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  1. Tan, Se Xian, Norhayati Ibrahim, Nuruljannah Johari, Nuruljannah Johari, Roszanadia Rusli, Zahara Abdul Manaf
    MyJurnal
    Obesity is a risk factor for chronic diseases which can affect work productivity and physical function of employees
    particularly among those in security sector. The study aimed to determine the association between obesity with total
    days of sick leave and health related quality of life (HRQoL) among Malay male security officers. A cross-sectional
    study was conducted among Malay male security officers working in a Malaysian higher learning institution. Subjects
    were evaluated using anthropometric measurements, quality of life and number of sick leave taken within two months
    prior to the study. A total of 194 subjects (mean age 40.12 ± 11.41 years) were recruited. A total of 30.4% were obese,
    39.7% were pre-obese and only 29.9% had normal body weight or underweight. Central obesity was observed in 57.7%
    of them and 87.1% shown excessive body fat percentage. Number of sick leave days was positively correlated with Body
    Mass Index (BMI) (r = 0.162, p = 0.024) and waist circumference (r = 0.181, p = 0.012). Score of the general health
    component was negatively correlated with BMI (r = -0.161, p = 0.025), waist circumference (r = -0.194, p = 0.007) and
    body fat percentage (r = -0.191, p = 0.008). Physical functioning score was lowest in obese subjects than normal and
    pre-obese subjects (p = 0.046). Score of the bodily pain component was positively correlated with waist circumference (r
    = 0.156, p = 0.030). Obesity is associated with number of sick leave days and quality of life in the studied group. Hence,
    body weight of the security staff should be monitored and appropriate intervention should be conducted to improve their
    work attendance and quality of life.
  2. Arumugam A, Tan SE, Tan SL, Tan JE, Hussin FH, Zenian MS, et al.
    Malays J Med Sci, 2023 Jun;30(3):93-102.
    PMID: 37425386 DOI: 10.21315/mjms2023.30.3.8
    BACKGROUND: Intracerebral haemorrhage (ICH) can be devastating, particularly if haematoma expansion occurs. The efficacy of tranexamic acid (TXA), an anti-fibrinolytic agent, in reducing haematoma expansion is now being studied worldwide. However, the optimal dosage of TXA has yet to be determined. This study was designed to further establish the potential of different doses of TXA.

    METHODS: A double-blinded, randomised, placebo-controlled study was carried out among adults with non-traumatic ICH. Eligible study subjects were randomly assigned to receive placebo, 2-g TXA treatment or 3-g TXA treatment. Haematoma volumes before and after intervention were measured using the planimetric method.

    RESULTS: A total of 60 subjects with 20 subjects in each treatment group were recruited for this study. Among the 60 subjects, the majority were male (n = 36, 60%), had known cases of hypertension (n = 43, 71.7%) and presented with full Glasgow coma scale (GCS) (n = 41, 68.3%). The results showed that there was no statistically significant difference (P = 0.315) in the mean changes of haematoma volume when compared with three study groups using ANCOVA, although the 3-g TXA group was the only group that showed haematoma volume reduction (mean reduction of 0.2 cm3) instead of expansion as in placebo (mean expansion 1.8 cm3) and 2-g TXA (mean expansion 0.3 cm3) groups. Good recovery was observed in all study groups, with only three subjects being moderately disabled. No adverse effects were reported in any of the study groups.

    CONCLUSION: To the best of our knowledge, this is the first clinical study using 3 g of TXA in the management of non-traumatic ICH. From our study, 3 g of TXA may potentially be helpful in reducing haematoma volume. Nonetheless, a larger-scale randomised controlled trial should be carried out to further establish the role of 3 g of TXA in non-traumatic ICH.

  3. Yap TC, Tan SE, Yap WN, Melchior RG, Bong JN, Wan Mohd Azaharuddin WNS, et al.
    Malays J Med Sci, 2026 Aug;33(4):140-157.
    PMID: 42936808 DOI: 10.21315/mjms-02-2026-113
    BACKGROUND: Access to neurosurgical care in remote regions remains challenging because of the uneven distribution of specialists, transportation limitations, and infrastructure constraints. For many years, patients from East Coast Sabah relied on transfer to Queen Elizabeth Hospital, Kota Kinabalu, for emergency and elective neurosurgical care, often requiring long-distance evacuation. This study describes the phased development of a decentralised neurosurgical service in Tawau and evaluates associated regional service trends.

    METHODS: This descriptive historical vignette and service evaluation reviewed aggregated neurosurgical data from Tawau Hospital, Duchess of Kent Hospital (Sandakan), and Lahad Datu Hospital from 2019 through April 2026. Service activity was analysed across three phases: the flying surgeon model, rotational specialist postings, and permanent specialist deployment. Referrals, admissions, outpatient attendance, operative activity, interhospital transfers, and mortality were evaluated descriptively.

    RESULTS: The East Coast Sabah Neurosurgical Service evolved from a monthly visiting service to rotational specialist coverage and, ultimately, a permanent Tawau-based hub in 2025. Referrals, outpatient attendance, and operative workload increased progressively across the three phases. Mean annual referrals increased from 1,388 to 1,802 and reached an annualised 2,130 during early Phase 3. Annual outpatient attendance increased from 1,117 to 1,675, with an annualised total of 2,526 visits. Operative volume increased from 202 to 366, with an annualised total of 374 procedures, while the proportion of elective procedures rose from 1.9% to 16.5%. Crude inpatient mortality rates were 5.8%, 4.9%, and 3.2% across the three phases. Following establishment of the permanent hub, emergency transfers from Tawau decreased from approximately 35 per year during Phase 2 to an annualised 18 per year during early Phase 3, corresponding to a crude administrative estimate of annual government cost avoidance of approximately RM425,000 to RM680,000 through reduced emergency air evacuations.

    CONCLUSION: The phased decentralisation of neurosurgical services in Tawau was associated with expanded local capacity, improved continuity of care, and reduced reliance on transfers to a tertiary referral centre for selected neurosurgical conditions.

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