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

Introduction: The number of elderly diabetes patients is rising all over the world. Therefore, the quality of life of older people as well as the factors that influence it are aimed to be evaluated in this study. Method: A cross-sectional study was carried out on 269 senior diabetes patients from government health clinic in Kuantan, Pahang. Their sociodemographic information was gathered, and the Diabetes Quality of Life Instrument (DQoL) was used to assess their quality of life. The connection between DQoL domains and covariates was determined by Mann-Whitney U test and the Kruskal-Wallis test. Linear regression analysis was used to find the predictors. Results: : The majority of patients in the B40 groups had at least a primary level of education (52.2%) and a source of income (97.3%).The majority of the clinics (61.3 %) were located in rural areas and did not have a family medicine specialist on staff (77.7 %). The majority of the patients had uncontrolled diabetes (71.7%), uncontrolled blood pressure (63.2%), uncontrolled cholesterol levels (74.0%), and abnormal abdominal circumferences (84.8%). Clinic location, diabetes control status, and old age were statistically significant in predicting the quality of life. Conclusion: Despite the perception of a significant risk of problems, this study found that decreasing the HbA1c goal further improved the quality of life of older patients. Those clinic headed by family medicine specialist gave the highest degree of patient quality of life. As a result, additional primary care physicians should be trained, as well as local treatment measures.

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

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

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

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