Objective: To determine abundance, distribution and diversity of potential breeding container habitats of the dengue vectors in public places including schools, restaurants, mosques and parks in southwest areas of Penang Island, Malaysia. Methods: Premises at restaurants, schools, parks and mosques were surveyed simulta-neously and inspected visually for container habitats and production of immature mosquitoes from March 2015 to March 2016. Abundance (mean ± SE) of breeding containers between sites was compared using One-way ANOVA. Independent sample t-test was used to compare total number of Aedes albopictus (Ae. albopictus) and Aedes aegypti (Ae. aegypti) surveyed. Results: The surveyed locations yielded a total of 3741 breeding containers and 19537 immature mosquitoes from four areas. Concurrent artificial and natural containers pro-duced 78.4%immature Ae. albopictus and 6.3%Ae. aegypti mosquitoes in wet season, with 14.2% Ae. albopictus and 1.1% Ae. aegypti mosquitoes in dry season. Artificial containers accounted for 98.1% of the total containers recorded, with restaurants being the most productive locations (8012) and schools being the least productive (2234). Conclusions: It was concluded that public places are good sources of potential container habitats of Aedes mosquitoes in Penang Island, Malaysia and Ae. albopictus has exclu-sively replaced the home-grown Ae. aegypti even in urban areas. Therefore, treatment of artificial containers in such locations is critical in Aedes mosquito control campaigns during dengue outbreaks.

Laboratory-bred females of Culex quinquefasciatus, Aedes aegypti and Aedes albopictus from the insectarium, Unit of Medical Entomology, Institute for Medical Research were used in the experiment. The late third stage of the F0 larvae which survived the high selection pressure of malathion, permethrin and temephos were reared and colonies were established from adults that emerged. Cx. quinquefasciatus larvae were subjected to selection by malathion and permethrin for 40 generations, Ae. aegypti larvae to malathion, permethrin and temephos for 32 generations and Ae. albopictus larvae were selected against malathion and permethrin for 32 generations and 20 generations against temephos. The rate of resistance development was measured by LC50 value. Cx. quinquefasciatus larvae developed higher resistance to malathion and permethrin compared to Ae. aegypti and Ae. albopictus. On the whole, permethrin resistance developed at a faster rate than malathion and temephos.
Permethrin ; Malathion ; Cancer resistance to treatment ; Aedes aegypti ; Aedes albopictus

Introduction: Anterior cruciate ligament (ACL) injuries are common among Malaysian military patients but has not been studied closely. The purpose of this study was to assess the type of activities leading to the ACL injury and the outcome of reconstructive ACL surgery at one year follow up. Methods: From the registry record, military patients who had undergone ACL reconstruction in two Malaysian military hospitals were identified. Their medical records were reviewed. The activities that they performed when the ACL injury occurred were identified. After ACL reconstruction, the patients’ ability to resume previous duty at one year follow up was evaluated. Results: From 111 patients, 82% of the ACL injuries were due to sporting activities whereas military activities and road traffic accident accounted for 14 % and 4 % respectively. Out of 69 patients with isolated ACL injury who were followed up at one year, all except two were able to resume their previous duty. Conclusions: Among the military patients who underwent ACL reconstruction, ACL injury was mainly due to sporting activity. ACL reconstruction showed good outcome at one year follow up.

Introduction: Pressure injuries are a common problem in acute and chronic healthcare settings with critical morbidity and mortality consequences on patients and healthcare systems. The objective of this study was to assess the predisposing risk factors associated with patients with community acquired pressure injuries and hospital acquired pressure injuries. Methods: Data were drawn from patients' electronic medical records from two hospitals with a total of 784 beds in the North Texas area and 94 records of HAPI and 206 records of CAPI patients were assessed. The measures examined included patients' socio-demographic variables, admission diagnosis, and Braden scale measures. Results: Scores for Albumin, weight, body mass index, length of stay and Braden measures were significantly higher for HAPI than CAPI patients at α < 0.05. Higher total Braden scores (OR=1.25, 95%CI: 1.15, 1.41), friction (OR=2.44, 95%CI: 1.39, 4.27), and longer length of stay (OR=1.13, 95%CI: 1.09, 1.18) were associated with a higher likelihood of HAPI. Conclusions: Interventions aimed at prevention of pressure injuries should target reducing friction and length of stay at care facilities.

Background: What we think we see consists of models constructed in our brains, which may be constrained, limited and perhaps modified at a cerebral level. Patients may view their mirror image differently to how others and the clini‑ cal team view them. Understanding potential variations in perception between real and mirror images is important in clinical practice. The aims were to assess differences in self-perception between frontal facial and mirrored photo‑ graphs, comparing the results with selfie photographs. Methods: Facial photographs were taken by one investigator under standardized conditions for preclinical and clini‑ cal students. Each student took a selfie photograph at rest and smiling using his/her smartphone. A mirror image was generated for each image. Each student was shown his/her original and mirror image, without being informed which was which. For each pair of images, students were asked to choose which photograph they perceived as more attractive. A set of photographs of a male volunteer was shown to all participants, to choose either the original or mir‑ ror image as the more attractive. Results: Most observers preferred the true image of the volunteer (P < 0.05), which may be evidence that most people prefer the true image of others, which is how they normally view them. Most observers preferred their own original photograph in frontal view at rest and smiling (P< 0.05), but preferred the mirror image of their selfie photo‑ graph at rest and smiling (P < 0.05). Conclusions Significant differences in perceptions of attractiveness between true and mirror-reversed frontal and selfie images were found. Observers preferred their image the way they view themselves in a mirror. The selfie is how other people view an individual. If a selfie is flipped horizontally, that is how an individual sees themselves in a mirror. Most observers preferred the mirror image of their selfie, which is how they would view themselves in a mirror.

OBJECTIVETo investigate the prevalence of container breeding mosquitoes with emphasis on the seasonality and larval habitats of Aedes aegypti (Ae. aegypti) in Makkah City, adjoining an environmental monitoring and dengue incidence.

METHODSMonthly visits were performed between April 2008 and March 2009 to randomly selected houses. During each visit, mosquito larvae were collected from indoors and outdoors containers by either dipping or pipetting. Mosquitoes were morphologically identified. Data on temperature, relative humidity, rain/precipitations during the survey period was retrieved from governmental sources and analyzed.

RESULTSThe city was warmer in dry season (DS) than wet season (WS). No rain occurred at all during DS and even precipitations did fall, wetting events were much greater during WS. Larval survey revealed the co-breeding of Aedes, Culex and Anopheles in a variety of artificial containers in and around homes. 32 109 larvae representing 1st , 2nd, 3rd, and 4th stages were collected from 22 618 container habitats. Culicines was far the commonest and Aedes genus was as numerous as the Culex population. Ae. aegypti larval abundance exhibited marked temporal variations, overall, being usually more abundant during WS. Ten types of artificial containers were found with developing larvae. 70% of these habitats were located indoors. 71.42% of indoor containers were permanent and 28.58% was semi-permanent during WS. Cement tanks was the only container type permanent during DS. Ae. aegypti larval indices (CI, HI, BI) recorded were greater during WS.

CONCLUSIONSTaken together, these results indicate a high risk of dengue transmission in the holy city.

Aedes ; Animals ; Culicidae ; Dengue ; transmission ; Ecosystem ; Environmental Monitoring ; Larva ; Prevalence ; Saudi Arabia ; epidemiology ; Seasons ; Weather

Objective To determine abundance, distribution and diversity of potential breeding container habitats of the dengue vectors in public places including schools, restaurants, mosques and parks in southwest areas of Penang Island, Malaysia. Methods Premises at restaurants, schools, parks and mosques were surveyed simultaneously and inspected visually for container habitats and production of immature mosquitoes from March 2015 to March 2016. Abundance (mean ± SE) of breeding containers between sites was compared using One-way ANOVA. Independent sample t-test was used to compare total number of Aedes albopictus (Ae. albopictus) and Aedes aegypti (Ae. aegypti) surveyed. Results The surveyed locations yielded a total of 3 741 breeding containers and 19 537 immature mosquitoes from four areas. Concurrent artificial and natural containers produced 78.4% immature Ae. albopictus and 6.3% Ae. aegypti mosquitoes in wet season, with 14.2% Ae. albopictus and 1.1% Ae. aegypti mosquitoes in dry season. Artificial containers accounted for 98.1% of the total containers recorded, with restaurants being the most productive locations (8 012) and schools being the least productive (2 234). Conclusions It was concluded that public places are good sources of potential container habitats of Aedes mosquitoes in Penang Island, Malaysia and Ae. albopictus has exclusively replaced the home-grown Ae. aegypti even in urban areas. Therefore, treatment of artificial containers in such locations is critical in Aedes mosquito control campaigns during dengue outbreaks.

Introduction: The expedited COVID-19 vaccine has challenged people’s belief and perception of its effectiveness. The purpose of this study was to identify whether knowledge related to Covid-19 and perception of effectiveness of Covid-19 vaccine would predict health-care workers’ willingness to take the vaccine. Methods: A cross-sectional design using a convenience sampling technique was used to collect data from 302 HCWs. HCWs targeted included all those working at healthcare settings in Jordan. Data collected regarding knowledge related Covid-19 and perception of effectiveness of Covid-19 vaccine. Data collected using a self-administered questionnaire. Results: HCWs have moderate to high level of knowledge related to vaccines of Covid-19 and its effectiveness. High level of willingness to take the vaccine was also observed among HCWs. Those with higher level of knowledge and positive perception of effectiveness of Covid-19 vaccine are more likely to take the vaccine (p < .05); however, not highly influential (R2 = 27%). Demographic characteristics have not been found to influence HCWs’ decision to take the vaccine. Conclusion: There is a need to enhance positive perception of effectiveness of Covid-19 vaccine among health professionals through appropriate education and procedures.

Objective:Escalator signage could be playing a vital role to alert users for safe use of escalators.This study aimed to evaluate the availability,standardization,and content of safety information on escalator signage in the shopping malls.Methods:An observational study was conducted from November 2017 to February 2018 to assess the availability,standardization of safety information among the signage inside the shopping mall,and the content of safety information for public safety in Malaysia.A checklist was developed by adapting escalator safety guidelines from seven countries and regions including Malaysia.Data collectors identified from the selected states were required to capture three photographs at different angles of the escalator signage for each ascending and descending directions at each entrance of the mall.Descriptive analysis was performed;each criterion was presented in frequency and percentage.Results:A total of 268 escalators from 84 shopping malls in 9 states of Malaysia were assessed.Two operating escalators were not equipped with signage.More than one-fifth (23.0％) of the signage was not standardized within the mall.The majority of safety information was displayed in the form of a pictogram,a minority of signage displayed information in both pictogram and text format:"children must hold hand" (12.7％) and "be careful of long clothing" (10.8％),respectively.Nevertheless,"toddlers should be carried" (8.6％) and "take extra care with rubber shoes/tied shoes/laces" (30.2％) were found absent in most of the signage.Conclusion:Escalator signage was present in almost all of the escalators observed.However,non-standardization of the signage of escalators should warrant the attention of relevant authorities to revise the safety guidelines and improve the quality of escalator.

Introduction: Total knee arthroplasty (TKA) commonly cause physical impairments, which necessitate physiotherapy post-operatively. Low-intensity pulsed ultrasound is an adjuvant treatment to conventional physiotherapy; however, its effects on TKA recovery require further investigation. The study aimed to ascertain the outcome of adding low-intensity pulsed ultrasound therapy into conventional physiotherapy on recovery from physical impairments after TKA. Methods: This assessor-blinded quasi-experimental study was conducted in a tertiary medical centre in Central Malaysia. Patients with TKA due to grade III and IV knee osteoarthritis (Kellgren-Lawrence grading system) were alternately allocated into either an experimental group (n=10) or a control group (n=10). Other than low-intensity pulsed ultrasound as received by the experimental group’s participants, the two groups received the same amount and content of conventional physiotherapy. Participants’ pain, knee swelling, active knee flexion range, and quadriceps strength were assessed at baseline, week 1 of the intervention, and the 1-week follow-up. The two interventions’ effects were analysed using a mixed model ANOVA. Results: The pain score and knee swelling decreased (P<0.05), while the knee flexion range and quadriceps strength increased significantly (P<0.001) after both interventions. The experimental group had a significantly lower pain score [3.07(2.18) at visual analogue scale] and a greater active knee flexion range [80.48(26.42) degrees] compared to the control group [pain score=4.29(1.54); knee flexion=67.00(25.15) degrees] following the interventions. There were no significant interaction effects for all outcomes. Conclusion: The combination of low-intensity pulsed ultrasound into a conventional physiotherapy program demonstrated more promising results in pain alleviation and knee motion recovery following TKA.