bluuebunny/crossref_metadata_2025 huggingface dataset:
Performance Evaluation of Dynamic QoS-Aware CAC (DQA-CAC) Algorithm for Broadband Networks
Authors: Yese Solomon Orduen , Abdulazeez Abdulhakeem , Mohammed Aminu
Published: November 2019

Call admission control (CAC) is a technique deployed in the management of network resources in mobile broadband networks. Despite its importance, the WiMAX technology like most mobile broadband networks does not make provision for CAC, making it an open area of research. A dynamic QoS-Aware Call Admission Control (DQACAC) scheme was recently proposed to improve resource utilization and ensure QoS. Several simulation experiments were conducted to evaluate the performance of the DQA-CAC against other CAC algorithms. The results of the simulation indicated that the DQA-CAC outperformed the existing CAC schemes in terms of reduced new connection blocking rate.  However, the evaluation failed to consider other performance metrics like resource utilization and throughput that are also very crucial in the real-world scenario. This paper therefore attempts to improve the performance of the DQA-CAC by investigating its performance in terms of additional metrics like the average system throughput and resource utilization that further mimic the real-world experience. A Java based discrete event simulator designed for the study was used and the simulation results indicate that the DQA-CAC algorithm outperforms the existing CAC algorithms in terms of improved per-flow throughput, average system throughput and resource utilization in addition to reducing the connection blocking rate.
Design, Structural and Electrostatic Analysis of Three MEMS Micro Accelerometers
Authors: Vidal Jose Luis Gonzalez , Calderon Osorno Jose Luis , Camarillo Edmundo Rene Duran , Sanchez Silvestre Ascencion Garcia
Published: November 2019

Three low-power MEMS micro-accelerometers were designed, the first with variable distance and the last with variable area. Then, electrostatic analysis and simulation by the finite element method was performed to show its behavior and performance. In the simulation and analysis the software COMSOL MULTIPHYSICS 5.1 was used. The results show that the variable area micro-accelerometer exhibits the best relationship between behavior and performance.
Effects of Virgin Coconut Oil as Adjunct Therapy in the Treatment of Allergic Rhinitis
Authors: Zainuddin Nazli , Mohd Shah Nurul Azira , Salim Rosdan
Published: November 2019

Introduction: The role of virgin coconut oil in the treatment of allergic rhinitis is controversial. Thus, the aim of the present study is to determine the effects of virgin coconut oil ingestion, in addition to standard medications, on allergic rhinitis. We also studied the side effects of consumption of virgin coconut oil. Methods: Fifty two subjects were equally divided into test and control groups. All subjects received a daily dose of 10mg of loratadine for 28 days. The test group was given 10ml of virgin coconut oil three times a day in addition to loratadine. The symptoms of allergic rhinitis were scored at the beginning and end of the study. Results:, the symptom score were divided into nasal and non-nasal symptom scores. Sneezing score showed a significant difference, however the score was more in control group than test group, indicating that improvement in symptom was more in control group. The rest of the nasal symptom and non-nasal symptom score showed no significant difference between test and control groups. Approximately 58% of the test subjects developed side effects from consumption of virgin coconut oil, mainly gastrointestinal side effects. Conclusion: In the present study, ingestion of virgin coconut oil does not improve the overall and individual symptoms of allergic rhinitis, furthermore it has side effects.
Functional Dependence and Nutritional Status among Leprosy Survivors in Sungai Buloh, Malaysia
Authors: Isa Mohamad-Rodi , Yasin Siti-Munira , Zamhuri Mohammad-Idris
Published: November 2019

Introduction: Leprosy is a chronic granulomatous disease which also known as Hansen’s disease caused by Mycobacterium leprae. The social rights and health requirements should not be neglected among the remaining survivors. Although nutritional status and leprosy invasion has been studied in the past, there is still an unclear relationship between these two. The aim of this study was to assess the relationship between nutritional status and disability among the leprosy survivors. Methods: A community based, cross-sectional study using convenience sampling was conducted at Sungai Buloh, Selangor area from June 2014 to July 2014. The degree of disability was assessed using Barthel’s Index and the nutritional status assessment was assessed using Mini Nutritional Assessment. The data was analysed using SPSS version 20. Results: A total of 73 patients were involved in the study (60.3% were male and 89.0% were Chinese). The prevalence of disability was 56.2% (95% CI: 44.5 – 67.8) with walking up-stair was the highest item that need help (50.7%). There were 9.6% malnourished and 49.3% were at risk of malnutrition. There was a negative strong correlation between Nutritional score and the Barthel’s index score (Spearman rho, ρ = -0.714, p < 0.001). Conclusions: Measures must be taken to improve their nutritional status in order to increase their ability to be more independent particularly those who are very old. The degree of disability increases with malnutrition.
Factors Associated with Homelessness and its Medical Issues among Urban Malaysians: A Qualitative Research
Authors: Ahmad Yani Nurul Mahfuzah , Zahari Nur Zakirah , Abu Samah Nur Fatini Haziqah , Mohamed Azahar Muhammad Ammar Faidhi , Yasin Siti Munira , Ahmad Saman Mohd Shahril , Mohd Noor Nor Aini
Published: November 2019

Introduction: Homelessness continues to exist in our country even though we hear of various initiatives that have been put in place to solve this ongoing issue. The objectives of this study are, first, to explore factors that lead to homelessness, second, to determine the associated medical conditions and third, to shed light on the views of homeless individuals regarding their future perspectives. Methods: This study employed the use of a qualitative research method in analysing the experiences of 24 homeless individuals. It will detail the causes that have led to the respondents’ homelessness and their future plans. Results: From the research conducted, it was found that the factors that lead to homelessness are family disorganization, job loss and underemployment, not having a place to call home and attitude problems. The future plans of the 24 respondents can be divided into several broad themes – finding a job, finding their families, finding a better shelter home and seeking for knowledge, while some had no obvious plans. Most of the 24 individuals had no knowledge of their own medical conditions. Conclusions: Initiatives from people with authority or organizations dedicated to working on issues of homelessness are not enough to prevent this condition from occurring. People who are homeless must themselves be willing to change their attitudes while family members must care and be responsible for their own families. Health awareness is very important and the occurrence of communicable diseases such as tuberculosis can be prevented if more attention is given to health.
Potassium Aluminium Sulphate (Alum) Inhibits Growth of Human Axillary Malodor-Producing Skin Flora in Vitro
Authors: Al-Talib Hassanain Issam , Mohd Nasir Nur Izzati Syamimi , Yaziz Hafizuddin , Zulkafli Nur Fatihah , Adani Nur Aqidah , Noor Rashidi Ahmad Ikhwan , Murugaiah Chandrika , Shaari Syahrul Azlin
Published: November 2019

Introduction: Axillary malodor is caused by microbial biotransformation of non-smelling molecules present in apocrine secretions, into volatile odorous molecules. This study aimed to determine the antimicrobial activities of potassium aluminium salts (alum) against four malodorproducing axillary bacterial flora, as an alternative natural product for reducing axillary malodor. Methods: The antimicrobial activity of alum against axillary bacterial flora [Micrococcus luteus (ATCC 49732) (M. luteus), Staphylococcus epidermidis (ATCC 14990) (S. epidermidis), Corynebacterium xerosis (ATCC BAA-1293) C. xerosis and Bacilus subtilis (ATCC 19659) (B. subtilis)], was tested in vitro using broth dilution method for different concentrations (0.937 – 20mg/mL) on Luria-Bertani broth. Subculture was done to determine colony-forming units (CFUs) and the minimum inhibitory concentrations (MICs). Results: Alum showed excellent inhibitory effects on all tested bacteria. The lowest MIC of alum was against C. xerosis, at 1.88 mg/mL. M. luteus, B. subtilis and S.epidermidis showed a higher MIC of 3.75, 5.00 and 7.50 mg/mL, respectively. All of the tested bacteria were completely inhibited at a concentration of 7.50 mg/mL. Conclusions: This study revealed that alum has excellent antimicrobial effects against axillary malodor -producing bacteria and is recommended to be used either directly by topical application or as an active ingredient in deodorants and antiperspirants.
Self-perceived Anxiety Symptoms and its Associated Factors among Type 2 Diabetic Patients in Rural Communities of Malaysia
Authors: Nikmat Azlina Wati , Fadzil Mohd Ariff , Idris Sakinah
Published: November 2019

Introduction: Little is known about anxiety symptoms among diabetic patients, especially among those who are living in rural areas in Malaysia. Thus, the aim of this paper is to investigate the prevalence of anxiety among diabetic patients and factors associated with anxiety in rural communities in Malaysia. Methods: A cross-sectional study involving 464 diabetes mellitus patients in rural health districts and outpatient clinics in Malaysia was conducted. Each participant was interviewed using the Hospital Anxiety and Depression Scale. Results: Respondents consisted of 193 (41.6%) males and 271 (58.4%) females. The mean age of participants was 59.65 ± 10.16 years and the mean duration of diabetes mellitus was 6.9 ± 6.3 years. Results indicate that 15% of the participants have anxiety symptoms. Multiple logistic regression analysis revealed that patients with history of ischemic heart disease and depression and those who were underweight have higher anxiety scores with adjusted OR 5.06 (95% CI 1.79 to 14.27), 27.71 (95% CI 14.23 to 53.98) and 14.6 (95% CI 2.49 to 84.82), respectively. Conclusions: This study suggests that although the prevalence of anxiety among diabetics is low, primary care physician should be trained to identify high risk patients and to manage their condition in order to improve the clinical outcome.
Seroprevalence of Enterically Transmitted Hepatitis in North West India
Authors: Bachhiwal Rekha , Sharma Rajni , Gupta Pooja , Shukla Jyotsna
Published: November 2019

Introduction: To ascertain the seroprevalence of enterically transmitted Hepatitis A (HAV) and Hepatitis E (HEV) in cases with acute/subacute hepatitis attending a tertiary care hospital in North West India. Methods: A total of 2936 cases were examined for the presence of current infection with HAV and HEV, determined by demonstration of HAV-IgM and HEV-IgM antibodies using ELISA. Results: Overall seroprevalence for enterically transmitted hepatitis was found to be 24.89%. HAV IgM was present in 7.35% and HEV IgM was present in 17.54% of total cases. HAV infection was predominantly found in pediatric age group while HEV infection was mostly seen among adults. Male preponderance was noted. Enteric hepatitis cases occurred throughout the year. No definitive seasonal pattern was observed. Conclusion: Our data demonstrated high seropositivity of enterically transmitted hepatitis indicating the need for improvement in personal and public hygiene, and development of HEV vaccine.
A Case Report of Intramuscular Abscess Secondary to Epicoccum nigrum infection
Authors: Mohd Shah Nurul Azira , Mohamed Zeehaida , Zainuddin Nazli , Md Noor Siti Suraiya
Published: November 2019

A 36-year-old man with underlying chronic lymphocytic leukemia had left arm swelling for a duration of 3 months. Clinically, the affected arm was swollen, erythematous and tender. Epicoccum nigrum was isolated from the culture of the tissue that was obtained intra-operatively. He was treated and responded to voriconazole therapy. To the best of our knowledge, this is the first case of intramuscular abscess as a result of E. nigrum infection in an immunocompromised patient.
Antiretroviral Treatment-Associated Labia Majora Lipohypertrophy: A Rare Case and Plastic Surgical Treatment Options
Authors: Hisham Akmal , Ilenghoven Devananthan , Wan Ahmad Kamal Wan Syazli , Ibrahim Salina , Mohd Yussof Shah Jumaat
Published: November 2019

The emergence of highly active antiretroviral therapy (HAART) has revolutionized the prognosis of HIV-infected patients. However, the extended use of HAART is associated with a disfiguring complication termed lipodystrophy, a disorder of body fat maldistribution causing peripheral fat loss (lipoatrophy) and central fat accumulation (lipohypertrophy). Lipoatrophy commonly affects the face, legs, buttocks and arm, whilst lipohypertrophy frequently favours the abdomen, breast and dorsocervical region. To our knowledge, we present only the second documented case in the literature of a labia majora lipohypertrophy in a HIV-positive patient receiving long-term HAART. The severity of labial abnormality caused significant physical and functional morbidities. Labiaplasty with dermolipectomy of the labia majora and excisional lipectomy of the mons pubis was successfully performed. At a 6-month follow-up, patient had no recurrence with resolution of symptoms and resumption of normal activities of daily living (ADL).
Effects of Neuroactive Amino Acids Derivatives on Cardiac and Cerebral Mitochondria and Endothelial functions in Animals Exposed to Stress
Authors: Popova TA , Prokofiev II , Mokrousov IS , Perfilova Valentina , Borisov AV , Lebedeva SA , Dudchenko GP , Tyurenkov IN , Ostrovsky OV
Published: November 2019

Introduction: To study the effects of glufimet, a new derivative of glutamic acid, and phenibut, a derivative of γ-aminobutyric acid (GABA), on cardiac and cerebral mitochondria and endothelial functions in animals following exposure to stress and inducible nitric oxide synthase (iNOS) inhibition. Methods: Rats suspended by their dorsal cervical skin fold for 24 hours served as the immobilization and pain stress model. Arterial blood pressure was determined using a non-invasive blood pressure monitor. Mitochondrial fraction of heart and brain homogenates were isolated by differential centrifugation and analysed for mitochondrial respiration intensity, lipid peroxidation (LPO) and antioxidant enzyme activity using polarographic method. The concentrations of nitric oxide (NO) terminal metabolites were measured using Griess reagent. Hemostasis indices were evaluated. Platelet aggregation was estimated using modified version of the Born method described by Gabbasov et al., 1989. Results: The present study demonstrated that stress leads to an elevated concentration of NO terminal metabolites and LPO products, decreased activity of antioxidant enzymes, reduced mitochondrial respiratory function, and endothelial dysfunction. Inhibition of iNOS by aminoguanidine had a protective effect. Phenibut and glufimet inhibited a rise in stress-induced nitric oxide production. This resulted in enhanced coupling of substrate peroxidation and ATP synthesis. The reduced LPO processes caused by glufimet and phenibut normalized the endothelial function which was proved by the absence of average daily blood pressure (BP) elevation episodes and a significant increase in platelet aggregation level. Conclusion: Glufimet and phenibut restrict the harmful effects of stress on the heart and brain possibly by modulating iNOS activity.
The Burden of Mental Illness: An Emerging Global Disaster
Authors: Salleh Mohd Razali
Published: November 2019

The global burden of disease (GBD) has shifted from communicable to non-communicable diseases, and from premature death to years live with disabilities (YLDs) over the past 30 years. Mental and substance use disorders constitute a major component in the scenario of the global health with a significant impact on the global burden of disease, especially in the developing countries. The 1990 GBD study listed depression as the fourth common cause of global burden of disease; while lower respiratory infections, diarrheal diseases and conditions arising during perinatal period are top in the list. In GBD 2000 study depressive disorders climbed to the third place, however still behind lower respiratory infections and diarrheal diseases. The subsequent 2010 GBD study ranked depression in the second place of the global disability burden, and are also considered as a major contributor to the burden of suicide and ischaemic heart disease. The WHO predicted that depressive disorders will be the leading cause of global burden in 2030.
Prevalence of Coronary Artery Disease in Young Sudden Death Cases and Correlation with Post-Mortem Computed Tomography Calcium Score
Authors: Omar Effat , Faizuddin R. , Chaincel Singh Mansharan Kaur , Rahimi Razuin , Mahmood Mohd Shah , Abdullah Nurliza , AM Zaleha , Mohd Nawawi Hapizah
Published: November 2019

Introduction: Data on prevalence of coronary atherosclerosis and coronary artery disease (CAD) in young sudden death autopsy cases in Malaysia are still scarce. Calcium scoring (CS) on Computed Tomography (CT) was suggested to be predictive for CAD; however the reports have been conflicting. Objectives: to investigate (i) the prevalence of young CAD in sudden death cases in a Malaysian population; (ii) the association between CT CS and CAD in such cases and correlation with age. Methods: Sudden death cases received at the National Institute of Forensic Medicine, Kuala Lumpur between September 2012 and December 2013 were recruited. The cases were divided into young [≤40] and old [>40 years old] age groups. Presence of CAD was recorded during autopsy. Results: A total of 155 cases was included; 64.5% of the subjects were below 40 years old. CAD was the cause of death of 34 [21.9%] cases; of these, young individuals comprise 47.1% of cases [n=16; 10.3% of total cases, 16% of young sudden death cases]. Both young and old subjects with CAD had lower CS compared to those without CAD [p<0.000; p=0.003 respectively]. Multivariable regression analysis showed CS to be significantly correlated with CAD in both young and old subjects. In contrast, other factors such as gender, ethnicity, body-mass index and waist-hip ratio did not show any correlation with CAD in both groups. Conclusion: The prevalence of CAD in young sudden death cases is
Assessment of Survival and Cardiotoxicity of Adjuvant Trastuzumab among HER2 Breast Cancer Patients in an Oncology Centre in Malaysia
Authors: Hasbullah Harissa Husainy , Bustamam Anita , Munn Tho Lye , Phua Vincent
Published: November 2019

Introduction: Adjuvant trastuzumab has been used in human epidermal growth factor-2 (HER2) breast cancer to improve survival but with concern of cardiotoxicity. Our study is the first to review efficacy and toxicity of adjuvant trastuzumab in Malaysia. Methods: This is a retrospective cohort study on HER2 non metastatic breast cancer patients in University Malaya Medical Centre diagnosed between October 2006 and May 2011. Two cohorts were created based on whether or not they received adjuvant trastuzumab. Disease free survival (DFS) and overall survival (OS) for both groups were estimated using Kaplan Meier method and compared using Log rank test. Cox proportional hazards regression models analysed for potential covariates of age, tumour size and grade, node and estrogen receptor (ER) status. Trastuzumab cardiotoxicity was defined as left ventricular systolic dysfunction or heart failure with or without symptoms and graded using Common Terminology Criteria for Adverse Events (CTCAE 4.0). Results: 170 HER2 non metastatic breast cancer patients were identified. Thirty-three received trastuzumab and 136 did not. Median age was 53.4 ± 10.3 years old. Significantly more ER negative patients received trastuzumab. Four years DFS in ‘trastuzumab’ versus ‘no trastuzumab’ cohort was 90.9% vs 74.5% (p = 0.027). Four years OS was 91% vs 84.7% (p = 0.30) respectively. Majority tolerated trastuzumab with no toxicity. Five patients (15.2%) experienced cardiotoxicity (all grade I).Conclusions: Adjuvant trastuzumab significantly improved DFS in HER2 breast cancer. Treatment was well tolerated. With this we propose the justification for adjuvant trastuzumab in HER2 breast cancer in our population.
Migraine Masquerading as Temporomandibular Disorders: A Case Report
Authors: Shoji Yoshinobu , Cohen Harold V
Published: November 2019

Migraine is a common disabling primary headache disorder. Ipsilateral radiation of pain to orofacial regions, including teeth, jaws and temporomandibular joints, although not a common complaint, could occur. The area of involvement may obscure the diagnosis and lead to unnecessary dental treatment. A case is presented in which a patient initially sought dental care for left jaw pain that radiated to her left maxillary teeth and temple region and she was also experiencing discomfort in the left masticatory musculature. Subsequently a medical consult diagnosed migraine headache without aura and fortunately unnecessary dental treatment was not done. The key issue here is the complexity of the Trigeminal nerve when the dentist is assessing a patient for dental or other orofacial pain complaints and dental pathology has been ruled out. Equally as important is the dentist taking thorough medical history since a patient may not tell a dentist about a “headache” because the pain is in the teeth and/or jaws. And, perhaps most important is the final differential diagnosis whether made by the dentist or medical care provider.
Principlism and Neonatology:
Authors: Min Mark Tan Kiak
Published: November 2019

Prematurity is the leading cause of infant mortality and one of the main reasons for newborn infants to be admitted to the Neonatal Intensive Care Unit (NICU). Advancements in medicine has made the NICU a maze of sophisticated modern technology and expensive to run. These advances in technology have also resulted in an added layer of complexity to many ethical dilemmas that are encountered in the NICU. In 1977, Beauchamp and Childress introduced the principles of biomedical ethics. These four principles of (1)respect for autonomy, (2)nonmaleficence, (3)beneficence and (4)justice, form a suitable starting point for the analysis of the moral challenges of medical innovation. This article explores how the four ethical principles relate to decision-making in the NICU, and how they can be applied to the treatment of sick newborn infants in clinical practice. It also highlights the reasons why healthcare personnel need to equip themselves with good communication skills and up to date knowledge of ethical considerations in the NICU in order to make quality decisions about care for their patients. This article also suggests that a Clinical Ethics Committee can play a vital role in ensuring that the best decisions are achieved for these patients. KEYWORDS: Medical ethics, principlism, neonatology, prematurity, clinical ethics
Detection of JAK2 V617F Mutation among Donors with Erythrocytosis
Authors: Mohammed Kamaruzzaman Siti Fatimah , Mohd Noor Noor Haslina , Hassan Mohd Nazri , Mohamed Yusoff Shafini , Abdullah Wan Zaidah
Published: November 2019

Introduction: It is mandatory that every blood donor must have their haemoglobin (Hb) values measured before blood donation. High Hb may indicate an underlying hidden pathological condition. The aim of this study is to investigate the occurrence of the JAK2 V617F gene mutation in blood donors with erythrocytosis. Methods: A cross-sectional study was conducted over a nine-month period involving blood donors with high pre-donation Hb. A total of 45 blood donors with total white cell (TWC) > 12.0x 109/l, platelet > 450x109/ l and Hb > 18g/dL were subjected to JAK2 V617F gene mutation analysis. Samples were collected and analysed for haematological tests and detection of JAK2 V617F mutation. Results: From a total of 2238 blood donors, 175 blood donors had high haemoglobin value. Samples from forty-five of these donors were then analysed for JAK2 V617F using allele-specific polymerase chain reaction (PCR). The prevalence of blood donors with erythrocytosis was 7.8%. All samples were negative for the JAK2 V617F mutation. Conclusions: Erythrocytosis can be relative or absolute and the different causes can be distinguished on the basis of clinical signs and symptoms. An absence of the JAK2 V617F mutation cannot by itself excludes the diagnosis of polycyhaemia vera (PV) since erythrocytosis is the single clinical feature that sets PV apart from other types of myeloproliferative neoplasm (MPN). Further study is required for the detection of other gene mutations that activates the JAK-STAT signalling pathway that could be identified in JAK2 V617F-negative MPN patients.   KEYWORDS: Blood donors, JAK 2 V617F mutation, erythrocytosis
The Lifestyle and Behavioural Risk Factors of Future Doctors in Universiti Teknologi MARA, Malaysia
Authors: Wee Chen Xin , Ismail Zaliha
Published: November 2019

Introduction: Lifestyle and behavioural risk factors in middle-aged adults are proven to have an impact on later-life outcomes; hence health promotion activities should aim at the population before they reach their mid-life. Medical students will be representing a community in promoting health, henceforth they should have a healthy lifestyle and behaviour in order to facilitate and adoption of preventive practices in their future life as physicians. Therefore, this study was aimed to determine the lifestyle and behavioural risk factors among future doctors in a public university in Malaysia. Methods: A cross-sectional study was conducted at the Faculty of Medicine, Universiti Teknologi MARA (Sungai Buloh Campus). Simple random sampling was used to select eligible subjects among undergraduate medical students (pre-clinical years). A self-administered pro forma checklist was given to the subjects who consented. Descriptive analysis was performed, and univariate analysis was done by Chi-square, Fisher’s Exact test and independent t-test. Results: A total of 252 subjects participated. The majority (96.8%) were of Malay ethnicity and three-quarter of the subjects were females (76.2%). A small number of subjects were smokers (2.4%) and alcoholic consumers (1.2%). Approximately half (57.3%) of the female subjects had normal body mass indices, while this was only seen in one-third (35.0%) of male subjects. Most subjects (72.2%) exercised at least once a week, however only 17.1% of the subjects exercised at the recommended levels. There was a significantly higher proportion of males who had adequate exercise compared to that of females. Conclusion: Inadequate physical activity and imperfect BMI of the study subjects warrant exclusive promotion and education of healthy lifestyle in this population. It would probably be beneficial if assessment of lifestyle and behavioural risk factors could be conducted before these subjects embark into their professional working life.  KEYWORDS: lifestyle, behaviour, risk factors, future doctors, Selangor.
Improper Technique of Eye Drop Instillation Leading to Corneal Ulcer in a Visually Impaired Glaucoma Patient
Authors: Azman Azhan , Embong Zunaina , Mohd Kamal Khairidzan , Sukaimy Fatimah Suhaila , Akhtar Ali Ahmad Nurfahmi
Published: November 2019

We report a case of visually impaired glaucoma patient with long term use of topical glaucoma medications presented with a corneal ulcer due to the improper technique of eye drop instillation. A 70-year-old gentleman with advanced primary open angle glaucoma (POAG) on his right eye and absolute glaucoma on his left eye, presented with painful redness and purulent discharge of the right eye for two weeks. He was using four types of topical glaucoma medication on his right eye since failed trabeculectomy two years ago. His right eye vision was 6/24 and painless blindness of the left eye before the presentation. He was administering all the medications himself despite his current vision status. Right eye examination showed visual acuity of 3/60 with clinical features of corneal ulcer. During the observation of his eye drop instillation technique, he consistently touched the tip of the bottle to his right cornea. The corneal contact area corresponded to the corneal ulcer area and size. In addition to this, the culture result obtained from both corneal ulcer and the bottles’ tips yielded similar microorganism which was Staphylococcus aureus. After an intensive course of topical antibiotics treatment, the corneal ulcer healed with a scar and the vision improved to 6/24 from 3/60. Although this incident is rare, it is crucial for the treating physicians to address the issue properly and co-manage these patients with pharmacists and nursing staffs as well as to seek support from the caretakers to prevent this blinding complication. KEYWORDS: corneal ulcer, glaucoma medication, eye drop instillation technique
Fitness to Practise for Doctors and Medical Students with Mental Issues in Malaysia
Authors: Abdullah Muhammad Darwiis , Ahmad Fuad Aiman Faiz , Rahman Hafiz Ilmie , Min Mark Tan Kiak
Published: November 2019

Mental illness is expected to become the second biggest health problem affecting Malaysians by 2020. Doctors and medical students are more prone to mental illness compared to the general population. However, they are often reluctant to and resist seeking help because of stigma and a (strong) sense of shame. This can lead to detrimental consequences for themselves and their patients. That said, a doctor with a mental illness receiving appropriate treatment and who is in a stable condition may still be permitted to practise provided patient safety is not compromised. Determining this is a key responsibility of a healthcare regulator like the Malaysian Medical Council (MMC). Using some prominent cases to illustrate this point, this article reviews the MMC guideline on ‘Managing Impaired Registered Medical Practitioners’. In the absence of similar local guidelines for medical students, we also allude to the UK General Medical Council’s guideline on ‘Supporting Medical Students with Mental Health Conditions’. The article recommends that doctors and medical students with mental illness should seek help; outlines a number of factors to consider in deciding whether a doctor should continue practising; and explores alternative career paths in instances where they should not. The article concludes that appropriate support goes a long way for doctors and medical students who grapple with mental health issues in that there is hope and a way through a seemingly devastating situation.
CRP and IL-6 levels of Gingival Crevicular Fluid in stroke survivors: A pilot study
Authors: Ab. Malik Normaliza , Mohamad Yatim Sa’ari , Jin Lijian , McGrath Colman
Published: November 2019

Introduction: The aim of this study was to evaluate the levels of C-reactive protein (CRP) and interleukin-6 (IL-6) in the gingival crevicular fluid (GCF) among stroke survivors in relation to the oral hygiene status and stroke characteristics. Methods: A multi-centre cross-sectional study was conducted among hospitalised stroke survivors. Socio-demographic data were collected. Oral clinical assessment (dental plaque scores) and functional dependency levels scores were carried out. Gingival Crevicular Fluids were collected, using absorbent papers and analysed using ELISA kit. Descriptive statistic and correlation analyses were performed using proportion and Spearmen correlation coefficient test. Results: A total of 53 patients were recruited from five public hospitals. There was a significant correlation between CRP and IL-6 levels of GCF (P=0.021, r=0.21). A significant correlation was also observed between CRP levels in GCF with dental plaque scores and functional dependency levels. There was no statistically significant correlation found between IL-6 levels in GCF with dental plaque scores and functional dependency levels. Dental plaque scores were associated with high levels of CRP in GCF (P=0.014), and swallowing problem was associated with high levels of IL-6 in GCF (P=0.002). Conclusions: IL-6 levels in GCF were correlated with the levels of CRP in GCF. High CRP and IL-6 levels in GCF were significantly associated with dental plaque scores and swallowing condition (presence of dysphagia), respectively. Thus, this pilot study suggests that CRP level in the oral cavity respond to the oral health conditions and may not be a predictor factor of stroke outcomes. Further studies are warranted to compare the level of inflammatory biomarkers from the oral cavity and serum in relation to the stroke conditions and outcomes.
An Overview of Lane Changing Model at Signalised Intersection
Authors: Md Diah Jezan , Tey Li Sian , Roslee Fathiyah
Published: November 2019

In recent years, lane changing has become a crucial issue in traffic engineering and safety aspect due to distribution of vehicles across lanes thus contributing to traffic movements. In order to keep the right route, drivers have to change their lanes. However, lane changing has a high potential of accidents, especially at signalised intersection. This may cause the traffic flow to become heavier and traffic congestion. The aims of this study are to study on lane changing issue at signalised intersection, to determine the factors contributing to lane changing at signalised intersection and to develop a model for improvement of traffic flow in lane changing behaviour at signalised intersection. Lane changing model is important because it will reduce traffic congestion and smoothen the traffic. This study will contribute in studying the changing lane issue at signalised intersection which is to control the flow of traffic in order to ensure the traffic flows smoothly and to reduce traffic congestion especially on the merging issue at signalised intersection.

Keywords: lane changing, signalised intersection, model, traffic flow
The Physical and Morphological Properties of Kenaf/ Epoxy Fibres in Coating Treatment Process
Authors: Mohd Ghaztar Muhammad Mustakim , Nik Ibrahim Nik Noor Idayu , Zakaria Sarani , Romli Ahmad Zafir
Published: November 2019

Natural fibre is an economical material that often used in various applications due to its low in density, non-abrasiveness in processing and biodegradable. But, its usage in various applications is still limited due to the low in overall properties. The acceptable method to improve the properties of the fibres is by chemical treatment method that is costly, meticulous process and high energy demand. Thus, a new, simple and cost-effective fibre coating treatment method was developed which was able to improve the physical and morphological properties that open a new path for natural based materials to be used in a more robust application. In this study, the physical and morphological properties of various coated Kenaf fibres were analysed to comprehend the cutting behaviour of coated fibres after subjected to the pulverisation process. The Kenaf fibres were individually immersed in 1:4, 1:5 and 1:6 epoxy to acetone coating solutions prior cured, and pulverised consecutively using 5 mm, 1 mm, 0.5 mm and 0.25 mm mesh sizes aperture. The morphological characteristic was analysed using polarised optical and scanning electron microscope. The result showed that 1:6 coating ratio solution able to effectively coat the fibres’ aspect ratio that forming individual coated fibre which in long length pulverised fibres. Moreover, the low viscous 1:6 solution able to penetrate inside fibre structure that supported by density and fibre cross-section analysis compare to the other solutions. In future, this analysis is crucial to give insight on the coated fibres behaviour after subjected to the mechanical means of cutting process that later relates to the reinforcing mechanism in the composite samples.
Pengaruh Dukungan Suami terhadap Istri yang Mengalami Kecemasan pada Kehamilan Trimester Ketiga di Kabupaten Gianyar
Authors: Diani Luh Putu Prema , Susilawati Luh Kadek Pande Ary
Published: November 2019

The pregnancy period is a period when the body of a pregnant woman experience physical changes and psychological changes caused by pregnancy hormones increase. Hormonal changes experienced by pregnant women will result the changes in emotion and elicits some reaction among others happiness, sensitive, getting sad easily, disappointed, hurt, anxiety and even stress. Under these conditions, the husband’s support needed during pregnancy.It is very important for pregnant women to reduce the level of anxiety,so that pregnant women can live a healthy life. This study aims to determine whether the presence or absence of husband’s support influence against wives who experience anxiety in the third trimester of pregnancy in Gianyar regency.

This study used nonprobability sampling with purposive sampling technique. Nonprobability sampling. This research is non-experimental (ex post facto) that consists of two groups: a control group and experimental group consisted of 30 people. Researchers use two scales,husbands support scale and the scale of anxiety in the third trimester pregnant women. Data obtained in this research is processed with independent samples t-test to see the effect of the husband to support his wife who experience anxiety in the third trimester of pregnancy.

Analysis Independent samples t-test produces sig. (2-tailed) of 0.000 (p <0,05). Results of this study indicate that there are significant influence between husband’s support  against wives who experience anxiety in the third trimester of pregnancy. The group of pregnant women who do not live with her husband has a high-anxiety category. Meanwhile, the group of third-trimester pregnant women living with their husbands has low-medium anxiety category.

Keyword        : Husband Support, Anxiety, Pregnancy Third Trimester
Perbedaan Intensitas Komunikasi Melalui Jejaring Sosial antara Tipe Kepribadian Ekstrovert dan Introvert pada Remaja
Authors: Widiantari Komang Sri , Herdiyanto Yohanes Kartika
Published: November 2019

The progress of information and communication technology influencethe increase of the usage of social network. Social network users are mostly inadult group. The existence of social networks can bring positive impact as well as negative impact to the society especially in adult group. The aim of this research is to find out the difference in communication intensity through social networks between extrovert and introvert types of personality in adolescents.   This research is a quantitative research with comparative method, the sampling technique used in this research is stratified proporsional randomsampling and the population is High School students in Denpasar, with the total respondents 218 student. The analysis data by t-test independent sample, and shown the result that there was a difference in the communication intensity through social network between introvert and extrovert type of personality in adolescents, the extrovert personality had a high level of communication better than introvert personality. The additional analysis, it is stated that there was a relationship between the number of social networks and the intensity of communication on social networks, and there was no difference in the intensity of communication based on gender.   Keywords: Communication intensity, social networks, extrovert,introvert
Pengaruh Pemberian Aromaterapi Terhadap Konsentrasi Siswa Kelas V Sekolah Dasar dalam Mengerjakan Soal Ulangan Umum
Authors: Agustini Ni Made Yanthi Ary , Sudhana Hilda
Published: November 2019

Aromatherapy in Balinese life very closely. Aromatherapy has an influence on the function of the body such as making a fresh indoor air, creating a calm, can be used as antibiotics, antiseptics may be useful to take the fight against the virus, soaking emotion, can be a tool for relaxation, and also improves concentration. Concentration in the world of education is a very important one in doing general replications. This study aimed to verify whether there are effects of aromatherapy to the concentration of children in the fifth grade of primary school working on the general test questions. This research is a quantitative study with pre-experimental methods, sampling technique used is cluster random sampling. Subjects in this study were fifth grade elementary school students who are following the general replication at SD Negeri 5 Tonja by 82 students. Collecting data using a concentration questionnaire with Likert scale and data analysis by independent sample t-test. After conducting validity and reliability there are 25 items left from a total of 34 items on the reliability coefficient of 0.876. After doing               the independent sample t-test significance p values obtained for 0.823 (> 0.05). This means there is no effect of aromatherapy to the concentration of children in the fifth grade of primary school working on the general test questions.  Based  on  additional  data  to  see  the  concentration  of  each  day,  there  is  an increasing concentration in the experimental group students, but has not reached a significant point.   Keywords: Aromatherapy, Concentration, Students, General Test
HUBUNGAN KEBUTUHAN AFILIASI DENGAN INTENSITAS PENGGUNAAN JEJARING SOSIAL TWITTER PADA REMAJA AKHIR
Authors: Putra I Putu Galang Dharma , Marheni Adijanti
Published: November 2019

McClelland said that one of three major human needs is the need for affiliation, or the need to establish relationships with other people who are generally at its peak when someone is at the stage of adolescence. One way to establish a relationship with another individuals is by communicate. One medium that people uses to communicate is internet. Twitter is one of many internet-based social media that often used by the adolescence. Various things communicated by teenagers on Twitter, from positive tweets, or even the controversial one. Thus, makes their intensity of adolescence’s tweets, because adolescence wants to established a communication with other people in order to satisfy their need for affiliation. Therefore, it can be assumed that adolescence’s need for affiliation is related to their intensity of Twitter usage A total of 415 adolescence aged between 18-21 years old were becoming subjects of this research. This study uses quantitative method with correlational approach. The sampling technique was multistage cluster sampling. The instruments that used in this research are the need for affiliation scale (21 items), and the intensity of twitter usage scale (2 items), with the need for affiliation scale’s reliability coefficient of 0.815 The main data in this research were processed by using the nonparametric Spearman correlation analysis with a correlation value of 0.342 and a probability value of 0.000. The supporting data were also processed using the nonparametric analysis to see the difference between subjects’ demographic data. The results indicate that the needs for affiliation variable and intensity of Twitter usage variable did not differ significantly by gender of respondents, however, it differ significantly based on age and length of ownership of the subjects’ Twitter account.   Keywords: Need for affiliation, intensity, Twitter, adolescence.
Hubungan antara Penerimaan Kelompok Teman Sebaya dengan Konsep Diri pada Remaja Panti Asuhan di Kabupaten Badung, Bali
Authors: Santiari I Gusti Agung Tri , Tobing David Hizkia
Published: November 2019

Self concept is a reflection of the judgement of others (Charles Cooley, in Watson, Borlall-Tregerthan, & Frank, 1984). The formation of individual self concept is influenced by several factors, one of which is peers in adolescence is a very important figure for indiciduals. Not all teens get through phase of adolescence his parents. There are some situations that cause adolescent should live apart from their parents, by staying at the orphanage institution for example. This different conditions will certainly affect the processes occurring friendship with the adolescent peer groups which will certainly affect the formation of self concept. The purpose of this study was to determine the relationship between peer group acceptance of the self concept in adolescents orphanage in the District Badung, Bali.Subjects in this study were 170 adolescents (girls=101, boys=69) who lived in the orphanage which is in the District Badung-Bali. The instrument of this research are self concept and peer group acceptance scale. Self concept scale consisted of 30 item with a reliability coefficient of 0,875. Peer group acceptance scale consisted of 21 item with a reliability coefficient of 0,873.Product moment correlation analysis result showed the correlation of 0,719 with a significance level of 0,000 (p<0,05), which means that there is a significant and positive relationship between peer group acceptance and self concept in adolescents orphanage in the District Badung, Bali. The higher the intensity of the peer group acceptance, the more positive self concept in adolescents orphanage in the District Badung, Bali.Keywords : Self Concept, Peer Group Acceptance, Adolescenct, Orphanage.
Dunia Sukarelawan Remaja: Frekuensi Aktivitas Kerelawanan dan Psychological Well-Being Sukarelawan Remaja di Bali
Authors: Natalya Ni Putu , Herdiyanto Yohanes Kartika
Published: November 2019

Voluntary activities are positive activities to facilitating the youth energy for psychologically health and have positive identity formation and predictors of psychological well-being (Bruns, 2012). These are appeal activities for youth. In fact, so much youth activity made a lot of volunteers who have been trained doesn?t participate in voluntary activities. However, there are some youth volunteers who have many years of volunteering spend some time to doing voluntary activities (Dewiyanti, 26 Oktober 2014). The amount of contributed time to voluntary activities may be related with self-acceptance, personal growth, positive relationship with others, environmental mastery, autonomy and purpose of life, there are part of psychological well-being. Purpose of this research are to know the correlation between the frequency of voluntary activities and psychological well-being and factors of that results in youth volunteers in Bali, also want to know the meaning of voluntary activities for youth volunteers in Bali.Methods of this research is quantitative combination in compelementary method (n = 398; age 13-22 years) and qualitative (n = 19 of 398). Spearman's test of quantitative data showed no significant correlation between the frequency of voluntary activities and psychological well-being of youth volunteers in Bali (Men rxy= 0,022;P=0,844, Women rxy= 0,033;P=0,556) because of early adolescence and frequency of voluntary activities can?t describe quality of voluntary activities. The meaning of voluntary activities by youth volunteer in Bali are a social identity, role and self esteem. Results of this research about factors of psychological well-being youth volunteer such as ages, quality voluntary activities, non-voluntary activities and meaning of voluntary activities will be discussed later.Keywords: volunteer, youth, psychological well-being