Introduction: Calorie restriction is the main strategy for loosing body weight in obese individuals. However, persistence to this strategy is a major challenge. Ghrelin, a hormone that influences an individual to consume food by modulating the feelings of hunger. This effect may be influenced by the % fat composition of a meal. Materials and Methods: Twelve young male participants with normal BMI, were administered in random order one of 2 isocaloric meals after an overnight fast. The 2 meals contained either 31 or 52% fat. After a 7 day gap, cross-over of the participants was carried out and they consumed the other meal similarly. Ghrelin levels were measured after fasting and 1 hour after diet consumption. An appetite rating on a visual analogue scale (VAS) was used to measure perceived hunger and satiety before and after the meal. Results: When compared to the baseline values, an average of 34% and 20% decrease in ghrelin levels were noted after the high-fat meal (p<0.025), and low-fat meal respectively. Analysis of the VAS showed that feelings of hunger decreased, while feelings of satiety increased after the meal, however there was no difference between the two meals. Conclusion: Thus, within this study group, though the feelings of hunger and satiety was comparable, consumption of isocaloric high fat caused ghrelin levels to decrease within one hour post meal. This shows that manipulation of % fat of the diet can achieve lower post-meal ghrelin levels.

Introduction: This paper explores the impact of a remediation programme on medical students’ overall performance. It also suggests a potential remediation framework encompassing planned learning sessions by subject experts, individualised coaching from an alumni group, professional counselling for psychological support, and participants’ learning commitment. Methods: Twenty-seven students were identified as academically weak students (AWS). This was done based on two criteria: students who failed more than one mini test (out of six mini tests) during the delivery of the first-year curriculum, and students who had to repeat the study after failing the end-of-year-1 (EOY-1) exam. A remediation strategy consisting of 1) planned learning sessions, 2) individualised alumni coaching sessions, and 3) counselling sessions were offered to these students. However, participation is optional (Group A (n=12) – participants and Group B (n=15) – non-participants). Evaluation of the remediation programme is performed using mixed-method analysis: 1) comparative analysis of the performance of Group A vs Group B, and 2) qualitative analysis using a semi-structured interview with openended questions to obtain students’ perceptions of the programme. Results: Group A showed significantly higher pass rates (83% vs. 66%, p < .001) in the EOY-1 exam. Interviews revealed positive perceptions of personalised alumni coaching and its role in enhancing learning and confidence. Conclusion The study concludes that early identification and targeted remediation support improve academic outcomes, benefit the student’s educational journey, and contribute to quality education.
Education, Medical ; Academic Performance

Introduction: Low back pain (LBP) is a common musculoskeletal disorder (MSD) that leads to a variety of negative consequences. The prevalence of LBP was found to be high worldwide. Individuals have been forced to remote studying or working conditions during the coronavirus disease 2019 (COVID-19) pandemic, exposing them to the risk factors of LBP to a greater extent. This is a cross-sectional study conducted among 623 adults and aimed to assess LBP intensity and prevalence among adults in Malaysia before and during the COVID-19 lockdown and to identify the association between demographic, physical and psychological factors with LBP. Methods: A self-administered questionnaire composed of 36 questions regarding demographic characteristics, physical activities and psychological aspects was distributed to the public. Pearson’s Chi-square and Fisher Exact tests were performed using collected data to assess the association between LBP intensity and various risk factors. Results: The prevalence of LBP increased from 64.4% before the lockdown to 83.5% during the lockdown. LBP intensity significantly increased during the lockdown. Before lockdown, factors associated with LBP intensity included gender and stress level. While during the lockdown, age, gender, occupation, time spent on computer use, ergonomics as well as stress level affected the intensity of LBP. Conclusion: The present study showed that the COVID-19 lockdown has contributed to the increase in both the prevalence and intensity of LBP among Malaysians. The identified risk factors include age, gender, occupation, duration of sitting and computer use, adherence to ergonomic recommendations, and stress level.