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The Crocker Formation, Late Eocene to Middle Miocene in age, was deposited in a deep-marine environment by a turbidity current. Most of the facies identified in the field are related to the sedimentary bed-form structures belonging to Bouma sequences. These prominently include unit divisions such as Ta referring to grading sand, Tb for parallel laminae, Tc for cross laminae, Td for mud laminae, and Te referring to hemipelagic mud. Five facies have adequately been identified using Bouma sequence implications, namely Facies 1 (F1: Ta-Tb layers), Facies 2 (F2: Ta-Te layers), Facies 3 (F3: Tb-Te layers), Facies 4 (F4: Tb / Tc-Te layers), and Facies 5 (F5: Td-Te layers). Based on the Crocker Formation facies analysis, three distinct groups of facies associations were recognised: Deep-Marine Channel-Lobe Association (Type A1), Deep-Marine Channel-Levee Association (Type A2), and Distal Lobe Association. These facies associations precisely revealed that the Crocker Formation's depositional environments were likely deposited in the middle-fan with associated outer-fan settings.

This study explored radiology procedure cost across available units in the Radiology’s Department UKMMC (University Kebangsaan Malaysia Medical Centre). In 2011, the total number of radiology procedures carried out in this department was 121,221. Nevertheless, the estimating expenses of offering these procedures are not known. An economic evaluation study was employed and cost centric data mining based on costing activity method was used to determine the charge of the procedure in every centre. Information on seven cost parameters was collected for each procedure: human resources, consumables, equipment, reagents, administration, maintenance and utilities. The results of the study show that the highest percentage of cost parameter for the human resource was Radiology (Mobile) 57.5%, the highest percentage of cost parameter for consumables and reagent was EIR (Endovascular International Radiology) Unit 75.8% and Medical Nuclear Unit 68.1% was the highest percentage of cost parameter for reagent. The MRI (Magnetic Resonance Imaging) Unit 81.4% was the highest cost parameter for equipment. The most top mean cost procedures were EIR MYR4330 and it was revealed that procedures with the highest difference ratio were procedures in EIR (18.50). Finding of this study is very useful to UKMMC management since it helps to enhance the efficiency of services and reduce unnecessary radiology procedures in patient’s management.

Waterfalls around Kenyir Lake, Terengganu naturally serve as an iconic symbol of amazing rock bounded formation amidst the wilderness, which stores a hidden story for millions of years. The waterfalls feeding the Kenyir Lake have become tourists’ main attractions since they are located separately on a different island. There are three naturally picturesque waterfalls worth seeing in the study area, namely Sungai Buweh Waterfall, Lasir Waterfall, and Saok Waterfall, which are made up of granitic rock body that emerged in the Eastern Belt during the Late Triassic (~251.2 Ma). To date, the waterfall landscape in any area concerned with geotourism focusses more on outcrop architecture and geomorphological features, but has only limited accessibility to rock records. This study was carried out to evaluate the geo heritage features, of the waterfall landscape as well as its rock-forming minerals. Three rock samples were carefully collected from the waterfalls and subsequently prepared for optical thin section petrography analysis using a polarised light microscope. The optical thin section petrography further revealed precise mineral compositions, fabrics, and microstructures. A photomicrograph of the thin sections was also taken at low and high magnification levels in plane polarised light (PPL) and cross polarised light (XPL). Additionally, petrographic modelling was constructed using optical microscopic data to help identify a microscopic mineral (a hidden material in rock) in detail so that the mineral becomes clear to both geologists and the public at large. Generally, this modelling will enlighten the public on the material embedded in the rocks and illustrate the importance of learning about rock-forming minerals as well as to embed the idea of making the waterfall a Sustainable Development Goal (SDG). Besides making geology an interesting field to embark on, this mineral find affirms the beauty of the waterfalls for tourism purposes, thereby connecting geotourism and nature. The minerals from various constituents are also useful for scientific heritage purposes and may benefit the economy by serving as sustainable tourism while being part of a geopark.

Purpose: Primary immunodeficiency disease (PID) affects various aspects of a patient’s life. However, the health-related quality of life (HRQOL) of PID patients in Malaysia patients is poorly described. This study aimed to determine the quality of life of Malaysian PID patients and parents. Method: This cross-sectional study was performed from August 2020 to November 2020. Patients with PID and their families were invited to answer the PedsQL Malay version (4.0) questionnaire, the tool used to assess the HRQOL. A total of 41 families and 33 patients with PID answered the questionnaire. A comparison was performed with the previously published value of healthy Malaysian children. Result: Parent of respondents recorded a lower mean of total score than the parents of normal healthy children (67.26±16.73 vs. 79.51±11.90, p-value = 0.001, respectively). PID patients reported lower mean total score to normal healthy children (73.68 ± 16.38 vs. 79.51 ± 11.90, p-value = 0.04), including psychosocial domain (71.67±16.82 vs. 77.58±12.63, p-value = 0.05), and school functioning, (63.94±20.87 vs. 80.00 ± 14.40, p-value = 0.007). No significant difference of reported HRQOL when comparing between subgroup of PID on immunoglobulin replacement therapy and those without immunoglobulin replacement (56.96±23.58 vs. 65.83±23.82, p-value 0.28). Socioeconomic status was found to be predictive of the lower total score of PedsQL in both parent and children reports. Conclusion: Parents and children with PID, especially those from middle socioeconomic status, have lower HRQOL and school function impairment than healthy children.

ObjectiveTo investigate the psychosocial impact of COVID-19 on Malaysian families.DesignA cross-sectional study performed using an anonymous online questionnaire distributed through social media, email and the Department of Social Welfare.SettingMalaysian families were invited to answer the questionnaires. The sampling was performed between 12 May 2020 and 9 June 2020.InterventionThe psychological impact was assessed using the Impact of Event Scale-Revised (IES-R) and Children’s Revised Impact of Event Scale (CRIES). The mental health status was assessed using the Depression, Anxiety and Stress Scale (DASS) 21.Main outcome measure(1) Psychological impact on Malaysian families. (2) Prevalence of mental health status of Malaysian families during COVID-19 pandemic.ResultA total of 409 Malaysian families have responded (409 parents and 348 children), 154 respondents (38%) reported high psychological impact (score 14) for psychological construct and 189 respondents (46%) reported high psychological impact (score 6) for behavioural construct. A significantly higher proportion of respondents with not permanent employment status of the family lead reported high psychological impact. The prevalence of anxiety reported from family respondents was 23%. Forty-five children answered the DASS-21 questionnaire; 28.5% reported anxiety, 31.4% reported depression and 13.3% reported stress. The job security status of the family lead was found to be the predictive factor for the mean total IES-R score (psychological construct) and ethnicity for mean total CRIES-8 and CRIES-13.ConclusionRates of depression and anxiety during the COVID-19 pandemic were high. Findings suggest that urgent measures to ensure job security among Malaysian families are important to reduce the impact of the COVID-19 pandemic on psychosocial and mental health outcomes.

The Middle Miocene sedimentary faciess classified as the Lambir Formation at Tusan Beach and Lambir Hill is revealed as tide dominated with exposed minor wave regimes association. Evidence of wave dominated facies is displayed mostly on shoreline deposits, such as planar cross stratified (PcS), swaley cross stratified (ScS), swaley-Hummocky cross stratified (SHcS) and hummocky cross stratified (HcS). The facies analysis reveals four facies associations, namely; foreshore facies association, upper shoreface, middle shoreface and lower shoreface. Whereas, tide dominated regime resulted three major facies association: tidal sand bar (TSB) facies association, tidal sand flat facies association (TSF) and subtidal mud flat (SMF). TSB facies association was developed from tide influenced shoreline that represented by herringbone cross stratified sandstone bed. The occurrence of herringbone cross stratified and other tidally structures within same facies explain that the current activities are in reversal process (flood and ebb). TSF and SMF facies associations, are widely distributed in the central Miri region including part of Lambir Hill and the Nakat River area. Wide exposure of frequent heterolitic beds, suggest that the Lambir Formation was deposited within the tidal flat environment.

The survey data on potential aquifer was collected at two sites located in Banggi Island (i.e. Laksian Primary School [LPS] and Padang Primary School [PPS]), Malaysia on 25 and 26 April 2013. Both locations are geologically surrounded by various types of lithologies, namely, sandstone, mudstone, siltstone, shale, chert, conglomerate, lignite, tuff, limestone, terrace sand, gravel and coral. The resistivity data consisted of six-line pole-dipole short arrays and were recorded in-situ using SAS 4000 ABEM Lund Imaging System, together with a relay switching unit (Electrode Selector ES 464), six multiconductor cables, steel rod electrodes and jumpers. The data, namely electrode spacing, depth of investigation, subsurface resistivity, type of material and horizontal data coverage were used to assess the characteristics of the potential aquifer. The recorded data were then processed using RES2DINV software to obtain 2-D inversion model of the subsurface. The data were also equipped with six models of inverse resistivity section for both areas. The data obtained can be used by the government and stakeholders for groundwater exploration and extraction in order to provide water supplies for local communities, especially since access to these resources from the surrounding water treatment plants on the island is limited.

Background The delivery of post stroke care is fragmented even in advanced public healthcare systems, globally. Primary care teams are entrusted to provide longer term care for stroke survivors in most developing countries. The integrated Care Pathway for Post Stroke patients (iCaPPS©) was designed to guide primary care teams to incorporate further rehabilitation and regular screening for post stroke complications among patients residing at home in communities, using the shared-care approach, especially in areas with limited access to specialist stroke care services. The iCaPPS© addressed coordination of rehabilitation and screening for post stroke complications which were absent in the current conventional care of patients managed at public primary care healthcentres. This study aimed to evaluate the cost effectiveness and impact of iCaPPS© on quality-adjusted- life-years (QALY) compared with current conventional monitoring at public primary care healthcentres. Methods A pragmatic healthcentre-based cluster randomised controlled trial-within trial on 151 post stroke patients from 10 public primary care facilities in Peninsular Malaysia was conducted to evaluate QALY of patients managed with iCaPPS© (n = 86) vs conventional care (n = 65) for 6 months. Costs from societal perspective were calculated, using combination of top down and activity-based costing methods. The 5-level EQ5D (EQ-5D-5 L) was used to calculate health state utility scores. Cost per QALY and incremental cost effectiveness ratio (ICER) were determined. Differences within groups were determined using Mann-Whitney tests. Results Total costs for 6 months treatment with iCaPPS© was MYR790.34, while conventional care cost MYR527.22. Median QALY for iCaPPS© was 0.55 (0,1.65) compared to conventional care 0.32 (0, 0.73) (z = − 0.21, p = 0.84). Cost per QALY for iCaPPS© was MYR1436.98, conventional care was MYR1647.56. The ICER was MYR1144.00, equivalent to 3.7% of per capita GDP (2012 prices). Conclusions Management of post stroke patients in the community using iCaPPS© costs less per QALY compared to current conventional care and is very cost effective. Trial registration Trial Registration number ACTRN12616001322426. Registered 21 September 2016. (Retrospectively registered).

Presently there is a gross lack of information on cost and cost weights in many developing countries that implement casemix system. Furthermore, studies that employed Activity Based Costing method (ABC) to estimate the costs of radiology procedures were rarely done in developing countries, including Malaysia. The main objective of this study is to determine the costs of radiology procedures for each group in casemix system, in order to develop cost weights to be used in the implementation of the casemix system. An economic evaluation study was conducted in all units in the Department of Radiology in the first teaching hospital using the casemix system in Malaysia. From the 25,754 cases, 16,173 (62.8%) of them were from medical discipline. Low One Third and High One Third (L3H3) method was employed to trim the outlier cases. Output from the trimming, 15,387 cases were included in the study. The results revealed that the total inpatients’ charges of all the radiology procedures was RM1,820,533.00 while the cost imputed using ABC method was RM2,970,505.54. The biggest cost component were human resources in Radiology Unit (Mobile) (57.5%), consumables (78.5%) of Endovascular Interventional Radiology (EIR) Unit, equipment (81.4%) of Magnetic Resonance Imaging (MRI) Unit, reagents (68.1%) of Medical Nuclear Unit. The one highest radiology cost weight, was for Malaysia Diagnosis Related Group (MY-DRG®) B-4-11-II (Hepatobiliary and Pancreas Neoplasms with severity level II, 2.8301). The method of calculation of the cost of procedures need to be revised by the hospital as findings from this study showed that the cost imposed to patient is lower than the actual cost. DOI : http://dx.doi.org./10.17576/JSKM-2018-1601-19

Background Maxillofacial injuries are one of the most common injuries among the road traffic accident (RTA) cases in Malaysia. The aim of this present study was to compare the pattern of maxillofacial injuries, severity and risk factors in two university hospitals in Peninsular Malaysia. The predictors of maxillofacial fractures were also quantified. Study design This is a prospective cross-sectional study conducted in Universiti Kebangsaan Malaysia Medical Centre (UKMMC) and Hospital Universiti Sains Malaysia (HUSM) from July 2010 to June 2011. Information related to demographics, socioeconomics, injury site and severity together with hospitalisation details were collected for analysis. Results A total of 278 maxillofacial patients were included in this study. Majority of the patients were single young Malay males with low socioeconomic status. Mid-facial fractures were more common than mandibular fractures in both hospitals. Among the concomitant injuries, orthopaedic injuries were shown to be the commonest in both hospitals. Most of these patients had mild Injury Severity Score (ISS). The final predictors for facial fractures in UKMMC were gender and the ISS while age group, gender, type of combined injuries and the ISS were shown for HUSM. Conclusions Midfacial fractures were the most common maxillofacial fractures in both hospitals. HUSM patients showed more severe injury patterns compared to UKMMC patients. Significant predictors for facial fractures were the Injury Severity Score for UKMMC while age, gender and type of combined injuries were shown for HUSM.

Bin Sulong Saperi,1 Roszalina Ramli,2 Zafar Ahmed,1 Amrizal Muhd Nur,1 Mohd Ismail Ibrahim,3 Muhd Fazlynizam Rashdi,2 Rifqah Nordin,2 Normastura Abd Rahman,4 Azizah Yusoff,4 Abd Jabar Nazimi,2 Roselinda Abdul Rahman,4 Noorhayati Abdul Razak,4 Norlen Mohamed 5 1International Centre for Casemix and Clinical Coding, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, 2Department of Oral and Maxillofacial Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, 3Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, 4School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian, 5Malaysian Institute of Road Safety Research, Kuala Lumpur, Malaysia Objective: Facial injury (FI) may occur in isolation or in association with injuries to other parts of the body (facial and other injury [FOI]). The objective of this study was to determine the direct treatment costs incurred during the management of facial trauma. Materials and methods: A prospective cohort study on treatment cost for FIs and FOIs due to road-traffic crashes in two university hospitals in Malaysia was conducted from July 2010 to June 2011. The patients were recruited from emergency departments and reviewed after 6 months from the date of initial treatment. Direct cost analysis, comparison of cost and length of hospital stay, and Injury Severity Score (ISS) were performed. Results: A total of 190 patients were enrolled in the study, of whom 83 (43.7%) had FI only, and 107 (56.3%) had FOI. The mean ISS was 5.4. The mean length of stay and costs for patients with FI only were 5.8 days with a total cost of US$1,261.96, whereas patients with FOI were admitted for 7.8 days with a total cost of US$1,716.47. Costs doubled if the treatment was performed under general anesthesia compared to local anesthesia. Conclusion: Treatment of FI and FOI imposes a financial burden on the health care system in Malaysia. Keywords: facial injury, road traffic crashes, cost analysis, university hospitals, Malaysia

Living mammalian especially European cats will face some problems when traveling from cold ambient in Europe to hot ambient country. Some of the problems are, these cats will become panting when exposed to the high temperature of ambient for a short term. Also, for a long term exposed to high temperature, the cats will experience heat stress and hair loss. The objectives of this study are on cat thermal comfort, cooling load for cat compartment, and analysis of air flow to achieve the desired temperature for the cat compartment using CFD simulation. In this study, three parts of analysis will be considered in CFD simulations which are the thermal distribution for four Peltier plates with aluminium heat sink using ANSYS Transient Thermal, air flow in the ducting to a cold heat sink, and air flow distribution in cat compartment using ANSYS Fluent. The temperature for the Persian cat’s thermal comfort is around 20-25°C. Cooling load gain from designed portable cat compartment with the desired space is 177 W. By ANSYS Transient Thermal, time taken for heat sink change from 22°C to 12°C is around 200-250 seconds. Then, by using ANSYS Fluent, the temperature of initial air temperature in the ducting when flow through a cold heat sink was changed from 27.15°C to 20.93°C by simple cooling. Next, the average air temperature in the cat’s compartment is 23.83°C that achieved average thermal comfort for mammal or Persian cat which is 20-25°C of dry bulb temperature. However, the study only focuses on steady-state dry air simple cooling analysis only with the laminar flow as a preliminary result by CFD simulation before build the actual portable cat compartment. The dry air simulation can be assumed similar as humid air for simple cooling process only proved by the comparison of the same cooling capacities values towards the different value of absolute humidity.

An operation theatre (OT) is a special room inside the hospital where medical surgery is carried out by a surgeon with the help of medical personnel. Technical standards or requirements which have been set for heating, ventilation and air conditioning (HVAC) inside an operation theatre is important not only for the comfort of surgeon, patient, and medical personnel, but also to reduce the risk of surgical site infection during surgery. This research focus on Minor Operation Theatre (MOT) which is dental surgery room at Universiti Malaysia Perlis Health Centre with room dimensions of 2.89 m(H)×3.12 m(W)×3.4 m(L) is used for numerical analysis. The air flow supplied to the MOT is from single unit air-conditioning system. Computational Fluid Dynamics (CFD) analysis is a part of an investigation to determine the air flow and temperature distribution inside the MOT. A simulation conducted by using ANSYS Fluent only consider dry air inside MOT. Therefore, the main aim of this research is to compare and analyze the simulation of dry air conducted with previously obtained experimental data of humid air distribution inside the MOT. The comparison of humid and dry air temperature throughout the MOT shows that the difference is 25.3%. The average temperature of humid air inside the MOT is 21.8 °C while for dry air is 16.3 °C. Moreover, the cooling capacity of humid air and dry air are 2.23 kW and 1.64 kW respectively. Thus, the difference between humid air and dry air-cooling capacity is 26.5%. However, the dry air simulation and humid air simulation is the same if only the process is considered as simple cooling.