Medical Journal of Malaysia最新文献

{"title":"Limitation of cane sugar solution as a tissue fixative for glycogen preservation in mouse liver.","authors":"I M Babar, P S Oo, J S Cheoh, L M Aye, M T Kyaw, S N Aye, P Krishnappa","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Sugar-based natural fixatives have been proposed as substitutes for formalin in histopathological practice because of their promising results in preserving tissue structures. However, they have not yet been applied. This study aimed to determine the optimal concentration of cane sugar solution (CSS) for tissue fixation, histochemical staining, and glycogen storage in mouse liver tissues.</p><p><strong>Materials and methods: </strong>A total of 24 mouse liver tissues from six mice were divided into four groups and fixed with 10% neutral buffered formalin (NBF), 30%, 50% and 70% CSS, respectively, for 24 h at room temperature. After tissue processing and sectioning, the samples were stained with hematoxylin and eosin (H&E), methyl green pyronin Y (MGPY) and peroxidase acid-Schiff (PAS). The tissue sections were evaluated under a light microscope by two blinded pathologists. Data were analyzed using one-way analysis of variance (ANOVA) and a post-hoc test to assess the differences among the experimental groups.</p><p><strong>Results: </strong>The gross morphology of all the samples showed minimal shrinkage without color changes. Microscopic examination revealed that the 50% and 70% CSS groups showed comparable efficacy in cytoplasmic and nuclear staining, H&E staining intensity, deoxyribonucleic acid (DNA) and ribonucleic acid (RNA) staining, and collagen staining with the 10% NBF group. The 30 percent CSS group showed significantly poorer nuclear and DNA staining than the 10% NBF group. All CSS groups failed to preserve glycogen in mouse liver tissues (p < 0.001) compared with the 10% NBF.</p><p><strong>Conclusions: </strong>Our study concluded that 50% and 70% CSS are potentially replaceable, eco-friendly fixatives for 10% NBF in small tissue samples for tissue fixation and histochemical staining. However, 10% NBF was still superior to CSS for glycogen preservation in mouse liver tissue.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 4","pages":"403-409"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754738","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 single centre study on prevalence of anemia in children and adolescents with atopic dermatitis and its associated factors.","authors":"N Ravindran, S Krishnasamy, A Jamil, G Preamala","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic inflammation, food avoidance, and the use of systemic immunosuppressants are associated with anemia in patients with atopic dermatitis (AD). This study aimed to determine the prevalence of anemia among children and adolescents with AD, the type of anemia, and its predisposing factors.</p><p><strong>Materials and methods: </strong>This is a cross-sectional study. Patients aged ≤18 years with AD were included in the study. The exclusion criteria were malignancy, chronic organ failure, and haematological diseases. Dietary patterns and nutrient intake were determined using a 3-day dietary recall. AD severity was assessed using a scoring tool known as Scoring Atopic Dermatitis (SCORAD). Peripheral blood counts, iron studies, and serum B12 and folate levels were determined.</p><p><strong>Results: </strong>A total of 77 patients were recruited for this study. The mean age was 8.58±5.26 years with 43(55.8%) boys and 34(44.2%) girls. Most (58.4%) were from economic bottomtier households with incomes below RM4850. Food avoidance was common (55.8%), primarily for shellfish (37.7%), nuts (33.8%), and eggs (22.1%). The prevalence of anemia was 58.4%, and 71.1% was due to iron deficiency. Younger age, male sex, underweight, and lower intakes of iron, protein, and fat were significantly associated with anemia. There was no association between the severity with anemia.</p><p><strong>Conclusion: </strong>The high prevalence of iron deficiency anemia in patients with AD was likely due to the lower intake of food restrictions compounded with chronic inflammation in AD.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 4","pages":"390-396"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754723","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":"Human T-lymphotropic virus-1 proviral load among patients on maintenance hemodialysis.","authors":"Z S Al-Jubouri, S F Abdullah","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Human T-lymphotropic virus type 1(HTLV-1) is a complicated leukemogenic retrovirus, it is the first oncogenic virus discovered and identified as the leading cause of T-cell malignancy and HTLV related myelopathy with a long latency period. Transmission via infected blood products is one of the common routes of HTLV-1 infection, and hemodialysis patients are potentially more vulnerable to blood-borne viral infections such as HTLV. This study aimed to determine the factors associated with HTLV-1 proviral load among hemodialysis patients.</p><p><strong>Materials and methods: </strong>A cross-sectional study of 130 patients undergoing hemodialysis was conducted between November 2023 and January 2024. After HTLV-1 RNA extraction, complementary DNA (cDNA) was synthesized. HTLV-1 pro-viral load (PVL) was quantified by real-time PCR (qRT-PCR).</p><p><strong>Results: </strong>HTLV-proviral load was detected in 57 (43.84%) blood samples, with a mean ± standard deviation (SD) of 16.3×103 ± 5.4×104(copies/μL), including 34 (26.2%) males and 23 (17.7%) females. The highest percentage of infection (22.3%) was detected in the 40-59 age group and married patients (39.2%); however, a high viral load was observed in the 20-39 age group. Frequent blood transfusions associated with HTLV-1 infection were observed in 42 patients (32.3%). Myelopathy-related muscle spasms and paresthesia were significantly associated with the HTLV-1 viral load (p<0.05). A statistically significant relationship was observed between asymptomatic patients and high HTLV-1 proviral load (p=0.004).</p><p><strong>Conclusion: </strong>These findings show that a significant number of dialysis patients were infected with HTLV-1. Therefore, hemodialysis patients should be frequently screened for HTLV-1 infections.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 4","pages":"410-415"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754734","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":"Assessment of mutagenic effects: Combined impact of nitrogen-fixing compounds and phenol on plant and animal organisms.","authors":"L K Abdukadirova, F I Salomova, B B Rakhimov, N O Akhmadalieva, K Sadullaeva","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Rapid industrialisation, urbanisation, and increased use of agricultural chemicals have significantly contributed to environmental pollution, particularly affecting air, water, and soil quality. These pollutants, including nitrogen-containing compounds and phenol, pose mutagenic risks, potentially leading to genetic alterations and health issues in exposed populations. This study aims to evaluate the mutagenic potential of sodium nitrate, sodium nitrite, phenol, and their combinations on plant and animal cells.</p><p><strong>Materials and methods: </strong>The study utilised two experimental models: Triticum aestivum (soft wheat) and albino mice. Wheat seeds were treated with ten different solutions, including sodium nitrate (0.5%), sodium nitrite (0.5%), phenol (0.1% and 0.01%), and their combinations. Chromosomal aberrations in the wheat root tips were assessed using the acetocarmine staining method. For the animal model, albino mice were divided into control and experimental groups, receiving varying concentrations of sodium nitrate and phenol, both individually and in combination. Bone marrow smears were analysed for chromosomal aberrations, including fragments and rings, using metaphase plates.</p><p><strong>Results: </strong>In wheat, the combined exposure to sodium nitrate (0.5%), sodium nitrite (0.5%), and phenol (0.1%) caused a significant increase in genetic alterations compared to individual treatments, with a mutation frequency 4.5 times higher than the control. In albino mice, combined exposure to high doses of phenol and nitrates induced cytogenetic changes, with the mutation frequency reaching 12.7%-1.5 times higher than the control group. Individual exposures to phenol and nitrates did not produce statistically significant mutations compared to controls.</p><p><strong>Conclusion: </strong>The combination of phenol, sodium nitrate, and sodium nitrite had a synergistic mutagenic effect in both plants and animals, leading to more significant genetic damage than individual exposures. These findings highlight the need for careful management of environmental pollutants, as their combined impact may pose serious risks to ecological and human health. Further clinical studies are necessary to assess these effects in human populations.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 4","pages":"490-495"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754727","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":"Echocardiography detection rate of newly diagnosed valvular heart disease amongst patients 12 years old and beyond, referred for transthoracic echocardiography in tertiary care settings.","authors":"T M Chen, J S Ang, P Josephine, M Z Siti Nabilah, R Philip, V Sanmuga, W K Cheah, C M Ang, N S Shaibdat, S S Eileen Toh, P Jeannie Yik Tien, Q Y Wong, S Y Yee, K Zarrin, R Kengeswari, J S Gurpreet Pal Singh, S Ramachandran, Y F Kwan, M H Hazleena, M A Nor Hanim","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Valvular heart disease (VHD) is a significant contributor to cardiovascular morbidity and mortality. Despite global awareness, data on the epidemiology and clinical profile of VHD in Malaysia remain limited. This study aimed to determine the echocardiographic detection rate of newly diagnosed VHD in tertiary care centres in Perak, Malaysia, as well as to examine its clinical characteristics, aetiologies, severity, associated comorbidities, and the rate of patient acceptance for valve intervention.</p><p><strong>Materials and methods: </strong>A retrospective, multi-center study was conducted involving patients who underwent echocardiography over a six-month period. The data were then analysed to address the study objectives. Statistical analysis was performed using SPSS version 25.0.</p><p><strong>Results: </strong>Of the 12,610 patients who underwent echocardiography, 946 were newly diagnosed with VHD, yielding a detection rate of 7.5%. The median age of VHD patients was 67 years, with a slight female predominance. The median left ventricular ejection fraction (LVEF) was 57%. Approximately 66% of patients were symptomatic, with dyspnoea being the most common symptom (46.85%). Pulmonary hypertension was observed in 35.3% of patients. Atrial fibrillation (AF) was present in 12.2% of cases. Mitral regurgitation (MR) was the most common valve lesion (34.1%), followed by tricuspid regurgitation (TR, 32.3%) and aortic regurgitation (AR, 19.2%). Functional aetiology was the most frequent cause of VHD, accounting for 59%. Rheumatic heart disease (RHD) was responsible for 51.7% of mitral stenosis (MS) cases, while degenerative causes predominated in AR (74.9%), aortic stenosis (AS) (84.6%), and primary MR (71.4%). The majority of VHD cases were mild (65.6%), with 29.2% moderate and 5.1% severe. Among VHD patients, 34.7% had clinically significant moderate or severe disease. In this subgroup, the predominant aetiologies were functional for MR (52.1%), TR (96.7%), and pulmonary regurgitation (PR, 100%), while degenerative causes were prevalent in AR (63.6%) and AS (84.3%), and RHD was the leading cause of MS (57.1%). Multiple valve involvement was observed in 72.6% of cases. Two-valve involvement accounted for 52.5%, with MR and TR being the most common combination (68.7%), mainly due to functional causes. AS was significantly associated with hypertension and dyslipidaemia. MR showed strong associations with AF, chronic kidney disease (CKD), and ischemic heart disease (IHD), while TR was more common in females. Despite 6.7% of patients requiring valve intervention, only 24.2% consented. A total of 36.4% declined intervention, primarily due to concerns about advanced age (62.5%) and fear of surgery (29.2%), while 39.4% remained undecided.</p><p><strong>Conclusion: </strong>The echocardiographic detection rate of newly diagnosed VHD was 7.5%, with functional MR being the most common lesion (20.7%). The majority of patients r","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 4","pages":"436-442"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754732","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":"Clinical review of laryngomalacia in a tertiary hospital.","authors":"L Ghazali, S S A Hamid, H Mohamad, A Aziz","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Laryngomalacia is the most common cause of stridor in infants, with severity ranging from mild to severe forms. Accurate classifications of severity is essential for guiding management and improving outcomes.</p><p><strong>Material and methods: </strong>We conducted a retrospective study of paediatric patients under two years of age diagnosed with laryngomalacia at a tertiary referral centre between January 2010 and December 2020. Data collected included demographic details, clinical presentation, comorbidities, endoscopic findings, treatment, and follow-up duration. Severity was classified using a symptoms-based scoring system by Shah et al, while laryngomalacia types were determined according to Olney et al's endoscopic classification. Association between severity, endoscopic findings, comorbidities and treatment choice were analysed using logistic regression.</p><p><strong>Results: </strong>A total of 148 patients were included (59.49% male). Mild, moderate, and severe laryngomalacia were observed in 45.27%, 35.14%, and 19.59% of patients, respectively. Type 3 laryngomalacia, identified via endoscopy, was significantly associated with severe disease (p<0.001). Comorbidities, particularly gastroesophageal reflux disease, cardiac, pulmonary, syndromic, neurological conditions and synchronous airway lesions, were significantly linked to higher severity (p<0.05). A strong association was found between severity and treatment: moderate cases had 89.6 times, and severe cases 133.3 times, the odds of receiving surgical intervention compared to mild cases (p<0.001).</p><p><strong>Conclusion: </strong>Mild laryngomalacia was most prevalent, but severity increased with specific comorbidities and endoscopic findings. Objective symptom scoring and endoscopic classification are valuable for assessing severity and guiding appropriate management in laryngomalacia.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 4","pages":"443-447"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754729","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":"Learning from the plain film competency assessment in the Singapore radiology residency programme.","authors":"M W C H'ng, J G X Wong, D S Y Sia, W E H Lim, D E S Wong","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The national Plain Film Competency Assessment (PFCA) was held to allow passing Residents to report plain radiographs independently and thus perform on-call night duties. Our study aimed to investigate factors influencing performance in this exam.</p><p><strong>Methods: </strong>This was a retrospective study of data from 2012- 20. Training data included previous experience in radiology as well as number of reported films (total and by body regions) whilst examination data comprised these scores as well as error analysis (classified as False Positives, False Negatives or Incorrect Abnormality) for the main and repeat sittings.</p><p><strong>Results: </strong>Up to 222 residents were included for statistical analysis. Those with previous radiology exposure were more likely to pass, 85.1% compared to 68.9% (χ=0.03) and had higher scores, 85.1 versus 81.3 (p<0.01). The number of co-reported films did not affect passing even after excluding those with previous experience. Chest and limb radiographs made up at least three-quarters of the reported films, with residents passing these whilst failing those from the abdominal, skull and spine regions. There was no significant difference between their improved scores after undergoing remediation of either one or four months in duration. However, error analysis after remediation revealed a lower combined percentage of False Positives and Negatives.</p><p><strong>Conclusions: </strong>Experience in a radiology posting after graduation facilitated passing. Although we could not establish an association between the number of reported films and passing, there was an imbalance in the variety of reported films, which should first be resolved.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 4","pages":"397-402"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754737","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":"Association between phenotypes and genotype of developmental and epileptic encephalopathy in next-generation sequencing methods in infants: A scoping review.","authors":"A Triono, E S Herini, K H Mooiindie, K Iskandar, Gunadi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Developmental and epileptic encephalopathy (DEE) is epilepsy related to developmental impairment that may be caused by both the underlying etiology (developmental encephalopathy) and superimposed epileptic activity (epileptic encephalopathy). The origin of DEE and the causes of its variations remain unknown. Owing the lack of clarity regarding the role of genetic variables in DEE, we conducted a scoping review to qualitatively identify the genes most important in the development of DEE to provide an up-to-date review.</p><p><strong>Material and methods: </strong>We searched all published studies related to the genetic factors of DEE. The identified publications were screened and selected by the authors on basis of on inclusion and exclusion criteria and assessed for methodological quality. Eighteen articles were included. The extracted data included age of onset, sex, gene mutations and inheritance (e.g. nucleotide change, protein change, and family testing), clinical manifestation, electroencephalogram, imaging, medication, and outcomes.</p><p><strong>Result: </strong>A total of 18 studies were included in this scoping review. The most frequently reported gene variants were STXBP1 in Ohtahara Syndrome, SLC1A2 in Early Myoclonic Encephalopathy (EME), CDKL5 in West Syndrome, SCN1A in Dravet Syndrome, and KCNT1 in Epilepsy of Infancy with Migrating Focal Seizures (EIMFS). Each gene was associated with distinct electroclinical features, including differences in age of onset, seizure type, EEG patterns, and developmental outcomes. While genotype and phenotype associations were heterogeneous, certain variants showed consistent patterns indicative of more severe disease courses.</p><p><strong>Conclusions: </strong>This review identified key gene variants commonly associated with early-onset DEE in infants, particularly STXBP1, SLC1A2, CDKL5, SCN1A, and KCNT1, each linked to unique clinical presentations and outcomes. These findings support the clinical utility of next-generation sequencing (NGS) for early diagnosis and tailored treatment planning in DEE. Understanding genotype-phenotype correlations may enhance prognostication and highlight potential avenues for targeted therapy in future research.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 4","pages":"521-530"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754728","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":"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":"","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}