This study was done to correlate the occurrence of posterior capsule rupture among patients with pseudoexfoliation during phacoemulsification. This was a retrospective audit of patients who underwent phacoemulsification type cataract surgery from January 2011 to December 2012 in a tertiary hospital in Malaysia. Data was obtained from the National Eye Database (NED) of Malaysia. The data was analysed using SPSS version 21.0. By using logistic regression analysis, it was found that there was no significant increase in the occurrence of posterior capsule rupture among patients with pseudoexfoliation. Hence, we concluded that there was no correlation between the occurrence of posterior capsule rupture and the presence of pesudoexfoliation among patients who underwent phacoemulsification.

Hormone replacement therapy (HRT) used to treat hot flashes has side effects, such as an increased risk of coronary heart disease and breast cancer. There are ongoing controversies regarding the risk of ovarian cancer associated with HRT. HRT is best avoided in conditions such as liver or gallbladder disease and gastrointestinal disorders. Evening primrose oil (EPO) has been used as an alternative treatment for hot flashes. We conducted a systematic review of randomized controlled trials and controlled clinical trials, following the PRISMA guidelines, to compare EPO with placebo or other interventions in alleviating hot flashes in menopausal women. We analyzed the data using Review Manager version 5.3, in conjunction with the Cochrane Collaboration tool. The severity of hot flashes was lower when EPO was administered for less than 6 months compared to placebo. However, there was no significant difference in the frequency and duration of hot flashes between EPO and placebo. Participants who received EPO complained of mild nausea and headache. EPO did not show any significant difference in the severity of hot flashes compared to black cohosh at 4 weeks; but the hot flashes were more severe at 8 weeks in the EPO group compared to black cohosh. The current evidence is insufficient to draw firm conclusions regarding the benefits of EPO in alleviating hot flashes. We hope that more research is conducted to provide sufficient evidence for menopausal women considering the use of EPO.

Hormone replacement therapy (HRT) used to treat hot flashes has side effects, such as an increased risk of coronary heart disease and breast cancer. There are ongoing controversies regarding the risk of ovarian cancer associated with HRT. HRT is best avoided in conditions such as liver or gallbladder disease and gastrointestinal disorders. Evening primrose oil (EPO) has been used as an alternative treatment for hot flashes. We conducted a systematic review of randomized controlled trials and controlled clinical trials, following the PRISMA guidelines, to compare EPO with placebo or other interventions in alleviating hot flashes in menopausal women. We analyzed the data using Review Manager version 5.3, in conjunction with the Cochrane Collaboration tool. The severity of hot flashes was lower when EPO was administered for less than 6 months compared to placebo. However, there was no significant difference in the frequency and duration of hot flashes between EPO and placebo. Participants who received EPO complained of mild nausea and headache. EPO did not show any significant difference in the severity of hot flashes compared to black cohosh at 4 weeks; but the hot flashes were more severe at 8 weeks in the EPO group compared to black cohosh. The current evidence is insufficient to draw firm conclusions regarding the benefits of EPO in alleviating hot flashes. We hope that more research is conducted to provide sufficient evidence for menopausal women considering the use of EPO.

Hormone replacement therapy (HRT) used to treat hot flashes has side effects, such as an increased risk of coronary heart disease and breast cancer. There are ongoing controversies regarding the risk of ovarian cancer associated with HRT. HRT is best avoided in conditions such as liver or gallbladder disease and gastrointestinal disorders. Evening primrose oil (EPO) has been used as an alternative treatment for hot flashes. We conducted a systematic review of randomized controlled trials and controlled clinical trials, following the PRISMA guidelines, to compare EPO with placebo or other interventions in alleviating hot flashes in menopausal women. We analyzed the data using Review Manager version 5.3, in conjunction with the Cochrane Collaboration tool. The severity of hot flashes was lower when EPO was administered for less than 6 months compared to placebo. However, there was no significant difference in the frequency and duration of hot flashes between EPO and placebo. Participants who received EPO complained of mild nausea and headache. EPO did not show any significant difference in the severity of hot flashes compared to black cohosh at 4 weeks; but the hot flashes were more severe at 8 weeks in the EPO group compared to black cohosh. The current evidence is insufficient to draw firm conclusions regarding the benefits of EPO in alleviating hot flashes. We hope that more research is conducted to provide sufficient evidence for menopausal women considering the use of EPO.

The purpose of this study was to determine the association of well-being and cognitive impairment with primary open angle glaucoma (POAG) patients attending a tertiary care hospital in Malaysia. Fifty-four individuals were recruited for study as cases were matched with 60 individuals as the control subjects, and data were collected using the WHO well-being index and the validated 6-item cognitive impairment test dementia test. The results showed that there was no significant association between gender, ethnicity, socioeconomic status and POAG. Patients with POAG had significantly lower well-being index scores (mean 67.93) than the control group (mean 81.60) with P-value < 0.001. Similarly, patients with POAG had a significantly higher score of cognitive impairment (CIT test) (mean 6.15) compared to the control group (mean 0.40) with P-value < 0.001. Consequently, POAG is likely to be associated with higher cognitive impairment and lower well-being index.

Introduction: Simulation of the clinical setting incorporates an educational approach connecting a learner to a particular environment of learning. Undergraduate students in the health sector experience anxiety during simulation that influences their performance which ultimately affects their learning outcome. This study attempts to correlate the impact of stressors on learning outcome of high-fidelity patient simulation (HFPS) in undergraduate medical education. Objective: This research is to analyze the impact of stressors and its relevance on the learning outcome of HFPS as a teaching-learning tool for the management of emergency surgical conditions including trauma. Materials and Methods: This study is a Quasi-experimental time series design. A total number of 347 final-year undergraduate (MBBS) students of Melaka-Manipal Medical College, Malaysia. They were grouped and assessed individually by pre-test and post-tests on their knowledge, performance and associated stressor scores. The one-way repeated measure of Analysis of Variance (ANOVA) was used to determine the statistically significant differences in total score at pre-test simulation and post-test-simulation sessions. Friedman test was used for assessment of individual components of stressors. Pre-test and post-tests scores were compared to note progress in confidence and stress reduction. P value <0.001 was considered statistically significant. Results: ANOVA with Bonferroni post hoc analysis showed a statistically significant (p <0.001) difference in stressor score over time. The drop-in stress was significant initially but flattened out later. Conclusion: Stress significantly decreased as the students were exposed to more sessions of HFPS which ultimately translated into better learning outcome.

Introduction: Medical simulation is a technique that allows interactive and immersive activity by recreating all or part of a clinical experience without exposing the patients to the antecedent risks. High-fidelity patient simulation-based teaching is an innovative and efficient method to address increasing student enrolment, faculty shortages and restricted clinical sites. Objectives: To assess the effectiveness of high-fidelity patient simulation (HFPS) as compared to video-assisted lecture-based teaching method (VALB) among undergraduate medical students. Methods: he study was a Randomized Controlled Trial which involved 56 final year undergraduate medical students. The effectiveness of teaching based on HFPS (intervention group) and VALB (control group), on acquisition of knowledge, was assessed by multiple choice questions (MCQs) in the first and fourth week. Similarly, the skills competency was assessed by objective structured clinical examination (OSCE) in the second and fourth week. Mean and standard deviation (SD) for total score of knowledge and skills assessments were used as outcome measures. P value < 0.05 was considered to be statistically significant. Results: In both groups, students had significant higher mean MCQ scores at Post-tests. The intervention group had higher mean change score of MCQ marks than the control group but the difference was not statistically significant. In both the first and second skills assessments, mean OSCE scores for intervention group were higher than control group but this difference was not statistically significant. Conclusion There was significant gain in knowledge in both methods of teaching but did not reach statistical difference in terms of skills enhancement in the intervention group as compared to the control group.
Education, Medical, Undergraduate