Parenting Factors and Child Obesity: A Study Among Preschoolers in Selangor, Malaysia Introduction Child obesity is a pressing global concern. In Malaysia, the rates of child obesity have risen significantly over recent decades, with 5.6% of children under the age of five being categorized as overweight or obese. Children's behavior is influenced by their home environment, which includes both physical and social aspects such as parental behavioral models, parenting styles, practices, beliefs, and societal norms. However, there is a scarcity of data on the prevalence of child obesity and its relationship with parental factors. This research set out to explore the link between parenting styles, parental physical activity, dietary habits, body image perception, screen time, and child obesity. Methods A survey using a quantitative approach was conducted among preschoolers in Selangor to test the proposed relationships between these factors. Data were gathered from 354 preschool students in Selangor. This study used a multi-stage sampling technique. In the multi-stage sampling technique, the researcher used a series of sampling frames by developing population strata and then selected using purposive sampling method. Results The analysis was carried out using SPSS version 26 and Smart PLS version 4.0. The direct effect analysis revealed that parenting styles (p = 0.000), along with parental dietary habits and body image perception (p=0.001), were significantly associated with child obesity. In contrast, parental physical activity (p = 0.167) and screen time (p = 0.739) did not show a significant relationship with childhood obesity. Conclusions The study's outcomes can assist healthcare practitioners in understanding and providing substantial evidence of the significant relationship between parenting styles, dietary practices, body image perception, and child obesity.

A Retrospective Analysis of Adolescent Pregnancy and Child Mortality Cases in Kota Kinabalu, Sabah Introduction Under-five mortality remains a critical public health challenge, particularly among vulnerable and underserved populations. This study aimed to identify distinct socio-clinical profiles associated with under-five deaths in Kota Kinabalu from 2020 to 2024 and to compare risk patterns between adolescent and adult mothers using cluster analysis. Methods A retrospective analysis of district health records was conducted. A total of 818 under-five mortality cases were included, of which 55 involved adolescent mothers (10–19 years). K-means clustering was applied to maternal-socioeconomic and clinical variables to identify distinct profiles. The optimal number of clusters was determined using silhouette scores and stability testing. Associations between cluster membership and maternal-child health variables were evaluated using chi-square tests. Results Three clusters emerged. Cluster 2 represented the most vulnerable group, predominantly comprising non-citizen adolescent mothers with no formal education, household incomes below RM 1,000, and inadequate antenatal care. This cluster exhibited the highest rates of preterm births and preventable under-five deaths. Significant associations were identified between cluster membership and maternal age, citizenship status, education level, antenatal care, and birth outcomes. Under the death category, 61.7% of child deaths were classified as preventable, highlighting areas for intervention, while 38.3% were deemed not preventable. Conclusions Intersecting social disadvantages such as young maternal age, non-citizenship, low education, and poverty amplify risks for both mothers and children. Addressing these broader determinants through culturally sensitive, accessible maternal health services and targeted adolescent outreach is essential. Integrating cluster analysis into surveillance can enable early identification of high-risk groups and support equity-focused interventions to reduce preventable child mortality.

Kesan Pendedahan Mikroplastik terhadap Jantung: Ulasan Naratif Introduction World Health Organization (WHO) reported that heart disease is among the global main cause of death. The significant environmental factor for heart disease is microplastic exposure. In cardiology, microplastic has been widely used due to stability and biocompatibility. Therefore, this narrative aimed to study the effect of microplastic exposure towards heart. The findings will contribute to evidence-based medicine in heart disease prevention strategies Methods A literature search was conducted on ninth November 2024, across three scientific databases of Scopus, PubMed, and Web of Science using specified keywords like microplastic and heart. The target was original articles published between 2019 and 2024. Results A total of six articles published within 2023 and 2024 have been analysed. All articles reported that microplastic exposure triggers the oxidative process and inflammatory response of cardiomyocyte cells. These processes led to myocardial ischemia and infarction that resulted in heart failure. Conclusions Microplastic exposure is a new risk factor for heart disease. The findings should be integrated in public health promotion programme and the clinical practice guideline of cardiovascular disease for multilevel prevention.

Pets and Mental Health Among Postgraduate University Students: A Narrative Review with Implications for Malaysia Introduction Postgraduate students experience disproportionately high levels of depression, anxiety, and stress compared to undergraduate peers and the general population. Pets are increasingly recognised as potential sources of psychosocial support, yet their role in shaping student wellbeing within Asian contexts remains underexplored. This narrative review synthesises evidence on the relationship between pet ownership and postgraduate student mental health, with a particular focus on Malaysian public university students. Methods Relevant studies were identified through PubMed, Scopus, PsycINFO and Google Scholar using combinations of terms related to “postgraduate students,” “mental health,” “pet ownership,” and “companion animals.” Articles published in English between 2015 and 2024 were included if they reported on student populations and examined psychosocial outcomes associated with pets. Data were narratively synthesised into major themes. As a narrative review integrating heterogeneous quantitative and qualitative evidence, the findings reflect associative patterns and conceptual trends rather than causal relationships. The absence of formal meta-analysis limits the ability to quantify effect sizes across studies. Results Four recurring themes emerged: (i) pets as sources of social support mitigating loneliness and enhancing belonging; (ii) pets and psychological wellbeing through stress and anxiety reduction; (iii) pets as facilitators of coping and academic adjustment; and (iv) risks and contextual nuances including financial burdens, cultural sensitivities, and zoonotic concerns. Evidence from Western settings demonstrated consistent benefits, while emerging data from Asia highlighted the importance of cultural and religious factors in moderating outcomes. Conclusions Pet ownership may provide meaningful psychosocial benefits to postgraduate students, yet these are context dependent. In Malaysia, the cultural acceptability of specific animals, financial pressures, and caregiving responsibilities shape how pets influencewellbeing. Further empirical research is required to establish culturally grounded, evidence-based approaches to incorporating animal companionship in student mental health promotion.

Cost-Effectiveness of Mobile Application Use in Managing Type 2 Diabetes Mellitus: A Systematic Review Introduction Type 2 diabetes mellitus (T2DM) is a debilitating condition that imposes a significant economic burden on its management. This study aims to systematically review the published evidence on the cost-effectiveness of mobile health (mHealth) application interventions for T2DM. Methods A search strategy was conducted using electronic bibliographic databases, including PubMed, Web of Science and Scopus for published studies. The inclusion criteria included original articles that reporting cost-effectiveness evaluation studies on mHealth application interventions directed at patients diagnosed or at risk of T2DM, English-language articles and published in the year 2016 to 2020. Results A total of 6 eligible studies were selected. The cost savings per person for treating T2DM ranged from USD 1,346 to USD 3,781 per year. The major contributor to cost savings was reduced complication management resulting from good glycaemic control. The direct impacts of the intervention include reduced hospitalisation and fewer unplanned clinic visits, while diabetes- related mortality was indirectly reduced usingmHealth. Conclusions The mHealth intervention was cost-effective in managing patients with T2DM. Implementation can be extended to other disease management areas to not only reduce total healthcare expenditure but also improve patients’ quality of life.

Background: Frailty is a health condition preceding impairment and disease, resulting in vulnerability and risk of poor outcomes. Frailty is a multidimensional geriatric syndrome encompassing physical, psychological and cognitive components. Psychological frailty refers to reduced emotional resilience, mood stability, and coping capacity. This paper aims to review the current literature on psychological frailty and mental health outcomes among older adults. Methodology : Four electronic databases, PubMed, Scopus, Science Direct and Web of science were used to systematically search for studies published between January 2019 and December 2023, that examined the effect of psychological frailty on mental health outcomes in older adults, including depression, anxiety, and overall well -being. Results: There were 154 articles screened, with 7 studies meeting inclusion criteria. All included studies assessed psychological frailty using the Tilburg Frailty Indicator (TFI), a multidimensional frailty tool with a psychological domain. Psychological frailty, as measured using the TFI, was consistently associated with depressive symptoms, anxiety, and reduced quality of life. The psychological domain of the TFI demonstrated moderate internal consistency (Cronbach ’s α = 0.712 -0.797). Conclusion: Psychological frailty is a potential risk factor for the development of adverse mental health outcomes in older adults. The use of validated measures, such as the TFI may improve the identification of psychological frailty for early intervention strategies in both community and medical settings to protect older adults ’ mental health

Case Report Open Access 15 Primary renal lymphoma without widespread nodal disease is a rare entity. Its diagnosis is challenging as it can mimic other more common renal malignancies such as renal cell carcinoma (RCC) or upper tract urothelial carcinoma (UTUC). We report a 65 -year-old male who presented a month history of bilateral flank pain. Initial computed tomography urography showed a soft tissue enhancing lesion with irregular margin in the left renal pelvis, extending distally to the left proximal ureter, suspicious of UTUC. He underwent laparoscopic left radical nephrectomy and bladder cuff excision. However, histopathology came back as a left renal in situ follicular B -cell neoplasm (ISFN). He was subsequently referred to haematology service for further management. This case report aims to raise awareness of ISFN and to consider renal lymphoma in a patient presenting with a renal mass. A high index of suspicion and judicious use of tissue biopsy can avoid unnecessary and potentially morbid surgical interventions

Case Report Open Access 15 Sinocutaneous fistula is a rare complication of chronic rhinosinusitis (CRS), most commonly involving the frontal sinus, with maxillary sinus involvement being uncommon and typically associated with trauma, surgery, or odontogenic infection. We report a rare case of a maxillary sinocutaneous fistula secondary to chronic maxillary rhinosinusitis in the absence of trauma, prior surgical intervention, fungal infection, or neoplasia. The condition resulted from longstanding inflammation with associated osteitis and cortical erosion of the maxillary sinus wall, leading to abnormal communication with the overlying facial skin. Diagnosis was established through clinical evaluation and contrast - enhanced computed tomography of the paranasal sinuses. Definitive management consisted of functional endoscopic sinus surgery with complete excision of the fistulous tract and primary multilayered closure. This case underscores the potential for chronic inflammatory sinonasal disease to cause rare bony complications and highlights the importance of considering CRS in the differential diagnosis of persistent facial cutaneous fistulae

Background: Frailty is a health condition preceding impairment and disease, resulting in vulnerability and risk of poor outcomes. Frailty is a multidimensional geriatric syndrome encompassing physical, psychological and cognitive components. Psychological frailty refers to reduced emotional resilience, mood stability, and coping capacity. This paper aims to review the current literature on psychological frailty and mental health outcomes among older adults. Methodology : Four electronic databases, PubMed, Scopus, Science Direct and Web of science were used to systematically search for studies published between January 2019 and December 2023, that examined the effect of psychological frailty on mental health outcomes in older adults, including depression, anxiety, and overall well -being. Results: There were 154 articles screened, with 7 studies meeting inclusion criteria. All included studies assessed psychological frailty using the Tilburg Frailty Indicator (TFI), a multidimensional frailty tool with a psychological domain. Psychological frailty, as measured using the TFI, was consistently associated with depressive symptoms, anxiety, and reduced quality of life. The psychological domain of the TFI demonstrated moderate internal consistency (Cronbach ’s α = 0.712 -0.797). Conclusion: Psychological frailty is a potential risk factor for the development of adverse mental health outcomes in older adults. The use of validated measures, such as the TFI may improve the identification of psychological frailty for early intervention strategies in both community and medical settings to protect older adults ’ mental health

Case Report Open Access 15 Primary renal lymphoma without widespread nodal disease is a rare entity. Its diagnosis is challenging as it can mimic other more common renal malignancies such as renal cell carcinoma (RCC) or upper tract urothelial carcinoma (UTUC). We report a 65 -year-old male who presented a month history of bilateral flank pain. Initial computed tomography urography showed a soft tissue enhancing lesion with irregular margin in the left renal pelvis, extending distally to the left proximal ureter, suspicious of UTUC. He underwent laparoscopic left radical nephrectomy and bladder cuff excision. However, histopathology came back as a left renal in situ follicular B -cell neoplasm (ISFN). He was subsequently referred to haematology service for further management. This case report aims to raise awareness of ISFN and to consider renal lymphoma in a patient presenting with a renal mass. A high index of suspicion and judicious use of tissue biopsy can avoid unnecessary and potentially morbid surgical interventions