The SE of Malaysian children with monosymptomatic NE aged 10 years and above is significantly lower than their peers. This effect is seen particularly among girls, adolescents and those with frequent wetting. In the light of these findings, the 'wait and see' approach by the Malaysian medical profession is no longer appropriate. Treatment should begin before the age of 10 years.

Background:Little is known about the relationship of blood pressure (BP) with adiposity indicators, dietary habits, physical activity, and sleep in school children in Malaysia. We aimed to study about the distribution of BP and its associated factors in primary school children.Materials and Methods:A survey was carried out on a random sample of 335 children in five primary schools. BP was measured with a mercury sphygmomanometer. Anthropometry was done by standard methods. Demographic information, dietary habits, physical activity, and duration of sleep were collected by interviews. World Health Organization classification based on body mass index (BMI) and waist circumference (WC) cut-offs were used to define overweight/obesity. Elevated BP was defined according to US reference standards.Results:A total 335 children (144 boys and 191 girls) were examined. Their mean age was 9.18 years (standard deviation [SD] = 0.28). Overall mean systolic blood pressure (SBP) and mean diastolic blood pressure (DBP) were 99.32 mmHg (SD = 10.79) and 67.11 mmHg (SD = 10.76), respectively. Mean BMI and WC were 16.39 (SD = 3.58) and 57.77 cm (SD = 8.98), respectively. The prevalence of pre-hypertension was 12.23% (95% confidence intervals [CIs] 8.73, 15.75) and hypertension was 13.4% (95% CIs 9.78, 17.09). Mean SBP and DBP was higher among overweight and obese children than normal children. By multivariate linear regression analyses, BMI (β = 0.250, P = 0.049) and WC (β = 0.308, P = 0.015) were positively associated with SBP; age (β = 0.111, P = 0.017), BMI (β = 0.320, P = 0.012) were positively associated with DBP but total (weekly) hours of sleep (β = −0.095, P = 0.037) was negatively associated with DBP.Conclusion:BP was associated with BMI and WC. Health promotion activities should be initiated in primary schools.

Purpose The purpose of this case study is to share the authors’ involvement and observation in adopting online exam as an evaluation tool, in the hope that others may too be able to adapt and circumvent this lockdown period while bringing a more reliable methodological approach in an online exam. Design/methodology/approach This is a case study that reports the application of an online examination for a year 3 MBBS Professional Exam during the period of lockdown (movement control). This case highlights the conduct of online theory in the form of single best answer multiple choice questions and online practical via objective structured clinical examination, without jeopardizing the integrity of the system, and the measures adapted to mitigate potential academic dishonesty. Findings The authors’ observation shows that online exam can be conducted in scenario where conventional exam is not possible. Research limitations/implications This is an observation in a real-life scenario that discusses the purpose and the process. A single study may not be sufficient to relate the reliability and generalizability of the analysis. Practical implications The practice of social distancing is a hindrance towards traditional classroom teaching. Online exam has promising potential to be the solution to this problem. The authors have demonstrated that an MBBS theory and practical exam can be conducted remotely without any physical contact, without any compromise in achieving the learning objectives within the curriculum. Medical education can proceed with a new drive while ensuring the learning process continues a stable momentum. Originality/value Online examination is almost unheard of, especially for undergraduates in the medical programme. This study highlights a plausible approach in the design of the online examination and identifies the barriers and favourable edges of this platform.

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