Characteristics, Risk Factors, and Treatment Practices of Known Adult Hypertensive Patients in Saudi Arabia

Objective. To determine the prevalence, risk factors, characteristics, and treatment practices of known adult hypertensives in Saudi Arabia. Methods. Cross-sectional community-based study using the WHO stepwise approach. Saudi adults were randomly chosen from Primary Health Care Centers catchment areas. Data was collected using a questionnaire which included sociodemographic data, history of hypertension, risk factors, treatment practices, biochemical and anthropometric measurements. Collected data was cheeked, computer fed, and analysed using SPSS V17. Results. Out of 4719 subjects (99.2% response), 542 (11.5%) subjects were known hypertensives or detected by health workers in the past 12 months. Hypertension was significantly associated with age, gender, geographical location, education, employment, diabetes, physical inactivity, excess body weight, and ever smoking. Multiple logistic analysis controlling for age showed that significant predictors of hypertension were diabetes mellitus, ever smoking, obesity, and hypercholesteremia. Several treatment modalities and practices were significantly associated with gender, age, education, and occupation. About 74% were under prescribed treatment by physicians, 62% on dietary modification, 37% attempted weight reduction, 27% performed physical exercise, and less than 7% used herbs, consulted traditional healers or quitted smoking. Income was not significantly associated with any treatment modality or patient practices. Conclusion. Hypertension (known and undetected) is a major chronic health problem among adults in Saudi Arabia. Many patients' practices need changes. A comprehensive approach is needed to prevent, early detect, and control the disease targeting, the risk factors, and predictors identified

Sustaining Competitiveness Through Product Development Activities Within Malaysian Automotive Suppliers

The local automotive suppliers are facing a number of important challenges such asglobalisation, new requirement in market specifications and the competition brought about by theAsean Free Trade Area (AFTA) agreements. In an effort to enhance the competitiveness of themanufacturing sector, the government has implemented the Second Industrial Master Plan, IMP2(1996-2005). The focus of the IMP2 is more on innovation and applications of new technologies, sothat industries can move up the value chain of their activities. Innovative capabilities achieved fromcompanies\u27 new product development activities have been recognized to be crucial for companies tosustain their competitiveness and organisational success. The importance of product development ismost obvious in the context of the discussion on the competitiveness of the Malaysian automotivesuppliers. The study will focus on the small medium enterprises (SMEs) that make up more than 60 %of these automotive suppliers. The study is to determine the extensiveness of the suppliers\u27 productdevelopment activities by examining the involvement of the suppliers in customer\u27s productdevelopment activities. Consequently, the impact of this involvement to the competitiveness of thesuppliers is examined. The results were established based from a survey to parts and componentssuppliers of Proton, the Malaysian car national assembler. The study has shown that the SMEs wereinvolved from the early stages of the product development process that is during the design stage. Theproduct development efforts have shown to contribute towards increasing firms\u27 market share andfirms were also able to gain a better understanding of future product demand. A significant number ofthe suppliers have managed to penetrate the export market. Unfortunately, among the respondents,there is only one system supplier. This indicates that, either the technological capabilities of theSMEs still needed upgrading for the requirement as a system suppliers or it may not be the onlydeciding factor for suppliers to be chosen as system suppliers. It is intended that this paper shouldserve to inform management in particular the suppliers on the present status of the SMEs in seekingto improve their competitiveness from product development effort

An Unbiased Systems Genetics Approach to Mapping Genetic Loci Modulating Susceptibility to Severe Streptococcal Sepsis

Striking individual differences in severity of group A streptococcal (GAS) sepsis have been noted, even among patients infected with the same bacterial strain. We had provided evidence that HLA class II allelic variation contributes significantly to differences in systemic disease severity by modulating host responses to streptococcal superantigens. Inasmuch as the bacteria produce additional virulence factors that participate in the pathogenesis of this complex disease, we sought to identify additional gene networks modulating GAS sepsis. Accordingly, we applied a systems genetics approach using a panel of advanced recombinant inbred mice. By analyzing disease phenotypes in the context of mice genotypes we identified a highly significant quantitative trait locus (QTL) on Chromosome 2 between 22 and 34 Mb that strongly predicts disease severity, accounting for 25%–30% of variance. This QTL harbors several polymorphic genes known to regulate immune responses to bacterial infections. We evaluated candidate genes within this QTL using multiple parameters that included linkage, gene ontology, variation in gene expression, cocitation networks, and biological relevance, and identified interleukin1 alpha and prostaglandin E synthases pathways as key networks involved in modulating GAS sepsis severity. The association of GAS sepsis with multiple pathways underscores the complexity of traits modulating GAS sepsis and provides a powerful approach for analyzing interactive traits affecting outcomes of other infectious diseases

The Hall Technique; a randomized controlled clinical trial of a novel method of managing carious primary molars in general dental practice: acceptability of the technique and outcomes at 23 months

<p>Abstract</p> <p>Background</p> <p>Scotland has high levels of untreated dental caries in primary teeth. The Hall Technique is a simplified method of managing carious primary molars using preformed metal crowns (PMCs) cemented with no local anaesthesia, caries removal or tooth preparation. This study compared the acceptability of the Hall Technique for children, their carers, and dentists, and clinical outcomes for the technique, with conventional restorations.</p> <p>Methods</p> <p>General dental practice based, split mouth, randomized controlled trial (132 children, aged 3–10). General dental practitioners (GDPs, n = 17) in Tayside, Scotland (dmft 2.7) placed conventional (Control) restorations in carious primary molars, and Hall Technique PMCs on the contralateral molar (matched clinically and radiographically). Dentists ranked the degree of discomfort they felt the child experienced for each procedure; then children, their carers and dentists stated which technique they preferred. The teeth were followed up clinically and radiographically.</p> <p>Results</p> <p>128 conventional restorations were placed on 132 control teeth, and 128 PMCs on 132 intervention teeth. Using a 5 point scale, 118 Hall PMCs (89%) were rated as no apparent discomfort up to mild, not significant; for Control restorations the figure was 103 (78%). Significant, unacceptable discomfort was recorded for two Hall PMCs (1.5%) and six Control restorations (4.5%). 77% of children, 83% of carers and 81% of dentists who expressed a preference, preferred the Hall technique, and this was significant (Chi square, p < 0.0001). There were 124 children (94% of the initial sample) with a minimum follow-up of 23 months. The Hall PMCs outperformed the Control restorations:</p> <p>a) 'Major' failures (signs and symptoms of irreversible pulpal disease): 19 Control restorations (15%); three Hall PMCs (2%) (P < 0.000);</p> <p>b) 'Minor' failures (loss of restoration, caries progression): 57 Control restorations (46%); six Hall PMCs (5%) (P < 0.000)</p> <p>c) Pain: 13 Control restorations (11%); two Hall PMCs (2%) (P = 0.003).</p> <p>Conclusion</p> <p>The Hall Technique was preferred to conventional restorations by the majority of children, carers and GDPs. After two years, Hall PMCs showed more favourable outcomes for pulpal health and restoration longevity than conventional restorations. The Hall Technique appears to offer an effective treatment option for carious primary molar teeth.</p> <p>Trial registration number</p> <p>Current Controlled Trials ISRCTN47267892 – A randomized controlled trial in primary care of a novel method of using preformed metal crowns to manage decay in primary molar teeth: the Hall technique.</p

Postural comfort of driver works space in vehicle package design geometry: A pilot study on malaysian drivers in sedan car and MPV

The study of driver posture and comfort in driver workspace is important in vehicle package design especially in two different type of vehicle, sedan and Multi-Purpose Vehicle (MPV). Due to different seat position in the driver workspace, investigation of driver accommodation in relations to driver anthropometry is essential to ensure its meet the ergonomic quality. Therefore, this research is to investigate the preferred driving posture of Malaysian driver in both sedan and MPV type of car. Sixty two subjects (32 males and 30 females) aged between 17-60 years old were selected to simulate the comfortable driving posture using mock-ups of sedan car and MPV. Measurements based on SAE J1100 vehicle package design geometry were carried out for each subject. Result shows slight differences in the range of posture angle between the two types of vehicles, the posture joint angle in MPV is slightly smaller as compared to those of sedan car. The range postural angles for Malaysian driver population also is slightly smaller compare to Caucasian people especially on lower body portion such as knee angle, hip angle and ankle angle. These angles are due to the body stature and body segment length in which the population of Malaysia have shorter thighs and legs than those in Europe and America

Fetal kicking monitoring device for intrauterine death prevention

The fetal health is possible to fluctuate and deteriorate and lead to unexpected loss of the pregnancy. Time is crucial for heart life and any decrease in oxygen to the heart muscle is crucial and means death. Therefore, it is substantial to do an obstetric tracing, in order to spot the sudden changes in the fetus health. Problem Statement: Away from all the methods that could measure heart health, fetus movements monitoring is one way to identify the fetal wellbeing. One very popular movement that is used to gauge fetal health is a fetal kick, in which a frequency of perceived and/or registered fetal kicks by a healthy fetus is higher as compared to the frequency of perceived and/or registered fetal kicks a by an unhealthy fetus. However, the conventional methods such as ultrasound and manual measurement endure some errors. Objective: The aim of this study is to develop a portable belt that can be used to measure the fetal movement accurately by setting the appropriate threshold. Methods: A total of 9 Force Sensitive Resistors (FSR) were used to detect a simulated force exerted by fetus on the abdomen of pregnant women in order to count the fetal movements. Finding: Based on the overall result the sensor detects 90% of the kicks given. Conclusion: We believe that this device could help the pregnant women to measure the fetal movement with less attention and can reduce the error

Sensorial, textural, and nutritional attributes of coconut sugar and cocoa solids based “bean-to-bar” dark chocolate

The impacts of cocoa solids and coconut sugar on the sensory perception of bean-to-bar dark chocolate were investigated with mixture design using response surface methodology. The maximum and minimum levels of cocoa nib, cocoa butter, and coconut sugar for the preparation of chocolate were 35–50%, 15–30%, and 20–35%, respectively. A suitable mathematical model was used to evaluate each response. Maximum and minimum levels of components caused a poor sensory acceptance of the resultant dark chocolate. The optimum level of independent variables, for the best set of responses, was 44.7% cocoa nib, 25.2% cocoa butter, and 30.2% coconut sugar, with a hedonic score of 8.28 for appearance, 8.64 for mouth feel, 8.71 for texture, 8.68 for taste, and 8.51 for overall acceptability, at a desirability of 0.86. The minimum time for grinding the chocolate mix was 24 hour, which was evident from the microscopic analysis of the chocolate mix. The optimized chocolate (70% dark) per 100 g constitutes 1.06 g moisture, 50.09 g crude fat, 10.37 g crude protein, 35.90 g carbohydrates, and 2.55 g ash content. The L, a, b values indicated a darker color and was stable under ambient condition with a hardness value of 59.52 N, which significantly decreased to 16.23 N within 10 min at ambient temperature (30 ± 2°C). The addition of coconut sugar along with cocoa solids incorporates polyphenols, flavonoids, antioxidant potential, and minerals into bean-to-bar dark chocolate and hence offers a commercial value and health potential for stakeholders