Purpose: To compare access to medicines in children living in poor households (income of USD1/person/day) between urbanised Klang Valley and rural East Coast of Peninsular Malaysia. Methods: A semi-structured interview was conducted with caregivers to determine demographics, access to medicines, knowledge, attitude and practice of parents in obtaining medicines for children. Results: There was no significant difference socio-demographically between poor households in Klang Valley (N = 58) and East Coast (N = 40). The study found that access to medicine for children (N = 325) in the households was adequate, where all households that reported illness in the children over the last 1 month and the last 6 month periods, obtained medicines and 99 % of the children were fully immunized. Qualitative analysis showed that poor households face several barriers in accessing medicines for their children such as financial, transportation, physical and attitudinal. Conclusion: Access to medicines for children living in poor households in both areas were similar and adequate. However, barriers to access remain and further studies are required.

Ageing is associated with increased oxidative stress accompanied by cognitive decline. The aim of this study was to evaluate oxidative stress biomarkers and their possible relationship with cognitive performances during ageing among the Malay population. Approximately 160 healthy Malay adults aged between 28 and 79 years were recruited around Selangor and Klang Valley. Cognitive function was assessed by Montreal Cognitive Assessment (MoCA), forward digit span (FDS), backward digit span (BDS), digit symbol, Rey Auditory Verbal Learning Test immediate recalled [RAVLT(I)] and delayed recalled [RAVLT(D)], and visual reproduction immediate recalled (VR-I) and delayed recalled (VR-II). DNA damage, plasma protein carbonyl and malondialdehyde (MDA) levels were also determined. Cognitive function test showed significant lower scores of MoCA, BDS, RAVLT(I), RAVLT(D), digit symbol, VR-I, and VR-II in the older age group (60 years old) compared with the 30-, 40-, and 50-year-old group. The extent of DNA damage was sequential with age: 60 > 50 > 40 > 30, whereas protein carbonyl was higher in 40-, 50-, and 60-year-old groups compared with the youngest group (30 years old). However, the MDA level was observed unchanged in all age groups. Approximately 21.88% of the participants had cognitive impairment. Multiple logistic regression analysis revealed that DNA damage and protein carbonyl levels are predictors for cognitive impairment in healthy Malays. In conclusion, cognitive decline occurred in healthy adult Malay population at an early age of 30 years old with corresponding higher DNA damage and protein oxidation.

Disturbance in brain oscillations is observed in many neuropsychiatric disorders. Any tool that has the potential to restore abnormal brain oscillations is therefore beneficial to patients with neuropsychiatric illnesses. Repetitive transcranial magnetic stimulation (rTMS) is one such tool. It is a non-invasive brain stimulation technique, which is able to alter brain oscillations depending on its parameters of stimulation and is used in clinical setting because of its potential therapeutic effects on the brain. However, the optimum stimulation parameters to induce the therapeutic effect of rTMS remains elusive. Therefore, it is important to investigate the differential effects between high versus low frequency of magnetic stimulation on the mechanism of brain oscillations in human subjects. Here we show, using combined rTMS and surface electroencephalography (EEG) that low and high frequencies of magnetic stimulation would induce dichotomy effects in EEG brain oscillatory activity. In particular, high-frequency rTMS 10Hz induces a synchronised oscillations for theta brain rhythm. In contrast, low-frequency rTMS 1Hz desynchronises neural oscillations on the same brain rhythm. Taken together, our results show that the desynchronisation effect of low-frequency rTMS 1Hz may potentially reverse the interference of altered neural oscillations. More extensive basic and clinical research using combined rTMS and EEG are needed to determine the optimum parameters of rTMS stimulation to restore adequate neural oscillations.

Purpose: To investigate the incidence, characteristics and risk factors of adverse drug reactions (ADRs) in hospitalized children in a Malaysian hospital. Methods: Patients admitted to the Paediatric Department of Hospital Ampang in Kuala Lumpur, Malaysia were monitored for occurrence of ADRs by spontaneous reporting or daily review of their case notes. Characteristics of ADRs were categorised and ADRs were analysed for causality, severity and preventability. Multivariate analyses were performed to determine associations between certain selected risk factors and ADR occurrence. Results: In 423 paediatric patients admitted in Hospital Ampang (436 admissions), the ADR incidence rate was 80 % (95 % CI, 5 - 11 %). The most commonly involved medications were systemic antibacterial drugs (77.4 %). About 61.3 % of the ADRs were of probable causality and 12.9 % were definitely preventable No severe ADRs were detected, with 41.9 % being moderate and 58.1 % being mild, based on a severity scale Younger children (OR = 3.387, 95 % CI, 1.377, 8.334) and the number of systemic antibacterial drugs given (OR = 1.469, 95 % CI 1.201, 1.798) were potential risk factors associated with ADRs. Conclusion: ADRs occur at a significant rate in the Malaysian children admitted to the hospital studied. Further studies are needed to provide drug safety data for the paediatric population in Malaysia.

Muslim faith healers are often sought by the Malaysian public as an avenue to address psychological distress. Ruqyah refers to the recitation of verses from the Qur'an and/or sayings of Prophet Muhammad (PBUH) and is used by Muslim faith healers as a method of treatment. This study was conducted to assess the knowledge and attitude of Muslim faith healers in dealing with psychiatric patients in Malaysia. Seven Muslim faith healers were interviewed. The interviews were transcribed verbatim, and analysed qualitatively using thematic content analysis. The authors identified four themes: understanding of psychiatric illnesses, diagnostic competence, patients' referral, and integrating ruqyah into mainstream psychiatry. It was found that the respondents had limited knowledge of psychiatric illness, focusing on ruqyah as the main intervention in treating psychiatric illness. Recognizing the important role played by Muslim faith healers in the treatment of psychiatric illness in Malaysia, collaboration between them and fellow psychiatrists is deemed highly necessary.

Introduction: Baseline information on knowledge, attitude and practice towards HPV vaccination is crucial to establish a progress track on the current HPV immunization program. Aims: This study was designed to assess the knowledge, attitude and practice towards human papillomavirus (HPV) infection, cervical cancer and HPV vaccination practice among secondary school students in rural areas of Negeri Sembilan, Malaysia. Methods: A cross sectional study was conducted in several schools in rural areas of Negeri Sembilan, Malaysia. The respondents were selected using simple random sampling method. Data was collected by face-to-face interview using standardized and validated questionnaire. Data analysis was done using SPSS version 21.0. Results: A total of 380 respondents participated in this study. Females scored significantly higher for the knowledge items compared to the males. Majority of respondents (86.6%) indicated their intention to get HPV vaccines. Willingness to be vaccinated was significantly associated with the level of knowledge of cervical cancer (AOR 1.658; 95% CI 1.018-2.698; p=0.042). Gender (AOR 3.289; 95% CI 1.999-5.412; p<0.001) is a significant predictor for someone who rejects vaccination due to side effects. In this study, 89.8% of female respondents had been vaccinated against HPV. Conclusion: Respondents showed poor knowledge level despite high HPV vaccination practice. Intention to get vaccinated was significantly associated with knowledge of cervical cancer. Therefore, it is necessary to educate the community members on HPV and HPV vaccine as HPV vaccination is the most effective way to prevent cervical cancer and its related diseases.

Introduction: Malay traditional medicine has been said to be cross-pollinated with Islamic traditional wisdom originating from the Middle East, including using ingredients mentioned by the Prophet Muhammad (p.b.u.h) referred to as prophetic foods. A systematic review of Malay manuscripts was conducted to delineate traditional medicinal practices for four common illnesses found in the 'bottom billion' of the world's population namely worm infestation, gastroenteritis, fatigue and anaemia. Methods: A search strategy was developed to scan established catalogues of Malay manuscripts. The physical manuscripts were then systematically handsearched for relevant treatments for the above illnesses. The relevant prescriptions were captured, transliterated and translated for analysis. Results: Traditional medicinal prescriptions were obtained from 80 Malay manuscripts and commonly used ingredients were nutmeg, black seed, garlic and others. Few treatments used prophetic food ingredients such as date palm and goat's milk. Conclusion: Malay traditional medicines draw mainly on local wisdom and ingredients, with enrichment from Islamic medicinal practices.

Background: Adverse drug reactions (ADRs) cause significant morbidity and mortality. Improved assessment of ADRs to identify the causal relationship, the severity, and the preventability will aid ADRs prevention or reduce patient burden. Objective: The aim of this study was to develop mobile apps in assisting clinical decision in ADR assessments of causality, severity, and preventability using validated tools. The usability of the apps was assessed. Methods: We designed mobile apps using validated assessment tools for ADRs. They are the Liverpool ADRs Causality Assessment Tool, Hartwig's Severity Assessment Scale, and the Modified Schumock and Thronton Preventability Scale. The apps were named Adverse Drug ReactionCausality, Adverse Drug ReactionSeverity, and Adverse Drug RxnPreventability. A survey was conducted using the System Usability Scale (SUS) to assess the usability of the developed apps among health care professionals. Results: These apps are available for download through Google Play Store for free since January 2015. From the survey, the mean SUS score was 70.9 based on 26 responses from the pediatric ward of Hospital Ampang, Malaysia. Conclusions: The developed apps received an overall acceptable usability among health care professionals. The usage of these apps will improve detection, assessment, and avoidance of future ADRs. They will also contribute to future research on ADRs, thus increasing drug safety.

Higher level of education is associated with better cognitive performance and lower risk of developing dementia. However, the effect of education on cognitive performance varies across different cognitive domains and in different populations. The aim of this study was to determine the relationship between education and performance of different cognitive domains among healthy Malay adults. A total of 53 individuals aged 29 to 77 years participated in a battery of neurophysiological tests consisting of Mini-Mental State Examination, Montreal Cognitive Assessment, digit span, visual reproduction and digit symbol speed test (DSST). Blood test was performed for each participant to obtain their biochemical profile. Educational level was divided into level 1 (PMR), level 2 (SPM), level 3 (STPM), level 4 (Diploma) and level 5 (Degree). Simple linear regression indicated that years of education was positively associated with scores of delayed visual reproduction (b=1.348, p=0.002) and DSST (b=3.257, p=0.012). However, scores of all the tests were not significantly different among different levels of education after controlling for age, gender and blood test profile by ANCOVA. Multiple linear regression analysis showed that MMSE score was associated with red cell distribution width (b=-0.628, p=0.005), age (b=-0.119, p<0.001) and there was interaction between high density lipoprotein (HDL) with age (b=0.047, p<001). MoCA score was associated with age (b=-0.121, p<0.001), gender (male compared to female, b=1.870, p=0.020) and HDL (b=1.681, p=0.047). Age was associated with backward digit span (b=-0098, p<0.001) and immediate visual reproduction (b=-0.348, p<0.001), resp. Delayed visual reproduction was associated with age (b=0.323, p<0.001) and potassium level (b=-4.471, p=0.016). DSST was associated with age (b=-0.911, p<0.001) and alanine aminotransferase (b=-0.754, p=0.002). The lack of association between educational level and cognitive performance after adjusting for confounders in this study maybe due to multiple factors influencing cognitive performance and further studies with a larger sample size are needed to further identify the factors involved.

The utilization of Halal, prophetic nutraceutical food products is increasing in Malaysia. Despite the high consumption of health-based products, the rate of non-communicable diseases especially heart diseases and cancer are increasing. In Malaysia, there are no specific regulations to control the sale of nutraceutical products which may contain dangerous substances. Every producer of prophetic based products claim that their product offer a lot of health benefits through testimonials and Quranic verses without showing any scientific evidence. Clinical trials should be done to obtain the right, safe and recommended dosage for the consumers. This study will focus on the issues, challenges and recommendations for consumers, manufacturers and Ministry of Health in with the aim of improving the public's understanding and perception towards prophetic nutraceutical products. This understanding is essential in building better quality of life from the science and Islamic perspective. As a conclusion, the scope of scientific research regarding prophetic foods must be expanded along with the references from the Holy Quran and Hadith.