Objective: The present study aims to assess verbal memory performance in patients with schizophrenia attending HUSM and determine the relationship between the patients’ verbal memory performance and their demographic/clinical factors. Methods: A cross sectional study of 114 patients with schizophrenia attending HUSM psychiatric services from December 2007 to May 2008 was conducted. The schizophrenia symptoms as well as verbal memory performance were assessed using the Brief Psychiatric Rating Scale, the Malay version of the Calgary Depression Scale (MVCDS), and the Malay version of the Auditory Verbal Learning Test (MVAVLT). The relationship between verbal memory performance and demographic/clinical symptoms was evaluated using Pearson Correlation. Results: Overall MVAVLT scores in all the trials were lowered in patients with schizophrenia compared to average healthy controls. There were significant relationships between occupational status and MVAVLT performance in Trial A1-A5 Total; between educational level and MVAVLT performance in Trial A1 and Trial A1-A5 Total and between severities of illness and MVAVLT performance in all indexes except Trial A1 after controlled for occupation and educational level. Conclusions: Patient with schizophrenia in HUSM performed significantly worse than healthy controls in verbal memory with or without interference. There were significant relationships between MVAVLT performance and patient’s occupational status, educational level and severity of the illness but not depressive symptoms.

Introduction: The trend of childhood obesity is on the rise and hence leading towards the increase in obesity related complications. Early recognition of obesity in children and accurate parental perception of the status of the weight of their children is vital. Furthermore, identification of sociodemographic risk factors contributing to obesity is crucial in order to identify children who are in the risk group and thus prevent potential complications. This study is aimed to establish the parental perception of the status of the weight of their children. Secondly, the study also to identify the sociodemographic risk factors associated with obesity in children. Methods: This was a cross-sectional study involving 245 children from 5 to 12 years of age. Following informed consent, the children were classified into either normal (body mass index (BMI) >5th to <85th percentile), overweight (BMI >85th to <95th percentile) or obese (BMI >95th percentile) groups. Parents responded to questionnaires which assessed their perception and sociodemographic factors. Results: A total of 157 participants (64.1%) had normal BMI while 41(16.7%) were overweight and 47(19.2%) were obese. More parents of overweight and obese group had misperceptions of their children’s weight status (p=0.001). Families with higher household income, children with higher birth weight, higher education of mothers and family history of obesity and type 2 diabetes had increased risk of higher BMI among their children (p=0.029, p=0.013, p=0.041 and p=0.001 respectively). Conclusions: Most parents of either overweight or obese children had inaccurate perception of the status of weight of their children. Higher household income, birth weight and education level of the mothers as well as history of diabetes and obesity in the family are associated with increased risk of childhood obesity

Introduction: This audit was performed to monitor the diagnosis and management of chronic kidney disease (CKD) according to the clinical practice guidelines (CPGs) of CKD 2018 in a primary care clinic. Methods: Patients who attended the clinic from April to June 2019 and fulfilled the diagnosis of CKD were included in this study, except for those diagnosed with a urinary tract infection, pregnant women and those on dialysis. These criteria were set based on the CPGs. The standards were set following discussions with the clinic team members with reference to local guidelines, the 2017 United Kingdom National CKD audit and other relevant studies. Results: A total of 384 medical records were included in this audit. Overall, 5 out of 20 criteria for processes and 3 of 8 clinical outcomes for CKD care did not meet the set standards. These included the following: documentation of CKD classification based on albumin category (43.8%); CKD advice (19.0%); dietitian referral (9.1%); nephrologist referral (45.5%); haemoglobin level monitoring (65.7%); overall blood pressure (BP) control (45.3%); BP readings for diabetic kidney disease (DKD) and non-DKD with > 1 g/day of proteinuria (≤ 130/80 mmHg, 37.0%); eGFR reduction of < 25% over the past year (77.2%). Identified problems included the absence of a CKD registry, eGFR and albuminuria reports, and a dedicated team, among other factors. Conclusions: Overall, 8 out of 28 criteria did not meet the standards of CKD care set for this audit. The problems identified in this audit have been addressed. Moreover, strategies have also been formulated to improve the diagnosis and management of CKD in this clinic.

Introduction: The use of e-cigarettes has increased rapidly around the world including in Malaysia. However, a significant proportion of people who started using e-cigarettes later discontinued using them. The aim of this study is to identify prevalence of former e-cigarette use and factors associated with quitting, among Malaysian adults. Methods: This study is a part of a national household survey examining the use of e-cigarettes among Malaysian adults aged 18 years and above in 2016. A multistage stratified cluster sampling method was used in the survey. A bilingual (Malay and English) structured questionnaire was used and data was collected via face-to-face interview. Prevalence of current e-cigarette use and former e-cigarette use were determined. A multiple logistic regression model was used to identify factors associated with quitting e-cigarettes. Results: A total of 4,288 adults participated in the survey, where 110 (3.2%) and 289 (8.6%) were identified as current and former e-cigarette users respectively. The following factors were significantly associated with quitting e-cigarette use: e-cigarette users who had no exposure to e-cigarettes at the workplace (aOR = 2.70; 95% CI: 1.39, 5.24); the perception that e-cigarette is more harmful to others compared to tobacco smoke (aOR = 2.46; 95% CI: 1.22, 4.97); and the perception that e-cigarettes do not help people to maintain cigarette abstinence (aOR = 2.19; 95% CI: 1.23, 3.92). Conclusions This study contributes to a better understanding of the factors associated with cessation of e-cigarettes. Findings from this study can assist any e-cigarette cessation intervention measures.

Introduction: Trauma is a Global threat and the 5th highest cause of all-cause mortality in Malaysia caused predominantly due to road traffic accidents. Majority of trauma victims are young adults aged between 21-40 years old. In Malaysia, 24 out of 100,000 population die annually due to trauma, rating us amongst the highest in South East Asia. These alarming figures justify aggressive preventive and mitigation strategies. The aim of this paper is to promote the implementation of evidence-based interventions that will reduce the rate of preventable death because of trauma. Tranexamic acid is one of the few interventions in the early management of severe trauma with level-one evidence. Tranexamic acid has been proven to reduce all causes of mortality and mortality due to bleeding. Evidence proves that it is most effective when administered early, particularly within the 1st hour of trauma. This proposed guideline is formulated based upon quality evidence from multicentre studies, clinical practices in other countries and consideration of the local demographic factors with the intent of enabling an easy and simple pathway to administer tranexamic acid early in the care of the severely injured. Conclusion: The guideline highlights select pre-hospital criteria’s and the methods for drug administration. The authors recognise that some variants may be present amongst certain institutions necessitating minor adaptations, nevertheless the core principles of advocating tranexamic acid early in the course of pre-hospital trauma should be adhered to.