Oropharyngeal carcinoma is uncommon cancer compared to other malignancies. It accounts for less than 3% worldwide cancer and classified under the head and neck carcinoma. Patients with locally advanced oropharyngeal malignancy are usually treated with surgery with combination of radiotherapy and chemotherapy. This later required regular follow up especially on supportive care and adaptation to swallowing. Difficulty in swallowing provided burden to the patient and may lead to underlying malnutrition and risk of infection including tuberculosis. This will end up with poor compliance to oral treatment and risk of resistance. Therefore, this case study is illustrating the challenging role of family medicine specialists in managing a case of sputum positive pulmonary tuberculosis with underlying swallowing difficulty from glossectomy and radiotherapy on top of defaulted tongue carcinoma supportive care follow up.

Combination of The Childhood Autism Rating Scale™ Second Edition - Standard Clinical Tool (CARS2-ST) with criteria for autism spectrum disorder (ASD) based on Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) is thought to improve diagnostic process. To meet diagnostic needs, localized, Indonesian-translated version of CARS2-ST is developed. Therefore, assessment of construct validity of the Indonesian-language translated CARS2-ST must be performed. A cross-sectional study was conducted in Child Development Center in Surabaya, Indonesia from August to December 2019. Diagnosis of ASD then performed by using CARS2-ST and DSM-5 criteria. To assess construct validity, principal components analysis and Kaiser-varimax rotation was performed for CARS2-ST in order to determine factors. DSM-5 criteria for ASD was used to compare scale.There were 201 children aged 2 - 6 years old with reported speech and behavior problems. Sixty-six children were diagnosed for ASD. Factor analysis using Kaiser-varimax rotation indicates a significant two factors: social communication and interaction factor and restrictive stereotyped behaviors and sensory factor sensitivites. The factors satisfyingly reflects the criteria for ASD in DSM-5.Construct validity of Indonesian-translated version of CARS2-ST is confirmed, as shown by its correspondence with DSM-5 criteria for diagnosing . This study supports the continued relevance of the Indonesian CARS2-ST in ASD assessment.

The application of artificial intelligence (AI) is on the rise in the healthcare industry. However, the study on the physicians’ perspectives is still lacking. The study aimed to examine physicians’ attitudes, expectations, and concerns regarding the application of AI in medicine. A cross-sectional study was conducted in October 2019 among physicians in a tertiary teaching hospital in Malaysia. The survey used a validated questionnaire from the literature, which covered: (1) socio-demographic profile; (2) attitude towards the application of AI; (3) expected application in medicine; and (4) possible risks of using AI. Comparison of the mean score between the groups using a t-test or one-way analysis of variance (ANOVA). A total of 112 physicians participated in the study: 64.3% from the clinical departments; 35.7% from the non-clinical specialties. The physicians from non-clinical departments had significantly higher mean attitude score (mean = 14.94 ± 3.12) compared to the clinical (person-oriented) departments (mean = 14.13 ± 3.10) and clinical (technique-oriented) departments (mean = 13.06 ± 2.88) (p = 0.033). The tech-savvy participants had a significantly higher mean attitude score (mean = 14.72 ± 3.55) than the non–tech-savvy participants (mean = 13.21 ± 2.46) (p = 0.01). There are differences in the expectations among the respondents and some concerns exist especially on the legal aspect of AI application in medicine. Proper training and orientation should precede its implementation and must be appropriate to the physicians’ needs for its utilization and sustainability.

Health literacy has shown to have some influence in preventive behaviour, including on colorectal cancer. Such a relationship, however, is not well established in Malaysia, particularly Sarawak. This study is aimed to estimate the level of health literacy and preventive practice against colorectal cancer and factors associated with it. This was a cross-sectional study conducted in Sarawak, among adults aged 50 years and above. Data was collected by face to face interviews using a validated questionnaire. Descriptive statistics were used to determine the health literacy and preventive behaviour on colorectal cancer. Multiple linear regression was used to determine the factors associated with preventive behaviour on colorectal cancer and also to examine its relationship with health literacy. A p-value of ≤0.05 was considered as statistically significant. A total of 829 respondents were included in the analysis. Mean age (standard deviation) of the respondents was 55.78 (5.01) years. A large proportion had an educational background of upper secondary school and above (41%) and from Iban ethnicity (32.4%). Only 1.1% of them had a family history of colorectal cancer. Multiple linear regression analysis revealed that gender (p<0.01), ethnicity (p<0.05), functional health literacy (p<0.05), and knowledge on colorectal cancer (p<0.05) appeared to be significant predictors for preventive behaviour on colorectal cancer. Health literacy has a positive effect on preventive behaviour on colorectal cancer. The findings assist in designing and developing targeted informational campaigns to promote preventive behaviour, particularly among low health literate group.

Body image is a complex and multifaceted construct with multiple associated factors determining its perception among adolescents. This study aimed to determine the perceived body image and its relationship with body mass index, self-esteem, body change strategy, and social network usage among rural adolescents. This study was a cross-sectional study design using a multistage random sampling technique to select adolescents aged 10 to 19 years. A total of 318 adolescents’ data were collected using a self-administered questionnaire. Data analysis was done using SPSS version 22.0 with a p-value of <0.05 was considered statistically significant. The mean (SD) age of adolescents was 14.6 (2.7) years with a male and female ratio of 1.09:1. The mean score (SD) of perceived body image was 3.63 (0.87). Multiple linear regression analysis revealed that gender, body mass index, and strategy to increase weight could predict perceived body image among adolescents. However, self-esteem did not correlate with perceived body image. Although, the body image dissatisfaction level was low among rural adolescents compared to other studies in Malaysia. However, it can still pose a threat to adolescents’ health if not addressed accordingly.

Tumour protein 53 (p53) plays an important role in the instruction of the cell cycle. In a variety of transformed cell lines, tumour protein is expressed in high amounts, and it is believed to contribute to transformation and malignancy. This research aimed to detect the anti-p53 antibodies in sera of patients with various malignant tumours and to evaluate the sensitivity and specificity of an enzyme-linked immunosorbent assay (ELISA). A case-control study was conducted on samples from 49 patients with various types of malignant tumours at Sultanah Bahiyah Hospital, Alor Setar, Kedah, Malaysia, and 32 healthy control cases with non‐malignant disease collected from Universiti Sains Malaysia clinic, Penang, Malaysia. The antibodies against p53 protein in the serum samples were analysed using the commercial ELISA kit, Calbiochem® p53- ELISAPLUS. The results showed that the rate of anti-p53 antibodies in patients with various malignant tumours was 13 out of 49 (26.5 %), compared with only 2 out of 32 (6.25%) in healthy controls (p < 0.001). The sensitivity of this kit reached 28.6% and the specificity was 93.8%. In conclusion, these results suggest that the anti-p53 antibodies can be detected in different sera of malignant tumour patients and the ELISA kit is highly specific; nevertheless, its discrimination power is not perfect because of its low sensitivity to determine the anti-p53 antibodies.

Indonesia has a double burden, which is besides facing the problem of malnutrition and other micronutrient deficiencies, Indonesia also faced the problem of obesity. Prevalence of short-fat status nutrition in Indonesia amounted to 6.8% in 2013. This study aimed at determining the risk factors for short-fat status nutrition in children aged 12-23 months in Indonesia.The design of this study was a cross-sectional study using secondary data from basic health Research (RISKESDAS) 2013, with a sample size of 378,308 children aged 12-23 months. the dependent variable in this study is short-fat nutrition status and the independent variables are exclusive breastfeeding, complementary feeding, neonatal visit, immunization, and Giving of Vitamin A. Further analysis of the data in several steps include univariate, bivariate (chi -Square), and multivariate (logistic regression). Sample of this study is mostly male 204,030 (53.9%) with the nutritional status based on the combined height/age and weight/height is not shot-fat status nutrition 352450 (93.2%). Based on bivariate test results, four variables are to be the risk factors in this study, are not exclusive breastfeeding OR = 1.047, Complementary food OR = 1.136, immunization OR = 0.761, and vitamin A consumption OR = 0.601. While the neonatal care visits variable as the risk factor. Multivariate analysis showed that the most dominant variable is the provision of complementary food OR 1.158 (95% CI 1.127 to 1.189). From these results, it can be concluded that giving complementary feeding is the most responsible for the short-fat nutrition status in children aged 12-23 months. Prevention efforts need to through monitoring the nutritional status of children, especially monitoring the growth of body length or height by age as early as possible for early detection of nutritional problems in children, so that management can quickly prevent that case.

The Malaysian government implemented an excise tax of MYR 0.40 per L on sugar-sweetened beverages in July 2019. Excise tax is imposed on sweetened drinks containing more than 5 g of sugar per 100 ml, flavoured Ultra High Temperature milk-based drinks, and fruit juices with more than 7 g and 12 g of sugar per 100 ml, respectively. We analysed the impact of excise tax on the consumption of SSBs by developing a demand model for SSBs to estimate the elasticity of demand using a two-way fixed-effect model. The tax increased the price of 1 L SSBs by 8.33%, and we estimated it to decrease the consumption of SSBs by 9.25%. The estimated own-price elasticity of demand for SSBs was −1.11 (95% CI: −1.97 to −0.25). Price of SSB is a determinant for SSB demand, but income or the price of milk are not. The estimated excise revenue calculated was MYR 357.61 million. However, industry responses via product reformulation and pass-through rates could reduce revenue and enhance or reduce health impacts.

This study examined the impact of universal screening in diagnosing and managing gestational diabetes (GDM) amongst antenatal mother and associated neonatal outcomes. It is a single-centre, retrospective study on routinely collected data of antenatal women in Health Clinic Seremban over one year in 2018. All women diagnosed with GDM, who were not known sufferers of type 1 or type 2 diabetes were included in this study. Participants were stratified according to risk factors for GDM to compare the performance of a selective high-risk screening approach to that of universal screening for detecting GDM. Subjects were categorized as high-risk for GDM based on the guidelines recommended by the Malaysian Clinical Practice guidelines. It was found that through universal screening, 246 antenatal mothers were tested positive for GDM out of the 987 of these mothers without prior diabetes, giving a prevalence of 24.9%. If selective screening using traditional risk factors had been employed, 54 (22%) of the antenatal mothers diagnosed with GDM would have been missed. It was established that risk factors for GDM included advancing age, other ethnicities (patients that are not of Malay, Chinese nor Indian ethnicities), obesity, history of abortion or GDM and family history of diabetes mellitus. Neonatal outcomes of those with GDM as compared to those without were similar. This study highlights that universal screening improved GDM detection rates amongst antenatal mothers. The increased detection helped facilitate an earlier intervention which may have contributed to better antenatal management and outcomes for neonates and their mothers.

Obesity become worrying problem among adolescents, they who are obesed are 80% have the opportunity to experience obesity as adults and have higher risk of serious diseases such as cardiovascular disease, stroke, diabetes, asthma, and some types of cancer. According to the health profile of Yogyakarta Special Province in 2017 the prevalence of obesity was 19.1% occurs in adolescents. The main purpose of the research is to analyze the direct and indirect effects of gadget usage, sleep habit, stress, and physical activity on obesity. The population in this research was obese junior and senior high school adolescents, totaling 150 persons. Determination of samples is taken by simple random sampling. Independent variables consist of gadget usage, stress level, sleep habit, and physical activity. While the dependent variable is obesity. Bivariate analysis with chi-square test is applied for cathegorical data and independent T-test for numerical data. Multivariate analysis is carried out with path analysis, using the Amos version 22.0 software program. The results of this research found that the conclusions of the path diagram generated are as follow: 1) Gadget usage variable path coefficient value has a positive effect on physical activity. 2) Physical activity variable path coefficient value has a positive in effect on obesity. 3) Sleep habit and stress variable path coefficient value has a positive effect on gadget usage. It can be concluded that gadget addiction is directly related to sleep habits, stress, physical activity, and indirectly with obesity.