MASH Journal Volume 8 Issue I

March 2023
Tuberculoma In A Healthcare Worker
Teo Kye Vonn, Nur Adlina, Ng Tyng Sam

Tuberculosis (TB) is an endemic and a public health concern around the world. It commonly affects the lungs, however it can affect other organs, which known as extrapulmonary tuberculosis. Extrapulmonary TB occurs in around 10-15% of all TB cases. Central nervous system (CNS) TB is one of the severe types of extrapulmonary TB, accounts for around 1% of TB cases. It resulted from Mycobacterium tuberculosis (MTB) spread via hematogenous to intracranial. Tuberculoma is around 0.2% of all biopsies brain masses.

Keningau Weave Technique: A modification Of The Japanese “Himawari” Method For Comminuted Patella Fixation
Eyrique G, Jeremy SV, Vickneshan S, Amir R, Looi C

Severely comminuted patella fractures deemed unsalvageable have traditionally been treated with patellectomies. This procedure significantly reduces the mechanical advantage the patella provides to the quadriceps for knee extension resulting in significant morbidity. The ‘Himawari Method’ developed in Japan has significantly reduced the need to resort to patellectomies. However, this procedure requires the use of expensive locking sleeves to be successful. The modified technique illustrated here excluded the need for the locking sleeves by weaving cerclage wires around multiple longitudinal k-wires creating an anterior cage over the patella. With the addition of a tension relieving wire, the efficacy of the modified procedure as the patient achieved fracture union with full range of motion at 12 weeks can be demonstrated. Outcome evaluated utilizing the patellar-femoral instability scorings, Favourable Kujala patellar instability scores & Oxford knee score were noted a year post-intervention.

A Brief Review of the Evolutionary Thought and Etiology of the Stomach Disorders with Prevention
Ashraful Kabir

The stomach of animals plays a significant role throughout life. After taking food, the nutrients of those foods maintain all biological processes. The stomach is a reservoir for storing food for several hours. If digestion within the stomach hampers, the entire body will undergo many ailments. Evolutionary changes in the stomach of various animals (herbivores, carnivores, and omnivores) to understand the quality or nature of the stomach based on their food. Based on some articles, oral communication, and an effective questionnaire proved that in a northern region of Bangladesh (Saidpur town under Nilphamari District), out of 60 families, 85% of family members were affected by acidity problems where 37% of college students (17-19 years) due to their excess taking of oily and spicy foods. On the other hand, their regular food intake showed 80% acidic, 7.5% neutral, and 12.5% alkaline food.

A Review of the Genetic Link Between Overweight and Extreme Obesity
Ashraful Kabir

In the present context of the world, obesity is increasing and creating life-threatening diseases in the human body. Everybody whether they are children or adults needs to be more conscious of this issue. Obesity comes from being overweight is nothing but the imbalance of energy within the body. Lots of published articles on the internet prove that obesity either genetic or acquired possible to overcome through diet and exercise according to the guidelines of such experts. Since morbid obesity (obese III) is rare in the world and in few cases, they need to attach surgery. When we take improper food in our usual daily foods, our bodily metabolic functions could be hampered, and finally first overweight then obesity persists. Nutrients of healthy food and physical activities those will burn extra calories are a must for maintaining a healthy life.

Does Peer Pressure and Time Management Play a Role in Academic Stress Among Medical Students?
Lee Yun Shuang, Muhammad Azhar bin Suffian, Kenley Ong Khang Yee, Yogarooban a/l Sreethar, Khine Lynn Phyu, Mila Nu Nu Htay, Soe Moe, Htoo Htoo Kyaw Soe

Academic stress refers to the physical and mental responses of students to academic challenges that are beyond their ability to cope. It can result in significant stress levels and anxiety, especially during exams and other assessments. A study was conducted on undergraduate medical students at Manipal University College Malaysia to investigate the relationship between peer pressure, time management, and academic stress. A total of 130 responses were collected via questionnaires distributed through social media and the data was analysed using Epi Info software. The results showed medical students experienced slightly higher levels of academic stress due to factors such as study pressure, workload, worrying about grades, and self-expectation. However, they experienced slightly lower levels of academic stress due to despondency. Our study also revealed a significant association between peer pressure and academic stress caused by despondency but no significant difference between time management and academic stress. Among the demographic variables, family income is found to be significantly associated with academic stress due to self-expectation and worrying about grades. In conclusion, medical students experienced moderate level of academic stress across all sources of stress. Academic stress among medical students can be caused by factors such as peer pressure and poor time management skills. Effective time managementabilities can aid students in managing their academic responsibilities and decreasing academic stress.

Correlation Between Health Beliefs And Lifestyle Among Medical Students In Malaysia: A Cross-Sectional Study
Bhargavi a/p Visualingam, Chong Guang Wen, Tharani R Mohan, Abhiraami Sathasivam, Hansika Gamage, Htoo Htoo Kyaw Soe, Soe Moe, Khatijah Taharah Mohamed Shah, Mila Nu Nu Htay

In student population, physical activity, dietary pattern, stress, screen time are intertwined to achieve a healthy lifestyle. Therefore, this study aimed to investigate the health beliefs, lifestyle, and dietary habits among the medical student population. This cross-sectional study was conducted by recruiting medical students from a private medical university with purposive sampling. Demographic characteristics, health belief model and lifestyle information were collected by using Google form. Data was analyzed by descriptive statistics, unpaired t-test, one-way ANOVA by using Epi info software (Version 7). A total of 160 students responded to this study.  Age of the respondents was significantly associated with nutritional confidence (P=0.033) and barrier (P=0.032) domains of health belief. While gender was significantly associated with barriers (P=0.041) and behavioral intention to do physical activity (P=0.018). Academic year was found to be associated with susceptibility domain (P=0.013) of health belief. Gender was significantly associated with the physical health and exercise (P<0.001) and psychological health (P=0.012) domains. Age was significantly associated with accident prevention domain (P=0.013). While BMI was significantly associated with physical health and exercises (P=0.001). Academic year was significantly associated with social concern (P=0.028) and sense of purpose (P=0.009) domains. Health beliefs among respondents were correlated with the nutritional and physical activity in their daily lifestyle. Especially having nutritional confidence, knowing the benefits of a healthy diet, behavioral intention to eat healthy food and to do physical activity were significantly correlated with the respondent’s nutrition intake and physical activities. Educational interventions and activities such as talks, trainings related to adopting healthy and active lifestyles could help the medical students in attaining a better lifestyle habit.


Trauma is one of the leading cause of death in the world among young and middle aged people1. Currently in the damage control resuscitation suite of emergency department Selayang Hospital, a CT Selayang Trauma Alert Diagnostic (STAD) protocol was introduced as the gold standard Whole Body CT scan diagnostic work-up to identify hidden injuries, grade injuries and recognize the source of bleed being arterial or venous in origin in major trauma patients. Early and accurate detection of organ injuries, grading the injuries and recognizing its origin in patients presenting with poly trauma to the Emergency Department can change the direction of care from operative to conservative3.

Encounter With An Obstructed Duodeno-Jejunal Flexure Tumour In An Emergency Setting, A Surgeons Dilemma: A Case Report
Chiew Junloong, Sekkapan Thannimalai Sambanthan, Nik Ritza Kosai & Soma Bala Ganapathy

The anatomy of the duodenum is complex, and tumours arising from it are rare even among small bowel tumours, with DJ flexure tumours being very uncommon in the entire gastrointestinal system. They usually present with vague symptoms and is of a unique challenge to surgeons for resection. We present a case report of a 41-year-old gentleman with an obstructed DJ flexure tumour encountered in an emergency setting and its challenges to the operative surgeon.

What Are The Attributes Among Malaysian Medical Students Towards Migrating Abroad? A Cross-Sectional Study
Fathima Nashfa, Ruhashini Chanla, Saranya Saghadevan, Udila Helitha Attygalle, Mila Nu Nu Htay, Soe Moe, Htoo Htoo Kyaw Soe

Brain drain of healthcare professionals is a global pandemic that equally affects Malaysia. Due to multiple ‘push factors’ in Malaysia and multiple ‘pull factors’ in the source country Malaysia is losing qualified doctors at an increasing rate. The study aims to determine the intention and attributes of Malaysian medical students towards migrating abroad. A cross sectional analytical study was carried out from August 2021 to October 2021 involving the medical students of Manipal University College Malaysia (MUCM), Malaysia. Purposeful sampling was applied in the selection of eligible participants. The total number of participants recruited was 168, majority form the clinical batches. Among the participants, 45.24% had a positive intention to migrate abroad, 19.64% did not want to migrate, while 35.41% were undecided. The significant ‘pull factors’ for migration were better quality of health care system and better quality of postgraduate education abroad. The significant ‘push factors’ were peer and family pressure and an unsatisfactory political system at home country. Females were significantly more interested in migrating abroad than males. As brain drain can bring about a negative impact on home country in all spheres, it is vital that the country takes active efforts to minimize the contributory causes and provide incentives that ensure satisfactory work environment for the medical doctors.

EUS-guided Gastrojejunostomy - A Novel Approach
Nicholas Heng Ee Zhing, Tan Sze Hao, Andre Ng Wen Hao and Glenn George Koleth

Endoscopic ultrasound-guided (EUS) gastrointestinal procedures have now been a novel approach to manage complications arising from gastrointestinal malignancy owing to its lower morbidity and mortality rate compared to surgical approach. We present a case of EUS-guided gastrojejunostomy for a patient with advanced pancreatic carcinoma with duodenal obstruction with distant metastasis.

MASH Journal Volume 8 Issue 2

September 2023
Effectiveness of Video-Based Learning on Students’ Memory: A Randomized Controlled Trial
Hathush Nehan Robert, Yaashiyni a/p Vejanthern, Samindi Navanchana Fernando, Kishanthini a/p Viswanaathan, Erick Tan Yan Jin, Soe Moe , Mila Nu Nu Htay, Htoo Htoo Kyaw Soe

In 1993 Rauscher et al. discovered that after listening to Mozart’s sonata for a short period of time, participants showed significantly better spatial reasoning skills. Since then, the Mozart effect has become widely used especially among students. The purpose of this study was to determine the impact of Mozart effect on short term emotional intelligence among undergraduate medical students. This study was a pilot randomized controlled trial conducted among batch 45 undergraduate medical students in a private medical university in Malaysia. Participants were divided into control (n=20) and intervention (n=20) group by block stratified randomization. A piece from Mozart Sonata for two Pianos in D, K.448 was played for 15 minutes and was given a content validated, self-developed questionnaire for the intervention group whereas only the self-developed questionnaire was given to the control group (no preceding music was played). The data analyzed by using unpaired t-test, mean, standard deviation and mean difference was calculated. The level of significance was set at P<0.05. Our research was divided to four main domains under emotional intelligence. First domain; emotionality was assessed using four questions and a mean (SD) of 13.90 (4.13) for intervention group and 11.35 (2.76) for control group was obtained (p= 0.027). The second domain; self- control was assessed by two questions and a mean (SD) of 8.00 (1.81) for the intervention group and 6.55 (1.79) for the control group (p= 0.016). The third domain; sociability was assessed by four questions and a mean (SD) of 14.80 (3.93) for the intervention group and 13.05 (2.99) for the control group (p= 0.121). The fourth domain; wellbeing was assessed by five questions and a mean (SD) of 19,9 (4.35) for the intervention group and 17.6 (3.68) for the control group (p= 0.079). The result of our study is in alignment with prior research that had been done in South Africa whereby the outlook, emotionality, and self -discipline of high school students were improved due to music involvement.

The Mozart Effect On The Short-Term Emotional Intelligence Status Among Medical Students In Manipal University College Malaysia: A Pilot Randomized Controlled Trial
Sindhiya Devi Anbananthan, Rheanogha Subramaniam, Shantinni Devi Subramaniam, Magalle Hewa Jayasundara Samadhi Divyangana, Kaleswar Mogan, Htoo Htoo Kyaw Soe , Soe Moe, Htay Lwin, Mila Nu Nu Htay

Along with the technological development, the use of video-based learning has increased rapidly in the higher education sector. This study aimed to assess the effectiveness of video-based learning on medical students’ memory while comparing with the effectiveness of text-based learning. A randomized controlled trial was performed in a private medical university in Malaysia by recruiting 40 medical students. The sample was randomized as block randomization. The intervention group was shown a video on DNA Fingerprinting and were given a questionnaire to assess the memory, concentration, satisfaction, and performance. The control group was given a text on the same topic which was followed by a questionnaire to assess the memory, concentration, satisfaction, and performance. All statistical tests were seen at two-tailed level of level of significance (p<0.05). The mean score percentage of the video-based learning was 74.5 whereas the text-based learning had a mean score percentage of 78.0. The text-based group scored more than the video-based group (mean score difference = 3.5±16.45, 95% CI = -7.93, 14.93, p= 0.538). The concentration was measured using a Likert scale and both the intervention and control group gave a score of 4. The study showed that the participants preferred video-based learning for future use. In conclusion, the video-based intervention learning was more preferred method than text-based learning although the mean score percentage was lower in the intervention group.

Case Report Of Secondary Nasopharyngeal Tuberculosis
Lyon Ian Bing Huong, Strahan Zhi Hui Teoh

Nasopharyngeal tuberculosis is a rare entity among the extrapulmonary manifestation of tuberculosis infection. It can be challenging to diagnose as it can mimics malignancy it when endoscopic examination shows left fossa of Rosenmuller mass. It presents as nasopharyngeal mass mimicking nasopharyngeal carcinoma.

Here we report a case of secondary nasopharyngeal tuberculosis with laryngeal, trachea-bronchial tree, pulmonary and cervical nodal involvement is reported.

Prompt diagnosis can bewas achieved with combination of endoscopic, bacteriological and imaging investigations.

Good treatment outcome wasis achieved with following 9 months of anti-tubercular medications.

Effect of Blackcurrant Juice on Perceived Stress and Mood among Medical Students - A Randomized Controlled Trial
Chean Ker Xin, Deveshwar a/l Raja Mohan, Dharishini a/p Parameswaren, Lithma Thamadhi De Silva, Mila Nu Nu Htay , Soe Moe, Htoo Htoo Kyaw Soe, Kazi Majidur Rahaman,

The high polyphenol content in blackcurrants is the most important component which makes it favorable for better mood enhancement and reduce perceived stress among medical students. There are a few randomized trials indicating that blackcurrant juice has a positive effect on mood. However, there are limited evidence showing that blackcurrant juice plays a role in reducing perceived stress. This pilot study utilized a randomized, single blind and placebo-controlled design to find out the effect of blackcurrant juice on mood and perceived stress. A total of 65 medical students were randomized into the intervention group (n=32) where they received blackcurrant juice for three consecutive days and into the control group (n=33) where they received placebo for three consecutive days as well. Evaluation of mood and perceived stress was done after three days by using Bond-Lader visual Analogue Scale, Positive and Negative Affect Schedule (PANAS), and Perceived Stress Scale (PSS). Results show the blackcurrant group had a higher score in terms of calmness in subjective mood, as measured by the Bond-Lader Visual Analogue Scale at post-intervention [mean difference 8.60; 95% CI 0.25 to 16.95; P=0.044]. However, there was no significant difference between the groups with regards to positive and negative affect of mood, alertness and contentment of subjective mood, and perceived stress, as measured by the PANAS and perceived stress scale at post-intervention. When comparing the baseline and post-intervention, participants in the group receiving blackcurrant juice showed significant difference in mood based on the Bond-Lader Visual Analogue Scale and perceived stress. Around 15.6% of blackcurrant juice group had the side effects such as gas/bleaching. In a nutshell, blackcurrant juice poses a good effect on the overall mood and perceived stress.