THE IMU CLINICAL SCHOOL RESEARCH DAY - IMU

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functional value of the patient. Furthermore, there were few limitations in our study which we need to explore further to get better outcome. OP04 Knowledge and Awareness of Cervical Cancer Among General Population in Seremban Foo Chuan Yi, Anishia A/P Veerappan, Annanthajothi A/P Revichandran, Adeline Lau Mai Chuan, Heong Yu Qian Objectives: The purpose of this study is to evaluate and ascertain the current knowledge and level of awareness toward cervical cancer (CC) among general population in Seremban. Methods: A cross-sectional study was conducted which involved 461 women and men aged between 21 and 60 years old at the public in Seremban, a subsequent statistical analysis was performed by SPSS version 25. Results: The study showed that the female population has higher knowledge and awareness level of cervical cancer than male and it was statistically significant (P < 0.05). Some of the gaps identified are the knowledge that only 36.6% of female respondents and 30.8% male respondents in Seremban are aware that multiparity is one of the risk factors for cervical cancer. The study showed that 56.6 % of male population were aware that multiple sexual partners can cause cervical cancer compared to 76.2% of female population. Both males and females identified smoking as more a cardiovascular risk rather than a risk for cervical cancer. Men were found to be more aware that obesity was a risk factor for cervical cancer. Unfortunately, in our study, only 48.4% men had awareness on this aspect. There was also poor knowledge on prolonged use of oral contraceptive pills and the correlation to cervical cancer as well as the fact that using intrauterine device helps in preventing cancer cervix. Only 47.3% males were aware that family history of cervical cancer increases risk of the female getting cervical cancer Conclusions: Our study in Seremban showed a statistically significant difference in knowledge and awareness level of cervical cancer between female and male populations in Seremban. Females have a higher awareness score. As Malaysia is culturally still a paternalistic society, increasing the knowledge of the males regarding the risk factors, causes, warning signs and preventive methods of cervical cancer will help in the males supporting and encouraging the females in the families to screen and prevent cervical cancer. Therefore, one of the targeted interventions to decrease cancer cervix is to educate our male population on cancer cervix prevention as well as our female population. There should be education material and media campaigns designed to reach out to the male population to assist them in acquiring the necessary knowledge. OP05 Comparing Self-Reported and Objective Smartphone Usage in Determining the Smartphone Addiction Risk Among Medical Students in a Malaysian Private University 10 Lim Yee Ching, Mark Kar Kei, Michael Lim Yang Song, Michelle Lim Wan Xuan, Mohamed Aman Page Waseem Background and aims: Smartphone addiction is on the rise among university students in Malaysia. Millennials spend a significant amount of time on their smartphones each day. Hence, smartphone users may be at a significant risk for addiction. This study explored the difference between self-reported and objectively collected smartphone usage data among medical students in International Medical University (IMU) and its relationship with smartphone addiction risk. Methods: This cross-sectional study was conducted on 155 medical students from semester 6 to semester 9 in International Medical University (IMU) through random sampling from 20 January 2019 to 14 June 2019. Data were collected via self-reported and objective smartphone usage questionnaire and Smartphone Addiction Inventory (SPAI) questionnaire. Collected data were analysed by IBM Statistical Package for Social Science (SPSS) Statistics Software version 24.0. Results and discussion: In total, 12.9% of participants are at risk of developing smartphone addiction. It shows a positive linear correlation between duration of smartphone usage during weekend and risk of smartphone addiction as shown by significance level (p-value) of less than 0.05. Self-reporting smartphone use may be provisional but are not accurate measures for actual use. We could guess that it is likely that 'self-conscious' users are likely to be careful, sensitive or depressed and are more aware of their behaviour. An objective data should be more advisable in future research as the self-report based decisions for diagnosis and improvement are apt to fail in reflecting the real state of the subjects. Conclusion: The findings indicated that self-reported usage duration can come close but are not accurate measures of actual duration of smartphone use. Moreover, usage time may not be a good indicator of addiction risk since it may be used for educational purposes. Hence, it is advisable to use an objective method to obtain data for future research rather than self- reported data. OP06 Efficacy and Safety of Prostaglandins vs Double Balloon Catheter in Inducing Labour: A Meta- Analysis Jia Sheng Chong, York Lin Chew, Ayendra Fernando Objective: To compare the efficacy and safety of double‐balloon catheter with prostaglandin E2 (PGE2) in the induction of labor. Search strategy: We searched electronic sources from MEDLINE, SCOPUS, PubMed, Science Direct and Cochrane Library Database of Systematic Reviews. Selection criteria: Only randomized controlled trials and observational studies comparing the PGE2 agents with double-balloon catheter for cervical ripening and labour induction in women with unfavorable cervix were included in the analysis. Data collection and analysis: The main outcomes included the vaginal delivery rate within 24 11 hours and cesarean section rate. We calculated relative risks and mean differences using fixed‐ and random‐effects models. Page Main results: Prostaglandin was more favourable for vaginal delivery within 24 hours compared to double balloon, but was not statistically significant (RR 1.17, 95%CI: 0.96-1.42, p =0.12). The induction to delivery time yielded a non-significant result that again favors prostaglandin (SMD 0.02, 95%CI: -0.18,0.22, p = 0.86). There was no significant difference in the cesarean section rate between the two groups (OR 1.00, 95% CI: 0.84-1.19, p = 0.97). Uterine hyperstimulation and Neonatal Intensive Care Unit (NICU) admissions were significantly higher with prostaglandin. (RR 0.09, 95%CI: 0.04, 0.23 p<0.00001 and RR 0.75, 95%CI: 0.61,0.92 p=007). Conclusions: No significant difference in the success of induction of labor. Uterine hyperstimulation and NICU admission was significantly higher in Prostaglandin group. OP07 Perception of Trust Among Ambulatory Patients Towards Their Healthcare Providers in Seremban: A Preliminary Exploration Using the Health Care Relationship Trust Scale Candal Chew She-Yi, Christine Chiw Yin Yin, Beh Jien Chien, Chong Yue Xin, Chang Rui Zhi Introduction: This study is a preliminary assessment of patient trust towards their healthcare providers among patients attending the Family Specialist Clinic in Klinik Kesihatan Seremban. Methods: A cross-sectional observational study whereby patients are asked to complete a self- administered questionnaire on patient trust. The questionnaire is based on the Health Care Relationship (HCR) Trust Scale and only English-speaking patients were enrolled. Results: 160 patients were enrolled into this study. The mean HCR Trust score was 36.72 (maximum score 52, SD 8.765). The alpha Cronbach was 0.888 (0.899 based on standardized items). There was no statistical difference in the HCR Trust score between age groups, gender, ethnicity, marital status, education level and income levels. Conclusions: The HCR score suggests a moderate trust level in the patients towards their healthcare providers in this clinic setting. Further studies will aim to refine this Scale for use in a wider population of patients in different languages and determine the HCR Score that represents the different levels of trust in our local population OP08 Comparing Prevalence of Depression Between Mothers and Fathers of Children with Autism Jeffrey Tan Yong Ye, Josephine Wong Siew Jin, Kor Win Sheng, Michelle Tham Hooi Chong, Jasvinder Singh Autism, a childhood psychiatric disorder dealing with social skills difficulties and abnormal behaviours have been studied in various perspectives. Research has shown that this disorder is one of the contributing stressors to parents leading to physical, psychological and emotional burden. In our research, we aim to compare the prevalence of depression between father and mother of those children diagnosed with autism. A prospective study of 106 pairs of parents who have children with autism have been studied and screened for depression using a 12 questionnaire and the Beck’s Depression Inventory. Our exclusion criteria include children from Page divorced family or children with other congenital disorders. The results have shown that mother has a higher prevalence rate of 59.4% to fall into depression as compared to father who only has 44.3% of prevalence rate to fall into depression. Some contributing factor that we have identified includes education level of the parents, monthly income, number of children with autism, period of diagnosis and the time spent with child per day. In conclusion, our hypothesis of mothers of children with autism do have a higher prevalence rate as compared to fathers. Early intervention can be offered for a better quality of life for the family. 13 Page ELECTRONIC POSTER PRESENTATIONS EP01 A Descriptive Study on Parental Expectations of Urban Private Paediatric Outpatient Service Lo Yee Miin, Lee Pei May, Leonna Lim Suk Hui, Ng Xin Yin, Mark Kar Man Objective: To assess parental expectations of a paediatric clinic in terms of services and facilities Methods: A survey was conducted among parents in two urban paediatric clinics by using self- administered questionnaire. It consisted of three sections to assess parents’ expectation on various aspects of services and facilities offered in the paediatric clinic together with their demographic information. 6-point Likert scales were applied in the questionnaire to obtain quantitative responses. Parents whose children were less than 18 years old were included while those who were related to the institutions were excluded. Statistical Package for the Social Science (SPSS) software version 25 was used for data analysis. Results: 387 questionnaires were filled up by the parents from both paediatric clinics. Most of the respondents were 38 years old and younger (63.3%), female (66.4%), and Chinese (58.7%). Most of the parents responded synonymously in terms of frequency on the Likert scale such as on the issue of medications, most of them would like to receive antibiotics when their children had high-grade fever (65.4%). On the aspect of doctors’ general appearance, the parents expected them to wear a white coat in the clinic (64.1%). The side effects of the medication (97.4%), consultation charges (83.2%), treatment charges (81.9%) as well as special facilities like breastfeeding room (92.5%) were shown to influence parents’ decision making in choosing a paediatric clinic. Furthermore, the parents with higher education level had lower expectation in receiving antibiotic (Mean: 3.88) as opposed to the lower education group (Mean: 4.48). Both higher and lower income groups agreed that consultation charges and treatment charges were important determining factors, with a mean of 4.30 and 4.63 respectively. Conclusion: Parents have moderate to high expectations for most of the services and facilities that could be, if not already provided, served in an urban private paediatric clinic. Improving such areas will fulfil parents’ expectation and increase the satisfaction towards patient care. EP02 Perception Towards Medical Related Applications Use in Smartphones and Tablets Among Medical Students Chan Yu-Ze, Ching Sue Lynn, Chong Chiun Perng, Fatin Nur Aina Ainie Binti Marzuki, Hawwa Nadha Najeeb Introduction: The usage of medical applications is reported to benefit students’ learning experience and has become increasingly popular among medical students. Various literatures 14 have evaluated the level of smartphone ownership among medical students and their patterns of usage of medical applications. The study of students’ perceptions towards medical Page applications use and the barriers faced by them during the usage of such applications is relatively lacking. Methods: This cross-sectional study was conducted in International Medical University Clinical Campus, Seremban, Negeri Sembilan, Malaysia. Self-administered paper-based questionnaires were distributed to medical students from semesters 6 to 9 who owned at least one mobile device. A total of 161 medical students participated in this study. Results: Majority of the students agreed that medical applications are a reliable and convenient source of information. In terms of professionalism, the students generally agreed that the usage of medical applications in clinical settings can be perceived as unprofessional. The students did not face much barriers while using medical applications, other than the lack of financial power to purchase certain applications. Conclusion: The participants of this study generally regard the usage of medical applications as an efficient means of enhancing their medical knowledge. They reported a possibility of compromised professionalism, as the majority agreed that the usage of medical applications in clinical settings can be perceived as rude and less engaged. The lack of financial power for purchase or subscription to certain medical applications was the main barrier faced by medical students. The usage of medical applications among medical students should be encouraged, as their accessibility and convenience expedite the process of learning. However, while using medical applications in the clinical setting, medical students should remain professional. EP03 Physical Activity and Quality of Life Among Medical Students in a Private Healthcare University of Malaysia Wong Zhen Zhe, Tan Lu Quan, Tan Shin Kiat, Ung Lik Ning Introduction: Physical activity has been well known to bring benefits and is hence crucial to good health. Quality of life (QoL), on the other hand, is important in health promotion and is known as a motivator of physical activity. Multiple studies have suggested an association between level of physical activity and quality of life. Therefore, this study aims to assess the level of physical activity and quality of life of medical students in a private institution (International Medical University Malaysia), and to determine any association between their level of physical activity and quality of life. This study will also compare the level of physical activity and quality of life between pre-clinical phase and clinical phase medical students. Methods: A cross-sectional study was conducted among medical students from International Medical University Malaysia, Malaysia’s most established private healthcare university to identify any association between level of physical activity and quality of life. The International Physical Activity Questionnaire (IPAQ) – Long Version is used to measure the participants’ level of physical activity, whereas the WHO Quality of Life – BREF (WHOQOL-BREF) Questionnaire is used to assess the participants’ quality of life (QoL) from various aspects and domains. Results: Out of 298 medical students, 35.2% of all students were highly active, 40.3% of 15 students were moderately active and 24.5% of students had low levels of physical activity. QoL of participants were reported using a 0-100 scale recommended by WHOQOL-BREF User Page Manual based on general quality of life, perceived health condition and 4 other domains, namely physical, psychological, social and environmental. Participants with high level of physical activity have significantly better self-perception of health condition compared to those with moderate and low levels of physical activity (p < 0.05). There is no significant difference between level of physical activity and quality of life between pre-clinical and clinical phase medical students. Conclusion: There is a positive association between level of physical activity and the perception of health condition among the medical students. However, more studies should be conducted to establish associations between different types of physical activity and the different aspects of quality of life EP04 Prevalence of Depression amongst Hemodialysis and Continuous Ambulatory Peritoneal Dialysis (CAPD) patients Lim Zi Xuan, Joanne Ong, Manthira Suresh, Lee Zheng Yang Brandon, Lai Lee Suan End stage renal disease (ESRD) is a chronic disease in which the kidneys cannot regulate electrolytes, acid-base balance, and fail to excrete waste products. ESRD can be treated by hemodialysis, peritoneal dialysis, or kidney transplantation. In Malaysia, by the end of 2016, 35781 patients were on hemodialysis (HD) and 3930 were on peritoneal dialysis (PD).1 Many chronic illnesses such as diabetes mellitus and hypertension are associated with depression. ESRD also has a prevalence of depression of 15%. As the commonest psychological condition amongst ESRD patient, depression also affects the compliance of the patients towards their treatment. Study also showed that ESRD patients have a 4-fold risk of depression than the general population. Depressed dialysis patients are more likely to face complications; some studies have demonstrated a relationship between depression and mortality in hemodialysis patients. EP05 [WITHDRAWN] EP06 Online Health Information Seeking Behaviour Yip Kah Chun, Lim Hooi Min, Wong Swee Shiuan, Adrian Chin Jian Zhi, Felicia Chang Wen Si, Teo Chin Hai, Adina Abdullah, Ng Chirk Jenn, Affiliations: Department of Primary Care Medicine, University Malaya, Kuala Lumpur Email: [email protected] Background: Internet plays an increasing role in health information access. There are conflicting views about the values of the internet as a tool to improve health outcomes. Online health information seeking showed to affect health outcomes, medical consultation, and patient-doctor 16 relationships. Objectives: To determine the prevalence of the use of the internet to seek health information Page and its associated factors among patients in a primary care clinic Methods: A cross-sectional questionnaire study was conducted on June 2019 in an outpatient primary care clinic in University Malaya Medical Centre. Patients aged ≥ 18 years were recruited using a systematic random sampling method. The questionnaire included socio-demography, online HISB, and eHealth literacy by using eHealth Literacy Scale (eHEALS). Data were analyzed using descriptive statistics and multiple logistic regression. Results: A total of 381 patients were recruited. The mean age was 57.1± 16.9 years with 62.7% (n=239) of female patients. There were 88.4%(n=336) patients had upper secondary education and above. A total of 54.7% (n=208) patients have used the internet to search health information in the past one month. The main online sources are Google (96.2%, n=200), WhatsApp’s (74.5%, n=155), YouTube (56.7%, n=118) and Facebook (55.3%, n=115). Higher education levels, longer duration of internet use and eHEALs score were significantly associated with online health information seeking. Discussion: This study contributes to a clearer understanding of the online HISB among patients in primary care setting. The use of search engines and social media as the main source of health information might contribute to the trust of misleading information if patients are unable to critically evaluate the information. Open discussion between doctors and patients regarding online health information has the potential to enhance doctor-patient partnership in health management. EP07 Would Empathy in Medical Students Be Affected by Their Mental Health Status? Choo Jian Yong Kazuya, Ho Mun Han, Iu Sheak Ni, Janet Leu Su Hui, Katthiraavan A/L Thiruvengadam Background: Empathy has been labelled the cornerstone of physician-patient relationship while higher prevalence of depression, anxiety and stress has been well-established. This study examines the relationship of depression, anxiety and stress with empathy among clinical year medical students of International Medical University (IMU) Method: A cross-sectional study of Semester 6 to 9 clinical year IMU students was conducted through the administration of validated, self-administered questionnaire of Depression, Anxiety and Stress Scale-21 (DASS-21) and Toronto Empathy Questionnaire (TEQ). Results: 221 responses were included in the analysis. The prevalence of depression, anxiety and stress were 39.3%, 53.4% and 27.9% respectively. The mean empathy score was 45.28 ± 7.332. Empathy score was significantly different among posting (p=0.019), with Obstetrics and Gynaecology (O&G) having the lowest empathy score (41.65) and Orthopaedics having the highest (47.25). Statistically significant relationship was found between stress and empathy in male students (p=0.028). Conclusion: The level depression, anxiety, stress and empathy among IMU clinical students were similar to that reported for comparable groups. The empathy was lowest during O&G posting and highest for Orthopaedics. There was a relationship between stress and empathy in 17 male students. Future research is needed to determine the factors affecting lower empathy scores in specific postings. Page EP08 Knowledge Regarding Chickenpox Disease and its Prevention Among Clinical Students in International Medical University Lawrence Ling Siaw Yee, Leow Kok Hoong, Lim Su Ying, Ian Yoo Yong Li, Isabel Yah Chuen Hwee Introduction: Chickenpox is a highly infectious disease that can cause complications such as bacterial superinfection of the skin, meningeal involvement, and so on. Objective: To assess the knowledge of medical students on chickenpox and to find out if there is a significant difference of knowledge of chickenpox between senior medical students (semester 9 & 10) and junior medical students (semester 6 and 7). Methods: A cross-sectional study of 203 students (95 from semester 6 & 7 and 116 from semester 9 & 10) from IMU campus in Seremban, Kluang and Batu Pahat was performed. A structured questionnaire has been constructed to collect and gather data on the subject’s knowledge regarding chickenpox, consisting of 15 true or false statements. Results: The level of knowledge on varicella was inadequate as 79.1% of the respondents score less than 65% (Passing Score) in the questionnaire. The respondents in semester 9 and 10 performed considerably better with a 26.7% passing rate compared to respondents in semester 6 and 7 where only 13.7% of the respondents passed. Conclusions: We concluded that the level of knowledge of varicella among respondents was inadequate with better knowledge among semester 9 and 10 students compared to semester 6 and 7 students. More awareness and vaccination programs should be held in University to educate students on the serious complications of chickenpox and the advantage of taking effective preventive measures EP09 The Prevalence of Depression, Anxiety and Stress and Its Association With Sleep Quality Among Medical Students of International Medical University Bong Jing Xian, Cheong Chee Qing, Woon Jia Sern, Vigneswarar A/L Velu, Zabedul Haque Patowary Introduction: Medical students were found to have deteriorating sleep quality, which is linked to depression, anxiety and stress but insufficient updated data to identify the present status. Objective: To (a) identify the association of sleep quality with depression, anxiety and stress among medical students, and (b) determine the prevalence of depression, anxiety and stress among pre-clinical and clinical phase IMU medical students. Methods: A cross sectional study was conducted on 329 medical students from International Medical University in Malaysia. Self-administered questionnaires were used to obtain the data. Depression Anxiety Stress Scale-21 (DASS-21) was chosen to screen for depression, anxiety and stress while Pittsburgh Sleep Quality Index (PSQI), was used to assess sleep quality. 18 Results: Analysis showed among all students, 19.4% had moderate depression, 22.6% had moderate anxiety, 8.2% of moderate stress. Depression and anxiety were more prevalent in Page preclinical phase students while sleep quality was poorer among clinical phase students. Depression, anxiety and stress are significantly associated with sleep quality. Conclusions: Anxiety had the highest prevalence compared to depression and anxiety. There is significant correlation of the three components of DASS-21(depression, anxiety, stress) to presence of clinical exposure, except for stress, and also its relation to sleep quality. More researches need to be conducted to further understand the causes of these differences in order to develop a better support programs and interventions for these groups of medical students. EP10 Trend of Cigarette Smoking Among Malaysian Adults: A Systemic Review of National Surveys Ashiya Begum Rafiq, Abu Bakar Tayyib, Andrew Wong Wei Jye, Calvin Lau Koh Sii, Sajini De Silva Objectives: To synthesize the smoking prevalence by age group among adults, gender, ethnicity over a 30-year period. Methods: The search strategy was implemented on two databases (PubMed and Scopus), Ministry of Health Malaysia website and contact with investigators between January 1986 and December 2017. National level studies with available English articles were included. Results: The data collected from the studies included in this review show a gradual drop in overall prevalence of smoking among Malaysian adults. Nonetheless, the prevalence of smoking among the males is not only higher than females, it has also shown a rise by 1.4% over the years. The prevalence of smoking among adults is highest among Malays compared to Indian and Chinese. Conclusion: This systemic review of the literature reports the decreasing trends of overall prevalence of smoking among Malaysian adults. Nonetheless, when subdivided according to gender, a slight increment is seen among the male gender. Therefore, further modified efforts and policies by the government may be necessary in handling this issue in the country. EP11 E-health Literacy and Trust of Online Health Information Among Patients in Primary Care Clinic Wong Swee Shiuan, Lim Hooi Min, Yip Kah Chun, Adrian Chin Jian Zhi, Felicia Chang Wen Si, Teo Chin Hai, Adina Abdullah, Ng Chirk Jenn. Affiliations: Department of Primary Care Medicine, University Malaya, Kuala Lumpur Email: [email protected] Background: The advancement in technology and the internet has changed the pattern of health information seeking behavior among patients. eHealth literacy is important which enables people to gain, assess and apply online health information. 19 Objectives: This study aims to determine the eHealth literacy of patients attending primary care clinic and its associated factors. It examines patients’ trust and ability to assess online health Page information. Methods: This is a cross-sectional study done in June 2019 in a primary care clinic in University Malaya Medical Centre. Patients aged 18 years old and above who attended the primary care clinic during the study period were recruited using systematic random sampling. eHealth literacy scale (eHEALS) was used to assess the eHealth literacy. A 5-point Likert scale was used to assess the trust of online health information sources. Data were analyzed using descriptive statistics and multiple linear regression. Results: Among 381 patients, the mean age was 57.1±16.9 years with 51.2%(n=195) aged ≥60 years. The mean eHEALS score was 24.4±7.6. The predictors for the eHEALS score were age, educational level, household income and duration of internet use. The trust of online health information was low (website 45.6%, search engine 41.1%, social media 21.7%) among patients who searched for health information online (n=208). Patients know what health information available online, how to search, locate and use this health information. However, they were lack of skills to assess the quality of health information especially on the aspects of privacy and sponsorship of the source. Discussion: This study reports a low eHealth literacy among patients in primary care as compared to eHEALS observed in other developed countries. The lack of confidence in evaluating online health information may lead to lower trust in online sources. Raising public awareness and patient education are needed to empower the eHealth literacy. EP12 Is Hand Hygiene Practised by Medical Students During Their Clinical Training? Toh Ee Syuen, Tey Yee Qi, Aishath Hana Zahir, Wenny Lee Pei Yi, Wong Sai Chin Background: Hand hygiene and hand washing is the first and basic clinical skill that is being taught in every medical school. However, the application of this skill into our basic practice has not been up to par due to multiple reasons when in clinical practice. The aim of the study was to determine the prevalence of adherence to hand hygiene protocol and the obstacles faced by medical students in performing hand hygiene in their clinical phase. Methods: We carried out a cross-sectional study via observational study, questionnaire survey and focus group study. We observed IMU medical students from 6 wards in Hospital Tuanku Jaafar for presence or absence of performing hand hygiene, before and after performing a physical examination on a patient. Upon completion of observation, the study subject is asked to complete a questionnaire on perceptions towards handwashing. We carried out two 30- minutes focused group discussion with 6-8 IMU medical students (Semesters 6, 7, 8, and 9), to discuss the reasons behind barriers to hand hygiene practice faced by medical students in clinical settings. Results: 68.4% (n=106) of the students observed practised hand hygiene (HH) before performing a physical examination (PE) on a patient, while 81.9% (n=127) practised HH after performing a PE. After a physical examination, male students were found to be less likely to perform HH compared to female students. Students in the Accidents & Emergency Department 20 wash their hands less compared to those observed in other wards. The top three reasons for not performing HH are forgetfulness, lack of accessibility of alcohol hand-rubs, and laziness. Page Discussion: Overall, the adherence to hand hygiene protocols amongst IMU medical students is deemed satisfactory. Future efforts to improve adherence include having periodic revision classes, briefings about hand hygiene before students enter each posting. Interventions can be targeted more towards students posted in the Accidents & Emergency department and male students. Hospitals can help adherence by increasing availability of bedside alcohol hand-rubs and wash basins. EP13 Research on Measuring Whole Gut Transit Time (WGTT) Among IMU Students Aged 20-24. Ling Chian Voon, Heyman Raj Bari, Lye Xin Yi, Lai Kah Jing, Janani Arjunan Objectives: To study the risk factors contributing to constipation and significance between clinical history and measured WGTT. Methods: 128 participants from IMU student aged 20-24 years old were recruited in this cross- sectional study which fulfilled the minimal number of sample size calculation. WGTT was measured using stool staining markers. Questionnaire was used to obtain the demographic data. The analysis of data was performed with SPSS 25, the test included descriptive study, Person Chi square and fisher exact. Results: The mean (95%CI) of the two attempts with carbon showed no significant difference (p=0.787). The mean WGTT for the two attempts with dragon fruit also show no significant difference (p=0.319). On all four occasions either with carbon or dragon fruit WGTT was <40 hours for 82-90% of individuals. Several individuals had WGTT <40 hours on one occasions and ≥40 hours on the other occasion classified into inconsistent group. The inconsistent group had 11.7% of subjects with carbon and 8.6% of subjects with dragon fruit. Over 4 occasions 75.8% of subjects were consistent in their group, of these only 1.6% had consistently long WGTT. 18.5% were inconsistent once. The remainder 5.6%, had long and short WGTT half the time. WGTT was significantly different for gender, ethnic group, frequency of bowel motion and Bristol stool type. It was not different for other features of bowel habit. Neither was it significant for lifestyle factors such as meat intake, exercise and feeling stressed. Discussion: Hylocereus polyrhizus demonstrated a prokinetic effect in whole gut transit time. Gender and ethnicity among IMU students are significantly associated with the whole gut transit length. 21 Page PRINT POSTER PRESENTATIONS PP01 Incidence of Never Smokers with COPD in Hospital Tuanku Jaafar: A Prospective Study Say Wei Xian, Siam Tze Xin, Tee Chen Giap, Wong Zhen Yu, Yee Li Xien Introduction: Chronic Obstructive Pulmonary Disease (COPD) is expected to be ranked as the world’s third leading cause of death by 2030, contributing to huge socio-economical and public health burden worldwide. While smoking has been recognized as the primary factor contributing to COPD, there are multiple studies proving their pivotal causative role in COPD. Up to almost 50% of COPD patients are non-smokers but this fact is often overlooked. According to a study conducted by Chest Journal, 42.9% of COPD patients were found to be never-smokers. The main objectives of this study are to report the incidence of never smokers in COPD patients, reassess the significance of smoking as a risk factor for developing COPD and to discuss the role of other risk factors in relation to causing COPD. Method: A prospective study was done in 112 COPD patients above the age of 49, including those with other comorbidities. Patients younger than 50 years old, having COPD as sequela to other diseases (e.g., Tuberculosis) or having bronchial asthma were excluded. A questionnaire was developed to collect data from our sample (Appendix B). Results: From the sample of 112 COPD patients, 55.4% are ex-smokers, 38.4% are active smokers and 6.3% are never smokers. Several other factors were outlined to contribute for the development of COPD, however none of them are statistically significant. Conclusion: Smoking remains to be the dominant factor in causing COPD. However, some of the other factors are not consistent with published studies. Further research is certainly vital as COPD remains as a major healthcare threat to our citizens. Public education regarding COPD and smoking is also needed in order to tackle this dilemma. PP02 Medical Students’ Actual Exposure to Recommended Radiology Cases in The Logbook at the Undergraduate Level Perry Faith Tan Tze Ming, Sangaraamunisen A/L Ramachandran, Nurul Amirah Binti Alias, Sharifah Sarah Binti Syed Abdul Rahman The field of radiology has been rapidly improving with the constant introduction of modern imaging techniques. Thus, it is undeniable that in medical practices radiology has become a very crucial tool in diagnosis. However, the exposure of medical students to radiological cases has been very vague. In this study, we aim to compare the medical logbook radiological case requirements to the actual exposure of medical students to radiological cases. We are hoping 22 to improve the radiological curriculum in regard to medical students’ exposure to radiological cases. In this study, more than half of the students, 51.82% reported that the exposure to Page radiology cases during radiology posting is inadequate. 40.91% (N=45) specified the cases they wish to learn further. Top four cases listed include abdominal x-ray (37.78%), sarcoidosis (8.89%), bronchiectasis (8.89%), and intracranial bleed (8.89%). 24.55 % students (N=27) specified the radiology procedures they wish to observe that were not included in the logbook. Top three cases listed are CT angiogram (18.52%) followed by positron-emission tomography PET Scan (14.81%), and CT urogram (11.11%). Radiology teaching is still deemed as inadequate at the undergraduate level. It should be made accessible to all undergraduate levels especially in the clinical phase of medical school. The lack of this field may jeopardize the future prospects of Malaysia’s healthcare system. PP03 Perception on Biofilm Among IMU Medical Students: A Cross-Sectional Study Ngu Chew Hua, Nur Khairina binti Rosli, Muhammad Mushayyad bin Aslam, Nesha A/P Balakrishnan, Ooi Sue Yuen Background: There is an increasing recognition in biofilm as new evidences show up to prove its significance in the field of medicine. But its awareness among medical students remain unknown. Aim: To determine and compare the awareness on biofilm among undergraduate medical students from International Medical University and to determine IMU students’ perception on biofilm. Materials and methods: A cross-sectional descriptive self-constructed questionnaire-based study was conducted among medical students from International Medical University (IMU). A total of 100 students participated. Results: Out of the 100 students, 23 were found to have poor awareness, 35 students were found to have average awareness and 42 students were found to have good awareness. There is no significant different in the awareness among the students. Generally, students have good perception on biofilm. Conclusion: Biofilm is a blooming field in clinical practice and research. Medical students with good prior knowledge to biofilm would be beneficial to their practice in the future. Certain actions can be taken to boost the awareness among medical students. PP04 Support Received During Toilet Training Process in Children Nurlina Hosni,, Nor Heidi Izzat Nor Azman, Nor Hazira Hishamuddin, Nur Ain Mohamed Halim. Background: Toilet training (TT) is an important milestone in a child’s development. The process can be frustrating and exhausting for many inexperience parents. Adequate support and information for parents may lessen parent’s anxiety and ensures the child has a pleasurable experience. Problems during TT may lead to possible negative consequences and should be 23 address early. The study aimed to explore the support parent’s received and sources of information during TT. Page Methodology: Self-administered questionnaires were completed by 284 parents of children age 2-6 years that attended 25 preschools in Seremban, Negeri Sembilan. Result: Parents began TT their children at a mean age of 36.9 months. Children achieved daytime and night continence at 41.2 and 43.3 months, respectively. The most frequent source of information were other parents, internet and grandparents. Support received by parents during toilet training were largely from their spouses, child’s preschool teachers and grandparents. In particular, health workers were least reported as a source of both information and support for parents. Most parents felt confident during TT process, however 18% of parents reported feeling frustrated, angry and poorly prepared. Conclusion: TT process is usually expected to just happen naturally in all children. Therefore, parents may blame it on their poor parenting skills when problems surrounding TT arises. Furthermore, parents will not seek help from health workers early resulting in further complications. PP05 The Total Waiting Time in Emergency Department: The Significance of Primary Team Review at Red Zone How Suet Yue, Hoi Win Nie, Hema Shallini A/P Thiagarajan, Chua Wen Yong, Chua Wei Ji Objective: The research aims to determine the time taken for primary team review and the total patient waiting time at the Red Zone in the Emergency and Trauma Department (ED) of Hospital Tuanku Jaafar (HTJ). According to the Four-Hour Standard that had been brought up by the National Health Service in England, patients in the emergency department should be admitted, transferred or discharged within 4 hours. (1) With that as a guidance, this study aims primarily to determine the time reviewed by the primary team which may plays a significant part in the total waiting time in the Red Zone. We are also looking into the relationship patient’s diagnosis and the review time by primary team. Methodology: This research was carried out retrospectively from March 2019 until May 2019, where the time from patient arrival to red zone of emergency department, the review time by primary team and the waiting time for admission to the ward were documented. This data along with clinical details and demographic data of patients were collected using a structured form. Results: A total of 321 patients’ data were collected in HTJ, but 117(36.4%) of the data were not detailed enough as the diagnosis and department they are admitted into are not available. The mean total patient waiting time in the red zone from arrival to red zone ED until admission is 5.3 hours. The mean duration upon arrival until time seen by Medical Officer in ED, the duration between time seen by MO of ED to time seen by primary team and the duration between time seen by primary team and time transferred to ward are 0.2 hours, 2.13 hours and 2.97 hours respectively. Majority of the patients are admitted to the ward with cardiac and respiratory causes. Among cardiac diagnosis, patients with cardiogenic shock have the longest mean waiting time to be reviewed by primary team since referral is made, which is 3.82 hours, 24 whereby the shortest mean waiting time reviewed by primary team is abdominal aortic aneurysm which is 0.50 hours. Among the respiratory diagnosis, the mean duration upon Page referral made with time reviewed by primary team are longest for pneumothorax and shortest for pneumonia, which are 3.12 hours and 1.87 hours respectively. Conclusion: Total waiting time in the red zone of emergency department is contributed by multiple factors. Emergency department review time, primary team review time and transfer time are among the main contributors for the long waiting hours. The exact causes have not been clearly identified yet. Hence, further study should be conducted in the future to identify the causes of delay in the aspect of clinical processes and logistic reasons. Improving the waiting time in the emergency department will lead to improvement in providing service for patient care in the emergency department. PP06 The Usage of Oral Therapies In Treatment Of Recurrent Urinary Tract Infection in Postmenopausal Women: A Systematic Review With Scoping Review Asurappuli Hewage Vihanga Randuna, Cholavarma Mogan Introduction: “Cystourethritis” or Urinary tract infection is defined as the inflammation of the urinary bladder (cystitis) and urethra (urethritis) presenting with increased frequency and suprapubic pain. Women in the menopausal age are greater risk in view of urogenital atrophy due to hypoestrogenism. A variety of oral therapies such as Trimethoprim-sulfamethoxazole, nitrofurantoin and fluoroquinolone have been employed. Recurrent cysto-urethritis or lower urinary tract infection (RUTI) is clinically defined as two or more infections within a span of six months or three and more episodes within a span of 12 months recorded by significant positive urine cultures (103 CFU/mL) or manifestation of signs and symptoms of urinary infections. The infections must be separated by two weeks or have evidence that the first infection was completely treated. Objectives: The study is aimed to analyse different oral therapies and compare their effectiveness and tolerability in treatment of recurrent cystourethritis in postmenopausal women. Methods: Literature search was done based on the PRISMA 2009 and PICO. Randomized placebo-controlled trials between 2008 to September 2018 were included. Only articles in English Language were the only ones included. Two authors (±) independently reviewed abstracts and extracted data from eligible studies. Full text articles from eligible studies were then independently evaluated and data extracted and tabulated by variables pre-determined. They were reviewed for congruence. The senior investigator (≠) was then consulted when there were disagreements. The data analysis was supposed to be performed using the software RevMan to generate forest plot and league table for the efficacy and tolerability of oral therapies in treating cystourethritis in postmenopausal women. Preliminary quick survey for relevant articles and work from a previous published paper one of the authors was involved in indicated that it may be difficult to obtain suitable studies with low heterogeneity and a scoping review may be appropriate. 25 Results: Three articles of randomized controlled trials were eligible for review. efficacy, tolerability and adverse effects of the oral therapies. Torrella et al. suggested that the efficacy Page of the combination of the oral therapy (Hyaluronic acid, Curcumin sulphate, Curcumin, Quercetin) and Estrogen showed a better efficacy than the use of individual therapy, by using odd ratios from forest plots of the study. Zhong et al showed that the continuous antibiotic therapy and the intermittent single dose antibiotic therapy showed no significant difference, but the former more susceptible to show adverse effects and antimicrobial resistance. Beerepoot et al showed that the use of TMP-SMX (Trimethoprim sulfamethoxazole) showed a better efficacy than lactobacilli in the study according to the odds ratio from the forest plots. Conclusion: Selecting appropriate oral therapy agents for recurrent urinary tract infection will need to factor in effectiveness, adverse effects and its tolerability. While it is difficult to select an ideal drug, evaluation using meta-analysis may guide choice of medication for best practice. From Torella’s study its very evident that the combination of oral therapy (Hyaluronic acid, Curcumin sulphate, Curcumin, Quercetin) and Estrogen would be a better choice for a patient than using the drugs by itself. In Zhong’s study it shows that the continuous antibiotic therapy and the intermittent single dose antibiotic therapy showed no significant difference , but the former more susceptible to show adverse effects and antimicrobial resistance and its financially more plausible to use the intermittent antimicrobial therapy, hence as a primary physician it will be more efficacious and tolerable to use the intermittent. In Beerepot’s study it shows that the use of TMP-SMX was more efficacious in the treatment of postmenopausal women with recurrent urinary tract infections than the use of lactobacilli regime. PP07 Prevalence and Severity of Low Back Pain in Construction Workers Su Je Yu, Wong Zhe Jia, Tong Jiun Yan, Wong Hui Yu, Soh Weng Who, Tee Ying Ai Introduction: Low back pain is the most common cause of job-related disability and a leading cause to absence at work especially among construction workers due to the nature of their work. Objectives: To determine the prevalence of low back pain in construction workers; to determine the relationship between type of work and severity of low back pain; and to identify level of disability due to low back pain in construction workers. Methods: 194 construction workers at MRT Seri Kembangan construction site participated in this study. Each of them was given 2 sets of questionnaires. The first questionnaire was aimed to collect the data of demographics. The second questionnaire was Oswestry Low Back Pain Disability Questionnaire to assess the level of disability in construction workers with low back pain. All the retrieved data collected will be analysed using SPSS version 24.0. The relationship between type of work and severity of low back pain was analysed using Chi-square test or Fisher Exact test for categorical variables and t-test for continuous variables. Statistical significance is set at p <0.05. Results: The data obtained in this research showed a low prevalence rate of low back pain in construction workers (26.3%), and the level of disability remained mild in scale. In addition, a close relationship between total type of work and level of disability is observed during the 26 study. Furthermore, the study also found a significant relationship between age and level of disability. Page PP08 Factors Affecting Students’ Perception Towards Peer-To-Peer Learning Lau Tian Ming, Mohamed Shimas Mohamed Riyaz, Lenon Loh Hao An, Ngu Ying Jing, Mohamed Shadhid Sharaz Hilmi Farouk Introduction: The purpose of this research was to determine the factors which affect the students’ perceptions towards peer-to-peer learning in International Medical University (IMU). Mainly, the duration of learning session, the size of learning group and the content of learning. This research particularly targets the integrated medical seminar (IMS) which is one of the theoretical peer-to-peer learning carried out in IMU, Seremban campus. Methods: This is a cross-sectional study involving 250 medical students of semester 6, 7, 8 and 9 from IMU Seremban campus carried out from December 2018 - October 2019. The data was gathered using pilot test validated questionnaires generated by the research members. The questionnaires consist of 11 questions of which 7 questions are provided with objective answers and 4 subjective questions to allow students to provide their feedbacks. Results: The results were generated by IBM SPSS software using descriptive analysis with frequency and percentage in the form of tables. Conclusion: The research concluded that students prefer to have their theoretical peep-to-peer learning, IMS to be carried out in smaller groups of 10 to 29 students and the current duration of IMS is adequate. However, the preference of learning content is inconclusive from the research. PP09 Time Delay in Seeking Medical Treatment for Chest Pain by Adults Diagnosed With Acute Coronary Syndrome: A Retrospective Study In Coronary Care Unit, Hospital Tuanku Ja’afar Seremban Malaysia Amanda Soo Xiao Tong, Ang Chong Chong, Aisha Nurilhayat Dikko, Yoon Yit Sam, Yuvithra Devi Introduction: Time factor plays a significant role in the prognosis of acute coronary syndrome. In this study we aim to study the presence of time delay in patients diagnosed with acute coronary syndrome who were admitted to the coronary care unit in Hospital Tuanku Ja’afar Seremban, Malaysia. Method: This is a retrospective study which focused on patients who are admitted to the coronary care unit in Hospital Tuanku Ja’afar Seremban, Malaysia during the period of April 2018 to September 2018. A data collection sheet is used to collect the demographics, risk factors, time factor and outcome of the subjects that met the inclusive and exclusive criterion. The relationship between subject’s presence of time delay and outcome is cross-tabulated and studied with multiple possible factors. Subject with time delay (arrived after 2 hours) were interviewed by telephone to further understand possible reasons causing the delay in time. 27 Results: 180 subjects were included in this study, of which 146 were male and 34 were female. Amongst the subjects, merely 56 has no time delay. 122 subjects took more than 2 hours (mean Page = 12.4, standard deviation = 23.7) to reach the emergency department after the onset of chest pain. We found that subjects who have dyslipidemia or ischaemic heart disease has significant lesser time delay. Conclusion: The study shows that there is a significant presence of time delay in seeking medical treatment for chest pain by adults diagnosed with Acute Coronary Syndrome in the population of Seremban. This is mostly attributed to the poor awareness regarding acute coronary syndrome in the community. Two-thirds of the subject shows significant delay in seeking medical help. In view of this, effort should be made by the general practitioner or family physician in patient education in every opportunity. PP10 Profiling Antenatal Mothers with Gestational Diabetes in Klinik Kesihatan Seremban: What Are The Risk Factors? Daniel Wong Bang Lung1, Nicholas Lee Wen Sheng2, Tiffany Grace Wong3, Safurah binti Ja’afar4, Salmiah binti Md. Shariff5 Affiliations: 1-3: Semester 7, IMU Medical Student 4: Department of Community Medicine Dept, IMU 5: Family Medicine Specialist, Health Clinic Seremban Email: [email protected] Background: Gestational diabetes mellitus (GDM) is an increasing concern in Malaysia due to the increase in prevalence of diabetes, especially with regards to those in the reproductive age group. Although GDM is usually resolves after pregnancy, the mother is at risk of developing Type 2 Diabetes Mellitus. Objectives: This study will be looking at the prevalence of GDM and evaluate the risk factors associated with GDM. Methods: Retrospective data analysis was performed on antenatal mothers registered in 2018 at Klinik Kesihatan Seremban using the block sampling technique. Results: Out of 1003 women, 262 (26.1%) were found to have GDM. Risk factors are if patients are more than 34 years old (p<0.001), Indian (p=0.002), obese (p<0.001), has had 2 abortions (p=0.012) and has personal history of GDM (p<0.001; OR 8.52; 95% CI: 4.90-14.81) and family history of GDM (p<0.001, OR 2.96; 95% CI: 2.20-3.97) are the most at risk. Hypertension diagnosed during pregnancy was weakly associated with GDM (p=0.052; OR 2.36; 95% CI: 0.97- 5.76). GDM patients tend to deliver through caesarean section (p<0.02; OR 1.75; 95% CI 1.09- 2.81) and have a premature delivery (p<0.001). However, booking week, number of gravida and parity and the weight of baby at birth are not significantly associated with GDM. The average fasting value (p<0.001) of GDM mothers is 5.11mg/dl compared to 4.32mg/dl for non-GDM women while the 2-hour postprandial value (p<0.001) is 8.09mg/dl for GDM patients compared 28 to 5.6mg/dl for non GDM patients. Page Discussion: The risk of getting GDM is strongly associated with patient’s race, age, BMI, number of abortions, personal and family history of GDM. GDM also plays a factor in determining the delivery week of the baby, method of delivery and developing Type 2 Diabetes Mellitus. PP11 Trend of Cigarette Smoking Among Adolescent in Malaysia: A Systemic Review of National Surveys Cheng Xuan Yu, Chia Tiong Ming, Ch’ng Hui Yu, Fatin Naziha Binti Modli, Fong Chi Xiang According to Malaysia Health and Morbidity Survey 2015, the national prevalence of current smokers at 22.8% (95%CI: 21.86-23.81); 20.5% (95%CI: 19.2-21.0) daily smoker and 2.3% (2.02- 2.6) occasional smoker in 2015. Age of 14 to 15 is the most common age of initiation of Malaysian smoker according to Adolescent Health Risk Behaviour 2013 (MyaHRB). Most people who use tobacco started during adolescence, and those who begin at a younger age are more likely to develop nicotine dependence and have trouble quitting. [4] Adolescents are in the phase of life whereby they are vulnerable to cigarette smoking as they are easily influence by peers. The mean age of initiation among current smokers was 13.6 years. The consequences as a result of indulging in the habit of smoking would lead to a number of diseases such as Lung Cancer, Chronic Obstructive Pulmonary Disease (COPD) and Ischemic Heart Disease (IHD), which would bear cost. The National Burden of Diseases Study in 2004 reported these three group of smoking-related diseases as among the top leading diseases contributing to burden of disease in Malaysia (MOH, 2005a).. Furthermore, the smoking related diseases pose a devastating economic implication to the Malaysian spending on health care. The health care cost attributable to lung cancer, COPD and IHD amounted to RM 2,924,756,050, which was 16.49 % of the National Health Expenditure as reported in 2007. Understanding national trends in prevalence and consumption is critical for prioritizing action and evaluating tobacco control progress, hence, indirectly improves overall health of Malaysian population. Thus, this systemic review will help to assess the need for interventions designed to reduce the prevalence of cigarette smoking among adolescent. PP12 [Not for competition, already presented in Negeri Sembilan Research Day 2019] The Correlation of Sonographic Features and Intraoperative Findings in Patients with Suspected Testicular Torsion Syed Mahmud Irfan Alsagoff, Roshinipriya Ganesin, Sumitta Thamil Selvam, Ooi Hooi Sheen, Nurul Qashira Izlan Introduction: Testicular torsion is a surgical emergency. Timely recognition and management of torsion is important for testicular salvage as it causes irreversible changes after 6 hours. The aim of this study is to identify association of key sonographic features and intraoperative 29 findings and factors that would influence the rate of testicular salvage. Methodology: A retrospective study carried out on patients with pain at the scrotum region Page from year 2013 to 2017 at Hospital Tuanku Ja’afar. Data collected was: patient’s age; symptoms; ultrasound findings (Doppler), surgical outcome of patients and time between pain onset, ultrasound & surgery. Statistical analysis was performed using SPSS 25.0. Data are presented as mean (SD) values. Differences between groups and predictive values were calculated using Chi-square, t-test and Mann-Whitney U-test and are expressed by value with 95% CIs. Values of p less than 0.05 were considered statistically significant. Results: 88 patients presented with acute testicular pain, 55 (62.50%) had testicular torsion. The results show that ultrasound has a sensitivity and specificity of 88.24% and 68.40%, respectively. Doppler ultrasound resulted in false-positive findings and false-negative finding is 31.6% and 11.8% respectively. Discussion/Conclusions: Patients with strong clinical suspicion of torsion should undergo surgical exploration. Ultrasound is a good tool for detecting Testicular Torsion when used with clinical judgement. In this study, ultrasound does not delay the time taken from onset of pain to surgery or have any effect on the surgical outcome. PP13 [Not for competition, already presented in Negeri Sembilan Research Day 2019] Low Back Pain Among IMU Medical Students: A Cross-Sectional Study [No abstract] 30 Page