Filogeni Katak Ranidae Di Semenanjung Malaysia Berdasarkan Morfologi Dan Gen 16s Rrna Mitokondria

A morphological and phylogenetic study was conducted on eleven (11) ranid frog species from three genera (Amolops, Odorrana, Hylarana) found in Peninsular Malaysia. The species investigated were Amolops larutensis, Odorrana hosii, Hylarana labialis, H. banjarana, H. erythraea, H. luctuosa, H. laterimaculata, H. glandulosa, H. signata, H. nigrovittata and H. nicobariensis. The combination of morphometric and molecular genetics approaches were employed to investigate and to determine phylogeny relationships among ranid frogs. Due to limited sample, only four species of ranid frogs namely A. larutensis, O. hosii, H. erythraea, and H. labialis were investigated in the morphometric analysis. Fifteen (15) measurements of characteristics were obtained from 121 adult individual of ranid frogs. The differences in characteristics between sexes of frogs and the results revealed that SVL was significantly different. Multivariate statistical analysis was able to differentiate and classify all four species into their classes respectively with minimal overlap. Odorrana hosii was the most differentiated because of its large size and shape. For both sexes, size and shape of the head region were the best discriminating region in differentiating among the species. Morphological findings were complemented by molecular genetic approaches using partial (490 bp) of the slow evolving mitochondrial 16S rRNA gene to estimate genetic distance and to investigate the phylogenetic relationships of 108 representative samples of the eleven ranid frogs species. Values of genetic distance (Kimura-2 parameter) revealed that A. larutensis had the highest intraspecies genetic variation value of 6.8% followed by H.labialis (2.3%) and H. nicobariensis (2.1%)

Maternal outcome of prenatally diagnosed lethal fetal anomalies: a year review

Objectives: To determine maternal morbidities in relation to prenatal diagnosis of lethal fetal anomalies and termination of pregnancy (TOP). Materials: Twenty five patients with prenatal diagnosis of lethal fetal anomalies in Hospital Tengku Ampuan Afzan, Kuantan, Malaysia. Methods: This was a retrospective review in Hospital Tengku Ampuan Afzan, Kuantan, Malaysia in the year of 2011. All patients diagnosed prenatally to carry lethal fetal anomalies was reviewed. Data regarding maternal morbidities and outcome was collected from patients’ case note in the hospital record office. Analysis was done by using SPSS version 17.0. Results: Twenty five pregnant patients were diagnosed with lethal fetal anomalies via ultrasound with or without genetic study. The patients’ mean age was 29.9±6.3 years old. The mean gestational age at diagnosis of lethal fetal anomalies and at TOP or delivery were 26.5±7.4 and 28.7±7.8 weeks respectively. The lethal fetal anomalies included fetuses with multiple structural abnormalities (40%), anencephaly or severe encephalocele (32%), non-immune hydrops fetalis (16%) and syndromic fetuses (12%) i.e. Pentalogy of Cantrell and Edward’s syndrome. Seven (28%) patients had early counseling and TOP at the gestation of <22 weeks. Beyond 22 weeks gestation, 8 (32%) patients had TOP and 10 (40%) patients had spontaneous delivery. Twenty (80%) patients delivered or aborted vaginally, 3 (12%) patients with assisted breech delivery, and 2 (8%) patients with abdominal delivery. The abdominal deliveries were for transverse lie in labour and emergency hysterotomy for failed induction complicated by hysterectomy due to intraoperative finding of ruptured uterus. Overall, the associated adverse events included abnormal lie during delivery (16%), symptomatic polyhydramnios requiring amnioreduction (16%), post-partum haemorrhage (12%), retained placenta (12%), blood transfusion (8%), uterine rupture (4%) and endometritis (4%). Mean duration of hospital stay was 6.6±3.7 days. Conclusions: Prenatal diagnosis and TOP at an early gestation may reduce maternal morbidities and improve the outcom

Maternal outcome of prenatally diagnosed lethal fetal anomalies: a year review

This was a retrospective review in Hospital Tengku Ampuan Afzan, Kuantan, Malaysia In the year of 2011. All patients diagnosed prenatally to carry lethal fetal anomalies was Reviewed. The outcome of the pregnancy including type of labour, mode of induction and delivery, and associated morbidities during antenatal, intrapartum, and postpartum period was analyse

Group B streptococcal bacteremia in a major teaching hospital in Malaysia: a case series of eighteen patients

BACKGROUND: Group B Streptococcus (GBS) is a leading cause of infections such as meningitis and septicemia in neonates and pregnant women; however the significance of invasive GBS disease has not been clearly defined in non-pregnant adults. METHODS: We reviewed the hospital records of 18 cases with GBS bacteremia who attended the Universiti Kebangsaan Malaysia Medical Centre from June 2010 to October 2011. We analyzed the clinical findings of both bacteremic adults and neonates and compared them to previous studies of GBS bacteremia. Serotyping was done by latex agglutination test using 10 distinct antisera (Ia, Ib, and II-IX). RESULTS: During the period of 1 year and 4 months, there were 18 patients with GBS bacteremia. Five cases occurred in neonates, one in a parturient woman, and 12 in other adults. All neonates with bacteremia were males and two of them were premature. Septicemia was the most common clinical presentation in neonates. They were treated with intravenous (IV) penicillin G and gentamicin. The adults included nine men (69%) and four women (31%). Their mean age was 60 years and all patients had more than two underlying conditions. The most common clinical syndrome was pneumonia (n=6, 46.5%). The others were peritonitis (n=3, 23.1%), primary bacteremia (n=2, 15.5%), septic arthritis (n=2, 15.5%), skin and soft tissue infection (n=1, 7.7%), meningitis (n=1, 8%), urinary tract infection (n=1, 8%), and intravascular device infection (n=1, 7.7%). Cardiovascular diseases (n=7, 53.8%) were the most common underlying conditions, and diabetes mellitus (n=5, 38.5%) was second. The other co-morbid conditions were hyperlipidemia (n=3, 23.1%), renal disease (n=3, 23.1%), liver disease and/or alcohol abuse (n=3, 23.1%), autoimmune disease or immunosuppressive condition (n=2, 15.5%), malignancy (n=2, 15.5%), respiratory disease (n=1, 8%), and postpartum condition (n=1, 8%), as well as miscellaneous conditions including intravenous drug abuse, HIV infection, and trauma (n=2, 15.5%). Polymicrobial bacteremia was found in five (45.4%) cases and Staphylococcus aureus was the most common concurrent bacterial isolate. Of the 18 GBS isolates in both adults and neonates, serotype Ia was predominant (38.9%), followed by VI (27.8%), V (11.1%), and III (5.5%); the remaining 16.7% were non-typeable. CONCLUSIONS: GBS bacteremia is a significant problem and is associated with serious underlying disease, which may result in a high rate of mortality, not only in neonates and pregnant women, but also in non-pregnant adults

Second trimester uterine rupture: lesson learned

ntroduction: Uterine rupture is a rare obstetrics catastrophic especially if it occurs during early pregnancy. We experienced three cases of ruptured uterus in the second trimester that first line doctors and obstetrician could learn lessons from. Objectives: To study the presentations and outcome of uterine rupture in the second trimester. Methodology: A retrospective review of uterine rupture in Hospital Tengku Ampuan Afzan from the 1st of April 2010 to the 1st of April 2011. Data obtained from case records, histopathological and autopsy reports. Result: There were 3 cases of uterine rupture. First case, uterine rupture at 15 weeks post sexual intercourse, undiagnosed until postmortem. Second case: ruptured uterus at 24 week diagnosed at laparotomy with the indication of failed medical termination for fetal anomaly. Third case: ruptured uterus at 21 weeks following abdominal massage with initial diagnosis of acute gastroentritis. The final diagnosis was ruptured uterus secondary to placenta percreta, related to medical induction and interstitial pregnancy respectively. Conclusion: Rupture uterus should be considered with or without any risk factors regardless of the gestational age whenever any impression of hemoperitoneum. Intensive surgical method would be needed for accurate diagnosis and immediate management even in early pregnancy is a life saving

PBL project reflection: Challenges in communicating change

The objective of this paper is to discuss challenges of implementing a Project Based Learning (PBL) approach at three selected schools in one of the northern states in Malaysia.For this purpose, semi-structured interviewing and observation methods were employed.The data were analyzed based on the Five Sentiments Approach (Armenakis, Harris, Cole, Lawrence & Self, 2007a).The findings revealed that there was a high resistance from the teachers and students towards change due to the blatant exam-oriented culture which was still practiced in Malaysian educational institutions

A retrospective review of 25 cases of lethal fetal anomalies

Introduction: To review the gestational age at diagnosis, method of diagnosis, pregnancy outcome and maternal complications of prenatally diagnosed lethal foetal anomalies. Methods: Retrospective review of 25 women who had aborted or delivered foetuses with lethal anomalies in a tertiary hospital in 2011 based on patient medical records. Results: There were a total of 10,088 deliveries, in which 25 (0.24%) women were found to have conceived foetuses with lethal anomalies. All of them were diagnosed by prenatal ultrasound and only 7 (28.0%) had both prenatal ultrasound and genetic study done. The women’s mean age was 29.9 years old. The mean gestational age at diagnosis of lethal foetal anomalies was 25.5 weeks (SD=12.5) and mean gestational age at termination of pregnancy (TOP) or delivery was 28.5 weeks (SD=12.5). Seven (28%) women had early counseling and TOP at the gestation of < 22 weeks. Beyond 22 weeks of gestation, eight (32%) women had TOP and ten (40%) women had spontaneous delivery. Twenty (80%) women delivered or aborted vaginally, three (12%) women with assisted breech delivery and two (8%) women with abdominal delivery which were performed due to transverse foetal lie in labour and a failed induction, leading to emergency hysterotomy complicated by hysterectomy due to intraoperative finding of ruptured uterus. Overall, the associated post-partum adverse events included post-partum haemorrhage (12%), retained placenta (12%), blood transfusion (8%), uterine rupture (4%) and endometritis (4%). Mean duration of hospital stay was 6.6 days (SD 3.7 days). Conclusion: Late diagnosis of lethal foetal anomalies leads to various maternal morbidities, in this case series , which could have been prevented if they were diagnosed and terminated at early trimester. A new direction is needed in our local practice

Perceived autonomy support and agentic engagement among Malaysian undergraduates: the mediatory role of personal best goals

Despite continuously growing literature that emphasises the significant role of students’ agency in classroom activities, the construct of agentic engagement has received scant attention in recent empirical research. Drawing from the self-determination theory, the present study aims to determine the relationship between teacher autonomy support and agentic engagement, and explore whether personal best goals mediate such associations. For this purpose, using a cross-sectional design, data from 536 university students in northern Malaysia were analysed. The associations among the constructs were evaluated using structural equation modelling. The empirical results indicate that students’ perceptions of teacher autonomy support were associated with personal best goals and agentic engagement. In addition, the findings suggest that personal best goals significantly mediate the relationship between teacher autonomy support and agentic engagement. These findings highlight the critical role of personal best goals as a mechanism by which an autonomy-supportive teaching style facilitates students’ agency during their learning activities

Third/fourth degree perineal tear: does anorectal symptoms correlate with manometry and endo-anal scan result?

Since the introduction of endoanal ultrasound in the early 1990’s. It was found that obstetric anal sphincter injuries (OASIS) rather than neurogenic injury was the leading cause of anal incontinence, where the later can have a devastating effect on a woman’s quality of life (QoL). OASIS is reported in approximately 2.8% of primigravidae and 0.4 % of multigravidae. Despite identification and immediate repair of OASIS, the outcome is still suboptimal. Due to the lack of clear follow up plan and management guidelines following OASIS in many centers, which is remain controversial issue. In this cohort study we assessed the short term outcome of OASIS primary repair which include anorectal symptoms, QoL, sphincter integrity and function and to find the correlation between anorectal symptoms and investigations result