The Malaysia DREEM: perceptions of medical students about the learning environment in a medical school in Malaysia Redhwan A Al-Naggar,1 Mahfoudh Abdulghani,2,14 Muhamed T Osman,3 Waqar Al-Kubaisy,1 Aqil Mohammad Daher,15 Khairun Nain Bin Nor Aripin,4 Ali Assabri,5 Dawood A Al-Hidabi,6 Mohamed Izham B Mohamed Ibrahim,7 Ahmed Al-Rofaai,8 Hisham S Ibrahim,9 Hassanain Al-Talib,10 Alyaa Al-Khateeb,11 Gamil Qasem Othman,6 Qaid Ali Abdulaziz,6 Karuthan Chinna,12 Yuri V Bobryshev131Population Health and Preventive Medicine Department, Faculty of Medicine, Universiti Teknologi MARA, 2Pharmacology Department, International Medical School, Management and Science University, 3Department of Pathology, Faculty of Medicine & Defence Health, National Defence University of Malaysia, Kuala Lumpur, Malaysia, 4Faculty of Medicine and Health Sciences, Islamic Science University of Malaysia, Kuala Lumpur, Malaysia; 5Community Medicine Department, Faculty of Medicine and Health Science, Sana'a University, 6University of Science and Technology, Sana'a, Yemen; 7College of Pharmacy, Qatar University, Doha, Qatar; 8School of Biological Sciences, Universiti Sains Malaysia, Minden, Penang, Malaysia, 9Physiology Discipline-Faculty Of Medicine and Health Sciences-Universiti Sultan Zainal Abidin, Terengganu, Malaysia, 10Laboratory Medical Science Cluster, Drug Discovery & Health Community of Research, Faculty of Medicine, Universiti Teknologi MARA, 11Biochemistry and Molecular Medicine Discipline, Drug Discovery & Health Community of Research, Faculty of Medicine, Universiti Teknologi MARA, 12Social and Preventive Medicine, University Malaya, Kuala Lumpur, Malaysia; 13Faculty of Medicine, School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia; 14Pharmacology Department, Unaizah College of Pharmacy (UCP), Qassim University, Al Qassim, Saudi Arabia; 15Department of Community medicine, Faculty of Medicine & Defence Health, National Defence University of Malaysia, Kuala Lumpur, MalaysiaBackground: Students’ perceptions of their learning environment, by defining its strengths and weaknesses, are important for continuous improvement of the educational environments and curriculum. Therefore, the aim of this study was to explore students' perceptions of their learning environment, among medical students in Malaysia. Various aspects of the education environment were compared between year levels and sex.Methods: This cross-sectional study was conducted at the Management and Science University, Shah Alam, Malaysia in 2012. A total number of 438 medical students participated in this study, and the response rate was 87.6%. Data were analyzed using SPSS. Comparisons of the mean scores of Dundee Ready Education Environment Measure (DREEM) subscales were calculated. The t-test was used to determine statistically significant differences.Results: The majority of the study participants were female, Malay, and from year 3 (68.7%, 65.3%, and 55.7%; respectively). Analysis of each of the 50 items of the DREEM inventory showed that 47 items scored ranged between 2.00 and 3.00, and three items scored below 2.00. These were identified as problem areas in this medical school that are required to be critically addressed. The overall score showed that the medical students’ perceptions were positive. The students' perception toward educational environment was positive for all five DREEM subscales.Conclusion: The study found that, in general, the perceptions of the participants about the learning environment were positive. Nevertheless, the study also found there is a need for curriculum improvement in this school and identified priority areas for such improvement.Keywords: students’ perceptions, DREEM, Malaysia, learning environment, medical education

Introduction: Psilocybin mushroom use is well documented in spiritual and religious ceremonies globally. This drug is now the most popular in Europe and the USA. Objective: The objective of this study is to explore the experiences and effects of psilocybin on patients with depression and anxiety. Method: A qualitative study was conducted interviewing ten participants currently taking psilocybin while experiencing depression and/or anxiety. Ethical approval was obtained from the University ethics committee. Participants were recruited via social media and groups are known to have used psilocybin for the treatment of anxiety and/or depression. Participants were informed of study aims and consent was obtained before interviews commenced. Confidentiality was maintained throughout this study. Interviews began with informing participants that psilocybin may be effective in the management of depression. Initially, information around the way treatment with psilocybin was obtained was sought. This was followed by queries around the effects of the drug in terms of experiences both during and after treatment. Finally, participants were asked to outline the positive effects of psilocybin on their lives. Results: The data were thematically coded using Grounded Theory as an underpinning philosophical paradigm. Emerging themes included enhancement of smell, vision, hearing, and taste sensations. Another theme emerging was the experience of being ‘connected with the universe’ while on the drug. Additionally, participants reported a stabilization of mood, an increase in optimism and emotional control, and a healthier emotional connection with others. Most also felt an increase in comfort, peace and calmness. Another theme that emerged centered on the mechanism of action of psilocybin. Participants stated that this substance seemed to ‘make new connections in their brain,’ resulting in new perspectives. Some participants felt this resulted in a calming influence on the mind and body. This aligns with research showing that psilocybin works by changing the thinking and improving information processing. Conclusion: Psilocybin has promising effects on the patients with depression/anxiety even after a single dose. Psilocybin is safe but the administration should be guided by a health professional to yield safe and positive outcomes.

Background. According to the WHO, glaucoma is the second leading cause of blindness worldwide. About 50% of the world’s glaucoma cases come from the Asian population, and in Malaysia itself, the prevalence of glaucoma is increasing. However, glaucoma is still a foreign word to our community despite the high prevalence. Therefore, there is an urgent need to determine the awareness of glaucoma among the community and its associated factors. Results. This study showed that only 25.2% of our respondents were aware of glaucoma and it is associated with ethnicity, religion, education, and household income. Besides, among those who were aware, they fall into the group of poor knowledge of glaucoma. On the other hand, the knowledge of glaucoma was associated with occupation and the awareness of glaucoma by definition. The validated questionnaire was distributed and the data were analyzed by SPSS software using t-test, one-way ANOVA, and chi-square test. Conclusion. Awareness and knowledge of glaucoma in this population is low. These findings suggest that there is a need for an efficient information and education strategy to be designed and conducted to increase the awareness and knowledge of glaucoma so that early detection can be made and effective management of individuals with this condition can be delivered.

Leptin has important roles in numerous physiological functions, including those in the regulation of energy balance, and in immune and reproductive systems. However, in the recent years, evidence has implicated it in a number of obesity-related diseases, where its concentrations in serum are significantly elevated. Elevated serum leptin concentrations and increased placental leptin secretion have been reported in women with hypertensive disorders of pregnancy. Whether leptin is responsible for this disorder remains to be established. Leptin injections in healthy rats and mice during pregnancy result in endothelial activation, increased blood pressure and proteinuria. A potential role for leptin in the pathogenesis of pre-eclampsia is hypothesised, particularly in women who are overweight or obese where serum leptin concentrations are often elevated. This review summarises pertinent information in the literature on the role of leptin in puberty, pregnancy, and hypertensive disorders of pregnancy. In particular, the possible mechanism that may be involved in leptin-induced increase in blood pressure and proteinuria during pregnancy and the potential role of marinobufagenin in this disease entity. We hypothesise a significant role for oxidative stress in this, and propose a conceptual framework on the events that lead to endothelial activation, raised blood pressure and proteinuria following leptin administration.

This study investigated the effects of Isoliquiritigenin (ISL) on adiposity in Wistar rats fed a high-fat diet (HFD), positing that ISL mitigates adiposity by inhibiting adipogenesis and promoting lipolysis via AMPK activation. Adult male Wistar rats were divided into six groups (n=8): Control (vehicle), Control + ISL (40 mg/kg), HFD (vehicle), HFD + ISL (20 mg/kg), HFD + ISL (40 mg/kg), and HFD + ISL (40 mg/kg) + Dorsomorphin (0.2 mg/kg) for 12 weeks. In a dose-dependent manner, ISL (thrice a week) significantly attenuated the increase in body weight and adipocyte size, improving glucose and insulin tolerance, HbA1c, and HOMA-IR without affecting food intake in HFD rats. Particularly, the higher dose of ISL (40 mg/kg) significantly increased the phosphorylation of AMPK (+193.3%), resulting in a p-AMPK/AMPK activity ratio increase of 191.0% in the white adipose tissue (WAT) of HFD rats. This dose also reduces body weight (24.6%), weight gain (28.7), fat deposit weight (-39.2% %), HOMA-IR (-67.62%), and serum triglycerides (-62.4%), cholesterol (56.7%), IL-6 (-66.1%) and TNF-α (-79.5%) in these HFD rats. It also increased p-ACC levels (+86.7%), Nrf2 mRNA (+392.7%), and PPARα mRNA (+255.0%), as well as the levels of HSL (+149.7%) and ATGL (139.62%). ISL (40 mg/kg) also decreased WAT levels of IL-6 (-57.86%), TNF-α (-74.96%), mRNA of SREBP1 (-38/8%), FAS (-50%) and NF-kB (58.8%), and levels of PLIN1 (-50.1) in these HFD rats. Dorsomorphin treatment reversed these effects in ISL + HFD rats. In conclusion, ISL demonstrates anti-obesity effects in HFD-induced rats through AMPK activation.