Introduction: Early identification of patients at risk for severe multisystem inflammatory syndrome in children (MIS-C) is essential for favourable clinical outcomes. This study aims to identify the clinical characteristics, factors and outcomes associated with severe MIS-C. Materials and methods: In this retrospective cohort study involving 14 major hospitals in Malaysia, children <15 years who met the United States Centres for Disease Control and Prevention case definition for MIS-C were included. Severe MIS-C was defined as children who required inotropic support, ventilatory support (invasive or non-invasive ventilation), or left ventricular ejection fraction of <55%. The factors investigated for severe MIS-C were demographic characteristics, the presence of comorbidities, clinical characteristics, and laboratory measures. Multivariable logistic regression was used to compute the adjusted odds ratio (aORs) of factors associated with severe MIS-C. Results: Among the 155 patients, 91 (58.7%) presented with severe MIS-C. Severe MIS-C was more likely in patients aged ≥5 years old (aOR 2.13, 95% confidence interval [CI] 1.08-4.21), with dehydration (aOR 3.80, 95% CI 1.53-9.45), lethargy (aOR 2.02, 95% CI 0.97-4.18), tachycardia (aOR 8.33, 95% CI 3.27-21.22), albumin <30g/L (aOR 3.36, 95% CI 1.58-7.13), creatine kinase >200U/L (aOR 3.68, 95% CI 1.57-8.64), D-dimer >3.0µg/mL (aOR 2.11, 95% CI 1.08-4.13), ferritin >500ng/mL (aOR 3.77, 95% CI 1.88-7.55), prothrombin time >12.7 seconds (aOR 3.22, 95% CI 1.61-6.43), and urea >6mmol/L (aOR 5.09, 95% CI 2.04-12.71). Conclusion: Identification of these associated factors of severity in MIS-C could aid in early recognition and prompt escalation of care, leading to better outcomes.

Evaluation of the Impact of Enhanced Primary Health Care Intervention Programme in Malaysia: A Repeat Cross-sectional Pre-Post Quasi Experimental Study Introduction Non-communicable diseases (NCD) lead to substantial mortality and morbidity worldwide. Malaysia is currently experiencing an epidemic of NCDs. This paper aims to evaluate the effectiveness of the Enhanced Primary Health Care (EnPHC) intervention in reducing the prevalence of undiagnosed diabetes, undiagnosed hypertension, and undiagnosed hypercholesterolemia as well as NCD risk factors in the population after about one year of intervention. Methodology This is a repeat cross-sectional pre-post quasi-experimental study comparing intervention and control groups. The target population included adults aged 30 years and above living within the 40 selected clinics' catchment areas for at least six months. Data were collected using face-to-face interviews and clinical assessments. A difference-in-difference (DID) analysis was used to determine the effect of the EnPHC intervention. Results The percentage of the population screened for diabetes mellitus, hypertension, and hypercholesterolemia increased from the baseline status by 8.7%, 9.9%, and 9.2%, respectively. The prevalence of undiagnosed diabetes mellitus and hypercholesterolemia decreased from the baseline status by 17.6% and 13.7% compared to the control group. However, the EnPHC intervention did not affect the prevalence of overweight, obesity and smoking. Conclusion The EnPHC intervention contributed to the reduction in the prevalence of undiagnosed NCDs. A more extended period of intervention would be required to show the effect on NCD risk factors. Further strengthening of the intervention would be needed for implementation in other localities

The expansion of healthcare services to serve as many people as possible has led to the decentralisation of laboratory testing. Many laboratory tests are now made available at district hospitals and rural health clinics for certain states or provinces. Consequently, there is a proliferation of laboratory tests, techniques, equipment, and other required commodities at the different medical laboratories. The lack of central governance has resulted in a widely-diverse and non-standardised laboratory services that may eventually affect the quality of healthcare delivery to patients. To ensure a high-quality and standardised healthcare delivery across a state or a province, it is important that the relevant stakeholders outline and implement the necessary strategies to establish a streamlined medical laboratory network. In this article, we discuss the significance of laboratory procurement consolidation and centralisation in the steering of the standardisation of laboratory operations leading to a high-quality and efficient chemical pathology services in a defined region.

Aims: Marine bacteria have been reported to produce potential natural pigment with pharmaceutical properties and their growth can be manipulated in the laboratory to increase pigment production and their antimicrobial activity. Hence, this study aimed to enhance the prodigiosin production in Serratia marcescens IBRL USM84 by improving physical conditions. Methodology and results: The quantification of the pigment produced by S. marcescens IBRL USM84, bacterial cell growth, and its antibacterial activity in the broth medium were determined using a spectrophotometry method. Meanwhile, the antibacterial effect of red pigment on MRSA cells was observed under a scanning electron microscope (SEM). This marine isolate produced the highest yield of prodigiosin (6.95 μg/mL) when cultivated in marine broth with the addition of 0.2% of agar, 25 °C incubation temperature, initial medium pH of 7, 150 rpm of agitation speed for 48 h of cultivation time under light illumination. There was an increment of 151.81% in prodigiosin production after enhancement compared to before the enhancement of cultural conditions. SEM observations revealed that severe damage to the cell’s morphologies was exposed to red pigment as indicated by the formation of small dents, which led to completely collapse and eventually, cell death. Conclusion, significance and impact of study A positive correlation between pigment production and antibacterial activity was observed in the present study. The results supported the fact that marine bacteria are a reservoir of various pigments with antimicrobial properties. Also, the pigment production by S. marcescens and its antibacterial activity were significantly influenced by physical parameters.
Prodigiosin ; Serratia marcescens ; Marine Biology

Biotechnology policies and regulations must be revised and updated to reflect the most recent advances in plant-breeding technology. New Plant Breeding Techniques (NPBT) such as gene editing have been applied to address the myriad of challenges in plant breeding, while the use of NPBT as emerging biotechnological tools raises legal and ethical concerns. This study aims to highlight how gene editing is operationalized in the existing literature and examine the critical issues of ethical and legal issues of gene editing for plant breeding. We carried out a systematic literature review (SLR) to provide the current states of ethical and legal discourses surrounding this topic. We also identified critical research priority areas and policy gaps that must be addressed when designing the future governance of gene editing in plant breeding.

Pengenalan: Kanser prostat merupakan ketiga tertinggi bagi golongan lelaki di Malaysia. Data 2018 melaporkan kanser prostat mencatatkan insiden 1,807 kes berbanding 1,186 kes pada tahun 2014. Kanser prostat ini turut memberi kesan terhadap beban penyakit serta beban ekonomi kepada negara dan memberi kesan terhadap kualiti hidup pesakit terutamanya pesakit berumur melebihi 65 tahun. Kajian ini dilakukan bagi mengukur tahap kualiti hidup pesakit kanser prostat dan menentukan faktor-faktor yang mempengaruhi kualiti hidup pesakit tersebut. Metodologi: Reka bentuk kajian adalah keratan rentas yang dilakukan dari Januari 2018 sehingga Disember 2018. Sampel kajian terdiri daripada pesakit kanser prostat yang didiagnos dan mendapatkan rawatan di Klinik Urologi, Jabatan Pembedahan dan Jabatan Onkologi dari tahun 2008 hingga 2017. Kajian menggunapakai set soal selidik EORTC QLQ-C30 dan EORTC QLQ-PR25 yang telah diterjemahkan ke Bahasa Melayu Hasil Kajian: Seramai 193 pesakit telah mengambil bahagian. Analisis mendapati tahap kanser memberi perbezaan yang signifikan kepada status kesihatan serta fungsi dan simptom kanser prostat (p < 0.001). Rumusan Kesimpulannya, analisis faktor penentu mendapati umur, skor Gleason dan juga tahap lewat kanser merupakan faktor penentu kepada kualiti hidup pesakit kanser prostat (p < 0.05). Langkah kesedaran, saringan serta rawatan awal dilihat perlu dipertingkatkan bagi meningkatkan tahap kualiti hidup pesakit kanser prostat di hopital ini.

ABSTRACT Orofacial clefts (OFC) are one of the most common birth defects that affects the lip, palate, or lip and palate of an infant. The deterioration of clefts is multifactorial involving multiple genes, various interactions from environmental factor and most forgotten, mitochondrial abnormality. The aim of this review is to highlight the importance of mitochondrial activity related to non-syndromic OFC deformity. Despite its important role in cells, the study on mitochondrial activity in cleft pathology was scarce and almost forgotten compared to other genetic investigations. This systematic review was completed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. The literature search was done via the following databases: Google Scholar, Pubmed and Scopus with a total of nine studies of mitochondrial abnormalities were included. We hypothesise that mitochondria play an important role in early craniofacial development. A decreased in its function or activity may result in cleft lip formation. Hence, we would like to shed light on the remarkable role of mitochondria activity in the pathogenesis of non-syndromic OFC.
Mitochondria--pathology ; DNA, Mitochondrial ; Cleft Lip ; Cleft Palate

Aims: Coral diseases have emerged over the last several decades, causing a loss of live coral cover in the Caribbean and Indo-Pacific reefs. Hence, microbiological and disease cultural techniques are commonly used to investigate their causative microbial agents. This is the first study to identify the potential of pathogenic Vibrio spp. isolated from apparently white syndrome (WS) coral disease in Tioman Island Marine Park using biochemical and molecular techniques. Methodology and results: The Vibrio colonies were isolated from 108 samples of WS infected corals (Acropora cytherea and Montipora aequituberculata) including seawater, sediment and algae found adjacent to infected coral colonies. A total of one hundred representative Vibrio isolates were characterized and most of them (n=50) were identified as V. vulnificus, V. alginolyticus and Photobacterium damselae following biochemical analysis. The molecular analysis revealed six Vibrio spp. (V. coralliilyticus, V. hepatarius, V. brasiliensis, V. tubiashi, V. campbellii, V. ishigakensis) and one Photobacterium rosenbergii. Vibrio coralliilyticus isolated from all infected coral samples may be highly responsible for the sign of WS disease. Conclusion, significance and impact of study The findings of this study provide baseline data and information on potential coral pathogens identified in the coastal waters of Tioman Island. Etiological disease study is suggested to validate their severity and virulence factors in the future.
Vibrio--pathogenicity ; Anthozoa