Pressure Ulcers (PUs) are a significant health problem for hospitalized patients associated with the leading cause of morbidity and mortality. Each year, more than 2.5 million patients suffer from PUs, and about 60,000 people died due to complications of PUs globally. Although PUs brings devastating consequences, fortunately, it can be prevented. The prevention of PUs represents a marker of quality of care and safety of a health-care organization. PUs prevention indeed needs multidisciplinary collaboration management; however, nurses' role is more significant as they are the frontline in providing patient care. This study aimed to assess knowledge, practice, and perceived barriers of PUs prevention among nurses in a Public Hospital in Selangor. A descriptive and cross-sectional study was used to obtain the data. A purposive sample of 220 nurses had been recruited from ICU, CCU, medical, surgical, and orthopedic wards at Public Hospital in Selangor. Data were obtained from self-administered questionnaires. The result was analyzed using the IBM Statistical Packages for Social Science (SPSS) Window Version 23. This study revealed that the respondents had adequate knowledge (95.0%) and good practice (96.8%) of PUs prevention. Heavy workload and inadequate staff were mostly cited as the barrier of PUs prevention. In overall, the respondents' knowledge and practice were good; however, deficits in a particular area of knowledge and practice of PUs prevention still exist. The hospital and nursing department should organize continuous education programs and in-house training in related field to optimized nurses’ knowledge and practice regarding pressure ulcer prevention and management.

The effects of children’s exposure on high concentration of airborne pollutants at schools often associated with increased rate of absenteeism, low productivities and learning performances, and development of respiratory problems. Recent studies have found that the presence of occupants in the classroom seems to give major effect towards the elevation of concentration of airborne pollutants in indoors. In order to evaluate and further understand on the significance of occupancy factor on IAQ, this study has been designed to determine and compare the level of selected physical (particulate matter (PM)) and chemical (carbon dioxide (CO2) and temperature) IAQ parameters and biological contaminants via colony forming unit (CFUm-3 ) for bacteria and fungi inside the selected classrooms during occupied and non-occupied period (first objective). The second objective is to describe the possible sources of airborne pollutants inside the classrooms at the selected primary schools around Kuantan, Pahang. Assessments of physical and chemical IAQ were done by using instruments known as DustMate Environmental Dust Detector and VelociCalc® MultiFunction Ventilation Meter 9565.The data were recorded every 30 minutes for 8 hours during schooldays and weekend at the selected sampling point in the classrooms. For microbial sampling, Surface Air System Indoor Air Quality (SAS IAQ) was used to capture the bacteria and fungi. The data obtained were compared with the established standard reference known as the Industrial Code of Practice on Indoor Air Quality (2010) constructed by the Department of Occupational Safety and Health (DOSH), Malaysia. This study has found that some of the IAQ parameters in the selected classrooms were exceeding the established standards during occupied period in schooldays compared to non-occupied period during weekend. Findings of this study provide the insights for future research including the site selection of school, arrangement of the classrooms and numbers of students per class.
Occupancy ; particulate matter (PM) ; airborne microbes ; indoor air quality ; primary schools

Validity test is important during the development of ergonomics measurement. Failure to conduct validity tests will result in the measurement method being developed to be incapable of providing reliable ergonomics measurements. The objective of this study is to conduct validity test on the simple method ergonomics measurement which was developed. The method named Simple Ergonomics Risks Assessment (SERA). Content validity test and criterion validity test were conducted. The content validity test consists of 6 ergonomics experts who actively provide inputs and positive feedbacks to improve the measurement method being developed. Meanwhile, the criterion validity test involves data collection of complaints on body parts among oil palm workers which were derived from Nordic Musculoskeletal Questionnaire (NMQ) and ergonomics risk assessment scores obtained from SERA. Both findings were tested with the Chi-square test to explore possible relations between the two findings. Results from the test conducted showed that there are significant relations in the scores of neck posture; hip, right and left shoulder, right and left wrists and the right hand associated with fresh fruit bunch (FFB) harvesting activities. In the loose fruits collection, the Chi-square test showed significant relations in the scores of neck posture, hip, right and left shoulders, right wrist, right arm and the left hand. However, there are body parts such as the legs which showed no significant relation. More tests should be conducted to further explore the validity of the method being developed. Findings from both validity tests show that SERA were verified by the experts and tested with validated method so that it is valid to be applied in the future.

Aims: To characterize the genotypic distribution of mec complex, bla complex, methicillin-resistance level (cefoxitinMIC) and β-lactamase activity in carriage methicillin-resistant Staphylococcus species for a potential correlation. Methodology and results: Biochemical test, 30 µg cefoxitin diffusion disc test, cefoxitin E-test, mec and bla complexes distributions, Pbp2a and β-lactamase assays were conducted to characterize phenotypic and genotypic of MRSA and MRCoNS in our collection. Phylogenetic tree was constructed using MEGA6 software to trace the diversity of blaZ gene of MRSA and MRCoNS. Sixteen MRSA and nineteen MRCoNS were identified by biochemical tests followed by 30 µg cefoxitin antibiotic disc susceptibility test and mecA gene screening. Twenty nine isolates carry complete mecA genes (2.1 kb), incomplete mec regulator (negative or truncated) and positive Pbp2a assay for both MRSA and MRCoNS. Only MRCoNS SC177 isolate with cefoxitin MIC of 32 µg/mL carries complete mec complex. Thirty-one of thirty-five isolates carry complete bla complex (blaZ, blaRI, blaI) with 10 MRSA produce strong β-lactamase and cefoxitin MIC of ≥12 µg/mL. Only 4 MRCoNS with cefoxitin MIC of ≤8 µg/mL produce strong β-lactamase. The diversity of blaZ gene was demonstrated by phylogenetic analysis and unusual amino acid mutation at position 145 for MRSA SA60 isolate may compromise its β-lactamase activity with low cefoxitin MIC level (2 µg/mL). Conclusions, significance and impact of the study: Isolates that carry complete complete mecA gene were largely consistent with the expression of Pbp2a. Nevertheless, there is no clear correlation of mec regulator genes in relation to cefoxitin-MIC in both methicillin resistant (MR) Isolates that carry Staphylococcus species. On the other hand, various expression level of β-lactamase may correlate with cefoxitin-MIC level in MRSA as compared to MRCoNS.

Aims: In this study, three putative factors that commonly contribute to antibacterial properties in honey were determined, namely acidity (pH level), peroxide compounds and non-peroxide compounds. Methodology and results: Honey samples were prepared based on the known factors of acidity, peroxide compounds,and non-peroxide compounds to identify factors that contribute to the antibacterial properties of the honey based on agar diffusion assay. Liquid chromatography quadropole time-of-flight mass spectrometry was employed to detect and quantify the presence of acidic, peroxide, and non-peroxide compounds in the honey samples. Acidity and non-peroxide compounds were identified as the significant factors contributing to the antibacterial properties of Kelulut, Tualang and Acacia honey. No peroxide compound was detected in this study across all honey samples. In Kelulut, the presence of the additional compounds (reptoside, platycogenic acid and kauranoic acid) may explain its higher antibacterial properties against Escherichia coli and Staphylococcus aureus as compared to Tualang and Acacia honey based on the inhibition zones on the agar plates. Conclusion, significance and impact of study The presence of multiple antibacterial factors in honey is notably important as it gives an advantage of using honey compared to antibiotics in preventing the growth of a wide range of bacterial species with multiple modes of action.

This paper provides a comprehensive review of the antibacterial properties of three different types of Malaysian honey, namely kelulut, tualang and acacia, in preventing wound infecting bacteria. The antibacterial activity of these honey is mainly attributed to the physicochemical and phytochemical, which have been shown to be effective against a broad range of bacterial pathogens. This review discusses the effectiveness of honey in inhibiting the growth of various wound-infecting bacteria, factors that contributed to the antibacterial properties of the honey, mechanisms of action of honey in inhibiting bacterial growth and their potential for future use in clinical practice. The findings of this review suggest that Malaysian honey has the potential to be used as an alternative and complementary therapy to conventional antibiotics in the prevention and treatment of wound infections.

Introduction: Methicillin-Resistance Staphylococcus aureus (MRSA) is known as a major nosocomial pathogen in healthcare. However, it has now spread in the community known as community-acquired MRSA (CA-MRSA). Thus, the survival and pathogenicity of CA-MRSA isolates were assessed using in vivo peritonitis model with comparison to ATCC-MRSA. Two CA-MRSA isolates; CA-MRSA1 and CA-MRSA2 that were isolated from healthy population, were studied and compared. Methods: Mice were assigned into 4 groups and injected intraperitoneally with ATCC-MRSA, CA-MRSA1 or CA-MRSA2, respectively. Sterile Dulbecco’s Phosphate-Buffered Saline (DPBS) represents negative control. Mice were observed twice daily, 0-72 hours of post-infection. Any signs of distress were recorded for severity score and survival analyses. Mice were euthanised at 72 hours post-inoculation or by referring to the Peritonitis Severity Scoring (PSS) system. Organs of interest, peritoneal lavage and abscess were processed for bacterial counts. Tissue samples were analysed for histopathological scores. Results: All mice inoculated with MRSA showed clear signs of illness with peritonitis symptoms of p<0.001 and comparable PSS scores were recorded in all infected mice groups. Intraperitoneal injection of lethal dose of MRSA resulted in significant death of ATCC-MRSA (p<0.05) and CA-MRSA-infected mice (p<0.01), compared to the un-infected. Bacterial burden was significantly high in all samples harvested from mice challenged with CA-MRSA2 compared to ATCC-MRSA except in abscess and lung. Significant liver necrosis and spleen inflammation were observed in CA-MRSA1, and lung inflammation in ATCC-MRSA-infected mice. Conclusion: Nasal carriage CA-MRSA isolates from a healthy population has the potential to cause peritonitis with comparable severity as ATCC-MRSA.

Aims: Maternal vaginal Group B Streptococcus (GBS) colonization is considered a risk factor for preterm delivery and, consequently, neonatal infections. Previous studies have portrayed the important roles of these virulence factors, including hemolytic pigment, hyaluronidase (HylB), serine-rich protein (Srr) and bacterial surface adhesion of GBS (BsaB) in mediating GBS colonization and intrauterine ascending infection, causing preterm delivery. This study aimed to investigate the association between mRNA expression of virulence genes in GBS isolates obtained from symptomatic pregnant women and preterm delivery. Methodology and results: GBS isolates were obtained from high vaginal swabs of 40 symptomatic pregnant women of gestational age of less than 37 weeks. RNA was extracted from these GBS isolates and RT-qPCR was performed to determine the relative mRNA expression of GBS virulence genes, including CylE (encode enzyme required for the biosynthesis of the hemolytic pigment), HylB, Srr-1 and BsaB. Socio-demographic details and obstetric history were not found to be associated with the delivery outcomes of these women. The GBS isolates from symptomatic pregnant women who delivered prematurely showed a higher expression of CylE gene and a trend towards an elevated expression of HylB gene compared to women with term delivery. Meanwhile the expression of both Srr-1 and BsaB genes was similar between symptomatic pregnant women who had term or preterm delivery. Conclusion, significance and impact of study The results suggest that following vaginal colonization, both CylE and HylB genes are likely to contribute to intrauterine ascending infection and inflammation, leading to preterm delivery in humans. These virulence factors may be targeted for the pre-clinical stages of vaccine development or therapeutic intervention.
Streptococcus agalactiae--isolation & ; purification ; Pregnant Women