Introduction: Elderly is a vulnerable population that is prone to sarcopenia which is associated with the loss of muscle mass, strength and function which are some of the diseases that affect the elderly. The association between environmental factors with sarcopenia should be explored as it has the potential to influence the health and disability of a person. At present, limited research is conducted to investigate the association that could be attributed to the complex interaction between human and environmental interactions. Hence this review is conducted to identify the environmental factors associated with sarcopenia. Methods: A systematic review was conducted using PubMed, SCOPUS, Web of Science and manual search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. We used articles that had been written in English and relevant articles were then screened, duplicates were removed, eligibility criteria were applied, and studies that met the criteria were reviewed. The keywords environmental factors, pollutants food environment, neighbourhood environment, locality and sarcopenia were included. Results: Initial search generated 934 publications and 12 articles were included after the inclusion and exclusion criteria for this review. In this review, environmental factors associated with sarcopenia are divided into 3 themes that comprises of food environment (availability and physical access, economic access and food quality and safety), neighbourhood environment and pollutants. Conclusion This systematic review revealed an association between the food environment, neighbourhood environment and pollutants with sarcopenia. The findings are salient as they could aid policymakers in formulating the necessary strategy to reduce the morbidity and mortality associated with sarcopenia, especially with the increase in the ageing population globally.

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.

Violence among adolescents is a significant public health issue. The focus was on school-going adolescents because of the life-long negative impact at an individual level both for the perpetrator and victim. Besides, it increases the costs to provide health, welfare, and criminal justice as well as decreases general productivity at the community level. The study aims to determine the prevalence of violence-related behavior, characteristics of both victims and perpetrators, in addition to inter and intrapersonal factors associated with violence-related behaviors. A study was carried out in 2013, which involved all upper secondary school students (aged 16 to 17 years). It was a part of the Malaysian Adolescent Health Risk Behavior (MyAHRB) study, which was conducted in 11 states in Peninsular Malaysia. Standardized, validated questionnaires were used for data collection. The prevalence of violence-related behaviors was 22.4%, and this was higher among male students as compared to females (29.1% vs. 16.3%). Multivariable analysis revealed that the odds of violence-related behaviour increased among males, Malay race, drug use, smoking, had exposure to sex, which sometimes and always felt lonely and had attempted suicide. Agreeable to ensure that their lifestyles do not transgress religious limit and belief was significantly protective. This study provides evidence for a targeted approach to combat violence-related behaviors among adolescents.

Bacteraemia is a common and one of the serious complications in haematopoietic stem cell transplantation (HSCT). To date, there are no published data on antibiotic resistance and clinical outcome among HSCT recipients in Malaysia. The aims of the present study was to analyse the prevalence, antibiotic resistance and clinical outcome of bacteraemia in HSCT recipients within 100 days following transplantation. We retrospectively analysed the prevalence, antibiotic resistance pattern and mortality rate of early bacteraemia among HSCT recipients in a single centre over a 5-year period (2013-2017). Thirty patients of 85 HSCT recipients developed bacteraemia with 40 positive cultures resulting in prevalence of 47% (40/85). Gram negative bacteria (GNB) accounted for 60.5% of total isolates. Enterobacteriaceae and Coagulase negative Staphylococcus (CoNS) were the commonest pathogens isolated. GNB showed a high resistance rate to ciprofloxacin. Only 30% of recipients responded to first line empirical antibiotics for febrile neutropenia (FN). The mortality rate was 13.3% (4/30), of which 50% was attributed to multi-drug resistance (MDR) Acinetobacter and 25% to extended spectrum beta-lactamase (ESBL) Enterobacteriaceae. Bacteraemia is a frequent and life-threatening early complication among HSCT recipients with MDR GNB being the commonest cause of mortality. The high rate of resistance to ciprofloxacin and failure of the first line empirical antibiotics to treat FN calls for a thorough evaluation of the current antibiotic prophylaxis and empirical treatment protocols. These findings have important clinical implications regarding the use and selection of both prophylactic and empiric antibiotic regimens to treat FN.

Many of our chronic kidney disease (CKD) patients venture into complementary and alternative medicine (CAM) to seek a cure for the disease beyond conventional management. The objective of this study was to determine the prevalence and pattern of CAM usage; and its association with the progression of CKD in our population. This was a cross-sectional survey recruited CKD patients from Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Data was collected via interview using questionnaires which explore the demographics, type and pattern of CAM use. Patients’ comorbidities and serum creatinine were extracted from the medical notes to assess the association between progression of CKD and usage of CAM. Chi-square, Independent Samples t-test, Mann-Whitney U test and logistic regression were used to evaluate for an association. Three hundred and seventy two eligible patients were recruited. The prevalence of CAM use was 29% in the past year. Younger age, higher education and higher income level were associated with significantly more usage of CAM. Natural products were the commonest type of CAM used (86.1%). The belief in the effectiveness of CAM was the main reason for its uptake and about 57.8% revealed their practice to their physician. We found that the use of CAM in Malaysian CKD patients did not influence the progression of the disease.

Chronic non-communicable diseases are the new emerging epidemic, and they are thought to challenge only rich countries; cardiovascular disease, cancer, diabetes, and other non-communicable diseases (NCDs) are now the leading cause of death and disability in low-income and middle-income countries, where they killed almost 8 million people younger than 60 years in 2013. Therefore, there is a need to develop a valid and reliable tool to measure the beliefs that influence people’s general behaviour, and a used to measure beliefs about chronic disease perceived susceptibility. The purpose of this study was to develop and validate the use of perception questionnaire among the young Iraqi adults. A total of 200 young adults participated who are free from any chronic diseases under study, and are living in Baghdad. The questionnaire, validated by an expert’s panel, translated to Arabic language, and pretested. Analyses included descriptive statistics of all the study variables, reliability estimates, and construct validity using confirmatory factor analysis (CFA). Results showed that mean age of respondents was 30 years old, majority were males 71.5%, and EFA showed that factor loading was more than 0.4. CFA results show that Chi-square (df) = 1.213(2); p value (>0.05) = 0.297. Internal consistency reliability analysis on health-related behaviour; special practice, information seeking and perceived probability of diseases have good Cronbach’s α value of between 0.8 - 0.9. These findings revealed that validation is favourable and can be utilized on larger scale of sample to proceed with main study on chronic disease perceived susceptibility among healthy people.
perception ; validity ; chronic disease

Tuberculosis (TB) is known as a disease that prone to spatial clustering. Recent development has seen a sharp rise in the number of epidemiologic studies employing Geographical Information System (GIS), particularly in identifying TB clusters and evidences of etiologic factors. The aim of this systematic review is to determine evidence of TB clustering, type of spatial analysis commonly used and the application of GIS in TB surveillance and control. A literature search of articles published in English language between 2000 and November 2015 was performed using MEDLINE and Science Direct using relevant search terms related to spatial analysis in studies of TB cluster. The search strategy was adapted and developed for each database using appropriate subject headings and keywords. The literature reviewed showed strong evidence of TB clustering occurred in high risk areas in both developed and developing countries. Spatial scan statistics were the most commonly used analysis and proved useful in TB surveillance through detection of outbreak, early warning and identifying area of increased TB transmission. Among others are targeted screening and assessment of TB program using GIS technology. However there were limitations on suitability of utilizing aggregated data such as national cencus that were pre-collected in explaining the present spatial distribution among population at risk. Spatial boundaries determined by zip code may be too large for metropolitan area or too small for country. Nevertheless, GIS is a powerful tool in aiding TB control and prevention in developing countries and should be used for real-time surveillance and decision making.
Tuberculosis cluster ; geographical information system ; spatial analysis

The purpose of this study was to determine the prevalence and factors associated with of Premature Ejaculation &Erectile Dysfunctionamong Malaysian men.A cross-sectional study was conducted in urban and rural areas using standardized and validated self-administeredquestionnaires.A total of 319 samples were recruited for PE screening. The overall prevalence of PE was 31.7% with 20.7% and 40.8% for urban and rural arearespectively. Depression, anxiety and frequent masturbation were significantly associated with PE. While For ED, infrequent sexual intercourse was the sole factor significantly associated with ED.PE and ED were highly prevalent in both urban and rural areas; with several significant preventable associated factors.
Premature Ejaculation ; Erectile Dysfunction ; Sexual Dysfunction ; Malaysia

As air travelling now becomes cheaper and available to almost all people of any walk of life, travelling across international borders is fast becoming a lifestyle of many. Having travel health service as part of health care services is important to address the issues of travel related illnesses among travellers. However, lacks of published guidelines pertaining to travel health service rendering many countries to overlook its importance. The aim of this paper is to review published literatures and authoritative websites on the components needed to develop guideline to establish travel health services. A systematic literature search was done using pre-specified keywords for literatures published between years 2000 – 2016. Literatures written in English and fully accessible were all included. No exclusion criteria was set before the search. Online authoritative websites pertaining to travel health were also referred. A total of six literatures ranging from expert opinion, review paper and original study, together with three authoritative websites related to travel health were reviewed. Among the important components needed to be considered for developing the guideline for establishing travel health services are to prioritise pre-travel health service, to set up specialised travel health clinic, to produce travel health/medicine specialist, to emphasize on continuous education and training of the practitioners and to apply multiagency and multidisciplinary approach with adequate fund for research in travel health. As a conclusion, policy makers should prioritise and select the most important components in developing guideline for travel health service.
Travel health service ; travel medicine ; guideline development

There is a large volume of published studies describing the adverse relationship between treatment non-adherence with tuberculosis treatment outcome. Non-adherence could result in increased risks of prolonged infectiousness, drug resistance, relapse cases and poor survival among tuberculosis patients. Nevertheless, few studies are to be found providing detailed on the reason of defaulting treatment among tuberculosis patients in Malaysia. Hence the goal of this paper is to find out the barriers and motivations factors that affect patients’ treatment compliance among our local tuberculosis patients. This is a qualitative study which included 12 in-depth interviews with tuberculosis non-compliance patients who were treated at Institute of Respiratory Medicine, Kuala Lumpur. All the conversations were recorded, transcribed and analysed by using thematic analysis. It was found that low knowledge, self-negative attitudes, traditional believes, negative perceptions towards health caregiver, drug side effects, stigma, financial problems, less family support and work commitments are the barriers that prevent the patients from religiously taking their anti-tuberculosis treatment. Meanwhile, factors that encourage them to continue their treatment were the believes of bad effects of the disease onto their lives and health, good relationship between patient and health caregiver and social support from people around them. In conclusion, non-adherence involved a dynamic influence of individual, socio-economic and treatment-related factors on the patients. The results presented here may facilitate improvement in the activities in promoting compliance among tuberculosis patients in the future which tailored to the patients’ specific needs.
Tuberculosis