In systemic lupus erythematosus (SLE), haematological abnormalities are frequent, although they are an uncommon cause of acquired von Willebrand syndrome (AVWS). AVWS is a rare condition that can cause a bleeding disorder. We presented a case of AVWS in the early diagnosis of SLE. One month before admission, the patient had a history of recurrent epistaxis. He presented to the hospital with symptomatic anaemia and was noted to have severe anaemia with iron deficiency. During hospitalisation, recurrent epistaxis recurred and was found to have prolonged activated partial thromboplastin time (aPTT), presence of lupus anticoagulant (LA), and lower von Willebrand factor (VWF), and factor 8 (VIII) levels. Simultaneously, he was diagnosed with SLE based on Systemic Lupus International Collaborating Clinics (SLICC) criteria. He underwent blood transfusions and was treated with immunosuppressive drugs such as steroids, mycophenolate mofetil, and an anti-fibrinolytic agent; he subsequently stopped bleeding and showed clinical improvement.

INTRODUCTION: Overweight and obesity are becoming a major health issue which contributes to increase in health morbidity and mortality. This study aimed to evaluate the effect of the mainly diet intervention and exercise for weight reduction among obese but healthy adults. METHODOLOGY: This was a quasi-experimental study using designed Structured Diet Program adapted from Malaysia Healthy Plate method (half-half quarter) for weight reduction that lasts for 10 weeks. The anthropometry and biochemistry parameters were monitored and collected pre and 10 weeks post program. The WHO BMI criteria for Asian population cut off points was used to define obesity in this study. RESULT: Thirty healthcare workers (HCWs) were recruited. However, only 27 HCWs completed the program. The pre and post program mean BMI was 32.90kg/m2 and 31.39kg/m2 and weight was 81.25 kg to 77.37kg. The total cholesterol reduced significantly with mean 5.65mmol/l to 5.34mmol/l. Other blood parameters showed some reduction but not statically significant with mean FBS 4.82mmol/l to 4.69mmol/l, mean HDL: 1.43mmol/l to 1.32mmol/l mean LDL: 3.54mmol/l to 3.42mmol/l and mean TG 1.52mmol/l to 1.31mmol/l. CONCLUSION Overall, the programme led to a considerable reduction in body weight, BMI, and Total Cholesterol. Even though other blood parameters do not show statistically significant reduction but they still showed some reduction post programme. This method is recommended to be implemented among Malaysians for longer duration to achieve significant reduction in blood parameters. However, the commitment and motivation of the HCWs are highly needed to ensure the effectiveness and adherence to the diet method.

COVID-19 is a highly contagious disease that caused a worldwide pandemic in 2020. Medical students are public advocates for COVID-19 vaccination to achieve herd immunity. Our objective is to ascertain the level of knowledge, attitude, and practice toward COVID-19 immunisation among medical students in Malaysia. The online study included four public universities in Peninsular Malaysia: Universiti Putra Malaysia, International Islamic University Malaysia, Universiti Sains Malaysia and Universiti Sains Islam Malaysia. Data collected include sociodemographic characteristics, history of COVID-19 infection, knowledge, attitude and practice towards COVID-19 immunisation. Analytical statistics were analysed with IBM Statistical Package Statistical Package for the Social Science (SPSS) v27.0 using Pearson chi-square or Fisher’s exact test (significant if p < 0.05). From the total of 427 respondents, 60.2% had good knowledge whereby clinical students 67.0% had a higher proportion of good knowledge as compared to preclinical students 53.5% (p = 0.004). Respondents in the age group of 21 to 24 years old (p < 0.001) and 25 to 29 years old (p = 0.016), and Indian ethnicity (p = 0.006) were more likely to have good knowledge. Respondents registered in Malaysia’s National COVID-19 vaccination program were considered as having a positive attitude (n = 264, 61.8%). A vaccination rate of 100% was observed. In conclusion, 60.2% of medical students had good knowledge, 61.8% had a positive attitude and 100% were vaccinated in these four public medical schools in Malaysia. Sociodemographic factors (age group and Indian ethnicity) have an association with only good knowledge but none with the level of attitude and practice towards COVID-19 immunisation.
COVID-19

Background: Body-image perception is one of the determinants in weight management, especially among adolescents. This study aimed to assess weight-control knowledge, attitude and behaviours along with body-image perceptions among Chinese high school students in order to compare the weight-control behaviours with those perceptions. Methods: A cross-sectional study was conducted among 277 Chinese students in Form 1 and Form 2 in Pulau Pinang, Malaysia using convenience sampling. The following outcomes were evaluated: weight-control knowledge, attitude and behaviours (weight-related knowledge and attitude questionnaire; weight control strategies scale) and body-image perceptions (figure rating scale). Results: Both genders were found to have high weight-control knowledge, with female adolescents scoring significantly higher than male adolescents (P = 0.010). However, only half of the adolescents (50.9%) perceived that obesity is bad for health. Although only 44.4% of adolescents were dissatisfied with their current weight status, 62.8% intended to change their present weight status. Male adolescents significantly engaged more in physical activity (PA) (P = 0.035) and self-monitoring (SM) (P = 0.014) compared to their female counterparts. Furthermore, male adolescents chose their current body size as their ideal body image, but female adolescents preferred a slimmer ideal figure. The percentage of male and female adolescents who desired a smaller body figure was 39.6% and 54.5%, respectively. Lastly, there was no significant difference between weight-control behaviours and adolescents’ body-image perceptions. Conclusion: Female Chinese adolescents had higher weight-control knowledge and preferred a slimmer body size, yet males were more likely to engage in PA and SM behaviours. Essentially, imprecise attitude towards obesity among half of the Chinese high school students is of particular concern.

Abstract Introduction: The objective of this study was to determine the factors and predictors of good glycaemic control among patients with Type 2 Diabetes Mellitus (T2DM) in two rural government health clinics in Kuala Selangor. Methods: This cross-sectional study involved 200 patients selected through systematic random sampling from a list of T2DM patients in two government health clinics in Kuala Selangor. Data was collected using a self-administered questionnaire while glycosylated haemoglobin (HbA1c) results were obtained from the patients’ blood results record at the clinic. HbA1c of 6.5 % and below was categorized as good glycaemic control. The factors studied were socio-demographic characteristics (age, gender, ethnicity, level of education, occupation and household income), T2DM medical history (T2DM duration and type of treatment), diabetes knowledge, health literacy, adherence to treatment, body mass index (BMI) and physical activity. Pearson’s chi square test was used to test for associations and multiple logistic regressions were used to determine the predictors. Results: The response rate was 86.9%. The proportion of good glycaemic control was 34.0%. Level of glycaemic control was significantly associated with duration of being diagnosed with T2DM (p=0.006) and type of treatment (p=0.009). The probability of having good glycaemic control was 2.5 times more likely among respondents diagnosed with T2DM for less than 10 years (AOR=2.458, 95% of CI=1.504-14.282, p=0.037). Conclusion: Shorter duration of being diagnosed with T2DM has been found to be a predictor of good glycaemic control in this study population, thus warranting stricter monitoring among patients who have been diagnosed for a longer period.

Abstract Introduction: Second hand smoke exposure to cigarette smoke leads to many medical conditions including asthma and lung cancer. Women are the most vulnerable adults of passive smoking at home. Even though Malaysia had its own smoke- free policy, the smoke- free home is voluntary in nature. Thus, this study was aimed to explore the practice of voluntary smoke- free- home among women in Alor Gajah and its determinants. Methods: A cross-sectional study based on multistage sampling was conducted among 180 non- smoking women in areas implemented Community Intervention Program (KOSPEN), which emphasized on healthy lifestyle, in Alor Gajah, Melaka from April 2018 to May 2018. Data on sociodemographic characteristic, characteristic of second hand smoke (SHS) exposure at home, knowledge, attitude and avoidance behaviour from SHS were collected using questionnaires. The data were then analysed using IBM Statistical Package for Social Science (SPSS) version 24.0 involving descriptive and inferential statistics. Results: Majority of the respondents practised smoke- free home (72.8%). The predictors of smoke- free home were those who attained higher education (AOR= 11.939, 95% CI 1.175- 121.277), did not live with any children (AOR= 3.546, 95% CI 0.985- 12.765) and lived with smokers other than their husband (AOR= 3.793, 95% CI 1.192- 12.076). Conclusion: Education level and household factors were significant predictors of smoke- free home. Thus, few measures were suggested to increase tobacco bans at home among women including periodic health programs, community empowerment programs and creating smoke- free housing.

Aesthetic or cosmetic dentistry is one of the main areas of dental practice. Increasing demands of patients for aesthetics has resulted in the development of several techniques for restoring the anterior teeth. Composite resin restorations have become an integral part of contemporary restorative dentistry and can be called “star of minimal invasion” due to its conservative concepts. The direct composite veneering allows restoring the tooth in a natural way and preservation of sound tooth structure when compared to indirect restorations. Before placement of direct composite veneers, a proper diagnosis, available treatment options, cost of treatment, patient’s expectations and duration of treatment should be taken into consideration. This article presents three case reports of aesthetic rehabilitation of anterior teeth using direct composite with satisfactory outcome that mimic the natural dentition.

ntroduction: Chinese Herbal Medicine (CHM) is becoming increasingly popular among cancer patients worldwide. While health-related quality of life (HRQoL) in relation to cancer outcomes has attracted global attention, there are few studies on CHM use and HRQoL among cancer patients in Malaysia. This study attempted to determine the association between use of CHM, including the types, reasons, and beliefs, and HRQoL among Malaysian cancer patients. Methods: cross-sectional study was conducted among 120 cancer patients (60 male and 60 female) recruited from government oncology clinics in Johor state. A purposive non-probability sampling was applied to recruit respondents. Results: Use of CHM was reported by about half of the patients (49.2%). Common types of CHM used included Chinese herbal extracts (27.5%), Sabah snake grass (12.2%), and ginger (11.5%). The median score for overall belief in CHM significantly differed between CHM users (71.7%) and non-users (65.0%) (p<0.001). The HRQoL was generally reported as ‘good’ with high scores for overall functioning scales and low scores for symptom scales. However, no significant difference in HRQoL between CHM users and non-users was noted. ‘Social Functioning’ scores between both groups showed a significant difference (p < 0.001) with respect to sex, with females scoring higher than males. No significant association was noted between CHM use and socio-demographic characteristics except for sex. Conclusion: There is a high prevalence of self-prescription of CHM among the cancer patients studied. Nonetheless use of CHM did not show any significant difference in terms of quality of life among CHM users.

Introduction: Appropriate oral health knowledge is essential to enable parents to be responsible for the oral health care of their children especially those with special needs. This study aimed to determine the oral health knowledge, attitude and practice (KAP) of parents and cariogenic food intake of their non-syndromic cleft lip with or without cleft palate children (NSCLP) compared to non-cleft children. Methods: A comparative cross-sectional study was conducted on randomly selected parents with children aged 1 to 6 years at Hospital Universiti Sains Malaysia and Kota Bharu Dental Clinic. A face-to-face interview using a validated questionnaire on oral health KAP and cariogenic food intake of their children was done. Data were analysed by using IBM SPSS version 22.0. Results: Sixty-four Malay parents with NSCLP (n=33) and non-cleft (n=31) children were recruited. The mean (SD) percentage score of oral health knowledge of parents in both groups (NSCLP and non-cleft) was fair, 59.5%(11.85) and 62.0%(15.00), P=0.4722; oral health attitude was good, 78.0% (9.30) and 80.2% (15.40), P=0.504; but oral health practice was poor 33.8% (5.94) and 36.1 (8.44), P=0.220. The cariogenic food frequency score was significantly higher in noncleft children; 40.2(10.32) compared to NSCLP children, 34.8(9.46), P=0.032. Conclusion: Parents of both groups had fair knowledge and good attitude but poor oral health practice. Cariogenic foods were consumed more by the non-cleft children. Oral health awareness among the parents needs to be strengthened towards good oral health attitude and practice and non-cariogenic food choices for the betterment of oral health status of their children.

Solitary fibrous tumours of the head and neck region are extremely rare. The clinical diagnosis is often difficult to establish, and this lesion may be indistinguishable from other soft tissue neoplasms. An 18-year old Chinese gentleman presented with a painless right submandibular swelling which was increasing in size for eight months. A computed tomography scan showed a well-defined solid mass measuring about 2.0 x 2.96 cm in the submandibular region. The tumour was resected and was confined within its capsule. Immunohistochemical staining was strongly positive for CD34, CD 99, and vimentin and negative for desmin, smooth muscle actin (SMA), cytokeratin, S100 and CD68. The microscopic and immunohistochemical profile were compatible with solitary fibrous tumour. Distinguishing solitary fibrous tumours from various spindle neoplasms can be difficult. In view of the resemblance, immunohistochemical staining can help differentiate solitary fibrous tumour from spindle neoplasm.
Neoplasms, Tumors, Cancer