Perceptions, attitudes and willingness of fourth year medical students for AY 2020-2021 on CIM CMSS-DOH telemedicine program: A cross-sectional study

Background@#The COVID-19 pandemic has been a great challenge to medical education, nonetheless it also offered medical schools an opportunity to incorporate a developing technology to address the accessibility of health services in the form of telemedicine. However, the success of any new technology would depend on factors of the users who engage in it.@*Objective@#To determine the perceptions, attitudes, and willingness of fourth-year medical students enrolled in the Cebu Institute of Medicine for the school year 2020-2021 on CIM CMSS – DOH telemedicine program@*Methods@#This was an analytical, cross-sectional study design conducted to 150 fourth year medical students of the Cebu Institute of Medicine from June to July 2021 using a validated, researcher-made electronic questionnaire@*Results@#The study had a response rate of 100 percent. Gender, pre-medical degrees and previous experience with telemedicine did not differ significantly in terms of their perception, attitude and willingness toward the telemedicine program. However, those medical students who are fluent in Tagalog have better attitudes toward it. A positive linear correlation also existed between the respondents’ perception scores and attitude scores, as well as between their perception scores and willingness scores indicating that better perception towards the program indicated better attitude and willingness.@*Conclusions@#The result of this study can be used to address the limitations perceived and demonstrated by medical students during the pandemic and how telemedicine bridged the gap in medical education. This can be the basis of adding telemedicine in the current medical curriculum, which would translate to future graduates who are able to provide holistic healthcare by adopting new technological strategies.

Chemoresistance in ovarian cancer: exploiting cancer stem cell metabolism / 부인종양

Ovarian cancer is most deadly gynecologic malignancies worldwide. Chemotherapy is the mainstay treatment for ovarian cancer. Despite the initial response is promising, frequent recurrence in patients with advanced diseases remains a therapeutic challenge. Thus, understanding the biology of chemoresistance is of great importance to overcome this challenge and will conceivably benefit the survival of ovarian cancer patients. Although mechanisms underlying the development of chemoresistance are still ambiguous, accumulating evidence has supported an integral role of cancer stem cells (CSCs) in recurrence following chemotherapy. Recently, tumor metabolism has gained interest as a reason of chemoresistance in tumors and chemotherapeutic drugs in combination with metabolism targeting approaches has been found promising in overcoming therapeutic resistance. In this review, we will summarize recent studies on CSCs and metabolism in ovarian cancer and discuss possible role of CSCs metabolism in chemoresistance.

Sero-prevalence study of IgE responses to allergens from Malaysian house dust (HDM) and storage mites (SM)

Allergens of Dermatophagoides and Blomia species are well-characterized but not for other species. This study was conducted to determine the prevalence of allergic sensitization to house dust (HDM) and storage mites (SM). One hundred adult subjects (aged > 18) were recruited. The mite specific IgE of all allergic subjects were higher compared with healthy subjetcs despite being not statistically significant except for D. farinae and G. malaysiensis. The mean serum IgE levels against HDM and SM for allergic subjects were significantly higher compared with those in healthy subjects. They were mainly sensitized to Dermatophagoides farinae (35%) and Glycycometus malaysiensis (37%). Immunoblots revealed not all allergic subjects showed positive immuno-reactivity against the mites tested. Single or multiple bands were observed for different species. The subjects were commonly sensitized to Group 2 (9-12 kDa), 10 (38 kDa) and 18 (40-48 kDa) allergens. Twenty-one out of 60 allergic subjects were sensitized to either one or more species. The majority of them (71%) were sensitized to single species. The allergic subjects were mainly sensitized to D. pteronyssinus, followed by Tyrophagus putrecentiae and Aleuroglyphus ovatus. Seven were solely sensitized to HDM while 10 were solely sensitized to SM. Four subjects were sensitized to both. Preadsorption study revealed no cross-reactivity. There was difference between the prevalence and reactivity to allergens of HDM and SM in these subjects. Both ELISA and immunoblot did not correlate well but can complement each other in improving the detection of mite allergens to the species level.

Improvement in Documentation of Intake and Output Chart

Intake and Output (I/O) records in hospitals were often found to be incomplete and illegible. The form used to record I/O is not user-friendly — i.e., they feature miniscule boxes, ‘total’ lines that do not correspond with shift changes and lack of instructions. Complaints often received from Specialists & Doctors regarding calculation errors or no totalling of I/O. Moreover, Nursing Sisters objective rounds often saw incompleteness of I/O chart. This study aims to identify the types of mistakes in recording the existing I/O chart. The second aim is to find out whether shift totalling of I/O chart helps in reducing mistakes. We try to determine whether the identified mistakes were repeated in the new I/O Chart. This study was conducted from October till December 2010 in 9 selected wards in Sibu Hospital. Data collection was divided into 3 phases. A pre-implementation audit using a checklist was carried out. The compliance rate of completeness of documentation of I/O Chart was 63%. A one month trial of new I/O chart was being done in the selected 9 wards. Post implementation audit showed a significant improvement of compliance rate (88%). Feedback from health care workers (N=110) showed that, 89% of doctors (n=17) and 60% of nurses (n=93) in the sample prefer to use the new format as more practical and relevant to the changing shift of nurses and doctors’ ward round. It is suggested to implement the new format to increase compliance rate of documentation of I/O charting. Briefing should be given to nurses periodically and the new format should be introduced to nursing students in nursing colleges.

Type-specific prevalence of human papillomavirus infection among women in the northwest territories, Canada

Certain types of Human Papillomavirus [HPV] are highly associated with cervical cancer and precursor lesions [dysplasia], but the distribution of HPVs in Northern Canada is largely unknown. This study determined the prevalences of HPV infection due to different virus types and the association of different virus types with cervical dysplasia in the Northwest Territories [NWT]. Between April 2008 and March 2009, women who underwent routine Pap testing in the NWT were included in the study. An in-house Luminex assay detected type-specific HPV infections. The HPV prevalence rates and population attributable risk fractions were calculated. In 5725 bio-samples, the overall HPV prevalence was 24.2%, and of the HPV-positive samples, 76.6% harbored high-risk types, 35.2% harbored multi-type infections, and 21.6% harbored HPV16 or 18 infections. The HPV prevalence was approximately 50% higher among Aboriginal than non-Aboriginal women. The age-specific HPV prevalence exhibited a U-shape distribution in the Aboriginal group. The prevalence of HPV16 or 18 infections found in high-grade lesions was 34.1%. Among this study population, 89.5% of the cases with cervical dysplasia were attributable to HPV infection, with 27.1% attributable to HPV16/18. The high prevalence of high-risk HPV in this population, particularly in the Aboriginal group, will require further studies to identify specific predictors of infection