Hospital Sungai Buloh

Previous studies have highlighted significant genetic structure among Southeast Asian populations, with Northern Borneo natives closely related to Austronesians from Taiwan and the Philippines, and Peninsular Malaysia indigenous populations potentially linked to the indigenous Andamanese. In this study, we analyzed 96 genomes from indigenous populations in Peninsular Malaysia, genotyped with approximately 2 million genome-wide autosomal SNPs, alongside datasets from Singapore cosmopolitan Malays and five native populations from Sabah, Northern Borneo. Our findings reveal distinct genetic structures between indigenous populations and Malays, despite their shared habitat. The Malays exhibit substantial admixture with East Asian, Austronesian, and indigenous Peninsular Malaysian ancestral components. Indigenous populations showed lower within-population diversity and longer linkage disequilibrium compared to benchmark populations. Estimated divergence times suggest that the Semang represent an earlier branching population (∼10,000 years ago), followed by Northern Borneo natives (∼7,600-6,H800 years ago), with Malays diverging more recently. These results support a scenario of successive migration waves into Southeast Asia, providing insights into the genetic history and population structure of the region.

ObjectiveTo validate the Workplace COVID-19 Knowledge and Stigma Scale (WoCKSS) using item response theory (IRT), exploratory factor analysis (EFA) and confirmatory factor analysis (CFA).DesignCross-sectional psychometric validation.SettingManufacturing companies registered in Malaysia.ParticipantsA total of 137 factory workers participated in the exploratory phase and 300 in the confirmatory phase. Inclusion criteria were Malaysian nationality and ability to read Malay.MethodsThe knowledge domain was examined using the two-parameter logistic IRT model in two stages: an exploratory IRT analysis in phase 1 to screen items and a confirmatory IRT analysis in phase 2 to evaluate the final item set. The stigma domain was analysed using EFA followed by CFA. Reliability was assessed using Cronbach’s alpha and McDonald’s omega (ω). The development process and content and face validity results were previously published.Results14 knowledge items were retained after exploratory IRT and formed the final knowledge scale evaluated in confirmatory IRT. For these final items, discrimination parameters ranged from 0.77 to 3.17 and difficulty values from −4.47 to 0.23, with unidimensionality supported (p=0.644). EFA supported a three-factor stigma structure (stereotype, fear, prejudice), and CFA confirmed excellent model fit (χ2=8.91, df=11, p=0.630; root mean square error of approximation=0.00; Comparative Fit Index=1.00; Tucker-Lewis Index=1.00; standardised root mean square residual=0.021). Composite reliability by McDonald’s omega ranged from 0.691 to 0.893.ConclusionWoCKSS is a reliable and valid instrument for assessing workplace COVID-19 knowledge and stigma in industrial sectors in Malaysia.

Pediatric Crohn's disease (pCD) is a chronic, relapsing inflammatory bowel disease with increasing incidence worldwide, including in Asia where it was once rare. Affected children often experience gastrointestinal symptoms, growth failure, malnutrition, and psychosocial impacts that significantly impair quality of life. This review summarizes current knowledge on the epidemiology and pathogenesis of pCD, highlighting the role of dysbiosis, environmental triggers, and immune dysregulation. Conventional management strategies, including aminosalicylates, corticosteroids, immunomodulators, biologics, surgery, and nutritional interventions such as exclusive enteral nutrition, are discussed, alongside their limitations in efficacy, tolerability, or long-term safety. The paper further explores emerging therapeutic approaches, including helminthic therapy, fecal microbiota transplantation, and synthetic biotics, which aim to modulate the gut microbiome or immune response more precisely. Although early data from clinical trials are promising, these novel modalities require further investigation, particularly in pediatric populations, to establish optimal protocols, safety profiles, and long-term outcomes. The integration of established and innovative strategies, informed by ongoing research, offers the potential for more personalized and effective care in managing pCD.

We performed a comprehensive systematic review and meta-analysis of repetitive transcranial magnetic stimulation (rTMS) to explore its use as an adjunctive therapy for adult patients with drug-resistant epilepsy (DRE). Following PRISMA guidelines, PubMed and Ovid MEDLINE databases were searched until January 2025 for English-language studies reporting pre- and post-rTMS seizure frequencies and detailed protocols in adult patients with DRE. Random-effects meta-analyses pooled standardized mean differences in weekly seizure frequency at immediate, 4-week, and 8-week follow-ups. Risk of bias was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools, and evidence certainty was graded using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) and Oxford Centre for Evidence-Based Medicine (OCEBM) frameworks. 12 studies involving 150 participants were included, with seven contributing to the meta-analysis. Meta-analysis demonstrated a small but statistically significant reduction in seizure frequency at 4 and 8 weeks following rTMS (pooled SMD -.49 [95% CI -.98 to -.01, p = .46] and -.19 [95% CI -.35 to -.02, p = .91]), with insignificant heterogeneity (I2 = 0%). In contrast, no statistically significant difference was observed immediately after rTMS (pooled SMD .19 [95% CI -1.69 to 1.31, p = .38]). Common adverse effects included headaches (14%-33%) and hearing problems (9%-14%). Quality of life improved significantly in two of three studies, and one study reported depression improvement in 67% of participants. Risk of bias was low in three studies, moderate in five, and high in four. rTMS use as adjunctive therapy for DRE demonstrated moderate (GRADE level 2) and low-quality (OCEBM level 3) evidence. rTMS was associated with modest reductions in seizure frequency in selected populations. However, effect sizes were small and heterogeneous. Larger, prospective, multicenter studies are needed to further evaluate its efficacy. International Prospective Register of Systematic Reviews (PROSPERO) (ID #CRD42024553998).

Betel quid chewing is a culturally-rooted oral health risk behavior that is prevalent in many Southeast Asian communities. Among Malaysia's indigenous community, particularly in isolated areas, data on betel quid chewing remain limited. This study investigated the influencing factors and health perceptions of betel quid use among 180 adults from a Proto-Malay Orang Asli community in Peninsular Malaysia. A validated questionnaire adapted from national health survey gathered data on demographics, betel quid chewing habits, and knowledge and attitude on betel quid use. Descriptive statistics determined prevalence and health behavior, while bivariate and multivariate logistic regressions identified associated factors. The prevalence of current betel quid chewing was 75.9%. Chewing was more common among individuals aged ≥ 40, those with lower education, and those with strong family traditions of chewing. Multivariate analysis showed that older age (AOR = 1.126; 95% CI: 1.071-1.183; p < 0.001) significantly predicted current use. The findings highlight the need for culturally sensitive oral health strategies tailored to each indigenous communities.

Cardiovascular diseases (CVD) remain a leading cause of morbidity and mortality due to the increasing prevalence of major CVD risk factors, including type 2 diabetes mellitus, hypertension, dyslipidaemia and obesity. Lifestyle intervention is crucial for tackling these risk factors and curbing CVD. A prerequisite for adopting healthy behaviour is an individual’s awareness of their CVD risk. Therefore, this study aimed to determine the overall CVD risk awareness and identify factors associated with higher CVD risk awareness among individuals with CVD risk factors in primary care. A cross-sectional study was conducted among individuals with at least one CVD risk factor at a university primary care clinic from June 2024 until February 2025. CVD risk awareness was measured using the Attitudes and Beliefs of Cardiovascular Disease $$\:-$$ Malay version (ABCD-M) questionnaire. Multiple linear regression was utilised to identify the factors associated with higher CVD risk awareness. A total of 394 patients were recruited. The mean age was 53.3 (± 8.9). The majority were Malays (59.6%), married (60.2%), and females (55.3%). The mean ABCD-M risk score was 60.1 (± 8.98), indicating high overall CVD risk awareness. Significant factors associated with higher CVD risk awareness included secondary education (B = 5.54, 95% CI: 4.75, 6.34, < 0.001), tertiary education (B = 13.3, 95% CI: 12.1, 14.4, p < 0.001), Middle 40% (M40) household income category (B = 2.57, 95% CI: 1.90, 3.25 p < 0.001), Top 20% (T20) household income category (B = 3.02, 95% CI: 2.12, 3.92, p < 0.001), personal history of CVD (B = 4.06, 95% CI: 3.17, 4.95, p < 0.001), first-degree family history of CVD (B = 2.52, 95% CI: 1.65, 3.39, p < 0.001), and high Framingham Risk Scores (FRS) (B = 2.04, 95% CI: 1.17, 2.91, p < 0.001). This study revealed a high mean score for overall CVD risk awareness among patients with CVD risk factors in our primary care clinic. Higher education levels, higher income categories, personal and family history of CVD and high FRS were significantly associated with higher CVD risk awareness. These findings could be used to develop targeted interventions to improve CVD risk awareness and promote healthy behaviours in primary care.

Current emerging evidence necessitates a comprehensive overhaul of the undergraduate paediatric dentistry curriculum. Recent studies demonstrate that the early inclusion of paediatric content strengthens both technical competence and the appreciation of the specific needs of child patients [1]. Yet, a scoping review of dental education has identified persistent gaps, including a poor correlation between basic science and clinical phases, insufficient patient-care experience, and limited exposure to geriatric, specialised paediatric, and medically compromised cases [2]. These deficits are significant contributors to the anxiety graduates face when confronting independent practice [2].To bridge these gaps, curricula must expand community-based rotations and introduce elective modules targeting specialised areas such as interceptive orthodontics, sleep medicine, and practice management [2]. Furthermore, instructional design that incorporates digital simulations and case-based exercises-particularly for primary tooth identification-has been proven to boost student engagement and the retention of crucial knowledge [1,2]. The rapid adoption of telehealth platforms further enables students to observe remote consultations, effectively preparing them for an increasingly digitised paediatric practice environment [1].Assessment of these new learning modalities requires robust standard-setting methods. The Modified Angoff approach, incorporating a reality-check component, currently offers the highest reliability for defining competency-based cut scores in health-professional assessments [3].Equally critical is the development of soft skills. Evidence indicates that communication, empathy, critical thinking, and interprofessional teamwork are indispensable for delivering patient-centred paediatric care [4]. Embedding structured soft-skill training early in the curriculum, and reinforcing it through interdisciplinary collaborations with nutrition, mental health, and public health professionals, will produce graduates who are both clinically proficient and compassionate.In summary, the future of undergraduate paediatric dentistry hinges on a curriculum that (i) introduces paediatric concepts early, (ii) provides ample and diverse clinical exposure, (iii) leverages modern instructional technologies, (iv) applies rigorous, evidence-based assessment standards, and (v) cultivates essential soft skills. I urge educators and policymakers to adopt these evidence-based recommendations to ensure that tomorrow's dentists are fully prepared to improve oral health outcomes for children.

Background: Lapatinib (LAP), a tyrosine kinase inhibitor (TKI) used to treat ErbB2-overexpressing breast cancer, is frequently associated with diarrhoea reported in 58–78 % of patients. Decreased Bifidobacterium spp. levels in TKI-treated patients have been observed, suggesting a link between LAP and gut microbiota alterations, but the underlying interactions remain unclear. The present study established a Caco-2/Bifidobacterium bifidum (BB) co-culture model to examine the effects of LAP on intestinal epithelial cell viability, bacterial viability, and bacterial adhesion. Methods: BB morphology was confirmed by Gram staining and scanning electron microscopy. Caco-2 cells, representing the intestinal epithelium, were co-cultured with BB at different bacterial concentrations and treated with LAP. Caco-2 cell viability was assessed using an MTS assay; BB viability was determined with a bacterial viability assay, while bacterial adhesion was quantified by recovering adhered BB following LAP treatment and enumerating colony-forming units (CFU). Results: LAP reduced Caco-2 cell viability at all bacterial concentrations, although differences were not statistically significant (p &gt; 0.05). Although not statistically significant, a higher BB concentration (1 × 10^8 CFU/mL) was associated with slightly greater cell viability (86.60 % ± 2.73). While LAP initially decreased BB viability, bacterial proliferation subsequently increased, reaching 115.66 % ± 6.25 by 96 hours. A high number of viable, adhered BB was recovered from Caco-2 cells even after LAP treatment, indicating that bacterial-host interactions persisted despite drug exposure. Conclusions: LAP suppresses epithelial cell viability and transiently reduces BB growth, but BB rapidly recovers and maintains adhesion to Caco-2 cells. LAP may induce epithelial stress that modifies surface properties, thereby favouring adhesion without preserving barrier integrity. Further studies assessing tight-junction proteins and permeability are needed to confirm whether BB adhesion mitigates LAP-induced epithelial disruption.