Cultural Competency of Medical Students: An Asian Context

@#Introduction: People of different cultures perceive health and disease differently. A culturally competent healthcare team is needed to provide quality healthcare. In Asian medical schools, less emphasis is laid on cultural competency training. In this context, the study aims to assess the cultural competency of medical students in Malaysia and to fathom the demographic factors influencing it. Methods: A cross sectional survey was conducted on students from all five years of a Malaysian medical school using an adapted version of Clinical Cultural Competency Questionnaire (CCCQ) to tap the self-perceived knowledge, skills, comfort level in cross-cultural encounters and attitude towards cultural competency. Descriptive and inferential statistics was used to analyse the data. Results: Among the 291 respondents, the cultural competency was found to be significantly different among medical students of different year of study, age, and ethnicity. However, with regards to gender, country of birth or the number of languages spoken, the difference was insignificant. The clinical year students had significantly higher scores on the knowledge, skills, comfort level and attitude domains of cultural competency when compared to the preclinical students. Chinese students’ perception on cultural competence was significantly distinct from Indian and Malay students. Conclusion: Exposure to cross cultural encounters in clinical settings and personal experiences seem to influence cultural competency of the medical students. It provides valuable data to plan for interventions, training and self-development strategies aimed at providing culturally attuned patient centred care.

The Malaysian Movement Control Order (MCO) Impact And Its Relationship With Practices Towards Coronavirus Disease 2019 (Covid-19) Among A Private University Students In Selangor

@#A novel strain of coronavirus was first detected in Wuhan, China in December 2019. It is the causative agent of a respiratory disease known as the Coronavirus Disease 2019 (COVID-19). On 12th March 2020, it was declared as a global pandemic by the World Health Organization. The aim of the study was to study the impact of MCO in terms of the academic performance and finance on the student population and to measure the level of knowledge, attitude and practice towards prevention of coronavirus disease 19 (COVID-19) among a private university students in Malaysia. On 22nd April until 30th April 2020, a cross-sectional study using a convenient sampling method was conducted among 401 students using a self-administered online questionnaire survey. It was found that 272 (67.8%) of the respondents had a less negative impact of MCO while 129 (32.3%) of the respondent had a more negative impact of MCO. The findings show also 229 respondents (57.1%) have adequate knowledge. As for the attitude, about 237 respondents (59.1%) have an adequate attitude and only 191 respondents (47.6%) have adequate practice towards the prevention of COVID-19. There was a significant relationship between knowledge, attitude, and practice with family income, a significant relationship between knowledge and practice, a significant relationship between knowledge and attitude, a sig. relationship between knowledge, attitude, practice with university faculties, the relationship between knowledge and source of information. The MCO showed significant association with knowledge level and with practice, also MCO was less negatively impact on the medical faculty students with p-value 0.004. The MCO was more negatively impacting those with less family income. The study findings concluded that the majority of the participants had a fair level of knowledge, attitude, and a lesser level of good practice towards the prevention of COVID-19. However, the COVID-19 is still considered a global pandemic and has not resolved yet. Therefore, to minimize the risk of future COVID-19 cases current efforts to educate the public towards knowledge, attitude, and practice towards prevention of COVID-19 in public health should be done.

Determinants of anemia among pregnant women: A hospital based cross sectional study

Background: The objective was to study the determinants of anemia among pregnant women. There is a negative effect on the health of the mother and as well as that of the child due to anemia in women with pregnancy. Death rate is more in women who are pregnant and having anemia. The objective of this study was to study the determinants of anemia among pregnant women.Methods: A hospital based cross sectional study was carried out among 40 pregnant women over a period of six months. Demographic data like age, residence, occupation etc was recorded. Obstetric data like gravida, parity, previous LSCS was also recorded. The data was presented as means and student’s t test was applied.Results: The mean age was 23.43±3.4 years. Majority were young between the ages of 19-22 years. Majority belonged to urban residents i.e. 57.5%. 20% of the subjects were found to be illiterate. Majority of the mothers were housewives i.e. 82.5%. Majority were multi-gravida i.e. 60%. Majority had no history of abortions in the past i.e. 75%. Out of total 19 repeat pregnancies, majority i.e. 84.2% had lower segment cesarean section. Majority reported that they had normal menstrual history. The mean hemoglobin level was found out to be 7.94 gm/dl. It was found that the mean hemoglobin level did not differ significantly across age, residence, education, occupation, gravidity, history of abortions, type of delivery but differed significantly by abnormal menstrual cycle.Conclusions: Mean hemoglobin level was more in women with normal menstrual history compared to those women with abnormal menstrual history and this difference was found out to be statistically significant. Hence abnormal menses should be promptly treated, hemoglobin assessed.

Meconium stained liquor and fetal outcome: a hospital based follow up study

Background: Meconium staining of the amniotic fluid is a common problem occurring in 10-22% of all deliveries. Meconium aspiration syndrome complicates approximately 1.5% of these deliveries with a reported mortality rate as high as 40%. Objectives of the study were to determine whether meconium stained liquor during labour is associated with fetal distress and to check if there is any correlation in between the degree of meconium staining liquor and fetal outcome.Methods: A clinical study of 200 cases of meconium stained amniotic fluid in cephalic presentation was undertaken among patients who were admitted in labour room were examined in detail and investigations were done. Fetal heart rate and its pattern were noted every fifteen min. Total APGAR score at one minute and five minute was noted down. Odds ratio with 95% confidence interval was calculated. Proportions were analyzed using chi square value.Results: Majority of the study subjects belonged to the age group of 21-30 years. Majority i.e. 54.5% were multigravida. Majority had toxemia in 24% of the cases. Fetal distress and the incidence of forceps delivery or LSCS was significantly more in those with thick meconium compared to those with thin meconium (p<0.05). But fetal asphyxia was not associated with type of stained meconium. It is seen that as the duration of the meconium staining increased, the proportion of babies with low APGAR score, perinatal mortality and morbidity increased.Conclusions: Thick meconium stained amniotic fluid was associated with increased rate of interventions, neonatal morbidity and mortality compared to thin meconium stained meconium fluid.

Knowledge, Attitude, And Practice Towards Dengue Fever Among Patients In Hospital Taiping

@#Dengue fever is the most common vector-borne disease and major concern issues in Malaysia. Thus, the present study aimed to evaluate factors influencing knowledge, attitude, and practices regarding dengue fever among patients in Hospital Taiping. A total of 300 patients were incorporated into a descriptive, public based cross-sectional study. The questionnaires were formulated to include several questions on demographic data, knowledge, attitudes, and practices concerning dengue fever. Most of the respondents were from the age group of more than 35 (43.3%). The largest representations of the participants were Malay (59.3%), married (65.7%), SPM is the highest education level (53.3%), and 60.7% of the participants were conscious about dengue fever eruption. Television/radio was voted as the frequent source of information (97.3%). There is no significant relationship between knowledge score and socio-demographic factors. However, around 57.0% of the respondents believe that abdominal pain is not a symptom of dengue fever and 32% convinced that blood transfusion can transmit dengue. No significant correlation was found between attitude and practice score to socio-demographic characters. However, a good practice towards dengue fever is associated with good knowledge (65.4 %) nevertheless it did not influence their attitude. Moreover, the attitude seems to be poor regardless of knowledge level (44.0%). Therefore, more prevention practices to raise the awareness of population toward dengue fever such as health campaigns and health education in school level should be initiated. These activities will aid in fertilizing better attitude and prevention practice towards dengue fever and bring down its incidence in Malaysia.

Eye of horus – Erratum revealed a prescription survey.

Background: The aim of this study was to survey the quality and the content of prescription of practitioners and also assess the legibility of alphabet, and short form of the drug. Methods: A survey of all prescription received by the patients that were written by general practitioners, consulting physicians and dentists in and around Virajpet and Madikeri (south Coorg) was included.The prescriptions were photocopied and returned back to the patients. The prescription was scored and analyzed by a qualified medical investigator. Results: A total of 171 prescription samples were collected. In most prescriptions, one or more aspects of patient’s personal details were missing. Concerned doctor’s details also lacked in most cases. 40.3% of the prescriptions were obtained wherein short form of the drug was used for prescribing drug. Legibility of alphabet was also evaluated and the most confusing letter noted in our study was letter “C”; followed by A, T, S, O, G, and D in this study the letter Rx was written in 7% of the prescription and in 19% prescription it was replaced by word “Adv” and 74% of prescription without symbol of Rx. Conclusions: The present data shows most prescriptions in the study was inadequate and important details were lacking, legibility of prescription was poor in rating.

Evaluation and comparison of automated analysers on hepatic enzymes.

Background: Clinical Biochemistry tests comprise over one third of all hospital laboratory investigation. The laboratory accreditation requirement has become an important aspect in selecting the analysers for analysing and evaluating the samples. Recently accrediting bodies are focusing on the importance of total quality management and assessment of trueness of laboratory measurements. The present study aimed to evaluate the hepatic enzymes using a single analytical methodology in 2 different automated analysers (semi autoanalyser and fully automated analyser) to understand the reliability of instrumentation on analytical methodology that would fit the laboratory performance standard. Methods: A total number of 50 serum samples from adult patients requested for liver function tests at Shri Sathya Sai medical college and research institute were analysed. The samples were evaluated for hepatic enzymes on (Cobasmira) Autoanalyser and (Biosystems) Semi Autoanalyser using the same analytical methodology and the values were compared between the 2 automated analysers. Data analysis was done by appropriate statistical methods. Results: No large differences were obtained in the values between the 2 automated analysers. Mean ± SD of each of the hepatic enzyme analysed by automated analysers were very close to each other indicating a minimum bias. Pearson’s correlation and scattered diagram showed significant positive correlation at 95% confidence interval between 2 automated analysers. Conclusion: The findings of this study confirm that both the automated analysers were reliable for evaluation of hepatic enzymes.

Role of Tribulus terrestris (Linn.) (Zygophyllacea) against mercuric chloride induced nephrotoxicity in mice, Mus musculus (Linn.).

The present study investigates the influence of methanolic fraction (MF) of Tribulus terrestris fruit extract on the kidney tissues of mercury intoxicated mice, Mus musculus. At median-lethal dose of mercuric chloride (12.9 mg/kg body weight), the whole kidney tissue showed an increased level of lipid peroxidation (LPO), glutathione peroxidase (GPx) activities and simultaneously a decreased level of superoxide dismutase (SOD), catalase (CAT), reduced glutathione (GSH). These parameters reached to near normal after administration of fruit extracts of T. terrestris for 7 days. The results suggested that the oral administration of methanolic fraction of Tribulus terrestris fruit extract at dose 6 mg/kg body weight provided protection against the mercuric chloride induced toxicity in the mice.