IIUM Medical Journal Malaysia

The Enduring Enigma of Spinal Tuberculosis in Modern Diagnostic Era and The Critical Role of Magnetic Resonance Imaging

2025-12-30T10:24:58+08:00

Laboratory Biomarkers in Assessing the Severity of COVID-19 at Referral Hospital in Indonesia

2025-06-20T10:26:34+08:00

Introduction: 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.

Effect of Stromal Vascular Fraction and Platelet-Rich Plasma on Epithelialization in Anal Trauma Healing in Wistar Rats

2025-07-17T17:57:48+08:00

INTRODUCTION: 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.

Utilization of “Skim Peduli Kesihatan untuk Kumpulan B40” (PeKa B40) Programme among Felda Residence in Kedah, Malaysia: The Participation Rate and its Determinants

2025-08-28T10:08:19+08:00

INTRODUCTION: 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.

Translation and Validation of the Readiness to Change Questionnaire for Alcohol Drinkers into an Indigenous Language (Jakun Version) in Malaysia

2025-06-26T22:11:27+08:00

INTRODUCTION: 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.

Effectiveness of Solifenacin Monotherapy and Mirabegron and Solifenacin Combination Therapy in Patients with Stent-Related Symptoms

2025-11-11T10:10:17+08:00

INTRODUCTION: 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.

Prevalence and Factors of Fall-Risk Increasing Drug Prescribing for Older Patients in Medical Wards

2025-08-28T00:51:32+08:00

INTRODUCTION: 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.

Therapeutic Effect of Thymoquinone on MAPK Signalling Pathway in K562 Chronic Myeloid Leukaemia Cells

2025-10-13T11:45:21+08:00

INTRODUCTION: 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.

Development and Validation of A Weight Management Program Model for Overweight and Obese Individuals

2025-10-27T10:21:16+08:00

INTRODUCTION: 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

Knowledge and Awareness of Jordanian Speech and Language Pathologists on Radiation Protection while Performing Videofluoroscopic Swallowing Study

2025-09-26T08:23:30+08:00

INTRODUCTION: 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.

The Prevalence of Malnutrition and Its Relationship with Clinical Outcomes Among Critically Ill Children in PICU and PHDU

2025-08-03T22:05:11+08:00

INTRODUCTION: 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.

Cross-Sectional Study of Glycaemic Control Among Women with Type 2 Diabetes Mellitus in A Primary Health Care Clinic: A Call for Tailored Intervention

2025-07-22T10:50:26+08:00

INTRODUCTION: 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.

Effects of Retinoic Acid on Liver Triglyceride Level and Diacylglycerol Acyltransferase-2 (DGAT2) Gene Expression in Rats with High-Cholesterol Diet-Induced Steatosis

2025-10-24T11:10:54+08:00

INTRODUCTION: 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.

The Impact of Qur’anic Reading and Listening Duration and Frequency on Cognitive Performance and Hippocampal Function: A Systematic Review

2025-10-17T19:27:22+08:00

Engaging 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.

Agarwood's Role in Inflammatory-related Conditions: A Systematic Review of Animal Models

2025-08-31T12:09:40+08:00

Agarwood (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.

Exploring Neonatal NaV1.5 Voltage-Gated Sodium Channel as a Therapeutic Target in Cancer

2025-09-24T20:50:58+08:00

Voltage-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.

Arabic Language and Medical Terminology in Education: A Systematic Review

2025-06-12T17:08:22+08:00

The 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.

Navigating the Diagnostic Challenges of Cervical Plexus Schwannoma: A Rare Entity

2025-05-07T15:30:08+08:00

Schwannomas 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.

Ultrasound Guided Dextrose Prolotherapy For Chronic Medial Collateral Ligament Injuries In Young Footballers

2025-05-12T19:06:42+08:00

Dextrose 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.

Prolonged Fever and Unremitting Back Pain in Elderly Patient: A Case of Disseminated Tuberculosis with Spondylodiscitis

2025-04-17T10:39:50+08:00

Disseminated 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.

Flare-Up in Full Bloom: Navigating Rosacea Fulminans During Pregnancy

2025-04-17T15:44:20+08:00

Rosacea 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.

A Case of Uncommon Hematemesis from Acute Esophageal Necrosis

2025-05-20T18:47:11+08:00

Acute 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.

Breast Fillers on the Rise: A Silent Epidemic of Unregulated Aesthetic Trend

2025-12-30T09:50:21+08:00

The 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.