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MyMedR (Malaysian Medical Repository) is an open-access collection of Malaysian health and biomedical research. The materials are imported from PubMed and MyJurnal. We gratefully acknowledge the permission to reuse the materials from the National Library of Medicine of the United States and the Malaysian Citation Centre. This project is funded by the Academy of Family Physicians of Malaysia. The project team members are CL Teng, CJ Ng, EM Khoo, Mastura Ismail, Abrizah Abdullah, TK Chiew, and Thanaletchumi Dharmalingam.

Please note that some citations are non-Malaysian publications. Common reasons are: (1) One or more authors had a Malaysian affiliation; (2) The article abstract mentioned Malaysia; (3) The study subjects included the Malay ethnic group.

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  1. Lai HY, Foo LL, Lim SM, Yong CF, Loh PS, Chaw SH, et al.
    Clin Auton Res, 2020 Feb;30(1):53-60.
    PMID: 29196938 DOI: 10.1007/s10286-017-0485-8
    PURPOSE: Comparison of hemodynamic profiles and pain scores in diabetic patients undergoing diabetic foot surgery receiving peripheral nerve block (PNB) or spinal anesthesia [subarachnoid block (SAB)].

    METHODS: This was a prospective, randomised controlled trial. We recruited diabetic patients aged > 18 years, American Society of Anesthesiologists class II-III, who were scheduled for unilateral diabetic foot surgery below the knee. All patients were assessed for autonomic dysfunction using the Survey of Autonomic Symptoms score. Participants were randomly assigned to receive either PNB or SAB for the surgery. Hemodynamic data, including usage of vasopressors, were recorded at 5-min intervals for up to 1 h after the induction of anesthesia. Pain scores were recorded postoperatively, and follow-up was done via telephone 6 months later.

    RESULTS: Compared to the PNB group, the SAB group had a larger number of patients with significant hypotension (14 vs. 1; p = 0.001) and more patients who required vasopressor boluses (6 vs. 0 patients). Compared to SAB group, the patients in the PNB group had a longer postoperative pain-free duration (9 vs. 4.54 h; p = 0.002) and lower pain scores 1 day after surgery (3.63 vs. 4.69; p = 0.01).

    CONCLUSION: Peripheral nerve block should be considered, whenever possible, as the first option of anesthesia for lower limb surgery in diabetic patients as it provides hemodynamic stability and superior postoperative pain control compared to SAB.

    TRIAL REGISTRATION: Clinical trial registry: ClinicalTrials.gov. ID NCT02727348.

    MeSH terms: Aged; Anesthesia, Spinal/methods*; Autonomic Nerve Block/methods*; Female; Follow-Up Studies; Hemodynamics/physiology*; Humans; Male; Middle Aged; Pain Measurement/methods*; Pain, Postoperative/diagnosis; Pain, Postoperative/physiopathology; Pain, Postoperative/prevention & control*; Prospective Studies; Single-Blind Method; Diabetic Foot/diagnosis; Diabetic Foot/physiopathology; Diabetic Foot/surgery*
  2. Saidon N, Anuar NA, Meng CK, Chuan OT, Mui TS, Gin GG, et al.
    Blood Cell Ther, 2020 Aug 25;3(3):44-47.
    PMID: 36714175 DOI: 10.31547/bct-2019-017
    Hematopoietic stem cell transplantation (HSCT) is now widely practiced worldwide. It has the potential to cure many hematological diseases, such as acute leukemia and thalassemia. As an emerging country, Malaysia has made advancements despite many challenges. HSCT has evolved rapidly since the first pediatric allogeneic HSCT case in 1987. The first adult HSCT was performed 5 years later in 1993. Currently, a total of 13 hospitals offer HSCT services throughout Malaysia. These include private healthcare services, substantially funded government hospitals governed by the Ministry of Health, and partially funded teaching hospitals governed by the Ministry of Education. Until 2015, 1,987 allogeneic and 1,648 autologous HSCT procedures were performed. This article narrates the history and development of HSCT in Malaysia and briefly discusses the challenging issues in this area.
  3. Liam CCK, Boo YL, Lee YL, Law KB, Ho KW, Shahnaz SAKS, et al.
    Blood Cell Ther, 2021 Feb 25;4(1):1-8.
    PMID: 36712843 DOI: 10.31547/bct-2020-009
    BACKGROUND: Multiple Myeloma (MM) is characterized by the presence of clonal plasma cells. These often result in complications including bone destruction, hypercalcemia, renal insufficiency, and anaemia. Induction with a triplet or quadruplet regimen followed by autologous stem cell transplantation (ASCT) has been the standard of care for transplant eligible patients to achieve durable remission.

    PURPOSE: This is a retrospective analytical study to determine the outcome of Multiple Myeloma patients who underwent ASCT in Ampang Hospital.

    MATERIALS AND METHODS: We included a 5-year cohort of patients transplanted from 1st July 2014 to 30th June 2019. Data were obtained through electronic medical records. Prognostic factors for progression-free survival (PFS) and overall survival (OS) were analyzed using simple and multiple Cox proportional hazard regression analysis. All analyses were done using software R version 3.6.2 with validated statistical packages.

    RESULTS: 139 patients were analyzed. The median age at transplant was 56 years old and 56.1% are males (n=78). The most common subtype is IgG Kappa (n=67, 48.2%). Only 93 patients in which the International Staging System (ISS) could be determined, and among them, 33.3% of patients (n=31) have advanced stage Ⅲ disease. The most common induction received before ASCT was a bortezomib based regimen and/or an immunomodulatory (IMiD) based regimen. 63.3% of patients achieved at least a very good partial response (VGPR) before ASCT. Most patients received myeloablative conditioning (MAC) (n=119, 85.6%). The mean cell dose is 3.68×106/kg. The median time to engraftment was 11 days for both platelet and absolute neutrophil count (ANC). With the median follow-up of 17.3 (range, 6.2-33.4) months, the median OS and PFS were not reached. The 1-year and 2-year PFS were 75% (95% CI 66-82%) and 52% (95% CI 42-62%), respectively. The 1-year and 2-year OS were 82% (95% CI 74-88%) and 70% (95% CI 60-78%), respectively. 6 patients (4.3%) had transplant-related mortality (TRM). IgA subtype was found to adversely affect PFS. Maintenance therapy and the absence of renal impairment was associated with better PFS and OS.

    DISCUSSION AND CONCLUSIONS: Our study found that ASCT following induction treatment is safe and beneficial to achieve a deeper remission status. In our study, the addition of maintenance therapy is associated with an improved outcome in PFS and OS.

  4. Jha NK, Ojha S, Jha SK, Dureja H, Singh SK, Shukla SD, et al.
    J Mol Neurosci, 2021 Nov;71(11):2192-2209.
    PMID: 33464535 DOI: 10.1007/s12031-020-01767-6
    The coronavirus disease 2019 (COVID-19) pandemic is an issue of global significance that has taken the lives of many across the world. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus responsible for its pathogenesis. The pulmonary manifestations of COVID-19 have been well described in the literature. Initially, it was thought to be limited to the respiratory system; however, we now recognize that COVID-19 also affects several other organs, including the nervous system. Two similar human coronaviruses (CoV) that cause severe acute respiratory syndrome (SARS-CoV-1) and Middle East respiratory syndrome (MERS-CoV) are also known to cause disease in the nervous system. The neurological manifestations of SARS-CoV-2 infection are growing rapidly, as evidenced by several reports. There are several mechanisms responsible for such manifestations in the nervous system. For instance, post-infectious immune-mediated processes, direct virus infection of the central nervous system (CNS), and virus-induced hyperinflammatory and hypercoagulable states are commonly involved. Guillain-Barré syndrome (GBS) and its variants, dysfunction of taste and smell, and muscle injury are numerous examples of COVID-19 PNS (peripheral nervous system) disease. Likewise, hemorrhagic and ischemic stroke, encephalitis, meningitis, encephalopathy acute disseminated encephalomyelitis, endothelialitis, and venous sinus thrombosis are some instances of COVID-19 CNS disease. Due to multifactorial and complicated pathogenic mechanisms, COVID-19 poses a large-scale threat to the whole nervous system. A complete understanding of SARS-CoV-2 neurological impairments is still lacking, but our knowledge base is rapidly expanding. Therefore, we anticipate that this comprehensive review will provide valuable insights and facilitate the work of neuroscientists in unfolding different neurological dimensions of COVID-19 and other CoV associated abnormalities.
    MeSH terms: Adolescent; Adult; Anoxia/etiology; Anoxia/physiopathology; Blood-Brain Barrier; Cerebrovascular Disorders/etiology; Child; Humans; Nervous System/virology; Nervous System Diseases/etiology*; Nervous System Diseases/immunology; Nervous System Diseases/physiopathology; Organ Specificity; Receptors, Virus/physiology; Synapses/virology; Coronavirus Infections/complications; Autoimmune Diseases of the Nervous System/etiology; Communicable Diseases, Emerging; Severe Acute Respiratory Syndrome/complications; Young Adult; Viral Tropism; Asymptomatic Infections; Pandemics*
  5. Iida M, Dodds A, Akter M, Srivastava A, Moon JH, Dung PC, et al.
    Blood Cell Ther, 2021 May 25;4(2):20-28.
    PMID: 36712901 DOI: 10.31547/bct-2020-013
    This report describes the results of the Asia-Pacific Blood and Marrow Transplantation Group (APBMT) Activity Survey 2016, focusing on the trends of haploidentical and cord blood (CB) transplants in the Asia-Pacific region. Mongolia and Nepal submitted their first activity data in this survey, and the number of countries/regions participating in the activity survey grew to 20. The annual number of transplants exceeded 20,000 for the first time in 2016, and the total number of centers increased to 686. About 87.9% of all hematopoietic stem cell transplantations (HSCTs) were performed in China, Japan, Korea, India, and Australia with China performing the highest number. Beginning with the 2016 survey, APBMT modified the survey forms and initiated the collection of the exact number of haploidentical transplants. The total number of such transplants was 3,871, and 66.0% of those were performed in China. Meanwhile, cord blood transplants in this region remained high (1,612), and 81.8% of them (1,319) were performed in Japan. The number of facilities and transplants, the ratio of haploidentical transplants to related transplants, the ratio of CB transplants to unrelated transplants, and proportions of haploidentical and CB transplants per capita significantly differed among countries/regions in the Asia-Pacific region. Data collection and analysis revealed the transition and diversity of transplants in this region. This report also shows a dramatic increase in haploidentical transplants as seen in other parts of the world, while revealing uniquely that the activity of cord blood transplant remains high in this region.
  6. Vijayan S, Mohammed AP, Kulkarni MS, Rao SK
    BMJ Case Rep, 2021 Jan 28;14(1).
    PMID: 33509874 DOI: 10.1136/bcr-2020-238366
    Synovial sarcomas are deep-seated, genetically distinct, malignant neoplasms seen in young adults, with a male preponderance. They have unusual clinical and pathological presentation and mimic many other sarcomas and carcinomas, making the diagnosis quite challenging. Although four variants are identified, occurrence in the hand is extremely rare and leads to significant morbidity. There is a high incidence of local recurrence and distant metastasis within the first 2 years. We report the case of an elderly woman with monophasic spindle cell synovial sarcoma who presented with painless swelling in her palm and underwent local excision of the neoplasm. At 2-year follow-up, she remains totally asymptomatic with normal function of the hand. We also attempt to give an overview about monophasic spindle cell synovial sarcoma with the differentials, which would help surgeons in prompt diagnosis and appropriate management.
    MeSH terms: Female; Hand*; Humans; Magnetic Resonance Imaging; Middle Aged; Soft Tissue Neoplasms/pathology; Soft Tissue Neoplasms/surgery*; Sarcoma, Synovial/pathology; Sarcoma, Synovial/surgery*; Margins of Excision
  7. Khoo YY, Farid NDN, Choo WY, Omar A
    J Hum Hypertens, 2022 Jan;36(1):106-116.
    PMID: 33536547 DOI: 10.1038/s41371-020-00478-0
    The continuous presence of elevated blood pressure (BP) when young is a strong predictor of future cardiovascular risk. This study aimed to elucidate the prevalence, awareness, treatment and control of young-onset hypertension (YOH) in Malaysia during the period 2006-2015. Data on respondents aged 18-39 diagnosed with YOH according to the 7th Joint National Committee Report (USA) were extracted from three National Health and Morbidity Surveys (2006, 2011, and 2015). The prevalence of YOH remained stable: 17.7%, 95% CI [17.0, 18.3] in 2006, 17.0%, 95% CI [16.0, 17.9] in 2011 and 18.4%, 95% CI [17.4, 19.4] in 2015. Awareness, treatment and control rates were suboptimal; 15% were aware of their diagnosis, of which less than 50% were on treatment and less than 40% who were on treatment had their BP controlled. Trend analysis revealed a significant increase in YOH prevalence among urban dwellers; those with no formal and tertiary education and middle-income earners. YOH awareness and treatment rates were lower among respondents <30 years; however, when treated, this group achieved overall better control rates. Females had higher awareness and treatment rates, but lower control. Treatment rates remained stable for all ethnicities with the exception of Chinese, which decreased. This study narrows the knowledge gap on YOH epidemiology in Malaysia by providing crucial information on the pervasiveness of hypertension among young adults. Results can be used to develop non-communicable disease policies and health promotion strategies specially targeted at young adults who are in the prime of life.
    MeSH terms: Adolescent; Adult; Awareness; Blood Pressure; Cross-Sectional Studies; Female; Humans; Health Knowledge, Attitudes, Practice; Malaysia/epidemiology; Risk Factors; Prevalence; Young Adult
  8. Ali LG, Nulit R, Ibrahim MH, Yien CYS
    Sci Rep, 2021 Feb 16;11(1):3864.
    PMID: 33594103 DOI: 10.1038/s41598-021-83434-3
    Rice is an important staple crop produced and consumed worldwide. However, poor seed emergence is one of the main impediments to obtaining higher yield of rice especially in hot and dry ecosystems of the world that are ravaged by drought. Therefore, this study was carried out to evaluate the effects of potassium nitrate (KNO3), salicylic acid (SA) and silicon dioxide (SiO2) priming in improving emergence, seedling growth, biochemical attributes and antioxidant activities of FARO44 rice under drought conditions. Rice seedlings primed with 2.5% and 5% KNO3, 3% and 3.5% SiO2, and 1 mM and 2.5 mM SA were subjected to three drought levels of low, moderate and severe under the greenhouse. Seed emergence, seedling growth, biochemical attributes and antioxidant activities were thereafter evaluated. Seed priming experiments were laid in a completely randomized design with five replicates per treatment. The results found that rice seedlings responded differently to different priming treatments. However, all primed rice seedlings had significantly (P ≤ 0.05) improved emergence percentage (72-92%), seedling growth, seedling vigor, seedling fresh and dry biomass and shorter emergence time compared with controls. Likewise, total soluble protein content, activities of catalase, ascorbate peroxidase and superoxide dismutase, carbohydrate, soluble sugar and total chlorophyll contents of rice seedlings were increased by more than two-folds by seed priming compared with control. Salicylic acid showed less effect in increasing emergence, seedling growth, antioxidant activities and biochemical attributes of rice. Thus, this study established that seed priming with KNO3 (2.5% and 5%) and SiO2 (3% and 3.5%) were more effective in improving emergence, seedling growth, biochemical attributes and antioxidant activities of FARO44. Thus, priming of FARO44 rice with this chemical is recommended for fast emergence, seedling growth and drought resistance in dry ecosystems.
    MeSH terms: Crop Production/methods; Antioxidants/metabolism; Nitrates/pharmacology*; Oryza/drug effects*; Oryza/enzymology; Oryza/growth & development; Silicon Dioxide/pharmacology*; Potassium Compounds/pharmacology*; Germination/drug effects*; Salicylic Acid/pharmacology*; Seedlings/growth & development; Droughts
  9. Huda-Shakirah AR, Kee YJ, Wong KL, Zakaria L, Mohd MH
    Sci Rep, 2021 02 16;11(1):3907.
    PMID: 33594187 DOI: 10.1038/s41598-021-83551-z
    This study aimed to characterize the new fungal disease on the stem of red-fleshed dragon fruit (Hylocereus polyrhizus) in Malaysia, which is known as gray blight through morphological, molecular and pathogenicity analyses. Nine fungal isolates were isolated from nine blighted stems of H. polyrhizus. Based on morphological characteristics, DNA sequences and phylogeny (ITS, TEF1-α, and β-tubulin), the fungal isolates were identified as Diaporthe arecae, D. eugeniae, D. hongkongensis, D. phaseolorum, and D. tectonendophytica. Six isolates recovered from the Cameron Highlands, Pahang belonged to D. eugeniae (DF1 and DF3), D. hongkongensis (DF9), D. phaseolorum (DF2 and DF12), and D. tectonendophytica (DF7), whereas three isolates from Bukit Kor, Terengganu were recognized as D. arecae (DFP3), D. eugeniae (DFP4), and D. tectonendophytica (DFP2). Diaporthe eugeniae and D. tectonendophytica were found in both Pahang and Terengganu, D. phaseolorum and D. hongkongensis in Pahang, whereas D. arecae only in Terengganu. The role of the Diaporthe isolates in causing stem gray blight of H. polyrhizus was confirmed. To date, only D. phaseolorum has been previously reported on Hylocereus undatus. This is the first report on D. arecae, D. eugeniae, D. hongkongensis, D. phaseolorum, and D. tectonendophytica causing stem gray blight of H. polyrhizus worldwide.
    MeSH terms: Ascomycota/genetics; Ascomycota/isolation & purification*; Ascomycota/pathogenicity; Phylogeny; Plant Diseases; Cactaceae/microbiology*; Host-Pathogen Interactions*
  10. Ahmad I, Cheema TN, Raja MAZ, Awan SE, Alias NB, Iqbal S, et al.
    Sci Rep, 2021 Feb 24;11(1):4452.
    PMID: 33627741 DOI: 10.1038/s41598-021-83990-8
    The objective of the current investigation is to examine the influence of variable viscosity and transverse magnetic field on mixed convection fluid model through stretching sheet based on copper and silver nanoparticles by exploiting the strength of numerical computing via Lobatto IIIA solver. The nonlinear partial differential equations are changed into ordinary differential equations by means of similarity transformations procedure. A renewed finite difference based Lobatto IIIA method is incorporated to solve the fluidic system numerically. Vogel's model is considered to observe the influence of variable viscosity and applied oblique magnetic field with mixed convection along with temperature dependent viscosity. Graphical and numerical illustrations are presented to visualize the behavior of different sundry parameters of interest on velocity and temperature. Outcomes reflect that volumetric fraction of nanoparticles causes to increase the thermal conductivity of the fluid and the temperature enhances due to blade type copper nanoparticles. The convergence analysis on the accuracy to solve the problem is investigated viably though the residual errors with different tolerances to prove the worth of the solver. The temperature of the fluid accelerates due the blade type nanoparticles of copper and skin friction coefficient is reduced due to enhancement of Grashof Number.
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