Introduction: This study was carried out to determine the prevalence of vegetable intake and its associated personal, socio-environmental and physical-environmental factors among Malay adolescents in rural Terengganu. Methods: This study was a cross-sectional study conducted from 1st January 2019 to 31st May 2019 at selected secondary schools in rural Terengganu in Marang and Hulu Terengganu districts. A total of 240 students were recruited by mul- tistage random sampling method in schools and based on inclusion criteria. A validated questionnaire was developed consisting of four (4) sections; demographic data, personal, socio-environmental and physical-environmental factors of vegetable intake. Reliability test found the validity and internal consistency of the questionnaire to be acceptable with a Cronbach Alpha value of 0.762. Results: The respondents consisted of 53% males and 47% females with mean age of 15.01 (1.00) years old. Majority of the respondents had normal BMI status (48%) follows by underweight (20%), overweight (16%) and obese (16%). Majority (83%) had inadequate vegetable intake per day. Factors that were associated with the vegetable intake among adolescents were liking (p=0.01), intention (p=0.01) and habit (p
Introduction: The trend of several mosquito-borne diseases in Malaysia has shown an increasing pattern over the past few years despite close monitoring and continuous control initiatives by public health authority. The objective of this study is to determine the spatial and temporal epidemiology of mosquito-borne disease in Terengganu from the year 2009 to 2018. Terengganu has been selected because it is geographically unique and experiences two monsoon seasons per year. Methods: Weekly surveillance data of mosquito-borne diseases which include dengue fever, malaria, filariasis, Japanese Encephalitis (JE) and chikungunya from 2009 to 2018 were collected from the Terengganu State Health Department. The variables included in the dataset mainly comprises of disease onset, di- agnosis, case category, area (district) and site of onset. The data has been monitored spatial and temporal in which to explore the distribution pattern of the disease. The annual average for each type of mosquito-borne disease was determined using time-series and is further analysed by using geographical information system (GIS) tools to form spatial statistical analysis. Results: Results indicate that the temporal distribution of the mosquito-borne disease in Terengganu increases slightly despite a fluctuating pattern from the year 2009 to 2018 and there are between each type of mosquito-borne disease. Spatial analysis showed different stratification between seasons as well as the areas that are more susceptible to each disease. Conclusion: The results obtained in this present study through spatial and temporal analysis revealed that mosquito-borne diseases show a dynamic pattern in distribution. It can be concluded that the occurrence of the diseases depends on the geographical area and the weather within the region. This study provides public health authorities with a comprehensive assessment that will be useful for surveillance and monitor- ing, as well as for predicting and managing mosquito-borne disease outbreaks effectively.
Introduction: Aberrant expression of E-cadherin has shown to have correlation with advanced disease of prostate cancer. In this study, we evaluated the potential of E-cadherin as a prostate cancer prognostic marker and determined its correlation with patient outcomes. Method: 46 prostate cancer specimens in the form of paraffin-embedded tissue blocks were retrieved from the Histopathology Unit, Department of Pathology, Hospital Kuala Lumpur. The expres- sion patterns of E-cadherin were determined by immunohistochemistry staining. The E-cadherin expression was evaluated and scored as positive (3+) and negative or loss of expression (2+ and 1+). The correlations of E-cadherin expression with patient outcomes which included biochemical failure, disease-free, metastasis and local recurrence were determined. Correlations of E-cadherin expression with the currently used traditional clinicopathological pa- rameters were also evaluated. Results: There were significant correlations between E-cadherin expression with bio- chemical failure (p=0.005) and local recurrence (p=0.003). However, there were no significant correlations between E-cadherin expression with disease-free (p=0.864) and tumour metastasis (p=0.430). Comparing the correlation of E-cadherin expression with the traditional clinicopathological parameters, there were significant correlations be- tween E-cadherin expression with pathological staging (p=0.001), Gleason score (p=0.004) and perineural invasion (p=0.001). However, there was no significant correlation between E-cadherin expression with positive tumour mar- gin (p=0.320). Conclusion: These results support the potential use of E-cadherin as a prognostic tool for prostate cancer as well as an additional marker along the currently available traditional clinicopathological parameters.
Introduction: Renal size measurement using ultrasound is a valuable parameter in the diagnosis of renal function and its diseases. This study is aimed to determine the differences of mean and correlation between the renal length (RL), renal width (RW) and renal parenchymal thickness (RPT) with age, gender and anthropometric measurements among indigenous population in Malaysia. Methods: A prospective cross-sectional study was carried out in this sur- vey. Abdominal sonography was performed on 240 subjects. Sonography of the renal size included measurements of RL, RW and RPT. A portable ultrasound machine (Mindray DP-50, Shenzen, China) with a 3.5 MHz convex probe was used in this study. An independent-samples t-test, one-way ANOVA and Pearson's correlation coefficient test
were performed in statistical analysis. Data were analyzed using SPSS program version 22.0. A P-value of
Introduction: Non-destructive analysis of biological evidence has been paramount importance in the forensic inves- tigation since it is an effective tool in establishing a standard that could be employed to differentiate ensuing destruc- tive tests of bio-fluids upon sample division between the plaintiff and defendant. Species identification of bloodstain found at the crime scene is very crucial in routine forensic work as this can assist the initial investigation by incor- porating or excluding stain that is not human and to identify its origin if animal blood is involved. Methods: In this research, identification and discrimination of various blood species collected from seven domestic animals namely chicken, cow, deer, duck, fish, goat, and pig were investigated using non-destructive analytical techniques; ATR- FTIR and visible spectroscopy coupled with principal component analysis and linear discriminant analysis (PCA- LDA) for classification purposes. Results: ATR-FTIR FTIR spectroscopic study demonstrated a higher rate of successful classification ( 90%) as compared to visible spectroscopic technique. Conclusion: ATR-FTIR spectroscopy has been an ideal, robust, and suitable tool for determining the blood species of domestic animals. The predictive model from PCA-LDA analysis can be utilised to produce higher classification rate for species determination from blood traces.
Introduction: Job satisfaction is the positive and negative feelings of the direction of the job provides the workers of the physical, psychological and social benefits compared to what this worker expects, which will have a significant impact on the level of work performance and productivity of work. This study aims to determine the level of job satisfaction of health workers and identify the type of constraints affecting the health workers and determining the importance of incentives that would raise the level of job satisfaction. Methods: A cross-sectional study conducted for the period from October 2017 to April 2018 in four general hospitals in Al- Najaf province. A number of 670 respondents were selected randomly. A self-administrated questionnaire in the Arabic Language was used to collect information after verifying its reliability. Results: This study found that 56.4% have a positive level of job satisfaction and the rest of the respondents believe that there are signs of constraints affecting health workers. On the other hand, there is a significant correlation between the age group and financial & moral support, there is a significant correla- tion between financial & moral support and job relationships, and between human resources and job relationships. Conclusion: there are more than half of the respondents were satisfied with their jobs and 56.1% of respondents were known about constraints affecting the health workers. Finally, 55.1% of respondents were familiar with the incentives that would raise the job satisfaction level.
Introduction: With the expanding need of nutrients to support fetal growth during pregnancy, pregnant women are recommended to take dietary supplements. However, the intake of these supplements in Malaysia are not much re- ported. We aimed to determine the awareness, attitude and behaviour among pregnant women related to intake of di- etary supplements during pregnancy and associated factors. Methods: A cross-sectional survey was conducted among pregnant women attending Obstetrics and Gynecology Specialist Clinic at Penang General Hospital between April and June 2018. Convenience sampling was used, and data was collected using a self-administered questionnaire. Awareness, attitude and behaviour were reported as frequency and percentages, and logistic regression was used to report associated factors. Analyses were performed using SPSS Statistics (Version 22). Results: A total of 273 respon- dents completed the questionnaires. While the awareness level on the role of dietary supplements during pregnancy is high (87.9%, n=240), only half of the respondents had a good attitude (53.5%, n=146) and had been taking essential supplements during pregnancy (49.1%, n=134). Having health problem was inversely associated with a good attitude towards the use of dietary supplements (OR=0.52, 95% CI 0.31-0.88), while respondents with a good awareness and a good attitude were more likely to consume dietary supplements (OR: 6.51, 95% CI 2.42 – 17.55, OR: 2.07, 95% CI 1.26 – 3.41, respectively). Conclusion: While the awareness level on the role of dietary supplements during pregnancy is high, only half of the respondents had a good attitude towards its intake and had been taking essential supplements during pregnancy.
Introduction: Nonvalvular atrial fibrillation is a common cause of cardioembolic stroke which accounts around 50% of all cardioembolic emboli. Oral anticoagulants remain the main choice of stroke prevention in patients with atrial fibrillation. Our study is aimed to determine the safety (absence or presence of bleeding events) and efficacy (absence or presence of ischemic stroke occurrence) of dabigatran versus warfarin for stroke prevention in patients with nonvalvular atrial fibrillation. Methods: A retrospective audit study was conducted based on past data obtained from Electronic Hospital Information System (EHIS) records in Serdang Hospital. Our sample was 150 patients with nonvalvular atrial fibrillation who were at risk of getting stroke and being prescribed with oral anticoagulants either warfarin or dabigatran from the year 2013 until 2019. Results: Our study showed that there was lesser occurrence of ischemic stroke in patients from dabigatran group (1.3%) as compared to those in warfarin group (2.7%). There were also almost 2 times lesser bleeding events in dabigatran group (6.7%) as compared to those in warfarin group (14.7%). The median of CHA2DS2-VASc Score in warfarin sampled patients (median=3+/-1) was lower than dabig- atran sampled patients (median=4+/-1). Conclusion: Both warfarin and dabigatran are effective in preventing stroke for patients with nonvalvular atrial fibrillation. However, dabigatran is associated with lesser bleeding events with lower incidence of major bleeds compared to warfarin.
Introduction: Children with dyslexia have disparate visual attention while reading varied structures of grapheme-pho- neme that have different congruency. Exploring more related with attention and reading disability, we investigated the visual attention, topographic mapping and correlation of ages of children with dyslexia using ERP study. Methods: A quantitative cross-sectional, non-interventional study was performed with simple randomization to select partici- pants. A total of 24 children were recruited into two groups; control (n=12) and dyslexic (n=12) groups. 128-ERP net was used for ERP experiment. Congruent (true meaningful Malay, 80%) and incongruent (meaningless, 20%) words were used for stimuli. Participants pressed button ‘1' and ‘2' when they saw congruent and incongruent words, re- spectively. Amplitudes and latencies of P300 ERP component were analysed at 19 electrode sites in 10-20 system. Results: Dyslexics evoked significantly higher P300 amplitude at T6 and shorter P300 latency at Fp1 areas compared with the control group. Moreover, pseudo word stimulations showed a high P300 voltage distribution in the prefrontal and right occipital area in the dyslexics, whereas there was more activation in the bilateral occipito-parietal areas in the controls. Significantly moderate positive correlation was found in the control group at F3, F7 and negative correlation in the dyslexic group at T4 areas for P300 latency. Conclusion: Children with dyslexia have higher visual attention with fronto-central topographic distribution for true Malay words and prefrontal and right occipital areas for pseudo Malay words. Age correlation results indicated that attention is directly related to the brain maturity of children.
Introduction: Hypertension treatment aims to reduce morbidity and mortality from cardiovascular and renal com- plications. In Malaysia, there is a high prevalence of uncontrolled hypertension among patients on treatment. This study aimed to identify the predictors of uncontrolled hypertension among patients receiving treatment from public primary care clinics in Pulau Pinang, Malaysia. Methods: An unmatched case-control study with 1:1 ratio was con- ducted among 334 hypertensive patients receiving treatment from selected public primary care clinics. Mean blood pressure measurements from the last two clinical visits were used to determine the hypertension status, and uncon- trolled hypertension was defined as 140/90 mm Hg or higher. The cases were those with uncontrolled hypertension, while the controls were those with controlled hypertension. Participants were recruited by simple random sampling. Independent variables were sociodemographic factors, clinical and psychosocial factors, medication adherence, lifestyle modification, and clinical inertia. Data were collected using validated questionnaires and review of medi- cal records. Multiple logistic regression analysis was performed by using IBM SPSS Statistics 25. Results: The mean age of respondents was 59 years (SD=11). Patients with medication non-adherence had 11.36 times higher odds of uncontrolled hypertension (aOR=11.36, 95% CI=6.59, 19.56, p
Introduction: Caregivers and parents are important to the healthy development of children. Therefore, this study was undertaken to assess the knowledge, attitude and oral health practice among caregivers of children with disabilities. Method: A cross-sectional study was conducted among caregivers in three special boarding schools in Kuantan, Pahang, who cared for 7 to 17 years old disabled children using self-administered questionnaires. Kruskal-Wallis and Chi-square test were used to analyse the data. Results: Most caregivers were female (73.2%). The overall mean knowledge score was 87.75%. All of caregivers have agreed that sugary or sticky food and drinks can cause caries and toothbrushing for children is important for oral health. All of the caregivers possess secondary educational level where 75% of the caregivers with tertiary educational level assist the children while brushing teeth. However, 71.9% of caregivers with tertiary educational level and 45% of caregivers with secondary educational level had shown poor oral health practice since they were frequently giving sweet food to the children. Surprisingly, most of the caregiv- ers with secondary educational level (95.2%) and caregivers with tertiary educational level (85%) thought children with disabilities can brush their teeth independently. Conclusion: Despite having adequate oral health knowledge among the caregivers in the special needs boarding schools, their attitude and oral health practice however were not up to the necessary standards. The implementation of oral health promotion related programmes in the special needs boarding schools must be taken into consideration in order to tackle the oral health problems of children with disabilities.
Introduction: Biodegradable materials, such as Mg-based, Fe-based, and Zn-based, bring as much attention as bone-implant materials due to its biocompatibility and biodegradability characteristics. Among them, the Mg is the most abundant elements in human body and primarily found in the bones. However, the Mg has a lower mechanical properties and resistances to fracture compared to the other biodegradable and non-biodegradable metals. Therefore, the aim of this study was to develop a possible biodegradable material made of Mg-Zn alloys reinforced with carbon nano fiber (CNF) and later tested with several testing procedures. Methods: The powder metallurgy method (PM) was utilized to fabricate a total of 24 samples of Mg-Zn alloys reinforced with 1.0%wt, 1.2%wt, 1.4%wt, 1.6%wt, 1.8%wt and 2.0%wt of CNF. The PM method was involved with the process of grinding using ball milling, compaction under 400MPa pressure and sintered under 400 °C. Compression testing was done to measure the mechanical strength meanwhile scanning electron microscope (SEM) and energy-dispersive X-ray spectroscopy (EDS) was used to identify the microstructural of samples. Results: From this study, it was found that Mg-Zn alloys with 1.6 wt% of CNF produce the highest Young's modulus (2687.91MPa) with acceptable yield strength (84.91MPa). For microstructural analysis, the results showed a compact surface for 1.2, 1.4 and 1.6 wt% of CNF and non-homogeneous structure of all the samples. Conclusion: In conclusion, this study has successfully shown the promising use of Mg-Zn-CNF composite as new materials for implant in terms of suitable strength and structure.
Introduction: Prevalence of musculoskeletal disorders (MSDs) among office workers found to be high worldwide, leading to considerable economic impacts and health issues. The relationship between MSDs and productivity loss is widely recognized. This study investigates the possible relationships between the self-reported musculoskeletal dis- orders and productivity in term of absenteeism/presenteeism and self-evaluated productivity levels during presentee- ism time among office workers. Methods: Cross-sectional study was carried among office workers (n=398) in three public sector organizations in Putrajaya. Socio-demographic and productivity data were determined using self-ad- ministered general questionnaire whereas prevalence of MSDs evaluated using Cornell Musculoskeletal Disorders Questionnaire (CMDQ). Results: This study found that prevalence of MSDs symptoms among office workers in any body parts is high (83.7%), low-back pain reported the highest (58.5%) whereas thighs pain reported less prevalent MSDs symptoms (25.4%) among participants. Also, the results showed a significant association between prevalence of MSDs and productivity loss in regard with presenteeism (p
Introduction: Multidrug resistance bacteria is alarming worldwide. A lot of research were done and are ongoing to search for the best, convenient and economically affordable ways to fight them. With the latest genome editing tool; Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) technology, this research was performed to develop a novel strategy to genetically modify the genome and inhibit the growth of Klebsiella pneumoniae (UPM ESBLKP1), an Extended Spectrum Beta Lactamases (ESBL) organism. Methods: A CRISPR-Cas9 vector was construct- ed together with guide RNAs designed specifically for the targeted uppP gene, a gene responsible for bacterial cell growth and protection. Results: The growth and cell wall integrity of the modified Klebsiella pneumoniae (UPM ESBLKP1) were significantly inhibited and reduced, respectively. Interestingly, wild type Klebsiella pneumoniae showed a normal growth curve while modified strains showed a faster doubling rate when supplemented with Luria-Bertani media. In contrast, slower growth rate of modified strain was observed in the M9 minimal media. This explained the higher doubling rate of mutants on nutrient rich medium earlier is being related to gene recovery. They grew slowly in the minimal media as they were adapting to a new environment while recovering the uppP gene and surviving, proving the success of its gene modification. Conclusion: The developed CRISPR-gRNA system was able to modify the targeted Klebsiella pneumoniae gene hence providing an opportunity to develop a new drug for Klebsiella pneumoniae infection as an alternative to antibiotics.
Introduction: Safety establishments at the workplace play a vital part in preventing ocular injuries in construction industries. Ocular injuries worsens the quality of life of workers, leading to economic loss. The arising of ocular injuries at emergency departments trigger a public health concern in Malaysia. This study aimed to investigate the factors causing ocular injuries among construction workers in Selangor, Malaysia. Methods: A cross-section- al study was conducted on construction workers in Klang Valley, Malaysia. A validated questionnaire evaluated factors consisting of environmental, behaviour and practice domains (α= 0.70 – 0.90) and Reichert Portable Slit Lamp assessed ocular injuries. Results: A total of 385 workers aged 18 to 65 years old completed the study. The prevalence of ocular injuries was 66.20% (n=255 eyes) which includes foreign body injuries (28.20%), subconjunc- tival haemorrhage (9.20%), corneal haze (4.75%), laceration (1.78%), corneal burn (1.18%) and traumatic cataract (0.29%). Environmental hazards such as dust 70.40% (n=271, p=0.00), chemical 75.80% ( n= 292, p=0.00), heat 68.10% (n=262, p=0.00), equipment 60.5% (n=233, p=0.00), fall 54.80% (n=211, p=0.00) and limited working space 52.70% (n=203, p=0.00) significantly contributed to the ocular injuries. However, behaviour and awareness did not contribute significantly to ocular injuries (p
Introduction: Proper nutrition for premature babies is vital for optimal growth. However, a lack of confidence and knowledge among parents causes them to search for online information which may sometimes be misleading or un- reliable. The primary objective of this study is to develop a validated website as an educational tool for parents about nutrition for premature babies. Methods: This study was conducted by referring to the Waterfall Software Develop- ment Life Cycle (SDLC) model, which consists of five main stages. Stages one to three are related to the development of the website, namely, the requirements stage, design stage and implementation stage. This is then followed by a testing stage where 11 expert panels evaluated the content and face validity of the website. The final stage is the main- tenance stage. Results: The website was developed with nine topics. The value of Item Content Validity Index (I-CVI) for every item exceeded the minimum value of I-CVI (0.78), the value of the content validity index by scale, average (S-CVI/Ave) is 0.98, and the content validity index by scale, universal agreement (S-CVI/UA) is 0.83. Both S-CVIs have exceeded the minimum value, which is 0.90 and 0.80 respectively. The value of Krippendorff's Alpha (Kalpha) for the overall section of face validity is 0.53, which does not achieve the minimum acceptable value of Kalpha (0.67). Conclusion: The content validation has high agreement among the expert panels. However, the interphase, layout, and design of the website need to be improvised.
Introduction: This study investigated the effect of combined plant-based protein supplementation and resistance training on muscular strength, blood markers of protein catabolism, immune function, and bone metabolism in sed- entary adult males. Methods: In this randomised, double-blinded study, 28 healthy males aged 19 – 29 years old were equally assigned into four groups: a combined plant-based protein with resistance training (PBPEX), plant- based protein alone (PBP), resistance training alone (EX) and control (C). Mode of resistance training was flat barbell press, machine shoulder press, wide grip lateral pull-down, seated cable row, barbell back squat, leg press and leg extension. The 8-week resistance training involved three sets of 60-70% of one-repetition maximum (1-RM) at 4-6 repetition/set/mode per session, three sessions/week. Participants in PBPEX and PBP groups consumed a plant-based protein supplement consisted of 9.8 g soy and pea protein for seven days/week. Results: PBPEX showed significant increases (p
The American College of Obstetricians and Gynaecologists (ACOG), US Department of Health and Human Services (HHS), and American College of Sports Medicine (ACSM) recommend that all pregnancies with medical clearance should engage in moderate-intensity physical activity (PA) at least 150 minutes per week. However, most of them are physically inactive. Thus, this article aims to identify predictors of physical inactivity among antenatal women. Four databases were used to search relevant articles using PICO strategy systematically. The screening began with examining titles, abstracts, and keywords, followed by scrutinizing and assessing full articles. Finally, a total of five studies were included for the data extraction, and the predictors are sociodemographic (trimesters, parity, marital status, and pre-pregnancy PA status), socioeconomic (household income), lifestyle (smoking and eating unhealthy diet) and health-related factors (multiple pregnancies, received fertility treatment, being unwell, musculoskeletal pain, symptom of early pregnancy and uterine contraction). All these predictors provide crucial information for the success of future physical activity intervention.
Introduction: The aim of the study was to compare the changes in the skeletal and dentoalveolar structures in Malay patients with Class II Division 1 malocclusion treated by prefabricated re-mouldable customizable functional appli- ance (T4FTM) and Twin Block (TB) appliance. Methods: A randomised clinical trial was carried out with samples ran- domly assigned to active (TB appliance) and experimental (T4FTM appliance) groups. Pre- and post-treatment lateral cephalometric radiographs were taken for each subject and the overjet was clinically measured at the same intervals. 20 angular and linear measurements were chosen and measured separately. Results: Independent t test was used to compare the changes between the two groups. A significant difference between the groups was seen with overjet at 2.14 mm (p < 0.01), Sv_Pog distance at 1.83mm (p < 0.05), Sv_ii distance at 2.55 mm (p < 0.001), horizontal distance from the upper to the lower incisor tip at 1.81 mm which was statistically significant (p < 0.05). The other variables SNB and ANB angles too showed a significant difference. However, all the favourable changes were noted in the TB group. Conclusion: T4FTM appliance could be an effective appliance for the management of British Standard Institute's Class II Division 1 malocclusion on Class II skeletal pattern. However, the TB group differed significantly and had a more favourable correction in terms of the sagittal skeletal and dentoalveolar discrepancy.
Introduction: Public transit is a sustainable transport mode that can improve the health and well-being of urban population. Following the development of mass rapid transits (MRT) in Greater Kuala Lumpur, this study aims to em- pirically test the behavioral framework behind the intention to use rail transport among private motor vehicle users. Methods: Data was obtained through a cross sectional travel survey (N=509) conducted on the catchment popula- tion of an upcoming MRT line in Greater Kuala Lumpur. The factors in the hypothesized framework were service quality, environmental health concerns, attitude and the intention to use. The data was modeled using the Maximum Likelihood (ML) estimation in structural equations. Results: The validated model indicated that service quality and environmental health concerns significantly affected respondents' intention to use rail transport, mediated by attitude. Reliability, convenience and comfort were the most valued service qualities, while environmental concerns were more valued than health concerns. There were significant moderation by age, income, and having children below 18 years old on the framework. Higher age groups valued more on service quality, while attitude had larger determin- ing effects on the higher income groups. Besides, the lower direct effect of service quality on attitude among higher income groups implied possibility of other affective factors for the subgroup. Conclusion: This study demonstrated the importance of service quality, attitude, and environmental health concerns in encouraging rail transport usage among private motor vehicle users. Certain subpopulations may be targeted for promotion strategies to improve rail transport use in the city.