Objective: Transition of people with cognitive impairment to nursing home is often an option when their disease progresses and their needs become too complex. The aim of this study was to identify the needs of people with cognitive impairment living in nursing homes and factors associated with higher level of needs. Methods: A cross sectional survey involving 110 respondents with cognitive impairment aged ≥60 was carried out. Respondents were assessed using the Short Mini Mental State Examination (SMMSE), Camberwell Assessment of Needs for Elderly (CANE), Barthel Index (BI), Friendship Scale (FS), and Geriatric Depression Scale (GDS). Results: Respondents with cognitive impairment had a mean of 2.81 (SD=3.72) for unmet needs and 11.95 (SD=3.14) for the met needs, with higher mean suggesting a better outcome measure. The most frequent unmet needs were intimate relationships (66.40%), company (40.00%), and daytime activity (34.50%). Unmet needs were significantly associated with depression, social isolation, and cognitive impairment. Conclusion: Most of the needs of people with cognitive impairment in nursing homes were fulfilled, except in social area. Therefore, attention should be given in improving the care system, which emphasizes collaboration between people with cognitive impairment, family members, community, and government in helping to reduce the risk of loneliness in those with cognitive impairment.

Mutagenicity of CORAGRAF (natural coral) and REKAGRAF (hydroxyapatite) was tested in Ames test with and without an external metabolic activation system (S9). The test revealed no mutagenic activity of both locally produced osseous substitutes.
Base Pair Mismatch/drug effects ; Biotransformation/physiology ; Bone Substitutes/*toxicity ; Calcium Carbonate/*toxicity ; Chromosome Aberrations ; Escherichia coli/genetics ; Hydroxyapatites/*toxicity ; *Materials Testing ; *Mutagenicity Tests ; Salmonella typhimurium/genetics

Multicentric disappearing bone disease, or Gorham disease, is a rare entity. A middle age woman, presented to us with left sided antalgic gait and severe bony deformity of her left knee. Radiograph revealed massive bone defect of the medial condyle of the left tibia with subluxation of the knee joint. She was scheduled for knee replacement in six months. However, she developed another lesion over the right hip that typically mimicked the disease progression of disappearing bone disease. The right femoral head vanished progressively within three months without significant history of infection or trauma. Subsequent bone biopsy of the right femoral head and left tibia condyle confirmed the diagnosis. Total knee replacement was carried out for her left knee. She remained pain free on her left knee. A year later, after confirming by sequential radiographs that the osteolysis had stopped, total right hip replacement was performed. Five years later, she remained pain free and both the arthroplasties were stable.
Osteolysis, Essential

Euphorbia tirucalli Linn. is traditionally used as medicine especially in the treatment of diseases caused by bacterial pathogens. The objectives of the present study were to identify the bioactive compounds in the stem of Euphorbia tirucalli Linn. using the gas chromatography-mass spectrometry (GCMS) analysis, and to investigate their potentials as an alternative for antimicrobial activity. Two-microliters of dried powdered of Euphorbia tirucalli Linn. stem were mixed with methanol followed by injection into splitless mode of GC-MS. Separation was achieved by Elite-5MS fused capillary column. The mass spectra were compared with the spectra of known components stored in the NIST and WILEY databases for compound identification. Forty-six chemical constituents were identified. The major constituents were lanosta-8,24-dien-3-ol, (3β)- (13.60%), (23S)-ethylcholest-5-en-(3β)-ol (7.02%), linoleic acid (2.96%) and viminalol (2.57%). Most of the active compounds present in the stem of Euphorbia tirucalli Linn. have previously been shown to exhibit antimicrobial properties.
Plants, Medicinal ; Medicine, Traditional

Objective: The number of people surviving until old age has been increasing worldwide. Reductions in both fertility and mortality rates, better living standards, nutrition and health care are claimed to be the key factors that increase the proportion of aged people within the population. Nevertheless, growing numbers of older adults also increases the susceptibility to diseases that commonly afflict the elderly, such as dementia. In this article, we discuss on the current issues of dementia in Malaysia and its challenge in providing a better management and services for this population. Methods and Results: Review of literature by searching the databases CINAHL, SCOPUS, MEDLINE and PsychINFO from June 2010 to November 2010 was done on the issues involving dementia patients in Malaysia such as ageing trend, awareness and availability of services. Conclusion: Despite a limited number of studies on dementia in Malaysia, literature revealed the importance of acknowledging the issues and improving the services for the patients. Efforts should be made by the government and private sectors to promote healthy ageing in Malaysia.

The National Health Morbidity Survey in 2006 showed Breast Self Examination (BSE) is still low in Malaysian women even though many awareness programs have been carried out. This study was conducted from May to December 2000 to observe the changes on the level of knowledge, practice and attitude amongst nurses at the Kuala Krai Hospital, Kelantan on the practice of BSE after a health education intervention program was conducted. The objective of the study is to increase the practice of BSE among nurses in that hospital. The study was performed by pre and post intervention without comparison. Respondents consist of 43 nurses selected by random sampling. The instrument used in this study was by questionnaires through direct interview with the respondent. The health education intervention program includes talks, BSE demonstration, counseling and exhibition, was conducted to educate the nurses on the proper time, frequency and correct technique of BSE. The results of the study showed a significant change in the level of knowledge (p < 0.001) before and after intervention. Meanwhile, analysis on practice showed no significant change towards correct BSE practice (p = 0.083). Analysis on attitude showed that all 43 or 100% respondents had changed from negative to positive towards perceived susceptibility, perceived barrier and perceived benefit. No relationship between the socio-demographic factors and the BSE practice (p = 0.63) was observed. Even though practice changes before and after intervention is still low and not significant, but the introduction of the health intervention program caused some changes among the nurses from Hospital Kuala Krai, even though there was no overall change.

Objective: To investigate the prevalence of parental stress and psychological wellbeing among parents with autistic children and their associations with dimensions of support system. Methods: This is a preliminary cross sectional study which randomly selected parents with clinically diagnosed autistic children. Those parents who attended psycho-education session on management of autistic children at Health Psychology Unit were randomly selected to enroll in the study. Psychological wellbeing, parental stress and dimensions of support system were assessed by using the General Health Questionnaire (GHQ-28), the Parenting Stress Index (PSI) and the Provision Social Relation (PSR), respectively. Results: Of 52 parents with autistic children (34 female and 18 male), about 90.4% of parents had significant parenting stress, and 53.8% of parents showed clinical disturbance in psychological wellbeing. Gender (t=1.67, p=0.02) and occupation (F=4.78, p=0.01) showed statistically significant association with psychological wellbeing. No association found between other socio-demographic factors, parental stress and psychological wellbeing with dimensions of support system among parents with autistic children. Conclusion: Parents with autistic children have high prevalence of stress and psychological disturbances. Interactions of various factors need to be acknowledged and considered in order to reduce the burden of parents with autistic children

A preliminary study has been conducted to screen psychogeriatric disorder among elderly. This survey was designed to determine the prevalence of cognitive impairment, stroke and depression in a population sample of 60-89 years old. A total of 40 subjects and informants were selected from the Klang Valley, Kuala Lumpur and Selangor. The screening tools that were used in this survey were Psychogeriatric Assessment Scale (PAS). The Psychogeriatric Assessment Scale (PAS) consists of two sections: the subject’s self report and the informant report. The subject’s self report was used to assess cognitive impairment, stroke and depression. Meanwhile the informant report was used to assess cognitive decline, stroke and behavioral changes in the subject. Results indicated that there was a high percentage cognitive impairment (male 67% case, female 64.3% case) and stroke (male 75% case, female 64.4% case) among elderly. There was also a significant correlation between the subject’s self report and the informant’s report according to PAS each subscale. PAS psychological assessment tool able to screen psychogeriatric problem among elderly and the accuracy of screening ability can be tested with informant report data. Psychogeriatic screening is important to detect early presentation of cognitive impairment and depression among elderly.

Objective: To investigate the prevalence of parental stress and psychological wellbeing among parents with autistic children and their associations with dimensions of support system. Methods: This is a preliminary cross sectional study which randomly selected parents with clinically diagnosed autistic children. Those parents who attended psycho-education session on management of autistic children at Health Psychology Unit were randomly selected to enroll in the study. Psychological wellbeing, parental stress and dimensions of support system were assessed by using the General Health Questionnaire (GHQ-28), the Parenting Stress Index (PSI) and the Provision Social Relation (PSR), respectively. Results: Of 52 parents with autistic children (34 female and 18 male), about 90.4% of parents had significant parenting stress, and 53.8% of parents showed clinical disturbance in psychological wellbeing. Gender (t=1.67, p=0.02) and occupation (F=4.78, p=0.01) showed statistically significant association with psychological wellbeing. No association found between other socio-demographic factors, parental stress and psychological wellbeing with dimensions of support system among parents with autistic children. Conclusion: Parents with autistic children have high prevalence of stress and psychological disturbances. Interactions of various factors need to be acknowledged and considered in order to reduce the burden of parents with autistic children.

Dengue is known to cause high morbidity and mortality worldwide. In recent years, there have been increasing cases of dengue fever associated with a rare complication: hemophagocytic syndrome (HPS), which is a dangerous disorder that carries high mortality. It is associated with infections, autoimmune disorders, and malignancies. Prolonged duration of fever and cytopenia together with multi-organ dysfunction out of proportion to the plasma leakage phase should alert clinicians to consider this condition. In this case study, we highlight a 45-year-old woman with underlying diabetes who was admitted due to dengue fever with warning signs. Her conditions deteriorated quickly: she had spontaneous bleeding, evidence of plasma leakage, severe hepatitis, and coagulopathy on the 11th day of illness. With the support of other blood results, such as raised serum ferritin and lactate dehydrogenase, she was diagnosed with severe dengue with hemophagocytosis syndrome. She responded well to intravenous dexamethasone and recovered on the 19th day of illness.