Identification of the stages of smoking cessation among smokers is essential to improve the rate of smoking cessation. The aims of this study were to determine the prevalence and factors associated with stages of smoking cessation across the demographic distribution of adult smokers in Malaysia. Data were derived from a population-based study among Malaysian adults aged 18 years and above. Face-to-face interviews were carried out by trained staff using a validated questionnaire to obtain data related to smoking from 4,288 selected respondents. Of 4,288, 438 respondents are current smokers. Multivariable logistic regression analysis was used to determine factors associated with stage of smoking cessation. Approximately 60% (n=269/438) of the current smokers were in the pre-contemplation stage and 40% (n=169/438) were in the contemplation and preparation stages of smoking cessation. The proportion of pre-contemplators was higher among smokers with higher levels of nicotine addiction (71.3%), lower education attainment (71.4%), and those who were single/widowed/divorced (66.9%). Multivariable analysis showed that males, and those who reported low to high level of nicotine addiction were more likely to be in the pre-contemplation stage whilst those in the older age groups were more likely to be in the advanced stage of smoking cessation. The study revealed that the majority of current smokers in Malaysia had no intention to quit smoking within 6 months. Specific interventions targeting males, young adults and smokers with low to high nicotine addiction should be introduced to ensure the smokers proceed to the advanced stage of smoking cessation.

Aims: The objective of this study is to investigate the potential of fungi isolated from forest soil as biocontrol against Ganoderma boninense, the causal pathogen of basal stem rot disease in Elaeis guineensis Jacq. (oil palm). Methodology and results: Total 195 isolates were isolated from 20 soil samples collected from Crocker Range of Sabah and 54 fungal isolates were identified with 14 of them showed Percentage Inhibition of Radial Growth (PIRG) greater than 50%. A potential fungi (F15) with PIRG of 84.85% was later identified as Penicillium simplicissimum using molecular technique. Microscopy examination on P. simplicissimum and G. boninense interaction showed the evidence on the damage of pathogen hyphae when challenged by P. simplicissimum. The secondary metabolites of P. simplicissimum which may possibly contribute to this observation were later extracted using hexane, ethyl acetate and acetone and the extracts were tested in agar dilution bioassay (0.2 mg/mL to 1.0 mg/mL) against the pathogen. Ethyl acetate extract gave the highest inhibition to G. boninense (14.12 % in 0.4 mg/mL of ethyl acetate extract). Conclusion, significance and impact of study This is the first report, on the bioactivity of P. simplicissimum isolated from Crocker Range of Sabah against Ganoderma boninense, the causal pathogen of basal stem rot disease. Overall, our results indicated that P. simplicissimum has the potential to be further investigated as a biocontrol agent against G. boninense.

Introduction: Adolescents are the future generation, and their support for smoke-free policies might create momentum for future stringent smoke-free initiatives. This study aimed to determine the levels and factors associated with support for smoking in public areas among Malaysian school-going adolescents aged 10-19 years Methods: The data were derived from the Tobacco and E-cigarettes among adolescents in Malaysia (TECMA), which employed the cross-sectional study design and multistage sampling to select the representative samples of school-going adolescents. Data was obtained through self-administered of pre-validated questionnaire. Descriptive study, cross-tabulation and multivariable analysis were used for analysis Conclusion The level of support for smoke-free initiative in public areas was high among youths in Malaysia, and this might offer promising prospects to expand the non-smoking areas to more public areas in the future.

INTRODUCTION: Melanomas in Asians have different clinicopathological characteristics and prognosis from melanomas in Caucasians. This study reviewed the epidemiology and treatment outcomes of cutaneous melanoma diagnosed at a tertiary referral dermatology centre in Singapore, which has a multiracial population. The study also determined whether Asians had comparable relapse-free and overall survival periods to Caucasians in Singapore. METHOD: This is a retrospective review of cutaneous melanoma cases in our centre between 1996 and 2015. RESULTS: Sixty-two cases of melanoma were diagnosed in 61 patients: 72.6% occurred in Chinese, 19.4% in Caucasians and 3.2% in Indians, with an over-representation of Caucasians. Superficial spreading melanoma, acral lentiginous melanoma and nodular melanoma comprised 37.1%, 35.5% and 22.6% of the cases, respectively. The median time interval to diagnosis was longer in Asians than Caucasians; median Breslow's thickness in Asians were significantly thicker than in Caucasians (2.6mm versus 0.9mm, CONCLUSION More physician and patient education on skin cancer awareness is needed in our Asian-predominant population for better outcomes.
Humans ; Melanoma/therapy* ; Prognosis ; Retrospective Studies ; Singapore/epidemiology* ; Skin Neoplasms/therapy* ; Treatment Outcome

Abstract Introduction: Total restriction on smoking in the home is an effective tool to reduce Second-hand smoke (SHS) exposure in private dwellings. The aim of this study is to determine the prevalence of total smoking restrictions in Malaysian homes and factors associated with its adoption. Methods: We analyzed data from a cross-sectional, household study – the Global Adult Tobacco Survey 2011, which involved a representative sample of Malaysian adults. Factors associated with the adoption of a totally smoke free home policy was determined by multivariable logistic regression. Results: Out of the 4250 respondents studied, 40.9% (95% CI 38.1-43.8) adopted a total smoking restriction within their homes. Adoption of total smoke-free home policy was significantly higher among Chinese and Indians, those without smokers in the house, non-smokers and government employees. The likelihood of adopting the total smoking restriction at home was lower among current smokers, of Malay ethnicity, low education attainment, having at least one house member who smoked, residing in rural areas, single or widow/widower/divorcee, those working in the private sector or self-employed. Conclusions: Less than half of Malaysian households implemented a total smoking restriction in their residence. Targeted activities to encourage the adoption of voluntary smoke-free rules among groups least likely to implement 100% smoking restrictions in the home are urgently needed with participation of all stakeholders to ensure its success.

Background/Aims: Nonalcoholic fatty liver disease (NAFLD) is closely associated with diabetes. The cumulative impact of both diseases synergistically increases risk of adverse events. However, present population analysis is predominantly conducted with reference to non-NAFLD individuals and has not yet examined the impact of prediabetes. Hence, we sought to conduct a retrospective analysis on the impact of diabetic status in NAFLD patients, referencing non-diabetic NAFLD individuals. Methods: Data from the National Health and Nutrition Examination Survey 1999–2018 was used. Hepatic steatosis was defined with United States Fatty Liver Index (US-FLI) and FLI at a cut-off of 30 and 60 respectively, in absence of substantial alcohol use. A multivariate generalized linear model was used for risk ratios of binary outcomes while survival analysis was conducted with Cox regression and Fine Gray model for competing risk. Results: Of 32,234 patients, 28.92% were identified to have NAFLD. 36.04%, 38.32% and 25.63% were non-diabetic, prediabetic and diabetic respectively. Diabetic NAFLD significantly increased risk of cardiovascular disease (CVD), stroke, chronic kidney disease, all-cause and CVD mortality compared to non-diabetic NAFLD. However, prediabetic NAFLD only significantly increased the risk of CVD and did not result in a higher risk of mortality. Conclusions Given the increased risk of adverse outcomes, this study highlights the importance of regular diabetes screening in NAFLD and adoption of prompt lifestyle modifications to reduce disease progression. Facing high cardiovascular burden, prediabetic and diabetic NAFLD individuals can benefit from early cardiovascular referrals to reduce risk of CVD events and mortality.

Introduction: Multitude studies have shown perception is an integral factor associated with smoking, However, no such tool was available in Malay language. In this study, we established a Bahasa Malaysia version of PTSQ (BM-PTSQ) and tested the validity and reliability among secondary school adolescents. Methods: The English version of PTSQ originally consists of 12 items. It was translated into Bahasa Malaysia and back-translated again into English to check for consistency. After face validity (face-to-face query) was determined among 20 secondary school adolescents, only 10 items were included in the survey. Construct validity was established from 407 school adolescents through random selection in the same locality. More than 60% of the respondents were female, a majority (67.3%) were schooling in rural areas. Then, the reliability of the questionnaire was determined with Cronbach's alpha. Results: EFA has grouped PTSQ into two components, they are associated with either knowledge or attitude towards smoking. The variance and Cronbach's alpha for the first and second component were 38.24% and 0.861 (7 items) and 21.62% and 0.661 (3 items) respectively. Conclusion The PTSQ showed good validity and reliability for measurement of perception in smoking among school adolescents in Malaysia, thus this is a viable measurement tool. More importantly this study shows an urgent need to improve the smoking education among adolescents in Malaysia.

Introduction: This study aimed to determine the prevalence and factors associated with female sexual dysfunction in an outpatient clinic in Malaysia. Methods: The study was conducted among female patients aged 50 years and older who attended the outpatient clinic of a public hospital in Malaysia. A self-administered questionnaire was used that was based on the Malay version of the Female Sexual Function Index questionnaire. The predictors of female sexual dysfunction were identified using multivariate logistic regression analysis. Results: A total of 263 females were recruited in this study, with a mean age of 60.6 ± 6.7 years. The distribution of the respondents’ ethnicities was mostly Malay (42.2%), followed by Chinese (41.8%) and Indian (16.0%). The prevalence of female sexual dysfunction among participants was 68.8%. The prevalence of the subscales of female sexual dysfunction was as follows: desire (85.2%), satisfaction (74.9%), arousal (71.1%), lubrication (66.9%), pain (61.2%), and orgasm (60.8%). According to multivariate logistic regression, patients of Indian ethnicity had an increased risk of female sexual dysfunction (OR=16.60, 95% CI=2.54–108.63), and a higher frequency of sexual intercourse was correlated with a lower risk of female sexual dysfunction (OR=0.13, 95% CI=0.08–0.24). Conclusion Seven-tenths of the middle-aged female patients attending the outpatient clinic suffered from female sexual dysfunction. Indian ethnicity and having a lower frequency of sexual intercourse were predictors of female sexual dysfunction. Future intervention studies are needed to address this problem.
Prevalence ; Sexual Dysfunction, Physiological ; Women ; Ambulatory Care Facilities ; Middle Aged