Factors Influencing Excessive Gestational Weight Gain Among Pregnant Women in Urban Malaysia Introduction Excessive gestational weight gain (GWG) is a growing public health concern due to its association with higher risk of adverse maternal and perinatal outcomes. Recognising the key factors of underlying GWG incidence is thus crucial for developing targeted interventions. This study aims to determine the prevalence of excessive GWG and its associated factors among pregnant women in an urban district of Klang Valley, Malaysia. Methods A retrospective cross-sectional study was conducted (betweenNovember 2017 and October 2018) among 472 pregnant women who gave birth between January 2015 and December 2016. Data on sociodemographic characteristics, medical illnesses, and pre-pregnancy body mass index (BMI) were retrieved from the birth registry and maternal health records. The classification of GWG is based on the Institute of Medicine's recommendation Results The classification of GWG is based on the Institute of Medicine's recommendation. A total of 113 (23.9%) pregnant women had excessive GWG. Multiple logistic regression showed the odds of getting excessive GWG were higher among those with lower education levels (Adj. OR = 1.85; 95% CI = 1.084, 3.147), being employed (Adj. OR = 2.30; 95% CI = 1.342, 3.928), nulliparous (Adj. OR = 2.46; 95% CI = 1.450, 4.164), and having pre-pregnancy BMI of ≥25kg/m2(Adj. OR = 6.47; 95% CI = 3.909, 10.721). Conclusions Lifestyle interventions, such as weight reduction programs and health education, should focus on women with high pre-pregnancy BMI, nulliparous women, working women and women with low education levels. Pre-pregnancy clinics and workplaces can serve as platforms to promote healthy dietary choices and encourage regular physical exercise.

We reported a case of recurrent subcutaneous swelling on the left foot of a diabetic patient. Two different organisms, Cladosporium spp. and Phaeoacremonium krajdenii were isolated, both of which are associated with phaeohyphomycosis and eumycetoma. The cure was achieved through surgical excision of the lesion and a course of antifungal therapy. The diagnosis was uncertain since clinical manifestations and laboratory results were insufficient to distinguish the two diseases.

Aims: Endophytic fungi are the remarkable category of host-associated fungal community that invades the intercellular regions of host tissues, benefiting their host while obtaining an advantage. Fungal endophytes have lately attracted prominence as a source of active secondary metabolites. This investigation aimed to identify fungal endophytes that reside inside the leaves and stems of Aquilaria malaccensis. Methodology and results: Healthy A. malaccensis stems and leaves samples were collected. Clean leaves and stems were cut to a size of 1 cm, followed by sterilization using 75% ethanol for 1 min, 3% sodium hypochlorite solution for 1 min, and finally, rinsing with sterile water 3 times for 1 min and drying with sterile paper. The sterile samples were put onto Potato Dextrose Agar (PDA) media containing chloramphenicol for 7-14 days until the mycelium grew for morphological identification under a light microscope. Five endophytic fungi were recovered from leaves, while nine endophytic fungi were obtained from stems. Using morphological approaches, nine of the endophytes had observed to produce conidia fungi, whereas the others did not. Neopestalotiopsis sp., Aspergillus sp., Arthrinium sp., Curvularia sp., Podospora sp., Mucor sp. and Verticillium sp. were identified as nine of the fourteen endophytes. Conclusion, significance and impact of study The number of endophytic fungi discovered in different organs varies. Not all endophytic fungi that grow can create sexual phages. Six genera of endophytic fungi were identified.
Endophytes ; Thymelaeaceae

Introduction: Flooding has become a major natural disaster in Malaysia in recent decades. There may be a gender difference in many aspects related to flood response and practice. This study aimed to examine the gender gap in knowledge, attitudes, and practice of flood preparedness in Malaysia. Method: This cross-sectional study was conducted among patients attending the primary care clinic at Universiti Sains Malaysia health campus, Kelantan. A validated questionnaire was used for data collection. Results: 328 subjects were recruited, 56.1% of them were females. The female respondents were younger than the males (36 vs. 41 years old). However, females have better knowledge, and practice on flood preparedness compared to male respondents. Among those, women were more aware of the local emergency plan than males (p=0.01). More female respondents kept their vaccination and personal medical records in a waterproof container or sealed plastic bag during past and future flood preparations (3-5 day supply of non-perishable food) than male respondents (p<0.05). In addition, with the practice of keeping a one-week supply of medication, and having their medical records in a waterproof container along with a first-aid kit (p=0.001). For future flood preparation, more women would filter the cloudy water through clean clothes for boiling (p=0.035). The determinants of good preparedness for future floods for female were older-age (p=0.001), blue-collar (p=0.043); whereas male were lower household income (p=0.014), being blue collar (0.014) and white collar (0.039) compared with student/retiree based on multivariate logistic regression. Conclusion: Our study reported that the determinants of good preparedness for future floods were older-age, blue-collar and having a lower-household income.

The global COVID-19 Pandemic combined with nationwide economic depression and public fear had caused dental clinics in Malaysia to experience a significant reduction in patient visits with a potential impact on the socio-economic and psychological status of Malaysian private dentists. This study assesses the socio-economic and psychological impacts of the COVID-19 pandemic on Malaysian private dentists. A cross-sectional online questionnaire included demographic profile, socioeconomic factors and psychological status was used. Participation was voluntary. Descriptive statistics on the three variables were generated. Pearson Chi-square test was used to check for significant difference (p<0.05). In all, 95 private dentists voluntarily participated. Male and female participants were equally represented, mostly in the 22-25 group (62%). The Job Insecurity Scale measurement showed 58% and 48.5% participants respectively, were socio-economically and psychologically affected. The Financial Threat Scale showed 44.4% of respondents were financially affected, while 51% (measured by the General health questionnaire) displayed affected health. The socio-economicpsychological aspect was found to be statistically significant (p =0.018). Within the limitation of sample size, participating private dentists were found to be socio-economically and psychologically affected by the COVID19 pandemic.

Introduction: Dengue fever (DF) is a prominent vector-borne disease spread by mosquitos of the Aedes genus (mainly Aedes aegypti, and even Aedes albopictus), a tropical regions vector. The purpose of this research was to establish the spatial and temporal distribution patterns of DF cases in the study area between 2010 and 2020. Methods: The correlation between the Kuantan sub-district and dengue haemorrhagic fever (DHF) incidence is examined in this study using spatial analysis. The correlation was calculated using spatial autocorrelation, Moran’s Index (Moran’s I) and Spatial Autocorrelation of Local Indicators (LISA). Moran’s index is a worldwide indicator used to determine whether or not disease transmission has geographical autocorrelation in disease transmission. Results: The results indicated that between 2011 and 2020, the monthly Moran’s I of dengue transmission in Kuantan was estimated to range between -0.685 and 0.338. The lowest reading of Moran’s index was -0.685 in May 2015, whereas the highest reading was 0.338 in May 2019. This reflects the strong spatial autocorrelation of dengue transmission in Kuantan over the last decade. The LISA analysis revealed significant spatial autocorrelations on DF cases in Kuantan for three (3) out of six (6) sub-districts (50%) with a significance level of 2%. This suggests that there are spatial autocorrelations in Kuala Kuantan, Beserah and Penor sub-district that influence the distribution of DHF transmission. Conclusion: The results reveal that the spatial autocorrelation analysis method can be a tool for relevant researchers to understand the pattern of DF transmission study and establish the direction for further study.

Intra-aural tick, also known as otoacariasis is commonly seen in Otorhinolaryngology (ORL) clinics, both in paediatric and adult patients. Patients mainly complain of otalgia or ear discomfort. Facial nerve paresis complicating of intra-aural tick is a rare condition. We report a three-year-old girl, who presented with left unilateral facial nerve palsy and middle ear effusion three days after removal of intra-aural tick.

Aims: Acne is a common skin disease among teenagers and also affects other ages. It occurs when the oil and dead skin cells plug into the hair follicles and causing pimples or whitehead. Although antibiotics have been used for many years in treating acne, the widespread use of it has led to the development of bacterial resistant, which resulted in unsuccessful treatment. Thus, in this study, Andrographis paniculata (AP) herbal formulation gel is proposed in order to determine its effectiveness in treating acne. Three different methodologies were used to compare the antimicrobial effect of A. paniculata herbal gel against acne-associated pathogens. Methodology and results: Well diffusion, disc diffusion and broth dilution methods were applied to evaluate the antimicrobial effect of AP herbal gel at concentrations of 1.5% (w/w), 2.5% (w/w) and 5.0% (w/w) onto selected pathogens associated with acne which consisted of Staphylococcus epidermidis, Staphylococcus aureus, Propionibacterium acnes and Candida albicans. Among the three methods, broth dilution showed the best antimicrobial effect towards all microorganisms used. AP herbal gel at concentration 2.5% (w/w) showed the optimum antimicrobial effect of S. aureus and C. albicans, while 5.0% (w/w) exhibited the best antimicrobial activities for P. acnes and S. epidermidis. Conclusion, significance and impact of study Broth dilution method appears to be a reliable method for the determination of antimicrobial effects for the pathogens tested. In addition, AP herbal formulation gel has great potential to treat acne effectively.
Anti-Infective Agents ; Andrographis paniculata ; Acne Vulgaris--microbiology

Introduction: Since pharyngitis in adults is one of the most common infectious diseases seen in general practitioner consultations in Malaysia, data on pharyngitis among adults concerning to its prevalence, socio-demographic, risk factors and clinical manifestations is very much lacking. This study aims to determine the prevalence of pharyngitis among adults in Sepang, Selangor, Malaysia from 2016 to 2017 and its associated demographic and risk factors. Methods: We conducted a cross-sectional study on 215 adult patients with a sore throat as the main symptom and who did not receive any antibiotic treatment within two weeks at three Malaysian primary care clinics. The researchers assessed the participants’ clinical manifestations and collected throat swabs for culture to determine the presence of group A streptococcus (GAS). Data on demographic characteristics, clinical manifestation and throat swab culture results were analyzed using chi-square test and multivariate logistic regression. Results: Pharyngitis was diagnosed in 130/215 (65%) adults with a sore throat. Only six isolates (2.8%) were identified as GAS. The overall mean age ± S.D was 36.43 ± 15.7. The majority of the participants were in the age group of 18-28 years. There were 42.3% males and 57.7% females; most participants were Malay 62.8%, followed by 30.2% Indian, 5.1% Chinese, and 1.9% other ethnicities. The most common symptom among the participants was cough 196 (91.2%), followed by rhinorrhea 161 (74.8%), tonsillar swelling or exudates 68 (31.6%), inflamed or reddish of pharynx 62 (28.8%), swollen anterior cervical lymph nodes 50 (23.3%), and fever ≥37.5°C 28 (13.0%). Conclusion: Besides, there was no significant association between pharyngitis and the demographic variables; the current findings emphasized that inflamed or reddish pharynx, tonsillar swelling or exudates were among the factors associated with pharyngitis.

The present study aimed to determine the test-retest reliability of subjective visual horizontal(SVH) testing when tested with solid and dotted line images. In this repeated measures study,36 healthy young Malaysian adults (mean age=23.3±2.3 years, 17 males and 19 females)were enrolled. All of them were healthy and had no hearing, vestibular, balance, or vision problems.The SVH angles were recorded from each participant in an upright body position using acomputerized device. They were asked to report their horizontality perception for solid and dottedline images (in the presence of a static black background). After 1 week, the SVH procedurewas repeated. The test-retest reliability of SVH was found to be good for both solid line[intraclass correlation (ICC)=0.80] and dotted line (ICC=0.78). As revealed by Bland-Altmanplots, for each visual image, the agreements of SVH between the two sessions were within theclinically accepted criteria (±2°). The SVH testing was found to be temporally reliable, which canbe clinically beneficial. Both solid and dotted lines in the SVH testing are reliable to be usedamong young adults. J Audiol Otol 2020;24(2):107-111