Background: Cerebrovascular accident is the fourth leading cause of death in Malaysia in 2022. Th... more Background: Cerebrovascular accident is the fourth leading cause of death in Malaysia in 2022. Therefore, medical students must recognize the factors associated with stroke management regarding early diagnosis and proper treatment, so no delay in the treatment, and better outcomes. The objective of this study is to assess the knowledge of International Medical University (IMU) medical students on the management of stroke from acute, hyperacute, and advanced levels. Method: A cross-sectional study of students from the IMU Clinical campus in Seremban, Kluang, and Batu Pahat was performed. A questionnaire has been constructed to collect and gather data on participants’ knowledge regarding acute stroke management, consisting of 29 true or false statements, and is adapted from The Acute Stroke Management Questionnaire (ASMaQ), which is used to measure the knowledge of acute stroke management among Malaysia healthcare professionals. Using statistical analysis, we assess the level of knowledge of IMU clinical campus junior medical students (Year 4) and senior medical students (Year 5) about stroke management. Result: A total number of 150 participants were enrolled, with 82 and 68 participants from junior and senior groups respectively. In terms of academic performance, all senior medical students and most junior medical students achieved passing marks by scoring ≥ 17 out of 29 questions correctly. Fisher Exact Test did not display a statistically significant result (p = 0.547, p < 0.05). Conclusion: The junior and senior medical students have adequate knowledge about acute stroke management. There is no significant difference in acute stroke management knowledge between junior and senior medical students in our study.
Journal of the Egyptian Society of Parasitology, 2024
Scrub typhus (Tsutsugamushi fever) is caused by Orientia tsutsugamushi (previous Rickettsia) and ... more Scrub typhus (Tsutsugamushi fever) is caused by Orientia tsutsugamushi (previous Rickettsia) and is transmitted to man by a mite vector of the Trombiculidae family (Leptotrombidium deliense and L. akamushi). Scrub typhus was confined geographically to the Asia Pacific region but now distributed in the Tsutsugamushi triangle. The patient usually presents with Eschar, a vesicular lesion at mite feeding site. Other complications are fever, maculopapular rash on the trunk, and spreading to limbs. Serious one in the form of myocarditis, pneumonia, meningoencephalitis, jaundice acute renal failure, gastrointestinal bleeding, and even acute respiratory distress syndrome may develop. The fever and eschar supported the diagnosis, which was confirmed serological by Scrub Typus IgM antibodies. The patient was improved by doxycycline injections. Doctors must be aware of zoonotic bacterial infections, which are easily treatable on early diagnosing.
Gardner's syndrome is an autosomal dominant form of polyposis characterized by the presence of mu... more Gardner's syndrome is an autosomal dominant form of polyposis characterized by the presence of multiple polyps in the colon together with extra-colonic manifestations like multiple osteomas, soft tissue tumors, and desmoid tumors (which are benign neoplasia arising from musculoaponeurotic structures throughout the body, with local aggressive nature and can cause painful abdominal mass, intestinal and ureteric obstruction leading to hydronephrosis, hemorrhage, and fistula) that occur in the mesentery and the abdominal wall. In our case, we will represent a case of 37-year-old male presents with abdominal pain on Clinical Examination we noticed epigastric mass diagnosed by core biopsy as Desmoid tumors, on physical examination, there is skull osteoma confirmed by skull X-ray and Colonoscopy did show multiple dysplastic polyps. From all the above we confirm the diagnosis of Gardner's Syndrome.
Industrialization, changing life style, newer modes of recreational sports like jet ski, buggy ri... more Industrialization, changing life style, newer modes of recreational sports like jet ski, buggy rides, donut boating has added to the woes of trauma by increasing the morbidity and mortality. Abdominal injuries occur in approximately 1% of all trauma patients. Blunt Abdominal trauma (BAT) can occur as a part of polytrauma or in isolation. Injury to the hollow viscus is less common in blunt trauma when compared to penetrating abdominal trauma. BAT can be silent initially and as time progresses can cause fatal complications. We present a case of a 21-year-old male who sustained trauma to the abdomen following hit by a donut boat. He had mild abdominal pain for 4 days. He presented to the hospital on the 5 th day and computerised tomography (CT) of the abdomen was done which was suggestive of a Gastro intestinal stromal tumour (GIST)/ Hematoma. His condition worsened in the ward and a laparotomy was performed. Intraoperatively there was transection of the ascending colon near the hepatic flexure with faecal contamination surrounded by the small bowel and the mesentery. Right hemicolectomy with double barrel stoma was done. His post-operative recovery was uneventful.
Introduction: Mental health problems are considered one of the common causes of disability in you... more Introduction: Mental health problems are considered one of the common causes of disability in young people between the ages of 15 to 44 years. Studying medicine is well established to be not easy, as medical students are subjected to greater academic and professional stress for a longer duration compared to the general population. Objective: Our study aims to assess the primary coping styles and their association with the levels of perceived stress among medical students. Methods: It is a cross-sectional study, conducted via a self-administered online questionnaire on 341 medical students at the International Medical University in Malaysia. Perceived stress levels were assessed by the Perceived Stress Scale questionnaire while the primary coping styles were determined by the Coping Orientation to Problems Experienced Inventory. Results: The emotion-focused coping style exhibited 17.99% increased utilization from low to high perceived stress levels. The avoidant focused coping style exhibited 38.80% increased utilization from low to high perceived stress levels. Conclusion: Emotion and avoidant focused coping styles are associated with higher perceived stress levels.
Annals of Clinical and Medical Case Reports & Reviews, 2023
Mauriac syndrome is one of the rare complications of type I diabetes mellitus ( It is characteriz... more Mauriac syndrome is one of the rare complications of type I diabetes mellitus ( It is characterized by marked hepatomegaly, growth puberty delay, and the presence of markedly elevated transaminases and serum lipids. It has become even less common in the post-insulin era, but it still exists especially in patients with poor insulin compliance It is important to recognize the disease as it has the potential for resolution following glycemic control. We report three adult cases presented with enlarged liver and elevated liver enzymes with poorly controlled type I diabetes mellitus A Liver biopsy was performed in all patients and revealed hepatic glycogen infiltration. All of them showed improved clinical and laboratory findings after tight glycemic control by insulin therapy. We conclude that Mauriac’s syndrome must be considered in any patient with DMI associated with hepatomegaly.
Cholelithiasis can present from a milder form of biliary colic to a more severe and complicated o... more Cholelithiasis can present from a milder form of biliary colic to a more severe and complicated one like empyema gallbladder and a lesser-known variant of gangrenous gallbladder called marbleization of the gallbladder. The clinical signs and symptoms are similar to acute cholecystitis. Diabetes mellitus could have a role in the process of marbleization. Diagnosing marbleization of the gall bladder is not easy preoperatively. Computerized tomography is a better diagnostic modality when compared to laboratory investigations. Urgent cholecystectomy is the only option, and there is no role of conservative treatment. We report a case of a 36-year-old man with newly diagnosed Diabetes Mellitus diagnosed initially as acute cholecystitis and managed conservatively. He did not respond to treatment and hence underwent cholecystectomy and intraoperatively was found to have marbleization of the gall bladder.
American Journal of Clinical and Medical Research , 2024
Background: Acute appendicitis is one of the common surgical emergencies. This study aims to high... more Background: Acute appendicitis is one of the common surgical emergencies. This study aims to highlight the variations in the Laparoscopic appendectomy (LA) techniques among Egyptian surgeons. Methods: A retrospective search of patients who underwent LA for acute appendicitis, from 1 st October 2019 to 31 st December 2019, then a group of surgeons was asked to complete a questionnaire aiming to evaluate the variation of techniques of LA & compare it against our own practice, and available literature. Results: During the period from 1 st October 2019 till 31 st December 42 patients had LA during this period at Kobri Kobba Armed Forces Hospital. Out of 120 surgeons who received the questionnaire, only 116 Surgeons responded to the questionnaire; only 41 of them have experience in LA. Conclusion: Laparoscopic appendectomy is a feasible safe technique in the management of acute appendicitis, even in complicated appendicitis. Considerable variation in techniques of LA among surgeons in Egypt.
Background: Metabolic syndrome as defined by The National Cholesterol Education Panel-Adult Treat... more Background: Metabolic syndrome as defined by The National Cholesterol Education Panel-Adult Treatment Panel III (NCEP-ATP III) is the presence of obesity, dyslipidaemia, the elevation of arterial blood pressure, and glucose intolerance. It affects 25% to 40% of the adult population of Malaysia and is associated with other medical conditions, especially cardiovascular disease. In this systematic review, the objective is to assess the effects of Nigella Sativa on parameters that reflect metabolic syndromes, such as lipid profile, blood pressure, blood glucose, and anthropometry indices. Methods: This systematic review was conducted by performing searches for relevant publications on two databases (PubMed and Scopus). The publication period was limited from January 2011 to December 2021. Cochrane collaboration tools were used for the risk of bias assessment of each trial. Result: Six out of 8 randomised controlled trials (n:776) demonstrated a significant improvement in lipid profile (p <0.05); 5 out of 7 trials (n:701) showed a significant reduction in glycaemic indices (p <0.05); 1 out of 5 trials (n:551) demonstrated significant improvements in blood pressure (p <0.05); and 2 out of 7 trials (n:705) showed a significant reduction in anthropometric measurements (p <0.05). Conclusion: Nigella Sativa has proved to have a significant positive effect on lipid profile and glycaemic index. The results showed in the parameters of blood pressure and anthropometric indices, are less convincing, as results were inconsistent across studies. Nigella Sativa can therefore be recommended as an adjunct therapy for metabolic syndrome.
International Journal of Medical Reviews and Case Reports, 2024
Background: Hernias are common surgical conditions, and hernioplasty is frequently performed. Thi... more Background: Hernias are common surgical conditions, and hernioplasty is frequently performed. This review analyzes the efficacy of various nanocoated mesh materials and different ways of mesh fixation in inguinal hernia repair. Methods: A literature search was conducted using PubMed, SCOPUS, and Google Scholar, focusing on studies from January 2018 to January 2024. Results: Meshes coated with polycaprolactone (PCL), graphene oxide (GO), and chitosan (CS) showed improved biocompatibility and antimicrobial properties. Conclusions: Nanocoated meshes, particularly those with GO, CS, and antimicrobials, are recommended for further clinical trials to confirm their benefits in reducing postoperative complications. Also, the best option for mesh fixation is either using the self-gripping meshes or fixation by stapler tacks.
American Journal of Clinical and Medical Research, 2024
Background: Accurate interpretation of electrocardiogram (ECG) abnormalities is a core competency... more Background: Accurate interpretation of electrocardiogram (ECG) abnormalities is a core competency for medical school graduates to be able to identify basic abnormalities that are commonly seen in clinical practice. Methods: A cross-sectional survey was conducted at International Medical University, medical students from third to fifth years were given an online-based questionnaire to evaluate the Electrocardiogram Competency level and its correlation with other factors such as seniority, future specialty interest, attendance of formal ECG classes, and self-study of ECG. The validity and the standard-setting of pass marks for the questionnaire were determined using the Angoff method by a panel of five qualified doctors from the medical department. Results: The total number of students that took part in the research was 150 (74 male,76 female). The students were able to interpret the primary ECG parameters such as identifying sinus rhythm, calculating the rate, and identifying the cardiac axis with percentages of 58%, 70%, and 60% respectively. For common ECG emergencies 88%, 84%, and 81% of students were able to accurately identify Hyperkalaemia, Ventricular Tachycardia, and ST elevation myocardial Infarction (STEMI)respectively, however, only 39% were able to identify hypokalaemia, 50% Ventricular Fibrillation, and 58% of 3 rddegree Atrioventricular (AV) block. For common non-emergencies, more than half of the participants were able to identify all ECGs correctly. The students achieved a score equivalent to or higher than the standard pass mark relevant to their semester with a significant P-value (P < 0.05). Conclusion: The study showed that a higher reported scale of confidence levels was directly associated with better competency in ECG interpretation skills among medical students, which is determined by many factors like self-directed learning, future specialty interests, web-based training, and attendance at formal ECG training via lectures or small group teaching.
Background: Acute appendicitis is the most common acute abdominal condition. For many decades the... more Background: Acute appendicitis is the most common acute abdominal condition. For many decades the diagnosis has depended mainly on clinical examinations, laboratory investigations such as leukocytosis, and abdominal sonography. Occasionally it can be challenging to reach the diagnosis, as there many differential diagnoses for right iliac fossa pains, especially in women. Thus, there is an encouraging demand for laboratory markers for the diagnosis. Objective: Our study aims to the assessment of total serum bilirubin level as a laboratory marker for diagnosing acute appendicitis. Methods: A prospective study collected data from 500 patients. All patients' demographic details, duration of symptoms, vital data, and blood samples were collected on admission for full blood count, and liver function tests including bilirubin. All the removed appendices will be sent for histopathological examination and were classified into 5 groups according to the histological diagnosis, variable from no pathological findings in the First group, to acute necrotizing appendicitis in the fifth group. Results: There were highly major differences between each group as regards the duration of symptoms in hours till the time of taking the samples. There was no difference between the patients regarding the temperature, and the pulse rate, but Total serum bilirubin (TSB) was ≥1.00 (mg/dl), with a sensitivity of 58% and specificity of 82%, with a diagnostic accuracy of 70%. White blood cells (WBCs) were≥11 (×103/µL), with a sensitivity of 68% specificity of 66%, and diagnostic accuracy of 67%. Conclusion: TSB is a valuable indicator of patients having acute appendicitis, with higher specificity than WBCs.
Background: Acute appendicitis is the most common acute abdominal condition. For many decades the... more Background: Acute appendicitis is the most common acute abdominal condition. For many decades the diagnosis has depended mainly on clinical examinations, laboratory investigations such as leukocytosis, and abdominal sonography. Occasionally it can be challenging to reach the diagnosis, as there many differential diagnoses for right iliac fossa pains, especially in women. Thus, there is an encouraging demand for laboratory markers for the diagnosis. Objective: Our study aims to the assessment of total serum bilirubin level as a laboratory marker for diagnosing acute appendicitis. Methods: A prospective study collected data from 500 patients. All patients' demographic details, duration of symptoms, vital data, and blood samples were collected on admission for full blood count, and liver function tests including bilirubin. All the removed appendices will be sent for histopathological examination and were classified into 5 groups according to the histological diagnosis, variable from no pathological findings in the First group, to acute necrotizing appendicitis in the fifth group. Results: There were highly major differences between each group as regards the duration of symptoms in hours till the time of taking the samples. There was no difference between the patients regarding the temperature, and the pulse rate, but Total serum bilirubin (TSB) was ≥1.00 (mg/dl), with a sensitivity of 58% and specificity of 82%, with a diagnostic accuracy of 70%. White blood cells (WBCs) were≥11 (×103/µL), with a sensitivity of 68% specificity of 66%, and diagnostic accuracy of 67%. Conclusion: TSB is a valuable indicator of patients having acute appendicitis, with higher specificity than WBCs.
Adequate knowledge of otolaryngology (Ear, Nose & Throat, ENT) for undergraduate medical students... more Adequate knowledge of otolaryngology (Ear, Nose & Throat, ENT) for undergraduate medical students and primary care providers (PCP) is vital for diagnosis and management as well as proper referral to the specialist for further management, as ENT problems are a major workload in primary care practice. In undergraduate medical study, it is vital to acquire ENT knowledge in the fourth year and sustain it in the final year and after graduation, to deliver efficient, realistic healthcare services to the population. This study was carried out to find out the sustainability of ENT knowledge in final-year International Medical University (IMU), Malaysia medical students with ENT posting in the fourth year. We also aimed to assess the adequacy of undergraduate ENT posting for the duration of two weeks. A cross-sectional study was carried out among 156 medical students from a population of 560 IMU undergraduate students. Structured knowledge-based otolaryngology (ENT) 20 multiple-choice question (MCQ) questionnaires were developed based on curriculum and validated by a panel of family medicine specialists and ENT specialists. Assessment and grading were decided by a panel of specialists using the Nedelsky method. We concluded that there was a statistical significance between the ENT knowledge of students before and after their ENT posting [t (114): -7.463, p: 0.000]. However, there was no statistically significant difference in the ENT knowledge of students who had recent ENT training and final-year students who completed their ENT training more than 6 months before.
Background: Various barriers lead to a shortage of organs for transplantation in Malaysia. One dr... more Background: Various barriers lead to a shortage of organs for transplantation in Malaysia. One drive to improve the organ donation rate operates through future healthcare practitioners and practitioner advocacy. This scoping review was carried out to establish and summarise findings about organ donation-related articles among the public, health sciences students and health personnel. A further aim was to synthesise the latest data on knowledge and attitudes towards organ donation in the Malaysian population. Methods: PubMed, Scopus, Google Scholar and the Malaysian Medical Repository (MyMedR) were used for a search conducted up to May 2022. Relevant search terms included 'Organ donation' and 'Malaysia'. Journal articles related to knowledge, attitudes and intention were grouped under the general public and health science. Students and health personnel were included. Eligible studies were reviewed by two independent reviewers. Any disagreements were resolved by consensus with a third reviewer. Results: The 31 included articles revealed an increased level of awareness among the public regarding organ donation. The analysis identified that nonrecognition of brainstem death (38.5%), no knowledge of how to contact the Organ Transplant Coordinator (82.3%) and never approaching the families of a potential donor (63.9%) led to a lack of confidence among healthcare practitioners to promote organ donation. Conclusion: The shortage of organ donors is the result of the failure to identify the expected donor, obtain consent and procure the organs due to the passivity of Malaysian health professionals in promoting the organ donation process.
Objective: Acute retention of urine is rarely caused by foreign bodies in the bladder. Various it... more Objective: Acute retention of urine is rarely caused by foreign bodies in the bladder. Various items have been retrieved from the urinary bladder which caused lower urinary tract symptoms. The reason for the foreign body in the bladder could be a result of self-introduction, iatrogenic, or migration from adjacent organs.
Patient results A 20-year-old female presented with acute retention of urine that required urinary catheterization. She had presented with lower urinary tract symptoms and was treated with antibiotics. On investigation which included a plain X-ray of the abdomen, a foreign body was seen. Digital rectal examination and pervaginal examination were normal. She underwent cystoscopy and a ballpoint pen was noted that required cystostomy.
Conclusion: Psychiatric evaluation is required in some patients especially those with high incidence of psychiatric disorders and mental retardation. Cystoscopy is an important diagnostic and therapeutic tool in such cases
Abstract
Introduction: Three of the ten most common causes of disability in people aged 15 to 44... more Abstract
Introduction: Three of the ten most common causes of disability in people aged 15 to 44 years old are mental health disorders, with the other causes significantly associated with mental health. Medical schools are well established to be stressful environments for students who are subjected to greater academic and professional stress for a longer duration compared to the general population.
Objective: This study aims to assess the primary coping styles and their association with the levels of perceived stress among medical students.
Methods: This is a cross-sectional study, conducted via a self-administered online questionnaire on 341 medical students at the International Medical University in Malaysia. Perceived stress levels were assessed by the Perceived Stress Scale questionnaire while the primary coping styles were determined by the Coping Orientation to Problems Experienced Inventory.
Results: The emotion-focused coping style exhibited a 17.99% increased utilization from low to high perceived stress levels. The avoidant focussed coping style exhibited a 38.80% increased utilization from low to high perceived stress levels.
Conclusion: Emotion and avoidant focussed coping styles are associated with higher perceived stress levels.
Postoperative ventral hernia represents one of the causes of anterior abdominal wall hernias. Rep... more Postoperative ventral hernia represents one of the causes of anterior abdominal wall hernias. Repair of this hernia can be very challenging for surgeons, as they are associated with cardiovascular and respiratory complications, development of compartment syndrome, and high recurrence rates. Our case is a 48-year-old woman was operated on twice. The first time was in 2015 due to perforation of colonic diverticulitis for which abdominal exploration and Hartmann’s procedure was performed. In 2016, the reverse of Hartmann’s procedure was done. Forty days after the second operation, she noticed a small hernia in the scar area that increased rapidly. After 1 year, it became irreducible with dimensions (30X17 cm) reached the para-umbilical region without any sign of intestinal obstruction. We decided to do hernioplasty using self-gripping mesh. Six weeks before surgery, botulinum toxin type A was injected intramuscularly to induce muscle weakness and restore the normal biomechanics of the ...
Background: Cerebrovascular accident is the fourth leading cause of death in Malaysia in 2022. Th... more Background: Cerebrovascular accident is the fourth leading cause of death in Malaysia in 2022. Therefore, medical students must recognize the factors associated with stroke management regarding early diagnosis and proper treatment, so no delay in the treatment, and better outcomes. The objective of this study is to assess the knowledge of International Medical University (IMU) medical students on the management of stroke from acute, hyperacute, and advanced levels. Method: A cross-sectional study of students from the IMU Clinical campus in Seremban, Kluang, and Batu Pahat was performed. A questionnaire has been constructed to collect and gather data on participants’ knowledge regarding acute stroke management, consisting of 29 true or false statements, and is adapted from The Acute Stroke Management Questionnaire (ASMaQ), which is used to measure the knowledge of acute stroke management among Malaysia healthcare professionals. Using statistical analysis, we assess the level of knowledge of IMU clinical campus junior medical students (Year 4) and senior medical students (Year 5) about stroke management. Result: A total number of 150 participants were enrolled, with 82 and 68 participants from junior and senior groups respectively. In terms of academic performance, all senior medical students and most junior medical students achieved passing marks by scoring ≥ 17 out of 29 questions correctly. Fisher Exact Test did not display a statistically significant result (p = 0.547, p < 0.05). Conclusion: The junior and senior medical students have adequate knowledge about acute stroke management. There is no significant difference in acute stroke management knowledge between junior and senior medical students in our study.
Journal of the Egyptian Society of Parasitology, 2024
Scrub typhus (Tsutsugamushi fever) is caused by Orientia tsutsugamushi (previous Rickettsia) and ... more Scrub typhus (Tsutsugamushi fever) is caused by Orientia tsutsugamushi (previous Rickettsia) and is transmitted to man by a mite vector of the Trombiculidae family (Leptotrombidium deliense and L. akamushi). Scrub typhus was confined geographically to the Asia Pacific region but now distributed in the Tsutsugamushi triangle. The patient usually presents with Eschar, a vesicular lesion at mite feeding site. Other complications are fever, maculopapular rash on the trunk, and spreading to limbs. Serious one in the form of myocarditis, pneumonia, meningoencephalitis, jaundice acute renal failure, gastrointestinal bleeding, and even acute respiratory distress syndrome may develop. The fever and eschar supported the diagnosis, which was confirmed serological by Scrub Typus IgM antibodies. The patient was improved by doxycycline injections. Doctors must be aware of zoonotic bacterial infections, which are easily treatable on early diagnosing.
Gardner's syndrome is an autosomal dominant form of polyposis characterized by the presence of mu... more Gardner's syndrome is an autosomal dominant form of polyposis characterized by the presence of multiple polyps in the colon together with extra-colonic manifestations like multiple osteomas, soft tissue tumors, and desmoid tumors (which are benign neoplasia arising from musculoaponeurotic structures throughout the body, with local aggressive nature and can cause painful abdominal mass, intestinal and ureteric obstruction leading to hydronephrosis, hemorrhage, and fistula) that occur in the mesentery and the abdominal wall. In our case, we will represent a case of 37-year-old male presents with abdominal pain on Clinical Examination we noticed epigastric mass diagnosed by core biopsy as Desmoid tumors, on physical examination, there is skull osteoma confirmed by skull X-ray and Colonoscopy did show multiple dysplastic polyps. From all the above we confirm the diagnosis of Gardner's Syndrome.
Industrialization, changing life style, newer modes of recreational sports like jet ski, buggy ri... more Industrialization, changing life style, newer modes of recreational sports like jet ski, buggy rides, donut boating has added to the woes of trauma by increasing the morbidity and mortality. Abdominal injuries occur in approximately 1% of all trauma patients. Blunt Abdominal trauma (BAT) can occur as a part of polytrauma or in isolation. Injury to the hollow viscus is less common in blunt trauma when compared to penetrating abdominal trauma. BAT can be silent initially and as time progresses can cause fatal complications. We present a case of a 21-year-old male who sustained trauma to the abdomen following hit by a donut boat. He had mild abdominal pain for 4 days. He presented to the hospital on the 5 th day and computerised tomography (CT) of the abdomen was done which was suggestive of a Gastro intestinal stromal tumour (GIST)/ Hematoma. His condition worsened in the ward and a laparotomy was performed. Intraoperatively there was transection of the ascending colon near the hepatic flexure with faecal contamination surrounded by the small bowel and the mesentery. Right hemicolectomy with double barrel stoma was done. His post-operative recovery was uneventful.
Introduction: Mental health problems are considered one of the common causes of disability in you... more Introduction: Mental health problems are considered one of the common causes of disability in young people between the ages of 15 to 44 years. Studying medicine is well established to be not easy, as medical students are subjected to greater academic and professional stress for a longer duration compared to the general population. Objective: Our study aims to assess the primary coping styles and their association with the levels of perceived stress among medical students. Methods: It is a cross-sectional study, conducted via a self-administered online questionnaire on 341 medical students at the International Medical University in Malaysia. Perceived stress levels were assessed by the Perceived Stress Scale questionnaire while the primary coping styles were determined by the Coping Orientation to Problems Experienced Inventory. Results: The emotion-focused coping style exhibited 17.99% increased utilization from low to high perceived stress levels. The avoidant focused coping style exhibited 38.80% increased utilization from low to high perceived stress levels. Conclusion: Emotion and avoidant focused coping styles are associated with higher perceived stress levels.
Annals of Clinical and Medical Case Reports & Reviews, 2023
Mauriac syndrome is one of the rare complications of type I diabetes mellitus ( It is characteriz... more Mauriac syndrome is one of the rare complications of type I diabetes mellitus ( It is characterized by marked hepatomegaly, growth puberty delay, and the presence of markedly elevated transaminases and serum lipids. It has become even less common in the post-insulin era, but it still exists especially in patients with poor insulin compliance It is important to recognize the disease as it has the potential for resolution following glycemic control. We report three adult cases presented with enlarged liver and elevated liver enzymes with poorly controlled type I diabetes mellitus A Liver biopsy was performed in all patients and revealed hepatic glycogen infiltration. All of them showed improved clinical and laboratory findings after tight glycemic control by insulin therapy. We conclude that Mauriac’s syndrome must be considered in any patient with DMI associated with hepatomegaly.
Cholelithiasis can present from a milder form of biliary colic to a more severe and complicated o... more Cholelithiasis can present from a milder form of biliary colic to a more severe and complicated one like empyema gallbladder and a lesser-known variant of gangrenous gallbladder called marbleization of the gallbladder. The clinical signs and symptoms are similar to acute cholecystitis. Diabetes mellitus could have a role in the process of marbleization. Diagnosing marbleization of the gall bladder is not easy preoperatively. Computerized tomography is a better diagnostic modality when compared to laboratory investigations. Urgent cholecystectomy is the only option, and there is no role of conservative treatment. We report a case of a 36-year-old man with newly diagnosed Diabetes Mellitus diagnosed initially as acute cholecystitis and managed conservatively. He did not respond to treatment and hence underwent cholecystectomy and intraoperatively was found to have marbleization of the gall bladder.
American Journal of Clinical and Medical Research , 2024
Background: Acute appendicitis is one of the common surgical emergencies. This study aims to high... more Background: Acute appendicitis is one of the common surgical emergencies. This study aims to highlight the variations in the Laparoscopic appendectomy (LA) techniques among Egyptian surgeons. Methods: A retrospective search of patients who underwent LA for acute appendicitis, from 1 st October 2019 to 31 st December 2019, then a group of surgeons was asked to complete a questionnaire aiming to evaluate the variation of techniques of LA & compare it against our own practice, and available literature. Results: During the period from 1 st October 2019 till 31 st December 42 patients had LA during this period at Kobri Kobba Armed Forces Hospital. Out of 120 surgeons who received the questionnaire, only 116 Surgeons responded to the questionnaire; only 41 of them have experience in LA. Conclusion: Laparoscopic appendectomy is a feasible safe technique in the management of acute appendicitis, even in complicated appendicitis. Considerable variation in techniques of LA among surgeons in Egypt.
Background: Metabolic syndrome as defined by The National Cholesterol Education Panel-Adult Treat... more Background: Metabolic syndrome as defined by The National Cholesterol Education Panel-Adult Treatment Panel III (NCEP-ATP III) is the presence of obesity, dyslipidaemia, the elevation of arterial blood pressure, and glucose intolerance. It affects 25% to 40% of the adult population of Malaysia and is associated with other medical conditions, especially cardiovascular disease. In this systematic review, the objective is to assess the effects of Nigella Sativa on parameters that reflect metabolic syndromes, such as lipid profile, blood pressure, blood glucose, and anthropometry indices. Methods: This systematic review was conducted by performing searches for relevant publications on two databases (PubMed and Scopus). The publication period was limited from January 2011 to December 2021. Cochrane collaboration tools were used for the risk of bias assessment of each trial. Result: Six out of 8 randomised controlled trials (n:776) demonstrated a significant improvement in lipid profile (p <0.05); 5 out of 7 trials (n:701) showed a significant reduction in glycaemic indices (p <0.05); 1 out of 5 trials (n:551) demonstrated significant improvements in blood pressure (p <0.05); and 2 out of 7 trials (n:705) showed a significant reduction in anthropometric measurements (p <0.05). Conclusion: Nigella Sativa has proved to have a significant positive effect on lipid profile and glycaemic index. The results showed in the parameters of blood pressure and anthropometric indices, are less convincing, as results were inconsistent across studies. Nigella Sativa can therefore be recommended as an adjunct therapy for metabolic syndrome.
International Journal of Medical Reviews and Case Reports, 2024
Background: Hernias are common surgical conditions, and hernioplasty is frequently performed. Thi... more Background: Hernias are common surgical conditions, and hernioplasty is frequently performed. This review analyzes the efficacy of various nanocoated mesh materials and different ways of mesh fixation in inguinal hernia repair. Methods: A literature search was conducted using PubMed, SCOPUS, and Google Scholar, focusing on studies from January 2018 to January 2024. Results: Meshes coated with polycaprolactone (PCL), graphene oxide (GO), and chitosan (CS) showed improved biocompatibility and antimicrobial properties. Conclusions: Nanocoated meshes, particularly those with GO, CS, and antimicrobials, are recommended for further clinical trials to confirm their benefits in reducing postoperative complications. Also, the best option for mesh fixation is either using the self-gripping meshes or fixation by stapler tacks.
American Journal of Clinical and Medical Research, 2024
Background: Accurate interpretation of electrocardiogram (ECG) abnormalities is a core competency... more Background: Accurate interpretation of electrocardiogram (ECG) abnormalities is a core competency for medical school graduates to be able to identify basic abnormalities that are commonly seen in clinical practice. Methods: A cross-sectional survey was conducted at International Medical University, medical students from third to fifth years were given an online-based questionnaire to evaluate the Electrocardiogram Competency level and its correlation with other factors such as seniority, future specialty interest, attendance of formal ECG classes, and self-study of ECG. The validity and the standard-setting of pass marks for the questionnaire were determined using the Angoff method by a panel of five qualified doctors from the medical department. Results: The total number of students that took part in the research was 150 (74 male,76 female). The students were able to interpret the primary ECG parameters such as identifying sinus rhythm, calculating the rate, and identifying the cardiac axis with percentages of 58%, 70%, and 60% respectively. For common ECG emergencies 88%, 84%, and 81% of students were able to accurately identify Hyperkalaemia, Ventricular Tachycardia, and ST elevation myocardial Infarction (STEMI)respectively, however, only 39% were able to identify hypokalaemia, 50% Ventricular Fibrillation, and 58% of 3 rddegree Atrioventricular (AV) block. For common non-emergencies, more than half of the participants were able to identify all ECGs correctly. The students achieved a score equivalent to or higher than the standard pass mark relevant to their semester with a significant P-value (P < 0.05). Conclusion: The study showed that a higher reported scale of confidence levels was directly associated with better competency in ECG interpretation skills among medical students, which is determined by many factors like self-directed learning, future specialty interests, web-based training, and attendance at formal ECG training via lectures or small group teaching.
Background: Acute appendicitis is the most common acute abdominal condition. For many decades the... more Background: Acute appendicitis is the most common acute abdominal condition. For many decades the diagnosis has depended mainly on clinical examinations, laboratory investigations such as leukocytosis, and abdominal sonography. Occasionally it can be challenging to reach the diagnosis, as there many differential diagnoses for right iliac fossa pains, especially in women. Thus, there is an encouraging demand for laboratory markers for the diagnosis. Objective: Our study aims to the assessment of total serum bilirubin level as a laboratory marker for diagnosing acute appendicitis. Methods: A prospective study collected data from 500 patients. All patients' demographic details, duration of symptoms, vital data, and blood samples were collected on admission for full blood count, and liver function tests including bilirubin. All the removed appendices will be sent for histopathological examination and were classified into 5 groups according to the histological diagnosis, variable from no pathological findings in the First group, to acute necrotizing appendicitis in the fifth group. Results: There were highly major differences between each group as regards the duration of symptoms in hours till the time of taking the samples. There was no difference between the patients regarding the temperature, and the pulse rate, but Total serum bilirubin (TSB) was ≥1.00 (mg/dl), with a sensitivity of 58% and specificity of 82%, with a diagnostic accuracy of 70%. White blood cells (WBCs) were≥11 (×103/µL), with a sensitivity of 68% specificity of 66%, and diagnostic accuracy of 67%. Conclusion: TSB is a valuable indicator of patients having acute appendicitis, with higher specificity than WBCs.
Background: Acute appendicitis is the most common acute abdominal condition. For many decades the... more Background: Acute appendicitis is the most common acute abdominal condition. For many decades the diagnosis has depended mainly on clinical examinations, laboratory investigations such as leukocytosis, and abdominal sonography. Occasionally it can be challenging to reach the diagnosis, as there many differential diagnoses for right iliac fossa pains, especially in women. Thus, there is an encouraging demand for laboratory markers for the diagnosis. Objective: Our study aims to the assessment of total serum bilirubin level as a laboratory marker for diagnosing acute appendicitis. Methods: A prospective study collected data from 500 patients. All patients' demographic details, duration of symptoms, vital data, and blood samples were collected on admission for full blood count, and liver function tests including bilirubin. All the removed appendices will be sent for histopathological examination and were classified into 5 groups according to the histological diagnosis, variable from no pathological findings in the First group, to acute necrotizing appendicitis in the fifth group. Results: There were highly major differences between each group as regards the duration of symptoms in hours till the time of taking the samples. There was no difference between the patients regarding the temperature, and the pulse rate, but Total serum bilirubin (TSB) was ≥1.00 (mg/dl), with a sensitivity of 58% and specificity of 82%, with a diagnostic accuracy of 70%. White blood cells (WBCs) were≥11 (×103/µL), with a sensitivity of 68% specificity of 66%, and diagnostic accuracy of 67%. Conclusion: TSB is a valuable indicator of patients having acute appendicitis, with higher specificity than WBCs.
Adequate knowledge of otolaryngology (Ear, Nose & Throat, ENT) for undergraduate medical students... more Adequate knowledge of otolaryngology (Ear, Nose & Throat, ENT) for undergraduate medical students and primary care providers (PCP) is vital for diagnosis and management as well as proper referral to the specialist for further management, as ENT problems are a major workload in primary care practice. In undergraduate medical study, it is vital to acquire ENT knowledge in the fourth year and sustain it in the final year and after graduation, to deliver efficient, realistic healthcare services to the population. This study was carried out to find out the sustainability of ENT knowledge in final-year International Medical University (IMU), Malaysia medical students with ENT posting in the fourth year. We also aimed to assess the adequacy of undergraduate ENT posting for the duration of two weeks. A cross-sectional study was carried out among 156 medical students from a population of 560 IMU undergraduate students. Structured knowledge-based otolaryngology (ENT) 20 multiple-choice question (MCQ) questionnaires were developed based on curriculum and validated by a panel of family medicine specialists and ENT specialists. Assessment and grading were decided by a panel of specialists using the Nedelsky method. We concluded that there was a statistical significance between the ENT knowledge of students before and after their ENT posting [t (114): -7.463, p: 0.000]. However, there was no statistically significant difference in the ENT knowledge of students who had recent ENT training and final-year students who completed their ENT training more than 6 months before.
Background: Various barriers lead to a shortage of organs for transplantation in Malaysia. One dr... more Background: Various barriers lead to a shortage of organs for transplantation in Malaysia. One drive to improve the organ donation rate operates through future healthcare practitioners and practitioner advocacy. This scoping review was carried out to establish and summarise findings about organ donation-related articles among the public, health sciences students and health personnel. A further aim was to synthesise the latest data on knowledge and attitudes towards organ donation in the Malaysian population. Methods: PubMed, Scopus, Google Scholar and the Malaysian Medical Repository (MyMedR) were used for a search conducted up to May 2022. Relevant search terms included 'Organ donation' and 'Malaysia'. Journal articles related to knowledge, attitudes and intention were grouped under the general public and health science. Students and health personnel were included. Eligible studies were reviewed by two independent reviewers. Any disagreements were resolved by consensus with a third reviewer. Results: The 31 included articles revealed an increased level of awareness among the public regarding organ donation. The analysis identified that nonrecognition of brainstem death (38.5%), no knowledge of how to contact the Organ Transplant Coordinator (82.3%) and never approaching the families of a potential donor (63.9%) led to a lack of confidence among healthcare practitioners to promote organ donation. Conclusion: The shortage of organ donors is the result of the failure to identify the expected donor, obtain consent and procure the organs due to the passivity of Malaysian health professionals in promoting the organ donation process.
Objective: Acute retention of urine is rarely caused by foreign bodies in the bladder. Various it... more Objective: Acute retention of urine is rarely caused by foreign bodies in the bladder. Various items have been retrieved from the urinary bladder which caused lower urinary tract symptoms. The reason for the foreign body in the bladder could be a result of self-introduction, iatrogenic, or migration from adjacent organs.
Patient results A 20-year-old female presented with acute retention of urine that required urinary catheterization. She had presented with lower urinary tract symptoms and was treated with antibiotics. On investigation which included a plain X-ray of the abdomen, a foreign body was seen. Digital rectal examination and pervaginal examination were normal. She underwent cystoscopy and a ballpoint pen was noted that required cystostomy.
Conclusion: Psychiatric evaluation is required in some patients especially those with high incidence of psychiatric disorders and mental retardation. Cystoscopy is an important diagnostic and therapeutic tool in such cases
Abstract
Introduction: Three of the ten most common causes of disability in people aged 15 to 44... more Abstract
Introduction: Three of the ten most common causes of disability in people aged 15 to 44 years old are mental health disorders, with the other causes significantly associated with mental health. Medical schools are well established to be stressful environments for students who are subjected to greater academic and professional stress for a longer duration compared to the general population.
Objective: This study aims to assess the primary coping styles and their association with the levels of perceived stress among medical students.
Methods: This is a cross-sectional study, conducted via a self-administered online questionnaire on 341 medical students at the International Medical University in Malaysia. Perceived stress levels were assessed by the Perceived Stress Scale questionnaire while the primary coping styles were determined by the Coping Orientation to Problems Experienced Inventory.
Results: The emotion-focused coping style exhibited a 17.99% increased utilization from low to high perceived stress levels. The avoidant focussed coping style exhibited a 38.80% increased utilization from low to high perceived stress levels.
Conclusion: Emotion and avoidant focussed coping styles are associated with higher perceived stress levels.
Postoperative ventral hernia represents one of the causes of anterior abdominal wall hernias. Rep... more Postoperative ventral hernia represents one of the causes of anterior abdominal wall hernias. Repair of this hernia can be very challenging for surgeons, as they are associated with cardiovascular and respiratory complications, development of compartment syndrome, and high recurrence rates. Our case is a 48-year-old woman was operated on twice. The first time was in 2015 due to perforation of colonic diverticulitis for which abdominal exploration and Hartmann’s procedure was performed. In 2016, the reverse of Hartmann’s procedure was done. Forty days after the second operation, she noticed a small hernia in the scar area that increased rapidly. After 1 year, it became irreducible with dimensions (30X17 cm) reached the para-umbilical region without any sign of intestinal obstruction. We decided to do hernioplasty using self-gripping mesh. Six weeks before surgery, botulinum toxin type A was injected intramuscularly to induce muscle weakness and restore the normal biomechanics of the ...
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Papers by Sherreen Elhariri
Method: A cross-sectional study of students from the IMU Clinical campus in Seremban, Kluang, and Batu Pahat was performed. A questionnaire has been constructed to collect and gather data on participants’ knowledge regarding acute stroke management, consisting of 29 true or false statements, and is adapted from The Acute Stroke Management Questionnaire (ASMaQ), which is used to measure the knowledge of acute stroke management among Malaysia healthcare professionals. Using statistical analysis, we assess the level of knowledge of IMU clinical campus junior medical students (Year 4) and senior medical students (Year 5) about stroke management.
Result: A total number of 150 participants were enrolled, with 82 and 68 participants from junior and senior groups respectively. In terms of academic performance, all senior medical students and most junior medical students achieved passing marks by scoring ≥ 17 out of 29 questions correctly. Fisher Exact Test did not display a statistically significant result (p = 0.547, p < 0.05).
Conclusion: The junior and senior medical students have adequate knowledge about acute stroke management. There is no significant difference in acute stroke management knowledge between junior and senior medical students in our study.
Methods: This systematic review was conducted by performing searches for relevant publications on two databases (PubMed and Scopus). The publication period was limited from January 2011 to December 2021. Cochrane collaboration tools were used for the risk of bias assessment of each trial.
Result: Six out of 8 randomised controlled trials (n:776) demonstrated a significant improvement in lipid profile (p <0.05); 5 out of 7 trials (n:701) showed a significant reduction in glycaemic indices (p <0.05); 1 out of 5 trials (n:551) demonstrated significant improvements in blood pressure (p <0.05); and 2 out of 7 trials (n:705) showed a significant reduction in anthropometric measurements (p <0.05).
Conclusion: Nigella Sativa has proved to have a significant positive effect on lipid profile and glycaemic index. The results showed in the parameters of blood pressure and anthropometric indices, are less convincing, as results were inconsistent across studies. Nigella Sativa can therefore be recommended as an adjunct therapy for metabolic syndrome.
Patient results A 20-year-old female presented with acute retention of urine that required urinary catheterization. She had presented with lower urinary tract symptoms and was treated with antibiotics. On investigation which included a plain X-ray of the abdomen, a foreign body was seen. Digital rectal examination and pervaginal examination were normal. She underwent cystoscopy and a ballpoint pen was noted that required cystostomy.
Conclusion: Psychiatric evaluation is required in some patients especially those with high incidence of psychiatric disorders and mental retardation. Cystoscopy is an important diagnostic and therapeutic tool in such cases
Keywords: Urethra, Foreign body, Urinary Bladder, Cystostomy.
Introduction: Three of the ten most common causes of disability in people aged 15 to 44 years old are mental health disorders, with the other causes significantly associated with mental health. Medical schools are well established to be stressful environments for students who are subjected to greater academic and professional stress for a longer duration compared to the general population.
Objective: This study aims to assess the primary coping styles and their association with the levels of perceived stress among medical students.
Methods: This is a cross-sectional study, conducted via a self-administered online questionnaire on 341 medical students at the International Medical University in Malaysia. Perceived stress levels were assessed by the Perceived Stress Scale questionnaire while the primary coping styles were determined by the Coping Orientation to Problems Experienced Inventory.
Results: The emotion-focused coping style exhibited a 17.99% increased utilization from low to high perceived stress levels. The avoidant focussed coping style exhibited a 38.80% increased utilization from low to high perceived stress levels.
Conclusion: Emotion and avoidant focussed coping styles are associated with higher perceived stress levels.
Method: A cross-sectional study of students from the IMU Clinical campus in Seremban, Kluang, and Batu Pahat was performed. A questionnaire has been constructed to collect and gather data on participants’ knowledge regarding acute stroke management, consisting of 29 true or false statements, and is adapted from The Acute Stroke Management Questionnaire (ASMaQ), which is used to measure the knowledge of acute stroke management among Malaysia healthcare professionals. Using statistical analysis, we assess the level of knowledge of IMU clinical campus junior medical students (Year 4) and senior medical students (Year 5) about stroke management.
Result: A total number of 150 participants were enrolled, with 82 and 68 participants from junior and senior groups respectively. In terms of academic performance, all senior medical students and most junior medical students achieved passing marks by scoring ≥ 17 out of 29 questions correctly. Fisher Exact Test did not display a statistically significant result (p = 0.547, p < 0.05).
Conclusion: The junior and senior medical students have adequate knowledge about acute stroke management. There is no significant difference in acute stroke management knowledge between junior and senior medical students in our study.
Methods: This systematic review was conducted by performing searches for relevant publications on two databases (PubMed and Scopus). The publication period was limited from January 2011 to December 2021. Cochrane collaboration tools were used for the risk of bias assessment of each trial.
Result: Six out of 8 randomised controlled trials (n:776) demonstrated a significant improvement in lipid profile (p <0.05); 5 out of 7 trials (n:701) showed a significant reduction in glycaemic indices (p <0.05); 1 out of 5 trials (n:551) demonstrated significant improvements in blood pressure (p <0.05); and 2 out of 7 trials (n:705) showed a significant reduction in anthropometric measurements (p <0.05).
Conclusion: Nigella Sativa has proved to have a significant positive effect on lipid profile and glycaemic index. The results showed in the parameters of blood pressure and anthropometric indices, are less convincing, as results were inconsistent across studies. Nigella Sativa can therefore be recommended as an adjunct therapy for metabolic syndrome.
Patient results A 20-year-old female presented with acute retention of urine that required urinary catheterization. She had presented with lower urinary tract symptoms and was treated with antibiotics. On investigation which included a plain X-ray of the abdomen, a foreign body was seen. Digital rectal examination and pervaginal examination were normal. She underwent cystoscopy and a ballpoint pen was noted that required cystostomy.
Conclusion: Psychiatric evaluation is required in some patients especially those with high incidence of psychiatric disorders and mental retardation. Cystoscopy is an important diagnostic and therapeutic tool in such cases
Keywords: Urethra, Foreign body, Urinary Bladder, Cystostomy.
Introduction: Three of the ten most common causes of disability in people aged 15 to 44 years old are mental health disorders, with the other causes significantly associated with mental health. Medical schools are well established to be stressful environments for students who are subjected to greater academic and professional stress for a longer duration compared to the general population.
Objective: This study aims to assess the primary coping styles and their association with the levels of perceived stress among medical students.
Methods: This is a cross-sectional study, conducted via a self-administered online questionnaire on 341 medical students at the International Medical University in Malaysia. Perceived stress levels were assessed by the Perceived Stress Scale questionnaire while the primary coping styles were determined by the Coping Orientation to Problems Experienced Inventory.
Results: The emotion-focused coping style exhibited a 17.99% increased utilization from low to high perceived stress levels. The avoidant focussed coping style exhibited a 38.80% increased utilization from low to high perceived stress levels.
Conclusion: Emotion and avoidant focussed coping styles are associated with higher perceived stress levels.