Express bus consortium : towards achieving the economies of scale case study : Transnasional Express Sdn. Bhd. / Nik Husna Nik Abdullah

Public transportation has become important today as to move people from one place to another place. One of the most popular public transportation is express bus service. The express bus service connecting two points over 100 kilometers being provided by a comfortable coach, as it takes a long journey. Nowadays, many operators exist to operate the express bus service as it seems to bring a profitable income, thus increase the competition among operators. Towards solving the problem, government has made a decision to form two consortiums to lead the industry. Two major companies has been chosen to lead the consortia, namely Mara Holding Sdn. Bhd (Transnasional Express Sdn. Bhd.) and Park May Berhad. The consortiums to achieve the government's objective towards providing an efficient and effective public transportation to the public

Ni endoscopic classification for Storz Professional Image Enhancement System (SPIES) endoscopy in the detection of upper aerodigestive tract (UADT) tumours

The diagnostic procedure for upper aerodigestive tract (UADT) tumours is by white light endoscopy (WLE) combined with biopsy. However, WLE has difficulty identifying minute epithelial changes which hinders early diagnosis. Storz Professional Image Enhancement System (SPIES) is designed to enhance the visualization of microvasculature on the mucosal surface and detect any epithelial changes. In this study, we aimed to evaluate the use of Ni endoscopic classification with SPIES endoscopy in the detection of UADT tumours. Fifty-nine patients with suspected UADT tumours underwent WLE followed by SPIES endoscopy. All the tumours were biopsied and sent for histopathological examination (HPE). The kappa index (kappa) was used to evaluate the agreement between the methods. The level of agreement between SPIES using Ni classification and HPE showed almost perfect agreement as compared to moderate agreement between WLE and HPE. The sensitivity and specificity for WLE and HPE were 77.5% and 84.2% respectively with positive predictive value (PPV) of 91.2% and negative predictive value (NPV) of 64%. The sensitivity and specificity for SPIES endoscopy using Ni classification and HPE were 97.5% and 94.7% respectively with PPV of 97.5% and NPV of 94.7%. SPIES endoscopy using Ni classification is a valid tool for earlier tumour detection

Case report: Unusual cause of difficulty in intubation and ventilation with asthmatic-like presentation of Endobronchial Tuberculosis

Endobronchial Tuberculosis is hazardous in causing circumferential narrowing of tracheobronchial tree despite the eradication of tubercle bacilli in the initial insult from Pulmonary Tuberculosis. They may present as treatment resistant bronchial asthma and pose challenge to airway management in the acute setting. We present a 25 year-old lady who was newly diagnosed bronchial asthma with a past history of Pulmonary Tuberculosis that had completed treatment. She presented with sudden onset of difficulty breathing associated with noisy breathing for 3 days and hoarseness of voice for 6 months. Due to resistant bronchospasm, attempts were made to secure the airway which led to unanticipated difficult intubation and ventilation. Subsequent investigations confirmed the diagnosis of Endobronchial Tuberculosis and patient was managed successfully with anti TB medication, corticosteroids and multiple sessions of tracheal dilatation for tracheal stenosis. This case highlights the unusual cause of difficulty in intubation and ventilation due to Endobronchial Tuberculosis, which required medical and surgical intervention to improve the condition

Habitual non-traumatic cricothyroid joint dislocation: a rare case of rotated larynx

A case of a 21 year old gentleman is described, with no history of preceding trauma, presenting with intermittent dysphagia to solids and fluids for 4 years. Neck examination at rest was normal. However on deep inspiration, the right thyroid lamina protrudes or becomes more prominent. The patient is able to return the larynx to its normal position with manual manipulation. Laryngeal examination with fibreoptic scope during rest and deep breath shows gross rotation of the laryngeal structures for more than 60° on deep breath, with the vocal cords axis rotated to the left side. Management was conservative

Optimization of a protease extraction using a statistical approach for the production of an alternative meat tenderizer from Manihot esculenta roots

Meat tenderness is the most important criterion in food quality because it strongly influences the consumer’s satisfaction. Tenderness generally depends on connective tissue and sarcomere length of muscle. One of the effective methods for meat tenderizing is protease treatment. In this study, Manihot esculenta root was chosen as a protease source due to its skin blistering effect, suggesting the presence of strong proteolytic activity. The extraction of the crude protease was optimized by using response surface methodology (RSM) with four independent variables, which were pH (X1), CaCl2 (X2), Triton X-100 (X3) and 2-mercaptoethanol (X4). Based on the RSM model, all the independent variables were significant and the optimum extraction conditions were pH 9, 3.24 mM CaCl2, 4.12% Triton X-100 and 6.32 mM 2-mercaptoethanol. Tukey’s test results showed that the difference between the expected and experimental protease activity value was 0.05%. A reduction of meat firmness was observed when samples treated with enzyme were compared with a control by using a texture analyser. Electrophoretic patterns also showed extensive proteolysis and a reduction of intensity and number of the protein bands in the treated sample. SEM clearly revealed the degradation of muscle fibres and connective tissue of meat treated with crude protease

Larvicidal effectiveness of azolla pinnata against aedes aegypti (Diptera: Culicidae) with its effects on larval morphology and visualization of behavioural response

Dengue is vector-borne diseases with 390 million infections per year extending over 120 countries of the world. Aedes aegypti (L.) (Diptera: Culicidae) is a primary vector for dengue viral infections for humans. Current focus on application of natural product against mosquito vectors has been the main priority for research due to its eco-safety. The extensive use of chemical insecticides has led to severe health problems, environmental pollution, toxic hazards to human and nontarget species, and development of insecticide resistance on mosquitoes. Azolla pinnata is an aquatic fern and predominantly used as feed in poultry industry and as fertilizer in agricultural field for enhancing the fertility of rice paddy soil. The present study was conducted to explore the larvicidal efficacy of A. pinnata using fresh and powdered form against late third-stage larvae (6 days, 5 mm in larvae body length) of Ae. aegypti (L.) (Diptera: Culicidae). The larvicidal bioassays were performed using World Health Organization standard larval susceptibility test method for different concentration for powdered and fresh A. pinnata. Powdered A. pinnata concentration used during larvicidal bioassay ranges from 500ppm to 2000ppm; meanwhile, fresh A. pinnata ranges from 500ppm to 9,000,000 ppm. The highest mortality was at 1853 ppm for powdered A. pinnata compared with fresh A. pinnata at 2,521,535 ppm, while the LC50 for both powdered and fresh A. pinnata recorded at 1262 ppm and 1853 ppm, respectively. Finally, the analysis of variance (ANOVA) showed significant difference on Ae. aegypti larval mortality (F=30.439, df=1, p≤0.001) and concentration (F=20.002, df=1, p≤0.001) compared to powdered and fresh A. pinnata at 24-hour bioassay test. In conclusion, the powdered A. pinnata serves as a good larvicidal agent against Ae. aegypti (L.) (Diptera: Culicidae) and this study provided information on the lethal concentration that may have potential for a more eco-friendly Aedes mosquito control program

Chetty: the unforgotten

Melaka is one of the historical cities which is famous with its culture and heritage values. Unfortunately, Chetty’s community is closely to be left out and forgotten despite of any tourism commercialization by the Melaka State Government. Therefore, in order to make this Chetty’s community to be acknowledged by the local people and tourists around the world, the concept of Augmented Reality is vital to be introduced in order to curb the distinction of this community. This initiative is produced in live brochure form to promote the culture and custom of the Chetty’s community in Melaka which resulted from an improper medium of marketing and promotion. Furthermore, this live brochure comprises of all the information related to the Chetty’s community such as navigation, attractions, activities, customs and lifestyle that present the Chetty’s features which located in Kampung Gajah Berang. Nevertheless, this initiative can lift up their image as one of the unique minority ethnics in Melaka World Heritage Site. The live brochure will also benefit the Chetty’s community in tourism activities specifically in preserving the priceless values of that community based on their history and custom which could be protected. Consequently, it will become one of the attractive tourism destinations in Melaka World Heritage Site with exclusive design of the brochure and able to captivate the tourists’ attention