Introduction: Adequacy of fruit intake contributes to an individual’s health including reducing the risk of non-communicable disease. This study aimed to assess consumption of fruits in various forms and to determine associated factors and barriers. Methods: In this cross-sectional study, a total of 300 adults aged 20-39 years were purposely recruited from several urban locations in the Klang Valley. Consumption of fruits in the past 12 months was assessed using a selfadministered food frequency questionnaire (FFQ), assisted with pictures of serving size of fruits. Anthropometric measurements were taken and body mass index and waist circumference computed. Results: Fruit intake among young adults was lower (1.6±1.0 servings/day) than the Malaysian Dietary Guideline 2010 of ≥ 2 servings/day. Only 32.3% consumed fruits as recommended, with women consuming significantly more fruits than men. Preferred fresh fruits were red apple, banana and papaya. Consumption of fruit juice was associated with increase in waist circumference (R2=0.261, p=0.027) after adjustment for age, sex, ethnicity, education level and marital status. Fruit intake showed no significant association with other anthropometric measurements. Sensory appeal, perceived health benefit, easy to prepare and influence of family were the main determinants of fruit intake, whilst affordability and availability were the major barriers. Conclusion: Fruit consumption among young adults in this study was lower than the recommendation for daily fruit intake. Studies with larger sample size are suggested to verify the finding of significant association between fruit juice consumption and risk of abdominal obesity.

Background：In September 2012, 10 cases suspected to be hepatitis A were notified to the Manjung District Health Department. An investigation was conducted to identify the possible mode of transmission, source of the outbreak and to recommend prevention and control measures.Methods：A case was a person with acute illness with discrete onset of symptoms and jaundice or elevated serum aminotransferase levels in September 2012 in the Manjung District. We conducted a case-control study and environmental assessments of processing plants and food premises.Results：There were 78 confirmed cases of hepatitis A; an attack rate of 3.1 per 10 000 population. Multiple logistic regression showed that being male (odds ratio [OR]: 18.4 [5.13–65.9]; P < 0.001) and drinking toddy at processing place A (Adjusted OR: 2.70 [1.17–6.25]; P < 0.05) were associated with being a case. Environmental investigations of this and one other processing place found them to be unhygienic, and the pH of the toddy was at levels that encouraged growth of hepatitis A virus.Conclusion：Toddy was possibly the primary source of this outbreak based on both epidemiological and environmental results. Both toddy preparation places and several food premises were closed as a result of this investigation.

During haze, at what level should Air Pollutant Index (API) showed, public or private school be closed is not without controversy and is very much debated. Therefore, the aim of this paper is to objectively quantify the potential inhaled dose of PM10 associated with exposure at school and home microenvironments during haze. The result of the health risk assessment will be used to propose the API level for closing the school during haze episode. A hypothetical haze exposure scenario was created using the breakpoints of PM10 concentration for calculation of API and respective inhaled dose during haze. To determine the potential inhaled dose, we have considered many factors that include time spent for specific physical intensity at school and home microenvironments, age-specific and physical intensity-specific inhalation rate (m3/min), and the indoor/outdoor ratio of PM10. To calculate risk quotient (RQ), the inhaled dose was compared with the health reference dose computed based on the concentration of PM10 in the Malaysian Ambient Air Quality Standard. When considering the specific exposure at each microenvironment (school and home), the potential inhaled dose of PM10 was substantially lower when school is closed for both primary and secondary school. The calculated risk quotient (RQ) indicates that primary school children are likely to be affected at slightly lower PM10 concentration (equivalent to API of 197) as compared to secondary school children. Short duration of high physical activity intensity during school breaks has contributed to a large proportion of inhaled dose among school children indicating the important to avoid physical activities during haze. Based on the assessment, taking into account the uncertainty of risk assessment methodology, we proposed school to be closed when API reach 190 for both primary and secondary schools. These findings and recommendations are only valid for naturally ventilated school and applicable in the context of the current API calculation system and the existing Recommended Air Quality Guideline values in Malaysia. ​

Bauxite mining is not known to most Malaysian except recently due to environmental pollution issues in Kuantan, Pahang. Potential impacts are expected to go beyond physical environment and physical illness if the situation is not controlled. Loss of economic potentials, and the presence of unpleasant red dust causing mental distress, anger and community outrage. More studies are needed to associate it with chronic physical illness. While evidences are vital for action, merely waiting for a disease to occur is a sign of failure in prevention. All responsible agencies should focus on a wider aspect of health determinants rather than merely on the occurrence of diseases to act and the need to emphasize on sustainable mining to ensure health of people is not compromised.

Introduction: This study aimed to identify dietary patterns (DPs) and their association with successful aging (SA). Methods: A comparative cross-sectional study was conducted among 579 elderly subjects recruited from four states in Malaysia through a multistage random sampling method. SA was defined as having no chronic illnesses, no functional limitation, normal global function, no depression, a good quality of life and good self-perceived health. Information on dietary intake was obtained using a diet history questionnaire. Cognitive functions were assessed using the Mini Mental State Examination (MMSE), depressive symptoms using Geriatric Depression Score-15 items (GDS-15) and a question regarding their perceived health and quality of life. Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) questionnaires were used to determine functional status. DPs were obtained using the principal component analysis (PCA) approach. An ordinal logistic regression model was used to examine associations between DP scores and SA. Results: Five DPs were identified namely ‘sweet foods-beverages’, ‘meat-vegetablesrice and noodles’, ‘local snacks-fish and seafood-high salt foods’, ‘fruits-legumes’, and ‘tropical fruits-oats’. A higher score for ‘tropical fruits-oats’ DP was associated with SA [Adjusted OR=1.59 (95% CI: 1.08-2.32)]. However, the association diminished when the model was adjusted for education level. Further analysis indicated that this DP increased the chance of SA among those with secondary education and above [Adjusted OR=2.43 (95% CI: 1.09–5.42)]. Conclusion: Tropical fruits-oats’ DP is associated with SA among elderly with secondary education and above. There is a need to investigate DPs among those with lower education.

The aim of this cross sectional case control study was to examine the serofrequency and serointensity of Toxoplasma gondii (Tg) IgG, IgM, and DNA among patients with schizophrenia. A total of 101 patients with schizophrenia and 55 healthy controls from Sungai Buloh Hospital, Selangor, Malaysia and University Malaya Medical Center (UMMC) were included in this study. The diagnosis of schizophrenia was made based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). The presence of Tg infection was examined using both indirect (ELISA) and direct (quantitative real-time PCR) detection methods by measuring Tg IgG and IgM and DNA, respectively. The serofrequency of Tg IgG antibodies (51.5%, 52/101) and DNA (32.67%, 33/101) among patients with schizophrenia was significantly higher than IgG (18.2%, 10/55) and DNA (3.64%, 2/55) of the controls (IgG, P=0.000, OD=4.8, CI=2.2-10.5; DNA, P=0.000, OD=12.9, CI=2.17-10.51). However, the Tg IgM antibody between patients with schizophrenia and controls was not significant (P>0.005). There was no significant difference (P>0.005) in both serointensity of Tg IgG and DNA between patients with schizophrenia and controls. These findings have further demonstrated the strong association between the active Tg infection and schizophrenia.
Adolescent ; Adult ; Aged ; Antibodies, Protozoan/*blood ; Case-Control Studies ; Cross-Sectional Studies ; DNA, Protozoan/*blood ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Immunoglobulin G/blood ; Immunoglobulin M/blood ; Malaysia ; Male ; Middle Aged ; Real-Time Polymerase Chain Reaction ; Schizophrenia/*complications ; Seroepidemiologic Studies ; Toxoplasma/classification/genetics/immunology/*isolation & purification ; Toxoplasmosis/*epidemiology/immunology/*parasitology ; Young Adult

The aim of this cross sectional case control study was to examine the serofrequency and serointensity of Toxoplasma gondii (Tg) IgG, IgM, and DNA among patients with schizophrenia. A total of 101 patients with schizophrenia and 55 healthy controls from Sungai Buloh Hospital, Selangor, Malaysia and University Malaya Medical Center (UMMC) were included in this study. The diagnosis of schizophrenia was made based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). The presence of Tg infection was examined using both indirect (ELISA) and direct (quantitative real-time PCR) detection methods by measuring Tg IgG and IgM and DNA, respectively. The serofrequency of Tg IgG antibodies (51.5%, 52/101) and DNA (32.67%, 33/101) among patients with schizophrenia was significantly higher than IgG (18.2%, 10/55) and DNA (3.64%, 2/55) of the controls (IgG, P=0.000, OD=4.8, CI=2.2-10.5; DNA, P=0.000, OD=12.9, CI=2.17-10.51). However, the Tg IgM antibody between patients with schizophrenia and controls was not significant (P>0.005). There was no significant difference (P>0.005) in both serointensity of Tg IgG and DNA between patients with schizophrenia and controls. These findings have further demonstrated the strong association between the active Tg infection and schizophrenia.
Adolescent ; Adult ; Aged ; Antibodies, Protozoan/*blood ; Case-Control Studies ; Cross-Sectional Studies ; DNA, Protozoan/*blood ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Immunoglobulin G/blood ; Immunoglobulin M/blood ; Malaysia ; Male ; Middle Aged ; Real-Time Polymerase Chain Reaction ; Schizophrenia/*complications ; Seroepidemiologic Studies ; Toxoplasma/classification/genetics/immunology/*isolation & purification ; Toxoplasmosis/*epidemiology/immunology/*parasitology ; Young Adult

Pulmonary hydatid cyst (PHC) in pregnancy is a very rare pathology. We report here a case of ruptured PHC during pregnancy in a 26-year old Syrian (refugee) woman who presented with complaints of productive cough with metallic taste and dyspnoea. PHC was suspected due to her clinical and radiological findings. Interestingly, the sputum examination confirmed the diagnosis as numerous protoscoleces were present. Serology for Echinococcus infection revealed positive at high titre. Early diagnosis and prompt treatment by providing care improves the patient outcome. Parasitological examination of the respiratory specimen in suspected ruptured PHC is desirable as a valuable detection tool.

Introduction: Diabetic foot infection is often associated with high morbidity, disability and poor quality of life. This study focuses on the demography, the number of repetitive surgery and length of stay in hospital of patients with diabetic foot infection. Method: This is a retrospective observational study. Patients who were admitted to the Orthopaedic ward of Hospital Segamat (HS), Johor, Malaysia from January 2016 to December 2018 and required surgical intervention were included in the study. Data was collected from the computer system of HS and medical notes of patients. Results: 35.6% of the total orthopaedic emergency surgeries performed were for patients with diabetic foot infection, 25% of the surgical procedures performed were major amputations of lower limb and 40% of the patients with diabetic foot infection required more than one surgical operation. Discussion: The demographics of the patients is consistent with the demographics of Malaysia where majority of them are Malays followed by Chinese, Indians and others. Despite being only 10% of total admission to the department, this group of patients contributed to 35.6% of the total emergency surgeries performed. The amputation rate in the centre is comparable to the other local studies. The average length of stay in hospital was found to be shorter compared to overseas due to different rehabilitation protocols.

Clinacanthus nutans Lindau is known as snake grass belonging to the Acanthaceae family. This plant has diverse and potential medicinal uses in traditional herbal medicine for treating skin rashes, insects and snake bites, lesions caused by herpes simplex virus, diabetes, and gout in Malaysia, Indonesia, Thailand and China. Phytochemical investigations documented the varied contents of bioactive compounds from this plant namely flavonoids, glycosides, glycoglycerolipids, cerebrosides and monoacylmonogalatosylglycerol. The pharmacological experiment proved that various types of extracts and pure compounds from this species exhibited a broad range of biological properties such as anti-inflammatory, antiviral, antioxidant, and anti-diabetic activities. The findings of toxicity study showed that extracts from this plant did not show any toxicity thus it can be used as strong therapeutic agents for specific diseased conditions. However, further experiments on chemical components and their mode of action showing biological activities are required to elucidate the complete phytochemical profile and assess to confirm their suitability for future drugs. This review summarizes the medicinal uses, phytochemistry and pharmacology of this plant in order to explore its therapeutic potential and gaps necessitating for prospected research work.