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Hypoactive sexual desire among depressed female patients treated with selective serotonin reuptake inhibitors: a comparison between escitalopram and fluoxetine

Sidi H, Asmidar D, Hod R, Jaafar NR, Guan NC

Int J Psychiatry Clin Pract, 2012 Mar;16(1):41-7.
PMID: 22122658 DOI: 10.3109/13651501.2011.617457

To determine the risk of hypoactive sexual desire (HSD) in depressed female patients treated with selective serotonin reuptake inhibitors, comparing escitalopram and fluoxetine. The associated factors were also examined.
Female sexual dysfunction in patients treated with antidepressant-comparison between escitalopram and fluoxetine

Sidi H, Asmidar D, Hod R, Guan NC

J Sex Med, 2012 May;9(5):1392-9.
PMID: 21477024 DOI: 10.1111/j.1743-6109.2011.02256.x

Selective serotonin reuptake inhibitor is one of the most widely used antidepressant and commonly associated with female sexual dysfunction (FSD).
Fulltext National HPV immunisation programme: knowledge and acceptance of mothers attending an obstetrics clinic at a teaching hospital, Kuala Lumpur

Ezat SW, Hod R, Mustafa J, Mohd Dali AZ, Sulaiman AS, Azman A

Asian Pac J Cancer Prev, 2013;14(5):2991-9.
PMID: 23803068

BACKGROUND: Introduction of the HPV vaccine is a forefront primary prevention method in reducing the incidence of carcinogenic human papillomavirus (HPV) and cervical cancer. The Malaysia government has implemented the National HPV immunisation programme since 2010, supplying HPV vaccine free to targeted 13 year olds. This study aimed to explore the level of knowledge among mothers on cervical cancer, HPV, HPV vaccine and National HPV (NHPV) immunisation programme since its' implementation. It also assessed acceptance of mothers towards HPV vaccine being administered to their daughter, son or themselves.
MATERIALS AND METHODS: A cross sectional study was conducted on 155 respondents using self-administered questionnaires; conducted in December 2012 at the Obstetrics and Gynaecology Clinic in a teaching hospital in Kuala Lumpur. Respondents were selected using a multistage sampling technique.
RESULTS: A response rate of 100% was obtained. Overall, 51.0% of mothers had good knowledge, with 55% having good knowledge of cervical cancer, 54.2% for both HPV and the National HPV immunisation programme and 51.0% for the HPV vaccine. Regression analyses showed that ethnicity was associated with knowledge on cervical cancer (p=0.003) while education was associated with knowledge on HPV (p=0.049). Three factors are associated with knowledge of the National HPV immunisation programme; ethnicity (p=0.017), mothers' education (p=0.0005) and number of children (p=0.020). The acceptance of HPV vaccine to be administered among daughter was the highest at 87.1%, followed by for mothers themselves at 73.5%, and the least is for sons 62.6%.
CONCLUSIONS: This study found that the overall level of knowledge was moderate. Adequate information on cervical cancer, HPV, HPV vaccination and the National HPV immunisation programme should be provided to mothers in order to increase acceptance of the HPV vaccine which can reduce the disease burden in the future.
Study site: O&G clinic, Pusat Perubatan Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
Coupled Plasma Filtration Adsorption (CPFA) plus Continuous Veno-Venous Haemofiltration (CVVH) versus CVVH alone as an adjunctive therapy in the treatment of sepsis

Hassan J, Cader RA, Kong NC, Mohd M, Rahman AR, Hod R

EXCLI J, 2013;12:681-92.
PMID: 26600735

To compare the efficacy of Coupled Plasma Filtration and Adsorption (CPFA) plus Continuous Veno-Venous Haemofiltration (CVVH) versus CVVH alone as an adjunct treatment of sepsis in terms of haemodynamic stability, inotropic requirement and inflammatory mediators.
Fulltext Ureteral stricture formation after ureteroscope treatment of impacted calculi: a prospective study

Fam XI, Singam P, Ho CC, Sridharan R, Hod R, Bahadzor B, et al.

Korean J Urol, 2015 Jan;56(1):63-7.
PMID: 25598938 DOI: 10.4111/kju.2015.56.1.63

Urinary calculi is a familiar disease. A well-known complication of endourological treatment for impacted ureteral stones is the formation of ureteral strictures, which has been reported to occur in 14.2% to 24% of cases.
A study on exposure to cyanide among a community living near a gold mine in Malaysia

Hassan NA, Sahani M, Hod R, Yahya NA

J Environ Health, 2015 1 27;77(6):42-8.
PMID: 25619035

Cyanidation in gold extraction has detrimental impacts on the ecosystem and the population in surrounding areas. The research described in this article aimed to assess the health effects of environmental exposure to cyanide in a community near a gold mining area in Malaysia. A total of 255 members of the exposed community and 117 members of the control community answered questionnaires on their exposure to a gold mine and health outcomes. Urine samples were collected for biomarker assessment (i.e., urinary thiocyanate). The authors found that the mean level of urinary thiocyanate was significantly higher among the exposed community (0.30 ± 0.26 mg/dL) than the control community (0.24 ± 0.23 mg/dL) (p = .0021). The exposed community had a significantly higher prevalence of headaches (prevalence odds ratio [pOR] = 2.6, p = .001), dizziness (pOR = 3.7, p < .001), skin irritation (pOR = 2.1, p = .040), and eye irritation (pOR = 5.1, p = .004). No association occurred between dietary exposure and urinary biomarkers. Smokers living near a gold mine had a higher urinary thiocyanate level (0.56 mg/dL) than smokers in the control community (0.49 mg/dL).
Fulltext Plasma isoflavones in Malaysian men according to vegetarianism and by age

Hod R, Kouidhi W, Ali Mohd M, Husain R

Asia Pac J Clin Nutr, 2016;25(1):89-96.
PMID: 26965767 DOI: 10.6133/apjcn.2016.25.1.02

Epidemiological studies indicate lower prevalences of breast and prostate cancers and cardiovascular disease in Southeast Asia where vegetarianism is popular and diets are traditionally high in phytoestrogens. This study assessed plasma isoflavones in vegetarian and non-vegetarian Malaysian men according to age. Daidzein, genistein, equol (a daidzein metabolite), formononetin, biochanin A, estrone, estradiol and testosterone were measured by validated liquid chromatography tandem mass spectrometry (LCMSMS). Plasma isoflavone and sex hormone concentrations were measured in 225 subjects according to age (18-34, 35-44 and 45-67 years old). In all age groups, vegetarians had a higher concentration of circulating isoflavones compared with non-vegetarians especially in the 45-67 year age group where all isoflavones except equol, were significantly higher in vegetarians compared with omnivores. By contrast, the 18-34 year group had a significantly higher concentration of daidzein in vegetarians and significantly higher testosterone and estrone concentrations compared with non-vegetarians. In this age group there were weak correlations between estrone, estradiol and testosterone with some of the isoflavones. This human study provides the first Malaysian data for the phytoestrogen status of vegetarian and nonvegetarian men.
Bullying and truancy: Predictors to sexual practices among school-going adolescents in Malaysia - a cross-sectional study

Azmawati MN, Dalila R, Idris IB, Hod R

Med J Malaysia, 2017 10;72(5):298-305.
PMID: 29197886

INTRODUCTION: Adolescents' involvement in sexual practices are becoming a major public health concern in Malaysia. This study aims to determine the prevalence of sexual practices among Malaysian school-going adolescents and its predictive factors.
METHODS: A cross-sectional study was carried out from April 2012 till September 2012 among 16-year-old school adolescents from two different schools. They were selected through simple random sampling and these adolescents answered a self-administered questionnaire consisting of three sections i.e. socio-demography, risk-taking behaviours and family-adolescents relationship. Data were analysed using Pearson Chi-Square test while Simple Logistic Regression and Multiple Logistic Regression were applied to determine the predictive factors.
RESULTS: The prevalence of sexual practices among the adolescents was 30.1% in which they were either involved in pornography (26.8%), pre-sexual activities (8.5%) or premarital sex (2.9%). Six predictive factors associated with sexual practices among this age group were identified which were male (adjusted Odds Ratio (aOR) 2.7, 95% Confidence Interval (95%CI) 1.4 to 2.5), truancy (aOR 2.3, 95%CI 1.3 to 4.2), bully (aOR 3.5, 95%CI 1.7 to 7.3), hanging out (aOR 2.8, 95% 1.4 to 5.6), staying out late (aOR 3.2, 95%CI 1.5 to 6.8) and conflict with family (aOR 4.1, 95%CI 1.9 to 8.9).
DISCUSSION: Asian background differs from the western countries and findings of this study may suggest suitable intervention programmes that can prevent high-risk sexual practices among Asian school-going adolescents.
Fulltext Mercury Hair Concentration among Primary School Children in Malaysia

Abdul Samad NI, Md Isa Z, Hod R

Children (Basel), 2017 Dec 14;4(12).
PMID: 29240681 DOI: 10.3390/children4120109

The main concern regarding mercury exposure is the adverse health effect on the developing nervous system. The objective of this cross-sectional study was to determine hair mercury levels and their association with socio-demographic characteristics, complaints about mercury poisoning symptoms and the fish consumption pattern among children in Malaysia. A cross-sectional study was conducted among 215 school children aged 11 years old. Hair was collected from the children and the total mercury was analyzed using oxygen combustion-gold amalgamation atomic absorption spectrophotometry. Anthropometric data, a fish consumption questionnaire and mercury poisoning symptoms were collected during a personal interview. The mean hair mercury level among primary school children was 0.63 ± 0.59 µg/g with the geometric mean of 0.47 µg/g. A total of 14% of respondents had hair mercury levels above 1 µg/g. A multiple binary logistic regression analysis outlined that fish consumption of at least one meal per week increased the likelihood of having a high mercury level (odds ratio (OR) 3.7, 95% confidence interval (CI) 1.3-10.4). This study confirms the existence of a mercury burden among Malaysian children and the level is high compared to other regional studies. This study provides important baseline data regarding the mercury level among children in Malaysia.
Fulltext Leptospirosis Outbreak After the 2014 Major Flooding Event in Kelantan, Malaysia: A Spatial-Temporal Analysis

Mohd Radi MF, Hashim JH, Jaafar MH, Hod R, Ahmad N, Mohammed Nawi A, et al.

Am J Trop Med Hyg, 2018 05;98(5):1281-1295.
PMID: 29532771 DOI: 10.4269/ajtmh.16-0922

Severe floods increase the risk of leptospirosis outbreaks in endemic areas. This study determines the spatial-temporal distribution of leptospirosis in relation to environmental factors after a major flooding event in Kelantan, Malaysia. We conducted an observational ecological study involving incident leptospirosis cases, from the 3 months before, during, and three months after flood, in reference to the severe 2014 Kelantan flooding event. Geographical information system was used to determine the spatial distribution while climatic factors that influenced the cases were also analyzed. A total of 1,229 leptospirosis cases were notified within the three study periods where incidence doubled in the postflood period. Twelve of 66 subdistricts recorded incidence rates of over 100 per 100,000 population in the postflood period, in comparison with only four subdistricts in the preflooding period. Average nearest neighborhood analysis indicated that the cases were more clustered in the postflood period as compared with the preflood period, with observed mean distance of 1,139 meters and 1,666 meters, respectively (both at P < 0.01). Global Moran's I was higher in the postflood period (0.19; P < 0.01) as compared with the preflood period (0.06; P < 0.01). Geographic weighted regression showed that living close to water bodies increased the risk of contracting the disease. Postflooding hotspots were concentrated in areas where garbage cleanup occurred and the incidence was significantly associated with temperature, humidity, rainfall, and river levels. Postflooding leptospirosis outbreak was associated with several factors. Understanding the spatial distribution and associated factors of leptospirosis can help improve future disease outbreak management after the floods.
Fulltext Effect of Air Pollution and Hospital Admission: A Systematic Review

Ab Manan N, Noor Aizuddin A, Hod R

Ann Glob Health, 2018 11 05;84(4):670-678.
PMID: 30779516 DOI: 10.29024/aogh.2376

IntroductionMany epidemiological studies have demonstrated associations between air pollution levels and human health in terms of hospital admissions. The aim of this paper is to gather evidence concerning air pollution effects on the risk of hospital admission. We hypothesised that increase in: particulate matter (PM), ozone (O3), carbon monoxide (CO), nitrogen dioxide (NO2), and sulphur dioxide (SO2) levels would be associated with the increasing trend of hospital admission.MethodsA systematic review of literature was carried out. Literature search was done in Sage, Ovid Medline, Science Direct, Wiley and ProQuest from 2010 to 2016 using keywords "hospital admission and air pollution". Studies of any relevant design were included if they presented original data, included at least one analysis where hospital admission was the specific outcome, and one or more of the following exposures were investigated: PM, O3, CO, NO2 and SO2.ResultsA total of 175 potential studies were identified by the search. Twenty two studies qualified for the review. Air pollution was noted to have an excessive risk of 3.46 (95%CI, 1.67, 5.27) of total hospital admissions. Cardiovascular admission was noted to have an increased risk of hospitalization for PM2.5 of 1.5 to 2.0; PM10 (1.007 to 2.7); NO2 (1.04 to 1.17) and SO2 (1.007). For respiratory admission, PM2.5 can caused an increased risk of hospitalization by 1.1 to 1.8; PM10 (1.007 to 1.13); NO2 (1.08 to 1.94) and SO2 (1.02). While O3 have minimal effect on COPD and stroke, CO does not influence in the effect of these hospitalization.ConclusionThe exposure to air pollutants confers an increased risk of admission of several disease. Our findings call for greater awareness of environmental protection and the implementation of effective measures to improve the quality of air, which may reduce the risks of adverse effects on the population's health.
Risk of concentrations of major air pollutants on the prevalence of cardiovascular and respiratory diseases in urbanized area of Kuala Lumpur, Malaysia

Tajudin MABA, Khan MF, Mahiyuddin WRW, Hod R, Latif MT, Hamid AH, et al.

Ecotoxicol Environ Saf, 2019 Apr 30;171:290-300.
PMID: 30612017 DOI: 10.1016/j.ecoenv.2018.12.057

Rapid urbanisation in Malaysian cities poses risks to the health of residents. This study aims to estimate the relative risk (RR) of major air pollutants on cardiovascular and respiratory hospitalisations in Kuala Lumpur. Daily hospitalisations due to cardiovascular and respiratory diseases from 2010 to 2014 were obtained from the Hospital Canselor Tuanku Muhriz (HCTM). The trace gases, PM10 and weather variables were obtained from the Department of Environment (DOE) Malaysia in consistent with the hospitalisation data. The RR was estimated using a Generalised Additive Model (GAM) based on Poisson regression. A "lag" concept was used where the analysis was segregated into risks of immediate exposure (lag 0) until exposure after 5 days (lag 5). The results showed that the gases could pose significant risks towards cardiovascular and respiratory hospitalisations. However, the RR value of PM10 was not significant in this study. Immediate effects on cardiovascular hospitalisations were observed for NO2 and O3 but no immediate effect was found on respiratory hospitalisations. Delayed effects on cardiovascular and respiratory hospitalisations were found with SO2 and NO2. The highest RR value was observed at lag 4 for respiratory admissions with SO2 (RR = 1.123, 95% CI = 1.045-1.207), followed by NO2 at lag 5 for cardiovascular admissions (RR = 1.025, 95% CI = 1.005-1.046). For the multi-pollutant model, NO2 at lag 5 showed the highest risks towards cardiovascular hospitalisations after controlling for O3 8 h mean lag 1 (RR = 1.026, 95% CI = 1.006-1.047), while SO2 at lag 4 showed highest risks towards respiratory hospitalisations after controlling for NO2 lag 3 (RR = 1.132, 95% CI = 1.053-1.216). This study indicated that exposure to trace gases in Kuala Lumpur could lead to both immediate and delayed effects on cardiovascular and respiratory hospitalisations.
Fulltext Estimating glomerular filtration rate in adult kidney transplant recipients in the Asian population

Kamaruzaman L, Mohd R, Zaki FM, Hod R, Aziz AA

Saudi J Kidney Dis Transpl, 2019 6 30;30(3):587-596.
PMID: 31249222 DOI: 10.4103/1319-2442.261331

Estimation of glomerular filtration rate (GFR) in renal transplant patients is often assessed by application of creatinine-based equations. The aim was to correlate the estimated GFR (eGFR) using creatinine-based equations [Cockroft-Gault, Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), Nankivell] with gold standard 51Cr-EDTA in kidney transplant patients in the Asian population. This is a single-center, cross-sectional study involving adult renal transplant patients. Background demographic data, medications, office blood pressure, and baseline investigations were taken. Correlations between measured GFR and eGFR were analyzed and Pearson's correlation coefficients, bias, and accuracy were assessed. Thirty-seven renal transplant patients with a mean age of 46 ± 13 years were recruited. Majority were Chinese (68%), Malay (24%), and Indian (8%). The median duration of the transplant was 84 (interquartile range 60,132) months. The mean measured GFR was 71 ± 21 mL/min/1.73 m2. Cockroft-Gault and CKD-EPI has the best correlation with 51Cr-EDTA with Pearson correlation coefficients of 0.733 (P <0.001) and 0.711 (P < 0.001), respectively. All formulae showed >80% accuracy with eGFR lies between 30% of the measured value. CKD-EPI and MDRD had the greatest accuracy with 89.2% each. Clinician may use any of these three serum creatinine-based equations to estimate GFR in kidney transplant recipients.
Time-kill and post-antibiotic effect of colistin at different static concentrations in in vitro Acinetobacter baumannii

Rasidin RSM, Suhaili Z, Mohamed AFS, Hod R, Neela V, Amin-Nordin S

Trop Biomed, 2020 Jun 01;37(2):471-481.
PMID: 33612816

Nosocomial infection caused by Acinetobacter baumannii is common among immunocompromised patients. Treatment strategy is limited due to rapid resistance development and lack of novel antibiotic. Colistin has been the last line therapy with good in vitro activity against infections caused by multi-drug resistance A. baumannii. However, pharmacological updates are required to support dosing optimisation. This study aimed to determine the time-kill kinetic and resistance development after antibiotic exposure as well as post-antibiotic effect of colistin at different static concentrations in in vitro A. baumannii system. The static in vitro time-kill and post-antibiotic effect experiments were conducted against two clinical isolates as well as one reference isolate ATCC 19606. Time-kill and postantibiotic effect were studied at colistin concentrations ranging from 0.25MIC to 16.0MIC and 0.5MIC to 4.0MIC, respectively. Post-exposure resistance development was examined in time-kill study. Killing activity and post-antibiotic effect were in a concentration-dependent manner. However, delayed killing activity indicates colistin tolerance. Development of resistance after exposure was not detected except for the ATCC 19606 strain. Dosing suggestion based on the observations include administration of supplemental dose 3 MIU at 12 hours after loading dose, administration of maintenance dose 9 MIU in two divided doses and application of extended interval in renal adjustment dose. However, the information is applicable for non-colistin-heteroresistance A. baumannii with colistin MIC < 1.0 mg/L. As for heteroresistance and strain with colistin MIC > 1.0 mg/L, combination therapy would be the more appropriate treatment strategy.
Fulltext COVID-19 among Health Workers in Germany and Malaysia

Nienhaus A, Hod R

Int J Environ Res Public Health, 2020 Jul 07;17(13).
PMID: 32645826 DOI: 10.3390/ijerph17134881

We report on the suspected case reports filed for SARS-CoV-2 infections and COVID-19 illnesses among health and social welfare workers in Germany. In addition, we report about COVID-19 in health workers in Malaysia. Claims for occupational diseases caused by SARS-CoV-2 are recorded separately in a database of the Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW). This database is analyzed according to its content as of May 22, 2020. In addition, the notifiable cases of SARS-CoV-2 infections from personnel in medical institutions (e.g., clinics and doctor's office) and social welfare institutions (e.g., nursing homes, shelters and refugee camps) following the German Infection Protection Act are analyzed. The report from Malaysia is based on personal experience and publications of the government. In Germany at present, 4398 suspected case reports for the diagnosis of SARS-CoV-2 infections among health and social workers have been filed. This figure is four times the number of all reported infections normally received per year. The majority of claims, regardless of being a confirmed infection, concerned nurses (n = 6927, 63.9%). The mortality rate for workers infected with SARS-CoV-2 is 0.2% to 0.5%. Doctors are affected by severe illness more frequently than other occupational groups (8.1% vs. 4.1%). In Malaysia, work-related infection of health workers (HW) occurred mainly when COVID-19 was not suspected in patients and no adequate personal protective equipment (PPE) was worn. Although knowledge on the spread of SARS-CoV-2 infections among workers remains limited, the impact appears to be substantial. This is supported by the mortality rate among infected workers. Occupational health check-ups carried out at the present time should be systematically analyzed in order to gain more information on the epidemiology of COVID-19 among HW. Since the supply and use of PPE improved, the infection risk of HW in Malaysia seems to have decreased.
Fulltext Prevalence and Factors Influencing Visual Memory Dysfunction among Epilepsy Patients-A Single-Center Study

Beh HC, Tan HJ, Hod R, Khoo CS, Mohamad K

Neurol India, 2020 7 10;68(3):581-585.
PMID: 32643667 DOI: 10.4103/0028-3886.289011

Background: Epilepsy is associated with cognitive impairment due to the disease itself or side-effects of antiepileptic drugs.
Objective: We aimed to study the prevalence of visual memory dysfunction among epilepsy patients and identify the predictors that could contribute to the impairment.
Materials and Methods: This was a cross-sectional study. We analyzed 250 patients with epilepsy from neurology clinic at our tertiary center. Assessment of visual memory was done using Wechsler Memory Scale-IV (WMS-IV) with scores from subsets of visual reproduction I, II and designs I, II contributing to visual memory index (VMI) score. The correlation between continuous variables was analyzed using Pearson correlation; whereas the VMI scores of different factors were analyzed via a 1-way ANOVA test. The statistical significance was set at P < 0.05.
Results: The prevalence of visual memory dysfunction in our epilepsy population was 37.2%. Analysis of individual predictors showed that older patients, lower educational level, combined generalized and focal types of epilepsy, longer duration of epilepsy, greater number of antiepileptic drugs (AEDs) used, and abnormal neuroimaging contributed to poor visual memory. Multiple logistic regression analysis showed that educational level, types of epilepsy, and the number of AEDs used were significant predictors for visual memory impairment.
Conclusion: Visual memory dysfunction in patients with epilepsy was due to manifold confounding factors. Our findings enabled us to identify patients with visual memory dysfunction and modifiable factors that contribute to it. WMS-IV is a suitable assessment tool to determine visual memory function, which can help clinicians to optimize the patients' treatment.
Fulltext Effects of temperature, humidity, air quality and anthropic activities on the transmission of SARS-CoV-2: a systematic review protocol

Jeevananthan C, Muhamad NA, Jaafar MH, Hod R, Ab Ghani RM, Md Isa Z, et al.

BMJ Open, 2020 11 04;10(11):e039623.
PMID: 33148753 DOI: 10.1136/bmjopen-2020-039623

INTRODUCTION: The current global pandemic of the virus that emerged from Hubei province in China has caused coronavirus disease in 2019 (COVID-19), which has affected a total number of 900 036 people globally, involving 206 countries and resulted in a cumulative of 45 693 deaths worldwide as of 3 April 2020. The mode of transmission is identified through airdrops from patients' body fluids such as during sneezing, coughing and talking. However, the relative importance of environmental effects in the transmission of the virus has not been vastly studied. In addition, the role of temperature and humidity in air-borne transmission of infection is presently still unclear. This study aims to identify the effect of temperature, humidity and air quality in the transmission of SARS-CoV-2.
METHODS AND ANALYSIS: We will systematically conduct a comprehensive literature search using various databases including PubMed, EMBASE, Scopus, CENTRAL and Google Scholar to identify potential studies. The search will be performed for any eligible articles from the earliest published articles up to latest available studies in 2020. We will include all the observational studies such as cohort case-control and cross-sectional studies that explains or measures the effects of temperature and/or humidity and/or air quality and/or anthropic activities that is associated with SARS-CoV-2. Study selection and reporting will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and Meta-Analysis of Observational Studies in Epidemiology guideline. All data will be extracted using a standardised data extraction form and quality of the studies will be assessed using the Newcastle-Ottawa Scale guideline. Descriptive and meta-analysis will be performed using a random effect model in Review Manager File.
ETHICS AND DISSEMINATION: No primary data will be collected, and thus no formal ethical approval is required. The results will be disseminated through a peer-reviewed publication and conference presentation.
PROSPERO REGISTRATION NUMBER: CRD42020176756.
Fulltext Anatomy Education Environment Measurement Inventory (AEEMI): a cross-validation study in Malaysian medical schools

Hadie SNH, Yusoff MSB, Arifin WN, Kasim F, Ismail ZIM, Asari MA, et al.

BMC Med Educ, 2021 Jan 14;21(1):50.
PMID: 33446203 DOI: 10.1186/s12909-020-02467-w

BACKGROUND: The Anatomy Education Environment Measurement Inventory (AEEMI) evaluates the perception of medical students of educational climates with regard to teaching and learning anatomy. The study aimed to cross-validate the AEEMI, which was previously studied in a public medical school, and proposed a valid universal model of AEEMI across public and private medical schools in Malaysia.
METHODS: The initial 11-factor and 132-item AEEMI was distributed to 1930 pre-clinical and clinical year medical students from 11 medical schools in Malaysia. The study examined the construct validity of the AEEMI using exploratory and confirmatory factor analyses.
RESULTS: The best-fit model of AEEMI was achieved using 5 factors and 26 items (χ 2 = 3300.71 (df = 1680), P
Fulltext A Systematic Review of the Effects of Equol (Soy Metabolite) on Breast Cancer

Hod R, Maniam S, Mohd Nor NH

Molecules, 2021 Feb 19;26(4).
PMID: 33669783 DOI: 10.3390/molecules26041105

Equol is a soy isoflavone metabolite that can be produced by intestinal bacteria. It is lipophilic and resembles natural oestrogens with an affinity to oestrogen receptors. This review is focused on how equol affects breast cancer, as evidenced by in vivo and in vitro studies. Equol is considered chemoprotective in specific endocrine-related pathologies, such as breast cancer, prostate cancer, cardiovascular diseases, and menopausal symptoms. In humans, not everyone can produce equol from gut metabolism. It is postulated that equol producers benefit more than non-equol producers for all the endocrine-related effects. Equol exists in two enantiomers of R-equol and S-equol. Earlier studies, however, did not specify which enantiomer was being used. This review considers equol's type and concentration variations, pathways affected, and its outcome in in vivo and in vitro studies.
Fulltext The Impacts of Illegal Toxic Waste Dumping on Children's Health: A Review and Case Study from Pasir Gudang, Malaysia

Ibrahim MF, Hod R, Toha HR, Mohammed Nawi A, Idris IB, Mohd Yusoff H, et al.

Int J Environ Res Public Health, 2021 02 24;18(5).
PMID: 33668186 DOI: 10.3390/ijerph18052221

Poor management of hazardous waste can lead to environmental pollution, injuries, and adverse health risks. Children's exposure to hazardous waste may cause serious acute and chronic health problems due to their higher vulnerability to the toxic effects of chemicals. This study examines an incident of illegal chemical dumping in Pasir Gudang, Malaysia and its potential health impacts on children. The study introduced a risk assessment of possible health-related effects due to chemical contamination based on a real case scenario where quantification of the contamination was not feasible. A literature review and spatial analysis were used as research methods. On 6th March 2019, tons of hazardous waste were illegally disposed into Kim Kim River, Pasir Gudang, Malaysia. They were identified as benzene, acrolein, acrylonitrile, hydrogen chloride, methane, toluene, xylene, ethylbenzene, and d-limonene. As a result, 975 students in the vicinity developed signs and symptoms of respiratory disease due to the chemical poisoning. The findings of this study indicate that more effective policies and preventive actions are urgently needed to protect human health, especially children from improper hazardous waste management.

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