MATERIALS AND METHODS: Eighteen wistar rats were made into incisional hernia models and divided into three groups of FOP, FOP-PPM, and CM at the 14th day. After each group underwent hernia repair, abdominal wall samples were taken to examine the expression of qPCR VEGF, COL3A1, COL1A1, and COL1A2 at the 21st day.
RESULTS: There were no significant different in the gene expression of VEGF, COL3A1, COL1A1, COL1A2 and COL1A1/COL3A1 ratio between FOP, FOP-PPM and CM group (p-value >0.05). In addition, non-significant result also found at the comparative analysis between FOP-PPM and MC groups.
CONCLUSIONS: FOP can give the similar result as CM for defect closure surgery in incisional hernia, either when combined with PPM or as a single option. However, further clinical study is needed to support this animal study.
MATERIALS AND METHODS: This is a cross-sectional study with 60 DM patients, selected by simple random sampling. The instrument used consists of the DM patient observation sheet-based user view and the M-DFEET application. Categorical data were classified as frequency and percentage, while the numerical data were reported as mean and standard deviation (SD).
RESULTS: The evaluation results show that all 60 participants (100%) rated the functionality of the M-DFEET application as excellent in helping with foot care. Furthermore, most participants, 55 (91.7%), assessed the efficiency of the application as good. Regarding the usability, 58 participants (96.7%) considered it good, while the remaining participants deemed it adequate. These findings underscore the application's potential to optimize time and effort for its users effectively.
CONCLUSIONS: The feedback on the M-DFEET application is overwhelmingly positive, with all participants rating its functionality as very good for foot care. The application is likely to be well-received by users especially T2DM patients, and holds potential as an evaluative tool in foot care management.
MATERIALS AND METHODS: A quantitative, cross-sectional design was employed in this study. Respondents were recruited from June to December 2021 among students attending higher education institutions in Malaysia. Institutions were sampled using stratified random sampling and the respondents were selected via convenience sampling. Data were collected via an online survey that inquired about respondents' socio-demographic characteristics, ACE, religiosity, knowledge on sexuality, attitude towards premarital sex, mental health status (MHS), and engagement in SRB. The data were analysed using SPSS version 27 for descriptive analysis, and SPSS AMOS version 27 for structural equation modelling (SEM) analysis.
RESULTS: A total of 1171 respondents were recruited in this study. From the SEM analysis, the proposed model indicated a good fit, and it explained 26% of the SRB variance. There was a partial mediation effect of the relationship between ACE on SRB through MHS (p<0.05), as well as religiosity on SRB through MHS (p<0.05). There was no significant mediation effect was found for the other variables.
CONCLUSION: This study highlighted the mediation effect of MHS between ACE on SRB, as well as between religiosity and SRB. Apart from addressing ACE and religiosity of the young adults, MHS should also need to be explored when dealing with SRB issues and vice versa. Preventive measures should be considered at younger stage to prevent high risk behaviour among young adults.
MATERIALS AND METHODS: A retrospective cross-sectional study was conducted for about 7 months (from 23 January 2024 to 9 August 2024) among adult Type 2 diabetic patients in the non-communicable disease section of Seremban Health Clinic to determine the association between statin use and depression. The data was collected via interviewerguided questionnaire that consisted of 5 sections: Section A (Participant Information), Section B (Depression, Anxiety and Stress Scale 21 [DASS-21]), Section C (Beliefs about Medicines Questionnaire [BMQ]), Section D (Malaysia Medication Adherence Assessment Tool [MyMAAT]) and Section E (Patient Health Questionnaire-9 [PHQ-9]). Consecutive patients that met inclusion and exclusion criteria who consent to be involved in the study were sampled. Although the ideal sample size that was required is 242, only 82 participants were enrolled in this study. These participants were also part of the Seremban Diabetes cohort study.
RESULTS: Since only 82 participants consented to be part of this study, the response rate was 33.9%. About 25% of patients had depression. As the statin dosage intensity increased, the prevalence of depression also increased but this was not statistically significant. Based on Pearson's chi square test, only stress (p<0.001), anxiety (p=0.002), beliefs about medicines (p=0.010) and marital status (p=0.039) had a statistically significant association with depression. Upon adjusted logistic regression of the 4 factors (marital status, stress, anxiety and belief about medicines), only stress (OR 14.000, 95% CI 2.682 - 73.076, p=0.002) was statistically significant.
CONCLUSION: The association between depression and statin use among patients with Type 2 diabetes mellitus is not statistically significant. Further studies are needed to confirm the cause of depression in this group of patients.
MATERIALS AND METHODS: This was a quantitative crosssectional study conducted from November 2020 until March 2021 which involves 139 HBCD caregivers in Kelantan. Validated questionnaire was used which consisted of 27 questions based on demography, knowledge and attitude towards CPR. The data was keyed in and analysed using software SPSS version 26.
RESULTS: A total of 139 respondents participated in the study. The mean attitude score obtained by the caregivers was 16.67 with SD = 4.22. There were 89 caregivers (64%) with poor knowledge among the 139 HBCD caregivers in the study compared to 50 HBCD caregivers (36%) who had good knowledge. Caregivers who were exposed with CPR training had 5.91 higher odds of having good CPR knowledge compared to those without being exposed to CPR training (Wald-statistic (df) = 21.12 (1), OR (95% CI) = 5.91 (2.77, 12.61), p<0.001). Caregivers with experience in handling CPR were 5.91 of higher odds in having good CPR knowledge compared to those without the experience in handling CPR when adjusted for the duration of caregiver's experience (Wald-statistic (df) = 21.12 (1), OR (95% CI) = 5.91 (2.77, 12.61), p<0.001). HBCD caregivers' experience was the only variable that had a significant p-value when tested in the regression model (p = 0.023).
CONCLUSION: The findings revealed that HBCD caregivers in Kelantan had inadequate CPR knowledge, potentially increasing the risk of OHCA. Planned and regular training for them is mandatory. Exposure to CPR was the associated factor that contributes to knowledge level among HBCD caregivers whereas years of experience as HBCD caregivers influence attitude towards CPR.
MATERIALS AND METHOD: This was a prospective observational study involving Malaysian health care professionals participating in ICOE shoulder dystocia simulation, where standardized curriculum was used. Pre and post-test skills assessment were conducted to evaluate the effectiveness of the course content and delivery.
RESULTS: 609 Malaysian health care professionals attended ICOE training; 400 midwives, 128 medical officers, 55 specialist and 26 consultants. Participants were derived from 25 consecutive courses, from 2014 to 2019 and tested on predetermined skills in the management of shoulder dystocia. Their mean TIPS pre-test vs post-test score were (2.55 vs 6.77) midwives, (3.78 vs 7.25) medical officers, (5.16 vs 7.82) specialists & (3.62 vs 6.88) consultants. All four group of participants showed statistically significant improvement (51-165%) in their skills (p<0.001). The mean post test score in noting time of dystocia and call for help were significantly higher among midwives than others. All four groups statistically improved their delivery skills in McRoberts manoeuvre and directed suprapubic pressure. Pre-skills for delivery of the posterior arm was suboptimal and post skills test showed statistically significant improvement in all four groups.
CONCLUSION: ICOE shoulder dystocia simulation training module improved the psychomotor and cognitive skills in the management of delivery of shoulder dystocia.
MATERIALS AND METHODS: A retrospective cohort study was conducted involving 592 prediabetic adults from 28 health clinics in Terengganu between January 2019 and June 2023. Participants were selected based on oral glucose tolerance test (OGTT) results indicating prediabetes. Sociodemographic, medical background, and clinical data, including body mass index (BMI), blood pressure, fasting blood sugar (FBS), and lipid profiles, were extracted from medical records. Glycaemic outcomes were classified into three categories: reversion to normoglyacemia, persistent prediabetes, or progression to DM, based on glycated haemoglobin (HbA1c) levels taken within two years of follow-up. Ordinal logistic regression analysis was used to identify the significant predictors influencing these outcomes.
RESULTS: Analysis showed age, BMI, underlying dyslipidaemia, FBS, and triglyceride levels as significant predictors of glycaemic progression. Specifically, each additional year of age and each one-unit increase in BMI raised the likelihood of progression to DM by 3% and 6%, respectively. Participants with dyslipidaemia were noted to have a 67% higher risk of worsening glycaemic status, while increases in FBS and triglyceride levels were associated with 65% and 34% greater odds of diabetic progression, respectively.
CONCLUSION: This study identifies critical predictors of glycaemic outcomes in prediabetic adults, emphasizing the role of age, BMI, dyslipidaemia, FBS, and triglycerides in the disease progression. These findings support the development of targeted interventions that address these risk factors to curb diabetes progression in high-risk individuals, contributing valuable insights into diabetes prevention strategies tailored for Malaysian populations.
MATERIAL AND METHODS: A cross-sectional, hospital-based study was conducted from 2022 to 2024 at Hospital Shah Alam and Hospital Pakar Universiti Sains Malaysia. A total of 109 Malay children aged 7-17 years participated, including 88 with myopia and 21 with emmetropia. Each participant underwent a comprehensive ocular examination, including non-cycloplegic refraction and axial length measurement. Choroidal thickness was assessed using Cirrus SD-optical coherence tomography, with one eye from each subject randomly selected for analysis.
RESULTS: The mean subfoveal choroidal thickness was significantly thinner in myopic children (284.91 μm) compared to emmetropic children (347.62 μm) (p<0.001). Additionally, choroidal thickness varied significantly with the degree of myopia: mild myopia had a mean subfoveal thickness of 319.69 μm, moderate myopia 290.04 μm, and high myopia 225.72 μm, with high myopia showing the thinnest choroid (p<0.001). A significant negative correlation was observed between axial length and subfoveal choroidal thickness, while a positive correlation was found between spherical equivalent and choroidal thickness. No significant correlation was identified between age and subfoveal choroidal thickness.
CONCLUSION: Malay children with myopia exhibit a thinner mean choroidal layer compared to their emmetropic peers, with the thinnest choroid observed in cases of high myopia. This indicates that thinning of the choroidal vasculature occurs with the increase in axial length and worsening severity of myopia.
MATERIALS AND METHODS: This retrospective comparative analysis examines inpatient prescription data collected from the same hospital wards during three distinct periods: 1st January to 31st March 2023 (59,663 handwritten prescriptions), 1st October to 31st December 2023 (43,363 electronic prescriptions at 3 months post-CPOE implementation) and 1st January to 31st March 2024 (44,317 electronic prescriptions at 6 months post-CPOE implementation). The CPOE system was implemented in July 2023.
RESULTS: The CPOE system significantly reduced medication prescribing errors (3 months post-CPOE: n=832, 1.92%; 6 months post-CPOE: n=617, 1.39%) compared to handwritten prescriptions (n=3532, 5.92%). The odds of errors occurring 3 months and 6 months post-CPOE implementation were 65% and 75% lower, respectively, than during the handwritten phase [Odds Ratio (OR), 0.35; 95% Confidence Interval (CI), 0.32 - 0.38] and [OR, 0.25; 95% CI, 0.23 - 0.28]. Potential error sources associated with handwritten prescriptions, such as illegible prescriptions, non-standard abbreviations and incomplete prescriptions, were entirely eliminated with CPOE adoption. Significant differences in error types were observed between handwritten and electronic prescriptions (p<0.001). However, errors related to incorrect dosage, frequency and unit of measurement increased under the CPOE system compared to handwritten prescriptions (p<0.001). A significant reduction in odds occurred with wrong unit of measurement [OR, 0.61; 95% CI, 0.52 - 0.72) followed by frequency errors [OR, 0.58; 95% CI, 0.47 - 0.73) from the 3 months to 6 months post-CPOE implementation. Non-significant reductions or increments in odds were observed for other error types including wrong dosage, wrong route, wrong form, wrong strength and wrong or inappropriate drugs between the two 3-month post-CPOE periods.
CONCLUSION: The implementation of the CPOE system has significantly minimized the factors contributing to medication prescribing errors associated with handwritten prescriptions. However, the CPOE-related errors can still occur and may persist or change over time. To further improve prescribing safety, it is essential to address the factors contributing to these errors and periodically assess them to minimize the gap. Future studies should explore additional aspects of medication safety such as prescriber knowledge, types of medicines prescribed, long term error patterns and contextual factors including disease complexity across clinical settings, particularly with the integration of advanced clinical decision support tools.
MATERIALS AND METHODS: This is a cross-sectional survey study. A total of 145 subjects studied in secondary school and pre-university programme were involved in this study. An exploratory survey questionnaire was used to assess the symptoms of computer vision syndromes encountered by the students and their electronic device usage behavior before and during fully remote learning started.
RESULTS: Average time spent by students on outdoor activities reduced from one to two hours per day (40.7%) to less than an hour per day (56.6%) after fully remote learning. Average time spent on entertainment activities using electronic devices increased from one to two hours per day (38.6%) to four hours and above per day (40.0%) after fully remote learning. The majority of time spent on school assignments using electronic devices increased from one to two hours (44.8%) to three to four hours per day (33.8%) after fully remote learning. Increased frequency of students experienced eye pain (44.1%), eye fatigue (57.2%), headache (56.6%), eye itchiness (18.6%), glare (31.7%), dry eye (40.0%), blurry vision (31.7%) and double vision (7.6%) after fully remote learning began.
CONCLUSION: An observed increase frequency of computer vision syndrome was noted in relation to the reduction of time spent on outdoor activities and increased usage of electronic devices for entertainment activities and completing school assignment during COVID-19 lockdown in Malaysia.
MATERIALS AND METHODS: We searched across multiple databases (PubMed, Google Scholar, ScienceDirect, Academia.edu, ResearchGate and Semantic Scholar) and suitable articles from 1993 to 2022 were systematically chosen according to PRISMA guideline. The analysis was performed on the maternal characteristics, signs and symptoms of the uterine torsion, management, complications and outcomes of both the mothers and infants. All case reports or case series reporting uterine torsion in pregnancy from English language journals were included without restriction on the geographical origin.
RESULTS: A total of 149 cases from 146 publications and one from our centre were included for analysis. Most of the cases were seen in the third trimester and presented with acute abdominal symptoms and signs. It presented a challenge in diagnosis and had a myriad of complications to the mothers and infants. The maternal mortality is 2.0% while the perinatal mortality stands at 38.2%.
CONCLUSION: Uterine torsion in pregnancy is a rarely encountered but serious condition with no specific precipitating factor or diagnostic criteria. It can occur at any gestation, has a wide range of non-specific clinical presentations, and carries a significant risk to the mother and child.
MATERIALS AND METHODS: We searched electronic databases. All available randomized controlled trials (RCTs) were included, and we considered the scientific novelty of the study, the reliability of the reported study results; the high methodological level of the study of non-statin therapy in patients with dyslipidemia and high residual platelet reactivity, with no language or date restrictions. We did separate random-effects meta-analyses for LDL-С, HRRP on their effects on LDL-С levels and outcomes, taking into account the reliability of the reported study results and the high methodological level of the study. The challenge of achieving target LDL-С levels, their impact on high residual platelet reactivity, and the choice of optimal antiplatelet and lipid-lowering therapy remains unresolved.
RESULTS: The integration of newer therapies, such as inclisiran and PCSK9 inhibitors, may play a critical role in achieving optimal outcomes for patients at high cardiovascular risk.
CONCLUSION: The necessity of applying an individual multidisciplinary approach in order to determine the best regimen of antiplatelet and lipid-lowering therapy in patients with coronary heart disease, including after revascularization, is shown. This approach will reduce the risk of recurrent cardiovascular events. Few studies on the relationship between LDL-С and HRPR dictate the need for more detailed research in this area.
MATERIALS AND METHODS: A recent survey that involved all the government (Ministry of Health, MOH) and university hospitals in Malaysia was conducted by a group of neurologists and researchers to provide insights into the hyperacute stroke services in Malaysia from 2012 to 2023.
RESULTS: The results from the survey found that out of 142 MOH hospitals, 29 (20%) hospitals offer only intravenous thrombolysis (IVT) service, and seven (5%) hospitals offer both IVT and mechanical thrombectomy (MT) services. The majority or two-thirds of MOH hospitals still offer office hour services for both IVT and MT. For university hospitals, four (67%) out of six university hospitals provide both IVT and MT services and one (16%) university hospital provides only IVT service. Most university hospitals offer 24-hour services for IVT and MT. The availability of IVT service across MOH hospitals has increased significantly from 2012 to 2023. Thus, there was a substantial increase in the number of IVT cases treated in MOH hospitals. The growth in MT service has been more gradual. Only 22% of the MOH hospitals that provide hyperacute stroke services are equipped with acute stroke unit (ASU). Whereas ASU is available in 80% of the university hospitals that offer hyperacute stroke services. The higher availability of ASU in university hospitals compared to MOH hospitals may be due to better resources, specialised expertise, and advanced facilities in the university hospitals. The National Stroke Registry (NSR) Malaysia was established in 2009 to monitor stroke management practices, patient outcomes and promote quality improvement initiatives.
CONCLUSION: Despite suboptimal adherence on several key performance indicators, the NSR reports recent improvements in thrombolysis rates, reduced mortality, and better functional outcomes. Key recommendations center on promoting greater participation, feedback systems, adequate funding, and governance structures to translate registry findings into national policies and targeted interventions for equitable access to quality stroke care.
METHODS: This study uses data from the Global Burden of Disease (GBD) study spanning 1990-2021 to analyze PCa trends in CEE. We assessed age-standardized rates (ASRs) of PCa to identify trend changes through joinpoint regression analysis, explored regional disparities using QGIS software, and made projections for 2031 using the ARIMA model.
RESULTS: Eastern Europe experienced greater changes across health metrics compared to Central Europe, with higher average annual percentage change values for incidence, prevalence, mortality, and DALYs rates. In 2021, Lithuania and Estonia recorded the highest PCa prevalence rates, while Estonia had the highest total percentage change (240.3). Estonia and Latvia also had the highest mortality rates (34.1 and 33.6 per 100,000, respectively). CEE's prevalence rates are projected to remain stable.
CONCLUSION: The findings highlight significant regional disparities in the burden of prostate cancer in CEE. Efforts to address these disparities should focus on enhancing diagnostic programs and treatment access, particularly in Eastern Europe, to reduce the ongoing burden of PCa in the region.