Background: Antiretroviral therapy (ART) has transformed the management of human immunodeficiency virus (HIV) infection and significantly improved survival rates, but there is lack of such survival data from Malaysia. Objective: The objective was to determine the survival rates and prognostic factors of survival in HIV-infected adults treated with ART in Malaysia. Materials and Methods: This retrospective cohort study considered all HIV-positive adult patients registered in Sungai Buloh Hospital, a major referral center in Malaysia, between January 1, 2007 and December 31, 2016. Then, patients were selected through a systematic sampling method. Demographic, clinical, and treatment data were extracted from electronic medical records. Person–years at risk and incidence of mortality rate per 100 person–years were calculated. The Kaplan–Meier survival curve and log-rank test were used to compare the overall survival rates. Cox proportional hazards regression was applied to determine the prognostic factors for survival. Results: A total of 339 patients were included. The estimated overall survival rates were 93.8%, 90.4%, 84.9%, and 72.8% at 1, 3, 5, and 10 years, respectively, from ART initiation. The results of multiple Cox proportional hazard regression indicated that anemic patients were at a 3.76 times higher risk of mortality (95% confidence interval [CI]: 1.97–7.18; P < 0.001). The hazard risk was 2.09 times higher for HIV patients co-infected with tuberculosis (95% CI: 1.10, 3.96; P = 0.024). Conclusion: The overall survival rates among HIV-infected adults in this study are higher than that from low-income countries but lower than that from high-income countries. Low baseline hemoglobin levels of <11 g/dL and tuberculosis co-infection were strong prognostic factors for survival.

Background and purpose: Anxiety is a common condition among acute coronary syndrome (ACS) patients. This syndrome often goes unrecognised and can persist for months to years, while impacting substantially the quality of life. Therefore, this study aimed to identify the associated factor of anxiety among ACS patients in Hospital Universiti Sains Malaysia (USM) and Hospital Sultanah Nur Zahirah (HSNZ). Materials and Methods:This cross-sectional study involved ACS patients admitted to Hospital USM, Kelantan and HSNZ, Terengganu between August 2014 and May 2015. A standardised questionnaire was developed to interview the respondents. The questionnaire was separated into two sections. The first section comprised the socio-demographic details of the patients. The second section was the validated Depression Anxiety Stress Scale 21 (DASS-21) questionnaire. Simple and multiple logistic regressions were used for analysing the collected data. Results: The mean (standard deviation (SD)) age of ACS patients was 60.4 (11.3) years and 61.2 (10.4) years in Hospital USM and HSNZ respectively. The majority of ACS patients who experienced anxiety were male (86.3%) with 84.9% of them Malay ethnicity and 85.9% of them married. The factor associated with anxiety among ACS patients was having a history of ischemic heart disease (adjusted odd ratio (OR): 2.20, as well as confidence interval (CI): 1.19, 4.10, p=0.013). Conclusion: It was concluded that anxiety had myriad effects on cardiovascular physiology, which plays an important role in the increased incidence of ischemic events in patients. A screening tool should be created to refine and identify the psychological status of ACS patients, so that early treatment could be given.

Background Environmental factors are important for students’ learning during online classes, especially during a pandemic, such as COVID-19. This study aimed to validate the environmental factors’ questionnaire during online learning. Methods A total of 218 undergraduate medical students at the Health Campus, Universiti Sains Malaysia, participated in a cross-sectional study that involved an online survey. Environmental factor scales were assessed with the nine-item lighting, noise, and temperature (LNT) scale and the six-item technology scale. Analysis was performed using confirmatory factor analysis (CFA). Results The English version of the LNT scale with nine items and three factors showed a good fit to the data, with no item deleted. For LNT, the composite reliability (CR) was 0.81, 0.81, and 0.84, respectively, while the average variance extracted (AVE) was 0.61, 0.59, and 0.6, respectively. The English version of the technology scale, with six items and one factor, also showed a good fit to the data, with no item deleted. The CR was 0.84, and the AVE was 0.51. Conclusions The results provide psychometric evidence for environmental questionnaire scales in evaluating the factors associated with online learning among Malaysian university medical students. All items were retained and confirmed to fit the sample data.

Background: Epithelial ovarian cancer is among the leading causes of death in women and is driven by angiogenesis. Microvascular density (MVD) can be used to evaluate angiogenesis in carcinomas and thus it can be used as a potential biomarker for ovarian cancer. This study is aimed to establish the association between endocan-MVD with clinicopathological factors in primary epithelial ovarian cancer. Methods: The clinicopathological characteristics were acquired from the medical records filed between January 2008 and December 2018 of 89 epithelial ovarian cancer cases in Hospital Universiti Sains Malaysia, Kelantan, Malaysia. Sectioned samples were analyzed for endocan through immunohistochemistry followed by the quantification of MVD. The association between clinicopathological characteristics and endocan-MVD was analyzed using the Pearson chi-square test and Fischer’s exact test. Results: All cases of epithelial ovarian carcinomas were positive for endocan. The mean ± standard deviation value of endocan-MVD level was 21.6±14.60 microvessels per 200x field. A total of 53 (59.6%) cases had low and 36 (40.04%) had high endocan-MVD values. High endocan-MVD level had a significant association with the older age group (p-value = 0.009), smaller tumor size (p-value<0.001), type II tumor (p-value<0.001), high-grade tumor (p-value<0.001), advanced FIGO stage (p-value=0.002), and presence of tumor recurrence (p-value=0.017). No significant association was found between endocan-MVD and the other clinicopathological characteristics such as race, pre-operative serum CA-125 level, presence of diabetes mellitus, endometriosis, lymph node involvement, distant metastasis, and family history of malignancy. Conclusion: Endocan-MVD showed a significant association with age, tumor size, tumor type, tumor grade, FIGO stage, and recurrence in primary epithelial ovarian cancer. Thus, endocan-MVD could be implemented as a reliable marker to predict prognosis in epithelial ovarian cancer in the future.