Nitrate in Groundwater and its Associated Health Risk: A Cross-Sectional Study in Mukim Salor, Kota Bharu, Kelantan, Malaysia

Background: Mukim Salor is an agricultural area in the district of Kota Bharu, Kelantan state, Malaysia. Farmers there use nitrogen-based fertilizers for paddy and vegetable planting. The use of these types of fertilizers may lead to contamination of nitrate in groundwater by the process of leaching into the soil. Kota Bharu is one of the areas in this country where the population still rely on groundwater as their main source of potable water. Daily use of water contaminated with nitrate may give rise to problems including “methe­moglobaenamia” or blue baby syndrome and shortness of breath. At the moment, there are no data available on nitrate levels or hazard index associated with nitrate exposure in groundwater in Mukim Salor. This study aimed to determine nitrate levels in groundwater and to perform health risk assessment from nitrate exposure among residents in Mukim Salor, a subdistrict in the district of Kota Bharu, Kelantan, an east coast state in Peninsular Malaysia. Subjects and Method: This cross-sectional study was conducted among residents from Mukim Salor, Kelantan, Malaysia. Fifty (50) respondents were chosen based on the inclusion and exclusion criteria and they were initially interviewed in order to obtain demographic data and groundwater usage information. Groundwater samples were taken from each of the respondent’s house who used groundwater exclusively for drinking and cooking. The samples were then analyzed using a HACH brand DR 1900 direct reading spectro­photometer. Risk assessment on exposure to nitrate was also calculated. Results: Nitrate levels ranged from 0.1 to 2.8 mg/L, with a mean of 1.08 + SD 0.64 mg/L. Nitrate levels in the area of study did not exceed the standard set by the health authorities (<10 mg/L) and there was no significant risk of nitrate contamination in ground water (where HI<1). Conclusion: Residents in Mukim Salor, Kelantan, Malaysia, were exposed to low levels of nitrate in groundwater. Keywords: Agriculture, nitrate, groundwater, methemoglobinaemia, health risk assessment, Mukim Salor

Fluoride Level in Drinking Water in Federal Territory of Labuan, Malaysia

BACKGROUND: Fluoride in drinking water is one of few chemicals that have been shown to cause health effect. Low concentration of fluoride in drinking water has beneficial effect on teeth. But excessive exposure to fluoride can give rise to adverse effects. About 50% of fluoride intake are excreted via kidney, thus fluoride content in urine is an indicator for exposure to fluoride. According to the National Standard for Drinking Water Quality, Malaysia, the optimum level of fluoride in drinking water should be 0.40 to 0.60 mg/L. This study aimed to determine fluoride level in drinking water in Labuan, Malaysia. SUBJECT AND METHODS: This was a prevalence study, conducted in Labuan federal territory, Malaysia. Three samples of drinking water were collected in three consecutive days. A DR/2500 HACH direct reading spectrophotometer was used to analyze water samples for fluoride. The data was analyzed using SPSS 21. RESULTS: Mean (SD) of fluoride level in drinking water was below the recommended range, i.e. 0.36 (±0.13) mg/L. More than half (57–63%) of drinking water samples had fluoride levels lower than the recommended range. CONCLUSION: More than half of the water samples had low levels of fluoride

Fluoride in Drinking Water and Urine: a Cross-Sectional Study among Secondary School Children in Kuala Kubu Bharu, Selangor, Malaysia

Background: This study aimed to determine the levels of fluoride in drinking water and levels of urinary fluoride, to determine whether fluoride in both drinking water and urine were under the acceptable range stated by NDWQS and NIOSH Method 8308 respectively, to determine any significant difference in urinary fluoride between gender, and to determine the relationship between fluoride levels in drinking water and urinary fluoride among study subjects. Subjects and Methods: A cross-sectional study was conducted in Kuala KubuBharu, Selangor, Malaysia. A sample of secondary school children aged 14-years-old at a selected school were selected based on several criteria, including living at least 6 years on the same area and not having any health problems. Then a briefing was given to selected study subjects before distribution of a set of questionnaire were made. After obtaining parents’ permission, a set of high density polyethylene bottle (HDPE) and urine collection container was given to study subjects for drinking water and urine samples collection for 2 consecutive days. Both samples were analyzed using a HACH Brand Direct Reading Spectrophotometer model DR/ 1900 by Method 8029 which was accepted by the US EPA for reporting of drinking water and wastewater analysis purposes. Results: Fluoride levels in drinking water ranged between 0.41 to 0.59 ppm with a median of 0.46 (SD=0.04). Fluoride level in urine ranged between 0.45 to 2.29 ppm with a mean 1.48 (SD=0.43). There was no significant difference in urinary fluoride between genders. Also, there was no significant relationship between fluoride levels in drinking water and urinary fluoride levels among study subjects. The median value fluoride in drinking water obtained was 0.46 which was still in the range of NDWQS standards. Urinary fluoride was within the range stated by NIOSH. Conclusion: Levels of fluoride in both drinking water and urine in Kuala KubuBharu, Selangor, Malaysia, were within the acceptable limit. Keywords: fluoride, drinking water, urinary fluoride, secondary school children, Kuala KubuBhar

Health risk assessment after exposure to aluminium in drinking water between two different villages.

A cross-sectional study was conducted at Mukim Parit Lubok (MPL) and Parit Raja (PR), Batu Pahat, Malaysia. The main objective of this study was to determine the aluminium concentration in drinking water and to perform health risk assessment prediction among respondents from these two residential areas. A total of 100 respondents were selected from the study areas based on inclusive and exclusive criteria. Two duplicates of treated water samples were taken from each respondent’s house using 200mL high-density polyethylene (HDPE) bottles and 0.4 mL (69%) pure concentrated nitric acid were added as a preservative. Aluminium concentrations were analyzed using a Lambda 25 UV/V spectrophotometer. The result showed that aluminium concentration in drinking water from MPL was 0.18 ± 0.022 mg/L and 0.22 ± 0.044 mg/L for PR. Statistical analysis showed that 14 (28%) water samples collected from MPL and 35 (70%) from PR recorded concentration of aluminium above the standard limit set by the Ministry of Health, Malaysia for drinking water guideline (0.2 mg/L). The mean value of Chronic Daily Intake (CDI) of aluminium in drinking water from PR (0.00707 mg/kg/day) was significantly higher compared to MPL (0.00164 mg/kg/day). Hazard Index (HI) calculation showed that all respondents had “HI” of less than 1. In conclusion, there was an unlikely potential for adverse health effects from aluminium intake in drinking water from both study areas. However, it was necessary for some actions to be taken in order to reduce aluminium levels found in drinking water for both locations

Assessing Consumer Preference using Community Pharmacy Preference Evaluation Questionnaire (ComPETe): A Pilot Survey in a Malaysia City

Purpose: To assess the consumer preference for community pharmacy (CP) for filling prescription, and purchasing over-the-counter (OTC) and health products among customers frequenting eight departmental stores located in a Malaysian city.Method: A cross-sectional study was conducted in the city of Wakaf Bharu, Kelantan, Malaysia. A total of 400 respondents in the area were randomly selected to participate in the 14-item Community Pharmacy Preference Evaluation Questionnaire (ComPETe). The results were then subjected to data analysis.Results: A total of 198 respondents returned the questionnaire but only 120 respondents completely filled in them. Majority of the respondents was between the age of 18 and 30 years (42.4 %), female (55.0 %) and married (66.7 %). Most of them (90.8 %) agreed that location is an important criterion for choosing a CP. About 62 and 56 % of the respondents went to the same preferred CP and at least once a month, respectively. Interestingly, customers with a monthly income of &lt;RM 1000 (equivalent to USD 280) and married were more likely to visit the same preferred CP (p &lt; 0.05). More than half of the respondents preferred heavily subsidized medical treatment for minor ailments from government healthcare institutions. For OTC products, preference among consumers was almost the same among CPs and local stores. With regard to health supplements and screening test kits, most respondents preferred to go to CPs.Conclusion: The respondents showed variability in their preference for CPs. The findings about consumer preference for CPs and health products should facilitate the process of launching a successful CP establishment.Keywords: Consumer Satisfaction, Community Pharmacy Preference, Prescription Filling, Over-the-counter Products, Financial Managemen

Vulnerable plaque detection: The role of 18-fluorine fluorodeoxyglucose in identifying high risk patients

Positron emission tomography computed tomography (PET-CT) is a combined functional and structural multi modality imaging tool that can be utilized to detect vulnerable and atherosclerotic plaques. In this study we observe the prevalence of active and calcified plaques in selected arteries during whole-body 18F-FDG PET-CT and correlate the findings with risk factors in developing coronary artery disease. There was a significant relationship between patients with high body mass index and vulnerable plaques. We concluded that 18F-FDG PET-CT can be utilized in detecting focal high FDG uptake within vascular plaque in early recognition of high risk patients having vascular accidents.Keywords: Atherosclerosis; Plaque; Computed tomography; Positron emission tomography; Fluorodeoxyglucose; Multimodalit

Human limbal mesenchymal stem cells express ABCB5 and can grow on amniotic membrane

Aim: To isolate and characterize limbal mesenchymal stem cells (LMSCs) from human corneoscleral rings. Materials & methods: Cells were isolated from corneoscleral rings and cultured in a mesenchymal stem cell (MSC)-selective media and examined for differentiation, phenotyping and characterization. Results: LMSCs were capable of trilineage differentiation, adhered to tissue culture plastic, expressed HLA class I and cell surface antigens associated with human MSC while having no/low expression of HLA class II and negative hematopoietic lineage markers. They were capable for CXCL12-mediated cellular migration. LMSCs adhered, proliferated on amniotic membrane and expressed the common putative limbal stem cell markers. Conclusion: Limbal-derived MSC exhibited plasticity, could maintain limbal markers expression and demonstrated viable growth on amniotic membrane

The influence of Middle East crisis on the flow of tourists to Jordan

Despite the Middle East is considered as a conflict-ridden region, relatively some major tourism destination such as Jordan is safe, however, these destinations' geographic location has resulted in tourists’ misperceptions and had a negative effect on tourism throughout the Middle East. This study aimed to uncover the challenges of decreased the flow of tourists to the Jordan to restore a positive image after the crisis following the Arab Spring uprisings. Literature analysis method was applied to review previous literature on perceived risks in the Middle East. Results of the analysis revealed the issues that influence tourists’ perceived risk toward the region and Jordan particularly were geographical ignorance of safe destinations, a biased coverage of the media, different culture influence personal characteristics concerning freedom, and weakness of previous experiences. Findings further revealed that studies regarding during international tourists in the Middle East are limite

Role of perceived risks to tourists in building their future intention: a conceptual model

Tourism is vital to the economy of a country. Successful tourism marketing strategies require an understanding of why people travel and what factors influence their behavioural intention of choosing a travel destination. Tourism scholars have recognized the impact of perceived risk on travel behaviour and decision, because tourists are likely to avoid destinations with greater perceived risk regardless of whether that notion is a real representation of the level of safety in a destination. While overall the field of tourism has been abundantly researched, there are certain areas where there is a paucity of research such marketing strategies of destinations that sorted by tourists as a risky destination. This article contributes to this extremely important researched subject, specifically, this study seeking to investigate the role of perceived risks in building the tourists future intentions toward the destination. The research is focusing on developing a conceptual model which identifies the components of the tourist behaviour that corresponding to the three stages, namely, perceived risks stage, actual experience stage, and future intention stag