Introduction: Studying in a university can be stressful for any undergraduate student, and the excessive stress is associated with physical and mental health problems. The purpose of the study was to examine the prevalence and determinants of perceived stress among undergraduate students in a Malaysian university. Methods: 456 undergraduate students participated in this study. The Perceived Stress Scale and the Student Stress Survey ( SSS) were implemented as indicators; PSS as a global measure of perceived stress, and the SSS for the identification of the sources of stress. Results: The prevalence rate of perceived stress among the undergraduate students was 37.7%. The overall PSS mean score was 27.5 ( SD 4.763), with a cut-off value of perceived stress at 28. Multivariate logistic regression model identified that the female student (OR 1.995, 95% CI 1.313-3.031) and the first year student (OR = 2.383, 95% CI 1.047-5.422) perceived more stress than the others.Conclusion: The present study demonstrated a high prevalence rate of perceived stress among undergraduate students in general, and the female and the first year undergraduate students in particular. There is a need for further studies on the borderline stress of the undergraduate students and the sources of stress.

In the current study, we report a new technique to place a tunnelled peripherally inserted central catheter (PICC) at the upper arm of patient under real-time ultrasound-guided venipuncture using disposal equipment provided within a standard PICC set. The tunnelling of the PICC required an extra time of 5 minutes but was well tolerated by all patients involved in the study. The tunnelled PICC was applied on 50 patients and the infection rate as well its catheter dwell time were compared to another 50 patients with conventional PICC. The rate of patients who developed infection decreased from 34% for conventional PICC to 16% in tunnelled PICC patients. The central line-associated blood stream infections rate was also decreased from 4.4 per 1000 catheter-days for conventional PICC to 1.3 per 1000 catheter-days for tunnelled PICC. The mean time to infection development for tunnelled PICC (24 days) was longer than those observed with conventional PICC (19 days). Tunnelled PICC has also increased the mean catheter dwell time from 27 days (for conventional PICC) to 47 days. Tunnelling a PICC has the potential to reduce the infection rate while increase the catheter dwell time.

The study was taken to assess the feasibility of diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) mapping using different b-values for magnetic resonance-guided focused ultrasound (MRgFUS) treatment of uterine fibroid and adenomyoma. The contrast-enhanced T1-weighted image (cT1WI) as well as DWIs and ADC maps of different b-values (i.e. 200, 600 and 800 s/mm2) were obtained from nine fibroid and five adenomyoma patients, immediately after, and 12 months after MRgFUS treatment. The image contrast score, non-perfused volume (NPV) and NPV ratio obtained were compared to determine the feasibility of DWI and ADC mapping for MRgFUS treatment outcome evaluation. Our finding showed thatimmediately after MRgFUS treatment, the DWI acquired using 200 s/mm2 b-value gave the highest image contrast score among all other b-values. The NPV calculated from DWI of 200 s/mm2 showed the best correlation (R2 = 0.938) with post-contrast NPV. At 12 months follow-up, there was no specific b-value considered as significantly superior to others in terms of image contrast. However, the NPVs and NPV ratios obtained from all DWIs and ADC maps of different b-values were in good agreement with the post-contrast NPV and NPV ratio. We observed that the DWI, particularly obtained with a low b-value (i.e. 200 s/mm2), is feasible for delineation and quantitative volumetric evaluation of the ablated region immediately after the MRgFUS treatment. At 12 months follow-up, both DWIs and ADC maps are feasible for NPV and NPV ratio calculation.

Introduction: Recent compensators are commonly applied in IMRT. The precise properties of applied compensators such as thickness, attenuation coefficient and build up factor are intensively important for IMRT calculations. Method: The brass compensator used for 6 MV photon beam was studied to estimate the relative effect of thickness and field size on IMRT calculations. Various field size together with several compensator thicknesses were examined. Result: The average reduction of effective attenuation coefficient (EAC), for the fields of 10×10 cm2 to 20×20 cm2, was 9.94%. By increasing the field size, EAC was decreased. The major reduction of EAC due to increasing field size was found to be 9.62%. The build up factor was increased by 2% to 21.8% respect to field size and compensator thickness. Also, the build up factor was increased by adding up the thickness. The rate of changes ranged from 24% to 48 %.Conclusion: The compensator thickness and field size are significantly important to calculate the effective attenuation coefficient and build up facto

Background:Hepatitis C Virus (HCV) is a major public health problem worldwide. About 130- 200 million people are infected with HCV worldwide leading to 500,000 deaths annually (WHO 2014). Healthcare workers (HCWs) have played an important role in the transmission of HCV infection, either as victims or as sources of infection.Objectives: To determine the prevalence of HCV, antibodies (Abs) RNA and genotypes among the female HCWs in Baghdad and to identify whether HCWs were infective or only infected.Subjects and Methods:A cross-sectional study involving 1001 women attending 17 health care centres in Baghdad, Iraq, was carried out. Information on type and duration of their occupation was obtained. HCV Abs (anti-HCV) were tested using a third generation enzyme immunoassay (EIA-3) and immunoblot assay (Lia Tek-111). Molecular analysis using RT-PCR and DNA enzyme immunoassay (DEIA) for HCV-RNA and genotype detections were carried out for 63 serum samples.Results:Only 160/1001 (15.98%) were HCWs. Anti-HCV and HCV- RNA seroprevalence were significantly higher (6.37%, p=0.0057, 88.83%, p= 0.011 respectively) among HCWs than non HCWs. HCWs were at a significantly higher risk of exposure to HCV infection (OR=2.75, 95% C.I. =1.31-5.79). There was no significant association between HCV genotypes and the HCWs. HCV-4 showed higher expression (62.5%) among HCWs.Conclusion:Female HCWs were infective and infected with HCV, thus there is a need for medical equipment to be sterilized and cleaned thoroughly.

Background: School children are at great risk of nutrition-related chronic diseases. Their eating pattern in school is influenced by the availability of food served within the school environment. The purpose of this paper was to determine the effectiveness of a canteen-based food nutrition intervention, designed according to the theory of planned behaviour, on the knowledge, perception and choices of healthy food among primary schoolchildren. Methods: This was a prospective intervention study using a two-group design. Six school canteens from the ninety-eight primary schools were randomly allocated to an intervention group or a control group. All the food handlers in the intervention group were given a twelve-week training course in food nutrition. On the completion of the course, 293 Standard Six students from these schools, were interviewed with a nutritional questionnaire on food in their school canteens. The training programme for the intervention group and the questionnaire for the students were developed and validated for the study, and a power calculation made for the sample size of students.Results: The students in both groups were homogeneous in gender and body mass. The mean body mass index (BMI) was 19.26 (SD: 0.38) and 19.47 (SD: 0.39) for the intervention and the control group respectively. There were more schoolchildren in the intervention group who purchased foods in school canteens (p 0.0036)of milk and milk products (p 0.034), and white rice (p<0.001). Fewer purchased fast food (p<0.001), and more had a better perception towards serving of healthy food (p 0.001). There were no significant differences in the knowledge level (p 0.095) and purchased fruit (p 0.557) between the groups. Conclusion: A school-based nutrition programme was associated with significant improvement in the perception of students towards foods served in school canteens and in their choices of healthy food. The study provided a framework for the design and implementation of future food nutrition intervention in school canteens.

Background: The rise in substance-use-related problems among Malaysian adolescents called for a study to assess the efficacy of an anti-drug educational program to improve the knowledge, attitudeand perception (KAP) of Malaysian students regarding substance use. Methods: This study involved 573 students from four Malaysian Chinese schools in Malacca. Each student filled out a Likert-scale mandarin translated questionnaire (KAP-C) on substance use ( Pre-test). Following an educational program on substance use, the KAP-C questionnaire was given again to the students, immediately following the program (PT 1), and after a month (PT 2) and two months (PT3) of the programme. Results: The students showed improvement in knowledge of the types of substance use in PT 1 (p<0.001), PT 2 (p<0.001) and PT 3 (p<0.001). The study also showed persistent changes in their attitude towards drug treatment strategies at two months following the program (p < 0.05). Changes were also noted in their attitudestowards harm reduction strategies. Perceptions towards the substance-related problems changed following the module (p=0.001), and remained even after two months (p<0.001). Conclusion: This module effectively changed the KAP of students on substance use.

The adoption of technologically advanced medical devices assisted healthcare providers to examine and treat diseases. However, technological advancements could increase the threats to safety, security, and reliability of the devices from complications associated with manufacturing, functionality, and the clinical application of the devices.

Porto-spleno-mesenteric vein thrombosis is a rare, life-threatening condition of extrahepatic portal venous system thrombosis. We report a rare case of a 49-year-old lady with late presentation of acute portal vein thrombosis in a non-cirrhotic liver with an incidental finding of left adnexal teratoma. She presented with a one-week history of severe abdominal pain associated with vomiting and diarrhea. She gave no history of prior risk for venous thromboembolism or liver diseases. Physical examination revealed a tender mass extending from suprapubic to left iliac fossa. Abdominal computed tomography scans showed a well-defined fat-containing left adnexal mass, likely a benign teratoma, with no involvement of surrounding structures or calcification. There was evidence of porto-splenic-mesenteric vein thrombosis with liver infarction, bowel and splenic ischemia. Management of the extensive thrombosis causing multi-organ failure includes resuscitation, supportive care and treatment of thrombosis. Treatment options include early anticoagulation and if feasible, thrombolysis

Oral ulcer is a lesion with multifactorial causes and occurs worldwide. The lesion usually resolved within 14 days, but the pain may have an impact on the quality of patient’s life. Therefore, having a natural derived remedy that can reduce healing time would be a great advantage. This study aims to investigate histological sections of buccal ulcer on rats treated with aqueous extract of Piper sarmentosum (AEPS).Glacial acetic acid was used to induce buccal ulcer on male Sprague Dawley rats. Control group received normal saline while the experimental group received AEPS for treatment. On certain days of post-ulcer induction, buccal ulcer tissue samples were harvested, sectioned and stained with Hematoxylin and Eosin (H&E). Histological slides were examined for inflammation and scored. The inflammation severity reduced from day 2 to day 12. In the experimental group there was a statistically significant differences of inflammation score, particularly on day 2 with a score of (2.8 + 0.2). Neutrophils were less in the experimental group and the tissue debris clearance was faster compared to control group. Full reepithelization was observed on both treated tissue sections on day 12 with less severe inflammation. Topical application of AEPS is proven to have anti-inflammatory effect by reducing the number of neutrophils during inflammation phase of oral ulcer healing