Introduction: Colorectal cancer is one of the top three most commonly occurring cancer worldwide with more than 1.8 million cases in 2018. In Malaysia, colorectal cancer is the most common cancer in males and the second most common cancer in females. Albeit being the second most common form of cancer in Malaysia, there is a lack of a formal or structured national colorectal cancer screening programme in Malaysia and it remains a low priority in healthcare planning and expenditure in Malaysia. The risk of developing colon cancer is greatly influenced by factors such as lifestyle habits, genetic inheritance, diet, weight, and exercise. Kras, the most frequently mutated oncogene in cancer, occurs in about 50 percent of colorectal cancers. Methods: This study maps the kras gene involved in colon cancer pathway, using bioinformatics applications such as STRING version 11.0 and Cytoscape version 3.7.0 to provide a clear visualisation of all the related and involved proteins and genes that interact with this kras gene in the pathway. Results: The 3391 protein interactions were assembled and visualized in y organic form. Six spe-cific non-overlapping clusters of various sizes, which emerged from the huge network of protein-interactors using MCODE version 1.32 clustering algorithm were found. Biological Networks Gene Ontology (BiNGO) was used to determine two ontologies (molecular function and biological process) involved in the protein network. Based on the resulting protein-protein network interaction map, each interaction plays an important role in the cell cycle, meta-bolic pathways and signal transduction. Conclusion: Understanding these interactions provide insight into cellular activities and thus assist in the understanding of the aetiology of disease.
MeSH terms: Cell Cycle; Colonic Neoplasms; Diet; Health Expenditures; Female; Habits; Life Style; Malaysia; Male; Genes, ras; Colorectal Neoplasms; Signal Transduction; Cluster Analysis; Computational Biology; Early Detection of Cancer; Gene Ontology
Immunomodulation is essential for controlling the immune system to maintain efficient immune surveillance and inflammation. Both arms of immunomodulation, namely immunostimulation and immunosuppression, are equally crucial in setting the optimal balance of immune response. However, diseases or conditions such as autoimmune diseases, tissue rejection due to transplantation and chronic inflammation require downregulation of overwhelming immune reactions. The conventional immunosuppressive drugs prevent the activation of immune cells, yet create an unsafe condition with toxic adverse effects. In such predicament, mesenchymal stem cells (MSCs) emerged as one of the safe immunosuppressive regiments and widely tested in clinical trials for numerous chronic inflammatory dis-eases. Mesenchymal stem cells are the origin of the stromal/mesenchymal cells in almost all solid organs, including the pulp of the tooth. In addition to providing structural support to the organ, MSCs participate in the tissue repair and regeneration by ameliorating an overly activated immune response locally and systemically. Regardless of the source, MSCs profoundly suppress the proliferation and effector functions of both innate and adaptive immune cells. The mechanism of inhibition primarily took place in the early phase of cell cycle and mediated via suppression of mainstream signalling pathways that involve cyclins and other cell cycle proteins. The antiproliferative activity of MSCs is not only limited to the healthy immune cells but extends to the various tumour cells of the immune system. Similarly, an array of cell signalling pathways that executed by cell cycle proteins found downregulated in the pres-ence of MSCs. The immunosuppressive activity exerted by MSCs is not specific to particular immune cells where it impairs a group of the common cell signalling pathways or putative cell cycle proteins which are vital elements for the proliferation.
Over the past decade, research involving immunometabolism, has been gaining much interest. The immune cell re-sponses of an individual may be influenced by metabolites released by the host or derived from the microbiota. How-ever, the immune response of an individual may vary depending on the health condition of an individual. During infection, the metabolic processes derived from the infectious diseases can effect the function of immune cells and thus determine the response or survival of the host during infection. Immunometabolism also has a role in tumor development although the mechanism of how tumor cells influence immune cell function is not well understood. Among the major meatbolic pathways that have been studied in immune cells include glycolysis, the tricarboxylic acid cycle, the pentose phosphate pathway, fatty acid oxidation, fatty acid synthesis and amino acid metabolism. Understanding the tight connection between metabolomics and immunity in health and disease will be crucial as this could lead to therapeutic interventions or in developing metabolomic biomarkers in immunology.
The immune system responds to stimulus by activation/increase or inhibition/decrease in activities. These immu-nomodulatory effects may be triggered by various factors in the environment including cytokines, hormones and growth factors, as well as flavonoids, antioxidants and various antigens in food and the environment. Immunosup-pression has a direct effect on the capacity of the immune system to fight against infection and cancer formation. A pro-inflammatory response, however, may induce further progression of tumours that had formed. Inflammation is also associated with many chronic illnesses including pain. The suppressive effects from phytochemicals have been shown in the potential to reduce T-lymphocyte proliferation in vitro and in vivo. Studies have demonstrated inhibi-tion of pro-inflammatory cytokines from flavonoid such as naringenin, green tea polyphenol extract, encapsulated fruit and vegetable juice powder concentrate. Feijoa sellowiana Berg var. coolidge fruit juice consumption exerted anti-inflammatory activity on edema-induced mice within first hour of treatment while agipenin, a natural flavonoid reduced neuroinflammation by protection against damage from dendritic cells stimulated T cells in experimental autoimmune encephalomyelitis mouse models. Dietary polyphenols were found to exert a regulatory role on den-dritic cell function. Our own study showed immunosuppressive effect from increased T regulatory cells from papaya consumption. Increased regulatory cells are associated with cancer conditions. On the other hand, grape juice con-sumption mobilized gamma–delta T cells. Ginseng berry extract increased pro-inflammatory molecules in dendritic cells in the spleen while polysaccharide fractions from Momorica charantia, an edible medicinal vegetable increased various immune indexes. Fruits may also have endo-immunomodulatory function causing differential effects in male and female. Sex hormones can influence immune changes based on sex as seen in increased NK cells in males and antibodies in females. We observed a population of CD4-CD45RA-CD69+CD25- cells was significantly lower in males. However, none of these studies have been directly conducted on cancers. Investigation into this area may help improve decision making in cancer management.
A balanced oral microbiome is essential in maintaining a healthy oral cavity. Oral microbiome comprises of var-ious microorganisms that belong to different kingdoms, including bacteria (bacteriome) and fungal (mycobiome). Multiple factors have been shown in oral carcinogenesis including alcohol consumption, tobacco smoking, betel nut chewing and microbial infections. Since the oral cavity comprises of various microbial kingdoms, thus, in-ter-kingdom interactions are suggested in promoting oral carcinogenesis. Dysbiosis, which is defined as imbalance inter-kingdom microbiome, alone may not cause oral carcinogenesis; thus, it is suggested that nutritional factor may also play a vital role in this disease development. A recent study has shown that sucrose consumption can induce the production of glucosyltransferases (gtfs) by Streptococcus mutans which lead to the increasing attachment of Candida albicans in polymicrobial biofilms form. The yeast has been reported to be potentially involved in oral carcinogenesis, particularly in the immunocompromised patient. This is due to the inflammation that is caused by candidal infection, which increases pro-inflammatory cytokines such as interleukin-6, interleukin-8 and interleu-kin-10, that have been linked to oral carcinogenesis. However, further study is needed to conform to the claim. In addition, over-consumption of alcoholic beverages has also been related to carcinogenesis which the ethanol has been reported to be converted into acetaldehyde by C. albicans using acetaldehyde dehydrogenases enzymes. In Malaysia, oral cancer has also been related to the consumption of cured and salted fish, which mostly consumed by the Chinese ethnics. However, its relationship to oral microbiome remains unclear. In conclusion, oral microbiome and nutrition may have a role in oral carcinogenesis; however, further study is needed to elucidate the role of both factors in oral cancer development.
MicroRNAs (miRNAs) are small noncoding RNAs that involved in various normal and cancer-related cellular pro-cesses. Studies on expression profiling of miRNAs have been performed and the data showed that some miRNAs are up-regulated or down-regulated in cancer. miRNAs play a crucial role in HNSCC development, metastasis, prognosis and survival rate. Several studies have been conducted previously to investigate that use of miRNAs as the biomark-ers in disease diagnostic/prognostic and potential therapeutic targets management that may improve the outcomes of HNSCC. Our previous study revealed that upregulation of oncogenic miRNAs including hsa-miR-181a-2*, hsa-miR-29b-1*, hsa-miR-181a, hsa-miR-181b, hsa-miR-744, hsa-miR-1271 and hsa-miR-221* were able to distinguish HNSCC from normal samples. These miRNAs may contribute in a simple profiling strategy to identify individuals at higher risk of developing head and neck cancers, thus helping in the elucidation of the molecular mechanisms involved in head and neck cancer pathogenesis.
MeSH terms: Head and Neck Neoplasms; Humans; Neoplastic Processes; Oncogenes; Prognosis; Down-Regulation; Up-Regulation; Survival Rate; MicroRNAs; RNA, Small Untranslated
Cancers of the oral cavity are more common worldwide in men than in women, and the same is true for cancer of the nasopharynx region, whereby nasopharyngeal carcinoma (NPC) incidence rate in men is 2.5 times that in women. Different risk factors, including environmental, lifestyle and genetic factors, come into play in terms of contributing towards the development of these cancers. The increased incidence of oral cancers in developed countries in recent years are attributable to rises in the consumption of tobacco and/or alcoholic beverages, in addition to the traditional practice of betel quid chewing in some communities. As for NPC, the risk factors include male sex, overconsump-tion of preserved salted fish and smoking. In terms of etiology due to microbial agents, the human papillomavirus (HPV) has been linked with oral cancers whereby HPV DNA was found in about 2 out of 3 oropharyngeal cancer cases. In contrast, the Epstein-Barr virus (EBV) has been closely associated with most cases of NPC. Specifically, NPC is categorized by the WHO into two main histological types—keratinizing squamous cell carcinoma (type I) and non-keratinizing squamous cell carcinoma (types II and III), and it is the non-keratinizing type (types II and III) which has very high percentage of EBV DNA. The oncogenicity of these viruses had been studied extensively, and they are now recognized as crucial early triggers of NPC and oral cancers. Genetic factors can also predispose a person to the development of either oral cancer or NPC. Certain HLA class I alleles are associated with increased risks for NPC. Genetic polymorphisms in genes encoding the cytochrome P450 enzymes and glutathione S-transferase had been identified as potential risk factors for NPC. In our studies, we had shown that polymorphism in the XPD gene which encodes a DNA helicase enzyme involved in nucleotide excision repair was linked to risk for NPC in Malaysian population. We also found that the combination of CGC allele from hOGG1, ITGA2 and XPD polymorphisms was significantly associated with increased odds of NPC. In oral cancers, studies by other researchers revealed that gene polymorphisms in HOTAIR gene and the interaction with betel quid chewing are linked to oral cancer risk. Specific COX-2 gene polymorphisms were also found to be associated with increased risk for oral cancer development and progression. Taken together, these studies show a strong correlation between viral etiology combined with the indi-vidual’s genetic background coupled with certain risky lifestyle behaviours which together contribute towards the development of oral cancer and NPC.
Probiotics are live microorganisms and when consumed in adequate amounts will confer health benefit on the host. Probiotic effects of Lactic Acid Bacteria (LAB) have been reported extensively, which rely generally on the viability of LAB cells. However, we have reported extensively the prominent probiotic effects of cell less postbiotics metabolites produced by various strains of Lactobacillus plantarum isolated from Malaysian foods on rats, poultry and pigs. L. plantarum is a major species of LAB. Despite the emerging evidence of anticancer properties of LAB, very limited information is available on the cytotoxic and antiproliferative activities of cytobiotic metabolites produced by LAB. Recently, we have documented the selective antiproliferative and cytotoxicity of cytobiotic produced by six strains of L. plantarum on normal human primary cells, breast, colorectal, cervical, liver and leukemia cancer cell lines via MTT assay, trypan blue exclusion method and BrdU assay. Haemolytic assay was used to determine the toxicity of cytobiotic using human and various animal red blood cells. The cytotoxicity mode was subsequently determined for selected UL4 cytobiotic on MCF-7 cells due to its pronounced cytotoxic effect by fluorescent microscopic ob-servation using AO/PI dye reagents and flow cytometric analyses. The selective cytotoxicity effect on various cancel cells that occurred in a strain-specific and cancer cell type-specific manner whilst sparing the normal cells will be discussed in the presentation. Moreover, the antiproliferative effects and induction of late apoptosis effects against selected malignant cancer cells will be discussed further in the presentation. This report reveals the vast potential of cytobiotics produced by L. plantarum strains as functional supplement and as an adjunctive treatment for cancer.
Host induced control of pathogens involves, but not limited to, withholding of essential transition metals as well as releasing the metals at a toxic level. Zinc is one of these transition elements that plays critical role in controlling the pathogens in that manner – a key mediator in nutritional immunity. A number of subcellular and molecular mecha-nisms such as transport and storage proteins are known to maintain Zn homeostasis and scuffle with the pathogens. Pathogenic bacteria also use a number of mechanisms to combat the scuffle and fight for the right amount of Zn for their survival and growth. From the host perspective, a “delicate” balance of Zn must be maintained for immune surveillance while making the level of Zn either to starve or to intoxicate the pathogens. Metallothionein (MT), a group of low molecular weight proteins, is well known for its Zn transport and storage ability and is expected to play an important role in that nutritional immunity. Zn homeostasis by MT to fight oral pathogens is not unexpected too. Periodontitis and dental caries are two most common oral diseases which are linked to the pathogenic carnival of opportunistic bacteria. Can those culprits be exterminated through nutritional immunity using MT? Or could it be - those human hosts who become the easy prey of those pathogens lack inducible expression of MT in their oral tissues? The synthesis or degradation of MT in response to invading pathogens in oral tissues, the human-MT medi-ated Zn homeostasis in response to infectious insult in oral tissues are evident. Nonetheless, the cross talk between MT and Zn in oral nutritional immunity is largely unknown.
Head and neck cancers have been reported to have high immune infiltration scores, and clinical benefits of the anti-PD1 checkpoint inhibitor have been demonstrated in recurrent and metastatic cancers. Recent genetic signa-tures of the immune compartment have provided insights to delineate immune-active and -exhausted subtypes, to understand the immune status of OSCC patients that could further drive the development of novel immunotherapies. Vaccination with tumour-associated antigens is an approach to improve tumour recognition which could result in the eradication of cancer cells. Here, I would describe our efforts in developing antigen-specific vaccines for head and neck cancer. Using the B6.Cg-Tg(HLA-A/H2-D)2Enge/J mice bearing established tumours overexpressing the tumour antigens, we demonstrated that the vaccine delayed tumour growth, and in combination with anti-PD1, completely eliminated the tumour. The vaccine increased the expression of PD1 in T cells, and vaccinated animals showed increased antigen-specific responses by the ELISPOT assay. In summary, our data show that antigen-specific vaccine works synergistically with anti-PD1 and could be a promising therapeutic agent for head and neck cancer.
MeSH terms: Animals; Antigens, Neoplasm; Head and Neck Neoplasms; Humans; Immunotherapy; T-Lymphocytes; Vaccination; Vaccines; HLA-A Antigens; Mice; Enzyme-Linked Immunospot Assay
Colorectal cancer (CRC) is an important health problem that is on the rise globally, where it is the fourth most com-mon cause of deaths from cancer. CRC is now the 2nd commonest cancer in men and 3rd commonest in women in Malaysia. Diet, lifestyle, genetics and environmental interaction, together with underlying gut conditions such as inflammatory bowel disease have been reported to contribute to the disease. In addition, the gut microbiome has also been increasingly reported to be associated with CRC development, with dysbiosis of the commensal bacteria ob-served in CRC patients. Bacterial genera such as Bacteroides, Fusobacterium and Prevotella are more commonly de-tected in CRC patients compared to healthy individuals. Nevertheless, not much is known about the gut microbiome among Malaysians with different ethnicities. In Malaysia, the Chinese has the highest incidence of CRC, followed by Malays and Indians. The reason behind this difference may be contributed by the differences in the dietary intake that could modulate the gut microbiome and contribute towards the development of CRC. The current knowledge on this field still much depends on reports from individuals of American, European, Chinese, Brazilian and Japanese descendants in origin. The oncogenic potential of bacteria was suggested to include inflammation and the produc-tion of mutagenic toxin. A significant increase in certain intestinal microbiota including the genuses Enteroccus and Streptococcus spp. was detected in the advanced stage of colorectal adenoma. However, there are discrepancies in the previous studies, where some bacteria genera might be over-reported or underestimated. It is likely that the gut microbiome differs between populations. There is also no available data on the gut microbiome of the healthy individuals, colorectal adenoma (pre-cancerous) and colorectal cancer patients in the Malaysian population. Recent advancements in next generation sequencing allow faster and more accurate determination of microbial consortium in various niches of the human body and environment. In particular, sequencing of the 16S rRNA gene with specific primers have been reported to allow accurate determination of bacterial orders commonly found in the human gut as well as for those which are not expected in the digestive system. Recent developments in gut microbiome DNA ex-traction also contributed to the robustness of gut microbiome determination and analysis. All the above will contrib-ute towards an accurate and rapid cataloging process of the Malaysian gut microbiome and also enable comparison between healthy individuals, colorectal adenoma and CRC patients of the Malaysian population.
MeSH terms: Gastrointestinal Microbiome; Bacteroides; Cause of Death; Female; Fusobacterium; Humans; Japan; Malaysia; Male; Mutagens; RNA, Ribosomal, 16S; Traction; United States; Incidence; Human Body; Prevotella; Microbial Consortia; High-Throughput Nucleotide Sequencing; Dysbiosis
Introduction: Ovarian cancer is the fourth most common cancer among Malaysian women. Despite being a malig-nancy with low incidence, ovarian cancer has a high mortality rate with just about 35.2% of 5-year survival. There is a limited published study on the risk factors for this cancer in Malaysia. This study aimed at identifying the repro-ductive risk factors of ovarian cancer among women at selected hospitals in Klang Valley. Methods: A hospital-based case-control study was conducted from April 2017 to November 2019. Subjects were Malaysian citizens and aged 18 years and above. The case referred to a known case ovarian based on histopathological examination (HPE) and had been diagnosed not more than 2 years during the recruitment into the study. Controls were selected based on a negative result of HPE or intra-operative visual inspection and examination or normal findings from the ultrasound. Data was collected using a self-administered questionnaire. Results: A total of 111 cases and 134 controls who ful-filled the inclusion criteria participated in this study. Binary multiple logistic regression analysis showed that age at first pregnancy and infertility experience were significantly associated with risk of ovarian cancer. The odds of first pregnancy after the age of 25 years among cases was higher compared to the odds among controls (AOR=2.997, 95%CI: 1.295, 6.932, p=0.010). On the other hand, the odds of infertility experience among cases was lower com-pared to the controls (AOR=0.289, 95%CI: 0.099, 0.846, p=0.024). The lower odds of infertility experience among cases shown in this study must be interpreted with care because of wide interval and as infertility was reported to be a risk factor of ovarian cancer elsewhere. Conclusion: Reproductive risk factor for ovarian cancer were aged at first pregnancy of 25 years and above. Prevention of ovarian cancer should be targeted to his group.
Introduction: Low back pain (LBP) is a common symptom among working population worldwide. Foggers prone to have LBP because there are exposed to physical factors such as lifting heavy object, awkward body posture and vibration. However, LBP had never been studied among the fogger. The objective of this study was to determine the prevalence and the factors associated with LBP. Methods: A cross-sectional study was carried out in all District Health Office in Johor, Malaysia by using a validated self-administered questionnaire and anthropometric measure-ments. Chi-square or Fisher’s exact test was used for inferential statistic and multiple logistic regression was used to determine the associated factors. The significance level was determined at p < 0.05. Results: The response rate was 83.9%. Majority of them are male (99.6%), Malay (95.8%), married (85.8%) and educated up to secondary school (53.5%). Majority of respondents do not have part time job (89.6%) but they work overtime everyday (62.7%). Most of them do four hours overtime daily (77.3%). The prevalence of LBP was 68.5% among respondents. There was a significant association between doing part time job, duration of doing overtime per week, body mass index (BMI) and duration of fogging activities. Finally, the associated factors of LBP were doing overtime for more than 20 hours per week (adjusted OR=1.914, 95% CI [1.102, 3.324], p = 0.021), BMI of more than 23.00 kg/m2 (adjusted OR=2.066, 95% CI [1.090, 3.916], p = 0.026) and having no part time job (adjusted OR=0.135, 95% CI [0.031, 0.599], p = 0.021). Conclusion: Prevention needs to be initiated to change the modifiable factors of LBP in order to reduce the prevalence of LBP among them.
MeSH terms: Anthropometry; Cross-Sectional Studies; Malaysia; Male; Posture; Surveys and Questionnaires; Vibration; Body Mass Index; Prevalence; Logistic Models; Low Back Pain; Lifting
Introduction: Child abuse is an epidemic and in Malaysia, the numbers are rising. Statistic showed that 60% of the victims were below seven years old. Since most of them goes to preschool at this age, the role of childcare providers (CPs) in addressing this issue is crucial. However, previous data showed that referrals made by them to the author-ities was less than 1%. The objective of this study was to determine the knowledge and attitude of CPs in KEMAS preschools towards child abuse. Methods: This is a cross-sectional study involving CPs working in the KEMAS pre-schools in Kota Bharu and Tumpat, Kelantan, Malaysia, from April to June 2019. Results: From 218 respondents, 78% and 83% of them had good awareness on signs of neglect and physical abuse respectively compared to sexual abuse (64.6%). In terms of knowledge, 80% answered correctly about signs of abuse. However, only 18.8% an-swered correctly about sexual abuse. Moreover, 86.7% of CPs believed that they should be responsible to lodge a report, while only 6% of them objected. Although 76.1% were correct about the information to be prepared for reporting, only 4.6% of them realised that suspicions about a case would suffice to lodge a report. There were 94.5%, and 65.1% of CPs who correctly answered about the protection of the reporter under the law and its penalty respectively. But, only 26.6% of the CPs were correct about the category of mandated reporters according to the law. Conclusion: Although majority of CPs had good knowledge and awareness, there was still 26.6% who did not realise that they were mandated to report suspected cases. Therefore, educational programs need to be planned to increase awareness and knowledge on abuse and its legal aspects among CPs.
MeSH terms: Physical Abuse; Child Health; Attitude; Child; Child Abuse; Child Care; Child, Preschool; Cross-Sectional Studies; Humans; Malaysia; Surveys and Questionnaires; Referral and Consultation; Sex Offenses
Introduction: Dengue fever currently remains as one of the major public health issues in Malaysia. Dengue inci-dence in Malaysia has been increasing in the last 20 years. Dengue fever has been causing an economic burden to the country each year. Vector control is one of the preventions and control activities to reduce its incidence. Vector control activities, especially fogging is a resource-intensive activity. It uses most of the allocated budget of a district health office (33%). The major cost components of the prevention and control activities were human resources and pesticides with 60.7% were for human resources and 13.6% of the costs were for pesticides. Therefore, it is important to know, cost of each fogging activity and the factors that contribute to that cost. The objective of this study was to determine the costs of fogging activities carried out by Hulu Langat Health District Office, Selangor, Malaysia. Meth-ods: This study was a retrospective descriptive and analytical study using data from the Hulu Langat District Health Office for the year 2018. Cost analysis of fogging activities was carried out using the activity-based costing method-ology. The factors associated with, and predictors of, the costs of fogging activities were determined using chi-square and multiple linear regression. Results: In 2018, Hulu Langat District Health Office carried out total of 2,063 fogging activities. The average cost of each fogging activity was estimated as RM 1,579. Types of insecticides was statistically significant associated and predictive factor of the cost of fogging activity. Conclusion: The present study showed that the estimated average cost per fogging activity is RM 1,579 and water-based insecticide was found to be the cheaper option compared to oil-based insecticide. However, as this study did not determine the effectiveness of these insec-ticides, recommendations cannot be made as to which insecticide should be used.
MeSH terms: Budgets; Dengue; Humans; Insecticides; Malaysia; Pesticides; Public Health; Retrospective Studies; Water; Weather; Incidence; Linear Models; Cost of Illness
Introduction: Malaysia has been nominated among the top four well-established healthcare system in the world. However, with the status of a developing country, there are still lacking in offering healthcare services and aware-ness among poverty. The objective of this review is to look into the factors hindering healthcare coverage in poverty. Methods: These literature reviews were carried out by using the electronic databases included, Google Scholars, Medline, PUBMED and EBSCOhost. Results: In current economic status, poverty status needs to be revised as the cost of living has markedly increased especially in the urban. Many factors affect the health status, which include the issues in term of rising health expenditure, demography-geography and imbalance workload distribution. Less expo-sure to health and wellness and geographical-demographic profile are the main reasons for the lack of self-awareness in assessing health services. Various actions had been taken by the stakeholders to improve health statuses such as telehealth, referral system and integration between agencies. Suggestion to improve the existing plan with the atten-tion given especially in the rural area which composed of multi-ethnicity and demography-geographical distribution. In Islam, Prophet Muhammad PBUH promotes health through his eating habits, physical activities include prayer and sports, proper sleep habit and through fasting. Conclusion: Poor and lack of awareness of healthcare services and health ownership have been the main reason for low health-seeking in poverty. Factors such as rising health expenditure, demography-geography factors and lack of facilities provided and unbalance workload distribution in the public-private sector contribute to the issue of concern.
MeSH terms: Delivery of Health Care; Developing Countries; Ethnic Groups; Health Expenditures; Fasting; Health Status; Humans; Islam; Malaysia; Ownership; Socioeconomic Factors; MEDLINE; Workload; Private Sector; PubMed
Introduction: Anaemia is a significant public health problem among adolescents globally but there is limited data in many countries, including Malaysia. This study aims to investigate the 5-years incidence of anemia among Malaysian adolescents by gender, ethnicity, locality of schools, Body Mass Index, stature and diet intake. Methods: A secondary analysis of existing data from MyHeART study was conducted within a closed cohort of 528 adolescents (aged 13 years) attended 15 public secondary schools from Kuala Lumpur, Selangor and Perak. The adolescents who were followed up at 15 and 17 years old had completed haemoglobin assessment, anthropometric measurements and -days diet history. The data was cleaned and missingness was handled accordingly with multiple imputation. SPSS Software version 21 was used to analyse the data, with Generalised Estimating Equation (GEE) showing the effect of time on the trajectory of prevalence of anaemia over the 5 years. Results: The prevalence or incidence? of anaemia in 2012, 2014 and 2016 was 7.9% (95%CI: 5.0-12.3), 13.9% (95%CI: 10.0-19.0) and 15.8% (95%CI:11.3-21.7). In females, anaemia increased from 11.1% (95%CI:6.7-18.7) to 15.7% (11.4-21.3) and 23.1%(95%CI: 16.8-31.0); the change was significant from 13 to 15 years old. Similar trend was noticed in those who are stunted, overweight/obese, in both urban/rural schools and didn’t meet their daily recommended nutrient intake for total calorie, protein and iron. Conclusion: Anaemia is increasing in trend among the adolescents over the years and deems attention from the relevant stakeholders to create a robust anemia prevention program.
MeSH terms: Adolescent; Anemia; Attention; Diet; Ethnic Groups; Female; Hemoglobins; Humans; Iron; Malaysia; Obesity; Public Health; Software; Body Mass Index; Incidence; Prevalence; Overweight
Introduction: Job stress is defined as harmful physical, negative, emotional responses that occur when the require-ments of the job do not match the capabilities, resources or needs of the worker. Factors influencing job stress among nurses in primary healthcare in Malaysia are poorly identified. The objective of this study is to assess the job stress score and identify the predictors of job stress among nurses in Primary Health Care (PHC) facilities in Kuala Lan-gat district of Selangor. Methods: A cross-sectional study conducted among 216 nurses in PHC facilities of Kuala Langat District. Data collection conducted using self-administered questionnaire adopted and modified from Job Stress Scale, Nursing Stress Scale (NSS) and Expanded Nursing Stress Scale (ENSS). Results: There is evidence of job stress with mean score of 28.4(5.5) among nurses in PHC facilities of Kuala Langat District, Selangor, Malaysia. There are association between age, role in organization, duration of services, outside job scope, family size, doing house chores, balance between work and family, balance between work and leisure activities, workload, inadequate preparation, lack of staff support, uncertainty concerning treatment, role conflicts and patients and their families with job stress (p
MeSH terms: Cross-Sectional Studies; Family Characteristics; Health Resources; Humans; Leisure Activities; Malaysia; Primary Health Care; Surveys and Questionnaires; Workload; Uncertainty
Introduction: Low job satisfaction among healthcare workers may lead to high turnover intention, poor job perfor-mance, high absenteeism, and low patient satisfaction. Global and local needs for health workforce are increasing in trend to meet current health demands. Addressing job satisfaction of the healthcare workers is a practical way to uti-lise the available human resources optimally. The main aim of this study is to determine job satisfaction level and its associated factors among healthcare workers in health clinics under the Petaling District Health Office jurisdiction in Selangor, Malaysia. Methods: A cross-sectional study was conducted among healthcare workers in ten health clinics in Petaling District from April until May 2019. Simple random sampling method proportionate to the number of staffs from each health clinics was done. A structured self-administered questionnaire was used. Results: The response rate was 93%. Majority of the respondent were female (83%), married (82%), diploma holder (41%), nurses (33%) and working in health clinics with specialists (93%). The job satisfaction mean score for the studied population was 4.46 (SD = 0.72). Self-rated physical health and mental stress status were significantly associated with job satisfaction (p < 0.001). Conclusion: The job satisfaction level of the studied population was comparable to other local studies and higher than studies from Iran, Ethiopia and China. Extra attention should be given to healthcare workers with poor physical health and poor mental stress. More objective study on physical health and mental stress is required.
Introduction: Family plays an important role in the development of an adolescent. Several theories postulate in-fluences of bully behaviours within family context. Persistent act of school bullying may lead to violence and eventually disruption of a normal adolescence mental health. This study was done to address whether family factors were associated with school bully perpetrator. Methods: This was a cross sectional study conducted among Form One students from twenty-five schools in Selangor. Parental and respondents’ consents were obtained prior to this research. Data was collected using a self-administered questionnaire comprising of sociodemographic data of the respondents, their family characteristics and parenting style. Cronbach alpha ranged from 0.70- 0.89. Data was analysed using SPSS v25. Ethical approval was obtained from the Ethics Committee for Research Involving Human Subject of Universiti Putra Malaysia (UPM). Results: Response rate was 92.7% with 1221 respondents. Majority of the respondents were females (62%), Malays (82.8%) and lived with married parents (91.2%). Prevalence of bully perpetrator was 12.8%. Parental marital status (p < 0.05), presence of substance abuse among family member (p < 0.05), presence of violence act among family member (p < 0.05), witnessing violence at home (p < 0.05), sibling violence (p < 0.05), presence of family hostility (p < 0.05) and permissive maternal parenting style ( p < 0.05) were associated with school bully perpetrators. Conclusion: This study showed the association between family factors and the development of school bully perpetrators. It is a strong message for parents, educators, policy makers and health providers to collaborate and redesign prevention programmes in an effort to contracept the birth of a school bully.