A motorcyclist was involved in a motor vehicle accident and presented with respiratory distress and neck swelling with surgical emphysema. He sustained gross tracheal injury, severe pneumothoraces and lung contusions. As intubation was successful, the tracheal injury was not addressed immediately in view of the other severe respiratory problems. Evidence of aspiration lead to further investigations which confirmed the diagnosis 22 days post trauma. Thyrotracheal anastomosis was carried out without stenting. A complete cricotracheal separation is a rare event and can be easily overlooked in the emergency department.

Musca domestica Linnaeus or house fly is one of the well-known cosmopolitan pests. Poultry farms, horse stables and ranches are some of the main habitats for house flies to extend their interference and disturbance. Since 1999, large number of fly population around horse stables and barns in Terengganu Equestrian Resort (TER) was detected and still persists till today. Imported horse food are speculated to be the main cause for the increasing number of these flies. The current study was conducted to determine the effect of imported horse food (i.e. chaff, pallet and alfalfa) and the food conditions (wet and dry) on house fly population densities. Commercial sticky papers were used for trapping house fly distribution around the horse stables and barns in TER from October 2013 to January 2014. A total of 36,751 flies were caught during the eight week study period. The highest number of flies (2,843 individuals) was caught when using ‘wet alfalfa + chaff’ whereas the lowest catch was when using ‘dry alfalfa’ (1,652 individuals). Generally, the wet food treatments captured higher flies compared to dry food treatments. The total number of captured flies was found to be influenced by relative humidity. Higher mean number of flies was captured during lower weekly humidity. Our findings conclude that the wet condition of imported horse food in TER increases the house flies population densities. Thus, urgent action should be taken as soon as possible and may need special management considerations in order to reduce the impact of house flies on the horse industry in Malaysia.

Aims: Bakanae disease on rice has been widely distributed in all countries where rice is grown commercially, especially in Asian countries including Malaysia. As an alternative measure in controlling Fusarium fujikuroi, two approaches have to be adapted i.e. by using resistant varieties and biocontrol agents as reported in the present study. Methodology and results: A total of 31 Malaysian rice varieties were used in screening and results showed that variety MR211 was the most susceptible and MR220 was slightly susceptible. Out of 60 isolates of Trichoderma harzianum isolated from soils in Malaysia and tested against the pathogen under in vitro condition, 13 isolates showed high percentage of inhibition (PIRG > 60%). All isolates of T. harzianum showed that the PIRGs were significantly different at p≤0.05 with those of control plates. Conclusion, significance and impact of study: Biocontrol agent and resistant variety are better alternative for controlling plant diseases. We found a variety MR220 was slightly susceptible, but none of tested varieties is resistant towards pathogen of bakanae disease. T. harzianum has the ability to inhibit the growth of F. fujikuroi (T3068P) under in vitro condition. The findings of the Malaysian susceptible/resistant variety and potential T. harzianum isolate as a biocontrol agent of bakanae are important for future tests in the plant house and field trials.
Biological Control Agents ; Oryza

Each human being exhibits their own personality traits and each aspect of stress and coping is essential and related. The relationship between the big five personality traits, coping mechanisms and stress level among final year medical students of Universiti Kebangsaan Malaysia (UKM) was investigated in this study. In this cross-sectional study, 152 final year medical students batch 2017/2018, were randomly selected, excluding those who had chronic diseases, married and repeated final year. The questionnaires used were Big Five Personality Inventory and 12-Item General Health Questionnaire. An open-ended question was used to determine how the respondents cope with their stress. Data was analyzed using SPSS 20.0. Agreeableness was the most common personality trait portrayed among the students, whereas Openness to Experience appeared to be the least. The relationship between the Big Five Personality Traits and coping mechanisms (p=0.016; p<0.05) were significantly related. Students with Neuroticism personality had the highest rate of practicing avoidant coping mechanism, while students with Extraversion personality had the highest rate of practicing active coping mechanism. Total score of stress were significantly difference between the different personality traits (p<0.001; p<0.05). However, the p value of 0.359 (p>0.05) and 0.94 (p>0.05) for the Big Five Personality Traits and level of stress showed no significant results on academic performance. Identified own personality were beneficial for final year medical students as it helps to identify the most effective coping mechanism in reducing stress during studying medicine.

Life expectancy from birth is increasing dramatically. Due to this increase, the population of elderly people will increase. Consequently, geriatric related illnesses will increase leading to increased necessity to build up comprehensive and coordinated cost effective health care services appropriate for elderly people. Frailty is not a disease, but rather considered as a syndrome requiring comprehensive and multidisciplinary care approach. It is a prevalent reversible pathological transitional stage between healthy aging and disability. Frailty is associated significantly with increased health care utilization, mortality, and comorbidities such falls, hospitalizations, physical dependence, and poor perception of health. The aim of this review is to compile existing literature on the economic cost of frailty syndrome among elderly people in the recent years. Search queries were constructed to look for articles related to the economic cost of frailty in the electronic databases available at the National University of Malaysia library for articles published between the years 2011 and 2019. The accessed electronic database included New England journal of medicine, Science Direct, SCOPUS, BMJ, Cochrane, and Wiley Online Library. Articles included in this review when they were original research, participants were defined as frail elderly, manuscripts written in English language, and involved clearly described measures of frailty cost. Among the literature, twenty one articles were found to satisfy the inclusion criteria of the review process. The cost of care for frail elderly was ranging from US $ 8,620 to 29,910 per patient per year. The cost of health care was ranging from US $ 2,540 to 221,400. The health care cost was accounting for 40% to 76% of the total care cost. Hospitalization cost was the highest, it was ranging from US $ 806 to 152,726. Outpatient cost was ranging from US $ 200 to 18,000. Medications cost was ranging from US $ 7 to 3,434 per frail elderly patient per year. Home help cost was ranging from US $ 804 to 19,728 per frail elderly patient per year. In conclusion, frailty is a costly syndrome. It can be considered as a cost effective target for health promoting interventions to contain future elderly cost.

Rail maintenance routines are necessary to enable the all rail operations to achieve its aim in maintaining a safe and efficient operation. The maintenance tasks expose the workers to vibration and noise, as they handle specialized machineries and heavy self-propelled vehicles. Exposure of noise above the permissible exposure limit and over the daily allowable duration may cause noise-induce hearing loss (NIHL). Investigation on the type of task that has high noise level exposure on the maintenance workers was conducted to justify the needs to further detailed of this study. This paper will describe the task analysis on maintenance workers and to identify possible tasks with exposure to high level of noise. It scopes down to grinding crew of the maintenance department of light rail transit. Methods used were real-time sound measurement using a sound level meter, observation and interviews. Then, data were analysed to understand the situation of exposure of noise during rail maintenance. An ergonomic risk assessment was also conducted by adoption of the latest guideline on Ergonomic Risk Assessment (ERA) at Workplace Guidelines recommended by Department of Occupational Safety and Health (DOSH), Malaysia. A hierarchical task analysis (HTA) was generated on the task of the maintenance worker, focusing on rail grinding crew. The newly generated HTA had allowed better understanding about the nature of work and the task conducted by a rail grinder during the work shifts. Tasks involving high noise level was identified. Data recorded shows that the noise level for the blowing activity was relatively high and exceeded the permissible exposure limit of 90dBA. The exposure level was currently controlled by practicing the usage of hearing protection equipment (HPE) and by controlling exposure time in accordance to recommendations of the Factory and Machinery Act (FMA). Thus, it had confirmed that maintenance workers were exposed to high noise levels when performing their daily task. Further studies are needed to investigate the relationship between the duration of exposure and noise-induce hearing loss (NIHL) with consideration of the lifestyles of the maintenance workers.

Background: Antiphospholipid syndrome (APS) is a multisystem disease that may present as venous or arterial thrombosis and/or pregnancy complications with the presence of antiphospholipid antibodies. Until today, heterogeneity of pathogenic mechanism fits well with various clinical manifestations. Moreover, previous studies have indicated that genes are differentially expressed between normal and in the disease state. Hence, this study systematically searched the literature on human gene expression that was differentially expressed in Obstetric APS. Methodology: Electronic search was performed until 31st March 2015 through PubMed and Embase databases; where the following Medical Subject Heading (MeSH) terms were used and they had been specified as the primary focus of the articles; gene, antiphospholipid, obstetric, and pregnancy in the title or abstract. From 502 studies retrieved from the search, only original publications that had performed gene expression analyses of human placental tissue that reported on differentially expressed gene in pregnancies with Obstetric APS were included. Two reviewers independently scrutinized the titles and the abstracts before examining the eligibility of studies that met the inclusion criteria. For each study; diagnostic criteria for APS, method for analysis, and the gene signature were extracted independently by two reviewers. The genes listed were further analysed with the DAVID and the KEGG pathways. Results: Three eligible gene expression studies involving obstetric APS, comprising the datasets on gene expression, were identified. All three studies showed a reduction in transcript expression on PRL, STAT5, TF, DAF, ABCA1, and HBEGF in Obstetric APS. The high enrichment score for functionality in DAVID had been positive regulation of cell proliferation. Meanwhile, pertaining to the KEGG pathway, two pathways were associated with some of the listed genes, which were ErBb signalling pathway and JAK-STAT signalling pathway. Conclusion: Ultimately, studies on a genetic level have the potential to provide new insights into the regulation and to widen the basis for identification of changes in the mechanism of Obstetric APS.

The rearrangement of the actin cytoskeleton has been shown to play a critical role in the development of transformation and malignant phenotype of cancer cells. Rho family GTPases regulate the arrangement of the actin cytoskeleton. By wound-healing assay, we have found that NIH 3T3 fibroblast cells move towards the wound- gaps by extending filopodial and lamellipdial structures at the leading edge of the moving cells. We have inactivated the function of Rho GTPases of v-Ras transformed NIH 3T3 cells by overexpressing Rho GTPase-activating (RhoGAP) domain of RhoGAP of p190. We have observed that inactivation of Rho, Rac and Cdc42 GTPases by overexpressing RHG causes inhibition of: (i) polymerization of actin to form filaments, (ii) formation of lamellipodia, filopodia and stress fibres, (iii) cell motility, (iv) cell spreading and (v) cell-to-cell adhesions. These results further strengthen the current knowledge on the role of Rho, Rac and Cdc42 GTPases in the regulation of the rearrangement of actin cytoskeleton. Our results, for the first time, demonstrate that RhoGAP domain of RhoGAP could be used to study the molecular mechanism of Ras-mediated signalling in growth, differentiation and carcinogenesis.
Animals ; Biological Assay ; Cell Line, Transformed ; Cell Movement/*physiology ; Cell Transformation, Neoplastic/*ultrastructure ; Mice ; Microfilaments/metabolism/*ultrastructure ; NIH 3T3 Cells ; Research Support, Non-U.S. Gov't ; Wound Healing ; rho GTP-Binding Proteins/genetics/*physiology

Paddy cultivation is one of the widely planted crop in Malaysia. The growth of agricultural activity leads to the use of Organophosphate pesticide to protect the crop. This study is to determine the relationshi p between the levels of blood cholinesterase with the performance of motor coordination of children living in paddy farming area in Tanjung Karang, Selangor. This cross sectional study was conducted among 683 children from four schools in an agricultural area. Majority of the children have at a family member worked as farmer and was involved with pesticides. A set of questionnaire on the was given to the children to be filled by t heir parents. To measure their exposure to pesticide, blood cholinesterase levels were measured. Blood samples were taken through finger prick technique and were then analysed using LOVIBOND 412870 AF287. The children were administered with motor - coordina tion performance test using WHO Neurobehavioral Core Test Battery and McCarthy Learning Ability Scale. Young group children (6 - 85 years) showed a mean score of 56.66 in motor - coordination test while older group children (10 - 11)= years) scored a mean of 45 .37. There was a significant relationship between blood cholinesterase level and motor coordination performance among the young - group children (r=0.215, p<0.001) and the older - group children (r=0.106, p=0.049). Based on the Linear Regression test results, total household income of family, and mode of transport used were found to have significant relationship with blood cholinesterase level of children in both groups. In addition, blood cholinesterase level and mothers’ occupation were found to have signific ant relationship with the motor - coordination performance of all children.

Routine diagnosis of intestinal microsporidiosis in clinical diagnostic laboratories relies mostly on detection of microsporidial spores via special staining and microscopic techniques. This paper describes the comparative evaluation of Calcofl uor White M2R method, with modifi ed Gram-chromotrope Kinyoun method as the reference standard. One hundred and six stool samples were examined for the presence of microsporidial spores. Sensitivity, specifi city, positive and negative predictive values of the Calcofl uor White M2R method compared to the reference technique were 95.2%, 4.3%, 78.2% and 20.0%, respectively. The positive predictive value (PPV) was 78.2% and the negative predictive value (NPV) was 20.0%. Despite low specifi city of the CFW method due to its ability to stain chitinous wall of microorganisms, the presence of distinct deep-blue horizontal or equitorial stripes in microsporidial spores in modifi ed Gram-chromotrope Kinyoun would likely reduce the false positive results obtained in the Calcofl uor White M2R. Hence, the simultaneous use of these two methods would give better performance and accuracy for the detection of microsporidial spores in patients with intestinal microsporidiosis.