Waqar Al-Kubaisy

The Malaysia DREEM: perceptions of medical students about the learning environment in a medical school in Malaysia

Background Students’ perceptions of their learning environment, by defining its strengths and weaknesses, are important for continuous improvement of the educational environments and curriculum. Therefore, the aim of this study was to explore students’ perceptions of their learning environment, among medical students in Malaysia. Various aspects of the education environment were compared between year levels and sex. Methods This cross-sectional study was conducted at the Management and Science University, Shah Alam, Malaysia in 2012. A total number of 438 medical students participated in this study, and the response rate was 87.6%. Data were analyzed using SPSS. Comparisons of the mean scores of Dundee Ready Education Environment Measure (DREEM) subscales were calculated. The t-test was used to determine statistically significant differences. Results The majority of the study participants were female, Malay, and from year 3 (68.7%, 65.3%, and 55.7%; respectively). Analysis of each of the 50 items of the DREEM inventory showed that 47 items scored ranged between 2.00 and 3.00, and three items scored below 2.00. These were identified as problem areas in this medical school that are required to be critically addressed. The overall score showed that the medical students’ perceptions were positive. The students’ perception toward educational environment was positive for all five DREEM subscales. Conclusion The study found that, in general, the perceptions of the participants about the learning environment were positive. Nevertheless, the study also found there is a need for curriculum improvement in this school and identified priority areas for such improvement.

Maternal obesity and its relation with the cesarean section: A hospital based cross sectional study in iraq

BackgroundObesity during pregnancy is reported in approximately one in five pregnant women worldwide. It increases the risk of pregnancy complications many of which necessitate Cesarean section (CS). This study determines the association between obesity and type of delivery.MethodsA cross-sectional study involving 404 pregnant women was carried out at Al-Yarmouk Teaching Hospital, Baghdad, Iraq. Women with hypertension, diabetes, preterm labor, fetal presentation other than cephalic presentation and multiple gestations were excluded from the study. BMI and past obstetric history were recorded.ResultsThe overall rate of CS was 38%. The overall mean body mass index (BMI) was 25.0 ± 4.52 Kg/m2 and it was significantly higher among women who delivered by cesarean section. Significantly high rate of CS was found in primigravida and multigravida women with high BMI. Moreover, all obese multigravid women with history of previous CS were delivered by CS. The rate of CS was higher in women with primary level education when compared to women with secondary or tertiary education. CS was significantly lower in women with a previous history of abortion.ConclusionObese women with or without a previous history of CS are at a higher risk of having a CS and should therefore be considered as high risk and managed appropriately during pregnancy. Weight management prior to or during pregnancy could help reduce the need for CS.

Hepatitis C Virus Prevalence and Genotyping among Hepatocellular Carcinoma Patients in Baghdad

Hepatocellular carcinoma (HCC) is the third most common cause for cancer death in the world, now being especially linked to chronic hepatitis C virus (HCV) infection. This case-control study consisting of 65 HCC patients and 82 patients with other malignant tumours as controls was conducted to determine the association of HCV markers with HCC. Serum of each participant was obtained for detection of HCV Ab and RNA by DNA enzyme immunoassay (DEIA). Twenty six per cent (26.0%) of HCC patients had positive anti-HCV which was significantly greater than the control group (p=0.001). HCC patients significantly have a risk of exposure to HCV infection almost 3 times than the control group (OR=2.87, 95% C.I=1.1-7). Anti-HCV seropositive rate was significantly (p=0.03) higher among old age HCC patients and increases with age. Males with HCC significantly showed to have more than 9 times risk of exposure to HCV infection (OR=9.375, 95 % CI=1.299-67.647) than females. HCV-RNA seropositive rate was (70.8%) significantly higher among HCC patients compared to (22.2%) the control group (p=0.019). The most prevalent genotype (as a single or mixed pattern of infection) was HCV- 1b. This study detected a significantly higher HCV seropositive rate of antibodies and RNA in HCC patients.

Is dental extraction a risk factor for contracting HCV infection: Abs, RNA and genotype detection

Background: The medical risk factor associated with hepatitis C virus (HCV) infection such as blood transfusion and surgery had been intensely studied in many countries. Up to 40% of patients infected with HCV may have non identifiable routes of viral acquisition. Dental extraction may be one of these risk factors. The purpose of the present study was to determine the existence of infection and the predominated HCV genotype among subjects with dental extraction. Material and methods: A case-control study involving pregnant women with and without history of dental extraction (n=776, n=2715, respectively). HCV antibodies (anti-HCV) were tested using subsequently third generation enzyme immunoassay (EIA-3) and immunoblot assay (Lia Tek-111). In addition 94 serum samples were subjected to molecular analysis using RT-PCR and DNA enzyme immunoassay (DEIA) method for HCV-RNA and genotypes. Results: Anti-HCV seroprevelance was significantly higher (6.3%) among cases with dental extraction (cases) than their counter control group (control) (2.63%) (p=0.00001). Dental extraction act as a risk factor for HCV infection (OR=2.73; 95% CI=1.8-3.9). HCV-RNA was found to be significantly higher (74.6%) in cases than (38.7%) control group (p=0.0016). No significant association between HCV genotypic and the history of tooth extraction but HCV-1b showed higher rate (90%) among dental extraction cases.

Factors Associated with Smoking Behaviour among University Students in Syria

Cross-sectional study was conducted on 774 students from a Syrian University using questionnaire to estimate the prevalence of smoking among University students and to identify factors related to smoking. Smoking prevalence was 20.75%. Mean age (years) of smokers (25 ± 2.2) was significantly older than non-smokers (21 ± 1.8). Smoking prevalence among males was 26.1%, significantly higher than among females (9.5%). Female students consumed significantly higher number of cigarettes /day ( 21 ± 5) than the male (9 ± 2). Smoking was significantly higher (27.8%) among students living away from their families than (16.2%) those living with families. Keywords: smoking, risk factors, youth © 2017. The Authors. Published for AMER ABRA by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.

Sociodemographic Characteristics of Acne among University Students in Damascus, Syria

To estimate the prevalence and identify risk factors that may be associated with acne among university students in Syria, a cross-sectional study was conducted in the Syrian International University for Science and Technology in December 2009. A sample of 500 students was chosen. Each participant was subjected to an interview and clinical examination of acne in addition to height and weight measurements. Acne prevalence was 34.7% (172/496). Male students had higher rate of acne compared to females (42.9% versus 23.6%, ) and their acne started significantly at a younger age (18.13 versus 19.04 years old, ). Face was the commonest site for acne in both males and females. Washing face frequently per day in both sexes has a significant relation with a decreased prevalence of acne. Moreover, psychological stress particularly when the students were away from family was associated with a significant higher rate of acne. We found that the prevalence of acne steadily increased with increasing body mass index. Acne is a health and psychological problem among university students particularly when affecting the face. Several factors such as gender, body mass index, and stress were found to be associated with acne formation.

Epidemiological study of bloody diarrhoea among children in Baghdad, Iraq

Introduction: Diarrhoea is a preventable and treatable disease; however it is still a major public health problem particularly in the developing world. Bloody diarrhoea in young children is usually a sign of invasive enteric infection that carries risk of serious morbidity and death. In Iraq, diarrhoea is the second common cause of mortalities among children.

Human Papilloma Virus (HPV) self-sampling: do women accept it?

Abstract This study aims to determine the acceptability of Human Papilloma Virus (HPV) self-sampling and the factors associated with willingness to buy HPV self-sampling kit in the future. A total of 164 women aged 28–60 years old from Obstetrics & Gynaecology clinics at a teaching hospital performed HPV self-sampling using the Digene HC2 DNA collection kit. After samples were taken, the participants were given self-administered questionnaires. The majority of the participants were Malay (93.9%), had attained tertiary education (65.2%) and were employed (70.1%). The acceptability was good. More than half of the participants felt that self-sampling was easy. Only 1.2% felt that the procedure was difficult to perform. Most reported no pain at all during the procedure (66.9%). The commonest concern was getting a good sample (90.1%). A number of Pap smears were found to be significantly associated with the willingness to buy the HPV self-sampling kit. HPV self-sampling has the potential to be included in the cervical cancer screening programme. Impact Statement What is already known on this subject: HPV self-sampling is acceptable in some developed and developing countries. It is acceptable because it was easy to perform with very minimal pain or discomfort. Studies on the acceptance of self-screening are needed to plan a policy on self-sampling in the future. What the results of this study add: Our study adds new findings to the body of knowledge on self-sampling in the local population. We found that more women are willing to do the self-sampling at the clinic rather than at home. Although more than 90% expressed willingness to do self-sampling in the future, only 70% of them were willing to purchase the kit. Cost is a potential barrier to women who have the interest to perform the self-sampling. Given the global economic challenges, cost is inevitably an important predictor that we have to consider. What the implications are of these findings for clinical practice and/or further research: Future research should examine women from the rural areas and those who are resilient to Pap smear screening. In clinical practice, clinicians should acknowledge that cost is a potential barrier for women who are willing to do self-sampling. Self-sampling could be an option for women with no financial constraint to buy the kit. However, clinicians should counsel women so that they can make an informed choice in determining their screening method.

SOCIODEMOGRAPHIC CHARACTERISTICS AND THEIR ASSOCIATIONS WITH KNOWLEDGE, ATTITUDE, AND PRACTICE ON LEPROSY

Background: Garbage has the potential to cause pollution and health problems. Pollution can occur in the air as a result of waste decomposition, can also contaminate water and soil caused by leakage (liquid waste) resulting in various skin diseases. The skin disease are caused by several types of pathogenic microorganism that live and breed in the waste. This study aimed to determine the impact of long residence adjacent to sanitary landfill, distance to landfill, and skin contact with garbage on skin disease symptoms at Putri Cempo final waste disposal, Mojosongo, Surakarta. Subjects and Method: This was an analytic observational study using cross sectional design. This study was conducted in Putri Cempo final waste disposal, Mojosongo, Surakarta, Central Java. A sample of 102 residents living near the Putri Cempo waste disposal were selected for this study. The dependent variable was symptoms of skin disease. The independent variables were duration of residence near the sanitary landfill, house distance to landfill, and skin contact with garbage. The data were collected by questionnaire and analyzed using multiple logistic regression. Results: Residence near the sanitary landfill near ≥ 3 years (OR= 6.00; 95% CI= 1.97 to 18.20; p= 0.002) and house distance to landfill <1 km (OR = 9.50; 95% CI= 3.10 to 28.80; p = 0.001) increased the risk of skin disease symptoms. Indirect contact with waste (OR= 0.68; 95% CI= 0.10 to 2.90; p= 0.605) was associated with decreased skin disease symptoms, but it was statistically insignificant. Conclusion: Residence near the sanitary landfill near ≥ 3 years and house distance to landfill <1 km increase the risk of skin disease symptoms. Keywords: skin disease, symptomp, waste disposal, sanitary landfill, residence

Pharmaceutical Manipulation of Chronic Anal Fissure

Physiologically, it is the resting tone of the internal anal sphincter that chiefly interferes with the healing of the fissure. An anal fissure which does not heal with sitz baths and laxatives is a chronic anal fissure. Till now, the treatment for chronic anal fissures has been surgery in the form of anal dilatation or lateral sphincterotomy. Fissures heal in most patients, but a few develop transient or even permanent incontinence. There are exciting new advances in the form of chemical sphincterotomy, by the application of drugs that relax the sphincter. Glyceryl trinitrate and isosorbide dinitrate relax smooth muscle. They promote healing in about half of patients, but often cause headaches. Consequently compliance is a problem. The calcium antagonists, nifedipine and diltiazem, also reduce anal pressure by 28 %, but healing rates are low. Botulinum toxin is the most promising of the agents used for chemical sphincterotomy. This toxin can be used to weaken smooth muscle in the gastrointestinal tract, for example in achalasia and infantile hypertrophic pyloric stenosis. Botulinum toxin injection near the fissure reduces anal pressure lasts for about 3 months. This allows the fissure to heal, thus eliminating the need for surgery. After injection of botulinum toxin, there is a decrease in resting anal pressure by 18–30 %. The injection relieves the pain almost immediately. Cure rates are over 60 %, and the procedure can be repeated. Botulinum toxin is a reasonable first-line alternative to surgery in the management of chronic anal fissure.