Venous thromboembolism (VTE) is thought to be a rare occurrence in Asian patients. The clinical features of VTE are elusive and the disease often unsuspected. Objective testing such as the duplex ultrasound scans and pulmonary imaging are necessary as clinical diagnosis alone is inaccurate. Fatality can occur in untreated patients not suspected of the disease as shown by our post-mortem studies. Indeed VTE is one of the leading causes of maternal mortality in Singapore. There is a rising trend in the incidence of VTE in Asia. Initial studies found an incidence of about 3 per 10,000 hospital admissions in Hong Kong and Malaysia in 1988 and 1990, respectively; rising to 8 and 15.8 per 10,000 hospital admissions in Singapore 1992 and 2000, respectively. The major risk factors for developing deep vein thrombosis (DVT) in our patients are immobilisation, surgery and malignancy. While Factor V Leiden mutation and mutation at position 20,210 in the prothrombin gene are found to be extremely rare in Chinese, the rest of the thrombophilia has not been formally studied. Studies in Singapore reported rates of 3% to 7% of DVT after general surgery, 9.7% after hip surgery and 14% after total knee replacement surgery. It is difficult to compare with studies from other centres because of differences in patient selection and diagnostic criteria. Studies in Singapore showed that the use of prophylactic low molecular weight heparin completely abolished the occurrence of DVT for patients undergoing total knee replacement and colorectal surgery without an increase in bleeding complications. In conclusion, VTE is not an uncommon problem here. Major acquired risk factors do not differ from the Caucasian populations. VTE is a preventable disease and a better understanding of its epidemiology, patient-risk factors and biological factors will allow better management of this condition.
A survey was conducted in December 1995 to study car occupant restraint usage in Selangor. A total of 1082 car occupants were observed in 536 cars. The results of the study shows that only 57.3% of the car occupants observed were protected by any form of restraints. Most of the cars (99.8%) examined had front seat belts but only 44.2% had rear seat belts. Only 0.6% of the cars were found to have child restraints in the cars. 80.2% of drivers used restraints and only 65.4% of front seat passengers used any forms of restraints. In the case of the rear seat passengers, only 0.42% used an available restraint. More people in the urban areas (84.42%) than in the rural areas (66.51%) used seat belts. Usage of seat belts by car drivers influenced the use of seat belts by front seat passengers. Type of seat belts fitted was associated with usage rate. It is sad to note that 21.9% of the drivers used seat belts incorrectly.
A new species of small, insular, forest floor skink, Sphenomorphus perhentianensis sp. nov., is described from Pulau Perhentian Besar of the Perhentian Archipelago, Peninsular Malaysia. This species is differentiated from all other 36 Sundaland species of Sphenomorphus based on a unique collection of morphological and colour pattern characteristics. These unique characteristics include a snout-vent length of 30.0 mm, 29 midbody scale rows, smooth as opposed to striated dorsal scales, 65 paravertebrals, 61 ventrals, 4 supraoculars, parietals contacting the posterior-most supraocular, 1 medially projecting superciliary scale, 2 loreals, 6 supralabials and infralabials, 10 lamellae beneath the fourth toe, smooth subdigital lamellae, enlarged preanal scales, no body bands, a dark brown, diffuse, dorsolateral stripe extending to just past the axilla, a cream coloured dorsolateral stripe on the nape and anterior-most portion of the body, and no cream coloured postorbital stripe. The discovery of a second endemic reptile in the Perhentian Archipelago underscores the unrealized biodiversity of its herpetofauna. Additional works will describe two additional species from the Perhentian Archipelago.
A 2.4 GHz variable-gain low noise amplifier (VGLNA) intended for use in a Wide-band Code Division
Multiple Access receiver was designed in 0.18 um CMOS process for low voltage and low power applications. Rivaling classical designs using voltage mode approach, this design used the current mode approach, utilizing the current mirror principle to obtain a controllable gain range from 8.26 dB to 16.95 dB with good input and output return losses. By varying the current through the widths of transistors and a bias resistor, the VGLNA was capable of exhibiting 8 dB gain tuning range without degrading the noise figure. Therefore, higher gain was possible at lower current and thus at lower power consumption. Total power consumption simulated was 4.63 mW from a 1 V supply and this gave a gain/power quotient of 3.66 dB/mW. Comparing this with available published data, it was observed that this work demonstrated a good gain tuning range and the lowest noise figure with such power consumption.
Total lockdown caused deleterious mental health to many, resulting from a sudden change in daily routine, working and self-isolation at home, and job and income losses. Therefore, the current study aims to assess the social determinants of self-reported psychological distress in Malaysian adults during the COVID-19 pandemic. Snowball and purposive sampling approaches were adopted to enroll potential respondents. Respondents were required to self-report gender, age, ethnicity, educational attainment, marital status, number of dependents, and the presence of clinically diagnosed psychological disorders. Psychological distress during the pandemic was assessed using 21-item of the Depression Anxiety Stress Scales (DASS-21). The findings revealed that respondents with primary/secondary educational attainment were 1.962 times (95% CI: 1.018-3.781, p= 0.044) more likely to suffer from depression than those with tertiary educational attainment. Conversely, the Malaysian Indians had significantly lower odds for depression compared to Malaysian Malays (AOR = 0.538, 95% CI: 0.302-0.957, p= 0.035). Likewise, females were found to have significantly greater odds for anxiety (AOR = 2.369, 95% CI: 1.317-4.260, p= 0.004) and stress (AOR = 1.976, 95% CI: 1.007-3.879, p = 0.048) than males. Being single was at significantly higher odds for anxiety (AOR = 2.032, 95% CI: 1.133-3.646, p= 0.017) during the pandemic. This study highlights the urgency to address the escalated psychological distress in Malaysian adults during the pandemic.
This survey was conducted to determine the opinions and practices of peri-operative venous thromboembolism (VTE) prophylaxis among surgical and intensive care specialists in Asia.
Allergic rhinitis causes an impairment of the mucociliary function in the nose. It is hoped that treatment of perennial allergic rhinitis would be able to revert mucociliary function to normal. This study aims to compare pre and post treatment mucociliary transport time in 3 different treatment modalities. Ninety-two newly diagnosed patients with allergic rhinitis were randomised into 3 groups and started on different treatment regimes. At the end of 8 weeks, the group treated with only intranasal beclomethasone showed some, though not significant, improvement in the mucociliary function. There were no changes in the mucociliary function in the other two groups treated with beclomethasone and loratidine or loratidine alone.
Study site: ENT clinic in Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
UKM
Infertility is a worldwide reproductive health problem which affects approximately 15% of couples, with male factor infertility dominating nearly 50% of the affected population. The nature of the phenomenon is underscored by a complex array of transcriptomic, proteomic and metabolic differences which interact in unknown ways. Many causes of male factor infertility are still defined as idiopathic, and most diagnosis tends to be more descriptive rather than specific. As such, the emergence of novel transcriptomic and metabolomic studies may hold the key to more accurately diagnose and treat male factor infertility. This paper provides the most recent evidence underlying the role of transcriptomic and metabolomic analysis in the management of male infertility. A summary of the current knowledge and new discovery of noninvasive, highly sensitive and specific biomarkers which allow the expansion of this area is outlined.
The role of sanitation in performance of insecticidal bait stations containing 0.5% chlorpyrifos against the American cockroach, Periplaneta americana (L.), was investigated in residential premises. Test sites were chosen from three locations in Penang Island, Malaysia, and clustered according to their sanitary conditions. Results indicated that at 1-week post-treatment, houses with good sanitary conditions showed a significantly faster reduction (P > 0.05) in the number of cockroaches trapped (> 95%) than those with moderate and poor conditions. At 6 weeks post-treatment, all houses treated with insecticidal baits showed no significant difference in terms of reduction rate of cockroach numbers (P > 0.05), irrespective of sanitary condition. However, the bait performance in houses with poor sanitary conditions could not be sustained up to 12-week post-treatment.
We report the genome sequence of a healthcare-associated MRSA type ST239 clone isolated from a patient with septicemia in Malaysia. This clone typifies the characteristics of ST239 lineage, including resistance to multiple antibiotics and antiseptics.
This study evaluates the sugarcane bagasse derived activated carbon (SBAC) prepared by microwave heating for the adsorptive removal of ammonical nitrogen and orthophosphate from the semi-aerobic landfill leachate. The physical and chemical properties of SBAC were examined by pore structural analysis, scanning electron microscopy, Fourier transform infrared spectroscopy and elemental analysis. The effects of adsorbent dosage, contact time and solution pH on the adsorption performance were investigated in a batch mode study at 30°C. Equilibrium data were favorably described by the Langmuir isotherm model, with a maximum monolayer adsorption capacity for ammonical nitrogen and orthophosphate of 138.46 and 12.81 mg/g, respectively, while the adsorption kinetic was best fitted to the pseudo-second-order kinetic model. The results illustrated the potential of sugarcane bagasse derived activated carbon for the adsorptive treatment of semi-aerobic landfill leachate.
The preparation of tamarind fruit seed granular activated carbon (TSAC) by microwave induced chemical activation for the adsorptive treatment of semi-aerobic landfill leachate has been attempted. The chemical and physical properties of TSAC were examined. A series of column tests were performed to determine the breakthrough characteristics, by varying the operational parameters, hydraulic loading rate (5-20 mL/min) and adsorbent bed height (15-21 cm). Ammonical nitrogen and chemical oxygen demand (COD), which provide a prerequisite insight into the prediction of leachate quality was quantified. Results illustrated an encouraging performance for the adsorptive removal of ammonical nitrogen and COD, with the highest bed capacity of 84.69 and 55.09 mg/g respectively, at the hydraulic loading rate of 5 mL/min and adsorbent bed height of 21 cm. The dynamic adsorption behavior was satisfactory described by the Thomas and Yoon-Nelson models. The findings demonstrated the applicability of TSAC for the adsorptive treatment of landfill leachate.
Portfolio writing is a method of encouraging reflective learning among professionals. Although portfolio-based learning is popular among educators, not many studies have been done to determine students' perceptions of portfolio as a learning tool. A questionnaire survey was conducted among 143 medical students to find out their perceptions of the portfolio as a learning tool. A majority of the students felt that the portfolio is a good learning tool. However, they also perceived that it is stressful and time-consuming to develop a proper portfolio. The study indicates that students need appropriate guidance from the academic staff for the system to succeed.
Complications that arise from self-cleaning the external ear canal are common. This is a prospective study using standard questionnaire on the practice of ear cleaning in 50 subjects. A loose tip cotton bud was also shown to them to assess if it was acceptable to replace their current cotton bud. Thirty six percent of them clean their ears by introducing an object into the ear canal once or more a day. The commonest reason to clean the ears was the presence of earwax. Only 6% used a cotton bud to mop fluid from the ear canal. Almost all (92%) the subjects used a cotton bud to clean the ear. A complication rate of 2% was noted. A loose tip cotton swab was shown to the subjects. Despite explaining that it is safer and better, only 24% of the subject were willing to change to this loose tip cotton bud. Seventy four percent of the subjects cleaned their ear regularly because of earwax. The misconception of needing to clean the ear canal by introducing an object into the ear is rampant. This practice should be avoided and health care providers can play an important role in this.