Medical Journal of Malaysia最新文献

{"title":"A rare case of tamoxifen induced bilateral optic neuritis.","authors":"R Akash, A V Panimalar, S K Puri, N Divya","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Tamoxifen, an oral medication that blocks estrogen activity, is frequently prescribed for the treatment of advanced breast cancer and as an additional therapy following surgical removal of early stage disease. A 45-year-old female with a history of breast carcinoma treated with tamoxifen presented with sudden onset bilateral visual impairment for 4 days. On ocular examination, the patient exhibited optic disc edema with hyperemia and bilateral anterior pathway defects in visual evoked potentials. Magnetic resonance imaging revealed a thickened right optic nerve sheath with patchy enhancement of the left optic nerve sheath. The patient was diagnosed with bilateral optic neuritis and treated with intravenous methylprednisolone, which resulted in significant improvement in visual acuity and resolution of optic disc edema. This case underscores the importance of vigilant ophthalmological monitoring in patients undergoing tamoxifen therapy to facilitate the early detection and management of ocular complications.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 Suppl 1","pages":"7-9"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956363","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 decade of intracapsular cataract extraction: Clinical profile and visual outcomes at Hospital Melaka, Malaysia.","authors":"H Nur Faizah, M N Nurul Hafizah, J Juliana, W H Wan-Hazabbah","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Cataract is a leading cause of visual impairment globally and in Malaysia, with surgery being the definitive treatment. While intracapsular cataract extraction (ICCE) is now less commonly performed due to advancements in surgical techniques, it remains essential in specific cases, such as those with weak zonular support. This study aims to evaluate the incidence, clinical profiles, and visual outcomes of patients who underwent ICCE, with or without intraocular lens (IOL) implantation, at Hospital Melaka, Malaysia, over the past decade.</p><p><strong>Materials and methods: </strong>A retrospective review was conducted on patients who underwent ICCE at Hospital Melaka, Malaysia, from January 2014 to December 2023.</p><p><strong>Results: </strong>A total of 143 ICCE surgeries were performed on 135 patients. Most patients were male (n=88, 65.2%), with females comprising 34.8% (n=47). Most surgeries were performed on patients aged 60-69 years (n=48, 35.5%), followed by those aged 50-59 years (n=31, 23.0%) and 70-79 years (n=28, 20.7%). Incidence was lower among patients below 50 years and above 80 years. In terms of ethnicity, the highest incidence was among Malays (n=77, 57.0%), followed by Chinese (n=42, 31.1%) and Indians (n=15, 11.1%). The leading cause of ICCE was senile cataract with weak zonular support (n=58, 40.6%), followed by trauma (n=33, 23.1%), intraoperative complications (n=30, 21.0%), congenital cataracts (n=14, 9.8%), pseudoexfoliation (n=4, 2.8%), and lens-induced glaucoma (n=4, 2.8%). Post-surgery, 76 patients (53.1%) were left aphakic. Among those receiving IOL implants, 21.0% (n=30) had anterior chamber IOL, 14.7% (n=21) received an iris-claw IOL, and 11.2% (n=16) had a scleral-fixated IOL. Twelve weeks after IOL implantation, 60.9% (n=39) achieved good visual acuity of 6/12 or better, while 17.2% (n=11) had moderate vision (6/18 to 6/36), and 21.9% (n=14) had poor vision (worse than 6/60).</p><p><strong>Conclusion: </strong>The incidence of ICCE was low, accounting for only 0.66% of the 21,596 cataract surgeries performed at Hospital Melaka, Malaysia, during the study period. The primary indication was senile cataracts with weak zonular support. Most patients achieved favourable visual outcomes at 12 weeks postsurgery following IOL implantation, with the iris-claw IOL showing superior postoperative visual results compared to other IOL types.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 1","pages":"68-71"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985103","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":"An in vitro evaluation of anti-oxidant properties of novel nano-composite material containing titanium oxide, zinc oxide and green tea extract.","authors":"S Joseph, D Nallaswamy, S Rajeshkumar, P C Dathan, N Rasheed, M Tharani, J Jacob, L Jose","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Green tea is a medicinal beverage extracted from the plant Camellia sinensis. Antioxidants that exist naturally can be extracted as pure compounds from their parent materials for nutraceutical and medicinal applications. The present study aims to assess the antioxidant activity of Zinc oxide-titanium dioxide nano-composites (ZnO-TiO2 NCs) containing green tea extract.</p><p><strong>Materials and methods: </strong>The antioxidant activity was tested by Hydrogen Peroxide [H2O2] assay, Fluorescence recovery after photo-bleaching [FRAP] assay and 2, 2-diphenyl-1- picrylhydrazyl[DPPH] assay. All tests have shown very good results for the ZnO-TiO2 NCs.</p><p><strong>Results: </strong>In this study, we present a straightforward, ecofriendly alternative for producing non-toxic zinc oxide and titanium oxide nano-composite material. This study could make a valuable contribution and create new opportunities in the market such as biological and pharmaceutical applications.</p><p><strong>Conclusion: </strong>The in vitro tests concluded that the novel nanocomposite containing ZnO-TiO2 and green tea extract has good anti-oxidant properties and it is non-toxic to the biological systems.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 Suppl 1","pages":"52-58"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956365","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 factors of the survival of pancreatic cancer patients in peninsular Malaysia: A survival analysis.","authors":"M M T Aung, N N Naing, M R A Hassan, N Wan-Arfah, H K Chan, H Harman Shah, S S Oo, M S Ibrahim","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Pancreatic cancer incidence in Malaysia is steadily on the rise, now ranking as the 14th most common malignancy in the country. Despite this upward trend, research on prognostic factors affecting pancreatic cancer survival remains limited, highlighting the need for ongoing investigation to improve patient survival outcomes.</p><p><strong>Materials and methods: </strong>This study was conducted retrospectively by reviewing records of pancreatic cancer patients hospitalized between January 2011 and December 2018 across multiple health centres in Malaysia. Using Cox proportional hazards regression analysis, several prognostic factors were identified.</p><p><strong>Results: </strong>The study revealed that being Chinese, having a family history of pancreatic cancer, having hepatitis C, presenting with jaundice, experiencing pale stools, having a palpable mass in the abdomen, the presence of ascites, receiving palliative care and end-of-life care were associated with higher mortality risk. Conversely, being female, having hypertension, and higher haemoglobin levels were linked to decreased mortality risk.</p><p><strong>Conclusions: </strong>These study findings offer valuable insights into prognostic factors for predicting patient outcomes and optimizing individual prognosis in pancreatic cancer cases within Malaysia context. Future research should build on these findings, exploring how these factors can be integrated into comprehensive care plans that address the specific needs of diverse patient populations.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 1","pages":"43-49"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984508","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":"Predictors of acupuncture referral for chronic non-specific low back pain among medical practitioners in Malaysia.","authors":"S K Sim, M M Rahman, H F Wong","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic non-specific low back pain (cnLBP) is a common primary care health issue. While acupuncture offers promising potential as a complementary treatment, its acceptance and integration into standard medical care for cnLBP remains inconsistent. This study investigated the predictors of acupuncture referral for cnLBP using the Theory of Planned Behaviour (TPB).</p><p><strong>Materials and methods: </strong>This was a cross-sectional observational study. Medical practitioners were recruited from the Malaysian Medical Association via email invitations. Data were collected via a validated online questionnaire and analysed using SPSS, employing bivariate correlation and multiple linear regression analyses to examine the predictors of referral behaviour.</p><p><strong>Results: </strong>A total of 389 medical practitioners were recruited. The respondents were predominantly general practitioners aged 35-44 years, with 10-19 years of clinical experience, and approximately 90.0% managed cnLBP. Despite the high awareness of the Traditional and Complementary Medicine Act (92.0%), only 33.2% referred patients to acupuncture. Few had acupuncture training (3.6%) or personal experience (7.7%), and services were available in 12.1% of the workplaces. Medical practitioners possess substantial knowledge about acupuncture treatment for cnLBP; however, misconceptions and uncertainties regarding its mechanisms persist. Using multiple linear regression analysis, the significant predictors of acupuncture referral were self-experience (β=0.151, p<0.01), attitude (β=0.189, p<0.001), and perceived behavioural control (β=0.101, p<0.05).</p><p><strong>Conclusions: </strong>Despite positive attitudes and substantial awareness, barriers hinder the broader integration of acupuncture in cnLBP treatment. Targeted education, institutional support, and enhanced research collaborations are essential for improving referral rates and expanding the treatment options for cnLBP.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 1","pages":"60-67"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984106","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":"Recommendations for enhancing research outcomes and the efficacy of transcranial direct current stimulation in post-stroke motor rehabilitation for local settings.","authors":"S K Sim","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Transcranial direct current stimulation (tDCS) has emerged as a potential adjunct therapy for post-stroke motor rehabilitation. While conventional rehabilitation methods remain the primary approach to improving motor function after stroke, many patients experience incomplete recovery, necessitating the exploration of additional interventions. This commentary article examines the role of tDCS in poststroke motor recovery, focusing on its mechanisms, efficacy, and limitations. Herein, the variability in research findings and individual patient responses as well as the recommended methods for optimising tDCS use in local clinical settings are highlighted.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 1","pages":"108-110"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984837","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 role of quantitative electroencephalography in ischaemic stroke through spectral and topographic mapping.","authors":"K L Liew, J K Tan, C S Khoo, K Y Ng, C Wilbert, Y T Lew, C M Ting, O Hernando, Z Nursyazwana, Z Y Lee, H J Tan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Stroke is a major cause of morbidity and mortality worldwide. While electroencephalography (EEG) offers valuable data on post-stroke brain activity, qualitative EEG assessments may be misinterpreted. Therefore, we examined the potential of quantitative EEG (qEEG) to identify key band frequencies that could serve as potential electrophysiological biomarkers in stroke patients.</p><p><strong>Materials and methods: </strong>A single-centre case-control study was conducted in which patients admitted with stroke and healthy controls were recruited with consent. EEG was performed within 48 hours of admission for stroke patients and during outpatient assessments for controls. The EEG signals were pre-processed, analysed for spectral power using MATLAB, and plotted as topoplots.</p><p><strong>Results: </strong>A total of 194 participants were included and equally divided into patients with ischemic stroke and controls. The mean age of our study cohort was 55.11 years (SD±13.12), with a median National Institute of Health Stroke Scale (NIHSS) score of 6 (IQR 4-6) and lacunar stroke was the most common subtype (49.5%). Spectral analysis, with subsequent topographic brain mapping, highlighted clustering of important channels within the beta, alpha, and gamma bands.</p><p><strong>Conclusion: </strong>qEEG analysis identified significant band frequencies of interest in post-stroke patients, suggesting a role as a diagnostic and prognostic tool. Topographic brain mapping provides a precise representation that can guide interventions and rehabilitation strategies. Future research should explore the use of machine learning for stroke detection and provide individualized treatment.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985109","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 unsuccessful treatment outcomes among relapse tuberculosis patients in selangor registered in National Tuberculosis Registry from year 2015 - 2019.","authors":"N A C Rameli, S S Yaacob, N Ismail, M Azzani, T Harishah","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the availability of highly effective treatment for tuberculosis (TB), patients with TB may experience a relapse, which can be either a result of the disease reactivating or a new episode induced by reinfection. In Malaysia, there has been a noticeable rise in relapse TB cases, with a substantial rate of unsuccessful treatment outcomes among this population. This study seeks to examine the trends of unsuccessful treatment outcomes in relapse TB patients and explore how factors such as sociodemographic characteristics, TB disease profile, TB treatment profile, and comorbidities contribute to the outcomes.</p><p><strong>Materials and methods: </strong>This is a retrospective cohort study utilising secondary data from the National Tuberculosis Registry (NTBR). The study was conducted in Selangor among relapsed TB patients who were registered in NTBR from 1 January 2015 to 31 December 2019. TB disease profile, TB treatment profile, comorbidities, and sociodemographic data were examined. The determinants of unsuccessful treatment outcomes among relapsed TB patients were identified using multiple (binary) logistic regression analyses.</p><p><strong>Results: </strong>896 patients who experienced relapsed tuberculosis were included in this study. 32.25% were reported to have unsuccessful treatment outcomes. Multiple (binary) logistic regression revealed that the absence of sputum smear examination at 5 months and beyond was a determinant of unsuccessful treatment outcome (AOR 1.70 (95% CI: 1.19, 2.44). Additionally, being treated in government facilities, such as government hospitals and government primary health clinics, was a protective factor (AOR 0.06 (95% CI: 0.03, 0.15) and AOR 0.02 (95% CI: 0.01, 0.04), respectively.</p><p><strong>Conclusion: </strong>The high proportion of unsuccessful treatment outcomes among relapse TB patients stresses the importance of adherence to routine sputum monitoring and public-private partnerships.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 1","pages":"9-16"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985105","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 rare case of pigmented seborrhoeic keratosis of scalp.","authors":"D Arosish","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Seborrheic keratosis (SK) is a prevalent hyperkeratotic dermatological condition characterized by benign proliferation of epidermal keratinocytes, typically occurring in the middle to advanced stages of life. While the trunk is the primary site for lesions, they can also manifest on the extremities, face, and scalp. Although SK is typically benign, there can be morphological overlap with malignant skin lesions, necessitating meticulous differentiation for an accurate diagnosis. This case report describes a 63-year-old male presenting with scalp swelling that was, initially suspected to be malignant. However, histopathological examination revealed pigmented seborrheic keratosis, prompting the need for a comprehensive management approach. Surgical excision with a rotational flap cover was performed successfully, highlighting the importance of precise diagnosis and management in addressing cutaneous lesions. The exact etiology of SK remains elusive, with potential genetic associations implicated in its pathogenesis. Although treatment may not always be necessary, various modalities are available for lesion removal or symptom management, with surgical intervention reserved for cases exhibiting signs of malignancy. Clinicians should be aware of the atypical presentations of SK and, emphasize the need for a multidisciplinary approach involving dermatologists, pathologists, and surgeons for optimal outcomes.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 Suppl 1","pages":"80-83"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956453","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":"Quorum quenching nanoparticles against wound pathogens - A scoping review.","authors":"A Jayasree, S Rajeshkumar","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Quorum sensing (QS) enables bacteria to coordinate colony-wide activities, including those associated with infections. Quorum quenching (QQ) inhibits QS and is a promising method for controlling bacterial infections. Several In vitro experiments have been conducted to identify nanoparticles (NPs) as potential quorum quenching inhibitors. This review examines the potential of nanoparticles for quorum quenching, focusing on the QS-regulated pathogenicity of wound pathogens.</p><p><strong>Materials and methods: </strong>Observational studies were conducted to explore the capacity of nanoparticles to quorum quench wound pathogens.</p><p><strong>Results: </strong>A review of observational studies indicated that nanoparticles exhibit significant quorum-quenching capabilities against wound pathogens. Numerous nanoparticles, including silver, gold, and zinc oxide, have been demonstrated to inhibit QS-regulated activities, thereby reducing bacterial virulence and biofilm formation. These results suggest that nanoparticles could serve as potent agents for mitigating bacterial infections and enhancing wound healing.</p><p><strong>Conclusion: </strong>Nanoparticles show considerable potential as quorum-quenching agents, effectively decreasing bacterial virulence and biofilm formation in wound pathogens. These results indicate promising applications of nanoparticles in managing bacterial infections and improving wound healing.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 Suppl 1","pages":"69-76"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956488","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}