Introduction: One of the risk factors for cancer is the habit of smoking. Some carcinogenic substances in ciga-rettes are nicotine and nitrosamine. In cigarette smoke there are free radical molecules or Reactive Oxygen Species (ROS) that can cause DNA mutations that can disrupt the balance of cell metabolism. One of them is the apoptosis, apoptosis is a programmed cell death mechanism. In cancer conditions there are apoptotic disorders and excessive proliferation of cells. The process of apoptosis is influenced by the death receptor, Tumor Necrosis Factor apoptosis inducing ligand R1 (TRAIL R1). This study aims to determine the effect of smoke exposure to expression of TRAIL R1 on the mucosal epithelium of the tongue of the Wistar rat (Rattus Novergicus). Methods: The subjects of this study were 24 male Rattus Novergicus with the age range of 12-14 weeks and weighing ± 170 grams. Divided into 4 groups with 2 control groups 4 weeks (K4), 8 weeks (K8) and 2 treatment groups each given 2 cigarettes / day ex-posure to cigarette smoke for each rat for 4 weeks (P4) and 8 weeks (P8). Results: The results showed that exposure to cigarette smoke can cause interference with TRAIL R1 expression. There was a significant difference in TRAIL R1 expression between the control and treatment groups and there was a significant difference in TRAIL R1 expression between the duration of cigarette smoke exposure (P4 and P8). Conclusion: Exposure to cigarette smoke can interfere with the process of apoptosis.
Introduction: Tissue-engineered oral mucosa (TEOM) is increasingly being used to model oral mucosal diseases and to assess drug toxicity. Current TEOM models are constructed using normal oral fibroblasts (NOF) contained within a hydrogel matrix with normal oral keratinocytes (NOK) cultured on top. NOK are not commercially available and suffer from donor-to-donor variability. Therefore, oral mucosal models based on immortalised keratinocytes may offer advantages over NOK-based models. The objective of this study was to construct and characterise the TEOM developed using TERT2-immortalised oral keratinocyte (FNB6) cells and validate its similarity to normal oral muco-sal tissue. Methods: TEOM were constructed by culturing FNB6 cells on top of a NOF-populated collagen type-1 hydrogel in tissue culture transwell inserts cultured at an air-to-liquid interface and collected at 14 day. TEOM were subjected to morphological (H&E and PAS), ultrastructural (TEM) and immunohistological (Ki-67, cytokeratin 14 and E-cadherin) analysis. Results: Histologically TEOM mimicked native oral mucosa displaying a stratified epithelium, fibroblast-containing connective tissue and basement membrane. Furthermore, TEM confirmed the presence of des-mosomes and hemi-desmosomes in the epithelium. IHC revealed expression of differentiation markers (cytokeratin 14), proliferation (Ki-67), cell adhesion (E-cadherin). Conclusion: FNB6 mucosal models able to mimic native oral mucosa structure. It has potential for drug delivery and toxicity evaluation, and replacing models based on NOK where access to primary cells is limited.
Introduction: Dengue fever currently remains as one of the major public health issues in Malaysia. Dengue inci-dence in Malaysia has been increasing in the last 20 years. Dengue fever has been causing an economic burden to the country each year. Vector control is one of the preventions and control activities to reduce its incidence. Vector control activities, especially fogging is a resource-intensive activity. It uses most of the allocated budget of a district health office (33%). The major cost components of the prevention and control activities were human resources and pesticides with 60.7% were for human resources and 13.6% of the costs were for pesticides. Therefore, it is important to know, cost of each fogging activity and the factors that contribute to that cost. The objective of this study was to determine the costs of fogging activities carried out by Hulu Langat Health District Office, Selangor, Malaysia. Meth-ods: This study was a retrospective descriptive and analytical study using data from the Hulu Langat District Health Office for the year 2018. Cost analysis of fogging activities was carried out using the activity-based costing method-ology. The factors associated with, and predictors of, the costs of fogging activities were determined using chi-square and multiple linear regression. Results: In 2018, Hulu Langat District Health Office carried out total of 2,063 fogging activities. The average cost of each fogging activity was estimated as RM 1,579. Types of insecticides was statistically significant associated and predictive factor of the cost of fogging activity. Conclusion: The present study showed that the estimated average cost per fogging activity is RM 1,579 and water-based insecticide was found to be the cheaper option compared to oil-based insecticide. However, as this study did not determine the effectiveness of these insec-ticides, recommendations cannot be made as to which insecticide should be used.
Introduction: Child abuse is an epidemic and in Malaysia, the numbers are rising. Statistic showed that 60% of the victims were below seven years old. Since most of them goes to preschool at this age, the role of childcare providers (CPs) in addressing this issue is crucial. However, previous data showed that referrals made by them to the author-ities was less than 1%. The objective of this study was to determine the knowledge and attitude of CPs in KEMAS preschools towards child abuse. Methods: This is a cross-sectional study involving CPs working in the KEMAS pre-schools in Kota Bharu and Tumpat, Kelantan, Malaysia, from April to June 2019. Results: From 218 respondents, 78% and 83% of them had good awareness on signs of neglect and physical abuse respectively compared to sexual abuse (64.6%). In terms of knowledge, 80% answered correctly about signs of abuse. However, only 18.8% an-swered correctly about sexual abuse. Moreover, 86.7% of CPs believed that they should be responsible to lodge a report, while only 6% of them objected. Although 76.1% were correct about the information to be prepared for reporting, only 4.6% of them realised that suspicions about a case would suffice to lodge a report. There were 94.5%, and 65.1% of CPs who correctly answered about the protection of the reporter under the law and its penalty respectively. But, only 26.6% of the CPs were correct about the category of mandated reporters according to the law. Conclusion: Although majority of CPs had good knowledge and awareness, there was still 26.6% who did not realise that they were mandated to report suspected cases. Therefore, educational programs need to be planned to increase awareness and knowledge on abuse and its legal aspects among CPs.
Introduction: Low back pain (LBP) is a common symptom among working population worldwide. Foggers prone to have LBP because there are exposed to physical factors such as lifting heavy object, awkward body posture and vibration. However, LBP had never been studied among the fogger. The objective of this study was to determine the prevalence and the factors associated with LBP. Methods: A cross-sectional study was carried out in all District Health Office in Johor, Malaysia by using a validated self-administered questionnaire and anthropometric measure-ments. Chi-square or Fisher’s exact test was used for inferential statistic and multiple logistic regression was used to determine the associated factors. The significance level was determined at p < 0.05. Results: The response rate was 83.9%. Majority of them are male (99.6%), Malay (95.8%), married (85.8%) and educated up to secondary school (53.5%). Majority of respondents do not have part time job (89.6%) but they work overtime everyday (62.7%). Most of them do four hours overtime daily (77.3%). The prevalence of LBP was 68.5% among respondents. There was a significant association between doing part time job, duration of doing overtime per week, body mass index (BMI) and duration of fogging activities. Finally, the associated factors of LBP were doing overtime for more than 20 hours per week (adjusted OR=1.914, 95% CI [1.102, 3.324], p = 0.021), BMI of more than 23.00 kg/m2 (adjusted OR=2.066, 95% CI [1.090, 3.916], p = 0.026) and having no part time job (adjusted OR=0.135, 95% CI [0.031, 0.599], p = 0.021). Conclusion: Prevention needs to be initiated to change the modifiable factors of LBP in order to reduce the prevalence of LBP among them.
Introduction: The number of children diagnosed with Autism Spectrum Disorder (ASD) keeps increasing every year. ASD is a neurodevelopmental disability that affects social communication and social interaction. They also demon-strate restricted, repetitive pattern of behaviour, interest or activities (RRB) that shows at an early developmental age. Due to this characteristic, ASD children are facing difficulties in social skills aspect such as eye contact, expression, and making friends. Studying and reciting the Quran are often used in Malaysia to ameliorate the symptoms, but there is no specific study in Malaysia that demonstrates the impact of these renditions on ASD’s children’s social skills. The objective of this study was to investigate the effect selected Qur’anic verses recitation on the social skills of the children with Autism Spectrum Disorder (ASD). Methods: This study will use the quasi-experimental research design. This study will be held at IDEAS Autism Centre, Rawang. The purposive sampling technique will be used and 14 ASD Muslim children aged 4-6 years old will be chosen. The ASD children will be divided into an experimental and control group. The experimental group will be listening to selected Qur’anic verses before the intervention. The Social Responsiveness Scale- Second Edition (SRS-2) will be used to assess the response. The scale consists of a 65-item questionnaire, with a 4-point Likert-scale. Results: The expected result for this study is the ASD children in the experimental group will have lower Total-scores of SRS-2 compared to control group. Conclusion: Listening to Qur’anic recitation provides a cost-effective complementary therapy to improve social skills among Muslim ASD children. Information from this study also can be used as a stepping stone in developing the teaching module to ASD children.
Introduction: Family plays an important role in the development of an adolescent. Several theories postulate in-fluences of bully behaviours within family context. Persistent act of school bullying may lead to violence and eventually disruption of a normal adolescence mental health. This study was done to address whether family factors were associated with school bully perpetrator. Methods: This was a cross sectional study conducted among Form One students from twenty-five schools in Selangor. Parental and respondents’ consents were obtained prior to this research. Data was collected using a self-administered questionnaire comprising of sociodemographic data of the respondents, their family characteristics and parenting style. Cronbach alpha ranged from 0.70- 0.89. Data was analysed using SPSS v25. Ethical approval was obtained from the Ethics Committee for Research Involving Human Subject of Universiti Putra Malaysia (UPM). Results: Response rate was 92.7% with 1221 respondents. Majority of the respondents were females (62%), Malays (82.8%) and lived with married parents (91.2%). Prevalence of bully perpetrator was 12.8%. Parental marital status (p < 0.05), presence of substance abuse among family member (p < 0.05), presence of violence act among family member (p < 0.05), witnessing violence at home (p < 0.05), sibling violence (p < 0.05), presence of family hostility (p < 0.05) and permissive maternal parenting style ( p < 0.05) were associated with school bully perpetrators. Conclusion: This study showed the association between family factors and the development of school bully perpetrators. It is a strong message for parents, educators, policy makers and health providers to collaborate and redesign prevention programmes in an effort to contracept the birth of a school bully.
Introduction: Ovarian cancer is the fourth most common cancer among Malaysian women. Despite being a malig-nancy with low incidence, ovarian cancer has a high mortality rate with just about 35.2% of 5-year survival. There is a limited published study on the risk factors for this cancer in Malaysia. This study aimed at identifying the repro-ductive risk factors of ovarian cancer among women at selected hospitals in Klang Valley. Methods: A hospital-based case-control study was conducted from April 2017 to November 2019. Subjects were Malaysian citizens and aged 18 years and above. The case referred to a known case ovarian based on histopathological examination (HPE) and had been diagnosed not more than 2 years during the recruitment into the study. Controls were selected based on a negative result of HPE or intra-operative visual inspection and examination or normal findings from the ultrasound. Data was collected using a self-administered questionnaire. Results: A total of 111 cases and 134 controls who ful-filled the inclusion criteria participated in this study. Binary multiple logistic regression analysis showed that age at first pregnancy and infertility experience were significantly associated with risk of ovarian cancer. The odds of first pregnancy after the age of 25 years among cases was higher compared to the odds among controls (AOR=2.997, 95%CI: 1.295, 6.932, p=0.010). On the other hand, the odds of infertility experience among cases was lower com-pared to the controls (AOR=0.289, 95%CI: 0.099, 0.846, p=0.024). The lower odds of infertility experience among cases shown in this study must be interpreted with care because of wide interval and as infertility was reported to be a risk factor of ovarian cancer elsewhere. Conclusion: Reproductive risk factor for ovarian cancer were aged at first pregnancy of 25 years and above. Prevention of ovarian cancer should be targeted to his group.
Colorectal cancer (CRC) is an important health problem that is on the rise globally, where it is the fourth most com-mon cause of deaths from cancer. CRC is now the 2nd commonest cancer in men and 3rd commonest in women in Malaysia. Diet, lifestyle, genetics and environmental interaction, together with underlying gut conditions such as inflammatory bowel disease have been reported to contribute to the disease. In addition, the gut microbiome has also been increasingly reported to be associated with CRC development, with dysbiosis of the commensal bacteria ob-served in CRC patients. Bacterial genera such as Bacteroides, Fusobacterium and Prevotella are more commonly de-tected in CRC patients compared to healthy individuals. Nevertheless, not much is known about the gut microbiome among Malaysians with different ethnicities. In Malaysia, the Chinese has the highest incidence of CRC, followed by Malays and Indians. The reason behind this difference may be contributed by the differences in the dietary intake that could modulate the gut microbiome and contribute towards the development of CRC. The current knowledge on this field still much depends on reports from individuals of American, European, Chinese, Brazilian and Japanese descendants in origin. The oncogenic potential of bacteria was suggested to include inflammation and the produc-tion of mutagenic toxin. A significant increase in certain intestinal microbiota including the genuses Enteroccus and Streptococcus spp. was detected in the advanced stage of colorectal adenoma. However, there are discrepancies in the previous studies, where some bacteria genera might be over-reported or underestimated. It is likely that the gut microbiome differs between populations. There is also no available data on the gut microbiome of the healthy individuals, colorectal adenoma (pre-cancerous) and colorectal cancer patients in the Malaysian population. Recent advancements in next generation sequencing allow faster and more accurate determination of microbial consortium in various niches of the human body and environment. In particular, sequencing of the 16S rRNA gene with specific primers have been reported to allow accurate determination of bacterial orders commonly found in the human gut as well as for those which are not expected in the digestive system. Recent developments in gut microbiome DNA ex-traction also contributed to the robustness of gut microbiome determination and analysis. All the above will contrib-ute towards an accurate and rapid cataloging process of the Malaysian gut microbiome and also enable comparison between healthy individuals, colorectal adenoma and CRC patients of the Malaysian population.
Introduction: Anaemia is a significant public health problem among adolescents globally but there is limited data in many countries, including Malaysia. This study aims to investigate the 5-years incidence of anemia among Malaysian adolescents by gender, ethnicity, locality of schools, Body Mass Index, stature and diet intake. Methods: A secondary analysis of existing data from MyHeART study was conducted within a closed cohort of 528 adolescents (aged 13 years) attended 15 public secondary schools from Kuala Lumpur, Selangor and Perak. The adolescents who were followed up at 15 and 17 years old had completed haemoglobin assessment, anthropometric measurements and -days diet history. The data was cleaned and missingness was handled accordingly with multiple imputation. SPSS Software version 21 was used to analyse the data, with Generalised Estimating Equation (GEE) showing the effect of time on the trajectory of prevalence of anaemia over the 5 years. Results: The prevalence or incidence? of anaemia in 2012, 2014 and 2016 was 7.9% (95%CI: 5.0-12.3), 13.9% (95%CI: 10.0-19.0) and 15.8% (95%CI:11.3-21.7). In females, anaemia increased from 11.1% (95%CI:6.7-18.7) to 15.7% (11.4-21.3) and 23.1%(95%CI: 16.8-31.0); the change was significant from 13 to 15 years old. Similar trend was noticed in those who are stunted, overweight/obese, in both urban/rural schools and didn’t meet their daily recommended nutrient intake for total calorie, protein and iron. Conclusion: Anaemia is increasing in trend among the adolescents over the years and deems attention from the relevant stakeholders to create a robust anemia prevention program.
Introduction: Malaysia has been nominated among the top four well-established healthcare system in the world. However, with the status of a developing country, there are still lacking in offering healthcare services and aware-ness among poverty. The objective of this review is to look into the factors hindering healthcare coverage in poverty. Methods: These literature reviews were carried out by using the electronic databases included, Google Scholars, Medline, PUBMED and EBSCOhost. Results: In current economic status, poverty status needs to be revised as the cost of living has markedly increased especially in the urban. Many factors affect the health status, which include the issues in term of rising health expenditure, demography-geography and imbalance workload distribution. Less expo-sure to health and wellness and geographical-demographic profile are the main reasons for the lack of self-awareness in assessing health services. Various actions had been taken by the stakeholders to improve health statuses such as telehealth, referral system and integration between agencies. Suggestion to improve the existing plan with the atten-tion given especially in the rural area which composed of multi-ethnicity and demography-geographical distribution. In Islam, Prophet Muhammad PBUH promotes health through his eating habits, physical activities include prayer and sports, proper sleep habit and through fasting. Conclusion: Poor and lack of awareness of healthcare services and health ownership have been the main reason for low health-seeking in poverty. Factors such as rising health expenditure, demography-geography factors and lack of facilities provided and unbalance workload distribution in the public-private sector contribute to the issue of concern.
Introduction: Workplace violence (WPV) among healthcare workers (HCW) remains a significant public health issue in Malaysia. This study aimed to determine the prevalence and associated factors of WPV among HCW in Emergency Departments of public hospitals in Melaka. Methods: A cross-sectional study was conducted among 231 HCW who were selected in Emergency Departments (ED) from three public hospitals in Melaka through proportionate stratified random sampling method. Data was collected using self-administered questionnaire which consists of three parts (personal and workplace data, workplace violence, and psychosocial workplace environment factors). The period of workplace violence studied was any occurrence of it within six months prior to this study. The data were anal-ysed using Statistical Package for Social Sciences (SPSS) software version 24. Results: The prevalence of WPV was found to be 38%, of which 88.9% were psychological violence, and were mostly perpetrated by combinations of type of perpetrators (51.9%). Multiple logistic regression shows that those aged 40 years and below have 5.4 times more likely to experience workplace violence compared to other age group, respondents with low job support has 2.9 times more likely to experience workplace violence compared to its counterpart, and respondents who work in secondary hospital have 2.7 times more likely to experience workplace violence compared to those who work in tertiary hospital. Conclusion: Preventive measures to prevent this issue should be in placed to tackle WPV especially among the at risk groups.
Introduction: Refractive error is the most common cause of visual impairment among the school children. The visual acuity screening has long been administered through the school health service in Malaysia. The objective of this study was to examine the status of refractive error in the school health screening from year 1990 to 2017. Methods: Every year an average of 1.2 million students were screened for refractive errors through school health service. Stu-dents with visual acuity reading of 6/9 or worst based on 6-meter Snellen chart ware referred for confirmation of refractive error. Secondary data on school visual acuity screening from the Health Informatics for the period of 1990 to 2017 were used to describe the changing pattern of refractive errors. Results: It was observed that the prevalent of suspected refractive errors amongst the Standard 1 student increased from 7 per 1,000 students examined in 1990 to 44.4 per 1,000 students in the 2000 and further increased to 74 per 1,000 students before slow decline to 55 per 1,000 students from year 2015 to 2017. A higher level of detection was observed for students in standard 6 and form 3 between the period of 1990 to 2009 (78/1,000 and 65/1,000 respectively) and further decline thereafter to lowest level in 2017 (33/1,000 to 21.5/1,000 respectively). Conclusion: The Standard 1 students in the 21st century have higher rate of suspected refractive errors compared to their counterpart that lived in the 20th century. Community awareness program need to be introduce for early detection of visual acuity problem.
Introduction: Workers in health sector are exposed 5 times more workplace violence as compared to workers in other sectors. Their consequences can range from mild to severe, affecting the victim, quality of services and orga-nization. The objective is to evaluate the effectiveness of educational intervention on workplace violence among healthcare workers in health clinics. Methods: This study is a single blinded cluster randomized trial to see the ef-fectiveness of education intervention on coping with workplace violence involving 10 cluster clinics with total 82 respondents in each control and intervention group. Data was collected using pretested questionnaire at baseline, 1-month and 6-months post intervention. The analysis used were descriptive, compared mean at baseline, repeated measures of variance and Mixed Model. Results: Response rate 94% at 1-month due to loss to follow up. Majority of the respondents were female (82.3%), and Malays (83.5%). The prevalence of workplace violence was 27.4% and mostly involved psychological violence (95.6%). There were no significant different between control and interven-tion group characteristic at baseline. Repeated measures MANOVA test was conducted to test intervention effect on dependent variables. The results until 1-month time showed significant difference between intervention and control group on combination of the dependent variables over time in coping (F(1,162)=9.51, p=0.002, and η2=0.06), knowledge (F(1,162)=10.47, p=0.001, and η2=0.061) and confidence (F(1,162)=15.65, p
Introduction: Food poisoning may occur as single sporadic cases or massive outbreak in any institution, including boarding schools. Early this year, Cheras District Health Office had implemented set of interactive games on food safety programme at two boarding schools in Cheras which had repeated incidences of food poisoning outbreak. This study aims to evaluate the effectiveness of interactive games on knowledge of food safety among school children in Cheras. Methods: This study is a retrospective study based on secondary data. Two boarding school with total of 135 students were. The students were divided into 4 groups and participates in all 4 modules of interactive games. There were 10 items pre and post questionnaire on food safety knowledge collected during the program with score ranged zero to ten. The data were analysed descriptively and analytically with paired t test. Results: The response rate of this study was 100 %. Majority of the respondents were Malays (68.1%) and male (66.7%). The mean score at pre and post were 6.78 and 7.72 respectively. Paired t test showed that there was a significant increase of 0.94 mean score of knowledge after the programme (p-value < 0.05, CI 95%= -1.212, -0.664). Conclusion: The knowledge scores on food safety of the students increased significantly after the interactive game. However, without control group, the improvement cannot be said solely due to the program itself.
Introduction: Low job satisfaction among healthcare workers may lead to high turnover intention, poor job perfor-mance, high absenteeism, and low patient satisfaction. Global and local needs for health workforce are increasing in trend to meet current health demands. Addressing job satisfaction of the healthcare workers is a practical way to uti-lise the available human resources optimally. The main aim of this study is to determine job satisfaction level and its associated factors among healthcare workers in health clinics under the Petaling District Health Office jurisdiction in Selangor, Malaysia. Methods: A cross-sectional study was conducted among healthcare workers in ten health clinics in Petaling District from April until May 2019. Simple random sampling method proportionate to the number of staffs from each health clinics was done. A structured self-administered questionnaire was used. Results: The response rate was 93%. Majority of the respondent were female (83%), married (82%), diploma holder (41%), nurses (33%) and working in health clinics with specialists (93%). The job satisfaction mean score for the studied population was 4.46 (SD = 0.72). Self-rated physical health and mental stress status were significantly associated with job satisfaction (p < 0.001). Conclusion: The job satisfaction level of the studied population was comparable to other local studies and higher than studies from Iran, Ethiopia and China. Extra attention should be given to healthcare workers with poor physical health and poor mental stress. More objective study on physical health and mental stress is required.
Introduction: Job stress is defined as harmful physical, negative, emotional responses that occur when the require-ments of the job do not match the capabilities, resources or needs of the worker. Factors influencing job stress among nurses in primary healthcare in Malaysia are poorly identified. The objective of this study is to assess the job stress score and identify the predictors of job stress among nurses in Primary Health Care (PHC) facilities in Kuala Lan-gat district of Selangor. Methods: A cross-sectional study conducted among 216 nurses in PHC facilities of Kuala Langat District. Data collection conducted using self-administered questionnaire adopted and modified from Job Stress Scale, Nursing Stress Scale (NSS) and Expanded Nursing Stress Scale (ENSS). Results: There is evidence of job stress with mean score of 28.4(5.5) among nurses in PHC facilities of Kuala Langat District, Selangor, Malaysia. There are association between age, role in organization, duration of services, outside job scope, family size, doing house chores, balance between work and family, balance between work and leisure activities, workload, inadequate preparation, lack of staff support, uncertainty concerning treatment, role conflicts and patients and their families with job stress (p
Introduction: Obesity is a major public health concern worldwide. The increasing prevalence of obesity in all ages can cause chronic illnesses, such as Type 2 Diabetes Mellitus and Cardiovascular Diseases. The Body Mass Index (BMI) is generally used to classify an adult population as underweight (BMI =25.0 kgm-2) or obese (BMI >=30.0 kgm-2). The normal BMI range lies between 18.5 and 24.99 kgm-2. Physical activity is an important component of lifestyle interventions for weight loss and the prevention of weight regain. The objective of this study was to assess the impact of physical activity in reducing the obesity among the selected participants in Taman Impian Ehsan, Hulu Langat. Methods: This study was a one-group pretest-posttest quasi-experimental design. The physical activity program took place three times a week for six months started from June to December 2018 which is a part of KOSPEN activity. Results: Thirty participants were recruited in the program. For pre- intervention study, 4 participants have normal body weight (BMI 18.5-24.99), 12 participants were overweight (BMI 26.0 to 30.0kgm-2) and 14 participants were obese (BMI > =30.0 kgm-2). Twenty six of participants were retained in the program while the rest quitted. Post-intervention study shows that seven participants have normal BMI, 10 partici-pants were still overweight and nine participants still categorized as obese. Post-intervention study showed that 17 participants managed to lose weight with minimum of 1.2 kg and maximum of 22.6 kg. The average reduction of the body weight was 5%. Conclusion: Physical activity is one of most feasible approach that can assist communities in developing healthy behaviours that promote weight loss and maintain ideal body weight.
Introduction: Learning disability (LD) is a neurologically related processing problem which can interfere with basic and higher learning skill. The prevalence of learning disability was estimated to be ranging from 5 and 9 percent in general population. The aim of this study was to describe the trend of LD among lower primary school children particularly among Year 3 school children from 2013 to 2018. Methods: Data were taken from the Ministry of Health database on LD among lower primary school children particularly among Year 3 school children in Malaysia from 2013 until 2018. These data were collected from the assessment of LD school children who were referred from schools nationwide to the government medical practitioners. Results: There were approximately 2.6 million Year 3 school children in Malaysia from 2013 until 2018. Of these, a total of 9,063 school children were diagnosed to have LD. There was an increase trend in the incidence of LD from 13 per 10,000 school children in 2013 to 77 per 10,000 school children in 2016. From 2017 onwards there was a reduction in the incidence which consistently remained at 35 per 10,000 school children. Of these, the highest incidence was seen in school children with Intellectual Disabil-ity (ranging from 18 to 36 per 10,000 school children) followed by those with Specific Learning Disability (ranging from 1 to 23 per 10,000 school children) from 2013 until 2018. Conclusion: Learning disability although not as common as other disabilities in general population is still an important issue that need to be tackled to improve the well-being of those affected.
Head and neck cancers have been reported to have high immune infiltration scores, and clinical benefits of the anti-PD1 checkpoint inhibitor have been demonstrated in recurrent and metastatic cancers. Recent genetic signa-tures of the immune compartment have provided insights to delineate immune-active and -exhausted subtypes, to understand the immune status of OSCC patients that could further drive the development of novel immunotherapies. Vaccination with tumour-associated antigens is an approach to improve tumour recognition which could result in the eradication of cancer cells. Here, I would describe our efforts in developing antigen-specific vaccines for head and neck cancer. Using the B6.Cg-Tg(HLA-A/H2-D)2Enge/J mice bearing established tumours overexpressing the tumour antigens, we demonstrated that the vaccine delayed tumour growth, and in combination with anti-PD1, completely eliminated the tumour. The vaccine increased the expression of PD1 in T cells, and vaccinated animals showed increased antigen-specific responses by the ELISPOT assay. In summary, our data show that antigen-specific vaccine works synergistically with anti-PD1 and could be a promising therapeutic agent for head and neck cancer.