Knowledge Regarding Management of Diabetic Nephropathy Among Medical Officers (MO) at HUSM and Its Association With MO Profiles

Background: Many studies had assessed the knowledge and practices among the physicians in the management of chronic kidney disease (CKD) but no specific study to assess the knowledge of medical officers regarding the management of diabetic nephropathy. Many patient with diabetic nephropathy are seen by medical officers level, who are less experienced than nephrologists to offer optimal care. It is not known whether knowledge regarding management of diabetic nephropathy among medical officers are adequate in care of diabetic nephropathy patient and whether characteristics of medical officer are associated with having adequate knowledge. Study Design: Cross-sectional study. Setting & Participants: Self administered Questionnaire to medical officers at two medical based department HUSM (n=102) with distribution of 51 Internal Medicine and 51 Family Medicine in April 2011. The questionnaire consist of four knowledge domains regarding management of diabetic nephropathy and had established validation. Predictor or Factor: MO characteristics, including age, sex, specialties, years since graduation, attended seminar, status (either service MO or Master MO) and year of master program. Outcomes & Measurements: Total performance score (maximum=35). Adequate level of knowledge determined by expert panels as score of ≥67%. Regression analysis of the association between MO profiles and overall MO knowledge of diabetic nephropathy. Results: Total 102 out of 108 (94%) eligible medical officers returned a completed survey. Overall, 49% of medical officers have adequate level of knowledge. All medical officers have managed diabetic nephropathy cases but even so, only 78% of them have attended seminars/ talks or workshops regarding diabetic nephropathy. Overall, no relationship between level of knowledge and MO specialties (Internal Medicine Vs Family Medicine department). There were also no significant relationship between level of knowledge and status of MO (service MO or master MO). There were significant relationship between level of knowledge and year of master (p=0.016) and year four masters MO had more than 7 fold greater odds of showing a adequate level of knowledge compared with MO who are not yet joining master (95% CI 1.44,36.20, p = 0.016). Limitations: The questionnaire type of study is limited to test all type of knowledge (such as recall, comprehension, application, analysis, synthesis and evaluation). Domain of patient management such as patient education were not included in this questionnaire. This study not addressed the attitude and practice of MO regarding management of diabetic nephropathy. Conclusion: We found that medical officers have significant gaps in their knowledge regarding management of diabetic nephropathy that might require further improvement for better future patient care. Master training may offer the best opportunity to improve the awareness and knowledge of diabetic nephropathy guidelines through more focused educational efforts

The technology assessment implementation at science and technology research institute in defense, Malaysia (Stride)

The roles of the technology assessment are to give inputs in terms of not only technical efficiency and economic rationality but also social and ecological consequences of the introduction of a specific technology.The aim of the technology assessment is to determine the risk as early as possible before any decision making in technology purchased is made.Despite the technology assessment basic concept evolution, technology assessment can be applied in various sectors but it is most prevalent in the health, environmental if compared to the defense sector.This is because the defense sector is a country specific whereby security is the main concern of a nation and the information regarding the technology assessments practices are not publish for public knowledge. The purpose of the study was to investigate the extent of STRIDE technology assessment roles in assisting defense ministry in relation to technology acquisition decisions.This study employs case study approach to acquire in depth information on the STRIDE roles in technology assessment using a structured interview to collect the data. The findings indicated that the scope of assessment done was more on development aspect. In addition, STRIDE employed two types of methodologies in determining the priority areas in R&D; brainstorming and Delphi analysis.The implication of the finding would provide clear definitions, scope and guidelines for future technology assessment task

Actual online shopping behavior among Jordanian customers

Internet technology is becoming increasingly important in our daily life in general and in business world particularly.This increased role of the Internet encourages the researchers to investigate the customer behavior in this emerging market. The aim of this study is to examine the factors that give rise to the formation of the actual online shopping behavior of Jordanian customers.The study analyses the predictor variables of planned behavior among 313 university academic staff selected on the basis of probability sampling.Structural equation modeling (SEM) was used to analyze the causal relationships in accordance with the theory of planned behavior (TPB).The findings depicted that subjective norm and perceived behavioral control to have significant positive effects on intention. Attitude has no direct significant impact on online shopping intention.Online shopping intention also has a positive and significant impact on actual online shopping behavior.The practical implication of the research is discusse

Persepsi pelajar berisiko terhadap iklim pembelajaran

Learning is a process which occurs in a social context. The streaming of students into academically weak classrooms creates a negative learning context or climate for teaching and learning. Therefore, the risk of failure increases among these students in their learning process. As such, it is important to understand the learning climate in these classrooms in order to overcome the problems of at-risk students. This paper attempts to highlight the findings of a study pertaining to perceptions of students toward their classroom learning climate, involving 1,689 form two students from 28 schools in Kuala Lumpur and Selangor. Data were gathered by utilizing the questionnaire and analyzed descriptively. The findings reveal that in general, students in the various streams perceive their classroom learning climate as moderate. However there is a significant difference in perceptions of students from the three streams studied, with regards to their teachers in terms of their treatment of students, their teaching approaches and their expectations of their students. High achievers have more positive perception towards their teachers, as compared to the low and extremely low achievers. Implications of the findings and some suggestions are also discussed

At-Risk Students' Response to Learning Mathematics and Science in a Second Language

The Malaysian government recently reverted to the English language as the medium of instruction in its education system for important content subjects such as Mathematics and the Sciences. This policy decision was made in the midst of widespread concern over the perceived falling standards of English language proficiency after the country had used Malay, the native language of the majority Malays, as the medium of instruction for almost two decades. This year marks the first year high school students will sit for the national standardized examinations in English. Dissenters to this policy shift in the language of instruction fear that many will suffer as a result of this change. In this study, the self reports of academically high and low performing students are compared in terms of their ability to perform language related tasks in Malay and the English language. Using the Chi-square statistic, the results of the yes-no responses given by the students indicate that while high performing students report no major difficulties in either language, responses from the low performing students indicate otherwise. Additionally open-ended responses to learning Science and Mathematics in a second language are also qualitatively analysed in order to obtain a more comprehensive view of the challenges these students may face. Several implications based on these results are also discussed

Kimura’s Disease: A Rare Cause of Nephrotic Syndrome with Lymphadenopathy

Kimura’s disease is a rare condition and typically presents as non-tender subcutaneous swellings in the head and neck region, usually in the pre-auricular and submandibular areas. It is associated with lymphadenopathy (both local and distal), marked peripheral eosinophilia, and an elevated IgE level. It can easily be mistaken for a malignant disorder. Fine needle aspiration can be misleading, and a diagnosis is established only by histopathological examination. Renal involvement, which may affect up to 60% of patients, is the only systemic manifestation. We report a case of Kimura’s disease in a Malay patient who was associated with steroid-responsive nephrotic syndrome

Pembelajaran awal Sains dan kompetensi sosioemosi kanak-kanak prasekolah: satu kajian literatur sistematik

Kanak-kanak mempunyai sifat ingin tahu yang tinggi. Ianya membawa kepada penerokaan dan penemuan dunia di sekeliling mereka yang menjadi asas kepada perkembangan pembelajaran sains. Pembelajaran Awal Sains dilihat mempunyai potensi dalam memupuk perkembangan kompetensi sosioemosi kanak-kanak kerana dalam ekplorasi sains yang mereka jalani bersama rakan-rakan, mereka juga dapat memperkembangkan kemahiran sosioemosi seperti memahami kepentingan peraturan, belajar menunggu giliran, mendengar arahan dengan baik, bekerjasama dengan rakan-rakan, membantu orang lain dan mengenali serta memahami perasaan yang berbeza antara setiap individu. Dalam artikel ini, penulis menerangkan bagaimana Pembelajaran Awal Sains dapat dimanfaatkan untuk mempertingkatkan kompetensi sosioemosi kanak-kanak. Secara khususnya, makalah ini bertujuan untuk mengupas sejauh mana aktiviti-aktiviti yang dijalankan dan kemahiran-kemahiran proses sains yang digunakan berpotensi dalam memupuk kompetensi sosioemosi kanak-kanak. Berdasarkan kajian literatur yang telah dijalankan, penulis menyenaraikan dan memperincikan tentang lima elemen-elemen Pembelajaran Awal Sains yang dikaitkan dengan kompetensi sosioemosi kanak-kanak prasekolah iaitu: i) peluang terlibat secara aktif; ii) peluang interaksi sosial; iii) peranan guru; iv) persekitaran pembelajaran dan v) pengalaman bermakna. Elemen-elemen ini didapati mempunyai kesan yang positif dan berpotensi dalam mempertingkatkan kompetensi sosioemosi kanak-kanak prasekolah dan boleh dipertimbangkan untuk dilaksanakan di prasekolah kerajaan dan swasta di Malaysia. Adalah diharapkan kajian literatur sistematik ini dapat memperluaskan perspektif dan pemahaman terhadap kebolehlaksanaan Pendidikan Sosioemosi merentasi kurikulum pendidikan awal kanak-kanak

Bronchoscopic Features and Morphology of Endobronchial Tuberculosis: A Malaysian Tertiary Hospital Experience

The diagnosis of endobronchial tuberculosis (EBTB) is difficult as it is not well visualized radiologically, and bronchoscopy is not routinely performed for tuberculosis (TB) patients. Bronchoscopic characterization via endoscopic macroscopic features can speed up the diagnosis of EBTB and prompt immediate treatment. In this study, we identified the clinical and bronchoscopic morphology of 17 patients who were diagnosed with EBTB from 2018 to 2020. Demographics, radiological, microbiological and histopathological data were recorded. Endobronchial lesions were classified according to Chung classification. The diagnosis was made based on a histopathological examination (HPE) of endobronchial biopsy, and/or positive ‘Acid-fast bacilli’ (AFB) microscopy/Mycobacterium tuberculosis (MTB) culture on microbiological examination of bronchial alveolar lavage (BAL) and/or positive MTB culture on endobronchial biopsy specimens. Furthermore, EBTB was predominant in young women, age 20 to 49 years old, with a male to female ratio of 1 to 2. Underlying comorbidities were found in 53% of the patients. Cough, fever and weight loss were the main symptoms (23.5%). The indications for bronchoscopy are smear-negative TB and persistent consolidation on chest radiographs. Consolidation was the main radiological finding (53%). An active caseating lesion was the main EBTB endobronchial subtype (53%). The leading HPE finding was caseating granulomatous inflammation (47%). All patients showed good clinical response to TB treatment. Repeated bronchoscopy in six patients post TB treatment showed a complete resolution of the endobronchial lesion. EBTB bronchoscopic characterization is paramount to ensure correct diagnosis, immediate treatment and to prevent complication

Gut microbiome of women diagnosed with breast cancer within Pahang, Malaysia

Background Breast cancer is an ongoing issue that is plaguing many young women especially within the regions of Asia. Many factors have been studied thoroughly and have been ruled out over the years. Nevertheless, emergent studies towards the gut microbiome suggest its potential as another cause or treatment to the current predicament. This study aims to elucidate the role of the microbiome in relation to breast cancer by comparing the observed gut flora within healthy individuals to those afflicted with breast cancer in Pahang, Malaysia. Methods Stool samples were collected from all 69 participants. 36 subjects were of newly diagnosed breast cancer patients, pre-treatment while 33 subjects were control group. Samples were homogenized with water prior to performing DNA extraction using standard protocols of QIAamp® PowerFecal® Pro Kit. Metagenome sequencing of V3 variable region of 16S rRNA gene was conducted on a NovaSEQ6000 (Illumina, San Diego, CA) using standard protocols. Data analysis was conducted on the MicrobiomeAnalyst platform using default settings. Results We report a total of 114 695 read counts generated which represents 704 operational taxonomic units (OTUs) from the raw data. IDDF2022-ABS-0263 Figure 1 shows the top 30 features observed among the groups at genus level where it was shown that Holdemanella and Akkermansia were more abundant within the cancer group. Significant beta-diversity results from IDDF2022-ABS-0263 Figure 2 (p-value ≤ 0.001) suggest that the composition between breast cancer patients and healthy individuals are distinct from each other. Furthermore, IDDF2022-ABS-0263 Figure 3A indicates that Holdemanella is significant to the study whereas IDDF2022-ABS-0263 Figure 3B shows that Akkermansia has positive correlations towards breast cancer patients.Conclusions This study found that the microbiome observed within breast cancer patients is indeed different from healthy individuals at least within Pahang, Malaysia. Genera of interest are Holdemanella and Akkermansia which are found to be more abundant within the cancer group. Further studies are warranted to better understand the roles of these features towards breast cancer development or treatment