sweswelatt dr
Personal StatementDemonstrator in Preventive and Social Medicine Department, University of Medicine Mandalay (UMM), Myanmar in 2004. Assistant Lecturer in Preventive and Social Medicine Department, UMM in 2007. Assistant Lecturer in Medical Education Science and Information Communication Technology Department/ Environmental and Occupational Health Department, University of Public Health (UOPH), Yangon, Myanmar in 2008. Lecturer in Preventive and Social Medicine Department, UMM, in 2011. Lecturer in Preventive and Social Medicine Department, University of Medicine 2 (UM2), Yangon, in 2012. Lecturer in Community Medicine Department, Kulliyyah of Medicine, International Islamic University Malaysia (IIUM) in 2013. Senior Lecturer at Unit of Community Medicine, Faculty of Medicine at AIMST University, Kedah, Malaysia in 2016.
Supervisors: Special Study Modules Coordinator (Clinical) , Special Study Modules Supervisor (Clinical), and Faculty of Medicine Research and Human & Animal Ethical Committee (FOMRHAEC) member
Supervisors: Special Study Modules Coordinator (Clinical) , Special Study Modules Supervisor (Clinical), and Faculty of Medicine Research and Human & Animal Ethical Committee (FOMRHAEC) member
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ABSTRACT:
Introduction: The entire world is having a crisis on the attitudes and challenges faced by people in the e-learning areas. Online learning or e-learning carries the definition of having the education through an online basis. It is realized that online learning establishes various kinds of conceptions and barriers in achieving academic goals. Purpose: This study aims to assess the attitudes and challenges faced by the UNIMAS pre-clinical medical students concerning their academic achievements based on online medical education using e-learning systems. Methodology: In this study, the attitudes of students regarding the challenges faced by respondents and their experience during e-learning are measured. In the online survey conducted among pre-clinical medical students, the sample population was selected through convenience sampling technique taken from Year 1 and 2 medical students of UNIMAS, the data collected concerning their opinion about the experience during e-learning and the challenges faced by them. The sample data collected were statistically analysed using the T-test and Chi-Square test. Results: The results showed few significant correlations of some attitudes towards online learning and the challenges with regard to various socio-demographic factors. The results suggest that some socio-demographic factors affect the attitudes and challenges faced directly or indirectly. Most of the UNIMAS pre-clinical medical students showed a neutral attitude towards online learning while facing moderate challenges in this matter. There was no significant association between the majority variables of the socio-demographic with the respondents' attitudes except for the internet connectivity. Ethnicity and internet connectivity showed a true relationship with the challenges faced by the respondents during online learning. Conclusion: The study concludes no evidence of significant negativity among the students' attitudes with regard to their demographic background and internet connectivity. Although there were students who had faced difficulties with regard to online learning. The study suggests that online learning should have facilitated approaches in achieving total learning activities of students around the world, preparation of competent technical personnel, funding of facilitation, and collaboration between universities, specifically in developing countries.
Leela A3, Khaing IK3, Devaraj. S4
1Department of Public Health Medicine, RCSI and UCD Malaysia Campus, Penang, 10450, Malaysia.
ABSTRACT:
Antimicrobial resistance is a global problem that will add to the healthcare system's burden and impose an increasing threat to Public Health. This study has evaluated knowledge, attitude, and medication practice on antibiotics (AB) and identified its association with socioeconomic characteristics. A cross-sectional study was conducted using an assisted self-administered questionnaire among 105 adult respondents at a selected residential area in Kedah. A student t-test, the Pearson correlation, and regression analysis were done for the analysis. Most respondents (86.7%) were aware of AB, and 42.9% had used it in the previous year. The respondents were confused about antibiotics knowledge, implying that AB kills germs (69.5%) and viruses (48.6%). Two-thirds of the respondents, 70%, had a moderate understanding of AB, but only a few can correctly recognize AB, its side effects, and the appropriate medication. More than half of the respondents, 58% and 53%, have a positive attitude toward AB and good medication practice. However, the majority are unaware that skipping one or two doses can result in ABR. Antibiotics are still misused, as more than half of the respondents did not always complete the entire course of medication. There was a weak positive correlation between knowledge and attitude scores (p<0.01). Since the respondents have had insufficient knowledge of AB, they may misuse it in the future, leading to increased microbial resistance. It is time to educate the public about the safe use of AB through periodic health education and focus group discussions.
Background: Management of lateral condyle fracture of the humerus needs accurate reduction and stabilization because of rotational displacement. Neglected lateral condyle fractures of humerus are misdiagnosed or insufficiently treated fractures, presenting later than 3 weeks after injury. This study aimed at analyzing the morphological and functional outcomes with hospital-based prospective and descriptive clinical study design of the neglected lateral condyle fracture of humerus in children at the Yangon Children Hospital, Myanmar.
Methods: Sixty-two patients with unilateral neglected lateral condyle fractures of humerus were included in the study from January 2017 to January 2020. Seven patients had Milch’s type I fracture and 55 patients had Milch’s type II fractures. Open reduction with two smooth Kirschner wire fixation was done. Long arm plaster of Paris (POP) posterior slab was applied with the elbow at 90 degrees of flexion and forearm in a neutral position. Six weeks after the operation, the POP posterior slab and Kirschner wires were removed following a radiograph check. Thereafter, all patients were assessed both functionally and radiologically every month.
Results: The outcome of 12 months follow up data were calculated. For the radiological union time, the age group of less than 5 years and 5 years of age group achieved the bone union considerably faster than the age of 6 to 10 years of age group and above 10 years of age group. (p<0.001). According to the Hardacre Scoring System for the Clinical Evaluation, 96.7% of the patients had good and excellent outcome scores using the data of 12-month follow-up. Hardacre score of an excellent and good result was statistically significantly different from the mean age of the fair functional results with p=0.018 and p=0.039.
Conclusion: The study findings showed that open reduction and internal fixation in a majority of neglected lateral condyle fractures of the humerus in children gain good radiological and functional outcomes.
Introduction: Medical students build their clinical knowledge from previously obtained basic medical science knowledge during the pre-clinical year. The pre-clinical performances have some predictive value in the clinical discipline. Basic Medical Science (BMS) taught in pre-clinical years also supported the development of clinical reasoning skills and critical analysis of medical intervention. This study explored the preference, attitude and perception toward BMS subjects among the pre-clinical medical students. Materials and methods: An institution-based cross-sectional study was conducted among 189 pre-clinical students in a public university in East Malaysia by using the nine-scale statements questionnaires by West and co-workers. An independent sample t-test, one-way ANOVA, Pearson correlation and simple linear regression were used to analyze the data. Results: Among 10 BMS subjects, anatomy (29.1%) is the most preferred, followed by pathology (24.9%). Subject preference is influenced by the interesting curriculum with the highest frequency of 100%, followed by clinically useful (75.0%). The majority of students found poor attitude and perception in some items. There is no significant difference in attitude and perception toward BMS subjects between Year 1 and Year 2 students, male and female, different pre-university programs, students with scholarship and self-finance, and having family members in the medical field and those without. Conclusions and recommendation: Different teaching styles of medical faculty along with coordination with clinical departments may help the students to be more interested in learning medical education. Further study on the teaching techniques that aid in positive attitude and perception of pre-clinical students should be done.
Vascular access is an essential component for a successful hemodialysis program. Cannulation technique is an important factor for dialysis access survival. For patients with exhausted upper limb vascular access, lower extremity permanent dialysis vascular access (LE-PDVA) is one of the alternatives. The buttonhole cannulation (BHC) technique for LE-PDVA has never been reported in literature. Here we report on a 57-year-old endstage renal failure patient who had suffered multiple complications related to dialysis access and ended up with exhausted upper limb vascular access. The BHC technique was successfully used on his LE-PDVA for hemodialysis.
Keywords: lower extremity permanent dialysis vascular access, buttonhole cannulation technique, vascular access, hemodialysis
Keywords: assessment for learning, quiz-game, teaching-learning tool, Student-engagement, Kahoot!
Aim: Acetaminophen (paracetamol) is commonly used as analgesic and antipyretic agent. This drug is taken together with coffee sometimes but effect of drinking coffee on pharmacokinetics of oral acetaminophen is not stated. So, to explore the interaction of coffee with paracetamol is considered to avoid toxicity.
Methods: To assess the influence of coffee on the pharmacokinetic of acetaminophen, a complete one way cross-over design study was done in fifteen normal healthy male volunteers in which each subject performed as its own control. Each subject received acetaminophen (500 mg) alone followed by acetaminophen with 1g and 3g of coffee containing 65 mg and 195 mg of caffeine at 2 weeks interval. Caffeine concentration in coffee was determined by high performance liquid chromatography method (HPLC) and serum acetaminophen concentration was assayed by spectrophotometry. Acetaminophen pharmacokinetic parameters were determined.
Results: There was an increase in acetaminophen rate and extent of absorption with coffee containing 65 mg of caffeine (P < 0.001) but decrease absorption rate with drinking coffee containing 195 mg of caffeine (P < 0.001), increase maximal plasma drug concentration (Cmax) and the elimination half-life (T1/2el) were prolonged after taking acetaminophen with coffee.
Conclusion: In this study, coffee may enhance the production of optimal therapeutic effect of and prolong duration of acetaminophen action. This synergistic action might be alteration of pharmacokinetics of acetaminophen by coffee. So, acetaminophen taken together with coffee containing 65 mg and 195 mg of caffeine (one to three cups of coffee) may produce a better therapeutics outcome.
Student disrespect in higher education is a topic of increasing focus in recent times. This internal audit on faculty perception of student disrespect was conducted among the staff from the Faculty of Medicine in northern Malaysia.
Material and Methods:
A cross-sectional audit was done among the 95 staff of a private university using the online Google-form as voluntary and anonymous in nature. The descriptive statistics and inferential statistics were done by SPSS software.
Results:
The total number of respondents were 72 (76%). Of the eight responders (11%) who perceived student disrespect, seven of them perceived it among the students in clinical years. There was no significant association between the gender of the respondent and the perception on student disrespect. The themes of student disrespect were 'not following rules; not being punctual, lack of social grace or etiquette and absenteeism without prior notice'.
Conclusion:
Several studies have documented that incivility and disrespectful behaviour are often displayed in the clinical environment, which might adversely affect patient safety and promote medical students' disrespect. For the medical students to learn proper behaviour by role-modelling, the medical educators and professionals must eschew rudeness and incivility in the workplace.
Teachers need to change the approach of teaching to integrate classroom teaching by not only acquiring knowledge, but also developing critical thinking and clinical reasoning. Thus, changes are needed from the old didactic teaching. To maximize student learning, a diversity of teaching styles and a variety of methods are also needed by utilizing the present technology. This study explored the students' attitude towards the effectiveness of current teaching methods and the preferred method that gave them maximum benefit of their everyday life. A cross sectional study was carried out among 324 third and fourth year medical (204) and dental (120) students in a private medical university using a self-administered questionnaire to assess their preferences on current teaching methods. The chi-square test was carried out to elicit association of various socio demographic factors and the different types of class room teaching. Independent samples t test was used to measure between medical and dental students' attitude towards different teaching methods. The overall results of students' attitude towards effectiveness of current teaching methods were highest in video (75.1%) followed by questions (70%), problem based learning (PBL) (69.6%), discussion (69.3%), case study (67.2%), lecture (66%), power point presentation (PPT) (65.9%), quiz (60.4%), group work (56.4%), role play (49.2%) and debate (43.3%) respectively. Dental students have significantly higher mean score differences in preferences on video (0.54), PPT (0.33) and lecture (0.28) and medical students have higher mean score differences in preferences on discussion (0.34), quiz (0.50) and debate (0.30) with p <0.05. Around one third of the students' choice of best method was the standardized lecture slides with proper learning outcomes and well explanation by the lecturers. The study suggests that to shift our teaching strategies from didactic traditional teaching and recommend a combination of other methods like PBL, videos, quiz and discussions to cater the needs of the adult learning and also to make it more interesting, interactive and effective.
Methods: A cross-sectional study was conducted among 296 adult males from Felda Bukit Goh in Kuantan, Malaysia in 2015. Socioeconomic status, history of smoking, quit attempt and reasons with failing quit were explored by using a self-administered questionnaire. Level of ND was assessed by validated Malay version of the Fagerstrom Test for ND questionnaires. The chi-square test was performed to determine the associated factors of current smokers and nicotine dependence level.
Results: The prevalence rate of current smokers was 61.1% (n=181) and the prevalence of low and (moderate to high) ND level was 76.2 % (n=138) and 23.8 % (n=43) respectively. Among the current smokers, 54.1% (n=98) were tried to quit smoking, ranging from 1 to 30 times by self-awareness (48%) and their main reason to fail was an addiction (71.9%). Respondents with higher prevalence of current smoking were age group 18 to 40 years and secondary educational level with (p=0.031) and (p<0.001). The respondents with total monthly household income RM2000 and above have more likely to have moderate to high nicotine dependence compared to income less than RM2000 with p= 0.042.
Conclusion: Despite the high prevalence of current smoking, majority (76.2%) of smokers had low ND and addiction was the main reason to fail quit attempt. However, they are addicted to smoking, it is better to support the smokers who want to quit smoking starting with low level of ND. The medical professional may facilitate them to do an early assessment of the ND level before engaging in the quit smoking program and to provide tailored nicotine replacement therapy to them regardless of their socioeconomic background.
KEYWORDS: current smokers, nicotine dependence, adult males, quit smoking
Authors: SWE SWE LATT, JAMALLUDIN AR, RAZMAN MR, HTIKE MP, KARIMAH HANIM AA
The prevalence of ever e-cigarette user was 36.1%, among them 7.2 % was current user and 63.9% was never used. Regarding knowledge on e-cigarette, most students (88.7%) did not have information on harmful effect of e-cigarette on health and 36% thought that e-cigarettes are less harmful to health than normal cigarettes. The total knowledge mean (SD) score of the students was 5.23 (1.66), with a range of (0-8).
Concerning with attitude, more than half of the students (57.7%) disagreed with using e- cigarette is fun, but some students (13.4%) have mistaken belief on e-cigarette usage as fun. The total attitude mean (SD) score of the students was 11.21 (3.83), with a range of (0-15). Female students, students who never use e-cigarette and those with a high knowledge score had significantly higher attitude score compared to their counterparts.
This study highlighted that most of the students did not have background knowledge on harmful effect of e-cigarette on health. Besides some students have misconception on e-cigarette usage as fun. School health education programme and lifestyle modification activities should be intensified in order to increase the students’ knowledge, and to motivate them to adopt and maintain healthy practices.
Keywords: e-cigarette, secondary school students, harmful, misconception
Methods: A cross-sectional descriptive study was done at IIUM, Kuantan Campus, Pahang in July 2015. A total of 103 first year medical students was organized purposely. Internet addiction of the participants was assessed using online questionnaires containing Internet Addiction Test-20. Benefits (7-items) and disadvantages (5-items) Internet usage from Islamic perspective was analysed with (12) relevant questionnaires pertaining basic themes of Islam such as, “Islamic Religion, Ibadah, Greeting, Social Responsibility, Muslim’s Issues, Ummah, Daw’ah, Islamic Business, Al Quran, Hadith, Sunna, Islamic Study”.
Results: Prevalence of normal (5.8%, n=6), mild IA (48.5%, n=50), moderate IA (44.7%, n=46) and severe IA (1%, n=1) were resulted respectively. Mean (SD) age of students was 20.9 (0.5) years, 35.9% male, 64.1% female, 96.1% residents at dormitory, 48.5% using the Internet more than 7 years, 64.1% spend on line 2 to 5 hours/day and 78.6% Smartphone users. Regarding Islamic perspective, 80% of the users acknowledged that Internet usage can provide benefits in enhancing Islamic knowledge, while 20% disagreed with regarding positive Internet usages. For negative usages of the Internet, 60% of the users approved as negative and 40% recognized as it was beneficial.
Conclusion: Internet usage has been proven to be beneficial to all Muslims and it can be an effective tool for Dawah activities, but it is highly recommended that it has to be utilized with a great caution while keeping the importance of the concept of Islamic teaching.
Key words: Internet Addiction, Islamic perspective, medical student, misconception, Dawah
Introduction: With increasing number of dengue cases in Malaysia, it's of utmost importance that immediate action be taken to limit the epidemic. Since dengue control is a behavioural problem, the knowledge, attitude and practice in population needs to be studied in order to control the disease.
Objective: The aim of this study is to assess knowledge, attitude and practice regarding dengue and its associated factors among adult residents of Felda Sungai Panching Timur (SPT), Kuantan, Pahang, 2014.
Methodology: A cross sectional study was carried out involving 265 adult respondents. A face to face interview questionnaire which was divided into 2 parts (Part A: Sociodemographic; Part B: Knowledge, Attitude and Practice) was used. Data was analysed using descriptive statistics, simple and multiple logistic regression.
Results: 53.2% of the respondents had good knowledge about dengue and it was found that the main source of information was form mass media (76.6%). However, only 43.4% were found to have good attitude towards dengue. Multiple Logistic Regression analysis showed that there was no association between sociodemographic characteristics with the level of knowledge and attitude towards dengue. There was also no association found between knowledge of dengue and the attitude of the respondents towards dengue. Descriptive analysis on the practice of dengue showed majority of the respondents who had possible breeding site for Aedes mosquitoes (water container, drains/gutter/roof/flower pots/ tires) int heir compound practiced good habit in preventing the Aedes mosquitoes from breed.
Conclusion: Although knowledge and practice towards dengue is good, their attitude requires improvement.
Abstract:
Introduction: Eating disorders are a poorly understood condition characterised by severe psychiatric and medical manifestations, in which eating habits, physical health and psychosocial functioning are disturbed. College and university students are among the population who are prone to eating disorder. The aim of this study is to determine the prevalence of eating disorders risk in the International Islamic University Malaysia (IIUM), Kuantan campus amongst the medical students and to identify its associated factors. Materials and Methods: A cross sectional study involving 200 medical students of IIUM Kuantan campus session 2014/2015 of all years (20-26 years old) of both genders using a self-administered questionnaire through an online website which is a Google drive between 29th June till 10th July 2015. Result: This study revealed that the prevalence of risk for eating disorder among IIUM Kuantan campus medical students is 15.0 percent. On the same note, the risk is noted to be higher among single female of Malay ethnicity, being middle child, overweight and physically inactive; albeit none of these factors significantly associated with risk of eating disorder among this population. Conclusion: The prevalence of those who have the risk of eating disorder in this study is comparable to the result from the previous studies conducted among college and university students in Malaysia. Nevertheless, the risk of eating disorder is documented among IIUM medical students and warrant a closer look and appropriate reference for those who have the risk.
Tin Myo Han*, Swe Swe Latt**, Iskandar Firzada Osman***, Thuraiappah DM****, Aung Gyi*****, Mohd Aznan Md Aris******, Fa'iza Abdullah******, Tin Tin Aye*******
*Medical Statistics Unit, Kulliyyah of Dentistry, International Islamic University Malaysia, **Community Medicine Department, Kulliyyah of Medicine, International Islamic University Malaysia (IIUM), ***Klinik Kesihatan Jaya Gading, Kuantan, ****Primary Care Department, Faculty of Medicine, MAHSA University, Kuala Lumpur, *****Pathology and Laboratory Medicine Department, Kulliyyah of Medicine, International Islamic University Malaysia, ******Family Medicine Department, Kulliyyah of Medicine, International Islamic University Malaysia, *******Department of Community& Family Medicine, Faculty of Medicine and Health, University Malaysia Sabah
ABSTRACT
Introduction: ASEAN countries are included in the 30 most highly dengue endemic countries in the World. Evaluation of the accuracy of dengue diagnostic tests is essential for clinical management, surveillance, control activities and vaccine development. Aim of this study is to review the accuracy of diagnosis tests used for POCT for dengue infection.
Methods: The accuracy results of 31 dengue diagnosis tests in 5308 ASEAN patients except Brunei were extracted from 14 articles published between 2007 and 2014. Rapid diagnosis tests (RDT) and WHO-Clinical criteria were considered for POCT. ELISA tests with/without WHO-Clinical criteria were included in meta-analysis. Pooled sensitivity (SN) and specificity (SP) were computed. Egger-bias was analysed for publication bias.
Results: Pooled (range) SN of NS1(RDT), IgM/IgG(RDT), NS1+IgM/IgG (RDT) and WHO-Clinical criteria were 65% (44-79), 14% (3-50), 80% (69-86) and 93% (80-97) while SP (range) of those tests were 99% (96-100), 97% (93-99), 96% (84-98) and 34% (20-57) respectively. Pooled (range) of SN and SP of NS1 (ELISA) were 64% (45-82) and 99% (93-100. SN/SP (95% CI) of IgM/IgG (ELISA) were 50% (40-60) / 100% (96-100) and those of NS1+IgM/IgG (ELISA) were 94% (89-97)/92 % (81-97) and those of NS1+IgM/IgG (ELISA) with WHO-Clinical criteria were 91% (86-95)/ 94 % (84-98) respectively. Egger-bias was significant (p<0.0001).
Discussion and conclusion: Both RDT and ELISA tests have high SP to rule in dengue diagnosis. Wide range of SN value (WHO-Clinical Criteria vs IgM/IgG RDT) highlighted to improve SN of the tests for ruling out. Added value of dengue epidemic information in the accuracy of the tests should be verified. A multi-centre study with a standardised protocol should be conducted for diagnostic test accuracy variation for POCT among ASEAN patients.
Key words: Meta-analysis, accuracy, dengue diagnostic tests, ASEAN countries, POCT
Abstract:
The aim of study was to compare effectiveness of three different health education interventions to obtain proper hand washing (PHW) knowledge (why, when to wash) and practices (how to wash) among selected Myanmar preschoolers. A Quasi-experimental study was conducted among 60 preschoolers aged between 3-5 years in Mandalay, in 2006. The 20 children in each group were allocated for the 3 interventions (Group-A, Group-B and Group-C). Matching on child age, gender and socio-demographic status of parents was considered in allocation of the children for grouping. The participatory style learning using poem & gesture in group-A, 10 minutes video show to group-B and selected trained five children for peer demonstration to group-C regarding PHW based on WHO-guideline were intervened for 1month.The knowledge level score was assessed using pre-structured questionnaires in face to face interview and practice score was assessed by the checklists. Total knowledge, practices and grand total knowledge and practices score (GTKPS) was transformed into the score (%). Chi-square test, paired "t" test and ANOVA were used to compare the effectiveness of 3 interventions and matching of the groups. The total knowledge and practices mean scores (%) of the preschoolers on PHW were increased significantly in all 3 groups after interventions. The highest mean score differences (%) of GTKPS before and after the intervention was noticed in group-C (49.4±12), comparing with group-A (47±17.6) and group-B (33.3±17.6). In Scheffe post-hoc test comparison, although, significant difference of GTKPS (%) was found between Group-A and Group B with 4.1 % and between Group-C and Group-B with 4.7%, there was no significant difference between Group-A and Group-C with 0.7%. The comparison results pointed out that peer demonstration and poem & gesture were more the effective edutainment interventions than the education video show for the Myanmar preschoolers to obtain the proper hand washing knowledge and practices.
Key words:
Proper hand washing, effectiveness, health education interventions, Preschoolers, Myanmar
ABSTRACT:
Introduction: The entire world is having a crisis on the attitudes and challenges faced by people in the e-learning areas. Online learning or e-learning carries the definition of having the education through an online basis. It is realized that online learning establishes various kinds of conceptions and barriers in achieving academic goals. Purpose: This study aims to assess the attitudes and challenges faced by the UNIMAS pre-clinical medical students concerning their academic achievements based on online medical education using e-learning systems. Methodology: In this study, the attitudes of students regarding the challenges faced by respondents and their experience during e-learning are measured. In the online survey conducted among pre-clinical medical students, the sample population was selected through convenience sampling technique taken from Year 1 and 2 medical students of UNIMAS, the data collected concerning their opinion about the experience during e-learning and the challenges faced by them. The sample data collected were statistically analysed using the T-test and Chi-Square test. Results: The results showed few significant correlations of some attitudes towards online learning and the challenges with regard to various socio-demographic factors. The results suggest that some socio-demographic factors affect the attitudes and challenges faced directly or indirectly. Most of the UNIMAS pre-clinical medical students showed a neutral attitude towards online learning while facing moderate challenges in this matter. There was no significant association between the majority variables of the socio-demographic with the respondents' attitudes except for the internet connectivity. Ethnicity and internet connectivity showed a true relationship with the challenges faced by the respondents during online learning. Conclusion: The study concludes no evidence of significant negativity among the students' attitudes with regard to their demographic background and internet connectivity. Although there were students who had faced difficulties with regard to online learning. The study suggests that online learning should have facilitated approaches in achieving total learning activities of students around the world, preparation of competent technical personnel, funding of facilitation, and collaboration between universities, specifically in developing countries.
Leela A3, Khaing IK3, Devaraj. S4
1Department of Public Health Medicine, RCSI and UCD Malaysia Campus, Penang, 10450, Malaysia.
ABSTRACT:
Antimicrobial resistance is a global problem that will add to the healthcare system's burden and impose an increasing threat to Public Health. This study has evaluated knowledge, attitude, and medication practice on antibiotics (AB) and identified its association with socioeconomic characteristics. A cross-sectional study was conducted using an assisted self-administered questionnaire among 105 adult respondents at a selected residential area in Kedah. A student t-test, the Pearson correlation, and regression analysis were done for the analysis. Most respondents (86.7%) were aware of AB, and 42.9% had used it in the previous year. The respondents were confused about antibiotics knowledge, implying that AB kills germs (69.5%) and viruses (48.6%). Two-thirds of the respondents, 70%, had a moderate understanding of AB, but only a few can correctly recognize AB, its side effects, and the appropriate medication. More than half of the respondents, 58% and 53%, have a positive attitude toward AB and good medication practice. However, the majority are unaware that skipping one or two doses can result in ABR. Antibiotics are still misused, as more than half of the respondents did not always complete the entire course of medication. There was a weak positive correlation between knowledge and attitude scores (p<0.01). Since the respondents have had insufficient knowledge of AB, they may misuse it in the future, leading to increased microbial resistance. It is time to educate the public about the safe use of AB through periodic health education and focus group discussions.
Background: Management of lateral condyle fracture of the humerus needs accurate reduction and stabilization because of rotational displacement. Neglected lateral condyle fractures of humerus are misdiagnosed or insufficiently treated fractures, presenting later than 3 weeks after injury. This study aimed at analyzing the morphological and functional outcomes with hospital-based prospective and descriptive clinical study design of the neglected lateral condyle fracture of humerus in children at the Yangon Children Hospital, Myanmar.
Methods: Sixty-two patients with unilateral neglected lateral condyle fractures of humerus were included in the study from January 2017 to January 2020. Seven patients had Milch’s type I fracture and 55 patients had Milch’s type II fractures. Open reduction with two smooth Kirschner wire fixation was done. Long arm plaster of Paris (POP) posterior slab was applied with the elbow at 90 degrees of flexion and forearm in a neutral position. Six weeks after the operation, the POP posterior slab and Kirschner wires were removed following a radiograph check. Thereafter, all patients were assessed both functionally and radiologically every month.
Results: The outcome of 12 months follow up data were calculated. For the radiological union time, the age group of less than 5 years and 5 years of age group achieved the bone union considerably faster than the age of 6 to 10 years of age group and above 10 years of age group. (p<0.001). According to the Hardacre Scoring System for the Clinical Evaluation, 96.7% of the patients had good and excellent outcome scores using the data of 12-month follow-up. Hardacre score of an excellent and good result was statistically significantly different from the mean age of the fair functional results with p=0.018 and p=0.039.
Conclusion: The study findings showed that open reduction and internal fixation in a majority of neglected lateral condyle fractures of the humerus in children gain good radiological and functional outcomes.
Introduction: Medical students build their clinical knowledge from previously obtained basic medical science knowledge during the pre-clinical year. The pre-clinical performances have some predictive value in the clinical discipline. Basic Medical Science (BMS) taught in pre-clinical years also supported the development of clinical reasoning skills and critical analysis of medical intervention. This study explored the preference, attitude and perception toward BMS subjects among the pre-clinical medical students. Materials and methods: An institution-based cross-sectional study was conducted among 189 pre-clinical students in a public university in East Malaysia by using the nine-scale statements questionnaires by West and co-workers. An independent sample t-test, one-way ANOVA, Pearson correlation and simple linear regression were used to analyze the data. Results: Among 10 BMS subjects, anatomy (29.1%) is the most preferred, followed by pathology (24.9%). Subject preference is influenced by the interesting curriculum with the highest frequency of 100%, followed by clinically useful (75.0%). The majority of students found poor attitude and perception in some items. There is no significant difference in attitude and perception toward BMS subjects between Year 1 and Year 2 students, male and female, different pre-university programs, students with scholarship and self-finance, and having family members in the medical field and those without. Conclusions and recommendation: Different teaching styles of medical faculty along with coordination with clinical departments may help the students to be more interested in learning medical education. Further study on the teaching techniques that aid in positive attitude and perception of pre-clinical students should be done.
Vascular access is an essential component for a successful hemodialysis program. Cannulation technique is an important factor for dialysis access survival. For patients with exhausted upper limb vascular access, lower extremity permanent dialysis vascular access (LE-PDVA) is one of the alternatives. The buttonhole cannulation (BHC) technique for LE-PDVA has never been reported in literature. Here we report on a 57-year-old endstage renal failure patient who had suffered multiple complications related to dialysis access and ended up with exhausted upper limb vascular access. The BHC technique was successfully used on his LE-PDVA for hemodialysis.
Keywords: lower extremity permanent dialysis vascular access, buttonhole cannulation technique, vascular access, hemodialysis
Keywords: assessment for learning, quiz-game, teaching-learning tool, Student-engagement, Kahoot!
Aim: Acetaminophen (paracetamol) is commonly used as analgesic and antipyretic agent. This drug is taken together with coffee sometimes but effect of drinking coffee on pharmacokinetics of oral acetaminophen is not stated. So, to explore the interaction of coffee with paracetamol is considered to avoid toxicity.
Methods: To assess the influence of coffee on the pharmacokinetic of acetaminophen, a complete one way cross-over design study was done in fifteen normal healthy male volunteers in which each subject performed as its own control. Each subject received acetaminophen (500 mg) alone followed by acetaminophen with 1g and 3g of coffee containing 65 mg and 195 mg of caffeine at 2 weeks interval. Caffeine concentration in coffee was determined by high performance liquid chromatography method (HPLC) and serum acetaminophen concentration was assayed by spectrophotometry. Acetaminophen pharmacokinetic parameters were determined.
Results: There was an increase in acetaminophen rate and extent of absorption with coffee containing 65 mg of caffeine (P < 0.001) but decrease absorption rate with drinking coffee containing 195 mg of caffeine (P < 0.001), increase maximal plasma drug concentration (Cmax) and the elimination half-life (T1/2el) were prolonged after taking acetaminophen with coffee.
Conclusion: In this study, coffee may enhance the production of optimal therapeutic effect of and prolong duration of acetaminophen action. This synergistic action might be alteration of pharmacokinetics of acetaminophen by coffee. So, acetaminophen taken together with coffee containing 65 mg and 195 mg of caffeine (one to three cups of coffee) may produce a better therapeutics outcome.
Student disrespect in higher education is a topic of increasing focus in recent times. This internal audit on faculty perception of student disrespect was conducted among the staff from the Faculty of Medicine in northern Malaysia.
Material and Methods:
A cross-sectional audit was done among the 95 staff of a private university using the online Google-form as voluntary and anonymous in nature. The descriptive statistics and inferential statistics were done by SPSS software.
Results:
The total number of respondents were 72 (76%). Of the eight responders (11%) who perceived student disrespect, seven of them perceived it among the students in clinical years. There was no significant association between the gender of the respondent and the perception on student disrespect. The themes of student disrespect were 'not following rules; not being punctual, lack of social grace or etiquette and absenteeism without prior notice'.
Conclusion:
Several studies have documented that incivility and disrespectful behaviour are often displayed in the clinical environment, which might adversely affect patient safety and promote medical students' disrespect. For the medical students to learn proper behaviour by role-modelling, the medical educators and professionals must eschew rudeness and incivility in the workplace.
Teachers need to change the approach of teaching to integrate classroom teaching by not only acquiring knowledge, but also developing critical thinking and clinical reasoning. Thus, changes are needed from the old didactic teaching. To maximize student learning, a diversity of teaching styles and a variety of methods are also needed by utilizing the present technology. This study explored the students' attitude towards the effectiveness of current teaching methods and the preferred method that gave them maximum benefit of their everyday life. A cross sectional study was carried out among 324 third and fourth year medical (204) and dental (120) students in a private medical university using a self-administered questionnaire to assess their preferences on current teaching methods. The chi-square test was carried out to elicit association of various socio demographic factors and the different types of class room teaching. Independent samples t test was used to measure between medical and dental students' attitude towards different teaching methods. The overall results of students' attitude towards effectiveness of current teaching methods were highest in video (75.1%) followed by questions (70%), problem based learning (PBL) (69.6%), discussion (69.3%), case study (67.2%), lecture (66%), power point presentation (PPT) (65.9%), quiz (60.4%), group work (56.4%), role play (49.2%) and debate (43.3%) respectively. Dental students have significantly higher mean score differences in preferences on video (0.54), PPT (0.33) and lecture (0.28) and medical students have higher mean score differences in preferences on discussion (0.34), quiz (0.50) and debate (0.30) with p <0.05. Around one third of the students' choice of best method was the standardized lecture slides with proper learning outcomes and well explanation by the lecturers. The study suggests that to shift our teaching strategies from didactic traditional teaching and recommend a combination of other methods like PBL, videos, quiz and discussions to cater the needs of the adult learning and also to make it more interesting, interactive and effective.
Methods: A cross-sectional study was conducted among 296 adult males from Felda Bukit Goh in Kuantan, Malaysia in 2015. Socioeconomic status, history of smoking, quit attempt and reasons with failing quit were explored by using a self-administered questionnaire. Level of ND was assessed by validated Malay version of the Fagerstrom Test for ND questionnaires. The chi-square test was performed to determine the associated factors of current smokers and nicotine dependence level.
Results: The prevalence rate of current smokers was 61.1% (n=181) and the prevalence of low and (moderate to high) ND level was 76.2 % (n=138) and 23.8 % (n=43) respectively. Among the current smokers, 54.1% (n=98) were tried to quit smoking, ranging from 1 to 30 times by self-awareness (48%) and their main reason to fail was an addiction (71.9%). Respondents with higher prevalence of current smoking were age group 18 to 40 years and secondary educational level with (p=0.031) and (p<0.001). The respondents with total monthly household income RM2000 and above have more likely to have moderate to high nicotine dependence compared to income less than RM2000 with p= 0.042.
Conclusion: Despite the high prevalence of current smoking, majority (76.2%) of smokers had low ND and addiction was the main reason to fail quit attempt. However, they are addicted to smoking, it is better to support the smokers who want to quit smoking starting with low level of ND. The medical professional may facilitate them to do an early assessment of the ND level before engaging in the quit smoking program and to provide tailored nicotine replacement therapy to them regardless of their socioeconomic background.
KEYWORDS: current smokers, nicotine dependence, adult males, quit smoking
Authors: SWE SWE LATT, JAMALLUDIN AR, RAZMAN MR, HTIKE MP, KARIMAH HANIM AA
The prevalence of ever e-cigarette user was 36.1%, among them 7.2 % was current user and 63.9% was never used. Regarding knowledge on e-cigarette, most students (88.7%) did not have information on harmful effect of e-cigarette on health and 36% thought that e-cigarettes are less harmful to health than normal cigarettes. The total knowledge mean (SD) score of the students was 5.23 (1.66), with a range of (0-8).
Concerning with attitude, more than half of the students (57.7%) disagreed with using e- cigarette is fun, but some students (13.4%) have mistaken belief on e-cigarette usage as fun. The total attitude mean (SD) score of the students was 11.21 (3.83), with a range of (0-15). Female students, students who never use e-cigarette and those with a high knowledge score had significantly higher attitude score compared to their counterparts.
This study highlighted that most of the students did not have background knowledge on harmful effect of e-cigarette on health. Besides some students have misconception on e-cigarette usage as fun. School health education programme and lifestyle modification activities should be intensified in order to increase the students’ knowledge, and to motivate them to adopt and maintain healthy practices.
Keywords: e-cigarette, secondary school students, harmful, misconception
Methods: A cross-sectional descriptive study was done at IIUM, Kuantan Campus, Pahang in July 2015. A total of 103 first year medical students was organized purposely. Internet addiction of the participants was assessed using online questionnaires containing Internet Addiction Test-20. Benefits (7-items) and disadvantages (5-items) Internet usage from Islamic perspective was analysed with (12) relevant questionnaires pertaining basic themes of Islam such as, “Islamic Religion, Ibadah, Greeting, Social Responsibility, Muslim’s Issues, Ummah, Daw’ah, Islamic Business, Al Quran, Hadith, Sunna, Islamic Study”.
Results: Prevalence of normal (5.8%, n=6), mild IA (48.5%, n=50), moderate IA (44.7%, n=46) and severe IA (1%, n=1) were resulted respectively. Mean (SD) age of students was 20.9 (0.5) years, 35.9% male, 64.1% female, 96.1% residents at dormitory, 48.5% using the Internet more than 7 years, 64.1% spend on line 2 to 5 hours/day and 78.6% Smartphone users. Regarding Islamic perspective, 80% of the users acknowledged that Internet usage can provide benefits in enhancing Islamic knowledge, while 20% disagreed with regarding positive Internet usages. For negative usages of the Internet, 60% of the users approved as negative and 40% recognized as it was beneficial.
Conclusion: Internet usage has been proven to be beneficial to all Muslims and it can be an effective tool for Dawah activities, but it is highly recommended that it has to be utilized with a great caution while keeping the importance of the concept of Islamic teaching.
Key words: Internet Addiction, Islamic perspective, medical student, misconception, Dawah
Introduction: With increasing number of dengue cases in Malaysia, it's of utmost importance that immediate action be taken to limit the epidemic. Since dengue control is a behavioural problem, the knowledge, attitude and practice in population needs to be studied in order to control the disease.
Objective: The aim of this study is to assess knowledge, attitude and practice regarding dengue and its associated factors among adult residents of Felda Sungai Panching Timur (SPT), Kuantan, Pahang, 2014.
Methodology: A cross sectional study was carried out involving 265 adult respondents. A face to face interview questionnaire which was divided into 2 parts (Part A: Sociodemographic; Part B: Knowledge, Attitude and Practice) was used. Data was analysed using descriptive statistics, simple and multiple logistic regression.
Results: 53.2% of the respondents had good knowledge about dengue and it was found that the main source of information was form mass media (76.6%). However, only 43.4% were found to have good attitude towards dengue. Multiple Logistic Regression analysis showed that there was no association between sociodemographic characteristics with the level of knowledge and attitude towards dengue. There was also no association found between knowledge of dengue and the attitude of the respondents towards dengue. Descriptive analysis on the practice of dengue showed majority of the respondents who had possible breeding site for Aedes mosquitoes (water container, drains/gutter/roof/flower pots/ tires) int heir compound practiced good habit in preventing the Aedes mosquitoes from breed.
Conclusion: Although knowledge and practice towards dengue is good, their attitude requires improvement.
Abstract:
Introduction: Eating disorders are a poorly understood condition characterised by severe psychiatric and medical manifestations, in which eating habits, physical health and psychosocial functioning are disturbed. College and university students are among the population who are prone to eating disorder. The aim of this study is to determine the prevalence of eating disorders risk in the International Islamic University Malaysia (IIUM), Kuantan campus amongst the medical students and to identify its associated factors. Materials and Methods: A cross sectional study involving 200 medical students of IIUM Kuantan campus session 2014/2015 of all years (20-26 years old) of both genders using a self-administered questionnaire through an online website which is a Google drive between 29th June till 10th July 2015. Result: This study revealed that the prevalence of risk for eating disorder among IIUM Kuantan campus medical students is 15.0 percent. On the same note, the risk is noted to be higher among single female of Malay ethnicity, being middle child, overweight and physically inactive; albeit none of these factors significantly associated with risk of eating disorder among this population. Conclusion: The prevalence of those who have the risk of eating disorder in this study is comparable to the result from the previous studies conducted among college and university students in Malaysia. Nevertheless, the risk of eating disorder is documented among IIUM medical students and warrant a closer look and appropriate reference for those who have the risk.
Tin Myo Han*, Swe Swe Latt**, Iskandar Firzada Osman***, Thuraiappah DM****, Aung Gyi*****, Mohd Aznan Md Aris******, Fa'iza Abdullah******, Tin Tin Aye*******
*Medical Statistics Unit, Kulliyyah of Dentistry, International Islamic University Malaysia, **Community Medicine Department, Kulliyyah of Medicine, International Islamic University Malaysia (IIUM), ***Klinik Kesihatan Jaya Gading, Kuantan, ****Primary Care Department, Faculty of Medicine, MAHSA University, Kuala Lumpur, *****Pathology and Laboratory Medicine Department, Kulliyyah of Medicine, International Islamic University Malaysia, ******Family Medicine Department, Kulliyyah of Medicine, International Islamic University Malaysia, *******Department of Community& Family Medicine, Faculty of Medicine and Health, University Malaysia Sabah
ABSTRACT
Introduction: ASEAN countries are included in the 30 most highly dengue endemic countries in the World. Evaluation of the accuracy of dengue diagnostic tests is essential for clinical management, surveillance, control activities and vaccine development. Aim of this study is to review the accuracy of diagnosis tests used for POCT for dengue infection.
Methods: The accuracy results of 31 dengue diagnosis tests in 5308 ASEAN patients except Brunei were extracted from 14 articles published between 2007 and 2014. Rapid diagnosis tests (RDT) and WHO-Clinical criteria were considered for POCT. ELISA tests with/without WHO-Clinical criteria were included in meta-analysis. Pooled sensitivity (SN) and specificity (SP) were computed. Egger-bias was analysed for publication bias.
Results: Pooled (range) SN of NS1(RDT), IgM/IgG(RDT), NS1+IgM/IgG (RDT) and WHO-Clinical criteria were 65% (44-79), 14% (3-50), 80% (69-86) and 93% (80-97) while SP (range) of those tests were 99% (96-100), 97% (93-99), 96% (84-98) and 34% (20-57) respectively. Pooled (range) of SN and SP of NS1 (ELISA) were 64% (45-82) and 99% (93-100. SN/SP (95% CI) of IgM/IgG (ELISA) were 50% (40-60) / 100% (96-100) and those of NS1+IgM/IgG (ELISA) were 94% (89-97)/92 % (81-97) and those of NS1+IgM/IgG (ELISA) with WHO-Clinical criteria were 91% (86-95)/ 94 % (84-98) respectively. Egger-bias was significant (p<0.0001).
Discussion and conclusion: Both RDT and ELISA tests have high SP to rule in dengue diagnosis. Wide range of SN value (WHO-Clinical Criteria vs IgM/IgG RDT) highlighted to improve SN of the tests for ruling out. Added value of dengue epidemic information in the accuracy of the tests should be verified. A multi-centre study with a standardised protocol should be conducted for diagnostic test accuracy variation for POCT among ASEAN patients.
Key words: Meta-analysis, accuracy, dengue diagnostic tests, ASEAN countries, POCT
Abstract:
The aim of study was to compare effectiveness of three different health education interventions to obtain proper hand washing (PHW) knowledge (why, when to wash) and practices (how to wash) among selected Myanmar preschoolers. A Quasi-experimental study was conducted among 60 preschoolers aged between 3-5 years in Mandalay, in 2006. The 20 children in each group were allocated for the 3 interventions (Group-A, Group-B and Group-C). Matching on child age, gender and socio-demographic status of parents was considered in allocation of the children for grouping. The participatory style learning using poem & gesture in group-A, 10 minutes video show to group-B and selected trained five children for peer demonstration to group-C regarding PHW based on WHO-guideline were intervened for 1month.The knowledge level score was assessed using pre-structured questionnaires in face to face interview and practice score was assessed by the checklists. Total knowledge, practices and grand total knowledge and practices score (GTKPS) was transformed into the score (%). Chi-square test, paired "t" test and ANOVA were used to compare the effectiveness of 3 interventions and matching of the groups. The total knowledge and practices mean scores (%) of the preschoolers on PHW were increased significantly in all 3 groups after interventions. The highest mean score differences (%) of GTKPS before and after the intervention was noticed in group-C (49.4±12), comparing with group-A (47±17.6) and group-B (33.3±17.6). In Scheffe post-hoc test comparison, although, significant difference of GTKPS (%) was found between Group-A and Group B with 4.1 % and between Group-C and Group-B with 4.7%, there was no significant difference between Group-A and Group-C with 0.7%. The comparison results pointed out that peer demonstration and poem & gesture were more the effective edutainment interventions than the education video show for the Myanmar preschoolers to obtain the proper hand washing knowledge and practices.
Key words:
Proper hand washing, effectiveness, health education interventions, Preschoolers, Myanmar
Abstract:
Background:
Old traditional didactic teaching is still used by some lecturers and to find out if a change is needed, a study on how health professional students learn and their attitude towards the current teaching methods was carried out at Aimst University.
Objectives:
This study explored the students’ attitude towards the effectiveness of current teaching methods and the preferred method that gave them maximum benefit of their everyday life.
Methods:
A cross sectional study was carried out among 324 third and fourth year medical (204) and dental (120) students in a private medical university using a self - administered questionnaire to assess their preferences on current teaching methods. Independent samples t test was used to measure between medical and dental students’ attitude towards different teaching methods.
Results:
The overall results of students’ attitude towards effectiveness of current teaching methods were highest in video (75.1%) followed by questions (70%), problem based learning (PBL) (69.6%), discussion (69.3%), case study (67.2%), lecture (66%), power point presentation(PPT) (65.9%), quiz (60.4%), group work (56.4%), role play (49.2%) and debate (43.3%) respectively. Dental students have significantly higher mean score differences in preferences on video (0.54), PPT (0.33) and lecture (0.28) and medical students have higher mean score differences in preferences on discussion (0.34), quiz(0.50) and debate(0.30) with p<0.05. Around one third of the students’ choice of best method was the standardized lecture slides with proper learning outcomes and well explanation by the lecturers.
Conclusion
The study suggests that to shift our teaching strategies from didactic traditional teaching and recommend a combination of other methods like PBL, videos, quiz and discussions to cater the needs of the adult learning and also to make it more interesting, interactive and effective.
SWE SL*, LEELA ANTHONY, INN KK, AZILA, SUPRAVA DAS, MARIETTE DSOUZA
Background:
Old traditional didactic teaching is still used by some lecturers and to find out if a change is needed, a study on how health professional students learn and their attitude towards the current teaching methods was carried out at Aimst University.
Objectives:
This study explored the students’ attitude towards the effectiveness of current teaching methods and the preferred method that gave them maximum benefit of their everyday life.
Methods:
A cross sectional study was carried out among 324 third and fourth year medical (204) and dental (120) students in a private medical university using a self - administered questionnaire to assess their preferences on current teaching methods. Independent samples t test was used to measure between medical and dental students’ attitude towards different teaching methods.
Results:
The overall results of students’ attitude towards effectiveness of current teaching methods were highest in video (75.1%) followed by questions (70%), problem based learning (PBL) (69.6%), discussion (69.3%), case study (67.2%), lecture (66%), power point presentation(PPT) (65.9%), quiz (60.4%), group work (56.4%), role play (49.2%) and debate (43.3%) respectively. Dental students have significantly higher mean score differences in preferences on video (0.54), PPT (0.33) and lecture (0.28) and medical students have higher mean score differences in preferences on discussion (0.34), quiz(0.50) and debate(0.30) with p<0.05. Around one third of the students’ choice of best method was the standardized lecture slides with proper learning outcomes and well explanation by the lecturers.
Conclusion
The study suggests that to shift our teaching strategies from didactic traditional teaching and recommend a combination of other methods like PBL, videos, quiz and discussions to cater the needs of the adult learning and also to make it more interesting, interactive and effective.
Dr Swe Swe Latt, Wong Yong Jin, MBBS Batch 20 year 4 Group A students
Abstract :
Objective:
To find out the underlying levels of knowledge, practice and attitude of residents of Taman Lembah Bujang towards different accessibility and availability of healthcare resources among different social classes in January 2017.
Methods:
Data were collected through Focus Group Discussion. It is a qualitative method to elicit on the accessibility of healthcare resources among the residents and their feedback on the current healthcare resources available.
Subjects:
A total of two focus groups were conducted. Groups ranged in size of five participants each and lasted for 50 minutes. Each focus group was homogenous in that it represented one resident type. Residents represented in focus groups included high income family (household income ≥RM2,000.00) and low income family (household income <RM2,000.00).
Analysis:
Focus group interview foot note were transcribed into written record and went through several phases of analysis. A preliminary analysis was conducted in order to get a general sense of the data and reflect on its meaning. Data from across all focus groups was again analysed so it could be organized into categories. Then these categories or key findings were analysed to determine the interconnectedness of issues and conditions that may have given rise to the categories.
Results:
From the discussion, it is found out that, most of the residents prefer traditional medication over going to the healthcare centre provided by the government when they fall sick. They do agree that the physician in the clinic and hospital are more well trained; however, the high cost in the private medical centre and long waiting time in the government healthcare centre has hindered them from seeking healthcare in those centre. It is undeniable that the long waiting time in the local healthcare is the major problem faced by the residents while seeking healthcare from the clinic and it is also a major factor causing the residents to not seek healthcare services from the healthcare centre. Besides, this also affected they income as they need to apply for leave in order to see the doctor in the clinic which could be a big burden for them as their monthly per-capita income is just sufficient for the whole family’s expenditure. The problem with the long waiting time could mainly due to the fact that there is an inadequate of healthcare personnel in the government clinics and hospitals to accommodate the large population of patients.
Conclusion:
The study proves that the different among the income groups in the population does affect the healthcare seeking behaviours. In order to improve the accessibility and availability of healthcare resources among all the population regardless of the social status, the government should take proactive and dynamic measures. However, empirical research is required in order to investigate systematically the effect of different processes and variables on the final outcome of focus group interviews.
Ooi Jia Yi2
Affiliation: 1Senior Lecturer, Unit of Community Medicine, Faculty of Medicine, AIMST University, Kedah, Malaysia, 08100.
2 Year 5 Medical Students, Faculty of Medicine, AIMST University, Kedah, Malaysia, 08100.
ABSTRACT:
The unprotected sexual relationships, limited knowledge and incorrect usage of contraceptive methods increase the risk of teenage pregnancy, unintended pregnancy and sexually transmitted infections. This study measured the prevalence of knowledge on different contraceptive methods and preferred methods for friends among first year medical students at AIMST University. A cross-sectional study with universal sampling was conducted using self-administered questionnaire on six contraceptive methods in April 2017. The chi-square test was used to analyze the association between sociodemographic characteristics and knowledge of different methods. Out of 157 respondents, female (68.8%) and male (31.2%) were involved. Most students obtained their first source of information on contraceptive methods from secondary schools (74.5%) and from teachers (68.8%). The percentages of correct answers on knowledge about different contraceptive methods were: condom (92.4%), followed by abstinence (82.8%), oral contraceptive pills (80.3%), hormonal injection (73.9%), withdrawal (73.2%) and emergency OCP (46.5%) respectively. The knowledge on withdrawal method among male students (83.7%) was significantly higher than female students (68.5%) (p= 0.04). Respondents’ choice on most suitable method for friends who came for their advice were condom (51.5%) then OC pill (21.9%), periodic abstinence (10.3%), withdrawal and emergency pill (6.4%) each, hormonal injection (2.1%) and others (1.3%). Respondents’ sufficient knowledge on various contraceptive methods reflects the effectiveness of sexual health education in their secondary schools. Therefore, early reproductive health education should be encouraged in institutions to prevent unwanted consequences.
Keywords: Contraceptive methods, medical students, contraceptive advice, adolescent reproductive health
Antibiotics (AB) resistance occurred by previous use and misuse of antimicrobial drugs and it is becoming global public health threat. The World Health Organization encourages best practices among the general public, health workers and policy makers to avoid the further emergence of antibiotic resistance. This study evaluated on the usage of AB and identified its association with socioeconomic conditions. A cross-sectional study was conducted among 105 respondents of age 18 years and above at Taman Lembah Bujang, Bedong, Kedah in January 2017 with convenience sampling. Assisted self-administered questionnaire on knowledge, attitude and practices on AB was used. The chi-square test was analyzed for association between socioeconomic characteristics and usage of AB. Most of the respondents (86.7%) had awareness on AB and 42.9% was currently using AB within one year. Respondents mean (SD) age was 35.9 (11.3) with female (70.5%), completed secondary education (61.9%), monthly household income from 1000 to 3000RM (60%) respectively. Regarding practices on AB, the respondents who would stop treatment after 2 to 3 doses of antibiotics prescribed by doctors (73.3%), saved remaining AB for the next illness (47.6%), gave the rest AB to their family/friend (42.9%), not discarded the remaining AB (72.4%), not completed the full course (57.1%) and not checked the expiry date (11.4%). Monthly household income (1000-3000RM) was associated with never stop treatment regardless of feeling better (p= 0.011) and age group (26-40 years) was associated with never giving the rest AB to family (p= 0.009). This study determined the abuse of antibiotics usage and respondents did not understand appropriate use of AB. The health professionals should educate the patients on the importance of finishing the full course of antibiotics regardless of their socioeconomic status, not to share AB with others to avoid further rise in AB resistance in future.
Keywords: Antibiotics, misuse, antibiotic resistance
Abstract:
Background: Edutainment using songs, poem with gesture, finger puppet shows, video shows, games and demonstration method with audiovisual aids are mostly applied in health education activities for preschoolers. In the study, effectiveness of different edutainment interventions to acquire proper hand washing (PHW) knowledge and practices among Myanmar preschoolers was compared to assist in setting further health education plan for PHW which is the single most effective way to prevent the spread of infections transmitted by contaminated hands. Methods: A Quasi-experimental study was conducted at No-1, pre-primary school in Mandalay, Myanmar in 2006 to compare the effectiveness of three different edutainment interventions (poem & gesture, video show and peer demonstration) in which knowledge (why to wash, when to wash) and practices (how to wash) for PHW were included based on WHO guide lines. Sixty preschoolers aged within 3-5 years and similar socio-demographic status was selected to form 3 groups (A, B and C) with 20 in each. Participatory style teaching–learning using poem & gesture in Group-A and 10 minutes video show in Group-B were intervened. Five peers were selected from Group-C and trained them for peer demonstration for PHW in their group. The knowledge of PHW was assessed using pre-structured questionnaires in face to face interview with the preschoolers and their practice was assessed by the checklist before and one month after the intervention. Results: The total knowledge and practices scores of the preschoolers on PHW were significantly (p <0.05) increased in all three groups after one month edutainment interventions. The highest mean score differences (in percent) before and after the intervention was noticed in Group-C (49.3±12), comparing with Group-A (47±17.6) and Group-B (33.3±17.6). In accordance with Scheffe post-hoc test comparison, significant (<p<0.05) mean score differences was found between Group-A and Group B with 4.1 % and between Group-C and Group-B with 4.7%. There was no significant mean scores differences (p>0.05) between Group-A and Group-C with 0.7%. Conclusion: The comparison results highlighted that peer demonstration (Group-C) and poem & gesture (Group-A) may be the most effective edutainment interventions for the Myanmar preschoolers to acquire proper hand washing knowledge and practices.
Abstract:
Although the Internet is undeniably helpful in medical students’ life, they need to be aware of their level of internet usage and proper time management. This study measured the prevalence of Internet addiction (IA) and its related factors among year 1 to 5 medical students at International Islamic University Malaysia. A cross-sectional study was done at Faculty of Medicine, Kuantan Campus in August 2015 among 270 medical students using a self-administered online questionnaire (Internet Addiction Test-20) with quota sampling method. Chi-square test,‘t’ test and ‘U’ test were applied to infer an association between IA and factors related to using Internet. The prevalence of normal, mild and moderate internet user were 60.9% (n=164), 36.9% (n=100) and 2.2% (n=3) respectively. Internet addiction (mild and moderate) was higher among mean (SD) age of 22.7(1.9) years old, female (61%), Year 1(27%), living in dormitory (90%), using Smartphone (72%), using Internet for 7 years and more (48%), night user (63%) and spent 2 to 5 hours per day (40%) with fast speed Internet (52%). They used the Internet for communicating with friends and family (96%), searching scientific research (84%), checking emails (81%), reading news (76%), chatting with new people (73%), and downloading films and music (64%). However, these findings were not statistically significant. High prevalence of normal Internet user and no severe IA among medical students under study is a favorable condition to instill awareness on their level of Internet usage and students should manage their time wisely by participating in other activities.
Abstract:
Although research in high-income countries highlighted that peer influence served as an important factor in the first-time use of e-cigarette among the secondary school students, there is lacking research on the topic in Malaysia. This study measured the prevalence of future intention to smoke e-cigarette and to explore peer influence to be one of the strongest factors among form 4 students. A cross-sectional study was done in Sekolah Menengah Kebangsaan Indera Mahkota 2 (SMKIM 2) in April 2016 among 101 students using assisted self-administered questionnaire. Data were presented as frequencies, percentages and Chi-square test. Almost all of the students (96%) had previously heard of e-cigarette, and the prevalence of ever user and never user was 36.1% and 63.9% respectively. About 28.4% reported that more than half of their friends used e-cigarette. The prevalence of intention to smoke e-cigarette in the next 12 months was 8.2% (n=8). Among them, 87.5% were ever user and 75% male students. Ever user was significantly (p=0.003) indented to use e-cigarette. The prevalence of intention to smoke e-cigarette if offered by best friend was 20.6% (n=20). Both ever user 100% and male students 90% were Significantly (p<0.001) intended to use e-cigarette if offered by a best friend. This study highlighted that peer influence is one of the contributing factors for their future smoking behaviour among the form 4 students at SMK IM2. School health education programme may be one of the effective strategies to prevent smoking e-cigarette too.
Abstract:
Most of the smokers remain as active smokers and unrecognized their nicotine dependence (ND) level. ND was an important reason to addict smoking. The study determined the prevalence of smoking and ND among adult males and their difficulties to quit smoking. A cross-sectional study was conducted among 296 males aged 18 years and above from Felda Bukit Goh at Kuantan, Malaysia in 2015. Socio-economic status, history of smoking, quit attempt and reasons for failing quit were explored by using a self-administered questionnaire. Level of ND was assessed by validated Malay version of Fagerstrom Test for ND questionnaires. Stratified analysis on relationship among socio-economic status and current smoking status, level of ND was done. The prevalence of current smokers was 61.1% and the prevalence of low and moderate to high ND level was 76.2 % and 23.8 % respectively. Among them 54.1% of smokers were tried to quit smoking ranging from 1 to 30 times by self-awareness (48%) and their main reason to fail was addiction (71.9%). Smokers with monthly household income (RM2000-2999) was independently associated with moderate to high ND with AOR=4.73 (95% CI 1.83-12.18) compared to those with income (less than RM2000). Despite high prevalence of smoking, majority of smokers have low ND and addiction was the main reason to fail quit attempt. Household income was a contributing factor for moderate to high ND. The finding provides hope for the success of smoking cessation programme if it is to be done in this locality.
Khine Soe Win, Swe Swe Latt, Wathan Seezar Kyaw
Abstract:
Background: Daily life of Myanmar general practitioners (GPs) are stressful dealing with variety of patients and solving their physical, mental and health related social problem as first-line care providers in Myanmar. However, there has been no evidence regarding how they provided care to the patients with mental problems and their exhaustion because of doctor’s professional life. Objectives: To assess mental health status of Myanmar GPs and application of mental health assessment tool (DASS-21 questionnaires) among their patients with mental health problems
Methods: A cross sectional descriptive and analytical study was carried out in June, 2014 among 80 Myanmar GPs who attended CME course conducted by Myanmar Medical Association in Yangon. Demographic, academic and practice background, practicing mental health assessment for their patients, application of Depression, Anxiety and Stress Score (DASS-21) in their practices were assessed by using a validated self-administrated questionnaire. DASS-21 was applied to assess the mental health status of the participants. Influence of demographic, academic and practice background on depression, anxiety and stress status of the participants was analysed.
Results: Out of 80 participants, 60% were male and graduated from Medical University (1 and 2) Yangon (69%). Sixty percents were currently engaged in the practices and 61% were solo practices with practicing year ranged from one month to 35 years. Prevalence of depression, anxiety and stress were 38%, 55% and 29% respectively. One-third (32%) did mental health assessment of their patients while 31% referred to specialists. Most of them (63%) were unfamiliar with DASS-21. Depression, anxiety and stress level of the participants were not influenced by their ddemographic, academic and practices background (p>0.05)
Conclusion: The study pointed out the need of professional care to Myanmar GPs for their work- related depression, anxiety and stress. Mental health care training including assessment tools used in primary care should be provided.
Key words: Mental health, Myanmar GPs, DASS-21
Abstract:
Introduction:The prevalence of work-related mental health problem is increasing trends in Malaysia. Among adult population, 12% suffered mental illness such as anxiety, stress, depression and schizophrenia. Majority of them are still working. Mental health assessment among staff is an entry point in providing appropriate mental health care to reduce mental health illness and its related social and behavior problems.
Objectives: To compare mental health status among staff in accordance with type of workplace in an institution.
Methods:A cross sectional descriptive study was conducted among 135 participants of “HEALTHY LIFESTYLE CAMPAIGN 2014” workshop” at International Islamic University, Malaysia(IIUM), Kuantan in May 2014. Occupational status of the participants was categorized into security staff (SS) and non-security administrative and supportive staff (Non-SS). Demographic and relevant clinical data were collectedusing a self-administered questionnaire together with validated Malay version Depression and Anxiety Stress Scales 21 (DASS 21) for mental health assessment. A cross analysis was done to compare mental health status between SS and non-SS.
Results:Among 135 participants, 82 (61%) were Non-SS and 53 (39%) were SS. Most of SS were male (87%) and aged more than 41 years old (59%) while non-SS were female (81%) and aged between 20-40 years old (85%).Prevalence of depression (30% vs 24%), anxiety (51% vs 42%) and stress (28% vs 24%) of SS and Non-SS were not significantly different (p>0.05). Both SS and Non-SS with chronic disease encountered more stress. Non-SS with post traumatic event suffered more depression and stress. Married staff of Non-SS encountered more depression, anxiety and stress (<0.05).
Conclusion: High prevalence of anxiety, depression and stress among the staff from IIUM alarmed healthcare providers to provide timely treatment and to initiate mental healthpromotion and prevention activitiesespecially among married staff with chronic diseases and post-traumatic event.
WC: 298/300
Keywords:
Mental health status, DASS 21, Security staff, Administrative and Supportive staff, International Islamic University Malaysia (IIUM), Kuantan
Abstract:
Background:W.H.O recommends using laboratory tests in dengue diagnosis for prevention, clinical management and control activities. Evidences regarding which dengue diagnostic tests used by primary care physicians as point of care testing (POCT) have been limited.
Objectives:To explore dengue diagnostic tests used by primary care physicians (PCPs) for point of care testing.
Methods:A cross-sectional descriptive and analytical study was conducted in August 2015 among 49 PCPs attending Diploma Family Medicine in Malaysia. Demo-academic and practice-background, choice of the tests for POCT and its selection reasons, dengue cases reporting to local authority, receiving dengue out-break information and its application in case management were explored by using a pre-tested questionnaire. A cross analysis between type of clinics, academic background, duration of practices and types of the tests used was done.
Results:Among 49 PCPs, 37 were medical officers (MOs) from public clinics while 12 were private general practitioners. One-third of participants (17/49) practiced in Selangor, followed by Johor (8), Penang (7), Kuala Lumpur(5), 2 each from Sabah and Perak, one each from Melaka, Pahang, Penang and Sarawak. They graduated from Malaysian public universities (24.5%), private (2.4%) and overseas Medical Universities (53.1%). Duration of practice ranged from 3 to 36years and 56% were in 6-10 years. NS1-RDT(65.3%) was mostly used, followed by NS1+IgM/IgG-RDT(40.8%), IgM/IgG-RDT(38.8%), IgM/IgG-ELISA(14.3%), WHO-clinical criteria+NS1+IgM/IgG-RDT(14.3%) and WHO-clinical criteria+NS1+IgM/IgG-RDT+ Out-break information(14.3%), NS1+IgM/IgG-ELISA(8.2%) and WHO-clinical criteria+NS1+IgM/IgG-ELISA(4.1%). No significant influence of type of clinics, academic back-ground and duration of practices on use of the tests was noticed. Reasons for selection of the tests were clinical preference, cost of the tests and market availability.
Conclusion:Awareness and adherence of W.H.O recommendation in dengue diagnostic tests used for point of care testing needs to be promoted among PCPs. A further study with adequate sample size should be conducted to get more valid results.
Abstract:
Background: Early detection of dengue cases via general practitioners (GPs), major primary care providers is an effective strategy in mitigation of dengue burden in Myanmar. Confirmation of dengue cases using laboratory tests is recommended by W.H.O for clinical management, prevention and control activities. Nevertheless, evidence on dengue diagnostic tests used by Myanmar GPs as point-of-care testing (POCT) has not been founded yet. Objective: To compare dengue diagnostic tests used as POCT between young GPs and senior GPs Methods: A cross-sectional descriptive and analytical study was conducted in August, 2015 among 72 GPs in Yangon. A pre-tested questionnaire was used to collect data regarding demo-academic and practice-background, dengue diagnostic tests used for POCT and its reasons. GPs aged under 30 years and currently practiced for 1-5 years as young GPs and their counter-part were defined as senior GPs for inferential analysis. Results: Young GPs and senior GPs were 35% (25/72) and 24% (17 /72) respectively while others 41% (30/72) were in-active in practice and did not meet with young-senior GPs definition. Dengue diagnostic tests application was still limited in GPs’ clinics. NS1-RDT (20.8%) was mostly used followed by Hess’s test (19.4%), NS1+IgM/IgG-RDT(18.1%),IgM/IgG-RDT(16.7%),WHO-clinical-criteria+NS1+ IgM/IgM-RTD+ Out-break information (16.7%) and WHO-clinical-criteria+NS1+ IgM/IgG-RDT(11.2%). Although both young and senior GPs did not use ELISA tests as POCT, 2.8 % of other GPs used it. Senior GPs used Hess’s tests significantly more than young GPs (35% vs 20%). WHO-Clinical-criteria+ outbreak information with RDT tests were more used by young GPs, but it was not statistically significant. Following clinical guideline, confirmation of cases, easy to perform, cost and market availability were reasons given for using the tests. Conclusion: Low utilization of dengue diagnostic tests highlighted to promote adherence of W.H.O recommendation among Myanmar GPs. POCT training should be arranged. A further study is needed for more valid findings.
Abstract:
Background: The vast majority of smokers want to quit and most make repeated attempts to do so. Although, effective treatment for nicotine dependence (ND) is present now, repeatedly fail to quit is still a common issue among smokers because of beyond nicotine addiction. Objective: To measure nicotine dependence (ND) level among adult male smokers and influences of socio-economic (SE) characteristics on ND and failing to quit smoking. Methods: A cross-sectional descriptive and analytical study was conducted in 2015 among 156 current adult male smokers in Kuantan, Malaysia. Socio-demographic and economic status, history of smoking and quitting attempt within 12 months and reasons for failing quit were identified by using a self-administered questionnaire. Level of nicotine dependence was assessed by validated Malay version of Fagerstrom Test for Nicotine Dependence questionnaires. Influence of socio-demographic and economic status on attempt to quit smoking and level of ND was analyzed. Results: Prevalence of low, moderate and high nicotine dependence level were 69.9%, 28.2% and 1.9% respectively. Among them, 55.1% were tried to quit smoking during 12 months. The most of reasons to fail quit attempt were nicotine addiction (69.8%) followed by uncomfortable/ tension/ not alert (10.5%), peer smoking/ social (10.5%), feel sleepy (7.9%) and desire to eat a lot (1.3%). Married smokers (56.6%) aged 31-40 years old (66%) with secondary education (52.9%) , private employee (68.3%), 1000-3000 RM family income per month (58.1%), and low ND score (59.6%) were tried to quit attempt and failed to quit. Smokers with low mean ND score (2.93) were attempted to quit significantly than those with high mean ND score (3.73). Conclusion: Nicotine dependence as a main reason for failing to quit smoking was confirmed in the study; however, influence of socio-demographic and economic characteristics was highlighted to consider in plan for successful quit smoking.
Abstract:
Internet today has become a greater part of every citizen’s life which helps many successful although, many fall in failure if not utilize it carefully. The usage of Internet is bringing welfare of mankind while avoiding different types of drawback, many of us unable to identify it. This study measured the level of Internet addiction (IA) among students and explored their perspectives on using Internet based on religious background. Methods: A crosssectional descriptive study was done at IIUM, Kuantan Campus, Pahang in July 2015. A total of 103 first year medical students were organized purposely. Internet addiction of the participants was assessed using online questionnaire containing Internet Addiction Test-20. Benefits (7-items) and disadvantages (5- items) Internet usage from Islamic perspective was analysed with (12) relevant questionnaires pertaining basic themes of Islam such as, “Islamic Religion, Ibadah, Greeting, Social Responsibility, Muslim’s Issues, Ummah, Daw’ah, Islamic Business, Al Quran, Hadith, Sunna, Islamic Study”. Results: Prevalence of normal (5.8%, n=6), mild IA (48.5%, n=50), moderate IA (44.7%, n=46) and severe IA (1%, n=1) were resulted respectively. Mean(SD) age of students was 20.9(0.5) years, 35.9% male, 64.1% female, 96.1% residents at dormitory, 48.5% using Internet more than 7 years, 64.1% spend on line 2 to 5 hours/day and 78.6% Smartphone users. Regarding Islamic perspective, 80% of the users acknowledged that Internet usage can provide benefits in enhancing Islamic knowledge, while 20% disagreed to it regarding positive Internet usages. For negative usages of Internet, 60% of the users approved as negative and 40% recognized as it was beneficial. Conclusion: Internet usage has been proven to be beneficial to all Muslim and it can be an effective tool for Dawah activities, but it is highly recommended that it has to be utilized with a great caution while keeping the the importance of concept of Islamic teaching.
Tobacco smoking is one of the leading preventable mortality due to its related diseases. Most of the smokers remain as active smokers and heed all the warnings since they do not know their status on the nicotine dependence level. Within a few years of daily smoking, most smokers will become dependent, both physically and psychologically. WHO supports the conclusions reported by the Surgeon General of the United States 2014 that major chemical component respon¬sible for addiction is nicotine. All form into tobacco have the potential to be addictive because they contain nicotine2, 3.
Besides, ciga¬rettes as the most common form of tobacco have been specifically engineered in its manufacturing so that the initiation of smoking will lead to depen¬dency and hard to stop. This is because in addition to nicotine, cigarette also comprises acetaldehyde, ammonia compounds and menthol, which increase its addictive effects 4, 5.
Nicotine dependence was assessed by the Fagerstrom Test for Nicotine Dependence (FTND). FTND is a standard instrument for assessing the intensity of physical addiction to nicotine. The test was designed to provide an ordinal measure of nicotine dependence related to cigarette smoking. It contains six items (Shown in table below).
For scoring the FTND, yes/no item is scored from 0 to 1 and multiple choice items are scored from 0 to 3. The items are summed to yield a total score of 0 to 10. The higher the total score, the more intense the subject’s dependence on nicotine. A score of 0-4 indicates that the subject has low nicotine dependence. For moderate nicotine dependence level, the score is 5-7, followed by a score of 8-10 which denotes high nicotine dependence6. The Malay version of Fagerstrom Test for Nicotine Dependence (FTND-M) can be used for Malay population which was done by Anne Yee H.A., et al, 2011.
Summary: Cigarette smokers are addicted smoking within a few years of daily smoking mostly due to nicotine content. Smokers can assess the level of nicotine dependence himself with FTND. It is one of the useful assessment tools before introducing nicotine replacement therapy to them.
Fagerstrom Nicotine Dependence Scale
No Question Answer/ scoring
1 How soon after you wake up do you smoke your first cigarette? 3. Within 5 minutes
2. Within 6-30 minutes
1. Within 31-60 minutes
0. After 60 minutes
2 Do you find it difficult to refrain from smoking in places where it is forbidden (e.g., in church, at the library, in cinema, etc)? 1. Yes
0. No
3 Which cigarette would you hate most to give up?
1. The first one in the morning
0. Any other
4 How many cigarettes per day do you smoke?
0. 10 or less
1. 11-20
2. 21-30
3. 31 or more
5 Do you smoke more during the first hours after waking than during the rest of the day? 1. Yes
0. No
6 Do you smoke even you are ill enough to be in bed most of the day? 1. Yes
0. No