curve 0.814 (95% confidence interval 0.745-0.871, p
Subclinical changes that occur in the heart at an early age may provide valuable information to outline prevention strategies for cardiovascular diseases. Heart rate variability (HRV) reflects regulation of autonomic balance, heart, and vascular tone, which are the determinants of blood pressure. Therefore, this study aimed to determine the difference in heart rate variability (HRV) of Malay male young adult with their BMI and adiposity level. MATERIALS AND METHODS:A total of 201 Malay male young adult aged between 19 to 24 years old were screened and their BMI and adiposity level were measured. Three non-invasive tests; Valsalva Manoeuvre, orthostatic response and 30/15 ratio of heart rate were performed. Short term HRV time and frequency domains were recorded. RESULTS:Despite few significant differences in HRV parameters of overweight/obese subjects, the result is inconclusive to conclude any reduced variability. However, those with high adiposity regardless of their BMI reported significantly lower mean of R-R SD in time domain and lower mean of LF/HF ratio in frequency domain. The orthostatic reflex results revealed that high adiposity subjects had significantly lower mean of LF and HF. A decrement of -0.28 ms2HF/LF during Valsalva manoeuvre, -0.35 LF ms2in orthostatic reflex and 0.33 ms2in orthostatic reflex per 1% of body fat percentage were observed. CONCLUSION: HRV parameters were inversely proportional to the adiposity level which was suggestive of modulation of sympathetic function can occur at an early age.
The purpose of the study is to determine the optimal condition for mixing factors of natural cellulose or epoxy composite by using response surface method. Three mixing factors selected for the study were degassing agent content, stirring time, and sonication time. As a response, the fracture toughness of the composites was determined by using single edge notch bending test. The level of each factor was selected at 3 conditions which were low, medium, and high. The analysis of variance showed degassing agent content and sonication time were the most significant factors affecting the fracture toughness of the composite. The optimal conditions for mixing factors were 1.34 wt% degassing agent content, 5 minutes for stirring time, and 60 minutes for sonication time. The predicted fracture toughness was 1.6836 MPa.m0.5 with a desirability value of one. Three validation experiments were conducted to test the generated mathematical model and results showed the percentage difference was in the range of 6% to 15%.
Serumosmolality measured by cryoscopic techniquein laboratory is the reference method.In clinical settings,serum osmolality measurement is notfeasible at bedside. In normal subjects, sodium, potassium glucose, and urea are the primary circulating solutes. These solute concentrations can be used to predict measured osmolality if no other solutes present at high millimolar concentrations.Many equations of serum osmolality have been proposed. The osmolal gap (OG) is the difference between measured osmolality and calculated osmolality.The major use of OG is to screen for presence of exogenous toxic substances and to screen alcohol intoxicationcases.Aim/Objective: The purpose of this study was to compare the calculated osmolality using various formulaewith the measured osmolality to determine which calculated formula fit best with measured osmolality.Materials and Methods: Serum osmolality resultsfromJanuary 2015 to December 2015 were extracted from the laboratory information system (LIS). Serum osmolality performed simultaneously with renal and liver function tests, serum electrolytes and plasma glucose were included.Serum osmolality measured for patients with the history of drug abuse and poisoning were excludedfrom the study.405serum osmolality results were chosen and divided into two groups. Group 1 included 205data with normal serum osmolality, renal, liver function tests and plasma glucose level less than 7.8 mmol/L.For the second group (n=200), data with low serum osmolality (n=90) and high serum osmolality (n=80) and normal serum osmolality (n=30) were included. Group 1 data was to identify which equation correlated with the measured osmolality and the Group 2 datato study the performance of equationthat correlated with the measuredosmolality.Results: Only four out of19 formulae were identified as optimal by havingthemean OG ≤ 2 mOsm/kg. The Smithline-Gardner formula (2Na+ Glu + BUN) showed the smallest osmolal gap with mean bias 0.3mOsm/kg. The Dorwart-Chalmers formulaincorporated in most autoanalysers for calculation of osmolalityunderestimatedcompared to measured osmolality.Conclusion: We recommend Smithline-Gardner formula for calculation of osmolal gap, as the OG gap is close to zero, simple, easy to calculate at bedside and easily incorporated in the Laboratory Information System.
Parapharyngealspace tumor has been known to be uncommon. It accounts only about 0.5% of head and neck neoplasm.Most of the lesions are benign in nature and salivary gland neoplasm being the most common.A 32-year old Ma lay gentle man presented with long-standing parapharyngeal mass which m ialized the latera l pharyngeal wa ll. Biopsy was taken intraorally by soft pa late mucosal incisionrevealed carcino ma e x-p leo morphic adeno maand t ranscervical approach successfully re moved the mass in total. Post-operative radiotherapy was commenced and patient is we ll until recent fo llo w up.Despite of the rarity of pleomorphic adenoma in parapharyngeal space, it should be a mong the differential diagnosis and a complete removal should be the aim as ma lignant transformation is possible in this type of pathology. Computed tomographyscan e xtending fro m base of skull till upper thora x a re important in p lanning the approach for complete removal of the mass followed by radiotherapy in malignant transformation cases.
Dengue is an emerging mosquito-borne viral infection transmitted between humans by Aedesspp. The rapid growth of dengue cases globally created a public health challenge in managing it. Since the dengue is a viral disease, a patient usually presented with non-specific clinical features with no definite drug or vaccine proven to treat it. Hence, a simple diagnostic tool for the early phase of the illness, early supportive treatment and efficient vector control measures are the essential elements in a holistic approach to managing a dengue infection. However, with a non-specific presentation of the disease and high variability of rapid diagnostic test sensitivity and specificity, the diagnosis is more challenging. The failure of detecting dengue infection, especially the severe variety may lead to a grave consequence. This case illustrates how a non-specific presentation with false negative diagnostic test result leads to unnecessary surgical intervention in a severe dengue patient.
Different disease risk for diabetic nephropathy (DN) may be partly due to the diverse genetic susceptibility of the disease. This systematic review aimed to identify the genetic variants with a substantial effect on DN and to evaluate the genetic models used in the reviewed studies. We searched the ScienceDirect and PubMed databases for all eligible studies comparing genetic variants in patients with and without DN from 2005-2016. We included a total of 14 studies and identified 13 genes with 17 related variants. The OR was from 2.9 to 9.95. The genes were involved in the pathogenesis of DN via the hemodynamic (ACE, AGT, AGTR1), metabolic (ACACB, MTHFR, PPARGC1A) and inflammatory (TNF-, TGFβ1, eNOS, CCR5, HSP70-1, MPO, OPN gene promoter) pathways. The results of these studies were presented according to pre-specified genetic models: basic, additive, dominant and recessive. No genetic model selection was biologically justified. We identified 17 genetic variants that were significantly associated with DN and were determined using different genetic models. To reduce error, further replication with the best genetic model should be carried out to determine the role of these variants in DN.
The discovery of new antimalarial drugs from medicinal plants is urgently neededdue to the development of multidrug-resistant Plasmodium falciparum. Therefore, Piper sarmentosum(kaduk), a commonly used as a herbal medicine to treat malarial symptoms was screened for antimalarial as well as toxicological activities of their methanol and water leaves extracts. The inhibitory concentration (IC50) of P. sarmentosum methanol and water extracts against a chloroquine-sensitive strain (3D7) of P. falciparumwas determined by using a malarial SYBR Green I-based fluorescence (MSF) assay. The lethal concentration (LC50) of the plant extracts was evaluated by using a brine shrimp lethality test (BSLT). The presence of heavy metal contents in the crude extract was alsodetected by using an atomic absorption spectrometry (AAS). Both methanol and water extracts showed an inactive antimalarial activity with an IC50value of 138.8 ± 0.122 μg/mL and 229.7 ± 0.125 μg/mL, respectively. The water extract was considered non-toxic (LC50= 2741.7 3.16 ppm), while the methanol extract was toxic (LC50= 894.94 0.018 ppm). The heavy metals such as plumbum (Pb), zinc (Zn), cadmium (Cd) and chromium (Cr) were identified in the crude extract but they were below the safety limits recommended except for arsenic (As). Further investigations are required to determine the toxicological profiles of P. sarmentosum extracts on mammalian models.
De Quervain's tenosynovitis is a common cause of radial sided wrist pain and is described as an entrapment tendinitis of the tendons in the first extensor compartment. Physiotherapy and splinting are initial conservative treatment. Steroid injections are an effective treatment modality but may fail due to the anatomical variation in the first dorsal compartment of the wrist. We present a 39-year-old female who failed conservative treatment. She received a steroid injection, but symptoms resolved for 6 months only. We proceeded to surgery and noted three subcompartments consisting of one for the extensor pollicis brevis and two for the abductor pollicis longusas opposed to one extensor compartment. The steroid injection may have failed to infiltrate all the subcompartments resulting in treatment failure. General practitioners and surgeons must be aware of this variation if there are to provide effective treatment. Ultrasonographic guidance may be required for steroid injections in recalcitrant de Quervain's disease.
Probiotics are the food products containing live microorganisms which when up-taken in sufficient quantities, converse health benefits to consumers. This study was aimed to find parental awareness, level of utilization, assessment of their experiences and sentiments about probiotics among their children.This descriptive study was undertaken in King Edward Medical University Lahore during July 2017 to January 2018. A total of 127 questionnaires were successfully completed comprising 45 (35.5%) from health care staff, 52 (40.9%) from parents visiting pediatric outpatients and 30 (23.6%) from school teachers. Maternal parent remained predominant in this study as there were 109 (85.8%) female and 18(14.2%) male respondents. Only 20(15.7%) were familiar with the term probiotics, 49 (38.6%) were somewhat familiar while 58 (45.6%) had no idea about term. On pursuing about preferences regarding probiotics use majority 106/127 (83.5%) of parents like to available in liquid as it is easy to consume for children. Use of probiotics among children is not very much common however it is been prescribed for number of gastrointestinal problems. Only a limited class of people is familiar with health benefits probiotics. Around 20% users do not know about the organism present in specific probiotic is also of astonishing. Due to different social set up health care providers and family physicians must discuss about the dietary supplements in terms of potential risks and benefits
The prevalence of premarital pregnancy among adolescents in Malaysia is alarmingly on the rise. In finding ways to curb this, it is important toexplore on their reproductive health knowledge. Although knowledge alone will not influence adolescent’s behaviour, it is one of the most important factors that affect their reproductive health. The study aimed to assess the reproductive health knowledge of premarital pregnant adolescents in adolescent rehabilitation centres in Malaysia and the associated factors. A cross-sectional study involving premarital pregnant adolescents staying in adolescent rehabilitation centres in three states (Kelantan, Johor and Penang) was conducted for one month. Thirty-three eligible adolescents participated through a self-administered validated questionnaire which assessed their knowledge on reproductive organs, sexual activity and pregnancy, contraception and complications of sexual activity.Majority of participants scored well in terms of correct responses in reproductive organs, sexual activity and pregnancy as well as complications of sexual activity. However, they obtained the least correct responses in contraception as evidenced by these responses: having a hot shower after sexual intercourse prevents pregnancy (30.3%) and vaginal washing after sexual intercourse prevents pregnancy (33.3%). Their main source of information on reproductive health was from mass media (72.7%), and eighty two percent participants were not willing to discuss about sex with their parents. A multiple linear regression analysis showed that the mean knowledge score was significantly influenced by four factors namely age at first coitus, history of rape, age of partner at first coitus of the girl and watching pornography. The premarital pregnant adolescents have good knowledge on reproductive health except on pregnancy prevention. The information taken from mass media has failed to equip them with the correct knowledge on contraception. This warrants the need to adjust the current reproductive health education to be more children-and adolescent-friendly so it can be the point of reference in the future
Objective: The aims of this study were to compare associations between dental health and pregnancy circumstances, birth history and early childhood health in children with and without Molar-Incisor Hypomineralisation (MIH). Methods: A matched case-control (n=101) study investigated perinatal and early childhood factors that could be associated with development of MIH. Case group (n=46) children (with MIH) were identified from the University of Otago Paediatric Dentistry Clinic. Control group (n=55) children (matched for age and gender, and with no signs of MIH) were selected from another clinic. Clinical examination recorded dental enamel defects and caries status. Pregnancy history and the child’s development and medical history were recorded by questionnaire. Mothers and children’s birth records were examined. Results: There were no significant socio-demographic differences between case or control groups. Children diagnosed with MIH had more problems at birth, including oxygen deprivation, one or more signs of foetal distress, premature birth or low birth weight. More mothers of MIH children had received drugs during delivery, including nitrous oxide, pethidine, or antibiotics. Conclusion: In this study, premature birth was found to be significantly associated with the occurrence of MIH.
This study aimed to integrate polyether sulfone (PES) membrane with hydroxyapatite synthesized from fish scale biowaste (HAp) to form ion exchange membrane. The PES incorporated by self-assembled with different concentrations of HAp solution; 0.2, 0.4, 0.6, 0.8 and 1.0 wt%. The prepared ion exchange membranes were characterized regarding permeability coefficient, porosity, morphology, ion exchange capacity (IEC), AT-IR, and fouling analysis. The promising characteristics and outstanding performance demonstrated by PES membrane incorporated with 0.8 wt%. Via SEM images and ATIR spectra, the PES/HAp-0.8 membrane depicted the adequate number, well distributed and low agglomeration of HAp onto the membrane surface with a strong attachment. The membrane also demonstrated good ion exchange capacity around 49%. Permeability coefficient for PES/HAp-0.8 membrane was 101.5 L/m2.h with 87.69 % membrane porosity.
The plug-in hybrid electric vehicle (PHEV) has received extensive attention due to the alternatives it provides for reducing the dependency on petroleum. Nowadays, many simulation software such as ADVISOR and AUTONOMIE, were built to help in PHEV research. In this paper, the effect of three main PHEV powertrains such as engine power, traction motor power and battery capacity on fuel consumption, electric consumption and carbon oxide emission is studied using AUTONOMIE. The simulation is designed and run using AUTONOMIE with example of commands used in MATLAB. The overall simulation results show that the fuel consumption decreases as the motor power increases with the same battery capacity and engine power. In additions, the simulation results also show that the electric and fuel consumptions are contrary to each other. Meanwhile, the carbon oxide emission and fuel consumption increase following each other’s.
In this paper, the water driving cycle had been chosen to determine and compare the component sizing of conventional boat and Plug-in Hybrid Electric Recreational Boat (PHERB) powertrains. PHERB is an improvement on conventional boat to reduce the fuel consumption and emissions. The locations of water driving cycle in this research are at Pulau Kapas and Tasik Kenyir, Terengganu. Boat energy and power requirement was calculated according boat parameters, specifications and performance requirements to study the differences component sizing of conventional boat and PHERB powertrains. Power flow analyses are used to decide the size and capacity of main components for achieving the design specifications and requirements of conventional boat and PHERB powertrains. The results for PHERB powertrain requirement using steady state velocity are 20 kW at 3000 rpm for Internal Combustion Engine (ICE), 30 kW for Electric Machine (EM) and 5 kWh for Energy System Storage (ESS). The acquired results show that the PHERB gained the most existing powertrains and has extraordinary potential in applications to marine transportation in reducing fuel consumption and emission.
Objective: The main objective of this study is to compare patients’ outcome in anticoagulation treatment before and after Warfarin Medication Therapy Adherence Clinic (WMTAC). The study compares the cost of INR test between usual care (UC) and WMTAC. The study also determines factors affecting International Normalized Ratio (INR) level among WMTAC patients.
Methods: A retrospective study involving WMTAC patients was conducted by trained pharmacists at Dungun Hospital. Patients were reviewed by UC for 4 months and continuously followed up by WMTAC for another 4 months were included in this study. Patients who passed away, transferred out and defaulted were excluded from the study. The data were derived from Patient Medical Record and recorded in Warfarin Data Collection Form for analyze.
Results: The time in therapeutic range (TTR) was 73.46% for WMTAC and 45.58% for UC (p
Introduction: All pharmaceutical products in Malaysia must be registered with the Drug Control Authority (DCA) whereas cosmetics must be notified with the National Pharmaceutical Regulatory Agency (NPRA). Availability of unregistered products and unnotified cosmetics in the market are longstanding issues affecting public safety and health. It is vital that all government healthcare personnel (GHP) as the front liners are equipped with the knowledge to properly advise the public on this issue.
Objective: This study aims to determine the level of knowledge towards registered products and notified cosmetics among various groups of GHP under the Ministry of Health facilities in Labuan.
Methods: This was a cross-sectional study performed from August to November 2017 using a validated 12 question questionnaire. Respondents were divided into 4 groups (doctors/dentist, pharmacist, nurse, allied healthcare professional) and results between the groups were analysed using Chi-square analysis. Respondent’s knowledge was given score and those who scored 9 marks and above were considered to have good knowledge. Those who scored 8 marks and below were considered to have poor knowledge.
Results: Only 40.2% Pharmacists have the highest score of good knowledge on registered products and notified cosmetics at 81.8% (n=18). The level of good knowledge among allied health professionals (AHP) stood at 42.9% (n=21), 36.4% of nurses (n=43) and 20% of doctors (n=6). However in total, only 40.2% (n=88) of the study population had good knowledge.
Conclusion: The level of knowledge towards registered products and notified cosmetics among doctors, pharmacist, nurses and allied health professional in Labuan is poor as only 40.2% have good knowledge. This study shows a significant association between the levels of knowledge among GHP varies between groups of profession. Pharmacist group has the highest score in knowledge in this study and thus should be another reference for the general public and patients when it comes to health-related matters. Further re-education should be conducted to improve the knowledge of GHPs in Labuan with regards to this subject.
Anaerobic wastewater treatment technology has become one of the most popular technologies due to its economic and environmental benefits. Therefore, a reliable method to study the specific methanogenic activity (SMA) of anaerobic sludge is presented using SMA test. This test helps to determine suitable organic loading rate (OLR) to the anaerobic process. Meanwhile, SMA act as a benchmark to the anaerobic system performance where a slight change in SMA stipulate the accumulation of inhibitory substances from influent wastewater. One of the possible substances that inhibit the anaerobic digestion process is the presence of excessive light metal ions such as sodium (Na+) from the wastewater. The objective of this research was to investigate the specific methanogenic activity of anaerobic sludge in anaerobic filter and anaerobic digester as well as to compare and analyze anaerobic methanogenic bacteria under the effect of potentially inhibitory compound in both anaerobic digester and anaerobic filter. Two sources of inoculums (one from the anaerobic digester and one from the anaerobic filter) were adapted with sodium with varied range of concentrations which was 0 to 5 g Na + /l, before conducting SMA test by means of pressure differences. For the anaerobic digester, the SMA varied from 0.25 to 0.31 g COD/g VS.day meanwhile for the anaerobic filter, the SMA varied from 0.40 to 0.51 g COD/g VS.day. The result obtained confirmed that sludge from POME have better tolerance towards sodium than influents from petrochemical wastewater.