Clinical Competence ; Competency-Based Education ; Cross-Sectional Studies ; Data Collection ; Humans ; Malaysia ; Postal Service ; Students, Medical

The protein nutritive value of anchovy, mackerel and canned sardine samples together with casein as a reference formulation were evaluated. Proximate composition, protein quality and protein digestibility were determined. Procedures for evaluation included Protein Efficiency Ratio (PER) using the rat bioassay and in vivo Apparent Digestibility (AD). Rats fed with canned sardine diet had the highest mean body weight (154.8±12.28g) while rats fed with anchovy diet had the lowest mean body weight (145.27±15.89g) with significant differences between all the groups. Mean body weight of rats fed with selected fish diet was higher compared to rats fed with casein diet. For PER value, canned sardine has the highest value (2.48), followed by anchovy (2.46) and mackerel (2.34). PER value for all selected fish is lower than that for casein (3.14). Mackerel had the highest value of in vivo AD (96.99%), followed by casein (96.96%), canned sardine (96.88%) and anchovy (91.29%). In conclusion, among the types of fish compared, sardine had the highest protein quality while mackerel showed the highest digestibility.
Proteins ; Diet ; Caseins ; Protein measurement ; Rattus norvegicus

Introduction: Newborns have low vitamin A reserves and rely on breastmilk to meet their vitamin A needs. This study aimed to determine factors associated with vitamin A concentration in colostrum of rural postpartum mothers. Methods: Out of 180 postpartum women interviewed at seven Community Health Centers in South Sulawesi Province, 160 who met the inclusion criteria were included in the study. Breastmilk (colostrum) samples were obtained shortly after delivery from the breast that was not full and not fed to the infant for at least 30 min. Breastmilk samples of 3-5 mls were collected into sterile plastic tubes using a manual pump. The samples were immediately placed in an icebox and transported to the laboratory within six hours after collection. Vitamin A concentrations were determined using HPLC method. Socioeconomic characteristics, anthropometric measurements, gestational age, and dietary intake of mothers (24-hour recall) were obtained. Bivariate and multiple linear regression analysis were undertaken to determine factors associated with vitamin A concentration in colostrum. Results: Dietary assessment showed unsatisfactory intake levels of calories, fat, protein, vitamin A, iron and zinc compared to the recommendations for Indonesia. Mean vitamin A concentration in colostrum was 58.2 μg/dl, and about 81.2% of the participants had normal colostrum vitamin A concentration. Iron intake and gestational age were significantly associated with colostrum vitamin A concentrations. Conclusion: Majority of the postpartum mothers had normal colostrum vitamin A concentration. Maternal dietary intake including iron is important to ensure adequacy of vitamin A in breastmilk.

The art of talking to patients and their relatives does not come naturally to most of us and the ability to put oneself in the patients’ predicament is difficult particularly for the young doctors. To identify the communication abilities of the young doctors, a cross sectional study was carried out on 32 house officers who graduated from UKM in 2004 during their house jobs at different hospitals in Malaysia. A standardized questionnaire was used to collect the data. Fifty nine percent respondents claimed that they had communicated very well with patients while 69% with support staff and 88% with peers. On the other hand 38% and 41% of the respondents claimed they communicated very well with their superiors and families of patients. Only 22% of the graduates’ skills of communication in breaking bad news were very well, while 50% and 81% were very well in counselling patients and taking consent for procedures. Curriculum planners need to emphasize the importance of developing good communication skills in all aspects for the future doctors.

Background and Objectives: Malnutrition is a serious public health problem in developing countries, including Indonesia. Based on RISKESDAS 2018, the prevalence of stunting aged 13-15 years in Takalar Regency is 24.83%. This study aimed to assess the prevalence of stunting and the determinants of stunting in adolescent girls aged 13-15 years in the South Galesong District, Takalar Regency. Methods: This is a cross-sectional study using purposive sampling method that included 247 adolescent girls in selected junior high schools. Data collection used questionnaires and anthropometric measurements. An anthropometric measurement was converted to the indices of nutritional status using World Health Organization Anthro Plus software. Results: The prevalence of stunting was 25.1%. Bivariate analysis showed determinant factors related significantly to stunting were energy intake (p<0.001), protein intake (p<0.001), iron intake (p<0.005), and zinc intake (p<0.001). Multivariate analysis showed determinant factors related significantly to stunting were zinc intake (p<0.001, OR=7.993), protein intake (p<0.05, OR=2.248), and knowledge level (p<0.05, OR=2.032). Conclusion The occurrence of stunting is related to the quality and quantity of food and the level of adolescent knowledge about balanced nutrition. It is necessary to hold educational programs and interventions on improving nutrition initiated by stakeholders and the department of health, in this case, the health center is needed to reduce stunting rates, especially among adolescents.
Malnutrition ; Growth Disorders ; Adolescent

Background: The high rate of transmission and infection of coronavirus disease 2019 (COVID-19) is a public health emergency of major epidemiological concern. No definitive treatments have been established, and vaccinations have only recently begun. We aim to review the efficacy and safety of Interferon Beta (IFN-β) in patients who have a confirmed COVID-19 diagnosis. Materials and Methods: A search from PubMed, Science Direct, Cochrane, and Clinicaltrials.gov databases were conducted from December 2019 to December 2020 to review the efficacy and safety of IFN-β in adult patients with COVID-19 confirmed. We included randomized controlled trials, case reports, and experimental studies. Correspondences, letters, editorials, reviews, commentaries, case control, cross-sectional, and cohort studies that did not include any new clinical data were excluded. Results: Of the 66 searched studies, 8 were included in our review. These studies demonstrated that although IFN-β did not reduce the time to clinical response, there was an increase in discharge rate at day 14 and a decrease in mortality at day 28. The time to negative reverse transcription polymerase chain reaction (RT-PCR) was shown to be significantly shortened in patients receiving IFN-β, along with a lower nasopharyngeal viral load.Further, patients receiving IFN-β had a less significant rise in IL-6. IFN-β was shown to decrease intensive care unit (ICU) admission rate, the requirement of invasive ventilation in severe cases, and improve the survival rate compared to control groups. There were no severe adverse events reported.Our review found that patients who received early treatment with IFN-β experienced significantly reduced length of hospitalization, mortality, ICU admission, and mechanical ventilation. A greater chance of clinical improvement and improved imaging studies was noted in patients who received IFN-β. There were no reported deaths associated with the addition of IFN-β. Further randomized trials involving more significant sample sizes are needed to better understand the effect of IFN-β on survival in COVID-19. Conclusion This review identified encouraging data and outcomes of incorporating IFN-βto treat COVID-19 patients. IFN-β has been shown to decrease hospital stay's overall length and decrease the severity of respiratory symptoms when added to the standard of care. Also, in some studies, it has been demonstrated to reduce the length of ICU stay, enhance survival rate, and decrease the need for invasive mechanical ventilation. There were minor side effects reported (neuropsychiatric symptoms and hypersensitivity reaction). However, randomized clinical trials with a large sample size are needed to assess IFN-β's benefit precisely.

Background: The high rate of transmission and infection of coronavirus disease 2019 (COVID-19) is a public health emergency of major epidemiological concern. No definitive treatments have been established, and vaccinations have only recently begun. We aim to review the efficacy and safety of Interferon Beta (IFN-β) in patients who have a confirmed COVID-19 diagnosis. Materials and Methods: A search from PubMed, Science Direct, Cochrane, and Clinicaltrials.gov databases were conducted from December 2019 to December 2020 to review the efficacy and safety of IFN-β in adult patients with COVID-19 confirmed. We included randomized controlled trials, case reports, and experimental studies. Correspondences, letters, editorials, reviews, commentaries, case control, cross-sectional, and cohort studies that did not include any new clinical data were excluded. Results: Of the 66 searched studies, 8 were included in our review. These studies demonstrated that although IFN-β did not reduce the time to clinical response, there was an increase in discharge rate at day 14 and a decrease in mortality at day 28. The time to negative reverse transcription polymerase chain reaction (RT-PCR) was shown to be significantly shortened in patients receiving IFN-β, along with a lower nasopharyngeal viral load.Further, patients receiving IFN-β had a less significant rise in IL-6. IFN-β was shown to decrease intensive care unit (ICU) admission rate, the requirement of invasive ventilation in severe cases, and improve the survival rate compared to control groups. There were no severe adverse events reported.Our review found that patients who received early treatment with IFN-β experienced significantly reduced length of hospitalization, mortality, ICU admission, and mechanical ventilation. A greater chance of clinical improvement and improved imaging studies was noted in patients who received IFN-β. There were no reported deaths associated with the addition of IFN-β. Further randomized trials involving more significant sample sizes are needed to better understand the effect of IFN-β on survival in COVID-19. Conclusion This review identified encouraging data and outcomes of incorporating IFN-βto treat COVID-19 patients. IFN-β has been shown to decrease hospital stay's overall length and decrease the severity of respiratory symptoms when added to the standard of care. Also, in some studies, it has been demonstrated to reduce the length of ICU stay, enhance survival rate, and decrease the need for invasive mechanical ventilation. There were minor side effects reported (neuropsychiatric symptoms and hypersensitivity reaction). However, randomized clinical trials with a large sample size are needed to assess IFN-β's benefit precisely.