Background: Changes in cognitive function are associated with increased depression and decreased quality of life (QOL). This study aimed to determine the relationship between the characteristics of geriatric patients and anesthetic management with changes in postoperative cognitive function and QOL of geriatric patients undergoing elective surgery. Methods: This prospective observational analytic multicenter study included patients aged ≥60 years who underwent elective surgery in hospitals in Indonesia. We used the whole sampling method and performed follow-up 30 days after surgery. Data were analyzed using bivariate chi-square and multivariate regression tests with a confidence interval of 95% and α=5%. Results: Among the 933 geriatric patients included in this study 55.0%, females most (59.8%) received general anesthesia. Factors including age (p<0.001, B=-0.374, odds ratio [OR]=0.688), body mass index (BMI) (p<0.05, B=0.129, OR=1.138), and physical status based on American Society of Anesthesiologists (ASA) classification (p<0.001, B=-0.458, OR=0.633) were significantly associated with postoperative cognitive function. BMI (p<0.001, B=-0.218, OR=1.244), absence of comorbidities (p<0.05, B=-0.312, OR=0.732), regional anesthesia (p<0.05, B=0.606, OR=1.883), and changes in cognitive function (p<0.05, B=0.288, OR=1.334) were significantly correlated with changes in postoperative QOL. Conclusion Age, BMI, and ASA physical status were significantly associated with postoperative cognitive function in geriatric patients, whereas BMI, comorbidities, regional anesthesia, and changes in postoperative cognitive function were associated with QOL. These preoperative factors can predict postoperative cognitive function and QOL and may be useful during preoperative planning.

Background: Changes in cognitive function are associated with increased depression and decreased quality of life (QOL). This study aimed to determine the relationship between the characteristics of geriatric patients and anesthetic management with changes in postoperative cognitive function and QOL of geriatric patients undergoing elective surgery. Methods: This prospective observational analytic multicenter study included patients aged ≥60 years who underwent elective surgery in hospitals in Indonesia. We used the whole sampling method and performed follow-up 30 days after surgery. Data were analyzed using bivariate chi-square and multivariate regression tests with a confidence interval of 95% and α=5%. Results: Among the 933 geriatric patients included in this study 55.0%, females most (59.8%) received general anesthesia. Factors including age (p<0.001, B=-0.374, odds ratio [OR]=0.688), body mass index (BMI) (p<0.05, B=0.129, OR=1.138), and physical status based on American Society of Anesthesiologists (ASA) classification (p<0.001, B=-0.458, OR=0.633) were significantly associated with postoperative cognitive function. BMI (p<0.001, B=-0.218, OR=1.244), absence of comorbidities (p<0.05, B=-0.312, OR=0.732), regional anesthesia (p<0.05, B=0.606, OR=1.883), and changes in cognitive function (p<0.05, B=0.288, OR=1.334) were significantly correlated with changes in postoperative QOL. Conclusion Age, BMI, and ASA physical status were significantly associated with postoperative cognitive function in geriatric patients, whereas BMI, comorbidities, regional anesthesia, and changes in postoperative cognitive function were associated with QOL. These preoperative factors can predict postoperative cognitive function and QOL and may be useful during preoperative planning.

Background: Changes in cognitive function are associated with increased depression and decreased quality of life (QOL). This study aimed to determine the relationship between the characteristics of geriatric patients and anesthetic management with changes in postoperative cognitive function and QOL of geriatric patients undergoing elective surgery. Methods: This prospective observational analytic multicenter study included patients aged ≥60 years who underwent elective surgery in hospitals in Indonesia. We used the whole sampling method and performed follow-up 30 days after surgery. Data were analyzed using bivariate chi-square and multivariate regression tests with a confidence interval of 95% and α=5%. Results: Among the 933 geriatric patients included in this study 55.0%, females most (59.8%) received general anesthesia. Factors including age (p<0.001, B=-0.374, odds ratio [OR]=0.688), body mass index (BMI) (p<0.05, B=0.129, OR=1.138), and physical status based on American Society of Anesthesiologists (ASA) classification (p<0.001, B=-0.458, OR=0.633) were significantly associated with postoperative cognitive function. BMI (p<0.001, B=-0.218, OR=1.244), absence of comorbidities (p<0.05, B=-0.312, OR=0.732), regional anesthesia (p<0.05, B=0.606, OR=1.883), and changes in cognitive function (p<0.05, B=0.288, OR=1.334) were significantly correlated with changes in postoperative QOL. Conclusion Age, BMI, and ASA physical status were significantly associated with postoperative cognitive function in geriatric patients, whereas BMI, comorbidities, regional anesthesia, and changes in postoperative cognitive function were associated with QOL. These preoperative factors can predict postoperative cognitive function and QOL and may be useful during preoperative planning.

The issue of food waste has garnered much attention globally due to its adverse impacts on the economy, food security, natural resources, the environment, and human health. Despite this, the academic literature lacks systematic, historical, and synthesising investigations on healthcare food waste. This bibliometrics analysis study aims to summarise the growing trends of food waste publications and highlight common and potential research topics of food waste in healthcare settings. The Scopus database analysed 193 journal articles published between 1952 and 2022. We identified several common and potential research topics for future research in the area, including food waste and malnutrition, related intervention strategies, the impact of healthcare food service systems on food waste, and their economic and environmental impact. Healthcare food waste research in developing nations is still limited. Thus, it is recommended that policymakers support its development as one of the steps to encounter food waste.

Introduction: This methodological research study aimed to measure content validity and reliability of a newly developed questionnaire of knowledge, attitudes, and self-reported practices towards pureed diet preparation (KAP DYS Puree) among hospital food handlers for dysphagia management. Methods: The study was conducted through face validation, content validation, content reliability and construct validation. A cross-sectional design with convenience sampling was carried out involving 4 panels for face validation, 10 raters for content validity and 161 food handlers participated for Exploratory Factor Analysis (EFA), while 30 food handlers were involved for test-retest reliability. The questionnaire which consisted of 40 items distributed into 3 domains and was assessed and analyzed using modified kappa (k*) for reliability. Results: Content Validity Index revealed the following I-CVI values: knowledge = 0.915, attitudes = 0.922 and self-reported practices = 0.900 and modified kappa values (k*) knowledge = 0.983, attitudes = 0.9214 and self-reported practices = 0.899. The EFA was employed for two dimensions which were self-reported practices and attitudes based on principal axis of factoring with varimax rotation. The factor analysis yielded two factors with a total of 10 items in the attitudes domain and two factors with a total of 9 items in the self-reported practices domain that had satisfactory factor loading (> 0.3). The Kaiser-Meyer-Olkin (KMO) values for attitudes = 0.816 and self-reported practices = 0.776. Bartlett’s test of sphericity was significant at p < 0.0001 for attitudes and self-reported practices indicating the suitability of this data for factor analysis. Interclass Correlation Index (ICC) values for attitudes = 0.739 and self-reported practices = 0.789. Conclusion: This instrument can be used as a need assessment tool in the development of a comprehensive training module for pureed diet preparations in dysphagia management.

COVID-19 is a highly contagious disease that caused a worldwide pandemic in 2020. Medical students are public advocates for COVID-19 vaccination to achieve herd immunity. Our objective is to ascertain the level of knowledge, attitude, and practice toward COVID-19 immunisation among medical students in Malaysia. The online study included four public universities in Peninsular Malaysia: Universiti Putra Malaysia, International Islamic University Malaysia, Universiti Sains Malaysia and Universiti Sains Islam Malaysia. Data collected include sociodemographic characteristics, history of COVID-19 infection, knowledge, attitude and practice towards COVID-19 immunisation. Analytical statistics were analysed with IBM Statistical Package Statistical Package for the Social Science (SPSS) v27.0 using Pearson chi-square or Fisher’s exact test (significant if p < 0.05). From the total of 427 respondents, 60.2% had good knowledge whereby clinical students 67.0% had a higher proportion of good knowledge as compared to preclinical students 53.5% (p = 0.004). Respondents in the age group of 21 to 24 years old (p < 0.001) and 25 to 29 years old (p = 0.016), and Indian ethnicity (p = 0.006) were more likely to have good knowledge. Respondents registered in Malaysia’s National COVID-19 vaccination program were considered as having a positive attitude (n = 264, 61.8%). A vaccination rate of 100% was observed. In conclusion, 60.2% of medical students had good knowledge, 61.8% had a positive attitude and 100% were vaccinated in these four public medical schools in Malaysia. Sociodemographic factors (age group and Indian ethnicity) have an association with only good knowledge but none with the level of attitude and practice towards COVID-19 immunisation.
COVID-19

Background/Aims: Substantial proportions of patients with constipation-predominant irritable bowel syndrome (IBS-C) linked their symptoms with particular intake of foods. However, there is lack of current data regarding the intake among IBS-C patients before any dietary interventions. Thus, this study aimed to evaluate the dietary adequacy among IBS-C against the standard recommended nutrient intake (RNI) and healthy controls. Methods: A retrospective case-control study was conducted involving IBS-C patients and healthy control subjects. A validated 126-food items frequency questionnaire was administered to all the subjects to assess their dietary intake, guided by dietitians. The calculated nutrients intake for IBS-C patients was then compared against the standard RNI and healthy controls. Results: A total of 306 subjects were recruited, among which 218 were diagnosed with IBS-C and 88 were included as healthy controls. IBS-C patients had significantly lower intake of wholegrain products, fried foods, dairy products, fruits, and vegetables compared to healthy controls. The daily intake of energy, certain macronutrients, and micronutrients among IBS-C patients was significantly lower than the healthy subjects. Less than 5% of IBS-C patients and healthy subjects achieved the standard recommendation for dietary fiber. Also, various vitamin intake (B1, B2, B6, folate, B12, E, K, and potassium) among IBS-C patients did not meet the standard RNI. Conclusions Dietary intakes of IBS-C patients did not meet the recommended intake for Malaysian and showed the nutritional inadequacies compared to the control subjects. Our study highlighted the importance of dietary evaluation prior to planning strategies for dietary intervention targeting IBS-C patients.

Introduction: Limited studies have been documented on the presence of pathogenic Leptospira in public markets serving the community in sub-districts of Selangor. The aim of this study was to detect the presence of pathogenic Leptospira in rats using a gene encoding an outer membrane lipoprotein LipL32. Methods: Polymerase chain reaction (PCR) was performed using LipL32 primers on sixty kidney samples of rats trapped at two locations of study; Pasar Borong Selangor in Seri Kembangan and Pasar Basah Bandar Baru Bangi in Bangi. Results: Out of 60 samples analysed, 36.7% were positive for the presence of LipL32. All positive samples highly matched (>94%) nucleotide sequence for LipL32 of pathogenic Leptospira and related to the pathogens through phylogenetic analysis. Conclusion: The detection of LipL32 indicates the potential presence of pathogenic Leptospira species at public markets. Although only 60 rats were successfully trapped, the rats are mobile and might further transmit the pathogenic organisms to other areas.

Knowledge of renal vasculature anomalies is important during the preparation of renal and abdominal surgeries. In this case report, we described a rare finding of bilateral aberrant renal arteries, located at the superior pole of both kidneys, in a cadaver of an elderly Asian man during an anatomy practical session. The aberrant arteries branch from the abdominal aorta, slightly above the level of the normal renal arteries. Additionally, an accessory left renal vein was found to originate from the superior pole of the left kidney which later drains into the left renal vein. No accessory right renal vein was observed. The left renal vein was usually located anterior to the aorta, and bilateral testicular veins were noted to drain into common destinations.

Diabetes mellitus (DM) is known to cause reproductive impairment. In men, it has been linked to altered sperm quality and testicular damage. Oxidative stress (OS) plays a pivotal role in the development of DM complications. Glutathione (GSH) is a part of a nonenzymatic antioxidant defense system that protects lipid, protein, and nucleic acids from oxidative damage. However, the protective effects of exogenous GSH on the male reproductive system have not been comprehensively examined. This study determined the impact of GSH supplementation in ameliorating the adverse effect of type 1 DM on sperm quality and the seminiferous tubules of diabetic C57BL/6NTac mice. GSH at the doses of 15 mg kg