Authors: Pei Khim Lee, Wei Fern Siew, Wai Mun Tang.

ABSTRACT

Background: Psychosocial care remains an important component in holistic care nursing and is crucial for patients’ recovery outcomes.

Objective: The purpose of the study was to determine nurses’ perception towards their role in psychosocial care.

Methodology: The research design was descriptive and cross-sectional. Nurses’ Role in Psychosocial Care Questionnaire (NRPCQ) was used for data collection and approximately 110 registered nurses (response rate = 52.38%) participated in the study via convenience sampling. Descriptive and inferential statistics, Mann-Whitney U test were used for data analysis.

Results: In general, nurses’ perception towards their role in providing psychosocial care was positive (M = 73.71, SD ± 12.20). Items on “demonstrating warmth and friendliness by smiling” (M = 3.92, SD ± 0.28); and “explaining nursing procedures or interventions to the patient” (M = 3.88, SD ± 0.32) were rated most positive. Nevertheless, items on “referring patients to other health care team members” (M = 3.32, SD ± 0.83), and “discussing with patient and patient’s family regarding planned care” (M = 3.44, SD ± 0.69) were rated the least positive. The Mann-Whitney U test analysis revealed significant association between nurses’ age and perception towards their role in psychosocial care (p = 0.025), in which the older nurses have a more positive perception towards their role in psychosocial care than the younger nurses.

Conclusion: The findings highlighted some important gaps in the practice of psychosocial care among the registered nurses. The information serves as a baseline for the planning and implementing of relevant strategies in enhancing nurses’ role in psychosocial care provision.

Keywords: Perception, role, psychosocial care, registered nurses, hospital.

Citation: IeJSME 2018 12(3): 21-29

DOI: https://doi.org/10.56026/imu.12.3.21

Authors: Donald Koh Fook Chen, Joon Wah Mak, Soo Shen Ooi, Kok Fee Mak, Kwai Hoe Chong.

ABSTRACT

Background: We previously evaluated the biochemical changes induced by the local product TCM for diabetes (TCM-D™) on blood glucose levels and other biochemical changes in normal mice fed orally with the recommended human dose (30 ml/kg daily) and ten times this dose for eight weeks. TCM-D™ is an aqueous extract of the roots of Trichosanthes kirilowii Maxim, Paeonia lactiflora Pall, Glycyrrhiza uranlensis Fisch. and Panax ginseng Meyer (red) combined at the dry weight proportions of 36%, 28%, 18% and 18% respectively. The study showed that at these dosages the blood glucose levels as well as the body weights in treated mice were significantly reduced when compared with pretreatment values and control animals. The present study evaluated the effect of the extract in a mouse model of Type 1 diabetes mellitus.

Methods: TCM-D™ extract was prepared as a 10x concentrate and given orally at 0.3 ml/100 g and 1.5 ml/100 g to mice which were experimentally induced diabetic with intraperitoneal injections of streptozotocin (5 mg/100g) in sodium citrate (pH 4.5). Control diabetic mice were dosed with extract diluent (distilled water).

Results: At the doses studied the compound did not show any significant lowering of the glucose levels in a mouse model of Type 1 diabetes. There were significant increases in the alanine aminotransferase (ALT) and creatinine levels which were most likely due to the treatment with the compound. There were no significant changes in the aspartate aminotransferase (AST) and blood urea levels due to the treatment. Neither was there any significant effect on the weight of the treated animals due to the treatment.

Conclusions: It is concluded that TCM-D™ did not have any significant blood glucose lowering effect on streptozotocin induced diabetic mice when fed orally at 1-5 times the recommended human dose. Further work is needed to determine if the extract has any significant effect in a mouse model with Type 2 diabetes mellitus.

Keywords: Traditional Chinese Medicine; experimental diabetes in mice; Type 1 diabetes mellitus, Trichosanthes kirilowii Maxim; Paeonia lactiflora Pall; Glycyrrhiza uranlensis Fisch; Panax ginseng Meyer (red).

Citation: IeJSME 2013 7(1): 4-9

DOI: https://doi.org/10.56026/imu.7.1.4

Authors: Siew Kheong Lum, Wei Rong Lee, Syn Dee Ch’ng, Navin Raj a/l Balachandran, Chee Kit Tee.

ABSTRACT

Introduction: Undergraduate medical education should be broad-based, holistic, integrated and should promote a framework for the development of higher order cognitive skills like communication, professionalism and teamwork to prepare the student for a life-long challenging medical career. Recent calls for a competency-based medical education require, in addition, competency in clinical and procedural skills prior to graduation. This study investigates how often opportunities exist for medical students to perform four common ward procedures prior to graduation.

Method: A prospective cross-sectional study to assess the opportunities a medical student have in performing four common ward procedures, comprising intravenous cannulation, nasogastric tube insertion, urinary catheterisation and chest tube insertion, in a State General hospital in Malaysia was done.

Results: A medical student has sufficient opportunity to perform only intravenous cannulation prior to graduation. He has a remote chance to insert a urinary catheter and is unlikely to have the opportunity to insert a nasogastric tube or insert a chest tube prior to graduation.

Conclusion: Although competency in clinical skills and procedural skills prior to graduation are desirable, this is increasingly difficult to achieve due to shortage of clinical material, teachers to supervise, the large numbers of medical students and house officers, the short time spent on the main disciplines and the failure of many universities to invest heavily in skills laboratories staffed by full time clinicians. The calls to introduce competency-based medical education in undergraduate medical education, particularly in procedural competence, should take into account the challenges in delivery and the realities in the hospitals today. This is necessary to avoid demoralising students who are unable to achieve their quota of procedures through no fault of theirs.

Keywords: procedural competency, medical education Malaysia.

Citation: IeJSME 2013 7(1): 10-14

DOI: https://doi.org/10.56026/imu.7.1.10

Authors: Tri Yuliani, Sudibyo Martono, Sansan Sukamdani Tjipto, Muhammad Yusuf Putroutomo, Irwan Desyanto Raharjo Indartono.

ABSTRACT

Background: Glutathione S-transferases (GSTs) have an important role in the detoxification of electrophiles, such as some anticancer drugs. Compounds with phenolic and/or α,b-unsaturated carbonyl group have been known as GSTs inhibitor in vitro. Cefadroxil in vitro decreased GST-Pi activity but not GSTs in rat kidney cytosol. GST inhibitor in a specific organ and of a specific class is needed for safety in cancer chemotherapy. The study aims to observe the effect of cefadroxil on GSTs in vivo in rat kidney cytosol and then compare it to those seen for liver, lung, and spleen in vivo.

Methods: Cefadroxil was given twice a day by forcefeeding for five days. Rat kidney cytosol was then prepared and its protein concentration was determined. Cytosolic total GST, GST-Mu and GST-Pi activities were monitored by a continuous spectrophotometric method using the following substrates: 1-chloro, 2,4-dinitrobenzene (CDNB) (non specific substrate), 1,2-dichloro-4-nitrobenzene (DCNB) for GST-Mu, and ethacrynic acid (EA) for GST-Pi.

Results: The data showed that cefadroxil significantly increased the activity of GSTs, GST-Mu, and GSTPi in rat kidney cytosol (8.75%, 47.81%, and 6.67% respectively).

Conclusion: Cefadroxil did not inhibit GSTs, GST-Mu, and GST-Pi in rat kidney in vivo indicating that it does not inhibit chemotherapy detoxification by GSTs, GSTMu, and GST-Pi in normal kidney cells.

Keywords: GSTs, cefadroxil, specific substrates, in vivo, co-therapy.

Citation: IeJSME 2013 7(1): 15-20

DOI: https://doi.org/10.56026/imu.7.1.15

Author: Abu Bakar Suleiman

Citation: IeJSME 2013 7(1): 21-23

DOI: https://doi.org/10.56026/imu.7.1.21

Author: Siang Tong Kew

ABSTRACT

Building on two decades as a private health professional university, the International Medical University prepares for the third decade, taking stock of the challenges in changing epidemiology and pattern of disease, changing demography and healthcare, as well as explosion in knowledge and information technology. The Global Independent Commission provided a framework for instructional and institutional reforms, and the IMU will use its 3 I’s (insight, imagination & innovation) in adopting these measures. Some of the instructional reforms are already in place, others need to be further nurtured and promoted. In its third decade, competency based curriculum, inter-professional learning, IT, global collaboration, educational resources, new professionalism and emphasis on quality improvement will help ensure IMU train and produce competent, caring and ethical health professionals fit to tackle 21st century challenges.

Keywords: Health professional, education, 21st century, instructional reform.

Citation: IeJSME 2013 7(1): 24-28

DOI: https://doi.org/10.56026/imu.7.1.24

Authors: Thiruselvi Subramaniam, Rosalind Chi Neo Loo, Sangeetha Poovaneswaran.

ABSTRACT

Background: This cross sectional study was done to identify the areas of lack of knowledge, practice and awareness of students about the effective use of personal protective equipment (PPE).

Methods: A total of 40 students were selected when they were posted to the accident and emergency unit (A&E) in Seremban Hospital; all of them answered a questionnaire and were observed unaware on the effective use of PPE in the A&E.

Results: We found that 17.5% of students were unaware of the right technique of removing the gloves after a procedure and 25% of students were unaware of safety of hand washing. During invasive procedures, 12.5% of students did not wash their hands before invasive procedures, 65% did not wear aprons and 57.5% did not wear masks. During non- invasive procedures more than 25% of students did not wash hands before or after the procedures.

Conclusion: There is still significant lack of knowledge in students about the effective use of PPE that needs to be addressed.

Keywords: PPE, Personal protective equipment, effective practice of PPE, A&E.

Citation: IeJSME 2013 7(2): 29-32

DOI: https://doi.org/10.56026/imu.7.2.29

Authors: Leela Anthony, Nagarajah Lee, Stephen Ambu, Lokman Hakim S.

ABSTRACT

Background: This study examined the trend of major congenital anomalies (CA) in the state of Penang using the ICD 10 database from 1999 to 2004. The data was collected from various health centres and hospitals. The aim was to study the magnitude of the problem for congenital anomalies in the state of Penang in terms of trends and also to calculate the incidence rate by districts. If a trend was noticed, this in turn will determine whether to carry out further in-depth studies in the future and to find out the linkages to the environment if any.

Methods: This was a retrospective study of congenital anomalies that were registered in the state of Penang and the data was obtained from the ICD10 database from 1999 to 2004. Under ICD 10, congenital anomalies are coded as “Q”. Only major congenital anomalies coded as “Q” from Q1 to Q11 were extracted and analysed. Only new cases were analysed, double and repeat entries were excluded. Trend analysis was than carried out according to districts in Penang.

Results: Incidence rate per 1000 birth was calculated to determine the common congenital anomalies. It was found that there was an increasing trend in the incidence of CA for all the five districts studied; topping the list was Barat Daya while Seberang Perai Selatan had the lowest incidence rate. It is noteworthy to mention that Barat Daya is an industrialised district while Seberang Perai Selatan is mainly an agricultural and residential area. This preliminary study however did not look into the reasons or causative factors for the high or low incidence in the respective districts. In terms of the types of congenital anomalies, the highest was that from malformation of circulatory system while the lowest from respiratory system. The congenital anomalies with the incidence rate at least 3 per 1000 births were malformations from the nervous system, circulatory system, digestive system, genital organs, malformation/ deformation of musculoskeletal system and cleft lip and cleft palate.

Conclusion: This study showed a rising trend in congenital anomalies in all districts in the state of Penang and a high incidence was observed in the district of Barat Daya, where a number of factories are located in the Bayan Lepas Industrial Zone. However further studies need to be carried out to determine the causative factors and their linkage to the environment. The limitation of this study was that the data analysed was only from notified cases to the Penang State Health Department.

Keywords: Trend, ICD, Congenital, Anomalies, Environment.

Citation: IeJSME 2013 7(2): 33-40

DOI: https://doi.org/10.56026/imu.7.2.33

Authors: Bharti N Karelia, Ajita Pillai, Bhavisha N Vegada.

ABSTRACT

Background: Item analysis is the process of collecting, summarising and using information from students’ responses to assess the quality of test items. Difficulty index (P) and discrimination index (D) are two parameters which help to evaluate the standard of MCQ questions used in an examination, with abnormal values indicating poor quality.

Methods: In this study 200 test items of 10 MCQ tests from 2008 to 2012 were selected and analysed to obtain their difficulty and discrimination indices. The relationship between the difficulty index and discrimination index for each test item was determined by Pearson correlation analysis.

Results: Mean difficulty index scores of the individual summative tests were in the range of 47.17% to 58.08%. Twenty nine percent of total test items crossed the difficulty index of 70% indicating that those items were easy for the students. Seventy eight percent of the test items showed acceptable (> 0.2) discrimination index. Forty six percent of the test items showed excellent discrimination index. Discrimination index correlated poorly with difficulty index (r=0.11). The correlation is insignificant at 5% (p>0.10).

Conclusion: A consistent level of test difficulty and discrimination indices was not maintained from 2008 to 2012 in all the ten summative type A MCQ tests.

Keywords: Difficulty index Discrimination index Item analysis, Summative tests, Type A MCQ.

Citation: IeJSME 2013 7(2): 41-46

DOI: https://doi.org/10.56026/imu.7.2.41

Authors: Kwee Choy Koh, Sheila Rani Kovil George, Jun Wee Pak, Ying Tian Liow, Jie Xun Khor.

ABSTRACT

Background: The International Medical University (IMU) has an outcome-based curriculum defined by eight major curriculum outcome domains. The attributes, qualities and competencies expected of a health care professional form the basis for these outcome domains. Community service is an effective curriculum delivery tool widely practised by medical universities around the world. We present the results of a survey among IMU students to explore the effectiveness of community service as a curriculum delivery tool in enabling activities defined within the major curriculum outcome domains of IMU.

Methods: A self-administered 6-point Likert scale questionnaire was used to survey student participants of 20 community service events held in a rural village between 2007 – 2012. The survey tool included questions on demographic data as well as the perception of the students on whether participation in the events enabled them to experience activities defined under the eight major curriculum outcome domains of IMU. The one sample Student t-test was used to test for statistical significance while regression analysis was done to look for significant predictors.

Results: A total of 255 students were surveyed, of which 229 (90.5%) were medical students while the rest were nursing students. Most of the students were in the 3rd (48.2%) and 4th (43.8%) year of their studies and have completed the surgery, internal medicine and family medicine posting. Six out of the 8 curriculum outcomes domains were achieved through participation in the community service programme.

Conclusion: Community service is an effective curriculum delivery tool for the outcome-based curriculum of IMU where activities defined in six out of eight outcome domains were achieved.

Keywords: Medical Education, Medical Students, Community-Based Medical Education, International Medical University.

Citation: IeJSME 2014 8(1): 24-31

DOI: https://doi.org/10.56026/imu.8.1.24