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)

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

Embolization in Haemorrhage-associated Transurethral Resection of Prostate: An Advancement of Endovascular Technique

Benign prostatic hyperplasia is common in the elderly. The surgery of choice in those who failed medical treatment is transurethral resection of the prostate (TURP). Post- TURP haematuria can be distressing and difficult to manage. The physiological changes in the elderly have led to inability to withhold hypovolaemic states especially in inoperable patients. Using endovascular modalities, this complication can be managed efficiently without endangering patients’ well-being. Herein, we present a case of a successful prostatic artery embolization in a patient with a post-TURP hemorrhagic complication ineligible for surgery

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

Spontaneous Omental Infarction: An Unusual Etiology of Abdominal Pain

A 49-year-old lady with previous scars complained of acute abdominal pain for two days. Her right hypochondrium was tender and guarding upon assessment. The laboratory investigations were unremarkable. Due to a diagnostic incongruity, computed tomography of the abdomen was performed showing a suspicious lesion at anterolateral aspect of the ascending colon. Surgical intervention was decided and intraoperative finding was consistent with spontaneous omental infarction. Omentectomy was undertaken and final histology was compatible with the intraoperative diagnosis. Although it is exceptional, omental infarction should be considered as part of the differential diagnoses of right-sided acute abdominal pain with normal laboratory investigations. This case highlights its unexpected discovery and we describe its literature reviews

Gut-microbiota link in Parkinson’s disease: current perspectives

Parkinson’s disease(PD) is a metacentric neurodegenerative disorder results with accumulation and aggregation of alpha-synculein(α-Syn) (or alpha-synculeinopathy) in the substantia nigra in the central nervous system(CNS).Contributory factors include pesticide exposure, head injury and agriculture background. PD has been considered to be a non-genetic disorder, however around 15% individuals with PD have firstdegree relative who has the disease Mutations in genes including SNCA,LRRK2 and gluococerebrosidase (GBA) found to be risk factor for sporadic PD. Brain cells could be lost due to an abnormal accumulation of the protein alpha-synculein.This insoluble protein accumulates inside neurons forming inclusions called Lewy bodies. Other cell death mechanisms include proteasomal and lysosomal system dysfunction, but the mechanisms are not fully understood. Brain –gut axis(GBA) refers to central nervous system(CNS) control of the enteric nervous system(ENS) through vagus nerve intervention. PD is characterized by alphasynculeinopathy affecting all levels of the brain-gut axis.Both clinical and neuropathological evidences indicate the neurodegenerative changes in PD are accompanied by gastrointestinal symptoms that may precede or follow the central nervous systemimpairment. Frequent symptoms in PD include tremor, rigidity, slowness of movement and difficulty with walking. Treatment with L-DOPA(levodopa),with dopamine agonist, medications become less effective and produce complications. Research studies recommend new therapeutic approach in PD based on modification of the gut microbiota with probiotics, prebiotics, or even fecal microbiota transplantation

Occupational Exposure to Dust and the Relationship with the Respiratory Symptoms, Lung Function among Construction Workers of the University of Malaysia Sabah

BACKGROUND: The respiratory tract often becomes the site of injury from occupational exposure. All construction sites generate high levels of dust, typically from concrete, silica, asbestos, cement, wood, and stone, sand, and therefore, the workers are exposed to this airborne dust and increased their risk of developing respiratory disorders. Limited studies have been conducted to assess the relationship between respiratory symptoms, lung function, and occupational dust exposure among construction workers in Sabah. AIM: The objectives of this study are to determine the occupational exposure to dust and the relationship with the respiratory symptoms as well as lung function among construction workers in UMS Teaching Hospital. MATERIALS AND METHODS: This cross-sectional study consisted of construction workers working in all sections in the development of UMS Teaching Hospital. A standard respiratory questionnaire was distributed to construction workers and lung function measurement was performed using Spirometry and the results of their respiratory status were compared between workers who were exposed and unexposed to dust. Occupational dust exposure was determined by the gravimetric method using an air sampler. The total duration of the collection was 8 h and the filters with the dust samples were analyzed in the laboratory. RESULTS: The result showed three parameters that were significantly associated with respiratory symptoms, namely, age, marital status, and smoking status. Male workers had a higher prevalence (42.7%) of having respiratory symptoms compared to female workers (21.4%). Widow/widower/divorced (50.0%) had a higher prevalence of having respiratory symptoms compared to married (45.8%) or single workers (25.0%). Workers who smoke had a higher prevalence (51.2%) of having respiratory symptoms compared to non-smoker’s workers (22.7%). CONCLUSION: The highest dust exposure is the piping workstation, followed by the cement and plastering workstations. These warrant the compulsory use of personal protective equipment by construction workers during work, improving the quality of dust masks, and standardizing their usage. Effective engineering controls should also be promoted on construction sites

Association and correlation between cardiorespiratory fitness, bmi, musculo-skeletal and handgrip strength among young adult student girl population in Sullia, Karnataka, India

Background: Obesity is at a rising trend among the childhood age group and is a WHO priority on classification of non-communicable diseases. High income group countries once had a statistically higher percent of obesity problems which has been extended both to the developing and low-income countries. Prevalence rate of obesity in India vary between 11.8% to 31.3% and is higher among the women than men. Obesity also affects the physical and cardio-respiratory fitness thereby leading to a group of metabolic, cardiovascular and musculoskeletal disorders. An association between BMI, musculo-skeletal and cardio-respiratory fitness is less reported among the young adult girl population in the context of Indian professional students. Aim & Objectives: To assess few of the musculo-skeletal, cardio-respiratory parameters in relation to BMI among the young adult girl students of medical and dental colleges. Material & Methods: One hundred and seventy-one girl students in the range of 19 to 21 years were randomly selected from the educational institute of Sullia, Dakshina Kannada, Karnataka and were assessed for BMI, muscular strength, handgrip strength, flexibility test, cardio-respiratory test and pulmonary function test by standard methods. Data was analysed. Results: Musculo-skeletal flexibility, strength, cardio-respiratory fitness and pulmonary functions have an inverse association when compared to the BMI and weight of the girl students. Conclusion: Obesity and overweight reduces the flexibility, musculoskeletal and cardio-respiratory fitness in addition to the pulmonary functions among the young adult girl population as confirmed by the battery of tests. © 2021, Ibn Sina Trust. All rights reserved

Impetigo herpetiformis: a rare pregnancy-specific dermatosis

Impetigo herpetiformis (IH) is a pregnancy-specific dermatosis that is currently considered a form of generalised pustular psoriasis and mainly occurs in late pregnancy during the third trimester. IH presents as erythematous patches and pustules and might have systemic involvement. The disease may be associated with severe maternal, fetal, and neonatal complications. IH treatment is very challenging, however, various therapeutic options are available and effective for disease treatment