IIUM Medical Journal Malaysia

Synthesis of Evidence on the Combination of High-Intensity Laser Therapy and Rehabilitation Exercise for Knee Osteoarthritis: An Umbrella Review of Systematic Reviews

Yan Ling Tay — 2026-07-01

High-intensity laser therapy (HILT) is a promising adjunctive treatment for knee osteoarthritis (KOA) due to its deep tissue penetration and anti-inflammatory effects. However, inconsistent findings hinder clinical interpretation. This umbrella review synthesised current evidence on the effects, safety, and clinical applicability of HILT in KOA management. A systematic search of five electronic databases was conducted in accordance with PRISMA guidelines, covering studies up to December 2024. Eligible systematic reviews included adult populations with KOA receiving HILT, assessing outcomes such as pain, stiffness, physical function, and safety. Methodological quality was evaluated using AMSTAR-2 and PRISMA checklists. The Corrected Covered Area (CCA) was calculated to assess overlap among primary studies. Seven systematic reviews published between 2017 and 2024 were included, comprising 50 unique primary studies involving adults aged 40–70 years. The CCA score of 0.047 indicated minor overlap. Most studies applied HILT in combination with rehabilitation exercise rather than as a standalone therapy. HILT significantly reduced pain and improved physical function, often exceeding minimal clinically important differences. Treatment parameters ranged from 808–1064 nm and 0.51–120 J/cm², administered over 4–8 weeks. Compared to low-level laser therapy, HILT demonstrated greater effects in pain relief and functional outcomes, with a favourable safety profile. While HILT can be used independently, combining it with exercise is the most commonly applied and effective approach for KOA. Despite promising results, variability in protocols and limited long-term data highlight the need for standardised treatment guidelines and further research.

Exercise, GLUT4 and Skeletal Muscle Glucose Uptake: Advances and Emerging Directions

Mohd Fadly Mohd Noor — 2026-07-01

Skeletal muscle is the principal site of postprandial glucose disposal, and its exercise-stimulated glucose uptake is a cornerstone of metabolic health. This process depends on the glucose transporter GLUT4, which is regulated by both insulin- and contraction-stimulated pathways. Understanding exercise-driven GLUT4 dynamics is crucial for combating insulin resistance and type 2 diabetes. Over the past decades, research has progressed from descriptive physiology to a mechanistic framework, identifying key insulin-independent regulators such as AMPK, Rab GTPases, SNAREs, Rac1, and redox mediators. Emerging methodologies, including high-resolution imaging, quantum dot tracking, and proteomics profiling, have provided insight into vesicle docking, fusion, and signalling convergence. Comparative exercise studies reveal modality-specific effects (e.g., HIIT) and that regulation varies by age, sex, and metabolic status, highlighting the need for population-specific approaches. Nevertheless, important questions remain: the kinetics of GLUT4 exocytosis and endocytosis in human muscle remain incompletely defined, and the integration of redox signalling with canonical kinases such as AMPK and CaMKII is poorly understood. Moreover, most mechanistic insights are derived from rodent models or young male subjects, limiting generalisability to elderly, female, or insulin-resistant populations. Addressing these gaps requires translational studies combining advanced imaging, CRISPR reporters, and molecular phenotyping with human exercise interventions. Integrating exercise with pharmacological or nutritional strategies may also unlock synergistic effects on glucose regulation. In conclusion, GLUT4 sits at the nexus of exercise biology and metabolic disease. Elucidating its regulation across diverse populations is pivotal for advancing precision exercise medicine and developing targeted interventions for insulin resistance and type 2 diabetes.

The Involvement of Long Non-coding RNAs, MicroRNAs and Circular RNA in the Prediction of Cardiovascular Disease in Hypertensive Disorder of Pregnancy- A Scoping Review

Prianeesha Ganesan — 2026-07-01

Hypertensive disorders of pregnancy (HDP) is a common condition in pregnant women affecting 5% to 10% of pregnancies worldwide. Women who have had HDP are at a higher risk of developing cardiovascular diseases (CVD) earlier in life compared to those who remained normotensive during pregnancy. HDP is associated with a significant increased risk of early-onset of CVD particularly hypertension and stroke, and this can lead to maternal mortality. Non-coding RNAs (ncRNAs) have been linked to HDP, particularly the long non-coding RNA (lncRNA), microRNA (miRNA), and circular RNA (circRNA). This scoping review identifies the most significant ncRNAs involved in predicting CVD in HDP. The protocol by Arksey and O’Malley was used in this scoping review. The steps were carried out in a systematic manner, including the identification of research questions, identification and selection of relevant studies, data charting and collating, summarizing the data, and reporting the findings. Multiple databases were searched for data collection, including Semantic Scholar, Scopus, PubMed Central, and Science Direct. In all thirty-one relevant studies were explored in this review. This review demonstrates the types, models, methodologies, and descriptions of non-coding RNAs associated with HDP. This review highlights that non-coding RNAs play a key role in predicting heart disease linked to high blood pressure in pregnancy by influencing blood vessels, inflammation, and stress, thus emphasizing their potential as early markers and the need for further study.

Unfortunate Series of Fractured Cannula: Rare Venous Access Complications

Julina Md Noor — 2026-07-01

Cannulas are essential medical devices that are used daily for intravenous access, facilitating fluid and medication delivery. Although complications such as phlebitis, pain, and swelling at the cannulation site are commonly observed, cannula fractures remain a rare but potentially serious complication. This case series describes four incidents of fractured intravenous cannulas, occurring within 6 months at a tertiary centre without vascular surgery services, during its early operational phase. All cases were successfully managed through prompt identification and removal under local anaesthesia. Investigations revealed contributing factors, including inappropriate cannula size selection, prolonged dwell time, insertion in high-mobility areas, and patient-related anatomical challenges. These cases highlight the need for strict adherence to intravenous catheter protocols and proper cannula selection based on indication and duration. These case series aim to raise awareness among medical professionals and manufacturers about the associated risks, promote better prevention strategies, and drive improvements in cannula design and manufacturing, ultimately enhancing patient safety.

Complete Hydatidiform Mole and Co-Existing Foetus with Severe Maternal Thyrotoxicosis: A Case Report

Shu Khien Thong — 2026-07-01

Twin molar pregnancy refers to the coexistence of a complete or partial hydatidiform mole alongside a foetus. A complete hydatidiform mole with co-existing foetus (CHMCF) is an exceptionally rare obstetric phenomenon, with an incidence of approximately 1 in 20,000 to 100,000 pregnancies. Owing to its rarity, no standardized management guidelines currently exist. We report a case of a 33-year-old woman, G5P4, diagnosed with CHMCF at 15 weeks gestation, who developed severe maternal thyrotoxicosis and rapid uterine enlargement necessitating termination of pregnancy for maternal safety. Following termination of pregnancy, she was monitored closely with β-hCG surveillance due to the potential risk of gestational trophoblastic neoplasia. This case highlights the diagnostic dilemma, as well as challenges of management and post-treatment surveillance in CHMCF. Early diagnosis and multidisciplinary care are essential for optimal maternal outcomes.

Breast Cancer in Neurofibromatosis Type 1: Screening, Diagnostic and Therapeutic Challenges – A Case Report

Ajimah Julasrin — 2026-07-01

Neurofibromatosis type 1 (NF1) is a genetic disorder characterized by an increased risk of various tumours, including breast cancer, particularly in women under 50. This case report discusses a 47-year-old woman with NF1 who was diagnosed with metastatic invasive ductal carcinoma of the breast. She initially presented with respiratory symptoms, and subsequent clinical evaluation revealed a left breast ulcer and underlying mass, which the patient had attributed to NF1-related cutaneous changes. Histopathological examination confirmed bilateral hormone receptor positive, HER2-negative invasive breast carcinoma with metastatic involvement. Management options, including systemic therapy, were discussed within a multidisciplinary team, and the patient elected to proceed with endocrine therapy using Tamoxifen. This case highlights the clinical complexity of breast cancer detection in individuals with NF1, where overlapping benign cutaneous manifestations may influence symptoms interpretation. It also highlights the importance if early and regular breast cancer screening, beginning at age 30, using appropriate imaging modalities such as mammography and contrast-enhanced breast MRI. Individualised screening strategies patient education remain essential to optimise outcomes in this high-risk population.

Rapid Progression From Chronic Phase to Blast Crisis: Prognostic Implications of Bone Marrow Fibrosis in Chronic Myeloid Leukemia

Divya Rajendra R. Ajmera — 2026-07-01

Chronic myeloid leuka;emia (CML) demonstrates variable responses to tyrosine kinase inhibitors (TKI). The prognostic impact of bone marrow fibrosis (BMF), particularly at diagnosis, remains under-recognised, especially in adolescent patients. We report a case of a 14-year-old male diagnosed with chronic-phase CML who progressed rapidly to blast crisis within 12 months. Despite treatment with imatinib followed by nilotinib, the patient failed to achieve a complete cytogenetic response due to severe cytopenia and frequent dose interruptions. Retrospective analysis of the initial bone marrow biopsy revealed grade 3 fibrosis. The disease remained refractory despite high-dose induction chemotherapy. This case highlights the potential prognostic relevance of BMF in adolescent CML and supports the integration of reticulin staining into the diagnostic workup to guide timely intervention.

Breaking the Rule of Stone: Expanding Urolithiasis Analysis to the Microbiome and Metabolome

Mohd Nazli Kamarulzaman — 2026-07-01

Trends in Treatment of Obesity: Is it a "déjà vu" Moment for Surgeons?

Prof. Dr. Nasser Mohammad Amjad — 2026-07-01

Genetic Variation of the BCL-2 Gene and its Relation to Breast Cancer in Iraqi Women

Sabah Subhi Ismael Barani — 2026-07-01

INTRODUCTION: B-cell lymphoma-2 (BCL-2) is a key regulator of apoptosis, and its dysregulated expression contributes to cancer cell survival in several malignancies, including breast cancer. The BCL-2 gene, specifically rs2279115, has been found to significantly modulate transcriptional activity and affect BCL-2 protein expression in various tissues and diseases. Genetic differences affecting apoptotic pathways may therefore contribute to the susceptibility and progression of breast cancer. The present study aims to investigate variation in the BCL-2 genotype in humans, determine the nucleotide sequence of the gene, and determine whether this correlates with the incidence of breast cancer in 45 women. MATERIALS AND METHODS: This case–control study included 30 women with breast cancer and 15 an age-matched group of healthy women controls. The genetic polymorphism of the BCL-2 gene in situ (rs2279115) was determined using the tetra-primer amplification refractory mutation system-polymerase chain reaction technique. Nucleotide sequencing of the amplified fragments was performed using DNA sequencing technology. Fisher’s exact test was used to compare the genotype and allele frequencies between patients and controls. RESULTS: There is genetic variation of the BCL-2 gene in patients with breast cancer, with three genotypes, CC, CT, and TT, in comparison with one genotype in healthy controls. The percentage of incidence of the T allele was 25% in breast cancer patients compared to 0% in controls. The sequencing test for the amplified BCL-2 gene reported multiple nucleotide variations in the breast cancer samples compared with controls. CONCLUSION: The present study showed a possible genetic variation with multiple mutations in the BCL-2 gene in patients with breast cancer, which needs to be confirmed by further larger cohorts.

Prevalence and Factors Associated with Loneliness Among Urban-Dwelling Older Persons in Kuala Lumpur

Mohd Fadzil Mohd Hussin — 2026-07-01

The World Health Organization (WHO) declared loneliness as a global public issue. Each individual faces this psychological state in some stages of their lives as people from all age categories, including older persons may experience it. In this study, we aimed to determine the prevalence and factors associated with loneliness among older persons in Kuala Lumpur. MATERIALS AND METHODS: This cross-sectional study was conducted at government health clinics located in two districts located in Kuala Lumpur, Malaysia between October 2024 and March 2025. 423 older persons were recruited. The De Jong Gierveld Loneliness Scale (DJGLS-6), Duke Social Support Index (DSSI-11), Lubben Social Network Scale (LSNS-6), Geriatric Depression Scale (GDS-14) and self-rated health (SRH) questionnaires were used for data collection. Ordinal logistic regression was used to identify significant factors. RESULTS: The mean age of participants was 67.80 (±5.75) years. Analysis of the collected data indicated a 47.0% prevalence of loneliness among participants. Ordinal logistic regression found that female [adjusted odds ratio (AOR)=1.50; 95% confidence interval (CI): 1.04 – 2.19], age (AOR= 1.03; 95% CI: 1.00–1.07) and functional social support (AOR=0.92; 95% CI:0.89 – 0.96) were significantly associated with loneliness. CONCLUSION: Based on these findings, social and community programmes can be tailored to reach older persons at greater risk of experiencing loneliness. Identification of these individuals can be informed by their sociodemographic, health, and interpersonal characteristics highlighted in this study.

Health-Related Quality of Life in Young Adults with Hypertension: A Comparative Cross-Sectional Study in Malaysia

Lyana Shahirah Mohamad Yamin — 2026-07-01

INTRODUCTION: Hypertension in young adults is associated with a prolonged disease course and elevated lifetime cardiovascular risk, significantly affecting quality of life (QoL). Despite its growing prevalence and potential to affect multiple QoL dimensions, this relationship remains understudied in Malaysia. This study aimed to compare QoL between normotensive (NT) and hypertensive (HTN) young adults. MATERIALS AND METHODS: A cross-sectional study involving 124 participants (64 NT and 60 HTN) aged 18-39 years. QoL was assessed using the validated WHOQOL-BREF questionnaire across four domains: physical health, psychological well-being, social relationships, and environmental satisfaction. Body mass index, waist-to-hip ratio, and sociodemographic data were also collected. RESULTS: The HTN group demonstrated significantly lower scores than the NT group in physical health (67.5±14.5 vs 73.67±15.5, p=0.024) and in environmental domains (71.0±12.4 vs 75.5±11.3, p=0.037). Waist-to-hip ratio was the only consistent factor across all QoL domains, showing significant negative associations with physical health (B=-33.920, p=0.025), psychological well-being (B=-27.444, p=0.049), social relationships (B=-35.662, p=0.048), and the environmental domain (B=-38.132, p = 0.001). Body mass index was negatively associated with physical health (B=-0.495, p=0.045), and employment status was significantly associated with psychological well-being (B=-7.931, p=0.022). CONCLUSION: Hypertension management in young adults should extend beyond blood pressure control to encompass broader QoL considerations, particularly addressing central obesity and psychosocial determinants of health.

Caregiver Perception in Supporting Communication for People with Dementia

Shaniel Izzati Dania Shahrulnizam — 2026-07-01

Introduction: Dementia progressively impairs cognitive abilities and negatively affecting communication between people with dementia (PWD) and their caregivers. This study explored caregivers’ experiences in communicating with PWD. Materials and Methods: This qualitative study received ethical approval from Universiti Kebangsaan Malaysia (JEP-2024-266). Sixteen family caregivers of PWD were purposively recruited from the Psychiatric Clinic, Occupational Therapy Unit, and Speech Therapy Unit at a public university hospital. Semi-structured face-to-face interviews were conducted individually, lasting 30–40 minutes, and were recorded via Microsoft Teams. The transcripts were analysed using thematic content analysis. Coding reliability achieved 81.33% agreement, and discrepancies were resolved through discussion. Results: Two main themes were identified: Communication Challenges (CC) and Strategies to Support Communication (SSC). The CC theme comprised of four subthemes: cognitive deficits, other PWD-related factors, communication difficulties, and impacts on caregivers’ personal lives. The SSC theme comprised of three subthemes: comprehensive support, active engagement, and the use of communication aids. Communication breakdowns, behavioural issues, coexisting health conditions, and limited family support contributed to caregiver stress, whereas memory support, emotional reassurance, cognitive stimulation, and multimodal communication strategies improved interaction. Conclusion: Caregivers’ wellbeing is affected by the cognitive and behavioural challenges of PWD as well as the availability of family support. External support, engagement activities, and communication aids may enhance caregiver–PWD interaction and strengthen social connections. The findings highlight the need for culturally tailored interventions and caregiver training programs to improve communication experiences and overall quality of life for both caregivers and PWD.

Assessment Of Pain, Balance, Functional Performance, And Quality Of Life In Patients With Meniscus Lesions: A Cross-Sectional Study

Aslı Nur Tuncer — 2026-07-01

Introduction: This study aimed to compare pain, balance, functional performance, and quality of life between individuals with meniscal injury and healthy controls. To evaluate the differences in pain, balance, functional performance, and quality of life between individuals with meniscal injury and healthy controls. Materials and Methods: Seventy participants were enrolled, including 35 patients with MRI-confirmed meniscal injury and 35 age- and sex-matched healthy controls. Pain was measured using the Visual Analog Scale (VAS), balance and mobility with the Berg Balance Scale (BBS) and Timed Up and Go Test (TUG), functional performance with the Five Times Sit to Stand Test (5TSTS), and quality of life with the Western Ontario Meniscal Evaluation Tool (WOMET). Muscle strength and range of motion (ROM) were also assessed. Results: Compared with healthy controls, individuals with meniscal injury reported higher pain levels and demonstrated poorer functional performance and quality of life (p<0.05). The meniscal tear group reported higher pain levels (p<0.001) and demonstrated worse functional mobility (longer TUG and 5TSTS times) and quality of life (higher WOMET scores, p<0.05). A significant correlation was found between VAS and WOMET outcomes in the meniscal tear group (p<0.05) and between VAS and both WOMET and BBS outcomes in the control group (p<0.05). Conclusion: This study emphasizes the need for rehabilitation strategies addressing both physical recovery and quality of life for individuals with meniscal injuries. Future research should explore targeted pain management and rehabilitation programs to improve patient well-being.

Evaluation of Anaesthesia Information Provision on Pre-Operative Anxiety in Patients Undergoing Planned Surgery in a Tertiary Centre

Ajayan Nair — 2026-07-01

Introduction: Pre-operative anxiety is associated with physiological and psychological implications in the peri-operative period. Pre-operative education and anaesthesia information provision help alleviate concerns and anxiety regarding anaesthesia for planned surgeries. This study aims to compare differences in levels of anxiety with anaesthesia information provision and factors contributing to anxiety. Materials and Methods: Seventy patients, aged between 18 and 65, with American Society of Anesthesiologists classes I or II undergoing planned surgery were recruited into this study. They were divided into Group A, which received regular pre-anaesthetic counselling one day prior to surgery, and Group B, which received the counselling and an anaesthesia information sheet (AIS). Both groups were then given an Amsterdam Preoperative Anxiety Information Scale (APAIS) questionnaire at the end of the pre-anaesthetic visit and again on the morning of the planned surgery. The scores were calculated to determine the level of anxiety. Results: Group B showed a significant reduction in anxiety levels compared to Group A [Difference (95% CI): -1.51 (-1.96, -1.07); p< 0.001]. For the information desire component, a significant decrease was observed in both Group A (p = 0.037) and Group B (p< 0.001). Group B demonstrated a greater decrease [Difference (95% CI): - 1.17 (-1.62, -0.73)] compared to Group A [Difference (95%CI): -0.40 (-0.77, -0.03)]. Past surgical history was a factor shown to be of statistical significance [coeff (95% CI): -2.39 (-4.21, -0.57); p= 0.011]. Conclusion: Provision of AIS significantly reduced the level of anxiety in patients undergoing planned surgery and has been shown to alleviate concerns in patients with no past surgical history.

Unravelling the Potential of Trans-3-Hydroxycinnamic Acid on Metabolic Indices, Biochemical, and Haematological Parameters in Rats with Metabolic Disturbances

Amirah Suhaila A Aziz — 2026-07-01

Introduction: Metabolic disturbances caused by high-calorie diets contribute significantly to global mortality. Trans-3-hydroxycinnamic acid (HCA), a bioactive antioxidant, may offer protective effects against such imbalances. This study evaluated the metabolic, biochemical, and haematological effects of HCA in rats fed a high-fat, high-fructose (HFHF) diet. Materials and Methods: Male Sprague Dawley rats aged 7-8 weeks were fed with HFHF diet for 6 consecutive weeks. Rats with metabolic disturbances received HCA at 15 mg/kg, 30 mg/kg, or 60 mg/kg, and were continuously fed with HFHF diet for another 6 weeks. Normal control rats received normal pellets. The effects of HCA on metabolic indices, biochemical, and haematological parameters were evaluated. Results: HCA treatment for 6 weeks ameliorates metabolic indices, including weight gain, Lee obesity index, abdominal and thoracic circumferences, TC/HDL ratio, glucose, and fat pad deposition. Improved AST and ALT levels indicated the hepatoprotective effect of HCA, supported by decreased fat vacuolation. The most significant effects were observed at 30 mg/kg. No significant haematological or renal toxicity was detected. Conclusion: Our results indicated HCA at 30 mg/kg is the optimum dose that exerts its ameliorative effects in reducing metabolic indices, along with no severe biochemical and haematological changes.

Mapping Health Influencers on Social Media: A Bibliometric Analysis of Trends and Challenges (2010–2024)

Hidayatul Radziah Ismawi — 2026-07-01

INTRODUCTION: Social media platforms such as YouTube, Instagram, and TikTok have become vital tools for health communication, with influencers shaping public perceptions, promoting healthy behaviours, and addressing global health challenges. MATERIALS AND METHODS: This bibliometric analysis examined the evolving role of health influencers between 2010 and 2024, through 516 Scopus-indexed peer-reviewed publications, comprising 479 original research articles and 37 reviews. Bibliometric measures, including citation analysis, institutional mapping, and keyword co-occurrence, were applied using Bibliometrix, Biblioshiny, and VOSviewer. RESULTS: The most productive year was 2024 with 92 publications (2199 citations). The United States of America (USA) contributed the most citations (49.81%), with Fishman E.K. from Johns Hopkins University as the most prolific author. The most cited article had 602 citations (40.1 citations/year). The Journal of Medical Internet Research led in publications. Medicine accounted for 66.4% of publications. Dominant themes included misinformation, content quality, health promotion, and medical education. While USA and Canada dominate, international collaboration remains limited, highlighting underrepresentation from low- and middle-income countries. CONCLUSION: This analysis highlights the intersection of social media, health communication, and public engagement strategies. Health influencers hold potential to amplify health promotion, but issues of misinformation, ethical concerns, and unequal global participation persist. For policymakers, the findings highlight the need for regulatory frameworks to ensure content accuracy and credibility. For practitioners, the study highlights opportunities to collaborate with health influencers to promote evidence-based, culturally sensitive health messaging. Future research should broaden database coverage, evaluate health influencer’s behavioural impact, and establish guidelines for ethical, evidence-based health communication.

Hand Strength Differences Across Cardiometabolic Conditions: A Cross-Sectional Comparative Study

Ahmad Aiman A.Wahab — 2026-07-01

Introduction: Handgrip and pinch strength are critical indicators of upper limb function and health, and may be affected by cardiometabolic conditions such as type 2 diabetes mellitus (T2DM), hypertension (HPT), and hyperlipidemia (HPL). This study aimed to compare handgrip and pinch strength among healthy adults, individuals with T2DM+HPT, and those with T2DM+HPT+HPL in a Malaysian population. Materials and Methods: A cross-sectional study was conducted with 204 adults (n=68 per group), matched by age, gender, and health condition. Handgrip and pinch strength were assessed using the Jamar Hydraulic Dynamometer and Pinch Gauge following the American Society of Hand Therapists (ASHT) protocol. Statistical analyses included One-way ANOVA and Pearson correlation. Results: Hand strength differed significantly across groups (p<0.001). Healthy adults demonstrated higher grip and pinch strength than participants with T2DM+HPT and T2DM+HPT+HPL. Strength measures showed strong bilateral correlations (0.85-0.92, p<0.001). Weak positive associations were observed between random blood sugar and grip/pinch strength (r=0.239-0.271), while diastolic blood pressure showed weak associations with grip strength only (r=0.239-0.265). HbA1c was not significantly associated with hand strength. Conclusion: Cardiometabolic conditions are associated with reduced hand strength, particularly when T2DM coexists with HPT and HPL. Grip and pinch strength may serve as accessible functional markers for clinical assessment and early intervention in at-risk populations.

Mental Health Help-Seeking Attitude and its Associated Factors among Chinese International University Students in Malaysia

Liuying Lin — 2026-07-01

INTRODUCTION: Amid growing concerns about mental health in academic settings, especially among international students facing cross-cultural stress and stigma, understanding factors associated with mental health help-seeking attitudes is crucial for effective strategies. This study aimed to examine mental health help-seeking attitudes and associated factors among Chinese international university students in Malaysia. MATERIALS AND METHODS: A cross-sectional study was conducted from October 2024 to July 2025 among Chinese international students selected through convenience sampling. Data were collected using a questionnaire comprising socio-demographic characteristics, the Attitude Toward Seeking Professional Psychological Help-Short Form (ATSPPH-SF), the Language Proficiency subscale of the Revised Sociocultural Adaptation Scale (SCAS-R), the Self-Stigma of Seeking Help Scale (SSOSH-3), the Stigma Scale for Receiving Psychological Help (SSRPH), and the Multidimensional Scale of Perceived Social Support (MSPSS). Data were analysed using descriptive statistics and multiple linear regression. RESULTS: A total of 222 participants were analysed. The median help-seeking attitude score was 16.5 (IQR: 14–21). Self-stigma (adjusted β = -0.550, p < 0.001) and students from health and life sciences field (vs. science and technology) (adjusted β = -2.533, p = 0.027) were significant negative predictors, age (adjusted β = 0.148, p = 0.030) and social support (adjusted β = 0.072, p = 0.011) were significant positive predictors. CONCLUSION: Personal and environmental factors were associated with mental health help-seeking attitudes. Universities may improve attitudes by strengthening support systems. Future studies are recommended to further explore strategies to improve mental health help-seeking attitudes among international university students

Characteristics, Risk Factors, and Maternal-Foetal Outcomes of Pregnant Women with COVID-19 Admitted to Hospital Sungai Buloh, Malaysia: A Single-Centre Retrospective Cohort Study

Nur Munirah Ibrahim — 2026-07-01

INTRODUCTION: Malaysia was hit by one of the biggest waves of COVID-19 in year 2021, the worst-case morbidity and mortality since the pandemic started in 2020. Hospital Sungai Buloh (HSB), Selangor was the first hospital designed to treat COVID-19 cases only and was the referral centre for COVID-19 in the Klang Valley, hence all pregnant patients with COVID-19 in Selangor was referred here for treatment and care. This study aims to describe the characteristics and outcomes of pregnant women with COVID-19 admitted to HSB, and to identify the risk factors associated with severe outcomes. MATERIALS AND METHODS: This study is a single centre, retrospective cohort study whereby electronic records of pregnant patients with COVID-19 admitted to HSB from May to August 2021 were searched and data on sociodemographic and clinical characteristics, management, complication and outcomes of the mother and foetal were retrieved. RESULTS: Out of 282, 66 women had severe covid-19 (stage 4 &5) and 216 had non-severe COVID-19 (stage 1-3). We found that pregnant patients with severe COVID-19 infection are more likely to be obese, have lower absolute lymphocyte counts and higher C-reactive protein (>50) on admission, and higher day of illness on admission. CONCLUSION: Severe COVID-19 resulted in longer hospital stay, associated with higher disease related complications and adverse maternal and foetal outcomes. However, vertical transmission is rare although possible in COVID-19. Our study provides a valuable local data from a single COVID-19 centre in Malaysia