METHODS: We performed a retrospective review on 54 cases of severe malaria in a district hospital in Kapit, Sarawak, from January 2018 to May 2019. The patients' demographics, clinical features, complications based on organ involvement, and treatment outcomes were examined.
RESULTS: There were 54 cases of severe malaria, with the majority being male (70%) and between the ages of 40 and 49 (26%). All patients with severe malaria were febrile or had a history of pyrexia except for one patient. P. knowlesi (81.5%) was the most common species causing severe malaria in our study, followed by P. falciparum (13%), and P. vivax (5.5%). There were no cases of severe malaria caused by P. ovale or P. malariae. Hyperparasitaemia was present in 76% of patients and the median parasitemia value at hospital admission was 33,944 parasites/μL (interquartile range: 19,920-113,285 parasites/μL). Circulatory shock was observed in 17 patients (31.5%). There were eight patients with acute renal failure and six patients with respiratory distress. One patient died as a result of severe malaria with multiorgan involvement (1.9% fatality rate).
INTERPRETATION & CONCLUSION: P. knowlesi is the most common cause of severe malaria in Kapit, Sarawak, Malaysia. Recognizing symptoms of severe malaria and prompt administration of antimalarial are critical for good clinical outcomes.
OBJECTIVE: The aim of this study was to translate and adapt cross-culturally the OHLI into French, to evaluate its psychometric properties and to compare its results to oral health knowledge.
METHOD: This study followed and applied well-established processes of translation, cross-cultural adaptation and validation, based on the recommendations of the World Health Organization guidelines and on the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) study design checklist for patient-reported outcomes. Two psychometric assessments were planned, the comparison of OHLI-F scores according to education level and frequency of dental visits, and the test-retest reliability of the OHLI-F.
RESULTS: A total of 284 participants answered the OHLI-F. The OHLI-F scores were significantly different between participants with different levels of education and frequency of dental visits (p
METHODOLOGY: We conducted a retrospective data retrieval from the medical records of 254 paediatric patients who had been diagnosed with confirmed cases of dengue fever. The clinical characteristics were compared between severe and non-severe dengue. Multiple logistic regression analysis was utilised to elucidate the variables that exhibited associations with severe dengue.
RESULTS: A total of 254 paediatric patients were included, among whom 15.4% (n = 39) were diagnosed with severe dengue. Multiple logistic regression analysis identified lethargy, systolic blood pressure (SBP) below 90 mmHg, capillary refilled time (CRT) longer than 2 seconds, ascites, and hepatomegaly were independently associated with severe dengue.
CONCLUSION: In paediatric patients, severe dengue is associated with specific clinical indicators, including lethargy, low systolic blood pressure, prolonged capillary refill time (CRT), and the presence of ascites and hepatomegaly. Identifying these clinical features early is crucial for primary care physicians, as it enables accurate diagnosis and timely intervention to manage severe dengue effectively.
METHODS: The synthesis involved reacting ethylenediamine and KCl with Zn metal. The complex formed was characterized using a conductometer, UV-Vis spectroscopy, FT-IR spectroscopy, and XRD, while the activity was measured against HeLa cells.
RESULT: The synthesis yielded a 56.12% conversion with a melting point of 198-200 oC and a conductivity value of 2.02 mS/cm. The Zn(en)Cl2 complex showed potential activity against HeLa cells with an IC50 value of 898.35 µg/mL, which was evidenced by changes in the morphological structure of HeLa cells. Its interaction with DNA targets was investigated by employing molecular docking.
CONCLUSION: The observed data indicated that the Zn(en)Cl2 complex bound to DNA at the nitrogenous base Guanine (DG) by coordinate covalent bonds. Interestingly, DG maintained interaction with the complex until the end of the docking simulation. Additionally, molecular dynamics (MD) simulation was conducted, and the results showed that Zn(en)Cl2 remained bound to the DNA binding pocket all through the process.
MATERIAL AND METHODS: A sample of 85 patients diagnosed with superficial bladder tumours was selected to be used in fitting the non-mixture cure model. In order to estimate the parameters of the suggested model, which takes into account the presence of a cure rate, censored data, and covariates, we utilized the maximum likelihood estimation technique using R software version 3.5.7.
RESULT: Upon conducting a comparison of various parametric models fitted to the data, both with and without considering the cure fraction and without incorporating any predictors, the EE distribution yields the lowest AIC, BIC, and HQIC values among all the distributions considered in this study, (1191.921/1198.502, 1201.692/1203.387, 1195.851/1200.467). Furthermore, when considering a non-mixture cure model utilizing the EE distribution along with covariates, an estimated ratio was obtained between the probabilities of being cured for placebo and thiotepa groups (and its 95% confidence intervals) were 0.76130 (0.13914, 6.81863).
CONCLUSION: The findings of this study indicate that EE distribution is the optimal selection for determining the duration of survival in individuals diagnosed with bladder cancer.
MATERIALS AND METHODS: This study was conducted in Hospital Kepala Batas (HKB), a district hospital in Penang State, Malaysia, which was the designated regional COVID hospital during the pandemic. It was a retrospective observational study, where children who were admitted from November 2020 to March 2021, and attended follow-up clinics from Jan 2021 to May 2021, were recruited.
RESULTS: This study comprised 90 subjects, from 3 months old to 12 years old, mean of 6.5 years old. When comparing asymptomatic and symptomatic children, children with comorbidities were more likely to be symptomatic with a pvalue of 0.045 using the Pearson Chi-square test. All our patients' symptoms resolved upon discharge. During followup at 2-4 months after COVID-19 infection, all children were reported as back to their usual selves. Fifteen patients had recurrent symptoms. Most of their symptoms pointed towards an acute infection. One patient had two episodes of illness, while the rest had one. The most common symptoms were cough, fever and runny nose. The average duration of illness of these 16 episodes was 4.5 days with a standard deviation of 2.48. None of these symptoms lasted more than seven days. None of them required hospital admission. None of them had recurrent COVID-19 infections. Tweleve out of 72 children who had been going to school stopped physical school after COVID-19 infection. Our findings differed from other studies. These could be due to the limitations that we faced.
CONCLUSION: Most children who contracted COVID-19 infection recovered fully after acute infection, and most of them recovered fully without long-term sequelae.
MATERIALS AND METHODS: This is a prospective observational study to develop, validate and evaluate the ARSIA questionnaire based on ARIA guidelines. The sample will be obtained from the list of patients under follow-up in the ORL clinic HSAH and HUSM with ages of 18 to 60 years, patients clinically diagnosed with allergic rhinitis, and with positive skin prick test.
RESULTS: A total of 150 patients with a positive skin prick test participated in this study. In the 'nasal symptom' and 'impact on daily activities' domains, calculated Cronbach's alpha shows a value of 0.878 and 0.811 respectively. The inter-item correlation was calculated to analyse internal consistency reliability. Items B3 and B4 were dropped from the questionnaire as both showed a low correlation with other items. New Cronbach's alpha for the daily activities domain was 0.830, which showed better internal consistency reliability. All of the items were analysed for sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Clinician diagnosis from the proforma was used as a comparison to the participant's responses. In the analysis, a cut-off points of 12 was used to classify the patient's nasal symptoms into intermittent or persistent, with a sensitivity of 75%, specificity of 86%, PPV of 95%, and NPV of 51%. Whereas, a cut-off point of 15 was used to classify the rhinitis impact on daily activities into mild or moderate/severe, with a sensitivity of 58%, specificity of 100%, PPV of 100%, and NPV of 42%. The only item in the 'control' domain has been dropped out following a consensus of experts and judgement as it has not been used in the clinician diagnosis and thus, is unable to test for sensitivity, specificity, PPV, and NPV.
CONCLUSION: This newly developed, validated, and evaluated questionnaire is a good tool for the evaluation of allergic rhinitis symptoms and their impact on daily activities. It is important to understand that AR symptoms could have a significant impact on daily activities. Although further study and testing are needed, it provides an initial means for evaluating the patient condition and control level, as well as patients' perception of their rhinitis control.
MATERIALS AND METHODS: This is quantitative research with a true experimental approach. Actual bleeding volume was simulated by an acrylic phantom containing Iodine contrast media (5 ml, 10 ml, 15 ml, and 20 ml). The phantom was scanned using routine CT protocol using the helical and sequence technique. Bleeding volume from each technique was measured manually using the Broderick formula and automatic software (ROI based). Accuracy was assessed by comparing the volume measurement result to the actual bleeding volume. Data was analysed using the Friedman test and by Wilcoxon.
RESULTS: The standard deviation of measured bleeding volume from the manual and automatic measurements compared to the actual bleeding volume were (0.220; 0.236; 0.351; 0.057) and (0.139; 0.270; 0.315; 0.329) in helical technique, and (0.333; 0.376; 0.447; 0.476) and (0.139; 0.242; 0.288; 0,376) in sequence technique. There are differences in the measurement results from the helical and sequence techniques (p <0.05) and using manual and automatic methods (p <0.05).
CONCLUSION: The measurement of bleeding volume that has a standard deviation value compared to the actual volume is more accurate in the helical technique using the automatic method, while the sequence technique is the manual method.
MATERIALS AND METHODS: This was a retrospective study that included all RA patients receiving biologics therapy in 13 tertiary hospitals in Malaysia from January 2008 to December 2018.
RESULTS: We had 735 RA patients who received biologics therapy. Twenty-one of the 735 patients were diagnosed with TB infection after treatment with biologics. The calculated prevalence of TB infection in RA patients treated with biologics was 2.9% (29 per 1000 patients). Four groups of biologics were used in our patient cohort: monoclonal TNF inhibitors, etanercept, tocilizumab, and rituximab, with monoclonal TNF inhibitors being the most commonly used biologic. The median duration of biologics therapy before the diagnosis of TB was 8 months. 75% of patients had at least one co-morbidity and all patients had at least one ongoing cDMARD therapy at the time of TB diagnosis. More than half of the patients were on steroid therapy with an average prednisolone dose of 5 mg daily.
CONCLUSION: Although the study population and data were limited, this study illustrates the spectrum of TB infections in RA patients receiving biologics and potential risk factors associated with biologics therapy in Malaysia.
MATERIALS AND METHODS: This study is an analysis of a matched case-control study with a ratio of 1:2. The case group contained 206 respondents, and the control group contained 412. All CRC cases were confirmed with the histological results. The control group was matched for links between age, sex and ethnicity with CRC. The Statistical Package for Social Sciences Statistics (SPSS) IBM version 28.0 was used to conduct descriptive analysis using chi-squared testing and simple logistic regression. The statistical significance was P < 0.05.
RESULT: Overall, 618 respondents took part in this survey, of which 256 (41.4%) were female and 362 (58.6%) were male. The maximum age was 76, with a mean age ± SD of 53.17 ± 11.4. Those of Bajau ethnicity comprised 24.6% (152) of the population, followed by Dusun with 22.8% (141), Kadazan with 17.6% (109%), other North Borneo ethnic groups with 15.5% (96), Bugis with 9.7% (60), Brunei with 4.4% (27) and other predominant races with 5.3% (33). Regression analyses revealed that the incidence of CRC in North Borneo, Malaysia, was substantially correlated with income, occupation, other linked diseases and BMI.
CONCLUSION: Various risk factors are linked to CRC, based on the findings related to socio-demographic characteristics and BMI. Therefore, to lower the nationwide prevalence of CRC, national public health campaigns should include collaboration with the regional authorities to highlight the incidence and risk factors of CRC based on ethnicity.
MATERIALS AND METHODS: This is a comparative crosssectional study using secondary data from the eNotifikasi system and hepatitis B case investigation forms between 2018 and 2022 from four district health offices in Pahang, Malaysia. Demographic data, hepatitis B vaccination status and risk factors were assessed. Data analysis employed were independent chi-squared tests, t-tests and binary logistic regression.
RESULTS: The study included 285 cases (141 indigenous and 145 non-indigenous). Among the indigenous cases, 72.3% were unvaccinated and 59.6% reported a history of infected mother, followed by percutaneous exposure, multiple sexual partners, and sharing syringe. The odds for those with a history of an infected mother being indigenous group is 2.5 times (95% CI: 1.4-4.4) compared to those with a history of an infected mother being non-indigenous group.
CONCLUSION: Significant difference exists in hepatitis B risk factors between indigenous and non-indigenous populations. The main risk factor for indigenous community is history of infected mother. Thus, the necessity of incorporating hepatitis B screening into the current practice of antenatal HIV screening, specifically targeting the indigenous community, should be given consideration.
MATERIALS AND METHODS: A retrospective cross-sectional analysis was performed on patients who presented to our institution from April 2020 until July 2021 for acute stroke and had MRI brain as first-line neuroimaging. A total of 31 subjects were included in this study. Two radiologists assessed the signal patterns in DWI sequence and compared them with SWI and CT Brain, whenever available, as the gold standard for observing the presence of intracranial haemorrhage.
RESULTS: The majority of patients with hyperacute bleed proven to be revealed on SWI or CT, thus showed characteristics of central hyperintensity and peripheral hypointense rim, on DWI. Slightly more than half (51.6%) presented with mild to moderate NIHSS scores (1-15). The sensitivity, specificity, positive predictive value and negative predictive value of DWI in detecting intracranial intra-axial haemorrhages were exceptionally high. There is strong interobserver level of agreement in identifying central haemorrhagic signal intensity [kappa = 0.94 (0.06), p < 0.05].
CONCLUSION: This study supported the DWI sequence as a reliable sequence in MRI, to detect intracranial haemorrhage in hyperacute stroke.