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The rehabilitation of forest areas is not new to Malaysia as forest replanting activities have been carried out throughout the country for years to meet the demand for woody and nonwoody products as well as to nurture degraded forestland. Thus it is important for a soil to be evaluated to ascertain the degree to which rehabilitation activities have succeeded in restoring forest health, particularly in sustaining soil quality in rehabilitated forests. This review article aims to provide a corpus of information for forest managers and related agencies who work closely with forestry. The aim is to provide an overview on the importance of soil quality in measuring the success of forest rehabilitation programs. Research articles on the evaluation of soil properties at selected rehabilitated forests in Peninsular Malaysia were included in the review. The impact of forest rehabilitation in relation to soil properties comprising soil compaction, moisture, acidity, macronutrients, cation exchange capacity, microbial count, microbial enzymatic activity, and microbial biomass is discussed. Natural forest is used as a benchmark to see the effect of forest rehabilitation programs. Our review indicates that rehabilitated forests that were established earlier and have gone through a longer period of time have better soil quality compared to the soil of forests established later. This shows that rehabilitated forests are able to restore their soil quality and achieve fertility on par with natural forests, if given longer periods of time for recovery. Soil quality analyses should be done regularly to measure the extent of success in rehabilitation programs. [ABSTRACT FROM AUTHOR]

Objectives: This study was carried out to determine the proportion of hypertension and its associated factors among current drinkers in Malaysia. Methodology: The data were obtained from the National Health and Morbidity Survey 2015, a cross-sectional population survey design with two-stage stratified random sampling method which involved Malaysian adults above 18 years. Data on alcohol consumption were obtained through a validated self-administered Alcohol Use Disorder Identification Test questionnaire. A complex sampling analysis and multiple logistic regression analysis were applied. Results: A total of 1065 adults (8.4%; 95% confidence interval: 7.4-9.5) were categorized as current drinkers. Among the current drinkers, 28.4% were identified as having a risky drinking pattern and a fourth (26.6%) of them had hypertension. The multivariable model shows that hypertension risk among current drinkers was significantly higher in male (adjusted odd ratio [AOR] 2.05), with increasing age (AOR 1.06), with risky drinking pattern (AOR 1.44), in current drinkers with diabetes (AOR 2.56) and in overweight (AOR 3.54). Conclusions: The proportion of current drinker having hypertension was alarming and become deleterious, especially among men, increase of age, risky drinker and those with other non-communicable disease co-morbidities. Preventive counselling for alcohol use among them should be integrated into primary care. [ABSTRACT FROM AUTHOR]

One of the most well-liked energizing drinks is now tea, which is primarily used in Malaysia. The natural radioactivity in the associated soils where tea plants are cultivated plays a major role in determining the presence of radionuclides in tea leaves. The present study assesses the transfer of radionuclides from soil-to-tea leaves and then estimates the committed effective doses through tea consumption. Tea leaves and the associated soils were obtained from the largest tea plantation area, which is located in the Cameron Highlands, Malaysia. The marketed tea leaves in powdered form were obtained from the supermarkets in Kuala Lumpur. HPGe gamma-ray spectrometry was used to determine the prevailing concentrations of long-lived radioactive materials in tea leaves. Activity concentrations of 226 Ra, 232 Th, and 40 K in tea soils ranged from 49 to 101.7 Bq kg -1 , 74.5-124.1 Bq kg -1 and 79.6-423.2 Bq kg -1 , respectively, while the respective values in tea leaves are 14.4-23.8 Bq kg -1 , 12.9-29.5 Bq kg -1 and 297-387.5 Bq kg -1 . Transfer factors of radionuclides showed typical values (<1.0) except for the 40 K. The threshold tea consumption rates suggest that one should not consume more than 67 g of tea leaves per day (around 4 g of tea leaves are needed for making 1 cup of tea, so 17 cups per day) to avoid negative health effects. Committed effective doses due to tea consumption are found to be lower (5.18-6.08 μSv y -1 ) than the United Nations Scientific Committee on the Effects of Atomic Radiation (2000) reference dose guidance limit of 290 μSv y -1 for foodstuffs; however, it should be noted that the guidance limit is recommended for all foodstuffs collectively. Providing data on natural radioactivity in tea leaves grown in Malaysia, this study may help people manage a healthy lifestyle., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Among refugees residing in countries of first asylum, such as Malaysia, high rates of psychological distress call for creative intervention responses., Aims: This study examines implementation of a Screening, Brief Intervention, and Referral to Treatment (SBIRT) model promoting emotional well-being and access to services., Method: The one-session intervention was implemented in community settings by refugee facilitators during 2017 to 2020. 140 Participants including Afghan ( n  = 43), Rohingya ( n  = 41), and Somali ( n  = 56) refugees were randomized to receive either the intervention at baseline, or to a waitlist control group. At 30 days post-intervention, all participants completed a post-assessment. Additionally, after completing the intervention, participants provided feedback on SBIRT content and process., Results: Findings indicate the intervention was feasible to implement. Among the full sample, Refugee Health Screening-15 emotional distress scores reduced significantly among participants in the intervention group when compared to those in the waitlist control group. Examining findings by nationality, only Afghan and Rohingya participants in the intervention condition experienced significant reductions in distress scores compared to their counterparts in the control condition. Examining intervention effects on service access outcomes, only Somali participants in the intervention condition experienced significant increases in service access compared to the control condition., Conclusions: Findings indicate the potential value of this SBIRT intervention, warranting further research.

Present study concerns the radiological character of Malaysian honey. A total of 18 samples (representative of the various most common types) were obtained from various honey bee farms throughout the country. Using a high-purity germanium γ-ray spectroscopic system, the samples were analysed for the naturally occurring radionuclides 226Ra, 228Ra and 40K. The respective range of activities (in Bq/kg) was: 3.49 ± 0.35 to 4.51 ± 0.39, 0.99 ± 0.37 to 1.74 ± 0.39 and 41.37 ± 3.26 to 105.02 ± 6.91. The estimated associated committed effective doses were derived from prevailing data on national consumption of honey, the annual dose being found low compared with the UNSCEAR reference dose limit of 290 μSv y-1. The estimated threshold consumption rate for honey indicates a maximum intake of 339 g/d, which poses an insignificant radiological risk to public health; however, the total dietary exposure may not, the guidance level of 290 μSv y-1 being applicable to dietary intake of all foodstuffs. The study is in support of the cultivation of a healthy lifestyle, acknowledging prevailing radioactivity within the environment., (© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Background: With the advancement of antiretroviral therapy scale-up, it is possible for women living with HIV to breastfeed safely. However, this practice has not been adopted in Malaysia. Instead, infants are provided with subsidized human milk substitutes for their first 2 years of life., Research Aim: This study describes the infant feeding experiences of women living with HIV in Malaysia., Methods: From August to October 2021, a nationwide, community-based qualitative study was conducted among women living with HIV and who received care from the Malaysian Ministry of Health. Using purposive sampling, participants who met the inclusion criteria were recruited. Interview and focus group transcripts were coded based on a secondary thematic analysis., Results: Six in-depth interviews and five focus group discussions were conducted among 32 participants. Study participants were mostly Malay secondary school graduates in their 30s and 40s. Due to the fear of vertical transmission, which was explained by healthcare providers to the participants, none of the women breastfed their infants. The three primary themes that emerged from analyzing the women's infant feeding experiences were (1) a human milk substitute was the only option and was encouraged; (2) feeding infants with a human milk substitute made the women feel incomplete as mothers; and (3) the women encountered difficulties in obtaining the subsidized human milk substitute., Conclusion: Women living with HIV in Malaysia have been advised to provide human milk substitutes to their infants in fear of HIV transmission., Competing Interests: Disclosures and Conflicts of InterestThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: In Malaysia, studies on self-reported bone fractures are scarce. Due to the fact that bone fractures may serve as an indicator of osteoporosis in the community, this study aimed to identify the factors associated with their occurrence among adults in Malaysia., Materials and Methods: Epidemiological data for selfreported bone fractures were obtained through direct interviews using a validated questionnaire from the Prospective Urban and Rural Epidemiology (PURE) study., Results: Of 15,378 respondents, 6.63% (n=1019) reported bone fractures, with a higher proportion of men (65.8%, n=671) than women (34.2%, n=348). Higher odds of selfreporting bone fractures were seen in males (aOR, 2.12; 95%CI: 1.69, 2.65), those with a history of injury (aOR 5.01; 95%CI: 3.10, 6.32) and those who were obese (aOR: 1.46; 95% CI: 1.13, 1.89), highly active (aOR 1.25; 95%CI: 1.02, 1.53), smokers (aOR 1.35; 95%CI: 1.11, 1.65) and alcohol consumers (aOR 1.67; 95%CI: 1.20,2.32)., Conclusion: Adopting a healthier lifestyle that includes a balanced diet and moderate physical activity is critical for weight loss, increased muscle and bone mass and better stability, which reduces the likelihood of fractures following a fall.

Palm oil is the main cash crop of tropical Asia, and the implementation of LPWAN (low-power wide-area network) technologies for smart agriculture applications in palm oil plantations will benefit the palm oil industry in terms of making more revenue. This research attempts to characterize the LoRa 433 MHz frequency channels for the available spreading factors (SF7-SF12) and bandwidths (125 kHz, 250 kHz, and 500 kHz) for wireless sensor networks. The LoRa channel modeling in terms of path-loss calculation uses empirical measurements of RSS (received signal strength) in a palm oil plantation located in Selangor, Malaysia. In this research, about 1500 LoS (line-of-sight) and 300 NLoS (non-line-of-sight) propagation measurement data are collected for path-loss prediction modeling. Using the empirical data, a prediction model is constructed. The path-loss exponent for LoS propagation of the proposed prediction model is found to be 2.34 and 2.9 for 125-250 kHz bandwidth and 500 kHz bandwidth, respectively. Again, for the NLoS propagation links, the attenuation per trunk is found to be 7.58 dB, 7.04 dB, 5.35 dB, 5.02 dB, 5.01 dB, and 5 dB for SF7-SF12, and the attenuation per canopy is found to be 9.32 dB, 7.96 dB, 6.2 dB, 5.89 dB, 5.79 dB, and 5.45 dB for SF7-SF12. Moreover, the prediction model is found to be the better choice (mean RMSE 2.74 dB) in comparison to the empirical foliage loss models (Weissberger's and ITU-R) to predict the path loss in palm oil plantations.

Background: Around 130 million infections of hepatitis C virus with 3% overall prevalence are there worldwide. There are approximately 4-5 million persons coinfected with HIV. The main objectives of this study were to determine the prevalence of HCV among HIV-positive individuals and to assess the predictors involved in the outcomes of HIV-HCV coinfected patients., Methods: A retrospective, cross-sectional study was conducted on patients enrolled from 2007 to 2012 at Infectious Disease Unit, Hospital Palau Pinang, Pinang, Malaysia. Sociodemographic da%)ta as well as clinical data were collected with the help of a valid data collection form from the patients' records. Data were entered and analyzed by using statistical software SPSS version 20.0, and p < 0.05 was considered significant., Results: The overall prevalence of hepatitis C among 708 HIV-infected patients was 130 (16.1 including 541 (76.4%) males and 167 (23.6%) females. High prevalence of HIV-HCV coinfection was significantly observed in males (122 [17.2%]) compared to females (8 [1.1%]) (p < 0.001). The main route of transmission among HIV-HCV coinfected patients was heterosexual contact (98 [13.8%]), followed by homosexual contact (4 [0.4%]). The statistically significant predictors involved in treatment outcomes of HIV-HCV coinfected patients are gender (OR = 2.015, p = 0.002) and intravenous drug users (OR = 2.376, p ≤ 0.001)., Conclusion: The current study shows that HCV infection has an impact on the recovery of CD4 cells of the patients on HAART. Screening of HCV among HIV patients who were smokers and intravenous drug users should be monitored before starting HAART., (© 2021 S. Karger AG, Basel.)

Refugee families experience uncertainty and stress when residing in countries of first asylum, such as Malaysia, and may benefit from supportive parenting interventions. In the greater Kuala Lumpur, Malaysia area we piloted an eight-week parenting program with 79 Rohingya and Afghan mothers in nine separate groups. Participants were randomized to an intervention group or a waitlist control group and those in each arm completed a 3-month follow-up assessment. Program content addressed positive discipline, strengthening family relationships, adapting to a new environment, and improving health and emotional well-being. Measures assessed included child intensity and parenting self-efficacy from the Child Adjustment and Parent Efficacy Scale; positive parenting, inconsistent discipline, and poor supervision from the Alabama Parenting Questionnaire-Short Form; family intimacy and family conflict from the Family Functioning Scale, and emotional well-being from the Refugee Health Screening-15. Participating in the intervention led to beneficial changes in child intensity, parenting self-efficacy, family intimacy, family conflict, and emotional distress for the treatment group, and all changes except for emotional distress were maintained over time. However, the intervention did not lead to changes in positive parenting, inconsistent discipline, or poor supervision in the treatment group. Findings point to the potential benefits of parenting programs for refugee communities in transitory settings and contribute to the limited body of literature examining such programs., (© 2020 Family Process Institute.)

Objective: To explore differences in nutritional practices and growth outcomes among preterm infants in neonatal units in Malaysia and the UK., Design: Prospective exploratory study of infants born at <34 weeks gestational age (GA)., Setting: Two neonatal units, one in Malaysia and one in the UK (May 2019 to March 2020)., Methods: Data collected from birth until discharge and compared between units., Results: From 100 infants included, median GA (IQR) was 31 (30-33) and mean±SD birth weight was 1549±444 g. There were more small-for-gestational age infants in Malaysian unit: 12/50 (24%) vs UK: 3/50 (6%), p=0.012 and more morbidities. More Malaysian infants received breast milk (Malaysia: 49 (98%) vs UK: 38 (76%), p=0.001), fortified breast milk (Malaysia: 43 (86%) vs UK: 13 (26%), p<0.001) and exclusive breast milk at discharge (Malaysia: 26 (52%) vs UK: 16 (32%), p=0.043). There was higher parenteral nutrition use among Malaysian infants (40/50 (80%)) vs UK (19/50 (38%)) (p<0.001) with higher protein intake (mean±SD Malaysia: 3.0±0.5 vs UK: 2.7±0.6 g/kg/d, p=0.004) in weeks 1-4 and smaller cumulative protein deficits (mean±SD Malaysia: 11.4±6.1 vs UK: 15.4±8.0 g/kg, p=0.006). There were no significant differences in short-term growth between units and more than half of the infants in both units had ≥1.28 changes in weight-for-age Z-score at discharge (p=0.841)., Conclusions: An exploratory comparison of practices showed differences in patient characteristics and nutritional practices which impacted growth. Future studies with larger sample sizes and detailed analysis of maternal characteristics and infants' outcomes are needed for improving care of preterm infants in all settings., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Fertility preservation is significant for oncology patients to maintain their ability to start a family when they are ready. Onco-fertility, as a discipline, exists at the intersection of oncology and reproductive medicine that safeguards and expands the fertility options for cancer survivors, by facilitating early intervention and suitable treatment with favourable outcomes. Successful fertility preservation requires a comprehensive networking among the gynaecologists, oncologists, pathologists, imaging and other specialists, involved in diagnosing and treating cancer in the reproductive age group. There are several ways in which fertility can be preserved, like role of gonadotrophin releasing hormone analogues, in vitro maturation, and cryopreservation.

Objective: This study investigated relationships among spirituality, hope, and overall quality of life in Muslim women with breast cancer in Malaysia., Method: A cross-sectional descriptive design with a convenience sample of 145 Malay patients was used. The mediating role of hope in the relationship between spirituality and quality of life as well as the moderating effect of education level on the spirituality hope link were examined., Results: Participants with higher self-reported spirituality reported more hope (b = 6.345, p < 0.001) and higher levels of quality of life (b = 1.065, p < 0.001). Higher educational attainment weakened relationships between spirituality and hope (b = -1.460, p < 0.001)., Significance of Results: The role of advanced education in contributing to lessened hope in relation to spirituality emphasizes the importance of skilled and personalized spiritual counseling in the respective socio-cultural religious context.

We assessed the prevalence of cessation of e-cigarette and its associated factors among adolescents in Malaysia. This study analyzed data from the Tobacco and E-Cigarette Survey among Malaysian Adolescent (TECMA) in 2016, a cross-sectional study with 2-stage stratification cluster sampling. A total of 14 832 school-going adolescents aged 10 to 19 years participated in this survey. A complex sampling design and multiple logistic regression analysis were applied. Nearly half of the adolescents (49.9%; 95% confidence interval [CI] = 44.9-55.0) who had ever used e-cigarette ceased the usage. Based on multivariate analysis, adolescents were more likely to quit e-cigarette because they could not afford the e-cigarette (adjusted odds ratio [aOR] = 2.39, 95% CI = 1.78-3.20), if they are aged 13 year and older (aOR = 1.80, 95% CI = 1.25-2.61), and those who claimed their e-cigarette does not contain nicotine (aOR = 1.35, 95% CI = 1.03-1.78). E-cigarette prevention efforts among adolescents could consider the cessation factors described in this study.

Background: Many studies on biochemical and psychological variables have aimed to elucidate the association between aging and cognitive function. Demographic differences and protein expression have been reported to play a role in determining the cognitive capability of a population., Objective: This study aimed to determine the effect of age on the protein profile of Malay individuals and its association with cognitive competency., Methods: A total of 160 individuals were recruited and grouped accordingly. Cognitive competency of each subject was assessed with several neuropsychological tests. Plasma samples were collected and analyzed with Q Exactive HF Orbitrap. Proteins were identified and quantitated with MaxQuant and further analyzed with Perseus to determine differentially expressed proteins. PANTHER, Reactome, and STRING were applied for bioinformatics output., Results: Our data showed that the Malay individuals are vulnerable to the deterioration of cognitive function with aging, and most of the proteins were differentially expressed in concordance. Several physiological components and pathways were shown to be involved, giving a hint of a promising interpretation on the induction of aging toward the state of the Malays' cognitive function. Nevertheless, some proteins have shown a considerable interaction with the generated protein network, which provides a direction of focus for further investigation., Conclusion: This study demonstrated notable changes in the expression of several proteins as age increased. These changes provide a promising platform for understanding the biochemical factors affecting cognitive function in the Malay population. The exhibited network of protein-protein interaction suggests the possibility of implementing regulatory intervention in ameliorating Malay cognitive function.

The present study examined the best available evidence regarding energy and macronutrient intake during adulthood (age 19 to 59 years) in Malaysia and assessed whether intakes adhere to national recommendations, in order to develop recommendations for dietary improvement based on population consumption patterns. A literature review and meta-analysis evaluated intake based on the following characteristics, using information from food balance sheets, national surveys, and individual studies: (1) levels of intake, (2) proportion of the population whose diets adhere to/exceed/fail to meet Malaysian Recommended Nutrient Intake (RNI) levels, and (3) sources of macronutrients observed in these studies. Food balance data suggested high levels of available energy, animal source protein, vegetable fat, and refined carbohydrates. Twenty studies (five nationwide, 15 individual) indicated that Malaysian adults generally met or exceeded recommendations for fat and protein, but were inconsistent with respect to energy and carbohydrates. Information on dietary sources was limited. Due to methodological limitations, insufficient evidence exists regarding energy and macronutrient intakes of Malaysian adults. Improved dietary assessment methods (including use of biomarkers), better data analysis, and updated food composition data, will provide more reliable information on which to base policy decisions and recommendations for improvement.

Background: Hypertension is the leading cardiovascular risk factor globally as well as in Malaysia. This study aimed to estimate the prevalence, awareness, treatment, control and the socio demographic determinants of hypertension among Malaysian adults., Method: The analytic sample consisted of 11,288 adults aged ≥ 30 years recruited at baseline in 2007-2011 from the REDISCOVER Study which is an ongoing, prospective cohort study involving 18 urban and 22 rural communities in Malaysia. Socio-demographics, anti-hypertensive treatment details and an average of at least two blood pressure measurements were obtained., Results: The age-adjusted prevalence was 42.0 % (CI: 40.9-43.2) and was higher in men [43.5 % (CI: 41.2-45.0)] than women [41.0 % (CI: 39.8-42.3)]. Participants from rural areas (APR: 1.12, CI: 1.04-1.20); aged at least 40-49 years (APR: 1.86, CI: 1.62-2.14); who were overweight (APR: 1.24, CI: 1.15-1.34) and obese (APR: 1.54, CI: 1.43-1.6) were more likely to have hypertension. The Indigenous ethnic group was less likely to be aware (APR: 0.81, CI: 0.69-0.92) and to be on treatment (APR: 0.66, CI: 0.55-0.79). Those in rural areas were less likely to have their hypertension controlled (APR: 0.61, CI: 0.49-0.75). On the other hand, control was more likely in females (APR: 1.25, CI: 1.01-1.54) and Indigenous group (APR: 1.64, CI: 1.19-2.25)., Conclusion: Hypertension is common in the Malaysian adults. The control of hypertension has increased over the years but is still quite low. Public health measures, as well as individual interventions in primary care are crucial to reduce their risk of developing complications.

Objective: Nephrolithiasis is one of the most common disorders of the urinary tract. The aim of this study was to examine a possible relationship between DNase I/II activity and E3 SUMO-protein ligase NSE2 in the sera of nephrolithiasis patients to evaluate the possibility of a new biomarker for evaluating kidney damage., Methods: Sixty nephrolithiasis patients and 50 control patients were enrolled in a case-control study. Their blood urea, creatinine, protein levels and DNase I/II activity levels were measured by spectrometry. Serum NSMCE2 levels were measured by ELISA. Blood was collected from patients of the government health clinics in Kuantan-Pahang and fulfilled the inclusion criteria., Results: The result indicated that mean levels of sera NSMCE2 have a significantly increase (P<0.01) in patients compared to control group. Compared with control subjects, activities and specific activities of serum DNase I and II were significantly elevated in nephrolithiasis patients (P$lt;0.01)., Conclusion: This study suggests that an increase in serum concentrations of DNase I/II and E3 SUMO-protein ligase NSE2 level can be used as indicators for the diagnosis of kidney injury in patients with nephrolithiasis., (Copyright © 2015 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.)

Background: Mutations of the FMS-like tyrosine kinase-3 (FLT3) receptor gene may promote proliferation via activation of multiple signaling pathways. FLT3-internal tandem duplication (FLT3-ITD) is the most common gene alteration found in patients diagnosed with acute myeloid leukaemia (AML) and has been associated with poor prognosis., Materials and Methods: We performed mutational analysis of exons 14-15 and 20 of the FLT3 gene in 54 AML patients using PCR-CSGE (conformational sensitive gel electrophoresis) followed by sequencing analysis to characterise FLT3 mutations in adult patients diagnosed with AML at Hospital USM, Kelantan, Northeast Peninsular Malaysia., Results: FLT3 exon 14-15 mutations were identified in 7 of 54 patients (13%) whereas no mutation was found in FLT3 exon 20. Six ITDs and one non-ITD mutation were found in exon 14 of the juxtamembrane (JM) domain of FLT3. FLT3-ITD mutations were associated with a significantly higher blast percentage (p-value=0.008) and white blood cell count (p-value=0.023) but there was no significant difference in median overall survival time for FLT3-ITD+/FLT3-ITD- within 2 years (p-value=0.374)., Conclusions: The incidence of FLT3-ITD in AML patients in this particular region of Malaysia is low compared to the Western world and has a significant association with WBC and blast percentage.

This article investigates the influence of perceived health status on the daily activity participation of older Malaysians. Data from the Survey on Perceptions of Needs and Problems of the Elderly, which was conducted in 1999, were used. The negative binomial regression results show that older persons with good perceived health status reported more varieties of daily activity participation, especially among the uneducated and those with below-average self-esteem. The multinomial logistic regression model suggests that older persons with good perceived health status tended to engage daily in paid work only or with leisure activities, whereas those perceived to have poor health were more likely to engage in leisure activities only or leisure and family role activities. Promotion of a healthy lifestyle at a younger age encourages every person to monitor and take responsibility for their own health, which is a necessary strategy to ensure active participation at an older age, and thus improve their well-being.

Background: The effectiveness of trauma services provided by three hospitals operating at different levels of care, district general (DGH), tertiary care, and central tertiary, were compared in Malaysia., Methods: Cases were recruited prospectively for 1 month. Outcome measures included death or, among survivors, disability at discharge., Results: Leading causes of injuries were road traffic (72%), falls (9%), industrial (6%), and assaults (5%). Fifty-nine percent of cases were direct admissions and 41% were interhospital transfers. Of the 286 direct admissions, 12% arrived by ambulance and the remainder mostly by private car. For direct admissions, logistic regression identified an increased odds of dying associated with admission to DGH (compared with central tertiary) (odds ratio [OR], 9.8; 95% confidence interval [CI], 1.3-73.7), severe injuries (Injury Severity Score > 15) (OR, 33.1; 95% CI, 7.5-146.7), and older age (> or = 55 years) (OR, 10.8; 95% CI, 2.0-56.8). Disability at discharge was associated with being severely injured (OR, 6.4; 95% CI, 2.4-17.1)., Conclusion: In this study in Malaysia, admission to DGH, older age, and severe injuries are associated with increased odds of fatality.