This article is a narrative review that discusses the recommended sample size requirements to design a pilot study to assess the reliability of a questionnaire. A list of various sample size tables that are based on the kappa agreement test, intra-class correlation test and Cronbach’s alpha test has been compiled together. For all calculations, type I error (alpha) was set at a maximum value of 0.05, and power was set at a minimum value of 80.0%. For the kappa agreement test, intra-class correlation test, and Cronbach’s alpha test, the recommended minimum sample size requirement based on the ideal effect sizes shall be at least 15, 22, and 24 subjects respectively. By making allowances for a non-response rate of 20.0%, a minimum sample size of 30 respondents will be sufficient to assess the reliability of the questionnaire.The clear guideline of minimum sample size requirement for the pilot study to assess the reliability of a questionnaire is discussed and this will ease researchers in preparation for the pilot study. This study provides justification for a minimum requirement of a sample size of 30 respondents specifically to test the reliability of a questionnaire.

Objectives: This paper aims to serve as a useful guide for sample size determination for various correlation analyses that are based on effect sizes and confidence interval width. Materials and Methods: Sample size determinations are calculated for Pearson’s correlation, Spearman’s rank correlation, and Kendall’s Tau-b correlation. Examples of sample size statements and their justification are also included. Results: Using the same effect sizes, there are differences between the sample size determination of the 3 statistical tests. Based on an empirical calculation, a minimum sample size of 149 is usually adequate for performing both parametric and non-parametric correlation analysis to determine at least a moderate to an excellent degree of correlation with acceptable confidence interval width. Conclusions Determining data assumption(s) is one of the challenges to offering a valid technique to estimate the required sample size for correlation analyses. Sample size tables are provided and these will help researchers to estimate a minimum sample size requirement based on correlation analyses.

Introduction: The morphology of the condyles changes naturally with age, gender, face type, occlusal force, functional load, malocclusion type, and the right and left sides. Although condylar shape and size differ throughout populations, there have been few investigations on condylar morphology, particularly in the Malaysian population. Methods: This retrospective, observational, cross-sectional survey was conducted at the Oral and Maxillofacial Surgery Clinic of Sarawak General Hospital from September 2021 to March 2022, involving radiographic assessment of condylar morphology from 893 panoramic radiographs. Age, gender, ethnicity and dentition status using Eichner index were extracted from the data. Descriptive statistics were used. Pearson’s chi-square test was used to determine the association between the independent variables (age, gender, ethnicity and dentition status) and the shape of the mandibular condyle. A p-value of < 0.05 was considered statistically significant. Results: Only 450 panoramic radiographs were included in this study. The condyles were outlined and grouped into four categories, namely pointed (40.2%), round (32.8), angled (18.8), and flat (8.2%). Condylar morphology was found to be significantly associated with gender (p<0.005) and insignificant with other independent variables. Conclusion: The findings suggest that the most prevalent condylar morphology among the Sarawak population is the pointed shape, in contrast with other previous studies that reported the round shape condylar morphology as the majority shape.

Background: Atopic dermatitis (AD) is a common chronic inflammatory skin disorder that significantly burdens both children and caregivers’ quality of life. This study aimed to investigate the prevalence and sociodemography of AD and determine its impact on the quality of life among AD children and their families in Sarawak. Methods: This was a cross-sectional, observational population-based epidemiological study of primary school children in Kuching. The U.K. Working Party’s Diagnostic (UKWPD) criteria was utilized to diagnose atopic dermatitis. Disease impact on quality of life was assessed via standardized questionnaires. Skin examination was performed. Results: A total of 968 children aged 7 to 12 years were recruited. The prevalence of AD was 7.0%. Malays were the commonest affected ethnic group. Most of the AD children had other associated atopies. Majority of children with AD had mild to moderate severity based on IGA with mean EASI score (standard deviation) of 1.50 (2.0). The mean Children’s Dermatology Quality Life Index (CDQLI) and Dermatitis Family Impact (DFI) were 7.26 (5.53) and 7.74 (6.12), respectively. “Symptoms of itch, sore or pain” was the most affected domain in children, whereas “Treatment impact” most affected in families. There was significant association between disease severity and children’s quality of life. Conclusion Atopic Dermatitis is common in Kuching school children. Children with AD and their families had a significant impact on quality of life, although most were mild diseases.
Dermatitis, Atopic ; Sarawak (Malaysia)

Introduction: A proper prioritisation system of emergency cases allows appropriate timing of surgery and efficient allocation of resources and staff expertise. The aim of this study was to determine the impact of colour coding classification on Time-to- theatre (TTT) of patients in comparison with the normal practice. Method: Categorisation was a surgical judgment call after thorough clinical assessment. There were 4 levels of urgency with their respective TTT; Red (2 hours), Yellow (8 hours), Green (24 hours), Blue (72 hours). Caesarean cases were excluded in colour coding due to pre - existing classification. The data for mean TTT was collected 4 weeks before the implementation (Stage 1), and another 4 weeks after implementation (Stage II). As there was a violation in the assumption for parametric test, Mann Whitney U test was used to compare the means between these two groups. Using logarithmic (Ln) transformation for TTT, Analysis of Covariance (ANCOVA) was conducted for multivariate analysis to adjust the effect of various departments. The mean TTT for each colour coding classification was also calculated. Results: The mean TTT was reduced from 13 hours 48 min to 10 hours, although more cases were completed in Stage II (428 vs 481 cases). Based on Mann-Whitney U test, the difference in TTT for Stage I (Median=6.0, /IQR=18.9) and Stage II (Median=4.2, IQR=11.5) was significantly different (p=0.023). The result remained significant (p=0.039) even after controlled for various department in the analysis. The mean/median TTT after colour coding was Red- 2h 24min/1h, Yellow- 8h 26min/3h 45 min, Green- 15h 8min/8h 15min, and Blue- 13h 46min/13h 5min. Conclusion: Colour coding classification in emergency Operation (OT) was effective in reducing TTT of patients for non-caesarean section cases.

Introduction: A cross-sectional study is used to evaluate the lifestyle factors associated with cardiovascular disease (CVD) risk among healthcare workers in tertiary hospitals in Sarawak, Malaysia. Methods: A questionnaire-based survey using the Simple Lifestyle Indicator Questionnaire (SLIQ) was administered to, and anthropometric measurements were collected from, 494 healthcare workers. Results: Te mean age of the subjects was 32.4±8.4, with a range of 19 to 59 years. Te subjects were from the allied health (45.5%), management and professional (25.1%) and executive (29.4%) felds. Overall, 47.4% of the subjects were of normal weight, 30.2% were overweight, 17.2% were obese and 5.2% were underweight. Te mean number of working hours per week for the subjects was 47.6±14.0 with the highest working hours found among the management and professional group, followed by the executive and allied health groups. Overall, 39.7% of the healthcare workers worked ofce hours, 36.6% worked within the shift system, 20.9% worked ofce hours and were on-call and the remaining 2.8% worked a mixture of ofce hours and shifts. Based on the SLIQ score, 58.1% were classifed as at intermediate risk for CVD, 38.5% were in the healthy category and 3.4% were in the unhealthy category. Factors associated with a healthier lifestyle were being female (Odds Ratio [OR]= 12.1; CI= 3.2- 46.4), professional (mean score= 6.70), in the allied health group (mean score=7.33) and in the normal BMI group (OR= 9.3, CI= 1.8- 47.0). Conclusion: In our study, healthcare workers had an intermediate risk of developing CVD in the future. Tus, there is a need to intervene in the lifestyle factors contributing to CVD.

Objective: A quick assessment tool for screening individuals with depression or anxiety is pertinent in mental-health set up. This study aims to validate the K10 and the K6 to screen patients with non-specific psychological distress in a Malaysian population. Methods: Translation of the questionnaire was done from English to Malay. Face validity was conducted on patients, and a pilot study was performed to assess the reliability of the K10 questionnaire. Fieldwork was conducted to determine the reliability and validity of the K10 questionnaire based on convenience sampling of healthy individuals and patients diagnosed with psychiatric illness. Malay version for K10 was administered to healthy participants (group without psychological distress) and patients on psychiatric clinic follow up (psychological distress). Data collection was done between August 2016 and September 2016. Result: A total of 94 subjects were recruited in the study, of which 32 formed the case group. The Cronbach’s alpha coefficients for K10 were 0.837(control) and 0.885 (case), as for K6 were 0.716 (control) and 0.859 (case). The total score of the K10 and the K6 clearly differentiated between the control and case groups (p<0.001). The area under the curve for K10 and K6 were 0.84 with 95% CI (0.81, 0.96) and 0.86 with 95% CI (0.77, 0.94) respectively. For K10, at the optimal cut-off score of 17, the sensitivity and specificity were 84.4% and 75.3% respectively while for K6, at the optimal cut-off score of 11, the sensitivity and specificity were 78.1% and 75.8%, respectively. Conclusion: The Malay version of the K10 and the K6 are reliable and valid to be used for screening patients with non-specific psychological distress in a Malaysian population. Kessler psychological distress scale has minimal items and yet this Kessler psychological distress scales have minimal items and yet are an effective screening tool.

Introduction: Non-communicable diseases (NCD) is a global health threat. the Chronic Care Model (CCM) was proven effective in improving NCD management and outcomes in developed countries. Evidence from developing countries including Malaysia is limited and feasibility of CCM implementation has not been assessed. this study intends to assess the feasibility of public primary health care clinics (PHC) in providing care according to the CCM. Methodology: A cross-sectional survey was conducted to assess the public PHC ability to implement the components of CCM. All public PHC with Family Medicine Specialist in Selangor and Kuala Lumpur were invited to participate. A site feasibility questionnaire was distributed to collect site investigator and clinic information as well as delivery of care for diabetes and hypertension. results: there were a total of 34 public PHC invited to participate with a response rate of 100%. there were 20 urban and 14 suburban clinics. the average number of patients seen per day ranged between 250-1000 patients. the clinic has a good mix of multidisciplinary team members. All clinics had a diabetic registry and 73.5% had a hypertensive registry. 23.5% had a dedicated diabetes and 26.5% had a dedicated hypertension clinic with most clinic implementing integrated care of acute and NCD cases. Discussion: the implementation of the essential components of CCM is feasible in public PHCs, despite various constraints. Although variations in delivery of care exists, majority of the clinics have adequate staff that were willing to be trained and are committed to improving patient care.

Background: In the course of managing preterm labour, increasing trends of total white cell count raises concern for the obstetrician, suggesting a possible underlying infectious aetiology. Although mild leukocytosis is expected in pregnancy, the patterns of increment after corticosteroid administration are not well described beyond animal models and in a small number of human studies. Methods: Seventy-three consecutive patients who required antenatal corticosteroids for either preterm labour or prelabour caesarean section were recruited and given a standard course of 12mg dexamethasone phosphate, twelve hours apart. Venous blood samples were taken before administration, at six hours and 36 hours after the first dose of dexamethasone. Results: The total white count trend was 10.31±2.62 at baseline, 11.44±3.05 at six hours and 12.20±3.49 at 36 hours. Neutrophil-lymphocyte ratio was 3.60±1.31, 8.73±3.63 and 3.24±1.49 respectively, reflecting relative neutrophilia and lymphopenia which normalised by 36 hours. Conclusion: In contrast to previous studies, we found only a slight increment in total white cell count of about 10%. The marginal changes described in our study would not normally raise any clinical concern, although vigilance should be exercised if higher levels were observed.
Leukocytosis ; Pregnancy

Objective: We aimed to validate the Malay version of Diabetes Quality of Life (DQOL) questionnaire for Malaysian adult population with type 2 diabetes mellitus (DM). Methods: This is a cross-sectional study to validate Malay version of DQOL among the adult diabetic patients. DQOL questionnaire has 46 items consist of three domains, namely Satisfaction Domain, Impact Domain and Worry Domain. Both forward and backward translations from the English version of DQOL into Malay version were performed. After the face validity of the Malay version was established, it was then pilot-tested. Finally, the validity and reliability of the final Malay version of DQOL questionnaire were evaluated. Results: There were 290 patients participated in this study with a mean (SD) age of 53.1 (10.0) years. The Cronbach's alpha coefficients of the overall items and the main domains were between 0.846 and 0.941. The Pearson's correlation coefficients for the three domains were between 0.228 and 0.451. HbA1C was found to be positively correlated with Impact Domain (P = 0.006). The Worry Domain was associated with diabetic retinopathy (P = 0.014) and nephropathy (P = 0.033). Conclusion: The Malay version of diabetes quality of life (DQOL) questionnaire was found to be a valid and reliable survey instrument to be used for Malaysian adult patients with diabetes mellitus.