Glycemic control and its associated factors among type 2 diabetes mellitus in a selected hospital university at east coast Malaysia

Introduction: Type 2 diabetes mellitus (T2DM), a prevalent chronic metabolic disorder, is widely observed locally and globally. Patients with poorly controlled diabetes will encounter life-long complications earlier than those with controlled diabetes. Hence, this study aims to determine the prevalence and factors associated with glycemic control in T2DM patients in Sultan Ahmad Shah Medical Centre (SASMEC) at IIUM, a university hospital in Kuantan. Materials and Methods: This was a cross-sectional study conducted at the Medical Outpatient Clinic of SASMEC at IIUM, from August to September 2023 involving 205 T2DM patients, selected using a universal sampling method. Data were collected using a self-administered questionnaire for socio-demographic and clinical data. Relevant investigation results were retrieved from the patient’s medical record. Descriptive statistics and regression test were performed for data analyses. Results: The response rate was 100%. 64.9% of the respondents have poor diabetic control, which was associated with age below 65 years old (p=0.016), Indian ethnicity (p=0.004), longer duration of T2DM (p=0.020), type of diabetic medications used (p<0.001), and knowledge on diabetes (p=0.007). The probability of having poor glycaemic control was 2.3 times more likely among respondents with T2DM for more than 10 years (p=0.025), 5.5 more likely among insulin users (p=0.012), 3.3 more likely in both OGLDs and insulin users (p<0.001) and 0.7 times less likely among those aged 65 and above. Conclusion: The prevalence of poorly controlled diabetes was high and significantly associated with age below 65 years old, Indian ethnicity, longer duration of T2DM, medications used, and knowledge on diabetes. Therefore, T2DM with these factors needs to be targeted for early intervention to prevent life-long complications of diabetes

Physical health of preclinical medical students during covid-19

Due to the COVID-19 pandemic, several preventive measures have been put in place including movement restriction and closure of non-essential services in Malaysia including educational premises and shifting towards online learning. Physical inactivity may impact medical students’ quality of life, particularly their physical and mental health, as both are especially influenced by doing physical activity. This study aimed to assess the physical health of medical students during the pandemic. This study has been approved by the institutional research committee (Research ID: 735). All Year 1 and Year 2 International Islamic University Malaysia (IIUM) medical students were invited to participate in this cross-sectional study. Participants were asked to complete an online, self-administered abbreviated World Health Organisation Quality of Life (WHOQOL-BREF) questionnaire from July until August 2021. Data were analysed using IBM SPSS Statistics 26 (IBM, New York). We received 158 responses, consisting of 77 Year 1 and 81 Year 2 students. All participants were undertaking online remote learning at the time of study. The mean score for overall quality of life was 14.58 (3.23) whereas the physical health domain mean score was 14.18 (2.48). We found that the requirement for medical treatment scored the highest 17.70 (3.42) whereas work capacity scored the lowest 12.25 (3.95). There was no significant difference in the scores between 14.50 (2.56) and 13.87 (2.37) for Year 1 and Year 2 students in the individual items (p=0.107- 0.862). We concluded that despite the nationwide lockdown, the medical students in IIUM reported acceptable-good quality of life and physical health. This could be due to their adaptation to the new norms by applying the right coping strategy. Future study to re-assess their quality of life is due should the lockdown are further extended or tightened

Association of barriers of learning during COVID-19 pandemic with mental health

On March 11, 2020, World Health Organization (WHO) declared that COVID-19 has become a pandemic. Therefore, online learning (OL) has replaced face-to-face teaching and learning sessions in many schools and colleges. This has forced the students to adapt to a new environment and overcome some barriers during the OL. However, the increase in suicidal rate among students is a disturbing phenomenon due to mental vulnerability experienced during the current worldwide situation. This study was done to investigate the association between barriers of learning during Covid-19 with mental well-being among International Islamic University Malaysia (IIUM) pre-clinical medical students. A cross-sectional study was conducted among the Year 1 (n=77) and Year 2 (n=81) medical students of IIUM, from July until August 2021. They were recruited to answer self-administered online questionnaires based on 5 remote learning barriers (inadequate interaction with classmates and teachers, lack of peer support and confidence to handle online tasks, and difficulty in applying taught concepts). The survey includes Generalised Anxiety Disorder (GAD-5) and Well Being Index (WHO5) to assess mental well-being and was approved by the institutional ethical committee (Research ID: 735). The results were analysed using IBM SPSS Statistics 26 (IBM, New York). The prevalence of depression and anxiety among medical students were 27.8% and 86.7% respectively. More than half of the respondents agreed with all learning barriers listed. However, the difficulty in applying taught concepts is the only significant barrier associated with depression (p<0.05). In conclusion, although only one item was identified as significant, it was an undeniable factor. Corrective measures must be taken to minimize it as continuous exposure may deteriorate mental health among medical students. Careful evaluation is required in order to ensure the quality of education remains upheld to its highest standards without jeopardizing the students’ psychological well-being

Satisfaction of IIUM medical students towards online learning and its facilitating factors

The declaration of COVID-19 as a pandemic on 11th March 2020 has left a significant mark on the global education ecosystem. The transition from conventional to online learning is challenging for the administrators, teachers and students. The purpose of this study is to determine the satisfaction towards online learning and its facilitating factors among medical students in the International Islamic University Malaysia (IIUM). We conducted a cross-sectional study among first- and second-year medical students in IIUM from July to August 2021. The study protocol has been approved by the institutional research committee (Research ID 735). We asked the participants to complete a web-based self-administered Online Learning Experience Questionnaire (OLEQ) and rated the items using the 4 and 5-Likert scales. We used IBM SPSS Statistics 26 (IBM, New York) to describe and analyse the data. We received 50% (n=77) and 59% (n=80) responses from first- and secondyear medical students respectively. In general, the satisfaction of the students towards online learning was positive (mean 2.84-3.87 out of 4). In both cohorts, access to information and learning material scored the highest satisfaction followed by interaction with teachers. Meanwhile, the topmost factor facilitating online learning was being encouraged to take responsibility for their learning [4.11 (0.82) out of 5] followed by electronic communication with the teacher [3.92 (0.91)]. We found a positive association between the satisfaction score towards online learning and the facilitating factors score (r=0.635, p<0.001). In a nutshell, we can see that the IIUM medical students’ satisfaction towards online learning was positive and this could be attributed to the facilitating factors. This finding could be useful for policy-makers and administrators in education to focus on these factors to keep the system relevant in this current pandemic situation

Prevalence of depression and anxiety among IIUM pre-clinical medical students during COVID 19 pandemic

Given the tough nature of studying medicine, medical students are at higher risk of developing mental health-related issues such as depression and anxiety than the general public. The worries about what the future holds, lack of social interactions due to shifting towards online learning, and being confined inside the house for a long period of time due to government-imposed lockdown, might negatively affect medical students’ state of mind. This study was done to determine the prevalence of depression and anxiety among International Islamic University Malaysia (IIUM) preclinical medical students during COVID-19. A cross sectional study involving Year 1 (n=77) and Year 2 (n=81) medical students of IIUM was conducted from July till August 2020, and they were recruited to answer a self-administered online survey. This study was done in accordance with terms stipulated by the institutional ethical committee (Research ID: 735). The Generalized Anxiety Disorders Scale (GAD-7) and Well Being Index (WHO-5) scores were used to assess the level of anxiety and depression among the students respectively. The data were analysed using IBM SPSS Statistics 26 (IBM, New York). From 158 respondents, 27.8% of the students experienced depression, while 86.7% of the students flagged symptoms of anxiety. In accordance with this outcome, the concern about their physical well-being, social relationship and ffectiveness of online learning during this pandemic crisis are among the factors that might contribute to the increase of depression and anxiety among the students. This study has concluded that IIUM medical students showed an increased risk of suffering from depression and anxiety during COVID-19 era. It is highly suggested that proper interventions such as university support group online gathering, interactive online learning and gamification, and promotion of online counselling be administered in order to preserve good mental health of medical students during this pandemi

Perceptions of the online learning experience among medical students during COVID-19

Social gatherings have been limited during the COVID 19 pandemic to reduce the transmission of viruses. Many academic institutions have shifted their classes from traditional methods into online remote teaching and learning sessions. Since neither the students nor lecturers were familiar with this setting, the delivery of medical education has undoubtedly impacted as the lectures, clinical placements and key examinations were discontinued. Many adjustments need to be made in order to make sure that the online teaching is held properly. This study was conducted to investigate the perceptions of online learning experience among medical students during the pandemic. An online survey was distributed to 158 medical students from Year 1 and Year 2 of International Islamic University Malaysia (IIUM) from July 2021 till August 2021. The Learning Community Scale and Student Support Scale based on Course Experience Questionnaire (CEQ) were applied to measure the participants' perceptions. The data were analysed using Statistical Package for the Social Sciences (SPSS) version 26. Based on the Learning Community scale, higher response values signified better feelings towards the learning community. The average scores of all five questions were high level (3.68-4.36 on 5-Likert scale), suggesting that the participants were feeling well towards their learning community. Likewise, higher response values in the Student Support scale indicated that better student support is perceived. The average scores of all five questions were also high (3.11-4.31 on 5-Likert scale), indicating that the respondents perceived an adequate amount of student support. In conclusion, the study conjectured positive perceptions towards their learning experience during COVID-19 pandemic among the students despite the sudden shift from physical to online teaching and learning sessions. However, broader ethnic groups and larger sample sizes might be useful for more precise and reliable future results

Perceptions of the online learning experience among medical students during covid-19

Social gatherings have been limited during the COVID 19 pandemic to reduce the transmission of viruses. Many academic institutions have shifted their classes from traditional methods into online remote teaching and learning sessions. Since neither the students nor lecturers were familiar with this setting, the delivery of medical education has undoubtedly impacted as the lectures, clinical placements and key examinations were discontinued. Many adjustments need to be made in order to make sure that the online teaching is held properly. This study was conducted to investigate the perceptions of online learning experience among medical students during the pandemic. An online survey was distributed to 158 medical students from Year 1 and Year 2 of International Islamic University Malaysia (IIUM) from July 2021 till August 2021. The Learning Community Scale and Student Support Scale based on Course Experience Questionnaire (CEQ) were applied to measure the participants' perceptions. The data were analysed using Statistical Package for the Social Sciences (SPSS) version 26. Based on the Learning Community scale, higher response values signified better feelings towards the learning community. The average scores of all five questions were high level (3.68-4.36 on 5-Likert scale), suggesting that the participants were feeling well towards their learning community. Likewise, higher response values in the Student Support scale indicated that better student support is perceived. The average scores of all five questions were also high (3.11-4.31 on 5-Likert scale), indicating that the respondents perceived an adequate amount of student support. In conclusion, the study conjectured positive perceptions towards their learning experience during COVID-19 pandemic among the students despite the sudden shift from physical to online teaching and learning sessions. However, broader ethnic groups and larger sample sizes might be useful for more precise and reliable future results

Association of mental health status with quality of life among medical students in IIUM during covid-19

The existence of COVID 19 has significantly changed humans daily life in this world. The new norm of living in this pandemic has also led to a different approach on managing quality of life. With the current method of online teaching and learning, medical students may encounter a variety of stressors such as heavy workload, stressful examination and also inadequate learning environment which may influence their mental health. This study is conducted to investigate the association of mental health status with quality of life among medical students in International Islamic University Malaysia (during the pandemic. A cross-sectional study was conducted online among 158 medical students of Year 1 and Year 2 between July and August 2021. This survey used validated questionnaires to assess depression (WHO 5 anxiety (GAD 5 and Quality of Life BREF (WHOQOL BREF) WHOQOL BREF measures five domains: overall quality of life (physical health, psychological health, social relationships, and environmental quality of life. The result was analysed using Statistical Package for the Social Sciences (SPSS) version 26. The prevalence rates of anxiety and depression-related symptoms were 27.8% and 86.7% respectively with more students developing anxiety as compared to depression. The proportion of students with anxiety was higher than depression in both Year 1 (n=67) and Year 2 (n=70) students. Students with anxiety and depression symptoms had a significantly poorer overall QOL score (p<0.001) compared to students without mental health problems. Both categories of students were associated with lower physical, psychological and environmental domain scores (p<0.05). In conclusion, the quality of life of medical students are significantly affected by the presence of anxiety and depression. Progressive strategies need to be implemented to maintain good mental health care among medical students in IIUM as it will improve their quality of life during Covid-19

Poor sleep quality among IIUM medical students; a cross-sectional study

Good quality sleep plays an integral role to ensure optimal physical as well as mental health, especially among medical students. Given the surge in COVID-19 cases, with the closure of universities around the globe, students are obliged to adapt to online learning which poses new sets of challenges that may negatively impact their quality of sleep. This study aimed to evaluate sleep quality among preclinical medical students of International Islamic University Malaysia (IIUM) during the COVID-19 pandemic. We conducted an observational, cross-sectional study involving 158 Year 1 and Year 2 medical students of IIUM. The study protocol was approved by the institution research committee (Research ID: 735). We assessed their sleep quality over the past one month using an online self-administered Pittsburgh Sleep Quality Index (PSQI) questionnaire. We analysed the data using IBM SPSS Statistics 26 (IBM, New York). In general, the average global PSQI score was 8.08 (3.59). Almost three- quarters of the subjects (n=117) experienced poor sleep quality (PSQI global score >5). Amongst all PSQI components, sleep latency scored the highest mean of 2.37 (1.99). Additionally, there was no significant difference in sleep quality between Year 1 and Year 2 medical students (p=0.273). Subjects with poor sleep are prone to negative psychological effects that are related to the lockdown restriction during the pandemic. Further decline in sleep quality can lead to unhealthy practices such as unhealthy diet and nutrition and sedentary lifestyle. Based on our study, there was a significant proportion of IIUM preclinical medical students with poor sleep quality during the COVID-19 pandemic. It is crucial to further investigate the factors contributing to their poor sleep quality and introduce measures to rectify the problem. Especially, as future healthcare providers should advocate on healthy lifestyles, inclusive of good sleep quality