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Introduction: Early diagnosis of Severe Combined Immunodeficiency (SCID) increases survival outcomes and quality of life while significantly minimizing healthcare burden and costs. Despite growing evidence supporting the benefits and cost-effectiveness of SCID detection through newborn screening (NBS), it has yet to be implemented in Malaysia. This study aims to explore experts’ opinions on the current status, challenges, and crucial strategies needed for the successful implementation of SCID NBS. Methodology: A guided, structured interview was employed to explore opinions on the current status, barriers, and strategies for implementing SCID NBS in Malaysia. All 13 invited experts participated in this study, indicating complete participation from the entire Malaysian immunology fraternity (consisting of eight clinical immunologists and five immunopathologists). Key findings: Several initiatives are ongoing to establish SCID NBS in Malaysia. Hindrances such as low immunologist-to-patient ratio, unequal placements of immunologists throughout Malaysia, society’s low disease awareness, national health prioritization, lack of stakeholder engagement, and inadequacy of local study/data were highlighted. Pilot research on SCID NBS, advocacy workshops, and promotion materials are among the ongoing activities outlined in the blueprint, paving the way for this nationwide NBS program to be achievable in the near future. Conclusion: This article provides recommendations to policymakers in mandating SCID NBS. Strategies by key stakeholders are underway, particularly in advocacy programs and efforts to increase awareness among clinicians and the public. [ABSTRACT FROM AUTHOR]

Background: In addition to the conventional aetiologic agents of oropharyngeal squamous cell carcinoma (OPSCC) such as tobacco usage, alcohol consumption and betel quid usage, it has been established that a proportion of OPSCC are driven by persistent oncogenic human papillomavirus (HPV) infections. Currently, there is a lack of data on the burden of HPV- associated OPSCC in Asian countries including Malaysia. Methods: A cross-sectional multicentre study with tissue analysis of Malaysian patients diagnosed with primary OPSCC within a five-year period, from 2015 to 2019 between 01/01/2015 to 31/12/2019 was undertaken. Determination of HPV status was carried out using p16INK4a immunohistochemistry on tissue microarrays constructed from archived formalin-fixed paraffin-embedded tissue. Results: From the cases identified, 184 cases had sufficient tissue material for analysis. Overall, median age at diagnosis was 63.0 years (IQR = 15) and 76.1% of patients were males. In our cohort, 35.3% of patients were Indian, 34.2% were Chinese, 21.2% were Malay and 9.2% were from other ethnicities. The estimated prevalence of HPV-associated OPSCC in our cohort was 31.0% (CI 24.4–38.2%). The median age for the HPV-associated OPSCC sub-group of patients was not significantly lower than the median age of patients with HPV-independent OPSCC. More than half of HPV-associated OPSCC was seen in patients of Chinese ethnicity (54.4%). Patients with HPV-associated OPSCC had a much better overall survival than patients with HPV-independent OPSCC (Log rank test; p < 0.001). Patients with HPV-associated OPSCC with no habit-related risk factors such as smoking, were found to have much better overall survival when compared to all other sub-groups. Conclusions: The findings from our study suggests that prevalence of HPV-associated OPSCC in Malaysia, though not as high as some developed countries, is however on an upward trend. HPV-associated OPSCC appears to be more frequently encountered in patients of Chinese ethnicity. Conventional risk-factors associated with OPSCC such as smoking, alcohol consumption and betel quid chewing should still be considered when estimating prognosis of patients with HPV-associated OPSCC. [ABSTRACT FROM AUTHOR]

Over the past era, the complicated procedures and complexity of designs had become challenging to the Quantity Surveying practices. Errors in term of quantities and time consumption are the major impact on Quantity Surveyors when it comes to performing their task. Building Information Modelling (BIM) has been introduced in 2012, developed and expanded in the construction industry to minimize errors while improving the efficiency of work in terms of time, cost, and accuracy of quantities measured. Thus, this research aims to identify the impact of BIM tools on the roles currently played by the Quantity Surveyors in our local industry. To achieve the aim, this research investigated the usage of BIM tools by the Quantity Surveying consultant firms by analysing the demand for its usage and its effect to the overall profession. A survey-based approach was conducted, whereby 33 sets of sampling size were identified through a random sampling method with only 25 sets of questionnaires received from the respondents. Findings from questionnaires showed that the adoption of BIM did leave significant impacts on Quantity Surveyors practices in the long run. Results have shown that the level of awareness on BIM is still low among the Quantity Surveyors. However, BIM is still worth being implemented as it could help to improve in terms of time saving and accuracy of measurement. This will improve the Quantity Surveyors' profession tremendously in the future. [ABSTRACT FROM AUTHOR]

The high and growing prevalence of obesity in Malaysia is a public health concern. There is a growing effort towards creating an environment that supports healthy lifestyles through instituting appropriate public health policies. The Sweetened Beverages Excise Duty is a recent initiative in this direction that was enforced on July 1st, 2019. In this status update, we trace the developments in the implementation of the tax. This paper collates the preparatory considerations preceding the implementation of the tax, the proposed objectives of the tax, its format as reported in the media. The early sentiments expressed by the stakeholders in the duration leading to the implementation and immediately after (10 days' post-implementation) the enforcement of the duty are also presented here. This preliminary information will be useful to evaluate the effectiveness of this newly introduced Sweetened Beverages Excise Duty in Malaysia. [ABSTRACT FROM AUTHOR]

Context: The Palliative Care Outcome Scale (POS) is an easy-to-use assessment tool to evaluate the effectiveness of palliative care. There is no published literature on the use of POS as an assessment tool in Malaysia. Aim: To define the concordance in the assessment of quality of life between patients with advanced cancers and their palliative care nurses using a Malay version of the POS. Settings and Design: This study was conducted in the palliative care unit of the Hospital Tuanku Ja'afar Seremban, Malaysia, from February 2014 to June 2014. Subjects and Methods: We adapted and validated the English version of the 3-day recall POS into Malay and used it to define the concordance in the assessment of quality of life between patients and palliative care nurses. Forty patients with advanced stage cancers and forty palliative care nurses completed the Malay POS questionnaire. Statistical Analysis Used: The kappa statistical test was used to assess the agreement between patients and their palliative care nurses. Results: Slight to fair concordance was found in all items, except for one item (family anxiety) where there was no agreement. Conclusions: The Malay version of the POS was well accepted and reliable as an assessment tool for evaluation of the effectiveness of palliative care in Malaysia. Slight to fair concordance was shown between the patients and their palliative care nurses, suggesting the needs for more training of the nurses. [ABSTRACT FROM AUTHOR]

Background: At the International Medical University (IMU), a half day cardiac life support teaching session was provided to fourth year medical students which included training on the use of the defibrillator machine, how to handle cardiac or respiratory arrest and drugs used for resuscitation. A new CLS (cardiac life support) training session was introduced and increased to a oneday course where students were given practical training first, which included 5 stations (airway equipment, mega codes, drugs for resuscitation, defibrillator use and cardiac rhythm identification) , MCQ (multiple choice questions) test and a mega code (practical)assessment. Objective: To evaluate the students' knowledge on cardiac resuscitation after a change in the delivery of the cardiac life support training (CLS). Methodology: Group I, consisted of 82 students taught using the traditional teaching and Group II consisted of 77 students taught using hands on simulation. The students in both groups had an online manual to read prior to the session, were given an identical written exam six months after the CLS training. Group II, however, had an online pre-test. Results: There was a statistical difference in the final mean marks between the two groups with group II scoring higher (67.3) than group 1 (62.1). No significant marks difference was noted between male and female students for both the cohorts. Conclusion: There is a significant difference in medical students' knowledge when cardiac life support is taught using simulation. IMU has adopted the new teaching method with simulated training for the cardiac life support courses with plans to implement higher fidelity and technology to the existing simulated teaching in other areas of medicine. [ABSTRACT FROM AUTHOR]

Carrageenophyte farming is an expanding economical activity in North Borneo Island, Malaysia. During routine monitoring of “ice-ice” disease and epiphyte outbreak at commercial farms, it was apparent that culture lines were heavily (60–80%) infested with biofoulers, particularly Acanthophora spp. and Laurencia majuscula. However, only L. majuscula showed dominance and flourished even during “ice-ice” disease outbreak. Presence of chemical defense against seaweed pathogens was investigated in two populations of L. majuscula collected from three major carrageenophyte farms in two districts; (A) Lohok Butun, Selakan Island, and Bum-Bum Island, in Semporna district, and (B) Telutuh, Carrington Reef, and Balambangan Island, in Kudat district. The first population contained elatol ( 1), and iso-obtusol ( 2), and, second population contained ( Z)-10,15-dibromo-9-hydroxy-chamigra-1,3(15),7(14)-triene ( 3) and ( E)-10-15-dibromo-9-hydroxy-chamigra-1,3(15),7(14)-triene ( 4), as their antibacterial metabolites. All four metabolites showed highly selective inhibition against “ice-ice” disease bacteria compared to human pathogens at 30 µg disk−1. In addition, seasonal variation of these compounds at two representative farms (Selakan Island [P-1] and Balambangan Island [P-2]) revealed a 120–170% increase in concentration during “ice-ice” disease outbreak. Microscopy of fresh specimens showed the presence of corps en cerise, which is the synthesis and storage site of halogenated metabolites at superficial cortical cells, branch tips, and trichoblasts. This suggests the importance of these metabolites as defense chemicals against “ice-ice” disease bacteria in L. majuscula that grows on seaweed culture lines. [ABSTRACT FROM AUTHOR]

With recent medical advances and the availability of newer sophisticated technologies, critically ill patients tend to survive longer.1 Thus, decisions to forgo life-sustaining medical treatment generate challenging issues that all doctors must face.2 The aim of this pilot study was to assess attitudes towards end-of-life care in ICU which included futile therapy (withholding and withdrawing therapy) among final year medical students who had received the same degree of clinical exposure and training in medical school. The results revealed varying attitudes and views towards end-of-life care in ICU suggesting other factors such as religion, ethnicity and culture may influence decision making. [ABSTRACT FROM AUTHOR]