Malaria is a life-threatening, preventable, and curable vector borne disease caused by parasites that are transmitted to people through the bites of infected female Anopheles. The WHO Global Report 2010-2016 reported insecticide resistance in malaria. The main objective of this study is to determine the effectiveness of new generation Long-Lasting Insecticidal Nets (LLIN) compared to standard LLIN and untreated nets in terms of the mortality rate of adult female Anopheles gambiae. A comprehensive review of the literature was published in three databases (PubMed, Ovid, EBSCO Host) since 2010. Publications were searched with keywords including malaria, long-lasting treated bed net, long lasting insecticide-treated bed net, LLIN, and experimental hut. The search has identified 60 articles. Based on the PRISMA flowchart, 10 articles are qualified for data collection and analysis. The gathered data was analysed using Review Manager. Following meta-analysis between subgroups, a risk difference of 0.31 between standard LLINs versus untreated net (p<0.001, I²=100% 95% CI:0.01,0.60). A comparison of upgraded LLINs with the untreated net has shown a significant difference with a pooled risk difference of 0.54 favours upgraded LLINs (p<0.001, I²=100% 95% CI: 0.54,0.84). Comparison between upgraded LLINs versus standard gave an overall risk difference of 0.24 (p < 0.001, I² = 100%, 95% CI: 0.10–0.39). Upgraded LLINs significantly increase Anophelesmortality compared to standard LLINs and untreated nets, suggesting their potential for improved malaria control. Thus, using upgraded nets in the field and translating them into malaria preventive programs would help achieve the target and improve healthoutcomes for those living in endemic areas.

Colorectal cancer (CRC) carries a significant burden in most world regions. However, its screening uptake remains low. This study aimed to explore awareness and perspectives on CRC screening program in a multiethnic population and their preference for CRC screening decision aid. In-depth interviews were conducted until data saturation was reached. All interviews were audiotaped, transcribed verbatim, translated to English and analysed thematically using hybrid inductive and deductive approaches. 17 informants from three main ethnic groups (Malay, Chinese and Indian) with various levels of risk for developing CRC were recruited. Awareness on CRC screening program was found to be low. Majority of informants never heard of CRC screening program. Among 11 eligible informants, only five experienced CRC screening uptake. Thematic analysis of the transcripts yielded six major themes; knowledge on CRC, screening process, authority’s role, curability, willingness to screening and preference for decision aid, and theywere mapped onto the Health Belief Model. Specific multiethnic perspectives found included preference for traditional medicine coming from all ethnics, and reliance in God coming from Malay informants. Majority preferred short videos as CRC screening decision aid, in the form of animation and live-action screenplay. Exploration of perspective of CRC screening helps in producing impactful decision aids. Future efforts should focus on developing short videos that incorporate population’s perspectives and can be disseminated through electronic media.

Worldwide, around 8 million people die yearly due to tobacco usage. Cigarette smoking is the most popular form of tobacco usage. Smoking has linked to many detrimental health effects among adults and adolescents. Recognising the burden of smoking, World Health Organization have implemented various tobacco control strategies under the Framework Convention of Tobacco Control and mPOWER. This includes implementation of plain packaging and pictorial warning. In Asia, only Thailand, Singapore, Turkey, Saudi Arabia, and Israel have implemented plain cigarette pack. However, some countries have made progress to implement plain cigarette pack. Although some countries have not implemented plain pack, implementation of larger pictorial warning serve as a pathway for implementation of plain packaging. Countries with pictorial warning on cigarette pack should ensure it covers at least 50% of pack. Timor Leste has the largest pictorial warning on cigarette pack in the world. In conclusion, only 5 countries in Asia have implemented plain pack and some countries in this region are yet to implement size of pictorial warning according to requirement of World Health Organization. All countries should target to implement standardized pack to denormalise tobacco usage.

Objectives: A history of severe hypoglycemia (SH) is associated with cardiovascular (CV) events among patients with type 2 diabetes mellitus (T2DM). In this study, we compared the severity of atherosclerotic coronary artery disease (ACAD) in T2DM patients with and without a history of SH. Methodology: We conducted a comparative case-control study involving 28 T2DM patients with a history of SH within the last 5 years with no documented ACAD, and matched them with 28 T2DM patients with no history of SH. All subjects underwent coronary artery calcium scoring (CACS) with or without coronary computed tomographic angiography (CCTA) to evaluate the severity of ACAD. Results: A history of SH in T2DM was associated with a higher prevalence of significant ACAD (79% versus 46%, p=0.026). A high CACS (≥100) was seen in a greater number of patients with a history of SH compared to those without (75% versus 43%, p=0.029). Similarly, there was a higher prevalence of obstructive CAD in those with a history of SH compared to those without (72% versus 39%, p=0.036). Median C-reactive protein level was also higher among patients with a history of SH (0.41 mg/dL versus 0.16 mg/dL, p=0.029). Conclusion In patients with T2DM, a history of SH is significantly associated with ACAD compared to those without SH. A history of SH warrants screening for ACAD.
Hypoglycemia ; Coronary Artery Disease ; Diabetes Mellitus, Type 2 ; C-Reactive Protein

Introduction The new technological innovation can have a vast potential for interventions to help weight loss and combat obesity. The current meta-analysis aimed to compare the effectiveness of smartphone applications (apps) with other methods for promoting weight loss. Methods PubMed, Ovid and Science Direct were searched from 2014 all-inclusive up to May 2019 for relevant studies that assessed any smartphone/mobile phone app intervention with anthropometric measurement. Statistical analysis performed to examine mean difference (95% CI) of body weight, body mass index and waist circumference. Six articles were included for meta-analysis. Findings According to the results, compared with conventional or other interventions, smartphone app interventions showed statistically non-significant decreases in body weight, body mass index and waist circumference. Intervention through smartphone apps alone does not produce substantial evidence of weight loss, even though they might be useful for specific groups. Originality/value There remain prospects to explore regarding the use of smartphone apps in combination with other approaches to aid and promote weight loss, as smartphone use has been proven to influence health-related behavioural modification.

OBJECTIVES: Maternal folic acid supplementation is considered mandatory in almost every country in the world to prevent congenital malformations. However, little is known about the association of maternal folic acid intake with the occurrence of childhood cancer. Hence, this study aimed to determine the effects of maternal folic acid consumption on the risk of childhood cancer. METHODS: A total of 158 related articles were obtained from PubMed, Google Scholar, Scopus, and ProQuest using standardized keywords, of which 17 were included in the final review. RESULTS: Eleven of the 17 articles showed a significant protective association between maternal folic acid supplementation and childhood cancer. Using a random-effects model, pooled odds ratios (ORs) showed a protective association between maternal folic acid supplementation and childhood acute lymphoblastic leukaemia (OR, 0.75; 95% confidence interval [CI], 0.66 to 0.86). However, there was no significant association between maternal folic acid supplementation and acute myeloid leukaemia (OR, 0.70; 95% CI, 0.46 to 1.06) or childhood brain tumours (OR, 1.02; 95% CI, 0.88 to 1.19). CONCLUSIONS Maternal folic acid supplementation was found to have a protective effect against childhood acute lymphoblastic leukaemia. Thus, healthcare professionals are recommended to provide regular health education and health promotion to the community on the benefits of folic acid supplementation during pregnancy.

OBJECTIVES: Maternal folic acid supplementation is considered mandatory in almost every country in the world to prevent congenital malformations. However, little is known about the association of maternal folic acid intake with the occurrence of childhood cancer. Hence, this study aimed to determine the effects of maternal folic acid consumption on the risk of childhood cancer. METHODS: A total of 158 related articles were obtained from PubMed, Google Scholar, Scopus, and ProQuest using standardized keywords, of which 17 were included in the final review. RESULTS: Eleven of the 17 articles showed a significant protective association between maternal folic acid supplementation and childhood cancer. Using a random-effects model, pooled odds ratios (ORs) showed a protective association between maternal folic acid supplementation and childhood acute lymphoblastic leukaemia (OR, 0.75; 95% confidence interval [CI], 0.66 to 0.86). However, there was no significant association between maternal folic acid supplementation and acute myeloid leukaemia (OR, 0.70; 95% CI, 0.46 to 1.06) or childhood brain tumours (OR, 1.02; 95% CI, 0.88 to 1.19). CONCLUSIONS: Maternal folic acid supplementation was found to have a protective effect against childhood acute lymphoblastic leukaemia. Thus, healthcare professionals are recommended to provide regular health education and health promotion to the community on the benefits of folic acid supplementation during pregnancy.
Brain ; Case-Control Studies ; Delivery of Health Care ; Folic Acid ; Health Education ; Health Promotion ; Odds Ratio ; Pregnancy

Introduction Tuberculosis (TB) a major global health challenge especially in low- and middle-income countries reflects improper, delayed or missed diagnosis. Contact screening should be utilized both as an efficient and effective targeted approach to intensify TB case finding.Methods Through a comprehensive systematic literature review of online database, this paper aims at providing an insight into the current practice of TB contact screening and to provide evidence based practice for formulation of appropriate policies in low- and middle-income countries. There are 24 articles included in this review from studies published from 2005 to 2014.Results Findings in literature varies substantially. Generally, contact screening is better intensified with clear operational guidelines, adequate training, include close contact outside household as appropriate and follow up at least for 1 year. Prioritizing high risk close contacts is helpful in resource limited setting. Tuberculin skin test is still of value as screening tool and intensified case finding must be accompanied with effective management protocol. Prophylaxis treatment is recommended especially for children especially less than 5 years old, unvaccinated, malnourished, living with person having HIV and close contact with MDR-TB.Conclusion Policy recommendations in improving TB management must incorporate complementary strategies to enhance case finding, effective management protocol for follow up or prophylaxis treatment, training for public health capacity and concerted dedication from various stakeholders.

Pneumococcal disease causes considerable morbidity and mortality, including among adults. Adult pneumococcal vaccines help to prevent these burdens, yet, they are underutilized. Our objective is to systematically collect and summarize the available evidence on the potential factors that lead to pneumococcal vaccination acceptance among of adult community.

Umbilical cord (UC) is a discarded product from the operating theatre and a ready source of mesenchymal stromal cells (MSCs). MSCs from UC express both embryonic and adult mesenchymal stem cell markers and are known to be hypoimmunogenic and non-tumorigenic and thus suitable for allogeneic cell transplantation. Our study aimed to determine the degree of immunotolerance and bone-forming capacity of osteodifferentiated human Wharton's jelly-derived mesenchymal stromal cells (hWJ-MSCs) from different segments of UC in an allogenic setting. UCs were obtained from healthy donors delivering a full-term infant by elective Caesarean section. hWJ-MSCs were isolated from 3 cm length segment from the maternal and foetal ends of UCs. Three-dimensional fibrin constructs were formed and implanted intramuscularly into immunocompetent mice. The mice were implanted with 1) fibrin construct with maternal hWJ-MSCs, 2) fibrin construct with foetal hWJ-MSCs, or 3) fibrin without cells; the control group received sham surgery. After 1 month, the lymphoid organs were analysed to determine the degree of immune rejection and bone constructs were analysed to determine the amount of bone formed. A pronounced immune reaction was noted in the fibrin group. The maternal segment constructs demonstrated greater osteogenesis than the foetal segment constructs. Both maternal and foetal segment constructs caused minimal immune reaction and thus appear to be safe for allogeneic bone transplant. The suppression of inflammation may be a result of increased anti-inflammatory cytokine production mediated by the hWJ-MSC. In summary, this study demonstrates the feasibility of using bone constructs derived from hWJ-MSCs in an allogenic setting.
Adult ; Animals ; Bone Regeneration ; Cell Transplantation ; Cesarean Section ; Female ; Fibrin ; Humans ; Infant ; Inflammation ; Mesenchymal Stromal Cells ; Mice ; Osteogenesis ; Pregnancy ; Tissue Donors ; Tissue Engineering ; Transplants ; Umbilical Cord ; Wharton Jelly