Breast cancer is ranked number one from the ten most frequent cancers in female, Peninsular Malaysia. Various studies provide negative evidence on malignancies and one of the end results is impaired quality of life (QOL). Studies show lifestyle approaches are key factors in enhancing the QOL among cancer survivors. The purpose of this study is to describe the lifestyle practices (LP) among breast cancer survivors (BCS) which consist of dietary intake, exercise habits, and stress management and to determine whether these practices have influence on the QOL among Malaysian BCS. This study adopts a cross-sectional study design using a self-administered questionnaire. A total of 280 BCS from public and private hospitals throughout Peninsular Malaysia had participated. The questionnaire covers QOL and LP items which consist of dietary intake (consumption of high-fat food, high-fibre food, fruits and vegetables), exercise habits, and stress management. Descriptive statistics and one-way ANOVA were used to determine the relationship between LP and QOL. Mean age of the study sample was at 41 (SD=7.37). Majority of them were Malay (74%), 53% were diagnosed with breast cancer between 1 to 2 years whereas 54% were presented with stage 2 at diagnosis. There was a statistically significant difference (p< 0.05) in the overall quality of life score for the three LP groups (Better, No change, Worse). Malaysians’ BCS reported an improvement in LP and the enhancement in LP may result to better QOL outcomes.
Life Style ; Quality of Life ; Breast Neoplasms ; Survivors

This study investigates work engagement of employed breast cancer survivors in comparison to unmatched control samples of healthy working women without cancer and any other chronic diseases from the general population. A case-control study design using unmatched controls was adopted in this study. The case comprised of 80 female breast cancer survivors who have returned to full-time employment selected using purposive sampling technique. Meanwhile, controls were 88 healthy female working women in full time paid employment, selected using quota sampling. Questionnaire covering socio-demographic characteristics and self-rated work engagement measured using Utrecht Work Engagement Scale (UWES) was distributed to the cancer survivors through face-to-face meeting during their hospital visits. For the healthy controls the questionnaires were distributed using drop-and-collect method through the human resource personnel of the participating organization. The results revealed, after controlling for age, marital status, ethnic group and tenure with organization, no significant differences in the overall work engagement was found between the breast cancer survivors [mean (SD) = 4.66 (0.92)] and the healthy controls [mean (SD) = 4.75 (0.85)]; F(1, 163) =1.70. In comparison to the work engagement domains, only the Vigor domain was found to be significantly lower for the survivors, survivors [F (1, 163) =14.94; p<.001] compared to healthy controls. However, the effect size was small (2= 0.004). No significant difference was found in the mean absorption and dedication domain scores. The findings suggest, except for vigor domain, work engagement of breast cancer survivors who have returned to work do not differ from individuals without cancer.​
Breast Neoplasms ; Survivors ; Work

Introduction: Ultraviolet (UV) A is the longest wavelength of UV radiation, accounts for approximately 95% of the radiation reaching the earth's surface. It can penetrate deeply into the skin layer and able to induce photoaging and photocarcinogenesis through the activation of reactive oxygen species (ROS). Polysaccharides-containing Pleurotus flabellatus (known as a pink oyster mushroom) has antioxidative properties and may inhibit free radical activities generated from UV radiation. Hence, this present study was to evaluate the antioxidative and photoprotective properties of exopolysaccharides (ExPFE) and exopolysaccharides (EnPFE) of Pleurotus flabellatus extracts on UVA irradiated human dermal fibroblast (HS-27) cell line. Methods: The antioxidant level of ExPFE and EnPFE was determined using 1,1-Diphenyl-2-picrylhydrazyl (DPPH) scavenging assay, while both cytotoxicity and photoprotective effects of the extracts on the HS-27 cell line were determined using CellTiter-Blue® cell viability assay. The effects of ExPFE and EnPFE on the HS-27 cell migration was evaluated using the scratch assay. Results: Both ExPFE and EnPFE exhibited respectable antioxidant and scavenging activity in DPPH. The extracts also demonstrated a non-cytotoxicity, but photoprotective effects to the HS-27 cells by increasing the percentage of cell viability and enhancing cell migration activity upon UVA exposure. Conclusion: The ExPFE and EnPFE exhibit antioxidative and photoprotective effects on UVA irradiated HS-27 cell line. This study suggests that pink oyster polysaccharides could be a potential natural bioactive compound for skin protection against UVA radiation.

Introduction: The COVID-19 pandemic significantly impacted the global teaching and learning process (TnL). Unfortunately, to date, not many qualitative studies have been published specifically on the impact of COVID-19 on the Family Medicine course, particularly in Malaysia. Hence, this study aimed to explore the impact of COVID-19 pandemic on the teaching and learning experience of undergraduate students undergoing their Family Medicine course at a local university. Methods: A qualitative study using focused group discussion (FGD), was conducted among undergraduate students during the lockdown period. A semi-structured interview guide was used to interview 20 students, in their fifth undergraduate year, undertaking their fourth to fifth week of a total six-week course. They were selected using purposive snowball sampling method. There were four focus group discussions (FGD) with five students in a group. All interviews were audio-taped, transcribed verbatim, and the contents were analysed using the standard content analysis framework. Subsequently, thematic content analysis was conducted, and three major themes were produced. Results: The three major themes were (1) facilitators to learning, (2) barriers to learning, and (3) rooms for improvement. Conclusion: Although COVID-19 pandemic had significant impact on TnL of Family Medicine course among undergraduates, the students remained optimistic and proposed some improvement from their point of view. However, a creative, realistic, effective, and impactful way of TnL, particularly in clinical aspects should be developed and experimented. Technological progress and advancement should permit this idea to be achievable and implemented in near future.

Pandemic fatigue encompasses exhaustion, emotional strain, and decreased motivation due to prolonged pandemic effects. This scoping review examines pandemic fatigue issues related to COVID-19, aiming to suggest effective management strategies. We assessed 2,558 records from 1st of December 2019 until 27th of March 2022 in PubMed, Science Direct, ProQuest, and ClinicalKey. Following Arksey and O’Malley (2005) and PRISMA-ScR principles, we selected 31 studies including research papers employing either quantitative or qualitative methods and editorials and other summary articles after excluding redundant and irrelevant works. The authors provide six critical answers to understand better and manage pandemic fatigue, including the need for more research and support, the collaboration between key stakeholders and the community, and the use of information to address pandemic fatigue. The review found that pandemic fatigue is prevalent among certain groups, such as students and healthcare workers. Factors contributing to pandemic fatigue include age, gender, high perceived severity of COVID-19, low trust in government or health organizations, and low social connectedness. The review also identified an instrument, the COVID-19 Pandemic Fatigue Scale, that can be used to measure pandemic fatigue. The review concluded that identifying pandemic fatigue as early as possible is absolutely important and people and their government should work together to handle the fatigue. Many countries have acknowledged the presence hence manage it differently. Nonetheless the strategy suggested by WHO has provided an excellent framework to tackle the pandemic fatigue.

Introduction: Intravenous thrombolysis (IVT) is the gold standard for the treatment of patients with acute ischemic stroke (AIS) presenting within four and a half hours of onset. However, development of new thrombolytic agents and advanced imaging has led to extended time for thrombolysis based on advanced imaging. Here we describe four patients who presented in the extended hours; that benefitted from thrombolysis. Case series: We advocate magnetic resonance imaging (MRI) for AIS, that includes diffusion weighted imaging (DWI), apparent diffusion coefficient (ADC), fluid attenuated inversion recovery (FLAIR), susceptibility weighted imaging (SWI), and magnetic resonance angiography (MRA). We included four patients who were more than 18 years old, with National Institute of Health Stroke Scale (NIHSS) of six or more, presenting between four and a half to nine hours after stroke onset with no contraindications for intravenous thrombolysis. The imaging criteria used to determine eligibility for IVT is evidence of DWI-FLAIR mismatch on MRI. If FLAIR detects no signal change in the area of stroke on DWI, it is then termed DWIFLAIR mismatch, or FLAIR-negative – indicating high probability that the brain tissue is still viable, and that patients are good candidates for IVT. Conclusion: For patients with AIS who present within nine hours, DWI-FLAIR mismatch serves as an excellent surrogate marker of salvageable brain tissue, allowing a greater proportion of patients benefiting from this life-saving therapy. Our experience also shows that with careful patient selection, treatment with IVT can safely be given without an increased risk of bleeding or mortality.

Stroke care service in Malaysia is suboptimal despite the fact that it is one of the commonest cause of death. This is due to several limitations, including lack of resources and funding for the stroke care establishment and the management itself. Alternatively, other regions have come up with numerous ways to combat the difficulties in order to provide better stroke care services. We have identified the overwhelming benefits of creating stroke care units, thrombolysis services, and endovascular thrombectomy. For this reason, we designed a Regional Emergency Stroke Quick Response Network (RESQ) based on the needs of the current situation in Malaysia. With a standardised RESQ training, we hope to achieve close-knitted cooperation in between the emergency medical services, emergency department team and the RESQ, which subsequently will create an ideal improvised stroke care units.