Background/Objectives: Respiratory syncytial virus (RSV) is the most common cause of lower respiratory tract infection in young children, especially during infancy, resulting in substantial morbidity and mortality. Methods: Acknowledging the real-world evidence on RSV immunization, the College of Pediatrics, Academy of Medicine of Malaysia, has appointed an expert panel to develop a position paper on recommendations for infant and/or maternal vaccination against childhood RSV, specifically in the Malaysian context with year-round RSV activity. Results: Recognizing the potential constraints and limitations in the implementation process, the expert panel recommends targeted immunization with long-acting RSV monoclonal antibody (mAb) for high-risk infants as a pragmatic first step, with subsequent scale-up to universal immunization of infants when resources permit. Conclusions: Immunization is the most effective strategy to prevent RSV-related lower respiratory tract infection in childhood. Year-round maternal vaccination between 28 and 36 weeks’ gestation, combined with immunization at six months for all infants, may potentially circumvent the unclear seasonality.
INTRODUCTION:Breast cancer continues to be a substantial global health concern, constituting a substantial proportion of new cancers diagnosed. Breast Imaging Reporting and Data System (BI-RADS) is a standardised instrument that facilitates the appraisal of lesions in mammographic reporting. A hook wire localisation biopsy (HWLB) is frequently employed to diagnose suspicious microcalcifications or non-palpable lesions. The study aims to ascertain the probability of detecting malignancies in non-palpable breast lesions by examining the malignancy rate detected by BI-RADS classification and HWLB results. MATERIALS AND METHODS:This retrospective study utilised data from patients who underwent HWLB at a tertiary hospital from January 2016 to December 2021. RESULTS:Among the 65 patients analysed, 21.5% exhibited malignant lesions, predominantly detected through routine mammogram screening. There was a statistically significant association (p=0.007) between BI-RADS classification and the malignancy status. Using BI-RADS 4A as the threshold ensures 100% sensitivity but leads to a low specificity of 13.73%, Positive Predictive Value (PPV) of 24.1% and Positive Likelihood Ratio (LR+) of 1.2. While increasing the threshold to BI-RADS 4B improves specificity to 80.4%, reducing false positives. This suggests that many BI-RADS 4A cases are actually mostly benign. CONCLUSION:BI-RADS 4A notably exhibited a high false-positive rate, possibly due to benign lesions mimicking cancer radiologically and the operator-dependent nature of radiology. Despite these constraints, findings affirm the crucial role of hook wire localisation biopsy and BI-RADS classification in evaluating non-palpable breast lesions.
BACKGROUND:Dengue remains a major public health burden in Malaysia, with vaccination offering a promising strategy for control. Following conditional approval of the TAK-003 vaccine for individuals aged 4 years and above, understanding acceptance among public and healthcare workers is essential. METHODS:This cross-sectional study was conducted from November 2024 to April 2025 at a tertiary hospital in Negeri Sembilan, Malaysia. Parents/guardians of pediatric patients and healthcare workers completed a questionnaire on vaccine acceptance, decision-making factors, and perceived promoters and barriers. Data were analyzed using descriptive statistics and univariate logistic regression. RESULTS:Of 386 participants (57% parents/guardians, 43% healthcare workers), 59.8% expressed willingness to receive the vaccine, while 53.7% of parents/guardians were willing to vaccinate their children. The most important decision-making factors were vaccine efficacy, advice from healthcare professionals, and long-term safety. Promoters included fears of severe dengue and belief in vaccine efficacy, while barriers included potential side effects, long-term safety, and doubts about vaccine efficacy. No sociodemographic factor was significantly associated with vaccine acceptance. CONCLUSION:This study, conducted within the first year of the dengue vaccine's approval in Malaysia, found a moderate level of acceptance. These early perceptions may evolve as awareness of the vaccine grows.
Background Chronic kidney disease (CKD) is a growing global health burden whose diagnosis depends on the estimated glomerular filtration rate (eGFR) derived from serum creatinine, a marker requiring venepuncture. As approximately 10–15% of circulating creatinine diffuses into saliva, salivary creatinine has been proposed as a non-invasive alternative. This study evaluated the correlation between salivary and serum creatinine across CKD stages and the diagnostic performance of salivary creatinine for identifying reduced kidney function. Methods This was a prospective cross-sectional study at a single tertiary centre in Malaysia from October 2021 to January 2023 which included 150 adults with CKD stages 1–5 (30 per stage). Participants provided saliva and blood samples in the same setting. eGFR was calculated using the 2021 CKD-EPI creatinine equation. Spearman’s rank correlation was used to examine the association between salivary and serum creatinine, overall and by CKD stage. The differences across stages were assessed using the Kruskal–Wallis test. Receiver operating characteristic (ROC) analysis was used to evaluate the identification of an eGFR below 60 mL/min/1.73 m² by salivary creatinine. The optimal cut-off was identified by the Youden index. Results The mean age was 62.1 ± 15.0 years and 56.7% were women. Median salivary creatinine rose across CKD stages, and salivary and serum creatinine were positively correlated overall (Spearman ρ = 0.45, 95% CI 0.31–0.57, p < 0.001), with the correlation strongest in stages 4 (ρ = 0.44) and 5 (ρ = 0.55) and weak or non-significant in stages 1–3. Salivary creatinine differed significantly across stages (Kruskal–Wallis p < 0.001). The ROC analysis for an eGFR below 60 mL/min/1.73 m² gave an area under the curve of 0.72 (95% CI 0.63–0.81, p < 0.001). A salivary creatinine cut-off value of 9.5 µmol/L yielded a sensitivity of 71% and a specificity of 72%. Conclusions Salivary creatinine correlates moderately with serum creatinine, most strongly in advanced CKD and shows acceptable discrimination for reduced kidney function. These findings support its potential as a non-invasive point-of-care screening adjunct, while the modest accuracy indicates that multicentre validation with standardised sampling is required before clinical use.
