Malaysian Journal of Medical Sciences最新文献

{"title":"Transforming the Process of Recognition of Medical Specialist in the Ministry of Health: A Shift from Specialist Gazettement to Supervised Work Experience.","authors":"Hirman Ismail, Mohd Azman Yacob, Mohamed Hirman Abdullah, Ahmad Badruridzwanullah Zun, Sabrizan Osman, Siti Baizura Amran, Nur Ainina Idris, Farah Ruwaida Fakhrul Ruzi, Siti Norsyazwanis Jalaluddin, Ahmad Yamany Othman, Nora Eliza Abdul Halim, Nor Akmal Hakim Kamarulzaman","doi":"10.21315/mjms-08-2025-s01","DOIUrl":"https://doi.org/10.21315/mjms-08-2025-s01","url":null,"abstract":"<p><p>The supervised practice of newly credentialed medical practitioners within the public sector following completion of specialist training, referred to previously in Malaysia as specialist gazettement or post-qualification working experience (PQWE), is a unique regulatory mechanism aimed at safeguarding the quality and safety of specialist care. This probationary phase enables senior consultants or specialists to assess the competence and readiness of the practitioners for independent clinical practice. In response to evolving demands on healthcare delivery and workforce governance, the Ministry of Health has introduced a series of strategic reforms to strengthen its framework, especially within the public healthcare setting. These include legislative amendments to formalise and regularise the implementation of the probationary phase through supervised work experience or SWE (legal transformation), fiscal measures to support financing incentives (financial transformation), and digital innovations that enhance experience and administrative efficiency (digital transformation). This paper describes these transformative interventions, positioning the Ministry of Health's approach within broader policy discourses on clinical governance and health system sustainability.</p>","PeriodicalId":47388,"journal":{"name":"Malaysian Journal of Medical Sciences","volume":"32 4","pages":"1-11"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822244","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":"Chronic Granulomatous Disease: A Multicentre Study of DHR Flow Cytometry Results and Clinical Correlations in Malaysia.","authors":"Nahla Mohammed Saif, Zarina Thasneem Zainudeen, Intan Juliana Abd Hamid, Nurul Khaiza Yahya","doi":"10.21315/mjms-03-2025-149","DOIUrl":"https://doi.org/10.21315/mjms-03-2025-149","url":null,"abstract":"<p><strong>Background: </strong>Chronic granulomatous disease (CGD) is an inherited primary immunodeficiency disease that results from a defect in one of the respiratory burst oxidases (NADPH oxidase) genes that form its components. The diagnostic laboratory assessment for CGD includes evaluation of NADPH oxidase function in neutrophils, using DHR test. The main objective of this project is to develop an internal reference range by determining the relative proportion of oxidising cells percentages and the mean fluorescence intensity (MFI) for complete interpretation of the test results and more accurate results.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 107 individuals referred for DHR testing from Institut Perubatan dan Pergigian Termaju (IPPT) and Hospital Universiti Sains Malaysia (HUSM). Purposive sampling was employed. Logistic regression was used to explore relationships between groups and test parameters, and receiver operating characteristic curve (ROC) analysis assessed test precision.</p><p><strong>Results: </strong>From our findings, the optimum cut-point for IPPT to differentiate CGD patients from healthy group with fMLP% was 0.26%, and FMLP MFI was 9.15, PMA% was 58.70%, and PMA MFI was 50.00. For the HUSM data, the best possible cut-point for fMLP% was 3.86%, FMLP MFI was 999.50, PMA% was 45.69%, and PMA MFI was 1130.50. The parameters showed a good analytical ability since all the area under the curve (AUC) values were significant (<i>P</i> > 0.5).</p><p><strong>Conclusion: </strong>This study confirmed the importance of developing an internal reference range for accurate diagnosis of CGD. This data showed a difference between two centres in terms of test results and cut-points, highlighting the need for standardised reference ranges in diagnostic testing.</p>","PeriodicalId":47388,"journal":{"name":"Malaysian Journal of Medical Sciences","volume":"32 4","pages":"145-155"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822207","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":"When An Apology Implicates A Doctor: Legal Consideration.","authors":"Choon Yong Alex Tan","doi":"10.21315/mjms-04-2025-247","DOIUrl":"https://doi.org/10.21315/mjms-04-2025-247","url":null,"abstract":"<p><p>In recent years, the increasing volume of medical negligence in Malaysia has highlighted crucial concerns regarding the standard of care, informed consent, and liability within the healthcare system. If left unchecked, the rising compensation awards will inevitably affect consumers, namely, the community. Various means exist to potentially prevent litigation, such as engaging in alternative dispute resolution, which includes seeking a sincere apology from the doctor. However, in the judicial system, apologising to patients may also convey the admission of liability, which holds the doctor responsible for negligence. Currently, there is no specific legal framework governing the consequences of apologies in medical error cases. The outcome often depends entirely on the judicial interpretation.</p>","PeriodicalId":47388,"journal":{"name":"Malaysian Journal of Medical Sciences","volume":"32 4","pages":"236-239"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822299","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":"Continuum of Care for Diabetes and Hypertension Patients During the Pandemic Era: Bridging the Gap.","authors":"Kurnia Widyaningrum, Lilik Zuhriyah, Viera Wardhani, Achmad Rudijanto","doi":"10.21315/mjms-12-2024-989","DOIUrl":"https://doi.org/10.21315/mjms-12-2024-989","url":null,"abstract":"<p><strong>Background: </strong>Diabetes mellitus (DM) and hypertension (HT) are chronic diseases with an increasing prevalence in Indonesia. Continuum of care (CoC) offers a crucial management strategy, yet its implementation has faced challenges, particularly during the COVID-19 pandemic. This study examines how the Health Belief Model (HBM) construct intersects with CoC implementation in primary healthcare (PHC) settings under pandemic conditions, addressing a critical gap in understanding chronic disease management adaptations.</p><p><strong>Methods: </strong>A cross-sectional study, involving 351 DM or HT patients at nine PHC centres, was conducted between February and April 2021. Data collection included HBM-based questionnaires and structured patient surveys, analysed through descriptive statistics and path analysis.</p><p><strong>Results: </strong>Respondents were predominantly women (55.0%) aged 41-60 years old (48.1%), and with secondary or higher education (74.6%). A total of 43% reported self-medicating during the pandemic, reflecting behavioural shifts in care-seeking. Path analysis showed age consistently influenced all five HBM perceptions, while education was associated with three: perceived susceptibility, severity and benefit. Perceived benefit was the strongest positive predictor of revisit behaviour (<i>β</i> = 0.264; <i>P</i> = 0.019), whereas perceived severity had a negative effect (<i>β</i> = -0.146; <i>P</i> = 0.024). Indirectly, age and education influenced revisit behaviour through perceived benefit and susceptibility, which were the most consistent mediators.</p><p><strong>Conclusion: </strong>This study demonstrates the utility of HBM in understanding CoC adherence during health crises. The findings support the tailoring of chronic disease strategies by age and education, and enhancing CoC with digital technologies and expanded Prolanis programmes. Future research should assess the long-term impacts of HBM-based interventions on adherence and outcomes.</p>","PeriodicalId":47388,"journal":{"name":"Malaysian Journal of Medical Sciences","volume":"32 4","pages":"212-223"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822134","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":"Do We Actually Need a New Scale? Improving Postpartum Depression Screening in Malaysia: A Narrative Literature Review.","authors":"Rania Nafi' Suleiman Alsabi, Amilia Afzan Mohd Jamil, Rima Anggrena Dasrilsyah, Aishah Siddiqah Alimuddin, Ruthpackiavathy Rajen Durai","doi":"10.21315/mjms-05-2025-341","DOIUrl":"https://doi.org/10.21315/mjms-05-2025-341","url":null,"abstract":"<p><p>Postpartum depression (PPD) is a major maternal health concern in Malaysia, impacting both maternal well-being and infant development. Despite the availability of several validated screening tools, concerns remain about their cultural appropriateness and diagnostic accuracy in Malaysia's multiethnic context. This narrative review critically evaluates the psychometric properties, contextual relevance, and clinical limitations of PPD screening tools used in Malaysian healthcare. The objective is to assess whether current instruments sufficiently detect PPD in Malaysian women and explore the rationale for a culturally tailored alternative. A targeted literature search was conducted across six databases-PubMed, Scopus, Ovid MEDLINE, Wiley Online Library, Cochrane, and Google Scholar-for studies published between 2000 and 2024, using keywords such as \"postpartum depression\", \"screening tools\", \"Malaysia\", and \"psychometric validation\". The inclusion criteria focused on studies examining Malaysian populations and reporting on the implementation, psychometric properties, or contextual adaptation of common screening tools. The Edinburgh Postnatal Depression Scale (EPDS), Postpartum Depression Screening Scale (PDSS), and Patient Health Questionnaire-9 (PHQ-9) were the most commonly used tools. Although they demonstrated moderate validity and reliability, their use in Malaysia is limited by suboptimal linguistic translation, poor contextual adaptation, and inconsistent validation procedures. Furthermore, these tools often overlook key sociocultural determinants like postpartum confinement practices, stigma, and healthcare access disparities. This review highlights the inadequacy of foreign-developed PPD screening tools for Malaysian mothers. Thus, a culturally sensitive, empirically validated tool that incorporates biopsychosocial risk factors specific to Malaysia is warranted to enable timely detection, appropriate intervention, and improved maternal mental health outcomes.</p>","PeriodicalId":47388,"journal":{"name":"Malaysian Journal of Medical Sciences","volume":"32 4","pages":"74-88"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822158","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":"Radiation Dose of Abdominal and Lung Computed Tomography Based on Body Mass Index as an Indicator.","authors":"Muhammad Kabeer Sulayman, Farouk Kabir Umar, Bashiru Lukuman, Muhammad Khalis Abdul Karim, Nor Azura Muhammad, Izdihar Kamal, Che Azura Che Abdullah, Juliana Mohd Radzi, Mazliana Ahmad Kamarudin","doi":"10.21315/mjms-04-2025-280","DOIUrl":"https://doi.org/10.21315/mjms-04-2025-280","url":null,"abstract":"<p><strong>Background: </strong>Radiation dose generated from computed tomography (CT) has drawn more attention to diagnostic radiology. It is a known fact that the risk of radiation-induced cancer is increasing, thereby necessitating the optimisation of dose in CT protocols. This study focused on determining the radiation dose of CT scans for the abdomen and lung using a 64-slice CT scanner to evaluate their correlation with body mass index (BMI). The objective of the study was to critically evaluate the relationship between BMI and radiation dose metrics in both CT lung and CT abdomen examinations.</p><p><strong>Methods: </strong>Data from 106 patients who underwent CT lung and CT abdomen examinations at an advanced diagnostic center were retrospectively analysed. The volume CT dose index (CTDI_vol), dose-length product (DLP), the scan range, and skin to skin antero-posterior (AP) and lateral (LAT) of the patients were documented for further analysis. Effective dose (E) and size-specific dose estimate (SSDE) were also computed.</p><p><strong>Results: </strong>The mean BMI for CT lung was recorded as 24.85 (5.65). However, the correlation between BMI and the dose metrics (SSDE, E, DLP, and CTDI_vol) was not significant, with correlation coefficients of 0.1278, 0.047, 0.047, and 0.1147, respectively. In contrast, the BMI for CT abdomen scans showed a moderate correlation with E (0.5898), SSDE (0.6288), DLP (0.5898), and CTDI_vol (0.612). The results demonstrate that BMI can be used as a radiation dose metric in the case of CT abdomen scans, but has no influence on CT lung scans.</p><p><strong>Conclusion: </strong>These results further suggest that BMI could provide radiation dose analysis, which in turn leads to optimisation of CT scan parameters.</p>","PeriodicalId":47388,"journal":{"name":"Malaysian Journal of Medical Sciences","volume":"32 4","pages":"156-169"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822220","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":"Congenital Cytomegalovirus Infection in Malaysia: A Scoping Review, Clinical Insights and Future Directions.","authors":"Asrar Abu Bakar, Wan Muhammad Najib Wan Mahmud Sabri, Nurlin Ali Hanafiah, Nurfarisha Ahmad Fazli, Ciang Sang Tan, Haema Shunmugarajoo, Nik Khairulddin Nik Yusoff","doi":"10.21315/mjms-05-2025-334","DOIUrl":"https://doi.org/10.21315/mjms-05-2025-334","url":null,"abstract":"<p><p>Congenital cytomegalovirus (cCMV) infection is the most common congenital infection worldwide, greatly contributing to neonatal morbidity and long-term neurological and audiological complications. Despite its clinical burden, cCMV remains underdiagnosed in Malaysia due to the absence of routine screening programmes and limited awareness among healthcare professionals. This review presents an overview of the epidemiology, clinical manifestations, diagnostic approaches, and management strategies of cCMV in Malaysia, highlighting gaps in current practices and potential future approaches. The seroprevalence of cytomegalovirus (CMV) among pregnant women in Malaysia is high, with reported maternal seropositivity rates between 74% and 84%. However, cCMV incidence remains poorly defined due to the lack of systematic screening. Clinical features range from asymptomatic infection to severe neurodevelopmental impairments, sensorineural hearing loss, and visual deficits. Current diagnostic methods rely on polymerase chain reaction (PCR)-based detection of CMV DNA from urine, saliva, or blood within the first three weeks of life. However, access to molecular testing is limited. Treatment with antiviral agents such as valganciclovir can improve neurodevelopmental outcomes, particularly in symptomatic infants, but remains underutilised due to cost and availability constraints. Emerging research on rapid antigen-based diagnostics and maternal antiviral prophylaxis offers opportunities for improving early detection and intervention. Future strategies should focus on increasing awareness among healthcare providers, implementing targeted or universal newborn screening, and promoting research on cost-effective diagnostic and treatment modalities. Strengthening national policies and integrating cCMV management into existing maternal and child health programmes is vital to mitigate its long-term impact.</p>","PeriodicalId":47388,"journal":{"name":"Malaysian Journal of Medical Sciences","volume":"32 4","pages":"12-28"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822139","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":"Exploring the Involvement of PINK1 in Parkinson's Disease: A Scanning Tunnelling Microscopy Study of Electron Transfer in Synthetic DNA Samples.","authors":"Muhammad Hanif Che Lah, Mohammed Faruque Reza, Shaharum Shamsuddin, Isao Watanabe, Jafri Malin Abdullah","doi":"10.21315/mjms-12-2024-956","DOIUrl":"https://doi.org/10.21315/mjms-12-2024-956","url":null,"abstract":"<p><strong>Background: </strong>Parkinson's disease (PD) is a neurodegenerative disorder with a complex aetiology involving several genetic and environmental factors. Although no clear evidence of a direct link between the electronic features of DNA and PD has been found, elucidating the role of DNA in cellular function and dysfunction could provide valuable insights into the mechanisms of the disease (e.g. mutations occurring in the phosphatase and tensin homolog [PTEN]-induced kinase 1 [PINK1] DNA of PD). This study aimed to analyse topographic images and measure the electronic conductivity of synthetic normal and mutant PINK1 DNA molecules.</p><p><strong>Methods: </strong>Two 15-mer synthetic oligonucleotides of Oligo1 normal PINK1 (5'-CAG CTG CTG GAA GGC-3') and Oligo2 mutant PINK1 (5'-CAG CTG CCG GAA GGC-3') were measured using scanning tunnelling microscopy and spectroscopy.</p><p><strong>Results: </strong>The study's findings revealed that the mean values of the voltage gap (V_g) between Oligo1 normal and Oligo2 mutant PINK1 DNA molecules at the mutation region A2-C2 are 1.204 ± 0.198 V and 0.676 ± 0.495 V, respectively, indicating differences in the electronic properties between the Oligo1 normal and Oligo2 mutant PINK1 DNA molecules. However, the mean V_g values of Oligo1 normal and Oligo2 mutant PINK1 DNA molecules were found to not significantly differ from each other (<i>P</i> = 0.162 > <i>α</i> = 0.05).</p><p><strong>Conclusion: </strong>The study found that the voltage gap between normal and mutant PINK1 DNA molecules is not significantly different, suggesting that DNA sequence differences may not directly alter electrical properties. However, PINK1 mutations play a role in early-onset PD due to mitochondrial dysfunction, and future therapies should focus on restoring PINK1-Parkin signalling and mitochondrial health.</p>","PeriodicalId":47388,"journal":{"name":"Malaysian Journal of Medical Sciences","volume":"32 4","pages":"129-144"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822177","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":"Perioperative Anaesthetic Management and Outcomes in Bariatric Surgery: A Sevenyear Retrospective Cohort Study at Hospital Pakar Universiti Sains Malaysia.","authors":"Kavitha Kandasamy, Laila Ab Mukmin, Sanihah Che Omar, W Mohd Nazaruddin W Hassan, Umairah Esa, Mohd Nizam Md Hashim, Zaidi Zakaria, Wan Fadzlina Wan Muhd Shukeri","doi":"10.21315/mjms-03-2025-193","DOIUrl":"https://doi.org/10.21315/mjms-03-2025-193","url":null,"abstract":"<p><strong>Background: </strong>Perioperative anaesthetic management in bariatric surgery presents unique challenges due to patient comorbidities and elevated perioperative risk. This study aimed to evaluate perioperative anaesthetic practices and determine factors associated with postoperative high-dependency unit (HDU) admissions among bariatric surgery patients at a tertiary centre in Malaysia.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted involving 104 adult patients who underwent elective bariatric surgery between 2016 and 2022 at Hospital Pakar Universiti Sains Malaysia. Demographic, clinical, surgical, and anaesthetic data were collected. Univariate and multivariate logistic regression analyses were performed to identify factors associated with postoperative HDU admission.</p><p><strong>Results: </strong>The mean age of the patients was 42.5 years (standard deviation [SD] = 9.7), with a female predominance (68.3%) and a mean body mass index (BMI) of 49.6 kg/m² (SD = 11.3). Obstructive sleep apnoea (OSA) (56.7%) was the most common comorbidity. Laparoscopic sleeve gastrectomy was the most frequently performed procedure (66.3%). The overall HDU admission rate was 34.6%, with a decreasing trend from 2020 to 2022. Patients admitted to the HDU had a significantly higher BMI, more comorbidities, longer operative times, and a higher prevalence of OSA. Multivariate analysis identified OSA (adjusted odds ratio [OR] = 2.6; 95% confidence interval [CI]: 1.003-6.781; <i>P</i> = 0.049) and longer duration of surgery (adjusted OR = 2.1; 95% CI: 1.018-4.375; <i>P</i> = 0.045) as independent predictors of HDU admission. There were no cases of difficult intubation, postoperative pneumonia, or in-hospital mortality.</p><p><strong>Conclusion: </strong>Obesity-related diseases, particularly OSA, were highly prevalent. The incidence of difficult intubation was negligible with the use of video laryngoscopy in the ramped position. The HDU admission rates were higher than international benchmarks, influenced primarily by BMI, comorbidities, and surgery duration.</p>","PeriodicalId":47388,"journal":{"name":"Malaysian Journal of Medical Sciences","volume":"32 4","pages":"180-188"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822223","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":"Reperfusion Therapies and Post-Stroke Seizures: Evidence, Mechanisms and Clinical Implications-A Narrative Review.","authors":"Erum Shariff","doi":"10.21315/mjms-03-2025-166","DOIUrl":"https://doi.org/10.21315/mjms-03-2025-166","url":null,"abstract":"<p><p>Seizures are a frequent complication of stroke and are often linked to worse functional outcomes. With advancements in acute stroke care, particularly the use of reperfusion therapies (RTs) such as intravenous thrombolysis, intra-arterial therapies and mechanical thrombectomy, the relationship between these treatments and post-stroke seizures (PSS) requires re-evaluation. This review explores the mechanisms connecting RTs to acute symptomatic seizures (ASS) and post-stroke epilepsy (PSE), summarises current evidence on their association and identifies gaps in knowledge to guide future research. A literature search was conducted using PubMed, Scopus, Cochrane and Google Scholar, focusing on terms such as \"seizures,\" \"epilepsy,\" \"stroke,\" \"thrombolysis,\" \"rtPA,\" \"reperfusion therapies,\" and \"thrombectomy.\" The reported frequency of seizures following thrombolysis was 4%-15%, with RTs potentially influencing PSS through complex, sometimes opposing, mechanisms. While some studies suggested that RTs could increase seizure risk due to factors like reperfusion injury or haemorrhagic transformation, others proposed a protective effect by reducing infarct size and stroke severity. Current evidence does not confirm a strong link between RTs and PSS, and most research has focused on ASS rather than PSE. The pathophysiology of seizures in this context remains unclear, with multiple contributing factors. The effect of RTs on PSS is poorly understood, highlighting the need for better definitions of seizures, standardised monitoring and high-quality, multicentre prospective studies. Leveraging stroke registries and addressing clinical challenges, such as stroke characteristics and reperfusion success, are critical to clarifying this relationship and improving stroke care.</p>","PeriodicalId":47388,"journal":{"name":"Malaysian Journal of Medical Sciences","volume":"32 4","pages":"29-49"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822226","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}