MATERIALS AND METHODS: A retrospective record review was carried out, utilising secondary data obtained from the TB registry of Selangor and Wilayah Persekutuan Kuala Lumpur. All registered DR-TB cases between 2016 and 2020 that met the study criteria were analysed descriptively using SPSS software version 27.
RESULTS: Of 443 cases of registered DR-TB over 5 years, 430 cases fulfilled the study criteria. The prevalence of DR-TB increased from 0.27 to 1.79 per 100,000 population between 2016 and 2020. The average age was 40.96 years, majority were males (70.7%), Malaysian (79.3%), with Malays comprising 50.2%. Most patients had up to secondary school education (51.9%), married (57.0%), employed (53.3%) and 34.9% were smokers. For clinical characteristics, 23.5% had diabetes, and 10.9% were HIVpositive. Retreatment cases accounted for half the total, and 83.9% had positive smear results. Minimal chest X-ray lesions were observed in 54.4% of cases. The majority (66.7%) received supervised treatment from healthcare providers after being diagnosed with DR-TB, and 37.4% had more than one anti-TB resistance. Favourable treatment outcomes were observed in 56.7% of cases, while 42.1% had unfavourable outcomes, mainly due to loss to follow-up (49.7%), death (42.6%) and treatment failure (7.7%).
CONCLUSION: The rising cases of DR-TB call for comprehensive public health interventions and stakeholder commitment to reduce its occurrence and transmission. These findings provide valuable guidance for policymakers in strengthening DR-TB control and prevention strategies.
OBSERVATIONS: Thirty-eight previous parasite studies in rodents conducted in Malaysia were reviewed, and 44 ectoparasites species and 58 endoparasites species across 19 rodent species were revealed. Six ectoparasite and eight endoparasite species were identified as zoonotic among these parasites. Morphological identification of parasite species typically succeeded only at the genus level because of their identical morphological characteristics. However, these studies used a molecular approach to identify parasites at the species level using species-specific primers. The pathological findings of various organs of infected rodents were also summarized, including gross and histological lesions exhibited by parasites.
CONCLUSIONS AND RELEVANCE: This review highlights the list of parasites infecting rodents in Malaysia, provides information on the molecular and pathological findings from previous studies, and identifies some of the limitations and knowledge gaps that suggest future research to address the issues, including the paucity of information on blood parasites, molecular, and histopathological studies of parasites in rodents.
METHODS: This study is a cross-sectional study information was gathered from among 353 secondary school students in the Klang Valley using a questionnaire. The instrument that was used in this study was Pittsburgh Sleep Quality Index (PSQI) Malay version, screen-based media usage (SCREENS-Q) and Hopkins Symptom Check List-25 (HSCL-25) Malay version. The sampling method was stratified and convenience sampling method. The analysis study used the Smart Partial least squares (PLS) method to analyze the data.
RESULTS: Using the Smart PLS technique, we examined the relationship between these variables and identified revealed that screen time has a direct, positive, and significant impact on anxiety level (Mean = 0.134, β = 0.123, p 0.05) and depression (Mean = 0.044, β = 0.043, p
MATERIALS AND METHODS: A total of 119 AA patients had been identified from hospital records of the involved sites, namely Queen Elizabeth Hospital in Sabah, Sarawak General Hospital, Sibu Hospital, Miri Hospital and Bintulu Hospital in Sarawak from Jan 2006 to Dec 2017.
RESULTS: The median age at diagnosis was 46 years, and native ethnic group from Sabah, Kadazan-Dusun, recorded the highest percentage of 41.2%, which could be explained by higher frequency of HLA-DRB1*15:01, an alelle linked to increased risk of AA, among this ethnic group. The majority of patients (59.7%) received cyclosporine (CsA) as monotherapy or in combination with other non-IST agents such as danazol, which was instituted in 48.7% of the patients, while a third of them (33.7%) received antithymocyte globulin (ATG) therapy with or without CsA, and 12.4% underwent allogenic SCT. The five-year overall survival (OS) for all AA patients was 76.1%. Elderly patients >60 years old and those with severe disease had more inferior 5-year survival.
CONCLUSION: A prospective study is warranted to determine the true incidence rate, epidemiological distributions, treatment outcome and overall survival of AA patients in Malaysia. Establishment of allogenic SCT in East Malaysia is imperative to make this curative therapy more accessible to patients with severe disease and improve the outcome.
PURPOSE: To assess the feasibility of a Fracture Liaison Service in Malaysia and to benchmark our service against the International Osteoporosis Foundation Best Practice Framework.
METHODS: This feasibility study was conducted at a tertiary hospital in Malaysia from March 2021 to March 2022. Patients aged ≥ 50 years admitted with fragility fractures were recruited. Excluded were those with poor prognosis or transferred out from the hospital during admission. Patients were screened, assessed, and followed up at months 4 and 12 post-fracture presentations. Data was collected using Microsoft Excel and the REDCap database. The feasibility of the Fracture Liaison Service was evaluated using the typology of feasibility.
RESULTS: A total of 140 patients (female (93/140, 66.4%), median age 77 (IQR 72, 83), hip fractures (100/140, 65.8%)) were recruited into the Fracture Liaison Service. The recruitment rate was (140/215, 65.1%), as some patients were "missed" due to the COVID-19 pandemic. The completion rate was high (101/114, 88.6%). Among those indicated for antiosteoporosis medication, 82/100 (82%) were initiated on treatment. Various "Best Practice Standards," such as patient evaluation (140/140, 100%), fall prevention (130/140, 92.9%), and medication review standards (15/15, 100%) were high. Complicated referral pathways, inexperienced staff, lack of resources, and communication issues were some of the barriers identified while implementing the Fracture Liaison Service. Challenges were overcome by modifying the service workflow and coordinating with different departments.
CONCLUSION: The Fracture Liaison Service was found to be feasible in Malaysia. It demonstrated promise in improving bone health management; however, several changes were needed to adapt the service to suit our environment.
METHODS: A cross-sectional study was conducted online using Google Forms™. Sociodemographic as well as work and workplace data were collected. The Job Demand Inventory, Physicians' Lack of Professional Autonomy, and Health Professions Stress Inventory questionnaires were used to assess the job demand score, job autonomy score, and the level of work-related stress, respectively. Multiple linear regression was performed to determine the significant factors associated with higher work-related stress.
RESULTS: A total of 301 PCDs participated in this study with the majority being female (76.1%), Malay (67.8%), married (73.1%), medical officers (68.8%), and worked in urban (70.4%) and public primary care clinics (83%). The mean (SD) score for work-related stress was 62.8 (18.4), (score range 0-120). PCDs who had any degree of worry about being alienated by friends and relatives because of close contact with COVID-19 patients had higher work-related stress levels compared to PCDs who did not have any worry [rarely (b = 10.23, 95% CI:5.57, 14.89), sometimes (b = 10.41, 95% CI:5.68, 15.13), often (b = 10.12, 95% CI:4.16, 16.08), and always (b = 14.65, 95% CI:7.43, 21.89)]. The other significant factor was higher job demand scores (b = 1.13, 95% CI:0.91, 1.35). In contrast, PCDs who always received support from supervisors at their workplace were found to have lower work-related stress levels compared to those who did not receive any support (b=-5.65, 95% CI:-10.38, -0.93).
CONCLUSIONS: The level of work-related stress among Malaysian PCDs during the COVID-19 pandemic was higher compared to American PCDs and Malaysian physicians before the pandemic but lower compared to Australian emergency physicians during the pandemic. Urgent measures to address the above-mentioned associated factors should be implemented as another pandemic may be just around the corner.
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.
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: 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 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: 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.
METHODS: Clinical data, including age at symptom onset, was collected from 289 patients who presented to our multidisciplinary clinic from 2016 until 2024. A least squares linear regression model was constructed from the logarithm of approximated incidence and the logarithm of age. Population incidence was approximated by adjusting the absolute numbers of patients in 5 year groups by the size of the general population in the respective age group.
RESULTS: A linear relationship between log of incidence versus log of age was observed, with a slope of 4.57 (95% CI, 3.3-5.8) and an r2 value of 0.93, suggesting a 6-step process.
CONCLUSION: Progression toward symptom onset in Malaysian ALS patients appears consistent with a multistep model of disease as observed in other cohorts.
METHODS: A prospective observational study was conducted at Hospital Raja Permaisuri Bainun (HRPB), Hospital Sultanah Aminah (HSA), and University of Malaya Medical Centre (UMMC) over a 8 month period. Data were collected from mothers of neonates born with congenital abnormalities, and the Spielberg State-Trait Anxiety Inventory (STAI) was used to assess maternal anxiety.
RESULTS: A total of 58 patients were recruited. The overall antenatal detection rate for congenital abnormalities was 43.1%, comparable to high-income countries despite resource limitations. Antenatal counselling by pediatric surgeons was rare (6.9%) and showed no significant reduction in maternal anxiety (p = 0.374).
CONCLUSION: The antenatal detection rates at the three Malaysian centers align with those in more developed nations, underscoring the potential of middle-income healthcare systems to deliver high-quality prenatal care. However, improving access to diagnostic technologies and involving pediatric surgical teams in antenatal counselling could further enhance care.