Objective: To determine the prevalence of teenage pregnancy and compare its obstetric and perinatal outcomes with those of non-teenage pregnancy. Method: This retrospective hospital-based case-control study was conducted in the Department of Obstetrics and Gynaecology in Hospital Tuanku Ja’afar Seremban. The study made use of the Malaysian National Obstetric Registry (NOR) records of teenage pregnant women aged 11–19 at Hospital Tuanku Ja’afar Seremban over a 12-month period between May 2015 and May 2016 (n=164). Socio-demographic profiles, obstetric outcomes, and perinatal outcomes were detailed for each pregnant woman. The results were compared to a control group of 169 pregnant women aged 20–30 who also delivered in hospital Tuanku Ja’afar Seremban during the same period. The aim of this study was to assess the obstetric outcomes of teenage pregnancy and to compare them with those of the control group. A chi-squared test was used to identify the statistical significance of the relationship between teenage pregnancy rates and obstetric outcomes. Results with p <0.05 was considered statistically significant. Results: The prevalence of teenage pregnancy was 2.8%. The mean age of the teenage group was 17.9; that of the control group was 26.4. Teenage mothers had a significantly higher risk of anemia (p<0.05), episiotomy (p<0.001), preterm labor (p<0.001), and delivering low-birthweight babies (p<0.001). There were no significant differences between the two groups in mode of delivery, antenatal complications, birth outcomes, APGAR scores at 5th minute, or neonatal complications. Conclusion: The prevalence of teenage pregnancy in this study is relatively low but is associated with an increased risk of some perinatal complications. The primary care physician’s role is pivotal in educating adolescents on sexual health, providing continual care in hospitals, and empowering teenagers in their reproductive health decisions.

Objective: The present study was aimed to investigate the preliminary phytochemical analysis and HPTLC profiling and the antibacterial activity of P. pterocarpum methanolic flower extracts against the bacteria isolated from human infections. Methods: The preliminary phytochemical screening was performed according to the Harborne method. HPTLC studies were carried out using Harborne and Wagner et al method. The methanolic flower extracts of P. pterocarpum were tested against Salmonella typhi (MTCC 733), Staphylococcus aureus (MTCC 96), Proteus mirabilis (MTCC 742), Bacillus subtilis (MTCC 441) and Escherichia coli (MTCC 443). The antimicrobial activity was tested through well diffusion method. Results: The phytochemical studies on methanolic flower extract of Peltophorum pterocarpum (DC.) Baker ex Heyne. revealed the presence of glycosides, flavonoids, phenolics, saponins, catechin and alkaloids. The HPTLC separation was achieved using ethyl acetate-methanol-ethanol-water (8.1: 1.1: 0.4: 0.8) as the mobile phase. The methanolic extract of P. pterocarpum showed four different Rf values 0.16, 0.31, 0.77 and 0.82 which indicated various glycosides present in the flower extract. The methanolic extract of P. pterocarpum showed the maximum zone of inhibition against Proteus mirabilis followed by Salmonella typhi. Conclusion: Bio-assay revealed the presence of specific and selective antimicrobial compounds in the fractions. Broad range activity of plant extracts as per observations in this study was due to presence of multiple antimicrobial compounds or synergic effects of these compounds. Therefore, standardization of active fractions and study for in vivo efficacy may result in development of better antimicrobial drugs.

Acquaintance is scanty on primaquine (PQ) efficacy and Plasmodium vivax recurrence in Udupi district, Karnataka, India. We assessed the efficacy of 14 days PQ regimen (0.25 mg/kg/day) to prevent P. vivax recurrence. Microscopically, aparasitemic adults (≥18 years) after acute vivax malaria on day 28 were re-enrolled into 15 months’ long follow-up study. A peripheral blood smear examination was performed with participants at every 1–2 month interval. A nested PCR test was performed to confirm the mono-infection with P. vivax. Of 114 participants, 28 (24.6%) recurred subsequently. The median (IQR) duration of the first recurrence was 3.1 (2.2–5.8) months which ranged from 1.2 to 15.1 months, including initial 28 days. Participants with history of vivax malaria had significantly higher risk of recurrence, with hazard ratio (HR) (95% CI) of 2.62 (1.24–5.54) (P=0.012). Severity of disease (11.4%, 13/114) was not associated (P=1.00) with recurrence. Of 28 recurrence cases, the nPCR proved that P. vivax mono-infection recurrence rate was at least 72.7% (16/22) at first recurrence. In Udupi district, PQ dose of 0.25 mg/kg/day over 14 days seems inadequate to prevent recurrence in substantial proportion of vivax malaria. Patients with a history of vivax malaria are at high risk of recurrences.
Adult ; Follow-Up Studies ; Humans ; India* ; Malaria ; Malaria, Vivax* ; Plasmodium vivax* ; Plasmodium* ; Polymerase Chain Reaction ; Primaquine* ; Recurrence ; Tertiary Healthcare* ; Treatment Failure

BACKGROUND: Bilateral superficial cervical plexus block (BSCPB) provides good postoperative analgesia, but its effect on anesthetic consumption is unknown. This study evaluated the effects of BSCPB on sevoflurane consumption during thyroid surgery. METHODS: Fifty patients were randomly allocated into groups A and B of 25 each in this prospective double-blind study. Group A received BSCPB with 20 ml 0.25% bupivacaine, whereas group B received 20 ml saline immediately before entropy-guided general anesthesia. Intraoperative hemodynamic parameters, end-tidal sevoflurane concentration, minimum alveolar concentration, and sevoflurane consumption were recorded. Postoperative pain was assessed using a visual analog scale, and the time of the first request for analgesia was noted. All side effects were recorded. RESULTS: Demographics were comparable. Mean sevoflurane consumption [for 30 min: group A = 7.2 (1.1) ml, group B = 8.8 (2.0) ml, P = 0.001; for 60 min: group A = 13.5 (1.7) ml, group B = 16.5 (3.9) ml, P = 0.002] and mean end-tidal sevoflurane concentration [for 30 min: group A = 1.2% (0.2%), group B = 1.4% (0.2%), P = 0.008; for 60 min: group A = 1.2% (0.1%), group B = 1.4% (0.2%), P = 0.010] were significantly lower in group A. Patients in group A had a longer duration of analgesia [361.6 (79.5) min vs. 151.0 (60.2) min, P < 0.001] compared to those in group B. CONCLUSIONS: Preinduction BSCPB during thyroid surgery significantly reduced sevoflurane consumption and increased the duration of postoperative analgesia.
Analgesia ; Anesthesia, General* ; Bupivacaine ; Cervical Plexus Block* ; Cervical Plexus* ; Demography ; Double-Blind Method ; Entropy ; Hemodynamics ; Humans ; Nerve Block ; Pain, Postoperative ; Prospective Studies* ; Thyroid Gland* ; Thyroidectomy ; Visual Analog Scale

Introduction: Health care involves team work. Physicians, nurses, pharmacists and social workers need to work in collaboration to deliver quality health care. It is therefore vital that team work and collaboration are integrated into the training of medical students. In a medical school where interprofessional education has not been introduced, the preclinical students are trained in silos whereas the clinical students have interprofessional experiences in hospital and community centers. This study was conducted to explore medical student’s receptiveness for interprofessional education and to identify any differences in attitude among the preclinical and clinical year students. Methods: This study adopted a cross-sectional study design using purposive sampling technique at a private medical school in Malaysia. Participants completedthe standardized Readiness for inter-professional learning Scale and the data was analyzed. Results: 436 students witha mean age of 22 years participated in this study. Among them, 170 were from preclinical and 266 were from clinical years Both the groups scored high on team work while clinical students scored better than preclinical students in understanding professional identity and recognizing their roles. Conclusion: This study shows a readiness among medical students for IPE. Clinical year medical student’s attitude was similar to preclinical students.

Introduction: In medical education one of the main goal is to facilitate the development of professional identity of medical students. It is influenced by sociocultural factors whose influence has been examined by the empirical scholarship on professional identity research in a robust way. The current research studied the influence of gender, ethnicity and year of study on the professional identity of medical students using a validated instrument. Methods: The quantitative research approach using the cross sectional survey design is adopted in the present study. The instrument for the measurement of professional identity was developed using the items adapted from previous research. Stratified random sampling was used to collect the data from 318 participants. The reliability and construct validity of the instrument was evaluated using Smart PLS 3. Data was analysed, for descriptive and inferential statistics using SPSS version 26. Result: Ethnicity, gender and year of study had an impact on the professional identity of medical students. Indian ethnicity had significantly higher positive influence. The female students had higher professional identity than male medical students. As the students’ progressed to higher level of their training their professional identity progressively decreased. Conclusion: The medical students trained with similar curricular activities and the learning experiences develop different levels of professional identity. The level of professional identity developed by the medical students in deferent gender, ethnicity, and year of study differes. The sociocultural factors need to be considered when designing activities aimed at development of medical students’ professional identity.

Introduction: Medical students are highly motivated compared to other students in higher education. Various factors internal and external to the students can affect their academic motivation. It has direct bearing on their performance as well as their professional development. The present study aims to validate the adapted questionnaire on academic motivation of medical students in Malaysia and to study the influence of gender, ethnicity, and year of study on it. Methods: The quantitative research approach using the cross-sectional survey design is used in the present research. Stratified random sampling method used to collect data from 318 participants using adapted academic motivation scale for college students. The reliability and construct validity of the instrument was evaluated. The data was analysed, for inferential statistics using SPSS version 26. Results: The intrinsic and extrinsic motivation was higher in female medical students. However, the male students are significantly amotivated. Variation in different types of motivation was observed among three ethnic groups. A significant (p<0.005) difference was found in Introjected regulation and amotivation among ethnic groups. Medical students of clinical years had higher score for Intrinsic motivation and lower score for extrinsic motivation. Amotivation was comparable in medical students of all years with lowest in year 2 students. The level of different types of motivation differs among the medical students of different gender, ethnicity, and year of study. Conclusion: The educators and the curriculum designers need to strategize to improve the motivation of the medical students which will improve their academic performance and well-being.

Introduction: People of different cultures perceive health and disease differently. A culturally competent healthcare team is needed to provide quality healthcare. In Asian medical schools, less emphasis is laid on cultural competency training. In this context, the study aims to assess the cultural competency of medical students in Malaysia and to fathom the demographic factors influencing it. Methods: A cross sectional survey was conducted on students from all five years of a Malaysian medical school using an adapted version of Clinical Cultural Competency Questionnaire (CCCQ) to tap the self-perceived knowledge, skills, comfort level in cross-cultural encounters and attitude towards cultural competency. Descriptive and inferential statistics was used to analyse the data. Results: Among the 291 respondents, the cultural competency was found to be significantly different among medical students of different year of study, age, and ethnicity. However, with regards to gender, country of birth or the number of languages spoken, the difference was insignificant. The clinical year students had significantly higher scores on the knowledge, skills, comfort level and attitude domains of cultural competency when compared to the preclinical students. Chinese students’ perception on cultural competence was significantly distinct from Indian and Malay students. Conclusion: Exposure to cross cultural encounters in clinical settings and personal experiences seem to influence cultural competency of the medical students. It provides valuable data to plan for interventions, training and self-development strategies aimed at providing culturally attuned patient centred care.

Introduction: Though there are abundant studies on entrepreneurial intention among students pursuing higher education, there is a lacuna in understanding the entrepreneurial intention of medical students. In the present scenario of increasing unemployment among young medical graduates, this quantitative study was conducted with an aim to examine the level of entrepreneurial intention among medical students and the socio-demographic factors influencing it. Methods: The participants were 318 medical students of a private university in Malaysia. A cross-sectional study design with a validated adapted questionnaire was used to collect data. The data was analysed using descriptive and inferential statistics. Results: A moderately high level of entrepreneurial intention was found among the study population. Regression analysis revealed a statistically significant impact of gender and marital status on their entrepreneurial intention while ethnicity, year of study, household income or educational loan did not have a significant influence. Conclusion: Medical students in Malaysia showed a moderately high inclination towards an entrepreneurial career. Non-economic factors like gender and marital status proved to be stronger influencers of entrepreneurial intention than economic factors. This may help policy makers plan strategies to sustain their entrepreneurial intentions and facilitate for more entrepreneurial activities among young doctors in the futu

ABSTRACT The oral microbiome comprises several hundreds of bacterial species that contribute to periodontitis, the most complex polymicrobial inflammatory disorder. Porphyromonas gingivalis is a prominent periodontitis pathogen that produces gingipains as a major virulent factor. Gingipain facilitates P. gingivalis survival, pathogenicity, and growth. Several genes were identified to have a role in the regulating of P. gingivalis pathogenesis. Studies suggest that gingipains inhibition is key for the successful treatment of periodontitis. As of now, several gingipain inhibitors have been developed, some exhibit high inhibition activity against gingipains. However, most inhibitors offer unknown toxicity and undesirable side effects. Hence, the development of highly potent and safe gingipain inhibitor is a major concern for periodontitis treatment. The present review highlights the connectivity between P. gingivalis, virulent factors, and its gene, periodontitis, and gingipain inhibitors. Development of gingipains inhibitors would not only treat periodontitis but would also assist in the treatment of other associated systemic diseases, for example: rheumatoid arthritis, cardiovascular diseases, diabetes, and Alzheimer's disease.
Porphyromonas gingivalis--pathogenicity ; Gingipain Cysteine Endopeptidases