Awareness and acceptance of Pre-exposure Prophylaxis (PrEP) for HIV among undergraduate students in a private medical university in Malaysia

Posted Posted in Original Article

Authors: Kwee Choy Koh, Nur Illiana Mohamad Zaki, Priyanka Ravindharan, Sarah Nur Hanin Shamsuddin, Yi Ling Teh.


Background: Pre-exposure prophylaxis (PrEP) is an evidence-based strategy recommended for at-risk populations for prevention of HIV transmission. However, the level of PrEP awareness and acceptance among Malaysian undergraduate students is currently unknown.

Objectives: To assess the sexual activities, sexual behaviors, risk perception, awareness, and acceptance of PrEP of medical compared to non-medical students in a private medical university.

Method: Demographic data, sexuality, sexual activity and behaviors, source of HIV knowledge, self- perceived risk of HIV, awareness and acceptance of PrEP were collected using an online anonymous survey among medical and non-medical students at a private medical university. Descriptive, comparative and regression analyses were performed where applicable. A p-value < 0.05 was considered statistically significant.

Results: A total of 369 (187 medical, 182 non-medical) students responded. The median age was 22 with female:male ratio of 2:1. Eighty-one (22%) were sexually active of which 54% used condoms inconsistently, 58% had condomless sex in the preceding six months and 35% had casual or transactional sex. Despite this, 33 perceived themselves to be at low risk of HIV. Most learned about HIV from their coursework. PrEP awareness was 40% versus 20% while PrEP acceptance was 69% versus 67%, between medical and non-medical students, respectively.

Conclusion: Awareness of PrEP among medical students was low and even lower among non-medical students. PrEP acceptance was fair after viewing an introductory video on PrEP. PrEP must be included in the course curriculum. Studies to identify reasons for PrEP-hesitancy should be conducted to help guide policies and initiatives toward promoting PrEP as an additional tool in HIV prevention.

Keywords: Preexposure prophylaxis, Malaysia, HIV, acceptance, awareness.

Citations: IeJSME 2023 17 (2): 10-17


Prevalence of cyberbullying and its effects on studies, personal life and mental health of medical students in a private medical university in Malaysia

Posted Posted in Original Article

Authors: Wei Sean Kang, Sherry Soo Jin Lee, Alissa Sonia Ali Munawar, Saleema Sakul, Gardiya Weligamage Ruvimi Kaushadhi, Kwee Choy Koh.


Introduction: Cyberbullying is the use of information and communication technologies to support deliberate, repeated, and hostile behaviour by an individual or group to harm others. Cyberbullying may negatively affect the studies, personal lives and mental health of victims who are students. We report on the prevalence of cyberbullying and its effects on personal lives, studies, and mental health among medical students.

Methods: A self-administered online questionnaire was used to collect demographic data, determine the prevalence of cyberbullying, and its effects on personal lives, studies and mental health of medical students. Student-t test was used for comparison of means, and logistic analysis was used to identify predictors of being cyberbullied.

Results: 40 out of 261 study participants reported being cyberbullied in the preceding 6 months (prevalence: 15.3%). Cyberbullying did not negatively affect the studies and personal lives of victims. Most victims reported none or minimal-to-mild depression. Malay ethnicity was a predictor of being cyberbullied. Female students were 5-times more likely to be cyberbullied because of their lifestyle compared to males.

Conclusion: The prevalence of cyberbullying among medical students in this study was relatively low compared to reports from other universities. Cyberbullying had little to no effect on the studies, personal life, and mental health of medical students in our study. Malay ethnicity was a significant predictor to being cyberbullied. Females were more likely to be cyberbullied for their lifestyle. Support systems, awareness of good internet etiquette, and promotion of early help-seeking behaviour, especially targeted at identified vulnerable groups, should be put in place to check the practice of cyberbullying.

Keywords: cyberbullying, Malaysia, medical students, personal life, mental health

Citations: IeJSME 2023 17 (2): 18-26


Quality evaluation of child feeding related websites on complementary feeding in Malaysia

Posted Posted in Original Article

Authors: Zi Jie Lim, Kanimolli Arasu, Seong Ting Chen


Introduction: The internet is widely used by parents to access child feeding related information. The accuracy and reliability of information available online remain uncertain. The objective of this study was to evaluate the quality of child feeding related websites on complementary feeding for children aged 6-24 months in Malaysia.

Methods: A cross-sectional study was conducted between December 2021 to April 2022 to evaluate complementary feeding-related websites in the Bahasa Malaysia (BM) language. The key terms were entered into Google Chrome and the first 30 websites were screened. Websites that could not be accessed due to broken links, duplicated websites and not freely accessible websites were excluded from the study. The quality was evaluated using Health-Related Websites Evaluation Form to appraise content, accuracy, author, currency, audience, navigation, external links, and structure of the web-based information. The website was rated as excellent (at least 90% of the total possible score), adequate (75 90%) and poor content (<75%).

Results: Twenty-one websites out of 1006 websites screened were selected for evaluation. 81% of the websites were rated as excellent while 19% were with adequate quality. Websites with excellent quality ratings had higher scores for currency (p=0.039) and navigation (p=0.039) as compared to adequate quality websites.

Conclusions: This study highlighted that complementary feeding practices websites in the BM language were generally of good quality. The accuracy, currency and content of these websites can be further improved by including the resources developed by dietitians to optimise child feeding practices for optimal growth and development of children between 6–24 months.

Keywords: Child feeding information, evaluation, internet, quality, websites

Citations: IeJSME 2023 17 (2): 27-33


Non-Hodgkin lymphoma research (excluding all B cell lymphoma) in Malaysia: A review

Posted Posted in Review Articles

Authors: Kean Ghee Lim, Sunil Pazhayanur Venkateswaran, Afshan Sumera, Ismail Abdul Sattar Burud, Purushotham Krishnappa, Nabeel Ibraheem Jaafar.


Introduction: Lymphoma is a diverse group of malignant proliferations that arise as discrete tissue masses. The 5th edition of the World Health Organization classification of Tumours of Haematopoietic and Lymphoid Tissues was released on 22nd June 2022. The WHO-HAEM5 classification of Mature T and NK neoplasms is further subclassified into various categories which are detailed in this review.

Methods: A search was conducted using bibliographic databases, various repositories, and the Clinical Research Centre website retrieving journal articles, conference proceedings, book Chapters, guidelines, and thesis. The search terms used were Malaysia AND lymphoma.

Results: The search earmarked a total of 561 papers. There were nine case series retrieved from 1967 to 2022. The site, age distribution, prognostic markers, and the various subclassification of NK/T cell lymphomas were studied. The gastrointestinal tract was the commonest site for extranodal lymphomas. Prognostic markers associated were EBV, C-MYC protein and staining for CD2, CD3, CD20, CD56, and CD57 antigens. For anaplastic large cell lymphoma (ALCL), CD30 (Ki-1) and ALK antigens were noted as important. The use of 18F-Fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PETCT) has emerged as an important investigation. Various chemotherapeutic regimens, surgical interventions where necessary and autologous peripheral blood stem cell transplantation when indicated are the mainstay of treatment.

Conclusion: Research on NK/T cell lymphoma, including ALCL, has been ongoing in recent years. This review adds on to the existing literature on lymphoma in Malaysia that can lead to further research, into the diagnosis and treatment of lymphoma in Malaysia and around the world.

Keywords: Lymphoma, NK/T cell, anaplastic large cell lymphoma (ALCL), Malaysia

Citations: IeJSME 2023 17 (2): 34-52


Synchronous Clinical Simulation: An Effective Teaching Modality in Medical Education During COVID-19 and Beyond

Posted Posted in Original Article

Authors: Thiruselvi Subramaniam, Mohammad Arshad Ikram, Shamala Ramasamy.


Background: The spread of COVID-19 forced many countries including Malaysia to switch from on-campus learning to exclusively online learning. The modality of the synchronous session allows the learners to interact with the instructor and obtain instant feedback. The purpose of this study was to evaluate the effectiveness of synchronous simulation among medical students in clinical years in the absence of hospital-based clinical education.

Methods: This was a prospective observational study involving 54 clinical year students, conducted in the simulation lab at International Medical University. Scenarios for each session were built around clinical skills targeting specific learning outcomes. The perception of the simulation session was evaluated using a 5-point Likert Scale. Synchronous debriefing followed each simulated session allowing active participation by all students. Focus group discussion was conducted among 6 students who volunteered representing online participants to obtain feedback on their learning experience.

Results: The highest mean scores were obtained for the items referring to team communication (4.09±0.734), debriefing (4.06±0.811) and timetabling (3.92±1.007). Results from the focus group discussion revealed that: simulated sessions assisted in application of knowledge by observing their peers; the repetitive process of observing and performing was preferred over observing per se; observing the performance of peers from the same cohort was preferred, and critiques on technical logistics were reported.

Conclusion: The synchronous simulation sessions were well received by the students. It is believed that this will be a novel teaching modality to adopt even after the passing of the pandemic.

Keywords: Clinical teaching, medical student, medical education, simulation, synchronous, teaching modality.

Citations: IeJSME 2023 17 (1): 02-08


A Cross-Sectional Study on the Knowledge, Attitude and Practice of Hand Hygiene among Adults in the Chowrasta Market, Penang

Posted Posted in Original Article

Authors: Woan Ching Chang, Elvina Yuh Harn Lau, Yi Xuan Goh, Yen Wen Tan.


Background: The community plays a crucial role in practising effective hand hygiene to prevent disease transmission. Several studies conducted on hand hygiene practices among healthcare practitioners show positive outcomes in decreasing disease transmission particularly during the COVID-19 pandemic. However, studies related to hand hygiene among adults in the local communities are scant.

Aim:  This study aimed to determine 1) the level of knowledge, attitude, and practice of hand hygiene, and 2) the relationship between demographic factors and hand hygiene practice among adults in a local community in Penang.

Methods: This was a cross-sectional quantitative survey combined with direct observation of hand hygiene practice. A self-administered questionnaire on knowledge and attitude towards hand hygiene, and an observational checklist of hand hygiene practice were adapted to measure the variables studied. Non-random quota sampling technique was used to recruit the required 398 sample size.

Results: The study found that the level of knowledge using an internationally commonly used 12 item questionnaire was good. Attitude towards hand hygiene measured on another 7 item questionnaire was also good. A majority of the participants (73.9%) had a good level of hand hygiene practice. No significant relationship was found between age, gender, level of education, and hand hygiene practice.

Conclusion: Local health authorities are urged to continue to emphasise to the public on the importance of hand hygiene to reduce disease transmission in the community. Further studies are recommended to explore the possible barriers that hinder people from adopting good hand hygiene practice.

Keywords: adults, attitude, hand hygiene, knowledge, practice

Citations: IeJSME 2023 17 (1): 09-18