Mapping Palliative Care Availability and Accessibility: A First Step to Eradicating Access Deserts in the Low- and Middle-Income Settings.

Objective: Palliative care is unavailable and/or inaccessible for the majority of people in low- and middle-income countries (LMIC). This study aims to determine the availability and accessibility of palliative care services in Malaysia, a middle-income country that has made good progress toward universal health coverage (UHC).

Method: Publicly available data, and databases of registered palliative care services were obtained from governmental and nongovernmental sources.

Posterolateral Premature Ventricular Complex Manifest as Posteroseptal Premature Ventricular Complex: A Case Report.

Premature ventricular complex (PVC) is one of the most common arrhythmias detected in young patients. We report a case of a young patient with symptomatic high-burden PVC suspected to originate from the posterior right ventricular outflow tract (RVOT) who underwent an electrophysiology study (EPS) and was subsequently successfully ablated with markedly reduced PVC burden. The following day, it was noted that there was a change in PVC morphology.

Atraumatic Isolated Dislocation of Pisiform With Ulnar Nerve Palsy.

Isolated pisiform dislocation is an uncommon condition, with a limited number of cases reported in the literature. We present a unique case of a 15-year-old male who experienced an atraumatic isolated dislocation of the pisiform bone in his left wrist and presented with pain, deformity, and ulnar nerve palsy in his little and ring fingers. Radiographic investigations confirmed the diagnosis of isolated pisiform dislocation, and the patient successfully underwent an open reduction, stabilization of pisiform, and exploration of the ulnar nerve.

ECG lead misplacement in the frontal and horizontal plane mimicking A myocardial infarction.

Background/aims: Electrocardiogram (ECG) is an inexpensive, fundamental screening tool used in daily clinical practice. It is essential in the diagnosis of life-threatening conditions, such as acute myocardial infarctions, ventricular arrhythmias etc. However, ECG lead misplacement is a common technical error, which may translate into wrong interpretations, unnecessary investigations, and improper treatments.

Development of a Malaysian potentially inappropriate prescribing screening tool in older adults (MALPIP): a Delphi study.

Introduction: Polypharmacy and potentially inappropriate medications (PIM) are common among older adults. To guide appropriate prescribing, healthcare professionals often rely on explicit criteria to identify and deprescribe inappropriate medications, or to start medications due to prescribing omission. However, most explicit PIM criteria were developed with inadequate guidance from quality metrics or integrating real-world data, which are rich and valuable data source.

Impact of deprescribing intervention on potentially inappropriate medications and clinical outcomes among hospitalized older adults in Malaysia: a randomized controlled trial (REVMED RCT) protocol.

Background: Polypharmacy and the use of potentially inappropriate medications (PIMs) are prevalent among older patients admitted to hospitals, posing a heightened risk of adverse drug events. This trial aims to evaluate the effectiveness of a pharmacist-led deprescribing intervention in reducing medications, PIM and improving clinical outcomes, using the locally developed Malaysian Potentially Inappropriate Prescribing Screening tool in Older Adults (MALPIP).

Methods: This is an 18-month cluster-randomized, open-label, parallel-arm controlled trial conducted at 14 public hospitals in the Perak state of Malaysia.

Validation of Faecal Pyruvate Kinase Isoenzyme Type M2 (Faecal M2PK Quick) Test in Detection of Colorectal Adenoma and Adenocarcinoma Among High-Risk Malaysian Population.

Background: Colorectal neoplasia is a multistep process that can lead to the development of colorectal cancer. Colonoscopy is the gold standard for diagnosis and screening of colorectal cancer, but its uptake is often hindered by unpleasant experiences and logistic obstacles. Therefore, non-invasive biomarker tests such as the M2-pyruvate kinase (M2PK) test have been explored as a potential screening tool.

MAFLD fibrosis score: Using routine measures to identify advanced fibrosis in metabolic-associated fatty liver disease.

Background: Early screening may prevent fibrosis progression in metabolic-associated fatty liver disease (MAFLD).

Aims: We developed and validated MAFLD fibrosis score (MFS) for identifying advanced fibrosis (≥F3) among MAFLD patients.

Methods: This cross-sectional, multicentre study consecutively recruited MAFLD patients receiving tertiary care (Malaysia as training cohort [n = 276] and Hong Kong and Wenzhou as validation cohort [n = 431]).

A Retained Lens Fragment Lying Dormant for Over 20 Years in the Eye Following Phacoemulsification: A Case Report.

A 66-year-old male presented with a three-month history of subacute painless decreased vision in the left eye. His ocular history included complicated phacoemulsification surgery of the left eye more than 20 years prior to the presentation. Slit lamp examination revealed a retained lens nuclear fragment in the superonasal quadrant.

Incident sarcopenia in hospitalized older people: A systematic review.

Hospitalization has been associated with the development of sarcopenia. This study aimed to examine the new incidences of hospital sarcopenia, associated risk factors and health outcomes, as defined by internationally recognized diagnostic criteria in hospitalized older people. Pre-defined search terms were run through five databases.

Sphenoid Lymphoma: A Diagnostic Challenge.

Sphenoid sinus lesions grasp the attention of Otorhinolaryngologists due to their prime location and vital surrounding structures. Once detected, these lesions require prompt investigation to identify the underlying cause, usually attributed to a tumor, fungal infection, sinusitis, or polyps, thus allowing tailored treatment. We report a case of an elderly lady whose neurological presentation lead to the diagnosis of sphenoid sinus lymphoma.

Breaking through the steroid stigma: a single-centre study on topical corticosteroid perception and adherence in dermatology patients and caregivers.

Introduction: Topical corticosteroid phobia is a common phenomenon that can result in poor treatment adherence and therapeutic failure.

Objectives: This study aims to evaluate the prevalence and degree of topical corticosteroid phobia and its impact on treatment adherence in various dermatological conditions. Additionally, we explored the sources of information regarding topical corticosteroids.

Comparing the Effectiveness and Adherence between Fixed and Non-Fixed Dorzolamide/Timolol Maleate in Open-Angle Glaucoma Patients in Hospital Universiti Sains Malaysia.

Introduction: Glaucoma is an irreversible chronic eye disease in which intraocular pressure (IOP) control is important. This study aimed to assess the IOP-lowering effects and adherence scores between fixed combination dorzolamide/timolol maleate (FCDT) and non-fixed combination dorzolamide and timolol XE (NFDT) in open-angle glaucoma (OAG) patients.

Methods: A randomised controlled trial in a parallel, single-blinded study involving 60 OAG patients was conducted.

Effects of one-year supplementation with on fibrosis score and metabolic markers in patients with non-alcoholic fatty liver disease: A randomized, double-blind, placebo-controlled trial.

Background and Purpose: and purpose: Non-alcoholic fatty liver disease (NAFLD) is a significant global health concern with limited pharmacotherapy options. This study aimed to evaluate the effectiveness of a standardized extract of in mild-to-moderate NAFLD.

Materials And Methods: This was a 12-month randomized controlled trial, in which adults with a controlled attenuation parameter (CAP) score >250 dB/m and a fibrosis score <10 kPa were randomly assigned to receive a standardized extract at a dose of 3,000 mg daily (n = 112) or a placebo (n = 114).

Rapid onset of effect of benralizumab in a severe eosinophilic and allergic asthma patient with allergic bronchopulmonary aspergillosis.

There is limited data on the use of benralizumab in patients with severe asthma, who have allergic bronchopulmonary aspergillosis (ABPA). We report the case of a 65-year-old woman with combined severe eosinophilic and allergic asthma, who presented with refractory respiratory symptoms, hypereosinophilia and high immunoglobulin E (IgE) level. The patient had consistently poor Asthma Control Test (ACT) scores, despite a maximum dose of inhalation therapy.

Long-term clinical outcomes of adults with metabolic dysfunction-associated fatty liver disease: a single-centre prospective cohort study with baseline liver biopsy.

Background: There are limited data on the long-term adverse clinical outcomes of adults with metabolic dysfunction-associated fatty liver disease (MAFLD).

Methods: This is a single-centre prospective study of a well-characterized cohort of MAFLD patients who underwent liver biopsy and followed every 6-12 months for adverse clinical outcomes.

Results: The data for 202 patients were analyzed [median age 55.

Airway ultrasound to detect subglottic secretion above endotracheal tube cuff.

Background: Subglottic secretion had been proven as one of the causes of microaspiration and increased risk of ventilator-associated pneumonia (VAP). The role of ultrasound to detect subglottic secretion has not yet been established.

Purpose: The purpose of this study is to determine the sensitivity and specificity of upper airway ultrasound (US) in the detection of subglottic secretions as compared to computed tomography (CT) scanning.

Convalescent plasma transfusion in severe COVID-19 patients: Clinical and laboratory outcomes.

Introduction: The objective of this study was to investigate the effect of convalescent plasma (CP) transfusion on clinical and serial laboratory parameters in severe COVID-19 patients. The Coronavirus Disease 2019 (COVID-19) pandemic presents a challenge to the healthcare system worldwide due to the limited treatment options available. The body of evidence reported that CP containing anti- COVID-19 antibodies could be effective against the infection.

Mucosal Sporotrichosis from Zoonotic Transmission: Descriptions of Four Case Reports.

Background: Sporotrichosis is a subacute or chronic mycosis caused by a dimorphic fungus of the genus . Zoonotic-transmitted sporotrichosis has become a major public health concern and is characterised by a different clinical pattern from the traditional epidemiology of sporotrichosis.

Case Presentation: We present the details of four patients with mucosal sporotrichosis with regional lymphadenopathy (three cases of granulomatous conjunctivitis and one case of nasal sporotrichosis).

Malaysian Society of Allergy and Immunology Consensus Statement on Sublingual Immunotherapy in Allergic Rhinitis.

Allergic rhinitis (AR) is an IgE-mediated inflammatory disease of the upper airway. AR affects the patients' quality of life, is a known risk factor for asthma and a socio-economic burden. Allergen-specific immunotherapy (AIT), comprising sublingual immunotherapy (SLIT) and subcutaneous immunotherapy (SCIT), involves administering increasing doses of the causative allergen to induce clinical and immunologic tolerance to the allergens.

Predicting successful live birth from single serum hCG measurement in assisted reproductive technology (ART) cycle.

Introduction: Assisted reproductive technology may result in various outcomes, causing a significant stress both physically and emotionally to the patients. This study aims to determine the level of serum human chorionic gonadotrophin (hCG) following embryo transfer in predicting successful live births in in vitro fertilisation (IVF) cycles.

Materials And Methods: This is a retrospective analysis of 407 IVF pregnancies in Hospital Sultanah Bahiyah Kedah from 2014 to 2019.

Can patients achieve sufficient peak inspiratory flow rate (PIFR) with Turbuhaler® during acute exacerbation of asthma?

Introduction: Anti-inflammatory reliever (AIR) with or without regular maintenance delivered through Turbuhaler® has been widely recommended in the GINA strategy document. These patients are not prescribed with additional reliever inhalers, but dependent on Turbuhaler during acute asthma episodes. The peak inspiratory flow rate (PIFR) is crucial in drug delivery from a dry powder inhaler (DPI) such as Turbuhaler.

Patient profile and antibiotic use in a dedicated upper respiratory tract infection clinic based in a primary healthcare setting during COVID-19 pandemic in Malaysia: A cross sectional study.

Introduction: Upper respiratory tract infection (URTI) is commonly encountered at the primary care level. Its management is particularly challenging due to the similarity of its symptoms to coronavirus disease 2019 (COVID-19) infection. Our study evaluated the profiles and antibiotic use of patients seeking care from a dedicated community-based URTI clinic during the COVID-19 pandemic.