Category: Articles

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

Authors: Kwee Choy Koh, Benjamin Ze Wei Kok, Yun Ni Cheah, Swen Huey Bee, Charlottee Yen Shin Lee, Dalili Hezreen Nazari.

ABSTRACT

Introduction: The COVID-19 pandemic in 2020 resulted in a complete lockdown of educational institutions in Malaysia necessitating an immediate shift from conventional face-to-face teaching to online teaching-learning (OTL). This invariably affected the work-life balance and mental health of medical lecturers. This study was done to assess the adequacy of training of lecturers to conduct OTL and the challenges faced, and the impact of transitioning to OTL on the work-life balance and mental health of medical lecturers. The mental health status of lecturers was compared according to age categories of Gen-X, Gen-Y and Baby Boomer (BB) generations.

Methods: An online survey was conducted between August and October 2021. Participants were asked to answer a series of questions designed to assess adequacy of training received, impact on work life balance, and score themselves with validated scoring tools to assess for anxiety, depression, and stress levels.

Results: A total of 179 lecturers participated in the study. Training for OTL was deemed to be adequate and prepared the lecturers well for OTL. The transition to OTL negatively disrupted work-life balance causing extra work hours, disruption to family life, sleep issues, exhaustion, and stress but were positive in many other aspects. Gen-X and Gen-Y lecturers had higher perceived stress compared to BB.

Conclusions: Transitioning to online teaching during COVID-19 pandemic impacted work-life balance positively and negatively. Moderate to high perceived stress were reported, especially among younger lecturers. Training to equip lecturers to conduct online teaching and support for mental health and wellbeing should be provided.

Keywords: COVID-19 pandemic, mental health, online teaching, work-life balance, medical lecturers.

Citations: IeJSME 2024 Vol 18 (3): 04-14

DOI: https://doi.org/10.56026/imu.18.3.4

Authors: Noor-i-Kiran Naeem, Siti Nurma Hanim Hadie, Irwan Mahazir Ismail, Samina Malik, Usman Mahboob, Subhan Ullah, Muhamad Saiful Bahri Yusoff.

ABSTRACT

In light of the increasing use of online learning platforms in medical education, there is a critical need to assess the current state of online learning environments. Despite the global emphasis on digital education, limited studies have systematically explored how medical students perceive the effectiveness and quality of these environments, particularly in Pakistan. This study aims to fill this gap by evaluating medical students’ experiences with their institution’s online learning environments and identifying key strengths and challenges that impact learning outcomes.

A mixed-method, sequential exploratory design was used, starting with a quantitative assessment followed by qualitative inquiry. Data from 253 medical students were collected via a survey, and 30 focus group interviews were conducted to provide deeper insights into the challenges students face in navigating the online learning environment. The findings revealed critical areas in need of improvement, including digital infrastructure, student engagement, and the accessibility of online resources. Qualitative data highlighted the need for more interactive and student-centred approaches to online education.

By focusing on the status of online learning in medical education, this research provides valuable insights for educators and policymakers aiming to enhance the quality of digital learning environments. The study contributes to ongoing efforts to develop more effective, engaging, and responsive online learning strategies for medical students in Pakistan.

Keywords: Online learning, Undergraduate Medical Education, Learning environment, Digi-MEE, Perception.

Citations: IeJSME 2024 Vol 18 (3): 15-32

DOI: https://doi.org/10.56026/imu.18.3.15

Authors: Sheema Gunasegaram, Seok Shin Tan, Sumaira Hussain

ABSTRACT

Academic stressors can hinder the wellbeing of students and impact their eating habits. In this study, we apply the socio-ecological model to academic stressors and explore the influence they have on eating behaviour among university students. This cross-sectional study was set in a private health sciences university in Malaysia among a sample of 183 pre-university students, which was obtained using systematic random sampling technique. The academic stressors of the participants were assessed using the Academic Stress Questionnaire while eating behaviour was determined using The Three Eating Factor Questionnaire Revised-18 Items. Significant association (p ≤ 0.05) was found between academic stressors and eating habits. The increase in academic stressors increased the unhealthy eating behaviours: Cognitive Restraint, Uncontrolled Eating, and Emotional Eating. The findings illustrate that academic stressors should be taken into consideration for future university health interventions to promote healthy eating behaviour.

Keywords: socio-ecological model, academic stressors, eating behavior, student

Citations: IeJSME 2024 Vol 18 (2): 06-15

DOI: https://doi.org/10.56026/imu.18.2.6

Authors: Siew Houy Chua, Wei Joe Lai, Yuan Fang Lim, Joshua Shadrach Daniel, Keshvien Inbashekaran, Suk Chyn Gun

ABSTRACT

Introduction: Coronavirus disease 2019 (COVID-19) has severely influenced all aspects of life since its emergence and one of the strategies to end this pandemic rests on the vaccination to achieve herd immunity. While vaccinations are usually a safe and effective tool, the abbreviated development process of the available COVID-19 vaccines has increased uncertainties about the safety among the general population especially among patients with rheumatic and musculoskeletal diseases (RMD).

Methods: A cross-sectional analysis was performed on rheumatic disease (RMD) patients from the rheumatology clinic at Hospital Tuanku Ja’afar Seremban (HTJS), investigating adverse events occurring within one month of receiving COVID-19 vaccines administered from 1st May 2021 to 30th September 2021.

Results: 549 RMD patients were recruited in this study. Pfizer/BioNTech was the predominant vaccine (n = 257, 64.3%), followed by Sinovac (n = 60, 47.2%), Oxford/AstraZeneca (n = 7, 1.3%) and Moderna (n = 1, 0.2%). 330 (60.1%) patients experienced at least one adverse event, none of which required hospitalisation. Common side effects included pain at the site of injection (n = 169, 30.8%), generalised muscle pain (n = 91, 16.4%), fever (n = 90, 16.4%), arthralgia (n = 55, 10.0%), and lethargy (n = 43, 7.7%). Female patients (OR = 0.88, CI 0.79-0.97, p = 0.012), Sinovac recipients (OR = 0.51, CI 0.34-0.76, p = 0.001) and age >50 years (OR = 0.62, CI 0.44-0.89, p = 0.009) had significantly lower risks of experiencing adverse events. Among patients with autoimmune rheumatic disease (AIRD), 28 (6.4%) experienced disease flare. Patients with spondyloarthropathy (SpA) and overlap syndrome were more likely to experience disease flare following COVID-19 vaccination compared to rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) patients (OR = 2.87, CI 1.23 – 6.69, p = 0.014). The use of combination conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) was associated with a tendency toward increased risk of disease flare (OR = 2.34, CI: 0.97–5.64, p = 0.056). However, the use of glucocorticoids (OR = 2.02, CI 0.72–5.61, p = 0.17) and an active disease state (OR = 1.94, CI 0.75–5.02, p = 0.171) did not show a statistically significant impact on the frequency of disease flares.

Conclusions: The study affirms the overall safety of COVID-19 vaccines in rheumatic musculoskeletal disease patients, supporting efforts to address vaccine hesitancy in this population.

Keywords: Adverse events; COVID-19; Rheumatic and musculoskeletal disease; SARS-CoV-2; Vaccination

Citations: IeJSME 2024 Vol 18 (2): 16-24

DOI: https://doi.org/10.56026/imu.18.2.16

Authors: Haliza Abdul Mutalib, Bashirah Ishak, Mohd Norhafizun bin Mohd Saman, Ahmad Rohi Ghazali, Elly Liyana Zainodin.

ABSTRACT

Background
There are a few dry eye remedies available in the market. Currently, artificial tears and lubricants are still the most common management for dry eyes.

Objective
We proposed a new method in managing dry eyes.

Methods
A pre-soaked contact lens in virgin coconut oil (VCOCL) is being used as a vehicle to deliver virgin coconut oil (VCO) in dry eyes. VCOCL was prepared in sterilised conditions where daily soft hydrogel contact lenses were immersed in raw VCO. The efficacy of VCOCL in delivering the VCO to eyes was assessed by measuring the Tear Break-Up Time (TBUT) values, corneal staining of the anterior eye, Schirmer Test values and the measurement of residual VCO volume in tears at baseline and at 15 minutes after insertion on subjects with dry eyes. Pre- and post-data were used to analyse all the measurable variables.

Results
This study showed a significant difference in the TBUT, corneal staining, and residual VCO volume for both eyes (p<0.05). However, there were no changes in the Schirmer Test value (p>0.05). VCOCL was proven to improve tear quality in dry eye subjects and was able to maintain its presence in the eye even after 15 minutes.

Conclusion
This study suggests a new method for dry eye management.

Keywords: Contact Lens, VCO, Therapeutic, Dry Eye, Tearfilm

Citations: IeJSME 2024 Vol 18 (2): 25-34

DOI: https://doi.org/10.56026/imu.18.2.25

Authors: Rulin Lee, Alexius Weng Onn Cheang, Serena In.

ABSTRACT

Various studies have highlighted that women are at a higher risk of becoming victims of cyberbullying, with the severity of cyberbullying among women in many countries increasing and the urgency of having necessary intervention steps by governments and legal institutions in place. Nonetheless, the taboo of discussing mental health and individual struggles has hindered victims from disclosing their cyberbullying experiences they have gone through or are still currently experiencing due to the fear of being discriminated against. Therefore, this study aimed to explore cyberbullying from a victim’s perspective among women with heavy social media usage, as well as their coping strategies. A qualitative research design was utilised to understand the cyberbullying experience and coping strategies among five young women aged between 20 to 26 years old. Participants were recruited through social media. Collected data were analysed using thematic analysis which revealed three cyberbullying themes: “harassment”, “relational aggression” and “trolling”, three initial reaction themes: “anger”, “sadness” and “confusion”, two crossroad themes: “helplessness” and “sense of control” that either lead to the relapse of cyberbullying experience or coping strategies, and three coping strategy themes: “social coping”, “emotion-focused coping” and “problem-focused coping” and lastly, cognitive reappraisal. The findings provide comprehensive insights into understanding cyberbullying experiences and coping strategies among women with heavy social media usage. Understanding the effectiveness of various forms of coping allows mental health professionals to support their clients by finding out the implemented coping strategy and expanding on other forms of coping to build a more holistic support for their clients.

Keywords: coping strategies, cyberbullying from a victim’s perspective, heavy social media usage, women

Citations: IeJSME 2024 Vol 18 (1): 08-27

DOI: https://doi.org/10.56026/imu.18.1.8