Authors: Samuel Jun Hao Chau, Zheng Yi Ooi, Jun Yi Ng, Ji Chao Leong, Sasikala Devi Amirthalingam, Sivalingam Nalliah

ABSTRACT

Introduction
This systematic review aims to appraise clinical practice guidelines and consensus statements on the management of common benign vulvar disorders using the AGREE II checklist.

Methods
A systematic search for articles was conducted employing PubMed, EMBASE, Cochrane, and Science Direct from 1 January 2013 to 31 December 2023. The quality of eighteen practice guidelines was independently assessed by four appraisers using the AGREE II checklist.

Results
Of the eighteen guidelines assessed, one was classified as “recommended”, sixteen were designated as “recommended with modifications” and one as “not recommended”.

Conclusion
All guidelines proposed similar management strategies for the selected vulvar disorders with only minor variations. Medical practitioners are encouraged to treat patients in accordance with evidence-based recommendations in these guidelines.

Keywords: vulvar disorders, practice guidelines, and consensus, quality appraisal

Citations: IeJSME 2025 Vol 19 (3): 18-30

Authors: Thin Thin Win, Saint Nway Aye, Sunil Pazhayanur Venkateswaran, Purushotham Krishnappa, Dhanashri Kshitij Panse, Arun Kumar Basavaraj

ABSTRACT

Introduction
Virtual microscopy (VM) has emerged as a valuable adjunct to light microscopy (LM) in medical education, enabling remote access to high-quality histopathological images. While many studies report improved satisfaction and comparable better learning outcomes with VM, effectiveness in student performance was not properly studied. This study evaluated students’ satisfaction and effectiveness of VM compared to LM in undergraduate pathology teaching of a Malaysia private institution.

Methods
A randomised cross-over trial was conducted among Year 1 and Year 2 medical students. Pre- and post tests consisting of 10 one-best-answer (OBA) questions, mapped to the histopathology slides used in pathology practical sessions, were used to analyse effectiveness of VM and LM. After crossover swapping the groups, students completed pre-validated 5-point Likert scale questionnaires to assess the satisfaction on both methods.

Results
A majority (≥65%) expressed satisfaction with both LM and VM; however, VM scored higher for ease of use, time efficiency, and image quality. Group (B) with VM followed by LM had higher mean pre-test scores (6.85 ± 1.80) than Group A with LM followed by VM (5.92 ± 2.29), suggesting possible baseline differences. Post-test scores improved significantly in both groups (p < 0.001). Although Group B’s post test mean was higher (9.13 ± 1.19) than Group A’s (8.61 ± 1.63), this may reflect initial group performance rather than VM superiority alone.

Conclusion
Although the reliability statistics of tests could not be analysed, this study concluded that VM is a reliable adjunct tool to replace traditional LM in teaching learning. However, differences in baseline performance between groups highlight the need for cautious interpretation when comparing modalities. Integration of VM into e-learning platforms may enhance blended pathology education.

Keywords: Virtual microscopy; Light microscopy; Histopathology; Undergraduate medical education; Student satisfaction; Learning outcomes.

Citations: IeJSME 2025 Vol 19 (3): 31-45

Authors: Muhammad Muqri Bin Barudinsah, Khalid Ahmad Ali AL Sunaidar

ABSTRACT

Background: Healthcare professionals, particularly pharmacists, play a crucial role in adverse drug reaction (ADR) reporting and pharmacovigilance activities. Despite retail pharmacies being the most accessible point of care for the patients to report mild ADRs, ADR reporting by community pharmacists in Malaysia remains low. Hence, increasing reporting rate among community pharmacists is crucial to promote medication safety.

Objective: This study aimed to assess the knowledge, attitudes, and barriers related to ADR reporting and pharmacovigilance among community pharmacists in Perak, Malaysia, and explore associations between their sociodemographic characteristics with their good knowledge, positive attitudes and high barriers level.

Methods: A cross-sectional study design was employed through both physical and online survey, involving 179 community pharmacists in Perak. Data were collected using a 38-item self-administered online structured questionnaire. Statistical analyses were subsequently conducted.

Results: This study revealed that community pharmacists exhibited good knowledge (82.1%), positive attitudes (68.7%) and low barriers (86.1%) towards ADR reporting and pharmacovigilance. However, several significant barriers hindered their reporting efforts, including the time-consuming nature of the reporting process (37.4%) and doubts about the causality of ADRs (29.7%). Remarkably, gender and CPD programmes participation were associated with good knowledge. While female gender, younger age and recent pharmacovigilance course exposure were associated with positive attitudes, higher education level was inversely associated with positive attitudes.

Conclusion: Despite possessing good knowledge and positive attitudes, several barriers prevent community pharmacists in Perak from effectively reporting ADRs. Targeted interventions are necessary to address these barriers and improve ADR reporting rates among community pharmacists.

Keywords: ADR, adverse drug reactions, attitude, barriers, community pharmacists, knowledge, pharmacovigilance.

Citations: IeJSME 2025 Vol 19 (3): 46-63

Authors: Ket Li Ho, Teguh Haryo Sasongko, Sook Han Ng, Pei Kuan Lai, Lay Cheng Lim & Sook Yee Gan

ABSTRACT

Many tools exist for conducting meta-analyses in systematic reviews, but they are often expensive or difficult for beginners to use. This challenge arises because most tools either fail to address all aspects of meta-analysis comprehensively or lack sufficient guidance for navigating their features. To address these limitations, we developed Meta-IMU, a free R-based Shiny application tailored specifically for beginners. Unlike many existing tools that focus solely on standard systematic reviews, Meta-IMU supports both systematic reviews and umbrella reviews, offering a more versatile approach. To ensure accessibility, Meta-IMU includes built-in instructional videos that guide users step by step, from navigating the application to interpreting the results produced. This guidance ensures users can confidently perform analyses without prior expertise. Meta-IMU encompasses a comprehensive range of features covering key aspects of meta-analysis, such as defining review questions, developing search terms, retrieving studies from various databases, assessing risk of bias, creating tables and plots, analysing small-study effects, performing meta-regression and subgroup analyses, conducting sensitivity analyses, assessing the certainty of evidence, summarizing findings, and generating PRISMA checklist reports. By integrating these functionalities into a single platform, Meta-IMU provides a user-friendly, all-in-one solution. In summary, Meta-IMU is a comprehensive, free application designed to simplify the process of meta-analysis for both systematic reviews and umbrella reviews, making advanced analytical techniques accessible to researchers at any level of experience.

Keywords: Systematic review, umbrella review, metaanalysis, R, Shiny

Citations: IeJSME 2025 Vol 19 (3): 64-83

Authors: Haliza Abdul Mutalib, Bashirah Ishak, Mohd Norhafizun Mohd Saman

ABSTRACT

This study investigated the spectral transmittance of six different types of soft contact lenses after exposure to normal eyedrops use over one month. The normal eyedrops were only meant to be instil into the eyes without contact lenses. The objective of this lab study was to look at the effect of the eyedrops on the spectral transmittance of all contact lenses.

The two types of eyedrops for dry eye (eyedrop A) and eye irritation (eyedrop B) were applied to the surface of each contact lens (two drops each) at 2-hour intervals (n = 15), following which the lenses were immediately immersed in saline solution. This process was repeated four times daily (eight hours for Eyedrop A) and five times daily (10 hours for Eyedrops B), with the lenses subsequently soaked in Optifree disinfecting solution overnight. This constituted one complete cycle, which was repeated daily for 30 consecutive days. The control group underwent a similar procedure but used a saline solution instead of a disinfecting solution.

Spectral transmittance measurements were conducted on Day 0 and Day 30 for both the experimental and control groups. The results were analysed to determine the average of spectral transmittance values, and the absolute differences between the measurements were calculated. All recorded values fell within the tolerance limits outlined in ISO 18369.

This study concluded that neither type of eyedrop induced significant changes in spectral transmittance after 30 days of daily use as recommended by the manufacturer. All tested lenses (in the FDA categories) exhibited consistent spectral transmittance values throughout the study. Therefore, the eyedrops evaluated in this trial were deemed not to affect the spectral transmittance of any soft contact lens types.

Keywords: Spectral transmittance, contact lenses, ophthalmic solutions, ISO, Eyedrop.

Citations: IeJSME 2025 Vol 19 (2): 18-27

Authors: Kavitha Nagandla, Sasikala Devi Amirthalingam, Malanashita Ganeson, Sharifah Sulaiha Syed Aznal, Ismail Abdul Sattar Burud, Shahid Hassan, Alex Chern Loong Lim.

ABSTRACT

Background: Mobile applications with multi-source feedback and learner analytics identifying individual students’ learning needs, providing personalised learning, and remediation are utilised to enhance Workplace-based assessment (WBA). This pilot study aims to investigate the utility and feasibility of WBA digital application, H. Prime, in the settings of clinical experiential learning.

Methods: A mixed methods analysis using quantitative data collected in Phase 1 and qualitative experience data from focus group discussion in Phase 2 was conducted. The educational impact was assessed using Kirkpatrick’s hierarchical model of evaluation pyramid from level 1, “satisfaction” to level 4, “results”.

Results: A total of 392 assessments were completed among 200 students across their clinical postings.
78.5% of students and 87.1% of faculty assessors perceived the application as an acceptable usability experience. Thematic analysis revealed a need to improve the digital interface and communication when scheduling assessments. Students found verbal and recorded feedback in the digital application closed learning gaps and facilitated reflective learning.

Conclusions: In summary, a digital app-based delivery of WBA is a positive experience for students and assessors. Students acknowledged that feedback generates opportunities for self-reflection and closing learning gaps. On technical aspects, there is a need to improve the process of timely scheduling sessions with assessors. We acknowledge prior training of the faculty, academic support staff, provision of additional time in timetables, student knowledge, and sensitisation, are paramount for successful timely completion and enhancement of the educational impact of the WBAs.

Keywords: Workplace-based assessment, Digital app, Clinical training.

Citations: IeJSME 2025 Vol 19 (2): 28-36

Author: Jun Ai Chong

ABSTRACT

Introduction: Dental caries is a preventable chronic disease whereby identification of risk factors will
facilitate preventive measures. This study aims to determine the level of oral health literacy (OHL), self-care practices (SCP), salivary parameters and ascertain its assocation with caries status amongst the
undergraduates in IMU University.

Methods: Levels of OHL (Knowledge-OHL, dental services utilisation, and label reading habit) and SCP were assessed through a self-administered questionnaire. Chairside saliva kits were used to measure the salivary parameters whilst clinical examination was performed to assess caries status. Independent T-test and Analysis of Variance (ANOVA) was used to compare differences between sex and courses respectively for measures of interest (OHL, SCP, salivary parameters, and caries status) whereas bivariate correlation with Pearsons’s coefficient was performed to examine their association with caries status.

Results: The participants (n=132) had a mean Knowledge-OHL score of 23.75±8.09 with no significant difference between sex (females, 24.01±8.51; males, 23.48±7.69; p=0.15). Dentistry students had significantly higher Knowledge-OHL score than students of all other courses (p=0.01). The mean SCP score was 20.19±3.16 whereas mean DMFT was 2.32 ±3.14. All participants had healthy saliva parameters. Caries status was significantly correlated with Knowledge-OHL score (p=0.02, r=-0.18), dental services utilisation (p=0.04, r=-0.15) but not with label reading habit (p=0.78, r=0.03), SCP (p=0.30, r=-0.05) and all salivary parameters.

Conclusion: Knowledge-OHL and oral health services utilisation are significantly associated with oral health status.

Keywords: dental caries, health literacy, oral health, saliva, self-care

Citations: IeJSME 2025 Vol 19 (1): 09-16

DOI: https://doi.org/10.56026/imu.19.1.9

Authors: Farah Nabila Lubis and Joshua Joo Hou Ng

ABSTRACT

Objective: One key factor found to be related to creativity is creative self-efficacy. Creative selfefficacy
(CSE) refers to one’s own conviction in their own ability to produce creative work effectively. The study aims to explore on the predictive values of time management and reading habit on CSE, as well as on
the significant difference between gender and CSE.

Method: This study (n = 313) is a cross-sectional survey design. The inclusion criteria for the participants are full-time university students studying in Malaysia and aged between 18-25 years old. Data collected was analysed by linear regression, multiple linear regression and independent sample t-Test.

Results: Reading habit is a significant positive predictor of CSE. Both daily planning and confidence
in long-range planning in time management are significant positive predictors of CSE. However, there
is no significant difference between gender in terms of male and female and CSE.

Conclusion: This study provided evidence on the role of reading habits and time management on
creative self-efficacy amongst undergraduate student in Malaysia.

Keywords: creative self-efficacy; gender; reading habit; time management; emerging adulthood stage; university students

Citations: IeJSME 2025 Vol 19 (1): 17-31

DOI: https://doi.org/10.56026/imu.19.1.17

Authors: Yik Shen Teoh, Norsakinah Jazmin Abu Bakar, Sammi Ahmed Khan Javeed Khan, Muhammad Afif Najmi Mohamed Azhar, Siti Aisyah Zaidi, Yita Tang, Norfarizan Azmi, Ismail Abdul Sattar Burud, Kandasami Palayan

ABSTRACT

Introduction: COVID-19 pandemic placed unprecedented strain on hospital resources and manpower. This study assesses the impact of Malaysia’s nationwide lockdown on the incidence, types, severity, and outcomes of emergency general surgery (EGS) cases at a tertiary care hospital.

Methods: This retrospective cohort study analysed the data of patients who underwent EGS procedures for the period 2017 and 2021.

Results: During the pandemic period, there was a 48.3% reduction in EGS cases (n=889) compared to the pre-pandemic period (n=1720). Significant reductions were observed in surgeries for appendicitis, soft tissue infection, colorectal, urology, peptic ulcer, and vascular disorders in the COVID period. Conversely, procedures for biliary disorders and hernia complications increased by 7.4% and 5.5%, respectively. Length of hospital stay increased by 57.8% for patients with small bowel disorders, while ICU/HDU admissions rose by 43.5% for colorectal cases (P < 0.05). There was no significant difference in mortality rates between the two periods.

Conclusions: The overall reduction in EGS procedures during the COVID-19 period was consistent with global trends. Despite the challenges posed by the pandemic, the outcomes related to duration of stay, ICU/HDU utilisation, and mortality remained comparable to the pre-pandemic period. These findings highlight the adaptability of healthcare professionals in maintaining continuity and quality of emergency surgical care during a crisis.

Keywords: Emergency surgery, COVID-19, Pandemic, Outcomes, Tertiary care public hospital

Citations: IeJSME 2025 Vol 19 (1): 32-43

DOI: https://doi.org/10.56026/imu.19.1.32

Authors: Carolina Santiago, Kavitha Nagandla, Sharifah Sulaiha Syed Aznal, Brinnell Annette Caszo, Malanashita Ganeson

ABSTRACT

Introduction: This paper explores the impact of a remediation programme on medical students’ overall performance. It also suggests a potential remediation framework encompassing planned learning sessions by subject experts, individualised coaching from an alumni group, professional counselling for
psychological support, and participants’ learning commitment.

Methods: Twenty-seven students were identified as academically weak students (AWS). This was done
based on two criteria: students who failed more than one mini test (out of six mini tests) during the
delivery of the first-year curriculum, and students who had to repeat the study after failing the end-of-year-1 (EOY-1) exam. A remediation strategy consisting of 1) planned learning sessions, 2) individualised alumni coaching sessions, and 3) counselling sessions were offered to these students. However, participation is optional (Group A (n=12) – participants and Group B (n=15) – non-participants). Evaluation of the remediation programme is performed using mixed-method analysis: 1) comparative analysis of the performance of Group A vs Group B, and 2) qualitative analysis using a semi-structured interview with openended questions to obtain students’ perceptions of the programme.

Results: Group A showed significantly higher pass rates (83% vs. 66%, p < .001) in the EOY-1 exam. Interviews revealed positive perceptions of personalised alumni coaching and its role in enhancing learning and confidence.

Conclusion: The study concludes that early identification and targeted remediation support improve academic outcomes, benefit the student’s educational journey, and contribute to quality education.

Keywords: Remediation programme, medical education, academic performance, peer coaching

Citations: IeJSME 2025 Vol 19 (1): 44-53

DOI: https://doi.org/10.56026/imu.19.1.44