Based on data generated from 180 randomly selected households with children age under five years old in Aysaita district of Afar region of Ethiopia, this study explored prevalence of malnutrition and scrutinized household characteristics, maternal characteristics, specifics of the child and economic variables associated with child malnutrition. The height-for-age Z-scores (HAZ), weight-for-height Z-scores (WHZ) and weight-for-age Z-scores (WAZ) were used to measure the extent of stunting, wasting and underweight, respectively. The results revealed that prevalence of long term nutritional imbalance and malnutrition status indicator (i.e. stunting) was 67.8%. The short term measure (wasting) was found to be 12.8% and underweight was found to be 46.1%. Moreover, children in households which are headed by women, and characterized by more dependency ratio, less access to assets, health services and institutions are more likely to be undernourished.
Anthropometry ; Child ; Child Nutrition Disorders ; Dependency (Psychology) ; Ethiopia ; Family Characteristics ; Female ; Head ; Health Services ; Humans ; Malnutrition ; Prevalence ; Thinness

Introduction: Screening for alpha (α) thalassaemia trait (TT) is challenging especially in the presence of iron deficiency (ID). Red blood cell size factor (RSf) is a parameter introduced by Beckman Coulter capable of detecting acute and chronic changes to cellular haemoglobin status and iron supply. The research aimed to investigate the clinical usefulness of RSf as screening parameter for α TT and the effect of concomitant ID to RSf mean values (m.v) among respondents with α TT. Methods: A cross-sectional retrospective laboratory analysis involved 55 respondents’ data selected from January 2014 to December 2015 in Pathology Department, Hospital Tuanku Ja’afar Seremban, Negeri Sembilan. The significant difference at p <0.05 in the RSf m.v. among respondents with α0 TT, α+ TT, and ID groups and the effect concomitant ID to RSf m.v. were determined using statistical test, one-way analysis of variance (ANOVA). Results: Significant differences were detected in RSf m.v. i) between α0 TT, α+ TT and ID, F (2, 52) = 18.99, p=0.001. ii) between α TT without ID, α TT with ID and ID cohorts for both a) α0 TT [F (2, 33) = 23.77, p=0.001) and b) α+ TT [F (2, 28) = 5.37, p=0.011]. iii) between α TT and ID group regardless of the presence of ID for both a) α0 TT and b) α+ TT. Conclusion: RSf is a potential screening parameter in evaluating patients with hypochromic microcytosis in identifying possible cases of alpha TT regardless of iron status.
Thalassaemia trait

Objectives: The primary objective of this study was to describe the accuracy of pneumonia diagnosis, both community-acquired pneumonia (CAP) and hospitalacquired pneumonia (HAP). Secondary objectives were describing the choice of antibiotics used, pathogens isolated, and predictive parameters in diagnosing pneumonia. Methods: This was a prospective cross-sectional study to determine the accuracy of the diagnosis of CAP and HAP admitted to Hospital Tuanku Ja’afar. All patients aged ≥12 years admitted to the general medical ward with the diagnosis of CAP or HAP were included in the study. Chest radiograph interpretation was done by certified radiologists. An accurate diagnosis of pneumonia was defined by clinical signs and symptoms of pneumonia supported by radiographical evidence. Results: A total of 159 patients were enrolled into the study from January 2018 to February 2018. Of these only 59(37.1%) cases were accurately diagnosed as pneumonia. Amongst those with pneumonia diagnosis made by the emergency department, medical officers and specialists of medical department; 65.4%, 60% and 47.3% respectively were not pneumonia. Amoxicillin with clavulanate and azithromycin were amongst the most common first choice of antibiotic used (46.5%). In this study, pathogens were isolated either by blood culture or sputum culture in only 20 (12.6%) patients. There was no significant predictive parameter identified in this study, which included white cell counts, Creactive protein (CRP) levels, erythrocyte sedimentation rate (ESR), and Pao2/FiO2 ratio. Conclusion: About two-thirds of patients diagnosed with pneumonia did not have a compatible radiological finding. Better tools and systems are needed to aid in the diagnosis of pneumonia

Introduction: Reverse total shoulder arthroplasty provides a surgical alternative to standard total shoulder arthroplasty for the treatment of cuff tear arthropathy, arthritis and fracture sequelae. This study aimed to assess the short-term outcomes following reverse total shoulder arthroplasty for patients in a large public hospital in Malaysia. Materials and Methods: We identified and performed five primary reverse total shoulder arthroplasties between 1 May 2019 and 1 June 2020. All patients were contactable and available for analysis. Assessment of functional outcomes was performed using the Constant-Murley score, the patient satisfaction score (PSS), and imaging studies. The mean follow-up from operation to the time of reporting was 9.6 months (range, 3 to 14 months) Results: The median age for our patients was 58 years (±11.91). The most common indication for surgery was posttraumatic arthritis, followed by rotator cuff arthropathy and osteoarthritis. The mean Constant score improved from 9.0 pre-operatively to 52.3 post-operatively at a mean of 9.6 months. The majority of the patients were satisfied with the surgery as the post-operative range of motion, especially anterior elevation and abduction, improved in four of our patients and there were no short-term complications, for example, of infection or revisions, reported at the last followup. Conclusion: This study has shown that reverse total shoulder arthroplasty can yield good short-term outcomes for the treatment of complex shoulder problems in addition to cuff tear arthropathy. It should be considered a treatment for rotator cuff tears, severe arthritis and ≥ 3 parts proximal humeral fractures.

Introduction: Archidendron bubalinum is an underutilised plant with numerous antioxidant properties and has a great potential to inhibit enzymes linked with diabetes and obesity. Food irradiation is an advanced technology to prolong the lifespan of plant, prevent physical spoilage and eradicate food borne disease. Present study was aimed to determine the total antioxidant activity, enzymatic inhibition against alpha-amylase, alpha-glucosidase and pancreatic lipase and the toxicity levels of non-irradiated and irradiated (3, 6, 9 & 12 kGy) hot aqueous extract of A. bubalinum. Methods: The antioxidant ability of the extract was determined by total phenolic content (TPC), total flavanoid content (TFC), Diphenyl-1-Picrylhydrazyl (DPPH), β-carotene assay and ferric reducing antioxidant potential (FRAP) assay. The inhibitory activities were evaluated using α-amylase, α-glucosidase, and pancreatic lipase inhibition assay. The toxicity levels of A. bubalinum extract were determined using Brine shrimp and Zebra-fish assays. Results: Results showed that irradiated A. bubalinum at 12 kGy demonstrated the highest TFC (448.99 ± 5.02 mg GAE/g), FRAP (2.55 ± 0.40 mmol Fe2+/g) and β-carotene bleaching activity (79.49%). Whereas, non-irradiated A. bubalinum samples expressed the highest TPC (2517.07 ± 15.81 mg GAE/g) and exhibited the lowest IC50 values of α-amylase (31.99 ± 3.15 μg/ml), α-glucosidase (23.40 ± 0.69μg/ml) and pancreatic lipase (32.81 ± 7.96 μg/ml) activity. The toxicity assays also showed no significant different between irradiated and non-irradiated samples. Conclusion: The study suggests that gamma irradiation has the prospective future to increase antioxidant properties and maintaining the enzyme inhibitory activities to preserve the sample of A. bubalinum for commercial purposes
Antioxidant

Background: Managing potential COVID-19 patients is challenging when resources were limited. The objective of this study was to evaluate the predictive parameters and management strategy for potential COVID-19 cases who are without contact or travelling history. Methods: Retrospective study of potential COVID-19 patients without direct contact or travelling history, admitted to Hospital Tuanku Ja’afar Seremban. Patients were riskstratified to either low or medium risk and admitted to designated wards, respectively. They were categorised to severe acute respiratory infection (SARI); influenzalike illness (ILI); dengue fever or viral fever like (DVF); or none. Clinical, laboratory and radiological variables were evaluated for predictive value. Positive cases were isolated to negative pressure isolation rooms and the neighbouring patients underwent surveillance. Results: 812 patients were studied, with 478 fulfilled SARI, ILI, and DVF. 18 (2.2%) of them were COVID-19 positive, and all patients in “none” group were negative. Hypoxia without dyspnoea and medium risk criteria were significant in predicting COVID-19 with p<0.01 (OR 7.18; 95% CI 2.70, 19.13) and p<0.01 (OR 35.77; 95% CI 11.25, 113.71) respectively. Absolute lymphocyte count showed no predictive value (P=0.88 95% CI -0.78, 0.90). Absolute neutrophil count ≥10 x10^9/L cells (OR 0.11; 95% CI 0.01, 0.87) helped to exclude COVID-19. Chest radiograph of 16 (88.9%) COVID-19 patients showed heterogeneous Ill-defined opacities. No nosocomial transmission occurred during this study period. Conclusion / Implication Initial attention to predictive parameter, riskstratification, clinical grouping strategy, and proper ward management helps in containment of COVID-19 and resources management without risk of nosocomial transmission.
COVID-19 ; SARS-CoV-2

Introduction: A neuroendocrine neoplasm (NEN) is a type of heterogenous tumour originating and spreading from neuroendocrine cells and peptidergic neural crest Kulchitsky cells (silver-addicted cells). The occurrence of gallbladder NEN (GB-NEN) is extremely rare and accounting for only 0.5% of all neuroendocrine tumours and 2.1% of all gallbladder tumours. Case Presentation: A 60-year-old female with chronic cholecystitis and cholelithiasis, presented with septic shock and clinical condition suspicious of perforated viscus. The CT examination and laparotomy findings were suggestive of gallbladder carcinoma. The diagnosis of GB-NEN was later confirmed by histopathological examination and immunohistochemical studies. Following laparotomy, the patient’s condition deteriorated and succumbed to death. Discussion: The diagnosis of GB-NEN is challenging due to ambiguous clinical manifestation and existing limitations of diagnostic techniques. Immunohistochemical staining is effective in diagnosing GB-NEN and highly specific markers have been identified. Surgery remains the mainstay of treatment for GB-NEN and following adjuvant therapy may prolong survival. Conclusion Current literature on GB-NEN is scarce and the standard treatment plan is under exploration. Early detection of GB-NEN improves prognosis and is encouraged for patients with chronic cholecystitis and cholelithiasis. Individualised treatment plan should be emphasised to maximise patients’ benefits in clinical practice.

Background & Objective: Varicella is a common infection during childhood and generally self-limiting. However, it can rarely cause neurological complications. Isolated acute peripheral facial palsy (APFP) is extremely rare during primary varicella infection with estimated incidence of <0.01%. There have also been conflicting opinions on its natural history, prognosis and management worldwide. We aimed to establish the natural history, prognosis and treatment for varicella-related isolated APFP in immunocompetent individuals, without co-morbids. Methods: Systematic review was performed with systematic literature search in Google Scholar and PubMed. Data was analysed with statistical analysis software. Results: Thirty cases were included. The complete remission rate of APFP was 66.67% for nontreatment group and 72.22% for treatment group (p=0.643). Early and late treatment group had a similar complete remission rate of 88.89% and 80% respectively (p=1.000). However, early treatment group (within 3 days of onset) had achieved complete remission 3 weeks earlier than the late treatment group (p=0.091). Antiviral group tends to have better outcome than steroid monotherapy group, although statistically insignificant (p=0.055). Conclusions: This condition generally has good prognosis even without treatment. However, early treatment and antiviral therapy may at least accelerate remission and reduce morbidities although these cannot alter the final outcome. Clinicians may consider antiviral therapy if patients present within 3 days of onset. These findings need to be applied with caution, considering the limitations of our review.

Internet Addiction (IA) is becoming increasingly recognized as a serious public health issue, particularly for children and adolescents. This review article discussed the complexity of IA diagnostic criteria and IA-related risk factors from a public health perspective with the intention of fostering a better understanding of IA in adolescents and children. The entire discussion pointed out how the epidemiological triad of disease framework helps to explain the IA associated factors among adolescents. This framework emphasises the agent (Internet characteristics and its content), host (e.g., self-personality, comorbidity, psychological status, inter- and intrapersonal relationship), and environment as extrinsic factors (i.e., physical pollution, socioeconomic status, availability, and accessibility of the Internet) that facilitate interaction between the agent and the host. Evaluation of all three components and their association with IA is essential as it allows for a more comprehensive understanding of how the issues arise, which can be useful in developing future effective public health measures for IA

Introduction: Concerns about the quality of life (QoL) of parents of children with autism spectrum disorder have been raised by previous study. Policy decision-makers and healthcare professionals can be better informed about the environmental factors associated with parental QoL, which will enhance outcomes for both parents and children. The objective of this review is to perform a comprehensive review that assesses the environmental relevant factors associated with quality of life (QoL) of parents of ASD children (under 18 years old). Methods: To identify the environmental factors associated with parental QoL, a scoping review was conducted using the Arksey and O'Malley original and enhanced framework. Three electronic database (PubMed, Scopus & WOS) and reference list checks were used in the search. Results: Social support, family support, residential condition, and access to services were all factors linked to the parental quality of life in this group. Conclusions The review highlighted environmental factors as one of the variables that have an association with parental QoL. The results of this analysis also highlighted potential areas of support that have implications on future policy and practices.