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  1. Rajah R, Lim KY, Ng BH, Soo CI
    Malays J Med Sci, 2021 Aug;28(4):146-152.
    PMID: 34512139 DOI: 10.21315/mjms2021.28.4.15
    Acute dyspnea is one of the prevalent reasons for admission to the emergency department. The use of N-terminal pro-B-type natriuretic peptide (NT-proBNP) as an adjunct for assessing acute dyspnea is not a common practice in many public hospitals in Malaysia. This retrospective review is part of our clinical audit to determine the utility of NT-proBNP as an adjunct to non-standardised clinical evaluation in identifying acute heart failure (HF) in patients with persistent dyspnea (24 h) post-admission. In this cohort of 30 patients with acute dyspnea, NT-proBNP was positive in 20 patients (87%) with acute HF. Three patients (13%) who were treated for septic shock recorded a NT-proBNP false-positive. NT-proBNP demonstrated an overall sensitivity of 90%, a specificity of 70%, a positive predictive value of 85.7% and a negative predictive value of 77.8% in identifying acute HF. These results reinforce that age-stratified NT-proBNP cut-off values are useful for ruling-in or -out acute HF. Thus, NT-proBNP should be considered a crucial point of care, testing to decifer the conundrum of acute dyspneic patients.
  2. Alwi ZB
    Malays J Med Sci, 2005 Jul;12(2):4-12.
    PMID: 22605952
    Pharmacogenomics is the study of how genetic makeup determines the response to a therapeutic intervention. It has the potential to revolutionize the practice of medicine by individualisation of treatment through the use of novel diagnostic tools. This new science should reduce the trial-and-error approach to the choice of treatment and thereby limit the exposure of patients to drugs that are not effective or are toxic for them. Single Nucleotide Polymorphisms (SNPs) holds the key in defining the risk of an individual's susceptibility to various illnesses and response to drugs. There is an ongoing process of identifying the common, biologically relevant SNPs, in particular those that are associated with the risk of disease. The identification and characterization of large numbers of these SNPs are necessary before we can begin to use them extensively as genetic tools. As SNP allele frequencies vary considerably across human ethnic groups and populations, the SNP consortium has opted to use an ethnically diverse panel to maximize the chances of SNP discovery. Currently most studies are biased deliberately towards coding regions and the data generated from them therefore are unlikely to reflect the overall distribution of SNPs throughout the genome. The SNP consortium protocol was designed to identify SNPs without any bias towards these coding regions. Most pharmacogenomic studies were carried out in heterogeneous clinical trial populations, using case-control or cohort association study designs employing either candidate gene or Linkage disequilibrium (LD) mapping approaches. Concerns about the required patient sample sizes, the extent of LD, the number of SNPs needed in a map, the cost of genotyping SNPs, and the interpretation of results are some of the challenges that surround this field. While LD mapping is appealing in that it is an unbiased approach and allows a comprehensive genome-wide survey, the challenges and limitations are significant. An alternative such as the candidate gene approach does offer several advantages over LD mapping. Ultimately, as all human genes are discovered, the need for random SNP markers diminishes and gene-based SNP approaches will predominate. The challenges will then be to demonstrate convincing links between genetic variation and drug responses and to translate that information into useful pharmacogenomic tests.
  3. Chokphukiao P, Poncumhak P, Intaruk R, Thaweewannakij T, Somboonporn C, Amatachaya S
    Malays J Med Sci, 2023 Oct;30(5):129-143.
    PMID: 37928794 DOI: 10.21315/mjms2023.30.5.11
    BACKGROUND: Older adults frequently experience body composition changes-decreased lean body mass (LBM) and bone mineral content (BMC), along with increased body fat mass (FM)-which affect their health and independence. However, the need for standard complex and costly imaging modalities could delay the detection of these changes and retard treatment effectiveness. Thus, this study explored the ability of practical measures, including simple muscle strength tests and demographic data, to determine the body composition of older adults.

    METHODS: Participants (n = 111, with an average age of 77 years old) were cross-sectionally assessed for the outcomes of the study, including upper limb loading during a seated push-up test (ULL-SPUT), hand grip (HG) strength test and body composition.

    RESULTS: The ULL-SPUT significantly correlated with body composition (r or rs, = 0.370-0.781; P < 0.05), particularly for female participants and was higher than that found for the HG strength test (rs = 0.340-0.614; P < 0.05). The ULL-SPUT and HG strength test, along with gender and body mass index (BMI), could accurately determine the LBM and BMC of the participants up to 82%.

    CONCLUSION: The ULL-SPUT along with gender and BMI can be used as a practical strategy to detect the LBM and BMC of older adults in various settings. Such a strategy would facilitate timely managements (i.e. standard confirmation or appropriate interventions) in various settings.

  4. Wahab IA, Akbar B, Zainal ZA, Che Pa MF, Naina B
    Malays J Med Sci, 2019 Mar;26(2):77-87.
    PMID: 31447611 MyJurnal DOI: 10.21315/mjms2019.26.2.9
    Background: Studies have shown that the use of medicines with anti-cholinergic (Ach) properties can increase elderly patients' risk of experiencing falls, confusion, and longer hospital stays (LOS). These adverse effects are preventable with appropriate intervention. Little is known about the use of medicines with Ach properties and their impact on Malaysian elderly patients. This study aimed to investigate the use of medicines with Ach properties and their impact on fall risk, confusion, and longer LOS among hospitalised elderly patients.

    Methods: This study utilised a cross-sectional design and was conducted at a single centre where convenience sampling was employed to collect data from elderly patients (> 60 years) admitted to geriatric and medical wards at Hospital Tuanku Ja'afar during a 2-month period (July 2017-August 2017). Patients were excluded from this study if their hospital admission was planned for an elective procedure or if neurocognitive and hepatic impairment were diagnosed prior to the hospital admission. Medicines with Ach properties were identified and classified according to the anti-cholinergic drug scale (ADS). Univariate and multiple logistic regression statistical analyses were performed to assess its impacts on falls, confusion, and LOS.

    Results: A total of 145 elderly patients with a mean age of 71.59 years old (SD = 8.02) were included in the study. Fifty-two percent of the participants were female, and the average hospital stay was 6 days (SD = 2.09). Medicines with Ach properties were administered in 62% (n = 90) of the cases. The most commonly prescribed medicine with Ach properties was furosemide (n = 59), followed by ranitidine (n = 44), warfarin (n = 23), and methylprednisolone (n = 22). Compared to patients who did not receive medicines with Ach properties, patients who received them had a significantly higher risk of falls [odds ratios (OR) = 2.61; 95%CI: 1.18, 5.78; P = 0.018], confusion (OR = 3.60; 95%CI: 1.55, 8.36; P = 0.003), and LOS (OR = 4.83; 95%CI: 2.13, 10.94; P < 0.001). Multiple comorbidities also showed a significantly increased risk of falls (OR = 3.03; 95%CI: 1.29, 7.07; P = 0.010).

    Conclusion: Medicines with Ach properties had a significant impact on elderly patients' health. Strategies for rationally prescribing medicines with Ach properties to Malaysian elderly patients need to be improved and be recognised as an important public health priority.

  5. Priscilla D, Hamidin A, Azhar MZ, Noorjan K, Salmiah MS, Bahariah K
    Malays J Med Sci, 2011 Jul;18(3):49-56.
    PMID: 22135601 MyJurnal
    The paper examined the quality of life of haematological cancer patients according to their socio-demographic profiles and clinical diagnoses.

    Study site: Ampang Hospital, Kuala Lumpur
  6. Akhir MKAM, Choy CS, Abdullah MA, Ghani FA, Veerakumarasivam A, Hussin H
    Malays J Med Sci, 2020 Feb;27(1):37-45.
    PMID: 32158343 MyJurnal DOI: 10.21315/mjms2020.27.1.4
    Introduction: Lin-11, Isl-1 and Mec-3 domains (LIM) homeobox genes are among the most important sub-families of homeobox genes. These genes are thought to play an important role in cancer. In this study, the protein expression of these genes was examined in urothelial carcinoma of the bladder. The expression pattern of Islet-1 (ISL1) and LIM homeobox 5 (LHX5) across different cancer stages and grades, as well as the association between the protein expression of these genes and patient demographics and clinicopathological features, were examined.

    Methods: A total of 100 formalin-fixed paraffin-embedded urothelial carcinoma tissues were selected from the Department of Pathology, Hospital Kuala Lumpur and the protein expression of ISL1 and LHX5 was determined using immunohistochemistry.

    Results: Positive expression of ISL1 and LHX5 was detected in 94% and 98% of the samples, respectively. There were no distinct LHX5 expression patterns associated with different cancer stages, but the proportion of high-expressing tumours was higher in high-grade tumours. In addition, there was a significant association between the expression of LHX5 and tumour grade. The proportion of tumours expressing high levels of ISL1 was found to be highest in later stage tumours.

    Conclusion: The high percentage of tumours expressing both these genes suggests that ISL1 and LHX5 play an important role in bladder tumourigenesis across multiple stages.

  7. Lim OW, Yong CC
    Malays J Med Sci, 2019 Sep;26(5):98-112.
    PMID: 31728122 MyJurnal DOI: 10.21315/mjms2019.26.5.9
    Background: The prevalence of known hypertension has resulted from the progression of undiagnosed hypertension. This study is targeted to examine and compare the risk factors based on the estimated odds ratios of modifiable and non-modifiable risk factors on different outcome levels of hypertension.
    Methods: A nationwide representative secondary data from the Fourth National Health of Morbidity Survey (NHMS IV) which consists of 24,632 non-institutionalised Malaysian population conducted by the Ministry of Health in 2011 has been used. Odds ratio (OR) with 95% confidence interval has been estimated using multinomial logistic regression.
    Results: Obese and overweight respondents exhibit increased likelihood of having undiagnosed and known hypertension. Physically inactive, ex-smokers and unclassified drinkers are found having higher likelihood to have known hypertension. However, current drinkers are found to have higher likelihood of having undiagnosed hypertension. Elderly, retirees, home makers and lower educated respondents are shown higher odds to have undiagnosed hypertension. Likewise, the likelihood of having known hypertension has been found to increase among the elderly and other Bumiputra.
    Conclusion: Through this research, significant predictors which consist of obese and overweight respondents, current drinkers, older respondents (above 65 years old) and primary educated respondents are having higher likelihood to have undiagnosed hypertension.
    Study name: National Health and Morbidity Survey (NHMS-2011)
  8. Idris IB, Barlow J, Dolan A, Surat S
    Malays J Med Sci, 2021 Feb;28(1):125.
    PMID: 30914900 MyJurnal DOI: 10.21315/mjms2021.28.1.18
    [This retracts the article DOI: 10.21315/mjms2019.26.1.12.].
  9. Chung QE, Abdulrahman SA, Khan MKJ, Sathik HBJ, Rashid A
    Malays J Med Sci, 2018 Sep;25(5):88-102.
    PMID: 30914866 MyJurnal DOI: 10.21315/mjms2018.25.5.9
    Background: This study aimed to explore the prevalence of physical activity among medical and health sciences students at Cyberjaya University College of Medical Sciences (CUCMS) and to determine the relationship of their physical activity level with their academic achievement and self-determination level.

    Methods: An analytical cross-sectional study was conducted among 244 Medical and Health Sciences undergraduate students at CUCMS from January to April 2017 using self-administered short-form version of the International Physical Activity Questionnaire (IPAQ-SF) and the third version of the Behavioural Regulation in Exercise Questionnaire (BREQ-3). Multiple regression models were fitted using SPSS version 20 to examine the relationships between study variables.

    Results: Half of the male students (51.7%) were in the health-enhancing physical activity (HEPA) group, as compared to only 24.7% of females. The odds of having a good grade point average was twice as high among HEPA active students (odds ratio [OR] = 1.89, 95% CI [1.09, 3.27], P = 0.023) than among non-HEPA active students. Further, the odds of being HEPA active was higher for males (OR = 3.16, 95% CI [1.61, 6.14], P < 0.01) than for females and higher for overweight students than for normal weight students (OR = 2.58, 95% CI [1.24, 5.57], P = 0.017). The odds of being HEPA active was 1.79 times higher for each unit increase in the integrated regulation score (OR = 1.79, 95% CI [1.14, 2.91], P = 0.020).

    Conclusion: The prevalence of physical inactivity was higher among females than males. This study also confirmed a significant association between physical activity level and academic achievement. HEPA active students performed better academically than those who were non-HEPA active.

  10. Rakhshani T, Motlagh Z, Beigi V, Rahimkhanli M, Rashki M
    Malays J Med Sci, 2018 Nov;25(6):100-109.
    PMID: 30914883 DOI: 10.21315/mjms2018.25.6.10
    Background: Nursing is a stressful occupation, and nurses face multiple stressors daily. Emotional intelligence causes an individual to overcome environmental stresses. The aim of the present study was to determine the relationship between emotional intelligence and job stress among nurses in Shiraz.

    Methods: A cross-sectional study was conducted with 500 nurses, selected through multistage cluster sampling, from the hospitals in Shiraz in 2017. The data collection tools were the Siberia Schering's Emotional Intelligence Standard Questionnaire and the Hospital Job Stress Standard Questionnaire, completed through the self-report method. The data were analysed using SPSS 22 software.

    Results: The mean scores of emotional intelligence and job stress were 113.59 ± 14.70 (total score = 165) and 97.10 ± 14.27 (total score = 175), respectively. The correlation test showed that there was an inverse relationship between emotional intelligence and job stress (r = -0.474, P < 0.001). Also, the multiple linear regression analysis showed that self-awareness, social consciousness, and income predicted 25% of the job stress in the subjects under study (r2 = 0.25).

    Conclusion: Regarding the relatively strong and inverse relationship between the nurses' emotional intelligence and job stress, it is suggested that emotional intelligence workshops be included in the in-service training programs of the nurses.

  11. Aazami S, Shamsuddin K, Akmal S, Azami G
    Malays J Med Sci, 2015 Jul-Aug;22(4):40-6.
    PMID: 26715907 MyJurnal
    The workplace environment has a great influence on employees' health. Job dissatisfaction has been widely recognised as a workplace stressor that can influence employees' psychological and physical health statuses. However, job satisfaction is a multi-dimensional concept, and it is necessary to investigate its different facets and their unique consequences. Therefore, the aim of this study was to assess the relationship between the nine facets of job satisfaction and psychological health and somatic complaints (i.e., sleep disorders, headache, gastro-intestinal and respiratory problems).
  12. Samsuddin N, Razali A, Rahman NAA, Yusof MZ, Mahmood NAKN, Hair AFA
    Malays J Med Sci, 2019 Mar;26(2):131-137.
    PMID: 31447616 MyJurnal DOI: 10.21315/mjms2019.26.2.14
    The objectives of occupational health services (OHS) are to create a healthy and safe working environment, prevent work-related diseases, optimise employees' functional capacity and promote health. According to the literature, global accessibility to OHS has not shown much improvement and even worsened in certain countries. The main challenges come from the small and medium enterprises (SMEs). To respond to these global challenges, the basic occupational health services (BOHS) guideline was published under the purview of the World Health Organization and the International Labour Organization. The guideline describes BOHS as part of the infrastructure called the occupational safety and health system, an essential element that ensures the high service coverage and sustainability of the programme. The BOHS guideline was introduced in Malaysia by the Department of Occupational Safety and Health with a focus on SMEs, but its accessibility is low. A gap analysis was conducted between the current BOHS in Malaysia and the published international guideline. The important challenges identified that contributes to the low BOHS accessibility in Malaysia is the weakness in the BOHS infrastructure and OHS system provision. The proposed BOHS infrastructure model is meant to increase accessibility and to provide fair and equitable health services for Malaysians.
  13. Hidrus A, Kueh YC, Bachok N, Kuan G
    Malays J Med Sci, 2020 May;27(3):125-136.
    PMID: 32684813 MyJurnal DOI: 10.21315/mjms2020.27.3.13
    Background: Processes of change (POC) comprise one of the psychological constructs in the Transtheoretical Model. The objective of this study is to test the validity and reliability of the Malay version of the POC scale among university students by using a confirmatory approach.

    Method: A cross-sectional study design with a convenience sampling method using a self-administered questionnaire was carried out. University undergraduate students were approached to fill in the questionnaire, which consisted of demographic information and a POC scale. The POC scale consisted of 30 items and two main factors (i.e., cognitive and behavioural). The POC scale was translated into the Malay language using a standard procedure of forward and backward translation. Confirmatory factor analysis (CFA) was performed, and composite reliability was computed using Mplus version 8.

    Results: A total of 620 respondents with a mean age of 20 years (standard deviation = 1.15) completed the questionnaire. Most of the participants were female (74.7%) and Malay (78.2%). The initial CFA model of the POC scale did not exhibit fit based on several fit indices (comparative fit index (CFI) = 0.880, Tucker Lewis index (TLI) = 0.867, standardised root mean square residual (SRMR) = 0.075 and root mean square error of approximation (RMSEA) = 0.058). Several re-specifications of the model were conducted and the modification included adding correlation between the items' residuals. The final model for the Malay version of the POC scale showed acceptable values of model fit indices (CFI = 0.922, TLI = 0.911, SRMR = 0.064 and RMSEA = 0.048). The composite reliability of both the cognitive and behavioural processes was acceptable at 0.856 and 0.752, respectively.

    Conclusion: The final model presented acceptable values of the goodness of fit indices, indicating that the scale is fit and acceptable to be adopted for future study.

  14. Mohd Sidik S
    Malays J Med Sci, 2010 Apr;17(2):18-23.
    PMID: 22135533 MyJurnal
    Urinary incontinence is a common but poorly understood problem in the elderly population. The aim of this study was to determine the prevalence of urinary incontinence and its associated factors among the elderly in a community setting.
  15. Pasyar N, Rambod M, Behrouzi Z
    Malays J Med Sci, 2020 May;27(3):75-83.
    PMID: 32684808 DOI: 10.21315/mjms2020.27.3.8
    Background: Thalassemia is a prevalent chronic blood disorder, which is accompanied with a wide range of challenges. This study aimed to determine the predictor role of perceived social support and spiritual intelligence in hope among thalassemia patients.

    Methods: This cross-sectional study was conducted on 300 thalassemia patients. The data were collected using Miller hope scale, spiritual intelligence scale, and personal resource questionnaire. The data were analysed using Pearson's correlation coefficient and multiple regression analysis.

    Results: The results indicated that the mean score of hope was 173.38 (standard deviation [SD] = 24.6). Besides, 86.7% of the patients showed high levels of hope. The mean score of spiritual intelligence was 134.66 (SD = 18.07). In addition, 91.7% of the patients showed moderate levels of spiritual intelligence. The mean score of social support was 127.87 (SD = 20.19) and the patients showed high social support levels. The results revealed a significant association between hope and perceived social support (r = 0.65, P < 0.001) as well as between hope and spiritual intelligence (r = 0.63, P < 0.001). Moreover, perceived social support (b = 0.43, P < 0.001) and spiritual intelligence (b = 0.37, P < 0.001) were the predictors of hope among thalassemia patients.

    Conclusion: Considering the study results, in addition to common treatments for thalassemia, policymakers' are recommended to pay attention to spiritual intelligence and more importantly social support to enhance thalassemia patients' hope.

  16. Hassan Y, Awaisu A, Al-Meman AA, Aziz NA
    Malays J Med Sci, 2008 Apr;15(2):3-13.
    PMID: 22589618
    Our objectives were to discuss a general overview on the description and recognition of heparin-induced thrombocytopenia (HIT) and present a critical review of the traditional and most recent advances in its pharmacotherapy. Computerized searches were done on MEDLINE and Iowa Drug Information Service (IDIS) databases from June 2001 until June 2007 and from May 2005 until May 2007, respectively. Search terms used included 'heparin-induced thrombocytopenia', 'heparin-associated thrombocytopenia', therapeutics, HIT, HAT. We largely selected publications within the timeframe above, but did not exclude commonly referenced and highly regarded older publications. The commonly referenced published articles were obtained through manual searches derived from bibliographic citations and retrievals from the authors' personal files. Pertinent literatures (89 key articles) that were thought to have substantially contributed new information to the therapeutics of HIT within the last 6 years were identified, reviewed and presented. The following limits were used for the MEDLINE and IDIS searches: 'human', drug therapy', 'review', 'meta-analysis', 'clinical trial', and case reports. The therapeutics of HIT is rapidly evolving and needs to consider an evidence - based approach. It is imperative that practitioners be aware of the associated risk and be up-to-date with the current advances in the management of this fatal clinical condition.
  17. Nour Azimah Z, Abdullah JM
    Malays J Med Sci, 2021 Aug;28(4):1-4.
    PMID: 34512125 DOI: 10.21315/mjms2021.28.4.1
    In this Editorial, we report on the trend of manuscript submissions during the peak of COVID-19 pandemic in 2020. The total monthly new manuscript submissions from 2018 to 2020 were compared to examine the overall trends in submission and publication activities. Apart from that, we also report on the changes in the journal's administration and the external recognition received by the journal.
  18. Cheraghali R, Farshidmehr P
    Malays J Med Sci, 2021 Aug;28(4):97-102.
    PMID: 34512134 DOI: 10.21315/mjms2021.28.4.10
    Background: This prospective cohort study aims to evaluate the primary and exchanged femoral catheter patency rates, as well as mortality rates and determine the probable risk factors affecting femoral catheter survival.

    Methods: All 79 tunneled femoral catheters created in our hospital from 2017 to 2020 were included in this study. Patients having no other means for dialysis access other than the femoral catheter was recruited in this study. Data collected included patient age, sex, comorbidities (diabetes and hypertension), transplant history, dialysis duration, catheter complications, femoral access history, and primary and exchanged femoral patency rates. Patients were followed for 4-36 months.

    Results: The median catheter primary patency was 7 months (95% confidence interval [CI]: 5.77, 8.22) and the primary patency rates at 2, 4 and 6 months were 79%, 68% and 48%, respectively. The median exchanged catheter survival was 8 months (95% CI: 0.83, 15.17) and the exchanged patency rates at 1, 3 and 8 months were 72%, 64% and 32%, respectively. Of the patients (n = 62), 8% (5 patients) died because they had no other option for dialysis access.

    Conclusion: Tunneled femoral catheters have a low patency rate and should be the last option for haemodialysis patients when other probable accesses are not available.

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