The Medical Journal Of Malaysia[JOURNAL]
Sun
200 papers
D-dimer value for predicting pulmonary embolism in COVID-19 patients: A retrospective study.
Maulana SAA, Mat Hassan N, Wan Ibrahim WZ … +3 more , Borian N, Wan Taib WR, Wan-Arfah N
Med J Malaysia · 2025 Dec · PMID 41446999
INTRODUCTION: Pulmonary embolism (PE) is a significant complication in patients with COVID-19, often associated with elevated D-dimer levels. However, there remains uncertainty around the D-dimer threshold for predicting...
INTRODUCTION: Pulmonary embolism (PE) is a significant complication in patients with COVID-19, often associated with elevated D-dimer levels. However, there remains uncertainty around the D-dimer threshold for predicting PE in COVID-19 patients as it is influenced by multiple disease factors. This study aimed to establish the D-dimer cut-off value for predicting pulmonary embolism (PE) in patients with COVID-19, evaluate the sensitivity and specificity of this cut-off value, and describe the occurrence of PE and its significant factors. MATERIALS AND METHODS: A retrospective analysis was conducted on 320 patients with COVID-19 who underwent computed tomography pulmonary angiography (CTPA) due to clinical suspicion of PE between 2020 and 2021 at a single centre in Malaysia. Clinical and biological factors associated with PE were analyzed, including age, sex, race, and D-dimer levels. RESULTS: Among the study population, 23.4% of males and 15.4% of females tested positive for PE, with no significant differences noted across racial groups. Age was significantly associated with PE development (p = 0.013). Ddimer levels in PE-positive patients were five times higher than in PE-negative patients (p = 0.001). An optimal D-dimer cut-off of 2799 ng/ml level was identified with an area under the curve (AUC) of 0.744 (95% CI: 0.676-0.813), and sensitivity of 81%, and specificity of 51%. CONCLUSION: This study highlights the role of D-dimer as a predictive biomarker for PE in COVID-19 patients. The identified cut-off value offers a practical threshold for clinical decision-making, balancing sensitivity and specificity. Further studies are needed to validate these findings in broader population.
Prevalence of Haemoglobin Constant Spring in the Malaysian population: Insights from a single-center study.
Sharifatul FE, Adibah D, Mohammad HN … +1 more , Sumaiyah A
Med J Malaysia · 2025 Dec · PMID 41446998
INTRODUCTION: Thalassemia is a significant public health concern in Malaysia, with an estimated 6.8% of the population being carriers. These individuals may experience varying severities of anaemia. Alpha thalassemia, in...
INTRODUCTION: Thalassemia is a significant public health concern in Malaysia, with an estimated 6.8% of the population being carriers. These individuals may experience varying severities of anaemia. Alpha thalassemia, in particular, results from deletions or mutations within the α- globin gene complex, leading to reduced or absent α-globin chain production. Haemoglobin Constant Spring (Hb CS) is one of the most common non-deletional alpha-thalassemia variants, characterized by a specific mutation in the HBA2 gene. MATERIALS AND METHODS: A cross-sectional study utilized data from 159 samples collected during the National Thalassemia Screening Program for Form 4 students in Terengganu from 2019 till 2022. Haemoglobin analysis was conducted with the capillary electrophoresis (CE) and high-performance liquid chromatography (HPLC) methods. DNA analysis was performed using multiplex PCR and ARMS to detect both deletional and non-deletional α-thalassemia. RESULTS: Three different types of Hb CS were observed. Among the 159 samples, 137 (86.2%) were heterozygous, 20 (12.6%) were compound heterozygous, and 2 (1.3%) were homozygous for Hb CS. CONCLUSION: These findings offer valuable insights for improving genetic counselling practices and public health strategies, especially in regions with a high prevalence of thalassemia.
Practices related to dietary salt intake and associated factors among adults in Kuala Terengganu.
Aung MMT, Oo SS, Mat Azmi ISM … +6 more , Megat Mustaqim MI, Aniza AA, Naing NN, Nik Mahdi NNR, Mazlan A, Abas MI
Med J Malaysia · 2025 Dec · PMID 41446997
INTRODUCTION: Sodium plays a crucial role in regulating blood volume and osmotic balance; however, excessive intake can lead to fluid retention and increased blood pressure. Assessing knowledge, attitudes, and practices...
INTRODUCTION: Sodium plays a crucial role in regulating blood volume and osmotic balance; however, excessive intake can lead to fluid retention and increased blood pressure. Assessing knowledge, attitudes, and practices (KAP) related to salt consumption is a fundamental step in developing effective public health strategies to reduce excessive salt intake. MATERIALS AND METHODS: This cross-sectional study was conducted among 1,001 adults in Kuala Terengganu using a snowball sampling method to assess salt-related KAP and the factors associated with good dietary salt intake practices. Eligible participants were aged 18 years and above, proficient in Bahasa Malaysia, and had access to a smartphone with internet connectivity. Data were collected through a structured, pre-tested questionnaire administered via Google Forms and analysed using multiple logistic regression to identify factors associated with good dietary salt intake practices. RESULTS: Among the total respondents, 28.8% (95% CI: 26.0% - 31.6%) demonstrated good dietary salt intake practices. The study revealed a disconnect between knowledge and practice, indicating that awareness alone did not translate into healthier dietary behaviours. Multiple logistic regression analysis identified employment status (adjusted OR: 1.541, 95% CI: 1.166 - 2.038; p<0.001) and higher attitude scores (adjusted OR: 1.138, 95% CI: 1.065 - 1.215; p<0.001) as significant positive predictors of good dietary salt intake practices. CONCLUSION: The findings provide valuable insights into salt consumption behaviours and associated factors among the self-selected adults in Kuala Terengganu. The results underscore the importance of targeted public health interventions, particularly those promoting positive attitudes and addressing employed populations, to encourage healthier dietary salt intake practices.
Apoptosis and anti-migratory effects of Methyl gallate combined with Cisplatin in human breast cancer (MCF-7) cells.
Mamat N, Abdullah H, Muhamad N … +1 more , Abdul Rahim NS
Med J Malaysia · 2025 Dec · PMID 41446996
INTRODUCTION: Breast cancer is among the leading causes of cancer-related death in women worldwide. Cisplatin is a widely used chemotherapeutic drug because of its strong efficacy in killing various cancer cells. However...
INTRODUCTION: Breast cancer is among the leading causes of cancer-related death in women worldwide. Cisplatin is a widely used chemotherapeutic drug because of its strong efficacy in killing various cancer cells. However, it presents several toxicity effects and development of drug resistance. Looking at these shortcomings, there is growing interest in combining conventional chemotherapeutic drugs with natural compounds. Therefore, a natural phenolic compound, methyl gallate, known to have strong anticancer and antioxidant properties, is a potential candidate for enhancing the therapeutic efficacy and reducing the side effects of current chemotherapy drugs. MATERIALS AND METHODS: This study aims to determine the antiproliferative effect of methyl gallate and its combination with cisplatin on MCF-7 cells using MTT assay. The combination effect was evaluated using MTT assay and then analysed using CompuSyn software. Besides, this study was done to evaluate the morphology of apoptotic cells using AO/PI stain and to determine the ability of the combination treatment to inhibit the migration of MCF-7 cells using wound healing assay. RESULTS: The cell viability was inhibited dose-dependently with IC values of methyl gallate and cisplatin were 20.21 µg/mL and 13.38 µg/mL respectively. Methyl gallate at fixed concentration combined with the lowest concentration of cisplatin inhibited greater MCF-7 cell growth compared to cisplatin alone with a combination index value of less than 1 indicating the synergistic effect. The MCF-7 cells treated with single and combination drugs exhibited several apoptotic characteristics. Migration of MCF-7 cells was also significantly inhibited by single and combination treatments. CONCLUSION: In conclusion, this study suggested that methyl gallate in combination with cisplatin has a good potential to be developed as a chemotherapeutic agent for breast cancer.
Depression prevalence and its associated factors among sub-urban residents in Kuala Nerus.
Aung MMT, Oo SS, Mat Azmi ISM … +6 more , Megat Mustaqim MI, Mazlan A, Naing NN, Nik Mahdi NNR, Aniza AA, Abas MI
Med J Malaysia · 2025 Dec · PMID 41446995
INTRODUCTION: Depression is a prevalent mental health disorder and a growing public health concern. Understanding its burden, this study aimed to determine the prevalence of depression and identify its associated factors...
INTRODUCTION: Depression is a prevalent mental health disorder and a growing public health concern. Understanding its burden, this study aimed to determine the prevalence of depression and identify its associated factors among suburban adult residents of Kuala Nerus, Malaysia. MATERIALS AND METHODS: A community-based cross-sectional study was conducted among 689 adults aged 18 and above who had resided in a suburban area for at least one month and were proficient in Bahasa Malaysia. Data were collected through a house-to-house survey using a pre-tested, validated questionnaire administered via Google Form. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9), and multiple logistic regression analysis was performed to identify associated factors. RESULTS: The prevalence of depression among respondents was 26.4% (95% CI: 23.1, 29.7). Multiple logistic regression analysis identified several significant factors associated with depression. Older age (adjusted OR: 0.972, 95% CI: 0.948, 0.996; p=0.020), being married (adjusted OR: 0.377, 95% CI: 0.188, 0.754; p=0.006), engaging in physical activity (adjusted OR: 0.669, 95% CI: 0.459, 0.976; p=0.037), and higher total knowledge scores (adjusted OR: 0.883, 95% CI: 0.825, 0.945; p < 0.001) were less likely to have depression. Conversely, being female (adjusted OR: 1.614, 95% CI: 1.076, 2.421; p=0.021) and having a history of depression (adjusted OR: 2.977, 95% CI: 1.122, 7.899; p=0.028) were more likely to have depression. CONCLUSION: The study highlights the substantial burden of depression in suburban communities and underscores the need for targeted mental health interventions. Efforts to improve mental health literacy and promote protective factors, particularly among vulnerable groups such as younger individuals and females, are essential. Further research is warranted to develop effective prevention and treatment strategies.
Factors associated with mortality among retinoblastoma patients in Malaysia: A retrospective cohort study.
Nor-Aizura Z, Wan-Arfah N, Naing NN … +6 more , Hashim SE, Shatriah I, Ain-Nasyrah AS, Hamzah N, Rahmat J, Salowi MA
Med J Malaysia · 2025 Dec · PMID 41446994
INTRODUCTION: Retinoblastoma is the most common primary intraocular cancer worldwide. Research into factors associated with mortality in retinoblastoma from the Southeast Asian region is currently limited. The present st...
INTRODUCTION: Retinoblastoma is the most common primary intraocular cancer worldwide. Research into factors associated with mortality in retinoblastoma from the Southeast Asian region is currently limited. The present study aims to identify the associated factors that predict mortality among retinoblastoma patients in Malaysia. MATERIALS AND METHODS: A retrospective cohort study was conducted on retinoblastoma patients diagnosed between January 2004 and April 2023 at hospitals with paediatric ophthalmology services in Malaysia. Data were collected from the Retinoblastoma Registry of the National Eye Database and patients' medical records. The adjusted hazard ratio (AHR) was used in the multivariable Cox regression model to identify the factors associated with mortality among retinoblastoma patients. RESULTS: A total of 402 retinoblastoma patients were included in the study. Of these, 22 (5.5%) patients died, while 353 (87.8%) were alive and under follow-up at the end of the study, and 27 (6.7%) were lost to follow-up. The univariable Cox regression model identified laterality, lag time, and recurrence as the associated factors. The multivariable Cox regression model confirmed that bilateral (AHR: 3.64; 95% CI: 1.46, 9.02; p=0.004) and longer lag time (AHR: 4.03; 95% CI: 1.57, 10.35; p=0.004) were independent predictors of mortality. CONCLUSION: This study found that bilateral and longer lag time were independent prognostic factors associated with higher mortality among retinoblastoma patients in Malaysia. These results highlight the utmost importance of early diagnosis and access to appropriate treatment to improve survival outcomes for retinoblastoma patients.
The need to consider oral hygiene in preventing the onset of oral bacteria-related systemic diseases: Commentary.
Yasuhiro H
Med J Malaysia · 2025 Nov · PMID 41328855
No abstract available.
No abstract available.
Immunotherapy for non-oncogene driven resectable non-small cell lung cancer: A true gamechanger but for whom and when?
Sachithanandan A
Med J Malaysia · 2025 Nov · PMID 41328854
No abstract available.
No abstract available.
Getting to outcomes (GTO) approach towards stewardship of patient blood management for the Malaysian health care system.
Ishak N, Kamarudin SS, Hsu LL
Med J Malaysia · 2025 Nov · PMID 41328853
INTRODUCTION: The Patient Blood Management (PBM) program provides optimal stewardship of limited blood resources using evidence-based practice. PBM applies evidencebased strategies for reducing costs and improving patien...
INTRODUCTION: The Patient Blood Management (PBM) program provides optimal stewardship of limited blood resources using evidence-based practice. PBM applies evidencebased strategies for reducing costs and improving patient outcomes while conserving scarce blood bank resources. However, implementing a PBM program requires multidisciplinary collaboration, organizational support, organizational change, and motivating a wide range of stakeholders. The COVID pandemic has abridged blood donations globally to the point that there is a chronic critical shortage in many locations. MATERIALS AND METHODS: This paper explored the application of the Getting To Outcomes® (GTO) implementation science framework to support effective PBM implementation. GTO integrates Readiness Assessment and Empowerment Evaluation techniques to assess local needs, build capacity, and ensure stakeholder alignment. These methods are particularly useful for adapting programs to dynamic healthcare environments. RESULTS: Evidence from the literature indicates that GTO enhances organizational readiness, engages diverse stakeholders, and promotes sustainable implementation. The structured 10-step process of GTO enables PBM programs to be tailored to local settings. A hub-and-spoke peer-mentoring model is also proposed to support wider adoption. CONCLUSION: Systematic execution and sustainability of PBM Programs is facilitated by structural approach of the implementation of science in adapting PBM programs to local needs, using framework such as the Readiness Assessment and Empowerment Evaluation from the Getting to Outcomes model. Successful implementation guided by this framework could support the development of hub-andspoke networks of peer mentorship and help fulfill the World Health Organization's call to strengthen patient blood management worldwide.
Unlocking the potential of augmented reality 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 Nov · PMID 41328852
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.
Incidence and clinical patterns, severity and preventability of cutaneous adverse drug reactions among hospitalized patients in a tertiary centre.
Ramnan MM, Jamil A, Preamala G
Med J Malaysia · 2025 Nov · PMID 41328851
INTRODUCTION: Cutaneous adverse drug reactions (cADRs) are among the most common manifestations of adverse drug reactions, ranging from mild eruptions to severe, lifethreatening conditions such as Stevens-Johnson syndrom...
INTRODUCTION: Cutaneous adverse drug reactions (cADRs) are among the most common manifestations of adverse drug reactions, ranging from mild eruptions to severe, lifethreatening conditions such as Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) and drug reaction with eosinophilia and systemic symptoms (DRESS). Despite increasing reports from Malaysia's National Pharmaceutical Regulatory Agency, local epidemiological data at the state level remain scarce. This study aimed to determine the incidence, clinical patterns, severity, and preventability of cADRs among hospitalized patients in Hospital Tuanku Ja'afar Seremban (HTJS), and to identify the drugs most frequently implicated and predictors of severe disease. MATERIALS AND METHODS: We conducted a prospective, observational cross-sectional study over six months (February-July 2024) at HTJS. Patients admitted with, or developed cADRs during hospitalization secondary to systemic medications were included. Exclusion criteria were allergic/irritant contact dermatitis, chemotherapy-induced alopecia, allergic reactions to radiographic contrast or blood products, and outpatient cases. Data on demographics, clinical features, implicated drugs, severity (modified Hartwig and Siegel scale), preventability (Schumock and Thornton scale), and causality (Naranjo's Algorithm) were collected. Multiple logistic regression identified predictors of severe cADRs. RESULTS: Among 30,667 admissions, 70 patients met inclusion criteria (incidence: 0.228%). The mean age was 46.2 ± 21.4 years; 55.7% were female and 71.4% Malay. Most cases occurred in medical departments (60%). The commonest reaction patterns were maculopapular eruption (37.1%) and urticaria (35.7%). Antibiotics accounted for 50% of cases, with penicillin being the leading culprit (37.1%), followed by NSAIDs, analgesics, anti-platelet and antituberculosis drugs. Most reactions were of moderate severity (80.0%); one SJS/TEN case was classified as severe according to Hartwig scale. Preventability assessment found 14.3% definitely preventable events, primarily due to re-exposure to known allergens. Multiple logistic regression identified raised eosinophil count (AOR 21.83, p=0.001), mucosal involvement (AOR 29.82, p=0.016), and impaired renal function (AOR 7.98, p=0.024) as independent predictors of severe reactions. CONCLUSION: Our study highlights a cADR incidence of 0.228% among hospitalized patients, with antibiotics, especially penicillin group, being the most frequent culprit drug. While most reactions were moderate and not preventable, significant predictors of severity included raised eosinophils, mucosal involvement, and renal impairment. Enhanced vigilance, careful drug selection, and early recognition of high-risk clinical features are crucial to reducing the burden of cADRs in hospital settings.
MUC5AC gene expression in COVID-19 nasal discharge with rhinorrhea symptoms.
Irfandy D, Afriwardi A, Andani EP … +1 more , Bestari JB
Med J Malaysia · 2025 Nov · PMID 41328850
INTRODUCTION: Coronavirus Disease 2019 (COVID-19) is an acute respiratory infection caused by SARS-CoV-2. On May 1, 2021, there were 153 million confirmed positive cases worldwide with a total of 3.2 million deaths. The...
INTRODUCTION: Coronavirus Disease 2019 (COVID-19) is an acute respiratory infection caused by SARS-CoV-2. On May 1, 2021, there were 153 million confirmed positive cases worldwide with a total of 3.2 million deaths. The number of Indonesian cases on November 10, 2021, was recorded at 4,249,323 confirmed positive cases with 143,592 deaths. In COVID-19, rhinorrhea symptoms were found in 4% of cases, while in influenza and the common cold, 91% of cases experienced rhinorrhea. COVID-19 causes epithelial destruction and stimulates local immune response and the release of macrophages, monocytes, inflammatory cytokines, B cells, and T cells. The nasal epithelium is a physical barrier that protects the nasal mucosa from inflammatory agents by producing glycoproteins such as mucin, cytokines, and chemokines. MATERIALS AND METHODS: The study aimed to analyze the relationship between MUC5AC expression in nasal secretions and COVID-19 infection. This research was analytical research with a cross-sectional design. We used stored nasal swab samples at a laboratory designated for COVID-19 detection from 2021 until 2022, the pandemic. Selection of the sample using a simple random sampling technique. The population in this study were patients with a positive (n=40) and negative (n=40) diagnosis of COVID-19 confirmed by RT-qPCR and according to the inclusion and exclusion criteria. The data were analyzed using an independent Student's t-test. RESULTS: The sample characteristics in this study showed that 58% of females and 42% of males were confirmed positive for COVID-19. About 22% of COVID-19 positive cases had runny nose symptoms. The relative expression of MUC5AC increased 9.77 times. CONCLUSION: MUC5AC expression is increased in the nasal secretions of COVID-19 patients, but this study found that only 22% of cases experienced symptoms of a runny nose.
Evaluation of analytical performance of Sebia Capillarys 3 Octa electrophoresis method for serum protein electrophoresis.
Razak AA, Jelani AM, Tuan Salwani TI … +4 more , Wan Azman WN, Husin A, Iberahim S, Shafii N
Med J Malaysia · 2025 Nov · PMID 41328849
INTRODUCTION: Protein electrophoresis is a crucial test in clinical diagnostic laboratory, aimed for evaluation of plasma protein distribution. With its capability for highresolution protein separation, rapid analysis an...
INTRODUCTION: Protein electrophoresis is a crucial test in clinical diagnostic laboratory, aimed for evaluation of plasma protein distribution. With its capability for highresolution protein separation, rapid analysis and automated features, capillary electrophoresis (CE) has emerged as a valuable alternative to the traditional gel-based methods that are widely used in our country. This study aimed to evaluate the analytical performance of Sebia Capillary 3 Octa CE system in our laboratory setting. MATERIALS AND METHODS: The study was conducted at the Protein Diagnostic Laboratory, Hospital Pakar Universiti Sains Malaysia. Within-run and between run precision was assessed using Sebia Capillarys 3 Octa CE system with commercially available normal and pathological control sera. Accuracy was evaluated by comparing results from the Sebia Capillarys 3 Octa with those from the Sebia Hydrasys 2 Scan gel electrophoresis analyzer using both healthy and patient serum samples. Reference interval verification involved testing serum from healthy volunteers. Statistical analyses included mean, standard deviation, coefficient of variation (CV), linear regression, and Bland-Altman analysis. RESULTS: Sebia Capillarys 3 Octa demonstrated good precision across all serum protein fractions, with within-run CVs for normal serum ranging from 0.97% (albumin) to 7.04% (alpha-1), and between-run CVs below 7.22%. Pathological serum showed CVs from 0.60% (gamma) to 5.09% (alpha-1), and from 0.89% (albumin) to 10.32% (alpha- 2) for within-run and between run CV, respectively. CE correlated strongly with gel electrophoresis for albumin and gamma globulin (r > 0.95), with alpha 1, alpha2 and beta showed good correlation (r >0.80) between the two methods. There was minimal bias (-1.1 to +2.1) noted. Reference interval verification confirmed compatibility with manufacturer-provided ranges. CONCLUSION: Sebia Capillarys 3 Octa provides reliable, automated analysis for serum protein fractions, offering performance comparable to the conventional agarose gel electrophoresis analyzer with enhanced operational benefits for routine laboratory use.
Prevalence and factors associated with seizures in tuberculous meningitis.
Nazleen Z, Rajah R, Khoo CS … +4 more , Lee ZY, Muhammad Samir Haziq AR, Rosnad S, Tan HJ
Med J Malaysia · 2025 Nov · PMID 41328848
INTRODUCTION: Tuberculous meningitis (TBM) is a severe manifestation of extrapulmonary tuberculosis that can lead to debilitating neurological complications. Seizures in TBM pose diagnostic and therapeutic challenges and...
INTRODUCTION: Tuberculous meningitis (TBM) is a severe manifestation of extrapulmonary tuberculosis that can lead to debilitating neurological complications. Seizures in TBM pose diagnostic and therapeutic challenges and are associated with adverse outcomes and prolonged hospitalisation. This study aims to determine the prevalence, risk factors, and outcomes associated with seizures in patients with TBM patients. MATERIALS AND METHODS: A retrospective observational study was conducted on 96 adult patients diagnosed with TBM at a tertiary hospital in Malaysia. Patients with the diagnosis of tuberculous meningitis were included and classified into the seizures and non-seizures groups. Clinical, laboratory, radiological, and treatment-related variables were analysed. Antiseizure medication use and neurological outcomes were also assessed. RESULTS: Seizures occurred in 30.2% (n=29) of patients; generalized seizures were the predominant type. Patients with seizures were more likely to present with altered behaviour (48.3% vs 31.3%) and focal neurological deficits (24.1% vs 14.9%). Patients with seizures were more likely to be on antiseizure medications, particularly phenytoin, valproate and levetiracetam (p<0.05). Lower Glasgow Coma Scale scores on admission were more common among seizure patients (17.2%) compared to non seizure group (7.5%). Patients with seizures had higher rates of mortality (27.6% vs. 13.4%) and poor functional outcomes compared to those without seizures. CONCLUSION: Seizures are common in TBM and are associated with worse clinical outcomes. Early clinical signs such as altered behaviour and focal deficits may help identify high-risk TBM patients with seizures. Seizures in TBM are associated with worse neurological outcomes. The common antiseizure therapy initiated for treatment include phenytoin, valproate and levetiracetam. Further prospective studies are needed to refine risk stratification and optimize management.
Thoracic vent versus conventional intercostal tube drainage in management of pneumothorax in a tertiary referral centre.
Azat Azrai A, Mas Fazlin MJ, Nik Azuan I … +3 more , Isa Azzaki Z, Nik Farhan NF, Mohamed Faisal MF
Med J Malaysia · 2025 Nov · PMID 41328847
INTRODUCTION: Strategies in managing primary spontaneous pneumothoraces are shifting toward simple aspiration and ambulatory follow-up rather than the traditional chest tube and hospital admission. This study is to deter...
INTRODUCTION: Strategies in managing primary spontaneous pneumothoraces are shifting toward simple aspiration and ambulatory follow-up rather than the traditional chest tube and hospital admission. This study is to determine the differences in outcome between the treatment of pneumothorax using a Thoracic Vent (TV) versus conventional intercostal chest tube drainage (CITD) in terms of pain (Visual Analogue Score, 0-10 cm), complications, rate of expansion, and length of stay (LOS). MATERIALS AND METHODS: Randomized single-center prospective interventional study of inpatient pneumothorax patients. Subjects were randomized to treatment with True- Close Thoracic Vent with Heimlich valve or conventional chest tube. Both arms received standard medical care and analgesia. Pain score was assessed at baseline (2 hours post insertion), 24 hours after, and before removal. RESULTS: Twenty subjects were recruited and randomly assigned to treatment with TV (n=10) and CITD (n=10). The mean pain score at baseline (2 hours post insertion) for TV was 1.36. The mean time to chest expansion in those treated with TV is 1.9±0.56 days and 4.9±2.23 days for the CITD group. The mean time of removal in TV was about 3 days, while CITD was almost 8 days. Mean LOS in those treated with TV and CITD was 4.8±3.6 days and 13.1±4.7 days, respectively. We recorded 3 cases of recurrences within 14 days from both groups. CONCLUSION: Pain scores were significantly lower in the TV group, and the lung expansion and LOS rate were substantially shorter than CITD. There were fewer complications in the TV group, and no difference in pneumothorax recurrence on follow-up between the two groups.
Association of oxytocin massage with oxytocin hormone levels and breast milk production in mothers with postpartum blues.
Hidayati H, Syafar M, Syamsuddin S … +3 more , Jusuf EC, Ahmad M, Chaliks R
Med J Malaysia · 2025 Nov · PMID 41328846
INTRODUCTION: Postpartum blues is a mild adaptation disorder in postpartum mothers that affects psychological and physiological conditions, including breast milk production. This condition significantly impacts maternal...
INTRODUCTION: Postpartum blues is a mild adaptation disorder in postpartum mothers that affects psychological and physiological conditions, including breast milk production. This condition significantly impacts maternal health and infant development. This study aimed to examine the association between oxytocin massage, oxytocin hormone levels, and breast milk production in mothers with postpartum blues. MATERIALS AND METHODS: A quasi-experimental pre-test and post-test design with treatment and control groups was used. The study was conducted at Siti Fatimah Special District Hospital for Maternal and Child Makassar and Pertiwi Mother and Child Hospital Makassar, from February to November 2024. A total of 68 postpartum mothers with postpartum blues were divided into two groups (34 participants per group). Screening was performed using the EPDS scale, oxytocin levels were measured using the ELISA method, and Breast milk production was assessed using a composite scoring system based on three main indicators: (1) infant weight gain, evaluated using the mean value (X̄) and standard deviation (SD); (2) breastfeeding frequency, recorded through maternal reports and structured observation; and (3) breastfeeding duration, assessed based on the average time per feeding session. Each indicator was assigned a score ranging from 1 to 3, corresponding to low (score 1), moderate (score 2), and high (score 3) levels. The total score from these three components was used to classify overall breast milk production into three categories: high production (total score 7-8), moderate production (total score 5-6), and low production (total score 3-4). Statistical analysis was conducted using SPSS. RESULTS: The baseline characteristics were evenly distributed across between the groups. The reduction in EPDS scores was greater in the treatment group (13.44 ± 2.765 to 12.12 ± 3.832) than in the control group (13.97 ± 3.196 to 13.26 ± 2.864), with a significant between-group difference (p = 0.000). Moreover, oxytocin levels increased significantly in the treatment group (47.57 ± 10.42 pg/mL to 52.62 ± 11.33, p = 0.001), whereas no significant change was observed in the control group, except for the comparison of the difference in oxytocin levels between the two groups confirming that this difference is statistically significant (p = 0.007). CONCLUSION: This study suggests that oxytocin massage may serve as a complementary approach therapy for reducing postpartum blues symptoms and enhancing breast milk production. Its integration into clinical practice can support maternal postpartum care by promoting emotional well-being and improving lactation outcomes.
Relationship between degree of central adiposity, inflammatory status and risk of sarcopenia in obese children.
Anantyo DT, Hardaningsih G, Wistiani … +3 more , Laksmi ZZA, Sandradewi KM, Laryan VEA
Med J Malaysia · 2025 Nov · PMID 41328845
INTRODUCTION: Childhood obesity is a most prevalent condition worldwide. The accumulation of adipose leads to its infiltration into various organs, including skeletal muscle, which called sarcopenia. Children with sarcop...
INTRODUCTION: Childhood obesity is a most prevalent condition worldwide. The accumulation of adipose leads to its infiltration into various organs, including skeletal muscle, which called sarcopenia. Children with sarcopenic-obesity are at an increased risk of developing cardiovascular or metabolic diseases. This study aims to investigate the association between central adipose accumulation and the degree of chronic inflammation on muscle performance in obese children, a topic that has not been studied in Indonesia. MATERIALS AND METHODS: This study employed a crosssectional design with consecutive sampling involving obese primary school children aged 7-13 years from Semarang and its surrounding areas who met the inclusion and exclusion criteria. Data collection included anthropometric measurements (waist and hip circumferences, waist-to-hip ratio, muscle mass assessed by bioelectrical impedance analysis/BIA), handgrip strength, three-day dietary recall, and blood biomarkers (CRP and IL-6). Muscle mass was classified as low when skeletal muscle mass adjusted for age and sex (SMMa z-score) was less than -2 SD. Reduced muscle strength was defined as handgrip strength below the 15th percentile (age/sex-specific). Central adiposity was defined as waist-to-height ratio (WHtR) ≥ 0.50 or waist-to-hip ratio (WHR) above the 90th percentile for age and sex. Elevated inflammatory markers were defined as CRP ≥ 3 mg/L and IL-6 > 5 pg/mL. Associations between variables were analyzed using chi-square or Fisher's exact tests, and logistic regression models were applied with a significance level set at α=0.05. RESULTS: Of the 86 children, 84.8% had low muscle mass, 38.4% had reduced muscle strength, and 69.8% demonstrated impaired physical performance. High waistto- height ratio (WHtR) was significantly associated with low muscle mass (p = 0.016) and reduced muscle strength (p = 0.007). High C-reactive protein (CRP) levels were also associated with low muscle mass (p = 0.013). In addition, protein intake was significantly related to muscle mass (p = 0.016). In logistic regression analysis, WHtR was an independent predictor of both reduced strength (OR = 5.324, p = 0.021, 95% CI: 1.280-22.148) and low muscle mass (OR = 0.163, p = 0.011, 95% CI: 0.037-0.714). Although interleukin- 6 (IL-6) was elevated in the majority of children, it did not show a significant association with sarcopenia outcomes. CONCLUSION: Central adiposity, particularly as measured by WHtR, is a key predictor of sarcopenia in obese children, with significant associations observed with reduced muscle mass and strength. Elevated CRP levels further underscore the role of systemic inflammation in sarcopenia. These findings highlight the need for early identification and targeted interventions to mitigate the adverse effects of sarcopenic obesity in children.
Perceived usability of hospital information system and associated factors: Perspectives from healthcare providers in Hospital Al-Sultan Sbdullah, UiTM.
Ibrahim Z, Ahmad Taufik J, Khalid I
Med J Malaysia · 2025 Nov · PMID 41328844
INTRODUCTION: The successful integration of Hospital Information Systems (HIS) in Malaysia is crucial for enhancing healthcare delivery, yet usability remains a significant concern among healthcare providers. This study...
INTRODUCTION: The successful integration of Hospital Information Systems (HIS) in Malaysia is crucial for enhancing healthcare delivery, yet usability remains a significant concern among healthcare providers. This study aims to evaluate the perceived usability of the locally developed HIS (UniMEDS) and identify associated organisational and technological factors influencing usability among healthcare providers in Hospital Al-Sultan Abdullah (HASA), Universiti Teknologi MARA (UiTM). MATERIALS AND METHODS: A cross-sectional study was conducted from May 2025 to June 2025 at HASA, Puncak Alam. Data were collected using a structured online questionnaire incorporating the System Usability Scale (SUS) and items on organisational and technological factors. Incomplete questionnaires were excluded listwise. Descriptive and inferential analyses were performed using SPSS version 29, with p < 0.05 considered statistically significant. A SUS score of ≥68 was classified as "good" usability. RESULTS: The analysis involved a total of 164 respondents. UniMEDS was perceived as having good usability by 74.4% of respondents, with a mean SUS score of 68.02 (SD = 15.91). In multivariable analysis, good usability was significantly associated with perceived adequacy of data storage and privacy (AOR = 2.04; 95% CI: 1.15-3.64) and userfriendliness (AOR = 1.91; 95% CI: 1.15-3.16). CONCLUSION: Overall, the UniMEDS at HASA achieved a borderline good usability among healthcare providers. Factors related to data storage, privacy, and userfriendliness were key determinants of perceived usability. Enhancing these aspects through user-centred design and secure system optimisation could improve HIS adoption and satisfaction among healthcare providers in Malaysia.
Perspectives on peer mentoring initiatives: Insights from first-year medical students.
Hnin PP, Kye MMS, Shwe S … +1 more , Avneet K
Med J Malaysia · 2025 Nov · PMID 41328843
INTRODUCTION: The transition into medical school represents a period of intense academic, social, and personal adjustment for students. Mentoring programmes have proven to be effective in enhancing students' academic, be...
INTRODUCTION: The transition into medical school represents a period of intense academic, social, and personal adjustment for students. Mentoring programmes have proven to be effective in enhancing students' academic, behavioural, emotional, and social well-being. Mentorship plays a crucial role in the success of a medical career, with growing evidence supporting the positive impacts of mentoring initiatives in undergraduate medical education. These initiatives significantly contribute to both professional and personal growth. Due to the limited research on peer mentoring programmes for new medical students, this study aimed to explore their perceptions of the Peer Mentoring Programme (PMP) at Universiti Tunku Abdul Rahman (UTAR). MATERIALS AND METHODS: A mixed-methods study was conducted, combining a cross-sectional survey with a qualitative focus group discussion among first-year medical students from the 2023/2024 academic year. Quantitative data were analysed using descriptive statistics in SPSS version 29, while qualitative data underwent thematic analysis according to Braun and Clarke's framework. RESULTS: A total of 37 students participated (90.24% response rate) in this study. The findings indicated a positive perception of the PMP with an overall mean score of M=3.63 (SD=0.74). Academic support was the primary reason for mentor meetings (83.8%). Also, thematic analysis revealed two major themes: 'Perceived Benefits of the Programme', which highlighted its role in academic guidance and social integration, and 'Suggestions for Improvement,' which called for better programme clarity, improvement in mentor matching, and increased peer interaction. CONCLUSION: The findings indicated an overall positive perception of the peer mentoring programme among the students. While effective in providing academic and social support, its impact could be significantly increased by providing more structured enhancements, which can include formal mentor training, an improved matching process, and a continuous evaluation and monitoring system.
Effectiveness of a developed module for colorectal cancer patients receiving chemotherapy in reducing depression at the National Cancer Institute, Malaysia.
Mamta Vesudave RK, Sherina MS, Rampal L … +2 more , Ismail SIF, Periasamy U
Med J Malaysia · 2025 Nov · PMID 41328842
INTRODUCTION: Colorectal cancer (CRC) is one of the most common cancers globally. The burden continues to grow globally, exerting tremendous physical, emotional and financial strain on individuals, families, communities...
INTRODUCTION: Colorectal cancer (CRC) is one of the most common cancers globally. The burden continues to grow globally, exerting tremendous physical, emotional and financial strain on individuals, families, communities and health systems.CRC patients undergoing chemotherapy frequently experience considerable depression. The objective of the study was to develop, implement, and evaluate the effectiveness of the developed module for pharmacists in reducing depression among CRC patients undergoing chemotherapy. MATERIALS AND METHODS: A systematic, single-blinded study involving 98 patients receiving chemotherapy was carried out at the National Cancer Institute (NCI). The estimated sample size was 98 participants (49 in each group). A selfadministered validated questionnaire was used to collect data on the sociodemographic characteristics of the respondents. The validated PHQ-9 (Patient Health Questionnaire-9) and the Multidimensional Scale of Perceived Social Support (MSPSS) were used to assess the depression level and social support of the patients. The intervention group received chemotherapy counselling using the newly developed module during their first, second, and third follow-up. The control group received the standard practice chemotherapy counselling upon their initial visit and during the first cycle. Data were analysed using the Statistical Package for Social Sciences (SPSS) version 26. Independent t-test and two-way repeated measures analysis of variance (ANOVA) were used to analyse the effectiveness of the intervention. A p-value <0.05 was considered significant, and partial eta squared was used to measure effect size. RESULTS: All participants completed the questionnaire at baseline and followed the first, second, and third chemotherapy counselling sessions, giving a response rate of 100%. No significant difference was detected between the intervention and control groups at the baseline concerning sociodemographic characteristics, depression and social support. The depression scores of the intervention group recorded significant decrements at the third follow-up (p= 0.043), indicating the effectiveness of repetitive counselling in addressing the psychological issues faced by CRC patients. CONCLUSION: The newly developed counselling module was effective in reducing depression among colorectal cancer patients undergoing chemotherapy. This study provided evidence-based data on repetitive counselling in improving the psychological and social support of chemotherapy in CRC patients by pharmacists.
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