Using the canine hookworm Ancylostoma caninum as model we aimed to investigate the anthelmintic activity of goat's milk in vitro by describing in detail the nature of damage taking place cross sectionally in the worm cuticle after exposure to goat's milk through careful observation by transmission electron microscope (TEM). Adult worms were obtained from routine culling of unwanted dogs from Selayang Municipal Council (MPS) animal detention center, Rawang, Malaysia. Fresh raw goat's milk was used. Worms were cut into 1mm3 slices, fixed in 4% glutaraldehyde, washed with 0.1sodium cacodylate buffer, post fixed in 1% osmium tetroxide, washed again in 1%sodium cacodylate buffer, dehydrated in acetone, embedded in resin, polymerized, ultrathin cross section cut and stained with uranyl acetate before being viewed under transmission electron microscope. Goat's milk resulted in worm cuticular damage in the form of irregularity and significant thinning similarly seen with cysteine proteinases mediated damage. Internal hypodermic changes were also observed in the form of mitochondrial degeneration which appeared as large vacuoles similarly seen in albendazole affected worms. Understanding anthelmintic mechanism through transmission electron micrography has provided critical information in developing novel therapies from natural products. It also provides basis for the consumption of goat's milk as functional food for parasitic worm control.

This study aimed to explore the socio-demographic characteristics, mental health status, and perceived causes of pandemic fatigue with COVID-19 pandemic fatigue among the general population of Malaysia. The data was collected online during the transition from the COVID-19 pandemic phase to the endemic phase in Malaysia from 1 to 30 April 2022. Sociodemographic data, Depression Anxiety Stress Scale-21 (DASS-21), perceived causes of pandemic fatigue, and the Fatigue Assessment Scale (FAS) were included in the survey. The chi-square test and a simplelogistic regression analysis were used to identify predictors of pandemic fatigue. The completed survey (N = 775) included individuals aged 18 years or above [mean 31.98 (SD = 12.16)] from all states in Malaysia. Pandemic fatigue prevalence was 54.2%. Severe to extremely severe depression, anxiety, and stress symptoms were detected in 11.2%, 14.9%, and 9.1% of the participants, respectively. Younger age, non-Malay ethnicity, living alone, and higher income categories were significantly higher in the fatigued group. Higher DASS-21 scores on all domains were associated with higher FAS scores. Meanwhile, high scores for perceived tiredness from complying with the COVID-19 Standard Operating Procedure (SOP), perceived risk of infection from COVID-19, perceived hardship due to the pandemic, perceived public complacency during the pandemic, and perceived changes due to the pandemic were associated with a higher FAS score. This study provides valuable information for policymakers and mental health professionals worldwide on pandemic fatigue and its associated factors, including mental health status in Malaysia.

Background. Impaired fasting glucose (IFG) poses a higher risk of diabetes. Honey has been reported to improve metabolic abnormalities including lowering hyperglycemia. This study is sought at determining the effect of Malaysian Kelulut honey (KH) on fasting glucose levels and metabolic parameters in IFG patients. Methods. This quasi-experimental intervention study of 30-day duration was conducted among 60 adult patients with IFG. They were allocated into taking 30g/day KH group (experimental group, n=30) and not taking KH group (control group, n=30). Body mass index (BMI), waist circumference, blood pressure (BP), fasting glucose, and lipid profile levels (total cholesterol, triglyceride, high-density lipoprotein, and low-density lipoprotein) were measured before and after treatment. Results. There was no significant difference in all measured variables at day 30 compared to day 1 within both groups. Similarly, all measured variables neither at day 1 nor at day 30 had shown a statistically significant difference between the groups. Conclusions. Daily intake of 30g KH for 30 days resulted in insignificant effect on fasting glucose, fasting lipid profiles, and other metabolic parameters in patients with IFG. Further studies that employ longer study duration are needed to ascertain the finding.

Background The Coronavirus disease 2019 (COVID-19) pandemic occurred due to the dispersion of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Severe symptoms can be observed in COVID-19 patients with lipid-related comorbidities such as obesity and diabetes. Yet, the extensive molecular mechanisms of how SARS-CoV-2 causes dysregulation of lipid metabolism remain unknown. Methods Here, an advanced search of articles was conducted using PubMed, Scopus, EBSCOhost, and Web of Science databases using terms from Medical Subject Heading (MeSH) like SARS-CoV-2, lipid metabolism and transcriptomic as the keywords. From 428 retrieved studies, only clinical studies using next-generation sequencing as a gene expression method in COVID-19 patients were accepted. Study design, study population, sample type, the method for gene expression and differentially expressed genes (DEGs) were extracted from the five included studies. The DEGs obtained from the studies were pooled and analyzed using the bioinformatics software package, DAVID, to determine the enriched pathways. The DEGs involved in lipid metabolic pathways were selected and further analyzed using STRING and Cytoscape through visualization by protein-protein interaction (PPI) network complex. Results The analysis identified nine remarkable clusters from the PPI complex, where cluster 1 showed the highest molecular interaction score. Three potential candidate genes (PPARG, IFITM3 and APOBEC3G) were pointed out from the integrated bioinformatics analysis in this systematic review and were chosen due to their significant role in regulating lipid metabolism. These candidate genes were significantly involved in enriched lipid metabolic pathways, mainly in regulating lipid homeostasis affecting the pathogenicity of SARS-CoV-2, specifically in mechanisms of viral entry and viral replication in COVID-19 patients. Conclusions Taken together, our findings in this systematic review highlight the affected lipid-metabolic pathways along with the affected genes upon SARS-CoV-2 invasion, which could be a potential target for new therapeutic strategies study in the future.

Evidence of gut microbiota involvement in regulating glucose metabolism and type 2 diabetes mellitus (T2DM) progression is accumulating. The understanding of microbial dysbiosis and specific alterations of gut microbiota composition that occur during the early stages of glucose intolerance, unperturbed by anti-diabetic medications, is especially essential. Hence, this systematic review was conducted to summarise the existing evidence related to microbiota composition and diversity in individuals with prediabetes (preDM) and individuals newly diagnosed with T2DM (newDM) in comparison to individuals with normal glucose tolerance (nonDM). A systematic search of the PubMed, MEDLINE and CINAHL databases were conducted from inception to February 2021 supplemented with manual searches of the list of references. The primary keywords of “type 2 diabetes”, “prediabetes”, “newly-diagnosed” and “gut microbiota” were used. Observational studies that conducted analysis of the gut microbiota of respondents with preDM and newDM were included. The quality of the studies was assessed using the modified Newcastle-Ottawa scale by independent reviewers. A total of 18 studies (5,489 participants) were included. Low gut microbial diversity was generally observed in preDM and newDM when compared to nonDM. Differences in gut microbiota composition between the disease groups and nonDM were inconsistent across the included studies. Four out of the 18 studies found increased abundance of phylum Firmicutes along with decreased abundance of Bacteroidetes in newDM. At the genus/species levels, decreased abundance of Faecalibacterium prausnitzii, Roseburia, Dialister, Flavonifractor, Alistipes, Haemophilus and Akkermansia muciniphila and increased abundance of Lactobacillus, Streptococcus, Escherichia, Veillonella and Collinsella were observed in the disease groups in at least two studies. Lactobacillus was also found to positively correlate with fasting plasma glucose (FPG), HbA1c and/or homeostatic assessment of insulin resistance (HOMA-IR) in four studies. This renders a need for further investigations on the species/strain-specific role of endogenously present Lactobacillus in glucose regulation mechanism and T2DM disease progression. Differences in dietary intake caused significant variation in specific bacterial abundances. More studies are needed to establish more consistent associations, between clinical biomarkers or dietary intake and specific gut bacterial composition in prediabetes and early T2DM.

This study aimed to determine prevalence and to identify factors associated with Low Back Pain (LBP) among medical students in a public university in Selangor, Malaysia. This is cross sectional study among undergraduate medical students in a public university in Selangor, Malaysia, conducted from May until June 2019 using a universal sampling via online questionnaire. The prevalence of ever having LBP since studying in medical school was 64.5% while the prevalence of having LBP is the past 12 months was 54.0%. Having current LB is associated with body mass index (p=0.031) and there was no significant difference between gender, pre vs clinical years, average sitting and standing hours, ways of carrying daily items and perceived stress scale. The prevalence of LBP among medical students in this medical school is high with obesity as a significant risk factor. Early personal and environmental intervention will be of benefit to the students.

Date palm (Phoenix dactylifera) fruit is an important food in the Middle East. Some date palm cultivars like the Ajwa is revered for its health-promoting properties. Phytochemicals like phenolic compounds are in part responsible for such health benefits. However, detailed information on these compounds is lacking. The present work aimed to investigate phytochemical components of Ajwa cultivar using UHPLC-ESI-QTOF-MS/MS in three different extraction solvents (aqueous, methanol–water, acetone–water) and three different extraction durations (2, 5 and 24 h). The proposed method provided tentative identification of 169 bioactive compounds out of which 44 (polyphenols and other phytochemical compounds) were successfully identified from three different extracts and three different extraction durations. Twenty-one compounds never previously reported in the Ajwa cultivar were identified. Aqueous-based extraction solvent and 24-h extraction duration yielded most phytochemical compounds.

Introduction: The novel coronavirus disease 2019 (COVID-19) continues to deteriorate economic and health system globally. Globally including Malaysia, the government strives relentlessly through public health measures to contain the transmission of COVID-19 and prevent a continuous exponential rise of cases. As a pandemic consequence, many families were affected which in need of humanitarian aid in getting access to appropriate nutritious foods. Children became more vulnerable and were at a greater risk of malnutrition because of the disruptions in food system and change in lifestyle habits. Objective: The aim of this article is to review the impact of COVID-19 pandemic on children’s nutrition and identify targeted measures primarily for vulnerable children to combat the nutrition crisis. Method: PubMed, Scopus, and ScienceDirect were searched from December 2019 to February 2021. The search terms include “impact” AND “COVID-19” AND “children” AND “nutrition”. A narrative review was written based on the articles found. Results: A total of 15 articles were found to be of relevant. Reviewed articles revealed that children’s nutrition was disproportionately affected by the pandemic due to food insecurity, affected financial resources, changes in dietary patterns and lack of access to healthcare facilities, increasing their vulnerability to childhood malnutrition. On-going initiatives include food basket and food bank programs, social protection programs and the deployment of community health workers to remote areas. Mass media played an important role as a continuous effort to help spread awareness on the importance of maintaining nutritious food intake during the pandemic. Conclusion: It is crucial to recognize the effects of the pandemic on children’s nutrition and the effectiveness of the current initiatives that has been done. This will aid public health authorities in restructuring future nutritional policies in anticipation of future pandemics.

Children daycare centres have nowadays become a necessity due to the guardians’ job constraint in this modern globalization era. Increasing demand of daycare centres showed ramiϑication on unintentional injuries at the childcare settings. The incidence is becoming more common and this may lead to a lawsuit for negligence. Failure to provide proper ϑirst aid response is one of the issues faced by the caregivers. To the best of our knowledge, this is the ϑirst study investigating the effects of ϑirst aid training and certiϑication on knowledge, attitude and conϑidence (KAC) among childcare providers in Negeri Sembilan, Malaysia. A self-administered questionnaire was given to 54 Negeri Sembilan childcare providers before and after they received a comprehensive module on the ϑirst aid training. The training comprised of three major components; basic life support, trauma injuries and non-trauma injuries. Throughout the training, participants were given a series of lectures, hands-on practicals and small group discussion on speciϑied topics from the module. Overall results showed a signiϑicant increase in knowledge, attitude and conϑidence (p<0.001) after the respondents’ had received the FAT4CP© training. The ϑirst aid training provided to the childcare providers was found effective and had successfully improved their knowledge by 12.5% and their conϑidence to perform ϑirst aid increased by 20.0%. They are now more prepared and efϑicient at handling any emergency situations at childcare centres. Our results suggested that FAT4CP© training programme was able to increase knowledge, attitude and conϑidence of childcare providers in Negeri Sembilan to handle emergency cases. Therefore, the programme is suggested to be implemented at all childcare centres in order to improve and sustain the providers’ abilities in handling emergency situations.

Introduction: Parasitic worm infection is a global affliction with significant disease burden. The disease however is endemic in the tropics where poverty stricken communities live in substandard living conditions. In Malaysia, the infection is largely limited to Orang Asli (aborigine) and rural communities across the country where prevalence may reach up to 90%. Objective: This study investigates the parasitic worm infection in an aboriginal primary school closely located to Cyberjaya, the modern IT capital of Malaysia. Materials and Methods: 42 pupils from Bukit Cheeding primary school participated in this study and were screened for hel- minth infection by faecal sample examination using Kato-Katz technique. Result: The overall prevalence of soil-transmitted helminth (STH) infection was 59.5%. Majority of pupils were infected with Trichuris trichiura and Ascaris lumbricoides and double infection with Trichuris and Ascaris constituted 16.6% prevalence. None of the pupils were infected with hookworm. The infection rate amongst the males (66.7%) seemed to be higher than the females (46.7%). The mean worm burden for Ascaris lumbricoides was 2495.6 ± 1709 while for Trichuris trichiura was 1093.1 ± 433. Conclusion: Despite the rising affluence in Malaysia's Klang Valley, minority communities such as the aborigine who live side by side to modernity are still plagued with soil-transmitted helminth infection. More efforts are needed to address this problem.

Mucus secretion by intestinal goblet cells constitutes an important mechanism in TH2 response following helminth infection mediated by the key cytokine IL-22. This indirect mechanism rather than directly attacking the parasite is important in preventing helminth attachment hence promoting helminth expulsion from the intestinal tract. We hypothesized that natural products having an anthelmintic activity like caprine milk may exert similar response. Using human intestinal LS174T cells treated with IL-22 to simulate helminth infection, we tested whether or not the co-treatment with caprine milk induces MUC1, MUC3, MUC4 and MUC5B genes expression. Optimal concentrations for caprine milk was determined to be 25% and 50% from cell viability assay. IL-22 induced helminth infection model was confirmed. However, the indirect anthelmintic effect of caprine milk was only relative as treatment of caprine milk in LS174T cells and IL-22 in vitro did not significantly induce MUC1, MUC3, MUC4 and MUC5B genes expression when compared to treatment with IL-22 alone. In conclusion, caprine milk was not significantly associated with the mechanism of increased mucus production through up regulation of mucin genes by intestinal cells. Caprine milk may possess direct anthelmintic effect rather than indirect.

Background/Aims: Date palm, Phoenix dactylifera, is mentioned 27 times in the Holy Quran and is considered a prophetic food. Islamic scripture together with Jewish and Christian holy texts refers to date palm fruit as having many beneficial effects on health including medicinal properties. This study aims to characterize scientific studies on date palm fruit relating to human health in published scientific literature. Methods: Five major scientific databases of published literature were searched for papers relating to the effects of date palm on human health. A scientometric analysis was then performed on the studies obtained. Results: Analysis of 270 relevant papers revealed a lack of human subject studies despite numerous papers reporting beneficial nutritional properties and promising results from animal studies. Saudi Arabia leads global research output on this topic. Conclusion: Further research should be supported to advance knowledge useful to local populations, especially in Islamic countries where the widely accessible date palm fruit can confer many potential health benefits.