Introduction: The elderly population is highly vulnerable to malnutrition, including those in the community. The use of nutrition education as part of nutrition intervention is able to improve their nutritional status. Hence, provision of a nutrition resource kit addressing the needs of at-risk and malnourished elderly would be advantageous. This research aimed to develop, validate and evaluate the acceptance of a newly developed nutrition resource kit, which served as an educational material among at-risk and malnourished elderly in Malaysian health clinics. Methods: This study was conducted in three phases: Phase I comprised of qualitative needs assessment to identify the types of nutrition resource kit needed; Phase II was the development and validation of the nutrition resource kit; while Phase III was acceptance evaluation, which involved individual in-depth interview and triangulation. Results: An A5-sized booklet with incorporation of an educational video in a QR code was developed. Both printed material and educational video had excellent content and face validity. Suggestions by experts and elderly from validation were considered and revision was done accordingly. Acceptance evaluation revealed four themes: 1) positive acceptance, 2) elderly-friendly, 3) valuable, and 4) individual preference. Triangulation data revealed that all elderly positively evaluated both resources. Additional suggestions given by elderly were considered for improvement. Conclusion: This newly developed nutrition resource kit, both in the printed and electronic format, was well-accepted among the at-risk and malnourished elderly. It could be used as an important reference for the elderly, especially those attending health clinics, in treating and preventing malnutrition.

Introduction: Human immunodeficiency virus (HIV)-related stigmatisation and discrimination adversely affect health outcomes in terms of timely diagnosis, treatment and care. Despite global efforts, they remain common among healthcare workers worldwide. In Malaysia, family medicine specialists are entrusted with the care of HIV patients at the primary care level. This study aimed to assess HIV-related knowledge, acts of discrimination, stigmatising attitudes and their associated factors among family medicine trainees in Malaysia. Methodology: This cross-sectional study was conducted among 397 family medicine trainees in Malaysia using a validated, self-administered questionnaire that assessed the participants’ sociodemographic information, HIV/AIDS knowledge, stigmatising attitudes (attitudes of blame, attitudes towards imposed measures, comfort in dealing with HIV patients) and acts of discrimination. Results: The most common stigmatisation was “attitudes of blame” (mean [SD] score: 3.0 (0.74); range score:1–5), and the most frequent discriminatory act was breaching patient confidentiality (54.9%). Around 82.1% had good knowledge of HIV/AIDS. Married participants and participants who had 7 years or less in service were more stigmatising in “attitudes of imposed measures” towards people living with HIV (p=0.006). Conclusion Family medicine trainees exhibited stigmatisation and discrimination towards HIV patients despite having good HIV knowledge. Hence, appropriate and concerted health education should be given to all family medicine trainees to eliminate stigmatisation and discrimination.
Discrimination, Psychological ; Social Discrimination ; HIV

Introduction: A dilemma arises when a bone graft or fracture fragment is accidentally dropped on the operation theatre floor and becomes contaminated. This study aimed to determine the efficacy of simple and readily available antiseptic solutions in disinfecting contaminated bones. Materials and methods: This experimental study involved 225 bone specimens prepared from discarded bone fragments during a series of 45 knee and hip arthroplasty surgeries. The bone fragments were cut into five identical cubes and were randomly assigned to either control (positive or negative), or experimental groups (0.5% chlorhexidine, 10% povidone-iodine or 70% alcohol). The control negative was to determine pre-contamination culture. All bone specimens, except the control negative group were uniformly contaminated by dropping on the operation theatre floor. Subsequently, the dropped bone specimens except for the control positive group, were disinfected by immersing in a respective antiseptic solution for 10 minutes, before transported to the microbiology laboratory for incubation. Results: The incidence of a positive culture from a dropped bone fragment was 86.5%. From the 37 specimens sent for each group, the incidence of positive culture was 5.4% (2 specimens) after being disinfected using chlorhexidine, 67.6% (25 specimens) using povidone-iodine and 81.1% (30 specimens) using alcohol. Simple logistic regression analysis demonstrated that chlorhexidine was significantly effective in disinfecting contaminated bones (p-value <0.001, odd ratio 0.009). Povidone-iodine and alcohol were not statistically significant (p-value 0.059 and 0.53, respectively). Organisms identified were Bacillus species and coagulase negative Staphylococcus. No gram-negative bacteria were isolated. Conclusion: A total of 0.5% chlorhexidine is effective and superior in disinfecting contaminated bones.

Congenital insensitivity to pain with anhidrosis is a rare autosomal recessive disorder presenting with loss of pain sensation, thermal sensation defects, and self-mutilating behavior. In the present study, we recruited two consanguineous pedigree showing pain insensitivity symptoms from Pakistan for clinical and molecular investigations. In family A, one female patient displayed classical CIPA symptoms along with microcephaly and severe intellectual disability. During course of the disease, her right foot was amputated and had remarkable dental degeneration and teeth shedding. In family B, one boy presented with classical symptoms of congenital insensitivity to pain with anhidrosis. Blood was collected from both families for molecular studies. Sequencing with the Ilumina Trusight One Sequencing Panel covering 4813 OMIM genes revealed a known homozygous mutation c.2084C>T; p.P695L of NTRK1 in family A and a novel truncated mutation c.2025C>G; p.Y681X in family B. Protein modeling analysis of both mutations (p.P695L and p.Y681X) predicted loss of the rigidity in tyrosine kinase domain of NTRK1 that led to conformational changes as well as deleterious effect on protein function. The known mutation was reported more than a decade ago in a family from Northern Israel and other non-sense mutation is newly identified. It is interested that most of NTRK1 mutations are associated with this domain. This is first ever report of NTRK1 variants in congenital insensitivity to pain with anhidrosis patients from Pakistan.
Pain Insensitivity, Congenital

Aims: Camellia sinensis ( green t ea) is known for its therapeutic properties (anti - inflammatory, anti - oxidative and anti - ageing). The aim of this study was to determine the in vitro inhibitory activity of gree n tea extract on some odorous skin commensal bacteria. Methodology and results: Tea leaves were collected from MARDI Agro Technology Park, Cameron Highlands. A standardised protocol was used to obtain green tea extract. Aqueous green tea extracts were tes ted for antibacterial activity by well diffusion method. Minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) assays were performed by broth microdilution assays using green tea extract concen trations from 16 to 0.0313 mg/ mL . Green tea extract showed antibacterial activity against skin microbiota. The high antimicrobial effect was achieved against Micrococcus luteus with MIC and MBC of 0.125 and 0.25 mg/μL respectively, followed by Staphylococcus epidermidis with MIC and MBC o f 0.25 and 0.25 mg/μL respectively, Bacillus subtilis with MIC and MBC of 0.5 and 0.5 mg/μL respectively and lastly, Corynebacterium xerosis with MIC and MBC of 0.5 and 1.0 mg/μL respectively. Conclusion, significance and impact of study: The results obta ined from the study confirm the in vitro anti - microbial activity of green tea extracts against skin microbiota. The antibacterial effects of green tea against skin bacteria with its anti - oxidant and anti - aging properties will help in keeping skin healthy, fresh and reducing unpleasant odo rs .
Camellia sinensis

Introduction: The lack of evidence that proves the benefit of traditional and complementary medicines (T&CM) in treating chronic medical conditions does not deter its usage among patients worldwide. Prevalence of usage among post-stroke patients in Malaysia especially is unknown. This study aims to determine the prevalence, practice and perception of T&CM use among stroke survivors attending an outpatient rehabilitation program in a teaching hospital. Methods: A cross-sectional study was conducted among 104 post stroke patients attending an outpatient rehabilitation program. A structured self-administered questionnaire was used to collect data on sociodemographic and clinical profile of patients, as well as types of therapy used and perception on T&CM usage. Descriptive analysis was done, and bivariate analysis was used to determine associations between categorical data. Results: Mean age of patients was 62 years (SD 12.2), 54% were Chinese and 75% of the patients had ischaemic stroke. Mean age of T&CM users was younger compared to nonT&CM users (61 years vs. 66 years, p=0.04). Two-thirds (66%) of patients admitted to concurrent T&CM usage while attending conventional post stroke rehabilitation. Acupuncture (40.4%), massage (40.4%) and traditional Chinese medicine (11.5%) were the most common T&CM used. Positive perception was recorded in terms of ability of T&CM usage to relieve post stroke symptoms (68%), and it was safe to use because it was made from ‘natural sources'. Negative perception recorded: T&CM caused significant adverse effects (57.6%) and was not safe to be used in combination with other conventional medicines (62.5%). Conclusions: Concurrent T&CM usage among post-stroke patients attending structured outpatient rehabilitation program is widely practised especially acupuncture, massage and traditional Chinese medici
Complementary Therapies, Stroke

Multislice computed tomography (MSCT) is the imaging modality of choice in assessing clinically stable patients with blunt abdominal trauma. This study assessed the role of MSCT in the detection of intra abdominal injury caused by blunt trauma in our centre within a two-year-period (2008-2009). A total of 151 patients had MSCT abdomen for blunt abdominal trauma within this study period. Positive scan were seen in 126 patients (83.4%). Out of these positive scans, liver, spleen and renal injuries were seen in 42.1% (n=53), 34.9% (n=44) and 30.0% (n=34) of cases respectively. Laparotomies were performed in 45 patients. Out of these 45 laparotomies, 10 patients had surgically significant injuries that were missed on CT scan findings. The injuries were bowel perforation (n=4), serosal tear of bowel (n=1), mesenteric injuries with active haemorrhage (n=3), spleen injury (n=1) and liver injury (n=1).

OBJECTIVETo evaluate the antitumor activity of Manilkara zapota (M. zapota) L. stem bark against Ehrlich ascites carcinoma (EAC) in Swiss albino mice.

METHODSThe in vivo antitumour activity of the ethyl acetate extract of stem bark of M. zapota L. (EASM) was evaluated at 50, 100 and 200 mg/kg bw against EAC using mean survival time. After administration of the extract of M. zapota, viable EAC cell count and body weight in the EAC tumour hosts were observed. The animal was also observed for improvement in the haematological parameters (e.g., heamoglobin content, red and white blood cells count and differential cell count) after EASM treatment.

RESULTSIntraperitoneal administration of EASM reduced viable EAC cells, increased the survival time, and restored altered haematological parameters. Significant efficacy was observed for EASM at 100 mg/kg dose (P<0.05).

CONCLUSIONSIt can be concluded that the ethyl acetate extract of stem bark of M. zapota L. possesses significant antitumour activity.

Animals ; Antineoplastic Agents ; isolation & purification ; therapeutic use ; Body Weight ; Carcinoma, Ehrlich Tumor ; drug therapy ; Cell Survival ; drug effects ; Disease Models, Animal ; Injections, Intraperitoneal ; Male ; Manilkara ; chemistry ; Mice ; Plant Bark ; chemistry ; Plant Extracts ; isolation & purification ; therapeutic use ; Survival Analysis ; Treatment Outcome

The aim of this study was to determine the genotoxicity of a locally produced nanocomposite by Universiti Sains Malaysia, Malaysia using Comet assay. Stem cells from human exfoliated deciduous teeth (SHED) were treated with the nanocomposite at five different concentrations (0.006, 0.0125, 0.025, 0.05, and 0.1 mg/ml) along with concurrent negative (medium alone) and positive control (zinc sulfate heptahydrate) and incubated at 37°C for 24 hours in an incubator at 5% CO2. The tail moment was used to assess the extent of DNA damage. The tail moment for the group of SHED treated with nanocomposite (for all the five different concentrations) was not statistically significant as compared to the negative control, suggesting that the locally produced dental nanocomposite did not induce any DNA damage. Hence, it can be concluded that the locally produced nanocomposite is non-genotoxic on stem cells from human exfoliated deciduous teeth.