Medical Journal of Malaysia最新文献

{"title":"Assessment of acceptability, appropriateness, and feasibility of the mindfulness and well-being toolkit for depression in Malaysian primary care clinics: A cross-sectional study.","authors":"A Khalil, Z I Azhar, X W Chen, N Shuib","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Depression is a major contributor to disability worldwide, and mild to moderate depressive symptoms are frequently managed in primary care, where time and specialist access are constrained. The Mindfulness and Well-being Toolkit (Mind-WELL Kit) was developed to support primary care providers in delivering brief, structured mindfulness-based support for depression, but its implementation potential requires evaluation.</p><p><strong>Materials and methods: </strong>A cross-sectional online survey was conducted among providers from a systematic sample of primary health care clinics in Selangor. Participants received the Mind-WELL Kit in portable document format (PDF) and were given approximately two weeks to review it before completing the acceptability of intervention measure (AIM), intervention appropriateness measure (IAM), and feasibility of intervention measure (FIM), along with a singleitem overall satisfaction rating (1-5). Pearson correlation, independent-samples t-test, and one-way ANOVA were used to examine differences by participant characteristics.</p><p><strong>Results: </strong>A total of 151 healthcare providers participated in the study, with a mean (standard deviation, SD) age of 37.83 (5.67) years, and 80.8% were female. Participants reported favourable perceptions of the Mind-WELL Kit, with mean (SD) scores of 4.13 (0.55) for AIM, 4.07 (0.59) for IAM, and 3.96 (0.61) for FIM. Scores did not differ significantly according to age, gender, ethnicity, job category, duration of service, or clinic type (p>0.05). Overall satisfaction was high, with a mean (SD) score of 4.21 (0.78), and 84.8% of participants rated the toolkit 4 or 5 out of 5.</p><p><strong>Conclusions: </strong>The Mind-WELL Kit showed promising perceived implementation potential, with high acceptability and appropriateness, favourable feasibility, and strong overall satisfaction among primary care providers.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 4","pages":"525-532"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of lymphovascular space invasion on recurrence and survival rate among women with stage I endometrioid endometrial cancer.","authors":"W Gherbal, Y P Wong, G C Tan, S E Phon, C K Nirmala","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Endometrial cancer is the most common gynecologic malignancy in developed countries, with rising incidence worldwide. While early stage disease generally carries a favorable prognosis, recurrence remains a significant clinical concern. Among the histopathological features, lymphovascular space invasion (LVSI) has emerged as a critical prognostic factor, reflecting tumor aggressiveness and potential for metastatic spread. LVSI is associated with increased risk of recurrence, distant metastasis, and reduced survival, even in patients with otherwise low risk disease. Understanding the role of LVSI in endometrial cancer is essential for refining risk stratification, guiding adjuvant therapy decisions, and improving patient outcomes. Our study to evaluate the impact of lymphovascular space invasion (LVSI) on treatment outcomes, recurrence, and survival in patients with stage I endometrioid endometrial cancer.</p><p><strong>Materials and methods: </strong>A retrospective cohort study was conducted at the Hospital Canselor Tuanku Muhriz (HCTM) Gynecologic Oncology Clinic, with ethical approval from Universiti Kebangsaan Malaysia. Patients with stage I endometrial carcinoma, classified according to the International Federation of Gynecology and Obstetrics (FIGO) 2018, and confirmed on hysterectomy specimens were included. Demographic clinicopathological, and treatment data were collected. LVSI was defined as the presence of tumor cells within endothelial lined spaces. Overall survival (OS) was the primary endpoint. Statistical analyses were performed using SPSS version 26, employing chi square, t tests, and Kaplan-Meier estimates, with significance set at p < 0.05.</p><p><strong>Results: </strong>Of 180 patients, 163 had endometrioid carcinoma; 114 were included in the final analysis (mean age 58 years; 79.8% postmenopausal). LVSI was present in 14.2% of cases and was associated with higher grade and deeper myometrial invasion. Recurrence occurred in 8.5% overall, with 18.8% in LVSI positive and 4.1% in LVSI negative patients. The 2 year disease free survival (DFS) rate was 93.4% (80.8% LVSI positive vs 99% LVSI negative). The 5 year DFS rate was 91.1% (73.4% LVSI positive vs 94% LVSI negative). The OS rate was 97.3% (87.5% LVSI positive vs 99% LVSI negative). Distant metastasis predicted 2 year DFS, whereas LVSI positivity independently predicted reduced 5 year OS. At 5 years, the DFS rate was 91.1% (SE = 0.031), while the OS rate was 97.3% (SE = 0.013). The similarity between DFS and OS reflects the low number of recurrence and death events, indicating favorable prognosis and effective disease control. Median survival was not reached.</p><p><strong>Conclusion: </strong>LVSI was associated with higher recurrence and poorer survival in patients with Stage I endometrioid endometrial carcinoma, independently predicting 5-year survival, supporting its role in risk stratification and treatment planning.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 4","pages":"513-520"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714086","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":"Psychological distress and associated stressors with proposed stress reduction model for Chinese international postgraduate students in Malaysia: A cross-sectional study.","authors":"Y Liu, V Perumal, S Suppiah, P F Lee, A R Tualeka","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>In recent years, there has been an exponential rise in students inbound to Malaysia to pursue their postgraduate studies. In particular, Chinese international postgraduate students (CIPS) represent a rapidly growing student population in this country, which is postulated to lead to substantial psychological distress resulting from academic, cultural, and financial adjustments that are required of the students immersing themselves in a new environment. Nevertheless, quantitative evidence regarding depression, anxiety, and stress among CIPS in Malaysian public universities remains limited.</p><p><strong>Materials and methods: </strong>A cross-sectional study was conducted among 347 Chinese international postgraduate students at Universiti Putra Malaysia (UPM) using mixedmode convenience sampling. Data were collected using a structured questionnaire that included sociodemographic variables, stressors, stress-relieving activities, and the Depression Anxiety Stress Scales-21 (DASS-21). For the statistical analysis, we performed descriptive statistics, group comparisons, Pearson correlations, and hierarchical regression analyses.</p><p><strong>Results: </strong>The prevalence of mild-to-extremely severe symptoms was 61.1% for depression, 67.1% for anxiety, and 56.2% for stress. Psychological distress was significantly associated with perceived discrimination, financial concerns, poorer self-rated health, and depression history. In the final hierarchical regression model, perceived discrimination emerged as the strongest predictor of distress (β = .270, p < .001). Furthermore, financial concerns, poorer self-rated health, and participation in artistic activities such as calligraphy classes were also positively associated with increasing DASS-21 scores, whereas positive future outlook scores showed a negative association. The final model explained 53.1% of the variance in psychological distress.</p><p><strong>Conclusion: </strong>Psychological distress among CIPS at UPM was substantial and appeared to be strongly related to acculturative stress and resource-related pressures. A proposed model to overcome this should include universitydriven, culturally responsive mental health services, antidiscrimination support, and financial and academic assistance to ensure the successful onboarding and orientation of international postgraduate students.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 4","pages":"489-496"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714124","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":"Cervical cancer survival rate after abdominal vs. laparoscopic radical hysterectomy in two government hospitals in Jakarta, Indonesia.","authors":"L Novianti, D Calvin, Y Feharsal, F V D Candrani, T D Anggraeni, F Kusuma, A D Putra, C S Singoprawiro, G Purwoto, H Winarto","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Cervical cancer ranks among the top ten globally. Its five-year survival rate is 67.9% across all stages. In Indonesia, laparoscopic radical hysterectomy (LRH) is gaining traction but remains less common than abdominal radical hysterectomy (ARH). Limited research exists on cervical cancer survival rates in Indonesia. Our study compared ARH to LRH survival rates for cervical cancer patients.</p><p><strong>Materials and methods: </strong>We reported a retrospective study that included 275 patients of all cervical cancer stages who met inclusion criteria from 2015 to 2019 in two of Jakarta's national teaching hospitals. The patients underwent ARH or LRH, radiotherapy, and chemotherapy and were observed for five years. Univariate and multivariate analyses were performed to investigate survival rates.</p><p><strong>Results: </strong>236 patients underwent ARH, and 39 patients underwent LRH. The median survival of LRH and ARH were 23.9 months and 29.6 months, respectively. The five-year survival rates of LRH and ARH patients were 75.0 % and 83.5%, respectively. The early-stage survival rate was higher than in the advanced stage (76.7% vs. 73.5%, p=0.006). Cox multivariate modelling determined that surgical approach (ARH vs. LRH) (HR: 2.3; 95% CI: 1.2 - 4.5; p = 0.01) and cancer stage (HR: 1.9; 95% CI: 1.18 - 2.92; p = 0.007) were significant factors.</p><p><strong>Conclusion: </strong>The higher cancer stage resulted in a lower fiveyear survival rate. In this limited sample study, LRH demonstrated an inferior five-year survival rate compared to ARH.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 3","pages":"337-342"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148102066","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":"Sixteen years of cochlear implant surgery in cochleovestibular malformation and cochlear nerve deficiency: Insights from northern Malaysia.","authors":"J H Khoo, I H Zainon, Y Md Yusoff, N A Nik Othman","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Congenital sensorineural hearing loss associated with cochleovestibular malformations (CVM) and/or cochlear nerve deficiency (CND) presents distinct surgical and audiological challenges. Patients with CVM face elevated risks of intraoperative cerebrospinal fluid (CSF) gushers and aberrant facial nerve courses, while those with CND have historically been viewed as poor candidates for cochlear implantation (CI) due to concerns regarding neural sufficiency. This study aims to bridge this gap by evaluating the surgical safety and audiological outcomes of CI in a focused cohort of patients with CVM and CND at a tertiary referral centre in northern Malaysia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;A retrospective cohort study was conducted on 20 cases with CVM and/or CND performed between January 2009 and December 2024 at Hospital Sultanah Bahiyah, Kedah, Malaysia. The study population included patients with radiologically confirmed CVM classified according to the Sennaroglu classification and CND. Surgical outcomes, including the incidence of CSF gushers, were analysed by Fisher's exact test following stratification into high-risk and low-risk gusher group. Primary audiological outcomes were assessed using the aided average pure tone audiometry (PTA), analysed longitudinally using a linear mixed-effects model. Secondary functional audiological outcomes were evaluated by comparing pre-implantation and 12-month post-implantation Categories of Auditory Performance-II (CAP-II) scores using the Wilcoxon signed-rank test.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The cohort was predominantly prelingual (90.0%). Surgical analysis revealed a shift in technique over the 16- year period, moving from cochleostomy to round window insertion. Intraoperative CSF gushers were encountered in 12 of 20 ears (60%). We found no statistically significant difference in the incidence of gushers between the \"high risk\" group (enlarged vestibular aqueduct and incomplete partition type II) and to the \"low risk\" group (p=0.559). There were no incidences of facial nerve injury. In terms of audiology outcome, the linear mixed-effects model revealed a highly significant improvement in aided PTA over time for all ears (p&lt;0.001). Crucially, comparing CND versus non- CND ears revealed no statistically significant difference in outcomes, with both groups following a parallel trajectory of auditory improvement. Functional analysis confirmed that these gains translated into real-world benefits, with CAP-II scores improving significantly from a median of 2.0 preoperatively to 4.5 at 12 months (p=0.003).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Cochlear implantation is a safe and effective intervention for children with CVM and/or CND. Our findings indicate that the risk of intraoperative CSF gushers extends beyond specific high-risk groups, underscoring the need for broad surgical readiness across the spectrum of malformations. The audiological outcomes observed, i","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 3","pages":"374-381"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148102015","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":"Prevalence of metabolic associated fatty liver disease (MAFLD) and its associated factors among type 2 diabetes mellitus (T2DM) in primary care settings in Kuantan, Pahang.","authors":"N A Jamani, N Zainun, M A Abd Rahman, K H Abd Aziz, M D Che Yusuf","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Metabolic associated fatty liver disease (MAFLD) is a common comorbidity in type 2 diabetes mellitus (T2DM) and is associated with adverse hepatic and metabolic outcomes. Early detection in primary care is limited by restricted access to imaging, highlighting the need for practical non-invasive screening tools. This study aimed to determine the prevalence of MAFLD using the Fatty Liver Index (FLI) and identify associated factors among T2DM patients in Kuantan, Pahang.</p><p><strong>Materials and methods: </strong>A cross-sectional study was conducted among T2DM patients aged ≥18 years selected through systematic random sampling from primary care clinics. Sociodemographic and clinical data were obtained from interviews and medical records. FLI, calculated using BMI, waist circumference, triglycerides, and gammaglutamyl transferase, was used to estimate hepatic steatosis, with MAFLD defined as FLI ≥60. Data were analysed using SPSS version 29, and multiple logistic regression was used to identify independent predictors.</p><p><strong>Results: </strong>Among 430 participants, MAFLD prevalence was 51.2% (n=220). Patients with MAFLD were younger (56.4 vs. 61.5 years, p<0.001), had shorter diabetes duration (6 vs. 8 years, p=0.011), and poorer glycaemic control (HbA1c ≥7%: 64.5% vs. 48.2%, p<0.001). Prevalence was highest among Indians (61.9%), followed by Malays (53.7%) and Chinese (35.1%) (p=0.008). Multivariable analysis demonstrates younger age (AOR=0.974; 95% CI: 0.956-0.992) and poor glycaemic control (AOR=2.016; 95% CI: 1.326-3.065) were independently associated with MAFLD.</p><p><strong>Conclusion: </strong>MAFLD prevalence was high among T2DM patients in primary care. Younger age and poor glycaemic control were independently associated with MAFLD. Routine FLI screening may support early identification of high-risk patients and timely intervention.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 3","pages":"382-388"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148101948","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":"Ten-year review of paediatric cataract surgery outcomes at a tertiary referral centre.","authors":"M M Hazirah, M S Ahmad-Anwaar, I M Ilham, N Zamri, T J Tengku-Norina, K S Ng, I Shatriah","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Paediatric cataract is a major cause of preventable childhood visual impairment, with surgical outcomes associated with several factors. This study aimed to investigate the post-operative visual outcomes, complications, and factors associated with poor visual outcomes in paediatric patients who underwent cataract surgery, one-year post-operation.</p><p><strong>Materials and methods: </strong>Retrospective study on paediatric patients who underwent cataract surgery in Hospital Raja Perempuan Zainab II, Malaysia from January 2014 until December 2023. The data was collected from medical records.</p><p><strong>Results: </strong>48 paediatric patients (65 eyes) were recruited. The mean age was 7.7 ±4.79 years. 32 (66.7%) males and 16 (33.3%) females. 17 patients had bilateral while 31 patients had unilateral cataract. 44 eyes (67.7%) had primary cataract, and 21 eyes (32.3%) had secondary cataract. Overall, 53.8% (35 eyes) achieved good visual outcomes of 6/12 or better, but outcome was better in primary cataracts with 56.8% achieved good vision compared to 47.6% in secondary cataracts. 52.4% (11 eyes) of the secondary cataracts was traumatic in nature, with male predominance (72.7%) and 72.7% (8 eyes) achieved good vision. Postoperative complication occurred in 18.5% (12 eyes), with posterior capsular opacification being the commonest. Overall, ocular and systemic comorbidities contributed to poor visual outcome. Specifically for traumatic cataracts, the factors leading to poor visual outcomes were significant corneal opacity and amblyopia. Implantation of posterior chamber IOL was significantly associated with good visual outcomes (60.7%).</p><p><strong>Conclusion: </strong>Paediatric cataract surgery outcomes at our centre are comparable with previous studies, with posterior chamber IOL implantation give favourable results. Ocular and systemic comorbidities significantly elevate the risk of poor outcomes. Corneal scarring and amblyopia were common causes of poor vision in traumatic cataracts.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 3","pages":"350-355"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148102026","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":"Genetic polymorphisms of XRCC1 on cervical cancer susceptibility risk.","authors":"M R Hamid, N Mohd Yunus, A A Abdul Aziz, A Azwari Annuar","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Cervical cancer is the fourth most frequently diagnosed cancer and the fourth leading cause of cancerrelated mortality among women worldwide. Genetic polymorphisms in DNA repair genes may influence susceptibility to cervical carcinogenesis. X-ray repair crosscomplementing protein 1 (XRCC1), an important scaffolding protein in the base excision repair (BER) pathway, plays a crucial role in repairing DNA damage. This study investigated the association of XRCC1 Arg399Gln G>A (rs25487) and XRCC1 Arg194Trp C>T (rs1799782) polymorphisms with cervical cancer susceptibility risk.</p><p><strong>Materials and methods: </strong>A total of 133 cervical cancer patients and 133 healthy female controls were enrolled. Genotyping of both polymorphisms was performed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Genotype and allele frequencies were compared between groups using chi-square analysis, while logistic regression analysis was performed to determine Odds Ratios (ORs) with 95% confidence intervals (CI).</p><p><strong>Results: </strong>A significant association was observed between XRCC1 Arg399Gln G>A (rs25487) polymorphism and cervical cancer susceptibility. The heterozygous GA genotype showed a significantly increased risk of cervical cancer (OR: 2.325, 95% CI: 1.380-3.918, p=0.002). In contrast, no significant association was identified between XRCC1 Arg194Trp C>T (rs1799782) polymorphism and cervical cancer risk.</p><p><strong>Conclusion: </strong>In conclusion, XRCC1 Arg399Gln G>A (rs25487) polymorphism may contribute to cervical cancer susceptibility and could potentially serve as a future biomarker for early detection. Further large-scale studies involving multiple genes and polymorphisms are required to validate these findings.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 3","pages":"356-361"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148102058","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":"Evaluation of vision-related quality of life and its associated factors in patients with diabetic vitreoretinal disease post trans pars plana vitrectomy using visual functioning questionnaire-25.","authors":"Z Y Lai, Q Z Ngoo, Z Embong, Z Noordin, N I Ismail, R Sudarno, S A A Hamid","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetic vitreoretinal disease often requires trans pars plana vitrectomy (TPPV) to preserve useful vision. Its impact on patients' vision-related quality of life (VRQoL) has not been fully detailed locally, especially Kelantan. We evaluated post-operative changes in VRQoL, using the validated Malay version National Eye Institute- Visual Functioning Questionnaire-25 (NEI-VFQ-25) questionnaire, and identified pre-operative and clinical factors associated with 3-months post TPPV NEI-VFQ-25 scores.</p><p><strong>Materials and methods: </strong>In this prospective cohort study, 85 patients with type 1 or 2 diabetic vitreoretinal disease undergoing first TPPV at Hospital Pakar Universiti Sains Malaysia and Hospital Raja Perempuan Zainab II were recruited between December 2023 and December 2024. Demographic data, systemic and ocular profiles were reviewed and recorded. VRQoL was assessed preoperatively and at 3-months post TPPV using the NEI-VFQ- 25 questionnaire. Factors associated with VRQoL at 3- months post TPPV were analysed using linear regression analysis.</p><p><strong>Results: </strong>A total 85 patients completed 3 months follow-up post TPPV. NEI-VFQ-25 composite score significantly improved from 49.28±13.98 pre-operatively to 57.45±12.30 at 3-months post TPPV (mean difference 8.16; 95% Confidence Interval 7.13-9.20; p<0.001). In univariate analyses, employment, hyperlipidaemia, diabetic nephropathy, preoperative blindness status, tertiary education level and preoperative NEI-VFQ-25 score were the significant factors associated with 3-months post TPPV VRQoL (p<0.05). In multivariable regression, secondary and tertiary education level, presence of other comorbid and pre-operative NEIVFQ- 25 score were the significant factors (p<0.001).</p><p><strong>Conclusion: </strong>TPPV yields significant improvements in VRQoL by 3 months. Patients' pre-operative VRQoL, as well as higher education levels and presence of other comorbid are among the strongest determinants of post-operative VRQoL, emphasising the value of early intervention and patient counselling.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 3","pages":"366-373"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148102098","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":"Trends and determinants of pertussis mortality in Sabah, Malaysia.","authors":"S Mohd Shah, N Ayob, K Lazi, E de Cruz, A Omar, M A Abd Rahim","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Pertussis remains a major cause of infant morbidity and mortality despite widespread vaccination. Sabah, Malaysia, has consistently reported the nation's highest pertussis burden. This study described the epidemiology of pertussis and identified factors associated with mortality among confirmed cases in Sabah.</p><p><strong>Material and methods: </strong>A retrospective registry-based study was conducted using data from the Communicable Disease Control Information System (CDCIS) for all confirmed pertussis cases reported between January 2023 and December 2024. Sociodemographic, vaccination, and clinical variables were extracted. Univariable and multiple logistic regressions were performed to determine factors associated with death; variables with p < 0.25 were entered into the multivariable model. Adjusted odds ratios (aOR) with 95 % confidence intervals (CI) were reported.</p><p><strong>Results: </strong>A total of 287 confirmed pertussis cases were recorded, including 35 deaths (case-fatality rate = 12.2 %). Most deaths occurred in infants < 2 months and among non- Malaysian or unvaccinated children. In the multivariable model, shortness of breath (aOR = 21.6; p < 0.001), cyanosis (aOR = 5.45; p = 0.006), fitting (aOR = 14.2; p = 0.027), and post-tussive vomiting (aOR = 136.0; p = 0.004) were independent predictors of death. Male sex was protective (aOR = 0.23; p = 0.008). Age, citizenship, and vaccination status were not statistically significant after adjustment. The model demonstrated good fit (Hosmer-Lemeshow p = 0.807; Nagelkerke R² = 0.471).</p><p><strong>Conclusion: </strong>Pertussis mortality in Sabah remains high and is driven primarily by severe clinical manifestations, with additional influence from demographic and structural factors. Strengthening early clinical recognition, improving referral and intensive care capacity, and expanding preventive strategies particularly maternal vaccination and equitable immunisation for non-Malaysian populations are critical to reducing preventable deaths.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 3","pages":"343-349"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148101950","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}