IIUM Medical Journal Malaysia (IMJM)
Not a member yet
1450 research outputs found
Sort by
Validating Fibula Length as a Reliable Estimator for Femoral Nail Length: A Comparative Analysis with the Standard AO Method
Get PDFINTRODUCTION: An appropriate femoral nail length is required to be measured preoperatively to ensure optimal surgical outcomes. Conventionally, measurements are obtained clinically or radiographically on the contralateral femur or by using forearm referencing. This study is aimed to determine whether fibula length can be used as an additional clinical method for estimating maximum femoral nail length. MATERIALS AND METHOD: This study involves measuring the femurs and fibulas of 140 patients using a standard tape measure. Femur length is measured adhering to the standard Arbeitsgemeinschaft für Osteosynthesefragen (AO) method, while fibula length was measured from the tip of the fibula head to the tip of the lateral malleolus. Pearson correlation coefficient (r) determines any correlation between the two measurements. RESULTS: The overall mean femoral length was 37.98cm (SD=2.72), with a range of 32.0 to 46.5 cm, and the mean fibula length was 37.72cm (SD=2.61), with a range of 32.4 to 47.0 cm. A robust and positive correlation (r=0.940, p<0.001) was observed between fibula length and femoral length. Age, body mass index, and gender did not affect this correlation. Both inter-observer and intra-observer reliabilities were high. A formula for estimating maximum femoral nail length was derived from the correlation graph: femoral nail length = 1 + (0.98 x fibula length). CONCLUSION: Fibula length demonstrates a strong correlation with femoral length, offering a reliable alternative clinical method for estimating femoral nail length. This method proves particularly useful in cases of bilateral femoral fractures with concurrent forearm fractures where forearm referencing method is impractical
Perception of Combined Team-Based Learning and Project-Based Learning among Undergraduate Medical Students: An Integration of Active Learning Strategies in Medical Education
Get PDFINTRODUCTION: Team-based learning (TBL) is an active learning session in small groups equipped with an instructional strategy giving students the opportunity to apply knowledge through various phases of activities. The phases are: i) pre-class preparation, ii) individual readiness assurance testing (IRAT) and group readiness assurance testing (GRAT), iii) immediate feedback, and iv) knowledge application phase. However, a 2-hour TBL session could be exhaustive. To address this issue and improve students’ enthusiasm towards self-learning process in TBL, project-based learning (PrBL) was incorporated in the final phase of TBL. This pilot study aimed to evaluate the perception of students on the implementation of combined TBL-PrBl in teaching and learning activity. TBL-PrBl also addresses the creativity element of the 21st century learning skills. MATERIALS AND METHODS: This cross-sectional pilot study was conducted among preclinical students enrolled in a Pathology course, involving 44 students. The research instrument was a validated questionnaire which assessed four key components in TBL namely; i) teamwork skills, ii) motivation, iii) subject-specific knowledge comprehension, and iv) overall satisfaction. RESULTS: Most students believed that TBL-PrBl improved teamwork, thinking skills, and enhanced understanding. 59.1% preferred TBL-PrBl over the didactic lecture, and 63.6% agreed that TBL-PrBl should be continued in the teaching and learning of Pathology. CONCLUSION: Based on the findings, TBL-PrBl has the potential to fulfil the 21st-century learning skills and fills in the gap of the limitation imposed by the traditional TBL
Development and Validation of Menstrual Disorder of Adolescent (MenDA) Questionnaire in the Malay Language
Get PDFIntroduction: Menstrual disorders negatively affect adolescents’ quality of life, with physical discomfort and emotional distress often contributing to anxiety. To address this, the present study aimed to develop and validate the Menstrual Disorder of Adolescent (MenDA) questionnaire for assessing adolescents’ knowledge, attitudes, and practices (KAP) regarding menstrual disorders. Materials and Methods: The questionnaire was systematically developed through literature review, focus group discussions, and expert consultation. Six experts assessed content validity, while face validity was tested among 46 adolescents. A cross sectional validation study was conducted with 485 adolescents. The MenDA tool comprised three domains: knowledge (23 items), attitude (18 items), and practice (21 items). Construct validity was evaluated using exploratory factor analysis with principal component extraction and varimax rotation. Internal consistency was determined using Cronbach’s alpha coefficient. Results: The finalized MenDA questionnaire contained 62 items, structured into three domains. The knowledge domain included 23 items and demonstrated good reliability with Cronbach’s alpha of 0.739. The attitude domain, comprising 18 items, showed a Cronbach’s alpha of 0.711, while the practice domain, with 21 items, achieved a Cronbach’s alpha of 0.793. These results confirmed satisfactory internal consistency across all domains. Factor analysis further supported construct validity, reinforcing the appropriateness of the three-domain structure in evaluating adolescents’ menstrual health KAP. Conclusion: The MenDA questionnaire has demonstrated strong validity and reliability as a tool to assess knowledge, attitudes, and practices regarding menstrual disorders among Malaysian adolescents. It provides an evidence based framework for identifying gaps and guiding interventions to improve menstrual health education and management.
The Level of Self-Efficacy in Obesity Counselling and its Associated factors Among Primary Care Doctors in East Coast Malaysia
Get PDFINTRODUCTION: Obesity counselling is imperative in the management of obesity. Hence the self-efficacy of the primary care doctors (PCDs) in obesity counselling influences the outcome. This study investigated the level of self-efficacy in obesity counselling among PCDs and its associated factors. MATERIALS AND METHODS: This was a web-based cross-sectional survey involving 156 PCDs working in government health clinics. Participants were selected by simple random sampling and were invited through a letter. Participants then visited the survey website and filled up an online questionnaire. The level of self-efficacy was assessed using the Obesity, Nutrition, and Physical Activity Counselling by Residents (ONPAR) questionnaire. The data was analysed using SPSS software version 22 and presented as mean (SD) or frequency (%). Simple and multiple linear regression analysis were performed. Significant p-value was set at 0.05 with a 95% confidence interval. RESULTS: The response rate was 79.5%. The mean score for self-efficacy in obesity counselling was 66.9% (10.67) with the lowest mean score was for the “confidence in prescribing a plan for physical activity for someone with arthritic knees”. The mean knowledge score was 55.4% (23.9). The level of self-efficacy was associated with knowledge on obesity management guidelines recommendations (p=0.02, 95% CI 0.02, 0.17). CONCLUSIONS: The level of self-efficacy in obesity counselling among government PCDs in East Malaysia was modest. The best predictor of higher self-efficacy in obesity counselling is knowledge of the obesity management guidelines recommendations. A structured training program is needed to improve self-efficacy among primary care doctors
High-Intensity Interval Training as A Game-Changer in Type 2 Diabetes Mellitus Management: A Narrative Review
Get PDFDiabetes mellitus (DM) is a chronic health condition that affects millions of people worldwide. Diabetes mellitus is characterized by high blood sugar or glucose levels due to the body's inability to produce or use insulin, a hormone that regulates blood sugar levels. Type 2 diabetes mellitus (Type 2 DM) is the most common form of diabetes, accounting for up to 90% of all cases, and is often linked to lifestyle factors such as poor diet, lack of exercise, and obesity. Physical activity is a highly effective intervention for managing and preventing Type 2 DM. Exercise helps to lower blood sugar levels, improve insulin sensitivity, and promote weight loss. High-intensity interval training (HIIT) is a specific type of exercise that involves short bursts of intense activity followed by periods of rest or low-intensity exercise. HIIT has been found to be particularly effective for patients with Type 2 DM, as it can improve glucose control and cardiovascular health in a relatively short amount of time. This review delves into the role of HIIT in managing Type 2 DM, highlighting its ability to increase insulin sensitivity through processes such as GLUT 4 translocation, mitochondrial activity, and vasodilator function, as well as improving glycaemic control by increasing aerobic capacity and the activity of mitochondria. By synthesizing recent research, we aimed to provide insights in a narrative review of the benefits and mechanisms of HIIT for managing Type 2 DM
Atypical Cystic Carcinoma: A rare malignancy of the lower eyelid
Get PDFAdenoid cystic carcinoma (ACC) is a rare malignancy of the secretory glands, most commonly originating in the lacrimal gland but rarely involving the eyelids. ACC is known for its aggressive behaviour, high recurrence rate, and potential for metastasis, leading to a poor prognosis. Histopathological examination is essential for the diagnosis, and early detection with complete excision offers the best chance for a favourable outcome. This case highlights the importance of comprehensive management to reduce the recurrence risk and improving patient survival. The authors present a 56-year-old man with ACC of the left lower eyelid, who underwent surgical excision followed by reconstruction, ensuring tumour-free margins
Disorders/Differences of Sex Development (DSD) and Gender Dysphoria: The Need of a National Guideline for Malaysia
Get PDFDisorders/Differences of Sex Development (DSD) are congenital conditions characterized by atypical chromosomal, gonadal, or anatomical sex, affecting approximately 0.1–2% of the global population. A subset of individuals with DSD also experiences gender dysphoria (GD), a psychological distress arising from incongruence between assigned sex at birth and experienced gender. Misdiagnosis between GD and DSD remains a major concern, particularly in Muslim-majority contexts such as Malaysia, where socio-cultural, religious, and medical perspectives intersect. Many individuals with unrecognized DSD are mistakenly categorized as transgender, resulting in stigmatization, marginalization, and limited access to healthcare, education, and religious participation. Islamic jurisprudence introduces the concept of khuntha to describe sex ambiguity, which overlaps with some DSD cases but requires nuanced differentiation from mutasyabbih (gender imitation) and transgenderism. While classical scholars distinguished between khuntha wadhih (discernible) and khuntha mushkil (intractable), contemporary management demands multidisciplinary collaboration. Integrating medical expertise with Shariah rulings is essential to determine appropriate pathways, including gender assignment, surgical interventions, and psychosocial support. The absence of structured guidelines in Malaysia exacerbates clinical, ethical, and religious dilemmas in managing these complex cases. This paper argues for the urgent development of a national guideline that combines evidence-based medical protocols with Islamic jurisprudence, ensuring culturally competent and patient-centered care. Such a framework would harmonize the roles of endocrinologists, psychiatrists, psychologists, religious scholars, and community stakeholders, providing comprehensive management that upholds both health outcomes and spiritual well-being. Establishing this synergy positions Malaysia to pioneer an integrated model for DSD and GD management in Muslim societies.
Predictors to Mental Well-Being at Workplace: A Quantitative Case Study Among Administrative Staff of a Public University in Malaysia
Get PDFINTRODUCTION: The Malaysian Public Service Department reported many staff were at risk of mental health crisis or illness and an independent study revealed concerning rate of suicidal ideation. This study intends to: (a) describe the level of mental health literacy (MHL), mental health self-efficacy (MHSE), and mental well-being (MWB) among university administrative staffs, and (b) explore the dynamic influence between mental health literacy, mental health self-efficacy, and mental well-being. MATERIALS AND METHODS: A cross-sectional study using validated questionnaires was done on 91 administrative staff in one public university in Malaysia. The questionnaire consists of 37 items measuring MHL (subdimensions: knowledge, erroneous belief, first aid, and self-help), MHSE (subdimensions: optimism, factor coping, and advocacy), and MWB. Data was analysed using descriptive statistics, Pearson’s correlation, and multiple linear regression. RESULTS: The mean scores for subdimensions of MHSE ranged from 14.2 to 28.6 (SD=2.73 to 4.45), subdimension of MHL from 6.1 to 25.5 (SD=2.17 to 3.35), and MWB was 18.5 (SD=3.36). Correlation analyses revealed all subdimensions of MHSE and MHL, as well as MWB showed significant weak to strong correlation (r=0.22 to 0.69). Only optimism subdimension of MHSE retained significance in predicting MWB (B=0.43) and among MHL subdimensions, only first aid retained significant prediction to optimism. CONCLUSION: The findings provide valuable insights to the dynamic role between subdimensions of MHL and MHSE, as well as their contribution towards MWB. Healthcare professionals should consider this dynamic into designing mental health promotion activity
Photobiomodulation Therapy for Wound Healing: A Narrative Review
Get PDFPhotobiomodulation is a therapy method that employs light to stimulate cellular function. It has emerged as a promising approach to healing wounds due to its potential to accelerate tissue repair. Wounds can vary in severity from minor cuts to more serious injuries that involve deeper tissue damage. Wound healing is the natural process of the body to repair the injured tissue that causes disruptions to the integrity of the body's tissue. It has been known that photobiomodulation has established its positive effects on wound healing in various factors by modulating the inflammatory response. This review aims to understand the efficacy of photobiomodulation and the clinical application of light transmission as a therapy in enhancing the healing of wounds. Articles on photobiomodulation and its application in wound healing were searched from the available peer-reviewed journals. Published papers were collected from PubMed, Scopus, and Science Direct using photobiomodulation, wound healing, and soft tissue as the keywords. The initial paper search yielded 124 results, and 37 full-text eligible articles were assessed in this review. In conclusion, photobiomodulation has been seen to offer a promising therapeutic approach to enhancing wound healing despite ongoing development. Continued research is essential to comprehend the full potential of photobiomodulation therapy in accelerating wound recovery. It will provide insights into future research areas on photobiomodulation, thus improving the clinical treatment modality and the patient's quality of life
Occurrence of aac(6’)-Ib-cr and Qnr Genes among Quinolone-Resistance Enterobacteriaceae Isolated from Patients with Urinary Tract Infection in Najaf, Iraq
Get PDFINTRODUCTION: The aac(6’)-Ib-cr gene is one of the most common genes among plasmids and has dual activity against both aminoglycoside and quinolone antibiotics, making it among the most important plasmid-mediated quinolone resistance genes. This research aimed to confirm the frequency of aac(6’)-Ib-cr and qnr genes in quinolone-resistant Enterobacteriaceae isolates obtained from patients with urinary tract infection in Najaf, Iraq. MATERIALS AND METHODS: Quinolone resistance was examined in 318 urine samples taken from individuals who had suspected urinary tract infections (135 Klebsiella pneumonia cases, 75 Proteus mirabilis cases, and 108 Escherichia coli cases). Using PCR, antibiotic susceptibility patterns were assessed for quinolone resistance isolates and the presence of the aac(6’)-Ib-cr, qnrA, qnrB, and qnrS were looked into. RESULTS: Quinolone-resistant isolates totaling 176 were identified. aac(6’)-Ib-cr was detected in 93 (52.8%) cases, 50 of which were E. coli, 39 were K. pneumonia, and 4 were P. mirabilis, according to PCR analysis data. qnrA 6 (3.4%), qnrB 22 (12.5%), and qnrS 5 (2.8%) isolates were identified to have the following qnr genes. P. mirabilis did not have the qnrS gene, which was absent from all analyzed genes detected in bacterial isolates. CONCLUSION: It was shown that of the plasmid-mediated quinolone resistance genes, the aac(6’)-Ib-cr gene was the most common. Every gene analyzed was present in both K. pneumoniae and E. coli