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.

One of the most frequent complaints of individuals with hearing impairment is listening comfort in noisy environments. In order to improve listening comforts in background noise, digital noise reduction (DNR) systems are incorporated into hearing aids (HAs). Each hearing aid manufacturer has its proprietary algorithm for the DNR system. The amount of attenuation (dB) provided by the DNR system can be quantified using the hearing aid analyser. However, the standard test signals in the hearing aid analyser could not quantify the attenuation of DNR for speech mixed with noise signals. Therefore, this study aimed to (i) develop speech-plus-noise test signals that incorporate Malay sentences and (ii) quantify the efficacy of DNR systems in commercial hearing aids using the newly developed test signals. Six different brands of hearing aids with identical technology but from different manufacturers were subjected to electroacoustic testing utilising newly created Malay speech-in-noise test signals with and without DNR enabled. The total root-meansquare (RMS) gain reduction for each HA was calculated. The results show that the types of noise, the signal-to-noise ratio and the gender of the speaker have a significant effect (p<0.05) on the amount of gain reduction in the HA output as a result of the DNR system in each HA . In conclusion, the newly developed Malay speech-in-noise test signals can be used to verify the efficacy of DNR system in commercial hearing aids.

Aims: The natural coexistence of high humidity and warm temperatures in Malaysia and Nigeria and poor storage facilities used by most poultry feed vendors provide suitable conditions for the proliferation of aflatoxigenic fungi and aflatoxigenesis. This study aims to characterise and evaluate the toxigenicity of Aspergillus section Flavi (ASF) from Malaysian and Nigerian poultry feeds. Methodology and results: This study utilised standard mycological techniques to determine the bioburden and distribution of mycoflora in 132 and 144 Malaysian and Nigerian poultry feeds, respectively. The ASF isolated from the samples were tested for aflatoxigenicity by thin-layer chromatography (TLC) and then characterised by multivariate using attenuated total reflectance fourier transformed infrared spectroscopy (ATR-FTIR). A total of 128 and 75 mould fungal isolates belonging to 12 and 11 species were obtained from the Malaysian and Nigerian samples with a bioburden ranging from 2.0 to 6.97 log CFU/g and the highest overall mean count of 5.66 ± 4.51 log CFU/g and 5.6 ± 4.76 log CFU/g, respectively. Aspergillus fumigatus, Aspergillus felis, Aspergillus flavus/parasiticus and Fusarium graminearum were predominant in poultry feeds from both countries. Overall, 16 ASF were isolated (Malaysia = 7, Nigeria = 9), of which only three produce aflatoxins. The multivariate cluster analysis of ATR-FTIR spectra showed 97.78% similarity between the toxigenic and atoxigenic ASF with primary differences at 600 to 800 cm-1 and 2927 to 4000 cm-1 only. Conclusion, significance and impact of study The bioburden of fungal flora in the samples was higher than the ICMSF's acceptable range of 2.0 to 5.0 log CFU/g, indicating that they could be hazardous to poultry and necessitate stricter control measures. Irrespective of the country/source of samples, the ATR-FTIR has discriminated the toxigenic from atoxigenic ASF, implying its promising prospects for rapid identification of toxigenic ASF.

Background: Aneurysmal bone cysts (ABCs) are infrequent, benign, and locally destructive lesions that most commonly occur during the first two decades of life. They usually affect the metaphysis of the long bones, but the pelvis is involved in 8%–12% of the cases. The management of pelvic ABCs is a challenging issue due to difficulties in choosing the appropriate approach, adjacent neurovascular bundles, the risk of intraoperative bleeding with difficulty achieving good hemostasis, and the risk of injury to the hip or sacroiliac joints. Limited data exist concerning the use of denosumab as a non-surgical treatment for pelvic ABCs. Our hypothesis was that denosumab might be an effective and safe solo treatment of cases with ABCs in the pelvis. Methods: We retrospectively assessed 20 patients with ABCs in the pelvis, who were treated by denosumab as a solo agent without surgery. Patients were assessed regarding disease control, the incidence of recurrence and non-oncological complications, and functional outcome. Results: The mean follow-up period was 38.5 months. Disease control was achieved in 16 patients (80%), with no local recurrence. Tolerable drug-related complications occurred in 15% of cases. The mean Musculoskeletal Tumor Society score was 92.3%. Conclusions Denosumab may provide a reliable option in the nonsurgical treatment of ABCs of pelvic origin with expected lower morbidity than the surgical solution and tolerable complications. Further studies on the safety profile and long-term effects of denosumab especially in skeletally immature patients are required.

Background: Alternative and complementary medicines are widely used to treat migraine headaches. This review aimed to determine the effectiveness of essential oils as an alternative treatment approach. Methods: A structured search was conducted to identify randomized trials comparing essential oils with a placebo for migraine headaches, using databases (MEDLINE and CENTRAL) to search for articles published between 1966 and 2021. We included trials involving adult males and females diagnosed with migraine headaches according to the International Headache Society. The outcomes included number of attacks, headache severity, associated symptoms, number of days of limited activity, headache duration, use of analgesics, and adverse effects. Seven trials were included with a total of 558 participants. Results: No difference was observed in the number of migraine headache attacks compared to placebo (mean difference [MD], -1.34; 95% confidence interval [CI], -3.31 to 0.64; I2=94%; P=0.190; four trials, 242 participants; moderate- quality evidence). There was no difference in this outcome between the essential oils treated group and the placebo (MD, -0.38; 95% CI, -1.76 to 0.99; I2 statistics=86%; P=0.580; five trials, 240 participants; moderate-quality evidence). Conclusion We found no significant difference between the use of essential oils and placebo in managing migraine headaches.

Background: There are a few dry eye remedies available in the market. Currently, artificial tears and lubricants are still the most common management for dry eyes. Objective: We proposed a new method in managing dry eyes. Methods: A pre-soaked contact lens in virgin coconut oil (VCOCL) is being used as a vehicle to deliver virgin coconut oil (VCO) in dry eyes. VCOCL was prepared in sterilised conditions where daily soft hydrogel contact lenses were immersed in raw VCO. The efficacy of VCOCL in delivering the VCO to eyes was assessed by measuring the Tear Break-Up Time (TBUT) values, corneal staining of the anterior eye, Schirmer Test values and the measurement of residual VCO volume in tears at baseline and at 15 minutes after insertion on subjects with dry eyes. Pre- and post-data were used to analyse all the measurable variables. Results: This study showed a significant difference in the TBUT, corneal staining, and residual VCO volume for both eyes (p<0.05). However, there were no changes in the Schirmer Test value (p>0.05). VCOCL was proven to improve tear quality in dry eye subjects and was able to maintain its presence in the eye even after 15 minutes. Conclusion This study suggests a new method for dry eye management.
Contact Lenses ; Therapeutics ; Dry Eye Syndromes

This manuscript aims to examine depression and the relationship between depression and other comorbidity diseases among women involved in prostitution in Kuala Lumpur. A total of 126 women were interviewed face to face using a structured questionnaire. The M.I.N.I Neuro-Psychiatric Interview Diagnostic Test Tool 6.0 Bahasa Malaysia Version was used to measure depression among women involved in prostitution in Kuala Lumpur. Meanwhile other comorbidity diseases were measured based on the women’s infectious disease status such as Sexually Transmitted Diseases, Hepatitis, HIV and AIDS. The results of study were analysed using SPSS software version 21. Descriptive tests were used to determine the status of depression among women involved in prostitution. The Chi-square test was used to identify the relationship between the status of other comorbidity diseases and depression among women involved in prostitution. The results of the descriptive analysis revealed that 92 out of the 126 women who were interviewed reported suffering from depression. In fact, the results of Chi Square test (p≤0.05) analysis showed that there was a significant relationship between the status of other comorbidity diseases especially Hepatitis C and depression among women involved in prostitution in Kuala Lumpur. The findings of the study indicated that women s who were positive with Hepatitis C were more prone to report depressive disorders. Therefore, mental health education program and treatment specially for women involved in prostitution need to be integrated into the prevention programs of the infectious diseases.

Introduction: This study measured the outcome of the Optimal Health Program (OHP) among frontline healthcare workers during the COVID-19 pandemic. The OHP is a wellness-based self-management intervention focused on well-being to gain optimal health. OHP is originally from Australia and has been translated, culturally adapted and branded as the Program Kesihatan Optimum Sanubari (SANUBARI). The program was conducted as a psychosocial intervention and the outcomes measured were self-efficacy, coping styles and well-being. Methods: Eligible participants were nurses who actively managed COVID-19 inpatients in Hospital Kuala Lumpur and committed to complete the intervention. Those who did not provide consent or had comorbidity, unstable medical or psychiatry illnesses were excluded. 43 nurses were recruited through convenience sampling method and completed outcome measures from General Self-Efficacy Scale, Brief COPE and WHO-5 Well-being Index, before and 1-month after the intervention. The OHP was conducted via group-based, using OHP Sanubari workbook with 5 weekly sessions by trained facilitators and lasted for 60 to 90 minutes per session. Results: Significant improvement was observed 1-month post intervention for self-efficacy (t(42)=5.64, p <0.001) and well-being(t(42)=2.14, p<0.05); different approach coping strategies(acceptance, use of informational support, positive reframing, active coping, and planning) and avoidant coping strategies(distraction, venting, denial, and substance use). Whilst, humor coping reduced significantly 1-month post-intervention (t(42)=3.66, p<0.05). Conclusion: This study reports the positive outcome of OHP on the mental health status of healthcare workers during the pandemic. This program can be considered as a tool towards optimal health throughout their career.

Tonsillar malignancy typically presents with asymmetrical tonsillar enlargement, lesion on the tonsils, sore throat or a neck mass. We report a case of unsuspected tonsillar malignancy in a 56-year-old gentleman who presented with symptoms of obstructive sleep apnoea. His tonsils were grade III bilaterally with normal mucosa. Tonsillectomy was performed to improve patient’s compliance with Continuous Positive Airway Pressure (CPAP) therapy. These tonsillar specimens were reported to be Mantle Cell Lymphoma (MCL) based on the histology and ancillary studies. This case highlights that benign-looking symmetrical tonsillar enlargement can harbour occult malignancy. It is important to note that OSA symptoms may be the presentation for haematological malignancies. Tonsillar specimens should be sent for histopathological examination regardless of the indication to avoid misdiagnosis and delay in treatment.

Introduction: Atopic dermatitis (AD) is not only a cosmetic nuisance but is also associated with a significant impact on mental health and quality of life. Psychological symptoms are highly related to poor treatment adherence and recovery, more comorbidities, and a significant overall socioeconomic burden. Identifying the factors associated with anxiety and depression among patients with AD is important to modify and reduce the risk of developing these psychiatric complications. Methods: This was correlational research conducted in the dermatology clinic of four hospitals in Klang Valley, namely Hospital Kuala Lumpur, Hospital Tengku Ampuan Rahimah Klang, Hospital Selayang, and Hospital Ampang. By using a purposive sampling method, 128 samples (n=128) of adult patients with AD aged 18-65 were included. A questionnaire was administered regarding sociodemographic background, illness characteristics of AD, the Investigator’s Global Assessment (IGA), Malay version of the Automatic Thought Questionnaire-17, GAD-7, and PHQ-9. Results: The prevalence of anxiety and depressive symptoms among adult patients with AD is 31.3% and 46.9% respectively. Multivariable logistic regression analysis revealed that age and personal maladjustment (PM) predict anxiety symptoms, while only negative self-concept/expectation (NSNE) predicts depressive symptoms. The hierarchical logistic regression model explained 51% (Nagelkerke’s R2) of the variance in anxiety symptoms and 56% (Nagelkerke’s R2) of depressive symptoms. Conclusion: There is a high proportion of anxiety and depressive symptoms among adult patients with AD which is associated with negative automatic thoughts. In the management of adult patients with AD, clinicians should consider mental health symptom screening and monitoring.