Medical Journal of Malaysia最新文献

{"title":"Artificial intelligence in healthcare: A call for strategic implementation to maximize impact and minimize costs.","authors":"K S Chew","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Artificial Intelligence (AI) is transforming healthcare by improving diagnostics, decision-making, and patient outcomes. This commentary emphasizes the need for strategic AI implementation to maximize benefits while minimizing costs. Although AI can automate routine tasks and freeing clinicians to focus more on patient care, challenges like costs and medicolegal concerns must be addressed. A two-dimensional impact-effort framework is proposed to prioritize AI tools implementation based on their impact and costs.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 3","pages":"378-381"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175223","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":"Eye cases that widened the vision on medical negligence.","authors":"N K S Tharmaseelan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>No abstract available.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 3","pages":"277-281"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175230","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":"Challenges in setting up the first cyto-reductive surgery (CRS) and hyperthermic intra-peritoneal chemotherapy (HIPEC) service in Malaysia.","authors":"M R A Aziz, N A Aziz, R G Xavier, T L Khong, A C Roslani","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Cyto-Reductive Surgery (CRS) with Hyperthermic Intra-Peritoneal Chemotherapy (HIPeC) improves survival in selected patients with peritoneal surface malignancies (PSM) of various tumour entities. This treatment was not available in the Malaysian public health sector prior to 2018, due to lack of expertise, funding and accessibility. We report our challenges in establishing the first such service.</p><p><strong>Materials and methods: </strong>Patients referred for CRS-HIPeC between February 2018 and November 2023 were discussed in a multidisciplinary team meeting. Prospectively collected data, including patient demographics, extent of disease (radiological stage, peritoneal carcinomatosis index - PCI), pre-operative workup, completeness of cytoreduction (CCR) score and surgical outcomes, were analysed.</p><p><strong>Results: </strong>Of 162 patients referred, 47 (30.0%) underwent CRS-HIPeC. The median age was 59 years (range 20-76 years). Median PCI was 11 (range 1-39). CCR distribution was as follows: CCR 0 - 40 (85.1%), CCR 1 - 2 (4.3%), CCR 2 - 2 (4.3%) and CCR 3 - 3 (6.3%). Median operative time was 645 minutes (range 360 -1575 minutes) with a median length of in-hospital stay of 11 days (range 6-146 days). All patients were initially managed in the intensive care unit. Sixteen (34.0%) patients developed complications of Clavien-Dindo Class 3 and above, with three operative mortalities (6.3%).</p><p><strong>Conclusion: </strong>CRS-HIPeC requires adequate clinical expertise, facilities and volume. Its labour and resourceintensive nature mean that centralization of services is necessary for sustainability. Further evaluation of its costbenefit in our setting will be required.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 3","pages":"359-365"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175224","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 dry eye pre and post phacoemulsification in diabetic patients.","authors":"H Nur Faizah, Y Mohd Feendi, M K Siti Zakiah, W H Wan-Hazabbah","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Dry eye is a common condition influenced by various factors, including cataract surgery and systemic diseases like diabetes. Phacoemulsification, a widely used cataract procedure, often leads to increased postoperative dry eye symptoms due to inflammation and changes in tear film stability. Diabetic patients, already prone to dry eye, may experience further worsening after surgery. This study evaluates dry eye status in diabetic patients before and after phacoemulsification.</p><p><strong>Materials and methods: </strong>This study included 126 patients, divided into diabetic and non-diabetic groups from Hospital Melaka and Hospital Pakar Universiti Sains Malaysia between September 2022 and July 2024. Patient demographics and dry eye parameters, including the Ocular Surface Disease Index (OSDI), Tear Break-Up Time (TBUT), and Schirmer's test, were evaluated at baseline, one week, and three months after surgery. Only patients who underwent uncomplicated phacoemulsification were included, while those undergoing extracapsular cataract extraction, intracapsular cataract extraction, or lens aspiration were excluded. The mean values of OSDI, TBUT, and Schirmer's test across the three time points were compared among groups with diabetic retinopathy, without diabetic retinopathy and non-diabetic patients using repeated measures ANOVA.</p><p><strong>Results: </strong>126 patients were studied: 44 non-diabetic, 40 diabetic without retinopathy (no DR), and 42 diabetics with retinopathy (DR). The mean ± SD (standard deviation) age was 64.06 ± 5.30 years, with males comprising 54.0% of the cohort. Hypertension was the highest proportion of comorbidity (75.4%), particularly in the DR group (90.5%). Dry eye parameters showed significant temporary changes post-cataract surgery. OSDI scores improved significantly from baseline to three months in all groups, with diabetic groups showing higher scores at three months than nondiabetics (p < 0.05). TBUT declined significantly at one week in the diabetic groups (DR, p = 0.028; no DR, p = 0.019) but showed substantial recovery by three months, with significant improvements across all groups. In all groups, Schirmer's test values improved significantly between one week and three months (p < 0.05), although baseline and one-week differences were not statistically significant.</p><p><strong>Conclusion: </strong>Three months after cataract surgery, significant improvements in OSDI scores, TBUT, and Schirmer's test values were observed, indicating a recovery in dry eye status. Diabetic patients experienced more pronounced early postoperative changes but demonstrated comparable recovery trends to non-diabetics by three months. These findings highlight the importance of monitoring dry eye parameters in diabetics, particularly during the early postoperative period, to optimise outcomes and patient satisfaction.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 3","pages":"298-306"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175228","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":"Exploring the factors leading to tiered referrals of pregnant women until tertiary healthcare facilities: An in-depth analysis.","authors":"M M Rizal, R Pranadyan, A Izza, H E Dharmayanti, P H Habibie, A Musyarrofah","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Maternal mortality in Indonesia remains a significant health issue, with a mortality rate of 305 per 100,000 live births, the highest in Southeast Asia. Prolonged referral processes and delays in receiving medical assistance are major factors contributing to the high maternal mortality rate.</p><p><strong>Objective: </strong>This study aims to explore the factors influencing tiered referrals of pregnant women to tertiary healthcare facilities.</p><p><strong>Materials and methods: </strong>This descriptive analytical study uses secondary data from medical records of patients admitted to the Obstetrics and Gynecology Maternity Room at Dr. Soetomo Hospital, Surabaya, from July to September 2023, with ethical clearance number 2813/104/4/III/2024. Sampling was done using the total sampling method, with the dependent variable being the referral source (hospital and non-hospital) and independent variables including the number of Antenatal Care (ANC) visits, BMI, gravidity, residence, occupation, and education. Data analysis was performed using multiple logistic regression with SPSS Software.</p><p><strong>Results: </strong>Among the 280 patients studied, the majority were referred from hospitals (196 patients), and most had abnormal BMI (193 patients). Logistic regression analysis showed that women from rural areas had significantly higher delays in referrals compared to urban residents (p=0.004), while other variables such as age, number of ANC visits, BMI, gravidity, occupation, and education did not show significant influence.</p><p><strong>Conclusion: </strong>Place of origin is a critical factor influencing referral outcomes, highlighting the significant role of geographical and socio-economic determinants in the accessibility and quality of maternal healthcare services. This study underscores the necessity of an effective and timely referral system to mitigate maternal mortality rates in Indonesia, particularly emphasizing the need for enhanced referral infrastructure in rural areas to ensure prompt access to maternal care and ultimately reduce maternal mortality.</p><p><strong>Summary: </strong>Indonesia's maternal mortality rate remains high (305 per 100,000 live births), influenced by prolonged referral processes. Secondary data from 280 medical records at Dr. Soetomo General Hospital, Surabaya (July- September 2023), revealed that most patients were referred from hospitals (196), predominantly exhibiting abnormal BMI (193). Logistic regression analysis identified residential location (rural vs. urban) as significantly impacting referral outcomes (p=0.004), whereas other factors (age, ANC visits, BMI, gravidity, occupation, education) showed no significant influence. These findings highlight the critical role of geographic and socioeconomic conditions in maternal healthcare accessibility and emphasise the importance of an efficient and timely referral system to reduce maternal mortality in Indonesia.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 3","pages":"373-377"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175229","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":"The impact of facial acne scars on quality of life, anxiety, depression and its associated risk factors.","authors":"M M Heah, D W Low, R S Ng, N Mohd Ali, A Jamil","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Acne scars negatively impact psychosocial and emotional wellbeing. However, data on the impact of acne scarring on anxiety and depression as well as quality of life are limited. This study assessed the effects of facial acne scars on quality of life, anxiety, and depression, and identifies risk factors associated with scar severity.</p><p><strong>Materials and methods: </strong>We conducted an observational cross-sectional study between February 2023 and January 2024 at dermatology clinics in two public hospitals. A total of 175 patients with facial acne scars were recruited. Data collection included patient demographics, acne severity, scar severity (SCAR-S) and questionnaires such as Dermatology Life Quality Index (DLQI) and Hospital Anxiety and Depression Scale (HADS). The association between scar severity, quality of life, anxiety, and depression was analyzed using Chi-square tests and ordinal logistic regression.</p><p><strong>Results: </strong>The median age of participants was 26.9 years and 56% were female. Most patients had mild (37.7%) to moderate (28.6%) acne scars. Among patients with severe/very severe scars, 69.2% reported a significant impact on quality of life (DLQI>10). A significant association was observed between scar severity and anxiety (p=0.009) as well as depression (p<0.001). There was a positive correlation between HADS and DLQI scores (r=0.602, p<0.001). Delayed or absent treatment after acne onset was a significant risk factor for acne scar severity.</p><p><strong>Conclusion: </strong>Facial acne scars are associated with impairment in quality of life and increased anxiety and depression. Timely and effective acne treatment is essential to reduce the severity of scarring and its psychosocial burden.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 3","pages":"313-320"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175205","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":"Development and validation of a questionnaire assessing disease knowledge and self-care (ARKSc) level among allergic rhinitis patients.","authors":"A H H Ahmad Nizar, A Aziz, B Abdullah, A K Azidah, W M Zahiruddin, N S Abd Mutalib","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Understanding a patient's knowledge and selfcare level regarding allergic rhinitis (AR) is essential these factors significantly influence treatment outcomes. Currently, there is a lack of validated measurement tools specifically designed to assess disease knowledge and selfcare among patients with AR. Therefore, this study aimed to develop and validate a new questionnaire - the Allergic Rhinitis Knowledge and Self-care (ARKSc) questionnairefor this purpose.</p><p><strong>Material and methods: </strong>A questionnaire development and validation study was conducted in two phase. The first phase involved developing a self-administered questionnaire through literature review and consultations with an expert panel. Content validation was evaluated by a group of content experts using the content validity index (CVI), while face validity was assessed by AR patients using the Face Validity Index (FVI). In the second phase, construct validity of the final ARKSc questionnaire was examined at Hospital Sultan Abdul Halim, Kedah, Malaysia and Universiti Sains Malaysia Specialist Hospital (HPUSM), Kelantan, Malaysia involving 136 AR patients. Exploratory factor analysis (EFA) and reliability analysis were performed to assess the factorial structure and internal consistency of the questionnaire.</p><p><strong>Results: </strong>The preliminary questionnaire included 16 questions (22 items) assessing AR knowledge and 11 questions on self-care. During content validation, three items with low item-CVI (I-CVI) score were removed. The average Scale-CVI (S-CVI/Ave) for both knowledge and selfcare domains was 0.83. The scale-level face validity index value (S-FVI/Ave) 0.95, indicating excellent clarity and comprehensibility. Following construct validation, the final version of questionnaire consisted of 11 items in the knowledge section and 4 items in self-care section. The Cronbach's alpha was 0.659 for the knowledge section, and 0.663 for the self-care section, reflecting acceptable internal consistency.</p><p><strong>Conclusion: </strong>The newly developed and validated ARKSc questionnaire is a valid and reliable instrument for assessing disease knowledge and self-care among patients with allergic rhinitis. This study provides a foundation for future development of more refined tools and underscores the importance of evaluating these domains to enhance disease management and patient outcomes.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 3","pages":"335-345"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175226","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":"Treating newly diagnosed Diffuse Large B-cell Lymphoma in the elderly patient with R-mini-CHOP: A single centre analytical retrospective observational study.","authors":"N L Lai, P C Bee","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Diffuse large B-cell lymphoma (DLBCL) forms the bulk of non-Hodgkin lymphoma (NHL) cases encountered in clinical practice among the elderly. For the majority of cases of DLBCL, treatment comprising of Rituximab, Cyclophosphamide, Doxorubicin, Vincristine and Prednisolone (R-CHOP) is suggested as first line chemotherapy. However, chemotherapy in the elderly population may be hampered by multiple factors, including reduced bone marrow reserves, significant comorbidities, and greater side effects from chemotherapy. Treatment as such aims to offer disease control and prolong life whilst minimising treatment related complications in this group of patients. Treatment with R-mini-CHOP, a reduced dose form of R-CHOP offers survival benefits and is recommended for treatment of elderly DLBCL patients and those who are frail. Our study examined local Malaysian experience of treating the newly diagnosed elderly DLBCL patient with R-mini- CHOP.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;We retrieved retrospective data of all DLBCL patients aged &gt;65 years old from the electronic medical records in Pusat Perubatan Universiti Malaya who received R-mini-CHOP. Treatment response was assessed by the overall response rate (ORR), defined as the proportion of patients attaining complete and partial remission after six cycles of treatment. We excluded patients with transformed lymphomas and relapsed refractory disease. For secondary analysis, we examined patients' treatment response according to their baseline demographic characteristics, development of complications during therapy as well as their survival in months from diagnosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Our study identified 33 patients in the period of January 2017 till June 2023. The mean age of the sample cohort was 78 years old (Range from 66 to 86 years old). Majority of the samples had advanced stage lymphoma at initial diagnosis with n=21/33 (63.6%) having stage III and IV disease. At the end of treatment, one patient did not have assessment scans and hence was excluded from analysis. n=16/32 patients (50.0%) had attained ORR when analysed by intention to treat, n=14/32 (43.7%) attained complete response and n=2/32 (6.25%) attained partial response. When analysed for treatment response, those who attained ORR were more likely to have Stage 1 or 2 disease (p value = 0.028) and had statistically significant increased progression free survival (28.5 vs 5.5 months, p value &lt;0.01) and overall survival (28.5 vs 9.0 months, p value = 0.03) compared to those who did not attain ORR. In terms of treatment associated complications, n=9/32 (28.1%) of patients developed severe infection necessitating hospitalization, n=14/32 (43.7%) developed at least Grade 2 and above cytopenias, and n=13/32 (41.6%) developed some other adverse side effects, most of which were mild to moderate in terms of severity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The ORR for our patients treated with R-mini-","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 3","pages":"307-312"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175232","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":"Effect of oral colostrum application every 2 hours and 4 hours in order to achieve trophic feeding in preterm infants: A randomized controlled trial.","authors":"A T Indriani, S Wandita, E L Haksari, T Wibowo, A Anggraini, H Natalia","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Enteral feeding in preterm neonates starts with trophic feeding, which is the practice of feeding minute volumes of enteral feeds (starting at 10-25mL/kg/day) through an orogastric tube. Colostrum has protective effects, such as anti-inflammatory, immunomodulatory, and antimicrobial effects. The oral colostrum application is a safe, effective and economical therapy. However, the most optimal frequency of the oral colostrum application is not yet conclusive. This study aims to evaluate the effects of applying colostrum orally every 4 and 2 hours in order to achieve trophic feeding in preterm infants.</p><p><strong>Materials and methods: </strong>In this randomized controlled trial with an open-label design, very-low-birth-weight neonates admitted to RSUP Dr. Sardjito from March to August 2023 were allocated to receive oral colostrum applications either every two hours or every four hours. Subjects were randomized into study groups using a random block size of four through computer-generated in a 1:1 ratio. The primary outcome was the time to achieve trophic feeding. The extraneous variables were necrotizing enterocolitis, sepsis, hemodynamically significant Patent Ductus Arteriosus (hsPDA) and gender. Data analysis was conducted using SPSS.</p><p><strong>Results: </strong>A total of 40 neonates were analyzed for primary outcome. Of these, 20 neonates received oral colostrum applications every 2 hours, and the other 20 subjects were fed every 4 hours. Bivariate analysis showed that colostrum application given every 4 hours achieved the trophic feeding 0.47 day faster than the colostrum application every 2 hours. However, the difference between the two feeding methods was not statistically significant (p=0.703).</p><p><strong>Conclusion: </strong>There is no significant difference in achieving trophic feeding in preterm neonates (less than 34 weeks) whether the colostrum was given every 2 or 4 hours.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 3","pages":"328-334"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175227","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":"Factors associated with depression among the community-dwelling elderly In Kudat, Malaysia.","authors":"N Azhar, A Alias, W H N Wan Mohamad Lotfi, A Omar, K Mokti, S S Syed Abdul Rahim, M S Jeffree, M Y Ibrahim, M Musa, M R Hassan, Y Shobugawa","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The burden of elderly depression is rising with the growing ageing population, particularly in rural areas with limited healthcare access. In Malaysia, 27.8% of the elderly experience depression, with 16.5% of depressive symptoms reported among community-dwelling older adults. This study aimed to determine the prevalence of depression and its associated factors among the elderly in Kudat, a rural area in Sabah.</p><p><strong>Materials and methods: </strong>A cross-sectional study was conducted using the Malay version of the Geriatric Depression Scale (M-GDS-14). Logistic regression analyses were used to analyse the relationships between elderly depression and sociodemographic, socioeconomic, physical health, lifestyle, and psychosocial factors.</p><p><strong>Results: </strong>A total of 310 participants were involved, with a mean age of 69.4 years. Most were of Rungus ethnicity (78.7%) and married (73.9%). About 72% had a household income below RM 1,000; half were retirees, while 43.2% were still working. The prevalence of depression was high at 73.2% (95% CI: 70.7, 75.7). Comorbidities and moderate-topoor self-rated health were significantly associated with higher odds of depression, with adjusted odds ratios of 1.99 and 2.09, respectively.</p><p><strong>Conclusion: </strong>The findings highlight the high level of depression among the elderly in Kudat and the significant association with comorbidities and self-rated health status. Public health programs should focus on managing comorbidities and promoting positive self-perceived health to reduce depression in this population.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 3","pages":"290-297"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175231","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}