Sunday 31 July 2011

Digital natives in education and work (Part 2)

We'll continue discussion of hardware since there are a lot of gadgets in the market worldwide today. The world today is a mobile world, so gadgets are made for people on the move (roving, if you please). Some of the interesting gadgets available at the time of this writing include the following:

Apple products: iPhone, iPad, iPod, MacBook Air
BlackBerry products: BlackBerry smartphones, BlackBerry PlayBook tablet
Sony products: VAIO laptops, Sony tablet, digital cameras, camcorders, TV, home theatres
Acer products: notebooks, tablet 
Hewlett-Packard products: laptop-tablet

If you own or use any of the above, then you must be IT-savvy and a digital native/migrant.

Lately, I have seen the tablets made their in-roads into academia and the health care. The light-weight laptops (notebooks) now compete with the thin wafer-like tablets. The tablet is preferred by new students who are starting out in studying medicine. The tablet is preferred by IT-savvy doctors in the hospital setting especially in the orthopedic and neuro wards. The tablet is preferred by medical specialists who are also lecturing, especially on radio-imaging techniques in Radiology. It therefore looks like the tablet is here to stay for quite some time. What is the tablet good for? Please write in if you are using your tablet for something or something else. Let's share that knowledge about using the tablet.

Are other gadgets useful for education? Yes, definitely - the digital camera. What is the digital camera good for? Depends on what the objects of photography are. Photographic objects can be patients or their body parts, normal or diseased. Remember, there is an ethical code that guides us in taking photographs of patients and their body parts. Then what can we do about this restriction? Can we simply take photos of patients and their body parts? Certainly no! But there's a leeway if you are working in the photography department, still the photographs have a purpose - for teaching, research or archive. Patients' rights and privacy are guarded at each hospital. In fact, cameras (camera-fitted phones or smartphones) may not be brought into hospitals, clinics and treatment centres. Even if they are brought to hospital, they must be switched off. As such the digital camera (and camcorder, camera-fitted phones or smartphones) are useless in the true setting where everything must remain private (ideally). What's the point of learning then? The restrictions should mean that one needs prior permission in order to photograph a patient or a patient's body parts. Students are reminded that they need permission from their lecturers/superiors before they can photograph patients/body parts while in the clinics and wards. Violation of the ethical code and hospital rules is common as our students and society do not know that it is wrong to take photographs of patients/body parts and worse still, to make them public - to post them on the Internet and elsewhere. Even though rules and regulations are in place, they are broken more often than not. It's human to err.



Digital natives in modern education and work (Part 1)

Since the digital revolution began some time in the early 1980s, we have broadly and arbitrarily categorised users as "digital natives" (those born after 1982) and "digital migrants" (those born before 1982). I was born in 1958; that makes me a digital migrant. I am therefore not a good user of digital technology (not IT savvy). The focus of digital technology worldwide today is to cater for the wants and needs of digital natives (they would be less than 30 years old today). If you are less than 30 years old, you are considered a digital native. That also means you are an able and good user of digital technology; you are highly receptive to almost all technology that comes on the market today and in the future. You are IT savvy (more often than not). Now that digital technology is here to stay, how does that affect our education - the way we learn, and the way we work, now and in the future?

Let's discuss hardware first. Well, all I can envision is the laptop is here to stay and everyone wants to own one. If you have not got your own laptop, then it is high time to save for one. In Kota Bharu, there in KB Mall and a shop called Monaliza that sells reasonably priced new laptops which come with pre-installed bundled software. Nowadays one can get a new laptop for RM1,200 (which translates to saving RM200/mo for 6 months). Acer brand has been dependable and reliable so far for me. I wouldn't buy other brands. For SONY brand sold in Malaysia, these laptops cost ~RM1,4000 and are made in China and often develop some problems later on. The last SONY laptop I had went for repairs at a SONY repair centre in Jalan Gajah Mati. If you really need a SONY laptop, then buy ones that are priced above RM7,000 each - these are assembled in Japan and are genuine machines (check the packaging) - buy them from Queensbay Mall, Penang. The external hard disk (HD) is a necessity to store a lot of multimedia files and high-resolution (hi-res) digital images in the form of digital albums. Today, an external HD (298GB) costs ~RM300. Toshiba and Imation are reliable brands (I use a Toshiba) - buy external HD from Monaliza. A pen drive of 16GB is good to have to store some big files and presentations for a meeting or workshop. A good place to bargain for pen drives is a small shop in First Avenue, Penang (on the third floor) - it is called Asus Shop (smthg like that) - here the pen drives come in attractive shapes and will make you crazy - the store assistants are helpful too, in case you don't recognise pen drives. Harvey Norman in Queensbay Mall, Penang used to sell 16GB Toshiba pen drives. Buy lots of pen drives as you will them at odd times when there are no shops around. A digital camera, either built-into a mobile phone or separately. The digital cameras have jumped from being 8 megapixels a few years ago to 10 megapixels now (which means each file captured occupies a larger footprint and needs a larger storage space). I keep 2 digital cameras for my hectic work (8 megapix and 10 megapix). In Kota Bharu, digital cameras can be bought at a small outlet on the ground floor in Billion Shopping Centre; the parent store is on the second floor - it also does digital camera repairs for a postal fee of RM25 if the camera is still covered by warranty - it ships the defective camera to KL - you pay for to-and-fro postal charges). Beware though, these digital cameras are made in China and tend to become faulty for no reason. That's what you get for cheap technology.

Let's talk about software in another post.

Friday 29 July 2011

Online Learning

Physical universities are a thing of the past, before the digital revolution and computers began, some time before 1980s. Nowadays, students can register online and also take course offered online without ever coming to class - there's no classroom anyway. There are no teachers too except for facilitators or mentors and study guides. It is a new way of learning now and in the near future. Why did it ever become this way? It turned out to be this way as learning is a personal interest, some more interested than others. Some are fast learners and others otherwise. Some want to learn for a true educational reason; others just need a degree for a job application. How one gets a degree doesn't matter anymore. Alarming as it may sound but it's true. This is the real educational world today. Of course we tend to be apprehensive about things virtual but we can always do our own research to see for ourselves. I would caution degree-go-getters to be sincere in obtaining their degrees, now that the traditional way also has virtual means. Unscrupulous people dare sell paper degrees and parents as well as their university students may not be aware of possible degree scams. Paper degrees are sold in little coffee shops, in back lanes, in all possible place just like illegal documents are (passports, birth certificates, marriage certificates, etc). The whole educational world has resorted to virtual degrees as a cheaper means to procure students (and thus easy money) but we should exercise much caution in deciding where to actually bank in on even a virtual program, never mind a full degree course. Just be careful what you are paying for and where things are really coming from. Check and double check.
Further reading on online learning

Saturday 16 July 2011

OSCE Checklists

OSCE (Objective-Centred Clinical Examination) is usually hosted in the second year onward when clinicals have been introduced and can therefore been asked in exams. Most OSCEs use checklists in order to be fair to students and to avoid examiner-bias.

OSCE Checklists for the different organ-systems can be found on Scribd

Examples of OSCE checklist are on Scribd by Michael Smith. They can serve as a learning aid as well as training guides. Checklists on real OSCEs are fine-tuned and then vetted for use in exams.

Friday 15 July 2011

KLE University (Part 1)

STUDY IN INDIA: BANGALORE VS BELGAUM

There are two universities in India which take Malaysian students for the medicine degree program. One is operated by the Management Science University (MSU) with HQ in Shah Alam, and the other by Universiti Sains Malaysia (USM) with HQ in Penang.

The preparatory course for prospective MSU students is done at the Shah Alam campus. MSU is running the prep course for the 5th time this year (2011). The course content is very good and has a lot of resources. However, student housing is a bit crammed at the Shah Alam shop-house hostels.

It is not known where USM conducts its preparatory course for its prospective students or whether there is one. I don't have much info of the USM prep course and program at Belgaum. 

MSU operates the MSU-IMS (International Medical School) medical program in Bangalore and uses the Ramaiah Hospital.

USM operates the USM-KLE (Karnataka Lingayat Education) University medical program in Belgaum. It is not known which hospital is used at the time of this writing. Belgaum is approx. 8 hours drive from Bangalore airport or 1 hour flight.

https://www.facebook.com/USM-KLE-International-Medical-Programme-Belgaum-394434213979967/timeline

Both programs are ok. The Academic Session begins at the beginning of October each year. Students have a 1-month break at the end of first year before they continue into second year.

Both programs have applied for MQA approval. MSU-IMS applied for MQA approval last year, October 2010. USM-KLE applied for MQA approval just recently, in June 2011. Once approved, medical graduates are acknowledged by JPA (Jabatan Perkhidmatan Awam, Malaysia) and students can work as doctors. Check and re-check with JPA that these overseas programs comply with MQA set standards. Do your own homework too.

If there is no MQA approval for the overseas medical program, the downside is graduates will not be recognised after they graduate and have to fall back on their highest academic achievement, either SPM or STPM. This will be a waste after all the 5 years spent overseas. Better to be safe than sorry.

Parents must scrutinise medical programs and ask a lot of questions. Never take anything for granted. Don't be misled. Read the fine print too before signing any document. Don't sign if you don't understand.

Prof Faridah

Tuesday 12 July 2011

Skin cysts, lumps and bumps

The article is copyrighted. Please access directly from the link provided below.

Cysts Symptoms, Types, Signs, Causes, Diagnosis and Treatment Information by MedicineNet.com can be accessed at http://www.medicinenet.com/cysts/article.htm

The above link provides useful information of the different types of cancerous & non cancerous skin cysts/lumps/bumps and cysts found inside organs (liver, kidney, pancreas, eye, bone, etc).

Cysts found just under the skin (subcutaneous) are easily detectable and can be felt (palpable). The nature and size of a cyst is important. The exact nature and size of a cyst can be determined or approximated by imaging techniques.

Cysts found inside organs will need imaging techniques to view them. Imaging techniques are x-ray, ultrasound (US), magnetic resonance imaging and (MRI). All imaging techniques are expensive and involve expensive equipment. Patient preparation will be required for imaging using US and MRI. X-ray generally does not require prior patient preparation.

Please note: In another blog managed by us, Dr Mohamed Tahir had written about cysts due to pork tapeworms.

Prof Faridah

How beneficial is the citrus?

What studies say
Scientific studies indicate compounds in citrus, including lemon, have real potential as anti-cancer agents. Studies have indicated that citrus limonoids do have potential as anti-cancer agents.

Grey areas
However, it is not yet clear exactly HOW effective citrus will ultimately prove to be in preventing or fighting against cancer in humans. It is PREMATURE and INACCURATE to claim that lemon is a "proven remedy against cancers of all types." Nor, at this point, can it be said that lemon is a viable alternative to traditional treatments such as chemotherapy. But lemon, like other kinds of citrus is likely to be a healthy addition to your diet and may even reduce the risk of cancer. However, these findings do not give validity to the exaggerated and unsupported claims made wrt lemons so far. To be useful, health advice needs to be valid, accurate and be supported by credible medical sources. Sending on spurious health information is unlikely to be beneficial.

Research results we have so far
A number of studies have indicated that compounds found in citrus (including lemon) may be effective as anti-cancer agents, at least for certain types of cancer. A December 2004 Science Daily article reports:
Research by Texas Agriculture Experiment Station scientists has shown that citrus compounds called limonoids targeted and stopped neuroblastoma cells in the lab. They now hope to learn the reasons for the stop-action behavior and eventually try the citrus concoction in humans. [......]

Harris explained that flavonoids and limonoids – nutrient-packed pigments that give color and taste to fruit – may work against cancer in any of three ways: prevent it from forming, slow the growth of existing cancer, or kill cancer cells.

"The limonoids, which differ structurally from flavonoids, seem to do all three," he said of tests in his lab by one of Patil's graduate students, Shibu Poulose, who also worked in Harris' College Station lab. Their work emphasized the compounds' ability to kill the existing neuroblastoma cells with the rationale that if the method and time limonoids take to obliterate the cancer could be found, perhaps scientists could exploit it to help cure the disease.
A May 2000 report about the potential of citrus limonoids as anticancer agents explains:
The experimental results described above indicate that citrus limonoids may provide substantial anticancer actions. The compounds have been shown to be free of toxic effects in animal models so potential exists for use of limonoids against human cancer in either the natural fruit , in citrus fortified with limonoids, or in purified forms of specific limonoids . Although the initial studies are very promising , they have been conducted primarily with in vitro cell culture and animal models. Thus , research is needed to determine whether the limonoids may be useful in preventing or treating cancer in humans .
And a report on the medicinal use of citrus published on the University of Florida EDIS website notes:
Citrus flavonoids have potential antioxidant (prevents aging), anti-cancer, antiviral, anti-inflammatory activities, effects on capillarity, and cholesterol-lowering ability. The principal carotenoids in pink grapefruit are lycopene and beta-carotene. Lycopene-containing fruits and vegetables have been shown to contribute to a significant reduction in prostate and mammary cancer risk. Recent studies have further shown that limonoids inhibit the development of cancer in laboratory animals and in human breast cancer cells as well as reducing cholesterol. Researchers have also suggested that, if ingested, limonoids may not be absorbed in the large intestine, and therefore could be distributed throughout the body, with beneficial effects.
 Source: http://www.hoax-slayer.com/lemon-cancer-cells.shtml


Out of Africa Theory and the Genographic Project

The Origin of Homo sapiens
Our human ancestor was the Prophet Adam (a.s.). From him grew all other humans. But where was Adam born? Where and when did he meet Eve (Hawa)? Who were his children? How did humans propagate?

Out of Africa Theory
Most scientists believe that humans came out of Africa, and hold on to the theory that human migrations resulted in the various populations we see today. Even our USM VC believes this is so, and celebrates the "Out of Africa Theory"
http://news.bbc.co.uk/2/hi/science/nature/7358868.stm

Out of Africa poster at USM Chancelory building in Penang.

How do we detect human migrations and determine where people moved?
In determining human migration routes, the Y-chromosome is matched for similarities of a person's SNPs (short nucleotide polymorphism) with those of his likely ancestors. In this way, males who have been tested can safely say that they are Indian, Arab or belong to other ethnic group and their position in the evolutionary migration tree can be pinpointed. Critics have been quick to lash such testing and considered them as nothing more than a waste of money and creating cultural tensions.

How did early humans get along?
Did we get along fine as humans? Did we fight till death? Or did we love each other and went on with breeding, creating more new humans? Did the black African male population expand and killed all other men, causing an extinction the white Neanderthal man? Is the black African man more skillful than the white Neanderthal man for survival outside of Africa?

Who is more fit and brighter?
Is the black African man brighter than the white Neanderthal man? Haven't genes got to do with intelligence?

Sources:
http://en.wikipedia.org/wiki/Genographic_Project 
http://www.hotspotsz.com/New_twist_on_out-of-Africa_theory
http://mathildasanthropologyblog.wordpress.com/neanderthal

Prof Faridah


Monday 11 July 2011

PubMed and NLM

Please take note that most journal articles of interest to medicine can be searched and found online. There are keyword searches and other types of searches. Books can be found in other databases.

  1. PubMed - Wikipedia, the free encyclopedia


    en.wikipedia.org/wiki/PubMed - CachedSimilar
    The United States National Library of Medicine (NLM) at the National Institutes of Health .... NCBI. 2011. http://www.ncbi.nlm.nih.gov/nlmcatalog/journals. ...
  2. National Library of Medicine (NLM) < National Institutes of Health ...


    dir.yahoo.com/...nih_/national_library_of_medicine__nlm_/ - CachedSimilar
    Learn about the National Library of Medicine (NLM), the world's largest medical library operated by the U.S. federal government for both the public and health ... www.nlm.nih.gov; National Center for Biotechnology Information (NCBI) ...

    The NCBI and the NLM are under the NIH in Maryland.

    1.      U.S. National Center for Biotechnology Information (NCBI) http://www.ncbi.nlm.nih.gov
    2.      U.S. National Library of Medicine (NLM), 8600 Rockville Pike, Bethesda MD, 20894 USA. http://www.nlm.nih.gov/
    3.      U.S. National Institutes of Health (NIH). http://www.nih.gov/

Thursday 7 July 2011

The Killings

Is killing legal?

Is taking leave off work legal?

Must we strictly follow?

Everyday and every minute, someone is killed by more than one means. Babies are found dead in wastebins, and in waterways (rivers and large monsoon drains). Who killed such babies? Their unwedded parents.

Who must look after the babies born to women who choose prostitution as a livelihood? We allow prostitution of various forms, so we tend to get weird unexplained cases of baby dumping. Is psychology to blame and psychiatry to treat society's ills?

We had heard about parents putting their tiny babies in the microwave oven and cooking their little ones alive like for Christmas Eve dinner! Why?

We have heard maids killing the families' babies.

We know nowadays parents kill children and children also kill their parents and siblings. Why?

What has happened to our society? What are the causes of such bizarre behaviours? Why did they occur?

Amok (from mengamuk) refers to a man going off tangent and acting bizare.

Suicide is high among university students. Why?

Even fathers do set their wives and children on fire while they are fast asleep. Sleep is no longer safe, what is? Why?

Why have we become a cruel and brutal hostile family member? Who will blame whom?

To go back to what we were like before Merdeka is like telling us "go ride your bike to the moon!"

When will we ever stop learning? Does learning ever end?

Friday 1 July 2011

Pre-implantation Genetic Diagnosis (PGD)

"Death is not the opposite of life. Life has no opposite. The opposite of death is birth. Life is eternal."
~Eckhart Tolle

Since nobody or no parent wants a defective child, how do we obtain 100% perfect babies? By doing pre-implantation genetic diagnosis (PGD). It means we carefully plan which genes should go into a baby which we researchers will design for a couple, so that the newborn designer baby becomes the source of cure for its own older siblings. In designing babies, we are actually selecting good genes which do not have any defects, so that the newborns are supposedly healthy and normal, not sick or with the same genetic disease(s) of their siblings.

We have a big problem with patients suffering from various difficult-to-cure diseases and the potential of research which we can do to help such patients. Since Watson and Crick first built their double-stranded helix DNA model in 1953, we are plunged into deeper and bigger grey areas where ethics rules all judgment and we still have conscience about trespassing them when we know about the potential of DNA and stem cell for curing such difficult hard-to-cure diseases caused by DNA mutations which are life-long and without a simple straight forward cure at this time. We may think we live in a first world, or even a make-belief first world, but when we have a life-long disease at hand to worry about its cure or find a cure, then we have to know whether to pitch on safe grounds or pitch in the grey zone and wait for the critics to lash their laser-sharp tongues! Researchers and medical students alike must know what is right and what is wrong in medical practice and research concerning such issues, and be able to weigh the benefits of what critics consider bad against what researchers  consider "not too bad", "may work somewhat", or "could work and then fail but worth trying".

A good example of tough decision-making is to consider "designer babies", a term favourably used to describe how babies are precisely designed and engineered in the research lab, so as not to contain genetic errors, so that these babies can become "saviour babies" when they are born. Their cord blood is highly prized for harvesting stem cells for use in curing hard-to-cure life-long diseases of their own older siblings who are still toddlers or pre-schoolers. Is designing such babies ethically right or wrong? Are doctors and researchers wrong and must they be held accountable if they try to find a cure for the impossible? Blunders are synonymous with research. Two patients who received genetic therapy died from leukaemia. Whom do we blame? The doctors & researchers who intervened, the patients or their parents? Since we can't depend on gene therapy, the only avenue we have now is stem cell extracted from cord blood of designer babies and from the bone marrow of the long bones. What are the long bones in our body? How are stem cells extracted from the bone marrow?

An analogy is we didn't have penicillin prior to WWII. Was it fortuitous to discover this drug? If we don't try, we will never know the worth of a cure for any difficult disease. It is therefore best to leave such delicate decision-making in the hands of experts. This means experts must also have at least some basic knowledge before they can make a good decision.

As a researcher, I would like to qualify that there must be an active watch dog committee that truly understands and studies every decision that researchers and scientists do today. The grey zone in this type of research is merging and overlapping with clear areas and can possibly turn what is already clearly wrong to be the best research option we have and therefore the right thing to do, and the next course of action. Blinding the lay public must never be allowed loose. The public must know what research is trying to do and achieve. New medical students must know. Issues in medical research today are life-and-death issues. Diseases today are life-threatening and life-long but the cures are hidden somewhere on earth. Too many people suffer and die in sheer agony when we try to slow down research as we allow such ethical issues to be ironed out in our courts. Stem cells have helped overcome diseased blood vessels. Next in the pipeline is stem cells for glaucoma, in trying to stem blindness.

Prof Faridah

Viewpoints on PGD from fiqhmedic.wordpress.com. Covers "hukum".