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Fulltext Workers’ safety awareness level on hand related injury accident in metal fabrication industry

Mohammad, R., Amin, Z., Abdul Aziz, S., Othman, N.

Journal of Advanced Research in Applied Sciences and Engineering Technology, 2015;1(1):1-12.
MyJurnal

The aim of this paper is to measure the safety awareness level of workers by means of
hand related injury accident recorded in Production Department of Metal Fabrication Process
Company located in southern peninsular Malaysia. Base on the accident data obtained from year
2008 until 2012, it showed an increasing numbers of accidents involving hand. In year 2008 the rate
is 36.3%, year 2009 is 30%, year 2010 is 37.5%, year 2011 is 33.3% and year 2012 is 37.5%. Site
observation has been conducted to assess the hazards involve (safety and ergonomic) to the metal
fabrication activities being carried out. Survey Questionnaires have been distributed to 80
respondents from different job trade. The Respondent data was analysed to obtain the safety
awareness level for each worker’s trade. Copyright © 2015 Penerbit Akademia Baru - All rights
reserved.
Fulltext Clinical correlates of erectile dysfunction among male patients on methadone maintenance therapy (MMT) in Kuala Lumpur

Nik Ruzyanei, N.J., Noormazita, M., Azlin, B., Normala, I., Hazli, Z., Abdul Aziz, S., et al.

Malaysian Journal of Medicine and Health Sciences, 2012;8(1):27-35.
MyJurnal

Sexual dysfunction is common but not often assessed in the routine clinical care among males on opiate substitute treatment.
Objective: To determine the association between clinical variables and erectile dysfunction (ED) among men on methadone maintenance therapy (MMT).
Methods: A cross-sectional study involving 108 participants who attended the Drug Clinic, Hospital Kuala Lumpur. The instruments used include the Structured Clinical Interview for DSM-IV Axis-I Disorder (SCID-I), Beck Depression Inventory (BDI) and International Index of Erectile Function-15 (IIEF-15).
Results: Concurrent heroin abuse was significantly associated with presence of ED (p=0.024). Treatment factors including methadone dose and duration of methadone treatment were not significantly associated with ED.
Conclusion: Education on sexual dysfunction as a potential adverse effect and its association with illicit heroin use should be considered in the doctor-patient consultation to encourage treatment adherence and abstinence from heroin.
Study site: Drug Clinic, Hospital Kuala Lumpur, Malaysia
Fulltext Assessing The Medication Use Among Diabetic Patients With Comorbid Diseases

Azmi S, Mustapha FI, Abdul AS

Value Health, 2014 Nov;17(7):A359.
PMID: 27200726 DOI: 10.1016/j.jval.2014.08.776
Fulltext Plasma-derived microparticles in polycythaemia vera

Ahadon M, Abdul Aziz S, Wong CL, Leong CF

Malays J Pathol, 2018 Apr;40(1):41-48.
PMID: 29704383 MyJurnal

INTRODUCTION: Microparticles are membrane bound vesicles, measuring less than 1.0 um, which are released during cellular activation or during apoptosis. Studies have shown that these circulating microparticles play a role in coagulation, cell signaling and cellular interactions. Increased levels of circulating microparticles have been observed in a number of conditions where there is vascular dysfunction, thrombosis and inflammation. The objective of this study was to determine the various plasma-derived microparticles in patients with polycythaemia vera (PV) in Universiti Kebangsaan Malaysia Medical Centre and to compare them with normal control.
METHODS: A total of 15 patients with PV and 15 healthy volunteers were included in this cross-sectional descriptive study. Plasma samples from both patients and healthy volunteers were prepared and further processed for isolation of microparticles. Flow cytometry analyses were then carried out in all samples to determine the cellular origin of the microparticles. Full blood count parameters for both groups were also collected. Data collected were analyzed using SPSS version 12.0.
RESULTS: Patients with PV had a significantly higher percentage of platelet derived microparticles compared to healthy controls (P <0.05). The control group had a higher level of endothelial derived microparticles but the differences were not statistically significant (P > 0.05).
CONCLUSION: The median percentage of positive events for platelet derived microparticles was higher in patients with PV compared to normal healthy controls.
Fulltext An evaluation of medical services at two maternal and child health clinics in Kuala Lumpur, 1985

Lubis SH, Hisham JH, Abdul Aziz S

Family Practitioner, 1986;9(2):41-45.

A study was undertaken to evaluate the efficiency of health services at two maternal and child health (MCH) clinics in Kuala Lumpur. The time spent for individual patient care by the clinic staff was used as an indicator for the evaluation. The main objective was to derive a model of ideal operation time for specific patient care activities at a MCH clinic. Primary data was collected through systematic random sampling of patients between 25/7/1985 and 31/7/1985. Secondary data was obtained from available clinic records for July, 1985. The time a patient spent at the clinic and the time she spent at each examination station and waiting between stations was recorded with digital watches. Results show tha patients spent 80% of their time at the clinics waiting. The actual time spent on each patient was found to be considerably less than the ideal time measured under ideal conditions. Various recommendation are presented in the paper to reduce waiting time and extend examination time. The ideal patient capacity for the two clinics was also calculated.
Fulltext Hemolytic disease of the fetus and newborn caused by anti-D and anti-S alloantibodies: a case report

Yousuf R, Abdul Aziz S, Yusof N, Leong CF

J Med Case Rep, 2012;6:71.
PMID: 22348809 DOI: 10.1186/1752-1947-6-71

Hemolytic disease of the fetus and newborn is most commonly caused by anti-D alloantibody. It is usually seen in Rhesus D (RhD)-negative mothers that have been previously sensitized. We report here a case of hemolytic disease of the fetus and newborn in a newborn baby caused by anti-D and anti-S alloantibodies, born to a mother who was RhD negative, but with no previous serological evidence of RhD alloimmunization.
The association of waist circumference with glycaemic control in diabetic patients in an Asian population. [Abstract]

Azmi S, Feisul MI, Abdat A, Goh A, Abdul Aziz SH

Value Health, 2015 Nov;18(7):A600.
PMID: 26533372 DOI: 10.1016/j.jval.2015.09.2060

Conference abstract:
Objectives: The aim of the study was to explore the association of waist circumference with glycaemic control in Malaysian patients with type 2 diabetes.
Methods: We utilised data of type 2 diabetes patients followed up in Malaysian public sector primary care clinics contained in the National Diabetes Registry in the year 2012. The variable of interest was poor glycaemic control, defined as HbA1c≥ 6.5%. Multiple logistic regression was used to explore the association between glycaemic control and waist circumference, which was adjusted for age, sex, duration of diabetes, systolic blood pressure, total cholesterol, use of insulin and other medications.
Results: A total of 98,825 patients with type 2 diabetes were included in the study. The mean age of patients was 59.9 years (SD: 10.9) and 38.9% were males. The mean duration of diabetes was 6.8 years (SD: 5.0) and 76.2% of patients had HbA1c ≥ 6.5%. The mean waist circumference was 94.0 cm (SD: 11.8) for male and 90.7 cm (SD: 11.8) for female; while 78.3% of the patients had waist circumference above the cut-off (≥ 90 cm for men and ≥ 80 cm for women). Larger waist circumference was found to be significantly associated with HbA1c≥ 6.5% (adj. OR 1.009; p< 0.001; 95% CI: 1.007–1.011) after adjusting for confounding factors.
Conclusions: Analysis showed that glycaemic control was poorer in patients with higher waist circumference than in patients with lower waist circumference.
The association of waist circumference and microvascular complications in diabetic patients in an Asian population. [Abstract]

Azmi S, Feisul MI, Abdat A, Goh A, Abdul Aziz SH

Value Health, 2015 Nov;18(7):A597.
PMID: 26533354 DOI: 10.1016/j.jval.2015.09.2042

Conference abstract:
Objectives: The aim of the study was to explore the association of waist circumference with microvascular complications in Malaysian patients with type 2 diabetes.
Methods: We utilised data of type 2 diabetes patients followed up in Malaysian public sector primary care clinics contained in the National Diabetes Registry in the year 2012. Variables of interest were the presence of microvascular complications, namely nephropathy and retinopathy. Multiple logistic regression was used to explore the association between presence of microvascular complications and waist circumference, which was adjusted for age, sex, duration of diabetes, systolic blood pressure, insulin use, total cholesterol and HbA1c.
Results: A total of 114,719 patients with type 2 diabetes were included in the study. The mean age of patients was 59.8 years (SD: 11.2) with mean duration of diabetes of 6.8 years (SD: 5.1). Male
patients comprised 39.9% of the sample population and 83.5% of the patients were overweight with BMI ≥ 23 kg/m2. Nephropathy and retinopathy was present in 9.1% and 7.9% of patients respectively. The mean waist circumference was 94.1 cm (SD: 11.8) for males and 90.8 cm (SD: 11.8) for females; while 78.4% of the patients had waist circumference above the cut off (≥ 90 cm for men and ≥ 80 cm for women). Larger waist circumference was found to be significantly associated with nephropathy (adj. OR 1.005; p-value< 0.001; 95% CI: 1.003–1.008) after adjusting for confounding factors. However, waist circumference was not significantly associated with retinopathy (adj. OR 0.998; p= 0.209; 95% CI: 0.996–1.001).
Conclusions: Analysis showed that patients with higher waist circumference were more likely to have nephropathy than patients with lower waist circumference. The analysis also showed that waist circumference was not associated with retinopathy in the study population.
Fulltext Antibiogram Profiles and Risk Factors for Multidrug Resistance of Salmonella enterica Recovered from Village Chickens (Gallus gallus domesticus Linnaeus) and Other Environmental Sources in the Central and Southern Peninsular Malaysia

Mohammed Jajere S, Hassan L, Zakaria Z, Abu J, Abdul Aziz S

Antibiotics (Basel), 2020 Oct 15;9(10).
PMID: 33076451 DOI: 10.3390/antibiotics9100701

The emergence of multidrug resistance (MDR), including colistin resistance, among Enterobacteriaceae recovered from food animals poses a serious public health threat because of the potential transmission of these resistant variants to humans along the food chain. Village chickens or Ayam Kampung are free-range birds and are preferred by a growing number of consumers who consider these chickens to be organic and more wholesome. The current study investigates the antibiogram profiles of Salmonella isolates recovered from village chicken flocks in South-central Peninsular Malaysia. A total of 34 isolates belonging to eight serotypes isolated from village chickens were screened for resistance towards antimicrobials including colistin according to the WHO and OIE recommendations of critical antibiotics. S. Weltevreden accounted for 20.6% of total isolates, followed by serovars Typhimurium and Agona (17.6%). The majority of isolates (73.5%) demonstrated resistance to one or more antimicrobials. Eight isolates (23.5%) were resistant to ≥3 antimicrobial classes. Colistin resistance (minimum inhibitory concentrations: 4-16 mg/L) was detected among five isolates (14.7%), including S. Weltevreden, S. Albany, S. Typhimurium, and Salmonella spp. Univariable analysis of risk factors likely to influence the occurrence of MDR Salmonella revealed that the flock size, poultry production system, and use of antibiotics in the farm were not significantly (p > 0.05) associated with MDR Salmonella. The current study highlights that MDR Salmonella occur at a lower level in village chickens compared to that found in live commercial chickens. However, MDR remains a problem even among free-range chickens with minimal exposure to antibiotics.
Mixed phenotype acute leukaemia with t(9,22), BCR-ABL1: A case report

Yong WL, Yusof N, Ithnin A, Shuib S, Tumian R, Yousuf R, et al.

Malays J Pathol, 2020 Dec;42(3):469-476.
PMID: 33361731

INTRODUCTION: Mixed phenotype acute leukaemia (MPAL) is a rare entity of acute leukaemia.
CASE REPORT: Here we report a case of a 39-year-old lady, with an incidental finding of hyperleukocytosis (white blood cells count: 139.2 x 109/L). Her peripheral blood film revealed 36% of blasts and a bone marrow aspiration showed 53% of blasts. Immunophenotyping showed a population of blasts exhibiting positivity of two lineages, myeloid lineage and B-lymphoid lineage with strong positivity of CD34 and terminal deoxynucleotidyl transferase (Tdt). A conventional karyotyping revealed the presence of Philadelphia chromosome. She was diagnosed with MPAL with t(9,22), BCR ABL1, which carried a poor prognosis. She was treated with acute lymphoblastic leukaemia (ALL) chemotherapy protocol coupled with a tyrosine kinase inhibitor and was planned for an allogeneic stem cells transplant.
CONCLUSION: This MPAL case was diagnosed incidentally in an asymptomatic patient during medical check-up. We highlight this rare case report to raise the awareness about this rare disease. Understanding the pathogenesis of the disease with the underlying genes responsible for triggering the disease, uniform protocols for diagnosis and targeted treatment will help for proper management of these patients.
Fulltext Incidence of Red Cell Alloantibody among the Transfusion Recipients of Universiti Kebangsaan Malaysia Medical Centre

Yousuf R, Abdul Aziz S, Yusof N, Leong CF

Indian J Hematol Blood Transfus, 2013 Jun;29(2):65-70.
PMID: 24426338 DOI: 10.1007/s12288-012-0155-x

Red blood cell alloimmunization is a common complication among the transfusion recipients. In Malaysia, multiple ethnicity causes genetic heterogeneity among the population which in turn can cause a wide variation of antibody. The objective of this study was to analyse the red cell alloantibody detected during the pre-transfusion testing. This was a cross-sectional study done in the blood bank of Universiti Kebangsaan Malaysia Medical Centre during the period of January-December 2010. The data was retrieved from the hospital laboratory information system. A total of 24,263 patients' blood samples were subjected for pre-transfusion testing. Antibody screening was done using an indirect antiglobulin test method. The positive samples were further identified for antibody specificity. Antibody screening tests were positive in 184 patients out of 24,263 samples with the incidence of 0.76 %. Autoantibodies and alloantibodies were detected in 39/184 (21.2 %) and 140/184 (76.1 %) of the patients respectively. In five patients (2.7 %) the antibody specificity remained undetermined. Total 161 alloantibodies were identified. The suspected Anti-Mia alloantibody was observed most frequently (49/161, 30.4 %) followed by anti-E (30/161, 18.6 %) and anti-D (22/161, 13.7 %). Anti-E and anti-c were the most common combination of multiple alloantibodies. In view of the high incidence of suspected Anti-Mia antibodies, more efforts are needed to look into the techniques for confirmation of the Anti-Mia antibodies. Besides that, we suggested that all multiply transfused patients should be phenotyped for the Rh system and to supply Rh phenotype specific blood in order to limit alloimmunization.
Fulltext Genetic variability of vancomycin-resistant Enterococcus faecium and Enterococcus faecalis isolates from humans, chickens, and pigs in Malaysia

Getachew Y, Hassan L, Zakaria Z, Abdul Aziz S

Appl Environ Microbiol, 2013 Aug;79(15):4528-33.
PMID: 23666337 DOI: 10.1128/AEM.00650-13

Vancomycin-resistant enterococci (VRE) have been reported to be present in humans, chickens, and pigs in Malaysia. In the present study, representative samples of VRE isolated from these populations were examined for similarities and differences by using the multilocus sequence typing (MLST) method. Housekeeping genes of Enterococcus faecium (n = 14) and Enterococcus faecalis (n = 11) isolates were sequenced and analyzed using the MLST databases eBURST and goeBURST. We found five sequence types (STs) of E. faecium and six STs of E. faecalis existing in Malaysia. Enterococcus faecium isolates belonging to ST203, ST17, ST55, ST79, and ST29 were identified, and E. faecium ST203 was the most common among humans. The MLST profiles of E. faecium from humans in this study were similar to the globally reported nosocomial-related strain lineage belonging to clonal complex 17 (CC17). Isolates from chickens and pigs have few similarities to those from humans, except for one isolate from a chicken, which was identified as ST203. E. faecalis isolates were more diverse and were identified as ST4, ST6, ST87, ST108, ST274, and ST244, which were grouped as specific to the three hosts. E. faecalis, belonging to the high-risk CC2 and CC87, were detected among isolates from humans. In conclusion, even though one isolate from a chicken was found clonal to that of humans, the MLST analysis of E. faecium and E. faecalis supports the findings of others who suggest VRE to be predominantly host specific and that clinically important strains are found mainly among humans. The infrequent detection of a human VRE clone in a chicken may in fact suggest a reverse transmission of VRE from humans to animals.
Fulltext A rare case of anti-jk3 antibody detected on pre-transfusion investigation

Yousuf R, Abdul Aziz S, Yusof N, Leong CF

Indian J Hematol Blood Transfus, 2014 Sep;30(3):208-10.
PMID: 25114411 DOI: 10.1007/s12288-012-0211-6

We report a 47-year-old Malay lady, para 4 + 1, with known medical history of hypertension whom presented at Emergency Department with severe anaemia, most likely secondary to menorrhagia caused by uterine fibroids. Her haemoglobin was 5.5 g/dl and she was transfused with three units of packed cell without any adverse reaction, her haemoglobin level increased to 9.8 g/dl. She was then planned for total abdominal hysterectomy and bilateral salpingo-oophorectomy later. Four months later when she came for the elective surgery, her pre transfusion investigations showed blood group as B Rh D positive, with a probable R1R1 phenotype. Her antibody screening was positive in all the three panel cells. Further testings showed a negative Direct Coomb's test and negative autocontrol, antibody identification showed pan-agglutination reaction on all 11 panel cells with enzyme enhancement. Patient's red cell phenotype was Jk(a-b-). Anti-Jk3 was suspected and further confirmed in the reference laboratory by phenotyping as well as negative urea lysis test. This case report highlights an extremely rare but clinically significant anti-JK3 antibody detected during pretransfusion testing. This phenotype is rare in the white population, more commonly seen in various polynesians. Increased awareness among the blood bank personnel regarding the variability of the blood group phenotype and the capricious nature of the Kidd antibodies may contribute to the better management of these patients.
Immunomodulatory effects of zerumbone isolated from roots of Zingiber zerumbet

Keong YS, Alitheen NB, Mustafa S, Abdul Aziz S, Abdul Rahman M, Ali AM

Pak J Pharm Sci, 2010 Jan;23(1):75-82.
PMID: 20067871

In this study, the immunomodulatory effects of zerumbone isolated from Zingiber zerumbet were investigated by evaluating the effects of this compound towards the lymphocytes proliferation (mice thymocytes, mice splenocytes and human human peripheral blood mononuclear cells, PBMC), cell cycle progression and cytokine (interleukin 2 and 12) induction. Lymphocyte proliferation assay showed that zerumbone was able to activate mice thymocytes, splenocytes and PBMC at dosage dependent pattern where the best concentration was 7.5 microg/ml. Flow cytometry analysis showed the highest population of PBMC entered into G2/M phase after treatment for 72 h with 7.5 microg/ml zerumbone. The production of human interleukin-2 and human interleukin-12 cytokines in culture supernatant from zerumbone activated lymphocytes was prominently upregulated at 24 hour and decreased from 48 h to 72 h. The above results indicate that zerumbone can be used as immunomodulatory agent which can react toward the immune cell cytokine production in dosage dependent pattern.
Risk factors of erectile dysfunction in patients receiving methadone maintenance therapy

Nik Jaafar NR, Mislan N, Abdul Aziz S, Baharudin A, Ibrahim N, Midin M, et al.

J Sex Med, 2013 Aug;10(8):2069-76.
PMID: 23445463 DOI: 10.1111/jsm.12105

INTRODUCTION: While methadone effectively treats opiate dependence, the side effect of erectile dysfunction (ED) may interfere with treatment adherence and benefits.
AIM:To determine the rate of ED and the associated factors which predict ED in male patients on methadone maintenance therapy (MMT) in a Malaysian population.
MAIN OUTCOME MEASURES: The main outcome measures were the International Index of Erectile Function-15 (IIEF-15) and the Beck Depression Inventory (BDI).
METHODS: A total of 108 participants diagnosed with heroin dependence were assessed. We used the Structured Clinical Interview for DSM-IV Axis-I Disorders (SCID-I) on subjects who received MMT, and they were assessed using the IIEF-15, the BDI, and measures of other clinical and sociodemographic variables.
RESULTS: The rate of ED among men on MMT was 68.5% (mild ED, 36.1%; mild to moderate ED, 22.2%; severe ED, 3.7%). The mean age of the participants was 43.45 years. Older age (P = 0.002), concurrent illicit heroin use (P = 0.024), and having an older partner (P = 0.039) were significantly associated with ED. Following multivariate analysis, it was found that older age was the only significant predictor of ED, with an adjusted odds ratio of 1.07 (95% CI = 1.02-1.16). Methadone dose and duration of methadone treatment were not significantly associated with ED.
CONCLUSION: ED was highly prevalent among male patients on MMT. This suggests that there is a need for routine assessment of sexual function in patients on methadone. Among the risk factors, age was the only factor that was significantly associated with ED. The current use of MMT in Malaysia in terms of dosage and duration did not pose a significant risk for ED.
KEYWORDS: Erectile Dysfunction; Methadone Therapy; Opiate Dependence
Study site: outpatient clinic for opiate substitution therapy, Hospital Kuala Lumpur (HKL), Malaysia
Case-control investigation on the risk factors of melioidosis in small ruminant farms in Peninsular Malaysia

Musa HI, Hassan L, Shamsuddin ZH, Panchadcharam C, Zakaria Z, Abdul Aziz S, et al.

J Appl Microbiol, 2015 Aug;119(2):331-41.
PMID: 25891038 DOI: 10.1111/jam.12830

Epidemiology of melioidosis is poorly understood because its occurrence is influenced by complex interaction of environmental, climatic, physicochemical and host factors. We investigated the potential risk factors for the exposure to Burkholderia pseudomallei in small ruminants' farms in Peninsular Malaysia.
Fulltext Salmonella in native "village" chickens (Gallus domesticus): prevalence and risk factors from farms in South-Central Peninsular Malaysia

Jajere SM, Hassan L, Abdul Aziz S, Zakaria Z, Abu J, Nordin F, et al.

Poult Sci, 2019 Nov 01;98(11):5961-5970.
PMID: 31392329 DOI: 10.3382/ps/pez392

Village chicken or Ayam Kampung, common to Southeast Asian countries, has always been regarded as superior in comparison to commercial broiler chicken in terms of wholesomeness and health benefits. The current study investigates the prevalence and risk factors of Salmonella among village chicken flocks from the central and southern states of Peninsular Malaysia. A total of 35 village flocks were sampled from Selangor (n = 19), Melaka (n = 10), Johor (n = 4), and Negeri Sembilan (n = 2). In total, 1,042 samples were collected; these included cloacal swabs (n = 675), eggs (n = 62), pooled drinking water (n = 175), pooled feeds (n = 70), and pooled flies (n = 60). Isolation of Salmonella from cloacal swabs, poultry drinking water, and feeds was carried out according to the protocols and recommendations of the World Organization for Animal Health (OIE) terrestrial manual. The prevalence of Salmonella at an individual bird-level was 2.5% (17/675, 95% CI: 1.6 to 4.0). All eggs screened were negative; in the case of environmental samples, however, Salmonella was detected in 5.14% (9/175), 7.14% (5/70), and 5.0% (3/60) for water, feed, and flies, respectively. A total of 34 isolates and 8 Salmonella serotypes were identified. Weltevreden (20.6%) was the most common, followed by Typhimurium and Agona (17.6%), Albany and Enteritidis (8.8%), Molade (5.9%), Corvallis and Schleissheim (2.9%), and others grouped as Salmonella spp. (11.8%). Multivariable logistic regression models revealed that Salmonella positivity among flocks could be strongly predicted by storage of feeds (uncovered feeds; OR = 10.38; 95% CI: 1.25 to 86.39; p = 0.030) and uncovered water tanks (uncovered tank; OR = 6.43; 95% CI: 1.02 to 40.60; p = 0.048). The presence of Salmonella in village chickens in the study area was lower than that of commercial chickens in Malaysia.
Fulltext Effects of Inclusion of Different Doses of Persicaria odorata Leaf Meal (POLM) in Broiler Chicken Feed on Biochemical and Haematological Blood Indicators and Liver Histomorphological Changes

Abdul Basit M, Abdul Kadir A, Loh TC, Abdul Aziz S, Salleh A, Kaka U, et al.

Animals (Basel), 2020 Jul 16;10(7).
PMID: 32708616 DOI: 10.3390/ani10071209

This research was conducted to estimate the effects of Persicaria odorata leaf meal (POLM) on haematological indices, serum biochemical attributes, and internal organs parameters, including histomorphological features of the liver, in broiler chickens. A total of 120 one-day-old male broiler chicks (Cobb-500) were randomly allocated into four experimental groups. The dietary treatments were basal diet (BD), which served as the control (C), along with BD + 2 g/kg POLM (Po2), BD + 4 g/kg POLM (Po4), BD + 8 g/kg POLM (Po8), which were the supplemented groups. The body weight gain (BWG) showed a linear increase and feed conversion ratio (FCR) showed a linear decrease with increasing POLM dosage at day 42 (p ˂ 0.05) and for the overall growth performance period (p ˂ 0.01). On day 21 and day 42, the values of red blood cells (RBCs), white blood cells (WBCs), haemoglobin (Hb), and packed cell volume (PCV) showed linear increases (p ˂0.05) as the dosage of POLM increased in the diet. On day 21, dietary supplementation of POLM linearly decreased (p ˂ 0.05) the serum activity of alkaline phosphatase (ALP), aspartate aminotransaminase (AST), alanine aminotransaminase (ALT), and serum levels of urea and creatinine. On the other hand, serum levels of total protein (TP), albumin, and globulin showed a linear increase (p ˂ 0.05) as the POLM dosage increased. On day 42, the serum activity of AST and ALT and serum levels of glucose, cholesterol, triglycerides, urea, and creatinine showed linear decreases (p ˂ 0.05) with increased levels of POLM in the diet. However, POLM supplementation linearly increased (p ˂ 0.05) the serum levels of TP and globulin. Dietary inclusion of POLM did not influence the organ parameters and showed no adverse effects on the liver histomorphology. In conclusion, supplementation of POLM increased the growth performance, improving haematological indices and serum biochemistry profiles of broiler chickens without any deleterious effects on the liver histomorphology. The results of the present study provide evidence that POLM can be safely used at a dose rate of 8 g/kg of feed as an alternative to conventional antimicrobial growth promoters (AGPs).
Fulltext Comparative Efficacy of Selected Phytobiotics with Halquinol and Tetracycline on Gut Morphology, Ileal Digestibility, Cecal Microbiota Composition and Growth Performance in Broiler Chickens

Basit MA, Kadir AA, Loh TC, Abdul Aziz S, Salleh A, Zakaria ZA, et al.

Animals (Basel), 2020 Nov 19;10(11).
PMID: 33227911 DOI: 10.3390/ani10112150

The current experiment was designed to estimate the comparative efficacy of selected phytobiotics Persicaria odorata leaf meal (POLM) and Piper betle leaf meal (PBLM) with halquinol, and tetracycline in broiler chickens. The 150-day-old broiler chickens were randomly assigned to five dietary groups. The dietary supplementation groups were the basal diet (BD), which served as the negative control (NC), and BD + 0.2 g/kg tetracycline, which served as the positive control (PC); BD + 0.03 g/kg halquinol (HAL), BD + 8 g/kg POLM (Po8), and BD + 4 g/kg PBLM (Pb4) were the treatment groups. Growth performance, gut morphology, ileal digestibility, and cecal microbiota composition were measured. On day 21, the body weight gain (BWG) was enhanced (p < 0.05) in the broiler chickens fed on phytobiotics (Po8 and Pb4) relative to the NC group, however, on day 42 and in terms of overall growth performance, BWG was enhanced (p < 0.05 in diets (Po8, Pb4, HAL and PC) in comparison with the NC group. Conversely, feed conversion ratio (FCR) was recorded reduced (p < 0.05) in Pb4, Po8, HAL, and PC group in comparison with the NC group. Supplementation of phytobiotics (Po8 and Pb4), HAL and PC, positively improved the gut morphology compared to the NC group. Furthermore, the maximum (p < 0.05) villus height (VH) in duodenum and jejunum was observed in broilers fed on diet Pb4. Supplementation of phytobiotics, HAL and PC, improved (p < 0.05) the digestibility of dry matter (DM) (except for HAL), organic matter (OM), crude protein (CP), ether extract (EE), and ash compared to the NC group. Dietary supplementation of phytobiotics (Po8 and Pb4), HAL and PC, significantly reduced the E. coli, Salmonella, and Staphylococcus aureus (except for HAL) counts compared to the NC group. However, supplementation of Pb4 resulted in significantly decreased total anaerobic bacteria and Clostridium spp. counts compared to the NC group. In addition, supplementation of phytobiotics significantly increased the Lactobacillus count compared to HAL, PC, and NC groups. In conclusion, dietary supplementation of phytobiotics improved the gut morphology, positively modulated and maintained the dynamics of cecal microbiota with enhanced nutrient digestibility, thus, increased the growth performance. Based on current results, phytobiotics could be used as an alternative to AGPs for sustainable broiler chicken production.
Primary care nurses' challenges, opportunities, and facilitators of elder abuse intervention in Malaysia

Mohd Mydin FH, Othman S, Choo WY, Mohd Hairi NN, Mohd Hairi F, Ali Z, et al.

Public Health Nurs, 2021 Aug 12.
PMID: 34386986 DOI: 10.1111/phn.12961

OBJECTIVES: To explore the views of nurses on challenges, perceived roles and improvement strategies concerning elder abuse intervention in Malaysia.
DESIGN AND SAMPLE: Eleven focus group discussions were conducted using a semi-structured interview based on the socio-ecological framework. The data were analyzed using a multistep process of thematic analysis.
RESULTS: Three themes emerged from the data analysis: (1) The predicament: being unwilling or not able to intervene (2) Bridging the older people and health system gap (3) Getting to grips with the barriers. There are multifactorial contributors identified at the individual, interpersonal, organizational, community and policy levels in each theme. These factors interact across the levels to influence nurses' capability to intervene in elder abuse.
CONCLUSION: A framework is needed to articulate Malaysian nurses' role in elder abuse intervention in terms of personal and professional development through culturally sensitive education and the establishment of clinical guidelines in the primary care setting. Strengthening organizational support and the institution of national policy and permissive reporting laws of elder abuse will empower the primary care nurses to address elder abuse in primary care settings and communities.

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