Handgrip strength, and erectile dysfunction among men with metabolic syndrome attending an institutional primary care clinic in Malaysia: A cross-sectional study.

Background: Erectile dysfunction (ED) is an independent predictor for cardiovascular diseases (CVD). The prevalence increases with age, but little is known about the relationship between handgrip strength (HGS) and ED, especially among men with a high risk of CVD. This study aimed to determine the prevalence of ED among men aged ≥40 years with metabolic syndrome (MetS) and its association with HGS. Materials and Methods: A cross-sectional study at an institutional primary care clinic in Malaysia was conducted between June 2021 and October 2021. HGS and erectile function were assessed using a hand dynamometer and International Index of Erectile Function (IIEF-5) questionnaire, respectively. Multiple logistic regression analyses were performed to determine the association between sociodemographics, clinical characteristics, and HGS with ED. Results: A total of 334 participants were recruited. The prevalence of ED was 79% (95% confidence interval [CI]: 0.75-0.84). ED was associated with elderly aged ≥60 years (odds ratio [OR] 3.27, 95%CI: 1.60-6.69), low HGS (OR 15.34, 95%CI: 5.64-41.81) and high total cholesterol (OR 0.36, 95%CI: 0.16-0.78). Conclusion: In conclusion, age above 60 years and those with low HGS are at higher risk of ED. Thus, robust screening of ED among men with MetS and improving muscle strength and physical fitness may be warranted.

Work-life balance mediating stress and quality of life in academics during COVID-19 in Malaysia.

Background: Following the implementation of the Movement Control Order (MCO) during the coronavirus disease 2019 (COVID-19) pandemic, academicians from the universities in Malaysia needed to ensure that the quality-of-service delivery to the stakeholders is undisturbed by adopting new challenging norms. This compromises the work-life balance (WLB), causes more stress and potentially affects their quality of life (QoL). Aim: This study investigates how perceived stress (PS) impacts the QoL of Malaysian academicians during the COVID-19 pandemic, focusing on the mediating role of WLB. Setting: Academics working in Malaysia during COVID-19 pandemic. Methods: A cross-sectional study, using a voluntary response sampling method, was conducted among 417 academicians from universities in Malaysia in September 2021. A self-reported online questionnaire, measuring PS, WLB and QoL, was distributed. Results: The QoL scored a mean of 50 (standard deviation [s.d.] = 9.84), PS scored a mean of 24.26 (s.d. = 8.19) and WLB had a mean score of 51.12 (s.d. = 18.73). Work-life balance was a significant mediator of PS and QoL (ß = -0.43, 95% confidence interval [CI] = -0.52 to -0.35, p = 0.0001). Perceived stress was a significant predictor of WLB (ß = 1.62, p = 0.0001). Conclusion: Institutions should consider implementing flexible working arrangements, and providing workshops on crisis management, time management, and resilience. Stress coping methods are recommended for enhancing WLB among academicians. Contribution: This study contributes to the pool of evidence to support intervention strategies and policy recommendations aimed to enhance well-being.

Budget Impact Analysis of Dapagliflozin in Treating Patients With Heart Failure With Reduced Ejection Fraction From the Perspective of Malaysian Public Healthcare System.

PURPOSE: This is a budget impact analysis that compared the scenario of treating heart failure with reduced ejection fraction (HFrEF) using dapagliflozin plus standard of care (SoC) versus a scenario without dapagliflozin, from the perspective of Ministry of Health (MOH) Malaysia over a 5-year time horizon. METHODS: A Microsoft Excel-based cost calculator was developed for such comparison. The estimated size of eligible population, uptake rates for dapagliflozin, as well as costs related to drugs, clinical events, and adverse events were based on published data, official tariffs, and databases, and expert opinion. Clinical data from the DAPA-HF trial were used to inform efficacy and safety inputs (i.e., hospitalization for heart failure (hHF), cardiovascular death, and adverse events). Results were reported as total annual and cumulative costs (in 2023 Malaysian Ringgits [RM], United States Dollars [USD], and European Union Euros, [EUR]; with exchange rates of 1 USD = RM 4.40 and 1 EUR = RM 4.90]), as well as the number of clinical events. Sensitivity and scenario analyses were also conducted. FINDINGS: The base-case analysis estimated that over a five-year period, the adoption of dapagliflozin for HFrEF treatment would result in a cumulative cost-saving of RM 2.6 million (USD 0.6 million/EUR 0.5 million), representing a 0.3% reduction in costs, driven primarily by reduced expenditure on hHF. Moreover, dapagliflozin treatment would lead to 731 fewer hHF and 366 fewer cardiovascular deaths. Sensitivity and scenario analyses revealed that the results were most sensitive to assumptions regarding loop diuretic requirements and the cost of dapagliflozin. Although cost savings or a net-zero balance were projected for the first four years, an anticipated 2.5% annual increase in dapagliflozin uptake in the longer term would lead to additional costs for the MOH, starting from the fifth year. IMPLICATIONS: Incorporating dapagliflozin into the SoC can improve health outcomes for HFrEF patients and may generate cost savings, potentially easing the economic strain of HFrEF management on Malaysia's public healthcare system in the short term. Nonetheless, a modest increase in budget should be anticipated as more patients gain access to the treatment over time.

Metabolic associated fatty liver disease (MAFLD): assessing the knowledge and practice of primary care doctors in Seremban District, Negeri Sembilan.

Introduction: Metabolic-associated fatty liver disease (MAFLD) is the liver manifestation of metabolic syndrome, which is commonly seen in primary care settings. This study aimed to determine the knowledge and practice of primary care physicians regarding MAFLD in Seremban District, Negeri Sembilan. Methods: This cross-sectional study was conducted among medical officers in 14 health clinics in Seremban District, using a validated, self-administered online questionnaire. Results: A total of 240 medical officers from 14 health clinics in Seremban District, participated in this study. Most participants (85.4%) passed the knowledge test. Their practice was acceptable, but only a minority were familiar with non-invasive testing of liver fibrosis (e.g. APRI or FIB-4), medication and specific diet for the treatment of MAFLD. Conclusion: Most primary care physicians in Seremban District are knowledgeable in identifying risk factors and managing patients with MAFLD. However, there are still areas to improve in terms of management, particularly regarding the use of silymarin, vitamin E and pioglitazone.

10-year risk for cardiovascular diseases according to the WHO prediction chart: findings from the National Health and Morbidity Survey (NHMS) 2019.

BACKGROUND: There has been a significant increase in the incidence of cardiovascular disease (CVD) in Malaysia. It is important to identify the group at high risk of CVD. This study aimed to assess the population distribution and factors associated with 10-year CVD risk among adults aged 40 to 74 years in Malaysia. METHODS: This study used secondary data from the NHMS 2019, a nationally representative cross-sectional population study. The following measurements were collected: anthropometric, systolic blood pressure, fasting blood glucose, total cholesterol, smoking, and sociodemographic. The 2019 WHO Southeast Asia laboratory-based charts were used to estimate individuals' CVD risk. These charts predict significant cardiovascular events over ten years. Multiple logistic regression analysis was employed to ascertain the factors that are linked to elevated or extremely elevated risk of CVD. RESULTS: A total of 5,503 respondents were included in the analysis. Less than one-quarter of the respondents were current smokers and obese. Approximately 41.7%, 30.9%, and 22.5% of the participants had extremely low risk (less than 5%), low risk (between 5% and less than 10%), and moderate risk (between 10% and less than 20%), respectively. A total of 4.9% of the participants were categorised as having high (20% to < 30%) or very high (CVD) risk (≥ 30%). This classification was more prevalent among males (7.3%) than among females (2.5%; p < 0.001). The factors associated with high/very high CVD risk were unemployment (aOR = 1.88, 95% CI = 1.47-2.40), those with non-formal and primary education level (aOR = 2.36, 95% CI = 1.36 - 4.12 and aOR = 3.28, 95% CI = 2.10 - 5.12, respectively), and being physically inactive with obesity (aOR = 2.19, 95% CI = 1.18 - 4.08). CONCLUSIONS: This study revealed that almost 5% of the population in Malaysia has a high 10-year CVD risk. These findings highlight Malaysia's urgent need for comprehensive CVD prevention efforts.

Purpose in Life and Cognitive Function in the Malaysian Ageing and Retirement Study.

OBJECTIVES: Evidence for the association between purpose in life and cognitive health is primarily from North American and European samples. This study evaluates this association in a large sample from Malaysia, an upper-middle-income country in Southeast Asia. METHODS: Participants (N = 5,579) from the Malaysian Ageing and Retirement Study reported on their purpose in life and subjective memory and were administered tasks that measured episodic memory, verbal fluency, and overall cognitive function. RESULTS: Purpose was associated with better subjective memory (ß=.13), episodic memory (ß=.06), verbal fluency (ß=.12), and overall cognitive function (ß=.07) (ps < .001). The associations were similar across sex and retirement status; purpose was more strongly related to subjective memory and overall cognitive function among older participants. Behavioral/social factors accounted for up to one-third of the associations, but all associations remained statistically significant. CONCLUSIONS: The positive association between purpose and cognition generalizes to a middle-income country in Southeast Asia. Similar to Western samples, behavioral and social factors accounted for part but not all the association. More research is needed in lower- and other middle-income countries to fully evaluate generalizability. CLINICAL IMPLICATIONS: Purpose may help support healthier cognitive aging across diverse populations and be a useful target to improve cognitive aging outcomes.

Prevalence of Bordetella pertussis among children aged 4 years and above presenting with acute respiratory tract infection: a cross-sectional study.

INTRODUCTION AND AIM: In Malaysia, pertussis in children beyond infancy is underreported. This study aimed to determine the prevalence of Bordetella pertussis and the prevalence of pertussis-susceptible children aged ≥4 years who presented with acute respiratory infections. METHODS: This single-center, cross-sectional study conducted at the Paediatric Emergency Department from 1 October 2022, to 31 January 2023, included children aged 4 years and older with ARTIs symptoms and excluded those who were COVID-19 positive. B. pertussis was detected via quantitative Polymerase Chain Reaction on nasopharyngeal swabs and pertussis toxin (PT) IgG enzyme-linked immunosorbent assay. RESULTS: Children (n = 298) with a median (Interquartile range, [IQR]) age of 6.0 (5.0, 8.0) years old were recruited, and 98% were vaccinated adequately. Two cases of B. pertussis (n = 2/298, 0.67%) were detected. Both children were also co-infected with Bordetella spp. The majority of the patients (n = 246/296, 83.1%) had low protective antibodies against pertussis (anti-PT IgG <5 IU/ml), and children 5 years and older were more likely to have lower anti-PT Ig G levels of <5 IU/ml (odds ratio 2.02 [95% CI 1.04,3.90]) compared to children 4 years old. CONCLUSION: The prevalence of pertussis was low. However, there is significant waning immunity. Booster doses of pertussis vaccine should be given to all school-aged children.

Ageing well with tech: Exploring the determinants of e-healthcare services adoption in an emerging economy.

The adoption of e-healthcare services is critical for improving healthcare accessibility and efficiency, particularly in regions with diverse populations, such as Malaysia. Although e-healthcare services offer numerous advantages, their adoption is considerably low and requires a thorough understanding of the key factors that influence their use. This study investigated the determinants and dynamics of e-healthcare adoption among adults over 40 years by extending the unified theory of acceptance and use of technology. We employed a quantitative research approach, specifically a cross-sectional design. Data were collected from 393 Malaysian respondents through a structured survey questionnaire, using convenience sampling. They were analyzed using partial least-squares-structural equation modeling. The findings revealed that performance expectancy, effort expectancy, social influence, and perceived product value significantly influenced individuals' intentions to use e-healthcare services. Meanwhile, perceived risk had an insignificant negative effect. Facilitating conditions significantly influenced individuals' intentions and actual usage of e-healthcare services. Furthermore, individuals' intentions to use e-healthcare services significantly affected their actual use of these services. Additionally, the intention to use e-healthcare services mediated the relationship between the factors and usage of e-healthcare services, except for perceived risk. Surprisingly, perceived service accuracy had no significant moderating effect on the relationship between individuals' intention to use and their actual use of e-healthcare services. This study offers valuable insights for educators, practitioners, and policymakers, enriching the scholarly discourse in this field. For education, integrating e-healthcare topics into curricula can enhance digital health literacy. In practice, healthcare providers should focus on improving user experience and addressing barriers to technology adoption. For policy making, developing supportive policies, and infrastructure to facilitate e-healthcare adoption is crucial to enhancing public health outcomes.

Comorbidities and Monitoring in Patients with Chronic Hepatitis B on Nucleos(t)ide Analogues Attending a Tertiary Hospital in Malaysia, Southeast Asia: A Critical Perspective.

Background: Chronic hepatitis B (CHB) is a significant global public health concern in Malaysia. It is a potentially life-threatening liver disease caused by the hepatitis B virus (HBV), which can lead to long-term complications such as cirrhosis, liver failure and hepatocellular carcinoma. In managing CHB, nucleos(t)ide analogues (NAs) have become the preferred treatment due to their ability to suppress viral replication and prevent disease progression. The question of liver-associated comorbidities related to patients with CHB on NAs remains unresolved in Malaysia despite the impending burden of CHB in the country. This study intends to address this and related aspects. Method: We assessed 136 CHB patients on NAs in one centre, the Hospital Universiti Sains Malaysia. Demographic and epidemiological data on the treatment, concomitant disease and monitoring strategies were collected and analysed. Result: Patients on NAs aged 50 years old-70 years old had the highest proportion of CHB (45.59%), with males representing 61.03% of that age group. There was a statistical significance in CHB acquisition and presence of comorbidities at P > 0.005. Our cohort displayed seven comorbidities (diabetes, obesity, rheumatoid diseases, renal impairment, spontaneous bacterial peritonitis, hypertension, non-hepatocellular malignancies and carcinoma); hypertension had the highest incidence (69.12%), while renal impairment had the lowest incidence (8.09%). Whole blood count, liver function and creatinine tests were the major monitoring tests used in over 90% of the cohort compared to viral load (6.1%). Conclusion: Diabetes, hypertension and obesity were independent risk factors for acquiring liver cirrhosis and hepatocellular carcinoma. Malaysian CHB patients treated with NAs have several comorbidities that could affect disease outcomes. Therefore, careful monitoring is required.

Detection of Congenital Toxoplasmosis and Cytomegalovirus Infections Using Paired Sample Serodiagnosis from Suspected Cases at a Tertiary Teaching Hospital in Malaysia.

Background: Congenital toxoplasmosis and congenital cytomegalovirus (cCMV) infections are noteworthy in Malaysia and can cause serious health problems in neonates. The prompt and effective detection and treatment related to both illnesses may mitigate the possibility of adverse consequences from both infections. Methods: A total of 219 neonates with suspected clinical indications of congenital toxoplasmosis and/or cCMV infections from January 2022 to December 2022 were enrolled. The first samples for IgM and IgG antibodies were screened by electrochemiluminescence immunoassay. For positive results indicative of congenital toxoplasmosis and cCMV infections, second serum samples were requested and tested within a period of 2-4 weeks after testing the first sample. Results: From the 219 first serum samples, the overall seroprevalence of congenital toxoplasmosis antibodies in suspected cases was 53%; meanwhile, the overall seroprevalence of cCMV in the suspected cases was 98.6%. The results of the paired serum sample collected for investigating congenital toxoplasmosis cases revealed that 47% of the cases presented no serological evidence of exposure while the remaining 53% of cases might have acquired passive immunity from the mother. For cCMV, the number of cases with no serological evidence of exposure was 1.4%, whereas acute infection was 1.8% and possible passive immunity from the mother represented 96.8%. Conclusion: This study found a high seroprevalence of congenital toxoplasmosis and cCMV infections, probably because they are suspected cases. This study also indicates that using paired sample analysis in the categorisation of cases can aid in accurate diagnosis and more effective treatment.

Healthy Ageing in Malaysia by 2030: Needs, Challenges and Future Directions.

This Editorial addresses the critical need for developing a healthy ageing society in Malaysia by 2030. With the country's elderly population projected to increase significantly, the article explores current challenges, including healthcare disparities, a shortage of geriatric specialists and malnutrition. It evaluates existing policies and highlights successful international and local initiatives, suggesting specific recommendations to improve healthcare infrastructure, healthy ageing support and technological integration. Emphasising the importance of engaging private sectors, non-governmental organisations (NGOs) and community groups, this Editorial calls for a collaborative approach to address the economic and cultural aspects of ageing. This comprehensive strategy aims to ensure a resilient, healthy and inclusive environment for Malaysia's ageing population by 2030.

Modelling the role of tourism in the spread of HIV: A case study from Malaysia.

This study aimed to assess the role of tourism in the spread of human immunodeficiency virus (HIV) using Malaysian epidemiological data on HIV and acquired immunodeficiency syndrome (AIDS) incidence from 1986 to 2004. A population-level mathematical model was developed with the following compartments: the population susceptible to HIV infection, the clinically confirmed HIV-positive population, the population diagnosed with AIDS, and the tourist population. Additionally, newborns infected with HIV were considered. Sensitivity analyses and variations in fixed parameter values were used to explore the effect of changes to various parameter values on HIV incidence in the model. It was determined that variations in the rate of HIV-positive inbound tourist entries and the rate of foreign tourist exits (i.e., the duration of time tourists spent in Malaysia) significantly impacted the predicted incidence of HIV and AIDS in Malaysia. The model's fit to observed HIV and AIDS incidence was evaluated, resulting in adjusted R2 values of 53.3% and 53.2% for HIV and AIDS, respectively. Furthermore, the reproduction number (R0) was also calculated to quantify the stability of the HIV endemicity in Malaysia. The findings suggest that a steady-state level of HIV in Malaysia is achievable based on the low value of R 0  = 0.0136, and the disease-free equilibrium was stable from the negative eigenvalues obtained, which is encouraging from a public health perspective. The Partial Rank Correlation Coefficient (PRCC) values between the proportion of newborns born HIV-positive, the rate of Malaysian tourist entries returning home after contracting HIV, and the rate of foreign tourist exits have a significant impact on the R 0 . The methods provide a framework for epidemiological modelling of HIV spread through transient population groups. The model results suggest that the role of tourism should not be overlooked within the set of available measures to mitigate the spread of HIV.

Knowledge, attitude and practice levels regarding malaria among the Semai sub-ethnic indigenous Orang Asli communities in Pahang, Peninsular Malaysia: a stepping stone towards the prevention of human malaria re-establishment.

BACKGROUND: In Malaysia, despite a decline in cases, malaria remains a major public health concern, especially among the vulnerable indigenous people (i.e. Orang Asli) in remote areas. Effective preventive and control measures require an evidence-based understanding of their knowledge, attitudes, and practices (KAP) regarding malaria. This study aimed to evaluate the KAP regarding malaria in an indigenous settlement in Peninsular Malaysia. METHODS: A household-based cross-sectional study was conducted in March 2024 in six Semai sub-ethnic indigenous villages in Pos Lenjang, Kuala Lipis, Pahang. A structured questionnaire was administered to randomly selected individuals (≥ 12 years old) to collect data on sociodemographic characteristics and KAP. Data were analysed using descriptive statistics and predictors of KAP were determined using logistic regression. A p-value less than 0.05 was considered statistically significant. RESULTS: A total of 267 individuals from 160 households were interviewed. Nearly half had good knowledge (49.4%) and positive attitudes (54.3%) towards malaria, with high practice scores for prevention and control (83.1%). Multivariate logistic regression analysis showed higher odds of good knowledge in those aged 40-59 years (adjusted odd ratio [aOR] = 6.90, p = 0.034), with primary (aOR = 2.67, p = 0.015) or secondary education (aOR = 2.75, p = 0.019), and with previous malaria history (aOR = 5.14, p < 0.001). Higher odds of a good attitude were found in those with secondary education (aOR = 4.05, p < 0.001) and previous malaria history (aOR = 2.74, p = 0.017). Lower odds were observed for the unemployed (aOR = 0.25, p = 0.018) and those collecting forest products (aOR = 0.25, p = 0.049) for attitude and practice, respectively. DISCUSSION: The overall practice level on malaria prevention was high among the Semai Orang Asli in Pahang. However, to ensure sustainability, the low levels of knowledge and attitude regarding malaria must be strengthened through increased health education and continuous community engagement.

A retrospective observational study of mangrove pit viper envenomation presented to selangor middle zone cluster hospitals in Malaysia.

OBJECTIVE: There is very limited published experience on mangrove pit viper envenomation in the medical literature. This study aims to analyze the clinical characteristics, treatment modalities and outcomes of patients presenting to Selangor middle zone cluster Hospitals in Malaysia with confirmed mangrove pit viper bites. METHODS: We conducted a retrospective observational study, reviewing medical records of patients treated for mangrove pit viper bites between July 1, 2020 to June 30, 2023. Data on patient demographics, clinical characteristic, laboratory findings, treatment modalities and clinical outcomes were collected and analyzed. RESULTS: A total of 25 patients were included in this study. The majority of the patients were male (n = 23, 92%) with the mean age of 38.7 ± 17.6 years. Most frequent anatomical region involved is foot (n = 12, 48%). Common clinical presentation included localized pain (n = 24, 96%), swelling (n = 22, 88%) and fang mark (n = 22, 88%). Systemic symptoms were less common, with 1 patient exhibiting coagulopathy with clinical bleeding at 28 h post bite. Antivenom was administered to 68% (n = 17) of the patients. The majority of the patients (n = 23, 92%) recovered without significant morbidity while 8% (n = 2) of the patients developed skin infection that required antibiotic therapy. No fatalities were reported. CONCLUSION: Mangrove pit viper envenomation encountered in these regions predominantly causes local symptoms while systemic symptoms were less common. This study provides a glimpse to the clinical characteristics and management of mangrove pit viper envenomation, coagulopathy may be delayed due to characteristic of the snake venom and patient's preexisting illness. Further research is needed to enhance our understanding of this snakebite envenomation.

Tick-associated Trypanosoma species (Apicomplexa: Kinetoplastida) from cattle ticks (Acari: Ixodidae) in Peninsular Malaysia.

A Trypanosoma screening was conducted on 130 pools comprising 1,241 ticks, collected from 674 selected farm ruminants in Peninsular Malaysia. Of these, nine pools were tested positive for Trypanosoma. Subsequent BLAST searches revealed that the 18S rRNA gene sequences were closely related to Trypanosoma rhipicephalis isolate Chaco CB, with percentage similarities ranging from 95.56 % to 99.84 %. Phylogenetic analysis showed that three of the nine sequences formed a clade with Trypanosoma rhipicephalis. The remaining six Trypanosoma sequences formed a distinct clade, separate from T. rhipicephalis and other Trypanosoma species, with genetic distances of 4.34 % and 4.33-4.58 %, respectively. This study marks the first report of tick-associated Trypanosoma in Malaysia and underscores significant research gaps regarding trypanosome interactions with tick hosts in the region.

Rabies epidemiology in Malaysia (2015-2023): A cross-sectional insights and strategies for control.

BACKGROUND: Malaysia currently faces significant challenges in controlling the spread of dog-mediated human rabies, as evidenced by recurrent outbreaks in newly affected areas and increasing human fatalities. MATERIALS AND METHODS: A cross-sectional study was conducted to analyse surveillance data from 2015 to 2023 to examine the epidemiological characteristics of rabies in Malaysia. Data from multiple sources were used, and descriptive statistics, incidence rates, and reproductive numbers were calculated. QGIS software was used to map the distribution of rabies cases, and statistical methods were employed to evaluate associations between rabies incidence, vaccination coverage, and risk factors. We further explored the effectiveness of vaccination campaigns and public health interventions in reducing rabies transmission. RESULTS: Our findings revealed 995 confirmed rabies cases in animals. Sarawak reported the highest proportion of rabies cases at 97.99 %, showing a significant correlation between location and rabies cases (p < .001). Dogs comprised 89.35 % of confirmed cases, while the average annual vaccination rate was only 16.66 %, far below the 59.05 % needed for herd immunity. Moreover, human rabies cases reported in Sarawak had an alarmingly high fatality rate of 90.28 %, highlighting the urgent need for improved public health measures and surveillance. CONCLUSION: This research provides critical insights for policymakers and health officials to improve rabies control strategies in Malaysia.

ESBL Producing E. coli in Chickens and Poultry Farms Environment in Selangor, Malaysia: A Cross-Sectional Study on Their Occurrence and Associated Risk Factors With Environment and Public Health Importance.

INTRODUCTION: Extended-spectrum ß-lactamase-producing Escherichia coli (ESBL-EC) are widespread multidrug-resistant zoonotic bacteria that threaten animal production, food safety and antimicrobial therapy worldwide including Malaysia. Poultry has been reported as one of the pathways for human exposure to ESBL-EC. There has been little research on the occurrence of ESBL-EC within the Malaysian poultry food chain. Hence, the objectives of the study were to determine the occurrence of ESBL-EC in chickens and to identify the potential risk factors associated with their occurrence in poultry farms. METHODS: A cross-sectional study was conducted on 400 samples, consisting of 240 cloacal swabs from chickens and 160 from poultry farms environments in eight districts in Selangor, Malaysia using culture and disk combination methods and multiple polymerase chain reaction assays. In the determination of possible factors associated with the presence of ESBL-EC at poultry farms, a questionnaire was used to obtain the information and data. RESULTS: The findings demonstrated the wide distribution of ESBL-EC in all the farms with an overall occurrence of 37.2%. Farms in Gombak, Klang and Hulu Selangor had the highest occurrence rates at 62%, 50% and 50%, respectively, followed by farms in Petaling 38%, Sepang at 34%, Kuala Langat at 26% and Kuala Selangor at 24%, and the lowest was in Hulu Langat 14%. Among the study samples, chickens had the highest occurrence rate at 45.4%, followed by chicken house floors at 40% and flies at 30%, while feed and water samples at 17.5% and 12.5%, respectively. The present study indicated the high occurrence and wide dissemination of ESBL-EC in chickens and poultry farms environment. The ESBL-EC occurrence was associated with several factors including imprudent use of antibiotics, poor husbandry, management and biosecurity practices at the farms. CONCLUSIONS: Our study showed the presence and spread of ESBL EC among chickens in the farms and their environment; this may lead to being spread to outside of farm environment by flies, vermins, flying birds, litter and farm wastes and possibly to humans upon contact with the contaminated environment and by poultry meat. Thus, the findings of the study can assist to serve as a piece of useful information to veterinary authority in designing evidence-based mitigation strategies for the control of ESBL-EC in poultry farms.

Prospective associations between an empirically derived dietary pattern and life satisfaction in Malaysian adolescents.

BACKGROUND: Little is known on the prospective associations between an empirically derived dietary pattern (DP) and life satisfaction among adolescents. This PUTRA-Adol follow-up study aimed to assess the prospective associations between the empirically derived DP and life satisfaction during adolescence. METHODS: A total of 585 and 262 adolescents participated in the baseline PUTRA-Adol study in 2016 and PUTRA-Adol follow-up study in 2019-2020, respectively. These adolescents were recruited from three southern states in peninsular Malaysia, namely Negeri Sembilan, Melaka and Johor. Dietary assessments were estimated using a validated food frequency questionnaire (FFQ) while a Multidimensional Students' Life Satisfaction Scale (MSLSS) was used to measure life satisfaction at baseline in 2016 as well as at follow-up in 2019-2020. A DP characterised by foods high in free sugar and energy dense was identified using reduced rank regression (RRR), cross-sectionally at baseline and was reported elsewhere. Similar RRR analysis was used to find a DP that best explained the variation in response variables linked to poorer life satisfaction, including dietary energy density (DED), fiber density, and percentage of energy from total fat and sugar at the PUTRA-Adol follow-up study. Prospective relationship between adherence to the identified DPs and overall life satisfaction scores as well as its domains between 2016 and 2019-2020 were evaluated using generalized estimating equation models (GEE). RESULTS: A DP characterized by high intakes of percentage energy from sugar, fibre and low in DED and percentage energy from total fat was identified at the 2019-2020 follow-up. The identified DP explained 11% of total variations in the response variables and was characterized by high intakes of sweets, sugar sweetened beverages (SSB) and fruits. Female adolescents [67.6(8.9)] had a mean (SD) of life satisfaction that was higher than male adolescents [67.5(10.8)] p < 0.05 in 2019-2020. Prospective analysis found a significant positive association between the identified DP and school domain, in male adolescents (ß = 0.117; 95% CI 0.001, 0.234) and an inverse relationship between the DP z-score and self-domain in all adolescents (ß = - 0.060; 95% CI - 0.115, - 0.005) from 2016 to 2019-2020. CONCLUSIONS: An increasing score for the predominant 'High sugar and High fibre' DP was prospectively associated with increasing life satisfaction score for the school domain in male adolescents and decreasing score for self-domain in both male and females during adolescence. A lifestyle intervention targeting reduced dietary intakes, particularly sugar, may improve life satisfaction in adolescents and promote healthier future without compromising dietary intakes for chronic disease prevention later in life.

Concerning Predation on Small Vertebrates by Alien Gold Morph Midas cichlid, Amphilophus citrinellus (Cichlidae).

Neotropical cichlid possesses territorial aggression which explains their success as alien species that pose threats to local fauna. The feeding ecology of Midas cichlid, Amphilophus citrinellus species outside its native range had never been fully understood. We aim to determine the stomach content, length-weight relationship and condition factor of this non-native species in one of the agroecosystems in Malaysia. The fish was collected using a cast net, and the guts were dissected. The stomach content (n = 35) revealed Midas cichlids feed on a wide array of preys including fish, amphibian and gastropod. The b-value is 2.60 (negative allometric growth) and the relative condition factor, Kn is 1.04. This result represents an initial study on the feeding aspect of this cichlid. Subsequent and continued researches are needed to evaluate the feeding behaviour and prey preferences of this species in its introduced range.

Setting the Priorities for LGBT+ Research and Intervention Effort in Malaysia Through Community Voices: A Brief Report.

Internationally, there is a growing acceptance of gender and sexuality diversity and acknowledgment of LGBT + identities as health determinants. However, caution is warranted when applying research and intervention priorities from Global North countries to regions where LGBT + identities remain criminalized. In 2024, Malaysia maintains legal stances persecuting LGBT + individuals and shows no intent to address this human rights issue. This study offers an overview of pivotal issues identified by LGBT + communities in Malaysia that urgently require attention and resolution. Data were employed from a large-scale community-based survey: the KAMI Survey that recruited LGBT + participants in Malaysia in late 2023 and descriptive analyses were conducted on the responses of 637 participants (mean age = 27.75). Results revealed key issues deemed 'very important' to address by participants comprised HIV/AIDS, training for healthcare providers, police mistreatment, and discrimination, with more than 80% reporting each of these. When prompted to select a single issue for urgent resolution, three-fifths (61.0%) prioritized 'criminalizing laws affecting LGBT + individuals'. Echoing prolonged advocacy by local LGBT + community organizations, the author emphasizes the need for collective allyship across stakeholders to develop evidence-based practices and policies to address the concerns articulated in this paper.