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@#Introduction: The COVID-19 pandemic significantly impacted the global teaching and learning process (TnL). Unfortunately, to date, not many qualitative studies have been published specifically on the impact of COVID-19 on the Family Medicine course, particularly in Malaysia. Hence, this study aimed to explore the impact of COVID-19 pandemic on the teaching and learning experience of undergraduate students undergoing their Family Medicine course at a local university. Methods: A qualitative study using focused group discussion (FGD), was conducted among undergraduate students during the lockdown period. A semi-structured interview guide was used to interview 20 students, in their fifth undergraduate year, undertaking their fourth to fifth week of a total six-week course. They were selected using purposive snowball sampling method. There were four focus group discussions (FGD) with five students in a group. All interviews were audio-taped, transcribed verbatim, and the contents were analysed using the standard content analysis framework. Subsequently, thematic content analysis was conducted, and three major themes were produced. Results: The three major themes were (1) facilitators to learning, (2) barriers to learning, and (3) rooms for improvement. Conclusion: Although COVID-19 pandemic had significant impact on TnL of Family Medicine course among undergraduates, the students remained optimistic and proposed some improvement from their point of view. However, a creative, realistic, effective, and impactful way of TnL, particularly in clinical aspects should be developed and experimented. Technological progress and advancement should permit this idea to be achievable and implemented in near future.
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@#Introduction: Older persons are more susceptible to malnutrition. However, malnutrition identification through nutrition screening is not routinely performed in Malaysia’s health clinics due to no specific nutrition screening guideline and validated tool in this setting. This study aimed to develop a nutrition screening guideline for older patients and assess its feasibility for use by healthcare staff in health clinic setting. Methods: This study was conducted in three phases. In Phase I, needs assessment was conducted amongst healthcare staff. Development of nutrition screening guideline in Phase II involved scoping review and validation amongst six experts and twelve healthcare staff. In Phase III, twenty-two healthcare staff participated in feasibility assessment using in-depth interviews after completing nutrition screening in older patients. Interview data was analysed thematically using NVivo Software 12.0. Results: A Malay language version of nutrition screening guideline in A4-sized with 31 pages was developed and validated. Items with a content validity index ≥0.83 from experts review were retained, while <0.83 were revised accordingly. Validation amongst healthcare staff showed positive responses. The guideline was then assessed for feasibility, where 110 older patients (mean age= 68.7±6.1 years) were screened by healthcare staff using the newly developed nutrition screening guideline. Four themes emerged from in-depth interviews: 1) Ease of use; 2) Identification and management of malnutrition; 3) Acceptability; and 4) Implementation of nutrition screening. Conclusion: The newly developed and validated nutrition screening guideline is well-accepted and feasible for healthcare staff to screen older patients in health clinic setting for timely malnutrition identification and management.
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@#Introduction: Malnutrition, specifically undernutrition, in community-dwelling older adults reduces their well-being and predisposes to diseases. Therefore, timely malnutrition identification through nutrition screening is needed to identify at risk and malnourished patients. This study aimed to develop the content of nutrition screening guideline to facilitate healthcare staffs in health clinics to administer a validated nutrition screening tool specifically for older adults. Methods: A scoping review was conducted electronically using SCOPUS, PubMed, ProQuest Health & Medical Complete, and Cochrane databases. The systematic search was performed up to 31st December 2021. Search terms were created for identification of eligible and related articles. Inclusion and exclusion criteria were determined for the systematic search. The search was limited to English and Malay languages, and full text articles with no limitation of years. All data were extracted and analysed, guided by the PRISMA extension for scoping reviews (PRISMA-ScR). Results: From 728 identified articles, 18 articles were included in the analysis. Identified information for the guideline content were: introduction, aims and objectives, definition of malnutrition, prevalence of malnutrition, implementation of nutrition screening, guidance on administering items in validated tools, and guidance on anthropometric measurements. Meanwhile, format and flow charts from established guidelines served as references for the guideline development process. Conclusion: Appropriate content to develop a nutrition screening guideline has been identified based on this review. Development of a guideline based on this content can facilitate healthcare staffs to perform timely nutrition screening in older adults.
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@#Introduction: The elderly population is highly vulnerable to malnutrition, including those in the community. The use of nutrition education as part of nutrition intervention is able to improve their nutritional status. Hence, provision of a nutrition resource kit addressing the needs of at-risk and malnourished elderly would be advantageous. This research aimed to develop, validate and evaluate the acceptance of a newly developed nutrition resource kit, which served as an educational material among at-risk and malnourished elderly in Malaysian health clinics. Methods: This study was conducted in three phases: Phase I comprised of qualitative needs assessment to identify the types of nutrition resource kit needed; Phase II was the development and validation of the nutrition resource kit; while Phase III was acceptance evaluation, which involved individual in-depth interview and triangulation. Results: An A5-sized booklet with incorporation of an educational video in a QR code was developed. Both printed material and educational video had excellent content and face validity. Suggestions by experts and elderly from validation were considered and revision was done accordingly. Acceptance evaluation revealed four themes: 1) positive acceptance, 2) elderly-friendly, 3) valuable, and 4) individual preference. Triangulation data revealed that all elderly positively evaluated both resources. Additional suggestions given by elderly were considered for improvement. Conclusion: This newly developed nutrition resource kit, both in the printed and electronic format, was well-accepted among the at-risk and malnourished elderly. It could be used as an important reference for the elderly, especially those attending health clinics, in treating and preventing malnutrition.
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@#Introduction: The elderly population are susceptible to malnutrition due to many factors. Hence, timely malnutrition identification through nutrition screening needs to be performed routinely in health clinics. However, the nutrition screening practice in health clinics need to be improvised for malnutrition identification among the elderly population. This study identifies barriers and opportunities for nutrition screening in elderly patients in health clinic settings. Method: A qualitative study was conducted among healthcare staff from urban and rural health clinics in Kuantan, Pahang, Malaysia. In-depth individual interviews were performed, audio-recorded and transcribed verbatim. Non-participant observations that act as triangulation were conducted among elderly patients (aged ≥60 years) attending the sampled health clinics. Both data from the interviews and observations were analysed thematically using NVivo software. Results: Twenty healthcare staff participated in the interviews were medical officers (n=6), medical assistants (n=8), staff nurses (n=4), and community nurses (n=2) with a mean age of 33.7±6.3 years. Twenty- one elderly patients were involved in non-participant observations. The four themes that emerged as barriers and opportunities were: time, patient factors, organisation factors and nutrition screening knowledge. Time constituted the main barrier, whilst incorporating a validated nutrition screening tool into current health screening practices was identified as the most practical approach to performing nutrition screening. Staff also highlighted the need for appropriate guidelines for implementing nutrition screening. Conclusion: This study identified appropriate approaches to implementing nutrition screening among elderly patients in health clinics. Developing a comprehensive nutrition screening guideline may facilitate healthcare staff in performing nutrition screening.
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@#Introduction: Elderly population is at high-risk to suffer from malnutrition and nutritional inadequacy. The use of nutrition resource kit which provides nutritional guidance could be helpful to improve their dietary intake. There is no study performed previously on the type of nutrition resource kit that can be used to overcome and prevent malnutrition among Malaysian elderly. Therefore, this study aimed to identify the types of nutrition resource kit needed by community living elderly in Malaysian health clinic setting. Methods: Qualitative study was conducted to explore the types of nutrition resource kit needed by community living elderly in health clinics. Recruitment for in-depth individual interview targeted elderly aged ≥60 years old who met the inclusion and exclusion criteria and received primary healthcare services in four health clinics in Kuantan, Pahang. Interview questions addressed the knowledge on existing nutrition educational materials, preference for types of nutrition resource kit and opinion on technology-based materials. Data were audiotaped, transcribed verbatim and thematically analyzed using NVivo software version 12. Results: 21 participants involved in this study (mean age=67.24 ±6.98 years). Five key themes identified from the data: provision of nutrition resource kit; preference for printed version; eye-friendly; facilitate understanding with diagram; and support for technology-based materials. This study also found that majority of elderly preferred for A5-sized booklet for nutrition resource kit. Conclusion: Future development of nutrition resource kit tailored to the need of elderly is needed to deliver nutritional guidance effectively and served as an important reference for them to overcome malnutrition.
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Aims@#This study is focused on the potential of Bacillus cereus ATCC 14579 to degrade natural rubber (NR) latex film and NR latex film added with Metroxylan sagu pith waste (NR/TSPW latex film). @*Methodology and results@#Bacillus cereus is proved capable to utilise rubber as main source of carbon and energy. The biodegradation studies were analyzed by growth profile, weight loss, protein content and tensile strength test. Fourier Transform Infrared Spectroscopy (FTIR) test was applied to confirm the biodegradation process. In shake cultures, OD of culture increased by 19.2% from the initial inoculum after 14th cultivation days with NR/TSPW latex film. An increase in protein content up to 0.037 mg/g with 12.377% weight loss of film was obtained after biodegradation. Tensile test result shows tensile strength and elongation break are decreased by 10.203%. @*Conclusion, significance and impact of study@#The demand of rubber products is increasing time to time. Due to the high consumable and disposable of rubber latex products, hence remain inert to degradation and leading to their accumulation in the environment. An attempt to combine Natural Rubber (NR) latex system with other degrading materials have been made to facilitate biodegradation process. Thus, Bacillus cereus ATCC 14579 has potency to provide a biotechnological solution to the waste rubber disposal problem.
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This study aimed to examine the correlation between carotid artery intima-media thickness [IMT] and luminal diameter [LD] with body mass index [BMI] and other cardiovascular risk factors. This observational cross-sectional study took place between June 2013 and March 2014 in the Radiology Department of Rizgary Teaching Hospital in Erbil, Iraq. Non-randomly selected subjects >/=20 years old [n = 140] were divided into BMI groups and evaluated for the following cardiovascular risk factors: gender, age, hypertension [HTN], diabetes [DM], smoking, alcohol consumption, blood pressure, serum total cholesterol and triglyceride [TG] levels. IMT and LD of the extracranial carotid arteries were measured by B-mode ultrasonography. The mean IMT was 0.8 +/- 0.3 mm, ranging from a total mean of 0.7 mm in the normal BMI group to 1.0 mm in the extremely obese group. A significant correlation was found between IMT and BMI [P = 0.04], but not between BMI and LD [P = 0.3]. No significant difference in mean IMT or LD was seen between genders. Significant correlations were found between IMT and age, HTN, DM, high serum cholesterol and TG levels [P <0.001]. An increase of one BMI unit caused a 0.009 mm increase in IMT and an increase of one year in age caused a 0.011 mm increase in IMT. Age, obesity, HTN, DM, high serum cholesterol and TG levels were found to have an impact on carotid IMT, which is a strong marker for the early development of atherosclerosis
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The present investigation was conducted to study the effects of experimental Clostridium perfringens type D enterotoxaemia in teddy goats. Clinical signs started to appear after 30 min of experimental infection like anorexia, diarrhea, dehydration, frothing and dyspnea. Gross lesions consisted of severe congestion in tissues of varying intensity with enlarged mesenteric lymph nodes while histological examination revealed edema of lungs, kidney, and lymph nodes and to some extent in brain along with hemorrhages in lungs and intestines. Clostridium perfringens type D carrying alpha and epsilon toxin genes were amplified with amplicon size about 247 bp and 665 bp, respectively. Human erythrocytes showed the highest hemolysis, 68%, followed by mice, 57%, against culture supernatants. The percentage of hemolysis was significantly higher at 37[degree]C as compared to 25[degree]C except for rabbit and dog
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Animals , Enterotoxemia , Goats , Hemolysis , ErythrocytesABSTRACT
Objective: Circumcision is one of the most frequently performed elective procedures in male. In general, post circumcision complications are minor and treatable but complications requiring expert intervention are seen when the circumcision is performed by inexperienced/untrained person and in non-sterile setting and inadequate equipments
Materials and Methods: From March 2008 to May 2012, 59 patients with circumcision related complications were received at age range of 6 months to 5 years with a mean age of 2.4 years. The most common complication was urethra-cutaneous fistulae in 18 patients, followed by meatal stenosis in 9, bleeding in 6, incomplete circumcision in 6, buried penis in 5, glanular injury in 4, skin Bridge in 4, complete amputation of phallus 3, hole in the prepuce in 3 patients and one patient with coronal constriction and fistula
Results: Urethral fistulae were closed in all 18 patients with recurrence in 16%. Two patients with extensive bleeding required blood transfusion and all 6 children required hematoma evacuation under general anesthesia in the operating room. The circumcision was revised in those with an incomplete procedure, a hole in prepuce, buried penis and residual skin bridge. Meatotomy was the procedure of choice in 6 of 9 patients with meatal stenosis, but in the remainder meatal dilatation was effective. Glanular injuries were managed conservatively. A short residual after glanular injury needed grafting
Conclusion: Circumcision is considered a simple and minor surgical procedure, yet it needs to be performed competently by only medically qualified and trained personnel and with a great care
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Introduction: Several pedagogical methods can be used to impart medical education but the challenge is to make students appreciate critical thinking and apply their knowledge. Objectives: We developed a strategy to train students in public health due to the managerial constraints and academic interest. The academic purpose was to avoid passive learning, increase student involvement, encourage interaction and make learning more engaging and effective. Methods: Instead of delivering lectures, we encouraged the students to prepare seminars on topics of public health importance based on the guidelines provided by the lecturers and present them to their peers. The lecturers were present only to guide and supervise the students. Using a questionnaire, students’ perception on the lecture and seminar mode of teaching was evaluated. Results: Lecture: Organizational content and the learning outcomes were better (p=0.00). Study material easily available (p=0.003), useful (p=0.01), better content (p=0.00) and quality (p=0.00). The students claim that there was more teacher guidance (p=0.00), care for student learning (p=0.00) and the interest and understanding in the subject taught increased (p=0.00). Flow of the subject matter was also better (p=0.00).Seminar: More students assumed that their knowledge was adequate prior to the seminars (p=0.00). They found the seminars to be difficult. Motivation to read about the topic was increased. Improved the students presentation skills (p=0.001), communication skills (p=0.00) and provoked interest in the topics taught (p=0.04). Played a bigger role in student interaction, problem solving and teamwork. More students agreed that there was more student involvement and that seminar provoked their interest. Conclusion: From the findings of this study we found that a combination of both the methodologies is ideal as both have strengths as well as weaknesses
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Aim: To facilitate and promote racial understanding among medical students as part of their training Methodology: A descriptive study comprising of opinions of students and foster parents about the home stay programme and its influence on racial understanding. Results and Discussion: 229 medical students and 47 foster parents participated to state their opinions regarding living with other races, the home stay programme and racial understanding. Results showed a positive change post home stay among the students and foster parents on these three domains. There was also a significant change in the mean scores of the students’ perception about the villagers and their own skills and ability post home stay. Majority of the foster parents experienced moderate improvement of their understanding of the different races and their cultures. Conclusions: The home stay programme has made a positive change in the perception of the participants on racial understanding. It is particularly of importance because the students are in training for an important profession; that of a medical doctor.
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The different types of weapons are used in Autopsy cases. To determine the weapon pattern in Autopsy cases. DHQ Hospital Rawalpindi. From January 2007 to December 2007. 170 cases were taken from the record of autopsy cases conducted at DHQ Hospital Rawalpindi. The 170 cases were taken from DHQ Hospital Rawalpindi. The weapons used is significant in Autopsy cases
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Autopsy , Firearms , IncidenceABSTRACT
Trypanosoma are extra-erythrocytic, protozoan parasites of domestic and wild animals. It is transmitted by biting flies and a cause of fever, anemia, myocarditis and corneal opacity. In the present study, Trypanosoma infection is reported in a male bull dog of two years age at Lahore, Pakistan. Clinical signs and symptoms of infection are recorded. Confirmation of case was done by microscopic examination of Trypanosoma organism in thick blood smear. Furthermore, their effect on certain hematological parameters was studied and concluded that there was decrease of hemoglobin [Hb] concentration and packed cell volume [PCV] while erythrocytes sedimentation rate [ESR] was increased in the infected dog. The animal was successfully treated with single dose of diminazene diaceturate at the dose rate of 3.5 mg/kg body weight, intramuscularly alongwith the supportive therapy
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Animals , Trypanosomiasis/blood , Trypanosomiasis/drug therapy , Dogs/parasitology , /analogs & derivatives , Trypanosoma , Hemoglobins , Hematocrit , Blood SedimentationABSTRACT
The present study was performed to evaluate the incidence of organophosphorus toxicity among agrarian and non agrarian subjects residing near agriculture fields. The location of this study was Nawakot village, Multan. From the cotton producing area of Multan, 225 volunteers [farmers] including 103 females and 122 males were selected. Children <12 years of age constitute 15% of the population. A total of 100 volunteers [non agrarians] from Multan city were taken as control. Blood [4 ml] was drawn from the volunteers to test the level of acetylcholine estrase [Ach E] in plasma. The blood samples were then analysed at the laboratory of National Poison Control Center [NPCC]. Organo-phosphate [OP] and carbamates [CM] both act to block Ach E hydrolysis, necessary for synaptic response in the CNS. Acute illnesses were seen in 6 [2.67%], children [group 1]. They had fever and signs of pulmonary infections. Generalised weakness was found in 9 males and 13 females. Paraesthesia was found in 11 volunteers of group IV. Blood sampling test revealed that 6 volunteers [2.67%] had plasma Ach E below 5300 IU/ml [< 50% reduction], whereas 4 volunteers had Ach E level between 5300 - 5500 IU/ml [< 45% reduction], 81 volunteers fall in group "c", and 126 individuals had an Ach E reduction of at least 25% and 8 volunteers had the serum cholinesterase level above 10000 IU/ml. None of volunteers had the value above 11000 IU whereas plasma Ach E level of control population was between 11500 - 13500 IU/ml. Medical tests of the level of Ach E in plasma suggest that the overall incidence of poisoning from exposure to OP and CM is quite high, and appears to be consistent with the results from other studies in other developing countries
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Humans , Male , Female , Environmental Exposure , Incidence , Organophosphorus Compounds/toxicity , Acetylcholinesterase/blood , CarbamatesABSTRACT
Caesarean section is one of the most important operations in obstetrics while the postoperative stay in hospital mostly depends on the hospital policy and the presence of complications. To evaluate the effect of early post elective caesarean section discharge within 24 hours, in relation to the indication of the elective caesarean section, intra operative procedures, post operative antibiotics, analgesia and time of starting feeding and mobilization. This is a retrospective review of all elective caesarean sections done in one hospital from the 1[st] of November 2005 to the 31[st] of January 2006 [total 374]. Files were reviewed for intra operative procedure, post operative antibiotics, analgesia, time of starting feeding and mobilization. Any maternal and fetal complication was recorded. The attendant obstetricians were asked for their opinions, disadvantages, complications, mortality, readmission and also for patient inconvenience from this policy of early discharge. The number of elective caesarean section was 374, the mean time between operation and discharge was 20.57 hours. The mean age of the women was 27.8 years, the mean parity was 2.1. The indications for elective caesarean section were previous scar [39.31%], postdate [20.59%], decrease fetal movement [12.57%], abnormal lie [3.48%], breech presentation [4.00%] and on the personal request of the patient [4.00%]. General anesthesia was used in 362 [96.8%] of the patients, while epidural was used only in 12 [3.2%]. Diclofenac was used as postoperative analgesia in 203 [54.3%] of patients, tramadol in 109 [29.1%] and both in 62 [16.6%]. The mean time for starting feeding was 7.23 hours and mobilization in 6.95 hours. The pelvic and parietal peritoneum was sutured [closed] in 284 [75.9%] of patients. One patient stayed in hospital 36 hours for caesarean hysterectomy and was then readmitted for severe infection. Ten patients had minor infection and were treated as outpatients. There was one fetal loss because of respiratory distress syndrome. This study reveals that early post elective caesarean section discharge [less than 24 hours] is safe, regardless of the indication of elective caesarean section, intra operative procedure, post operative analgesia, antibiotics and time of starting feeding and mobility
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Humans , Female , Cesarean Section , Evaluation Studies as Topic , Time Factors , Elective Surgical Procedures , Length of Stay , Retrospective StudiesABSTRACT
Five compounds were isolated from the n-hexane and chloroform soluble fractions of a methanol extract of the stem bark of Erythrina variegata. The structures of the isolated compounds were elucidated as alpinum isoflavone [1], epilupeol [2], 6-hydroxygenistein [3], 3beta 28-dihydroxyolean-12-ene [4] and stigmasterol [5] by extensive spectroscopic studies, including high field NMR analyses. Different partitionates of the methanol extract exhibited mild to moderate antimicrobial activity and varying degrees of cytotoxicity. Although, alpinum isoflavone [1] has previously been reported from E. variegata, this is the first report of isolation of compounds 2-4 and stigmasterol from this plant species
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Fabaceae , Isoflavones , Stigmasterol , Triterpenes , FlavonoidsABSTRACT
To evaluate serum lipids in children with type 1 diabetes mellitus and its relation to glycemic control, in comparison with sex and age matched non-diabetic children. Fasting blood glucose, glycosylated haemoglobin [HbAlc] and lipid profile were estimated in 45 children [20 males and 25 females] with type 1 diabetes attending diabetic clinic at Sulaymani children hospital from the period of November 2005 till Jully 2006. Fifty health children [23 males and 27 females] admitted to the same hospital with acute illnesses like respiratory tract infections were randomly selected as controls. Mean total cholesterol, triglycerides, LDL-C, VLDL-C, and LDL-C/HDL-C ratio were significantly higher in diabetic children compared to the control. However, there was no significant difference in the levels of HDL-C in both groups .In addition to that, diabetic patients with poor control have a significantly higher levels of blood glucose, total cholesterol, triglycerides, LDL-C and LDL-C/HDL-C ratio as compared to those with good control. A significant correlation between most lipid variables and HbAlc was observed in diabetic patients. Children with type 1 diabetes should be screened for serum lipids as significant lipid abnormalities are related to glycemic control. Both can be improved with dietary guidelines and insulin therapy