IIUM Medical Journal Malaysia (IMJM)
Not a member yet
1450 research outputs found
Sort by
Development and Validation of A Weight Management Program Model for Overweight and Obese Individuals
Full text linkINTRODUCTION: Developing a structured and theory-based model can enhance the effectiveness of weight management program. However, the underlying model requires validation to ensure its accuracy and applicability. Therefore, this study aimed to demonstrate the development and validation process of a weight management program model for overweight and obese individuals. MATERIALS AND METHODS: A weight management program model was previously developed using thematic analysis and scoping review by utilizing Theory of Change as the framework. Seven experts were invited to evaluated using the content validity index through online questionnaire, comprising 42 items, and provided feedback on its features for face validity. RESULTS: The developed model structured with 6 domains, 6 constructs, and 23 sub-constructs. More than 85.71% of the experts agreed on the face validity of the developed model. The content validity result indicated that the experts reached a consensus on all 6 domains. The modified kappa represented excellence in all 6 domains, with a k* value of 0.97-1.00. Meanwhile, the S-CVI/Ave and S-CVI/UA values ranged from 0.97-1.00 and 0.80-1.00, respectively. Several experts suggested ideas and recommendations for improvement. The validation led to all items being accepted without elimination. CONCLUSION: The weight management program model has been validated, and all 6 domains were retained following expert validation. This model is expected to provide insightful and valuable guidance for future practitioners in planning and executing weight management programs among individuals with overweight and obesity issues
Prolonged Fever and Unremitting Back Pain in Elderly Patient: A Case of Disseminated Tuberculosis with Spondylodiscitis
Full text linkDisseminated tuberculosis (DTB) is a life-threatening condition caused by the hematogenous spread of Mycobacterium tuberculosis. As the clinical presentation is often nonspecific, it leads to late diagnosis. We reported a case of a 75-year-old man who presented with intermittent fever for one month and lower back pain for four months. Bronchoscopy with bronchoalveolar lavage revealed low-level of Mycobacterium tuberculosis, leading to a diagnosis of smear-negative pulmonary tuberculosis. Magnetic resonance imaging of the thoracolumbar spine showed multiple enhancing skip lesions involving thoracic and lumbar vertebrae bodies with a T8/T9 paravertebral abscess compressing onto the spinal cord, suggestive of tuberculous spondylodiscitis and confirming a diagnosis of DTB. The patient’s condition improved with anti-tuberculosis therapy. This case emphasizes the need for high clinical suspicion in patients with multisystem involvement and the importance of timely, targeted investigations to confirm the diagnosis.
Laboratory Biomarkers in Assessing the Severity of COVID-19 at Referral Hospital in Indonesia
Full text linkIntroduction: The COVID-19 pandemic is challenging due to its high transmissibility and mortality rates. COVID-19 patients can rapidly deteriorate, underscoring the need to identify lab biomarkers for high-risk categorization. This study aims to explore the role and correlation of various laboratory parameters, including Neutrophil-to-Lymphocyte Ratio (NLR), Ferritin, Prothrombin (PT), D-Dimer, C-reactive protein (CRP), and Procalcitonin (PCT), in distinguishing between severe and non-severe cases of COVID-19. Materials and methods: This retrospective cross-sectional study was carried out at Sulianti Saroso Infectious Disease Hospital in Jakarta with approval from the ethics committee. The inclusion criteria for subjects consist of patients confirmed with COVID-19 through PCR test results, adults aged over 18 years, and those with relevant laboratory parameter results. The exclusion criteria include pregnant patients, patients who arrive in a state of death on arrival (DOA), and patients with incomplete data. A sample of 1,598 adult COVID-19 patients was analysed. Laboratory data were extracted from electronic medical records (SIMINTRO) from March 2020 to December 2022. The significance of the means was assessed through the independent Mann-Whitney test, with a p-value <0.05 regarded as statistically significant. After constructing the ROC (receiver-operating characteristic) curve, threshold values were identified based on Youden's index (J). Result: There are differences in the severe and non-severe groups based on age, gender, transmission risk factors, symptoms, and comorbidities (p<0.05). Severe COVID-19 patients show markedly elevated levels of (NLR, Ferritin, Prothrombin, D-Dimer, CRP, and Procalcitonin) compared to non-severe ones, and the statistical cut-off values between severe and non-severe groups according to parameters (NLR, Ferritin, PT, D-Dimer, CRP, and PCT) are significant (p<0.001). Conclusion: Besides clinical findings, biochemical parameters are valuable predictors for assessing COVID-19 severity.
Ultrasound Guided Dextrose Prolotherapy For Chronic Medial Collateral Ligament Injuries In Young Footballers
Full text linkDextrose prolotherapy (DPT) is increasingly recognized for its regenerative potential in managing ligamentous injuries. However, evidence supporting its use in medial collateral ligament (MCL) injuries among young athletes remains scarce. This case series describes four adolescent footballers (aged 14–16 years) with chronic medial knee pain unresponsive to rehabilitation. Three athletes with isolated MCL injuries achieved complete pain resolution within 4–6 weeks following ultrasound-guided 12.5% dextrose injections, combined with knee bracing and structured rehabilitation. They successfully returned to full training after passing functional assessments, with no reinjury at 3- and 6-month follow-ups. Conversely, the fourth athlete, with concomitant MCL, anterior cruciate ligament, and meniscal injuries, experienced only partial pain relief and sustained reinjury after premature return to play, ultimately requiring surgical intervention. These findings suggest that DPT may accelerate recovery in isolated chronic MCL injuries but has limited benefit in multi-ligament knee injuries.
Agarwood's Role in Inflammatory-related Conditions: A Systematic Review of Animal Models
Full text linkAgarwood (Aquilaria spp.) is a resinous wood traditionally used in various medicinal systems across Asia for treating inflammation-related ailments. Despite its longstanding ethnopharmacological use, scientific validation of its anti-inflammatory effects remains fragmented. This scoping review aims to systematically evaluate and synthesize current evidence from animal studies investigating the anti-inflammatory potential of agarwood. A comprehensive literature search was conducted using PubMed, Scopus, and Web of Science. Inclusion criteria focused on original animal studies assessing the anti-inflammatory effects of agarwood extracts, essential oils, or derivatives. Data on study design, animal models, agarwood species, treatment dosage, duration, biomarkers, and outcomes were extracted and summarized narratively due to methodological heterogeneity. Eight studies met inclusion criteria, involving models of inflammation-related conditions such as pain, neuroinflammation, gastrointestinal injury, cancer, and toxicity. Agarwood treatment consistently reduced pro-inflammatory cytokines (e.g., IL-1β, IL-6, TNF-α), modulated oxidative stress markers (e.g., NO, SOD, GSH), and regulated signalling pathways including NF-κB, p38 MAPK, and Nrf2–ARE. Notably, improvements were observed in behavioural and histological outcomes across models, with evidence of dose-dependent effects in several studies. In conclusion, preclinical evidence supports agarwood’s broad-spectrum anti-inflammatory and antioxidant properties across multiple organ systems. These findings provide mechanistic insights and a scientific basis for its traditional use. However, variability in species, extraction methods, and study designs highlights the need for standardised protocols and clinical validation to advance agarwood as a potential therapeutic agent.
Therapeutic Effect of Thymoquinone on MAPK Signalling Pathway in K562 Chronic Myeloid Leukaemia Cells
Full text linkINTRODUCTION: Chronic Myeloid Leukaemia (CML) is a hematopoietic malignancy caused by the BCR-ABL1 fusion oncoprotein, originating from Philadelphia chromosome translocation that enhances leukemic cell survival and therapeutic resistance. Aberrant MAPK pathway activation promotes proliferation and inhibits apoptosis, contributing to CML progression and resistance to tyrosine kinase inhibitors like imatinib with prolonged use. Thymoquinone (TQ), a bioactive molecule, has attracted considerable interest Z for its anticancer characteristics that are worth investigating. MATERIALS AND METHODS: K562 CML cells were divided into an untreated group and a TQ-treated group and observed for 24 and 48 hours. Different TQ concentrations were administered to the TQ-treated group. Dose and time dependent effects on cell growth were assessed to evaluate cytotoxicity and determine the IC50 value in both groups. RNA was extracted from K562 CML cells based on the IC50 value and proceeded with RT-qPCR analysis on 7 genes involved, assigned as Raf1, B-Raf, ERK1, ERK2, K-Ras, H-Ras, and N-Ras genes, while the beta-actin gene was used as a housekeeping gene. Protein was extracted for the determination of protein and phosphorylation levels of Raf, MEK1/2, and ERK1/2, and assessed using the Jess Simple Western protocol. The Wilcoxon Signed-Rank test was performed using IBM SPSS, with p<0.05 considered statistically significant. Results: TQ treatment significantly reduced the expression of all genes analysed in K562 cells. It also decreased protein and phosphorylation levels of Raf, MEK1/2, and ERK1/2. Conclusion: These findings suggest that TQ effectively inhibits MAPK signalling in K562 CML cells, highlighting its potential as a future treatment for CML.
The Impact of Qur’anic Reading and Listening Duration and Frequency on Cognitive Performance and Hippocampal Function: A Systematic Review
Full text linkEngaging with the Qur'an, whether through reading or listening, necessitates complex cognitive processing of the written or spoken Arabic language. This activity demands concentration and attention, thereby engaging cognitive functions such as selective attention, Arabic language processing, and auditory perception. The purpose of this paper is to review the effects of reading and listening to the Qur'an on hippocampal cognitive function. A literature search was conducted using online databases: ScienceDirect, PubMed/ Medline, and Scopus. The keywords used in the literature search were “cognitive”, “Qur'an”, and “hippocampus”. This approach included six full-length articles. A manual search of the cited references was also used to find additional considerations for the discursive analysis of each topic discussed in this review. As a sacred text, the Qur'an engages both reading and listening skills and involves cognitive processes that impact memory and comprehension. Regular engagement with the Qur'anic text and its recitation can significantly improve brain activity, memory, and cognitive development. Reading and listening are essential skills for language comprehension and communication. When a person reads the Qur'an, he or she engages in visual Arabic language processing, while when listening to its recitation, the person is involved in auditory language processing. These activities stimulate different parts of the brain, contributing to a more comprehensive understanding of the Qur'an text.
Exploring Neonatal NaV1.5 Voltage-Gated Sodium Channel as a Therapeutic Target in Cancer
Full text linkVoltage-gated sodium channels (VGSCs) play pivotal roles in cancer progression and have emerged as promising therapeutic targets and biomarkers. VGSCs comprise multiple subtypes with distinct tissue distributions, influencing tumour characteristics in different ways. Among these, the tetrodotoxin-sensitive α-subunits and the β1 subunit, commonly found in breast cancer, have been implicated in metastasis and tumour aggressiveness. The NaV1.5 channel and its neonatal variant (nNaV1.5) are overexpressed in aggressive cancers such as breast, prostate, colorectal, and lung cancers, thereby enhancing their invasive capacity. nNaV1.5 is particularly significant due to its tumour-specific expression and strong association with poor prognosis, especially in breast cancer, where it regulates cell proliferation, invasion, and tumour microenvironment remodelling. This review highlights nNaV1.5 as a critical ion channel that drives metastasis through ion regulation, extracellular acidification, and cytoskeletal remodelling. We further evaluate current therapeutic strategies, including siRNA, monoclonal antibodies, and small-molecule inhibitors, while addressing translational challenges such as tumour heterogeneity, drug delivery limitations, and off-target cardiotoxicity due to its similarity with the adult isoform. In addition, we explore the potential of nNaV1.5 as a biomarker subject to epigenetic regulations by factors including RE1-silencing transcription factor (REST) and histone deacetylase 2 (HDAC2), which may facilitate patient stratification and treatment optimization. By integrating mechanistic insights, therapeutic opportunities, and translational challenges, this review goes beyond descriptive summaries to provide a framework for advancing nNaV1.5 research from preclinical studies toward clinical application in cancer therapy.
The Prevalence of Malnutrition and Its Relationship with Clinical Outcomes Among Critically Ill Children in PICU and PHDU
Full text linkINTRODUCTION: Malnutrition is a significant concern in critically ill pediatric patients, as it is associated with increased morbidity, prolonged hospital stays, and higher mortality rates. The aim of this study is to determine the nutritional status of patients in the Pediatric Intensive Care Unit (PICU) and the Paediatric High Dependency Unit (PHDU) of a teaching hospital, and to investigate the effects of malnutrition on clinical outcomes. MATERIALS AND METHODS: A retrospective cohort study was conducted, and patients admitted between March 2024 and September 2024 to the Pediatric Intensive Care Unit (PICU) and Pediatric High Dependency Unit (PHDU) were screened based on inclusion and exclusion criteria. The prevalence of malnutrition and its association with clinical outcomes, including length of hospital stay, duration of mechanical ventilation, and mortality risk, were evaluated and assessed. RESULTS: This study involved 51 patients aged between 6 months to 17 years old. The prevalence of malnutrition was 54.9%, with the most common forms being underweight (31.4%), followed by stunting (25.5%), wasting (17.6%), and thinness (7.8%). Moreover, this study identified a significant association between undernutrition and longer hospitalisation (P=0.051). However, no significant association was found between undernutrition and the duration of mechanical ventilation (P=0.154) or the risk of mortality (P=0.866). CONCLUSION: The prevalence of undernutrition remains high among critically ill children, with the most prevalent forms being underweight, stunting, wasting and thinness. Undernourished children had prolonged hospitalisation, but there was no association with duration of mechanical ventilation and mortality risk.
Navigating the Diagnostic Challenges of Cervical Plexus Schwannoma: A Rare Entity
Full text linkSchwannomas are the most commonly occurring neurogenic tumours. However, cervical plexus schwannomas are rare, and they mostly present with an asymptomatic neck mass. An elderly male with multiple comorbidities presented with a painless posterior triangle neck mass for a year without any neurological symptoms. After undergoing a few diagnostic modalities, including ultrasound-guided biopsy and MRI, the mass was suggestive of a schwannoma. Post-excision biopsy, no neurological deficits or recurrence were seen. This case exemplifies the challenges associated with diagnosing cervical plexus schwannomas and highlights the necessity of integrating multiple diagnostic modalities for their accurate identification. The rarity of this tumour, coupled with its uncommon anatomical location, highlights the importance of considering cervical plexus schwannomas in the differential diagnosis of asymptomatic lateral neck masses.