Introduction: Colorectal cancer (CRC) is the second leading cause of cancer related death in the world after lung cancer. Early detection of CRC leads to improvement in cancer survival rate. In recent years, efforts have been made to discover a non-invasive screening marker of higher sensitivity and specificity. Fecal occult blood testing (FOBT) and genetic testing become alternative modalities to screen CRC in the population other than colonoscopy. The aim of this systematic review and meta-analysis is to determine the diagnostic accuracy, sensitivity and specificity of FOBT and genetic testing as screening tools in colorectal cancer. Methods: A literature search of PubMed, ScienceDirect, and Scopus was carried out. The search strategy was restricted to human subjects and studies are published in English. Data on sensitivity and specificity were extracted and pooled. Heterogeneity was assumed at significance level of p < 0.10 and was tested by chi squared. Degree of heterogeneity was quantified using the I 2 statistic, and values of less than 25% is considered as homogenous. All analyses were performed using the software Meta-Disc. Results: A total of eleven studies were suitable for data synthesis and analysis. Five studies were analyzed for the accuracy of genetic testing, the pooled estimate for sensitivity and specificity were 71% (95% CI: 66, 75%) and 95% (95% CI: 93, 97%) respectively. Another group of studies which had been evaluated for the accuracy of FOBT, the pooled sensitivity was 31% (95% CI: 25, 38%) while the pooled specificity was 87% (95% CI: 86, 89%). Conclusions: FOBTs is recommended to use as population-based screening tools for colorectal cancer while genetic testing should be focusing on patients with moderate and high risk individuals.

Background: COVID-19 related knowledge, attitude and practice plays a major role in determining the readiness of the community to adopt the behavioural change towards recommended preventive measures outlined by public health officials. This study aims to assess the knowledge, attitude, and practice regarding COVID-19 among university students as well as its associated factors. Method: This is a cross sectional study that was conducted among students in a public university during the early phase of COVID-19 pandemic in Malaysia. An online validated self-administered questionnaire was used to collect the data. Mann-Whitney U and Kruskal Wallis test was used to determine the association between independent variables with knowledge, attitude, and practice score.Results: Overall response rate of this study was 92.9 (n=524). Median score of knowledge domain was 78.0 (IQR= ±12.0), median attitude score of 49.0 (IQR= ±5.0), and median practice score of 80.0 (IQR= ±11.0). The mean knowledge, attitude and practice score were significantly higher among diploma holder (vs degree holder, p<0.05), residing in main Kota Kinabalu campus (vs non-KK campus, p<0.001), studying in medical faculty (vs non-medical faculty, p<0.001), and attended COVID-19 education (vs non-attendance; p<0.05).Conclusion: COVID-19 related knowledge and attitude were below satisfactory level during earlier phase of the pandemic. However, majority of respondents have positive behaviour towards COVID-19 prevention. This highlights the importance of accurate and tailored health education to improve the level of knowledge, attitude and practice of recommended measures to prevent COVID-19 spread.

Background: Helicobacter pylori (H. pylori) infection is known to be associated with peptic ulcer and gastric cancer. Detection of H. pylori infection is a significant part of peptic ulcer and gastric cancer prevention and management. 13 C-urea breath test (UBT) provides a good option for the pathogen detection due to its accuracy and safety. Objective: This review aims to evaluate the 13 C-UBT diagnostic accuracy studies conducted among Asian population and validate its use for the Asian population. Methods: Original articles were systematically searched in PubMed, Scopus, and Google Scholar using the PICOS strategy by applying relevant keywords. Only studies published in English and conducted in Asia were included. Our search returned 276 articles. After assessment, 11 articles which answered our research question and met the criteria set for systematic review and meta-analysis were accepted. A total of 15 study protocols were extracted from the 11 accepted articles. Findings: Majority of the studies were conducted in Hong Kong (six), followed by Taiwan (five), Japan (two), and one each in Singapore and Israel. All studies had used histology as part of its gold standard of reference. All but one study was performed on adult populations. The summary estimate for sensitivity was 97% (95% CI: 96, 98%), and specificity was 96% (95% CI: 95, 97%), with significant heterogeneity between studies. Adjusting for the dose (50 mg) and breath sample collection time (20 minutes) had improved both accuracy estimates and significantly reduced heterogeneity. Conclusion: This review supports the test-and-treat strategy for H. pylori infection management. Prevalence and cost-effectiveness studies are mandatory for health authorities to adopt this strategy into national policy.

Introduction: COVID-19 has trickle-down psychological effects on multiple strata of society, particularly university students. Apart from the worry of contracting or spreading COVID-19, Malaysian university students were also locked down on their campuses, suffering significant psychological distress. Hence, an online mindfulness intervention was proposed to alleviate psychological distress and improve psychological flexibility and mindfulness. Methods: This was a quasi-experimental study with university students as participants. Intervention group participants were instructed to complete online questionnaires which covered basic demographics and instruments assessing depression, anxiety, stress, mindfulness, psychological flexibility, and fear of COVID-19 before and after the one-hour intervention. The control group also completed before and after questionnaires and were subsequently crossed over to the intervention group. Repeated measures ANOVA was conducted to assess time*group effects. Results: 118 participants were involved in this study. There were significant differences in anxiety (F (1,116) = 34.361, p < 0.001, partial eta-squared = 0.229) and psychological flexibility between the two groups (F (1,116) = 11.010, p = 0.001, partial eta-squared = 0.087), while there were no differences in depression, stress, mindfulness, or fear of COVID-19. Conclusion:The results of this study corroborate the efficacy of online single-session mindfulness therapy as a viable short-term psychological intervention under financial and time constraints. Since university students are in the age group with the highest incidence of depressive and anxiety disorders, it is crucial to utilize resources to address as many students as possible to ensure maximum benefit.

that 5 years survival of CRC in Malaysian patients is about 40%, which is lower than the high income countries such as Singapore (60%) and South Korea (73%) (Veettil et al., 2017). Furthermore, malignant tumour is among five top causes of death among Malaysian and increasing in trend for the past 20 years, accounts for 8.6% on 1996 and 13.6% deaths on 2015 in Malaysians hospitals (Ministry Abstract Background: Colorectal cancer (CRC) is still a major public health threat. In the effort to reduce CRC incidence and mortality, faecal occult blood test (FOBT) is currently the screening tools used for early detection of CRC. However, the uptake of FOBT screening is less than promising. This study aims to identify the prevalence and predictors of Never Screened with FOBT (NS-FOBT). Methods: A cross sectional study was conducted in five health clinics under Kota Kinabalu district, Sabah, Malaysia Borneo involving 162 attendees with age of 50 years old and above. A validated self-administered questionnaire was used to collect the data. Multiple logistic regression analysis was used to determine the predictors of NS-FOBT. Results: The prevalence of NS-FOBT was 85.8% (n=139).

Healthcare workers typically work in shift to ensure smooth operation of healthcare industries around the clock. However, working in shift put them at risk of developing occupational fatigue and sleepiness during and after work, with multiple adverse effects to themselves and patients under their care. This review aims to identify available evidence-based intervention for fatigue and sleepiness among healthcare workers working in shift. We searched PubMed, Scopus and CENTRAL database from January 2013 to December 2017. Selection criteria included randomised controlled trials (RCTs) that investigated the effect of any interventions on fatigue and/or sleepiness among shift workers. Two authors independently screened titles and abstracts for relevant studies, extracted data, and assessed risk of bias. We included 8 relevant trials with 7 review-relevant participants. Given the methodological diversity of the included studies in terms of interventions and assessment tools, it is not possible to determine the effectiveness of these interventions to reduce occupational fatigue or sleepiness among healthcare workers working in shift. More good quality RCTs with comparable assessment tools is needed.

Background   Similar to other coronaviruses, COVID-19 is transmitted mainly by droplets and is highly transmissible through close proximity or physical contact with an infected person. Countries across the globe have implemented public health control measures to prevent onwards transmission and reduce burden on health care settings. Social or physical distancing was found to be one of appropriate measure based on previous experience with epidemic and pandemic contagious diseases. This study aims to review the latest evidence of the impact of social or physical distancing implemented during COVID-19 pandemic towards COVID-19 and other related infectious disease transmission.   Methodology   The study uses PRISMA review protocol and formulation of research question was based on PICO. The selected databases include Ovid MEDLINE and Scopus. Thorough identification, screening and eligibility process were done, revealed selected 8 articles. The articles then ranked in quality through MMAT.   Results   A total of eight papers included in this analysis. Five studies (USA, Canada, South Korea and the United Kingdom) showed physical distancing had resulted in a reduction in Covid-19 transmission. In comparison, three other studies (Australia, South Korea and Finland) showed a similar decline on other infectious diseases (Human Immunodeficiency Virus (HIV), other sexually transmitted infections (STI), Influenza, Respiratory Syncytial Virus (RSV) and Vaccine-Preventive Disease (VPD). The degree of the distancing policy implemented differ between strict and lenient, with both result in effectiveness in reducing transmission of infectious disease.   Conclusion   Physical or social distancing may come in the form of extreme or lenient measure in effectively containing contagious disease like COVID-19, however the stricter the measure will give more proportionate impact towards the economy, education, mental health issues, morbidity and mortality of non-COVID-19 diseases. Since we need this measure to ensure the reduction of infectious diseases transmission in order to help flattening the curve which allow much needed time for healthcare system to prepare adequately to response, ‘Precision physical distancing” can be implemented which will have more benefit towards the survival of the community as a whole.

Colorectal cancer (CRC) is a major public health threat. Therefore, CRC screening uptake has been a focus with the established precancerous lesion and the strong association of early detection with staging and survival of the disease. However, CRC screening is relatively low in many countries. This article briefly discussed the current situation of CRC, recommendations, and current uptake of CRC screening in various countries. Besides that, this article also highlights the potential factors that help to predict the CRC screening uptake worldwide. Identification of those factors could guide policymakers to develop an effective strategy to improve the CRC screening uptake and ultimately improve the health outcome of the population.