Journal of the Asian Medical Students Association
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Piercing Tribal Language Barriers in Health Communication
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Language barriers are the main cause of miscommunication between healthcare providers and patients which could lead to misdiagnosis, inappropriate treatment, and death. 46.8% of the linguistic minority patients’ adverse events had a level of harm ranging from moderate temporary harm to death. Solutions have been developed to solve barriers between common foreign languages. However, the medical miscommunication caused by tribal languages has not been addressed and solved properly. In Thailand, there are about 3 million people in over 40 ethnic groups with distinct languages causing difficulties in obtaining patients’ information and conveying messages back to the patients, so effective policies should be proposed. The past solution in Thailand relies on a group of volunteer interpreters enrolled by local hospitals which lacks unified and standardized regulation. Furthermore, the volunteers may not have been equipped with adequate skill set to practically deal with medical communication. To demolish the language barriers, the proper mode of interpretation must be inaugurated.
Methods
A suggested policy would be to establish a center to function as a medium between certified interpreters and doctors. These interpreters will be recruited from each ethnic group and trained in a specifically designed program which will provide attendants with essential knowledge and skills required in medical translation. This includes understanding of patient confidentiality, suitable methods in delivering messages to the patients, for example breaking bad news, and basic comprehension in medical terms and procedures.
Key findings
Corresponding to the suggested policies, this measure would possibly lead to the improvement of health communicatio
Improving Emergency Medical System using Machine Learning through E-mergency to Overcome Trauma Care Problems in Indonesia
Get PDFIntroduction In Indonesia, the number of road traffic accidents (RTA) in 2019 shows an increasing trend, where they caused high mortality and morbidity rate. It is crucial to establish adequate early management of RTA victims by shortening the time needed to mobilize the victims into nearby hospitals and for the bystanders to perform first aid care. Despite its importance, the Indonesian citizens’ knowledge in first aid seems to be low, and there are no current systems capable of solving RTA prehospital care-related problem gaps.
Method This paper is created through the discussion outcomes with several stakeholders and analysis of journal articles and media reports in Indonesia.
Findings No concrete studies examined Indonesian citizens’ knowledge about first aid care, and no proposals regarding emergency-designed applications had all the qualities we look for.
Proposed solution(s) We proposed E-mergency, which uses Machine Learning in its back-end to provide features for (1) reporting RTAs based on their precise location, (2) sending the best suggestion to the integrated networks of nearby ambulances, trauma centers, health facilities, or hospitals, (3) describing the overall situation of RTAs and general status of the victims, (4) Badan Penyelenggara Jaminan Sosial (BPJS) insurance payment options via digital wallets to the assigned hospital that would accept the patients, and (5) providing instructional first aid videos that the users can watch as guidance for them to help the victims before paramedics come to prevent most of the mortality and morbidity rate caused by RTA in Indonesia.
Conclusion Comprehension and capability of first aid by bystanders and the victim themselves could be an effective way to optimize golden hour usage and thus, prevent most of the mortality and morbidity rate caused by RTA in Indonesia. Developing E-mergency by utilizing smartphone technology could be a new solution to overcome the trauma problems in Indonesia
Are We Thinking Too Straight? Why We Need More LGBTQ+ Studies in India: A Perspective
Get PDFDespite India’s antiquity recognizing all types of queer sexualities, there is still much stigma and taboo that surrounds the Indian LGBTQ+ community. This stigmatization can be reflected in the scarcity of literature that focuses on the community. This article discusses the lack of LGBTQ+ studies in India, the consequences, and how encouraging more studies for this community can help eradicate prejudice and discrimination
CORNEAL CONFOCAL MICROSCOPY AS AN EARLY DIAGNOSTIC TOOL FOR DIABETIC NEUROPATHY: A SYSTEMATIC REVIEW
Get PDFObjective: To evaluate the effectiveness of corneal confocal microscopy, its parameters, and threshold as an early diagnostic method for diabetic neuropathy
Method: A systematic review was conducted through PubMed, CENTRAL, and Scopus, searching for studies implementing corneal confocal microscopy (CCM) in patients with diabetes for detecting neuropathy in the early stage. Quality assessment of studies selected were performed using selected risk-of-bias assessment tool.
Results: The search yielded 9 studies with a total of 2027 subjects. From the 9 studies reviewed, CCM proved to be a reliable method of diagnosis for diabetic neuropathy with consistent sensitivity and specificity. Fiber length, density, and bead size are the most reliable parameters for diagnosis.
Conclusion: Significant correlation between CCM parameters and diabetic neuropathy were found. Therefore corneal confocal microscopy showed promising potentials as an early diagnostic tool for diabetic neuropathy
Statins and the COVID-19 Vaccines: a viewpoint
Get PDFThe COVID-19 pandemic has caused many scientists to promptly make vaccines against the disease. A large number of people who will receive the vaccines will likely be older adults, many of whom being long-term statin users. Statins, known to be immunomodulators, can interact with vaccines and alter their effects. Whether this effect is significant or not is up for debate, like in the case of the influenza vaccine. Thus, the interaction between statins and the COVID-19 vaccines should be investigated and understood, and guidelines should be written to ensure that the vaccines perform optimally
The HPV Vaccine Crisis in Japan
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HPV vaccination is one of the most effective ways to prevent cancer. After 14 years since its introduction in 2006, HPV vaccine has been proven to be extremely safe and effective against cervical cancers and other cancers caused by HPV infection. Combined with cervical, rapid scale-up of HPV vaccination can make cervical cancer elimination achievable in most countries. While many countries are on their way to eliminate cancer, the situation in Japan is not promising. After reports of severe adverse events following immunization, the government suspended the recommendation for HPV vaccine, resulting in a significant drop in vaccine coverage to almost 0%. The situation has remained for 7 years, leaving female, especially young women to be extremely vulnerable to cervical cancer. This is a matter of paramount importance and actions should be taken promptly to improve the situation.
Methods
We conducted an extensive literature review and consulted with a Secretariat of the Immunization Committee of Ministries of Health, Labor, and Welfare, an Obstetrics and Gynecology Professor, and an Infectious Disease Professor to better assess the local situation.
Key findings
We propose a comprehensive and strategic communication plan, involving the key stakeholders and using multiple channels, with a monitor and evaluation system, to counter the misinformation about the HPV vaccine and improve the status quo
Surfing the Waves of Infodemic: Building a Cohesive Philippine Framework Against Misinformation
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The sudden exponential increase in information accompanying COVID-19 has presented significant barriers to effective health communication. In a country where 76 million active social media accounts originate, this Infodemic due to the pandemic has exposed inadequacies in Philippines information systems. As such, this paper aims to present the Infodemic in the Philippine context, analyze existing frameworks countering misinformation, identify problems, and propose solutions for misinformation.
Methods
A comprehensive review of existing policies was conducted by inputting keywords in known databases, and analyzing literature, laws, and social media policies in the Philippines.
Key findings
The analysis has showed that (1) the current un-centralized system presents difficulties in mobilizing experts; (2) the older demographic is a neglected population amid high risk for misinformation; (3) individual passivity in searching for legitimate sources put people at higher risk; (4) current legal frameworks insufficiently characterize and delineate misinformation and disinformation, leading to concerns on implementation and human rights. To address this, evidence recommends (1) creating a centralized government institution, representative of various sectors, to serve as the source of understandable and reliable scientific information; (2) strengthening current legal frameworks, with an emphasis on education, due process, and human rights; (3) ingraining a culture of fact-checking within the Filipino psyche via stakeholder engagement. Clear roles and responsibilities, along with active stakeholder engagement, are needed to build individual resilience against misinformation and strengthen veritable institutions that aid the country in responding to future health crises
Mesenchymal Stem Cells (MSCs) As Neuroregenerative and Locomotor Recovery-Promoting Agent for Spinal Cord Injury: A Systematic Review and Meta-Analysis
Get PDFIntroduction: Despite decades of extensive research, spinal cord injury (SCI) remains a complex health burden mainly affecting active patients and may cause a catastrophic permanent paralysis of the limbs (tetraplegia) and might even result in death. The current treatments are not sufficient to repair such damage. The development and discovery of the treatments that are capable of inducing the regeneration of axonal functions are hindered by the injured spinal cord’s limited neuroplasticity. Mesenchymal stem cells (MSCs) are ideal transplantable cells which have been shown to modulate the injury cascade of SCI mostly through paracrine effects.
Objective: This systematic review and meta-analysis aimed to investigate the association between the MSCs treatment and neuroregenerative effects in the SCI model-rodents by assessing the locomotor development based on Basso-Beattie-Bresnahan (BBB)/Basso Mice Scale (BMS) locomotor rating scale.
Materials and Methods: This meta-analysis was reported based on criteria from Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A literature search was conducted with multiple electronic databases, such as PubMed, ScienceDirect, Scopus, Google Scholar. Mean Difference (MD) and Standard Deviation (SD) with the confidence interval (CI) of 95% were used to determine the association between MSCs therapy and the increase in the BBB scale after SCI. Fixed and Random Effect Model was used based on heterogeneity level and p value<0.05 was considered statistically significant. Risk of biases were assessed for each study using Cochrane Risk of Bias (RoB) tool developed by the SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE).
Results: Twenty studies were included in the qualitative synthesis, and eleven studies were included in the quantitative meta-analysis. The current study showed that MSCs therapy for SCI was very beneficial (pooled MD=4.71, 95% CI (3.86-5.55), p=0.006, I2=59%).
Conclusion: This systematic review and meta-analysis provide valuable evidence suggesting MSCs as a potential treatment for SCI.
Keywords: Spinal cord injury, MSCs, regenerative medicine, systematic review, meta-analysis
 
Telemonitoring implantable cardiac devices in reducing heart failure complications: an updated systematic review
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As a newly invented technology, the use of telemonitoring (TM) in healthcare only has weak evidence in international guidelines.
Significance
This systematic review serves to supplement the evidence gap to determine whether telemonitoring implantable cardiac devices can reduce all-cause mortality and heart failure (HF)-related hospitalization in worsening heart failure compared to standard care. This innovative communication technology could revolutionize healthcare by sending the right message and effectively detecting upstream predisposing factors to improve heart failure outcomes.
Methods
Electronic databases EMBASE and MEDLINE (Ovid), Web of Science and CENTRAL were searched for English full text randomized controlled trials (RCT) for adult heart failure population in peer-reviewed journals from 2010 up to 14 of November 2020, supplemented by a second search in clinicaltrials.gov. Articles were extracted and screened independently by two reviewers with their validity assessed.
Results
11 randomized controlled studies that enrolled a total of 5588 patients were identified. 10 trials reported on all-cause mortality with 512 deaths and 10 trials reported on hospitalization with 2121 patients admitted. Modified Cochrane Collaboration tool is used to assess risk of bias of the trials. CASP (Critical Appraisal Skills Programme) checklist is utilized to critique on the quality of the RCTs.
Conclusion
Of all types of implantable cardiac devices, intrathoracic impedance fluid monitoring did not show improvement in outcomes while cardiac rhythm and pulmonary pressure monitoring show the highest effectiveness in reducing heart failure related hospitalization
Plugging the Gap: The Millennial Surge in Melancholy
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In Singapore, the prevalence of Major Depressive Disorder (MDD) is steadily on the rise, with even more cases remaining undetected and undiagnosed. Recent statistics also show a growing trend of suicidal ideation amongst millennials arising from MDD. Despite efforts by the Singapore Government to address this concern, social stigma towards MDD remains one of the greatest barriers to help-seeking behavior in millennials. This is reflected in the significant 12-month treatment gap of 73% for MDD. That, in turn, has profoundly dire consequences on those afflicted, their families and friends, and Singapore at large.
Methods
This paper is informed by discussions with multiple stakeholders including psychiatrists, policy-makers and millennials afflicted with MDD; and is reinforced by media reports and journal articles.
Key findings
It recommends a three-pronged approach that tackles every level of society – digitalizing individual anonymity with community support groups, delivering Depression First Aid courses for families and friends, and developing a collective narrative in Singapore society