SELF-SYSTEM AND MENTAL HEALTH STATUS AMONG MALAYSIAN YOUTH ATTENDING HIGHER EDUCATIONAL INSTITUTIONS: A NATIONWIDE CROSS-SECTIONAL STUDY Introduction: Mental health disorders (MHDs) are a global health burden with an increasing prevalence. During the COVID-19 pandemic, depression was the commonest MHD, followed by anxiety and stress. This nationwide study aimed to determine the prevalence and associated factors of depression, anxiety and stress among Malaysian students attending higher educational institutions. Methods: A cross-sectional study was conducted from June to December 2021. Institutions were selected via stratified random sampling and students via convenience sampling. A self-administered questionnaire comprising questions on socio-demographic characteristics, academic background, substance abuse, childhood abuse, religiosity and the Depression Anxiety Stress Scale-21 was used. Data were analysed using SPSS version 27; descriptive, point-biserial correlation, chi-square and multiple binary logistic regression analyses were conducted. Results: Sex and adverse childhood experiences significantly predicted all three MHDs (P<0.05). The students from public institutions (odds ratio [OR]=0.71, 95% confidence interval [CI]=0.56–0.90, P=0.004) had a lower risk of depression than those from private institutions. The smokers/vapers (OR=1.43, 95% CI=1.02–2.02, P=0.041) a higher risk of depression than the non-smokers/non-vapers. The social science students (OR=1.29, 95% CI=1.01–1.65, P=0.039) had a higher risk of anxiety than the science students. The students who highly engaged in organisational religious activity (OR=0.91, 95% CI=0.84–0.98, P=0.015) had a lower risk of anxiety than their counterparts. Conclusion: Anxiety is the commonest MHD among Malaysian youth, followed by depression and stress. Childhood abuse is a crucial related factor requiring further attention. Screening, surveillance, preventive measures and comprehensive interventions for MHDs should be initiated among youth.

Uterine leiomyosarcoma is a malignant smooth muscle tumour of the uterus. It is rare and accounting for less than 2% of cases in malignant gynaepathology. To date, only a few reported cases of leiomyosarcoma arising from leiomyoma documented in the literature. We shared an uncommon occurrence of leiomyosarcoma arising from leiomyoma. Presented herein is a case of a ‘rare epithelioid subtype’ of leiomyosarcoma arising from a leiomyoma in a postmenopausal woman. We highlighted the importance of recognizing the possibilities of this event to allow for a timely diagnosis of leiomyosarcoma and to provide insights on management of patients presented with clinically presumed fibroid.

Periosteum is a connective tissue that envelopes the outer surface of bones and is tightly bound to the underlying bone by Sharpey’s fibers. It is composed of two layers, the outer fibrous layer and the inner cambium layer. The periosteum is densely vascularised and contains an osteoprogenitor niche that serves as a repository for bone-forming cells, which makes it an essential bone-regenerating tissue and has immensely contributed to fracture healing. Due to the high vascularity of inner cambium layer of the periosteum, periosteal transplantation has been widely used in the management of bone defects and fracture by orthopedic surgeons. Nevertheless, the use of periosteal graft in the management of bone defect is limited due to its contracted nature after being harvested. This review summarizes the current state of knowledge about the structure of periosteum, and how periosteal transplantation have been used in clinical practices, with special reference on its expansion.

Introduction: Over the last decade, tuberculosis (TB) has remained the main cause of death from communicable diseases in Malaysia. This study was aimed to determine the risk factors of unfavourable treatment outcomes (UTO) among new TB cases in Hulu Langat. Methods: A cohort study was prospectively conducted among the new TB cases registered in the government health clinics of Hulu Langat district. The event was defined as any one of the UTO (default, transferred out, treatment failure and death) whichever came first. This data was analysed using SPSS version 25.0. Survival pattern was assessed by Kaplan-Meier plots and Log rank test. Hazard ratios of unfavourable TB treatment outcomes among the new TB cases at 95% confidence interval and level of significance set at 0.05 were calculated using Cox proportional hazard model. Results: Of the 321 patients analysed, 80.4% (n=258) had favourable treatment outcomes and 19.6% (n=63) had UTO with 10.9% (n=35) transferred out, 6.9% (n=22) defaulted and 1.9% (n=6) died. There was no treatment failure. The mean survival time was 5.2 (SD=0.09) months. The risk factors of hazard probability of UTO were male, ethnicity type Others, positive human immunodeficiency virus (HIV) status and not done sputum at 2 months of treatment. Conclusion: Transferred out and default formed the bulk of the UTO in Hulu Langat. New interventions to improve the existing TB prevention and control program should be planned in the first three months of treatment.

The application of artificial intelligence (AI) is on the rise in the healthcare industry. However, the study on the physicians’ perspectives is still lacking. The study aimed to examine physicians’ attitudes, expectations, and concerns regarding the application of AI in medicine. A cross-sectional study was conducted in October 2019 among physicians in a tertiary teaching hospital in Malaysia. The survey used a validated questionnaire from the literature, which covered: (1) socio-demographic profile; (2) attitude towards the application of AI; (3) expected application in medicine; and (4) possible risks of using AI. Comparison of the mean score between the groups using a t-test or one-way analysis of variance (ANOVA). A total of 112 physicians participated in the study: 64.3% from the clinical departments; 35.7% from the non-clinical specialties. The physicians from non-clinical departments had significantly higher mean attitude score (mean = 14.94 ± 3.12) compared to the clinical (person-oriented) departments (mean = 14.13 ± 3.10) and clinical (technique-oriented) departments (mean = 13.06 ± 2.88) (p = 0.033). The tech-savvy participants had a significantly higher mean attitude score (mean = 14.72 ± 3.55) than the non–tech-savvy participants (mean = 13.21 ± 2.46) (p = 0.01). There are differences in the expectations among the respondents and some concerns exist especially on the legal aspect of AI application in medicine. Proper training and orientation should precede its implementation and must be appropriate to the physicians’ needs for its utilization and sustainability.

Introduction: Accelerants and fabrics are commonly used to spread fire attributable to their highly flammable properties. Hence, having the ability to discriminate the different types of accelerants on various types of fabrics after fire and/or arson using the non-destructive Attenuated Total Reflectance-Fourier Transform Infrared (ATR-FTIR) spectroscopy coupled with chemometric techniques appears forensically relevant. Methods: Six types of fabrics viz. cotton, wool, silk, rayon, satin, and polyester, were burnt completely with RON95 and RON97 gasoline as well as diesel. Subsequently, the samples were analyzed by ATR-FTIR spectroscopy followed by Principal Component Analysis (PCA) and Linear Discriminant Analysis (LDA) for discriminating the different types of accelerants on such burned fabrics. Results: RON95 showed the fastest rate of burning on all fabric types. Results also revealed that while wool had the slowest burning rate for all the three different accelerants, polyester, cotton, and satin demonstrated the highest rate of burning in RON95, RON97, and diesel, respectively. FTIR spectra revealed the presence of alkane, alcohol, alkene, alkyne, aromatic, and amine compounds for all fabrics. The two dimensional PCA (PC1 versus PC2) demonstrated 71% of variance and it was improved by cross-validation through the three dimensional LDA technique with correct classification of 77.8%. Conclusion: ATR-FTIR spectroscopy coupled with chemometric techniques had enabled identification of the functional groups, as well as statistically supported discrimination of the different accelerants, a matter of relevance in forensic fire and arson investigations.

Introduction: High-intensity interval training (HIIT) has been found to improve cardiometabolic health outcome as compared to moderate-intensity continuous exercise. However, there is still limited data on the benefits of HIIT on the expression of regulatory proteins that are linked to skeletal muscle metabolism and insulin sensitivity in obese adults. This study investigated the effects of HIIT intervention on expressions of peroxisome proliferatoractivated receptor-γ coactivator 1-α (PGC-1α) and adiponectin receptor-1 (AdipoR1), insulin sensitivity (HOMAIR index), and body composition in overweight/obese individuals. Methods: Fifty overweight/obese individuals aged 22-29 years were assigned to either no-exercise control (n=25) or HIIT (n=25) group. The HIIT group underwent a 12-week intervention, three days/week, with intensity of 65-80% of age-based maximum heart rate. Anthropometric measurements, homeostatic model of insulin resistance (HOMA-IR) and gene expression analysis were conducted at baseline and post intervention. Results: Significant time-by-group interactions (p<0.001) were found for body weight, BMI, waist circumference and body fat percentage. The HIIT group had lower body weight (2.3%, p<0.001), BMI (2.7%, p<0.001), waist circumference (2.4%, p<0.001) and body fat percentage (4.3%, p<0.001) post intervention. Compared to baseline, expressions of PGC-1α and AdipoR1 were increased by approximately three-fold (p=0.019) and two-fold (p=0.003) respectively, along with improved insulin sensitivity (33%, p=0.019) in the HIIT group. Conclusion: Findings suggest that HIIT possibly improved insulin sensitivity through modulation of PGC-1α and AdipoR1. This study also showed that improved metabolic responses can occur despite modest reduction in body weight in overweight/obese individuals undergoing HIIT intervention.

Abstract Introduction: Noise was evident to reduce job satisfaction among workers which will negative impacts to workers including increase job turnover, decrease motivation and increased number of accidents. This study aims to explore job satisfaction and its risk factors among workers working in a noisy workplace. Method: The study design was cross-sectional study which involved 167 workers in a cable manufacturing factory selected by simple random sampling. MSQ was used to assess employee’s satisfaction with their job on seven facets and sound level meter was used to measure workplace noise level. Results: All respondents were exposed to noise above permissible exposure limit. Most workers (49%) were moderately satisfied with their work. Factors that were rated as lowest level of satisfaction were work itself (the ability to work alone) (40%) and the way company system policies are implemented (40%). Factors with the highest level of satisfaction were their freedom to implement their judgement (responsibility) (51%) and the supervision quality of their superiors (51%). The most dominant facet predicting total satisfaction level was recognition followed by advancement and company policy and administration. All variables in socio-demographical and job characteristics were not significantly associated with their level of job satisfaction except noise. Noise was significant in predicting one facet of job satisfaction which was physical work condition. Conclusion: Overall, the average level of job satisfaction among respondents were moderate and they were exposed to occupational noise which was the only significant study variable correlated with their job satisfaction.

Introduction: Flood is a natural disaster cause by heavy rainfall and high tide phenomenon. In the event of flood, substantial amount of wastes tend to be moved away and washed with mud that cause the task of waste recovering extremely challenging. The objective of the study was to assess flood victims participation, duration and major problem arise during post flood waste clean-up activity together with respondent’s knowledge and psychological importance in the recovery process. Methods: A cross sectional survey using interview and self-administered questionnaire was conducted involving 150 flood victims in Kuala Krai, Kelantan, who were heavily affected by the recent flood. Results: Respondents participation in the clean-up process was high (N = 126, 84%). Average 1 to 3 months were taken for the clean-up activity. Majority of the respondents had low and moderate satisfaction on the cleaning service provided by the authority (N = 84, 56%). Major problem arises from the past flood waste clean up activity was the biased waste removal process (N = 124, 83%), victims have to find alternative ways for disposal (N = 108, 72%) and the temporary disposal site were located near to the housing area that creates discomfort (N = 105, 70%). The correlation test obtained significant relationship between knowledge and education level (X2 = 0.203, p=0.013). But no significant relationship was obtained between knowledge with gender, age, monthly income, duration of clean-up process, respondents participation and satisfaction. Conclusion: Disaster debris management and disposal is critically important to support the victims in their recovery process.
Natural disaster

Background: Prolonged exposure of heavy metals in the respirable particulate matter (PM10) from municipal solid waste (MSW) landfills may affect children health. Objective: To investigate the association of reported respiratory symptom with heavy metals in PM10, with heavy metals in fingernails among children residing close to MSW landfills. Methods: Two groups of children age 7 to 12 years old were involved in this cross-sectional study. Those residing within 3 km radius from a landfill were the exposed group and those residing more than 3 km radius as the unexposed group. Questionnaires adapted from American Thoracic Society were applied in the survey. Fingernails were used as biomarker. Ten heavy metals elements in PM and fingernail samples were analysed using inductively coupled plasma mass spectrometry (ICP-MS). Results: The cadmium, chromium, copper, manganese, nickel and lead concentrations in PM around the MSW landfills and residential areas exceeded the Canada and USEPA standard permissible limit. Heavy metals in fingernails (p<0.001) of exposed group were significantly higher than the unexposed group. Children with no pets have less reported respiratory symptoms. Elevated level of heavy metals in PM and fingernails were associated with high risk of reported respiratory symptoms. Conclusion: Heavy metals in PM10 and fingernails were associated with potential risk factor of respiratory health in children.