Wabak demam kepialu (Tifoid) di daerah Bachok, Kelantan Mac - Mei 2005

Penyakit tifoid adalah penyakit berjangkit bawaan air dan makanan yang disebabkan oleh Salmonella typhii. Penyakit ini berlaku di seluruh dunia dan endemik di Kelantan. Pada April 2005, terdapat peningkatan kes tifoid yang dinotifikasi di daerah Bachok dan wabak telah diistiharkan. Pasukan siasatan telah dibentuk di mana setiap kes disiasat dengan segera dan tindakan kawalan telah diambil seperti pemeriksaan dan penutupan premis makanan, kerja-kerja sanitasi dan pendidikan kesihatan. Pengesanan kes secara aktif juga telah dilakukan. Mukim Gunong mencatatkan jumlah kes tertinggi iaitu 46.3%. Majoriti daripada kes terdiri daripada pelajar. Dua pembawa dari kalangan kontek juga turut dikesan. Lekuk epidemik menggambarkan berlakunya wabak punca lazim. Lima daripada 111 bilangan sampel air dan dua daripada 146 bilangan sampel makanan yang diperiksa adalah positif terhadap Salmonella spesies tetapi tiada yang positif terhadap Salmonella typhii. Meskipun Pasar Jelawat merupakan lokasi yang disyakki sebagai punca utama jangkitan, ianya tidak dapat disahkan melalui penyiasatan dan ujian makmal

Dietary adherence component of modified end-stage renal disease adherence questionnaire (ESRD-AQ): translation and validation

Introduction:A nutritionally balanced diet is crucial among end-stage renal disease (ESRD) patients to maintain their health status. An appropriate instrument is needed to assess ESRD patients’ adherence towards dietary recommendations. Several questionnaires to measure adherence behaviours of ESRD patients are available but none has ever been translated into the Malay language. Therefore, this study aimed to translate the modified version of the End-stage Renal Disease Adherence Questionnaire (ESRD-AQ), focusing on the dietary adherence component, from English to Malay.Methodology:Forward and backward translations of the questionnaire were conducted involving experts in dietetics and linguistics to produce a pre-harmonized Malay translation and two backward English translations according to established guidelines. An expert committee reviewed these translated questionnaires to produce a harmonized version. This then underwenta pre-test conducted using cognitive interview, as wellas facevalidity assessment, involving 15 haemodialysis patients. Results:Minor amendments were made to several phrases during the expert committee review to ensure the translated questionnaire was contextually appropriate and culturally adapted to the Malay language. All questions in the Malay version of the modified ESRD-AQ achieved a Face Validity Index (FVI) value of 1.00, indicating high validity. Conclusion:The Malay version of the modified ESRD-AQ (Dietary Adherence Component) underwent translation and validation protocols, the findings of which indicate that it is clear and comprehensible for use in assessing dietary adherence among ESRD patients in Malaysia

Heavy metals biomonitoring via inhibitive assay of acetylcholinesterase from Periophthalmodon schlosseri

Acetylcholinesterase (AChE) generally known to be sensitive toward insecticides but its sensitivity toward heavy metals was least reported. Herein, a sensitive assay for heavy metals has been pursued using AChE in a rapid and economic manner. The AChE from a mudskipper, Periophthalmodon schlosseri has been found to be sensitive toward copper > mercury > chromium > and arsenic ions at the sub parts per million levels. Field trial works showed that the assay was applicable in detecting heavy metals pollution from effluents of industrial sites at near real time and verified using ICP-OES and Flow Injection Mercury System (FIMS 400). Furthermore, hierarchical cluster analyses of inhibition profiles were performed, revealing a comparable capability of the AChE compared to the gold standard of Microtox™ method

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Estimation of the on-site Coulomb potential and covalent state in La_{2}CuO_{4} by muon spin rotation and density functional theory calculations

The on-site Coulomb potential, U, and the covalent state of electronic orbitals play key roles for the Cooper pair symmetry and exotic electromagnetic properties of high-T_{c} superconducting cuprates. In this paper, we demonstrate a way to determine the value of U and present the whole picture of the covalent state of Cu spins in the mother system of the La-based high-T_{c} superconducting cuprate, La_{2}CuO_{4}, by combining the muon spin rotation (μSR) and the density functional theory (DFT) calculation. We reveal local deformations of the CuO_{6} octahedron followed by changes in Cu-spin distributions caused by the injected muon. Adjusting the DFT and μSR results, U and the minimum charge-transfer energy between the upper Hubbard band and the O 2p band were optimized to be 4.87(4) and 1.24(1) eV, respectively