Introduction:Acyclovir, a widely marketed antiviral drug is used for the treatment of Herpes Simplex infection. High doses of acyclovir are prescribed to patients to attain its maximum therapeutic effect due to its poor absorption and low oral bioavailability. The current therapeutics regiment of acyclovir are known to cause unwarranted adverse effects, thus prompted the need for a suitable drug carrier to improve the pharmacokinetic limitations. Develop-ment of solid lipid nanoparticles for oral delivery of acyclovir proposed in this study aimed to enhance acyclovir oral bioavailability. Methods: Comprehensive experiments and a series of optimization process were carried out to ensure reproducibility and assurance of product quality. The physicochemical characteristics of the solid lipid nanoparticles developed from plant-based solid lipid, Biogapress Vegetal 297 ATO with polysorbate 80 as an emul-sifying agent were also evaluated. Results: The spherical-shaped nanoparticles had an average size of 123 nm with good drug entrapment efficiency, up to 80%. The in vitro drug release study showed that solid lipid nanoparticles had prolonged acyclovir release in simulated intestinal fluid for 24 hours. The nanoparticles formulation was con-sidered stable during storage at refrigerated temperature for at least three months. In vivo oral bioavailability study showed that acyclovir-loaded solid lipid nanoparticles possessed superior oral bioavailability when compared with the commercial acyclovir suspension. Conclusion: In conclusion, this study exhibited the feasibility of solid lipid nanoparticles as an oral delivery vehicle for acyclovir and therefore represent a new promising therapeutic concept of nanoparticulate delivery system.
Introduction: This study examined the antioxidant activity and phenolic, flavonoid and saponin contents from mul-tiple solvent extracts of Albizia myriophylla (ABZ) bark. Antioxidant activity of the methanol extract and its derived fractions namely hexane, chloroform, ethyl acetate, butanol and a residual aqueous fraction of the bark of ABZ was assessed. Methods: All the extracts showed a significant presence of phenolic, flavonoids and saponins. In DPPH (1, 1-diphenyl-2-picrylhidrazyl) radical scavenging test, ABTS (2-2’-azinobis 3-ethyl-6-sulfonic acid) radical scavenging test and reducing activity on ferrous iron (FRAP) test, the total antioxidant capacity was found to be varied in different fractions. Results: The IC50 calculated value of the three assays showed that the methanolic extract of ABZ bark had the lowest IC50 value for each assay, compared to the other extracts signifying highest anti-oxidant activity. Methan-olic extract of ABZ was tested in high-fat diet induced mice, which showed reduce adipocyte cellularity and reduces the cholesterol, triglyceride, LDL level while increasing the HDL level. Conclusion: The antioxidant capacity with probable free radical scavenging activity of the methanolic extract of ABZ may be useful for the treatment of chronic inflammatory-related metabolic diseases such as obesity.
Introduction:Transfusion Transmitted Infections is occurring worldwide. The common organisms related reported in literature were Human Immunodefiency Virus, Hepatitis B and C Virus, bacterial contamination and Malaria par-asites. Meanwhile, Melioidosis is endemic disease in Malaysia and especially Sabah. Mortality due to Melioidosis septicaemia was also high. It ranges between 60%-80%. In Sabah, 74% of Thalassemia children were diagnosed with Bacteraemia Melioidosis and 50% had died due to the organisms. The incidence of Melioidosis Transfusion Transmitted Infection is rarely reported in the literature. Case Description: A 17-year-old girl was diagnosed having Beta thalassemia major since 5 years old and splenectomised 8 years ago. Currently on prophylaxis Penicillin and Ex-jade. She was admitted into hospital for monthly blood transfusion. Two days prior to admission, patient complained of having sore throat and cough but no fever and other complained. On examination, the tonsil enlarged and was treated as exudative tonsillitis. She was transfused with 2 pint packed cells within 2 days. No transfusion reaction noted. Day seven admission, she had high grade fever and redness of the right hand cannulation site and was treated as right hand cellulitis with intravenous Cloxacillin. Full blood count shows Total White Cell count was 24.9 x109 /L, Haemoglobin level was 9.3 g/dl and Platelets was 462x109/L. Blood for culture and sensitivity was taken and Chest X-ray noted haziness over the left mid and lower zone of the lung and was treated as Hospital Acquired Pneumonia. She was referred to tertiary hospital for further management. Her conditioned deteriorated and died at the casualty unit in the tertiary hospital. Blood culture was positive for Burkholderia pseudomallei. The case was reported to Dis-trict health office for further investigation. Blood donor tracing was done and was positive for Melioidosis through Elisa Antibody titre IgM for Melioidosis (1:320). The patient’s house and school were visited and investigated. All environmental samples were negative for Burkholderia pseudomallei. Conclusion: Its shows a relationship between blood donations infected with Burkholderia pseudomallei causing mortality of Beta Thalassemia patients. It is highly recommended to screen all blood products for communicable disease fatal organisms.
Introduction: Hypertension is a condition where there is persistently raised pressure in the blood vessels. In Malay-sia, higher prevalence of hypertension could be explained by lifestyle factors such as higher rates of obesity, excess dietary intake of sodium and fat and lack of physical activity. The main objective of this study was to determine the prevalence, risk factors and co-morbidities of hypertension in villagers aged 18 years and above in Kampung Tajau Laut, Kudat, Sabah. Methods: Non-probability convenience sampling method was used to select a total of 210 villagers for interview, anthropometric examinations and blood pressure measurements. House to house and face to face interview by trained year four medical students done using a pretested validated questionnaire. The ques-tionnaire contained data on socioeconomic status, tobacco use, physical activity, diet, extra-salt use, family history of hypertension, co-morbidity, anthropometric measurements and blood pressure. Results: Respondents noted to be hypertensive were 67.6%, and out of this, 61.3% were undiagnosed. There was a significant association between hypertension and family history (Chi-squared test=38.280, p=0.000), hypertension and smoking status (Chi-squared test=7.673, p= 0.006), hypertension and obesity (Chi-squared test= 8.731, p=0.003), hypertension and gender (Chi-squared test=5.126, p=0.024), hypertension and age (Chi-squared test=26.110, p=0.000) of respondents. There was no significant association between hypertension with vegetable intake, fruit intake, physical activity, marital status, ethnicity, economic status, level of education, and occupational status of respondents. Half of the known hyperten-sive respondents have comorbidities with most commonly being dyslipidaemia and diabetes mellitus. Conclusion: Hypertension was found to have a significant association with family history, smoking status, obesity, age and gender among the studied population.
Sexual orientation other than heterosexuality is believed to be unnatural, sinful and dangerous in a country like Malaysia that is steadfast in religion and culture. Children sexual orientation has subsequently been a sensitive, challenging, and frightening topic for parents. Past studies have documented the role of nature and nurture in the development of social orientation. Although preliminary studies have found genetic to be a significant factor, it was inconclusive if it was the only factor in determining sexual orientation. Hence, this paper will highlight the role of parents in nurturing sexual orientation of children. Despite lack of studies in local and Western context, the few stud-ies available indicated that a secure attachment bond between parent and child is essential for healthy psychosexual and identity development. Additionally, this paper highlights the importance of communication, unconditional love and support between parent and child throughout the developmental stages leading to adulthood. Furthermore, this paper will briefly discuss possible treatment options for children with sexual orientation issues and its impact on chil-dren psychological health and well-being. This paper will conclude with suggestions on future research to further understand the development of sexual orientation in children.
Many a times, community targeted strategy works in silo and done haphazardly without any long-term planning and impact to the community. This wayward fashion has cost us millions of dollars, lost resources and dimmed motiva-tion. Most of the time, incoherent planning and short-term targets are the motivators. Getting plans into policy is not a task to be taken lightly. Policies that are incoherent, disintegrated with organisational and national plans, will not be taken up as policy papers. Overcoming resistance is another method to ensure smoothness of policy acceptance. This involves enlisting communication with multiple stakeholders and hearing out qualms by community members. Community based insurance is an example. The initial social insurance has been in the agenda for multiple years already. In the past 3 years, this agenda has been sped up by political masterminds and NGOs. The Peka B40 and MySalam have been introduced in the Malaysian healthcare system. It is hoped that these two social health insurance will provide the much needed relief for community in the lower categories.
The Family Health Programme in Malaysia started off with a humble beginning in the 1920s by the introduction of midwifery legislation under the Straits Settlement Ordinance and the Federal Malay states Midwifery Enactment. Institutionalisation of nursing training took placed in the 1940s while the rural health services for pregnant women and children were established in the 1950’s. In 1967, the school health program was initiated, followed by the de-livery of the school health services in 1972. The Ministry of Health (MoH) set up a Maternal and Child Health unit within the MoH organisation in 1974 to oversee the maternal, child and school health activities. In 1996, the Family Health Development Division was established with the prenatal, adolescent, adult, people with disability and nu-trition health services were incorporated into the family health activities. Subsequently, the age-group wellness and population genetic screening were introduced in year 2000. The family health programme has embraced the public health approach as its building blocks. Throughout the years, individual patient care has advanced the most through the improvement of standards and quality of services within the health clinics. Plateauing of maternal mortality ratio and under-5 mortality rate, increasing trend of non-communicable diseases, remerging of communicable diseases, urbanisation and globalization, and increasing ageing population are new challenges in the delivery of family health services to the community. In order to cater for these challenges, it is crucial to recognise the population health as one of the main component in the family health programmes. Transformation in the scope of new family and popu-lation health is needed to improve the delivery of family programme beyond the boundary of MoH facilities.
Introduction: Detailed information of structural and functional anatomy of thenar muscle is very significant in order to improve diagnostic and various conditions of hand surgeries so that the function of hand movement can be re-stored and to prevent further iatrogenic injuries. Methods: In this study, fifty hands were dissected to determine the variation in each of the thenar muscle. Results: Only the abductor pollicis brevis showed significant findings. Normal formation of one belly in abductor pollicis brevis represented 72.0% (18) and 84.0% (21) for the left and right hands, respectively. Variations according to the number of belly of the abductor pollicis brevis were also observed. One of the variations is the absence of the abductor pollicis brevis, 4.0% (1) in the right hand. Two belly formations of abductor pollicis brevis were observed, 28.0% (7) and 12.0% (3) for left and right sides of hand respectively. Thus, more variations were observed to occur on the left hand (7) compared to the right hand (4). Many studies describe about the variations of each thenar muscle, but few literatures were found discussing on the association of thenar muscle variation with the sides of hand. Using the Fisher Exact Test, it showed that there was no significant associa-tion of variations in the thenar muscle in relation to the sides of hand. Conclusion: This study conclude that there is no consistency between variations of the thenar muscle in relation to the sides of hand. However, clinical awareness of these variations is important in the context of compartment syndrome, use of the aberrant structures as grafting material in reconstructive surgery and proper interpretation of imaging modalities.
The keynote addresses the topic of “Health as a domain of family well-being” to provide an overarching perspective to the conference’s theme, “Health intervention towards community wellness”. “Well-being” is taken as the big-ger focus of living a healthy life, and “health” as one of several domains towards achieving well-being. The WHO definition (1948) links health explicitly to well-being. Well-being can be viewed from 2 perspectives (i) Objective well-being (basic human needs, e.g. food, shelter, health). (ii) Subjective well-being, (self-perception of well-being, e.g. satisfaction with life). The National Population and Family Development Board (LPPKN), Malaysia, conducts surveys to measure the Family Well-being Index. In this index, family well-being has eight domains: health, family relationships, economy, family and community, safety, housing and environment, religion/spirituality, and use of communication technology. The health domain measures health level, health practice and stress management. Two surveys have been conducted, i.e. in 2011 and 2016, and the third one is currently ongoing. The Family Well-being Index is a figure between 0 and 10. In 2011, the national Family Well-being Index was 7.55, and in 2016 it was 7.33. Both scores were in the range of moderate level.
Introduction: Childhood malnutrition is common and severe among indigenous community. The Community Feed-ing Program was first launched in 2010 among 15 villages in Kemar indigenous settlement among children below six years old. The objective of this study was to improve the nutrition status of indigenous children in Kemar settlement, Hulu Perak. Methods: All the indigenous children aged below six received high calorie food, full cream milk and multivitamin with an average of 500kcal/day. Ready to Use Therapeutic Food (RUTF), specified for malnourished children, provides nutrition that accounts for one-half to two-thirds of a child’s daily needs. The feeding sessions was carried out once a day, five days a week and managed by a group of trained local volunteers and research assistants. Weight and height were measured monthly. Results: The coverage throughout 2013 to 2018, ranged from 90.3% to 100%. The percentage of children with normal body weight had increased from only 38.7 % in 2010 to 60.6% in 2018. From year 2013 to 2018, the percentage of stunted children had reduced from 77% to 72.5%, and severe stunting reduced from 35.2% in 2015 to 24.9% in 2018. Conclusion: The continuity of this program is essential to sustain normal nutritional status and hence the wellbeing of this group of children in the interior remote community.
Introduction: According to PDRM statistic, in average, 100 babies are dumped every year, in Malaysia. The stig-ma of having babies out of wedlock, feeling of desperation and lack of support are some reasons why babies were dumped at the unimaginable places. Even if they were found and saved, these babies will be placed and raised at institutions. This will lead to the negative effects of institutionalisation as they do not receive appropriate adult care and attention which is crucial in developing their potential. OrphanCare Foundation advocates and provides services that ensure babies and children who are in institutions and those whose lives are at risk grow up in the care of a loving family. Methods: OrpahnCare Foundation provides a safe haven for babies that are being abandoned through baby hatch centres, finding a family for these babies through a legal adoption programme, and deinstitutionalisation (DI) i.e. removing all children currently in institutions, to family based care. Results: Since 2010, OrphanCare Foun-dation has saved a total of 369 babies and successfully arranged for the adoption of 221 babies. Forty even children were taken out from institutions and brought home to their families. Conclusion: The best place for a child to grow up is in the love and care of a family. They will receive personalised guidance, support and love that they need to develop to their full potential.
Introduction:A unilateral enlarged tonsil always is a suspicion of carcinoma. Especially if it is with fungating ulcer-ative surface. Neoplasms in unilaterally enlarged tonsil include squamous cell carcinomas and lymphomas. Lym-phomas in oropharynx are not common specially with fungating surface. Usually lymphomas in these areas are Non-Hodgkin’s type. Case description: A 62-year-old woman was admitted in the tertiary level hospital of Kota Kinabalu, Sabah, with the complaint of sore throat, odynophagia and right neck swelling. She was treated as a case of acute tonsillitis by general practitioner without any noticeable improvement. Oral cavity examination revealed a hugely enlarged right tonsil with fungating ulcerative surface and almost obstructing the oropharynx. Trismus was seen which make the examination difficult. A non-tender right upper neck swelling was palpable. All baseline lab-oratory investigations were normal. A contrast-enhanced computed tomography (CECT) showed a heterogeneously enhancing mass at oropharynx compromising the airway, right supraclavicular lymphadenopathy. Histology of biop-sy from right tonsillar mass showed High grade B-cell lymphoma. Chemotherapy was planned. First cycle of chemo-therapy was administered, Patient was discharged home with the complete plan of chemotherapy. Conclusion: This patient was clinically suspicious of carcinoma of palatine tonsil. But later proven as high grade B-cell lymphoma. All unilateral enlarged tonsils are not always carcinoma.
Introduction: Tuberculosis (TB) of the elbow joint is uncommon. Prompt diagnosis and treatment are important to prevent joint destruction and preserve function. We present a case of TB synovitis of the elbow joint in a patient with active rheumatoid arthritis (RA). Case description: A 56-year-old woman with a known seropositive RA on metho-trexate and Leflunomide was seen in the outpatient rheumatology clinic as part of her monthly follow-up. She com-plained of persistent bilateral elbow pain and swelling, despite optimisation of her disease-modifying antirheumatic drugs (DMARD) and steroid therapy. The suspicion for another diagnosis for her elbow symptoms stems from the persistent pain and swelling amidst increased titration of methotrexate and prednisolone dosages. Ultrasound scan of her elbows revealed bilateral complex olecranon bursitis with active synovitis. The left elbow aspiration yielded cloudy yellowish synovial fluid and the sample was sent for fluid culture, acid-fast bacilli (AFB) stain, and GeneXpert. No AFB was seen but the GeneXpert test confirmed the presence of Mycobacterium Tuberculosis. Thus, a diagnosis of TB synovitis of the left elbow was made, and she was promptly started on anti-tubercular therapy (ATT) consisting of Rifampicin, Isoniazid, Ethambutol and Pyrazinamide with the aim to complete 9 months of ATT. Conclusion: The diagnosis of tuberculous synovitis is challenging. In the absence of constitutional or respiratory symptoms, joint TB is usually low on the initial differential diagnosis in patients presenting with joint pain and swelling. The diagnosis is made even more difficult in patients with concomitant rheumatoid arthritis. This case demonstrates the importance of a high index of suspicion for TB, particularly when evaluating patients in high TB prevalence area with an underlying immunosuppressive state.
Introduction:Light’s criteria for pleural fluid analysis has long been the standard for distinguishing transudates from exudates. In pleural tuberculosis, the resulting pleural fluids are usually exudates. We present a case of presumed transudative effusion which was eventually diagnosed as pleural tuberculosis. Case description: A 59-year-old man with end-stage renal failure (ESRF) on regular haemodialysis presented with a one-day history of acute onset dys-pnoea associated with pleuritic chest pain and cough. Chest radiograph revealed bilateral pleural effusions and thoracentesis was done. The pleural fluid result was interpreted as transudative effusion according to Light’s criteria because his pleural fluid to serum protein ratio was less than 0.5. AFB 1+ was seen in the pleural fluid with negative gram stain and culture. This resulted in conflicting opinions on whether to start this patient on anti-tuberculous ther-apy (ATT) and there was even a suggestion to get a second opinion for the possibility of AFB fluid contamination. The initial diagnosis was written as fluid overload secondary to ESRF but ATT was started anyway to cover for pleural TB. On further analysis of his pleural fluid, the pleural protein 32 g/L which on its own is a marker of exudative effusion. Subsequent investigations revealed the presence of exudative ascitic fluid which further raised the suspicion for a concomitant peritoneal TB. Conclusion: Premature conclusion that the pleural fluid was transudative occurred prob-ably due to the bilateral nature of the pleural effusion associated with a known tendency for the patient to develop pulmonary overload secondary to his ESRF. This case is a reminder that Light’s criteria also requires serum and fluid LDH measurement for the diagnosis of transudative pleural effusion. More importantly, a high level of suspicion for TB is important when evaluating patients from areas where TB is prevalent and a positive AFB result should not be taken lightly.
Introduction: Nicotine addiction is one of the major issue in public health especially in Malaysia. Nicotine addiction also make a quitting smoking process difficult for most smokers and could cause relapse and failure. This study inves-tigated relationship between nicotine addiction and psychosocial factors such as anxiety, depression and social sup-port among smokers registered in quit smoking clinic services in the hospital around Klang Valley, Malaysia. Meth-ods: A cross-sectional study has been conducted among 115 smokers. Results: Results showed that 23.5% smokers had high nicotine addiction, 24.3% had moderate nicotine addiction, and the rest had low nicotine addiction. There is a positive significant relationship between nicotine addiction with age and smoking duration (r=0.34, p< 0.01 and r=0.41, p< 0.01, respectively). There is also a positive significant relationship between nicotine addiction with anxi-ety and depression (r=0.33, p< 0.01 and r=0.38, p< 0.01, respectively). In addition, there is a negative significant re-lationship between nicotine addiction with social support overall and social support from significant others (r= -0.22, p< 0.05 and r= -0.19, p< 0.05, respectively). The study shows that psychosocial factors such as anxiety, depression, social support and socio-demographic factors such as age and smoking duration were potentially affecting smoker ́s nicotine addiction. Conclusions: Besides pharmacological treatment, this study proves the importance of psycho-social factors involvement in helping client with nicotine addiction issues. Therefore, psycho-education, behaviour modification and psychosocial support skills should be enhanced for the quit smoking clinic handler. Studies on the need for psychosocial factors in helping smokers reduce their psychological and behaviours dependence on nicotine addiction should also be explored in greater depth.
Introduction:Malaysia has the highest prevalence of obesity among the Southeast Asian nations which increases the risk for non-communicable diseases such as diabetes mellitus and hypertension. Since rural communities regularly face challenges in receiving medical services, regular health screening programs targeting these communities are necessary for early diagnosis and intervention to prevent complications as well as preserve the patients’ quality of life. Methods: A community health screening program was performed in the Inanam sub-district of Kota Kinabalu, Sa-bah, Malaysia. A total of 50 participants via convenience sampling were examined for body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) to determine their general and central obesity status. Estimation of body fat percentage (Fat%) and body fat mass was conducted by using bioelectrical impedance analysis. Addition-ally, systolic blood pressure (SBP), diastolic blood pressure (DBP), and capillary blood glucose were also measured. Results: The participants had a median age of 39.50 years. The prevalence of general obesity was 28%, while the prevalence of central obesity was 78% (based on WC) and 74% (according to WHR). Hypertension and hyperglyce-mia prevalence was reported at 24% and 20%, respectively. BIA showed that both Fat% and fat mass had positive associations with BMI (r=0.656, p=0.001 for Fat%; r=0.868, p=0.001 for fat mass) and WC (r=0.505, p=0.001 for Fat%; r=0.761, p=0.001 for fat mass). The DBP had positive associations with the BMI (r=0.390, p=0.005), WC (r=0.467, p=0.001), and WHR (r=0.331, p=0.019), while the SBP had a positive association with the WC alone (r=0.341, p=0.015). Conversely, there were no significant associations between capillary blood glucose and BMI, WC, or WHR. Conclusion: The rural community of Inanam sub-district had a higher prevalence of central obesity than the national level. This should raise concern among healthcare professionals regarding future hypertension and hyperglycemia risk in this community.
Introduction: High altitude retinopathy (HAR) is part of high altitude illness (HAI) which includes acute mountain sickness, high altitude cerebral oedema and pulmonary oedema. We present a case of bilateral HAR with right eye central scotoma during Mount Everest expedition. Case description: A 37-year-old lady presented with decreased right eye (OD) vision and central scotoma during ascending to the top of Mount Everest at 5100m. She developed respiratory symptoms with shortness of breath at the same time and warranted her a rapid descend on day eight of her excursion. Ocular examination revealed visual acuity of 6/36 OD and 6/6 left eye (OS). Both pupils were normal without relative afferent pupillary defect. Anterior segment and intraocular pressure were unremarkable. Fundus examination revealed bilateral multiple retinal haemorrhages along vascular arcades, with macula involvement in the right eye only. Otherwise there was no sign of optic disc swelling, vascular sheathing or choroidal involvement. Optical coherence tomography (OCT) of the macula showed hyperreflectivity changes on the right fovea at the level of superficial nerve fiber layer. Diagnosis of bilateral HAR was made and treated conservatively. She was also diag-nosed with HAI with acute pulmonary oedema and pneumonia by the treating physician. The retinal haemorrhages started to resolve after two weeks with full recovery of vision in ten weeks. Conclusion: With increasing popularity of mountaineering, ophthalmologists should be prepared to recognise HAR as part of HAI. Visual impairment depends on the location and extent of the lesions. HAR is self-limiting with good prognosis but can be associated with poten-tially fatal conditions of HAI e.g. pulmonary oedema in our case.
Manisya Zauri Abdul Wahid, Tengku Rogayah T. Abd. Rashid, Hariyati Md. Ali, Hamadah Mohd Shafiff, Mohd. Shamsul Samsuddin, Syarifah Nur Aisyatun Syed Mohd Salleh, et al.
Introduction:Echoviruses are Enteroviruses (HEVs) that infect millions of people annually worldwide, primarily paediatrics. These viruses are frequently associated with outbreaks and sporadic cases of viral meningitis, enceph-alitis, paralysis, myocarditis, severe systemic infections; and hand-foot-mouth disease. This study is a retrospective study to identify Echovirus serotypes circulating in Malaysia from January 2014 to June 2019, and their roles in outbreak prediction. This study investigated the Echovirus serotypes circulating in Malaysia from January 2014 to June 2019. Methods: A total of 13,855 inpatient samples consisting respiratory secretion, stool, tissue and body fluid from around the country were received by the Virology Unit, Institute for Medical Research between January 2014 and June 2019. The presence of HEV’s RNA was detected by qPCR. The identified positive sample was further isolated by cell culture and identified by Immunofluorescence Assay (IFA). The IFA positive samples were subjected to amplification of partial VP4 gene by RT-PCR, and proceeded to Sanger sequencing for phylogenetic analysis by using ChromasPro and MEGA Software. The sequence generated were analysed by BLAST to confirm the sequence serotypes generated. Results: Echovirus genome was detected in 0.35% (37/10,681) of the patients. The circulating Echovirus subtypes in Malaysia between January 2014 and June 2019 were Echo-11 (43.2%; 16/37), followed by Echo-6 (16.2%; 6/37); 8.1% (3/37) of Echo-7 and Echo-13, respectively. Meanwhile, other types of Echoviruses (24.3%; 9/37) such as Echo 3-5, Echo-14, Echo-16, Echo-18, Echo-25 and Echo-30 were also detected in this study. Conclusion: In this study, it has been found that Echovirus 11 serotype is the most predominant Echovirus serotype circulating in Malaysia between January 2014 and June 2019. It has been reported to cause severe diseases, such as aseptic meningitis. Therefore, the identification of circulating serotypes of Echovirus is critical to predict the Echovi-rus outbreak and to reduce the risk of developing severe disease in Malaysia.
Introduction: Nutrition education is crucial to promote healthy eating behaviours and lifestyle that can prevent nutrition related non-communicable diseases. Young children are known to be amenable to nutrition education programmes and the school setting provides ideal opportunity for young children to learn. It is important to measure the impact of such programmes to determine its usefulness. Thus, the current study described the impact of a short-term nutrition education programme in kindergarteners. Methods: This pre and post-test design study involved 20 kindergarteners (aged 6 years) at Pusat Minda Lestari, Universiti Malaysia Sabah. The participants of the programme received a nutrition education module at school which comprised of nutrition lessons on key messages in the Ma-laysian Dietary Guidelines and related hands-on activities for 30min/day on 10 consecutive school days. Main outcomes were children’s nutrition knowledge and attitude, their preference for fruits and/or vegetables in a meal and types of physical activity most frequently done. These were all measured using established age-appropriate methods and tools. Results: After receiving the nutrition module; study participants’ mean score for overall nutrition knowledge significantly improved by 60%, self-reported attitude towards healthy foods were more positive and the majority of participants (85% combined) reported that they would prefer to include either vegetables, fruits or vege-tables & fruits in their meal rather than none at all (65% preferred no fruits and vegetables at baseline). The number of participants who said they preferred doing healthier types of physical activities rather than sedentary activities increased by 40% after the programme. Conclusion: This short-term nutrition programme appeared to increase kin-dergarteners’ interest in making healthy food choices and doing moderate to high intensity physical activities. Thus, the nutrition education module used in this programme may be useful in promoting healthy eating behaviours and physical activity in young children.
Introduction:Filariasis is an endemic infection in tropical and subtropical countries. The disease is caused by para-sites from the group filarodidae. Epidermolysis Bullosa, on the other hand is a group of rare genetic skin diseases that characterize by skin blister and erode facilely. Due to rarity of Epidermolysis Bullosa and uncommon occurrence of Filariasis, there is extremely limited case or paper reporting on safety profile of medication that are used to treat Filariasis patient with underlying Epidermolysis Bullosa.Serious adverse event that is anticipated in this cohort of patient are Stevens-Johnson syndrome and Mazotti reaction. Case description: Surveillance activity is necessary in high endemic localities in Sabah in order to control the spread of this mosquitoes-borne disease. The available tool is Brugia RapidTM kit, a test kit that detects filarial antibodies.A 13 year-old boy with underlying Epidemolysis Bullosa Simplex was detected during surveillance activities. It was further confirmed with night blood on microscopic slide that depicted high density of parasite (microfilaria count: 31). The WHO specifically exempted the following groups from the treatment - children under 5 years of age; pregnant women; and seriously ill individuals i.e. those who are having acute or chronic illness that makes them too sick or weak to get out of bed; and those with an illness who are life-dependent on medical intervention. This is because ingestion of the medications can result in adverse events due to the destruction of killed parasites. No guideline is available for treatment of lymphatic filariasis in rare genetic disorders. Conclusion: The recommended dosage for IDA is Ivermectin 3mcg/kg, Diethylcarbamazine 6mg/kg and Albendazole 400mg for positive patient yearly. Patient was admitted in hospital for observation treatment with the suggested dose. From the case study it shows it is safe to treat this cohort patient. However, it is advisable to treat such rare cases by case basis and in comparison to others where treatment is given in the community this patients should be treat in more control environment such in the hospital.