MATERIALS AND METHODS: A single-centre case-control study was conducted in which patients admitted with stroke and healthy controls were recruited with consent. EEG was performed within 48 hours of admission for stroke patients and during outpatient assessments for controls. The EEG signals were pre-processed, analysed for spectral power using MATLAB, and plotted as topoplots.
RESULTS: A total of 194 participants were included and equally divided into patients with ischemic stroke and controls. The mean age of our study cohort was 55.11 years (SD±13.12), with a median National Institute of Health Stroke Scale (NIHSS) score of 6 (IQR 4-6) and lacunar stroke was the most common subtype (49.5%). Spectral analysis, with subsequent topographic brain mapping, highlighted clustering of important channels within the beta, alpha, and gamma bands.
CONCLUSION: qEEG analysis identified significant band frequencies of interest in post-stroke patients, suggesting a role as a diagnostic and prognostic tool. Topographic brain mapping provides a precise representation that can guide interventions and rehabilitation strategies. Future research should explore the use of machine learning for stroke detection and provide individualized treatment.
MATERIALS AND METHODS: This is a retrospective cohort study utilising secondary data from the National Tuberculosis Registry (NTBR). The study was conducted in Selangor among relapsed TB patients who were registered in NTBR from 1 January 2015 to 31 December 2019. TB disease profile, TB treatment profile, comorbidities, and sociodemographic data were examined. The determinants of unsuccessful treatment outcomes among relapsed TB patients were identified using multiple (binary) logistic regression analyses.
RESULTS: 896 patients who experienced relapsed tuberculosis were included in this study. 32.25% were reported to have unsuccessful treatment outcomes. Multiple (binary) logistic regression revealed that the absence of sputum smear examination at 5 months and beyond was a determinant of unsuccessful treatment outcome (AOR 1.70 (95% CI: 1.19, 2.44). Additionally, being treated in government facilities, such as government hospitals and government primary health clinics, was a protective factor (AOR 0.06 (95% CI: 0.03, 0.15) and AOR 0.02 (95% CI: 0.01, 0.04), respectively.
CONCLUSION: The high proportion of unsuccessful treatment outcomes among relapse TB patients stresses the importance of adherence to routine sputum monitoring and public-private partnerships.
MATERIALS AND METHODS: A cross-sectional study was conducted on 543 HCWs from the KOSPEN WOW ("Komuniti Sihat Pembina Negara" or "Healthy Community Builds the Nation-Wellness of Workers") database in three district health offices (DHOs) under the Selangor State Health Department in Malaysia. To estimate the office-based Globorisk model, factors such as age, sex, current smoking status, systolic blood pressure (SBP), and body mass index (BMI) were included. Data analysis employed were Pearson chi-square test, Fisher's exact test, Welch's t-test and binary logistic regression.
RESULTS: Among 543 participants, 453 (83.4%) were female, 439 (80.8%) were Malay with mean (SD) age of 44.4 (4.38). Majority of moderate-high CVDs risk identified among primary HCWs was male with 26 (86.7%), Malay with 25 (83.3%), and non-clinical group with 17 (56.7%). The prevalence of low CVDs risk was 94.5% (95% CI: 92.2-96.2) and 5.5% (95% CI: 3.8-7.8) for the moderate-high risk category. Factors associated with moderate-high CVDs risk were job category with non-clinical group (95% CI: 1.43, 6.85), elevated blood glucose (95% CI: 3.25, 19.41) and anxiety symptom (95% CI: 1.46, 13.86).
CONCLUSION: The KOSPEN WOW platform is effective for screening and guiding implementation of intervention programmes to prevent CVDs.
MATERIALS AND METHODS: A total of 160 individuals were selected, comprising 80 psoriasis patients and 80 controls, matched for age, gender, ethnicity, marital status, education levels, and prevalence of comorbidities. Cognitive function was assessed using the VCAT. The relationship between cognitive impairment and various disease-related factors, including psoriasis severity measured using Psoriasis Area Severity Index (PASI scores), disease duration, and the presence of psoriatic arthropathy, was examined.
RESULTS: The mean VCAT scores for the psoriasis and control groups were 25.38 (SD = 3.18) and 25.94 (SD = 2.67), respectively, with no significant difference between the two groups (p = 0.227). While most cognitive domains showed no significant differences, the VCAT attention sub-score was significantly lower in psoriasis patients (p < 0.05). There was no significant association between psoriasis and cognitive impairment. No significant association was found between cognitive function and PASI scores nor psoriatic arthropathy. A negative association was found between disease duration and VCAT scores, suggesting longer disease duration correlates with lower cognitive function (p = 0.05).
CONCLUSIONS: This study did not find broad cognitive impairment in psoriasis patients compared to controls, the specific deficit in attention and its association with the duration of psoriasis warrants further investigation. Understanding and addressing the cognitive aspects of psoriasis could significantly improve the overall quality of life for these patients.
MATERIALS AND METHODS: We conducted a retrospective cohort study of HL patients treated from January 1, 2006, to December 31, 2018, with follow-up until December 31, 2021. Data on demographics, clinical features, treatments, and outcomes were analyzed. OS and PFS were estimated using the Kaplan-Meier method.
RESULTS: Among 126 patients, the median follow up was 41 months. Most were male (55.6%) and of Malay ethnicity (97.6%). Nodular sclerosis was the predominant histology (52.4%), with 77.8% presenting with advanced-stage disease. All patients received chemotherapy, while 23.1% underwent combined modality therapy either with radiotherapy or immunotherapy. Post-treatment, only 34.1% achieved complete response. The 3-year OS and PFS rates were 74.9% and 59.5%, respectively-relatively lower than rates reported in developed countries. Independent adverse prognostic factors for OS and PFS included advanced-stage disease, bulky disease, elevated erythrocyte sedimentation rate.
CONCLUSION: This study highlights the need for tailored treatment approaches to improve HL outcomes in northeast Peninsular Malaysia. The relatively modest OS and PFS rates compared to developed nations suggest potential benefits from enhanced access to advanced therapied and diagnostic tools like positron emission tomography computed tomography (PET-CT) scan.
MATERIALS AND METHODS: A cross-sectional study was conducted with 244 occupational therapy practitioners; 43 males; and 181 females. The level of empathy and listening style were assessed using the Jefferson Scale of Empathy Health Professional version and Listening Styles Profile- Revised questionnaires. Data were collected using Google Form. Analysis data were done using IBM SPSS Statistical Software version 26.
RESULTS: Statistical analysis showed that Malaysia occupational therapists preferred perspective taking (mean 55.67, Standard Deviation, SD 10.54) in empathy and the analytical listening in listening styles approach (mean 34.71, SD 6.76). In addition, there was a moderate to strong significant correlation between the level of empathy and listening styles (r= 0.419 to 0.648, p<0.05). Furthermore, there is significant difference between listening styles and empathy in relation to gender (male>female) p=0.001-0.038), race (Indian higher than Malay and Chinese) and areas of practice (paediatric higher than psychiatric) (p= 0.016 to 0.039).
CONCLUSION: The findings are helpful for occupational therapists to improve their quality services by being more listening and empathetic while providing proper intervention to the patients.
MATERIALS AND METHODS: This study was conducted retrospectively by reviewing records of pancreatic cancer patients hospitalized between January 2011 and December 2018 across multiple health centres in Malaysia. Using Cox proportional hazards regression analysis, several prognostic factors were identified.
RESULTS: The study revealed that being Chinese, having a family history of pancreatic cancer, having hepatitis C, presenting with jaundice, experiencing pale stools, having a palpable mass in the abdomen, the presence of ascites, receiving palliative care and end-of-life care were associated with higher mortality risk. Conversely, being female, having hypertension, and higher haemoglobin levels were linked to decreased mortality risk.
CONCLUSIONS: These study findings offer valuable insights into prognostic factors for predicting patient outcomes and optimizing individual prognosis in pancreatic cancer cases within Malaysia context. Future research should build on these findings, exploring how these factors can be integrated into comprehensive care plans that address the specific needs of diverse patient populations.
METHODS: This is a retrospective cohort study among TB with Comorbidities cases in Negeri Sembilan using multiple secondary surveillance databases: National Tuberculosis Registry (NTBR), National Aids Registry (NAR) and National Diabetic Registry (NDR). The data review was from April 2024 until June 2024. All registered TB cases with comorbidities in Negeri Sembilan from the year 2018 to 2023 were analysed to determine the determinants of successful TB treatment among TB with comorbidities patients.
RESULTS: Out of 712 TB cases with comorbidities, 541 (76.0%) achieved a successful TB treatment outcome, and 171 (24.0%) did not. The successful TB treatment among TB with comorbidities showed predominantly among male (72.5%), Malay ethnicity (65.4%), secondary education level (60.3%), and unemployed working status (70.1%). Diabetes mellitus (DM) was the most common comorbidity (70.4%), followed by hypertension (44.8%), dyslipidaemia (36.0%), HIV (19.5%), and viral hepatitis (18.1%). Factors significantly associated with successful TB treatment were those who had a secondary education level (AOR: 2.222; 95% CI: 1.129, 4.374) and a tertiary education level (AOR: 4.474; 95% CI: 1.428- 14.01), were diagnosed with TB in the government hospital (AOR: 0.053; 95% CI: 0.008-0.376), and were not done Acid- Fast Bacillus sputum in the intensive phase of treatment (AOR: 0.191; 95% CI: 0.046, 0.785), cases followed the Directly Observed Therapy at the intensive phase (AOR: 9.045; 95% CI: 4.604, 17.770), and the treatment duration was more than 6 months (AOR: 6.511; 95% CI: 3.383, 12.532).
CONCLUSION: The successful treatment outcome for TB with comorbidities still falls short of the target and, if not treated well, could potentially lead to prolonged disease transmission, higher mortality rates, and increased healthcare costs. Identifying the proportion of successful treatment rates and their determinants provides insight into the disease burden and helps the public health sector and medical professionals assess and take appropriate action to improve local integration and collaborative service approaches for TB patients with concurrent comorbidities.
MATERIALS AND METHODS: This was a cross-sectional observational study. Medical practitioners were recruited from the Malaysian Medical Association via email invitations. Data were collected via a validated online questionnaire and analysed using SPSS, employing bivariate correlation and multiple linear regression analyses to examine the predictors of referral behaviour.
RESULTS: A total of 389 medical practitioners were recruited. The respondents were predominantly general practitioners aged 35-44 years, with 10-19 years of clinical experience, and approximately 90.0% managed cnLBP. Despite the high awareness of the Traditional and Complementary Medicine Act (92.0%), only 33.2% referred patients to acupuncture. Few had acupuncture training (3.6%) or personal experience (7.7%), and services were available in 12.1% of the workplaces. Medical practitioners possess substantial knowledge about acupuncture treatment for cnLBP; however, misconceptions and uncertainties regarding its mechanisms persist. Using multiple linear regression analysis, the significant predictors of acupuncture referral were self-experience (β=0.151, p<0.01), attitude (β=0.189, p<0.001), and perceived behavioural control (β=0.101, p<0.05).
CONCLUSIONS: Despite positive attitudes and substantial awareness, barriers hinder the broader integration of acupuncture in cnLBP treatment. Targeted education, institutional support, and enhanced research collaborations are essential for improving referral rates and expanding the treatment options for cnLBP.
MATERIALS AND METHODS: A retrospective review was conducted on patients who underwent ICCE at Hospital Melaka, Malaysia, from January 2014 to December 2023.
RESULTS: A total of 143 ICCE surgeries were performed on 135 patients. Most patients were male (n=88, 65.2%), with females comprising 34.8% (n=47). Most surgeries were performed on patients aged 60-69 years (n=48, 35.5%), followed by those aged 50-59 years (n=31, 23.0%) and 70-79 years (n=28, 20.7%). Incidence was lower among patients below 50 years and above 80 years. In terms of ethnicity, the highest incidence was among Malays (n=77, 57.0%), followed by Chinese (n=42, 31.1%) and Indians (n=15, 11.1%). The leading cause of ICCE was senile cataract with weak zonular support (n=58, 40.6%), followed by trauma (n=33, 23.1%), intraoperative complications (n=30, 21.0%), congenital cataracts (n=14, 9.8%), pseudoexfoliation (n=4, 2.8%), and lens-induced glaucoma (n=4, 2.8%). Post-surgery, 76 patients (53.1%) were left aphakic. Among those receiving IOL implants, 21.0% (n=30) had anterior chamber IOL, 14.7% (n=21) received an iris-claw IOL, and 11.2% (n=16) had a scleral-fixated IOL. Twelve weeks after IOL implantation, 60.9% (n=39) achieved good visual acuity of 6/12 or better, while 17.2% (n=11) had moderate vision (6/18 to 6/36), and 21.9% (n=14) had poor vision (worse than 6/60).
CONCLUSION: The incidence of ICCE was low, accounting for only 0.66% of the 21,596 cataract surgeries performed at Hospital Melaka, Malaysia, during the study period. The primary indication was senile cataracts with weak zonular support. Most patients achieved favourable visual outcomes at 12 weeks postsurgery following IOL implantation, with the iris-claw IOL showing superior postoperative visual results compared to other IOL types.
MATERIALS AND METHODS: A single-blinded Randomized Controlled Clinical Trial was conducted at the IKN between January 2023 and June 2023. The estimated sample size was 120 participants. A sequential numbering system assigned a unique identifier to each participant until a total of 120 participants were recruited, with 60 participants in both the intervention and control groups. The intervention group received chemotherapy counselling using a newly developed module. QoL and depression were assessed at multiple time points using a validated questionnaire. Data were analysed using SPSS version 26, with independent tests and two-way repeated measures ANOVA. A p-value < 0.05 was considered significant, and partial eta squared was used to measure effect size.
RESULT: Overall, in age distribution, the intervention group had the highest percentage of participants in the 41-60 years category (40.0%), whereas the control group had the highest percentage of participants aged ≥61 years (38.3%). The counselling module was effective in improving QoL and depression among participants at baseline and for three consecutive follow-ups following interventions. The QoL showed improvement in all four domains in the intervention group, which were Physical Health (p < 0.001), Psychological (p < 0.001), Social Relationship (p < 0.001), and Environment (p = 0.001). There was also a moderate effect reduction on depression (p < 0.001).
CONCLUSION: The newly developed counselling module was effective in improving the QoL and depression among breast cancer patients. Repetitive counselling sessions by pharmacists, which were conducted during the module implementation, played a key role in ensuring the well-being of breast cancer patients throughout the treatment journey.
MATERIALS AND METHODS: The Second Victim Experience and Support Tool for Recovery (SVEST-R) questionnaire was utilized to conduct an anonymous survey on the healthcare providers in Sarawak General Hospital (SGH) from August to October 2018.
RESULTS: A total of 482 respondents participated in the survey and 46.1% of the respondents reported SVE following their involvement in PSIs. Notably, symptoms such as flashbacks, fear, and stress tend to persist for longer durations compared to other symptoms. It is worth noting that non-work-related support received the highest mean (medical doctors = 3.83; nurses = 3.70), indicating that respondents preferred to seek emotional support from their friends and families. Furthermore, nurses reported a significantly higher experience of absenteeism following PSIs than doctors (p=0.003). In addition, most respondents expressed a desire for discussion or counselling with a respected peer or supervisor following their involvement in PSIs.
CONCLUSION: Present study reported a relatively high prevalence of SVE among healthcare providers at SGH. Hence, proactive measures, including non-work related and supervisor support, are essential in facilitating their overall well-being and successful recovery.
MATERIALS AND METHODS: Seventy-one patients with carotid atherosclerotic plaques (95 plaques) were studied on CEUS. Contrast enhancement in the plaque was evaluated with visual interpretation and quantitative analysis. The intraplaque neovascularisation (IPN) test was graded on a 3- point scale. IPN was quantified using dedicated software for CEUS image analysis.
RESULTS: It was found that the CEUS quantitative parameters were significantly different for plaques with varying types of echoes. The quantitative parameters also differed in soft, hard, and mixed plaques. The quantification of carotid IPN using CEUS was found feasible. The quantitative parameters measured from CEUS provide multiple references for carotid IPN of different echo types. This can help identify and monitor unstable atherosclerotic plaques.
CONCLUSION: CEUS has the potential to be an important tool in clinical application, specifically for diagnosing carotid atherosclerotic plaque features and vulnerability.
MATERIALS AND METHODS: This retrospective study analysed 119 COVID-19 patients admitted to Al-Sultan Abdullah Hospital (HASA) from March until December 2020. Demographics, medical histories, admission laboratory results, electrocardiogram (ECG), echocardiogram (echo), were captured from the hospitals' health records. Myocardial injury is an injury to the myocardium that can be diagnosed by elevated cardiac troponin T or I level above the 99th percentile upper reference limit (URL), an abnormal ECG, and an abnormal echo. Data were analysed using Statistical Package for Social Sciences (SPSS) Version 27.
RESULTS: From this study, it was founded that the prevalence of myocardial injury is 36.1% (43 subjects out of 119). The risk factors are older age (odds ratio, 2.347; p=0.028), males (odds ratio, 2.019; p=0.125), Indians (odds ratio, 3.659; p=0.296), hypertension (odds ratio, 2.776; p=0.009), diabetes mellitus (odds ratio, 1.732; p=0.155) and category 4 and 5 COVID-19 patients (odds ratio, 2.325; p=0.038).
CONCLUSION: Myocardial injury is prevalent among patients affected by COVID-19 and is associated with older age, hypertension and category 4 and 5 COVID-19. The researchers suggested conducting a more thorough investigation of the sizable population in multiple settings and conducting a prospective study where all infected COVID-19 patients have to undergo several tests, such as ECG, troponin T, and echocardiogram.
MATERIALS AND METHODS: The screening process yielded 13 studies conducted in various countries and regions. These studies, employing designs such as cross-sectional, cohort, and clinical trials, focused on CKD patients across different stages, including early and late-stage CKD.
RESULTS: The study revealed that musculoskeletal disorders are a considerable concern within the CKD population but are insufficiently explored among ESKD patients. Common musculoskeletal disorders identified include osteoarthritis, osteoporosis, fibromyalgia, carpopedal spasm, and chronic musculoskeletal pain syndrome. The prevalence of these disorders varied, with sub-group analysis revealing higher prevalence among hemodialysis patients compared to preand non-dialysis patients. While musculoskeletal pain remains consistent across CKD stages, potential confounding factors, such as palliative care settings and mobility issues warrant careful consideration.
CONCLUSION: The study underscores the importance of understanding and addressing musculoskeletal disorders in the CKD population, emphasizing the need for tailored interventions and future research endeavors.
OBJECTIVE: this article aims to analyze the expression of TNF-α, RANKL, and osteoclast cells count after application of DDMM as GBR in mandibular bone defects.
METHODOLOGY: this is an experimental study with a post-test only control group design, which began with the randomization of 120 rats into five groups: K(-), without membrane implantation; K(+), PPCM; P1, DDMM; P2, DDMM + bone graft; P3, PPCM + bone graft. The expression of TNF-α, RANKL, and osteoclast cells count were observed, followed by analysis using a one-way ANOVA and post hoc Tukey HSD comparison test.
RESULTS: there were significant differences in the expression of TNF-α, RANKL, and osteoclast cells count in all study groups (p=0.000). TNF-α showed a decreasing difference with the highest expression in the K(-) group on day 3 of 12.00±2.16. RANKL expression increased on day 14 and decreased on day 21 in all groups. The osteoclast cells count generally showed a critical period with the highest increase in the K(-) group on day 14 of 73.00±0.00.
CONCLUSION: DDMM has the potential to be a superior membrane substitute compared to PPCM as GBR in alternative treatment for craniofacial bone defects reconstruction.