IIUM Medical Journal Malaysia (IMJM)
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Prevalence and Factors of Fall-Risk Increasing Drug Prescribing for Older Patients in Medical Wards
Full text linkINTRODUCTION: Falls represent a major health concern among older adults, frequently compounded by the use of fall-risk-increasing drugs (FRIDs). This study aims to assess the prevalence of FRID prescribing among older patients admitted to medical wards and at discharge in a Malaysian hospital and investigates the associations between patient characteristics and the prescribing of FRIDs. MATERIALS AND METHODS: This is a retrospective cross-sectional study involving 455 older patients aged ≥60 years. FRIDs were identified using the Screening Tool of Older Persons’ Prescriptions in older adults with high falls risk (STOPPFall) criteria. Sociodemographic and clinical data, including polypharmacy and comorbidities, were analyzed for associations with FRID prescribing during admission and discharge. Results: FRIDs were prescribed to 60.7% of patients during admission and 48.4% at discharge. During admission, FRID prescribing demonstrated significant associations with polypharmacy, prolonged hospitalization, and the presence of multiple chronic conditions. At discharge, FRID prescribing was significantly associated with polypharmacy and multiple chronic conditions. The most prescribed FRIDs during admission included diuretics (28.4%), opioids (20.7%), and sedative antihistamines (8.1%), with these patterns persisting at discharge. Conclusion: FRID prescribing is prevalent during admission and at discharge, highlighting the need for targeted interventions. Pharmacists can play a critical role in mitigating fall risks through comprehensive medication reviews, deprescribing, and patient education
Translation and Validation of the Readiness to Change Questionnaire for Alcohol Drinkers into an Indigenous Language (Jakun Version) in Malaysia
Full text linkINTRODUCTION: Assessing readiness to change is crucial in managing alcohol-related conditions and can be achieved by using the Readiness to Change Questionnaire (RCQ), grounded in the Transtheoretical Model (TTM). This is especially important in Indigenous communities in Peninsular Malaysia, where alcohol use is intertwined with cultural practices. This study aimed to translate and validate the RCQ from English into the Jakun language spoken by an Indigenous tribe in Malaysia to ensure its linguistic and cultural relevance for assessing readiness to change among Jakun alcohol drinkers. MATERIALS AND METHODS: This cross-sectional study was conducted among current alcohol drinkers in three Indigenous Jakun settlements in Rompin, Pahang, Malaysia. The RCQ underwent translation into Jakun language, followed by validation (face and construct) and reliability assessment. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and internal consistency were used to evaluate its construct validity and reliability. RESULTS: A total of 317 participants were recruited, most of whom were males, aged 18-29, married, had primary education, were self-employed, and had low household income. From the EFA, the original three factors were retained (pre-contemplation, contemplation, and action), but three items were removed, one from each construct. The final model demonstrated acceptable fit in CFA. Cronbach’s alpha values ranged between 0.733 and 0.838, indicating good internal consistency. CONCLUSION: The RCQ (Jakun version) is a valid and reliable tool for assessing readiness to change among Indigenous Jakun alcohol drinkers. It can potentially assist healthcare professionals in tailoring interventions based on stages of change to address risky alcohol use in this population.
Effect of Stromal Vascular Fraction and Platelet-Rich Plasma on Epithelialization in Anal Trauma Healing in Wistar Rats
Full text linkINTRODUCTION: Anal trauma should be treated immediately; early debridement should be performed to prevent infection and sepsis. The use of stromal vascular fraction (SVFs) and platelet-rich plasma (PRP) have now become an alternative surgical alternative. The aim of this study was to determine the effect of stromal vascular fraction (SVFs) and platelet-rich plasma (PRP) on morphological scores for epithelialization during induced anal trauma healing in Wistar rats. MATERIAL and METHODS: This experimental study assessed 32 male Wistar rats over a 2-month period. The rats were randomly allocated into four groups: Group A (negative control), Group B (anal trauma treated with PRP + SVF), Group C (anal trauma without PRP + SVF), and Group D (donor rats for PRP and SVF preparation; excluded from outcome analysis). RESULT: Although Group B (PRP+SVF) demonstrated higher epithelialization scores compared with Group C (control), the differences were not statistically significant on Day 1 (p=0.083), Day 7 (p=0.157), or Day 14 (p=0.317). However, a significant improvement in morphological scores was observed in the within-group comparison of the PRP+SVF treatment group between Day 1 and Day 14 (p=0.049). CONCLUSION: The combination of PRP and SVFs led to a significant improvement in morphological scores for epithelialization within the treatment group (PRP+SVF group) over 14 days. However, this combination therapy did not demonstrate a statistically significant acceleration of wound healing when compared to the untreated control group at the observed time points.
The CAPE will Influence the Angiogenesis in Traumatic Brain Injury
Full text linkINTRODUCTION: Traumatic brain injury (TBI) is a frequent and highly heterogeneous neurological disorder which has the potential to cause major social and economic consequences. However, Caffeic Acid Phenethyl Ester (CAPE), obtained from propolis through extraction from honey bees, has long been known as a folk medicine. This study identifies the predictor factors for angiogenesis in a TBI rat model following the provision of CAPE. MATERIALS AND METHODS: This experimental control treatment and randomization study used fifteen male Sprague-Dawley rats with surgically induced brain injury. The rats were treated with CAPE. We measured vascular endothelial growth factor (VEGF) levels as an indicator and Myeloperoxidase (MPO) as a polymorphonuclear activity marker. The gauges for brain edema and oxidative stress were mRNA, AQP4, and F2 Isoprostane, respectively. The correlation test of TBI parameters in the form of MPO, mRNA AQP4, and F2 isoprostane against VEGF as an angiogenesis process indicator was performed to identify the factors associated with post-TBI angiogenesis. RESULTS: Mean values were obtained using a descriptive tests, while the correlation test results were VEGF (938274.352), AQP4 mRNA (10099.00), MPO (9284222.028), and F2-Isoprostane (307346.562). The findings suggested a strong correlation between all TBI parameters and VEGF as an angiogenesis indicator (p<0.001). In addition, polymorphonuclear activity (MPO) and the presence of brain edema, as indicated by mRNA AQP4 expression, were identified as the most significant influences. CONCLUSION: The post-TBI angiogenesis (VEGF) process, conducted by administering CAPE, was influenced by polymorphonuclear activity (MPO) and increased water content in the brain (mRNA AQP4)
Consensus Development of Resilience Components in Malaysian Breast Cancer Survivors: Findings from a Delphi Study
Full text linkINTRODUCTION: Resilience significantly influences the mental health and treatment outcomes of cancer patients. This study aimed to establish expert consensus on key resilience components specific to Malaysian breast cancer survivors using a Delphi method. MATERIALS AND METHODS: A Three-Round Modified Delphi Technique was conducted on 10 expert panelists involving psychiatrists, psychologists, and breast cancer survivors. In Round 1, open-ended questions identified initial resilience components. In Rounds 2 and 3, panelists rated the importance of each component using a 5-point Likert scale. Consensus was defined as a mean score ≥4.0 with at least 75% agreement. Both median scores and percentage agreement were used to ensure reliability. RESULTS: The final framework consisted of 10 main components and 25 subcomponents, with two subcomponents excluded due to low consensus. Main components included emotional, cognitive, knowledge, physical, religious and spirituality, social support, family support, mental health, financial, and other relevant domains. Endorsed subcomponents included emotional flexibility, self-regulation, optimism, gratitude, knowledge of cancer, physical health, religious coping, spiritual practices, social and family support, mental health self-efficacy, and financial status. CONCLUSION: This expert-endorsed framework offers a culturally relevant foundation for developing resilience-building strategies among Malaysian breast cancer survivors. These identified components may guide future psychosocial interventions aimed at improving emotional well-being and treatment outcomes among breast cancer survivor
Remission of Hypertension Through Lifestyle Modification: A Case Study
Full text linkHypertension is a common comorbidity associated with obesity, and weight reduction offers numerous health benefits, including improved blood pressure control. This case study presents a 38-year-old man with an initial body mass index (BMI) of 35.5 kg/m2 who achieved hypertension remission through comprehensive lifestyle modifications. A structured program incorporating dietary changes, regular physical activity, and behavioral therapy led to a sustained BMI reduction to 25.8 kg/m². This weight loss was accompanied by a gradual normalization of blood pressure, allowing for the discontinuation of three antihypertensive medications irbesartan, hydrochlorothiazide, and amlodipine after approximately one year of lifestyle modification. Remarkably, his blood pressure remained within the normal range for three years following medication cessation, which was maintained through continued adherence to lifestyle interventions
Knowledge, Attitudes, and Implementation Challenges of Preventive Rehabilitation Programs among Malaysian Collegiate Football Players: A Cross-Sectional Analysis
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INTRODUCTION: Football is a high-risk sport for lower limb injuries, prompting the use of Football Injury Prevention Programs (FIPP). Despite evidence of effectiveness, implementation remains inconsistent. This study aimed to (i) explore Malaysian collegiate football players’ knowledge, attitudes, and challenges regarding FIPP and (ii) examine the influence of demographic and institutional contexts, particularly between public and private institutions. MATERIALS AND METHODS: A cross-sectional survey using an online structured interview was conducted among Malaysian collegiate football players aged 18 and above who were actively participating at the college or university level. The survey comprised seven sections: demographics, football background, FIPP implementation, injury rates, knowledge of FIPP, attitudes, and barriers to implementation. Data were analysed using descriptive, cross-tabulations, and correlation statistics. RESULTS: Out of 103 responses, 80 met the inclusion criteria. The respondents were predominantly Malay (51.2%) and Chinese (36.3%), with a mean age of 23.4±4.55 years. Notably, 82.5% reported previous football-related injuries, while 81.3% utilized some form of injury prevention, primarily running (56.3%) and strength training (52.5%). Despite 67.5% acknowledging the benefits of FIPP, 46.3% perceived their knowledge as insufficient, and only 36.3% had received any formal training. Furthermore, a significant positive correlation was found between knowledge and attitudes toward FIPP (r = 0.438, p < 0.001). Key barriers included insufficient knowledge (41.3%) and limited access to qualified instructors (40.1%). CONCLUSION: Despite positive attitudes toward preventive rehabilitation, knowledge deficits and implementation barriers persist, underscoring the need for targeted education to improve FIPP adoption and reduce injury rates
Relationship Between Female Reproductive Factors and Osteoporosis among Postmenopausal Women in Malaysia: A Systematic Review and Meta-Analysis of Observational Studies
Full text linkNumerous studies in Malaysia have investigated the potential link between female reproductive factors and osteoporosis in postmenopausal women; however, a comprehensive synthesis of these findings is lacking. This systematic review seeks to elucidate the association between female reproductive factors and bone health indices in postmenopausal Malaysian women. A comprehensive search of PubMed, Scopus, and the Cochrane Library databases was conducted up to October 2024. Inclusion criteria comprised case-control and cross-sectional studies that reported comparisons, correlations, or regression analyses involving years-since-menopause, parity, or lactation with osteoporosis. Qualitative analysis was conducted on eight cross-sectional studies and one case-control study. Five out of the nine studies indicated a relationship between years-since-menopause and osteoporosis. Additionally, two out of four studies found a relationship between parity and osteoporosis, while two out of three studies demonstrated a relationship between lactation and osteoporosis. Quantitatively, a meta-analysis was performed for five studies, with a pooled sample size of 1134 postmenopausal women. A significant negative correlation emerged between years-since-menopause and osteoporosis indices (Fisher’s correlation coefficient: -2.51 [95% CI-0.305-0.195], p<0.001, fixed-effect model, I2 97%). Unfortunately, the available data on parity and lactation history were insufficient for meta-analysis of correlation. Limitations in the regression data did not allow for meta-analysis. The findings underscore the potential importance of years-since-menopause as a reproductive factor associated with osteoporosis in postmenopausal Malaysian women. Additional research is imperative to substantiate this association and contribute to the development of a robust risk assessment tool.
Scientific Evidence of Prophetic Medicine: Exploring Its Role in Integrative Medicine – A Review and Bibliometric Analysis
Full text linkProphetic medicine embodies teachings by Prophet Mohammadﷺ regarding health and well-being. Despite its historical significance, there is a growing global interest in traditional medicine in the context of modern medicine, necessitating a comprehensive and critical analysis its relevance today. This study aimed to evaluate the scientific landscape and research trends surrounding prophetic medicine through a bibliometric approach, complemented by a review of recent evidence on key natural remedies. Literature from the Scopus database was retrieved using relevant keywords. Inclusion and exclusion criteria were applied, with final selection of 171 articles for bibliometric analysis using VOSviewer software. The analysis identified 15 authors, 9 countries, 15 journals, 14 documents, and 157 keywords that fulfilled the chosen threshold. Although article publication fluctuated over the years, upward trend emerged, with rapid growth from 2022 to 2023, reflecting the recent surge in scholarly attention. Salah Mohamed El Sayed was identified as the most prolific author, while Evidence-based Complementary and Alternative Medicine was the leading journal. Saudi Arabia emerged as a recent key contributor to prophetic medicine research and had the closest collaboration with Malaysia. Common research hotspots included “black cumin” and “antioxidant activity,” with recent interest focusing on honey and olives. The bibliometric findings highlight the novelty of study by quantitatively mapping the current research landscape, identifying gaps, and highlighting emerging areas of focus. This review also integrates scientific evidence supporting the bioefficacy of prophetic remedies, reinforcing their relevance as complementary components of integrative medicine. The findings encourage further in-depth investigations to substantiate therapeutic benefits
Spatial and Temporal Intensity of HFMD Cases in Pulau Pinang, Malaysia between 2017 and 2022
Full text linkIntroduction: Hand, foot and mouth disease (HFMD) remains a significant public health concern in Malaysia, persisting despite existing control measures. This study aimed to assess the spatial and temporal dynamics of HFMD in Pulau Pinang, a north-western state of Malaysia. Materials and methods: Data were retrieved from the Communicable Diseases Control Information System (CDCIS) E-Notification Version 2011, including all notified HFMD cases in Pulau Pinang from 2017 to 2022. The number of cases by district was estimated using the points-in-polygons function in the sf package in RStudio. Kernel Density Estimates (KDE) were used to assess spatial intensity, while spatial clustering was evaluated using the nearest neighbor index (NNI). Results: A total of 15 586 notified HFMD cases reported in Pulau Pinang between 2017-2022. Temporally, the spatial intensity of cases fluctuated, with a peak in 2018, followed by a marked decline in 2020 and 2021 and a resurgence in 2022. Spatially, the highest intensity of infections was consistently observed in the district of Timur Laut, particularly in urban subdistricts such as Bandar Georgetown and Mukim 13 (Paya Terubong). Over time, high-intensity areas expanded to include Barat Daya and parts of Seberang Perai, including Mukim 12 (Bayan Lepas) and central areas of Seberang Perai Tengah, Utara, and Selatan. Evidence of significant spatial clustering was detected across all years based on nearest neighbor index values (NNI: 0.21–0.50). Conclusion: HFMD cases in Pulau Pinang showed marked spatial clustering and shifting intensity patterns, especially in densely populated and newly developed areas. These findings highlighted the need for targeted, locality-specific prevention strategies to curb HFMD transmission.