Achieving social equity by addressing the needs of disabled people in heritage building conservation in Malaysia.

Social equity is one of the three main thrusts for a country’s sustainable development that is achieved only when a country fulfills the needs of everyone including those of disabled people. It is known that the design, implementation and management of heritage buildings, undertaken by both the public and private sectors, are influenced by conservation practices that may not consider the needs of disabled people. In Malaysia, with the passing of the National Heritage Act in 2005, it is important to ensure that conservation practices follow sustainable development principles, in particular, social equity. Our paper aims to show the extent to which services for disabled people are being provided in the Malaysian heritage tourism sector through four case studies of heritage buildings. The case studies were conducted to ascertain whether the concepts of Barrier-Free, which are 1. Accessibility, 2. Usability and 3. Safety, were adhered to in the design and management aspects of building conservation. Our survey method was using access audits based on the country’s standards and international guidelines. The results show that in all cases some attempts were made to create accessibility, but often conservation objectives tend to over-ride access. Clearly, a lot is still to be done to ensure that accessibility for disabled people is addressed in Malaysia

The adherence of doctors to brain CT referral criteria: a service evaluation survey from Basrah teaching hospital

Background: CT scans are increasingly utilised in outpatient and emergency departments due to their ability to facilitate swift diagnosis and treatment planning. However, inappropriate use of CT scans, particularly CT scans of the brain, can have negative consequences. Objectives: This study aims to evaluate the adherence of Basrah Teaching Hospital doctors to the international referral criteria for brain CT scans. Methods: A retrospective review of medical records was conducted to investigate the utilisation of brain CT scans in the radiology departments of Basra Teaching Hospital for two months and involved 108 referrals. The medical records were thoroughly reviewed to extract relevant information related to the indications of referral, referring doctor, referring place, brain CT results, and assessing the request form completions. The standard referral criteria were extracted from the United Kingdom and European brain CT referral guidelines. Results: Most of the referrals (75.9%) met the referral criteria, and most of the doctors, regardless of their levels, met the referral criteria; however, the highest rate was among the junior doctors (88.9%), followed by specialists and senior resident doctors. Moreover, most of the units adhered to the referral criteria, but the highest adherence rate was among those referrals from inpatient wards (91.7%). Furthermore, the majority of the doctors and most of the referring wards completed their request forms; however, the highest completion was in specialty and consultant doctors’ groups (77.8%). The results also showed that about half of positive brain CT results are due to neurological causes (46%), followed by head trauma referral (34.6%). Conclusions: The majority of the doctors at Basrah Teaching Hospital met the international standards for brain CT referrals, and most of the referral wards followed these guidelines

Clinical and Neurophysiological Evidence of Mononeuritis Multiplex During the COVID-19 Era

Infection with the novel coronavirus that causes coronavirus disease 2019 (COVID-19) results in a variety of clinical symptoms, including various neurological abnormalities. Peripheral nervous system symptoms, such as peripheral neuropathies, were often recorded in the medical literature, primarily as Guillain-Barré syndrome. Mononeuropathy multiplex is a multifocal axonal neuropathy commonly associated with vasculitis or connective tissue disease. Recent evidence about its associations with severe COVID-19 infection and intensive care unit hospitalization is being considered. A 58-year-old man with clinical and electrophysiological confirmation of mononeuropathy multiplex was reported during the peri-COVID-19 illness. He was treated with steroids and achieved a satisfactory response. Therefore, clinical and neurophysiological evaluation is recommended for any patient presenting with neurological manifestations following COVID-19 infection

Myographic evidence of polymyositis and dermatomyositis in COVID-19 patients

Idiopathic inflammatory myopathies, commonly known as myositis, are a diverse group of disorders defined clinically by persistent muscle weakness and reduced muscle endurance, as well as inflammatory cell infiltrates inside the muscle tissue. Myositis as a complication of coronavirus disease 2019 (COVID-19) has been described in an increasing number of reports. An analytical and cross-sectional study was undertaken in Basrah to analyze nerve conduction studies (NCS) and electromyographic (EMG) data in a COVID-19-affected patient. During the evaluation of 2240 patients, three cases of myositis were reported among the COVID-19 population, two of them with new clinical and EMG evidence of inflammatory myositis after the onset of COVID-19 infection, and one patient had a history of polymyositis before the COVID-19 pandemic, but a relapse was triggered by COVID-19, resulting in respiratory failure and death. The study found that the prevalence of myositis among the COVID-19 population was equal to 0.22%, which is 44 times higher than the prevalence of myositis (0.005%) worldwide before the onset of COVID-19 (P < 0.001)

Emerging Axonal Variants of Guillain Barré Syndrome “ AMAN and AMSAN “ as a Part of COVID-19 Sequalae

Background: Guillain-Barré syndrome (GBS) is an immune-mediated peripheral nerve disease. Its frequency was noticed to have increased during the COVID-19 period. Based on electrophysiological studies, the most common type of this disease is the demyelinating type. However, axonal types have also been seen. Methods: A large, analytical, cross-sectional study involving 2523 patients over a one-year period was conducted in Basrah, southern Iraq, to evaluate the neurophysiological changes for peripheral neuropathies following COVID-19 infection using nerve conduction studies and needle electromyography. The current study aims to evaluate the prevalence, clinical, and neurophysiological characteristics of patients with axonal variants of GBS. Results and conclusions: The study found that the axonal variants of GBS represent about 10% of the total reported GBS in the governorate, and they are developed in about 1 in 1000 patients attending the neurology and neurophysiology clinics who had a history of COVID-19 infectio

Warisan Budaya Miring dalam Masyarakat Iban di Sarawak

Ritual miring merupakan upacara memberi sajian persembahan makanan dan semahan sebagai tanda terima kasih kepada Petara (Tuhan) dalam budaya masyarakat Iban

Relationship between blood lead concentration and nutritional status among Malay primary school children in Kuala Lumpur, Malaysia.

A cross-sectional study was conducted to identify the relationship between blood lead concentration and nutritional status among primary school children in Kuala Lumpur. A total of 225 Malay students, 113 male and 112 female, aged 6.3 to 9.8 were selected through a stratified random sampling method. The random blood samples were collected and blood lead concentration was measured by a Graphite Furnace Atomic Absorption Spectrophotometer. The nutrient intake was determined by the 24-hour Dietary Recall method and Food Frequency Questionnaire. An anthropometric assessment was reported according to growth indices (z-scores of weight-for-age, height-for-age, and weight-for-height). The mean blood lead concentration was low (3.4 ± 1.91 ug/dL) and was significantly different between gender. Only 14.7% of the respondents fulfilled the daily energy requirement. The protein and iron intakes were adequate for a majority of the children. However, 34.7% of the total children showed inadequate intake of calcium. The energy, protein, fat and carbohydrate intakes were significantly different by gender, that is, males had better intake than females. Majority of respondents had normal mean z-score of growth indices. Ten percent of the respondents were underweight, 2.8% wasted and 5.4% stunted. Multiple linear regression showed inverse significant relationships between blood lead concentration with children's age (β= -0.647, p<0.001) and per capita income (β=-0.001, p=0.018). There were inverse significant relationships between blood lead concentration with children's age (β=-0.877, p=0.001) and calcium intake (β= -0.011,p=0.014) and positive significant relationship with weight-for-height (β=0.326, p=0.041) among those with inadequate calcium intake. Among children with inadequate energy intake, children's age (β= -0.621, p< 0.001), per capita income (β= -0.001,p=0.025) and protein intake (β= -0.019, p=0.027) were inversely and significantly related with blood lead concentration. In conclusion, nutritional status might affect the children's absorption of lead and further investigation is required for confirmation

Firefly distribution and abundance on mangrove vegetation assemblages in Sepetang estuary, Peninsular Malaysia

Pteroptyx fireflies are commonly reported to congregate in large numbers in mangroves. Not much is known about the relationships between firefly distribution and abundance with specific mangrove vegetation assemblages. We conducted a study to investigate the vegetation assemblages that structure the distribution and abundance of Pteroptyx tener in Peninsular Malaysia. The distribution and abundance of fireflies were assessed along an 8 km stretch of mangroves in Sepetang estuary using visual assessment. Statistical analysis was carried out to test the correlation between length of display section and percentage cover of P. tener colonies and the relationship between percentage cover of fireflies with different vegetation assemblages. Five distinct vegetation assemblages were identified comprising different combination of four mangrove species. It was found that shorter display sections had higher percentage cover of P. tener colonies. In addition, vegetation assemblage which consisting of mainly Sonneratia caseolaris and Nypa fruticans was the most preferred type. The results of this study point to the necessity to consider not only a single mangrove species but the entire vegetation assemblage for firefly conservation