The increasing number of homeless children is concerning. This study aimed to assess the dietary intake, diet quality, and nutritional status of homeless children in Klang Valley, as well as the relationship between diet quality and nutritional status. Methods: Approximately 120 homeless children aged 7 to 12 years from four locations in Klang Valley were enrolled. Their dietary intake and nutritional status were assessed using a two-day 24-hour dietary recall and body mass index-for-age, respectively. The Healthy Eating Index (HEI) was used to examine diet quality. Results: Prevalence of normal weight respondents was 58.3% (mean±SD: -0.79±1.80), with 25.0% classified as moderately and severely thin. Mean energy intake was significantly lower than recommended nutrient intakes (RNI) (p<0.050), while protein intake was higher (p<0.050). Calcium and zinc intakes were also significantly lower (p<0.001). Boys aged 7-9 years had significantly higher iron intake (median=11.6, IQR=8.7 mg, p=0.003), whereas girls aged 10-12 years had significantly lower intakes of iron (mean±SD=11.4±5.1, 11.1±4.7) and vitamin A (median=416.6, IQR=450.4 µgRE, p<0.001 for both). Mean HEI score was 51.30±6.78, indicating a need for diet quality improvement. No significant association between diet quality and nutritional status was observed (p=0.380). Conclusion: This study provided insights into dietary intake, diet quality, and nutritional status of homeless children. Further research is vital to shape evidence-based nutrition interventions.

Discordant lymphoma (DL) is the coexistence of two or more distinct subtypes in separate anatomic sites. There are limited reports on DL cases especially involving more than two subtypes in more than two sites. We report a 76-year-old man who presented with constitutional symptoms, flank mass and painless lymphadenopathies for six months. Laboratory tests revealed moderate anaemia, markedly elevated serum IgM (13400 mg/dL), IgM Lambda paraproteinemia and Lambda light chain paraproteinuria with unmeasurable serum lactate dehydrogenase due to hyperviscous sample. CT scan showed multiple subcutaneous masses over chest wall and retroperitoneum, with lytic bone lesions, and hepatosplenomegaly. Further biopsy findings with morphological, immunohistochemical and molecular analysis of the tissue sections revealed diffuse large B-Cell lymphoma in the chest wall mass, follicular lymphoma in the inguinal lymph node and lymphoplasmacytic lymphoma in the bone marrow. This case highlights the rare DL. The importance of histopathological evaluation of lymphoma despite the availability of PET-CT scans for disease staging is undeniable.

Objective: Foodborne disease is a significant global public health concern, with Bacillus cereus being a frequent cause of outbreaks. However, due to the relatively mild symptoms caused by infection with B. cereus, the shorter duration of illness and the challenges of testing for it in both stool and food samples, outbreaks are often underreported. This report describes the epidemiology of cases of foodborne illness, the causative agent and risk factors associated with an outbreak in a boarding school in Seremban district, Negeri Sembilan state, Malaysia, that occurred in November 2021. Methods: Epidemiological, environmental and laboratory investigations were performed. A case was defined as any person with abdominal pain, vomiting or diarrhoea that occurred after consuming food served by the canteen at the school. The data were analysed using Microsoft Excel and the Statistical Package for the Social Sciences (SPSS). Results: A total of 152 cases were identified among the 597 students, giving an attack rate of 25.5%. All cases were females aged 13–17 years. They presented with abdominal pain (100%), nausea (97.4%, 148), vomiting (78.3%, 119) or diarrhoea (61.8%, 94), or a combination of these. The mode of transmission of the outbreak was a continual common source. The foods associated with becoming a case were beef rendang (a dry curry) (odds ratio [OR]: 20.54, 95% CI: 4.89–86.30), rice (OR: 19.62, 95% CI: 2.62–147.01), rice cubes (OR: 18.17, 95% CI: 4.31–76.55) and vermicelli (OR: 17.02, 95% CI: 4.03–71.86). Cross-contamination and inadequate thawing and storage temperatures contributed to the outbreak. Discussion: This outbreak of foodborne illness at a boarding school was likely caused by B. cereus. The findings highlight the importance of proper food preparation, temperature monitoring, hygiene practices among food handlers and compliance with food safety guidelines.

Objective: Malaysia’s first case of coronavirus disease (COVID-19) was reported in January 2020, with the first case in the state of Negeri Sembilan diagnosed on 17 February 2020. The National COVID-19 Immunisation Programme commenced in early March 2021 in Negeri Sembilan. This study describes the COVID-19 cases and vaccination coverage in Seremban District, Negeri Sembilan, during 2021. Methods: The demographic and clinical characteristics of COVID-19 cases and the district’s vaccination coverage were described. Vaccination coverage was plotted against COVID-19 cases on the epidemic curve. The chi-square test was used to examine the differences between the vaccination status of COVID-19 cases and severity category, hospitalization status and mortality. Results: In Seremban District, there were 65 879 confirmed cases of COVID-19 in 2021. The data revealed that the 21–30-year age group had the highest proportion of cases (16 365; 24.8%), the majority of cases were male (58.3%), and most cases were from the sub-district of Ampangan (23.1%). The majority of cases were Malaysian. Over half (53.5%) were symptomatic, with fever (29.8%) and cough (22.8%) being the most frequently reported symptoms. COVID-19 vaccination status was significantly associated with severity category, hospitalization and mortality (P < 0.001 for all categories). Discussion: This is the first study to describe two-dose vaccination coverage and the trend in COVID-19 cases in Seremban District. It was observed that COVID-19 cases had been reduced following more than 60.0% vaccination coverage.

Insulin degludec/insulin aspart (IDegAsp) co-formulation provides both basal and mealtime glycaemic control in a single injection. The glucose level-lowering efficacy of IDegAsp is reported to be superior or non-inferior to that of the currently available insulin therapies with a lower rate of overall hypoglycaemia and nocturnal hypoglycaemia. An expert panel from Malaysia aims to provide insights into the utilisation of IDegAsp across a broad range of patients with type 2 diabetes mellitus (i.e. treatment-naïve or insulin-naïve patients or patients receiving treatment intensification from basal-only regimens, premixed insulin and basal–bolus insulin therapy). IDegAsp can be initiated as once-daily dosing for the main meal with the largest carbohydrate content with weekly dose adjustments based on patient response. A lower starting dose is recommended for patients with cardiac or renal comorbidities. Dose intensification with IDegAsp may warrant splitting into twice-daily dosing. IDegAsp twice-daily dosing does not need to be split at a 50:50 ratio but should be adjusted to match the carbohydrate content of meals. The treatment of patients choosing to fast during Ramadan should be switched to IDegAsp early before Ramadan, as a longer duration of titration leads to better glycated haemoglobin level reductions. The pre-Ramadan breakfast/lunch insulin dose can be reduced by 30%–50% and taken during sahur, while the pre-Ramadan dinner dose can be taken without any change during iftar. Education on the main meal concept is important, as carbohydrates are present in almost all meals. Patients should not have a misconception of consuming more carbohydrates while taking IDegAsp.
insulin degludec [Supplementary Concept] ; Insulin Aspart ; Glucose ; Hypoglycaemia ; Diabetes Mellitus, Type 2

ABSTRACT Implant periapical lesion (IPL) is also known as retrograde peri-implantitis and as the name suggests, it involves inflammation surrounding the apical part of the dental implants. Previously, many studies have reported the event of IPL that further delays osseointegration, and some reported failure of implant placement due to this disease. In this article, we described two cases of early dental implant failure that was associated with active IPL and correlated the clinical and radiographical findings with the histopathological findings.
Dental Restoration Failure ; Dental Implants--adverse effects ; Periapical Tissue

Major depressive disorder (MDD) is a common but complex illness that is frequently presented in the primary care setting. Managing this disorder in primary care can be difficult, and many patients are underdiagnosed and/or undertreated. The Malaysian Clinical Practice Guidelines (CPG) on the Management of Major Depressive Disorder (MDD) (2nd ed.), published in 2019, covers screening, diagnosis, treatment and referral (which frequently pose a challenge in the primary care setting) while minimising variation in clinical practice.
Depression ; Depressive Disorder, Major ; Primary Health Care ; Therapeutics

Introduction: Childhood obesity is a public health problem in Malaysia. Intake of sugar-sweetened beverages (SSB) is associated with obesity in children. There is a lack of studies on factors associated with SSB consumption in Malaysia. This study aimed to determine the sociodemographic factors associated with SSB consumption among Malaysian adolescents. Methods: Data of 2,021 students, aged 10-17 years on sociodemographic, SSB intake and anthropometrics were drawn from the school-based Adolescent Nutrition Survey 2017. A multistage stratified cluster sampling was used to obtain a nationally representative sample of primary and secondary school students. Body mass index (BMI)-for-age status was determined based on calculated z-score using the World Health Organization 2007 reference. SSB consumption was obtained from a food frequency questionnaire. Results: The prevalence of overweight and obesity among Malaysian adolescents were 16.6% and 14.7%, respectively. Malaysian adolescents consumed 1.4 cups of SSB per day. Rural children had a significantly higher SSB intake (1.5 cups) than urban (1.3 cups) children, while males (1.5 cups) had a significantly higher intake than females (1.3 cups). There were no significant differences in SSB consumption between thin, normal, overweight and obese adolescents. Conclusion: Almost all Malaysian adolescents consumed SSB during one month prior to the survey and the average amount consumed was 1.4 cups per day. Rural locality and male were associated with higher SSB consumption. There were differences in SSB consumption between Chinese and Malays, between Chinese and Indians, and between Chinese and Bumiputra Sarawak. There were no differences in consumption between the different BMI-for-age categories.

Introduction: In medical physics applications, effective atomic numbers are often employed to set apart and specify the interaction of ionizing radiation with matter. Methods: The effective atomic number of soy-lignin bonded with Rhizophora spp. particleboards were analyzed using Energy Dispersive X-ray analysis and Carbon Hydrogen Nitrogen Analyzer. The effective atomic number were compared and recorded with reference to the effective atomic value of water. Results: The result showed that the effective atomic number calculated for adhesive bound Rhizophora spp. samples were close to effective atomic value of water, with 3.34 – 3.47 % differences by using Energy Dispersive X-ray and 6.47 – 6.78 % differences by using Carbon Hydrogen Nitrogen analysis. The result revealed that through Energy Dispersive X-ray method, the effective atomic number was much closer to water compared to Carbon Hydrogen Nitrogen analysis. Conclusion: Despite the availability of hydrogen content in the samples in Carbon Hydrogen Nitrogen analysis, Energy Dispersive X-ray method was much more preferred and gave better result compared to Carbon Hydrogen Nitrogen analysis thus provide a compelling argument for the use of Energy Dispersive X-ray method to measure the effective atomic number of Rhizophora spp. particleboard in medical physics applications.

Introduction: Sexually transmitted Infections (STIs) are major public health concerns reaching an all-time high, globally. In Malaysia data on the prevalence of STIs remains scarce which limits the understanding of STI transmission dynamics and the role of interventions in the control of STIs. The aim of this study is to determine the epidemiology characteristics of STIs mainly from Malaysian private healthcare institutions. Method: A two years (2016 and 2017) retrospective review was conducted on 160 multiplex RT-PCR STI reports from KPJ hospitals, Malaysia. Results: There were 65 (40.6 %) patients positive STIs [male: 21/65 (32.3 %); female: 44/65 (67.7 %)]. The STIs was prevalent among young adults (56/65; 86.2 %) from the central region (46/65; 70.8 %). Females had 1.7 times greater risk to develop STI (20 per 100) and two times higher chance to have multiple STIs (10 per 100) in comparison to male. The single STIs was caused mainly by U. parvum (N=17). In males, U. urealyticum (N=3) and C. trachomatis (N=3) were prevalent, while U. parvum (N=15) was prevalent in females. There were 19 dual infections of STIs which were commonly caused by U. parvum and M. hominis (N=5). There were seven STIs cases caused by three pathogens concurrently including U. urealyticum, U. parvum and C. trachomatis (N=2) and U. urealyticum, M. genitalium and C. trachomatis (N=2). Females from urban communities have higher risk in comparison to males for developing multiple STIs. Conclusion: This study provides an imperative platform for temporal trends of STIs in Malaysia which reflects the health status of certain populations that warrant immediate public health interventions.