Investigating the perception and acceptance towards smartphone and its application as learning tool among Universiti Teknologi MARA dental students / Nor Faharina Abdul Hamid, Nur Saiyidah Hanisah Ali and Nadia Syahirah Mohd Nazri.

The development of smartphones throughout the years had made it a very valuable tool in teaching and learning activities. The purpose of this study was to investigate the perception and acceptance towards the use of smartphones as additional learning tool among Universiti Teknologi MARA (UiTM) dental students. Methods: All undergraduate dental students were invited to participate in a self‐ administered questionnaire (content validated, pre-tested) survey, conducted online, involving students across all academic years. Results: Of the 215 respondents, (99.1%) owned a smartphone, with majority of them were iPhone and Android user. 94%, n=202 of the respondent had access to internet data via a third generation (3G) mobile carrier and WiFi connection. Most of the respondents gave positive remarks of all ten statements in regards the perception and acceptance towards smartphone and its application as learning tool. 96.7%, n=208 of respondents agreed that smart phone help them in finding resources related to their study while 74%, n= 159 of them stated that smartphone can help them to manage their study. Conclusion: In conclusion, the results of this study suggested that UiTM undergraduate dental students have positive perception and acceptance towards use smartphones in teaching and learning activities

Xerophthalmia in picky eater children

Xeropthalmia refers to a range of ocular symptoms caused by vitamin A deficiency (VAD), ranging from night blindness and Bitot's spots to corneal xerosis, ulceration, and keratomalacia, which can lead to blindness. We report two cases of xerophthalmia in children with intellectual disabilities. Ocular examination revealed generalized conjunctival xerosis, corneal xerosis, and dense superficial punctate keratopathy. Both share a history of a strict self-selective diet of mainly rice and noodles. Serum vitamin A levels for these children showed a very low level (<0.10 µmol/L) and were categorized as severe VAD. One of the cases showed signs of improvement, and the other one succumbed to death secondary to pneumonia. Therefore, proper history-taking, early detection, and prompt treatment are important to prevent the devastating sequelae of VAD

Elevated alpha-fetoprotein in a 3-month-old infant: the significance in a patient with beckwith-wiedemann syndrome

A 3-month-old female infant with omphalocele, posterior cleft palate and bilateral hydronephrosis was inadvertently discovered to have macroglossia, hepatomegaly, and facial nevus flammeus during hospitalisation for community-acquired pneumonia. A clinical diagnosis of Beckwith-Wiedemann syndrome (BWS), a disease with a higher predisposition to developing embryonal tumours was made. A liver ultrasound revealed a haemangioma at section VIII with the absence of hepatoblastoma. A serum alpha-fetoprotein (AFP) of 413 IU/mL was initially a concern given it was 60 times higher than the stated reference interval but was noted to be age-appropriate and related to the patient’s underlying disease. This case report highlights the importance of reporting an AFP age-specific reference interval as well as the necessity of monitoring AFP in a child with BWS due to the higher risk of hepatoblastoma

A rare cause of primary adrenal insufficiency

Adrenal hypoplasia congenita (AHC) is a rare inherited condition due to the failure of the adult zone of the adrenal cortex to develop despite normal development of its foetal counterpart. Affected patients are usually asymptomatic at birth but will present with clinical features of acute adrenal insufficiency during early infancy. It is clinically indistinguishable from the more common congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency. Here, we report a case of a one-month-old male infant with primary adrenal insufficiency (PAI) whose initial laboratory investigations revealed hyponatraemia and severe hyperkalaemia. The early onset of PAI with the absence of ambiguous genitalia and low baseline and adrenocorticotropic-stimulated 17-hydroxyprogesterone and undetectable dehydroepiandrosterone sulfate levels, suggest the possibility of AHC in this infant. Genetic analysis is crucial to confirm the diagnosis of this condition and to differentiate from CAH as their prognoses and management differ

Reporting of hyperprolactinaemia post-polyethylene glycol (PEG) precipitation at Hospital Tengku Ampuan Rahimah Klang, Malaysia

Introduction: Macroprolactinaemia is defined as hyperprolactinaemia due to excess macroprolactin in the presence of normal monomeric prolactin. Failure to identify macroprolactinaemia may result in patients being subjected to unnecessary investigations and inappropriate treatment for hyperprolactinaemia. In our centre, screening for macroprolactinaemia is currently performed at the request of the treating physician. The study thus aimed to determine the frequency of macroprolactinaemia in samples with serum prolactin ≥700 mIU/L in Hospital Tengku Ampuan Rahimah (HTAR) and to determine the presence of true hyperprolactinaemia in these cases. Methods: A cross-sectional study among hyperprolactinaemic subjects in HTAR, using serum specimens received by the laboratory for measurement of prolactin between October 2018 and September 2019. Samples with prolactin ≥700 mIU/L were screened for macroprolactinaemia using the polyethylene glycol (PEG) precipitation technique. Macroprolactinaemia was present when the percentage recovery of prolactin post-PEG was &lt;40%. Assay-specific post-PEG monomeric prolactin levels were also reported, with levels above the upper limit of reference intervals indicated the presence of true hyperprolactinaemia. Results: A total of 101 samples were subjected to PEG precipitation. Macroprolactinaemia was found in four (4%) samples, whilst eight (7.9%) were categorised as indeterminate (percentage recovery of 40-60%). The remaining 89 (88.1%) samples had a percentage recovery &gt;60%, hence considered negative for macroprolactinaemia. All four samples with macroprolactinaemia also had raised monomeric prolactin levels indicating the co-existence of macroprolactinaemia in subjects with true hyperprolactinaemia. Similarly, in the indeterminate group, all eight had raised monomeric prolactin levels. Conclusion: In one-year period in HTAR, macroprolactinaemia was detected in 4% of subjects with prolactin ≥700 mIU/L, all of whom also had raised monomeric prolactin levels. The common occurrence of both macroprolactinaemia and true hyperprolactinaemia warrants the reporting of both percentage recovery and monomeric prolactin levels post-PEG

Topologies of DC-DC Converter in Solar PV Applications

Solar energy plays an important role in renewable energy generation systems since it is clean, pollution-free sustainable energy as well as the increasing cost-of-electricity which causes high-growth demands amongst utility customers. This paper presents various circuit topologies of DC-DC converters in solar photovoltaic (PV) applications. There are three types of DC-DC converter presented in this paper that can be integrated with solar PV system which are buck, boost and buck-boost converter in various applications. This paper also presents the application on DC-DC converter in solar PV system for maximum power point tracking (MPPT) feature. The advantages and disadvantages of each topology will be discussed further in term of cost, components, efficiency and limitations

Derivation and internal validation of an equation for albumin-adjusted calcium at a tertiary hospital in Selangor, Malaysia

Introduction: Total calcium concentration is widely used to assess body calcium status although limited by many confounding factors. Thus, this study aimed to derive and internally validate an albumin-adjusted calcium equation for a selected Malaysian population. Method: This cross-sectional study involved 1011 adults at an emergency department of a tertiary hospital. Patients who had total calcium, ionised calcium and albumin measurements taken simultaneously were included. Derivation of the albumin-adjusted calcium equation was based on the adjustment equation obtained from the Association for Clinical Biochemistry and Laboratory Medicine 2015 position paper. Additionally, the equation was internally validated and compared with ionised calcium (gold standard) and the conventional Payne’s equation. Results: The newly derived equation = total calcium + 0.017 (41.35 – albumin). Internal validation exhibited the amount of shrinkage of 0.049. It tends to overestimate the adjusted calcium by a mean difference of 0.029 mmol/L compared to Payne’s equation. The comparison between Payne’s equation and the new equation with ionised calcium reclassified 402 and 486 patients, respectively into different calcium status. When both equations were compared, calcium status classification significantly differed in all and hypoalbuminaemic subjects by 90 and 16 patients, respectively. Conclusion: Locally derived albumin-adjusted calcium equation differed statistically in calcium status classification when compared to the Payne’s equation. However, to confirm this significance, the result must be compared to ionised calcium under strict, controlled preanalytical conditions. In terms of clinical significance, there was no difference in classification of calcium status between Payne’s and the new equation at medical decision limits