Chlorophyllum Molybdites “Delicious Poisoning Snack” in Patients Diagnosed with Acute Gastroenteritis

Introduction: Since time immemorial, mushrooms have been used as a part of human diet, some of them are very well known for their nutritive and medicinal properties and some are known to cause poisoning to the human body. A number of post ingestion fatalities due to poisonous mushrooms has been reported worldwide. These poisonous mushrooms are often misidentified as edible ones, which accounts for accidental poisoning.Objective: The main objective of this report was to describe the clinical manifestations of mushroom poisoning cases presented at the Emergency Department (ED), Taiping Hospital.Case Presentation: There were two cases presented, who suffered from moderate dehydration due to acute gastroenteritis after taking 'delicious mushrooms', also known as Chlorophyllum Molybdites. This study found that both cases had complaints of abdominal cramping, diarrhoea and vomiting more than twenty times a day. There was no history of numbness or weakness noted, and no chest pain or shortness of breath. On arrival, both cases presented signs of moderate dehydration with coated tongue and normal blood pressure, with slightly increased in temperature (37.30C). Abdomen was soft but discomfort upon palpation and described as bloated. Both cases were resuscitated with 20ml/kg normal saline. Charcoal, antiemetic, proton pump inhibitor and ceftriaxone antibiotic were given at the ED. Both survived and were treated as infectious acute gastroenteritis. Nausea and vomiting were the most common early symptoms of intoxication and should be considered as a medical emergency. Alpha Amanitin levels should be checked where possible if amanita poisoning is suspected. An early diagnosis and immediate treatment are required for a successful outcome.Conclusion: All patients with the history of mushroom ingestion should be admitted. If laboratory detection of toxin is not available, history of mushroom ingestion, clinical manifestation and their trends could define mushroom poisoning.International Journal of Human and Health Sciences Supplementary Issue: 2021 Page: S17

Healthcare Practitioner’s Views on the Teddy Bear Hospital (TBH) by IMACATS in Malaysia

Introduction: This is a part of a bigger study entitled “Exploring the Views of Healthcare Practitioners on the Teddy Bear Hospital (TBH) as a Personal Safety Module Towards Prevention of Child Sexual Abuse (CSA): A Qualitative Study”. TBH is a make-believe-play hospital utilising soft toys to demonstrate a pretend clinical setting with the aim to educate children on health issues. Studies has shown its effectiveness and reducing anxiety towards the hospital setting and increasing health-related knowledge. IMAM Children’s and Teen Super teen (IMACATS) is one of the non-governmental organisations (NGO) which has adopted this concept to tailor to the local community. The volunteers are healthcare practitioners who are engaged with children in their practice.Objective: To explore the views of healthcare professional towards TBH by IMACATS in Malaysia.Methods: In-depth qualitative audio recorded interviews were conducted with a purposive sample of 18 healthcare professionals. The data obtained were transcribed and analysed thematically.Results: Three themes were derived from the interviews: i) Awareness of the TBH concept. Seven participants have volunteered in TBH previously. However, there was a speculation that many doctors are still unknowing of this concept. ii) Benefits of TBH. This includes reducing children’s anxiety, changing children’s presumption on healthcare, increasing children’s health knowledge and encouraging healthy behaviour and bridging the gap between the public and healthcare. iii) Suggestion of Module for future TBH: (a) More school-based programmes should be organised in addition to hospital and community based; (b) Ministry of Health (MOH) should encourage children health screening using this concept; (c) A module for hospitalised children should be conducted.Conclusion: Participants interviewed suggested for TBH to be organised in a wider scale as it is an approachable concept for educating children. There are many ways in which it can benefit this community.International Journal of Human and Health Sciences Supplementary Issue: 2021 Page: S18

The Use of Magnetic Resonance Imaging in Managing Intra-Abdominal Pregnancy

Introduction: Most pregnant women will experience a normal pregnancy process. However, there are some complications that may occur during pregnancy, including intra-abdominal pregnancy. Intra-abdominal pregnancy, or pregnancy outside of the uterus, are commonly reported besides abortion, pregnancy-induced hypertension (PIH) and gestational diabetes mellitus (GDM). Thesecomplications are believed to be the main cause of maternal and perinatal death. Therefore, the use of appropriate diagnostic imaging inthe management of obstetric cases should be focused.Objective: This case study intended to evaluate the use of magnetic resonance imaging (MRI) in managing intra-abdominal pregnancy.Case Presentation: The study focused on one case with intra-abdominal pregnancy which continued into the second trimester. A 30-year-old woman, G2 P0+1 at 12-13 weeks’ gestation was presented to a public hospital complaining of recurrent epigastric pain with no history of vaginal bleeding. An MRI was performed and the mother was identified as having an intraabdominal pregnancy. Urgent laparotomy was done. Intraoperative finding noted hematoperitoneum with active bleeding seen from the placenta that adhered to the omentum. Partial omentectomy was done. The foetus in about 14 week’s gestation was seen and removed. Case studies have proven that the option to perform an MRI on a suspected intra-abdominal pregnancy can help provide information to establish an accurate diagnosis and appropriate patient care management.Conclusion: The use of MRI is highly recommended for all cases that are expected to experience intra-abdominal pregnancy as it will save the patient as well as avoiding obstetric complications.International Journal of Human and Health Sciences Supplementary Issue: 2021 Page: S16

Knowledge of Postnatal Care among Confinement Ladies in Malaysia during COVID-19 Pandemic: A Pilot Study

Objective: This study aims to evaluate the knowledge of postnatal care among confinement ladies in Malaysia and assess the effectiveness of an intervention workshop.Methods: A quasi-experimental study was conducted among 65 confinement ladies residing in East Coast Malaysia. Among them, 36 ladies were purposely selected to participate in a workshop, while 29 ladies were selected using a snowball sampling method to be in the control group. A validated Malay translation of Knowledge on Postnatal Care for Mothers and Care of the Newborn Questionnaire was used. Data were analysed using IBM SPSS Statistics (Version 25). Multiple logistic regression was employed to determine factors associated with baseline knowledge. Repeated measure ANCOVA was used to measure the effectiveness of the intervention workshop.Results: Overall, the mean (SD) age of the respondents was 46.23 (8.49) with mean (SD) number of children of 4.0 (2.0) and working experience as confinement ladies of 36.0 months (20.24). Majority (77.1%) were married, from B40 group (91.4%) and received at least secondary education (77.1%). Confinement ladies who received secondary and tertiary education were found to have higher knowledge scores compared to those with primary education (p=0.026 and p=0.049 respectively). There was a significant increase in knowledge of postnatal care scores in those attending the postnatal care workshop (p <0.001)Conclusion: Education level plays an important role in determining the level of knowledge of a confinement lady. The workshop conducted was effective in improving the postnatal care knowledge among confinement ladies. Hence, more interventional programs should be held in the future.International Journal of Human and Health Sciences Supplementary Issue: 2021 Page: S22

Educating Children and the New Norm

The lockdown from March to November 2020 in its various forms have seriously impacted education of children, both nationally and internationally. In Malaysia; more than 1 million students were affected and 100,000 teachers and 20,438 members of school support staff were forced to stay at home. UNICEF noted that 24 million children around the world will drop out and students from vulnerable communities will be particularly and failed to return to class. This has forced almost all education providers to switch the education deliveries online. While some of the more established educational institutions which are more prepared than others, sailed plainly through this switch, a sizable majority found this switch a devastating blow to the delivery of education especially to children. The Parent Group for Education, Malaysia reported that 66% Malaysian children do not have good internet connectivity at home and the Ministry of Education also reported that 37% do not own devices for online learning. The outcome of these is almost predictable. 20% children were discovered to have lost interest in schoolwork and become demotivated while 7% have indeed dropped out from school. Although most children are no stranger to handphones and other devices, the use of these for education is daunting. For the first 10 weeks of the MCO, online teaching is noted to be adhoc, random, unstructured and even non-existent. Timetable was created in May but not strictly adhered to by teachers who are not familiar with technology. The Ministry of Education set up a free portal such as www.eduwebtv.moe.edu.my and the Digital Educational Learning Initiative Malaysia (DELIMA) as immediate mitigation. The future and the new norm for education is predictable and we have no choice. Online education delivery has to be strengthened by firm efforts to boost connectivity. School digital packages should consist of laptops or tablets, with video cams, telecommunication towers, especially in the rural areas must be built urgently. Mini and micro credentialing of children and teachers must be held to train them on the basics of online teaching, while more immersive applications are being prepared. We have little choice.International Journal of Human and Health Sciences Supplementary Issue: 2021 Page: S4

Committee Members of Islamic Medical Association of Malaysia (Imam) Symposium 2020 on Covid-19: Planning for the Future

not availableInternational Journal of Human and Health Sciences Supplementary Issue: 2021 Page: S1-S2

Forum Panelist 4: COVID-19 Response: Speaking for the Unspoken for

The COVID-19 pandemic has brought about unparalleled changes in all our lives, on an individual, societal and global level that it draws us into a necessary reflection of how we have lived our lives as an individual, a community and ashumankind. As health practitioners, we need to appraise our ways of working and have the courage to speak and call for the change we want to see. A time for an honest examination of policies of exclusion and marginalization of any sections of populations, and consequences of such policies in the face of a pandemic. A time for health professionals and those who speak for the unspoken to rise to the forefront with the right intention at heart, to set the right knowledge to action in moving towards a more inclusive and resilient health system. If we continue in our old ways, the lesson will be lost on us and this may be the pandemic that deepens the divide, which will be to our own detriment. Balancing the priorities in public health, and the politico-socio-economic priorities of a nation, what path would best address these priorities? As there are challenges, there are opportunities to have inclusive policies, coordinated health programming, with collaborative efforts in strengthening preparedness and response mechanisms, engaging the public, civil society, academia, international organizations and private sectors.International Journal of Human and Health Sciences Supplementary Issue: 2021 Page: S9

Forum Panelist 1: COVID-19 Response: BBNGO ‘crossing’ the nationality borders

The Movement Control Order (MCO) due to the COVID-19 Pandemic implemented on18 March 2020 for Malaysia and the closing of the borders between Malaysia and Thailand caused a lot of strain on the Thai citizens working in Malaysia. Many of them were unable to do their usual job especially in the restaurants all over Malaysia.Efforts were taken by the NGOs and its sponsors in Thailand to relieve the Thai citizens’ suffering. On the 13th of April an agreement was signed between the Thai Islamic Medical Association of Thailand and ‘PertubuhanGabunganBantuanBencana NGO’ Malaysia (BBNGO) to support the Thai citizens in their daily life due to the difficulties during the MCO. Majority of those affected were the restaurant workers.According to reports there were about 40,000 Thai workers in Malaysia, most of whom worked in restaurants. On 18th April 2020 The Malaysian-Thai border was opened limitedly via five checkpoints, only 350 Thai citizens were allowed to cross each day. By early May 2020 more than 7,200 Thais have crossed the border including 2,100 who entered illegally by foot or small boats.Through the agreement between TIMA and BBNGO more than 400 packs of food supply were delivered to the Thai citizens mainly in Kelantan, Terengganu, Pahang, Penang, Perlis and Kedah. Information about their addresses and phone numbers were provided. Some were delivered direct to their homes while in some areas, they were asked to collect supplies from the nearby sundry shops. Knowing the difficulty of movement between districts during the MCO, the help of local NGOs was very much needed. The ‘Pertubuhan Ikram Malaysia’ (through its Yayasan Ikram/I-Bantu), having branches in many districts of Malaysia became our main partner. The SOPs were maintained during the deliveries. Due to our good, continuous cooperation and relationship since our engagement in the 2014 flood in Kelantan and the 2016/17 flood in Southern Thailand, we have managed to implement several humanitarian missions and social activities with the Thai Islamic Medical Association and its partners. Other BBNGO activities during the MCO include aid for the university students, fresh cooked food for the front-liners, preparation of PPEs, food supply for the poor and needy.COVID-19, you are a blessing in disguise; you bring our hearts together may it be citizens or non-citizens, people of all races and religion. May Allah blessthe human race and its submission to God.International Journal of Human and Health Sciences Supplementary Issue: 2021 Page: S6

Forum Panelist 2: MODA: Protecting Malaysia’s Frontliners, One Stitch at a Time

When COVID-19 brought on the MCO or Movement Control Order in March 2020, it was an unprecedented & uncertain time for Malaysians. As the battle to treat infections began, the issue of personal protective equipment (PPE) arose. Shortage of availability, high cost, suitability of materials were the challenges faced by our medical frontliners and to which MODA decided to step up to fill the gap.MODA is a Non-Profit Organization (NPO) whose members comprise local fashion designers as well as persons & companies involved in Malaysia’s fashion industry. Thus, began a mission to raise funds, procure suitable locally produced material, mobilize manpower from designers with staff & facilities to produce PPE, to individual volunteers who cut, sew, packed & transported completed PPE to hospitals throughout the country.However, while this initiative addressed Malaysia’s needs currently, it is a short-term solution. In this article, we wish to not only share MODA’s experience in producing PPE but look ahead towards a solution for the future. Reusable PPE that will reduce the massive amount of waste, suitable materials that can be produced locally and is suitable for our climate, a PPE bank and storage facilities so that we are better prepared should another pandemic arise. Together let us learn from this experience and face the future better prepared as a nation!International Journal of Human and Health Sciences Supplementary Issue: 2021 Page: S7

Effectiveness of Resuscitation Device when Intubating Suspected COVID-19 Patient at Emergency and Trauma Department

Introduction: The rapid spread of COVID-19 had expanded into a pandemic, and thousands of medical staff had been infected worldwide. Thus, the access to personal protective equipment (PPE) for health workers had become a key concern. PPE was essential in providing a physical barrier between microorganism and health care providers. In the case of cardiac arrest, the use of a resuscitation device as PPE had provoked various reactions and complaints from physicians.Objective: To determine the effectiveness of the use of an intubation box and ergonomic screening booth as a device during intubation procedures on positive COVID-19 patients in the Department of Emergency and Trauma at Taiping Public Hospital.Methods: The study was designed as a single-blind, prospective, randomized study and was approved by the committee at study location setting. Physicians selected had been given three days of training related to the use of the device as one of the PPE, before being used on patients. The procedure was carried out on three patients with unclear history of COVID-19who required intubation. The time given for each intubation procedure was 5 to10 seconds with a maximum of three attempts for each patient.Results: The results found that all three intubation procedures required longer time whereby all procedures took two attempts for each patient. The process of intubation took more than 30 seconds for the first attempt and failed but all cases took about 5 to 10 seconds for second attempts.Conclusion: This has proven that the use of an intubation box and ergonomic screening booth as a device during intubation procedures was not effective. It is suggested that this device should not be continued by paramedics and a proper management plan is needed to provide appropriate and suitable device innovations.International Journal of Human and Health Sciences Supplementary Issue: 2021 Page: S14