Repository@USM
Welcome to closed access digital repository of Universiti Sains Malaysia (USM).
This repository contains multiple types of scholarly materials, especially USM theses and exam papers.
To access the full text, please log in with your USM email account.
Research outputs
6288
Projects
0
People
0
Recent Additions
- PublicationFactors associated with non-initiation of tuberculosis preventive treatment among latent tuberculosis infection cases in Negeri Sembilan from 2022-2024(2025-06)Background: Tuberculosis Preventive Treatment (TPT) is essential in reducing the risk of progression from latent tuberculosis infection (LTBI) to active disease. However, the factors associated with the non-initiation of TPT have not been explored thoroughly. Objective: This study aimed to determine the proportion of LTBI patients who did not initiate TPT and to identify factors associated with non-initiation in Negeri Sembilan between 2022 and 2024. Methodology: A retrospective cross-sectional study was conducted involving 757 LTBI cases reported from January 2022 to December 2024. Data were extracted from the National Tuberculosis Registry system using a universal sampling method and analysed with SPSS software. Univariable and multivariable logistic regression analyses were performed to determine the factors significantly associated with non-initiation of TPT. Results: Overall, 9.3% of patients did not initiate TPT. Occupation emerged as a significant predictor; the “unemployed young” group (comprising students and children under five) had significantly higher odds of non-initiation compared to professionals (aOR = 3.52; 95% CI: 1.35,9.16; p = 0.010). The district of residence was also influential, with patients from Tampin having five times the odds of not initiating TPT compared to those from Seremban (aOR = 5.12; 95% CI: 2.59,10.11; p < 0.01), while residence in Jempol had lower odds (aOR = 0.10; 95% CI: 0.01,0.74; p = 0.024). In addition, foreign nationals were significantly more likely not to initiate treatment compared to Malaysian citizens (aOR = 3.83; 95% CI:1.65,8.85; p = 0.020). Conclusion: Occupation, nationality, and geographical location significantly influence the initiation of TPT among LTBI patients in Negeri Sembilan. These findings highlight the importance of centralised LTBI care, robust follow-up mechanisms, and tailored health education efforts to improve treatment uptake especially among high-risk group such as people living with HIV (PLHIV), contact of TB index cases, healthcare worker, prisoners and residents of nursing home.
- PublicationKnowledge, attitude, and practice of telemedicine among attendees in outpatient clinics at Hospital Pakar USM Kelantan(2025-06)Introduction: Telemedicine has become an increasingly important modality in delivering healthcare services, especially in the post COVID-19 era. Despite growing uptake, limited data exist on patient knowledge, attitudes, and behaviors regarding telemedicine use in public tertiary hospitals in East Coast Malaysia. Objective: This study aimed to determine the prevalence of good knowledge, attitude, and practice (KAP) and to identify associated factors toward telemedicine among outpatient clinic attendees at Hospital Pakar USM Kelantan. Methodology: A cross-sectional study was conducted between October 2024 and June 2025 involving 255 participants, systematically sampled from four outpatient clinics. A previously validated Bahasa Malaysia KAP instrument was used to assess telemedicine-related knowledge, attitude and practice. Data were analyzed descriptively and using multivariable logistic regression. Results: A total of 255 participants from outpatient clinics at Hospital Pakar USM were included in the study. The prevalence of good knowledge, attitude, and practice toward telemedicine was 60.4%, 75.7%, and 52.2% respectively. Telemedicine practice was reported by only 52.2% of participants, despite generally high knowledge and positive attitudes. Multivariable logistic regression revealed that younger age (AOR = 0.95, 95% CI: 0.96–0.98, p < 0.05), being married (AOR = 2.86, 95% CI: 1.34–6.24, p < 0.05), and having a history of telemedicine use (AOR = 2.82, 95% CI: 1.27–6.98, p < 0.05) were significantly associated with good knowledge of telemedicine. Younger age (AOR = 0.95, 95% CI: 0.92–0.97, p < 0.05) and being married (AOR = 3.69, 95% CI: 1.51–9.34, p < 0.05) were significantly associated with good attitude. Meanwhile, younger age (AOR = 0.97, 95% CI: 0.95–0.99, p < 0.05) and a history of telemedicine use (AOR = 3.11, 95% CI: 1.42–7.43, p < 0.05) were significant predictors of good practice toward telemedicine. Conclusion: Although knowledge and attitude toward telemedicine were relatively high, findings highlight a moderate uptake gap, particularly among older and higher-income individuals. Interventions targeting digital literacy and guided exposure to telemedicine may help improve utilization in these subgroups. These findings can inform targeted components of Malaysia’s digital health roadmap, including integration into tele-primary care expansion and public hospital teleconsultation protocols. Given the single-center design and exclusion of acutely ill patients, findings may not fully represent the broader outpatient population in Malaysia.
- PublicationFactors associated with confirmed measles cases among notified measles of children in Perak 2017-2024(2025-06)Background: Measles is a highly contagious and vaccine preventable disease. It remains a significant public health concern globally, particularly among children, despite the availability of the vaccines. Thus, it is crucial to understand the associated factors of measles in children to strengthen the prevention strategies. Objective: This study aimed to determine the proportion and factors associated with confirmed measles cases among notified measles as well as to describe the clinical presentation of confirmed measles cases of children in Perak from 2017 to 2024. Methods: A cross-sectional study was conducted using secondary data extracted from the SM2 measles surveillance database of the Perak State Health Department for the years 2017 to 2024. Simple random sampling was applied to obtain the sample size of 498. The relevant data were collected by using proforma checklist. The data were analysed by using descriptive analysis, simple and multiple logistic regression analyses. Results: A total of 498 notified measles cases of children were included in the study. The proportion of confirmed measles cases among notified measles of children in Perak was 15.1% (CI: 12.0,18.2) and ranged from 2.9% to 29.2% per year throughout the year 2017 to 2024. Among the 75 confirmed measles cases in children, the most frequently reported clinical features were fever and maculopapular rash (98.7%) followed by cough (62.7%), coryza (57.3%) and conjunctivitis (22.7%). The significant factors associated with confirmed measles cases were ethnicity, measles vaccination status, history of contact with confirmed measles case and hospital admission. Orang Asli children had significantly greater odds of confirmed measles than other ethnic groups (Adj OR 3.37, 95% CI: 1.05,10.88, p-value 0.042). Incomplete and no vaccination were associated with higher odds of measles confirmation compared to complete vaccination (Adj OR 2.27, 95% CI: 1.09,4.71, p-value 0.028) and (Adj OR 3.42, 95% CI: 1.63,7.19, p-value 0.001) respectively. Contact with a confirmed measles case showed a strong association with confirmed measles (Adj OR 51.76, 95% CI: 11.25,238.21, p-value < 0.001), as did hospital admission (Adj OR 4.198, 95% CI: 1.51,11.65, p-value 0.006). Conclusion: Ethnicity, measles vaccination status, history of contact with confirmed measles case, and hospital admission were identified as significant factors associated with confirmed measles cases among notified measles of children in Perak from 2017 to 2024. These findings underscore the importance of formulating targeted public health interventions to enhance the effectiveness of measles prevention and control measures particularly among children.
- PublicationTrend and factors associated with stillbirth at Hospital Pakar Universiti Sains Malaysia (HPUSM) from 2019 to 2023(2025-06)Background: Stillbirth remains a major public health challenge, especially in low- and middle-income countries. Despite being a tertiary referral center, stillbirths continue to occur at Hospital Universiti Sains Malaysia (HPUSM), underscoring the need to identify preventable risk factors through focused investigation. Objective: This study aimed to describe the incidence rate trend of stillbirth and to determine the factors associated with stillbirth among deliveries at Hospital Universiti Sains Malaysia (HPUSM) from 2019 to 2023. Methodology: This was a case-control study using record review from the Department of Obstetrics and Gynaecology, Hospital Universiti Sains Malaysia (HPUSM), conducted between October 2023 and May 2024. Relevant data were collected using a standardized proforma and analysed using SPSS software version 29. The data were analysed using descriptive statistics, simple logistic regression, and multiple logistic regression. Results: A total of 46,012 deliveries were included for trend analysis, with the stillbirth incidence ranging from 5.06 to 7.24 per 1,000 births over the five-year period, showing a fluctuating trend. For the association analysis, 196 stillbirth and 268 randomly selected live birth were included. Multiple logistic regression analysis revealed that advanced maternal age (aOR = 1.11; 95% CI: 1.05, 1.18; p < 0.001) and abruptio placenta (aOR = 12.89; 95% CI: 1.55, 107.12; p = 0.018) were significantly associated with higher odds of stillbirth. Conversely, anemia (aOR = 0.34; 95% CI: 0.13, 0.91; p = 0.033), low birth weight (aOR = 0.28; 95% CI: 0.15, 0.55; p < 0.001), and lower gestational age (aOR = 0.66; 95% CI: 0.55, 0.79; p < 0.001) appeared as protective factors against stillbirth. Conclusion: Advanced maternal age, anemia, low birth weight, preterm delivery, and abruptio placenta were significantly associated with stillbirth. Strengthening antenatal surveillance and timely management of high-risk pregnancies are essential to reduce stillbirths and improve the quality of care at HPUSM.
- PublicationKnowledge, attitude, and determinants of sugar sweetened beverage consumption in Malaysia(2025-06)weekly.ِ Theِmultipleِ logisticِ regressionِ analysesِ revealedِ thatِmaleِ genderِ (Adjustedِ ORِ =ِ 2.43;ِ 95%ِ CI:ِ 1.56,ِ 3.77)ِ andِ non-degreeِ educationِ levelِ (Adjustedِ ORِ =ِ 1.69;ِ 95%ِ CI:ِ 1.05,ِ 2.71)ِ wereِ significantlyِ associatedِ withِ higherِ SSBِ consumptionِ (9ِ timesِ orِ moreِ perِ week),ِ whileِ B40ِ householdِ incomeِ wereِ significantlyِ associatedِ withِ higherِ SSBِ consumptionِ (9ِ timesِ orِ moreِ perِ week)ِ whenِ comparedِ toِ M40ِ andِ T20ِ groupِ (Adjustedِ ORِ =ِ 0.09ِ toِ 0.53;ِ pِ <ِ 0.05).ِ Theِ studyِ underscoresِ theِ influenceِ ofِ knowledgeِ andِ sociodemographicِ factorsِ onِ dietaryِ behaviourِ andِ highlightِ theِ needِ forِ targetedِ interventionsِ focusedِ onِ menِ andِ socioeconomicallyِ disadvantagedِ populationsِ toِ reduceِ SSBِ intakeِ andِ promoteِ healthierِ lifestylesِ evenِ amongِ thoseِ whoِ areِ alreadyِ aware.
Most viewed
- ItemKnowledge, attitude and practice toward family planning among married men in Hospital Universiti Sains Malaysia. Masters thesis, Universiti Sains Malaysia(Pusat Pengajian Sains Perubatan, Universiti Sains Malaysia, 2020)Family planning is important for a family institution. Family planning can be a disharmony to the family if they take things too easily. The objectives of this study were to determine knowledge, attitude and practice towards family planning among married men in Hospital Universiti Sains Malaysia (HUSM). A cross- sectional design study was undertaken involving 90 respondents that were recruited using non-probability convenience sampling in pharmacy, HUSM. The data collection period was from February 2020 until March 2020. A self-administered questionnaire was used to collect the data. The data were then analyzed using software (SPSS) version 24.0. Only 44.4% of married men have good knowledge about FP which is considered moderate. However, the attitude and practice of FP among married men is 60% good attitude and 73.3% have poor practice respectively. Therefore, we can see that married men have a good attitude but poor knowledge and practice when it comes to family planning. The Chi -square test used to examine the association between selected socio-demographic characteristics and it was found that there is a significant association between prevalence rate on family planning and education level (p<0.044) among married men. In conclusion, this study showed that knowledge and attitude toward family planning among married men was not adequate. However, each man who is married need more interactive health education to enhance their knowledge, attitude and practice.
- ItemStudies Of Removal And Recovery Of Palladium From Chloride Media Via An Electrogenerative System(Universiti Sains Malaysia, 2019-08)The use of palladium nowadays is extensive especially as catalytic converter of vehicles which contributed to increasing demand every year. With the limited source and higher cost in mining and purifying process, palladium is recycled by the industries. However, this precious metal is difficult and required high cost to be treated especially in such low concentration (<500 mg L-1). To overcome this problem, an electrogenerative system was introduced to recover palladium in chloride medium. It is alternative method to other electrochemical methods where the chemical reaction takes place spontaneously in this system since it does not require any external supply of energy. A static batch cell was set up to treat low concentration of palladium in dilute solutions. The dilute chloride with the concentration of 0.1-0.2 M NaCl was optimum to treat palladium with concentration 100-500 mg L-1. A three-dimensional cathode material of reticulated vitreous carbon (RVC) treated with sulphuric acid appeared to give the best performance for optimum palladium deposition. The RVC was found to have low resistance and high mass transfer from supporting analysis using electrochemical impedance spectroscopy and cyclic voltammetry. The generated flow current in this system was supported with a zinc as an anode. Overall, this system showed about >90% of palladium being recovered within 6 h of operation. The reduction of palladium ion was proved by controlled potential using cyclic voltammetry. The deposited palladium on the cathode RVC is visible with naked eyes and was further confirmed by the scanning electron microscopy-energy dispersive Xray spectroscopy.
- ItemSurvival time and prognostic factors of AIDS patients in Kelantan : 2010-2014(Pusat Pengajian Sains Perubatan, Universiti Sains Malaysia, 2018-05)Background: The AIDS death is still a worldwide concern as well as in Kelantan. However, the median survival time and predictor factors that contributing to risk of death among AIDS patients in Kelantan were unknown. Objectives: To determine the overall median survival time and survival rate of AIDS patients and predictors factors of death in Kelantan population from 2010 to 2014. Methodology: A retrospective cohort study was conducted in January 2018 using secondary data obtained from National AIDS Registry for the period of 1st January 2010 to 31st December 2014 and followed-up until 31st Mac 2015. A complete 1073 data was selected for descriptive analysis and survival analysis. Kaplan- Meier survival analysis and Cox’s proportional hazard regression model with estimates of hazard ratio and 95% confidence interval were used. Result: The mean (SD) age was 37.08 (7.37). The patients were predominantly males (87.0%), Malays (87.5%), single (62.3%), unemployed (38.0%), with background of secondary education (78.1%) and cases without HIV-TB co-infection (62.8%). Approximately 53% of the patients death during follow-up. The overall median survival time was 11 months. The probability of survival in 1-year, 2-year and 5-year were 49.1%, 47.8%, and 46.7% respectively. Multivariate Cox regression showed that significant prognostic factors were age 30-49 years (Adj. HR 1.57; 95% CI: 1.14, 2.16; p=0.006), male (Adj. HR 1.39; 95% CI: 1.07, 1.79; p=0.012), unemployed (Adj. HR
- PublicationA comparative study of intra venous patient-controlled analgesia morphine and tramadol in patients undergoing major operation(2004)The success of major surgery depends partly on providing effective post-operative pain relief, which can be achieved by morphine administration via PCA system. Tramadol is a weak opioid analgesic, which act mainly on f..L-opioid receptor. The purpose of this study was to evaluate the effectiveness of intravenous patient-controlled analgesia (PCA) Tramadol in comparison with PCA Morphine in tenn of analgesic properties, sedation and other side effects such as nausea, vomiting and pruritus. randomized, double-blinded study was conducted on 160 selected ASA I and II patients who were divided into two groups by a closed envelope technique. Following surgery, the PCA morphine (M) group (n=80) received a loading dose of 0.1 mglkg of intravenous morphine followed by I mg ( 1 mg/ml) of PCA infusion as required. The PCA tramadol (T) group (n=80) received a loading dose of 2.5 mg/kg of intravenous tramadol followed by 10 mg (10 mg/ml) ofPCA infusion as required. The lockout intervals for both groups were 10 minutes. None of the patients received baseline infusion. In the recovery room, patients were given oxygen via facemask and monitored for pain score according to Modified Pain Score, sedation score according to Ramsay Sedation Score, respiratory rate, nausea, vomiting, pruritus, blood pressure and pulse rate. Patients were evaluated at the end of 30 minutes in recovery room. After 4 hours, 24 hours and 48 hours post operation, patients were again evaluated in the ward. Showed no difference in the demographic data between the two groups (p>0.05). The mean pain score in tramadol group at 30 minutes, 4 hours, 24 hours and 48 hours post operation were 1.32 ± 0.79, 1.04 ± 0.79, 0.35 ± 0.48 and 0.09 ± 0.33 respectively. Whereas, the mean pain score in morphine group at 30 minutes, 4 hours, 24 hours and 48 hours post operation were 1.35 ± 0.99, 1.14 ± 0.81, 0.40 ± 0.54 and 0.10 ± 0.34 respectively. There were no significant differences in the mean pain score between the t\vo groups at each duration of assessment (p>0.05). The mean sedation score in tramadol group at 30 minutes, 4 hours, 24 hours and 48 hours post operation were 0.90 ± 0.74, 0.56 ± 0.59, 0.08 ± 0.27 and 0.02 ± 0.16 respectively. Whereas, the mean sedation score in morphine group at 30 minutes, 4 hours, 24 hours and 48 hours post operation were 0.84 ± 0.70, 0.46 ± 0.64, 0.08 ± 0.27 and 0.01 ± 0.11 respectively. There were no significant differences in the mean sedation score between the two groups at each duration of assessment (p>0.05). There were also no significant differences between the two groups in the incidence of nausea, vomiting and pruritus. This study indicates that PCA tramadol is suitable to be used as an alternative to PCA morphine in controlling pain following major surgery. The incidence of sedation, Dallfiea and pruritus were similar in the two groups.
- ItemA Study Of Burkholderia Pseudomallei K96243 Hypothetical Bpsl3393 Gene Product As A Putative Coa-Binding Protein(Universiti Sains Malaysia, 2014-01)Burkholderia pseudomallei is the causative agent of melioidosis. From the whole genomic comparison by using B. pseudomallei K96243 as reference genome, a total 48 genes were found specifically and common in B. pseudomallei strains. Amongst, the hypothetical gene, BPSL3393, was deduced to contain the CoA-binding motif based on its sequence analysis. However, this gene is still remaining as a putative gene where it is still functionally uncharacterized. The objective of this study is to elucidate the biological function of gene BPSL3393 in B. pseudomallei K96243. An unmarked deletion mutant of gene BPSL3393 was constructed by using pDM4 suicidal vector. This vector employed catR, chloramphenicol resistant gene as the selection marker and sacB, levansucrase gene as the counter-selection marker. The biochemical profiles of ΔBPSL3393 mutant and wild type strains were determined by using th Biolog GN2 MicroPlateTM system. The ΔBPSL3393 mutant showed significant reduction in 2-aminoethanol utilization as compared to wild type. Apart from this, the ΔBPSL3393 mutant also has shown some physiological difference as compared to wild type. The ΔBPSL3393 mutant aggregated at the exponential phase in M9 minimal media whereas the wild type did not. Thus, further study is needed to characterize this ΔBPSL3393 mutant and to uncover its biological role.