Drawing on the lived experiences of the Pengkids and their girlfriends in the deprived district of the capital city of Malaysia, Kuala Lumpur, this article examines transgender practices and women's same-sex desires within the local contexts of urbanization and political Islam. This article questions the assumed marginal positions of transgender practices and same-sex desires in society, and provides a nuanced understanding of the politics of identity, gender, sexuality and religion involved in a Muslim country. While the Muslim-Malay sexual minorities are increasingly subjected to the threats of moral policing in Malaysia, Pengkid has become a new identity marker for the marginalized sexual subject framed by the Islamic discourse of this country.
There is no doubt that gender bias has been inherent in medical and public health education, research, and clinical practice. This paper discusses the central question for medical and public health educators viz. whether women's health concerns and needs could be best addressed by the conventional biomedical approach to medical and public health education, research, and practice. Gender inequalities in health and gender bias in medical and public health education are revealed. It is found that in most public health and prevention issues related to women's health, the core issue is male-female power relations, and not merely the lack of public health services, medical technology, or information. There is, thus, an urgent need to gender-sensitize public health and medical education. The paper proposes a gender analysis of health to distinguish between biological causes and social explanations for the health differentials between men and women. It also assessed some of the gender approaches to public health and medical education currently adopted in the Asia-Pacific region. It poses the pressing question of how medical and public health educators integrate the gender perspective into medical and public health education. The paper exhorts all medical and public health practitioners to explore new directions and identify innovative strategies to formulate a gender-sensitive curriculum towards the best practices in medicine and public health that will meet the health needs of women and men in the 21st century.
Introduction: Constipation is affecting a quarter of human population at any one time in all age groups. However, a proper gamma scintigraphic study of whole GI transit is rarely performed in Malaysia due to the lack of suitable radiopharmaceutical. Hence, this study was taken to develop a suitable radiotracer formulation for gamma scintigraphy study of whole gastric-intestinal transit. Methods: The biocompatible polystyrene (PS) incorporated with 152Sm2O3 (5%, w/v) will be used to synthesize the radiotracer. The 152Sm-labelled PS particles was neutron activated to 153Sm in a nuclear reactor for 5 minutes. Characterization of the physicochemical properties, gamma spectrometry and in-vitro radiolabeling studies in simulated gastric fluid (SGF) and simulated intestinal fluid (SIF) were carried out to study the properties and stability of the radiotracer before and after neutron activation. Results: Scanning electron microscope (SEM) and particle size analysis showed that size, shape and surface morphology of the particles remained after neutron activation. The synthesized 153Sm-labelled PS radiotracer (100 mg) particles achieved an activity of 3.7 MBq after 46 hrs. As indicated by the gamma spectrometry result, there is no long half-life radioimpuirties present in the samples. The 153Sm-labelled PS particles achieved radiolabeling efficiency of more than 95% in both SGF and SIF over 72 hrs. Conclusions: A 153Sm-labelled radiotracer particles formulation has been successfully developed from biocompatible PS. The proposed formulation has the advantage of cheaper, easier to be produced and reduced radiation exposure to staff. Further studies are required to validate the in-vivo performance of 153Sm-labelled formulation for assessing GI motility and transit in clinical use.
Introduction: Cancer has become a major economic and societal burden. The National Cancer Registry of Malaysia (NCR) estimates that one in four Malaysian (1:4) will develop cancer by the age of 75. This project aims to develop a prototype named “Laser ablation needle” for tissue cauterization and percutaneous hyperthermia cancer therapy. Our ultimate goal is to develop a highly flexible, operator-friendly and cost-effective laser ablation needle for tissue cauterization and hyperthermia cancer therapy, hence to improve the overall cancer survival rate and quality of life among the cancer patient population. Methods: The laser ablation needle is a closed loop opto-electronic control system, consists of a 2 mm Fiber Bragg Grating (FBG) – optical fiber temperature sensor, a laser driven hot needle and a micro-controller. Based on real-time temperature input from the FBG sensor, the micro-controller can perform a dynamic PID control on laser intensity for a safe hyperthermia treatment. In the fabrication, a medical grade optical fiber with a diameter of 800 μm was used for laser delivery. The optical fiber was embedded inside a biocompatible resin-made needle and connected to a 450 nm high power blue laser diode. The FBG temperature sensor was incorporated in the needle for real-time temperature monitoring and control. Focal hyperthermia produced by the laser-driven hot needle was conducted on ex-vivo bovine liver. Results: The rise in temperature was recorded by increasing laser power. The temperature profile was obtained at each depth. Irreversible thermal denaturation during irradiation was captured. Conclusion: These preliminary results suggest that this technique can be applied safely and effectively for cancer treatment. The developed prototype comprised of the diode laser showed that it can deliver its energy via simple optical fiber. This laser is cheaper and much smaller than the conventional high power lasers used in other studies.
Introduction: Colon cancer is one of the leading cause of cancer death and current treatments often bring about undesired toxicities and resistance. Hence targeted therapeutic regimens for cancer are developed. Anticancer agent incorporated with copper has been synthesized to selectively target cancer cells that are reported to take up more copper compared to normal cells. Cu(SBCM)2 synthesized from the condensation of s-benzyldithiocarbazate and 3-aetylcoumarin was demonstrated to exhibit anti-proliferative effect towards MCF-7 cells and MDA-MB-231 breast cancer cells via cell cycle arrest and apoptosis. However, the mode of cell death of Cu(SBCM)2 on colon cancer cells has not been explored. This study investigated the anti-cancer properties of Cu(SBCM)2 on HT-29, colorectal cancer cell line. Methods: The growth inhibition of the copper complex was determined using MTT assay and xCELLigence real time cell monitoring analysis. Results: Cu(SBCM)2 was shown to inhibit the growth of HT-29 cells significantly in time- and dose- dependent manner with IC50 of 25.23 ± 8.22 uM at 48 hours. Morphological studies using inverted light microscope indicating Cu(SBCM)2-treated HT-29 cells displayed characteristics of apoptosis such as cellular shrinkage and membrane blebbing. Cell cycle analysis was carried out using flowcytometer and Cu(SBCM)2 was found to induce G2M cell cycle arrest at 24 and 48 hours. ROS assay was carried out to determine the involvement of oxidative stress on Cu(SBCM)2 treated HT-29 cells. Nevertheless, results indicated Cu(SBCM)2 significantly suppressed the formation of ROS compared to control. Conclusion: In summary, Cu(SBCM)2 shows promising potential in cancer therapy against colon cancer cells.
Purple urine bag syndrome (PUBs) is a rare and startling phenomenon of purple discolouration in the urine or urinary catheter and bag. It is reported in chronically debilitated elderly patients, mostly in women on long-term urinary catheters. Its prevalence is strikingly more common in nursing home residents. Several factors contribute to the formation of indigo (blue) and indirubin (red) pigments from a breakdown of dietary tryptophan, which stains the urine purple. These factors include constipation, dysmotility of the bowel, bowel bacterial overgrowth, dehydration, and urinary tract infection. The presence of purple urine may cause undue alarm to both the patient and the doctor. Thus, we present this case report on an 86-year-old woman, a nursing home resident on a long-term urinary catheter, who presented to the primary care clinic. Her urine cleared after antibiotic therapy, replacement of her urinary catheter, and supportive management, which included hydration and nutrition. In addition to these measures, reducing the time between urinary catheter changes was recommended to prevent recurrence of this condition.
Findings on knowledge, attitudes and beliefs related to HIV/AIDS among 520 Malaysian adolescents, aged 15 to 21 years, based on a survey conducted in Peninsular Malaysia showed that the average score for knowledge on HIV/AIDS was high, and majority showed a positive attitude towards the disease. However, misconceptions regarding transmission and gender bias related to sexual behaviour and contracting the disease prevailed. Although 72 percent of the sexually-experienced did not use protection at first sexual intercourse, 80 percent did not perceive themselves to be at risk of contracting HIV/AIDS. A critical review of existing HIV/AIDS prevention programmes to focus on adolescent risk-taking behaviour and sexuality issues, including male-female negotiation skills, is warranted.
Thromboembolic disease remains an important cause of maternal mortality worldwide. The risk assessments for prevention of thromboembolism in pregnancy are controversial due to lack of large-scale randomised controlled trials. Unfractionated heparin is at present, the anticoagulant of choice during pregnancy. However, it may be superseded by low-molecular-weight heparin in the near future because of its safety and efficacy.
Introduction: Hepatic radioembolization is a minimally invasive procedure involving intrarterial administration of radioembolic microspheres for the treatment of liver tumours. In this study, a biocompatible polystyrene (PS) microspheres formulation containing radioactive Samarium-153 (153Sm) was synthesized and tested. The 153Sm emits both diagnostic gamma energy and therapeutic beta radiation, renders the synthesized microspheres an ideal theranostic radioembolic agent for hepatic radioembolization. Methods: First, the 152Sm2O3 (20 – 50%, w/v) was encapsulated in PS microspheres using solid-in-oil-in-water solvent evaporation method. The 152Sm-labelled PS microspheres were then activated to 153Sm (Eβmax = 807.6 keV, half-life = 46.3 hours) via 152Sm (n,γ) 153Sm reaction in a nuclear reactor with a neutron flux of 2.0 x 1012 n.cm-2.s-1. Physicochemical characterization, gamma spectroscopy and in-vitro radiolabeling studies were carried out to study the properties and stability of the microspheres before and after neutron activation. Results: The 153Sm -labelled PS microspheres achieved a nominal activity of 4.0 GBq.g-1 after 6 hours of neutron activation. Scanning electron microscope (SEM) and particle size analysis show that the microspheres remained spherical with diameters within 15 – 60 μm after neutron activation. No long half-life radioimpurities were found in the samples as revealed by the gamma spectroscopy results. The 153Sm-labelled PS microspheres achieved radiolabeling efficiency of more than 95% in saline and blood plasma over 480 hours. Conclusion: A biocompatible 153Sm-radiolabelled PS microspheres formulation has been successfully developed. The formulation achieved desirable properties for theranostic treatment of liver tumours. The formulation is relatively cheaper, easier to be produced and more readily available.
OBJECTIVE: This study examines the extent to which preventive and promotive advice is integrated into the clinical practice of doctors.
STUDY DESIGN: Using a cross-sectional descriptive survey design, the study compares the performance of doctors in giving healthy lifestyle advice for five clinical conditions, their perceived practice and their rating on the importance of disseminating selected key lifestyle messages.
DATA EXTRACTION METHODS: A total of 28 volunteers were trained to simulate the five clinical conditions which required related health advice and to rate the doctors' performance with the use of a prepared checklist. Simulated patient ratings of 343 doctor-patient encounters provided the data on doctors' health promotion efforts for the selected clinical conditions. A post-visit self-administered questionnaire survey of a sub-sample of 100 doctors gave an insight into their opinions and perceived practice.
PRINCIPAL FINDINGS: Only in 49% of the instances was a health promotion message given. The doctors' encouraging interest in health education and health promotion and their positive perceptions of their volume of healthy lifestyle counselling were not borne out in actual clinical practice.
CONCLUSIONS: The results indicate that the extent of preventive and promotive health education in both the public and private health sectors is unacceptably low. The matter needs to be addressed through training programmes as well as the formulation of clear health promotion priorities and strategies in Malaysia.
Thirty six clinical isolates of Cryptococcus neoformans were tested for their susceptibility to 5-fluorocytosine and amphotericin B by the determination of minimum inhibitory concentrations and minimum fungicidal concentrations. 22.2% of the isolates were resistant to 5-fluorocytosine and 36.1% indicated 5-fluorocytosine tolerance. All strains were sensitive to amphotericin B.
The incidence of Campylobacter jejuni in patients with and without diarrhoea was studied in Kuala Lumpur, Malaysia. C. jejuni was recovered from 3.8% and 4.3% of diarrhoeal stools of children and adults, respectively. From the patients without diarrhoea, the relative isolation rates for children and adults were 2.6% and 0%, respectively. Dual infections occurred in two children, with Salmonella and enteropathogenic Escherichia coli being the other enteric pathogen in each case. Cary-Blair medium was found to be an effective transport medium in recovering C. jejuni. Campylobacter enteritis occurred in patients of various age groups, indicating that this organism should be sought routinely by diagnostic laboratories in faecal specimens from patients with diarrhoea.