Introduction: : Influenza is an upper respiratory infection is caused by the influenza virus. It occurs throughout the whole year in Malaysia with occasional outbreaks. Influenza-like illnesses (ILI) are generally treated as outpatient care while the more severe (SARI) is managed in patient care. The Casemix system, used in healthcare professionals' practices, may help in estimating the cost of influenza management. Methods: : This cross-sectional study extracts the cost of influenza management from different public hospitals in years 2016, 2017 and 2018. Data used selected ICD-10 codes, and the cost was abstracted from Malaysian Diagnostic Related Groups (MyDRG) software. The secondary data are from 2 sources, an urban teaching hospital Hospital Cancellor Tuanku Muhriz (HCTM) and Ministry of Health (MoH) inpatient hospitals database. The sample size of the study was 586, while a structured datasheet collating patients' sociodemographic data and cost of admission, per case, was obtained from the MyDRG software. Microsoft Excel and SPSS software were used in the analysis. Results: : Most influenza cases (61.8%) are between the ages of 0 and 10, Malays, and have similar gender proportions. Overall, the influenza treatment cost for inpatient care, totalled to RM 294,017,112. In 2018, the GDP for health consumed 3.76% of Malaysia's GDP income of RM 1.4 trillion, with an estimated RM 60,339 million used for health. Thus, the three-year public cost consumed 0.5% of 2018 GDP. Conclusion: Influenza screening at the primary healthcare setting, health education and treatment compliance should be scale-up to minimize the cost of influenza management of the public providers.

Aims: Leaf blight disease caused by Pantoea spp. reduces rice yields in numerous nations. However, the exact strategy to combat Pantoea spp. has yet to be determined. Bactronophorus thoracites is a promising source of natural antimicrobial agents due to their potential as a substrate to generate peptides with high antimicrobial activity. This study determined the effects of lactic acid fermentation using Lactobacillus casei ATCC334 as a starter culture on antimicrobial activity against rice pathogens, proximate composition, and amino acid profiles from B. thoracites crude extract. Methodology and results: Bactronophorus thoracites was washed and deshelled to collect the flesh and homogenised at 4 °C before freeze-drying. The freeze-dried samples were fermented with L. casei for 4 to 8 days at 37 °C. The antimicrobial activity, MIC and MBC were determined using a spectrometer. The fermented protein was subjected to proximate and amino acid analyses. The antimicrobial activity of fermented B. thoracites protein (FBTP) was significantly (p<0.05) decreased with the increased fermentation days (from 4 to 8 days). The antimicrobial activity was also increased when the glucose concentration increased from 2% to 3%. However, raising the glucose concentration to 4% decreased the antimicrobial activity. The antimicrobial activity was significantly (p<0.05) increased when the substratewater (S/W) ratio increased from 0.84% to 0.96%. The FBTP (4 days, 3% glucose concentration and 0.96% S/W ratio) showed high antimicrobial activity against Pantoea ananatis and P. stewartii. The MIC and MBC values for FBTP were 500 μg/mL and 250 μg/mL against P. ananatis and P. stewartii. The zones of inhibition value for FBTP were 16.0 ± 0.5 mm (1000 μg/mL) and 9.33 ± 0.57 mm (500 μg/mL) for P. ananatis, and 11.7 ± 0.61 mm (1000 μg/mL), 9.33 ± 0.58 mm (500 μg/mL) and 7.17 ± 0.77 mm (250 μg/mL) for P. stewartii. The proximate composition and amino acid profiles of the freeze-dried protein hydrolysate powder were characterised. FBTP produced a higher value of protein (61.56%) and ash (32.38%) and a lower value of total fat (0.273%) and carbohydrates (6.27%) than the B. thoracites crude extract. Total amino acid content was 39.480 g/100 g in B. thoracites crude extract and 155.442 g/100 g in FBTP. The essential amino acid glutamine was the most abundant in B. thoracites crude extract and methionine in FBTP. Conclusion, significance and impact of study This study showed that lactic acid fermentation could produce FBTP using L. casei with improved functional characteristics and as a source of a natural antimicrobial agent against rice pathogens.
Lactic Acid ; Anti-Infective Agents

Major depressive disorder (MDD) is a common but complex illness that is frequently presented in the primary care setting. Managing this disorder in primary care can be difficult, and many patients are underdiagnosed and/or undertreated. The Malaysian Clinical Practice Guidelines (CPG) on the Management of Major Depressive Disorder (MDD) (2nd ed.), published in 2019, covers screening, diagnosis, treatment and referral (which frequently pose a challenge in the primary care setting) while minimising variation in clinical practice.
Depression ; Depressive Disorder, Major ; Primary Health Care ; Therapeutics

Introduction: Coronavirus disease-2019 (COVID-19) was declared a global pandemic in March 2020, with 15 million people have been infected worldwide, and this number is increasing. Our study sought to assess the knowledge and practice of healthcare workers (HCWs) in a teaching hospital in Malaysia. Methods: This cross-sectional study was undertaken using online Google form links among HCWs. Knowledge and practice were assessed using a validated questionnaire. The analysis was performed with SPSS version 26. Factors associated with poor knowledge were analysed using multivariate analysis. Results: A total of 193 HCW responded to our online survey. Majority of our HCWs were female (74.1%) with a mean age of 32.5 years. We found 53 (27.5%) and 134 (69.4%) of our HCWs had good knowledge and good practice on COVID-19, respectively. Knowledge gap was identified in the symptomatology, investigation methods and management. Based on multiple logistic regression, determinants of poor knowledge scores were those work as medical attendants (aOR = 3.626; 95% CI = 1.489, 8.834) and nurses (aOR = 4.107; 95% CI = 1.175, 14.358). Conclusion: Around one-third and 70% of our HCWs have good knowledge and practice of COVID-19 infection respectively. Continuous, specifically targeted and updated medical education, need to be carried out to improve the knowledge and practice among our HCWs in order to keep abreast of the fast-moving pace of COVID-19 knowledge development.