Objectives: This study aimed to examine the temporal dynamics of dengue cases in Malaysia from 2022 to 2024 using seasonal-trend decomposition and time-series modeling. Methods: Weekly dengue case counts from the national registry were analyzed across all states using seasonal-trend decomposition using LOESS (STL) to separate trend, seasonal, and irregular components. Autoregressive integrated moving average (ARIMA) and seasonal ARIMA(SARIMA) models were fitted to validate temporal structures, with model selection based onthe Akaike information criterion (AIC), corrected AIC, and Bayesian information criterion.Diagnostic checks, including residual analysis and Ljung-Box testing, were performed to ensure model adequacy. Results: Dengue incidence showed marked heterogeneity across states. STL decompositionindicated that long-term trends contributed more strongly to case dynamics than seasonality in most states, although seasonal influences were significant in the states of Kedah and Kelantan. Seasonal peak timing varied between states, highlighting differences in epidemic cycles. ARIMA and SARIMA modeling confirmed that no single temporal structure could adequately represent all states; while some series were well fitted by simple ARIMA models,others required seasonal adjustments. Residual diagnostics demonstrated that the selected models were statistically adequate. Conclusion Dengue dynamics in Malaysia are shaped by both trend and seasonal components, with considerable variation across states. Combining STL decomposition with ARIMA/SARIMA modeling strengthens the evidence base for state-specific forecasting and proactive vectorcontrol. Tailoring surveillance systems and interventions to local temporal patterns may improve early warning capacity and optimize resource allocation for dengue prevention.

Objectives: Dengue remains hyperendemic in Malaysia despite extensive vector control activities. With dynamic changes in land use, urbanisation and population movement, periodic updates on dengue transmission patterns are crucial to ensure the implementation of effective control strategies. We sought to assess shifts in the trends and spatial patterns of dengue in Kelantan, a north-eastern state of Malaysia (5°15’N 102°0’E). Methods: This study incorporated data from the national dengue monitoring system (eDengue system). Confirmed dengue cases registered in Kelantan with disease onset between January 1, 2016 and December 31, 2018 were included in the study. Yearly changes in dengue incidence were mapped by using ArcGIS. Hotspot analysis was performed using Getis-Ord Gi to track changes in the trends of dengue spatial clustering. Results: A total of 10 645 dengue cases were recorded in Kelantan between 2016 and 2018, with an average of 10 dengue cases reported daily (standard deviation, 11.02). Areas with persistently high dengue incidence were seen mainly in the coastal region for the 3-year period. However, the hotspots shifted over time with a gradual dispersion of hotspots to their adjacent districts. Conclusions A notable shift in the spatial patterns of dengue was observed. We were able to glimpse the shift of dengue from an urban to peri-urban disease with the possible effect of a state-wide population movement that affects dengue transmission.

When the first report of COVID-19 appeared in December 2019 from Wuhan, China, the world unknowingly perceived this as another flu-like illness. Many were surprised at the extreme steps that China had subsequently taken to seal Wuhan from the rest of the world. However, by February 2020, the SARS-CoV-2 virus, which causes COVID-19, had spread so quickly across the globe that the World Health Organization officially declared COVID-19 a pandemic. COVID-19 is not the first pandemic the world has seen, so what makes it so unique in Malaysia, is discussed to avoid a future coronacoma.

The article introduces readers to the Master of Public Health and Doctor of Public Health programmes, offered by the Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia. The programme vision, structure and accomplishments over the decade are presented to provide an understanding of the programme. It is hoped that this professional programme will continue to flourish and produce new generations of public health medicine specialist equipped with the necessary knowledge and skills to make significant contribution towards improving the health of the population.

The worldwide upsurge of Type 2 Diabetes Mellitus (T2DM) warrants the attention of public health, especially in complications. Diabetic Retinopathy (DR), the commonest ocular complication, contributes to the growing incidence of blindness. Recommendations that the visual acuity (VA) assessment guidelines should be used in DR screening was not routinely practiced. This study aims to model the predictive effect of VA - a simple economic clinical assessment - upon DR in patients with T2DM. A case-control study was conducted in Hospital Universiti Sains Malaysia with subjects recruited from the ophthalmology clinic. The primary variable during analysis was VA, and the outcome variable was DR. Models with eight control variables which included age, gender, and duration of DM were developed. The predictive effect measured by logistic regression showed that when unadjusted; four variables had a significant association with DR, at p-value<0.25; they were the duration of DM, systolic blood pressure, glycosylated haemoglobin and VA. From the eight different predictive models, the estimated adjusted odds ratio produced ranges from 6.09 to 11.64. Our study shows that VA has a predictive effect upon DR in T2DM patients. We suggest VA assessment, to be on par with the monitoring of blood pressure and blood glucose.
Predictive ; Visual acuity ; Diabetic Retinopathy ; Type 2 Diabetes Mellitus

Purpose: We compared the patency and the suitability of arteriovenous fistula (AVF) created for vascular access by two approaches: (a) physical examination with preoperative vascular mapping and (b) physical examination alone. Methods: We compared the patency and the suitability of AVF created in patients for dialysis. There were two cohorts of patients of 79 patients each: (a) patients with AVF created based on the combination of physical examination and preoperative vascular mapping (PE+VM) and (b) patients with AVF created based on physical examination (PE) alone. Fistula patency is defined as clinical detection of thrill (or auscultation) of murmur over the fistula and coded as having thrills (patent) versus not having thrills (not patent). Suitability of fistula is defined as functioning AVF (AVF can be adequately used via 2-needle cannulation for dialysis) and coded as suitable versus not suitable. Results: AVF created after the preoperative vascular mapping (PE+VM) has 5.70 (at six weeks) and 3.76 (at three months) times higher chance for patency, and 3.08 times higher chance for suitable AVF for dialysis than AVF created after the physical examination (PE) alone. Conclusion: Physical examination with preoperative ultrasound mapping (PE+VM) significantly improves the short term patency and the suitability of AVF for dialysis.

Statistical editors of the Malaysian Journal of Medical Sciences (MJMS) must go through many submitted manuscripts, focusing on the statistical aspect of the manuscripts. However, the editors notice myriad styles of reporting the statistical results, which are not standardised among the authors. This could be due to the lack of clear written instructions on reporting statistics in the guidelines for authors. The aim of this editorial is to briefly outline reporting methods for several important and common statistical results. It will also address a number of common mistakes made by the authors. The editorial will serve as a guideline for authors aiming to publish in the MJMS as well as in other medical journals.

Renal replacement therapy in Malaysia has changed dramatically. In 1980 there were only 59 patients on dialysis. Since then the number of patients has increased exponentially from 4,540 in 1998 to almost 15,000 in 20061. Autogenous Arteriovenous Fistula (AVF) provides an excellent long term hemodialysis access with low rates of infection, thrombosis and is cost effective. Hospital Sultanah Bahiyah is a tertiary hospital situated in the northern region of Peninsular Malaysia. Vascular Access creation is one of the main services provided by our surgical unit; with an average of 100 patients seen in the vascular access clinic per month. The number of AVF operations has increased from 30 cases in 2001 to 328 in 2007. The reported rates of Primary Fistula Failure (fistula fail to mature) varies from 8% to 53%2,4. Immature fistulae will lead to prolonged dependence on dialysis catheters. This phenomenon is well known to be associated with the risk of infective complications, central venous thrombosis or stenosis and patients’ inconvenience. Numerous studies have reported the predictors of successful fistulae, but are varied in their design, definitions, end points and clinical factors considered 2,3 Preoperative imaging also has been proposed, but their widespread use is generally limited in most of the centres4. Knowing the risk factors for failure will help the surgeon to take the necessary precautions and preventive measures more effectively. The information may help to stratify the patients into various risk groups based on their likelihood to develop fistula failure. Thus, the main objective of this study was to identify clinical risk factors that are related to Failure to Mature (FTM) of autogenous AVF.

Background: No previous study has assessed the impact of childhood disability on parents and family in the context of Malaysia, and no instrument to measure this impact has previously been available. The objective of this cross-sectional study was to determine the reliability of a Malay version of the PedsQL™ Family Impact Module that measures the impact of children with disabilities (CWD) on their parents and family in a Malaysian context. Methods: The study was conducted in 2009. The questionnaire was translated forward and backward before it was administered to 44 caregivers of CWD to determine the internal consistency reliability. The test for Cronbach’s alpha was performed. Results: The internal consistency reliability was good. The Cronbach’s alpha for all domains was above 0.7, ranging from 0.73 to 0.895. Conclusion: The Malay version of the PedsQL™ Family Impact Module showed evidence of good internal consistency reliability. However, future studies with a larger sample size are necessary before the module can be recommended as a tool to measure the impact of disability on Malay-speaking Malaysian families.

Background: Traumatic brain injury (TBI) has been associated with an acute stress response mediated by the sympathoadrenomedullary axis, which can be assessed by measuring blood glucose level. Methods: This prospective observational study was conducted for a year in 2007 among 294 patients who had been treated for TBI in Hospital Kuala Lumpur. Patients fulfilling the set criteria were recruited into the study and data, including blood glucose level and Glasgow Outcome Score at 3-month follow-up, were collected. Results: 294 patients were included in the study: 50 females (17.0%) and 244 males (83.0%). The majority of cases were young adult patients (mean age of 34.2 years, SD 13.0). The mean blood glucose level during admission and post-surgery were 6.26 mmol/L (SD 1.30, n = 294) and 6.66 mmol/L (SD 1.44, n = 261), respectively. Specifically, the mean admission glucose level associated with mild TBI was 5.04 mmol/L (SD 0.71); moderate TBI, 5.78 mmol/L (SD 1.02); and severe TBI, 7.04 mmol/L (SD 1.18). The mean admission glucose level associated with a poor outcome in patients with isolated TBI was 6.98 mmol/L (SD 1.21). Patients with admission glucose of 5.56 mmol/L (SD 1.21) were more likely to have a favourable outcome. Conclusion: Mild, moderate, and severe TBI were associated with an increase in blood glucose levels during admission, and the mean increase in glucose levels is based on the severity of the isolated TBI. Surgical intervention did not cause further significant changes in blood glucose levels. Patients with isolated TBI and minimal increases in blood glucose levels were more likely to have a favourable outcome.