Dynamic interactions among gestational diabetes mellitus (GDM), gut microbiota, inflammation, oxidative stress, and probiotics are increasingly acknowledged. This meta-analysis aimed to summarize the effects of probiotics in GDM, focusing on lifestyle intervention and pre-intervention washout, in addition to metabolic, inflammation, oxidative stress, and pregnancy outcomes. Three electronic databases (i.e., PubMed, Scopus, and CENTRAL) were searched from inception until October 2020. A meta-analysis was performed, and the effect sizes were reported as either mean differences or odds ratios with 95% confidence intervals. Altogether, 10 randomized controlled trials enrolling 594 participants were included. The meta-analysis indicated that probiotics supplementation effectively reduced fasting plasma glucose by 3.10 mg/dL, and subgroup analyses suggested that the duration of intervention, number of species, pre-intervention washout period, and dietary intervention may determine the effects of probiotics. Probiotics also reduced the level of inflammatory markers (high-sensitivity C-reactive protein, interleukin-6, tumor necrosis factor-α, and malondialdehyde), incidence of macrosomia, and newborn hospitalization. In conclusion, this meta-analysis suggests that probiotics may have positive effects on metabolic, inflammation, oxidative stress, and neonatal outcomes in women with GDM. Additionally, diet and pre-intervention washout may modify the effects of probiotics. Future studies are warranted on a larger scale to ascertain the clinical significance.
Background: Cervical cancer is the third leading cause of death in Malaysia, and Human Papilloma Virus (HPV) is the principal aetiology that is responsible for its development. This study was aimed to determine the prevalence and distribution of HPV types among different age groups, ethnicity, and areas in Malaysia. Materials and Methods: A total of 764 women aged 20-74 years old within the cities of Johor Bahru, Kuala Lumpur, Ipoh, Penang, and Kota Kinabalu underwent both cervical cytological assessment and HPV DNA analysis. Cervical cytology glass slides were prepared using the liquid base technique (Path TEZT TM). HPV DNA was extracted using TANBead ® Nucleic Acid Extraction Kit (Taiwan Advanced Nonotech Inc.), then the types were further identified using a DR.HPV Genotyping IVD kit. Results: The prevalence of HPV infection was 14.0% (107/764) with high-risk type at 10.7% (82/764) and low-risk type at 3.27% (25/764). The most common high-risk HPV types were HPV-52, 66, 33, 39, and 58 whereas low-risk HPV types were HPV-6, 40, and 81. The majority of HPV infections (80.37%) were detected in women with normal cytology results. The most prevalent HPV type among Chinese is 33 (n=6) followed by 16, 44, 58, 66 and 68 (n=5). Among Malays, HPV 16 and 51 were the two most prevalent types (n=2). The sensitivity of the HPV DNA test compared to cytology was 100% with a specificity of 88.37%. Conclusion: This study revealed that the most common high-risk HPV type among women living in urban areas in Malaysia is HPV 52, unfortunately which is not the type of infection the current HPV vaccine is covered for protection among females. These findings may contribute beneficial information to health care providers for the appropriate use of HPV vaccine in the prevention of cervical cancer in Malaysia.
The knowledge and the beliefs on medical education influence the teaching-learning approach used by medical educators and their perception of students' ability to be active learners. This paper highlights the student-centred teaching methods used by the medical educators of the Faculty of Medicine and Defence Health, National Defence University of Malaysia for undergraduate medical student teaching, their medical education approach in teaching and their perception on students' performance.
A comparative study was conducted between residents exposed and not exposed to electromagnetic radiation (EMR) from TELCO towers in Penang Island with the objective of determining the possible health effects using 14 non-specific health symptoms (NSHS). Interviews on 201 respondents were conducted using structured questionnaire for demographic details, health related problems and the public concern. Comparison of symptoms frequencies and its significance (Chi-square test) between the exposed and not exposed residents from the TELCO tower showed statistical significance (p < 0.05) for headache, giddiness, insomnia, loss of memory, diarrhea, mental slowness, reduced reaction time and mood swing. The odds ratio for the development of the NSHS scored > 1 for all that gave a conclusion that respondents who were exposed were more likely to suffer symptoms as compared to the respondents who were not exposed to EMR. This outcome showed that the existence of TELCO tower in these communities has detrimental health effects towards the residents who were exposed to the electromagnetic fields radiation that was emitted. Measures to be taken to minimize adverse health effects on residents should include imposing more stringent guidelines in terms of safety distance and radiation intensity, practicing of WHO precautionary approach, encouraging electromagnetic fields radiation related conference, researches and public awareness, sharing of transceivers by TELCO companies and using protective barriers. These steps will ultimately promote a healthier, harmonious and sustainable living environment.
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