Thermal Stability, Dynamic Mechanical Analysis and Flammability Properties of Woven Kenaf/Polyester-Reinforced Polylactic Acid Hybrid Laminated Composites.

This paper presents the thermal and flammability properties of woven kenaf/polyester-reinforced polylactic acid hybrid laminated composites. The effects of the fiber content and stacking sequences of hybrid composites were examined. The hybrid composites were fabricated using the hot press method. Thermogravimetric analysis, differential scanning calorimetry, dynamic mechanical analysis, and flammability properties of woven kenaf/polyester-reinforced polylactic hybrid composites were reported. The thermal results have demonstrated the effect of the hybridization of the composites on the thermal stability and viscoelastic properties of the laminates. The work also measured the burning rate of the hybrid composites during the flammability test. The S7 sample that consisted of all woven kenaf layers in composite recorded the highest char residue of 10%, and the S8 sample displayed the highest decomposition temperature among all samples. However, as for hybrid composites, the S5 sample shows the optimum result with a high char yield and exhibited the lowest burning rate at 29 mm/min. The S5 sample also shows the optimum viscoelastic properties such as storage and loss modulus among hybrid composites.

Knockdown resistance (kdr) gene of Aedes aegypti in Malaysia with the discovery of a novel regional specific point mutation A1007G.

BACKGROUND: Improved understanding of the molecular basis of insecticide resistance may yield new opportunities for control of relevant disease vectors. In this current study, we investigated the quantification responses for the phenotypic and genotypic resistance of Aedes aegypti populations from different states in Malaysia. METHODS: We tested the insecticide susceptibility status of adult Ae. aegypti from populations of three states, Penang, Selangor and Kelantan (Peninsular Malaysia), against 0.25% permethrin and 0.25% pirimiphos-methyl using the World Health Organisation (WHO) adult bioassay method. Permethrin-resistant and -susceptible samples were then genotyped for domains II and III in the voltage-gated sodium channel (vgsc) gene using allele-specific polymerase chain reaction (AS-PCR) for the presence of any diagnostic single-nucleotide mutations. To validate AS-PCR results and to identify any possible additional point mutations, these two domains were sequenced. RESULTS: The bioassays revealed that populations of Ae. aegypti from these three states were highly resistant towards 0.25% permethrin and 0.25% pirimiphos-methyl. Genotyping results showed that three knockdown (kdr) mutations (S989P, V1016G and F1534C) were associated with pyrethroid resistance within these populations. The presence of a novel mutation, the A1007G mutation, was also detected. CONCLUSIONS: This study revealed the high resistance level of Malaysian populations of Ae. aegypti to currently used insecticides. The resistance could be due to the widespread presence of four kdr mutations in the field and this could potentially impact the vector control programmes in Malaysia and alternative solutions should be sought.

3D Printing and Shaping Polymers, Composites, and Nanocomposites: A Review.

Sustainable technologies are vital due to the efforts of researchers and investors who have allocated significant amounts of money and time to their development. Nowadays, 3D printing has been accepted by the main industry players, since its first establishment almost 30 years ago. It is obvious that almost every industry is related to technology, which proves that technology has a bright future. Many studies have shown that technologies have changed the methods for developing particular products. Three-dimensional printing has evolved tremendously, and currently, many new types of 3D printing machines have been introduced. In this paper, we describe the historical development of 3D printing technology including its process, types of printing, and applications on polymer materials.

Detection of foetal anomaly in advanced maternal age.

OBJECTIVE: The aim of this study was to assess the prevalence of foetal anomaly diagnosed during a detailed ultrasonography amongst patients of advanced maternal age (AMA) and to identify the related anomalies in these age groups. METHOD: A retrospective observational study amongst AMA mothers was done in Universiti Kebangsaan Malaysia Medical Centre, a Malaysian teaching hospital. The data over a period of three years (January 2013 - December 2016) obtained from the Maternal Foetal Medicine clinic registry was analysed. AMA mothers with singleton pregnancy presenting for foetal structural anomaly scan was included. They were later subdivided into 2 groups (35-39 years and ≥ 40 years). The logistic regression analysis was used to analyse the association of the chromosomal anomalies and the age groups. RESULTS: In all 486 patients were recruited and 84 patients were identified with foetal anomaly (17.3%). There was no significant difference in the prevalence of foetal anomalies or significant association with a specific structural foetal anomaly identified (p>0.05). However, the number of followups for these patients are significantly higher (p<0.001). CONCLUSION: The prevalence of structural foetal anomalies identified in detailed ultrasonography was low in AMA mothers. Hence, referral criteria for detailed anomaly ultrasonography need to be re-looked.

Use of Industrial Wastes as Sustainable Nutrient Sources for Bacterial Cellulose (BC) Production: Mechanism, Advances, and Future Perspectives.

A novel nanomaterial, bacterial cellulose (BC), has become noteworthy recently due to its better physicochemical properties and biodegradability, which are desirable for various applications. Since cost is a significant limitation in the production of cellulose, current efforts are focused on the use of industrial waste as a cost-effective substrate for the synthesis of BC or microbial cellulose. The utilization of industrial wastes and byproduct streams as fermentation media could improve the cost-competitiveness of BC production. This paper examines the feasibility of using typical wastes generated by industry sectors as sources of nutrients (carbon and nitrogen) for the commercial-scale production of BC. Numerous preliminary findings in the literature data have revealed the potential to yield a high concentration of BC from various industrial wastes. These findings indicated the need to optimize culture conditions, aiming for improved large-scale production of BC from waste streams.

First case of pulmonary hydatid cyst in a pregnant Syrian refugee woman in Malaysia.

Pulmonary hydatid cyst (PHC) in pregnancy is a very rare pathology. We report here a case of ruptured PHC during pregnancy in a 26-year old Syrian (refugee) woman who presented with complaints of productive cough with metallic taste and dyspnoea. PHC was suspected due to her clinical and radiological findings. Interestingly, the sputum examination confirmed the diagnosis as numerous protoscoleces were present. Serology for Echinococcus infection revealed positive at high titre. Early diagnosis and prompt treatment by providing care improves the patient outcome. Parasitological examination of the respiratory specimen in suspected ruptured PHC is desirable as a valuable detection tool.

Simulated field study on the efficacy of the thermal application of a synergized pyrethroid formulation against Aedes aegypti (Linn.) and Culex quinquefasciatus Say.

Thermal application of a synergized pyrethroid formulation containing 0.8% w/w sbioallethrin, 18.7% w/w permethrin and 16.8% w/w piperonyl butoxide was performed to evaluate its efficacy against adult and larva of Aedes aegypti and Culex quinquefasciatus. Three cages each containing 15 mosquitoes and paper cups each containing 25 larvae in 250 ml of water were deployed at each test point between 3 and 20 feet. The formulation was diluted (formulation:water) 1:33, 1:50 and 1:100, respectively, and applied using a thermal fogger. Sixty minutes post spraying, the adult knock down rate of Ae. aegypti and Cx. quinquefasciatus at a maximum distance of 15 feet using all dilution ratios ranged from 96.67 - 100% and 43.33 - 100%, respectively. More than 70.00% adult mortalities were recorded for both mosquito species at the distance between 3 feet and 15 feet 24 hours post spraying. In contrast, complete larval mortalities of Ae. aegypti were obtained at a maximum distance of 10 feet with dilution ratio of 1:33, while more than 80.00% larval mortalities were observed for Cx. quinquefasciatus at similar maximum distance using all dilution ratios. These results showed that thermal application using synergized pyrethroid formulation was effective against both mosquito species tested especially the adult stage.

Functional limitation and health-related quality of life, and associated factors among long term stroke survivors in a Malaysian community.

PURPOSE: this study aimed to evaluate function and quality of life (QoL) and associated factors among long term stroke survivors in the Malaysian community. METHODS: A cross-sectional study was conducted involving stroke survivors living in the community at two or more years post-stroke. Eligible participants with the diagnosis of stroke were identified from 2005-2010 case mix database of a tertiary hospital. the patients' medical records were analysed and data on demographic and clinical profiles were collected. telephone interviews were conducted to assess existing stroke-related impairments, comorbidities, stroke recurrences, current level of function and QoL, with the usage of rivermead mobility index (rMI), barthel index (bI) and stroke specific quality of life scale (ssQOL). RESULTS: A total of 203 stroke survivors; mean age 64.5 (standard Deviation(sD) 12.2) years, 45.3% males, stroke duration 44.7 (sD 13.8) months completed the interviews. Mean rMI was 11.7 (sD 3.4) and bI was 89.8 (sD 19.8). Forty three percent and 99% had difficulty in ascending/descending stairs and fast walking, respectively. Up to 20% had limitations in most of the bI subsets. Mean ssQOL was 207.6 (sD 37.2), with domains mostly affected were 'energy' and 'social role'. Function and QOL were both influenced by age (p<0.01) and stroke related impairments (p<0.05), but not by co-morbidities or stroke recurrence. QoL and function (both mobility and ADL) were strongly positively correlated with each other (p<0.01). CONCLUSIONS: It was observed that functional limitations especially mobility, remains post-stroke major problem and were attributed mainly to stroke-related impairments.

Pregnancy outcomes with a primary complaint of perception of reduced fetal movements.

Reduced fetal movement is a worrisome common complaint, not only for mothers but also for the attending medical personnel. The aim of this study was to analyse the pregnancy outcomes of women who presented primarily with reduced fetal movements (RFM). A retrospective study was performed based on patients' perception alone. Obstetric, past medical history, current presentation and outcomes of pregnancy were analysed. A total of 230 case notes were reviewed, with the majority being primigravidae. Less than half (48.7%) of the women had spontaneous labour, 45.7% had induction and 5.6% had elective caesarean section. There were no maternal complications in 97.4% (n = 224) of them. About 0.9% (n = 2) and 1.7% (n = 4) had primary postpartum haemorrhage and extended perineal tear, respectively. Although there was no major neonatal mortality and morbidity, until a randomised trial with a significant sample is conducted in the management of RFM, careful selections for elective delivery or conservative management would prevent untoward complications.

Serum soluble FMS-like tyrosine kinase 1 and placental growth factor concentration as predictors of preeclampsia in high risk pregnant women.

Soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) contribute in the development of preeclampsia and are suggested as prediction markers in healthy pregnant women but limited data is available in women with major preeclampsia risk factors. This study aimed to determine the role of sFlt-1 and PlGF in predicting preeclampsia among high risk pregnant women. This was a prospective study and samples were collected for a period of ten months. Blood samples were obtained from 84 pregnant women who had at least one risk factor for preeclampsia at 25 to 28 weeks and at 29 to 36 weeks of gestation. SFlt-1 and PlGF concentrations were determined by immunoassay method. There were significantly higher median sFlt-1 and sFlt-1:PlGF ratio at gestational interval 25 to 28 weeks and sFlt-1:PlGF ratio at 29 to 36 weeks in high risk women who developed preeclampsia. Significant lower median serum PlGF levels at 25 to 28 weeks and 29 to 36 weeks were observed in this group of women. In conclusion, the concentrations of these markers were altered in high risk preeclamptic women, a similar pattern seen in low risk preeclamptic women. However the predictive value of these markers could not be established clearly.

A randomized control trial evaluating the prevalence of obstetrical anal sphincter injuries in primigravida in routine versus selective mediolateral episiotomy.

OBJECTIVE: To evaluate the prevalence of obstetrical anal sphincter injuries (OASIS), which include third and fourth degree perineal tears in primigravida in routine versus selective mediolateral episiotomy. Secondly, to determine the rate of episiotomy in local settings. METHODS: This randomized control trial was carried out in the labor ward of a tertiary hospital of the Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia between May and October 2009. The trial included 171 primigravida beyond 38 weeks gestation who achieved vaginal delivery, and randomly assigned to selective and routine episiotomy groups. The type of perineal injuries following childbirth among 171 women were evaluated. RESULTS: The overall episiotomy rate from both groups was 76.6%. The prevalence of third degree perineal tears was 3.7% in the routine compared with selective mediolateral episiotomy at 1.1%. There was no occurrence of fourth degree tears in both groups. However, selective mediolateral episiotomy was associated with an increased risk of periurethral and labial injury compared with the routine group (4.5% versus 0%). CONCLUSION: Routine mediolateral episiotomy in primigravida is associated with a higher prevalence of obstetrical anal sphincter injuries. As anal sphincter injuries are known to have morbidities, selective mediolateral episiotomy in primigravida is therefore recommended in the implementation of new delivery practice, and in an attempt to reduce our high episiotomy rate.

Outcome of molar pregnancies in Malaysia: a tertiary centre experience.

Gestational trophoblastic disease (GTD) is a common problem among Asian ethnics. A total of 102 women with molar pregnancies between 1 January 2005 and 31 December 2010, were analysed. The aim of the study was to determine the outcome of all molar pregnancies in our institution. The local incidence of molar pregnancy was 2.6 per 1,000 deliveries. A total of 48 women (47.1%) had complete hydatidiform mole and another 54 (52.9%) had partial mole. The mean age of the women with molar pregnancies was 32.0 ± 7.9 years. The mean gestational age at initial diagnosis was 11 weeks ± 3 days. The majority (97 women, 95.1%) had symptoms of vaginal bleeding and 18 (17.6%) women had a uterus larger than dates. A total of 48 (47.1%) women had ultrasound scan findings of 'snow-storm' appearance. None of the women with uncomplicated molar pregnancy had evidence of relapse following one undetectable serum ß-hCG level. Four out of the 102 women (3.9%) developed persistent trophoblastic disease before attaining one undetectable serum ß-hCG level. All four women required single agent methotrexate and they remained in remission. The prognosis for uncomplicated molar pregnancy is good. Establishment of a National Trophoblastic Centre is recommended to maintain optimal outcome.

Maternal level of pregnancy-associated plasma protein A as a predictor of pregnancy failure in threatened abortion.

Threatened miscarriage is a common complication of pregnancy. Despite initial viability confirmation by ultrasound scan, some of these patients had further spontaneous abortion. A highly sensitive and specific biomarker would be useful to determine the outcome of pregnancy and to prevent emotional impact to these women. A prospective 14-month cohort study was conducted in the Obstetrics and Gynaecology Department of Universiti Kebangsaan Malaysia Medical Centre to determine whether low serum levels of pregnancy-associated plasma protein A (PAPP-A) measured in early pregnancy can predict the outcome of threatened abortion. 42 pregnant women between 6 to 22 weeks of gestation with threatened abortion and 40 controls were enrolled. Serum samples were collected at presentation and PAPP-A was assayed by electrochemiluminescent immunoassay technique. Pregnancies were followed-up until 22 weeks of gestations and the outcome documented. Nine patients (11%) developed spontaneous abortion and 73 patients (89%) had successful pregnancy. The median PAPP-A level was significantly lower in patients with spontaneous abortion compared to those who had successful pregnancies in the threatened abortion group: 0.78 MoM (0.41-1.00 MoM) vs 1.00 MoM (1.00-2.0 MoM) respectively (p < 0.05). The best sensitivity of 44% and specificity of 93% were obtained at the cut of value of 0.66 MoM (95% CI, 0.561-0.773). In conclusion, low PAPP-A value in threatened abortion women is associated with pregnancy failure, although the use of PAPP-A as a one-time single marker has limited value.

Direct medical cost of stroke: findings from a tertiary hospital in malaysia.

This study aimed to estimate cost of in-patient medical care due to stroke in a tertiary hospital in Malaysia. A retrospective analysis of stroke patients admitted to Universiti Kebangsaan Malaysia Medical Centre (UKMMC) between January 2005 and December 2008 were conducted. Cost evaluation was undertaken from the health provider's perspective using a top-down costing approach. Mean length of stay (LOS) was 6.4 ± 3.1 days and mean cost of care per patient per admission was MYR 3,696.40 ± 1,842.17 or 16% of per capita GDP of the country. Human resources made up the highest cost component (MYR 1,343.90, SD: 669.8 or 36% of the total cost), followed by medications (MYR 867.30, SD:432.40) and laboratory services (MYR 337.90, SD:168.40). LOS and cost of care varied across different stroke severity levels (p<0.01). A regression analysis shown significant influence of stroke severity on cost of care, with the most severe stroke consumed MYR 1,598.10 higher cost than the mild stroke (p<0.001). Cost of medical care during hospital admission due to stroke is substantial. Health promotion and primary prevention activities need to take priority to minimise stroke admission in future.

Work-related injuries among physiotherapists in public hospitals: a Southeast Asian picture.

OBJECTIVES: A cross-sectional study was conducted to measure the prevalence of work-related injuries among physiotherapists in Malaysia and to explore the influence of factors such as gender, body mass index, years of work experience and clinical placement areas on the occurrence of work-related musculoskeletal disorders. METHODS: Self-administered questionnaires adapted from the Nordic Musculoskeletal Questionnaire were sent to 105 physiotherapists at three main public hospitals in Kuala Lumpur, Malaysia. The questionnaire had 12 items that covered demographic information, areas of musculoskeletal problems and physiotherapy techniques that could contribute to work-related musculoskeletal disorders. The data obtained were analyzed using the Statistical Package for Social Science version 14 software. RESULTS: The overall prevalence of work-related injuries during the past 12 months was 71.6%. Female therapists reported a significantly higher prevalence of work-related musculoskeletal disorders than the male therapists (73.0%, p,0.001). Significant differences were observed between the proportion of therapists who had work-related musculoskeletal disorders and those who did not for the group with a body mass index (BMI) .25 (x² = 9.0, p = 0.003) and the group with a BMI of 18-25 (x² = 7.8, p = 0.006). Manual therapy (58.6%) and lifting/transfer tasks (41.3%) were the two physiotherapy techniques that most often contributed to work-related musculoskeletal disorders. CONCLUSION: Work-related injuries are significantly higher among the physiotherapists in Malaysia compared with many other countries. Female therapists reported a higher incidence of work-related musculoskeletal disorders in this study, and work-related musculoskeletal disorders were more common among therapists working in the pediatric specialty. This study contributes to the understanding of work-related disorders among physiotherapists from a southeast Asian perspective where the profession is in its development stage.

Childhood Cryptosporidium infection among aboriginal communities in Peninsular Malaysia.

Cryptosporidium is a coccidian parasite that is prevalent worldwide, some species of which cause morbidity in both immunocompromised and immunocompetent individuals. The prevalence and predictors of Cryptosporidium infection, and its effect on nutritional status, have recently been explored among 276 children (141 boys and 135 girls, aged 2-15 years) in aboriginal (Orang Asli) villages in the Malaysian state of Selangor. Faecal smears were examined by the modified Ziehl-Neelsen staining technique while socio-economic data were collected using a standardized questionnaire. Nutritional status was assessed by anthropometric measurements. Cryptosporidium infection, which was detected in 7.2% of the aboriginal children, was found to be significantly associated with low birthweight (≤2.5 kg), being part of a large household (with more than seven members) and prolonged breast feeding (>2 years). The output of a binary logistic regression confirmed that large household size was a significant predictor of Cryptosporidium infection (giving an odds ratio of 2.15, with a 95% confidence interval of 1.25-5.02). Cryptosporidium infection is clearly a public-health problem among the aboriginal children of Selangor, with person-to-person the most likely mode of transmission.

Species identification of intestinal microsporidia using immunofluorescence antibody assays.

Abstract. The species identification of Enterocytozoon bieneusi and Encephalitozoon intestinalis is only possible using transmission electron microscopy (TEM), mo lecular techniques and immunofluorescence antibody assays (IFA). In this study, 50 positive and 50 negative fecal specimens for microsporidial spores using the Weber modified trichrome (WMT) staining technique were examined using IFA-MAbs. Of the 100 specimens examined, the microsporidial spores identified by IFA-MAbs were Enterocytozoon Bieneusi 42 (75%) Encephalitozoon intestinalis 7 (12.5%) and mixed infections 7 (12.5%). The sensitivity and specificity of IFA-MAbs in detecting microsporidial spores were 98% and 86%, respectively. The agreement between the WMT staining technique and IFA-MAbs was statistically significant by Kappa statistics (K = 0.840; p < 0.001). E. bieneusi was the commonest Microsporidia species isolated from the studied population; the presence of microsporidial spores detected by IFA-MAbs should be confirmed by other methods.

Evaluation of gram-chromotrope kinyoun staining technique: its effectiveness in detecting microsporidial spores in fecal specimens.

This study was conducted to evaluate the modification of the usual Gram-chromotrope staining technique developed in-house known as Gram-chromotrope Kinyoun (GCK) in comparison with the Weber Modified Trichrome (WMT) staining technique; as the reference technique. Two hundred and ninety fecal specimens received by the Microbiology Diagnostic Laboratory of Hospital Universiti Kebangsaan Malaysia were examined for the presence of microsporidial spores. The sensitivity and specificity of GCK compared to the reference technique were 98% and 98.3%, respectively. The positive and negative predictive values were 92.5% and 99.6%, respectively. The agreement between the reference technique and the GCK staining technique was statistically significant by Kappa statistics (K = 0.941, P < 0.001). It is concluded that the GCK staining technique has high sensitivity and specificity in the detection of microsporidial spores in fecal specimens. Hence, it is recommended to be used in the diagnosis of intestinal microsporidiosis.