Etiology and incidence of infection in Mechanically Ventilated Medical Intensive Care Unit Patients in a Tertiary Care Hospital

Introduction@#Intensive care unit (ICU) patients are at the greatest risk of acquiring nosocomial infections, partly because of their serious underlying disease, but also by exposure to life-saving invasive procedures. Hospital-acquired infections increase patient morbidity, increase the length of hospital stay and hospital costs, and also increases mortality rate. The basic knowledge of organisms infecting ICU patients is very important to empirically select appropriate antibiotics, so that the most likely infecting organisms are addressed.@*Objective@#The aim of the study was to find out the etiologic agents causing infection in medical intensive care unit patients.@*Results@#In our study of 289 patients, 180 (62.3%) showed a growth of organism during the stay in ICU. The most common site of infection was the respiratory tract in 138 patients (47.8%) with 60 patients (20.8%) showing Acinetobacter baumannii.

Needle Stick and Sharp Injuries among Health Care Workers in Kelantan: A Retrospective Six-Year Cohort Study

@#Introduction: The prevalence of needle stick and sharp injuries (NSSIs) still high among healthcare workers and many of them, without reason had defaulted the post management follow up. Thus, the aim of the study was to determine factors associated with default follow up among healthcare workers sustained NSSIs in Kelantan. Method: A retrospective cohort study using secondary data from Sharp Injury Surveillance notification system within period of six years started from January 2010 was done. Data were collected using proforma and analysed using SPSS version 22.0. Two hundred and seventy cases were selected by using multistage random selection method. Binary logistic regression analysis was used to determine the factors. Result: Majority of reported NSSIs involved female, with the mean age of 33 years. Most of them were intern that had less than ten years’ experience. Most of the accident occurred during office hours at tertiary healthcare setting during venepuncture for blood or intravenous fluid management. The workers with age less than 40 years and those who work at hospital setting have higher possibility to default the follow up with (Adj. OR 2.80; 95% CI: 1.12,7.00; p = 0.027) and (Adj. OR 4.65; 95% CI: 1.77,12.33; p = 0.002) respectively. Conclusion: NSSIs can occur at all level of occupational setting particularly among those who has less experience and work at tertiary healthcare setting. Thus, an intensive precaution action should focus on them since they are also the group that has higher odd to default the post management follow up.

Measuring Health Clinics’ Workload Pressure in Kelantan Using the Workload Indicator of Staffing Needs

@#Introduction: Proper distribution of human resources is an important factor ensuring high-quality performance and sustained service quality. The aim of this study was determining the workload pressure among medical officers in health clinics (HCs) in Kelantan. Method: A record review survey was conducted between January and April 2019 using human resources data for 2018 involving HCs in Kelantan. It included all the HCs in Kelantan and excluded community clinics. Workload pressure was determined using a tool known as Workload Indicator of Staffing Needs, developed by World Health Organization. A high workload pressure was defined as a ratio between required and acquired medical officers of less than 1. The data were presented descriptively using as frequencies and percentages. Results: All 85 HCs in Kelantan were involved in the study; 90% (9/10) of the Kelantan districts recorded high workload pressure. Moreover, 68.2% (58/85) HCs had high workload pressure. Tanah Merah, Tumpat, Pasir Mas, and Kota Bharu had the most HCs with high workload pressure, and most such HCs were found in areas with a high-density population, requiring huge coverage. Conclusion: The Kelantan State Health Department should develop better human resource distribution strategies to ensure the sustainability of quality care in HCs.

Factors Associated with Poor Perceptions of Graphic Warning Signs (GWS) on Cigarette Package among Adult Smokers in Kelantan

@#Introduction: Initially, studies showed that graphic warning signs (GWSs) on cigarette packages encouraged smoking cessation. However, there have been recent concerns over the effectiveness of GWSs to change smoker perceptions and behavior over time. Our goals were to assess the latest perceptions of GWSs among smokers in Kelantan and to determine the factors associated with them. Methods: This cross-sectional study was conducted among respondents who attended outpatient clinics in a teaching hospital in Kelantan. Their perceptions were analyzed with a validated Malay questionnaire containing four domains: fear, influence, credibility, and picture content. Results: The average smoking age was 17 (3.04) years old. The mean smoking time was 11 (7.49) years. The average daily cigarettes smoked was 8 (6.26). Most respondents perceived low levels of fear (83%), poor picture content (65.5%), low influence (87.6%), and low levels of credibility (70.1%) in GWSs. Those with low levels of education were significantly associated with poor perceptions of GWSs. Conclusion: Despite vigorous efforts by the government to discourage smoking in Kelantan, smokers still poorly perceive GWSs. More effective health-promotion strategies are essential to influence smokers in this area.

Patients’ Expectations and Perceptions of Services Provided by Primary Health Clinics in Kota Bharu, Kelantan, Malaysia

@#Introduction: Primary health care plays an important role in healthcare systems. In Malaysia, One (1) Malaysia Clinic (now known as Community Clinic since 2018) was established in 2010 aims to increase healthcare services accessibility within the poor urban population. The aim was to look at the effectiveness of One (1) Malaysia Clinic as a new form of public primary health clinic by looking at expectations and perceptions of the quality of the provided services by the patients. Method: It applied a cross sectional study involving nine clinics in of the busiest district in Kelantan namely, Kota Bharu district. 386 respondents which were Malaysian citizen, 18 years old and above were involved in this study. The survey used Malay validated SERVQUAL questionnaire. The Service Quality (SQ) gap was calculated. Result: The empathy dimension obtained the highest expectation and perception score, while the tangible dimension has the lowest expectation and perception score. In all SERVQUAL dimension, the expectations and perceptions of the service provided was significantly different with P < 0.001. The most critical dimension identified was tangible dimension as it has the largest negative SQ gap score. Conclusion: Negative gaps for all SERVQUAL dimensions and individual items indicated that provided services at One (1) Malaysia Clinic still could not fulfilled the patient’s expectation. A continuous improvement program is needed especially on tangible dimension in delivering a quality healthcare services.

Channelizing the Existing Perceptions of Medical Students Towards Reflective Learning: ANew Insight

Introduction: Reflection is an important component of medical education promoting deeper learning. It createsresponsibility among medical students for their own learning. The aim of the present study is to gain insightsinto their existing perceptions on the concept of reflection in terms of attitudes and practices. Channelizingsuch perceptions helps in transformative learning to apply in similar situations in future. Methodology: Atotal of 76 first year MBBS students both male and female were included in study. Two questionnaires wereadministered with an interval of one week with priming, to channelize their outlook towards reflective learning.Questionnaire I was used for quick assessment of existing attitudes towards learning and need- orientedpractices. Questionnaire II was developed to assess changes in their attitudes on reflective learning and goaloriented practices after priming. Results: The responses showed a shift in the perceptions on attitudes andreflective learning practices from rather naive to a more mature type. Discussion: Priming indeed had animportant role in enabling students to express their true behavior and help channelize their reflective habits.These differences in the responses were further explained on the lines of defense mechanisms probablyoperating at different levels in the minds of the students. Conclusion: Including reflective practices routinelyin the curriculum would help students learn, remember and perform better as future health care professionalsand also inculcate the habit of lifelong learning.

Co-Curricular Activities and Motives for Participating in Physical Activity among Health Sciences Students at Universiti Sains Malaysia, Malaysia

@#Background: The purpose of the study was to compare the motives for participating in physical activity (PA) through the different types of co-curricular activities chosen by health sciences undergraduate students at Universiti Sains Malaysia (USM), Malaysia. Methods: The participants were university students at USM’s Health Campus, who were invited to volunteer and complete two measures: a demographic form, including the types of co-curricular activities in which the students chose to enrol (sports, uniform and art), and the Physical Activity and Leisure Motivation Scale (PALMS). Results: A total of 588 university students (female = 79.1%, male = 20.9%) with a mean age of 19.77 (SD = 1.39) participated in the study. The results showed significant differences in the motives of affiliation (P < 0.001), appearance (P = 0.008) and physical condition (P = 0.010) across the types of co-curricular activities in which the students participated. The students who enrolled in sports generally showed higher motives of affiliation, appearance and physical condition for participating in PA than other types of co-curricular activities. Conclusion: The study findings can provide further insights into the motives for participating in PA among health sciences students and encouragement for students to integrate PA into their daily routines.

The Unmet Needs Among Parents of Disabled Children at Support Institutions in Kelantan, Malaysia

Abstract@#Introduction: Parents of a disabled child might require extra basic needs which most of the time are unmet due to several factors. Thus, understanding the unmet needs could help the respective institution to provide and prioritise the needs required. Methods: A cross-sectional study was conducted between September to December 2013 to determine the proportion of unmet needs among parents of children with disabilities at support institutions in Kelantan, Malaysia. Biological parents of disabled children aged between 2 to 18 years old were included in the study. A 35item validated Malay version of the Family Needs Survey was used in this study. A scoring of 4-point Likert scale was used; the prevalence of unmet needs was determined based on the proportion of those who scored “3” from each domain. Results: A total of 226 parents were involved in the present study. The mean age of parents and children were 44.6 (8.99) and 10.2 (4.85) years old respectively. The most common type of disabilities was learning disability (n=151, 66.8%). The unmet need for information has the highest prevalence (97.8%), followed by the unmet need for social support (93.8%). Conclusion: Parents with disabled children require information to guide them in managing their children. Findings from this study may better enable policymakers to devote resources in assisting parents, and service providers in designing appropriate interventions in fulfilling the unmet needs of these parents.

Article knowledge, Attitude And Perception Of Contraception Among Medical Students In Universiti Putra Malaysia

@#The incidence of unintended pregnancy and unsafe abortion are significantly high due to the lack of knowledge and negative attitude towards contraception and it can be prevented by effective and appropriate contraceptive knowledge and usage. Considering the future role of medical students as family planning educator as well as counsellors, it is not only important to determine their knowledge, attitude and perception towards contraception but also should be updated for improvement on the quality of future healthcare professionals on contraceptive knowledge which may lead to the reduction in the number of unintended pregnancy with improving maternal morbidity and mortality. This was a cross sectional study using self-reported questionnaires survey that consists of four sections as socio-demographic characteristics information, knowledge towards contraception, attitude towards contraception, and perception of education and training in sexual and reproductive health among medical student. Questions were, distributed among medical students in Faculty of Medicine and Health Sciences and analyzed. The response rate was 100%. and most of the respondents in this study were Malay (64·4%), female (68·3%), single (98·6%) and live in urban area (69·1%). Most of their parents had tertiary education level (father educational level, 63·3%; mother educational level, 50·0%). 56·1% of the respondents had poor level of knowledge and 59.2% of them had negative attitude towards contraception. Regarding the perception on contraception, most of the respondents thought that they did not have sufficient clinical practice (50·4%) though adequate training (57·6%) in counselling the patients for family planning service during their clinical posting. There was a significant association between gender, place of birth, ethnicity, marital status, father educational status and level of knowledge. There were a higher percentage of respondents who had poor knowledge and negative attitude towards contraception. Assessing the knowledge and attitude of medical students on contraception and their relationship with socio-demographic characteristics and socio-economic factors plays a leading role in public health projects which are aimed to combat maternal mortality through reducing unintended pregnancies. To change the attitude towards contraception and further increase the level of knowledge of contraception among medical students, collaborated health education and similar studies among health workers are highly recommended.

A Case of Perioperative Management in a Patient with Rare Red Blood Cell Phenotype

@#The current focus of perioperative management of anaemia has shifted from allogeneic transfusion to optimising and conserving the patient’s blood through the implementation of patient blood management (PBM) strategies. We hereby report a case to illustrate the success of applying PBM strategies in managing a surgical patient with an extremely rare red blood cells (RBC) phenotype. An 80-year-old Malay man was planned for urgent major abdominal surgery following diagnosis of intestinal obstruction secondary to an advanced rectosigmoid tumour. A request of two units packed RBC was made given anticipated blood loss intraoperatively. His pre-operative haemoglobin was 135 g/L. His previous immunohaematological record showed that he had an extremely rare P2k (P1-, P-, Pk+) phenotype with clinically significant anti-P, anti-PX2, and anti-P1. The elements of PBM strategies were explored and applied. Eventually, the patient successfully underwent a surgical operation without any allogeneic RBC transfusion.

Purification and identification of novel cytotoxic oligopeptides from soft coral Sarcophyton glaucum / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Globally, peptide-based anticancer therapies have drawn much attention. Marine organisms are a reservoir of anticancer peptides that await discovery. In this study, we aimed to identify cytotoxic oligopeptides from Sarcophyton glaucum. Peptides were purified from among the S. glaucum hydrolysates produced by alcalase, chymotrypsin, papain, and trypsin, guided by a methylthiazolyldiphenyl-tetrazolium bromide (MTT) assay on the human cervical cancer (HeLa) cell line for cytotoxicity evaluation. Purification techniques adopted were membrane ultrafiltration, gel filtration chromatography, solid phase extraction (SPE), and reversed-phase high-performance liquid chromatography (RP-HPLC). Purified peptides were identified by de novo peptide sequencing. From papain hydrolysate, three peptide sequences were identified: AGAPGG, AERQ, and RDTQ (428.45, 502.53, and 518.53 Da, respectively). Peptides synthesized from these sequences exhibited cytotoxicity on HeLa cells with median effect concentration (EC50) values of 8.6, 4.9, and 5.6 mmol/L, respectively, up to 5.8-fold stronger than the anticancer drug 5-fluorouracil. When tested at their respective EC50, AGAPGG, AERQ, and RDTQ showed only 16%, 25%, and 11% cytotoxicity to non-cancerous Hek293 cells, respectively. In conclusion, AERQ, AGAPGG, and RDTQ are promising candidates for future development as peptide-based anticancer drugs.

Understanding Dieting and Previous Weight Loss Attempts among Overweight and Obese Participants: Insights into My Body Is Fit and Fabulous at Work Program / 가정의학회지

BACKGROUND: A qualitative study providing an in-depth exploration of people's view and the increasing burden of overweight and obesity is required. This study aimed to explore the understanding of dieting and previous experiences on weight loss attempts among overweight and obese government employees in Kelantan, Malaysia, prior to recruitment into the intervention program. METHODS: Thirteen focus group discussions involving 129 participants from a weight-loss intervention program were conducted within the first 1 month of recruitment. These discussions were moderated by two trained researchers in the Malay language and assisted by an interview guide. They were audio-recorded and transcribed verbatim. A thematic analysis was performed, and codes and themes from each discussion were constructed. RESULTS: The participants understood dieting with various meanings, including skipping meals and removing rice from daily diets. They applied numerous methods to lose weight and achieved various outcomes. Health and appearance, social support, and compliance with current trends were the factors motivating these participants to lose weight. Their determination to lose weight was limited by lack of self-control and motivation, experiences of unpleasant effects, influence on weight, and environmental and health factors. CONCLUSION: Real-life weight loss experiences and perceptions provided relevant insights into current weight loss management strategies. Some of these issues and misunderstandings should be emphasized in weight loss strategies during health promotion.

Perceived Stress and Coping Styles among Malay Caregivers of Children with Learning Disabilities in Kelantan

Background: Caregivers of children with learning disabilities have been shown to experience increased stress and greater negative caregiving consequences than those with typically developing children. There remains a lack of studies focusing on stress and coping mechanisms among caregivers of a wider age group and diagnosis of individuals with disabilities in Asian countries. The current study examines levels of perceived stress and associated child and caregiver factors among caregivers of children with learning disabilities in the Malaysian context. An additional aim was to determine whether caregiver coping styles may be predictors of perceived stress. Methods: The Malay version of the Perceived Stress Scale with 10 items and the Brief COPE Scale were administered to a sample of 190 Malay caregivers of children with learning disabilities registered with community-based rehabilitation centres in Kelantan, a state in Peninsular Malaysia. Multiple linear regression analysis was applied to determine the predictors of perceived stress. Results: The mean total perceived stress score of caregivers was 16.96 (SD = 4.66). The most frequently used coping styles found among caregivers included religion, acceptance and positive reframing, while substance use and behavioural disengagement were least frequently used. Higher perceived stress was significantly predicted among caregivers with fewer children, frequent use of instrumental support and behavioural disengagement coping, and lack of emotional support and religious coping. Conclusion: Findings indicate that the perceived stress levels among caregivers were significantly predicted by different coping styles. It is vital to help the caregivers improve their good coping styles in order to reduce their stress levels.

The Association of Parent Education and Family Monthly Income on Intelligence Quotient (IQ) among Students with Special Needs in Kelantan, Malaysia / Jurnal Sains Kesihatan Malaysia

This paper investigate the effect of parents’ education background and family monthly income on the Intelligence Quotient (IQ) of students with special needs in Kelantan, Malaysia. This cross-sectional method study was employed multistage random sampling to obtain information drawn from 130 participants from 10 selected school in Kelantan, Malaysia. Questionnaire was used to obtain parents’ education background, family monthly income and demographic variables. Students IQ were assessed using Comprehensive Test for Non-Verbal Intelligence (CTONI 2nd Edition). Data analysis involve independent sample t-test, one-way between group ANOVA, Pearson’s correlation and multiple linear regression. From analysis of IQ score, 63.8% of the special needs students scored very poor IQ, 12.3% scored below average and only 1.5% score average IQ. Significant mean difference were revealed between age group (p = 0.002), parents’ education (p = 0.018) and family monthly income (p < 0.05) on special needs students IQ. Post-hoc tukey shows significance between parents who never went to school, went to secondary school (p = 0.037) and university/college (p = 0.021). In term of family monthly income, significance difference were found between family with low and high monthly income (p < 0.05). Family monthly income (r = 0.393, p < 0.01) showed positive moderate correlation on special needs students IQ. After being forwarded by multiple linear regression, it was found that family monthly income (B = 3.605, p < 0.05) and age group of special needs students (B = 0.879, p = 0.002) were significant predictor for IQ score and explained 22.5% of the variance (R2 = 0.225, F (5,124) = 83.94, p < 0.05. Overally, majority of special needs students in current study have very poor IQ score. Further explanation are discussed on the paper.

Evaluation of Endothelial Cell Adhesion Molecules and Anti-C1q Antibody in Discriminating between Active and Non-Active Systemic Lupus Erythematosus

Background : Detecting the active state of systemic lupus erythematosus (SLE) is important but challenging. This study aimed to determine the diagnostic accuracy of serum endothelial cell adhesion molecules (ICAM-1 and VCAM-1) and anti-C1q antibody in discriminating between active and non-active SLE. Methods: Using SELENA-SLE disease activity index (SLEDAI), 95 SLE patients (45 active and 50 non-active) were assessed. A score above five was considered indicative of active SLE. The blood samples were tested for serum ICAM-1, VCAM-1 and anti-C1q antibody using enzyme-linked immunosorbent assay (ELISA). Results: The levels of serum VCAM-1 and anti-C1q antibody were significantly higher in active SLE patients. Both VCAM-1 and anti-C1q were able to discriminate between active and non-active SLE ( p -value < 0.001 and 0.005, respectively). From the receiver operating characteristic curves (ROCs) constructed, the optimal cut-off values for VCAM-1 and anti-C1q antibody in discriminating between active and non-active SLE were 30.5 ng/mL (69.0% sensitivity, 60.0% specificity, PPV 58.5%, NPV 66.7%) and 7.86 U/mL (75.6% sensitivity, 80% specificity, PPV 77.3%, NPV 78.4%), respectively. However, serum ICAM-1 level was unable to discriminate between the two groups ( p -value = 0.193). Conclusion: Anti-C1q antibody demonstrated the best diagnostic accuracy in discriminating between active and non-active SLE patients

Perceived Stress among Malay Caregivers of Children with Learning Disabilities in Kelantan / Jurnal Sains Kesihatan Malaysia

Parents or caregivers of children with learning disabilities have been shown to experience increases in stress and greater negative caregiving consequences than those with typically developing children. The current study sought to assess the perceived stress among Malay caregivers of children with learning disabilities in Kelantan. The Malay version of Perceived Stress Scale 10 items was administered to a sample of 40 caregivers of children with learning disabilities who were registered to five Pusat Pemulihan Dalam Komuniti (PDK) in Kelantan. Higher scores indicate higher levels of stress. The caregivers had mean age of 47.68 (SD = 9.18) years old, of whom 90% were fathers or mothers. Ninety percent of them were married, majority were unemployed or housewives and had secondary school education. The majority of children with learning disabilities were males and half of them were Down Syndrome children. The mean total Perceived Stress Scale score of the caregivers was 16.77 (SD = 5.74). There were no significant associations between total perceived stress score and any of the independent variables. The mean total perceived stress score showed that the perceived stress level was in the category of slightly higher than average and health concern level was high, while the average stress level was between score of 12 to 15. In conclusion, this result indicated that the caregivers had slightly higher levels of stress than the average score, and might increase susceptibility to stress-induced illness.

Comparison of Digestion Methods for the Determination of Trace Elements and Heavy Metals in Human Hair and Nails

Background: Microwave is the most reliable sample digestion method. However, it requires expensive microwave digester automation and has relatively low productivity. In this study, three non-automated digestion methods, i.e. wet acid digestion using nitric acid (HNO3) and hydrogen peroxide (H2O2), wet acid digestion using HNO3, and dry washing, are compared in order to determine the best approach. Methods: Certified reference material IAEA-086 (International Atomic Energy Agency, Austria) and hair and nail samples from 20 female students of Universiti Kebangsaan Malaysia, aged 19 to 30 years, were collected and analysed using the three digestion methods. Results: For hair samples, analysis of variance of repeated measures showed significant differences in the level of all elements (P < 0.001) between the three methods. For nail samples, only the copper (Cu) level showed no significant difference (P = 0.100) between methods. Wet acid digestion using HNO3 and H2O2 showed the best within- and between-run relative standard deviation (RSD) values, with within-run RSD for all elements, except for selenium (Se), < 5%. The between-run precision ranges from 6.14% to 17.96% for hair and from 3.53% to 11.52% for nail samples. Wet acid digestion using HNO3 and H2O2 showed both good accuracy and precision for manganese (Mn) and magnesium (Mg), with percentage recoveries of 110% and 96.9%, respectively. All elements show higher method detection limit (MDL) values than the previous study: 0.05 μg/g Mg for wet acid digestion using HNO3, 0.02 μg/g Se for wet acid digestion using HNO3 and H2O2, and 0.2 μg/g Mg for dry ash method. Conclusion: Wet acid digestion using HNO3 and H2O2 proved to be the best method in terms of precision, accuracy, recovery, and MDL. However, only Mn and Mg showed adequate precision, accuracy, and percentage of recovery.

Reliability and Validity of Malay Language Version of International Physical Activity Questionnaire (IPAQ-M) among the Malaysian Cohort Participants

Validation of instruments is essential when assessing physical activity (PA). The aim of this study was to validate a Malay language version of the International Physical Activity Questionnaire (IPAQ-M) against Actical accelerometer and to determine its reliability and validity. A total of 90 Malay adults aged 35-65 years old participating in The Malaysian Cohort project were recruited for this study. The IPAQ-M is comprised of 12 items, covering vigorous, moderate, walking, sitting and sleeping activities, and was administered on two occasions (Day 1 and Day 9) by interviewing the participants. Participants wore the Actical accelerometer for seven consecutive days between the two interview sessions. Validity tests showed that time spent in moderate-vigorous physical activity (MVPA) (min wk-1) from IPAQ-M was significantly correlated with MVPA from accelerometer (ρ=0.32, p<0.01). Time spent in vigorous activity (ρ=0.44) and total activity (ρ=0.36) from IPAQ-M were significantly correlated (p<0.01) with that measured by accelerometer, but no correlation was observed for sedentary behaviour. Reliability tests revealed significant correlations between the two interview sessions for all intensities of PA (=ρ0.55 to 0.71, p<0.01). Bland-Altman plots showed that time spent in MVPA for IPAQ-M was significantly different from that measured by accelerometer (mean difference: 98.02 min wk-1; 95% limits of agreement: -785.33 to 1317.83 min wk-1; p<0.01). When classifying people into meeting PA recommendation, the agreement between the two instruments was fair (κ=0.22). The IPAQ-M has acceptable validity for MVPA, vigorous and total physical activity, and was reliable for assessing the physical activity of Malay adults.​

Acute Effect of Caffeine on Oxygen Consumption and Rating of Perceived Exertion during Moderate Intensity Exercise among Sedentary Young Female Adults / Jurnal Sains Kesihatan Malaysia

Caffeine had been shown to have an ergogenic effect on trained individuals; however, studies investigating the physiological effects of caffeine on the sedentary population are limited. The aim of this study was to examine the effect of caffeine on oxygen consumption and rating of perceived exertion during moderate intensity exercise among sedentary young adult females. Subjects comprised 16 female undergraduates aged between 22 to 24 years studying at Universiti Kebangsaan Malaysia. Eligibility criteria were based on low physical activity level and daily caffeine intake of less than 50 mg a day, which was screened using the International Physical Activity Questionnaire (short version) and caffeine consumption questionnaire, respectively. The design of this study is single-blind, crossover, placebo-controlled with all subjects serving as their own controls. Subjects were required to report to the physical activity laboratory for two experimental sessions after either ingesting placebo or caffeine capsule with an interval of 3 days between these two experimental sessions. Sixty minutes after ingesting placebo capsule (Glucolin, glucose) or 100 mg caffeine (Pro-plus, United Kingdom), subjects were required to run on a treadmill for 30 minutes at a standardized power output equivalent to 60% of maximal heart rate. Oxygen consumption, heart rate, and rating of perceived exertion were recorded at 20th, 25th and 30th minutes, while blood pressure was recorded immediately after subjects completed their 30 minutes run. Mean body fat percentage was 28.4 ± 5.4. Differences were recorded after every subject completed both the placebo and caffeine experiments. Paired t-tests showed no significant difference between placebo vs caffeine trials for oxygen consumption (13.99 ± 2.47 vs 14.49 ± 1.73, p = 0.440), rating of perceived exertion (12.3 ± 2.5 vs 12.3 ± 2.1, p = 1.000), systolic blood pressure (113 ± 10 vs 117 ± 11, p = 0.129), diastolic blood pressure (67 ± 8 vs 69 ± 10, p = 0.408) and heart rate (127.3 ± 11.0 vs 127.1 ± 11.6, p = 0.912). There was strong significant negative correlation between body fat percentage and oxygen consumption (r = –0.568, p < 0.05) and strong significant positive correlation between body fat percentage and rating of perceived exertion (r = 0.515, p < 0.05). The non-significance in the results obtained could be due to the small effect size of the study (d = 0.24). Hence, future studies with a larger number of participants should be carried out to examine the effects of caffeine during exercise in a sedentary population

Short Review Of Fourteen Years Maternal Mortality In Achieving Mdg5 In UKMMC

Worldwide maternal mortality rate had reduced tremendously including Malaysia. At the 2000 Millenium Summit, eight Millenium Development Goals (MDGs) were established with target for the year 2015. Three years remained until the dateline to achieve MDG5, which comprised of two targets and one being reducing the maternal mortality ratio by 75%. This review compared the trend of maternal mortality and its causes in our centre to the national data. The national data had shown a reduction from 44 to 27.6 in 100 000 live births in1991 and 2008 respectively. The subsequent rate had stabilized for the past seven years. In contrast the UKM Medical Centre (UKMMC) data in the past 15 years had not been stable. The target of MDG5 seemed to be achievable by our country but may require longer time as we have yet to find ways to overcome medical care inadequacy in remote areas.