IntroductionThe rapidly increasing of incidence colorectal cancer (CRC) in Malaysia and the introduction of new treatments that prolong survival advocating treatment outcome measures such as patients' quality of life (QOL) are evaluated in this study. The study aims to determine QOL in CRC patients according to cancer stage and age.MethodsA cross‐sectional study was performed from June to December 2011 at four public tertiary hospitals. The European Organization for Research and Treatment in Cancer (EORTC) Quality of Life Questionnaire Core‐30 (EORTC QLQ C‐30) questionnaire was used through face‐to‐face interview and the medical records of 160 respondents were reviewed.ResultsThe mean age of respondents was 58.47 ± 12.04 years with 57.5% of respondents being male and 42.5% female. The majority of respondents were in CRC stages III and IV. Median global health status (GHS) score was 83.33 (IQR 16.67). Sikhs and Indians had a higher median GHS score compared to other ethnicities (Kruskal–Wallis, χ2 = 12.12, p = 0.007). Emotional, cognitive and social functions were higher in respondents with earlier stage of disease (Kruskal‐Wallis, χ2 = 6.06, 6.36, 10.58, p = 0.048, 0.042, 0.005). Median pain, dyspnea, diarrhea and financial implication scores were significantly higher in advanced stage of disease (Kruskal‐Wallis, χ2 = 9.31, 6.26,6.77, 7.28, p = 0.010, 0.044,0.034,0.026). Median diarrhea score (p = 0.012) was significantly different between age groups.DiscussionEmotional, cognitive and social functions deteriorate with advanced stage of disease. Patients with advanced stage disease experience more pain, dyspnea, diarrhea and financial implications. A systematic screening program to detect cases as early as possible is essential nationwide.

On the 7th of October 2018, Baling District Health Office was alerted on the admission of nine patients to Hospital Gerik, Malaysia for acute gastroenteritis following the consumption of Laksa Kebok, which was bought at Kupang, Baling, Kedah, Malaysia on the 4th of October 2018. The present work thus aimed to confirm and identify the epidemiological characteristics and causative agent related to the outbreak. The investigation team performed active and passive case detection to identify cases involved in this outbreak. A case was defined as any individual who had consumed Laksa Kebok, bought from a stall in Kupang, Baling, Kedah, Malaysia on the 4th of October 2018 onwards, and exhibited symptoms such as diarrhoea, vomiting, abdominal pain, or fever. The team also evaluated the hygienic status of sanitation, food, and water supply at the food premises involved. All clinical and environmental samples were sent for chemical and microbiological tests. An attack rate of 93.2% (n = 83/89) was recorded from a total of 89 people from three states that had consumed the Laksa Kebok. Majority of the cases involved women, with a mean age of 31 years. The most frequent symptoms were diarrhoea (86.7%), fever (65.1%), vomiting (53.0%), and abdominal pain (50.6%). Less than 10% of the cases were hospitalised and treated symptomatically, while two deaths were reported from this outbreak. The epidemic curve showed that the incubation period was between 8.5 and 26 h. The likely causative agent was identified as Salmonella enterica serovar Weltevreden. Inadequate knowledge and improper practices of food handling and preparation had contributed to food contamination. This outbreak was likely caused by the dough used to make the laksa noodles being contaminated by Salmonella Weltevreden. Health education on the importance of food safety and quality for the consumers and food handlers should be developed, improved, and implemented.