Objective: To determine the effect of Ashwagandha extract on sleep. Methods: A comprehensive search was conducted in CENTRAL, MEDLINE, SCOPUS, Google Scholars, World Health Organization Trials Portal, ClinicalTrials.gov, Clinical Trial Registry of India, and AYUSH Research Portal for all appropriate trials. Randomized controlled trials that examined the effect of Ashwagandha extract versus placebo on sleep in human participants 18 years old and above were considered. Two authors independently read all trials and independently extracted all relevant data. The primary outcomes were sleep quantity and sleep quality. The secondary outcomes were mental alertness on rising, anxiety level, and quality of life. Results: A total of five randomized controlled trials containing 400 participants were analyzed. Ashwagandha extract exhibited a small but significant effect on overall sleep (Standardized Mean Difference -0.59; 95% Confidence Interval -0.75 to -0.42; I² = 62%). The effects on sleep were more prominent in the subgroup of adults diagnosed with insomnia, treatment dosage ≥600 mg/day, and treatment duration ≥8 weeks. Ashwagandha extract was also found to improve mental alertness on rising and anxiety level, but no significant effect on quality of life. No serious side effects were reported. Conclusion: Ashwagandha extract appears to has a beneficial effect in improving sleep in adults. However, data on the serious adverse effects of Ashwagandha extract are limited, and more safety data would be needed to assess whether it would be safe for long-term use.

Many parents have experienced difficulties in parenting children with autism. We, therefore, consider a more in-depth understanding that is necessary to explore the challenges facing parents and families to provide a better outcome for both. We interviewed 21 parents of 24 children with autism spectrum disorder (ASD) to qualitatively explore the challenges they experienced through a phenomenological framework. Four main aspects emerged as challenges to the parents: inadequate knowledge, psychological distress and stigma, lack of support, and barriers to services. These four themes reflect a lack of balance between the needs of caregivers and the services and resources or support available in the community to meet those needs. Our study contributes to an understanding of how parents perceive challenges, making it easier to take necessary action to meet their needs and ease their burden of stress. A concerted effort is needed to coordinate services across all disciplines to address these challenges.

Background: The prevalence of Autism Spectrum Disorder (ASD) has been increasing for the past two decades. Parents with autism have been known to be at risk of psychological distress and maladaptation, but many parents were able to overcome this adversity and lead to a good quality of life. Methods: In-depth interviews were conducted among 21 parents of children with ASD. Interviews were transcribed and evaluated using thematic analysis. Results: The analysis discovered three main themes: acceptance and positive outlook, reaching for helping hands, and understanding autism and finding its solutions. Conclusions: Although the findings cannot be generalised to other populations with ASD, this study provides a detailed perspective on their unique coping strategies. Insights gained from this study could help health care providers, authorities, and communities to address a specific need and able to advocate relevant support measures to assist them.

Type 2 diabetes mellitus (T2DM) and tuberculosis (TB) together impose a high disease burden in terms of both mortality and health economics worldwide. The objective of this study was to estimate the prevalence and risk factors of latent TB infection (LTBI) in patients with T2DM in Malaysia. A cross-sectional study was performed, and adult T2DM patients (n = 299) were included. Simple and multiple logistic regression analyses were performed to identify the LTBI-associated risk factors in patients with T2DM. Multiple logistic regression was used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CIs) between T2DM and LTBI and was adjusted for potential confounders. The prevalence of LTBI in patients with T2DM was 11.4% (95% CI: 8.0–15.0%). There was no significant difference in the socio-demographic characteristics between LTBI and non-LTBI subjects. No significant difference in the smoking status, the duration of smoking, and the duration of T2DM, HbA1c, or treatments was observed. Interestingly, a higher level of education was observed to be associated with a lower prevalence of LTBI in T2DM patients (aOR: 0.08, 95% CI: 0.01–0.70, p = 0.02). Although the prevalence of LTBI in T2DM was low, it is important to screen for it in T2DM patients due to the risk of developing severe active TB.

We sought to determine the prevalence of traditional and complementary medicine (TCM) use for knee osteoarthritis and its associated factors among patients attending a referral hospital in an eastern coastal state of Malaysia. This cross-sectional study included 214 patients with knee osteoarthritis. A universal sampling method was applied to patients who attended the outpatient clinic in Hospital Universiti Sains Malaysia from May 2013 to October 2013. Participants were given a questionnaire to determine their sociodemographic information and a validated Bahasa Malaysia version of the Western Ontario and McMaster Universities Arthritis Index (WOMAC). This questionnaire was used to assess the severity of knee osteoarthritis (i.e., pain, stiffness, and disturbances in daily activity). Over half (57.9%) of patients reported using TCM to treat knee osteoarthritis. Factors associated with TCM use were gender (odd ratio (OR) = 2.47; 95% confidence interval (CI): 1.28-4.77), duration of knee osteoarthritis (OR = 1.51; 95% CI: 1.03-2.23), and the severity of knee pain (OR = 2.56; 95% CI: 1.71-3.86). The prevalence of TCM use among eastern Malaysian patients with knee osteoarthritis was high. Physicians caring for these patients should be aware of these findings so that inquiries regarding TCM use can be made and patients can be appropriately counseled.