Introduction: Poor dietary diversity is one of the key factors that increases the rate of complications during pregnancy. Pregnancy complications significantly increase the risk of maternal mortality. The aim of this study was to explore the associated factors between dietary diversity and complications during pregnancy. Method: A cross-sectional study was conducted among 450 randomly selected pregnant women. Individual dietary diversity score (IDDS) was used to assess dietary diversity based on Food Frequency Questionnaire (FFQ). IDDS was derived from 24-hour recalls from nine food groups. Results: Most of the pregnant women (48.9%) included in this study were in their second trimester; 19.3% and 31.8% were in first trimester and third trimester, respectively. About 83.8% of respondents included in this study experienced pregnancy complications. According to IDDS, most participants (77.1%) consumed a medium-diversified diet. Only 4.4% and 18.4% of pregnant women had low and highly diversified dietary intakes, respectively. Mean IDDS was 5.62±0.93, which indicated medium diversity of dietary intake. Dietary diversity had a statistically significant correlation with age (p=0.003), monthly income (p=0.003), education level (p=0.001), and respondent’s employment (p=0.004). The study exposed that pregnancy complications had a negative correlation with food diversity (r=-0.223), marriage age (r=-0.066), and education level (r=-0.163). Conclusion: The study concluded that pregnancy complications can be alleviated by improving dietary diversity practices during pregnancy.

The study aimed to compare and correlate serum levels of IL-6, 10, and 25-hydroxycholecalciferol in individuals with asthma with and without post-COVID condition (PCC). The study was designed to investigate the inflammatory response and serum 25-hydroxycholecalciferol status in asthmatics with and without PCC. A cross-sectional study of 252 subjects (128 asthmatics and 124 non-asthmatic subjects) was carried out. Interleukins and 25-hydroxycholecalciferol levels were estimated on ELISA. The principle findings were that IL-6 and 25-hydroxycholecalciferol levels were significantly increased (p<0.001), while IL-10 levels were non-significant in asthmatics with PCC compared to those without PCC. However, 25-hydroxycholecalciferol levels were significantly increased, but no significant change was observed in IL-6, and IL-10 levels in non-asthmatics with and without chronic PCC. A significant positive correlation (r = 0.258) was found between 25-hydroxycholecalciferol and IL-6 but a significant negative correlation (r = -0.227) with IL-10 in asthmatics with PCC. Similarly, a significant negative correlation (r = -0.285) was found between 25-hydroxycholecalciferol and IL-10 but was non-significant with IL-6 in asthmatics without PCC. The correlation of 25-hydroxycholecalciferol with IL-10 was significant (0.683), but IL-6 was non-significant in non-asthmatics with PCC. Multiple regression analysis showed that age, IL-6, gender, and PCC were significantly related in adjusted values to 25-hydroxycholecalciferol. This study sheds light on the complex liaison between 25-hydroxycholecalciferol levels and inflammatory responses in asthmatics, especially those with PCC. The findings suggest that although asthmatics with PCC maintain sufficient levels of 25-hydroxycholecalciferol, they show a substantial increase in the proinflammatory response. This suggests that PCC exacerbates the pro-inflammatory response in asthma. Moreover, the study reveals that asthmatics, whether with or without PCC, display a negative correlation between 25-hydroxycholecalciferol and the anti-inflammatory response. This emphasizes the main influence of asthma on the overall inflammatory response. These findings reveal a complex interplay between vitamin D levels and inflammatory mediators in asthmatic individuals with and without PCC.

Objective: While sperm freezing (cryopreservation) is an effective method for preserving fertility, it can potentially harm the structure and function of sperm due to an increase in the production of reactive oxygen species. This study aimed to assess the impact of zinc oxide nanoparticles (ZnONPs) and selenium oxide nanoparticles (SeONPs) on various sperm functional parameters, including motility, plasma membrane integrity (PMI), mitochondrial membrane potential (MMP), acrosome membrane integrity (ACi), and malondialdehyde (MDA) levels. Methods: Semen samples were collected from 20 Albino Wistar rats. These samples were then divided into six groups: fresh, cryopreservation control, and groups supplemented with SeONPs (1, 2, 5 μg/mL) and ZnONPs (0.1, 1, 10 μg/mL). Results: Statistical analysis revealed that all concentrations of SeONPs increased total motility and progressive reduction of MDA levels compared to the cryopreservation control group (p<0.05). However, supplementation with ZnONPs did not affect these parameters (p>0.05). Conversely, supplements of 1 and 2 μg/mL SeONPs and 1 μg/mL ZnONPs contributed to the improvement of PMI and ACi (p<0.05). Yet, no significant change was observed in MMP with any concentration of SeONPs and ZnONPs compared to the cryopreservation control group (p>0.05). Conclusion The findings suggest that optimal concentrations of SeONPs may enhance sperm parameters during the freezing process.

Purpose: To assess the efficacy of total neoadjuvant therapy (TNT) for rectal carcinoma in comparison with conventional chemoradiotherapy (CRT). Methods: A systematic review was performed according to the PRISMA guidelines. A Bayesian network meta-analysis was done using NetMetaXL and WinBUGS. This study was registered in PROSPERO on March 3, 2022 (No. CRD-42022307867). Results: Outcomes of 2,719 patients from 10 randomized trials between 2010 and 2022 were selected. Of these 1,191 (44%) had conventional long-course CRT (50–54 Gy) and capecitabine, 506 (18%) had induction chemotherapy followed by CRT (50–54 Gy) and capecitabine (iTNT), 230 (9%) had long-course CRT (50–54 Gy) followed by consolidation chemotherapy (cTNT), and 792 (29%) undergone modified short-course radiotherapy (25 Gy) with subsequent chemotherapy (mTNT). Total pathologic complete response (pCR) was 20% in the iTNT group, 21% in the mTNT group, 22% in the cTNT group, and 12% in the CRT group. Statistically significant difference in pCR rates was detected when comparing iTNT with CRT (odds ratio [OR], 1.76; 95% credible interval [CrI], 1.06–2.8), mTNT with CRT (OR, 1.90; 95% CrI, 1.25–2.74), and cTNT with CRT groups (OR, 2.54; 95% CrI, 1.26–5.08). No differences were found in R0 resection rates. No significant difference was found in long-term outcomes. Conclusion The early administration of systemic chemotherapy in the TNT regimen has improved short-term outcomes, though long-term results are underreported. Randomized trials with survival as the endpoint are necessary to evaluate the possible advantages of TNT modes.

Aims: The antibiofilm activity of endophytic fungus Nigrospora sphaerica CL-OP30 isolated from Swietenia macrophylla King was investigated. Methodology and results: The ability of the fungal endophytic crude extract to impede Streptococcus mutans biofilm formation was preliminarily screened with Congo red agar test. It was proven that S. mutans biofilm formation was hindered on the agar supplemented with the fungal endophytic crude extract. The antibiofilm activity of the fungal endophytic crude extract was evaluated using a microtiter plate method on both initially formed and preformed biofilm. Antibiofilm activity was recorded in a concentration-dependent pattern whereby higher concentrations reduced biofilm formation better than the lower concentrations of extract for both initially formed and preformed biofilm. The architecture of biofilm tested with fungal endophytic crude extract was also observed. Visualization under a light microscope and SEM revealed that the adherence of S. mutans biofilm treated with fungal endophytic crude extract was significantly reduced in both initially formed and preformed biofilm. In addition, observation under SEM showed that the matrices surrounding the bacterial cells were disintegrated and bacterial cells in biofilm completely lost their original shape. The overall data demonstrated that the ethyl acetate N. spaherica CL-OP30 crude extract showed good antibiofilm activity. Conclusion, significance and impact of study The antibiofilm study suggested the potential of N. sphaerica CL-OP30 crude extract against S. mutans biofilm by disrupting the biofilm formation, the disintegration of matrices surrounding the biofilm and responsible for the formation of irregular cell shape. This extract may have a promising potential to be developed as an antibiofilm agent.

Aims: The aquaculture industry has been identified as one of the sources for the emergence of antimicrobial resistant bacteria. This study aimed to determine the level of bacterial contamination from selected catfish pond farming at Jasin, Melaka and its susceptibility to antimicrobial agents. The correlation between the sampling points’ Water Quality Index and the level of bacterial contamination was also determined. Methodology and results : Sampling was carried out at six sampling points of the river as well as selected catfish pond farming. Microbial counts were assessed using the membrane filtration and isolates were further identified by using the polymerase chain reaction (PCR) method. Antimicrobial susceptibility tests were carried out using the disk diffusion method. Results showed that the total bacterial count obtained was not significantly different (P>0.05) between sampling points with an average of 4.47 ± 0.41 log CFU/mL. A total of 27 different bacterial species were identified where 63% were identified as Gram-negative bacteria. A medium negative correlation (r=-6.16, P<0.01) was found between the sampling points’ Water Quality Index and the level of bacterial contamination. Among bacterial species identified, 18 species are pathogenic strains. Conclusion, significance and impact of study Antibiotic susceptibility test indicated that only 4 isolates showed resistance to antimicrobials tested and the study shows the potential cross contamination between fishponds and Kesang River, Melaka. Thus, public health concerns are tangible, and prevention of the cross contamination is crucial for the farm.

COVID-19 is a highly contagious disease that caused a worldwide pandemic in 2020. Medical students are public advocates for COVID-19 vaccination to achieve herd immunity. Our objective is to ascertain the level of knowledge, attitude, and practice toward COVID-19 immunisation among medical students in Malaysia. The online study included four public universities in Peninsular Malaysia: Universiti Putra Malaysia, International Islamic University Malaysia, Universiti Sains Malaysia and Universiti Sains Islam Malaysia. Data collected include sociodemographic characteristics, history of COVID-19 infection, knowledge, attitude and practice towards COVID-19 immunisation. Analytical statistics were analysed with IBM Statistical Package Statistical Package for the Social Science (SPSS) v27.0 using Pearson chi-square or Fisher’s exact test (significant if p < 0.05). From the total of 427 respondents, 60.2% had good knowledge whereby clinical students 67.0% had a higher proportion of good knowledge as compared to preclinical students 53.5% (p = 0.004). Respondents in the age group of 21 to 24 years old (p < 0.001) and 25 to 29 years old (p = 0.016), and Indian ethnicity (p = 0.006) were more likely to have good knowledge. Respondents registered in Malaysia’s National COVID-19 vaccination program were considered as having a positive attitude (n = 264, 61.8%). A vaccination rate of 100% was observed. In conclusion, 60.2% of medical students had good knowledge, 61.8% had a positive attitude and 100% were vaccinated in these four public medical schools in Malaysia. Sociodemographic factors (age group and Indian ethnicity) have an association with only good knowledge but none with the level of attitude and practice towards COVID-19 immunisation.
COVID-19

The present study compares the in vitro effects of nanoparticles loaded pentamidine drug and conventional pentamidine on Leishmania tropica. Herein, pentamidine-loaded chitosan nanoparticles (PTN-CNPs) have been synthesized through an ionic gelation method with sodium tripolyphosphate (TPP). Next, the physical characteristics of PTN-CNPs were determined through the surface texture, zeta potential, in vitro drug release, drug loading content (DLC), and encapsulation efficacy (EE) and compared its efficacy with free pentamidine (PTN) drug against promastigotes and axenic amastigotes forms of L. tropica in vitro. The PTN-CNPs displayed a spherical shape having a size of 88 nm, an almost negative surface charge (-3.09 mV), EE for PTN entrapment of 86%, and in vitro drug release of 92% after 36 h. In vitro antileishmanial activity of PTN-CNPs and free PTN was performed against Leishmania tropica KWH23 promastigote and axenic amastigote using 3-(4, 5- dimethylthiazol-2-yl)-2, 5-diphenyletetrazolium bromide (MTT) assay. It was observed that the effect of PTN-CNPs and free PTN on both forms of the parasite was dose and time dependent. Free PTN presented low efficacy even at higher dose (40 µg/ml) with 25.6 ± 1.3 and 26.5 ±1.4 mean viability rate of the promastigotes and axenic amastigotes, respectively after 72 hrs incubation. While PTN-CNPs showed strong antileishmanial effects on both forms of parasite with 16 ± 0.4 and 19 ± 0.7 mean viability rate at the same higher concentration (40 µg/ml) after 72 hrs incubation. Half maximal inhibitory concentration (IC50) values of PTN-CNPs toward promastigotes and amastigotes were obtained as 0.1375 µg/ml and 0.1910 µg/ml, respectively. In conclusion, PTN-CNPs effectively inhibited both forms of the L. tropica; however, its effect was more salient on promastigotes. This data indicates that the PTN-CNPs act as a target drug delivery system. However, further research is needed to support its efficacy in animal and human CL.

Introduction: This study was carried out to quantify the selected bioactive compounds (i.e., chlorogenic acids, caffeine, and N-methylpyridinium) in instant coffee and to analyze its correlation with the gastric release effect of the HGT-1 cell line. Methods: Selected bioactive compounds in regular (REG), low sugar (LS), low fat (LF), white coffee (WC), white coffee low acid (WCA), decaffeinated (DC), and instant black coffee (BC) were quantified using HPLCDAD (high-performance liquid chromatography diode array detection) system and flow cytometry analysis for its gastric release effect when treated with HGT-1 cell. Results: The HPLC data showed the content of caffeine (60,212 ± 212 µg/ml) and chlorogenic acid (35,779 ± 3027 µg/ml) were significantly high in BC while the lowest caffeine value was found in DC coffee. Chlorogenic acid in other instant coffee samples showed insignificant content distinctions. As for N-methylpyridinium (NMP), the highest content was found in BC (565 µg/ml) and the lowest value was detected in WC (52 µg/ml) coffee. Gastric release activity by HGT-1 cells was significantly higher in DC and REG coffee treatment. Pearson correlation showed no significant correlation between the quantitative data and gastric release activity by HGT-1 cells. Conclusion: The selected bioactive compounds contained in instant coffees were unable to stimulate gastric release.

Introduction: Dengue fever is one of the world’s most severe mosquito-borne diseases, with high morbidity and mortality rate. Poor dengue prevention practices are one of the factors contributing to dengue outbreak. National Health and Morbidity Survey (NHMS) have collected lots of population data on the prevalence of various non-communicable and communicable diseases, including dengue. NHMS 2020 however, focus on communicable diseases i.e., Dengue, Malaria, HIV & Covid-19. Notwithstanding, data on Cognitive, Affective and Behaviour (CAB) domains are scarce. Thus, this study was aimed to develop and validate CAB questionnaire on dengue in Malaysia. Material and Methods: The questionnaire was developed by adapting and improvising similar previous questionnaires used during NHMS 2015, selected published questionnaires, expert panel and literature review. A sample of 200 respondents was used to evaluate the internal consistency of the final instrument. Results: 5 experts reviewed the content validity of the CAB questionnaire while 20 respondents tested its face validity. The Cronbach’s alpha coefficients scores were within the acceptable range from 0.661 to 0.677. Various adjustments were made by deleting items with low Cronbach alpha values in attempt to attain the highest possible alpha values, but further deduction could not be made due to the retention of several important domain-measurement items. Conclusions: The validity and reliability of the CAB-IHBR-Dengue-A-01 questionnaire were of ‘acceptable’ ranges and can be used to assess CAB. The questionnaire is a valid and reliable tool for assessing the CAB’s ability to influence dengue prevention among Malaysians.