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In this present study, we evaluated the hair growth promoting effect of a local commercial herbal cleanser which contains three Chinese herbs namely, Camellia oleifera Abel., Radix Angelica sinensis and Polygonum multiflorum Thunb. In vitro toxicology testing on the human fibroblast cell line, CCD-118Sk using the tetrazolium dye (MTT) assay showed that the herbal cleanser exhibited mild cytotoxic activity. An in vivo study was conducted whereby the shaved dorsal skin of male and female Wistar rats were treated daily with topical application of 10 and 20% solutions of the herbal cleanser for 30 days. Histological examination of skin biopsies taken from the treated areas at the end of the study period showed that the topical application of the herbal cleanser did not cause any apparent toxicity on the rats’ skin. In fact, a significant increase in hair follicles count was observed and more anagen phase hair follicles induced as compared to the control group. These findings suggest that the herbal cleanser has hair growth promoting potential.

The number of dengue cases has been increasing on a global level in recent years, and particularly so in Malaysia, yet little is known about the effects of weather for identifying the short-term risk of dengue for the population. The aim of this paper is to estimate the weather effects on dengue disease accounting for non-linear temporal effects in Selangor, Kuala Lumpur and Putrajaya, Malaysia, from 2008 to 2010. We selected the weather parameters with a Poisson generalized additive model, and then assessed the effects of minimum temperature, bi-weekly accumulated rainfall and wind speed on dengue cases using a distributed non-linear lag model while adjusting for trend, day-of-week and week of the year. We found that the relative risk of dengue cases is positively associated with increased minimum temperature at a cumulative percentage change of 11.92% (95% CI: 4.41–32.19), from 25.4 °C to 26.5 °C, with the highest effect delayed by 51 days. Increasing bi-weekly accumulated rainfall had a positively strong effect on dengue cases at a cumulative percentage change of 21.45% (95% CI: 8.96, 51.37), from 215 mm to 302 mm, with the highest effect delayed by 26–28 days. The wind speed is negatively associated with dengue cases. The estimated lagged effects can be adapted in the dengue early warning system to assist in vector control and prevention plan.

Aim The prevalence of diabetes mellitus among Malaysians aged ≥ 30 years of age has increased by more than twofold over a 20-year period. This study aimed to determine the current status and to evaluate the diagnostic usefulness of the HbA1c cut-off point of 48 mmol/mol (6.5%). Methods Using a two-stage stratified sampling design, participants aged ≥ 18 years were recruited from five zones selected to represent Malaysia. An oral glucose tolerance test was performed on all those not known to have diabetes. Results A total of 4341 subjects were recruited. By World Health Organization criteria, the prevalence of diabetes mellitus was 22.9%; of that percentage, 10.8% was known diabetes and 12.1% was newly diagnosed diabetes. Diabetes was most prevalent amongst Indians (37.9%) and Malays (23.8%). Prevalence of new diabetes mellitus was only 5.5% (95% CI 4.9–6.3) when based on the HbA1c diagnostic criteria of 48 mmol/mol (6.5%) and, although the cut-off point was highly specific (98.1%), it was less sensitive (36.7%) compared with 45 mmol/mol (6.3%), which showed the optimal sum of sensitivity (42.5%) and specificity (97.4%) in identifying new diabetes mellitus. Conclusion This study recorded an overall diabetes prevalence of 22.6%, almost a twofold increase from 11.6% reported in 2006. This was likely attributable to the higher prevalence of new diabetes (12.1%) diagnosed following an oral glucose tolerance test. An HbA1c of 45 mmol/mol (6.3%) was found to be a better predictive cut-off point for detecting new diabetes in our multi-ethnic population.

The daily variations of air pollutants in the Klang Valley, Malaysia, which includes Kuala Lumpur were investigated for its association with mortality counts using time series analysis. This study located in the tropic with much less seasonal variation than typically seen in more temperate climates. Data on daily mortality for the Klang Valley (2000–2006), daily mean concentrations of air pollutants of PM10, SO2, CO, NO2, O3, daily maximum O3 and meteorological conditions were obtained from Malaysian Department of Environment. We examined the association between pollutants and daily mortality using Poisson regression while controlling for time trends and meteorological factors. Effects of the pollutants (Relative Risk, RR) on current-day (lag 0) mortality to seven previous days (lag 7) and the effects of the pollutants from the first two days (lag 01) to the first eight days (lag 07) were determined. We found significant associations in the single-pollutant model for PM10 and the daily mean O3 with natural mortality. For the daily mean O3, the highest association was at lag 05 (RR = 1.0215, 95% CI = 1.0013–1.0202). CO was found not significantly associated with natural mortality, however the RR's of CO were found to be consistently higher than PM10. In spite of significant results of PM10, the magnitude of RR's of PM10 was not important for natural mortality in comparison with either daily mean O3 or CO. There is an association between daily mean O3 and natural mortality in a two-pollutants model after adjusting for PM10. Most pollutants except SO2, were significantly associated with respiratory mortality in a single pollutant model. Daily mean O3 is also important for respiratory mortality, with over 10% of mortality associated with every IQR increased. These findings are noteworthy because seasonal confounding is unlikely in this relatively stable climate, by contrast with more temperate regions.

Background: The effectiveness of lifestyle intervention for weight loss on cardiometabolic risk factors among overweight and obese individuals in the community setting remains inconclusive. This study aimed to evaluate the effect of a 6-month weight loss lifestyle intervention on cardiometabolic risk factors among overweight and obese women and the sustainability of the changes in those markers at 12-month follow-up, comparing an intervention group with a control group. Methods: A total of 243 participants from MyBFF@home were included in this study. Fasting blood samples at baseline, 6- and 12-month were assessed for fasting plasma glucose (FPG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides. The effect of the intervention on cardiometabolic risk markers were investigated within and between study groups using t-test and general linear model (GLM) repeated measure ANOVA. Results: Results from repeated measures ANOVA showed intervention effect only in TC where significant reduction was found in the intervention group (− 0.26 mmol/L [95% CI: – 0.47 to − 0.06], p < 0.01) compared to the control group (− 0.06 mmol/L [95% CI: – 0.28 to 0.17]) at 12 months. At 6 months, TC was reduced significantly in both groups but only intervention group retained the reduction in maintenance phase while, the level increased significantly in the control group (0.22 mmol/L [95% CI: 0.06 to 0.38]). This attributed to significant increase in TC/HDL-C ratio in the control group during maintenance phase (0.32 [95% CI: 0.15 to 0.50], p < 0.001). The intervention group also showed trend of reduction in FPG at 6 months and further decreased during maintenance phase (− 0.19 mmol/L [95% CI: – 0. 32 to − 0.06], p < 0.01). At 6 months HDL-C was maintained in the intervention group but reduced significantly in the control group (− 0.05 mmol/L [95% CI: – 0.10 to − 0.01], p < 0.05). No significant difference was detected in both markers when compared between groups. Conclusions: In the context of low socio-economic communities, this study supports that weight loss related lifestyle modifications over a 6-month period could improve selected cardiometabolic risk factors, particularly fasting glucose, TC and HDL-C in overweight and obese women with favourable sustainability over a 12-month period.

INTRODUCTION: Unplanned pregnancy is a major public health concern globally. Numerous studies found various factors that can predict or determine unplanned pregnancy. However, there were no studies that reported this problem in Malaysia. The objective of this study is to determine the prevalence of unplanned pregnancy in Malaysia and the associated factors. METHODS: This nationwide cross-sectional study targeted to women at postpartum period at government primary health care clinics throughout Malaysia. Structured questionnaire with face-to-face interview was used for data collection. The factors studied included mothers’ age, husband’s age, ethnicity, religion, marital status, education, occupation, household income, polygamous marriage, family support, contraception used, and disagreement of husband on contraception, smoking and alcohol consumption. History of emotional, physical and sexual intimate partner violence (IPV) were also studied. RESULTS: A total of 5727 Malaysian postpartum mothers were involved in this survey. The prevalence of unplanned pregnancy was 42.9% (95% CI: 38.6, 47.4). The multivariate logistic regression revealed that older mothers aged 45-49 years old (aOR: 8.010; 95%CI: 1.909, 33.013) and Muslim mothers (aOR: 2.465; 95%CI: 1.432-4.241) were significantly associated with unplanned pregnancy. In terms of household income, mothers with less than RM1000 per month were 1.712 (95% CI: 1.080, 2.713) times more likely to have unplanned pregnancy. The other significant associated factor was history of emotional intimate partner violence; aOR [1.720 (95% CI: 1.011, 2.925)]. CONCLUSIONS: Unplanned pregnancies were observed to be higher among older Muslim women from low income family. A possibility of unmet need for family planning should be considered and appropriate intervention strategies planned for these at-risk population.

Background: Diabetes and obesity are established risk factors for stroke. The current study aimed to assess risk factors of ischemic stroke recurrence in diabetic patients based on their body mass index (BMI). Methods: A total of 4005 diabetic patients who had a history of ischemic stroke were identified in a retrospective cross-sectional dataset from the Malaysian National Neurology Registry. Patients were classified based on BMI, and multivariable regression analysis was used to evaluate the association between risk factors and recurrent ischemic stroke. Results: Among obese patients, those with ischemic heart disease (aOR, 1.873; 95% CI, 1.131–3.103), received formal education (aOR, 2.236; 95% CI, 1.306–3.830), and received anti-diabetic medication (aOR, 1.788; 95% CI, 1.180–2.708) had a higher stroke recurrence risk, while receiving angiotensin receptors blockers (aOR, 0.261; 95% CI, 0.126–0.543) lowered the odds of recurrence. Overweight patients with hypertension (aOR, 1.011; 95% CI, 1.002–1.019) for over 10 years (aOR, 3.385; 95% CI, 1.088–10.532) and diabetes prior to the first stroke (aOR, 1.823; 95% CI, 1.020–3.259) as well as those received formal education (aOR, 2.403; 95% CI, 1.126–5.129) had higher odds of stroke recurrence, while receiving angiotensin-converting enzyme inhibitors (aOR, 0.244; 95% CI, 0.111–0.538) lowered the recurrence risk. Normal weight East Malaysians (aOR, 0.351; 95% CI, 0.164–0.750) receiving beta-blockers (aOR, 0.410; 95% CI, 0.174–0.966) had lower odds of stroke recurrence. Conclusions: Ischemic heart disease, hypertension, receiving anti-hypertensive agents, and educational level were independent predictors of recurrent stroke in obese patients. Managing the modifiable risk factors can decrease the odds of stroke recurrence.

Ruminants continue to be important in their traditional role in agricultural research and teaching. They are now also extensively used for studies in molecular biology; genetic engineering; and biotechnology for basic science, agricultural and clinical applications. Concern and interest for the welfare for these species and improved understanding of their biology and behavior have continued and are reflected in changing husbandry and management systems. This chapter addresses at high levels basic biology, husbandry, and the more common or important diseases of the three ruminant species used most commonly in the laboratory, namely sheep, goats and cattle.