Job Satisfaction ; Motivation ; Primary Health Care ; Education, Graduate

Non-Leisure Time Physical is the main component of physical activity in Malaysia. The aim of this study is to study the associated factors related to Non-Leisure Time Physical (occupational & travel) in Malaysia. This data is from the Third National Health and Morbidity Survey, consisting of 32,575 respondents. It was a cross-sectional study among Malaysian adult, aged 18 years and was conducted using proportional to the size stratified sampling method. Chi square test and logistic regression model were used to analyse the data. The result showed that non-leisure time physical activity (NLTPA) gives more contribution to total physical activity, as compared to leisure time physical activity with percentage of 64.3% and 35.7% respectively. There was a significant association between NLTPA with age (P < 0.001), gender (P < 0.001), ethnicity (P < 0.001), education (P < 0.001), occupation (P < 0.001), income (P < 0.001), marital status (P < 0.001), region (P <0.001) and residence (P < 0.001). The main component of physical activity in Malaysia is NLTPA. Promoting NLTPA may have potential to increase physical activity levels in Malaysia.

Introduction: Microbial keratitis is one of the most challenging complications of contact lens (CL) wear. Proper CL practice plays an important role to reduce the risk for contact lens related microbial keratitis (CLRMK). Methods: This multi-centre case-control study was conducted from January 2008 until June 2009 to determine the risk factors associated with CLRMK. Cases were defined as respondents who were treated for CLRMK, whilst controls were respondents who were contact lens wearers without microbial keratitis. Ninety four cases were compared to 94 controls to determine the risk factors for CLRMK. Results: The predictors for CLRMK were: Not washing hands with soap before handling CL (aOR 2.979, CI 1.020, 8.701 p=0.046), not performing rubbing technique whilst cleaning the CL (aOR 3.006, CI 1.198, 7.538 p=0.019) and, not cleaning the lens case with multipurpose solution daily (aOR 3.242 CI 1.463, 7.186 p=0.004). Sleeping overnight with the CL in the eye (aOR 2.864, CI 0.978, 8.386 p=0.049) and overall non-compliance with lens care procedures (aOR 2.590, CI 1.003, 6.689 p=0.049) contributed significantly to CLRMK. Conclusion: Health education and promotion in contact lens care are important and should be conducted by eye care practitioners to reduce the occurrence of CLRMK.
Contact Lenses

Introduction: A hospital based case control study was conducted in government hospitals on contact lens patients diagnosed with microbial keratitis. Methods: The objective of this study is to determine the visual outcomes of contact lens related microbial keratitis. The visual outcomes which comprised of visual acuity, keratometry readings, corneal topography findings and contrast sensitivity examinations was determined after three months from the first presentation at the hospitals. Results: The mean LogMAR visual acuity during presentation was 0.96 ± 0.73 or a Snellen equivalent 6/60 (n=76) and mean LogMAR visual acuity after three months was 0.10 ± 0.48 or a Snellen equivalent 6/7.5 (n=76) with a significant difference (t=11.22, df=78, p=0.001). Best fit curve for the cases had a regression coefficient, r=0.350 ± 0.063 (95% CI = 0.224, 0.447, df=78, p=0.001. The visual acuity in cases and controls was 0.10 ± 0.48 and -0.10 ± 0.14 respectively (t= -3.61, df=154 p=0.001) after three months which showed improvement. There was a reduction in the corneal uniformity index and corneal asphericity in the cases. The Corneal Uniformity Index (CU index) in cases was 63.03 ± 26.38 (n=76) and in controls, 80.13 ± 11.30 (n=77), (t= -5.22, df=151, p=0.001). There was also a reduction in the contrast sensitivity function at all spatial frequencies in the cases which was significantly different. Conclusion: Microbial keratitis reduced the vision, corneal uniformity index, asphericity and contrast sensitivity after three months in eyes of patients diagnosed with the condition.
Keratitis ; Eye

Sarcoidosis typically affects young adults with bilateral hilar lympadenopathy, lung parenchymal disease and/or skin lesion. Childhood sarcoidosis is relatively a rare entity. Concurrent ocular and renal involvements are extremely uncommon especially in childhood sarcoidosis. We presented a case of an Asian teenager with bilateral recurrent anterior uveitis and features of renal failure due to childhood sarcoidosis. He showed remarkable clinical improvements after combination of oral corticosteroids and methotrexate. His final visual outcome was satisfactory following augmented trabeculectomy in both eyes due to intractable glaucoma. It is essential to make a prompt diagnosis and initiate proper management to avoid ocular mobidity in this unusual presentation.

·A 27-year-old man was stung by a bee presented with severe pain in the right eye. It was associated with reduced vision and swelling of the eyelids. A retained stinger was identified at the center of the cornea, surrounded by dense corneal oedema and numerous folds in the Descemet's membrane. The sting was removed completely. He subsequently developed persistent corneal oedema and heterochromia iridis. He was treated with intensive topical steroids. He underwent penetrating keratoplasty five months after the injury. His visual acuity was satisfactory one year after the surgery. Corneal oedema is an uncommon complication of bee sting injuries. It can be persistent and results in severe visual impairment. An early penetrating keratoplasty offers a good visual outcome after bee sting injury.

​The prevalence of Type 2 diabetes mellitus (T2DM) is increasing worldwide and many of these affected individuals remain unidentified. Undiagnosed T2DM may impose substantial public health implications because these individuals remain untreated and at risk for complications. The objective of this study was to determine the national prevalence of undiagnosed T2DM and to identify the associated risk factors. A nationwide cross-sectional study was conducted involving 17,783 respondents. Two-stage stratified sampling design was used to select a representative sample of the Malaysian adult population. Structured validated questionnaires with face to face interviews were used to obtain data. Respondents, who claimed that they were not having diabetes, were then asked to perform a fasting blood glucose finger-prick test by Accutrend GC machine. The prevalence of undiagnosed T2DM was 8.9% (n=1587). The highest percentage of undiagnosed T2DM was found among males (10.2%), 55-59 years old (13.4%), highest education attainers of primary school (11.1%), Indians (10.3%), married (10.3%), working (8.9%) and living in the urban areas (9.2%). Multivariate analyses showed that factors associated with undiagnosed T2DM were gender, age group, ethnicity, marital status, obesity and hypertension. This study found an increasing trend of undiagnosed T2DM in Malaysia compared to 2006. This finding is alarming as risk factors associated with undiagnosed diabetes were related to most of the socio-demographic factors studied. Therefore, early diabetic screening is crucial especially among adults aged 30 and above to prevent more serious complications of this disease.​

Background For patients with cardiovascular disease (CVD), co-existence of peripheral artery disease (PAD) predicts increased mortality, and such patients are also more likely to benefit from aggressive therapy. Surveillance of PAD is often neglected at health clinics. Our aim is to highlight the importance and ease of surveillance of PAD in patients with CVD. Objective To determine the prevalence of symptomatic and asymptomatic PAD in a Malaysian patient population with documented CVD. Methods and Results A total of 393 subjects with established CVD were recruited from three centres (85 women and 308 men), as part of a larger international (AGATHA) survey. PAD, determined by presence of claudicant symptoms on interview and/or abnormal ankle-brachial index (ABI)score of less than 0.9, was present in 21.4% of patients - of whom 64% were asymptomatic. Abnormal ABI is associated with higher systolic blood pressure and number of arterial beds affected. Conclusions Concomitant PAD is prevalent among CVD patients in Malaysia. ABI screening is simple and yields a high proportion of patients with extensive atherosclerosis who may require more aggressive atherosclerotic risk management.

Toxicity of the fungicide Flutolanil was in vitro tested against 20 isolates of Macrophomina phaseolina and cotton seedlings of ten commercial cotton cultivars. The isolates were recovered from roots of cotton plants obtained from different cotton-growing areas in Egypt. Most of the tested isolates were sensitive to Flutolanil; however, they varied in sensitivity. Twenty-five percent of the isolates were highly sensitive where IC50 ranged from < 1 to 5.1 microg/ml, 20% of the isolates were sensitive where IC50 ranged from 15 to 30 microg/ml, 45% of the isolates were moderately sensitive where IC50 ranged from 46 to 58.5 microg/ml, and 10% of the isolates were not much sensitive (tolerant) where IC50 was > 100 microg/ml. Flutolanil was very safe on both shoots and roots of the tested cultivars (IC50 > 100 microg/ml). Treating cotton seeds with Flutolanil resulted in highly significant (P < 0.01) reductions in pathogenicity of 18 isolates and a significant reduction (P < 0.05) in pathogenicity of isolate M29. M1 was the only isolate, which was insensitive to the application of Flutolanil. In vivo toxicity to Flutolanil was not correlated with its in vitro toxicity. However, a highly significant correlation (r = 0.60, P < 0.01) was observed between pathogenicity of isolates and the in vivo toxicity of the fungicide.
Egypt ; Gossypium ; Inhibitory Concentration 50 ; Seedlings ; Virulence

PURPOSE: To report rates of and reasons for operation cancellation, and to prioritize areas of improvement. METHODS: Retrospective data were extracted from the monthly reports of cancelled listed operations. Data on 14 theatres were collected by the office of quality assurance at Jordan University Hospital from August 2012 to April 2016. Rates and reasons for operation cancellation were investigated. A Pareto chart was constructed to identify the reasons of highest priority. RESULTS: During the period of study, 6,431 cases (9.31%) were cancelled out of 69,066 listed cases. Patient no-shows accounted for 62.52% of cancellations. A Pareto analysis showed that around 80% of the known reasons for cancellation after admission were due to a lack of surgical theatre time (30%), incomplete preoperative assessment (21%), upper respiratory tract infection (19%), and high blood pressure (13%). CONCLUSION: This study identified the most common reasons for operation cancellation at a teaching hospital. Potential avoidable root causes and recommended interventions were suggested accordingly. Future research, available resources, hospital policies, and strategic measures directed to tackle these reasons should take priority.
Hospitals, Teaching* ; Hypertension ; Jordan ; No-Show Patients ; Quality Improvement ; Respiratory Tract Infections ; Retrospective Studies