Clinical skills program as a laboratory method is a valuable adjunct to other forms of undergraduate medical training. This article describes the process of developing a core curriculum in clinical skills based on the Dundee model for a clinical skills centre. The School of Medical Sciences, in Universiti Sains Malaysia (USM) has been provided with a well equipped skills centre. However, the PBL curriculum in the undergraduate medical program in the school needs to be integrated with a clinical skills lab program. This is to counter the general feeling that the contribution of PBL is insignificant in terms of building clinical competency in an integrated system such as that used in USM compared to the traditional curricula of other medical teaching institutions in Malaysia. Integrating clinical skills laboratory training with the PBL curriculum will provide evidence of PBL as an effective and innovative method for teaching and learning in Malaysia.
skills ; Clinical ; curriculum aspects ; Malaysia ; Teaching aspects

This paper describes the clinical characteristics of 14 cases of malignant melanoma treated in our department during a period of five years from 1997 to 2001 and their prognosis. Excluding one case whose stage could not be defined, five cases recognized at the early stage have survived, and six cases out of eight at the progressive stages were dead within one year after their first visit. When it came to the clinical characteristics, nine cases were primary cutaneous melanomas and five cases were metastatic carcinomas. Acral lentiginous melanomas, histopathologically the most common type of melanoma in Japan, were found in seven cases of the total 14 (50%). Most of the patients were aware of the primary lesions but left them untreated. Generally speaking, malignant melanoma grow rapidly and prognosis is poor because the cure rate by chemotherapy is low. To realize earlier detection and treatment, we thought it is crucial to educate the public, have the general practitioners understanding more about the malignancy of the skin neoplasm and to build up a collaborative relationship between medical professionals.
Melanoma ; seconds ; clinical aspects ; prognostic ; Clinical

Taking charge of in-vitro fertilization and embryo transfer in the laboratory per se amounts to a form of clinical support. To infertile patients, it would be of great benefit if laboratory technicians make direct contact with them and give a full account of the procedure.The apprehensions entertained by them regarding infertility treatment would be removed by hearing what they want to know.In hopes of dispelling the patients' fears and doubts, we have recently started to dialogue with the patients. The face-to-face interview has made us feel confident in what we are doing aside from the lab work and feel a sense of responsibility. Moreover, we have become aware of the need to further devote ourselves to reproductive medicine in order to improve the treatment outcome.One third of the questions frequently asked by patients concerns the quality of embryos and the risk of birth defects, which are issues that challenge us involved in reproductive medicine. To give answers to these and other questions most aptly, it is necessary to share all the up-to-date information, data and knowledge among members of the staff concerned.As the tasks to be grappled with fromnow on, there are problems with unsuccessful cases after repeated IVF trials and an increasing number of patients rangingin age from 45 to 49 years. Where the infertility treatment stops is yet to bedecided in the case of elder women.For providing information and psychological support sought by patients, we keenly felt that there is a necessity to establish a closer collaborative inter-departmental relationship.
Clinical ; Fertilization ; Laboratory culture ; Support ; therapeutic aspects

Data concerning clinical cases of pesticide poisoning/disorders were collected from members of the Japanese Association of Rural Medicine during 2001-2003, and were analyzed statistically.A total of 194 cases of poisoning/disorders by pesticide exposure were reported from 36 hospitals and other medical institutions. Suicide cases accounted for 74% of the total number of cases, which was followed by the cases caused by exposure during spraying (17%) and drinking/eating by mistake (7%).In 144 suicide cases, those of males accounted for 52%, the middle-aged and older people constituted the majority. By types of clinical manifestations, almost all of the cases were acute or subacute pesticide poisoning (98%). Organophosphate insecticides were the most frequent inducers of the cases (39%), which was followed by bipyridylium herbicides (23%). When it comes to the outcome, more than 80% of suicide cases with paraquat products resulted in death.There were 39 cases of pesticide poisoning/disorders resulting from exposure during spraying, preparation or settling, and working in sprayed area. In these cases, males accounted for 70% the middle-aged and older people made up the majority. By types of clinical manifestations, the cases of acute or subacute pesticide poisoning accounted for 39%, which was followed by acute dermatitis (33%), chemical burn (14%), and ocular disorders (11%). The pesticides that induced clinical cases varied greatly. Main factors contributing to the onset of pesticide poisoning/disorders were insufficient protective clothing (44%), self conceit (19%), insufficient information (14%), and carelessness (12%).
Pesticides ; Clinical ; Poisoning aspects ; Acute ; Cases

Shan Han Lun is an ancient Chinese medical book, that is written the acupoints meridian route. The acupoints meridian route is the functional connection route between acupoints Kampo medicine world in Japan has been ignored the exist of the meridian route, because the route is invisible. But if we make out the functional route of the autonomous nerve, we can understand Shan Han Lun sentence well. In addition, from a situation of acupuncture moxibustion treatment, that is important of a point of autonomous nerve. In paticular, the important acupoints is the “well” point secrete adrenalin, the “spring” point secrete IFNγ, the “stream” point secrete PGE 2, et all. It is important that I understand the work to the autonomous nerve as the acupuncture treatment.
Acupuncture ; Medicine, Kampo ; Nerve ; Clinical ; therapeutic aspects

The teaching of clinical communication skills to undergraduate medical students in the Faculty of Medicine, University of Malaya is described. It is a continuous process throughout the five-year medical curriculum which is divided into Phases I, II and III. Students are introduced to communication skills early in Phase I through an interactive session as well as a workshop on general communication skills. In Phase II, small-group two-day workshops cover the basic principles of clinical communication skills using videotapes, group discussion and role-plays. Direct contact between students and patients in actual clinical setting begin in Phase IIIA. Communication skills teaching with feedback training is carried out by videotaping the consultations. In Phase IIIB the two-way mirror is utilized as well as having workshops on certain difficult areas such as 'breaking bad news' and 'taking a sexual history'. Formal assessment is done by evaluating the behavior, language and actual interview content.
skills ; Communication ; Phase ; Teaching aspects ; Clinical

The publication of the 8th edition of the Paediatric Standard Treatment Book 30 years after the first edition was introduced in 1975 provided an opportunity to examine the changes in the book's content and composition that have occurred over time. A detailed analysis of all editions of the book was made. The 8th edition is bigger, contains more clinical and guidance topics, and is undoubtedly more complex than the first. Health workers of different levels of training undoubtedly value the book, but there is evidence that it is frequently not used appropriately. The books form an important historical record of the changes in treatment of various clinical conditions that have been driven by alterations in antimicrobial susceptibility and by the emergence of evidence for efficacy. The current book is intricately linked with the Integrated Management of Childhood Illness and the treatments it contains are based on best evidence and practicality. Whilst there are challenges in ensuring that the information in the standard treatment book is accessible, practical and up to date, the book will continue to provide the basis for treatment of the common conditions presenting in children in the future.
Books ; Book document ; Therapeutic procedure ; therapeutic aspects ; Clinical

Intestinal microsporidia is an emerging human disease caused by microsporidia. A study was conducted to determine the prevalence of microsporidia in patients with gastro-intestinal symptoms and to examine the clinical manifestations associated with intestinal microsporidiosis. A descriptive cross-sectional study using a well-structured questionnaire; a review of medical records was also undertaken. Positive stool samples were defined as presence of one or more pinkish-violet ovoid structures with a belt-like stripe under high power field (100x) using modified gram-chromotrope stain (MGC). A total of 353 faecal specimens of patients was examined and 100 patients were found to have positive stool samples for microsporidia. The overall prevalence of microsporidia was 28.3%. Acute and chronic diarrhoea were seen in 49.0% and 36.0% patients, respectively. The commonest clinical presentations were diarrhoea (85.0%) with 83.0% of patients having loose or watery stools, vomiting (75.0%), foul-smelling stools (60.0%), nausea (59.0%) and cramping abdominal pain (39.0%). The least common symptoms were fever (15.0%), mucous in stool (5.0%) and blood in stool (4.0%). This study concludes that the prevalence of microsporidia is still high (28.3%) and the majority of patients (93.0%) are symptomatic; the most common gastro-intestinal symptom is diarrhoea with loose or watery stools. Hence, it is recommended that a stool screening for microsporidia be done in selected patients presented with gastrointestinal symptoms.
Feces ; symptoms <1> ; Prevalence aspects ; Intestinal microsporidiosis ; Clinical