Displaying publications 1 - 20 of 1064 in total

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  1. López-Muñoz F, Povedano-Montero FJ, Chee KY, Shen WW, Fernández-Martín P, García-Pacios J, et al.
    Malays J Med Sci, 2018 May;25(3):40-55.
    PMID: 30899186 DOI: 10.21315/mjms2018.25.3.5
    Objective: We carried out a bibliometric study on the scientific papers related to second-generation antipsychotic drugs (SGAs) in Malaysia.

    Methods: With the SCOPUS database, we selected those documents made in Malaysia whose title included descriptors related to SGAs. We applied bibliometric indicators of production and dispersion, as Price's law and Bradford's law, respectively. We also calculated the participation index of the different countries. The bibliometric data were also been correlated with some social and health data from Malaysia (total per capita expenditure on health and gross domestic expenditure on R&D).

    Results: We found 105 original documents published between 2004 and 2016. Our results fulfilled Price's law, with scientific production on SGAs showing exponential growth (r = 0.401, vs. r = 0.260 after linear adjustment). The drugs most studied are olanzapine (9 documents), clozapine (7), and risperidone (7). Division into Bradford zones yields a nucleus occupied by the Medical Journal of Malaysia, Singapore Medical Journal, Australian and New Zealand Journal of Psychiatry, and Pharmacogenomics. Totally, 63 different journals were used, but only one in the top four journals had an impact factor being greater than 3.

    Conclusion: The publications on SGAs in Malaysia have undergone exponential growth, without evidence a saturation point.

  2. Chan CH, Ziyadi GM, Zuhdi MA
    Malays J Med Sci, 2019 May;26(3):49-63.
    PMID: 31303850 MyJurnal DOI: 10.21315/mjms2019.26.3.4
    BACKGROUND: Perioperative red blood cell (RBC) transfusion in coronary artery bypass grafting (CABG) has both benefits and harms. Our aim was to study the association between perioperative RBC transfusion and its adverse outcomes.

    METHODS: This was a retrospective study of patients who underwent isolated CABG in Hospital Universiti Sains Malaysia, Kelantan, Malaysia, from 1 January 2013 until 31 December 2017. Data were collected from medical records, and comparisons were made between patients who received perioperative RBC transfusions and those who did not have adverse outcomes after CABG.

    RESULTS: A total of 108 patients who underwent isolated CABG were included in our study, and 78 patients received perioperative RBC transfusions. Patients who received perioperative RBC transfusions compared to those who did not were significantly more likely to develop prolonged ventilatory support (21.8% versus 0%, P = 0.003), cardiac morbidity (14.1% versus 0%, P = 0.032), renal morbidity (28.2% versus 3.3%, P = 0.005) and serious infection (20.5% versus 3.3%, P = 0.037). With each unit of packed RBC transfusions, there was a significantly increased risk of prolonged ventilatory support (adjusted odds ratio [AOR] = 1.45; 95% confidence interval [CI] = 1.20-1.77; P < 0.001), cardiac morbidity (AOR =1.40; 95%CI = 1.01-1.79; P = 0.007), renal morbidity (AOR = 1.23; 95%CI = 1.03-1.45; P = 0.019) and serious infection (AOR = 1.31; 95%CI = 1.07-1.60; P = 0.009).

    CONCLUSION: Perioperative RBC transfusion in isolated CABG patients is associated with increased risks of developing adverse events such as prolonged ventilatory support, cardiac morbidity, renal morbidity and serious infection.

  3. Zolkefli Y
    Malays J Med Sci, 2021 Oct;28(5):137-141.
    PMID: 35115896 DOI: 10.21315/mjms2021.28.5.14
    Gift giving is generally well-intentioned and graciously accepted to healthcare professionals but it is also one of the concerns that cause an ethical dilemma in health care. Is the gift giving ethically appropriate? Tangible guidance about how healthcare professionals would respond to gift giving is possibly scarce and non-specific. In cases where there is an absence of hospital policy specifying how to treat patients' gifts, healthcare professionals may need to reflect several factors when addressing the dilemmas. This factor includes a reflection on the implications of responding to the gifts.
  4. Zolkefli Y
    Malays J Med Sci, 2018 May;25(3):135-139.
    PMID: 30899195 DOI: 10.21315/mjms2018.25.3.14
    Can a lie be justified if it saves a human life or a community, or if another great evil is avoided? The article proposes that health professionals need not always tell the truth, depending on situation; but, this does not refute the significance of telling the truth. It also elucidates the value of telling the truth, and the challenges for telling the whole truth. Two prominent theories of ethics, Deontological and Consequentialism are deliberated, together with the integration of examples to illustrate main areas of interest.
  5. Zolkefli Y
    Malays J Med Sci, 2021 Apr;28(2):157-160.
    PMID: 33958969 DOI: 10.21315/mjms2021.28.2.14
    People suffering from mental health conditions are often unwilling to reveal their status and this includes health professionals. They may wrestle with the pros and cons of revealing their health status to their employer in particular as they seek to reconcile personal privacy with professional duty. There is no simple, clear consensus as to whether they have a moral duty to share the information voluntarily or explicitly to share it with the employer. Additionally, there is a concern as to whether a degree of non-disclosure is justifiable to protect the privacy of health care professionals in some circumstances. Decisions surrounding the disclosure of a mental health problem are nuanced and may require that competing needs and values be reconciled. Although self-declared mental health status is an intrinsic moral good, the healthcare professional needs to feel confident and ready to come forward.
  6. Zolkefli Y
    Malays J Med Sci, 2020 Dec;27(6):144-147.
    PMID: 33447141 DOI: 10.21315/mjms2020.27.6.13
    We recognise that people lie to health professionals for several reasons. However, these incidents endanger the well-being of the professionals and bring us to the question of whether people have an exclusive moral duty to always profess the truth about their health and other facts, particularly in a pandemic crisis. This review argues that an honest patient is a key to undertaking their roles as health professionals and delivering the best services possible to meet the needs of the patient. Greater awareness and comprehension of the potential ramifications of dishonesty, not only helps establish the moral obligation, to tell the truth, particularly in a pandemic situation, but also translates into a better relationship with health professionals. It also enforces an ethical solidarity on every single of us to show tangible moral response to ensure that those most vulnerable to risks from the pandemic illness such as health professionals are protected as far as possible.
  7. Faisham WI, Mohammad P, Juhara H, Munirah NM, Shamsulkamaruljan H, Ziyadi GM
    Malays J Med Sci, 2011 Apr;18(2):74-7.
    PMID: 22135591
    We report a case of open fracture of the clavicle with subclavian artery and vein laceration and perforation of the parietal pleural below the first rib that caused massive haemothorax. Emergency thoracotomy and exploration followed by repair of both vessels were able to salvage the patient and the extremity.
  8. Kannan TP, Zilfalil BA
    Malays J Med Sci, 2009 Apr;16(2):4-9.
    PMID: 22589651 MyJurnal
    Fifty years have elapsed since the discovery of the number of human chromosomes in 1956. Newer techniques have been developed since then, ranging from the initial conventional banding techniques to the currently used molecular array comparative genomic hybridisation. With a combination of these conventional and molecular techniques, cytogenetics has become an indispensable tool for the diagnosis of various genetic disorders, paving the way for possible treatment and management. This paper traces the history and evolution of cytogenetics leading up to the current state of technology.
  9. Asha'ari ZA, Suhaimi Y, Fadzil A, Zihni M
    Malays J Med Sci, 2012 Oct;19(4):84-7.
    PMID: 23613654 MyJurnal
    Acquired subglottic cyst in infancy is almost always associated with episodes of early life intubation. Most cases typically presented late, usually days to months after extubation. We report a case of a subglottic cyst with different presentation than the norm. This case highlights that subglottic cyst can present acutely, and rapidly enlarging soon after the airway extubation. As the management of a large subglottic cyst can be challenging, a close observation for early diagnosis and intervention are recommended post extubation in the high-risk cases, such as in the premature infant.
  10. Mustika R, Yo EC, Faruqi M, Zhuhra RT
    Malays J Med Sci, 2021 Oct;28(5):108-117.
    PMID: 35115893 DOI: 10.21315/mjms2021.28.5.11
    Background: The coronavirus disease 2019 (COVID-19) pandemic has been found to negatively affect medical students' wellbeing. This finding may be related to how medical education is being conducted at present, with online learning replacing face-to-face teaching in many countries. This cross-sectional study aims to assess how the online learning environment is connected to medical students' wellbeing.

    Methods: A self-administered online questionnaire was distributed to undergraduate medical students at Universitas Indonesia. The study was conducted from September 2020 to February 2021. The questionnaire included a modified version of the Online Learning Environment Scale (OLES) and the Positive Emotion, Engagement, Relationships, Meaning and Accomplishment (PERMA) profiler. The OLES was used to evaluate students' perceptions of the online learning environment, whereas the PERMA Profiler was used to evaluate students' wellbeing. We validated the questionnaire before distribution. The content validity index was 1.0, with internal consistency coefficients of 0.87 and 0.89, respectively. Regression analyses were performed to evaluate the relationship between OLES and PERMA scores.

    Results: The questionnaire was completed by 274 undergraduate medical students. Students reported moderate to high degrees of positive perception towards online learning, high levels of positive emotions and moderate levels of negative emotions. Statistically significant differences were found across groups based on students' gender, year of study and academic programme. Almost all aspects of the online learning environment were significantly predictive of students' wellbeing, with personal relevance and evaluation and assessment being the two most important predictors (R 2 = 0.201; P < 0.001).

    Conclusion: Medical students generally enjoyed online learning, although some challenges were presented. The online learning environment was positively associated with students' wellbeing; however, some students expressed negative emotions including loneliness, anxiety, anger and sadness.

  11. Muthanna A, Salim HS, Hamat RA, Shamsuddin NH, Zakariah SZ
    Malays J Med Sci, 2018 Nov;25(6):6-21.
    PMID: 30914875 MyJurnal DOI: 10.21315/mjms2018.25.6.2
    This review highlights the clinical scoring tools used for the management of acute pharyngotonsillitis in primary care clinics. It will include the prevalence of group A pharyngotonsillitis among children and adults worldwide and the selective tests employed for diagnosing group A streptococcal pharyngotonsillitis. Pharyngotonsillitis is one of the common reasons for visits to primary care clinics worldwide, and physicians tend to prescribe antibiotics according to the clinical symptoms, which leads to overprescribing antibiotics. This in turn may lead to serious health impacts and severe reactions and may promote antibiotic resistance. These significantly add on to the health care costs. The available information from health organisations and previous studies has indicated the need to manage the diagnosis of pharyngotonsillitis to improve prescribing habits in primary care clinics.
  12. Abdul Rahim R, Eng Hong G, Nik Ismail NA, Zakaria R
    Malays J Med Sci, 2021 Dec;28(6):55-63.
    PMID: 35002490 DOI: 10.21315/mjms2021.28.6.6
    Background: Benign prostatic hyperplasia (BPH) is associated with severe lower urinary tract symptoms (LUTS). The severity of LUTS is assessed by the International Prostate Symptoms Score (IPSS). Prostate artery embolisation (PAE) is a newly available method for combating LUTS. This study aims to assess the outcomes of PAE in reducing LUTS and prostate volume in patients with BPH.

    Methods: Patients diagnosed with BPH with severe LUTS who had undergone PAE were included. Their IPSS score was ≥ 20 despite medical therapy. PAE was performed via the unilateral femoral artery using various types of embolic material. Bilateral or unilateral embolisation of the prostate artery was considered a technical success. The severity of LUTS pre- and post-PAE were assessed using IPSS while prostate volume pre- and post-PAE were assessed by ultrasound and magnetic resonance imaging (MRI).

    Results: Ninety percent of patients had technical success and one required transurethral resection of the prostate (TURP). The mean IPSS reduction at the final follow-up was 12.9 (P < 0.028). The mean reduction of prostate volume at the last follow-up by ultrasound was 114.99 mL (P < 0.028) and by MRI was 29.17 mL (P < 0.028).

    Conclusion: PAE is safe and effective in reducing severe LUTS and prostate gland volume in BPH patients.

  13. Mat MAC, Yaacob LH, Zakaria R
    Malays J Med Sci, 2020 Feb;27(1):124-133.
    PMID: 32158352 MyJurnal DOI: 10.21315/mjms2020.27.1.13
    Introduction: Acceptance of a screening programme for thalassemia is important in managing the disease and its associated complications. The objective of this study was to determine the knowledge of thalassemia and factors associated with thalassemia screening refusal among parents of secondary school children.

    Methods: This cross-sectional study was carried out from May 2017 to October 2017 among parents of fourth form students in three schools in Besut, Terengganu, Malaysia. Parents who are able to read and understand Malay and consented to the study were required to answer a validated questionnaire on their knowledge regarding thalassemia. They were also asked the reason for their acceptance or refusal of the thalassemia screening of their children.

    Results: In total, 273 participants took part in the study. The mean thalassemia knowledge score was 11.8 out of a maximum score of 21. Low knowledge scores (adjusted odds ratio [adj OR] 0.87; 95% confidence interval [CI]: 0.79, 0.95; P = 0.002) and female sex (adj OR 2.60; 95% CI: 1.04, 6.53; P = 0.040) had significant associations with parental thalassemia screening refusal. The main reason for screening refusal was that parents perceived that their children were not at risk for the disease since they did not have a family member with thalassemia.

    Conclusion: The mean thalassemia knowledge score among parents remains unsatisfactory. A high knowledge score is important since it is associated with parental acceptance of thalassemia screening for their children.

  14. Pei Lin L, Zakaria NS
    Malays J Med Sci, 2013 Jan;20(1):60-8.
    PMID: 23785256 MyJurnal
    Accurate medical information is essential among health care professionals to aid dissemination of information to the public. This study aimed to determine the level of knowledge about breast cancer and to identify related factors among undergraduate health sciences students in a public university in Terengganu, Malaysia.
  15. Lee CY, Yusof HM, Zakaria NS
    Malays J Med Sci, 2019 Sep;26(5):122-131.
    PMID: 31728124 MyJurnal DOI: 10.21315/mjms2019.26.5.11
    Background: Body-image perception is one of the determinants in weight management, especially among adolescents. This study aimed to assess weight-control knowledge, attitude and behaviours along with body-image perceptions among Chinese high school students in order to compare the weight-control behaviours with those perceptions.

    Methods: A cross-sectional study was conducted among 277 Chinese students in Form 1 and Form 2 in Pulau Pinang, Malaysia using convenience sampling. The following outcomes were evaluated: weight-control knowledge, attitude and behaviours (weight-related knowledge and attitude questionnaire; weight control strategies scale) and body-image perceptions (figure rating scale).

    Results: Both genders were found to have high weight-control knowledge, with female adolescents scoring significantly higher than male adolescents (P = 0.010). However, only half of the adolescents (50.9%) perceived that obesity is bad for health. Although only 44.4% of adolescents were dissatisfied with their current weight status, 62.8% intended to change their present weight status. Male adolescents significantly engaged more in physical activity (PA) (P = 0.035) and self-monitoring (SM) (P = 0.014) compared to their female counterparts. Furthermore, male adolescents chose their current body size as their ideal body image, but female adolescents preferred a slimmer ideal figure. The percentage of male and female adolescents who desired a smaller body figure was 39.6% and 54.5%, respectively. Lastly, there was no significant difference between weight-control behaviours and adolescents' body-image perceptions.

    Conclusion: Female Chinese adolescents had higher weight-control knowledge and preferred a slimmer body size, yet males were more likely to engage in PA and SM behaviours. Essentially, imprecise attitude towards obesity among half of the Chinese high school students is of particular concern.
  16. Samsudin EZ, Isahak M, Rampal S, Rosnah I, Zakaria MI
    Malays J Med Sci, 2021 Apr;28(2):142-156.
    PMID: 33958968 DOI: 10.21315/mjms2021.28.2.13
    Background: Research suggests that junior doctors often experience workplace bullying, which may have adverse impacts on medical training and delivery of quality healthcare. However, evidence among local population has not been established. The present study aims to examine the prevalence of workplace bullying among Malaysian junior doctors and explore its associated sociodemographic and employment factors.

    Methods: A multicentre cross-sectional study was conducted in 12 government hospitals accredited for housemanship training within the central zone of Malaysia. The study included a total of 1,074 house officers who had been working for at least 6 months in various housemanship rotations. The Negative Acts Questionnaire-Revised (NAQ-R) was used to examine workplace bullying.

    Results: The 6-month prevalence of workplace bullying among study participants was 13%. Work-related bullying such as 'being ordered to do work below your level of competence', person-related bullying such as 'being humiliated or ridiculed in connection with your work', and physically intimidating bullying such as 'being shouted at or being the target of spontaneous anger' were commonly reported by study participants. Medical officers were reported to be the commonest perpetrators of negative actions at the workplace. Study participants who graduated from Eastern European medical schools (adjusted odds ratio [AOR] 2.27; 95% confidence interval [CI]: 1.27, 4.07) and worked in surgical-based rotation (AOR 1.83; 95% CI: 1.13, 2.97) had higher odds of bullying compared to those who graduated from local medical schools and worked in medical-based rotation, whereas study participants with good English proficiency (AOR 0.14; 95% CI: 0.02, 0.94) had lower odds of bullying compared to those with poor English proficiency.

    Conclusion: The present study shows that workplace bullying is prevalent among Malaysian junior doctors. Considering the gravity of its consequences, impactful strategies should be developed and implemented promptly in order to tackle this serious occupational hazard.

  17. Othman A, Idris Z, Rosman AK, Abdullah JM, GhanI ARI, Zakaria AZ
    Malays J Med Sci, 2022 Oct;29(5):48-58.
    PMID: 36474530 DOI: 10.21315/mjms2022.29.5.6
    BACKGROUND: Cognitive impairment (CI) and neuropsychiatry manifestation (NM) are known complications among patients with traumatic brain injury (TBI). However, the clinical correlation between mild and moderate TBI with the above have not been extensively studied.

    METHODS: The patients (n = 54) were divided into mild and moderate TBI. Both groups were assessed at 3 months and 6 months post-trauma for the same measures. Diagnosis of CI was done using the Montreal cognitive assessment (MoCA) questionnaire while NM screening was performed using the 12-items General Health Questionnaire (GHQ-12) followed by MINI International Neuropsychiatry Interview (MINI).

    RESULTS: We found five patients (19.2%) with mild TBI had CI and five patients (19.2%) had NM at 3 months. Only one patient (3.8%) persistently has CI at 6 months while the rest recovered. As for moderate TBI, 11 patients (39.3%) had CI and seven patients (25%) had NM at 3 months but none had persistent CI or NM at 6 months. Age (P < 0.05) and blood pressure were significant risks (P < 0.05) for CI and NM at 3 months.

    CONCLUSION: This study highlighted the importance of screening following mild and moderate TBI at 3 months and 6 months. Early recognition facilitates effective rehabilitation programmes planning hence improve prognosis in the future.

  18. Biswal BM, Ruzman N, Ahmad NM, Zakaria A
    Malays J Med Sci, 2000 Jan;7(1):54-9.
    PMID: 22844216 MyJurnal
    Short course hypo-fractionated radiotherapy is a standard regime for the palliation of stage IV head and neck cancers. However few patients respond favorably and require further radiotherapy in curative intent. We have used split-course radiotherapy technique to find out this conversion rate from palliative to curative intent. This was a prospective study conducted from November 1998 to October 1999; twenty-six (26) patients with stage IV head & neck cancers were treated with a hypofractionated regime of radiotherapy. A tumor dose of 30 Gy in 10 fractions [time dose fraction (TDF) 62] over 2 weeks was delivered using a 6 MV linear accelerator. A conventional 2 field or 3 field technique was used. Patients were assessed for the regression of tumor on fifth day, tenth day of radiotherapy and 4 weeks after the completion of radiotherapy. Patients showing complete response and good partial response were allowed to receive further radiotherapy of 30 Gy in 15 fractions [TDF 49]. There were 21 males and 5 females in the study with a median age of 44 years (range 19-77 years). All patients completed the initial regime. Complete responses were observed among 14 patients (54%); partial response in 6 patients (23%), and no response was seen among 6 patients (23%). Sixteen patients (61%) were suitable for radical radiotherapy after phase-I course of the above schedule. Seventeen patients (65%) showed an improvement in the general well being with a better quality of life. One year actuarial survival was (76%), with a median survival time of 12 months. Split-course technique is a useful radiotherapy treatment in stage IV head and neck cancers to distinguish between the subset of patients who would require curative treatment and who would not.
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