Medical Journal of Malaysia最新文献

{"title":"Parental perception on home therapy and its associated factors for children with cerebral palsy: A qualitative study in Malaysia.","authors":"T Chandrabose, S Suppiah, A A Fauzi, J P Engkasan, M H Romli","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Children with cerebral palsy (CP) benefit from consistent rehabilitation intervention. Home therapy (HT) consists of therapeutic exercises and activities targeting physical and functional improvement. HT is vital to ensure the rehabilitation provided in the clinical setting is further continued by the client. However, the success of HT mostly depends on compliance and support from caregivers, especially the parents. The objective of this study was to explore parents' perceptions of home therapy and to identify facilitating factors and barriers to it.</p><p><strong>Materials and methods: </strong>An interview-based qualitative study was conducted in a public university hospital in Malaysia, utilizing in-depth interviews. Audio recordings of the interviews were transcribed verbatim. The transcript data were coded, and the codes were then organized into themes using a thematic analysis approach.</p><p><strong>Results: </strong>Data from twelve mothers and three fathers among a total of fifteen children with CP were acquired. Nine themes were derived from transcript data namely : HT is a simple home prescription,HT empowers and enhances experiences of care, Negative experience, goal-directed positive attitude, External Support System, physical health as a barrier, psychological health as barrier, limited time and limited external support system.</p><p><strong>Conclusion: </strong>Real-life experiences of parents with CP children regarding HT was explored and valuable outcomes were derived from this study to help clinicians to manage children with CP more efficiently and understand their family dynamics better in the local context. Overall, parents perceived HT as doable and it provided physical, functional, and psychological benefits for them as well as improved their confidence and skills to perform exercises on their children and empowered them to monitor their children's progression.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"79 6","pages":"721-728"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773301","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":"Prognostic role of Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio in critically ill COVID-19 patients: A retrospective study.","authors":"W Wulandari, M Z Syahrul, S Ermayanti, Z D Rofinda, E Usman, D Kurnia, M Lailani","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Critical coronavirus disease (COVID-19) patients have a high mortality rate. To identify high-risk patients, first-level healthcare facilities can use the neutrophil-lymphocyte ratio (NLR) and the plateletlymphocyte ratio (PLR) as prognostic markers. We aimed to assess the NLR and the PLR profile in critically ill COVID-19 patients to predict disease severity.</p><p><strong>Materials and methods: </strong>This descriptive retrospective study featured 221 patients diagnosed with clinically critical COVID-19 from August 2021 to March 2022 in the Intensive Care Unit (ICU) of RSUP Dr. M. Djamil, Padang, Indonesia. The study employed a total sampling technique to collect data from medical records in the hospital. Patients aged 18 years or older who underwent testing for leukocytes, platelets, neutrophils, and lymphocytes were included in the study. We analysed the data using descriptive univariate analysis. Then, the NLR and PLR of the patients were statistically compared based on comorbidities and coincidence.</p><p><strong>Results: </strong>According to the study, most patients with critically ill COVID-19 exhibited high levels of NLR (88.2%) and PLR (71.1%). The severe COVID-19 patients with comorbidity of kidney disease had the highest NLR (Mean ± SD) of 31.74 ± 27.95 (p-value <0.001) and the highest mean PLR (Mean ± SD) of 469.33 ± 362.95 (p-value 0.001).</p><p><strong>Conclusion: </strong>Our findings showed a significantly higher NLR and PLR in patients with critically ill COVID-19, particularly in patients with comorbidity of kidney disease. Thus, elevated levels of NLR and PLR were identified as potential prognostic markers for predicting disease severity in COVID-19 patients, especially those with kidney comorbidity.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"79 6","pages":"743-748"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773370","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":"A multicentre, retrospective study of epidemiology and outcome of aplastic anaemia among adult population in Sabah and Sarawak from year 2006 to 2017.","authors":"G W C Lee, M Y Yeap, X Y Tan, A S O Tang, Y F Ho, K B Law, S W F Lee, L P Chew, L L L Wong","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Aplastic anaemia (AA) is a rare disorder of bone marrow failure, characterized by bone marrow hypocellularity with pancytopenia. The annual incidence rates of AA in Asia are observed to be two to three times higher than Europe and North America. Since the introduction of immunosuppressive therapy (IST) and of allogenic stem cell transplant (SCT), the outcome of severe AA has significantly improved. We conducted a 12-year multi-centre retrospective study among the adult AA population in Sabah and Sarawak.</p><p><strong>Materials and methods: </strong>A total of 119 AA patients had been identified from hospital records of the involved sites, namely Queen Elizabeth Hospital in Sabah, Sarawak General Hospital, Sibu Hospital, Miri Hospital and Bintulu Hospital in Sarawak from Jan 2006 to Dec 2017.</p><p><strong>Results: </strong>The median age at diagnosis was 46 years, and native ethnic group from Sabah, Kadazan-Dusun, recorded the highest percentage of 41.2%, which could be explained by higher frequency of HLA-DRB1*15:01, an alelle linked to increased risk of AA, among this ethnic group. The majority of patients (59.7%) received cyclosporine (CsA) as monotherapy or in combination with other non-IST agents such as danazol, which was instituted in 48.7% of the patients, while a third of them (33.7%) received antithymocyte globulin (ATG) therapy with or without CsA, and 12.4% underwent allogenic SCT. The five-year overall survival (OS) for all AA patients was 76.1%. Elderly patients >60 years old and those with severe disease had more inferior 5-year survival.</p><p><strong>Conclusion: </strong>A prospective study is warranted to determine the true incidence rate, epidemiological distributions, treatment outcome and overall survival of AA patients in Malaysia. Establishment of allogenic SCT in East Malaysia is imperative to make this curative therapy more accessible to patients with severe disease and improve the outcome.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"79 6","pages":"749-756"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773241","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":"Take C.A.R.E of patient safety: A call to action.","authors":"A R J Kim, K S Chew, H U Ngian","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In a dynamic healthcare environment, patient safety is crucial. A \"Conscious Actions Reduce Errors\" (C.A.R.E) approach is needed to safeguard safety and reduce medical errors. The dual process theory highlights two thinking modes: intuitive (fast, automatic) and analytical (slow, deliberate). Intuitive thinking, though quick and often effective, can lead to cognitive biases like anchoring and availability heuristics. A C.A.R.E approach incorporating tools like the TWED checklist (Threat, What if I'm wrong? What else?, Evidence, Dispositional factors) and Shisa Kanko (Japanese method of pointing and calling) can help to improve decision-making and action precision in clinical settings.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"79 6","pages":"800-802"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773376","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 efficacy of vagus nerve stimulation for epilepsy in Malaysia.","authors":"S L Fong, K S Lim, A A Raymond, H J Tan, C S Khoo, A R Mohamed, C Y Fong, A H Sanihah, I Zamzuri, M A Jafri, D T Sangita, A Azmi, S C Suganthi, S Sapiah, A Y Nor, S S Tan, C T Tan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The first vagus nerve stimulation (VNS) implantation in Malaysia was back in 2000, and the implantation rate increased tremendously since 2019. VNS has been used in patients who had persistent seizures despite epilepsy surgeries or were not candidates for epilepsy surgeries. We aimed to study the efficacy of VNS in Malaysia.</p><p><strong>Materials and methods: </strong>We conducted a retrospective cross-sectional study on the VNS done in Malaysia. We included DRE patients from all age groups who underwent VNS from 1st January 2000 to 31st December 2022. We analysed the efficacy of VNS for patients with at least one year of implantation.</p><p><strong>Results: </strong>A total of 62 implantations were performed from 2000 to 2022. Most patients (52.5%) had implantation at <18 years old, 54.0% had focal seizures, 34.4% had Lennox Gastaut Syndrome and 23.0% had developmental epileptic encephalopathy. A total of 22.6%, 42.8%, and 63.3% of patients achieve ≥ 50% seizure reduction at three months, six months, and one-year post-implantation, respectively. At their last follow-up, 73.5% of patients had ≥ 50% seizure reduction. The majority of responders were at a current intensity of ≥ 2mA (98.0%) and 81.6% were at a duty cycle of ≥35%. No significant difference was found between responders and non-responders by age at implantation, duration of epilepsy, and seizure type.</p><p><strong>Conclusion: </strong>VNS is effective for patients with refractory epilepsy in Malaysia with two-third achieving more than 50% seizure reduction at one year and the last follow-up.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"79 6","pages":"729-734"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773380","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 oral multinutrient supplementation on in vitro fertilisation or intracytoplasmic sperm injection outcomes: A prospective controlled study.","authors":"M Gopinath, I S Khadijah, R Ruhaima, R Nuguelis, H Mukhri","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Micronutrients influence female fertility, thus adequate levels are important for oocyte quality, maturation, fertilisation and implantation. This study prospectively evaluated the impact of oral multinutrient supplementation on fertility outcomes in In vitro fertilisation or Intracytoplasmic sperm injection (IVF/ICSI).</p><p><strong>Materials and methods: </strong>This was a pilot study of N=50 women, who were planning for IVF treatment in University Malaya Medical Centre, Kuala Lumpur, Malaysia from July to December 2023. Women without prior nutritional treatment were consented and assigned to either the multinutrient supplementation (Omega 3, coenzyme Q10, folic acid, selenium, vitamin E, catechins) as the study group or 5mg folic acid daily as control group for at least a month prior to their IVF treatment. All women were treated using an antagonist protocol and ovarian stimulation was started with 200 -300IU of urinary HMG and or recombinant FSH. Antagonists (Ganirelix) commenced when the leading follicle reached a diameter of 11 mm. Triggering with hCG or GnRH agonist when at least 3 follicles of 17 mm in diameter were achieved. Oocyte retrieval was performed 36th hour after trigger. Conventional IVF/ICSI was used for fertilisation. All parameters recorded and analysed using SPSS.</p><p><strong>Results: </strong>The mean age (36.44 ± 3.33 vs 35.32 ± 3.47 years) and body mass index (25.28 ± 4.12 vs 24.80 ± 4.36 kg/m2) of women in multinutrient supplementation group was similar to control group. The Follicular Output Rate (FORT) in women on multinutrient supplementation showed a trend towards benefit compared to control group, although it is not statistically significant (68.12 ± 19.47 vs 64.91 ± 20.06, p=0.493). The mean number of MII oocytes retrieved from mature follicles and number of good quality embryo on day 3 after fertilisation were not statistically significant between the two groups (6.65 ±3.84 vs 6.09 ± 3.01, p=0.626 and 4.00 ± 3.10 vs 3.45 ± 2.30, p=0.549, respectively). In addition, there were no differences in endometrial thickness before embryo transfer in both groups (10.35 ± 1.32mm vs 10.36 ± 2.04mm, p=0.320). However, the total dose of follicle stimulating hormone and duration of controlled ovarian stimulation were lower in the study group compared to control group (2410 ± 656.82 IU vs 2706.82 ± 536.15 IU, p= 0.119 and 8.90 ± 2.13 days vs 9.68 ± 1.29 days, p=0.164, respectively).</p><p><strong>Conclusion: </strong>A multinutrient supplementation given for a minimum of 28 days, may have a positive effect on FORT and lower use of gonadotropin. More and larger sample research is warranted to prove this effect.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"79 6","pages":"715-720"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773384","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 alternative approaches to next of kin consenting in the semi-emergency neurosurgical scenario.","authors":"E N Zakaria, N A Abdullah, D Ganesan","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Prior to any surgical intervention, obtaining informed consent is necessary. In situations where patients are unable to provide informed consent due to mental incapacity or reduced consciousness, the responsibility falls on surrogate decision-makers, typically family members. This predicament commonly arises during neurosurgical emergencies. Various types of surgical emergencies exist, each with its own classification. In cases of life-threatening neurosurgical emergencies and in the absence of next of kin, two consultants have the authority to decide and grant surgical consent. However, for urgent and semi-emergency surgical cases, obtaining consent from the next of kin is crucial. The conventional requirement for the physical presence of the next of kin at the hospital often causes delays in the procedure. This study aims to explore alternative methods for efficiently and compliantly securing this consent for urgent and semi-emergency neurosurgical cases.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;A prospective, observational crosssectional survey was conducted from 1st May 2022 to 31st December 2022 at the University of Malaya Medical Centre, Kuala Lumpur. This survey included all neurosurgical patients aged 18 and above requiring urgent and semiemergency surgery. The next of kin were interviewed using a standardised questionnaire to obtain their perspectives on the effectiveness of the current consenting process, as well as to explore potential alternative methods for obtaining consent. Data were analysed using IBM SPSS Statistics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The survey had 103 responses. The analysis revealed that the most common semi-emergency surgical procedures were craniotomy (22 cases) and external ventricular drain insertion (18 cases), followed by burr hole and drainage (14 cases). The most common primary diagnosis that needed urgent intervention was acute hydrocephalus. Interestingly, more than half of the patients (58 cases, 56.3%) had to wait for over 30 minutes to obtain consent from their next of kin prior to surgery. The next of kin interviewed had an age range of 25 to 72 years. The relationships of the next of kin were children (33 subjects), spouses (26 subjects), siblings (25 subjects), and parents (16 subjects) of the patients. Additionally, 96.1% of the respondents owned a smartphone with a mobile internet data connection, and 85.4% had internet connectivity at home. The most preferred method of telecommunication for this exercise was via WhatsApp. An interesting finding was the association between the level of trust in medical professionals and the preferred consent method. It was discovered that individuals who preferred physical consent had lower trust in the hospital and doctors, while those who preferred remote consent had higher trust.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The urban Malaysian population are ready to embrace telecommunication for next-of-kin consent in semiemergen","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"79 6","pages":"735-742"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773295","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":"Pre-operative carcino-embryonic antigen prognosticates early disease-free survival following curative surgery for non-small cell lung cancer.","authors":"A Sachithanandan, A A B Sajak, H H Hoh","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Serum carcinoembryonic antigen (CEA) is prognostic for recurrence and survival in treated NSCLC. This prospective observational study evaluated CEA as a prognostic or surveillance biomarker in resectable early NSCLC.</p><p><strong>Materials and methods: </strong>18 patients with histologically confirmed early NSCLC (stage I-IIIA) were recruited from October 2019 to January 2021. The serum CEA was measured pre-operatively, and then at 6, 12, 18 and 24 months post-operatively, in conjunction with routine CT and/or CT-PET surveillance scans.</p><p><strong>Results: </strong>All patients had a curative R0 anatomical resection (lobectomy) with concurrent systematic mediastinal nodal dissection via a uniportal minimally invasive approach under single lung ventilation general anaesthesia. There was no operative, in-hospital or 30-day mortality. 7 patients (39%) had an elevated pre-operative baseline CEA level > 5.0ng/ml. The mean number of nodes sampled intraoperatively was 15. At median follow-up of 42 months, 11/18 (61.1%) patients were recurrence-free. There were no deaths and two recurrences (18.2%) amongst patients with a CEA < 5 (n=11). In the CEA > 5 subgroup (n=7), there were two deaths (28.5%) and 5/7 (71.4%) patients had a radiological recurrence. There was no difference in overall survival however disease-free survival (DFS) was significantly inferior in patients with a baseline CEA > 5. Median DFS was not reached in patients with CEA < 5 and 18 months in those with an elevated CEA > 5 (p<0.001) Conclusion: Almost 40% of local NSCLC patients had an elevated baseline CEA suggesting this is a useful prognostic and surveillance biomarker to incorporate in the routine work-up for any newly diagnosed NSCLC. Despite curative R0 resection and extensive intra-operative mediastinal lymph node sampling, an elevated pre-operative CEA was associated with a significantly reduced DFS and may be a surrogate for more aggressive tumour biology. Such patients will benefit from meticulous post resection surveillance and adjuvant therapy beyond conventional TNM criteria.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"79 6","pages":"683-689"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773362","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":"Assessing the impact of a 4-week physical training regimen on cardiorespiratory fitness among firefighter recruits.","authors":"I Rosnah, D I Z A Noor, A S Asnarulkhadi, J Fathiah, H M Nor, K O Abdul, A G Ismail, R A Ashrul","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiorespiratory fitness is crucial for safe and efficient performance in executing firefighting tasks. The study aims to assess the effects of Phase 1 of a newly designed 4-week physical training regimen on changes in cardiorespiratory fitness, health parameters and other physical fitness elements. Phase 1 was crafted to primarily focus on improving firefighter recruits' cardiorespiratory fitness to prime their body for the subsequent phase of exercise.</p><p><strong>Materials and methods: </strong>A quasi-experimental study employing a one-group pre- and post-intervention was carried out involving 142 male firefighter recruits from a Fire and Rescue Academy in Malaysia. Various aspects of physical fitness changes, including speed, agility, and coordination (SAC), muscle strength, endurance, and power, were evaluated at baseline (Week 1) and upon completion of the first phase (Week 5). Changes in health parameters, such as blood pressure, resting heart rate, body weight, muscle mass, body fat percentage, and body mass index, were also assessed. A paired sample t-test was conducted with the significance level set at 0.05. The magnitude of changes was assessed using the following criteria: values of 0.3 were considered a small effect size, 0.5 indicated a moderate effect size, and 0.8 signified a large effect size.</p><p><strong>Results: </strong>Upon completion of the first phase of the physical training regimen, there was a statistically significant improvement in cardiorespiratory fitness, with a mean increment of VO2max was 9 mL/kg/min (95% CI: 8.33, 9.58, p<0.001, large effect size of 2.40). Both pre-and postintervention assessments of abdominal and upper body muscle strength and endurance showed statistically significant improvement with the mean difference of 11 situps (95%CI: 10.08, 12.01; p<0.001, large effect size of 1.89) and 1.5 pull-ups (95%CI: 1.07, 1.86; p<0.001, moderate effect size of 0.63), respectively. Health parameters showed similar, except for systolic BP (SBP). There was a small increment in recruits' SBP following the 4-week training period with a mean difference of 4.3 mmHg (95%CI: 2.37, 6.24; effect size = 0.37, p<0.001).</p><p><strong>Conclusion: </strong>The first phase of the newly introduced fourweek physical training regimen has proven effective in enhancing cardiorespiratory fitness, as well as abdominal and upper body muscle strength and endurance. Additionally, the regimen has positively influenced several health parameters, except for systolic blood pressure. The observed increase in average systolic blood pressure indicates a necessity for continuous monitoring at the academy to address this issue effectively. confirm our findings.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"79 6","pages":"708-714"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773243","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 control of Actinium-225 radiopharmaceuticals: Current challenges and solutions in Malaysia.","authors":"Z Ashhar, M F Fadzil, M A Said, M Mujahid, S Suppiah","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Development of Prostate Specific Membrane Antigen (PSMA)-targeted radiopharmaceuticals for theranostics has changed the treatment landscape for patients with metastatic castration-resistant prostate cancer (mCRPC). The emerging use of [²²⁵Ac]Ac-PSMA-RLT has been effective and safe for the treatment of mCRPC. Nevertheless, challenges with the nuclear recoil of [²²⁵Ac]Actinium radionuclides, which may release the daughter radionuclide from the radiopharmaceutical and lead to unnecessary irradiation of other organs, poses threats such as organ dysfunction. Therefore, this short communication aims to highlight the current situation in Malaysia and explain the solutions by using a risk-based approach analysis for the inhouse preparation.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"79 6","pages":"794-799"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773374","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}