Dengue remains a public health threat that consumes a significant number of resources for its prevention and control. This systematic review aimed to solidify recent costing evidence in dengue management among South East Asian (SEA) countries. All studies conducted between 2010 and 2020 were retrieved using four international databases i.e. PubMed, Scopus, Web of Science, and Emerald Insight. The review was reported according to PRISMA guidelines. Quality assessments were done independently by two reviewers using a checklist adapted for the cost of illness studies. We identified 13 original articles representing several SEA countries. Among the common reported costing measure include total cost/ health expenditure; direct medical cost; direct non-medical cost; and indirect cost. The estimated total cost for dengue management varied between countries largely due to the difference in the total incidence of dengue cases. The estimated cost spent on dengue per capita GDP ranges from less than 0.001% to 0.1%, depending on the recorded number of dengue cases of the year. The majority of the articles focused on the economic burden from the perspective of treatment such as hospitalization and ambulatory care. In a nutshell, the economic burden of managing dengue infection is costly and the evidence suggests a steady increase in health expenditure with the growing number of dengue cases

Elderly abuse and neglect are among the primary public health problems linked to global demographic changes in the population, impacting not only the well-being of the elderly but also the growth of the nation or economy. This article discusses the effects of elder abuse and neglect on population health from the national and international perspectives through a narrative review of previously published articles on the concept of aging, the prevalence of elderly abuse and neglect, its risk factors and effects, and finally measures, legal perspectives, and recommendations to curb it. Interventions in Malaysia and selected nations, including Indonesia, South Korea, the United States, Australia, and Hong Kong, are examined. This issue is important as the majority of countries are moving toward being elderly populations. Improving global surveillance and the monitoring of instances is essential to inform policy actions to prevent elder abuse. In addition, a thorough assessment of the identified risk factors for violence and steps to prevent violence is required.

Introduction: Pushing and pulling activities are common in daily life and industrial workplaces. These activities are potentially contributing to muscle fatigue in the back and shoulder if not managed ergonomically. Therefore, this study aimed to quantify the maximum strength of Malaysian adults in horizontal symmetrical two-handed pushing and pulling with different handle heights and stances. Methods: Forty-seven participants of 24 males and 23 females were recruited in pushing and pulling experiments. The participants were assistant engineers and postgraduate students of a technical university. The dependent variable was the magnitude of push/ pull force. The independent variables consisted of action, handle height and stances. The experimental design was set for 2 actions, 3 handle heights and 2 stances, yielding 12 variables combinations. Results: Key findings of this study revealed that combination of pull action, handle height at elbow level and staggered stance exhibited greatest force. On the contrary, combination of push action, handle height at knuckle level and parallel stance resulted in lowest force. In pushing test, both male and female participants obtained greatest force of 233.3 N and 121.7 N, respectively, when the handle height was at elbow level and staggered stance. Similarly, in pulling test, males and females obtained highest force of 242.9 N and 152.4 N, respectively. Conclusion: This study concluded that handle height at elbow level and staggered stance exhibited greatest force in pushing and pulling activities. This study provides information to individuals who involved in pushing and pulling tasks with least force exertion to minimize muscle fatigue in the back and shoulder. Future studies should consider the following recommendations: 1) Participants of study should involve manufacturing industry workers. 2) To study the effect of pushing and pulling tasks on muscle activity.

It is believed that exposure to whole-body vibration (WBV) may increase seated occupant drowsiness and seated. The purpose of this paper is to investigate the strength of the hand grip among the young adults in Malaysia. Also, to examine the correlation between anthropometry factors such as hand length (HL), hand breadth (HB), wrist circumference (WC) and body mass index (BMI) with average full hand grip strength of young adults. 40 Malaysian young adults with equal females and males and the range age of 23 to 28 years old voluntarily basis participated in this study. Three experiments were conducted in sitting position according to American Standard Hand Therapist (ASHT) with 45º, 90o and 135o of hand flexion using dynamometer. The results show the significant different full hand grip strength between Malaysian young adult females and females, the difference full hand grip strength for different hand flexion angles in sitting position and difference correlations between anthropometry factors and full hand grip strength for both young adult males and females.

Spontaneous pneumothorax and pneumomediastinum is defined as presence of free air or gas in the pleural cavity and mediastinal structures respectively. Spontaneous pneumothorax seems to be associated with anatomical abnormalities such as subpleural blebs or bullae, however not for spontaneous pneumomediastinum which may developed without an apparent precipitating cause. Both usually may occur in young healthy adults without serious underlying lung disease. We report a case of spontaneous pneumothorax and pneumomediastinum after a trivial injury. He was initially presented with dyspnea after two weeks of initial trivial trauma. Chest radiograph showed left apical pneumothorax with pneumomediastinum with no evidence of rib fracture. His condition was deemed non-traumatic by surgical colleague, thus admitted to medical ward for observation and eventually discharged well.

Introduction: The causes of congenital hypothyroidism (CHT) are thyroid dysgenesis (TD), dyshormonogenesis (TDH) or transient hypothyroidism (TH). Methodology: This is a cross-sectional study looking at data over a period of 16 years (2000-2016). Confirmed cases had thyroid scan at the age of 3-years-old and repeated TFT (after 6 weeks off medications). Relevant data was collected retrospectively. Results: Forty (60% female) children with CHT were included in the study. Thirty (75%) children presented with high cord TSH. Nine (23%) presented after 2 weeks of life. Majority were diagnosed with TDH (42.5%) with TD and TH of 40% and 17.5% respectively. Median cord TSH of children with TD was significantly higher compared to TDH and TH (p=0.028 and p=0.001 respectively). L-thyroxine doses were not significantly different between TD, TDH and TH at diagnosis or at 3 years. Conclusions TDH is highly prevalent in our population. TD may present after 2 weeks of life. One in five children treated for CHT had TH. Differentiating TD, TDH and TH before initiating treatment remains a challenge in Malaysia. This study provides clinicians practical information needed to understand the possible aetiologies from a patient’s clinical presentation, biochemical markers and treatment regime. Reassessing TH cases may be warranted to prevent unnecessary treatment.
Thyroid Dysgenesis ; Thyroxine

The Asian Society of Gynecologic Oncology International Workshop 2018 on gynecologic oncology was held in the Ajou University Hospital, Suwon, Korea on the 24th to 25th August 2018. The workshop was an opportunity for Asian doctors to discuss the latest findings of gynecologic cancer, including cervical, ovarian, and endometrial cancers, as well as the future of fertility-sparing treatments, minimally invasive/radical/debulking surgery, radiotherapy, chemotherapy, targeted therapy, and immunotherapy. Clinical guidelines and position statement of Asian countries were presented by experts. Asian clinical trials for gynecologic cancers were reviewed and experts emphasized the point that original Asian study is beneficial for Asian patients. In Junior session, young gynecologic oncologists presented their latest research on gynecologic cancers.
Antineoplastic Agents ; Asian Continental Ancestry Group ; Drug Therapy ; Education ; Endometrial Neoplasms ; Female ; Gyeonggi-do ; Humans ; Immunotherapy ; Korea ; Ovarian Neoplasms ; Radiotherapy ; Uterine Cervical Neoplasms

Marital satisfaction is vital to the wellbeing and functioning of the individual and family. Marital dissatisfaction can lead to detrimental effects on mental, physical and family health. The study aimed to determine the proportion of marital dissatisfaction in outpatient setting and its association with sexual functioning and psychiatric morbidity in Kuala Lumpur, Malaysia. Materials & Methods: A crosssectional study was conducted in selected primary care using purposive sampling. Data collection was done using socio-demographic questionnaire and several validated Malay version of self-administered questionnaires. Marital satisfaction was measured by the Malay version of Golombok–Rust Inventory of Marital State (Mal-GRIMS). Results: The prevalence of marriage dissatisfaction in sample population was about 37.3% with almost equal prevalence in both, 36.5% (male) and 37.8% (female). Using a regression analysis, the significant factors that affect marital dissatisfaction were respondent’s age group between 31- 40 years old (Adjusted Odds Ratio, AOR. =11.4, 95% Confidence Interval, CI. =1.2-110.9), spouse’s salary of RM1000-RM2000 (lower income category) (AOR=7.3, 95% CI= 1.9-28.1), anxiety case (AOR= 4.8, 95% CI=1.1- 21.5), depression case (AOR= 4.8, 95% CI=1.0-22.8), female sexual dysfunction in term of arousal function (AOR= 0.01, 95% CI=0.0-0.7), satisfaction dysfunction (AOR= 9.4, 95% CI= 1.5-58) and pain function (AOR=43.7, 95% CI=1.28 - 1489.2). Conclusion: Marital dissatisfaction can be influenced by financial factor, sexual dysfunction and presence of psychiatric morbidity. Hence, in management of marital discord, thorough screening of these factors should be prioritized in clinical setting.

Objective: Several cases of suicide attempt by charcoal burning producing CO have been reported in Malaysia. This case report highlights a case of delayed delayed neuropsychiatry sequelae (DNS) in CO poisoning. Method: We report a young Chinese homemaker who presented with DNS who was detained in a Malaysian forensic psychiatric ward. Results: After approximately two weeks of admission, in a familicide attempt, she had started to exhibit subtle changes in her behaviour, including social withdrawal, impaired memory, and there was lack of emotional distress. Conclusion: We report an interesting DNS as one of the two forms of chronic sequelae of CO poisoning, whereas the other type of neuropsychiatric sequelae is the persistently progressive type.

Objective: This case report highlights the success of community services and supported employment program that may be of help to a woman with chronic inhalant use to achieve a complete abstinence. Methods: We report the case of a 45 year old lady who chronically abused glue, presented after 10 years with substance induced psychosis and comorbid mood disorder. Results: Abstinent from inhalant dependence was achieved after series of home treatment services and supported employment program. Conclusion: Provision of acute community service and incorporating this patient in supported employment program contribute to her successful journey in achieving abstinence from inhalant dependence.