Sedation with dexmedetomidine versus propofol during regional anaesthesia: comparing haemodynamic parameters, respiratory rates and offset times

This study aimed to compare dexmedetomidine and propofol, in terms of haemodynamic parameters, respiratory rates and offset times, when used for sedation in patients undergoing elective orthopaedic and surgical procedures under regional anaesthesia. This was a prospective, randomised, single-blind study where 88 patients were recruited. Patients were randomised into two groups to receive either dexmedetomidine or propofol infusion. Central neuraxial blockade (spinal, epidural or combined spinal epidural) was performed. After ensuring an adequate block and stable haemodynamic parameters, dexmedetomidine was infused 15 minutes later at 0.4 ?g/kg/hr, and propofol, at a target concentration of 2.5 ?g/ml. Both drugs were titrated to achieve a bispectral index score of 70 before surgery commenced. Sedation level was monitored using the bispectral index score and assessed by the Observer Assessment of Alertness Scale score. Drug infusion was adjusted to maintain bispectral index scores ranging between 70-80 during surgery. Both groups showed reductions in mean arterial pressure and heart rate from baseline readings throughout the infusion time. However there was no significant reduction in the first 15 minutes from baseline (p > 0.05). Haemodynamic parameters and respiratory rate between both groups were not significantly different (p > 0.05). No patient demonstrated significant respiratory depression or SpO2 ? 95%. Offset times were also not significantly different between both groups (p = 0.594). There were no significant differences in haemodynamic parameters, respiratory rates and offset times between dexmedetomidine and propofol used for sedation in patients undergoing elective orthopaedic and surgical procedures under regional anaesthesia

Assessment of GHG emission reduction potential from Source-separated Organic Waste (SOW) management: case study in a Higher Educational Institution in Malaysia

In Malaysia, the greenhouse gases (GHGs) emissions reduction via composting of source-separated organic waste (SOW) in municipal solid waste (MSW) has not been assessed. Assessment of GHG emissions reduction via composting of SOW is important as environmental impacts from waste management are waste-specific and local-specific. The study presents the case study for potential carbon reduction via composting of SOW in University of Malaya (UM). In this study, a series of calculations were used to evaluate the GHG emission of different SOW management scenarios. The calculations based on IPCC calculation methods (AM0025) include GHGs emissions from landfilling, fuel consumption in transportation and SOW composting activity. The methods were applied to assess the GHG emissions from five alternative SOW management scenarios in UM. From the baseline scenario (S0), a total of 1,636.18 tCO2e was generated. In conjunction with target of 22% recycling rate, as shown in S1, 14% reduction in potential GHG emission can be achieved. The carbon reduction can be further enhanced by increasing the SOW composting capacity. The net GHG emission for S1, S2, S3 and S4 were 1,399.52, 1,161.29, 857.70 and 1,060.48 tCO2e, respectively. In general, waste diversion for composting proved a significant net GHG emission reduction as shown in S3 (47%), S4 (35%) and S2 (29%). Despite the emission due to direct on-site activity, the significant reduction in methane generation at landfill has reduced the net GHG emission. The emission source of each scenario was studied and analysed

Pantun suku Kaum Mah Meri

Makalah ini membicarakan pantun yang terdapat di kalangan suku kaum Orang Asli Mah Men\u27 Pulau Carey dari segi asal usul, tema, motif dan fungsi. Suku kaum Mah Meri ini adalah subgolongan Senoi yang mendiami bahagian pesisir pantai negeri Selangorterutama di Pulau Carey. Pantun sejumlah 124 rangkap sama ada yang diujarkan dalam bahasa Bersisi dan bahasa Melayu telah diperolehi hasil penyelidikan di Kampung Sungai Judah, Kampung Sungai Rambai, dan Kampung Sungai Bumbun, Pulau Carey, Kuala Longat, Selangor: Umumnya, pantun Mah Meri menyerupai pantun Melayu kerana amalan berpantun adalah peminjaman daripada budaya Melayu hasil hubungan sosial golongan ini dengan orang Melayu tempatan, khususnya di kawasan Kelanang dan Jugra, di Kuala Longat. Pantun Mah Meri berkecenderungan bertemakan kasih sayang dan bemotifkan tempatan. Motif ini pula terdiri daripada objek-objek tempatan di Pulau Carey dan sekitarnya seperti topografi kawasan, nama tempat, sungai, serta bukit. Motif-motif itu dijalin dan diadunkan dengan sebaik mungkin untuk disesuaikan dengan tuntutan ciri-ciri pantun yang sungguh ketat. Walau bagaimana ketat sekalipun tunrutan ciri-ciri itu, pantun golongan Orang Asli Mah Meri ini seperti juga pantun orang Melayu lain berkeupayaan menonjolkan unsur keindahan dan seterusnya menyerlahkan jati diri golongan yang memilikinya. Kebiasaannya pantun ini disampaikan secara berlagu sama seperti orang Melayu melagukan dondang sayang, yang dinyanyikan bagi mengiringi tarian Jo\u27oh, iaitu satu tarian tradisi mereka

Corporatization and privatization of public services: origins and rise of a controversial concept

The Malaysian government has been implementing its policy of corporatization and privatization of public services (including social services such as health) since 1983. In this article, the concept of privatization of public services is traced back to the crisis of the welfare state in Britain and America and the influence of intellectuals and think tanks that favour free market policies and abhor government intervention in economic affairs. The growth in influence of this concept illustrates the impact that intellectuals can have when their ideas fall on the ears of sympathetic politicians and political movements under certain socioeconomic climates

Globalisasi dan negara pembangunan

Artikel ini membincangkan dampak globalisasi ke atas keupayaan negara untuk campur tangan dalam pembangunan berdasarkan wacana pembangunan kontemporer. Memang benar bahawa kegawatan ekonomi 1997 dan krisis ekonomi Jepun yang berpanjangan telah menyebabkan peranan negara dalam pembangunan semakin dipertikaikan. Negara dianggap tidak lagi relevan dan sepatutnya berundur bagi membolehkan pasaran mengendalikan urusan ekonomi secara lebih efisien. Walau bagaimanapun, soal pembangunan dan agihan tidak boleh diserahkan kepada kuasa pasaran semata-mata, peranan negara masih diperlukan tetapi negara mesti mengubahsuai peranannya supaya terus relevan seperti yang dibuktikan oleh kes Jepun, Korea Selatan dan Malaysia. Era negara autoriter yang dipimpin oleh tokoh-tokoh kuat sudah berlalu atas desakan pendemokrasian. Pada hari ini, negara masih boleh berperanan dalam pembangunan dengan syarat, ia memajukan pembangunan yang mesra-rakyat, iaitu pembangunan yang tidak mengenepikan soal kebebasan dan pilihan rakyat yang diperjuangkan oleh masyarakat sivil. Artikel ini menyimpulkan bahawa negara pembangunan boleh terus aktif dalam merangsang pertumbuhan dan mengagihkan kekayaan negara dengan menumpukan pada soal tadbir urus baik dan ketelusan

The role of NGOs and non-state actors in malaysia\u27s foreign policy formulation during the Mahathir era

In East Asia, during the 1990s, research on the foreign policies of certain countries began when private, non-profit organisations took a keen interest in promoting good governance. During this time, rapid economic growth in these countries had generated new complications brought on by the effects of economic and cultural globalization, hence the urge to apply theories of good governance. Complications culminated in the 1997 East Asian financial crisis. The aftermath of this disaster left many countries struggling with tottering economies, devalued currencies and rising unemployment, not to mention the social and political upheavals that subsequently developed. In many instances, the foreign policies of these countries were directly affected by modifications in the domestic political economy. This in turn had obvious impacts on the foreign policies of these countries. This paper discusses the domestic dynamics in Malaysian society during the premiership of Tun Dr. Mahathir Mohamad. The findings suggest that the Mahathir era signaled new areas of focus in Malaysia\u27s foreign relations, and that his administration had developed more involved mechanisms for foreign policy decision-making, particularly by engaging non-governmental organisations (NGOS) and other non-state actors

Are brain natriuretic peptide levels related to flow through autologous Aterio-venous fistulae for chronic haemodialysis?

Formation of arterio-venous-fistulae (AVF) may exacerbate cardiac failure in the ever increasing, elderly population on haemodialysis. Brain Natriuretic Peptide (BNP) may prove a useful marker of cardiac failure in this population. We aimed to determine effect of creation of an AVF and flow in AVF on BNP levels. Ten patients undergoing primary formation of an upper limb autologous AVF (pre-dialysis), were recruited. Serum BNP (pg/ml) and flow in AVF (cm3/s) were documented pre-operatively, and then 2, 6 and 12 weeks post-operatively. The relationship between flow and BNP levels was assessed. Ten patients (6 male), mean age of 66yrs were recruited. Five patients had a radio-cephalic and 5 had a brachio-cephalic AVF formed. There was no correlation between BNP levels and flow within the AVF (r=0.34, p=0.28) at any time point. There was a general trend towards increased flow in the AVF over time, with only the change between flow at 2-weeks and 3-months postoperatively reaching significance, p=0.043. There was a general trend for BNP to fall over time in the postoperative period, with no significant change between the postoperative sampling time points. BNP levels do not correlate with flow across an AVF

Anthropometric variables and nutritional status of adolescent school girls in a food insecure rural area of Bangladesh

This study estimated the anthropometric variables and nutritional status of rural adolescent school girls of food insecure Bera subdistrict of Pabnam district in Bangladesh. The cross sectional study was carried out in rural adolescent school girls of 21 governments approved high schools of Bera sudistrict of Pabna district, Bangladesh. Anthropometric and socio-demographic information from 2,196 adolescent girls were collected during 2011-2012 academic session. Height and weight were measured using standard procedure and the body mass index (BMI) was calculated. BMI was compared to the 2007 WHO growth reference. Height- for-age (HAZ), weight-for-age (WAZ) and BMI-for-age (BMIZ) were used to evaluate stunting, underweight and thinness respectively, based on the National Centre of Heath Statistics (NCHS) < - 2 Z score values. Classification of severity of malnutrition was done based on WHO recommendation. Mean BMI-for-age were less than those of 2007 WHO growth reference for girls at all ages.The overall rate of stunting, underweight and thinness was 33.13%, 28.06% and 17.92% respectively. Based on WHO classification of severity of malnutrition, the overall prevalence of stunting was high (30-39%), whereas those of underweight 20-29% was high. This study concludes that poor anthropometric variables and nutritional status among the adolescents indicated a major public health problem in food insecure rural areas of Bangladesh. An intensive and comprehensive approach is required to improve the nutritional status of rural adolescent girls of Bangladesh

Penglibatan ahli komuniti dalam program pembangunan komuniti: satu kajian ke atas program homestay di Kedah

Penglibatan ahli komuniti di dalam apa jua program pembangunan, termasuk program pembangunan pelancongan, merupakan pemacu dalam usaha mencapai kelestarian pembangunan. Namun begitu, terdapat kelopongan mengenai bagaimana sebenarnya penglibatan ahli komuniti di peringkat akar umbi. Artikel ini membincangkan ciri-ciri penglibatan ahli komuniti dalam program yang dirangka untuk pembangunan komuniti berdasarkan dapatan kajian yang dijalankan terhadap dua program homestay di Kedah. Kajian ini menghasilkan satu model untuk membantu kita memahami faktor-faktor yang mempengaruhi penglibatan ahli komuniti dalam program pembangunan komuniti