Despite publishing and securing research grants being obligatory in research universities, the literature on the factors influencing academic productivity is relatively scarce. Thus, in this study, we aimed to determine the personal and behavioural-related factors that influence the culture of publishing and securing research grants among academicians with lower research-related performance. This cross-sectional study was conducted among 49 academic staff members of Universiti Kebangsaan Malaysia (UKM). A self-administered questionnaire consisting of personal, attitude and behavioural (barriers, perceived stress scale, work extrinsic and intrinsic motivation scale, psychological well-being scale, and basic needs satisfaction scale) questions were distributed during a workshop and online. Simple linear regression (SLR) analyses were performed for each variable, followed by multiple linear regression (MLR) to identify the associated factors of research output. After adjusting for covariates, having a doctoral degree (β=0.396, 95% CI=0.221-2.146, p<0.05) and integrated regulation (β=0.574, 95% CI=0.036-3.612, p<0.05) were found to be associated with research grant acquisition (R2=0.273). Moreover, increasing age (β=0.426, 95% CI=0.088-0.397, p<0.05), living alone (β=0.331, 95% CI=0.944-6.626, p<0.05), having a doctoral degree (β=0.248, 95% CI=0.174-6.747, p<0.05), environmental mastery (β=0.318, 95% CI=0.013-0.347, p<0.05), self-acceptance (β=0.284, 95% CI=0.010-0.242, p<0.05), satisfaction incompetence (β=0.273, 95% CI=0.001-0.200, p<0.05) and relatedness (β=0.280, 95% CI=0.001-0.116, p<0.05) were found to be the factors that influence the publications produced among participants (R2 =0.423). The findings of this study could be used by management to formulate effective strategies to increase the productivity of academics in their research-related performance.

Hookworm disease is one of the tropical neglected diseases that significantly impacts human health to varying degrees. Hookworms produce various proteins to facilitate host invasion and immune evasion. Despite available treatments, reinfection is common, underscoring the need for effective vaccines. However, the complexity of the hookworm’s life cycle poses a challenge in understanding the immune response in the vaccine candidates. Reverse vaccinology (RV) offers a powerful approach to understand the immune response by using various bioinformatics tools. This study begins by identifying hookworm antigens capable of inducing host immune responses, followed by docking analysis with different dendritic cell (DC) receptors to investigate the immunological response of antigenic peptides and further correlated to the immunogenicity findings in clinical trial. Necator americanus GlutathioneS-Transferase-1 (Na-GST-1), a known immunogenic protein from Necator americanus, was selected for docking due to its strong antigenic properties. Fifteen DC receptors were evaluated against Na-GST-1, of which seven receptors (TLR2, TLR3, TLR4, TLR7, DEC-205, CD206, and CD36) exhibited stronger predicted interactions, as indicated by stronger binding affinities with Na-GST-1 utilizing various immunoinformatic tools. These receptors are associated with the mediation of Th1/Th2 immune responses, suggesting a potential correlation between docking affinity and the predicted immunogenicity of Na-GST-1. Overall, this study provides valuable insights into DC receptor–antigen interactions and demonstrate a computational approach for assessing the potential of hookworm antigens to engage DC receptors, thereby supporting rational hookworm vaccine design. These findings support the application of early in silico strategies for advancing vaccine candidates against hookworm infection and strengthening control efforts for neglected tropical diseases.

Colorectal cancer (CRC) carries a significant burden in most world regions. However, its screening uptake remains low. This study aimed to explore awareness and perspectives on CRC screening program in a multiethnic population and their preference for CRC screening decision aid. In-depth interviews were conducted until data saturation was reached. All interviews were audiotaped, transcribed verbatim, translated to English and analysed thematically using hybrid inductive and deductive approaches. 17 informants from three main ethnic groups (Malay, Chinese and Indian) with various levels of risk for developing CRC were recruited. Awareness on CRC screening program was found to be low. Majority of informants never heard of CRC screening program. Among 11 eligible informants, only five experienced CRC screening uptake. Thematic analysis of the transcripts yielded six major themes; knowledge on CRC, screening process, authority’s role, curability, willingness to screening and preference for decision aid, and theywere mapped onto the Health Belief Model. Specific multiethnic perspectives found included preference for traditional medicine coming from all ethnics, and reliance in God coming from Malay informants. Majority preferred short videos as CRC screening decision aid, in the form of animation and live-action screenplay. Exploration of perspective of CRC screening helps in producing impactful decision aids. Future efforts should focus on developing short videos that incorporate population’s perspectives and can be disseminated through electronic media.

Introduction: COVID-19 pandemic placed unprecedented strain on hospital resources and manpower. This study assesses the impact of Malaysia’s nationwide lockdown on the incidence, types, severity, and outcomes of emergency general surgery (EGS) cases at a tertiary care hospital. Methods: This retrospective cohort study analysed the data of patients who underwent EGS procedures for the period 2017 and 2021. Results: During the pandemic period, there was a 48.3% reduction in EGS cases (n=889) compared to the pre-pandemic period (n=1720). Significant reductions were observed in surgeries for appendicitis, soft tissue infection, colorectal, urology, peptic ulcer, and vascular disorders in the COVID period. Conversely, procedures for biliary disorders and hernia complications increased by 7.4% and 5.5%, respectively. Length of hospital stay increased by 57.8% for patients with small bowel disorders, while ICU/HDU admissions rose by 43.5% for colorectal cases (P < 0.05). There was no significant difference in mortality rates between the two periods. Conclusions The overall reduction in EGS procedures during the COVID-19 period was consistent with global trends. Despite the challenges posed by the pandemic, the outcomes related to duration of stay, ICU/HDU utilisation, and mortality remained comparable to the pre-pandemic period. These findings highlight the adaptability of healthcare professionals in maintaining continuity and quality of emergency surgical care during a crisis.
Acute Care Surgery ; COVID-19 ; Pandemics

DIAGNOSING OVARIAN TORSION IN THE EMERGENCY DEPARTMENT: A CASE REPORT AND LITERATURE REVIEW Diagnosing acute abdomen in emergency department setting, especially in women of childbearing age, is challenging. The patient may present with non-specific complaints. We were presented with a case of a 28-year-old lady with no known medical illness complaining of sudden onset left-sided abdominal pain. Multiple analgesics were given, but her pain persisted. Bedside ultrasonography was performed and noted a multiloculated cyst over the left ovary, with the largest measuring 4 x 4 cm. She then underwent laparoscopic left salpingo-oophorectomy, revealing an engorged, gangrenous left fallopian tube and the left ovarian cyst was twisted three times. Histopathological examination confirmed a left ovarian haemorrhagic twisted ovarian cyst with a paratubal cyst. This case concludes that acute abdominal pain in women of childbearing age requires prompt and thorough investigation. Clinicians should consider several potential diagnoses, including ovarian torsion.

POSTPARTUM PITUITARY APOPLEXY: A CASE REPORT Background: Postpartum pituitary apoplexy is an extremely rare neurological emergency. It may present with sudden onset of headache, vomiting, nausea and visual disturbances. This potentially life-threatening emergency requires a high index of suspicion from the attending clinician. Postpartum pituitary apoplexy was challenging to diagnose because of its symptoms that overlapped with multiple conditions. There are limited number of case reports on postpartum pituitary apoplexy. Case presentation: We present a case of a 30-year-old multipara with gestational diabetes mellitus presented with on and off headache since 37 weeks period of gestation. Her complaint was not investigated by medical personnel during her routine antenatal follow-up until she had a normal delivery. Subsequently, she developed diplopia, nauseated and vomiting episodes post-delivery but she only came to seek treatment in our emergency department on day 12 post-partum as symptoms are not resolving. Initial Contrast Enhanced Computed Tomography (CECT) of Brain revealed enhancing sellar lesion causing widening of pituitary fossa which then she was scheduled for Magnetic Resonance Imaging (MRI). MRI brain revealed lobulated sellar and suprasellar mass with mass effect to optic chiasm and she underwent endoscopic endonasal transsphenoidal excision of tumour. Post operatively, her vision improved and she was discharged subsequently with oral hormonal supplements. Conclusion: Diagnosis of pituitary apoplexy should be suspected whenever headache and neurological deficits are present although it is an extreme rare condition.

UNCOMMON PRESENTATION OF A LONG-STANDING CALCIFYING FIBROBLASTIC GRANULOMA IN THE POSTERIOR MANDIBLE A 14-year-old Malay female was referred in view of a five-year history of an enlarging swelling over her lower right teeth, causing a disturbance in eating, speaking, and reciting Quranic verses. Clinical examinations revealed a non-tender, pedunculated exophytic growth on the buccal site measuring approximately 1.3 cm x 1.5 cm and the lingual site approximately 2.9 cm x 2.5 cm in size. The lesion encompassed her right mandibular first molar and second premolars with pinkish-red overlying mucosa and ulcerations on the lingual and occlusal aspects of the swelling. The right mandibular first molar had grade I mobility and 5 mm periodontal pocket depth associated with grade I furcation involvement. Deep scaling was performed on the involved area, and the excisional biopsy was performed under general anaesthesia. Histopathological examination revealed cellular connective tissue with focal calcifications, which gave a final diagnosis of Calcifying Fibroblastic Granuloma (CFG). The patient had an evaluation for oral hygiene maintenance and phase I periodontal treatment, which included deep scaling and a prescription for chlorhexidine mouthwash. No recurrence was observed one year post-operatively.

Purpose: Tyrosine kinase inhibitors (TKIs) have improved the prognosis of chronic myeloid leukaemia (CML), allowing patients with favourable disease profiles and molecular responses to attempt treatment-free remission (TFR). We aim to establish the relapse-free survival (RFS) outcomes and identify prognostic factors for successful remission maintenance among those who attempt TFR. Methods: Adult CML patients who had undergone TFR from January 1, 2016, to June 30, 2024, were included. Upon TKI discontinuation, real-time quantitative polymerase chain reaction (RQ-PCR) was monitored monthly for the first 12 months, then every 3 months, with TKI reinitiated upon a transcript level above 0.1% (IS). Data analysis was performed using SPSS version 29.0 (SPSS Inc., Chicago, IL, USA). Results: Fifty-seven patients (27 males and 30 females) with a median age of 46 years (range 16 – 70) were analysed.The majority had a low EUTOS long-term survival (ELTS) score (61.4%, n = 35) and received imatinib (87.7%, n = 50).The median treatment duration was 8.8 years (range 4.2 – 18.8), and the median duration for sustained deep molecular remission (DMR) was 4.6 years (range 2.1 – 11.1). RFS was 70.2% at 6 months, 62.5% at 12 months and 56.8% at 2 years after a median follow-up of 34 months (range 9 – 101). The MR5 level was identified as an independent factor associated with sustained remission. All relapsed patients achieved DMR upon treatment reinitiation. Conclusion Treatment discontinuation can be safely performed, with many achieving long-term treatment-free remission. A deeper molecular response (MR5) is associated with an improved likelihood of remission maintenance.

Bungsu et al Brunei International Medical Journal 2025;21:82-87 Brunei International Medical Journal Brunei Colorectal Cancer Awareness and Risk Education for Screening (Bru-CARES) Community Project N BUNGSU1, AS HAJI MD ALI1, A HAJI GHAZALI1, S KONG1, MK ABU BAKAR1, NA GULZAR AHMAD1, S SUHAILI1, SK ONG1,2, P HASHMET1,3, VH CHONG1,2, K KOK1, E ERDAL1, H GHANI1*

PREVALENCE AND RISK FACTORS OF PRETERM BIRTH AMONG PREGNANT ADOLESCENTS IN KUALA LUMPUR: A CROSS-SECTIONAL STUDY Introduction: Adolescent pregnancies are often associated with a higher risk of adverse outcomes, including preterm birth, which may lead to severe physiological and psychological health impacts on both mothers and children. Despite the acknowledged risks, there is a knowledge gap regarding the risk factors of preterm birth among pregnant adolescents. This study aimed to determine the prevalence and associated sociodemographic, maternal, intrapartum and neonatal factors of preterm birth among pregnant adolescents in Kuala Lumpur. Methods: A cross-sectional study was conducted in Kuala Lumpur, Malaysia, from March to June 2024. Samples were selected using simple random sampling from the Wilayah Persekutuan Kuala Lumpur and Putrajaya Department of Health pregnant adolescents’ line listing from 2019 to 2023. Simple and multiple logistic regression analyses were used to determine the factors associated with preterm birth. Results: A total of 175 pregnant adolescents were included in the study. The prevalence of preterm birth was 16%. Anaemia at booking (adjusted odds ratio [aOR]: 7.8; 95% confidence interval [CI]: 2.53, 23.997), history of preterm birth (aOR: 11.654; 95% CI: 1.517, 89.498), history of smoking (aOR: 6.89; 95% CI: 1.397, 34.002) and low birth weight (aOR: 12.503; 95% CI: 3.858, 40.522) were significantly associated with preterm birth. Conclusion: Targeted interventions to address anaemia, history of smoking, previous history of preterm births and low birth weight babies in adolescent pregnancies are crucial to reduce the incidence of preterm birth and improve maternal and infant health outcomes in this population among adolescents.