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.

Improving outcomes in advanced lung cancer. Maintenance therapy in non-small-cell lung carcinoma

Systemic chemotherapy has remained the traditional treatment for metastatic non-small-cell lung carcinoma [NSCLC], enhancing survival rate at 1 year to 29%. The median survival had plateaued at around 10 months until early 2008, and in an attempt to enhance survival in advanced disease, maintenance chemotherapy trials were initiated which had recently demonstrated prolongation of survival by an additional 2-3 months in patients who had performance status [PS] 0-1 and well-preserved organ functions. Suitable patients with any degree of clinical benefit are treated with 4-6 cycles, and then one of the active agents is continued until best response, or toxicity [continued maintenance], or changed to a cross non-resistant single agent [switch maintenance]. The article briefly reviews the evolution of systemic therapy and describes key randomised trials of maintenance therapy instituting chemotherapy and targeted agents in an attempt to improve outcomes in advanced metastatic NSCLC, based on certain clinical features, histology, and genetics

Solid pseudopapillary neoplasm of the pancreas: a case report with review of the diagnostic dilemmas and tumor behavior

Solid pseudopapillary neoplasm of the pancreas is a rare tumor of the pancreas often detected initially on imaging. Of uncertain histogenesis, it has a low-grade malignant potential with excellent post-surgical curative rates and rare metastasis. Despite advances in imaging, pseudocysts and other cystic neoplasms feature in the differential diagnosis. Pathological and/or cytological evaluation remains the gold standard in reaching a definitive diagnosis. On morphology alone, other primary pancreatic tumors and metastatic tumors pose a diagnostic challenge. Recent advances in immunohistochemical characterization have made the histopathologic diagnosis more specific and, in turn, shed light on the likely histogenesis of this rare tumor. We report a case of solid pseudopapillary neoplasm of the pancreas that was suspected on radiology and diagnosed intraoperatively on imprint cytology guiding definitive surgery. The diagnostic dilemmas are reviewed.

Metastatic malignant melanoma during pregnancy: case report and a review of the literature

Malignant melanoma is one of the most rapidly increasing cancers and, when it occurs during pregnancy, it can frequently metastasise to the placenta and the foetus. Earlier reports suggested a rapid progress of the disease during pregnancy with a poor prognosis; however, recent controlled studies found that stage for stage, the prognosis of melanoma during pregnancy is similar to that in a non-pregnant state. Early diagnosis and prompt treatment can avoid a tragic outcome

Outcome as a measure of quality of care in oncology: experience at Sultan Qaboos University Hospital, Oman

Measurement of outcomes is increasingly employed as an indicator of the quality of clinical care. The most commonly measured outcome in many clinical studies, especially in oncology, still remains the overall survival rate. Sultan Qaboos University Hospital [SQUH], Oman, is striving for excellence through quality management. In seeking continual improvement, quality measurement exercises have been initiated throughout the Hospital. We present the overall survival rate of four of the ten most common cancers diagnosed in Oman. The cancers included non-Hodgkin's lymphoma [NHL], Hodgkin's lymphoma [HL], breast cancer, and stomach cancer. The studies were all retrospective and had been conducted previously. For present purposes, only the overall survival was compared with studies both from the region, and with bench-mark studies. For NHL, with a median follow-up of 8 months, the 2-year overall survival rate was 64%; 90% for low risk, 55% for intermediate risk, and 15% for high risk groups. For HL, the 5-year overall survival rate was 64%; 76% for low risk and 42% for high risk. For breast cancer, the 5-year survival rate was 67%; percentages were 88%, 75% and 59% for Groups I, II, and III respectively. For gastric cancer, the 5-year survival rate was 16.5%; 24% for the non-metastatic group. The outcome of patients with early stages and fewer adverse prognostic factors is comparable to what has been reported in the international literature; however, the outcome is inferior for patients presenting withadvanced stage disease and several adverse prognostic factors

Major advances in the treatment of cancer. What does a non-oncologist need to know?

The last few years have seen major advances in the management of cancers. Since it is not possible for the non-oncologist to keep abreast with the latest developments in the field of oncology, this review summarises the most significant advances in the area of treatment of various cancers over the past four years. In some areas, a paradigm shift has occurred setting new standards of care, for example, the use of targeted therapy [trastuzumab] in adjuvant treatment of breast cancer; the use of monoclonal antibodies[rituximab], with or without chemotherapy, in the treatment and maintenance of indolent lymphoma; the use of the tyrosine kinaseinhibitor, imatinib, in the adjuvant setting in resected gastrointestinal stromal tumours. In other areas, new treatments have emerged,such as, the use of targeted therapies in hepatocellular carcinoma [sorafenib] and renal cell carcinoma [sunitinib, sorafenib, temsirolimus, bevacizumab]. In some other cancers, the addition of targeted therapies has improved survival rates, for example, in colon cancer [bevacizumab, cetuximb, panitumumab], head and neck cancers [cetuximab], and pancreatic adenocarcinoma [erlotinib]. In yet another group, new targeted therapies have emerged where resistance was previously observed with the existing targeted therapies, for example, breast cancer [lapatinib], chronic myeloid leukemia [dasatinib]. Finally, the addition of chemotherapeutic agents has improved survival in some forms of cancer, for example, oxaliplatin in adjuvant treatment of colon cancer, temozolamide in glioblastoma multiforme, and adjuvant chemotherapy in non-small cell lung cancer. The information summarized here may provide useful for the busy physician needing an update in the field of oncology

Nodular lymphocyte predominant Hodgkin's lymphoma presenting as severe hypercalcaemia: a case report

Nodular lymphocyte predominant Hodgkin's lymphoma [NLPHL] is a recently described type of Hodgkin's lymphoma [HL] and accounts for 5-6% of all the cases of HL. Here we report the case of an elderly man who presented to Sultan Qaboos University Hospital, Oman, with severe hypercalcemia, and was diagnosed to have stage IV NLPHL. Although the incidence of hypercalcemia is estimated to be between 1-5% in classical HL, to our knowledge this is the first report of NLPHL presenting with severe hypercalcemia. The patient responded to the anti-CD20 monoclonal antibody, Rituximab, and has been in clinical remission for more than 3 years

Effect of dexamethasone on postoperative nausea and vomiting in children after tonsillectomy surgery

After approval by the local ethics committee sixty ASA 1 and 11 children, undergoing tonsillectomy surgery by dissection technique were included into the study. The parents of all children had been informed to the nature of the study and a written informed consent was obtained. The children who fulfilled our inclusion criteria were classified into three equal groups according to the timing of dexamethasone administration: Group I: Received dexamethasone 8mg IV one hour before induction of anesthesia. Group II. Received dexamethasone 8mg IV at the end of anesthesia. Group III: Received placebo [2 ml saline]. Anesthesia was managed in a standardized manner in the three groups. Postoperative pain was assessed by questioning the children on a visual analogue toy at one, two and, six hours postoperatively. Nausea and vomiting were assessed by 3 point ordinal scale: 0 = none. 1 = Nausea. 2 = Vomiting. Vomiting was assessed immediately after operation and was defined as forceful expulsion of gastric contents. Leach vomiting episode was counted in the operating room after the tracheal tube was removed. No distinction was made between vomiting and retching, [defined as active efforts without expulsion of gastric contents], and retching was graded as a vomiting event. The severity of vomiting episodes was recorded as: None [no emetic episode], Mild [1-3 episodes], Moderate [4-6 episodes], or Severe [> 7 episodes]. Vomiting was classified according to its time of occurrence after recovery as: none, early [within the first 180 minutes after the end of anesthesia], or delayed [after 180 minutes]. No vomiting and no rescue antiemetic medication during the 24 hour postoperative period were defined as successful protection. Surgery time, anesthesia time, need for rescue antiemetics, quality of oral intake in the PACU were recorded for each patient. Paracetamol suppositories 10 mg/kg 4-hourly were described for postoperative analgesia and on request of the patient, the total dose of paracetamol consumption was recorded. Our results showed that, at 0-2 hour postoperatively: Patients in group I reported a significantly less frequent incidence of PONV than those in group II and III with frequencies of 20%, 60% and 70% in group 1, II and III respectively. At 2-6 h postoperatively, no patient [0%]. Two patients]10%] and three patients [15%] suffered form vomiting in group I, II and III respectively. At 0-2h postoperatively, four patients [20%] in group I, and 12 patients [60%] in group II, and 14 patients [70%] in group III suffered vomiting early within 180 minutes after the end of anesthesia. At 2-6 hours postoperatively, no patient in group I suffered from vomiting, one patient [5%] in group II suffered vomiting early within 180 minutes after the end of anesthesia, and one patient [5%] in group II and 3 patients [15%] in group III had delayed vomiting after 180 minutes from the end of anesthesia. There were no children in group I who required antieienietic rescue while 4 patients [20%] in group II and 5 patients [25%] in group III required treatment with metoclopramide. Children in group I achieved early oral intake than the other two groups. We concluded that 8 mg IV dexamethasone, when administered 1 hour before the induction of anesthesia provided an effective antiemetic therapy throughout the first six hours of the postoperative period. On the other hand, dexamethasone when administred at the end of anesthesia, failed to provide an effective antiemetic therapy during the immediate postoperative period in children after tonsillectomy surgery

Factors influencing the success of family planning services in El Menia and Assuit governorates Egypt

Family planning is an added value to the health and weli-being of women, children, families, and communities and a key component of reproductive health services. The objectives of this study are to identify the cultural, social and environmental determinants associated with under utility of family planning services and assess women satisfaction towards the quality of family planning services. The study was carried out in two governorates El Menia and Assuit, in each governorate 10 primary health care units were selected, live of them have already got the golden star in quality of family planning service recently. The study was conducted during the period January 2004 to May 2004. The subjects of this study included; 300 women who attended the family planning services during the study period, 20 physicians, 20 nurses and 20 social workers [Raedat], who are working in the selected 20 primary health care units. The result revealed that there were no significant differences between the two groups as regards duration of marriage and the number of living children. The rate of illiteracy was around 54% in both groups. Considering the educational status of the husbands there was a significant difference between the two groups. 64% of physicians in PHCs with golden star used explanatory tools during discussion with clients compared to 43.3% in the second group. This difference was statistically significant [p<0.01]. The results pointed out that physicians were the first contact as mentioned by 20.7% of women in the first group compared to 10% in the second group this difference was statistically significant [p<0.05]. General examination was performed in 91.3% for women in the first group compared to 73.3% for women in the second group this difference was statistically significant [p<0.01]. The overall patient satisfaction rate was the same in both groups [87.8% per patient in the first group and 87.3% in the second group]. The study concluded from the results of interview and focus group discussions that reasons for distinguishing PHCs with golden stars relatively to those without golden stars may be attributed to many factors including the lower illiteracy rate of the husbands, the relatively lack of desire of the women to have more children in the next two years, the near distance of the PHCs to the houses, seeing the physicians on the first contact to the PHCs and using tools for explaining the contraceptive methods

Acute myeloid leukemia following regression of sarcoidosis: a case report

This report describes Acute Myeloid Leukemia [AML] occurring in a 46 years old woman previously diagnosed to have Sarcoidosis. There was no evidence of Sarcoidosis at the time of diagnosis of AML. Although the association is well recognized, a cause and effect relationship between the two diseases is not fully established. A brief review of the literature is presented. Case Reports: A 46 years old lady presented to the emergency room with a history of high grade fever, exertional dyspnoea and generalized weakness for the past 4 weeks. She had undergone coronary artery bypass grafting [CABG] five years back. A year before the current presentation, she had presented with a history of fever, dry cough and anorexia. Examination had been unremarkable, except for an ESR of 32 mm/hr and bilateral hilar lymphadenopathy on chest X-ray. She was treated with standard anti-tuberculosis therapy [ATT] empirically. Subsequent to a lack of response to ATT and cultures for Acid Fast Bacilli remaining negative, Angiotensin Converting Enzyme [ACE] levels were found to be elevated to 59 IU/L [normal 8-52 IU/L]. A lymph node had also appeared in the left supraclavicular region by this time; excisional biopsy of which revealed non-caseating granuloma. ATT was discontinued and the patient was started on oral steroids. Within the next two months she became asymptomatic and the chest X-ray showed a complete regression of hilar Lymph nodes. During her current admission, she was found to be febrile, pale, icteric with hepatosplenomegaly, but no lymphadenopathy Examination of the cardiovascular, respiratory and the central nervous system were unremarkable. Her laboratory data revealed a haemoglobin of 6.3 g/dl, total leukocyte count of 121x 109/L with 88% blast cells, and a platelet count of 24x109/L. Bone marrow aspirate revealed Auerrod containing blast cells which constituted 90% of the total nucleated cells. 80% of the cells showed reactivity to Sudan Black. The patient was diagnosed to have AML. The chromosomal analysis revealed a 46 XX karyotype. Serum chemistries revealed a BUN of 7 mg/dl; creatinine 1mg/dl; Na 140 mEq/L; K 2mEq/L; total bilirubin 3.6 mg/dl; ALT 11 IU/L; alkaline phosphate 52 IU/L; LDH 5487 IU/L; and uric acid 7.2 mg/dl. The ACE levels were within normal limits. The chest Xray showed evidence of previous sternotomy and no lymphadenopathy. She was started on induction chemotherapy consisting of cytosine arabinoside 100 mg/m2 for 7 days and mitoxantrone 12 mg/m2 for three days. Hematological remission was documented on the 29th day of induction treatment. Bone marrow biopsy did not reveal a granuloma or fibrosis

Increased levels of multiple forms of dihydrofolate reductase in peripheral blood leucocytes of cancer patients receiving haematopoietic colony-stimulating factors: interim analysis

The precise mechanism whereby granulocytes proliferate when haematopoietic colony stimulating factors (CSFs) are used in neutropenic cancer patients is poorly understood. The purpose of this study was to investigate whether these cytokines bring about leucocyte proliferation by increasing the levels of multiple forms of dihydrofolate reductase (DHFR). Blood samples were collected from 36 cancer patients (25 males and 11 females) with chemotherapy-induced neutropenia. One sample of blood from each patient was obtained before therapy either with CSF, such as granulocyte colony stimulating factor (G-CSF) and granulocyte-macrophage colony stimulating factor (GM-CSF) or with placebo, and another one at the time of resolution of neutropenia. Peripheral blood leucocytes in these blood samples were counted, separated and lysed. From lysates, cytoplasmic samples were prepared and analyzed for active DHFR by a methotrexate-binding assay and for total immunoreactive DHFR by an enzyme linked immunosorbent assay. The increase in total leucocyte count (TLC) was most prominent (P < 0.005) in the CSF group and less so (P < 0.05) in the placebo group. The mean +/- SD concentration values of active DHFR before and after stimulation with GM-CSF found were to be 0.34 +/- 0.4 ng/mg protein and 0.99 +/- 0.82 ng/mg protein, respectively, and in the group treated with G-CSF, 0.24 +/- 0.32 ng/mg protein and 1.18 +/- 2.4 ng/mg protein, respectively. This increase in active DHFR after stimulation with CSF was statistically significant (P <0.05). Similarly, concentration values of immunoreactive but nonfunctional form of DHFR (IRE) were 110 +/- 97 ng/mg protein and 605 +/- 475 ng/mg protein before and after stimulation with GM-CSF, and 115 +/- 165 ng/mg protein and 1,054 +/- 1,095 ng/ mg protein before and after stimulation with G-CSF. This increase in concentration of IRE after stimulation with GM-CSF or G-CSF was statistically significant (P < 0.005). In the control group, there was an increase in the concentration of both active DHFR and IRE after treatment with placebo. However, this was not statistically significant. Resolution of neutropenia was quicker in the groups treated with CSF compared to the control group. Results of this study indicate that colony stimulating factors (G-CSF and GM-CSF) induce white cell proliferation by increasing the levels of multiple forms of DHFR.

All trans retinoic acid in acute promyelocytic leukemia: case series and review of literature

Over the past few years All Trans-Retinoic Acid [ATRA] has been increasingly used to induce remission in Acute Promyelocytic Leukaemia [APL]. ATRA is thought to restore the structural integrity of the nuclear bodies whic are disrupted by the transcribed chimeric protein [APL-RAR alpha] formed as a result of a specific non-random chromosomal translocation [15:17].Six patients of APL with ATRA were treated at a dose of 45 mg/m[2] orally. There were five female and one male patient. Five patients presented with pancytopenia while all had a picture of disseminated intravascular coagulation [Dic]. Four out of six patients entered into complete remission either on ATRA alone or with the addition of cytotoxic chemotherapy. The other two patients developed serious side effects and the treatment with ATRA had to be stopped. One of these patients subsequently entered into remission with standard chemotherapy. The mean time to remission was 39 days. Since ATRA does not induce cytotoxicity, the problem of marrow suppression and exacerbation of Dic were largely alleviated. The patients remained at home for the most part of their treatment. Relevant literature is reviewed

Production of monoclonal antibodies against bovine parvovirus

Monoclonal antibodies [MAbs] against bovine parvovirus [BPV] were successfully produced after fusing the spleen cells of an immunized mouse with myelorna cells. A total of six hybridomas were found to produce MAbs against BPV with different reactivities using heamagglutination inhibition [HI] test. These clones are: 3B[10], 3C[5], 3D[6], 2H[6] and 1E[6]. The first three clones produced MAbs of IgG class, but the last three clones produced those of the IgM class and all of them contained K light chain

Some clinico-laboratory aspects of the problems of neonatal jaundice

This study included one hundred newborns with neonatal jaundices as well as twenty age and sex matched newborns as a control group. The detected causes of jaundice in this study were isoimmunization [Rh and ABO] [33%] and all cases were investigated for the presence of irregular antibodies, but with negative results. The second major cause of jaundice in the study was septicemia[15%], some other causes were found to play a minor role. Thyroid function test [T3, T4 and TSH] was evaluated for detection of hypothyroidism as a cause of neonatal hyperbilirubinemia and all cases were normal for age. Infant risk factors that were recorded among newborns with neonatal hyperbilirubinemia were also studied. The rate of these risk factors were as followed; males sex [72%], prematurity [20%] and intrauterine growth retardation [IUGR][12%]. Most of these cases recovered by treatment of the cause and phototherapy [75% versus 25% of phototherapy and exchange transfusion]. However, 78.5% of cases with Rh-incompatibility and 31.5% of cases with ABO-incompatibility needed exchange transfusion combined with phototherapy. Concerning the outcome of the studied cases, 82% were cured, 13% died and 5% developed complications. It was concluded that proper antenatal care for the pregnant mothers, early diagnosis and management of neonatal jaundice and keeping in mind the possibilities of congenital hypothyroidism are recommended