Objectives: In this study, we investigate the effects of dietary supplementation with standardized aqueous extracts of shatavari (Asparagus racemosus, Ar), ashwagandha (Withania somnifera, Ws), or their combination on menopausal symptoms, vascular dysfunction, bone turnover, and serum concentrations of inflammatory and oxidative stress markers in postmenopausal women. Methods: Postmenopausal women aged 40–55 were enrolled in a double-blind randomized study to receive one of six treatments:placebo, Ar 250 mg/500 mg, Ws 250 mg/500 mg, or 500 mg extract combining Ar 250 mg and Ws 250 mg. Primary outcomes were changes in the menopause-specific quality of life (MENQOL) questionnaire, bone mineral density/bone turnover markers (BTMs), and reflection index (RI) after 24 weeks. Secondary outcomes included changes in serum inflammatory and oxidative stress markers, and evaluation of supplement safety and tolerability. Results: Supplemented groups showed significant dose-dependent decrease MENQOL and RI compared with placebo (P < 0.0001).Women supplemented with Ws or Ar extracts had significantly decreased levels of the BTMs C-terminal telopeptide of type I collagen, bone alkaline phosphatase, and receptor activator of nuclear factor kappa-B ligand, and increased osteoprotegerin levels (P < 0.0001).Significantly decreased levels of inflammatory and oxidative stress markers high-sensitivity C-reactive protein and malondialdehyde, and increased glutathione and nitric oxide levels (P < 0.0001) were also observed. Conclusions Daily supplementation with Ws or Ar extracts dose-dependently reduces menopausal symptoms, vascular dysfunction, bone turnover/resorption, and estrogen deficiency-related inflammation and oxidative stress in postmenopausal women.

Objectives: In this study, we investigate the effects of dietary supplementation with standardized aqueous extracts of shatavari (Asparagus racemosus, Ar), ashwagandha (Withania somnifera, Ws), or their combination on menopausal symptoms, vascular dysfunction, bone turnover, and serum concentrations of inflammatory and oxidative stress markers in postmenopausal women. Methods: Postmenopausal women aged 40–55 were enrolled in a double-blind randomized study to receive one of six treatments:placebo, Ar 250 mg/500 mg, Ws 250 mg/500 mg, or 500 mg extract combining Ar 250 mg and Ws 250 mg. Primary outcomes were changes in the menopause-specific quality of life (MENQOL) questionnaire, bone mineral density/bone turnover markers (BTMs), and reflection index (RI) after 24 weeks. Secondary outcomes included changes in serum inflammatory and oxidative stress markers, and evaluation of supplement safety and tolerability. Results: Supplemented groups showed significant dose-dependent decrease MENQOL and RI compared with placebo (P < 0.0001).Women supplemented with Ws or Ar extracts had significantly decreased levels of the BTMs C-terminal telopeptide of type I collagen, bone alkaline phosphatase, and receptor activator of nuclear factor kappa-B ligand, and increased osteoprotegerin levels (P < 0.0001).Significantly decreased levels of inflammatory and oxidative stress markers high-sensitivity C-reactive protein and malondialdehyde, and increased glutathione and nitric oxide levels (P < 0.0001) were also observed. Conclusions Daily supplementation with Ws or Ar extracts dose-dependently reduces menopausal symptoms, vascular dysfunction, bone turnover/resorption, and estrogen deficiency-related inflammation and oxidative stress in postmenopausal women.

Objectives: In this study, we investigate the effects of dietary supplementation with standardized aqueous extracts of shatavari (Asparagus racemosus, Ar), ashwagandha (Withania somnifera, Ws), or their combination on menopausal symptoms, vascular dysfunction, bone turnover, and serum concentrations of inflammatory and oxidative stress markers in postmenopausal women. Methods: Postmenopausal women aged 40–55 were enrolled in a double-blind randomized study to receive one of six treatments:placebo, Ar 250 mg/500 mg, Ws 250 mg/500 mg, or 500 mg extract combining Ar 250 mg and Ws 250 mg. Primary outcomes were changes in the menopause-specific quality of life (MENQOL) questionnaire, bone mineral density/bone turnover markers (BTMs), and reflection index (RI) after 24 weeks. Secondary outcomes included changes in serum inflammatory and oxidative stress markers, and evaluation of supplement safety and tolerability. Results: Supplemented groups showed significant dose-dependent decrease MENQOL and RI compared with placebo (P < 0.0001).Women supplemented with Ws or Ar extracts had significantly decreased levels of the BTMs C-terminal telopeptide of type I collagen, bone alkaline phosphatase, and receptor activator of nuclear factor kappa-B ligand, and increased osteoprotegerin levels (P < 0.0001).Significantly decreased levels of inflammatory and oxidative stress markers high-sensitivity C-reactive protein and malondialdehyde, and increased glutathione and nitric oxide levels (P < 0.0001) were also observed. Conclusions Daily supplementation with Ws or Ar extracts dose-dependently reduces menopausal symptoms, vascular dysfunction, bone turnover/resorption, and estrogen deficiency-related inflammation and oxidative stress in postmenopausal women.

Introduction: Early identification of patients at risk for severe multisystem inflammatory syndrome in children (MIS-C) is essential for favourable clinical outcomes. This study aims to identify the clinical characteristics, factors and outcomes associated with severe MIS-C. Materials and methods: In this retrospective cohort study involving 14 major hospitals in Malaysia, children <15 years who met the United States Centres for Disease Control and Prevention case definition for MIS-C were included. Severe MIS-C was defined as children who required inotropic support, ventilatory support (invasive or non-invasive ventilation), or left ventricular ejection fraction of <55%. The factors investigated for severe MIS-C were demographic characteristics, the presence of comorbidities, clinical characteristics, and laboratory measures. Multivariable logistic regression was used to compute the adjusted odds ratio (aORs) of factors associated with severe MIS-C. Results: Among the 155 patients, 91 (58.7%) presented with severe MIS-C. Severe MIS-C was more likely in patients aged ≥5 years old (aOR 2.13, 95% confidence interval [CI] 1.08-4.21), with dehydration (aOR 3.80, 95% CI 1.53-9.45), lethargy (aOR 2.02, 95% CI 0.97-4.18), tachycardia (aOR 8.33, 95% CI 3.27-21.22), albumin <30g/L (aOR 3.36, 95% CI 1.58-7.13), creatine kinase >200U/L (aOR 3.68, 95% CI 1.57-8.64), D-dimer >3.0µg/mL (aOR 2.11, 95% CI 1.08-4.13), ferritin >500ng/mL (aOR 3.77, 95% CI 1.88-7.55), prothrombin time >12.7 seconds (aOR 3.22, 95% CI 1.61-6.43), and urea >6mmol/L (aOR 5.09, 95% CI 2.04-12.71). Conclusion: Identification of these associated factors of severity in MIS-C could aid in early recognition and prompt escalation of care, leading to better outcomes.

Introduction: Post-trauma patients are at risk of developing symptoms of post-traumatic stress disorder (PTSD) and major depression. The primary goal of this study is to estimate the prevalence of PTSD and depression symptoms in patients who have been hospitalised for the treatment of physical trauma. Additionally, we wanted to compare the prevalence of PTSD or depression symptoms alone versus PTSD associated with depression symptoms, in orthopaedic post-trauma patients. Materials and methods: This study had involved orthopaedic post-trauma patients in the orthopaedic ward and clinic of Hospital Tuanku Jaafar (HTJ), Seremban, Malaysia, using an online questionnaire, which consist of English and Malay language. We then determined the prevalence of depression and PTSD symptoms in orthopaedic post-trauma patients and compared this prevalence to the severity of the injuries sustained and any association between PTSD and depression symptoms. Results: Only 12.9% of the participants are likely to have post-traumatic stress disorder (PTSD) symptoms and 43.3% of participants have depression symptoms. There is no significant association between patient demographics and severity of the injuries with the prevalence of post-traumatic stress disorder (PTSD) and depression symptoms. However, of those deemed likely to have PTSD, 93.5% of them had both post-traumatic stress disorder (PTSD) symptoms as well as depressive symptoms. Conclusion: Only a few of the participants are likely to develop post-traumatic stress disorder (PTSD) while almost half of the participants are likely to have developed depression. Physicians caring for trauma patients should screen them for early symptoms of PTSD and depression and treat them accordingly.

Introduction: Ergonomics is the scientific study of the interactions between humans and other elements of a system to improve human well-being and overall system performance. In larger scope ergonomics examines human behavioral, psychological, and physiological capabilities and limitations. It has given a huge impact on the workers comfort which directly affects the work efficiency and productivity. In Malaysia, the electronics industry is the leading industry in the manufacturing sector and one of the largest employers. This study was conducted to examine the relationship between ergonomics factors and job performance among employees in electronics industry. Material and Method: A total of 155 employees in electronic industry were involved as respondents in this study. A cross-sectional study was conducted using self-administered questionnaires consisting of sections on physical ergonomics, cognitive ergonomics, and organizational ergonomics and job performance. The data were analysed using SPSS version 25, and descriptive statistics, person correlation and multiple liner regressions were used to identify the factors associated with job performance. Results: The findings showed that there is a significant relationship between ergonomics factors (physical ergonomics, cognitive ergonomics, and organizational ergonomics) and employee performance with p<0.05. While the multiple linear regression analysis found that the most contributing ergonomics factors was physical ergonomics that significantly affects job performance in the electronics industry in Malaysia. Conclusion: Ergonomics factors can be used to promote improved performance and productivity from the employees in the organization such as awareness training and education.

Introduction: The industrial park in the district of Parit Raja, Batu Pahat resulted in rapid growth of the town during the last 20 years and has been a reason of concern that this park also has contributed greatly to the problem of air pollution. The aim of this study was to evaluate the association between industrial air pollution and respiratory symptoms in adults living in the Parit Raja. Methods: A comparative cross-sectional study was undertaken among residents in the district of Parit Raja, Batu Pahat, Johor, Malaysia. A total of 110 residents aged between 19 and 65 years were randomly selected and information on personal characteristics and respiratory symptoms was obtained through a validated questionnaire. The prevalence of respiratory symptoms was compared between residents recruited from the areas situated about 5km radius of the industrial park (exposed) and >5km radius from the industrial park (comparative). Results: A total of 34.5% and 25.5% of adults from the exposed group reported experiencing coughing for the last 3 months and chest tightness for the last 3 years. The logistic regression models showed that symptoms of coughing was associated with the exposed group (aOR=6.34, 95% CI=2.08-19.35), male respondents (aOR=3.18, 95% CI=1.10-9.16) and who stay in Part Raja for more than 14 years (aOR=3.16, 95% CI=1.14-8.79). Conclusion: This study demonstrated that long-term air pollution exposures are consistently associated with respiratory symptoms in residents living in the proximity of industrial parks. Therefore, public health initiatives that aim to provide more conducive environment are needed, especially for residents living near industrial parks.

Pandemic fatigue encompasses exhaustion, emotional strain, and decreased motivation due to prolonged pandemic effects. This scoping review examines pandemic fatigue issues related to COVID-19, aiming to suggest effective management strategies. We assessed 2,558 records from 1st of December 2019 until 27th of March 2022 in PubMed, Science Direct, ProQuest, and ClinicalKey. Following Arksey and O’Malley (2005) and PRISMA-ScR principles, we selected 31 studies including research papers employing either quantitative or qualitative methods and editorials and other summary articles after excluding redundant and irrelevant works. The authors provide six critical answers to understand better and manage pandemic fatigue, including the need for more research and support, the collaboration between key stakeholders and the community, and the use of information to address pandemic fatigue. The review found that pandemic fatigue is prevalent among certain groups, such as students and healthcare workers. Factors contributing to pandemic fatigue include age, gender, high perceived severity of COVID-19, low trust in government or health organizations, and low social connectedness. The review also identified an instrument, the COVID-19 Pandemic Fatigue Scale, that can be used to measure pandemic fatigue. The review concluded that identifying pandemic fatigue as early as possible is absolutely important and people and their government should work together to handle the fatigue. Many countries have acknowledged the presence hence manage it differently. Nonetheless the strategy suggested by WHO has provided an excellent framework to tackle the pandemic fatigue.

Purpose: Decriminalisation of drug use is an alternative policy that many experts, including health experts, legal and enforcement experts, and stakeholders in non-government organisations (NGOs), uphold. In Malaysia, this policy was initiated in 2019 by the government to remove criminal penalties from various laws against drug possession for personal use. This study aimed to explore perceptions of drug rehabilitation officers and relapsed drug users towards decriminalising drug use that could be implemented in Malaysia. This qualitative research used an inductive approach. Methods: This study used a semi-structured, face-to-face individual interview guide. A total of 15 drug rehabilitation officers from the National Anti-Drug Agency (NADA) and 15 relapsed drug users were interviewed. Results: Thematic analysis generated three themes from raw transcripts: (1) potential outcomes of decriminalisation of drug use in Malaysia, (2) readiness of the public to accept decriminalisation of drug use, and (3) readiness of government and NADA in implementing decriminalisation of drug use. Conclusion Findings of this explorative research provide important insight into the growing body of knowledge on decriminalisation of drug use policy in Malaysia.

Choriocarcinoma occurs mainly in the gonads, but an extragonadal origin has been reported, albeit infrequently. Primary hepatic choriocarcinoma (PHC) is a rare malignancy, with only 11 cases reported. Most cases reported were in males, with none reported in pregnant females. A 23-year-old primigravida presented with a large liver lesion involving the right lobe of the liver at 28 weeks of pregnancy. Preoperative imaging was suggestive of hepatocellular carcinoma. She underwent a non-anatomical resection of the liver lesion. Surprisingly, her postoperative histopathology revealed a diagnosis of PHC. Her blood workup showed elevated beta human chorionic gonadotrophin. She underwent a termination of her pregnancy at 32 weeks. Before initiating adjuvant chemotherapy four weeks after surgery, a whole-body PET scan revealed multiple bi-lobar liver and pelvic deposits. After a multidisciplinary team discussion, she was started on adjuvant chemotherapy. She is currently under regular follow-up, seven months post-surgery. PHC, one of the vascular lesions of the liver, poses a diagnostic and therapeutic challenge, warranting a multidisciplinary approach.