Malaysian Journal of Medical Research (MJMR)

Readiness of Final-Year Nursing Students Towards Giving Health Education to Caregivers of Critically Ill Clients After Transfer Out of ICU

Nur Umairah Mohd Safreja, Suzilawati Mohamed Ariffin — Sat, 03 Jan 2026 00:00:00 +0000

Introduction: Critically ill patients often require complex care even after discharge from the Intensive Care Unit (ICU), and caregivers become crucial in providing continuous care at home. Preparing nursing students to educate these caregivers is essential to ensuring quality patient outcomes. Objectives: This study aimed to assess the readiness of final-year nursing students in providing health education to caregivers of critically ill patients following ICU discharge, focusing on their knowledge, skills and awareness, and confidence. The study also examined whether gender had a significant association with these competencies. Methodology: A quantitative cross-sectional design was employed, targeting 102 final-year nursing students at IIUM Kuantan. Participants were recruited using census sampling. Data collection was conducted from March to April 2025 through a self-administered online survey consisting of the Health Education Competency Instrument (I-Cepse) and the Casey-Fink Readiness for Practice Survey. Statistical analysis was performed using SPSS Version 27 for descriptive and inferential statistics, including chi-square tests. Results: Most students demonstrated high levels of knowledge (78.4%) and confidence (73.5%). However, a lower proportion (39.2%) reported high levels of skills and awareness. Gender showed no significant association with any of the readiness variables. Notably, knowledge was significantly associated with confidence (p < 0.05) and showed a borderline association with skills and awareness (p = 0.051). Conclusion: While final year nursing students are well-prepared theoretically, practical and communication skills related to caregiver education require further strengthening. The curriculum should incorporate simulation, interprofessional training, and caregiver engagement strategies to ensure holistic readiness.

Disease Trends and Reassessment of Knowledge, Attitudes, and Practices of Stakeholders in Trypanosomiasis-Prone Areas of Malawi: A One Health Perspective

James Majamanda, Andrew Mtewa, Mwayiwawo Madanitsa, Steven Gowelo — Sat, 03 Jan 2026 00:00:00 +0000

Background: Trypanosomiasis is a neglected tropical disease caused by Trypanosoma parasites, transmitted primarily by the tests fly vector and, in some instances, by other biting insects. In Sub-Saharan Africa, both the human and animal forms of the disease pose serious challenges, as they hinder agricultural productivity, affect human health, and impede national development. In Malawi, the three pillars of Vision 2063—agricultural productivity and commercialization, industrialization, and urbanization—may be significantly affected by the continued presence of trypanosomiasis, compromising the nation’s long-term developmental goals. Objectives: To review disease trends by comparing prevalence data and assessing stakeholders’ knowledge, attitudes, and practices (KAP) in trypanosomiasis-prone areas of Malawi, in order to inform prevention and control efforts. Methods: Peer-reviewed articles written in English were retrieved from various databases using targeted search phrases related to trypanosomiasis, disease prevalence, and KAP in Malawi. Retrieved studies were examined to map disease hotspots and characterize each focus area based on stakeholders’ KAP. Results: This review has revealed that knowledge gaps regarding trypanosomiasis significantly influence stakeholders’ attitudes and practices toward its prevention and control. These gaps contribute to sustained disease prevalence across trypanosomiasis-prone areas of Malawi. Conclusion: Strengthening community awareness and education campaigns could reduce knowledge gaps, improve attitudes and practices, and ultimately enhance the effectiveness of trypanosomiasis prevention and control efforts in Malawi and other endemic regions.

Cardioprotective Activity of Propionic Acid in High-Fat Diet/ Streptozotocin-Induced Cardiotoxicity in Diabetic Rats Model

Sat, 03 Jan 2026 00:00:00 +0000

Background: The healthcare sector is increasingly focusing on the discovery of toxic-free natural medicines to treat diabetes-related complications. The current study investigated the cardioprotective efficacy of propionic acid (PA) in a type 2 diabetic rat model. Methods: Twenty-five Wistar rats (200–300 g) were used. The rats were fed a high-fat diet for 8 weeks, and streptozotocin (30 mg/kg b.wt) was injected intraperitoneally to induce diabetes. The animals were divided into 5 groups (n = 5) and treated for 4 weeks. Group 1: normal control; Group 2: normal control + PA (60 mg/kg b.wt); Group 3: diabetic; Group 4: diabetic + PA (60 mg/kg b.wt); Group 5: diabetic + metformin (200 mg/kg b.wt). Serum and supernatant plasma retrieved from blood samples, along with heart tissue homogenate after centrifugation, were used to determine biochemical parameters. Results: Propionic acid administration significantly (p < 0.05) reduced serum insulin, fasting blood glucose, oral glucose tolerance, cardiac creatine kinase-myoglobin, troponin-I, Lactate dehydrogenase, brain natriuretic peptide, caspase-3, triglycerides, total cholesterol, low-density lipoprotein cholesterol, oxidative malondialdehyde, tumor necrosis factor-α, interleukin-1β, interleukin-6, heart rate, blood pressure, QT and QTc intervals, QRS interval, PR interval, and food and water intake. It also significantly increased cardiac B-cell lymphoma-2, superoxide dismutase, catalase, reduced glutathione, high-density lipoprotein cholesterol, P-wave, and body and heart weight in diabetic rats. Conclusion: Propionic acid lowered hyperglycemia and prevented cardiac injury by suppressing elevated cardiac injury markers, oxidative stress, and inflammation. Propionic acid may be useful as a natural medication for treating cardiac ailments in diabetes.

Evaluating Lead, Nickel and Copper Levels in Selected Pharmaceutical Products Available in Iraqi Local Market: Analytical and Toxicological Assessment

Noor Ahmed M. Waheed — Sat, 03 Jan 2026 00:00:00 +0000

Introduction: Lead, Nickel and Copper are widely spread heavy metals that are linked to many harmful effects to human body, they enter the body via food, water environment, pharmaceutical and cosmetic products. Exposure to these heavy metals could cause various organ damage including cardiovascular, neurological, immunosuppression and cancer. The harmful effect could take years or decades to appear. According to the International Council for Harmonization (ICH) it’s important to adhere with the permitted daily exposure (PDE) doses of these hazardous elements to avoid the potential health risks. Methods: In this study, we investigate the presence of Lead, Nickel and Copper in selected pharmaceutical products collected from local pharmacies in Mosul/ Iraq including four eye drops and six intravenous infusions which considered critical products due to their invasive effect and any contamination will lead to devastating outcomes. According to the maximum daily recommended dose of each product, the maximum ingested amount of Lead, Nickel and Copper were calculated and compared to the permitted daily exposure (PDE) of each metal. Results: The results showed that from the ten samples, three IV infusions (M1, M2, M3) contained high levels of Lead ranging from (0.1-0.15) ppm, while one IV infusion (M1) contained high levels of Nickel (5) ppm, Copper levels were within the safe limits in all investigated products. Conclusion: 30% of the samples investigated were found to be contaminated with unsafe levels of heavy metals, more research and screening studies should be done to confirm this finding, also such products should have more restricted quality control measures.

Determining the Effects of Multimodal Manual Therapy Alone and MMT along with Cognitive Behavioral Therapy on Keele STarT Back Screening Tool in Patients of Chronic Low Back Pain

Muhammad Mahmood Alam, Suriyakala Perumal Chandran, Saiem Alam, Athar Mansoor — Thu, 08 Jan 2026 00:00:00 +0000

Background: Low back pain (LBP) impacts 619 million individuals worldwide, leading to disability, decreased productivity, and significant economic costs. Addressing chronic low back pain (CLBP), which encompasses physical, psychological, and social dimensions, demands an integrated treatment strategy. Research indicates that combining Cognitive Behavioral Therapy (CBT) with Multimodal Manual Therapy (MMT) offers notable effectiveness. Randomized Controlled Trial (RCT). Methods: The study involved two groups: Group A, received MMT exclusively, and Group B, underwent a combination of CBT and MMT. Participants were closely matched by age and gender. Keele STarT Back Screening Tool (SBST) scores were recorded both before and after treatment to assess the risk of persistent disability, with statistical analyses performed to evaluate the effectiveness of the interventions within each group and between the groups. Results: The demographic analysis confirmed that both groups were well-matched, reducing the potential for bias in treatment outcomes. Pre-treatment SBST scores showed no significant difference between Group A and Group B. However, post-treatment, Group B exhibited significantly lower SBST scores than Group A, with a mean difference of 1.59. While both groups demonstrated significant improvements from pre- to post-treatment, the reduction was more pronounced in the CBT & MMT group. Conclusion: Combining CBT with MMT was more effective in lowering SBST scores, indicating a reduced risk of persistent disability compared to MMT alone. These findings emphasize the importance of integrating CBT with manual therapies for CLBP, reinforcing the value of a biopsychosocial approach that addresses both physical and psychological components in treatment planning.

A Clinical Rescue Pericardiocentesis with Point-of-Care Ultrasound of a Malignant Pericardial Effusion in Emergency Department

R V Shiva Shanghari Visvanathan, Gurjeet Singh a/l Harvendhar Singh — Mon, 12 Jan 2026 00:00:00 +0000

Pericardial effusion leading to cardiac tamponade can result from a wide range of underlying causes and may develop either acutely or sub acutely. Because of this variability in presentation, timely recognition and prompt intervention are essential, especially in the emergency department where delays can significantly impact patient outcomes. We describe the case of a 54-year-old woman with advanced lung cancer who presented with progressive respiratory distress. Although her initial vital signs, including blood pressure, appeared relatively stable, further evaluation revealed subtle but important features of early cardiac tamponade. An initial misinterpretation of her electrocardiogram (ECG), along with her seemingly preserved hemodynamics, contributed to a delay in initiating definitive management. Point-of-care ultrasound (POCUS) ultimately played a pivotal role in clarifying her condition. Key sonographic findings—including right-sided chamber collapse, a plethoric and non-collapsible inferior vena cava (IVC), and the characteristic “dancing heart” sign—raised immediate concern for evolving tamponade physiology. Guided by these ultrasound findings, the emergency team proceeded with real-time, ultrasound-guided pericardiocentesis, which resulted in rapid and significant improvement in the patient’s clinical status. This case underscores the critical value of POCUS in identifying cardiac tamponade, particularly in patients who do not exhibit the classic triad or expected hemodynamic instability. It highlights the importance of maintaining a high index of suspicion and using bedside ultrasound to support clinical decision-making. Early recognition through POCUS can expedite lifesaving interventions and prevent deterioration in patients with subtle or atypical presentations of cardiac tamponade.

Adverse Events Following COVID-19 Vaccination in Malaysia: A Cross-Sectional Study

Wan Nuraini Wan Hasan, Afreen Banu, Abeer Fathy Abdlhakim, Ann Maria Savathy — Mon, 12 Jan 2026 00:00:00 +0000

Background: Vaccination remains the most effective strategy for controlling the COVID-19 pandemic. However, the COVID-19 vaccinations have been linked to a number of side effects. This study aimed to assess the frequency of vaccine-related adverse events among individuals in Malaysia. Methods: A cross-sectional, online questionnaire-based survey was conducted among vaccinated individuals in Malaysia from March to November 2024. Participants were recruited using a snowball sampling method, in which the initial respondents were invited through social media platforms and institutional networks and were encouraged to share the survey link with other eligible individuals. A 17-item self-administered questionnaire was designed, validated, and subsequently distributed through online platforms. The inclusion criteria encompassed Malaysian residents aged 18 years and above who had received at least one dose of a COVID-19 vaccine, were able to read and understand English or Malay, and provided informed consent prior to participation. Respondents were excluded if they were below 18 years of age, unvaccinated, or submitted incomplete or inconsistent responses. Result: Of 408 respondents, 288 (70.6%) reported experiencing side effects. Females (66.3%) and individuals aged 45–54 years (26.4%) were more likely to report adverse events. Fever was the most common side effect, with the highest proportion observed among Pfizer vaccine recipients (71.4%). The majority of participants (92%) reported only mild to moderate effects, such as fever and localized injection-site pain, which resolved without hospitalization. A substantial proportion (74.2%) of respondents reported prior COVID-19 infection. Conclusion: This study provides important insights into post-COVID-19 vaccination experiences in Malaysia. Most adverse events were mild and self-limiting, with only a small fraction requiring medical attention.

Severe Methemoglobinemia Following Sodium Chlorate Ingestion: A Rare Case Report and Review of Management

Gurjeet Singh a/l Harvendhar Singh — Mon, 12 Jan 2026 00:00:00 +0000

Sodium chlorate is a highly effective oxidizing agent primarily used as a non-selective herbicide for weed control and eradication. While its popularity has decreased in some areas due to safety concerns, it continues to be available in agricultural settings, where its low cost and potency make it a viable option for herbicide application. However, its accessibility also poses risks, as it can be used for both accidental and intentional poisoning. Though sodium chlorate toxicity is rare, it is associated with severe health risks and can result in high morbidity and mortality. The toxic effects stem from its systemic oxidative properties, which can damage various organs. One of the most dangerous consequences of poisoning is acute hemolytic anemia, where red blood cells are destroyed at an accelerated rate. Renal failure may also occur due to the kidney’s inability to cope with the oxidative stress caused by sodium chlorate. Additionally, methemoglobinemia is a serious complication that can arise. In this condition, the hemoglobin in red blood cells is oxidized to methemoglobin, which is incapable of carrying oxygen, leading to impaired oxygen delivery to tissues and potentially causing life-threatening consequences. Thus, while sodium chlorate remains useful in certain agricultural practices, its risks should not be underestimated.

Think Beyond Ischemia: Cardiac Arrest in Elderly Hypertrophic Cardiomyopathy

Gurjeet Singh a/l Harvendhar Singh, Phang Eng Meng — Mon, 12 Jan 2026 00:00:00 +0000

Hypertrophic Cardiomyopathy (HCM) has traditionally been recognized as a condition predominantly affecting younger individuals, often presenting with sudden cardiac death, which left limited treatment options. This misconception has resulted in the underappreciation of HCM in elderly patients, leading to significant implications for timely diagnosis and emergency care. With advancements in cardiovascular medicine, including enhanced imaging technologies, the prevalence of late-onset HCM in the elderly population is increasingly recognized. Recent studies show that a substantial number of elderly patients with HCM present with emergency conditions, including cardiac arrest, emphasizing the need for heightened awareness in this age group. This case report highlights a 68-year-old male with a history of dyslipidemia and ischemic heart disease who suffered an out-of-hospital cardiac arrest while playing badminton. Despite initial resuscitation and treatment for acute coronary syndrome, findings such as left ventricular hypertrophy and systolic anterior motion of the mitral valve raised suspicion of HCM. The patient's condition was confirmed as a potential case of HCM, showcasing the importance of considering this diagnosis in elderly patients presenting with cardiac events. This report underscores the importance of early detection and diagnosis of HCM in older adults, as it can lead to better management, reduced morbidity, and improved quality of life. With increasing use of electrocardiograms and echocardiography, timely identification can significantly reduce hospital visits and prevent disease progression. Through early intervention, the risk of sudden cardiac events can be minimized, ultimately improving patient outcomes in this growing demographic.