Malaysian Journal of Medical Sciences最新文献

{"title":"Developing and Validating a Breast Cancer Screening Health Literacy Questionnaire Guided by Sørensen's Integrated Model for Malaysian Adults.","authors":"Melissa Johari Chan, Nik Daliana Nik Farid, Nithiah Thangiah, Muhd Zulfadli Hafiz Ismail, Fairuz Abdul Rani, Siti Sarah Fadzil, Ruthashini R Selvasingam, Tan Cia Vei","doi":"10.21315/mjms-10-2025-719","DOIUrl":"https://doi.org/10.21315/mjms-10-2025-719","url":null,"abstract":"<p><strong>Background: </strong>Health literacy is essential for informed decision-making and cancer prevention. In Malaysia, limited health literacy contributes to delayed breast cancer diagnoses and poorer outcomes among disadvantaged populations. However, there is no validated instrument for assessing breast cancer screening health literacy. Accordingly, this study aimed to develop and validate such a questionnaire for Malaysian adults.</p><p><strong>Methods: </strong>A three-phase, multi-method design was employed. Phase One involved item generation through a systematic review, online surveys, expert validation and translation. Phase Two included cognitive debriefing and an analysis of test-retest reliability. Phase Three consisted of a cross-sectional survey of 779 adults (mean age 36.6 years; 66% female) attending clinics in Selangor and Johor. The scale was evaluated psychometrically with exploratory factor analysis, internal consistency and confirmatory factor analysis using covariance-based structural equation modelling.</p><p><strong>Results: </strong>The initial 66-item tool was refined to a questionnaire with 41 items in seven domains showing strong reliability (Cronbach's <i>α</i> ≥ 0.93; corrected item-total correlations ≥ 0.71). Weighted kappa values indicated moderate to almost perfect agreement (> 0.41) for most items. Confirmatory factor analysis showed factor loadings of 0.75 to 0.92, average variance extracted > 0.50, composite reliability > 0.70, heterotrait-monotrait ratios < 0.90 and acceptable fit indices (χ²/<i>df</i> = 2.18, GFI = 0.85, AGFI = 0.83, CFI = 0.95, TLI = 0.95, RMSEA = 0.052).</p><p><strong>Conclusion: </strong>The validated 41-item Breast Cancer Screening Health Literacy Questionnaire is a reliable and culturally appropriate tool in Bahasa Malaysia that can be employed in clinical and community settings to identify literacy gaps, develop tailored health promotion strategies and strengthen early detection initiatives.</p>","PeriodicalId":47388,"journal":{"name":"Malaysian Journal of Medical Sciences","volume":"33 1","pages":"129-144"},"PeriodicalIF":1.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13471903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of Rehabilitation Follow-Up Non-Adherence Among Stroke Patients in Sibu, Sarawak.","authors":"Nurul Raihana Rahim, Rou Chen Jee","doi":"10.21315/mjms-12-2025-865","DOIUrl":"https://doi.org/10.21315/mjms-12-2025-865","url":null,"abstract":"<p><strong>Background: </strong>Sarawak's vast geography, with remote communities and limited transport infrastructure, poses significant challenges for stroke rehabilitation, yet data on patient attrition in rural Borneo remain limited. This study aimed to evaluate the characteristics of stroke survivors referred for rehabilitation at Hospital Sibu and to identify independent predictors of non-adherence at follow-up.</p><p><strong>Methods: </strong>Inpatient referrals to the Rehabilitation Medicine Department at Hospital Sibu between February 2022 and December 2024 were retrospectively analysed. To avoid competing risk bias, patients who died before their first follow-up were excluded. Factors associated with non-adherence, including functional status, socioeconomic background and travel time, were examined using multivariable binary logistic regression.</p><p><strong>Results: </strong>The analytic cohort comprised 631 survivors (mean age 56.7 ± 15.1 years). Overall, 50.4% (<i>n</i> = 318) defaulted on their first outpatient appointment. Multivariable analysis identified travel time as the dominant barrier: patients living > 30 min from the hospital had a 40-fold higher risk of default (adjusted odds ratio [aOR] = 39.81; 95% confidence interval [CI]: 22.46, 70.58; <i>P</i> < 0.001). Functional dependency also predicted attrition (aOR = 0.98 per Modified Barthel Index point; <i>P</i> < 0.001). Ethnic disparities emerged after adjusting for geography: Chinese ethnicity was associated with lower default risk (aOR = 0.63; <i>P</i> = 0.028), while Melanau ethnicity remained strongly protective (aOR = 0.35; <i>P</i> = 0.001).</p><p><strong>Conclusion: </strong>Post-stroke rehabilitation attrition in central Sarawak is high (50%). Although functional dependency and ethnicity were significant predictors, geographical inaccessibility is the primary driver of non-adherence. Decentralising care is critical to overcoming this logistical barrier.</p>","PeriodicalId":47388,"journal":{"name":"Malaysian Journal of Medical Sciences","volume":"33 1","pages":"93-102"},"PeriodicalIF":1.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13471969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Formaldehyde-related Adverse Symptoms Among Laboratory Users in a University in Malaysian Borneo.","authors":"Muhammad Ezmeer Emiral, Sahipudin Saupin, Fatin Khairah Haron","doi":"10.21315/mjms-04-2025-313","DOIUrl":"https://doi.org/10.21315/mjms-04-2025-313","url":null,"abstract":"<p><strong>Background: </strong>Formaldehyde exposure in university laboratories poses significant health risks to students and staff. Understanding the prevalence of adverse symptoms and associated factors is essential for guiding preventive measures. This study assessed the prevalence and predictors of formaldehyde-related adverse symptoms among students and laboratory staff at a university in Malaysian Borneo.</p><p><strong>Methods: </strong>This cross-sectional study employed a validated self-administered questionnaire capturing sociodemographic characteristics, medical and allergy history, exposure frequency, and control measures. Data were analysed using bivariable logistic regression and multivariable logistic regression to identify independent predictors.</p><p><strong>Results: </strong>Among 157 respondents, 34.4% (95% confidence interval [CI]: 27.0, 42.4) reported formaldehyde-related adverse symptoms. The most common complaints were headaches/dizziness (19.1%), unusual tiredness or drowsiness (12.1%), and stress/irritability (7.0%). Five independent predictors were identified: female gender (adjusted odds ratio [aOR]: 3.56; 95% CI: 1.26, 10.10), age ≥ 30 years (aOR: 9.08; 95% CI: 2.33, 35.35), and a history of allergy (aOR: 2.80; 95% CI: 1.09, 7.25). Higher exposure frequency markedly increased symptom risk, with fortnightly (aOR: 7.76; 95% CI: 2.31, 26.09) and weekly formaldehyde handling (aOR: 3.32; 95% CI: 1.05, 10.52) associated with significantly higher odds than monthly exposure. Face mask use showed a strong protective effect (aOR: 0.04; 95% CI: 0.01, 0.10).</p><p><strong>Conclusion: </strong>Given the high prevalence of formaldehyde exposure symptoms, particularly among older individuals, women, individuals with allergy, and frequent handlers, strengthening control measures-particularly consistent mask use and reduction of exposure frequency-should be prioritised to minimise risks in university laboratory settings.</p>","PeriodicalId":47388,"journal":{"name":"Malaysian Journal of Medical Sciences","volume":"33 1","pages":"78-92"},"PeriodicalIF":1.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13471827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatitis B Seroprevalence and Associated Factors Among Inpatients from 2014 to 2023: A Single-Centre Retrospective Study in a Malaysian Tertiary Hospital.","authors":"Nurul Asyikin Kamaluddin, Nurzulaikha Abdullah, Yeong Yeh Lee, Mung Seong Wong, Nani Draman, Nazri Mustaffa","doi":"10.21315/mjms-04-2025-240","DOIUrl":"https://doi.org/10.21315/mjms-04-2025-240","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis B virus (HBV) remains a global health burden, causing significant health problems, including morbidity and mortality. The World Health Organization (WHO) aims to reduce new infections by 90% and deaths by 65% by 2030, with a focus on the Western Pacific and Southeast Asia. In Malaysia, HBV incidence rose from 2.26 per 100,000 in 2010 to 12.65 per 100,000 in 2015, classifying the country as having an intermediate burden with a seroprevalence of 1.5% to 9.8%. The major transmission routes include perinatal transmission, blood exposure, sexual contact, and needle sharing. This study aimed to provide insight into the epidemiology and disease burden of HBV in a large tertiary hospital in Malaysia. Insights from this study will assist in future directions regarding public health strategies to reduce the burden of hepatitis B by 2030.</p><p><strong>Methods: </strong>This study investigated the seroprevalence of hepatitis B infection (HBsAg) among inpatients at Hospital Universiti Sains Malaysia over 10 years from 1 January 2014 to 31 December 2023. This retrospective study included patients who underwent HBsAg screening during ward admission. Subjects were selected based on probability sampling after reviewing the inclusion and exclusion criteria. Descriptive and inferential analyses were performed following data collection. Statistical significance was determined by <i>P</i>-values using IBM SPSS version 29.</p><p><strong>Results: </strong>A total of 308 patients were identified. The overall seroprevalence was 9.1% (95% CI: 0.06, 0.12), with annual rates fluctuating between 6.3% and 10.7%. The highest positivity rate was observed in the 45 to 54 age group (14.3%), whereas the lowest positivity rate was observed in those aged > 64 years (5.0%). Males exhibited a higher positivity rate (11.7%) than females (6.5%). Private employees had the highest positivity rate (28.6%) among the occupational groups. Individuals coinfected with HIV had a strikingly high positivity rate of 62.5%. Our analysis identified needle sharing as a significant risk factor, with an adjusted odds ratio of (OR = 8.87; 95% CI: 1.64, 47.91; <i>P</i> = 0.011). Other risk factors, such as family history of chronic hepatitis, multiple sexual partners, history of blood transfusions, and body tattooing, showed increased odds but were not statistically significant.</p><p><strong>Conclusion: </strong>Our study provides insights into the local epidemiology, the burden of hepatitis B infection, and the factors that contribute to disease transmission. This study highlights the need for targeted public health interventions to reduce risk behaviours, particularly needle sharing, to control the spread of hepatitis B in the region.</p>","PeriodicalId":47388,"journal":{"name":"Malaysian Journal of Medical Sciences","volume":"33 1","pages":"103-116"},"PeriodicalIF":1.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13471909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic Polymorphisms Associated with Obesity in Southeast Asian Populations: A Systematic Review without Meta-Analysis.","authors":"Ubashini Vijakumaran, Nor Azian Abdul Murad, Muhammad Irfan Abdul Jalal, Chin Siok Fong, A Rahman A Jamal, Noraidatulakma Abdullah","doi":"10.21315/mjms-03-2025-201","DOIUrl":"10.21315/mjms-03-2025-201","url":null,"abstract":"<p><p>Obesity is a growing global public health challenge, with genetic factors playing a crucial role in its development. This review synthesises findings from Southeast Asian studies to investigate the association between gene polymorphisms and obesity risk across various ethnic populations. A comprehensive search of three databases, PubMed, Scopus, and Web of Science, initially retrieved 2,021 articles, from which 25 studies were meticulously selected based on stringent inclusion and exclusion criteria. The quality of the studies was assessed through the Newcastle-Ottawa Scale (NOS), a risk bias tool. These studies encompass 8,312 participants and examined 33 single nucleotide polymorphisms (SNPs). <i>UCP</i> polymorphism demonstrated a significant association with overall adiposity (OR = 2.02, <i>P</i> = 0.01) in Malaysian women, while the rs659366 <i>UCP2</i> was linked to weight gain in an Indonesian cohort. <i>LEP</i> variants were not significantly associated with obesity in Malaysians, and <i>FTO</i> variants showed mixed results, with rs9939609 (OR = 3.72, <i>P</i> = 0.009) and rs1421085 (OR = 3.22, <i>P</i> < 0.001) variants being associated with obesity and higher body mass index (BMI) in Indonesians, but no significant findings in Malaysians. These results emphasise the genetic diversity within Southeast Asia and the challenges in replicating genetic associations across populations. To address these inconsistencies and improve our understanding of obesity in Southeast Asia, there is a pressing need for more extensive and diverse cohort studies, complemented by comprehensive genome-wide association studies (GWAS), to identify robust obesity biomarkers in Southeast Asia.</p>","PeriodicalId":47388,"journal":{"name":"Malaysian Journal of Medical Sciences","volume":"32 6","pages":"5-25"},"PeriodicalIF":1.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13421552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in HIV, Syphilis, and Hepatitis B Virus Screening Coverage between Pregnant Women Presenting to Antenatal Care in Early and Late Pregnancy in Indonesia.","authors":"Mona Safitri Fatiah, Agung Dwi Laksono, Apriyana Irjayanti, Afwan Syarif","doi":"10.21315/mjms-08-2025-608","DOIUrl":"10.21315/mjms-08-2025-608","url":null,"abstract":"<p><strong>Background: </strong>Timely initiation of antenatal care (ANC), defined as the first ANC visit during the first trimester, is critical for the elimination of mother-to-child transmission (EMTCT) of human immunodeficiency virus (HIV), syphilis, and hepatitis B virus (HBV). In Indonesia, service coverage for these infections remains uneven, and the sociodemographic and service-related determinants of complete screening are not well understood.</p><p><strong>Methods: </strong>We analysed data from the 2023 Indonesian Health Survey in a cross-sectional study of pregnant women. Multivariable logistic regression was used to assess the effects of ANC initiation timing, maternal education, parity, and region on complete screening coverage, defined as receipt of all three recommended for HIV, syphilis, and HBV.</p><p><strong>Results: </strong>Most respondents were aged 20 to 34 years, and over half initiated ANC in the first trimester. Screening coverage exceeded 75% in Java, Nusa Tenggara, Kalimantan, and Papua, but was below 45% in parts of Sumatra and Eastern Indonesia. Late ANC initiation was associated with lower odds of complete screening (adjusted odds ratio [AOR]) = 0.68; 95% CI: 0.53, 0.86; <i>P</i> < 0.05). Regional disparities persisted after adjustment: women in Sumatra (AOR = 0.32; 95% CI: 0.25, 0.42), Sulawesi (AOR = 0.59; 95% CI: 0.45, 0.79), and Maluku-Papua (AOR = 0.47; 95% CI: 0.33, 0.69) had significantly lower uptake compared with Java-Bali. Lower educational attainment and high parity were also associated with reduced screening.</p><p><strong>Conclusion: </strong>Timing ANC initiation, maternal education, parity, and region of residence are strong determinants of comprehensive screening coverage for HIV, syphilis, and HBV among pregnant women. Policy efforts should focus on promoting early ANC attendance and reducing regional inequities to accelerate EMTCT progress in Indonesia.</p>","PeriodicalId":47388,"journal":{"name":"Malaysian Journal of Medical Sciences","volume":"32 6","pages":"109-118"},"PeriodicalIF":1.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13419056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcome of Epilepsy Surgery of The Temporal Lobe in Paediatric Group: A Retrospective Cohort Study.","authors":"Mohd Khairun Mohd Mispan, Azmi Alias, Ahmad Rithauddin Mohamed, Fauziah Kassim, Normawati Mat Said, Jafri Malin Abdullah","doi":"10.21315/mjms-12-2024-958","DOIUrl":"10.21315/mjms-12-2024-958","url":null,"abstract":"<p><strong>Background: </strong>This study was to identify seizure outcome following epilepsy surgery in paediatric group using Engel classification. We also identified histological and radiological findings of the study population.</p><p><strong>Methods: </strong>This study was a retrospective cohort study over a period of eight years from 1 January 2012 until 1 July 2019. Engel Outcome Classification was used to identify seizure outcome at immediate, three to six months and one year post-operation. Age, sex, age of seizure onset, age of operation, body weight, number of antiepileptic medications pre and post-operation, duration of stay in intensive care unit (ICU) and ward, magnetic resonance imaging (MRI) and histopathological findings and complications were noted. Analytically, Fisher's exact test was used for categorical data. Wilcoxon Signed Rank test was used for continuous but not normally distributed data. In this study, Univariate logistic regression is used to understand whether Engel Classification I can be predicted from categorical variables and numerical variables. A set <i>P</i>-value of < 0.05 was considered of statistical significant.</p><p><strong>Results: </strong>29 paediatric patients met study criteria. The mean time between seizure onset and surgery was 5.6 years. Non-invasive evaluation was used in all 29 patients during preoperative assessment. With the use of the Engel Outcome Classification, Engel I outcome or seizure free was achieved in 28 patients (96.6%) at immediate follow-up, 24 patients (82.8%) at three to six months follow-up and 24 (82.8%) at one year follow-up. Hippocampal Sclerosis was present in 13 patients (44.8%). Tumours were present in 16 patients (55.2%). The complication proportion was 14.4%. Only two patients (6.9%) underwent reoperations. There are significant changes in post operative Anti Epileptic Medications (AEDs) reduction in this study (<i>P</i> = 0.006). Possible risk factor of seizure was suggestive for less recurrence of seizure, which may become a predictor to achieve Engel I classification in this study (<i>P</i> = 0.052).</p><p><strong>Conclusion: </strong>The surgery outcome of epilepsy surgery of the temporal lobe in paediatric group was comparable in this study. Careful patient selection by multidisciplinary evaluations is mandatory.</p>","PeriodicalId":47388,"journal":{"name":"Malaysian Journal of Medical Sciences","volume":"32 6","pages":"54-71"},"PeriodicalIF":1.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13419293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-Guided Transverse Thoracic Muscle Plane Block (TTMPB) for Post-Sternotomy Pain: A Randomised Controlled Trial.","authors":"Navkiran Singh Gill, Ariffin Marzuki Mokhtar, Huda Zainal Abidin, Chong Soon Eu, Yusrina Zahari, Mohamad Hasyizan Hassan","doi":"10.21315/mjms-01-2025-065","DOIUrl":"10.21315/mjms-01-2025-065","url":null,"abstract":"<p><strong>Background: </strong>Poorly controlled acute surgical pain after cardiac surgery results from extensive tissue injuries and associated with high pain intensity and leading to chronic pain and excessive opioid use. The aim is to analyse the pain scores, patient controlled analgesia (PCA) fentanyl requirement and spirometry values in Transverse Thoracic Muscle Plane Block (TTMPB) vs. conventional opioid strategy in patients who underwent cardiac sternotomy surgeries.</p><p><strong>Methods: </strong>This is a randomised controlled trial involving 40 adult patients who underwent elective cardiac surgery with sternotomy, receiving either TTMPB (B, <i>n</i> = 20) or control (A, <i>n</i> = 20). We measured mean pain scores at rest and on movement postextubation using the Visual Analogue Scale (VAS), mean PCA fentanyl consumption, and incentive spirometry volume at 0, 3, 6, 12, 18, 24, and 48 h postextubation. Analysis was done using the repeated measure ANOVA.</p><p><strong>Results: </strong>At rest, there was a significant reduction in pain score across different time points observed between both groups (F [6, 228] = 3.180, <i>P</i> < 0.05). On movement, a significant interaction between the TTMPB treatment and pain score at movement across different time points (F [6, 228] = 2.249, <i>P</i> < 0.001) was shown. There was also a significant reduction in PCA fentanyl consumption across different time points (F [6, 228] = 2.080, <i>P</i> < 0.05). Similar outcomes were also observed in spirometry volume changes across time points between the two study groups (F [6, 228] = 10.855, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>The administration of the TTMPB resulted in significantly reduced pain scores at rest and movement, reduced the mean PCA fentanyl consumption and showed better incentive spirometry volume postextubation compared to the control group. This study supports TTMPB as efficient postoperative analgesia for post-cardiac surgery.</p>","PeriodicalId":47388,"journal":{"name":"Malaysian Journal of Medical Sciences","volume":"32 6","pages":"165-175"},"PeriodicalIF":1.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13419059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building Trust in Generics and Biosimilar: Strengthening Regulatory Confidence.","authors":"Mohammad Sharif Abu Hassan, Farshila Emran, Sharifah Fauziyah Syed Mohthar, Roziana Ab Rahim, Amielia Ab Hamid","doi":"10.21315/mjms-10-2025-s03","DOIUrl":"https://doi.org/10.21315/mjms-10-2025-s03","url":null,"abstract":"<p><p>This article discusses the crucial role of traditional small-molecule generic drugs and biosimilar medicines in enhancing healthcare accessibility, particularly in lower- and middle-income countries such as Malaysia. It highlights how Malaysia's evolving regulatory science, supported by the Drug Control Authority (DCA) and the National Pharmaceutical Regulatory Agency (NPRA), fosters an environment where quality, safety, efficacy, and affordability converge, aligning with national healthcare goals. Hanan Regulatory Services Sdn. Bhd. (HRS), the regulatory arm of the Hanan Group of Companies, upholds rigorous standards for product registration, bio-equivalence testing, manufacturing audits, pharmacovigilance and training. Malaysia's regulatory framework requires the actual measured difference in bioavailability between the generic and innovator products to be on average, extremely small-approximately 3.5% only. These measures, along with post-marketing surveillance and good manufacturing practice, address misconceptions about generics, emphasising that their lower price does not equate to inferior quality. On 4 March 2025, HRS registered Rapilin 30, Malaysia's first premixed insulin aspart biosimilar, reflecting the growing industry maturity. In the United States, generics and biosimilars generated an estimated USD 467 billion in savings in 2024, demonstrating the economic potential of such medicines. Malaysia's continued adherence to international regulatory standards and collaboration between public and private sectors will be key to sustaining confidence, achieving national pharmaceutical self-reliance and medicine security.</p>","PeriodicalId":47388,"journal":{"name":"Malaysian Journal of Medical Sciences","volume":"32 6","pages":"1-4"},"PeriodicalIF":1.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13419289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgery for Superior Cerebellar Artery Aneurysm.","authors":"Sarah Atiqah Mohd Zamri, Nurfaten Hamzah, Thinesh Kumaran Jayaraman","doi":"10.21315/mjms-05-2025-348","DOIUrl":"10.21315/mjms-05-2025-348","url":null,"abstract":"<p><strong>Background: </strong>Superior Cerebellar Artery (SCA) aneurysms account for about 1% to 3% of all intracranial aneurysms. SCA has an interesting anatomy, with multiple options of surgical approaches.</p><p><strong>Methods: </strong>From January 2022 to May 2023, a total of 167 aneurysm cases were treated at our centre. Only two patients were confirmed to have SCA aneurysm from cerebral angiography. Demographic study, clinical characteristics, radiological data, treatment plan and outcome were analysed.</p><p><strong>Results: </strong>The total number of vascular cases at our centre from January 2022 to May 2023 is 241. There were 167 cases of aneurysm (69.3%), where 115 patients (68.9%) went for surgery, and 52 (31.1%) opted for endovascular intervention. The distribution of aneurysms by location are ACA 7.2%, ACOM 24.6%, MCA 8.9%, PCOM 18.6%, ICA 21.6%, SCA 1.2%, PCA 1.8%, PICA 8.4%, vertebral artery 2.4%, and basilar artery 5.3%. Complex aneurysms made up 58.7% of all cases and were treated with endovascular procedures more often than simple aneurysms (36.7% vs. 23.2%, <i>P</i> = 0.04). Most patients in both the surgical and endovascular groups had good recovery outcomes (79.1% and 76.9%, respectively; <i>P</i> = 0.78). Both patients with SCA aneurysms were managed surgically. Two sample cases are presented: i) a proximal saccular SCA aneurysm treated with pterional craniotomy, transylvian approach, and clip reconstruction; and ii) a mid-SCA fusiform, multilobulated aneurysm managed with temporal craniotomy, subtemporal approach, Superficial Temporal Artery (STA)-SCA bypass, and excision of the aneurysm.</p><p><strong>Conclusion: </strong>SCA aneurysms are rare and present significant surgical challenges due to their complex anatomy. Choosing the right surgical approach depends on the aneurysm's location along the SCA segments. With proper technique and surgical experience, microsurgical treatment can offer favourable outcomes for patients.</p>","PeriodicalId":47388,"journal":{"name":"Malaysian Journal of Medical Sciences","volume":"32 6","pages":"151-164"},"PeriodicalIF":1.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13419295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}