BACKGROUND: The main aim of this study is to utilize the geographical information system (GIS) software and perform the spatial analysis in relation to clinical data for road traffi c injury (RTI) pediatric cases attending the emergency department.METHODS: The study sample included pediatric patients (age less than 18 years) with road-related injuries within a district in Malaysia who attended emergency departments of two tertiary hospitals within the district. In addition to injury, pre-hospital care and outcome data, the coordinate of the locations were obtained by the ambulance paramedics by using portable handheld GPS unit brand Garmin? model GPS 72 H. The data was transferred into the excel format which in turn underwent GIS analysis by using ARCGIS? (by ESRI) software version 10.1 licensed to the study institution.RESULTS: A total of 102 (24.8％) of all motor vehicle crash (MVC) victims involved the pediatric age group (age 18 years and below). The mean (SD) age of the pediatric victims was 14.30 years (SD 3.830). Male comprised of 68 (66.7％) of the cases. Motorcyclists [88 (88.0％)] were the most common type of victims involved. Interestingly, the majority of the severely injured victims [75 (73％)] sustained the RTI on roads with maximum speed limit of 60 km/hour. The mean (SD) length of hospital stay was 7.83 days (5.59).CONCLUSION: The pediatric related road traffic injury in Malaysia causes significant health and social burden in the country. This study showed both important clinical and geographical factors that need to be taken into consideration for future preventive action.

BACKGROUND: The main objective was to identify common geographical buildup within the 100-meter buffer of severely injured based on injury severity score (ISS) among the motor vehicle crash (MVC) victims in Malaysia. METHODS: This was a prospective cohort study from July 2011 until June 2013 and involved all MVC patients attending emergency departments (ED) of two tertiary centers in a district in Malaysia. A set of digital maps was obtained from the Town Planning Unit of the district Municipal Office (local district map). Vector spaces were spanned over these maps using GIS software (ARCGIS 10.1 licensed to the study center), and data from the identified severe injured cases based on ISS of 16 or more were added. Buffer analysis was performed and included all events occurring within a 100-meter perimeter around a reference point. RESULTS: A total of 439 cases were recruited over the ten-month data collection period. Fifty two (11％) of the cases were categorized as severe cased based on ISS scoring of 16 and more. Further buffer analysis looking at the buildup areas within the vicinity of the severely injured locations showed that most of the severe injuries occurred at locations on municipal roads (15, 29％), straight roads (16, 30％) and within villages buildup (suburban) areas (18, 35％). CONCLUSION: This study has successfully achieved its objective in identifying common geographical factors and buildup areas within the vicinity of severely injured road traffic cases.

Apolipoprotien E (apoE) polymorphism is a human genetic risk factor and has been well-established to be associated with Alzheimer’s disease, lipid abnormalities, and cardiovascular disease (CVD). ApoE gene polymorphism is reported to correlate with lipid metabolism disturbances and coronary artery stenosis. Furthermore, ε4 allele carriers were found to have poor prognosis in survival rates of post-myocardial infarction. The purpose of the review is to distinguish the possible of apoE gene polymorphism as a determinant for CVD and its association. Preliminary data suggest ε4 allele carrier identification could be beneficial for risk stratification of CVD and initiation of statin therapy as primary intervention. Numerous studies have been done, however, results varied between studies as well as in different population. The evidence presented herein can help describe the risk prediction based on apoE gene polymorphism.

Abstract Introduction: Recruitment of potential blood donors from a younger age group is a good effort because they would be in good health and may have a long journey in blood donation. This study evaluated the motivating and deterring factors for donating blood among blood donors, who are students pursuing higher education. Methods: This was a cross-sectional study using a set of questionnaires, involving 391 students in Kota Bharu, Kelantan, Malaysia. The research tool was adapted and modified, as well as validated and pilot-tested to ensure its validity and reliability. Data were analysed using the SPSS and Stata software. Results: The most highly rated motivating factor for donating blood was to help others and to create a good practice (98%). The motivating factor of being interested in a blood donation campaign was highly rated by female respondents (87%) compared to male respondents (79.1%). The most highly rated deterring factor was the dislike for skipping a class to donate blood (30.9%), which was highly rated as a positive response by female blood donors (35.1%). There was a significant difference between the motivating factors (p = 0.043) and the deterring factors (p = 0.011), as seen between gender. Items that have the logo of the blood donation centre, such as T-shirts, towels, mugs or bags are rated as the most attractive incentive (87%). Conclusion: Altruism was the main reason for young blood donors choosing to donate blood. Social media usage should be considered when promoting blood donation campaigns to this age group.

Introduction: Broken glass exhibits unique fracture patterns depend upon the nature of the impact. The fracture patterns provide information like point and angle of impact, direction of force and sequence of firing. Recent studies have shown that the use of shotgun in Malaysia is increasing, yet, the relationship existing among the fracture pattern and the projectile impact factors are not well documented. The objective was to analyse the fracture characteristics on different glass types of variable thickness and distance made by shotgun ammunition. Methods: Soda lime and tempered glass panel with dimension of 12’x 12’ with 3 or 4 mm thickness were shot from various distances of 4, 6 and 8 m from the muzzle end of the shotgun. Samples were analysed under fixed parameters and observations were recorded. Results: It is found that the bullet hole diameter of 4 mm tempered glass were larger compared to 4 mm soda lime glass ranged from 14.33 to 24.17 cm as distance increased. Tempered glass surface also exhibited dicing fragments unlike soda lime glass where only radial fracture patterns are evident. This can be attributed to high inherent strength and ductility that makes the tempered glass remarkably resistant to external force. Conclusion: The findings from this study can lead to distinguish the type of glass through examination of fracture patterns, whether it is soda lime silica or tempered glass. The type of glass and the source of impact can be determined using the fragments, no reconstruction necessary.

Introduction: The association between clinical characteristics and endoscopic profile of acute non-variceal upper gastrointestinal bleeding (NVUGIB) patients with red blood cell (RBC) transfusion has not been well explored in Malaysia. Therefore, a retrospective study was performed using a five-years database to analyse the factors clinically and endoscopically for RBC transfusion. Methods: All adult NVUGIB patients who received RBC transfusion within the study period of 2012-2017 in Putrajaya Hospital were enrolled. There were 180 patients selected by systematic random sampling. Our composed clinical data include demography, risk factor, aetiology, presenting symptoms, Glasgow-Blatchford Score (GBS), endoscopic findings according to Forrest Classification and number unit of RBC transfusion. These data were analysed using Mann-Whitney U-Test, Pearson Correlation and Multiple Linear Regression (MLR). Results: Total 180 patients, the mean age was 63.9 (SD 11.6). Their presenting symptoms were melaena (62.8%), haematemesis (38.3%), and haematochezia (10.6%), with the cause of bleeding was gastric erosion (65.6%), duodenitis/duodenal ulcer (26.1%), and oesophagitis (7.8%). The mean GBS score was 10.7, and the number of RBC transfusion unit was 2.8. The Forrest Classification showed Forrest III (36.1%), Forrest IIc (22.8%), Forrest IIb and Ib (14.4%) respectively. Pearson’s Correlation showed a strong correlation between GBS and unit of RBC transfusion (r = 0.922, p-value <0.001). MLR analysis revealed haematochezia (p = 0.022) and higher GBS (p <0.001) were independent factors associated with a higher number of RBC transfusion unit. Conclusion: Haematochezia and higher GBS score were two predictive factors for a higher RBC transfusion unit in NVUGIB patients.

Introduction: Accelerants and fabrics are commonly used to spread fire attributable to their highly flammable properties. Hence, having the ability to discriminate the different types of accelerants on various types of fabrics after fire and/or arson using the non-destructive Attenuated Total Reflectance-Fourier Transform Infrared (ATR-FTIR) spectroscopy coupled with chemometric techniques appears forensically relevant. Methods: Six types of fabrics viz. cotton, wool, silk, rayon, satin, and polyester, were burnt completely with RON95 and RON97 gasoline as well as diesel. Subsequently, the samples were analyzed by ATR-FTIR spectroscopy followed by Principal Component Analysis (PCA) and Linear Discriminant Analysis (LDA) for discriminating the different types of accelerants on such burned fabrics. Results: RON95 showed the fastest rate of burning on all fabric types. Results also revealed that while wool had the slowest burning rate for all the three different accelerants, polyester, cotton, and satin demonstrated the highest rate of burning in RON95, RON97, and diesel, respectively. FTIR spectra revealed the presence of alkane, alcohol, alkene, alkyne, aromatic, and amine compounds for all fabrics. The two dimensional PCA (PC1 versus PC2) demonstrated 71% of variance and it was improved by cross-validation through the three dimensional LDA technique with correct classification of 77.8%. Conclusion: ATR-FTIR spectroscopy coupled with chemometric techniques had enabled identification of the functional groups, as well as statistically supported discrimination of the different accelerants, a matter of relevance in forensic fire and arson investigations.

Introduction: ABO blood group can be associated with chronic diseases, for example, cancer and coronary heart disease, however it is not proven in Type 2 Diabetes Mellitus (T2DM). The aim of this study was to identify the association between the ABO blood group and disease control among T2DM patients at Kepala Batas, Penang. Methods: Approximately two mL vials of fresh blood were collected and typed using the tube method from 129 T2DM and 132 non-diabetic (control) patients, who visited the specialist clinic. The sociodemographic characteristics of the T2DM patients was analysed using descriptive analysis. The proportions of A, B, AB, and O blood groups among the diabetic and control patients were compared using the chi-square test. Any association between the ABO blood group and disease control was identified using the bivariate correlation test. Results: No significant association was found between the ABO group and T2DM patients (p = 0.152) when compared with the control group. However, blood group B was the most frequent among T2DM patients (33.3%) compared to blood group O within the control group (36.4%). Negative associations were observed between the ABO blood group and BMI (r = 0.098, p = 0.268), as well as the HbA1C value (r = -0.065, p = 0.464). Conclusion: No association was found between the ABO blood group and the associated risk factors (BMI and HbA1C). However, individuals with blood group B and risk factors, such as older age group, obesity, and high HbA1C value (more than 7.0%), should be monitored.

Introduction: Cardiovascular disease (CVD) is a group of disease which are related to the heart and its circulations. The main modifiable risk factors of the CVD disease are hypertension, hyperglycemia and obesity. This study aims to evaluate the knowledge, awareness and practice on cardiovascular disease risk factors among Gombak community in Kuala Lumpur. Methods: This was a cross-sectional study using self-administered questionnaire and anthropometric measurement among 388 subjects in Gombak District, Kuala Lumpur. Descriptive data analysis and multivariate binary logistic regression were carried to identify demographic and factors associated. Results: The prevalence of the risk factors was high among study subjects, including obesity (24.2%), hypertension (42.3%) and hyperglycemia (26.8%). More than half (64.4%) of the study subjects having at least one of the risk factor. The multivariate binary logistic model factor illustrated that compare to Malays, Chinese were 37% less likely to have obesity (CPR=0.67; 95% Cl: 0.26-1.69). Gombak district community are more likely to have the knowledge on the CVD risk factor but lack of awareness and poor in practicing the prevention action. The Indian ethnic group was less likely to be aware (APR: 0.33, Cl: 0.05-2.31) and others bumiputera ethnic group were less likely to prevent (APR: 0.58, CI: 0.20-1.65) the risk of CVD. The Chinese ethnic less likely to have the knowledge (APR: 0.88, Cl: 0.35-2.22). Conclusion: Gombak community was more likely to have the knowledge but less likely to be aware and lack of practice of prevention of the risk factors of CVD.