Malaysian Journal of Medical Sciences最新文献

Globally 8.4% of children under 5 years old have a neurodisability. The important factors contributing to this are infection and inflammation, nutrition and quality of care especially during pregnancy and in the first 2 years of life. In an attempt to reduce neurodisability arising from these factors, WHO launched the 1,000 days initiative in 2014. Recent data from the National Health and Morbidity, and Malaysian National Neonatal Registry is a cause for concern. The rate of low weight babies has shown a significant increase during this period. The percentage of pregnant mothers with diabetes has doubled over the last 6 years. In addition, 20% of children under 5 years old are stunted and 46% have anaemia. All of these impact on neurological development, potentially increasing the incidence of developmental disorders and motor deficits.

Background: This study aimed to examine the association between dietary patterns, lifestyle factors, and colorectal cancer (CRC) risk among the Malaysian population.

Methods: We recruited 100 patients and 100 controls from two selected government hospitals. Principal component analysis was used to identify dietary patterns using a 123-item semiquantitative food frequency questionnaire. Tobacco smoking and alcohol consumption questionnaires were modified from the WHO STEPS Survey questionnaire. Physical activity levels were assessed using the revised Global Physical Activity questionnaire. Associations between dietary patterns, lifestyle factors and CRC risk were assessed using logistic regression with SPSS version 24.0.

Results: Three dietary patterns were derived from factor analysis: i) vegetables; ii) meat, seafood and processed food; and iii) grains and legumes. High vegetable diet intake was independently and significantly associated with an 81% decreased risk of CRC (odds ratio [OR]: 0.19; 95% confidence interval [CI]: 0.08, 0.46). Both recreational-related physical activity (OR: 2.04; 95% CI: 1.14, 3.64) and vigorous physical activity (OR: 2.06; 95% CI: 1.13, 3.74) are significantly associated with decreased risk of CRC. Increasing the number of cigarettes smoked (≥ 16 cigarettes) per day significantly increased the odds of developing CRC (OR: 2.58; 95% CI: 1.95, 6.75). The duration of alcohol consumption cessation was inversely associated with CRC risk (OR: 2.52; 95% CI: 2.30, 10.57).

Conclusion: The protective effects of a fruit and vegetable diet, and a healthy lifestyle can be used to develop interventions that help reduce the risk of CRC in the Malaysian population.

Background: The purpose of this study is to compare axial length (AL) and the refractive outcome after phacoemulsification surgery from 2014 to 2019 at Hospital Sultanah Nur Zahirah, Terengganu, Malaysia.

Method: This was a retrospective record review of all cataract patients who met the inclusion criteria and underwent uneventful superior wound phacoemulsification with nontoric intraocular lens (IOL) by a single surgeon from 2014 to 2019. Using optical biometry or immersion technique, the preoperative AL determined solely via the Sanders, Retzlaff and Kraff 2 (SRK2) formula was selected. The postoperative spherical equivalent (SE) at 6 weeks-12 weeks was retrieved. Using Statistical Package for the Social Sciences version 24.0, the mean differences between targeted and actual postoperative SE were analysed based on the AL.

Result: In this study, 490 eyes of 472 patients aged 25 years old-88 years old (mean age 65.72 years old [SD 8.83]) were involved. There were 162 eyes (33%) in Group A (< 23 mm), 189 eyes (39%) in Group B (23.01 mm-24.0 mm) and 139 eyes (28%) in Group C (> 24.0 mm). The mean AL was 23.63 mm (SD 1.19). The mean differences between the targeted and actual postoperative SE were: -0.09 D (SD 0.60) in Group A, -0.07 D (SD 0.53) in Group B and -0.16 D (SD 0.52) in Group C. No significant difference was found between these groups (P = 0.327).

Conclusion: There was no significant difference in the refractive outcome using the SRK2 formula in different ALs after phacoemulsification surgery. Hence, there is no reason to modify or adjust the targeted SE based on AL.

Background: Various barriers lead to a shortage of organs for transplantation in Malaysia. One drive to improve the organ donation rate operates through future healthcare practitioners and practitioner advocacy. This scoping review was carried out to establish and summarise findings about organ donation-related articles among the public, health sciences students and health personnel. A further aim was to synthesise the latest data on knowledge and attitudes towards organ donation in the Malaysian population.

Methods: PubMed, Scopus, Google Scholar and the Malaysian Medical Repository (MyMedR) were used for a search conducted up to May 2022. Relevant search terms included 'Organ donation' and 'Malaysia'. Journal articles related to knowledge, attitudes and intention were grouped under the general public and health science. Students and health personnel were included. Eligible studies were reviewed by two independent reviewers. Any disagreements were resolved by consensus with a third reviewer.

Results: The 31 included articles revealed an increased level of awareness among the public regarding organ donation. The analysis identified that nonrecognition of brainstem death (38.5%), no knowledge of how to contact the Organ Transplant Coordinator (82.3%) and never approaching the families of a potential donor (63.9%) led to a lack of confidence among healthcare practitioners to promote organ donation.

Conclusion: The shortage of organ donors is the result of the failure to identify the expected donor, obtain consent and procure the organs due to the passivity of Malaysian health professionals in promoting the organ donation process.

Introduction: Ligation of the intersphincteric fistula tract (LIFT) is a sphincter-preserving procedure for treating anal fistula of cryptoglandular origin. Our prospective study aimed to determine the postoperative outcomes of patients undergoing LIFT in emergency and elective settings.

Methods: This was a single-centre prospective observational study of the LIFT procedure for the treatment of anal fistulas. The differences in the 6-month postoperative outcomes between the emergency and elective procedures were analysed, including the healing rate, healing time, recurrence rate, recurrence time, postoperative complications and length of hospital stay.

Results: Twenty-two patients were recruited for this study: 11 patients underwent LIFT as an emergency procedure (EM-LIFT), while the others underwent LIFT as an elective procedure (EL-LIFT). The healing rate for the EM-LIFT group was 90.9% (n = 10), with a median healing time of 2 months (range 0.5-4). For the EL-LIFT group, the healing rate was 100% (n = 11), with the same median healing time of 2 months (range 0.5-4). Two of the patients in the EM-LIFT group developed recurrence, with a median recurrence time of 5 months (range 4-6) and three developed recurrence in the EL-LIFT group, with the same median recurrence time of 5 months (range 4-6). There were minor postoperative complications of pain and subcutaneous infection, with no faecal incontinence. There was no statistically significant difference in postoperative outcomes between the groups.

Conclusion: EM-LIFT is a feasible and safe primary procedure for active cryptoglandular-type anal fistulas.

Healthcare practitioners face significant risks of workplace violence due to various reasons such as hospital congestion, miscommunication, and aggressive behaviours of patients and relatives. Exposure to workplace violence may disrupt the workflow process and compromise patient care in healthcare facilities, ultimately affecting job performance, reducing job satisfaction, and negatively affecting the physical and mental health of healthcare practitioners. This study aimed to review all the published studies conducted on the experiences of workplace violence among healthcare practitioners. This study is a systematic review of qualitative studies. Data were collected through online databases including ScienceDirect, PubMed, MEDLINE and JSTOR were searched from the year 2015-2021. The inclusion criteria were: qualitative methods and mixed methods of data collection and analysis; studies that were carried out among healthcare practitioners who have been experience on workplace violence; scope of the primary studies included experience of workplace violence; and published in English/Malay in academic journal between 2015 and 2021. A total of 15 papers were included in the final analysis. The overall quality of the included papers was high. Of the 15 papers, 12 studies fully met the CASP criteria. The results of the 15 included studies were organised into the thematic groups of: i) verbal violence as the common workplace violence; ii) perceived causes of workplace violence and iii) seeking help. Across different countries, verbal violence was the most common type of workplace violence reported by healthcare practitioners. This review also identified that a lack of information, failure to meet patient expectations, and delayed treatment were the main contributing factors to workplace violence.

Background: As the third leading cause of mortality in Malaysia, stroke is recognised as a medical emergency which requires urgent medical attention within a limited timeframe to prevent exacerbation of the brain damage and death in patients. Recent report revealed a high prevalence of pre-hospital delay amongst the stroke patients due to the lack of awareness on symptoms and risk factors of stroke, as well as poor understanding on appropriate action towards stroke. A number of studies had assessed stroke awareness amongst urban population residing in central region of Malaysia but yet amongst rural population.

Methods: A cross-sectional survey was conducted amongst individuals residing in rural districts of Selangor by using a set of questionnaires assessing the sociodemographic characteristics, as well as the awareness and action towards stroke symptoms and risk factors.

Results: All 343 respondents were able to recognise at least one modifiable risk factor for stroke. Meanwhile, only 36.44% were able to identify all the stroke symptoms. Despite majority of them were familiar with the stroke term, less than half of the respondents were aware of calling the emergency medical service as the appropriate action towards stroke symptoms.

Conclusion: The present study indicated a poor level of awareness and action towards stroke symptoms and risk factors amongst rural population residing in Selangor.

Infertility affects millions of people of reproductive age worldwide. Thyroid hormones and prolactin (PRL) affect reproduction and pregnancy; therefore, these two hormones influence fertility. This systematic review and meta-analysis aimed to summarise the strength of the correlation between serum PRL and thyroid stimulating hormone (TSH) in infertile women and to explore selected factors influencing the correlation. We conducted a systematic search of online databases (PubMed, Scopus, ScienceDirect, SAGE and Google Scholar) from inception until March 2021 and a manual search of the bibliographies of the included studies to identify relevant publications. The original research paper describing the correlation between PRL and TSH in reproductive-age women with infertility (primary and secondary) was included. The risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross-Sectional Studies. A random effect model was used to estimate the pooled correlations of PRL and TSH, followed by an assessment of heterogeneity and a sensitivity analysis. From a total of 822 relevant articles identified, 11 were eligible and included in this systematic review and meta-analysis. The random effect pooled correlation estimates between PRL and TSH was 0.431 (95% CI: 0.251, 0.582), with substantial heterogeneity between the included studies (I² = 80%, τ² = 0.067, P < 0.001). No significant publication bias was observed. Study region, types of infertility, sample size and year of the study did not influence the correlation estimates. Our results highlighted a significant positive moderate correlation between serum PRL and serum TSH in infertile women.

Background: With Malaysia's ageing population, the utilisation of primary healthcare services by older individuals with comorbidities is expected to increase. Patient satisfaction serves as a key indicator for assessing the quality of healthcare services. Thus, the aim of this study is to evaluate patient satisfaction among older persons attending public primary healthcare facilities and to identify associated factors.

Methods: A cross-sectional survey was conducted from October 2017 to January 2018, involving face-to-face interviews with older outpatients in primary health clinics. Minimum 300 participants were required and systematic random sampling were used. The measurement included sociodemographic variables, patient comorbidity and patient satisfaction using the Short-Form Patient Satisfaction Questionnaire (PSQ-18).

Results: A total of 317 participants enrolled in this study, resulting in a response rate of 95.6%. The findings indicated that 35.7% of participants reported high satisfaction, while 64.3% reported moderate satisfaction. Participants with at least secondary education (OR = 3.12) were more likely to experience satisfaction compared to those without formal education. Participants with monthly incomes above RM2,000 (OR = 0.40) and RM1,000-RM1,999 (OR = 0.53) were less likely to be satisfied compared to those earning less than RM999. Moreover, participants with two or more comorbidities were less likely to be satisfied compared to those with one comorbidity. Gender, marital status, employment status and living arrangements were not significant factors.

Conclusion: This study highlights the need for healthcare authorities to examine factors such as patients' education level, income level and comorbidity status that are associated with healthcare satisfaction to enhance overall patient satisfaction.