Interleukin 31 (IL-31)is one of the cytokines which appears to be an important regulator of Th2 responses. Previous study has been done to determine IL-31 serums levels in atopic dermatitis (AD). However, the serum levels of IL-31 in allergic rhinitis (AR) and atopic asthma (AA) is not many reported and still unclear. The objective of this cross sectional study is to determine an association between IL-31 and other predisposing factors with allergic diseases in HRPZ II (Hospital Raja PerempuanZainab II) and HUSM (Hospital UniversitiSains), Kelantan, Malaysia. This study involved 70 patients of AD, 70 patients of AR, 70 patients of AA and 70 healthy controls from staffs and people in HUSM.Five milliliters of blood were withdrawn and centrifuged for 5 minutes at 2000 rpm to obtain the serum and analyzed for IL-31 levels by using enzyme-linked immunosorbent (ELISA) kits (Human IL 31 Duoset, R&D System). Simple and multiple logistic regressions were used to analyze the association between IL-31 levels and predisposing factors among allergic diseases. The levels of IL-31 and other predisposing factors showed significant associations in smoking status, occupational exposure and area of living for AD and AR, however in AA, the significant association only found in smoking status and occupational exposure. In conclusion, we found that there were associations between IL-31 serum levels and other predisposing factors with AD, AR and AA. The findings can be the pilot study to determine IL-31 levels in allergic diseases in Malaysia.

Interleukin 31 (IL-31)is one of the cytokines which appears to be an important regulator of Th2 responses. Previous study has been done to determine IL-31 serums levels in atopic dermatitis (AD). However, the serum levels of IL-31 in allergic rhinitis (AR) and atopic asthma (AA) is not many reported and still unclear. The objective of this cross sectional study is to determine an association between IL-31 and other predisposing factors with allergic diseases in HRPZ II (Hospital Raja PerempuanZainab II) and HUSM (Hospital UniversitiSains), Kelantan, Malaysia. This study involved 70 patients of AD, 70 patients of AR, 70 patients of AA and 70 healthy controls from staffs and people in HUSM.Five milliliters of blood were withdrawn and centrifuged for 5 minutes at 2000 rpm to obtain the serum and analyzed for IL-31 levels by using enzymelinked immunosorbent (ELISA) kits (Human IL 31 Duoset, R&D System). Simple and multiple logistic regressions were used to analyze the association between IL-31 levels and predisposing factors among allergic diseases. The levels of IL-31 and other predisposing factors showed significant associations in smoking status, occupational exposure and area of living for AD and AR, however in AA, the significant association only found in smoking status and occupational exposure. In conclusion, we found that there were associations between IL-31 serum levels and other predisposing factors with AD, AR and AA. The findings can be the pilot study to determine IL-31 levels in allergic diseases in Malaysia.
IL-31 ; serum levels ; predisposing factors ; allergic diseases ; Kelantan

Background: Parenting behaviour is culturally sensitive. The aims of this study were (1) to translate the Parental Bonding Instrument into Malay (PBI-M) and (2) to determine its factorial structure and validity among the Malaysian population. Methods: The PBI-M was generated from a standard translation process and comprehension testing. The validation study of the PBI-M was administered to 248 college students aged 18 to 22 years. Results: Participants in the comprehension testing had difficulty understanding negative items. Five translated double negative items were replaced with five positive items with similar meanings. Exploratory factor analysis showed a three-factor model for the PBI-M with acceptable reliability. Four negative items (items 3, 4, 8, and 16) and item 19 were omitted from the final PBI-M list because of incorrect placement or low factor loading (< 0.32). Out of the final 20 items of the PBI-M, there were 10 items for the care factor, five items for the autonomy factor and five items for the overprotection factor. All the items loaded positively on their respective factors. Conclusion: The Malaysian population favoured positive items in answering questions. The PBI-M confirmed the three-factor model that consisted of care, autonomy and overprotection. The PBI-M is a valid and reliable instrument to assess the Malaysian parenting style. Confirmatory factor analysis may further support this finding.

Kacip Fatimah also known as Labisia pumila (Myrsinaceae), is a traditional herbal medicine with a long history in the Malay community. It has been used by many generations of Malay women to induce and facilitate childbirth as well as a post-partum medicine. We tested the genotoxic potential of Kacip Fatimah in bone marrow cells obtained from Sprague-Dawley rats using micronuclei formation as the toxicological endpoints. Five groups of five male rats each were administered orally for two consecutive days with doses of 100, 700 and 2000 mg/kg body weight of Kacip Fatimah extract dissolved in distilled water. Micronucleus preparation was obtained from bone marrow cells of the animals following standard protocols. No statistically significant increase in micronucleated polychromatic erythrocytes (MNPCEs) was observed at any dose level and sacrifice/harvest time point (24, 48 and 72h). However, a significant decrease in polychromatic erythrocytes/normochromatic erythrocytes (PCE:NCE) ratio was observed from the highest dose level (2000 mg/kg of body weight) at 48h harvest time point. In this study, we investigated the effect of Kacip Fatimah on mammalian bone marrow cells using micronuclei formation to assess the genotoxicity of the herb.
Micronuclei ; Erythrocytes ; Bone Marrow ; in vivo ; assay

This study aimed to estimate cost of in-patient medical care due to stroke in a tertiary hospital in Malaysia. A retrospective analysis of stroke patients admitted to Universiti Kebangsaan Malaysia Medical Centre (UKMMC) between January 2005 and December 2008 were conducted. Cost evaluation was undertaken from the health provider’s perspective using a top-down costing approach. Mean length of stay (LOS) was 6.4 ± 3.1 days and mean cost of care per patient per admission was MYR 3,696.40 ± 1,842.17 or 16% of per capita GDP of the country. Human resources made up the highest cost component (MYR 1,343.90, SD: 669.8 or 36% of the total cost), followed by medications (MYR 867.30, SD:432.40) and laboratory services (MYR 337.90, SD:168.40). LOS and cost of care varied across different stroke severity levels (p<0.01). A regression analysis shown significant influence of stroke severity on cost of care, with the most severe stroke consumed MYR 1,598.10 higher cost than the mild stroke (p<0.001). Cost of medical care during hospital admission due to stroke is substantial. Health promotion and primary prevention activities need to take priority to minimise stroke admission in future.

Objective: Family Environment Scale (FES) is one of the most widely used instruments to measure many family aspects. Cross cultural adaptation of the original FES is essential prior to local utilization as different cultures percept their family environments differently. We attempted to translate the FES into the Bahasa Malaysia language for adolescents, evaluate its reliability using internal consistency and compare its results with the original study. Methods: This is a cross-sectional study, involving adolescents aged 12-17 from four secondary schools. The adolescents were selected using quota sampling for different age, ethnic and academic performance. The study was divided into four phases, namely: i) translation of FES, ii) pilot test iii) internal consistency reliability test and iv) comparison of the study results with the original FES. Results: A total of 295 adolescents participated in this study. All of the reliability measurements generated (ranged between Cronbach’s alpha 0.10 - 0.70) were lower than those originally reported for this instrument (ranged between Cronbach’s alpha 0.61 -0.78). Five subscales in the Bahasa Malaysia version were found to be less than Cronbach’s alpha 0.5, which were below the acceptable level for practical or research use. There was considerable variation observed between the sample population of this study and that of the original study, which could be due to the social cultural differences. Conclusion: The Bahasa Malaysia version of FES requires further culturally appropriate revision. A new measuring scale could also be devised to provide an accurate evaluation of the family environment as perceived by Malaysian adolescents, which has acceptable levels of reliability and validity.

Objective: The smoking rate among patients with mental health problem is higher than in the general population. Effective pharmacotherapy to treat nicotine addiction is thus needed to reduce the morbidity and mortality associated with cigarette smoking among these patients. This article reviews the literature on the suitability of varenicline for smokers with mental health problems. Methods: A search of the literature was conducted using PubMed from year 2001 to July 2009 using key words varenicline alone and varenicline and mental health. Articles chosen were narrowed to those published in English. The type of articles chosen included clinical trials, meta-analyses, case reports, and review articles. Results: The search produced a total of 322 articles on varenicline and 14 articles on varenicline and mental health. Varenicline, a new drug for smoking cessation is an α4β2 partial agonist and partial antagonist at nicotinic acetylcholine receptor. As a partial agonist, varenicline relieves craving and withdrawal symptoms that occur during smoking abstinence and also reduce the rewarding effects of smoking in patients who relapse. However, at present, there is concern regarding the neuropsychiatric side effects such as aggressive behaviour, suicidal ideation, mania and depression associated with varenicline use in patients with mental health problems, but these reports did not show a causal-link or lack of link between these symptoms and varenicline. Conclusion: Current available data support the effectiveness of varenicline to treat nicotine dependence. However its safety among smokers with mental health problems remains to be elucidated. At present, further safety assessment is needed in this patient population. Until new data is available regarding the safety of varenicline in these populations, psychiatrists and physicians prescribing this medication should be extra cautious and monitor for possible psychiatric side effects when prescribing this medication to patients with pre-existing psychiatric disorders or have vulnerability to psychoses.

Road Safety remainsone the most important issuesaffecting educational institutions especiallythe school. The prevalence of road accidentsin recent news reportsunderlines the importance of this issue. Such accidents involving school pupils have further escalated this concern. As such,safety awareness among school teachersis crucial in order for them to identify the suitable methods to prevent more road accidents in future. This study was conducted to analyse teachers’ awareness of road safety in school to gauge the training requirementson road safety. Road safety education and training in school is just as important as improving safety for road users outside schools. For this study, a set of survey questionnaire wasdistributedto 400 school teachers from 111 schools randomly selected from the 10 District Education Offices in Kelantan. Results were then analysed using Statistical Package for the Social Sciences (SPSS). From the results, 40% of respondentswere male and 60% of them were female. Descriptive analysis showed that school teachers understood road safety as 90% of them possessed basic safety knowledge, while 10% of them lacked basicknowledge on road safety. However, they did not implement safety practice that may have contributed to unfortunate eventshappening outside of school including road accidents as reported in the news. This study suggests that school teachers must undergo road safety training to promote and improve road safety in school.With higher awareness and more information about the road safety, the teacherscould create a safer environment in their school. Undoubtedly, teachers have a vital roleto ensure safety of their pupils and their commitment will likely reduce the number of road accidents.
Road ; Safety ; Accident ; Awareness ; Teachers ; Training

​An Analysis of a Survey Questionnaire on health care workers’ knowledge and practices regarding of infection control and complains them to apply universal precautions. Health care workers are at substantial risk of acquiring blood borne pathogen infections through exposure to blood or other products of patients. To assess of infection control among health care workers in Sana'a healthcare centers, Yemen. A cross-sectional study was conducted in the health center to assess knowledge and practices regarding of infection control among 237 health workers in Sana,a city. A structured self-administered questionnaires were used and data was analyzed using SPSS version 20 and the associations were tested with chi-square, with p-value of < 0.05. The health care workers in public centers ware (51.1%) and (48.9%) of them works in private centers. One hundred and seventeen (49.4%) respondents had poor infection control knowledge, 113 (43.5%) had fair knowledge, and 17 (7.2%) had good knowledge. The knowledge was significantly associated with type of center (P < 0.018), such that the public center had the highest proportion with poor knowledge. And nurses and midwife having the highest proportion with fair knowledge of infection control. Eight (3.4%) respondents had a poor practice of universal precautions, 93 (39.2%) had fair practice, and 136 (57.4%) good practice. The practice was significantly associated with the profession, level of education and work experience (P < 0.001), (P < 0.006), (P < 0.001) respectively, and nurses and midwives as the profession with the highest proportion with good practice. We conclude that the practices and knowledge of universal precautions were low and that's need for intensive programmes to educate health care workers on various aspects of standard precautions and infection control programmes and policies.

Background: The prevalence of teenage smoking has decreased over the past decade following the implementation of the national tobacco control programme. However, the effect of the programme on smoking cessation in teenagers has not been determined. Methods: Twenty-eight participants (12 teenagers, 8 teachers, and 8 doctors) were interviewed using 5 in-depth interviews and 3 group discussions. Social cognitive theory (SCT) was applied as the theoretical framework. Semi-structured interview protocols were used, and thematic analysis and analytic generalisation utilising SCT were performed. Results: The current national tobacco control programme was found to be ineffective in promoting smoking cessation among teenagers. The participants attributed the ineffective campaign to the followings: inadequacy of message content, lack of exposure to the programme, and poor presentation and execution. In addition, the participants perceived the developed tobacco control policies to be a failure based on poor law enforcement, failure of retailers to comply with the law, social availability of cigarettes to teenagers, and easy availability of cheap, smuggled cigarettes. This study highlighted that the programme-related problems (environmental factors) were not the only factors contributing to its perceived ineffectiveness. The cunning behaviour of the teenagers (personal factor) and poor self-efficacy to overcome nicotine addiction (behavioural factor) were also found to hinder cessation. Conclusion: Tobacco control programmes should include strategies beyond educating teenagers about smoking and restricting their access to cigarettes. Strategies to manage the cunning behaviour of teenagers and strategies to improve their self-efficacy should also be implemented. These comprehensive programmes should have a foundation in SCT, as this theory demonstrates the complex interactions among the environmental, personal, and behavioural factors that influence teenage smoking.