Patient cancer care education aims to inform and empower patients by providing clear, relevant information about cancer, including its mechanisms, treatment options, and management strategies. This study evaluated the effectiveness and accuracy of existing patient cancer care education materials in Malaysia, specifically assessing patients’ understanding of treatment, side effects, and their management. Method: A descriptive, correlational study was conducted involving 20 cancer patients at Gleneagles Penang Medical Center, using the Patient Cancer Education Needs Assessment questionnaire. Data analysis was performed using SPSS version 21.0 and Microsoft Excel 2013. Result: Patient age, education level, occupation, and socioeconomic status were not significant factors influencing understanding. Findings highlight the need to improve existing educational materials to enhance patient comprehension and ensure materials are comprehensive, culturally appropriate, and innovative. Conclusion: Patient cancer care education materials should be comprehensive, interactive, and patient is friendly. Current materials require revision and enhancement to keep pace with technological developments, ensuring they are accessible, understandable, and effective in supporting patients’ knowledge of cancer treatment, side effects, management strategies, and psychosocial aspects.

Purpose: Adjuvant radiotherapy (RT), while effective in reducing cancer recurrence and improving survival rates, often comes with radiation toxicity that can adversely affect the patient’s quality of life (QoL). Evaluating toxicity after RT is crucial because it helps to identify and manage adverse effects that can significantly impact a patient’s QoL. By monitoring toxicity, we can adjust treatment plans to mitigate these effects, improve patient comfort, and ensure a better overall outcome. Therefore this study aimed to evaluate and compare QoL following 3D-conformal hypofractionated RT in breast cancer patients. Methods: We included twenty-one Malaysian women with unilateral breast cancer treated with lumpectomy (n=15) or mastectomy (n=6) followed by 3D-conformal hypofractionated RT. QoL was evaluated using the EORTC QLQ-BR45 questionnaire before, during, and after RT. Results: During RT, there was a significant increase in the mean score of the breast symptoms scale compared to baseline (p=0.002), with the most common symptoms being skin problems, followed by swelling and oversensitivity. However, these symptoms were generally mild for most patients. The other quality of life scales remained stable during RT. Post-RT, most QoL scales showed improvements compared to both baseline and during RT, with significant enhancements in the mean breast symptoms score and breast satisfaction score (all p<0.05). Conclusion: Radiotherapy negatively impacted the QoL of our breast cancer patients, specifically on the breast symptoms scale. However, these symptoms improved after 4 months, resulting in high breast satisfaction and indicating a near-excellent cosmetic outcome. Future studies with larger cohorts are essential to validate these findings, as the small sample size (n=21 at baseline; n=13 post-RT) may have limited the detection of more subtle changes

Parenting children with autism spectrum disorder comes with challenges that impact parenting stress and quality of life, with social support being an influencing factor. The cultural context appears to influence associations between parenting stress, social support, and quality of life. There is a lack of reviews examining these associations in Asia. Thus, this review aims to provide an overview of the relationship between parenting stress, QOL and social support specific to the population in Asian countries. Systematic searches based on PRISMA guidelines were conducted on Medline, Web of Science, and Scopus, which found 26 eligible studies to be included in the review. Findings from the studies demonstrated social support, parenting stress, and quality of life to be significantly associated with each other directly and indirectly. They are also related to multiple variables like coping strategies and self-efficacy. In the future, data from a wider scope of Asian countries will be beneficial since most literature originated from China. Furthermore, more studies on potential moderator and mediator variables could be conducted.

Public interest in cognitive enhancement has driven the widespread availability of dietary supplements claiming to support brain health and memory. This comparative cross-sectional study explores the commercial availability and marketing claims of cognitive-enhancing dietary supplements across offline and online retail platforms. A dual-component design was employed in a comparative cross-sectional study. The first component involved assessing the commercial availability and marketing claims of cognitive-enhancing dietary supplements sold through offline retail outlets in Kuala Lumpur using a purposive sampling approach. The second component consisted of a parallel assessment conducted on online platforms, employing a convenience sampling strategy. A total of 13 products were identified on offline retail platforms in Kuala Lumpur, and 117 products were identified on online platforms. Capsules were the most common dosage form, both offline (46.2%) and online (79.5%). Products sold offline most frequently originated from Singapore (69.2%), whereas online products predominantly came from the United States of America (74.4%). The median prices of offline products were RM 190 (55.5), and online products were RM 196 (183), which are comparable, although the online products exhibited a wider price range (RM14–RM1,147). The most frequent claims were “brain health” for offline products and “memory” for online products. Natural or compound extracts were the most common active ingredients. This study’s findings found significant differences between offline and online dietary supplements in terms of availability, country of origin, price and marketing claims. These inconsistent findings underscore the need for stronger regulation and improved transparency in labelling to safeguard consumer health and ensure product credibility. Future research should focus on dosage accuracy, long-term safety, and mechanisms of action for supplements with cognitiveenhancing claims.

Dialisis merupakan rawatan yang lazim bagi pesakit kegagalan buah pinggang. Dari tahun ke tahun, bilangan pesakit yang menjalani dialisis semakin meningkat dengan kadar yang membimbangkan. Tahap keupayaan fungsi pesakit dialisis adalah lebih rendah berbanding pesakit diabetes yang tidak menjalani dialisis. Kajian ini bertujuan untuk mengenal pasti bagaimana dialisis mempengaruhi prestasi Aktiviti Kehidupan Seharian (ADL) dalam kalangan pesakit diabetes di Kuala Selangor serta faktor-faktor yang mempengaruhi prestasi ADL mereka. Kajian berkaitan prestasi ADL dalam kalangan pesakit dialisis yang menghidap diabetes masih terhad. Oleh itu, kajian ini menggunakan kaedah kualitatif melalui sesi temu bual bersemuka secara separa berstruktur. Seramai sepuluh peserta telah direkrut berdasarkan kriteria kemasukan yang ditetapkan. Lima tema utama telah dikenal pasti daripada temu bual, iaitu: (i) meningkatkan kualiti kehidupan seharian: perspektif baharu terhadap aktiviti harian; (ii) kesan diabetes terhadap aktiviti kehidupan seharian; (iii) kesan dialisis terhadap aktiviti kehidupan seharian; (iv) prestasi fungsi dalam aktiviti asas kehidupan seharian; dan (v) aktiviti harian yang dianggap penting. Hasil kajian menunjukkan bahawa pelbagai jenis aktiviti kehidupan seharian telah terjejas akibat kelemahan fizikal yang dialami oleh peserta. Kajian ini dapat memberi pemahaman yang lebih mendalam kepada ahli terapi cara kerja dan bidang pemulihan lain mengenai keupayaan fizikal pesakit diabetes yang menjalani hemodialisis

Voltage-gated sodium channels (VGSCs) play pivotal roles in cancer progression and have emerged as promising therapeutic targets and biomarkers. VGSCs comprise multiple subtypes with distinct tissue distributions, influencing tumour characteristics in different ways. Among these, the tetrodotoxin-sensitive α-subunits and the β1 subunit, commonly found in breast cancer, have been implicated in metastasis and tumour aggressiveness. The NaV1.5 channel and its neonatal variant (nNaV1.5) are overexpressed in aggressive cancers such as breast, prostate, colorectal, and lung cancers, thereby enhancing their invasive capacity. nNaV1.5 is particularly significant due to its tumour-specific expression and strong association with poor prognosis, especially in breast cancer, where it regulates cell proliferation, invasion, and tumour microenvironment remodelling. This review highlights nNaV1.5 as a critical ion channel that drives metastasis through ion regulation, extracellular acidification, and cytoskeletal remodelling. We further evaluate current therapeutic strategies, including siRNA, monoclonal antibodies, and small-molecule inhibitors, while addressing translational challenges such as tumour heterogeneity, drug delivery limitations, and off-target cardiotoxicity due to its similarity with the adult isoform. In addition, we explore the potential of nNaV1.5 as a biomarker subject to epigenetic regulations by factors including RE1-silencing transcription factor (REST) and histone deacetylase 2 (HDAC2), which may facilitate patient stratification and treatment optimization. By integrating mechanistic insights, therapeutic opportunities, and translational challenges, this review goes beyond descriptive summaries to provide a framework for advancing nNaV1.5 research from preclinical studies toward clinical application in cancer therapy.

Introduction: Tinea imbricata (TI) outbreak poses a significant health burden among indigenous populations in rainforest regions due to their geographical isolation and poor socioeconomic conditions. This study aimed to investigate the epidemiological trends, antifungal susceptibility patterns, and treatment outcomes of TI among the Bateq subtribe in Pahang, Malaysia. Materials and Methods: A cross-sectional survey was conducted between July–October 2023 in five villages within the National Rainforest Park, Malaysia. Socio-demographic characteristics, clinical manifestations, and treatment outcomes were collected through interviews, laboratory investigations, and clinical examinations. Treatment modalities were evaluated for their effectiveness in reducing disease burden. Results: 569 individuals were surveyed, revealing a TI prevalence rate of 7.91% with children aged 15 years and below exhibiting the highest susceptibility (9.22%). Antifungal susceptibility testing of clinical isolates of Trichophyton concentricum demonstrated high sensitivity to terbinafine (GM MIC=0.144 μg/ml, GM MFC=0.198 μg/ml, p<0.05) and griseofulvin (GM MIC=1.741 μg/ml, GM MFC=4.782 μg/ml, p<0.05), while clotrimazole showed moderate activity (GM MIC=5.897 μg/ml, GM MFC=22.291 μg/ml). Fluconazole demonstrated the least potency, with no fungicidal activity observed at concentrations up to 128 μg/ml. Treatment outcomes indicated that combination therapy (terbinafine gel and oral griseofulvin) significantly outperformed terbinafine gel alone, achieving an almost complete lesion resolution (LA reduced to 0.158±0.158 cm versus 3.684±1.522 cm , p<0.05). Conclusion: These findings provide critical insights into the epidemiology and emerging drug resistance of TI in the Bateq subtribe, highlighting the importance of continued surveillance, monitoring, and adaptation of treatment strategies to combat evolving antifungal resistance patterns.

Introduction: Estradiol benzoate is widely used to mimic dysmenorrhea in mice, inducing oxidative stress and inflammation during menstruation. Since curcumin is a potent natural antioxidant, it presumably decreases dysmenorrhea and oxidative stress during menstruation. This study aims to investigate the effect of curcumin on superoxide dismutase (SOD) and malondialdehyde (MDA) concentration in estradiol benzoate-induced dysmenorrhea in mice. Methods: Forty mice were randomly grouped into five groups. The first three groups were treated with curcumin twice a day with 100 mg/kg (Dys+Cur100), 200 mg/kg (Dys+Cur200), and 400 mg/kg (Dys+Cur400) in corn oil. The next two groups were treated with either 100 mg/kg ibuprofen (Dys+Ibu) or corn oil as placebo (Dys). Oxytocin was used to induce a writhing response to pain in mice. On day 11, blood serum was taken for examination of SOD and MDA concentration in mice. Results: Significant differences were observed between the SOD concentration in the Dys+Cur100 vs. Dys group (p < 0.05). The MDA concentration did not differ between groups (p > 0.05). Although the antioxidant effect of curcumin failed to lower the MDA concentration, it succeeded in elevating the SOD concentration in mice treated with 100 mg curcumin. Conclusion: The antioxidant activity of curcumin improved SOD levels but not MDA levels in dysmenorrhea-induced mice, highlighting the indirect effect of curcumin on dysmenorrhea treatment.

Abstract Hyperkalemia (serum potassium >5.0 mEq/l) is a significant complication in patients with heart failure, chronic kidney disease, and diabetes mellitus, particularly when treated with renin-angiotensin-aldosterone system inhibitors (RAASi). Both hyperkalemia and RAASi interruption are associated with increased cardiovascular events, hospitalizations, and mortality. This expert opinion document, developed between January and December 2024 through a systematic process, aims to establish guidance for hyperkalemia treatment in Indonesian patients with cardiorenal diseases receiving RAASi therapy, addressing the unique challenges within the Indonesian healthcare context. A comprehensive literature review of international guidelines and regional studies was conducted by a panel of 11 expert specialists (3 cardiologists, 6 internist-nephrologists, and 2 internist-cardiologists), who evaluated 29 statements covering diagnosis, monitoring, prevention, and treatment of hyperkalemia. Of the 29 statements, 26 reached consensus: 17 statements achieved very high agreement (≥90%) and 9 attained high agreement (≥67% – <90%). The agreed statements covered key areas, including potassium monitoring frequency, RAASi dose optimization strategies, dietary modifications, and treatment thresholds. Three statements regarding alternative therapeutic approaches did not receive agreement (<67%) due to limited local availability and cost considerations. Key recommendations include structured monitoring protocols for high-risk patients, strategies for RAASi dose optimization while managing hyperkalemia risk, and specific interventions adapted to local resources. This document provides a practical approach for managing hyperkalemia in Indonesian patients with cardiorenal diseases while maintaining optimal RAASi therapy, considering local Indonesian healthcare resources and constraints.
Hyperkalemia ; Cardio-Renal Syndrome ; Renin-Angiotensin System ; Indonesia

Objectives: This study aimed to estimate the prevalence of loss to follow-up (LTFU) among tuberculosis (TB) patients in Indonesia and to identify associated factors. Methods: This study analyzed data from the 2022 Tuberculosis Information System in Indonesia. A total of 71,665 drug-sensitive TB patients were included in the analysis. Age, sex,employment status, diagnosis type, human immunodeficiency virus (HIV) status, diabetesmellitus, TB type, mode of treatment, treatment standard, referral status, and type of residence.Categorical variables were analyzed using chi-square tests, followed by multivariable logistic regression to identify confounder-adjusted independent predictors of LTFU. Results: The prevalence of LTFU was 18.4%. A higher likelihood of LTFU was observed amongolder adults aged ≥65 years (adjusted-prevalence-odds-ratio [aPOR], 1.862), men (aPOR, 1.187), unemployed individuals (aPOR, 1.136), non-referred patients (aPOR, 1.547), patients with HIV (aPOR, 3.712), and those obtaining TB drugs out of pocket (aPOR, 4.998). The strongest predictorwas receipt of non-standard treatment, which was associated with a markedly increasedlikelihood of LTFU (aPOR, 26.912). In contrast, rural residence demonstrated a protective association (aPOR, 0.610). All associations were statistically significant (p < 0.001). Conclusion This study highlights a substantial burden of LTFU among TB patients in Indonesia,with nearly one in five patients discontinuing treatment. Multiple sociodemographic and clinical factors—particularly non-standard treatment, non-referral status, and HIV co-infection—were strongly associated with LTFU, underscoring gaps in the TB care continuum.These findings emphasize the need for targeted, patient-centered interventions, strengthenedreferral pathways, improved communication, and enhanced care coordination to reduce LTFU in high-risk groups.