Nordin Bin Simbak

Perceptions of students in different phases of medical education of the educational environment: Universiti Sultan Zainal Abidin.

Background The Dundee Ready Education Environment Measure (DREEM) was planned and designed to quantify the educational environment precisely for medical schools and health-related professional schools. DREEM is now considered a valid and reliable tool, which is globally accepted for measuring the medical educational environment. The educational environment encountered by students has an impact on satisfaction with the course of study, perceived sense of well-being, aspirations, and academic achievement. In addition to being measurable, the educational environment can also be changed, thus enhancing the quality of medical education and the environment, and the medical education process. The objective of this study was to assess the educational environment of the Universiti Sultan Zainal Abidin (UniSZA) undergraduate medical program from the students’ perspective. The study expected to explore UniSZA medical students’ overall perceptions, perceptions of learning, teachers, atmosphere, academic self-perception, and social self-perception using the DREEM questionnaire. Methods A cross-sectional survey was conducted to study the perceptions of the students toward the educational environment of UniSZA as a new medical school, using the DREEM questionnaire. All medical students of UniSZA from Years I–V enrolled in the Bachelor of Medicine and Bachelor of Surgery programs were the target population (n=270). Therefore, the universal sampling technique was used. The data were analyzed using the SPSS 20 software. This study obtained ethical clearance from the Faculty of Medicine and Health Sciences, UniSZA. Results A total of 195 out of 270 students responded. Respondents included 31% males and 69% females. The overall DREEM scores were significantly higher (P<0.001) for females than males. Conclusion The medical students at UniSZA showed a positive perception of their educational environment. The new medical faculty, established for only a few years, has achieved an above-average, conducive educational environment for students. Most of the students showed a positive perception for the entire five domains tested in the DREEM survey. Females were consistently satisfied with UniSZA’s educational environment, and self-perception was high, as compared to male undergraduates.

Computational Characterization of the Promoter Region of SMN2 (Survival of Motor Neuron) Gene

SMN (Survival of Motor Neuron) has two isotypes; SMN1 and SMN2 encoding for FL-SMN protein (functional SMN) and ?7SMN protein (non functional). The lack of SMN1 produce spinal muscular atrophy (SMA) and the increasing gene dosage of SMN2 have been shown to decrease the severity of the SMA. The core promoter region of the SMN genes is still not identified but previous literature have shown these genes to be regulated by a 4.6 kb region up stream of the transcription start site (TSS). There was a need of computational analysis of this region as the presence of important features can help to develop a strategy for gene therapy against spinal muscular atrophy (SMA). In this analysis, the open reading frames, Pribnow box sequences, restriction sites and the transcriptional factor binding sites were identified. Important restriction sites were determined with in 15 open reading frames. Total of 15 ORFs and 24 nested ORFs were determined with 7 and 11 ORFs on the complementary strand. These ORFs contained 15 TATA box sequences reflecting the diverse function integrity of SMN promoter region. The whole data was used for the prediction of the promoter region of the SMN. Up to the best of our knowledge this is the first reported study in the literature reflecting the computational analysis of the ~4.6 kb expected promoter region of the SMN genes towards analyzing the core promoter region of the SMN genes in the future studies.

Quadriceps Muscle Activity During Exercise

Various forms of exercises are imparted for patients with lower extremity problems. These exercises are helpful in strengthening the muscles of the lower limb mainly those of quadriceps and hamstring. This study was intended to investigate the activity of vastusmedialis oblique and vastuslateralis during selected exercises of Static Quadriceps Exercise (SQE), Inner Range Quadriceps exercise (IRQ), Straight Leg Raise (SLR), Active Knee Extension exercise (AKE) and semisquat. About 50 healthy individuals (15 Males and 35 Females) in the age group of 18 -24 years (Male= 21.2 ± 1.21, Female= 20.3 ± 0.8) were recruited for the study based on the inclusion criteria. Surface electromyographic electrodes were affixed to Vastusmedialis Oblique (VMO) and vastuslateralis (VL) muscle. Each subject was advised to perform all the five exercises, and the muscle activity during each exercise was recorded using MyotracInfiniti, and the data were analysed with the aid of Biograph Infiniti software. Descriptive and inferential statistics were performed using SPSS version 22.0. The findings of the research indicated that inner range quadriceps exercise was significantly better in facilitating VMO and VL with no significant difference between the two during various exercise. It was also observed that the VMO/VL ratio was similar in all the exercise indicating equal activation of both muscles.

Effect of Combined Brain and Back Muscle Stimulations on Level of Physical Disability among Chronic Low Back Pain Patients

The purpose of this study is to determine the effect of combining anodal cortical and back muscle stimulations in chronic low back pain (CLBP). Forty eight patients divided into four groups participated in the study. The control group received infrared therapy (IRT) and a session soft tissue massage (STM), while those in the other groups received combined dorsolateral prefrontal cortex (DLPFC) and Back muscle stimulation plus IRT and STM, combine primary motor cortex (PMC) and Back muscle stimulations plus IRT and STM and Williams flexion exercise plus IRT and STM respectively. The primary outcome (disability level) was assessed using modified Oswestry low back pain disability questionnaire while bothersome questionnaire (secondary outcome) was used to assess the level of bothersome of the participants. Statistical analysis revealed that participants that received DLPFC/Back muscle stimulation plus IRT and STM (p=0. 046, z=-2.02) have much improvement in disability compare to those that received PMC /Back muscle stimulations plus IRT and STM. In addition, the control intervention (IRT and STM) proves to be more effective (P=0.025, Z=-2.24) compare to other groups. It is concluded that IRT and a session of STM is more effective in the reduction of disability and improvement of the functions in CLBP than the combine stimulations, but the result cannot be generalized because of the small sample size and type of design used in this clinical trial.

Strengthening Exercises of the Thigh Muscles- A Review

The muscles of the thigh are important in the functioning of the lower extremity. The main muscles of the lower limb that is effectively involved in the biomechanics of the lower limb are the quadriceps femoris and hamstring. Many researchers have investigated the activity of these muscles during various daily activities and exercises. The main focus of this review is to highlight the anatomy of these muscles, the methodology of measuring the activity of these muscles and researches that have measured the activity of these muscles in different strengthening exercises that were commonly used in rehabilitation of people with orthopedic crises. The main articles that were included in the review were those in which the exercises such as static quadriceps, inner range quadriceps, straight leg raise, active knee extension and semi squat were performed and the activity of quadriceps femoris and hamstrings were measured. Electromyography (EMG) analysis provides information on the relative amount of muscular activity during the exercise. The main muscles that were reviewed were those of the vastus medialis oblique, vastus lateralis, rectus femoris and biceps femoris. This review has highlighted the importance of the exercises that were frequently advised for patients with orthopedic problems and the activity of the muscles during the exercises. There are evidences that the strength of the thigh muscles influence the quality of life an individual. The level of activity of the muscles is evident from this review and it could give a clear idea on the exercises that could be performed in order to strengthen an individual muscle.

The Effect of Strength Training Programme in the Enhancement of Trunk and Hip Muscles Activations among Healthy Females Subject

Research has illustrated that the risk of lower back pain (LBP) among women population is signi?cantly higher owing to the hormonal and reproductive factors such as irregular or prolonged menstrual cycle and hysterectomy. The trunk and hip muscles are regarded as the most affected muscles in LBP patients and as such precise training of these muscles could be of value to the patients. Diverse exercises programmes exist, yet, the appropriate training that could be suitable in stimulating certain groups of muscles for a specified gender remains a challenge. As a result, this study aims to determine the efficacy of a strength training programme (STTP) in improving and stimulating the trunk and hips muscles of female’s subjects. 25 healthy females with normal BMI and ages range from 19 to 24 years performed five sets of strength exercises three times a week for five weeks. Electromyography (EMG) data were collected from 5 muscles of rectus abdominis, external oblique, multifidus, gluteus maximus and gluteus medius. The readings from the EMG were compared after the five weeks interventions (pre and post). An independent t-test was administered to the data collected to study the effectiveness of the STTP between pre and post on the trained muscles. A statistically significant difference of muscle activations between the pre and post on all the assessed muscles were obtained p < 0.05. The finding suggests that STTP intervention is effective in stimulating the females’ pelvic muscles activations. STTP could be a viable means for prevention and rehabilitation of LBP.

Moderation of Back pain by Rehabilitation Exercises; Multifidus Muscle’ Perspective

Low back pain (LBP) is highly prevalent in our society and the multifidus muscle is the most important muscle for lumbar segment stability as per its relationship its atrophy and recurrences of low back pain besides, its recovery to normal size in patients undergone an exercise program resulting in stress, deterioration of the lumbar multifidus muscle tissue leading to impaired function. Nevertheless, particular important risk factor regarding low back pain is the weakness of multifidus muscle and conditioning of this muscle is connected with significant improvements on a chronic low back (CLBP), as well as with decreased useful disability. Strengthening of multifidus muscle can be helpful for preventing chronic low back pain (CLBP). Beneficial exercises are wide use in the treatment of lower back pain. In this review, we have tried to list all the effective exercises for the low back pain (LBP) to decrease pain and strengthening of multifidus muscles.

Assessment of First-Year Students’ Metacognitive Ability in Faculty of Medicine, Universiti Sultan Zainal Abidin (UniSZA): Toward Curriculum Development

Introduction: Metacognition is the awareness of knowledge how one learns in addition to whatone learns and to understand how a task will be performed. Metacognitive skill as self-assessmentis recognised as an important contributor to the development of critical capacity, reflective attitudeand autonomous life-long learning. Accurate, self-assessment of knowledge and skills is essential forstudents to maintain and improve through self-directed learning. Objective: The objective of thisstudy was to explore, how well students’ evaluate their own level of understanding for lectures toreflect their metacognitive skill that can be used in educational strategy to promote students’ personaland professional growth. Methods: To assess the metacognition of the students, a questionnaire basedon three items was designed. All 60 (17 male and 43 female) preclinical, first-year medical studentswere included in this study. The metacognition as planning, monitoring and evaluating the lecture wasjudged through students’ response on 33 lectures in terms of understanding of knowledge, clearingof misconceptions and presenting of a well prepared material respectively in the field of haematologyand parasitology. Metacognition as reflected in the lecture understanding level (LUL) score, lecturespreparation level (LPL) score and students question level (SQL) score was estimated for its correlationwith student’ achievement score in pre-clinical phase of MBBS program. Results: The data wasanalysed for correlation between metacognition and overall students’ achievement scores and astatistically significant correlation between LUL and multiple true false (MTF) of 268 (p = .039),LPL and MTF of .282 (p = .029) as well as between SQL and MTF of .360 (p = .005) was comparedto poor correlation between LUL, LPL and SQL and the other three assessment tools (short essayquestions [SEQ], problem-based questions [PBQ] and objectively structured practical examination[OSPE]) was found. Conclusion: The significant correlation of students’ metacognition and theirachievement score in classroom setting with MTF and poor correlation with SEQ, PBQ and OSPE isattributed to multiple factors discussed in this study, imperative to students’ personal and professionalgrowth.

Social intelligence of parents with autism spectrum disorders impacts their emotional behaviour: A new proposed model for stabilising emotionality of these parents impacting their social intelligence

Autism spectrum disorder (ASD) may affect all spheres of a childs life. Indeed, parents and siblings also live with emotional instabilities in the family. The experience of parents with ASD child can be distressing since they need to make more adjustments to the demanding need to cope with their life situations. Perhaps, their life is drastically exaggerated with their complexities of life. Particularly, their social life is radically affected. The presence of pervasive and severe deficits in children with ASD isolates these parents from their social life; demanding adjustments to their social environment of parents in their life situations shove them into distress and unstable emotions. Finally, they culminate being shattered in their interpersonal relationship, their family and social life. Indeed, these aspects of distress mask social intelligence of these parents, thus narrow down their focus more on the treatment rather than holistic management of their child. Thus, the management of ASD with these parents of the deficit children to reach their fullest abilities remains doubtful. Therefore, the objectives of this study are as follows: (a) to examine the impact of emotionality on social intelligence of parents blessed with autistic child, (b) to develop awareness regarding social intelligence and its significance among these parents, (c) to propose a new model stabilising emotionality of these parents through developing social adaption skills and (d) to suggest a new model as a guide in the current intervention regimens to ensure the emotional well-being and better social adoption. This study is made based on the keenly examined past evidence with the correlation of emotionality and its impact on social intelligence of the parents with ASD children. The results reveal that the social intelligence is perceived as lowered evidenced by poor social adjustment reflected in social isolation observed in the parents of children with ASD. A new model proposed for stabilising and developing awareness of social intelligence among the parents of ASD children. Integrating this model with the existing treatment paradigm has been suggested to attain the better result. The conclusion is drawn in this study by analysing the fact that considerable improvement in the diagnosed child may not amend the parent and family distress and drastically affect social intelligence. Indeed, the intervention can be more promising with the healthy personality of parents, where their multiple aspects of intelligence are not affected. The new proposed model of intervention can pave the way for further research in this regard.

Study on personality dimension negative emotionality affecting academic achievement among Malaysian medical students studying in Malaysia and overseas

Personality dimension negative emotionality is known to be associated with academic achievement. The present study focuses on the influence of negative emotionality (neuroticism) on the medical students’ academic achievements. The main objective of this study was to ascertain the negative emotionality scores among the first year Malaysian medical students studying in Malaysia and India, further to find out the association between negative emotionality and their academic achievements. The current study sample includes 60 first year Malaysian medical students from Universiti Sultan Zainal Abidin, Malaysia, and USM-KLE IMP, Belgaum, India. They were selected by convenient sampling technique. The Medico-Psychological questionnaire was used to find out the negative emotionality scores among the students and these scores were compared with academic scores. The data were analyzed using SPSS- 20. Thus, the study result goes with the prediction that there is a significant correlation between academic achievement and negative emotionality. We concluded that negative emotionality has a negative impact on medical student’s academic achievement regardless of the fact whether they study in their own country or overseas.