Correlation between Peer Assessment Score and Final Examination Mark among IIUM First Year Medical Students

Background: Peer assessment has been shown to complement both formative and summative evaluations in education and used in some medical programmes. The study was aimed to find correlation between group work peer assessment score and final examination mark among four batches of International Islamic University Malaysia (IIUM) first year MBBS students. Method: A set of four questions was constructed and tested to assess students’ overall role in their group research project. The difference in distribution according to years was tested by using one-way ANOVA or Kruskal-Wallis, depending on the data distribution. Pearson correlation coefficient test was done to test the linear association between peer score and final examination mark. Partial correlation test was used to adjust the correlation for four academic years. Results: From the analysed data of 502 students, there was moderate, significant positive correlation (0.366) between peer assessment score and the final examination mark (P < 0.001). Adjustment to the academic years resulted in correlation coefficient of 0.371. Conclusion: The results provide an important insight on the influence of peers’ perception in predicting the medical student academic performance

Validation of Noise Induced Hearing Loss Questionnaire Among Malay Sawmill Workers in Kelantan Malaysia

Introduction: Exposure to excessive noise is the major avoidable cause of permanent hearing impairment. Sawmill is one of the workplaces where workers are exposed to hazardous noise level. This study was conducted to determine the reliability and validity of noise-induced hearing loss questionnaire among sawmill workers. Materials and Methods: This cross sectional study was conducted in March 2007 among 35 consented sawmill workers. A total of 40 items; 10 items for knowledge (8 areas), 20 items for attitude (7 areas) and 10 items for practice (2 areas) were assessed. Statistical analysis for reliability analysis was test by internal consistency and construct validity by exploratory factor analysis using principal components and Varimax rotation method. Results: Cronbach’s alpha coefficients were acceptable for attitude (0.90) and practice (0.75). However, it was low for knowledge (0.67). Exploratory factor analysis showed three meaningful exploratory factors that could explain the three dimensions in the questionnaire. Conclusion: The results of the validation study suggested that the noise-induced hearing loss questionnaire is reliable and valid tool for assessing knowledge, attitude and practice among sawmill workers

Arterial Stiffness and its Association with Dyslipidemia

Introduction: Cardiovascular diseases (CVD) are the leading cause of mortality in Malaysia as well as in other countries. It is associated with many risk factors, such as increasing age, hypertension, diabetes, dyslipidemia, oxidative stress and autonomic dysfunction and arterial stiffness. The objectives of this study were to measure the prevalence of arterial stiffness and to assess its association with dyslipidemia. Methods: A cross sectional study was conducted in a rural community in Malaysia involving 146 subjects. Data were collected using an interviewer administered questionnaire which included three sections – sociodemographic characteristics, personal profile, and past medical history. In addition, Seca Body Meter (Seca 220) was used to measure height and weight. Sphygmomanometer (OMRON Automatic Blood Pressure Monitor HEM 907) and SphygmoCor-AtCor MM3 SERIAL/RS-232 were used for blood pressure and augmentation index (AIx) measurement. Data were analysed using the SPSS for Windows, Version 18.0. Results: The mean age of respondents was 49.5 years, SD±15.6. The prevalence of arterial stiffness was 23.3% (95% Confidence Interval (CI): 16.44 – 30.16). The prevalence of dyslipidemia was 82.9% (95% CI: 76.79 – 89.01). Multivariate logistic regression revealed that total cholesterol was significantly associated with arterial stiffness (OR=4.56, CI 1.10-18.90). Conclusion: The prevalence of dyslipidemia was high. Despite an insignificant association between dyslipidemia and AIx, there is a significant association between TC level and AIx

Prevalence of Diabetic Retinopathy and its Associated Factors among Diabetic Patients in Primary Care Clinics, Kuantan, Pahang

Introduction: Diabetic retinopathy (DR) is one of the commonest complications of diabetes mellitus. This study was to determine the prevalence of DR and its association with chronic kidney disease (CKD), high HbA1c and dyslipidemia among diabetic patients in government primary care clinics. Materials and Methods: A cross sectional study was carried out. The respondents were selected from diabetic registry at two government primary care clinics in Kuantan, Pahang via stratified random sampling method during the study period from May 2010 to April 2011. The respondents were interviewed and assessed clinically using a structured questionnaire. Retinal examination was performed by accredited staff using non-mydratic retinal imaging and DR was classified according to the International Clinical Diabetic Retinopathy Disease Severity Scale. Results: Out of 400 respondents, 58.8% were diagnosed with diabetes less than 5 years and 51.0% had uncontrolled blood pressure (>130/80 mmHg). The prevalence of DR and maculopathy were 33.5% and of 17.8% respectively. Most of these patients (22.3%) had mild non-proliferative DR. DR patients had higher percentages CKD (17.9% vs. 6.8%; p<0.001) and a higher mean of HbA1C (8.69 vs. 8.11; p=0.015) compared to non-DR patients. The study revealed that DR was independently associated with CKD {OR: 3.46, 95% CI (1.76, 6.80)} and high HbA1c {OR: 1.12, 95% CI (1.02, 1.23)}. Those with dyslipidemia however, has 39% less risk of DR {OR: 0.61, 95% CI (0.39, 0.94)}. Conclusion: This study showed that diabetic patients with CKD and high HbA1c have greater risks to develop DR but has protective risk with dyslipidemia

Occupational noise exposure and hearing loss: A study on knowledge, attitude and practice among Tanzanian iron and steel workers

We assessed Knowledge Attitude and Practice (KAP) regarding occupational noise exposure, Noise-induced hearing loss, audiometry and use of hearing protection devices among iron and steel factory workers exposed to high noise level. A modified, validated, structured questionnaire was used to collect information from 253 male workers randomly selected from the four factories. The sum scores for each domain of KAP were computed. Scores above 75% were defined as good knowledge and positive attitude. For practice, scores of >50% were defined as good. Independent samples t-test and Chi-squared test were used to analyze association between KAP and continuous/categorical variables respectively. Majority of workers displayed poor knowledge and poor practice (94%), but 76% displayed a positive attitude. Most of the workers (86%) had never been provided with hearing protection devices. The mean scores for attitude and practice differed significantly between the four factories (one-way ANOVA, p < 0.001). Implementation of hearing conservation program with provision of hearing protection devices are suggested.publishedVersio

Psycho-social and Spiritual Backgrounds, Experiences, and Needs as a Transsexual: A Qualitative Study within Persatuan Insaf Pahang

Introduction: Transsexuals face discriminations and rejections from the Malaysian society. The number of studies done on understanding the phenomenology, experiences, and problems faced by transsexuals is still few in Malaysia. This research aims to document their psycho-social and spiritual backgrounds and the relevant experiences, and to explore their perceptions and needs as male-to-female transsexuals in the context of Persatuan Insaf Pahang, Malaysia. Materials and Methods: A qualitative research was carried out in July and August 2015 among eight male-to-female transsexual adults in Kuantan, Pahang. Snowball sampling was used. Participants who gave consent were interviewed in two focus groups. Data obtained was transcribed and used as the primary data source. Results: Subjects in this study reported confusions over their gender identity since childhood. They struggled against conflicts regarding their transsexuality in adolescence, and eventually many quit their studies. As adults, they were discriminated against in employment and religious settings. They provided positive feedbacks on religious authorities who could understand problems unique to transsexuals and empathise with the transsexual community. Conclusion: The psycho-sexual phenomenology is the same in transsexuals all over the world. Misunderstanding and discrimination from the society remain heavy towards this community. Transsexuals should learn to adapt to meeting expectations from the society as well, so they could be accepted in public. They will need religious guidance and spiritual support for better quality of life. Dedicated efforts are still needed in training professionals in the educational, medical, and religious fields to attend to the specific needs of transsexuals in this country

Mak Nyahs and Sex Reassignment Surgery – A Qualitative Study from Pahang, Malaysia

Introduction: Mak nyahs are locally known male-to-female transgenders in Malaysia. In Western countries, medicalization of transgenderism allows strictly selected patients to undergo sex reassignment surgery. However, a standardized treatment system is not yet available in Malaysia. A number of mak nyahs underwent sex reassignment surgery at their own will. This study aimed to explore mak nyahs’ knowledge and perception on sex reassignment surgery. Materials and Methods: A qualitative research was carried out from 13th July 2016 till 31st August 2016 among 8 adult mak nyahs in Kuantan, Pahang. Snowball sampling was used. Participants who gave verbal consent were interviewed individually and in focus groups. Data obtained was transcribed and used as the primary data source. Results: All informants were Malays and Muslims. They generally had some knowledge about the standard procedures and risks in sex reassignment surgery. All informants expressed their desire to have the surgery, but chose not to. Reasons discouraging them from having the surgery were: i) religion, ii) forbiddance from family, iii) fear of regret, iv) death from surgery, and v) the lack of necessity. Factors driving them to have the surgery: i) more income from sex work, ii) pressure from sex clients, iii) securing a stable relationship, iv) self-satisfaction, and v) hope for a better future. Conclusion: Religion seemed to be the main reason refraining them from undertaking the surgery. Counselling mak nyahs should include the advantages and disadvantages of sexual reassignment surgery. Islamic religious preaching is very important to help reduce high risk behaviours, as well as teaching mak nyahs to cope with challenges in adult life. Further research is necessary to show association between religious knowledge and successful rehabilitation of the mak nyahs’ community