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The clinical case presentation is an important mode of professional communication as well as an academic genre in medical education. Examining both students’ and experienced doctors’ linguistic practices can reveal how students differ in their underlying knowledge, interpretation and execution of the case presentation that mark their novice status. In this paper, we describe differences in the use of theme in initiating sentences in case presentations produced by doctors and medical students. Theme analysis, an analysis of the linguistic elements that are used to begin a clause, was used. The data comprised 50 audio- recorded oral case presentations elicited from 20 doctors and 30 students in two medical schools. Choice of theme in doctors’ and students’ presentations was compared. The findings show that doctors and students differ significantly in their use of specific theme types indicating their different understanding and use of the oral case presentation as well as their social position in the professional field. Indexing students’ novice status are differences in the use of conjunctive adjuncts, interpersonal, existential and pronoun themes, and marked themes as overt signalling of the presentation structure. These findings contribute to provide some insight on students’ learning trajectory and can inform appropriate educational interventions.

The clinical case presentation is an important mode of professional communication as well as an academic genre in medical education. Examining both students’ and experienced doctors’ linguistic practices can reveal how students differ in their underlying knowledge, interpretation and execution of the case presentation that mark their novice status. In this paper, we describe differences in the use of theme in initiating sentences in case presentations produced by doctors and medical students. Theme analysis, an analysis of the linguistic elements that are used to begin a clause, was used. The data comprised 50 audio- recorded oral case presentations elicited from 20 doctors and 30 students in two medical schools. Choice of theme in doctors’ and students’ presentations was compared. The findings show that doctors and students differ significantly in their use of specific theme types indicating their different understanding and use of the oral case presentation as well as their social position in the professional field. Indexing students’ novice status are differences in the use of conjunctive adjuncts, interpersonal, existential and pronoun themes, and marked themes as overt signalling of the presentation structure. These findings contribute to provide some insight on students’ learning trajectory and can inform appropriate educational interventions.

International travel is common, increasing the risk for travel related infections, making it important to understand the knowledge, attitudes and practices (KAP) of international travellers regarding prevention of travel related illnesses. We aimed to determine the KAP of travellers at two Malaysian airports, in order to inform traveller health programs. We conducted face to face interviews with travellers at Kuala Lumpur International Airport and Sultan Abdul Aziz Shah Airport, Malaysia in 2014. Study subjects were selected via convenient sampling. Inclusion criteria were travellers aged ≥18 years who were departing from the studied airports, were able and willing to participate in the study. Subjects were asked about their KAP regarding various travel health subjects. The data from these interviews were collected, summarized and examined with SPSS version 21 and multiple logistic regression analysis to determine factors associated with poor KAP regarding travel health. A total of 316 subjects were included in the study; 57.6% were male and 55.4% were Malaysians. Forty point five percent of subjects sought pre-travel health advice. Of those who sought pre-travel health advice, 39.8% sought it from family or friends, 35.2% from the internet and 12.5% from a physicians. Fifty-two point eight percent of subjects had received pre-travel vaccinations. No subjects were traveling to a malaria high risk country as determined by the Centers for Disease Control and Prevention, 8.2% were travelling to a moderate risk country, 28.9% were travelling to a low risk country, 12.0% were travelling to a very low risk country and 50.9% were travelling to a country with no malaria risk. Four point one percent of subjects took malaria prophylaxis medication. On multivariate logistic regression analysis, the older the study subject age, the better the travel health knowledge [odds ratio (OR)=1.03; 95% confidence interval (CI): 1.01-1.05; p = 0.009]. Being female (OR: 1.92; 95%CI: 1.16-3

International travel is common, increasing the risk for travel related infections, making it important to understand the knowledge, attitudes and practices (KAP) of international travellers regarding prevention of travel related illnesses. We aimed to determine the KAP of travellers at two Malaysian airports, in order to inform traveller health programs. We conducted face to face interviews with travellers at Kuala Lumpur International Airport and Sultan Abdul Aziz Shah Airport, Malaysia in 2014. Study subjects were selected via convenient sampling. Inclusion criteria were travellers aged ≥18 years who were departing from the studied airports, were able and willing to participate in the study. Subjects were asked about their KAP regarding various travel health subjects. The data from these interviews were collected, summarized and examined with SPSS version 21 and multiple logistic regression analysis to determine factors associated with poor KAP regarding travel health. A total of 316 subjects were included in the study; 57.6% were male and 55.4% were Malaysians. Forty point five percent of subjects sought pre-travel health advice. Of those who sought pre-travel health advice, 39.8% sought it from family or friends, 35.2% from the internet and 12.5% from a physicians. Fifty-two point eight percent of subjects had received pre-travel vaccinations. No subjects were traveling to a malaria high risk country as determined by the Centers for Disease Control and Prevention, 8.2% were travelling to a moderate risk country, 28.9% were travelling to a low risk country, 12.0% were travelling to a very low risk country and 50.9% were travelling to a country with no malaria risk. Four point one percent of subjects took malaria prophylaxis medication. On multivariate logistic regression analysis, the older the study subject age, the better the travel health knowledge [odds ratio (OR)=1.03; 95% confidence interval (CI): 1.01-1.05; p = 0.009]. Being female (OR: 1.92; 95%CI: 1.16-3

Background: Tobacco use is a major preventable cause of premature death and disease. The used of electronic cigarettes (e-cigarettes) has gained its popularity recently. Unfortunately, the health impact of e-cigarettes is widely unknown till today. Objective: To explore adult’s perceptions of risks and benefits to e-cigarettes. Methods: This is a cross-sectional single-centre study among young adults in a Malaysian tertiary care centre. A total of 247 young adults in Serdang Hospital were included in this study. A written, self-administered questionnaire was used for data collection. Result: Majority of the respondents of this study consist of Malay female. Although these respondents recorded low usage of both cigarette and e-cigarette, they are highly aware of e-cigarettes. The results showed a high agreement on the perceived risk of e-cigarettes in which majority of them perceived e-cigarettes as harmful to one’s health and socially unacceptable. Despite that, a minority of the respondents still believed that e-cigarettes are useful in conforming to the society. Conclusion: This study provides fundamental information on their risk and benefit perception to enable appropriate measures to be carried out in tackling young adults engaging with e-cigarettes.

Background: Tobacco use is a major preventable cause of premature death and disease. The used of electronic cigarettes (e-cigarettes) has gained its popularity recently. Unfortunately, the health impact of e-cigarettes is widely unknown till today. Objective: To explore adult’s perceptions of risks and benefits to e-cigarettes. Methods: This is a cross-sectional single-centre study among young adults in a Malaysian tertiary care centre. A total of 247 young adults in Serdang Hospital were included in this study. A written, self-administered questionnaire was used for data collection. Result: Majority of the respondents of this study consist of Malay female. Although these respondents recorded low usage of both cigarette and e-cigarette, they are highly aware of e-cigarettes. The results showed a high agreement on the perceived risk of e-cigarettes in which majority of them perceived e-cigarettes as harmful to one’s health and socially unacceptable. Despite that, a minority of the respondents still believed that e-cigarettes are useful in conforming to the society. Conclusion: This study provides fundamental information on their risk and benefit perception to enable appropriate measures to be carried out in tackling young adults engaging with e-cigarettes.

Introduction: Internet is important to university students, especially for medical students who use it to search for literature and relevant information. However, some of the users are experiencing a gradual loss of the ability to reduce the duration and frequency of their internet activities, despite the negative consequences. The literature on internet usage among Malaysian medical students is limited. This study aims to determine the prevalence and factors associated with internet usage among medical students in a public university in Malaysia. Methods: This cross-sectional study was performed among all the medical students (Year 1-5). Students were assessed on their internet activities using the internet addiction questionnaires (IAT). A Multiple Logistic Regression was used for data analysis. Results: The study was conducted among 426 students. The study population consisted of 156 males (36.6%) and 270 females (63.4%). The mean age was 21.6 ±1.5 years. Ethnicity distribution among the students was: Malays (55.6%), Chinese (34.7%), Indians (7.3%) and others (2.3%). According to the IAT, 36.9% of the study sample was addicted to the internet. Using the multivariate logistic regression analysis, we have found that the use of internet access for entertainment purposes (odds ratio [OR] 3.5, 95% confidence interval [CI] 1.05-12.00), male students (OR 1.8, 95% CI 1.01-3.21) and increasing frequency of internet usage were associated with internet addiction (OR 1.4, 95% CI 1.09-1.67). Conclusion: Internet addiction is a relatively frequent phenomenon among medical students. The predictors of internet addiction were male students using it for surfing and entertainment purposes.

Introduction: Internet is important to university students, especially for medical students who use it to search for literature and relevant information. However, some of the users are experiencing a gradual loss of the ability to reduce the duration and frequency of their internet activities, despite the negative consequences. The literature on internet usage among Malaysian medical students is limited. This study aims to determine the prevalence and factors associated with internet usage among medical students in a public university in Malaysia. Methods: This cross-sectional study was performed among all the medical students (Year 1-5). Students were assessed on their internet activities using the internet addiction questionnaires (IAT). A Multiple Logistic Regression was used for data analysis. Results: The study was conducted among 426 students. The study population consisted of 156 males (36.6%) and 270 females (63.4%). The mean age was 21.6 ±1.5 years. Ethnicity distribution among the students was: Malays (55.6%), Chinese (34.7%), Indians (7.3%) and others (2.3%). According to the IAT, 36.9% of the study sample was addicted to the internet. Using the multivariate logistic regression analysis, we have found that the use of internet access for entertainment purposes (odds ratio [OR] 3.5, 95% confidence interval [CI] 1.05-12.00), male students (OR 1.8, 95% CI 1.01-3.21) and increasing frequency of internet usage were associated with internet addiction (OR 1.4, 95% CI 1.09-1.67). Conclusion: Internet addiction is a relatively frequent phenomenon among medical students. The predictors of internet addiction were male students using it for surfing and entertainment purposes.

Background: In Malaysia, the number of reported cases of dengue fever demonstrates an increasing trend. Since dengue fever has no vaccine or antiviral treatment available, it has become a burden. Complementary and alternative medicine (CAM) has become one of the good alternatives to treat the patients with dengue fever. There is limited study on the use of CAM among patients with dengue fever, particularly in hospital settings. This study aims to determine the prevalence, types, reasons, expenditure, and resource of information on CAM use among patients with dengue fever. Methods: This is a descriptive, cross-sectional study of 306 patients with dengue fever, which was carried out at the dengue clinic of three hospitals. Data were analysed using IBM SPSS Statistics version 21.0 and logistic regression analysis was used to determine the factors associated with CAM use. Results: The prevalence of CAM use was 85.3 % among patients with dengue fever. The most popular CAMs were isotonic drinks (85.8 %), crab soup (46.7 %) and papaya leaf extract (22.2 %). The most common reason for CAM use was a good impression of CAM from other CAM users (33.3 %). The main resource of information on CAM use among patients with dengue fever was family (54.8 %). In multiple logistic regression analysis, dengue fever patients with a tertiary level are more likely to use CAM 5.8 (95 % confidence interval (CI 1.62–20.45) and 3.8 (95 % CI 1.12–12.93) times than secondary level and primary and below respectively. Conclusion: CAM was commonly used by patients with dengue fever. The predictor of CAM use was a higher level of education.

Background: In Malaysia, the number of reported cases of dengue fever demonstrates an increasing trend. Since dengue fever has no vaccine or antiviral treatment available, it has become a burden. Complementary and alternative medicine (CAM) has become one of the good alternatives to treat the patients with dengue fever. There is limited study on the use of CAM among patients with dengue fever, particularly in hospital settings. This study aims to determine the prevalence, types, reasons, expenditure, and resource of information on CAM use among patients with dengue fever. Methods: This is a descriptive, cross-sectional study of 306 patients with dengue fever, which was carried out at the dengue clinic of three hospitals. Data were analysed using IBM SPSS Statistics version 21.0 and logistic regression analysis was used to determine the factors associated with CAM use. Results: The prevalence of CAM use was 85.3 % among patients with dengue fever. The most popular CAMs were isotonic drinks (85.8 %), crab soup (46.7 %) and papaya leaf extract (22.2 %). The most common reason for CAM use was a good impression of CAM from other CAM users (33.3 %). The main resource of information on CAM use among patients with dengue fever was family (54.8 %). In multiple logistic regression analysis, dengue fever patients with a tertiary level are more likely to use CAM 5.8 (95 % confidence interval (CI 1.62–20.45) and 3.8 (95 % CI 1.12–12.93) times than secondary level and primary and below respectively. Conclusion: CAM was commonly used by patients with dengue fever. The predictor of CAM use was a higher level of education.

Aims and Background: Central pontine myelinolysis (CPM) and extrapontine myelinolysis (EPM) are recognized as osmotic demyelination syndrome (ODS). ODS is pathologically characterized by non-inflammatory demyelination of several brain structures with sparing of axons. This condition is usually associated with overzealous correction of hyponatraemia. Acute psychosis as the sole clinical manifestation is extremely rare. Presentation of Case: Hence, we report an interesting case of a middle-aged man who was diagnosed with EPM, following rapid correction of hyponatraemia and subsequently developed acute psychosis. He made a good recovery with supportive treatment alone. Discussion and Conclusion: The possibility of psychosis as a manifestation of ODS, particularly in patients with recent correction of hyponatraemia. The rate of correction of plasma sodium level is the key point for preventing ODS and its complications.

Aims and Background: Central pontine myelinolysis (CPM) and extrapontine myelinolysis (EPM) are recognized as osmotic demyelination syndrome (ODS). ODS is pathologically characterized by non-inflammatory demyelination of several brain structures with sparing of axons. This condition is usually associated with overzealous correction of hyponatraemia. Acute psychosis as the sole clinical manifestation is extremely rare. Presentation of Case: Hence, we report an interesting case of a middle-aged man who was diagnosed with EPM, following rapid correction of hyponatraemia and subsequently developed acute psychosis. He made a good recovery with supportive treatment alone. Discussion and Conclusion: The possibility of psychosis as a manifestation of ODS, particularly in patients with recent correction of hyponatraemia. The rate of correction of plasma sodium level is the key point for preventing ODS and its complications.