Search results for: Malay medical manuscript

Authors: Mohammad Tahir Yousafzai, Nighat Nisar, Rehana Khalil

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The aim of this study is to assess the practices of sharp injuries and factors leading to it among medical practitioners in slum areas of Karachi, Pakistan. A cross sectional study was conducted in slum areas of Landhi Town Karachi. All medical practitioners (317) running the private clinics in the areas were asked to participate in the study. Data was collected on self administered pre-tested structured questionnaires. The frequency with percentage and 95% confidence interval was calculated for at least one sharp injury (SI) in the last one year. The factors leading to sharp injuries were assessed using multiple logistic regressions. About 80% of private medical practitioners consented to participate. Among these 87% were males and 13% were female. The mean age was 38±11 years and mean work experience was 12±9 years. The frequency of at least one sharp injury in the last one year was 27%(95% CI: 22.2-32). Almost 47% of Sharp Injuries were caused by needle recapping, less work experience, less than 14 years of schooling, more than 20 patients per day, administering more than 30 injections per day, reuse of syringes and needle recapping after use were significantly associated with sharp injuries. Injection practices were found inadequate among private medical practitioners in slum areas of Karachi, and the frequency of Sharp Injuries was found high in these areas. There is a risk of occupational transmission of blood borne infections among medical practitioners warranting an urgent need for launching awareness and training on standard precautions for private medical practitioners in the slum areas of Karachi.

Keywords: injection practices, private practitioners, sharp injuries, blood borne infections

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Authors: Athicha Cherdpunt, Patompong Satapornpong

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The medical cannabis is made up of components also known as cannabinoids, which consists of two ingredients which are Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD). Interestingly, the Cannabinoid can be used for many treatments such as chemotherapy, including nausea and vomiting, cachexia, anorexia nervosa, spinal cord injury and disease, epilepsy, pain, and many others. However, the adverse drug reactions (ADRs) of THC can cause sedation, anxiety, dizziness, appetite stimulation and impairments in driving and cognitive function. Furthermore, genetic polymorphisms of CYP2C9, CYP2C19 and CYP3A4 influenced the THC metabolism and might be a cause of ADRs. Particularly, CYP2C19*17 allele increases gene transcription and therefore results in ultra-rapid metabolizer phenotype (UM). The aim of this study, is to investigate the frequency of CYP2C19*17 alleles in Thai patients who have been treated with medical cannabis. We prospectively enrolled 60 Thai patients who were treated with medical cannabis and clinical data from College of Pharmacy, Rangsit University. DNA of each patient was isolated from EDTA blood, using the Genomic DNA Mini Kit. CYP2C19*17 genotyping was conducted using the real time-PCR ViiA7 (ABI, Foster City, CA, USA). 30 patients with medical cannabis-induced ADRs group, 20 (67%) were female, and 10 (33%) were male, with an age range of 30-69 years. On the other hand, 30 patients without medical cannabis-induced ADRs (control group) consist of 17 (57%) female and 13 (43%) male. The most ADRs for medical cannabis treatment in the case group were dry mouth and dry throat (77%), tachycardia (70%), nausea (30%) and arrhythmia(10%). Accordingly, the case group carried CYP2C19*1/*1 (normal metabolizer) approximately 93%, while 7% patients carrying CYP2C19*1/*17 (ultra rapid metabolizers) exhibited in this group. Meanwhile, we found 90% of CYP2C19*1/*1 and 10% of CYP2C19*1/*17 in control group. In this study, we identified the frequency of CYP2C19*17 allele in Thai population which will support the pharmacogenetics biomarkers for screening and avoid ADRs of medical cannabis treatment.

Keywords: CYP2C19, allele frequency, ultra rapid metabolizer, medical cannabis

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Authors: Ferdi Afian, Inne Yuliawati

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Background: The change in causes of death from infectious diseases to non-communicable diseases also occurs in the aviation community in Indonesia. Non-communicable diseases are influenced by several internal risk factors, such as age, lifestyle changes and the presence of other diseases. These risk factors will increase the incidence of heart diseases resulting in the incapacity of Indonesian aviators which will disrupt flight safety. Method: The study was conducted by collecting secondary data. The retrieval of primary data was obtained from medical records at the Indonesian Aviation Health Center in 2016-2017. The subjects in this study were all cases of incapacity in Indonesian aviators medical conditions. Results: In this study, there were 15 cases of aviators in Indonesia who experienced incapacity of medical conditions related to heart and lung diseases in 2016-2017. Based on the secondary data contained in the flight medical records at the Aviation Health Center Aviation, it was found that several factors related to aviators incapacity causing its inability to carried out flight duties. Conclusion: Incapacity of Indonesian aviators medical conditions are most affected by the high value of Body Mass Index (86%) and less affected by high of Uric Acid in the blood (26%) and Hyperglycemia (26%).

Keywords: incapacity, aviators, flight, Indonesia

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Authors: Radzuan Junin, Dayang Zulaika A. Hasbollah

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The increasing amount of greenhouse gasses in the atmosphere recently has become one of the discussed topics in relation with world’s concern on climate change. Developing countries’ emissions (such as Malaysia) are now seen to surpass developed country’s emissions due to rapid economic development growth in recent decades. This paper presents the potential storage sites suitability and storage capacity assessment for CO2 sequestration in sedimentary basins of Malaysia. This study is the first of its kind that made an identification of potential storage sites and assessment of CO2 storage capacity within the deep saline aquifers in the country. The CO2 storage capacity in saline formation assessment was conducted based on the method for quick assessment of CO2 storage capacity in closed, and semi-closed saline formations modified to suit the geology setting of Malaysia. Then, an integrated approach that involved geographic information systems (GIS) analysis and field data assessment was adopted to provide the potential storage sites and its capacity for CO2 sequestration. This study concentrated on the assessment of major sedimentary basins in Malaysia both onshore and offshore where potential geological formations which CO2 could be stored exist below 800 meters and where suitable sealing formations are present. Based on regional study and amount of data available, there are 14 sedimentary basins all around Malaysia that has been identified as potential CO2 storage. Meanwhile, from the screening and ranking exercises, it is obvious that Malay Basin, Central Luconia Province, West Baram Delta and Balingian Province are respectively ranked as the top four in the ranking system for CO2 storage. 27% of sedimentary basins in Malaysia were evaluated as high potential area for CO2 storage. This study should provide a basis for further work to reduce the uncertainty in these estimates and also provide support to policy makers on future planning of carbon capture and sequestration (CCS) projects in Malaysia.

Keywords: CO₂ storage, deep saline aquifer, GIS, sedimentary basin

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Authors: Syahrul Bariah Abdul Hamid, Colin W. Binns, Jun Hui Chih

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The total of obese mothers is growing throughout Asia. Breastfeeding provides the perfect nutrition for infants, by promoting a higher IQ and protecting against childhood and adult diseases. A prospective cohort study was carried out of mothers attending eight antenatal clinics run by the Ministry of Health in Selangor, Malaysia to document the prevalence of obesity and its relationship with breastfeeding outcomes. Mothers were enrolled during the antenatal period and followed up until 6 months postpartum to document breastfeeding outcomes. A total of 652 Malay mothers were recruited for the study a response rate of 93.1 %. The pre-pregnancy body mass index (BMI) of the mothers showed that 36.5% of the mothers were overweight or obese. There were a total of 78 obese mothers in the sample and 41 (52.6%) of these mothers were able to initiate breastfeeding within one hour of birth compared to 238/337 (70.6 %, χ² 9.35, p<0.001) of those with a normal BMI. At 6 months, 23.1 % of obese mothers were exclusively breastfeeding their infants, compared to 56.0 % of the normal BMI mothers. On the other hand, the rate of infant formula feeding was higher in the obese mothers by 53.8 % compared to 19.0 % among normal weight mothers, χ² 37.6, p<0.001). Further analysis suggested these factors were found to be positively associated with discontinued exclusive breastfeeding at 6 months among obese mothers; mothers whom delayed breastfeeding initiation, had health problems during pregnancy, caesarean delivery, reported had insufficient colostrum/milk and babies had sucking problems at or before 4 weeks. Besides that, mothers who perceived their biological mothers had preference towards formula feeding or were ambivalent about the feeding method and had biological mothers without experience in breastfeeding for more than 1 month also were more likely to discontinue exclusive breastfeeding at 6 months. These findings suggested that the greater the pre-pregnant BMI, the earlier the cessation of exclusive breastfeeding and they were also less likely to initiate breastfeeding and have less adequate milk supply. Future investigations of the effects of maternal obesity on breastfeeding outcomes should be conducted along with effective interventions to advance the care of obese women at reproductive age and their children.

Keywords: exclusive breastfeeding, body mass index (BMI), breastfeeding discontinuation, maternal obesity

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Authors: Ling-Lang Huang, Yih-Jer Wu

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Empathy is crucial for a patient-physician relationship and medical professionalism. Internet activity, gaming, or even addiction, have been more and more common among medical students. However, there’s been no report showing whether internet behavior has a substantial impact on empathy in medical students to our best knowledge. All year-2 medical students taking the optional course 'Narrative, Comprehension, and Communication' were enrolled. Internet behaviors are divided into two groups, 'internet users without online gaming (IU)' and 'internet users with online gaming (IG)', each group was further divided into 3 groups according to their average online retention time each day (< 2, 2 - 6, > 6 hours). Empathy was evaluated by the scores of the reports and humanities reflection after watching indicated movies, and by self-measured empathy questionnaire. All students taking the year-2 optional course 'Narrative, Comprehension, and Communication' were enrolled. As compared with students in the IU group, those in the IG group had significantly lower scores for the reports (81.3 ± 3.7 vs. 86.4 ± 5.1, P = 0.014). If further dividing the students into 5 groups (IU < 2, IU 2-6, IG < 2, IG 2 - 6, and IG > 6 hours), the scores were significantly and negatively correlated to online gaming with longer hours (r = -0.556, P = 0.006). However, there was no significant difference between IU and IG groups (33.0 ± 5.4 vs. 34.8 ± 3.2, P = n.s.), in terms of scores in the self-measured empathy questionnaire, neither was there any significant trend of scores along with longer online hours across the 5 groups (r = -0.164, P = n.s.). To date, there has been no evidence showing whether different internet behaviors (with or without online gaming) have distinct impacts on empathy. Although all of the medical students had a similarly good self-perception for empathy, our data suggested that online gaming did have a negative impact on their actual expression of empathy. Our observation has brought up an important issue for pondering: May IT- or gaming-assisted medical learning actually harm students’ empathy? In conclusion, this data suggests that long hours of online gaming harms expression of empathy, though all medics think themselves a person of high empathy.

Keywords: empathy. Internet, medical students, online gaming

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Authors: A. Chenafa, S. Boulenouar, M. Zitouni, M. Boukouria

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The sterilization of medical devices constitutes for all the medical professions, an inescapable obligation. It has for objective to prevent the infectious risk, both for the patient and for the medical team. The Dental surgeon as every healthcare professional has to master perfectly this subject and to train his staff to the various techniques of sterilization. It is the only way to assure the patients all the security for which they are entitled to wait when they undergo a dental care. It’s for it, that we undertook to lead an investigation aiming at estimating the sterilization practice at the dental surgeon of Sidi bel Abbes. The survey result showed a youth marked with the profession with a majority use of autoclave with cycle B and an almost total absence of the sterilization controls (test of Bowie and Dick). However, the majority of the dentists control and validate their sterilizers. Finally, our survey allowed us to describe some practices which must be improved regarding control, regarding qualification and regarding staff training. And suggestions were made in this sense.

Keywords: dental surgeon, medical devices, sterilization, survey

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Authors: Carla O'Connor, Shanta' Robinson, Alaina Neal, Elan Hope, Adam Hengen, Samantha Drotar

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In this paper, we provide a preliminary analysis of the stories teachers tell about their Black students in their efforts to make sense of and professionally resolve the underperformance of Black students in their district. The teachers themselves hail from three demographically distinct districts that participate in the state coordinated inter-district school choice system. The districts are Varuna Hills (a pseudonym, as are all other names in this manuscript), a district that serves a predominantly White and affluent community; Newport, a district that serves a socioeconomically diverse but still majority White population; and Aspen, a district in which the student body is predominantly Black and predominantly working to lower middle class. Relying upon teacher focus group interviews in each of these districts which share a common reform context, we show how teachers’ everyday and narrative discourse makes meaning of the bodies and achievement of Black students and their families. More specifically, we show that these discourses construct Black students as interlopers, as suffering from extraordinary neediness, and in dire need of proper parenting. Our analysis reveals that there are nuances by which the teachers articulate these discourses with the nuances being a function of how the schools of choice reform context intersects with the demographics of each school and beliefs about the demographics of the schools of choice population. We unpack the racialized and classed nature of these narratives and the implications for teachers’ personal practical knowledge.

Keywords: black achievement, educational access and opportunity, race and schooling, teacher knowledge and education

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Authors: Nitin Joseph

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Objectives: This study was done to assess emotional intelligence levels and to find out its association with socio demographic variables and perceived stress among medical students. Material and Methods: This study was done among first and second year medical students. Data was collected using a self-administered questionnaire. Results: Emotional intelligence scores was found to significantly increase with age of the participants (F=2.377, P < 0.05). Perceived stress was found to be significantly more among first year (t=1.997, P=0.05). Perceived stress was found to significantly decrease with increasing emotional intelligence scores (r = – 0.226, P < 0.001). Conclusion: First year students were found to be more vulnerable to stress than their seniors probably due to lesser emotional intelligence. As both these parameters are related, ample measures to improve emotional intelligence needs to be supported in the training curriculum of beginners so as to make them more stress free during early student life.

Keywords: emotional intelligence, medical students, perceived stress, socio demographic variables

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Authors: Tahsien Mohamed Okasha

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Simulation is one of the emerging educational strategies that depend on the creation of scenarios to imitate what could happen in real life. At the time of COVID, we faced big obstacles in medical education, specially the clinical part and how we could apply it, the simulation was the golden key. Simulation is a very important tool of education for medical sector students, through creating a safe, changeable, quiet environment with less anxiety level for students to practice and to have repeated trials on their competencies. That impacts the level of practice, achievement, and the way of acting in real situations and experiences. A blind Random sample of students from different specialties and colleges who came and finished their training in an integrated environment was collected and tested, and the responses were graded from (1-5). The results revealed that 77% of the studied subjects agreed that dealing and interacting with different medical sector candidates in the same place was beneficial. 77% of the studied subjects agreed that simulations were challenging in thinking and decision-making skills .75% agreed that using high-fidelity manikins was helpful. 75% agree .76% agreed that working in a safe, prepared environment is helpful for realistic situations.

Keywords: simulation, clinical training, education, medical sector students

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Authors: Semra Çörekçi̇

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In this study, a new source on Ottoman Self-narratives, Kulakzâde Mahmud Paşa’s Düşname (Dreambook), will be introduced to illustrate how dreams can provide a ground for historical analysis. The manuscript looks like a private notebook of an Ottoman official, Mahmud Pasha, who lived and operated in Rumelia in the early eighteenth century. It provides insight into the ordinary and daily concerns of a bureaucrat who had the knowledge and tools to record them in writing. On the one side of the notebook, Mahmud Pasha recorded his travels and appointments in 1730-1731. He wrote places that he reached and stayed every day. On the reverse side, the same author kept a record of his dreams and named that part of his notebook, Düşname. He recorded his dreams on a daily basis in writing and therefore they were well-preserved in a dream diary. This study aims at drawing the social, cultural and psychic life of an early modern Ottoman bureaucrat. It will uncover the ways and means whereby he interpreted his environment, as well as how he made meaning of his dreams considering the social milieu and historical context within which he lived. The first part will focus on 'official dreams' uncovering how his official life and ambitions coincide with his spiritual life. Related to this, connection between anxiety and dream narratives will be evaluated as dreams in which the mundane concerns of securing a post occupied the most central place in the construction of his narrative. A further point will be made by questioning Mahmud Pasha’s possible Sufi connections and his familiarity with the tradition of dream interpretation. Also, considering Mahmud Pasha’s inclusion of other’s dreams in his Düşnâme, the issue of dream-telling will be questioned in order to reveal how dreams were interconnected and how they created a space for social gathering.

Keywords: Ottoman self-narratives, dreams, diary, Ottoman cultural history

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Authors: Malay K. Das, Bhanu P. Sahu

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Furosemide is a weakly acidic diuretic indicated for treatment of edema and hypertension. It has very poor solubility but high permeability through stomach and upper gastrointestinal tract (GIT). Due to its limited solubility it has poor and variable oral bioavailability of 10-90%. The aim of this study was to enhance the oral bioavailability of furosemide by preparation of nanosuspensions. The nanosuspensions were prepared by nanoprecipitation with sonication using DMSO (dimethyl sulfoxide) as a solvent and water as an antisolvent (NA). The prepared nanosuspensions were sterically stabilized with polyvinyl acetate (PVA).These were characterized for particle size, ζ potential, polydispersity index, scanning electron microscopy (SEM), differential scanning calorimetry (DSC), X-ray diffraction (XRD) pattern and release behavior. The effect of nanoprecipitation on oral bioavailability of furosemide nanosuspension was studied by in vitro dissolution and in vivo absorption study in rats and compared to pure drug. The stable nanosuspension was obtained with average size range of the precipitated nanoparticles between 150-300 nm and was found to be homogenous showing a narrow polydispersity index of 0.3±0.1. DSC and XRD studies indicated that the crystalline furosemide drug was converted to amorphous form upon precipitation into nanoparticles. The release profiles of nanosuspension formulation showed up to 81.2% release in 4 h. The in vivo studies on rats revealed a significant increase in the oral absorption of furosemide in the nanosuspension compared to pure drug. The AUC0→24 and Cmax values of nanosuspension were approximately 1.38 and 1.68-fold greater than that of pure drug, respectively. Furosemide nanosuspension showed 20.06±0.02 % decrease in systolic blood pressure compared to 13.37±0.02 % in plain furosemide suspension, respectively. The improved oral bioavailability and pharmacodynamics effect of furosemide may be due to the improved dissolution of furosemide in simulated gastric fluid which results in enhanced oral systemic absorption of furosemide from stomach region where it has better permeability.

Keywords: furosemide, nanosuspension, bioavailability enhancement, nanoprecipitation, oral drug delivery

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Authors: Haykal. Kay-Anne

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The health and well-being of students is a priority for the Faculty of Medicine at the University of Ottawa. The demands of medical studies are extreme, and many studies confirm that the prevalence of psychological distress is very high among medical students and that it is higher than that of the general population of the same age. The main goal is to identify risk factors for mental health among medical students at the University of Ottawa. The secondary objectives are to determine the variation of these risk factors according to demographic variables, as well as to determine if there is a change in the mental health of students during the 1st and 3rd years of their study. Medical students have a mandatory first and third-year wellness check meeting. This assessment includes a questionnaire on demographic information, mental health, and risk factors such as physical health, sleep, social support, financial stress, education and career, stress and drug use and/or alcohol. Student responses were converted to numerical values and analyzed statistically. The results show that 61% of the variation in the mean of the mental health score is explained by the following risk factors (R2 = 0.61, F (9.396) = 67.197, p < 0.01): lack of sleep and fatigue (β = 0.281, p < 0.001), lack of social support (β = 0.217, p <0.001), poor study or career development (β = 0.195, p < 0.001) and an increase stress and drug and alcohol use (β = -0.239, p < 0.001). No demographic variable has a significant effect on the presence of risk factors. In addition, fixed-effects regression demonstrated significantly lower mental health (p < 0.1) among first-year students (M = 0.587, SD = 0.072) than among third-year students (M = 0.719, SD = 0.071). This preliminary study indicates the need to continue data collection and analysis to increase the significance of the study results. As risk factors are present at the beginning of medical studies, it is important to offer resources to students very early in their medical studies and to have close monitoring and supervision.

Keywords: assessment of mental health, medical students, risk factors for mental health, wellness assessment

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Authors: Kawthar F. Albasri, Abdullah M. AlHudaithi, Dana B. AlTurairi, Abdullaziz S. AlQuraini, Adoub Y. AlDerazi, Reem A. Hubail, Haitham A. Jahrami

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Several studies have found that medical students have a significant prevalence of anxiety. The purpose of this review paper is to carefully evaluate the current research on anxiety among medical students in the MENA region and, as a result, estimate the prevalence of these disturbances. Multiple databases, including the CINAHL (Cumulative Index to Nursing and Allied Health Literature), Cochrane Library, Embase, MEDLINE (Medical Literature Analysis and Retrieval System Online), PubMed, PsycINFO (Psychological Information Database), Scopus, Web of Science, UpToDate, ClinicalTrials.gov, WHO Global Health Library, EbscoHost, ProQuest, JAMA Network, and ScienceDirect, were searched. The retrieved article reference lists were rigorously searched and rated for quality. A random effects meta-analysis was performed to compute estimates. The current meta-analysis revealed an alarming estimated pooled prevalence of anxiety (K = 46, N = 27023) of 52.5% [95%CI: 43.3%–61.6%]. A total of 62.0% [95% CI 42.9%; 78.0%] of the students (K = 18, N = 16466) suffered from anxiety during the COVID-19 pandemic, while 52.5% [95% CI 43.3%; 61.6%] had anxiety before COVID-19. Based on the GAD-7 measure, a total of 55.7% [95%CI 30.5%; 78.3%] of the students (K = 10, N = 5830) had anxiety, and a total of 54.7% of the students (K = 18, N = 12154) [95%CI 42.8%; 66.0%] had anxiety using the DASS-21 or 42 measure. Anxiety is a common issue among medical students, making it a genuine problem. Further research should be conducted post-COVD 19, with a focus on anxiety prevention and intervention initiatives for medical students.

Keywords: anxiety, medical students, MENA, meta-analysis, prevalence

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Authors: Tanakrit Doltanakarn

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Introduction: These days, cannabis is being accepted in many countries due to the fact that cannabis could be use in medical. The medical cannabis is used to treat and reduce the pain many diseases. For example, neuropathic pain, Parkinson, autism disorders, cancer pain reduce the adverse effect of chemotherapy, diabetes, and migraine. Active ingredients in cannabis that modulate patients' perceptions of their conditions include Δ9‐tetrahydrocannabinol (THC), cannabidiol (CBD), flavonoids, and terpenes. However, there is an adverse effect of cannabis, cardiovascular effects, psychosis, schizophrenia, mood disorder, and cognitive alternation. These effects are from the THC and CBD ingredients in the cannabis. The metabolize processes of delta-9 THC to 11-OH-delta 9 -THC (inactive form), THC were cause of adverse effects. Interestingly, the distributions of CYP2C9 gene (CYP2C9*2 and CYP2C9*3, poor metabolizer) that might affect incidences of adverse effects in patients who treated with medical cannabis. Objective: The aim of this study we want to investigate the association between genetic polymorphism of CYP2C9 frequency and Thai patients who treated with medical cannabis. Materials and Methods:We recruited sixty-five unrelated Thai patients from the College of Pharmacy, Rangsit University. DNA were extracted using Genomic DNA Mini Kit. Genotyping of CYP2C9*2 (430C>T, rs1799853) and CYP2C9*3 (1075A>C, rs1057910) were genotyped by the TaqMan Real-time PCR assay. Results: Among these 31 medicals cannabis-induced ADRs patients, they were diagnosed with 22 (33.85%) tachycardia and 3 (4.62%) arrhythmia. There were 34 (52.31%) medical cannabis-tolerant controls who were included in this study.40 (61.53%) Thai patients were female, and 25 (38.46%) were male, with median age of 57 (range 27 – 87) years. In this study, we found none of the medical cannabis-induced ADRs carried CYP2C9*2 variant along with medical cannabis-tolerant control group. CYP2C9*3 variant (intermediate metabolizer, IM) was found just only one of thirty-one (3.23%) in the medical cannabis-induced ADRs and two of thirty-fourth (5.88%) in the tolerant controls. Conclusions: Thus, the distribution of CYP2C9 alleles offer a comprehensive view of pharmacogenomics marker in Thai population that could be used as a reference for worldwide to investigate the pharmacogenomics application.

Keywords: medical cannabis, adverse effect, CYP2C9, thai patients

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Authors: Kuo-Kai Lin, Po-Lun Chang

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Background: The Emergency Care Research Institute released a list for the top 10 medical technology hazards in 2017, with the following hazard topping the list: ‘infusion errors can be deadly if simple safety steps are overlooked.’ In addition, hospitals use various assessment items to evaluate the safety of their medical equipment, confirming the importance of medical equipment safety. In recent years, the topic of patient safety has garnered increasing attention. Accordingly, various agencies have established patient safety-related committees to coordinate, collect, and analyze information regarding abnormal events associated with medical practice. Activities to promote and improve employee training have been introduced to diminish the recurrence of medical malpractice. Objective: To allow nursing personnel to acquire the skills needed to operate common medical equipment and update and review such skills whenever necessary to elevate medical care quality and reduce patient injuries caused by medical equipment operation errors. Method: In this study, a quasi-experimental design was adopted and nurses from a regional teaching hospital were selected as the study sample. Online videos instructing the operation method of common medical equipment were made and quick response codes were designed for the nursing personnel to quickly access the videos when necessary. Senior nursing supervisors and equipment experts were invited to formulate a ‘Scale-based Questionnaire for Assessing Nursing Personnel’s Operational Knowledge of Common Medical Equipment’ to evaluate the nursing personnel’s literacy regarding the operation of the medical equipment. From March to October 2017, an employee training on medical equipment operation and a practice course (simulation course) were implemented, after which the effectiveness of the training and practice course were assessed. Results: Prior to and after the training and practice course, the 66 participating nurses scored 58 and 87 on ‘operational knowledge of common medical equipment,’ respectively (showing a significant statistical difference; t = -9.407, p < .001); 53.5 and 86.3 on ‘operational knowledge of 12-lead electrocardiography’ (z = -2.087, p < .01), respectively; 40 and 79.5 on ‘operational knowledge of cardiac defibrillators’ (z = -3.849, p < .001), respectively; 90 and 98 on ‘operational knowledge of Abbott pumps’ (z = -1.841, p = 0.066), respectively; and 8.7 and 13.7 on ‘perceived competence’ (showing a significant statistical difference; t = -2.77, p < .05). In the participating hospital, medical equipment operation errors were observed in both 2016 and 2017. However, since the implementation of the intervention, medical equipment operation errors have not yet been observed up to October 2017, which can be regarded as the secondary outcome of this study. Conclusion: In this study, innovative teaching strategies were adopted to effectively enhance the professional literacy and skills of nursing personnel in operating medical equipment. The training and practice course also elevated the nursing personnel’s related literacy and perceived competence of operating medical equipment. The nursing personnel was thus able to accurately operate the medical equipment and avoid operational errors that might jeopardize patient safety.

Keywords: medical equipment, digital teaching plan, simulation-based teaching plan, operational knowledge, patient safety

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Authors: Sabah Mohammed, Jinan Fiaidhi, Darien Sawyer

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Describing clinical cases according to a clinical charting standard that enforces interoperability and enables connected care services can save lives in the event of a medical emergency or provide efficient and effective interventions for the benefit of the patients through the integration of bedside and bench side clinical research. This article presented a multi-tenant extension to the problem-oriented medical record that we have prototyped previously upon using the GraphQL Application Programming Interface to represent the notion of a problem list. Our implemented extension enables physicians and patients to collaboratively describe the patient case via using multi chatbots to collaboratively describe the patient case using the SOAP charting standard. Our extension also connects the described SOAP patient case with the HL7 FHIR (Health Interoperability Resources) medical record for connecting the patient case to the bench data.

Keywords: problem-oriented medical record, graphQL, chatbots, SOAP

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Authors: Mannan Mridha, Usama Gazay, Kosovare V. Aslani, Hugo Linder, Alice Ravizza, Carmelo de Maria

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In most developing countries, although the vast majority of the people are living in the rural areas, the qualified medical doctors are not available there. Health care workers and paramedics, called village doctors, informal healthcare providers, are largely responsible for the rural medical care. Mishaps due to wrong diagnosis and inappropriate medication have been causing serious suffering that is preventable. While innovators have created many devices, the vast majority of these technologies do not find applications to address the needs and conditions in low-resource settings. The primary motive is to address the acute lack of affordable medical technologies for the poor people in low-resource settings. A low cost smart medical device that is portable, battery operated and can be used at any point of care has been developed to detect breathing rate, electrocardiogram (ECG) and arterial pulse rate to improve diagnosis and monitoring of patients and thus improve care and safety. This simple and easy to use smart medical device can be used, managed and maintained effectively and safely by any health worker with some training. In order to empower the health workers and village doctors, our device is being further developed to integrate with ICT tools like smart phones and connect to the medical experts wherever available, to manage the serious health problems.

Keywords: e-health for low resources settings, health awareness education, improve patient care and safety, smart and affordable medical device

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Authors: Malay K. Pramanik

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In recent years, climate change has become a major threat and has been widely documented in the geographic distribution of many plant species. However, the impacts of climate change on the distribution of ecologically vulnerable medicinal species remain largely unknown. The identification of a suitable habitat for a species under climate change scenario is a significant step towards the mitigation of biodiversity decline. The study, therefore, aims to predict the impact of current, and future climatic scenarios on the distribution of the threatened Garcinia indica across the northern Western Ghats using Maximum Entropy (MaxEnt) modelling. The future projections were made for the year 2050 and 2070 with all Representative Concentration Pathways (RCPs) scenario (2.6, 4.5, 6.0, and 8.5) using 56 species occurrence data, and 19 bioclimatic predictors from the BCC-CSM1.1 model of the Intergovernmental Panel for Climate Change’s (IPCC) 5th assessment. The bioclimatic variables were minimised to a smaller number of variables after a multicollinearity test, and their contributions were assessed using jackknife test. The AUC value of 0.956 ± 0.023 indicates that the model performs with excellent accuracy. The study identified that temperature seasonality (39.5 ± 3.1%), isothermality (19.2 ± 1.6%), and annual precipitation (12.7 ± 1.7%) would be the major influencing variables in the current and future distribution. The model predicted 10.5% (19318.7 sq. km) of the study area as moderately to very highly suitable, while 82.60% (151904 sq. km) of the study area was identified as ‘unsuitable’ or ‘very low suitable’. Our predictions of climate change impact on habitat suitability suggest that there will be a drastic reduction in the suitability by 5.29% and 5.69% under RCP 8.5 for 2050 and 2070, respectively. Finally, the results signify that the model might be an effective tool for biodiversity protection, ecosystem management, and species re-habitation planning under future climate change scenarios.

Keywords: Garcinia Indica, maximum entropy modelling, climate change, MaxEnt, Western Ghats, medicinal plants

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Authors: Randy M. Fitratullah, Afriwardi, Nurhayati

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Overweight-obesity caused by exercise. The objective of this research is to analyze the relation between exercise with the incidence of overweight-obesity of medical students of medical faculty of Andalas Univesity batch 2013. This is an analytical observational research with case-control method. This research conducted in FK Unand on September-October 2015. The population of this research is medical students batch 2013. 26 samples (13 samples were case, 13 samples were control) were taken by purposive sampling technique and analysed using statistical univariate and bivariate analysis. Exercise questionnaire was used as research instruments. Based on the interview with questionnaire, anaerobic exercise was majority in case group and aerobic exercise was majority in control group. The case and control group have a rare category in exercise. Less category was majority in exercise duration of case and enough category was majority in control group. Bivariate analysis is using chi-square test with cell combining to 2x2 table, obtained p-value=0.097 in sort of exercise, p-value=1,000 in the frequency of exercise, and p-value=0,112 in duration of exercise, which means statistically unsignificant. There is no relation between exercise with the incidence of overweight-obesity of medical students of FK Unand batch 2013. For medical students suffers overweight-obesity is suggested for increase the frequency of exercise.

Keywords: overweight-obesity, exercise, aerobic, anaerobic, frequency, duration

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Authors: Shadrack Mambo, Karim Djouani, Yskandar Hamam, Barend van Wyk, Patrick Siarry

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This paper discusses the current trends in medical image registration techniques and addresses the need to provide a solid theoretical foundation for research endeavours. Methodological analysis and synthesis of quality literature was done, providing a platform for developing a good foundation for research study in this field which is crucial in understanding the existing levels of knowledge. Research on medical image registration techniques assists clinical and medical practitioners in diagnosis of tumours and lesion in anatomical organs, thereby enhancing fast and accurate curative treatment of patients. Literature review aims to provide a solid theoretical foundation for research endeavours in image registration techniques. Developing a solid foundation for a research study is possible through a methodological analysis and synthesis of existing contributions. Out of these considerations, the aim of this paper is to enhance the scientific community’s understanding of the current status of research in medical image registration techniques and also communicate to them, the contribution of this research in the field of image processing. The gaps identified in current techniques can be closed by use of artificial neural networks that form learning systems designed to minimise error function. The paper also suggests several areas of future research in the image registration.

Keywords: image registration techniques, medical images, neural networks, optimisaztion, transformation

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Authors: Prima Gusti Yanti, Fairul Zabadi

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The purpose of the study is to find out relation of moral massage with the authority ang globalization in proverb. Proverb is one of the many forms of cultural identity of the Indonesian/Malay people fulled with moral values. The values contained within those proverbs are beneficial not only to the society, but also to those who held power amidst on this era of globalization. The method being used is qualitative research by using content analysis which is done by describing and uncovering the forms and meanings of proverbs used within Indonesia Minangkabau society. Sources for this study’s data were extracted from a Minangkabau native speaker in the subdistrict of Tanah Abang, Jakarta. Said sources were retrieved through a series of interviews with the Minangkabau native speaker, whose speech is still adorned with idiomatic expressions. The research findings show that there existed 30 proverbs or idiomatic expressions in the Minangkabau language that are often used by its indigenous people. The thirty data contain moral values that are closely interwoven with the matter of power and globalization. Analytical results show that there are fourteen moral values contained within proverbs reflect a firm connection between rule and power in globalization; such as: responsible, brave, togetherness and consensus,tolerance, politeness, thorough and meticulous,honest and keeping promise, ingenious and learning, care, self-correction, be fair, alert, arbitrary, self-awareness. Structurally, proverbs possess an unchangeably formal construction; symbolically, proverbs possess meanings that are clearly decided through ethnographic communicative factors along with situational and cultural contexts. Values contained within proverbs may be used as a guide in social management, be it between fellow men, men between nature, or even men between their Creator. Therefore, the meanings and values contained within the morals of proverbs could also be utilized as a counsel for those who rule and in charge of power in order to stem the tides of globalization that had already spread into sectoral, territorial and educational continuums.

Keywords: continuum, globalization, identity, proverb, rule-power

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Authors: H. Hakim, C. Kibert, C. Fabre, S. Monadizadeh

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Construction industry is an industry saddled with chronic problems of high waste generation. Waste management that is to ensure materials are utilized in an efficient manner would make a major contribution to mitigating the negative environmental impacts of construction waste including finite resources depletion and growing occupied landfill areas to name a few. Furthermore, ‘material resource efficiency’ has been found an economically smart approach specially when considered during the design phase. One effective strategy is to utilizing off-site construction process which includes a series of prefabricated systems such as mobile, modular, and HUD construction (Department of Housing and Urban Development manufactured buildings). These types of buildings are by nature material and resource-efficient. Despite conventional construction that is exposed to adverse weather conditions, manufactured construction production line is capable of creating repetitive units in a factory controlled environment. A factory can have several parallel projects underway with a high speed and in a timely manner which simplifies the storage of excess materials and re-allocating to the next projects. The literature reports that prefabricated construction significantly helps reduce errors, site theft, rework, and delayed problems and can ultimately lead to a considerable waste reduction. However, there is not sufficient data to quantify this reduction when it comes to a regular modular house in the U.S. Therefore, this manuscript aims to provide an analysis of waste originated from a manufactured factory trend. The analysis was made possible with several visits and data collection of Homes of Merits, a Florida Manufactured and Modular Homebuilder. The results quantify and verify a noticeable construction waste reduction.

Keywords: construction waste, modular construction, prefabricated buildings, waste management

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Authors: Grace Omowunmi Soyebi

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A computerized medical record system is a collection of medical information about a person that is stored on a computer. One principal problem of most hospitals in rural areas is using the file management system for keeping records. A lot of time is wasted when a patient visits the hospital, probably in an emergency, and the nurse or attendant has to search through voluminous files before the patient's file can be retrieved, this may cause an unexpected to happen to the patient. This Data Mining application is to be designed using a Structured System Analysis and design method which will help in a well-articulated analysis of the existing file management system, feasibility study, and proper documentation of the Design and Implementation of a Computerized medical record system. This Computerized system will replace the file management system and help to quickly retrieve a patient's record with increased data security, access clinical records for decision-making, and reduce the time range at which a patient gets attended to.

Keywords: programming, computing, data, innovation

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Authors: Wendy Maddison

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This paper describes an Action Research project which was undertaken to inform professional practice in order to develop a newly created Centre for Student Success in the specific context of transnational medical and nursing education in the Middle East. The objectives were to enhance the academic performance, persistence, integration and personal and professional development of a multinational study body, in particular in relation to preclinical medical students, and to establish a comfortable, friendly and student-driven environment within an Irish medical university recently established in Bahrain. Expatriating a new part of itself into a corner of the world and within a context which could be perceived as the antithesis of itself, in particular in terms of traditional cultural and organisational values, the university has had to innovate in the range of services, programmes and other offerings which engages and supports the academic success of medical and nursing students as they “encounter the world in the classroom” in the context of an Arab Islamic culture but within a European institution of transnational education, engaging with a global learning environment locally. The outcomes of the project resulted in the development of a specific student success ‘signature’ for this particular transnational higher education context.

Keywords: transnational higher education, medical education, action research, student success, Middle Eastern context, student persistence in the global-local, student support mechanisms

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Authors: M. Dasgupta, S. Banerjee

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Content Based Image Retrieval (CBIR) coupled with Case Based Reasoning (CBR) is a paradigm that is becoming increasingly popular in the diagnosis and therapy planning of medical ailments utilizing the digital content of medical images. This paper presents a survey of some of the promising approaches used in the detection of abnormalities in retina images as well in mammographic screening and detection of regions of interest in MRI scans of the brain. We also describe our proposed algorithm to detect hard exudates in fundus images of the retina of Diabetic Retinopathy patients.

Keywords: case based reasoning, exudates, retina image, similarity based retrieval

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Authors: Murat Iskender Aktaş, Sadi Ergin, Rasime Acar Aktaş

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In the light of fast-paced changes and developments in the health sector, the Ministry of Health started a new structuring with decree law numbered 663 within the scope of the Project of Transformation in Health. Accordingly, hospitals should ensure patient satisfaction through more efficient, more effective use of resources and sustainable finance by placing patients in the centre and should operate to increase efficiency to its maximum level while doing these. Within this study, in order to find out how efficient the hospitals were in terms of medical waste management between the years 2011-2014, the data from six hospitals of Amasya Public Hospitals Union were evaluated separately through Data Envelopment Analysis (DEA) method. First of all, input variables were determined. Input variables were the number of patients admitted to polyclinics, the number of inpatients in clinics, the number of patients who were operated and the number of patients who applied to the laboratory. Output variable was the cost of medical wastes in Turkish liras. Each hospital’s total medical waste level before and after public hospitals union; the amounts of average medical waste per patient admitted to polyclinics, per inpatient in clinics, per patient admitted to laboratory and per operated patient were compared within each group. In addition, average medical waste levels and costs were compared for Turkey in general and Europe in general. Paired samples t-test was used to find out whether the changes (increase-decrease) after public hospitals union were statistically significant. The health facilities that were unsuccessful in terms of medical waste management before and after public hospital union and the factors that caused this failure were determined. Based on the results, for each health facility that was ineffective in terms of medical waste management, the level of improvement required for each input was determined. The results of the study showed that there was an improvement in medical waste management applications after the health facilities became a member of public hospitals union; their medical waste levels were lower than the average of Turkey and Europe while the averages of cost of disposal were the highest.

Keywords: medical waste management, cost of medical waste, public hospitals, data envelopment analysis

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Authors: Yuli Paola Cifuentes Sanabria, Lina Paola Beltrán Beltrán, Leonardo Juan Ramírez López

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The availability to deploy mobile applications for healthcare is increasing daily thru different mobile app stores. But within these capabilities the number of hacking attacks has also increased, in particular into medical mobile applications. The security vulnerabilities in medical mobile apps can be triggered by errors in code, incorrect logic, poor design, among other parameters. This is usually used by malicious attackers to steal or modify the users’ information. The aim of this research is to analyze the vulnerabilities detected in mobile medical apps according to risk factor standards defined by OWASP in 2014.

Keywords: mHealth apps, OWASP, protocols, security vulnerabilities, risk factors

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Authors: Robin L. Rohrer

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Introduction: Pre-natal or early childhood exposure to the medical radiation used in diagnosis or treatment is an identified risk for childhood cancers but can be difficult to document. The author developed a family questionnaire/interview form to identify possible exposures. Aims: This retrospective study examines pre-natal and early childhood medical radiation exposure in a cohort of children diagnosed with a solid tumor including brain tumors from 1985-2015 at the Children’s Hospital of Pittsburgh (CHP). The hospital is a tri-state regional referral center which treats about 150-180 new cases of cancer in children per year. About 70% are diagnosed with a solid tumor. Methods: Each consented family so far (approximately 50% of the cohort) has been interviewed in person or by the phone call. Medical staff and psycho- social staff referred patient families for the interview with the author. Results: Among the families interviewed to date at least one medical radiation exposure has been identified (pre-conception, pre-natal or early childhood) in over 70% of diagnosed children. These exposures have included pre-conception sinus or chest CT or X-ray in either parent, sinus CT or X-ray in the mother or diagnostic radiation of chest or abdomen in children. Conclusions: Exposures to medical radiation for a child later diagnosed with cancer may occur at several critical junctures. These exposures may well contribute to a ‘perfect storm’ in the still elusive causes of childhood cancer. The author plans to expand the study from 1975 to present to hopefully further document these junctures.

Keywords: pediatric, solid tumors, medical radiation, cancer

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Authors: D. W. M. S. Samarathunga, Isuru Dharmarathne

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In aphasia, various levels of symbolic language processing (semantics) are affected. It is shown that Persons with Aphasia (PWA) often experience more problems comprehending some categories of words than others. The study aimed to determine lexical semantic deficits seen in Auditory Comprehension (AC) and to describe lexical-semantic deficits across six selected word categories. Thirteen (n =13) persons diagnosed with post-stroke aphasia (PSA) were recruited to perform an AC task. Foods, objects, clothes, vehicles, body parts and animals were selected as the six categories. As the test stimuli, black and white line drawings were adapted from a picture set developed for semantic studies by Snodgrass and Vanderwart. A pilot study was conducted with five (n=5) healthy nonbrain damaged Sinhala speaking adults to decide familiarity and applicability of the test material. In the main study, participants were scored based on the accuracy and number of errors shown. The results indicate similar trends of lexical semantic deficits identified in the literature confirming ‘animals’ to be the easiest category to comprehend. Mann-Whitney U test was performed to determine the association between the selected variables and the participants’ performance on AC task. No statistical significance was found between the errors and the type of aphasia reflecting similar patterns described in aphasia literature in other languages. The current study indicates the presence of selectivity of lexical semantic deficits in AC and a hierarchy was developed based on the complexity of the categories to comprehend by Sinhala speaking PWA, which might be clinically beneficial when improving language skills of Sinhala speaking persons with post-stroke aphasia. However, further studies on aphasia should be conducted with larger samples for a longer period to study deficits in Sinhala and other Sri Lankan languages (Tamil and Malay).

Keywords: aphasia, auditory comprehension, selective lexical-semantic deficits, semantic categories

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