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Introduction: The effect of COVID-19-related changes (such as disturbance of face-to-face human association, breakdown of propensities, vulnerability almost long-term, money related frailty, and depression) on people's mental well-being. The enormous utilize of the Web can be a double-edged sword: on the one hand, get to to innovation has cultivated people's well-being and has encouraged the get to to social back; on the other hand, it may have turned into tricky utilize, particularly with respect to compulsive utilize and cognitive distraction. Methods: A sample of 311 was calculated by using the Raosoft software. Descriptive analysis, univariate analysis and multivariate analysis were carried out. Binary logistic regression and multiple logistic regression were used for analysis to access the associated factors with internet addiction. Results: The majority of respondents 323(61.5%) belonged to the normal level of internet addiction, which was followed by Moderate level of internet addiction by 113(21.5%) respondents. 8(1.5%) respondents were severely addicted to internet. Conclusion: During COVID 19 pandemic, the prevalence of psychological problems such as Internet Addiction increased especially among young adults. Therefore, national policy should be refined to reduce the stressful lifestyle in order to reduce the impact of internet addiction especially for young adults in India.

Introduction: Globally, the needs for more focused research to understand the effects of COVID-19 vaccines among the population to verify the previous research and generate more reliable data. Therefore, this cross-sectional study was aimed to identify the factors associated with the effects of COVID-19 vaccination among adults in Malaysia. Methods: Malaysian people aged 18 and up were enrolled in a cross-sectional online survey. For data collection, a Google form was used to design an online questionnaire which was distributed through social media and in person by the author. Results: A total of 446 responses were analyzed. 58% participants received Pfizer BioNTech Covid 19 vaccine followed by Sinovac (21%) and AstraZeneca (16%). The most reported effect was local reaction pain, swelling and redness at the site of injection with 54.3% of participants. It was seen more in Pfizer BioNTech (56.8%) and AstraZeneca (57.1%) recipients in comparison to Sinovac recipients (42.9%), but this difference was not significant (x2=3.453; p-value=0.315). Tiredness/fatigue was the next most reported effect 51.3% by participants. The other more frequently reported effects were body pain (43.3%), muscle pain (41%), fever (41%) and headache (33%) respectively, which are significantly associated with the type of vaccine.

Medical field is continuously evolving, and the current practice is focused on the evidence-based medicine. Therefore, there is a growing interest in the undergraduate research training. Systematic, structured training on research methodology, conducting health research projects, and critical appraisal will equip undergraduate medical students to develop the research and appraisal skills to apply them in their future career. Learning theories explains about how the students receive, process, and retain knowledge, influence of the teacher and learning environment, influence of teaching plan, and peers in their learning process. Behaviorism, Cognitivism, Constructivism, and Social cognitive theories are intercalated in health research training especially in the undergraduate programme. The medical educators should accentuate the learning theory underpinning the research training to develop effective strategies and to achieve the intended learning outcomes.

BackgroundExcessive ultraviolet light (UV) can cause premature skin aging and potentially skin cancer. This study evaluated the knowledge, attitude of sunscreen, and skin cancer among Malaysian medical students.MethodsThis cross-sectional study was conducted from October 2022 to November 2022 among the clinical year medical students in a private medical university in Malaysia. The respondents were recruited by purposive sampling method. The content validated questionnaire was used to collect the data, and the data collection was done via online platform.ResultsThere are a total of 117 responses that we collected through an online questionnaire via Google Forms. Among the respondents, 59.8% of the respondents reported of having a poor knowledge about sunscreen. However, 64.96% reported to have good knowledge about skin cancer. Approximately half of the respondents (48.7%) had a good attitude towards sunscreen. Females are more likely to use them compared to men (OR: 9.12, 95% CI: 3.52, 23.64) and there is a difference between ethnicity and the usage of sunscreen.ConclusionThis study demonstrated limited knowledge of sunscreen among medical students. However, they are having better knowledge of skin cancer. Our results spotted the need for education about sunscreen among Malaysian medical students.

A 58 year old man was brought to hospital in state of deep coma following severe headache for one day. His GCS was 3/15 and had flaccid all 4 limbs with equivocal planter response on both sides on arrival. NECT head showed acute subdural haemorrhage with surrounding cerebral oedema, mid-line shift and corning of brain stem. After giving mannitol and dexamethasone, four hours later, he became fully conscious and orientated; his motor power returned to normal. He was on warfarin 3mg daily for rheumatic mitral valvular heart disease with atrial fibrillation and his INR on arrival was 3.5. He had intractable hiccups once he regained consciousness. Both pharmacological and non-pharmacological measures were tried for distressing hiccups; there was no therapeutic success. His hiccups disappeared completely only after removing the haematoma by burr hole surgery.

Sickle cell disease (SCD) includes a group of inherited haemoglobinopathies affecting multiple organs including the eyes. Some people with SCD develop ocular manifestations. Vision-threatening complications are mainly due to proliferative sickle retinopathy, which is characterised by proliferation of new blood vessels. Laser photocoagulation is widely applicable in proliferative retinopathies. It is important to evaluate the efficacy and safety of laser photocoagulation in the treatment of proliferative sickle retinopathy (PSR) to prevent sight-threatening complications.To evaluate the effectiveness of various techniques of laser photocoagulation therapy in SCD-related proliferative retinopathy.We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Haemoglobinopathies Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books. Date of last search: 4 July 2022. We also searched the following resources (26 June 2022): Latin American and Caribbean Health Science Literature Database (LILACS); WHO International Clinical Trials Registry Platforms (ICTRP); and ClinicalTrials.gov.Randomised controlled trials comparing laser photocoagulation to no treatment in children and adults with SCD.Two review authors independently assessed eligibility and risk of bias of the included trials; we extracted and analysed data, contacting trial authors for additional information. We assessed the certainty of the evidence using the GRADE criteria.We included three trials (414 eyes of 339 children and adults) comparing the efficacy and safety of laser photocoagulation to no therapy in people with PSR. There were 160 males and 179 females ranging in age from 13 to 67 years. The trials used different laser photocoagulation techniques; one single-centre trial employed sectoral scatter laser photocoagulation using an argon laser; a two-centre trial employed feeder vessel coagulation using argon laser in one centre and xenon arc in the second centre; while a third trial employed focal scatter laser photocoagulation using argon laser. The mean follow-up periods were 21 to 32 months in one trial, 42 to 47 months in a second, and 48 months in the third. Two trials had a high risk of allocation bias due to the randomisation method for participants with bilateral disease; the third trial had an unclear risk of selection bias. One trial was at risk of reporting bias. Given the unit of analysis is the eye rather than the individual, we chose to report the data narratively. Using sectoral scatter laser photocoagulation, one trial (174 eyes) reported no difference between groups for complete regression of PSR: 30.2% in the laser group and 22.4% in the control group. The same trial also reported no difference between groups in the development of new PSR: 34.3% of lasered eyes and 41.3% of control eyes (very low-certainty evidence). The two-centre trial using feeder vessel coagulation, only presented data at follow-up for one centre (mean period of nine years) and reported the development of new sea fan in 48.0% in the treated and 45.0% in the control group; no statistical significance (P = 0.64). A third trial reported regression in 55% of the laser group versus 28.6% of controls and progression of PSR in 10.5% of treated versus 25.7% of control eyes. We graded the evidence for these two primary outcomes as very low-certainty evidence. The sectoral scatter laser photocoagulation trial reported visual loss in 3.0% of treated eyes (mean follow-up 47 months) versus 12.0% of controlled eyes (mean follow-up 42 months) (P = 0.019). The feeder vessel coagulation trial reported visual loss in 1.14% of the laser group and 7.5% of the control group (mean follow-up 26 months at one site and 32 months in another) (P = 0.07). The focal scatter laser photocoagulation trial (mean follow-up of four years) reported that 72/73 eyes had the same visual acuity, while visual loss was seen in only one eye from the control group. We graded the certainty of the evidence as very low. The sectoral scatter laser trial detected vitreous haemorrhage in 12.0% of the laser group and 25.3% of control with a mean follow-up of 42 (control) to 47 months (treated) (P ≤ 0.5). The two-centre feeder vessel coagulation trial observed vitreous haemorrhage in 3.4% treated eyes (mean follow-up 26 months) versus 27.5% control eyes (mean follow-up 32 months); one centre (mean follow-up nine years) reported vitreous haemorrhage in 1/25 eyes (4.0%) in the treatment group and 9/20 eyes (45.0%) in the control group (P = 0.002). The scatter laser photocoagulation trial reported that vitreous haemorrhage was not seen in the treated group compared to 6/35 (17.1%) eyes in the control group and appeared only in the grades B and (PSR) stage III) (P0.05). We graded evidence for this outcome as low-certainty. Regarding adverse effects, only one occurrence of retinal tear was reported. All three trials reported on retinal detachment, with no significance across the treatment and control groups (low-certainty evidence). One trial reported on choroidal neovascularization, with treatment with xenon arc found to be associated with a significantly higher risk, but visual loss related to this complication is uncommon with long-term follow-up of three years or more. The included trials did not report on other adverse effects or quality of life.Our conclusions are based on the data from three trials (two of which were conducted over 30 years ago). Given the limited evidence available, which we assessed to be of low- or very low-certainty, we are uncertain whether laser therapy for sickle cell retinopathy improves the outcomes measured in this review. This treatment does not appear to have an effect on clinical outcomes such as regression of PSR and development of new incidences. No evidence is available assessing efficacy in relation to patient-important outcomes (such as quality of life or the loss of a driving licence). Further research is needed to examine the safety of laser treatment compared to other interventions such as intravitreal injection of anti-vascular endothelial growth factors (VEGFs) . Patient-important outcomes as well as cost-effectiveness should be addressed.

Background: Coronavirus Disease 2019 (COVID-19), emerged in China at the end of 2019, became a major threat to health around the world. Breakthrough infection following COVID-19 vaccine has clinical and public health significance. The highest groups at risk of infection during the COVID-19 pandemic is health care workers; the physicians are the frontline workers. This study aimed to assess the prevalence of breakthrough COVID-19 infection and their clinical presentation, co-morbidities and outcome among physicians who were fully vaccinated, working in COVID-19 treatment centers in Myanmar. Methods: A cross-sectional descriptive study was conducted among physicians, at least 14 days after receiving second dose, working at COVID-19 treatment centers in Myanmar, during the third wave from end of May to August 2021. Data were collected by using standardized forms and analysis was done. Results: Among 410 physicians, 98.2% (221/225) received two dose of vaccination: Covaxin 90.0%, Covishield 9.5% and Sputink V 0.5%. They received first dose of vaccine in January/February 2021 and second dose in March/April 2021. In Myanmar, third wave started in end of May; the largest pandemic surge had reached its peak in July, 2021. In the third wave, most of them 72.9% (161/221) did not experience no infection. The prevalence of fully vaccinated break through infection was 27.1% (60/221); the majority 78.3% (47/60) were mild symptomatic infection. Severe infection was seen in 10% of physicians with breakthrough infection who required hospital admission and oxygen therapy. The common presenting symptoms in order of frequency were body aches and pain 62.6%, sneezing 56.6%, headache 53.5%, cough 52.5%, sore throat 45.5%, anosmia 33.3%, runny nose 23.2% and loose motion 27.3%. The uncommon symptoms were dyspnoea 9.1%, vertigo 6.1%, skin rash 5.1%, vomiting 5.1%, petechiae 3.0%, tinnitus 3.0% and silent hypoxia 3.0%, and non-per-os 1%. Most of them did not have any significant comorbidities. One out of six physicians having severe infection had diabetes mellitus and two were obese. The mean duration of hospital stay was 7 days. None of the cases was fatal. Conclusions: In this study, over 98% of physicians were fully vaccinated; majority with Covaxin. One in four physicians had breakthrough infection in third wave; mainly mild form. Nearly half of them had possible delta symptoms; aches and pain, sneezing, runny nose, headache, cough, and sore throat. Awareness of rare but important symptoms like Non-per-Os and vertigo should be highlighted both to public and health care personnel. Ten percent of physicians with breakthrough infection were severe. Mortality rate was zero.

A large-scale land reclamation project was carried out in the eastern part of Singapore involving 2000 hectares of land at a foreshore location from 1991 to 2005. The land was reclaimed, by placing sand hydraulically on the seabed comprising soft marine clay. Prefabricated vertical drains with surcharge preloading and deep compaction techniques, were used to improve the soft marine clay and reclaimed sand fill. Several specialist in situ tests were conducted during the project, such as with the cone penetration test (CPT), cone pressuremeter test (CPMT), dilatometer test and self-boring pressuremeter tests. The CPMT is an in situ testing method used to measure both the soil strength and stiffness parameters. The CPMT combines the advantages of a conventional pressuremeter test and a CPT. The CPT provides a continuous profile of the soil by measuring the stress on the cone tip, the sleeve friction and the pore-water pressure. The CPMT enables the assessment of the soil strength and stiffness at selected depths. CPMT tests were conducted on both the reclaimed sand and underlying soft marine clay layers during the Changi East reclamation project.

Asien, Nr. 98 (2006): ASIEN (Januar)

Herpes simplex encephalitis (HSE) is a medical emergency associated with high mortality and morbidity. Definitive diagnosis is established by history, clinical examination, neuroimaging studies, supportive electroencephalogram (EEG) findings, and cerebrospinal fluid (CSF) analysis. A 7-year-old Malay girl with known case of right hemiplegia secondary to herpes encephalitis presented to the neuropediatric ward, in General Hospital with refractory seizure. She had a moderate learning disability and diagnosed as right hemiparesis secondary to herpes encephalitis complicated with epilepsy. She was planned for the positron emission tomography (PET) scan and to undergo operation if PET scan was feasible (Hemispherectomy). However, the patient refused for operation. Prompt clinical recognition is important in the HSE to prevent progressive brain tissue damage, haemorrhagic changes, and worsening of the encephalitis. Diagnosis is usually confirmed through an extensive evaluation, including a thorough clinical examination with attention to findings on mental status changes, cerebrospinal fluid (CSF) analysis, electroencephalogram (EEG) testing and findings on neuroimaging. Once HSE is suspected, high-dose acyclovir should be started immediately before lumbar puncture (LP), and only stopped once a definitive alternate diagnosis has been established. This case is reported because the patient has generalized epilepsy with right hemiparesis secondary to herpes encephalitis. Herpes encephalitis with right hemiparesis cases are quite rare.

Yangon is highly dense populated city in Myanmar. Today Yangon area has undergone very rapid development and expansion because of its socio-economic cum political significance. Therefore it is required to expand the new satellite town. Therefore, geotechnical site characteristics and zonation of Yangon area is carry out. In Yangon, three geological rock units such as alluvial deposits, Irrawaddy Formation and Pegu Group can be found. For this research, geotechnical characteristics and foundation condition of Pegu Group is investigated. Based on the sample collected and the laboratory results, foundation condition of Pegu Group are studied. The purpose of the research is to point out the engineering characteristics and foundation properties of Pegu Group in the Yangon Area. The Pegu Group consists of three lithostratigraphic units recognizable from surface geologic characters and subsurface data. They are Besapet Alternation, Thardugan Sandstone and Hlawga Shale from youngest to old. Besapet Alternation consists of shales and thinly laminated sandstone which are exposed in the vicinity of Besapet Lake and also exposed behind the police training school. Besapet Alternation is characterized by blunish grey to greenish grey, bedded to nonbedded, silty shale with very thin parting of micaceous sandstones. Thardugan Sandstone consists of blunish grey to brownish grey, fine to medium grained micaceous and argillaceous sandstone with ferruginous bands. They are exposed around the Thardukan Pagoda, southwestern and south of Hlawga Lake.It exposes as massive body sandstone around Thadukan Pagoda and thin bedded sandstone at police training school. Hlawga Shale consists of shale and laminated clay. They occur at the low land area at the west of Hlawga Lake beside the Thardugan Sandstone. According USCS classification, CL, ML, MH, SC, SM and SW soil types are found as residual soil in Pegu Group. The ultimate bearing capacity of residual soil of Pegu Group is 15 kPa to 600 kPa. The unconfined compressive strength of Thardugan Sandstone varies from 8 MPa to 61 MPa.

Introduction: The main cause of overweight and obesity is the imbalance between energy intake and expenditure. Obesity is the abnormal accumulation of ≥20% of body fat, over the individual's ideal body weight. Obesity is diagnosed by measuring the weight in relation to the height of an individual, thereby determining or calculating the body mass index (BMI). Methodology: This study is a cross-sectional study with the secondary data analysis of the health records of the patients who had attended the medical camps conducted in Melaka, Malaysia. All of the attendee’s body weight and height were measured. The blood pressure measurement was done according to the Clinical Practice Guidelines, Ministry of Health, Malaysia. Hypertension is defined as if the participant has systolic blood pressure (SBP) of > 140 mmHg and/ or diastolic blood pressure (DBP) of 90 mmHg or more. Some peoples were taking treatment of Hypertension. Results: The mean SBP among females was 11.64 units and mean DBP was 5.29 units lower compared to male participants. With an increase in age, SBP is expected to increase by .29 units, provided other variables remain unchanged. Regarding to BMI, every unit increase in BMI, SBP increased by 1.99 units and DBP increased by .86 units provided other variables remain unchanged. Conclusion: This study found that BMI is associated with SBP and DBP, which suggested that interventions for bodyweight management might be beneficial for the management of hypertension.

The process of grouping a set of physical objects into classes of similar objects is called clustering. Clustering is a process of grouping the data into classes or cluster so that objects within a cluster have high similarity in comparison to one another, but are very dissimilar to objects in other clusters. Dissimilarities are assessed based on the attribute values describing the objects. This system studies how to compute dissimilarities between objects represented by interval scaled variables. This system is intended to implement the dissimilarity matrix for interval-scaled variables using Euclidean, Manhattan, and Minkowski distance methods. This stores a collection of proximities that are available for all pairs of n objects.

This Student registration at University involved students being registered in Student Affairs Department and make a deposit in Finance Department within the University, where they would present a form which had previously been filled in by the student. Students often wait for minutes, hours, half day or days to receive registration service for which they were waiting. Delays in the registration may result in difficulties of scheduling at speciality units and decrease in student satisfaction. This system examines the wide-spread problem of extended waiting times for registration. This system implements as student flow scheduling system and can help staff of student affairs department to reduce student congestion in department. This system uses Queuing analysis and Computer Simulation in Operation Research (OR) field. OR is a scientific approach to analyse problem and reduce waiting time. Simulation is the use of a system model that has the mapped characteristics of existence in order to produce the essence of actual operation. This system presents stand-alone application to help student registration using queuing analysis and computer simulation whose are finding appropriate waiting time for student affairs department.

Nonunion of intertrochanteric fracture is uncommon because there are excellent blood supply and good cancellous bone in the intertrochanteric region of the femur. A diagnosis of primary intertrochanteric nonunion is made when at least 15 weeks after the fracture there is radiological evidence of a fracture line, with either no callus (atrophic) or with callus that does not bridge the fracture site (hypertrophic). The patient was subsequently treated successfully with an open reduction procedure. Open reduction and internal fixation with right DHS (Dynamic Hip Screw) with 8 screw holes plate inserted first and then 6 screws inserted under the guidance of Image Intensifier (C Arm). We would like to report a case of right intertrochanteric fracture with non-union. A 60 years old patient presented with the history of pain in the right hip, off and on for many years after the operation. The pain was associated with stiffness of the right hip joint. This case is selected for reporting because it’s a relatively rare incidence.

Introduction: Obesity, high body fat percentage and hypertension could increase the mortality and morbidity due to cardiovascular diseases. These risk factors develop during childhood and adolescent period. The present study aimed at determining the association between body fat composition and BP level among the Chinese community in Melaka, Malaysia. Methodology: This is a cross-section study with the secondary data analysis of the health records of the patients who had attended the medical camps conducted in Melaka, Malaysia. The body fat and visceral fat were measured by using (Handheld Body Fat Scale Analyzer). The blood pressure measurement was done according to the Clinical Practice Guidelines, Ministry of Health, Malaysia. The participants who had systolic blood pressure (SBP) of 140 mmHg and/ or diastolic blood pressure (DBP) of 90 mmHg were defined as hypertension. Results: The prevalence of hypertension among male participants was 42.5%, meanwhile, among female was 23.6%. The prevalence of overweight and obesity was higher among males (37%) compared to females (20.8%). Gender, body fat (%) and was found to be associated with systolic blood pressure. Visceral fat (%) was the only associated factor of diastolic blood pressure. Conclusion: This study found that body and visceral fat compositions are significantly correlated with systolic BP and visceral fat composition is significantly correlated with diastolic BP. High body and visceral fat composition should be used as a measure of increased risk for hypertension among old age peoples.

Background: Medical doctors have to develop in professionalism in addition to become competent in clinical skills. Therefore, educators in Melaka Manipal Medical College have inculcated personal and professional development (PPD) projects into medical curriculums. The projects were in the form of Role Plays/Narratives/Creative writing and Mentored Student Project (MSP). Short terms outcomes of the projects were evaluated, and the research disclosed the positive effect of all PPDs on medical students. However, the long-term effect was yet to be evaluated. The findings of the previous study have not explained why those PPD projects are successful. While twenty fresh medical graduates were asked to reflect on one best learning experience as a qualitative evaluation of the programme, students’ appreciation of MSP disclosed. This study aimed to explore the students’ reflection to identify the reasons for their appreciation of MSP and the long-term effect of it. Study Design: Qualitative research. Methodology: Three reflective writings by fresh graduates were analyzed using the interpretive phenomenological analysis (IPA) approach. Students expressed their conscious perceptions about MSP in the form of words in their reflections. The researcher carefully read the reflections and interpret the words and phrases to catch the students’ perception of MSP. Results: The qualitative analysis revealed the reasons for participating in MSP and their appreciation about MSP. The main reason for students’ participation in MSP was to fulfill the requirement of the medical programme although one student mentioned that she was interested in MSP due to the nature of MSP. Four themes were formulated as reasons for their appreciation of MSP: (1) having an opportunity to choose their research topic, (2) the presence of a mentor to guide each student group, (3) opportunity for the poster presentation on results of MSP and (4) satisfaction with the overall outcome of the MSP. Conclusion: This study highlights the long-term impacts of MSP on students which matched with the expected learning outcomes set by Ministry of Education Malaysia. The analysis disclosed not only the outcome but also the process of MSP contribute for its success.