National

Undergraduate
Research Conference
2019

Organized by: International Medical University, Seremban Campus

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Date: 7 November 2019

ABSTRACT BOOK CONTENT
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1. Organizing Committee 2
2. Welcome message from Vice Chancellor 3
3. Welcome message from Dean, School of Medicine 4
4. Welcome message from Organizing Committee 5
5. Conference programme and speakers 6
6. Criteria for judging research presentations 7
7. Oral presentation abstracts 8-13
8. Electronic poster abstracts 14-21
9. Print poster abstracts 22-30

Organizing committee
Dato' Professor Dr Sivalingam Nalliah (Advisor)
Professor Dr Esha Das Gupta (Chairperson)
Professor Dr C L Teng (co-chairperson)
Professor Dr K G Lim
Eza Norjuana binti Kamarudin
Ahmad Sobri bin Jelani

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Message from the Vice-Chancellor

The purpose of research is to generate new knowledge. This is often in the form of a
publication in the peer reviewed journal. To achieve that, the investigator first need to develop
a critical mind and identify a worthwhile research question.

Making significant medical discoveries is not easy. However, medical students had done so 100
years ago: Jay Mclean (a medical student from John Hopkins University) assisted in the
identification of heparin in 1916, and Charles Best (a medical student from University of
Toronto) played a key role in the discovery of insulin in 1921. A PubMed search retrieved over
500 publications conducted by medical students in the year 2019 alone.

Research meeting that you are attending today provide you the opportunity to present your
research work and subject it to the scrutiny of your peers and more senior researchers. It is
through such critique that you may improve your research methodology or even develop a new
idea for your future research.

On behalf of the university, I wish to extend a warm welcome to you for participating in the
National Undergraduate Research Conference. Do enjoy the academic stimulation in this
conference, as well as to make new friends.

With regards,

Prof Dr Abdul Aziz Baba

Vice-Chancellor
International Medical University
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Message from the Dean, School of Medicine

If you were to ask a university student why he/she studied for a university degree, it is not
uncommon to hear "to get a good qualification so that I can get a good job." However,
educators have always clamour for higher purpose in university education. In fact, Daniel Coit
Gilman, the first president of Johns Hopkins University in his inaugural address on February 22,
1876, stated these aim of university education:
"It is a reaching out for a better state of society than now exists;… it is a craving for intellectual
and moral growth; …it means a wish for less misery among the poor, less ignorance in schools,
less bigotry in the temple, less suffering in the hospital, less fraud in business, less folly in
politics; it means more study of nature,…"

The challenging of task of a university graduate to work toward a better society require many
skills, the most important perhaps is the ability to be critical of the status quo and able to
search for a better solution. One way of developing your inquiring mind is conducting your own
research project.

Ever since the beginning our MBBS programme 20 years ago, International Medical University
has produced over 3000 medical graduates who now served in various disciplines in Malaysia
and elsewhere.

I appreciate the effort of medical colleagues in the School of Medicine in organizing this
National Undergraduate Research Conference. I note that in this conference the speakers and
participants of this conference comes from various disciplines, including those from the basic
sciences. This augurs well for the future, as the solutions towards a better health and better
society need collaboration from all.

With regards,

Dean,
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School of Medicine
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International Medical University

Welcome remarks from the Organizing Committee

This year’s National Undergraduate Research Conference is held in conjunction of with the 20th year of
the IMU MBBS programme. It is gratifying to note participants of this conference come from medical
students of several local Malaysian universities.

This year the conference has a mix of lectures by senior researchers on various topics, such as
systematic review, healthcare big data, where to publish, etc. There are two concurrent tracks of oral
presentations as well as electronic and print poster presentation.

We hope you will find the programme stimulating, and enjoy the networking with your peers from
various universities.

The research presentation will take three forms:

1. Oral presentation (two concurrent session): Abstracts OP01-08
Each presenter will present for eight minutes using powerpoint slides with four minutes of Q&A.
This will be done in a lecture hall/seminar room
2. e-Poster: Abstracts EP01-013
Each presenter will present for four minutes using a single slide (poster view) with 2 minutes of
Q&A. This will be done in a lecture hall/seminar room
3. Print-poster: Abstracts PP01-011
Each presenter will present for four minutes with 2 minutes of Q&A. This will be done in front of
their print posters.

We wish to thank the following faculty members who served as judges of the research presentation:
1. Oral Presentation (Stream A): Prof CL Teng, Dato Prof Dr Sivalingam Nalliah [Abstracts OP01-04]
2. Oral Presentation (Stream B): Prof Nazimah Idris, Dr Noorlita Adam [Abstracts OP05-08]
3. E-Poster (Stream A): Assoc Prof Verna Lee, Assoc Prof Dr Puneet Agarwal [Abstracts EP01-06]
4. E-Poster (Stream B): Prof Philip George, Dr Mohamed Arshad Ikram [Abstracts EP07-013]
5. Print Poster: Professor Dato' Dr Hj Mohamad Farouk Bin Abdullah; Dr Mastura Ismail [Abstracts
PP01-011]

We wish to thank the students and academic staff for supporting this event.

Best regards,

Prof Dr Esha Das Gupta, Organizing & Scientific Chairperson

Prof Dr CL Teng, Scientific co-Chair 5
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Conference programme

Time Topics and speakers Photo of speakers

0830-0900 Welcome addresses
Prof Dr James Koh Kwee Choy, Associate Dean
Prof Dr Esha Das Gupta, Organizing Chairperson
0900-0945 Relevance of research in undergraduate medical
education
Prof Dr James Koh Kwee Choy
Consultant Physician and Infectious Disease Specialist
International Medical University

0945-1015 How to Conduct a Systematic Review

Prof Lai Nai Meng
Paediatrician and Director of Clinical Campus
Taylor University

1015-1045 What is BIG DATA in Medicine

Prof Leong Chee Onn
Deputy Head, Institute of Research Development and
Innovation,
International Medical University

1045-1115 TEA BREAK

1115-1300 Poster presentation

(electronic and print)
1300-1400 LUNCH BREAK

1400-1500 Oral presentation

1500-1545 Medical Writing: Where to Publish

Prof Teng Cheong Lieng
Family Physician
International Medical University

1545-1615 Prize giving by Professor Nazimah Idris

Associate Dean, IMU Seremban Campus
1615-- Tea
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CRITERIA FOR THE ASSESSMENT OF ALL PRESENTATIONS

Item Description Score Mark

given
Scientific Content
1 Research question 10
Originality of research idea, relevance to clinical practice,
adequacy of literature review
2 Conduct of study 20
Appropriateness of study design, ethical consideration and
approval process, validity of data collection
3 Analysis of results 20
Appropriateness of data analysis and data presentation
4 Significance of study findings 20
Adequacy of discussion in relation to previous studies,
highlight significance of findings to the local context
Quality of Presentation
5 Oral delivery 15
Organisation of oral presentation, time management,
response to audience’s query
6 Audio-visual aids 15
Clarity and flow of presentation, aesthetic quality of
slides/poster
TOTAL SCORE 100

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ABSTRACT

ORAL PRESENTATIONS

OP01
Comparison of ECG Competency among Third, Fourth and Final Year Medical Students in
International Medical University, Malaysia: A Cross-Sectional Study

Muhammad Amir Ashraf Bin Zakaria, Muhammad Mujibuddin Bin Hassan, Ng Lee Mei, Ou Kai
Qi, Rawan Elwalid Ali Mohamed Amin Gad

Objectives: This study is done to evaluate and compare ECG competency of medical students
from 3rd, 4th and 5th year in International Medical University, Malaysia. Apart from that, we
wanted to discover whether there is an association between student performance with self-
reported confidence and adequacy of ECG training.
Method: A cross-sectional study was conducted which involved 150 clinical medical students in
International Medical University between years 3 to 5, a subsequent statistical analysis was
performed by the Statistical Package for the Social Sciences (SPSS).
Result: In this research the students are tested in their competency in interpretation of ECG
parameters, common ECG patterns and uncommon ECG patterns. The competency level
between juniors and seniors was significant (p<0.05). As the seniority increases, the
competency level is 9 times more likely to increase. Apart from that, the competency level of
students was influenced by the future specialty of interest, number of ECG classes attended,
number of formal ECG classes given and number of ECG classes that the participants thought
was sufficient.
Conclusion: Clinical medical students in International Medical University demonstrated a good
level of proficiency in interpretation of common & uncommon emergency and non-emergency
ECG abnormalities. Better competency in ECG interpretation skills are associated with higher
reported scale of confidence levels.

OP02
Prevalence and Factors Associated with Irritable Bowel Syndrome among Medical Students in
International Medical University Clinical Campus Seremban: A Cross Sectional Study

Sarvesh Seger, Sabrina Lizy Fernendez, Nur Nabila Binti Nasharuddin, Siti Rahmah Binti Md
Yunus, Nicole Teh Mae Shun

Objective: To determine the prevalence of undiagnosed irritable bowel syndrome and the
factors associated with irritable bowel syndrome among medical students in IMU Clinical
Campus Seremban
Methods: A cross sectional study was conducted among the medical students from semester 6
to semester 9 (year 3, year 4 and year 5) of IMU Clinical Campus Seremban selected by
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convenience sampling method. Participants were asked to complete a self-administered

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questionnaire. The questionnaire consisted of 2 main sections. Section A consisted of

demographic data and section B consisted of the Hospital Anxiety and Depression Scale (HADS),
the Pittsburgh Sleep Quality Index (PSQI) and the Rome IV Questionnaire for Irritable Bowel
Syndrome. Statistical Package for Social Science (SPSS) software was used for data analysis.
Results: 190 questionnaires were filled up by the students of IMU Clinical Campus Seremban.
Most of the respondents were below 23 years old (62.6%), female (56.3%), Chinese (66.3%) and
from Semester 9 (37.9%). Among the 190 students who completed the questionnaires, 28
(14.7%) had symptoms consistent with a diagnosis of irritable bowel syndrome (IBS).
Depression was found to be significantly associated with IBS (OR: 2.659, CI: 1.110 - 6.370)
Conclusion: The prevalence of possible irritable bowel syndrome (IBS) among medical students
in the International Medical University Clinical Campus Seremban is 14.7% based on the Rome
IV Questionnaire in our study. There was a significant association between irritable bowel
syndrome (IBS) and depression. Offering the appropriate interventions to students suffering
from these conditions is recommended.

OP03
An Audit on Timing of Hip Fracture Stabilisation on Morbidity & Mortality in Hospital Tuanku
Ja’afar, Seremban

Thevaraj A/L Munusamy, Tey Yi Ling, Yii Sue Kee, Teoh Poh Jian, Vanessa Premnitha Francis

Objective: To identify the time delay from fracture and admission to stabilization following hip
fracture. To identify short and long term outcomes in terms of morbidity and mortality
following hip fracture stabilization.
Methods: All total hip replacement and hemi-arthroplasty was included in this study from
January 2012 until December 2017, there were no exclusion criteria. All patients were extracted
from the computerized operating theatre documentation system with the keywords, total hip
replacement and hemi-arthroplasty. We called all patients and collected the data according to
demographics, time taken in days from fall until the day of surgery and the post-operative Total
Hip Replacement and Hemiarthroplasty functional questionnaire by the New Zealand joint
registry. A descriptive data analysis was analysed with the use of IBM Statistical Package for the
Social Sciences version 25.
Results: Those 79 patients were categorised into three groups for duration between date of fall
and surgery done. About 25.32 % of those patients (n=20) has 0 to 3 days of delay, 44.3%
(n=35) had 4 to 10 days of delay and about 30.38% (n=44) had delay of more than 10 days. The
questionnaire outcome was categorised into 4 groups. As the poor group results showed
highest percentage, 46.84 % as compared to the other outcomes. Then it was followed by
excellent with percentage of 22.78% then by good and fair with equal percentage of 15.19%. A
cross-tabulation was made accordingly between the number of days from admission to surgery
and functional score of 79 patients responded to our questionnaire. The p-value of this cross-
tabulation showed 0.822 which >0.05 and it is insignificant. This shows contraindicated results
as for our hypothesis proposed.
Conclusion: The result of this study was insignificant. However, our active respondent numbers
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were small and therefore, we could not conclude that delay in surgery would not affect the
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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
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Lim Yee Ching, Mark Kar Kei, Michael Lim Yang Song, Michelle Lim Wan Xuan, Mohamed Aman
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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
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hours and cesarean section rate. We calculated relative risks and mean differences using fixed‐
and random‐effects models.
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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
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questionnaire and the Beck’s Depression Inventory. Our exclusion criteria include children from
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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.

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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
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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
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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
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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
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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: stanleykc97@gmail.com

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
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relationships.
Objectives: To determine the prevalence of the use of the internet to seek health information
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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.
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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
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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: sweeshiuan97@outlook.com

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.
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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
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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.
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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.

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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
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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.
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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
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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
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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.
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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
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= 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: danielwong_dwp97@hotmail.com

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.

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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
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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
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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]

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