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@#Introduction: The consumption of sugar-sweetened beverages (SSBs) among young adults in Malaysia has witnessed a notable increase in recent years, giving rise to concerns regarding the potential adverse health effects, including obesity and diabetes. Despite the urgent need for targeted interventions, there is a dearth of research examining the knowledge, attitudes, and practices (KAP) related to SSBs among Malaysian young adults. To address this research gap, the present study aims to assess the level of KAP concerning SSB intake and its associated factors in this specific population. Methods: A cross-sectional study was conducted involving 408 Malaysian young adults aged between 15 and 29 years. Respondents completed an online questionnaire survey, which encompassed the assessment of socio-demographic characteristics and KAP regarding SSB consumption. The collected data were analyzed using IBM’s Statistical Package for the Social Sciences (SPSS) version 22.0. Spearman correlation tests were performed at a significance level of 0.05. Results: The majority of respondents demonstrated moderate knowledge (60%) and practices (60%), while exhibiting a high positive attitude (100%) towards reducing SSB consumption. Significant correlations were observed between knowledge and attitude (p = 0.003, rs = 0.148) and between knowledge and practice (p = 0.005, rs = 0.138). Moreover, the attitude scores were found to be significantly associated with gender (χ2 (1, N = 408) = 10.421, p = 0.001) and locality (χ2 (1, N = 408) = 4.106, p = 0.043), while the practice scores exhibited a significant association with ethnicity (p = 0.006). Conclusion: This study provides valuable insights into the relationship between KAP related to SSB consumption and socio-demographic factors among Malaysian young adults. The findings underscore the importance of utilizing these insights to develop strategic interventions that aim to curtail SSB consumption and promote a healthy lifestyle, ultimately contributing to the reduction of non-communicable diseases. Health authorities are encouraged to capitalize on these findings to design targeted interventions tailored to the unique needs and circumstances of this population.
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@#Introduction: Tobacco production is increasing in certain regions of Indonesia due to its high economic value. Tobacco and its products can have harmful effects on the health of consumers, producers and processing workers. Analysis of blood samples has shown that tobacco farmers are at risk of developing occupational diseases related to pesticide exposure and nicotine absorption through the epidermis of wet tobacco leaves. The aim of this study was to compare blood cholinesterase levels in tobacco plantation workers in relation to their working hours and use of personal protective equipment (PPE). Methods: This cross-sectional observational study was conducted in ten subdistricts in Jember district, Indonesia, and included 50 participants selected using proportional sampling. Spearman’s test was used to analyse the relationship between variables. Results: The significance value of the relationship based on Spearman’s test between working hours and blood cholinesterase levels of tobacco farmers in Jember was 0.058 > α (0.05). Meanwhile, the significance value of the relationship between working hours and complete blood count, specifically mean corpuscular haemoglobin concentration (MCHC), was 0.00 < α (0.05), and between PPE use and blood cholinesterase levels was 0.035 < α (0.05). Conclusion: Working hours were not associated with blood cholinesterase levels, but were associated with blood MCHC levels. Meanwhile, the use of PPE was found to be associated with cholinesterase levels in tobacco farmers.
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@#Simulium takahasii (Rubtsov), which was originally described from Japan, and recorded from Korea and China, is the first among the 19 species of the subgenus Wilhelmia Enderlein recorded from East Asia. It is striking in mating, blood-feeding and ovipositing in captivity and in experimentally transmitting Dirofilaria immitis (Leidy) and Brugia pahangi (Buckley & Edeson), and it is a severe biter of cattle and horses, rarely of humans. Nevertheless, updated information about its morphological characteristics was lacking, making comparisons with related species described from China difficult, since species of the subgenus Wilhelmia are almost indistinguishable from one another, in particular, in their female terminalia, male genitalia and most of larval features. In this study, as many morphological characteristics as possible of S. takahasii based on specimens from Japan are redescribed. New information about many features of this species including the length of the female sensory vesicle against the third palpal segment, number of male upper-eye (large) facets, arrangement of the eight pupal gill filaments, presence or absence of tiny dark setae on the dorsum of the larval abdomen and the number of rows and hooklets of the larval posterior circlet will be useful in evaluating the species status of several Wilhelmia species in China including the species regarded as S. takahasii.
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@#Simulium (Gomphostilbia) okinawense Takaoka and S. (G.) tokarense Takaoka, both from the Nansei Islands, Japan, were morphologically reexamined and genetically analysed by using the COI gene sequences. The female, male, pupa and mature larva of the two species are redescribed. Morphological reexamination shows that both species are more similar to species in the S. asakoae species-group than to those in the S. ceylonicum species-group, by having a medium-long female sensory vesicle, yellow tuft hairs (S. (G.) okinawense) or yellow tuft hairs mixed with a few to several dark hairs (S. (G.) tokarense) at the base of the radial vein in the female and male, and medium-long larval postgenal cleft. However, the body of the male ventral plate (viewed ventrally) is parallel-sided (S. (G.) okinawense) or parallelsided or slightly narrowed (S. (G.) tokarense) and not emarginated basally, differing from those of most species in the S. asakoae species-group. Our genetic analysis shows that S. (G.) tokarense is in the S. asakoae species-group, and S. (G.) okinawense formed a separate sister clade with other members of the S. asakoae species-group with high bootstrap support. From the results of morphological and genetic analysis combined, S. (G.) okinawense and S. (G.) tokarense are transferred from the S. ceylonicum species-group to the S. asakoae species-group.
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@#Introduction: Healthy meals play an essential role in the healthy physical and mental development of adolescents. Breakfast at home is associated with improved nutritional choices, and skipping breakfast is detrimental. This study assessed prevalence of skipping breakfast at home among adolescent students in the Badia Region of Jordan, identifying the reasons and characteristics associated with such behavioural choice. Methods: A cross-sectional survey among adolescent students (aged 13-16 years, in 8th-9th grades) from six public schools in Badia Region, Mafraq Governorate, Jordan, was conducted through self-administered questionnaire from February to March 2022. Results: Results showed that 68.1% of 552 student participants regularly skipped breakfast at home (72.4% boys vs. 61.3% girls; p=0.007). Among those who regularly skipped breakfast, three main rationales for this choice were not feeling hungry (5.3%), lack of time (2.7%), and lack of appetite (3.5%). Conclusion: The prevalence of skipping breakfast at home among adolescents in Badia Region was high for various reasons, including lack of time, not feeling hungry, seeking to manage weight, and insufficient knowledge on the importance of healthy breakfast. Therefore, understanding the reasons and factors that contribute towards breakfast skipping may help in solving the problem, underscoring that positive beliefs should be reinforced in schools, with parents encouraging adolescents to eat healthy breakfast.
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@#Introduction: There is limited evidence on dietary patterns and the risk of type 2 diabetes (T2D) in women with a history of gestational diabetes mellitus (GDM) compared to their non-GDM counterparts, especially in the Asian population. The pilot study investigated dietary patterns in women with a history of GDM (HGDM) and without a history of GDM (non-HGDM), and the association with T2D risk. Methods: This comparative cross-sectional study involved 64 women (32 HGDM, 32 non-HGDM). Food intake was assessed using a validated food frequency questionnaire. Principal component analysis derived the dietary patterns. T2D risk score was determined using the Finnish Diabetes Risk Score tool. Results: HGDM group had significantly higher proportion of first-degree family history of diabetes; higher risk of T2D and better diabetes knowledge; lower gestational weight gain and postpartum weight retention; and consumed more fast food than nonHGDM. ‘Rice-noodle-pasta-meat’ dietary pattern was significantly associated with increased T2D risk after adjusting for age (β=0.272, p=0.032). ‘Bread-cereals-fast food-meat’ dietary pattern was positively and significantly associated with T2D risk after adjusting for confounders, including age, education level, family history of diabetes, diabetes knowledge score, gestational weight gain, and postpartum weight retention (β=0.251, p=0.012). Conclusion: Dietary patterns high in bread, cereals and cereal products, fast food and meat, as well as rice, noodle, pasta and meat were associated with an elevated T2D risk. A more extensive study is warranted to establish the association between dietary patterns and risk of T2D, focusing on women with a history of GDM.
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@#Introduction: Breast cancer is now one of the leading causes of death and morbidity worldwide, including in Indonesia. Every health care professional and community member should pay close attention to these issues. Women diagnosed with breast cancer will experience physical, psychological, and social issues. Methods: This study looked into breast cancer patients’ experiences with holistic nursing care. The complexity of the difficulties confronting breast cancer patients will influence their experiences and perceptions, necessitating a holistic approach to nursing services. A qualitative exploratory, descriptive method was adopted in the investigation. During data collection, fifteen participants were recruited and interviewed. Focus Group Discussion (FGD) was utilized to collect data. Result: The study’s findings provide five significant themes: (1) knowledge and understanding of breast cancer; (2) experiences felt at the beginning of breast cancer complaints; (3) non-health breast cancer treatment; (4) perception of nursing services received by breast cancer patients; (5) facts and holistic needs during and beyond treatment; and (6) patients’ expectations of nursing services to help their needs. Conclusion: The findings provide information on how breast cancer patients understand the examination procedure, accept a diagnosis, and proceed to treatments.
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@#Crowding is the most common dental case worldwide. This case report describes the diagnosis and management of a 20-year-old woman with severe crowding, deep bite, and midline shifting. The patient presented with the chief complaint of crowding and an unaesthetic smile. Upon examination, the patient had Angle Class I Malocclusion. The severe crowding was treated comprehensively and successfully corrected using fixed orthodontic appliances and without extraction, only interproximal reduction (IPR).
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@#Pancreatic pseudoaneurysms are possible complications of chronic pancreatitis. These may present as hemosuccus pancreaticus, a rare cause of upper gastrointestinal tract bleeding where a pseudoaneurysm erodes into an adjacent pseudocyst or pancreatic duct, manifesting as bleeding through the pancreatic duct into the duodenal papilla. We report a case of a 32-year-old male with a history of chronic pancreatitis presenting as intermittent upper gastrointestinal tract bleeding secondary to hemosuccus pancreaticus from a pancreatic pseudoaneurysm. The patient underwent multiple sessions of endovascular embolization, which successfully controlled the bleeding despite some failed attempts; thus, a potentially morbid last-resort surgery was avoided.
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Aneurysm, False , Pancreatitis, ChronicABSTRACT
@#Introduction: Lean sustainability has gained prominence in the health sector for operational and business advantages. However, understanding the link between lean and healthcare sustainability, especially in social and environmental aspects, remains limited. This study introduces a preliminary framework for measuring lean healthcare sustainability in hospitals. The framework aligns Critical Success Factors (CSFs) with sustainability objectives and business strategies to ensure successful and enduring lean deployment. Methods: The study was conducted among 52 Lean Agile Hospitals in Malaysia using a cross-sectional approach. The validated questionnaire was employed for data collection. A reliability test and Exploratory Factor Analysis (EFA) were also performed to assess and validate the framework using Statistical Package for Social Sciences (SPSS) version 27. Results: The content validation was 0.9, which indicates that the instrument is sufficient to measure the research objective. The data screening test was performed to eliminate problem observation. The overall reliability value was over 0.830 which depicts data consistency and stability. The Kaiser-Meyer-Olkin exceeded 0.6, Bartlett’s test was under 0.001 and factor loading was between 0.507 to 0.948, thus indicating a significant correlation matrix among at least some of the variables. Therefore, the latent factors were significant to specific items of the research. Conclusion: It is concluded that important CSF is aligned with the strategic level influence of lean deployment in healthcare, which has a specific impact on certain sustainability performance. Thus, this paper proposed a generic preliminary framework to measure lean healthcare sustainability.
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@#Introduction: Hospital length of stay (LOS) is one of the measurable indicators which can be used to evaluate hospital administration, operative performance, and quality of patient care. Prolonged LOS has been associated with poor outcomes in patients and inefficient use of hospital resources. Due to the scarcity of findings in this field in Malaysia, this study aims to identify the factors affecting LOS. Methods: A single health facility-based retrospective cross-sectional study was conducted in Hospital Serdang. Data of patients admitted to the surgical ward from 2017 to 2021 were retrieved. Result: A total of 114 surgical patients’ data were analysed, of which most were adults (72.8%), female (69.3%) and Malay (67.5%). The mean LOS was 5.90 ± 4.35 days. Pearson correlation revealed age (r = 0.309, p = 0.001) and preoperative albumin (r = -0.397, p <0.001) having a significant correlation with LOS. An independent samples T-test showed that males had significantly higher mean LOS than females (t = 2.653, p = 0.009). Surprisingly, having been seen by dietitians and being supplemented by oral nutrition supplements (ONS) had longer stay compared to groups who were not seen by dietitians and given ONS respectively (t = 4.278, p<0.001), (t = 3.111, p = 0.002). Furthermore, those with a moderate and high risk of malnutrition spent approximately 3.27 days longer hospitalized than low-risk patients (t = -2.868, p = 0.007). Conclusion: Factors that influence LOS are age, gender, preoperative albumin, seen by a dietitian, risk of malnutrition and oral nutrition supplementation.
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@#Disaster risk reduction (DRR) plays essential roles in ensuring food security to avoid adverse social, economic and financial implications to the disaster victims. This article aims to review existing DRR strategies in food security during flood disasters and recommend strategies that can be adapted into policies in Malaysia according to the Sendai Framework. Sendai Framework provides comprehensive, globally recognized priority themes in DRR while highlighting governmental and stakeholders’ responsibility. A literature review was carried out by searching available published literatures from online databases and selected information used in this review is taken from articles, journals, reports, national reports, news, and thesis regarding the topic from November 2021 to January 2022. This review revealed that DRR strategies of food security during flood disasters in Malaysia lack one out of 14 work areas in four priorities in the Sendai Framework, which is the national-level risk and vulnerability assessment system and tools. This article proposed 19 recommendations to improve eight work areas across all four priority areas to enhance national food security during flood disasters.
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@#Objective To investigate the left ventricular reverse remodeling (LVRR) in patients with aortic valve insufficiency with reduced ejection fraction (AIrEF) and aortic valve insufficiency with preserved ejection fraction (AIpEF) after transcatheter aortic valve replacement (TAVR). Methods The clinical and follow-up data of patients who underwent TAVR in the Department of Cardiothoracic Surgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from 2018 to 2021 were retrospectively analyzed. According to the guideline, the patients with left ventricular ejection fraction<55% were allocated to an AIrEF group, and the patients with left ventricular ejection fraction≥55% were allocated to an AIpEF group. Results A total of 50 patients were enrolled. There were 19 patients in the AIrEF group, including 15 males and 4 females with a mean age of 74.5±7.1 years. There were 31 patients in the AIpEF group, including 19 males and 12 females with a mean age of 72.0±4.8 years. All patients underwent TAVR successfully. Echocardiographic results showed that TAVR significantly promoted LVRR in the patients. Significant LVRR occurred in the early postoperative period (the first day after the surgery) in both groups. It remained relatively stable after the LVRR in the early postoperative period (the first day after surgery) in the AIpEF patients, while it continued to occur in the early postoperative period (the first day after surgery) to three months after the surgery in the AIrEF patients, and then remained relatively stable. Compared to preoperative values, AIrEF patients had a reduction in the average left ventricular end-diastolic volume index and left ventricular end-systolic volume index by 16.8 mL/m2 (P=0.003) and 8.6 mL/m2 (P=0.005), respectively, and the average left ventricular end-diastolic diameter index and end-systolic diameter index decreased by 2.5 mm/m2 (P=0.003) and 1.9 mm/m2 (P=0.003), respectively on the first day after the surgery. In comparison to the first day after the surgery, AIrEF patients experienced an average increase of 12.1% in the left ventricular ejection fraction three months after the surgery (P<0.001). Conclusion TAVR has achieved good therapeutic effects in patients with aortic valve insufficiency, significantly promoting the LVRR in patients, and has better curative effects in AIrEF patients.
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@#Aim and design: This systematic review aimed to estimate the prevalence of online natural health products (NHPs) purchases among consumers. Data Sources: Four databases (PubMed, Science Direct, Scopus and Web of Sciences) were searched for articles published up to July 1, 2021. Review Method: Studies included were those reporting the prevalence of online NHPs purchases, those excluded were case reports, commentaries, letters, editorials, review articles, theses and non-English studies. The risk of bias of selected studies was assessed using the Joanna Briggs Institute’s checklist, and the pooled prevalence of online NHPs purchases was generated using the random-effect model. Results: A total of 30 studies were included in the meta-analysis, representing a total of 40,535 respondents. The pooled prevalence of online NHPs purchases was estimated at 7.60% (95% CI: 5.49, 10.01). Prevalence was higher in studies conducted in recent years, among physically active populations and when sports nutrition was included within the scope of NHPs. More than half of the selected studies have a moderate risk of bias, and considerable heterogeneity was observed across the selected studies. Conclusion and Impact: Online purchases of NHPs are not common among consumers, but they have become more common in recent years. A wide range of NHPs were investigated across studies, which may have contributed to the considerable heterogeneity reported in this review. It is suggested that future studies investigating online NHPs purchases consider reporting individual prevalence statistics specific to each NHP type, to facilitate meaningful comparisons between studies.
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@#Introduction: This study objectives were to evaluate the youth’s knowledge and awareness of reproductive health issues among the Hashemite University students and to measure the effectiveness of the interactive teaching approach in delivering the reproductive health knowledge course. Methods: Quantitative and qualitative research designs were used. The sample was 160 (two cohorts) undergraduate students who enrolled in the reproductive health course during two semesters at the Hashemite University. Quantitative data was collected from the students before and after receiving a reproductive health course. Qualitative data was collected through focus group discussions. Results: The study results showed an improvement in the reproductive health awareness level of students. There was a statistically significant increase in the total score of knowledge between the pretest (M = 19.97, SD = 3.89) and posttest (M = 21.65, SD = 4.03) for the first cohort at p =.00. There was a statistically significant increase in the total score of knowledge between pretest (M = 19.33, SD = 2.89) and posttest (M = 20.66, SD = 5.78) for the 2nd cohort at p =.00. Qualitative data revealed that the students were very interested in the reproductive health course and found it very useful for themselves, their families, friends, and society. Conclusion: The interactive learning approach was useful in teaching reproductive health course and increased university students’ awareness regarding reproductive health topics, which were important for students. It was recommended by students to teach reproductive health course to other students in all universities using interactive learning.
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Objective@#To explore the clinical application value of mixed reality technology in locating perforator vessels and assisting perforator vessel dissection to harvest anterolateral thigh flaps.@*Methods@#Six patients who needed anterolateral thigh flap repair after resection of oral and maxillofacial tumors were recruited from the Department of Oral and Maxillofacial Surgery of Nanchong Central Hospital from January 2020 to January 2021. Before surgery, the CT angiography data of the lower limbs of the patients carrying the calibration points were imported into the data workstation to perform 3D reconstruction of the perforator vessels and surrounding tissues of the thigh, and the reconstruction results were imported into Microsoft HoloLens 2 glasses. During the operation, calibration was performed at the calibration point of the operative area so that the preoperative reconstruction results were superimposed on the operative area through Microsoft HoloLens 2 glasses. The clinical application value of mixed reality technology assisted perforator vessel location and anatomy of anterolateral femoral perforator flap was discussed from six aspects: whether the perforator vessel was reconstructed preoperatively, intraoperative calibration time, whether the actual position of the perforating vessels passing through the fascia lata fulcrum deviated from the preoperative reconstruction result within 1 cm, time required to harvest the flap, and whether the actual route of the perforator vessel was consistent with the reconstruction result, and whether the postoperative flap survived.@*Results @# The position and course of perforating vessels were successfully reconstructed in 6 cases before the operation. The actual course of perforating vessels during the operation was consistent with the reconstruction results. The deviation between the actual position of the perforating points and the preoperative reconstruction results was within 1 cm, which met the requirements of the actual asisting of the anterolateral thigh flap. The average time of flap harvest was (70.50 ± 7.20) min. The average calibration time was (13.33 ± 5.50) min. All flaps survived.@* Conclusions @# Mixed reality technology projects the reconstruction results of anterolateral femoral perforator vessels directly into the operative area, which provides a new method for asisting localization and anatomy of anterolateral femoral flap perforator vessels and reduces the possibility of injury to perforator vessels.
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Background@#Periampullary malignancies traditionally occur during the later decades of life, but casual observations at the Philippine General Hospital (PGH) have shown more patients presenting at younger ages. Updates on the epidemiology and clinical features of these uncommon cancers may improve detection and result in better outcomes. @*Objective@#The study aimed to describe the current epidemiology of adult patients diagnosed with periampullary malignancies seen in the past five years at the PGH Department of Surgery. @*Methods@#Demographic and clinical data were obtained on patients with either pancreatic head, ampullary, distal bile duct, or duodenal cancer diagnosed from 2015 to 2019. Age and sex distributions, rates of symptom presentation, utilization of diagnostic modalities, and prevalence of comorbid conditions were analyzed per individual primary site and for the entire study population. @*Results@#Two hundred seventy-seven patients were included in the study, comprised mostly of pancreatic head cancers (56.32%) followed by ampullary (19.86%), duodenal (9.75%), and distal CBD cancers (7.58%). The mean age of presentation was 59.30 years. 33.94% of cases occurred in the 6th decade of life, while 24.91% of patients were aged 50 years and below. There was a nearly equal distribution by sex (50.90% female, 49.10% male). Majority of patients presented with jaundice (89.65%) and abdominal pain (71.64%). CT scan was used to diagnose 71.48% of patients. We observed a higher prevalence of diabetes mellitus (21.32%), biliary stone disease (19.12%), and smoking history (36.88%) in the study group compared to the general Philippine population. @*Conclusion@#The epidemiology of periampullary malignancies at UP-PGH showed a younger age at presentation and an equal sex ratio compared to published data. Distributions of the primary sites, symptom frequency, and rate of associated comorbidities were consistent with previous findings from the literature.
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EpidemiologyABSTRACT
Aims@#The rise of drug-resistant infectious diseases worldwide has spurred experts' interest in developing safe and effective alternative medicine. Melaleuca cajuputi extracts have been shown to exhibit antimicrobial activity in vitro against various bacterial species. This study evaluated the antimicrobial activity of local M. cajuputi leaf extracts (MCEs) against Candida albicans.@*Methodology and results@#Phytoconstituents of aqueous and ethanolic MCEs were screened conventionally using chemical tests. Broth microdilution assay and scanning electron microscope (SEM) were performed to study the anti-Candida activity of the extracts. Both MCEs contained terpenoids, phenols, flavonoids and tannins. Aqueous and ethanolic MCEs showed good fungicidal activity against the tested organism with minimum inhibitory concentration (MIC) values of 50 mg/mL and 25 mg/mL, respectively and a minimum fungicidal concentration (MFC) to MIC ratio of less or equal to 2. Scanning electron micrographs revealed yeast cell surface morphology alterations when treated with both MCEs at 1× MIC.@*Conclusion, significance and impact of study@#In conclusion, MCEs have anti-Candida properties and thus, M. cajuputi extract could be an excellent potential source of natural antimicrobial agents for disease remedies.
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Anti-Infective Agents , In Vitro Techniques , TreesABSTRACT
@#Introduction: Handgrip strength is a crucial biomarker of aging. Poor handgrip strength among hospitalized elderly increases the risk of health complications leading to a higher risk of hospital readmissions and mortality. This study aimed to determine handgrip strength among hospitalized elderly in Klang Valley hospitals alongside its associated factors. Methods: A total of 57 subjects were recruited for this study. Face-to-face interviews and physical assessments were conducted to obtain data on sociodemographic factors, medical background, anthropometry assessments and biochemical markers level. Dietary intake was obtained through two days of 24-hour dietary recall while tools such as Global Oral Health Assessment Index (GOHAI) and Mini Nutrition Assessment- Short Form (MNA-SF) were used to assess perception towards oral health and malnutrition risk, respectively. Reference value from the Asian Working Group of Sarcopenia (2014) was used to compare handgrip strength. Results: 94.7% of the subjects were found to have low handgrip strength with a mean value of 8.28 + 6.92 kg/force. Factors including age (r=- 0.370, p=0.005), educational level (r=0.471, p=<0.0005), perception towards oral health (r=0.370, p=0.005) and energy intake (r=0.367, p=0.005) were significantly associated with handgrip strength. Meanwhile, other variables were not significantly associated. Conclusion: The majority of the subjects had poor handgrip strength. Factors such as age, educational level, perception towards oral health and energy intake were significantly associated with handgrip strength while the rest were non-significantly associated. Thus, more research and intervention strategies should be done to improve handgrip strength among hospitalized elderly to achieve a healthy aging nation.