IIUM Medical Journal Malaysia (IMJM)
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Integration of Islamic Perspectives into Medical Imaging Curriculum: an Outcome Based Education Approach
Get PDFThis paper presents a conceptual approach to the integration of Islamic perspectives into a Medical Imaging Curriculum to the concept of Outcome-Based Education (OBE). This work is seen within the context of harmonising Islamic principles to a currently accepted concept in education. Although there have been discussions that question the concept of OBE, this paper contends that the integration can benefit from the practicality aspect of OBE. This can reduce the complexities and fatigue in addressing the integration using an educational approach that is different to that being applied to the human sciences. This paper features the main elements in OBE in the form of Islamic programme educational objectives, Islamic programme outcomes, and Islamic domain learning outcomes. The justification to use domain learning outcomes instead of course learning outcome is given. The teaching and learning strategies, as well as the assessment, are examined through a lens that serves to provide a desirable, practical and holistic model of Islamic integration. It is felt that the currently accepted teaching and assessment methodologies can be adapted for the integration exercise. This work also highlights two often overlooked elements of OBE; teacher and student characteristics. The various terminologies that describe the Islamic teacher characteristics and the differences in student learning styles and preferences are presented. Furthermore, suggestions are made to align the assessment of the integration to various taxonomies of learning, with the aim in evaluating the internalisation of the Islamic essences. This work contents that a holistic approach towards integration of Islamic perspectives into Medical Imaging curriculum can be realised
Towards a Shariah Compliance Model for Healthcare Centres with reference to Spiritual Healers: Issues and Challenges
Get PDFGenerally, a good healthcare centre comprises of qualified manpower, right policies and right procedures in providing primary care, secondary care and tertiary care for the patients as well as in public health. Other than manpower, healthcare centres must also look at social, religious and cultural factors affecting the recipients of the healthcare services given by the healthcare centres. In this paper, the author will look at some pertinent issues such as the need to have spiritual healers in any healthcare centre to help the patients in dealing with fatal illness. The spiritual healer is to help the patient and give him motivation so that he could have a positive mind throughout his journey in battling with his illness. Sometimes we have patients who refused to listen to the doctor's advice. Thus, the role of the spiritual healer would be important in assisting the healthcare centres and its management to convince him. Another issue is the privacy, respect and trust between patients and doctors as well as with the management of the healthcare centres. One of the duties of the healthcare centres’ management and doctors is, to respect the patient's religion and his faith. These three issues are amongst the important issues which every healthcare centre must look upon. Definitely there are a lot of challenges in addressing the above mentioned issues such as the procedures, methods on how to execute these issues and most importantly the perception of the public. In Islam, health care is one of the five important elements in which the Prophet SAW has mentioned in one hadith to be taken care of. A study has shown that a nation-building efforts has no meaningwithout the best public health and healthcare delivery system to the people
Effect of Thermocycling on the Compressive Strength of Selected Luting Cements
Get PDFIntroduction: The purpose of this in vitro study was to evaluate the effect of thermocycling on the compressive strength of selected luting cements. Material and methods: 5 types of luting cements were tested. A total of thirty cylindrical specimens measuring 6mm in height and 4mm in diameter were prepared for each type of cement which were then divided into two groups ie Group 1: Exposure, and Group 2: Control. Both groups were stored in distilled water at 37°C for 24 hours. Group 1 was subjected to 500 cycles in a thermocycling baths of 5ºC and 55ºC with 20 seconds in each bath. Group 2 was not exposed to thermocycling procedure. The compressive strength for each cement type was determined by using a universal testing machine. Results: Resin adhesive cement had the highest compressive strength; followed by conventional glass ionomer cement (GIC) whilst resin modified GIC was the least. Thermocycling had no significant effect on the compressive strength of RelyXTM ARC and Fuji I (p>0.05), but a significant effect on Fuji I CAPSULE, Fuji CEM, Fuji Plus CAPSLUE (p<0.05) was observed. Conclusion: The effect of thermocycling on the compressive strength of luting cements differed considerably with respect to their chemical compositions
Protective Effect of Virgin Coconut Oil on Cyclophosphamide-induced Histological Changes in Lymphoid Tissues
Get PDFIntroduction: Virgin coconut oil (VCO) is known for its health and therapeutic benefits. However, the immunomodulatory effects of VCO have not been extensively investigated. Objective: The present study was devoted to examining the effects of VCO on cyclophosphamide (CY)-induced toxicity of lymphoid tissues. Methods: Thirty healthy male Wistar rats were sorted into 5 groups of 6 animals. The first control (NC) group was given distilled water via gavage at 5 ml/kg once daily. The second (CY) group received CY orally at 10 mg/kg/day for 4 weeks. Rats in the other three groups (CV5, CV10, and CV15) were given 10 mg/kg/day CY for 4 weeks, 5 m/kg/day, 10 ml/kg/day and 15 ml/kg/day VCO for 6 weeks, respectively. Rats were sacrificed at the end of 6th week; blood sample from the animals was collected for full blood count and biochemical analysis. The thymus and spleen of each animal was processed for histological examination. Results: The thymus and spleen showed marked reduction in lymphoid cellularity following daily administration of CY. The thymus also showed a marked reduction in the size of the medulla, and the white pulp areas of spleen had reduction in the follicle number and size. Supplementation with 10 ml/kg and 15 ml/kg VCO showed evidence of restoration of both the thymus and splenic lymphoid architecture. The total white cell counts, absolute lymphocyte counts and plasma globulin levels of the VCO groups were significantly increased compared to CY group. Conclusion: VCO displayed potential protective effects on CYinduced histological changes in lymphoid tissues
Prehypertensive State, Mild Hypertension, Metabolic Syndrome and Cardiovascular Risk Factors among Young Adults in Rural Malaysia
Get PDFIntroduction: Prehypertension precedes overt hypertension and has been acknowledged by many guidelines. Hypertension is an important risk factor for cardiovascular disease in Malaysia. Hypertension prevalence is at 42.6% and population-based control is poor at 26.8%. The objective of the study is to ascertain the cardiovascular risk profile of prehypertensive and mildly hypertensive young adults against age-matched controls in rural Malaysia. Methods: 484 (four hundred and eighty four) subjects attending primary care clinic were screened. 91 (Ninety one) young adults with pre/mild hypertension and normotensive, agematched controls were enrolled. The blood pressure and biochemical profiles for both groups were assessed and compared. Results: Fifty-four subjects and 37 controls were enrolled. Amongst subjects, 46.3% had prehypertension and 53.7% had mild hypertension. Mean values compared to age-matched controls for MAP were 102.68 ± 7.48 vs 83.25 ± 6.08 mmHg (p< 0.001), LDL 3.75 ± 0.95 vs 3.32 ± 0.93 mmol/L (p=0.03), FBG 4.65 ± 0.54 vs 4.33 ± 0.42 mmol/L (p=0.03), BMI 28.81 ± 5.16 vs 24.12 ± 4.91 (p< 0.001). The mean BP was significantly associated with BMI, FBG, triglycerides, HDL and the TC/HDL ratio. Conclusions: Greater BMI, FBG, HDL, triglyceride levels and TC/HDL ratio characterised the young adults with pre/mild hypertension. The data suggests that hypertension in young adults is secondary to metabolic syndrome
Bacteriology in Diabetic Foot Infections: A Multicentre Crosssectional Study in Malaysia and Comparison with Southeast Asia Countries
Get PDFIntroduction: Diabetes mellitus is a major non-communicable disease in Malaysia and Southeast Asian Countries. In this study, we aimed to determine the microbiological profile of diabetic foot infection and the antibiotic susceptibility in Malaysia and to compare our findings with that from other Southeast Asia countries. Materials and Methods: A cross-sectional study was conducted in three district hospitals (Bentong, Raub and Kuala Lipis) from the 1 st January to the 31st December 2016. Microbiological profiles of intra-operative deep tissue and bone samples from diabetic foot infection were included. Studies reporting the microbiological profiles from Southeast Asia countries were reviewed and the data were extracted for comparison. Results: A high incidence of gram negative pathogens was isolated (73.4%). The predominant pathogens isolated included Staphylococcus sp (17.5%), Klebsiella sp (17%), Pseudomonas sp (15.4%) and Proteus sp (13.8%). Among those gram negative pathogens tested, a high number of them were resistant to ampicillin and amoxicillin/clavulanic acid. They were sensitive to imipenem (98.9%), tazosin (97.7%) and ampicillin-sulbactam (84.8%). All Southeast Asian countries studied except Singapore have high gram negative to gram positive pathogens ratio. Conclusion: The empirical antibiotics should be tailored to the local bacteriological profiles of diabetic foot infection
Deformity Correction Surgery in Adolescent Idipathic Scoliosis-Our Early Experience
Get PDFIntroduction: Adolescent Idiopathic Scoliosis (AIS) is the most common spinal deformity among teenage girls. It is defined as three dimensional lateral curvature in coronal plane of more than 10 degrees. For those indicated, early surgical intervention allows better surgical correction due to flexibility of the spine during teenage years, hence good functional outcome and better cosmesis can be expected. Materials and Methods: We reported our early experience in managing five patients surgically using the Posterior Spinal Instrumentation and fusion. Preoperatively patients were examined at IIUM Medical Centre spine clinic, all necessary investigations were carried out. Thorough explanation was done to patient and parents regarding procedure, risk and benefit. All patients were treated using same surgical technique. Neuromonitoring were used throughout the whole surgery until skin closure. All patients were hospitalised around one week. Post-operatively patients were follow-up at two weeks, six weeks, three months, and every six months thereafter. Result: It is important for clinicians to identify patients with AIS as early detection and timely treatment will change the natural history of curve progression. Conclusion: Surgical intervention when necessary will be easier and with less risk of complications when surgery was carried out during teenage years as the spine is more flexible and the deformity is less severe
Good Recovery Of Prostate Carcinoma with Spine Metastases to T9 Following Laminectomy
Get PDFWe present a rare case of a patient diagnosed with prostate carcinoma with spine metastases of T9 vertebrae whom had good neurological recovery following decompression. Six months post surgery patient was able to ambulate with a walking aid. About 6.7% of prostate cancer patient will have spinal compression. A 65 year old gentleman diagnosed with prostate carcinoma 2 years ago done orchidectomy and chemotherapy, presented with progressive worsening of bilateral lower limb weakness and numbness for 5 months duration associated with back pain. On admission the Visual Analog Score for back pain was 5/10. Neurological examination revealed complete paralysis of bilateral lower limb, absent bilateral knee and ankle jerk and sensation. Plain radiograph and MRI showed osteoblastic bone metastases at T9 level with epidural extension. A wide laminectomy of T9 vertebra while preserving the bilateral facet joint was done. No instrumentation was needed as there were no significant vertebral body collapsed due to the osteoblastic nature of the lesion. Six months after the surgery patient showed good neurological recovery with the power of MRC grade 4 for bilateral lower limb and Visual Analog Score for back pain reduced significantly. Numerous study had shown poor outcome in Frankel grade A in terms neurological recovery post decompression. It is a rare outcome that the motor power regained from 0 to 4, free from back pain and able to regain normal urinary and bowel function. As his surgery was a palliative surgery, his quality of life had improved markedly
Knowledge, Practice and Barriers of Pap Smear Screening among Patients in Obstetrics and Gynaecology Ward of the Largest Government Hospital in Pahang
Get PDFIntroduction: Cervical cancer is the third most common cancer among women in Malaysia. It has the advantage of having the Pap smear as a reliable screening test. Unfortunately, the screening uptake in Malaysia is still very low. This study was performed to determine the knowledge, practice and barriers of Pap smear screening among sexually active patients in Obstetrics and Gynaecology wards in the largest government hospital in the state of Pahang. Materials and Methods: These cross sectional study was conducted in August 2017 using self-administered validated questionnaire covering the socio-demographic factors, knowledge on Pap smear and risk factors of cervical cancer, practice, and barrier of Pap smear screening. Bivariate analyses were used for associations between the variables. Results: The mean score of knowledge of the 156 women recruited was 52.01. Forty nine percents had good knowledge about Pap smear and only 39.7% ever had Pap smear screening. Majority of the patients were not aware of the risk factors for cervical cancer. The most common barrier to screening was time constraint (45.5%). There was statistically significant association between parity and practice of Pap smear (p <0.001) Conclusion: Knowledge and practice of Pap smear among the respondents were inadequate. These results indicated the need to increase effort in providing knowledge of Pap smear to the community. This is important for early abnormal cervical changes detection to further reduce the incidence of cervical cancer in Malaysia