Gastrointestinal stromal tumours (GISTs) are mesenchymal tumours commonly found in the gastrointestinal tract, particularly in the stomach, but they can mimic gynaecological tumours. We report the case of a 56 -year-old postmenopausal woman who presented with a right adnexal pelvic mass. Computed tomography (CT) revealed a large, lobulated pelvic mass with liver lesions. Pan - endoscopy showed normal findings, and her tumour markers were within normal limits. Based on these findings, the gynaecological oncology team proceeded with a laparotomy and tumour debulking, diagnosing the pelvic mass as likely ovarian in origin. Intraoperatively, the mass was found to originate from the stomach and extend posteriorly to the transverse colon. An en -bloc resection with primary anastomosis was performed and histopathology confirmed a high -risk GIST. The patient made a good post -operative recovery and was scheduled for adjuvant chemotherapy at her follow -up visit. This case highlights the importance of considering GIST as a differential diagnosis in postmenopausal women presenting with an abdominopelvic mass that may mimic an ovarian tumour

Gastrointestinal stromal tumours (GISTs) are mesenchymal tumours commonly found in the gastrointestinal tract, particularly in the stomach, but they can mimic gynaecological tumours. We report the case of a 56 -year-old postmenopausal woman who presented with a right adnexal pelvic mass. Computed tomography (CT) revealed a large, lobulated pelvic mass with liver lesions. Pan - endoscopy showed normal findings, and her tumour markers were within normal limits. Based on these findings, the gynaecological oncology team proceeded with a laparotomy and tumour debulking, diagnosing the pelvic mass as likely ovarian in origin. Intraoperatively, the mass was found to originate from the stomach and extend posteriorly to the transverse colon. An en -bloc resection with primary anastomosis was performed and histopathology confirmed a high -risk GIST. The patient made a good post -operative recovery and was scheduled for adjuvant chemotherapy at her follow -up visit. This case highlights the importance of considering GIST as a differential diagnosis in postmenopausal women presenting with an abdominopelvic mass that may mimic an ovarian tumour

Introduction: Isolated hypothyroxinemia (IH) in pregnancy, characterized by low free thyroxine 4 (FT4) with normal thyroidstimulating hormone (TSH), has a reported prevalence of 1.3–8%. We present a diagnostically challenging case that initially mimicked central hypothyroidism before evolving into classic IH. Case: A 37-year-old G4P3 female at 22 + 3 weeks gestation with β-thalassemia trait presented with palpitations and tachycardia (150–184 bpm). A bedside echocardiogram showed volume depletion. Her heart rate improved to 108– 116 bpm following a 1.5 L normal saline bolus. Incidentally, thyroid function tests (TFTs) revealed both low FT4 6.04 pmol/L (7.86–14.41) and low TSH 0.009 mIU/L (0.38–5.33). Anti-thyroid peroxidase antibody was markedly elevated at 360 IU/mL (<35). At 24 + 4 weeks, TFTs showed persistently low FT4 (5.84 pmol/L) and TSH (0.022 mIU/L). Differential diagnoses included central hypothyroidism or assay interference. Tests were repeated using different platforms. Both the Beckman system (FT4: 5.73 pmol/L, TSH: 0.086 mIU/L) and Roche system (FT4: 8.83 pmol/L [12.0–22.0], TSH: 0.11 mIU/L [0.27–4.20]) confirmed low values, ruling out assay interference. Following endocrinology consultation and given her asymptomatic status, IH was considered most likely, and a plan for close monitoring was initiated. Serial follow-up demonstrated biochemical evolution. By 31 + 6 weeks, TFTs showed a low TSH (0.753 mIU/L) with an FT4 level (5.86 pmol/L) within the normal reference range, a pattern typical of IH in pregnancy. Repeat TFTs 6 weeks postpartum showed both TSH and FT4 within normal range. Conclusion This case illustrates a rare and unexpected biochemical progression of IH in pregnancy, initially presenting with a pattern indistinguishable from central hypothyroidism. It underscores that in an asymptomatic, fertile patient, IH can manifest with an atypical pattern early in gestation. The findings suggest that vigilant serial monitoring, rather than immediate extensive pituitary workup, may be a prudent initial approach in such scenarios, as the biochemical profile can normalize toward the classic IH pattern as pregnancy advances.
Female ; Pregnancy ; Thyrotropin

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.

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: 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.

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.