Background：In September 2012, 10 cases suspected to be hepatitis A were notified to the Manjung District Health Department. An investigation was conducted to identify the possible mode of transmission, source of the outbreak and to recommend prevention and control measures.Methods：A case was a person with acute illness with discrete onset of symptoms and jaundice or elevated serum aminotransferase levels in September 2012 in the Manjung District. We conducted a case-control study and environmental assessments of processing plants and food premises.Results：There were 78 confirmed cases of hepatitis A; an attack rate of 3.1 per 10 000 population. Multiple logistic regression showed that being male (odds ratio [OR]: 18.4 [5.13–65.9]; P < 0.001) and drinking toddy at processing place A (Adjusted OR: 2.70 [1.17–6.25]; P < 0.05) were associated with being a case. Environmental investigations of this and one other processing place found them to be unhygienic, and the pH of the toddy was at levels that encouraged growth of hepatitis A virus.Conclusion：Toddy was possibly the primary source of this outbreak based on both epidemiological and environmental results. Both toddy preparation places and several food premises were closed as a result of this investigation.

Objective: The smoking rate among patients with mental health problem is higher than in the general population. Effective pharmacotherapy to treat nicotine addiction is thus needed to reduce the morbidity and mortality associated with cigarette smoking among these patients. This article reviews the literature on the suitability of varenicline for smokers with mental health problems. Methods: A search of the literature was conducted using PubMed from year 2001 to July 2009 using key words varenicline alone and varenicline and mental health. Articles chosen were narrowed to those published in English. The type of articles chosen included clinical trials, meta-analyses, case reports, and review articles. Results: The search produced a total of 322 articles on varenicline and 14 articles on varenicline and mental health. Varenicline, a new drug for smoking cessation is an α4β2 partial agonist and partial antagonist at nicotinic acetylcholine receptor. As a partial agonist, varenicline relieves craving and withdrawal symptoms that occur during smoking abstinence and also reduce the rewarding effects of smoking in patients who relapse. However, at present, there is concern regarding the neuropsychiatric side effects such as aggressive behaviour, suicidal ideation, mania and depression associated with varenicline use in patients with mental health problems, but these reports did not show a causal-link or lack of link between these symptoms and varenicline. Conclusion: Current available data support the effectiveness of varenicline to treat nicotine dependence. However its safety among smokers with mental health problems remains to be elucidated. At present, further safety assessment is needed in this patient population. Until new data is available regarding the safety of varenicline in these populations, psychiatrists and physicians prescribing this medication should be extra cautious and monitor for possible psychiatric side effects when prescribing this medication to patients with pre-existing psychiatric disorders or have vulnerability to psychoses.

Objectives: The objective of the study is to determine the prevalence of substance abuse for alcohol, cannabis, opiates, stimulants, solvent and other substances among patients with schizophrenia in Hospital Bahagia Ulu Kinta (HBUK), Perak , Central Peninsular of Malaysia. This study also aims to determine the association of substance abuse with aggression, the demographic characteristics and total duration of hospitalization. Methods: This was a retrospective cross-sectional study whereby the first 194 subjects diagnosed to have schizophrenia based on International Classification of Disease, 10th edition (ICD-10) criteria were taken from data registry of patients admitted to HBUK from January until February 2004. The subjects’ medical files were examined for documentation of substances abuse, aggression and accumulative duration of hospitalization. Results: The results showed the prevalence of substances misuse among patients with schizophrenia in general (including alcohol) was 24.7%. Cannabis 16.7%, alcohol 13.4%, opiates(heroin) 6.7%, Amphetamine type stimulants (amphetamine, metamphetamine, ecstacy) 5.7%, and other substances (benzodiazepine, solvents) 1.5%. Conclusion: There is higher prevalence of substance misuse in patients with schizophrenia as compared to general population. Male patients with history of substance misuse are more likely to have aggression than female. This group needs special precaution and probably in need of specialist help.

Nutrition education on healthy eating during childhood plays an important role in ensuring healthy growth process of children. One method of doing so is by using age-appropriate education tools. This cross-sectional, quasi-experimental study was to assess the effectiveness of interactive book, which had its content appropriateness assessed, as an education tools in improving knowledge level on healthy diet among preschoolers. 116 subjects aged 4-6 years (60±10 months) were recruited and randomly grouped into intervention group and control group (each with 58 subjects) from five kindergartens in Bangi, Selangor where only those subjects from intervention group were exposed to the interactive book prepared prior to this study. A same set of questionnaires, with a total score of 32, was used to assess changes in subjects’ knowledge levels at Pre-test (before intervention), Post-test I and Post-test II (one-week after Pre-test), where Post-test I only involved subjects from intervention group. At Pre-test, the intervention group scored 25±5, while the control group scored 26±4. After intervention, mean score for intervention group increased to 29±4 for both Post-test I and Post-test II; whereas it remained relatively unchanged for control group for Post-test II (26±5). Significant increase in knowledge level (p<0.001) was found in intervention group, both after intervention and effect of group*time, compared to control group (p=0.077). Hence, this study proved that interactive book could potentially be an effective education tool in nutrition education and improving knowledge level on healthy diet among preschoolers and children.

Objectives: The use of technology has rapidly increased in the past century. Artificial intelligence (AI) and information technology (IT) are now applied in healthcare and medical education. The purpose of this study was to assess the readiness of Indonesian teaching staff and pediatric residents for AI integration into the curriculum. Methods: An anonymous online survey was distributed among teaching staff and pediatric residents from 15 national universities. The questionnaire consisted of two sections: demographic information and questions regarding the use of IT and AI in child health education. Responses were collected using a 5-point Likert scale: strongly disagree, disagree, neutral, agree, and highly agree. Results: A total of 728 pediatric residents and 196 teaching staff from 15 national universities participated in the survey. Over half of the respondents were familiar with the terms IT and AI. The majority agreed that IT and AI have simplified the process of learning theories and skills. All participants were in favor of sharing data to facilitate the development of AI and expressed readiness to incorporate IT and AI into their teaching tools. Conclusions The findings of our study indicate that pediatric residents and teaching staff are ready to implement AI in medical education.

Objectives: The use of technology has rapidly increased in the past century. Artificial intelligence (AI) and information technology (IT) are now applied in healthcare and medical education. The purpose of this study was to assess the readiness of Indonesian teaching staff and pediatric residents for AI integration into the curriculum. Methods: An anonymous online survey was distributed among teaching staff and pediatric residents from 15 national universities. The questionnaire consisted of two sections: demographic information and questions regarding the use of IT and AI in child health education. Responses were collected using a 5-point Likert scale: strongly disagree, disagree, neutral, agree, and highly agree. Results: A total of 728 pediatric residents and 196 teaching staff from 15 national universities participated in the survey. Over half of the respondents were familiar with the terms IT and AI. The majority agreed that IT and AI have simplified the process of learning theories and skills. All participants were in favor of sharing data to facilitate the development of AI and expressed readiness to incorporate IT and AI into their teaching tools. Conclusions The findings of our study indicate that pediatric residents and teaching staff are ready to implement AI in medical education.

Objectives: The use of technology has rapidly increased in the past century. Artificial intelligence (AI) and information technology (IT) are now applied in healthcare and medical education. The purpose of this study was to assess the readiness of Indonesian teaching staff and pediatric residents for AI integration into the curriculum. Methods: An anonymous online survey was distributed among teaching staff and pediatric residents from 15 national universities. The questionnaire consisted of two sections: demographic information and questions regarding the use of IT and AI in child health education. Responses were collected using a 5-point Likert scale: strongly disagree, disagree, neutral, agree, and highly agree. Results: A total of 728 pediatric residents and 196 teaching staff from 15 national universities participated in the survey. Over half of the respondents were familiar with the terms IT and AI. The majority agreed that IT and AI have simplified the process of learning theories and skills. All participants were in favor of sharing data to facilitate the development of AI and expressed readiness to incorporate IT and AI into their teaching tools. Conclusions The findings of our study indicate that pediatric residents and teaching staff are ready to implement AI in medical education.

Objectives: The use of technology has rapidly increased in the past century. Artificial intelligence (AI) and information technology (IT) are now applied in healthcare and medical education. The purpose of this study was to assess the readiness of Indonesian teaching staff and pediatric residents for AI integration into the curriculum. Methods: An anonymous online survey was distributed among teaching staff and pediatric residents from 15 national universities. The questionnaire consisted of two sections: demographic information and questions regarding the use of IT and AI in child health education. Responses were collected using a 5-point Likert scale: strongly disagree, disagree, neutral, agree, and highly agree. Results: A total of 728 pediatric residents and 196 teaching staff from 15 national universities participated in the survey. Over half of the respondents were familiar with the terms IT and AI. The majority agreed that IT and AI have simplified the process of learning theories and skills. All participants were in favor of sharing data to facilitate the development of AI and expressed readiness to incorporate IT and AI into their teaching tools. Conclusions The findings of our study indicate that pediatric residents and teaching staff are ready to implement AI in medical education.

Introduction: Myopia is an emerging vision problem that causes public health and economic burden worldwide and associated with increased risk to many ocular conditions leading to blindness. This study aimed to evaluate patterns of visual field defects in Malay population with myopia. Methods: A retrospective study was conducted between January 2018 until June 2018 at MSU Eye Centre and data was obtained from patient records of Malay subjects with myopia and free from any ocular and systemic diseases. The spherical equivalent (SE) of the refractive errors and the global indices (mean deviation, MD and pattern of standard deviation, PSD) of OCULUS Twinfield® 2 with SPARK strategy were recorded for this study. Results: A total of 90 eyes with the mean age of 29.16 (SD: 10.27) years old and SE (M= -2.92 D, SD:2.94 D) were selected. The mean of MD was -1.71 dB (SD 3.95 dB) and PSD was 1.81 dB (SD:1.82 dB) respectively. Significant differences was found in MD (p=0.012) and PSD (p=0.01) between the three groups. The localised field defect was observed in the moderate to high myopic eyes in all quadrants (p=0.01) for PP2, and also more prevalent pattern found in all quadrants for PP1 except at superior quadrant (p=0.08). Conclusions: There is a localised visual field defect found in a higher degree of myopia particularly at temporal, nasal and inferior quadrants. Thus, the visual field test is recommended as a routine procedure in moderate to high myopic eyes and need to be interpreted with caution.

This manuscript aims to examine depression and the relationship between depression and other comorbidity diseases among women involved in prostitution in Kuala Lumpur. A total of 126 women were interviewed face to face using a structured questionnaire. The M.I.N.I Neuro-Psychiatric Interview Diagnostic Test Tool 6.0 Bahasa Malaysia Version was used to measure depression among women involved in prostitution in Kuala Lumpur. Meanwhile other comorbidity diseases were measured based on the women’s infectious disease status such as Sexually Transmitted Diseases, Hepatitis, HIV and AIDS. The results of study were analysed using SPSS software version 21. Descriptive tests were used to determine the status of depression among women involved in prostitution. The Chi-square test was used to identify the relationship between the status of other comorbidity diseases and depression among women involved in prostitution. The results of the descriptive analysis revealed that 92 out of the 126 women who were interviewed reported suffering from depression. In fact, the results of Chi Square test (p≤0.05) analysis showed that there was a significant relationship between the status of other comorbidity diseases especially Hepatitis C and depression among women involved in prostitution in Kuala Lumpur. The findings of the study indicated that women s who were positive with Hepatitis C were more prone to report depressive disorders. Therefore, mental health education program and treatment specially for women involved in prostitution need to be integrated into the prevention programs of the infectious diseases.