Medical Journal of Malaysia最新文献

{"title":"Moving from tobacco control to tobacco endgame in Malaysia.","authors":"L Rampal","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 4","pages":"385-389"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754739","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":"Determinants of measles cases with complications in Selangor, Malaysia from year 2014 to 2023 using e-Measles registry.","authors":"M M Shahriman Teruna, Z I Azhar, M S Ahmad Saman, F Kusnin","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Measles is a highly contagious vaccinepreventable disease endemic to Malaysia. This study aimed to determine the determinants of measles cases with complications in Selangor, Malaysia, from 2014 to 2023.</p><p><strong>Materials and methods: </strong>This was a cross-sectional study of confirmed measles cases in Selangor using the secondary surveillance database, Sistem Maklumat Siasatan Measles (SM2). The data were reviewed from April 2024 to June 2024. All registered measles cases in Selangor from 2014 to 2023 were analyzed to determine the determinants of measles cases with complications, the type of measles complications, and the characteristics of those who developed measles complications.</p><p><strong>Results: </strong>Of 3074 measles cases, 479 (15.6%) developed measles complications, of which diarrhea was the most common complication (87.6%), followed by pneumonia (11.6%), otitis media (0.6%), and subsclerosing panencephalitis (0.2%). The majority of those who developed measles complications were aged less than one year old (42.1%) and 1-6 years (31.4%). The significant determinants of measles cases with complications were non-Malaysian nationality (aOR: 2.1, 95% CI: 1.44, 3.05), cases from urban areas (aOR: 1.8, 95% CI: 1.22, 2.76), cases that fulfilled the measles clinical case definition (aOR: 2.1, 95% CI: 1.59, 2.76), cases with a history of contact with other measles cases (aOR: 4.4, 95% CI: 3.43, 5.67), cases from the measles outbreak (aOR: 1.5, 95% CI: 1.10, 2.19), and cases that were hospitalized (aOR: 5.6, 95% CI: 4.49, 7.07).</p><p><strong>Conclusion: </strong>Strengthening immunization coverage, particularly among high-risk groups, such as non- Malaysians and young children, is essential. Enhanced surveillance, targeted health education, and improved outbreak response strategies are crucial to reduce measles complications in the community. Further research is needed to explore additional factors contributing to measles complications and to assess the effectiveness of intervention measures.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 4","pages":"416-424"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754731","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":"Impact of structured physical exercise during pregnancy on maternal health and fetal outcomes: A systematic review.","authors":"F H MohdNor, N A Jamani, K H AbdAziz","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Current guidelines recommend that pregnant women engage in physical activity. Exercise during pregnancy has been shown to positively impact both maternal and fetal outcomes. Therefore, we conducted a systematic review to evaluate the impact of structured physical activity during pregnancy on maternal health and fetal outcomes.</p><p><strong>Materials and methods: </strong>A systematic search was conducted on relevant articles published between 2015 and 2020 using PubMed, Google Scholar, ScienceDirect, Scopus, and the Cochrane Library. Studies on pregnant women, comparative study designs with concurrent controls, structured physical intervention and health outcomes for both maternal and fetal were targeted. Maternal outcomes include gestational weight gain, lumbopelvic pain, gestational diabetes and preeclampsia, while fetal outcomes include prematurity and birth weight. Only original studies with published data were included. This review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta- Analysis.</p><p><strong>Results: </strong>A total of 3441 published articles were retrieved from different databases. After assessing the obtained papers, studies that did not meet the inclusion criteria were excluded. Twenty studies involving 5188 populations that met the inclusion criteria were included in this review. However, due to the heterogeneity of the studies, metaanalysis was not done. Structured physical activity significantly reduced the risk of gestational diabetes (OR: 0.57; 95% CI: 0.40-0.81; p = 0.002), but had no statistically significant effect on lumbopelvic pain (OR 0.98 (95% CI: 0.49 to 1.93) p=0.95), gestational weight gain (OR 0.88 95% CI: (0.44, 1.76) p=0.71), pre-eclampsia (OR 0.78, 95% CI: 0.41, 1.49, p=0.46) causing preterm delivery (OR 0.91, 95% CI (0.69, 1.20), p=0.50) or affecting fetal birth weight (mean difference 0.93, 95% CI (-42.67, 44.53), p=0.97) CONCLUSION: Structured physical activity during pregnancy, three times a week, 30 minutes per day of moderate intensity, is safe and benefits pregnant women and the fetus. Our findings challenge the view that physical exercise during pregnancy is not helpful and can be harmful. To generate further evidence, there is a need for high-quality, standardised trials that assess specific types of structured exercise program with better reporting of adherence and outcomes.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 4","pages":"508-520"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754736","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":"Poor waste disposal and effect on health- an insight and review.","authors":"N K Devaraj","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The generation of waste products, including urine, faeces, and household items such as glass and plastic, has increased in line with the growth of the world's population. Physical, psychological, and social issues can invariably arise if these wastes are not properly managed, which has a direct effect on the population's health and is the source of the nation's productivity. Waste dumping has been a persistent problem, despite the government's efforts to educate consumers on proper waste dumping. Despite regular enforcement activities, this socially unacceptable habit persists.</p><p><strong>Methodology: </strong>Various studies on waste disposal and its potential deleterious effects on the health of humans, animals, and the environment were reviewed and included in this narrative review to summarise the nature of the problem and its health effects. These include both local and international articles on this subject. This is to ensure that various strategies can be developed to manage this important and ever-persisting issue.</p><p><strong>Results and conclusion: </strong>The literature reviewed have been able detailed the physical, psychological, and social issues of improper waste disposal that may affect the health of the population. Taking care of the environment is a top priority, as are modern issues of climate change and its effects on the nation's coffers. Enhancing public education, promoting community-based environmental activities such as gotongroyong, using modern technology or methods, and stricter enforcement will ensure that waste is disposed properly. In turn, this will ensure the sustainability of Mother Earth for future generations.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 4","pages":"496-499"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754740","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":"Psychometric validation of a healthcare professionals' attitude assessment scale toward maternal vaccination: A rasch model analysis.","authors":"M A Muhd Helmi, N Ismail, A Abu Bakar","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Maternal vaccination is a proven strategy to protect newborns from vaccine-preventable diseases, yet its success depends heavily on healthcare professionals' attitudes and recommendations. In Malaysia, a validated and culturally appropriate tool to measure these attitudes is lacking. This study aimed to develop and validate a culturally relevant, reliable tool to assess healthcare professionals' attitudes toward maternal vaccination MATERIALS AND METHODS: The items were initially developed based on an extensive review of literature, vaccination guidelines, and expert reviews, followed by content and face validity involving nine and 30 reviewers, respectively. A pilot study was conducted on 196 respondents, and the reliability and validity were assessed using Rasch analysis (RA).</p><p><strong>Results: </strong>Initially, 26 items were developed. However, only half of the items passed the content validity phase, with another two items removed post face validation. Eleven items were piloted for assessment of reliability and validity. Three items were removed due to concerns over their fit indices, and one item for redundancy. The final refined questionnaire consisted of seven items, demonstrating good reliability (person reliability = 0.80, separation index = 1.98), unidimensionality, and appropriate rating scale functioning, confirming its suitability for assessing healthcare professionals' attitudes toward maternal vaccination.</p><p><strong>Conclusion: </strong>This study presents a psychometrically sound tool to measure healthcare professionals' attitudes toward maternal vaccination.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 4","pages":"466-472"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754742","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":"High-fidelity simulation vs video-assisted teaching for early ECG learning - Randomised controlled trial.","authors":"R Saha, B Pal, R Harinarayan, A Aranan, K M M Swe, P Kumarasamy, G Kaur, P A L S Wijegunathileke","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Electrocardiography (ECG) interpretation is a vital yet challenging competency for preclinical medical students due to limited clinical exposure. While high-fidelity simulation teaching (HFST) offers immersive, experiential learning, video-assisted teaching (VAT) provides scalable, consistent instruction. Despite growing interest in both methods, comparative evidence remains limited. This study aimed to evaluate the effectiveness of HFST versus VAT in enhancing ECG knowledge and retention among preclinical students using a Multiple-Choice Question (MCQ) assessment for knowledge cognition.</p><p><strong>Materials and methods: </strong>It was a randomised controlled trial study where 136 first year undergraduate medical students were randomised into control (VAT) and intervention (HFST) groups. The intervention group received a 20-minute simulation session using SimMan, demonstrating ECG lead placement, interpretation, and basic management, followed by a 20-minute interactive discussion whereas the control group underwent a VAT session mirroring the HFST content with a 20-minute pre-recorded video followed by a 20-minute faculty-led discussion. MCQs were used to assess the acquisition and retention of knowledge, both as a pre-test (week 1) and a post-test (week 12). The outcomes were measured using the mean and standard deviation of the total scores of MCQ. Intragroup analyses were conducted using a dependent sample t-test, whereas intergroup analyses were performed using an independent samples t-test. ANCOVA was used to assess the difference in post-test MCQ scores among the groups after adjusting the Pre-test scores. The Pvalue was set at 0.05. \"Institutional research trial registration number\": RMC_NUIR_2024_21 RESULTS: Both groups demonstrated significant enhancement in knowledge gain and retention from the pretest to the post-test. The VAT group showed a greater mean score improvement compared to the HFST group. While the VAT group outperformed the HFST group in the post-test, this difference was not statistically significant. Adjusting for pre-test scores using ANCOVA further confirmed the nonsignificance of post-test score differences between the two groups. Two-way mixed ANOVA revealed no significant interaction between group and time point, indicating comparable patterns of knowledge gain across both teaching methods.</p><p><strong>Conclusion: </strong>Both HFST and VAT significantly increased knowledge and retention among preclinical medical students. The VAT group showed a slightly higher knowledge gain than the HFST group, although the difference was statistically insignificant. The study demonstrated that both VAT and HFST were effective in midterm knowledge acquisition and may offer a viable alternative for inclusion in undergraduate preclinical curricula.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 4","pages":"473-480"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754733","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 systematic review of water-soluble contrast use in videofluoroscopic examination of dysphagia.","authors":"M K Almardini, M Alshipli, P Maniam, H Mohd Ibrahim","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The Videofluoroscopic Swallow Study (VFSS) is a key diagnostic tool for evaluating swallowing function, providing dynamic visualization of bolus transit and swallowing mechanism. Traditionally, barium is used as the contrast medium due to its effectiveness in highlighting anatomical and functional aspects of swallowing. However, water-soluble contrast (WSC) agents, which differ in osmolarity, viscosity, and iodine atom-particle ratio, have emerged as alternatives and their optimal use in VFSS remains unclear. This systematic review investigates the utilization of WSC agents in VFSS.</p><p><strong>Materials and methods: </strong>This systematic review was conducted following the PRISMA 2020 guidelines, extensively analyzing WSC agents use in VFSS. Searches were conducted across PubMed, Scopus, and Google Scholar using keywords \"Water-Soluble Contrast, Videofluoroscopic, High-Osmolar Water-Soluble Contrast, and/or Low-Osmolar Water-Soluble Contrast\". A total of 574 papers were initially identified.</p><p><strong>Results: </strong>Nine studies (2013-2021) investigated the use of WSC agents in VFSS. The studies varied in methodology and WSC agents used, with no standardized protocols identified. Findings indicated that low-osmolar WSCs may reduce the risk of complications, such as aspiration and pulmonary edema, compared to barium sulfate. WSC agents were utilized in high-risk populations, such as those with head and neck surgeries or neurological conditions.</p><p><strong>Conclusion: </strong>WSC agents may serve as a viable alternative to barium sulfate in VFSS, particularly for high-risk patients. However, further research is needed to compare their diagnostic accuracy, patient outcomes, and safety profiles, as well as to establish standardized protocols for their use in dysphagia evaluation.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 4","pages":"500-507"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754724","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":"Procedural safety and outcome of rigid bronchoscopy in malignant central airway obstruction.","authors":"R L Ho, S S Kho, C S Chai, S Eng, S K Chan, M C Yong, S T Tie","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Malignant central airway obstruction (CAO) affects 20-30% of patients with primary lung cancer and is associated with poor prognosis without treatment. Therapeutic rigid bronchoscopy (RB) is an essential diagnostic and therapeutic tool in this group of patients. We aimed to assess the overall procedural outcomes and safety of RB for symptomatic malignant CAO at our institution.</p><p><strong>Materials and methods: </strong>Retrospective chart review included 57 patients with malignant CAO who underwent RB between March 2016 and June 2022.</p><p><strong>Results: </strong>Our cohort comprised 75.4% males with a median age of 60 years. Isolated right and left main bronchus involvement was observed in 50% and 41.7% of the patients, respectively, with 21.1% experiencing concurrent tracheal involvement. In our cohort, 80% had primary lung cancer, with 35.1% of these cases being squamous cell carcinoma. The re-canalization success rate was 98%, with no intraoperative or immediate postoperative mortality. More than half of the patients (54.4%) required airway stenting to maintain patency after re-canalization. Patients with tracheal involvement, non-intrinsic type of CAO, and right main bronchus involvement had a higher likelihood of requiring airway stenting. There were 24 cases with mild, self-limiting complications and 3 cases with severe procedure-related complications. The 30-day survival rate of our cohort was 91.6%.</p><p><strong>Conclusion: </strong>RB is a safe and effective procedure in patients with malignant CAO. Long term prospective data from multiple centers in our region are anticipated to determine long-term safety and outcomes.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 4","pages":"425-431"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754741","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":"Accuracy of age estimation method by panoramic radiographic examination in paediatric dental patients: A diagnostic study in Indonesia.","authors":"S R Laksmiastuti, R Tanjung, I Farizka","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Cases of violence and criminality in children continue to increase, with implications for the increasing need for identification measures, especially for living victims for judicial or law enforcement purposes. Teeth are one of the indicators that determine a child's identity. The methods often used to estimate a child's age through dental radiographic examination during the period of deciduous and mixed teeth are the Al Qahtani, Demirjian, and Blenkin & Evans methods.</p><p><strong>Materials and methods: </strong>An analytical cross-sectional study was conducted. The children's ages were estimated using dental examination and 103 digital panoramic radiographs. Descriptive statistics, normality test followed by difference test based on five parameters: p-value Wilcoxon test, Intraclass Correlation Coefficient (ICC), Spearman correlation coefficient, and Bland-Altman analysis by looking at % out of Limit of Agreement and looking at Mean Difference.</p><p><strong>Results: </strong>Wilcoxon's p-value showed that Blenkin's method and Demirjian's method vs. chronological age were significantly different, whereas Al Qahtani's method was not significantly different. The Demirjian method had the highest ICC. Spearman's correlation coefficient was strongly correlated between Blenkin's and Demirjian's methods and the chronological age (r ≥ 0.8). The Bland-Altman analysis showed that the Demirjian Method had the best % out of LOA = 5.8, while the Al Qahtani Method had the most minor differences.</p><p><strong>Conclusion: </strong>The Demirjian method showed results closest to the patient's chronological age.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 4","pages":"432-435"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754725","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":"Impact of challenging-to-treat areas on quality of life and mental health among plaque psoriasis patients from Sabah, Malaysia.","authors":"E Y L Ong, S Y M Voo","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with psoriasis with involvement of challenging-to-treat-areas often have higher disease burden. We studied the impact of the challenging-to-treat areas namely scalp, face, nail, palms, soles and genitalia on the quality of life and mental health of psoriatic patients.</p><p><strong>Materials and methods: </strong>We conducted a cross-sectional study involving 120 patients aged 18 years and above with plaque psoriasis. Those with challenging-to-treat-areas were compared to those without.</p><p><strong>Results: </strong>The prevalence of challenging-to-treat-areas were scalp (35.8%), face (26.7%), nails (38.3%), palms (6.7%), soles (5.0%) and genitalia (15.0%). Psoriasis Area and Severity Index (PASI) was higher in patients with challenging-to-treat areas, with a median of 4.55 (IQR: 3.00, 7.80) compared to 1.80 (IQR: 0.60, 2.85) in those without (p < 0.001). Patients with these areas demonstrated a significantly higher Disease Life Quality Index (DLQI) scores compared to those without (mean ± SD: 5.13 ± 6.17 vs 11.02 ± 7.19; p < 0.001). Overall the prevalence of depression, anxiety and stress, scored using Depression, Anxiety and Stress Scale-21 Item (DASS-21), were 19.2%, 28.3% and 14.2% respectively with two thirds of patients had challenging-to-treat areas. Significantly more patients with challenging-to-treat-areas suffered from moderate to extremely severe depression (8.4% vs 5.0%, p = 0.034) and anxiety (33.4% vs 16.7%, p = 0.001). Patients with challenging-to-treat areas had higher mean itch Numeric Rating Scale (NRS) (4.28 ± 2.90) compared to those without (1.45 ± 1.58) (p < 0.001).</p><p><strong>Conclusion: </strong>Patients with psoriasis with challenging-totreat- areas reported greater impairment in quality of life and higher risk of depression and anxiety.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 4","pages":"481-489"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754735","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}