Introduction: Gestational diabetes mellitus (GDM) is a common pregnancy complication associated with adverse maternal and neonatal outcomes, including hypertensive disorders, caesarean delivery, macrosomia, and increased lifetime risk of type 2 diabetes. Despite its clinical importance, considerable international variation exists in GDM screening and diagnostic criteria. Multiple frameworks are currently used, including those from the World Health Organization (WHO), International Association of Diabetes and Pregnancy Study Groups, Carpenter and Coustan, and the National Diabetes Data Group. Differences in glucose thresholds, testing protocols (one-step versus two-step), and universal versus risk-based screening contribute to heterogeneity in reported prevalence and healthcare burden. In multi-ethnic, middle-income settings such as Malaysia, identifying an evidence-informed and contextappropriate diagnostic approach is critical. Methodology: This scoping review follows the Joanna Briggs Institute methodology and will be reported in accordance with the PRISMA Extension for Scoping Reviews (PRISMA-ScR). PubMed, Scopus, and ScienceDirect will be searched for English-language studies, reviews, guidelines, and consensus statements reporting GDM diagnostic criteria. Two reviewers will independently screen and select studies. Results: Data will be charted on country, study type, diagnostic criteria, gestational age at screening, and reported challenges. Findings will be synthesized descriptively and presented in tables and figures. No formal risk-of-bias assessment will be conducted. Conclusion This review will provide a comprehensive overview of global diagnostic practices, highlight variations and gaps, and support evidence-based selection of a suitable GDM screening and diagnostic strategy for Malaysia.
Diabetes, Gestational ; Malaysia ; Policy ; Review Literature as Topic

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

Introduction: Differences in baseline characteristics and response to treatment in different age groups of patients with chronic myeloid leukaemia (CML) in resource-limited countries have not been extensively studied. We aimed to determine the differences in clinicopathological parameters at diagnosis and response to imatinib in adult CML patients with younger (under 60 years; YCML) and older (60 years and older; OCML) age treated at our institution from March 2001 to March 2021. Methods: A retrospective analysis of consecutive adult CML patients receiving imatinib was performed. Clinicopathological parameters and treatment response were reviewed and analysed using hospital medical records and electronic data reports. Results: The median age at diagnosis was 50 years. OCML patients (n=17) had significantly more comorbidities. The YCML group (n=50) generally had a palpable spleen >5cm from the costal margin, mild anaemia, hyperleukocytosis and thrombocytosis. A starting dose of 400 mg/day was observed in 84% of YCML and in 65% of OCML. Cumulative complete cytogenetic response was 50% in YCML versus 70.6% in OCML, p=0.158. OCML tended to have a higher percentage of major molecular response (MMR) (52.9% versus 32%) and a shorter time to MMR, 22 months (range 5-70) versus 35 months (range 8-53). OCML experienced more haematological and non-haematological treatment-related adverse events after imatinib therapy. Conclusion: Although OCML patients had more comorbidities and treatment intolerances, overall long-term treatment response was comparable to YCML. In OCML, a more personalised approach to initial and subsequent dosing of imatinib may be considered.

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.

Homocystineimia is an Inborn Errors of Metabolism (IEM) which can occur due to accumulation of homocysteine. Homocysteine is one of the sulfur-containing amino acid with thiol group that is formed by demethylation of methionine. Deficiency of enzymes involves in homocysteine metabolism can give rise to seven types of homocystinemia subject to total homocysteine level. Therefore reference ranges are needed to differentiate between normal and abnormal population as well as the type of homocystineimia depending on the enzymes defect in the pathway. Hence, homocysteine reference ranges in children for the Malaysian population were postulated. 3 mL of blood was collected from 86 normal individuals (52 boys and 34 girls) and then subsequently processed and analysed using High Performance Liquid Chromatogrphy – Ion Exchange Chromatography (HPLC-IEC). The calculated mean total homocysteine for the population was 8.1 ± 3.89 µM (95% confidence interval, l 7.3-8.9 µM). Reference range was 2.5 – 16.2 µM with lower and upper cut-off were 1.0 µM dan 21.0 µM, respectively. The newly developed reference range of total homocysteine for Malaysian children is able to reduce false negative cases in the laboratory.