Displaying publications 21 - 40 of 173 in total

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  1. Barling, Peter Michael
    MyJurnal
    This paper presents the solution to a calculation of the pH of a very dilute solution of a strong acid or base, taking into account the effect of the hydronium or hydroxyl ions generated from the ionisation of the strong acid or base on the ionisation of water, as a second very weak acid. To be solved successfully, this calculation involves the concepts of conservation of charge, pH and the application of the general solution to a quadratic equation. Such an exercise involves the application of skills in basic numeracy, and can provide a core of understanding that can prepare students for
    many different sorts of calculations that represent reallife problems in the medical and biological sciences.A programme is presented in C++ which enables the work of students to be individualised so that each student in a class can work through a slightly different pH calculation, in such a way that a class supervisor can quickly check each student’s result for accuracy. This exercise is presented as a potential means of enabling students to undertake and master similar types of calculations involving simple or more complex equilibria.
  2. Kavana, N.J., Lim, L.H.S., Ambu, S.
    MyJurnal
    Background: The present study describes the morphology of sparganum (larva) of the Malaysian Spirometra spp. collected from naturally infected frogs (Rana cancrivora) from rice fields in Tanjung Karang, Malaysia.

    Materials and Methods: Spargana of Spirometra spp. collected from naturally infected frogs (Rana cancrivora) were used for the morphological studies. Stretched on a metal ruler, measurements of the worm were recorded. Specimens were stained in Alum-carmine.

    Results: The length of the body ranged from 11-50 mm and the width ranged from 0.5-1.5 mm. Specimens stained with Alum-carmine showed ridges (formation of segments) on the surface of the body, and no sexual organs in the body.

    Conclusion: The Malaysian Spirometra spp. are similar in measurement and morphology to Spirometra erinacei but further studies are required for confirmation.
  3. Mitra, N.K., Nagaraja, H.S., Ponnudurai, G., Judson, J. P.
    MyJurnal
    Item analysis is the process of collecting, summarizing and using information from students’ responses to assess the quality of test items. Difficulty index (P) and Discrimination index (D) are two parameters which help evaluate the standard of MCQ questions used in an examination, with abnormal values indicating poor quality. In this study, 120 test items of 12 Type A MCQ tests of Foundation 1 multi-disciplinary summative assessment from M2 / 2003 to M2 / 2006 cohorts of International Medical University were selected and their P-scores in percent and D-scores were estimated using Microsoft Office Excel. The relationship between the item difficulty index and discrimination index for each test item was determined by Pearson correlation analysis using SPSS 11.5. Mean difficulty index scores of the individual summative tests were in the range of 64% to 89%. One-third of total test items crossed the difficulty index of 80% indicating that those items were easy for the students. Sixty seven percent of the test items showed acceptable (> 0.2) discrimination index. Forty five out of 120 test items showed excellent discrimination index. Discrimination index correlated poorly with difficulty index (r = -0.325). In conclusion, a consistent level of test difficulty and discrimination indices was maintained from 2003 to 2006 in all the twelve summative type A MCQ tests.
  4. Lim, Swee Geok, Yam, Siew Woan
    MyJurnal
    Introduction: Patient falls has been identified as one
    of the major issues in today’s health care despite efforts
    taken in preventing such incidents from happening
    (Cox et al., 2014). Patient falls can be prevented by
    using fall risk assessment tools such as Morse Fall Scale.
    Morse Fall Scale was implemented in the year 2014 in a
    private hospital in Malaysia but the patient fall rate did
    not decrease.

    Objective: The research objective is to determine the
    nurses’ level of knowledge and competency in the use
    of the Morse Fall Scale as an assessment tool in the
    prevention of patient falls.

    Method: A quantitative, descriptive, cross-sectional
    research design was conducted with 100 registered nurses
    from a private hospital in Selangor, Malaysia. Universal
    sampling technique was used to recruit the nurses.
    Results: The registered nurses had a moderate level
    of knowledge (M = 7.72; SD = 1.72) and competency
    (scoring Morse Fall Scale, M = 4.75; SD = 1.26;
    planning intervention, M = 13.19; SD = 1.89) in using
    the Morse Fall Scale.

    Conclusion: It is recommended that a review of the
    training programme on the use of the Morse Fall Scale
    be implemented in a more structured manner.
  5. S. Sulaiha S.A., Wee, Yun Ling, Lie, Joo Chin, Eow, Wei-Liang, Muhamad Faiz, S., Chien, Noris Fook Tan
    MyJurnal
    Background: Nosocomial infection is among the leading problem in many major hospitals resulting in soaring cost expenditure in managing its affect.Hand washing practice is a crucial preventive way to contain such mischief but many ignored its importance. This is perhaps due to lack of appropriate role modeling from senior practitioners.
    Subjects and methods: Our study examined the prevalence of hand washing practice among medical students from year 3 to 5 and compared it to their knowledge and level of awareness on its importance in clinical practice. 142 students were randomly observed during their clinical work in the wards on this practice and questionnaires were later distributed to 268 students from all semesters on their knowledge on the technique and awareness on its importance.
    Results: Out of 142, almost 80% washed their hands but only 41.6% performed effective hand washing. In contrary, 80 to 90% showed good level of knowledge and awareness as well as perception about its importance in clinical practice.
    Conclusions: The contradictory findings between the actual practice of hand washing and knowledge as well as awareness suggest that enforcement on the practice is necessary. This requires motivation and cooperation from all health alliances and higher authority in the health system. Remedial measures are much needed in order to contain high incidence of nosocomial infection in our local practice.
  6. Nalliah, Sivalingam
    MyJurnal
    This is a cross sectional study conducted in July 2010 at the International Medical University, Seremban, Malaysia. The objective of this study was to ascertain the relationship between working memory capacity of final MBBS medical students using the digit span backward test and their academic achievement based on the total score at the modified
    essay questions (MEQ) which was the principal component of the theory examination. Seventy eight final year medical students were recruited,41 (52.6%) were females and remaining 37 (47.4%) were males. Working memory capacity was measured by digit span backward test (DSBT) which ranged from3 to 8 digits. The mean digit score was 6.6 ± 1.1 falling under the category of ‘above average’ score. There was no significant difference between working memory capacity and gender (p>0.05). There was no significant difference in the MEQ mean score and the different categories of working memory capacity (p>0.05).
    The DBST shows uniformity in working memory adequate to pass the modified essay questions. Medical students appear to use encoding and retrieval process in problem solving based on functionality and pattern recognition in tackling the problems in the MEQ.
  7. Radhakrishnan, Ammu Kutty, Lee, Nagarajah, Young, Mei-Ling
    MyJurnal
    Background: Medical schools have long been concerned with establishing a suitable process of
    admission. The criteria used to select students have traditionally focussed on high academic achievement. Method: The International Medical University (IMU) accepts students from a wide range of pre-university entry qualifications for admission into the medical programme. The criteria for the various pre-university entry qualifications used by the IMU were agreed and accepted by the IMU Academic Council (AC), which consist of deans of the IMU’s partner medical schools (PMS). In this study, the various entry qualifications were first grouped into five categories based on the educational pedagogy. Then, this was aligned with the entry qualification data of all students who had been admitted into the IMU medical programme for the period of December 1993 to March 2000. During this period 1,281 students were enrolled into the IMU medical programme. The relationship between the five groups of pre-university entry qualifications and the students’ academic achievement in three end-ofsemester (EOS) examinations namely EOS 1, EOS 3, and EOS 5 were analysed. Results: Students with better grades in their preuniversity examinations showed better performance in their EOS examinations, regardless of the subjects that they took at the pre-university level. Cluster analysis revealed that students who came in with certain preuniversity qualifications generally performed poorly than the more conventional qualifications. However,
    after their first year in medical school, there were no significant differences in the clustering of the students. Conclusion: Students with better grades in their preuniversity examinations showed better performance in their EOS examinations, regardless of the science subjects that they took at the pre-university level.
  8. Stephen Ambu
    MyJurnal
    The global environment is in a dynamic flux due to rapid development. As a result of this, new
    diseases are emerging and old diseases are re-emerging in many parts of the world. Therefore there is a constant need for appropriate data for formulation of effective policies to mitigate the adverse effects of environmental degradation on human health. The Kyoto Protocol of 1997 is a milestone that sets the direction for good environmental management initiatives and the success
    of this depends on good data. Malaysia currently has the Environmental Quality Act 1974 in place to
    control environment related problems. However good guidelines must be developed to keep the initiatives for good environmental management on course, for this we need good data. The Centre for Environmental and Population Health at IMU, coordinates research activities in specific thrust areas in an endeavour to produce important data that is required for developing appropriate guidelines for environmental health.
  9. Nazimah Idris, Sivalingam Nalliah
    MyJurnal
    This paper attempts to utilise clinical scenarios where ethical issues are embedded and requires appropriate application of the steps of the framework mentioned. A step by step sequential approach is adopted to illustrate how the ‘ethical decision model ‘can be used to resolve ethical problems to arrive at a reasonable conclusion. The UNESCO ethical method of reasoning is used as the framework for decision making. Physician-educators should be competent to use ethical decision models as well as best available scientific evidence to be able to arrive at the best decision for patient care as well as teach health professional trainees how reasonable treatment decisions can be made within the perimeter of medical law and social justice.
  10. Kandasami P
    MyJurnal
    The only potential curative therapy for gastric cancer is the resection of both the tumor and the regional lymph nodes at the early stage of the disease. The majority of patients with gastric cancer in Malaysia have an advanced disease at initial diagnosis, and curative surgery is possible in less than 20% of operated cases. Acurate preoperative staging is crucial in determining the most suitable therapy and avoiding unnecessary attempts at curative surgery. While computed tomography remains as the most widely used imaging modality for gastric cancer staging, its ability to detect local invasion, peritoneal and liver metastases is limited. In the recent years laparoscopy has become an important component in the staging algorithm of gastric cancer. The aim of this review is to evaluate the efficacy of routine preoperative laparoscopic staging in the management of gastric cancer, and in particular describe the Malaysian experience.
  11. Tamara Gien Pooke, Rozi Mahmud, Suraini Mohamad Saini, Yap, Poh Sin, Sharifah Roohi Syed Waseem Ahmad, Harwant Singh
    MyJurnal
    Introduction: The goal of this study was to assess the effectiveness of seated combined extension-compression and transverse load (ECTL) traction as a new method for increasing a reduced lordosis of less than 30 degrees in a Malaysian population between the ages of 18 and 60 years. Possible changes in disc height were measured in accordance with the underlying theoretical framework, that suggests the anterior cervical structures would elongate due to creep over the fulcrum of the traction device.
    Method: This was a single centre, randomised, blinded controlled clinical trial with parallel groups, used to test the superiority of the seated combined ECTL traction together with physiotherapy exercises when compared with the same physiotherapy exercises used as a control. Fifty randomly allocated subjects who completed the forty treatments over the fourteen weeks were analysed using non-parametric tests for changes in outcomes.
    Results: There were no significant changes in outcomes for disc height changes seen in this study. The findings of a greater overall increase in posterior disc height changes compared with anterior disc height changes were in contrast with the proposed underlying theoretical framework for this type of ECTL traction. The greater height changes occurring in the control group were also unexpected.
    Conclusion: The findings in this study of the contrasting changes in disc height of greater posterior than anterior height changes, question the underlying theoretical framework as postulated for this type of traction.
  12. Stephen Ambu, Stacey Foong Yee Yong, Yvonne Ai Lian Lim, Mak Joon Wah, Donald Koh Fook Chen, Soo Shen Ooi, et al.
    MyJurnal
    Background: The public health issue of consuming groundwater is a major concern because people often extract groundwater directly from the aquifers either through wells or boreholes without treating it with any form of filtration system or chlorine disinfection. Based on the Malaysian National Drinking Water guidelines the current study was designed to provide a better understanding on the variable factors that are influencing the quality of well-water in an urbanised village in Malaysia. Well water quality assessment of heavy metals, chemicals, microbial and physical parameters were carried out for Sungai Buloh Village in the Klang Valley to ensure it was safe for human consumption.

    Materials and Methods: Water samples were collected from wells at four sites (Sites A,B,C,D), a river and a tap inside a house in Sungai Buloh village. Soil was sampled from the riverbed and area surrounding the wells. Samples were collected every two months over a one year duration from all sites. The water samples were processed and examined for viruses, coliforms and protozoa as well as for heavy metal contaminants.

    Results: The turbidity and colour ranged in the average of 0.57-0.13 Nephelometric Turbidity (NTU) and 4.16-5.00 Total Conjunctive Use (TCU) respectively for all sites except Site C. At Site C the turbidity level was 2.56 ± 1.38 NTU. The well-water was polluted with coliforms (1.2 to 2.4 x 103 CFU/100 ml) in all sites, E. coli (0.12 - 4 x 102 CFU/100 ml CFU/ 100 ml) and Cryptosporidium oocysts (0.4 cysts/100 ml). All the heavy metals and chemical parameters were within the Malaysian Guidelines’ limits except manganese. The average pH ranged from 5.44 - 6.62 and the temperature was 28 ºC.

    Conclusion: In summary, the well water at Sungai Buloh is considered unsafe for consumption due to pollution. Therefore the major thrust will be to provide better quality of drinking water to the residents of the village.
  13. Judson, John Paul
    MyJurnal
    The relationship between anatomy and surgery has been historic and epic, spanning many centuries, complementing each other in medical education and being independent as well as interdependent in many ways. However, curricular changes that have happened globally in recent years with the introduction of several contemporary styles of medical teaching have subtly downplayed the importance of anatomy in medicine, allowing young doctors with poor knowledge of anatomy to become surgeons. With a whimsical introduction that metaphorically hints at the strained relationship that exists between anatomy and surgery, the article attempts to explore the ‘anatomy’ of anatomy itself, examining its origins in recorded ancient history, evolution along the centuries in tandem with surgery and its current status in medical education.
  14. Suleiman AB
    MyJurnal
    In ancient times, before Hippocrates, disease and illness were attributed as a sign of divine dismay, and the Gods needed to be appeased to achieve a cure. Hippocrates and his followers showed courage in breaking away from this paradigm. They moved away from the divine and supernatural, to focus on the biology of the body. In the process they put the patient at the centre of their focus. They collected detailed case histories, dismissed religious and supernatural explanations and developed remedies in the form of diets, exercise and mixed minerals and herbs based on their understanding of ill health.
  15. Syed Aznal SA, Nurjahan MI, Lee N
    MyJurnal
    Introduction: Task-based learning (TBL) has been accepted as an effective tool in teaching and learning activities in most medical schools. Many studies have looked at competencies and learning outcomes essential for undergraduates. Among the essential competencies are interpersonal skills and the ability to engage in a group discussion which this study has focused on. The evidence supporting higher interpersonal skills is however limited because many relevant competencies are hard to measure and require long observational periods.
    Objective: To determine students’ self-perceived value of TBL in enhancing their interpersonal skills during the clinical phase.
    Material and Methods: All students’ (semesters 6-10) in the clinical school of International Medical University (IMU) were invited to participate in this cross-sectional study done in December 2007 utilising a self-administered questionnaire with a 5-point Likert scale. It assessed the students’ perception on TBL sessions conducted during their clinical attachments in the various disciplines. Mean-scores, standard deviations, and confidence interval were used.
    Results: Response rate was 62%. The results indicated that students were favorable in their opinion on TBL as a suitable forum for active communication and participation in group discussion. The results also show that both male and female students’ have similar perception. As for the comparison according to semesters, this showed that students’ maturity does not influence their perception as well.
    Conclusion: In conclusion, the study has shown positive students’ perception on the effect of TBL on acquired skills such as interpersonal communication. Our findings are consistent with many earlier studies which show students’ perception of the method of learning as important factor in the enhancement of their interpersonal skills which is fundamental to clinical practice. Further research is necessary; long-term and larger scale observational studies would undoubtedly be optimal to minimise response bias.
  16. Kow, Ren Yi, Aziah Abdul Aziz, Muhammad Firdaus Abas, Low, Chooi Leng, Akmal Azim Ahmad Alwi
    MyJurnal
    The human foot serves as an important part to support
    the body weight and accounts for the majority of our
    movements. A mangled limb involves injury to at least
    three out of four systems, namely the soft tissues, nerves,
    blood supply and bone. While amputation is indicated in
    some cases of mangled limb, with proper planning, limb
    salvaging surgical management is also a viable option.
    Special consideration to the skeletal stabilization, control
    of infection, vascular status and soft tissue coverage is
    paramount to the success of limb salvaging surgery. We
    present a case of mangled limb which was successfully
    treated with limb salvaging surgical management. Initial
    debridement, Kirschner wires insertion and cross ankle
    external fixation were used for skeletal stabilization. An
    antibiotic spacer was inserted for local antibiotic and to
    maintain the length left due to the loss of medial and
    intermediate cuneiform bones. The anterior tibialis
    artery and its venae comitantes were utilized for free
    vascularized fibular graft to provide bony reconstruction
    as well as soft tissue coverage for the mangled foot.
  17. Toh, Peng Yeow, Wai, Sun Choo, Amir S. Khir, Li, Cher Loh
    MyJurnal
    Background: Clinical clerkship in a busy hospital environment forms an important part of undergraduate medical training. Regular objective assessment of this activity with feedback would be expected to improve outcome.

    Methods: We implemented fortnightly clinical assessments using modified OSLER (Objective Structured Long Examination Record), and over a 6-week clinical rotation. Modifications included provision of individualized feedback. The assessment process was evaluated by both students and teachers via a questionnaire measuring their perceived educational impact, feasibility and acceptability.

    Results: Students agreed that the patient spectrum was appropriate and fair, resulting in improved history taking and presentation skills (96.6%), clinical examination skills (89%) and clinical reasoning skills (90.7%). It was graded to have helped learning “tremendously” and “moderately” by 64.7% and 32.8% of students respectively. Perceived improvement was attributable mainly to the repetitive nature of the assessments since only 63% of students were provided with feedback. 96.6% of students and 94.1% of assessors perceived the format created a stressful but positive learning environment. 52.9% of assessors agreed that the exercise consumed significant time and resources but 88.2% rated it as manageable and supported its continuation.

    Conclusion: Frequent and regular in-course clinical assessments with emphasis on individual feedback is feasible, acceptable and has significant positive educational impact.
  18. Htar Htar Aung, Nilar Shwe, Tin Tin Myint, Tin Moe Nwe
    MyJurnal
    Introduction: It is still a challenge that the
    dissecting room has a place in learning gross anatomy.
    Understanding the students’ preference of learning
    tools is important to devise alternative teaching aids
    for improvement in learning anatomy. This study was
    conducted to assess student’s preference of learning tools
    available in the anatomy laboratory of an integrated
    curriculum.

    Methods: A cross-sectional comparative study was
    carried out for 4 weeks among 741 medical and dental
    students of International Islamic University Malaysia
    (IIUM), Universiti Teknologi MARA (UiTM),
    University Sabah Malaysia (UMS) and University
    Malaysia Sarawak (UNIMAS). Pre-tested, semistructured,
    self-administrated questionnaires including
    open-ended questions were distributed. The data were
    analyzed by using SPSS 17.

    Results: Most of the participants were Malays (86%) and
    female (67%). The students from IIUM, UiTM, UMS
    and UNIMAS preferred the plastic model in terms of
    handability and application in examination (OSPE). It was
    statistically significant (p
  19. Chin, Yow-Wen, Loh, Li-Cher, Wong, Thim-Fatt, Abdul Razak Muttalif
    MyJurnal
    Introduction: To review the sputum bacteriology and its in-vitro antibiotic susceptibility in patients hospitalized with community-acquired pneumonia (CAP) in a state tertiary-referral Hospital (Penang hospital, Malaysia) in order to determine the most appropriate empiric antibiotics.
    Methods: From September 2006 to May 2007, 68 immunocompetent adult patients [mean age: 52 years (range 16-89); 69% male] admitted to respiratory wards for CAP with positive sputum isolates within 48 hours of admission were retrospectively identified and reviewed.
    Results: 62 isolates were Gram(-) bacilli (91%) & 6 were Gram(+) cocci (9%). The two commonest pathogens isolated were Pseudomonas aeruginosa (n=20) and Klebsiella pneumoniae (n=19) together constituted 57% of all positive isolates. Among the Pseudomonas isolates, 84.2% were fully sensitive to cefoperazone and cefoperazon/sulbactam; 95% to ceftazidime, cefepime, piperacillin/tazobactam, ciprofloxacin and amikacin, and 100% to gentamycin, netilmycin, imipenem and meropenem. Among the Klebsiella isolates, 5.3% were fully sensitive to ampicillin; 84.2% to amoxicillin, ampicllin/sulbactam, cefuroxime and ceftriazone; 89.5% to piperacillin/ tazobactam; 93.3% to cefoperazon/sulbactam and 100% sensitive to ceftazidime, cefepime, ciprofloxacin, all aminoglycosides and carbopenems.
    Conclusion: In view of the high prevalence of respiratory Pseudomonas aeruginosa, ampicillin/ sulbactam, currently the most prescribed antibiotic to treat CAP in our respiratory wards, may not be the most appropriate empiric choice. Higher generation cephalosporins with or without beta-lactamase inhibitors, ciprofloxacin or carbapenem may be the more appropriate choices. The lack of information on patients’ premorbidities such as recent hospitalization and prior antibiotic exposure, limits the interpretation of our findings and may have biased our results towards higher rates of Gram negative organisms.
  20. Sangeetha Poovaneswaran, Justin Zon Ern Lee, Whei Ying Lim, Navarasi S Raja Gopal, Fauziah Mohd Dali, Ibtisam Mohamad
    MyJurnal
    Solitary adrenal metastasis is a rare presentation in breast cancer and it presents the clinician with a difficult therapeutic dilemma as there are no existing guidelines for optimal management. On literature review, we only found one published case report of solitary adrenal metastasis from infiltrating ductal carcinoma of the breast. Here we present a case of a 75 year-old lady who presented with a right breast lump which was subsequently confirmed to be infiltrating ductal carcinoma. She underwent a right mastectomy and axillary clearance. Computerised tomography (CT) staging revealed a solitary adrenal metastasis. She was treated with aromatase inhibitors and her tumour markers which were initially raised has now normalised.
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