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  1. Martono, Fatmawati F, Mulyanti S
    Malays J Med Sci, 2023 Jun;30(3):84-92.
    PMID: 37425387 DOI: 10.21315/mjms2023.30.3.7
    The case of coronavirus disease (COVID-19) has become a global crisis. In addition, more variants of the virus have been discovered with easier transmission and more harmful effects. Thus, understanding the risk factors associated with the susceptibility and severity of COVID-19 is critical for disease control. This review article aims to describe the risk factors associated with the severity of COVID-19. This study uses the article review method from research results obtained through searching the journal sites Google Scholar, PubMed, ProQuest and ScientDirect in the 2020-2021 period. To find articles that match the inclusion criteria we used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) strategy. A total of nine studies met the inclusion criteria for this review. These nine studies were assessed for quality, data extraction and synthesis. Risk factors that contribute to the severity of COVID-19 are age, gender, chronic comorbidities, cardiovascular disease, diabetes, hypertension, kidney failure, cancer and a history of smoking. New findings, unvaccinated patients are at higher risk of severity. Risk factors associated with the severity of COVID-19 include a person's individual characteristics, co-morbidities, smoking history and unvaccinated.
  2. Bohang SAM, Sohaimi N
    Malays J Med Sci, 2023 Jun;30(3):60-72.
    PMID: 37425388 DOI: 10.21315/mjms2023.30.3.5
    The increasing utilisation of computed tomography (CT) in the medical field has raised a greater concern regarding the radiation-induced health effects as CT imposes high radiation risks on the exposed individual. Adherence to radiation protection measures in CT as endorsed by regulatory bodies; justification, optimisation and dose limit, is essential to minimise radiation risks. Islam values every human being and Maqasid al-Shari'ah helps to protect human beings through its sacred principles which aim to fulfil human beings' benefits (maslahah) and prevent mischief (mafsadah). Alignment of the concept of radiation protection in CT within the framework of al-Dharuriyat; protection of faith or religion (din), protection of life (nafs), protection of lineage (nasl), protection of intellect ('aql) and protection of property (mal) is essential. This strengthens the concept and practices of radiation protection in CT among radiology personnel, particularly Muslim radiographers. The alignment provides supplementary knowledge towards the integration of knowledge fields between Islamic worldview and radiation protection in medical imaging, particularly in CT. This paper is hoped to set a benchmark for future studies on the integration of knowledge between the Islamic worldview and radiation protection in medical imaging in terms of other classifications of Maqasid al-Shari'ah; al-Hajiyat and al-Tahsiniyat.
  3. Liew TK, Yong GY, Zainal Abidin Z, Asnir ZZ
    Malays J Med Sci, 2023 Jun;30(3):135-142.
    PMID: 37425384 DOI: 10.21315/mjms2023.30.3.12
    BACKGROUND: The article aims to study the demographics and clinical characteristics of ocular trauma patients presenting to the Eye Casualty Clinic between COVID-19 and non-COVID-19 era in Ampang Hospital, Malaysia.

    METHODS: In this cross-sectional study, data of patients presented with ocular trauma injury to the Ampang Hospital during the COVID-19 era from 18 March 2020 to 17 September 2020 were retrieved and compared with the similar period of the previous non-COVID-19 era year.

    RESULTS: Among the total number of 453 patients, 76.82% (n = 348) were predominantly males. The commonest age group was between 21 years old-40 years old (49.45%, n = 224), and the commonest location of ocular trauma injury occurred at the workplace (38.19%, n = 173); welding was the commonest work-related injury (13.83% in 2019; 12.50% in 2020). Injury-to-treatment time was significantly longer during the COVID-19 era, where patients who sought treatment within a day of injury were 27.27% (n = 69) in 2019 and 18.50% (n = 37) in 2020 (P = 0.030). During the COVID-19 pandemic, patients with vision worse than 6/60 on presentation were higher at 8% compared with 3.56% before the COVID-19 pandemic (OR = 2.35; 95% CI: 1.01, 5.48; P = 0.047). Similarly, patients with a vision worse than 6/60 post-treatment during the COVID-19 period were significantly higher at 7.00% compared with 1.58% before the COVID-19 pandemic (OR = 4.72; 95% CI: 1.53, 14.62; P = 0.007).

    CONCLUSION: The majority of ocular trauma cases in this study population were male adults between 21 years old and 40 years old, and welding was the commonest work-related injury. COVID-19 era has a higher percentage of patients presented with severe visual impairment, longer injury-to-treatment time and poorer post-treatment visual outcomes.

  4. Abdul Aziz NA, Baharudin NS, Alias NA
    Malays J Med Sci, 2023 Jun;30(3):176-183.
    PMID: 37425381 DOI: 10.21315/mjms2023.30.3.16
    INTRODUCTION: A high level of perceived social support can lessen stress. However, the lack of knowledge on stress and perceived social support among students during the coronavirus disease (COVID-19) pandemic was explored. Thus, this study aimed to investigate the relationship between stress and perceived social support among undergraduate Health Sciences students.

    METHODS: A convenience sampling method was used in a cross-sectional study of 290 undergraduate Health Sciences students in public universities. The Perceived Stress Scale (PSS-10) was used to measure the perception of stress, and the Multidimensional Scale of Perceived Social Support (MSPSS) was used to measure perceived social support from three sources, including family, friends and significant others.

    RESULTS: A statistically significant correlation was found between the stress level and the total score of the MSPSS (r = -0.432), perceived social support from family (r = -0.429), significant others (r = -0.328), and friends (r = -0.219, P < 0.001). Over three-quarters (73.4%) of the students have a moderate stress level (mean = 21.17, SD = 5.75). The highest social support perceived was from a family (mean = 5.21, SD = 1.48).

    CONCLUSION: The study suggested that social support from family is the strongest for students to go through the stress of tough times. It also highlighted the need for attention to stress management among undergraduate students for healthy well-being. Future studies that involve other academic fields of study and qualitative research would give useful information on perceived social support among students.

  5. Zainudin AM, Ghulam Rasool AH, Mat Nor MZ, Hassan NB, Muhamad R, Wan Mohamed WMI
    Malays J Med Sci, 2024 Apr;31(2):98-112.
    PMID: 38694587 DOI: 10.21315/mjms2024.31.2.9
    BACKGROUND: Many patients with type 2 diabetes mellitus (T2DM) do not achieve the desired glycaemic control despite being treated with insulin. Studies found this due to an improper understanding of insulin function, its intensification process and patients' negative perspective on insulin. We developed an education module to enhance adherence to insulin therapy.

    METHODS: This study applied a mixed design. It was conducted in three phases: i) Phase I: literature search and focus group discussions (FGDs), ii) Phase II: module development and iii) Phase III: content and face validation of Universiti Sains Malaysia-Insulin Adherence Module (USM-IAM). FGDs were used to gather patients' opinions. All researchers repeatedly discussed about the module content and arrangement, the words and images used, and the grammar in producing the final draft. Specialists and target audience performed content and face validation of the module.

    RESULTS: Thirty-six participants were involved in the FGDs. Data saturation was achieved at the 4th FGD. Three themes emerged from qualitative data analysis and were incorporated into the module. USM-IAM was finalised with five units. The content validity index (CVI) was 0.92, while face validity agreements were between 86% and 97%.

    CONCLUSION: The CVI and face agreement for USM-IAM exceed the cut-off point for a sound module. It has good potential to be used as a resource for educating patients in enhancing insulin adherence.

  6. Shamsul BM, Adamu MT, Mohd Desa MN, Khairani-Bejo S
    Malays J Med Sci, 2016 Sep;23(5):65-71.
    PMID: 27904427
    BACKGROUND: Several occupational diseases of multiple origins are encountered among abattoir workers. Presence of indicator microorganisms (coliforms) on hands of workers can be used a gauge for hygienic practices.

    METHODS: A cross-sectional study was performed to assess the prevalence of E.coli and enterobacteriaceae among Halal abattoir workers in some government halal abattoirs of Malaysia. A total of one hundred and sixty-five hand swab samples were collected from workers of Halal abattoirs in Malaysia. The samples were subjected to microbiological analysis for characterisation and serotyping.

    RESULTS: The results have shown that no Escherichia coli O157:H7 was isolated on the hands of abattoir workers before and after work. However, a total prevalence of 9.7% was recorded for all samples during work. For non-O157:H7, total prevalence of 33.3% during work and 13% after work were obtained. High prevalence was recorded in sample taken during work from Tampin, Jasin and Kemaman (100% each) while low prevalence where observed in Shah Alam, Banting and Ipoh (20% each).

    CONCLUSIONS: Based on the findings the hygienic practices of hand washing among the workers in few locations was found to be low especially after work.

  7. Lau PL, Goh SL, Lau EKL, Garry K, Kueh YC, Wong NL
    Malays J Med Sci, 2024 Apr;31(2):170-178.
    PMID: 38694590 DOI: 10.21315/mjms2024.31.2.15
    BACKGROUND: People with disabilities are marginalised in mainstream culture and they also experience increased restrictions in a variety of areas, such as sport. The barriers they encounter may adversely affect their life satisfaction, especially if they have a low perceived sense of autonomy and resilience. The purpose of this study was to investigate the relationship between autonomy, resilience and life satisfaction in para-badminton athletes and the mediating role of resilience in the relationship between autonomy and life satisfaction.

    METHODS: Data were collected from 137 para-badminton athletes (male: 65.0% and female: 35.0%). Self-reported measures were used to assess the participants' autonomy, resilience and life satisfaction levels.

    RESULTS: A structural equation model analysis was performed; the model had sufficient fit indices (comparative fit index [CFI] = 0.94, root mean square error of approximation [RMSEA] = 0.06, standardised root mean square residual [SRMR] = 0.07). The findings showed that autonomy had a significant effect on resilience (β = 0.32, P = 0.001). Further, resilience had a significant effect on life satisfaction (β = 0.19, P = 0.011) and significantly mediated the effect of autonomy on life satisfaction (β = 021, P = 0.033).

    CONCLUSION: This study revealed that autonomy fosters resilience among athletes, in turn allowing them to achieve greater life satisfaction. Therefore, society and sport communities should actively seek ways to improve the autonomy and resilience levels of athletes with disabilities.

  8. Hussin SA, Mohamad NA, Othman MK, Wan Mohamed WMI
    Malays J Med Sci, 2024 Apr;31(2):159-169.
    PMID: 38694591 DOI: 10.21315/mjms2024.31.2.14
    BACKGROUND: Achieving good glycaemic control is essential to reducing the risk of diabetes complications. Insulin is the most effective therapy for achieving good glycaemic control; however, it is associated with a higher risk of hypoglycaemia, especially with human insulin. This study aimed to evaluate the efficacy of intensification from human to analogue insulin and its added cost.

    METHODS: This retrospective study was conducted at the Hospital Universiti Sains Malaysia (HUSM). Patients with type 2 diabetes mellitus (T2DM) who underwent intensification for at least 3 months from human to analogue insulin were included in this study. The patients' medical records, haemoglobin A1c (Hba1c) and fasting blood sugar (FBS) were retrieved. The total cost pre- and post-intensification of insulin was obtained from the pharmacy database. Differences in HbA1c, FBS and total insulin cost pre- and post-intensification were analysed.

    RESULTS: A total of 163 patients with T2DM who had intensification from human to analogue insulin were included in this study. HbA1c and FBS levels were significantly lower in analogue insulin. However, the differences were not clinically significant, as the mean reduction in HbA1c was less than 0.5%. Meanwhile, the total costs of analogue insulin for 3 months were higher.

    CONCLUSION: There were no clinically significant improvements in patients' HbA1c and FBS after the intensification of insulin, despite the extra costs spent. Hence, it is vital to choose the right group of patients to receive an insulin analogue to maximise its benefit but at the most optimal cost.

  9. Dinesh ML, Mohd MI, Shasindrau BR, Jeyaraman D
    Malays J Med Sci, 2024 Apr;31(2):179-187.
    PMID: 38694589 DOI: 10.21315/mjms2024.31.2.16
    BACKGROUND: Acute appendicitis is a global surgical emergency. Radiographic modalities usually identify acute appendicitis, although radiographers' competence is questionable. This study examines how clinical radiographers' education and experience affect their ability to identify acute appendicitis using computed tomography (CT), magnetic resonance imaging (MRI) and ultrasonography (USG) characteristics. The study also aimed to determine which variable strongly influences their knowledge level.

    METHODS: The study surveyed radiographers with a four-part self-administered questionnaire containing demographic information and eight knowledge-based questions about the appearance of acute appendicitis in MRI, CT and USG, separately. Before distribution, the questionnaire was validated and checked the reliability.

    RESULTS: Clinical radiographers' knowledge about using MRI to diagnose acute appendicitis was strongly affected by education and experience (η2 = 0.13 and 0.14; P < 0.05), with bachelor's degree holders scoring higher regardless of experience. Radiographers with more than 5 years of experience knew more about CT and USG features to identify acute appendicitis (η2 = 0.40 and 0.27; P < 0.05). Radiographers with a bachelor's degree and greater experience had higher overall knowledge of MRI, CT and USG to diagnose acute appendicitis (η2 = 0.51 and 0.11; P < 0.05). With adjusted R2 = 54% (F [2, 44] = 27.94; P < 0.001), education and experience highly predicted the overall knowledge level.

    CONCLUSION: The study found gaps in radiographers' knowledge of the radiographic appearance of acute appendicitis. Clinical radiographers' education level and years of experience substantially affect their knowledge level. In addition, experience is a good predictor than education level for overall knowledge level. Therefore, the study emphasises the importance of continuing education and training for radiographers to diagnose acute appendicitis quickly and accurately.

  10. Mard SA, Jalalvand K, Jafarinejad M, Balochi H, Naseri MK
    Malays J Med Sci, 2010 Oct;17(4):4-13.
    PMID: 22135555
    BACKGROUND: The antidiabetic and antilipaemic effects of Phoenix dactylifera leaf extract (PDE) and its fractions were investigated in various rat models.

    METHODS: Diabetes was induced in male Wistar rats by alloxan monohydrate. Diabetic animals were randomly divided into 8 groups (1 diabetic control and 7 treated groups). Diabetic control animals received saline (5 mL/kg) orally, whereas the treatment groups received different doses of PDE (100, 200, and 400 mg/kg), PDE fractions (50, 100, and 200 mg/kg), or glibenclamide (4 mg/kg) orally once a day for 14 days. Blood was withdrawn for glucose determination on the 1(st), 6(th), 10(th), and 14(th) days. The rats were fasted overnight and then sacrificed on the 14(th) day; blood was collected for biochemical evaluation, including the levels of blood glucose, plasma insulin, serum triglyceride, and cholesterol.

    RESULTS: Subacute administration of PDE or its fractions in alloxan-induced diabetic rats significantly reduced blood glucose (P < 0.01). Water intake, serum triglyceride, and cholesterol also decreased in treated animals compared with the control group (P < 0.01). Plasma insulin level increased in the treated groups relative to the control group (P < 0.01).

    CONCLUSION: The results suggested that PDE exhibits antidiabetic and antilipaemic effects in alloxan-induced diabetic rats.

  11. Muhammad Ismail HI
    Malays J Med Sci, 2024 Apr;31(2):1-5.
    PMID: 38694588 DOI: 10.21315/mjms2024.31.2.1
    Globally 8.4% of children under 5 years old have a neurodisability. The important factors contributing to this are infection and inflammation, nutrition and quality of care especially during pregnancy and in the first 2 years of life. In an attempt to reduce neurodisability arising from these factors, WHO launched the 1,000 days initiative in 2014. Recent data from the National Health and Morbidity, and Malaysian National Neonatal Registry is a cause for concern. The rate of low weight babies has shown a significant increase during this period. The percentage of pregnant mothers with diabetes has doubled over the last 6 years. In addition, 20% of children under 5 years old are stunted and 46% have anaemia. All of these impact on neurological development, potentially increasing the incidence of developmental disorders and motor deficits.
  12. Ibrahim N, Ong HC, Wahab S
    Malays J Med Sci, 2017 May;24(3):83-91.
    PMID: 28814936 MyJurnal DOI: 10.21315/mjms2017.24.3.10
    INTRODUCTION: Caregivers often experience stressful situations while in the midst of the caregiving process. Thus, various methods of coping have been widely applied and studied in previous researches. The aim of this study was to develop a novel questionnaire to assess the coping strategies employed by those who provide care to patients, and to further validate it among caregivers of schizophrenia patients in Malaysia.

    METHODS: This study, which involved the caregivers of schizophrenia patients from a hospital in Kuala Lumpur, Malaysia, was comprised of three parts, namely in-depth interviews, a pilot study, and the validation of the developed questionnaire, known as Caregiver Cope (CgCopeTM).

    RESULTS: Part A originally consisted of eight themes, and it was later modified to seven themes with four items each after discussions with some experts. Part B initially had 28 items derived from the seven themes in Part A, which were then reduced to six components after a factor analysis. Part C of the questionnaire consisted of 19 items, with six components (Distraction, Caring for patient, Venting, Religion, Recreation, and Social support) having a moderate to high reliability ranging from a Cronbach's alpha coefficient of 0.54 to 0.82. A factor analysis showed that the six factors of coping accounted for 62.36% of the total variance.

    CONCLUSION: The CgCOPETM questionnaire is suitable for use among caregivers of schizophrenia patients. There is a need to further validate the instrument among caregivers of other patient populations.

  13. Jafari H, Heidari M, Heidari S, Sayfouri N
    Malays J Med Sci, 2020 May;27(3):20-33.
    PMID: 32684803 DOI: 10.21315/mjms2020.27.3.3
    Natural disasters have multiple psychological effects including increased risk of suicide among victims. Reviews have shown that suicidal behaviours can be an aftermath of natural disasters. The present study attempted to identify the suicide-related risk factors after natural disasters. This study was a systematic review probing English language articles related to suicide and its risk factors after natural disasters and published between 1 January 1990 and 27 September 2018 in Google Scholar, PubMed, Web of Science, Science Direct, Scopus, ProQuest and Cumulative Index of Nursing and Allied Health Literature (CINAHL) databases. After reviewing and screening the collected studies by means of specific criteria, only 30 studies were qualified to enter the survey. It was found that most of these studies had investigated suicide after earthquake. Gender, age, serious mental disorders, depression, post-traumatic stress disorder (PTSD), loss of family members, low economic status, low social support, and injury to the person and the family/relatives were identified as the most important risk factors for suicide after natural disasters. Women, adolescents, elderly, people with depression and PTSD, those suffer from low social support and parentless people were found to be among the ones being highly vulnerable to suicide after natural disasters. There is, therefore, a need for providing psychosocial support for these people after such disasters.
  14. Ping NPT, Shoesmith WD, James S, Nor Hadi NM, Yau EKB, Lin LJ
    Malays J Med Sci, 2020 Mar;27(2):51-56.
    PMID: 32788841 MyJurnal DOI: 10.21315/mjms2020.27.2.6
    The ultra-brief psychological interventions (UBPI) was created in 2018 to empower healthcare providers with psychological skills that can be delivered within a short period. Techniques used within UBPI were adopted from a variety of well established psychotherapies and distilled into its core essentials. This enabled practitioners of UBPI to deliver specific psychological skills in the appropriate context to the client within a period of 15-20 min. UBPI was also manualised to standardised training of practitioners. During the novel coronavirus disease of 2019 (COVID-19) pandemic, UBPI was modified to suit the unique psychological demands of the pandemic. This article presents how UBPI was adapted and used with healthcare providers dealing with COVID-19 and also with the public who required psychological first aid (PFA).
  15. Koh Boon Yau E, Pang Tze Ping N, Shoesmith WD, James S, Nor Hadi NM, Loo JL
    Malays J Med Sci, 2020 Mar;27(2):45-50.
    PMID: 32788840 MyJurnal DOI: 10.21315/mjms2020.27.2.5
    The novel coronavirus infection, COVID-19, is a pandemic that currently affects the whole world. During this period, Malaysians displayed a variety of behaviour changes as a response to COVID-19, including panic buying, mass travelling during movement restriction and even absconding from treatment facilities. This article attempts to explore some of these behaviour changes from a behaviourist perspective in order to get a better understanding of the rationale behind the changes.
  16. Sulistiyowati I, Yunus J, Sari DCR, Arfian N
    Malays J Med Sci, 2020 Mar;27(2):37-44.
    PMID: 32788839 DOI: 10.21315/mjms2020.27.2.4
    BACKGROUND: Cellular senescence may play a role in the development of kidney fibrosis, but its specific association with apoptosis or proliferation have yet to be determined.

    OBJECTIVES: This study aims to determine the effects of unilateral ureteral obstruction (UUO) on proliferation, cellular senescence and apoptosis in kidney fibrosis.

    METHODS: A unilateral ureteral obstruction (UUO) procedure was performed to induce kidney fibrosis in 24 Swiss mice (3 months old, 30 g-40 g). Mice were sacrificed on day 3 (UUO3, n = 6), day 7 (UUO7, n = 6) and day 14 (UUO14, n = 6). Sham operation (SO) procedures were performed on the control group. The expression of Bcl-2, p16 and Bax mRNA was quantified with reverse transcription polymerase chain reaction (RT-PCR). Immunohistochemical (IHC) staining with anti-Bcl-2 and p53 antibodies was used to determine the localisation of proliferation and apoptosis. Data were analysed using one-way ANOVA followed by a post hoc least significant difference (LSD) test (P < 0.05).

    RESULTS: RT-PCR analysis showed higher mRNA expression of Bcl-2, p16 and Bax in the UUO groups compared with SO group (P < 0.05). Immunostaining showed that Bcl-2 and p53 expression in tubular epithelium in the UUO groups, except Bcl-2 expression was found in interstitial areas of UUO14 group.

    CONCLUSION: Senescence in UUO might be associated with epithelial apoptosis and myofibroblast proliferation.

  17. Noh ASM, Ismail CAN
    Malays J Med Sci, 2020 Feb;27(1):6-21.
    PMID: 32158341 MyJurnal DOI: 10.21315/mjms2020.27.1.2
    Chronic pain is a debilitating condition that occurs after tissue damage, which substantially affects the patient's emotional state and physical activity. The chronic pain in rheumatoid arthritis (RA) is the result of various autoimmune-induced inflammatory reactions in the joints. Both types of peripheral and central pain processing can lead to sensitisation. Non-steroidal anti-inflammatory drugs (NSAIDs) and disease-modifying anti-rheumatic drugs (DMARDs) can result in potent anti-inflammatory effect. However, these drugs are not able to suppress the pain from RA for a prolonged period. For years, researchers have examined the role of the N-methyl-D-aspartic acid receptor 2B (NR2B) subunit of N-methyl-D-aspartate receptors (NMDAR) in chronic and neuropathic pain models. This NMDAR subtype can be found in at the peripheral and central nervous system and it represents an effective therapy for RA pain management. This review focuses on the NR2B subunit of NMDAR and the different pathways leading to its activation. Furthermore, specific attention is given to the possible involvement of NR2B subunit in the peripheral and central pathogenesis of RA.
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