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Background: Inpatient hyperglycaemia is common and associated with poor outcomes such as increased mortality and prolonged hospital stay. This study aimed to determine the prevalence of inpatient hyperglycaemia and glycaemic control in Putrajaya Hospital, Malaysia. Secondary objectives were to compare the length of stay (LOS), 30-day readmission rate, and death between controlled and uncontrolled glycaemic groups. Methods: This cross-sectional study was conducted between 1 July and 31 December 2019 among patients in medical wards who had a blood glucose (BG) level of > 7.8 mmol/L and stayed in the wards for ≥ 24 h. We retrieved information on demographics, diabetes history and BG profiles. The definition of controlled glycaemic status is when ≥ 80% of BG readings were between 4.0 mmol/L and 10.0 mmol/L during the hospital stay. Results: The prevalence of inpatient hyperglycaemia was 55.2%. There were 841 patients who met the eligibility criteria; their mean age was 60 (13.8) years old. Most (79.4%) of the patients were Malay and 53.9% were male. There were 452 (53.7%) patients in the uncontrolled group. They were younger and admitted with more kidney complications compared to those in the controlled group. The median LOS for both groups was 3 (2) days. The uncontrolled group showed a higher percentage of readmission within 30 days (7.5% versus 4.6 %) and death during admission (3.3% versus 1.6 %) (P = 0.100 and P = 0.082). Conclusion: The prevalence of inpatient hyperglycaemia was high. More than half of them had uncontrolled BG. Both groups had a similar average length of stay. The 30-day readmission rate and death during admission were higher in the uncontrolled group, although statistically not significant. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to examine the construct verification of the knowledge on the Noor evidence-based medicine (EBM) questionnaire using the Rasch measurement model. Methods: A cross-sectional study was conducted among ninety healthcare professionals working in a government hospital. The Rasch model was used to investigate the distribution of statistics, unidimensionality, polarity, misfit, and Wright map. Results: The Rasch analysis showed that the 15 items had high reliability of items at 0.96, while reliability for persons were 0.81. Item K15 is a misfit (PtMea Corr=0.22, outfit MnSq=1.95, outfit z-std=5.00, infit MnSq=1.63, infit z-std=3.60); the item does not contribute to the construction of scale but not degrading. Three items (K1, K14, and K9) can easily be answered even by low ability respondents. Conclusions: The Noor EBM questionnaire knowledge is robust with excellent psychometric properties that can be used for both research and clinical purposes. [ABSTRACT FROM AUTHOR]

Pemphigus foliaceus is a benign variety of pemphigus group. It is a rare autoimmune blistering disease that affects the skin without mucosal involvement. It can present in endemic and sporadic form; whereby endemic form is common in Brazil and Tunisia, known as fogo selvagem. There was no previous case reported in Malaysia. We report a case of a 43-year-old man, who presented with generalized extensive blisters and vesicles that form crust and scale. The full evaluation established the diagnosis of pemphigus foliaceous. Delay in diagnosis can lead to poor outcomes. Primary care practitioners should be aware of this since the condition can mimic eczema, specifically photodermatitis. [ABSTRACT FROM AUTHOR]

Background: COVID-19 was declared a pandemic by the World Health Organization (WHO). COVID-19 is highly contagious, making it a threat to healthcare workers, including those working in mortuaries. Therefore, it is important to determine if the cause of death (COD) could be identified using limited autopsy, diagnostic tests and post-mortem imaging modalities instead of full autopsy. This study aims to examine the effectiveness of post-mortem imaging, specifically post-mortem computed tomography (PMCT) at determining the COD during a pandemic. Methods: This cross-sectional study included 172 subjects with suspected or unknown COVID-19 status brought in dead to the institute's mortuary during the pandemic in Malaysia. PMCT images reported by forensic radiologists and their agreement with conventional autopsy findings by forensic pathologists regarding COD were analysed to look at the effectiveness of PMCT in determining COD during a pandemic. Results: Analysis showed that 78.7% (133) of cases reported by forensic radiologists concurred with the COD certified by forensic pathologists. Of these cases, 85 (63.9%) had undergone only external examination and real-time reverse transcriptase polymerase chain reaction (rRT-PCR) COVID-19 testing, meaning that imaging was the sole method used to determine the COD besides history from available medical records and the investigating police officer. Conclusion: PMCT can be used as a complement to medicolegal autopsies in pandemic contexts, as it provides significant information on the possible COD without jeopardising the safety of mortuary health care workers. [ABSTRACT FROM AUTHOR]

Issues which are consist in learning disability context for the blind comprises several aspects such as; teachers did not teach the Quran by using the Quran in braille, have not mastered in Quran Braille code, have not basic learning on the Quran and alphabetical character. This article attempts to find out the issues and challenges of learning disabilities experienced by Muslim Blind Community in Malaysia. The study also aims to solve problems on learning disabilities among Muslim blind community in Malaysia by using braille approach. This study undertakes an analysis of people with learning disabilities based on issues and challenges as the main sources of reference by adopting the document analysis method. Therefore, this study used a qualitative method with a protocol of observation and analysis of several sources to get data and information. The outcome of this article suggests that the Malaysia government needs to make improvements in order to enhance the quality of education for people with learning disabilities and create a special education program for them. This paper clarifies that the methods and point solutions to the problems faced by this kind of people is considered as a new issue and supposed to be handled by government and private sector. [ABSTRACT FROM AUTHOR]

In Peninsular Malaysia, barn owls (Tyto javanica javanica) have been utilized as biological control of rats since the 1960s. In this study, the impact of introduced barn owls on rat populations in an oil palm plantation in Sabah, Malaysia, were studied. There were three treatment areas in this study: T1 (barn owl area) was an oil palm plot where no rodenticides were applied and rat control relied solely on predation of the introduced barn owls, T2 was an oil palm plot where one fixed baiting campaign was carried out per year, and T3 was an oil palm plot where two fixed baiting campaigns were carried out per year. Rat abundance and fresh fruit bunch (FFB) damage were assessed monthly throughout the four-year study period. The dominant species at all treatment areas was the House rat, Rattus rattus diardii. Both rat abundance and FFB damage were higher in the first year of study at all three treatment areas. FFB damage was lowest at T3 compared to the other two treatment areas throughout the entire study period, probably due to the intensive baiting carried out at T3. FFB damage at T1 was comparable to FFB damage at T2 (with the exception of the first year of study). Additionally, FFB damage at T1 after the first year was frequently below the 5% FFB damage threshold level. The results of this study indicate that introduced barn owl control of rat pests was sufficient for at least three years and perhaps more. [ABSTRACT FROM AUTHOR]

Background: Healthcare providers are vulnerable in the fight against COVID-19 and may experience significant psychological and mental health consequences. This study aimed to compare the levels of depressive symptoms among frontline and non-frontline healthcare providers in response to the COVID-19 pandemic. Methods: A comparative cross-sectional study was conducted in two government hospitals managing COVID-19-related cases in Kelantan, Malaysia from May to July 2020 to identify and compared depressive symptoms levels of frontline and non-frontline healthcare providers. Convenient sampling was applied in the selection of eligible participants and those diagnosed as having any psychiatric illnesses were excluded. The self-administered questionnaires for the Malay versions of the Hospital Anxiety and Depression Scale to measure depressive symptoms score and the Medical Outcome Study Social Support Survey to measure social support score as an important confounder. A descriptive analysis, independent t-test and ANCOVA were performed using SPSS version 26. Results: A total of 306 respondents from healthcare providers were recruited which 160 were frontline healthcare providers and 146 were non-frontline healthcare providers. The level of depressive symptoms (HADS score >8) was 27.5% for the frontline healthcare providers and 37.7% for the non-frontline healthcare providers. The mean depressive symptoms score for the non-frontline healthcare providers was 0.75 points higher than that of the frontline healthcare providers after adjusting for gender, duration of employment and social support. Conclusion: Non-frontline healthcare providers are also experiencing psychological distress during the COVID-19 pandemic even though they do not have direct contact with COVID-19 patients. [ABSTRACT FROM AUTHOR]

The participation of women in entrepreneurship plays a significant role in economic development especially in reducing unemployment, increasing production and consumption, achieving gender equality, social and cultural reforms. One of the dominant areas for women is batik and songket entrepreneurs who are synonymous with women on the East Coast of Peninsular Malaysia. Studies have identified three key elements that contribute to the development of this craft entrepreneur, viz. attitude, business inheritance and religious value culture. Qualitative design methods based on case studies and in-depth interviews were used in this study on 12 informants in the state of Kelantan and Terengganu in Malaysia. The findings show that there are three main factors that cause the formation of women handicraft entrepreneurs, namely attitude, family heritage and religious values. Hence, all the factors that make up a female handicraft entrepreneur in Malaysia are discussed in this article. The findings imply that increasing women entrepreneurs in handicrafts can raise the quality of handicraft products into becoming the best tourism products in the East Coast. [ABSTRACT FROM AUTHOR]

Background: In the fight against the COVID-19 pandemic, frontline healthcare providers who are engaged in the direct diagnosis, treatment, and care of patients face a high risk of infection yet receive inadequate protection from contamination and minimal support to cope with overwork, frustration, and exhaustion. These problems have created significant psychological and mental health concerns for frontline healthcare providers. This study aimed to compare the levels of vicarious traumatization between frontline and non-frontline healthcare providers in response to the COVID-19 pandemic. Methodology: All the subjects who met the inclusion criteria were recruited for this comparative cross-sectional study, which was conducted from May to July 2020 in two hospitals in Kelantan, Malaysia. A self-administered questionnaire, namely, the Malay-version Vicarious Traumatization Questionnaire and the Medical Outcome Study Social Support Survey were utilized. A descriptive analysis, independent t-test, and analysis of covariance were performed using SPSS Statistics version 26. Results: A total of 160 frontline and 146 non-frontline healthcare providers were recruited. Vicarious traumatization was significantly higher among the non-frontline healthcare providers (estimated marginal mean [95% CI]: 79.7 [75.12, 84.30]) compared to the frontline healthcare providers (estimated marginal mean [95% CI]: 74.3 [68.26, 80.37]) after adjusting for sex, duration of employment, and social support. Conclusion: The level of vicarious traumatization was higher among non-frontline compared to frontline healthcare providers. However, the level of severity may differ from person to person, depending on how they handle their physical, psychological, and mental health. Hence, support from various resources, such as colleagues, family, the general public, and the government, may play an essential role in the mental health of healthcare providers. [ABSTRACT FROM AUTHOR]

What are the roles and limitations of domestic election monitoring organizations (DEMOs) in Malaysia, which lie at the midpoint of the democracy/autocracy continuum? Although DEMOs have been active in Malaysia since GE 1990, until the 10 series of by-elections held after the historic 2018 General Election (GE 2018), they were not as prominent as legitimate third parties compared to DEMOs in several other Southeast Asian countries. This article identifies three factors that play a key role in influencing the operation of DEMOs in Malaysia: the dual character of the Malaysian electoral system, the polarisation of civil society and political complexion of DEMOs. Although the post-2018 General Election saw the Election Commission diversify the involvement of DEMOs, it ironically created a convergence among pro-Pakatan Harapan DEMOs. The findings also suggest that the three crucial factors in developing election monitoring involvement of civil society, democracy assistance and a combination of grievances and the structure of political opportunities did not play a complementary role in Malaysia. [ABSTRACT FROM AUTHOR]

The under-utilized legume Mucuna bracteata is a potential biomass resource in Malaysia. A 24-month study was conducted under 10-year-old mature oil palm trees to determine the effects of several harvesting frequencies of M. bracteata on the legume biomass and soil properties. The experimental design was a randomized complete block design (RCBD) for the biomass and a two-factorial RCBD for the soil properties. The treatments were the harvesting frequencies, which were once every two, four, six, and twelve months. The control treatment was without harvest. There were significant effects on the legume's cumulative biomass, standing biomass, leaf area, nutrient contents, and total nutrient harvested for N, Ca, Mg, and cellulose content. Generally, the more frequent the harvest, the more biomass was obtained, but the more legume standing biomass and leaf area were reduced. Despite the reduction in legume growth and leaf area in the field, harvesting the legume did not affect any of the soil physicochemical properties. The biomass N, Ca, and Mg contents and nutrient harvested were also affected by harvesting. This was due to the production of relatively more young shoots after harvesting, which would remove most of the aboveground plant parts. The cellulose content in the legume also increased for the same reasons. Results showed that harvesting M. bracteata once every six months was an acceptable compromise between collecting large amounts of legume biomass and having a reduced legume growth recovery and leaf area in the field, but yet not detrimentally affecting the soil properties. [ABSTRACT FROM AUTHOR]

Introduction: Dietary patterns (DP) and its relationship with academic performance especially among schoolchildren have received significant attention in nutritional epidemiology studies. The objective of this cross-sectional study was to determine the determinants of academic success among Malay teenagers in Terengganu, Malaysia. Methods: Habitual dietary intakes were obtained using a semi-quantitative food frequency questionnaire, anthropometry data were measured by trained researchers and information on academic performance were gathered from the school registrar’s office. The method of reduced rank regression was employed in order to determine the dietary patterns (DPs) and multivariable linear regression models were employed to examine the relationships between DP and academic performance. Results: Of the 375 study participants, half of the sample were female (50.1%), with 61.9% having a normal BMI. The main DP identified in this study was “high sugar, high sodium and high saturated fatty acid (SFA)”. The models showed that there were significant inverse associations between the DP with Science marks (β=-1.87; 95%CI:-0.39,-3.36; p=0.013) and the combination of Mathematics and Science marks (β=-3.49; 95%CI:-0.45,6.52; p=0.024). Findings showed that a ‘high sugar, sodium and SFA’ DP could negatively impact the academic performance of adolescents, particularly in STEM-related subjects. Conclusion: These could serve as a basis for developing nutritional education among adolescents to enhance academic performance for a better future. [ABSTRACT FROM AUTHOR]

Introduction: There is a significant increase in the number of divorce cases among Malay Muslim couples over the past years which serves as a strong signal for the government to take initiatives to understand the current situation. A plethora of literature can be found on marriage satisfaction and the quality of the relationship within marriages. However, exploration on contributing factors to long lasting marriages amongst the Malay Muslim community are lacking. This paper aims to share the initial findings in an effort to explore of the strength of relationship in a lasting marriage amongst Malay Muslim couples in Malaysia. Methods: This paper adopted a quantitative approach utilizing the Eternal Love Instrument (c) 2016 which consisted of 171 items, distributed to 350 respondents based on simple random sampling technique. Results: The findings indicated that there are three main considerations in selecting a spouse which were (1) Religion (95.2%); (2) Character (responsible) (96.1%); well mannered (95.8%); and (3) Race (79.3%). Age, looks and type of jobs were the least considered factors amongst the respondents surveyed. The respondents perceived that the strongest element in their relationship was communication (69.6%), followed by tolerance (62.6%) and responsible towards family wellbeing (56.4%). Conclusion: The initial survey has indicated that a lasting marriage is a consequence of having a responsible partner with good religious background. Also, from all these five constructs, these respondents considered their spouses to be highly responsible. [ABSTRACT FROM AUTHOR]

Introduction: Healthcare workers play a crucial role in supporting COVID-19 vaccination as they are the most trusted source of information to the public population. Assessing the healthcare workers' hesitancy towards COVID-19 vaccination is pertinent, however, there are limited validated tools to measure their hesitancy on COVID-19 vaccines. This study aims to adapt and validate the first COVID-19 hesitancy scale among healthcare workers in Malaysia. Materials and methods: This study adapted and translated the Vaccine Hesitancy Scale (VHS) developed by the WHO SAGE Working Group. The scale underwent a sequential validation process, including back-back translation, content, face, and construct validity for Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). The reliability was tested using internal consistency (Cronbach's alpha composite reliability (CR) and average variance extracted (AVE)). Results: The data for EFA and CFA were completed by a separate sample of 125 and 300 HCWs, respectively. The EFA analysis of the C19-VHS-M scale was unidimensional with 10 items. A further CFA analysis revealed a uniform set of nine items with acceptable goodness fit indices (comparative fit index = 0.997, Tucker-Lewis index = 0.995, incremental fit index = 0.997, chi-squared/degree of freedom = 1.352, and root mean square error of approximation = 0.034). The Cronbach's alpha, CR and AVE results were 0.953, 0.95 and 0.70, respectively. Conclusions: The questionnaire was valid and reliable for use in the Malay language. [ABSTRACT FROM AUTHOR]

Background: Maternal mortality has been the main way of ascertaining the outcome of maternal and obstetric care. However, maternal morbidities occur more frequently than maternal deaths; therefore, maternal near miss was suggested as a more useful indicator for the evaluation and improvement of maternal health services. Our study aimed to explore the experiences of women with maternal near miss and their perception of the quality of care in Kelantan, Malaysia.Methods: A qualitative phenomenological approach with in-depth interview method was conducted in two tertiary hospitals in Kelantan, Malaysia. All women admitted to labour room, obstetrics and gynaecology wards and intensive care units in 2014 were screened for the presence of any vital organ dysfunction or failure based on the World Health Organization criteria for maternal near miss. Pregnancy irrespective of the gestational age was included. Women younger than 18 years old, with psychiatric disorder and beyond 42 days of childbirth were excluded.Results: Thirty women who had experienced maternal near miss events were included in the analysis. All were Malays between the ages of 22 and 45. Almost all women (93.3%) had secondary and tertiary education and 63.3% were employed. The women's perceptions of the quality of their care were influenced by the competency and promptness in the provision of care, interpersonal communication, information-sharing and the quality of physical resources. The predisposition to seek healthcare was influenced by costs, self-attitude and beliefs.Conclusions: Self-appraisal of maternal near miss, their perception of the quality of care, their predisposition to seek healthcare and the social support received were the four major themes that emerged from the experiences and perceptions of women with maternal near miss. The women with maternal near miss viewed their experiences as frightening and that they experienced other negative emotions and a sense of imminent death. The factors influencing women's perceptions of quality of care should be of concern to those seeking to improve services at healthcare facilities. The addition of a maternal near miss case review programme, allows for understanding on the factors related to providing care or to the predisposition to seek care; if addressed, may improve future healthcare and patient outcomes. [ABSTRACT FROM AUTHOR]

Background: Given the growing interest in severe maternal morbidity (SMM), the need to assess its effects on quality of life is pressing. The objective of this study was to compare the quality of life scores between women with and without SMM at 1-month and 6-month postpartum in Kelantan, Malaysia.Methods: A prospective double cohort study design was applied at two tertiary referral hospitals over a 6-month period. The study population included all postpartum women who delivered in 2014. Postpartum women with and without SMM were selected as the exposed and non-exposed groups, respectively. For each exposed case identified, a non-exposed case with a similar mode of delivery was selected. The main outcome measures used were scores from the Short Form-12 Health Survey (SF-12).Results: The study measured 145 exposed and 187 non-exposed women. The group-time interaction of the repeated measure analysis of variance (RM ANOVA) showed no significant difference in the mean overall SF-12 physical component summary score changes (P = 0.534) between women with and without SMM. Similarly, the group-time interaction of the RM ANOVA showed no significant difference in the mean overall SF-12 mental component summary score changes (P = 0.674) between women with and without SMM. However, women with SMM scored significantly lower on a general health perceptions subscale at 1-month (P = 0.031), role limitations due to physical health subscale at 6-month (P = 0.019), vitality subscale at 1-month (P = 0.007) and 6-month (P = 0.008), and role limitations due to emotional problems subscales at 6-month (P = 0.008).Conclusions: Women with severe maternal morbidity demonstrated comparable quality of life during the 6-month postpartum period compared to women without severe maternal morbidity. [ABSTRACT FROM AUTHOR]

Background: Knowledge on the factors associated with severe maternal morbidity enables a better understanding of the problem and serves as a foundation for the development of an effective preventive strategy. However, various definitions of severe maternal morbidity have been applied, leading to inconsistencies between studies. The objective of this study was to identify the sociodemographic characteristics, medical and gynaecological history, past and present obstetric performance and the provision of health care services as associated factors for severe maternal morbidity in Kelantan, Malaysia.Methods: A comparative cross-sectional study was conducted in two tertiary referral hospitals in 2014. Postpartum women with severe morbidity and without severe morbidity who fulfilled the inclusion and exclusion criteria were eligible as cases and controls, respectively. The study population included all postpartum women regardless of their age. Pregnancy at less than 22 weeks of gestation, more than 42 days after the termination of pregnancy and non-Malaysian citizens were excluded. Consecutive sampling was applied for the selection of cases and for each case identified, one unmatched control from the same hospital was selected using computer-based simple random sampling. Simple and multiple logistic regressions were performed using Stata Intercooled version 11.0.Results: A total of 23,422 pregnant women were admitted to these hospitals in 2014 and 395 women with severe maternal morbidity were identified, of which 353 were eligible as cases. An age of 35 or more years old [Adj. OR (95 % CI): 2.6 (1.67, 4.07)], women with past pregnancy complications [Adj. OR (95 % CI): 1.7 (1.00, 2.79)], underwent caesarean section deliveries [Adj. OR (95 % CI): 6.8 (4.68, 10.01)], preterm delivery [Adj. OR (95 % CI): 3.4 (1.87, 6.32)] and referral to tertiary centres [Adj. OR (95 % CI): 2.7 (1.87, 3.97)] were significant associated factors for severe maternal morbidity.Conclusions: Our study suggests the enhanced screening and monitoring of women of advanced maternal age, women with past pregnancy complications, those who underwent caesarean section deliveries, those who delivered preterm and the mothers referred to tertiary centres as they are at increased risk of severe maternal morbidity. Identifying these factors may contribute to specific and targeted strategies aimed at tackling the issues related to maternal morbidity. [ABSTRACT FROM AUTHOR]

Background: Severe maternal conditions have increasingly been used as alternative measurements of the quality of maternal care and as alternative strategies to reduce maternal mortality. We aimed to study severe maternal morbidity and maternal near miss among women in two tertiary hospitals in Kota Bharu, Kelantan, Malaysia.Methods: A cross-sectional study with record review was conducted in 2014. Severe maternal morbidity and maternal near miss were classified using the new World Health Organization criteria. Health indicators for obstetric care were calculated and descriptive analyses were performed using SPSS version 22.0.Results: In total, 21,579 live births, 395 women with severe maternal morbidity, 47 women with maternal near miss and two maternal deaths were analysed. The severe maternal morbidity incidence ratio was 18.3 per 1000 live births and the maternal near miss incidence ratio was 2.2 per 1000 live births. The maternal near miss mortality ratio was 23.5 and the mortality index was 4.1 %. The process indicators for essential interventions were almost 100.0 %. Haemorrhagic disorders were the most common event for severe maternal morbidity (68.6 %) and maternal near miss (80.9 %) and management-based criteria accounted for 85.1 %.Conclusions: Comprehensive emergency care and intensive care as well as overall improvements in the quality of maternal health care need to be achieved to substantial reduce maternal death. [ABSTRACT FROM AUTHOR]

Background: Pharmacist's involvement in optimizing medication adherence among diabetic patients has been implemented for over a decade. Diabetes Medication Therapy Adherence Clinic (DMTAC) was set up to educate diabetic patients, monitor treatment outcomes, and manage drug-related problems. While evidence shows that pharmacist-led DMTAC was effective in reducing HbA1c, there was limited data regarding the impact of different intervention types and default to follow-up on glycemic control. Aim: To assess the impact DMTAC on glycemic control and the difference in glycemic control between hospital and health clinic settings as well as defaulter and non-defaulter. In addition, the impact of pharmacist's interventions, DMTAC follow-up frequencies, and duration of diabetes on glycemic control were also determined. Methods: A retrospective study was conducted among diabetes patients under DMTAC care between January 2019 and June 2020 in five hospitals and 23 primary health clinics. Patients' demographics data, treatment regimens, frequencies of DMTAC visits, defaulter (absent from DMTAC visits) and types of pharmacists' intervention were retrieved from patients' medical records and electronic database. HbA1c was collected at baseline, 4–6 months (post-1), and 8–12 months (post-2). Results: We included 956 patients, of which 60% were females with a median age of 58.0 (IQR: 5.0) years. Overall, the HbA1c reduced significantly from baseline (median: 10.2, IQR: 3.0) to post-1 (median: 8.8, IQR: 2.7) and post-2 (median: 8.3, IQR: 2.6%) (p < 0.001). There were 4317 pharmacists' interventions performed, with the majority being dosage adjustment (n = 2407, 55.8%), followed by lab investigations (849, 19.7%), drugs addition (653, 15.1%), drugs discontinuation (408, 9.5%). Patients treated in hospitals received significantly more interventions than those treated in primary health clinics (p < 0.001). We observed significantly less reduction in HbA1c in DMTAC follow-up defaulters than non-defaulters after 1 year (− 1.02% vs. − 2.14%, p = 0.001). Frequencies of DMTAC visits (b: 0.19, CI: 0.079–0.302, p = 0.001), number of dosage adjustments (b: 0.83, CI: 0.015–0.151, p = 0.018) and number of additional drugs recommended (b: 0.37, CI: 0.049–0.691, p = 0.024) had positive impact on glycemic control whereas duration of diabetes (b: − 0.0302, CI: − 0.0507, − 0.007, p = 0.011) had negative impact. Conclusion : Glycemic control improved significantly and sustained up to one year among patients in pharmacists-led DMTAC. However, DMTAC defaulters experienced poorer glycemic control. Considering more frequent visits and targeted interventions by pharmacists at DMTAC resulted in improved HbA1c control, these strategies should be taken into account for future program planning. [ABSTRACT FROM AUTHOR]

This study evaluated the effectiveness and safety of Labisia pumila var alata ( L. pumila) water extract for improving quality of life, cardiovascular and hormonal balance. A randomized, double-blind, placebo-controlled, parallel group, 16-week study in healthy pre- and postmenopausal women aged 40-60 years was conducted in Kelantan, Malaysia. The subjects were randomized to 400 mg propriety extract of L. pumila or placebo. A Women's Health Questionnaire was used to assess quality of life. Repeated-measures analysis of variance was used to evaluate the data. A total of 197 subjects ( L. pumila: n=102 and placebo: n=95) were analyzed. Subjects in the herbal group showed improved memory/concentration, vasomotor symptoms, menstrual symptoms, and sleep problems by 8.3%, 15.9%, 11.8%, and 31.0%, respectively. The greatest improvement was observed for the question: 'I get frightened or panic feelings for apparently no reason at all' with a 53% decrease as compared with placebo. Improvements were also seen in the cardiovascular parameters, and the safety profiles were normal. Postmenopausal women supplemented with L. pumila showed no changes in gynecological relevant hormones luteinizing hormone (LH), follicle-stimulating hormone (FSH), and 17 β-Estradiol. Water extract of L. pumila was shown to be safe and effective for improving several parameters of quality of life and cardiovascular risks factors (total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C]). [ABSTRACT FROM AUTHOR]

Background: Maternal red blood cell (RBC) alloimmunization may lead to production of harmful antibodies that result in hemolytic disease of fetus and newborn (HDFN). There is insufficient data on the prevalence of HDFN due to RBC alloantibodies in the Malay neonatal population. Aim: The aim of this study was to determine the incidence of HDFN in the Malay neonatal population due to clinically significant RBC alloantibodies. Subjects and Methods: A cross sectional study was conducted in Transfusion Medicine Unit, Hospital University Sains Malaysia over one year period from January to December 2009. A total of 5163 Malay pregnant women who attended labor room for delivery were collected and analyzed prospectively. The blood samples were subjected to the standard immunohematological procedure for RBC antibody screening and identification using reagents of Diamed-ID Gel microtyping system. All the newborns with RBC alloantibody were investigated for the evidence of HDFN. Results: Thirty (0.58%) women were found to have clinically significant RBC alloantibodies. Most of the alloantibodies belonged to Rhesus (Rh) system (56.7%) where anti-E (33.3%) was the most common followed by anti-D (10.0%). Rh antibodies were the main cause of HDFN in fourteen (0.27%) neonates. Anti-D and anti-c were identified to cause moderate to very severe HDFN. Conclusions: With the low prevalence of clinically significant RBC alloantibodies and HDFN, routine antenatal antibody screening practice may not be advised as a routine practice at present, preferably reserved for those women of RhD negative or with history of HDFN, significantly of those attributed to anti-c. [ABSTRACT FROM AUTHOR]

Survivability of Vibrio cholerae O1 and Vibrio parahaemolyticus in a popular Malaysian fish sausage snack, keropok lekor (either boiled or fried) in two conditions (closed or opened) was investigated by spiking ca. 8.00 log CFU/ml of each bacterial culture. Spread plate method onto TCBS agar was used to determine the numbers of inoculated vibrios that had survived as per tested condition. V. parahaemolyticus was more sensitive than V. cholerae O1 and lost viability in saline (control, closed condition). Both vibrios were not detected in the opened condition control after 1 h but keropok lekor proved to significantly support the viability of vibrios for up to 6 h. No significant growth or reduction (p > 0.05) was detected in an enclosed container but a significant reduction (p < 0.05) was observed in the opened condition over a 6 h incubation period. After 6 h incubation, V. cholerae survived at 7.95 ± 0.05 log CFU/g (boiled, enclosed), 6.11 ± 0.18 log CFU/g (fried, enclosed), 4.23 ± 0.48 log CFU/g (boiled, opened) and 3.08 ± 0.46 log CFU/g (fried, opened), respectively. Though V. parahaemolyticus showed poor viability in saline, they persisted well in keropok lekor with numbers recorded at 5.75 ± 0.09 log CFU/g (boiled, enclosed), 5.49 ± 0.59 log CFU/g (fried, enclosed), 2.85 ± 0.45 log CFU/g (boiled, opened) and 2.13 ± 0.52 log CFU/g (fried, opened), respectively. While vibrios are known to be easily killed by heat, post-cooking contamination might lead to food poisoning as a result from vibrios persistence in keropok lekor. [ABSTRACT FROM AUTHOR]

The paper explores a framework combining remote sensing and GIS-cellular automata (CA) concepts aimed at improving the modeling of unauthorized land use sprawl. Remote sensing data have been used in urban modeling and analysis, the use of high-resolution remote sensing data in assessing unauthorized development is quite unexplored. This work has demonstrated systematic combination utilization of geospatial analyses tools to acquire a new level of information to enable urban modeling and sprawl analysis in assisting urban sustainable management. In this study, Kuantan city, Malaysia was selected in simulation of the unauthorized land use with CA concept for a period of 15 years (2000-2015), with main input time-series land use observation from 1995 to 2005. The 2000 and 2005 land use input was also used as calibrated and test assessment of the simulation. The results show excellent agreement between in-situ changes of the unauthorized land use classes and the corresponding simulated classes within the same periods. In conclusion, CA model can lead to new levels of understanding of how urban areas grow and change as in view of digital earth aspiration. [ABSTRACT FROM AUTHOR]

Cobra bite envenomation is one of the commonest causes of snake related injuries in Malaysia. Local tissue injury following a cobra bite is a complex sequalae of envenomation that is attributed to various peptides and enzymes including cytotoxin, metalloproteases, phospholipase A2 and hyaluronidase. This case involves a young construction worker who was bitten by an unidentified snake on the dorsum of his left foot. He presented with typical features of local and systemic envenomation of a Naja species. Remote Envenomation Consultancy Services was consulted and the appropriate antivenom was administered. The patient underwent wound debridement and subsequent skin grafting. Follow up at outpatient clinic showed good skin graft uptake and recovery. Managing a significant Naja species bite envenomation can be a lengthy process requiring expertise from various subspecialties. Timely and seamless multidisciplinary approach in managing a Naja species envenomation ensures a favorable outcome with minimal complication.. [ABSTRACT FROM AUTHOR]

In some circumstances, like driving a motor vehicle, group membership is irrelevant. In others, individual interest motivates group alignment. Sometimes choices have to be made between individual responses and group alignment, or between alignment on the basis of class, or ethnicity, or religion. The authors describe a technique used to assess the strength of ethnic loyalty relative to self-interest and personal obligation among an urban sample in Malaysia. Predictions of how a representative Malay would react in situations of value conflict made possible the measurement of pluralistic ignorance. The technique could be used elsewhere. It could be used to generate predictions about trends in the strengthening, maintenance or weakening of ethnic boundaries. [ABSTRACT FROM AUTHOR]

Malaysia's heritage structures are facing challenges due to rapid local development and societal challenges that threaten their cultural and artistic values. Improving conservation approaches in this context is an urgent and crucial task. The application of geo-information technologies in laser scanning, photogrammetry, and geographic information systems (GISs) has significantly improved these conservation approaches. In this study, we fused drone images and range data from a laser scanner to construct a high-resolution three-dimensional GIS city model for one traditional Malay settlement located in Malaysia. The results showed that fusing photogrammetry and laser scanning can effectively capture the architectural uniqueness of Malay buildings, including specific façade geometries on walls, roofs, and motifs. The findings show that the development of various geoinformation approaches can assist with the conservation of Malay city heritage in this region. [ABSTRACT FROM AUTHOR]

Introduction: In Malaysia, there is a lack of data on the prevalence of occupational stress among port terminal workers. The study’s goal was to find out how common and risky occupational stress was for those who worked at the port terminal. Methods: Designing a cross sectional structure was done at the port terminal. In order to determine the prevalence of occupational stress, the Job Content Questionnaire (JCQ) assesses four factors: social support, job uncertainty, psychological job demands, and decision latitude. Results: A remarkable 68.8 percent of workers reported experiencing some form of work-related stress, indicating a high level of occupational stress in the workplace. The age factor has shown a significant association with work-related stress among the sociodemographic factors (p-value =0.038). Social support (p-value =0.01), task (p-value =0.00), exposure (p-value =0.02), skilled work (p-value = 0.04), and organizational culture (p-value =0.00), and company culture were all found to be significantly linked to the risk of occupational stress. Conclusion: This study sheds light on the alarming prevalence of occupational stress among Malaysian port terminal employees. The identified factors, including age, social support, task-related aspects, exposure levels, specialized work involvement, and organizational culture, play crucial roles in defining the risk of occupational stress in this context. These results not only contribute to the current understanding of the issue, but also provide important insights for future research and interventions aimed at addressing and mitigating occupational stress among port workers. [ABSTRACT FROM AUTHOR]

Introduction: This retrospective and cross-sectional study evaluated the prevalence and distribution of dental anomalies (hypodontia and supernumerary teeth) in the permanent dentition among children by using orthopantomogram (OPG). Methods: A total of 4656 OPGs taken from January 2010 until December 2018 were initially screened at a dental referral centre for Malaysian Northern region. Following the inclusion and exclusion criteria, 744 children [mean (SD) age = 12.38 (3.97) years, 272 males and 472 females] were included. Results: Hypodontia and supernumerary teeth prevalence were 15.9% and 2.0%, respectively. Hypodontia has higher predilection in females (16.3%) compared to males (15.1%). Besides, males showed higher distribution in mandible while females showed higher distribution in maxilla. The most commonly involved tooth as hypodontia for males was maxillary left second premolar (2.6%) whereas maxillary left lateral incisor (2.5%) was commonly seen in females. Males (4.0%) showed more supernumerary teeth occurrence compared to females (0.8%) with higher observation in the maxillary arch. The most commonly involved tooth in supernumerary was mesiodens (1.6%). A higher occurrence of hypodontia was seen as the age of the subjects increased (p < 0.000). For supernumerary teeth, the highest occurrence was found in 7 to 12 years old age group (p < 0.001). Supernumerary teeth were found to be strongly associated with gender of the subjects (p < 0.017). Conclusion: The prevalence of hypodontia was higher compared to supernumerary teeth and its distribution was also higher among female subjects compared to male subjects. [ABSTRACT FROM AUTHOR]

The zakat instrument plays an important role as a component in the economic system to build a more prosperous socio-economy for Muslims in Malaysia, in addition to the existing tax system. The total collection of zakat on income increases every year in each state. This is caused by various factors, including the possibility of zakat payers who pay zakat on income in excess of the zakat obligatory rate. However, the purpose of this study is to determine the factors that influence zakat payers to pay zakat on income in excess of the zakat obligatory rate. This study is significant because the zakat institution needs to focus on these factors so that the amount of zakat collection of income will continue to increase at a larger rate, which will ultimately increase the benefits of zakat distribution to asnaf. This study examined the factors that influence the Muslim community to pay zakat on income in excess of the prescribed rates. It also analyzed the community’s perception of the implementation of the zakat and tax systems in Malaysia. Descriptive analysis of mean score test, Alpha Cronbach analysis, and values of difference in GAP mean were applied to respondents at Jabatan Agama Islam Melaka (JAIM). The findings show that the ratio of income zakat payment to the obligatory zakat exceeded by 0.4, which is capable of constituting 21 percent of total zakat collection of Melaka. Interestingly, the study finds that this behaviour is driven by religious factors and that the altruism factor significantly affects the behaviour of paying income zakat in excess. Next, the results of the study show that the majority of respondents are more satisfied with the zakat information and system rather than with the tax system. Some suggestions and policy implications were also discussed in this study. [ABSTRACT FROM AUTHOR]

Current suicide risk assessments for predicting suicide attempts are time consuming, of low predictive value and have inadequate reliability. This paper aims to develop a predictive model for suicide attempts among patients with depression using machine learning algorithms as well as presents a comparative study on single predictive models with ensemble predictive models for differentiating depressed patients with suicide attempts from non-suicide attempters. We applied and trained eight different machine learning algorithms using a dataset that consists of 75 patients diagnosed with a depressive disorder. A recursive feature elimination was used to reduce the features via three-fold cross validation. An ensemble predictive models outperformed the single predictive models. Voting and bagging revealed the highest accuracy of 92% compared to other machine learning algorithms. Our findings indicate that history of suicide attempt, religion, race, suicide ideation and severity of clinical depression are useful factors for prediction of suicide attempts. [ABSTRACT FROM AUTHOR]

Geometric morphometrics is a new approach for shape identification in diagnosis of malocclusion. Lateral cephalogram is an X-ray that taken for diagnosing malocclusion in dental setting. The aim of this study was to determine the differences of craniofacial shape in malocclusion by application of two-dimensional geometric morphometrics and to compile the database of malocclusion in adult Malaysian population. Lateral cephalogram radiographs of 381 adults Malaysia (age 18-45) were retrieved retrospectively and assigned to three groups according to their occlusion: class I, class II, and class III. The geometric morphometric shape study incorporated nine landmarks and was analyzed in details using tpsUtil p software. Geometric morphometric analysis such was done using MorphoJ software. The results of the principal component's analysis (PCA) yielded 14 main components responsible for 100% of the variation exhibited by the malocclusion with three highly significant PCA. The highest Mahalanobis distances were exhibited by the malocclusion class II and III population. The Procrustes ANOVA showed that the shape effect was highly significant (P<0.01). The discriminant function analysis showed the high percentage of 80% discriminate among the malocclusions after cross-validation. There are significant differences for ANB angle (A point-Nasion-B point) in all malocclusion groups. Class II has the widest ANB angle while class III has the most acute ANB angle. Skeletal shape was clearly associated with dental malocclusion and showed considerable variation. Geometric morphometrics is an alternative research tool and can be used for diagnosing individual classification of malocclusion. [ABSTRACT FROM AUTHOR]

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked genetic disorder characterized by reduced G6PD enzyme levels in the blood. This condition is common in populations exposed to malaria; an acute febrile disease caused by Plasmodium parasites. G6PD-deficient individuals may suffer from acute hemolysis following the prescription of Primaquine, an antimalarial treatment. The population at risk for such a condition includes the Senoi group of Orang Asli, a remote indigenous community in Malaysia. This study aimed to elucidate the G6PD molecular heterogeneity in this subethnic group which is important for malaria elimination. A total of 662 blood samples (369 males and 293 females) from the Senoi subethnic group were screened for G6PD deficiency using a quantitative G6PD assay, OSMMR2000-D kit with Hb normalization. After excluding the family members, the overall prevalence of G6PD deficiency in the studied population was 15.2% (95% CI: 11–19%; 56 of 369), with males (30 of 172; 17.4%) outnumbering females (26 of 197; 13.2%). The adjusted male median (AMM), defined as 100% G6PD activity, was 11.8 IU/gHb. A total of 36 participants (9.6%; 26 male and 10 female) were deficient (<30% of AMM) and 20 participants (5.4%; 4 male and 16 female) were G6PD-intermediate (30–70% of AMM). A total of 87 samples were genotyped, of which 18 showed no mutation. Seven mutations were found among 69 genotyped samples; IVS11 T93C (47.1%; n = 41), rs1050757 (3'UTR +357A>G)(39.1%; n = 34), G6PD Viangchan (c.871G>A)(25.3%; n = 22), G6PD Union (c.1360C>T)(21.8%; n = 19), c.1311C>T(20.7%; n = 18), G6PD Kaiping (c.1388G>A)(8.0%; n = 7), and G6PD Coimbra (c.592C>T)(2.3%; n = 2). Our analysis revealed 27 hemizygote males, 18 heterozygote females, 7 homozygote females, and 2 compound heterozygote females. This study confirms the high prevalence of G6PD deficiency among the Senoi Malaysian Orang Asli, with a significant degree of molecular heterogeneity. More emphasis should be placed on screening for G6PD status and proper and safe use of Primaquine in the elimination of malaria among this indigenous population. [ABSTRACT FROM AUTHOR]

Introduction: COVID-19 is a respiratory illness that is caused by a coronavirus. Infected people will have a chance to develop post-COVID-19 syndrome. The aim of this study is to identify the association of gender, marital status, age and university on knowledge, awareness and attitude of post-COVID-19 syndrome among medical students in four universities in Malaysia. Methods: A cross-sectional study was conducted from October 2021 to July 2022 at four universities in Malaysia which are Universiti Putra Malaysia (UPM), Universiti Islam Antarabangsa Malaysia (UIAM), Universiti Sains Malaysia (USM) and Universiti Sains Islam Malaysia (USIM). A self-administered questionnaire was administered to 355 respondents consisted of four sections, assessing socio-demographic data and knowledge, awareness and attitudes of post-COVID-19 syndrome. Results: 54.4% of the respondents had high knowledge, 53.8% had high awareness, and 55.21% had a high attitude towards post-COVID-19 syndrome. In this study, there is a significant association between knowledge on post-COVID-19 syndrome and the age among respondents. Knowledge and awareness, knowledge, and attitude as well as awareness and attitude on post-COVID-19 syndrome was also found to have significant association among respondents. Conclusion: The older age of the respondents have good knowledge towards post-COVID-19 syndrome. [ABSTRACT FROM AUTHOR]

This article describes the importance of mental health/clinical social workers in Malaysia. Convenience sampling was utilised and an in-depth, semi-structured interview methodology was employed. Four participants – two social workers, a psychiatrist and a community nurse – were involved. Data were analysed using thematic analysis. Participants reported that mental health social workers are important in providing psychoeducation and conducting assessments. Specialised training in the field of mental health would benefit social workers and their health care counterparts. [ABSTRACT FROM AUTHOR]

Red blood cell (RBC) alloimmunization is an important complication of blood transfusion. Variations in the frequency of alloimmunization have been noted among different patient populations. We aimed to determine the prevalence of RBC alloimmunization and associated factors among chronic liver disease (CLD) patients in our center. This is a case-control study involving 441 patients with CLD who were being treated at Hospital Universiti Sains Malaysia and subjected to pre-transfusion testing from April 2012 until April 2022. Clinical and laboratory data were retrieved and statistically analyzed. A total of 441 CLD patients were included in our study, with the majority being elderly, with the mean age of patients 57.9 (SD ± 12.1) years old, male (65.1%) and Malays (92.1%). The most common causes of CLD in our center are viral hepatitis (62.1%) and metabolic liver disease (25.4%). Twenty-four patients were reported to have RBC alloimmunization, resulting in an overall prevalence of 5.4%. Higher rates of alloimmunization were seen in females (7.1%) and patients with autoimmune hepatitis (11.1%). Most patients developed a single alloantibody (83.3%). The most common alloantibody identified belonged to the Rh blood group, anti-E (35.7%) and anti-c (14.3%), followed by the MNS blood group, anti-Mia (17.9%). There was no significant factor association of RBC alloimmunization among CLD patients identified. Our center has a low prevalence of RBC alloimmunization among CLD patients. However, the majority of them developed clinically significant RBC alloantibodies, mostly from the Rh blood group. Therefore, phenotype matching for Rh blood groups should be provided for CLD patients requiring blood transfusions in our center to prevent RBC alloimmunization. [ABSTRACT FROM AUTHOR]

• The AY.59 and AY.79 strains displaced B.1.617.2 and became the predominant lineage. • Different circulating SARS-CoV-2 lineage patterns were seen in the east and west Malaysia. • Policies restricting movement and border closure might affect viral transmission. • Relaxing the border restrictions aided in the spread of Omicron in Malaysia. This study reported SARS-CoV-2 whole genome sequencing results from June 2021 to January 2022 from seven genome sequencing centers in Malaysia as part of the national surveillance program. COVID-19 samples that tested positive by reverse transcription polymerase chain reaction and with cycle threshold values <30 were obtained throughout Malaysia. Sequencing of SARS-CoV-2 complete genomes was performed using Illumina, Oxford Nanopore, or Ion Torrent platforms. A total of 6163 SARS-CoV-2 complete genome sequences were generated over the surveillance period. All sequences were submitted to the Global Initiative on Sharing All Influenza Data database. From June 2021 to January 2022, Malaysia experienced the fourth wave of COVID-19 dominated by the Delta variant of concern, including the original B.1.617.2 lineage and descendant AY lineages. The B.1.617.2 lineage was identified as the early dominant circulating strain throughout the country but over time, was displaced by AY.59 and AY.79 lineages in Peninsular (west) Malaysia, and the AY.23 lineage in east Malaysia. In December 2021, pilgrims returning from Saudi Arabia facilitated the introduction and spread of the BA.1 lineage (Omicron variant of concern) in the country. The changing trends of circulating SARS-CoV-2 lineages were identified, with differences observed between west and east Malaysia. This initiative highlighted the importance of leveraging research expertise in the country to facilitate pandemic response and preparedness. [ABSTRACT FROM AUTHOR]

Flies (Diptera) play a significant role in the ecosystem as pollinators and decomposers, and they are also important vermin and disease vectors. Studies on the dipteran species are still lacking in Malaysia; therefore, the dipteran species' biology, morphology, distribution, and abundance are necessary. The objectives of this study were to identify dipteran species using a molecular approach, determine flies' Bovidae hosts, and investigate the diversity of the fly's species at three different cattle farms purposively selected in Selangor, Malaysia. The fly species were identified using cytochrome oxidase subunit I (COI) (Haematopota javana, Tabanus rubidus, Tabanus fontinalis, Iranihindia martellata, Musca domestica, and Chrysomya megacephala), while another six species only up to genus level (Haematopota sp. 1, Musca sp. 1, Asilus sp., Metopia sp., Anasillomos sp., and Ommatius sp.). In addition, two species of hosts: Bos indicus and Bos taurus, were proven to be the associated host species for the dipteran species based on molecular data of cytochrome b (cytb). However, there were no significant differences between farms in species diversity and richness (F = 1.262, df = 2, p = 0.2459 >0.05). Interestingly, the two most dominant dipteran genera collected from the cattle farms were Musca and Chrysomya. At the same time, its abundance may have been influenced by the structure of the cattle cage flooring, which serves as a breeding site and food source. These findings contribute to fundamental epidemiological data in developing control strategies for dipteran species and are of great economic and health importance to livestock production in Malaysia. [ABSTRACT FROM AUTHOR]

Background. Patient satisfaction influences the outcomes of the patient-physician encounter. Objective. The objective of this study was to validate the Malay version patient satisfaction (MISS-21) questionnaire using a confirmatory validity approach. Methods. A cross-sectional study was conducted involving 252 patients attending primary health clinic, Hospital Universiti Sains Malaysia. Construct validity (convergent and discriminant) using confirmatory factor analysis and internal consistency were performed after the translation, content validity and face validity processes. Criterion validity was assessed using Pearson correlations with the scale of shared decision making 9-item questionnaire (SDMQ-9). The data was analysed using Analysis of Moment Structure version 19. Results. A total of 252 (100%) outpatients responded to this study. The final model that consists of three domains with 11 items had a good fit; (χ2(df) = 65.805 (32), P < 0.001, Tucker–Lewis indices = 0.902, comparative fit index = 0.927, root mean square error of approximation = 0.061, standardized root mean square residual = 0.058). Composite reliability and average variance extracted of the domains ranged from 0.541 to 0.760 and 0.240 to 0.522, respectively. The SDMQ-9 had a moderate correlation with the total score of the final construct (r = 0.406, P <0.001). Conclusion. The study suggested that the three-factor model with 11 items of the Malay version MISS-21 could be used to assess patient satisfaction on patient-physician interaction in primary health care setting because it is acceptably valid, reliable and simple. The validated Malay version questionnaire was called as ‘Skala Kepuasan Interaksi Perubatan-11’. [ABSTRACT FROM PUBLISHER]

The paper explores the relationship between service quality and customer satisfaction on customer loyalty with regards to mobile phone usage among the postgraduate students of a university in Northern Malaysia. The sample consists of 341 students randomly selected from the population frame provided by the university. The respondents are made of up students from various part of the world such Asia, Middle-east and Africa. The results show that both service quality and customer satisfaction significantly affect the level of customer loyalty of mobile phone users in Malaysia. Hence, all the hypotheses except one have been supported. It was therefore, recommended that mobile service providers should pay special attention to their service quality and the factors that drive customer satisfaction. Suggestion for future research was also offered. [ABSTRACT FROM AUTHOR]

Background: Melioidosis is an important public health problem causing community acquired sepsis in the northeastern part of Malaysia. Methodology: From January 2001 to December 2005, we reviewed case reports of all bacteraemic melioidosis admitted to a tertiary teaching hospital, Hospital Universiti Sains Malaysia. Results: Thirty-five patients had positive blood culture for meliodosis and 27 case reports were traceable for further analysis. The mean age was 46.8 + 20.0 years. Twenty patients (74.1%) were male. The main clinical presentation was fever that occurred in 23 (85.2%) patients. Eighteen patients (66.7%) had lung involvement and three patients had liver abscess. Two patients presented with scrotal swelling, one of whom further developed Fournier's Gangrene. Nineteen (70.4%) patients had underlying diabetes, five of whom were newly diagnosed during the admission. Thirteen (48.1%) patients were treated with high-dose ceftazidime and six (22.2%) patients were treated with imipenem. Eight (29.6%) patients were not given anti-melioidosis therapy because the causative agents were not identified until after the patients died. The patients were admitted 16.8 days + 18.1. Seventeen patients (63.0%) died in this series, 13 patients of whom died within four days of admission. Conclusions: The wide range of clinical presentations and the fatal outcomes of melioidosis require a high level of suspicion among physicians to develop an early appropriate therapy and reduce the mortality rate. [ABSTRACT FROM AUTHOR]

A small number of children and adolescents need dental treatment under general anaesthesia (GA), either for medical reasons or due to lack of cooperation during dental treatment. The objective of the study is to identify the type of treatment that has been carried out under GA in Hospital Universiti Sains Malaysia (HUSM). A retrospective record review study from hospital records of dental patients (under 18 years old) receiving dental treatment under GA from 2003 until 2007 were retrieved from the database. Information such as the reason for GA, and the type of treatment provided was recorded in data sheet. The data were analyzed using SPSS 12.0.1 for Windows. It was checked and verified for errors. A total of 349 cases were treated of which 43.6% had medical problems. Patients were mostly diagnosed to have rampant caries (77.1%) and some of them have behavioural problems (34.4%). Treatment pattern in deciduous dentition revealed more extraction (97.8%) as compared to restoration (75.7%) whereas in permanent dentition more restoration was done (24.3%) as compared to extraction (2.2%). Majority of the restorations were done using Glass Ionomer Cements (47.5%). Biopsy (4.3%) contributed mainly to the surgery (24.1%) done during GA. General anesthesia is necessary when dental disease is interfering with health and general well-being of patient and it can facilitated dental treatment allowing dentists to benefit from improved treatment conditions and provide a higher quality of care. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to determine admissions for diabetes emergencies among patients who fasted or planned to fast one month before, during and one month after Ramadan 2019 in public hospitals in Malaysia.Materials and Methods: This was a cross sectional prospective study done in 18 public hospitals in Malaysia from 7/4/2019 to 2/7/2019. Data was collected prospectively with universal sampling. All adult Muslim patients with previous diagnosis of diabetes, who were admitted for hypoglycemia, DKA or HHS were included if they had fasted and had intentions to fast.Results: 295 admissions for diabetes emergencies were analyzed. The pre-Ramadan period recorded the highest number of admissions (119) followed by during (106) and post-Ramadan (70). Admissions for hyperglycemic emergencies accounted for 2/3 of total admissions. 37% of admissions for hypoglycemia occurred during pre-Ramadan period compared to 32.1% during Ramadan. Contributing factors included use of sulphonylurea (59.6%), presence of nephropathy (54.5%) and past history of hypoglycemia (45.5%). Admissions for DKA were more common than HHS (119 versus 77) and highest during Ramadan period (36.1%). Most of the admissions for hyperglycemic emergencies were among those with Type 2 diabetes (75.9% for DKA and 97.4% for HHS). Only 31.5% of patients admitted for diabetes emergencies recalled having received Ramadan advice in the past.Discussion: Admissions for diabetes emergencies were highest during pre-Ramadan period followed by Ramadan and post-Ramadan period. This suggests that fasting during Ramadan does not increase admissions for diabetes emergencies. [ABSTRACT FROM AUTHOR]

Introduction: Coronavirus disease-2019 (COVID-19) was declared a global pandemic in March 2020, with 15 million people have been infected worldwide, and this number is increasing. Our study sought to assess the knowledge and practice of healthcare workers (HCWs) in a teaching hospital in Malaysia. Methods: This cross-sectional study was undertaken using online Google form links among HCWs. Knowledge and practice were assessed using a validated questionnaire. The analysis was performed with SPSS version 26. Factors associated with poor knowledge were analysed using multivariate analysis. Results: A total of 193 HCW responded to our online survey. Majority of our HCWs were female (74.1%) with a mean age of 32.5 years. We found 53 (27.5%) and 134 (69.4%) of our HCWs had good knowledge and good practice on COVID-19, respectively. Knowledge gap was identified in the symptomatology, investigation methods and management. Based on multiple logistic regression, determinants of poor knowledge scores were those work as medical attendants (aOR = 3.626; 95% CI = 1.489, 8.834) and nurses (aOR = 4.107; 95% CI = 1.175, 14.358). Conclusion: Around one-third and 70% of our HCWs have good knowledge and practice of COVID-19 infection respectively. Continuous, specifically targeted and updated medical education, need to be carried out to improve the knowledge and practice among our HCWs in order to keep abreast of the fast-moving pace of COVID-19 knowledge development. [ABSTRACT FROM AUTHOR]

Natural salt lick (sira) is a strategic localisation for ecological wildlife assemblage to exhibit geophagy which may act as a population dynamic buffer of prey and predators. Undoubtedly, many agree that geophagy at natural licks is linked to nutritional ecology, health and assembly places facilitating social interaction of its users. Overall, natural salt licks not only save energy of obtaining nutrient leading to health maintenance but also forms the basis of population persistence. The Royal Belum Rainforest, Malaysia (Royal Belum) is a typical tropical rainforest in Malaysia rich in wildlife which are mainly concentrated around the natural salt lick. Since this is one of the most stable fauna ecology forest in Malaysia, it is timely to assess its impact on the Malayan tiger (Panthera tigris) home range dynamics. The three-potential home ranges of the Malayan tiger in this rainforest were selected based on animal trails or foot prints surrounding the salt lick viz (e.g. Sira Kuak and Sira Batu; Sira Rambai and Sira Buluh and Sira Papan) as well as previous sightings of a Malayan tiger in the area, whose movement is dependent on the density and distribution of prey. Camera traps were placed at potential animal trails surrounding the salt lick to capture any encountered wildlife species within the area of the camera placements. Results showed that all home ranges of Malayan tiger were of no significance for large bodied prey availability such as sambar deer (Rusa unicolor), and smaller prey such as muntjacs (Muntiacus muntjac) and wild boar (Sus scrofa). Interestingly, all home range harbour the Malayan tiger as the only sole predator. The non-significance of prey availability at each home range is attributed to the decline of the Malayan tiger in the rainforest since tigers are dependant on the movement of its preferred prey surrounding natural salt licks. Thus, the information from this study offers fundamental knowledge on the importance of prey-predator interaction at salt lick which will help in designing strategy in rewilding or rehabilitation programs of the Malayan tiger at the Royal Belum Rainforest. [ABSTRACT FROM AUTHOR]

Objective: To develop and validate a questionnaire which evaluates the blood donors' satisfaction. Background: In Malaysia, blood procurement relies mainly on voluntary non-remunerated donors. Hence, it is important to ensure the satisfaction of the blood donors in order to increase retention. Methods: This study was conducted among blood donors who attended blood donation and understood the Malay language. Non-Malaysian and illiterate donors were excluded. The questionnaire was developed by the transfusion medicine team. Content validity was established by content reviewers, while face validity was examined in the cognitive debriefing stage. For the 18-item questionnaire, 90 respondents were required based on the 1:5 ratio. A retest was performed in two weeks' time. Results: One hundred and thirty-seven participants responded in the first phase, while 103 responded after two weeks. The five domains were: technical, interpersonal, accessibility/ convenience, physical experience and overall satisfaction. The Kaiser-Meyer-Olkin (KMO) value was 0.896, with significant Bartlett's Test of Sphericity (P < 0.001). The factor loadings ranged from 0.729 to 0.953. The Cronbach alpha values of the five domains ranged from 0.814 to 0.955 and the intraclass correlation coefficient ranged from 0.663 to 0.847. Conclusion: The Malaysian blood donor's satisfaction (M-BDS) questionnaire is a reliable and valid tool suitable for the assessment of blood donor's satisfaction in blood donation centres. [ABSTRACT FROM AUTHOR]