Authors: Masayuki Niwa, Satoshi Yoshida, Kazuhiro Takamizawa, Satoshi Nagaoka, Nobumitsu Kawakubo, Yuzo Takahashi, Yasuyuki Suzuki.

ABSTRACT

Background: Development in internet technology enables e-learning at the higher education level. We have developed the Internet PBL-Tutorial System/Rakuichi that allows multi-directional communication among participants with web-based bulletin boards. Although this system has been successful in medical education at the undergraduate level, we sought to encourage “readonly members” to participate more fully in the program.

Methods: To this end, we compared the posting frequency among three strategies: (1) students and tutors had an off-site meeting to promote face-to-face communication during the course, (2) several classes were allowed to watch the discussion in other classes in the second half of the course, (3) three classes (5 – 6 students each) in one topic were combined into one class (16 students) in the second half.

Results: No meaningful effects were observed for strategies (1) or (2). However, the posting frequency increased 50 % for strategy (3).

Conclusion: Facilitation of communication among participants was achieved by increasing the number of student participants. We predicted that an optimal number of students in each class in internet-based PBL would be ~20 people.

Keywords: Web-based, PBL-tutorial, master course, facilitation, education method, group size.

Citation: IeJSME 2014 8(2): 4-11

DOI: https://doi.org/10.56026/imu.8.2.4

Authors: Jenn Haw Fong, Kenny Voon, Stephen Ambu, Joon Wah Mak.

ABSTRACT

Background: The tissue specimens used for extraction of DNA in this study were from rodents trapped in four states in Peninsular Malaysia, namely Kedah, Kelantan, Selangor and Johor.

Methods: Histological sections of these rodent muscle tissues stained with hematoxylin and eosin showed infection with Sarcocystis spp. Based on these results, the current study was carried out to determine the phylogenetic relationship among the identified Sarcocystis spp. in these rodents. The formalin fixed paraffin embedded (FFPE) rodent muscle blocks were subjected to DNA extraction and followed with semi nested PCR targeting 5’ and 3’ regions of 18S rRNA of Sarcocystis spp.

Results: Phylogenetic analysis showed two distinct groups of Sarcocystis spp. among the rodents in Peninsular Malaysia. Most of the identified Sarcocystis spp. were genetically closely related to Sarcocystis rodentifelis and Sarcocystis muris and were also observed to be genetically closely related to Sarcocystis sp. ex Columba livia and Sarcocystis sp. cyst type I ex Anser albifrons.

Conclusion: Further classification to confirm these Sarcocystis spp. was not possible as only partial sequences of 18S rRNA was available and this was insufficient for optimal differentiation.

Keywords: Sarcocystis, rodents.

Citation: IeJSME 2014 8(2): 12-17

DOI: https://doi.org/10.56026/imu.8.2.12

Authors: Yaya Liliana Hanapian, Joon Wah Mak, Paul Chieh Yee Chen.

ABSTRACT

Background: In Malaysia, the most common soil-transmitted helminth infections are A. lumbricoides, T. trichiura and hookworms. However, as there have been no extensive surveys on these infections, it is difficult to estimate with certainty the current overall incidence of infection with soil-transmitted helminths (STHs) among the Malaysian population including the Orang Aslis.

Materials and Methods: A study was conducted to determine the infection rate of soil-transmitted helminths and intestinal protozoa among the Jehai Orang Aslis (Aborigines). The study was conducted between December 2005 and August 2006, in four Jehai villages of Perak State, Malaysia. A total of 175 stool samples was collected and personal identification such as name, age, household identification, and date of collection were recorded on the spot during collection. Faecal smears were stained with Trichrome for protozoa cysts and trophozoites and the modified Ziehl-Neelsen acid-fast method for the oocyst of Cryptosporidium and Isospora. Wet mounts with tincture of iodine of both stool samples (10% formalin and PVA) were also examined to detect cysts, ova and larva of intestinal helminths.

Results: The prevalence rates of Trichuris trichiura, Ascaris lumbricoides and hookworm among the Jehai were 70.8%, 24.0%, and 10.9% respectively. The prevalence of Entamoeba coli, Entamoeba histolytica, Giardia intestinalis, Blastocystis hominis, and microsporidium was 40.6%, 33.7%, 25.7%, 91.4%, and 27.4% respectively. The difference in prevalence rates among the different age-groups and sex were found not significant. Children aged 0-9 years old had the highest prevalence rate of intestinal parasites and only 2 (1.1%) were free of any intestinal parasites.

Conclusion: Intestinal parasitic infections were therefore still common among these people. Children aged 0-9 years old were found to have the highest infection rate of all the intestinal parasites examined. Further investigations are needed to determine more specific transmission of these infections, so that an attempt to control these infections can be made.

Keywords: Soil-transmitted helminths and intestinal protozoa, intestinal parasitic infections, Orang Asli.

Citation: IeJSME 2014 8(2): 18-23

DOI: https://doi.org/10.56026/imu.8.2.18

Authors: Zhi Yee Lee, Joshua Chuan Yung Foo, Mei Qian Lim, Zheng Xian Koh, Wendy Hui Yi Wong, Tony Kock Wai Ng.

ABSTRACT

Introduction: A recently published meta-analysis showed that each additional serving of rice increased risk of type 2 diabetes mellitus (DM) by an alarming 11%. We investigated whether this phenomenon is seen in the Malaysian population by studying the effect of rice intake and added sugar consumption on fasting plasma glucose (FPG) and fasting triacylglycerol (TAG).

Methods: Ninety subjects (60 females, 30 males, aged 30-70 years), adequate to detect a weak-to-moderate Pearson correlation of r=0.26 at a=0.05 and power=0.80, were recruited by convenience sampling from six communities in the Klang Valley, Malaysia. Fasting blood samples were collected by finger-prick and analysed for FPG (AccuCek, Roche) and TAG (Accutrend, Roche). Macronutrient intakes, including rice, were obtained by a single interview using a previously-evaluated food frequency questionnaire (FFQ) and quantitated as grams by the DietPLUS V2 programme. Added sugar intakes by subjects were estimated using an Added Sugar Intake excel programme.

Results: Rice contributed to 85% of dietary carbohydrates, accounting for 41.8 % kcal of the average 1750-kcal diet. Rice intakes or added sugar consumption did not have a significant correlation (p>0.05) with FPG nor fasting TAG. Added sugar consumption, which averaged 44g/person/day (5% kcal) was markedly lower than the 137g/person/day reported elsewhere for the Malaysian population.

Conclusion: High consumption of rice as a risk factor of type 2 DM was not indicated in the present study. Since white rice consumption varied 10-fold in the present subjects, the reduction in daily intake of this staple food represents a feasible option for cutting back on calorie intake for overweight or obese individuals.

Keywords: Rice intake, added sugar, fasting plasma glucose, triacylglycerol.

Citation: IeJSME 2015 9(1): 26-31

DOI: https://doi.org/10.56026/imu.9.1.26

Authors: Swee Geok Lim, Aun Cyi Lim, Xiao Jing Wong.

ABSTRACT

Introduction: The prevalence of cataract surgeries ranges from 7 to 12 million cases in 2000, 20 million in 2010 and an estimation of 32 million cataract surgeries annually by the year 2020 worldwide (WHO, 2015). Traditionally, the healthcare providers were only able to give health education before the patient is discharged from the healthcare setting while follow-up can only be done when the patient comes for their follow-up. But most of the patients will remain confused or had forgotten about the post-operative care even after receiving a comprehensive discharge preparation. However, with the advancement of technologies in this modern era, nurse-led telephone follow-up can be considered as a tool to assist healthcare providers in the follow-up care in Malaysia. On the same note, a private
eye specialist organisation with centres throughout Malaysia, had taken the initiative to provide telephone follow-up service for their patients with three main objectives namely, to provide pre- and post-education on cataract surgery, to detect early post cataract surgery complications as well as to minimise anxiety among their patients. However, till date no patient feedback regarding the service was conducted.

Objective: The research objective for this study was to determine patient’s level of satisfaction with the nurse-led telephone follow-up after cataract surgery at a private eye specialist centre in Penang.

Method: A cross sectional quantitative descriptive study design was used to study ninety post cataract patients in a private hospital, Penang through universal sampling method. A validated self-developed questionnaire based on the three main objectives of the telephone follow-up service was used for this study.

Results: Overall, the level of patient’s satisfaction with nurse-led telephone follow-up after cataract surgery at a private eye specialist centre in Penang was high (49.9±4.85) especially for the health education provided (4.18 ±0.21) followed by the effort to detect early complications (4.16 ±0.12) and to minimise patients’ anxiety level (4.16 ±0.12).

Keywords: cataract surgery, level of satisfaction, nurse-led telephone follow-up, patient.

Citation: IeJSME 2018 12(2): 4-13

DOI: https://doi.org/10.56026/imu.12.2.4

Authors: Siew Eng Ho and Sok Ching Tee.

ABSTRACT

Introduction: Nurses are obligated to respond competently in the event of cardiac arrest. Nurses could be hesitant to intervene due to low self-efficacy in their ability to manage cardiac arrest patients.

Objective: The objective of this study was to determine the level of nurses’ perceived self-efficacy in cardiopulmonary resuscitation (CPR) at a private hospital in Kuala Lumpur.

Method: A cross-sectional descriptive study was conducted with 112 respondents who fulfilled the inclusion criteria. A 19 item questionnaire on Resuscitation Self-Efficacy Scale (RSES) was adapted and scored using a 5-point Likert scale.

Results: The total mean score and standard deviation of perceived self-efficacy score in resuscitation was (M = 77.68; SD ± 11.77) which indicated a high degree of self-efficacy among nurses. There were significant differences between respondents’ age groups with (t = -2.520; p = 0.013), unit of working (t = -4.086; p = 0.001), real experiences in resuscitation (t = 2.532; p = 0.013), and the number of participations in resuscitation (t=-6.668; p=0.001) and nurses perceived self-efficacy in CPR. There were also significant differences between respondents’ years of working experience with (F = 7.286; p =0.001) and types of last resuscitation training (F= 7.088; p = 0.001). However, there was no significant difference between the nurses’ time of their last resuscitation training (F = 1.225; p = 0.298) and the nurses perceived self-efficacy in CPR.

Conclusion: In conclusion, nurses were deemed to possess a high sense of self-efficacy in CPR. This study concluded that nurses’ age groups, years of working experience, unit of working, real experiences in resuscitation and the number of participations in resuscitation and types of last resuscitation training are factors contributing towards self-efficacy in CPR performances. However, the time of last resuscitation training reported no significant difference towards nurses’ perceived self-efficacy in CPR. Therefore, repetitive CPR and ACLS certification training are pivotal in order to strengthen nurse’s self-efficacy in resuscitation and team collaboration through training in this private hospital.

Keywords: Nurses, perception, self-efficacy, cardiopulmonary resuscitation.

Citation: IeJSME 2018 12(2): 14-21

DOI: https://doi.org/10.56026/imu.12.2.14

Authors: Cheong Lieng Teng, Kean Ghee Lim, Chun Yiing Ang, Soo Yin Chan, Edwin Keat Song Sam, Jason Chee Siang Wee, Yee Chiing Ong.

ABSTRACT

Introduction: This study aims to describe the content of several pre-independence medical journals published in
British Malaya.

Methods: The content of five journals were retrieved from National Library of Singapore e-resources and print collection of the Reference Library, Institute for Medical Research, Kuala Lumpur, Malaysia. The content of these journals was classified and descriptive analysis performed.

Results: The five journals identified were Journal of the Straits Medical Association, Journal of the Malaya Branch of the British Medical Association, Malaya Medical Journal, Malayan Medical Journal and Journal of the Malaya Branch of the British Medical Association (new series). A total of 81 issues with 873 articles were retrieved. Almost one-third of articles were concerned with these topics: malaria, mosquito control, beri-beri, tuberculosis, sexually transmitted diseases, helminthiasis, leprosy and cholera. One-fifth of the articles were case reports and 95% of the articles were written by single authors.

Discussion: The content of these journals is a good resource for those who are interested in the history of medicine – it provided substantial details on the state of public health and chronicled the medical writings of medical workers in British Malaya. It illustrates well the introduction of Western medicine to tackle health problems that arose from the interplay of immigration, poor environmental sanitation and economic exploitation.

Keywords: British Malaya; Health care; History of medicine; Journals.

Citation: IeJSME 2019 13(2): 23-26

DOI: https://doi.org/10.56026/imu.13.2.23

Authors: Ren Yi Kow, Mohd Jumaidi Md Hashim, Anas Nazha, Ed Simor Khan Mor Japar Khan, Chooi Leng Low.

ABSTRACT

Introduction: Solat or prayer, as one of the five pillars of Islam, is associated with bio-psycho-social benefits in Muslim patients. Many Muslim patients neglected solat while being hospitalized as they are unaware of the convenience (rukhsoh) available for them. Ibadah Friendly Hospital Courses have been conducted in different states of Malaysia to impart knowledge to the hospital staff who can in turn educate their patients. This study aims to construct a content-validated assessment tool to assess the effectiveness of a state-level Hospital Mesra Ibadah course.

Materials and methods: A self-administered questionnaire was constructed and content-validated by a panel of three experts (two religious teachers and one consultant spine surgeon). All 15 questions achieved item-level content validity index (I-CVI) of 1.00 after two rounds of validation. The questionnaires were distributed to participants of a state-level Hospital Mesra Ibadah course to compare the participants’ pre-course and post-course test scores.

Results: A total of 88 participants (48.9%) were included in this study. There was a significant difference in the pre-course test mean score and post-course test mean score among the participants. There was also a significant reduction of unsure answers after the course. There was no significant association found between the gender, place of work and occupation with the pre-post test score difference.

Conclusion: This study demonstrates that the Hospital Mesra Ibadah course is effective in imparting as well as consolidating the knowledge among participants, hence it should be routinely organized to benefit more participants.

Keywords: Prayer; Muslim; religion; medicine; quality of life.

Citation: IeJSME 2019 13(3): 3-9

DOI: https://doi.org/10.56026/imu.13.3.3

Authors: Gerard Thomas Flaherty, Lydia Sze Teng Lee, Aida Lina Alias, Hasnain Zafar Baloch, Bryan Chang Wei Lim, Kok Leong Tan, Victor Lim, Lokman Hakim Sulaiman.

ABSTRACT

Introduction: Massive open online courses (MOOCs) are designed to accommodate large numbers of geographically dispersed learners. Few healthcare students receive exposure in travel medicine. We aimed as partner medical universities to develop a novel introductory MOOC in travel medicine suitable for undergraduate healthcare students, and to evaluate it among a cohort of learners.

Methods: A course development team, comprising a senior travel medicine academic from National University of Ireland Galway, local International Medical University faculty and instructional/graphic designers, was convened in November 2017. The MOOC proposal was subsequently refined. Course construction commenced in December 2017 and involved communication between team members based in Malaysia and Ireland. Lectures were recorded in January-July 2018. Development of learning and assessment material and the pilot phase were completed in December 2019. Course evaluation was based on the results of a questionnaire and qualitative free text comments from users.

Results: The MOOC is being delivered to a multinational cohort on a rolling basis. It is organised into five four-themed units: travel health risk assessment; pre-travel health advice; tropical infectious diseases;
specialised travellers; and illness in returned travellers. Pedagogical methods include short video lectures, journal articles, a discussion forum, and self-assessment quizzes. Learners have the option of completing an online test to receive a certificate of achievement. Participant evaluation from the first run of the MOOC has revealed very high levels of satisfaction with content and mode of delivery.

Conclusions: This is the first MOOC in travel medicine and it may provide a model for development of other collaborative international e-learning courses. It will address a significant deficit in undergraduate health professional education.

Keywords: Travel medicine, global health, MOOC, medical education, e-learning.

Citation: IeJSME 2020 14 (2): 5-25

DOI: https://doi.org/10.56026/imu.14.2.5

Authors: Wei Fern Siew, Yen Ling Wong, Sheau Wei Lee.

ABSTRACT

Background: Physical examination in nursing practice is a systematic process of checking patients from head to toe using inspection, palpation, percussion, and auscultation techniques. This is part of a process to assist nurses in determining nursing diagnoses for patients’ care needs. A trained nurse with competent assessment skills can monitor treatment outcome and rapidly detect early signs of deterioration in patients.

Objective: The purpose of this study was to determine the perceived personal competence, the frequency of use of physical examination techniques, the factors that influenced physical examination practices and to identify training needs on physical examination skills among the registered nurses (RNs) in a selected private hospital in Malaysia.

Methods: This is a cross-sectional descriptive study. A self-reporting questionnaire was adapted with permission and pilot tested to ensure its suitability for use in this local study. A total of 154 registered nurses (RNs) from various clinical areas responded to this survey.

Results: The regularly used physical examination techniques by the RNs were mostly inspection and vital signs assessment. The frequency of physical examination skills used was higher among RNs with 4-5 years of working experience. Lack of time, role boundaries/scope of practice and ward culture were some of the factors identified that influenced nurses’ physical examination practices. Physical examinations of the cardiovascular, neurological and respiratory systems were the top three skills asserted as training needs by the RNs.

Conclusions: Inspection technique and vital signs checking are commonly practiced at ease by the RNs, but they perceived that they were least competent with palpation, percussion and auscultation techniques. Physical examination training is vital to ensure that the RNs keep their skills current in their nursing practice.

Keywords: Health assessment, perceived competency, influencing factors, training needs.

Citation: IeJSME 2020 14 (2): 26-37

DOI: https://doi.org/10.56026/imu.14.2.26