The prevalence of occupational stress among academician is increasing in developed and developing countries. The job is not only to teach, but also involve in doing research, publications, consultation and administrative work. This study aims to assess the prevalence of occupational stress among academic staff in a research university and to investigate the association and correlation between stress and job factors which are career development, research, teaching and interpersonal relationship. One research university in Malaysia was selected randomly. A cross-sectional study was conducted and the respondents were recruited by using a randomized stratified sampling method. A total of 380 self-administered and validated Depression, Anxiety and Stress Scale-21 (DASS-21) and Stress Sources Questionnaires (SSQ) were distributed among academic staff between March to May 2012. The statistical analyses used were χ2, independent–t test and Pearson Correlation. Response rate was 81.1%. Stress prevalence was 22.1%. All socio-demographic factors showed no association with stress except ethnic group. Teaching, research and career development had significant association with stress among academic staff (p<0.05). Overall result showed career development, that include university condition and required publications for promotion were the greatest source of stress among the academicians. Occupational stress showed positive linear relationship to career development, research and teaching. There was a fair positive relationship between occupational stress and career development, research and teaching. It is recommended to organize continuous stress assessment program to identify and evaluate the current level of stress at the university level. This data could be a foundation for implementing prevention and control measures to reduce stress in the workplace.

This study explores the experience of both learners and a teacher during a team-based learning (TBL) session. TBL involves active learning that allows medical students to utilise their visual, auditory, writing and kinetic learning styles in order to strengthen their knowledge and retain it for longer, which is important with regard to applying basic sciences in clinical settings. This pilot study explored the effectiveness of TBL in learning medical genetics, and its potential to replace conventional lectures. First-year medical students (n = 194) studying at Universiti Kebangsaan, Malaysia, during 2014/2015 were selected to participate in this study. The topic of ‘Mutation and Mutation Analysis’ was selected, and the principles of TBL were adhered to during the study. It was found that the students' performance in a group readiness test was better than in individual readiness tests. The effectiveness of TBL was further shown in the examination, during which the marks obtained were tremendously improved. Collective commentaries from both the learners and the teacher recommended TBL as another useful tool in learning medical genetics. Implementation strategies should be advanced for the benefit of future learners and teachers.

Dental treatment under general anaesthesia may be needed for some children and adolescents due to medical or behaviour problem. The objective of the study is to identify the type of treatment that has been carried out under GA in Hospital Universiti Sains Malaysia (HUSM). A retrospective record review study from hospital records of dental patients (under 18 years old) receiving dental treatment under GA from 2003 until 2007 were retrieved from the database. Information such as the reason for GA, and the type of treatment provided was recorded in data sheet. The data were analyzed using SPSS 12.0.1 for Windows. It was checked and verified for errors. A total of 349 cases were treated of which 43.6% had medical problems. Patients were mostly diagnosed to have rampant caries (77.1%) and some of them have behavioural problems (34.4%). Treatment pattern in deciduous dentition revealed more extraction (97.8%) as compared to restoration (75.7%) whereas in permanent dentition more restoration was done (24.3%) as compared to extraction (2.2%). Majority of the restorations were done using Glass Ionomer Cements (47.5%). Biopsy (4.3%) contributed mainly to the surgery (24.1%) done during GA. General anesthesia is necessary when dental disease is interfering with health and general well-being of patient and it can facilitated dental treatment allowing dentists to benefit from improved treatment conditions and provide a higher quality of care.

Introduction: Cryotherapy and salicylic acid ointment are the two most common treatments used for treating plantar warts. The aim of this study is to compare the clearance rate of plantar warts at 12 weeks between liquid nitrogen cryotherapy and 20% salicylic acid ointment. Methods: Patients with plantar warts were randomized into cryotherapy and 20% salicylic acid groups. Patients assigned into cryotherapy group received a maximum of four treatments given two weeks apart. Patients recruited into 20% salicylic acid group were instructed to apply the salicylic acid ointment onto the wart nightly and to cover the treated area with a hypoallergenic plaster. Both groups were also provided with a personal foot file to thin out the surrounding callus daily at home. Digital pictures were taken at first visit and 12 weeks after enrolment to assess the resolution of plantar wart. Results: Eighty patients with plantar warts were included. Thirty-nine patients were randomized into cryotherapy group and forty-one patients were randomized into 20% salicylic acid ointment group. Thirteen (33.3%) patients had a complete clearance of the warts with cryotherapy whereas eleven (26.8%) patients had a complete clearance of the warts with topical 20% salicylic acid ointment (p=0.526). Nine patients were lost to follow-up. With cryotherapy, two patients reported blister formation and one patient developed hyperpigmentation. No side effects were reported with 20% salicylic acid ointment. Conclusion: There is no difference in effectiveness between cryotherapy and 20% salicylic acid ointment in the treatment of plantar wart.

Introduction: Managing feeding problems and gastrointestinal (GI) symptoms in children with Autism Spectrum Disorders (ASD) is a challenging process for professionals and parents especially if they become persistent and longstanding. The aim of the study was to assess the evidence on feeding problems and GI symptoms among primary school children with ASD. Methods: A scoping review using electronic journal databases, published reports and other types of publication in the last 10 years was conducted. Key terms were defined in the searches and a scoping review framework was used to chart the evidence on feeding problems and GI symptoms in children with ASD. Eighty three articles met the inclusion criteria and 50 articles were used in the review. Results: There is emerging literature reporting consistently on a wide spectrum of feeding problems and GI symptoms among children with ASD. In addition, there is little published literature reporting or investigating the impact of these problems in children with ASD which include financial, social and stress impact on parents, children and their families. This review indicates that many school-aged children with ASD can experience several types of feeding problems and GI symptoms. Conclusion: It is important for professionals working in the community or public health, and educational settings to be able to identify these issues at an early stage, so that professionals could support parents with appropriate information and advice. A specific tool is needed to assess feeding problems and GI symptoms in children with ASD.

Low Grade Papillary Nasopharyngeal Adenocarcinoma (LGPAC) is a very rare tumour of mucosal origin compared to a higher incidence of well differentiated keratinized/non-keratinized nasopharyngeal carcinoma. It is an epithelial tumour with glandular differentiation. Its papillary figure seen histologically, is also seen in metastatic papillary thyroid carcinoma. This has caused a significant challenge to the Pathologist to differentiate primary papillary nasopharyngeal adenocarcinoma and metastatic tumour. Thyroid Transcription Factor-1 (TTF-1) is also expressed in subsets of papillary nasopharyngeal adenocarcinoma, which is valuable as a diagnostic tool. LGPAC is a benign-like malignant neoplasm. An early diagnosis with a complete tumour removal via conventional excision or endoscopic approach has offered a good prognosis with low risk of recurrence.
Thyroid Neoplasms

In 1977, the World Health Assembly (WHA) set the social target--the "Health For All" goal and in 1995, urged member states to "re-orientate medical education and medical practice for "Health For All" (resolution WHA 48.8). This led to World Health Organisation to enunciate the "5-star doctor" needing skills in healthcare management, quality assurance and health economics. The Faculty of Medicine, University of Malaya introduced the New Integrated Curriculum (NIC) in 1995. The objective was aimed at producing a competent doctor with a holistic approach to the practice of medicine. This was to be achieved by having 3 strands of studies i.e. The Scientific Basis of Medicine (SBM), the Doctor, Patient, Health and Society (DPHS), and Personal and Professional Development (PPD) over the 5-year programme, split into 3 phases. Elements of the "5-star doctor" were introduced in strand 2--DPHS and strand 3--PPD. Management studies were introduced in the Personal and Professional Development (PPD) strand. This led to an instructional module--"Principles of Management in Health Care Services (PMGT)" comprising of the Management of Self, Resources and People and incorporating a three week field programme. Evaluation is undertaken at the end of the phase IIIA of the studies. This NIC approach will be able to produce a "5-star doctor", a team player, leader, communicator and an effective manager.
Management ; Purified Protein Derivative of Tuberculin ; Medicine ; Health ; Education, Medical

A study was carried out on 79 female telephone operators working in a Telecommunication Centre in Kuala Lumpur to determine the prevalence of Work Related Upper Limb Disorders (WRULD) and its risk factors. Data collection for this study was done between December 2000 and May 2001. The presence of WRULD was determined based on a guided questionnaire and physical examination. The response rate for this study was 94.9% (n= 75) and results showed that the prevalence of WRULD among the female telephone operators was 48.0%: Stage 1= 38.9%, Stage 2= 19.4%, Stage 3= 38.9%, Stage 4= 0% and Stage 5= 2.8%. In the telecommunication centre, it was found that those with WRULD had a mean of 11.59±9.09 years of employment duration whereas those without WRULD had a mean of 9.89 ± 8.48 years of employment duration. None of the factors studied such as Body Mass Index, age, ethnicity, menstrual cycle, hormone replacement therapy, overtime work, duration of employment in the present unit and in the telecommunication centre differ in distribution between subjects with and without WRULD. This could be contributed by factors such as small number of subjects or the common healthy worker effect found in occupational health research. The findings studied of this study show that almost 40.0% of the workers experienced pain and neurological symptoms. Since none of the factors was found to be associated with WRULD, an elaborate study with a case-control design is needed in order to match cases and enable researchers to control the effect of confounding factors. This will ensure risk factors pertinent to WRULD in the Malaysian setting to be identified.

Health care has emerged as one of the fastest growing industry worldwide. This induced health care costto rise tramendously. However, it is important to preserve high quality health care services that are equitable and affordable. In many countries, people are expected to contribute to the cost of the health care. Are populations ready to accept the concept and willing to pay for health financing scheme? What possible factors that may associate with their decision? This is the objective of the study, to examine the relevance evidence for this through a systematic review of literatures.We systematically searched Ovid MEDLINE and Google Schoolar databases until April 2016. We assessed the study population willingness to pay for health financing scheme and determine the significant variables that associate with WTP. 19 full-text articles were included in the review. Factors that were found significantly associated with WTP for health financing scheme by many studies were age, education, income and residential locality. Other factors that also found associated with WTP were health care services utilization and expenditure. The review findings showed that WTP for health financing scheme is beyond the households’ financial capacity and has multifactorial influences.
Willingness to pay, health financial scheme, health insurance, social health insurance

This study was conducted to obtain tympanometric normative data for Malay preschoolers and compare them between genders. Non-pathological factors such as age, gender and ethnicity may influence tympanometric normative data. Guidelines for middle ear screening by American Speech and Hearing Association (ASHA) are based on Caucasian children population and may not be applicable to Malay children population. The tympanometric parameters measured were peak compensated static acoustic admitan (peak Ytm), volume ear canal (Vea) and tympanometric width (TW). Onehundred and sixty-one Malay pre-schoolers (eighty boys and eighty-one girls) participated in this study. However only fourty-five boys and fourty-six girls (163 out of 182 ears) had fulfilled the study inclusion criteria which include normal otoscopic findings, pass hearing screening and presence of ipsilateral acoustic reflex at 1000 Hz. Two-way Mixed ANOVA to compare the mean tympanometric parameters of boys and girls showed no significant difference for the mean peak Ytm ( p > 0.05), mean Vea [( p > 0.05), mean TW (p > 0.05). Thus data from the two groups were combined. Overall, the mean peak Ytm was 0.55 ± 0.28 mmhos, mean Vea was 0.90 ± 0.40 cm3, and mean TW was 104.68 ± 32.08 daPa. The 90th percentile values for peak Ytm, Vea and TW were 0.27 to 1.18 mmhos, 0.45 to 1.65 cm3 and 59.60 to 149.80 daPa consecutively. This current study suggests that the data obtained are applicable to Malay preschoolers but gender-specific norms are not necessary. Application of each value of TW > 200 daPa and Vea > 1.0 cm3 by ASHA on Malay preschoolers will cause under referral rate and over-referral rate consecutively.