Increasing prevalence of chronic diseases is a major contributor for rapid rise in healthcare cost in developing countries since the last decade. It was estimated that around 54% of deaths in developing countries are due to chronic non-communicable diseases which is predicted to rise by 65% by 2030. Diabetes mellitus is among the most prevalent chronic diseases suffered by more than 180 million people worldwide. By 2030 it is estimated that around 400 million people in the world will be afflicted with diabetes. Annual deaths attributable to diabetes are probably as high as 3 million with more than 80% occur in developing countries. India, China and Indonesia are three countries in the Asian region with most number of people with diabetes. The total number of cases in these three countries is expected to increase more than double from 61 million in 2000 to 163 million in 2030. China and India will suffer cumulative GDP loss of 13.8% and 16.7% respectively, over the next ten year period. Assessing economic burden of diabetes is a challenging task for researchers because identification of direct and indirect cost of the disease is often complex since patients with diabetes also suffers from other complications and co-morbidities. In conclusion, the heavy economic burden of diabetes pose major challenges to health policy makers in developing countries to assess the current approach in managing this chronic disease. Serious efforts should be made on focusing and up-scaling activities on health promotion and prevention of diabetes so that to provide a more cost-effective solution to this condition with huge and increasing economic loss.

Composite resins Amaris is claimed to have hydrophobic effect which minimizes the staining intake. This study is to investigate the colour stability of Amaris compared to Filtek Z250 in coffee solution. Sixty discs of composite resins Filtek Z250 (3M ESPE) and Amaris (Voco) with diameter of 5mm and depth of 2mm were fabricated by packing in a drinking straw and sectioned with hard tissue cutter (Exakt, Japan). The surfaces of the specimens were polished with Sof-Lex disc before each group of the samples is immersed in coffee solution. They were kept in the solution for 4 days at 370C and assessed at the period of 2 hours, 1 day, 2 days, 3 days, and 4 days. The staining was assessed visually and recorded using Lobene (1968) Stain Index and score was given accordingly. The colour changes of both groups were not statistically significant (p<0.05) for period of 2 hours, 1day, 2 days, 3 days and 4 days All groups showed the score values increased gradually with time. Both composite resins have similar colour stability in coffee solutions.

A cross-sectional study was carried out at a medical centre to determine the cognitive profiles of 30 Parkinson’s disease patients with age of 69.76 ± 7.39 years. Thirty-seven percent of the patients were found to be at risk for dementia. The scores on subscales of working memory and alternating verbal fluency were significantly lower in Parkinson’s disease patients who were older than 77 years old. The scores on a subtest of working memory on the Parkinson’s Disease Cognitive Rating Scale (PDCRS) were significantly lower in Parkinson’s disease patients with a duration of illness of more than 10 years. In cognitive measurement, the subtests of verbal memory, delayed free recall and verbal fluency on the PD¬CRS were significantly lower in patients with less than six years of education. The patients who had difficulty with sustained attention, working memory and movement had significant anxiety and depression symptoms. In conclusion, multiple patterns in cognitive profiles influence the quality of life of patients with Parkinson’s disease in multi-dimensional ways.

Acute Disease ; Adult ; Antidotes ; therapeutic use ; Antiparkinson Agents ; therapeutic use ; Benserazide ; Cholinesterase Inhibitors ; poisoning ; Humans ; Insecticides ; poisoning ; Levodopa ; therapeutic use ; Male ; Organophosphate Poisoning ; Parkinson Disease ; drug therapy ; pathology ; Pralidoxime Compounds ; therapeutic use ; Trihexyphenidyl ; therapeutic use

Aims: Marine bacteria are a great source of natural pigments, which can be used as colouring agent in food, textile, cosmetics and aquaculture industry to overcome the drawbacks poses by the synthetic pigments. The aim of the study is to identify the potential bio pigment producer, determine the antimicrobial susceptibilities, and characterize the pigment produced. Methodology and results: In this study, the surface attached marine bacteria isolated from the surface of seaweed, Enteromorpha sp. has been identified as Pseudoalteromonas rubra BF1A IBRL through the molecular identification step. This species produced intracellular and extracellular red pigment with antibacterial activity. The susceptible bacteria include Bacillus subtilis, Bacillus cereus, Methicillin Resistant Staphylococcus aureus, Staphylococcus aureus and also Acinetobacter anitratus with inhibition zone ranges from 7.33 to 10.33 mm, whereas Minimum inhibitory concentration (MIC) values ranges from 0.055 to 8.88 mg/mL. The UV/vis analysis indicated that the maximal absorbance of ISO and DE pigment extract were at 531 and 534 nm, respectively. Based on the antimicrobial activity, the extracellular extract poses greater antibacterial activity, thus was selected as the potential pigment extract and were further evaluated. The Thin Layer Chromatography (TLC) profile of the DE extract showed one major band under visible light ((Rf = 0.87) and the bioautography analysis of the pigmented band showed positive activity against both Gram-positive and Gram-negative bacteria. The pigment in DE extract was identified as prodigiosin based on the spectroscopic properties, presumptive test and HPLC analysis. Conclusion, significance and impact of study This study highlights the dual benefits of the P. rubra BF1A IBRL pigment extract, which exhibited both tinctorial and pharmacology benefits, thus it can be act as colouring agent with own preservative value in food, textile, or cosmetics industries.

AIM: To report a case of cryptococcus meningitis in an immunocompetent teenager that presented early with diplopia and bilateral poor vision.METHODS:A case report RESULTS:A 17-year-old boy presented with blurring of vision in both eyes and diplopia for 3 weeks. It was associated with severe throbbing headaches, nausea and vomiting. He was also having low grade fever. On physical examination he was afebrile with no sign of meningism. His vision was 6/15 in both eyes with constricted visual field. Anterior segment was normal in both eyes. Extraocular muscles movement showed bilateral sixth nerve palsies. Fundoscopy revealed bilateral hyperaemic and slightly elevated optic disc. CT scan of the brain was normal with no evidence of intracranial mass or abnormal ventricles. Lumbar puncture revealed high opening pressure >300mmH2O. Cerebrospinal fluid(CSF) microscopically and culture showed presence of cryptococcus neoformans . This case was combinedly managed with neuro-medical team. Patient was started on intravenous Amphotericin B and fluconazole. His neurological symptoms recovered after a week. His vision was improved to 6/6 in both eyes with recovery of peripheral visual field. The diplopia improved with recovery of sixth nerve palsies in both eyes. Unfortunately, patient developed nosocomial lower respiratory tract infection and was treated for the problem.CONCLUSION: This case highlights the indolent nature of cryptococcus meningitis and the fact that the overt signs of meningism may not be present even in immunocompetent person. Diplopia may be one of the early presentations of meningitis patient.

·Acquired uniocular blindness in pediatric group deserves an urgent attention. The blindness usually results from mechanical injury to the globe. It is one of the leading causes of acquired blindness in this group. Most of the ocular injuries were accidental and resulted from mechanical trauma. Firecracker is one of the potential causes for acquired uniocular blindness. The nature of injury varies from mild to severe, penetrating or blunt trauma, chemical or thermal. The irreversible nature of the visual loss is preventable. Public awareness will be one of the main contributors in preventing the ocular morbidity.

Aim: This study was to determine the antibacterial activity of Melastoma malabathricum stem bark acetone extract (MMSBAE) against Streptococcus mutans. Methodology and results: Antibacterial activity of the extract was determined by minimal inhibitory concentration (MIC), minimal bactericidal concentration (MBC), biofilm formation, adherence inhibition, time kill studies and effect on S. mutans membrane integrity. MIC and MBC values of MMSBAE were 1.25 and 5 mg/mL, respectively. Time kill studies showed that reduction of colony forming unit in treated cells is 3 log10 after 10 h of treatment (p ˂ 0.05). The extracts reduced 50% biofilm and adherence activity of S. mutans at 1.88 mg/mL. The effect on S. mutans membrane integrity after exposure to MMSBAE for 90 and 120 min was determined by measuring leakage of cell content at 2 different wavelengths of 260 nm and 280 nm. In leakage assay, the percentage of absorbance (260 nm) in treated cell material showed 57% at 90 min and 60% at 120 min which is higher than negative control (<20%) but less than positive control (100%). The percentage absorbance of treated cell material (280 nm) was 61% at 90 min and 63% at 120 min. Identification of compound in MMSBAE was done by gas chromatography mass spectrometry (GCMS). Ten compounds were identified in the MMSBAE with some of them important in antimicrobial activity such as ethyl ester, undecene, and gamma sitosterol. Conclusion, significance and impact of study: MMSBAE showed excellent bactericidal and antibacterial activities against S. mutans. The antibacterial mode of action of MMSBAE is suggested to be the disruption of the S. mutans membrane structure. The MMSBAE significantly inhibited biofilm and adherence activities of S. mutans in dose dependent manner (p ˂ 0.05). MMSBAE has potential in the development of antibacterial agent with anti-biofilm and anti-adherence activities.

Background: No previous study has assessed the impact of childhood disability on parents and family in the context of Malaysia, and no instrument to measure this impact has previously been available. The objective of this cross-sectional study was to determine the reliability of a Malay version of the PedsQL™ Family Impact Module that measures the impact of children with disabilities (CWD) on their parents and family in a Malaysian context. Methods: The study was conducted in 2009. The questionnaire was translated forward and backward before it was administered to 44 caregivers of CWD to determine the internal consistency reliability. The test for Cronbach’s alpha was performed. Results: The internal consistency reliability was good. The Cronbach’s alpha for all domains was above 0.7, ranging from 0.73 to 0.895. Conclusion: The Malay version of the PedsQL™ Family Impact Module showed evidence of good internal consistency reliability. However, future studies with a larger sample size are necessary before the module can be recommended as a tool to measure the impact of disability on Malay-speaking Malaysian families.

Diffusion Tensor Imaging (DTI) is an advanced magnetic resonance imaging (MRI) technique. DTI provides quantitative information at microstuructural level via its parameter indices e.g. mean diffusivity (MD) and fractional anisotropy (FA). It also allows for visualization of neuron fibres through a specific technique called fibre tractography. Leukoaraiosis is an asymptomatic pathological condition of the brain white matter which appears hyperintense on T2-weighted MRI images. Association of leukoaraiosis with age and ischemic heart disease have been previously reported. The objective of this study is to compare MD and FA values measured in various areas of the brain white matter (WM), grey matter (GM), and cerebrospinal fluid (CSF) in humans using DTI. 30 subjects with leukoaraiosis and 12 subjects without leukoaraiosis underwent brain scan using GE 1.5 Tesla MRI system. Region of interests were located in the CSF and various WM and GM areas. Comparison of MD and FA values was made between leukoaraiosis tissue (LA) and normal appearing brain tissue (NABT) measured within the same leukoaraiosis subjects, and with normal brain tissue (CONTROL) of healthy control subjects. LA demonstrated a significantly higher MD and lower FA compared to NABT and CONTROL in frontal and occipital WM areas. No differences were observed in MD in any brain region between NABT and CONTROL. Whereas no differences were observed in FA between NABT and CONTROL except in the occipital WM. Fibre tractography showed 31.7% to 56.1% lesser fibre tracts in LA subjects compared to CONTROL subjects. Significant differences were found between pathological tissue compared to normal appearing brain tissue and normal brain tissue. Fibre tractography exposed reduced number of neural fibres in leukoaraiosis subjects as compared to normal subjects.
Diffusion Tensor Imaging