Malaysian Journal of Medical Sciences最新文献

Background: Injuries from road traffic accidents, falls, and other causes are a global health burden. In Malaysia, while mechanical and geographical factors in injuries are well studied, the role of psychosocial aspects, such as personality traits, remains underexplored. This study investigates the influence of personality traits, measured by the Universiti Sains Malaysia Personality Inventory (USMaP-i), on minor injury occurrence among patients at Hospital Universiti Sains Malaysia, focusing on extraversion, neuroticism, openness, agreeableness, and conscientiousness.

Methods: A cross-sectional study was conducted with 150 adult patients, comparing those with minor injuries to a control group without injuries. The Big Five personality traits were assessed using the USMaP-i, and associations with injury risk were analysed using independent t-tests, Pearson's chi-square tests, and multiple logistic regression (MLR).

Results: Significant associations were identified between specific personality traits and injury risk. Higher levels of extraversion were correlated with an increased injury risk, whereas openness demonstrated a protective effect. Gender also played a role, with males showing a 2.8- fold higher likelihood of injury than females. Other traits, such as neuroticism, agreeableness, and conscientiousness, were not significantly associated with injury occurrence.

Conclusion: Extraversion and openness significantly influenced the injury risk. The findings of this study enable the development of evidence-based prevention strategies through i) personality-based screening in the emergency department to identify high-risk individuals, particularly those with elevated extraversion scores; ii) targeted safety education programmes addressing trait-specific risk behaviours; and iii) gender-specific interventions focusing on male risk-taking tendencies. These tailored approaches can enhance existing injury prevention frameworks by incorporating psychological and behavioural factors alongside traditional safety measures.

Background: Tobacco use, usually initiated during adolescence, represents a significant public health problem worldwide. This study aimed to determine the prevalence of current users and ever users of tobacco products among adolescents and their associated factors.

Methods: This was a cross-sectional study which was conducted among Form 1, Form 2 and Form 4 students in six secondary schools in the Selangor state of Malaysia. A pre-tested and validated self-administered questionnaire was used.

Results: A total of 386 adolescents agreed to participate and fulfilled the inclusion criteria, giving a response rate of 89.4%. The prevalence of current users and ever users of all tobacco products was 9.8% and 26.2%, respectively. Vape or e-cigarettes recorded the highest prevalence of current users (8.0%) and ever users (17.4%), followed by cigarette smoking (current users: 3.1%; ever users: 14.0%) and snuff (current users: 2.1%; ever users: 9.6%). Tobacco products that recorded a lower prevalence of current and ever users included cigars, chewing tobacco, and pipe smoking (0.3% to 0.8%). The significant factors for current and ever users of tobacco products usage were Malay ethnicity, males, fathers smoking, peers who smoke, and interaction between gender and ethnicity.

Conclusion: In conclusion, about 1 in 10 adolescents were current smokers, and 1 in 4 were ever-smokers. The most popular method of tobacco consumption (current and ever usage) was vaping. Personal, parental, and peer influences were key predictors of smoking, highlighting the need to address them in anti-smoking programmes.

Background: Enhanced Recovery After Surgery (ERAS) is a multimodal perioperative care programme aimed at expediting recovery, reducing complications and minimising hospital stay by mitigating the metabolic stress response to surgery. One key shift in ERAS protocols is the replacement of traditional overnight fasting with carbohydrate-loading. Prolonged fasting increases insulin resistance, reduces cellular glucose uptake and glycogen formation, and may lead to hyperglycaemia. While maltodextrin is commonly used for carbohydrate-loading, it has a high glycaemic index and limited nutritional value. Kelulut Honey, a natural product rich in Trehalulose (a low-GI sugar), antioxidants, proteins, and vitamins may serve as a beneficial alternative.

Methods: A randomised double-blind controlled trial involving 64 patients was conducted to evaluate the safety and efficacy of Kelulut Honey as a carbohydrate-loading agent in patients undergoing elective intra-abdominal surgery. Participants received either Kelulut Honey or commercial maltodextrin (Carborie^®) according to ERAS protocol. Outcomes assessed included insulin resistance, residual gastric volume (RGV) and post-operative recovery parameters.

Results: No significant difference was observed in blood glucose levels between the two groups. Average blood glucose at induction ranged from 5.3 to 5.6 mmol/L, with post-operative levels remaining below 10 mmol/L. Most participants passed flatus within 12 hours post-operatively, with over half ambulating and tolerating clear fluids within the same period. No significant differences were noted between groups in terms of complications, length of stay, pain control, or functional recovery. Intention-to-treat analysis confirmed comparable outcomes across all primary and secondary endpoints.

Conclusion: Kelulut Honey is a safe and effective alternative to conventional carbohydrate drinks for pre-operative carbo-loading in abdominal surgery. It supports a modern shift away from the traditional surgical dogma of overnight fasting, with equivalent outcomes in glynaecmic control, RGV, and recovery compared to maltodextrin-based solutions.

Background: Oral and maxillofacial surgeons often deal with skin wounds, where the healing process involves phases such as inflammation and remodelling. Excessive inflammation can disrupt healing, leading to complications such as abnormal scarring and impaired tissue regeneration. Probiotics, especially strains such as Streptococcus salivarius K12, show promise in modulating inflammation and enhancing wound healing. Recent studies have aimed to explore how these probiotics affect inflammatory markers during wound healing, potentially offering new therapeutic benefits.

Methods: This quasi-experimental study, conducted in June-July 2023 at IPB (Institut Pertanian Bogor) University's Veterinary Teaching Hospital, included 24 healthy Sprague-Dawley rats. The rats were randomly assigned to two groups: one was treated with Streptococcus salivarius K12, and the other was the control group. The treated group's palatal wounds received Streptococcus salivarius K12, covered with a daily-changed mucosal patch, whereas the control group received only the patch. Four rats per group were sacrificed on days 3, 7, and 14. Wound areas were examined histopathologically, and neutrophil, macrophage, and lymphocyte counts were quantified using ImageJ software. Statistical analysis was conducted using MANOVA and the Tukey HSD test.

Results: All inflammatory indicators (neutrophils, macrophages, and lymphocytes) showed significant differences between the control and treated groups, as well as across different necropsy days.

Conclusions: The inflammation modulation by the probiotic Streptococcus salivarius K12 contributes to enhanced wound healing. In the treated group, there were higher counts of neutrophils, macrophages, and lymphocytes compared with the control group, with notable variations observed over time.

Background: Interpreting the effects of exercise is complicated because lipid profiles contain four different markers. Thus, scoring tools are required to aid interpretation of the effects of exercise on lipid profiles. A Scoring tool for Lipid profile Interpretation in EXercise (SLIEX) was designed specifically for use by health professionals to interpret effects of exercise intervention on lipid profiles.

Methods: The tool consisted of 18 scores (4 scores for changes pre- and post-intervention, and 14 scores for weightage of changes). This score provides the proportion of improvement in the lipid profile following exercise intervention. Kappa statistics (κ) were used to measure interobserver agreement, and the interclass correlation coefficient (ICC) was used to check the reliability of the scoring tool. One-way ANOVA was used to identify systematic differences between observers using the Statistical Package for the Social Sciences (SPSS) version 28 with statistical significance set at P < 0.05.

Results: The summated SLIEX scores for each observer showed no systematic differences [F (2, 69) = 0.09, P = 0.991]. The summated SLIEX scores of the three observers showed significant association and excellent agreement as follows: Observers 1 and 2: ICC = 0.950, 95% confidence interval (CI), 0.889-0.978, P < 0.001; Observers 2 and 3: ICC = 0.993, 95% CI, 0.983-0.997, P = 0.000; Observers 1 and 3: ICC = 0.972, 95% CI, 0.937-0.988, P < 0.01.

Conclusion: The SLIEX score is a new and reliable tool designed for health professionals to interpret the effect of exercise intervention on lipid profiles.

Background: Hospital Information Systems (HIS) are pivotal in enhancing decision-making, operational efficiency, and patient care. The quality of the provider-supported HIS, particularly in outsourced settings, critically influences user satisfaction and perceived net benefits. This study investigates the impact of provider quality, including system, service, and information quality, on user satisfaction and perceived net benefits in Malaysian public hospitals. Employing the DeLone and McLean Information System Success Model as a theoretical framework, this study also explores the mediating role of user satisfaction.

Methods: Structural Equation Modelling using Analysis of Moment Structures (AMOS) was applied to data from 1,376 respondents across six hospitals.

Results: The structural model revealed significant direct effects: system quality (β = 0.480, P < 0.001) and service quality (β = 0.438, P < 0.001) positively impacted user satisfaction, whereas information quality had no significant effect (P = 0.232). Service quality also significantly influenced perceived net benefits (β = 0.135, P < 0.001), as did user satisfaction (β = 0.342, P < 0.001). The indirect effects highlighted user satisfaction as a key mediator, with significant mediation observed for system quality (β = 0.164, P < 0.001) and service quality (β = 0.150, P < 0.001).

Conclusion: This study highlights the critical mediating role of user satisfaction, providing deeper insights into user interactions in healthcare settings. In addition, it offers valuable contributions to understanding how system quality and service quality impact user satisfaction and perceived net benefits, along with practical recommendations for improving HIS.

Background: Ischaemic stroke is a leading cause of physical disability, significantly impacting patients' independence in daily activities. The inability to perform basic activities of daily living poses a major challenge for post-stroke patients, affecting their quality of life. Discharge planning is a crucial approach in stroke rehabilitation aimed at enhancing patient independence after hospitalisation. This study evaluated the impact of structured discharge planning on the independence of ischaemic stroke patients.

Methods: A quasi-experimental design was employed, with the intervention group receiving discharge planning and the control group receiving no intervention. Patient independence was assessed by applying the Barthel Index, evaluating their ability to perform daily activities before and after the intervention.

Results: The intervention significantly improved the independence levels of the participants in the intervention group, as measured by the Barthel Index, with their mean score increasing from 2.8 to 11.3. In comparison, the control group also showed improvement, with the mean score rising from 5.7 to 10.1.

Conclusion: Discharge planning effectively enhances the independence of patients with ischaemic stroke. Implementing this programme in hospitals is expected to reduce patient dependency and improve the quality of life.

The cranium houses the brain, and layers formed by the scalp, cranial bones, and meninges protect it from external energy, including light. Therefore, the brain can be viewed as a black body in a black box. The layers also protect the brain from external atmospheric or gravity force, and together with cerebrospinal fluid (CSF), it creates a microgravity or buoyant brain compartment. The brain curving (microgravity posture) mainly occurs at the mesencephalic-diencephalic junction and is thought to be because of the microgravity environment, thus, creating a nearly spherical-like brain geometry. The roughly spherical brain geometry, a black body with its heat irradiation, the presence of charged fluid in the brain extracellular space, and brain requirements to optimally cleanse waste products and be protective against micro-organisms may suggest a possible presence of plasma-like brain energy. This energy has the capability to emit infrared, and its amount is determined by black-body radiation and thermodynamics principles.

The recurrence rate of stroke, particularly ischaemic stroke, is considered high, which highlights the importance of secondary stroke prevention. Pharmacists are becoming increasingly involved in poststroke care. Ease of public access to community pharmacists provides opportunities for pharmacists to educate patients about the significance of secondary stroke prevention. The literature outlining comprehensive educational materials for stroke patients to prevent secondary stroke is still limited. This review aimed to obtain the details of the educational material presented by the pharmacist and to determine whether it led to positive outcomes-a comprehensive search involved PubMed, Scopus, Science Direct, and Cochrane Library databases. The Joanna Briggs Institute's (JBI) critical appraisal techniques were utilised to analyse the quality assessment for all study categories. As many as 12 studies were deemed eligible for inclusion. There are seven main categories under which information on secondary stroke prevention education is presented: modifiable risk factors, medication therapy management (MTM), medication adherence, cardiovascular risk factors, stroke (disease state), patient engagement, and quality of life. Pharmacists, mostly in community settings, play an important role in managing stroke risk factors (blood pressure, low-density lipoprotein [LDL], and A1c), promoting medication adherence, preventing hospital readmissions, increasing the level of knowledge, and enhancing patient satisfaction, which showed a favourable effect on preventing stroke recurrence following the pharmacist's educational intervention.