Self-perception of sexual harassment: A comparison between female medical and nursing students during clinical practice.

BACKGROUND: Sexual harassment (SH) may occur anywhere in the world, including the hospital setting. Medical and nursing students are not excluded from being sexually harassed during their clinical practice. This study examined the experiences and compared the perception of SH between female medical and nursing students during their clinical practice in Perak, Malaysia. METHODS: A comparative cross-sectional study design was done among female medical and nursing students during their clinical practice. RESULTS: Total respondents were 481 female medical and nursing students (response rate of 96.2%). About 17.8% of medical and 18.8% of nursing students had been sexually harassed. The most common harasser for medical and nursing students were males (51.2% and 48.8%, respectively), patients (39.7% and 60.3%, respectively), age 30s (41.0% and 59.0%, respectively) and 40s (65.5% and 34.5%, respectively), occurred in medical wards for both groups (50% each). From the SH checklist, 76.9% of medical and 73.5% of nursing students had experienced at least one item of the total 18 items. The abnormal sexual desire of an individual was chosen as the reason for SH by 44.9% of medical and 33.8% of nursing students. The majority of respondents said the issue of SH in clinical practice was very serious. Around 32% of medical students choose the fear of being disadvantaged during clinical practice as the reason why the victims kept quiet while 41.5% of nursing students chose because of not having evidence. Both groups of students suggested establishing rules and laws relating to SH (30.8% and 35.5%, respectively) as effective methods to prevent it. About 75.3% of medical and 81.6% of nursing students agreed that it was very necessary for implementing a SH prevention program. DISCUSSION: Although SH is not a new issue, there is insufficient exposure about SH among medical and nursing students. This can be corrected by increasing their knowledge and awareness about SH.

Analysis of chemical compositions and larvicidal activity of nut extracts from Areca catechu Linn against Aedes (Diptera: Culicidae).

BACKGROUND: There is a growing need to use green alternative larvicidal control for Aedes larvae compared to chemical insecticides. Substantial reliance on chemical insecticides caused insecticide resistance in mosquito populations. Thus, research for alternate chemical compounds from natural products is necessary to control Aedes larvae. This study explores the analysis of chemical compositions from Areca catechu nut as a potential larvicide for Aedes (Diptera: Culicidae). METHODS: The Areca catechu nut collected from Ipoh, Perak, Malaysia was grounded into powder and used for Soxhlet extraction. The chemical analysis of the extracts and their structures were identified using the GCMS-QP2010 Ultra (Shimadzu) system. National Institute of Standards and Technology (NIST) Chemistry WebBook, Standard Reference Database 69 (https://webbook.nist.gov/chemistry/) and PubChem (https://pubchem.ncbi.nlm.nih.gov/), the two databases used to retrieve the synonyms, molecular formula, molecular weight, and 2-dimensional (2D) structure of chemical compounds. Next, following WHO procedures for larval bioassays, the extracts were used to asses larvicidal activity against early 4th instar larvae of Aedes aegypti and Aedes albopictus. RESULTS: The larvicidal activities were observed against early 4th stage larvae with different concentrations in the range from 200 mg/L to 1600 mg/L. The LC50 and LC95 of Aedes aegypti were 621 mg/L and 2264 mg/L respectively; whereas the LC50 and LC95 of Aedes albopictus were 636 mg/L and 2268 mg/L respectively. Mortality was not observed in the non-target organism test. The analysis using gas chromatography and mass spectrometer recovered several chemical compounds such as Arecaidine, Dodecanoic acid, Methyl tetradecanoate, Tetradecanoic acid , and n-Hexadecanoic acid bioactive components. These chemical constituents were used as additive formulations in pesticides, pest control, insect repellent, and insecticidal agents. CONCLUSIONS: Our study showed significant outcomes from the extract of Areca catechu nut and it deserves further investigation in relation to chemical components and larvicidal actions between different species of Aedes mosquitoes. Even though all these findings are fundamental, it may have some interesting potentials to be developed as natural bio-larvicidal products.

Socio demographic and lifestyle factors of metabolic syndrome among adult rural indigenous Malaysian population from Perak State, Malaysia.

Metabolic syndrome (MetS) is defined as a cluster of known disorders that increase the risk for morbidity and mortality from cardiovascular diseases (CVD) and type 2 diabetes mellitus. This cross sectional study was carried out to estimate the prevalence of MetS using Adult Treatment Panel 3 (ATP 3) classification and socio-demographic and lifestyle factors contributing to metabolic syndrome among rural indigenous Malaysian population from Perak state, Malaysia which included 148 rural Malay and 145 Orang Asli(OA) individuals. This community based cross-sectional study revealed that the prevalence of MetS was significantly higher among Malays (27.7%) as compared to Orang Aslis (13.8%). Overall Prevalence of Metabolic syndrome in the rural indigenous Malaysian population was 20.8%. Prevalence of abdominal obesity and high blood pressure were significantly higher among Malays as compared to OA population. Metabolic syndrome was significantly higher among those above 45 years of age group in overall rural indigenous Malaysian population and among OA. The prevalence of MetS was significantly higher among those who were obese and overweight and among Malays who were regularly taking snacks between meals. There was no significant association between other dietary risk factors, smoking, alcohol use or physical activity with metabolic syndrome.

Perceptions of Malaysian medical students from different academic years on primary care: a qualitative research.

Objective: To explore the perception of medical students from a private medical college in Perak, Malaysia, on primary care practice and induce the factors influencing their perception and willingness to consider primary care as a career pathway. Design: Qualitative study using focus group discussions. Participants' responses were audio recorded, transcribed, grouped under various domains and listed out and analysed. Setting: A private medical college in Perak state, Malaysia. Participants: Forty-six medical students from years 2 to 5 were included. Eight focus groups were formed with two focus groups from each academic year (six students each in seven groups and four students in one group). Students were informed through their respective student leader of each year and received a participant information sheet and an informed consent form which were completed and returned if they decided to participate in the focus group discussions. Results: The participants had different levels of understanding of primary care depending on their level of exposure to primary care. Senior students with more exposure had a better understanding about primary care and its services. Attractive factors towards choosing primary care as a career included short working hours with a more balanced family and social life, being able to treat patients as a whole with continuity of care and closer relationship with patients. Unattractive factors included routine, unchallenging and boring practice, poor salary, work overload and administrative work in government clinics, being less recognised by other specialties; and the poor perception by other doctors that those pursuing primary care were not 'brilliant enough' for more 'sophisticated disciplines like surgery or paediatrics'. Conclusion: This study showed that the medical students' level of exposure to primary care played a crucial role in determining their understanding of primary care practice and their choice of career in primary care. Issues to be addressed include remuneration, workload and the prejudice against primary care as a career pathway. Suggestions included introducing early exposure to fun and challenging primary care postings in the medical curriculum and producing well trained, skilled and enthusiastic role models.

Attitudes towards vasectomy and its acceptance as a method of contraception among clinical-year medical students in a Malaysian private medical college

INTRODUCTION@#This study explored attitudes towards vasectomy and its acceptance as a method of contraception among clinical-year medical students, and determined the association between their demographic characteristics, and attitudes and acceptance.@*METHODS@#A cross-sectional survey was conducted among clinical-year medical students from a Malaysian private medical college using a self-administered questionnaire.@*RESULTS@#There were 330 participants with a female preponderance and a mean age of 22.0 ± 1.1 years. The largest proportion of respondents were from Year 3. The vast majority were ethnically Malay (91.8%) and followed Islam (92.4%). Overall, 60.9% of participants had a positive attitude towards vasectomy and 76.0% showed good acceptance. Gender, academic year, ethnicity and religion variables were not associated with attitudes and acceptance (p > 0.05). A significantly higher proportion of male respondents thought that vasectomy was religiously forbidden and would give a bad impression. A significantly higher proportion of Year 5 students agreed to the statement 'I would recommend vasectomy to relatives, friends and people close to me' compared to Year 3 and 4 students.@*CONCLUSION@#Students' perception of vasectomy as a contraceptive method was encouraging. Our results suggest that their knowledge improved as medical training progressed, and attitudes evolved for the better irrespective of their traditional, cultural and religious beliefs - highlighting the importance of providing students with evidence-based learning about male sterilisation, which is more cost-effective and is associated with lower morbidity than female sterilisation. A qualitative study involving students from different ethnicities and religions would provide a better understanding of this subject.

Visualizing Hyperactivation in Neurodegeneration Based on Prefrontal Oxygenation: A Comparative Study of Mild Alzheimer's Disease, Mild Cognitive Impairment, and Healthy Controls.

Background: Cognitive performance is relatively well preserved during early cognitive impairment owing to compensatory mechanisms. Methods: We explored functional near-infrared spectroscopy (fNIRS) alongside a semantic verbal fluency task (SVFT) to investigate any compensation exhibited by the prefrontal cortex (PFC) in Mild Cognitive Impairment (MCI) and mild Alzheimer's disease (AD). In addition, a group of healthy controls (HC) was studied. A total of 61 volunteers (31 HC, 12 patients with MCI and 18 patients with mild AD) took part in the present study. Results: Although not statistically significant, MCI exhibited a greater mean activation of both the right and left PFC, followed by HC and mild AD. Analysis showed that in the left PFC, the time taken for HC to achieve the activation level was shorter than MCI and mild AD (p = 0.0047 and 0.0498, respectively); in the right PFC, mild AD took a longer time to achieve the activation level than HC and MCI (p = 0.0469 and 0.0335, respectively); in the right PFC, HC, and MCI demonstrated a steeper slope compared to mild AD (p = 0.0432 and 0. 0107, respectively). The results were, however, not significant when corrected by the Bonferroni-Holm method. There was also found to be a moderately positive correlation (R = 0.5886) between the oxygenation levels in the left PFC and a clinical measure [Mini-Mental State Examination (MMSE) score] in MCI subjects uniquely. Discussion: The hyperactivation in MCI coupled with a better SVFT performance may suggest neural compensation, although it is not known to what degree hyperactivation manifests as a potential indicator of compensatory mechanisms. However, hypoactivation plus a poorer SVFT performance in mild AD might indicate an inability to compensate due to the degree of structural impairment. Conclusion: Consistent with the scaffolding theory of aging and cognition, the task-elicited hyperactivation in MCI might reflect the presence of compensatory mechanisms and hypoactivation in mild AD could reflect an inability to compensate. Future studies will investigate the fNIRS parameters with a larger sample size, and their validity as prognostic biomarkers of neurodegeneration.

Role of the Whole Body Vibration Machine in the Prevention and Management of Osteoporosis in Old Age: A Systematic Review.

A literature search of related articles was carried out in electronic data sources. Initially, 276 randomised controlled trials related to the title were collected, after which 44 were selected using the keywords. Overlapping articles, articles with a study duration of less than six months, and studies involving young participants were removed from the list. The remaining 20 articles were checked for entitlement using the PEDro scale. A total of nine eligible articles with 1486 participants were analysed. Seven trials used dual-energy x-ray absorptiometry (DXA) to measure bone mineral density (BMD). The six trials published from 2005 to 2013 found a significant increase in BMD. In the remaining one trial, there was no significant increase in BMD. One study published in 2013 reported a significant increase in BMD measured with peripheral qualitative computed tomography, whereas another trial published in 2014 stated that there was a reduction in calcaneal bone density measured by peripheral qualitative ultrasound. From these findings it can be concluded that the whole body vibration machine is a good adjunctive therapy for the prevention and management of osteoporosis in postmenopausal women. However, further investigations are necessary before the same can be recommended for elderly men.

Review on the comparison of effectiveness between denosumab and bisphosphonates in post-menopausal osteoporosis.

OBJECTIVES: Osteoporosis is a rapidly rising cause of concern for elderly patients. Various classes of drugs are available in the market. Bisphosphonates are considered as a first-line therapy for the prevention and treatment. Denosumab is an antiresorptive agent which is a RANK ligand inhibitor. There is a scarcity of comparison between these two classes of drugs. The aim of this study is to compare efficacy of Bisphosphonates and Denosumab in various parameters. METHODS: Literature search was done for randomized controlled trials (RCTs) comparing bisphosphonates with denosumab. RCTs with a treatment period of at least one year with a baseline bone mineral density (BMD) and bone turnover markers (BTM) and follow up values at one year were included in the study. All included studies were also analysed for complications. The study has also been registered in PROSPERO International prospective register of systematic reviews. RESULTS: A total of five RCTs were identified providing data on 3751 participants. In all five studies, the BMD changes at both hip and spine were statistically significant in favour of denosumab. Result was similar in three studies that studied BMD changes at the wrist. Denosumab also produced significant reduction in BTM as early as one month, but at one year there was no difference compared to the bisphosphonates. There was no statistically significant differences in the complication rates. CONCLUSIONS: Though both bisphosphonates and denosumab were effective with similar side effects, the latter was statistically superior in increasing the BMD and reducing the BTM.