Malaysian Journal of Medical Sciences最新文献

The surface anatomy of dermatomes and sensory examination play crucial roles in assessing and diagnosing various medical conditions. Understanding the distribution of dermatomes and conducting sensory examinations are essential in identifying and localising neurological disorders, such as nerve damage or compression. This manuscript describes the surface anatomy of the face and body and their respective key sensory examination points for sensory and neurological examination to aid Malaysian medical students and trainees in lesion localisation.

Healthcare systems, particularly operating theatres (OTs), are among the leading causes of pollution due to energy-intensive procedures, anaesthetic gases, and single-use surgical instruments. This perspective review provides actionable, evidence-based recommendations that not only minimise the environmental impact but also offer quality patient care. A wide literature search of available studies on green surgery was conducted. Searches were conducted in databases, including PubMed, Science Direct, Scopus, ProQuest, and Web of Science, from January 2013 to the present. A review of global practices highlighted the effectiveness of green surgical initiatives. Some initiatives related to the health sector report reductions in carbon emissions by reusable surgical instrument implementation in hospitals of up to 97%, energy savings of up to 50% with modifications to heating, ventilation, and air-conditioning (HVAC) systems, and waste management programmes, including the recycling and reprocessing of single-use devices, reporting waste reductions from 40% to 66%. Key strategies include shifting to renewable energy sources by promoting reusable instruments, optimising HVAC systems, and promoting comprehensive staff training for sustainability. All these factors are important for decreasing the environmental burden without compromising operational efficiency. The integration of sustainable practices in Malaysian OTs can significantly reduce carbon emissions and waste generated by hospitals while maintaining patient safety. These measures support the national goals of achieving Sustainable Development Goals (SDGs) and advancing Universal Health Coverage (UHC). Aligning with global sustainability efforts, Malaysia's health care system can reduce its carbon footprint.

Background: Functional Movement Screen (FMS)™ can be a valuable tool for assessing movement patterns and identifying potential movement dysfunctions. However, it is limited in terms of subjectivity and consistency of the ratings, especially among less proficient raters. Knowledge of minimally required training thresholds will provide valuable information on training adequacy. Thus, this study aimed to determine the interrater reliability of FMS™ among completely novice raters undergoing a one-off training session.

Methods: Twenty active adults with no musculoskeletal injuries or muscular dysfunction performed seven FMS™ tasks while being recorded. Subsequently, 12 novice raters with no prior knowledge and skills about FMS™ rated the recorded movement videos at a normal play speed and without rewinding.

Results: The interrater reliability analysis of the composite FMS™ score revealed an Intraclass Correlation Coefficient (ICC) of 0.60. Moreover, the mean coefficient for interrater reliability for the seven FMS™ components score is 0.35.

Conclusion: The results implied that a one-off FMS™ training produced a large variability in the rating consistency, especially for rotary stability, deep squats, and in-line lunge ratings.

One in eight people globally, prevalent mainly in some ethnic groups and those from low socioeconomic backgrounds, is a critical global health challenge of obesity. The telehealth system would be valuable in arresting obesity, with better access to care and a supporting digital community that encourages regular practice of physical activities, healthy diets, and health monitoring, all within reach and at affordable prices. Digital health interventions such as telehealth, mHealth applications, and wearable devices are new modalities for the treatment of obesity that increase monitoring of energy expenditure, physical activity level, and caloric intake. These technologies enhance the possibilities of therapy against barriers, such as maintaining motivation and improving the diet. This review summarises current evidence regarding digital health interventions for obesity management by considering and evaluating various global digital strategies to reduce obesity. The literature emphasises the effectiveness of eHealth interventions toward weight loss and maintenance. Furthermore, artificial intelligence (AI) and Information and Communications Technology (ICT) can predict and prevent paediatric obesity. By contrast, virtual reality (VR) applications can determine real-world behaviour in clinical practice. These digital interventions could increase the reach and efficacy of traditional weight management programmes by becoming more embedded in clinical practice. However, because of their broad implementation across different clinical settings, concerns regarding the security and privacy of these technologies must be addressed.

Background: Streptococcus pneumoniae (pneumococcus) is an opportunistic pathogen that causes severe upper and lower respiratory tract infections, leading to life-threatening diseases. This study aims to determine the genetic variation of serotypes among a collection of clinical S. pneumoniae isolates using multilocus sequence typing (MLST) and multilocus variable-number tandem repeat analysis (MLVA).

Method: A total of 103 viable isolates were serotyped and subjected to MLVA; only those with discrete serotypes (n = 91) were subjected to MLST analysis.

Results: The comparative phylogenetic analysis resulted in the segregation of clonal complexes (CC) and 36 singletons accordingly. The major clonal complex, MLST CC320 (n = 23; 25.3%), had a close association with the Taiwan^19F-14 clone, consisting of ST236, ST271, and ST320. The second largest group, MLST CC9 (n = 12; 13.2%), had an association with the England¹⁴-9 clone, comprising ST7 and ST9. MLVA analysis demonstrated its ability to differentiate subgroups within CCs that share the same sequence type (ST) with distinct MLVA types (MTs).

Conclusion: The integration of MLST and MLVA in this study serves as a model for pneumococcal surveillance indicating some well-known globally circulating clones that have been persisting at this study setting.

Excellence in medical school demands a steadfast commitment to amanah-a trust upheld with integrity and accountability. This responsibility spans academics, student mentorship, research, and service, requiring academicians to balance their roles. A good understanding of curricular principles for undergraduate and postgraduate programmes, strengthened by robust quality assurance, serves as the cornerstone of academic excellence. The educational agenda, guided by the value-driven HEBAT framework and seamlessly integrated in diverse programmes, aims to boost student excellence. Related initiatives nurture intercultural competence and shape compassionate, resilient professionals equipped with the insight needed to navigate and excel in the complexities of modern medical practice. Research clusters foster innovation and promote interdisciplinary collaboration. By balancing team dynamics and focused groups, they can enhance productivity and impact. Aligning community service with the Sustainable Development Goals requires strategies for properly documenting and measuring impact. A hallmark of academic excellence is time management which enables academicians to harmonise their responsibilities. The way forward for medical schools lies in enriching collaborations and international engagement. Together, these efforts affirm the value of amanah of academicians to drive excellence.

Background: The present study evaluated the reliability and validity of the Streamlined Wolf Motor Function Test for Chronic Stroke (SWMFT-C), a shortened and redesigned version of the Wolf Motor Function Test (WMFT) to determine upper extremity (UE) motor abilities.

Methods: Twenty individuals with chronic stroke were included in a cross-sectional study design. The Fugl-Meyer Assessment of the Upper Extremity (FMA-UE) and the Stroke Impact Scale (SIS) were used to assess impaired motor recovery of the UE in these patients. The SWMFT-C's test-retest (two weeks) reliability and inter-rater reliability (three physical therapists) were examined using the intra-class correlation coefficients (ICCs) ICC_2,1 and ICC_3,1. Validity was analysed by FMA-UE and SIS-hand function at baseline and 2 weeks using Pearson's r values.

Results: The SWMFT-C performance time(s) demonstrated excellent test-retest reliability (ICC_3,1 = 0.943, 95% confidence interval [CI] = 0.859-0.978, standard error of measurement [SEM] = 0.15) and outstanding inter-rater reliability (ICC_2,1 = 0.999, 95% CI = 0.998-1.000, SEM = 1.15). The functional ability scale (FAS) also demonstrated excellent test-retest reliability (ICC_3,1 = 0.945, 95% CI = 0.861-0.978, SEM = 0.12) and inter-rater reliability (ICC_2,1 = 0.973, 95% CI = 0.944-0.989, SEM = 0.18). Internal consistency (IC) was calculated using the overall Cronbach's alpha and demonstrated outstanding agreement as shown by values of 0.99 and 0.94 in performance time(s) and FAS, respectively; the values of minimum detectable change (MDC₉₅) were 2.26 seconds and 0.34 seconds, respectively. The validity was good to excellent as correlated with FMA-UE and SIS-hand function, ranging from -0.86 to -0.52 in performance time(s) and 0.65 to 0.80 in FAS.

Conclusion: The SWMFT-C is a valid, reliable clinical instrument for the population with chronic stroke.