There is a strong correlation between stress and the quality of care provided by informal carers. In this regard, an accurate understanding about factors contributing to stress among informal carers is crucial in order to find appropriate interventions to solve their problems. A pilot study was conducted in October 2009 in the Klang Valley area, to test the instrument liability in the local context. In-depth interviews were conducted with two informal caregivers who are providing full-time care for their chronically-ill family members. Informal caregivers face multiple types of stress. A variety of factors such as financial problems, an unsupportive community, fatigue, the unavailability of social services to assist them and their inability to accept the fact that their loved ones are terminally ill, contribute to their stress. Differences in factors contribute to stress, and lead to the adoption of different styles of coping strategies: emotion and problem focused coping.
Patient Care ; Adaptation, Psychological

Objective: To synthesize silver nanopaticles from leaves extract of Eucalyptus chapmaniana (E. chapmaniana) and test the antimicrobial of the nanoparticles against different pathogenic bacteria, yeast and its toxicity against human acute promyelocytic leukemia (HL-60) cell line.Methods:Ten milliliter of leaves extract was mixed with 90 mL of 0.01 mmol/mL or 0.02 mmol/mL aqueous AgNO3 and exposed to sun light for 1 h. A change from yellowish to reddish brown color was observed. Characterization using UV-vis spectrophotometery and X-ray diffraction analysis were performed. Antimicrobial activity against six microorganisms was tested using well diffusion method and cytoxicity test using 3-(4, 5-Dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide, a yellow tetrazole was obtained on the human leukemia cell line (HL-60). Results: UV-vis spectral analysis showed silver surface plasmon resonance band at 413 nm. X-ray diffraction showed that the particles were crystalline in nature with face centered cubic structure of the bulk silver with broad beaks at 38.50 ° and 44.76 °. The synthesized silver nanoparticles efficiently inhibited various pathogenic organisms and reduced viability of the HL-60 cells in a dose-dependent manner. Conclusions: It has been demonstrated that the extract of E. chapmaniana leaves are capable of producing silver nanoparticles extracellularly and the Ag nanoparticles are quite stable in solution. Further studies are needed to fully characterize the toxicity and the mechanisms involved with the antimicrobial and anticancer activity of these particles.

Herbal-based slimming products which are consumed orally may be contaminated with heavy metals as well as microorganisms. This study aimed to evaluate the safety level of these slimming products by determining heavy metals and microbial contamination in different batch production. Six different brands of herbal-based slimming products (A, B, C, G, H and I) with three different batch productions (1, 2 and 3) were investigated (n =18). Five heavy metals Arsenic, Cadmium, Chromium, Copper and Zinc were determined using an Inductively Coupled Plasma-Mass Spectrometry (ICP-MS). The presence of microorganisms was determined by total aerobic count and the bacteria were identified. The samples’ moisture content was determined by calculating the percentage of water loss after drying process. All batches of samples A and B had high content of zinc, over the permissible level of 5ppm while, 6 samples contained Chromium above the permissible level (1.5 ppm). All 3 batches of sample A presented with the highest total daily intake of heavy metals. Bacteria were present in all the samples tested with the highest numbers in samples G, H and A followed by B, I and C. The highest number of fungi was found in product A while product I was free from fungal contamination. Aspergillus spp. was the predominant fungus present in the samples. There was a weak correlation between moisture content and bacteria (r = 0.087) and fungal (r = 0.253) presence in the samples. As some herbal slimming products contain heavy metals as well as microorganisms, consumers need to be more vigilant and discerning when selecting products to be consumed.
Metals, Heavy

p style=text-align: justify;strongOBJECTIVE:/strong To describe our experience in performing the lower cheek flap for access to the infratemporal fossa combined with the neurosurgical approach. br /br /strongMETHODS:/strongbr /strongDesign:/strong Case report br /strongSetting:/strong Tertiary Referral Center br /strongPatients:/strong Two br /br /strongRESULTS:/strong Two unusual tumours involving the infratemporal and middle cranial fossa were excised using this combined appoach. The infratemporal fossa tumour was accessed via the lower cheek flap while the intracranial portion was resected from above via craniotomy.br /br /strongCONCLUSION:/strong The lower cheek flap in combination with the neurosurgical approach allows optimal exposure to tumours involving the infratemporal and middle cranial fossae. It has less complications and better aesthetic outcome compared to other approaches./p
Human ; Male ; Female ; Surgical Flaps ; Surgically-Created Structures ; Cheek ; Neoplasms ; Neurosurgical Procedures ; Cranial Fossa, Middle ; Infratentorial Neoplasms

Overweight and obesity are major health concerns in Malaysia, which are linked to other health consequences such as type 2 diabetes mellitus, cardiovascular diseases and several others. Among dietary factors, sugar-sweetened beverages (SSBs) are reported to be one of the leading factors of weight gain and a higher body mass index (BMI). Sugar-sweetened beverages are beverages with added sugar that only add calories to an individual’s normal diet and they represent the largest contributor to the added sugars intake. This study was aimed to determine the prevalence of SSB consumption among university students in Kuala Nerus, Terengganu, as well as to investigate the association between the students’ SSB consumption and their BMI. A cross-sectional study was conducted among 350 Universiti Sultan Zainal Abidin (UniSZA) Gong Badak Campus and Universiti Malaysia Terengganu (UMT) students by using the convenience sampling. Each participant was given a questionnaire consisting of socio-demographic details, anthropometric assessment and beverage intake. The results revealed that half of the students consumed 2 cups (500 mL) of SSBs on average days (49.4%), whereas 21.7% of them consumed at least 3 cups daily. It was found that sweetened tea was the students’ most preferred SSB and there was also an association between the SSB consumption and the BMI. In conclusion, university students in Kuala Nerus drink 2 cups of SSBs daily and sweetened tea is their preferred SSB. Since the students’ SSB consumption influences their BMI, these students must be aware on the contents of SSB and the related health consequences in order to reduce the consumption of these beverages and hence, reduce their BMI to a healthy level.

Emergency Medicine and Disaster Medicine are two specialties which are similar in the multidisciplinary involvement during the acute phase of the disaster. Recently, there was an increase in the number of disasters in the world but not many physicians are familiar with the principles for dealing with such situations, the unique organizational demands, coordination and the urgent need for medical assistance and relief. This case report delineates our experiences at a tsunami disaster area and the approach to setting up a medical relief team in the affected area. A medical reconnaissance team comprising of an emergency doctor from Hospital Universiti Sains Malaysia (H.U.S.M) and two MERCY Malaysia members was assembled. The team flew to Colombo on day 5 after the tsunami with medical supplies and related materials. The mission started from December 31st 2004 until January 8th 2005. Our surveillance area covered the Southern and Eastern Province with a total distance of 1700 km along the coast. The strategies employed during this medical reconnaissance included risk analysis, devising a resources matrix, developing lines of communication and rapport with other relief teams, Sri Lankan government agencies, and local and international non-government organizations. As a result, our team was able to set up a medical relief camp and distribute the relief items to the tsunami victims. In conclusion, the Disaster Emergency Medical Assistant Team (DEMAT) from H.U.S.M and MERCY Malaysia were able to set up and provide medical relief with our limited resources to a large scale disaster situation.
Disasters ; legal surveillance ; Sri Lanka ; Malaysia ; After values

Aneurysm, Infected ; etiology ; microbiology ; physiopathology ; Aorta, Abdominal ; diagnostic imaging ; physiopathology ; Comorbidity ; Female ; Humans ; Psoas Abscess ; etiology ; microbiology ; physiopathology ; Psoas Muscles ; diagnostic imaging ; physiopathology ; Radiography ; Salmonella ; isolation & purification ; Salmonella Infections ; complications

Food insecurity affects food intake, and it could prevent an individual from consuming enough nutritious food to support and maintain health. The aim of this paper is to determine the prevalence and factors influencing food insecurity among Malaysian households. In 2014, the Malaysian Adult Nutrition Survey (MANS) was carried out, and one of the components measured was food insecurity. Six out of sixteen questions from the food security core-module questionnaire were adopted and answered by 2962 adults. The results showed that about 25.0% adult experienced food quantity insufficiency, 25.5% had food variety insufficiency, 21.9% practised reduced size of the meal, and 15.2% skipped main meal due to lack of money to spend on. For the parents, 23.7% only rely on cheap food to feed children, and 20.8% could not afford to purchase various foods to feed their children. Location, strata, race, level of education, working status and household income shows significant difference while none of the nutritional status components found to be difference in all six parameters of food insecurity measured. Logistic regression with adjusted odds ratios discovered race, education level and household income were related to risk to all six parameters of food insecurity. In conclusion, food insecurity can be a serious problem in Malaysia. An effective and comprehensive effort by the government in terms of policy solution is required to increase education level and ensure an adequate income for every household. Therefore, future research should focus on some of those promising policy solutions and at the same time, study the other possible underlying factors that may lead to food insecurity.
Food Insecurity ; Malaysia ; Adult ; Nutrition Survey

In the article, two co-authors were missing in the author list.

OBJECTIVETo synthesize silver nanopaticles from leaves extract of Eucalyptus chapmaniana (E. chapmaniana) and test the antimicrobial of the nanoparticles against different pathogenic bacteria, yeast and its toxicity against human acute promyelocytic leukemia (HL-60) cell line.

METHODSTen milliliter of leaves extract was mixed with 90 mL of 0.01 mmol/mL or 0.02 mmol/mL aqueous AgNO3 and exposed to sun light for 1 h. A change from yellowish to reddish brown color was observed. Characterization using UV-vis spectrophotometery and X-ray diffraction analysis were performed. Antimicrobial activity against six microorganisms was tested using well diffusion method and cytoxicity test using 3-(4, 5-Dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide, a yellow tetrazole was obtained on the human leukemia cell line (HL-60).

RESULTSUV-vis spectral analysis showed silver surface plasmon resonance band at 413 nm. X-ray diffraction showed that the particles were crystalline in nature with face centered cubic structure of the bulk silver with broad beaks at 38.50° and 44.76°. The synthesized silver nanoparticles efficiently inhibited various pathogenic organisms and reduced viability of the HL-60 cells in a dose-dependent manner.

CONCLUSIONSIt has been demonstrated that the extract of E. chapmaniana leaves are capable of producing silver nanoparticles extracellularly and the Ag nanoparticles are quite stable in solution. Further studies are needed to fully characterize the toxicity and the mechanisms involved with the antimicrobial and anticancer activity of these particles.

Anti-Infective Agents ; chemical synthesis ; pharmacology ; toxicity ; Bacteria ; drug effects ; Candida albicans ; drug effects ; Cell Line, Tumor ; Eucalyptus ; chemistry ; Humans ; Metal Nanoparticles ; chemistry ; toxicity ; Plant Extracts ; chemistry ; pharmacology ; toxicity ; Plant Leaves ; chemistry ; Silver ; pharmacology ; toxicity