Browse publications by year: 2024

  1. Balakumar P
    World J Nephrol, 2024 Jun 25;13(2):95410.
    PMID: 38983761 DOI: 10.5527/wjn.v13.i2.95410
    Renal epithelial-to-mesenchymal transition (EMT) is a process in which epithelial cells undergo biochemical changes and transform into mesenchymal-like cells, resulting in renal abnormalities, including fibrosis. EMT can cause diabetic nephropathy through triggering kidney fibrosis, inflammation, and functional impairment. The diverse molecular pathways that drive EMT-mediated renal fibrosis are not utterly known. Targeting key signaling pathways involved in EMT may help ameliorate diabetic nephropathy and improve renal function. In such settings, understanding precisely the complicated signaling networks is critical for developing customized therapies to intervene in EMT-mediated diabetic nephropathy.
  2. Kumarasamy G, Khairiz K, Chang WL, Aye TT, Ali A
    Front Immunol, 2024;15:1400247.
    PMID: 38983864 DOI: 10.3389/fimmu.2024.1400247
    Early diagnosis and effective management of Primary immunodeficiency diseases (PIDs), particularly severe combined immunodeficiency (SCID), play a crucial role in minimizing associated morbidities and mortality. Newborn screening (NBS) serves as a valuable tool in facilitating these efforts. Timely detection and diagnosis are essential for swiftly implementing isolation measures and ensuring prompt referral for definitive treatment, such as allogeneic hematopoietic stem cell transplantation. The utilization of comprehensive protocols and screening assays, including T cell receptor excision circles (TREC) and kappa-deleting recombination excision circles (KREC), is essential in facilitating early diagnosis of SCID and other PIDs, but their successful application requires clinical expertise and proper implementation strategy. Unfortunately, a notable challenge arises from insufficient funding for the treatment of PIDs. To address these issues, a collaborative approach is imperative, involving advancements in technology, a well-functioning healthcare system, and active engagement from stakeholders. The integration of these elements is essential for overcoming the existing challenges in NBS for PIDs. By fostering synergy between technology providers, healthcare professionals, and governmental stakeholders, we can enhance the efficiency and effectiveness of early diagnosis and intervention, ultimately improving outcomes for individuals with PIDs.
    MeSH terms: Developing Countries; Feasibility Studies*; Humans; Infant, Newborn; Malaysia; Early Diagnosis
  3. Bakeri NA, Amirullah NA, Sulaiman N, Gan WY, Loh SP, Ahmad Fuzi SF, et al.
    Cureus, 2024 Jun;16(6):e61984.
    PMID: 38984009 DOI: 10.7759/cureus.61984
    Sugar-sweetened beverages (SSBs) are a major source of dietary sugar, and their consumption is on the rise among children and adolescents. Excessive sugar intake is a significant contributor to overweight, obesity, and non-communicable diseases (NCDs). The consumption of SSBs, particularly that of children and adolescents, has been of interest as of late, as they are implicated in affecting body weight status. Thus, the goal of this study was to determine the predictive criterion-related validity of the SSB questionnaire that was administered to children and adolescents to assess their SSB and non-SSB intake. A nationwide cross-sectional study involving 5211 respondents aged 7-17 years old and their parents was conducted. The self-administered Malay questionnaire was distributed to collect information on socioeconomic background, the frequency of eating out at restaurants or other food premises, the availability of SSBs at home, and SSB consumption patterns of children and adolescents within a week. The predictive criterion-related validity was determined by using six hypotheses that can differentiate between two independent sample means of SSB consumption based on age, gender, locality, monthly household income, frequency of eating out at restaurants or other food premises, and availability of SSBs at home. The independent samples t-test and one-way ANOVA were used to conduct the validation process. Five out of six hypotheses were accepted. Significant mean differences were observed between sociodemographic factors, such as age (t=-10.56, p<0.001), localities (t=-5.37, p<0.001), monthly household income (F=26.83, p<0.001), and SSB consumption. Behavioural factors, including eating out at restaurants or other food premises (t=9.93, p<0.001) and environmental factors such as the availability of SSBs at home (F=136.24, p<0.001) also showed a significant difference with SSB consumption. The SSB questionnaire demonstrated the ability to differentiate between groups. Thus, this SSB questionnaire appears to be valid to measure the SSB consumption of children and adolescents.
  4. Harbi AS, Soh KL, Yubbu PB, Soh KG
    F1000Res, 2024;13:596.
    PMID: 38984016 DOI: 10.12688/f1000research.152315.1
    BACKGROUND: Cardiovascular disease (CVD) continues to be the foremost mortality internationally. Cardiac rehabilitation has proven as an effective program in reducing CVD burden. Participation in cardiac rehabilitation programs is very low. Digital health intervention emerged as an alternative method to deliver Cardiac rehabilitation. This review aimed to investigate the impact of digital health intervention on the outcomes of interest.

    METHODS: the following databases: PubMed, CINAHL, Scopus, and Cochrane Library have been searched to retrieve randomized controlled trials that examine the impact of digital health intervention on blood pressure, body mass index, lipid profile, blood glucose, Six-Minute Walk Test, and peak oxygen consumption. filters were set to include studies published in English between 2000-2023.

    RESULTS: Nineteen studies were included in this review. Six-Minute Walk Test (MD = 16.70; 95% CI: 6.00 to 27.39, p = 0.000) and maximal oxygen consumption (SMD = 0.27; 95% CI: 0.08 to 0.45, p = 0.004) significantly improved following digital health intervention, after employing the sensitivity analysis significant improvement was observed in systolic (MD = -2.54; 95% CI: -4.98 to -0.11, p = 0.04) and diastolic blood pressure (SMD = -2.0182; 95% CI: -3.9436 to -0.0928, p = 0.04) favoring experimental groups. Subgroup analysis revealed significant improvement in quality of life after three months of follow-up (SMD = 0.18; 95% CI: 0.05 to 0.31, p = 0.00), no significant differences have been observed in body mass index, lipid profile, and blood glucose.

    CONCLUSION: The findings emphasize the significant impact of digital vs CBCR or usual care on physical capacity, blood pressure, and quality of life. Despite the non-statistically significant differences in body mass index and lipid profile, the comparable effect between the two methods suggests the superiority of digital over CBCR or usual care due to its convenient nature, accessibility, and cost-effectiveness.

    MeSH terms: Blood Pressure; Humans; Oxygen Consumption; Quality of Life; Body Mass Index; Telemedicine; Walk Test
  5. Teh HL, Keowmani T, Tang MM
    Malays J Med Sci, 2024 Jun;31(3):133-148.
    PMID: 38984235 DOI: 10.21315/mjms2024.31.3.10
    BACKGROUND: In Malaysia, following extensive COVID-19 vaccination, Hospital Kuala Lumpur reported an increase in cutaneous reactions post-immunisation. To understand this, a case-control study was initiated to identify potential risk factors.

    METHODS: This registry-based, unmatched case-control study encompasses all adverse event following immunisation (AEFI) reports associated with COVID-19 vaccines, received by the Department of Pharmacy at Hospital Kuala Lumpur through the Malaysian Adverse Drug Reactions Advisory Committee (MADRAC) AEFI reporting forms. Twenty-four potential risk factors were evaluated, including demographic information, medical history, food allergies, COVID-19 vaccination history and prior SARS-CoV-2 infection, were evaluated using MADRAC AEFI reporting forms. Odds ratio (OR) with 95% confidence interval (CI) were estimated using univariable and multivariable logistic regression.

    RESULTS: Cutaneous reactions were more frequent in middle-aged females, especially after the first COVID-19 vaccine dose. These reactions, primarily mild and generalised, included pruritus and urticaria. Notably, 52% were delayed reactions (more than 4 h post-vaccination). Factors associated with increased risk of cutaneous reaction following COVID-19 immunisation included history of seafood and shellfish allergy (adjusted odds ratio [adjOR]: 2.11; 95% CI: 1.12, 3.96; P = 0.020), history of vaccine allergy (adjOR: 4.07; 95% CI: 1.44, 11.54; P = 0.008), past dermatological diseases (adjOR: 5.48; 95% CI: 2.03, 14.78; P = 0.001), and past medication allergy (adjOR: 2.12; 95% CI: 1.36, 3.31; P = 0.001).

    CONCLUSION: Self-reported histories of allergies to vaccines, foods or medications were found to increase the likelihood of cutaneous reactions following COVID-19 vaccination. These reactions, which were predominantly mild, did not hinder the administration of the second vaccine dose. The majority of reactions occurred after the first dose, manifesting as generalised pruritus and urticaria. They were effectively managed with oral antihistamines and low-dose corticosteroids, thereby avoiding the need for hospitalisation.

  6. Nur-Hasanah R, Siti Munira Y, Nadzimah MN, Mohamad Rodi I
    Malays J Med Sci, 2024 Jun;31(3):194-203.
    PMID: 38984236 DOI: 10.21315/mjms2024.31.3.15
    BACKGROUND: This study examined the effectiveness of an exercise programme as an adjunct to smoking cessation treatments. The effects of exercise on smoking habits and tobacco withdrawal symptoms (TWS) were evaluated among smokers who were in the pre-contemplation and contemplation stages.

    METHODS: This was a case study with convenience sampling techniques. This study lasted approximately 2 years, beginning in February 2016. This study was divided into two phases: an intervention phase followed by an interview. The participants were invited to undergo the 8-week supervised moderate aerobic exercise programme. This qualitative study involved 14 participants selected from the intervention phase. They were interviewed about their experiences using a semi-structured questionnaire guided by the health belief model.

    RESULTS: This study involved 14 participants who were aged between 26 years old and 40 years old and smoked from 11 to 20 cigarettes per day. Most participants perceived benefits and self-efficacy regarding smoking habits and tobacco withdrawal symptoms (TWS) following the exercise intervention.

    CONCLUSION: This study demonstrated that moderate exercise might be helpful in increasing self-efficacy in smoking cessation and the findings encourage further research on exercise programmes as an adjunct to smoking cessation treatments in Malaysia.

  7. Sumy MSA, Parh MYA, Soni MSM, Saifuddin N, Elma JF, Zarei H, et al.
    Malays J Med Sci, 2024 Jun;31(3):229-240.
    PMID: 38984237 DOI: 10.21315/mjms2024.31.3.18
    BACKGROUND: This study sought to compare the prevalence of underweight and overweight among ever-married, non-pregnant women of reproductive age in Bangladesh by urban or rural residency status.

    METHODS: This study used Bangladesh Demographic and Health Survey (BDHS), 2017 data. Cross-sectional study design with two-stage stratified sampling method was employed. A sample of ever-married non-pregnant women of reproductive age was selected and multinomial logistic regression was utilised in analysis.

    RESULTS: It was found that around half of rural women (45.0%, N = 4,934) and more than half of urban women (60.3%, n = 3,913) were overweight. Nearly one in seven rural women (14.0%, n = 1,537) and 1 in 12 urban women (9.0%, n = 564) were reported as underweight. Our analyses revealed that being overweight was substantially connected with age, husband's occupation, economic status, television access, and division for both urban and rural areas. Women from poor households were significantly more likely to be underweight than women from middle- income households for both urban (P < 0.05; OR: 1.41; 95% CI: 1.03, 1.94) and rural (P < 0.05; OR: 1.23; 95% CI: 1.04, 1.46) areas. Interestingly, women without television access both in urban (P < 0.001; OR = 0.78; 95% CI: 0.67, 0.91) and rural (P < 0.001; OR = 0.75; 95% CI: 0.68, 0.84) areas had an inverse association with overweight/obesity compared to women with television access. In both areas, women in Sylhet and Mymensingh had higher likelihood of being underweight than Barisal division. Additionally, in both residential zones, women in Sylhet had lower likelihood of being overweight than Barisal division.

    CONCLUSION: This study reveals that multiple characteristics are linked to both overweight and underweight among ever-married, non-pregnant women of reproductive age in Bangladesh. Addressing these variables should be a priority in public health efforts to combat the dual challenge of malnutrition in Bangladesh.

  8. Krihariyani D, Woelansari ED, Haryanto E, Sasongkowati R, Handayati A, Astuti SSE
    Malays J Med Sci, 2024 Jun;31(3):107-116.
    PMID: 38984238 DOI: 10.21315/mjms2024.31.3.7
    BACKGROUND: Infectious illnesses are a serious health concern in Indonesia. Widespread use of self-medication by the community increases the risk of developing multi-drug resistant (MDR) bacteria. This study assessed the potential of sappan wood as an inhibitor of extended-spectrum beta-lactamase (ESBL) encoded by blaSHV, blaTEM and blaCTX-M genes.

    METHOD: In silico testing was conducted to develop an effective and economical starting strategy. Thereby, this study significantly advances the development of novel treatments to combat antibiotic resistance. Using clavulanic acid as the benchmark medicine, the potency of the beta-lactamase inhibitor brazilein was predicted. Using the Molegro Virtual Docker computer tool, docking was performed to estimate the chemical and physical properties of the compounds, as well as the biological activity of brazilein toward the required receptor. The receptors used were SHV-1 beta-lactamase, PDB code: 2H0T; TEM-1 beta-lactamase, PDB code: 4OQG and CTX-M-14 beta-lactamase, PDB code: 6VHS. Data analysis was performed by comparing the binding energies of the docking results between the ligands and the target receptor. The more stable the bond that formed between the ligand and the target receptor, the lower the bond energy.

    RESULTS: The in silico test results on the blaSHV gene were as follows: binding energy of ligand MA4_400[A] = -100.699, brazilein = -82.206, clavulanic acid = -79.3704; in the blaTEM gene: ligand bond energy 2UL_301[B] = -107.681, brazilein = -82.0296, clavulanic acid = -103.3; in the blaCTX-M gene: X57_301[A] ligand bond energy = -86.6197, and brazilein = -88.1586, clavulanic acid = -101.933.

    CONCLUSION: The findings of this study demonstrate the significant potential of brazilein sappan wood to block the beta-lactamase activity of blaCTX-M.

  9. Noordin N, Abdullah NN, Yunus RM
    Malays J Med Sci, 2024 Jun;31(3):204-216.
    PMID: 38984239 DOI: 10.21315/mjms2024.31.3.16
    BACKGROUND: Coronavirus disease (COVID-19) has affected everyone and stress-related mental health issues affect young people more than other groups, including marginalised populations. As a result of this pandemic, society is being urged to examine indigenous psychological resilience, especially among Orang Asli (OA) communities in Malaysia. Hence, this study aims to identify factors associated with psychological resilience among OA youths of Kampung Orang Asli (KOA) in Gombak during the COVID-19 pandemic.

    METHOD: A cross-sectional study comprising OA communities was conducted between January 2022 and September 2022 in the Gombak District, Selangor. A self-administered online questionnaire using Google Forms and a self-administered printed questionnaire was used to collect data from youths aged 18 years old-24 years old. The Malay version of Conner-Davidson Resilience Scale-25 (CD-RISC-25) was used to assess psychological resilience. Data analysis was performed using SPSS version 28.0, and multiple linear regression analyses were conducted to evaluate the associated factors and their significance level.

    RESULT: A total of 158 participants were involved in this study. The mean score for psychological resilience was estimated at 69.28 (SD = 14.52). The social relationships domain recorded the highest mean score for quality of life (71.54, SD = 13.72). Meanwhile, the total mean score for self-esteem fell into the high-level category (35.77, SD = 4.94), and the domain of relationship and family dynamics under family environment scored the highest mean score of 18.83 (SD = 2.89). Psychological resilience was associated with youths of KOA Batu 12 (β = -14.274, P < 0.05), KOA Ulu Batu (β = -17.789, P < 0.05), less than four siblings (β = -6.495, P < 0.05), owner of residential property (β = -7.543, P < 0.05), high self-esteem (β = 0.612, P < 0.05) and good relationship and family dynamic (β = 1.391, P < 0.05).

    CONCLUSION: Developing interventions aimed at psychological resilience determinants may assist OA youths in coping with future threats.

  10. Salleh NS, Tang LY, Husain M, Lim Abdullah K, Kueh YC
    Malays J Med Sci, 2024 Jun;31(3):217-228.
    PMID: 38984240 DOI: 10.21315/mjms2024.31.3.17
    BACKGROUND: Often, the indirect impact of autism spectrum disorder (ASD) presents the family with significant challenges. One of these challenges is affiliate stigma due to parental affiliation with their child. This study aimed to explore affiliate stigma, resilience and quality of life (QoL) among parents of children with ASD.

    METHODS: Cross-sectional study of 144 parents of children with ASD were recruited from two main tertiary hospitals in Kelantan, Malaysia, a developing country in Southeast Asia. Pearson correlation was used to examine the relationship between parental affiliate stigma, resilience and QoL. Simple and multiple linear regression analyses were used to identify the significant associated factors of affiliate stigma, resilience and QoL.

    RESULTS: Correlational analyses revealed that perceived affiliate stigma demonstrated an inverse relationship with resilience and QoL. Additionally, resilience had a positive relationship with QoL. Regression analyses revealed that the father's employment status, the mother's level of education, having a disability card, the child's age at ASD diagnosis, comorbidities of the child and ASD severity perceived by parents were associated with parental affiliate stigma, resilience and QoL.

    CONCLUSION: Study findings highlight the contribution of socio-demographic characteristics of children with ASD and their families in the determination of affiliate stigma, resilience and QoL.

  11. Zolkefli Y
    Malays J Med Sci, 2024 Jun;31(3):252-256.
    PMID: 38984241 DOI: 10.21315/mjms2024.31.3.20
    The incidence of aggression within healthcare environments has exhibited a discernible rise. As a response, restrictive measures, including restraints, are enforced. Due to the safety and ethical concerns associated with using restraint, de-escalation measures are regarded as the most efficient course of action. The paper posits that it is critical to identify the causes of aggression before employing restraint through a multidisciplinary risk assessment. In addition, the reasonableness and proportionality of administering restraint must be carefully measured. The significance of cultivating a therapeutic and compassionate environment is emphasised. The paper will exclusively examine physical restraint as a form of restriction intervention.
  12. Abdul Razak LH, Denis T, Murugiah Y, Yoong WK, Idris Z, Senik MH
    Malays J Med Sci, 2024 Jun;31(3):52-74.
    PMID: 38984242 DOI: 10.21315/mjms2024.31.3.4
    Having a good memory is essential for carrying out daily tasks. People cannot study, plan, remember or navigate life effectively if they are memoryless. People may be at risk when mistakes made in the past will be repeated and lessons regarding danger cannot be learned. In the community, traumatic brain injury (TBI) is common and individuals with TBI frequently have memory problems. It is crucial to study how TBI affects memory to better understand the underlying mechanism and to tailor rehabilitation for patients with a range of pathologies and severity levels. Thus, this paper aimed to review studies related to TBI's effect on memory. This review examined recent studies to learn more regarding and comprehend the connection between TBI and memory, including short-term memory (STM), working memory (WM) and long-term memory (LTM). This will undoubtedly have a big impact on how memory problems that may arise after TBI will be addressed. Virtual reality and other technological advancements have given the medical community a new way to investigate rehabilitative therapy.
  13. Cheah YK, Suleiman A, Ramly M
    Malays J Med Sci, 2024 Jun;31(3):160-172.
    PMID: 38984243 DOI: 10.21315/mjms2024.31.3.12
    BACKGROUND: Female sex workers (FSWs) have a high risk of human immunodeficiency virus (HIV) infection. In spite of the alarming fact that a large proportion of FSWs does not have adequate HIV knowledge, the association between sociodemographic factors and HIV knowledge among FSWs have yet to be thoroughly explored in the context of Malaysia. The aims of this study are the following: i) to determine HIV knowledge and ii) to examine the associated factors of HIV knowledge.

    METHODS: An observational cross-sectional study was conducted. Data from the Integrated Biological and Behavioral Surveillance Survey (IBBS) 2017 (n = 630) were used. The survey was carried out in all states in Malaysia and its duration was 4 months (from March 2017 to June 2017). Ordered probit regressions were utilised to shed light on the association between sociodemographic variables and levels of HIV knowledge.

    RESULTS: A large proportion of FSWs had middle-level HIV knowledge (44.1%). FSWs with tertiary-level education were 19.5% more likely to have high-level HIV knowledge compared to those without formal education. The probability of having low-level HIV knowledge was 6.8% lower among FSWs with monthly incomes of RM1,500-RM1,999 than those having incomes of ≤ RM499. Being single instead of married was associated with 7.6%-8% lower probabilities of having low- and middle-level HIV knowledge.

    CONCLUSION: Public health interventions to improve FSWs' HIV knowledge need to take into consideration the role of sociodemographic factors.

  14. Hassan SK, Wong PC, Seevaunnamtum P, Che Omar S, Nik Mohamad NA
    Malays J Med Sci, 2024 Jun;31(3):117-124.
    PMID: 38984244 DOI: 10.21315/mjms2024.31.3.8
    BACKGROUND: Phenylephrine (PE) is one of the vasopressor used to treat hypotension during anaesthesia. The primary aim of this study was to compare the effect of prophylactic infusion and rescue bolus of PE on the haemodynamic changes during spinal anaesthesia (SA) for Caesarean section (CS) in obese parturients.

    METHODS: A total of 74 obese parturients scheduled for elective CS under SA were randomised into two groups; Group A (n = 37) received prophylactic PE infusion starting at 50 μg min-1 and adjusted according to the given algorithm and Group B (n = 37) received 100 μg PE bolus to treat hypotension. The measured parameters were systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), the total requirement of PE and neonatal Apgar score.

    RESULTS: Six patients were excluded from the analysis due to missing data and only 68 were analysed. Group A showed significantly higher SBP, DBP and MAP than Group B (P < 0.05). The requirement of PE was higher in Group A than Group B [817.7 (265.7) μg versus 360.6 (156.0) μg; P = < 0.05]. Both groups had no difference in terms of the neonatal Apgar score.

    CONCLUSION: Prophylactic PE infusion provided better haemodynamic control than therapeutic boluses in obese parturients undergoing CS under SA.

  15. Ismail H, Abdullah MH, Osman S, Che Arshad F, Jalaluddin SN, Osman NF, et al.
    Malays J Med Sci, 2024 Jun;31(3):1-17.
    PMID: 38984245 DOI: 10.21315/mjms2024.31.3.1
    Mapping the distribution of medical specialists in the Ministry of Health (MOH) Malaysia facilities is expected to be more complex as the demand for specialty and subspecialty services increases in the future. A more robust and definitive gap analysis is needed to facilitate planning and resource allocation. The Medical Development Division developed a master list of framework of specialties, subspecialties and areas of interest, and Specialist Database Module in the Medical Programme Information System (MPIS) as tools to facilitate mapping of services. Relational database of specialists' location, facilities, workload, population profile and other relevant parameters were developed to provide data visualisation in specific dashboard. Needs versus supply ratio is proposed as one of parameters to visualise specialised medical services distribution by geographical localities.
  16. Nakanishi S, Shimoda M, Kimura T, Katakura Y, Sanada J, Fushimi Y, et al.
    Malays J Med Sci, 2024 Jun;31(3):185-193.
    PMID: 38984246 DOI: 10.21315/mjms2024.31.3.14
    BACKGROUND: The impact of hand strength in consideration of sedentary behaviour on diabetes management in patients with type 2 diabetes mellitus (T2DM) is unclear. The purpose of this study was to examine the impact of hand strength on HbA1c, body mass index (BMI) and body composition by group according to the duration of sedentary behaviour in Japanese patients with T2DM.

    METHODS: In this retrospective, cross-sectional, single-centre study, hand strength standardised by bodyweight (GS) and sedentary time (ST), were obtained and analysed in a total of 270 Japanese T2DM outpatients in 2021. After dividing the patients into four categories of median values (high and low GS, and long and short ST), odds ratios (ORs) for good control of HbA1c, BMI, waist circumference (WC) and intra-abdominal fat (IAF) were investigated using logistic regression models.

    RESULTS: The high GS/short ST group was found to have a significantly higher (OR = 2.01; 95% CI: 1.00, 4.03; P = 0.049) for controlled HbA1c compared with that of the low GS/long ST group. The high GS/short ST and the high GS/long ST groups had significantly higher ORs for controlled BMI, WC and IAF compared with the OR of the low GS/long ST group. In addition, the ORs were significantly increased with a positive trend in order from low GS/long ST, low GS/short ST, high GS/long ST, to high GS/short ST in all models (P < 0.001 for trend).

    CONCLUSION: Hand strength, with modest effects from sedentary behaviour, could be helpful for diabetes management in T2DM patients.

  17. Kuan G, Sut Txi MR, Mat Salleh FN, Wong KY, Tan H, Kueh YC
    Malays J Med Sci, 2024 Jun;31(3):241-251.
    PMID: 38984247 DOI: 10.21315/mjms2024.31.3.19
    BACKGROUND: In the world of sports, motivation is an essential concept that can affect the sporting performance of athletes and help them accomplish their goals. The coach is regarded as an important individual with the ability to significantly influence the athlete's motivation. To assess the impact of the coach-athlete relationship on motivation, the objective of this study was to evaluate the psychometric properties of the Malay version of the Coach-Athlete Relationship Questionnaire (CART-Q) for coaches and athletes.

    METHODS: A cross-sectional survey was conducted among the coaches and athletes in Malaysia. Data were collected using a convenience sampling approach over a 6-month period. The study was carried out in two phases using two independent samples of coaches and athletes to assess the construct validity and internal consistency of the Malay version of the CART-Q. The CART-Q consisted of 11 items measuring three constructs: i) closeness (four items), ii) commitment (three items) and iii) complementarity (four items). In phase 1, the subjects consisted of 211 coaches (21 years old-65 years old) from both sexes and from individual and team sports, ranging from levels 1 to 5. In phase 2, the subjects consisted of 362 athletes (12 years old-39 years old), also from both sexes and from individual and team sports. The statistical analyses performed included confirmatory factor analysis (CFA) to validate the translated version scale, composite reliability (CR), average variance extracted (AVE) and internal consistency (Cronbach's alpha).

    RESULTS: In phase 1, the sample of coaches, with 190 males (90.0%) and 21 females (10.0%), had a mean age of 38.6 (SD = 8.74) years old. The major sport type was archery (19.0%). The CFA revealed adequate fit indices with all 11 items retained (root mean square error of approximation [RMSEA] = 0.059, comparative fit index [CFI] = 0.964, Tucker and Lewis Index [TLI] = 0.950, standardised root mean square residual [SRMR] = 0.037). The CR values were closeness = 0.874, commitment = 0.566 and complementarity = 0.757. The AVE values were closeness = 0.357, commitment = 0.194 and complementarity = 0.275. The Cronbach's alpha values were closeness = 0.867, commitment = 0.553 and complementarity = 0.794. In phase 2, the sample of athletes, with 175 males (48.1%) and 189 females (51.9%), had a mean age of 20.2 (SD = 3.35) years old. The major sport type was archery (11.5%). The CFA revealed satisfactory fit indices with all 11 items retained (RMSEA = 0.092, CFI = 0.948, TLI = 0.924, SRMR =.038). The CR values were closeness = 0.893, commitment = 0.786 and complementarity = 0.949. The AVE values were closeness = 0.401, commitment = 0.253 and complementarity = 0.418. The Cronbach's alpha values were closeness = 0.900, commitment = 0.772 and complementarity = 0.900.

    CONCLUSION: Overall, the study findings supported the conclusion that the Malay version of the CART-Q has adequate psychometric properties to assess the perceptions of coaches and athletes regarding their relationship.

  18. Goh SL, Wong NL, Lau PL, Kuan G, Chongwei L, Lau EKL
    Malays J Med Sci, 2024 Jun;31(3):173-184.
    PMID: 38984248 DOI: 10.21315/mjms2024.31.3.13
    OBJECTIVE: To explore regional differences (i.e. Europe, Asia and others) in the well-being of para-athletes and its potential psychosocial determinants, including the Athletic Identity Measure Scale (AIMS), the Brief Resilience Scale (BRS) and the Satisfaction with Life Scale (SWLS).

    METHODS: The study was a cross-sectional survey using data from multinational badminton federations. The study participants were athletes registered in the Para Badminton Classification Master List of the Badminton World Federation (BWF). The main study outcome is the WHO Quality of Life-Disability Questionnaire (WHOQOL-DIS).

    RESULTS: There were 1,385 (aged 36 years old, IQR 18 years old) registrants on the master list. Respondents totaled 170. Only 137 (65% were males) were included in the analysis after excluding those with missing data (Europe 40%, Asia 30%, others 30%). Following the results of factor analysis, the original Athletic Identity Measure Scale (AIMS) was separated into self-identity (SI) and AIMS-modified. SI, AIMS-modified, the BRS and the Satisfaction with Life Scale (SWLS) were all scored above average. The AIMS-modified scores of Europeans were significantly lower than those of other non-Asians (U = 757.000, P < 0.05). BRS was statistically higher among those with acquired disabilities (median: 3.33) compared to those with congenital disabilities (median: 3.0) (U = 1,717.000, Z = -2.711, P < 0.05) and among Europeans (median: 3.3) compared to Asians (median: 3.0) (U = 704.500, P < 0.05). The regression model explained 32% of the variability in quality of life (QOL) with five significant predictors. The SWLS (β = 0.307, P = 0.01), BRS (β = 0.269, P = 0.01), full-time employment (β = 0.191, P = 0.05) and being female (β = 0.162, P = 0.05) all had a positive effect on QOL, but not the AIMS (-0.228, P = 0.05).

    CONCLUSION: The results show that the athletes' resilience, satisfaction with life and identity vary across regions. Furthermore, satisfaction with life, employment and gender were found to be significant predictors of athletes' QOL.

  19. Arifin SRM, Syaziman NSS, Abang Abdullah KH, Abd Aziz KH, Che Mat K, Muhammad NA, et al.
    Malays J Med Sci, 2024 Jun;31(3):149-159.
    PMID: 38984249 DOI: 10.21315/mjms2024.31.3.11
    BACKGROUND: Existing research indicated a high prevalence of mental health issues among adolescents. Gender and parenting styles are two factors that may influence adolescents' mental health. Nonetheless, most published studies focused on either secondary school or university students. In contrast, there is a dearth of similar research involving pre-university students. This study aimed to determine the prevalence of mental disorders among pre-university students and their association with parenting styles.

    METHODS: A cross-sectional study via online questionnaire survey was conducted among students from a pre-university college on the East Coast of Malaysia. Convenience sampling was used to recruit the participants. The questionnaire consisted of three parts: i) sociodemographic data, ii) the Parental Authority Questionnaire and Depression, and iii) the Anxiety and Stress Scale (DASS-21). An online invitation to answer the questionnaire was done via the Student Representative Council (SRC). Data were analysed using descriptive statistics and Pearson's chi-square test.

    RESULTS: A total of 431 participants responded to the online survey. The prevalence of depression, anxiety and stress was 49.0% (n = 210), 68.0% (n = 293) and 37.6% (n = 162), respectively. In addition, father's educational level (χ2 = 10.332, P = 0.001) and the authoritarian parenting style (χ2 = 10.099, P = 0.006) were significantly associated with mental health disorders among adolescents.

    CONCLUSION: The prevalence of mental disorders among pre-university students is relatively high. Pre-university admission mental health screening is vital for early detection and intervention of mental disorders among this vulnerable group. Further research is imperative to establish a comprehensive plan of action that targets parental involvement in managing adolescent mental health disorders.

  20. Ng HK, Loo CH, Lim MS
    Malays J Med Sci, 2024 Jun;31(3):125-132.
    PMID: 38984250 DOI: 10.21315/mjms2024.31.3.9
    BACKGROUND: Supine percutaneous nephrolithotomy (s-PCNL) offers great benefits from urological and anaesthetic points of view. We present the first evaluation of the outcomes of s-PCNL in Malaysia. Our aim was to explore the safety and efficacy of s-PCNL.

    METHODS: Institutional review board approval was obtained from the National Medical Research Register (NMRR ID-21002225-WLP). We retrospectively reviewed 115 patients with renal pelvis stones who underwent single renal access during s-PCNL between November 2020 and May 2023. Patients who underwent simultaneous ipsilateral or contralateral endourological procedures were included. The data were analysed to determine stone-free rates (SFR), major complication rates, blood transfusion rates, operative times and lengths of hospital stay (LOS).

    RESULTS: The SFR was higher for the single middle calyceal renal access (MCA) group than for the lower calyceal renal access (LCA) or upper calyceal renal access (UCA) groups (OR: 1.76; 95% confidence interval [CI]: 0.63, 4.92). In total, 0, 1 and 2 patients had major complications in the UCA, MCA and LCA groups, respectively (P = 0.453). One of the 115 patients (0.9%) needed blood transfusion. Subgroup analysis revealed mean operative times of 76.3 min and 78.6 min for patients who underwent sole s-PCNL (PCNL-only group) and those who had simultaneous ipsilateral and contralateral endourological procedures (PCNL-plus group), respectively (P = 0.786). The overall mean LOS was 2.9 days.

    CONCLUSION: s-PCNL is a safe and effective alternative treatment for renal stones. We would recommend s-PCNL for patients who require an ipsilateral/contralateral endourological procedure (URS/RIRS) because it is time-efficient. All renal accesses are safe. Single MCA is recommended for complete stone clearance.

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