The Medical Journal Of Malaysia[JOURNAL]
Sun
200 papers
Effect of multi-strain probiotics on enhancing apoptosis in lung cancer cells A549.
Gondokesumo ME, Lesmana R, Geson GR … +2 more , Anggara IGY, Kirtishanti A
Med J Malaysia · 2026 Jan · PMID 41617515
INTRODUCTION: Apoptosis is an important pathway for regulating cell proliferation and the occurrence of cancers such as lung cancer. The release of Caspase-9 and activation of Caspase-3 influence the process of apoptosis...
INTRODUCTION: Apoptosis is an important pathway for regulating cell proliferation and the occurrence of cancers such as lung cancer. The release of Caspase-9 and activation of Caspase-3 influence the process of apoptosis in lung cancer cells, making these proteins markers of apoptosis in lung cancer cells. Multi-strain probiotics show increased benefits due to the combined effects of different strains. The probiotic metabolites, such as short-chain fatty acids (SCFA), become important metabolites in lung immunity. This study aimed to examine the effectiveness of multi-strain probiotics in increasing apoptosis through increasing Caspase-3 and Caspase-9 expression in A549 cultures. MATERIAL AND METHODS: The study was conducted in vitro using a cytotoxic assay to determine the IC50 value of multistrain probiotics, followed by an In Cell Western assay to assess Caspase-3 and Caspase-9 expression. RESULTS: The cytotoxic assay IC result of the multi-strain probiotic was 58.952 ppm. Based on the result of the cytotoxic assay, the multi-strain probiotic in this study is not toxic to A549 lung cancer cells. In the Cell Western assay results, the multi-strain probiotic at concentrations of 2xIC and 0.5xIC showed the highest Caspase-3 and Caspase-9 expression, respectively, compared to the control group. CONCLUSION: Multi-strain probiotics can stimulate the expression of Caspase-3 and Caspase-9 proteins in A549 lung cancer.
Epidemiology of major trauma in Malaysia: Preliminary findings from the Malaysian Trauma Registry.
Ahmad IKB, Shah JMY, Rossman H … +4 more , Yeoh CC, Aylwin C, Shamila MA, Rathini I
Med J Malaysia · 2026 Jan · PMID 41617514
INTRODUCTION: Epidemiological data regarding major trauma in Malaysia is limited due to the unavailability of a sustainable trauma registry (TR). Recognising its importance, a national TR known as the Malaysian Trauma Re...
INTRODUCTION: Epidemiological data regarding major trauma in Malaysia is limited due to the unavailability of a sustainable trauma registry (TR). Recognising its importance, a national TR known as the Malaysian Trauma Registry (MTR) was established in 2020. This study aims to investigate the epidemiology of major trauma in Malaysia utilising data from the MTR. MATERIALS AND METHODS: A retrospective analysis of the MTR data from 1st January 2021 to 30th April 2024 was conducted. This study focused on major trauma patients who presented at the participating hospitals or were transferred from other healthcare facilities and met the MTR enrolment criteria. A total of 2774 patients were included in the analysis. RESULTS: The most frequently affected group by major trauma was young males aged 15-44. Road traffic accidents (RTAs) were the leading cause of injury, followed by falls. More than half of the patients arrived at the hospital via ambulance, with a median time of 45 minutes from the emergency call to hospital arrival. In the emergency department (ED), nearly 80% of the patients were treated in a shared resuscitation bay, and the trauma team was activated for only one-third of cases. The most common type of Computed Tomography (CT) performed was CT brain. The median time from arrival to first CT was 95 minutes. Approximately 19.5% of patients were directly sent from the ED to the operating theatre for emergency surgery, while 19.6% required admission to the intensive care unit. The head and neck were the most frequently injured body regions (31.7%), with the head and thorax having the highest severity according to the Abbreviated Injury Scale. The median Injury Severity Score was 13 (IQR 7-19), and the median length of hospital stay was 4.4 days (IQR 1.9-10.6 days). The in-hospital mortality rate was 10.9%, with the highest rates observed among young males aged 15-44 and those involved in RTAs. CONCLUSION: This study has highlighted the burden of major trauma and provided insight into the current quality of trauma care in Malaysia. The information gathered will be used to understand the standard of the existing trauma system and assist in designing trauma care enhancement plans.
Digital eye strain among library users: Prevalence and ROC-derived cut-off point for the DESRIL-27.
Ayob N, Jeffree MS, Shah S … +3 more , Lazi K, Cruz E, Omar A
Med J Malaysia · 2026 Jan · PMID 41617513
INTRODUCTION: Digital eye strain (DES), also known as computer vision syndrome, has become a growing public health issue among students due to prolonged screen exposure. Reliable, locally validated screening tools are es...
INTRODUCTION: Digital eye strain (DES), also known as computer vision syndrome, has become a growing public health issue among students due to prolonged screen exposure. Reliable, locally validated screening tools are essential to estimate prevalence and guide prevention. This study aimed to establish a receiver operating characteristic (ROC)-based cut-off for the Digital Eye Strain and Risk Level Questionnaire (DESRIL-27) against the Computer Vision Syndrome Questionnaire (CVS-Q) as the reference standard, and to estimate the prevalence of DES among university library users. MATERIALS AND METHODS: A cross-sectional study was conducted between June and September 2024 among users of Universiti Malaysia Sabah libraries. Participants completed the DESRIL-27 and CVS-Q via Microsoft Forms. Data were exported to Excel, cleaned, and analysed in RStudio (version 2025.05.1). Reliability was assessed using Cronbach's alpha. ROC analysis determined the optimal DESRIL-27 cut-off, and diagnostic performance was quantified using sensitivity, specificity, predictive values, and likelihood ratios. Prevalence was estimated based on the optimal threshold with 95% confidence intervals (CI). Ethical approval was obtained from the Medical Research Ethics Committee, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah (JKEtika 3/24 (8)). RESULTS: A total of 277 participants were included (mean age 24.2 years, 67% female). Internal consistency was excellent (α=0.964 for symptoms; α=0.921 for risk factors). ROC analysis yielded an area under the curve of 0.982 (95% CI: 0.970, 0.994). The optimal cut-off was ≥14.5, demonstrating sensitivity of 90.9% and specificity of 96.7%, with a positive predictive value of 98.3% and a negative predictive value of 83.8%. The likelihood ratios were LR+ =27.6 and LR- =0.09. At this threshold, the prevalence of DES was 62.1% (95% CI: 56.1, 67.8). CONCLUSIONS: The DESRIL-27 demonstrated excellent reliability and diagnostic performance, with an empirically derived cut-off of ≥14.5. These findings support its use as a screening tool for digital eye strain in university settings.
Outcome of Hepatitis C Screen-and-Treat Program at a Drug Rehabilitation Centre in Perlis State.
Kaman N, Mohd Suan MA, Samsurizal AA … +2 more , Abu Bakar R, Abu Hassan MR
Med J Malaysia · 2026 Jan · PMID 41617512
INTRODUCTION: Hepatitis C virus (HCV) infection is prevalent among people who inject drugs globally and in Malaysia. Drug rehabilitation centres (PUSPEN) offer opportunities for intervention, but the feasibility of HCV c...
INTRODUCTION: Hepatitis C virus (HCV) infection is prevalent among people who inject drugs globally and in Malaysia. Drug rehabilitation centres (PUSPEN) offer opportunities for intervention, but the feasibility of HCV care cascades in these settings requires evaluation. This study aims to evaluate the outcome of an integrated HCV screen-and-treat program implemented at PUSPEN Perlis, Malaysia. MATERIALS AND METHODS: This retrospective cohort study analysed data from an HCV screen-and-treat program conducted between October 2022 and December 2023 at PUSPEN Perlis. The program involved initial screening with rapid antibody testing, confirmatory HCV RNA testing, APRIbased fibrosis assessment, and Direct-Acting Antiviral (DAA) treatment, with Sustained Virologic Response at 12 weeks post-treatment (SVR12) as the primary outcome. RESULTS: Screening of 461 participants during study period identified 62 (13.4%) as HCV antibody positive. Significant attrition occurred before confirmatory testing, with 34 (54.8%) undergoing HCV RNA tests, of whom 33 (97.0%) were positive. Treatment initiation was also limited, with 17 (51.5%) starting DAA therapy, primarily due to anticipated short rehabilitation stays. One participant transferred during therapy; the remaining 16 completed the 12-week regimen, all achieving SVR12 (100%) without reported adverse effects. CONCLUSION: HCV screen-and-treat programs are feasible in Malaysian drug rehabilitation centres but face challenges in linkage to confirmatory testing and treatment initiation, largely due to limitations imposed by the duration of stay. While DAA therapy is highly effective when completed, strategies addressing diagnostic streamlining, potentially shorter regimens, and continuity of care post-release are crucial to optimise HCV elimination efforts in this vulnerable population.
Measles in Selangor: A Comparative Analysis Between Adults and Children Using the E-Measles Registry, 2015-2024.
Ismail NS, Mariam M, Faridah K … +2 more , Wan Mustapha SM, Leny SS
Med J Malaysia · 2026 Jan · PMID 41617511
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.
Prevalence and factors associated with seizures among patients with infective encephalitis.
Fathimath M, Tan JK, Rathika R … +6 more , Khoo CS, Tan MM, Sutan R, Abd Rahman MSH, Mohamed NA, Tan HJ
Med J Malaysia · 2026 Jan · PMID 41617510
INTRODUCTION: Seizures are a common and clinically significant complication of infective encephalitis, often associated with greater disease severity and poorer neurological outcomes. Identifying reliable clinical and di...
INTRODUCTION: Seizures are a common and clinically significant complication of infective encephalitis, often associated with greater disease severity and poorer neurological outcomes. Identifying reliable clinical and diagnostic predictors of seizures is critical to improve early risk stratification and guide targeted management. However, regional data on the seizure prevalence and associated factors in encephalitis remain limited. This study aims to determine the prevalence, clinical characteristics, and risk factors associated with seizure occurrence in patients with infective encephalitis admitted to a tertiary care centre in Malaysia. MATERIALS AND METHODS: We conducted a retrospective observational study involving 173 patients diagnosed with infective encephalitis and admitted to a tertiary referral hospital. Data on demographics, clinical presentation, Glasgow Coma Scale (GCS) scores, electroencephalography (EEG), neuroimaging, and cerebrospinal fluid (CSF) parameters were extracted from medical records. Seizure occurrence and characteristics were analysed. Statistical analyses included univariate and multivariate logistic regression to identify independent predictors of seizures. Missing data for selected variables were imputed using median substitution based on the distribution of available data. RESULTS: Seizures were reported in 55.5% of patients (n=96), with generalised seizures being more common than focal. EEG abnormality emerged as the most significant independent risk factor for seizure occurrence (aOR 5.22, 95% CI 2.22-12.26, p <0.001). Altered behaviour (aOR 0.22, 95% CI 0.11-0.45, p < 0.001) and elevated CSF protein (OR 0.44, 95% CI 0.20-0.95, p = 0.036) were significantly associated with lower odds of seizures. Functional outcomes at discharge (assessed by Glasgow Outcome Scale), showed that higher seizure burden, particularly status epilepticus (p<0.001) and increased seizure frequency (p=0.008) was significantly associated with poorer recovery at discharge. CONCLUSION: This study confirms the substantial clinical burden of seizures in infective encephalitis and highlights the need to prioritise systemic risk stratification in routine care. EEG abnormality is the strongest independent predictor of seizure risk and should be incorporated into early diagnostic evaluation for risk stratification. Early EEG monitoring, timely antiseizure management, and structured neurological assessment are critical to mitigate secondary brain injury and optimise outcomes.
Custodial HTK Cardioplegia in conventional cardiac surgery: A retrospective analysis From UiTM.
Syukri TM, Kasran A, Afham WM … +3 more , Samsuddin MJ, Khairuddin A, Mokhtar RABR
Med J Malaysia · 2026 Jan · PMID 41617509
INTRODUCTION: Custodial-HTK (Histidine-Tryptophan- Ketoglutarate) solution and blood cardioplegia are both established methods for myocardial protection during cardiac surgery. However, their utility in patients undergoi...
INTRODUCTION: Custodial-HTK (Histidine-Tryptophan- Ketoglutarate) solution and blood cardioplegia are both established methods for myocardial protection during cardiac surgery. However, their utility in patients undergoing complex cardiac surgery is not extensively study. This study compares clinical outcomes between patients receiving Custodial-HTK and blood cardioplegia in one of the tertiary Malaysian cardiac center. MATERIALS AND METHODS: We retrospectively analyzed data from 79 patients who underwent elective, on-pump, crossclamp cardiac surgeries at Faculty of Medicine, Universiti Teknologi MARA (UiTM) from August 2022 to July 2023. Patients undergoing emergency procedures, off-pump, or incomplete records were excluded. Patients receiving Custodial-HTK were typically those with impaired LVEF or requiring complex surgeries. RESULTS: Custodial-HTK was used in 12% of cases. These patients had slightly higher mean age (61.9 ± 7.6 vs. 59.9 ± 8.8 years) and higher mean EuroSCORE II, although the latter was not statistically significant (p = 0.115). Comorbidities including diabetes, hypertension, stroke, and renal disease were comparable between groups. The Custodial group showed significantly lower mean LVEF (43.7 ± 14.7%) and greater use of pre-induction intra-aortic balloon pump (IABP) (20%). Complex procedures were more frequent (50%), with longer mean cardiopulmonary bypass (181.7 ± 65.1 minutes) and cross-clamp durations (131.3 ± 50.4 minutes). Despite these differences, postoperative complication rates, ICU stay, total hospital stay, and 30-day mortality did not differ significantly between groups. CONCLUSION: Although patients receiving Custodial-HTK had higher surgical complexity and poorer baseline cardiac function, postoperative outcomes were within acceptable clinical range to the blood cardioplegia group. These findings support the use of Custodial-HTK as a safe and effective alternative in high-risk cardiac surgery patients.
Open-window thoracostomy in empyema thoracis: A retrospective review.
Said E, Narasimman S, Dharmaraj B … +1 more , Balasubbiah N
Med J Malaysia · 2026 Jan · PMID 41617508
INTRODUCTION: Open-window thoracostomy offers a chance of treatment for cases of empyema thoracis not amenable for closed drainage or decortication. We review herein a collection of 12 cases based on our five years' expe...
INTRODUCTION: Open-window thoracostomy offers a chance of treatment for cases of empyema thoracis not amenable for closed drainage or decortication. We review herein a collection of 12 cases based on our five years' experience in Kuala Lumpur Hospital, Malaysia performing this procedure. MATERIALS AND METHODS: Medical records of open-window thoracostomy cases performed from March 2018 till February 2023 were reviewed retrospectively. Data extracted included demographic information, indication for surgery, surgical approach, perioperative parameters, complications, and 18-months outcome. The primary end point for this study is sepsis resolution. Secondary endpoints are length of stay and spontaneous closure. RESULTS: 12 patients with mean age of 50.6 years underwent open-window thoracostomy. Five cases of empyema thoracis caused by bronchopleural fistula, five cases of destroyed lung and two recurrent empyema thoracis following unsuccessful decortication. All patients were extubated post-operatively except for two who required postoperative ventilatory support for two days. The primary end point was reached in all cases except one. Three complications were encountered in which blood loss exceeded 750mls. CONCLUSIONS: Open-window thoracostomy may be performed safely in cases of empyema thoracis not amenable for closed drainage or decortication. Preoperative planning, preparation and counselling are vital to ensure good outcome and to manage patient's expectation.
Job insecurity and psychological wellbeing among junior doctors in Malaysia: A national cross-sectional study.
Siow SL, Chuah JS, Subramaniam S … +3 more , Mahendran HA, Bujang MA, Kok JL
Med J Malaysia · 2026 Jan · PMID 41617507
INTRODUCTION: In Malaysia, the rising number of medical graduates has led to a shift from permanent to contract employment in the healthcare system since 2016. This study investigates the impact of employment status on m...
INTRODUCTION: In Malaysia, the rising number of medical graduates has led to a shift from permanent to contract employment in the healthcare system since 2016. This study investigates the impact of employment status on mental health outcomes, job satisfaction, and career perceptions among junior doctors in Malaysia. MATERIALS AND METHODS: This nationwide study compared 1,966 contract and 698 permanent junior doctors in Malaysia using validated instruments (Maslach Burnout Inventory, DASS-21, WHOQOL-BREF) and career perception measures. RESULTS: Contract doctors showed higher depression (adjusted mean 8.72 [95% CI: 8.18-9.26] vs 6.88 [95% CI: 6.25- 7.51], p<0.001), anxiety (adjusted mean 6.41 [95% CI: 5.96- 6.86] vs. 4.89 [95% CI: 4.36-5.41], p<0.001), stress (adjusted mean 8.74 [95% CI: 8.24-9.23] vs 7.86 [95% CI, 7.28-8.44], p<0.001), emotional exhaustion (adjusted mean 32.14 [95% CI: 30.86-33.42] vs 27.18 [95% CI: 25.68-28.68], p<0.001), and depersonalization (14.10 [95% CI: 13.41-14.80] vs 11.94 [95% CI: 11.13-12.76], p<0.001). Their quality of life was lower in physical (adjusted mean 10.48 [95% CI: 10.30-10.67] vs 11.09 [95% CI: 10.87-11.31], p<0.001), psychological (adjusted mean 11.50 [95% CI: 11.29-11.70] vs 11.86 [95% CI: 11.63- 12.10], p<0.001), and environmental domains (adjusted mean 12.42 [95% CI: 12.18-12.65] vs 13.11 [95% CI 12.83-13.38], p<0.001). Contract doctors reported significantly lower satisfaction across multiple domains. Despite similar aspirations to succeed in medicine (OR 0.8 [95% CI: 0.6-1.1], p=0.117), contract doctors reported lower career security (OR 0.04 [95% CI: 0.03-0.05], p<0.001), reduced confidence in specialty training access (OR 0.3 [95% CI: 0.2-0.3], p<0.001), and higher intentions to change careers (OR 5.9 [95% CI: 4.7- 7.5], p<0.001) or emigrate (OR 1.9 [95% CI: 1.5-2.3], p<0.001). CONCLUSION: Contract employment is associated with poorer mental health, reduced job satisfaction, and diminished career confidence despite similar professional aspirations. These findings suggest current employment practices may threaten healthcare workforce sustainability and highlight the need for policy reforms.
Comparing the administration of rt-PA among stroke fast track patients who arrived by emergency medical services and non-emergency medical services.
Saneemanomai S
Med J Malaysia · 2026 Jan · PMID 41617506
INTRODUCTION: Stroke is a leading cause of death and disability worldwide. Prompt treatment with recombinant tissue plasminogen activator (rt-PA) and endovascular therapy improves outcomes in acute ischemic stroke. Altho...
INTRODUCTION: Stroke is a leading cause of death and disability worldwide. Prompt treatment with recombinant tissue plasminogen activator (rt-PA) and endovascular therapy improves outcomes in acute ischemic stroke. Although Emergency Medical Services (EMS) facilitate timely treatment. This study compared rt-PA administration rates and clinical outcomes between patients who arrived via EMS and those who did not in Mueang District, Chachoengsao Province. MATERIALS AND METHODS: A retrospective descriptive study was conducted from January 2021 to January 2024, including patients presenting within 4.5 hours of onset, without inter-hospital transfer, and completing 90-day follow-up. Data included transport mode, treatment times, and outcomes. RESULTS: Of 103 patients, 28 (27.2%) arrived by EMS and 75 (72.8%) by non-EMS. Lipid-lowering agent use was less frequent in the EMS group (17.9% vs. 46.7%, p = 0.008). Onset-to-hospital, door-to-needle, and onset-to-needle times showed no significant differences, and rt-PA administration rates were comparable. In univariable analysis, EMS patients had a higher median NIHSS score than non-EMS patients (median difference = 6.00, 95% CI: 0.99-11.01, p = 0.019), but this was not significant in multivariable analysis (median difference = 0.45, 95% CI: -1.99 - 2.84, p = 0.706). rt-PA was administered in 53.6% of EMS patients and 38.7% of non- EMS patients (p = 0.174). Mechanical thrombectomy was performed more often in EMS patients (42.9% vs. 22.7%, p = 0.043). Discharge NIHSS and 90-day mRS did not differ significantly. CONCLUSION: EMS use was associated with greater thrombectomy referral but not with higher rt-PA administration rates or improved outcomes.
A retrospective study on patterns of acute chemical poisoning in an urban tertiary hospital in Malaysia.
Hamzah NH, Arithra A, Nor J
Med J Malaysia · 2026 Jan · PMID 41617505
INTRODUCTION: Acute poisoning is a frequent reason for emergency department (ED) visits, with varying patterns of presentation across different regions. This study examines the clinical characteristics, sociodemographic...
INTRODUCTION: Acute poisoning is a frequent reason for emergency department (ED) visits, with varying patterns of presentation across different regions. This study examines the clinical characteristics, sociodemographic factors, and outcomes associated with acute chemical poisoning in a Malaysian population. MATERIALS AND METHODS: This is a retrospective case note review of acute chemical poisoning presenting to the ED of a tertiary government hospital in Malaysia from 2016 to 2018. Data were collected on sociodemographic details, clinical presentations, and outcomes, with multiple logistic regression used to identify factors associated with its complications. RESULTS: A total of 260 cases were included, with 168 (64.6%) being intentional poisonings and 92 (35.4%) accidentals. The majority of patients were single (60.8%), male (58.5%), and of Indian ethnicity (57.3%). The most common agents were pesticides (42.2%). The overall complication rate was 14.2%, and the mortality rate was 4.6%. The most frequent complications were respiratory insufficiency (11.5%) and renal failure (6.5%). Factors significantly associated with complications included intentional poisoning (AOR 3.18, 95% CI 1.05-9.66, p=0.042), ethnicity (Chinese: AOR 12.85, 95% CI 1.40-118.35, p=0.024; other races: AOR 25.99, 95% CI 2.34-238.00, p=0.004), exposure during daytime hours (AOR 12.79, 95% CI 1.52-107.42, p=0.019), and a delay of 2-12 hours before ED visit (AOR 2.30, 95% CI 1.02-5.20, p=0.045). CONCLUSION: Acute chemical poisoning is more common in single males with intentional exposures. Important factors associated with its complications include age, ethnicity, the time of exposure, and delayed presentation to the ED.
Association between irregular eating habits and irritable foods with dyspepsia syndrome in students.
Trini S, Stella SK, Tiroy SBS
Med J Malaysia · 2026 Jan · PMID 41617504
INTRODUCTION: A group of conditions affecting the upper gastrointestinal tract, known as dyspepsia syndrome, includes epigastric pain, discomfort, bloating, frequent belching, nausea, and vomiting. According to the World...
INTRODUCTION: A group of conditions affecting the upper gastrointestinal tract, known as dyspepsia syndrome, includes epigastric pain, discomfort, bloating, frequent belching, nausea, and vomiting. According to the World Health Organization (WHO) data in 2015, dyspepsia was found to affect 13-40% of the population annually and is listed as one of the top 10 non-communicable diseases in Indonesia that can increase morbidity. MATERIALS AND METHODS: This study aimed to investigate the relationship between dietary habits and the prevalence of dyspepsia syndrome among preclinical medical students at the Christian University of Indonesia in the 2023 class. The methodology employed was a descriptive-analytical study, utilizing a cross-sectional approach and a sequential sampling strategy, with 108 participants. This study employed univariate and bivariate analysis as its analytical methods. RESULTS: The findings of the univariate study revealed that most participants were 18 years old, and 76 women (70.4%) of the total respondents reported experiencing dyspepsia syndrome, accounting for 61.1% of the sample. In this study, bivariate analysis using the Chi-square test revealed a strong correlation (p-value < 0.001) between the incidence of dyspepsia syndrome and diet. CONCLUSION: This study concluded that there is a relationship between diet and the development of dyspepsia syndrome.
Developmental and emotional behavioural outcomes after COVID-19 febrile seizures: A single-centre experience.
Ong JJ, Cheng XL, Chok M … +4 more , Hashim J, Choo YX, Gan YZ, Ng DCE
Med J Malaysia · 2026 Jan · PMID 41617503
INTRODUCTION: Children with febrile seizures often experience favourable long-term outcomes. However, the outcomes of COVID-19 febrile seizures remain uncertain. The study investigated the developmental and emotional/beh...
INTRODUCTION: Children with febrile seizures often experience favourable long-term outcomes. However, the outcomes of COVID-19 febrile seizures remain uncertain. The study investigated the developmental and emotional/behavioural outcomes of children with and without COVID-19, presenting with febrile seizures. MATERIALS AND METHODS: Participants were families of children with febrile seizures admitted from January to April 2022, during the peak of COVID-19 Omicron variant infection cases. The children were assessed 9-18 months after the seizure event, using the Schedule of Growing Skills II developmental screening tool and their parents completed the Strengths and Difficulties Questionnaire, a measure of emotional/behavioural outcome. A child with positive COVID-19 is characterised by the presence of respiratory symptoms and a positive COVID-19 rapid antigen test. We compared the outcomes of children with and without COVID- 19 using Fisher's exact test and Mann-Whitney U test. RESULTS: Twenty-two families, with 15 (68.2%) COVID-19 and 7 (31.8%) non-COVID-19 febrile seizures participated in the study. A substantial proportion of children from both groups were delayed in various developmental domains (13.6- 27.3%), with 9 (40.9%) delayed in 2 or more domains and 2 (9.1%) experienced emotional behavioural difficulties. Children with COVID-19 febrile seizures were not more likely to have developmental delay and emotional/behavioural difficulties. CONCLUSIONS: Children with COVID-19 febrile seizures were not at greater risk of developmental delay or emotional/behavioural difficulties. Further longitudinal studies with a larger sample size are warranted.
Factors associated with the practice of home blood pressure monitoring among healthcare providers in public healthcare clinics in Putrajaya.
Mohd Noor NFA, Rashid AA, Saad FS
Med J Malaysia · 2026 Jan · PMID 41617502
INTRODUCTION: Hypertension remains a leading global health concern due to its high prevalence and serious health complications. Nowadays, home blood pressure monitoring (HBPM) has emerged as a valuable non-pharmacologica...
INTRODUCTION: Hypertension remains a leading global health concern due to its high prevalence and serious health complications. Nowadays, home blood pressure monitoring (HBPM) has emerged as a valuable non-pharmacological intervention to control blood pressure (BP). Numerous studies have demonstrated the pattern of HBPM practice among hypertensive patients. However, information on optimal practice of HBPM instruction by the healthcare providers (HCPs) is still lacking. Therefore, the main objective of this study is to assess the prevalence of optimal practice of HBPM instruction methods by the HCPs to their hypertensive patients and factors associated with it. MATERIALS AND METHODS: This is a cross-sectional study, conducted among HCPs with working experience of more than a year, from all four government primary health clinics in Putrajaya between March 2023 and September 2024. The validated Malay-version i-HBPM questionnaire, also known as "the practice of HBPM instruction methods for hypertensive patients" questionnaire was used in this study. RESULTS: A total of 285 HCPs were recruited in this study. The prevalence of optimal practice of HBPM instruction methods by the HCPs to their hypertensive patients was 14.4%. The most frequently reported barriers to HBPM recognition among HCPs were a lack of understanding of HBPM (28.8%), a lack of HBPM guidelines (17.2%) and the high cost of devices (16.5%). From the HCPs' thought and perspective, the top three most significant patient-related barriers were a lack of understanding of HBPM (42.1%), followed by high device cost (33.0%) and low education level (29.5%). Attending HBPM training was the only significant factor associated with the optimal practice of HBPM instruction methods given by HCPs to their patients (adjusted OR 3.48, 95.0% CI 1.29, 9.34, p = 0.013). CONCLUSION: This study demonstrated a low prevalence of optimal practice of HBPM instruction methods provided by HCPs to their hypertensive patients despite high recognition and recommendation of HBPM among HCPs. HBPM training for HCPs is very crucial to improve their knowledge and consultation skills on HBPM.
Evaluating the efficiency of one stop crisis centres in managing domestic violence cases.
Siew KL, Wong SSL, Chew KS … +3 more , Kandasamy V, Bustam A, Abdul Haid MI
Med J Malaysia · 2026 Jan · PMID 41617501
INTRODUCTION: As domestic violence (DV) poses a critical threat to public health worldwide, this prompts the need for efficient and effective intervention. In Malaysia, although One Stop Crisis Centres (OSCCs) have been...
INTRODUCTION: As domestic violence (DV) poses a critical threat to public health worldwide, this prompts the need for efficient and effective intervention. In Malaysia, although One Stop Crisis Centres (OSCCs) have been offering multisectoral services to DV victims for many decades, an evaluation of the efficiency of these centres has yet to be conducted. This study aimed to assess the efficiency and effectiveness of three Malaysian OSCCs using a two-stage Data Envelopment Analysis (DEA) approach. MATERIALS AND METHODS: A total of 153 adult DV victims were recruited from OSCCs in Sarawak General Hospital, Universiti Malaya Medical Centre, and Hospital Universiti Sains Malaysia. The inputs included the number of doctors, nurses, and other personnel whereas the outputs were total response time and service quality, measured via a validated 35-item OSCC-Qual instrument. Stage 1 employed an inputoriented Banker, Charnes, and Cooper (BCC) DEA model to determine how efficiently OSCCs managed resources to minimize response times. Stage 2 used an output-oriented BCC model to evaluate the centre's ability to maximize service quality. RESULTS: The social workers unit recorded notably long mean response times across three centres. Correlation analysis revealed a strong negative association between the number of personnel and the multisectoral coordination dimension of service quality. While most units showed high pure technical efficiency in the input-oriented DEA, scale inefficiencies were shown to be common in all centres. Pure technical efficiency measures how well resources are utilized regardless of scale, whereas scale efficiency assesses whether an organization operates at its optimal size (neither too large nor too small). In the output-oriented model, all centres similarly demonstrated good pure technical efficiency but continued to grapple with scale inefficiencies, especially at Sarawak General Hospital and Hospital Universiti Sains Malaysia. CONCLUSION: These findings highlight the importance of optimizing operational scale in OSCCs. Tailoring resource allocation and strengthening coordination among multidisciplinary teams could reduce response times and improve care for DV victims.
Competency in chest X-ray interpretation: Variations across medical experiences and training levels.
Koa AJ, Cheah WL, Yew TT … +1 more , Ahmad TJ
Med J Malaysia · 2026 Jan · PMID 41617500
INTRODUCTION: Chest X-ray (CXR) remains one of the most commonly used diagnostic imaging tools in clinical practice. However, the accuracy and competency in reading and interpreting CXRs can vary significantly across dif...
INTRODUCTION: Chest X-ray (CXR) remains one of the most commonly used diagnostic imaging tools in clinical practice. However, the accuracy and competency in reading and interpreting CXRs can vary significantly across different levels of medical practitioners, ranging from house officers to senior specialists. The purpose of this study was to assess competency in CXR interpretation among doctors at different stages of their medical careers. MATERIAL AND METHODS: This is a cross-sectional study conducted using CXRs, which were displayed digitally. A total of 305 participants were recruited, including house officers, medical officers, and registrars in specialty training. A standard set of ten radiographs was chosen, and the participants were required to interpret the CXR in multiple-choice format. Data analysis was performed via IBM SPSS Statistics software, version 25. RESULTS: Clinical history improved the ability to accurately interpret CXR, with the percentage of participants who accurately interpreted CXRs increasing from 21% of participants who achieved high scores without clinical history to 63.6% of participants who achieved high scores with clinical history. The participants' field of interest and confidence level when reporting a CXR without history were associated with higher accuracy (p<0.05) when interpreting a CXR. However, when the clinical history was given to the participant, only the confidence level of the participant affected the final score of the CXR. There is no significant difference in the ability of doctors to interpret CXR despite the difference in seniority in practice; moreover, undergraduate exposure does not play a significant role. CONCLUSION: Structured teaching, continuous practice, feedback and integration into clinical decision-making are the keys that translate to greater competency in CXR interpretation. Future researches should emphasize on multicenter approach as it enhances the generalizability of findings to a broader national context.
Artificial intelligence foundation models in healthcare: A Malaysian perspective.
Lee SH, Mohamad I
Med J Malaysia · 2026 Jan · PMID 41617499
One of the most revolutionary breakthroughs in modern artificial intelligence research over the past decade has been the introduction of foundation models - deep learning models trained on extensive datasets that can be...
One of the most revolutionary breakthroughs in modern artificial intelligence research over the past decade has been the introduction of foundation models - deep learning models trained on extensive datasets that can be adapted to tackle a wide range of downstream tasks. The rise of foundation models has significantly accelerated the adoption of AI in healthcare where there is increasing digitalization, enabling the integration of medical imaging, clinical notes, and genomic data to provide a more holistic understanding of patient health and supporting personalized interventions. In this Editorial, we will explore how foundation models are catalysing insights in precision health and offer our perspective of how foundation models can be integrated into the Malaysian healthcare system. In addition, we will also highlight some of the issues concerning governance, ethical, regulatory and policy challenges of implementing these foundation models in the Malaysia.
Precision Medicine for Oral Cancer: Exploiting the miR-34/SATB2 Regulatory Network.
Shazia FJH, Selvaraj J, Vishnu Priya V
Med J Malaysia · 2025 Dec · PMID 41456150
No abstract available.
No abstract available.
Navigating Airway Obstacles: Effective Anesthesia Strategies for Severe Robinson Sequence in a 3 year old.
Kaur H
Med J Malaysia · 2025 Dec · PMID 41456149
Pierre Robin Sequence (PRS) is a congenital condition characterized by micrognathia, glossoptosis, and airway obstruction, often accompanied by a cleft palate. Severe cases pose additional challenges in surgical manageme...
Pierre Robin Sequence (PRS) is a congenital condition characterized by micrognathia, glossoptosis, and airway obstruction, often accompanied by a cleft palate. Severe cases pose additional challenges in surgical management due to anatomical abnormalities. A 3-year-old male with severe PRS underwent a cleft palate repair procedure, which was a multidisciplinary approach, and the successful repair of the cleft palate and uneventful postoperative recovery were attributed to the team's collaborative efforts. This case also highlights the importance of genetic evaluation and testing in managing PRS cases. This case highlights the importance of thorough preoperative assessment, advanced airway management skills, and genetic evaluation for better patient outcomes. Future research should explore innovative techniques and strategies to improve the outcomes of patients with PRS and other complex congenital conditions.
Oxybenzone in Sunscreen: A Comprehensive Ecotoxicological Review.
Abinaya G, Jenifer D, Devi VV … +1 more , Kumaravel K
Med J Malaysia · 2025 Dec · PMID 41456148
INTRODUCTION: Oxybenzone (benzophenone-3) is a widely used organic compound in sunscreens and other personal care products due to its ability to absorb ultraviolet (UV) radiation. It is effective in protecting the skin f...
INTRODUCTION: Oxybenzone (benzophenone-3) is a widely used organic compound in sunscreens and other personal care products due to its ability to absorb ultraviolet (UV) radiation. It is effective in protecting the skin from harmful UV rays, thereby reducing the risk of skin cancer and photoaging. However, increasing concerns have emerged regarding the environmental impact of oxybenzone, particularly in marine ecosystems. MATERIALS AND METHODS: A comprehensive literature search was conducted using databases such as PubMed, Scopus, and Web of Science. Keywords included "oxybenzone," "sunscreen," "ecotoxicology," "marine organisms," and "environmental impact." Studies published from 2000 to 2023 were included to ensure a thorough understanding of the topic. RESULTS: Oxybenzone has been detected in various marine environments, with concentrations ranging from nanograms to micrograms per litre. Oxybenzone has been shown to cause bleaching in corals, impairing their ability to recover from stress. Research indicates that oxybenzone exposure can lead to endocrine disruption in fish, affecting reproductive success and behaviour. Oxybenzone has been found to be toxic to various invertebrates, including mollusks and crustaceans. Sub-lethal effects include impaired growth and development, as well as altered feeding behaviour. The data indicate a clear concentration-response relationship for oxybenzone toxicity across different species. Lower concentrations tend to produce sub-lethal effects, while higher concentrations can lead to mortality. DISCUSSION: The findings of this review highlight the significant ecotoxicological risks posed by oxybenzone in marine environments. The widespread use of oxybenzone in sunscreens, combined with its persistence in aquatic ecosystems, raises concerns about its long-term effects on marine biodiversity. A balanced approach that considers both human health and environmental sustainability is essential for the future of sunscreen formulations.
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