Displaying publications 1 - 20 of 1064 in total

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  1. Ahmad NA, Mohd MH, Musa KI, Abdullah JM, Othman NA
    Malays J Med Sci, 2021 Oct;28(5):1-9.
    PMID: 35115883 DOI: 10.21315/mjms2021.28.5.1
    Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19 disease, which has become pandemic since December 2019. In the recent months, among five countries in the Southeast Asia, Malaysia has the highest per-capita daily new cases and daily new deaths. A mathematical modelling approach using a Singular Spectrum Analysis (SSA) technique was used to generate data-driven 30-days ahead forecasts for the number of daily cases in the states and federal territories in Malaysia at four consecutive time points between 27 July 2021 and 26 August 2021. Each forecast was produced using SSA prediction model of the current major trend at each time point. The objective is to understand the transition dynamics of COVID-19 in each state by analysing the direction of change of the major trends during the period of study. The states and federal territories in Malaysia were grouped in four categories based on the nature of the transition. Overall, it was found that the COVID-19 spread has progressed unevenly across states and federal territories. Major regions like Selangor, Kuala Lumpur, Putrajaya and Negeri Sembilan were in Group 3 (fast decrease in infectivity) and Labuan was in Group 4 (possible eradication of infectivity). Other states e.g. Pulau Pinang, Sabah, Sarawak, Kelantan and Johor were categorised in Group 1 (very high infectivity levels) with Perak, Kedah, Pahang, Terengganu and Melaka were classified in Group 2 (high infectivity levels). It is also cautioned that SSA provides a promising avenue for forecasting the transition dynamics of COVID-19; however, the reliability of this technique depends on the availability of good quality data.
  2. Arung ET, Ramadhan R, Mandzilkh LD, Santoso PA, Matsumoto M, Nagata M, et al.
    Malays J Med Sci, 2022 Oct;29(5):146-153.
    PMID: 36474534 DOI: 10.21315/mjms2022.29.5.15
    The broader objective of this study is to identify natural materials that might inhibit the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We have focused on stingless bee honey, which has a unique taste that is both sweet and sour and sometimes bitter. We screened 12 samples of honey from 11 species of stingless bees using an angiotensin-converting enzyme 2 (ACE2)-spike protein-binding assay and phytochemical analysis. Ten of the samples showed inhibition above 50% in this assay system. Most of the honey contained tannins, alkaloids, flavonoids, triterpenoids, carotenoids and carbohydrates. Our findings in this in vitro study showed that honey from stingless bees may have a potent effect against SARS-CoV-2 infection by inhibiting the ACE2-spike protein-binding.
  3. Joo CL, Husain M, Fadzil NA, Kueh YC
    Malays J Med Sci, 2022 Oct;29(5):105-116.
    PMID: 36474540 DOI: 10.21315/mjms2022.29.5.11
    BACKGROUND: Medical officers (MOs) face multiple sources of work-related stress, including work system transition, job insecurity, dissatisfaction with income and intense working environments. This study aimed to examine the quality of life (QOL), effort-reward imbalance (ERI) and their association among MOs working in government hospitals in Kuching, Sarawak, Malaysia.

    METHODS: This cross-sectional study was conducted among MOs from Sarawak General Hospital and Hospital Sentosa from May 2018 to March 2020. A total of 614 participants were selected through convenient sampling. An email with a link to three sets of questionnaires via Google forms including a questionnaire on sociodemographic data and job characteristics, the World Health Organization Quality of Life-Brief version (WHOQOL-BREF) (Malay version) and the effort-reward imbalance (ERI-Q) (long version) was sent to potential participants. A total of 276 MOs completed and returned the questionnaires. Data were analysed using descriptive, simple and multiple logistic regression analysis. A P-value of less than 0.05 was taken as a statistically significant result.

    RESULTS: Most MOs reported no adversity in the workplace (i.e. 29% low effort/high reward, 5.1% high effort/high reward, 6.2% low effort/low reward and 23.6% high effort/low reward). More than half of MOs (54%) reported poor general QOL and were associated with a combination of active and passive on-calls (adjusted odds ratio [AOR] = 5.36, 95% confidence interval [CI]: 1.21, 23.79). Poor QOL in the physical domain was associated with the presence of chronic illness (AOR = 23.35; 95% CI: 4.25, 128.45), active on-calls (AOR = 14.75; 95% CI: 1.16, 188.35) and a combination of active and passive on-calls (AOR = 18.25; 95% CI: 1.39, 238.98). Men had a higher risk of poor QOL in the environmental domain (AOR = 2.03; 95% CI: 1.04, 3.98). Only 23.6% of MOs reported psychosocial adversity at work (high effort/low reward). High effort/low reward was associated with poor QOL in general (AOR = 4.71; 95% CI: 1.71, 13.01), physical (AOR = 4.53; 95% CI: 2.02, 10.17), psychological (AOR = 5.95; 95% CI: 2.82, 12.58) and environmental domains (AOR = 4.21; 95% CI: 1.95, 9.08). Low effort/high reward was found to have a lower likelihood of poor QOL in the social domain (AOR = 0.13; 95% CI: 0.04, 0.44).

    CONCLUSION: Higher ERI was found to be associated with poor QOL among MOs in government hospitals. Future research should focus on interventions to improve working conditions.

  4. Aminuddin F, Bahari MS, Mohd Nor Sham Kunusagaran MSJ, Zaimi NA, Shahari MR, Mohd Hassan NZA
    Malays J Med Sci, 2022 Oct;29(5):93-104.
    PMID: 36474536 DOI: 10.21315/mjms2022.29.5.10
    BACKGROUND: Postnatal care (PNC) in Malaysia is believed to have played a role in reducing maternal and child mortality. A pilot study was thereby conducted to estimate the cost of PNC in public primary care facilities in Negeri Sembilan from the perspective of healthcare providers.

    METHODS: This study employed a cross-sectional design that involved six public primary care facilities in Negeri Sembilan, Malaysia. The PNC-related costs data were collected between May and July 2017, utilising cost data for the year 2016 and involving 287 eligible mothers. The PNC costs were calculated using mixed top-down and activity-based costing (ABC) approaches.

    RESULTS: The mean cost of PNC per patient was RM165.65 (median, RM167.12). Personnel cost was the main cost driver for PNC, which accounted for the most significant proportion of the total cost at 94.2%. Education level, type of health facilities and postnatal visits were positively associated with the total PNC cost.

    CONCLUSION: This study highlighted the average cost of PNC in the public primary care facilities in Negeri Sembilan. The cost of PNC was revealed to be primarily driven by personnel cost. The findings of this pilot study could add to the evidence base of PNC and serve as a vital reference for improving future estimates to better allocate scarce resources.

  5. Ishak B, Azizan ANA, Mariappan V
    Malays J Med Sci, 2022 Oct;29(5):126-132.
    PMID: 36474533 DOI: 10.21315/mjms2022.29.5.13
    BACKGROUND: Many factors determine the success of wearing contact lens, including knowledge and compliance towards lens care. This study aimed to evaluate the level of knowledge and compliance between two groups of adult contact lens wearers in Kuala Lumpur, Malaysia.

    METHODS: A total of 60 participants aged 18-30 years old volunteered to participate in this study (30 participants prescribed contact lenses at the Universiti Kebangsaan Malaysia [UKM] optometry clinic and 30 participants fitted at private practices). Participants were interviewed using a structured questionnaire consisting of nine questions on basic knowledge related to lens wear and 13 questions on compliance, categorised into questions on the cleaning process, disinfection, accessories care and replacement schedule.

    RESULTS: All participants wore disposable contact lens 53.3% (n = 32) participants preferred using monthly disposable lenses. Both groups had the same level of knowledge, except knowledge of the effects of makeup (P < 0.000) and duration of the solution used for cleaning (P < 0.010), showing lack of knowledge on contact lenses among participants in private practices group. There were no significant differences between the groups in terms of the level of compliance with the cleaning process (P = 0.830), disinfection (P = 0.725), accessories care (P = 0.865) and replacement schedule (P = 0.699).

    CONCLUSION: Participants from UKM optometry clinic had better knowledge on wearing contact lens; moreover, both groups had good compliance towards lens care. Contact lens practitioners should provide all the necessary information to contact lens wearers so that they are equipped to handle contact lenses correctly, which would minimise the risk of eye complications.

  6. Ueda M, Yoshida M, Yamashita E, Bhandari D, Endo M, Ozaki A
    Malays J Med Sci, 2022 Oct;29(5):154-158.
    PMID: 36474538 DOI: 10.21315/mjms2022.29.5.16
    Previous laboratory studies of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) revealed that the stability of the virus in the air or on surfaces is sensitive to seasonally relevant environmental conditions. However, the seasonality of the virus in the real world remains unclear because each country adopted various infection control policies. Therefore, we investigated peak dates with regard to new confirmed cases of coronavirus disease 2019 (COVID-19) and an association of these dates with the timing of the lockdown among G20 countries that have four seasons from 1 June 2020 to 18 February 2021. As a result, countries in both hemispheres experienced seasonal peaks in the number of COVID-19 cases both in the middle of warm and cold seasons. In addition, there were no apparent relationships between the peak date and periods with stringent measures. Our study demonstrated that SARS-CoV-2 causes seasonal outbreaks in the winter and possibly summer and thus, countries might need to consider measures to prepare for resurgence of the virus in the middle of 2021.
  7. Shamsuddin AS, Mohd Abu Bakar WA, Syed Ismail SN, Jaafar NH, Mohd Yassin W, Norhizat M
    Malays J Med Sci, 2022 Oct;29(5):24-38.
    PMID: 36474532 DOI: 10.21315/mjms2022.29.5.4
    Approximately 230 million children under 5 years old of age suffer from malnutrition and over half of the children below 5 years old deaths are due to malnutrition nowadays. To gain a better understanding of this problem, the application of spatial analysis has risen exponentially in recent years. In this review, the present state of information on the use of spatial analysis in childhood malnutrition studies was evaluated using four databases of digital scientific journals: ScienceDirect, Scopus, PubMed and CINAHL. We chose 2,278 articles from the search results and a total of 27 articles met our criteria for review. The following information was extracted from each article: objective of study, study area, types of malnutrition, subject, data sources, computer software packages, spatial analysis and factors associated with childhood malnutrition. A total of 10 spatial analysis methods were reported in the reviewed articles and the Bayesian geoadditive regression model was the most common method applied in childhood malnutrition studies. This review highlights the importance of the application of spatial analysis in determining the geographic distribution of malnutrition cases, hotspot areas and risk factors correlated with childhood malnutrition. It also provides implications for strategic initiatives to eradicate all forms of malnutrition.
  8. Chainchel Singh MK, Mohd Noor MH, Ibrahim MA, Siew SF, Lai PS
    Malays J Med Sci, 2022 Oct;29(5):83-92.
    PMID: 36474535 DOI: 10.21315/mjms2022.29.5.9
    BACKGROUND: COVID-19 was declared a pandemic by the World Health Organization (WHO). COVID-19 is highly contagious, making it a threat to healthcare workers, including those working in mortuaries. Therefore, it is important to determine if the cause of death (COD) could be identified using limited autopsy, diagnostic tests and post-mortem imaging modalities instead of full autopsy. This study aims to examine the effectiveness of post-mortem imaging, specifically post-mortem computed tomography (PMCT) at determining the COD during a pandemic.

    METHODS: This cross-sectional study included 172 subjects with suspected or unknown COVID-19 status brought in dead to the institute's mortuary during the pandemic in Malaysia. PMCT images reported by forensic radiologists and their agreement with conventional autopsy findings by forensic pathologists regarding COD were analysed to look at the effectiveness of PMCT in determining COD during a pandemic.

    RESULTS: Analysis showed that 78.7% (133) of cases reported by forensic radiologists concurred with the COD certified by forensic pathologists. Of these cases, 85 (63.9%) had undergone only external examination and real-time reverse transcriptase polymerase chain reaction (rRT-PCR) COVID-19 testing, meaning that imaging was the sole method used to determine the COD besides history from available medical records and the investigating police officer.

    CONCLUSION: PMCT can be used as a complement to medicolegal autopsies in pandemic contexts, as it provides significant information on the possible COD without jeopardising the safety of mortuary health care workers.

  9. Mohamed Z, Jit Singh GK, Dediwadon NS, Mohamad Saleh NA, Jupri NN, Ganesan Y
    Malays J Med Sci, 2022 Oct;29(5):117-125.
    PMID: 36474539 DOI: 10.21315/mjms2022.29.5.12
    BACKGROUND: Stress related to nursing education and clinical placement encounters by students since the beginning of their nursing course has been an issue of concern. This study aims to examine the prevalence of adult personality traits and their relationship with stress levels, coping mechanisms and academic performance among nursing students.

    METHODS: This cross-sectional study was conducted among 92 nursing students at Universiti Kebangsaan Malaysia (UKM). The Big Five Inventory (BFI), Student Nurse Stress Index and Brief COPE instruments were used to measure the respondents' personality traits, stress level and coping mechanisms, respectively. Data were analysed using IBM SPSS version 26.

    RESULTS: The most prevalent personality trait of the students was openness (mean = 33.58). Conscientiousness (r = -0.226, P = 0.030) and neuroticism (r = 0.326, P = 0.002) are significantly related to stress level. Extraversion (r = 0.219, P = 0.036), conscientiousness (r = 0.206, P = 0.049) and openness (r = 0.219, P = 0.036) show significant relationships with the approach coping mechanism, while agreeableness (r = -0.257, P = 0.013) and neuroticism (r = 0.297, P = 0.004) show significant relationships with the avoidant coping mechanism. However, no significant relationship was noted between personality traits and academic performance (r = 1.000, P > 0.05).

    CONCLUSION: Knowledge of ones' personality traits may benefit students in understanding themselves and in using the best ways to cope with their stress while studying nursing.

  10. Mato L, Chankavee N, Amatachaya S, Thaweewannakij T
    Malays J Med Sci, 2022 Oct;29(5):74-82.
    PMID: 36474537 DOI: 10.21315/mjms2022.29.5.8
    BACKGROUND: Patients with incomplete spinal cord injury (iSCI) and lower extremity muscle weakness often fall while standing up from a chair. The sit-to-stand (STS) task primarily uses the strength of the knee extensor muscles. The five times sit-to-stand test (FTSST) is often applied to determine lower limb function and the results are related to lower extremity muscle strength. This study explored the cut-off point for knee extensor muscle strength in patients with iSCI to independently determine their FTSST results and the correlation between knee extensor muscle strength and FTSST results.

    METHODS: Forty-four participants were assessed for knee extensor muscle strength using a hand-held dynamometer (HHD) and the FTSST.

    RESULTS: The data indicated that knee extensor muscle strength ≥ 53.06 Newton was the best independent predictor of the FTSST results (sensitivity 72.7%, specificity 72.7%). Moreover, knee extensor muscle strength was significant and correlated with the FTSST results (r = -0.45, P = 0.035).

    CONCLUSION: The findings offer a cut-off point for the knee extensor muscle strength measured while standing up from a chair that may help medical professionals set rehabilitation goals for patients with iSCI.

  11. Wan Mohamad Darani WNS, Chen XW, Samsudin EZ, Mohd Nor F, Ismail I
    Malays J Med Sci, 2023 Feb;30(1):172-184.
    PMID: 36875201 DOI: 10.21315/mjms2023.30.1.15
    BACKGROUND: Concerted efforts have been undertaken to reduce the human immunodeficiency virus (HIV) infection by the year 2030 in Malaysia. A situational analysis of the performance of successful HIV treatment and its determinants is vital; however, this information remains scarce. This study aimed to identify the determinants of undetectable viral load among people living with HIV (PLHIV).

    METHODS: Newly diagnosed HIV cases (n = 493) registered under the Malaysia HIV/AIDS-related national databases from June 2018 to December 2019 were studied. The deterministic matching method was applied to link the records in two national databases (at Kuala Lumpur and Putrajaya Federal Territories Health Department, JKWPKLP HIV line-listing database and National AIDS Registry). Successful HIV treatment, an outcome variable, was measured by the undetectable viral load < 200 copies/mL after 1 year of antiretroviral therapy initiation. Logistic regression analysis was applied in the current study.

    RESULTS: Results showed that 454/493 (92.2%; 95% confidence interval [CI]: 89.8%, 94.6%) PLHIV had successful HIV treatment. Study participants had a mean (SD) age of 30 (8.10) years old, predominantly male (96.1%) and sexually transmission (99.9%). The multiple logistic regression analysis revealed two significant determinants including the timing of ART initiation (AOR = 3.94; 95% CI: 1.32, 11.70; P = 0.014) and establishment of Sexually Transmitted Infection Friendly Clinic (STIFC) (AOR = 3.40; 95% CI: 1.47, 7.85; P = 0.004). Non-significant variables included gender, education level, HIV risk exposure, and co-infections of tuberculosis and Hepatitis C.

    CONCLUSION: JKWPKLP is on the right track to achieving universal treatment as a prevention strategy. Reinforcement of early ART initiation and establishment of STIFC are recommended.

  12. Mohd Salleh N, Theophilus SC, Rahman NAA, Ghani ARI, Abdullah JM, Idris Z, et al.
    Malays J Med Sci, 2023 Feb;30(1):107-115.
    PMID: 36875199 DOI: 10.21315/mjms2023.30.1.9
    BACKGROUND: Hypopituitarism following traumatic brain injury (TBI) is not rare however most patients were left undiagnosed and untreated. Association of post TBI hypopituitarism causing neurobehavioural and quality of life impairment. The aim of the study is to determine the incidence of the chronic anterior pituitary deficiency in patients with traumatic brain injury. Subsequently determine the risk factor and the outcome of the patient with chronic anterior pituitary dysfunction.

    METHODS: This is single centre cross-sectional study involved 105 traumatic head injury patients under the Neurosurgical Department Hospital Sultanah Aminah, Johor Bahru, Malaysia. The primary investigator will do an interview and the patients will be asked question to complete a questioner from SF-36 (36 questions). Subsequently, consent for participation will be taken and blood sampling will be done.

    RESULTS: Thirty-three patients were noted to have anterior pituitary dysfunction. The mean age was 36.97 ± 12.96 years old. Twenty-seven patients (32.5%) were male and six patients were female (27.3%). Chronic anterior pituitary dysfunction in patients with a severe traumatic head injury around 47.1% (23 patients), as compared to a moderate head injury (8 patients, 38.1%) and 2 sustained mild head injury (5.6%). The mean duration after the onset of trauma was 10.3 ± 1.79 months. All patient with anterior pituitary dysfunction had positive CT brain findings with 22 had subarachnoid haemorrhage (SAH) at the basal cistern and 27 patients had a base of skull fracture, where 52.1% of the patient underwent surgical intervention, 84.8% involved one axis and another 5 patients had two axes involved. Severity of the head injury (P < 0.001), prolonged duration of hospital stay (P = 0.014), radiological findings of a base of skull fracture (P < 0.001) and presence of SAH at basal cistern (P < 0.001) was significantly associated with pituitary dysfunction. The patient with anterior pituitary dysfunction has the lower 36-item Short Form Survey (SF-36) marks 56.3 ± 10.3.

    CONCLUSION: The prevalence of hypopituitarism was 31%. Indicators are increased TBI severity, prolonged hospitalisation and positive finding in radiological assessment. Post-traumatic chronic anterior pituitary dysfunction also related with poor quality of life as showed by low SF-36 marks.

  13. Wan Ahmad WA, Mohd Ghazi A, Abdul Ghapar AK, Muthusamy TS, Liew HB, Zainal Abidin I, et al.
    Malays J Med Sci, 2023 Feb;30(1):49-66.
    PMID: 36875198 DOI: 10.21315/mjms2023.30.1.5
    Globally, heart failure with preserved ejection fraction (HFpEF) is quickly becoming the dominant form of heart failure (HF) in ageing populations. However, there are still multiple gaps and challenges in making a firm diagnosis of HFpEF in many low-to-middle income Asian countries. In response to this unmet need, the Malaysian HFpEF Working Group (MY-HPWG) gathered and reviewed evidence surrounding the use of different diagnostic modalities indicated for patients with HFpEF to identify diagnostic tools that could be conveniently accessed across different healthcare settings. As a result, five recommendation statements were proposed and an accompanying algorithm was developed, with the aim of improving the diagnostic rate of HFpEF. The MY-HPWG recommends using more easily accessible and non-invasive tools, such as natriuretic peptide (NP) biomarkers and basic echocardiogram (ECHO), to ensure timely HFpEF diagnosis in the primary and secondary care settings, and prompt referral to a tertiary care centre for more comprehensive assessments in uncertain cases.
  14. Teng CL, Lee VKM, Malanashita G, Sulaiman LH, Bujang MA
    Malays J Med Sci, 2023 Feb;30(1):162-171.
    PMID: 36875195 DOI: 10.21315/mjms2023.30.1.14
    BACKGROUND: Many published studies in Malaysia have examined and assessed self care among type 2 diabetes mellitus (T2DM) patients using the Summary of Diabetes Self Care Activities (SDSCA) scale. The current paper is a meta-analysis of related studies that also examines how gender and ethnicity influence and shape T2DM self care practices in Malaysia.

    METHODS: We undertook a bibliographic search for studies conducted and published in Malaysia on T2DM adults using the SDSCA scale. This is a two-stage individual participant meta-analysis of SDSCA which synthesised the overall and subscale score based on gender and ethnic groups as well as the correlation between SDSCA and HbA1c.

    RESULTS: We examined 11 studies that utilised SDSCA to analyse 3,720 T2DM patients. The overall SDSCA score was 33.46 (47.8% of the 7-day week). The subscale score for general diet, specific diet, exercise, blood glucose self-monitoring and foot care were 4.80, 4.09, 2.87, 1.80 and 3.21, respectively. A small but statistically significant better self care in some gender or ethnic groups was noted. The SDSCA diet subscale and HbA1c showed statistically significant correlation.

    CONCLUSION: The finding suggested Malaysian T2DM patients were deficient in exercise and blood glucose self-monitoring. In fact, overall self care among Malaysian adult T2DM patients appears to be suboptimal across gender and the three main ethnic groups. Greater efforts are therefore needed to educate Malaysian adult T2DM patients to improve their self care practices.

  15. Anuar MNN, Ibrahim M, Zakaria NH, Ichwan SJA, Md Isa ML, Mat Alewi NA, et al.
    Malays J Med Sci, 2023 Feb;30(1):82-91.
    PMID: 36875196 DOI: 10.21315/mjms2023.30.1.7
    BACKGROUND: Head and neck cancer patients usually need nutritional support due to difficulties in swallowing and chewing. Therefore, this study aimed to formulate Musa paradisiaca and Trigona sp. honey jelly (MTJ) as a convenient functional food.

    METHODS: The antioxidant properties were analysed using 2,2'-diphenyl-1 picrylhydrazyl (DPPH), ferric reducing antioxidant potential (FRAP) and 2,2'-azinodi 3-ethylbenthiazolinesulfonate (ABTS) assays. Cytotoxicity was assayed using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) test and the induction of apoptosis was observed via caspase-3/7 activity assay. The identification of phenolic compounds was done via ultra-high-performance-liquid chromatography coupled to mass spectrometer (UHPLC-MS/MS).

    RESULTS: The antioxidant analysis exhibited: the half inhibitory concentration (IC50) of DPPH inhibition, 54.10 (SD = 4.51) μg/mL; the FRAP value, 30.07 (SD = 0.93) mM TEQ/100 g; and the ABTS value, 131.79 (SD = 8.73) mg TEQ/100 g. Cinnamic acid was the most abundant phenolic compound, followed by maleic acid and salicylic acid. The IC50 for ORL115 and ORL188 were 35.51 mg/mL and 43.54 mg/mL, respectively. The cells became rounded and dissymmetrical which reduced in number and size. The apoptotic cell death in ORL115 and ORL188 was deduced as caspase-3/7 activities that significantly increased (P < 0.05).

    CONCLUSION: The study evidenced that the antioxidant activity of MTJ could influence the induction of apoptosis in ORL115 and ORL188 in future investigations and verifications.

  16. Abdullah B, Idorus MY, Daud S, Aazmi S, Pillai TK, Zain ZM
    Malays J Med Sci, 2023 Feb;30(1):116-128.
    PMID: 36875193 DOI: 10.21315/mjms2023.30.1.10
    BACKGROUND: This study has analysed the pattern of gut microbiota during the first and third trimesters among pregnant Malay women.

    METHODS: This was a pilot prospective observational study involving 12 pregnant Malay women without any endocrine disorders and on neither antibiotics nor probiotics. Demographic details and anthropometric measurements were obtained, and the faecal 16S ribosomal ribonucleic acid (rRNA) metagenome microbiota of the first and third trimesters (T1 and T3) were analysed. Univariate and multivariate statistics, partial least squares discriminant analysis (PLSDA) and Kendall rank correlation testing were used to identify key genera and associations with pregnancy trimester and body mass index (BMI).

    RESULTS: The most abundant phyla were Bacteroidetes, Firmicutes, Proteobacteria and Actinobacteria, with significant differences in composition at the genus level demonstrated between T1 and T3. Sequencing showed a statistically significant difference in beta diversity between normal and abnormal BMI at all taxonomic ranks (R 2 = 0.60; Q 2 = 0.23) and genus levels (R 2 = 0.57; Q 2 = 0.37). The relative abundances of Akkermansia (P < 0.05; false discovery rate [FDR] < 0.05), Olsenella (P < 0.05; FDR < 0.05) and Oscillospira (P < 0.05; FDR < 0.05) were found to be significantly higher in normal BMI cases by 2.4, 3.4 and 3.1 times, respectively.

    CONCLUSION: Three genera (Akkermansia, Olsenella and Oscillospira) were correlated with normal BMI during pregnancy. All three could be promising biotherapeutic targets in body weight regulation during pregnancy, subsequently reducing complications associated with higher BMI.

  17. Md Jaffri J
    Malays J Med Sci, 2023 Feb;30(1):7-20.
    PMID: 36875194 DOI: 10.21315/mjms2023.30.1.2
    The skin has a solid protective system that includes the stratum corneum as the primary barrier and a complete antioxidant defence system to maintain the skin's normal redox homeostasis. The epidermal and dermal cells are continuously exposed to physiological levels of reactive oxygen species (ROS) originating from cellular metabolic activities. Environmental insults, such as ultraviolet (UV) rays and air pollutants, also generate ROS that can contribute to structural damage of the skin. The antioxidant defence system ensures that the ROS level remains within the safe limit. In certain skin disorders, oxidative stress plays an important role, and there is an established interplay between oxidative stress and inflammation in the development of the condition. Lower levels of skin antioxidants indicate that oxidative stress may mediate the pathogenesis of the disorder. Accordingly, the total antioxidant level was also found to be lower in individuals with skin disorders in individuals with normal skin conditions. This review attempts to summarise the skin oxidant sources and antioxidant system. In addition, both skin and total antioxidant status of individuals with psoriasis, acne vulgaris, vitiligo and atopic dermatitis (AD), as well as their associations with the progression of these disorders will be reviewed.
  18. Abdollahpour S, Ashrafizaveh A, Azmoude E
    Malays J Med Sci, 2023 Feb;30(1):21-30.
    PMID: 36875197 DOI: 10.21315/mjms2023.30.1.3
    There are controversial debates regarding the effects of contraceptive vaginal ring devices on females' sexual function. Therefore, the meta-analysis of before-after was conducted on the intervention studies published in the past years to clarify these contradictions. The existing literature on the subject was reviewed by searching through such databases as PubMed, Scopus, ISI Web of Sciences, Embase, Cochrane Library and Google Scholar up to July 2021. Before-after intervention studies that had examined the effect of vaginal rings on females' sexual function were collected as well. In total, five studies with 369 participants were included in quantitative syntheses. Pooled results from the random-effect model showed that NuvaRing had a positive effect on females' sexual function three months after insertion (WMD: 2.48; 95% CI: 0.30, 4.67; P = 0.026); however, this effect was not significant after 6 months (WMD: 4.38; 95% CI: -4.95, 13.72; P = 0.357). Meta-regression analysis suggested that the effect of this device is associated with users' age and body mass index 3 months after insertion. No publication bias was found by Egger's test or funnel plots. Overall, the results of this meta-analysis support the view that vaginal ring use is associated with a positive effect on the sexual function of women 3 months after insertion, while the effect of this device on the sexual function of women was insignificant after 6 months. However, given the dearth of available data, it is not possible to reach a definite conclusion on the effect of vaginal rings on females' sexual function.
  19. Vijian K, Cheng YT, Idris Z, Izaini Ghani AR, Abdul Halim S, Abdullah JM
    Malays J Med Sci, 2023 Feb;30(1):198-212.
    PMID: 36875200 DOI: 10.21315/mjms2023.30.1.17
    Neurological examination is an important tool in diagnosing patients with neurological and neurosurgical conditions. As the complexity and knowledge of neurological and neurosurgical conditions increases, we are now required to learn and indoctrinate our peers and students with the correct skills and methods of examination. Emphasis on the correct techniques of testing muscle strength is essential to avoid errors in recording muscle power and in testing specific muscles which may have overlapping functions. The manual muscle testing of muscles of scapula and upper limbs was performed as to mimic a bedside clinical examination and involved an examiner, a patient and a videographer. The manual muscle testing has been performed in rostrocaudal manner starting from the scapula and ending with the thumbs. A reliable and consistent method of manual muscle testing is lacking among students and clinicians. By adhering to the methods delineated in our text and accompanying video, we hope to reduce inter-examiner variability and increase the reliability and validity of this important examination.
  20. Zahari NH, Abd Hamid IJ, Tuan Din SA, Hashim IF, Zainudeen ZT, Mohd Shariff N, et al.
    Malays J Med Sci, 2023 Jun;30(3):112-121.
    PMID: 37425378 DOI: 10.21315/mjms2023.30.3.10
    BACKGROUND: Intravenous immunoglobulin (IVIG) replacement therapy is increasingly in demand. This study focused on the characteristics of IVIG usage and associated factors toward the frequency status of IVIG among patients in Hospital Kuala Lumpur.

    METHODS: A retrospective cross-sectional study was performed on patients who received IVIG in Hospital Kuala Lumpur. Data were extracted from the request forms for IVIG recorded in the Pharmacy Department from January 2018 until December 2019. Chi-squared test and t-test analysis were used for statistical analysis, and a P-value of < 0.05 was considered significant.

    RESULTS: A total of 482 patients received IVIG in Hospital Kuala Lumpur. There were 243 (50.4%) females and 228 (47.3%) males with median age of the patients was 27 years old. The highest indications for IVIG among all patients were hypogammaglobulinemia and other deficiency states in 127 patients (26.3%). The most common indication for one-off treatment in adults was hypogammaglobulinemia and other deficiency states, 35%; whereas in paediatrics, it was Kawasaki disease, 20.3%. The highest indication for regular therapy among adult patients was chronic inflammatory demyelinating polyneuropathy (23.4%), while in paediatrics it was sepsis (31.1%). The clinical category was associated with the frequency status of IVIG usage in both adult and paediatric cohorts with P = 0.004 and P = 0.017, respectively.

    CONCLUSION: There were significant differences between the indication of one-off treatment and regular therapy among adult and paediatric patients. A national guideline on the prescription of IVIG for patients is instantly needed to help clinicians in prescribing IVIG appropriately.

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