Psychological status among Emergency Department personnel in Hospital Universiti Sains Malaysia

OBJECTIVE: The aim of this study is to determine the psychological status, particularly level of depression, anxiety and stress level among Emergency Department personnel in Hospital Universiti Sains Malaysia and its association to demographic factors. METHODS: This prospective cross-sectional study was conducted in Emergency Department (ED) Hospital Universiti Sains Malaysia from March to June 2014. A total of 122 personnel from the ED who fulfilled the inclusion criteria were included in the study. Each personnel was given a set of questionnaire consisting demographic background and the DASS 21 form. Demographic factors assessed were age, gender, race, profession and years of working experience. RESULTS: The results from 122 personnel showed a total of 2 personnel (2%) recorded score for moderate depression, 5 personnel (4%) recorded for moderate anxiety and 3 personnel (2%) recorded for severe anxiety. No personnel recorded for moderate-severe stress. Among the demographic factors tested, statistically significant associations were found between stress levels with age, profession and working experience of personnel. Significant associations were also found between depression levels with the gender of personnel. CONCLUSION: The psychological status, particularly depression, anxiety and stress level among ED personnel were generally low. The stress level was noted to be most affected by demographic factors compared to depression and anxiety

Assessment of practical science communication skills as a core competency of admission to undergraduate medical programmes: nationwide outcomes and associated factors

Interprofessional scientific communication skills are an essential part of the medical profession. Multiple research suggests poor interprofessional communication has direct correlations with poor patient outcomes. As part of the inaugural Multiple Mini Interview (MMI) at Universiti Malaysia Sabah, a 5-minute station on science communication was introduced, assessed on three domains – logical thinking, communication skills, and general impression. This station featured a panicky nurse calling a doctor to get them to calculate doses of a medication, using only upper primary school-level arithmetic and knowledge of ratios. Methods: 255 candidates, grouped into 3 separate geographical groups – Klang Valley, non-Klang Valley, and Borneo – participated in the MMI featuring a science communication station. Candidates were graded in the abovementioned three domains, and correlations were calculated between scores and various sociodemographic factors, with an objective written basic science test, and with overall scores. Also, quantitative analysis was done of the “red flag” comments for candidates deemed unsuitable for the practise of medicine. Results: The average scores for West Malaysia for logical thinking scores were higher than Borneo, with non-Klang Valley scores (4.1) significantly higher than Klang Valley (3.6). Communication scores were also significantly lower in Borneo compared to West Malaysia. General impression scores hence also showed a discrepancy between West Malaysian and Bornean scores. There were a total of 8 red flags, with reasons ranging from gross miscalculation with misplaced confidence, to nervous breakdowns while performing calculations. Conclusion: The present study showed that there is a distinct separation of science communication scores between geographic regions. Also it illustrates the yawning gap between academic knowledge and “translational” scientific knowledge. The results illustrate the need for medical curricula to boost resilience and translational computational skills in medical graduates who will be working in environments that demand usual abilities under unusual and trying circumstances

Can Clinical Skill Laboratories (CSLs) be Online?

Clinical skill laboratories (CSLs) are integrated community, objective, and outcome-based learning processes that integrate basic knowledge with clinical skills. CSLs are hospital or medical school-based teaching which includes self-directed, student-centered and problem-based learning. CSLs can be taught in the procedural room, out-patient department, primary healthcare center, casualty department, and simulation settings (Al-Elq, 2007). Experienced clinician, a small group of self-motivated students, cooperative patients, adequate and reliable instruments, enough time to practice, and a comfortable room with adequate ventilation are factors for effective CSLs (Ramani & Leinster, 2008). The teaching activities and learning can be face-to-face or blended learning, e-learning and online learning. Nowadays, blended and online learning is gaining more popularity. Blended learning combines face-to-face and online learning that supports creative, critical thinking skills (Garrison & Kanuka, 2004). Synchronous and asynchronous learning is the part of online learning where teachers use video and audio technologies (Gormley et al., 2009)

Near infrared illumination optimization for vein detection hardware and software approaches

Venepuncture is one of the most crucial processes in many medical procedures. However, finding a real-time and vibrant visualization of the vein structures faces many difficulties. Several devices were introduced to solve this problem, yet, these devices shared common drawbacks, primarily when visualizing deep veins or veins in a thicker tissue of the human body. This study proposes a novel method for visualizing vein structures using a near-infrared (NIR) imaging technique enhanced with Hessian ridge detection. Several factors, including the wavelength of NIR light, square LED and ring LED arrangement and the effect of the diffuser and number of LEDs, were evaluated in the study. This study improves the overall quality of the acquired vein images and highlights the vein-morphological structure through image processing techniques. The study’s main aim is to achieve the highest number of visible veins. Based on the optical window, the maximum absorption range in the NIR spectrum was found from 700 to 950 nm. The NIR light absorption of human deoxygenated blood in the vein was highest at 850 nm peak of wavelength. The image processing further enhances the vein image by highlighting the extracted vein. The study also suggests that the square LED arrangements of NIR illumination are much more robust than the ring LED arrangement in ensuring excellent light penetration. The light diffuser further adds promising effects to the NIR illumination process. In terms of the square LED arrangement, increasing the square LED for enlarging the illumination area did not show any degradation effects in the visualization process. Overall, this paper presents an integrated hardware and software solution for the NIR image acquisition of a vein visualization system to cope with the image visualization of the vein for a thicker part of the human tissue, particularly on the arm and palm area

A Diagnostic Conundrum in a Localized Ascending Aortic Aneurysm

Aortic dissection (AD) is an uncommon life-threatening emergency. Its development is usually subtle and easily missed. On the other hand, an aneurysm nearly always requires immediate surgical intervention. Both interventions are technically different and pose their own challenges. We experienced a distinct case of AD of the ascending aorta in a 65-year-old lady, who presented with a sudden onset of severe chest pain and shortness of breath. Thoracic aortic aneurysm was suspected as computed tomography revealed a saccular aneurysm of the proximal ascending aorta with no involvement of the valve and aortic branches. Surgery was decided after considering the risk of rupture and mortality. However, a diagnosis of localized aortic dissection was discovered and repaired accordingly. We discuss the pitfalls of diagnostic modalities and the techniques of surgical repair

Factors Associated with Uncontrolled Hypertension among Hypertensive Patients in Tuaran, Sabah, Malaysia: A Cross- Sectional Study

Hypertension prevalence is increasing globally and has become a major issue of disease as it is a major cause for cerebrovascular, kidney and cardiovascular diseases. Even among treated patients, there is a disproportional of blood pressure control causing a major public health challenge. This study is aimed to decide on the prevalence of uncontrolled hypertension and its associated factors among hypertensive patient attending hypertension clinic at primary health clinics in Tuaran district. This study is justified by the fact that uncontrolled hypertension leads to high mortality, morbidity and even premature death. Methods: This study is a cross-sectional study among 460 hypertensive patients attending three primary health clinics in Tuaran district, Sabah. Data were collected using structured modified questionnaires through interviews, physical examinations and patient’s medical records. Types of data collected include socio-demography, lifestyle behavior, physical examination, co-morbidity status and medical adherence. Data analysis done using SPSS version 24.0. Results: Prevalence of uncontrolled hypertension was 45.9%. The study found that factors significantly associated with uncontrolled hypertension with p<0.05 were lower medication adherence (OR 1.834, 95% CI: 1.256, 2.678), presence of diabetes mellitus (OR 3.436, 95% CI: 2.104, 5.613), high BMI status (OR 1.975, 95% CI: 1.305, 2.990) and male gender (OR 2.1, 95% CI: 1.442, 3.061). Conclusion: The prevalence of uncontrolled hypertension was found in nearly half of the study population. The present of other associated factors such as lower hypertensive medication compliance, diabetes mellitus and obesity had a higher impact on uncontrolled hypertension patients in the study group. Further study is needed to address attitude change, extra guidance, coaching and empowerment issues in the treatment of hypertensive patients

Pemphigoid Gestationis and adverse pregnancy outcomes: A literature review

Pemphigoid gestationis (PG), also known as gestational pemphigoid, as it is specifically associated with a pregnancy event, is among the rare pregnancy-related dermatoses, characterised by the formation of autoantibodies against Bullous Pemphigoid antigens 180 and 230 (BP180 and BP230), causing significant damage to the basement membrane of the skin, resulting in marked pruritus and blisters on the abdomen and extremities. Diagnosis of PG is basically made by the characteristic clinical picture and confirmed by immunofluorescence studies and histopathology of a skin biopsy. Treatment, just as for other autoimmune dermatoses, is achieved by corticosteroids with the risk of relapses in subsequent pregnancies. Fetal growth restriction and pre-maturity are potential fetal complications associated with the disease, hence the recommended combined antenatal care by a dermatologist as well as an obstetrician, however, this disease is unlikely to be a source of significant maternal morbidity or mortality

Factors associated with uncontrolled hypertension among hypertensive patients reported from different primary health clinics in Tuaran, Sabah, Malaysia: a cross sectional study

Objective: Hypertension is a major global issue and in an increasing trend. A disproportional balance between blood pressure controls among treated hypertensive patients is a challenge in public health as uncontrolled hypertension is the main contributor to cardiovascular, cerebrovascular and kidney diseases. Aims of the study are to determine the prevalence of uncontrolled hypertension and associated factors among hypertensive patients attending hypertension clinic at primary health clinics in Tuaran district. Justification of this study is uncontrolled hypertension causing high morbidity and mortality including premature death. Material and Methods: Study included 460 participants; is a cross-sectional study among hypertensive patient registered at three primary health clinics in Tuaran district, Sabah. Data were collected using structured modified questionnaires and analyzed using SPSS version 24.0. Results: Prevalence of uncontrolled hypertension was 45.9%. The study found that male gender (OR 2.1, 95% CI: 1.442, 3.061), high BMI status (OR 1.975, 95% CI: 1.305, 2.990), presence of diabetes mellitus (OR 3.436, 95% CI: 2.104, 5.613) and lower medication adherence (OR 1.834, 95% CI: 1.256, 2.678) were significantly associated with uncontrolled hypertension with p <0.05. Conclusion: The prevalence of uncontrolled hypertension in this study population was high with nearly half of the study population had uncontrolled hypertension. Combination of associated factors such as obesity, diabetes mellitus and lower hypertensive medication compliance had a higher impact on uncontrolled hypertension among the study group. This study further needed to address an attitudinal change, extra guidance, coaching and empowerment in the treatment of hypertensio

Medical education during the COVID-19: a Malaysian experience

The novel coronavirus (SAR-CoV-2) pandemic has affected all levels of education, including medical education worldwide. Most medical schools have had to withhold all face-to-face classes and resort to online classes, adapting from live clinical exposure to a virtual one. This conversion to online methods has led to many difficulties in delivering psychomotor and affective topics, thus leaving many concerns on the quality of graduates produced. However, the pandemic has enhanced online education, telehealth, and adaptive research protocol advancement in another perspective. These occurred as all parties embarked on exploration for the best online class and examination approach to surrogate face to face exposure. This article discussed the experience of the medical students in the Medical Doctor Programme of the Universiti Malaysia Sabah (UMS) in adapting the medical students' training with the emergence of the coronavirus disease (COVID-19) pandemic