Authors: Shamala Ramasamy, Joo Hou Ng, Cheryl Sin Yi Tham, Serena In

Citations: IeJSME 2023 Vol 17(3): 09-12

DOI: https://doi.org/10.56026/imu.17.3.9

Authors: Eunice Chieu Teng Yap, Sushela Devi Somanath, Saatheeyavaane Bhuvanendran, Ammu Kutty Radhakrishnan

ABSTRACT

Vaccines are vital tools in public health as they play critical roles in preventing and controlling infectious diseases. Vaccine technology has advanced from virus-infected lesions to live attenuated, inactivated or killed pathogens, toxoids, and subunits that consist of only specific pathogen parts needed to elicit an immune response. The progression of virus-like particle vaccines, recombinant viral-vectored vaccines, toxoids, protein or polysaccharide-based vaccines designed to conjugate with a distinct carrier protein to enhance immune reaction is a significant milestone. However, some infectious pathogens can avoid the adaptive immune system, while traditional methods may be unsuitable against non-infectious diseases like cancer. Recent studies have demonstrated the potential of messenger RNA (mRNA) vaccines as an alternative to traditional vaccine approaches. mRNA vaccines contain mRNA that encodes the specific antigen and triggers a directed immune response. The two main forms of mRNA used in the study of mRNA vaccines are conventional non-amplifying mRNA and self-amplifying mRNA (saRNA). This article discusses the mRNA vaccine structure, delivery strategies, and protective functions, focusing on mRNA vaccines’ safety and therapeutic potential. Pre-clinical research has demonstrated the broad utility of mRNA vaccines in animal models. Human clinical trials, however, are still under validation. Hence, further studies will need to focus on adapting reliable results of preclinical trials to human applications. The evidence to date suggests that mRNA vaccines are promising next-generation vaccines and, in the future, clinical trials would transform basic research into mRNA therapeutics in medical practices.

Keywords: COVID-19, mRNA vaccine, safety, therapeutic potential, vaccination

Citations: IeJSME 2023 Vol 17(3): 13-25

DOI: https://doi.org/10.56026/imu.17.3.13

Author: Pei Kuan Lai

ABSTRACT

Introduction: Travel medicine is an emerging branch of medicine concerned with the well-beings of travellers before, during, and after travel. Pre-travel health advice and medical services are important to keep travellers healthy and ensure a safe and pleasant journey by minimising impact of illness and accidents.

Objective: This paper serves as a literature review paper on the pre-travel health advice seeking behaviours amongst travellers as well as the pre-travel health advice and medical services provided by the health professionals.

Methodology: An extensive online literature search using the search terms of “pre-travel”, “health advice”, “medical services”, and “health professionals” was done on electronic bibliographic databases including PubMed and Scopus supplemented by Google Scholar.

Results: Twenty original studies as retrieved from the online databases which fulfilled the inclusion criteria were included in the review. Prevalence of pre-travel advice seeking behaviour is reportedly low in Malaysia (36.8% – 40.5%). Studies done amongst pharmacists in Malaysia revealed that the Malaysian
pharmacists have been actively involved in providing pre-travel health advice and medical services (76.6% – 85%). High percentages of healthcare professionals in Europe and American (68% – 94.7%) provide pre-travel advice and medical services, followed by 79.5% in Saudi and 44.7% in Qatar. The top 5 topics of health advice most frequently cited were on malaria, travel insurance, sexually transmitted disease/HIV, vaccinations and first aid kit. The average duration spent for pre-travel consultation range from 5 to 30 minutes.

Conclusion: Travellers should be educated on the importance of seeking pre-travel advice and vaccinations to raise their awareness. Healthcare practitioners should be well-trained and informed to
provide good pre-travel advice and services.

Keywords: Pre-travel, health advice, medical services, travellers.

Citations: IeJSME 2022 16 (3): 12-21

DOI: https://doi.org/10.56026/imu.16.3.12

Authors: Kok Wei Poh, Shobhana Sivandan, Kwee Choy Koh.

ABSTRACT

COVID-19 caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can result in multiple complications such as long COVID syndrome, pulmonary fibrosis, and organizing pneumonia (OP). Although OP is a well-known complication of COVID-19, several challenges remain; from suspecting and confirming the diagnosis to its management. These challenges are aggravated further in patients who are critically ill and when surgical biopsy is not feasible. Post-COVID-19 OP is a subset of secondary organizing pneumonia that shares similar clinical and radiological characteristics and similar computerized tomography (CT) scan features with OP of various etiologies. In this review, we propose a clinical approach based on current available evidence for the management of COVID-19 patients with suspected OP. Typical CT findings such as consolidations, perilobular opacity, reversed halo sign and ground-glass opacities are highly suggestive of OP, but are not pathognomonic. Confirmation by histopathology should be done but when not possible, a trial of corticosteroid therapy may be considered. However, biopsy should be done if corticosteroid therapy fails or when there is clinical deterioration and worsening of hypoxia while on corticosteroid therapy especially if the onset of the symptoms is longer than two weeks.

Keywords: COVID-19; SARS-CoV-2; organizing pneumonia; corticosteroid; computerized tomography scan

Citations: IEJSME 2022 16 (2): 9-27

DOI: https://doi.org/10.56026/imu.16.2.9

Authors: Shivani Harikrishnan, Sangeetha Shyam, Suan Phaik Khoo.

ABSTRACT

Recent studies have theorised that visfatin plays a significant role in the development and progression of Type 2 Diabetes Mellitus (T2DM). Some studies indicate that levels of serum visfatin are increased in subjects with T2DM whereas other studies dispute this claim. Since the results of these studies remain inconsistent, a systematic review and meta-analysis were performed. A search of PubMed, Ebsco-MEDLINE, Scopus, ScienceDirect, and Cochrane was conducted up till February 2019. Data analysis was performed using Review Manager 5.3. The standardised mean difference (SMD) with a 95% confidence interval (CI) was used to pool the effect size. The Newcastle Ottawa scale (NOS) was used to evaluate bias in the selected studies and a funnel plot was used to assess publication bias. A total of 17 studies were included in this systematic review and meta-analysis. Overall, levels of serum visfatin in subjects with T2DM were significantly higher when compared to the healthy adults (SMD: 1.68 95% CI [1.22,2.14], p<0.00001, I2=92%). Sensitivity and subgroup analyses did not decrease heterogeneity. Among subjects with T2DM, those with additional comorbidity showed moderately increased levels of serum visfatin when compared to the subjects without comorbidity (SMD: 0.73 95% CI [0.14,1.32], p< 0.00001, I2=92%). Sensitivity and subgroup analyses performed did not significantly decrease heterogeneity. Levels of serum visfatin are increased in subjects with T2DM when compared to healthy adults. Levels of serum visfatin are increased in subjects with T2DM with comorbidity when compared to subjects with T2DM without comorbidity. However, these findings must be interpreted with caution as high heterogeneity (I2=92%) was observed.

Keywords: Serum visfatin, Type 2 Diabetes Mellitus, Systematic Review, Meta-Analysis.

Citation: IeJSME 2021 15 (3): 5-20

DOI: https://doi.org/10.56026/imu.15.3.5

Author: John Ruedy

ABSTRACT

The recent elaboration of the range of physician competencies upon which the quality of health care is dependent has fostered the development of a variety of methods of assessing medical student competencies and performance. Such assessments are essential in providing feedback to students to guide their learning and to faculty on the success of the curriculum in achieving competency outcomes. In addition they provide evidence that students have achieved minimum requirements for progressing. Well-designed Observed Structured Clinical Examinations (OSCEs), Mini-Clinical Examinations (Mini-CEXs) and some forms of Multi-Source Feedback (MSF) can meet acceptable standards of validity and reliability and are feasible. Competency assessments are limited in predicting how a student will actually act in the work situation particularly in humanistic skills. More emphasis needs to be placed on student performance, in such competencies as communication and professionalism, in a variety of settings by a number of observers.

Keywords: assessment, evaluation, clinical competence, performance, multi-source feedback.

Citation: IeJSME 2007: 1 (1): 15-21

DOI: https://doi.org/10.56026/imu.1.1.15

Authors: Stephen Arthur Hudson, John Jackson Mc Anaw, Barbara Julienne Johnson.

ABSTRACT

A clinical role for pharmacists has developed in response to the societal need to improve the use of medicines. Clinical role development has been led by initiatives in the hospital sector which have enabled Schools of Pharmacy to make shifts in the pre-graduate education of pharmacists. The increasing complexity in the management of drug therapy has given pharmacists clear roles that integrate within the healthcare team. The history is one in which the development of changing roles of pharmacists is an example of progress in healthcare delivery creating the need for revision of the curriculum for a whole profession.

Milestones in the changing roles and in the preparation of pharmacists for those roles have been; Establishment of clinical pharmacy in the US hospitals and the doctorate (PharmD) as the professional entry qualification; postgraduate clinical pharmacy education in UK and elsewhere, notably Asia and Australasia; hospital pharmacist specialisation across the wide range of medical specialties; the clinical teaching of pharmacists; the concept of ‘pharmaceutical care’ as a factor in public health; changes in Schools of Pharmacy – with professors of pharmacy practice and a shift to patient-centred teaching.

Future evolution of pharmacist roles will follow the wider use of quality systems to address errors in prescribing and drug administration; the automation of systems of drug prescribing and administration and improved documentation of care; widening of prescribing roles; increased patient education and higher patient expectations; patient-centred research in Schools of pharmacy; development of primary care and improved accessibility to pharmaceutical advice; integration of pharmacists’ public health roles in strategies to address prevention and management of disease.

Keywords: clinical pharmacy, pharmacy education, pharmaceutical care, chronic disease management, drug therapy problems, public health.

Citation: IeJSME 2007: 1 (1): 22-34

DOI: https://doi.org/10.56026/imu.1.1.22

Author: Tony Ng Kock Wai

ABSTRACT

A review of the literature indicates that food scientists and health authorities in several countries, especially member countries of the European Union, are still very concerned about the potential health hazards of oxidized products and lipid polymers formed in repeatedly-used deep frying oils. During the frying process at temperatures of 170° – 200°C, steam formed from moisture in the food being fried help volatile products rise to the surface of the frying medium and into the kitchen atmosphere, imparting a mixture of fried-flavours and off-flavours. The non-volatile compounds formed, however, gradually build up in the oil as it is being repeatedly-used for food frying operations. These non-volatiles, primarily “polar compounds” (PC) and to a lesser extent lipid polymers, get absorbed into fried foods and eventually end up in our body system. Available local data suggests that deep-frying oil samples obtained from food hawkers and those produced under simulated deep-frying conditions in the laboratory, are generally safe as they contain PC within safe limits and rarely exceed the upper limit (UL) of 25%. This contrasts with the situation in some European countries where a very high proportion of frying oil samples collected from fast-food restaurants were reported to contain PC exceeding this UL. Appropriately, promotion of Hazard Analysis and Critical Control Points (HACCP) certification and gazetting of food regulations to limit the PC content in frying oils have been introduced in these countries to protect the health of consumers. Meanwhile, simple gadgets/test kits are available commercially to monitor the quality of the frying oil. This would greatly assist kitchen supervisors at restaurants and franchised fried-food outlets to know when best to change a batch of frying oil before the ULs of frying oil quality are breached.

Keywords: Frying oils, Polar compounds, Safety.

Citation: IeJSME 2007: 1 (2): 55-60

DOI: https://doi.org/10.56026/imu.1.2.55