IIUM Medical Journal Malaysia (IMJM)
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Effectiveness of Solifenacin Monotherapy and Mirabegron and Solifenacin Combination Therapy in Patients with Stent-Related Symptoms
Full text linkINTRODUCTION: Ureteral stents are commonly used for internal urinary drainage but frequently cause stent-related symptoms (USRSs), which can negatively affect patient quality of life. This study aimed to evaluate the short-term effectiveness of solifenacin monotherapy compared to a solifenacin-mirabegron combination therapy in patients experiencing USRSs. MATERIALS AND METHODS: This double-blind, randomised controlled trial included 54 participants with USRSs. Patients were randomised to receive either solifenacin 5 mg/day (monotherapy) or a combination of solifenacin 5 mg/day and mirabegron 25 mg/day (combination therapy) for four weeks. The Ureteral Stent Symptom Questionnaire (USSQ) was used to compare treatment outcomes. Data were analysed using an independent t-test, with p-values <0.05 considered statistically significant. RESULTS: The solifenacin monotherapy group showed significantly lower (better) scores in the Urinary Symptoms domain compared to the combination group at week 1 (p=0.001) and week 2 (p=0.017), and in the General Health domain at week 1 (p=0.005), week 2 (p=0.027), and week 4 (p=0.045). The combination therapy group demonstrated significantly better scores for Sexual Function at week 2 (p=0.017). No statistically significant differences were observed between groups for Pain or Work domains. Both treatments were generally well-tolerated, with a low incidence of mild adverse events. CONCLUSIONS: Solifenacin monotherapy appears to provide superior short-term relief for urinary symptoms and general health issues compared to a low-dose solifenacin-mirabegron combination. The combination therapy demonstrated a targeted benefit in improving sexual function. Both treatment regimens were generally safe and well-tolerated.
A Case of Uncommon Hematemesis from Acute Esophageal Necrosis
Full text linkAcute esophageal necrosis (AEN) is a rare and severe condition characterized by extensive tissue necrosis of the esophagus. This condition predominantly affects the distal part of the esophagus. Reports estimate the prevalence of AEN to be up to 0.2% in autopsy studies, while endoscopic series report a prevalence ranging from 0.01% to 0.28% of cases. It primarily affects patients with poor nutritional health and multiple comorbidities often as a result of underlying systemic condition. Patients present with upper gastrointestinal bleeding, such a hematemesis and melena. We report a case of AEN in a female patient who had presented with hematemesis.
Cross-Sectional Study of Glycaemic Control Among Women with Type 2 Diabetes Mellitus in A Primary Health Care Clinic: A Call for Tailored Intervention
Full text linkINTRODUCTION: More than two thirds of the women attending primary health care (PHC) clinics have poor glycaemic control with lifestyle, stress, and attitudes as risk factors towards poor type 2 diabetes mellitus (T2DM) control. This study aims to determine the prevalence and identifying the factors associated with poor glycaemic control among the T2DM women in PHC clinic. MATERIALS AND METHODS: This is a cross-sectional study on women with T2DM in Seremban Health Clinic (HC), Negeri Sembilan, conducted over 3 months from January-April 2023. The women were recruited through systematic random sampling. Information was gathered using medical records and self-administered questionnaires. Factors associated with poor glycaemic controlled were determined using multiple logistic regression analysis. RESULT: The prevalence of poor glycaemic control among women with T2DM in Seremban HC is 57.8%. Factors found to be associated with poor glycaemic control among these women included age ≥60 years old (aOR 2.26; 95% CI 1.35, 3.78), non-Malay ethnicity (aOR 1.89; 95% CI 1.05, 3.40), non-insulin treatment (aOR 7.56; 95% CI 4.13, 13.84), and perceived social support (aOR 1.47; 95% CI 1.12, 1.91). CONCLUSION: Over half of the women with T2DM attending Seremban HC have poor glycaemic control, associated with factors such as age ≥ 60 years, non-Malay ethnicity, non-insulin treatment, and perceived higher social support. This suggests a need for a women-centred primary care strategies to manage T2DM, potentially enabling the development of tailored interventions specifically for women. Collaboration with healthcare providers and policymakers could further enhance the glycaemic control among women with T2DM.
Breast Fillers on the Rise: A Silent Epidemic of Unregulated Aesthetic Trend
Full text linkThe use of breast fillers for aesthetic enhancement is gaining popularity over the past decade, driven by social media influence, accessibility, and the perception of minimal invasiveness. However, unlike approved breast implants, many injectable breast fillers remain unregulated and often administered by unqualified personnel in non-medical settings. This growing trend is accompanied by a striking lack of public awareness regarding its potential complications. Reported complications range from localized inflammatory reactions, granuloma formation, chronic pain, and infection to devastating sequelae such as tissue necrosis, migration of filler material, breast deformity, and systemic embolic phenomena. Breast fillers also cause profound difficulties to routine breast cancer surveillance and diagnosis. These complications often results in substantial physical, psychological and socioeconomic burden to affected individuals. This article highlights the emerging public health concerns surrounding the use of unregulated breast fillers, emphasizing the gap between increasing popularity and insufficient patient education on safety and long-term consequences. Thus, greater regulatory enforcement, improved public awareness, and multidisciplinary collaboration between clinicians, radiologists, and policymakers are urgently needed to curb these unsafe practices, in order to safeguard patient welfare in the era of rapidly expanding aesthetic medicine
The Enduring Enigma of Spinal Tuberculosis in Modern Diagnostic Era and The Critical Role of Magnetic Resonance Imaging
Full text linkEffects of Retinoic Acid on Liver Triglyceride Level and Diacylglycerol Acyltransferase-2 (DGAT2) Gene Expression in Rats with High-Cholesterol Diet-Induced Steatosis
Full text linkINTRODUCTION: Non-alcoholic fatty liver disease (NAFLD) incidence is rising globally without effective treatment available. Serum retinoic acid level was found to be low in NAFLD patients. Thus, this study investigated the effects of retinoic acid administration on liver triglyceride levels and Diacylglycerol acyltransferase 2 (DGAT2) gene expression in high-cholesterol diet-induced steatosis rats. MATERIALS AND METHODS: Forty male Sprague-Dawley rats were divided into five groups (n=8/group). Groups A and B received a normal diet, while groups C, D, and E were fed a high cholesterol diet (HCD) for four weeks to induce steatosis (Phase 1) and continued with the same diet for the next four weeks (Phase 2). In Phase 2, Group D received vehicle (Olive oil), while Groups B and E received retinoic acid (7.5mg/kg subcutaneously) twice weekly with their respective diet. Liver triglyceride levels were measured using the Bligh and Dyer’s method, and hepatic DGAT2 gene expression was quantified using Real-Time qPCR. Data was analysed using the One-Way Analysis of Variance (ANOVA) test. RESULTS: Retinoic acid-treated groups showed a reduced pattern in liver triglyceride levels, in which Group E level is 3.6±0.88 mg/g compared with Group C 4.12±1.5 mg/g, but statistically insignificant (p>0.05). The DGAT2 expression was significantly reduced in Group E by 0.63-fold (63%) when compared to Group C. CONCLUSION: These findings suggest that retinoic acid administration might reduce the liver triglyceride level by down-regulating DGAT2 gene expression. However, further studies are required to confirm retinoic acid as a potential candidate for improving NAFLD
Knowledge and Awareness of Jordanian Speech and Language Pathologists on Radiation Protection while Performing Videofluoroscopic Swallowing Study
Full text linkINTRODUCTION: Videofluoroscopic swallowing studies (VFSS) are essential diagnostic tools used by speech-language pathologists (SLPs) to assess dysphagia. However, VFSS involves ionising radiation exposure, making comprehensive radiation safety knowledge critical for minimising risks to both patients and healthcare providers. This study evaluates radiation protection knowledge and practices among Jordanian SLPs performing VFSS. MATERIALS AND METHODS: A cross-sectional survey was conducted among 115 Jordanian SLPs who perform VFSS. The validated 22-item questionnaire assessed demographics, professional experience, radiation safety knowledge, and current practices. Data was analysed using descriptive statistics and cross-tabulations to examine relationships between education level, experience, and radiation exposure practices. RESULTS: Significant knowledge gaps were identified in fundamental radiation safety principles. Only 20.9% of respondents accurately estimated the appropriate exposure times (≤5 minutes), while 38.3% overestimated the VFSS duration to 16-20 minutes. Although 35.7% reported using pulsed fluoroscopy, 34.8% were uncertain about their equipment type. Only 27.8% correctly identified scattered radiation as the primary exposure hazard. While basic protective equipment knowledge was adequate comprehensive shielding understanding was limited. Educational background influenced duration estimates, with master's degree holders reporting longer procedures compared to bachelor's degree practitioners. On-the-job training was the predominant source of radiation safety knowledge (46.1%), yet overall self-rated competency remained moderate to low. CONCLUSION: Jordanian SLPs demonstrate inconsistent radiation safety knowledge with significant gaps in exposure time limits, equipment specifications, and comprehensive protective practices. These findings highlight urgent needs for structured radiation safety education, standardised national guidelines, and interprofessional training programs to ensure safe VFSS procedures.
Utilization of “Skim Peduli Kesihatan untuk Kumpulan B40” (PeKa B40) Programme among Felda Residence in Kedah, Malaysia: The Participation Rate and its Determinants
Full text linkINTRODUCTION: The Malaysian government has implemented the “Skim Peduli Kesihatan untuk Kumpulan B40” (PeKa B40) programme in response to the growing rate of non-communicable diseases (NCD) among the Malaysian population. This study aims to determine the participation rate of PeKa B40 programme utilization and its determinants. MATERIALS AND METHODS: This was a cross-sectional study designed at Felda Lubuk Merbau Kedah. A total of 237 participants were involved using the simple random sampling method from January-April 2023. Multiple logistic regression analysis was used to determine the determinants. RESULTS: The participation rate of PeKa B40 utilization among participants was 41.8%. The determinants of utilization of PeKa B40 programme were positively associated with age [Adj. OR: 1.06 (95%CI: 1.03, 1.10)], female gender [Adj. OR: 2.32 (95%CI: 1.15, 4.66)], presence of chronic disease [Adj. OR: 2.62 (95%CI: 1.28, 5.37)], persistent pain that mildly disturbs daily activities [Adj. OR: 3.30 (95%CI: 1.31, 8.33)], and high disturb daily activities [Adj. OR: 14.34 (95%CI: 2.18, 94.26)]. The determinants were also negatively associated with poor self-rate health [Adj. OR: 0.05 (95%CI: 0.01, 0.47)], intermediate self-rate [Adj. OR: 0.25 (95%CI: 0.06, 0.95)], and good self-rate [Adj. OR: 0.22 (95%CI: 0.06, 0.82)]. CONCLUSION: The participation rate of PeKa B40 among residents of Felda Lubuk Merbau was higher than at the national and state levels. Therefore, the government needs to advertise this programme and take more proactive steps to advertise the programme especially, to adult men. This programme needs to be extended to those respondents who are sick and need medical treatment.
Arabic Language and Medical Terminology in Education: A Systematic Review
Full text linkThe use of Arabic in medical education and healthcare communication remains limited despite growing linguistic needs in Arabic-speaking populations. Issues related to translation accuracy, cultural sensitivity, and curriculum alignment hinder its integration. The objective of this study is to systematically review how Arabic medical terminology has been translated, validated, and applied in educational and clinical contexts. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Searches were conducted in May 2025 across three databases: Scopus, Web of Science (WoS), and the Education Resources Information Center (ERIC). A total of 769 records were retrieved, and 19 peer-reviewed articles were selected based on inclusion criteria. A six-point quality appraisal framework was applied to ensure methodological rigour prior to thematic synthesis. Three major themes emerged: (1) translation and cultural adaptation, highlighting the importance of expert validation and semantic accuracy; (2) psychometric evaluation, where tools such as the Postgraduate Hospital Educational Environment Measure (PHEEM) demonstrated strong internal consistency and contextual clarity; and (3) educational application, showing varied success in enhancing communication, comprehension, and learner confidence. Gaps in terminology standardisation and the limitations of automated translation tools were noted across studies. In conclusion Arabic medical terminology, when supported by structured processes and expert review, makes a meaningful contribution to education and communication. Further efforts should prioritise the development of validated terminology repositories, multidisciplinary collaboration, and the integration of Arabic-language resources into medical curricula to support inclusive and patient-centred care.
Flare-Up in Full Bloom: Navigating Rosacea Fulminans During Pregnancy
Full text linkRosacea fulminans (RF) is a rare and severe variant of rosacea, characterized by the sudden onset of extensive facial skin lesions. Hormonal changes, particularly during pregnancy have been proposed as potential contributing factors for RF. Management of RF in pregnant patients poses unique challenges, as standard therapeutic options may carry teratogenic risk. To date, reported cases of RF during pregnancy in the medical literature is very limited. We report a case of RF that developed during pregnancy, likely precipitated by hormonal fluctuations. This case underscores the importance of prompt recognition and timely intervention to prevent permanent facial scarring, which may have profound psychological consequences for affected patients.