This study was conducted to describe corneal endothelial cell density and morphology in Malay eyes. Non-contact specular microscopy was performed in 125 eyes of 125 Malay volunteers, aged 20-87 years. Studied parameters included endothelial cell density (CD), mean cell area (MCA), coefficient of variation (CV) in cell area, as well as hexagonal appearance of the cells. Mean endothelial cell density in the study population was 2648 ± 310 cell/mm². Mean CA, CV and percentage of hexagonal cells were 382.8 ± 47.7μm², 58.1 ± 22.6, 44.3% ± 11.5% respectively. There was a statistically significant decrease in endothelial cell density (correlation - 0.300, P = 0.001) and CV in cell size (correlation - 0.208, P = 0.02) with age. There was a statistically significant increase in mean cell area (correlation 0.300, P = 0.001) with increasing age. The correlation between age and percentage of hexagonal cells was insignificant (correlation 0.074, P = 0.41). In conclusion, a consistent decrease was noted in the endothelial cell density with increasing age. The differences in endothelial cell density between genders were statistically insignificant.

Respiratory Tract Infections ; Prescriptions ; Anti-Bacterial Agents

Leisure involvement is an essential element in the daily life of the elderly people. Little is known, however, about the perceived leisure constraints among them, especially among the increasing elderly population in Malaysia. This study aims to explore constraints perceived by the elderly that prevent them from actively involved in leisure. In depth interviews were conducted, involving a total of 20 elderly aged 60 years and above with stratification by background characteristics. Each interview was conducted for an average of 15 to 30 minutes and discontinued when a saturation point was achieved. They were purposively selected from two health clinics located in two different districts in the state of Selangor, representing an urban and a rural area. Elderly participation in leisure activities was constrained by many factors. These factors can be divided into individual, family and community factors such as increasing age and related physical deterioration , education level, health status and the existence of chronic illness, absence of family member or friends to perform the activity together and non-conducive environment. The constraints should be endorsed and acknowledged by the relevant agencies and authorities in order to facilitate effective implementation of related policies, strategies and programmes to improve the health of the elderly people. These include the provision of appropriate services and facilities to cater senior citizens from various health and demographic perspectives.

This finite element analysis is aimed at comparing relative stiffness of three different posterior instrumentation constructs: the Hospital Universiti Kebangsaan Malaysia Spinal Instrumentation System (HUKM-SIS), the Cotrell-Dubousset Instrumentation (CDI) and Harrington Instrumentation System (HIS), used in the treatment of adolescent idiopathic scoliosis (AIS). The constructs were tested under various loads using MSC Patran 2001 r2a. Under increasing flexion loads, there was a linearly corresponding increase in deflection magnitudes for all constructs on the load-deflection curve. The CDI was the stiffest construct under axial, forward flexion and extension loads, followed by the HUKM-SIS and HIS. Under lateral bending loads, the HUKM-SIS construct was the stiffest followed by CDI and HIS. The HUKM-SIS construct was stiffer than HIS under torsional loads. We conclude that multiple pedicle screws increase the stiffness of posterior instrumentation constructs under all loads and inter-segmental spinous processes wiring increase the stiffness against lateral bending.
instrumentation ; PDGFB Gene ; System ; Spinal ; Scoliosis, unspecified

This study aims to review existing studies on the relations between indoor dampness and mould in different public occupied buildings with the risk of adverse health effects among both children and adults. This study specifically focused on the dampness-related problems from countries with tropical climate. A systematic literature search of ScienceDirect, PubMed, Google Scholar and Wiley Online Library from 2000 through December 2015 was conducted. Furthermore, the reference lists of recent reviews and of relevant articles were identified in our search. Crosssectional, case-control, and cohort studies in children or adults were selected according to a priori criteria. The search yielded a total of 18 studies on damp buildings, dampness and mould in buildings and indoor mould. Dampness and mould exposure in buildings is a risk factors for respiratory symptoms, wheeze, cough, bronchitis, rhinitis, eczema and upper respiratory tract infection as well as general symptoms such as headache and tiredness. Evident strongly suggested increased asthma development and exacerbation of current or ever diagnosis of asthma in children. Based on the results of the review, indoor dampness and mould problems in buildings are associated with substantial and increases in prevalence of a variety of respiratory and asthma-related health outcomes.
Indoor dampness ; mold contamination ; health ; review

This study aims to review existing studies on the relations between indoor dampness and mould in different public occupied buildings with the risk of adverse health effects among both children and adults. This study specifically focused on the dampness-related problems from countries with tropical climate. A systematic literature search of ScienceDirect, PubMed, Google Scholar and Wiley Online Library from 2000 through December 2015 was conducted. Furthermore, the reference lists of recent reviews and of relevant articles were identified in our search. Cross-sectional, case-control, and cohort studies in children or adults were selected according to a priori criteria. The search yielded a total of 18 studies on damp buildings, dampness and mould in buildings and indoor mould. Dampness and mould exposure in buildings is a risk factors for respiratory symptoms, wheeze, cough, bronchitis, rhinitis, eczema and upper respiratory tract infection as well as general symptoms such as headache and tiredness. Evident strongly suggested increased asthma development and exacerbation of current or ever diagnosis of asthma in children. Based on the results of the review, indoor dampness and mould problems in buildings are associated with substantial and increases in prevalence of a variety of respiratory and asthma-related health outcomes.

Introduction: This study was conducted on 215 working women from four private corporate companies in a suburb in Malaysia to determine the factors related to their physical activity levels. Methods: Data were collected using a questionnaire which included socio-demographic characteristics, the International Physical Activity Questionnaire (IPAQ), perceived barriers and benefits to physical activity, self-efficacy to physical activity and an 8-item questionnaire on current behavioral stage of physical activity. Results: The majority of the respondents were Malay (81.9%) with 10.2% being Chinese and 7.9% Indian. Most of the respondents were executives (64.2%), while the rest were non-executives (24.7%) and managers (11.2%). The mean weight, height, BMI and waist circumference were 59.4±13.1 kg, 1.6±0.6 m, 23.7±4.8 kg/m² and 77.0±12.1cm respectively. In this sample, 24.7% and 7.9% were overweight and obese respectively, while 34% were at risk of abdominal obesity. A total of 28.8% of the respondents had low physical activity level, while 48.8% and 22.3% were in the moderate and high physical activity categories respectively. An association was found between monthly income (χ2=110.17; p<0.05) and current behavioral stage of physical activity (χ2=27.527; p<0.05) with physical activity, but no relationship was found between job category and physical activity category (χ2=8.940; p>0.05). Physical activity category was also positively correlated with perceived barriers (r=0.227, p<0.05) and benefits to physical activity (r=0.280, p<0.05). However, physical activity was not associated with self-efficacy to physical activity. Conclusion: In this sample of working women, socio-demographic and psychosocial factors (except self-efficacy to physical activity) were found to have an association with physical activity level of the respondents. Further studies should be conducted to confirm these findings in the general working women population.

Pregnancy-related deaths in four published perioperative mortality review reports were analysed. The aim is to look at the quality of surgical and anaesthetic services along with the perioperative care provided. The audit identified shortfalls in the logistic and support services and recommended remedial strategies. The review was conducted by a committee consisting of practising anaesthetists, surgeons and obstetricians who analysed the questionnaires collectively. A consensus was reached to categorise the death. There were 280 pregnancy-related deaths. Post-partum haemorrhage accounted for 31.8%, followed by hypertensive disorders of pregnancy (20.0% obstetric embolism (16.1%), sepsis (10.7%) and associated medical conditions (21.4%). In brief, there were comings in preoperative, intra-operative and post-operative care in some of the cases. Increased consultant input, clinical audit, improvements in monitoring and expansion of critical care facilities were the integral issues recommended.
Pregnancy ; Review [Publication Type] ; Aspects of mortality statistics ; seconds ; Sepsis

While mortality and morbidity from pulmonary tuberculosis (PTB) have improved, diagnosis of this infectious disease remains suboptimal without a point-of-care test. Antibody/ antigen-based serodiagnostics is the most amenable for point-of-care translation but hampered by a lack of validated biomarkers and a heterogeneous patient antibody response. Using a case-control design, we assessed serodiagnostic potential of immunoglobulins G, A, and dimeric IgA responses against 18 antigenic preparations, followed by antibody-subclass responses against antigen 60 (A60), and four markers of host innate immunity by enzymelinked immunoassay using sera samples (n=110) collected from April to October 2007 in VietNam from human immunodeficiency-negative patients with provisional diagnosis of PTB. We further analyzed host variables to investigate factors driving biomarker heterogeneity observed in patients. Among active pulmonary tuberculosis patients, low correlation was observed between anti-A60 antibody-classes, and between anti-A60 immunoglobulin G subclasses, but anti-A60 immunoglobulin A subclasses were significantly correlated. The best diagnostic combination of anti-A60 immunoglobulin G/A and a C-reactive protein “ruleout” remains insufficient at 82%/92% sensitivity/specificity (95%CI: 72-92%/82-98%). Heterogeneity of anti-A60 immunoglobulins G2, G3, M, as well as C-reactive protein and serum amyloid A levels observed in this study population appeared to be significantly associated with history of previous tuberculosis, hemoptysis, age, vaccination, night sweats, smoking, chest pain, fever, alcohol, and solid culture count. Further research on tuberculosis serological biomarkers may require consideration of host factors and new approaches using multiple biomarkers.

Objective: Various techniques and instruments have been developed to provide safe and secure closure of laparoscopic wounds. Herein we describe a simple method to close laparoscopic supraumbilical wounds with the aid of a laparoscopic port. Method: This was a retrospective review of prospective data, which were from 151 patients who underwent laparoscopic cholecystectomy for symptomatic gallstone disease from December 2009 to December 2010 in Sultanah Bahiyah Hospital. A senior consultant hepato-pancreato-biliary (HPB) surgeon and two HPB trainee surgeons performed the operations. Postoperatively, all patients were followed up at 4 weeks. Results: All patients successfully underwent closure of the supraumbilical wound with the assistance of a 5mm laparoscopic port. None of the patients had incisional hernia on follow up. Conclusion: Port assisted closure of supraumbilical laparoscopic wounds is a feasible and safe technique.
Laparoscopy