The Medical Journal Of Malaysia[JOURNAL]
Sun
200 papers
Diagnostic performance of computed tomography colonography following incomplete colonoscopy and its associated factors: A single-centre retrospective study.
Mohd Hayati MF, Abdul Wahid AA, Shamsidi MAT … +3 more , Hidrus A, Mohd Murad MSH, Ong LW
Med J Malaysia · 2026 May · PMID 42216752
INTRODUCTION: Incomplete colonoscopy presents an important clinical challenge, as segments of the colon that are not visualised may contain significant pathology. Computed tomography colonography (CTC) provides a minimal...
INTRODUCTION: Incomplete colonoscopy presents an important clinical challenge, as segments of the colon that are not visualised may contain significant pathology. Computed tomography colonography (CTC) provides a minimally invasive alternative for comprehensive luminal evaluation, but local evidence regarding its diagnostic yield remains limited. This study aimed to evaluate the diagnostic yield of CTC following incomplete colonoscopy and to determine its associated factors with demography. MATERIALS AND METHODS: A retrospective cohort study was conducted among 93 adult patients who underwent CTC after incomplete colonoscopy between 2018 and 2023 at Hospital Tengku Ampuan Afzan, Kuantan. Patient demographics, prior surgical history, CTC findings and lesion characteristics were analysed using descriptive statistics, Chi-square and Fisher's exact tests. RESULTS: CTC demonstrated a diagnostic yield of 21.5%. In this cohort, females accounted a 58.1% of the population. Polyps were the most frequent pathology, followed by diverticulosis, segmental wall thickening, and a single case of colorectal mass. Statistical analysis showed no significant association between abnormal findings and demographic factors such as age, gender, ethnicity, previous abdominal surgery, clinical indications, or most proximal colonoscopic intubation (p >0.05). Although statistical significance was not significant, abnormalities were more often detected in older patients and when colonoscopic intubation was confined to the rectosigmoid colon. CONCLUSION: CTC detected clinically important finding in more than one-fifth of patients, reconfirming its role as a valuable adjunct when colonoscopy is incomplete. These results showed polyps and diverticulosis as the main abnormalities with no clear predictors from patient factors. Larger prospective studies are needed to refine patient selection and optimise imaging quality in local setting.
Gender representation across surgical specialties in Malaysia.
Teh JX, Nah SA
Med J Malaysia · 2026 May · PMID 42216751
INTRODUCTION: Although female enrolment exceeds 50% in many undergraduate medical programmes worldwide, surgeons remain overwhelmingly male despite studies reporting better outcomes by female surgeons. We aimed to charac...
INTRODUCTION: Although female enrolment exceeds 50% in many undergraduate medical programmes worldwide, surgeons remain overwhelmingly male despite studies reporting better outcomes by female surgeons. We aimed to characterise gender representation across surgical specialties in Malaysia. MATERIALS AND METHODS: We performed a cross-sectional study, extracting data of all surgical specialties from the Malaysian Specialist Register up to 30th September 2023. Gender proportions were assessed using the UNESCO Gender Parity Index (GPI), GPI<1 indicating fewer females. Gender parity was considered present at GPI 0.97-1.03. Disparities were categorised as extreme (<0.5,>1.5), intermediate (0.5-0.89, 1.11-1.5), and close to parity (0.9- 0.96,1.04-1.1). Number of years post-specialisation for each surgeon were calculated. RESULTS: 5236 surgeons were included. Only one specialty (Obstetrics & Gynaecology, GPI=1.03) showed parity and two specialties (Breast & Endocrine, GPI 2.67 and Ophthalmology, GPI 1.27) had more female surgeons. The other thirteen specialties showed various degrees of male predominance. Most GPI values trended higher when younger surgeons were included in the calculation, indicating greater female representation in recent years. CONCLUSION: Most surgical specialties in Malaysia show extreme gender inequity. Further work is needed to identify root causes and improve trends. Future efforts should further examine gender disparities and strengthen measures such as mentorship, supportive policies, transparent processes, and inclusive cultures, to advance equity in surgery.
Non-specific orbital inflammation: Clinical and histopathological insights from a 6-year single-centre Malaysian cohort.
Sharifah Izzati SJ, Farez Mukhriz MJ, Adlina AR … +2 more , Muzaliha MN, Shahidatul Adha M
Med J Malaysia · 2026 May · PMID 42216750
INTRODUCTION: Non-specific orbital inflammation (NSOI), formerly known as idiopathic orbital inflammatory disease (IOID), is a rare, exclusion-based orbital disorder with diverse clinical manifestations. This study evalu...
INTRODUCTION: Non-specific orbital inflammation (NSOI), formerly known as idiopathic orbital inflammatory disease (IOID), is a rare, exclusion-based orbital disorder with diverse clinical manifestations. This study evaluates the demographic patterns, clinical features, histopathological profiles, and treatment outcomes of NSOI cases managed at a tertiary referral centre in Malaysia. MATERIALS AND METHODS: A six-year retrospective review was conducted at a tertiary referral centre in northern Malaysia, involving 36 patients diagnosed with NSOI between January 2018 and December 2023. Diagnosis was based on clinical features, exclusion of systemic and infectious causes through serology, and supportive imaging or biopsy findings. Only cases with histopathological confirmation and immunohistochemical staining negative for lymphoma, carcinoma, and other malignancies were included. Data included demographics, clinical presentation, imaging and histopathological findings, serologic evaluations, and treatment modalities. Outcomes were assessed based on symptom resolution, radiologic improvement, recurrence, and treatment response. RESULTS: Most patients were male (61.1%), with a mean age of 43.6 years. Unilateral involvement predominated (77.8%). Common presentations included periorbital swelling (69.4%), ophthalmoplegia (22.2%), conjunctival mass (22.2%), and proptosis (19.4%). Imaging revealed frequent involvement of the lacrimal gland (45.8%), extraocular muscles (37.5%), and conjunctiva (37.5%). The main histopathological findings included reactive lymphoid hyperplasia (40%), granulomatous inflammation (20%), and chronic inflammation (23.3%). Of the 36 patients, 19 received medical treatment, with 84.2% given systemic corticosteroids, while the remaining 17 patients were managed conservatively without any medical treatment, and they remained clinically stable throughout follow-up with no evidence of disease progression. Among treated cases, recurrence occurred in 25%, predominantly in males. CONCLUSION: NSOI shows varied clinical and anatomical patterns. Corticosteroids remain the mainstay of treatment, but conservative management is appropriate in stable, nonprogressive cases when close monitoring and diagnostic exclusion are assured. These findings support individualised therapeutic strategies and long-term followup.
Prevalence of metabolic associated fatty liver disease (MAFLD) and its associated factors among type 2 diabetes mellitus (T2DM) in primary care settings in Kuantan, Pahang.
Jamani NA, Zainun N, Abd Rahman MA … +2 more , Abd Aziz KH, Che Yusuf MD
Med J Malaysia · 2026 May · PMID 42216749
INTRODUCTION: Metabolic associated fatty liver disease (MAFLD) is a common comorbidity in type 2 diabetes mellitus (T2DM) and is associated with adverse hepatic and metabolic outcomes. Early detection in primary care is...
INTRODUCTION: Metabolic associated fatty liver disease (MAFLD) is a common comorbidity in type 2 diabetes mellitus (T2DM) and is associated with adverse hepatic and metabolic outcomes. Early detection in primary care is limited by restricted access to imaging, highlighting the need for practical non-invasive screening tools. This study aimed to determine the prevalence of MAFLD using the Fatty Liver Index (FLI) and identify associated factors among T2DM patients in Kuantan, Pahang. MATERIALS AND METHODS: A cross-sectional study was conducted among T2DM patients aged ≥18 years selected through systematic random sampling from primary care clinics. Sociodemographic and clinical data were obtained from interviews and medical records. FLI, calculated using BMI, waist circumference, triglycerides, and gammaglutamyl transferase, was used to estimate hepatic steatosis, with MAFLD defined as FLI ≥60. Data were analysed using SPSS version 29, and multiple logistic regression was used to identify independent predictors. RESULTS: Among 430 participants, MAFLD prevalence was 51.2% (n=220). Patients with MAFLD were younger (56.4 vs. 61.5 years, p<0.001), had shorter diabetes duration (6 vs. 8 years, p=0.011), and poorer glycaemic control (HbA1c ≥7%: 64.5% vs. 48.2%, p<0.001). Prevalence was highest among Indians (61.9%), followed by Malays (53.7%) and Chinese (35.1%) (p=0.008). Multivariable analysis demonstrates younger age (AOR=0.974; 95% CI: 0.956-0.992) and poor glycaemic control (AOR=2.016; 95% CI: 1.326-3.065) were independently associated with MAFLD. CONCLUSION: MAFLD prevalence was high among T2DM patients in primary care. Younger age and poor glycaemic control were independently associated with MAFLD. Routine FLI screening may support early identification of high-risk patients and timely intervention.
Sixteen years of cochlear implant surgery in cochleovestibular malformation and cochlear nerve deficiency: Insights from northern Malaysia.
Khoo JH, Zainon IH, Md Yusoff Y … +1 more , Nik Othman NA
Med J Malaysia · 2026 May · PMID 42216748
INTRODUCTION: Congenital sensorineural hearing loss associated with cochleovestibular malformations (CVM) and/or cochlear nerve deficiency (CND) presents distinct surgical and audiological challenges. Patients with CVM f...
INTRODUCTION: Congenital sensorineural hearing loss associated with cochleovestibular malformations (CVM) and/or cochlear nerve deficiency (CND) presents distinct surgical and audiological challenges. Patients with CVM face elevated risks of intraoperative cerebrospinal fluid (CSF) gushers and aberrant facial nerve courses, while those with CND have historically been viewed as poor candidates for cochlear implantation (CI) due to concerns regarding neural sufficiency. This study aims to bridge this gap by evaluating the surgical safety and audiological outcomes of CI in a focused cohort of patients with CVM and CND at a tertiary referral centre in northern Malaysia. MATERIALS AND METHODS: A retrospective cohort study was conducted on 20 cases with CVM and/or CND performed between January 2009 and December 2024 at Hospital Sultanah Bahiyah, Kedah, Malaysia. The study population included patients with radiologically confirmed CVM classified according to the Sennaroglu classification and CND. Surgical outcomes, including the incidence of CSF gushers, were analysed by Fisher's exact test following stratification into high-risk and low-risk gusher group. Primary audiological outcomes were assessed using the aided average pure tone audiometry (PTA), analysed longitudinally using a linear mixed-effects model. Secondary functional audiological outcomes were evaluated by comparing pre-implantation and 12-month post-implantation Categories of Auditory Performance-II (CAP-II) scores using the Wilcoxon signed-rank test. RESULTS: The cohort was predominantly prelingual (90.0%). Surgical analysis revealed a shift in technique over the 16- year period, moving from cochleostomy to round window insertion. Intraoperative CSF gushers were encountered in 12 of 20 ears (60%). We found no statistically significant difference in the incidence of gushers between the "high risk" group (enlarged vestibular aqueduct and incomplete partition type II) and to the "low risk" group (p=0.559). There were no incidences of facial nerve injury. In terms of audiology outcome, the linear mixed-effects model revealed a highly significant improvement in aided PTA over time for all ears (p<0.001). Crucially, comparing CND versus non- CND ears revealed no statistically significant difference in outcomes, with both groups following a parallel trajectory of auditory improvement. Functional analysis confirmed that these gains translated into real-world benefits, with CAP-II scores improving significantly from a median of 2.0 preoperatively to 4.5 at 12 months (p=0.003). CONCLUSION: Cochlear implantation is a safe and effective intervention for children with CVM and/or CND. Our findings indicate that the risk of intraoperative CSF gushers extends beyond specific high-risk groups, underscoring the need for broad surgical readiness across the spectrum of malformations. The audiological outcomes observed, irrespective of the presence of CND, support the expansion of CI candidacy to this challenging population, provided there is requisite surgical expertise and thorough family counselling.
Evaluation of vision-related quality of life and its associated factors in patients with diabetic vitreoretinal disease post trans pars plana vitrectomy using visual functioning questionnaire-25.
Lai ZY, Ngoo QZ, Embong Z … +4 more , Noordin Z, Ismail NI, Sudarno R, Hamid SAA
Med J Malaysia · 2026 May · PMID 42216747
INTRODUCTION: Diabetic vitreoretinal disease often requires trans pars plana vitrectomy (TPPV) to preserve useful vision. Its impact on patients' vision-related quality of life (VRQoL) has not been fully detailed locally...
INTRODUCTION: Diabetic vitreoretinal disease often requires trans pars plana vitrectomy (TPPV) to preserve useful vision. Its impact on patients' vision-related quality of life (VRQoL) has not been fully detailed locally, especially Kelantan. We evaluated post-operative changes in VRQoL, using the validated Malay version National Eye Institute- Visual Functioning Questionnaire-25 (NEI-VFQ-25) questionnaire, and identified pre-operative and clinical factors associated with 3-months post TPPV NEI-VFQ-25 scores. MATERIALS AND METHODS: In this prospective cohort study, 85 patients with type 1 or 2 diabetic vitreoretinal disease undergoing first TPPV at Hospital Pakar Universiti Sains Malaysia and Hospital Raja Perempuan Zainab II were recruited between December 2023 and December 2024. Demographic data, systemic and ocular profiles were reviewed and recorded. VRQoL was assessed preoperatively and at 3-months post TPPV using the NEI-VFQ- 25 questionnaire. Factors associated with VRQoL at 3- months post TPPV were analysed using linear regression analysis. RESULTS: A total 85 patients completed 3 months follow-up post TPPV. NEI-VFQ-25 composite score significantly improved from 49.28±13.98 pre-operatively to 57.45±12.30 at 3-months post TPPV (mean difference 8.16; 95% Confidence Interval 7.13-9.20; p<0.001). In univariate analyses, employment, hyperlipidaemia, diabetic nephropathy, preoperative blindness status, tertiary education level and preoperative NEI-VFQ-25 score were the significant factors associated with 3-months post TPPV VRQoL (p<0.05). In multivariable regression, secondary and tertiary education level, presence of other comorbid and pre-operative NEIVFQ- 25 score were the significant factors (p<0.001). CONCLUSION: TPPV yields significant improvements in VRQoL by 3 months. Patients' pre-operative VRQoL, as well as higher education levels and presence of other comorbid are among the strongest determinants of post-operative VRQoL, emphasising the value of early intervention and patient counselling.
The relationship between neutrophil to lymphocyte ratio and the success of hydrostatic reduction in patients with intussusception.
Agitya SY, Akhmad M, Andi D … +3 more , Gunadi, Gibran K, Eko P
Med J Malaysia · 2026 May · PMID 42216746
INTRODUCTION: Intussusception is a common emergency condition in children. Intussusception leads to inflammation, which is marked by an increase in acute inflammatory markers, including the Neutrophil-Lymphocyte Ratio (N...
INTRODUCTION: Intussusception is a common emergency condition in children. Intussusception leads to inflammation, which is marked by an increase in acute inflammatory markers, including the Neutrophil-Lymphocyte Ratio (NLR). Reduction of sedation (SR) using air or fluid enema is considered safe and effective. We present examining the relationship between NLR and the success of hydrostatic reduction in patients with intussusception for 3 years. MATERIALS AND METHODS: A retrospective study was conducted from July 2021 to July 2024 in Yogyakarta, Indonesia, involving 41 children with intussusception who underwent hydrostatic reduction under sedation. Demographic, clinical, and laboratory data were collected from medical records, and NLR values were calculated from neutrophil and lymphocyte counts. Receiver operating characteristic (ROC), bivariate, and multivariate analyses were performed to evaluate the association between NLR and successful reduction. RESULTS: The average age of children who successfully underwent reduction was 25.5 months, compared to 9 months in those who failed. The proportion of children with bleeding stool in the successful reduction group was 28.6%, while it was 73.3% in the unsuccessful, with a p-value <0.05 (0.005). Bivariate analysis indicated that NLR is a significant predictor of successful reduction under sedation procedure with a p-value <0.05 (0.031). Children with NLR <1.73 had a success rate of 84.6%, with a p-value of <0.05 (0.036). CONCLUSION: The success rate of hydrostatic reduction is higher in children with a low NLR. This study provides new insights into how NLR can predict the success of SR in children with intussusception.
Genetic polymorphisms of XRCC1 on cervical cancer susceptibility risk.
Hamid MR, Mohd Yunus N, Abdul Aziz AA … +1 more , Azwari Annuar A
Med J Malaysia · 2026 May · PMID 42216745
INTRODUCTION: Cervical cancer is the fourth most frequently diagnosed cancer and the fourth leading cause of cancerrelated mortality among women worldwide. Genetic polymorphisms in DNA repair genes may influence suscepti...
INTRODUCTION: Cervical cancer is the fourth most frequently diagnosed cancer and the fourth leading cause of cancerrelated mortality among women worldwide. Genetic polymorphisms in DNA repair genes may influence susceptibility to cervical carcinogenesis. X-ray repair crosscomplementing protein 1 (XRCC1), an important scaffolding protein in the base excision repair (BER) pathway, plays a crucial role in repairing DNA damage. This study investigated the association of XRCC1 Arg399Gln G>A (rs25487) and XRCC1 Arg194Trp C>T (rs1799782) polymorphisms with cervical cancer susceptibility risk. MATERIALS AND METHODS: A total of 133 cervical cancer patients and 133 healthy female controls were enrolled. Genotyping of both polymorphisms was performed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Genotype and allele frequencies were compared between groups using chi-square analysis, while logistic regression analysis was performed to determine Odds Ratios (ORs) with 95% confidence intervals (CI). RESULTS: A significant association was observed between XRCC1 Arg399Gln G>A (rs25487) polymorphism and cervical cancer susceptibility. The heterozygous GA genotype showed a significantly increased risk of cervical cancer (OR: 2.325, 95% CI: 1.380-3.918, p=0.002). In contrast, no significant association was identified between XRCC1 Arg194Trp C>T (rs1799782) polymorphism and cervical cancer risk. CONCLUSION: In conclusion, XRCC1 Arg399Gln G>A (rs25487) polymorphism may contribute to cervical cancer susceptibility and could potentially serve as a future biomarker for early detection. Further large-scale studies involving multiple genes and polymorphisms are required to validate these findings.
Ten-year review of paediatric cataract surgery outcomes at a tertiary referral centre.
Hazirah MM, Ahmad-Anwaar MS, Ilham IM … +4 more , Zamri N, Tengku-Norina TJ, Ng KS, Shatriah I
Med J Malaysia · 2026 May · PMID 42216744
INTRODUCTION: Paediatric cataract is a major cause of preventable childhood visual impairment, with surgical outcomes associated with several factors. This study aimed to investigate the post-operative visual outcomes, c...
INTRODUCTION: Paediatric cataract is a major cause of preventable childhood visual impairment, with surgical outcomes associated with several factors. This study aimed to investigate the post-operative visual outcomes, complications, and factors associated with poor visual outcomes in paediatric patients who underwent cataract surgery, one-year post-operation. MATERIALS AND METHODS: Retrospective study on paediatric patients who underwent cataract surgery in Hospital Raja Perempuan Zainab II, Malaysia from January 2014 until December 2023. The data was collected from medical records. RESULTS: 48 paediatric patients (65 eyes) were recruited. The mean age was 7.7 ±4.79 years. 32 (66.7%) males and 16 (33.3%) females. 17 patients had bilateral while 31 patients had unilateral cataract. 44 eyes (67.7%) had primary cataract, and 21 eyes (32.3%) had secondary cataract. Overall, 53.8% (35 eyes) achieved good visual outcomes of 6/12 or better, but outcome was better in primary cataracts with 56.8% achieved good vision compared to 47.6% in secondary cataracts. 52.4% (11 eyes) of the secondary cataracts was traumatic in nature, with male predominance (72.7%) and 72.7% (8 eyes) achieved good vision. Postoperative complication occurred in 18.5% (12 eyes), with posterior capsular opacification being the commonest. Overall, ocular and systemic comorbidities contributed to poor visual outcome. Specifically for traumatic cataracts, the factors leading to poor visual outcomes were significant corneal opacity and amblyopia. Implantation of posterior chamber IOL was significantly associated with good visual outcomes (60.7%). CONCLUSION: Paediatric cataract surgery outcomes at our centre are comparable with previous studies, with posterior chamber IOL implantation give favourable results. Ocular and systemic comorbidities significantly elevate the risk of poor outcomes. Corneal scarring and amblyopia were common causes of poor vision in traumatic cataracts.
Trends and determinants of pertussis mortality in Sabah, Malaysia.
Mohd Shah S, Ayob N, Lazi K … +3 more , de Cruz E, Omar A, Abd Rahim MA
Med J Malaysia · 2026 May · PMID 42216743
INTRODUCTION: Pertussis remains a major cause of infant morbidity and mortality despite widespread vaccination. Sabah, Malaysia, has consistently reported the nation's highest pertussis burden. This study described the e...
INTRODUCTION: Pertussis remains a major cause of infant morbidity and mortality despite widespread vaccination. Sabah, Malaysia, has consistently reported the nation's highest pertussis burden. This study described the epidemiology of pertussis and identified factors associated with mortality among confirmed cases in Sabah. MATERIAL AND METHODS: A retrospective registry-based study was conducted using data from the Communicable Disease Control Information System (CDCIS) for all confirmed pertussis cases reported between January 2023 and December 2024. Sociodemographic, vaccination, and clinical variables were extracted. Univariable and multiple logistic regressions were performed to determine factors associated with death; variables with p < 0.25 were entered into the multivariable model. Adjusted odds ratios (aOR) with 95 % confidence intervals (CI) were reported. RESULTS: A total of 287 confirmed pertussis cases were recorded, including 35 deaths (case-fatality rate = 12.2 %). Most deaths occurred in infants < 2 months and among non- Malaysian or unvaccinated children. In the multivariable model, shortness of breath (aOR = 21.6; p < 0.001), cyanosis (aOR = 5.45; p = 0.006), fitting (aOR = 14.2; p = 0.027), and post-tussive vomiting (aOR = 136.0; p = 0.004) were independent predictors of death. Male sex was protective (aOR = 0.23; p = 0.008). Age, citizenship, and vaccination status were not statistically significant after adjustment. The model demonstrated good fit (Hosmer-Lemeshow p = 0.807; Nagelkerke R² = 0.471). CONCLUSION: Pertussis mortality in Sabah remains high and is driven primarily by severe clinical manifestations, with additional influence from demographic and structural factors. Strengthening early clinical recognition, improving referral and intensive care capacity, and expanding preventive strategies particularly maternal vaccination and equitable immunisation for non-Malaysian populations are critical to reducing preventable deaths.
Cervical cancer survival rate after abdominal vs. laparoscopic radical hysterectomy in two government hospitals in Jakarta, Indonesia.
Novianti L, Calvin D, Feharsal Y … +7 more , Candrani FVD, Anggraeni TD, Kusuma F, Putra AD, Singoprawiro CS, Purwoto G, Winarto H
Med J Malaysia · 2026 May · PMID 42216742
INTRODUCTION: Cervical cancer ranks among the top ten globally. Its five-year survival rate is 67.9% across all stages. In Indonesia, laparoscopic radical hysterectomy (LRH) is gaining traction but remains less common th...
INTRODUCTION: Cervical cancer ranks among the top ten globally. Its five-year survival rate is 67.9% across all stages. In Indonesia, laparoscopic radical hysterectomy (LRH) is gaining traction but remains less common than abdominal radical hysterectomy (ARH). Limited research exists on cervical cancer survival rates in Indonesia. Our study compared ARH to LRH survival rates for cervical cancer patients. MATERIALS AND METHODS: We reported a retrospective study that included 275 patients of all cervical cancer stages who met inclusion criteria from 2015 to 2019 in two of Jakarta's national teaching hospitals. The patients underwent ARH or LRH, radiotherapy, and chemotherapy and were observed for five years. Univariate and multivariate analyses were performed to investigate survival rates. RESULTS: 236 patients underwent ARH, and 39 patients underwent LRH. The median survival of LRH and ARH were 23.9 months and 29.6 months, respectively. The five-year survival rates of LRH and ARH patients were 75.0 % and 83.5%, respectively. The early-stage survival rate was higher than in the advanced stage (76.7% vs. 73.5%, p=0.006). Cox multivariate modelling determined that surgical approach (ARH vs. LRH) (HR: 2.3; 95% CI: 1.2 - 4.5; p = 0.01) and cancer stage (HR: 1.9; 95% CI: 1.18 - 2.92; p = 0.007) were significant factors. CONCLUSION: The higher cancer stage resulted in a lower fiveyear survival rate. In this limited sample study, LRH demonstrated an inferior five-year survival rate compared to ARH.
Health-related quality of life of people living with HIV in a Malaysian state hospital during the COVID-19 pandemic.
Ang WC, Jafferi NFS, Bohari NS … +2 more , Roselan A, Shafie AA
Med J Malaysia · 2026 May · PMID 42216741
INTRODUCTION: Assessing health-related quality of life (HRQOL) promotes understanding well-being of people living with HIV (PLHIV). This study aims to determine factors influencing HRQOL. MATERIALS AND METHODS: The cross...
INTRODUCTION: Assessing health-related quality of life (HRQOL) promotes understanding well-being of people living with HIV (PLHIV). This study aims to determine factors influencing HRQOL. MATERIALS AND METHODS: The cross-sectional study used a self-administered questionnaire among PLHIV receiving treatment in HIV clinic of a state hospital in Perlis, Malaysia. Potential subjects were approached in the waiting areas during routine clinic visits. The Malay questionnaire consists of WHOQOL-HIV BREF, EQ-5D-5L and EQ-VAS. Multiple linear regressions (MLRs) were used to identify independent predictors of HRQOL, and Spearman's correlations assessed the relationships between instruments. RESULTS: There were 88 participants in this study (mean age 43.5±13.1 years; 63.6% male). All were on antiretroviral therapy with undetectable viral loads. The mean overall WHOQOL score was 74.9±13.1 (on a 0-100 scale), EQ-5D index 0.90±0.13, and EQ-VAS 88.5±13.2. Each one-year increase in age was associated with a 3.3-point (β≈+3.3) higher WHOQOL score and middle-range household income of MYR3171-3970 (≈USD757-948 as of 1 USD=4.188 MYR) was linked to higher WHOQOL(β≈+8.7). In contrast, part-time employment corresponded to a lower WHOQOL(β≈-7.4). Having tertiary education and high income >MYR4850 (≈USD1158) were associated with lower EQ-VAS (β≈-10.3 and -16.0, respectively). An HIV transmission mode other than sex and intravenous drug use predicted significantly lower scores across all three HRQOL indicators. WHOQOL had a moderate positive correlation with EQ-5D (r=0.421) and a weaker correlation with EQ-VAS (r=0.265). CONCLUSION: PLHIV in Perlis, Malaysia reported generally good HRQOL despite the COVID-19 pandemic. Higher age and moderate income were associated with better WHOQOL, whereas higher education and income paradoxically lowered self-rated health (EQ-VAS). Multi-dimensional assessment (WHOQOL, EQ-5D, EQ-VAS) revealed consistent trends and underscores the importance of holistic care for PLHIV in pandemic conditions.
Overview of paediatric cataract in Malaysia.
Karimmah W, Shatriah I
Med J Malaysia · 2026 May · PMID 42216740
Paediatric cataract is a leading cause of preventable childhood visual impairment in Malaysia. Despite a relatively strong healthcare system, delayed diagnosis and referral, particularly in rural areas, remain major chal...
Paediatric cataract is a leading cause of preventable childhood visual impairment in Malaysia. Despite a relatively strong healthcare system, delayed diagnosis and referral, particularly in rural areas, remain major challenges affecting visual outcomes. The condition may be congenital or acquired, with causes including genetic disorders, infections, metabolic diseases, and trauma. Surgical treatment, mainly lens aspiration with or without intraocular lens implantation, is effective, but visual prognosis depends on early intervention and adherence to amblyopia therapy. Malaysian studies show improved surgical outcomes, yet late presentation often leads to irreversible amblyopia. Strengthening screening programs and early referral systems is essential to reduce childhood blindness.
Serum kisspeptin levels in women with polycystic ovary syndrome: A systematic review and meta-analysis.
Siahaan SC, Sa'adi A, Hendarto H … +6 more , Santoso B, Dwiningsih SR, Anas JY, Primariawan RY, Widyanugraha MYA, Tunjungseto A
Med J Malaysia · 2026 Mar · PMID 41914593
INTRODUCTION: Kisspeptin is a key regulator of the hypothalamic-pituitary-gonadal axis and has been implicated in the pathophysiology of polycystic ovary syndrome (PCOS). However, reported associations between kisspeptin...
INTRODUCTION: Kisspeptin is a key regulator of the hypothalamic-pituitary-gonadal axis and has been implicated in the pathophysiology of polycystic ovary syndrome (PCOS). However, reported associations between kisspeptin levels and PCOS have been inconsistent. MATERIALS AND METHODS: A systematic search of PubMed, Scopus, and Web of Science was performed from inception to August 2025 for studies comparing serum kisspeptin concentrations between PCOS patients and controls. Data extraction was conducted independently by two reviewers. A random-effects meta-analysis was used to calculate pooled standardized mean differences (SMD) with 95% confidence intervals (CI). Heterogeneity was assessed using the Q statistic and I index. Meta-regression was performed to examine BMI as a predictor of kisspeptin levels. RESULTS: Twenty studies involving 670 participants were included. Pooled analysis demonstrated significantly higher serum kisspeptin levels in PCOS patients compared with controls (SMD = 0.511; 95% CI: 0.376-0.646; p < 0.001; I = 0%). Meta-regression revealed that BMI significantly moderated the association, with overweight/obese PCOS patients showing the greatest elevation in kisspeptin concentrations (β = 0.756; 95% CI: 0.483-1.029; p < 0.001). CONCLUSION: Serum kisspeptin levels are elevated in women with PCOS, particularly among those with overweight/obese BMI, suggesting a possible interaction between metabolic status and reproductive neuroendocrine regulation. These findings support the potential of kisspeptin as a biomarker for PCOS and highlight the need for further research into its mechanistic role and clinical applicability.
Transforming patient care: The QWIC system to optimise waiting times and efficiency in surgical outpatient clinics in Malaysia.
Shariff R, Harith AA, Tee SC … +1 more , Jahit MS
Med J Malaysia · 2026 Mar · PMID 41914592
INTRODUCTION: Waiting time at surgical outpatient clinics in Malaysian hospitals has become a critical concern, impacting patient satisfaction and overall healthcare efficiency. Many facilities face challenges leading to...
INTRODUCTION: Waiting time at surgical outpatient clinics in Malaysian hospitals has become a critical concern, impacting patient satisfaction and overall healthcare efficiency. Many facilities face challenges leading to extended waiting periods for surgical consultations and procedures. These delays not only affect patient outcomes but also contribute to increased anxiety and frustration among patients. Implementing innovative solutions, such as advanced queue management systems, can play a significant role in operational workflows and reducing wait time. Thus, this study aims to determine the efficiency of waiting time using the Queue Won't Intimidate Customer (QWIC) system towards surgical outpatient clinics at the National Cancer Institute (NCI). MATERIALS AND METHODS: Data were collected retrospectively through a cross-sectional design over a six-month period, from April 1 to September 31, 2021, following the implementation of the QWIC system on 3 surgical clinics (bariatric clinic, general surgery (GS) clinic, and Upper gastrointestinal (UGI) clinic) under NCI. The Ministry of Health (MOH) established an acceptable waiting time benchmark of 60 minutes or less. RESULTS: The most efficient clinic was GS (98.9%), followed by UGI (96.2%) and bariatric (83.4%). Based on logistic regression analysis, bariatric clinic (COR: 18.72, 95% CI: 6.51-51.28, p < 0.001; AOR: 15.33, 95% CI: 5.32-44.13, p <0.001) and new surgical cases (COR: 3.19, 95% CI: 1.96- 5.22, p < 0.001 and AOR: 2.56, 95% CI: 1.42-4.52, p = 0.001) are strongly associated with longer waits. UGI clinic also show increased waiting times (COR: 3.67, 95%CI: 1.23:10.94, p = 0.020; AOR: 3.34, 95% CI: 1.12-10.02, p = 0.031). Conversely, consultation durations over 60 minutes and attendance status did not significantly affect waiting times. CONCLUSION: The QWIC System represents a significant advancement in managing patient appointments and consultations within surgical clinics. Overall, types of surgical clinic and case status were key factors influencing waiting times in surgical clinics.
Prevalence and determinants of Tuberculosis Preventive Treatment (TPT) completion in Latent Tuberculosis Infection (LTBI) among TB contacts in Selangor, from January 2022- December 2024: National TB Registry (NTBR).
Izanna I, Mohamad Ikhsan S, Mariam M … +1 more , Siti Hasmah I
Med J Malaysia · 2026 Mar · PMID 41914591
INTRODUCTION: Measles remains a persistent public health concern in Malaysia. Despite sustained high vaccination coverage in states such as Selangor, reported cases continue to increase. This trend suggests a possible sh...
INTRODUCTION: Measles remains a persistent public health concern in Malaysia. Despite sustained high vaccination coverage in states such as Selangor, reported cases continue to increase. This trend suggests a possible shifting age-distribution of measles, a pattern that has been observed in countries with a high vaccination rate. Understanding the epidemiology and clinical characteristics of measles between adults and children is critical in guiding targeted public health interventions aimed at control and elimination of measles. This study aimed to describe the incidence of measles in adults and children in Selangor, and to compare their sociodemographic, clinical, vaccine, and exposure-related differences. MATERIALS AND METHODS: This comparative cross-sectional study used secondary data from the Selangor e-Measles Registry from 2015 to 2024. Confirmed cases were classified as adults (≥18 years) and children (<18 years). The incidence of each group was calculated annually over ten years. Descriptive statistics, chi-square test, Fisher's exact test, and Mann-Whitney U test were used to describe and compare the differences between the two groups. Data were analysed using SPSS version 29. RESULTS: A total of 3954 confirmed measles cases were included in the study, with 540 (13.7%) adult cases and 3414 (86.3%) cases in children. Between 2015 and 2024, the incidence of measles was consistently higher in children as compared to adults, with risk ratios ranging from 14.43 (95% CI: 11.25, 18.73) in 2017 to 87.65 (95% CI: 27.39, 278.66) in 2022. With the exception of 2019-2022, adults showed a gradual increase in number over the study period, with the highest proportion in 2023 (16.4%). Significant differences between adults and children were observed (p<0.05) according to nationality, ethnicity, clinical symptoms, hospitalisation, complications, vaccination status, and duration since the last vaccination. DISCUSSION: The findings suggest that despite the increase in adult cases, measles predominantly affects children in Selangor. The findings highlight the need to strengthen vaccination efforts through the National Immunisation Programme (NIP) and prioritising Supplementary Immunisation Activities (SIAs) among children aged below 6 years old. Additionally, the gradual rise in cases in adults and children aged 7-12 years old should be monitored closely to detect emerging epidemiological shifts. Significant clinical differences between adults and children highlight the need for training of healthcare providers and public education to support diagnosis, prevent outbreaks, and avoid complications. Digitalisation of health records, such as the documentation of vaccination history, is needed. CONCLUSION: Measles in Selangor showed age-specific trends and differences. Addressing these issues through strengthened childhood immunisation, targeted interventions and continuous surveillance is essential to achieve measles control and elimination in Selangor and Malaysia.
Total corneal astigmatism magnitude and vector orientation in diabetic and non-diabetic Malay eyes.
Afira AS, Ahmad MA, Ibrahim MS … +3 more , Adzahar S, Khairidzan MK, Hudzaifah-Nordin M
Med J Malaysia · 2026 Mar · PMID 41914590
INTRODUCTION: The influence of diabetes mellitus (DM) on total corneal astigmatism (TCA) remains incompletely understood. Using total keratometry (TK), this study characterised TCA magnitude and orientation in a Malay ad...
INTRODUCTION: The influence of diabetes mellitus (DM) on total corneal astigmatism (TCA) remains incompletely understood. Using total keratometry (TK), this study characterised TCA magnitude and orientation in a Malay adult population and evaluated the influence of metabolic control and ocular parameters on TCA. MATERIALS AND METHODS: This cross-sectional study analysed 190 eyes (88 non-diabetic; 102 diabetic). TCA magnitude and axis were derived from TK obtained using swept-source optical coherence tomography (IOLMaster 700, Carl Zeiss Meditec, Germany) and decomposed into power-vector components; J0 (horizontal/vertical) and J45 (oblique). Corneal endothelial parameters were measured using specular microscopy (Topcon SP-1P, Japan). Group comparisons were performed using Welch's t-test. Within diabetic eyes, linear regression models identified independent predictors of TCA magnitude and orientation, adjusting for age, glycated haemoglobin (HbA1c), DM duration, cumulative metformin exposure, central corneal thickness, endothelial cell density, and white-to-white diameter. RESULTS: TCA magnitude did not differ significantly between diabetic and non-diabetic eyes (p = 0.066). Vector analysis demonstrated no significant between-group difference in J0 or J45, with substantial vector centroid overlap. In diabetic eyes, higher HbA1c was independently associated with greater TCA magnitude, while increasing age was independently associated with a shift towards more negative J0 values. DM duration and metformin exposure were not independently associated with TCA magnitude or vector components. CONCLUSION: Diabetes status alone was not associated with systematic differences in TCA magnitude or orientation. Age and metabolic control were the strongest factors associated with TCA characteristics. Vector-based analysis provides a robust framework for astigmatism assessment in diabetic and non-diabetic eyes.
A national survey on the implementation of Kangaroo Mother Care for premature infants in hospitals across Malaysia.
Foong SC, Foong WC, Shareena I … +2 more , Noraihan I, Jacqueline Ho J
Med J Malaysia · 2026 Mar · PMID 41914589
INTRODUCTION: Kangaroo Mother Care(KMC) is essential for preterm infants and strongly recommended by the World Health Organization. However, national data on KMC implementation in Malaysia are lacking. We aimed to descri...
INTRODUCTION: Kangaroo Mother Care(KMC) is essential for preterm infants and strongly recommended by the World Health Organization. However, national data on KMC implementation in Malaysia are lacking. We aimed to describe current KMC practices in Malaysian hospitals and identify factors influencing its adoption. MATERIALS AND METHODS: We conducted a cross-sectional survey using a self-administered online questionnaire. Ninety-three public and private hospitals providing Level II and/or III neonatal care were identified and invited to participate. The questionnaire covered KMC practices, facility availability, eligibility criteria, and documentation. RESULTS: Sixty-nine hospitals(74%) responded, including 48 public and 21 private facilities. Of these, 60(87%) hospitals self-reported implementing KMC (33 regularly, 27 occasionally), most commonly in NICUs and SCNs. Among hospitals implementing KMC, 73% allowed KMC for infants on tube feeds, 71% for those on nasal oxygen, 53% for those on intensive respiratory support, and 68% for infants born <32 weeks gestation. Only 55% documented KMC consistently, 37% had protocols, and 25% reported most staff were trained. Key barriers included limited administrative support, training, infrastructure, and comfort amenities. Logistic regression showed that availability of KMC protocols, front-button blouses, training, and documentation showed a borderline association with regular KMC practice. Among non-implementing hospitals, most cited overcrowding and lack of resources; nearly all expressed a need for training. CONCLUSION: KMC is practiced in most public and some private Malaysian hospitals, but key gaps remain. Simple measures such as providing front-button blouses, enhancing staff training, and introducing formal protocols can strengthen KMC as routine neonatal care.
Comparison between Single Incision Laparoscopic Appendectomy (SILA) and Multi Port Laparoscopic Surgery (MPLA) in paediatric appendectomy patients.
Pratama Y, Dwihantoro A, Gunadi … +2 more , Ahmad YI, Purnomo E
Med J Malaysia · 2026 Mar · PMID 41914588
INTRODUCTION: Single Incision Laparoscopic Appendectomy (SILA) and Multiport Laparoscopic Appendectomy (MPLA) are both established techniques for appendectomy, yet their differences in terms of aesthetics, operative woun...
INTRODUCTION: Single Incision Laparoscopic Appendectomy (SILA) and Multiport Laparoscopic Appendectomy (MPLA) are both established techniques for appendectomy, yet their differences in terms of aesthetics, operative wounds, and complications like wound dehiscence remain under study. This research compares the two approaches with a focus on minimizing surgical trauma and reducing infection risks. MATERIALS AND METHODS: A retrospective study was conducted involving 49 patients, with 26 undergoing SILA and 23 undergoing MPLA across two hospitals in Yogyakarta. Patient demographics, appendicitis grade, length of stay (LOS), operative time, and postoperative complications, including dehiscence, were analyzed using SPSS. RESULTS: Dehiscence was evaluated through outpatient follow-up based on wound leakage, while other complications were documented accordingly. The cohort comprised 17 female and 32 male patients (1:2 ratio), with no significant association between gender and appendicitis type (p=0.16). The most common appendicitis grade was grade 1 (36%), followed by grade 2 (34.7%), with chronic appendicitis being the least common (8.2%). was observed in 12.2% of cases, with 87.8% of wounds healing without issue. No significant difference in complication rates was found between SILA and MPLA techniques (p=0.876). LOS (p=0.523) and operative time (p=0.185) also showed no statistically significant differences. CONCLUSION: Both SILA and MPLA techniques for appendectomy offer comparable safety profiles, with no significant differences in complications, LOS, or operative time. SILA, however, may offer superior cosmetic outcomes due to fewer incisions.
Evaluation of a new quality of life instrument for children with infantile esotropia before and after strabismus surgery.
Waheeda-Azwa H, Hassan NB, Abdullah S … +2 more , Che-Hamzah J, Shatriah I
Med J Malaysia · 2026 Mar · PMID 41914587
INTRODUCTION: Infantile esotropia impacts the quality of life (QOL) of children and their families. In addition to surgical treatment, QOL assessment is an important tool for evaluating treatment success. Thus, this stud...
INTRODUCTION: Infantile esotropia impacts the quality of life (QOL) of children and their families. In addition to surgical treatment, QOL assessment is an important tool for evaluating treatment success. Thus, this study aimed to assess QOL before and after strabismus surgery using the newly developed Infantile Esotropia Quality of Life Questionnaire (IEQ). MATERIALS AND METHODS: A prospective study was conducted from September 2018 to June 2019 at the Ophthalmology Clinic, Hospital Pakar Universiti Sains Malaysia. Children aged 5-17 years diagnosed with infantile esotropia were recruited. QOL and clinical examinations were measured pre- and post-strabismus surgery. The comparison of QOL scores before and after surgery was analysed using the paired t-test. RESULTS: A total of 126 children participated in the study: 63 aged 5-8 years and 63 aged 9-17 years. Strabismus surgery significantly improved the QOL scores in both age groups. In the younger group, scores increased from 68.00 preoperatively to 89.36 postoperatively (P < 0.001), while in the older group, scores increased from 78.07 to 90.21 (P < 0.001). No significant association was found between QOL scores and gender, angle of deviation, or stereopsis (P > 0.05). CONCLUSION: Strabismus surgery significantly improved the quality of life in children with infantile esotropia in both age groups. The IEQ tool is a useful instrument for assessing functional and psychosocial outcomes in this population. Gender, ocular deviation, and stereopsis did not appear to influence QOL outcomes.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe