Introduction: Polycystic ovarian syndrome (PCOS) is a complex endocrine disorder that significantly affects adolescent girls, particularly those with overweight or obesity. However, data examining the determinants and metabolic profiles of PCOS among adolescents with overweight and obesity remain limited, especially in Malaysia. This protocol describes a case-control study investigating the cardiometabolic, dietary, and psychosocial determinants of PCOS among adolescents with overweight and obesity. Methodology: This study is designed as a case-control study involving adolescent girls aged 13–16 years with a body mass index z-score >+1 standard deviation. Cases are defined as adolescent girls with a confirmed diagnosis of PCOS based on the recommendations of the 2017 International Consortium of Paediatric Endocrinology (ICPE), while controls are those who do not meet the diagnostic criteria for PCOS. A total sample size of 440 participants is required. Participants will be recruited from 22 secondary schools selected from a list of schools in Kuala Lumpur. Data on sociodemographic characteristics, psychosocial health, physical activity, and dietary intake will be collected using structured questionnaires. Blood samples will be obtained and analyzed for diagnostic testing (free testosterone), exclusion tests (thyroid-stimulating hormone, folliclestimulating hormone, luteinizing hormone, estradiol, prolactin, and dehydroepiandrosterone sulfate), and biochemical parameters (liver function tests, lipid profile, hemoglobin A1c, fasting glucose, fasting insulin, and inflammatory markers). Results: The study is expected to generate comprehensive data on the cardiometabolic, dietary, and psychosocial determinants of PCOS among adolescents with overweight and obesity. The findings will inform early screening strategies and targeted interventions aimed at reducing long-term reproductive and cardiometabolic complications. Conclusion This protocol outlines a structured approach to investigating PCOS in adolescence and addresses current gaps in early identification and risk stratification among highrisk populations.
Adolescent ; Humans ; Case-Control Studies ; Overweight ; Polycystic Ovary Syndrome ; Obesity

Covering a quarter of the world’s tropical coastlines and being one of the most threat-ened ecosystems, mangroves are among the major sources of terrestrial organic matter to oceans and harbor a wide microbial diversity. In order to protect, restore, and better understand these ecosystems, researchers have extensively studied their microbiology, yet few surveys have focused on their fungal communities. Our lack of knowledge is even more pronounced for specific fungal populations, such as the ones associated with the rhizosphere. Likewise, the Red Sea gray man-groves (Avicennia marina) remain poorly characterized, and understanding of their fungal commu-nities still relies on cultivation-dependent methods. In this study, we analyzed metagenomic datasets from gray mangrove rhizosphere and bulk soil samples collected in the Red Sea coast, to obtain a snapshot of their fungal communities. Our data indicated that Ascomycota was the dominant phylum (76%–85%), while Basidiomycota was less abundant (14%–24%), yet present in higher numbers than usually reported for such environments. Fungal communities were more stable within the rhizosphere than within the bulk soil, both at class and genus level. This finding is consistent with the intrinsic patchiness in soil sediments and with the selection of specific microbial communities by plant roots. Our study indicates the presence of several species on this mycobiome that were not previously reported as mangrove-associated. In particular, we detected representatives of several commercially-used fungi, e.g., producers of secreted cellulases and anaerobic producers of cellulosomes. These results represent additional insights into the fungal community of the gray mangroves of the Red Sea, and show that they are significantly richer than previously reported.

This case report emphasizes the role of Assertive Community Treatment (ACT)in managing a family with four members suffering from mental illness, mainly schizophrenia. We report a case of middle-aged lady who was diagnosed with treatment resistant schizophrenia (TRS) living with two other family members with the same illness and their carer who developed major depression from shouldering the burden of caring for mentally ill family members. ACT, through its holistic approach, proved to have reduced hospitalizations and improve symptom control and quality of life in this family.
Schizophrenia

Introduction: Sexual dysfunction is common but not often assessed in the routine clinical care among males on opiate substitute treatment. Objective: To determine the association between clinical variables and erectile dysfunction (ED) among men on methadone maintenance therapy (MMT). Methods: A cross-sectional study involving 108 participants who attended the Drug Clinic, Hospital Kuala Lumpur. The instruments used include the Structured Clinical Interview for DSM-IV Axis-I Disorder (SCID-I), Beck Depression Inventory (BDI) and International Index of Erectile Function-15 (IIEF-15). Results: Concurrent heroin abuse was significantly associated with presence of ED (p=0.024). Treatment factors including methadone dose and duration of methadone treatment were not significantly associated with ED. Conclusion: Education on sexual dysfunction as a potential adverse effect and its association with illicit heroin use should be considered in the doctor-patient consultation to encourage treatment adherence and abstinence from heroin.