Medical Journal of Malaysia最新文献

{"title":"Implementation and clinical audit of a virtual thoracic oncology MDT in a low-resource setting in Malaysia.","authors":"S W Cheo, S S Kho, K J Cheng, G G Yeo, Q J Low, C S Chai, S T Tie, P W Tan, Z Abdul Hamid, K S Lau, S Y Soon, T F G Chua, A M Ismail, P J Voon","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Cancer care is increasingly complex, and in Sarawak, Malaysia, geographic and resource limitations further complicate management. This clinical audit describes the implementation, structure and workflow of a virtual thoracic oncology multidisciplinary tumor board (MDT) in a resource-limited setting, and describe the cases discussed and key issues raised.</p><p><strong>Materials and methods: </strong>A MDT was established in Sarawak, comprising pulmonologists, oncologists, pathologists, thoracic surgeons, and radiologists. Monthly virtual meetings were held to discuss complex cases. This retrospective study analyzed cases from July 2022 to December 2024, focusing on cancer types, challenges, and recommendation. As an audit of clinical practice, no treatment adherence or outcome measures were assessed.</p><p><strong>Results: </strong>A total of 94 cases were discussed (median age 60 years; 59.6% male). Cases per year: 21 (2022), 24 (2023), and 49 (2024). Common diagnoses included lung cancer (48.9%), lung lesions from other solid cancers (26.6%), suspected lung cancer (12.8%), non-malignant respiratory conditions (9.6%), and thymic cancer (2.1%). Among solid cancers with lung lesions, colorectal cancer (36%) was most frequent, followed by breast (12%), gynaecological (12%), sarcoma (8%), and others (32%). The main reasons for MDT discussions were therapeutic issues (58.5%) and diagnostic challenges (41.5%). Imaging review (83%) and management discussions (80.9%) were the most common points of discussion. Among 46 lung cancer patients, 43.5% had early-stage, 30.4% locally advanced, and 19.6% metastatic disease. Key recommendations included surgery (35.1%), surveillance (16%), systemic therapy (13.8%), biopsy (11.7%), PET/MRI (7.4%), EBUS staging (5.3%), radiotherapy (4.3%), and clinical trials (2.1%).</p><p><strong>Conclusion: </strong>This audit demonstrates that a virtual thoracic oncology MDT is feasible and can standardize multidisciplinary discussion, and improve access to specialist input in a resource-limited setting. While clinical outcomes were not evaluated, this audit provides insight into operational processes. Future prospective work incorporating structured data collection, MDT adherence and integration of electronic health records will help evaluate the MDT's impact on patient outcomes and guiding service improvement.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 2","pages":"225-233"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582574","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 and determinants of Tuberculosis Preventive Treatment (TPT) completion in Latent Tuberculosis Infection (LTBI) among TB contacts in Selangor, from January 2022- December 2024: National TB Registry (NTBR).","authors":"I Izanna, S Mohamad Ikhsan, M Mariam, I Siti Hasmah","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Measles remains a persistent public health concern in Malaysia. Despite sustained high vaccination coverage in states such as Selangor, reported cases continue to increase. This trend suggests a possible shifting age-distribution of measles, a pattern that has been observed in countries with a high vaccination rate. Understanding the epidemiology and clinical characteristics of measles between adults and children is critical in guiding targeted public health interventions aimed at control and elimination of measles. This study aimed to describe the incidence of measles in adults and children in Selangor, and to compare their sociodemographic, clinical, vaccine, and exposure-related differences.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;This comparative cross-sectional study used secondary data from the Selangor e-Measles Registry from 2015 to 2024. Confirmed cases were classified as adults (≥18 years) and children (&lt;18 years). The incidence of each group was calculated annually over ten years. Descriptive statistics, chi-square test, Fisher's exact test, and Mann-Whitney U test were used to describe and compare the differences between the two groups. Data were analysed using SPSS version 29.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 3954 confirmed measles cases were included in the study, with 540 (13.7%) adult cases and 3414 (86.3%) cases in children. Between 2015 and 2024, the incidence of measles was consistently higher in children as compared to adults, with risk ratios ranging from 14.43 (95% CI: 11.25, 18.73) in 2017 to 87.65 (95% CI: 27.39, 278.66) in 2022. With the exception of 2019-2022, adults showed a gradual increase in number over the study period, with the highest proportion in 2023 (16.4%). Significant differences between adults and children were observed (p&lt;0.05) according to nationality, ethnicity, clinical symptoms, hospitalisation, complications, vaccination status, and duration since the last vaccination.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;The findings suggest that despite the increase in adult cases, measles predominantly affects children in Selangor. The findings highlight the need to strengthen vaccination efforts through the National Immunisation Programme (NIP) and prioritising Supplementary Immunisation Activities (SIAs) among children aged below 6 years old. Additionally, the gradual rise in cases in adults and children aged 7-12 years old should be monitored closely to detect emerging epidemiological shifts. Significant clinical differences between adults and children highlight the need for training of healthcare providers and public education to support diagnosis, prevent outbreaks, and avoid complications. Digitalisation of health records, such as the documentation of vaccination history, is needed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Measles in Selangor showed age-specific trends and differences. Addressing these issues through strengthened childhood immunisation, targeted inter","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 2","pages":"304-312"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582589","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":"Cytopeutics umbilical cord-derived mesenchymal stem cells are associated with earlier clinical improvement compared to bone marrow aspirate concentrate with scaffold in knee cartilage injury: A Phase 1 feasibility and Phase 2 randomized controlled trial.","authors":"B A H Md Yusoff, N Mohamad, S P Chin, M N Ramlan, M S Zool Kipele, N S I Saffery, N A Mohd Nasir, A F Mohd Don, S K Lai, H Hussin, M F Yakop, S F Abdul Wahid, S K Cheong","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Despite advances in the development of mesenchymal stem cells (MSCs), the ultimate benefits of MSCs against current cell-based therapies are still limited. This study aimed to assess the safety, feasibility, and efficacy of Cytopeutics® umbilical cord-derived MSCs (Chondrocell-EX) in patients with knee cartilage injury.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;The study was conducted in two parts: a phase I feasibility study (PI) followed by a phase II randomized controlled trial (PII). Both studies were approved by UKM Research Ethics Committee (PI: UKM PPI/111/8; PII: UKM PPI/111/8/JEP-2019-304). Six patients were involved in the PI study in which all patients received Chondrocell-EX and 28 patients in the following PII study, where 17 patients received Chondrocell-EX with Hyaluronic acid (HA) (Arm A) and 11 patients received commercially available cell-based therapy, which is Bone Marrow Aspirate Concentrate (BMAC) with Hyaluronic acid-based scaffold (HA-S) (Arm B). Safety was assessed based on the occurrence of adverse events, while clinical outcomes were assessed based on the Knee Injury and Osteoarthritis Outcome Score (KOOS) and Pain Visual Analog Scale (VAS). Second-look arthroscopy and histological assessment were performed to assess their structural outcomes at 12 months.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In the PI feasibility study, significant pain reduction began at 3 months, with mean VAS decreasing from 6.83 ± 0.98 at baseline to 4.83 ± 1.17 (p &lt; 0.01), 3.00 ± 0.00 at 6 months (p &lt; 0.01), and 1.83 ± 0.75 at 12 months (p &lt; 0.01). In the PII study, Arm A (Chondrocell-EX + HA) demonstrated significant VAS improvements at all follow-up points compared to baseline (p &lt; 0.001), whereas Arm B (BMAC + HA-S) showed significant reductions only from 3 months onward. After adjustment for baseline age and VAS, Arm A achieved significantly lower pain scores than Arm B at 6 months (2.56 ± 1.41 vs 3.09 ± 1.22; p = 0.015) and 12 months (2.27 ± 1.49 vs 2.50 ± 1.35; p = 0.043), indicating earlier and sustained pain relief with Chondrocell-EX injection. Functional outcomes mirrored pain improvements. In PI, KOOS scores improved significantly from 3 months, reaching 85.83 ± 11.87 at 12 months (p &lt; 0.01). In PII, KOOS increased significantly in both arms (p &lt; 0.001), but Arm A demonstrated earlier gains at 3 months and significantly higher adjusted KOOS scores than Arm B at 6 (p = 0.009) and 12 months (p = 0.037). In KOOS subdomains analysis, it showed significantly greater improvements in Arm A, particularly in symptoms and stiffness, activity of daily living (ADL), pain, sport and recreation, and quality of life (QoL) at key time points.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Chondrocell-EX+HA treatment is more convenient, feasible, and minimally invasive with the findings suggesting that it is associated with faster functional improvement and pain relief, along with demonstration of hyaline-like cartilage regeneration","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 2","pages":"234-245"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582595","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":"Quality of life of Hirschsprung disease patients with a stoma.","authors":"J Gracia, S A Qisthi, A I Rezza, D F Harfanie, Z S Izzati, Q J Wijayatno, Y G Brahmandoko, K Iskandar, E Purnomo, Gunadi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Hirschsprung disease (HSCR) is a genetic disorder leading to gastrointestinal obstruction due to the absence of ganglion cells in the submucosal and myenteric plexuses. Treatment typically involves a pull-through surgery, sometimes starting with a colostomy. The COVID-19 pandemic has resulted in restrictions on general patient services, i.e., non-COVID-19 patients, at health facilities, leading to reduced hospital visits, including HSCR patients with stomas. This study aimed to determine whether there were differences in the quality of life (QoL) of HSCR patients with stomas before and after the COVID-19 pandemic.</p><p><strong>Materials and methods: </strong>This research was a descriptive study comparing the quality of life (QoL) of HSCR patients with stomas before and after the COVID-19 pandemic. It utilized a cross-sectional study design and assessed QoL using the PedsQL Generic Core Scales 4.0 questionnaire.</p><p><strong>Results: </strong>There was no significant difference in the QoL of HSCR patients before COVID-19 and after COVID-19, as indicated by parent reports (p=0.88) and child reports (p=0.12). However, there was a statistically significant difference in scores on the social dimension of child reports (p=0.04). Furthermore, there was no statistically significant relationship between parent and child reports (p>0.05).</p><p><strong>Conclusion: </strong>The QoL of HSCR patients with a stoma before and after the COVID-19 pandemic is similar, except for the social dimension in the child's report. Further studies with more cases are necessary to clarify the findings of this study.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 2","pages":"246-250"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582591","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":"Relationship between post-partum mothers' knowledge and essential newborn care practices in Jambi, Indonesia.","authors":"O Jayanti, E L Haksari, Ismarwati, D Ismail","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Essential Newborn Care (ENC) is crucial for neonatal survival, which is known to be very significant for the objective of Sustainable Development Goals in 2030 as an attempt to decrease neonatal morbidity and mortality. Mothers play an important role in ENC. This study aimed to delve into the relationship between mothers' knowledge, parity, education level, age, occupation, economic status, and ENC practices in post-partum mothers.</p><p><strong>Materials and methods: </strong>A cross-sectional design was conducted in Jambi, Indonesia from June to August 2021. There were 152 post-partum mothers who had neonates aged 0-28 days, consisting of 76 primiparous and 76 multiparous mothers. A questionnaire on ENC knowledge and practice was utilized to collect the data from the instrument of the previous study. The data were examined using univariate, bivariate, and multivariate analyses.</p><p><strong>Results: </strong>Multivariate analysis on ENC practices revealed that mothers with low knowledge had a higher risk of performing poor ENC practices with OR 10.6 than those with high knowledge, and it was significantly different. Mothers with low educational level had more risks of practicing poor ENC with OR 2.9 than those with high educational level, which was significantly different. Meanwhile, parity, age, occupation, and economic status of post-partum mothers did not present a statistically significant correlation (p>0.05) with ENC practices.</p><p><strong>Conclusion: </strong>There was a significant difference in ENC practices, with high risk in those who had low knowledge followed by low education. There was no association between ENC practices and parity, age, occupation, and economic status of post-partum mothers. These findings highlight the importance of improving the knowledge of post-partum mothers in supporting ENC practices. The result of the study should nevertheless be interpreted in such a way by considering the limitations of the study design and the instruments used.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 2","pages":"267-272"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582599","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 analytical performance of blood gases, electrolytes, and metabolites in critical care using the blood gas analyzer cartridge-electrochemical principle.","authors":"A H S Fashihah Sherina, W A Wan Norlina, W Z Wan Mohd Saifuhisam, M Mohd Zulfakar, T Say Koon, H Z Muhammad Anshorul","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Rapid assessment of blood gases, electrolytes, and metabolites is crucial in critical care settings. This study evaluates the performance and interchangeability of a portable blood gas analyser that operates on the cartridge-electrochemical principle.</p><p><strong>Materials and methods: </strong>This prospective study evaluates the precision of this analyser, which uses an electrochemical sensor within single-use cartridges. We compare its performance to that of a cartridge-based sandwich sensor cassette; the blood gas analyser used in intensive care units (ICU). A total of forty arterial blood samples were collected between July and November 2024. Performance was statistically assessed using Passing-Bablok regression, Bland-Altman plots, and the Intraclass Correlation Coefficient (ICC).</p><p><strong>Results: </strong>The blood gas analysis using the electrochemical sensor method demonstrated excellent within-run imprecision (CV%<5%) across all evaluated analytes, with total imprecision consistent with the manufacturer's specifications. Method comparison revealed a strong correlation (ICC>0.9) and agreement for most parameters between the two methods, including pH, partial pressure of carbon dioxide (pCO₂), sodium (Na⁺), potassium (K⁺), chloride (Cl^-), glucose, and lactate. However, Bland Altman showed a systematic bias of 9 mmHg in partial pressure of oxygen (pO₂) and 0.02mmol/L in ionised calcium (iCa²⁺).</p><p><strong>Conclusion: </strong>The analyser using the electrochemical sensor provides reliable performance for blood gases and biochemical analytes, with strong agreement with the cartridge-based sandwich sensor cassette principle. Nonetheless, caution is advised for pO₂ and iCa⁰ measurements due to observed bias, highlighting the importance of awareness of method-specific differences between analysers in clinical interpretation.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 2","pages":"216-224"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582560","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":"LIVERSTAT for the diagnosis of compensated advanced chronic liver disease in patients with type 2 diabetes.","authors":"J S C Lee, N M Z Chee, L L Lai, S R Vethakkan, W K Chan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>LIVERSTAT is a non-invasive artificial intelligence-based test that provides risk stratification for metabolic dysfunction-associated steatotic liver disease. We aimed to study the performance of LIVERSTAT compared with the Fibrosis-4 Index (FIB-4) as a stand-alone test and as a first-line test to identify patients for liver stiffness measurement (LSM) for the diagnosis of compensated advanced chronic liver disease (cACLD) in patients with type 2 diabetes (T2D).</p><p><strong>Materials and methods: </strong>This is a cross-sectional study of patients with T2D who underwent transient elastography. cACLD was defined as LSM ≥10 kPa. As a stand-alone test, LIVERSTAT Class D and increased FIB-4 ≥1.3 (≥2.0 if age ≥65 years old) were considered as having cACLD. As a first-line test, LIVERSTAT Class D and increased FIB-4 were considered as requiring LSM.</p><p><strong>Results: </strong>We analysed data for 221 patients (mean age 61 years, 41% male, cACLD 26%). The area under the receiver operating characteristic curve, sensitivity, specificity, positive predictive value, negative predictive value and misclassification rate for LIVERSTAT were 0.66, 32%, 88%, 47%, 79% and 27%, respectively. The corresponding values for FIB-4 were 0.61, 39%, 81%, 41%, 79%, and 30%, respectively. When using LIVERSTAT as a first-line test, the proportion of patients requiring LSM was 17% (38/221), while the proportion of false negatives was 19% (34/183). The corresponding values for FIB-4 were 24% (54/221) and 19% (31/167), respectively.</p><p><strong>Conclusion: </strong>LIVERSTAT has similar accuracy as FIB-4 when used as a stand-alone test or as a first-line test to identify patients for LSM for the diagnosis of cACLD in patients with T2D.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 2","pages":"209-215"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582512","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 national survey on the implementation of Kangaroo Mother Care for premature infants in hospitals across Malaysia.","authors":"S C Foong, W C Foong, I Shareena, I Noraihan, J Jacqueline Ho","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Kangaroo Mother Care(KMC) is essential for preterm infants and strongly recommended by the World Health Organization. However, national data on KMC implementation in Malaysia are lacking. We aimed to describe current KMC practices in Malaysian hospitals and identify factors influencing its adoption.</p><p><strong>Materials and methods: </strong>We conducted a cross-sectional survey using a self-administered online questionnaire. Ninety-three public and private hospitals providing Level II and/or III neonatal care were identified and invited to participate. The questionnaire covered KMC practices, facility availability, eligibility criteria, and documentation.</p><p><strong>Results: </strong>Sixty-nine hospitals(74%) responded, including 48 public and 21 private facilities. Of these, 60(87%) hospitals self-reported implementing KMC (33 regularly, 27 occasionally), most commonly in NICUs and SCNs. Among hospitals implementing KMC, 73% allowed KMC for infants on tube feeds, 71% for those on nasal oxygen, 53% for those on intensive respiratory support, and 68% for infants born <32 weeks gestation. Only 55% documented KMC consistently, 37% had protocols, and 25% reported most staff were trained. Key barriers included limited administrative support, training, infrastructure, and comfort amenities. Logistic regression showed that availability of KMC protocols, front-button blouses, training, and documentation showed a borderline association with regular KMC practice. Among non-implementing hospitals, most cited overcrowding and lack of resources; nearly all expressed a need for training.</p><p><strong>Conclusion: </strong>KMC is practiced in most public and some private Malaysian hospitals, but key gaps remain. Simple measures such as providing front-button blouses, enhancing staff training, and introducing formal protocols can strengthen KMC as routine neonatal care.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 2","pages":"285-296"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582557","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":"Serum kisspeptin levels in women with polycystic ovary syndrome: A systematic review and meta-analysis.","authors":"S C Siahaan, A Sa'adi, H Hendarto, B Santoso, S R Dwiningsih, J Y Anas, R Y Primariawan, M Y A Widyanugraha, A Tunjungseto","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Kisspeptin is a key regulator of the hypothalamic-pituitary-gonadal axis and has been implicated in the pathophysiology of polycystic ovary syndrome (PCOS). However, reported associations between kisspeptin levels and PCOS have been inconsistent.</p><p><strong>Materials and methods: </strong>A systematic search of PubMed, Scopus, and Web of Science was performed from inception to August 2025 for studies comparing serum kisspeptin concentrations between PCOS patients and controls. Data extraction was conducted independently by two reviewers. A random-effects meta-analysis was used to calculate pooled standardized mean differences (SMD) with 95% confidence intervals (CI). Heterogeneity was assessed using the Q statistic and I² index. Meta-regression was performed to examine BMI as a predictor of kisspeptin levels.</p><p><strong>Results: </strong>Twenty studies involving 670 participants were included. Pooled analysis demonstrated significantly higher serum kisspeptin levels in PCOS patients compared with controls (SMD = 0.511; 95% CI: 0.376-0.646; p < 0.001; I² = 0%). Meta-regression revealed that BMI significantly moderated the association, with overweight/obese PCOS patients showing the greatest elevation in kisspeptin concentrations (β = 0.756; 95% CI: 0.483-1.029; p < 0.001).</p><p><strong>Conclusion: </strong>Serum kisspeptin levels are elevated in women with PCOS, particularly among those with overweight/obese BMI, suggesting a possible interaction between metabolic status and reproductive neuroendocrine regulation. These findings support the potential of kisspeptin as a biomarker for PCOS and highlight the need for further research into its mechanistic role and clinical applicability.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 2","pages":"321-326"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582533","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":"Comparison between Single Incision Laparoscopic Appendectomy (SILA) and Multi Port Laparoscopic Surgery (MPLA) in paediatric appendectomy patients.","authors":"Y Pratama, A Dwihantoro, Gunadi, Y I Ahmad, E Purnomo","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Single Incision Laparoscopic Appendectomy (SILA) and Multiport Laparoscopic Appendectomy (MPLA) are both established techniques for appendectomy, yet their differences in terms of aesthetics, operative wounds, and complications like wound dehiscence remain under study. This research compares the two approaches with a focus on minimizing surgical trauma and reducing infection risks.</p><p><strong>Materials and methods: </strong>A retrospective study was conducted involving 49 patients, with 26 undergoing SILA and 23 undergoing MPLA across two hospitals in Yogyakarta. Patient demographics, appendicitis grade, length of stay (LOS), operative time, and postoperative complications, including dehiscence, were analyzed using SPSS.</p><p><strong>Results: </strong>Dehiscence was evaluated through outpatient follow-up based on wound leakage, while other complications were documented accordingly. The cohort comprised 17 female and 32 male patients (1:2 ratio), with no significant association between gender and appendicitis type (p=0.16). The most common appendicitis grade was grade 1 (36%), followed by grade 2 (34.7%), with chronic appendicitis being the least common (8.2%). was observed in 12.2% of cases, with 87.8% of wounds healing without issue. No significant difference in complication rates was found between SILA and MPLA techniques (p=0.876). LOS (p=0.523) and operative time (p=0.185) also showed no statistically significant differences.</p><p><strong>Conclusion: </strong>Both SILA and MPLA techniques for appendectomy offer comparable safety profiles, with no significant differences in complications, LOS, or operative time. SILA, however, may offer superior cosmetic outcomes due to fewer incisions.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"81 2","pages":"280-284"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582514","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}