METHODS: A literature search was undertaken to identify biopsy registries for medical kidney diseases. These data were supplemented with information from personal contacts and from registry websites. A questionnaire was sent to all identified registries, investigating age of registries, scope, method of coding, possible mapping to international terminologies as well as self-reported problems and suggestions for improvement.
RESULTS: Sixteen regional or national kidney biopsy registries were identified, of which 11 were older than 10 years. Most registries were located either in Europe (10/16) or in Asia (4/16). Registries most often use a proprietary coding system (12/16). Only a few of these coding systems were mapped to SNOMED CT (1), older SNOMED versions (2) or ERA-EDTA PRD (3). Lack of maintenance and updates of the coding system was the most commonly reported problem.
CONCLUSIONS: There were large gaps in the global coverage of kidney biopsy registries. Limited use of international coding systems among existing registries hampers interoperability and exchange of data. The study underlines that the use of a common and uniform coding system is necessary to fully realize the potential of kidney biopsy registries.
METHOD: This cross-sectional study was conducted from April to May 2020. The outcomes were assessed using the Depression, Anxiety and Stress Scale-21, Coping Orientation to Problems Experienced Inventory, and World Health Organisation Quality of Life-BREF Scale (WHOQOL-BREF) in both English and validated Malay versions.
RESULTS: Mild-to-severe depression was found in 28.2% (n = 149) of the 528 respondents. Respondents with mild-to-severe depression were significantly younger (33.09 ± 10.08 versus 36.79 ± 12.47 years), without partner (71.8% versus 45.6%), lived in the red zone (85.9% versus 71.0%), and had lower household income as defined in the category of B40 (51.7% versus 39.3%) compared to those without depression (all p
METHODS: Online databases (PubMed, Ovid MEDLINE and Scopus), reference lists of articles identified, and grey literature (Malaysian Ministry of Health website, WHO website) were systematically searched for relevant literature on pneumococcal serotype distribution across Malaysia up to 10th November 2020. No lower date limit was set to maximise the number of target reports returned. Results of serotypes were split by age categories, including ≤5 years, > 5 years and unreported for those that did not specify.
RESULTS: The search returned 18 relevant results, with a total of 2040 isolates. The most common serotypes across all disease types were 19F (n = 313, 15.3% [95%CI: 13.8-17.0]), 23F (n = 166, 8.1% [95%CI: 7.0-9.4]), 14 (n = 166, 8.1% [95%CI: 7.0-9.4]), 6B (n = 163, 8.0% [95%CI: 6.9-9.2]) and 19A (n = 138, 6.8% [95%CI: 5.8-7.9]).
CONCLUSION: Four of the most common serotypes across all isolate sources in Malaysia are covered by PCV10, while PCV13 provides greater serotype coverage in comparison to PCV10. There is still a need for surveillance studies, particularly those investigating serotypes in children under 5 years of age, to monitor vaccine effectiveness and pneumococcal population dynamic following implementation of PCV10 into routine immunisation.
MATERIALS AND METHODS: A cross-sectional study was conducted in the memory clinic at Hospital Kuala Lumpur (HKL). Medical records data from 2014 to 2019 were extracted. Mini Mental State Examination (MMSE) test was used to assess the neurocognitive function of patients.
RESULTS: A total of 298 patients (30 MCI, and 268 dementia) were evaluated, with dementia patients consisting of 78 Alzheimer's disease (AD), 93 Vascular dementia (VaD), 94 Mixed dementia, 2 early-onset Alzheimer's disease (EOAD) and 1 Logopenic Progressive Aphasia type of AD (LPA). MCI and dementia were significantly associated with a history of CVD, particularly stroke (p=0.023).
CONCLUSION: Given that stroke significantly predicted the risk of developing vascular dementia among the patients in a central Malaysian population, lifestyle modifications are recommended to alleviate these risk factors of CVD.
MATERIALS AND METHODS: This is a cross-sectional study where women aged between 20-80 years were recruited via convenient sampling from villages in Long Banga, Sarawak over a five-day outreach programme. Cervicovaginal selfsamples were obtained and screened for the presence of high-risk human papillomavirus DNA (HR-HPV) using the careHPVTM Test. A self-administered questionnaire was also administered to determine the sociodemographic and perception towards the self-sampling method.
RESULTS: The 55 women recruited consist of ethnic backgrounds of Penan (58.18%), Kenyah (25.45%), Iban (5.45%), Saban (3.64%), Kelabit (3.64%), Malay (1.82%) and Chinese (1.82%). The prevalence of HR-HPV was 1.85% (n=1/55). Nearly 80% of the women were unemployed, and more than half have had attended primary education. Nine (16.4%) have heard about HPV, and seven (13%) knew HPV infection could cause cervical cancer. Three of them had HPV vaccination, and only one (1.85%) knew the brand of the HPV vaccine. Although 40% preferred self-sampling over clinician-collection, only ten (18.2%) women have completed the self-collection perception questionnaire.
CONCLUSION: Primary HPV DNA screening using the selfsampling method can be carried out in the remote areas during the COVID-19 pandemic without compromising mobility restriction.
MATERIALS AND METHODS: Wistar male rats (3 months old, 160- 230 grams) were divided into 4 groups that consisted of six rats in each group. The obesity model was induced through the administration of high-fat diet for a month (OB1), two months (OB2), and four months (OB4). Standard chow was provided for the control group for four months. After the specified date the rats were euthanized and the liver and retroperitoneal white adipose tissue (RWAT) were harvested. We performed RT-PCR to assess the mRNA expressions involved in proinflammatory mediators, fibrosis and antifibrosis signaling. Sirius red staining was performed to assess liver fibrosis. Data were analyzed with SPSS 23 for Windows with significance set as p<0.05.
RESULTS: Obesity-induced high-fat diet stimulated an increase of body mass index (BMI) in the OB groups (p<0.05) compared to the control group. Increased BMI was followed by upregulation of proinflammatory mediators (MCP-1, CD68, TLR4, and NFκB) of the RWAT and liver in the obese groups (p<0.05), which promoted hepatic fibrosis in triad portal areas and upregulation of TGFβ (p<0.05) mRNA expression as well as downregulation of HGF and c-Met (p<0.05). In addition, hepatic ppET1 and EDNRB mRNA level expressions (p<0.05) were obviously upregulated in the obese groups followed by downregulation of eNOS (p<0.05) mRNA expressions.
CONCLUSION: Obesity enhanced inflammation in RWAT and was associated with inflammation and fibrosis of liver.
MATERIALS AND METHODS: This is a case-control study that included 105 RA patients classified into active and inactive groups according to disease activity score (DAS28) with 50 healthy matched controls. Clinical and laboratory assessments were done including enzyme-linked immunosorbent assay (ELISA) measurement of CCN1 with a bilateral assessment of CIMT using high resolutionultrasonography. Comparison of CCN1 between RA patients and controls, a correlation between CCN1, DAS28, swollen joint count (SJC), tender joint count (TJC), and CIMT were analyzed.
RESULTS: There was significant elevation of CCN1 in RA patients compared to controls (235.62±62.5 vs. 73.11±18.2, respectively). The cut off value of CCN1 was 99.25 pg/ml, with an area under the curve (AUC) =0.995, p<0.001, 98 % sensitivity and 95% specificity. CCN1 was inversely correlated with DAS28 and its components in both active and inactive RA patients (r=- 0.92, r=- 0.94, p<0.001). CCN1 was inversely correlated with SJC (r= -0.64, r= - 0.67, p<0.001), TJC (r=- 0.56, r= - 0.63, p<0.001), and with Larsen xray score (r=- 0.68, r= - 0.78, p<0.001) in both active and inactive RA patients, respectively. The CCN1 levels in active RA patients were significantly lower than that in patients with low disease activity. A significant positive correlation between CCN1 levels and CIMT in RA patient groups (r=0.88, r=0.47, p<0.001, respectively) was found.
CONCLUSION: Serum CCN1 could be a helpful biomarker in the diagnosis of RA, associated with RA remission. Disruption of serum CCN1 is engaged in the pathogenesis of atherosclerosis in RA patients which could be a clue for a future treatment strategy of atherosclerosis in RA by controlling CCN1 disruption. Regular follow-up of RA patients is recommended for early detection of subclinical atherosclerosis. New research ideas for controlling CCN1 disruption as new aspects of atherosclerosis treatment in RA patients are needed.
MATERIALS AND METHODS: A retrospective study was conducted by identifying all histologically confirmed colitis cases diagnosed at Hospital Universiti Sains Malaysia from January 2015 until December 2019. Clinicodemographic data was retrieved from case notes of patients.
RESULTS: Of the 299 cases with histological colitis, 23 (7.7%) were initially identified as MC. Two cases had incomplete data, while two others were excluded as the diagnoses were revised to inflammatory bowel disease. An incidence of 14 MC cases/1000 case-year was obtained using the 21 MC cases seen within the five-year period. MC subtypes for the 19 analysed cases i.e., lymphocytic colitis and collagenous colitis accounted for 13 (68.4%) and 6 (31.6%) cases, respectively. Eleven patients (57.9%) were females (M:F ratio 1:1.5) with a median age of 51 years. Only nine (47.3%) presented with diarrhoea; one subject (5.4%) had an autoimmune condition (Hashimoto thyroiditis). Normal endoscopic findings were found in 89.5% of patients.
CONCLUSION: Approximately half of the subjects in our study who had histologically confirmed MC did not present with diarrhoea. Adequate biopsy samples despite normal colonoscopy findings are important in order to not miss the diagnosis of MC.
MATERIALS AND METHODS: This is a descriptive retrospective study using data from the medical records of patients diagnosed with primary OC who underwent surgery at the Department of Obstetrics and Gynecology, Sanglah General Hospital Denpasar, Bali from January 2018 to December 2019.
RESULTS: A total of 94 OC or 19.4% from total gynecologic cancer (484 cases) were diagnosed. The characteristics of the majority of OC were as follows: 1. Socio demography: median age 46.5 years (interquartile range: 16.5) and 47.9% (45/94) had low educational level; 2. Hormonal factor: 48.9% (46/94) were multiparous, 59.6% (56/94) were premenopausal, and 97.9% (92/94) had never used oral contraceptive pills; 3. Genetic: all patients did not have a family history of ovarian cancer; 4. Clinical characteristics: 76.6% (72/94) with histologic type of epithelial tumors, 61.7% (58/94) with advanced stage, 74.5% (70/94) with unilateral tumor, and 44.7% (42/94) with mass sized 11-20 cm. In advanced OC, 63.8% (37/58) presented with ascites and omental carcinomatosis, 87.9% (51/58) without liver metastasis; and 5. Surgical outcome: 55.3% (52/94) underwent primary cytoreductive surgery and 78.8% (41/52) had suboptimal surgical outcome.
CONCLUSIONS: The characteristics of OC in the study population were different compared with the developed countries and the global population, i.e. the incidence of OC was most common among younger and premenopausal women. The majority of patients with advance OC had suboptimal surgical outcome.
MATERIALS AND METHODS: The development of PFME intervention was guided by the Medical Research Council Framework for Developing and Evaluating Complex Intervention (MRC Framework). This involved four phases: identification of current research evidence, expert opinion, validation via focus group discussions with physiotherapists and pregnant women, and piloting the intervention using a single group pre-post design among 30 pregnant women at Maternity Hospital Kuala Lumpur to assess the feasibility of the intervention by evaluating changes in knowledge and attitude. The qualitative approach was used to analyse the first three phases, while non-parametric methods were used to analyse the pilot prepost test results.
RESULTS: Based on research evidence and guidelines found during the literature review, a PFME intervention was developed using a new paradigm incorporating two theories, the Health Belief Model and Motivational Interviewing that have been shown to be important in continence promotion and exercise adherence. The contribution of the panel of experts in refining the intervention to meet the local context, endorses the achievement of the intervention's content validity. While, the focus group discussion with pregnant women and physiotherapists revealed the face-validity of the intervention. The findings of the pilot pre-testing showed that PFME knowledge (p<0.001) and attitude (p=0.011) improved significantly immediately following the intervention.
CONCLUSIONS: Evidently, this is a pioneer study that illustrates the development of a Malaysian context-adapting PFME intervention on the basis of recommended steps using the MRC Framework. Incorporating a theory-based and rigorous validation approach into the development of the PFME intervention brought novel perspectives to the intervention. Given the promising preliminary results of the pre-testing pilot study, the PFME intervention could be implemented in the planned randomised control trial to validate the robustness of the results.
MATERIALS AND METHODS: This prospective comparative study was conducted in the ophthalmology clinic of the Universiti Sains Malaysia Hospital, Kelantan, Malaysia. Overall, 139 patients with senile cataract were randomised into EM and RM groups. At three months post-operatively, patients were assessed for distance and near vision, as well as quality of life using a modified VF-14 questionnaire.
RESULTS: Thirty-six patients (64.3%) in the EM group and 30 patients (52.6%) in the RM group (p = 0.209) showed good distance vision (LogMAR 0.3 or better). Fifty patients (87.7%) in the RM group and 27 patients (48.2%) in the EM group gained significantly higher satisfactory near vision (p < 0.05). The quality of life in both groups was good, with a mean modified VF-14 score of 94.5 (SD 2.68) for the EM group and 95.1 (SD 3.19) for the RM group (p = 0.286). Female patients scored significantly higher than males for total activities (p = 0.010) and distance vision-related activities (p = 0.001). The RM group had significantly better patient satisfaction for near vision-related activities compared to the EM group (p = 0.001). In particular, the item 'reading small print' was significantly better in the RM group (p = 0.003).
CONCLUSION: Patients in the predicted RM group gained more satisfactory near vision than patients in the EM group, with significantly better quality of life for near vision activities.
MATERIALS AND METHODS: Reviews of CRC Screening Registry and medical case record were conducted on patients who underwent CRC screening program at Klinik Kesihatan Mahmoodiah, Johor Bahru (KKMJB) from 2016 to 2018 period. Sociodemographic data, clinical profile of patients, iFOBT results and colonoscopy outcomes were extracted for analysis. Descriptive and inferential statistics were performed using IBM SPSS version 25.
RESULTS: Out of 591 registered patients, 584 were included for analysis. Majority of the screened individuals were males (2016-2017) compared to females (2018). Chinese were most screened individuals in 2016 [94 (46.8%)] and 2017[87 (61.7%)]. Percentage of patients with appropriate indicators for screening and underwent colonoscopy for positive iFOBT were highest recorded in 2018 (74.7%, 58.8% respectively). Prevalence of CRC among those screened with iFOBT was 1 per cent for 2017 and 2018. Adherence to annual screening with iFOBT ranged between 1.1% (2016)- 2.2% (2018). Significant association observed between gender and iFOBT results, χ2(df)= 4.747, p=0.029 (2018). Median age and ethnicity were not significantly associated with iFOBT results (p>0.05) CONCLUSION: Screening for CRC among average risk groups in primary care should focus on recruiting female patients/clients as an organised activity. Prevalence of CRC detected from screening with iFOBT was 1 per cent. CRC screening programs should focus on proportion of iFOBT positive patients progressing to receive definitive colonoscopy and complying to annual surveillance screening.
MATERIALS AND METHODS: This was a retrospective, crosssectional study involving 111 ventilated patients admitted to the ICU at Hospital Universiti Sains Malaysia (HUSM) from 1 April 2018 to 30 June 2019. The patients were categorised into VAP and non-VAP groups using the clinical scoring for VAP at the end of the stay in ICU. Logistic regression analysis was performed to determine the factors independently associated with VAP and its outcomes.
RESULTS: Thirty-three patients were categorised into the VAP group and the remaining 77 patients were categorised into the non-VAP group. The proportion of patients who developed VAP was 30.0%. The VAP rate per 1000 people according to the Johansen, Clinical Pulmonary Infection Score (CPIS), and Center for Disease Control and Prevention (CDC) criteria were 6.9, 6.1 and 0.4, respectively. There was an association between duration of mechanical ventilation (MV; odds ratio [OR] = 1.22; 95% confidence interval [CI] 1.12, 1.34; p < 0.01) and length of ICU stay (OR = 1.213; 95% CI 1.107, 1.32; p < 0.01) and VAP. However, there was no difference in the patients between VAP and non-VAP groups in terms of mortality.
CONCLUSION: The VAP rate differs according to the diagnostic criteria. The factors associated with VAP in our centre were increased duration of MV and increased length of ICU stay. There was no difference in the mortality rate between the VAP and non-VAP groups.
MATERIALS AND METHODS: Fourteen HS and 14 TLE patients with age and gender matched underwent resting state functional magnetic resonance imaging (rsfMRI) scanning using a 3-Tesla MRI machine to investigate the EC and percentage of amplitude fluctuation (PerAF) involving SMG and PRE. The rsfMRI data were analysed using Statistical Parametric Mapping (SPM12) and Spectral Dynamic Causal Modelling (spDCM) from which causal models were specified, estimated and inferred.
RESULTS: Model with bidirectional connections between PRE and SMG was chosen as the winning model. The EC from PRE to SMG is positive but the EC from SMG to PRE is negative in both hemispheres and in HS and TLE. Based on the findings from the EC analysis, there is an excitatory effect shown by PRE to SMG connection indicating a dominant role of PRE over SMG in both groups.
CONCLUSION: There is important evidence showing that PRE might also have influence on areas outside resting state network and the influence changes in the presence of brain abnormality.
RESULTS: Of the 27 patients, 77.8% were female. Their ages group ranged from 18 to 35 years, and all patients had skin type III or IV. There were 14 mild acne patients and 13 moderate ones. There was a statistically significant improvement in mean acne severity score from 18.1± 4.3 at baseline to 14.3 ± 4.6 after two weeks post-IPL and 12.3 ± 4.9 after four weeks post-IPL. The result on satisfaction level of patients showed 'satisfied' in 3 patients, "very satisfied" in 5 patients; and, half of the patients (11) answered "fair" at the end of the study. Most patients tolerated well the procedure, and only 5 patients developed either post-inflammatory hyperpigmentation or skin hyperpigmentation.
CONCLUSION: The IPL of wavelength of 400-600nm offers effective, safe, and well-tolerated treatment of mild to moderate acne lesions in Malaysians with skin types III-IV. The majority of subjects had a fair score on treatment satisfaction. It is recommended that reasonable expectations for clinical results be addressed with patients before hands to prevent over-expectation.
MATERIALS AND METHODS: A total of 70 young men (20 - 40 years) who were sedentary, achieving less than 5,000 steps/day in casual walking with 2 or more cardiovascular risk factors were recruited in Institute of Vocational Skills for Youth (IKBN Hulu Langat). Subjects were randomly assigned to a control group (CG) (n=34; no change in walking) and pedometer group (PG) (n=36; minimum target: 8,000 steps/day). All parameter was measured at baseline, at 6 weeks and after 12 weeks.
RESULTS: At post intervention, the CG step counts were similar (4983 ± 366vs 5697 ± 407steps/day). The PG significant increased step count from 4996 ± 805 to 10,128 ±511 steps/day (p<0.001). The PG showed significant improvement in anthropometric variables and lipid (time and group effect p<0.001). After intervention, CRP, IL-6 and TNF- α were significantly reduced for time and group effect (p<0.001). However, no changes were seen in CG.
CONCLUSION: The pedometer-based walking programme improved health status in terms of improving inflammation and arterial stiffness.