Introduction: This paper is aimed to evaluate the feasibility of computed tomography (CT) based thermometry for radiofrequency ablation (RFA) through the investigation on the effects of principal CT acquisition parameters to the CT number. Methods: The effects of CT acquisition parameters (tube voltage, tube current, gantry rotation time, and CT reconstructed slice thickness), as well as metal artefacts on CT number were evaluated by using liver tissue equivalent polyacrylamide (PAA) phantom. The correlation between CT number and tissue temperature from 37 0C to 80 0C was studied with the use of PAA phantom with optimum CT acquisition parameters. Results: The CT numbers show insignificant changes under variation of tube voltages, tube currents, gantry rotation time, and CT reconstructed slice thickness respectively. The CT number difference obtained for each series of the variations are less than 2 HU, which indicates the changes in the CT acquisition parameters has insignificant effects on the CT number shift. On the other hand, the CT reconstructed image is able to improve the metal artefact caused by RF electrode through the increases of CT reconstruction condition. In this paper. A linear regression analysis on the CT number and temperature suggested the CT number is inverse linearly proportional to temperature, with a CT thermal sensitivity of –0.521 ± 0.061 HU/0C (R2 = 0.998). Conclusion: In summary, the results show that assessment of CT thermometry is feasible with the use of current CT technology as it produces high reproducibility and stable CT measurement, which is proved to be independent for CT acquisition parameters.
Introduction: Colon cancer is one of the leading cause of cancer death and current treatments often bring about undesired toxicities and resistance. Hence targeted therapeutic regimens for cancer are developed. Anticancer agent incorporated with copper has been synthesized to selectively target cancer cells that are reported to take up more copper compared to normal cells. Cu(SBCM)2 synthesized from the condensation of s-benzyldithiocarbazate and 3-aetylcoumarin was demonstrated to exhibit anti-proliferative effect towards MCF-7 cells and MDA-MB-231 breast cancer cells via cell cycle arrest and apoptosis. However, the mode of cell death of Cu(SBCM)2 on colon cancer cells has not been explored. This study investigated the anti-cancer properties of Cu(SBCM)2 on HT-29, colorectal cancer cell line. Methods: The growth inhibition of the copper complex was determined using MTT assay and xCELLigence real time cell monitoring analysis. Results: Cu(SBCM)2 was shown to inhibit the growth of HT-29 cells significantly in time- and dose- dependent manner with IC50 of 25.23 ± 8.22 uM at 48 hours. Morphological studies using inverted light microscope indicating Cu(SBCM)2-treated HT-29 cells displayed characteristics of apoptosis such as cellular shrinkage and membrane blebbing. Cell cycle analysis was carried out using flowcytometer and Cu(SBCM)2 was found to induce G2M cell cycle arrest at 24 and 48 hours. ROS assay was carried out to determine the involvement of oxidative stress on Cu(SBCM)2 treated HT-29 cells. Nevertheless, results indicated Cu(SBCM)2 significantly suppressed the formation of ROS compared to control. Conclusion: In summary, Cu(SBCM)2 shows promising potential in cancer therapy against colon cancer cells.
Introduction: The application of nanofibers in biomedicine has gained increasing interest due to their characteristic large surface area, high porosity and chemical tunability. Electrospinning is one of the most versatile techniques for the production of uniform nanofibers. It has been used for the fabrication of extracellular matrix (ECM)-mimicking fibrous scaffolds for several decades. Electrospun fibrous scaffolds provide nanoscale to microscale fibrous structures with interconnecting pores, resembling natural ECM in tissues, and showing a high potential to facilitate the formation of artificial functional tissues. Furthermore, electrospinning demonstrated potential as a vehicle for the encapsulation of bioactive compounds such as phenolic acids, which was suggested to have significant potential to treat wounds caused by trauma, diabetes, ischemic syndromes and other pathological diseases. This study investigates the application of electrospun nanofibers as bioactive carriers of phenolic acids, where gallic, caffeic and p-coumaric acids were incorporated to zein nanofibers at different concentrations (5%, 10% and 20%). Methods: The morphology of the produced fibers were examined with scanning electron microscopy (SEM) and exhibited diameters ranging from 396 to 655 nm. Meanwhile, the interaction between the phenolic compounds and zein was examined with attenuated total reflection-Fourier transform infrared (ATR-FTIR). Results: The antioxidant activity of the fibers was determined using 1,10-diphenyl-2-picrylhydrazyl (DPPH) assay and showed that gallic and caffeic acid had retained their active properties after the incorporation to zein electrospun fibers. Conclusion: Overall, the study provides an outline on the potential of electrospinning technique to produce nanofibers that may serve as substrates in skin tissue engineering and carriers for bioactive compounds such as phenolic acids.
Introduction: Acalypha indica is commonly referred to as “pokok kucing galak”. It is an herbaceous species that grow along the earth’s equator line, including the wet, temperate and tropical regions. Domestic cats experience the effect of this plant by reacting very favorably to the root. The first compilation of the ethnopharmacology and phytochemistry of the Acalypha plants was published. This genus is the fourth largest genus of the Euphorbiaceae family, with about 500 species. However, the review only represents about one third of the species from the Acalypha genus. Methods: Hence, this study is performed to obtain updates on the biochemistry of this plant, via literature search. Results: From the articles, almost every part of the plant, including the leaves, stems and roots, are used as traditional remedies. Local people consume the plant for therapeutic purposes such as anthelminthic, anti-ulcer, anti-bacteria, anti-microbial and wound healing. In homeopathy practice, it is used for asthma and bronchitis. Nevertheless,
there is still a potential risk of using A. indica. It was reported that this traditional medicine could induce Intravascular haemolysis in patients with a glucose-6-phosphate-dehydrogenase (G6PD) deficiency. Clinical evaluations of Acalypha extract could be utilized to justify the ethnomedicinal claims and for the safety of its therapeutic applications. Meanwhile, there is an increase in the phytochemical and chromatographic experiments of A. indica that could introduce the extract’s role in pharmaceutical, nutraceutical, zoology and veterinary fields. It contains secondary metabolites, including dihydroactinidiolide; a terpenoid, alkaloids, flavonoids and steroids, for example, brassicasterol. Conclusion: The finding of this review concludes that Acalypha is a natural source, worth to be further investigated. It is hoped that new biologically active constituents could be discovered, since only few Acalypha species were comprehensively studied.
Introduction: The Environment of Care (EoC) is less being the highlight as one of the important components in hospi-tal administration. The EoC is the interface between the patient and the organisation and it provides both a practical and safe area in which to provide patient care. The study aims to determine the correlation between the environment of care, patient satisfaction and willingness to recommend. Methods: This was a cross-sectional study conducted in one of the teaching hospitals in Malaysia. A Malay validated Hospital Consumer Assessment of Healthcare Provider and System (HCAHPS) questionnaire was used. The multistage sampling was applied. 13 wards represent medical, surgical and O&G based wards were selected randomly. Systematic random sampling method was used for pa-tient selection. Number of samples for each ward was calculated proportionately based on the average number of discharge patient monthly. The global rating item in HCAHPS was used to determine satisfaction level. Data was collected and analysed using SPSS version 22.0. Results: 547 respondents were involved in the study with 61.6% of them were female. Majority of respondents were young adult less than 60 years old. 36.9% of the respondents had positive experience with cleanliness of the ward meanwhile 26.7% had positive experience with quietness of the ward. 57.6% of the respondents were satisfied with the services and 64.5% were willing to recommend the hos-pital to others. There was a significant correlation between environment of care, satisfaction level and willingness to recommend. Conclusion: The healthcare facility needs to concentrate on creating a positive experience on EoC component as this can influence satisfaction level and willingness to recommend the hospital.
Introduction: Kidney transplantation (KT) is the preferred end-stage renal disease (ESRD) treatment because it pro-vides a better survival rate, quality of life as well as a cheaper alternative. However, Malaysia’s KT rates is consis-tently low considering that ESRD rates have been increasing exponentially. With only four hospitals performing KT, there’s a gap to indicate a lack of evaluation in KT system of Malaysia. Qualitative study was undertaken to explore and describe the barriers and solutions improve the rates and service of KT in Malaysia. Methods: Semi-structured interviews adopted as qualitative methodological approach to explore current KT policy and service in Malaysia be-tween March – May 2018 in Kuala Lumpur. Eight key-informants selected using stakeholder analysis and informed consent were obtained. Interviews were digitally audio-recorded, transcribed verbatim and analysed using thematic analysis. Results: Barriers and solutions of Malaysia’s KT are the results of complex interplay of personal, cultural, and environmental factors that can be categorized and described using the five levels of influence conceptualized by the socio-ecological model (SEM). Guidance for developing culturally appropriate and sensitive interventional strategies was elicited from the key informants’ experiences to improve KT rate and services in Malaysia. Conclusion:Malaysia is experiencing very low rate of KT compared to other countries. The use of SEM provided a framework to foster a better understanding of current practice, barriers and solutions to KT in Malaysia. Implications of these find-ings could prompt policy change for better KT service delivery model. Further stakeholder engagement and evalua-tion is required to align best practices to improve KT rates and service in Malaysia that is comparable to high-income countries.
Introduction: Crude herbs can be defined as raw plants materials (e.g. leaves, flowers, roots, etc.) which are not being/minimally processed or dried. Globally, particularly in Malaysia, the use of crude herbs has been increasing. The reasons were as an ailment of diseases underlying conditions and for general wellbeing. In this study, our aim was to investigate factors influences crude herbs use among older patients with chronic diseases. Methods: A cross-sectional survey was conducted using purposive sampling among patients attended government health clinic
at Klinik Kesihatan Kampar, Perak. Self-designed questionnaires were used to collect data and data was analysed using SPSS software (ver. 23). Results: A total of 441 participants were enrolled in this study, the response rate was 71.35%. Demographic characteristics of patients who consume crude herbs were; female (57.25%), Malays (45.06%), age between 50-59 years old (31.96%), secondary education level (49.1%), and earned income less than RM3000 (93.27%). Female gender was found associated with the use of crude herbs (p < 0.05). Other socio-demographic characteristics, such as age, race, education level, and salary range found not associated with crude herbs (p > 0.05). The common reasons given by patients to use crude herbs were; family influence, effectiveness in reducing sugar, and accessible and cheaper compared to commercialised herbal drugs. The prevalence of crude herbs use,
particularly among ageing patients is alarming. The physicians need to take into account on crude herbs used when prescribing medications. The use of crude herbs can be beneficial but yet can be detrimental if it is consumed while on prescribed medications. Conclusion: The findings of this study indicate that the survey area needs to broaden to other parts of Malaysia, particularly rural is warranted.
Introduction: Inflammation is one of the major cause of cardiovascular disease, obesity, cancer and stroke. Many dietary compounds containing kernel oil or coconut oil with anti-inflammatory effect can delay the onset of these chronic diseases however the underlying mechanism is unclear. Methods: This study compares the effects of 5% virgin palm kernel oil (VPKO), virgin coconut oil (VCO) and refined, bleached, deodorized olive oil (RBDOO) on selected immune markers in healthy sprague dawley (SD) rats (n=16 per treatment) across 8 weeks. Sera were obtained for four major immunological analyses including cluster of differentiation 4 (CD 4), cluster of differentiation 8 (CD 8), interleukin 6 (IL 6), and c reactive protein (CRP). Results were expressed in mean ± standard error of the mean (mean±SE). Results: Eight weeks fat feeding had no significant difference in weight gain across treatments. Interestingly, we observe significant different on the concentration of CD 4 (p=0.001) with the lowest CD 4 level in rats fed with VPKO 3.87±0.65 ng/ml. The concentration of CD 8 in rats fed with VPKO 8.19±0.25 (p=0.001) ng/ml was comparable to VCO fed rats but was found lower than the control group, RBDOO fed rats. Lower T cell count (CD 4 or CD 8) indicates suppression in inflammation. IL-6 and CRP concentration in rat fed with VPKO 10.89±0.22 pg/ml and 118.39±7.13 ng/ml were slightly higher than that of VCO fed rats but were lower than RBDOO fed rats. Conclusion: We postulate that VPKO could be a potential supplement as an alternative to VCO for relieving inflammation and enhancing body immune system.
Introduction: Systemic inflammation is the major clinical problem which is constellation of communicable and non-communicable infection equipped with acute to chronic inflammation. It may lead to unfavourable conditions for instance, systemic inflammatory syndrome, burns and sepsis. Systemic inflammation might rotate the steering towards vital clinical maladies including cardiomyopathy, neuroinflammation, hepatitis, liver and kidney diseases and even diabetes. In order to elucidate the molecular insights in these clinical implications, there is an intensive need
to design rodent model of systemic inflammation having close association with systemic inflammatory conditions in humans. Methods: Presently, lipopolysaccharide (LPS) induced systemic inflammatory rodent model is widely established, reproducible and acceptable among scientists. In this model animals are treated with intraperitoneal injection of LPS ranging from 1-10 mg/kg which leads to instant release of proinflammatory cytokines to provide robust model of systemic inflammation in order to elucidate pathological conditions and their in-depth mechanism to uncover the new anti-inflammatory therapeutic targets. Conclusion: Robust model would open new window to explore anti-inflammatory activities of phytochemicals, small molecules and drug candidates along with crosstalk of different signaling pathways at molecular level.
Introduction: The use of crude herbs for well-being as well as curation and prevention of ailments is evident globally, including Malaysia. To understand the effectiveness and reliability, the presence of phytochemical compounds as the factor influencing the use of crude herbs shall be determined. This study was conducted to screen the presence of phytochemical compounds in the local crude herbs consumed by patients with chronic diseases. This is part of
a larger study, where a cross-sectional study was conducted and reported elsewhere. Methods: In total, 15 types of crude herbs were reported by the patients with chronic diseases attending government health clinic at Kampar, Perak. The herbs were extracted using hot and standard cold methods respectively. Results: All the 15 crude herbs’ hot and cold extracts revealed the presence of eight phytochemical compounds, namely, phenols, quinones, tannins, terpenoids, saponins, flavonoids, glycosides, and alkaloids at varying intensity. Saponins, alkaloids, and glycosides were present in all the crude herbs extracts. However, terpenoids, tannins, and phenols were absent in Orthosiphon stamineus, Clinacanthus nutans, and Pandanus amaryllifolius extracts respectively. However, the cold extracts exhibited a higher intensity of phytochemicals compared to hot extracts. The present study confirms the presence of
phytochemicals in the local crude herbs consumed by patients with chronic diseases. The screened phytochemicals are bioactive compounds that possess medicinal properties that may trigger the patients to treat their diseases’ underlying conditions. However, the use of prescribed medicine, particularly among aging patients must be taken into account while consuming crude herbs. Conclusion: The findings of this study indicate that structured-evidence based crude herbs use interventions for patients with chronic diseases is warranted.
Introduction: The persistently increasing number of dengue cases costs a significant amount of health financial ex-penditure by the government. Communities throughout the country should be equipped with adequate knowledge and have a good practice in the avenue of reducing dengue infection incidence. This study aims to describe the knowledge and practice levels on dengue fever and their associated factors among adults in a rural village in Negeri Sembilan. Methods: This cross-sectional study was conducted in a village of Tampin District using a pretested struc-tured questionnaire. Face-to-face interview was conducted among participants whose houses were randomly select-ed. The questionnaire consisted of sections identifying the socio-demographic factors and assessing their knowledge and practice on dengue fever. Knowledge that was assessed includes the sign and symptoms of dengue fever, knowl-edge on the vector, preventive measures and legislation related to it while practice includes their routine action in preventing dengue fever. Results: A total of 221 respondents responded to the questionnaire. The prevalence of re-spondents ever had dengue fever was 10.4% (n=23). Out of 100, the mean (s.d.) knowledge and practice score was 77.2(13.1) and 75.8(16.7) respectively. Good knowledge and practice on dengue fever was found among 52.0% and 47.5% of the respondents respectively. Good knowledge was associated with being middle aged (p=0.001), married (p=0.010) and having higher household income (p= 0.037). There was a significant but weak positive correlation between knowledge and practice of dengue fever (r=0.237, p
Introduction: Zika infection was declared as Public Health Emergency of International Concern since year 2015. Despite of no new reported case via National Surveillance System for flavivirus, an underestimated seroprevalence might occur as the country contributes to the Asian lineage of the virus. Methods: Systematic literature search using PICO framework and PRISMA checklist across four databases for articles published from year 2013-2018 yielded 189 results, 37 articles accepted by titles following criteria were subjected to abstract screening, leaving 8 articles with clear risk proceed to full text analysis using Cochrane checklist and GRADE assessment. Results: There were four high quality articles and four low quality articles based on biases in studies. Blood product management and vac-cination are strategies strongly recommended to be implemented as Zika response while vector control and family planning are public health measures to be proposed as policy if feasible. Successful factors to improve Zika surveil-lance and management includes developing algorithm for blood product management, anti-Zika vaccine research, algorithm for new-born screening, participation of policy makers, healthcare capacity building, raising healthcare and public awareness on the infection, international funding, utilization of technology in data management and bio-logical control of vector. Conclusion: Implementation of Zika response as policy is timely, should be evidence-based and follow guidelines from WHO / CDC / FDA US after cost-effectiveness evaluation for Malaysia setting.
Introduction: Group A streptococcus (GAS) is responsible for high morbidity and mortality globally. Hence, the need to develop sensitive, reliable and cost- effective method of detection is crucial. In this study, we developed a visual detection method for the common virulence gene, streptococcal pyrogenic exotoxin B (speB) involved in invasive GAS diseases using loop-mediated isothermal amplification (LAMP) with fluorescent detection dye (calcein). Meth-ods: The LAMP reaction was optimized at 63°C for 35 minutes using five sets of primer designed with LAMP primer V5 software. When the dye was added prior to amplification, samples with speB DNA developed a characteristic green color after the reaction, but no color reactions were observed in samples with DNAs of non-GAS isolates. De-tection of speB by LAMP assay was done among 43 clinical isolates of blood, pus, wound, tissue and throat samples and ATCCs for controls. Our findings were further reconfirmed by subjecting the LAMP products to 0.5% gel electro-phoresis. Results: The detection limit of this LAMP assay for speB was 10-7 ng/μl of genomic DNA per reaction, which was 10,000-fold more sensitive than conventional PCR 10-3 ng/μl. All 100 % samples were positive for speB gene by LAMP, and 93% by conventional PCR method. Conclusion: LAMP assay could offer remarkably high sensitivity, specificity, repeatability, reliability, affordability, and visibility; it is appropriate for rapid detection of speB in Group A streptococci (GAS) as a point of care testing.
Introduction: Food poisoning usually occurs with the consumption of contaminated food. Some related factors are unsafe water supply, poor sanitation, unhygienic waste disposal and unhygienic practices or poor personal hygiene by food handlers. The purpose of this study is to describe the spatial epidemiology of food poisoning cases in the four districts of Sabah. Methods: This review consists of all food poisoning cases reported from 2011 to 2014 from Kota Kinabalu, Penampang, Putatan and Papar, Sabah. The coordinates used for locations of cases are based on home addresses. Tools such as SPSS v20, ArcGIS v10 and CrimeStat IV were used for data analysis and mapping. Results: A total of 1,787 cases of food poisoning were reported during this review period. In 2011, only Kota Kinabalu and Pa-par illustrated significant food poisoning clusters. Meanwhile, in the year 2012 to 2014, Kota Kinabalu, Penampang and Putatan had clustering of cases. Analysis of nearest neighbour hierarchical clustering analysis showed 32 food poisoning clusters. There were 4 food poisoning points at 500 meters radius around a market place, 2 food poisoning points near a sewage plant and 1 food poisoning point near a water treatment plant. No cases were near a municipal landfill. For rivers and coastline, there were 37 points of food poisoning cases in the proximity of 500 meters. Con-clusion: Food poisoning usually occurs in clusters with possible associated environmental factors.
Introduction: Dengue virus (DENV), Zika virus (ZIKV) and Chikungunya virus (CHIKV) are Arboviruses that are transmitted by the same vector, Aedes aegypti. Dengue has become a global problem since the Second World War and is common in more than 110 countries. In Malaysia, dengue is a major disease burden as total economic costs to the country as a result of dengue is close to RM1.05 billion in 2010 and estimated to rise to 1.3 billion by 2020. Apart from Dengue, Zika and Chikungunya are the other important mosquito borne diseases in Malaysia. The aim of this study was to develop a multiplex real-time assay for simultaneous detection of DENV, ZIKV and CHIKV in clinical specimens. Methods: The published singleplex protocols were used with key modifications to implement a triplex assay. A one-step multiplex real-time RT-PCR assay was developed that can simultaneously detect RNA of DENV, ZIKV and CHIKV with good performance for a routine diagnostic use. The assay was evaluated for inter- and intra-reproducibility by mean CT value. The diagnostic sensitivity was tested with 135 archived samples which had been defined positive or negative by routine singleplex assays. Whole blood, plasma and urines were used in this study. Results: Intra- and inter-reproducibility and sensitivity varied from 0.10% to 4.73% and from 0.45% to 5.98% for each virus respectively. The specificity of detection was 100%. The multiplex real-time RT-PCR assay showed concordance with test results performed by routine singleplex assays. No cross reaction was observed for any of the clinical samples. Conclusion: The development of a rapid, sensitive and specific molecular assay for DENV, ZIKV and CHIKV infections will produce a greater diagnostic capacity in our laboratory. This multiplex approach is cost effective and robust with the concurrent detection of 3 viruses of public health concern.
Introduction: Secondary Hemophagocytic Lymphohistiocytosis (HLH) is a condition seen in severe dengue that can be potentially fatal. Timely management using HLH-directed treatment such as steroids or etoposide have been seen to improve the outcome of patients however there is no protocol on how to manage the disease. Two criteria commonly used to guide the direction of treatment are namely the HLH-2004 criteria and the Hscore; with the latter being used more often. The best cut-off H score is 169 corresponding to a sensitivity of 93%, specificity of 86% and accurate classification of 90% of the patients. We described of five patients diagnosed with severe dengue compli-cated with HLH. Methods: 5 cases that were diagnosed with severe dengue with secondary HLH and received dexa-methasone were reviewed retrospectively and clinical data extracted. Results: All patients had fever beyond critical or leaking phase. Four out of five cases had Hscore higher than 169 and had a mean score of 181 with only one bone marrow performed. Three patients had concurrent leaking and bleeding and three patients had fast progression of se-vere transaminitis during the critical phase. The mean peak ferritin level was 21077 micro/L. The only bone marrow aspiration done revealed increased macrophages and hemophagocytic activity. All patients received a short course of dexamethasone and discharged well. Conclusion: Short course dexamethasone is effective in treatment of HLH in dengue despite the concerns of administration of steroids in bleeding dengue patient. Secondary HLH in dengue remains a clinical diagnosis with no conclusive diagnostic criteria. It should be suspected in a severe dengue patient with hyperferritinemia and persistent fever. Technical difficulty of performing bone marrow during severe dengue makes conclusive diagnosis remains elusive.
Introduction: Violence Against Women has increasingly been recognized in the international areas as an obstacle to women’s development and it may have a myriad of devastating consequences on women’s long or short- term health and wellbeing. The study explored the highlight the prevalence and health effects of Violence Against Women which might reflect the probable causes, the types of injuries, leading factors and consequences of the violence. Methods:Hospital based case study, which was referred to forensic department, Mandalay General Hospital from 1st Jan 2000 to 30th Sept 2000. Personal interview and medical examination of 50-100 victims, girls & women, who were phys-ically and sexually violated was done. Results: Total 92 patients were interviewed and examined, prevalence of dif-ferent age ranging from 5 to 56, were physically and sexually violated during the study period, 62 patients were phys-ically assaulted, and 30 victims were sexually violated. 20-40 age group is more commonly conflicted by physical violence 69.3%) while 10-20 age group were commonly conflicted by sexual violence (56.6%). Pattern of different types of injury and locations are also recorded as a consequence of physical assault and commonest injury is bruise (47%). Commonest location is injury over head & neck (61.8%). Relationship to perpetrator were recorded, physical assaults were commonly by spouse (39%) while sexual assaults were acquaintance (58%). Events leading to violence at home are recorded as nuclear family and alcohol consumption is more common, fights were most common events in community setting. Conclusion: Violence Against Women is neither prevalent nor uncommon in Myanmar. In this study, all forms of injuries were recorded and among them the commonest injuries were bruises, the event leading to violence recorded as fights, alcohol consumption, nuclear family was most common. Violence has a psychological impact on other members of the family, particularly children. However, a multi-sectoral approach has become a necessity to create a happy family, society and nation. It could be achieved by uplifting the socio-economic status of the family, practising the religious teachings and abiding within the framework of the laws. The Trans-National Committed should be formed to effectively minimize trafficking in women and children in the Region.
Introduction: Ventilator-associated pneumonia (VAP) is defined as pneumonia that occurs 48-72 hours or there-after following endotracheal intubation. VAP increased health care costs due to hospital length of stay. Since VAP can be prevented, this study underscores the importance of identifying the current knowledge and practice on the prevention of VAP among the ICU nurses in Queen Elizabeth Hospital 2 (QEH2). The objective of this study is to determine the nurse’s knowledge and practice towards VAP prevention. Methods: The methodology used for this study is a cross-sectional study to evaluate nurses’ knowledge and practice in the ICU, QEH2. 82 ICU QEH2 nurs-es participated. Data were collected using a modified structured questionnaire based on the checklist of VAP data elements. The elements covered in the questionnaire consist of three parts, which are Part A on socio-demographic information, Part B on knowledge ventilator-associated pneumonia events and Part C on nurse’s prevention practice on ventilator-associated events. The data was analyzed using SPSS version 20. Results: The overall results of this study are 45.1% of the nurses were less knowledgeable on VAP prevention and this could lead to a prevalence of VAP in the unit. VAP is a new concept implemented in 2013, meaning that 48.53% (n=33) nurses who trained 2-5 years ago may have not covered VAP in their infection prevention and control training. Most of the ICU nurses did not profoundly practices on subglottic suction (35/82), hand hygiene prior suctioning (40/82), hand hygiene after ETT suction (16/82) and delirium risk assessment (1/82). As a discussion, this could mean the ICU nurses do not have adequate knowledge and practice awareness on VAP prevention. Conclusion: For the conclusion of this study, the nurses working in ICU, QEH2 practiced most of the recommended VAP prevention but not all. Continuous training on prevention for VAP in ICU needs to be review. The hospital management to ensure the availability of the facilities needed and the adoption of guidelines based on evidence-based practice.
Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) is a bacteria or germ which many people carry in their nose or on their skin and it is resistant to a range of antibiotics including methicillin. The primary mode of transmission of S. aureus is by direct contact usually, skin-to-skin contact, although contact with contaminated objects and surfaces or might also play a role. The risk of infection by antibiotic-resistant organisms is a common problem in a hospital setting. When it comes to caring for the patient with an infectious disease such as MRSA, most nursing students tried to avoid caring for the patient because they fear of getting infected. So, in this regards that it is important to find out the perception of nursing students towards MRSA patients. Methods: This study is a descriptive cross-sectional study design and a structured questionnaire used to evaluate the perception among student nurses regarding care for a patient with MRSA. The population of this study consists only of the nursing student of year 2 and year 3, which is 118 students. A minimum of 60 respondents selected by convenient sampling from this population. Results: Findings showed the respondent’s perception towards MRSA patients that 83.55% (n=55) of the respondent has the feeling of avoiding getting close to MRSA patients. While 16.7% (n=11) did not have the feeling to avoid them. 47% (n=31%) respondents felt refused to do any procedure on MRSA patients. While 53% (n=35) did not feel refuse to do any procedure on MRSA patient. 92.4% (n=61) respondents wear full PPE before caring for patients with MRSA. The other 7.6% (n=5) did not wear full PPE before caring for patients with MRSA. 98.5% (n=65) respondents always follow 5 moments of hand hygiene. While the other 1.5% (n=1) did not always follow 5 moments of hand hygiene. Conclusion: To conclude, even though most of the respondents know about MRSA but some of them did not know that MRSA is curable or not, some confusion about the mode of transmission of MRSA and did not know that they should wear full PPE in caring for the patient with MRSA. Lack of knowledge about MRSA might influence them to ask their friends to do procedures for the patient instead of doing it by themselves. Without good knowledge and skills about how to handle infectious patients, it is difficult for the nursing students to approach the patient with an infectious disease such as MRSA.
Introduction: In this study, we evaluated the kinematics of lower limb during early and late phases of 2km time trial on stationary rowing ergometer among Malaysian male rowers. Methods: Seventeen national-level rowers voluntari- ly participated. Three dimensional lower limb kinematics data were collected to represent the first 400 m (i.e., early) and the last 400m (i.e., late) phases of 2km time trial on a stationary ergometer. The kinematics data at sagittal, frontal and transverse planes of dominant leg during catch and finish positions were compared across early and late phases of the time trial using paired T-test. Results: The kinematics of lower limb joints at three planes were not significantly different during early versus late phases of 2km time trial among male senior rowers except for hip flexion at finish (p=0.411), ankle rotation at catch (p=0.779) and ankle abduction at finish (p=0.677). Conclusion: Lower limb kine- matics particularly the hip flexion, ankle rotation and ankle abduction may change across early and late phases of 2km time trial due to fatigue. Coaches and rowers should monitor these motions during fatiguing rowing piece and develop necessary injury prevention measures.