Dengue remains a public health threat that consumes a significant number of resources for its prevention and control. This systematic review aimed to solidify recent costing evidence in dengue management among South East Asian (SEA) countries. All studies conducted between 2010 and 2020 were retrieved using four international databases i.e. PubMed, Scopus, Web of Science, and Emerald Insight. The review was reported according to PRISMA guidelines. Quality assessments were done independently by two reviewers using a checklist adapted for the cost of illness studies. We identified 13 original articles representing several SEA countries. Among the common reported costing measure include total cost/ health expenditure; direct medical cost; direct non-medical cost; and indirect cost. The estimated total cost for dengue management varied between countries largely due to the difference in the total incidence of dengue cases. The estimated cost spent on dengue per capita GDP ranges from less than 0.001% to 0.1%, depending on the recorded number of dengue cases of the year. The majority of the articles focused on the economic burden from the perspective of treatment such as hospitalization and ambulatory care. In a nutshell, the economic burden of managing dengue infection is costly and the evidence suggests a steady increase in health expenditure with the growing number of dengue cases

Problem: In September 2024, an illegal toxic waste dumping incident along the Tebrau River in Johor State, Malaysia, raised widespread health concerns in Johor Bahru and Kulai districts. The pollution released a strong, unpleasant odour, resulting in acute symptoms among exposed individuals, including sore throat, dizziness and coughing. Context: The Tebrau River is a vital waterway supporting urban populations in Johor. This was not the first chemical pollution event in the region, as previous incidents, including the Kim Kim River crisis in 2019, highlighted the region’s vulnerability to such events. The involvement of multiple districts and agencies during the response presented challenges in coordination and data sharing. Action: The Johor Bahru District Health Office promptly deployed a rapid assessment team to assess the affected areas and implement both active and passive case detection. Community engagement targeted vulnerable populations, such as schoolchildren, to minimize exposure risks. Additional dumping sites identified along the Tebrau River prompted expanded surveillance and a state-level response to coordinate efforts across districts and all health-care facilities. Outcome: A total of 484 individuals were exposed to the pollution, 334 of whom developed symptoms related to chemical exposure. Timely public health actions consisted of actions to mitigate the impact. Health facilities were placed on high alert and community trust was maintained through proactive engagement. However, gaps in cross-district coordination and challenges accessing environmental data underscored areas for improvement. Discussion: This incident highlighted the importance of rapid assessment, cross-sector collaboration, community engagement and integrated data systems. It also showed that effective public health action is possible despite environmental data limitations. The strengthening of communication, standardized protocols and real-time data sharing will be critical to improving future chemical pollution events.

Introduction: Young active patients with significant pain from knee osteoarthritis are a challenging group of patients to treat. For patients with symptomatic osteoarthritis involving both medial and lateral compartments, total knee arthroplasty (TKA) would traditionally be their only surgical option. Knee joint distraction (KJD) is a novel procedure in Asia that offers a joint preserving alternative for this cohort of patients. This study aims to evaluate patients with knee osteoarthritis treated with knee joint distraction (KJD). Materials and methods: Patients were included in this study if they had medial and lateral knee pain refractory to conservative treatment for more than 6 months, aged less than 50 and radiographs confirmed osteoarthritic changes in both the medial and lateral tibio-femoral compartments. An external fixator was placed in the distal femur and proximal tibia, and the knee joint was progressively distracted over a period of 3 days, to a total distance of 5mm. After six weeks, the external fixator is removed. Manipulation under anaesthesia was performed for patients who experienced stiffness post external fixator removal to achieved desired range of motion. Results: A total of three patients underwent KJD from 2020 to 2021. The patients’ age ranged from 44 to 49 years. The mean pre-operative Oxford Knee Score (OKS) was 37.6. At final follow-up at 2 years, the mean post-operative OKS was 17.6. All patients managed to attain the minimal clinically important difference in the OKS. Conclusion: In young patients with symptomatic bicompartmental knee osteoarthritis, KJD can be considered before doing a total knee replacement.

Introduction: This study looks at the patient’s perspective to determine the Catastrophic Health Expenditure (CHE) level and the possible factors which can be associated with CHE in cancer patients. Methods: This cross sectional study was done in National Cancer Institute, Malaysia with 206 patients sampled using the multilevel sampling method and data collected from interview with patients using a validated questionnaire. The CHE definition used in this study is when the monthly health expenditure exceeds more than 10% of the monthly household income. Results: This study showed a CHE level of 26.2%. CHE was higher in Indian ethnicity (P = 0.017), single marital status (P = 0.019), poverty income (P < 0.001), small household size (P = 0.006) and without Guarantee Letter (GL) (P = 0.002) groups. The significant predicting factors were poverty income aOR 5.60 (95% CI: 2.34 – 13.39), home distance near to hospital aOR 4.12 (95% CI: 1.74 – 9.76), small household size aOR 4.59 (95% CI: 1.07 – 19.72) and lack of Guarantee Letter aOR 3.21 (95% CI: 1.24 – 8.30). Conclusion: The information from this paper can be used by policy makers to formulate better strategies in terms of health financing so that high risk for CHE cancer patients groups can be protected under a better health financing system.

Introduction: Over the past two years, coronavirus disease 2019 (COVID-19) and tuberculosis (TB) have killed over 5.7 million people globally. TB and COVID-19 continue to be significant public health problems worldwide. A growing body of research supports a link between socio-environmental factors and the transmission of COVID-19 and TB disease. Methods: This review article discussed the socio-environmental factors influencing the transmission, prevention, and control of COVID-19 and Tuberculosis disease. Result: In this review, we highlight similarities and differences between these two infectious diseases and explore the roles of socio-environmental factors (air pollution exposure and climate change) and socioeconomic factors in disease transmission. A comprehensive, integrated TB-COVID-19 management for prevention and disease control, which includes administrative, engineering, environmental control, effective personal protective equipment, and community-based public health activities were discussed. Conclusion Understanding the similarities and differences between these two infectious diseases and the role of socio-environmental factors in disease transmission helps in planning and strengthening an integrated system for disease prevention and control strategies.

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.

Background and Objectives: Malnutrition is a serious public health problem in developing countries, including Indonesia. Based on RISKESDAS 2018, the prevalence of stunting aged 13-15 years in Takalar Regency is 24.83%. This study aimed to assess the prevalence of stunting and the determinants of stunting in adolescent girls aged 13-15 years in the South Galesong District, Takalar Regency. Methods: This is a cross-sectional study using purposive sampling method that included 247 adolescent girls in selected junior high schools. Data collection used questionnaires and anthropometric measurements. An anthropometric measurement was converted to the indices of nutritional status using World Health Organization Anthro Plus software. Results: The prevalence of stunting was 25.1%. Bivariate analysis showed determinant factors related significantly to stunting were energy intake (p<0.001), protein intake (p<0.001), iron intake (p<0.005), and zinc intake (p<0.001). Multivariate analysis showed determinant factors related significantly to stunting were zinc intake (p<0.001, OR=7.993), protein intake (p<0.05, OR=2.248), and knowledge level (p<0.05, OR=2.032). Conclusion The occurrence of stunting is related to the quality and quantity of food and the level of adolescent knowledge about balanced nutrition. It is necessary to hold educational programs and interventions on improving nutrition initiated by stakeholders and the department of health, in this case, the health center is needed to reduce stunting rates, especially among adolescents.
Malnutrition ; Growth Disorders ; Adolescent

Craniopharyngioma is uncommon benign intracranial tumour that can be cured by surgical resection followed by conventional radiotherapy. However, its anatomical localisation makes the treatment hazardous or impossible. This case report aims to discuss the first local experience of using beta-emitting Yttrium-90 radioisotope in treating a patient with refractory cystic craniopharyngioma. A 43-year-old male who has underlying refractory cystic craniopharyngioma complicated with visual impairment and panhypopituitarism was referred to our nuclear medicine department for intra-cavitary irradiation therapy.Initially, he was presented with blurring of vision and headache which he had two previous resection surgeries of cystic craniopharyngioma. However, due to persistent symptoms, he had Ommaya reservoir shunt inserted for regular aspiration.Despite regular aspiration, his symptoms worsen. He was unsuitable for radiotherapy thus was considered for intra-cystic irradiation with radioisotope. Prior to the therapy, he had pre-therapy assessment with Tc-99 m MAA. He subsequently received Ytrrium-90 citrate colloid of 300 Gy radiation dose to the inner surface of the tumour which complicated with post therapy inflammatory reaction. This first local experience highlights the role of radioisotope as the valuable minimally invasive adjuvant therapy in treating a patient with refractory cystic craniopharyngioma. Further follow-up is necessary to assess the outcome and possible late complications.

Oral squamous cell carcinoma (OSCC) is the commonest malignant tumour affecting the oral cavity with a poor 5-year disease free survival. We present an octogenarian with a recurrent oral cavity squamous cell carcinoma, treated with salvage mandibulectomy without bony reconstruction. No immediate or intermediate perioperative complications were documented. Subsequent monthly surveillance clinical examination, endoscopy and computed tomography at six months post-operative showed no evidence of residual tumour. Geriatric syndrome, perioperative risk and oncologic stratification are three main cornerstones in evaluating feasibility of oncologic surgery in an elderly patient. A multidisciplinary approach allowed surgical extirpation of OSCC with a good outcome

Aims: In this study, three putative factors that commonly contribute to antibacterial properties in honey were determined, namely acidity (pH level), peroxide compounds and non-peroxide compounds. Methodology and results: Honey samples were prepared based on the known factors of acidity, peroxide compounds,and non-peroxide compounds to identify factors that contribute to the antibacterial properties of the honey based on agar diffusion assay. Liquid chromatography quadropole time-of-flight mass spectrometry was employed to detect and quantify the presence of acidic, peroxide, and non-peroxide compounds in the honey samples. Acidity and non-peroxide compounds were identified as the significant factors contributing to the antibacterial properties of Kelulut, Tualang and Acacia honey. No peroxide compound was detected in this study across all honey samples. In Kelulut, the presence of the additional compounds (reptoside, platycogenic acid and kauranoic acid) may explain its higher antibacterial properties against Escherichia coli and Staphylococcus aureus as compared to Tualang and Acacia honey based on the inhibition zones on the agar plates. Conclusion, significance and impact of study The presence of multiple antibacterial factors in honey is notably important as it gives an advantage of using honey compared to antibiotics in preventing the growth of a wide range of bacterial species with multiple modes of action.