Context Ketogenic diet has recently made a comeback as a part of lifestyle and dietary modifications in patients with polycystic ovary syndrome (PCOS). Despite studies suggesting its beneficial effects in reversing hormonal imbalance in women with PCOS, evidence has been patchy and derived from small populations under varying conditions. Objective To pool evidence from clinical trials to study the effects of ketogenic diet on reproductive hormones (LH/FSH ratio, free testosterone, serum progesterone) and observe evidence of weight change. Methods PubMed, ScienceDirect, Scopus, and Web of Science core collection were searched for clinical trials evaluating the effects of ketogenic diet in established PCOS women consistent with the Rotterdam classification. Single- or double-arm studies that included an outcome of interest were included. Two investigators worked independently to screen potential articles and a designated investigator extracted data on study characteristics and evaluated the outcomes. Data were pooled using a random-effects model. The quality of selected studies was assessed using the Cochrane Risk of Bias Tool. Results Following ≥45 days of intervention with ketogenic diet among women with PCOS, significant improvement was observed in reproductive hormone levels, with reduced LH/FSH ratio (d −0.851; 95% CI −1.015, −0.686; P < .001), reduced serum free testosterone (d −0.223; 95% CI −0.328, −0.119; P < .001), and an increased in serum sex hormone binding globulin (SHBG) (d 9.086; 95% CI 3.379, 14.792; P = .002). Significant weight loss was unanimously observed in all included studies (d −11.56; 95% CI −14.97, −8.15; P < .001). Conclusion Short-term ketogenic diet potentially improved hormonal imbalances commonly associated with PCOS.

This study aimed to assess COVID-19 knowledge, attitude and practice (KAP) among healthcare workers (HCWs) in northwest Malaysia and recognise the challenges faced working during the Movement Contr...

Background: Per oral methadone maintenance therapy [MMT] was introduced as part of harm reduction strategy to manage rising numbers of HIV infections caused by intravenous use of illicit drugs. Method: We aim to review published articles related to the side effects of long-term methadone therapy, focusing on hematological derangements in human studies published between 1 January 2000 till 31 January 2021. Results: Our search databases include Web of Science, Scopus, and Medline. Our search yielded 971 articles, of which 55 articles were related to the effects of MMT on various organ systems: cardiovascular [n=12], respiratory [n=1], endocrine [n=10], central nervous system [n=12], neurobehavioral [n=10], gastrointestinal [n=1], and bone [n=1]. There were eight articles specifically related to the hematological side effects of chronic methadone therapy that include [i] immune system hyperactivation, [ii] reduced circulating lymphocytes, and [iii] increased blood viscosity. Conclusion: In view of all foreseeable health risks seen with prolonged methadone therapy, pharmacological modulation is warranted to find a better substitute for managing patients with opioid dependence.

Many significant psychosocial problems may go undetected and untreated in adolescents. We aim to determine the prevalence of high-risk behaviors among Malaysian adolescents. Retrospective data analysis was performed using data from the National Health and Morbidity Survey (NHMS) 2017 report. The dataset included 27,497 responses from adolescents aged 13 to 17 years old from five established topographic zones: northern peninsular, east coast peninsular, southern peninsular, central, and east Malaysia. The strength of associations between selected high-risk behaviors and different topographical zones were performed using logistic regression analysis. Adolescents from the northern peninsular reported the highest prevalence of suicidal attempt (27.1%) and active drug user (30.1%). The same region reported the highest prevalence of those who ever had sexual intercourse (SI) (27.2%), with 32.5% who had their first SI before 14 years old, while east Malaysia reported the highest prevalence of current smokers (26.1%) and current alcohol consumers (30.6%). Overall poor lifestyle choices were evident in the northern peninsular region. Hence, specific districts breakdown may enable targeted interventional lifestyle strategies for adolescents at risk.

Despite efforts of legitimate health education, fake news related to COVID-19 are prevalent in the social media. Our study seek to explore and understand the hu Despite efforts of legitimate health education, fake news related to COVID-19 are prevalent in the social media. Our study seek to explore and understand the hu

Introduction: Multi-disciplinary healthcare providers need to move beyond task-based responsibility towards a more collaborative approach. Chronic childhood diseases such as bronchial asthma demands effective multidisciplinary team collaboration to improve patient care. Objective: We aimed to examine the interprofessional collaboration between physicians and pharmacists in the management of paediatric bronchial asthm, to explore the views and experiences of both pharmacists and physicians on the important aspects of Paediatric Respiratory Medication Therapy Adherence Clinic (PRMTAC) and patient-centeredness, and to identify barriers against interprofessional shared decision-making in the management of paediatrics bronchial asthma. Method: The study involved a face-to-face interview involving paediatric medical officers and pharmacists involved with PRMTAC. The semi-structured interview included four pharmacists and three paediatric resident physicians from Hospital Tuanku Fauziah, Perlis, Malaysia. A full audio recording was used for detailed data retrieval and verbatim transcription. The session was deemed completed once all the probed questions had reached a thematic conclusion. Result and Discussion: Three main themes emerged: (I) The relevance and necessity of PRMTAC service to complement paediatric outpatient bronchial asthma management, (II) the lack of communication between pharmacist-physician in outpatient bronchial asthma management, and (III) recommendations for a combined clinic in the management of outpatient paediatric bronchial asthma. PRMTAC services were rated as highly relevant in the management of outpatient bronchial asthma among all study respondents, irrespective of profession. The detailed assessment of medication compliance and technical demonstration provided by PRMTAC services were deemed fundamental in holistic patient care. The current clinical scenario demonstrates that the pharmacist and paediatric medical team work independently and in parallel, rather than collaboratively. Such workflow challenges in-tandem decision-making with regards to patient-focused medication. The lack of interaction also impedes sharing of ideas and new knowledge that could benefit both parties in relation to the management of outpatient bronchial asthma. A combined clinic was unanimously suggested to remedy this. Conclusion: Proper planning with regard to allocation of support systems and mobilisation of human resources needs to be instituted to realise the implementation of a nationwide combined clinic in the management of paediatric bronchial asthma.