Malaysian Journal of Medical Sciences最新文献

The 2019 COVID-19 pandemic exposed significant challenges in global healthcare. In Malaysia, limitations in stroke care and the lack of digital interventions highlighted gaps in supporting the stroke community, increasing caregiver burdens and undermining the nation's stroke care system. The study is conducted to explore evidences about the digital health in stroke care and rehabilitation, especially for home-based care in Malaysia, including the current status and the availability of intervention modules. The literature search for this narrative review was conducted across databases such as PubMed, Scopus, Google Scholar, and others. Approximately 250 articles were identified through a combination of database searches and manual selection using keywords such as "stroke rehabilitation," "digital health," "mHealth," "caregiver burden," and "Malaysia". After screening 127 articles based on their titles and abstracts, 80 full-text articles were assessed for relevance to the review's inclusion criteria. Ultimately, 58 studies (research articles and website sources) were included in the final review, focusing on stroke rehabilitation, caregiver burden, and digital health interventions, particularly mobile health (mHealth) solutions. The results are presented in summative paragraphs of reviews complementing subtopics in order to reach final conclusion and future directions. The subtopics are: i) Understanding stroke and caregiver's burden; ii) Stroke in global digital health; iii) Stroke intervention modules for web-based and smartphone applications; and iv) Malaysia, mobile health (mHealth) and stroke intervention module. Evidence suggests that Malaysia still falls short in meeting the needs of the stroke community, and that stroke care must be made available through digital means.

Background: Emotional abuse is a pervasive form of maltreatment with severe mental health consequences, particularly in children. Despite its impact, emotional abuse often goes unnoticed, complicating its detection. In Malaysia, increasing awareness underscores the need for reliable and culturally adapted tools such as the Emotional Abuse Questionnaire-Malay Version (EAQ-M).

Methods: This cross-sectional validation study aimed to translate and validate the EAQ into Malay. The process involved forward and backward translation, finalised by six bilingual experts, including paediatricians, certified language lecturers, and medical officers. Face validity was assessed by 10 children aged 13 to 17 years, and content validity by six experts. A total of 165 secondary school students from Kota Bharu, Kelantan, participated. Confirmatory Factor Analysis (CFA) assessed construct validity, and Cronbach's alpha evaluated internal consistency. Test-retest reliability was determined using intraclass correlation coefficients (ICC).

Results: The EAQ-M demonstrated high content validity (S-CVI/UA = 0.96) and face validity (S-FVI/UA and S-FVI/Ave = 1). CFA confirmed the retention of 29 out of 30 items, maintaining the original six-factor structure. Fit indices indicated acceptable model fit (NC = 1.555, RMSEA = 0.058, GFI = 0.819, AGFI = 0.782, CFI = 0.873, TLI = 0.857, NFI = 0.717, and SRMR = 0.081). Internal consistency was high (Cronbach's alpha = 0.902), and test-retest reliability was strong (ICC = 0.917, 95% CI = 0.869-0.955).

Conclusion: The EAQ-M, with 29 of the 30 original items retained, is a reliable and valid six-factor tool for assessing emotional abuse among Malaysian children.

Infertility, a rising global concern, is frequently caused by genetic causes, making modern reproductive methods like in vitro fertilisation (IVF) and in vitro maturation (IVM) necessary for successful conception. Nonetheless, little is known about the molecular pathways causing infertility. This study conducted a systematic review following PRISMA guidelines, aiming to comprehensively elucidate the gene expression profiles of cumulus cells following IVM and their implications for reproductive outcomes. A thorough literature search was conducted across multiple databases, employing a combination of keywords related to cumulus cells, IVM, and gene expression. For this systematic review, screening processes identified four clinical human studies meeting inclusion criteria, published between 2013 and 2022. The studies used qPCR and RNA sequencing to compare gene expression in cumulus cells pre- and post-IVM or between IVF and IVM patients. Despite variations in sample sizes and methodologies, 22 differentially expressed genes (DEGs) were identified, with 10 common DEGs between IVF and IVM matured cumulus-oocyte complexes. Protein-protein interaction network analysis revealed a complex molecular network associated with cumulus cell function and oocyte maturation. Clustering analysis identified a significant cluster enriched in genes involved in the epidermal growth factor receptor signalling pathway and cell membrane dynamics. Gene ontology and pathway enrichment analysis highlighted the involvement of DEGs in cell-cell signalling, signal transduction, and ovarian steroidogenesis pathways. The findings emphasise the importance of understanding molecular mechanisms in infertility and provide valuable insights for optimising assisted reproductive technologies. Future research should focus on validating these findings and exploring potential therapeutic targets for improving reproductive outcomes.

Voltage-gated sodium channels (VGSCs) play a critical role in generating and propagating electrical signals in excitable cells. To date, the technology has gained much attention for its therapeutic potential in treating various diseases, including cancer. This study provides a comprehensive bibliometric analysis of VGSC research trends over 40 years (1984-2023) using the Scopus database. A total of 3,170 articles were analysed to explore publication productivity, authorship, key research topics, and collaboration patterns. The analysis identified the leading countries according to the number of articles contributed and determined that the USA, China, and Germany were the most productive. In fact, the USA alone accounts for 41.6% of global VGSC research on therapeutics. Additionally, based on the number of published articles, institutions such as Harvard Medical School and the University of Cambridge were found to be at the forefront of this field. Overall, the performed research focused on the therapeutic applications of VGSCs in conditions like atrial fibrillation, chronic pain, cancer, and genetic diseases. The study also highlights a growing interest in VGSC-related research in the past decade as a result of the advancements in molecular techniques such as next-generation sequencing (NGS) and small interfering RNA (siRNA). These findings suggest that VGSCs will remain a central point in therapeutic research for years to come, with a greater interest in international collaboration to drive further progress.

Background: Objective Structured Clinical Examination (OSCE) is an essential clinical skills evaluation method used in the preclinical stage. OSCE increases students' average readiness to practice the role of medical personnel. Good knowledge is expected to be directly proportional to clinical practice skills. The cumulative grade point average (GPA) is the parameter used to measure knowledge. Students are said to be ready to practice if they balance clinical skills, basic knowledge, and critical thinking which can be seen through comprehensive OSCE scores and student GPA. This study aims to examine the relationship between comprehensive OSCE scores and GPA on the readiness of undergraduate medical students to undergo clinical rotations at the Faculty of Medicine, Universitas Udayana.

Methods: This study was conducted at the Faculty of Medicine, Universitas Udayana, from May to October 2024. Its subject was research on medical students who will undergo clinical rotations. The research instrument used was the Preparedness for Hospital Practice Questionnaire (PHPQ). Data analysis was carried out using SPSS for Windows version 25.0 software.

Results: The mean age of respondents was 22.02 ± 0.835 years. Most respondents were female (61.1%) and international students (51.9%). The mean rating scale of the research respondents from the eight domains was 4-5, indicating that students' readiness to undergo clinical rotations was adequate to adequate. Comprehensive OSCE scores and GPA have a significant relationship with the readiness of undergraduate medical students for clinical rotations, respectively, in the domains of collaboration, holistic care, and interpersonal skills. Conclusion: The results of this study can serve as a reference for evaluating the readiness of undergraduate medical students to undergo clinical rotations and for preparing appropriate learning strategies at the Faculty of Medicine, Universitas Udayana, particularly during the transition to clinical rotations.

Background: The Exercise Habit Strength Questionnaire (EHSQ) has shown excellent psychometric properties. However, children in different weight categories exhibit distinct patterns of exercise engagement. Therefore, examining the EHSQ's psychometric properties across different weight groups across time may provide additional evidence of its discriminatory power and temporal stability.

Methods: This study was conducted in two samples. Sample 1 involved 450 secondary school students (mean age: 14.72 ± 1.19 years), consisting of 52% males and 48% females across different body mass index (BMI) categories-normal (17.70%), overweight (23.44%), and obese (58.85%). Data collection involved the EHSQ, Body Appreciation Scale and the Implicit Association Test. Sample 2 consisted of 60 female students aged 16 years from all-girls schools, with 48.3% in the normal category and the remaining underweight, overweight, and obese categories. The EHSQ was administered twice, with a three-month interval between administrations.

Results: Confirmatory factor analysis provided evidence of factorial validity (χ ² = 210.06, df = 129, P < 0.05; χ ²/df = 1.63; CFI = 0.96; GFI = 0.95; RMSEA = 0.04; AIC = 314.69). Item loadings were above 0.5, except for one item, with latent factor intercorrelations ranging from 0.2 to 0.5. The results of the Intraclass correlation coefficient analysis demonstrated excellent test-retest reliability. Additionally, internal consistency scores in Sample 2 mirrored those of Sample 1, with Cronbach's alpha values of 0.756 for patterned action, 0.757 for automaticity, 0.89 for negative consequences, and 0.84 for stimulus cue.

Conclusion: Overall, the results provided adequate support for the hypothesised psychometric properties of the ESHQ.

Background: Anxiety and depression are prevalent among people living with HIV/AIDS (PLWHA), with significantly higher rates than in the general population. As HIV has become a manageable chronic condition through antiretroviral therapy (ART), understanding its mental health impact is essential. This study examines the prevalence and key factors associated with anxiety and depression among PLWHA at an ART clinic in South Vietnam's Thu Duc City Hospital.

Methods: A descriptive cross-sectional study was conducted on 369 PLWHA being treated at the ART clinic at Thu Duc City Hospital from March to May 2024. Convenience sampling was used to select the participants, all age 18 and up, who were interviewed face-to-face using a structured questionnaire that included PHQ-9 and GAD-7.

Results: Of the study's 369 participants, 82.4% were male, with most between ages 19 and 39 (71.8%). Anxiety prevalence was 29.3% (95% CI: 24.6-34.1), while depression was reported by 23.0% of participants (95% CI: 18.8-27.6). Significant factors associated with anxiety disorders included experiencing side effects during ART treatment (AOR = 5.92, 95% CI: 1.54-22.7, P = 0.01) and high levels of HIV stigma (AOR = 2.51, 95% CI: 1.45-4.33, P = 0.001). Depression was associated significantly with severe anxiety (AOR = 101.61, 95% CI: 11.67-884.28, P < 0.001) and moderate anxiety (AOR = 58.06, 95% CI: 22.27-151.40, P < 0.001).

Conclusion: This study highlights the critical need to address mental health challenges among PLWHA in South Vietnam, with an emphasis on the importance of reducing stigma, managing ART-related side effects and integrating mental health care into HIV treatment. The findings provide valuable insights for developing appropriate contextual interventions.

Due to ongoing and unresolved disputes over the recognition of specialist training programmes and specialist registration, the Ministry of Health and the Ministry of Higher Education sought legal opinion from the Attorney General's Chambers. Following the legal opinion, both Ministries proposed a joint memorandum to the Cabinet to amend the Medical Act 1971 [Act 50]. This article outlines the need for these amendments, their content, and their impact on specialist training programmes conducted by the Ministry of Health.

Background: This study aims to determine the effects of an intervention programme on knowledge, attitude, and practice of nutrition and physical activity, and physical activity level among Middle Eastern adolescent students in Arabic schools in Malaysia.

Methods: A cluster randomised controlled trial was conducted among early adolescence, aged 13 and 14 years from February 2022 to September 2023. The study involved 250 participants, with 125 in the intervention group (IG) and 125 in the control group (CG). The IG underwent a "Healthy Lifestyle" educational programme, while the CG was not exposed to the programme. Knowledge, attitude, practice and physical activity level were assessed using questionnaires.

Results: The study began with 250 participants divided into two groups. Dropouts occurred, resulting in 116 IG and 119 CG participants pre-intervention, 113 IG and 115 CG post-intervention, and 111 IG and 112 CG at follow-up. A significant intervention effect was found in improved knowledge, attitude, practice and physical activity level of the IG post-intervention and at the three-month follow-up compared to pre-intervention (P < 0.001). Specifically, the mean scores for knowledge, attitude, and practice of IG have significantly changed from the pre-intervention to follow-up, with mean differences of -13.03, -15.62, and -10.90, respectively, while physical activity levels changed from the pre-intervention to follow-up, with mean differences of -0.33 in the IG.

Conclusion: The educational programme could increase awareness of nutrition, physical activity, and healthy behaviour among Middle Eastern adolescents, thereby potentially reducing obesity and non-communicable diseases among school students in the future.

The World Health Organization's Communication for Behavioural Impact (COMBI) strategy aims to promote healthy behaviours through integrated communication. Malaysia has adopted the COMBI approach to combat dengue; however, sustaining these efforts presents ongoing challenges. This review explored the facilitating factors and barriers associated with challenges in the sustainability of Malaysia's COMBI programme for dengue prevention. We used the SPIDER framework (Sample, Phenomenon of Interest, Design, Evaluation, Research Type) to identify relevant articles, and we searched Scopus, PubMed, ScienceDirect, BMJ, Sage, and Google Scholar. Our search followed PRISMA guidelines, using Boolean operators "AND" and "OR" to connect keywords like "dengue" and "Communication for Behavioural Impact (COMBI)." The review included five articles, which were appraised by the Joanna Briggs Institute (JBI) Critical Appraisal Tool. Findings indicate that COMBI programmes significantly enhance knowledge, attitudes, and practices (KAP) and reduce both dengue cases and mosquito breeding sites. The reviewed articles identified nine themes as either facilitating factors or barriers to the sustainability of COMBI: community engagement, leadership, political stability, mass media, public health campaigns, funding, human resources, multi-sectoral collaboration, and migration of residents. Identifying factors and barriers is key to improving the effectiveness and sustainability of COMBI programmes. This review highlights the importance of mixed methods research and community-centric engagement in addressing community issues and refining COMBI strategies. These comprehensive approaches are crucial for sustaining community involvement and ensuring the effectiveness of dengue prevention, thereby contributing to the long-term success of public health interventions in Malaysia and globally.