Homeless management during movement control order due to COVID-19 pandemic : experience from Federal Territory Kuala Lumpur, Malaysia

Malaysia has been hit by COVID-19 pandemic since 2020 and this problem also affects countries around the world. This COVID-19 infection does not distinguish age, gender, educational and financial status. Homeless people are also not exempt from being infected with COVID-19, especially when the government implements the Movement Control Order, particularly these people who have no permanent home. This article describes the activities carried out by the government agencies, especially from the Ministry of Health Malaysia, Department of Social Welfare, National Anti-Drugs Agency, Immigration Department of Malaysia, as well as other non-governmental agencies in the Federal Territory of Kuala Lumpur on homeless people during movement control orders. It is hoped that this shared experience can be a guide to government agencies, non-governmental organizations, private sectors and individuals in other states to manage this underprivileged group, especially during the ongoing COVID-19 pandemic

The fate of a Military Pilot in Malaysia: Lingering on the ground after young stroke

Strokes in young pilots can result in the devastating loss of productive years of life, especially for pilots at the peak of their careers. A 32-yr-old male military helicopter pilot was diagnosed with superior sagittal sinus thrombosis and bilateral parietal hemorrhages secondary to protein S deficiency after 15 years in military service. Two years post-stroke, he was carefully evaluated for a possible return to work after aeromedical assessment and the 1 percent rule being considered. A decision was made by the medical board for him to be disqualified to fly and grounded with work accommodation. The authors recommend that there is a need for reassessment up to two years using the objective PULHEEMS method for young pilots who failed aeromedical assessment due to stroke for returning to work as their experiences and knowledge is highly valuable

The benefits and challenges of paper handheld maternal record in Southeast Asia: a systematic review

Home-based maternal records were first designed for better monitoring during pregnancy, delivery, and the postpartum period. There are various studies that reported on the benefits of paper handheld record for mothers in across regions. However, majority of the studies on paper handheld record or home-based record were mainly addressing the benefit and very scare on the challenges faced by the users. This study aims to evaluate the benefits and challenges of the maternal paper handheld to users particularly to mothers and healthcare providers in Southeast Asia (SEA) region. Articles were searched from Scopus, Web of Science, and PubMed using relevant keywords based on the review topic. Based on PRISMA guidelines, the search results were then screened based on inclusion criteria: published between 2012 and 2021in English language, available in full text, open access, and conducted in Southeast Asia. Six articles were included in the final analysis, which were also appraised for their quality. There are six articles included in this review. Majority of the studies highlighted the benefits of paper handheld records to mothers. Upon further analysis, there are three major themes emerged from the outcome namely mother’s knowledge, maternal health service utilization and breastfeeding practice. Only one study reported on the challenges faced by mothers and care provider while utilising the paper handheld record. The paper handheld maternal record implementation in SEA exhibited great positive impact to the mothers in terms of knowledge, maternal health service utilization and breastfeeding practice. Nonetheless, it is quite difficult to find studies that addressed the challenges faced by the users in SEA region. It would be best to understand the challenges faced regionally or even locally to make improvement of the maternal health service as it needs to be comprehensive and suited with the local context

Predictors of Intershift Fatigue Recovery Among Doctors

Introduction: Doctors are exposed to various psychosocial hazards such as high task demands and demanding work schedule which may influence fatigue, recovery, stress, job satisfaction, wellbeing, and work-family interface. This research generally aims to examine the interrelationship between work-home domain variables with outcomes of fatigue, its recovery, and others related outcomes such as work-to-family conflict, general wellbeing, and perceived stress level among doctors working at public hospital at general and day-level on-call duty. Methods: This is a multicenter analytical mix cross sectional (general) and longitudinal (day-level) research among proposed 390 randomly-sampled on-call doctors working at seven core clinical disciplines from seven public tertiary hospitals in Malaysia. Data will be collected three times: (a) any days after obtaining informed consent (cross sectional), (b) at the end of on-call duty (first wave longitudinal), and (c) at the beginning of subsequent work period (second wave longitudinal). Data will be modelled by covariance-based structural equation modelling (SEM). Conclusion: This research is well justifiable in view of limited available research on complex interrelationship of work domain, home domain and work-home boundary control with fatigue, recovery and other psychological health consequences (e.g. stress, wellbeing, work-home conflict) among doctors, particularly in Asia and developed countries, including Malaysia. This research is expected to provide strong evidence to policy makers in developing prevention and management policy related to fatigue, recovery and other psychological health consequences among doctors. Keywords: doctor, fatigue, recovery, on-call, intershift, wellbeing, stress

Psychometric evaluation of the Malay version of the Impact of Weight on Quality of Life-Lite (IWQOL-LITE) questionnaire

Introduction The availability of obesity specific quality of life measurement tool is limited. The Malay version of Impact of Weight on Quality of Life-Lite is an obesity specific quality of life questionnaire which has been translated for use in Malaysia. The aim of this study is to evaluate the validity and reliability of this questionnaire to measure quality of life among different body mass index (BMI) groups. Methods One hundred and twenty subjects with different BMI categories who attended an outpatient government clinic were recruited for this study. The translated Malay version of IWQOL-Lite was used to assess the impact of weight on quality of life of respondents. Content validity, criterion validity and construct validity were used to assess the questionnaire validity while internal consistencies and test-retest reliability were used to assess the questionnaire reliability. Results The Malay version of IWQOL-Lite showed good psychometric properties. The content validity was agreed upon by expert panels. The mean score of all IWQOL-Lite domains were able to discriminate between different BMI groups. Good internal consistency was demonstrated by Cronbach alpha of 0.936. Test-retest reliability ranged from 0.828 to 0.932. The physical function score (IWQOL-Lite) correlated positively with Physical Component Summary of Short Form-36 questionnaire. Exploratory factor analysis found that the questions loaded on their respective five domains. Conclusions The results suggested that the Malay version of IWQOL-Lite is a valid and reliable tool to measure quality of life among obese and overweight subjects in Malaysia

Plain packaging and pictorial warning in Asia countries : where are we?

Worldwide, around 8 million people die yearly due to tobacco usage. Cigarette smoking is the most popular form of tobacco usage. Smoking has linked to many detrimental health effects among adults and adolescents. Recognising the burden of smoking, World Health Organization have implemented various tobacco control strategies under the Framework Convention of Tobacco Control and mPOWER. This includes implementation of plain packaging and pictorial warning. In Asia, only Thailand, Singapore, Turkey, Saudi Arabia, and Israel have implemented plain cigarette pack. However, some countries have made progress to implement plain cigarette pack. Although some countries have not implemented plain pack, implementation of larger pictorial warning serve as a pathway for implementation of plain packaging. Countries with pictorial warning on cigarette pack should ensure it covers at least 50% of pack. Timor Leste has the largest pictorial warning on cigarette pack in the world. In conclusion, only 5 countries in Asia have implemented plain pack and some countries in this region are yet to implement size of pictorial warning according to requirement of World Health Organization. All countries should target to implement standardized pack to denormalise tobacco usage

Subclinical hypothyroidism among patients with depressive disorders

Subclinical hypothyroidism (SHT) is a biochemical diagnosis, defined as an elevated Thyroid Stimulating Hormone (TSH) with normal free thyroxine (FT4). It affects 4-10% of the adult population and is more prevalent in elderly women. Its commonest cause is autoimmune thyroiditis, detected by anti-thyroid peroxidase antibody (TPO-Ab). About 2-5% of SHT patients progress to overt hypothyroidism annually. The SHT prevalence among depressed patients ranges between 3% and 17%. This study aimed to determine the prevalence of SHT and TPO-Ab positivity among patients diagnosed with depressive disorders. It was a cross-sectional study carried out in the Universiti Kebangsaan Malaysia Medical Centre over a 12 months period. Serum TSH, FT4 and TPO-Ab were measured. Results showed that 82% of depressed patients were euthyroid, 4% had SHT, 11% had subclinical hyperthyroidism and 2% had discordant thyroid function. TPO-Ab positivity among the subjects was 7%, one of whom had SHT. In conclusion, the prevalence of SHT and TPO-Ab positivity in the study population, at 4% and 7%, respectively, were comparable to previous findings

Nutritional Burden in Tuberculosis and Inter-sectoral Nutritional Management for Tuberculosis Patients in Malaysia

Undernutrition and tuberculosis (TB) are a vital issue in most developing countries of the world. Both of these medical problems tend to have interacted with each other and bidirectional. The undernutrition creates a more significant problem in patients with active TB rather than among healthy individuals. Despite that, there is no protocol available on nutritional support in Malaysia to tackle on this issue. The objective of this review is to explore the nutrition burden of TB disease and the management available in Malaysia. The treatment for TB lasts for six months and above. Hence, it causes a financial burden not only for the healthcare provider but for the patient and the family members. If treatment is not successful and extends to a few months, it will increase the cost of the treatment. Malnutrition in TB patients will cause a problem in the outcome of TB treatment. It includes worsening of the disease, delayed sputum conversion, and increased risk of mortality. Other problems include malabsorption of Rifampicin, drug-induced hepatotoxicity, increased rate of relapse, and persistent of positive cultures in MDR-TB. Benefits of nutritional support for tuberculosis patients include improved body weight, increase in adherence/compliance to the tuberculosis treatment and increase in the success of the treatment. Implementation of nutritional support protocol by the government and Non-profit organization (NGO) will be beneficial and improve the quality of life of tuberculosis patients

Effectiveness of sugar sweetened beverages tax on health and healthcare costs: a systematic review

Taxing sugar-sweetened beverages (SSB) is one of many other best strategies to reduce consumption of SSB among populations. It is known that SSB consumption is the main contributor which cause obesity and further lead to non-communicable diseases. This study aimed to gather the evidence on the effectiveness of sugar-sweetened beverages tax implementation, in terms of health outcome and healthcare cost benefit. A systematic review was done related to literature that reported about effectiveness of sugar-sweetened beverages tax implementation, in terms of health outcome and healthcare cost benefit. Four databases were used to identify the literature, namely PubMed, Cochrane, Scopus and Ovid and Medline. PRISMA flow checklist was used as a guide to search for the eligible articles. In total, there were sixteen eligible articles included in this systematic review. All studies are simulation studies. Results showed that both excise and ad valorem tax are effective to reduce healthcare costs and could avert diseases related to high sugar intake. Other than that, it is proven that implementing tax will gain favorable health outcome rather than do nothing. Better results seen when the tax is increased. As a conclusion, SSB tax is proven as an effective public health intervention in terms of giving benefit to the health outcome and healthcare cost

Ethnic differences in the prevalence, clinical outcome and cag Pathogenicity Island (cagPAI) virulence gene profiles of Helicobacter pylori strains from Malaysia

Different Helicobacter pylori genes may be well conserved within different ethnic groups and could give rise to different clinical outcomes. In this study, we demonstrated a low prevalence of H. pylori infection (19.2%) which is in concordance with the current trend demostrated locally and abroad. The Indians had the highest prevalence of H. pylori infection among other ethnic groups (Malays= 8.6 %, Chinese= 24.3 %, Indians= 33.9%). cagM and cagT were the most predominant genes found (63.4% for each), followed by cagA (62.2 %), cagE (48.2%), cag6-7 (46.3%), cag10 (42.1%), cag13 (4.9%) and IS605 (3.7%). No significant association was found between H. pylori infection and H. pylori genes with ethnic groups or clinical outcomes. Indians who had a combination of cagA/ E/M genes of H. pylori were likely to be associated with 21-time of having non-ulcer dyspepsia (NUD) than peptic ulcer disease (PUD). Therefore, these genes may serve as useful markers in predicting the clinical presentation of a H. pylori infection among Indians in our studied population. Hence, this preliminary data might explain why Indians have a low prevalence of gastric cancer and peptic ulcer disease despite having persistently high prevalence of H. pylori infection for many decades (“Indian enigma�) in Malaysian patients