The Medical Journal Of Malaysia[JOURNAL]
Sun
200 papers
The effect of serum eosinophilia and lymphocytosis on functional outcomes of Hirschsprung disease patients after Duhamel procedure.
Kumari D, Afrila H, Putri IF … +7 more , Tohari AI, Harfanie DF, Izzati ZS, Aditama LI, Puspitawati I, Makhmudi A, Gunadi
Med J Malaysia · 2025 Dec · PMID 41451723
INTRODUCTION: Hirschsprung disease (HSCR) is due to the failure of enteric nervous system precursors to colonize the distal intestine in embryonic development, with surgical treatment like the Duhamel procedure as a defi...
INTRODUCTION: Hirschsprung disease (HSCR) is due to the failure of enteric nervous system precursors to colonize the distal intestine in embryonic development, with surgical treatment like the Duhamel procedure as a definitive intervention. However, complications leading to functional disorders may occur, especially with increased eosinophil levels. No studies have assessed the effect of peripheral blood eosinophil and lymphocyte counts on functional outcomes in HSCR patients post-Duhamel procedure. MATERIALS AND METHODS: This observational retrospective study involved 54 patients undergoing Duhamel procedures from January 2014 to June 2020 at Dr. Sardjito Hospital. Patient records were analyzed using the Mann-Whitney U test for continuous variables and the Chi-Square test for categorical variables. RESULTS: The majority of patients had normal eosinophil levels (78.8%) and normal lymphocyte counts (96.2%). Functional outcomes revealed that 49 patients (94.2%) had no voluntary bowel movements (VBM), 45 patients (86.5%) did not experience constipation, and 48 subjects (92.3%) had no soiling issues. There was no significant association was found between eosinophilia and functional outcomes in Hirschsprung disease patients after Duhamel procedure (p > 0.05). Similarly, there was no significant association between lymphocytosis and functional outcomes in these patients following Duhamel procedure (p > 0.05) CONCLUSION: The functional outcomes of patients with Hirschsprung disease post-Duhamel procedure at our institution are favorable with most having normal eosinophil and lymphocyte counts. Eosinophilia and lymphocytosis might not significantly affect the outcomes of Hirschsprung disease patients after undergoing the Duhamel procedure at Dr. Sardjito Hospital.
Wanagama honey modulate macrophage phagocytic activity in mice.
Nugrahaningsih DAA, Pujiarti R, Yuniyanti MM … +1 more , Wijayaningsih RA
Med J Malaysia · 2025 Dec · PMID 41451722
INTRODUCTION: Honey is one of the natural ingredients that have long been used in the community to cure certain diseases and to maintain health. Several studies have shown that honey contains many active ingredients that...
INTRODUCTION: Honey is one of the natural ingredients that have long been used in the community to cure certain diseases and to maintain health. Several studies have shown that honey contains many active ingredients that have pharmacological effects, including immunomodulatory effects. The active compound of honey varies depending on the bee that produces honey and also the food source of the bees. Wanagama honey is honey produced in the forest in Gunung Kidul, Yogyakarta, Indonesia. Despite the use of Wanagama honey to improve immune system, there is no study regarding its immunomodulatory effect. This study aimed to study the immunomodulatory effects of Wanagama forest honey. MATERIALS AND METHODS: Twenty Balb c mice divided into 4 different groups received different treatment which were water (CONTROL), honey 10 mg/kg BW (DOSE 1), honey 25 mg/kg BW (DOSE 2), and honey 50 mg/kg BW (DOSE 3). The immunomodulatory effect evaluation was using the carbon clearance assay. Complete blood count and delta body weight were also measured. RESULTS: Mice in DOSE 3 group showed lowest delta body weight. the complete blood count parameters were not different significantly between groups of treatment. however, the phagocytic index was higher significantly in the groups receiving honey compare to those without honey treatment. CONCLUSION: This study showed the potential of Wanagama honey as immunomodulator.
Anti-inflammatory effect of UC-MSC secretome on diabetic ulcer model rats: Study of Ccl22 and Cxcl12 mRNA expression.
Prambodo AK, Nugrahaningsih DAA, Haryana SM … +5 more , Wirohadidjojo YW, Nuryana T, Susanti VY, Setiawan J, Malueka RG
Med J Malaysia · 2025 Dec · PMID 41451721
INTRODUCTION: Diabetes mellitus is a metabolic disorder which is characterized by chronic hyperglycemia condition and this condition can cause some complications such as diabetic ulcers. Secretome from UC-MSC is an alter...
INTRODUCTION: Diabetes mellitus is a metabolic disorder which is characterized by chronic hyperglycemia condition and this condition can cause some complications such as diabetic ulcers. Secretome from UC-MSC is an alternative treatment that being developed for accelerating wound healing of diabetic ulcers. The aim of this research is to study the effect of UC-MSC secretome for wound healing of diabetic ulcers in Nicotinamide-Streptozotocin (NA-STZ) induced Wistar rats and the mechanism through mRNA CCL22 and CXCL12 expression study. MATERIALS AND METHODS: Fifteen male Wistar rats were divided into the diabetes group and the normal group. The diabetes group consists of the diabetes control group given by 0.02 ml MEM-α, the secretome group 0.004 ml, the secretome group 0.02 ml, and the secretome group 0.4 ml, and the normal group. Wounds are created on the back of the hyperglycemia rats and given the treatment intradermally. Wounded skin was collected for RNA extraction. RNA total yield used for cDNA synthesis. cDNA used as a template for Polymerase Chain Reaction (PCR) and using Agarose electrophoresis to view mRNA CCL22 and CXCL12 expression. Gene expression was normalized using mRNA GAPDH. Online software Targetscan and miRTarbase are used for selection of miRNA which have potentially targeted CCL22 and CXCL12 mRNA. RESULTS: NA-STZ affect increasing blood glucose. Injection of 0.02 ml UC-MSC secretome showed a better impact on wound healing than the diabetes control group. Lower expression of mRNA CCL22 and CXCL12 showed in male Wistar rats induced NA-STZ with UC-MSC secretome treatments. CONCLUSION: UC-MSC secretomes have potential therapy as anti-ulcer on hyperglycemia male Wistar rats induced NASTZ with probability via hsa-23a-3p in nuclear factor-kappa β (NF-κβ) pathway via inflammation mechanism.
Patient's outcome after definitive surgery using krickenbeck continence score in anorectal malformation.
Wahid TOR, Herzoni MI, Ibrahim I
Med J Malaysia · 2025 Dec · PMID 41451720
INTRODUCTION: Anorectal malformations (ARM) are a common type of congenital anomaly seen in pediatric surgery, with an approximate incidence ranging from 1 in 2,000 to 5,000 live births. The main aim of neonatal care in...
INTRODUCTION: Anorectal malformations (ARM) are a common type of congenital anomaly seen in pediatric surgery, with an approximate incidence ranging from 1 in 2,000 to 5,000 live births. The main aim of neonatal care in patients with ARM is to ensure that patients achieve optimal functionality after definitive surgery. The Krickenbeck continence score is used to assess the outcomes of ARM patients. So, this study aimed to evaluate patient outcomes after definitive surgery in Arifin Achmad General Hospital. MATERIALS AND METHODS: This was a cross-sectional retrospective study utilizing electronic medical records of patients with ARM who had undergone a definitive surgery procedure at Arifin Achmad General Hospital, Indonesia, from 2019 to 2022. RESULTS: In this study, twenty-six patients with ARM were identified, including 12 males and 14 females. Approximately 76.9% of the patients had normal birth weight. The study found that 61.5% of the patients had ARM without fistula, 15.4% had ARM with rectourethral and perineal fistula, 3.8% had ARM with vestibular fistula, and 3.8% had ARM with cloaca. According to the Krickenbeck continence score, 61.5% of the patients achieved Voluntary Bowel Movement (VBM), while 11.5% experienced soiling and 7.7% experienced constipation. It was observed that normal birth weight patients had finer VBM compared to those with low birth weight (P <0.001), and male patients had finer VBM than females (P = 0.005). CONCLUSION: The results of ARM patients for functional outcomes at our hospital are generally positive. More than half of the children exhibit voluntary bowel movements (VBM), and only a little experience soiling and constipation. The number of VBM may be linked to the child's birth weight and gender.
Alterations in intestinal microbiota composition in children with Hhirschsprung disease: A comparative study with healthy controls.
Makkadafi M, Warsinggih W, As'ad S … +4 more , Ahmadwirawan A, Mariana N, Massi MN, Purnomo E
Med J Malaysia · 2025 Dec · PMID 41451719
INTRODUCTION: Hirschsprung disease (HSCR) is a congenital condition characterized by the absence of ganglion cells in the distal colon, resulting in bowel obstruction and motility disorders. Recent studies have highlight...
INTRODUCTION: Hirschsprung disease (HSCR) is a congenital condition characterized by the absence of ganglion cells in the distal colon, resulting in bowel obstruction and motility disorders. Recent studies have highlighted the role of intestinal microbiota in intestinal health and disease, yet its specific alterations in HSCR patients remain unclear. This study aimed to investigate the intestinal microbiota profile of children with HSCR and compare it with healthy controls to identify potential microbial signatures associated with the disease. MATERIALS AND METHODS: This comparative cross-sectional study analyzed fecal samples from 7 preoperative HSCR patients and 3 healthy controls using 16S rRNA gene sequencing. Inclusion criteria required no antibiotic use within the previous two weeks. Clinical data, including nutritional status, medication history, bowel management methods, and history of HAEC, were recorded. Microbiota composition was compared at the phylum and family levels. RESULTS: HSCR patients exhibited significantly higher relative abundance of Enterobacteriaceae (mean 0.2582) compared to healthy controls (mean 0.0236), representing an approximately eleven-fold increase. HSCR patients also showed decreased proportions of Firmicutes, Actinobacteria, Bacilli, and Clostridia, while Bacteroidales were increased. Classification of taxa revealed a reduction in beneficial bacteria (e.g., Lactobacillus, Bifidobacterium) and enrichment of potentially pathogenic taxa (e.g., Escherichia-Shigella). CONCLUSION: HSCR patients demonstrate a distinct dysbiotic microbiota profile, with reduced beneficial taxa and elevated Enterobacteriaceae levels. These findings highlight potential microbiota-targeted strategies for clinical management of HSCR.
Duodenojejunostomy versus Duodenoduodenostomy in Congenital Duodenal Obstruction: A retrospective study.
Diposarosa R, Iskandar D, Oktaviani P
Med J Malaysia · 2025 Dec · PMID 41451718
INTRODUCTION: Congenital duodenal obstruction (CDO) is a common cause of neonatal intestinal obstruction, most requiring surgery to restore bowel continuity. Duodenoduodenostomy (DD) is the preferred procedure, but duode...
INTRODUCTION: Congenital duodenal obstruction (CDO) is a common cause of neonatal intestinal obstruction, most requiring surgery to restore bowel continuity. Duodenoduodenostomy (DD) is the preferred procedure, but duodenojejunostomy (DJ) may be performed when DD is not feasible due to anatomy, particularly in small or premature infants. In our centre, choice of procedure was based on intraoperative findings, tension-free anastomosis feasibility, and surgeon preference. This study compared short-term outcomes of DJ and DD in CDO. MATERIALS AND METHODS: This is a retrospective study with a cross-sectional about outcome of congenital duodenal obstruction at Hasan Sadikin Bandung General Hospital in 2019-2024. Data were collected through medical records, including gestational age, age at surgery, surgical technique, operation time, time to first feed, time to full feed, length of stay, and mortality. RESULTS: There were a total of 36 congenital duodenal obstruction patients. There were 4 patients (11%) who died before surgery, and 32 patients (89%) underwent surgery. All procedures were performed open surgery. Duodenojejunostomy was performed in 10 patients (31%), duodenoduodenostomy in 22 patients (69%). Time to first feed (mean) is post operative day 8 vs 9 (P = 0.3), time to full feed (mean) post operative day 27.1 vs 25.4 (p=0.8) and length of stay (mean) 27.6 days vs 34.6 days (p=0.9). Three patient of each group died post operative due to sepsis. CONCLUSION: Duodenojejunostomy and duodenoduodenostomy have similar outcomes in neonates with congenital duodenal obstruction. These findings are relevant for surgeons who repair congenital duodenal obstruction with duodenojejunostomy or duodenoduodenostomy in open surgery.
Comparative outcomes of single incision laparoscopy versus conventional laparoscopy in paediatric population: a meta analysis.
Purnomo E, Pambudi BS, Nabilah AN
Med J Malaysia · 2025 Dec · PMID 41451717
INTRODUCTION: Single-incision laparoscopic surgery (SILS) and conventional laparoscopic surgery (CLS) are minimally invasive surgical techniques that are widely used as the treatment of appendicitis. While both technique...
INTRODUCTION: Single-incision laparoscopic surgery (SILS) and conventional laparoscopic surgery (CLS) are minimally invasive surgical techniques that are widely used as the treatment of appendicitis. While both techniques have demonstrated several advantages over laparotomy, such as reduced postoperative pain and faster recovery, SILS is hypothesized to further enhance clinical outcomes due to its less invasive approach. Hence, systematic comparisons of SILS and CLS are necessary to delineate the most efficient surgery for pediatric surgeons. This study aimed to compare postoperative outcomes between SILS and CLS in pediatric appendicitis, specifically focusing on complication rates, length of hospital stay (LOS), and duration of surgery. MATERIALS AND METHODS: A comprehensive search of four databases (PubMed, ProQuest, Scopus, and ScienceDirect) was conducted in October 2024 to identify the eligible studies. Meta-analysis was performed using Comprehensive Meta-Analysis software, applying a random-effects model to calculate pooled effect sizes. Heterogeneity was evaluated using the I² and Q statistics to assess consistency across studies. RESULTS: Six studies, encompassing a total of 838 children who underwent laparoscopic appendectomy, were included. The pooled analysis showed no statistically significant difference in complication rates between SILS and CLS (OR: 1.421, 95% Confidence Interval: 0.609-3.314, p=0.416), nor in length of hospital stay (SMD: -0.003, 95% Confidence Interval: -0.252-0.247, p=0.983). CONCLUSION: Both SILS and CLS demonstrate favorable outcomes for pediatric appendicitis surgery, with minimal differences in complication rates and recovery times. These findings suggest that both techniques were feasible choices, allowing for flexibility in choosing the surgical approach based on patient-specific factors and surgical expertise.
Cytomegalovirus infection impact on cholangitis in patients with biliary atresia following the Kasai procedure.
Yudhananto BA, Munandhar MA, Nurhidayah SS … +7 more , Purwosatrio PG, Megasakti B, Maisaroh S, Tonda KC, Adhityo P, Purnomo E, Gunadi
Med J Malaysia · 2025 Dec · PMID 41451716
INTRODUCTION: Biliary atresia (BA) is a congenital anomaly often found in neonates, with an incidence reaching 1:5500 per birth. BA is frequently associated with cytomegalovirus (CMV) infection in the patient, which caus...
INTRODUCTION: Biliary atresia (BA) is a congenital anomaly often found in neonates, with an incidence reaching 1:5500 per birth. BA is frequently associated with cytomegalovirus (CMV) infection in the patient, which causes a clinical appearance different from other types of BA. BA is usually treated by Kasai procedure, with cholangitis being the most common complication of this procedure. CMV infection is found to affect post-operative survival and bilirubin levels. However, it remains unclear whether the infection may affect the incidence of cholangitis in BA patients post-Kasai procedure. MATERIALS AND METHODS: This retrospective study used the medical records of 33 BA patients who underwent the Kasai procedure in Dr. Sardjito Hospital between 2017 and 2021. RESULTS: Among 33 patients, 17 (51.5%) were infected with CMV, and 12 (36.4%) developed cholangitis. The frequency of cholangitis following the Kasai procedure is not significantly influenced by the CMV infection (p=0.615). Interestingly, the incidence of cholangitis is significantly associated with the pre-operative gamma-glutamyl transferase (GGT) levels (p=0.026). Furthermore, preoperative ALP appears to have a protective effect against cholangitis, with these associations nearly reaching a significant level (p=0.093). CONCLUSION: CMV infection is unlikely to impact the incidence of cholangitis after the Kasai procedure in BA patients. Notably, the pre-operative GGT level might affect the incidence of cholangitis following the Kasai procedure, thereby increasing their risk.
Association between low cardiometabolic indexes and diastolic dysfunction in T2DM patients with HFpEF.
Susanti VY, Adhikara IM, Nugroho DB … +3 more , Sattwika PD, Anggraeni VY, Widyaningsih A
Med J Malaysia · 2025 Dec · PMID 41451715
INTRODUCTION: Dyslipidemia in metabolic syndrome characterized by low cardiometabolic indexes (TG/FBG, TG/HDL-C, and LDL-C/HDL-C) pose inherent risks for the development of diabetic cardiomyopathy. The tangible associati...
INTRODUCTION: Dyslipidemia in metabolic syndrome characterized by low cardiometabolic indexes (TG/FBG, TG/HDL-C, and LDL-C/HDL-C) pose inherent risks for the development of diabetic cardiomyopathy. The tangible association between type 2 diabetes mellitus (T2DM) and Heart Failure with Preserved Ejection Fraction (HFpEF) initiated by diastolic dysfunction also has been widely studied. However, whether cardiometabolic indexes may be independently associated with left ventricular (LV) diastolic dysfunction in T2DM patients with HFpEF remained elusive. The aim of this study is to investigate the association between cardiometabolic indexes (TG/FBG, TG/HDL-C, and LDL-C/HDL-C) and diastolic dysfunction in T2DM patients with HFpEF. MATERIALS AND METHODS: In this cross-sectional study, we analyzed electronic medical records from October 2021 to January 2022 from Dr. Sardjito Hospital. A total of 55 T2DM patients with clinical HFpEF were enrolled. Baseline characteristics, clinical and laboratory variables, medication, and echocardiography data were obtained. Cardiometabolic indexes are presented as numeric data (median with IQR). Meanwhile, the diastolic function is presented as categorical data based on the echocardiographic parameters. Mann-Whitney analysis was performed. P-value <0.05 represent significant associations. RESULTS: In a cohort of 55 T2DM patients with HFpEF, subjects with diastolic dysfunction demonstrated significantly lower median values for TG/FBG (p=0.015), TG/HDL-C (p=0.003), and LDL-C/HDL-C (p=0.044) compared to those with normal diastolic function. These findings suggest a potential, albeit paradoxical, link between these cardiometabolic markers and impaired ventricular relaxation in this population. CONCLUSION: TG/FBG, TG/HDL-C, and LDL-C/HDL-C were significantly associated with diastolic dysfunction. Optimal dyslipidemia control represented by high TG/FBG, TG/HDLC, and LDL-C/HDL-C may become an appealing approach to prevent HFpEF progression in T2DM patients.
Prognostic factors for five-year survival in children with biliary atresia after the Kasai procedure.
Nugraheni DU, Sandewa AT, Dennis … +7 more , Adhityo P, Gani R, Purwosatrio PG, Maharani M, Puspitawati I, Makhmudi A, Gunadi
Med J Malaysia · 2025 Dec · PMID 41451714
INTRODUCTION: Biliary atresia (BA) is an idiopathic disease characterized by progressive fibro-obliteration of extra- and intrahepatic biliary ducts manifesting jaundice >2 weeks. The primary treatment for BA is the Kasa...
INTRODUCTION: Biliary atresia (BA) is an idiopathic disease characterized by progressive fibro-obliteration of extra- and intrahepatic biliary ducts manifesting jaundice >2 weeks. The primary treatment for BA is the Kasai procedure. However, patient survival in BA is influenced by several prognostic factors. We aimed to identify the prognostic factors for 5-year survival of BA patients following the Kasai procedure at Dr. Sardjito Hospital, Yogyakarta, Indonesia. MATERIALS AND METHODS: This observational analytic study employed a retrospective cohort design, included BA patients who underwent Kasai procedures at our hospital between January 2012 and December 2018. RESULTS: There was no association between age at surgery (p=0.408), TB7 (p=0.973), operator experience (p=0.649), AST0 (p=0.973), AST7 (p=1), the AST7/AST0 ratio (p=0.682), ALT0 (p=0.682), ALT7 (p=0.697), and the ALT7/ALT0 ratio (p=1) with 5-year survival in BA patients after Kasai procedure. A log-rank analysis showed no significant results: age at surgery (p=0.264), TB7 (p=0.961), operator experience (p=0.479), AST0 (p=0.993), AST7 (p=0.931), AST7/AST0 ratio (p=0.562), ALT0 (p=0.708), ALT7 (p=0.640), and ALT7/ALT0 ratio (p=0.963). CONCLUSION: The timing of surgery, total bilirubin levels at 7 days post-surgery, surgeon experience, and both pre-and post-operative AST and ALT may not predict 5-year survival outcomes in BA patients following Kasai surgery. Further extensive cohort studies are necessary to confirm these preliminary findings.
Unlocking the potential of augmented reality (AR) in education: Insights from a systematic review of AR-enhanced instructional approaches.
Anuar WMFF, Mokmin NAM, Mohamad Asri SF … +2 more , Abu Bakar YI, Alias AH
Med J Malaysia · 2025 Dec · PMID 41447009
INTRODUCTION: This review explores instructional approaches for AR-enhanced learning to improve student motivation, engagement, and learning outcomes. With AR technology gaining momentum, educators aim to implement best...
INTRODUCTION: This review explores instructional approaches for AR-enhanced learning to improve student motivation, engagement, and learning outcomes. With AR technology gaining momentum, educators aim to implement best practices that leverage its benefits in diverse subject areas. MATERIALS AND METHODS: Using a systematic review approach and following PRISMA guidelines, this study analyzed 26 peer-reviewed articles published from 2014 to 2024. RESULTS: Findings were grouped around three central themes: AR's impact on learning and motivation, instructional approaches that support AR integration, and barriers to AR adoption in educational contexts. The analysis suggests that inquiry-based and collaborative approaches with AR improve student engagement, understanding, and academic performance. These results underscore the need for thoughtfully designed AR activities that provide a balance between student autonomy and guided instruction to avoid cognitive overload. However, challenges like accessibility, inclusivity, and limited resources remain obstacles to broader implementation, especially in under-resourced areas. CONCLUSION: Future research should concentrate on developing standardized frameworks for AR in education, improving inclusivity, and assessing AR's long-term impact on learning outcomes across various educational settings.
Interrupted sitting at work can alter postprandial glucose, triglycerides and non-esterified fatty acids (NEFA).
Mat Azmi ISM
Med J Malaysia · 2025 Dec · PMID 41447008
INTRODUCTION: Prolonged sitting at work is a major health issue as sedentary behaviour has been linked to cardiometabolic risks. Workplace interventions have trialled intermittent interruption to sitting throughout the w...
INTRODUCTION: Prolonged sitting at work is a major health issue as sedentary behaviour has been linked to cardiometabolic risks. Workplace interventions have trialled intermittent interruption to sitting throughout the working day to mitigate effects on employees' health. This study tested effects of the intensity of the interruptions to sitting on postprandial glucose, triglycerides and NEFA in a laboratory setting. MATERIALS AND METHODS: Overweight and obese adults (n=24) were recruited for a randomised cross over trial comparing, 1) uninterrupted sitting, 2) sitting interrupted by light intensity walking at 3 km.hr-1, and 3) vigorous intensity stair climbing at 60 steps.min-1. The interruptions to sitting were performed for two-minute bouts every 20 minutes following a meal. The moderate fat meal was provided two hours after the trial started and blood samples were collected each hour throughout the seven-hour sessions. RESULTS: There was a lower postprandial peak in plasma glucose and attenuation of the NEFA reductions for stair climbing compared to uninterrupted sitting. In contrast, triglycerides were reduced postprandially following light intensity walking compared to uninterrupted sitting. CONCLUSION: Interrupted sitting with higher intensity demonstrates greater improvements postprandially.
Development and validation of a group counselling resilience module intervention (GC-ReMI) among breast cancer patients.
Hashim NSF, Mat Nor MZ, Tengku Din TADA … +2 more , Yusoff MSB, Yaacob NM
Med J Malaysia · 2025 Dec · PMID 41447007
INTRODUCTION: Resilience is crucial for breast cancer patients. It can enhance mental health and treatment outcomes. Group counselling intervention supports these patients by fostering their inner strength and helping th...
INTRODUCTION: Resilience is crucial for breast cancer patients. It can enhance mental health and treatment outcomes. Group counselling intervention supports these patients by fostering their inner strength and helping them cope with the psychological impacts of their diagnosis and treatment. This intervention has improved their quality of life. MATERIALS AND METHODS: This study used a mixed design. It was conducted in two stages: i) Phase I: literature search, interviews, and focus group discussions (FGDs); ii) Phase II: module development, content, and face validation for the Group Counselling Resilience Module Intervention (GCReMI). Interviews and FGDs were used to gather information from patients and healthcare workers. Ten independent experts assessed the content validity, while ten counsellors and breast cancer patients evaluated the face validity. RESULTS: Twenty-three participants took part in the interviews and FGDs. Data saturation was reached at the third FGD and the fourteenth in-depth interview. Two themes emerged from the qualitative analysis and were integrated into the module. The final GC-ReMI module included nine subthemes. The content validity index (CVI) was 0.84, and the face validity index (FVI) was 1.0 for counsellors and 0.97 for breast cancer patients, all of which meet satisfactory levels. CONCLUSION: The GC-ReMI module has satisfactory and acceptable content and face validity, suggesting its potential as a valuable psychoeducational tool for enhancing resilience among breast cancer patients.
The effects of quercetin on lipid profile, inflammatory biomarkers and ACE2 in a dyslipidaemic rabbit model.
Abdullah N, Liba AN, Hambali KA … +5 more , Nordin ML, Ibrahim NI, Harafinova HS, Azzubaidi MSA, Siti HN
Med J Malaysia · 2025 Dec · PMID 41447006
INTRODUCTION: Dyslipidaemia is a major cardiovascular risk factor associated with elevated low-density lipoprotein (LDL) cholesterol and triglyceride levels. While statins are the primary treatment, inflammation remains...
INTRODUCTION: Dyslipidaemia is a major cardiovascular risk factor associated with elevated low-density lipoprotein (LDL) cholesterol and triglyceride levels. While statins are the primary treatment, inflammation remains a significant predictor of cardiovascular events, highlighting the need for adjunctive therapies targeting both lipids and inflammation. Quercetin, a flavonoid with antioxidant and antiinflammatory effects, has shown promise in preclinical models, although clinical results are mixed. This study investigates the effects of quercetin on lipid profiles, inflammatory biomarkers (bradykinin, C-reactive protein [CRP], interleukin-6 [IL-6]) and angiotensin-converting enzyme 2 (ACE2) levels in a rabbit model of dyslipidaemia, exploring its potential as an adjunctive therapy for dyslipidaemia. MATERIALS AND METHODS: Twenty male New Zealand White rabbits were randomly assigned to four groups (n=4): control, high-fat diet (HFD), HFD with quercetin (20 mg/kg/day), and HFD with atorvastatin (0.43 mg/kg/day, positive control). Rabbits received either a standard or HFD (1.2% cholesterol, 10% coconut oil) alone or HFD with quercetin or atorvastatin co-administered orally for 12 weeks. Blood samples were collected pre- and posttreatment for serum analysis. Body weight was measured weekly, and serum lipid profiles (total cholesterol, triglycerides, high-density lipoprotein [HDL], and LDL) were measured post-treatment. Serum levels of bradykinin, IL-6, CRP, and ACE2 pre- and post-treatment were quantified using enzyme-linked immunosorbent assay. RESULTS: The HFD significantly increased body weight, total cholesterol, triglycerides, and LDL cholesterol in rabbits, while atorvastatin and quercetin co-treatments effectively reduced total and LDL cholesterol levels (p < 0.05) but had no impact on body weight. Neither HFD nor treatments significantly altered HDL cholesterol, bradykinin, IL-6, CRP, or ACE2 levels after 12 weeks. Changes in these inflammatory and enzymatic markers from pre-treatment to post-treatment were also not significant across groups. CONCLUSION: Quercetin demonstrated lipid-lowering effects, particularly on total and LDL cholesterol, in a rabbit model of dyslipidaemia. However, it did not significantly affect systemic inflammatory or enzymatic markers. These findings suggest potential lipid-lowering effects independent of inflammation. While quercetin was not superior to atorvastatin, it shows promise as a natural adjunct or alternative therapy.
Comparing the risk of adverse effects of intrapartum and postpartum versus antepartum preeclampsia/eclampsia among women admitted at federal teaching hospital, Birnin Kebbi, northwest Nigeria.
Atamamen TF, Naing NN, Oyetunji JA … +2 more , Wan-Arfah N, Zakaria AR
Med J Malaysia · 2025 Dec · PMID 41447005
INTRODUCTION: Preeclampsia is a multi-organ system disorder that is responsible for a significant rate of maternal and perinatal morbidity and mortality worldwide. Though many studies have worked on the risk factors, the...
INTRODUCTION: Preeclampsia is a multi-organ system disorder that is responsible for a significant rate of maternal and perinatal morbidity and mortality worldwide. Though many studies have worked on the risk factors, there is a limited study on the adverse maternal outcomes highlighting the comparison between antepartum preeclampsia/eclampsia (APE/E), intrapartum preeclampsia/eclampsia (IPE/E) and postpartum preeclampsia/eclampsia (PPE). MATERIALS AND METHODS: A retrospective cohort study was conducted by reviewing records of gestational induced hypertension patients who progressed to having preeclampsia/eclampsia at admitted at the Federal Teaching Hospital, Birnin Kebbi, between January 2009 and December 2019. RESULTS: The multinomial logistic final model identified six maternal adverse outcomes of preeclampsia/eclampsia: stillbirth, (ARR 0.86 and 0.31, respectively), preterm delivery (ARR 8.55 and 3.10, respectively), induction of labour (ARR 0.39 and 0.36, respectively), maternal death (ARR 12.28 and 8.75, respectively), low birth weight (ARR 0.09 and 0.11, respectively) and convulsion (ARR 8.17 and 8.22, respectively). CONCLUSION: These study findings offer valuable insights into the adverse maternal outcomes of preeclampsia and eclampsia within the Nigerian context. It serves as a potential research project that can be applied to the clinical setting to help clinicians manage preeclamptic and eclamptic patients better.
The effects of transcranial direct current stimulation on serum superoxide dismutase levels in ambulatory ischaemic stroke patients: A randomised pilot study.
Umar AM, Raj NB, Sharifudin MA
Med J Malaysia · 2025 Dec · PMID 41447004
INTRODUCTION: Stroke is one of the leading causes of disability worldwide, imposing a significant public health and economic burden. Oxidative stress, which results from an imbalance between free radical production and a...
INTRODUCTION: Stroke is one of the leading causes of disability worldwide, imposing a significant public health and economic burden. Oxidative stress, which results from an imbalance between free radical production and antioxidant defences, exacerbates stroke outcomes via its role in promoting neuroinflammation and tissue damage. Superoxide dismutase (SOD), a critical antioxidant enzyme, plays a key role in mitigating oxidative stress. This study evaluates the effect of transcranial direct current stimulation (tDCS) on serum SOD levels in ambulatory ischaemic stroke patients with mild cognitive impairment. MATERIALS AND METHODS: In this randomized pilot study, 30 ischaemic stroke survivors (aged 20-65 years) were divided into two groups: control intervention physiotherapy (CIP, n=15) and tDCS combined with CIP (tDCS+CIP, n=15). Each group underwent 30-minute sessions, three times weekly, over four weeks. Serum SOD levels were measured pre- and post-intervention using SOD Activity Assay Kit. Paired t-test was used to evaluate within-group changes, and independent t-test assessed between-group differences and the influence of stroke risk factors such as body mass index and blood pressure. RESULTS: The tDCS+CIP group exhibited a significant increase in serum SOD levels post-intervention (289.02±64.94 U/L from 215.58±53.65 U/L, p=0.001), compared to the CIP group (216.67±45.02 U/L from 198.04±40.74 U/L, p=0.001). No significant association was observed between serum SOD levels and the studied risk factors. CONCLUSION: tDCS combined with conventional therapy significantly improves serum SOD levels, suggesting its potential as an adjunctive treatment for reducing oxidative stress in stroke rehabilitation. Further studies with larger sample sizes and extended follow-up are recommended to validate these findings and explore long-term benefits.
Antiproliferative activity of Neolamarckia cadamba (kelempayan) leaves methanol extract on human glioblastoma (U-87 MG) cells.
Muhamad N, Ab Hamid NS, Mamat N … +2 more , Badya N, Mohd Sairazi NS
Med J Malaysia · 2025 Dec · PMID 41447003
INTRODUCTION: Glioblastoma is a malignant brain tumor with a poor prognosis and high fatality rates. Current chemotherapy, primarily with temozolomide (TMZ), is limited by resistance and toxic side effects, underscoring...
INTRODUCTION: Glioblastoma is a malignant brain tumor with a poor prognosis and high fatality rates. Current chemotherapy, primarily with temozolomide (TMZ), is limited by resistance and toxic side effects, underscoring the need for alternative treatments. This study investigates the antiproliferative properties of Neolamarckia cadamba (NC) leaves methanol extract on glioblastoma (U-87 MG) cells as a potential alternative treatment. MATERIALS AND METHODS: NC leaves were collected, dried, and extracted using methanol via maceration. Phytochemical screening identified active compounds, including phenolics, flavonoids and tannins. U-87 MG cells were cultured in Dulbecco's Modified Eagle's Medium (DMEM) supplemented with 10% foetal bovine serum and 1% Penicillin- Streptomycin. The cells were treated with serial dilutions of NC extract and TMZ as a positive control for 24, 48 and 72 hours. Cytoselective of NC extract is conducted on noncancerous (Vero) cells. Cytotoxicity was assessed using the MTT assay, with IC50 values determined from doseresponse curves. Apoptotic induction was evaluated using Acridine Orange/Propidium Iodide (AO/PI) staining under a fluorescent microscope. RESULTS: Phytochemical screening of NC leaves extract revealed active compounds such as phenolics, flavonoids, tannins and saponins. The MTT assay demonstrated doseand time-dependent cytotoxicity of NC extract, with IC50 values of 198.7 µg/mL (24 hours), 321.4 µg/mL (48 hours), and 126.3 µg/mL (72 hours). NC extract also shows cytoselective on Vero cells with an IC50 value of more than 100 µg/mL for all timeframes. AO/PI staining confirmed apoptosis induction of the NC extract on U-87 MG cells. CONCLUSION: NC extract exhibited low potential as an alternative therapeutic agent for glioblastoma by inducing early apoptosis on U-87 MG cells.
A randomised controlled study on the synergistic effects of neuroplasticity-based interventions for trunk control in post-stroke rehabilitation.
Umar AM, Sharifudin MA, Raj NB
Med J Malaysia · 2025 Dec · PMID 41447002
INTRODUCTION: Trunk impairment after a stroke is a common complication in hemiplegic patients. Neuroplasticity-driven interventions, such as trunk rehabilitation exercises (TRE) and transcranial direct current stimulatio...
INTRODUCTION: Trunk impairment after a stroke is a common complication in hemiplegic patients. Neuroplasticity-driven interventions, such as trunk rehabilitation exercises (TRE) and transcranial direct current stimulation (tDCS), have shown potential to enhance trunk control, balance, and mobility. This study evaluates the individual and combined effects of TRE and tDCS on trunk function and mobility in post-stroke rehabilitation. MATERIALS AND METHODS: A randomised controlled study was conducted among post-ischaemic stroke survivors from a single medical institution. Participants (aged 24-85 years) with first-ever stroke of at least six months' duration, without a history of drug abuse or antidepressant use, with wellcontrolled comorbidities, and able to stand with minimal support were included. Exclusion criteria included recurrent stroke, fractures, amputations, or other neurological conditions affecting balance. Participants were randomly assigned to four groups: (1) control, (2) TRE, (3) tDCS, and (4) combined intervention (CI). Effectiveness was evaluated using the Trunk Impairment Scale, Postural Assessment Stroke Scale, and Rivermead Mobility Index, measured at baseline and after 8 weeks. RESULTS: Sixty-nine participants were enrolled and randomly assigned to four groups: control (n=18), TRE (n=17), tDCS (n=17), and CI (n=17). Although no statistically significant differences were observed across groups, the combined intervention group demonstrated higher improvement in Trunk Impairment Scale, Postural Assessment Stroke Scale, and Rivermead Mobility Index scores compared to single interventions or control. CONCLUSION: The combination of TRE and tDCS may be a promising approach to enhance trunk control and mobility in post-stroke patients. Further research with larger sample sizes is recommended to confirm these findings.
Psychometric evaluation of the Malay Health Belief Model for COVID-19 booster dose vaccination intention scale among Malaysians.
Husin NE, Rohim RAA, Yahaya R … +6 more , Yusoff HM, Jusoh AFW, Him NASN, Ibrahim MS, Mohamed NAN, Aniza AA
Med J Malaysia · 2025 Dec · PMID 41447001
INTRODUCTION: The COVID-19 pandemic has highlighted the importance of vaccination, with booster doses now integral to public health strategies. However, there is a lack of validated tools to assess vaccine intention for...
INTRODUCTION: The COVID-19 pandemic has highlighted the importance of vaccination, with booster doses now integral to public health strategies. However, there is a lack of validated tools to assess vaccine intention for booster doses, despite the Health Belief Model (HBM) being widely used for primary doses. This study aims to address this gap by validating a Malay version of the HBM-based COVID-19 booster dose vaccine intention scale to measure factors influencing booster vaccination decisions in Malaysia. MATERIALS AND METHODS: The study was conducted in three phases. Phase 1 involved translation, content, and face validity. The translation process employed a forwardbackward method, utilising two bilingual translators and an independent back-translator. Content validity was assessed by five experts from psychology, public health, and medicine, and face validity was evaluated through a pre-test with 40 laypersons. Phase 2 used Exploratory Factor Analysis (EFA) with 160 participants to identify the tool's underlying factor structure. Phase 3 employed Confirmatory Factor Analysis (CFA) with 556 participants to assess construct validity and reliability. Internal consistency was measured using Cronbach's alpha and Composite Reliability (CR). Participants aged 18 and above were recruited via online platforms, with eligibility determined by receipt of primary doses of the COVID-19 vaccine. RESULTS: The translation process resulted in a 16-item Malay COVID-19 HBM-Booster Dose Intention Scale (HBM-BDIS). Phase 1 confirmed content and face validity, with the Content Validity Index (CVI) for all items exceeding 3.0, and a satisfactory Face Validity Index (FVI). EFA in Phase 2 revealed a clear factor structure with factor loadings meeting the 0.33 threshold, and internal consistency was confirmed with Cronbach's alpha of 0.82. CFA in Phase 3 confirmed the scale's construct validity, with improved fit indices after revision (CFI = 0.926, TLI = 0.909, RMSEA = 0.084). The final model showed strong internal consistency, with CR values above 0.80 for all factors. CONCLUSION: The 16-item Malay COVID-19 HBM-BDIS is a valid and reliable measure for assessing COVID-19 booster dose vaccination intention in Malaysia, providing a solid foundation for future research and public health interventions.
Factors influencing mammogram uptake among women attending primary care clinics in Terengganu, Malaysia.
Daud N, Mat Hassan N, Juhari SN … +4 more , Idris NA, Yusof NA, Yunus NI, Yusoff HM
Med J Malaysia · 2025 Dec · PMID 41447000
INTRODUCTION: Breast cancer ranks as the most common cancer among women in Malaysia with its incidence rate steadily rising over the years. Mammograms are crucial for early detection, yet their usage remains low in Malay...
INTRODUCTION: Breast cancer ranks as the most common cancer among women in Malaysia with its incidence rate steadily rising over the years. Mammograms are crucial for early detection, yet their usage remains low in Malaysia, especially in Terengganu where the services are scarce. This study seeks to explore the factors influencing mammogram uptake among women visiting public primary care clinics in Terengganu. MATERIALS AND METHODS: A cross-sectional study was conducted at six public primary care clinics in Terengganu, selected using cluster random sampling from both urban and rural areas. A total of 739 women participated, of whom 231 met the eligibility criteria for mammogram screening according to Ministry of Health guidelines. A validated questionnaire was utilized to gather information on sociodemographic factors, knowledge and attitudes towards breast cancer and screening behaviours. Both univariable and multivariable logistic regression analyses were conducted to examine the relationships between independent variables and mammogram uptake. RESULTS: Only 16.5% of the eligible participants reported having undergone a mammogram at some point. The multivariable analysis indicated that age and education level significantly predicted mammogram uptake. Women with higher education levels exhibited 2.6 times greater odds (95% CI: 1.22, 5.43) of having undergone mammography, and each additional year of age increased the probability of screening by 7% (aOR: 1.07, 95% CI: 1.01, 1.13). CONCLUSION: The uptake of mammograms among women in Terengganu is alarmingly low and mirrors national trends. Women who possess higher education and are older were more likely to participate in mammography, proving the critical role of health literacy in screening behaviour. Addressing access and awareness are vital challenges in areas where mammogram services are limited. Implementing targeted educational initiatives and enhancing healthcare access, particularly in rural settings is crucial for improving breast cancer screening rates.
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