bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of Anti-vitiligo properties through an In-silico Computational screening of Selected Herbal Bioactive Components with the target protein Tyrosinase
Authors: CBS Bharath Christian , S Ethel Shiny , J Jayalakshmi , S Vasanth Singh , P Nirmaladevi , Joseph Vaiz John Michael
Published: April 2024

Background: Vitiligo is one of the most hypopigmented disorders of the skin, it can be correlated with Swetha kuttam or ven kuttam or ven pulli mentioned in Siddha classical literature. Current therapeutic management available for vitiligo is only moderately effective in controlling further severity of symptoms. Hence in recent times, people rely most on alternative complementary treatments for the management of vitiligo. The research articles have shown the following bio-active compounds present in the selected herbs Kaempferol, Quercetin, Anacardic acid, Glabridin, Isovitexin, Aristolochic acid and Hydnocarpin which is already mentioned in the Siddha literature for the management of vitiligo(venkuttam). Objective:  This research article attempts to carry out the molecular docking analysis of the chosen herbal bioactive components against the target enzyme Tyrosinase in Vitiligo. Methods: Docking calculations were done for the obtained bio-active compounds including Kaempferol from Indigofera aspalathoides(Vahl.), Quercetin from Smilax china(Linn.), Tinosporide from Tinospora cordifolia(Willd.)Hook.f.&Thoms, Anacardic acid from Semecarpus anacardium (Linn.), Glabridin from Glycyrrhiza glabra(Linn.), Isovitexin from Psoralea corylifolia (Linn.), Oleic acid from Nigella sativa(Linn.), Aristolochic acid from Aristolochia bracteolata (Lam.) & Hydnocarpin from Hydnocarpus laurifolia (Dennst.) Sleumer against Tyrosinase(PDB)-1WX3, the intended protein. Results: Nine bioactive compounds have been screened in total, the following leads as Quercetin, Glabridin, Isovitexin and Hydnocarpin which interact with target to form four interactions with  70–100% binding effectiveness with the protein – Tyrosinase enzyme. Conclusion: The computational analysis led to the conclusion that the bioactive molecules present in the chosen herbals had significant binding efficacy and may exert promising anti-vitiligo properties.
A systematic review on exploration of therapeutic potential of Aparajita (Clitoria Ternatea Linn)
Authors: Paymalle Laxmikant , Wadnerwar Nilima
Published: April 2024

Aparajita (Clitoria ternatea Linn), is an herb widely distributed in the humid, lowland tropics of Africa, Asia, and Central America. Aparajita is known for its katu, tikta, kashaya rasa, and vishaghna (which alleviate toxins) properties. It is used in the treatment of various diseases and is a major ingredient in various anti-poisonous formulations. Pharmacologically, it has actions like insecticidal, cholinergic, antioxytocic, antihistaminic, analgesic, diuretic, purgative, laxative, and abortifacient. A systematic review is attempted based on preclinical studies to prepare a strong platform for the clinical utilisation of Aparajita as a main drug. The research papers reporting the study of Clitoria ternatea Linn in animals (In vivo and in vitro) were searched for systematic review. The literature search was performed using keywords like 'preclinical studies on Aparajita,' 'animal studies on Aparajita,' and 'pharmacological studies on Aparajita,' in combination with various effects in animals, in the following databases: PubMed/Medline, Scopus, Science Direct, Google Scholar, AYUSH Research Portal, and DHARA for studies published up to December 2021. Many preclinical studies reported that Clitoria ternatea Linn has diuretic, nootropic, anti-asthmatic, anti-inflammatory, analgesic, antipyretic, antidiabetic, antilipidemic, antioxidant, and wound healing properties. In the contemporary view, several pharmacological studies and preclinical studies prove the effectiveness of Clitoria ternatea Linn in various diseases. However, very few clinical studies of Clitoria ternatea Linn were done. Further clinical research should be conducted to establish the therapeutic potential of the drug Aparajita.
Investigating the Prevalence of Stress and its Relationship with Sleep Quality in University Students: A Study in Iran
Authors: Raiesifar Zeinab , Damsaz Hafshejani Nazanin , Nasirzadeh Dashtegol Ali , Daemi Mojdehi Parastoo , Asadiyan Negin , Moradi Shiva , Darabiyan Pouriya , Raiesifar Afsaneh
Published: April 2024

Introduction: Students are willing to cut back on sleep in order to adapt and cope with their stressful work load and environment. This study examines the prevalence of stress and its relationship with sleep quality. Methods: This cross-sectional study was conducted using available sampling of male and female students of the Nursing and Midwifery Faculty of Jundishapur University of Medical Sciences, Ahvaz in 2022. Pittsburgh Sleep Quality Questionnaire was used to measure sleep quality and Kessler Psychological Distress Scale Questionnaire was used to measure stress. Results: The prevalence of all levels of stress among students was 53.2% (140 people). 61 people (23.2%) experienced mild stress, 35 students (13.3%) experienced moderate stress, and 44 students (16.7%) experienced severe stress. The average score of Kessler's psychological distress (K10) of the participants was 21.9 ± 7.3 (maximum = 50). No significant relationship was observed between stress and gender (p=0.25) and academic year (p=0.72). There was a statistically significant relationship between sleep quality and stress (p < 0.001). Conclusion: This study reports the high prevalence of stress and poor sleep quality in students of Ahvaz College of Nursing and Midwifery. This study shows a strong connection between sleep quality and stress.
Investigating the Relationship Between Cultural Competence and Job Burnout in Nurses: A Study in Southwest Iran
Authors: Raiesifar Zeinab , Maryam Roze Ahvazi Maryam , Karimi Dastenaei Zahra , Khakbaz Amirhossein , Shamshiry Raziyeh , Ghorbani Mahdieh , Moradi Shiva , Darabiyan Pouriya , Raiesifar Afsaneh , Parsianmehr Mohammad Javad
Published: April 2024

Providing nursing care based on respecting cultural differences is very effective in the relationship between nurse and patient. Nurses who are unable to recognise and accept different cultures often experience burnout and anxiety and stress in the work environment. On the other hand, the importance of cultural competence and its relationship with job burnout in nurses as the most important group providing care to patients is becoming more clear. Therefore, we conducted a study to determine the relationship between cultural competence and job burnout in nurses working in selected hospitals affiliated to Jundishapour University of Medical Sciences in Ahvaz in 2021. Methods: This descriptive cross-sectional study was conducted on 232 nurses working in selected hospitals of Jundishapour University of Medical Sciences, Ahvaz. The samples were selected using convenient sampling method. Demographic questionnaire, Mulder's cultural competence questionnaire and Maslach's job burnout questionnaire were used to collect data. Data were analysed using Pearson's correlation coefficient test and SPSS 16 software. Results: Most of the participants were female (74.3%) and 27.7% were male. Also, 71.3% of them were married and 92.3% had a bachelor's degree. There is an inverse relationship between job burnout dimensions and cultural competence dimensions (knowledge in cultural care, preparation for cultural care, attitude in cultural care, awareness in cultural care), but it is not statistically significant (p>0.05). Emotional exhaustion has an inverse and significant correlation with cultural competence (p = 0.000), (r = -0.494). Conclusion: The results of this study showed that cultural competence is related to job burnout in nurses.
Evaluation and method development for quantification of Piperine in Hutabhugadi Churna by RP- HPLC
Authors: SV Suresh Kumar , Banu D Karishma , C Rajitha , B Kalyani , I Samel , Saief ES Mohammad
Published: April 2024

Aim and Objective: The current work was aimed at preparing the Hutabhugadi Churna in the laboratory and evaluating the same including the method development for the estimation of a marker compound Piperine by using RP-HPLC. Methods: Prepared Hutabhugadi churna was subjected for macroscopic, physical, and chemical evaluation considering WHO guidelines. The methanolic extract was subjected for estimation of Piperine as marker using RP-HPLC. Results: The macroscopic characteristics like colour, odour and taste are recorded. The physical characteristics like loss on drying, ash value, extractive value, swelling index, foaming index, powder properties like angle of repose, bulk density, tapped density, compressibility index etc. were determined. Total phenolic content, total flavonoid content, preliminary phytochemical screening was also carried out. The results are compared with marketed formulation of Hutabhugadi churna. The retention time of the standard Piperine was found to be 5.517, while the Piperine in extracts of laboratory and marketed formulations was found to be was found to be 5.554 and 5.562 respectively. The concentration of Piperine in laboratory and marketed formulation was found to be 0.17 %w/w and 0.18 % w/w respectively. The method developed was also validated. Conclusion: The laboratory made Hutabhugadi churna and marketed formulation of Hutabhugadi churna was comparatively evaluated. The resulting data will be useful for the standardization of the Hutabhugadi churna, an Ayurvedic formulation.
What determines banking company stock returns? Empirical evidence from Indonesia stock exchange
Authors: Indupurnahayu  , Shanti Lysandra  , Evin Sofianti  , Renea Shinta Aminda  , Abrista Devi
Published: April 2024

The purpose of this study was to investigate the determinants of stock returns of banking companies listed on the Indonesia Stock Exchange (IDX). The panel econometric approach was used to analyze panel data obtained from 31 banking companies listed in the 2018-2019 period. The research findings show that profitability has a significant effect on stock returns. Net Profit Margin has a positive effect on stock returns, while Return on Equity has a negative effect. Meanwhile, the size and leverage of the company have no significant effect on stock returns.
The Complexities of SDGs Goal 5 and 13 in ASEAN Region: A Comparative Study between Balinese and Cambodian Women Campaign on Climate Action
Authors: Paramitha Gracia , Denni Rajagukguk  , Revy Marlina
Published: April 2024

Women tend to be objects and victims of climate change impact. The International Union for Conservation of Nature (IUCN) 2020 found that gender-based violence was aligned with climate and environmental crises in various developing countries. In addition, 9.9 women were affected heavily by natural disasters in Indonesia (BPS, 2017). Meanwhile, only 20% of women's leadership constitutes the entire energy sector (WEF, 2022). Another important statement from the IPCC (2022) said that women (particularly pregnant women) became highly impacted by the climate crisis. The Assessment Report on the State of Gender Equality and Climate Change in ASEAN (2022) built evidence on the importance of recognising women’s roles in climate action in ASEAN countries. In light of this background, this paper will analyse the critical complexities of ASEAN women's leadership towards climate action in order to evaluating the implementation of SDGs goal 5 and 13. To have further deep analysis, this paper will explore the case study of Balinese and Cambodian women who have best practices of climate action, locally, nationally and globally, which also enhance ASEAN countries' commitment to SDGs. Some of the best practices in Cambodia include a Renewable Energy (RE) programme that actively engages with and promotes women-led energy enterprises by implementing “The Smoke-Free Village” approach and training women as champions for gender-transformative Disaster Risk Reduction (DRR). Meanwhile, in Bali, Balinese women play an important role in climate action by establishing the Bali Women Climate Entrepreneur Project which encourages 10 start-ups to join the program and many other best practices to be explored further. As a methodology, the best practices of women leadership in both countries will be collected through literature reviews, interviews, statistics from the Balinese and Cambodia government/SDGs centres, and other relevant documents’ review. From those sources, this paper is expected to be the guide to mapping women leadership in climate action and also become a guide on how to develop effective communication for women in the ASEAN region on climate change.
Integración de la docencia y el aprendizaje activo en la educación superior. Metodologías, componentes y actores
Authors: Bell Rodríguez Rafael Félix , Lema Cachinell Alejandro Nicolás , Martin Alvarez Yissel Marely
Published: April 2024

Resulta imprescindible transformar la concepción tradicional de los componentes de la didáctica con la finalidad de propiciar un aprendizaje activo, siendo este una metodología educativa que se centra en la participación activa y la implicación directa del estudiante en su propio proceso de aprendizaje. A diferencia de enfoques más pasivos, como la simple recepción de información, el aprendizaje activo fomenta la exploración, la resolución de problemas y la aplicación práctica de conocimientos. Esta metodología busca desarrollar habilidades cognitivas, habilidades sociales y la capacidad de pensamiento crítico. La finalidad de esta ponencia es analizar algunos de los principales aspectos teóricos y metodológicos del aprendizaje activo y sus consecuencias en el proceso de aprendizaje en la enseñanza superior. A lo largo de la revisión bibliográfica se evidencia la estrecha relación existente entre los aspectos teóricos y metodológicos del aprendizaje activo y los desafíos que implica su concreción en la actividad de docentes y estudiantes, siendo este un enfoque totalmente necesario en la educación superior.
A Prospective Cohort Study Investigating Adverse Perinatal Outcomes in Mosul, Iraq, among Women with Grand Multiparity
Authors: Mohammed Rusul Faris , Salih Mohammed Zinah
Published: April 2024

Introduction: This prospective case-control study aimed to compare the incidence of fetomaternal complications between grand multiparous women under the age of 35 and pregnant women with low parity in the same age group.
Methods: The study was conducted at Al-khansaa and Al-Batool Teaching Hospitals from October 1, 2020, to June 1, 2021. One hundred pregnant women with singleton pregnancies in all three trimesters, aged between 18 and 34 years, were selected from the outpatient clinic and the ward. The participants were divided into two groups: Group A consisted of 50 grand multiparous women (with five or more deliveries), and Group B comprised 50 pregnant women with low parity (2-4 pregnancies) in the same age group. Results: The study found that gestational diabetes, anemia, meconium-stained amniotic fluid, cesarean section rate, postpartum hemorrhage, and neonatal intensive care unit admissions were significantly higher in the grand multiparity group compared to the low parity group. The mean Apgar scores at 1 and 5 minutes were significantly lower in Group A compared to Group B. Conclusion: The findings suggest that grand multiparity among younger mothers poses additional risks to pregnancy outcomes, including increased rates of gestational diabetes, anemia, postpartum hemorrhage, cesarean section, and neonatal intensive care unit admissions, especially in cases with inadequate antenatal care. The findings of this study underscore the need for further research in this area. Understanding the underlying mechanisms and risk factors associated with grand multiparity among younger mothers can lead to more targeted interventions and improved outcomes.
Impact of Mobile Application Intervention: DETAK in Early Detection and Early Treatment of Acute Coronary Syndrome
Authors: Ana Anggraini Novita , Mohd Said Faridah , Umar Nur Syazana , Ambarika Rahmania , Fauziah Wardah , Putra Made Mahaguna , Sri Haryuni
Published: April 2024

Introduction: Acute Coronary Syndrome (ACS) is still a major cause of mortality and morbidity globally. One of the factors that cause a prehospital delay is the delay in early detection and inaccuracy of early treatment of ACS. The Internet of Things, which is supported by the high use of smartphones with the DETAK application, can be an opportunity to facilitate ACS education programs so that ACS can be detected early. Method: This study has used a quantitative research design with a quasi-experimental approach which pretest and posttest, in which both the experimental and control groups participate. The inclusion criteria of this study were age >45 years; obesity; smoker; Respondents with a history of: hypertension/diabetes mellitus/hyperlipidemia/hypercholesterolemia/CVD/families with cardiovascular disease. 252 respondents who met the inclusion criteria were randomly divided into control (n=126) and intervention groups (n=126). The intervention group was given education through the DETAK application and the control group was given leaflet about ACS. Results: The results of the study showed that there was an increased in early treatment ability was only found in the intervention group (p<.001). Mean differences of the ability of early detection (p<.001) and early treatment (p=.019)between intervention and control groups were both significance. Conclusion: There is potential for DETAK applications to improve the early detection and treatment capabilities of ACS.
Psychological Distress and Its Association with Functional Disability Index Among Acne Patients Attending Dermatology Clinics in the Kuantan Tertiary Hospitals
Authors: Samsudin Suhaiza , Zulkifli Zuliyasmin , Hassan Noor Artika , Ismail Rasimah , Ramalingam Rajalingam
Published: April 2024

Introduction: Acne is the most common skin disease among adolescents and has significant psychological distress. Our objective is to assess acne severity, functional disability, and its psychological distress among acne patients. Methods: A cross-sectional study was conducted from November 2021 to May 2022 among 163 acne patients attending Dermatology Clinics in the district of Kuantan, Pahang. The severity of acne was graded using the Comprehensive Acne Severity Scale (CASS). The functional disability index was measured using a Cardiff Acne Disability Index (CADI), while Depression, Anxiety and Stress Scale (DASS-21) questionnaires were used as a screening tool to detect the psychological distress of acne. Data were analysed using a Chi-square test, Fisher’s exact test and multiple logistic regression. Results: The mean age was 23 years, 60.1% were female, 94.5% were Malay, and 68.1% were unemployed. The severity of acne was more prominent in the mild (30.7%) and moderate (28.2%) categories. A total of 20.2%, 11.7%, and 4.9% of the respondents had anxiety, depression, and stress symptoms, respectively. Regarding the respondents’ functional disability, 40.5% had mild impairment, 38.0% had moderate impairment, and 13.5% had severe impairment. Acne severity was found to be significantly associated with the functional disability index (P<0.05). The functional disability index was also found to be significantly associated with depression (p=0.019) and anxiety symptoms (p=0.042). Conclusion: Clinical management of acne patients should include not only pharmacological treatment but also consideration of the disease’s functional disability status and psychological distress.
Two-Dimensional Geometric Morphometric Method on Frontal Sinus for Race Estimation: A Lateral Skull Radiograph Study
Authors: Zulkiflee Nur Damia Iwani , Chainchel Singh Mansharan Kaur , Alias Aspalilah , Hadi Helmi , Chung Eric , Choy Ker Woon
Published: April 2024

Introduction: Race estimation of unknown individual is essential in forensic investigation. The resiliency of frontal sinus makes it a potential tool for biological profiling, particularly in cases where fragmented skeleton persists. Geometric morphometrics is an efficient way to characterise shape. However, the use of frontal sinus to identify race of Malaysians is yet to be investigated. This research employed a two-dimensional (2D) geometric morphometric to examine the morphological differences of the frontal sinus among the major races in Malaysia. Methods: Lateral skull radiographs which comprising of 453 adult Malaysian (151 Malays, Chinese and Indian respectively) were used. The 2D landmarks of eight were placed on the digitalized radiographs and 2D geometric morphometric analysis was performed using MorphoJ software. Results: Procrustes ANOVA revealed a significantly different frontal sinus shape (p-value < 0.05) between races. Canonical variate analysis showed significantly different frontal sinus morphology (p-value < 0.05) between Malay and Indian as well as Chinese and Indian. Discriminant function analysis with cross-validation demonstrated a 57.4% accuracy rate. Conclusion: This population-specific study based on frontal sinus of Malaysians using the 2D geometric morphometric, though less reliable, sheds new light on the potential applicability of this method for race estimation purpose.
Unraveling the Sugar Rush: A Cross-sectional Study of Knowledge, Attitudes, and Practices Related to Sugar- Sweetened Beverages Consumption among Malaysian Young Adults
Authors: Abu Bakar Siti Nur Athirah Aisyah , Ali Asma’ , Abdul Rahman Abdul Rais , Mhd Jalil Abbe Maleyki , Zakaria Noor Salihah
Published: April 2024

Introduction: The consumption of sugar-sweetened beverages (SSBs) among young adults in Malaysia has witnessed a notable increase in recent years, giving rise to concerns regarding the potential adverse health effects, including obesity and diabetes. Despite the urgent need for targeted interventions, there is a dearth of research examining the knowledge, attitudes, and practices (KAP) related to SSBs among Malaysian young adults. To address this research gap, the present study aims to assess the level of KAP concerning SSB intake and its associated factors in this specific population. Methods: A cross-sectional study was conducted involving 408 Malaysian young adults aged between 15 and 29 years. Respondents completed an online questionnaire survey, which encompassed the assessment of socio-demographic characteristics and KAP regarding SSB consumption. The collected data were analyzed using IBM’s Statistical Package for the Social Sciences (SPSS) version 22.0. Spearman correlation tests were performed at a significance level of 0.05. Results: The majority of respondents demonstrated moderate knowledge (60%) and practices (60%), while exhibiting a high positive attitude (100%) towards reducing SSB consumption. Significant correlations were observed between knowledge and attitude (p = 0.003, rs = 0.148) and between knowledge and practice (p = 0.005, rs = 0.138). Moreover, the attitude scores were found to be significantly associated with gender (χ2 (1, N = 408) = 10.421, p = 0.001) and locality (χ2 (1, N = 408) = 4.106, p = 0.043), while the practice scores exhibited a significant association with ethnicity (p = 0.006). Conclusion: This study provides valuable insights into the relationship between KAP related to SSB consumption and socio-demographic factors among Malaysian young adults. The findings underscore the importance of utilizing these insights to develop strategic interventions that aim to curtail SSB consumption and promote a healthy lifestyle, ultimately contributing to the reduction of non-communicable diseases. Health authorities are encouraged to capitalize on these findings to design targeted interventions tailored to the unique needs and circumstances of this population.
Effects of Residential Proximity to Industrial Zone on Respiratory Symptoms among Residents in Parit Raja, Batu Pahat
Authors: Mohd Isa Khairul Nizam , Md Som Nur Afza Natasha , Jalaludin Juliana , Hashim Nor Haslina
Published: April 2024

Introduction: The industrial park in the district of Parit Raja, Batu Pahat resulted in rapid growth of the town during the last 20 years and has been a reason of concern that this park also has contributed greatly to the problem of air pollution. The aim of this study was to evaluate the association between industrial air pollution and respiratory symptoms in adults living in the Parit Raja. Methods: A comparative cross-sectional study was undertaken among residents in the district of Parit Raja, Batu Pahat, Johor, Malaysia. A total of 110 residents aged between 19 and 65 years were randomly selected and information on personal characteristics and respiratory symptoms was obtained through a validated questionnaire. The prevalence of respiratory symptoms was compared between residents recruited from the areas situated about 5km radius of the industrial park (exposed) and >5km radius from the industrial park (comparative). Results: A total of 34.5% and 25.5% of adults from the exposed group reported experiencing coughing for the last 3 months and chest tightness for the last 3 years. The logistic regression models showed that symptoms of coughing was associated with the exposed group (aOR=6.34, 95% CI=2.08-19.35), male respondents (aOR=3.18, 95% CI=1.10-9.16) and who stay in Part Raja for more than 14 years (aOR=3.16, 95% CI=1.14-8.79). Conclusion: This study demonstrated that long-term air pollution exposures are consistently associated with respiratory symptoms in residents living in the proximity of industrial parks. Therefore, public health initiatives that aim to provide more conducive environment are needed, especially for residents living near industrial parks.
Ramadan Fasting: Effect on Anxiety Using The DASS-42 Scoring System
Authors: Ridho Sayid , Futihandayani Annisa
Published: April 2024

Introduction: Ramadan fasting affects dietary propensity and mental health. As part of their courses, medical students encounter stressors such as examinations, college assignments, and others that can impact their mental health and contribute to conditions such as anxiety. Limited research has been conducted to date on the impact of Ramadan fasting on anxiety scores among college students. This study aimed to explore the impact of Ramadan fasting on anxiety using DASS-42 scoring system. Methods: A prospective cohort analytic study was conducted with a cross-sectional approach and a one-group pretest-posttest design. A total of 242 medical students were sampled and selected by consecutive sampling. The DASS-42 questionnaire was used to evaluate the respondents’ anxiety scores. Results: We found 99 respondents were experiencing anxiety while 143 were normal. The findings revealed that the anxiety scores fell during the pre- to post-Ramadan period for all respondents (p = 0.003), the respondents who had anxiety (p = 0,000), and the normal respondents (p = 0.001). Conclusion: The current study reports that Ramadan fasting was proven to reduce the anxiety scores of all students including those who experienced anxiety and normal subjects.
Prevalence of Work Ability and its Associated Factors among Secondary School Teachers in Selangor, Malaysia
Authors: Zamri Eva Nabiha , Wan Mahiyuddin Wan Rozita
Published: April 2024

Introduction: Work ability is the relationship between a person’s personality, health, lifestyle, and employment-related factors. There are, however, few studies evaluating the variables linked to school teachers’ work ability. The purpose of this study was to assess school teachers’ work ability and the factors that affect it. Methods: A cross-sectional study of secondary school teachers was carried out. Sociodemographic characteristics, physical activity, body mass index, low back pain (LBP), psychological factors, work-related factors, health-related quality of life (HRQoL), and work ability were all collected through the questionnaire. The association between potential factors and job ability was investigated using ordinal logistic regression. Results were presented using odds ratios (OR) and 95 % confidence intervals (CI). Results: Of 1280, there were 1037 (81.0%) teachers who returned the questionnaire. The majority (71.9%) of the participants had moderate work ability, while 22.6% had good, and 5.5% had poor work ability. None of them were particularly had excellent work ability. The factors associated with increased work ability in the multivariable analysis were better HRQoL, namely physical (OR 1.11, 95%CI: 1.07, 1.15) and mental (OR 1.12, 95%CI: 1.06, 1.16) health and wellbeing. Conclusion: Positive associations exist between a teacher’s work ability and their physical and emotional well-being. Henceforth suggesting that these factors should be incorporated in workplace health promotion programs to maintain teachers’ work ability.
Readiness and Challenges in Cardiopulmonary Resuscitation Teaching: A Preliminary Perspective Amongst Malaysian Secondary School Principles
Authors: Haiqal Muhammad Hazim , Abdul Aziz Muhamad Nur Fariduddin , Ching Sin Siau
Published: April 2024

Introduction: Malaysia has not legalized CPR teaching in the national curriculum, leaving it to school principals to implement the teaching of CPR who may have limited knowledge. This study aims to investigate Malaysian secondary school principals’ level of readiness, defined as knowledge, attitude, willingness to teach CPR, and barriers to implementation. Methods: Malaysian secondary school principals were invited to complete a survey that consisted of five parts: (1) demographics, (2) CPR knowledge, (3) attitude towards CPR, (4) willingness to teach CPR, and (5) barriers to implementing CPR teaching. Results: A total of 54 secondary school principals responded to the survey. Three (5.6%) principals passed the CPR test. More than 80% agreed CPR course is important for students, mandatory to be taken before graduation and best taught by certified teachers. Principals are willing to qualify themselves and teachers with CPR certification and to provide funding to support and hire an outsider to teach CPR courses. Funding, teachers’ readiness for skills and knowledge proficiency, and curriculum burden are perceived as potential barriers to successful CPR teaching. One-way MANOVA analysis showed that gender (p = .257), age (p = .108), qualifications (p = .321), teaching experience (p = .194), and administrative experience (p = .193) did not have a significant effect on the combined dependent variables. Conclusion: Malaysian secondary school principals are aware of the importance of CPR and were willing to acquire the knowledge, skills, funds, equipment, and support in ensuring its implementation in the national curriculum.
Leptospirosis Knowledge, Attitude, and Practice of Town Service Workers in Kuching, Malaysia
Authors: Chung Thung Senk , Ismail Shaiful Bahari , Draman Nani , Mat Yudin Zainab
Published: April 2024

Introduction: This study aimed to evaluate town service personnel’s knowledge, attitudes, and practices (KAP) regarding leptospirosis prevention and the influencing factors to its practice. Methods: A cross-sectional study was conducted in Kuching, Malaysia, involving town service workers using a self-administered validated questionnaire comprising sociodemographic and KAP information. The eligibility criteria included 18 years old and above and having worked for more than six months. The KAP was determined using descriptive analysis, and associations were identified using logistic regression analysis. Results: About 189 town service workers responded, giving a response rate of 87.5%, and a majority of them were Bumiputera Sarawak, with a mean age of 38.6 (±11.00) years old. The mean duration of employment was 9.3 (±6.99) years. About 88.9% had good knowledge of leptospirosis. Meanwhile, 85.2% and 79.9% had satisfactory attitudes and good practices. The knowledge on the aetiology of leptospirosis ranged from 25% to 94%. No significant association was found between the knowledge score and income with the practice score. The attitude score (AOR 1.161; 95% CI = 1.090, 1.238; p = 0.000) and working experience (AOR 1.174; 95% CI = 1.023, 1.346; p = 0.022) were found to be significantly associated with their practice score. Conclusion: Most town service workers have good knowledge and practice regarding leptospirosis prevention. Workers with good attitudes demonstrate good practising habits toward leptospirosis prevention. Awareness and activities related to disease prevention should be encouraged to ensure the continuity of a positive attitude.
Barriers and Drivers of Physical Activity Participation Among Older Adults in Malaysia: A Systematic Review
Authors: Minhat Halimatus Sakdiah , Wan Ghazali Wan Syahirah , Mud Shukri Muhammad Ikhwan , Mohd Noor Norhafizah , Baharudin Mohd Hafiidz , Yuanyuan Zhao , Raja Adnan Raja Nurzatul Efah
Published: April 2024

Introduction: Ageing is commonly linked with physical inactivity. This review was performed to identify the factors associated with participation in physical activity among older adults in Malaysia. Methods: A systematic review was conducted using five databases; Pubmed, Sagepub, Scopus, Cochrane Library and Science Direct. Observational and intervention studies published between January 2010 and December 2020 were included, with Malaysian older adults aged 55 years and older being the main subject. Results: A total of 9 articles were included in the review. Analysis was guided by the Social Ecological Model for Health Promotion. The review had successfully identified gender, age, education level, health reasons, ethnicity and attitude as intrapersonal factors, social support (friend) and marital status as interpersonal factors, and locality as well as availability of facilities as environmental factors. Conclusions: Physical activity participation among Malaysian older adults were mainly determined by intrapersonal factors, particularly gender, health condition and educational level.
Effectiveness of Multimedia Approaches in Embryology Teaching: A Scoping Review
Authors: Hadie Siti Nurma Hanim , Dasiman Razif , Omar Noorkardiffa Syawalina , Abas Razif
Published: April 2024

Embryology is a critical subdiscipline in medical education, focusing on human body organ development and providing a foundation for understanding developmental anatomy. However, traditional teaching methods using static 2D graphics in textbooks may hinder students’ comprehension of the complex 3D embryonic growth processes. To address this, multimedia approaches, such as animations, videos, and interactive tools, have been explored for effective embryology education. This scoping review identifies five key elements of successful multimedia teaching in embryology: multimodal integrated instructional content, cognitive load-reduction strategies, cognitive engagement and physical interactivity, learner-controlled multimedia instruction, and development of tacit knowledge. These strategies promote active learning, enhance students’ understanding, and foster critical thinking skills. Future research should focus on evaluating the impact of multimedia approaches on students’ engagement, attitudes, and competency development. Embracing multimedia in embryology education can improve medical students’ clinical understanding and support effective medical practice.
Chronic Pain and Erectile Dysfunction: Mechanism, Treatment, and Future Perspective
Authors: Widyadharma I Putu Eka , Tedyanto Eric Hartono , Adnyana I Made Oka , Sri Wijayanti Ida Ayu
Published: April 2024

Erectile dysfunction is a problem with multiple causes and is challenging to diagnose. Chronic pain has been associated with erectile dysfunction in some studies. Chronic pain can be a potential direct or indirect cause of sexual dysfunction. A decreased sexual desire due to restricted sexual activity in chronic pain can result in erectile dysfunction. Erectile dysfunction has been linked to migraines, chronic pain, and psychological factors. Multiple neurotransmitters may contribute to the pathophysiology of erectile dysfunction. Depression and anxiety, as well as painkillers like pregabalin and opioids, can be indirect causes of erectile dysfunction. Numerous factors affect the occurrence of erectile dysfunction; therefore, erectile dysfunction must be treated holistically.
Catastrophic Health Expenditure Among Cancer Patients In National Cancer Institute (NCI), Malaysia And Its Influencing Factors
Authors: Wan Puteh Sharifa Ezat , Abdullah Yang Rashidi , Aizuddin Azimatun Noor
Published: April 2024

Introduction: This study looks at the patient’s perspective to determine the Catastrophic Health Expenditure (CHE) level and the possible factors which can be associated with CHE in cancer patients. Methods: This cross sectional study was done in National Cancer Institute, Malaysia with 206 patients sampled using the multilevel sampling method and data collected from interview with patients using a validated questionnaire. The CHE definition used in this study is when the monthly health expenditure exceeds more than 10% of the monthly household income. Results: This study showed a CHE level of 26.2%. CHE was higher in Indian ethnicity (P = 0.017), single marital status (P = 0.019), poverty income (P < 0.001), small household size (P = 0.006) and without Guarantee Letter (GL) (P = 0.002) groups. The significant predicting factors were poverty income aOR 5.60 (95% CI: 2.34 – 13.39), home distance near to hospital aOR 4.12 (95% CI: 1.74 – 9.76), small household size aOR 4.59 (95% CI: 1.07 – 19.72) and lack of Guarantee Letter aOR 3.21 (95% CI: 1.24 – 8.30). Conclusion: The information from this paper can be used by policy makers to formulate better strategies in terms of health financing so that high risk for CHE cancer patients groups can be protected under a better health financing system.
Trauma Team Activation in the Emergency Department: A Literature Review of Criteria, Processes and Outcomes
Authors: Siti Nurlaelah  , Kamal Achmad Fauzi , Dewi Irawati  , Mansyur Muchtaruddin , Bardosono Saptawati
Published: April 2024

Multiple traumas require a fast and comprehensive treatment to overcome challenges that emerge from the patient’s condition. The right time for trauma team activation is necessary to treat these multiple trauma patients to improve patient outcomes. This integrative review identifies the criteria used to activate the trauma team, the activation process and the outcome of the activation. The search was conducted from January to March 2023 with two databases, namely MEDLINE and PubMed, and grey literature via Google Scholar. The search was limited to articles written in English, with abstracts and available in full text. There was no year limitation. The review found four criteria that were used for trauma team activation: physiological, anatomical, mechanism of injury and others. The process of trauma team activation begins in the pre-hospital setting. Outcomes used to evaluate the impact of trauma team activation included the level of satisfaction of patients and families, the level of complaints, response time, discharge status, and mortality. The findings of this review recommend that the criteria, process, and outcomes of trauma team activation are tailored, based on the needs and available resources of the institutions. Moreover, standardized trauma team activation may be necessary for future development.
Diabetic Cardiac Autonomic Neuropathy: A Review of NLRP3 Inflammasome Complicity
Authors: Subramaniam Shamala Devi , Mhd Zain Nor Aini Lubis , Choy Ker Woon , Omar Noorkardiffa Syawalina , Abas Razif
Published: April 2024

Debilitating and often misdiagnosed cardiac autonomic neuropathy affects people with diabetes. Damage to the biggest sympathetic trunk ganglion of autonomic nerve fibers that innervate the heart and blood vessels, the superior cervical ganglion (SCG), is the cause of aberrant heart rate and vascular dynamics in people with diabetic cardiac autonomic neuropathy (DCAN). Mediating host immunological responses to microbial infection and cellular damage, inflammasomes are a class of cytosolic protein complexes that include NLRP3. This review compiled the findings of experimental investigations on DCAN and discussed their connection to the NLRP3 inflammasome’s involvement. SCG P2X7 receptor expression can be boosted by inflammation brought on by hyperglycemia,
leading to nerve injury. Unfortunately, there is a lack of research on DCAN-related inflammation in animal models, especially in inflammasome. Currently, only IncRNAUC.360+ shRNA and Schisandrin B, prove to alleviate the pathogenesis. Therefore, more research into the causes and potential remedies for DCAN is necessary.
Pregnancy-related Guillain-Barré syndrome: A Case Series
Authors: Mirawati Diah Kurnia , Subandi Subandi , Hamidi Baarid Luqman , Nugraha Dody Wahyu Lestya , Asaduddin Aiman Hilmi , Syahrizal Maulana Firdaus , Erdana Putra Stefanus , Muhammad Hafizhan
Published: April 2024

Introduction: Pregnancy-related Guillain-Barré syndrome (GBS) is a rare autoimmune disorder that affects pregnant women. With an annual incidence ranging from 0.81 to 1.89 cases per 100,000 population, GBS can occur at any trimester of pregnancy, as well as during the postpartum period are susceptible to GBS. The pillars of managing pregnancy-related GBS to improve outcomes include early diagnosis, prompt immune-modulatory therapy, and multidisciplinary input. Case Series: In this study, three case of GBS in pregnancy were reported. The first patient was a 35-year-old woman, G3A1P2 post emergency Transperitoneal Cesarean Section (TPCS), who experienced with lower limb weakness three days before TPCS. After being diagnosed with severe eclampsia and underwent emergency TPCS, her complaint of lower limb weakness worsened. The second patient, a 27-year-old woman, with G2P1A0 experienced weakness in all four limbs. The third patient, a 20-year-old woman with G1P0A0, in the third semester presented with weakness in all four limbs. The electroneurography investigation conducted on these patients supported the diagnosis of GBS, which was subsequently managed with plasma exchange (PE). After the administration of PE, there was observed improvement in the clinical manifestation of GBS. Conclusion: The development of GBS in pregnancy is typically preceded by bacterial or viral infection. Preeclampsia was found to be associated with two folds risk of GBS, which was usually diagnosed based on the neurological examinations with supportive studies, including serological tests, cerebrospinal fluid analysis and electroneurography. The management of pregnancy-related GBS included intravenous immunoglobulin, PE, physiotherapy, and supportive therapy, such as ventilator support.
Ulnar Nerve Reconstruction With a Basilic Vein Tributary Graft: A Practical and Easily Replicable Technique With Favourable Outcomes
Authors: Collin Looi Seng Kim , Md Yusoff Zuhri , Arumugam Manohar , Liew Siew Khei , Mohamed Saaid Firdati
Published: April 2024

A young gentleman presented with a closed fracture of the left radius and an open fracture of the left ulna complicated with segmental loss of the ulnar nerve measuring 1.5cm. After thorough debridement and stabilization of the bone injuries, the ulnar nerve gap was bridged with an autologous venous graft harvested off a tributary of the basilic vein that served as a nerve conduit. At 18 months post-surgery, sensori-motor function of the patient’s left ulnar nerve was nearly fully restored, indicative of successful reconstitution of the ulnar nerve using a basilic vein tributary vein graft.
Multiple SNPs Downregulate Gene Expression of Matrix Metallopeptidase 2 in MCF7 Breast Cancer Cells
Authors: Ahmad Suhaimi Shafinah , Chan Soon Choy , Chong Pei Pei , Chau De Ming , Saad Norazalina , Rosli Rozita
Published: April 2024

Introduction: On a global scale, breast cancer contributes the highest cancer-related deaths in women due to metastasis which renders the treatments ineffective and non-targeted. The members of Matrix Metallopeptidases, particularly Matrix Metallopeptidase 2 (MMP2), are among the key players in breast cancer metastasis. In most cases, MMP2 was markedly upregulated and linked to poor prognosis. In a previous study, in silico analyses revealed that several coding single nucleotide polymorphisms (SNPs) of MMP2 were shown to reduce gene expression and mRNA stability of MMP2 in Malaysian breast cancer patients. Therefore, to validate the in silico predictions, the objective of this study was to determine the effects of multiple coding SNPs of MMP2 on the gene expression and mRNA stability of MMP2 in breast cancer cells. Methods: In the current study, breast adenocarcinoma MCF7 cells were transfected with MMP2 wild type and variant containing the coding SNPs. After confirmation of transfection by DNA sequencing, the gene expression level of MMP2 was evaluated by quantitative reverse transcription polymerase chain reaction (RT-qPCR) whereas mRNA stability of MMP2 was determined following treatment with actinomycin D. Results: MMP2 wild type and variant were successfully transfected in MCF7 cells based on sequencing and PCR analysis. It was found that the presence of coding SNPs lowered the gene expression level of MMP2, but not the stability of MMP2 mRNA. Conclusion: This study supports the in silico effects of MMP2 coding SNPs on its gene expression in an in vitro model.
Phaehyphomycosis or Eumycetoma: A Case Report of a Diagnostic Dilemma
Authors: Md Salim Siti Norfairuz , Wan Ismail Wan Faisham , Amiruddin Fatihatul Munirah , Hussain Faezahtul Arbaeyah , Abdullah Rosmaniza , Abdul Rahman Zaidah
Published: April 2024

We reported a case of recurrent subcutaneous swelling on the left foot of a diabetic patient. Two different organisms, Cladosporium spp. and Phaeoacremonium krajdenii were isolated, both of which are associated with phaeohyphomycosis and eumycetoma. The cure was achieved through surgical excision of the lesion and a course of antifungal therapy. The diagnosis was uncertain since clinical manifestations and laboratory results were insufficient to distinguish the two diseases.
A Rare Presentation of a Common Disorder : Severe Hyponatremia Presenting as Reversible Unstable Bradyarrythmias
Authors: Md Pauzi Ahmad Luqman , Mohamad Amin Norhayati , Sazali Adi Putera , Hashim Juliana , Abdullah Muhammad Afif , Ismail Iskasymar , Wan Zukiman Wan Zulhaikal
Published: April 2024

Severe hyponatraemia is defined as a sodium level of less than 120 mEq/L, and it is frequently accompanied by neurological symptoms like coma, convulsions, respiratory arrest, and death. Clinical cardiac toxicity from hyponatremia, such as bradyarrhythmia, is extremely rare. In this article, we present a case of acute severe hyponatraemia that induced unstable bradyarrhythmia and led to refractory bradycardia, which did not improve despite receiving treatment in accordance with the standard Advanced Cardiovascular Life Support protocol. The patient’s bradyarrhythmia has completely resolved with the administration of 3% hypertonic saline, which restored her sodium levels. Due to the possibility that severe hyponatremia may contribute to the aetiology of cardiac malfunction, this case raises awareness about the significance of closely monitoring electrocardiograms and telemetry in patients with severe hyponatremia.
A Rare Case of Intrapleural Teratoma – Mimicking as Empyema Thoracis
Authors: Koa Ai Jiun , Teh Yong Sim
Published: April 2024

Teratoma is a type of germ cell tumor that derived from all the three embryonic layers which are endoderm, mesoderm and ectoderm. The commonest site of extragonadal germ cell tumor is at the mediastinum, which accounts for 50-70% of all mediastinal tumor. Intrapleural teratoma is exteremely rare, with only one previously reported case to date. Teratoma is usually a slow growing tumor, and symptoms typically presented late as a result of compression or obstruction to the surrounding structures. Due to its rare occurrence, intrapleural teratoma can pose a diagnostic challenge for clinicians. Familiarity with the presentation and imaging findings is therefore of great values which can guide the diagnosis and later the specific management plans. This case report highlights the rare case of intrapleural teratoma and summarizes the presentations and imaging findings of intrapleural teratoma which was initially misdiagnosed as empyema thoracis. Several learning points from this case were outlined.