Introduction: Paediatric asthma, a prevalent chronic disease among children in Malaysia, can have its morbidity reduced through effective education. This study aims to assess the knowledge and perceptions of childhood asthma in the Malaysian general population. Materials and methods: A prospective study was conducted among visitors attending paediatric wards and clinics at the Institute of Paediatric Hospital Kuala Lumpur. Participants, who gave their consent, completed validated questionnaires in written form that evaluated their knowledge of asthma symptoms, triggering factors, medication, prevention, and myth perception. A higher score indicated a deeper understanding of asthma. Results: The study included 200 participants, predominantly female (88%), with a median age of 35.5 years. Among them, 12% were asthmatics, and 36% had a family member with asthma. The primary source of asthma information was electronic media (82%). The average score for knowledge of asthma symptoms, triggering factors, medication prevention and myth was 62.13% (SD 17.6). 62.88% (SD 16.3), 56.7% (SD 16.5), 82% (SD 15.1) and 57.8% (SD 15.4) respectively. Asthma myth perception and source of asthma information from family members were strongly related (p-value of 0.042). Conclusion: The general population exhibits an average understanding of asthma, comparable to findings from previous studies in other countries. This highlights the need for targeted educational interventions to dispel myths and enhance asthma knowledge.

Psychiatric disorders are common in patients on hemodialysis. To the best of our knowledge there are no reported cases of psychosis developing in hemodialysis patients in the context of nephrectomy, and there is limited data on the use of long-acting antipsychotics in hemodialysis, which are generally not recommended in chronic kidney disease.We present the case of a 40-year-old lady with bilateral nephrectomy receiving hemodialysis who developed psychosis that resulted in her refusing to continue hemodialysis and was irregularly compliant with oral antipsychotics, necessitating the use of a long-acting injection. We report on the approach to clinical reasoning in the choice of aripiprazole and the need for a long-acting injection. Based on its pharmacological and pharmacokinetic properties oral aripiprazole 20 mg was commenced and after establishing tolerability and response, the patient was switched to long-acting aripiprazole 400 mg monthly achieving full remission of psychotic symptoms after 6 months with maintained improvement after 12 months. Based on its properties, aripiprazole may be a reasonable option in the treatment of psychosis in patients on hemodialysis with nephrectomy and can be considered even as a long-acting injection in these patients.

One of the most frequent complaints of individuals with hearing impairment is listening comfort in noisy environments. In order to improve listening comforts in background noise, digital noise reduction (DNR) systems are incorporated into hearing aids (HAs). Each hearing aid manufacturer has its proprietary algorithm for the DNR system. The amount of attenuation (dB) provided by the DNR system can be quantified using the hearing aid analyser. However, the standard test signals in the hearing aid analyser could not quantify the attenuation of DNR for speech mixed with noise signals. Therefore, this study aimed to (i) develop speech-plus-noise test signals that incorporate Malay sentences and (ii) quantify the efficacy of DNR systems in commercial hearing aids using the newly developed test signals. Six different brands of hearing aids with identical technology but from different manufacturers were subjected to electroacoustic testing utilising newly created Malay speech-in-noise test signals with and without DNR enabled. The total root-meansquare (RMS) gain reduction for each HA was calculated. The results show that the types of noise, the signal-to-noise ratio and the gender of the speaker have a significant effect (p<0.05) on the amount of gain reduction in the HA output as a result of the DNR system in each HA . In conclusion, the newly developed Malay speech-in-noise test signals can be used to verify the efficacy of DNR system in commercial hearing aids.

eToyBox is a learning management system for preschool teachers to improve their health literacy, which ultimately aims to improve children’s obesity-related behaviour. As part of the development process of eToyBox, assessment on digital literacy, acceptance of digitization of education materials, and perceived barriers in adopting online learning is needed. Fifty-four preschool teachers under the Community Development Department (KEMAS) in Kuala Lumpur, Selangor, and Sarawak, who participated in ToyBox Study Malaysia intervention in 2018, took part in this cross-sectional study. An online self-administered questionnaire was used to assess sociodemographic background, use of communication tools and media, and teacher’s views on adapting the ToyBox modules to digital education materials. Respondents were contacted, and questionnaire link was shared through WhatsApp messages. Most participants (74.0%) were Malay females aged 31 to 40 years old. Most participants had internet access (94.4%) and owned at least a smart phone, laptop or tablet (94.4%). Participants perceived their computer skills to be average (75.0%). Majority of respondents (65.0%) reported advanced and higher abilities in word processing and email, but only 22.0% in spreadsheet skills. The main barrier to accessing online material was unstable internet connection (74.1%). Most respondents (90.0%) agree that adapting effective modules to online learning will be beneficial for professional development and teaching practices. In conclusion, most participants supported digitizing Toybox Study Malaysia educational content and were comfortable 72 with its implementation via an online learning platform. The findings from this study can advise future development of online learning materials for preschool teachers in Malaysia.

Mullerian agenesis or Mayer-Rokitansky-Kuster-Hauser Syndrome (MRKH) Type-II is a congenital defect in the Mullerian duct that results in the absence of a uterus in women. The aetiology of this syndrome is unknown and has been considered a sporadic genetic disease. MRKH, together with anorectal anomaly, is an extremely rare condition and has only been reported in a few cases without any information on genetic analysis. This study investigated the mutational profile of a girl diagnosed with MRKH and anorectal anomalies with rectovaginal fistula. The whole exome sequencing (WES) trio-genetic analysis of a 5-year-old Malaysian girl diagnosed with MRKH (having anorectal anomaly with rectovaginal fistula) was performed together with her normal parents, using the Ion AmpliSeq Exome RDY kit (ThermoFisher Scientific, USA). Data were analysed using Torrent Suite v.5.0.4 and annotated using ANNOVAR. Single nucleotide polymorphisms (SNPs) with an allele frequency >0.01 were excluded, and the remaining variants were filtered based on de novo mutations, autosomal recessive, and autosomal recessive genetic traits. Related genes were analysed by biological pathway analysis (g:Profiler) and protein-protein interaction (HIPPIE v.2.3, STRING v.11.5, dan GeneMANIA). A total of 36 mutations were identified, and two of them, the LHX5 (p.P358Q), inherited from the father, and CFTR (p.R1158X), inherited from the mother. There were 28 de-novo mutations from 28 genes. All genes were involved in 27 biological processes that connected with 23 interactions, and are likely to cause MRKH syndrome in this patient.

Tooth avulsion is a dental emergency that needs prompt treatment to minimise complications. This study aims to evaluate the knowledge and awareness of avulsed tooth management among dental surgery assistants at the UKM Dental Polyclinic. This survey research design of a 19- item questionnaire was distributed to 59 dental surgery assistants (DSAs). The questionnaire consisted of demographic profile questions and questions regarding awareness and knowledge of tooth avulsion and its immediate management. The results showed that 78% of DSAs at the Institute know about first aid management of avulsed teeth, with the majority being taught during their training course. Moreover, 96.2% of the DSAs know what tooth avulsion is and recognise it as a dental emergency. Although 75% of the DSAs have never previously handled any avulsed tooth case, 50% are confident in advising the public on what to do with an avulsed tooth at the time of injury. As for the specific management questions of an avulsed tooth, the responses from the DSAs varied according to the questions, ranging from 50% to 85%. DSAs at the Institute have varying levels of awareness and knowledge regarding tooth avulsion. Therefore, regular education programmes on dental trauma and its management will help improve the DSAs’ current knowledge and ability to manage avulsion injuries better in emergencies.

Keropok lekor is a fish-based snack and traditional food originating from the East Coast of Peninsular Malaysia, especially in Terengganu. This study was conducted to identify the ingredients and packaging used in the manufacturing of keropok lekor by entrepreneurs in Selangor. This study is a qualitative study that requires in-depth interviews. The Nutritionist Pro application was used to determine the nutrients in keropok lekor. The sampling method for this study is purposive sampling and involves five keropok lekor operators around Selangor. The ingredients used in making keropok lekor are salt, fish filling (fringescale sardine), baking powder, monosodium glutamate (MSG), margarine, and sweet potato flour. Through this study, it was found that the main source of sodium in keropok lekor is salt. For keropok lekor packaging, all keropok lekor operators use the same packaging method, which is vacuum packaging. In addition, the majority of keropok lekor operators (80%) have been introduced to Modified Atmosphere Packaging (MAP). The results of the study show that the average sodium content in keropok lekor is 372.11mg/100g and is categorized as medium-level sodium. Although the majority of keropok lekor operators have been introduced to MAP packaging, further research needs to be conducted to find out whether keropok lekor operators have renewed their packaging methods or vice versa. In conclusion, based on the findings, the content of sodium in the manufacturing of keropok lekor in Selangor is still under control. The results of this study can be used to help the government monitor the sodium content found in keropok lekor around Selangor.

This study aims to determine the knowledge, attitudes and ergonomic practices (KAP) of office workers in Malaysia in preventing work-related musculoskeletal disorders. An online crosssectional survey of 266 office workers in Malaysia was conducted. All participants were asked to complete a five-part questionnaire to extract information on sociodemographic data, prevalence of work-related muscle disorders (WMSD), level of knowledge, attitudes, and ergonomic practices. The prevalence of WMSD was measured using the Cornell MS Discomfort Questionnaire (CMDQ) with high reliability and validity, with a Cronbach's Alpha value exceeding 0.95, and an intraclass correlation coefficient (ICC)= 0.69-0.95. Ergonomic knowledge was measured using the Ergonomic Knowledge Questionnaire with high validity (0.98) and fair reliability (r= 0.75). The attitude questionnaire was measured using a Likert scale consisting of yes, no, and maybe. Ergonomic practices are obtained by using the Rapid Office Strain Assessment (ROSA). ROSA is a questionnaire with high inter-observer and intraobserver reliability (ICC 0.88 and 0.91). Participants answered a picture-based questionnaire consisting of 3 parts: (1) chair, (2) monitor and telephone, (3) mouse. Most office workers experienced WMSD (99.3%) with moderate discomfort (66.5%). The common complaints being upper back (83%), right upper arm (78.9%) and neck (78.6%). A total of 73.7% of office workers have poor and little knowledge about ergonomics. The majority of office workers (97%) have a positive attitude towards ergonomics. 75.2% of office workers in Malaysia have good ergonomic practices. Most office workers in Malaysia have poor ergonomic knowledge, positive attitudes and good ergonomic practices.