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Fulltext Pre-hospital emergency medical service response time phenomenon in Klang valley: an answer for the society

MOHD SAID NURUMAL

Malaysian Journal of Qualitative Research, 2017;4(1):17-32.
MyJurnal

This qualitative descriptive study, underpinned by naturalistic inquiry, explored the prehospital emergency medical service response time in Klang Valley by providing an in-depth information of the phenomenon. In this study, various levels of health care personnel participated in focus group discussion and semi-structured interview. The staff members consisted of many levels of category from the lower ranks up to the higher level administrative officers. Content analysis was employed in analysing all data. Every one of the key informants was aware of the importance of making immediate responses to each ambulance call received. They shared their thoughts, experiences, and challenges in achieving the ideal response time in line with international recommendations. There were five categories of issues that emerged and challenges that arose from delays in response time, namely, 1) insufficient key information; 2) inconsistent information leading to delayed arrival of ambulance; 3) traffic condition causing delay in ambulance speed; 4) lack of resources contributing to an increase in workload; and, 5) unassertiveness in the attitude of members of staff. The findings have provided an answer to the society with regard to the current pre-hospital emergency medical service issues related to delay in the service delivered. Thus, policy makers and pre-hospital health care service providers should develop a strategic action plan by focusing on these findings to reduce the response time of ambulance call.
Fulltext Empowering the implementation of patient handover with increasing nurse knowledge and attitude at X General Hospital Indonesia

Lilis Suryani, Faridah Binti Mohd Said

Malaysian Journal of Medicine and Health Sciences, 2020;16(110):63-66.
MyJurnal

Introduction: In several studies it was described that ineffective communication during patient handover between the hospital departments or during shift-to-shift transfer result in discontinuity of care, inappropriate treatment, and potential risks of injury for patients. The patient handover is a professional responsibility and accountability related to nursing care. SBAR (Situation - Background - Assessment – Recommendation) method as part of the international pa- tient safety goals(IPSGs) was developed to improve communication breakdown. Knowledge and attitude are essential factors associated with the implementation of patient handover, yet limited research was done on this. The purpose of this study was to examine the relationship between nurse knowledge and attitude toward a patient handover. Meth- ods: A cross-sectional approach was applied in this study. A total of 61 nurses consisting of the head nurse, and team leaders participated in sampling technique done by simple random sampling method from the hospital database. Data collection used a structured questionnaire with a good result of validity and reliability. Univariate and bivariate test were used for data analyzing with Statistical Package for the Social Science (SPSS) Version 18. Results: There is a relationship between nurses' knowledge and attitude toward patient handover with OR 5.280 (1.063-26.227); OR 5.333 (1.351-21.062), respectively and statistically significant (p
Fulltext Influence of music therapy to reduce anxiety during periodontal surgical procedures

Abdul,Halim,, Noor,, Mohd,Fadzilah,, Mohd,Said,, Abdul,Halim,

Compendium of Oral Science, 2021;8(1):32-39.
MyJurnal

ABSTRACT
Objectives: To evaluate the influence of music in reducing patients’ anxiety during periodontal surgery. Methods:
This is a clinical trial of involving fifteen patients undergoing periodontal surgery. Patients indicated for
periodontal surgery were invited to participate in the study, and randomly assigned to music (n=8) or control
(n=7) groups. Participants’ dental anxiety were determined using the Corah Dental Anxiety Scale (CDAS) before
and after the surgery, while their blood pressure (BP) and heart rate (HR) were recorded at pre-, intra- and
post-procedures. Paired t-test was used to compare the statistical significant difference between pre- and postprocedural anxiety for both groups. Result: The participants of this study consist of 22 patients that underwent
periodontal surgery procedures, with majority of the subjects (53.3%) were males (n=8) and the mean age was
50.8 (SD=13.21). The measurement of blood pressure increased in patients allocated in music group compared
to control group were statistically significant with (p
Fulltext Out of hospital cardiac arrest in Kuala Lumpur: incidence; adherence to protocol; and issues: a mixed method study

Mohd Said Nurumal, Sarah Sheikh Abdul Karim

Malaysian Journal of Public Health Medicine, 2015;15(3):0-0.
MyJurnal

Information regarding out of hospital cardiac arrest incidence including outcomes in Malaysia is limited and fragmented. This study aims to identify the incidence and adherence to protocol of out of hospital cardiac arrest and also to explore the issues faced by pre-hospital personnel in regards to the management of cardiac arrest victim in Kuala Lumpur, Malaysia. A mixed method approach combining qualitative and quantitative study design was used. Two hundred eighty five (285) pre-hospital care data sheet for out of hospital cardiac arrest during the year of 2011 were examined by using checklists to identify the incidence and adherence to protocol. Nine semi-structured interviews and two focus group discussions were performed. Based on the overall incidence for out of hospital cardiac arrest cases which occurred in 2011 (n=285), the survival rate was 16.8%. On the adherence to protocol, only 89 (41.8%) of the cases adhered to the given protocol and 124 did not adhere to such protocol. All the relevant qualitative data were merged into few categories relating to issues that could affect the management of out of hospital cardiac arrest performed by pre-hospital care team. The essential elements in the handling of out of hospital cardiac arrest by pre-hospital care teamwasto ensure increased survival rates and excellent outcomes. Measures are needed to strengthen the quick activation of the pre-hospital care service, prompt bystander cardiopulmonary resuscitation, early defibrillation and timely advanced cardiac life support, and also to address all other issues highlighted in the qualitative results of this study.
Fulltext Great Teacher Creates Effective Learning Environment: A Study through IIUM Nursing Students’ Eyes

Mohd Said, N., Rogayah, A., Hafizah, A.

Medicine & Health, 2008;3(2):274-279.
MyJurnal

Learning environment in the universities plays an important role in producing highly competent graduates especially in nursing profession. Thus, the most important as-pects are the teaching activities and as well as student – teacher interaction in daily environment in the university. To investigate the International Islamic University Malay-
sia (IIUM) nursing students experience towards their teachers and to identify the rela-tionship between teaching and students learning perception in their learning environ-ment. This study used quantitative method and utilized two out of five subscales in Dundee Ready Educational Environment Measurement (DREEM). The subscales used
were students’ perception of learning (SPoL) , students’ perception of teacher (SPoT)
and total items in these both subscales are 12 and 11 items, respectively. The ques-tionnaire results revealed that IIUM nursing students scored 28.54/48.00 in (SPoL) and
28.13/44.00 in (SPoT). Both findings showed the IIUM nursing students’ experience their teachers and the learning environment are moving in towards positive directions. The regression finding was 51% of the total variation in students’ perception of teacher score was explained by students’ perception of learning. Although the overall sub-scales (SPoL) score in the current study falls in the category of a more positive per-ception, 2 out of 12 items were poorly scored by the IIUM nursing students. The re-searcher strongly agrees that listening to the expression of students is an important consideration for an educational institution. The overall mean score for (SPoT) showed that the students perceived their teachers as moving in the right direction. In this pre-sent IIUM study, one item showed a mean score of less then 2.00. As a result, these two subscales most probably should reflect the same outcome such as in their aca-demic performance and experience greatly during their student life on campus. The arising issues from this DREEM study at IIUM embrace the need for the creation of supportive environment as well as designing and implementing interventions to remedy unsatisfactorily elements of the learning environment for more effective and successful teaching and learning to be realised.
Time to achieve first blood pressure control after diagnosis among hypertensive patients at primary health care clinics: a preliminary study

Cheong AT, Mohd Said S, Muksan N

Asia Pac J Public Health, 2015 Mar;27(2):NP485-94.
PMID: 23343640 DOI: 10.1177/1010539512472361

This study aimed to examine the duration to achieve first blood pressure (BP) control after the diagnosis of hypertension. This was a retrospective cohort study on 195 hypertensive patients' (age ≥18 years) records from a primary health care clinic. The median time to achieve first BP control was 7.2 months (95% confidence interval [CI] = 4.99-9.35). Cox proportional hazards regression results showed female patients were 1.5 times more likely to achieve BP control when compared with male patients (hazard ratio [HR] = 1.50, 95% CI 1.09-2.09, P = .013). Those with monotherapy were 2 times more likely (HR = 2.09, 95% CI = 1.39-3.13, P < 0.001) and those on 2 drugs were 3.5 times more likely (HR = 3.49, 95% CI = 1.65-7.40, P = .001) to achieve BP control than those with nonpharmacological treatment. The median time to achieve BP control was longer than the recommended time. Doctors may need to consider starting the pharmacological treatment early and be more aggressive in hypertensive management for male patients.
Fulltext Lactase deficiency and lactose intolerance in a multiracial Asian population in Malaysia

Goh LH, Mohd Said R, Goh KL

JGH Open, 2018 Dec;2(6):307-310.
PMID: 30619942 DOI: 10.1002/jgh3.12089

Background and Aims: There have been few reports on lactase deficiency (LD) and lactose intolerance (LI) in Malaysia, which has a peculiar mix of three distinct major Asian races-Malay, Chinese, and Indian. The aim of this study was to determine the prevalence of LD and LI in a young multiethnic Malaysian population.
Methods: Lactase activity was measured with a 13CO2 lactose breath test using an infrared spectrometer. Each subject took 25 g of lactose naturally enriched in 13CO2 together with 250 mL of water after an overnight fast. Breath samples were collected at baseline and at 15-min intervals for 180 min. Subjects were asked to report gastrointestinal (GI) symptoms following ingestion of the lactose test meal.
Results: Of the 248 subjects tested, 216 (87.1%) were lactase deficient. We found no significant differences in the presentation of LD between gender and races. LD was found in 87.5% of males and 86.8% of females (P = 0.975) and in different races: Chinese (88.5%) versus Malay (83.1%) (P = 0.399), Indian (90.5%) versus Malay (P = 0.295), and Chinese versus Indian (P = 0.902). LI was diagnosed in only 49 (19.8%) subjects; 35 patients had diarrhea, while the remainder had at least two other GI symptoms after the lactose meal.
Conclusion: The prevalence of LD was high in all three major ethnic groups-Malays, Chinese, and Indians. Ironically, the prevalence of LI was low overall.
Haemorrhagic transformation: A serious complication of massive ischemic stroke

Mohd Said MR, Mohd Firdaus MAB

Med J Malaysia, 2021 03;76(2):258-260.
PMID: 33742641

Acute ischaemic stroke is a debilitating disease and may lead to haemorrhagic transformation associated with few factors such as high National Institute of Health Stroke Scale (NIHSS), low Modified Rankin Score (MRS), cardio-embolic clot and others.1 We report herein a 61 years old man whom presented with left sided weakness and diagnosed with acute right middle cerebral artery (MCA) infarction. Thrombolytic therapy was not offered due to low Alberta Stroke Program Early CT (ASPECT) score and hence managed conservatively. However, within 24 hours, his Glasgow Coma Scale (GCS) reduced by 4 points and urgent Computed Tomography (CT) brain confirmed haemorrhagic transformation with midline shift. He underwent emergency surgical decompression and subsequently had prolonged hospital stay complicated by ventilated acquired pneumonia. He recovered after a course of antibiotic and discharged to a nursing home with MRS of 5.
Fulltext Effective triaging in Putrajaya health clinic

Mohd Said N, Othman J, Hairi F

Malaysian Journal of Public Health Medicine, 2002;2(2):58-62.
MyJurnal

Malaysia's healthcare delivery system in Vision 2020 will be recognized as one of the world’s best. Putrajaya Health Clinic is our first paperless health clinic in Malaysia that incorporates the Health Information System (HIS). This system cuts across programmes and sections in the operational work process in the clinic with the ultimate aim of achieving a paperless status. This clinic provides a comprehensive health care service at the point of contact and focuses on wellness, clientfriendly, seamless and borderless care with e]§‘icient use of resources and towards high a quality of service. This health clinic which seesthe majority of the attendance being well persons, through the immunization programme, antenatal, postnatal, family planning, school health, and well clinics for child and adult, will continue to extend and further expand its services to include geriatric, ill mental, occupational and rehabilitative care. The e-government within Putrajaya will facilitate the use of an
appointment system, which can be done through e—mail, fax, telephone or walk-in. Information and
communication technology will also facilitate the promotion of health education for individuals and communities. To facilitate efective streaming or screening of clients/attendees, a simple triage system is introduced. Prompt, short and accurate is the rule for triaging, thus providing timely and ejfective care. New information and communication technologies will allow healthcare providers to adopt a more virtual, more integrated and more distributed approach in the delivery of health services. It was documented that the average contact time at the triage counter in Putrajaya Health Clinic was 1.16 minutes, i.e. the shortest among other services provided here.
Blue phase liquid crystal: strategies for phase stabilization and device development

Rahman MD, Mohd Said S, Balamurugan S

Sci Technol Adv Mater, 2015 Jun;16(3):033501.
PMID: 27877782

The blue phase liquid crystal (BPLC) is a highly ordered liquid crystal (LC) phase found very close to the LC-isotropic transition. The BPLC has demonstrated potential in next-generation display and photonic technology due to its exceptional properties such as sub-millisecond response time and wide viewing angle. However, BPLC is stable in a very small temperature range (0.5-1 °C) and its driving voltage is very high (∼100 V). To overcome these challenges recent research has focused on solutions which incorporate polymers or nanoparticles into the blue phase to widen the temperature range from around few °C to potentially more than 60 °C. In order to reduce the driving voltage, strategies have been attempted by modifying the device structure by introducing protrusion or corrugated electrodes and vertical field switching mechanism has been proposed. In this paper the effectiveness of the proposed solution will be discussed, in order to assess the potential of BPLC in display technology and beyond.
Hydrogels based on seafood chitin: From extraction to the development

Zhang J, Mohd Said F, Jing Z

Int J Biol Macromol, 2023 Dec 31;253(Pt 1):126482.
PMID: 37640188 DOI: 10.1016/j.ijbiomac.2023.126482

Chitin is extensively applied in vast applications due to its excellent biological properties, such as biodegradable and non-toxic. About 50 % of waste generated during seafood processing is chitin. Conventionally, chitin is extracted via chemical method. However, it has many shortcomings. Many novel extraction methods have emerged, including enzymatic hydrolysis, microbial fermentation, ultrasonic or microwave-assisted, ionic liquids, and deep eutectic solvents. Chitin and its derivatives-based hydrogels have attracted much attention due to their excellent properties. Nevertheless, they all have many limitations. Therefore, the preparation and application of chitin and its derivatives-based hydrogels are still facing great challenges. This review focuses on the challenges and prospects for sustainable chitin extraction from seafood waste and the preparation and application of chitin and its derivatives-based hydrogels. First section summarizes the mechanism and application of several methods of extracting chitin. The different extraction methods were evaluated from the aspects of yield, degree of acetylation, and protein and mineral residuals. The shortcomings of the extraction methods are also discussed. Next section summarizes the preparation and application of chitin and its derivatives-based hydrogels. Overall, we hope this mini-review can provide a practical reference for selecting chitin extraction methods from seafood and applying chitin and its derivatives-based hydrogels.
Fulltext A study of learning environments in the kulliyyah (faculty) of nursing, international islamic university malaysia

Mohd Said N, Rogayah J, Hafizah A

Malays J Med Sci, 2009 Oct;16(4):15-24.
PMID: 22135508 MyJurnal

In a nursing programme, the main objective is to produce nursing graduates who can provide comprehensive care and treatment to the community. A good approach to the systematic design of a learning environment can lead to positive outcomes for graduates. The learning environment is more than student-teacher interaction, teaching and learning activities. Good physical structures and facilities provided by the university are important, too. Furthermore, the university must also be concerned about meeting students' psychosocial and emotional needs. The aim of this study is to measure the learning environment by administering the Dundee Ready Educational Environment Measure (DREEM) questionnaire to students across the four years of the Bachelor of Nursing programme at the Faculty of Nursing, IIUM, and to identify areas for change that may contribute to a more meaningful student learning experience.
Fulltext Assessing and exploring the competency of prehospital emergency medical service personnel in Klang Valley, Malaysia: a mixed method approach

Mohd Said N, Sukonthasarn A, Wangsrikhun S, Chanpransit C

International Medical Journal Malaysia, 2014;13(2):7-20.
MyJurnal

Introduction: The notion of competency in pre-hospital emergency medical service (EMS) personnel is mainly focused on the professional proficiency that he/she has to provide intervention outside of hospital setting. Consequently, the effectiveness of pre-hospital EMS performance very much depends upon the capability of the personnel at the scene and as well during transport to the definitive care center. The aim of this study is to appraise and explore the competency of pre-hospital care staff and provide strategies for improvement.

Methods: A mixed method approach combining the qualitative and quantitative study design. Of 134 staffs only 111(82.84%) returned the questionnaire. Nine semi-structured interviews and two focus group discussions were performed. The main informants were nurses/assistant medical officers, nurse/assistant medical officer administrators, and emergency physicians.

Results: From the quantitative finding on the competency of staff handling pre-hospital EMS, all had the essential knowledge and skills. However, most of them reported not having good knowledge and skills for invasive procedures (31%-61%), include giving medications (61%-66%). The qualitative information provided insight about the issues and strategies for the personnel in regards to competency. All the relevant qualitative data were merged into 5 categories relating issues and 5 categories to strategies that could affect the competency of the personnel.

Conclusion: Pre-hospital EMS systems need to consider that the competency of pre-hospital EMS personnel has to come along with the responsible attitude of the staff itself, the support of medical direction, clear protocol for guiding them whenever needed, and continuous professional-development courses require them to maintain their professional proficiency.
Workplace injuries in Malaysian Manufacturing Industries

Saad Mohd Said, Zairihan Abdul Halim, Fatimah Said

Journal of Occupational Safety and Health, 2012;9(1):21-31.
MyJurnal

This study analyzes the determinants of workplace injuries across 44 four-digit manufacturing industries in Malaysia from 1993 to 2008 through the business cycle and structural approaches. The results of fixed-effects estimations revealed that workplace injuries in Malaysian manufacturing sector were negatively influenced by firm size and positively influenced by business cycle. Consistent with the findings of previous studies in other countries, the empirical evidence of this study supports the pro-cyclical behavior of injury rates in manufacturing industries towards business cycle. The analysis demonstrates that both structural and cyclical variation effects are important determinants of workplace injuries in Malaysia.
Fulltext Dental knowledge and self-reported oral care practices among medical, pharmacy and nursing students

Tuti Ningseh Mohd-Dom, Shahida Mohd Said, Zamirah Zainal Abidin

Jurnal Sains Kesihatan Malaysia, 2009;7(1):13-23.
MyJurnal

A self-administered questionnaire survey was conducted to investigate the level of dental knowledge among senior medical, pharmacy and nursing students of Universiti Kebangsaan Malaysia, and to determine self-reported practices of oral care. Students were invited to complete a set of questionnaires on knowledge related to causes, prevention, signs and treatment of dental caries and periodontal disease; and practices related to oral hygiene and dental visits. A total of 206 questionnaire forms were distributed. 204 forms were returned complete (response rate = 99%). Dental knowledge scores ranged from 0 (no correct answer given) to 16 (gave all correct answers). The mean knowledge scores between the groups were statistically different (p < 0.05): pharmacy students scored highest (mean = 12.29, 95% CI 11.44, 13.14) followed by the medical students (mean = 12.02, 95% CI 11.33, 12.71) and nursing students (mean = 10.83, 95% CI 10.40, 11.26). Areas that had lowest knowledge scores were signs and treatment of gum disease. With regard to oral care practices, majority cited that they brushed teeth at least twice a day (94.6%) and used toothbrush and toothpaste (97.5%). Not many (21.8%) used dental floss and about half (54.2%) reported visiting the dentist more than twelve months ago. Reasons for dental visits included getting check-ups (64.6%), restorations (45.6%) and emergency care such as extractions (24.0%). In general students had at least a moderate level of dental knowledge but demonstrated poor knowledge in some areas. While most reported good oral hygiene habits, behaviour related to dental visits need to be improved. Findings suggest a need for inclusion of oral health education in the medical, pharmacy and nursing curriculum.
Fulltext Does integration of information and communication technology (ICT) in a primary health care clinic improves client’s satisfaction ?

Nora 'i Mohd Said., Hamzah Abdul Ghani, Farizah Hairi

Malaysian Journal of Public Health Medicine, 2001;1(1):30-38.
MyJurnal

The objective of this study was to find out whether integration of Information and Communication Technology (ICT) in a Primary Health Care Clinic improves client’s waiting time. This was a descriptive study based on a total of 588 clients, i.e. 291 clients from an ICT integrated primary health care clinic, which was Putrajaya Health Clinic and 297 clients from a manual health clinic, which was Salak Health Clinic, from 5th December 2000 until 10th January 2001. Clients attending both clinics during this study period were systematically random sampled. Information was obtained from structured questionnaires. Data were analysed with Statistical Package for Social Sciences (SPSS) version 10.0. Selected quantitative time variables, their mean and standard deviation were calculated. Integration of ICT in a primary health care clinic did not improve client’s waiting time. It was demonstrated by this study that the integration of ICT in Putrajaya Health Clinic led to significantly longer average waiting time (39.76 minutes) and longer average total time spend in the clinic (57.14 minutes) as compared to a manual clinic, Salak Health Clinic where its average waiting time was only 23.13 minutes and average total time spend in the clinic was 39.15 minutes. Based on the findings, it is possible that integration of ICT in a primary health care clinic could not play as a significant factor for improving or reducing client’s waiting time in Putrajaya Health Clinic yet, at least not for the time being. This is the first study to document waiting times specifically in our first ICT integrated primary health care clinic. Since it was found that integration of ICT in a primary health care clinic had made client’s waiting time significantly longer than the waiting time in a manual clinic, it could be interesting for future research to look into client’s satisfaction in an ICT environment clinic.
Key words: ICT, client satisfaction, primary care
Tropical seagrass as a bioindicator of metal accumulation

Faridahanim Ahmad, Shamila Azman, Mohd Ismid Mohd Said, Lavania-Baloo

Sains Malaysiana, 2015;44:203-210.

Seven species of tropical seagrass found at seagrass bed located in Johor, Malaysia were analysed for As, Cu and Cd accumulation. The species were identified as Enhalus acoroides, Halophila minor, Halophila spinulosa, Halophila ovalis, Thalassia hemprichii, Halodule uninervis and Cymodocea serrulata. Seagrass plant is rapidly becoming one of the methods to determine the overall health condition of aquatic environment. Each seagrass samples were collected and divided into three parts i.e roots, rhizomes and leaves. Samples were grinded, digested and the correlation between each part was analysed using SPSS version 16. Each part of seagrass tissues have the ability to assimilate metals for example the concentration of As, Cu and Cd in tropical seagrass were in the range of 5-48, 6-60 and 10-69 μg/gDW, respectively. Halophila minor and Halophila ovalis indicates positive correlations to translocate metals (As, Cu and Cd) in plants parts (leaves-rhizomes, rhizomes-roots and roots-leaves). Seagrass can accumulate metals depending on pollution that occur, seasonal variation and internal capabilities to translocate metals. The seagrass species especially Halophila ovalis and Halophila minor can act as bioindicator for metal pollution.
Fulltext Mobility and Balance and Their Correlation with Physiological Factors in Elderly with Different Foot Postures

Mohd Said A, Manaf H, Bukry SA, Justine M

Biomed Res Int, 2015;2015:385269.
PMID: 26583104 DOI: 10.1155/2015/385269

This study determines (1) the correlation between mobility and balance performances with physiological factors and (2) the relationship between foot postures with anthropometric characteristics and lower limb characteristics among elderly with neutral, pronated, and supinated foot. A cross-sectional observational study was conducted in community-dwelling elderly (age: 69.86 ± 5.62 years). Participants were grouped into neutral (n = 16), pronated (n = 14), and supinated (n = 14) foot based on the foot posture index classification. Anthropometric data (height, weight, and BMI), lower limb strength (5-STS) and endurance (30 s chair rise test), mobility (TUG), and balance (FSST) were determined. Data were analyzed using Spearman's correlation coefficient. Body weight was negatively and moderately correlated (r(s) = -0.552, P < 0.05) with mobility in supinated foot; moderate-to-high positive linear rank correlation was found between lower limb strength and mobility (r(s) = 0.551 to 0.804, P < 0.05) for pronated and neutral foot. Lower limb endurance was negatively and linearly correlated with mobility in pronated (r(s) = -0.699) and neutral (r(s) = -0.573) foot. No correlation was observed in balance performance with physiological factors in any of the foot postures. We can conclude that muscle function may be the most important feature to make movement possible in older persons regardless of the type of foot postures.
Abdominal wall necrotising fasciitis: A rare but devastating complication of the percutaneous endoscopic gastrostomy procedure

Mohd Said MR, Abdul Rani R, Raja Ali RA, Ngiu CS

Med J Malaysia, 2017 02;72(1):77-79.
PMID: 28255151 MyJurnal

Percutaneous Endoscopic Gastrostomy (PEG) tubes were often offered to patients requiring long term enteral feeding. Even though the procedure is relatively safe, it is associated with various complications such as peritonitis or even death.1 We presented a case of a 54-year-old gentleman with underlying ischemic stroke and pus discharges from a recently inserted PEG tube. Computed Topography (CT) scan confirmed abdominal wall necrotising fasciitis complicated with hyperosmolar hyperglycaemia state (HHS) and later succumbed after 48 hours of admission. Our case illustrated the rare complication related to the insertion of PEG tube; abdominal wall necrotising fasciitis that was associated with mortality.
Fulltext Composition and Antibacterial Activity of the Essential Oils of Orthosiphon stamineus Benth and Ficus deltoidea Jack against Pathogenic Oral Bacteria

Azizan N, Mohd Said S, Zainal Abidin Z, Jantan I

Molecules, 2017 Dec 05;22(12).
PMID: 29206142 DOI: 10.3390/molecules22122135

In this study, the essential oils of Orthosiphon stamineus Benth and Ficus deltoidea Jack were evaluated for their antibacterial activity against invasive oral pathogens, namely Enterococcus faecalis, Streptococcus mutans, Streptococcus mitis, Streptococcus salivarius, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis and Fusobacterium nucleatum. Chemical composition of the oils was analyzed using gas chromatography (GC) and gas chromatography-mass spectrometry (GC-MS). The antibacterial activity of the oils and their major constituents were investigated using the broth microdilution method (minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC)). Susceptibility test, anti-adhesion, anti-biofilm, checkerboard and time-kill assays were also carried out. Physiological changes of the bacterial cells after exposure to the oils were observed under the field emission scanning electron microscope (FESEM). O. stamineus and F. deltoidea oils mainly consisted of sesquiterpenoids (44.6% and 60.9%, respectively), and β-caryophyllene was the most abundant compound in both oils (26.3% and 36.3%, respectively). Other compounds present in O. stamineus were α-humulene (5.1%) and eugenol (8.1%), while α-humulene (5.5%) and germacrene D (7.7%) were dominant in F. deltoidea. The oils of both plants showed moderate to strong inhibition against all tested bacteria with MIC and MBC values ranging 0.63-2.5 mg/mL. However, none showed any inhibition on monospecies biofilms. The time-kill assay showed that combination of both oils with amoxicillin at concentrations of 1× and 2× MIC values demonstrated additive antibacterial effect. The FESEM study showed that both oils produced significant alterations on the cells of Gram-negative bacteria as they became pleomorphic and lysed. In conclusion, the study indicated that the oils of O. stamineus and F. deltoidea possessed moderate to strong antibacterial properties against the seven strains pathogenic oral bacteria and may have caused disturbances of membrane structure or cell wall of the bacteria.

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