Enjoyment of sexuality among older persons, including people with dementia, is always being neglected. There is limited literature exploring sexuality in dementia within Asia countries where mostly in Taiwan. This study aimed to explore opinions about sexuality in dementia from the biological, psychosocial, and social perspectives, as well as experiences and adaptations in dealing with sexuality among people with dementia, family members, caregivers, and healthcare providers. This study was carried out based on qualitative research with a phenomenological approach and used the Model of Human Occupation as a theoretical framework. Data collection was carried out at two acute hospital memory clinics in Kuala Lumpur and Selangor through convenience sampling. Semi-in-depth interviews were conducted to people with dementia, family members, and healthcare practitioners. Data were analyzed with thematic analysis. The total number of 11 participants recruited included 3 people with dementia, 2 family members, 1 private caregiver, and 5 healthcare practitioners. The majority of them are female, Chinese, in early adulthood, and middle-income group. Five themes emerged from the data analyzed: (a) meaning of sexuality; (b) real-life experience of sexuality; (c) impact of disease; (d) management of sexuality; and (e) social environment. Real-life experience of sexuality among people with dementia in Malaysia was affected by the perceptions from taboos, myths, and religions held by themselves as well as people surrounding them, like family members. Lack of training and policy is a common problem in healthcare professions. The findings of this study were believed to be a foundation for future research design involving people in long-term care as well as the public.

BackgroundHypertension is a major risk factor for cardiovascular diseases and premature death worldwide. Less than half of adults with hypertension are not properly diagnosed and treated indicating a need for better diagnostic and treatment strategies. Exosomal miRNAs have been implicated in hypertension development and show potential as non-invasive disease biomarkers. Therefore, this study aimed to investigate potential exosomal miRNA biomarkers of hypertension to enhance early detection.MethodsPlasma exosomes from newly identified, stage I essential hypertensive adults and their controls were isolated and characterised. The miRNA profiles were compared using small RNA sequencing, then validated with quantitative PCR (qPCR). Enriched pathways and gene ontologies of predicted miRNA targets were compared against systemically dysregulated pathways to validate its biological function.ResultsHypertensives showed preferential release of exosomes larger than 150 and significantly reduced expression of exosomal CD9. After qPCR validation, a unique hypertensive exosomal miRNA profile consisting of three downregulated and one upregulated miRNA was identified. The combination of this miRNA signature (hsa-miR-184, hsa-miR-432-5p, hsa-miR-1-3p, and hsa-miR-1246) with BMI demonstrated the highest diagnostic value. Predicted target pathways of the miRNA signature and systemically dysregulated proteomics pathways highlighted the convergence of aberrant metabolic pathways in the development of hypertension.ConclusionThis study identified a unique hypertensive exosomal miRNA profile when used combination with BMI. The miRNA signature provided insights into the mechanisms involved in the early stages of hypertension and offers leads for further validation in biomarker discovery to alleviate the burden of cardiovascular diseases.

Alopecia areata (AA) is a disabling hair disorder which usually begins in teenage years. Worldwide prevalence is 0.1-0.2%, with no data of prevalence in Malaysia. The aim of this study was to determine the quality of life of people with AA and associated factors in major tertiary hospitals in the capital city of Malaysia. Materials and methods: A cross-sectional study was conducted at three Dermatology Outpatient Clinics in three tertiary hospitals in the capital city of Malaysia over one year starting September 2021. A validated questionnaire incorporating the Dermatology Life Quality Index (DLQI) was used. A total of 150 participants with AA were successfully recruited. Results: The Dermatology Life Quality Index (DLQI) mean score was 28.9 with those scoring 29 and above classified as having a poor quality of life and those scoring 28 or less as having a good quality of life. Univariate and bivariate analysis showed that marital status and presence of diabetes was significantly associated with a poorer quality of life. In multivariate analysis, it was found that those who were not married had 1.39 higher odds of having poor quality of life as compared to those who were married (95% CI 1.23-1.65, p=0.04). It was also found that those with diabetes had 2.99 higher odds of having poor quality of life (95% CI 1.83-4.12, p=0.02). Conclusion: In conclusion, participants with AA who weren’t married and with diabetes had poor quality of life. These findings can help physicians build on the body of literature in managing AA.

Objectives: Malaysian doctors often face long hours and inadequate rest, increasing their risk of road crash involvement (RCI). To address this, IMAM collaborated in a study with institutes of higher learning and non-governmental organizations to assess the prevalence and predictors of RCI among doctors. Methods: This study was part of a larger study approved by the Medical Research and Ethics Committee, Ministry of Health Malaysia (NMRR-18-3983-40609), and the Ethics Committee for Research Involving Human Subject, Universiti Putra Malaysia. It involved doctors who are fully or partially registered with the Malaysian Medical Council and their contacts. Data were collected through non-probability sampling using a self-administered online questionnaire between April 2020 and May 2021. Results: 6.7% and 37.9% of 375 medical doctors have reported being involved and nearly involved (due to tiredness, nodding off, and sleepiness) in RCI within the past 2 weeks, respectively. Not napping had higher odds of being in RCI due to nodding off (AOR; 2.193, 95% CI 1.157, 4.157) and sleepiness (AOR; 1.941, 95% CI: 1.030–3.657). Unmarried doctors were at higher risk of near-miss RCIs due to tiredness, nodding off, and sleepiness. Female doctors had lower odds of near-miss RCIs related to nodding off (AOR; 0.619, 95% CI: 0.394–0.972). Non-house officers also had reduced odds of near-miss RCIs due to tiredness (AOR; 0.562, 95% CI: 0.438–0.720), nodding off (AOR; 0.530, 95% CI: 0.396–0.711), and sleepiness (AOR; 0.603, 95% CI: 0.467–0.778). Avoiding overtime and chemical exposure also decreased the likelihood of nearmiss RCIs. Conclusion: Doctors who do not take naps are at a higher risk of RCIs, while unmarried doctors are more prone to near-miss incidents. In contrast, female doctors, non-house officers, and those who avoid overtime and chemical exposure experience a lower risk of near-miss RCIs.International Journal of Human and Health Sciences Supplementary Issue 01: 2025 Page: S29

Introduction:Menopausal symptoms, such as vasomotor disturbances, mood changes and atrophic vaginitis, significantly affect women's quality of life. This study aimed to examine how primary care doctors (PCDs) manage these symptoms and the clinical conditions influencing their decision to offer menopause hormone therapy (MHT), bridging gaps between guidelines and real-world practices. Methods:A cross-sectional study was conducted from June to October 2022 among PCDs in public health clinics in Selangor, Kuala Lumpur and Putrajaya. An online survey was distributed to 1301 PCDs, achieving a 42.9% response rate (559 respondents). Data were analysed descriptively. Results:Lifestyle modifications were the most common recommendation (98.4%), while complementary treatments were widely recommended (54.8%). MHT was discussed by 83.5% of the PCDs but directly prescribed by only 0.9%, with 66.0% referring patients to tertiary care. MHT was primarily offered for vasomotor symptoms (80.5%) and mood disorders (56.7%) but less commonly for non-communicable diseases such as hypertension (14.1%) and diabetes mellitus (25.2%). It was withheld in cases of breast cancer (91.9%) or venous thromboembolism (86.0%), with breast cancer concerns being a major barrier (75.3%). Conclusion:Lifestyle modifications and complementary treatments were common practice options. MHT discussions were frequent, but prescription was limited due to patient concerns and comorbidities. Targeted updates to guidelines and tools can support healthcare professionals in counselling, risk assessment and effective management of menopausal symptoms.

Introduction: Inadequate public knowledge and healthcare-seeking behavior regarding stroke impede efforts to reduce its burden, particularly in developing nations. This study evaluates the impact of stroke awareness campaigns on public knowledge and healthcare-seeking behavior in Malaysia. Materials and methods: A cross-sectional study with pre- and post-survey design was conducted among adults aged 18 and older who registered for the Virtual ResQ Stroke Run event (May-November 2021), part of the ResQ Stroke Campaign (RSC) for World Stroke Day. 178 participants were recruited. Validated questionnaires assessing stroke knowledge, treatment attitudes, and actions during a stroke incident were administered before and after the campaign. Participants engaged in stroke awareness activities, including online forums, virtual runs, and social media campaigns promoting stroke recognition. SPSS version 28 was used for data analysis, with non-parametric methods due to non-normal distribution. McNemar's test compared pre- and post-campaign data. Results: Post-RSC, respondents were 80% more likely to recognize FAST stroke signs compared to pre-RSC. For actions, positive outcomes were observed, with most respondents stating they would call an ambulance or go to the hospital within the recommended 4.5 hours on the same day (pre: 66.9%, post: 91%). However, attitudes toward stroke require improvement, as 48% indicated they would seek non-emergency medical help, despite 96.1% stating they would go to the hospital. Conclusion: Knowledge, actions, and attitudes toward stroke improved after the media-driven RSC. However, continuous campaigns are needed to maintain public awareness of stroke symptoms and appropriate action.

The association between high salt intake and elevated blood pressure levels has been well-documented. However, studies on how effectively this knowledge translates into actionable practices, particularly across different ethnic groups, remain limited. This study aimed to evaluate the knowledge, attitudes, and practices (KAP) towards dietary salt intake across ethnicities and determine its association with hypertension. 5128 Malaysian adults recruited from a national blood pressure screening study completed questionnaires on demographics, and KAP related to dietary salt intake. There were 57.4% Malay, 23.5% Chinese, 10.4% Indian, and 8.7% individuals of other ethnic groups. Overall, more than 90% of the participants knew that a high salt intake causes serious health problems, but only around one-third knew the relationship between high salt intake and strokes and heart failure. Participants of different ethnic groups displayed significant differences in the KAP domains, where Indians generally exhibited better knowledge, attitudes, and reported better practices such as reading salt labels and using spices. Those who were unaware of the difference between salt and sodium and who reported not reading salt labels had higher odds of having elevated blood pressure. These findings demonstrate that while there is a suboptimal translation of salt knowledge into practice in Malaysia, with significant differences in KAP observed between ethnic groups, the potential of improving health outcomes by improving the clarity and awareness of salt labels is substantial. Tailored education promoting salt-label reading, minimizing processed foods intake and discretionary salt use should be ethnic-specific to better curb this escalating hypertension epidemic.

BACKGROUND:Guidelines recommend Menopausal Hormone Therapy (MHT) as the most effective treatment for menopausal symptoms. However, a local study found that the usage of MHT among menopausal women was low (8.1%), with one of the main reasons being it is not recommended by doctors. Therefore, the objectives of this study are to determine the prevalence of offering MHT in treating symptomatic menopausal women among primary care doctors (PCDs) and its associated factors. METHODS:This cross-sectional study involved PCDs from the Federal Territory of Kuala Lumpur, the Federal Territory of Putrajaya and the state of Selangor. All PCDs provided services in government primary care clinics from the three states were invited through the doctor in charge of each clinic. An online survey links was provided for the participants to the self-administered questionnaire. The questionnaire included PCDs' demographics, their menopause management practices, attitudes towards MHT, perceived barriers in offering MHT, knowledge of related guidelines and received training on menopause management. The outcome variable was offering MHT which defined as either prescription of MHT or referral to hospital for MHT initiation. Multivariate logistic regression analysis was performed to determine the factors associated with offering MHT. RESULTS:The response rate was 42.9% (559/1301). Of those who participated in the study, 77.8% of PCDs were female and 89.1% were medical officer. Although 66.9% of the participants reported offering MHT to their patients, the actual prescription rate was low (0.9%). Most PCDs (66%) would refer the patients to hospitals. 87.1% of PCDs (487/559) reported that MHT was not available in their clinic. In the past 12 months, 83% of PCDs had not received any related training. Female PCDs (AOR:2.5, CI: 1.51-4.13, p<0.001), perceiving MHT as preference treatment for menopause symptom (AOR:3.6, CI: 2.13-6.19, p < 0.001), having likelihood to recommend MHT to family and friends (AOR:3.0, CI: 1.87-4.83, p < 0.001), and receiving training on menopause management (AOR:2.7, CI: 1.30-5.56, p = 0.008) were the positive predictor of offering MHT. The negative predictors in offering MHT were no-experience in prescribing MHT (AOR: 0.4, CI: 0.15-0.87, p = 0.024) and lack of information regarding MHT for the patient (AOR: 0.4, CI:0.20-0.67, p < 0.001). CONCLUSION:The study revealed a low rate of MHT prescription among PCDs, with many relying on referrals to hospitals for managing menopausal symptoms. The findings underscore the need for strategies that includes fulfilling professional training gaps, improving MHT availability, and improving information dissemination for patient.

Background Physical restraints (PRs) are frequently used in adult critical care units to protect staff and prevent self-harm, despite the fact that they represent significant safety risks. Restraint complications may have an impact on the patient’s long- and short-term outcomes. This integrative review aimed to meticulously evaluate existing evidence pertaining to physical restraint practices in adult critical care settings. The review was specifically geared towards examining the prevalence of PR, identifying influential factors, elucidating the role of nurses in PR implementation, exploring nurses’ experiences in caring for patients under restraint, and scrutinizing the complications associated with PR application Method This integrative review included the studies published between January 2009 and December 2019 and the literature search was conducted in July 2020. The databases searched included EBSCOhost, Ovid, ProQuest, PubMed, Wiley Online Library, SCOPUS, and ScienceDirect. The keywords included in the search were restraint, critical care, intensive care, ICU, mechanical ventilation, intubation, nursing, and experience. A checklist based on the CASP checklist and the JBI Critical Appraisal Tool was used to assess the methodological quality. Results The findings were evaluated and summarized into seven key topics after twenty-one publications were found to be evaluated. i) High prevalence of PR application in adult critical care unit; ii) determinants of PR applications; iii) types of PR in adult critical care units; iv) decision maker of PR; v) moral and ethical dilemma in PR application; vi) awareness and guidelines for PR applications; vii) common complications and use of sedation, analgesics, antipsychotic drugs in PR application. Conclusion The number of days PR is used is related to the risk of an adverse event. In order to standardize nursing practice, ICU nurses require greater training on the ideas of PR use. Evidence-based recommendations will assist critical care nurses in making the best judgments possible concerning the use of PR.

Introduction: Detection of peripheral neuropathy is important for early intervention to prevent the complication. This cross-sectional study aimed to evaluate the accuracy of vibration test, temperature, ankle reflex, and pinprick sensation examination compared to the biothesiometer test for the identification of peripheral neuropathy in a community setting. Methods: A cross-sectional study was conducted among adults aged 18 years and above who visited retail pharmacies in Malaysia, utilizing a convenience sampling method from March 2021 to May 2022. Peripheral neuropathy was assessed using the biothesiometer test, vibration test, temperature, ankle reflex, and pinprick sensation examination. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each screening tool. SPSS version 26 was used to perform the analysis. Results: A total of 1,283 participants were recruited. The prevalence of peripheral neuropathy was 22.7%. Among the screening tools, ankle reflex had the highest sensitivity (34.12%), followed by vibration (31.76%), pinprick sensation (24.41%), and temperature (6.76%). All tests demonstrated high specificity (95.02%-97.78%). Vibration testing had the highest PPV (83.72%). Conclusion: Vibration testing had the highest PPV among the screening tools evaluated, suggesting its potential usefulness for the early detection of peripheral neuropathy in a non-clinical setting. However, further research is needed to validate these findings and assess the cost-effectiveness of implementing these screening tools in community-based settings.

Men's lifestyle is a relevant factor influencing pregnancy outcomes; however, their participation in preconception health is often overlooked. Therefore, the objective of this study is to determine the prevalence of men's intention to implement preconception lifestyle changes and the factors that influence it. This single-centre, cross-sectional study used systematic random sampling to invite 352 married men with pregnancy plans who attended the clinic from February until April 2023. The respondent's intention, selfefficacy, and social influences regarding preconception lifestyle changes were assessed through a validated self-administered questionnaire. A median score of 5 (minimum = 0, maximum = 10) was used as the cutoff to categorise intention as either low or high as the outcome variable. A total of 352 respondents were invited, and 284 (79.6%) men completed the questionnaire. Overall, 56.7% (n = 161) of married men indicated high intentions to make preconception lifestyle changes. The positive predictors of the intention to make preconception lifestyle changes among married men were having attended preconception counselling (adjusted odds ratio (aOR) = 13.33, 95% confidence interval (CI) = 2.82-63.02, p = 0.001), having higher self-efficacy (aOR = 1.76, 95% CI = 1.39-2.24, p < 0.001), influence of social norms (aOR = 1.39, 95% CI = 1.03- 1.87, p = 0.030), and social influence from recognising the importance of other's opinions (aOR = 1.23, 95% CI = 1.12-1.35, p < 0.001). More than half of the respondents have the intention to make preconception lifestyle changes. Preconception lifestyle interventions should focus on fostering self-efficacy among men with substance dependence to facilitate behavioural changes by leveraging their social influences.

Peripheral neuropathy is a common cause for neurological consultation, especially among those with diabetes mellitus. However, research on peripheral neuropathy among the general population is lacking in Malaysia. This study aimed to determine the prevalence and factors associated with peripheral neuropathy in a setting of retail pharmacies. This cross-sectional study of 1283 participants was conducted at retail pharmacies in Selangor. Peripheral neuropathy was defined as the final score in the mild to severe category in the severity rating scale using a biothesiometer. SPSS version 26 was used to perform the analysis. Multiple logistic regressions were used to determine the factors associated with peripheral neuropathy. The prevalence of peripheral neuropathy based on the biothesiometer was 26.5%. According to multiple logistic regression, the predictors of peripheral neuropathy were those who have diabetes (AOR = 3.901), aged more than 50 years (AOR = 3.376), have secondary education or below (AOR = 2.330), are male (AOR = 1.816), and have underlying hypertension (AOR = 1.662). Peripheral neuropathy is a reasonably prevalent condition, affecting a quarter of the general population, and often goes undiagnosed. It is crucial for healthcare providers to proactively screen for peripheral neuropathy, particularly in high-risk populations, to prevent potential complications.

Patients with peripheral neuropathy could have damaged peripheral nerves, which leads to sensory and motor dysfunction. Diabetes, infections, and trauma are the major causes of peripheral neuropathy. Vibratory perception threshold (VPT) tools are commonly used to detect peripheral neuropathy. This study aims to determine the assessment of peripheral neuropathy through the different diagnostic tools in the community in Malaysia. A total number of 1283 participants were recruited from the seven retail pharmacies located in Selangor, Malaysia. The peripheral neuropathy test was conducted based on VPT tools on both feet using the digital biothesiometer. Following that, Neurological Symptom Score (NSS) and Neurological Disability Score (NDS) were taken from the participants to assess the neurological symptoms. Participants had an average age of 40.6 ± 12.9 years and were mostly of Chinese ethnicity (54.1%). The findings show that increasing age was associated with more severe peripheral neuropathy across the various assessment tools, but gender differences were found with the biothesiometer test and ethnicity has severity in the biothesiometer and disability scores. The sensitivity and specificity of the biothesiometer test were 0.63 and 0.84, respectively. The combined tool NSS and NDS had high specificity and a high positive predictive value, suggesting that it could be a reliable indicator of peripheral neuropathy when both scores are elevated. The findings show that the biothesiometer test, NSS, and NDS are considered screening VPT tools for diagnosing peripheral neuropathy. However, further evaluation and diagnostic testing are necessary in cases of a positive test result.

Introduction: This study aims to determine the prognostic factors and survival outcomes of patients that underwent this surgery. Method: A retrospective review of 43 patients who underwent exenteration for periocular malignancies over a 14-year period was carried out. Patient demographics, tumour histology, treatment details, surgical margins’ status and post-operative survival were recorded. The survival outcome examined was the overall survival (OS) rate. Cox regression and Kaplan-Meier analysis were used to evaluate post-exenteration survival. Results: In total, 20 females and 23 males with a median age of 62 ± 17.3 years were identified. The most common indication for exenteration was basal cell carcinoma (20.9%), followed by squamous cell carcinoma (18.6%), adenocystic carcinoma (14%), malignant melanoma (14%) and sebaceous gland carcinoma (11.6%). The independent predictors for worse OS on multivariate analysis were Chinese ethnicity (adjusted hazard ratio [aHR] 4.95, p =0.017), sebaceous gland carcinoma (aHR 57.61 p=0.006), adenocystic carcinoma (aHR 45.87, p=0.008), clear surgical margins (aHR 5.41, p=0.025), receiving only chemotherapy (aHR 169.13, p=0.004), and receiving both adjuvant chemotherapy and radiotherapy (aHR 41.51, p=0.010). Conclusion: We recommend targeted public health initiatives for Chinese patients due to their increased mortality risk from peri-ocular malignancies. In addition, we advise comprehensive adjuvant therapy for all patients regardless of whether a clear surgical margin is achieved. Basal cell carcinoma and adenocystic carcinoma may also benefit from genetic research. We advocate more training for ophthalmologists to identify periocular malignancies earlier for better treatment options and increased chances of survival.

Dementia affects the individual's functional ability including sexual activity. Limited understanding is available to support sexual health practices. This meta-synthesis review aimed to identify the gaps in the study of sexuality in dementia using the Model of Human Occupation (MOHO). Electronic searches utilizing six databases for existing articles involving persons living with dementia, care partners, and healthcare workers. The result showed that available studies primarily explored sexuality from the viewpoint of spouses of persons living with dementia. The volition domain of MOHO was the most explored provides a deeper understanding of volition on intrinsic perspective on sexuality in people with dementia. The environment domain was the least explored, highlighting healthcare professionals' need for social support and training. The topic of sexuality remains sensitive, limiting the availability of evidence-based interventions in this area.

Background:Physical restraints (PRs) are frequently used in adult critical care units to protect staff and prevent self-harm, despite the fact that they represent significant safety risks. Restraint complications may have an impact on the patient's long- and short-term outcomes. This integrative review aimed to meticulously evaluate existing evidence pertaining to physical restraint practices in adult critical care settings. The review was specifically geared towards examining the prevalence of PR, identifying influential factors, elucidating the role of nurses in PR implementation, exploring nurses' experiences in caring for patients under restraint, and scrutinizing the complications associated with PR application. Method:This integrative review included the studies published between January 2009 and December 2019 and the literature search was conducted in July 2020. The databases searched included EBSCOhost, Ovid, ProQuest, PubMed, Wiley Online Library, SCOPUS, and ScienceDirect. The keywords included in the search were restraint, critical care, intensive care, ICU, mechanical ventilation, intubation, nursing, and experience. A checklist based on the CASP checklist and the JBI Critical Appraisal Tool was used to assess the methodological quality. Results:The findings were evaluated and summarized into seven key topics after twenty-one publications were found to be evaluated. i) High prevalence of PR application in adult critical care unit; ii) determinants of PR applications; iii) types of PR in adult critical care units; iv) decision maker of PR; v) moral and ethical dilemma in PR application; vi) awareness and guidelines for PR applications; vii) common complications and use of sedation, analgesics, antipsychotic drugs in PR application. Conclusion:The number of days PR is used is related to the risk of an adverse event. In order to standardize nursing practice, ICU nurses require greater training on the ideas of PR use. Evidence-based recommendations will assist critical care nurses in making the best judgments possible concerning the use of PR.

Knowledge, attitudes and practice of salt intake and blood pressure level in a multi-ethnic population in Malaysia Objective: A changing lifestyle in the transition from a developing to a more developed country has led to increases in obesity, physical inactivity and unhealthy diet, including high salt intake. Studies have shown that salt consumption is high in Asia, but little is known about the practice among different ethnic groups. This study aimed to examine the knowledge, attitudes and practice of salt intake among Malaysian adults by different ethnic groups. Design and method: Participants aged = > 18 years were recruited during a blood pressure health screening campaign from various centres. All participants completed a questionnaire that capturing information on socio-demographics, knowledge, attitudes and practice about salt consumption. Weight and height were measured and seated blood pressure (BP) measurements using an oscillometric sphygmomanometer were taken twice and averaged. Hypertension is defined as a systolic BP = > 140mmHg and/or diastolic BP = > 90 mmHg. Results: A total of 5128 participants were included in the study. The mean age of the participants was 39.5 ± 17.4 years and 59.6% were female. The mean SBP was 121.4 ± 17.6 mmHg and mean DBP 75.5 ± 11.1 mmHg. 61.5% knew the correct amount (< = 5 g) of daily dietary salt intake and 8.4% did not think it was important to reduce salt intake. 68.6% took measures to control salt intake; 69.9% avoided/minimized canned food, only 34.2% look at the salt labels and less than a third do not add salt during cooking, used spices during cooking and avoid eating in outlets and all of these practices were statistically significant between ethnic groups (p < 0 .001). Knowledge, attitude and practice of not reducing high intake of dietary salt does contribute to raise high BP as shown in Table 1. Conclusion: Our study reported that good knowledge does not translate into the desired attitude or practice of lower salt intake. More needs to be done to improve attitudes and behaviours about dietary salt intake, and to tailor it to different ethnic groups. This is warranted to prevent the increasing prevalence of hypertension.

Introduction: Burnout is a growing trend among medical students worldwide. The aim of this study was to determine the prevalence and factors associated with burnout among medical students at a public university in Malaysia. Methods: A cross-sectional study was conducted among 1st through 5th year medical students at a public university using a simple random sampling method in recruiting participants. In this study, The Maslach Burnout Inventory-General Survey for Student (MBI-SS) was used and burnout is defined as severely emotionally exhausted and severely depersonalised. Results: A total of 328 medical students were recruited with a with response rate of 88.6%. The burnout prevalence was 10.1%. Based on multivariate logistic regression, presence of smartphone addiction with adjusted (odds ratio (OR) 7.37, 95% confidence interval (CI) = 1.67, 32.49), course choice not based on personal interest or due to family pressure (OR 2.72, 95% CI = 1.08, 6.85) and the presence of family relationship problems (OR = 3.58, 95% CI = 1.27, 10.04) are more likely to be associated with burnout among the medical students. Conclusion: Our study has shown that every tenth medical students suffers from burnout. Medical students who are addicted to smartphone, have chosen medical course against individual interest or because of family pressure and have family relationship problems are at risk of getting burnout. Intervention is required to address this issue for the future well-being of medical students.

Introduction: As future healthcare providers, it is vital for medical students to be well-versed in home blood pressure monitoring (HBPM), which plays a crucial role in hypertension management. This study aimed to assess the level of knowledge on HBPM among medical students and factors associated with good knowledge. Method: A cross-sectional study was conducted among Year One to Five medical students in a Malaysian public university using universal sampling. Data was gathered via an online questionnaire on HBPM knowledge. The analysis of the data was performed using SPSS v26. Multiple logistic regression identified the determinants of good HBPM knowledge after adjusting for confounding. Results: A total of 370 medical students were recruited. The median age was 22 (2) years old, and 73.2% were female. 63.2% of them were from clinical years. The proportion of medical students with good HBPM knowledge was 55.7% (28.7% from preclinical students and 46% from clinical-year students). Multiple logistic regression revealed that clinical-year students were more likely to have good knowledge about HBPM than preclinical-year students. (OR=2.96; 95% CI=1.91-4.58, p<0.001). Conclusion: This study showed that preclinical-year students possess a poorer knowledge of HBPM. However, less than half of clinical year students exhibited good knowledge, despite greater patient exposure suggesting current clinical teaching may not impart comprehensive HBPM understanding. Medical schools should strengthen the curriculum by incorporating more practical HBPM learning during clerkships and rotations. This can better equip future physicians to effectively utilize HBPM for diagnosing and managing hypertension.

Article rejection.What a pain it causes.Especially for the budding new scientists who are submitting their first few articles.The research done perhaps even got a distinction at undergraduate level or postgraduate level but don't seem to fit in to the journals it was submitted to.But wait.It is not rejected due to the editors' whims.What can be the common reasons?Well, let's look at some of it:1. Failing the pre-review stages This can due to reasons such as plagiarism, not following author instructions, poor grammar, irrelevant or references > 5 years old, among others. 2.