Aims: Streptococcus pneumoniae is the most common bacterial respiratory pathogen that can lead to invasive diseases such as pneumonia, bacteremia, and meningitis. The interaction of S. pneumoniae with host respiratory epithelial cells is crucial in the colonization of human respiratory tract and involve in the virulence. The aim of the study is to investigate the adherence of S. pneumoniae and the effect of serotypic variation on neuraminidase genes (NanA and NanB) after interaction of A549 human lung epithelial cells with S. pneumoniae serotypes. Methodology and results: Six different serotypes of S. pneumoniae were used (1, 3, 5, 19F, 23F, and 14). A549 human lung epithelial cells were inoculated with pneumococcal strains of different serotype for 3 hours. The number of adherent bacteria was determined by serial dilution followed by spread plate technique on tryptic soy agar supplemented with 5% sheep blood. Bacterial RNA was harvested from the infected A549 cells. The differential expression level of neuraminidases was observed by quantitative real-time PCR (qRT-PCR). Based on bacterial adherence assay, serotype 14 showed highest adherence, meanwhile, serotype 23F showed lowest adherence. This suggests that serotype 14 has a better affinity to adhere to A549 cells as compared to serotype 23F. Higher NanA gene expression was observed in serotype 5, 23F and 19F, while lower expression in serotype 14. In contrast, NanB gene shows low-level expression in serotype 23F and 19F, while higher expression in serotype 14. This postulates that NanA and NanB gene may have different functions in the pathogenesis of S. pneumoniae. Conclusion, significance and impact of study: Our finding on differential expression of neuraminidase gene of S. pneumoniae of various serotypes on A549 cells might give a better understanding of host pathogen interaction between bacteria serotypes and host cell.

In this study, the effect of beverages (Coke TM, Sprite™, Ribena™, Chrysanthemum tea and mineral water) on the demineralisation of the enamel surface was investigated. Demineralisation was determined by the rate of calcium released from the enamel surface on exposure to the beverages. Calcium was determined using the EDTA titration method. The pH of these beverages was measured using a pH meter and found to be in the acidic range (2.43 to 5.79) while mineral water which served as a control has a pH of 7.00. Ii was found that the rate of calcium released from Coke™(0.76 J..lg/min) showed a significant mean difference from Sprite™ (0.38 J..lg/min), Chrysanthemum tea (0.10 J..lg/min) and mineral water (0.00 J..lg/min)at p< .05, but was however not significantly different from Ribena™. Likewise, Chrysanthemum tea and mineral water also showed statistically no significant mean difference in the released of calcium during the study period. The results obtained in this study indicated that beverages with low pH may pose detrimental effect on the enamel surface which could have clinical implication, especially in people with salivary gland dysfunction or low salivary flow.

Background: Pulegone as principal component of essential oil, reported to have antibacterial, antioxidant and anti-inflammatory properties. The present study was aimed to evaluate wound healing activity of pulegone in a rat model. Method: Forty rats were used for excisional and incisional wound healing models. For each model twenty male white Wistar rats were randomly divided into five groups (n = 4) of control (CG), Sham surgery, E1, E2 and E3. Wound size, hydroxyproline content of wound and biomechanical testing were assessed. Result: In E2 animals, the wound size was reduced earlier than in E1 and E2 groups (P = 0.035). However, time had significant effect on wound contraction of all wounds. Hydroxyproline contents in the groups CG, sham surgery, E1, E2 and E3 were found to be 51.25 ± 3.40, 58.41 ± 4.62, 68.59 ± 3.53, 86.32 ± 3.18, and 74.26 ± 4.73 mg g-1, respectively. Hydroxyproline contents were increased significantly in E2 compared to E1 and E3 which implied more collagen deposition compared to other experimental groups (P = 0.001). The biomechanical indices, maximum stored energy, stiffness, ultimate strength and yield strength obtained for E2 group were significantly higher than those obtained for E1 and E2 groups (P = 0.002). Conclusion: The pulegone showed a reproducible wound healing potential in rats.

Sudden cardiac death (SCD) continues to be a major health issue in many countries including Malaysia due to its large magnitude in all-cause mortality as well as the emotional and socioeconomic impact of the deceased leaving the love ones behind in an abrupt manner. Data in Malaysia shows that the majority of sudden natural deaths are due to sudden cardiac death and are in the productive age group of 41 to 50 years. A study in Germany pointed out that about 90% people who died of SCD actually had warning signs such as chest pain, breathlessness, nausea, vomiting, dizziness and fainting before they collapsed. The majority belonged to the high-risk group for SCD having had previous medical histories including coronary artery disease, cardiomyopathies, valvular heart disease, congenital heart disease, underlying electrophysiological abnormalities or are taking drugs which are capable of provoking ventricular tachyarrhythmias. The key step is to define a sequence of risk stratifiers that will identify patients who are at risk but in whom implantation of expensive devices will be cost-effective. Amongst the investigative tools proven to be helpful to achieve this are ECG screening for left ventricular hypertrophy, increased QRS width, T-wave alternans, heart rate variability, baroreceptor responsiveness, QT dispersion, and T-wave heterogeneity; Holter monitoring to demonstrate ventricular arrhythmias; and stress test in identifying ischaemia. Prompt action is crucial since restoring circulation as fast as possible improves the chances of survival. Family members and caregivers of people with heart disease and at increased risk should be trained to recognize symptoms and perform cardiopulmonary resuscitation (CPR) to reduce the likelihood of death from cardiac arrest. Training and prevention efforts should focus on how to recognize the emergency, CPR training, and automated external defibrillator (AED) use. An implantable cardioverter-defibrillator (ICD) is the preferred therapeutic modality in most survivors of SCD. The incidence of SCD can be reduced by improving the current situation through selection of high risk groups for initiation of therapies, education to the public awareness of early warning symptoms and early emergency management that should be readily available in the community.
Anemia, Sickle Cell ; Death, Sudden, Cardiac ; Risk ; Cardiopulmonary Resuscitation ; symptoms <1>

Pre-pregnancy Clinic (PPC) services is one the plausible efforts towards achieving the Millennium Development Goals. However, various issues still need to be addressed for improvement of the services. Considering this view, an attempt was made to explore the barriers, strength and weakness of current practice of pre-pregnancy clinic services in Sarawak, since the programme has been implemented in this state from the year 2011. This cross-sectional study was conducted at nine selected health care facilities throughout Sarawak. A multistage sampling procedure was adapted to select the health care facilities. An unstructured open-ended questionnaire was administered to get the in-depth perceived views and current practice of pre-pregnancy clinic services. A total of 322 health care providers from nine selected health care facilities gave their feedback. In the present paper, a qualitative analysis was done for the open-ended questions to get in-depth views of barriers, strength and weakness of pre-pregnancy clinic services. The results of the study were narrated in textual form and a thematic analysis was done manually. The identified themes for perceived barriers to the provision of pre-pregnancy care were perception, attitude and acceptance of PPC services, socio-economic issues, services and client factors. The perceived weaknesses of the services are listed under two main themes: working environment and service factors, while, the strength of services produced three thematic areas which are preparation for pregnancy, prevention of mortality and morbidity and comprehensive services. Though pre-pregnancy services are beneficial for society wellbeing, various issues still need to be considered for the improvement of the quality of services. Lack of awareness, no ministerial guidelines or Standard Operating Procedures (SOP) and knowledge pertaining to the services were few of the main areas which need to be pondered upon. Promotional activities and campaigns should be geared up ensuring availability the services to the general population.
Barriers ; Perception ; Pre-pregnancy Care ; Sarawak

School vision screening program is a scheduled program under the Ministry of Health, Malaysia for 7, 12 and 15 years-old children in the government schools. The aim of this study was to review the school vision screening program from the perspective of the personnel involved as the screener. Methods: The evaluation of the performance of the screener was based upon the accurate referrals' outcome from the school health database of Betong Division in Sarawak, Malaysia in the year of 2008. Results: The total accuracy of the referrals was 50.7%. Lower accuracy of the referrals was found significantly associated with Grade 1 [χ2 (2.N=304) = 28.810, p<0.001, OR 4.472, CI.95= 0.843=2.335] and among Native Iban [χ2 (2.N=304) = 7.901, p<0.05, OR 1.502, CI.95= 0.935=2.414]. Conclusions: Further review on the training modules demanded improvement and enhancement to suggest that training module might be one of the contributing factors on the performance of the screener.

Dual Time Point Imaging (DTPI) technique is a specialised protocol adopted in 18F-Fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) imaging. This technique is claimed to be useful in differentiating malignant and infective lesions. The authors adopted this technique in a patient diagnosed with tuberculous spondylodiscitis and psoas abscess which demonstrated higher Maximum Standardized Uptake Value (SUVmax) during initial scans as compared with those obtained on delayed scans. The SUVmax changes between the two time points are believed to be a valuable finding for chronic granulomatous infective lesions such as tuberculosis.

Objective: Medical training has always been regarded as a highly stressful environment to students. This article described a preliminary data on impact of a stress-management programme on medical students’ stress level. Methods: This is a quasi-experimental before after comparison study design. The programme was run over half-day and convenient sampling method was applied. Sample size as calculated for this preliminary study was 38. The 12 items General Health Questionnaire (GHQ-12) was administered prior to the programme and four months later. Data was analysed using SPSS version 12. Results: 34 participants were involved in this study. This study found that there was a significant difference in participants’ GHQ-12 scores before and after the programme (p<0.001). It also found that the percentage of distressed participants to have significantly reduced after they went through the programme (p<0.05). Conclusion: This study showed that the programme is a promising stress-management programme with the evidence of positive impact on the medical students’ mental health by improving and reducing their stress level. Apart from that it is a well accepted programme by the medical students. Perhaps similar approach can be considered relevant to be incorporated in other set up.

Objective: Postgraduate medical training has always been regarded as a highly stressful environment to students. This article described an initial finding on prevalence and sources of stress among postgraduate students. Method: This is a cross-sectional study conducted on postgraduate students in the School of Medical Sciences, Universiti Sains Malaysia. Sample size as calculated for this preliminary study was 38 and convenient sampling method was applied. The 12 items General Health Questionnaire (GHQ-12) and Postgraduate Stressors Questionnaire (PSQ) were administered during a workshop involving postgraduate students. Data was analysed using SPSS version 12. Results: Thirty three participants participated in this study. This study found that the prevalence of distressed postgraduate students was 36.4%. The top ten stressors were tests and examinations, large amount of content to be learnt, time pressure to meet deadlines, doing work beyond ability, work overload, unfair assessment by superior, fears of making mistakes that can lead to serious consequences, doing work that mentally straining, work demands affect my personal and home life, and lack of time to review what have been learnt. Conclusion: This study found that there was a high prevalence of distressed postgraduate students. It also found that the Introduction Postgraduate medical training environment has always been regarded as highly stressful to students. The stressors of medical training and its associated negative consequences to the mental, emotional and physical health, particularly for undergraduate medical students, have been described in many studies [1-10], however, for postgraduate students there is very limited data on this. It is noteworthy that generally excessive and ASEAN Journal of Psychiatry, Vol.11 (2): July – December 2010 major stressors were related to academic and performance pressure

Production of Lactobacillus salivarius i 24, a probiotic strain for chicken, was studied in batch fermentation using 500 mL Erlenmeyer flask. Response surface method (RSM) was used to optimize the medium for efficient cultivation of the bacterium. The factors investigated were yeast extract, glucose and initial culture pH. A polynomial regression model with cubic and quartic terms was used for the analysis of the experimental data. Estimated optimal conditions of the factors for growth of L. salivarius i 24 were; 3.32 % (w/v) glucose, 4.31 % (w/v) yeast extract and initial culture pH of 6.10.