Mild hyperkalaemia does not typically cause cardiac symptoms. However, for an elderly patient on atrio-ventricular (AV) nodal blocker, even mild hyperkalaemia may result in disastrous outcome. We report a case of persistent bradyarrythmia caused by iatrogenic hyperkalaemia in a patient who had concomitant use of AV nodal medication. An 81-year-old lady with multiple comorbidities and a long list of medications presented with symptomatic bradyarrhythmia. She, in fact, had two AV nodal blockers in her prescription, a beta-blocker and amiodarone. Her potassium level was found to be mildly elevated due to acute renal failure. She remained bradycardic despite initial treatment and was subsequently dependant on intravenous isoproterenol until her renal function improved. This case highlights the different threshold for manifestation of hyperkalaemic symptoms in a growing group of patients: elderly patients with multiple comorbidities and polypharmacy.
Keywords: bradyarrythmia, bradycardia, elderly, hyperkalaemia, polypharmacy
Patients with chronic heart failure suffer from undesirable effects in their daily activities. Effective self-care management in conjunction with social support gives improved the wellbeing of patients with chronic heart failure. This study determines social support and self-care management among patients with chronic heart failure. A cross-sectional study was conducted at the Cardiology Clinic in Hospital Serdang, Selangor from April 2014 to June 2014. A questionnaire consisting of demographic characteristics, MOS Social Survey and Self-Care Heart Failure Index (SCHFI) was distributed to a total of 113 respondents. The results show moderately high level of social support (3.51±0.89) and level of self-care management (160.49±44.39). For instance, social support and self-care management were not statistically significant with the demographic characteristics (p>0.05). There was a positive correlation between social support and self-care management (r=0.263, p<0.05) and the findings suggest that social support should be considered a predictor in self-care management of patients with chronic heart failure.
Keywords: social support, self-care management, patient(s), chronic heart failure
Study site: Cardiology Clinic in Hospital Serdang, Selango
Acrylamide is a monomer to polyacrylamide; a polymer with diverse application in basic research, industries and agriculture. The monomer is highly toxic while the polymeric form is slowly degraded to its monomeric form in the environment. In this mini review, the toxicity, uses, pollution and biodegradation of this important monomer are discussed. An important aspect of this review is to highlight the application of microorganisms as remediating agent for the removal of this compound from the environment.
Jatropha curcas Linn. is a multipurpose plant in the Euphorbiaceae family. Numerous reports
have indicated the antioxidant properties of phenolics and flavonoids present in J. curcas root
methanolic extract. In the present study, 80% methanolic extract of J. curcas root was prepared
and used for extraction of bioactive compounds with five solvents (hexane, chloroform, ethyl
acetate, n-butanol and water) by liquid-liquid fractionation. The fractions were evaluated for
total phenolic content (TPC), total flavonoid content (TFC) and antioxidant activities by using
the 2-2’-diphenyl-1-picrylhydrazyl (DPPH), ferric reducing/antioxidant potential (FRAP) and
2,2′-azino-bis-3-ethylbenzthiazoline-6-sulphonic acid (ABTS) assays. The phytochemical
compounds present in each fraction were identified by liquid chromatography mass spectrometry
(LCMS) analysis. The TPC of ethyl acetate and n-butanol fractions were 34.0 ± 0.02 μg GAE/g
DW and 33.1± 0.01 μg GAE /g DW, respectively, while the TFC were 9.2 ± 0.04 μg CE/g DW
and 10.1 ± 0.01 μg CE/g DW, respectively. The free radical scavenging activity varied with the
solvents used. Ethyl acetate fraction showed the highest inhibition for DPPH (48.7%) and FRAP
(79.6%) assays, while n-butanol fraction showed the highest ABTS radical scavenging activity
(94.8%). The LCMS analysis showed the compounds present in the various fractions were
phenolic and flavonoid derivatives such as coumaric acid, epigenin, quercetin, leuteolin and pcoumaroylquinic
acid. The results showed that TPC, TFC and antioxidant activity for ethyl
acetate and n-butanol fractions were higher compared to the other solvent fractions.
Objectives: This study aimed to investigate the perceptions of International Islamic University Malaysia (IIUM) Kuantan nursing students, clinical nurse instructors, and staff nurses of the support offered to student nurses during learning in a clinical setting.
Methodology: A cross-sectional study was carried out on undergraduate nursing students (n=118), and clinical instructors (n=8) at the faculty or Kulliyyah of Nursing, IIUM, using the Clinical Learning Environment, Supervision and Nurse Teacher (CLES-T) survey. Descriptive analysis was used to investigate the sociodemographic data, and further statistical tests were conducted with regard to their levels of perception.
Results: Overall, the participants perceived the clinical learning environment to be good. There was no difference in perception between nursing students and the clinical nurse instructors (p>0.05). There was no significant difference in terms of gender and levels of perception (p>0.05). This study did find a significant relationship between level of study and area of posting for students and perception levels (p
Introduction: Childhood obesity becomes a global epidemic with the majority are living in developing countries. Obese children are at risk of becoming obese adults with non-communicable diseases, which may further lead to huge economic burden for the affected countries. The study objectives were to determine the biosocial background contributing overweight and obesity among preschoolers in Putrajaya (2017) - sociodemographic, pre-and perinatal factors, feeding and weaning practices. Methods: Cross-sectional study was performed using cluster random sampling among 897 preschoolers, whose anthropometric body weights and heights were measured. The calculated BMI was used to determine their obese status based on WHO Growth Standards 2006 and Reference 2007. Their mothers were distributed with self-administered, validated, and pre-tested questionnaires regarding their children’s first two-years-of-life experience. Chi Square test was used for bivariate categorical analysis, Independent T-test and Mann Whitney U test for continuous data analysis. Multivariate binary logistic regression was executed to determine predictors of child obesity. Results: The prevalence of obese children was 7.4%, which can be predicted by the increase in child’s age (Adjusted Odd Ratio: 2.619; 95%CI: 1.435 – 4.780), mothers with higher level of education (AOR: 3.896; 95%CI: 1.127 – 13.470), and higher maternal BMI (AOR: 1.132; 95%CI: 1.057 – 1.213). Conclusion: Three predictors of child obesity can be derived from sociodemographic and pre-and perinatal factors. Further application on these predictors in more targeted interventions and policies need to be considered to reduce the prevalence of obesity and related non-communicable diseases in the country.
This The fields of corporate social responsibility (CSR) and human resource (HR) function have gained
increasingly importance to corporate strategies. As many hotels are concerned with sustainability
issues and CSR, the HR function is positioned to assist implementing and enhancing CSR strategy as
well as administering its core functions. In most cases, CSR in the hotels are housed in HR Department
where the managers have responsibility for the strategic application of CSR in the hotels. This paper
presents a case study of five hotels in Penang Island, Malaysia as an attempt to demonstrate how
Human Resource managers of these hotels perform their CSR practices. Specific focus is placed on the
role of Human Resource managers who are not well-equipped with social work experience or
background and specifically to investigate how these managers perceive CSR concept, the impact of
their CSR programs on beneficiaries and the challenges that they encountered in the process. To
answer these questions, we have conducted interviews with five managers from four and five star
hotels in Penang. Our findings have reflected the importance of conceptualization of CSR particularly
in hotel sector as well as gaining insight into current HR profession in administering CSR activities to
consider someone with social work background in a bid to improve the quality of life of targeted
communities.
The application of ultrasound technology has been widely accepted in clinical settings, particularly in Obstetrics and Gynaecology. This is in light of its ability to detect early foetal malformations apart from enabling foetal monitoring throughout gestation. While ultrasonography is an imaging method that is regularly used in Obstetrics, it is questionable as to whether it is safe for foetuses. The purpose of this paper was to review the evidence regarding the thermal effects of ultrasound exposure on foetal development, particularly. It is hoped that the importance of prudent usage of prenatal ultrasonography will be impressed on clinicians and the public in order to avoid the unnecessary usage of ultrasonography when it is not medically indicated. This is so that the welfare of pregnant women will be looked after, besides contributing to the better health of the next generation by ensuring that the benefits outweigh the known risks or potential harms.
Non-citizen labors in the country have been found to face difficulties in accessing healthcare services. The study seeks to investigate the existence of barriers in accessing primary healthcare services by non-citizen labors in Malaysia. This study was conducted on 323 non-citizen labors residing in the urban areas of Malaysia, particularly of Johor Bahru and Klang Valley from May to September 2017. Relevant information regarding the personal barriers (language, preference for physician's gender, difficulty taking leave from work), structural barriers (availability of public clinic in residential area, travel time to the public clinic,physician's knowledge and skill) and financial barriers (insurance coverage, fear of losing daily income,transportation costs) on using primary healthcare services at public clinics were obtained. The result of the analysis revealed that the barriers cited by non-citizens to seek primary healthcare in Malaysia were lack of medical insurance protection (75.1%), non-availability of a public clinic in the residential area (38.7%), not receiving the needed or wanted services (21.3%), long travel time to the nearest public clinic (17.3%), language (10.2% of respondents), negative perception about the doctors' knowledge and skills (9.9%), difficulty taking leave (7.8%), fear of losing daily income (7.7%), high transportation cost (3.7%) and different doctor gender preference (2.5%). Therefore, barriers to access healthcare services among noncitizens exist in Malaysia.
Optical sensing material for detection of pH has been prepared by immobilising phenol red in nafion membrane. Glass slides with dimension 3 in × 1 in were used as a support. The nafion membrane doped with phenol red was characterized by using uv-Visible Spectrophotometer to study the responses at different pH, repeatability and photo stability. The sensing materials were able to be used for the development of an optical pH sensor since the reagent could be successfully immobilised and produced good responses at different pH.
Bahan sensor untuk pengesanan pH telah disediakan dengan memegunkan reagen fenol merah dalam membran nafion. Slaid kaca yang berukuran 3 in × 1 in telah digunakan sebagai penyokong. Setelah dipegunkan. membran terdop dengan reagen fenol merah dicirikan menggunakan Spektrofotometer uL-Nampak untuk mengkaji kebolehulangan. kestabilan foto dan kesan terhadap pH berbeza. Hasil kajian menunjukkan bahawa bahan ini boleh digunakan sebagai bahan sensor dalam pembinaan sensor optik pH kerana reagen berjaya dipegunkan dan memberikan rangsangan yang baik pada pH yang berbeza.
1-Methylcyclopropene (1-MCP) has been found to inhibit ethylene action and thus it can delay the fruit ripening process. The effects of 1-MCP (90 ppb for 12 h) on softening related changes were determined through physiological changes, fruit firmness and activities of the cell wall degrading enzymes including α-galactosidase, β-galactosidase, pectin methylesterase (PME) and xylanase during ripening in papaya (Carica papaya L. cv Sekaki). In this study, fruits were treated with 90 ppb concentration of 1-MCP gaseous vapors for 12 h in airtight container maintained at 28oC. After the treatment fruits were placed at ambient temperature (28oC). Papaya treated with 1-MCP experienced a significant delayed in skin color development, weight loss and reduced firmness loss compared with the fruit without 1-MCP treatment. As softening progressed, activity of the cell wall degrading enzymes in fruit without 1-MCP treatment increased significantly coincident with a rapid decline in fruit firmness. With 1-MCP application, fruit experienced a delay in activity of cell wall degrading enzymes but continued to increase until later stage of ripening. Thus it may be suggested that 1-MCP treatment may aid in delaying softening-related process and thereby extended the postharvest life and maintained the quality of the ‘Sekaki’ papaya fruit.
Termites are one of the social insects living in large colonies that can cause economic loss. The objective of this study was to estimate foraging territory of infested subterranean termites on building structure. A mark-recapture study was conducted on eight Coptotermes gestroi colonies located at selected infested building structures in Penang, Malaysia. From the foraging study, the population of C. gestroi was estimated to be within the range of 106,592±6,968 to 4,185,000±2,127,328. Additionally, the foraging territory was from 13 to 300 m2 of the infested building structures. Meanwhile the maximum foraging distance was from 4 to 30 m of the infested structures. The results indicated that each of the building structures was infested by a single colony. This study also showed that the triple mark recapture technique used to estimate the population size of the termite colony was capable of providing rough estimates of foraging population of C. gestroi.
Samples of Mn0.6-zMgzZn0.4Fe2O4 ferrites (z = 0, 0.1, 0.2, 0.3, 0.4, 0.5 and 0.6) were prepared by solid state reaction. X-ray diffraction (XRD) confirmed the formation of a single phase spinel structure. Analysis of XRD data indicates that the lattice parameter (a) and XRD density (ÏXRD) decrease with the substitution of Mn by Mg. This ferrite system indicates a maximum magnetization at a certain composition of Mg. The initial permeability (µi) increases for samples with higher magnetization, while the coercivity vary in the opposite manner. DC resistivity (Ï) at 300 K was obtained for annealed an unannealed samples. It is seen that the resistivities at 300 K for samples with z = 0.3, 0.4, 0.5 and 0.6 are lower than the others. The electrical resistivity as a function of temperature in one complete cycle (300 K---680 K---300 K) for unannealed samples indicates anomalies at Neel temperature (TN) and around a certain temperature (Tot). Anomaly at Tot can be seen during heating run and is greater for samples with higher Mg content. The anomaly is absent during cooling run and for the annealed samples except for Z = 0.6. The existence of this anomaly is discussed as due to a contribution of conductivity from the tetrahedral sites and cation redistribution between the two interstitial A and B sites. TN was determined from the variation of resistivity with temperature for the anealed samples and is seen to increase with increasing Mg content. The ferrimagnetic activation energy (Ef) is smaller than the paramagnetic activation energy (Ep) for all samples.
Sistem ferit Mn0.6-zMgzZn0.4Fe2O4 (z = 0, 0.1, 0.2, 0.3, 0.4, 0.5 dan 0.6) disediakan melalui kaedah tindakbalas keadaan pepejal. Pembelauan sinar-X (XRD) mengesahkan kesemua sampel berstruktur spinel fasa tunggal. Analisa data XRD menunjukkan pemalar kekisi (a) dan ketumpatan XRD (rXRD) yang berkurang dengan penggantian Mn oleh Mg. Sistem ferit ini menunjukkan pemagnetan maksimum pada suatu komposisi Mg. Kebolehtelapan awal (µi) meningkat bagi sampel dengan pemagnetan yang tinggi manakala koersiviti (Hc) berubah sebaliknya. Kerintangan elektrik arus terus (Ïat) pada 300 K diukur untuk sampel yang disepuh lindap dan yang tidak disepuh lindap. Nilai kerintangan elektrik pada 300 K untuk sampel dengan z = 0.3, 0.4, 0.5 dan 0.6 didapati lebih rendah berbanding dengan yang lain. Perubahan kerintangan elektrik terhadap suhu dalam satu kitar (300 K---680 K---300 K) bagi sampel yang tidak disepuh lindap menunjukkan anomali pada suhu Neel (TN) dan suatu anomali di sekitar suatu suhu (Tot). Anomali pada Tot dicerap semasa pengukuran suhu meningkat dan semakin jelas untuk sampel dengan kandungan Mg yang tinggi. Anomali tersebut lenyap untuk pengukuran suhu menurun dan pengukuran bagi sampel yang disepuh lindap kecuali untuk z = 0.6. Kewujudan anomali tersebut dibincangkan sebagai berpunca daripada sumbangan kekonduksian pada tapak tetrahedron dan taburan semula kation-kation di antara dua tapak interstis A dan B. TN ditentukan daripada lengkung kerintangan melawan suhu untuk sampel yang disepuh lindap dan didapati meningkat dengan kandungan Mg. Kesemua sampel menunjukkan tenaga pengaktifan ferimagnet (Ef) yang lebih kecil daripada tenaga pengaktifan paramagnet (Ep ).
The electrical resistivity of Mg0.6Zn0.4Fe2O4 ferrite was measured as a function of temperature in the range 300-630 K. Two anomalies are observed in the resistivity curves for measurements during heating up. These anomalies are identified as a magnetic anomaly at the Neel temperature, TN = 598 K, while the other one at TOt = 445 K is discussed as due to the contribution of conduction from the tetrahedral sites. The anomaly at Tot was reduced in the measurements during recooling, while the anomaly at TN was disappeared completely during recooling and second cycle. These effects are discussed as due to the increase of Fe2+ ions at the octahedral sites as a result of cation redistribution at higher temperatures. A relatively small anomaly at Tot still can be observed during the second run. This is possible if the Fe2+ ions have a preference to be relocated at the tetrahedral sites at lower temperatures.
Kerintangan elektrik Mg0.6Zn0.4Fe2O4 ferit telah diukur sebagai fungsi suhu dalam julat 300 - 630 K. Dua anomali dapat dicerap pada lengkung kerintangan bagi pengukuran semasa pemanasan. Dua anomali tersebut dikenalpasti sebagai anomali magnet pada suhu Neel, TN = 598 K, manakala yang satu lagi pada Tot = 445 K dibincangkan sebagai berpunca daripada sumbangan kekonduksian pada tapak tetrahedron. Anomali pada Tot mengurang dalam pengukuran semasa penyejukan semula pada julat suhu yang sarna, manakala anomali pada TN terus lenyap dalam pengukuran semasa penyejukan semula dan juga semasa kitar kedua. Kesan ini dibincangkan sebagai disebabkan oleh peningkatan ion Fe2+ pada tapak oktahedron daripada proses taburan semula kation pada suhu tinggi. Anomali yang berkurang pada Tot masih boleh dicerap semasa pengukuran kitar kedua. Keadaan seperti ini adalah mungkin jika ion Fe2+ mempunyai kecenderongan untuk bertempat semula pada tapak tetrahedron apabila suhu menurun.
Four areas of Malaysia were selected for the study of filamentous micro fungi occupying soil habitats. Ampang, Kota Bharu, Bandar Melaka, and Kuantan were examined for micro-fungi species content and diversity of isolates. Species recovered from the soils of Malaysia, represent 63 genera and four classes, according to current concepts of fungal taxonomy (Clements and Shear, 1964; Domsch and Gams, 1980). Most isolates belonged to the imperfect fungal class Deuteromycetes, a few species represented the Zygomycetes, and only isolated incidents of Mastigomycetes and Ascomycetes were found occupying the soil of these regions.
Empat kawasan di Malaysia di pilih untuk penyelidikan pembiakan mikrofungi dipermukaan tanah. Kawasan-kawasan kajian yang mengandungi berbagai-bagai species mikro-fungi tersebut ialah Ampang, Kota Bharu, Bandar Melaka, dan Kuantan. Mengikut pengelasan konsep fungi (Clements dan Shear, 1964; Domish dan Gams, 1980) species mikro-fungi yang ditemui dipermukaan tanah Malaysia terdiri dari 63 "genera" dan empat kelas. Kebanyakannya terdiri dari kelas "Deuteromycetes", sebilangannya mewakili kelas "Zygomycetes", dan cuma sebilangan kecil sahaja terdiri dari kelas "Mastigomycetes" dan "Ascomycetes ".
A study was conducted to examine the usage of application software and its development practices in Malaysia. The study has shown that the use of application software is greatly emphasized by organizations in their respective businesses. And for most organizations, the application software is supplied by a vendor or through in house development. For the software development practices, the deployment of a current technique and technology is still inadequate. Therefore, most of the existing information technology practitioners should be given additional training on the latest techniques of software development. Other aspect of improvement on software development practices is also discussed.
Satu kajian terhadap status pemakaian dan kegiatan pembangunan perisian gunaan di Malaysia telah dijalankan. Kajian ini menunjukkan yang aspek pemakaian sangat diberi penekanan oleh organisasi. Manakala proses perolehan perisian gunaan pula terbahagi secara setara di antara buat sendiri dengan menggunakan pihak ketiga. Namun begitu yang ketara ialah kadar penggunaan teknologi dan teknik terkini dalam kegiatan pembangunan perisian masih berkurangan. Oleh itu disarankan supaya aspek latihan teknik kakitangan teknologi maklumat organisasi perlu dipertingkatkan secara berterusan. Di samping itu kajian ini memaparkan beberapa aspek amalan pembangunan perisian yang boleh diperbaiki lagi.
A study on water quality and heavy metal concentration in sediment at selected sites of Sungai Kelantan was carried out. Ten water samples were collected along the river for physical and chemical analysis and twenty-six water and sediment samples were collected for heavy metal analysis. Water was sampled at three different dates throughout the study period whereas sediments were collected once. In addition to heavy metal analysis, sediment samples were also analysed for texture, pH and organic content. The physical and chemical water quality analyses were carried out according to the APHA procedures. Result of water quality analysis (physico-chemical) indicated that Sungai Kelantan is characterised by excellent water quality and comparable to pristine ecosystems such as the National Park and Kenyir Lake. This river was classified into class I – class III based on Malaysian interim water quality standard criteria (INWQS). Heavy metals Pb, Zn, Cu and Cd was detected at low concentration in sediment samples, except for Fe and Mn. The presence of Fe and Mn in sediment samples was though to be of natural origin from the soil. Anthropogenic metal concentrations in sediment were low indicating that Sungai Kelantan has not experienced extreme pollution.
The main objective of this research is to optimize the trench depth, trench width, epitaxial resistivity and epitaxial thickness in trench power MOSFET so as to obtain high breakdown voltage but low on-resistance. Optimisation of these parameters are based on 2k factorial design method for achieving specific on-resistance 0.1 mΩcm2 and blocking voltage higher than 30 V. ATHENA and ATLAS software from Silvaco Int. were used for fabrication simulation and device electrical characterisation. The results obtained were, the optimisation value for trench width was 1.25 μm, trench depth was 1.25 μm, epitaxial thickness was 4.75 μm and epitaxial resistivity was 0.32 Ωcm. The predictive value of breakdown voltage was 39.41 V and significant to factors trench depth, epitaxial thickness and epitaxial resistivity. The predictive value for on-resistance was 0.105 mΩcm2 with significant to factors trench depth, epitaxial thickness and epitaxial resistivity. In conclusion, 2k factorial design method is successfully utilised in optimizing n-channel trench power MOSFET.
Surface modification of rice husk (RH) with alkali pre-treatment (NaOH solution 5% w/v) was carried out at the initial state to investigate the effect of surface treatment of fibre on the surface interaction between fibre and rubber. Further modification of RH surfaces after alkali treatment was using Liquid Epoxidized Natural Rubber (LENR) coating at three concentrations, 5%, 10%, and 20% wt LENR solution in toluene. Interfacial morphology and chemical reactions between RH fibre and rubber were analyzed by FTIR and Scanning Electron Microscope (SEM). It was found that 10% wt LENR solution gave the optimum interaction between fibre and rubber. Matrix and composite blends derived from 60% natural rubber (NR), 40% high density polyethylene (HDPE) reinforced with RH fibre were prepared using an internal mixer (Brabender Plasticoder). Result showed that pre-treatment of RH treated with 5% NaOH followed by treatment with 10% LENR solution given the maximum interaction between fibre and matrix that gave rise to better mechanical properties of the composites.
In this paper, the steady Falkner-Skan solution for gravity-driven film flow of a micropolar fluid is theoretically investigated. The resulting nonlinear ordinary differential equations are solved numerically using an implicit finite-difference scheme. The results obtained for the skin friction coefficient as well as the velocity and microrotation or angular velocity profiles are shown in table and figures for different values of the material or micropolar parameter K.