Medical Journal of Malaysia最新文献

{"title":"Transforming patient care: The QWIC system to optimise waiting times and efficiency in surgical outpatient clinics in Malaysia.","authors":"R Shariff, A A Harith, S C Tee, M S Jahit","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Waiting time at surgical outpatient clinics in Malaysian hospitals has become a critical concern, impacting patient satisfaction and overall healthcare efficiency. Many facilities face challenges leading to extended waiting periods for surgical consultations and procedures. These delays not only affect patient outcomes but also contribute to increased anxiety and frustration among patients. Implementing innovative solutions, such as advanced queue management systems, can play a significant role in operational workflows and reducing wait time. Thus, this study aims to determine the efficiency of waiting time using the Queue Won't Intimidate Customer (QWIC) system towards surgical outpatient clinics at the National Cancer Institute (NCI).</p><p><strong>Materials and methods: </strong>Data were collected retrospectively through a cross-sectional design over a six-month period, from April 1 to September 31, 2021, following the implementation of the QWIC system on 3 surgical clinics (bariatric clinic, general surgery (GS) clinic, and Upper gastrointestinal (UGI) clinic) under NCI. The Ministry of Health (MOH) established an acceptable waiting time benchmark of 60 minutes or less.</p><p><strong>Results: </strong>The most efficient clinic was GS (98.9%), followed by UGI (96.2%) and bariatric (83.4%). Based on logistic regression analysis, bariatric clinic (COR: 18.72, 95% CI: 6.51-51.28, p < 0.001; AOR: 15.33, 95% CI: 5.32-44.13, p <0.001) and new surgical cases (COR: 3.19, 95% CI: 1.96- 5.22, p < 0.001 and AOR: 2.56, 95% CI: 1.42-4.52, p = 0.001) are strongly associated with longer waits. UGI clinic also show increased waiting times (COR: 3.67, 95%CI: 1.23:10.94, p = 0.020; AOR: 3.34, 95% CI: 1.12-10.02, p = 0.031). Conversely, consultation durations over 60 minutes and attendance status did not significantly affect waiting times.</p><p><strong>Conclusion: </strong>The QWIC System represents a significant advancement in managing patient appointments and consultations within surgical clinics. Overall, types of surgical clinic and case status were key factors influencing waiting times in surgical clinics.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 2","pages":"313-320"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biologic drug survival in psoriasis: insights from a multi-center retrospective study in West Malaysia.","authors":"K V Chan, A A K Moonyza, A Mohd Affandi, M Mashor, J W Kwan, S Latha, H L Lee, S E Lee, E W Y Yap, A R Nazatul Shima, S B Wong, C S Lee, P Gunabalasingam","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Psoriasis is a chronic immune-mediated skin disorder with significant impact on patients' quality of life. Biologic therapies have revolutionized the treatment of moderate-to-severe psoriasis, but data on their long-term effectiveness, measured through drug survival rates, remains limited in Malaysia. This study aimed to analyze the drug survival of biologic therapies and identify factors influencing treatment discontinuation among psoriasis patients in Malaysia.</p><p><strong>Materials and methods: </strong>This retrospective cohort study analyzed 285 psoriasis patients receiving 437 biologic treatment courses in 10 tertiary hospitals in West Malaysia. Data on demographic characteristics, clinical profiles, and biologic treatments were collected and analyzed. Drug survival was evaluated using Kaplan-Meier analysis, and predictors of treatment discontinuation were identified using Cox proportional hazards modeling.</p><p><strong>Results: </strong>The study cohort had a mean psoriasis onset age of 28 (⊕ 13) years, with biologic initiation at 39 (⊕ 16) years. Secukinumab (53.7%) was the most commonly prescribed first-line biologic, followed by Ustekinumab (28.1%). Loss of efficacy was the leading cause of discontinuation, increasing from 49.6% in the first line to 100% by the fifth. Kaplan-Meier analysis showed Secukinumab had the longest mean survival (45.5 months), followed by Ustekinumab (41.4 months) and Rizankizumab (41.3 months). Cox regression revealed prior biologic use significantly increased discontinuation risk (HR = 1.415, p = 0.049), while diabetes mellitus approached significance increase discontinuation risk (HR = 1.575, p = 0.054).</p><p><strong>Conclusion: </strong>Biologic drug survival in Malaysian psoriasis patients reflects global trends, with Secukinumab demonstrating superior durability. Loss of efficacy and funding issues were key barriers to persistence. The findings emphasize the need for optimized treatment strategies with wider access to biological treatment.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 2","pages":"251-258"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a new quality of life instrument for children with infantile esotropia before and after strabismus surgery.","authors":"H Waheeda-Azwa, N B Hassan, S Abdullah, J Che-Hamzah, I Shatriah","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Infantile esotropia impacts the quality of life (QOL) of children and their families. In addition to surgical treatment, QOL assessment is an important tool for evaluating treatment success. Thus, this study aimed to assess QOL before and after strabismus surgery using the newly developed Infantile Esotropia Quality of Life Questionnaire (IEQ).</p><p><strong>Materials and methods: </strong>A prospective study was conducted from September 2018 to June 2019 at the Ophthalmology Clinic, Hospital Pakar Universiti Sains Malaysia. Children aged 5-17 years diagnosed with infantile esotropia were recruited. QOL and clinical examinations were measured pre- and post-strabismus surgery. The comparison of QOL scores before and after surgery was analysed using the paired t-test.</p><p><strong>Results: </strong>A total of 126 children participated in the study: 63 aged 5-8 years and 63 aged 9-17 years. Strabismus surgery significantly improved the QOL scores in both age groups. In the younger group, scores increased from 68.00 preoperatively to 89.36 postoperatively (P < 0.001), while in the older group, scores increased from 78.07 to 90.21 (P < 0.001). No significant association was found between QOL scores and gender, angle of deviation, or stereopsis (P > 0.05).</p><p><strong>Conclusion: </strong>Strabismus surgery significantly improved the quality of life in children with infantile esotropia in both age groups. The IEQ tool is a useful instrument for assessing functional and psychosocial outcomes in this population. Gender, ocular deviation, and stereopsis did not appear to influence QOL outcomes.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 2","pages":"273-279"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total corneal astigmatism magnitude and vector orientation in diabetic and non-diabetic Malay eyes.","authors":"A S Afira, M A Ahmad, M S Ibrahim, S Adzahar, M K Khairidzan, M Hudzaifah-Nordin","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The influence of diabetes mellitus (DM) on total corneal astigmatism (TCA) remains incompletely understood. Using total keratometry (TK), this study characterised TCA magnitude and orientation in a Malay adult population and evaluated the influence of metabolic control and ocular parameters on TCA.</p><p><strong>Materials and methods: </strong>This cross-sectional study analysed 190 eyes (88 non-diabetic; 102 diabetic). TCA magnitude and axis were derived from TK obtained using swept-source optical coherence tomography (IOLMaster 700, Carl Zeiss Meditec, Germany) and decomposed into power-vector components; J0 (horizontal/vertical) and J45 (oblique). Corneal endothelial parameters were measured using specular microscopy (Topcon SP-1P, Japan). Group comparisons were performed using Welch's t-test. Within diabetic eyes, linear regression models identified independent predictors of TCA magnitude and orientation, adjusting for age, glycated haemoglobin (HbA1c), DM duration, cumulative metformin exposure, central corneal thickness, endothelial cell density, and white-to-white diameter.</p><p><strong>Results: </strong>TCA magnitude did not differ significantly between diabetic and non-diabetic eyes (p = 0.066). Vector analysis demonstrated no significant between-group difference in J0 or J45, with substantial vector centroid overlap. In diabetic eyes, higher HbA1c was independently associated with greater TCA magnitude, while increasing age was independently associated with a shift towards more negative J0 values. DM duration and metformin exposure were not independently associated with TCA magnitude or vector components.</p><p><strong>Conclusion: </strong>Diabetes status alone was not associated with systematic differences in TCA magnitude or orientation. Age and metabolic control were the strongest factors associated with TCA characteristics. Vector-based analysis provides a robust framework for astigmatism assessment in diabetic and non-diabetic eyes.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 2","pages":"297-303"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation and clinical audit of a virtual thoracic oncology MDT in a low-resource setting in Malaysia.","authors":"S W Cheo, S S Kho, K J Cheng, G G Yeo, Q J Low, C S Chai, S T Tie, P W Tan, Z Abdul Hamid, K S Lau, S Y Soon, T F G Chua, A M Ismail, P J Voon","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Cancer care is increasingly complex, and in Sarawak, Malaysia, geographic and resource limitations further complicate management. This clinical audit describes the implementation, structure and workflow of a virtual thoracic oncology multidisciplinary tumor board (MDT) in a resource-limited setting, and describe the cases discussed and key issues raised.</p><p><strong>Materials and methods: </strong>A MDT was established in Sarawak, comprising pulmonologists, oncologists, pathologists, thoracic surgeons, and radiologists. Monthly virtual meetings were held to discuss complex cases. This retrospective study analyzed cases from July 2022 to December 2024, focusing on cancer types, challenges, and recommendation. As an audit of clinical practice, no treatment adherence or outcome measures were assessed.</p><p><strong>Results: </strong>A total of 94 cases were discussed (median age 60 years; 59.6% male). Cases per year: 21 (2022), 24 (2023), and 49 (2024). Common diagnoses included lung cancer (48.9%), lung lesions from other solid cancers (26.6%), suspected lung cancer (12.8%), non-malignant respiratory conditions (9.6%), and thymic cancer (2.1%). Among solid cancers with lung lesions, colorectal cancer (36%) was most frequent, followed by breast (12%), gynaecological (12%), sarcoma (8%), and others (32%). The main reasons for MDT discussions were therapeutic issues (58.5%) and diagnostic challenges (41.5%). Imaging review (83%) and management discussions (80.9%) were the most common points of discussion. Among 46 lung cancer patients, 43.5% had early-stage, 30.4% locally advanced, and 19.6% metastatic disease. Key recommendations included surgery (35.1%), surveillance (16%), systemic therapy (13.8%), biopsy (11.7%), PET/MRI (7.4%), EBUS staging (5.3%), radiotherapy (4.3%), and clinical trials (2.1%).</p><p><strong>Conclusion: </strong>This audit demonstrates that a virtual thoracic oncology MDT is feasible and can standardize multidisciplinary discussion, and improve access to specialist input in a resource-limited setting. While clinical outcomes were not evaluated, this audit provides insight into operational processes. Future prospective work incorporating structured data collection, MDT adherence and integration of electronic health records will help evaluate the MDT's impact on patient outcomes and guiding service improvement.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 2","pages":"225-233"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and determinants of Tuberculosis Preventive Treatment (TPT) completion in Latent Tuberculosis Infection (LTBI) among TB contacts in Selangor, from January 2022- December 2024: National TB Registry (NTBR).","authors":"I Izanna, S Mohamad Ikhsan, M Mariam, I Siti Hasmah","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Measles remains a persistent public health concern in Malaysia. Despite sustained high vaccination coverage in states such as Selangor, reported cases continue to increase. This trend suggests a possible shifting age-distribution of measles, a pattern that has been observed in countries with a high vaccination rate. Understanding the epidemiology and clinical characteristics of measles between adults and children is critical in guiding targeted public health interventions aimed at control and elimination of measles. This study aimed to describe the incidence of measles in adults and children in Selangor, and to compare their sociodemographic, clinical, vaccine, and exposure-related differences.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;This comparative cross-sectional study used secondary data from the Selangor e-Measles Registry from 2015 to 2024. Confirmed cases were classified as adults (≥18 years) and children (&lt;18 years). The incidence of each group was calculated annually over ten years. Descriptive statistics, chi-square test, Fisher's exact test, and Mann-Whitney U test were used to describe and compare the differences between the two groups. Data were analysed using SPSS version 29.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 3954 confirmed measles cases were included in the study, with 540 (13.7%) adult cases and 3414 (86.3%) cases in children. Between 2015 and 2024, the incidence of measles was consistently higher in children as compared to adults, with risk ratios ranging from 14.43 (95% CI: 11.25, 18.73) in 2017 to 87.65 (95% CI: 27.39, 278.66) in 2022. With the exception of 2019-2022, adults showed a gradual increase in number over the study period, with the highest proportion in 2023 (16.4%). Significant differences between adults and children were observed (p&lt;0.05) according to nationality, ethnicity, clinical symptoms, hospitalisation, complications, vaccination status, and duration since the last vaccination.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;The findings suggest that despite the increase in adult cases, measles predominantly affects children in Selangor. The findings highlight the need to strengthen vaccination efforts through the National Immunisation Programme (NIP) and prioritising Supplementary Immunisation Activities (SIAs) among children aged below 6 years old. Additionally, the gradual rise in cases in adults and children aged 7-12 years old should be monitored closely to detect emerging epidemiological shifts. Significant clinical differences between adults and children highlight the need for training of healthcare providers and public education to support diagnosis, prevent outbreaks, and avoid complications. Digitalisation of health records, such as the documentation of vaccination history, is needed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Measles in Selangor showed age-specific trends and differences. Addressing these issues through strengthened childhood immunisation, targeted inter","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 2","pages":"304-312"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of life of Hirschsprung disease patients with a stoma.","authors":"J Gracia, S A Qisthi, A I Rezza, D F Harfanie, Z S Izzati, Q J Wijayatno, Y G Brahmandoko, K Iskandar, E Purnomo, Gunadi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Hirschsprung disease (HSCR) is a genetic disorder leading to gastrointestinal obstruction due to the absence of ganglion cells in the submucosal and myenteric plexuses. Treatment typically involves a pull-through surgery, sometimes starting with a colostomy. The COVID-19 pandemic has resulted in restrictions on general patient services, i.e., non-COVID-19 patients, at health facilities, leading to reduced hospital visits, including HSCR patients with stomas. This study aimed to determine whether there were differences in the quality of life (QoL) of HSCR patients with stomas before and after the COVID-19 pandemic.</p><p><strong>Materials and methods: </strong>This research was a descriptive study comparing the quality of life (QoL) of HSCR patients with stomas before and after the COVID-19 pandemic. It utilized a cross-sectional study design and assessed QoL using the PedsQL Generic Core Scales 4.0 questionnaire.</p><p><strong>Results: </strong>There was no significant difference in the QoL of HSCR patients before COVID-19 and after COVID-19, as indicated by parent reports (p=0.88) and child reports (p=0.12). However, there was a statistically significant difference in scores on the social dimension of child reports (p=0.04). Furthermore, there was no statistically significant relationship between parent and child reports (p>0.05).</p><p><strong>Conclusion: </strong>The QoL of HSCR patients with a stoma before and after the COVID-19 pandemic is similar, except for the social dimension in the child's report. Further studies with more cases are necessary to clarify the findings of this study.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 2","pages":"246-250"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cytopeutics umbilical cord-derived mesenchymal stem cells are associated with earlier clinical improvement compared to bone marrow aspirate concentrate with scaffold in knee cartilage injury: A Phase 1 feasibility and Phase 2 randomized controlled trial.","authors":"B A H Md Yusoff, N Mohamad, S P Chin, M N Ramlan, M S Zool Kipele, N S I Saffery, N A Mohd Nasir, A F Mohd Don, S K Lai, H Hussin, M F Yakop, S F Abdul Wahid, S K Cheong","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Despite advances in the development of mesenchymal stem cells (MSCs), the ultimate benefits of MSCs against current cell-based therapies are still limited. This study aimed to assess the safety, feasibility, and efficacy of Cytopeutics® umbilical cord-derived MSCs (Chondrocell-EX) in patients with knee cartilage injury.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;The study was conducted in two parts: a phase I feasibility study (PI) followed by a phase II randomized controlled trial (PII). Both studies were approved by UKM Research Ethics Committee (PI: UKM PPI/111/8; PII: UKM PPI/111/8/JEP-2019-304). Six patients were involved in the PI study in which all patients received Chondrocell-EX and 28 patients in the following PII study, where 17 patients received Chondrocell-EX with Hyaluronic acid (HA) (Arm A) and 11 patients received commercially available cell-based therapy, which is Bone Marrow Aspirate Concentrate (BMAC) with Hyaluronic acid-based scaffold (HA-S) (Arm B). Safety was assessed based on the occurrence of adverse events, while clinical outcomes were assessed based on the Knee Injury and Osteoarthritis Outcome Score (KOOS) and Pain Visual Analog Scale (VAS). Second-look arthroscopy and histological assessment were performed to assess their structural outcomes at 12 months.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In the PI feasibility study, significant pain reduction began at 3 months, with mean VAS decreasing from 6.83 ± 0.98 at baseline to 4.83 ± 1.17 (p &lt; 0.01), 3.00 ± 0.00 at 6 months (p &lt; 0.01), and 1.83 ± 0.75 at 12 months (p &lt; 0.01). In the PII study, Arm A (Chondrocell-EX + HA) demonstrated significant VAS improvements at all follow-up points compared to baseline (p &lt; 0.001), whereas Arm B (BMAC + HA-S) showed significant reductions only from 3 months onward. After adjustment for baseline age and VAS, Arm A achieved significantly lower pain scores than Arm B at 6 months (2.56 ± 1.41 vs 3.09 ± 1.22; p = 0.015) and 12 months (2.27 ± 1.49 vs 2.50 ± 1.35; p = 0.043), indicating earlier and sustained pain relief with Chondrocell-EX injection. Functional outcomes mirrored pain improvements. In PI, KOOS scores improved significantly from 3 months, reaching 85.83 ± 11.87 at 12 months (p &lt; 0.01). In PII, KOOS increased significantly in both arms (p &lt; 0.001), but Arm A demonstrated earlier gains at 3 months and significantly higher adjusted KOOS scores than Arm B at 6 (p = 0.009) and 12 months (p = 0.037). In KOOS subdomains analysis, it showed significantly greater improvements in Arm A, particularly in symptoms and stiffness, activity of daily living (ADL), pain, sport and recreation, and quality of life (QoL) at key time points.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Chondrocell-EX+HA treatment is more convenient, feasible, and minimally invasive with the findings suggesting that it is associated with faster functional improvement and pain relief, along with demonstration of hyaline-like cartilage regeneration","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 2","pages":"234-245"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between post-partum mothers' knowledge and essential newborn care practices in Jambi, Indonesia.","authors":"O Jayanti, E L Haksari, Ismarwati, D Ismail","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Essential Newborn Care (ENC) is crucial for neonatal survival, which is known to be very significant for the objective of Sustainable Development Goals in 2030 as an attempt to decrease neonatal morbidity and mortality. Mothers play an important role in ENC. This study aimed to delve into the relationship between mothers' knowledge, parity, education level, age, occupation, economic status, and ENC practices in post-partum mothers.</p><p><strong>Materials and methods: </strong>A cross-sectional design was conducted in Jambi, Indonesia from June to August 2021. There were 152 post-partum mothers who had neonates aged 0-28 days, consisting of 76 primiparous and 76 multiparous mothers. A questionnaire on ENC knowledge and practice was utilized to collect the data from the instrument of the previous study. The data were examined using univariate, bivariate, and multivariate analyses.</p><p><strong>Results: </strong>Multivariate analysis on ENC practices revealed that mothers with low knowledge had a higher risk of performing poor ENC practices with OR 10.6 than those with high knowledge, and it was significantly different. Mothers with low educational level had more risks of practicing poor ENC with OR 2.9 than those with high educational level, which was significantly different. Meanwhile, parity, age, occupation, and economic status of post-partum mothers did not present a statistically significant correlation (p>0.05) with ENC practices.</p><p><strong>Conclusion: </strong>There was a significant difference in ENC practices, with high risk in those who had low knowledge followed by low education. There was no association between ENC practices and parity, age, occupation, and economic status of post-partum mothers. These findings highlight the importance of improving the knowledge of post-partum mothers in supporting ENC practices. The result of the study should nevertheless be interpreted in such a way by considering the limitations of the study design and the instruments used.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 2","pages":"267-272"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LIVERSTAT for the diagnosis of compensated advanced chronic liver disease in patients with type 2 diabetes.","authors":"J S C Lee, N M Z Chee, L L Lai, S R Vethakkan, W K Chan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>LIVERSTAT is a non-invasive artificial intelligence-based test that provides risk stratification for metabolic dysfunction-associated steatotic liver disease. We aimed to study the performance of LIVERSTAT compared with the Fibrosis-4 Index (FIB-4) as a stand-alone test and as a first-line test to identify patients for liver stiffness measurement (LSM) for the diagnosis of compensated advanced chronic liver disease (cACLD) in patients with type 2 diabetes (T2D).</p><p><strong>Materials and methods: </strong>This is a cross-sectional study of patients with T2D who underwent transient elastography. cACLD was defined as LSM ≥10 kPa. As a stand-alone test, LIVERSTAT Class D and increased FIB-4 ≥1.3 (≥2.0 if age ≥65 years old) were considered as having cACLD. As a first-line test, LIVERSTAT Class D and increased FIB-4 were considered as requiring LSM.</p><p><strong>Results: </strong>We analysed data for 221 patients (mean age 61 years, 41% male, cACLD 26%). The area under the receiver operating characteristic curve, sensitivity, specificity, positive predictive value, negative predictive value and misclassification rate for LIVERSTAT were 0.66, 32%, 88%, 47%, 79% and 27%, respectively. The corresponding values for FIB-4 were 0.61, 39%, 81%, 41%, 79%, and 30%, respectively. When using LIVERSTAT as a first-line test, the proportion of patients requiring LSM was 17% (38/221), while the proportion of false negatives was 19% (34/183). The corresponding values for FIB-4 were 24% (54/221) and 19% (31/167), respectively.</p><p><strong>Conclusion: </strong>LIVERSTAT has similar accuracy as FIB-4 when used as a stand-alone test or as a first-line test to identify patients for LSM for the diagnosis of cACLD in patients with T2D.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 2","pages":"209-215"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}