Medical Journal of Malaysia最新文献

{"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":"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":"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":"Proportions and determinants of successful tuberculosis treatment among tuberculosis patients with comorbidity registered in National Tuberculosis Registry in Negeri Sembilan from year 2018-2023.","authors":"A R Dashuki, A N M Ruzlin, M A I A Zamzuri, X W Chen","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Tuberculosis (TB) is one of the major global health challenges and concerns. Despite the availability of effective treatment in Malaysia, it remained a consistently high notification rate of TB cases. The objective of this study was to determine the proportion of successful TB treatment outcomes and its determinants among TB with comorbidities patients in Negeri Sembilan, Malaysia.</p><p><strong>Methods: </strong>This is a retrospective cohort study among TB with Comorbidities cases in Negeri Sembilan using multiple secondary surveillance databases: National Tuberculosis Registry (NTBR), National Aids Registry (NAR) and National Diabetic Registry (NDR). The data review was from April 2024 until June 2024. All registered TB cases with comorbidities in Negeri Sembilan from the year 2018 to 2023 were analysed to determine the determinants of successful TB treatment among TB with comorbidities patients.</p><p><strong>Results: </strong>Out of 712 TB cases with comorbidities, 541 (76.0%) achieved a successful TB treatment outcome, and 171 (24.0%) did not. The successful TB treatment among TB with comorbidities showed predominantly among male (72.5%), Malay ethnicity (65.4%), secondary education level (60.3%), and unemployed working status (70.1%). Diabetes mellitus (DM) was the most common comorbidity (70.4%), followed by hypertension (44.8%), dyslipidaemia (36.0%), HIV (19.5%), and viral hepatitis (18.1%). Factors significantly associated with successful TB treatment were those who had a secondary education level (AOR: 2.222; 95% CI: 1.129, 4.374) and a tertiary education level (AOR: 4.474; 95% CI: 1.428- 14.01), were diagnosed with TB in the government hospital (AOR: 0.053; 95% CI: 0.008-0.376), and were not done Acid- Fast Bacillus sputum in the intensive phase of treatment (AOR: 0.191; 95% CI: 0.046, 0.785), cases followed the Directly Observed Therapy at the intensive phase (AOR: 9.045; 95% CI: 4.604, 17.770), and the treatment duration was more than 6 months (AOR: 6.511; 95% CI: 3.383, 12.532).</p><p><strong>Conclusion: </strong>The successful treatment outcome for TB with comorbidities still falls short of the target and, if not treated well, could potentially lead to prolonged disease transmission, higher mortality rates, and increased healthcare costs. Identifying the proportion of successful treatment rates and their determinants provides insight into the disease burden and helps the public health sector and medical professionals assess and take appropriate action to improve local integration and collaborative service approaches for TB patients with concurrent comorbidities.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 1","pages":"50-59"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984744","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":"Quantitative characterisation of carotid atherosclerotic plaque neovascularisation using contrast-enhanced ultrasound imaging: A feasibility study.","authors":"M Tian, N Mohamad, X Z Gao, N H Mohd Taib","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Contrast-enhanced ultrasound (CEUS), an in vivo imaging tool for evaluating intraplaque neovascularisation (IPN), is an increasingly researched marker of susceptible atherosclerotic plaque. This study aims to assess the feasibility of quantifying carotid IPN using CEUS and to identify and characterise the neovascularisation in carotid plaques. The hospital's ethical committee approved the study, and the informed individual consent form of CEUS was obtained from all patients before the examination.</p><p><strong>Materials and methods: </strong>Seventy-one patients with carotid atherosclerotic plaques (95 plaques) were studied on CEUS. Contrast enhancement in the plaque was evaluated with visual interpretation and quantitative analysis. The intraplaque neovascularisation (IPN) test was graded on a 3- point scale. IPN was quantified using dedicated software for CEUS image analysis.</p><p><strong>Results: </strong>It was found that the CEUS quantitative parameters were significantly different for plaques with varying types of echoes. The quantitative parameters also differed in soft, hard, and mixed plaques. The quantification of carotid IPN using CEUS was found feasible. The quantitative parameters measured from CEUS provide multiple references for carotid IPN of different echo types. This can help identify and monitor unstable atherosclerotic plaques.</p><p><strong>Conclusion: </strong>CEUS has the potential to be an important tool in clinical application, specifically for diagnosing carotid atherosclerotic plaque features and vulnerability.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 1","pages":"88-95"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984836","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 musculoskeletal disorders in end-stage kidney disease: a systematic review.","authors":"S Sharma, S Rampal, A Jaiman, S L Saravanamuttu, A Jaiman, L Kamaruzaman, C A Lopes, M A Ikram","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>This study focuses on the association between musculoskeletal disorders and chronic kidney disease (CKD), specifically end-stage kidney disease (ESKD). Its primary objective is to explore the spectrum of musculoskeletal disorders and to identify their prevalence rates and symptoms within diverse CKD subpopulations.</p><p><strong>Materials and methods: </strong>The screening process yielded 13 studies conducted in various countries and regions. These studies, employing designs such as cross-sectional, cohort, and clinical trials, focused on CKD patients across different stages, including early and late-stage CKD.</p><p><strong>Results: </strong>The study revealed that musculoskeletal disorders are a considerable concern within the CKD population but are insufficiently explored among ESKD patients. Common musculoskeletal disorders identified include osteoarthritis, osteoporosis, fibromyalgia, carpopedal spasm, and chronic musculoskeletal pain syndrome. The prevalence of these disorders varied, with sub-group analysis revealing higher prevalence among hemodialysis patients compared to preand non-dialysis patients. While musculoskeletal pain remains consistent across CKD stages, potential confounding factors, such as palliative care settings and mobility issues warrant careful consideration.</p><p><strong>Conclusion: </strong>The study underscores the importance of understanding and addressing musculoskeletal disorders in the CKD population, emphasizing the need for tailored interventions and future research endeavors.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 1","pages":"102-107"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985108","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 ten-year cardiovascular disease risk prediction among primary healthcare workers using the office-based globorisk tool: A cross-sectional study.","authors":"Z Zakiman, A N Mat Ruzlin, X W Chen, R Muhamad Robat","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiovascular diseases (CVDs) remain to be the leading cause of premature mortality worldwide, and healthcare workers (HCWs) are potentially at risk for developing CVDs. Office-based Globorisk is a ten-year risk prediction tool for CVDs risk scores. This present study aims to determine the prevalence of CVDs risk and risk factors associated with moderate-high CVDs risk among primary HCWs in government health clinics in Selangor.</p><p><strong>Materials and methods: </strong>A cross-sectional study was conducted on 543 HCWs from the KOSPEN WOW (\"Komuniti Sihat Pembina Negara\" or \"Healthy Community Builds the Nation-Wellness of Workers\") database in three district health offices (DHOs) under the Selangor State Health Department in Malaysia. To estimate the office-based Globorisk model, factors such as age, sex, current smoking status, systolic blood pressure (SBP), and body mass index (BMI) were included. Data analysis employed were Pearson chi-square test, Fisher's exact test, Welch's t-test and binary logistic regression.</p><p><strong>Results: </strong>Among 543 participants, 453 (83.4%) were female, 439 (80.8%) were Malay with mean (SD) age of 44.4 (4.38). Majority of moderate-high CVDs risk identified among primary HCWs was male with 26 (86.7%), Malay with 25 (83.3%), and non-clinical group with 17 (56.7%). The prevalence of low CVDs risk was 94.5% (95% CI: 92.2-96.2) and 5.5% (95% CI: 3.8-7.8) for the moderate-high risk category. Factors associated with moderate-high CVDs risk were job category with non-clinical group (95% CI: 1.43, 6.85), elevated blood glucose (95% CI: 3.25, 19.41) and anxiety symptom (95% CI: 1.46, 13.86).</p><p><strong>Conclusion: </strong>The KOSPEN WOW platform is effective for screening and guiding implementation of intervention programmes to prevent CVDs.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 1","pages":"17-24"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984911","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":"Secondary Retinitis pigmentosa subsequent to docetaxel and carboplatin combination - A rare cytotoxic chemotherapy complication.","authors":"G Taarika, A V Panimalar, S K Puri, N Divya","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Visual loss following secondary retinitis pigmentosa (RP) is a rare complication of cytotoxic chemotherapy. Few cases of docetaxel- and/or platinum-induced retinal toxicity have been reported. Routine ocular examination of patients undergoing chemotherapy is required for early recognition and intervention of ocular toxicity. A 72- year-old female undergoing docetaxel and carboplatin combination chemotherapy for the past 3 months presented with complaints of defective vision in both eyes for 2 months. Fundus examination revealed a waxy pale disc in both eyes, arteriolar attenuation, and peripheral bony spicules, suggesting secondary retinitis pigmentosa. Optical Coherence Tomography (OCT) of the macula revealed macular dystrophy. The Humphrey Visual Field (HVF) showed field defects. Despite the reduction in chemotherapy dosage, no improvement was observed during the threeweek follow-up period.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 Suppl 1","pages":"26-28"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956492","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}