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Introduction: One of the most useful tool to assess the extent of depression, anxiety and stress symptoms is the validated Depression, Anxiety and Stress Scale, 21 items (DASS-21). The availability of online mental health resource centre provides big data capable of machine learning analytics for early detection of mental health issues. However, prediction accuracy of these data using machine learning method remains elusive. Methods: A cross sectional study was conducted, using secondary data of respondents who answered an online DASS-21 questionnaire from an online resource center. Depression, anxiety and stress were measured using DASS21 as either the outcome or predictor, depending on the model. The model includes sociodemographic predictors such as gender, age, race, marital status, education level and occupational status. A feed-forward artificial neural network was constructed based on multilayer perceptron machine learning procedure using IBM SPSS version 23. Results: A total of 339,781 respondents data were obtained. The observed prevalence of depression, anxiety and stress was 39.9%, 48.5% and 13.4%, respectively. This resulted in 76.4% prediction accuracy for depression, 76.3% accuracy for anxiety and 87.4% prediction accuracy for stress. Stress and anxiety were the most important factors contributing to the disease model. Conclusion: The prediction models have high accuracy to predict the true observed depression, anxiety and stress prevalence. The clinical relevance of these prediction models still needs the human intellect judgment based on Maqasid al-Shariah principles. Machine learning therefore should not be abused but to help in decision-making towards early detection and prompt treatment.

COVID-19 has affected university medical students, resulting in the new norm of learning and practice. Understanding these students’ knowledge, attitude and their practice would be essential as they would serve as the future doctor in Malaysia. The study attempted to evaluate medical students’ knowledge, attitude and practice (KAP) in the east coast states of Peninsular Malaysia. An online and multi centre cross-sectional study was undertaken among all the three public medical schools in the east coast region of Peninsular Malaysia, between 8th July to 21st July 2020. The questionnaire consisted of sociodemographic data and the three domains which included COVID-19 KAP. Students were invited to participate via social media platform such as WhatsApp and students’ email. A total of 1,008 medical students voluntarily participated in the study with female to male ratio of 2.6:1. A total of 356 (35.3%) of the medical students had satisfactory knowledge score, with 75% of them were female. The majority of the students had positive attitude towards COVID-19 and practiced meticulous social distancing during the pandemic. We noted that seniority influenced knowledge score, and this was evident as 264 (26.2%) of the students were in their clinical year. Overall, the knowledge scores regarding COVID-19 among the medical students in East Coast of Peninsular Malaysia was reasonable and there were opportunities to augment these standards. Meticulous plans are needed to enhance knowledge and preparedness of the current crops of medical students to be competent future frontliner for Malaysia.

Background: Excessive screen time in young children is associated with many harmful consequences including screen dependency. Research has shown a worrying prevalence of media-related dependency among adolescents and pre-school children. There are a few available questionnaires among adolescents but none for pre-school children. This study aimed to design and validate a questionnaire to assess screen dependency among pre-school children aged 4 to 6 years old. Methodology: A cross-sectional two-phase study was carried out to develop the scale. In phase 1, a preliminary parent-report measure questionnaire was developed in Bahasa Malaysia. Later, it was sent to four experts for content validity followed by face validity. In Phase 2, a total of 386 parents of pre-school children aged 4 to 6 years old, split into two samples, were involved in the field study for exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Result: Sample 1 was used to perform EFA to determine the factorial structure of the SDS. All items with a factor loading of >0.4 were included. Sample 2 was used to perform the CFA. RMSEA and CFI analysis showed that the SDS has a good fit and confirms the dimensional structure found via EFA. The final questionnaire consists of 15 items with a 4 factors’ structure and has excellent internal consistency reliability. Conclusions: The Screen Dependency Scale (SDS) is a reliable and valid questionnaire to detect screen dependency among pre-school children aged 4 to 6 years old in Malaysia.

Introduction Vertigo, or the perception of a spinning sensation, is a common symptom experienced by patients who are referred to Otorhinolaryngology clinics. Betahistine is a medication that has been widely used to treat vertigo and its accompanying symptoms. However, the effects of this medication on the vestibulo-ocular reflex (VOR) are still unknown. Initially, it was assumed that betahistine should be discontinued prior to any vestibular tests, particularly the video head impulse test (vHIT). Method Thirty young healthy adults were randomly divided into two equal groups for this randomized double-blind clinical study (betahistine 24 mg and placebo). Baseline pure-tone audiometry (PTA), tympanometry, and VOR measurements were taken, followed by experimental measurements at one hour, four hours, eight hours, and 24 hours after consumption. The video head impulse test (vHIT) was used to determine the VOR. Result Betahistine had no statistically significant effect on vestibulo-ocular reflex gain (F(4,140) = 0.601, p = 0.662). The gain variability across repetitive head impulses remained constant over time. Conclusions Betahistine has no effect on the vestibulo-ocular reflex. As a result, this medication can be taken prior to the vHIT procedure.

The aim of this systematic review was to demonstrate how the oral pathogenicity of Actinomyces naeslundii is associated with its interactions with other microbes in the oral microbiome. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA-P) 2015 protocol was used for this review. Articles published between January 2010 and February 2020 were searched in the PubMed, Web of Science, Science Direct, and Scopus databases. Articles included in the final analysis mainly discuss the symbiotic relationship of A. naeslundii with other oral microbes. The findings show that A. naeslundii is not directly involved in oral pathogenesis; instead, initial tooth surface colonization is promoted by polymicrobial interactions in the oral microbiome in which A. naeslundii participates.

Solid waste management is a growing challenge to many countries. The implications of poorly managed waste on health are numerous. Improper waste management serve as the breeding places for many vectors resulting in proliferation of vector-borne diseases. This article highlights the impact of improper solid waste management on the public health and the increase risk of vector-borne diseases.

Introduction: The prevalence of oral cancer has been reported annually along with high mortality rate. Probiotics have been suggested to possess anti-cancer properties, however the role of these microorganisms on oral cancer is remain unclear. The objective of the present study is to identify the mechanisms exerted by probiotics on oral carcinogenesis by using systematic review and meta analysis with the hypothesis that probiotics inhibit oral carcinogenesis. Materials and method: Comprehensive literature search was conducted on PubMed, Scopus and Web of Science electronic database from January 2019 until April 2019. Main keywords that were used are “probiotic” AND “oral cancer”. Articles that were published in English language were included in this review. Articles were selected independently by three authors and inspected independently by another researcher. The titles and abstracts of the studies were screened to identify studies that meet the inclusion criteria. Full text articles of the remaining studies were assessed to determine the availability to be included in the review. Meta-analysis was conducted by using RevMan 5 software, and the result was graphically plotted on the forest plot. This review was done according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA-P) 2015 guidelines. Results: After thorough screening of the full text articles, seven papers were eligible to be included in the systematic review. The included articles were mainly discussed on the association of probiotics and oral cancer. Two from the seven papers were selected to be analyse for quantitative synthesis (meta-analysis). The present study also showed that, Lactobacillus salivarius REN produces protective effect from developing neoplastic tongue lesions with odd ratio < 1. Conclusion: Probiotics were found to confer positive effect as an inhibitory agent against the oral carcinogenesis thus supported the hypothesis of the present study that probiotics can inhibit oral carcinogenesis.

Introduction: Coronary artery disease (CAD) is the leading cause of mortality in Malaysia. Psychological risk factors are associated with detrimental outcomes in CAD. Our study aimed to evaluate procedural anxiety and depression levels among subjects who underwent coronary angioplasty. Methods: A single-centre prospective cohort study was conducted on patients electively admitted to a tertiary hospital in Malaysia for percutaneous coronary intervention (PCI) over a half-year period. The Hospital Anxiety and Depression Scale (HADS) and the EuroQol-5 Dimension (EQ5D) Health Questionnaire were used to evaluate subjects’ psychological statuses. The EQ Visual Analogue Scale was used for the global assessment of their health. Results: The analysis included 65 patients with a mean age of 63 years from a predominately educated population ( n=54; 83.1%). Before the PCI procedure, female sex was found to be protective against depression, with an odds ratio (ORs) of 0.29 (95% confidence interval (CI) 0.08–1.03). A high level of education was protective against anxiety (OR=0.21; 95% CI 0.06–0.83). After the PCI, females were more likely to be depressed (OR=3.89; 95% CI 1.13–13.37), and those of Malay ethnicity were more likely to be anxious (OR=4.2; 95% CI 1.03–17.07). Using the HADS, subjects were significantly less anxious and depressed (pre-PCI: median (IQR) score=4 (7.0)); post-PCI: median (IQR) score=3 (5.0), p=0.02), measured by the HADS. Using the EQ5D, subjects had an improved mean VAS score (post-PCI: 75±14.9; pre-PCI: 68±12.6; pConclusions: PCI may predispose patients with CAD to psychological stressors. Female patients and those of Malay ethnicity are more likely to experience psychological stress. Being highly educated is protective against such stress.