The undersigned author(s) transfer/assign or otherwise convey all copyright ownership of the manuscript entitled ("article title") to Journal of the University of Malaya Medical Centre. And referring to continuing medical education, he said: “The most difficult conviction to get into the mind of a beginner is that the education in which he is engaged is not a college course, not a medical course, but a life, for which the work of several years under a teacher is but a preparation (1). Thus, it is evident that the growing trend of drug addiction poses a threat to the future of the nation (1, 6, 9).
Conclusion
REVIEW OF RESEARCH IN LEARNING ENVIRONMENT
Introduction
Educational environment research has shown that there is a high price to pay for a dysfunctional learning environment. Levy et al (1973) examined the learning environment of a Georgia Medical School in the context of curriculum change assessment. Marshall developed in 1978 the MSLES (50 items) (Medical Schools Learning Environment Survey) to measure aspects of the learning environment relevant to student stress.
The Meaningful Learning Experience, 5. The Flexibility subscale that measures an individual's perception of the learning environment). Strayhorn and Frierson (1989) conducted a longitudinal study of first-year medical students at the University of North Carolina (UNC) School of Medicine to determine the correlations between students' perceptions of the medical school learning environment and both their academic performance as well as their achievements. their perception of well-being using the 99-item questionnaire. They found that both black and white students had similar perceptions of the quality of the learning environment.
Dunn and Burnett (1995) used the Clinical Learning Environment (CLE) scale (23 items) to identify factors that characterize a clinical learning environment. Approaches to the study and learning environment at medical schools with special reference to the Gulf countries.
DO MEDICAL LECTURERS NEED TO BE SPECIALLY TRAINED IN TEACHING?
Establishing the need to change
Therefore, to facilitate education reform in a medical university, it is essential that its key workforce (i.e. lecturers) is systematically trained (not through ad hoc training) to remain relevant and effective. The lecturer's positive attitude, creating an environment that encourages student effort in solving problems and taking risks. Certainly, and I think that understanding theoretical approaches can provide a lecturer with many insights.
Transfer of learning is defined in educational psychology as “the ability to apply knowledge or procedures learned in one context to new contexts” (20). The Institute of Medicine calls on educators and accrediting organizations to ensure that students and working health professionals are trained to deliver patient-centered care as members of an interdisciplinary team (6), with an increased call for interdisciplinary collaboration (5). 5) Ethics, Professionalism and Education In this era, university educators must recognize that increasing awareness of the ethical dimensions and responsibilities of teaching is essential for both greater teaching professionalism and, importantly, improved teaching practice. While the art of teaching involves skillfully communicating the learning objectives; The science of teaching JUMMEC is essentially the skillful integration of educational theories with contemporary issues and challenges so that the education of health professionals is consistent with the principles of the 21st century healthcare system.
Indeed, 'to restructure clinical education to be consistent with the principles of the 21st century health system'. 5), there must be a system of reward and recognition for lecturers who embrace the art and science of teaching. This will help advance the ultimate goal of health education, which is to generate and/or nurture a generation of caring, reflective, theory-led health practitioners who are able to identify the needs of the people they serve. and respond accordingly. to provide high quality, relevant, efficient and fair care and services.
COMPARATIVE STUDY OF ACUTE PANCREATITIS IN DIFFERENT ETHNIC POPULATIONS IN A MALAYSIAN
Patients and Methods
The diagnostic values were as follows: serum amylase more than 800 units, urine diastase more than 800 units, LDH more than 600 u/l. Ultrasonogram was done for all the patients and the presence of pancreatic edema, peripancreatic fluid collection and pancreatic necrosis was noted in some patients.
Results
Discussion
Out of 54 patients admitted for acute pancreatitis, gallstone disease was observed in 17 of them and alcohol consumption was noted in eighteen cases. In our study, both alcohol and biliary diseases were found to be equally significant causative factors for the production of acute pancreatitis. Severe acute pancreatitis (SAP), a multisystem disease, is characterized by multiple organ system failure and additionally by local pancreatic complications such as necrosis, abscess or pseudocyst (11).
Bile disease is known to be a chronic process, which can be complicated by infection that can lead to serious problems. Excessive alcohol intake is an acute damage to the pancreas and AP due to alcohol can be better treated without serious complications. Our study highlights the striking differences in the etiological factors for acute pancreatitis between the two different ethnic groups in Malaysia.
This is most likely due to differences in alcohol consumption between ethnic groups. Clinical features and complications were found to be more severe in Malaysians compared to Indians.
Acknowledgement
ROAD TRAFFIC INJURIES AMONG PATIENTS WHO ATTENDED THE ACCIDENT AND EMERGENCY UNIT
It showed that driver behavior is the main cause of road accidents, contributing to 76.1%. The purpose of this study is to get an overview of the road users involved in road traffic accidents and patients treated at the Accident and Emergency Unit at the University of Malaya Medical Center (UMMC) in January 2005. It is also intended. by identifying the socio-demographic characteristics of patients, describing the types of traffic accidents and injuries and the severity of the outcome for further prevention and control.
Material and Methods
However, statistical analysis showed no significant difference between the gender of the patients and the severity of road injuries (df = 1, p = 0.62). This research shows that most road injuries occur in the age group of 21 to 30 years, followed by 11 to 20 years. A report by the Royal Malaysian Police shows that the majority of road accidents, Table 4.
This study also found that the majority of patients who attended accident and emergency units for road traffic accidents suffered minor injuries. There was a significant relationship between the mode of transport and the severity of road traffic injuries. Additional information is needed to assess the outcome of road traffic injury survivors discharged from UMMC.
This study describes the types of road injuries among patients who visited the Accident and Emergency Department of the UMMC in January 2005. There was a significant association between the severity of injuries and the types of traffic accidents.
Acknowledgements
There were not enough cases to reveal the true picture of traffic injuries in this area. One reason could be because some patients were brought in by passers-by who did not know about the patients. Some of the motorcyclists were underage students, and some of them did not have a driver's license.
Another study conducted in New Zealand reported that seat belt use among drivers was 91%, front seat passengers 93% and rear seat passengers 40%. The reasons for not wearing a seat belt were driving short distances, forgetfulness and being in a hurry. Parents can help reduce traffic accidents by deciding when their children are ready to get a driver's license and what vehicle they are allowed to drive.
Schools have a role to play in stressing the importance of road safety such as seat belts and proper driving practices to teenagers and young adults as they will eventually become road users. Prevention and control with an emphasis on behavioral change, education and law enforcement can reduce the number of road accidents in the future.
CHRONIC MYELOID LEUKAEMIA PRESENTING AS PRIAPISM – HOW SHOULD WE TREAT THESE?
Case Report
The duration of less than 48 hours is purely arbitrary as studies (4, 5) have cited a high risk of corporal fibrosis, as mentioned above). The duration of priapism is an important factor in determining whether corporal fibrosis would occur. In general, the risk of corporal fibrosis is about 60% when the duration of priapism is more than 48 hours (4, 5).
Our patient presented late (72 hours) and achieved only partial detumescence with body aspiration and Winter shunt, therefore we opted for medical treatment, i.e. cytoreductive chemotherapy to achieve complete detumescence. Cytoreductive chemotherapy is a difficult adjunct in the treatment of priapism associated with chronic myeloid leukemia. Priapism secondary to chronic myeloid leukemia: value of initial treatment with cavernous lavage plus adjunctive methoxamine.
Effects of priapism lasting 24 hours or longer resulting from intracavernous injection of vasoactive drugs.
SUDDEN VISUAL LOSS IN ACUTE LEUKAEMIA
Partial clearing of hemorrhage with visualization of the macula (arrow) immediately after posterior Nd:YAG laser hyaloidotomy performed four days later. At presentation, there were multiple intraretinal hemorrhages with a small area of inferotemporal subhilaoid hemorrhage (arrow) in the macula. In summary, this case illustrates visual loss as part of the presenting symptoms of acute leukemia caused by premacular subhyaloid hemorrhage.
Intravitreal tPA and SF6 promote clearance of premacular subhyaloid hemorrhages in shaken and battered infant syndrome. Long-term results after pulsed Nd:YAG laser drainage of premacular subhyaloid hemorrhage into the vitreous.
ANTEROLATERAL THIGH FREE FLAP IN
RECONSTRUCTION OF ORAL CAVITY MALIGNANCY
UMMC EXPERIENCE
A neck dissection was performed and the anterior jugular vein was preserved for flap anastamosis. The remaining portion of the flap was placed laterally to cover the buccal mucosa over the left mandible. The artery supplying the flap was analyzed end-to-end with the left superior thyroid artery under microscopy.
End-to-end single-vein anastamosis was then performed using a branch of the anterior jugular vein. She was placed on subcutaneous heparin for three days and covered with intravenous cefuroxime and metronidazole. Postoperative histopathologic examination was consistent with the initial biopsy, which was moderately differentiated squamous cell carcinoma.
She was able to walk well without major problems regarding the donor site on the right thigh (Figure 3).
