Hypertensive patients' preferences for complementary and alternative medicine and the influence of these preferences on the adherence to prescribed medication

Purpose: This study aimed to understand hypertensive patients' perceptions of and adherence to prescribed medication. Methods: A qualitative research study based on 23 purposely selected participants from a community health clinic in Malaysia. The participants underwent in-depth semi-structured interviews, and the data were analyzed using qualitative content analysis method. Results: The participants were presented with six types of perceptions of medication. The majority of the participants had negative perceptions of Western medicine (WM), self-adjusted their prescribed medication with complementary and alternative medicine (CAM) and concealed their self-adjusting habits from their doctors. Participants who thought positively of WM took their prescribed medication regularly. Most of the participants perceived the nature of WM as not being curative because of its side effects. Patients have the right to choose their preferred medication when they understand their illness. Conclusion: Local health care systems should provide patients with alternative health services that suit their requests

Formation Of Chitosan-Alginate Capsules Using Extrusion-Dripping Method: Effect Of Stirring Speed And Biopolymers Types

Abstract: The aim of this study was to investigate the effect of stirring speed and biopolymer types on size and shape of chitosan-alginate capsules produced through extrusion-dripping method. Chitosanalginate capsules were produced by extruding chitosan-calcium chloride solution into sodium alginate solution. As a result, capsules with defined inner core and membrane were formed. Under the tested conditions, chitosan-alginate capsules with diameter in a range of 3.6 mm to 4.1 mm were produced. The result shows that the shape of chitosan-alginate capsules was significantly affected by the stirring speed. At the stirring speed of 600 rpm, mainly small and spherical capsules were produced. It was found that chitosan-alginate capsules produced from guluronic acid-rich alginate (AHG) were larger in term of diameter and membrane thickness as compared to those produced from mannuronic acid-rich alginate (AHM). The molecular weight of chitosan has no significant effect on diameter, shape and membrane thickness of the capsules

The Macrobrachium rosenbergii nodavirus: a detailed review of structure, infectivity, host immunity, diagnosis and prevention

The Macrobrachium rosenbergii nodavirus causes white tail disease, which primarily infects giant freshwater prawns, Macrobrachium rosenbergii. The infection leads to almost 100% mortality in post-larvae, causing significant economic losses in aquaculture farms. To develop effective measures against outbreaks, a good understanding of the virus is essential. In this review, we discuss key aspects of the Macrobrachium rosenbergii nodavirus including its structure, mechanisms of transmission and infection and common strategies for detection and prevention of outbreaks. Structurally, cryogenic electron microscopy revealed that the nodavirus has a T = 3 icosahedral structure with dimeric blade-like spikes on its surface. Homology modelling comparing wild-type and enzymatically cleaved Macrobrachium rosenbergii nodavirus-like particles revealed the significance of these spikes or protruding domains for binding. In vitro and in vivo studies have identified key aspects of Macrobrachium rosenbergii nodavirus infectivity, including (i) the viral binding targets such as transglutaminase and caveolin-1, (ii) utilisation of B2-like proteins in promoting infectivity and intracellular migration, (iii) replication mechanisms and (iv) co-infection with the extra small virus. Though susceptible at a post-larvae stage, adult Macrobrachium rosenbergii is immune to Macrobrachium rosenbergii nodavirus infection. During outbreaks, polymerase chain reaction and in situ hybridisation-based detection techniques are commonly used to identify infected populations. Currently, the most useful strategies for an outbreak are physical biosecurity measures and prophylaxis such as vaccination and immunostimulants. Finally, critical gaps in research include development of immortalised shrimp cell models, elucidation of time-resolved protein changes post-infection and development of therapies to treat infections to mitigate economic losses during outbreaks

Clinical spectrum of children receiving palliative care in Malaysian hospitals

Introduction: Awareness for paediatric palliative care has resulted in the impetus for paediatrician-led palliative care services across Malaysia. However, there is paucity of local data on patients receiving hospital-based paediatric palliative care. We aim to review the clinical spectrum of patients referred to these services. Methods: An observational study of children aged between 0-18 years receiving palliative care at 13 hospitals between 1st January and 31st December 2014 was carried out. Results: There were 315 patients analysed, 90 (28.6%) and 46 (14.6%) were neonates and adolescents respectively. The main ICD-10 diagnostic categories for all patients were identified to be ‘Congenital malformations, deformations and chromosomal abnormalities’ 117 (37.1%), ‘Diseases of nervous system’ 76 (24.1%) and ‘Neoplasms’ 60 (19.0%). At referral 156 (50%) patients had holistic needs assessments. Patients with ‘Diseases of nervous system’ were assessed to have significantly more physical needs than the other two diagnostic categories. Majority of patients who knew of their diagnosis and prognosis were those with malignancy. Over a fifth of referrals were at their terminal admission. Of 144 who died, 111 (77.1%) had advanced care plans. There was bereavement follow-up in 98 (68.1%) patients. Conclusion: Patients referred for palliative care have varied diagnoses and needs. To ensure all paediatricians are competent to deliver quality care to all children, further education and training initiatives is imperative

Pattern of head injury in motorcycle fatalities

Head injury contributes to a significant proportion of motorcycle fatalities. The site and pattern of head injury in victims of fatal motorcycle crashes in 1995 were studied retrospectively. The site of impact on the head was determined based on the injuries on the scalp, pattern of skull fractures and injuries of the brain. Of 54 cases, 9 had massive crush injuries. Of the remaining 45 cases, the site of impact was as follows: frontal 21, lateral 14, posterior 4, vertex 1, chin 1 and unascertainable in 4 cases. The majority of injuries occurred on the front and lateral aspects of the skull. Motorcycle helmets are currently tested for impact energy attenuation and penetration test at the vertex. Helmet standards need to take into account site and nature of injury

Knowledge-based contextual processor for text recognition

Proceedings of the Conference on Artificial Intelligence Applications465-PCAA

Understanding the perception concerning medication and types of adherence behaviour in hypertensive patients

Hypertension is a significant public health problem. Despite the availability of effective treatment, non-adherence to treatment has been identified as the main cause of failure in controlling hypertension. The fragmented pattern of research related to adherence is unavoidable because it is a complex phenomenon and affects not only the health of patients but also their entire lives. The research gap in this field is the absence of the patients’ perspective and a dearth of qualitative research. The aim of this study was to understand the patients’ perception concerning medication and the extent that these perceptions are reflected in adherence behaviour. This is a qualitative exploratory study on hypertensive patients in a community health clinic in the state of Selangor, Malaysia. It was found that the participants perceive prescribed Western Medicine (WM) from the clinic as scientifically proven but has undesirable side effects. Therefore, Complementary and Alternative Medicine (CAM) are used to counteract the harmful effects of WM. The types of adherence behaviour found include faithful follower, self-regulator and intentional non-adherer. The reason to engage in particular adherence behaviour indicates a contextual relationship with the perception concerning the medication. Thus, it was concluded that patients acquire knowledge phenomenologically to cope with hypertension. Therefore, to improve self-management and self-efficacy in adherence with treatment, patient-tailored education and an empowerment approach should be introduced