Browse publications by year: 2024

  1. Aminuddin A, Brown MJ, Azizan EA
    Front Endocrinol (Lausanne), 2024;15:1423027.
    PMID: 39170743 DOI: 10.3389/fendo.2024.1423027
    Hypertension affects one-third of the adult population worldwide, with primary aldosteronism (PA) accounting for at least 5-10% of these cases. The aldosterone synthase enzyme (CYP11B2) plays a pivotal role in PA manifestation, as increased expression of CYP11B2 leads to excess aldosterone synthesis. Physiological expression of CYP11B2 in humans is normally limited to cells of the adrenal zona glomerulosa under tight homeostatic regulation. In PA, however, there are CYP11B2-positive lesions in the adrenal cortex that autonomously secrete aldosterone, highlighting the dysregulation of adrenal cortex zonation and function as a key aspect of PA pathogenesis. Thus, this review aims to summarize the development of the adrenal glands, the key regulators of adrenal cortex homeostasis, and the dysregulation of this homeostasis. It also discusses the development of CYP11B2 inhibitors for therapeutic use in patients with hypertension, as well as the current knowledge of the effects of CYP11B2 inhibition on adrenal cortex homeostasis and cell fate. Understanding the control of adrenal cell fate may offer valuable insights into both the pathogenesis of PA and the development of alternative treatment approaches for PA.
    MeSH terms: Adrenal Cortex/cytology; Adrenal Cortex/metabolism; Animals; Cell Differentiation; Homeostasis; Humans; Hypertension/metabolism; Hypertension/pathology; Zona Glomerulosa/metabolism
  2. Muhammad H, Chan WS, Jaafar J, Wan Hitam WH
    Cureus, 2024 Jul;16(7):e65138.
    PMID: 39171063 DOI: 10.7759/cureus.65138
    Eight-and-a-half syndrome is a rare neuro-ophthalmologic condition, which is characterized by ipsilateral horizontal gaze palsy, internuclear ophthalmoplegia (INO), and ipsilateral lower motor neuron facial palsy. We report a case of eight-and-a-half syndrome secondary to acute brainstem infarction. A 55-year-old gentleman with underlying diabetes mellitus and hypertension presented with a sudden onset of double vision in the right lateral gaze for one day. On examination, there was a limitation in the left eye horizontal eye movement with limited right eye adduction. Further neurological examination revealed left lower motor neuron facial nerve palsy. Magnetic resonance imaging (MRI) of the brain showed an acute infarct involving the left side of the thalamus extending to the left side of the midbrain, pons, and medulla. He was diagnosed with eight-and-a-half syndrome secondary to acute brainstem infarction. The patient was referred to the neuromedical team, where he was treated with anti-platelet medications. He showed gradual improvement on follow-up and had complete resolution of ophthalmoplegia after three months. There was only minimal residual facial nerve weakness. Eight-and-a-half syndrome has a localizing value to the dorsal tegmentum of the pons. It requires thorough neurological examination and imaging studies for accurate diagnosis and management. This case highlights the potential for a significant recovery in patients with eight-and-a-half syndrome when timely and appropriate treatment is administered.
  3. Idris ZM, Wahid W, Seri Rakna MIM, Ghazali N, Hassan NW, Abdul Manap SNA, et al.
    Front Public Health, 2024;12:1412496.
    PMID: 39171304 DOI: 10.3389/fpubh.2024.1412496
    INTRODUCTION: Anaemia remains a primary concern of public health in developing countries. Indigenous populations are a significant and frequently underreported group at risk for anaemia. This study aimed to assess the prevalence of anaemia and identify its determinants in the Temiar sub-ethnic indigenous Orang Asli (OA) community in Peninsular Malaysia.

    METHODOLOGY: A community-based cross-sectional study was conducted among 640 indigenous Temiar OA participants from a remote settlement in Gua Musang, Kelantan, Malaysia. Data was collected using face-to-face interviews with a standardised pretested questionnaire and through blood samples collected for haemoglobin (Hb) testing. Anaemia status was determined using the Hb level cut-off established by the World Health Organization (WHO). Descriptive analysis was used to determine the prevalence of anaemia, while multiple logistic regression was used to determine factors associated with anaemia.

    RESULTS: The overall anaemia prevalence was 44.7% (286/640), and the prevalence rates of mild, moderate and severe anaemia were 42.7, 50.7 and 6.6%, respectively. Anaemia-specific prevalence varied significantly by age group (p  40 (aOR 0.25, p 

    MeSH terms: Adolescent; Adult; Aged; Child; Child, Preschool; Cross-Sectional Studies; Ethnic Groups/statistics & numerical data; Female; Humans; Malaysia/epidemiology; Male; Middle Aged; Surveys and Questionnaires; Risk Factors; Severity of Illness Index; Prevalence; Young Adult
  4. Chen D, Lee YY, Tan CP, Wang Y, Qiu C
    J Agric Food Chem, 2024 Sep 04;72(35):19480-19493.
    PMID: 39171455 DOI: 10.1021/acs.jafc.4c05495
    Pickering foams have great potential for applications in aerated foods, but their foaming ability and physical stability are still far from satisfactory. Herein, solid lipid particles (SLNs) were fabricated by using diacylglycerol of varying acyl chain lengths with modification by a protein. The SLNs showed different crystal polymorphisms and air-water interfacial activity. C14-DAG SLN with a contact angle ∼ 79° formed aqueous foam with supreme stability and high plasticity. Whey protein isolate and sodium caseinate (0.1 wt %) considerably enhanced the foamability and interfacial activity of SLNs and promoted the packing of particles at the bubble surface. However, high protein concentration caused foam destruction due to the competitive adsorption effect. β-sheet increased in protein after adsorption and changed the polymorphism and thermodynamic properties of SLN. The foam collapsing behaviors varied in the presence of protein. The results gave insights into fabricating ultrastable aqueous foams by using high-melting DAG particles. The obtained foams demonstrated good temperature sensitivity and plasticity, which showed promising application prospects in the food and cosmetic fields.
    MeSH terms: Adsorption; Lipids/chemistry; Liposomes; Particle Size; Thermodynamics
  5. Chan SC, Patrick Engkasan J
    Am J Phys Med Rehabil, 2024 Jul 01;103(7):650-651.
    PMID: 38529617 DOI: 10.1097/PHM.0000000000002493
    MeSH terms: Humans; Review Literature as Topic; Wound Healing/physiology; Treatment Outcome
  6. Kok HC, McCallum GB, Yerkovich ST, Grimwood K, Fong SM, Nathan AM, et al.
    Pediatr Infect Dis J, 2024 Sep 01;43(9):872-879.
    PMID: 38830139 DOI: 10.1097/INF.0000000000004407
    BACKGROUND: Pediatric community-acquired pneumonia (CAP) can lead to long-term respiratory sequelae, including bronchiectasis. We determined if an extended (13-14 days) versus standard (5-6 days) antibiotic course improves long-term outcomes in children hospitalized with CAP from populations at high risk of chronic respiratory disease.

    METHODS: We undertook a multicenter, double-blind, superiority, randomized controlled trial involving 7 Australian, New Zealand, and Malaysian hospitals. Children aged 3 months to ≤5 years hospitalized with radiographic-confirmed CAP who received 1-3 days of intravenous antibiotics, then 3 days of oral amoxicillin-clavulanate, were randomized to either extended-course (8-day oral amoxicillin-clavulanate) or standard-course (8-day oral placebo) arms. Children were reviewed at 12 and 24 months. The primary outcome was children with the composite endpoint of chronic respiratory symptoms/signs (chronic cough at 12 and 24 months; ≥1 subsequent hospitalized acute lower respiratory infection by 24 months; or persistent and/or new chest radiographic signs at 12-months) at 24-months postdischarge, analyzed by intention-to-treat, where children with incomplete follow-up were assumed to have chronic respiratory symptoms/signs ("worst-case" scenario).

    RESULTS: A total of 324 children were randomized [extended-course (n = 163), standard-course (n = 161)]. For our primary outcome, chronic respiratory symptoms/signs occurred in 97/163 (60%) and 94/161 (58%) children in the extended-courses and standard-courses, respectively [relative risk (RR) = 1.02, 95% confidence interval (CI): 0.85-1.22]. Among children where all sub-composite outcomes were known, chronic respiratory symptoms/signs between groups, RR = 1.10, 95% CI: 0.69-1.76 [extended-course = 27/93 (29%) and standard-course = 24/91 (26%)]. Additional sensitivity analyses also revealed no between-group differences.

    CONCLUSION: Among children from high-risk populations hospitalized with CAP, 13-14 days of antibiotics (versus 5-6 days), did not improve long-term respiratory outcomes.

    MeSH terms: Australia; Child, Preschool; Double-Blind Method; Female; Hospitalization*; Humans; Infant; Malaysia; Male; New Zealand; Treatment Outcome; Amoxicillin-Potassium Clavulanate Combination/administration & dosage; Amoxicillin-Potassium Clavulanate Combination/therapeutic use
  7. Ahmad MA, Nor AM, Abd Hamid HS
    Curr HIV Res, 2024;22(3):181-194.
    PMID: 38867529 DOI: 10.2174/011570162X300696240530095046
    INTRODUCTION: Living with HIV/AIDS is more difficult for gay, bisexual, and queer (GBQ) people as they face stigma on both the disease and sexuality, which puts significant stress on coping with stressors, and online platforms have become an alternative coping channel.

    METHODS: This study investigated the use of online coping strategies in moderating the HIV stigma mediated by sexual identity stigma on mental health in Malaysia. 123 GBQ people living with HIV between the ages of 20 and 39 participated in the study, responding to the HIV Stigma - Short Form Scale, adapted China MSM Stigma Scale, Online Coping Inventory, and DASS-21.

    RESULT: Results were analyzed using OLS, and logistic regression path modeling showed a statistically significant indirect effect of sexual identity stigma mediating HIV stigma on depressive (ab = 0.1362), anxiety (ab = 0.1259), and stress (ab = 0.1636) levels. Problem-focused online coping strategy was found to moderate the indirect association between HIV stigma and depression levels via sexual identity stigma at low (β = 0.2110, SE = 0.0741, p

    MeSH terms: Adaptation, Psychological*; Adult; Depression/psychology; Female; Humans; Malaysia; Male; Surveys and Questionnaires; Stress, Psychological/psychology; Internet; Young Adult; Social Stigma*
  8. Obnial JC, Escuadra CJ, Miranda AV, Lucero-Prisno Iii DE
    Osong Public Health Res Perspect, 2024 Aug;15(4):329-339.
    PMID: 39091163 DOI: 10.24171/j.phrp.2024.0058
    BACKGROUND: This study compared the research output of Association of Southeast Asian Nations (ASEAN) countries to understand research trends and clarify past, present, and future patterns using scientometric techniques.

    METHODS: This scientometric study systematically mined health and social science publications from the Web of Science and Scopus databases using keywords associated with infectious disease. The analysis included only English-language articles and review articles by authors from any ASEAN country. Publication, citation, and text co-occurrence network analyses were performed. R Studio and VOSviewer enabled data management, analysis, and visualization.

    RESULTS: Searches identified 12,511 articles published between 1925 and 2022, with a notable increase in research publications since 2003. The leading journals on infectious disease were associated with established publishing houses, including BMC, BMJ, and The Lancet. The most-cited articles were primarily global burden of disease studies, with 7,367 citations. Among ASEAN countries, Thailand, Malaysia, and Singapore had the most publications and collaborative efforts on the topic. Analysis of keyword co-occurrence revealed clusters related to global health, dengue, bacterial studies, non-dengue viral topics, and diagnostics. Most early studies examined diagnostics, gene and sequencing methodologies, and virology; later, the focus shifted toward herbal and alternative medicine.

    CONCLUSION: Recently, the research capacity of Southeast Asia has expanded dramatically, with substantial contributions from high-income countries. Intense cooperation between member states is essential, emphasizing the role of HICs in supporting their neighbors. Increased research efforts and collaboration must be dedicated to innovative approaches to combat persistent health conditions, along with emerging issues like climate change.

  9. Salowi MA, Naing NN, Mustafa N, Wan Nawang WR, Sharudin SN, Ngah NF
    BMJ Open Ophthalmol, 2024 Aug 12;9(1).
    PMID: 39134324 DOI: 10.1136/bmjophth-2024-001732
    BACKGROUND/AIMS: Population surveys are required to measure the prevalence of cataract blindness in the community. We conducted simultaneous surveys in two regions in Malaysia in 2023 to estimate the prevalence of untreated cataract, measure the visual outcomes after cataract surgery and compare the results with the survey in 2014.

    METHODS: The surveys were done in Eastern and Sarawak administrative regions using the rapid assessment of avoidable blindness technique. It involved a multistage cluster sampling method, each cluster comprising 50 residents aged 50 years and older. The prevalence of cataract was determined through a visual acuity (VA) check and eye examination. The VA of those who had undergone cataract surgery was measured, and the findings were compared with the previous survey.

    RESULTS: A total of 9709 subjects, 50 years old and older, were examined (percentages of response were 94.5% and 96.2% for Eastern and Sarawak, respectively). Comparing the current to the previous survey in 2014, the prevalence of cataract at all levels of surgical thresholds (except unilateral VA <6/60 and <6/18 in the Eastern) was reduced. The percentages of cataract surgery visual outcomes with good VA (6/12) were improved, and those with poor VA (<6/60) were reduced in both regions.

    CONCLUSION: There was a reduction in cataract prevalence and improved visual outcomes in both regions. These favourable results could be attributed to the surgical performance monitoring initiatives and the community cataract programme implemented soon after the survey in 2014.

    MeSH terms: Aged; Aged, 80 and over; Female; Health Surveys; Humans; Malaysia/epidemiology; Male; Middle Aged; Visual Acuity*; Prevalence; Age Distribution
  10. Ridlo MR, Andityas M, Primatika RA, Widantara H, Loong SK, Nuraini DM
    Vet Q, 2024 Dec;44(1):1-14.
    PMID: 39162149 DOI: 10.1080/01652176.2024.2390945
    Indonesia has a long history of livestock brucellosis, but the overall pooled prevalence remains unclear. This study aims to determine the pooled estimated prevalence of livestock brucellosis in Indonesia using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Five databases were searched and screened using predefined inclusion and exclusion criteria. Data from included studies were extracted and analyzed using a random effects model in R 4.3.0 for pooled estimated prevalence, subgroup meta-analysis, and meta-regression. Publication bias and sensitivity tests were conducted using Egger's test, funnel plot, trim and fill plot, and leave-one-out. The screening process identified 46 included studies, representing 47,057 samples for brucellosis testing. The pooled estimated prevalence for livestock brucellosis was 3.25% (95% CI, 1.81%-5.78%) with high heterogeneity (Q = 2130.91, p = 0, I2=98%). Subgroup meta-analysis indicated no significant difference in the prevalence of livestock brucellosis across the main islands in Indonesia (p = 0.44) and across provinces in Sulawesi Island (p = 0.83), but significant differences were found among provinces in Java (p 
    MeSH terms: Animals; Cattle; Cattle Diseases/microbiology; Cattle Diseases/epidemiology; Goats; Indonesia/epidemiology; Sheep; Sheep Diseases/microbiology; Sheep Diseases/epidemiology; Swine; Goat Diseases/microbiology; Goat Diseases/epidemiology; Prevalence
  11. Sen CJ, Cheng YC
    Afr J Paediatr Surg, 2024 Jul 01;21(3):204-206.
    PMID: 39162758 DOI: 10.4103/ajps.ajps_159_22
    A chemoport is widely used in paediatric oncology population. Removal is a relatively easy procedure, but difficulty can be encountered in case the catheter is densely adherent to the vascular wall. It is a rare complication and is associated with long indwelling duration and acute lymphoblastic leukaemia (ALL). Forceful traction can lead to vascular injury and high morbidity. Herein, we report a 7-year-old girl with precursor B ALL who had delayed chemoport removal due to the coronavirus disease (COVID-19) pandemic. The removal process was difficult, as the catheter was adherent to the right innominate vein. Out of panic, the surgeon pulled it out forcefully. Fortunately, the catheter and its fragment were successfully retrieved completely and the child was discharged the next day. The management strategy varies and ranges from minimally invasive to open surgery. Leaving a stuck chemoport catheter in situ can be a bailout method or part of conservative management.
    MeSH terms: Catheterization, Central Venous/adverse effects; Catheters, Indwelling/adverse effects; Child; Female; Humans; Device Removal*; Pandemics*
  12. Tan SL, Chan CK, Ahmad TS, Teo SH, Ng WM, Selvaratnam L, et al.
    PMID: 39162995 DOI: 10.1089/ten.TEC.2024.0230
    Mesenchymal stromal cell(MSCs) has immense potential for use in musculoskeletal tissue regeneration, however, there is still a paucity of evidence on the effect of tenogenic MSCs(TMSC) in tendon healing in vivo. This study aimed to determine the effects of GDF5-induced rbMSCs in infraspinatus tendon healing in a New Zealand White rabbit model. In this study, bone marrow-derived rbMSCs were isolated, and 100 ng/ml GDF5 was used to induce tenogenic differentiation in rbMSC. The effects of GDF5 on rbMSC in vitro were assessed by total collagen assay, gene expression analysis and immunofluorescence staining of tenogenic markers; native tenocytes isolated from rabbit tendon were used as a positive control. In in vivo, a window defect was created on the infraspinatus tendons bilaterally. After three weeks, the rabbits(n=18) were randomly divided into 6 groups and repaired with various interventions: (i)surgical suture; (ii)fibrin glue; (iii)suture and fibrin glue; (iv)suture, fibrin glue and tenocytes(rbTenocyte); (v)suture, fibrin glue and MSCs as well as, (vi)suture, fibrin glue and TMSC. All animals were euthanized at 6 weeks postoperative. The in vitro GDF5-induced rbMSCs (or TMSC) showed increased total collagen expression; augmented scleraxis(SCX) and type-I Collagen(COL-I) mRNA gene expression levels. Immunofluorescence showed similar expression inGDF5-induced rbMSC to that of rbTenocyte. In vivo histological analysis showed progressive tendon healing in TMSC treated group; cells with elongated nuclei aligned parallel to the collagen fibers and the collagen fibers were in more organized orientation, along with macroscopic evidence of tendon callus formation. Significant differences were observed in cell treated groups compared to the non-cell treated groups. Histological scoring showed a significantly enhanced tendon healing in TMSC and MSC treated groups compared to rbTenocyte group. The SCX mRNA expression levels, at 6 weeks following repair, were significantly up-regulated in the TMSC group. Immunofluorescence showed COL-I bundles aligned in parallel orientation; this was further confirmed in AFM imaging. SCX, TNC and TNMD were detected in the TMSC group. In conclusion, GDF5 induces tenogenic differentiation in rbMSCs, and TMSC enhances tendon healing in vivo compared to conventional suture repair.
  13. Zhao J, Wang C, Ibrahim H, Chen Y
    PLoS One, 2024;19(8):e0309099.
    PMID: 39163358 DOI: 10.1371/journal.pone.0309099
    The use of digital technology by banks and other financial institutions to facilitate financial inclusion is referred to as digital financial inclusion. This fusion of digital finance and traditional banking methods has the potential to impact banks' operational effectiveness. This study uses the panel effects model to examine the link between digital financial inclusion and bank performance in 30 Chinese provinces from 2012 to 2021. This research uses kernel density estimation to examine the spatial-temporal growth patterns of both variables. The mediator variable in examining how digital financial inclusion affects bank performance is risk-taking. Finally, the paper analyses the regional heterogeneity of the impact. It presents the following conclusions: (1) In China, digital financial inclusion and bank performance have constantly increased, with noticeable regional variances in their development levels. This regional inequality has widened gradually since 2018, yet it has not resulted in polarization. (2) The significant positive correlation between digital inclusive finance and banking performance indicates that banking performance tends to increase with the enhancement of digital inclusive finance. (3) Digital financial inclusion impacts bank performance, with risk-taking as a moderator. The spread of digital financial inclusion services enhances banks' willingness to take risks, enhancing overall efficiency. (4) Digital financial inclusion boosts bank performance in the Northwest, South, North, and East regions while lightly inhibiting it in the Central region. Based on the findings, this study makes bank and government suggestions.
    MeSH terms: Banking, Personal; China; Financial Management*; Humans; Risk-Taking; Models, Economic
  14. Yusof MZ, Zahaba M, Mohd Aris MS, Shafiee S', Abdul Hadi H, Maghpor MN, et al.
    Toxicol Ind Health, 2024 Aug 20.
    PMID: 39163360 DOI: 10.1177/07482337241273755
    This study aimed to estimate workers' occupational lifetime exposure to chrysotile and examine the respiratory symptoms and lung cancer risk. A total of 112 workers were interviewed about their occupational histories. Exposure modeling using information on the determinants of exposure was used to estimate chrysotile emissions. The cumulative lifetime exposure was then assessed for each worker. Respiratory symptoms were obtained using a validated questionnaire. Lung cancer mortality rate was also predicted using a model. Almost all the workers were male and young (mean age = 30 years, SD = 7). The estimated lifetime occupational chrysotile inhalation exposure ranged from 0.0001 to 0.0486 f/mL.years (median = 0.0018 f/mL.years, IQR = 0.486). A high prevalence of cough symptom (11.7%), and low estimated cancer risk (<1%) were reported. In conclusion, the lung cancer risk among our cohort of workers was at a low level because of lower cumulative lifetime occupational chrysotile exposure.
  15. Regmi P, Aryal N, Bhattarai S, Sedhain A, K C RK, van Teijlingen E
    PLoS One, 2024;19(8):e0309203.
    PMID: 39163385 DOI: 10.1371/journal.pone.0309203
    In recent years, international media and the scientific community have expressed concerns regarding rising kidney health-related risks among Nepalese labour migrants in Gulf countries and Malaysia. Previous studies have highlighted poor lifestyles and work conditions among Nepalese migrants, which could potentially impact their kidney health. This qualitative study aims to explore the lifestyles and work environment of returnee Nepalese migrants who were diagnosed with kidney health problems. In-depth interviews were carried out with twelve returnee migrants, all males, with half having worked abroad for at least a decade. Our analysis yielded seven themes: (a) living and lifestyles; (b) work environment; (c) exposure to pollutants; (d) Chronic Kidney Disease (CKD) experience; (e) use of painkillers and healthcare; (f) medical expenses for CKD patients; and (g) pre-departure training. This study indicates that Nepalese migrants face numerous challenges, including limited access to clean water and sanitation facilities, poor diets, exposure to occupational hazards, and overuse of pain medication, all of which may contribute to an increased risk of kidney disease. An enhanced pre-departure and on-arrival orientation programme focusing on kidney health-related topics, including the necessary advocacy at the country of destination to provide access to basic services, may encourage migrants to adopt healthy lifestyles and safe working environments, as well as help sensitise migrants to their kidney health risks.
    MeSH terms: Adult; Humans; Life Style*; Male; Middle Aged; Nepal/epidemiology; Workplace; Renal Insufficiency, Chronic/epidemiology
  16. Boyle MJW, Sharp AC, Barclay MV, Chung AYC, Ewers RM, de Rougemont G, et al.
    Curr Biol, 2024 Aug 19;34(16):R770-R771.
    PMID: 39163835 DOI: 10.1016/j.cub.2024.06.059
    Insects are posited to be declining globally. This is particularly pertinent in tropical forests, which exhibit both the highest levels of biodiversity and the highest rates of biodiversity loss. However, for the hyper-diverse tropical insects there are scant data available to evidence declines. Understanding tropical insect diversity and its response to environmental change has therefore become a challenge, but it is estimated that 80% of tropical insect species remain undescribed1. Insect biodiversity predictions are based mostly on well-studied taxa and extrapolated to other groups, but no one knows whether resilience to environmental change varies between undescribed and described species. Here, we collected staphylinid beetles from unlogged and logged tropical forests in Borneo and investigated their responses to environmental change. Out of 252 morphospecies collected, 76% were undescribed. Undescribed species showed higher community turnover, reduced abundance and decreased probability of occurrence in logged forests. Thus the unknown components of tropical insect biodiversity are likely more impacted by human-induced environmental change. If these patterns are widespread, how accurate will assessments of insect declines in the tropics be?
    MeSH terms: Animals; Borneo; Tropical Climate*; Biodiversity*; Forests
  17. Daud MRHM, Yaacob NA, Arifin WN, Sani JAM, Ibadullah WAHW
    Osong Public Health Res Perspect, 2024 Oct;15(5):429-439.
    PMID: 39164020 DOI: 10.24171/j.phrp.2024.0156
    BACKGROUND: Despite effective vaccination strategies, measles remains a global public health challenge. The study explored individual and contextual factors associated with measles infection in Malaysia from 2018 to 2022, informing the development of targeted public health interventions.

    METHODS: This cross-sectional study utilised data from the Ministry of Health, the Department of Statistics, and the Department of Environment Malaysia. Multilevel logistic regression analysis was employed to examine individual-level factors, including age, sex, ethnicity, nationality, contact history, travel history, and vaccination status. Concurrently, contextual factors were assessed, encompassing district-level determinants such as population density, median household income, urbanisation, the number of health and rural clinics, vaccination rates, fine particulate matter less than 2.5 μm (PM2.5) levels, relative humidity, and temperature, to determine their impact on measles infection risk.

    RESULTS: Measles infection was significantly associated with various individual factors. These included age (adjusted odds ratio [aOR], 1.02; 95% confidence interval [CI], 1.02-1.03), ethnicity, non-Malaysian nationality (aOR, 34.53; 95% CI, 8.42- 141.51), prior contact with a measles case (aOR, 2.36; 95% CI, 2.07-2.69), travel history (aOR, 2.30; 95% CI, 1.13-4.70), and vaccination status (aOR, 0.76; 95% CI, 0.72-0.79). Among contextual factors, urbanisation (aOR, 1.56; 95% CI, 1.16- 2.10) and the number of clinics (aOR, 0.98; 95% CI, 0.97-0.99) were significant determinants.

    CONCLUSION: This multilevel logistic regression analysis illuminates the complexities of measles transmission, advocating public health interventions tailored to individual and contextual vulnerabilities. The findings highlight the need for a synergistic approach that combines vaccination campaigns, healthcare accessibility improvements, and socioeconomic interventions to effectively combat measles.

  18. Tan SB, Chai CS, Ng DLC, Zainuddin SI, Capelle DP, Lam CL, et al.
    PMID: 39164043 DOI: 10.1136/spcare-2023-004762
    OBJECTIVES: Cancer pain is a prevalent and challenging symptom affecting a significant number of patients globally, with inadequate control remaining a substantial challenge despite advancements in pain management. Non-pharmacological interventions, including mindfulness-based approaches, have shown promise in alleviating cancer-related pain. This study aimed to explore the efficacy of a single session of 20-minute mindful breathing in reducing pain among patients with cancer.

    METHODS: A randomised controlled study was conducted at the University of Malaya Medical Centre, Malaysia, involving adult cancer inpatients with a pain score of ≥4/10. Participants were randomly assigned to a 20-minute mindful breathing intervention or a 20-minute supportive listening control group. Outcome measures included pain intensity, pain unpleasantness and Hospital Anxiety and Depression Scale score, assessed before and after the intervention.

    RESULTS: The 20-minute mindful breathing sessions demonstrated significant efficacy in reducing pain intensity, pain unpleasantness and anxiety compared with the control group.

    CONCLUSION: This research broadens the repertoire of cancer pain management by highlighting the rapid and holistic benefits of a single session of 20-minute mindful breathing. The findings suggest the potential integration of brief mindfulness exercises into routine cancer care to enhance pain management and overall well-being.

  19. Rashid NSA, Mohamad Marzuki MF, Abdullah NN, Mohamad M, Takshe AA, Mohd Yunus R, et al.
    Sci Rep, 2024 Aug 20;14(1):19302.
    PMID: 39164373 DOI: 10.1038/s41598-024-69947-7
    Dementia significantly impacts caregivers, particularly in low and middle-income countries where support is often inadequate. Given the gap in affordable and culturally relevant digital resources for Malaysian dementia caregivers, we developed "Demensia KITA," a mobile application (app) specifically tailored to their needs. This study utilized a theoretical framework proposed from existing literature and the "Model of Carer Stress and Burden". This paper discusses our app content development, highlighting key findings and challenges. To assess caregivers' needs, the Nominal Group Technique (NGT) with five dementia caregivers was conducted, followed by a Focus Group Discussion (FGD) with eight medical professionals. Both sessions were conducted online via Google Meet. In the NGT, ideas were generated, organized, prioritized, reviewed, and refined by medical professionals in the FGD. Content relevant to addressing the complexities of dementia caregiving was then discussed. Topics were either adapted from established modules or newly developed from credible sources. Subsequently, these were organized into modules and themes, and subsequently underwent expert validation. From the NGT, three key domains emerged: Knowledge, Services, and Support. These were further organized into two modules: 'Patient Care for Caregivers' and 'Caregiver Wellbeing'. Within these, twelve sub-modules were identified, covering a range of topics including basic knowledge on dementia, patient care, nutritional management, oral and dental care, simple exercises, daily activity and memory rehabilitation, service directories, support groups, emotional and stress management, welfare assistance, and daily motivation. This framework was developed to address the specific needs of dementia caregivers in terms of psychoeducation, psychosocial and caregiving skills, incorporating expert opinions in the field. This study corroborates the feasibility of online methods for mobile health app content development and encourages similar research. Future studies should evaluate Demensia KITA's effectiveness in alleviating caregiver burden across all regions, assess users' acceptance, and ensure it meets the evolving needs of Malaysian caregivers with regular updates.
    MeSH terms: Adult; Aged; Female; Humans; Malaysia; Male; Middle Aged; Social Support; Stress, Psychological; Focus Groups; Mobile Applications*
  20. Ramzi NH, Hoong ATC, Johari NA, Nathan AM, Teh CSJ, Sulaiman NA, et al.
    BMC Public Health, 2024 Aug 20;24(1):2255.
    PMID: 39164673 DOI: 10.1186/s12889-024-19789-9
    BACKGROUND: S. pneumoniae (SPN) is the most common cause of pneumonia. The disease can be effectively prevented through immunisation. Since December 2020, the Malaysian Government has included the 10-valent pneumococcal conjugate vaccine (PCV10) for all infants born on or after 1 January 2020 as part of the National Immunisation Programme (NIP). However, the epidemiology of pneumonia remains poorly understood. To fill the knowledge gap, we established a multicentre surveillance study to understand the burden of pneumococcal pneumonia among young children in Peninsular Malaysia.

    METHODS: MY-Pneumo is a multicentre prospective case-control study conducted in three sentinel sites located in three different states of Peninsular Malaysia - Kuala Lumpur, Pahang, and Kelantan. A cohort of at least 500 incident cases and 500 controls is enrolled beginning in October 2021 and matched for age. Cases are hospitalised children 

    MeSH terms: Clinical Studies as Topic*; Child, Preschool; Female; Humans; Infant; Malaysia/epidemiology; Male; Prospective Studies; Research Design*; Multicenter Studies as Topic*; Case-Control Studies; Pneumococcal Vaccines/administration & dosage
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