Food Safety Knowledge, Beliefs and Behaviour among Health Sciences-related Field Undergraduate Students at a Local University (Pengetahuan, Kepercayaan dan Tingkah Laku Keselamatan Makanan dalam Kalangan Pelajar Bidang Berkaitan Sains Kesihatan di Sebuah Universiti Tempatan) / Jurnal Sains Kesihatan Malaysia

@#Foodborne disease is among the primary illness that causes morbidity and mortality in the world. Several studies show that most students do not have adequate food safety knowledge to protect themselves against foodborne diseases. This study aimed to determine the food safety knowledge, behaviour, and beliefs among undergraduate students at a local university in Malaysia. This cross-sectional study involves 121 respondents from three health science-related faculties at the studied institution. The questionnaire was distributed via an online platform. This study used multiple-choiceformat questions for Food Safety Knowledge and a Likert type scale for Food Safety Behaviour and Belief question statements. Most of the respondents were female (78%). About 16% of the respondents have experience working / volunteering in food services, and half of them are involved in food handling during their services. This study recorded a moderate score in all sections (knowledge, behaviour, beliefs) with a total percentage score of 60.3%, 60.3%, and 66.1%, respectively. A strong but not significant correlation between food safety knowledge and beliefs (r = 0.69 p > 0.05) and between food safety knowledge and behaviour (r = 0.83 p > 0.05) were observed. This study is useful as a basis to develop a targeted food safety education program among undergraduate students. Students with high knowledge of food safety will increase food safety beliefs and behaviour, thus preventing them from getting any foodborne illness.

Intention to seek professional help for depression and its associated factors among elderly patients in Tenkera Health Clinic, Melaka, Malaysia

@#Background: Prevalence of mental disorders such as depression in the elderly is rising with the ageing population. This study is aimed to determine the prevalence of depression, their intention to seek help and the factors associated to seek professional help among elderly patients in a primary care clinic. Methods: This was a cross-sectional with systematic sampling conducted from June to December 2019 in Tengkera Health Clinic (THC). Patient Health Questionnaire9 (PHQ-9), socioeconomic data and a dichotomous yes-no response for intention to seek help was collected from 273 elderly patients attending the outpatient clinic. Results: The prevalence of elderly depression at THC was 10.3% and the prevalence of intention to seek professional help for depression among elderly patients at Tengkera Health Clinic was 27.5%. Factors that were associated with intention to seek professional help for depression were prior experience of seeking professional help, adjusted OR 3.45[95%CI (1.41-8.48)] and education level of the respondents- secondary education, adjusted OR 3.10 [95%CI (1.01-9.53)] comparing with no formal education; tertiary education, adjusted OR 4.66 [95%CI (1.08-20.04)] comparing with no formal education. Conclusion: The prevalence of elderly depression was high while the prevalence of intention to seek professional help for depression in the sample population was low. Primary care physicians play a vital role in identifying elderly patients with low education level for screening and treatment as well as promoting awareness and breaking down barriers and stigma towards mental illness.

Risk perception and knowledge regarding diabetes among offspring of type 2 diabetics at a tertiary institution

@#(T2DM) among the younger age groups is a growing concernworldwide. Thus, assessing the perception of risk andknowledge among those at risk may provide an opportunityfor early intervention, delay or even prevent the onset. Objective: The aim of this study was to determine theperceived risk of developing T2DM and its knowledgeamong the offspring of diabetic patients.Methods: A cross sectional study using a self-administeredquestionnaire was conducted among university studentswhose parents had type 2 diabetes to determine theirperceived risk and knowledge on T2DM. Results: A total of 336 university students participated inthis study and 56.5% of them correctly identified themselvesat risk of developing T2DM. About half of them (52.7%) hadhigher knowledge of T2DM. Male students appeared to havebetter risk perception (p=0.024) compared to females whilethose with mothers affected by T2DM appear to have higherknowledge regarding diabetes (p=0.007). Most of theirinformation regarding T2DM was obtained from the internet(87.5%) and other family members (77.9%).Conclusion: The students whose mothers had T2DM appearto have better knowledge and information regarding T2DMand this was mostly obtained from the internet and familymembers. Awareness regarding diabetes and healthylifestyles advice through primary patients may be beneficialfor their offspring.

Management of diabetes in pregnancy in primary care

@#Diabetes in pregnancy is associated with risks to the woman and her developing fetus. Management of the condition at the primary care level includes pre-conception care, screening, diagnosis, as well as antenatal and postpartum care. A multidisciplinary approach is essential in ensuring its holistic management.

The Use of Medicines with Anti-cholinergic Properties and Their Health Impacts among Hospitalised Malaysian Geriatric Patients

@#Background: Studies have shown that the use of medicines with anti-cholinergic (Ach) properties can increase elderly patients’ risk of experiencing falls, confusion, and longer hospital stays (LOS). These adverse effects are preventable with appropriate intervention. Little is known about the use of medicines with Ach properties and their impact on Malaysian elderly patients. This study aimed to investigate the use of medicines with Ach properties and their impact on fall risk, confusion, and longer LOS among hospitalised elderly patients. Methods: This study utilised a cross-sectional design and was conducted at a single centre where convenience sampling was employed to collect data from elderly patients (> 60 years) admitted to geriatric and medical wards at Hospital Tuanku Ja’afar during a 2-month period (July 2017–August 2017). Patients were excluded from this study if their hospital admission was planned for an elective procedure or if neurocognitive and hepatic impairment were diagnosed prior to the hospital admission. Medicines with Ach properties were identified and classified according to the anti-cholinergic drug scale (ADS). Univariate and multiple logistic regression statistical analyses were performed to assess its impacts on falls, confusion, and LOS. Results: A total of 145 elderly patients with a mean age of 71.59 years old (SD = 8.02) were included in the study. Fifty-two percent of the participants were female, and the average hospital stay was 6 days (SD = 2.09). Medicines with Ach properties were administered in 62% (n = 90) of the cases. The most commonly prescribed medicine with Ach properties was furosemide (n = 59), followed by ranitidine (n = 44), warfarin (n = 23), and methylprednisolone (n = 22). Compared to patients who did not receive medicines with Ach properties, patients who received them had a significantly higher risk of falls [odds ratios (OR) = 2.61; 95%CI: 1.18, 5.78; P = 0.018], confusion (OR = 3.60; 95%CI: 1.55, 8.36; P = 0.003), and LOS (OR = 4.83; 95%CI: 2.13, 10.94; P < 0.001). Multiple comorbidities also showed a significantly increased risk of falls (OR = 3.03; 95%CI: 1.29, 7.07; P = 0.010). Conclusion: Medicines with Ach properties had a significant impact on elderly patients’ health. Strategies for rationally prescribing medicines with Ach properties to Malaysian elderly patients need to be improved and be recognised as an important public health priority.

3,5-Bis(arylidene)-4-piperidones as potential dengue protease inhibitors

Dengue is a severe mosquito-borne viral infection causing half a million deaths annually. Dengue virus NS2B/NS3 protease is a validated target for anti-dengue drug design. A series of hitherto unreported 3,5-bis(arylidene)-4-piperidones analogues-were synthesized and screenedagainst DENV2 NS2B/NS3 protease to elucidate their binding mechanism and orientation around the active sites. Results were validated through anDENV2 NS2B/NS3 protease assay using a fluorogenic Boc-Gly-Arg-Arg-AMC substrate. Nitro derivatives of 3,5-bis(arylidene)-4-piperidones (and) emerged as promising lead molecules for novel protease inhibitors with an ICof 15.22 and 16.23 µmol/L, respectively, compared to the standard, panduratin A, having ICof 57.28 µmol/L.

Distribution of doctors' workforce in Erbil governorate

Background and objective: Imbalance in the distribution of health workforce might result in inequities in health services delivery. The aim of this study was to assess the distribution of doctors' workforce in Erbil governorate and identify the possible reasons for rapid turnover of doctors

Methods: This descriptive cross-sectional study included all the 962 doctors working in the health facilities of Erbil governorate. A questionnaire was used to collect data that included 40 questions divided into four broad sections of identification information, socio-demographic characteristics, information on professional characteristics and factors influencing employment process in rural areas

Results: There were 5.1 doctors per 10,000 populations. Most of the doctors were deployed in urban areas [83.6%]. Most doctors were working in hospitals [74.2%] and 23.3% in primary health centers. Specialists constituted the largest categories of doctors [33.5%] and general practitioners the smallest [6.7%]. Doctors' willingness to stay at the current workplace was significantly associated with being married, having opportunities to select workplace, working in private clinics and having the workplace inside Erbil

Conclusion: The density of doctors per 10,000 populations in Erbil governorate is below the regional and international average, with a remarkable urban-rural imbalance in numerical, geographical and institutional terms

Utility of alpha-blockade in a hypotensive pheochromocytoma patient with myocardial infarction

The aim of this case study is to emphasize the importance of alpha-blockade in managing a rare complication of an untreated pheochromocytoma. Clinical Presentation and Intervention: A 41-year-old man with previous bilateral pheochromocytoma presented with chest pain. He was suffering from cardiac failure and persistent hypotension requiring an inotrope. Cardiac markers, an electrocardiogram and an echocardiogram confirmed acute myocardial infarct with poor ejection fraction and global hypokinesia. An [18]F-fluorodeoxyglucose PET/CT scan showed progressive left suprarenal and organ of Zuckerkandl pheochromocytomas. Blood pressure stabilisation proved challenging but was achieved by titrating an incremental dose of alpha-blocker against a tapering inotropic dose. This case showed the efficacy of an alpha-blocker despite persistent hypotension in a patient with pheochromocytoma-induced cardiomyopathy

Epidemiological indicators and clinical profile of leprosy cases in Dhaka

Objective: To evaluate epidemiological indicators and clinical profile of leprosy patients in Dhaka City

Methods: In this cross-sectional observational study 722 new leprosy patients registered in six different clinics of The Leprosy Mission International - Bangladesh, Dhaka program over two and half year [January 2011 to June 2013] were included. Demographic details and clinical characteristics during diagnosis were recorded

Results: Out of 722 patients, 390 [54%] were males and 332 [46%] were females. Proportion of cases under 15 year age was 8.7%. Borderline tuberculoid was the most common form of the disease [81.0%] followed by tuberculoid [9.3%], lepromatous [4.3%], borderline lepromatous [3.5%], borderline [1.8%] and pure neural [0.1%]. Proportion of multibacillary leprosy was 22.4%. Most of the patients had duration of symptoms from 6 months to 1 year [53.0%]. 12% of patients had history of contact with leprosy patients. Type 1 reaction was more prevalent than type 2 [7.6% and 2.9%, respectively]. Proportion of cases with grade 2 disability was 5.9%. Most common presentation was with hypopigmented macule with obvious margin, marked anesthesia and mild infiltration. Ulnar nerve was the most common nerve to be involved [15.8%]

Conclusion: Leprosy cases are being frequently diagnosed in Dhaka city. Epidemiological indicators reflect that there may be ongoing disease transmission and relative delay in diagnosis despite a strong surveillance program

Carbimazole-induced agranulocytosis treated with granulocyte colony-stimulating factor [GCSF]: a report of two cases

Agranulocytosis is the most serious and potentially fatal side-efiect of antithyroid drug therapy. We report two cases presenting with carbimazole-induced agranulocyotsis. The first patient received 20 mg of carbimazole daily, and developed agranulocytosis within one month of commencementoftherapy. The second patientpresented with agranulocytosis complicated by a thyroid storm following Ingestion 60 mg of carbimazole, daily for two months. Both patients were treated with 300 mg of granulocyte colony factor [GCSF] subcutaneously [in addition to discontinuation of their anti-thyroid drugs] and broadspectrum antibiotics for neutropenic sepsis. The total white and neutrophil counts returned to baseline following five and six days of treatment, respectively, with the resolution the use of GCSF in the treatment will be being discussed

Tako-tsubo cardiomyopathy or broken heart syndrome

Tako-tsubo cardiomyopathy is a rare but reversible entity that mimics acute myocardial infarction or congestive heart failure. Its timely recognition is important not only for appropriate treatment of this condition but also to prevent the disease recurrence and the use of potentially life threatening procedures for comparable conditions

Tinea pedis: a clinical dilemma in Bangladeshi population

Tinea pedis is an important public health problem because of the increase in immunosuppressive states. Large scale studies in Asia are scarce, and the baseline incidence of tinea pedis is not firmly established. To find out the clinical types of tiena pedis amont the Bangladeshi population. 200 clinically suspected cases of tinea pedis were included in this study. In all cases, samples were collected for KOH microscopy and culture. Clinical pattern and associated relevant factors were noted according to a predetermined protocol. Papulosquamous tinea pedis was the most common clinical pattern in 80 [40%] followed by interteriginous type in 70 [35%] patients. Hyperkeratotic pattern was found less commonly in 45 [22.5%] patients followed by bullous pattern in 5 [2.5%] patients. The incidence of papulosquamous type of tinea pedis is relatively higher among the Bangladeshi population than other countries

Ethnic distribution and clinical features of systemic lupus erythematosus in the Sudan

Systemic lupus erythematosus [SLE] is a multisystem chronic inflammatory autoimmune disease characterized by periods of remissions and relapses. It is thought to develop when genetically predisposed individuals are exposed to one or more environmental triggers. The ethnically mixed population of the Sudan offers an opportunity to look into the effect of ethnicity on the distribution and systemic expression of the disease. Eighty seven consecutive patients fulfilling the clinical and laboratory criteria for the diagnosis of SLE were prospectively interviewed and examined using a unified protocol in three medical clinics in different parts of Khartoum. Appropriate investigations, including renal biopsies were carried out when indicated. Eighty three of the 87 patients [95.4%] were females [female to male ratio 20.6:1]. Mean age at diagnosis was 31.89 years [range 21-30]. The disease was most frequently seen in tribes of mixed ethnicity [Afro-Arabs] and least common in pure African tribes. Thus, subjects with Afro-Arab ancestry constituted 94.3% of the sample seen whereas, subjects from Nubian ancestry [descendents from ancient tribes living in central and northern Sudan] were 5.7% of the group and no subjects from the black tribes of Southern and Western Sudan were represented. The disease affected multiple systems as seen elsewhere. Most of the patients [96.6%] were antinuclear antibodies [ANA] positive while [51.1%] were antidouble stranded dioxyribonucleic acid [Anti-dsDNA] positive. The clinical features of SLE in our patients are comparable to what has been studied in the region. However, there was an overwhelming tendency of the disease to affect subjects of mixed ethnicity and less affection of subjects of pure African ancestry. The study is in support of the observation that SLE is rare in Black Africans living in Africa, however, it is not uncommon in subjects with Afro-Arab genetic admixture

Sleep disordered breathing in different endocrinal diseases

Sleep-disordered breathing [SDB] is an extremely common condition that compromises the vital functions of respiration and circulation. As currently defined, obstructive sleep apnea [OSA] is associated with considerable morbidity and mortality, whereas the currently available treatments are associated with either limited efficacy and/or poor compliance. An improvement in the understanding of the nature and pathophysiology of the disorder may lead to novel treatments. The objectives of the present study are to detect apnea /hypopnea as an indicator of SDB in patients with some endocrinal diseases, namely diabetes mellitus, hypothyroidism, acromegaly and Cushing for early management and better quality of life. We studied sixty-five patients with different endocrinal diseases [group A]. They were further subdivided into: group 1 [25 patients with diabetes mellitus], group 2 [16 patients with hypothyroidism], group 3 [12 patients with acromegaly] and group 4 [12 patients with Cushing disease]. All groups were subjected to full clinical and neurological assessment, sleep history, laboratory investigations, and an overnight polysomnographic [PSG] study. Twenty healthy subjects were selected as a control group [group B]. Respiratory disturbance index [RDI] was significantly higher in all patients groups compared to control group. HbA1c, FBS, as well as 2hr PP correlated positively with RDI in group [1]. No significant correlation was observed between RDI and serum TSH, T3 and T4 levels in group [2]. Acromegalic patients with SDB had significantly higher growth hormone [GH] level which correlated positively with RDI in group [3]. No significant correlation was observed between RDI, serum ACTH and 24 hours urinary cortisol levels in group [4]. There are complex interactions between OSA and neuroendocrine function. Understanding this complex relation may lead to more effective, better tolerated treatment for sleepiness and SDB. It is increasingly important that in patients presented to sleep laboratory, careful medical evaluation should be done to all cases presented with sleepiness and had manifestation of sleep apnea to exclude different endocrinal diseases

Some tribal medicinal plants of Ghagra union of Rangamati district and their uses

Chakma is the largest tribal community in the Ghagra union of Rangamati District. Majority of them still depend on medicinal plants for the treatment of different ailments. A study was carried out in that area to document their knowledge about medicinal plants. 52 species under 38 families have been recorded which are used for the treatment of 43 diseases. Botanical name, tribal name, parts used and doses are mentioned

Efficacy of topical tacrolimus in atopic dermatitis

Mainstay treatments for atopic dermatitis include cutaneous hydration, antihistamines and topical glucocorticoids. To avoid side effects associated with long term and higher potency topical corticosteroids, further topical immunosuppressive agents should be tried. Topical tacrolimus has been extensively studied and shows promise in treatment of inflammatory skin diseases such as atopic dermatitis. To determine the safety and efficacy of tacrolimus in atopic dermatitis. In this randomized, case-control study, out of 60 patients with atopic dermatitis [age ranging 2 to 45 years], 30 [case] were treated with tacrolimus [0.03%] ointment twice daily and 30 [control] were treated with vaseline twice daily for up to 3 weeks. Evaluation included per cent body durface area [%BSA] affected, individual signs of atopic dermatitis, the Severity Score of Atopic dermatitis [SCORAD], and the patient's assessment of pruritus. The outcome variables like erythema, edema/papulation, oozing/crusting, excoriation, pruritus, body surface area involved and SCORAD in the case group improved significantly compared to those in the control group [p< 0.001, <0.001, <0.001, <0.005, <0.001, <0.001 and <0.001, respectively]. After 3 weeks of tacrolimus, all variables except lichenification score responded significantly. Significantly higher number complained of burning sensation in cases [20%] as compared to none in the control group. Topical 0.03% tacrolimus is more effective than the vehicle alone

Intraperitoneal dextromethorphan and levo-bupivacaine mixture for reduction of postoperative visceral hyperalgesia and cytokine production in patients undergoing laparoscopic cholecystectomy

To assess the efficacy and safety of intraperitoneal administration of a dextromethorphan-levo-bupivacaine mixture in different volumes and doses on hemodynamics, postoperative pain intensity and types, opioid consumption and cytokine levels in patients undergoing elective laparoscopic cholecystectomy. Seventy-five patients ASA grade I and II undergoing laparoscopic cholecystectomy under general anaesthesia were studied. The patients were allocated into one of three groups according to dose and volume of intraperitoneally administered mixture: Large volume and dose of dextromethorphan and levo-bupivacaine 0.125% mixture [120ml with 90mg of dextromethorphan], small volume and dose of dextromethorphan and levo-bupivacaine 0.125% mixture [60ml with 45mg of dextromethorphan] and control group in which levo-bupivacaine 0.125% 60ml was administered. Intravenous patient controlled analgesia [I.V. PCA] with morphine was initiated and maintained for 24 hours. Pain was assessed for 24 hours by visual analogue scale. Stress response to surgery was evaluated by cytokine levels including tumour necrosis factor alpha [TNF-alpha] and interleukin-l beta [IL-1 beta]. Side effects, sedation level and morphine consumption were also recorded. Demographic data were similar. Pain intensity [intra-abdominal and shoulder pains] was lower in large volume and dose of dextromethorphan-levo-bupivacaine mixture [LDL] group when compared to other two groups. The addition of dextromethorphan to levo-bupivacaine in large volume and dose of dextromethorphan-levo-bupivacaine mixture [LDL] and small volume and dose of dextromethorphan-levo-bupivacaine mixture [SDL] groups resulted in better control of pain than intraperitoneal levo-bupivacaine [control group] alone. Shoulder pain was better controlled than intra-abdominal pain. Postoperative morphine consumption by I.V-PCA was less in LDL group with decreased number of repeated requests. TNF-alpha and IL-1 beta levels were significantly less in LDL and SDL groups up to 24 hours postoperatively when compared to control group with no significant changes at 12 hours to preoperative levels indicating decreased stress response to surgery. The use of intraperitoneal large volume and dose of dextromethorphan [90mg] in 120ml of levo-bupivacaine 0.125% resulted in better postoperative control of pain intensity, opioid consumption and cytokine release in response to surgical stress when compared to either small volume and dose of dextromethorphan [45mg] in 60ml of levo-bupivacaine mixture or levo-bupivacaine 60ml alone

Comparative efficacy of griseofulvin and fluconazole in the treatment of tinea capitis

Tinea capitis is caused by different species of dermatophytes particularly Microsporum and Trichophyton .Children are affected predominantly. Many systemic drugs e.g.griseofulvin, fluconazole, itraconazole, terbinafine, ketoconazoe etc are available for the treatment of tinea capitis. To compare the efficacy of griseofulvin and fluconazole in the treatment of tinea capitis. A total of 50 patients of age group 2-15 years were selected for the study.The cases were diagnosed clinically and confirmed by Wood 's lamp examination, KOH microscopy and culture.The patients were divided into two equal groups. Group A was given griseofulvin and group B was given fluconazole for a period of two months. Topical adjuvant therapy econazole nitrate was given in both groups. The patients were followed up at 2 weekly interval for clinical response and Wood 's lamp examination and finally KOH microscopy and culture. In group A clinical response was 84%and mycological response was 68%whereas in group B clinical response was 68%and mycological response was 56%. The present study showed that griseofulvin is more effective in the treatment of noninflammatory type of tinea capitis than fluconazole