Screen Media Dependency and Its Associated Factors Among Preschool Children in Kuala Lumpur

@#Introduction: Excessive screen time among young children is associated with screen dependency. At this moment, there is a lack of data on screen dependency among young children in Malaysia. This study aimed to measure the prevalence of screen dependency and its associated factors among preschool children in Kuala Lumpur. Methods: A cross-sectional study was carried out at registered preschools in Kuala Lumpur. 300 parents of preschool children aged 4 to 6 years old who fulfilled the inclusion and exclusion criteria were recruited via simple random sampling. The Screen Dependency Scale (SDS) were used to assess their dependency to screen media. Univariate and multivariate statistics were analysed using IBM SPSS version 27. Results: The prevalence of screen dependency among preschool children in Kuala Lumpur was 65.7%. Multivariate logistic regression analysis identified that using the screen to resolve children’s quarrels (aOR 2.855, 95% CI 1.187 - 6.868), children who use smartphones (aOR 2.735, 95% CI: 1.244 - 6.013), children’s screen time exceeds 2 hours over the weekend (aOR 2.261, 95% CI: 1.058 - 4.830) and having a television in the bedroom (aOR 5.562, 95% CI: 1.591 - 19.442) were predictors for screen dependency. While active co-use mediation (aOR 0.505, 95% CI: 0.302 - 0.845) were protective. Conclusion: The prevalence of screen dependency was high among preschool children in Kuala Lumpur. Active screening at health care clinics or in schools is essential to identify early children with risk factors for screen dependency.

Tools to Assess Screen-related Dependency in Children: a Narrative Review of Validated Questionnaires

@#Children are using digital screen media at an even younger age as they use it for a wide range of activities such as watching videos, playing games, and educational purposes. Due to its accessibility and portability, children also spend a significant amount of time on screen. Excessive screen time in children is associated with many consequences, including language delay, hyperactivity, impulsivity, visual problems, and lower psychological well-being. With the emergence of behaviour addictions related to technologies such as addiction towards online games, the internet, and the mobile phone, researchers are looking into these incidences among children. However, a validated and reliable tool is important to detect the problem early, especially for young children at increased risk. To date, many tools have been developed to detect screen-related dependencies for adolescents and adults but lacking among children. This review aims to elicit tools available specifically for children below 10 years of age, to analyse its psychometric properties and validation process as well as to compare between them.

Isolated Gastrointestinal Symptoms as Initial Presentation in Systemic Lupus Erythematosus and Its Differential Diagnosis

@#Initial clinical presentation of Systemic Lupus Erythematosus (SLE) is varied as it affects various organs in the body. While the typical presentation of SLE is mucocutaneous, musculoskeletal and haematological manifestation, gastrointestinal (GI) manifestation is a rare initial presentation of SLE. We discuss the case of a 13-year-old girl who was diagnosed with SLE after she presented with isolated gastrointestinal symptoms. She presented with vomiting, diarrhoea, mild colicky abdominal pain and bilateral ankle oedema; and was treated as acute gastroenteritis. She returned after one week with worsening symptoms. Her full blood count showed bicytopenia; urinalysis had proteinuria and haematuria, and renal profile revealed acute on chronic kidney injury which triggered suspicions of a more serious disease rather than simple viral gastroenteritis. Further investigations of positive anti-nuclear antibody, low complements and positive Coombs’s test supported the diagnosis of SLE. The diagnosis of SLE was confirmed when her renal biopsy reported crescentic lupus nephritis ISN/RPS Class IV. Additional investigation to investigate the cause of her gastrointestinal symptoms included an ultrasound abdomen which showed minimal ascites and bilateral renal parenchymal disease. She was planned for colonoscopy but due to the unavailability of paediatric endoscopy, colonoscopy was postponed. However, her symptoms markedly improved with intravenous Cyclophosphamide which supported the diagnosis of GI SLE. This case report is to highlight that a patient with symptoms of simple viral gastroenteritis might have a more serious underlying disease. Even though rare, SLE can present with gastroenteritis symptoms and is one of the differential diagnoses that should be considered.

Exploring women’s perceptions and experiences of menopause among East Coast Malaysian women

@#Background: Menopause signifies the beginning of a non-reproductive phase from the reproductive period. Although it is considered a natural life transition, recent studies have indicated that a woman’s menopausal experience may impact her quality of life. While studies have examined Malaysian women’s knowledge and awareness of menopause, they have focused on the prevalence of menopausal symptoms and sociocultural aspects. These investigations also used a quantitative design that may have limited the information regarding the nature and experience of menopause. Objectives: This study explores women’s perceptions and understanding of their menopausal experience. Methods: A total of 20 menopausal women were recruited using purposive sampling through social media in the state of Pahang, Malaysia. In-depth semi-structured interviews were used to explore how they perceived their menopausal experience. The data were then analyzed using thematic analysis. Results: Three themes that emerged from the findings included perceptions of menopause, biopsychosocial changes and help-seeking behavior. For many Muslim women, menopause was perceived as a time for them to engage in religious commitment more than they had before. Conclusion: The study findings uncovered a knowledge gap and a lack of support for women impacted by menopause. Muslim women regarded their menopause phase as a time for them to engage in religious duty fully. These results indicate the need for a psychosocial intervention and educational program to ensure women a better transition throughout their menopausal phase