Women with an abnormal Pap smear results are susceptible to distress. The objective of this study was to measure the reliability and validity of the Malay version of Psychosocial Effects with an Abnormal Pap Smear Questionnaire 14 Items (PEAPS-Q-14). A cross sectional study was conducted among 70 women with abnormal Pap smear results who were referred to three tertiary hospitals in East Coast Malaysia and completed colposcopy investigation. The self-administered PEAPS-Q-14 comprises of four domains and a total of 14 items. Descriptive analyses, Chronbach’s alpha and exploratory factor analysis were performed to measure the reliability and validity of the Malay version of PEAPS-Q-14. The final model of exploratory factor analysis on the Malay version of PEAPS-Q-14 indicated Bartlett’s Test of Sphericity was significant (Chi-square = 404.640, p value < 0.001) and the Kaiser-Meyer-Olkin (KMO) was 0.561. The items were reduced to four factors based on Eigenvalue exceeding 1 after removing an item. The retained 13 items fit the original PEAPS-Q-14 subdomains well. The model with full items demonstrated acceptable overall internal consistency of 0.724 respectively. The Chronbach’s alpha of each domain in PEAPS-Q-14 range from 0.666 to 0.917 and only an item (Item 7) under the second factor revealed corrected total item correlation of 0.183. Removal of Item 7 has resulted in better reliability of Factor 2 in which its Chronbach’s alpha increased to 0.752. Therefore, the problematic item (Item 7) will be revised and replaced before further confirmatory factor analysis.This study showed the Malay version for PEAPS-Q-14 were reliable and valid to assess the psychosocial burden among women with abnormal Pap smear results based on exploratory factor analysis.

Tahfiz school is an institution that specialises in educating students to memorize and recite the whole Al-Quran. Memorizing the Al-Quran by rote learning will activate the brain to improve the brain ability to process, store information and build memory. The presence of heavy metals affects the nervous system and interferes with the function of the central and peripheral nervous system which will then cause the impairment of mental and cognitive function. The ability to learn, remember or memorize, use of language and to understand something may be disrupted and cause small decrease in IQ and attention. Cross-sectional studies was conducted to measure and to determine the correlation between the levels of heavy metals, Al-Quran memorization and intelligence (IQ) among students in selected tahfiz schools compared to non-tahfiz schools in Selangor. Levels of heavy metals in nail and hair samples were analyzed by using the Inductively Coupled Plasma Mass Spectrometry (ICP-MS). WASI-II test for intelligence was used to measure the student’s IQ. Questionnaires was used to obtain demographic data and was analyzed by using the SPSS version 23.0. Based on the Pearson correlation test, there was a very weak negative correlation and significant relationship between manganese in the hair samples with the level of Al-Quran memorization (r= -0.178, p=0.017). In addition, there was a weak positive correlation but significant relationship between the level of intelligence (IQ) with the level of Al-Quran memorization (r= 0.375, p=<0.001). As a conclusion, the higher the concentration of manganese will cause a decline in the level of Al-Quran memorization and the higher the level of Al-Quran memorization will cause an increase in the level of intelligence (IQ).

Objective: The objective of this study was to establish the relationship between symptoms of PTSD and various scores of emotional intelligence scales. This study employed a cross-sectional research design. Participants were recruited from the local community health centre in Dearborn, Michigan, USA. The Child Posttraumatic Stress Reaction Index (CPTS-RI) measured the presence of PTSD symptoms and the Adolescents Multifactor Emotional Intelligence Scale (AMEIS) measured emotional intelligence. Results: The findings suggest an inverse relationship between PTSD severity and emotional intelligence. The PTSD score was negatively correlated with all AMEIS subscales. Two significant negative correlations were found in the tasks of using emotion and understanding emotion. Conclusion: Findings suggest that individuals with severe PTSD symptoms appear to lack the abilities to understand and use emotions. These findings might be useful in identifying factors that may contribute to decreasing the severity of PTSD symptoms of these children. Implications of the findings were discussed, and recommendations for future research are presented.

Biological Nitrogen Fixation (BNF) process benefits the agriculture sector especially for reducing cost of nitrogen fertilizer. In the process, the diazotrophs convert N2 into ammonia (NH3) which is useable by plants. The BNF process is catalysed by nitrogenase enzyme that involved protons and electrons together with evolution of H2 therefore, the assessment of N2 fixation is also available via H2 production and electron allocation analysis. Thus, the aims of this experiment were to estimate the nitrogenase enzyme activities and observe the influence of diazothrophs on growth of legume (soybean) and non legume (rice) plants. Host plants were inoculated with respective inocula; Bradyrhizobium japonicum (strain 532C) for soybean while Azospirillum brasilense (Sp7) and locally isolated diazotroph (isolate 5) for rice. At harvest, the plants were observed for plant growth parameters, H2 evolution, N2 fixation and electron allocation coefficient (EAC) values. The experiment recorded N2 fixation activities of inoculated soybean plants at 141.2 μmol N2 h-1 g-1 dry weight nodule, and the evolution of H2 at 144.4 μmol H2 h-1 g-1 dry weight nodule. The electron allocation coefficient (EAC) of soybean was recorded at 0.982. For inoculated rice plants, none of the observations was successfully recorded. However, results for chlorophyll contents and plant dry weight of both plants inoculated with respective inocula were similar to the control treatments supplied with full nitrogen fertilization (+N). The experiment clearly showed that inoculation of diazotrophic bacteria could enhance growth of the host plants similar to plants treated with nitrogenous fertilizer due to efficient N2 fixation process

The quality of relationship between a person with dementia and a family caregiver has been identified as one of important factor in informal dementia care. Currently there is no validated questionnaire to measure the dyadic relationship in Malaysia. The aim of present study is to examine the reliability and validity of Quality of the PatientCaregiver Relationship (QCPR) questionnaire in Malay version. A total of 70 patients with mild to moderate dementia and their caregivers were recruited from the psychogeriatric clinic, Universiti Kebangsaan Malaysia Medical Centre using a cross sectional study. The QCPR questionnaire was translated into Malay following the standard guidelines for crosscultural adaptation of measure. The person with dementia and their caregiver completed the QCPR Malay version separately. Internal consistency and test-retest examined for reliability. Construct validity was tested with principal component factor analysis. The reliability of patient QCPR Malay version was good with Cronbach’s alpha coefficients of 0.86 and intraclass correlation coefficients of 0.85. Item 11 was omitted from the caregiver QCPR Malay version due to its poor correlation with the corrected item-total score. The newly formed scale, 13 items caregiver QCPR Malay version, had satisfactory reliability (Cronbach’s alpha 0.89 and intraclass correlation coefficients 0.91). Principal component factor analysis extracted 4 factors for patient version and 3 factors for caregiver version which explained 69.44% (patients’ report) and 61.20% (caregivers’ report) of the total variance of the scale. As a conclusion, both the patient (14 items) and caregiver (13 items) adapted QCPR Malay version is a reliable and valid tool to measure the quality of dyadic relationship between people with mild to moderate dementia and the caregiver.
Informal care ; dementia ; caregiver ; questionnaire ; reliability ; validity

The Quality of Life-Alzheimer’s Disease (QOL-AD) questionnaire is a reliable, valid and popular outcome measure in dementia related studies. However, to date there is no published report on adopted version of QOL-AD in Malay language. Thus this preliminary study aimed to evaluate the reliability and validity of the QOL-AD in Malay language for patients with dementia and to examine the level of agreement between patient-caregiver as a proxy reports on patient’s quality of life. A total of 65 patients with mild to moderate dementia and their caregivers were recruited from the psycho-geriatric clinic, Universiti Kebangsaan Malaysia Medical Centre using a cross sectional study design. The QOL-AD was translated into Malay language using the standard guidelines for cross-cultural adaptation of measure. The patient-caregiver dyads completed the QOL-AD in Malay language separately. Test-retest and internal consistency was evaluated for reliability and construct validity was tested with principal component factor analysis. The reliability of QOL-AD in Malay language was good with Cronbach alpha coefficients of 0.82 and 0.79 and intraclass correlation coefficients of 0.77 and 0.89 for patients and caregivers report respectively. Meanwhile a positive moderate agreement was achieved between patient and caregiver rating (r=0.60, p<0.01). The principal component factor analysis extracted 4 factors for both patient and caregiver reports which explained 66.02% (patients’ report) and 64.24% (caregivers’ report) of the total variance of the scale. As a conclusion, the QOL-AD in Malay language is a reliable and valid tool to measure the quality of life of people with mild to moderate dementia.

Background: Previous studies have shown that serum VEGF levels were elevated in patients with active systemic lupus erythematosus (SLE), especially in those with lupus nephritis (LN). In this case control study, we aimed to compare serum levels of VEGF in SLE patients between LN, non-LN and healthy participants to determine the association between serum VEGF levels and the activity and histological classes of lupus nephritis. Methods: Blood samples were obtained from 92 SLE patients (46 LN and 46 non-LN) and 26 controls. Data were collected from medical records. Serum VEGF assays were performed by specific, enzyme-linked immunosorbent assay kits (ELISA). Laboratory investigations included urinalysis, urine protein–creatinine ratio, serum creatinine, albumin and VEGF levels. Blood pressure, renal biopsy result and treatment were recorded. LN activity was evaluated using the renal subscale of the British Isles Lupus Assessment Group (rBILAG, 2004). The rBILAG measures blood pressure (diastolic and systolic), urine protein, serum creatinine, calculated glomerular filtration rate (GFR), presence of active urinary sediments and histological evidence of active nephritis. Results: Serum VEGF was elevated in SLE patients with LN compared with the non-LN group and healthy controls. The levels found were significantly higher in the sera of patients with active nephritis compared to those with quiescent nephritis (P = 0.024). The study did not find a statistically significant relationship between serum VEGF levels and histological classes of LN. Conclusion: There was no significant difference of serum VEGF level between LN and non-LN SLE groups and between the non-LN group and healthy controls. However, there were increased levels of serum VEGF in the LN group, especially in patients with active nephritis as compared to quiescent nephritis group. This reflects the role of VEGF in the pathogenesis of lupus nephritis, however the clinical potential of this biomarker needs further study.

Assessment of amino acid decarboxylase activity can be conducted using tubed broth or plated agar. In this study, the test was carried out in microtitre plates containing lysine, ornithine, arginine, tyrosine, tryptophan, phenylalanine or histidine as biogenic amine precursors. Møller decarboxylase base broth (MDB) with or without 1% of a known amino acid were added to wells of a 96 well-microtitre plate. The wells were inoculated with Escherichia coli, Klebsiella pneumoniae, Acinetobacter anitratus or Staphylococcus aureus to the final concentration of 6.0 x 107 cfu/ml and incubated at 35oC. The absorbance of the culture broth was read at 570 nm at 0, 1.0, 2.0, 3.0, 4.0, 5.5, 6.5 and 7.5 hour. Comparison of means of A’570 between 0 hour and a specified incubation time was determined statistically. Positive decarboxylase activities were detected in the media inoculated with E. coli and K. pneumoniae in less than 6 hours. The current method is suitable for immediate producers of amino acid decarboxylase enzymes. It costs less as it uses less amino acid and it has the potential to be used for screening aliquots of food materials for amino acid decarboxylase activities.

Objective: To summarise the published research on teenage pregnancy in Malaysia, discuss the impact of the findings on clinical practice, and identify gaps in teenage pregnancy research in Malaysia. Methods: There were 31 articles related to teen pregnancy found after searching a database dedicated to indexing all original clinical research data published in Malaysia from year 2000 to 2014. Twenty-seven articles (including reports from the National Obstetrics Registry) were selected and reviewed on the basis of clinical relevance and future research implications. This literature review has been divided into eight sections: epidemiology, age at first marriage, adolescent fertility rate, unmarried childbearing, risk factors, maternal risks and neonatal outcome, future plan after delivery, and contraceptive use. Results: More than 19,000 births to teenage mothers were recorded each year between 2009 and 2011. Adolescent fertility rates were recorded at 6 births per 1000 women ages 15–19 years in 2013. Many of these births were from unwed pregnancies, which accounted for 1.99% of total deliveries. A majority of young mothers were willing to take care of their baby, although some of them planned to put their baby up for adoption. Risk factors for teenage pregnancy were found to be similar to those published in studies worldwide. Conclusion: More research is needed to better understand the issue of teen pregnancy. For the best results, collaborative studies among nationwide hospitals and institutions should be the way forward.
Pregnancy in Adolescence

Extracorporeal membrane oxygenation (ECMO) is a useful but less commonly used technique in right ventricular failure post cardiac surgery in our region. We report a case of successful use of ECMO for right ventricular failure post cardiac surgery. Our patient is a 27-year-old male presented with constrictive pericarditis post completion of treatment for disseminated Tuberculosis. He underwent pericardiectomy that was complicated with acute right ventricular failure. He was placed on extracorporeal membrane oxygenation after few hours post op that lasted for five days. The patient survived to hospital discharge and remained well on follow-up. From our experience, this aggressive management approach is beneficial in right ventricular failure and can be safely utilised in all cardiothoracic centres.