Barriers to the provision of asthma services and perceived practice towards asthma management among urban community pharmacists in Selangor, Malaysia

This study aims to assess the perceived practice and barriers towards the provision of asthma management services among urban community pharmacists in Selangor, Malaysia. The study also highlights both pharmacist and patient-related barriers in asthma counseling. One hundred fifty urban community pharmacists in Selangor, Malaysia, were randomly selected and recruited for the present cross sectional baseline study. Previous studies have explored pharmacists' perception on their roles in asthma management in different parts of the world. The data was collected through self-explanatory questionnaires (containing 47 items). The extracted data from the completed questionnaires were analyzed descriptively and inferentially using Statistical Package for Social Science (SPSS) version 19. Results showed that pharmacists perceived their roles in asthma management along three major dimensions: 'patient self-management', 'medication use' and 'asthma control', mean (±SD) score of the perception towards asthma management was 99.29 ± 4.58 over a maximum possible score of 110 with 90.26%. There were significant differences between the pharmacy education level and perceived practice of asthma management while there were insignificant differences between age, gender, ethnicity, number of practicing year and perceived practice of asthma management among respondents. Most common barriers towards asthma counselling including lack of time, lack of asthma knowledge, lack of counselling space and cost of asthma drugs. Conclusively, urban community pharmacists in Selangor, Malaysia, demonstrate good perceived practice of better management of asthma with multidimensional dimensional role against in disease care.

Identification of polygala oligosaccharide esters and their metabolites in rat plasma after oral administration of ethanol extract of Kai Xin San by UHPLC-MS / 药学学报

Using a UHPLC-TOF/MS method combined with software of Masslynx V4.1 and database in the literatures, a total of 20 polygala oligosaccharide esters (POEs) were identified in 60% ethanol extract of Kai Xin San (KXS-60%E). Furthermore, 14 POEs as well as 4 POE-metabolites were identified in rat plasma. The results revealed that POEs and POE-metabolites which were identified in rat plasma, were key components in KXS-60%E and the potential bioactive compounds for KXS action in the treatment of AD.

Contribution of public places in proliferation of dengue vectors in Penang Island, Malaysia

Objective: To determine abundance, distribution and diversity of potential breeding container habitats of the dengue vectors in public places including schools, restaurants, mosques and parks in southwest areas of Penang Island, Malaysia. Methods: Premises at restaurants, schools, parks and mosques were surveyed simulta-neously and inspected visually for container habitats and production of immature mosquitoes from March 2015 to March 2016. Abundance (mean ± SE) of breeding containers between sites was compared using One-way ANOVA. Independent sample t-test was used to compare total number of Aedes albopictus (Ae. albopictus) and Aedes aegypti (Ae. aegypti) surveyed. Results: The surveyed locations yielded a total of 3741 breeding containers and 19537 immature mosquitoes from four areas. Concurrent artificial and natural containers pro-duced 78.4%immature Ae. albopictus and 6.3%Ae. aegypti mosquitoes in wet season, with 14.2% Ae. albopictus and 1.1% Ae. aegypti mosquitoes in dry season. Artificial containers accounted for 98.1% of the total containers recorded, with restaurants being the most productive locations (8012) and schools being the least productive (2234). Conclusions: It was concluded that public places are good sources of potential container habitats of Aedes mosquitoes in Penang Island, Malaysia and Ae. albopictus has exclu-sively replaced the home-grown Ae. aegypti even in urban areas. Therefore, treatment of artificial containers in such locations is critical in Aedes mosquito control campaigns during dengue outbreaks.

Psychophysiological Effects of Bamboo Plants on Adults / 生物医学与环境科学（英文）

The present study was conducted to clarify the psychophysiological relaxation effects of viewing bamboo on university students. Forty healthy Chinese participants enrolled in this study to clarify the psychophysiological relaxation effects of viewing bamboo. The effects of visual stimulation using a pot both with and without a bamboo were recorded by measuring the student's blood pressure, EEG and STAI. We observed that viewing bamboo plants resulted in significantly lower systolic (female, P < 0.001; male, P < 0.001; P < 0.05) and diastolic (female, P < 0.001; male, P < 0.001; P < 0.05) blood pressures, but no changes in the pulse rate (female, P = 0.09; male, P = 0.07; P > 0.05) were observed. The results of the EEG analysis indicated brainwave variation (all P < 0.05) and lower anxiety scores (P < 0.01) after 3 min of viewing bamboo compared with the control. These findings indicate that visual stimulation with bamboo plants induced psychophysiological relaxation effects on adults.

effect of two shading techniques on value of Zirconia-based crowns

Statement of the Problem: By introducing the coloring liquids, it is claimed that it is possible to make the color of frameworks fabricated from zirconium oxide extremely close to the natural tooth color.

Purpose: The purpose of this research was to evaluate the effect of two staining techniques on value changing in zirconia crowns.

Materials and Method: Three groups A, B, and C, each containing ten zirconia crowns, were used. The zirconium cores samples were fabricated by a CAD/CAM device. Group A was left uncolored, Groups B was submerged for two minutes in A2 coloring liquid and Group C was stained with brush. Then all cores were sintered and the porcelain was applied by using the layering technique. Ultimately, the crowns color was determined using a spectrophotometer. Their color changing [Delta E] and value changing [Delta L] in relation to A2 color were also assessed. The data were analyzed with one-sample t-test, post-hoc Tukey, and one-way ANOVA tests with significant level set at 0.05

Results: The mean value in all groups was higher than the value obtained from A2 color samples [p= 0.001]. The highest mean value was 78.31 +/- 1.22 belonging to group C [staining with brush] and the lowest mean value was 76.99 +/- 0.65 belonging to group B [submerging]. The results of post-hoc Tukey regarding both Delta E and Delta L variables showed a significant difference between groups A [uncolored] and C [staining with brush] with P Delta E=0.006 and P Delta L=0.039, respectively. A significant difference between group B [submerging technique] and C [staining with brush] were shown when these two variables were compared [P Delta E=0.001, P Delta L=0.015]

Conclusion: Due to the higher value increase in surface staining [brush], it is recommended to use the submerging technique for staining zirconia cores

Unusual developing sites of dengue vectors and potential epidemiological implications

Objective: To identify the unusual breeding sites of two dengue vectors, i.e. Aedes albopictus (Ae. albopictus) and Aedes aegypti (Ae. aegypti). Methods: During the second half of 2010, we performed an occasional survey in rural (Teluk Tempoyak) and urban (Gelugor) areas of Penang Island, Malaysia, to identify cryptic breeding sites. Results: In the rural area, we found heterogeneous immature stages of Ae. albopictus in the water bowl of an encaged bird. We also observed Ae. aegypti eggs deposited in the flush tank of a toilet in the urban area. Conclusions:It can be concluded that both breeding patterns can increase contact with hosts (humans and birds) and presumably population densities of Ae. albopictus and Ae. aegypti, thereby potentially boosting the risks for spread and transmission of arboviral diseases.

Bcl-2 expression in CagA strain H. pylori gastritis [immunohistochemical and insitu hybridization study]

Carriage of Helicobacter Pylori in the human stomach is associated with increased risk of peptic ulcer disease, distal gastric adenocarcinoma and gastric B-cell mucosa associated lymphoid tissue lymphoma. To study the immunohistochemical expression of bcl-2, as apoptosis makers in the gastric mucosa of patients infected with cagA Helicobacter Pylori demonstrated by insitu hybridization method. Gastric antrum biopsies from 99 patients presented with dyspeptic symptoms [50 men, 49 women, median age 40] were analysed for the presence of H. pylori, and were classified according to updated Sydney system. Insitu hybridization technique was done to detect cagA H. pylori. Immunohistochemical expression of bcl-2 using [Avidin-Biotin method] was performed on paraffin embedded biopsy specimens. Forty four patients [44.44%] had H. pylori cagA positive starin. Atrophy of gastric mucosa was present in 14 [14.14%] patients. Intestinal metaplasia was present in 8 [8.08%] patients. The frequency of atrophy and intestinal metaplasia were significantly higher in cagA H. pylori gastritis than non-cagA H. pylori gastritis [p=0.023 and 0.041 respectively]. Bcl2 expression was not significantly higher in H. pylori gastritis than non-H. pylori gastritis [p=0.101]. Bcl2 expression was significantly higher in the presence of atrophy [p<0.001]. Bcl2 expression was significantly higher in the presence of intestinal metaplasia [p<0.001]. The rate of apoptosis decreases when lesions [gastric atrophy and intestinal metaplasia] are present

[Simultaneously determination of some drugs from different therapeutic groups in a biological and other medium by using the HPLC method]

The separation and determination of a selective drugs as fluoxetine, Oxybutynin, Valsartan, Enalapril, clonidine, ketoprofen [IS] were done in plasma by high-performance liquid chromatography reversed phase. The chromatographic conditions were gradient mobile phase A -Acetonitrile and B- 10mM KH[2]PO[4] buffer PH 3.3, flow rate 1.0 ml/min., column of octadecyle ODS YMC. 3 micro [150 mm x 46 mm] with guard column. The extraction method based on the technique used liquid/ liquid [LLE] and SEP. No interferences were between drugs and plasma in the mobile phase. The extraction recoveries were 86-90% for all products. This method permits the Simultaneous determination of all these compounds in plasma. Our method is simple and sensitive, based on qualitative and quantitative studies, the Coefficient regression was 0.9998 and Coefficient of variation was between 0.47-0.77% and the limit of detection was between 0.18-0.30 micro g/ L. The limit of quantification under the described conditions was 25-75 micro g/L for these drugs. Consequently, our results were useful for quality control in the therapeutic drug monitoring and the poisoning control centers and other fields

Gallbladder carcinoma; frequency in patients under going cholecystectomy for chronic cholecystitis

Chronic Cholecystitis is one of the commonest diseases presenting in surgical department and is subjected to cholecystectomy each time. Asuspicious gall bladder on ultrasound initiates further investigations to rule out carcinoma of gall bladder yet some times a benign looking gall bladder on ultrasound turns out to be carcinoma of gall bladder on histopathology. Descriptive study. District Head Quarters Hospital, Sargodha, from September 2007 to March 2009. 200 patients who underwent both open and Laparoscopic cholecystectomy for cholelithiasis were subjected to this study. All relevant data was documented on a standardized data form. Patients were between the ages of 28-74. Patients already diagnosed as Gallbladder Carcinoma, empyema gall bladder, mucocele and gall bladder polyp were excluded from the study. Gall bladders removed after each surgery ware sent to laboratory for histopathological evaluation. A total of 200 cases were studied [161 females, 39 males; M: F ratio 1:4]. The mean age was 45 years [range 28-74 years]. The most common presenting complaint was pain right hypochondrium with nausea and vomiting [85%].The average operating time was 50 minutes in case of open cholecystectomy and 1 hour in laparoscopic cholecystectomy. Complications included biliary leak in 2 patients [1%], Wound Infection in 3 patients [1.5%] and death in one case [0.5%]. The overall rate of complications was 3%. There were a total of 5 patients of laparoscopic cholecystectomy who required extension of the incision, for Carcinoma Gallbladder. Carcinoma of gall bladder is a very aggressive malignancy and usually presents at a very advance stage as its symptoms mostly are marked by symptoms of cholecystitis. Detection of gall bladder carcinoma is very difficult in early stages on ultrasound. Any findings in ultrasound suggesting malignancy should be confirmed on further investigations like CT scan .Carcinoma of Gall bladder is not very common in cases of cholecystectomy for chronic Cholecystitis but once found should be dealt with extreme precision following established operating protocols

[Separation and assay of some methyl biphenyl derivatives used as angiotensin II antagonists and antihypertensives by using high performance liquid chromatography reversed phase]

Angiotensin II antagonists are major development in hypertension management in over decade, because of their excellent lower side effects and their specific action, as well as their effectiveness. So the research purposed to develop HPLC reserved phase for separation and assay of some angiotensin II antagonists, Valsartan, Losartan and Irbesartan in, raw materials and tablets. Chromatographic separation was achieved on coloun C18 using isocratic elution [at flow rate 1.5 ml/min] by using 10 mM potassium dihydrogen, phosphate buffer [pH=3] and acetonetrile [60: 40 v/v] as the mobile phase and ultraviolet detector set at 254 nm. This method had been validated and accepted, then this method had applied on human serums after using solid-liquid extraction for determination therapeutic concentrations of valsartan in group of patients treated with it

The treatment action campaign and the three dimensions of lawyering: Reflections from the rainbow nation

The spread and perpetuation of the HIV/AIDS epidemic in South Africa has hindered the country's social and economic growth after apartheid. This paper documents my experiences while working with the Projects Abroad Human Rights Office and specifically my interactions with the Treatment Action Campaign (TAC); an organization which has taken a multidimensional approach in order to educate people about HIV/AIDS and attempt to provide access to medicines for millions of South Africans afflicted with the disease. I discuss how TAC has used both traditional and non-traditional methods of advocacy to combat the epidemic and equate access to health care to a social justice issue by empowering marginalized communities. The paper's dual purpose is to applaud TAC's continuous success in combating HIV/AIDS with such a multidimensional approach and illustrate how other organizations can utilize such an approach in order to affect social change. To illustrate TAC's approach; I utilize Lucie White's three dimensions of lawyering and equate TAC to a single cause lawyer; signifying that White's characterization of multi-dimensional activism is not limited to individuals; but can rather be applied at the firm level. White's three dimensions include: (a) advocacy through litigation; (b) advocacy in stimulating progressive change; and (c) advocacy as a pedagogic process. From this analysis; I conclude that TAC's multi-dimensional approach and specifically its inherent practice of White's three dimensions has been the root of its success in educating millions about the virus and advocating for access to medicines for those who have contracted HIV. TAC's innovative advocacy has also mobilized a new generation of South African activists who have helped TAC grow into a vibrant and integral organization within the country's post-apartheid culture. Such an example can serve as a framework for future organizations who wish to tackle other challenges that face the country

Wound infection; frequency in clean surgical operations

The aim of the study was to evaluate the frequency of infection in clean surgical cases [General and Orthopaedic]. A descriptive study. This descriptive study was conducted at department of surgery and orthopaedic DHQ Teaching Hospital Sargodha from July 2007 to Dec, 2008. In this study 1500 clean surgical cases were included. Wounds were examined on third post operative day and then regularly after removal of stitches. Surgical wounds were examined finally on fifteenth post operative days. Description of wound condition and detailed data of patients were collected on preformed performas. Patients with wound infection developed pain at operation site and fever on third post operative day. Wounds were examined for swelling, redness, discharge; stitch abscess. Routine investigations were done as per protocol ie complete blood examination, complete urine examination, blood sugar, C-reactive proteins etc. Wounds swab was taken for microscopy and culture sensitivity. This study was carried out on fifteen hundred clean surgical cases [General and Orthopaedic]. There were 1064 males and 436 females. Male to Female ratio was 2.4:1. Infection was detected in 110 patients [7.3%] while no infection was found in 1390. Infection was maximum in patients more than 60 yrs of age [10.9%]. Wound infection was minimum in young patients [3.5%].commonest micro organism isolated from the infected wound was staphylococcus areus. Other organism isolated was streptococcus pyogenes, proteus and pseudomonas. No MRSA was detected. In our case study clean cases were found generally free of infection especially young patients. Whereas increased incidence of infection was noted in old patients. Wound infection is associated with significant morbidity in the form of delayed wound heeling, prolonged hospital stay and increased economical pressure on the patient

Correlation between leptin hormone levels and bone mineral density in hepatitis C patients with chronic liver disease

There is accumulating evidence that leptin has a pleiotropic role in hematopoiesis, immune response, fibro-genesis, and hepatocarcinogenesis. The aim of this study was to determine the correlation between leptin levels and bone mineral density in HCV chronic liver disease patients. A medical history to retrieve information about health status, current medications and history of viral or toxic hepatitis; a physical examinations including height and weight; a fasting blood draw for the determination of liver profile and leptin. BMD values were measured by dual-energy X-ray absorptiometry [DEXA] at the L2-L4 lumbar spine and femoral neck. Fasting leptin was highly increased in HCV CLD patients with osteopenia than HCV CLD patients with normal hone mineral density [p<0.05]. Leptin showed a significant negative correlation with bone mineral density [BMD] in HCV CLD patients [r=-0.191, p=0.039] and significant positive correlation with age [r=0.331, p=0.041]. Serum concentrations of leptin is positively correlated in chronic liver disease patients with age and negatively correlated with BMD especially in patients with hepatitis C infection

comparative study between ultrasound, CT and MRI of white matter brain injury in premature newborns

Evaluate role of ultrasound and computed tomography in diagnosis of white matter damage in premature neonates. Analytic comparative study in Farwania Hospital, Kuwait. Accurate identification of predisposition of white matter injury in premature neonates is important for counseling parents and for targeting these high-risk neonates of patients with respiratory distress syndrome, Diabetes mellitus, preeclampsia, severe anaemia, and their rehabilitation. Our study is based on ultrasound [US] computed tomography [CT] and Magnetic Resonance Imaging [MRI] done for these patients depending on their clinical condition. Neonates were studied with US, CT, MR imaging at a median postconceptional age of 30 weeks [range, 24-36 weeks] with Apgar scores less than 7. White matter abnormalities shown on US, CT, MRI were classified and used in the analysis to determine the relative validity of each imaging modality. These were followed up until the patients were in the hospital. White matter abnormalities were diagnosed in [28.5%] neonates based on abnormal Ultrasound, CT and MR. Neonates with Apgar less than 5 were more associated with hypoxic ischemic changes. The severity of the hypoxic insult and sequelae is also inversely related to the patient's postconceptual age. Ultrasonography as a first hand screening tool with high sensitivity to detect white matter damage [WMD], however, relatively low specificity and high false positive cases make MRI is the best modality for WMD validation and grading. It is not a sensitive modality for the milder spectrum of MR imaging-defined white matter abnormalities, however, cranial US of demonstrates high reliability in the detection of cystic white matter injury, however, it display significant diagnostic value. This is important, because non-cystic WM injury is considerably more common than cystic WM injury

[ comparison study between the release of mebeverin hydrochloride from tablets using hydrophilic and insoluble polymers]

Polymers play an important role in the drug release from solid dosage forms, and this importance varies as the kind of polymer and its percentage in the formulation. In this research we reveal the role of hydrophilic polymers or insoluble polymers in the release of mebeverine hydrochloride from sustained release tablets. HPMC15000 had a great effect in controlling the release of mebeverine hydrochloride from tablet after it had been used at rate of 15% in the inner phase, where the release rate of mebeverine hydrochloride reached 70% during 12 hours, and 86% after 24 hours, and when increasing the dose of mebeverine hydrochloride from 200 mg per tablet to 300 mg, it was necessary to increase the rate of HPMC15000 up to 17,5% and the average release was 62% during 12 hours and 86% after 24 hours. But when using neutral polymers of acrylic acid derivatives [Eudragit RL and RSI there were noticed differences in the release rate of mebeverine hydrochloride from the prepared tablets, and that was according to the type of Eudragit used and the rate of hydrophilic groups in it, Eudragit RL caused a total release of mebeverine hydrochloride from tablet after only 8 hours, and a combination of Eudragit RS and RL [3/1] released 90% of mebeverine hydrochloride during 24 hours, while Eudragit RS alone released 80% of this drug

Seperation and determination of anticoagulant cumarins which have different therapeutical effects by HPLC

The separation and determination of some anticoagulants drugs like cumarins derivatives were done directly by high performance liquid chromatography reverse phase.We got two separate mobile phases in different percentages, the first one is water 5%: methanol 95%, and the second is water 20%: acetonitril 80% with PH = 4 for both mobile phases. The steady phase was a column of octadecyle 5 micrometre [250mm X 46mm] Nucleosil, then we have got the best results of separation and retention time and determination of the concentrations using different wave lengths of U. V as a detector, that there was a special maximum wave length for each cumarin derivative, where coefficient variation was between 0.04%-3.9% and the limit of detection was between 0.3-1.9 microgram/ml for studied cumarins depending on the mobile phase and cumarin derivative. The assay method was used to qualify the purity of studied cumarin compounds especially used in human uses and quantify and separate it of other compounds in addition to toxicity cases. This method is accurate and sensitive based on quantitative studies

Seperation and determination of anticoagulant cumarins HPLC

The separation and determination of some anticoagulants drugs and cumarins derivatives sodium warfarin were done directly by high performance liquid chromatography reverse phase [where steady phase is less polar than mobile phase]. We used two separate mobile phases in different percentages, the first one is water: methanol, and the second is water: acetonitril with PH = 4 till we got the best percentages. The steady phase was a column of octadecyle 5 micron Nucleosil [250 mmx 46mm], then we've got the best separation and retention time and determination of the concentrations using maximum wave length of U.V 283n.m for sodium warfarin [cumarin derivative], where variation coefficient was 0.12%-3.5% and the limit of detection was 1.9-0.5 micro g/ml. The assay method was used to qualify the purity of studied sodium warfarin used in human uses as an anticoagulant and quantify and separate it of other compounds in tablets in pharmaceutical companies. Consequently our results showed a very good correlation and they were useful for quality control in the drug industries

Effect of spinal fixation on postural patterns: a neurophysiologic study

Spinal fixation is a commonly used-procedure to manage spinal instability and mal-alignment as in spondylolisthesis and scoliosis. Restriction of the movement of the spinal segment is among its mechanical consequences. This restriction is assumed to reduce the proprioceptive output from the spine that is essential for proper postural control patterns. Was to investigate the parameters of the automatic postural response of the leg and trunk in patients who have undergone spinal fixation. Sixteen patients whose spine was fixed for management of spondylolisthesis and another 15 patients who had spinal fixation for idiopathic scoliosis were studied. Their automatic postural response parameters following backward perturbation of their erect stance, were compared with the response from 20 healthy volunteers. The study showed evidence supportive of significant deviation from normality of the automatic postural response of the patients' group. The abnormality was in the form of delayed erector spinae response latency as well as increased time gap between the trunk response and the leg response. Additionally, there was erector spinae response amplitude reduction in the patients' group. Finally, there was a statistical evidence of a tight link of the leg and trunk muscle response suggesting a stiffening pattern that was not observed among the control group. The results suggest a problem with the proprioceptive information coming out of the fixed spine that may probably be responsible for the response abnormality observed in the study. These abnormalities may put uncontrolled mechanical burden both on the trunk and the overall body balance

Functional outcome after rehabilitation in young stroke patients

The study was designed to determine the functional outcome after rehabilitation in young stroke patients using both the Modified Barthel and Motoricity Indices at the end of the 1[st] week, 3[rd] week and 6[th] month of stroke. Fifty young stroke patients were included. Their age ranged from 18 years to 40 years old with a mean of [34.8] +/- 4.7 Thirty-two patients were males and 18 were females. First week variables were of great importance in predicting functional outcome in young stroke patients including the level of motor loss as recorded with the Motoricity Index, activities of daily living recorded with the Modified Barthel Index, presence of sensory deficit, and presence of aphasia, sphincteric disturbances or affected consciousness. All these variables significantly affect functional outcome in young stroke patients. In the present study an interesting finding was that the change in the Modified Barthel Index was relative to Motoricity Index changes in patients who demonstrated considerable motor gain and documented recovery post- stroke. Patients with cortical stroke had less functional gains than those with subcortical and brain stem stroke. Young stroke patients with a right-sided lesion had less functional gains than patients with lesions on the left side. Functional outcome according to the type of stroke whether, hemorrhagic or ischemic showed no difference. No significant difference was found in the functional outcome between males and females. Functional outcome among those of age