The aim of this review was to document the recently reported prevalence and risk factors for chronic obstructive pulmonary disease (COPD) in the last ten years. A scoping review of studies released between 2011 and 2021 was done. The main findings on selected studies’ prevalence and risk factors were summarised. Thirty-seven studies in total were chosen. The overall data on COPD prevalence was 1.3-36.7%, and the average incidence rate was 9.1%. The risk factors of COPD prevalence were identified as unchangeable risk factors (gender, age, family history of respiratory and cardiovascular disease, high blood pressure, and environmental temperature and humidity) and changeable risk factors (outdoor and indoor air pollution, cigarette smoking, occupational exposure, low education, low household income, obesity, underweight, physical inactivity, and cooking method). The highest changeable risk factors were cigarette smoking, indoor air pollution, and occupational exposure. In contrast, the lowest changeable risk factors were physical inactivity and cooking methods. Changeable risk factors significantly increase COPD risks. The COPD caused by household emissions from biofuel cooking in low-income rural areas deserves attention. Emphasis on healthy lifestyle interventions and economic and educational policies to reduce environmental impacts may prevent COPD.

Background: Oxidative damage culminates in diabetic macrovascular complication. Ethanolic extract propolis of Heterotrigona itama exhibits antioxidative, antidiabetic and cardioprotective properties. However, vasoprotective activity has yet to be reported. This research was designed to investigate the effects of the ethanolic extract of propolis on histology and oxidative stress parameters in the aorta of diabetic rats. Methods: Raw propolis from Kelantan bee farm was ground, dissolved and distilled with ethanol into crude extract. Adult male Sprague Dawley rats were divided into four groups, n=8/group: normoglycemia (NG), untreated diabetes (DM), metformin-treated diabetes (DM+M, 300 mg/kg/day) and propolis-treated diabetes (DM+P, 300 mg/kg/day). A single injection of intraperitoneal streptozotocin (60 mg/kg) was used to induce diabetes mellitus, followed by a four-week treatment, via oral gavage, administered immediately after successful diabetes-induction with evidence of hyperglycaemia. Both NG and DM groups were given one millilitre of the vehicle. Rats were sacrificed at the end of the experiment; blood was collected for determination of serum lipid profile; the aorta was fixed and processed for histomorphology and histomorphometry evaluation; aortic tissue homogenate assay for oxidant/antioxidant activities. Differences in the parameters between groups were analysed using one-way analysis of variance (ANOVA) with post-hoc adjustment. Reults: Propolis treatment elevated the high-density lipoprotein level and suppressed protein oxidation in diabetic rats. Furthermore, propolis halted the thickening of tunica intima and aberrant proliferation of vascular smooth muscle cells in tunica media. Conclusion In conclusion, this proof-of-concept study indicated the potential of propolis as a vasoprotective agent against the early pathogenesis of diabetic macroangiopathy through anti-oxidative and anti- hyperglycaemic activities.
Antioxidants

COVID-19 is a highly contagious disease that caused a worldwide pandemic in 2020. Medical students are public advocates for COVID-19 vaccination to achieve herd immunity. Our objective is to ascertain the level of knowledge, attitude, and practice toward COVID-19 immunisation among medical students in Malaysia. The online study included four public universities in Peninsular Malaysia: Universiti Putra Malaysia, International Islamic University Malaysia, Universiti Sains Malaysia and Universiti Sains Islam Malaysia. Data collected include sociodemographic characteristics, history of COVID-19 infection, knowledge, attitude and practice towards COVID-19 immunisation. Analytical statistics were analysed with IBM Statistical Package Statistical Package for the Social Science (SPSS) v27.0 using Pearson chi-square or Fisher’s exact test (significant if p < 0.05). From the total of 427 respondents, 60.2% had good knowledge whereby clinical students 67.0% had a higher proportion of good knowledge as compared to preclinical students 53.5% (p = 0.004). Respondents in the age group of 21 to 24 years old (p < 0.001) and 25 to 29 years old (p = 0.016), and Indian ethnicity (p = 0.006) were more likely to have good knowledge. Respondents registered in Malaysia’s National COVID-19 vaccination program were considered as having a positive attitude (n = 264, 61.8%). A vaccination rate of 100% was observed. In conclusion, 60.2% of medical students had good knowledge, 61.8% had a positive attitude and 100% were vaccinated in these four public medical schools in Malaysia. Sociodemographic factors (age group and Indian ethnicity) have an association with only good knowledge but none with the level of attitude and practice towards COVID-19 immunisation.
COVID-19