A comparative study on how medical students learn about the use of abbreviations in medical practice

Posted Posted in Original Article

Authors: Farah Syazana Ahmad Shahabuddin, Nur Hazirah Ahmat, Ahmed Ikhwan Mohamad, Kit Mun Lau, Siti Aisyah Mohd Yusof, Pei Chiek Teh, Kwee Choy Koh.

ABSTRACT

Background: Misinterpretation of abbreviations by healthcare workers has been reported to compromise patient safety. Medical students are future doctors. We explored how early medical students acquired the practice of using abbreviations, and their ability to interpret commonly used abbreviations in medical practice.

Method: Eighty junior and 74 senior medical students were surveyed using a self-administered questionnaire designed to capture demographic data; frequency and reasons for using abbreviations; from where abbreviations were learned; frequency of encountering abbreviations in medical practice; prevalence of mishaps due to misinterpretation; and the ability of students to correctly interpret commonly used abbreviations. Comparisons were made between senior and junior medical students.

Results: Abbreviation use was highly prevalent among junior and senior medical students. They acquired the habit mainly from the clinical notes of doctors in the hospital. They used abbreviations mainly to save time, space and avoid writing in full sentences. The students experienced difficulties, frustrations and often resorted to guesswork when interpreting abbreviations; with junior students experiencing these more than senior students. The latter were better at interpreting standard and non-standard abbreviations. Nevertheless, the students felt the use of abbreviations was necessary and acceptable. Only a few students reported encountering mishaps in patient management as a result of misinterpretation of abbreviations.

Conclusion: Medical students acquired the habit of using abbreviations early in their training. Senior students knew more and correctly interpreted more standard and non-standard abbreviations compared to junior students. Medical students should be taught to use standard abbreviations only.

Keywords: Abbreviations, medical students, medical practice, medical errors, patient safety.

Citation: IeJSME 2015 9(2): 13-21

DOI: https://doi.org/10.56026/imu.9.2.13

The morphological characteristics of the sparganum stage of the Malaysian Spirometra species

Posted Posted in Original Article

Authors: Kavana N J, Lim L H S, Ambu S.

ABSTRACT

Background: The present study describes the morphology of sparganum (larva) of the Malaysian Spirometra spp. collected from naturally infected frogs (Rana cancrivora) from rice fields in Tanjung Karang, Malaysia.

Materials and Methods: Spargana of Spirometra spp. collected from naturally infected frogs (Rana cancrivora) were used for the morphological studies. Stretched on a metal ruler, measurements of the worm were recorded. Specimens were stained in Alum-carmine.

Results: The length of the body ranged from 11-50 mm and the width ranged from 0.5-1.5 mm. Specimens stained with Alum-carmine showed ridges (formation of segments) on the surface of the body, and no sexual organs in the body.

Conclusion: The Malaysian Spirometra spp. are similar in measurement and morphology to Spirometra erinacei but further studies are required for confirmation.

Keywords: Spirometra, spargana, scolex, body, morphology.

Citation: IeJSME 2015 9(2): 22-24

DOI: https://doi.org/10.56026/imu.9.2.22

Knowledge and practice of medical students of the usage of personal protective equipment: A comparison of two cohorts of students at the International Medical University

Posted Posted in Original Article

Authors: Thiruselvi Subramaniam, Rosalind Chi Neo Loo.

ABSTRACT

Introduction: Standard precautions in health care is the essence of medical practice encompassing the safety of patients and health care workers including  medical students. Barriers to the proper use of personal protective equipment (PPE) exist across the world but identification of areas of weaknesses and appropriate remedies will reduce them. This study assesses knowledge and use of PPE among fourth year students after a period of educational interventions.

Objective: To evaluate appropriate use, awareness and knowledge about PPE among fourth year students after interventions.

Method: A cross-sectional study where forty year 4 students (Group B) were randomly observed and later asked to answer a questionnaire. Students had undergone interventions to improve PPE use, which included lectures and video sessions during each posting. Results were compared with a previous group (Group A). Chi-square test or Fisher’s exact test was used to analyse the data.

Results: There was statistically significant improvement in the use of PPE like wearing and removing mask during invasive procedures (p < 0.001) and hand-washing before and after a non- invasive task (p < 0.001). Comparison of Groups A and B on the results of the questionnaire for ‘Questions in which more than 10% students answered incorrectly’, showed that there was improvement in Group B in all the questions, some being statistically significant with p value=0.01.

Conclusion: An overall improvement in the use of the PPE and knowledge was noted. Sometimes, students’ attitude and personality may be a challenge and these students may defy changes, but this can be overcome if the strategies are embedded in the curriculum and taught from as early as the first semester.

Keywords: Personal protective equipment (PPE), standard practice, patient safety, attitudes, medical students.

Citation: IeJSME 2015 9(2): 25-31

DOI: https://doi.org/10.56026/imu.9.2.25

A cross sectional study of chronic pain relief after bekam (traditional malay “cupping”) therapy

Posted Posted in Original Article

Authors: Kean Ghee Lim, Shu Whey Chuah, Michelle Ee Shan Too, Zheng Guo Wong, Ashwin Murugesan, Syed Ameer Bin Syed Azman.

ABSTRACT

Introduction: Bekam, an Islamic variant of cupping, is an ancient form of traditional medicine still practised today in Malaysia. There are published findings indicating that cupping benefits patients with low back pain, other musculoskeletal pain and even pain from cancer, herpes zoster and trigeminal neuralgia when pain is measured on an analogue scale. We proposed to investigate whether in addition to pain improvement on an analogue scale we could show if pain relief might be demonstrated in terms of reduction of analgesic use.

Methods: We carried out a retrospective cross sectional study on subjects who had been for outpatient clinic treatment with chronic pain of at least one month and who completed at least two bekam therapy sessions. In addition to documenting a pain score before and after therapy we documented their analgesic consumption.

Results: A total of 77 respondents, with overlapping symptoms of headache, backache and joint pains were included. The mean pain score before bekam therapy was 6.74±1.78, and was 2.66±1.64 after two sessions of therapy. Twenty eight respondents completed six sessions of bekam therapy and had a mean pain score of 2.25±1.32 after. Thirty-four patients consumed analgesic medication before starting bekam therapy and only twelve did so after. The consumption of analgesics was significantly lower after bekam therapy.

Conclusions: Bekam therapy appears to help patients experience less pain and reduce the amount of analgesic medication they consume. Nevertheless only a randomised prospective study will eliminate the biases a retrospective study is encumbered with and we believe would be worth doing.

Keywords: Bekam, cupping, chronic pain, analgesic use, pain score.

Citation: IeJSME 2015 9(2): 32-36

DOI: https://doi.org/10.56026/imu.9.2.32

A diagnostic workup of perioperative anaphylaxis reveals a selective type 1 hypersensitivity to cefazolin

Posted Posted in Case Study & Report

Authors: Meera Thalayasingam, Lynette Pei-Chi Shek.

ABSTRACT

Anaphylaxis in the operating room although infrequent can be potentially fatal.1 The diagnosis of perioperative anaphylaxis is complex due to a multitude of factors. Firstly, patients under anesthesia cannot verbalize their complaints, the anesthetic agents themselves can alter vital parameters (e.g. heart rate and blood pressure) and cutaneous signs in a completely draped patient may be missed.2 Secondly, the differential diagnosis of intraoperative anaphylaxis is wide. Conditions such as asthma exacerbation, arrhythmia, hemorrhage, angioedema, mastocytosis, acute myocardial infarction, drug overdose, pericardial tamponade, pulmonary edema, pulmonary embolus, sepsis, tension pneumothorax, vasovagal reaction, venous air embolism, laryngospasm, blood transfusion reaction and malignant hyperthermia need to be considered.3 Thirdly, the diagnostic workup is challenging due to the multiple medications administered and other exposures encountered such as latex and chlorhexidene. However, through a timely allergy consultation and a systematic approach, identification of the culprit agent and safe alternatives can be established to prevent future occurrences as illustrated in the case below.

Keywords: Allergy, anaphylaxis, cefazolin, cephalosporin, perioperative anaphylaxis.

Citation: IeJSME 2015 9(2): 37-39

DOI: https://doi.org/10.56026/imu.9.2.37

Comprehensive review of mnemonic devices and their applications: State of the art

Posted Posted in Review Articles

Authors: Kamil Jurowski, Anna Jurowska, Małgorzata Krzeczkowska.

ABSTRACT

Mnemonic devices can be defined as learning strategies which can often enhance the learning process and later the recall of information. On the other hand, mnemonic systems are special techniques or strategies consciously used to improve memory, they help employ information already stored in long-term memory in order to make memorisation an easier task. There is no doubt that mnemonic techniques are one of the most important methods and methodologies used in education. However, nowadays these methods seem to be unremembered and seldom used by teachers or students. There is a deficit in the actual reviews on this subject. In this article we review mnemonic methods from the point of view of teaching and learning science subjects. This article is the first work in literature that refers to and emphasises various and complex aspects of mnemonic devices applications in didactic practice like science learning and teaching, helping students with disabilities and behaviour problems and second language acquisition.

Keywords: Mnemonic devices, methods, students with disabilities, behaviour problems, second language.

Citation: IeJSME 2015 9(3): 4-9

DOI: https://doi.org/10.56026/imu.9.3.4

E-cigarettes: Facts and legal status

Posted Posted in Review Articles

Authors: Davendralingam Sinniah, Erwin Jiayuan Khoo.

ABSTRACT

The sale of tobacco-based cigarettes has declined in western countries, and ‘Big Tobacco’ is trying to make up the deficit in profits from the developing world. The recent introduction of e-cigarette, in which they have invested both their hopes and their finances, has been a boon to them as it serves to confuse smokers and non-smokers about the real issues relating to the toxicity, dangers, and the promotion of nicotine addiction especially among youths who have not previously smoked cigarettes. E-cigarettes cause inflammation and damage to epithelial cells in human airways and increased risk of infection. E-cigarette vapour contains more carcinogens like formaldehyde and acetaldehyde compared to a regular cigarette. Long-term vaping is associated with an incremental lifetime cancer risk. E-cigarettes are neither safe nor effective in helping smokers quit; there is enough evidence to caution children, adolescents, pregnant women, and women of reproductive age about e-cigarette’s potential for long term consequences to foetal and adolescent brain development that sub-serve emotional and cognitive functions. The nicotine effects that cause modification of late CNS development constitute a hazard of adolescent nicotine use. The American Heart Association (AHA), Food and Drug Administration (FDA), World Health Organisation (WHO) and two-thirds of the major nations in the world discourage the promotion of e-cigarettes as an alternative to proven nicotine-addiction treatments. Doctors, health care workers, and medical students should be armed with the facts about e-cigarettes, its dangers, and the legal status concerning its use, in order to be able to offer proper counselling to patients and adolescents, in particular, with special reference to the Malaysian context.

Keywords: E-cigarettes, nicotine addiction, cancer risk, brain development consequence, legislation.

Citation: IeJSME 2015 9(3): 10-19

DOI: https://doi.org/10.56026/imu.9.3.10

Family response to presume consent system on organ donation from a review of literature

Posted Posted in Original Article

Authors: Makmor Tumin, Khaled Tafran, NurulHuda Mohd Satar.

ABSTRACT

Background: Most countries around the world have experienced a shortage in organs needed for transplantation. Organ donation performance is widely attributed to two important factors: the legislation and the role of the family. Thus, this literature review aims to examine the willingness of people for organ donation while highlighting the importance of having a presumed consent system.

Methodology: In this study, we explored many papers of which 10 articles were studied to gain conclusive understanding of the two factors and their interactions.

Results: Our analysis of literature regarding the legislation and family response showed that the presumed consent system for organ donation accounted for 21 – 30% higher organ donation rates than the informed consent system. We also found a gap between the willingness of people to donate their own and their relatives’ organs. The ratio of people willing to donate their organs after death was estimated to be 10 – 12% higher than the ratio of those willing to donate their relatives’ organs. Furthermore, the study revealed the  importance of a presumed consent system in raising the willingness of the people and their relatives for donation, but that did not eliminate the gap.

Conclusion: Countries seeking to overcome organ shortage and increase organ donation rates by moving towards  the presumed consent system should consider the importance of providing families with proper information about this system. The fact that a gap between the willingness of the people to donate their own as well as their deceased relatives’ organs exists, has to be conveyed to the governments, which will be helpful in optimising organ donation rates.

Keywords: Family, informed consent, organ donation, presumed consent, public view.

Citation: IeJSME 2015 9(3): 20-26

DOI: https://doi.org/10.56026/imu.9.3.20