Harlina Halizah Siraj

Advanced abdominal pregnancy resulting from late uterine rupture.

BACKGROUND: Advanced abdominal pregnancy is rare, and one that occurs after uterine rupture with delivery of a viable fetus is exceptional. CASE: A multiparous patient was admitted at 29 weeks of gestation for conservative management of placenta previa. She complained of intermittent abdominal pain, but repeated assessment suggested that both the patient and the fetus were doing well. At 36 weeks, an abdominal pregnancy was diagnosed with radiological features suggestive of uterine rupture. Laparotomy was performed and a healthy infant was delivered. CONCLUSION: Fetal viability was achieved in this case of abdominal pregnancy secondary to uterine rupture after close maternal and fetal surveillance.

Educational environment in a multicultural society to meet the challenges of diversity

ABSTRACT Educators in a multicultural-environment face complex-tasks in teaching for diversity. The objective of this study was to determine the educational environment in a Malaysian medical school, aimed to face the diversity. This cross-sectional study was conducted utilising “Dundee Ready Education Environment Measure”, a validated instrument that contained 50 items rated 0-4 with a maximum 200 score under five sub-scales. Sub-scales were perceptions of: learning, teacher, academic-self, atmosphere and social-self. Respondents were 193 year-5 medical students of session 2011-2012, comprised of Malays, Chinese, Indians and Other ethnic-group. The overall mean score perceived by all ethnicity was 130/200 (65%). All sub-scales perceived >60% scores except social-self and atmosphere. The social-self sub-scale perceived the lowest score (53.57%) by the Other ethnic group while interestingly social-self also perceived highest (75%) by the Indians. Atmosphere sub-scale perceived a score of 58.33% by Other ethnic-group. Positive perceptions of educational enviornment among the students of diverse ethnicity reflects that educational environment at the medical school is well equiped to meet the challenges of diversity. However, there is opportunity to increase further positivity in general and social-self and atmosphere sub-scales in particular. Educators in a multicultural-environment must work to avoid monocultural instructional methodoligies to promote a multicultrul society.

Does palm oil vitamin E reduce the risk of pregnancy induced hypertension

In view of the high anti-oxidative potential oftocotrienol, the role of the tocotrienol-rich fraction (TRF) of palm oil in preventing pregnancy induced hypertension (PIH) was explored in a randomized double-blind placebo-controlled clinical trial in an urban teaching hospital. Healthy primigravidae were randomized to receive either oral TRF 100 mg daily or placebo, from early second trimester until delivery. Out of 299 women, 151 were randomized into the TRF arm and 148 into the placebo arm. A total of 15 (5.0%) developed PIH. Although there was no statistically significant difference in the incidence of PIH (4/151 or 2.6% in the TRF arm vs. 11/148 or 7.4% in the placebo arm, p = 0.058) between the two arms, there was a tendency towards a lower incidence of PIH in the TRF arm compared to the placebo arm. With TRF supplementation, the relative risk (RR) of PIH was 0.36 (95% CI 0.12-1.09). In conclusion, although TRF from palm oil does not statistically significantly reduce the risk of development of PIH in the population studied, the 64% reduction in incidence of PIH is substantial. The findings warrant further clinical trials, particularly in high risk populations.

Undergraduate Medical Education Research in Malaysia: Time for a change

Objective: Special Study Module (SSM) is a mandatory research module implemented in Universiti Kebangsaan Malaysia (UKM). The objective of this paper is to provide a brief overview on the student research activities and to find out the outcome measures in terms of publication. Methods: It was a retrospective study done on SSM research projects at UKM. The SSM research is conducted from beginning of year-4 until 1st seven weeks of year-5. In year-4, students are assigned to a faculty-supervisor in small groups and spend every Thursday afternoon to plan and carry the research. Whole first seven weeks of year-5, students are placed with their supervisor continuously to collect data, do analysis, write report and present in the scientific conference. Outcomes of 5-years SSM research-projects starting from 2008/2009 to 2012/2013 academic session were analyzed. Results: Total 257 projects were completed and presented in annual scientific meetings from which 57 (22.2%) articles were published in peer reviewed journals. Conclusion: Mandatory undergraduate student research project brings an opportunity to develop students’ capacity building from conception to final report writing and thereby narrowing the gap between education and practice. Medical schools should implement research module to bring changes in research and publication culture of undergraduate medical education.

Preparedness of the teachers for Team-Based Learning: Liking, disliking and suggestions of faculty.

Faculty development is an integral part of institutional development. This paper describes liking, disliking and suggestions of faculty members on a 2-days Team-Based Learning faculty training workshop, where 39 faculty members were attended. Participants liked the lively and informal discussions through which they got a new technique to teach students more interactively. However, they disliked too short demonstration and short notification given them to read pre-assigned material and suggested more workshops with more practical demonstration before its implementation. Faculty developers should address the needs of the faculty while organizing developmental workshop aimed to link between theory and practice for a sustainable development.

Impact of Undergraduate Research “Special Study Module (SSM)” on Universiti Kebangsaan Malaysia Medical Students and Alumni

Introduction: Mastering the art of conducting a research along with the competitive era of publishing papers showed the importance of undergraduate research. The purpose of this research was to study the impact of undergraduate research “Special Study Module (SSM)” on Universiti Kebangsaan Malaysia (UKM) medical students and alumni. Methodology: This was a cross-sectional study whereby 64 fifth year UKM medical students of academic-session 2014/2015 and 49 alumni of year 2010 were participated on their SSM research activities. The questionnaire administered online which enquired on participants’ level of interest, confidence and SSM research experiences. Frequency and percentage distribution were used for descriptive analysis. Result: Out of 119 participants,113 responded giving a response rate of 95%. More than 90% respondents in both group felt that SSM experience was enriching and 80%–90% felt SSM experience was pleasant. In both groups 47%–50% respondents believed, SSM experience contributed their high level of interest on research. The most influencing factors on their level of interest were supervisor guidance as reported by73%–80% respondents. It was said that SSM supervisor was academically stimulating, impressive as role model and supportive. The most confidence skill was the ability to function within a group and least confidence skill was manuscript writing. Conclusion: Undergraduate SSM research showed positive impact on participants’ research activities. More in-depth analysis should be considered especially on manuscript writing as the students were least confident in this skill.

Sleep Pattern and Academic Performance of Undergraduate Medical Students at Universiti Kebangsaan Malaysia

Sleep is an active, repetitive and reversible state of perceptual disengagement from the environment including unresponsiveness to it. Adequate sleep is extremely important for healthiness. But sleep loss is a remarkable problem in modern society. The objective of this study was to investigate the sleep pattern and its association with students’ academic performance. It was a cross sectional study conducted among 4th year UKM undergraduate medical students of session 2011-2012. Inclusive of all 234 registered 4th year students was selected for this study. A standard questionnaire that contained questions on demography, sleep habits, academic performance and ideal sleep was used to collect data. Out of 234 students, 186 were responded giving a response rate of 79.5% where 73% were female and 69% resided in-campus. Including weekdays and weekends averagely, 56.2% respondents slept for 6-8 hours, 29.1% for 8 hours. An average of 53.35% respondents had in-frequent day-nap, 34.9% frequent and 11.75% had no day-nap at all. Respondents who slept >6 hours were observed to have significantly higher academic performance. It is concluded that, people need to understand the role of sleep and have to take adequate sleep of 6-8 hours per day for health and wellbeing.