The prevalence of oral mucosal lesions in elderly
population is 22.8% to 61.6%. Conventional oral
examination (COE) is usually carried out to detect oral
mucosal lesions (OML). However, new diagnostic aids
have been introduced to improve OML detection. This
study aimed to determine the utility of autofluorescence
(AF) imaging in detecting OML from normal oral mucosa
and its anatomic variation among institutionalised elderly
Malaysian when compared with COE. Fifty subjects
randomly selected from 9 nursing homes and COE and AF
imaging using VELscope Vx, (LED Dental, Vancouver,
British Columbia, Canada) were carried out. Sensitivity,
specificity, positive (PPV) and negative predictive value
(NPV) and accuracy of AF imaging were calculated.
From the study, fifteen subjects had normal oral mucosa,
15 anatomic variations and 36 lesions were identified.
The sensitivity and specificity of AF imaging were 100%
and 70% whereas the PPV and NPV were 80% and 100%
respectively. The accuracy of AF imaging was 86.37%
when compared to COE. In conclusion AF imaging was
able to detect OML and differentiate them from normal
oral mucosa. However it has limited usefulness in
differentiating between these lesions. This study however,
was able to detail the AF imaging profile of normal oral
mucosa, its normal variants and some common reactive or
infective lesions which can be used in future OML studies
as comparison to oral potentially malignant lesions.
This cross-sectional study aims to determine and compare health-related quality of life profiles of schizophrenia family caregivers on the basis of their sociodemographic characteristics. Thirty outpatient family caregivers completed the generic 36-Item Short Form Health Survey instrument (male = 53.5%; mean age = 51 years; married = 76.7%). The highest mean score was reported for social functioning while role limitation-emotional was rated the worst. Significantly better health-related quality of life profiles were demonstrated by caregivers who were male, younger than 50 years, adequately educated, employed, and without health problems and were receiving monthly income. Understanding of on health-related quality of life matters for family caregivers is crucial to improve the quality of care for schizophrenia patients.
Study site: tients were
identified with assistance from psychiatrists
and nursing staff in-charge at a governmentfunded public hospital in Selangor, Malaysia.
Y-Short Tandem Repeats (Y-STR) data consist of many similar and almost similar objects. This characteristic of Y-STR data causes two problems with partitioning: non-unique centroids and local minima problems. As a result, the existing partitioning algorithms produce poor clustering results.
AIMS: To determine the satisfaction and current adherence status of patients with diabetes mellitus at the diabetes Medication Therapy Adherence Clinic and the relationship between patient satisfaction and adherence.
METHODS: This cross-sectional descriptive study was carried out at three government hospitals in the state of Johor, Malaysia. Patient's satisfaction was measured using the Patient Satisfaction with Pharmaceutical Care Questionnaire; medication adherence was measured using the eight-item Morisky Medication Adherence Scale.
RESULTS: Of n=165 patients, 87.0% of patients were satisfied with DMTAC service (score 60-100) with mean scores of 76.8. On the basis of MMAS, 29.1% had a medium rate and 26.1% had a high rate of adherence. Females are 3.02 times more satisfied with the pharmaceutical service compared to males (OR 3.03, 95% CI 1.12-8.24, p<0.05) and non-Malays are less satisfied with pharmaceutical care provided during DMTAC compared to Malays (OR 0.32, 95% CI 0.12-0.85, p<0.05). Older patients age group ≥60 years were 3.29 times more likely to adhere to their medications (OR 3.29, 95% CI 1.10-9.86, p<0.05). Females were the most adherent compared to males (OR 2.33, 95%CI 1.10-4.93, p<0.05) and patients with secondary level of education were 2.72 times more adherent to their medications compared to those in primary school and no formal education (OR 2.72, 95%CI 1.13-6.55, p<0.05). There is a significant (p<0.01), positive fair correlation (r=0.377) between satisfaction and adherence.
CONCLUSION: Patients were highly satisfied with DMTAC service, while their adherence levels were low. There is an association between patient satisfaction and adherence.
Keyword: Diabetes medication therapy adherence clinic (DMTAC)
Study site: Medication Therapy Adherence Clinic, Pharmacy, Hospitals, Johor, Malaysia
This review aims to provide an insight into human learning processes by examining the role of cognitive and emotional unconscious processing in mentally integrating visual and verbal instructional materials. Reviewed literature shows that conscious mental integration does not happen all the time, nor does it necessarily result in optimal learning. Students of all ages and levels of experience cannot always have conscious awareness, control, and the intention to learn or promptly and continually organize perceptual, cognitive, and emotional processes of learning. This review suggests considering the role of unconscious learning processes to enhance the understanding of how students form or activate mental associations between verbal and pictorial information. The understanding would assist in presenting students with spatially-integrated verbal and pictorial instructional materials as a way of facilitating mental integration and improving teaching and learning performance.
Rapid and highly accurate diagnostic tools are critically needed to diagnose Mycobacterium tuberculosis and rifampicin resistance in AFB smear-negative samples. In this study, we evaluated the diagnostic performance of Xpert MTB/RIF Ultra (Ultra) as a rapid test to diagnose tuberculosis in smear-negative cases in Malaysia. A retrospective study of 1960 smear-negative pulmonary and extrapulmonary samples obtained from patients was conducted. Culture was used as the reference standard for the study. The overall sensitivity and specificity of Ultra on the tested samples were 88.7 % and 77.2 %, respectively, while the PPV was 32.3 % and the NPV was 98.2 %. Ultra showed slightly higher sensitivity in pulmonary (89.9 %) compared to extrapulmonary samples (86.1 %). The overall accuracy of Ultra was 78.5 % (kappa=0.37; 95 %CI: 0.32,0.42). Ultra showed good diagnostic accuracy for detecting MTB and rifampicin resistance in various AFB smear-negative samples. Ultra also had excellent capability in rifampicin resistance detection.
The research presented here investigates the reaction mechanism of wollastonite in situ mineral carbonation for carbon dioxide (CO2) sequestration. Because wollastonite contains high calcium (Ca) content, it was considered as a suitable feedstock in the mineral carbonation process. To evaluate the reaction mechanism of wollastonite for geological CO2 sequestration (GCS), a series of carbonation experiments were performed at a range of temperatures from 35 to 90 °C, pressures from 1500 to 4000 psi, and salinities from 0 to 90,000 mg/L NaCl. The kinetics batch modeling results were validated with carbonation experiments at the specific pressure and temperature of 1500 psi and 65 °C, respectively. The results showed that the dissolution of calcium increases with increment in pressure and salinity from 1500 to 4000 psi and 0 to 90000 mg/L NaCl, respectively. However, the calcium concentration decreases by 49%, as the reaction temperature increases from 35 to 90 °C. Besides, it is clear from the findings that the carbonation efficiency only shows a small difference (i.e., ±2%) for changing the pressure and salinity, whereas the carbonation efficiency was shown to be enhanced by 62% with increment in the reaction temperature. These findings can provide information about CO2 mineralization of calcium silicate at the GCS condition, which may enable us to predict the fate of the injected CO2, and its subsurface geochemical evolution during the CO2-fluid-rock interaction.
Purpose: Modified top-down procedure was successfully employed in the synthesis of aragonite nanoparticles (NPs) from cheaply available natural seawater cockle shells. This was with the aim of developing a pH-sensitive nano-carrier for effective delivery of doxorubicin (DOX) on MCF-7 breast cancer cell line. Methods: The shells were cleaned with banana pelts, ground using a mortar and pestle, and stirred vigorously on a rotary pulverizing blending machine in dodecyl dimethyl betane solution. This simple procedure avoids the use of stringent temperatures and unsafe chemicals associated with NP production. The synthesized NPs were loaded with DOX to form DOX-NPs. The free and DOX-loaded NPs were characterized for physicochemical properties using field emission scanning electron microscopy, transmission electron microscopy, zeta potential analysis, Fourier transform infrared spectroscopy, and X-ray diffraction. The release profile, cytotoxicity, and cell uptake were evaluated. Results: NPs had an average diameter of 35.50 nm, 19.3% loading content, 97% encapsulation efficiency, and a surface potential and intensity of 19.1±3.9 mV and 100%, respectively. A slow and sustained pH-specific controlled discharge profile of DOX from DOX-NPs was observed, clearly showing apoptosis/necrosis induced by DOX-NPs through endocytosis. The DOX-NPs had IC50 values 1.829, 0.902, and 1.0377 µg/mL at 24, 48, and 72 hrs, while those of DOX alone were 0.475, 0.2483, and 0.0723 µg/mL, respectively. However, even at higher concentration, no apparent toxicity was observed with the NPs, revealing their compatibility with MCF-7 cells with a viability of 92%. Conclusions: The modified method of NPs synthesis suggests the tremendous potential of the NPs as pH-sensitive nano-carriers in cancer management because of their pH targeting ability toward cancerous cells.