Evaluation of Lung Ultrasound in Assessment of Critically Ill patients in Respiratory Intensive Care Unit

Reaching a proper diagnosis for critically ill patients is like collecting pieces of puzzle and bed side lung ultrasound (LUS) becomes a crucial piece complementary to clinical and laboratory pieces. It is a bed side, real time tool for diagnosis of patients in ICU who are critical to be transferred to radiology unit especially in Covid-19 pandemic with risk of infection transmission. The aim was to evaluate the accuracy of lung ultrasound in assessment of critically ill patients admitted to Respiratory Intensive Care Unit (RICU), moreover to assess its diagnostic performance in different pulmonary diseases as compared to the gold standard approach accordingly. This observational prospective (cross sectional) study with a total 183 patients who met the inclusion criteria,were selected from patients admitted at the RICU;Chest Department, Zagazig University Hospitals, during the period from September 2019 to September 2021. LUS examination was performed to diagnose the different pulmonary diseases causing RF. All cases were examined by LUS on admission. From a total 183 patients, 111 patients 60.7% were males and 72 patients 39.3% were females, with a mean age of 56+/-12.77 years, 130 patients were breathing spontaneously received conservative management with O2 therapy, 32 patients needed NIV while 21 patients needed IMV with ETT. Exacerbated COPD was the most common disease finally diagnosed followed by bacterial pneumonia, exacerbated ILD, post Covid-19 fibrosis and pulmonary embolism in32, 29,27, 19 and 11 patients respectively with corresponding diagnostic accuracy of LUS 97.3%, AUC=0.943, 93.9% (AUC=0.922), 96.7%(AUC=0.920), 97.8%, AUC=0.895, and 97.8% respectively, while Covid-19 pneumonia was the final diagnosis in 8 patients with LUS diagnostic accuracy of 97.8% (AUC=0.869) with no statistical significant difference p-value=0.818 with bacterial pneumonia in distribution of US profiles. A profile was the commonest detected US profile among the studied patients followed by B profile, C profile, A/B profile and A' profile in 37.2%, 24.6%, 15.8% 4.9%, and 3.8% of cases respectively. Bed side LUS has a reliable, valuable diagnostic performance when integrated with clinical and laboratory data for the diagnosis of most pulmonary diseases in RICU.Copyright © 2023, Colegio de Farmaceuticos de la Provincia de Buenos Aires. All rights reserved.

Mental health of pre-clinical medical students in Indonesia during the first year of the COVID-19 pandemic: A reflection

Background & Objective: Perceived awareness and concern for mental health issues among students in Indonesia are still lacking, proceeding before and during the coronavirus disease 2019 (COVID-19) pandemic. In order to gain future benefits, this study evaluates pre-clinical medical students' mental health during the first year of the COVID-19 pandemic in Indonesia. Materials & Methods: This cross-sectional study was conducted on pre-clinical medical students at the Faculty of Medicine, Universitas Islam Indonesia (FM UII), Yogyakarta, Indonesia, in April 2021. A total sampling method was employed. Participants completed online self-reported questionnaires, including socio-demographic data and the Depression, Anxiety, and Stress Scale-21 (DASS-21) questionnaire to evaluate mental health. Descriptive, bivariate, and multivariate analysis was performed. Results: A total of 273 pre-clinical medical students were included in this study. They suffered from depression (35.2%) and stress (40.3%) more than a third and about half suffered from anxiety (50.2%). Females were more likely to have depression (AOR: 2.22;95%CI: 1.19 to 4.15), anxiety (2.56;1.42 to 4.61), and stress (3.44;1.81 to 6.54) than males. Anxiety was less common in medical students in their second (0.48;0.23 to 0.98) and third (0.29;0.13 to 0.67) years than in the first year. Being a third-year student was a protective factor for stress (0.38;0.17 to 0.87). Conclusion: A high prevalence of depression, anxiety, and stress among pre-clinical students was observed. This study can become a reflection for educational institutions and policymakers to prepare good strategies to maintain pre-clinical students' quality and mental health during and after COVID-19 pandemic. © 2023, J Med Edu Dev.

Open Distance Learning in Medical Education: Does It Improve Students' Motivation?

The COVID-19 pandemic has affected the way of teaching and learning in medicine. Conventional medical education has been fully transformed to open distance learning that includes the full utilization of various digital platforms. Thus, this study explored the impact of digital learning usage on learning motivation among medical students of Universiti Kebangsaan Malaysia (UKM) before and during the COVID-19 pandemic period. A validated Students Motivation towards Science Learning (SMTSL) tool was used to assess the learning motivation of UKM undergraduate medical students throughout years 1 to 5. Digital learning during the COVID-19 pandemic was significantly higher compared to before the pandemic (p <.05) but there was no significant difference (p =.872) in learning motivation. The use of digital learning among clinical students was significantly higher during the COVID-19 pandemic as compared to preclinical students (p <.05). There was a moderately strong correlation (r =.512) between digital learning and learning motivation. Hence, digital learning should be utilized as an additional driving factor to increase learning motivation, especially during this current pandemic. © The Author(s) 2023.

The moderating role of market turbulence beyond the Covid-19 pandemic and Russia-Ukraine crisis on the relationship between intellectual capital and business sustainability

This paper examines the role of Intellectual Capital (IC) and its contribution to Business Sustainability (BS) among Large Manufacturing Firms (LMF) in Malaysia. It seeks to explain the relationship between them under turbulent market conditions. The study used the survey method to collect data from 203 large companies, and the hypotheses were tested using Partial-Least Squares-Structural Equation Modeling. Based on the findings, two dimensions of IC, namely Human capital (HC) and Structural Capital (SC), had a significant effect on business sustainability, but Relational Capital (RC) did not. Also results indicate that Market Turbulence (MT) moderates the relationship between two IC dimensions, HC and RC but not that between SC and BS. The study findings can be used as guidelines by CEOs of LMFs, policy makers and researchers to comprehend positive the influence of MT and IC on BS. © 2022

Consumer Confidence and Intention to Save During COVID-19 in Malaysia

This study compares gender, ethnicity, age, and income groups to the consumer confidence index in Malaysia during the period of COVID-19. Despite the widespread concern about consumer behaviour during the COVID-19 pandemic, the Consumer Confidence Index (CCI) measurement using micro-data has gained less publicity. This study aims to look at the four facets of consumer confidence: current personal finances (CPF), expected personal finances (EPF), current economic conditions (CEC), and buying conditions (BC). This study explores the correlation between consumer confidence and willingness to save for future consumption. Simultaneously, this study determines if the pandemic has shifted consumer behaviour towards precautionary savings. An online survey was done to collect data from 681 Malaysians, and the data were quantitatively evaluated using a statistical software package known as SPSS. The findings indicate people are less confident in current personal finance (CPF) than in the other three dimensions, with females being less confident than men, M40 being less confident than B40, and Malay being less confident than other races. This study discovers that Malay ethnic groups are 3.49 times more likely to have the intention to save than other ethnic groups. B40 households are 1.294 times more likely to save than other income groups. Consumers with less confidence in their buying condition are 0.689 times more likely to have the intention to save. Consumers who lack confidence in their finances are 0.613 times more likely to save. In contrast to others, a consumer who is less confident in the present economic climate is 0.306 more likely to have the intention to save. The findings suggest that government financial help is essential to instil consumer confidence in the face of the COVID-19 pandemic, justifying financial aid programmes targeted at B40 families, small enterprises, and job creation. © 2018 Malaysian Consumer and Family.

Post-cardiac surgery outcomes following COVID-19 infection in unvaccinated patients.

The provision of cardiac surgery services nationwide has been affected by the COVID-19 pandemic. We noticed a high COVID-19 mortality rate in unvaccinated patients who were diagnosed with COVID-19 after recent cardiac surgery. All the patients were tested negative for COVID-19 before surgery. We conducted a review of our hospital data and reported our findings. We identified 15 patients and reported 7 deaths (46.7%). All the patients died from COVID-19 or its complications. We recommend that cardiac centres actively promote vaccination before cardiac surgery and also enhance infection control measures to prevent nosocomial infections.

Open distance learning simulation-based virtual laboratory experiences during COVID-19 pandemic

The widespread of coronavirus disease 2019 (COVID-19) pandemic led to a discovery that open distance learning (ODL) has turned out to be the only choice for teaching and learning by most institution (s) of higher learning (IHLs). In Malaysia, ODL is considered a new approach as physical laboratory practice has always been conducted for laboratory courses. This is a quantitative study which explores the perceptions of e-Lab among the students of bachelor’s in electrical and electronic engineering (EE) by focusing on the effectiveness and readiness in conducting the e-Lab. Simulation-based model is proposed for conducting the e-Lab using an interactive media and validated with the final score performance. With the future goals of improving the e-Lab in terms of delivering methods and engaging mediums between students and laboratory instructor, this study also discovered the levels of response from students’ perception to substitute the conventional laboratory by providing an equivalent and comparable learning experiences of the students. © 2022 Institute of Advanced Engineering and Science. All rights reserved.

The Impact of COVID-19 Crisis upon the Effectiveness of E-learning in Higher Education Institution

The infestation of the world pandemic has significantly changed the landscape of teaching and learning experience in Malaysia. Particularly for the institution under study, E-learning, previously used as the support medium to face-to-face classroom teaching, has become the primary medium of teaching and learning amid Covid-19. E-learning platform has replaced the face-to-face classes. Even though it is only a temporary approach, less is known in terms of its effectiveness. The present paper intends to examine the factors contributing to E-learning's effectiveness in a Higher Education Institution in Malaysia amid the COVID-19 crisis. The Technology Acceptance Model underpinned the conceptual framework. This study investigated the relationship between the independent variables (perceived usefulness, perceived ease of use, and self-motivation) and E-learning effectiveness. The data were collected through an online self-administrated questionnaire using Google form and received a total of 354 respondents. The data were analyzed using SPSS and Smart PLS. The findings revealed that perceived usefulness, perceived ease of use, and self-motivation positively influenced E-learning's effectiveness. This paper concluded that regardless of whether as the support medium or the primary medium in the teaching and learning process, the determinant to E-Learning effectiveness is still perceived the same. This study also supports the TAM proposition while incorporate self-motivation in measuring learning effectiveness. © 2021 University of Tehran. All rights reserved.