Issue: IeJSME 2015 9(2)

Authors: Keat Seong Teo, Cheong Wooi Cheah, Joon Wah Mak.

ABSTRACT

Background: Sensitisation to house dust mite (HDM) has been regarded as a major risk factor for development of asthma. This study was carried out to investigate the profiles of HDM sensitisation among Malaysian children with asthma.

Material and Methods: The association between HDM sensitisation and control and severity of asthma was investigated. The salivary HDM specific IgE levels were quantified in different grades of control and severity of asthma in 125 unselected asthmatic children aged 5-12 years old attending the asthma follow-up clinic in Hospital Tuanku Ja’afar Seremban. An additional 29 non-asthmatic patients were selected as control. The skin prick test to assess sensitisation to Dermatophagoides pteronyssinus (DP) and Dermatophagoides farinae (DF) was performed on all the participants. A questionnaire regarding the control and severity of asthmatic symptoms of the subject was administered. Saliva was collected by voluntary spitting and ELISA was used to quantify the IgE specific to HDM antigen.

Results: There was a significant association between sensitisation to DP and DF and the control of asthma. The association between DP sensitisation and severity of asthma just failed to reach a significant level although there is a clear trend for this. Significant association was found between DF sensitisation and severity. The HDM specific IgE in the saliva was significantly higher in asthmatic patients compared to non-asthmatic patients. There was no significant difference between the specific IgE levels in patients with different severity status of asthma.

Conclusion: Salivary IgE levels may not be an appropriate indicator of the patients’ asthmatic condition in this study. However, it can be concluded that there is significant association between the sensitisation of HDM and the control and severity of asthma.

Keywords: Dermatophagoides pteronyssinus, Dermatophagoides farina, childhood asthma, house dust mite specific-salivary IgE.

Citation: IeJSME 2015 9(2): 3-12

DOI: https://doi.org/10.56026/imu.9.2.3

Authors: Farah Syazana Ahmad Shahabuddin, Nur Hazirah Ahmat, Ahmed Ikhwan Mohamad, Kit Mun Lau, Siti Aisyah Mohd Yusof, Pei Chiek Teh, Kwee Choy Koh.

ABSTRACT

Background: Misinterpretation of abbreviations by healthcare workers has been reported to compromise patient safety. Medical students are future doctors. We explored how early medical students acquired the practice of using abbreviations, and their ability to interpret commonly used abbreviations in medical practice.

Method: Eighty junior and 74 senior medical students were surveyed using a self-administered questionnaire designed to capture demographic data; frequency and reasons for using abbreviations; from where abbreviations were learned; frequency of encountering abbreviations in medical practice; prevalence of mishaps due to misinterpretation; and the ability of students to correctly interpret commonly used abbreviations. Comparisons were made between senior and junior medical students.

Results: Abbreviation use was highly prevalent among junior and senior medical students. They acquired the habit mainly from the clinical notes of doctors in the hospital. They used abbreviations mainly to save time, space and avoid writing in full sentences. The students experienced difficulties, frustrations and often resorted to guesswork when interpreting abbreviations; with junior students experiencing these more than senior students. The latter were better at interpreting standard and non-standard abbreviations. Nevertheless, the students felt the use of abbreviations was necessary and acceptable. Only a few students reported encountering mishaps in patient management as a result of misinterpretation of abbreviations.

Conclusion: Medical students acquired the habit of using abbreviations early in their training. Senior students knew more and correctly interpreted more standard and non-standard abbreviations compared to junior students. Medical students should be taught to use standard abbreviations only.

Keywords: Abbreviations, medical students, medical practice, medical errors, patient safety.

Citation: IeJSME 2015 9(2): 13-21

DOI: https://doi.org/10.56026/imu.9.2.13

Authors: Kavana N J, Lim L H S, Ambu S.

ABSTRACT

Background: The present study describes the morphology of sparganum (larva) of the Malaysian Spirometra spp. collected from naturally infected frogs (Rana cancrivora) from rice fields in Tanjung Karang, Malaysia.

Materials and Methods: Spargana of Spirometra spp. collected from naturally infected frogs (Rana cancrivora) were used for the morphological studies. Stretched on a metal ruler, measurements of the worm were recorded. Specimens were stained in Alum-carmine.

Results: The length of the body ranged from 11-50 mm and the width ranged from 0.5-1.5 mm. Specimens stained with Alum-carmine showed ridges (formation of segments) on the surface of the body, and no sexual organs in the body.

Conclusion: The Malaysian Spirometra spp. are similar in measurement and morphology to Spirometra erinacei but further studies are required for confirmation.

Keywords: Spirometra, spargana, scolex, body, morphology.

Citation: IeJSME 2015 9(2): 22-24

DOI: https://doi.org/10.56026/imu.9.2.22

Authors: Thiruselvi Subramaniam, Rosalind Chi Neo Loo.

ABSTRACT

Introduction: Standard precautions in health care is the essence of medical practice encompassing the safety of patients and health care workers including  medical students. Barriers to the proper use of personal protective equipment (PPE) exist across the world but identification of areas of weaknesses and appropriate remedies will reduce them. This study assesses knowledge and use of PPE among fourth year students after a period of educational interventions.

Objective: To evaluate appropriate use, awareness and knowledge about PPE among fourth year students after interventions.

Method: A cross-sectional study where forty year 4 students (Group B) were randomly observed and later asked to answer a questionnaire. Students had undergone interventions to improve PPE use, which included lectures and video sessions during each posting. Results were compared with a previous group (Group A). Chi-square test or Fisher’s exact test was used to analyse the data.

Results: There was statistically significant improvement in the use of PPE like wearing and removing mask during invasive procedures (p < 0.001) and hand-washing before and after a non- invasive task (p < 0.001). Comparison of Groups A and B on the results of the questionnaire for ‘Questions in which more than 10% students answered incorrectly’, showed that there was improvement in Group B in all the questions, some being statistically significant with p value=0.01.

Conclusion: An overall improvement in the use of the PPE and knowledge was noted. Sometimes, students’ attitude and personality may be a challenge and these students may defy changes, but this can be overcome if the strategies are embedded in the curriculum and taught from as early as the first semester.

Keywords: Personal protective equipment (PPE), standard practice, patient safety, attitudes, medical students.

Citation: IeJSME 2015 9(2): 25-31

DOI: https://doi.org/10.56026/imu.9.2.25

Authors: Kean Ghee Lim, Shu Whey Chuah, Michelle Ee Shan Too, Zheng Guo Wong, Ashwin Murugesan, Syed Ameer Bin Syed Azman.

ABSTRACT

Introduction: Bekam, an Islamic variant of cupping, is an ancient form of traditional medicine still practised today in Malaysia. There are published findings indicating that cupping benefits patients with low back pain, other musculoskeletal pain and even pain from cancer, herpes zoster and trigeminal neuralgia when pain is measured on an analogue scale. We proposed to investigate whether in addition to pain improvement on an analogue scale we could show if pain relief might be demonstrated in terms of reduction of analgesic use.

Methods: We carried out a retrospective cross sectional study on subjects who had been for outpatient clinic treatment with chronic pain of at least one month and who completed at least two bekam therapy sessions. In addition to documenting a pain score before and after therapy we documented their analgesic consumption.

Results: A total of 77 respondents, with overlapping symptoms of headache, backache and joint pains were included. The mean pain score before bekam therapy was 6.74±1.78, and was 2.66±1.64 after two sessions of therapy. Twenty eight respondents completed six sessions of bekam therapy and had a mean pain score of 2.25±1.32 after. Thirty-four patients consumed analgesic medication before starting bekam therapy and only twelve did so after. The consumption of analgesics was significantly lower after bekam therapy.

Conclusions: Bekam therapy appears to help patients experience less pain and reduce the amount of analgesic medication they consume. Nevertheless only a randomised prospective study will eliminate the biases a retrospective study is encumbered with and we believe would be worth doing.

Keywords: Bekam, cupping, chronic pain, analgesic use, pain score.

Citation: IeJSME 2015 9(2): 32-36

DOI: https://doi.org/10.56026/imu.9.2.32