[Breast Milk Nutrient Composition, Immunology and COVID-19] Komposisi Nutrien Susu Ibu, Imunologi dan COVID-19

Breast milk is the best food that a mother can give to a newborn baby up to the first six months of age. The purpose of this writing is to provide information on the nutrient content found in breast milk, the antibodies involved in helping reduce the infection of COVID-19 and how to breastfeed. The composition of breast milk will change according to the nutrient needs of the baby at every moment. The enzyme content in breast milk will help digestion and the nutrient content can prevent the baby from getting infections that cannot be replaced by formula milk. Antibodies or immunoglobulins are proteins produced by cells in the body's immune system to fight allergens, bacteria, and viruses that cause disease. The body has different types of antibodies such as IgA, IgG, IgM, and IgE. Newborns have immunoglobulins from the placenta. This immunoglobulin will quickly decrease immediately after the baby is born, while the newborn baby's body is not yet able to form the immunoglobulin. This condition will decrease when the baby gets breast milk. This is because breast milk contains a high level of secretory immunoglobulin A antibodies (sIgA) that will protect babies from various bacterial, viral, parasitic and fungal infections. Antibodies help the body's immune system recognize and destroy pathogens such as COVID-19. All mothers who recover from COVID-19 have antibodies to COVID-19 in their milk. These antibodies are very good at fighting diseases that attack the lining of the lungs such as COVID-19. Women with COVID-19 can breastfeed and the virus cannot be detected in breast milk. Safe breastfeeding involves following good respiratory hygiene, skin-to-skin contact for newborns, sharing a room with their baby, washing hands before and after touching the baby, and keeping all surfaces clean. Susu ibu merupakan makanan terbaik yang dapat diberikan ibu kepada bayi yang baru lahir sehingga usia enam bulan pertama. Tujuan penulisan ini memberikan informasi mengenai kandungan nutrien yang terdapat dalam susu ibu, antibodi yang terlibat membantu menurunkan jangkitan COVID-19 dan cara penyusuannya. Komposisi susu ibu akan berubah sesuai dengan keperluan nutrien bayi pada setiap saat. Kandungan enzim dalam susu ibu akan membantu pencernaan dan kandungan nutrien pula mampu mencegah bayi mendapat infeksi yang sememangnya tidak boleh diganti oleh susu formula. Antibodi atau immunoglobulin adalah protein yang dihasilkan oleh sel dalam sistem imuniti tubuh untuk melawan alergen, bakteria, serta virus penyebab penyakit. Tubuh memiliki pelbagai jenis antibodi seperti IgA, IgG, IgM, dan IgE. Bayi yang baru dilahirkan mempunyai immunoglobulin daripada plasenta. Immunoglobulin ini akan cepat menurun segera setelah bayi dilahirkan, sedangkan tubuh bayi yang baru lahir belum mampu membentuk immunoglobulin tersebut. Keadaan ini akan berkurangan apabila bayi mendapatkan susu ibu. Hal ini kerana susu ibu mengandungi kadar antibodi immunoglobulin A rembesan (sIgA) yang tinggi yang akan melindungi bayi daripada pelbagai penyakit infeksi bakteria, virus, parasit dan kulat. Antibodi membantu sistem imuniti tubuh mengenali dan menghancurkan patogen seperti COVID-19. Semua ibu yang pulih daripada COVID-19 memiliki antibodi untuk COVID-19 dalam susu mereka. Antibodi ini sangat baik dalam melawan penyakit yang menyerang lapisan paru-paru seperti COVID-19. Wanita yang menghidap COVID-19 boleh menyusukan bayi dan virus ini tidak dapat dikesan pada susu ibu. Penyusuan yang selamat harus mengikuti kebersihan pernafasan dengan baik, melakukan kontak kulit ke kulit untuk bayi yang baru lahir, berkongsi bilik dengan bayi mereka, mencuci tangan sebelum dan selepas menyentuh bayi, dan menjaga semua permukaan agar bersih

Educational needs among stroke patients admitted to Hospital Universiti Sains Malaysia: preliminary findings

Kajian ini dijalankan untuk menentukan jenis keperluan pendidikan di kalangan pesakit strok di Hospital Universiti Sains Malaysia. Pesakit strok (n = 41) dipilih menggunakan persampelan mudah dari Wad Perubatan dan Pembedahan antara September hingga Disember 2012. Data diperolehi menggunakan borang kaji selidik separa berpandu dan laporan perubatan. Pesakit diberi masa yang mencukupi untuk melengkapkan sejarah gaya hidup dan keperluan pendidikan berkaitan strok dengan bantuan penyelidik. Instrumen tentang keperluan pendidikan terdiri daripada lima tema termasuk maklumat umum mengenai strok, pengurusan faktor risiko, rawatan strok, rehabilitasi dan masalah pasca strok serta pengurusan pemakanan pasca strok. Hasil kajian menunjukkan majoriti pesakit strok adalah perempuan (58.5%), berusia antara 56 hingga 65 tahun (39.0%) dan menghidap strok iskemia (68.3%). Pesakit mempunyai sejarah tekanan darah tinggi (85.4%), kencing manis (46.3%), hiperlipidemia (29.3%), penyakit jantung iskemia (22.0%) dan fi brilasi atrium (2.4%). Sebelas daripada mereka (26.9%) adalah bekas perokok dan ramai mengamalkan gaya hidup kurang sihat seperti kurang bersenam (80.5%) dan gemar makanan bergoreng (68.3%). Kebanyakan pesakit diperskripsi pelbagai ubatan (92.7%) untuk merawat penyakit mereka. Secara umum, keperluan pendidikan yang paling ingin diketahui oleh pesakit strok adalah tentang pencegahan (92.7%), pengurusan bantuan kecemasan (85.4%), komplikasi (85.4%) dan kejadian strok berulang (85.4%). Keperluan pendidikan lain yang ingin diketahui ialah kemungkinan sembuh melalui ubatan (92.7%), senaman sendi (82.9%), pengambilan ikan (78.0%), pengambilan buah-buahan dan sayur-sayuran selepas strok (78.0%). Hasil kajian ini memberikan maklumat asas jenis keperluan pendidikan dalam kalangan pesakit strok. Intervensi pendidikan pesakit perlu dilaksanakan secara rutin untuk pencegahan awal dan pencegahan strok berulang di hospital dan komunit

Comparison of knowledge, attitude and practice on stroke knowledge in Malaysia and other nations: A review of literature

Background: There is an increasing trend of stroke occurrence among Malaysian populations recently. Thus, there is a need for further early management and secondary prevention of stroke. Objectives: To provide an overview on knowledge, attitude and practice (KAP) had been carried out among stroke patients and general population. Data sources: Published survey studies on KAP had been carried out among stroke patients general population in Malaysia and globally. Review methods: Searches were conducted in two data-bases (ProQuest, EBSCOhost). Reviews were included, if these were based on a survey study that measures KAP between 2005 and 2015. The authors had focused the survey study design, population and sampling method highlighting the tools and interview strategy used in order to obtain the information on KAP. The scope of interest were perceptions towards stroke, knowledge on risk factors, signs and symptoms of stroke and its association with socio-demography background of the participants. Results: A total of 22 articles were reviewed included, but none of them from Malaysia studies. However, only 14 were reviewed systematically on the basis of its completeness for quantitative synthesis. In this article, we had reviewed the existing literatures on the scope mentioned earlier and compared it with those of developed countries. Findings highlighted the level of stroke knowledge on risk factors as well as signs and symptoms were range from moderate to poor. This knowledge level was found to be associated with age, gender, education level and income status. Conclusion: Study on KAP is crucial in order to increase the awareness about stroke disease on the risk factors management, administration of appropriate treatment as well as further secondary prevention. This findings may be adopted in Malaysia to improve awareness and knowledge specifically for the stroke patients and their family members and among the public generally

Bioactive compounds in Cucumis melo L. and its beneficial health effects: a scoping review

Cucumis melo L. possesses numerous medicinal and nutritive functions due to the rich sources of biological active compounds. However, Cucumis melo L. processing generate by-products that threaten the environment. This study aims to explore the bioactive compounds present in different melon parts and the fruit’s beneficial health effects. A methodological framework proposed by Arksey and O’Malley was used to conduct the scoping review. An electronic database search for English academic articles was conducted using PubMed, Scopus and ScienceDirect encompassing years between 1999 and 2019. All types of studies, excluding systematic review or review papers were eligible for inclusion. Out of 602 studies identified, a total of 18 studies were included. Both peels and seeds were rich in phenolic compounds. The seed oil contained rich sources of tocopherols, while β-carotene and vitamin C were found in the flesh. Next, the main beneficial health effects included antioxidant, anti-inflammatory, anti-ulcer, anti-angiogenic, anti-diabetic, anti-bacterial and anti-hypothyroidism activities, which were attributable to the presence of bioactive compounds. In summary, Cucumis melo L., particularly its seeds and peels exhibited various health benefits. This was an indicative of the potential of incorporating these by-products into various food and nutraceutical applications to create novel functional food or dietary supplements

Bone Resorption Marker Status of Pre and Postmenopausal Malay Women in Kelantan and Its Corresponding Risk Factors (Status Petanda Resorpsi Tulang dalam Kalangan Wanita Melayu Pra dan Pascamenopaus di Kelantan dan Faktor Risiko yang Sepadan)

Menopause is the most prevalent cause of accelerated bone loss in women. Biochemical markers of bone resorption can be used clinically to predict future bone loss. This study aimed to determine the level of bone resorption markers in healthy pre and postmenopausal Malay women and determine their association with the risk. A total of 150 healthy women were recruited for this study (51 pre and 99 postmenopausal subjects). Data on socioeconomic, lifestyle habit and clinical were gained by personal interview. Fasting serum was collected to measure both C-telopeptide (CTx) and N-telopeptide (NTx) of type 1 collagen. Both markers were highly correlated with each other (r=0.568, p<0.001). Both intra- and inter-assay coefficient of variations (CV) of NTx were higher than those of CTx (8% and 12% vs 6% and 5%). The mean CTx values of pre and postmenopausal subjects were comparable with the expected values (0.2833 (0.1769) ng/mL and 0.4323 (1.851) ng/mL compared with 0.287 and 0.438 ng/mL, respectively). The NTx value for premenopausal subjects were higher than the expected values (15.2 (8.10) compared to 12.6 (3.20) nM BCE). The median was 19.929 nM BCE. The mean CTx and NTx levels of postmenopausal subjects were significantly lower than premenopausal subjects (p<0.05). The risk factors for bone resorption in this population were duration of menopause, marital status, body mass index (BMI), physical activity and education level. In conclusion, postmenopausal women showed a higher bone resorption, indicating higher bone loss. Increasing education and physical activity intervention might be effective to ensure better health in Malaysian older population. Menopaus adalah faktor utama yang mempercepatkan kadar hakisan tulang dalam kalangan wanita. Petanda biokimia bagi hakisan tulang boleh digunakan secara klinikal untuk meramal kehilangan jisim tulang. Objektif kajian ini adalah untuk mengenal pasti aras resorpsi tulang wanita pra dan pascamenopaus serta mengenal pasti faktor risiko resorpsi tulang dalam golongan ini. Seramai 150 subjek terlibat dalam kajian ini (51 pra dan 99 pascamenopaus). Data sosioekonomi, gaya hidup dan data klinikal diperoleh melalui temu bual secara individu. Serum subjek ketika berpuasa digunakan untuk menentukan petanda resorpsi tulang N- dan C- ‘terminal telopeptides of type 1 collagen’ (NTx dan CTx). Kedua-dua petanda resorpsi tulang ini mempunyai perkaitan yang tinggi (r=0.568, p<0.001). Kedua-dua ‘intra’ dan ‘inter-assay’ pekali ubah (CV) untuk NTx adalah lebih tinggi berbanding CTx (8% dan 12% vs 6% dan 5%). Nilai min CTx wanita pra- dan pascamenopaus dalam kajian ini sebanding dengan nilai jangkaan (0.2833 (0.1769) ng/mL dan 0.4323 (1.851) ng/mL berbanding 0.287 dan 0.438 ng/mL). Nilai NTx bagi wanita pramenopaus adalah lebih tinggi berbanding nilai jangkaan (15.2 (8.10) berbanding 12.6 (3.20) nM BCE). Nilai median adalah 19.929 nM BCE. Nilai min CTx dan NTx bagi subjek pascamenopaus adalah lebih tinggi berbanding subjek pramenopaus (p<0.05). Faktor risiko resorpsi tulang bagi populasi ini adalah tempoh pascamenopaus, status perkahwinan, indeks jisim badan (BMI), aktiviti fizikal dan tahap pendidikan (p<0.05). Kesimpulannya, wanita pascamenopaus mempunyai aras petanda resorpsi tulang yang menggambarkan kadar kehilangan tulang yang lebih tinggi. Meningkatkan tahap pendidikan dan intervensi aktiviti fizikal mungkin merupakan langkah yang berkesan bagi memastikan kesihatan tulang yang lebih baik dalam kalangan populasi warga tua di Malaysia

Re-evaluation of malnutrition risk screening tool-hospital (MRST-H) for geriatric patients: a multicentre study in Peninsular Malaysia

A local Malnutrition Risk Screening Tool-Hospital (MRST-H) has been developed to identify the risk of malnutrition among hospitalized geriatric patients in Malaysia. The aims of this multicenter study were to evaluate the criterion validity of the MRST-H against the reference standard Subjective Global Assessment (SGA) and revise its scoring criteria among Malaysian geriatric patients. A cross-sectional study was conducted among 542 geriatric patients at eight general hospitals in Peninsular Malaysia from January 2011 to February 2013. The Malay version MRST-H and SGA were administered to all participants through face-to-face interviews. Sensitivity and specificity of MRST-H were established using the Receiver Operating Characteristic (ROC) curves and the optimal cut-off scores were determined. The MRST-H had area under the ROC curve (AUC) values of 0.84 and 0.88 when validated against the SGA-determined malnutrition (SGA B+C) and severe malnutrition (SGA C) status. These high AUC values indicated that the MRST-H has very good overall diagnostic accuracy. However, the original cut-off score of five points for MRST-H has undesirable sensitivity in identifying the malnutrition (sensitivity = 0.12) and severely malnutrition (sensitivity = 0.35) status. The optimal cut-off score of MRST-H in identifying malnourished and severely malnourished participants were both established at the cut-off score of two points. The sensitivity of MRST-H increased substantially at this point without compromising its specificity. Therefore, the established cut-off score of two points with optimal sensitivity and specificity was selected to replace to original cut-off score for screening of risk of malnutrition among hospitalized geriatric patients

The Determinants of Stunting for Children Aged 24-59 Months in Kulon Progo District 2019

This study pertains to stunting in children in Indonesian with z-scores of less than -2 Standard Deviation (SD) and less than -3 SD. The preliminary study results showed the highest prevalence of stunting to be 22.6%, at the Temon II Primary Health Care in Kulon Progo District. The study aimed to assess the determinants of stunting children aged 24–59 months. This study was conducted from September 2018–May 2019. The design of this study was analytical observational with study design case-control. The sample was 60 children aged 24–59 months. The method utilized proportional sampling, whereas the data analysis applied chi-square and logistic regression.The analysis of statistical tests showed a significant correlation between the stunting children and energy intake factor (p-value = 0.030; α = 0.05; CI = 95%). Risk factors were energy intake, protein intake, suffering from acute respiratory tract infections, and suffering diarrhea. A non-risk factor was immunization status. Protective factors were access to clean water and the history of exclusive breastfeeding. The most influential factor for stunting children aged 24–59 months was energy intake

Prevalence and Risk Factors Associated with Malnutrition among Children with Learning Disabilities: A Scoping Review

Introduction: By the end of 2015, about 72,152 children with learning disabilities were registered under the Malaysian Welfare Service Department (JKM). Malnutrition has been found to be a common setback among children with learning disability (LD). This study presents available evidence on the prevalence and risk factors associated with malnutrition in children with LD. Methods: A framework suggested by Arksey & O`Male (2005) was used to carry out this scoping review. Published articles, reviews and reports were identified through a complete search. Inclusion criteria for the search were English articles related to LD, published from 2005 to 2016. Results: Seventeen international studies published from 2005 until 2015 with a total of 318,596 participants and one study involving 281 participants from Malaysia, were identified and included in this review (n=18). The target age range of the sample in these 18 studies was 2 - 20 years, with a mean age of 3.2 - 14.2 years. The prevalence of underweight among children with LD was 3.4 - 36%, overweight 7.6 - 37% and obesity 5.7 - 52%. Several studies reveal that malnutrition risk among children with LD is significantly associated with gender, age, genetic syndrome, type of disability, medication used, and country economic status. Conclusion: A number of studies show that children with LD have a higher prevalence of being overweight and obese than typically developing children and the risk associated with obesity significantly increases with age

Development of food composition database of Kelantanese foods

This study was conducted to determine nutrient composition, based on foods, which are widely available and popular among the people of Kelantan. This study will be very important in establishing reliable data on the nutrient composition of foods consumed by the community. Hundred types of foods that are served in Kelantan had been chosen in this study. Food samples for analysis were purchased from three different places of production. Macronutrients such as calorie, carbohydrate, moisture, protein, fat and ash were analyzed using the standard methods of AOAC (1995). The results showed that the foods analyzed generally high in carbohydrate. Although these foods are high in carbohydrates, Kelantanese still able to consume them by controlling the amount of food intake. These results will be used in the estimation of nutrient intake in relation to study of diet and health relationship for Kelantan population

Pengurusan pemakanan selepas strok (Dietary management after stroke)

Strok terjadi akibat gangguan bekalan darah yang dibawa oleh salur darah arteri ke otak. Ia terjadi akibat penyumbatan gumpalan darah serta plak kolesterol dalam salur darah arteri. Strok juga berlaku apabila salur darah arteri pecah. Strok juga dikenali sebagai serangan otak atau ''brain attack'. Kajian menunjukkan 80% serangan strok kali kedua boleh dicegah dengan mengubahsuai diet seharian dan mengawal tekanan di samping intervensi perubatan. Oleh itu, pemantauan faktor risiko yang boleh diubahsuai seperti aspek pemakanan tidak boleh dipandang remeh. Walaupun kita perlu makan setiap hari, namun begitu keperluan pemakanan individu di pelbagai kehidupan adalah berbeza. Pengambilan pemakanan seseorang bergantung kepada umur, jantina, status kesihatan seperti suhu dan tahap fizikal. Buku ini akan memberi fokus tentang PEMAKANAN SELEPAS STROK. Antara topik yang akan dibincangkan ialah konsep asas tentang pemakanan, kaedah mengubahsuai pengambilan pemakanan bagi pesakit strok dengan faktor risiko tertentu, diet disfagia bagi pesakit strok dengan masalah menelan dan kaedah pemberian nutrisi melalui tiub pemakanan. Untuk maklumat lanjut, anda perlu merujuk kepada doktor, pegawai pemakanan (Dietetik) dan jururawat di hospital serta klinik kesihatan berdekatan anda