Malaysian Journal of Medical Sciences最新文献

Background: Colorectal cancer (CRC) is one of the most common cancers globally, with the immunochemical faecal occult blood test (iFOBT) frequently used for population level screening. This study evaluated CRC screening uptake among urban-poor individuals aged 40-65, assessed their knowledge of CRC risk factors and symptoms before and after an educational programme, and identified determinants of polyps and CRC within this group.

Methods: A cross-sectional study recruited 577 individuals from seven People's Residential Project (PPR) areas in Cheras, Kuala Lumpur and Malaysia Madani Carnival between March 2022 and July 2023. Inclusion criteria were age 40-65 and smartphone ownership, excluding those with CRC history, acute gastritis, inflammatory bowel disease, or recent CRC screening. The iFOBT was administered, followed by questionnaires and educational talks. A follow-up questionnaire was conducted via phone two weeks post-programme.

Results: Overall, 321 participants fulfilled the eligibility criteria. Most iFOBT-positive participants were in their 50s (median [interquartile range, IQR]: 56 [16]), female (65%), 86.3% non-smokers, and 62.5% with moderate CRC risk based on the Asia Pacific Colorectal Screening (APCS) Score, showing no significant differences from iFOBT-negative participants. Among the 267 who returned iFOBT kits, 30.0% tested positive, with 28.8% undergoing colonoscopy. Polyps and CRC were detected in 21.74% and 4.35% of the participants, respectively. The mean knowledge score on CRC symptoms was significantly lower post-programme, with no significant change in awareness of CRC risk factors.

Conclusion: Detection rates for polyps and CRC are low. Awareness of CRC symptoms is higher pre-screening than post-screening, highlighting challenges in conducting CRC education in urban-poor communities.

Background: Pregnancy is associated with significant physical, emotional, and psychological changes. To adapt to these changes and ensure a healthy pregnancy, lifestyle interventions such as regular antenatal exercise (ANE) are vital. Hence, adequate knowledge of ANE among pregnant women is essential to promote the uptake of ANE. This study aimed to assess the knowledge, attitude, and practice (KAP) of ANE, and its associated factors among pregnant women in a suburban district.

Methods: A cross-sectional study was conducted among 571 pregnant women receiving antenatal care at primary health clinics in Kuala Selangor. Demographic data and maternal characteristics, as well as the KAP and associated factors of ANE, were obtained using a self-administered questionnaire. Descriptive statistics of the KAP of ANE were generated. Binary and multivariate logistic regressions were used to determine the predictors of ANE among pregnant women.

Results: About half (53.7%) of the study participants reported adequate knowledge while two-thirds (65.5%) had a positive attitude toward exercise. However, only 38.9% displayed a good practice of ANE. KAP of ANE was significantly associated with higher education, pre-pregnancy physical activity, and having received advice on physical activity. Women with positive attitudes were more likely to have good practice of ANE (AOR = 2.2; 95% CI: 1.5-3.2).

Conclusion: In short, this study indicated a moderate level of knowledge but a positive attitude towards ANE among pregnant women. Nevertheless, their actual practice of ANE needs to be improved. Future health education campaigns should focus on empowering women about the uptake and conduct of physical activity during pregnancy.

Background: Oral sodium bicarbonate is recommended for treating metabolic acidosis in chronic kidney disease (CKD). However, limited information exists on patient preferences between sodium bicarbonate tablets and powdered solutions. This study aimed to provide baseline data regarding the acceptance and adherence of patients with CKD to oral sodium bicarbonate therapy.

Methods: This prospective multicentre cross-sectional study was conducted across five Malaysian government hospitals involving adult patients with pre-dialysis CKD. A questionnaire assessed demographics, clinical characteristics, bicarbonate treatment, and included the Medication Acceptance Questionnaire (MAQ) (convenience, taste, appearance, efficacy, and tolerability), along with an individual adherence assessment.

Results: Among 203 patients analysed, the median age was 60 years (interquartile range [IQR], 16 years), and the majority were at stage 5 (n = 138, 68.0%). Sodium bicarbonate acceptance scores above 70% for all MAQ domains were significantly higher among tablet users than those of the powdered solution users, who only had scores above 70% for convenience, taste and tolerability domains. Tablet users were more adherent to treatment (88.9% vs. 70.9%, p < 0.014). A positive correlation was found between self-reported adherence and all five MAQ domain scores for the oral powdered sodium bicarbonate solution (convenience: r _s = 0.223, p = 0.005; taste: r _s = 0.223, p = 0.005; appearance: r _s = 0.161, p = 0.043; efficacy: r _s = 0.247, p = 0.002; tolerability: r _s = 0.279, p < 0.001). For tablet users, significant positive correlations were observed between self-reported adherence and the convenience (r _s = 0.413, p = 0.005), appearance (r _s = 0.449, p = 0.002), and efficacy (r _s = 0.355, p = 0.017) domains.

Conclusion: Tablet formulation of sodium bicarbonate was associated with higher patient acceptance and adherence, potentially leading to improved long-term clinical outcomes.

Background: This study aimed to determine the knowledge and attitude of the Malaysian public towards blood donation during the COVID-19 pandemic.

Method: This cross-sectional study utilised an online questionnaire to survey 409 Malaysians between 18 to 60 years old who were non-healthcare workers recruited via convenient snowball sampling. Data were analysed descriptively and via multiple logistic regression.

Results: About half (49.2%) of the participants have good knowledge of blood donation while 71.2% of them reported a positive attitude. Gender and blood donation experience were significantly associated with knowledge of blood donation. However, only gender was associated with attitude concerning blood donation. Gender, age, income and donation experience were significantly related to the perception of blood need. No factor was identified as significantly associated with the perception of blood donation risk. The majority of the participants quoted the main reason for blood donation as to save lives.

Conclusion: Most of the participants in this study showed a good knowledge and positive attitude towards blood donation. Gender, age, income and donation experience were the main associated factors. Based on these findings, future recruitment approaches for blood donors should target these identified groups, whereas promotional campaigns should be held among populations with poorer knowledge and attitudes towards blood donation, i.e., males, non-donors, younger populations and those with lower income.

GLOBOCAN 2022 reported that breast cancer is a primary contributor to the incidence and mortality rates of cancer in women. The very high and low Human Development Index (HDI) tiers are the primary contributors to the highest incidence and mortality rates, respectively. This study aimed to provide a comprehensive landscape overview of trends, dynamics, and research hot spots on the application of tamoxifen in treating breast cancer over the past 50 years. We retrieved data from the Scopus database, spanning from 1973 to 2022. We utilised Microsoft Excel, Harzing's Publish or Perish, and VOSviewer to perform exhaustive analyses, including the publication trend, co-authorship, co-citation, co-occurrence of authors, organisations, countries, and keywords. A total of 3,721 publications fit the inclusion and exclusion criteria. Jordan VC was the most prominent author, making substantial contributions to the research topic. Erasmus MC was the most prolific organisation, while the Swiss Group for Clinical Cancer Research exhibited the most robust international collaboration. The United States and the United Kingdom consistently have the highest publication, TLS, and h- and g-indices. Using keyword co-occurrence analysis, we identify adjuvant endocrine therapy, postmenopausal, EGFR, HER2, and autophagy as research hot spots. For the past five decades, the research output of the application of tamoxifen in breast cancer treatment has exhibited an upward trend. This endeavour provides a crucial reference for researchers to direct greater attention toward research hot spots in the hope that it will improve breast cancer patients' treatments and, consequently, increase their survival rate.

Oral protozoans, specifically Entamoeba gingivalis and Trichomonas tenax, have been identified in the oral cavity of individuals with periodontitis, frequently known as gum disease. Periodontitis is characterised by inflammation and degradation of the periodontal tissues and has been associated with the aggravation of systemic noncommunicable diseases. Although the importance of oral protozoans in periodontitis progression is often overlooked, their occurrence in individuals with periodontitis has reportedly been linked to the same modifiable risk factors contributing to numerous systemic noncommunicable diseases (NCDs). This article aims to provide a comprehensive overview of the occurrence patterns and potential connections among oral protozoans, periodontitis, and systemic NCDs while presenting the existing methods for the detection and identification of E. gingivalis and T. tenax.

Background: Undernutrition significantly affects surgical patient outcomes, prompting the Global Leadership Initiative on Malnutrition (GLIM) to establish a set of diagnostic criteria. This study assessed the prevalence of undernutrition using the GLIM criteria and determined a mid-upper arm circumference (MUAC) cutoff for malnutrition.

Methods: This cross-sectional study was conducted from December 2021 to May 2023. Biodata, information necessary for GLIM criteria, and anthropometric measurements including height, body weight, MUAC, fat mass (FM), and fat-free mass (FFM), were collected. Correlations among indicators analysed using Pearson's correlation. The MUAC cutoff points for underweight, obesity, and undernourishment were derived using receiver operating characteristics (ROC) and area under the curve (AUC), and the sensitivity, specificity, and positive and negative predictive values were calculated.

Results: Despite a mean body mass index (BMI) of 25.8 (6.0) kg/m², 30.0% of the patients met the GLIM undernutrition criteria. Overall, 13.4% of the patients were overweight, and 54.2% were obese. ROC analysis showed MUAC measures with an AUC ranging from 0.66-0.97. A MUAC cutoff of 28.9 cm identified undernourished patients with 66.7% sensitivity, 67.1% specificity, and 46.6% positive predictive value (PPV). Notably, the PPV increased to 75.4% in patients with cancer. The optimal MUAC cutoffs derived from the fat-free mass index (FFMI) for undernourished males and females were 26.8 cm and 26.1 cm, respectively.

Conclusion: Malnutrition is prevalent among surgical patients. The MUAC is a promising surrogate for assessing BMI and FFMI and serves as a valuable screening tool for nutritional status. These findings emphasise the importance of nutritional assessment in surgical care.

Candida auris was listed as a critical fungal priority group pathogen by the World Health Organization (WHO) in 2022. It has become a leading cause of invasive candidiasis in serious nosocomial infections globally. While Candida species, particularly C. albicans, are linked to cancer development, the role of C. auris in carcinogenesis remains unexplored. This scoping review aimed to evaluate the existing evidence on the role of C. auris infection in carcinogenesis and its associated risk factors. Following the PRISMA-ScR guidelines, a comprehensive search of three databases was conducted from January 2003 to January 2024 to identify studies addressing the role of C. auris infection in cancer development and its associated risk factors. A total of 124 articles were identified, of which six met the inclusion criteria. These studies reported the risk factors associated with C. auris infection in cancer patients. The findings showed an increased susceptibility of cancer patients to C. auris infections. However, to date, no direct relationship has been reported between C. auris infection and cancer development due to the limited accuracy of diagnostic tools. In conclusion, C. auris infections increase the susceptibility of cancer patients but are not directly involved in carcinogenesis, indicating the urgency for an accurate diagnostic tool for C. auris detection and specialised infection-control measures for cancer patients.