Kesan Pendedahan Mikroplastik terhadap Jantung: Ulasan Naratif Introduction World Health Organization (WHO) reported that heart disease is among the global main cause of death. The significant environmental factor for heart disease is microplastic exposure. In cardiology, microplastic has been widely used due to stability and biocompatibility. Therefore, this narrative aimed to study the effect of microplastic exposure towards heart. The findings will contribute to evidence-based medicine in heart disease prevention strategies Methods A literature search was conducted on ninth November 2024, across three scientific databases of Scopus, PubMed, and Web of Science using specified keywords like microplastic and heart. The target was original articles published between 2019 and 2024. Results A total of six articles published within 2023 and 2024 have been analysed. All articles reported that microplastic exposure triggers the oxidative process and inflammatory response of cardiomyocyte cells. These processes led to myocardial ischemia and infarction that resulted in heart failure. Conclusions Microplastic exposure is a new risk factor for heart disease. The findings should be integrated in public health promotion programme and the clinical practice guideline of cardiovascular disease for multilevel prevention.

Cost-Effectiveness of Mobile Application Use in Managing Type 2 Diabetes Mellitus: A Systematic Review Introduction Type 2 diabetes mellitus (T2DM) is a debilitating condition that imposes a significant economic burden on its management. This study aims to systematically review the published evidence on the cost-effectiveness of mobile health (mHealth) application interventions for T2DM. Methods A search strategy was conducted using electronic bibliographic databases, including PubMed, Web of Science and Scopus for published studies. The inclusion criteria included original articles that reporting cost-effectiveness evaluation studies on mHealth application interventions directed at patients diagnosed or at risk of T2DM, English-language articles and published in the year 2016 to 2020. Results A total of 6 eligible studies were selected. The cost savings per person for treating T2DM ranged from USD 1,346 to USD 3,781 per year. The major contributor to cost savings was reduced complication management resulting from good glycaemic control. The direct impacts of the intervention include reduced hospitalisation and fewer unplanned clinic visits, while diabetes- related mortality was indirectly reduced usingmHealth. Conclusions The mHealth intervention was cost-effective in managing patients with T2DM. Implementation can be extended to other disease management areas to not only reduce total healthcare expenditure but also improve patients’ quality of life.

Malaria is a life-threatening, preventable, and curable vector borne disease caused by parasites that are transmitted to people through the bites of infected female Anopheles. The WHO Global Report 2010-2016 reported insecticide resistance in malaria. The main objective of this study is to determine the effectiveness of new generation Long-Lasting Insecticidal Nets (LLIN) compared to standard LLIN and untreated nets in terms of the mortality rate of adult female Anopheles gambiae. A comprehensive review of the literature was published in three databases (PubMed, Ovid, EBSCO Host) since 2010. Publications were searched with keywords including malaria, long-lasting treated bed net, long lasting insecticide-treated bed net, LLIN, and experimental hut. The search has identified 60 articles. Based on the PRISMA flowchart, 10 articles are qualified for data collection and analysis. The gathered data was analysed using Review Manager. Following meta-analysis between subgroups, a risk difference of 0.31 between standard LLINs versus untreated net (p<0.001, I²=100% 95% CI:0.01,0.60). A comparison of upgraded LLINs with the untreated net has shown a significant difference with a pooled risk difference of 0.54 favours upgraded LLINs (p<0.001, I²=100% 95% CI: 0.54,0.84). Comparison between upgraded LLINs versus standard gave an overall risk difference of 0.24 (p < 0.001, I² = 100%, 95% CI: 0.10–0.39). Upgraded LLINs significantly increase Anophelesmortality compared to standard LLINs and untreated nets, suggesting their potential for improved malaria control. Thus, using upgraded nets in the field and translating them into malaria preventive programs would help achieve the target and improve healthoutcomes for those living in endemic areas.

Kimia Obesogen dan Obesiti Kanak-kanak sebagai Ancaman Kesihatan Awam: Satu Ulasan Naratif PengenalanObesiti dalam kalangan kanak-kanak ialah isu kesihatan global yang semakin meningkat dengan prevalens yang tinggi, termasuk di Malaysia. Faktor persekitaran seperti pendedahan kepada bahan kimia obesogen dipercayai menyumbang kepada peningkatan risiko obesiti. Ulasan naratif ini bertujuan untuk menyiasat hubungan antara bahan kimia obesogenik dan obesiti kanak-kanak secara mendalam bagi menyokong pembangunan strategi pencegahan yang lebih berkesan.MetodologiUlasan naratif ini dijalankan menggunakan pangkalan data PubMed, Google Scholar, Web of Science, dan Scopus untuk menyiasat hubungan antara bahan kimia obesogenik dan obesiti kanak-kanak. Kata kunci yang relevan digunakan untuk mengenal pasti artikel yang memenuhi skop kajian. Artikel tambahan diperoleh melalui rujukan silang daripada artikel yang dipilih dalam carian awal.Hasil KajianObesogen ialah bahan kimia eksogen yang mengganggu fungsi metabolik, mempromosikan pengumpulan lemak, dan meningkatkan risiko obesiti dalam kalangan kanak-kanak, terutamanya melalui mekanisme seperti gangguan adipogenesis, penurunan kadar metabolik basal, dan perubahan kawalan selera makan. Kajian menunjukkan hubungan yang signifikan antara pendedahan pranatal kepada bahan kimia seperti phthalate dan PFAS dengan peningkatan indeks jisim badan (BMI) dan risiko obesiti kanak-kanak. Kajian eksperimen turut mengesahkan bahawa obesogen seperti BPA dan phthalate mempromosikan adipogenesis dan gangguan metabolik dalam model haiwan dan sel manusia, memberikan bukti kukuh tentang peranan obesogen terhadap obesiti kanak-kanak.KesimpulanPendedahan kepada obesogen kimia memberi kesan negatif terhadap obesiti kanak-kanak. Oleh itu, tindakan segera melalui kawalan bahan kimia dan pendidikan awam amat diperlukan. Penyelidikan lanjutan dan perubahan polisi global juga perlu dilaksanakan bagi memastikan masa depan yang lebih sihat untuk generasi akan datang.

Risks, Incidents, Guidelines, and Strategies Pertaining to Chemical Storage and Handling in Primary Healthcare – A Narrative Review Introduction Effective chemical storage and handling are critical in primary healthcare (PHC) to safeguard healthcare workers, patients, and the environment. Despite their importance, PHC facilities face unique challenges due to limited resources, inadequate monitoring, and the absence of tailored guidelines and protocols. This narrative review explores the state of chemical storage and handling practices in PHC. Methods A systematic methodology guided this narrative review, including a comprehensive literature search using PubMed, Scopus and Web of Science with defined inclusion and exclusion criteria. Given the scarcity of PHC-specific studies, a purposive selection approach was employed to incorporate evidence from broader healthcare contexts. Data extraction and thematic analysis identified key risks, documented incidents, and evidence-based strategies for improving chemical storage and handling. Results Findings reveal that improper chemical practices lead to acute health effects such as respiratory distress and chemical burns, chronic conditions like asthma and operational disruptions. Non-compliance with regulations exacerbates financial and reputational risks. Case studies, including an ammonia gas leak in Malaysia and chlorine gas exposure in the United Kingdom, highlight the severe consequences of inadequate practices. Six strategies to improve chemical storage and handling in PHC settings were identified: i) regular monitoring and risk assessments, ii) safe physical storage practices, iii) training and education, iv) use of personal protective equipment (PPE), v) incident management and response plans, and vi) inventory organization and storage efficiency. Conclusions These evidence-based strategies can mitigate risks and enhance safety. The review underscores the urgent need for PHC-specific guidelines and future research to address existing gaps and foster safer PHC environments.

Pengurusan Sisa Penjagaan Kesihatan Pesakit di Rumah oleh Penjaga bagi Pesakit yang Menghidap Penyakit Tidak Berjangkit: Ulasan Naratif Pengenalan Pengurusan sisa penjagaan kesihatan adalah penting dalam menjaga alam sekitar dan kesihatan awam. Dalam konteks penjagaan pesakit penyakit tidak berjangkit (NCD) di rumah, penghasilan sisa berbahaya seperti benda tajam dan bahan berjangkit menuntut pengurusan yang berkesan bagi mengurangkan risiko pencemaran dan jangkitan. Ulasan naratif ini bertujuan untuk mengenalpasti jenis sisa yang dijana, amalan pelupusan dan kekangan yang dihadapi semasa pengurusan sisa penjagaan di rumah. Metodologi Kajian ini menggunakan pendekatan ulasan naratif dengan meneliti artikel jurnal, laporan kes, dan panduan berkaitan pengurusan sisa penjagaan kesihatan di rumah bagi pesakit NCD dalam tempoh 10 tahun. Carian artikel dilakukan dalam pangkalan data seperti PubMed, Scopus dan WOS. Hasil Tujuh artikel telah memenuhi kriteria inklusi melalui carian literatur yang dijalankan. Penemuan menunjukkan sisa yang dihasilkan terdiri daripada benda tajam, bahan berjangkit, dan sisa farmaseutikal. Walau bagaimanapun, terdapat kekurangan dalam amalan pengasingan dan pelupusan sisa yang sesuai oleh penjaga. Sebahagian besar penjaga membuang sisa klinikal bercampur dengan sisa domestik biasa, yang meningkatkan risiko kesihatan.KesimpulanPerbezaan amalan pengurusan sisa penjagaan pesakit di rumah adalah berdasarkan tahap ekonomi sesebuah negara. Kekurangan pengetahuan, garis panduan khusus serta pemantauan bagi pengurusan sisa penjagaan di rumah menyebabkan penjaga menghadapi cabaran dalampelupusan yang selamat. Di samping itu, ketiadaan infrastruktur yang mencukupi turut memburukkan keadaan bagi negara berpendapatan rendah atau sederhana. Latihan dan kesedaran kepada penjaga serta dasar yang komprehensif diperlukan untuk memastikan pengurusan sisa penjagaan kesihatan yang lebih selamat dan efektif. Hal ini penting bagi mengurangkan risiko jangkitan dan perlindungan alam sekitar.

Introduction: Risk factors for Parkinson’s disease (PD) fall into three broad categories, namely environmental, genetic, and lifestyle factors. Identifying environmental factors that increase the risk of PD would allow these exposure to be reduced and the disease prevented while facilitating experimental investigation of mechanisms and intervention options. Thus, the aim of this review is to summarise the current evidence on the role of environmental factors in the development of PD. Methods: All original articles published between 2018 and 2022 and written in English were searched from three databases, i.e., PubMed, Scopus Web of Science (WoS), using combination of primary keyword (PD and its MeSH and synonyms), and two secondary keywords; (“environment*”) and risk (factor*). Result: After a thorough screening process, nineteen articles were included in this scoping review. The environmental risk factors examined in the included studies fell into five categories: a) pesticide exposure, b) heavy metals and organic solvent exposure, c) drug abuse and d) air pollution and e) source of water. Conclusions In summary, PD is a complex neurological disorder for which there are several environmental risk factors involved. Identifying and reducing exposure to these environmental factors could have a significant impact on the future occurrence of the disease.

Introduction: Heatwave can increase the risk for heat-related illnesses and mortality. Many studies showed certain population are vulnerable to heatwave such as elderly, children and low-income households. However, the findings were inconsistent. Therefore, this systematic review provides a comprehensive review on heatwave impact and vulnerability factors on the mortality and morbidity impacts. Methodology: Five electronic databases (Pubmed, Ebsco Host, WOS, OVID Medline and Scopus) were primary searching tools to retrieve relevant literatures. This systematic review used the Medical Subject Heading (MESH) terms and keywords. An additional searching tool (Google Scholar) was used to seek further information and minimize missed evidence. We selected the literature based on the inclusion criteria (empirical full-text article, English language and published between 2010-2021). Two authors were assigned in each step of the process, starting from screening of the title, abstract and full text based on the inclusion criteria, data extraction and quality appraisal. Mixed-Method Appraisal Tool (MMAT) was utilized to assess the quality of selected articles. Thematic analysis and narrative approach were used to describe the findings. Conclusion This review presents the comprehensive evidence-based regarding heatwave impact and associated vulnerable groups for better understanding and effective preventive measure planning to reduce the impact of heatwave on population health.

Sexual dysfunction in women is a significant health problem that harms marriage stability. Women in the Western countries were reportedly being affected by this condition after childbirth but the magnitude of the problem in our local setting is still unknown. The aim of this cross-sectional study was to determine the prevalence of women with sexual dysfunction at four to six months postpartum and its possible risk factors in an urban primary care setting. The participants were given a set of questionnaire, consisting of three parts; i) sociodemographic and maternal characteristics ii) Malay version of Female Sexual Function Index and iii) Malay DASS-21 questionnaire. Responses from 249 women were analyzed. More than half (57.0%,n=142) were found to have sexual dysfunction. The most prevalent types of sexual dysfunction reported by the affected women were sexual satisfaction disorder (98.6%), followed by arousal disorder (58.5%) and lubrication disorder (28.9%). Three factors were found to be significantly associated with sexual dysfunction; household income of less than RM2000 (adj OR = 0.31, 95% CI 0.14, 0.70), Malay ethnic group (adj OR = 1.93,95% CI 1.02, 3.66) and breastfeeding (adj OR = 2.24,95% CI 1.03, 4.85). In conclusion, the prevalence of sexual dysfunction in the postpartum period was considerably high. Efforts should be made to incorporate sexual health as part of the routine postnatal assessment in primary care practice.

Field trials of Wolbachia-transinfected mosquitoes, as a biological approach to curb dengue transmission, have been initiated. This study aimed to determine the knowledge regarding dengue fever (DF), practice of vector control, and acceptance of Wolbachia as a dengue control method among Universiti Kebangsaan Malaysia Medical Centre (UKMMC) healthcare staff. A questionnaire assessing knowledge regarding DF, vector control practices, and acceptance of Wolbachia was conducted among 330 UKMMC healthcare staff via convenience sampling. More than 70% of the respondents had good knowledge regarding DF, good vector control practice, and good acceptance of Wolbachia. Being female and having household income >MYR3000 had higher odds of having good knowledge regarding DF [(aOR 2.40; 95%CI 1.13, 5.12) and (aOR 3.86; 95%CI 1.91, 7.80)]. Having household income >MYR3000 had higher odds of having good vector control practice (aOR 2.33; 95%CI 1.20, 4.54) while academicians were three times (1-0.24) less likely to have good vector control practice than non-academicians (aOR 0.24; 95%CI 0.13, 0.48). Good acceptance of Wolbachia was associated with being academicians (aOR 8.83; 95%CI 2.60, 29.96) and having good knowledge regarding DF (aOR 6.07; 95% CI 2.89, 12.74). Gender, different income level and type of occupation have significant association with either good knowledge regarding DF or practice on vector control. Different type of occupation and level of knowledge also were notably significantly associated with good acceptance on Wolbachia as dengue biological control. These factors may be the focus for future plan to enhance the knowledge, acceptance and practice regarding DF and its control.
Wolbachia ; Dengue, Aedes ; Knowledge ; Practice ; Acceptance ; Questionnaire ; Healthcare staff