8th Negeri Sembilan Research Day Program Book

8th Negeri Sembilan Research Day 2023 Translating Research Into Practice 22nd June 2023 Galeri Diraja Tuanku Ja’afar Seremban CLINICAL RESEARCH CENTRE, HOSPITAL TUANKU JA’AFAR SEREMBAN Translating Research Into Practice Organised by Supported by

8th Negeri Sembilan Research Day 2023 Translating Research Into Practice 22nd June 2023 Galeri Diraja Tuanku Ja’afar Seremban CLINICAL RESEARCH CENTRE, HOSPITAL TUANKU JA’AFAR SEREMBAN Translating Research Into Practice Organised by Supported by

Table of Contents 01 Foreword 06 Organising Committee 07 Tentative Programme 08 Scientific Committee 09 List of Oral Presentation 10 Oral Abstract 15 List of Poster Presentation (Doctor) 17 Poster Abstract (Doctor) 25 List of Poster Presentation (Allied Health) 28 Poster Abstract (Allied Health) 47 List of Case Report 51 Case Report Abstract 77 Acknowledgement 8th Negeri Sembilan Research Day 2023

8th Negeri Sembilan Research Day 2023 Foreword DIRECTOR GENERAL OF HEALTH Ybhg Datuk Dr. Muhammad Radzi Bin Abu Hassan 1 Assalamualaikum & salam sejahtera It gives me great pleasure to write this message to mark the 8th Negeri Sembilan Research Day since its inception on 2013. For their admirable efforts in making this event a success, I would like to congratulate the organising team for their hard work. Today, research plays a significant role in understanding the problems affecting individuals, communities and healthcare systems. One of the problems our researchers are facing nowadays is the lack of sharing of research findings as research is not published in a timely manner and the lack of translation for the research findings into clinical practice. The theme “Translating Research into Practice” is extremely crucial in the attempt to communicate and translate the findings of the research conducted into practice and contribute to the advancement of the treatment and healthcare system. I sincerely hope Negeri Sembilan will continue to serve as an excellent site for the betterment of healthcare provision in Malaysia and Clinical Research Centre Hospital Tuanku Ja’afar Seremban will continue to expand its wings further to motivate more healthcare workers to produce excellent researches, ultimately putting Negeri Sembilan on the world map as the centre of excellence for clinical researches. Once again, congratulations to Clinical Research Centre Hospital Tuanku Ja’afar for another impressive event. To all the attendees, I hope you have a productive, interactive and informative Research Day.

8th Negeri Sembilan Research Day 2023 Foreword DIRECTOR OF INSTITUTE FOR CLINICAL RESEARCH, NIH Ybhg Datin Dr. Sheamini Sivasampu 2 Salam sejahtera With the Institute of Clinical Research vision; to become a leading clinical research organisation in Asia, Clinical Research Centre shall contribute to the development of the research landscape, making Malaysia a favourite clinical trial site in Asia, thus contributing to our national wealth. This year once again, the organising committee has done an excellent job in bringing all the researchers and to-be researchers together in this event today in search of better outcomes for the community. Negeri Sembilan Research Day promotes knowledge translation by sharing our expertise and to disseminate the knowledge obtained through our research activities to other professionals, and show how this knowledge can improve health care and patient outcomes in line with this year theme “Translating Research into Practice”. It is my hope and expectation that this year’s Research Day will provide an effective learning experience and good networking platform for all, leading to a better patient care. With that, I would like to congratulate the organising committee for ensuring the success of this meaningful event. I wish you all an excellent time at 8th Negeri Sembilan Research Day 2023

8th Negeri Sembilan Research Day 2023 Foreword DIRECTOR OF HEALTH NEGERI SEMBILAN Ybhg Dato’ Dr. Harlina Binti Abdul Rashid 3 Praise be to Allah almighty. Prayers to His Messenger, Prophet Muhammad SAW, his family, companions and Followers. It gives me great pleasure to welcome everyone to this much awaited 8th Negeri Sembilan Research Day. Firstly, allow me to express my gratitude to the organising committee for organizing this significant event. Since 2013, Negeri Sembilan Research Day has celebrated research efforts across the state by allowing healthcare workers to present their research findings via oral or poster presentation. This event provides an excellent opportunity for healthcare staffs from various districts, hospitals and clinics and medical schools to reach out and connect. Not only that, this event is a celebration of creative endeavours by our local researchers. I would also like to take this opportunity to urge everyone to collaborate and work hand-in-hand as a team to conduct a good quality clinical research. In line with the theme this year, “Translating Research into Practice”, I sincerely hope that the translation of evidence can bring about cultural, behavioural and practice change reducing the research-practice gap, resulting in a more transparent and sustainable healthcare services for the people of Negeri Sembilan. To all the researchers participating in the Negeri Sembilan Research Day, I hope this event will be an enjoyable and inspiring encounter.

8th Negeri Sembilan Research Day 2023 Foreword DIRECTOR OF HOSPITAL TUANKU JA’AFAR Ybhg Dato’ Dr. Zaleha Binti Md Noor 4 Assalamualaikum & salam sejahtera As we celebrate our 8th Negeri Sembilan Research Day today, Hospital Tuanku Jaáfar is proud to celebrate this meaningful event. Every year, clinicians and healthcare workers all across the state of Negeri Sembilan come forward to this event and share the output of their researches. Negeri Sembilan Research Day is organised to highlight and create awareness regarding the importance of research in healthcare. Thus, it is important for us to link up education, training and experience in line with the creation of knowledge and development of skills I would like to applaud the enthusiasm and commitment of clinicians who are involved in ISRs and IIRs based in Hospital Tuanku Ja’afar Seremban. This reflects the potential of Hospital Tuanku Ja’afar Seremban to develop as a world-renowned centre of excellence in research in time to come. Last but not least, my heartfelt congratulations to the organising team for their diligent effort to make this event a success. I would also like to express my gratitude to the state health director for always providing support in the effort of encouraging and providing clinical researches in this state. It is my sincere wish that this meaningful event continues to provide a platform for researchers to exchange their ideas and to create awareness about research among healthcare workers.

8th Negeri Sembilan Research Day 2023 Foreword HEAD OF CLINICAL RESEARCH CENTRE HOSPITAL TUANKU JA’AFAR Dr. Lily Binti Mushahar 5 Welcome to the 8th Negeri Sembilan Research Day Year 2023 marked the 17-year anniversary of Clinical Research Centre Hospital Tuanku Ja’afar being operational in Hospital Tuanku Ja’afar. Negeri Sembilan Research Day is dedicated in highlighting the comprehensiveness of research and the discovery on issues of various disciplines being done at Negeri Sembilan through poster sessions, oral presentations and guest speakers. In line with Clinical Research Centre’s mission; “To improve patients’ health outcomes through ethical and quality clinical research”, the theme this year, “Translating Research into Practice” is essential to guide the policy and institutional leaders on how they may enhance research productivity to improve the patient outcomes. A heartfelt gratitude to Dr Akhmal Yusof and Clinical Research Malaysia team for their unwavering support to help improve our clinical research services. I want to extend my sincere gratitude to all of the participants, contributors, our guest speakers and judges. This year’s Research Day would not have been possible without the organising committee members who have worked tirelessly over the past couple of months to ensure that this event is fun, engaging, and educational. Take this opportunity to explore more on research and connect with people. I hope we can make the most of this event.

Organising Committee Chairman : Dr. Lily Mushahar Scientific Committee Chairman : Dr. Noor Lita Adam Co-Chairman : Dr. Fauzi Azizan Secretariat : Dr. Zulhijah Abdul Aziz Oral & Poster Presentation : Dr. Chua Aun Aun Programme Book : Dr. Wan Farahiyah Multimedia: Dr. Abdul Hadi Sharifudin Registration : Magdalene Mary Protocol : Engku Fatimah Syariah Refreshments : Nur Farahin Ahmad Faishal Prizes & Souvenirs : Siti Hawa Yusuff Exhibition Booth : Izyan Hazirah Zulkurnain 8th Negeri Sembilan Research Day 2023 6

Programme 8th Negeri Sembilan Research Day 2023 TIME EVENT 0800 - 0845 Registration 0845 - 0920 Opening Ceremony Welcoming address and Officiating Ceremony: · Dr. Lily binti Mushahar 8 th Negeri Sembilan Research Day 2023 Organizing Chairperson · Ybhg Dato' Dr. Harlina binti Abdul Rashid Director of Health Negeri Sembilan · Ybhg Datuk Dr. Nor Fariza binti Ngah Deputy Director General of Health (Research and Technical Support) 0920 -0930 Multimedia Presentation 0930 - 1015 Plenary 1: Ybhg Datin Dr. Sheamini Sivasampu Making Research Relevant and Inspiring in Medical Practice 1015 -1045 Tea Break / Poster Exhibition Viewing 1045 - 1130 Plenary 2: Prof. Dr. Noran Naqiah binti Mohd Hairi Strategies to Empower Next Generation Healthcare Researchers 1130 - 1245 Oral Presentation 1245 - 1300 Judges Discussion / Poster Exhibition Viewing 1300 - 1330 Prize Giving Ceremony 1330 Lunch and Adjourn 8th Negeri Sembilan Research Day 2023 7

Scientific 8th Negeri Sembilan Research Day 2023 8 Chairman Dr. Noor Lita Adam Senior Consultant Endocrinologist, Hospital Tuanku Ja’afar Co-Chairman Dr. Fauzi Azizan Head of Clinical Research Centre, Hospital Tuanku Ampuan Najihah Dr. Nurain Mohd Noor Chairperson Medical Research & Ethics Committee Ministry of Health Prof Dr. Lim Khean Gee Editor in Chief Clinical School International Medical University Prof Madya Dr. Norasyikin A. Wahab Head of Endocrinology Unit Hospital Canselor Tuanku Muhriz Dr. Lee Ming Lee Senior Lecturer in Pediatrics International Medical University Dr. Asmah Mohd Senior Consultant Rheumatologist Head of Medical Department Hospital Tuanku Ja’afar Prof Dr. James Koh Kwee Choy Head of Division of Medicine International Medical University Dato’ Dr. Gun Suk Chyn Senior Consultant Rheumatologist Columbia Asia Hospital Dr. Shalini Vijayasingham Head of Clinical Research Centre Hospital Melaka Dr. (Mr) Ismail Burud Associate Professor International Medical University Dr. Wong Kit Chan Psychiatrist Hospital Tuanku Ja’afar Dr. Nadiah Mohd Noor Consultant Rheumatologist Hospital Tuanku Ja’afar Dr. Iliza Idris Family Medicine Specialist Klinik Kesihatan Ampangan Committee

List of Oral Presentation No Title Presenting Author & Department Oral1 Clinical Manifestations and Severity of Omicron and Delta SARS-CoV-2 Infections in Children in Negeri Sembilan, Malaysia David Ng Chun-Ern Pediatric HTJS Oral2 Improving Outcomes for Atopic Dermatitis in Children: A Multimodal Atopic Dermatitis Education Bundle (MADE) Iyvone Yong Pei Sze Pediatric HTAN Oral3 Prophylactic Intravenous Metoclopramide Use in Patients Given Intravenous Tramadol: A Retrospective Cross-Sectional Study [TRAMAX STUDY] Keerthy Venthen Pharmacy HTAN Oral4 The Effects Of Oral Probiotics On Prevention Of Peritoneal Dialysis Related Peritonitis: A Pilot Randomised Controlled Trial Siti Hafizah Bt Mohammad Ismail Nephrology HTJS Oral5 Utility Of Right-Sided ECG In The Diagnosis Of Pulmonary Embolism (PE) Steven Wong Poh Hock Medical HTAN 8th Negeri Sembilan Research Day 2023 9

8th Negeri Sembilan Research Day 2023 Oral Abstract Presentation 10 Clinical Manifestations and Severity of Omicron and Delta SARS-CoV-2 Infections in Children in Negeri Sembilan, Malaysia David Ng Chun-Ern1 , Liew Chuin Hen2 , Tan Kah Kee3 , Chin Ling1 , Elida Hanan binti Awang1 , Debashini a/p Chandirasekharan1 , Maryam Jamilah binti Surdi Roslan1 , Munzir bin Jamil1 , Nor Zanariah Zainol Abidin4 , Cheah Yee Keat1 , Mohd Ferous bin Alias5 , Erwin Jiayuan Khoo6 . 1 Department of Pediatric, Hospital Tuanku Ja’afar, 2 Department of Pediatric, Hospital Tuanku Ampuan Najihah, 3 Perdana University Seremban 4 Department of Pathology, Hospital Tuanku Ja’afar 5 Negeri Sembilan State Health Department, Seremban 6 Department of Pediatrics, International Medical University Introduction: Understanding the clinical manifestations and severity of emerging SARS- CoV-2 variants in children is vital. We investigate and compare the clinical features and severity of the Omicron and Delta variant infection among children hospitalized for COVID-19 in Negeri Sembilan, and to identify factors associated with moderate/severe COVID-19. Methods: We identified children aged ≤12 years hospitalized for COVID-19 between 1 January 2021 to 31 March 2022 across five hospitals in Negeri Sembilan using the state’s pediatric COVID-19 registry. Disease severity was assessed using an adapted version of the WHO’S ordinal scale. Results: Among 1,367 eligible patients, 668 had Delta infection and 699 had Omicron infection. Propensity-score matching produced 558 matched pairs. Omicron infection was associated with higher likelihood of viral croup (OR 10.9, 95%CI 2.5- 46.6), lower respiratory tract infection (OR 2.3, 95% CI 1.5 – 3.6) and seizures (OR 8.4, 95% CI 5.0 – 14.0). Omicron-related hospitalizations were more likely to experience moderate disease (OR 6.6, 95% CI 5.1 – 8.6) with increased need for intravenous fluid therapy, corticosteroids, empirical antibiotics, and low-flow nasal oxygen therapy. Multivariate logistic regression revealed that Omicron was significantly associated with increased odds for moderate/severe disease in comparison with Delta variant infection (aOR 6.4, 95% CI 4.9 – 8.3). Conclusion: Omicron infection was associated with higher incidence of croup, lower respiratory tract infection and seizures compared to Delta. The significantly higher proportion of moderate/severe disease and increased utilization of healthcare resources with Omicron underscore the need for continued efforts to mitigate the impact of COVID-19 among the pediatric population. Oral 1

8th Negeri Sembilan Research Day 2023 Oral Abstract Presentation 11 Improving Outcomes for Atopic Dermatitis in Children: A Multimodal Atopic Dermatitis Education Bundle (MADE) Liew CH1 , Iyvone Yong PS1 , Nur 'Amira A1 1 Department of Pediatric, Hospital Tuanku Ampuan Najihah, Kuala Pilah Introduction: Parental education is the cornerstone of managing children with atopic dermatitis (AD). However, the role of integrating multimodal education interventions into a bundle using the Malay language is under-researched. Our study aimed to assess the effectiveness of a multimodal education bundle in Malay in reducing AD severity, improving patient quality of life (QOL), parental AD knowledge, and treatment compliance. Methods: We conducted a cross-sectional study at Hospital Tuanku Ampuan Najihah involving 47 patients aged 1 month to 12 years diagnosed with AD from January to December 2022. The MADE intervention includes structured teaching of AD, providing educational material (in Malay), live demonstration of topical drug application, improved labeling of topical medicine, and formulation of AD action plan (in Malay). We compared the AD severity (IGA= Investigator Global Assessment Scale, POEM= Patient-Oriented Eczema Measure score), QOL scores, parental knowledge, and treatment compliance 3 months after diagnosis between patients in the MADE intervention group and control group (conventional). Results: After 3 months of diagnosis, patients in the MADE group showed significant improvements compared to the control group, including a reduction in the surface area of dermatitis (Md= 2% versus 10.5%), lower IGA scale (Md= 1 versus 2), lower POEM score (M= 3 versus 11), better QOL (Md=1 versus 5), higher parental AD knowledge (Md= 100% versus 75%), and better treatment compliance for both emollient and topical steroid (Md= 100% compared to 0%). Conclusions: This study demonstrates the effectiveness of using a multimodal education bundle in the Malay language in managing AD. These findings highlight the importance of incorporating multimodal and culturally appropriate interventions into the management of AD. Oral 2

8th Negeri Sembilan Research Day 2023 Oral Abstract Presentation 12 Prophylactic Intravenous Metoclopramide Use in Patients Given Intravenous Tramadol: A Retrospective Cross-Sectional Study [TRAMAX STUDY] Keerthy Venthen1,2, Yu Xin Tan1, Pavithrah2 1 Department of Pharmacy, Hospital Tuanku Ampuan Najihah, Kuala Pilah 2 Emergency & Trauma, Hospital Tuanku Ampuan Najihah, Kuala Pilah Introduction: The routine use of Intravenous prophylactic antiemetics with Intravenous opioid analgesics is common practice in the Emergency & Trauma Department (ETD) of Hospital Tuanku Ampuan Najihah (HTAN) to prevent opioid-induced nausea and vomiting. However, this practice has dubious clinical benefits, generates additional costs, and might expose patients to potentially adverse effects. Approximately 6000 ampules of IV Metoclopramide are used by ETD HTAN annually. The sum seems ignorable, but in 10 years, this may total over RM1,000,000. Objective: The study aimed to evaluate the benefit of intravenous metoclopramide prophylaxis in patients receiving intravenous tramadol for acute pain relief. Methodology: A retrospective cross-sectional study was conducted at the ETD of HTAN using convenient sampling. Patient details were extracted from the medical record via standardized data collection form and analysed with the Statistical Package for Social Sciences version 25. Results: A total of 272 patients were included, half of whom were given intravenous Metoclopramide prophylactically. The overall incidence of nausea in the study population was 12.1%, with most cases rated mild. Only two patients (0.7%) in the metoclopramide group vomited within 2 hours of intravenous tramadol administration, which did not demonstrate a statistically significant association between metoclopramide prophylaxis and reduced emesis episode (P= 0.498, Fisher’s exact test). Conclusion: he low incidence of nausea and vomiting does not warrant the prophylactic use of intravenous Metoclopramide in tramadol-treated patients, suggesting a need to educate ETD medical officers on the findings to implement change in the routine prescribing practice in HTAN and subsequent cluster hospitals. Keywords: metoclopramide, tramadol, nausea, vomiting, emesis, prophylaxis Oral 3

8th Negeri Sembilan Research Day 2023 Oral Abstract Presentation 13 The Effects of Oral Probiotics on Prevention Of Peritoneal Dialysis Related Peritonitis: A Pilot Randomized Controlled Trial Mohammad Ismail SH1 , Hamdi NH1 , Abdul Shukor NS1 , Govindan S1 , Usamah A1 , Mushahar L1 1 Department of Nephrology, Hospital Tuanku Jaafar Objectives: Alterations in gut microbiome in peritoneal dialysis (PD) patients can lead to inflammation and increased cardiovascular risks. Probiotics have been suggested to improve gut microbial stability and peristalsis. This study aimed to evaluate the effects of probiotics on the rate of peritonitis and changes in biochemical and inflammatory parameters in patients on PD. Methods: A double-blind randomized controlled trial of 74 patients on PD (n=37 each arm) from June 2020 to June 2021. Patients were randomised into two groups: oral probiotic (HEXBIO® containing MCP® BCMC® strains) vs placebo prescribed twice daily for six months. Clinical, biochemical, anthropometric measurements and Bristol stool scale assessments were recorded before and 6 months after the intervention. Occurrence of peritonitis was documented; defined as presence of two of the following three criteria: abdominal pain or tenderness, turbid effluent with white cell count >100/µL(50% polymorphonuclear leukocytes) and an identified pathogen from effluent culture. Results: A total of 53 patients completed the study (23 in the probiotic and 30 in the control group). Peritonitis rate was 1 episode in 54.9 patient months in the probiotic and 1 episode in 45.2 patient months in the control group (p>0.95). Median (IQR) time to first PD peritonitis was 82 (51-95) days. In the probiotic arm, serum albumin increased significantly (p=0.03) while C-reactive protein decreased significantly (p=0.04) after 6 months of treatment. Patients in the probiotic group recorded improvements in their bowel habits using the Bristol stool index at end of the study compared with placebo (P<0.001). There was no significant difference in the upper arm circumference or triceps skinfold thickness over time between treatment groups. Conclusions: Our study showed probiotics improved bowel movements but did not reduce the risk of peritonitis in PD patients. Interestingly, oral probiotics significantly increased serum albumin levels and reduced C- reactive protein over time. Oral 4

8th Negeri Sembilan Research Day 2023 Oral Abstract Presentation 14 Utility Of Right-Sided ECG in The Diagnosis Of Pulmonary Embolism (PE) S.P.H. Wong1 , H.Y. Chan2 , F.Azizan1 1 Department Of Internal Medicine, Hospital Tuanku Ampuan Najihah 2 Department Of Internal Medicine, Hospital Tuanku Jaafar, Seremban Objective: Primary: To determine the utility of right-sided ECG in the diagnosis of PE. Secondary: To risk stratify patients whom have higher probability of PE, so that empirical treatment can be initiated while awaiting diagnostic imaging test especially in district hospitals and in times of pandemic such as Covid-19. Methods: A cross-sectional study among patients in 3 hospitals were conducted from 1/6/2021 to 31/3/2022. A total of 105 patients with suspected PE were identified where simultaneous left and right-sided ECG were recorded and compared. CTPA confirmed the diagnosis of PE in 79 of them. Results: 75% of the cohort were diagnosed with PE. 52 of them had normal left-sided ECG, but right-sided ECG showed changes in 45 of them; namely ‘qR pattern’ in one to three of the leads V4R, V5R and V6R (specificity 88.4%, sensitivity 50.6%) and ‘Slurred S wave’ in one to four of the leads V3R, V4R, V5R, V6R (specificity 84.6%, sensitivity 69.6%). 25 of patients with PE manifested RV strain pattern in both left and right-sided ECGs. There were 26 patients without PE, which served as a control group. Conclusion: Right-sided ECG has higher sensitivity and specificity than the standard ECG in the diagnosis of PE. Combining ‘qR’ and ‘Slurred S wave’ pattern in right precordial leads increases its specificity to 100% and sensitivity to 69.6%, which highlights the importance of recording right-sided ECG along with standard ECG in patients with clinical suspicion of PE. Oral 5

List of Poster Presentation No Title Presenting Author & Department D01 Comparison Between Mycophenolate Mofetil and Cyclosporine A As Maintenance Therapy In Paediatric Nephrotic Syndrome Caroline Eng Siew Yin Pediatric HTJS D02 Baseline Characteristics And Management Of Patients With Myocardial Infarction: A Single Non-Cardiac Centre Audit Chan Hui Ying Medical HTJS D03 Does Different Sources of Information Influence the Level of Fake Braces Knowledge Among Young Adults Population? Chia Zhi Mei Pejabat Pergigian K.Pilah D06 Comparison Of A 6-Year Trend in The Pre-Operative Visual Acuity Among Patients Presenting for Cataract Surgery at Cluster Ophthalmology Hospital Tuanku Ampuan Najihah, Kuala Pilah Nur Izzati Binti Mohd Salim Ophthalmology HTAN D07 Involvement of Implementers in Klinik Pergigian Mesra Promosi (KPMP) Program: Questionnaire Validation and Pilot Testing. Nurain Binti Abdul Samat Klinik Pergigian Seremban 8th Negeri Sembilan Research Day 2023 15 Doctor Category

List of Poster Presentation No Title Presenting Author & Department D08 Association Between Oral Health Literacy and Oral Health Practice Nurul Syariza Binti Kamal Klinik Pergigian Senawang D09 The Homeless in Seremban: An Oral Health Needs Assessment Patricia Ponniah Devadhoss Pejabat Pergigian Seremban D10 A Study on Under Five Childhood Acute Respiratory Infections (ARIs) In Seremban District, Negeri Sembilan. The Role of Mothers as Caregivers Rowena John Pejabat Kesihatan Daerah Jempol 8th Negeri Sembilan Research Day 2023 16 Doctor Category

8th Negeri Sembilan Research Day 2023 Poster Abstract Presentation 17 Comparison Between Mycophenolate Mofetil And Cyclosporine A As Maintenance Therapy In Paediatric Nephrotic Syndrome Caroline SY Eng1* , Ming Jie Chuah2*, Jia Yi Tham2 , Hai Liang Tan1 , Wei Mun Chang3 ,Sangeet Sidhu4 , Yok Chin Yap2 1 Department of Paediatrics, Hospital Tuanku Ja’afar, Seremban 2 Paediatric Nephrology Unit, Hospital Tunku Azizah, Kuala Lumpur 3 Department of Paediatrics, Hospital Raja Permaisuri Bainun, Ipoh 4 Department of Paediatrics, Hospital Pulau Pinang * co-first authorship Introduction: Mycophenolate mofetil (MMF) has been studied in children with frequently relapsing/ steroid dependent steroid sensitive nephrotic syndrome(FR/SDNS) with mixed outcomes. Methods: We performed a pragmatic, non-inferiority case-control study to compare MMF against cyclosporine A (CSA) in maintaining remission. CSA is the existing second line agent; after cyclophosphamide and levamisole. Children up to 18 years old with FR/SDNS with active disease despite treatment with first line agents were recruited. Primary endpoint set was the relapse rate. Non-inferiority margin was determined using the fixed-margin method. This is an interim analysis at 6 months and study is ongoing. Results: A total of 24 children were recruited. Majority were of Malay ethnicity (83.3%). Mean age was 8.9 ±3.15 years with a disease vintage of 4.2±2.75 years. Sixteen children received MMF and 6 received CSA. Annualised relapse rate was 0.97 (MMF) versus 1.95 (CSA). The relative risk of relapse in the MMF group was 0.524 (95% CI, 0.256 to 1.074);non-inferiority of MMF from CSA was demonstrated. Both the groups demonstrated improved height velocity;4.9cm/year (MMF) and 4.7cm/year(CSA). 63% of the children developed gingival hypertrophy by the 8th week. 87.5% children on CSA experienced a 15% rise in urea compared to 37.5% from the MMF group; p=0.034. Similar trends were observed for creatinine and potassium but statistical significance was not achieved. About 50% of children from both groups demonstrated mild leucopenia after 2 weeks of treatment but they improved spontaneously by the 8th week. None experienced increased infection while on treatment. All children who received MMF tolerated it without gastrointestinal side effects. Conclusion: Our study demonstrated favourable outcomes of MMF as an alternative maintenance therapy to CSA. Future studies should include pharmacokinetic analysis to guide clinicians better in drug dosing. D01

8th Negeri Sembilan Research Day 2023 Poster Abstract Presentation 18 Baseline Characteristics And Management Of Patients With Myocardial Infarction: A Single Non-Cardiac Centre Audit 1HY Chan, 1S Ramadas, 1N Mohd Noor 1 Department of Medicine, Hospital Tuanku Jaafar Seremban Background: Myocardial infarction (MI) is the major cause of death in Malaysia and worldwide. Objective: In this study, we aim to study the demographics, co-morbidities and intervention received by MI patients in a non-cardiac state hospital. Materials & methods: This observational study was conducted on 163 patients under MI clinic follow-up in a non-cardiac state hospital, Hospital Tuanku Ja’afar Seremban. Cases were analyzed for their cardiovascular risk factors, medical history, medications and interventions received. Results: A total of 163 patients were analyzed in the study. Mean age was 57.7 years (SD= 11.4). Males made up 139 (86.3%) of the patients. 85 (52.8%), 53 (32.9%) and 23 patients (14.3%) were Malays, Indian and Chinese respectively. Common risk factors include hypertension [n= 97 (59.5%)], diabetes [n= 82 (50.3%)], coronary artery disease [n= 58 (35.6%)], dyslipidaemia [n= 55 (33.7%) and smoking [n= 48 (29.4%). Mean baseline left ventricular ejection fraction was 46.8% (SD= 10.2). 163 patients were being analysed for intervention received. 46 (28.9%) patients were reviewed by cardiologist within 3 months. 70 (43.5%) patients have undergone coronary angiogram and 91 (56.5%) patients have yet to receive intervention. Out of this number, 57 patients are still waiting for coronary angiogram appointment which is the main reason for not receiving intervention yet. Conclusion: Majority of our MI patients are on medical therapy. In a tertiary centre, every effort should be made to ensure they receive coronary intervention in a timely manner. D02

8th Negeri Sembilan Research Day 2023 Poster Abstract Presentation 19 Does Different Sources Of Information Influence The Level Of Fake Braces Knowledge Among Young Adults Population? ZM Chia1 , KT Yap1 , MZ Ramlay2 1 Unit Of Orthodontic, Pejabat Pergigian Daerah Kuala Pilah, Negeri Sembilan 2 Bahagian Kesihatan Pergigian, Jabatan Kesihatan Negeri Selangor, Selangor Introduction: Fake braces is an appliance with similar design to orthodontic fixed appliance but lack of the function and poses risk and side effects to oral and general health. The aim of this research was to study the knowledge of fake braces among the young adults. Methods: A self-administrated questionnaire was distributed to 587 form four students in Jempol district. SPSS software was used for descriptive and Chi-square analysis. Results: A total of 569 (95.1%) respondents completed the questionnaire. The respondents of this study were predominantly Malay(74.2%) and from B40 (73.3%) income group. Almost half of the respondents (48.8%) showed low level of fake braces knowledge. The main source of information on fake braces was from social media (75%), friends and relatives (40%) and dental clinic (22%). There were significant different among those who received fake braces information from online source (p<0.001), advertisement (p<0.001), friends (P<0.001) and magazine (p<0.001). Those who received information from these sources acquired higher knowledge compared to those who did not. No significant different detected among groups who received information from dental clinic. Conclusion: Source of information does influence the young adults’ level of knowledge on fake braces. Therefore, effort should be made to ensure correct and validated information on fake braces disseminated through various sources. D03

8th Negeri Sembilan Research Day 2023 Poster Abstract Presentation 20 Comparison Of A 6-Year Trend In The Pre-Operative Visual Acuity Among Patients Presenting For Cataract Surgery At Cluster Ophthalmology Hospital Tuanku Ampuan Najihah, Kuala Pilah Nur Izzati MS1 , Sangeetha S2 , Jakiyah D3 ,Khairul Husnaini MK4 1 Department of Ophthalmology, Hospital Tuanku Ampuan Najihah, Kuala Pilah, Negeri Sembilan. Background: To demonstrate the trend in the presenting visual acuity(VA) for patients presenting for cataract surgery from Cluster Ophthalmology HTAN hospitals. Method: This registry review includes patients who have undergone cataract surgery over a 6-year period (Januay 2017-December 2022) at Hospital Tuanku Ampuan Najihah (HTAN), Hospital Tampin (HTAM) and Hospital Jempol (HJEM). Information on preoperative visual acuity, sociodemographic characteristics, ocular and systemic comorbidity were retrieved from the National Eye Database and descriptively analyzed. Results: Of the 3051 patients studied in HTAN, the mean age was 51.83 and males were 1393 (45.70%) whereas females were 1658 (54.30%). In HTAM, 1995 patients were studied, the mean age was 68.01 with 988 males (49.50%) and 1007 females (50.50%). While in HJEM, 966 patients were studied with 481 males (49.80%) and 485 female (50.20%). Prior to the Covid era, the predominant visual acuity was in the moderate visual impairment (6/18 - 6/60) that was followed by blind (<3/60) at all the three centres. However there is an increase in patients with VA of worse than 3/60 (blind) as the result of pandemic in HTAN. Conclusion: An increasing trend of patients with pre-operative VA of worse than 3/60 since the Covid Pandemic may be due to the inability to seek care earlier in view of the lockdown.Measures should be done to increase public awareness and early referral to a tertiary centre might reduce the time present to the eye clinic. Furthermore, this delayed presentation has negative implications on the mission to eliminate cataract blindness. D06

8th Negeri Sembilan Research Day 2023 Poster Abstract Presentation 21 Involvement of Implementers in Klinik Pergigian Mesra Promosi (KPMP) Program: Questionnaire Validation And Pilot Testing NA Samat1 , PP Devadhoss2 , NS Kamal3 , R Ngah4 , DMS Kamarozaman5 1 Bahagian Kesihatan Pergigian Negeri Sembilan 2 Pejabat Kesihatan Pergigian Daerah Seremban Background: Klinik Pergigian Mesra Promosi (KPMP) is an initiative program by Oral Health Program, Ministry of Health Malaysia with the aim to strengthen the prevention and promotional components in the delivery of oral health services in government dental clinics in Malaysia. The aim of this study was to develop a reliable and valid instrument to measure the perceived barriers and facilitators among Dental Officers and Dental Therapist towards the implementation of KPMP activities. Methods: The questionnaire comprised of 18 items divided into 2 domains of facilitating factors and barriers in implementing KPMP activities. The cross-cultural adaptation (English to Bahasa Melayu) was performed involving forward translation, backward translation and review. Translated questionnaire (Bahasa Melayu version) was used. To establish the content validity, the questionnaire was reviewed by and 3 expert panels and 10 respondents for face validity. Refined items were pilot-tested among 20 Dental Officers and Dental Therapists in KPMP facility in Seremban. Descriptive statistics was applied, face and content validity were assessed, internal consistency and test-retest reliability was performed. Results: The total mean ± standard deviation (SD) of the facilitating factors was 3.74± 0.25 and for barriers was 3.02± 0.50. The questionnaire items were found to have strong content item validity (CVI = 1). All domains were considered internally consistent (α > 0.7). The test-retest reliability was evaluated through Kappa Score for each item, and all meet the minimum recommended standard. Conclusion: The questionnaire was demonstrated to have good reliability and validity. D07

8th Negeri Sembilan Research Day 2023 Poster Abstract Presentation 22 Association Between Oral Health Literacy and Oral Health Practice Kamal NS 1 , Ramlay MZ2 , Mohd Arif BM3, Kamarozaman DMS1 , Saidin NI1 1 Seremban District Dental Office, Ministry of Health Malaysia 2 State Oral Health Division, Selangor Darul Ehsan 3 Faculty of Dentistry, MARA University of Technology Introduction: Health literacy empowers individual to use health information effectively. Adequate health literacy results in better health decision-making. The aim of this study is to determine the relationship between OH literacy (OHL) and oral health practice (OHP) among patients attending government dental clinics in Seremban. Methods: A validated questionnaire OHLI-M was used. The first part of OHLI-M was self-administered by the participants, while the second part was conducted via face-to-face interview. Information about patients’ sociodemographic profile, OHL and OHP were collected. OHP was evaluated on frequency of brushing, type of bristle, toothpaste and dental aid used. The relationship was tested using One-way ANOVA in SPSS. Results: Out of 199 participants, more than half (65.5%) has adequate level of OHL. Majority (94.0%) had good practice on frequency of toothbrushing habit. 49.7% of respondents used soft bristle toothbrush which is a sign of good OHP. Majority (86.9%) used fluoridated toothpaste. All participants reported the use of dental aid such as dental floss, mouthwash, and toothpick. In general, OHL was found to be significantly associated OHP (0.021, p<.05). OHL was significant with frequency of toothbrushing (0.045, p<.05) and type of bristle used (0.024, p<.05). No significant association found between OHL and type of toothpaste and use of dental aid. Conclusion: Patients with higher OHL has better OHP in terms of frequency of toothbrushing and type of bristle used. An understanding of participants’ oral health literacy levels is crucial for designing effective health educational materials and creating intervention programs to promote oral health. D08

8th Negeri Sembilan Research Day 2023 Poster Abstract Presentation 23 The Homeless in Seremban: An Oral Health Needs Assessment PP Devadhoss1 , NI Saidin2 , DMS Kamarozaman3 1 Klinik Pergigian Seremban, Negeri Sembilan 2 Klinik Pergigian Senawang, Negeri Sembilan 3 Pejabat Kesihatan Pergigian Daerah Seremban Introduction: Evidence shows that community-based oral health interventions are crucial for improving the access of homeless people to dental care. The aim of this retrospective analysis was to assess the oral health needs of a homeless population, in order to determine levels of unmet need. Methods: Clinical data reports generated from Gi-Ret 2.0 oral health database and oral health records of the homeless who attended a community and mobile dental service at Dapur Kausar, a soup kitchen in Seremban were retrospectively audited. Results: 5 visits were made to carry out oral health examinations for the homeless from January to March 2023. A total of 64 patients attended our service. The mean age of attendees was 58.8 (SD: 13.3) with half them being 60 years old and above. 76.6 % were male and 45.3% were Chinese. The mean D3vcMFT of the participants was 21.2 (SD 10.1); every participant had D3vcMFT>0. The largest component of the D3cvMFT was the missing teeth (17.3). More than half (51.6%) of patients had at least 1 missing tooth. 48.4% were missing more than half their teeth. A quarter of the patients were completely edentulous. Basic periodontal examination was carried out with 95.7% of dentate participants found to have calculus in at least 1 sextant. Conclusion: This sample of homeless adults was found to have high unmet oral health needs. These findings suggest the need to continue community-based oral health interventions to facilitate their access to dental treatment. D09

8th Negeri Sembilan Research Day 2023 Poster Abstract Presentation 24 A Study On Under Five Childhood Acute Respiratory Infections (ARIs) In Seremban District, Negeri Sembilan. The Role Of Mothers As Caregivers Rowena John, Sharina Mohd Shah, Ng Chiu Wan, Mohammad Faid B Abd Rashid, Zaza Hulwanee Binti Dato Mohd Zainee 1 Pejabat Kesihatan Daerah Jempol, 2 Pejabat Kesihatan Daerah Seremban 3 Social and Preventive Medicine University Malaya Introduction: About 6.6 million children under five die yearly; 95% are in low-income countries, and one-third are due to acute respiratory infections (ARIs).(Tazinya et al, 2018). Mothers play an important role as caregivers; thus, their knowledge, attitude, and practices (KAP)will be an important preventive measure for the disease. The study aimed to determine mothers' KAP level towards managing ARIs among children under five years old in Seremban District and to determine the associated factors. Methods: Cross-sectional study was conducted in randomly selected six health clinics in Seremban district among 340 mothers who attended the mother-child health clinic (MCH) in these clinics in the year 2019. Logistic regression and bivariate analysis were used in this study to measure the association of factors with KAP of mothers regarding managing ARIs. Results: Findings show a significant correlation between the knowledge and practice of mothers in managing ARIs, where p < 0.001. Using modified Bloom's cut-off point, where the score is good KAP as ≥ 80% and above, this study's findings show that most mothers had poor knowledge ( 56.2%), and 55.9% of mothers practiced poor practice. In multivariate analysis, age is a predictor of knowledge (AOR 2.050,95% CI 1.198,3.507), p= 0.009). For practice, family income is associated with practice where p = 0.025. Conclusion: From this study, it can be concluded that less than half of the mothers had good knowledge and practiced good practices for managing ARIs. Therefore, more awareness programs should be targeted at younger mothers and lower socioeconomic groups. Keywords: Acute respiratory infections, virus, bacteria, children < 5 years old, KAP D10

List of Poster Presentation No Title Presenting Author & Department AH01 Identification of Prevalence And Factors Associated With Potentially Inappropriate Medications (PIMS) Among Warded Geriatric Patients In The Wards of Hospital Tuanku Ja’afar (HTJ), Seremban Choong Qi Ying Pharmacy HTJS AH02 Knowledge, Attitude and Practices of Doctors, Pharmacists and Nurses regarding tablets splitting or crushing in Hospital Tampin Fathin Binti Abdul Halim Zaki Pharmacy H. Tampin AH03 Outcome of Quit Smoking Clinic with Active Pharmacist Involvement: A 5-Year Retrospective Study Gan Kim Yen Pharmacy KK Seremban AH04 Gait Comparisons During The Timed Up And Go Among Elderly With And Without Benign Paroxysmal Positional Vertigo: A Preliminary Study Haziqah Binti Nasruddin Physiotherapy HTJS AH05 Cost-Consciousness of Medications amongst Doctors in A District Specialist Hospital and Their Attitudes towards It Jonathan Teng Ern Yik Pharmacy HPD AH06 Assessment Of Patients’ Willingness To Pay (WTP) For Drugs For Non- Communicable Diseases In Klinik Kesihatan Senawang Kamalini A/P Sundraj Pharmacy KK Senawang AH07 Time Spent on Interventions of Problematic Prescriptions from Specialist Clinics in Outpatient Pharmacy and its Associated Factors Lydia Lim Sung Min Pharmacy HTJS 8th Negeri Sembilan Research Day 2023 25 Allied Health Category

List of Poster Presentation No Title Presenting Author & Department AH08 Impact Of Pharmacist Led Multimedia Counselling On Diabetic Knowledge And Medication Adherence Among Type 2 Diabetes Mellitus (T2DM) Patients At Klinik Kesihatan Ampangan, Seremban Natasha A/P C Sathasivam Pharmacy KK Ampangan AH09 Effective Online Education: A Pharmacist’s Perspective Nishakaran A/L Pushpa Rajah Pharmacy HTAN AH10 Health Related Quality of Life and Economic Burden Among Patients Undergoing Tuberculosis Treatment Noor Ainullisa Binti Abu Bakar Pharmacy HTJS AH11 Assessing Adherence and Knowledge of Oral Phosphate Binders Among Haemodialysis Patients in Hospital Tuanku Ja’afar Seremban Norlizawati Binti Sariffudin Pharmacy HTJS AH12 Prevalence and the Associated Factors of Proton-Pump Inhibitor (PPI) Co-Prescribed with Dual Antiplatelet Therapy (DAPT) among Adult Patients Diagnosed with Acute Coronary Syndrome (ACS) upon Hospital Discharge Nur Amira Binti Jemal Pharmacy HTJS AH13 Visual Acuity Pattern of Patients Presenting for Cataract Surgery and Evaluation of Visual Outcome After Cataract Surgery in Patient with Pre-operative Vision of 6/12 and Better. Nur Hidayah Bt Yusuf Ophthalmology HTAN 8th Negeri Sembilan Research Day 2023 26 Allied Health Category

List of Poster Presentation No Title Presenting Author & Department AH14 Incidence of Actual Drug-Related Problems among Geriatric Patients during Medication Reconciliation upon Hospital Admission Nur Shazwani Kamal Hassan Pharmacy HPD AH15 Ceftriaxone Audit in Medical Wards of Hospital Tuanku Ja’afar Seremban Nurhayati Abd Samad Pharmacy HTJS AH16 Time Series Analysis of an Antimicrobial Usage and Antimicrobial Resistance in a Malaysian Tertiary Hospital: A Retrospective Observational Registry Study (MyINTENSE Study) Nurul Akma Binti Hanan Pharmacy HTJS AH17 Medication Reconciliation: A Qualitative Analysis Of Healthcare Professionals’ Perceptions Nurul Akmar Binti Anuar Pharmacy HTAN AH18 Self-reported Mental Health Status, Social Support and Predictors of Viral Suppression among Patients with Human Immunodeficiency Virus (HIV) in Negeri Sembilan: A Multicentre Study Puvaneswari A/P Nitamakwuavan Pharmacy HTAN AH19 Awareness and Practice Towards Proper Home Storage and Handling of Opened Syrup/Suspension Medication Among Patients and Caregivers in A Public Hospital. Siti Bahiah Abdul Yazaid Pharmacy HPD 8th Negeri Sembilan Research Day 2023 27 Allied Health Category

8th Negeri Sembilan Research Day 2023 Poster Abstract Presentation 28 Identification of Prevalence And Factors Associated With Potentially Inappropriate Medications (PIMS) Among Warded Geriatric Patients In The Wards of Hospital Tuanku Ja’afar (HTJ), Seremban Nur Hayati Binti Abu Samad1 , Zetty Ellyssa Binti Sallehuddin1 , Dr Goh Cheng Beh2 , Iz Mohd Zaim Bin Md Zain1 , Choong Qi Ying1 1 Department of Pharmacy, Hospital Tuanku Ja’afar, Seremban 2 Department of Medicine, Hospital Tuanku Ja’afar, Seremban Introduction: Geriatric are more susceptible to adverse drug reactions (ADRs), due to alteration of pharmacokinetics and pharmacodynamics, as a result of ageing. Potentially inappropriate medications (PIMs) are the use of medications whose risks outweigh the benefits, which will potentially increase morbidity and mortality. Methods: A cross sectional study was conducted from November 2021 to January 2022, involving 124 geriatric patients (60 years and above) who were admitted in the wards of Hospital Tuanku Ja’afar Seremban. The medical history of the included patients were recorded and analyzed using AGS Beers Criteria 2019 for detection of PIMs. Data were further analyzed using SPSS and multiple logistic regression analysis for the identification of factors associated with PIMs. Result: A total of 124 patients were included in the study. A total of 61 (49.2%) patients were found to receive at least one PIMs. The most prescribed PIMs among the geriatrics were found to be frusemide, pantoprazole, and spironolactone. The factors that significantly associated with PIMs were the number of medications (adjusted odd ratio 1.306, 90% confidence interval (Cl) 1.224 to 1.388 ,p=0.001) and the number of comorbidities (adjusted odd ratio 1.53, 90% confidence interval (Cl) 1.361 to 1.703,p=0.013 ). Conclusion: This study gave an insight into the current status of drug prescribing for the geriatric patient in HTJS. However, this study is a single-centered study where the result cannot estimate the prevalence overall. Hence, more studies can be conducted in a larger scale and various settings for a more insightful data. AH01

8th Negeri Sembilan Research Day 2023 Poster Abstract Presentation 29 Knowledge, Attitude And Practices Of Doctors, Pharmacists And Nurses Regarding Tablets Splitting Or Crushing In Hospital Tampin Goh YT1 , Fathin AHZ1 , Ng RY1 1 Hospital Tampin, Negeri Sembilan Background: Tablet splitting or crushing has been accepted for many years and tend to be performed by pharmacists, nurses or patients. Paediatric and geriatric patients usually split or crush their tablets to acquire appropriate dosage requirements as the suitable doses are not available in the market. In order to obtain an appropriate dose, a larger dose that is available in the market, is being split to a lower dose. This study was conducted to determine the knowledge, attitude and practices of doctors, pharmacists and nurses in Hospital Tampin towards tablet splitting or crushing. Methodology: This study was conducted as a cross-sectional study using convenient sampling. In total, 134 online questionnaires were filled by the doctors, pharmacists, and nurses in Hospital Tampin within three months. Results: About 64.9 % of the respondents have encourage tablet splitting as a way for the patient to save money and they were not aware of the consequences of inaccurate tablet splitting. Concerning knowledge, attitudes, and practices of the healthcare workers in Hospital Tampin, most of the respondents (91%) agree that they are not sure whether tablets are suitable for spitting or crushing. Discussion/Conclusion: This study has identified knowledge, attitude, and practice gaps among healthcare workers regarding tablet splitting or crushing. Therefore, improving knowledge regarding tablet splitting and crushing is required by planning and developing a reference with continuous education towards healthcare workers which may lead to a better patient’s outcome. AH02

8th Negeri Sembilan Research Day 2023 Poster Abstract Presentation 30 Outcome of Quit Smoking Clinic with Active Pharmacist Involvement: A 5-Year Retrospective Study KY Gan1 , TI Ling1 , Nur Ain Izzati AL1 , Nabila Farhana AB1 , Hasnita J1 , Ratna S2 1 Unit of Pharmacy, Seremban Health Clinic, Negeri Sembilan, Malaysia. 2 Unit of Pharmacy, Seremban District Health Office, Negeri Sembilan, Malaysia. Introduction: Smoking is one of the major public health threats, which has caused millions of deaths annually throughout the world. Therefore, Malaysian government has established Quit Smoking Clinic (QSC) in government health facilities since 1998 to reduce the national burden of smoking prevalence. The main objective of this research is to study the 5 years outcome of QSC with active pharmacist involvement at Klinik Kesihatan Seremban by determining the CO-validated quit rate at 6 months and to identify predictors of successful smoking cessation. Methodology: A total of 200 participants attending QSC between 2016 until 2020 were selected by simple random sampling. Data were collected through standardised data collection form which consisted of sociodemographic characteristics, smoking characteristics and quit smoking clinic interventions. Smokers who quit smoking 6 months after setting their quit date and verified by carbon monoxide analyses were considered as successful quitters. Results: 57.5% CO-validated success rate was achieved. The significant predictors of successful smoking cessation were identified as smokers who set the quit date within 14 days (aOR=3.413, 95% CI:1.350-8.629), number of follow-ups (aOR=2.602, 95% CI:1.909-3.548) and longest duration of abstinence during previous quit attempt (aOR=24.110, 95% CI:2.347-247.734). Smokers with high dependence (aOR=0.113, 95% CI: 0.027-0.482) and very high dependence (aOR=0.020, 95% CI: 0.02-0.188) were less likely to quit smoking successfully. Conclusion: QSC with Smoking Cessation Pharmacotherapy Services achieved a high success rate with active pharmacist involvement. Setting the quit date and more frequent follow-up during the first 6 months period enhance medication compliance and motivation to quit. AH03

8th Negeri Sembilan Research Day 2023 Poster Abstract Presentation 31 Gait Comparisons During The Timed Up And Go Among Elderly With And Without Benign Paroxysmal Positional Vertigo: A Preliminary Study Haziqah Nasruddin1, 2, Haidzir Manaf1 , Maria Justine1 1 Center for Physiotherapy Studies, Faculty of Health Sciences, Universiti Teknologi MARASelangor,Puncak Alam Campus, 42300 Puncak Alam, Selangor, Malaysia. 2 Physiotherapy Department, Hospital Tuanku Ja’afar Seremban, Jalan Rasah, Bukit Rasah, 70300, Seremban Negeri Sembilan, Malaysia. Introduction: Turning while walking is an important functional mobility task. While there is a considerable body of work on postural alteration in benign paroxysmal positional vertigo, rarely study on gait has been done, especially among the elderly. This study aims to compare the gait parameters during the Timed Up and Go Test (TUG) among elderly with BPPV (BPPV) and without BPPV(WBPPV). Methodology: Thirty-four aged-matched participants (17 BPPV and 17 WBPPV) underwent gait assessment while performing the TUG. Gait parameters 1) time to complete TUG, 2) steps taken to complete TUG, 3) time taken to complete turn during TUG, 4) the number of steps taken during turning, 5) stride length, 6) stride time and 7) stride velocity were recorded using a videotaped. Results: A Mann-Whitney test indicated that time to complete TUG (22.0 vs 13.0, p= 0.008), steps taken to complete TUG (21.8 vs 13.2, P=0.04), turning time during TUG (22.6 vs 12.4, p= 0.005) turning step (22.3 vs 12.7, p=0.01) and stride time (21.7 vs 13.26, p=0.01) were significantly greater in the BPPV than WBPPV. Meanwhile, stride length (16.7 vs 18.3 p=0.6)) and stride velocity (15.18 vs 19.8, p=0.2) shows no significant different among BPPV and WBPPV. Conclusion(s): The result shows that BPPV altered gait function, especially during turning. Furthermore, the elderly with BPPV is at risk of getting a fall while turning. All older people who presented with BPPV must be assessed and prescribed with gait training. AH04

8th Negeri Sembilan Research Day 2023 Poster Abstract Presentation 32 Cost-Consciousness of Medications amongst Doctors in A District Specialist Hospital and Their Attitudes towards It JEY Teng1 , Amirul-Zahid AN1 1 Pharmacy Department, Port Dickson Hospital, Negeri Sembilan State of Health, Ministry of Health Malaysia Introduction: Many efforts to manage healthcare costs focus on doctors. However, data regarding cost consciousness, specifically for doctors in Malaysia, is lacking. Objective: This study aimed to investigate the doctors' familiarity with different cost concepts, assess their attitude towards cost consciousness, determine the perceived barriers that prevent doctors from considering medication costs while prescribing, and determine the factors associated with higher cost consciousness. Methods: A cross-sectional study was conducted among doctors practising in Port Dickson Hospital, using a questionnaire to collect data from December 2021 to April 2022. A convenience sampling method was used to recruit the study participants. Independent t-tests and One-way ANOVA were used for inferential analysis. Results: The response rate was 85%. Among 89 respondents, 59.6% were 31-40 years old, 59.6% were female, and 22.5% were from the medical department. 89.9% had never received any formal education/ training in health economics/ pharmacoeconomics; 70.8% agreed that every doctor must try to contain medication costs. Lack of knowledge and resources about cost (65.2%) was a prominent barrier. Higher cost-consciousness was observed among those who were >35 years old (p=0.04), familiar with the terms cost-consciousness (p<0.001) and cost-effectiveness (p=0.002) and were familiar with the concept of cost-effectiveness for medications (p<0.009). Conclusion: Doctors' familiarity with health economics/ pharmacoeconomics could have been improved. Most doctors demonstrated a positive attitude toward cost-consciousness, and lack of knowledge was a significant barrier. More than 35 years old and familiar with the health economics/ pharmacoeconomics terms and concepts associated with higher cost consciousness. Keywords: Cost-consciousness, healthcare costs, medication utilization AH05

8th Negeri Sembilan Research Day 2023 Poster Abstract Presentation 33 Assessment Of Patients’ Willingness To Pay (WTP) For Drugs For NonCommunicable Diseases In Klinik Kesihatan Senawang Kamalini Sundraj1 , Hemah Devi1 Nadia MS1 , Ratna S2 1 Unit of Pharmacy, Senawang Health Clinic, 70450, Seremban Negeri Sembilan, Malaysia 2 Unit of Pharmacy, Seremban District Health Office, Seremban, Negeri Sembilan, Malaysia Introduction: Willingness to pay (WTP) defined, as the amount of money one is willing to spend for medical interventions for a better health outcome of disease conditions. The objectives of this study are to assess patients’ willingness to pay (WTP) for drugs for non-communicable diseases in Klinik Kesihatan Senawang and determine its’ influencing factors. Methodology: Cross sectional study design was used. The study instrument was translated to Malay and distributed to 383 participants fitting the inclusion criteria. Results: Majority of the patients (33.3%) were aged 54-59. Two hundred and four (52.3%) respondents were female. Majority of them were Malay (52.6 %) followed by Chinese (26.7%), Indian (17.7 %) and others (3.1%). Mostly (53.3%) answered that introducing health services based on ability to pay was preferred.  There is no association between gender and willingness to pay for drugs, as the p value obtained is 0.498. No association found between education level and WTP for drugs as the p value is 0.522. Similarly, income and willingness showed no association as the p value obtained is 0.120. Positive association between dependants and WTP was found, as the p value obtained is 0.010 showing statistical significance. Furthermore, there is positive association between disease severity and WTP for drugs as the p value is 0.030. Conclusion: It is known that the ability to pay for NCD drugs in Klinik Kesihatan Senawang is in accordance with the type of services provided. Factors such as disease severity and number of dependants are positively associated with WTP. AH06

8th Negeri Sembilan Research Day 2023 Poster Abstract Presentation 34 Time Spent on Interventions of Problematic Prescriptions from Specialist Clinics in Outpatient Pharmacy and its Associated Factors Lydia SM Lim1 , Ahmad Afiq S1 , Fatin Najiha I1 , Kristen YL Lim1 , Ika Syafiqah A1 1 Department Of Pharmacy, Hospital Tuanku Ja’afar Seremban, Negeri Sembilan Introduction: Knowing the time required to perform interventions on problematic prescriptions is important in enabling the outpatient pharmacy department (OPD) to provide medication promptly since time delay in resolving problematic prescriptions could be the reason waiting time exceeds 30 minutes as stipulated in the client charter. Objective: The main objective of this study is to determine the duration of time required to perform interventions on problematic prescriptions received from specialist clinics in OPD, Hospital Tuanku Ja’afar Seremban (HTJS). Method: This analytical, cross-sectional study was conducted in OPD, HTJS and included both manual and electronic problematic prescriptions from specialist clinics. Selection was performed using convenience sampling and details of the interventions were recorded in the pharmacist intervention documentation form. Descriptive analysis was used to analyze possible factors affecting intervention time. Kruskal-Wallis test was performed to determine whether the differences in time taken was significant. Result and Discussion: The average total time taken to resolve problematic prescriptions was 7.1 minutes ± 3.77 minutes. Total time spent on interventions differed significantly across different clinics, X (17, N=379) = 48.580, p < .05. The most common error detected was incorrect dose (20.7%). Manual prescriptions had more errors than electronic prescriptions at 59.9%. The combined action of calling the clinic and through the operator was the most frequent action taken at 16.9%. Conclusion: In conclusion, the time required to perform interventions was affected by various factors. Further analysis and studies of these factors can be done so that intervention time can be shortened. AH07

8th Negeri Sembilan Research Day 2023 Poster Abstract Presentation 35 Impact Of Pharmacist Led Multimedia Counselling On Diabetic Knowledge And Medication Adherence Among Type 2 Diabetes Mellitus (T2DM) Patients At Klinik Kesihatan Ampangan, Seremban Natasha S1 , Balkis S1 , Sarah A1 , Amira S1 , Najihah S1 1 Unit of Pharmacy, Ampangan Health Clinic, Negeri Sembilan, Malaysia. 2 Unit of Pharmacy, Seremban District Health Office, Negeri Sembilan, Malaysia. Introduction: The prevalence of T2DM globally is expected to increase to 5.6% in 2025 from 2.4% in 1995. In Malaysia, the prevalence of T2DM increased from 11.2% in 2011 to 13.4% in 2015 and 18.3% in 2019.The prevalence of T2DM in Negeri Sembilan state showed the highest rate. Objectives of the study is to evaluate the impact of pharmacist led multimedia counselling on knowledge and medication adherence among T2DM patients. Methodology: A quasi-experimental study of 84 T2DM patients were allocated into intervention and control group. 42 subjects of intervention group had received multimedia and verbal conventional counselling from the pharmacist and 42 subjects of control group had received verbal conventional pharmacist counselling only. A validated questionnaire was used to assess knowledge regarding T2DM and medication adherence in both at baseline and at final follow-up. Results: Chi Square test showed no significant difference of sociodemographic characteristics that affect medication adherence and knowledge of T2DM patients. In Wilcoxon Signed Rank Test, there is increment of mean knowledge scores post study(8.1)compared to pre-study(5.52)which is statistically significant(p<0.001). The increment in mean MyMAAT scores in post study is (1.98)(p=0.083) compared to pre study (1.15)(p=0.180)but not statistically significant. Mann Whitney test showed mean difference of 2.69 between both groups and is statistically significant(p<0.001) Mean MyMAAT score difference is1.42 between both groups but not statistically significant(p=0.138) Conclusion: It was found that combination of pharmacists led multimedia counselling and verbal counselling is more effective compared to conventional counselling alone in improving patient’s knowledge and medication adherence AH08

8th Negeri Sembilan Research Day 2023 Poster Abstract Presentation 36 Effective Online Education: A Pharmacist’s Perspective Nishakaran Pushpa Rajah1 , Siti Mariam Saha1 , Raja Nur Hidayah Raja Hasnan2 , Intan Syahira Abdul Aziz3 1 Pharmacy Department, Hospital Tuanku Ampuan Najihah, Negeri Sembilan 2 Pharmacy Department, Hospital Jempol 3 Pharmacy Department, Klinik Kesihatan Gemencheh. Introduction: From around 2019 to 2021, healthcare professionals actively pursued online education to fulfil the requirements for their annual retention certificate. Since there are limited studies that explore a pharmacist’s perspective on online education, findings from this study would provide policy makers and educational content creators insights to produce more effective educational materials. Objective: This study aims to explore the perspective of pharmacists on effective online education. Method: Face-to-face, semi-structured interview involving 25 pharmacists who have experienced online education, were conducted. Respondents were queried about; perceived effectiveness of online education compared to face-to-face education and the facilitators and barriers of effective online education. Topic modelling via Latent Dirichlet Allocation (LDA) was used to identify insights from the data collected. Results: Identified themes include, “Accessibility”, “Applicability” and “Comprehension”. The theme of comprehension was prominent in the domain of ‘opinion’, ‘strengths’, ‘past experience’, ‘learning new clinical knowledge’ and ‘motivation in using ‘knowledge’, ‘obstacles and ‘impact’. The theme of accessibility was strongly expressed in the domain of ‘weaknesses’. Although not significant in any specific domains, the theme of applicability was seen in the domains of ‘obstacles’, ‘impact’ and ‘motivated in using the new knowledge’. Conclusion: The effectiveness of online education among pharmacists in Negeri Sembilan depends on how well the themes of comprehension, accessibility, and applicability are addressed. Online educational contents that are comprehensible, conveniently available and practical can boost the effectiveness of an online education. Keywords: Online education, pharmacist, cme, cpd, effectiveness AH09

8th Negeri Sembilan Research Day 2023 Poster Abstract Presentation 37 Health Related Quality of Life and Economic Burden Among Patients Undergoing Tuberculosis Treatment Noor Ainullisa Abu Bakar1 , Ghan Sheah Lin2 , Chong Wei Wen3 1 Hospital Tuanku Ja’afar, Negeri Sembilan, Ministry of Health Malaysia 2 Hospital Canselor Tuanku Muhriz, Pusat Perubatan UKM, Cheras, Kuala Lumpur, Malaysia 3 Faculty of Pharmacy, UKM, Kuala Lumpur, Malaysia Introduction: The increasing prevalence of tuberculosis (TB) contributed to disease, economic and psychological burden to TB patients and their family members. Studies on these areas in Malaysia are seldom conducted. Objective: This study aimed to evaluate HR-QoL of TB patients receiving TB treatment and the impact of TB on employment status and household income loss as well as any predictors contributed to HR-QoL. Methods: A prospective cross-sectional survey was conducted in the chest clinic from March until May 2019. A self-administered questionnaire consisting of demographic characteristics, SF-36v2 questionnaire, employment status and household income loss were distributed to eligible patients. HR-QoL was analyzed using NBS U.S. populations 1998 as reference. A multiple linear regression analysis was performed to identify predictive factors of HR-QoL scores. Results: The survey was completed by 105 patients. The mean + SD Physical Component Summary (PCS) scores in the intensive and maintenance phase were 33.6 + 17.8 and 40.6 + 14.5, respectively. Similarly, the mean + SD Mental Component Summary (MCS) scores in the intensive phase was 32.6 + 18.7 and in the maintenance phase was 39.4 + 15.1. There were significant differences in PCS (p=0.03) and MCS scores (p=0.05) between treatment phases where higher scores were reported in maintenance phase. More than 50% of patients in both phases were at risk of depression. Household income loss and unemployment were also observed. Maintenance phase was predictive factor for higher PCS and MCS scores. Comorbidity and Malay race were predictive factors for PCS and MCS scores, respectively. Conclusion: Compromised physical and mental health was observed in both phases despite higher PCS and MCS scores in maintenance phase. Households that were financially affected should be assisted and predictive factors of HR-QoL can be used to identify patients with expected low HR-QoL and appropriate measures can be taken. Keywords: Tuberculosis, Health-related quality of life, SF-36v2 health survey, economic burden. AH10

8th Negeri Sembilan Research Day 2023 Poster Abstract Presentation 38 Assessing Adherence and Knowledge of Oral Phosphate Binders Among Haemodialysis Patients in Hospital Tuanku Ja’afar Seremban Norlizawati binti Sariffudin1 , Noor Ainullisa binti Abu Bakar1 , Nur Syazaubaidah binti Zainal1 , Tan Yu Xin1,, Erlenda Julia binti Osman1 1 Department of Pharmacy, Hospital Tuanku Ja’afar Seremban, Negeri Sembilan  Introduction: Hyperphosphatemia is common among dialysis patient which treated with oral phosphate binders (PB). This study aimed to examine the adherence and knowledge level towards oral PBs among end-stage renal disease (ESRD) haemodialysis patients and to identify potential predictors of non-adherence.  Methods: A cross-sectional study was conducted among haemodialysis patients attending dialysis unit from September 2021 to October 2021. An interviewer-assisted questionnaire that addressed the participants’ socio-demographics, knowledge, and adherence score towards oral PBs was used for data collection. Data were analysed using descriptive and binary logistic regression using SPSS Version 24.  Results: A total of 115 patients participated in the study. Majority of them (89.6%) were prescribed with calcium carbonate tablet. Average number of oral PB taken by each patient was 6.63 ± 2.36 per day. 40% patients demonstrated good adherence and 44.4% patients have good knowledge about PB prescribed to them. Patients with higher level of education and longer duration diagnosed with ESRD (OR: 1.37; 95% CI: 1.15-1.64; p< 0.001) were more likely to adhere to their oral PBs. Besides, number of comorbidities (OR: 0.21; 95% CI: 0.07-0.66; p= 0.007) and number of PB pills (OR: 0.49; 95% CI: 0.31-0.78; p= 0.003) were associated with poor adherence.  Conclusion: The adherence towards oral PB was found to be moderate to poor among the study population. There is a crucial need to develop a more patient-centred intervention to address the factors identified in order to facilitate adherence and optimize the existing management of hypophosphatemia among ESRD patients.  Keywords: adherence, knowledge, phosphate binder, haemodialysis, end-stage renal disease  AH11

8th Negeri Sembilan Research Day 2023 Poster Abstract Presentation 39 Prevalence and the Associated Factors of Proton-Pump Inhibitor (PPI) Co-Prescribed with Dual Antiplatelet Therapy (DAPT) among Adult Patients Diagnosed with Acute Coronary Syndrome (ACS) upon Hospital Discharge Nur-Amira J1 , Nurul-Fadhilah MS1 1 Pharmacy Department, Port Dickson Hospital, Negeri Sembilan State of Health, Ministry of Health Malaysia Introduction: There is limited published evidence on the prevalence and factors associated with the co-prescription of PPI and DAPT among patients diagnosed with ACS. Objective: This study aimed to determine the prevalence of PPI co-prescribed with DAPT among patients diagnosed with ACS and the associated factors upon hospital discharge. Methods: This was a single-centre, cross-sectional study conducted among adult patients admitted for ACS who received DAPT with/without PPI upon discharge from the general wards of Port Dickson Hospital. Computer-generated random numbers were used to enroll study subjects hospitalized between January and December 2021. Data were collected in a standardized form, while independent t-test, Pearson chi-squared test and multiple logistic regression were used for inferential analysis. Results: Out of 322 study subjects, the majority were male (n=220, 68.3%), Malay (n=189, 58.7%), and diagnosed with Non-ST Elevation Myocardial Infarction (n=227, 70.5%). 234 (72.7%) study subjects were discharged with DAPT plus a PPI. Study subjects who received PPI at admission were twenty-eight times more likely to be co-prescribed with DAPT upon discharge than their counterparts (adj OR 28.003, 95% Cl 12.076 – 64.936, p<0.001). In addition, older study subjects and those with lower haemoglobin levels were more likely to get a PPI co-prescribed with DAPT upon discharge (adj OR 1.044, 95% Cl 1.015 – 1.073, p=0.003; adj OR 1.262, 95% Cl 1.068-1.490, p=0.006, respectively). Conclusion: This study's percentage of ACS patients discharged with PPI and DAPT was relatively high. The associated factors were older age, lower haemoglobin levels and use of PPI at admission. Keywords: Proton-pump inhibitor, Dual antiplatelet therapy, Acute coronary syndrome AH12

8th Negeri Sembilan Research Day 2023 Poster Abstract Presentation 40 Visual Acuity Pattern of Patients Presenting for Cataract Surgery and Evaluation of Visual Outcome After Cataract Surgery in Patient with Pre-operative Vision of 6/12 and Better. Nur Hidayah Y¹, Nurul Akimi A2 , Hasyimah H3, Nor Aisyati I4 1 Department Of Ophthalmology, Hospital Tuanku Ampuan Najihah Kuala Pilah, Negeri Sembilan Introduction: Worldwide, there is changing of pattern in patient presenting for cataract surgery. This research is aim to determine best corrected visual acuity (BCVA) pattern of patients presenting for cataract surgery at Hospital Tuanku Ampuan Najihah (HTAN) from 2012 to 2022. Besides, we also aim to compare post-operative visual outcome of 2022 cataract surgery between patients with pre-operative BCVA of 6/12 and better and pre-operative BCVA of worse than 6/12. Methodology: We conducted a retrospective study of cataract surgery patients in HTAN from 2012 to 2022 using the National Eye Database (NED). Information on sociodemographic characteristics, pre-operative BCVA, post-operative BCVA and ocular comorbidity were retrieved. Then, data of post-operative BCVA from 2022 cataract surgery were chosen to be evaluated and analyzed. Results: Of the 4453 patients studied, males were 2108 (47.3%) and female were 2345 (52.7%). The mean age of participants was 66.93 (± 8.78). The pattern of patient’s BCVA presenting for cataract surgery changed towards better vision. In the evaluation of 2022 postoperative visual outcome, there is no statistically significant different between patient with preoperative BCVA of 6/12 and better and preoperative BCVA of worse than 6/12 (p = 0.160) Discussion/conclusion: The study demonstrated decreasing visual thresholds for cataract surgery and good visual outcomes seen regardless of the initial preoperative visual acuity. AH13

8th Negeri Sembilan Research Day 2023 Poster Abstract Presentation 41 Incidence of Actual Drug-Related Problems among Geriatric Patients during Medication Reconciliation upon Hospital Admission Nur-Shazwani KH1 , Zainol AZ2 1 Pharmacy Department, Port Dickson Hospital, Negeri Sembilan State of Health, Ministry of Health Malaysia 2 Faculty of Pharmacy, Cyberjaya University College of Medical Sciences, Selangor, Malaysia Introduction: Multimorbidity is common among the geriatric population and requires multiple complex drug regimens. This could lead to drug-related problems (DRP), negatively impacting the patient's health outcomes. This study was designed to determine the incidence of DRP among geriatric patients during medication reconciliation and the overall incidence of DRP upon hospital admissions. Methods: This single-centre, cross-sectional study was conducted at the general wards of Port Dickson Hospital from the 1st of June 2022 until the 31st of July 2022. Study subjects were chosen by using the convenience sampling method. A standardized data collection form was used to identify and classify DRP according to the PCNE Classifications version 9.1. The identified DRPs were classified based on the problems, types and causes. Data were analyzed with an independent t-test and an ANOVA test. Results: Out of 200 study subjects, 79.0% experienced 175 incidences of DRP: 106 (60.6%) during medication reconciliation and 69 (39.4%) during physician rounds. The highest incidence was found among the male gender (56.6%), Malay ethnicity (36.0%), the youngest old age group (62.9%), patients with multimorbidity (68.0%) and those with polypharmacy (89.7%). The most common problem from DRP was treatment effectiveness (93.7%), with drug selection (41.7%) being the highest type of DRP encountered. While the primary cause of DRP found was the dosage of a single active drug being too high (14.3%). Conclusion: Most DRPs were detected by the pharmacist upon hospital admissions through medication reconciliation. Through medication reconciliation, DRP could be reduced and prevented, thus, improving patients' health outcomes. Keywords: Drug-related problems, Geriatrics, Pharmacist, Medication reconciliation AH14

8th Negeri Sembilan Research Day 2023 Poster Abstract Presentation 42 Ceftriaxone Audit in Medical Wards of Hospital Tuanku Ja’afar Seremban Nurhayati AS1 ,Seow RY1 , Zetty Elyssa S1 , Suvintheran T1 1 Department of Pharmacy, Hospital Tuanku Ja’afar, Seremban, Negeri Sembilan 2 Department Of Medicine, Hospital Tuanku Ja’afar Seremban, Negeri Sembilan Introduction: Ceftriaxone is the most commonly prescribed in Medical Department. Excessive use of 3rd generation Cephalosporin may lead to emergence of ESBL. Objectives: To evaluate the indication of Ceftriaxone prescribed in the medical wards and to identify areas of improvement to promote appropriate prescribing of Ceftriaxone. Method: All patients from 8 medical wards prescribed with Ceftriaxone from February 5th – May 30th 2022 were enrolled in the audit. Medical patients who only received Ceftriaxone stat dose at Emergency department and those from Covid wards were excluded in the audit. Patients’ notes and medication charts were reviewed and data included demographics, dose, duration, laboratory data, escalate/de-escalate status, and clinical indication were collected by the trained medical officers and ward pharmacists. Appropriateness of the indication was based on National Antibiotic Guideline (NAG) 2017. Data were analyzed using descriptive statistic using Microsoft Excel Pivot table. Results: 71 patients were evaluated in the audit. All cases were treated empirically. Majority of the cases treated for community acquired infection (n=58). The most common indication prescribed were for Pneumonia (21%) followed by sepsis from unknown cause (18%) and meningitis (17%). Only 32% cases treated as preferred treatment based on NAG. De-escalation done in 40% of the cases (n=29). Conclusion: From this audit, Ceftriaxone was used as a first line antibiotics in many medical patients despite the NAG recommending it as an alternative choice. De-escalation of Ceftriaxone was not performed in many cases. There is a significant role of antibiotic stewardship in order to prevent antimicrobial resistance. AH15

8th Negeri Sembilan Research Day 2023 Poster Abstract Presentation 43 Time Series Analysis of an Antimicrobial Usage and Antimicrobial Resistance in a Malaysian Tertiary Hospital: A Retrospective Observational Registry Study (MyINTENSE Study) NA Hanan1 , V Muniandy1 , S Shaari1 , A Murali1 1 Department Of Pharmacy, Hospital Tuanku Ja’afar Seremban, Negeri Sembilan Introduction: Antimicrobial overuse or misuse has been linked to the formation and spread of antimicrobial-resistant bacteria, rendering therapy ineffective and creating a severe public health danger. Objective: This study aims to investigate correlation between antimicrobial usage and antimicrobial resistance. Materials and method: Secondary data of periodical surveillance on antimicrobial consumption, incidence rate of infection from multidrug resistant microorganisms and total patient days of Hospital Tuanku Ja’afar Seremban from the period of January 2018 to December 2021 were retrospectively collected. The obtained data were reviewed, extracted into Microsoft Excel and statistically analysed using The Statistical Package for Social Science (SPSS). Pearson’s or Spearman’s correlation test was used. Results: Ceftriaxone consumptions and incidence of Extended-spectrum beta-lactamases (ESBLs) E. coli infections were found to be significantly positively correlated (r = .355, p = .013), however other individual cephalosporin antimicrobials showed no significant correlation. Imipenem consumptions with incidence of Carbapenem-resistant Enterobacterales (CRE) infections were significantly positively correlated as well (r = .255, p = .049). There was also a significant, positive correlation between meropenem consumptions with incidence of CRE infections (r = .343, p = .007). Conclusion: Changes in antimicrobial consumption affects the antimicrobial resistance at the hospital. Increased consumption of ceftriaxone significantly correlates with the increased incidence of ESBL infections compared to other extended spectrum of cephalosporins. Usage of meropenem and imipenem significantly correlates with the increased incidence of CRE infections. AH16

8th Negeri Sembilan Research Day 2023 Poster Abstract Presentation 44 Medication Reconciliation: A Qualitative Analysis Of Healthcare Professionals’ Perceptions N.A. Anuar, M.F. Mat Yatim, N. Osman Pharmacy Department, Hospital Tuanku Ampuan Najihah, Kuala Pilah Introduction: Medication discrepancies occur intentionally or unintentionally between a patient's medication list and medication administration. Medication reconciliation (MedRec) is a solution to attain a complete patient's medication list, reducing the occurrence of drug discrepancies. Objective: This study aims to explore healthcare professionals' perceptions of MedRec in Hospital Tuanku Ampuan Najihah Kuala Pilah (HTAN), specifically focusing on their perceptions, barriers and facilitators of MedRec and insight on the MedRec form. Methodology: This qualitative study used purposive sampling method, involving 10 pharmacists and doctors. A set of questions were asked to the participants regarding MedRec, which included 3 main themes consisting of perceptions on MedRec, barriers and facilitators to implement MedRec and the use of MedRec form and improvement to the form. All data were manually analysed using thematic analysis theory approach. Results: The interview data yielded 62 codes which were abstracted into 5 categories, and 3 themes. All participants agreed that MedRec is for patient’s benefits; by reducing medication error, increasing medication safety and optimising treatment regimen. They had mutual perception on barriers to execute the process. However they also had differing perspectives about the implementation of MedRec using the new form. Conclusions: The implementation of MedRec remains challenging. Both professions had mutual understanding on the benefit of MedRec but they had different views on the implementation of the new form. Time, poor history and workload were the three main barriers in conducting MedRec. Hence, addressing these barriers while increasing providers self-efficacy might improve MedRec and outcomes. AH17

8th Negeri Sembilan Research Day 2023 Poster Abstract Presentation 45 Self-reported Mental Health Status, Social Support and Predictors of Viral Suppression among Patients with Human Immunodeficiency Virus (HIV) in Negeri Sembilan:A Multicentre Study Pearly Zhi Qing Chia 1 , Lai San Kong 1 , Clara Christian R. Paramanatham 2 ,Puvaneswari A/P Nitamakwuavan 1 , Ren Yung Seow 2 , Fatin Amirah Ramli 2 , Boon Tiang Lau 3 1 Pharmacy Department, Hospital Tuanku Ampuan Najihah, Negeri Sembilan 2 Pharmacy Department, Hospital Tuanku Ja’afar, Negeri Sembilan 3 Pharmacy Department, Hospital Port Dickson, Negeri Sembilan Introduction: Mental health status and social support were part of the influencing factors in achieving viral suppression to ensure successful treatment among Human Immunodeficiency Virus (HIV) patients. However, self-reported mental health status, social support, and predictors of viral suppression among HIV patients in Malaysia remain unknown. Objective: To assess the self-reported level of mental health status, social support, and predictors of viral suppression among HIV patients receiving antiretroviral therapy (ART). Method: A cross-sectional study was conducted in three main hospitals in Negeri Sembilan from Dec 2021 to June 2022. Adult HIV patients receiving ART were recruited via convenience sampling to self-administer questionnaires. Validated questionnaires consisted of 12-item Multidimensional Scale of Perceived Social Support (MSPSS) and Depression, Anxiety and Stress Scale-21 (DASS-21) were used. Certain medical information was traced from medical records. Results: From 118 respondents recruited, 66.10% (n=78) achieved viral suppression. More than two-thirds of respondents self-reported normal mental health status (no depression: n=94, 79.66%; no anxiety: n=79, 66.95%; no stress: 101, 85.59%). Respondents with non- viral suppression were significantly more likely to have self-reported anxiety than their counterparts (p=0.010) but not significant for self-reported depression and stress. Most respondents reported medium (n=54, 45.76%) and high perceived social support (n=57, 48.31%). No significant association was found between social support and viral suppression (p=0.668). Significant predictors of viral suppression were age (p=0.039), marital status (divorce: p=0.019), and duration of ART (p=0.028). Conclusion: Addressing self-reported mental health status and social support, together with the predictors of viral suppression may help in future quality improvement in HIV patient treatment. AH18

8th Negeri Sembilan Research Day 2023 Poster Abstract Presentation 46 Awareness and Practice Towards Proper Home Storage and Handling of Opened Syrup/Suspension Medication Among Patients and Caregivers in A Public Hospital Siti-Bahiah AY1 , Nur-Sabrina-Natasha A1 1 Pharmacy Department, Port Dickson Hospital, Negeri Sembilan State of Health, Ministry of Health Malaysia Introduction: Although proper home storage and handling of syrup/suspension medication are essential to maintain its quality, safety and efficacy, the data in Malaysia is still lacking. Hence, this study was conducted to determine the prevalence of proper home storage and handling of opened syrup/suspension medication among patients and caregivers and their experience with its counselling. Methods: A cross-sectional study was conducted using convenience sampling to recruit participants who visited the Outpatient Pharmacy Department of Port Dickson Hospital from February 2022 to May 2022. A face and content-validated questionnaire were used for data collection. The data were analyzed descriptively. Results: The response rate was 98.0%. Of 351 study participants, 300 (85.5%) stored the opened antibiotic suspension properly in the refrigerator. However, some common medications were inappropriately kept either in the fridge or freezer: fever syrup (82.9%), flu syrup (76.1%), and cough syrup (78.3%). Many participants did not aware (49.6 %) or were unsure (25.4 %) that the expiry dates of the syrup/suspension medication would be different once opened. Almost half (43.3 %) would use the opened syrup/suspension medication until the expiry date printed on the packaging. Besides, most participants (88.3%) practised improper syrup/suspension medication disposal at home. It was found that only 28.8% of participants were counselled by healthcare professionals on proper home storage and syrup/suspension medication handling. Conclusion: Most study participants did not know or practise proper storage and handling of syrup/suspension medication at home. Healthcare professionals should emphasize and educate the public regarding this issue in the future. Keywords: Awareness, Storage, Handling, Disposal, Syrup or suspension AH19

List of Case Report 8th Negeri Sembilan Research Day 2023 47 No Title Presenting Author & Department CR01 A Case of Anterior Mediastinal Mass with Life Threatening Massive Left Chylothorax Afifah Binti Kamarudin Medical HTJS CR02 Ileo-ileal Intussusception with Concurrent Proximal Ascariasis: A Case Study Ahmad Faiz Bin Adnan Radiology l HTAN CR03 L-Asparaginase Associated Cerebral Venous Thrombosis (CVT) and Intracerebral Haemorrhage in Acute Lymphoblastic Leukemia (ALL) Chan Hui Ying Medical HTJS CR04 Single Step of Fabricating A Closed Hollow Bulb Obturator: A Case Report Chan Wan Wan Klinik Pergigian K.Pilah CR05 A Rare Case of NUT Midline Carcinoma; A Case Report With Diagnostic Challenges Dharshinie Devan Pathology HTJS CR06 Eagle Syndrome: A Case Report Fauzan Bin Mustapha Radiology HTAN CR07 Primary Laryngeal Histoplasmosis Ho Yuen Teng Medical HTJS CR08 Orbital Cellulitis Complicated With Cavernous Sinus Thrombosis Post COVID-19 Insyirah Binti Mohd Zuhudi Ophthalmology HTAN