Introduction: Polycystic ovarian syndrome (PCOS) is a complex endocrine disorder that significantly affects adolescent girls, particularly those with overweight or obesity. However, data examining the determinants and metabolic profiles of PCOS among adolescents with overweight and obesity remain limited, especially in Malaysia. This protocol describes a case-control study investigating the cardiometabolic, dietary, and psychosocial determinants of PCOS among adolescents with overweight and obesity. Methodology: This study is designed as a case-control study involving adolescent girls aged 13–16 years with a body mass index z-score >+1 standard deviation. Cases are defined as adolescent girls with a confirmed diagnosis of PCOS based on the recommendations of the 2017 International Consortium of Paediatric Endocrinology (ICPE), while controls are those who do not meet the diagnostic criteria for PCOS. A total sample size of 440 participants is required. Participants will be recruited from 22 secondary schools selected from a list of schools in Kuala Lumpur. Data on sociodemographic characteristics, psychosocial health, physical activity, and dietary intake will be collected using structured questionnaires. Blood samples will be obtained and analyzed for diagnostic testing (free testosterone), exclusion tests (thyroid-stimulating hormone, folliclestimulating hormone, luteinizing hormone, estradiol, prolactin, and dehydroepiandrosterone sulfate), and biochemical parameters (liver function tests, lipid profile, hemoglobin A1c, fasting glucose, fasting insulin, and inflammatory markers). Results: The study is expected to generate comprehensive data on the cardiometabolic, dietary, and psychosocial determinants of PCOS among adolescents with overweight and obesity. The findings will inform early screening strategies and targeted interventions aimed at reducing long-term reproductive and cardiometabolic complications. Conclusion This protocol outlines a structured approach to investigating PCOS in adolescence and addresses current gaps in early identification and risk stratification among highrisk populations.
Adolescent ; Humans ; Case-Control Studies ; Overweight ; Polycystic Ovary Syndrome ; Obesity

Introduction: Anaemia is common during pregnancy and can lead to miscarriage, intrauterine growth retardation, premature labour and antepartum haemorrhage. Anaemia in pregnancy is defined as a haemoglobin (Hb) level of <11 g/dL. Methods: This retrospective review included 407 antenatal mothers diagnosed with anaemia at 36±1 weeks of gestation at all 10 health clinics in Alor Gajah between January and December 2018. Results: According to the district annual returns, 2,407 antenatal mothers (36 weeks of gestation) were registered in the health clinics in Alor Gajah in 2018. Among them, the prevalence of anaemia was 18.6% (n=448). However, there were only 407 cards found. Most participants were Malays (89.4%), aged 20–40 years (93.6%) and married (96.3%). Almost all anaemia cases (96.5%) were mild (Hb level of 9–10.9 g/dL). Approximately 34.4% of the mothers were already anaemic at booking; 77.6% belonged to the B40 income group; and 31.6% had poor pregnancy spacing of <2 years. Iron deficiency anaemia was the most common type of anaemia (51.0%), followed by dilutional anaemia (34.0%), which did not normalise at 36 weeks of gestation. Anaemia was associated with lower educational (P<0.05) and Hb levels at booking (P<0.001). Conclusion Having normal maternal Hb levels in early pregnancy especially at booking is crucial, as it may reduce the possibility of anaemia during pregnancy. Early screening and supplementation of at-risk pregnancies may be applied as a preventive strategy. Suitable methods of iron treatment and investigation need further exploration.

Introduction: Cancer chemopreventive agents from natural sources have been actively investigated over the years to seek prevention against cancer. In this study, cocoa polyphenols extract (CPE) was examined to explore its antioxidant and cytotoxicity activities. Methods: CPE was analysed for total phenolic content (TPC) and antioxidant activity (DPPH radical scavenging activity and FRAP ferric-reducing antioxidant power assays). In vitro cytotoxicity effect of CPE against HepG2, HT-29, HeLa, MCF-7, MDA-MB-231 and WRL-68 cell lines after 48 h exposure was measured by MTT assay. Results: The study showed that CPE had higher total phenolic content (13560.0±420.1 mg GAE/100g dry weight of sample) than vitamin E (p<0.05). CPE exhibited strong antioxidant activity comparable with ascorbic acid in both DPPH (IC50 = 14.73±1.47 􀂗g/ml) and FRAP (2130.33±2.33 μM of FE/1 mg of dry weight of sample). The cytotoxicity study showed that CPE exhibited the highest cytotoxicity effect against MCF-7 with lowest IC50 value (3.00±0.29 mg/ml) compared to other cancer cell lines after 48 h treatment (p<0.05). Conclusion: Our results indicate that CPE demonstrated high total phenolic content, free radical scavenging activity, ferric reducing ability and cytotoxicity activity towards HepG2, HT-29, HeLa, A549, MDA-MB- 231 and MCF-7 cancer cell lines. Further isolation of bioactive constituents from CPE should be done to characterise its potential chemopreventive activity as well as to elucidate the mechanism of cancer cell death induced by CPE.