Prosiding The 5TH USIM INTERNATIONAL HEALTH CONFERENCE Lesson From The Pandemic: Reshaping Medicine & Healthcare

Prof. Datuk Dr. Lokman Hakim Sulaiman is currently serving as a Professor of Public Health, Director of Institute for Research, Development and Innovation (IRDI), and Pro Vice Chancellor for Research, International Medical University, Kuala Lumpur. He is also a Member of the Expert Advisory Group of the Pandemic Influenza Preparedness Framework, WHO, Geneva (2017 – 2019; 2020 -2022). As for his Academic qualification and professional experience, he is a medical doctor and public health physician, sub-specialising in infectious disease epidemiology. He is also an elected Fellow of the Academy of Science Malaysia, Academy of Medicine Malaysia, and Academy of Medicine Singapore. He was conferred the Honorary Fellow of the Malaysian College of Primary Care Physician and Honorary Member of the Malaysian Nutrition Society. Having served the Ministry of Health Malaysia for 32 years, he took an optional retirement in 2017 as Deputy Director General of Health (Public Health). As head of the public health program, he was responsible in the development and implementation of public health policies and programs of the Ministry of Health. Prof. Datuk Dr. Lukman served in various WHO Consultancy positions such as a Member of Malaria Advisory Committee WHO Geneva 2015, Member of Expert Advisory Group on Environmental Health to the WHO Regional Director of Western Pacific Office (WPRO) 2016, Scientific Ad-Hoc Committee for WHOTropical Disease Research (TDR) Program, 2016 and WHO Consultation on Plasmodium knowlesi Malaria 2017. During the COVID-19 pandemic, he was appointed as a member of the Greater Klang Valley COVID19 Task Force, July – October 2021. To date, he has published 84 scientific publications with 1,226 total citations and h-index of 22 (i10-index: 35). SYMPOSIUM 2:7 THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 45

COVID-19 pandemic is unprecedented in the history of public health crisis of our time. It is unprecedented in term of the speed of spread, number infected and death, devastating socio-economic impact as well as in the speed and expanse of the global response to the pandemic. Public health measures to contain the infection were also unprecedented such as molecular diagnosis as primary screening tool and prolonged movement restriction across local and international borders, impacting and crippling the global economy with long-term impact and far-reaching social wellbeing consequences. Vaccine, an important public health tool to contain the spread also experienced an unprecedented speed of development. Within less than a year, emergency use authorization of COVID-19 vaccine was issued, raising concern of its efficacy and safety which contribute towards vaccine hesitancy and even rejection. Despite hundred of million of doses of COVID-19 vaccines have been administered, doubt on its safety remained and conspiracy theories abound. All vaccines and drugs cause adverse events. In medicine and public health, risk-benefit consideration is the cardinal principle in considering any interventional strategy to be used. With millions of doses administered, rare adverse events including death got frequently reported, further compounded on the problem. A vaccine that does not prevent infection, invalidating the concept of herd immunity also created a risk communication nightmare. Rapidly evolving SARS-CoV-2 virus into various strains with differing infectivity and severity added to the complexity. Public health actions on COVID-19, be it at individual or population level, is all about assessing, communicating, and managing the risk. While vaccine may not be the silver bullet in containing the pandemic, and with the infection dynamics still evolving, large dataset thus far suggest that risk-benefit ratio support it use as one of the public health measures to minimize impact and burden of the infection. THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 46 ABSTRACT

Dr. dr. Susilorini, MSi.Med, Sp.PA is a lecturer in the Department of Pathology Anatomy, Faculty of Medicine, Universitas Islam Sultan Agung, Indonesia with special interest in medicine from an Islamic perspective, with multiple publications and speaking opportunities related to this topic. Dr. dr. Susilorini graduated with a medical degree from Diponegoro University Semarang and subsequently completed a masters in Biomedical Science from the same university in 2012. She then proceeded to attain her pathology specialist degree in 2013 from the same university. Dr.dr Susilorini recently completed her PhD from Universitas Sebelas Merat in 2021 with a dissertation titled, “Pengaruh Imunomodulasi Tahnik terhadap Ekspresi IL-12 dan Profil Limfosit T di Sirkulasi.” She has multiple publications locally and internationally related to topics of Tahneeq, and effects of honey on gut health. She has also been invited to speak in numerous local and international conferences speaking about Islam and immunization, bekam and immunomodulation of tahneeq using dates. Dr. dr. Susilorini is a member of Indonesian Pathology Anatomy Association and the International Pathologist Association. She is also currently the Indonesian delegate for the World Islamic Health Union, where she was previously the chairman of the science committee from 2020-2022. SYMPOSIUM 2:8 THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 Developing modern halal and thoyyib vaccines should fullfil some strict criteria including halal, safety, efficacy and reproducibility. There are 4 key steps to design halal and thoyyib vaccines. The indispensable first step in the design of halal vaccines was the concept that a vaccine should not violate “sunnatullah” of how Allah Almighty created human being especially human immune system. The second step is the understanding of the nature of humans as an ecosystem of human cells and human microbiome. It is currently known that the root of health problems is a change in the human microbiome ecosystem which is called dysbiosis and loss of homeostasis especially in human immune system. So the third step to design halal and thoyyib vaccines is describing the type of dysbiosis and the type of the unbalance of human immune system behind a disease. The third step is designing a vaccine which should restore the dysbiosis and the balance of human immune system. Halal and thoyyib vaccines should not damage human ecosytem and homeostasis. Based on some literature review, there are some platform of modern vaccines which is met the criteria i.e mucosal vaccines such as probiotic vaccine (symvivo vaccine for covid 19), M targeted cells vaccine and edible plant vaccines. 47 ABSTRACT

THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 Symposium 3 The Good, the Bad and the Ugly of the Pandemic and its Restrictions 48

Dr. Suhaila Sanip is an Associate Professor in Medical Education at the Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia. She obtained her Bachelor Degree in Medicine from Universiti Kebangsaan Malaysia (UKM) in 2001, Masters in Medical Education from University of Sydney, Australia in 2007 and PhD in Medical Education from University of Leeds, United Kingdom in 2016. She currently holds the posts of Head of Medical Education Unit and Quality Coordinator of the faculty. She previously held the positions of Deputy Dean (Students Affair and Alumni 2007-2011) and Deputy Dean (Academic & Internationalization) (2017-2018). At the national level, Dr Suhaila is appointed as the Undergraduate Subcommittee under Medical Education Committee of Malaysian Medical Council. She was involved in the drafting of the MMC’s Guide for Teaching, Learning and Assessment for medical education during the COVID-19 pandemic. She is also a task force member of Malaysian Medical Council for World Federation of Medical Education (WFME) Recognition and a Panel member for medical school accreditation. She is also actively involved in the Malaysian Association of Education in the Medical and Health Sciences. She was an exco member of the association from 2017 to 2019, Vice President from 2019 to 2021 and re- elected as exco member for 2021-2023. Her research interest is in medical curriculum, faculty development and bioethics. SYMPOSIUM 3:9 THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 49

THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 Online learning has already been one of the modes of learning prior to the pandemic. Its popularity skyrocketed during COVID19 pandemic. Even educators with prior resistance towards online learning, were left with not much choice but to learn how to employ online learning, to continue their teaching, learning and assessment activities with the students who are out of the campus. Online learning can reach the unreached and met its learning objectives when it is carefully designed for the target audience. Common factors such as the academics skills for online delivery, the students’ skills for online delivery, the academics and students’ geographical location, learning apparatus used (laptop, desktop or mobile phones) and internet connectivity, must be taken into consideration in designing online learning course. Not a single model will fit all. Online learning affected the academics and students differently in different aspects. It is important to know the enablers and barriers of online learning for both the academics and students. Enhancing the enablers and overcoming the barriers of online learning increases the chances of course outcomes attainment with the target audience. Of similar importance is maintaining the academics and students’ mental wellbeing during online learning. Enhancing the enablers and overcoming the barriers for maintaining healthy mental wellbeing during online learning further increases the chances of attaining the course outcomes. The exposure to online learning during COVID19 pandemics has made more educators to accept online learning as one of their modes of teaching, learning and assessment activities. Some courses in medical and health sciences require mandatory face-to-face contact. A correct balance of offline and online learning is, therefore, the way forward in medical and health sciences education. 50 ABSTRACT

Dr. Mohd Radzniwan A.Rashid is an Associate Professor in Family Medicine at the Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia . He obtained his medical undergraduate degree in 1997 from University College Dublin, Ireland and successfully obtained Master in Family Medicine in 2006 from Universiti Kebangsaan Malaysia and is now a consultant in the field since then. His special interest is in the area of non-communicable disease such as diabetes, hypertension, dyslipidaemia, kidney disease as well as community and men’s health. He has greatly immersed in community services and activities especially conducted by USIM health specialist clinic, now under USIM Healthcare Sdn. Bhd. In addition, he has held several important positions such as having been a member of the Board of Directors of Tijarah Holding Sdn Bhd, YDP PIBG in a trust school in Kuala Lumpur and he currently is the medical director of USIM Health Care Sdn Bhd. He had written several articles in medical journals both locally and internationally, and has published several books related to his area. Dr Mohd Radzniwan is actively involved in research activities where he had been awarded few local and national grants namely FRGS and obtained few consultation projects. In addition, he actively contributes his knowledge in writing articles in newspaper and magazine as well as sharing his views in other social media platform, and national television. SYMPOSIUM 3:10 THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 It has been a detrimental year since late 2019 until now when COVID-19 struck the world. A dramatic impact on health causes significant morbidity and mortality. Not only that, it has also tremendously destroyed the economy and social well- being of ordinary human interactions. Subsequently people feel strain out and exhausted by the restrictions being imposed on the social and all the routines until they feel too tired to go with the ‘new norms” of life. This condition is known as pandemic fatigue and has been formally announced by eminent world health body namely World Health Organization (WHO). According to the WHO, pandemic fatigue is defined as the demotivation to follow recommended protective behaviours, emerging gradually over time, and affected by a number of emotions, experiences and perceptions. The consequence is too detrimental when it demotivates them to obey the instruction until complacency set in. Therefore, identifying pandemic fatigue as early as possible is integral in combating the pandemic. The objective of this talk is to discuss how the pandemic fatigue has impacted and influenced our life, identifying the crucial causes as well as to assess the condition in Malaysia. The association of the pandemic fatigue with sociodemographic and psychological morbidity will be discussed pertaining to the current situation in Malaysia. 51 ABSTRACT

Hasnain Zafar Baloch is a senior manager, e-Learning with IMU. In this role, Hasnain manages and leads eLearning team consisting of Instructional Designer, Graphic Designer, Multimedia Designer, LMS administrators, Portal Management, providing all aspects of online, blended, Open and Distance Learning (ODL), Massive Open Online Courses (MOOC) and including Instructional Design and e-Learning Strategies. He has more than twenty-five years’ hands-on experience with implementing e-Learning and technology enhanced learning in higher education. In 2013, he was ranked no.6 in the world and no. 3 in Malaysia on the “Top e-Learning Movers and Shakers’ poll based on votes from 1800+ learning professionals/educators around the word. Hasnain has passion for new technologies, social collaboration strategies and the impact they have on learning. He has done research in several key e-Learning areas, including mobile collaborative learning, Hospital Management System, Student Information System, social media, Web 2.0, educational gaming, role-play simulation, virtual classroom, Learning (Content) Management system, engagement tools, e-Learning standards. Hasnain is module Coordinator for eLearning in Health Professions Educations in PG Certificate in Health Professions Educations. Hasnain holds Master of Science (Computer Science) from Universiti Sains Malaysia, Penang, Malaysia. SYMPOSIUM 3:11 THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 During pandemic most of tertiary education institutions must lock down and move to remote emergency learning mode. Some institutions were ready because of having appropriate resources and training provided to faculty and staff. They were investing on infrastructure and proper learning management system. Instructional designers and eLearning team works very closely with subject matter experts. Indeed, it was challenging task for some institutions to fully go online with limited resources. In my talk I will be sharing some of the best practices and how video-based content, interactive microlearning and immersive learning content for students with high bandwidth and proper devices. In my opinion all the good innovations we have explored during the pandemic for content design, delivery and online learning experiences, we should continue using them and seamlessly integrate with synchronous face -to- face activities online mode. Need to adopt and adapt for blended learning approach and evaluate the content design and gradually increase the level of interactivity and engagement. 52 ABSTRACT

Dr. Sri Wahyu Taher is currently the head of clinic and Consultant Family Medicine Specialist (FMS) at Klinik Kesihatan Simpang Kuala, Alor Setar Kedah, Malaysia since 2012. She became a FMS in 2000 after achieving a Master Degree in Family Medicine from National University Malaysia (UKM). She received BSc Med Science from St Andrews University Scotland and continued with MBChB from Glasgow University Scotland. She went for further fellowship training in Chronic Disease Management Primary Care in Monash University, Clayton Victoria Australia. She holds various posts in Ministry of Health in conducting research in primary care setting, setting policies for FMS training pathways and heads various community programs in the state of Kedah. SYMPOSIUM 3:12 THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 Two years have passed and where are we with regards to the pandemic COVID-19? Despite the endemic phase announced by the government starting 1 April 2022, the COVID-19 infection is very much around us. We have learnt a lot from the pandemic and the primary care clinics were most affected. Currently we are on standby and ‘ever ready’ mode even though the resources are still scarce. The memories of chaos and near collapse circumstances occurring at primary care clinics are still fresh in our mind. However, resilience and perseverance among the FMS who are the head of clinics were able to hold the fort commendably. We emerged into maturity and bravery. So, what happens now? The COVID-19 Infection and Prevention Control of the deadly virus are ongoing. The fever center, COVID Assessment Center and PPV are still active and thriving with minimal and miniscule support but the show must go on. In addition, the NCD management, promotion and complication prevention need to be revived after 2 years in domain. Targets were derailed due to COVID-19 pandemic and now we are realigning the resources to rescue the key performance index performances. Primary care clinics need significant support even more so now. The Health White Paper (HWP) Summit presented a lot of proposal to reform the healthcare system of Malaysia. Will primary care component receive paramount support and delegation? We could only wait and see the subsequent development. No matter what, primary care is the thrust of the health system and it should have been given the due attention long before HWP Summit 53 ABSTRACT

THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 DAY 2 54

Prof Dr. dr. Suryani As'ad interest in Nutrition Science began in the 1980s. She had her Bachelor's degree in Medical Sciences from the Hasanuddin University of Makassar in 1984. She then furthered her postgraduate studies in the Masters of Nutrition and Doctoral in Medical Sciences at the University of Indonesia, Jakarta and Hasanuddin University of Makassar. In addition, she also had qualifications in Medical Education from Amsterdam, the Netherlands and Kuwait Scope School. She has vast experience as a leader in Indonesia and internationally, from serving as the chairman of health research ethics, chairman of the department of nutrition at the Faculty of Medicine, Hasanuddin University Makassar and as the director of the health and nutrition clinic. Currently, she serves as the Dean of the Faculty of Medicine and Health Sciences at the Muhammadiyah University of Makassar. She has published three nutrition science textbooks and 68 journal publications. Likewise, she has participated in over 60 scientific activities in national and international conferences, seminars, and community services. She also has various research experiences in the development of educational science both in Indonesia and abroad Medical Nutrition therapy plays an essential role in COVID-19. Proper nutrition and hydration in managing patients with COVID-19 are vital, as it improves clinical outcomes. This is also shown in a clinical review of COVID-19 in-patients and outpatients in Indonesia who received nutritional intervention from medical nutrition specialists. A well-balanced diet consisting of proper macronutrients and micronutrients enhances the immune systems and lowers the risk of chronic illnesses and infectious diseases. For optimal health, fresh and unprocessed foods should be eaten daily to get the vitamins, minerals, dietary fibre, protein and antioxidants and remember to stay hydrated. THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 PLENARY 2 55 ABSTRACT

dr. Ancah Caesarina Novi Marchianti, Ph.D. is an Associate Professor from the department of Public Health, University of Jember, Indonesia. She graduated from Airlangga University in 2004 and subsequently obtained her MD in 2006 from the same university. She then proceeded to complete her PhD in Medical Science from Kagoshima University Graduate School of Medicine and Dental Science. Her interest lies in health promotion studies, including lifestyle and environmental factors related to Non Communical Diseases. Additionally, she is also inclined towards studies on occupational diseases and agromedicine. She has numerous international publications focusing on her area of interests, in both European and Japanese journals. Furthermore, dr Ancah has also published several textbooks including, “Formulasi modifikasi gaya hidup pada obesitas dan diabestas: studi masyarakat pandalungan) in 2022. Her interest in teaching has been inherent in her career, during which she has been teaching medical students since 2008, and has been the Vice Dean of faculty of medicine, University of Jember since 2019 THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 PLENARY 3 56

Integrated services (posyandu) health centre workers (HCW) and cadres in achieving the Ministry of Health's nutrition improvement intervention program including promotion and campaign of balanced nutrition and behavior change (specific nutrition intervention) and monitoring of growth and development (sensitive nutrition intervention) experienced obstacles due to the COVID-19 pandemic. The objective of this study is to search agromedicine health promotion innovations for mothers and children during the COVID-19 pandemic in the health centre setting. Posyandu HCW and cadres play a role in providing suggestions on the running of agromedicine health promotion services innovations for children using the android application through a focus group and panel discussion. This input will be very helpful in perfecting existing applications so that the fulfillment of nutritional health promotion needs for children can be achieved. As the result, despite health workers and cadres in the Jember area having actually received training in nutrition counseling, there was a difference in quality as counselors between health workers and cadres that can occur due to differences in prior knowledge they have. Since the COVID-19 pandemic, various posyandu service activities ranging from antenatal care, vitamin administration, maternal and child health checks, immunizations, and counseling conducted by midwives and posyandu cadres on health cannot be held and require alternative solutions or innovations, e.g. virtual posyandu. Some applicable areas did home visits and used applications as a guide for the cadre to give instruction to mothers. In conclusion, the utilization of applications can overcome differences in quality as instructors between health workers and cadres that can occur due to differences in prior knowledge and help to continue health centre programs in a pandemic situation. THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 57 ABSTRACT

Dr. Masliza Mahmood has made Malaysians very proud as she had been accorded the first Malaysian woman appointed as Associate Professor of Cardiovascular Medicine in an established and renowned university in the world, Oxford University in the UK. Born in Johore, Dr Masliza is an honorary consultant in Cardiac Imaging, Oxford University Hospitals and currently the head of Clinical Trials Group at the University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Division of Cardiovascular Medicine OCMR. Her research focuses on the use of cardiovascular magnetic resonance imaging (CMR) and spectroscopy techniques for early detection of cardiac abnormalities and to find novel treatment for patients with cardiomyopathy, heart failure, aortic valve disease and diabetes mellitus. Dr Masliza once had experienced working in Hospital Canselor Tunku Mukhriz, Cheras, Kuala Lumpur, obtained a DPhil (PhD) in Cardiovascular Medicine from Oxford followed by a period of postdoctoral fellowship at OCMR. Dr Masliza is a member of the Royal College of Physicians (MRCP) from London, Master of Internal Medicine (MMed) from Malaysia and primary medical degree (MBChB) from Otago University, New Zealand. She is currently a member of the Steering Committee of the British Society of Cardiovascular Magnetic Resonance (BSCMR) Heart Failure Research Task Force. Dr Masliza has contributed significantly in her field and has become an idol for every academician especially for her excellency and outstanding performance in research activities not only in Malaysia, but all over the world. THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 PLENARY 4 Clinical research is important in advancement of medical knowledge with the ultimate goal to improve healthcare of patients, as well as enhancing career progression for the individual researchers. What are the prerequisites for undertaking impactful clinical research, and what are the common challenges faced? In the era of COVID-19, how is clinical research affected, and what are the strategies in place to overcome the additional challenges? 58 ABSTRACT

THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 Symposium 4 Learning from the Pathogen 59

Kok Lian Ho is an Associate Professor at the Faculty of Medicine and Health Sciences, Universiti Putra Malaysia. His research interests include structural and molecular virology. He was trained in X-ray crystallography at the University of Edinburgh (2004-2008) under the supervision of Prof Dr. Malcolm Walkinshaw and Prof Sir Adrian Bird. He was a visiting scientist at the Centre for Virus Research, University of Glasgow in 2016, where he learnt cryo-electron microscopy in Prof. David Bhella’s laboratory. He has solved the three-dimensional structures of methyl-CpG binding proteins, the capsid of hepatitis B virus and the capsid of prawn nodavirus. He is now actively involved in research for vaccine development particularly for human influenza A virus, Japanese encephalitis virus, and coronavirus. He has published more than 70 papers in leading scientific journals including Molecular Cell, PLoS Biology, PLoS One, Scientific Reports, Vaccines, and Pharmaceutics. THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 SYMPOSIUM 4:13 60

Virus-like particles (VLPs) are multimeric nanostructures with morphology mimicking the native viruses but devoid of viral genetic materials, which render them neither infective nor replicative. VLPs can be engineered to display multiple copies of immunogenic viral epitopes for vaccine development. Like native viruses, specific epitopes displayed on VLPs can be presented by antigen-presenting cells to elicit potent specific humoral and cell-mediated immune responses. Macrobrachium rosenbergii nodavirus capsid protein (MrNV-CP) has been produced in Escherichia coli and Spodoptera frugiperda, which selfassembled into VLPs. To develop a universal influenza A vaccine targeting all influenza A virus (IAV) strains, multiple copies of the extracellular domain of Matrix 2 protein (M2e) were displayed on the surface of MrNV-CP VLPs. The displayed M2e was highly immunogenic which elicited anti-M2e antibody titers that corresponded well with increased survival, reduced immunopathology, and morbidity of the IAV-infected BALB/c mice. The mice immunized with MrNV-CP M2ex3 demonstrated lower H1N1 and H3N2 virus replications in the respiratory tract, and the vaccine activated the production of different antiviral cytokines when the mice were challenged with these viruses. Collectively, the results suggested that MrNV-CPM2ex3 is a potential universal influenza A vaccine. In another study, we displayed the domain III of Japanese encephalitis virus (JEV) envelope protein on the surface of the VLPs (MrNV-CPJEV-DIII). The mice injected with the chimeric VLPs expressed in E. coli successfully produced significant high levels of anti-JEV-DIII antibody. Immunophenotyping showed that the MrNV-CPJEV-DIII supplemented with alum triggered proliferation of cytotoxic T-lymphocytes, macrophages, and natural killer (NK) cells. Additionally, cytokine profiles of the immunized mice indicated the activation of adaptive cellular and innate immune responses mediated by MrNV-CPJEV-DIII VLPs. By and large, induction of innate, humoral and cellular immune responses by the MrNV-CPJEV-DIII VLPs suggests that the chimeric protein is a promising JEV vaccine candidate THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 61 ABSTRACT

DR. dr. Sitti Musafirah Arif, SpKK, FINSDV was born in Ujung Pandang in 1967. She had her Bachelor's degree in Medicine at Hasanuddin University Makassar. She then furthered her studies in the Dermatology and Venereology Specialist Program at Hasanuddin University, Makassar, followed by Postgraduate Education Program for Doctorate at Hasanuddin University. She has vast clinical experience as a general practitioner before becoming a Dermatology and Venereology Specialist at Dermatology Health Center, South Sulawesi Provincial Health Office. She started her journey as an academician in 2011 at the Faculty of Medicine and Health Sciences, University of Muhammadiyah Makassar. She holds national membership as a member of the Indonesian Society of Dermatology & Venereology (PERDOSKI) Branch of Makassar. She is also active in writing several scientific articles and books, attending several National Seminars and International Congresses, and being a speaker in various scientific sessions, both national and international events, in the field of Dermatology & Venereology, as well as Medical Education & Teaching. THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 SYMPOSIUM 4:14 The hair growth cycle consists of 3 phases: 1) anagen (growth phase), 2) catagen (transition phase) and 3) telogen (resting phase). Telogen Effluvium (TE) is the release of excessive amounts of telogen hair without the presence of inflammation caused by the telogen phase faster than it should be. Telogen Effluvium occurs within 3-4 months after the occurrence of the triggering factor. Various agents reported to be associated with TE consist of medication, psychic stress (high fever), emotional, and chronic infections, diet, iron deficiency, and smoking. Some studies and literature link TE and after SARS-CoV 2 infection. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV 2) is the cause of COVID-19 which spreads widely causing a pandemic, giving mild to severe symptoms, even to death. Some patients who have been infected with SARS-CoV2 and recovered may have experienced a sequel, including Telogen Effluvium. Several pathogenetic mechanisms have been suggested previously to associate TE after COVID-19 infection. The exact mechanisms by which this virus induces hair loss are not well known, but the most acceptable are: 1) Pro-inflammatory cytokines such as IL-6, TNFα, IL-1β, and IFNγ, which are released during systemic hyperinflammation of the COVID-19 may be responsible for the inhibition of hair shaft elongation, damage to matrix cells, and catagen development. 2) Micro thrombotic reaction due to decreased concentration of anticoagulant proteins, occlusion of the hair follicle vasculature, and the resulting cell death. 3) Direct infection of the hair follicle by SARS-CoV-2 has also been implicated in the development of ATE. 4) The psychosocial condition of patients who recovered from COVID-19 is seriously affected. 62 ABSTRACT

Dr Shuhaila Mat Sharani completed her undergraduate study at Universiti Kebangsaan Malaysia in Bioinformatics. Immediately after graduation she worked as a research assistant in extremophile genomes project. Then later she decided to pursue her Master study in genome analysis of extremophile adaptability with her project title “Glaciozyma antarctica genome annotation and in silico prediction of its adaptation strategies towards extreme cold temperature”. In 2020 She received her PhD in UKM. Her thesis paper on “Computational discovery and annotation of conserved small open reading frames in fungal genomes”. During her PhD, she also worked as a Scientist at Malaysia Genome Institute (MGI) for 8 years, working on genome and transcriptome analysis also conducting several bioinformatics workshops and successfully published genome database. An opportunity to work as a freelance scientist as cofounder of the Omicsbar came after she concluded her employment with MGI. She later developed her career at Institute Medical Research, National Institute of Health working closely with Bioinformatics Department group on a project SNP detection from exomesequencing data and RNA-seq analysis on nasopharyngeal cancer genome. She has also worked with Symphony Infotech as a Bioinformatician. Currently, she is a lecturer at School of Health Sciences, USM and involved in genome prediction and annotation, structure variant and evolutionary of SARS-CoV2, gene profiling of cancer patient and mobile genetic elements for pathogenesis study. THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 SYMPOSIUM 4:15 63

Background - The sharing of COVID-19 sequences from all countries around the world has allowed for comprehensive analyses of COVID-19 genomic diversity, regional, and demographical analysis. Data on the temporal distribution of COVID-19 variants and lineages enables better infection and outbreak control, surveillance, and facilitate policy making for public health. Methodology- SARS-CoV-2 sequences isolated from Negeri Sembilan COVID-19 cases were extracted and analysed from the GISAID database over the last year (Jan2021-June2022). A total of 417 sequences that satisfy the quality assurance (length ≥29,000 nts) were used for the study. The reference genome sequence of SARS-CoV-2 obtained is hCoV-19/Wuhan/WIV04/2019 (WIV04) which is also the official reference genome sequence used by GISAID. Gene annotation of the sequences was done using VIGOR (version 4.1.2) and SNPs were extracted from the GISAID database. The phylogenetic tree was constructed using the UPGMA method from all 417 whole completed genome sequences aligned with MAFFT. The tree was then constructed using the Maximum Composite Likelihood (MCL) model, uniform site rates, and a 1000-time bootstrap using MEGA X and visualize using iTol. Results- Phylogenomic analysis revealed a total of 20 lineages from Negeri Sembilan of which, 7 of the lineages are still circulating. 3 major GISAID clades were identified, namely GRA, GK and O on a maximum likelihood phylogenetic tree. Majority (60.4%) of viruses in Negeri Sembilan are of GRA lineage with strong representation from the Malaysian lineage BA.1.1 (24.7%). A time series analysis shows that the majority lineage AY.79 (30% of total samples) was the majority of circulating lineage from July21 – Jan22. From then on, the lineage BA.1.1 recorded a spike of cases from Dec21 – Mac22. Interestingly, several sub-lineages from Malaysian lineages (BA.2.40.1, BA.2.57 and BA.2.9) has emerged from Apr-22 onwards. It is likely that in the future, the viral evolution of SARS-CoV-2 would form regional sub-lineages tailored for every region. It was also interesting to note that since the subsiding of lockdowns in Oct '21, the number of cases submitted has increased. The two major lineage from phylogenetics tree show that mostly delta (B.1.617.2) and omicron (BA.1.1, BA.2.40.1, BA.2.57 and BA.2.9) variants cases highly found in Seremban and Tampin in Negeri Sembilan. Conclusion -Our data suggest that genomic evolution of SARS-CoV-2 is high – even at state level. Frequent data submission and surveillance is needed to track the evolutionary progress of SARS-CoV-2. THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 64 ABSTRACT

Associate Professor Dr. Norsham Juliana is a Senior Lecturer of Medical Physiology at Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia. Her educational background includes having a BBioMedSc, MMedSc (Internal Medicine), PhD (Nutrition) from UKM. Since 2019 till 2022. She has been appointed as Deputy Director of Research and Innovation Management Centre in Research Strategy and Recognition. Besides that, she is deeply involved in the development of university policies including Research and Innovation Policy, Research Data Management Policy, and Commercialisation Policy. As a researcher, she has published 45 papers, received 10 awards, presented more than 20 papers including 9 invited talks/plenaries both at the national and international levels, and written articles in the mainstream media. Her special interests are in translational cardiophysiology and chrononutrition research. She is currently leading multiple projects in relation to her interest and also being an active research member to her peers with cumulative grants received of more than RM 2 million up to date. Since 2009 until to date she collaborates with the National Heart Institute of Malaysia to be part in Dexmedetomidine Improve After-bypass Myocardial Outcome and Neuro-cognitive Dysfunction(DIAMOND), a clinical trial involving coronary artery bypass grafting patient. Being passionate in giving back to the community, she involves in applied research that directly benefitted the community. Multiple programmes such as series of ‘Knowledge transfer programme’, ‘Healthy Nutrition Programmes’ and many more has been conducted to assure the knowledge gained in evidence-based studies being transferred to the society. Currently she teaches and supervises undergraduate and postgraduate students in Universiti Sains Islam Malaysia (USIM), Universiti Teknologi Mara UiTM and also Universiti Kuala Lumpur (UniKL). THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 SYMPOSIUM 4:16 65

Currently, emerging of various communicable diseases including Covid-19, influenza, and hand foot and mouth disease (HFMD) outbreaks have been a challenge across the globe. Previous outbreaks have taught us that as an epidemic evolves, there is an urgent need to expand public health activities beyond direct clinical management and extend to cover basic principles of management and optimization of resource utilization. The nutritional status of individuals has for long been considered an indicator of resilience against any communicable diseases. It is mandatory to attain and maintain good nutritional status to boost immunity. Nevertheless, body immunity is influenced by optimal nutrition and dietary nutrient intake, therefore the only sustainable way to survive in the current battle against communicable diseases is to strengthen the immune system. There are conflicting evidences discussing the role of supplements in improving or curing the immune system except for Vit C, which was distinctively found as one of the best ways to improve immune system. However, a proper diet can ensure that the body is in a proper state to defeat any communicable diseases. Along with the dietary management guidelines, food safety management and good food practices are also compulsory. This topic will be explored further in IHEC 2022 on the role of nutrition to boost immunity, discussion on dietary guidelines about nutrition to withstand infections will also be discussed. THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 66 ABSTRACT

THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 Symposium 5 Lessons in Clinical Approach and Diagnostics 67

Dr. Hana Maizuliana Solehan is medical graduate from International Medical University. After graduating, Dr. Hana served Kementerian Kesihatan Malaysia (KKM) hospitals (Hospital Kuala Terengganu and Hospital Tengku Ampuan Rahimah Klang) for 4 years before joining USIM as a medical trainee lecturer in 2008. She then obtained her post-graduate degree in Internal Medicine from Universiti Kebangsaan Malaysia. She continued with a Fellowship in Neurology subspecialty at Universiti Kebangsaan Malaysia Medical Center and Epilepsy National Center, Shizuoka Japan. Currently, Dr. Hana is a senior medical lecturer, teaching Internal Medicine at Universiti Sains Islam Malaysia. She is also practicing at Klinik Pakar Kesihatan USIM Nilai. Additionally, Dr. Hana is a visiting neurologist at Columbia Asia Hospital Seremban and USIM’s teaching hospitals, namely Hospital Port Dickson, Hospital Ampang and Hospital Tampin. Dr. Hana has published articles regarding COVID-19 and neurology. Her special interest are neurology and epilepsy. THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 SYMPOSIUM 5:17 Since 2020, the COVID-19 pandemic has caused significant health and economic catastrophe globally. Shortness of breath, fever, coughing, and lethargy are the most common acute symptoms of COVID-19. However, three out of every four infected people showed no symptoms. Later in the pandemic, it is becoming more evident that COVID-19 patients might present with more prolonged, varied symptoms and long-term consequences. There are several terminologies that have been used to describe this condition, such as “post-COVID-19 syndrome”, “long COVID”, “long-hauler COVID-19”, “chronic COVID-19”, “persistent COVID-19 symptoms”, “persistent COVID-19 symptoms”, “chronic COVID-19”, and a few other terms. It is a complex issue with a wide range of physical and psychological symptoms, and our understanding of its pathogenesis and risk factors is still lacking. The most common long COVID-19 symptoms are fatigue, headache, difficulty in breathing and loss of concentration. Long COVID-19 symptoms are more likely to occur in those who are older, female, and / or have other concomitant illnesses such as hypertension and chronic pulmonary disease. The development of COVID-19 vaccine has dramatically shift the pattern of COVID-19 infection. COVID-19 vaccine has shown to reduce the likelihood of long COVID symptoms. Improvement is continued to be seen even after COVID-19 vaccine second dose and booster injections were given. However, long-term follow-up research is required to assess the longterm association between immunisation and long-term COVID, particularly the impact of the newly emerging COVID-19 variants. On the other hand, it is important for the health authority to continue emphasizing on the primary prevention of COVID-19. 68 ABSTRACT

Rozainanee Mohd Zain is currently the Consultant Clinical Virologist working at the Virology Unit, Infectious Disease Research Centre. She supervises all specialised viral diagnostics testing or activities that are carried out in the Unit to support the laboratory testing for most government hospitals and primary health care facilities in the country. As a Clinical Virologist, she is actively involved with the national reference laboratories activities and the designated reference laboratories; National Poliovirus Laboratory, WHO National Influenza Centre, National Reference Laboratory for HIV/AIDS, National Laboratory for Viral Hepatitis (recently designated) and National Laboratory for Japanese Encephalitis (until 2015). She led an important project in developing and implementing HIV drug resistance genotyping assay for the country. She also responsible in carrying out National External Quality Assurance Scheme (NEQAS) to detect the presence on HIV antibodies and to assess other government and private laboratories in the country in performing the tests to detect the HIV antibodies. NEQAS has substantially expanded to many hospitals and primary health care facilities. She is an active member of various committee members including of ISO 15189 Implementation and Institutional Biosafety and Biosecurity committees. Currently, she is the IMR Biosafety Officer and responsible in overseeing any research related to the use of modern biotechnology and living modified organisms (LMOs) THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 SYMPOSIUM 5:18 69 COVID-19 pandemic has caused a great impact on every aspects of our lives since its occurrence in early 2020. The emergence of SARS-CoV-2 as the cause for the COVID-19 has led the laboratories around the world to operate at unusual hours in coping with the number of samples received during the pandemics. Early in the pandemic, RT-PCR for COVID-19 detection was the mainstay of diagnostic test in identifying the patients with active infection as it was crucial to quarantine the patients in order to curb the spread of the disease. Many challenges needed to be faced by countries which to include insufficient facilities for PCR tests, inadequate test reagents and inadequate swabs. As the pandemic progressed, a new testing strategy with a use of COVID-19 antigen kit has emerged and been adopted by various countries in coping with the number of samples. With evidences of saliva sample can be used as alternative for COVID-19 detection, saliva rapid test kit has been developed and assessed. This is the start of a new era of selftesting at home for COVID-19. Many advantages and disadvantages have been associated with the selftesting at home which need to be further elucidated and understood. ABSTRACT

Dr Azureen Azmel is an Infectious Diseases Consultant at Hospital Tengku Ampuan Rahimah (HTAR), in Klang, Selangor. She obtained her medical degree from Universiti Kebangsaan Malaysia, followed by Masters Degree in Internal Medicine at University of Malaya and subspecialized in Infectious Diseases under the Malaysian Ministry of Health, Monash Health and The Alfred, Melbourne. Dr Azureen is an active member in various medical societies in which she holds the Secretary post in the Malaysian Society of Infection Control and Infectious Diseases (MyICID). She also leads the Antimicrobial Stewardship (AMS) programme in HTAR. She finds passion in teaching whereby she is involved as the facilitator in the national dengue online module for secondary care and Covid-19 management training for the hospital. She is also the honorary lecturer in Internal Medicine for Management and Science University (MSU) and Masters in Clinical Pharmacy, UITM. She is also one of the writers for the National Antiretroviral Therapy Guidelines for HIV. Her publications and presentations at congresses have included numerous topics on infectious diseases, especially on HIV, dengue and antimicrobial resistance. THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 SYMPOSIUM 5:19 70 ABSTRACT The spectrum of COVID-19 in adults ranges from asymptomatic infection to mild respiratory tract symptoms to severe pneumonia with acute respiratory distress syndrome (ARDS) and multiorgan dysfunction. Although Malaysia has entered the transition to endemic phase, certain group of population such as the elderly, individuals with co-morbidities, and immunocompromised hosts are still at risk of severe diseases. Early initiation of antivirals in patients with mild to moderate disease can prevent hospitalization and death. The availability of oral antivirals has made it possible for patients to obtain treatment as outpatient. The administration of oral antivirals in outpatient setting can prevent unnecessary hospital admissions which may potentially overburden the healthcare system. There is also substantial evidence to show that vaccination remains the most effective way to prevent SARS-CoV-2 infection and progression to severe disease. However, some individuals may not mount an adequate protective response to COVID-19 vaccines. Others may not have been fully vaccinated because they have a history of severe adverse reactions to a COVID-19 vaccine or its components. This group of patients may benefit from pre-exposure prophylaxis. The Malaysian Ministry of Health has published the updated guidelines on Clinical Management of Confirmed Covid-19 Cases in Adults which has included the novel oral antiviral agents and the indication of pre-exposure prophylaxis. However, not everyone is eligible for this therapy. Amongst the factors that are being taken into account when deciding on treatment initiation are age, disease severity, vaccination status and presence of co-morbidities. It is important for clinicians to know the indication and potential adverse effects of each specific treatment of Covid-19 and select the patients appropriately to ensure that patients obtain clear benefit from the treatment.

Dr. Nur Anna Chalimah Sa’dyah, Sp.PD-KEMD, FINASIM is an endocrinologist in the Faculty of Medicine Universitas Gadjah Mada from 2018. She graduated in 1993 and became an internist in 2003 in Faculty of Medicine, Gajah Mada University. She subsequently became an endocrinologist in the faculty of medicine in 2018. She has been a lecturer in the Internal Medicine Department Faculty of Medicine Universitas Islam Sultan Agung Semarang since 2002. She was also previously the Head of the Education Department of the university from 2004 to 2008 and subsequently was the Vice Dean of Partnership at the Faculty of Medicine, and the Director of Education and Medical Support from 2008 to 2014. She is the chief of Persatuan Diabetes Indonesia (PERSADIA) Unit in RSI Sultan Agung Semarang since 2008. She is also the 2nd chief of PEROSI (Perhimpunan Osteoporosis Indonesia) and a member of both PERKENI (Perhimpunan Endokrinologi Indonesia) and InaTA (Perhimpunan Tiroid Indonesia). Diabetes, endocrinology and patient education are always close to her heart and she appears regularly in public to give lectures on the importance of diabetes control and thyroid disease in general. She continues to actively give talks throughout the pandemic via webinars and lectures broadcasted on Facebook and Youtube. She is active on social media, and regularly promotes education for endocrine diseases, specifically diabetes mellitus on her social media platforms. THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 SYMPOSIUM 5:20 71 Coronavirus Disease (COVID-19) became a global pandemic in 2020. Millions of people have been affected by COVID-19, including diabetes patients. Diabetes mellitus is one of the important risk factors for severe COVID-19 cases. Some reports have shown that there are associated comorbidities and higher mortality rates in COVID-19 patients with diabetes. The mechanisms underlying the conditions are still unclear but there are a few hypotheses. Moreover, patients with poor glycaemic control have a higher risk of developing severe course COVID-19. The relationship between diabetes and COVID-19 is complicated and bidirectional. COVID-19 infections could lead to the worsening of hyperglycaemia. Hyperglycaemia itself can lead to glucose toxicity, thus the risk of severe COVID-19 in patients with diabetes is increased even further. SARS-CoV-2 might interact with β-cells, as a result, COVID-19 might cause new-onset diabetes or sustain hyperglycaemia at hospital admission. As the pandemic progresses, clinicians also face the challenge of the long-COVID effect. Patients that have recovered from the SARS-CoV-2 infections may develop diabetes. As the pandemic affects diabetes and metabolic condition in many aspects, there are some adjustments to the practices. ABSTRACT

THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 Symposium 6 Lessons on Social Well-Being 72

Mrs. Jacquline is a 37 year-old certified nurse in University of San Carlos, Philippines. She completed her B.S. Nursing at University of San Carlos in 2005. She then pursued Master of Arts in Nursing at University of San Carlos. Currently she is studying Doctor of Philosophy in Nursing at the Silliman University, Negros Oriental. She was a speaker in the 7th School of Health Care Professions Research Conference of the University of San Carlos. She is currently working in the academe, as a clinical instructor at the University of San Carlos, Department of Nursing. Mrs Jacqueline holds multiple professional membership and these includes the Philippine Nurses Association, Operating Room Nurses Association of the Philippines and the Academic Marketing and Promotional Committee of the University of San Carlos. THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 SYMPOSIUM 6:21 The COVID-19 infection, which started in Wuhan, China has literally brought panic and distraught worldwide. Limited knowledge and information about the disease brought devastating consequences to the entire country, especially the healthcare industry. Millions of people died because of the disease; hundreds of thousands of people succumbed to their death. Countries around the world respond differently to the challenges as burnout among those in the frontlines, such as doctors, nurses, clinicians and several others were massively reported and the shortage of personal protective equipment posed a greater threat to the health care workers. The advance of technology has greatly shaped the healthcare arena. The use of information technology, such as nursing informatics has helped in curbing the disease. Initiatives were taken by nurse informaticians/ informatics nurses in different parts of the world. These initiatives include collaboration and coordination among stakeholders to create policies in mitigating the disease, the use of social media platforms, such as Twitter to disseminate appropriate and correct information to the masses, and the wide utilization of telehealth. COVID-19 datasets were analyzed to assess any trends and predict possible outcomes of health among infected individuals. Nursing informatics in the academe setting also provided its own share of teaching nursing students in understanding the disease process and developing strategies to support organizations in fighting misinformation. Nursing informatics has still a long way to go. The integration of artificial intelligence will create a dramatic shift in our response to any possible infectious disease in the near future. 73 ABSTRACT

Hajjah Widad Asnawi, a mother of 7 children, is a successful momprenuer and social activist, well-known for her pioneering work and success in advocating elderly care for Muslims and effective early Quranic education for children in Malaysia. She is the Founder and Chairman of two NGOs – Pusat Jagaan dan Pendididikan Darul Insyirah (Darul Insyirah Elderly Care and Education Centre) and Pusat Kecemerlangan Pendidikan Ummah (PACU). She is also Executive Chairman of PACU Resources Sdn Bhd and DAWJIE Sdn Bhd. Under her leadership, Darul Insyirah established and currently runs three Muslim elderly care centres, with a new dedicated Darul Insyirah Complex under development. PACU has successfully launched four key initiatives – Raudhatul Huffaz Quranic reading classes for primary school children (13 branches, and 19 classes nationwide), Projek Tusyen Ummah (PROTU) tuition classes for secondary school students (8 branches and 14 classes nationwide), Pusat Komuniti Anjung Insyirah (AI) Quranic reading classes for adults (3 branches in Sabah), and KruPACU (Kelab Relawan Ummah), which currently has a membership of 3,000 registered volunteers.Hajjah Widad was the Deputy President of the International Women's Alliance for Family Institution and Quality Education (WAFIQ) for the term 2018/2021, Co-Chair of AgeCope (Persatuan Pengendali Berkediaman Wargaemas Se-Malaysia) for 2018/2019 and the first Chairperson for Gabungan Cakna Warga Emas Muslim (CAKNA) in 2019/2020. She is a member of the Majlis Dakwah Negara and actively contributes to other NGO and national causes in various advisory capacities. THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 SYMPOSIUM 6:22 74

Non-Governmental Organizations (NGOs) are an increasingly important entity in the Malaysian administrative system, NGOs play a major role especially in sectors that cannot be met with the government services. It is referred to as the third sector that helps to solve the nation problems and address various social needs including the issue of poverty and unemployment towards the well-being of the people. However, the presence of Corona Virus Diseases or better known as COVID-19 had a significant impact to non-governmental organization (NGO). Hence, this study aims to examine the social impact of the corona virus on the operations of NGO PACU and Darul Insyirah and its development in response to the Covid-19 outbreak. In addition, it investigates the relationship between operations, funding, services of residents/ students/ teachers and experiences throughout the occurrence of a Covid19 outbreak. Key data were collected through a survey questionnaire with five top management respondents (Chief Executive Officer, Chief Financial Officer, Chief Operating Officer 1, Chief Operating Officer 2 and Chief Human Resources Officer) of these NGOs who have experienced facing this epidemic from the beginning until now. Through discussions and interviews, the data collected can be analysed and the results discussed in the form of tables and charts. The results of this research analysis are discussed to understand the relationship between operation, funding, services of residents/students/faculty and the dependent variables of the effects of Covid-19 on its evolution. Finally, management implications also have been discussed to provide useful information to the operations of NGOs. THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 75 ABSTRACT

Professor Dato’ Dr. Ahmad Faizal bin Mohd Perdaus is the President of MERCY Malaysia, a position he has held since 2010. His involvement with MERCY Malaysia began in 2003 when he initially signed on as a volunteer and subsequently made an EXCO member heading the Drug Rehabilitation and Assistance Programme in Malaysia from 2003 to 2006. Dato’ Dr. Faizal was elected Vice President 1 in 2008 before acting as interim President in August 2009. In 2014, he was also appointed to the Board of Trustees for MERCY Malaysia UK (now MERCY Humanitarian UK). Dato’ Dr. Faizal is also a renowned Pulmonologist (Respiratory Specialist) currently practicing at KPJ Damansara Specialist Hospital. Dato’ Dr. Faizal has been involved as Head of Health & Emerging Hazards cluster of the Scientific Expert Advisory Panel (STEP) to the National Disaster Management Agency (NADMA) as well as a member of the Public-Private Partnership Group under the External Advisory Group (EAG) on COVID-19 to the Malaysian Government. Dato’ Dr. Faizal obtained his Bachelor of Medical Science (1989) and Doctor of Medicine (MD) degree (1992) from Universiti Kebangsaan Malaysia (UKM). He obtained his Master’s in Internal Medicine in 2001. He was accredited as a Respiratory Physician in 2003. In recognition of his work and contributions, Dato’ Dr. Faizal was conferred the Darjah Dato’ Paduka Mahkota Perak (D.P.M.P.) in 2010 by the Sultan of Perak Darul Ridzuan. THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 SYMPOSIUM 6:23 MERCY Malaysia established in 1999 and operating in 34 countries. MERCY Malaysia is an international non-profit organisation focused on providing excellence in medical assistance in both crisis and non- crisis situations as well as build climate and disaster resilient communities to reduce societal burden through meaningful humanitarian actions. 76 ABSTRACT

Professor Datin Dr. Sapora Sipon is a Professor in Psychology Counselling at the Faculty of Leadership and Management, Universiti Sains Islam Malaysia, Malaysia. She has produced more than 60 international journal articles and 50 books in her area of studies. She has been invited to give many keynotes addresses at various conferences and is also actively involved in research and has obtained grants from various resources including LRGS, FRGS, Newton-Ungku Omar and from several Ministries. She has been a weekly columnist for Harian Metro from 2007-2011, writing mainly on counselling the adolescent. She has also won many major international Innovation and Invention Competition including the British Invention Show (BIS). As a regular television guest, she talks on current issues especially those are related to counselling. THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 SYMPOSIUM 6:24 The world, due to COVID-19, undoubtly, has witnessed the largest single disruption to well-being. COVID19 has transformed the world and exacted a massive human, economic and social price. Massive fiscal recovery packages have been introduced to provide urgently-needed support. Yet, aftermath, in the post pandemic era, a great deal of uncertainty and hardship remains. Physical and digital damages and enormous burdens on healthcare systems occur. Unintentional detrimental of employee well-being remains. Thus, redefining and reshaping well-being in a post pandemic era need to be addressed in creating a brighter picture of the future. This paper will present a holistic approach to well-being. Emphasis on resilience, sustainability, restructuring caregiving policies, providing flexible work schedules, and delivering consistent, affordable, and sustainable avenues for supporting mental health in redefining, reshaping and optimizing well-being is the main agenda of this paper. 77 ABSTRACT

THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022

Abstract ID Presenter Title OP01 Mohd Radzniwan A Rashid Pandemic Fatigue: The Scoping Review on Literatures’ Patterns on Pandemic Fatigue and Measures Implemented OP02 Natasya Abdullah Development and Validation of an Instrument to Identify the Source of Stressors Among Academicians of Higher Learning Institutions in Malaysia During the COVID-19 Pandemic: A Pilot Study OP03 Noraziah Nordin Muricins Exhibit Potential Bcl-xl Inhibitor in Cancer Pharmacotherapy: A Molecular Docking Analysis OP04 Marjanu Hikmah Elias Biosensor for Human Papillomavirus Genotyping in Cervical Cancer – A Systematic Review OP05 Kamala Krishnan Association Between Physical Fitness Level and Psychological Health Among Dodgeball Players OP06 Azira Khalil The Radiology Workforce's Response to the COVID-19 Pandemic in Malaysia OP07 Anu Suria Misdiagnosis of Lupus in an Adolescent: A Case Report OP08 Ami Febriza Role of Resilience and Quality of Life on Academic Achievement Among Medical Students During Pandemic OP09 Azrul Hafiz Abdul Aziz The Perception of Students on Online Classes During COVID-19 Pandemic OP10 Nuurain Amirah Mohd Razi Does Burden Mediate the Relationship of Caregiving Demand and Resource With Burnout in Dementia Caregiving? An Application of the Job Demand-Resource (JD-R) Model OP11 Lailatul Hazzliza Binti Musa Factors Associated With Knowledge of Latent Tuberculosis Infection Among Medical and Nursing Students in Negeri Sembilan, Malaysia OP12 Raihan Abd Aziz Knowledge and Practices Towards Sexually Transmitted Infections (STI) Among Patients Attending STI-Friendly Clinic in a Primary Care Practice OP13 Assyifaa Nik Mazian A Rare Case of Spontaneous Intraperitoneal Bladder Rupture Post Normal Vaginal Delivery – Conservatively Treated OP14 Nusima Binti Mohamed Knowledge and Perception of Young Adults Patients Towards Dental Veneers and Fake Veneers. OP15 Nik Nur Syahida Binti Sanusi Telemedicine: Effectiveness, Drawbacks, and Challenges THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 79

Abstract ID Presenter Title OP16 Rahayu binti Othman The Prevalence and Factors Associated With Perceived Stress Among Senior and Junior Doctors During the COVID-19 Pandemic in Johor District Health Offices OP17 Ting Chuong Hock Experience of Psychiatric Education Among Medical Students of a Malaysian University During the COVID-19 Pandemic OP18 Tan Siew Tin Development of an Integrated-Weight Management Programme in Malaysian Government Primary Care Clinics Based on Focus Group Discussions OP19 Noor Mikraz Bt Mohamad Isa Clinical Outcome and Tolerability of Paxlovid Among COVID-19 Patients Attending COVID Assessment Centres (CAC) in Negeri Sembilan OP20 Aisyah Binti Mohd Rahimi Trimodality Image Registration for Aortic Valve Diagnosis and Surgical Guidance OP21 Zuliyasmin Zulkifli Psychological Distress Among Acne Patients and its Association With Functional Disability Index OP22 Diveyaa Sivakumar Expression of Inhibitory Neurotransmitter GABAA Receptors in Human Dental Pulp: A Potential Role in Dental Nociceptive Signalling OP23 Jamaah Mohd The Knowledge, Attitude and Practice (KAP) of Overweight and Obesity Among Staff of Universiti Sains Islam Malaysia (USIM) OP24 Nurul Nadiah Binti Mohd Iqbal Prevalence Of Platelet Dysfunction And Its Association With Urea Level And Other Parameters In Patients With Chronic Kidney Disease OP25 Jamil Aiman bin Mohd Baharudin Knowledge and Practice of Childhood Immunization Among Parents in Kelantan, Malaysia During the COVID-19 Pandemic. OP26 Martina Irwan Khoo Characterisation of 1-methyl-1-nitrosourea (MNU)-Induced Mammary Carcinogenesis in Curcumin-Treated Rats OP27 Muhammad Ihsan Kitta Management of Developmental Dysplasia of the Hip in Two Years of Age: A Case Report OP28 Sangita Pachal Investigating the Association of Anti-Depressant Medications in Relation to the Risk of Breast Cancer: A Systematic Review and Meta Analysis OP29 Ambusam Subramaniam Knowledge and Awareness Toward The Importance of Physical Activities in Preventing the Risk of Colorectal Cancer Among Adults in Klang Valley THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 80

Abstract ID Presenter Title OP30 Muhammad Firdaus Bin Rushdi Parental Acceptance on COVID-19 Vaccination and its Associated Factors: A Systematic Review. OP31 Sakinah Binti Mohd Razali Unexplained Limbs Pain in a Young Adult: A Case Of Multifocal Tropical Pyomyositis, The Great Mimicker. OP32 Sri Priyantini Significant Relationship Between Stunting and Head Circumference Growth in the First 3 years of Life: A Prospective Study OP33 Jalilah binti Jamaluddin Evaluation of B-Cell Populations in Children with Recurrent Infections OP34 Nazefah Abdul Hamid A Systematic Review of Gene Expression in Cervical Cancer: an Integrated Bioinformatical Analysis OP35 Mohd Hafiz Jaafar Prevalence and Factors Associated With Digital Health Literacy Level Among Population in Pondoi, Negeri Sembilan OP36 Aminatul Saadiah binti Abdul Jamil Health Rationing Redux: How the COVID-19 Pandemic "Shrink-flate" Healthcare Resources in Malaysia and Nigeria OP37 Nur Zaireena Binti Zainal Transient Bilateral Mild Ventriculomegaly of the Fetus Post Maternal COVID-19 Infection: Two Case Reviews OP38 Nur Fahada binti Mohammad Lazim Pandemic Aftermath: Pedophile Tracker Application and How Reliable in Protecting Our Children OP39 Qatrun Nada Binti Derani Differential Expression of MicroRNA and its Target Genes in Trigona Honey Treated Breast Cancer Cell Line OP40 Ulfa Eliah Skin Graft as an Acceptable Modality for the Reconstruction of PostBurn Contractures During Pandemic : A Case Report OP41 Clyde R. Lumahang The Use of The Anthocyanin Extract From Red Cabbage Brassica Oleracea L. Var Capitata f. Rubra as Meat Freshness Indicator for Chicken Gallus Gallus Domesticus and Pig Sus Scrofa Domesticus Meat OP42 Zul Azlin Razali Hujan Pagi: A Monumental Malay Novel Bridging Literature and Psychiatry OP43 Rini Riyanti Correlation Between NLR (Neutrophil Lymphocyte Ratio) and CRP (CReactive Protein) in COVID-19 Patients in Jember Regency OP44 Juliani Ibrahim Vaccination Program and Stunting Incidence at Tampa Padang Health Center: Effective Coverage Study THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 81

Abstract ID Presenter Title OP45 Moh. Asri Abidin Multiple Giant Cell Tumor With Hyperparathyroidism in a 33-Year-Old Male: A Case Report OP46 Andi Weri Sompa Neurological Manifestations of COVID-19 at Pelamonia Hospital as Teaching Hospital in Makassar City OP47 Dewi Intisari Evaluation of Clitoria Ternatea L. Flower Extract in Preventing Complications of Diabetes Mellitus OP48 Sheilla Rachmania COVID-19 Pandemic Lesson Learned: Student Volunteers during COVID-19 Pandemic as a Feasible Undergraduate Student Education OP49 Nur Muallima Diarrhea in Patients With COVID-19 and Intestinal Parasitic Infection OP50 Azka Darajat International Normalized Ratio for Predicting Pediatric Complicated Appendicitis OP51 Supangat The Use of WhatsApp© Group as Telemedicine Care and Education for Pediatric Surgery Patients' Parents During COVID-19 pandemic: A Survey Conducted at an Agricultural Area in Indonesia OP52 Muhammad Hasan Correlation Between Risk Factors and the Incidence of Knee Osteoarthritis OP53 Elly Nurus Sakinah Effect of Neem Gum on MDA levels of Diazinon Induced Rat OP54 Dara Ugi Aras Effect of Buni Fruit Extract (Antidesma bunius L.) on Body Weight and Fasting Blood Sugar in a Streptozotocin (STZ)-Induced Hyperglycemia Wistar Rats Model OP55 Sumarni Sensitivity Test of Lontar Leaves Extract (Borassus Flabellifer) Towards the Growth of Vibrio Cholerae OP56 Noremy Md Khir The Challenges of Community Leaders in Managing Flood Disasters During Pandemic COVID-19 OP57 Mharnelle June Jison Efficacy of Corn Bran as an Ingredient in the Production of Edible Sporks OP58 QT Marie E. Apolinario The Sensory Evaluation of a Prebiotic Drink From Banana (Musa acuminata × M. balbisiana (AAB Group) 'Silk') and Oats (Avena sativa Steel Cut Oats) OP59 Dini Agustina The Role of Interleukin-6 Inhibitor and Janus Kinase Inhibitor in Ameliorating Cytokine Release Syndrome Induced by Severe Infectious Diseases: A Systematic Review of Randomized Controlled Trial Studies THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 82

Abstract ID Presenter Title OP60 Jalina Karim The Stress Level and Coping Strategies Among Nursing Students in Universiti Kebangsaan Malaysia During COVID-19 OP61 Nur Adline Binti Mohammad Plasmodium berghei Infection Post Spleen Autotransplantation in the Mice Model OP62 Khairun Nain Bin Nor Aripin The Protective Effect of High Fibre Diets Against Severe COVID-19: A Scoping Review OP63 Noor Anisah Binti Abu Yazit Coronary Artery Bypass Graft in High-Risk Patients With Postoperative Cognitive Dysfunctions Downregulate Killer Cell Immunoglobulin-like Receptor Genes OP64 Amirah binti Azzeri Reshaping Medical Care in the Aftermath of COVID-19 With Paxlovid: How Much Are Our People Willing and Able to Pay for Health? OP65 Mohd Hafiz Jaafar Prevalence and Factors Associated With Depression Among the Elderly in Pondoi, Negeri Sembilan OP66 Abu Ubaidah Amir Bin Norazmi Sports Performance and Cardiorespiratory Fitness After COVID-19 Infection Among Athletes OP67 Fatin Ain Najwa Normi Dental Students’ Oral Health Knowledge, Attitude, and Practice Towards Oral Health Status: A Cross Sectional Study OP68 Tengku Amatullah Madeehah Binti T Mohd Loneliness Among Older Adults in a Rural Village in Negeri Sembilan OP69 Muhammad Waras Bin Samson Perception and Acceptance of COVID-19 Vaccination Among Pregnant Mother and its Impact on Maternal Health OP70 Monica Surbano Eating Pattern And Nutritional Status Among Sangguniang Kabataan in San Francisco, Cebu OP71 Rena Normasari Comparing Complete Freund's Adjuvant and Monosodium Iodoacetate-induced Knee Joint Arthritis in Wistar Rats OP72 Siti Aishah Binti Amir Yusdi Otorhinolaryngological Manifestations in Long Covid Patients and its Effect on Quality of Life OP73 Siti Soraya Ab Rahman Infection Control Measures in the Radiology Department During the COVID-19 Pandemic: A Scoping Review OP74 Khairullah Anuar Traumatic Epistaxis in Association With Pneumocranium. THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 83

OP 01 Introduction: The prolonged existence of covid-19, since it began from the end of 2019 causes pandemic fatigue(PF). The World Health Organization defines PF as the demotivation to follow recommended protective behaviours, emerging gradually and could affect people’s emotions, experiences, and perceptions. Objective(s): The study aimed at reporting current literatures’ patterns on pandemic fatigue and measures implemented by countries to contain the virus. Methodology: The review was conducted from December 2019 until 27 March 2022 emulating the five-phase framework for conducting scoping reviews by Arksey and O’Malley, using four databases; PubMed, Science Direct, Proquest and ClinicalKey. The articles related to fatigue caused by handing the pandemic by healthcare workers were excluded. The MeSH term used were (pandemic OR COVID19 OR COVID OR COVID-19 OR coronavirus) AND (fatigue OR lockdown) NOT (burnout OR compassion fatigue OR mental health OR mental illness OR depression OR anxiety OR stress). Duplicates articles were removed. Non-English articles were excluded. Results: A total of 2568 articles were screened from the title and abstract level, of which 30 articles were assessed at full text. The majority were opinion-based type (13) followed by cross-sectional study (12) and one of each of the following types: systematic review, policy paper, observational, questionnaires development and analysis. The cross-sectional studies were done mostly in Japan and Taiwan and the maximum sample size was 6532. As for and opinion-based articles, most are done in the USA, followed by in the UK. The opinions are variable in terms of the focus. Generally, most mainly mentioned that the PF should be managed effectively. Conclusion(s): Pandemic fatigue is real and should be identified and handled efficiently. The impact is detrimental as it causes people to become demotivated to obey rules and regulations to combat the pandemic. A. Rashid, Mohd Radzniwan¹; Addnan, Faizul Helmi¹; Roslan, Nuruliza¹; Syed Mohamad, Sharifah Najwa¹; Syed Mohideen, Fathima Begum¹; Ahmad Tajjudin, Ahmad Izzat¹; Baharom, Nizam¹; Jaafar, Aida²; Abdullah Suhaimi, Afiqah Syazwani¹. Pandemic Fatigue: The Scoping Review on Literatures’ Patterns on Pandemic Fatigue and Measures Implemented ¹Faculty of Medicine and Health Science, University Science Islam Malaysia (USIM), Bandar Baru Nilai, Nilai, Negeri Sembilan, Malaysia ²Faculty of Medicine and Health Science, University Pertahanan National Malaysia (UPNM), Sg Besi, Kuala Lumpur, Malaysia THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 84

OP 02 Introduction: The significant life-altering event of the COVID-19 pandemic has caused academicians at Higher Learning Institutions to experience work and life stress. Objective(s): This study aimed to develop and systematically quantify the validity and reliability of an instrument that identified the factors that contribute to the stressors among academicians. Methodology: This study involved the initial instrument development and three stages of measuring evidence of validity and reliability. The instrument was developed through a literature review and brainstorming sessions among the researchers. A panel of eight raters scored the items’ clarity and comprehension, and the content validity index for items (I-CVI) and overall scale (S-CVI) were calculated. Items that failed the content validation process, i.e., an index < 0.8, were excluded from the face validation process. Thirty samples responded to the remaining items while the face validity was tested. The item and scale level clarity indices were computed. Finally, Cronbach’s alpha coefficient () was used to determine the instruments’ internal consistency reliability. Results: 26 items were developed and categorised into three domains: pandemic, work, and related social stressors. Following the raters’ review, the average S-CVI value of 0.89 was obtained for domain 1, 0.84 for domain 2, and 0.88 for domain 3. 8 items were excluded for having I-CVI of less than 0.8. Face validity testing revealed that average S-CVI values for the remaining items ranged from 0.98 to 1.0. Cronbach’s alpha values were 0.698 for domain 1, 0.848 for domain 2, and 0.858 for domain 3. The Cronbach’s alpha increased to 0.797 after removing an item from domain 1. Conclusion(s): A systematic and objective approach is required to validate a newly developed instrument, ensuring that the study outcomes are of high quality. This study indicates that the final 17-items instrument have high content validity and an acceptable level of internal consistency reliability. Abdullah, Natasya¹; Mohamad Nor, Nadeeya ‘Ayn Umaisara¹; Sanip, Suhaila¹ Development and Validation of an Instrument to Identify The Source of Stressors Among Academicians of Higher Learning Institutions in Malaysia During The COVID-19 Pandemic: A Pilot Study ¹Faculty of Medicine and Health Science, University Science Islam Malaysia (USIM), Bandar Baru Nilai, Nilai, Negeri Sembilan, Malaysia THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 85

OP 03 Introduction: B-cell lymphoma-extra large (Bcl-xl), an anti-apoptotic protein that belongs to a BCL-2 family is a vital regulator of mitochondrial-mediated apoptosis. Overexpression of this protein leads to tumorigenesis and cancer chemotherapy resistance. The binding of Bcl-xl with BH3 pro-apoptotic only protein causes inhibition of apoptosis in the cells. Therefore, the development of natural inhibitors from muricins, suggests the induction of apoptosis by mimicking the action of BH3 pro-apoptotic into Bcl-xl protein. Objective: We aim to study the muricins as potential Bcl-xl inhibitors for cancer pharmacotherapy. Methodology: AutoDock Vina software was used to perform the docking simulation on ABT737, a Bcl-xl control ligand and seven muricins, namely muricin A, B, D, F, G, H and I into Bcl-xl protein. Bcl-xl protein was retrieved from the protein database, while ChemDraw software was used to draw the muricin structures. Results: Our findings have revealed that four muricins; muricin B, F, H and I docked strongly in the active site of Bcl-xl protein as compared with ABT 737. The binding affinities of muricin B, F, H and I showed better interaction of -12.1, -11.3, -11.3 and -11.5 kcalmol-1, respectively, while ABT 737 was -10.4 kcalmol -1 . The docked muricin B/Bcl-xl complex interacted with four H-bonds, indicating the highest H-bond formed among all. An Arg139 amino acid residue of Bcl-xl protein was noted as a conserved region for the inhibition process which also interacted with all muricins. All seven muricin’s structures varied according to their functional group position, reflecting their interaction in the docked complexes. Conclusion(s): This study predicted that four docked complexes of muricins (B, F, H and I) with Bcl-xl protein have the potential to be developed as potential Bcl-xl inhibitors. These promising docking results require further investigation of molecular dynamics and experimental studies for the discovery of a new pharmacotherapeutic drug for cancer. Nordin, Noraziah¹; Wan Sulaiman, Wan Noraini¹. Muricins Exhibit Potential Bcl-xl Inhibitor in Cancer Pharmacotherapy: A Molecular Docking Analysis ¹Department of Medical Sciences 1, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Nilai, Negeri Sembilan, Malaysia. THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 86

OP 04 Introduction: Human papillomavirus (HPV) genotyping is vital in cervical cancer screening. Among the high-risk HPVs, HPV-16 and HPV-18 are the most dangerous types of HPVs that can lead to cervical cancer. However, HPV genotyping is still not widely practised in cervical cancer screening due to limited access to the test, especially during the COVID-19 pandemic. Hence, various HPV genotyping biosensors from different platforms were developed. Despite the abundance of HPV genotyping biosensors available in the literature, there is still a lack of comparison on the effectiveness of the biosensors. Thus, this study aims to systematically accumulate and compare the biosensors reported in the literature. Methods: A comprehensive literature search was conducted using PubMed, Scopus, EBSCOhost, and Science Direct. Medical Subject Heading (MeSH) terms like human papillomavirus and biosensor were used as the keywords. The data like type of sample used, type of HPV detected, sample size, comparison method used, and biosensor’s platform were extracted from the studies. The quality of included studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools. Results: From 370 studies retrieved, 18 original articles published between 2012 and 2021 that investigated the effectiveness of newly developed biosensors on 399 HPV-infected women were included. Eighteen biosensors detected HPV-16 and/or HPV-18, while only one biosensor detected HPV-58, and another biosensor detected additional HPV-45 together with HPV-16 and HPV-18. Only two biosensors did not require additional sample preparation like DNA or RNA extraction and even polymerase chain reaction. Conclusion: The development of new HPV genotyping biosensors has rapidly increased. However, many biosensors still have not been validated using clinical samples. Biosensors without lab-based sample preparation are needed to allow a more comprehensive population screening for cervical cancer. Biosensor for Human Papillomavirus Genotyping in Cervical Cancer – A Systematic Review. Elias, Marjanu Hikmah¹, Sutaji, Zulazmi ¹,²; Abdul Hamid, Nazefah¹. ¹Faculty of Medicine &amp; Health Sciences, Universiti Sains Islam Malaysia, Persiaran Ilmu, 71800 Bandar Baru Nilai, Negeri Sembilan, Malaysia. ²Malaysia Department of Obstetrics & Gynecology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Cheras, 56000 Kuala Lumpur, Malaysia. THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 87

OP 05 Introduction: Dodgeball sports in Malaysia has been growing tremendously throughout the years as we can see more national athletes representing our country to compete internationally. For athletes to compete at such an elite level, both physical and psychological aspects must be in good condition as it can impede athlete’s performance. These two aspects are distinct in nature and are complementary to each other. Recent studies also showed that it is safe to say that these aspects play a crucial role in athlete’s performance as they are always interlinked. Objective: To investigate whether there is an association between physical fitness level and psychological health among recreational dodgeball players. Methodology: This cross-sectional study was participated by 49 recreational dodgeball players. An online questionnaire was administered to measure their physical fitness and psychological health. Maximal oxygen consumption (VO2max) during physical activity was measured using the Rockport Test. As for psychological health of dodgeball players, Sports Mental Toughness Questionnaire (SMTQ) was used as this questionnaire is used to obtain athlete’s mental toughness which is one of the components that make up psychological health of individual. Results: Forty-nine players responded with a mean age of 25.33. The collected data were normally distributed. Therefore, Pearson Correlation Coefficient was used to determine the association between the VO2max maximum score and SMTQ. Since the p<0.05, therefore, there is a significant association found between the physical fitness level and psychological health among the recreational dodgeball players. Conclusion: In conclusion, deterioration in physical fitness level may not directly affect the dodgeball players’ psychological health as there could be other factors that lead to their poor psychological health. Association Between Physical Fitness Level and Psychological Health Among Dodgeball Players Krishnan, Kamala¹; Krishnan, Premala¹; Pang, Timothy Ren Ming² ¹Lecturer, Department of Physiotherapy, Faculty of Medicine and Health Sciences, Kajang, Malaysia. ²Bachelor of Physiotherapy Student, Department of Physiotherapy, Faculty of Medicine and Health Sciences, Kajang, Malaysia. THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 88

OP 06 Introduction: The World Health Organization (WHO) then proclaimed Covid-19 as a Public Health Emergency of International Concern and a worldwide pandemic on 2020. Chest radiography and computed tomography (CT) examinations, coupled with blood biomarkers and the patient's clinical history, play a vital role in the early identification of Covid-19 due to their capacity to identify lung abnormalities. Thus, the radiology department is marked as one of the most important departments handling highly infectious patients. Objective(s): The purpose of this paper is to review the new management policy in medical imaging during the Covid-19 pandemic and standard operating procedure (SOP) introduced by the Ministry of Health (MoH) Malaysia to prevent and control intrahospital transmissions of Covid-19. Methodology: We propose a conceptual framework to highlight key areas in the national SOP for preventing Covid-19 intrahospital transmissions in the radiology department. The key areas were classified into four categories: planned requests (patient appointments), (ii) openaccess management (walk-in patient workflow and the triage system), (iii) direct contact (during radiology procedures), and (iv) exit policy and disinfection (post imaging conduct). Results: The Covid-19 SOP for the radiology department by the MoH was found to retain most of the patient quarantine and isolation guidelines by the Center for Disease Control and Prevention (CDC) and incorporated several international policies on patient triage and disinfection of radiological equipment. The Covid-19 SOP for the radiology department plays an important role in reducing the intrahospital spread of Covid-19, with some areas needing improvement. Conclusion(s): Health workers in the radiology department should continue implementing the Covid-19 SOP and increase their knowledge in identifying Covid-19 signs on radiographic images to help safeguard themselves and the patients from intrahospital transmissions. The Radiology Workforce's Response to The COVID-19 Pandemic in Malaysia Azira Khalil¹; Aminatul Saadiah Abdul Jamil¹; Shahrina Ismail¹ ¹Lecturer, Department of Physiotherapy, Faculty of Medicine and Health Sciences, Kajang, Malaysia. ²Bachelor of Physiotherapy Student, Department of Physiotherapy, Faculty of Medicine and Health Sciences, Kajang, Malaysia. THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 89

OP 07 Introduction: Lupus is an autoimmune disease commonly affecting females. It can present as various symptoms affecting multiple organs. When involving the skin, it is called cutaneous lupus. A delay in the diagnosis will lead to a significant effect on an adolescent’s health, including their mental status. Particularly among adolescents who attend different general practice clinics. Objective: This case illustrates the challenges experienced by general practitioners in diagnosing lupus in a teenage female whom was treated as chronic eczema since childhood. Early diagnosis and treatment of lupus -is important to prevent the consequence morbidity. Methodology: A 19-year-old teenage female presented with chronic worsening eczema since the age of ten. It was dry, scaly skin rash associated with hypopigmentation started over her arm, trunks, back and facial region. With multiple outpatient visits, her general practitioners diagnosed her as chronic eczema and treated her with steroids and moisturiser. She subsequently developed mild depression, with low self-esteem and withdrawal from her study as the condition did not resolve. In the current presentation, she presented with fever, multiple joint pains, generalised body ache, weakness, and epigastric pain. Systemic examination revealed an ejection systolic murmur over the pulmonary area with bibasal crepitations and tender epigastric region. Her blood investigation revealed anaemia with thrombocytopenia. Her liver function test was deranged with raised alanine transaminase and aspartate transaminase, and a positive anti-nuclear factor antibody. She was then referred to the rheumatologist and gastroenterologist as autoimmune hepatitis. Results: Her skin biopsy revealed the diagnosis of lupus. She was treated with Hydroxycholoroquine, where her symptoms and rashes had improved. She had resumed her studies. Conclusion: General practitioners should be aware of systemic lupus erythematous as a possible diagnosis in adolescents with chronic eczema. Cutaneous lupus can present with rashes with various morphology, location and distribution, rendering a diagnostic challenge to the primary care physician. Misdiagnosis of Lupus in an Adolescent: A Case Report Ganason, Anu Suria¹; Syed Mohideen, Fathima Begum¹; A.Rashid, Mohd Radzniwan¹; Syed Mohamad, Sharifah Najwa¹; Chamhuri, Nurul Hayati¹. ¹Primary Health Care Department, Faculty Of Medicine And Health Sciences, Universiti Sains Islam Malaysia, Nilai, Negeri Sembilan, Malaysia THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 90

OP 08 Introduction: Covid-19 pandemic has caused major changes to education process in the world. Medical education has a long period with many academic burdens and large volumes of lessons while dealing directly with conditions in hospitals, especially during this pandemic situation. It made them facing many stressors. Resilience has been proven to have impact to learning performance, due to its increase the ability to manage with stress. Objective: This study aim to investigate the association among resilience, quality of life and academic achievement that represents by Grade Point Average (GPA) on medical students during this pandemic. Methodology: This study was an observational study. Academic Resilience Scales-30 was used to assess resilience level. WHOQOL was used to evaluate four domain of quality of life; physical health, psychological, social relationship, environment. Academic achievement were reported from students’ GPA. Linear regression analysis was used to determine the association between resilience level and GPA. Results: A total of 132 students were classified into low (n=44), moderate (n=48) and high resilience (n=40). There is significant difference of quality of social relationship, environment and GPA among difference resilience groups. Quality of physical health and psychological domain modified the association resilience scales and GPA in low and moderate level of resilience. Conclusion: Resilience can be a predictor for students’ academic achievement in their courses during this pandemic. Role of Resilience and Quality of Life on Academic Achievement Among Medical Students During Pandemic Febriza, Ami¹; Halawing, M. Hendry²; Ashari, Irwan³ ¹Department of Physiology, Faculty of Medicine and Health Sciences, University of Muhammadiyah Makassar, Indonesia ²Undergraduate student, Faculty of Medicine and Health Sciences, University of Muhammadiyah Makassar, Indonesia ³Medical Education Unit, Faculty of Medicine and Health Sciences, University of Muhammadiyah Makassar, Indonesia THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 91

OP 09 Introduction: The coronavirus disease 2019 (COVID-19) pandemic has impacted all aspects of our lives, including economy and education sector. Many universities in Malaysia were forced to depend on online learning methods from May 2020. This was due to the movement control order (MCO) and conditional movement control order (CMCO). During this time, students were not allowed to attend physical classes. This has affected students learning as the online classes was a sudden move. Objective(s): Generally, this study was done to evaluate the students’ perception on online classes during Covid-19 pandemic. Apart from that, this study was also conducted to compare between perceptions of preclinical and clinical students regarding online classes during this time. Methodology: This cross-sectional study was conducted in the Faculty of Dentistry, Universiti Sains Islam Malaysia (USIM). The respondents of this survey were the preclinical and clinical undergraduate dental students from first year to fifth year who attended online classes during COVID-19 pandemic. The questionnaire was developed into 30 different questions. Consents were taken before the distribution of the questionnaire. Results: Data was collected from 179 study respondents from first year until fifth year dental students. The survey analysis shows that most of the students think that for the success of online learning to become a reality, mixed online and physical class should be considered to improve learning. Lastly, the results also shows that the method of delivering lectures and communication between students and lecturers remains a fundamental factor for success of an online classes. Conclusion(s): In summary, the results of this study provide further insight into matters experienced by students and how educators may give attention to students’ opinion when improving future online learning programs. Online learning can be considered as an alternative to replace conventional classes. The Perception of Students on Online Classes During Covid-19 Pandemic Anis Salbiana¹; Nur Hidayah¹; Azrul Hafiz¹ ¹Faculty of Dentistry, Islamic Sciences University of Malaysia, Kuala Lumpur, Malaysia THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 92

OP 10 Introduction: The increasing prevalence of dementia patients in Malaysia has put more people in the community to get involved in dementia caregiving. Caring for dementia patients without adequate resources, that is social support (SS) is difficult especially in the presence of the demand factor, that is the behavioral and psychological symptom of dementia (BPSD), which could lead to burnout. Objective(s): To apply the primary demand and resource factor of dementia caregiving in the JD-R model of burnout as to investigate the burnout process among informal caregivers of dementia patient in Klang Valley, and to determine the mediating role of caregiving burden on the relationship between caregiving demand and resource with burnout. Methodology: This is a cross-sectional study among 271 informal caregivers of dementia patients who attended the outpatient clinics of selected hospitals in Klang Valley. Caregivers were chosen through proportionate random sampling and given self-administered questionnaires consisting of NPI-Q, MSPSS, ZBI, and MBI tools. Burnout dimensions were studied as the dependent variables, while severity of BPSD and SS as the independent variables, and caregiving burden as the mediating variable. Data were analyzed using IBM SPSS AMOS for path analysis. Results: The significant direct relationship between BPSD and EE (B=.102, p=.012), as well as SS and EE (B=-120, p=.027) remain significant in the presence of burden, which implicates the partial mediation role of burden. Meanwhile, only the indirect relationship between BPSD (B= .221, p=.001) and SS (B=.092, p=.008) with DP were significant in the presence of burden, which shows a full mediation role of burden. Conclusion(s): EE and DP were the primary burnout dimensions contributed by severity of BPSD and SS, in the presence of burden. Partial mediation role of burden was observed in the relationship between caregiving demand and resource with EE, while full mediation in the relationship between caregiving demand and resource with DP. To reduce the impact of BPSD and low SS, caregiving burden should be assessed early and intervened by overcoming the specific burdens experienced by caregivers to prevent EE and DP. Does Burden Mediate the Relationship of Caregiving Demand and Resource with Burnout in Dementia Caregiving? An Application of the Job Demand-Resource (JD-R) Model M.Razi, Nuurain Amirah¹,²; Minhat, Halimatus Sakdiah²; Kadir@Shahar, Hayati²; Jaafar, Mohd Hafiz¹; Azzeri, Amirah¹; Abu Baharin, Mohamed Fakri¹; T.Mohd, Tengku Amatullah Madeehah¹ ¹Public Health Unit, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Bandar Baru Nilai, Malaysia ²Department of Community Health, Faculty of Medicine and Health Sciences, Umiversiti Putra Malaysia, Serdang, Malaysia THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 93

OP 11 Introduction: Tuberculosis (TB) is among the leading global causes of death from a single infectious agent in the developing world. Exposure to Mycobacterium tuberculosis among medical and nursing students may contribute towards development of latent tuberculosis infection (LTBI) cases. Objective(s): To determine level of and factors associated with knowledge of LTBI among medical and nursing students. Methodology: A cross sectional study was conducted among medical students in clinical years (year 4, 5 and 6) and nursing students (year 1, 2 and 3) using simple random sampling. All participants completed online questionnaire which included the following: demographic profile, exposure to tuberculosis, knowledge about LTBI. A 15 items knowledge scale was developed. Response options were “yes,” “no,” or “not sure”. Each correct answer scored 1 point and incorrect/not sure answer scored 0. Total knowledge score (max 15) was calculated and converted into percentage. Scores in percent were categorised according to Bloom’s classification of low, moderate and high level of knowledge. Results: Mean (SD) age of the respondents was 22.0 (2.4) years. Most of respondents were female (77.7%) and have heard about LTBI (79.1%). Most of the respondents did not have any history of close family (87.0%) and friends (74.5%) with tuberculosis. Only 21.4% had high level of knowledge of LTBI, while 40.9% was moderate and 37.7% was low. Factors significantly associated with higher knowledge of LTBI were age, ever heard about LTBI, history of friends with TB, ever had Mantoux test, course (medical/nursing), year of study, clinical hours per week and history of exposure to TB patients. Conclusion(s): Overall, the level of knowledge of LTBI among medical and nursing students was moderate. Several factors were associated with level of knowledge of LTBI. Health institutions need to emphasize on LTBI among healthcare students. Factors Associated with Knowledge of Latent Tuberculosis Infection Among Medical and Nursing Students in Negeri Sembilan, Malaysia Musa, Lailatul Hazzliza¹; Ahmad, Aini²; Ismail, Zarini¹; Mohamed, Nurul Azmawati¹; Baharom, Nizam¹; Ramli, Shalinawati¹. ¹Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Nilai, Negeri Sembilan, Malaysia. ²School of Nursing, KPJ University College, Nilai, Negeri Sembilan, Malaysia. THE 5TH USIM INTERNATIONAL HEALTH CONFERENCE 2022 94