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Fulltext Body mass index and nutritional status of adults in two rural villages in northern malaysia

Narayan KA, Khan AR

Malays J Nutr, 2007 Mar;13(1):9-17.
PMID: 22692185 MyJurnal

There has been a change in the lifestyles of populations, including reduced physical activity and consumption of foods high in calories. Overweight and obesity are now replacing the more traditional public health concerns such as under-nutrition and infectious diseases as some of the most significant contributors to ill health. Determination of the body mass index (BMI) profile and nutritional status of adults of two rural coastal villages in Northern Malaysia was part of a community diagnosis in a community survey. Height and weight were measured and BMI calculated. Blood pressure was measured using a manual sphygmomanometer according to WHO guidelines. A standardised questionnaire was used to interview the villagers concerning their health. Out of the total population, 504 were above 20 years of age. Data was available for 441 persons for analysis. There were 210 (47.6%) males and 231 (52.4%) females. The prevalence of underweight was 9.8% (n=43), overweight 25.9% (n=114) and obesity 17% (n=75). The problem of over-nutrition was significantly higher among females, especially housewives. (p< 0.05). Those in ages 41-70 years were the majority with problems of over-nutrition (p=<0.05). More than half (52.9%; n=39) of those who were obese had hypertension (p=<0.05). Results show that a higher number of women especially housewives were obese and more than half of those obese subjects had hypertension. A more thorough nutritional profile using waist, hip and body fat measurement as well as an assessment of the dietary intake and activity regime of these villagers is needed. Interventions need to be carried out before more serious complications of obesity become rooted in this community.
Fulltext Student perceptions regarding the usefulness of explicit discussion of "Structure of the Observed Learning Outcome" taxonomy

Prakash ES, Narayan KA, Sethuraman KR

Adv Physiol Educ, 2010 Sep;34(3):145-9.
PMID: 20826769 DOI: 10.1152/advan.00026.2010

One method of grading responses of the descriptive type is by using Structure of Observed Learning Outcomes (SOLO) taxonomy. The basis of this study was the expectation that if students were oriented to SOLO taxonomy, it would provide them an opportunity to understand some of the factors that teachers consider while grading descriptive responses and possibly develop strategies to improve scores. We first sampled the perceptions of 68 second-year undergraduate medical students doing the Respiratory System course regarding the usefulness of explicit discussion of SOLO taxonomy. Subsequently, in a distinct cohort of 20 second-year medical students doing the Central Nervous System course, we sought to determine whether explicit illustration of SOLO taxonomy combined with some advice on better answering descriptive test questions (to an experimental group) resulted in better student scores in a continuous assessment test compared with providing advice for better answering test questions but without any reference to SOLO taxonomy (the control group). Student ratings of the clarity of the presentation on SOLO taxonomy appeared satisfactory to the authors, as was student understanding of our presentation. The majority of participants indicated that knowledge of SOLO taxonomy would help them study and prepare better answers for questions of the descriptive type. Although scores in the experimental and control group were comparable, this experience nonetheless provided us with the motivation to orient students to SOLO taxonomy early on in the medical program and further research factors that affect students' development of strategies based on knowledge of SOLO taxonomy.
Fulltext Prevalence of undetected cognitive impairment and depression in residents of an elderly care home

Al-Jawad M, Rashid AK, Narayan KA

Med J Malaysia, 2007 Dec;62(5):375-9.
PMID: 18705469 MyJurnal

The elderly population in Malaysia is growing rapidly. Some of the most vulnerable are in residential care. Research is needed into the characteristics of this population to aid clinicians and policy makers in addressing the needs of this group. This observational, cross-sectional study aims to determine prevalence of undetected cognitive impairment and depression in elderly care home residents in Malaysia. One hundred and sixty-seven people over 60 years of age living in a state run residential home were interviewed. Validated assessment tools were used to measure dependency, cognitive impairment and depression. The prevalence of probable dementia is 36.5%, with increasing prevalence with age and level of dependence. Prevalence of depression is 67.0% (major depression 13.2%), with more depression in males and in the Indian population. None of the identified cases had been previously investigated or treated for dementia or depression.
Fulltext Unmet needs for contraception in married women in a tribal area of India

Patil SS, Abdul Rashid K, Narayan KA

Malaysian Journal of Public Health Medicine, 2010;10(2):44-51.
MyJurnal

Background and Objectives: Unmet need for contraception is the gap between women's reproductive intentions and their contraceptive behavior. This community based interventional study was carried out to determine the unmet needs for contraception, the reasons for this and to assess the impact of interventional measures on acceptance of contraception.
Subjects and Methods: This study was conducted in 52 villages in the state of Maharashtra, India, among 363 married women selected by cluster sampling. Data was collected using an interview guide. An intervention was done for the women who had an unmet need and an assessment of the change was done subsequently. Data was analyzed by using SPSS.
Results The prevalence of contraceptive usage was 59.2% and the prevalence of unmet need for contraception was 44% (160). The unmet need for spacing births was 53.8%, 38.7% for limiting births and 7.5% women were dissatisfied with the current contraceptive method. The reasons ranged from side effects to contraceptives to source of obtaining contraceptives. Age of the respondents, education and number of living children showed statistically significant association with unmet needs. Post intervention, the contraceptive prevalence rate increased significantly 85.7% and there was a significant reduction in the unmet needs for spacing and limiting births, equally there was a significant reduction of dissatisfaction with using contraception.
Conclusion: Improvement in the use of contraception and addressing the unmet need for contraception requires community involvement and ongoing, sustained efforts by health workers to ensure quality care to the beneficiaries.
Fulltext Traditional male circumcision in a rural community in Kedah, Malaysia

Khan AR, Teh SP, Narayan KA

International e-Journal of Science, Medicine & Education, 2009;3(2):19-23.
MyJurnal

Background: Circumcision though not mentioned in the Quran is believed to be a compulsory practice among the Muslims. In Malaysia, although there are several methods of circumcision available and traditional circumcision is still popular.
Methods: A cross-sectional survey was carried out in a small fishing village of Kedah to study the methods of circumcision available to the villagers. This was followed with an in-depth interview conducted with ‘Tok Mudim’, a practitioner of traditional method of circumcision.
Results: Forty three of the eligible 71 subjects participated in the study giving the response rate as 60.5%. The most common age for circumcision was 9 years old. Despite private clinics being the most common place of circumcisions, there was an increasing number of boys going to the ‘Tok Mudim’ for circumcision. A Mass Circumcision Ceremony is traditionally practiced. The ‘Tok Mudim’ described the procedure in detail and was of the opinion that the reason traditional method is still popular was because of the fear of injections and impotency among the parents. Most common complication faced by the ‘Tok Mudim’ was bleeding and infection.
Discussion and Conclusion: Till the community shifts entirely to using modern medicine, there is a need to integrate traditional practitioners into the system. Training the ‘Tok Mudim’ to use modern instruments and aseptic techniques should be considered.
Fulltext Pattern of drug utilization in rural Malaysia

Hasamnis AA, Patil SS, Narayan KA, Khan AR, Mohanty BK

Ann Afr Med, 2010 Apr-Jun;9(2):106-7.
PMID: 20587935 DOI: 10.4103/1596-3519.64746
Fulltext Assessment of Self Perception of Competencies among a Group of Dental interns in Pondicherry, India

Muthu J, Muthanandam S, Sethuraman KR, Narayan KA, Ananthakrishnan N, Adkoli BV

J Educ Health Promot, 2019;8:255.
PMID: 32002427 DOI: 10.4103/jehp.jehp_53_19

CONTEXT: The general dentist must not only have a broad biomedical and clinical education but also be able to demonstrate professional and ethical behavior as well as effective communication and interpersonal skills. In addition he or she must have the ability to evaluate and utilize emerging technologies, continuing professional development opportunities, and problem-solving and critical thinking skills to effectively address current and future issues in health care. But the extent to which the core competencies are taught and the students' level of proficiency in these competencies in Indian scenario is to be explored at large.
AIMS: The present study aims at assessing the self-perceived level of competencies and their importance for future practice and the extent to which the competencies are taught in the curriculum among interns of dental college in Pondicherry, India.
SETTINGS AND DESIGN: The cross-sectional observational study was conducted among dental interns of Indira Gandhi Institute of Dental Sciences, Pondicherry.
SUBJECTS AND METHODS: A total of 72 interns participated in the study. A short version of the Freiburg Questionnaire to Assess Competencies in Medicine" was used in this study. Questionnaire has three sections with same set of questions, which the student had to rate: (i) To what extent do you have the following competencies at your disposal? (ii) To what extent will your future job require the following competencies? and (iii) To what extent is competencies taught to you? After the results were obtained a focused group discussion with the responders was done. Focused group discussion consisted of open questions to the groups in all the four domains and the responses of the students were scribed.
RESULTS: In all four domains, self-perceived level of competency was not satisfactory. However, all students stated that the competencies were highly relevant for their future practice. Despite this, most of the competencies are not taught to necessary extent in the curriculum. The results of the present survey revealed that the participating students perceived deficiencies in all domains of competencies.
CONCLUSIONS: These results indicate that the core competencies are still barely integrated into dental curricula and that further research in this field is needed.