Authors: Kwee Choy Koh, Shanmugan Goonasakaren, Lam Kean Ng, Yi Lin Chua, Jia Ying Lee, Alaric Ding Tian Ang.

ABSTRACT

Background: Medical schools are escalating changes to meet the need for doctors competent to work in the era of precision medicine. Information on the current level of awareness of precision medicine among medical students can help effect the necessary changes in the medical curriculum. A cross-sectional comparative study was done to assess the knowledge, attitude and perception toward the practice of precision medicine among junior and senior medical students in a medical school in Malaysia.

Materials and Method: A survey instrument measuring attitude toward precision medicine, perceived knowledge of genomic testing concepts, and perception toward ethical consideration related to precision medicine, was distributed to junior and senior medical students. Comparisons were made between senior and junior medical students.

Results: Only about one-third of the 356 respondents had heard of precision medicine although 92.7% expressed interest to learn more about precision medicine. Overall, junior and senior medical students had positive attitude toward the adoption of genome-guided prescribing and precision medicine but were uncomfortable with their knowledge of genomic testing concepts. Both junior and senior students were largely well grounded in their understanding of ethical issues related to precision medicine.

Conclusions: Knowledge of precision medicine was low among junior and senior medical students. Although the students supported the use of precision medicine, they did not feel adequately prepared to apply genomics to clinical practice. Their perceptions on ethical issues related to precision medicine were sound. Seniority did not appear to influence the perceptions of the students.

Keywords: precision medicine, personalised medicine, medical students, medical practice, medical education.

Citation: IeJSME 2017 11(3): 10-19

DOI: https://doi.org/10.56026/imu.11.3.10

Authors: Wei Fern Siew, Kazuya Jian Yong Choo, Zi Xuan Lim, Azlan Kok Vui Tsia.

ABSTRACT

Background: It is an undeniable fact that exposure to tobacco smoke from the ambiance poses harmful effects to human health. Although many countries including Malaysia have imposed smoking bans and restrictions in indoor and outdoor public places, yet, to achieve a zero exposure to tobacco smoke from one’s surroundings remains a challenge.

Objective: The objectives of this study were to determine the second-hand smoke (SHS) knowledge and percentage of exposure among adults of rural Pedas, Negeri Sembilan and assess the association between socio-demographics and knowledge of SHS among these adults.

Methods: A cross sectional study with convenient sampling was carried out on 485 adults in Pedas, Negeri Sembilan. The instrument used was a validated questionnaire which was adapted with permission to suit the sample under study. The data collected were analysed with SPSS Statistics for Windows, Version 24.0.

Results: The percentage of SHS exposure among the non-smoking adults in rural Pedas, Negeri Sembilan was high (95.5%). More than 30% of the non-smoking respondents reported a daily exposure to SHS. The adults from this study however have good knowledge of SHS effects on health. A Mann-Whitney U test result revealed that knowledge on SHS scores was significantly higher for the non-smokers than that of smokers (U=17645, p < .001, r=.18). The top three locations identified as the most common places for SHS exposure were restaurants (38.9%), followed by workplace (26.2%) and home (19.4%).

Conclusions: The percentage of SHS exposure among the non-smoking adults of rural Pedas, Negeri Sembilan is high. Although the adults in this study have good knowledge of SHS health consequences, yet they are unavoidably exposed to SHS because smoking still occurs within their home, workplaces and public places. Our findings suggest the need for more comprehensive, assertive and strongly enforced policies to ban smoking in public areas, not only in this community but all across Malaysia.

Keywords: passive smoking; smoke exposure; awareness; adults; rural area.

Citation: IeJSME 2017 11(3): 20-29

DOI: https://doi.org/10.56026/imu.11.3.20

Authors: Tze Hao Wong, Esha Das Gupta, Ammu K Radhakrishnan, Suk Chyn Gun, Gandhi Chembalingam, Swan Sim Yeap.

ABSTRACT

Objective: Rheumatoid arthritis (RA) is a chronic inflammatory condition that can be associated with abnormal bone turnover and hence osteoporosis. Osteocalcin (OC) levels are increased in conditions with high bone turnover, including high RA disease activity. Thus, OC levels could possibly be used as a marker to assess bone health and disease activity in RA patients. As there have been no previous studies looking at serum OC levels in Malaysian RA patients, this study was performed to examine possible correlations between OC, bone mineral density (BMD) and disease activity in this population.

Methods: A cross-sectional study of 75 female RA patients and 29 healthy controls was performed. Serum OC was measured using a Quantikine® ELISA kit. Dualenergy x-ray absorptiometry (DXA) was used to assess BMD.

Results: Serum OC levels were not significantly different between RA patients (median 14.44 ng/mL, interquartile range [IQR 12.99]) compared to healthy controls (median 11.04 ng/mL IQR 12.29) (p=0.198). Serum OC increased with age (Spearman’s rho r=0.230, p=0.047). There was no significant correlation between serum OC and body mass index (BMI), menopause status, BMD, DAS28, swollen or tender joint counts. Overall, there were 11 (14.7%) patients with osteoporosis and 27 (36.0%) with osteopenia. Menopause status was significantly associated with BMD at all sites (lumbar spine p=0.002, femoral neck p=0.004, total hip p=0.002).

Conclusions: Serum OC were similar in RA patients compared to healthy controls. In RA patients, serum OC did not correlate with RA disease activity or BMD. Menopause status remains an important influence on BMD. Thus, measuring serum OC levels in Malaysian RA patients was not useful in identifying those at risk of low BMD.

Keywords: osteocalcin, bone mineral density, DAS28, rheumatoid arthritis, Malaysia.

Citation: IeJSME 2018 12(1): 4-10

DOI: https://doi.org/10.56026/imu.12.1.4

Authors: Htar Htar Aung, Nilar Shwe, Tin Tin Myint, Tin Moe Nwe.

ABSTRACT

Introduction: It is still a challenge that the dissecting room has a place in learning gross anatomy. Understanding the students’ preference of learning tools is important to devise alternative teaching aids for improvement in learning anatomy. This study was conducted to assess student’s preference of learning tools available in the anatomy laboratory of an integrated curriculum.

Methods: A cross-sectional comparative study was carried out for 4 weeks among 741 medical and dental students of International Islamic University Malaysia (IIUM), Universiti Teknologi MARA (UiTM), University Sabah Malaysia (UMS) and University Malaysia Sarawak (UNIMAS). Pre-tested, semi-structured, self-administrated questionnaires including open-ended questions were distributed. The data were analyzed by using SPSS 17.

Results: Most of the participants were Malays (86%) and female (67%). The students from IIUM, UiTM, UMS and UNIMAS preferred the plastic model in terms of handability and application in examination (OSPE). It was statistically significant (p<0.05). In terms of understanding and information, the students of IIUM, UiTM and UMS
preferred the plastic model while UNIMAS students preferred the prosected wet specimen over the plastic models. In terms of overall preference, students of IIUM and UiTM preferred the plastic model (85.8% and 44.1% respectively). In UNIMAS, their preference for the prosected wet specimen (90.7%) was slightly higher than for the plastic model (87.8%). UMS students preferred both cadaver (51.9%) and plastic model (50%).

Conclusion: Most of the students preferred the plastic model as the best learning tool in studying gross anatomy. This study suggests that plastic model may hold a role in enhancing students’ learning of gross anatomy in an integrated curriculum.

Keywords: Cadaver; learning tool; plastic model; prosected wet specimen; students’ preference.

Citation: IeJSME 2018 12(1): 11-17

DOI: https://doi.org/10.56026/imu.12.1.11