The Medical Journal Of Malaysia[JOURNAL]
Sun
200 papers
Prevalence, risk factors and etiologies of onychomycosis in patients with psoriasis.
Law ES, Loo CH, Tan WC … +2 more , Cheng JL, Murniyati H
Med J Malaysia · 2025 Nov · PMID 41328841
INTRODUCTION: Psoriasis is a chronic immune mediated inflammatory disease often involving nails, presenting significant physical and psychological impacts. Onychomycosis, frequently coexists with psoriatic nail manifesta...
INTRODUCTION: Psoriasis is a chronic immune mediated inflammatory disease often involving nails, presenting significant physical and psychological impacts. Onychomycosis, frequently coexists with psoriatic nail manifestations, complicating diagnosis and treatment. This study aims to evaluate the prevalence, etiology, and risk factors for onychomycosis among psoriasis patients in a tertiary public hospital in Malaysia. MATERIALS AND METHODS: A prospective cross-sectional study was conducted involving 191 psoriasis patients from October 2023 to August 2024. Nail involvement was assessed using the Nail Psoriasis Severity Index (NAPSI), and fungal diagnostics included potassium hydroxide microscopy, fungal cultures, and polymerase chain reaction. Associations between clinical variables and onychomycosis were analyzed. RESULTS: The prevalence of onychomycosis was 13.6%, with dermatophytes being the most common etiological agent (69%), followed by moulds (23%) and yeasts (8%). Higher NAPSI scores were significantly associated with increased odds of onychomycosis (Adj. OR: 1.02, p=0.001). Smoking also emerged as a potential risk factor (p=0.054). Other variables, including diabetes, treatment for psoriasis and BMI, were not significantly associated with onychomycosis in this study. CONCLUSION: Onychomycosis is prevalent among psoriasis patients, particularly those with severe nail involvement. Dermatophytes remain the primary pathogens, although moulds account for a notable proportion in this tropical setting. These findings underscore the importance of incorporating fungal diagnostics in psoriasis management to optimize outcomes and break the cycle of worsening disease.
Influenza vaccination uptake among public primary healthcare workers in Seberang Perai Tengah district, Penang.
Ling JM, Tohit NM, Yusof YM … +2 more , Hashim SM, Ng LY
Med J Malaysia · 2025 Nov · PMID 41328840
INTRODUCTION: Influenza poses a significant public health burden globally, contributing to substantial morbidity and mortality, particularly among vulnerable populations. Healthcare workers (HCWs) are at increased risk o...
INTRODUCTION: Influenza poses a significant public health burden globally, contributing to substantial morbidity and mortality, particularly among vulnerable populations. Healthcare workers (HCWs) are at increased risk of contracting and transmitting influenza, making vaccination a key preventive strategy. Despite the well-established benefits and strong recommendations advocating influenza vaccination for all HCWs, only a few studies have examined vaccination uptake among HCWs in Malaysia. This study aimed to determine the prevalence of influenza vaccination among public primary HCWs in Seberang Perai Tengah district, Penang, reasons for vaccination or non- vaccination and to identify its associated factors. MATERIAL AND METHODS: A cross-sectional study was conducted from January to March 2025 inviting all HCWs from nine health clinics and six dental clinics in the district. Data for socio-demography, work-related characteristics, history of influenza vaccination, reason to vaccinate or nonvaccination for influenza, knowledge and attitude towards influenza and its vaccination were collected using a validated self-administered questionnaire in a Google form. Knowledge and attitudes towards influenza and its vaccination were assessed using an 18-item questionnaire on a five-point Likert scale. A higher score for each component, knowledge (0-15) and attitude (0-3), indicates better knowledge and more positive attitudes, respectively. Descriptive statistics were used for demographic data and prevalence. Multiple logistic regression was performed to identify factors associated with vaccination uptake. RESULTS: A total of 359 HCWs participated. The participants had a mean age of 37.9 years (SD=7.09), with females comprising 77.7% of the sample. Nurses represented the largest proportion (33.7%), followed by assistant or aide (24.2%), and doctors (11.7%). The prevalence of influenza vaccination uptake was 97%, with only 12 participants reported never being vaccinated. The primary reasons for vaccination were self-protection (94.2%), followed by protecting family and friends (70.9%) and the availability of free vaccination at work (50.7%). Among the unvaccinated participants, 58.3% expressed concerns about side effects and 25% stated reasons for fear of getting sick from the vaccine and personal reluctance. Multiple logistic regression revealed that the attitude score was significantly associated with influenza vaccination uptake (Adjusted OR: 2.12, 95% CI: 1.30-3.44, p=0.002). Vaccinated participants had a higher median knowledge score (11.0, IQR 4.00), and attitude score (3.0, IQR 1.00) compared to non-vaccinated participants suggesting better knowledge and attitude towards influenza or its vaccinations. While most participants held positive views, misconceptions persisted; 30.4% believed the vaccine might cause influenza, and 39.3% believed influenza could be transmitted via blood. CONCLUSION: The high vaccination rate reflects strong acceptance and awareness among HCWs. Misconceptions regarding vaccine safety persist, and necessitate targeted educational efforts. Although high uptake suggests favourable attitudes, further longitudinal studies are needed to explore motivational factors and causality more definitely. Targeted education can address misconceptions and side effects, supporting sustained high vaccination rates and reducing hesitancy.
Hepatoprotective effect of medicinal plant in nanoemulsions form.
Damayanti MM, Sari AK, Siddiq TB … +1 more , Fakih TM
Med J Malaysia · 2025 Nov · PMID 41328839
INTRODUCTION: Clove extract (CE) and grape seed oil (GSO) are medicinal plant compounds. Clove (Syzygium aromaticum) and grape (Vitis vinifera) are widely recognized botanical species with established therapeutic benefit...
INTRODUCTION: Clove extract (CE) and grape seed oil (GSO) are medicinal plant compounds. Clove (Syzygium aromaticum) and grape (Vitis vinifera) are widely recognized botanical species with established therapeutic benefits. This study aims to assess the hepatoprotective effect of nanoemulsions containing CE and GSO in acute liver injury induced by carbon tetrachloride (CCl4) in rats (Rattus norvegicus). MATERIALS AND METHODS: Twenty laboratory mice with criteria were healthy, male, and weighing around 250 mg. Liver damage was induced in experimental animals using carbon tetrachloride (CCl4) on days 20 and 21 of treatment. The experimental animals were divided into four groups, the group 1 (G1) was a negative control group which was not induced and given standard feed, the group 2 (G2) was a positive control group which was induced and given standard feed, the 3 (G3) was induced and given CE nanoemulsion pretreatment and GSO formula A, the group 4 (G4) was induced and given pretreatment of nanoemulsion CE and GSO formula B. Giving nanoemulsion according to the group for 21 consecutive days. Next, on day 22, serum and liver tissue samples were taken to assess the condition of the liver tissue. RESULTS: The study's findings demonstrated that the administration of nanoemulsions containing CE and GSO exhibited a dose-dependent reduction in acute liver injury induced by CCl4. Liver function based on levels of serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) has a significant difference in group 2 compared to group 4 with a P value of 0.006 and 0.01. The liver histopathology showed a healing process in the group treated with clove and grape nanoemulsion therapy. In group 4 there was no vacuole degeneration, reduced inflammatory cell infiltration, and increased neovascularization compared to group 2. CONCLUSION: The hepatoprotective effect of nanoemulsions containing CE and GSO was observed to have antioxidant, antibacterial, and anti-inflammatory properties resulting in significant improvements in serum biomarkers related to hepatotoxicity and histopathological analysis of liver injury.
High expression of vascular endothelial growth factor is a risk factor for poor response to neoadjuvant Paclitaxel - carboplatin chemotherapy in stage IB3, IIA2, and IIB cervical cancer.
Ongko EG, Budiana ING, Winata IGS … +4 more , Mahendra INB, Darmayasa M, Marta KF, Mahayasa PD
Med J Malaysia · 2025 Nov · PMID 41328838
INTRODUCTION: Cervical cancer ranks among the top causes of death worldwide in gynecological cancers and is among the most prevalent cancers worldwide, particularly in Indonesia. This study aims to prove that high expres...
INTRODUCTION: Cervical cancer ranks among the top causes of death worldwide in gynecological cancers and is among the most prevalent cancers worldwide, particularly in Indonesia. This study aims to prove that high expression of Vascular Endothelial Growth Factor (VEGF) is a risk factor for a poor response to neoadjuvant paclitaxel-carboplatin chemotherapy in cervical cancer stages IB3, IIA2, and IIB. MATERIALS AND METHODS: This nested case-control study was conducted in Prof. I G.N.G. Ngoerah General Hospital, Denpasar. All medical data were collected from October 2022 to April 2023. The case group consisted of 28 patients with cervical cancer stages IB3, IIA2, and IIB who showed a poor response to three cycles of neoadjuvant paclitaxelcarboplatin chemotherapy, while the control group consisted of 28 patients who had a good response to the same treatment. The variables were the expression of VEGF protein, response to neoadjuvant chemotherapy, and baseline characteristics (primary tumor size, histopathological grading, histopathological type, age, parity, and BMI). Data analysis was performed descriptively and analytically using Chi-square tests and logistic regression. RESULTS: There was no significant differences in age, parity, BMI, primary tumor size, degree of differentiation, and histopathological type between the case and control groups. High VEGF expression was found in 78.5% of the case group and 25% of the control group. Further analysis showed that high VEGF expression was significantly associated with a poor chemotherapy response, with an odds ratio (OR) of 16.97 (95% CI 3.17 - 38.15, p = 0.001). CONCLUSION: High VEGF expression is a significant risk factor for a poor response to neoadjuvant paclitaxelcarboplatin chemotherapy in cervical cancer stages IB3, IIA2, and IIB.
Isotretinoin-induced severe dry eye disease and meibomian gland alterations in patients with acne vulgaris: A noncontact ocular surface analysis.
Julieana M, Sn-Humaira SMH, Wn-Hasbee WA … +1 more , Shahidatul-Adha M
Med J Malaysia · 2025 Nov · PMID 41328837
INTRODUCTION: Although isotretinoin causes various potentially vision-threatening ocular side effects, it remains widely prescribed for acne vulgaris (AV) globally due to its proven efficacy, particularly in severe or tr...
INTRODUCTION: Although isotretinoin causes various potentially vision-threatening ocular side effects, it remains widely prescribed for acne vulgaris (AV) globally due to its proven efficacy, particularly in severe or treatment-resistant cases. This study evaluated the effect of isotretinoin on ocular surface parameters to elucidate the underlying mechanisms of isotretinoin-associated dry eye disease (DED). MATERIALS AND METHODS: A comparative cross-sectional observational study was conducted at two tertiary hospitals between August 2022 and May 2023. A total of 48 patients with AV were recruited and categorised into the isotretinointreated (n=19) and isotretinoin-naive (n=29) groups. A LacryDiag® ocular surface analyser was used to evaluate meibomian gland loss (MGL) and tear film parameters. The Ocular Surface Disease Index (OSDI) questionnaire was administered to evaluate dry eye symptom, severity and functional effects. RESULTS: At enrollment, the mean duration of AV was 5.26 ± 3.28 and 6.39 ± 5.63 years in the treated and naive groups, respectively. Treated participants had completed at least a minimum of 16 weeks of daily isotretinoin therapy at the time of examination (mean: 16.89 ± 3.2 weeks). The OSDI score was markedly higher in the treated group than that in the naive group (43.20 ± 18.79 vs 18.15 ± 19.24). The isotretinointreated group had a significantly greater MGL percentage than the naive group (p<0.001), significantly lower noninvasive break-up time (NIBUT) (p=0.046) and lipid layer thickness (p<0.001). The mean tear meniscus height was also lower in the treated group, although the difference was not statistically significant (p = 0.462). Pearson's correlation analysis revealed a significantly moderate positive correlation between the MGL percentage and OSDI score (r=0.417, p=0.003) and a significantly moderate negative correlation between MGL percentage and NIBUT (r=-0.348, p=0.015). CONCLUSION: Isotretinoin therapy in patients with AV is remarkably associated with greater MGL, severe dry eye symptoms, and reduced tear film stability, supporting a lipiddeficient mechanism in isotretinoin-induced DED. Routine ocular surface evaluations are recommended for the early detection and management of ocular complications in patients receiving isotretinoin.
Leptospirosis in Perak state for the year 2024: Hospitalisation rate and its associated factors.
Nooratiqah AF, Mariam M, Aimi Nadira MR … +4 more , Abdulloh M, Husna Maizura AM, Norita S, Xin Wee C
Med J Malaysia · 2025 Nov · PMID 41328836
INTRODUCTION: Leptospirosis remains a public health concern in Malaysia, particularly in high-burden states like Perak. Understanding the hospitalisation rate and its associated factors is important for informing early i...
INTRODUCTION: Leptospirosis remains a public health concern in Malaysia, particularly in high-burden states like Perak. Understanding the hospitalisation rate and its associated factors is important for informing early intervention strategies and optimising disease management; however, local data on these aspects remain scarce. This study seeks to address this gap by determining the hospitalisation rate and identifying the risk factors associated with hospitalisation among probable and confirmed leptospirosis cases in Perak. MATERIALS AND METHODS: This is a retrospective cohort study using secondary data from two data sources obtained from the e-Notifikasi system database and laboratory reports of all registered leptospirosis cases in Perak from January to December 2024. The outcome variable, which was hospitalisation status, was determined by the treating team based on clinical manifestation and disease severity. Multiple logistic regression was applied to identify factors associated with hospitalisation cases. Data was analysed using SPSS version 29. RESULTS: A total of 764 registered leptospirosis cases were included in the study, with 75.5% (n=577) required hospital admission (95% CI: 72%,79%). The average age of patients was 32 years (SD: 20.5), with two-thirds (67.8%) being male. Kinta district reported the highest proportion of cases (30.4%). Factors significantly associated with hospitalisation included: presence of complications (aOR: 8.06, 95% CI: 1.57,41.48), vomiting (aOR: 11.00, 95% CI: 6.63,18.25), headache (aOR: 4.44, 95% CI: 2.70,7.32), onsetto- diagnosis (aOR: 1.37, 95% CI: 1.23,1.52), histories of recreational activity exposure (aOR: 3.41, 95% CI: 2.07,5.62), soil exposure (aOR: 2.60, 95% CI: 1.11,6.07) and types of occupation; student (aOR: 2.79, 95% CI: 1.58,4.93), agriculture (aOR: 5.06, 95% CI: 2.20,11.63), military personnel (aOR: 4.87, 95% CI: 1.08,21.92) and pensioners (aOR: 5.96, 95% CI: 3.31,10.74). CONCLUSION: This study adds to the existing knowledge on the hospitalisation rate and its associated factors among registered leptospirosis cases in Perak. These findings highlight the importance of targeted health education, enhanced clinical vigilance and risk-based interventions tailored to local exposure patterns. While the study's strengths include comprehensive case capture and validated data, limitations include the absence of meteorological, socioeconomic status and health literacy data. These limitations emphasise the need for future longitudinal and behavioural studies.
The accuracy of intraoperative assessment of myometrial invasion in early-stage endometrial cancer and its association with lymph nodes metastasis.
Jaafar JD, Omar J, Mohd Abas MN
Med J Malaysia · 2025 Nov · PMID 41328835
INTRODUCTION: Assessment of the depth of myometrial invasion is important for optimal surgical strategies and treatments. This study aims to assess the accuracy of intraoperative evaluation of myometrial invasion in FIGO...
INTRODUCTION: Assessment of the depth of myometrial invasion is important for optimal surgical strategies and treatments. This study aims to assess the accuracy of intraoperative evaluation of myometrial invasion in FIGO early-stage endometrial cancer and its association with lymph node metastasis, impacting treatment decisions and patient outcomes. MATERIALS AND METHODS: This is a retrospective study analysis of 150 patients diagnosed preoperatively with earlystage endometrial cancer who underwent surgical staging in Institut Kanser Negara (IKN), Putrajaya from January 2018 until December 2022. After the hysterectomy procedure, all uterine specimens will be opened for intraoperative assessment of the depth of myometrial invasion by a gynae oncology surgeon. According to FIGO classification, the depth was assessed to be either greater or less than 50% of myometrial thickness. Gross estimation during operation will be compared with the final histopathological result. This study aims to evaluate the accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of intraoperative myometrial invasion compared to the final histology. Secondly, this research aims to explore the association between depth of myometrial invasion and lymph nodes involvement. RESULTS: A total of 150 patients were recruited, the sensitivity and specificity of intraoperative assessment in detecting depth of myometrial invasion were 42% and 94%, respectively and the PPV and NPV were 78% and 76%. The overall accuracy was 77%. The sensitivity of only 42% in this study suggested that intraoperative myometrial assessment missed as many as 58% of patients who had deep myometrial invasion. A total of 9 (6%) patients were found to have lymph nodes involvement with 5 of them showing deeper myometrial invasion. Although there was a higher number of lymph node involvement observed in cases with deeper myometrial invasion, the difference was not statistically significant (p > 0.05). CONCLUSION: We conclude that intraoperative assessment of myometrial invasion is still reliable and inexpensive method to practice. Accuracy of assessment can be improved in integrate MRI.
Postoperative spondylodiscitis: Five-year, single-center retrospective analysis. Is it really postoperative?
Çelik AK, Simsek Bozok T
Med J Malaysia · 2025 Nov · PMID 41328834
INTRODUCTION: Postoperative spondylodiscitis (POSD) is not uncommon. The incidence of POSD varies between 0.21- 3.6% In this study, it was aimed to examine the clinical findings, diagnosis and treatment of postoperative...
INTRODUCTION: Postoperative spondylodiscitis (POSD) is not uncommon. The incidence of POSD varies between 0.21- 3.6% In this study, it was aimed to examine the clinical findings, diagnosis and treatment of postoperative spondylodiscitis (POSD). MATERIALS AND METHODS: Between September 2017 and October 2022, 37 patients were included in the study, who applied to the Infectious Diseases and Clinical Microbiology Clinic of the XXX Hospital and had POSD infection and were followed-up/treated as outpatients or inpatients. The following were examined: symptoms, physical examination findings, contrast-enhanced spinal MRI (magnetic resonance imaging) findings of the patients, laboratory findings, PPD (purified protein derivative) and QuantiFERON TB-Gold test and blood cultures. The antibiotics that were started and the clinical and radiological response of the patients to the treatment were evaluated. RESULTS: Of the patients 25 (67.6%) were female and 12 (32.3%) were male. The mean time to develop POSD after surgery was 44.8 months. In our study, we found that laboratory tests were not significant in diagnosing POSD other than C-reactive protein(CRP). Teicoplanin and ciprofloxacin were given to all patients except one patient with positive brucella slide and tube agglutination. With this treatment, clinical and radiological improvement was observed in 24 patients. The treatment of 13 patients, including the patient who was given Brucella treatment, was changed due to the lack of clinical and radiological improvement, and anti-tuberculosis treatment was started and recovery was achieved. The mean duration of the treatment was 3.5 months in the pyogenic POSD group and 9.5 months in the POSD patient group that recovered with anti-tuberculosis therapy. CONCLUSION: It Should be kept in mind that in cases where the POSD patients do not benefit from empirical treatment, the causative agent may be an agent other than the common microorganisms, for example M. tuberculosis, and if the agent cannot be detected, finding the diagnosis from treatment is also an option.
Postpartum glucose intolerance following gestational diabetes mellitus: A retrospective cohort analysis of prevalence and clinical predictors in Malaysia.
Idris NA, Yusof NA, Juhari SN … +5 more , Yunus NI, Mat Hassan N, Daud N, Pauzi MF, Ismail MZH
Med J Malaysia · 2025 Nov · PMID 41328833
INTRODUCTION: Postpartum glucose intolerance significantly increases the risk of developing type 2 diabetes mellitus (T2DM) in women with prior gestational diabetes mellitus (GDM). This study assessed the prevalence and...
INTRODUCTION: Postpartum glucose intolerance significantly increases the risk of developing type 2 diabetes mellitus (T2DM) in women with prior gestational diabetes mellitus (GDM). This study assessed the prevalence and identified clinical predictors of postpartum glucose intolerance among Malaysian women. MATERIALS AND METHODS: This retrospective cohort study included 600 women with previous GDM attending postpartum oral glucose tolerance testing (OGTT) at 16 primary health clinics in Terengganu, Malaysia. Data collected encompassed sociodemographic details, antenatal clinical characteristics, and postpartum OGTT outcomes. Multivariable logistic regression analyses identified significant predictors. RESULTS: The overall prevalence of postpartum glucose intolerance was 19%, with impaired glucose tolerance (IGT) predominant (76%). Significant predictors included family history of diabetes (aOR=2.110; 95% CI: 1.324-3.365), previous GDM history (aOR=1.874; 95% CI: 1.137-3.090), primiparity (aOR=1.804; 95% CI: 1.122-2.898), elevated fasting plasma glucose at GDM diagnosis (aOR=1.636; 95% CI: 1.196-2.238), and elevated 2-hour plasma glucose at GDM diagnosis (aOR=1.452; 95% CI: 1.267-1.663). CONCLUSION: The study highlights a substantial prevalence of postpartum glucose intolerance among Malaysian women with prior GDM. Identifying high-risk individuals based on family history, parity, and antenatal glucose levels may enable targeted preventive strategies to reduce the risk of progressing to T2DM.
Cross-sectional study on association of autoantibodies and organ involvement in systemic sclerosis patients.
Cheok LH, Goh WC, Chandran M … +2 more , Nadiah MN, Asmah M
Med J Malaysia · 2025 Nov · PMID 41328832
INTRODUCTION: Systemic sclerosis (SSc) is a connective tissue disease characterised by inflammation, fibrosis, and vascular abnormalities affecting multiple organs, including the skin, lungs, heart and kidneys. Between 7...
INTRODUCTION: Systemic sclerosis (SSc) is a connective tissue disease characterised by inflammation, fibrosis, and vascular abnormalities affecting multiple organs, including the skin, lungs, heart and kidneys. Between 75% and 95% of SSc patients have positive SSc-associated autoantibodies. The 2013 European League Against Rheumatism/American College of Rheumatology classification criteria for SSc includes autoantibodies as an important domain, highlighting their importance when clinical manifestations are subtle. However, the association of autoantibodies and specific clinical manifestations vary across different geographical regions and ethnicities, warranting further study across diverse populations. Hence, the objective of this study is to evaluate the association between autoantibodies and organ involvement in SSc patients at a tertiary centre in Malaysia. MATERIALS AND METHODS: This cross-sectional study included 48 SSc patients who received follow-up care at a tertiary centre in Malaysia from July 2013 to June 2023 (a ten-year period). Demographic, clinical, laboratory and radiological information were extracted from patient records. RESULTS: A total of 48 patients were enrolled in our study. Forty-five (93.8%) patients were female and 3 (6.2%) patients were male. Regarding ethnicity, 26 (54.2%) patients were Malay, 17 (35.4%) patients were Chinese and 5 (10.4%) patients were Indian. Mean age at diagnosis was 52.96 years (SD ± 13.99). Thirty-nine (81.2%) patients had limited subtype and 9 (18.8%) patients had diffuse subtype. The most common clinical manifestations were sclerodactyly (97.9%) and Raynaud's phenomenon (79.2%). The most commonly found autoantibodies were anti-Ro-60 (37.5%) and anti-Scl- 70 (33.3%) while anti-Jo-1 (2.1%) was the least detected. Antinuclear antibody (ANA) was detected in 87.5% of our cohort. Anti-Scl-70 was significantly associated with interstitial lung disease (ILD) and ILD progression. Anti- Centromere was significantly associated with telangiectasia and gastroesophageal reflux disease (GERD). Meanwhile, anti-La was associated with synovitis and anti- Ribonucleoprotein (RNP) was associated with microstomia. Twenty-nine (60.4%) patients had evidence of ILD and 11 (22.9%) patients had progressive ILD. Additionally, pulmonary hypertension of varying severity was observed in 14 (29.2%) patients. CONCLUSION: This study supports the well-established association of anti-Scl-70 with ILD and ILD progression. Other unique associations observed in this study could be due to the distinct ethnic and genetic background in the Malaysian population. To gain a more comprehensive understanding of these unique autoantibody-clinical manifestation patterns in Malaysian SSc patients, larger multicentre studies are recommended.
eDenguev2 Database: Factors associated with the occurrence of dengue hotspot localities in the Selangor State in 2022.
Siti Farhana MY, Mohamad Ikhsan S, Mariam M
Med J Malaysia · 2025 Nov · PMID 41328831
INTRODUCTION: The dengue outbreak in Selangor, Malaysia, has been a significant concern in recent years. Selangor has reported the highest number of dengue cases in the country, with over 22,000 cases in 2023 alone. The...
INTRODUCTION: The dengue outbreak in Selangor, Malaysia, has been a significant concern in recent years. Selangor has reported the highest number of dengue cases in the country, with over 22,000 cases in 2023 alone. The outbreak in Selangor has been overwhelming, and the outbreak was divided into controlled outbreaks, uncontrolled outbreaks, and hotspots according to the onset of the outbreak. Multiple factors have contributed to the occurrence of dengue hotspots in Selangor. This study aims to determine the factors associated with the occurrence of dengue hotspot localities in Selangor for the year 2022. MATERIALS AND METHODS: This is a cross-sectional study among dengue outbreak localities in Selangor that utilized data from the eDenguev2 database from the Selangor State Health Department for the year 2022. Data collection and analysis were conducted from April 2024 until June 2024. The first (index) case from each dengue outbreak localities of controlled outbreak and hotspot localities in Selangor for 2022 were identified and analyzed to determine the factors associated with the occurrence of hotspot localities. RESULTS: 391 (14%) out of 2751 dengue outbreak localities as hotspot localities. According to the demographic analysis of patients in these hotspot localities, the majority were adults aged 26-35 years old (24.04%), with a mean age of 33 years. The majority were female (57.30%), employed (58.57%), Malaysian nationals (93.09%), and of Malay ethnicity (62.15%). Geographically, the Petaling District reported a significant portion of hotspot localities (40.4%). A large number of cases originated in strata housing (67.8%) and urban areas (93.5%), with a delay of more than 48 hours for the commencement of source elimination activities. Notably, most hotspot areas did not have any possible breeding sites (99.2%), had low entomological parameters: Aedes Index (AI), Bruteu Index (BI), and Container Index (CI), and there were no delays in reporting cases, investigating them, verifying them, and registering them. The occurrence of hotspot localities was significantly associated with cases originating from urban areas, with a p-value of 0.048 and an adjusted odds ratio (aOR) of 2.343 (95% CI: 1.006, 5.456). CONCLUSION: Urban areas are significantly more likely to become a hotspot for dengue outbreaks. Public health implications highlight the need for urban-focused.
Factors associated with tuberculosis treatment outcome under directly observed treatment short-course in Hulu Langat district, Selangor, Malaysia.
Abu Johan MHS, Ahmad Zaki R, Suli Z … +2 more , Abdul Halib N, Za'abar MKH
Med J Malaysia · 2025 Nov · PMID 41328830
INTRODUCTION: Tuberculosis (TB) is a significant public health concern despite being a preventable and treatable infectious disease, as indicated by the rising incidence and mortality rates. This study aims to compare tr...
INTRODUCTION: Tuberculosis (TB) is a significant public health concern despite being a preventable and treatable infectious disease, as indicated by the rising incidence and mortality rates. This study aims to compare treatment outcomes by different Directly Observed Treatment, Short-Course (DOTS) supervisors and to identify significant factors associated with Tuberculosis treatment outcomes under DOTS in the Hulu Langat district. MATERIALS AND METHODS: A retrospective cohort study was conducted using registry-based data from the National Tuberculosis Registry (NTBR) between 2019 and 2023. Smear-positive PTB patients' sociodemographic, clinical and DOTS supervisor factors were extracted and analysed. Logistic regression was used to determine the significant factors associated with unsuccessful treatment outcomes. The data were analysed using SPSS version 29. RESULTS: Out of 5225 cases of Tuberculosis during the five years (2019-2023), 2548 cases met the inclusion criteria and were added to the analysis. The treatment success rate among Tuberculosis patients who enrolled in DOTS in the Hulu Langat district was 74.5%, comprising 70.8% who were cured and 3.6% who completed treatment. In contrast, 25.5% had unsuccessful treatment outcomes; 12.7% of patients died, followed by defaulters (8%), not evaluated or transferred out (2.6%), and treatment failure (2.3%). Compared to patients supervised by other DOTS supervisors, those supervised by family members had a significantly lower risk of unsuccessful treatment outcomes (AOR 0.34, 95% CI: 0.177-0.660, p=0.001). Besides that, significant factors associated with unsuccessful treatment outcomes include adult age (19-59 years) with an AOR of 3.60 (95% CI: 1.518-8.533, p=0.004), elderly age (≥60 years) with an AOR of 5.56 (95% CI 2.297-13.438, p<0.001), male gender (AOR 1.48, 95% CI: 1.183-1.838, p<0.001), foreigners (AOR 1.92, 95% CI: 2.366-3.687, p<0.001), rural residence (AOR 1.6, 95% CI: 1.090-2.349, p=0.016), HIV-positive (AOR 2.33, 95% CI: 1.508-3.586, p<0.001), moderate changes CXR findings (AOR 2.72, 95% CI: 1.245-5.945, p=0.012) and faradvanced CXR findings (AOR 5.30, 95% CI: 2.290-12.268, p<0.001). In contrast, the study found a significant decrease in the risk of unsuccessful treatment outcomes among Chinese ethnicity (AOR 0.74, 95% CI: 0.695-1.196, p=0.044) and tertiary education (AOR 0.55, 95% CI: 0.334-0.914, p=0.021). CONCLUSION: This study challenges the traditional focus on healthcare worker DOTS by highlighting the effectiveness of family-supervised DOTS in improving TB treatment outcomes. The findings underscore the potential for family- DOTS to be scaled up as a complementary strategy within the national TB programme. Thus, the study recommends that the Ministry of Health adopt a risk-stratified framework based on sociodemographic and clinical factors to guide the assignment of DOTS supervisors, ensuring each patient receives the most suitable type of supervision throughout their TB treatment. Tailored TB control strategies should also expand risk stratification beyond existing MOH highrisk groups to include males, the elderly, foreign nationals, rural residents, and those with abnormal radiological findings, with strengthened screening and supervision to improve treatment outcomes.
Accuracy of the Banjarmasin prediction score for appendicitis to differentiate complicated and non-complicated appendicitis.
Poerwosusanta H, Habiby RR, Oktaviyanti IK … +3 more , Utomo TK, Yulizar DR, Hartoyo E
Med J Malaysia · 2025 Nov · PMID 41328829
INTRODUCTION: Acute Appendicitis is typically felt in the right lower abdomen. Despite existing diagnostic methods to differentiate between complicated and non-complicated cases, achieving accurate diagnoses remains chal...
INTRODUCTION: Acute Appendicitis is typically felt in the right lower abdomen. Despite existing diagnostic methods to differentiate between complicated and non-complicated cases, achieving accurate diagnoses remains challenging. This study highlights the need for a reliable diagnostic tool to improve patient outcomes and inform surgical strategies, demonstrating the accuracy of the Banjarmasin Prediction Score for Appendicitis (BPSA). MATERIALS AND METHODS: This observational cross-sectional study involved patients diagnosed with acute Appendicitis at Ulin, Sultan Suriansyah, and Damanhuri Hospital in Banjarmasin, Indonesia. Data were collected through consecutive sampling and analysed using SPSS to ensure robust findings. The collected data were then compared between complicated and non-complicated appendicitis cases to evaluate the diagnostic accuracy of the BPSA and Alvarado scores. RESULTS: Among the 62 cases evaluated, 28 were classified as non-complicated and 34 as complicated Appendicitis. The BPSA showed a sensitivity of 71.4% and a specificity of 70.6%. The Alvarado score demonstrated lower sensitivity but a higher specificity of 79.4%. There was no significant difference in the Alvarado score (P > 0.05), while the BPSA score revealed a significant difference (P < 0.05) between complicated and non-complicated Appendicitis. Variations in histamine levels were also noted (P = 0.002), further underscoring the efficacy of the BPSA scoring system. CONCLUSION: The Alvarado score is key for diagnosing acute Appendicitis, and the BPSA score helps differentiate between complicated and non-complicated cases, enhancing treatment strategies. The study's limitation was confined to a single region and a relatively small sample size, which may affect the generalisability of the findings.
A time-to-treatment initiation analysis for treatment-naive early-stage resectable non-small cell lung cancer patients in the Malaysian private healthcare sector.
Sachithanandan A, Hoh HH, Lee J … +10 more , Lim YS, Naim CK, Lutfi FNM, Yong WWS, Hassanudin SA, Ten YY, Lam MD, Wee JCE, Deva DR, Satchithananthan S
Med J Malaysia · 2025 Nov · PMID 41328828
INTRODUCTION: Non-small cell lung cancer (NSCLC) remains a leading cause of cancer mortality in Malaysia, with 95% of cases diagnosed at advanced stages. Beyond screening for early detection, timely intervention is criti...
INTRODUCTION: Non-small cell lung cancer (NSCLC) remains a leading cause of cancer mortality in Malaysia, with 95% of cases diagnosed at advanced stages. Beyond screening for early detection, timely intervention is critical for optimal outcomes in early-stage, resectable NSCLC (e-NSCLC). Delays in the diagnostic, staging and referral pathway, measured as time-to-treatment initiation (TTI), are associated with poorer survival. This contemporary realworld study is the first to evaluate TTI in a cohort of Malaysian patients with e-NSCLC. MATERIALS AND METHODS: This is a retrospective study of 124 consecutive treatment-naive e-NSCLC patients who had a minimally invasive curative anatomical lung resection (lobectomy or segmentectomy) and systematic mediastinal nodal dissection between January 2021 and December 2024 at two tertiary private hospitals. Medical records were reviewed to capture key timepoints across three phases of care. The primary analysis (n=124) focused on demographics and assessed the timeline from initial general practitioner (GP) to specialist consultation, diagnosis, and definitive surgery. These patients were evaluated after surgical discharge to validation of histopathology and nextgeneration sequencing (NGS) reports, and oncology review. Patients who received adjuvant therapy were included in a secondary analysis to examine timelines from NGS report validation and oncology review to initiation of adjuvant therapy. RESULTS: The median time from the GP referral to surgery was 30.0 ± 24.5 days; GP consultation to specialist referral took 7.5 ± 17.0 days, specialist review to surgeon consultation took another 10.0 ± 16.3 days. Biopsy and staging PET-CT were completed within 3.0 ± 20.9 and 3.0 ± 20.5 days, respectively, from the initial specialist consultation. Definitive curative-intent surgery was performed 7.5 ± 13.1 days from the first cardiothoracic surgical consult and 18 ± 23.3 days following a confirmed histological diagnosis of NSCLC. The median interval from specialist review to definitive surgery was 20.0 ± 20.2 days. The median time from surgery to discharge and reporting of NGS results was 5.0 ± 2.6 days and 12.0 ± 7.7 days, respectively. Patients were seen at the first post-surgical review within 7.0 ± 3.7 days following discharge, while oncology review occurred at 19.0 ± 16.2 days post-surgery. For patients eligible for adjuvant therapy, treatment commenced 14.5 ± 11.4 days following the oncology review. CONCLUSION: TTI is known to prognosticate recurrence-free and overall survival for e-NSCLC. This contemporary realworld experience from two leading tertiary cancer centres demonstrates the agility and efficiency of Malaysian private healthcare for prompt diagnosis, meticulous staging and timely, curative-intent definitive surgery for e-NSCLC, aligning with global benchmarks. Our study suggests, if prioritised, a swift TTI is highly achievable with appropriate expertise and coordinated resources, and should be incorporated as a deliverable national quality metric to drive improved outcomes for potentially curable e-NSCLC.
Exosomes derived from human umbilical cord mesenchymal stem cells attenuate kidney inflammation in a 5/6 subtotal nephrectomy rat model.
Nurfatihah ZZ, Sari DCR, Yuniartha R … +15 more , Nugrahaningsih DAA, Satriyo PB, Wardhani Y, Susanti VY, Atmadi LR, Yuliningsih E, Faza N, Prawira MA, Selaparang TM, Moda KF, Murti H, Widyastuti HP, Faizah N, Khadijah K, Arfian N
Med J Malaysia · 2025 Nov · PMID 41328827
INTRODUCTION: Chronic kidney disease (CKD) is a noncommunicable disease that contributes to the rise of global mortality rate. The condition is marked by reduced kidney function persisting for three months or longer. The...
INTRODUCTION: Chronic kidney disease (CKD) is a noncommunicable disease that contributes to the rise of global mortality rate. The condition is marked by reduced kidney function persisting for three months or longer. The main cause of CKD is kidney fibrosis, resulting from chronic inflammation. Current CKD therapies, such as hemodialysis and kidney transplants, are limited in effectiveness. Stem cell-derived therapy, particularly mesenchymal stem cells (MSC), provide great potential for reducing inflammation and fibrosis. Notably, exosomes secreted by MSC offer a safer and more effective alternative by carrying bioactive molecules that can repair kidney function through modulating inflammatory processes. MATERIALS AND METHODS: Twenty-five male 3-month-old Wistar rat were divided into five groups: Sham operation (SO, n=5), 5/6 subtotal nephrectomy (SN, n=5), SN with exosome treatment at total protein concentration of 48.30 μg (SNE1, n=5), 96.61 μg (SNE2, n=5), and 193.21 μg (SNE3, n=5). The rat was euthanized, and the kidneys were harvested for analysis. The mRNA expression levels of NF-κB and MCP-1 were measured using RT-PCR. Macrophage infiltration was assessed using immunohistochemistry (IHC) staining with anti-CD68 antibodies. RESULTS: The mRNA expression of NF-κB was significantly higher in the SN group compared to the SO group. In the exosome groups (SNE1, SNE2, and SNE3), NF-κB expression was significantly lower than in the SN group (p = 0.011, 0.029, 0.026, respectively). The mRNA expression of MCP-1 in the exosome groups was not significantly different from the SN group. IHC staining showed the SN group had a more dominant macrophage infiltration compared to the SO group. The exosome group exhibited a less dominant macrophage infiltration compared to the SN group. CONCLUSION: Exosomes may attenuate kidney inflammation by inhibiting inflammatory gene expression and macrophage infiltration in a 5/6 subtotal nephrectomy rat model.
Prevalence and associated factors of meibomian gland dysfunction and dry eye disease among subjects presenting for transepithelial photorefractive keratectomy.
Kwan KJE, Muhammed J, Jameelah S
Med J Malaysia · 2025 Nov · PMID 41328826
INTRODUCTION: Transepithelial Photorefractive Keratectomy (Trans-PRK) is a modern refractive surgery that improves comfort and recovery but may predispose to meibomian gland dysfunction (MGD) and dry eye disease (DED), c...
INTRODUCTION: Transepithelial Photorefractive Keratectomy (Trans-PRK) is a modern refractive surgery that improves comfort and recovery but may predispose to meibomian gland dysfunction (MGD) and dry eye disease (DED), causing postoperative discomfort. Preoperative assessment of meibomian glands among Trans-PRK candidates remain limited. This study aimed to determine the prevalence of MGD and DED, identify associated factors, and assess the correlation of meibomian gland loss (MGL) among subjects undergoing Trans-PRK at Hospital Pakar Universiti Sains Malaysia. MATERIALS AND METHODS: A descriptive cross-sectional study was conducted from January 2024 to January 2025 among 110 subjects aged 20-45 years undergoing preoperative Trans-PRK evaluation. Demographic, occupational, and lifestyle data were collected, while ocular surface parameters were assessed through clinical examination, meibography, and standardized questionnaires. MGD and DED were diagnosed based on established criteria. Statistical analyses were performed using SPSS version 29.0. RESULTS: The prevalence of MGD and DED was 17.3% and 19.1%, respectively, with a mean age of 32.76 ± 7.65 years. Screen exposure exceeding four hours daily was significantly associated with MGD (OR = 9.05, 95% CI: 2.14- 38.28, p = 0.003) and DED (OR = 8.12, 95% CI: 2.16-30.54, p < 0.001). Increasing age increased the odds of MGD (OR = 3.65, 95% CI: 1.15-11.51, p = 0.027), while male gender was a significant risk factor for both. MGL correlated moderately with OSDI (r = 0.58) and meibum quality (r = 0.46), and weakly with meibum expressibility (r = 0.35) and corneal fluorescein staining (r = 0.36). Common gland changes were dropout (29.1%), tortuosity (25.5%), and shortening (20.9%). CONCLUSION: MGD and DED were observed in 17.3% and 19.1% of Trans-PRK candidates. Age, male gender, and screen exposure were associated with MGD, while male gender and screen exposure were associated with DED. MGL correlated with key ocular surface indices, highlighting the importance of comprehensive preoperative ocular surface assessment.
A survey study of vaccine hesitancy among children to COVID-19 vaccination and the roles of parental and social media influence.
Gill HS, Abdul Jalal MI, Cheah FC
Med J Malaysia · 2025 Nov · PMID 41328825
INTRODUCTION: The COVID-19 pandemic brought unprecedented shifts in public health measures, including accelerated mass vaccination programmes. Although most children with COVID-19 are asymptomatic or have mild disease, t...
INTRODUCTION: The COVID-19 pandemic brought unprecedented shifts in public health measures, including accelerated mass vaccination programmes. Although most children with COVID-19 are asymptomatic or have mild disease, they may act as reservoirs for SARS-CoV-2 transmission. Furthermore, multisystem inflammatory syndrome in children (MIS-C) can cause serious complications. COVID-19 vaccines became available in 2022 for Malaysian children aged 5-18, sparking public discussions on safety and necessity, which may have contributed to modest uptake in younger children. As most vaccine hesitancy studies focus on adults, our study aimed to assess hesitancy among children aged 10-17 and explore parental and social media influences on minors' assent to vaccination. MATERIALS AND METHODS: This study was conducted in the outpatient clinic of a tertiary and academic children's specialist hospital. A total of 200 parent-child pairs participated in a survey using an adapted and translated questionnaire in the Malay language, comprising 35-items divided into three sections with the attendance of a trained interviewer. Vaccine hesitancy was assessed using a 5-point Likert scale adapted from the Oxford COVID-19 Vaccine Hesitancy Scale. RESULTS: The parent-participants were predominantly mothers (81%) and child-participants were equally distributed between primary and secondary schoolers. Vaccine hesitancy rates were 50% and 46% among parents and children, respectively. The overall vaccine hesitancy score was graded as moderate (mean score, 2.44; SD 0.43) among the children. Parents who were unemployed or homemakers were significantly associated with vaccine hesitancy in the child when compared with those on fulltime jobs (69.4% versus 30.6%, p=0.010). Parental history of COVID-19 was significantly associated with vaccine hesitancy (p=0.025), whereas parental hesitancy to vaccinate their child was associated with increased child vaccine hesitancy (p=0.004). Primary school than secondary school children were more likely to be vaccine hesitant (56% versus 36%, p=0.005). Vaccine hesitancy was negatively associated with the child's full-vaccination status (p=0.021). More than half of the children surveyed spent at least 6 hours daily on their smart devices, with one-third spending at least three hours on social media. However, their preferred choice of media platforms to seek Covid-19 information, was television (20.5%), followed by social media (17%) and printed media (11.5%). Of note, children in the non-vaccine hesitant group preferred COVID-19 information accessed from television and printed media (t=2.755, p=0.006 and t=2.539, p=0.011, respectively). CONCLUSION: This study demonstrates that vaccine hesitancy in children negatively impacted the uptake of COVID-19 vaccine. Parental hesitancy significantly influences the child's hesitancy to vaccination. Health promotion programmes on vaccination may need to be intensified to the more at-risk for vaccine hesitancy among parents who are unemployed or homemakers and primary school children. Addressing vaccine hesitancy incorporating the child's agency in this respect for assent to vaccination may be a positive strategy in enhancing its uptake. While social media is undeniably an important channel, traditional media such as television remains an established and trusted option for dissemination of health policies and recommendations.
Patient-reported outcome measures and patient satisfaction after total knee replacement for osteoarthritis in Egyptian patients: An observational Study.
Ayman E, Bahaa H, Osama S … +2 more , Mahmoud A, Ismail B
Med J Malaysia · 2025 Nov · PMID 41328824
INTRODUCTION: Together with the clinical and radiological evaluation, patient-reported outcome measures (PROMs) provide a valuable tool to measure the success of TKA. This prospective study looked at the clinical outcome...
INTRODUCTION: Together with the clinical and radiological evaluation, patient-reported outcome measures (PROMs) provide a valuable tool to measure the success of TKA. This prospective study looked at the clinical outcome and patients' satisfaction following TKA using different PROM and scores at one-year post-operative. MATERIALS AND METHODS: A prospective cohort study was performed at an elective arthroplasty unit in Menoufia University Hospitals, Egypt, on 132 patients who received primary TKA from 1 May 2021 to 1 May 2022 with a minimum one-year follow-up. All Patients received fixed bearing posterior stabilized knee TKA because knee arthritis, either primary or secondary to autoimmune disorder were included. Demographic data were collected: age, sex, weight, height, body mass index (kg/m2), comorbidities, socioeconomic status, and occupation. Three scores were used for prospective evaluation. Oxford Knee Score (OKS), Western Ontario and McMaster Universities Osteoarthritis Index score (WOMAC), and VAS (Visual Analogue Scale). During the follow-up visits, the participants were then asked to conduct their PROM (6 months and one year), and radiological and functional outcomes were recorded. RESULTS: 132 patients with mean age 58.5±8.1 (range 35 to 80), a higher proportion of the patient's population were females 105 (79.5%), the body mass index was 28.8±1.37. Comparing the results received on 6 months and 12-month follow-up visits to that recorded preoperative. significant improvement of OKS, WOMAC score, and VAS, this was seen when comparing the measures at 6 months postoperative to the preoperative,12 months postoperative to the preoperative, and 6 months postoperative to 12 months postoperatively, with significant improvement between each of the pairs (P= <0.001). Correlation between both OKS and WOMAC score at 12 months postoperative and age, and BMI. At the 12-month follow-up visit, patients who gave responses on a 4-point Likert scale, with overall patient satisfaction was 72.7% (96 patients); with a dissatisfaction rate of 27.3% (36 patients). CONCLUSION: Despite being highly successful in relieving pain, TKA does not meet the expectations of all patients, especially those with demanding levels of knee activities. PROMs that measure functional outcomes should consider patients of different cultures and lifestyles.
Knees on fire: Investigating the impact of knee discomfort on cardiovascular fitness among Malaysian firefighters.
Rosnah I, Nor Hisham M, Ismail AG … +4 more , Ashrul Riezal A, Loganayagi S, Uszair Umair MJ, Hanizah MY
Med J Malaysia · 2025 Nov · PMID 41328823
INTRODUCTION: Firefighters require optimal cardiovascular fitness (CVF) to effectively perform fire suppression activities and other essential tasks. However, knee discomfort can reduce their engagement in leisure-time p...
INTRODUCTION: Firefighters require optimal cardiovascular fitness (CVF) to effectively perform fire suppression activities and other essential tasks. However, knee discomfort can reduce their engagement in leisure-time physical activity (LTPA), subsequently affecting their CVF during individual field-based testing. This study aimed to determine the impact of knee discomfort on CVF and to assess the necessity of adjusting field-based CVF test scores for firefighters experiencing such physical limitations. MATERIALS AND METHODS: This study used secondary data from 5,680 firefighters, collected between September and October 2023. A final 3,885 datasets that met the eligibility criteria were included for analysis. Knee discomfort was assessed using the Cornell Musculoskeletal Discomfort Questionnaire, with scores derived from the Rasch Measurement Model based on three items: frequency, severity, and work interference due to knee discomfort. CVF was estimated using self-reported field-based CVF tests, including the time taken to run 2.4 km, the beep test (level and shuttle), and the 6-minute walking test. VO₂ max estimation was calculated as a proxy for CVF. Multiple linear regression was used to analyse the impact of knee discomfort on CVF, controlling for age, male gender, sleep duration, intensity of weekly LTPA, and perceived work demands. Cohen's effect size (ƒ2) was observed, with values of 0.02, 0.15, and 0.35 indicating small, medium, and large effect sizes, respectively. RESULTS: The prevalence of knee discomfort among operational firefighters was 51.3%. Of these, 43.9% described the discomfort as mild, while 77.9% reported that it did not interfere or only slightly interfered with their work. LTPA (β = 0.70; 95%CI: 0.55, 0.85; p < 0.001) and knee discomfort scores (β = -0.04; 95%CI: -0.05, -0.03; p < 0.001) were associated with CVF among the participants, after controlling for age and gender. However, the impact of knee discomfort on CVF was negligible (ƒ2 = 0.012). CONCLUSION: Knee discomfort showed a statistically precise yet negligible effect on CVF, indicating that adjustment of field-based CVF test scores is unnecessary. However, for firefighters experiencing severe knee discomfort, a more lenient test, such as the 6-minute walking test, should be considered rather than exempting them from assessment.
Attitude and perception of house officers towards prescribing practice and prescribing competencies in Malaysia: A multi hospital survey.
Thamilmanni S, Ang YM, Chua SK … +5 more , Sim SM, Maxwell S, Mohamad Isa II, Mathialagan A, Karisnan K
Med J Malaysia · 2025 Nov · PMID 41328822
INTRODUCTION: Prescribing errors are a significant issue in healthcare systems globally and represent an imminent risk to patient safety. These errors have the potential to result in increased morbidity and mortality. Th...
INTRODUCTION: Prescribing errors are a significant issue in healthcare systems globally and represent an imminent risk to patient safety. These errors have the potential to result in increased morbidity and mortality. This study seeks to investigate the perceptions of House Officers (HOs) in Malaysia regarding their prescribing skills and competencies, as well as their views on the adequacy of clinical pharmacology and therapeutics training received during their undergraduate medical education. MATERIALS AND METHODS: A cross-sectional study was conducted among HOs in 9 hospitals across Malaysia. The study utilized a survey comprising 26 items to assess the HOs' perceptions of their knowledge in clinical pharmacology and therapeutics, as well as their prescribing practices during housemanship training. Data was analysed using descriptive and inferential statistics. RESULTS: A total of 319 HOs participated in the study, which was conducted between June 2019 and June 2021. The findings revealed that the majority of participants perceived themselves as possessing adequate knowledge to prescribe most commonly used classes of medications. Nevertheless, 45% of respondents reported feeling adequately prepared for prescribing tasks based on their undergraduate medical training. Additionally, 51% expressed confidence in their therapeutic knowledge for prescribing, while approximately 50% reported confidence in preparing and administering medications. CONCLUSION: The findings indicate that HOs generally perceive themselves as confident and knowledgeable in prescribing and preparing prescriptions. However, limitations in undergraduate education on prescribing contribute to feelings of inadequate preparedness as they transition into clinical practice. Strengthening educational support in this area is essential to improving prescribing competence, ensuring patient safety, and enhancing overall clinical outcomes.
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