Isolation and phylogenetic analysis of avian infectious bronchitis virus from an imported chicken meat product in Malaysia

@#Avian infectious bronchitis (IB), a Gammacoronavirus, is a highly contagious upper respiratory disease, affecting chickens of all ages with a significant economic threat to the poultry industry. In February 2020, a specimen of imported chicken meat product was received and requested for coronavirus testing. The result was positive for the avian coronavirus, the IB virus (IBV) by molecular detection in the pre-screening test. Thus, this study aimed to isolate and characterize the IBV from the specimen. Virus isolation via egg inoculation was attempted and IBV was successfully isolated. The S1 subunit of the spike (S) gene of the IBV was amplified, sequenced, and the Basic Local Alignment Search Tool (BLAST) analysis showed that the IBV has 99% and 98% nucleotide similarity with the Malaysian and China IBVs, respectively. The phylogenetic analysis indicated that the virus belongs to the GI-19 lineage (also known as the QX strain) and is grouped with other IBVs from Malaysia and China. The GI-19 lineage is one of the primary IB strains that circulate in Malaysia. The recovery of the virus may be due to the persistence characteristic of the virus on meat; and the cold chain practices in the imported food product prolong the survival of this coronavirus. Though IBV is not identified as a hazard in chicken meat or meat products, raw food should be cooked thoroughly before being consumed. With the increase in international trade in poultry and poultry products, disease screening at the entry point and import risk analysis is crucial to ensure food safety and prevent the introduction of new viruses into Malaysia.

Catastrophic Health Expenditure Among Cancer Patients In National Cancer Institute (NCI), Malaysia And Its Influencing Factors

@#Introduction: This study looks at the patient’s perspective to determine the Catastrophic Health Expenditure (CHE) level and the possible factors which can be associated with CHE in cancer patients. Methods: This cross sectional study was done in National Cancer Institute, Malaysia with 206 patients sampled using the multilevel sampling method and data collected from interview with patients using a validated questionnaire. The CHE definition used in this study is when the monthly health expenditure exceeds more than 10% of the monthly household income. Results: This study showed a CHE level of 26.2%. CHE was higher in Indian ethnicity (P = 0.017), single marital status (P = 0.019), poverty income (P < 0.001), small household size (P = 0.006) and without Guarantee Letter (GL) (P = 0.002) groups. The significant predicting factors were poverty income aOR 5.60 (95% CI: 2.34 – 13.39), home distance near to hospital aOR 4.12 (95% CI: 1.74 – 9.76), small household size aOR 4.59 (95% CI: 1.07 – 19.72) and lack of Guarantee Letter aOR 3.21 (95% CI: 1.24 – 8.30). Conclusion: The information from this paper can be used by policy makers to formulate better strategies in terms of health financing so that high risk for CHE cancer patients groups can be protected under a better health financing system.

Barriers and Drivers of Physical Activity Participation Among Older Adults in Malaysia: A Systematic Review

@#Introduction: Ageing is commonly linked with physical inactivity. This review was performed to identify the factors associated with participation in physical activity among older adults in Malaysia. Methods: A systematic review was conducted using five databases; Pubmed, Sagepub, Scopus, Cochrane Library and Science Direct. Observational and intervention studies published between January 2010 and December 2020 were included, with Malaysian older adults aged 55 years and older being the main subject. Results: A total of 9 articles were included in the review. Analysis was guided by the Social Ecological Model for Health Promotion. The review had successfully identified gender, age, education level, health reasons, ethnicity and attitude as intrapersonal factors, social support (friend) and marital status as interpersonal factors, and locality as well as availability of facilities as environmental factors. Conclusions: Physical activity participation among Malaysian older adults were mainly determined by intrapersonal factors, particularly gender, health condition and educational level.

The Impact of 2013 Haze on Emergency Department Utilizations for Acute Respiratory Diseases: A Retrospective Study

Introduction@#Haze imposes a substantial health burden especially in Southeast Asia where occurrences are frequent. Reduction in air quality levels has resulted in an increase in healthcare utilization, especially to the front door of healthcare, the emergency department (ED). Data on ED utilization during haze period is lacking. @*Methods@#This is a retrospective study aimed to determine the association between haze and ED utilization of haze-related acute respiratory illnesses between April 2013 to September 2013. The study period was divided into haze/ non-haze period. Clinical data was collected from the registration book and patients’ case notes. Environmental data was obtained from Institute of Environment and Development Universiti Kebangsaan Malaysia.@*Results@#Total number of patients presented to ED during the study was 32,661. Fifteen percent (n= 5177) presented with acute respiratory symptoms. Total Emergency Department visits during haze period reduced due to emergency declaration, hence reducing non-emergency visits. However, there was a significant increase in hospital admission (p=0.0015) and infective respiratory illnesses (p=0.001) during haze which correlates with increase air pollutant. Patients with chronic respiratory illnesses were more affected by haze (p = 0.001). PM10 and ozone were the main pollutant during the haze period.@*Conclusion@#Increasing pollutant levels from the haze significantly increases ED hospital admission. Evidence from this study can influence policymakers to prepare and allocate resources to hospitals in response to haze-related illnesses.

Ethnic variation in the most common shade of anterior teeth among malaysian students: a cross-sectional study / Variación del tono más común de los dientes anteriores entre estudiantes malasios de diferentes etnias: un estudio transversal

Aim: Determination of the most common shade of anterior teeth in Malaysian students of different ethnicities. Materials and Methods: A total of 120 subjects, 40 each from different ethnicities (Malay, Chinese, and Indian) aged 18-22 years were evaluated for tooth shade using the VITA Classical shade guide. The subject was asked to sit in an up-right position with teeth at the clinician's eye level and the subject was instructed to remove makeup or tinted eyewear which may affect the result. The procedure was done in natural daylight. The shade tabs were positioned adjacent to the maxillary central incisor and the middle 1/3rd of the facial surface was assessed by experts to determine the correct tooth shade. The data was statistically analysed. Results: The differences in tooth shade were seen among the subjects of different ethnicities. The Malay ethnicity has B1 (37%) as the most common tooth shade whereas Chinese has C1 (27%) and Indian C1 (40%). Conclusions: Under the limitation of the study, it was found that there is a relationship between tooth color and ethnic background. Malay students tend to have brighter teeth as compared to Chinese and Indian students.

Objetivo: Determinar el tono más común de los dientes anteriores en estudiantes malasios de diferentes etnias. Materiales y Métodos: Se evaluó el color de los dientes de un total de 120 sujetos, 40 de diferentes etnias (malayos, chinos e indios) de edades comprendidas entre 18 y 22 años, utilizando la guía de colores VITA Classical. Se pidió al sujeto que se sentara en posición vertical con los dientes al nivel de los ojos del médico y se le indicó que se quitara el maquillaje o las gafas teñidas, lo que podría afectar el resultado. El procedimiento se realizó con luz natural. Las pestañas de color se colocaron adyacentes al incisivo central superior y expertos evaluaron el tercio medio de la superficie facial para determinar el tono correcto del diente. Los datos fueron analizados estadísticamente. Resultados: Se observaron diferencias en el color de los dientes entre los sujetos de diferentes etnias. La etnia malaya tiene el B1 (37%) como el color de dientes más común, mientras que los chinos tienen el C1 (27%) y los indios C1 (40%). Conclusión: Bajo las limitaciones del estudio, se encontró que existe una relación entre el color de los dientes y el origen étnico. Los estudiantes malayos tienden a tener dientes más brillantes en comparación con los estudiantes chinos e indios.

The groove configuration of mandibular molars of malaysians of mongoloid ancestry / Configuración del surco de los molares mandibulares de los malayos de ascendencia mongoloide

Aim: Variation in dental structures is widely accepted as a combination of multiple factors such as gender, environmental effects and genetics. However, the characterization of similarities and differences in dental morphology has been lacking in relation to the factors mentioned. This study aims to assess and compare the variations in traits in mandibular molars and the influence of gender and ethnicity in affecting these traits amongst the Malaysian population of Mongoloid ancestry. Materials and Methods: Our study population was 180 dental casts of patients, from 15 to 40 years old, comprising 56 Malays and 124 Chinese; 60 were males and 120 were females. Traits like groove pattern, number of cusps, protostylids and deflecting wrinkles were observed, scored, and recorded. Results: This study revealed that the most common mandibular first molar (M1) was characterized by 5 cusps and displayed 'Y' groove pattern, while the most common mandibular second molar (M2) had 4 cusps and exhibited a groove pattern that resembled a '+'. Notably, all the traits studied were bilaterally symmetrical, except for the groove pattern of M1, while sexual dimorphism was observed in groove patterns of M2. Conclusions: This study found that M1 had a preponderance of 5 cusps with 'Y' groove pattern, while M2 were typically 4-cusped with '+' groove pattern.

Objetivo: La variación en las estructuras dentales es ampliamente aceptada como el resultado de una combinación de múltiples factores como el género, los efectos ambientales y la genética. Sin embargo, ha faltado la caracterización de similitudes y diferencias en la morfología dental en relación a los factores mencionados. Este estudio tiene como objetivo evaluar y comparar las variaciones en los rasgos de los molares mandibulares y la influencia del género y la etnia al afectar estos rasgos entre la población malaya de ascendencia mongoloide. Materiales y Métodos: Nuestra población de estudio fue de 180 modelos dentales de pacientes, de 15 a 40 años,conformados por 56 malayos y 124 chinos; 60 eran hombres y 120 eran mujeres. Se observaron, puntuaron y registraron rasgos como el patrón de surcos, el número de cúspides, los protostílidos y las arrugas desviadas. Resultados: Este estudio reveló que el primer molar mandibular más común (M1) se caracterizaba por 5 cúspides y mostraba un patrón de ranura en 'Y', mientras que el segundo molar mandibular más común (M2) tenía 4 cúspides y exhibía un patrón de ranura que se parecía a un ' +'. En particular, todos los rasgos estudiados eran bilateralmente simétricos, excepto el patrón de surco de M1, mientras que se observó dimorfismo sexual en los patrones de surco de M2. Conclusión: Este estudio encontró que M1 tenía una preponderancia de 5 cúspides con un patrón de ranura en 'Y', mientras que M2 tenía típicamente 4 cúspides con un patrón de ranura '+'.

Mental Health of University Students in Northern Malaysia

Context/Background: Today, poor mental health is one of the most neglected diseases although it is one of the leading causes of disabilities in both developed and developing countries. This mental health issue be-comes a problem among university students too. This study was aimed to determine the prevalence and asso-ciated factors of depression, anxiety, and stress (DAS) among university students. Methodology: A cross-sectional study was carried out in a private university of northern Malaysia during 2020. A random sample of 161 students were included and DASS-21 was used to determine the prevalence of DAS. Multiple logistic regression analysis was performed to examine the associated factors. Results: The prevalence of DAS among students were 34.8%, 42.2%, and 33.5%, respectively. In contrast to years 2 and 4, the prevalence of all types of mental disorders were lower in years 1 and 3. The students’ living area, residence, academic year, and parental income were significantly associated with anxiety whereas the age group of the students and parent’s income did so for depression. The variables; age group, academic year and parent’s income were identified as significant determinants for the presence of stress among students. Conclusions: The significant extent of the mental health problems was detected among university students in Malaysia. Despite the small sample, this analysis indicates that opportunities exist to improve campus-based mental health education and psychological support among university students.

Assessments of Aphasia: Practices and Challenges faced by Malaysian SpeechLanguage Therapists (Penilaian Aphasia: Amalan dan Cabaran yang dihadapi oleh Jurupulih Pertuturan-Bahasa Malaysia) / Jurnal Sains Kesihatan Malaysia

@#Aphasia assessment is crucial in diagnosing aphasia, determining the extent of language impairment, and identifying factors that may support or restrict aphasia recovery to design an appropriate plan of care for people with aphasia. Speech-language therapists (SLTs) play a major role in conducting aphasia assessments. Little is known about the practices of SLTs in assessing aphasia in low-resource regions. The present study aims to identify aphasia assessment practices among Malaysian SLTs and related challenges, as well as strategies for improving aphasia assessments from SLTs’ perspectives. A total of 32 SLT participants who have been practicing in Malaysia completed an online survey to gather their background information, data pertaining to practices and challenges in conducting aphasia assessments, and suggestions for improving aphasia assessments. Descriptive analyses were conducted for all numerical data. Suggestions for improving aphasia assessment practices were analysed qualitatively using the thematic content analysis approach. SLT practices in aphasia assessment were found to be consistent in certain aspects, but not all. Two major challenges were identified: (a) linguistic barriers between clinicians and clients/caregivers, and (b) a lack of standardized assessment tools for aphasia evaluations. Participants suggested “Internal Strategies” and “External Strategies” for improving aphasia assessment practices.

Perception of Malaysian Dental Practitioner on the provisional COVID-19 Guidelines in the Dental Practice: A Cross-Sectional Study (Persepsi Pengamal Pergigian Malaysia terhadap Garis Panduan COVID-19 sementara dalam Amalan Pergigian: Kajian Keratan Rentas) / Jurnal Sains Kesihatan Malaysia

@#Following the COVID-19 outbreak, the World Health Organization issued provisional guidelines to address considerations for essential oral health services in the pandemic situation. Compliance with the guidelines is essential to curb the potential spread of infection within a dental practice. This study aimed to assess the perception of Malaysian dental practitioners towards exercising the provisional COVID-19 dental practice guideline during the early phase of the pandemic. A self-administered questionnaire of a structured type consisting of demographic information and dentist perceptions of the provisional guidelines of dental care during the COVID-19 outbreak was distributed online from May 2021 until August 2021 through various social networking platforms among dental practitioners working at different healthcare sectors in all states in Malaysia. A total of 468 dental practitioners responded to this study. More than threequarters of the respondents were working in public dental care facilities (76.3%, n=357). The majority of respondents adhered to the provisional guidelines issued during the pandemic outbreak and exhibited a change in standard clinical practice (p<0.001). Dental practitioners working in public sectors perceive that swab tests prior to dental appointments should be mandatory, the reopening of dental clinics increases the risk of spread and the provisional guidelines of COVID-19 in dental practice will be changed in the future compared to private dental practitioners (p<0.001). The majority of dental practitioners in Malaysia have complied with the provisional guidelines imposed by the health bodies. As the COVID-19 virus will persist and become endemic in our communities, it is important to balance the safety issue and patient oral health needs.

Emergence Of Dengue Virus Type 4 During COVID-19 Pandemic In Patients Admitted to a Teaching Hospital In Malaysia (Peningkatan virus denggi serotip keempat semasa pandemik COVID-19 pada pesakit yang dimasukkan ke hospital pengajar di Malaysia) / Jurnal Sains Kesihatan Malaysia

@#Prior to COVID-19, dengue was an important public health problem in Malaysia. Due to the movement control order imposed by the Malaysian government to curb the COVID-19 transmission, a study predicted that mosquito-borne diseases would increase during lockdown and partial lockdown seasons. Thus, this study aims to determine the current situation of dengue incidence during the pre-COVID-19 pandemic (2019) and during the COVID-19 pandemic (2020 and 2021). We compared the number of laboratory-confirmed cases in the pre-COVID19 year (2019) and during the COVID-19 pandemic (2020 and 2021). In addition to that, we characterized the clinical manifestation, dengue serotype and viremia levels of dengue patients that were admitted to the Hospital Cancelor Tuanku Muhriz. We found a significant decrease in the number of laboratory-confirmed cases between COVID-19 pandemic and the pre-covid period (p2020=0.064; p2021<0.001). In this study, we found DENV 4 serotype was the most common serotype in dengue patients admitted to our hospital. There was no significant correlation between DENV serotype/viremia level with clinical manifestation of dengue fever and dengue with warning signs. However, patients infected with DENV4 had the highest viral load compared to patients infected with other serotypes. We also found high viremia levels were significantly associated with the febrile phase.

Poverty related diseases amongst Malaysia’s low-income community: a review

@#Poverty, as proven by several studies, is a driving force behind poor health and hygiene practices. This review attempts to outline common communicable and non-communicable diseases that disproportionately affect Malaysia’s 2.91 million low-income households. The current study also looks into the government’s housing and healthcare programmes for this demographic to improve their health and well-being. The initial examination yielded incredibly little research on this marginalised community, with event reporting typically generalised to the Malaysian community as a whole rather than analysing disease incidences based on household income, which would better reflect povertydriven diseases. As a result, there is an acute need for more accurate information on the epidemiology of diseases among the poor in order to address this public health issue and provide conclusions that can drive policy designs.

Current status of infectious diseases among migrants and non-citizens in Malaysia

@#The mass movement of migrants to Malaysia for employment is one of the factors contributing to the emergence and re-emergence of infectious diseases in this country. Despite mandatory health screening for migrants seeking employment, prevalence records of infectious diseases amongst migrant populations in Malaysia are still within negligible proportions. Therefore, the present review highlights the incidence, mortality and overall status of infectious diseases amongst migrants’ populations in Malaysia, which maybe be useful for impeding exacerbation of inequalities among them and improving our national health system thru robust and effective emergency responses in controlling the prevalent diseases found among these populations and maybe, Malaysian citizens too. Peer-reviewed articles from January 2016 to December 2020 were searched through online platform including SCOPUS, PubMed, Science Direct, and Google Scholar. Non-peer-reviewed reports and publications from ministry and government websites including data from related agencies were also scoured from in order to ensure that there are no cases being overlooked, as most published articles did not have migrants as the research subjects. A total of 29 studies had been selected in the final analysis. Migrants in Malaysia were at higher risk for tuberculosis, malaria, lymphatic filariasis, cholera, leprosy and leptospirosis. Lymphatic filariasis was still endemic among this population while thousand cases of TB and cholera had been reported among them due to cramp living conditions and poor sanitation in their settlements respectively. While malaria had gradually decreased and become sporadic, the influx of migrant workers had led to the rising of imported malaria cases. Low cases of leprosy had been recorded in Malaysia but a significant proportion of it was contributed by migrant workers. As for leptospirosis, studies found that there are prominent cases among migrant workers, which particularly highest within workers with lower educational attainment. Infectious diseases are still prevalent among migrants in Malaysia due to various interplay factors including their working sectors, country of origin, immunization status, type of settlement, impoverished living conditions, and language and cultural barriers that impeding access to health facilities.

Prevalence of Burnout and Its Associated Factors among Medical Students in a Public University in Selangor, Malaysia: a CrossSectional Study

@#Introduction: Burnout is a growing trend among medical students worldwide. The aim of this study was to determine the prevalence and factors associated with burnout among medical students at a public university in Malaysia. Methods: A cross-sectional study was conducted among 1st through 5th year medical students at a public university using a simple random sampling method in recruiting participants. In this study, The Maslach Burnout Inventory-General Survey for Student (MBI-SS) was used and burnout is defined as severely emotionally exhausted and severely depersonalised. Results: A total of 328 medical students were recruited with a with response rate of 88.6%. The burnout prevalence was 10.1%. Based on multivariate logistic regression, presence of smartphone addiction with adjusted (odds ratio (OR) 7.37, 95% confidence interval (CI) = 1.67, 32.49), course choice not based on personal interest or due to family pressure (OR 2.72, 95% CI = 1.08, 6.85) and the presence of family relationship problems (OR = 3.58, 95% CI = 1.27, 10.04) are more likely to be associated with burnout among the medical students. Conclusion: Our study has shown that every tenth medical students suffers from burnout. Medical students who are addicted to smartphone, have chosen medical course against individual interest or because of family pressure and have family relationship problems are at risk of getting burnout. Intervention is required to address this issue for the future well-being of medical students.

A Systematic Review on Caregiver’s Burden Among Caregivers of Dementia Patients in Malaysia

@#Introduction: Increasing prevalence of dementia and the associated caregiving burden are expected due to longer life expectancy. This review aimed to critically assess dementia-driven caregiving burden and the associated factors in Malaysia. Methods: A systematic search using several combinations of keywords was conducted in Ovid Medline, PubMed, Science Direct, ProQuest, and Ebscohost databases. The primary outcome was the score or level of caregiver burden, while the secondary outcome was the factors associated with such burden. The quality of the individual articles was assessed using the Newcastle–Ottawa Scale and the Joanna Briggs Institute checklist. Results: The systematic search resulted in seven studies being reviewed, consisting of six cross-sectional studies and one quasi-experimental study. Using the Zarit Burden Interview, two studies reported moderate caregiver burden with mean scores of 35.4 (15.08) and 46.0 (17.0). High levels of burden or strain were reported using the Caregiver Strain Index in other studies. The three main associated factors with burden identified in these studies were the presence of behavioural and psychological symptoms of dementia (BPSD), higher education level, and lack of social support. Conclusion: Moderate to severe caregiving burden level were found to be experienced by dementia caregivers in this country. High education, lack of support, as well as taking care of patient with BPSD being the most prominent factors associated with burden. Therefore, burden should be regularly assessed among the dementia caregivers especially among those with lack of social support and manage family members with BPSD, as to prevent adverse outcome from dementia caregiving.

Prevalence of coral diseases in the coastal waters of Kota Kinabalu: The potential of microbial and environmental agents

Aims@#The Indo-Pacific coral populations are under increasing threats from bleaching events and coral disease outbreaks. However, there is a significant gap in data and research on coral diseases in Malaysian waters. This study aimed to assess the prevalence of coral diseases and signs of compromised health at 27 reef sites in the coastal waters of Kota Kinabalu, Sabah.@*Methodology and results@#We conducted coral surveys using the Coral Video Transect (CVT) method and measured the prevalence using Coral Point Count with Excel Extension (CPCe) software. Our findings indicated that the majority of reefs appeared healthy (82.9% ± 1.8), while a smaller percentage displayed signs of disease (5.0% ± 0.6) or compromised health (12.1% ± 1.5). Reef sites exposed to higher levels of human activities exhibited a greater prevalence of coral diseases (e.g. yellow band disease, ulcerative white spots and skeletal eroding band) and signs of compromised health (e.g. sediment necrosis, skeletal damage and algal overgrowth). A total of 51 scleractinian hard coral genera were affected, with Porites and Acropora being the most predominantly affected by sediment necrosis and skeletal damage, respectively. A review of molecular approaches identified various coral pathogens, including Vibrio spp., which could potentially contribute to the occurrence of coral disease. @*Conclusion, significance and impact of study@#Unsustainable coastal development with unregulated human activities can exacerbate the severity of coral diseases and signs of compromised health. Therefor

Epidemiology of COVID-19 cases and vaccination coverage in Seremban District, Malaysia, 2021

@#Objective: Malaysia’s first case of coronavirus disease (COVID-19) was reported in January 2020, with the first case in the state of Negeri Sembilan diagnosed on 17 February 2020. The National COVID-19 Immunisation Programme commenced in early March 2021 in Negeri Sembilan. This study describes the COVID-19 cases and vaccination coverage in Seremban District, Negeri Sembilan, during 2021. Methods: The demographic and clinical characteristics of COVID-19 cases and the district’s vaccination coverage were described. Vaccination coverage was plotted against COVID-19 cases on the epidemic curve. The chi-square test was used to examine the differences between the vaccination status of COVID-19 cases and severity category, hospitalization status and mortality. Results: In Seremban District, there were 65 879 confirmed cases of COVID-19 in 2021. The data revealed that the 21–30-year age group had the highest proportion of cases (16 365; 24.8%), the majority of cases were male (58.3%), and most cases were from the sub-district of Ampangan (23.1%). The majority of cases were Malaysian. Over half (53.5%) were symptomatic, with fever (29.8%) and cough (22.8%) being the most frequently reported symptoms. COVID-19 vaccination status was significantly associated with severity category, hospitalization and mortality (P < 0.001 for all categories). Discussion: This is the first study to describe two-dose vaccination coverage and the trend in COVID-19 cases in Seremban District. It was observed that COVID-19 cases had been reduced following more than 60.0% vaccination coverage.

Outbreak of foodborne disease in a boarding school, Negeri Sembilan state, Malaysia, 2021

@#Objective: Foodborne disease is a significant global public health concern, with Bacillus cereus being a frequent cause of outbreaks. However, due to the relatively mild symptoms caused by infection with B. cereus, the shorter duration of illness and the challenges of testing for it in both stool and food samples, outbreaks are often underreported. This report describes the epidemiology of cases of foodborne illness, the causative agent and risk factors associated with an outbreak in a boarding school in Seremban district, Negeri Sembilan state, Malaysia, that occurred in November 2021. Methods: Epidemiological, environmental and laboratory investigations were performed. A case was defined as any person with abdominal pain, vomiting or diarrhoea that occurred after consuming food served by the canteen at the school. The data were analysed using Microsoft Excel and the Statistical Package for the Social Sciences (SPSS). Results: A total of 152 cases were identified among the 597 students, giving an attack rate of 25.5%. All cases were females aged 13–17 years. They presented with abdominal pain (100%), nausea (97.4%, 148), vomiting (78.3%, 119) or diarrhoea (61.8%, 94), or a combination of these. The mode of transmission of the outbreak was a continual common source. The foods associated with becoming a case were beef rendang (a dry curry) (odds ratio [OR]: 20.54, 95% CI: 4.89–86.30), rice (OR: 19.62, 95% CI: 2.62–147.01), rice cubes (OR: 18.17, 95% CI: 4.31–76.55) and vermicelli (OR: 17.02, 95% CI: 4.03–71.86). Cross-contamination and inadequate thawing and storage temperatures contributed to the outbreak. Discussion: This outbreak of foodborne illness at a boarding school was likely caused by B. cereus. The findings highlight the importance of proper food preparation, temperature monitoring, hygiene practices among food handlers and compliance with food safety guidelines.

COVID-19 clusters in Malaysia: characteristics, detection methods and modes of early transmission

@#Objective: Effective prevention and control measures are essential to contain outbreaks of infectious diseases, such as coronavirus disease (COVID-19). Understanding the characteristics of case clusters can contribute to determining which prevention and control measures are needed. This study describes the characteristics of COVID-19 case clusters in Malaysia, the method used to detect a cluster’s index case and the mode of early transmission, using the seven cluster categories applied in Malaysia. Methods: This cross-sectional study collected publicly available data on COVID-19 clusters occurring in Malaysia from 1 March 2020 to 31 May 2021. The characteristics of cases were described by category, and their associations with several outcomes were analysed. Descriptive analyses were performed to explore the method used to detect the index case and the mode of early transmission, according to cluster category. Results: A total of 2188 clusters were identified. The workplace cluster category had the largest proportion of clusters (51.5%, 1126/2188 clusters), while the custodial settings category had the largest median cluster size (178 cases per cluster) and longest median duration of cluster (51 days). The high-risk groups category had the highest mortality. There were significant differences in cluster size, duration and rate of detection across the categories. Targeted screening was most commonly used to detect index cases, especially in custodial settings, and in imported and workplace clusters. Household–social and social–workplace contacts were the most common modes of early transmission across most categories. Discussion: Targeted screening might effectively reduce the size and duration of COVID-19 clusters. Measures to prevent and control COVID-19 outbreaks should be continually adjusted based on ongoing assessments of the unique context of each cluster.

Professional Identity of Medical Students of Malaysia: Influence of Demographic Factors

@#Introduction: In medical education one of the main goal is to facilitate the development of professional identity of medical students. It is influenced by sociocultural factors whose influence has been examined by the empirical scholarship on professional identity research in a robust way. The current research studied the influence of gender, ethnicity and year of study on the professional identity of medical students using a validated instrument. Methods: The quantitative research approach using the cross sectional survey design is adopted in the present study. The instrument for the measurement of professional identity was developed using the items adapted from previous research. Stratified random sampling was used to collect the data from 318 participants. The reliability and construct validity of the instrument was evaluated using Smart PLS 3. Data was analysed, for descriptive and inferential statistics using SPSS version 26. Result: Ethnicity, gender and year of study had an impact on the professional identity of medical students. Indian ethnicity had significantly higher positive influence. The female students had higher professional identity than male medical students. As the students’ progressed to higher level of their training their professional identity progressively decreased. Conclusion: The medical students trained with similar curricular activities and the learning experiences develop different levels of professional identity. The level of professional identity developed by the medical students in deferent gender, ethnicity, and year of study differes. The sociocultural factors need to be considered when designing activities aimed at development of medical students’ professional identity.

Screen Media Dependency and Its Associated Factors Among Preschool Children in Kuala Lumpur

@#Introduction: Excessive screen time among young children is associated with screen dependency. At this moment, there is a lack of data on screen dependency among young children in Malaysia. This study aimed to measure the prevalence of screen dependency and its associated factors among preschool children in Kuala Lumpur. Methods: A cross-sectional study was carried out at registered preschools in Kuala Lumpur. 300 parents of preschool children aged 4 to 6 years old who fulfilled the inclusion and exclusion criteria were recruited via simple random sampling. The Screen Dependency Scale (SDS) were used to assess their dependency to screen media. Univariate and multivariate statistics were analysed using IBM SPSS version 27. Results: The prevalence of screen dependency among preschool children in Kuala Lumpur was 65.7%. Multivariate logistic regression analysis identified that using the screen to resolve children’s quarrels (aOR 2.855, 95% CI 1.187 - 6.868), children who use smartphones (aOR 2.735, 95% CI: 1.244 - 6.013), children’s screen time exceeds 2 hours over the weekend (aOR 2.261, 95% CI: 1.058 - 4.830) and having a television in the bedroom (aOR 5.562, 95% CI: 1.591 - 19.442) were predictors for screen dependency. While active co-use mediation (aOR 0.505, 95% CI: 0.302 - 0.845) were protective. Conclusion: The prevalence of screen dependency was high among preschool children in Kuala Lumpur. Active screening at health care clinics or in schools is essential to identify early children with risk factors for screen dependency.