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Nursing Students' Perceptions of their Educational Environment Based on DREEM Model in an Iranian University

Bakhshi Hamid ; Abazari Faroukh ; Bakhshialiabad MohammadHosein

Malaysian Journal of Medical Sciences.2013;20(4):56-63.

Background: The learning climate has been found to be significant in determining students’ academic achievement and learning. The purpose of this study was to measure the viewpoints of nursing students toward their learning environment at Rafsanjan University of Medical Sciences (RUMS). Methods: This descriptive, cross-sectional study was performed on 202 nursing students using the Dundee Ready Educational Environment Measure (DREEM). The items, as well as scale scores were compared among nursing students. Also, data was analysed by SPSS19 using t test and ANOVA. Results: The total mean DREEM score was 114.3 (SD 20.6) out of 200 (corresponding to 57.15% of the maximum score), which was considered as more positive than negative. The subscale with the highest mean score was Students’ Perceptions of learning. Mean score of this subscale was 27.3/48 0 (SD 5.9) corresponding to 56.87% of the maximum score. The lowest mean score was for the Academic Self-perceptions 20.31/32 (SD 4.51) (53.44%), The total DREEM score for female students was significantly higher than for males (P = 0.01). The total scores of new entry students were significantly higher than the others (P = 0.01). Conclusion: The school’s educational climate was generally perceived positively by students, but specific areas identified by students as needing improvement. It is essential for managers to make a greater effort to create an appropriate educational environment in order to provide and maintain high quality learning environments for students.
Environment ; Students, Nursing ; Psychometrics

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The Predicaments of People Whose Suicide was Captured on Film

Saxby Pridmore ; Garry Walter

Malaysian Journal of Medical Sciences.2013;20(4):64-70.

Background: Although suicide is commonly linked with mental disorder, the notion that suicide may occur in response to predicaments has been the subject of much recent study and attention. A predicament in this context refers to an uncomfortable situation from which escape is difficult. We aimed to examine the predicaments of people whose suicide was captured on film and displayed on the public record. Methods: The authors’ extensive private library and the web were explored for examples of suicide on film. The authors viewed the films and associated records, and extracted and listed details of the suicides. Results: Six individual cases and two groups (totalling 2200 plus individuals) were identified. The individual cases were Thich Quang Duc (1963), Christine Chubbuck (1974), Budd Dwyer (1987), Daniel Victor Jones (1998), Michael Marin (2012) and Jordon Romero (2012). The two groups were the Japanese Kamikaze pilots of 1944/1995, and those who jumped from the burning “Twin Towers” on September 11, 2001. One of the six individuals has evidence of a mental disorder, and all (individual and group cases) were in potent social/environmental predicaments. Conclusion: Both psychological autopsies and our clinical experience suggest that suicide is often associated with mental disorder. Nevertheless, social/environmental predicaments may lead to suicide. This study suggests that individuals whose suicide is captured on film are often seeking public exposure of their fatal act.
Suicide ; Motion Pictures as Topic ; Mass Media ; Internet

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Trends in the Antibiotic Resistance Patterns of Enteric Fever Isolates – a Three Year Report from a Tertiary Care Centre

Varsha Gupta ; Nidhi Singla ; Neha Bansal ; Neelam Kaistha ; Jagdish Chander

Malaysian Journal of Medical Sciences.2013;20(4):71-75.

Objectives: The incidence of multidrug resistant enteric fever is increasing alarmingly. This study was planned to determine the rate of isolation of Salmonella spp. and to compare the isolates for their epidemiological parameters and antimicrobial susceptibility patterns at our center. Methods: The study was conducted over a span of three years with a total of 8142, 8134, and 8114 blood culture samples processed for the years 2008, 2009, and 2010 respectively. The minimum inhibitory concentration (MIC) for ciprofloxacin and chloramphenicol was determined using an agar dilution method. The MIC for ciprofloxacin was also confirmed by Epsilon-test (E -test) strips. Results: Of the total 302 Salmonella spp. isolated, 257 were Salmonella enterica serotype Typhi (85.1%) and 45 (14.9%) were S. enterica serotype Paratyphi A. The majority of the isolates recovered were from the pediatric age group (54.6%) and males (60.6%). Complete susceptibility was observed to chloramphenicol, cefotaxime, ceftriaxone, and azithromycin over the last two years (2009 and 2010), with an increase in resistance to nalidixic acid (100%) and ciprofloxacin (13.6%). Conclusions: In our study, we found augmentation of resistance to nalidixic acid and fluoroquinolones and complete sensitivity to ceftriaxone along with reemergence of chloramphenicol sensitivity for Salmonella isolates. This report emphasises the necessity of continuous surveillance of antibiograms of enteric fever isolates in an area.
Drug Resistance, Microbial ; Ceftriaxone ; Ciprofloxacin ; Typhoid Fever ; Salmonella

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Human Adipose Tissue Derived Stem Cells as a Source of Smooth Muscle Cells in the Regeneration of Muscular Layer of Urinary Bladder Wall

Salah Abood Salem ; Angela Ng Min Hwei ; Aminuddin Saim ; Christopher Ho Chee Kong ; Ismail Sagap ; Rajesh Singh ; Mohd Reusmaazran Yusof ; Zulkifili Md Zainuddin ; Ruszymah Hj Idrus

Malaysian Journal of Medical Sciences.2013;20(4):80-87.

Background: Adipose tissue provides an abundant source of multipotent cells, which represent a source of cell-based regeneration strategies for urinary bladder smooth muscle repair. Our objective was to confirm that adipose-derived stem cells (ADSCs) can be differentiated into smooth muscle cells. Methods: In this study, adipose tissue samples were digested with 0.075% collagenase, and the resulting ADSCs were cultured and expanded in vitro. ADSCs at passage two were differentiated by incubation in smooth muscle inductive media (SMIM) consisting of MCDB I31 medium, 1% FBS, and 100 U/mL heparin for three and six weeks. ADSCs in non-inductive media were used as controls. Characterisation was performed by cell morphology and gene and protein expression. Result: The differentiated cells became elongated and spindle shaped, and towards the end of six weeks, sporadic cell aggregation appeared that is typical of smooth muscle cell culture. Smooth muscle markers (i.e. alpha smooth muscle actin (ASMA), calponin, and myosin heavy chain (MHC)) were used to study gene expression. Expression of these genes was detected by PCR after three and six weeks of differentiation. At the protein expression level, ASMA, MHC, and smoothelin were expressed after six weeks of differentiation. However, only ASMA and smoothelin were expressed after three weeks of differentiation. Conclusion: Adipose tissue provides a possible source of smooth muscle precursor cells that possess the potential capability of smooth muscle differentiation. This represents a promising alternative for urinary bladder smooth muscle repair.
Adipose Tissue ; Stem Cells ; Muscle Cells ; Regeneration ; Urinary Bladder

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Imprint Cytological Diagnosis of Colonic Adenocarcinoma Metastatic to Liver

Shashikant Adlekha ; Tandra Chadha ; Prasad Krishnan ; B Sumangala ;

Malaysian Journal of Medical Sciences.2013;20(4):88-90.

The liver is a common visceral site for metastatic tumours. Radiological features of the liver, fine needle aspiration cytology (FNAC) and histopathological evaluation (HPE) of liver nodules have a significant role in pre-operative diagnosis of liver lesions. In an intraoperative setting, frozen section biopsy plays a major diagnostic modality but the role of imprint cytology of liver nodules is also appealing. Imprint cytology is a valuable and precise tool in diagnosing the lesions for a rapid intraoperative diagnosis. This study presents a case of colorectal cancer liver metastasis diagnosed by imprint cytology intraoperatively.
Frozen Sections ; Adenocarcinoma ; Liver ; secondary

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Chordoid Meningioma, Part of a Multiple Intracranial Meningioma: A Case Report & Review

Prabu Rau Sriram

Malaysian Journal of Medical Sciences.2013;20(4):91-94.

Chordoid meningioma, classified as atypical meningioma according to the World Health Organisation (WHO) classification, is a rare subtype, which represents only 0.5% of all meningiomas and is associated with a high incidence of recurrence. Multiple intracranial meningiomas are rare in non-neurofibromatosis patients. We present a female patient with both of these rare types of meningioma. The patient presented with two concurrent intracranial meningiomas, with one a meningotheliomatous subtype and the other a chordoid meningioma. Given the wide array of histological differential diagnoses in chordoid meningioma, immunohistochemistry has a significant role to play in differentiating them. Recurrence in chordoid meningioma can be generally predicted based on the extent of resection, the percentage of chordoid element, and proliferation indices.
Meningioma ; Immunohistochemistry ; Brain Neoplasms

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Warfarin Therapy: Survey of Patients’ Knowledge of their Drug Regimen

Waqas Shuaib ; Hira Iiftikhar ; Richard Aalweis ; Hassan Shahid

Malaysian Journal of Medical Sciences.2014;21(4):37-41.

Background: Warfarin is utilised for the treatment of thromboembolic disease. Its use demands a careful and continual monitoring given its narrow therapeutic index and potentially life-threatening complications. The aim of this study was to assess the extent of patients’ knowledge of their warfarin therapy. Methods: A total of 200 consecutive patients from a single community hospital completed an online survey questionnaire (www.eSurveysPro.com). Using the responses to the questionnaire, we recorded compliance to warfarin therapy, knowledge about drug interactions, adverse effects of warfarin therapy, complications, and resulting hospitalisation. Results: We recruited 200 patients, 55% (109/200) women and 45% (91/200) men, among which 88% were compliant with their daily medication. Of the 200 patients, 56% were unaware of any potential drug interactions, 58% were unaware of any adverse effects, 27% had experienced adverse effects, 12% had been hospitalised because of adverse effects (33% of which were due to bleeding), and 65% kept a personal record of their international normalised ratio. Conclusions: Despite the high level of compliance, patient knowledge of warfarin therapy was low. Given the potential drug interactions and complexities involved with warfarin therapy, it is of high importance that medical professionals educate their patients and make them aware of any impending signs of emergent medical complications.

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Management and Prevention of Recurrent Paratesticular Liposarcoma

Chun Hoong Song ; Feng Yih Chai ; Mohd Faizal Mohamad Saukani ; Harbahajan Singh ; Din Jiffre

Malaysian Journal of Medical Sciences.2013;20(4):95-97.

Paratesticular liposarcoma is a rare entity. Compared to other genitourinary sarcoma, it is usually detected earlier and is easily resectable, resulting in an excellent prognosis. The recurrence of well-differentiated paratesticular liposarcoma after complete resection is extremely rare. Optimal management of the tumour recurrence includes complete re-excision and radiotherapy to the area of recurrence. Here, we describe a 48-year-old man with a recurrent left paratesticular well-differentiated liposarcoma, six years after its complete excision. Our discussion focused on the therapeutic strategy to prevent tumour recurrence. It is hoped that this case discussion can increase the awareness of this condition and assist in its management.
Liposarcoma ; Adult ; Sarcoma

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Right Phrenic Nerve Palsy: A Rare Presentation of Thoracic Aortic Aneurysm

Jamal Akhtar ; Mohammed Azfar Siddiqui ; Nafees Ahmad Khan ; Md Arif Alam

Malaysian Journal of Medical Sciences.2013;20(4):98-101.

Phrenic nerve palsy causing hemidiaphragm paralysis is a very uncommon feature of thoracic aortic aneurysm. In one case, a 45-year-old man complained of chronic chest pain, dysphagia, and hoarseness of voice; posteroanterior view chest radiograph revealed lobular enlargement of the superior mediastinum and elevated right hemidiaphragm. Contrast-enhanced computed tomography (CT) of the thorax revealed a giant partially thrombosed aneurysm originating from the ascending aorta and extending into the aortic arch, causing a widening of the aorta-pulmonary window and a compression of the thoracic esophagus. Right hemidiaphragm elevation was explained by the gross mass effect of the aneurysm on the right hilum, causing right phrenic nerve palsy. The patient was to be operated on for surgical correction of the aneurysm, but died before surgery due to spontaneous rupture.
Deglutition Disorders ; Hoarseness ; Aortic Aneurysm, Thoracic ; Paralysis ; Phrenic Nerve

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All the Vice Chancellor’s Neuroscientists: Unity to Achieve Success in Solving Malaysia’s Diseases via Upgrading Clinical Services and Neuroscience Research

Jafri Malin Abdullah

Malaysian Journal of Medical Sciences.2013;20(3):1-5.

President Obama of the United States of America announced this April the Brain Research Through Advancing Innovative Neurotechnologies (BRAIN for short) investment, while Professor Henry Markram’s team based in the European Union will spend over a billion euros on the Human Brain Project, breaking through the unknowns in the fifth science of the decade: Neuroscience. Malaysia's growth in the same field needs to be augmented, and thus the Universiti Sains Malaysia’s vision is to excel in the field of clinical brain sciences, mind sciences, and neurosciences. This will naturally bring up the level of research in the country simultaneously. Thus, a center was recently established to coordinate this venture. The four-year Integrated Neuroscience Program established recently will be a sustainable source of neuroscientists for the country. We hope to establish ourselves by 2020 as a global university with neurosciences research as an important flagship.
Neurosciences

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