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- PublicationA randomized controlled trial comparing two doses of caffeine for apnoea in prematurity(2021)Caffeine is the most used methyl xanthine for the prevention of apnoea in prematurity, but its ideal dose was uncertain. This study compared two doses of caffeine for prevention of apnoea in prematurity. A clinical trial was conducted on 78 preterm infants ≤32 weeks in NICU at tertiary center hospital. They were randomly allocated to receive the intervention (loading 40 mg/kg/day and maintenance of 20 mg/kg/day) or the control (loading 20 mg/kg/day and maintenance of 10 mg/kg/day) dose of caffeine. The primary outcome of the study was the frequency and total days of apnoea per duration of treatment for both groups. The frequency of apnoea range from zero to fourteen in the intervention and zero to twelve in control group. There was no statistically significant different between the groups with p value 0.839. The number of days of apnoea was also similar between both groups with p value 0.928. There was also no significant difference of adverse events between both regimens. This study did not support the use of higher dose caffeine as a prevention for apnoea in prematurity
- PublicationProvision of enteral feeding adequacy and reason for underfeeding in intensive care unit patients in HUSM(2018-06)Patient who admitted in the ICU require optimal amount of nutrition therapy for a better clinical outcome. The objectives of this study was to investigate the prevalence of enteral nutrition (EN) feeding adequacy, mean differences between feeding adequacy and biochemical indicator among patient and to identify the causes of under feeding. A cross sectional study was carried out at Trauma ICU, Medical ICU and 2 Delima, Hospital USM. Adult patients (2: 18 years old) who were, expected to stay for at least 24 hours in ICU and received enteral feeding during admission were included. Eligible patient was followed in ICU ward for maximum of 7 days or until death or discharge from ICU. A total of 55 patient were involved. Mean age 50.4 ± 17.2 years and mean BMI 25.7 ±6.9 kg/m2 (overweight). Among 55 patients, 34 (61.8%)did not received the recommended nutrition requirement (2: 80 of calculated energy and protein requirement). Changes in total protein , albumin and haemoglobin for 7 days between underfed and adequately fed were not statistically significant except for albumin for the first day of EN feeding. The most frequent reason for the feeding interruption were respiratory procedure (38%), operating room procedure (12%) and high GRV (> 500ml) (11 %). EN feeding was inadequate among critically ill patient as evidenced by majority (61.8%) of critically ill patient not receiving the recommended energy and protein. The causes feeding interruption should be improved via standard clinical protocol to avoid nutrition deterioration among critically ill patient.
- PublicationComparison of PreHospital index with MGAP score to determine outcome in trauma patients presented to emergency department Hospital Tengku Ampuan Rahimah Klang, Selangor(2020)Background Trauma is one of the leading causes of death worldwide including Malaysia. Death due to trauma is best explained by the Trimodal Death Model, death occurring immediately after trauma, intermediate death several hours after trauma and delayed death. The importance and significance of prehospital score system is to reduce the death rate in the intermediate group which can be prevented if given treatment in a timely manner. Methods This was a cross sectional observational study, using retrospective data from May 2019 till April 2020. A total of 502 patients were recruited, PHI and MGAP scores were calculated based on prehospital clerking done by responder at the scene or en route to the hospital. Convenient sampling was used with the researcher recruiting upon patient arrival in ED and follow up patient until they are discharged or until maximum 30 days post trauma for prolonged hospitalization cases. Results All 502 patient’s data were analysed. Pearson chi square was used to measure the finding of both scores. Both PHI and MGAP score were significant with a p value of <0.01 in determining patient’s general outcome (mortality, morbidity, prolonged hospital stay, major surgery prediction). However, PHI has higher sensitivity and specificity 72.97% and 95.91%, whilst MGAP score is 24.32% and 2.64%. Kappa was used to compare the association between the scores with the standard score to predict individual outcome of mortality, morbidity, prolonged hospital stay and prediction of major surgery. Both scores failed to predict prolonged hospitalization. For major surgery prediction also both scores failed to show significant result and Kappa score was less than 0, MGAP (-0.012) and PHI (0.060). In the prediction of morbidity and mortality PHI score showed slight agreement with ISS score, morbidity (0.299) and mortality (0.431), whilst MGAP showed no agreement for morbidity (-0.051) and mortality (-0.060). Conclusion We conclude that, between both scoring system, PHI has a better specificity and sensitivity in determining the outcome of trauma patients. However, both scores have low to no agreement with ISS score in predicting prolonged hospitalization, major surgery prediction, morbidity, and mortality. PHI can be used as screening tool to facilitate and tighten the management of trauma patients from the scene till arrival of patient to the hospital
- PublicationNutritional composition and textural properties of ready-to-eat compact rice developed from selected brown rice available in Malaysia(2018-06)Rice is a staple food for nearly two-thirds of world population. However, brown rice is less preferred compared to white rice due to its sensory and textural attributes, in addition to lack of availability. Therefore, this study is one of the alternative to increase the availability of wholegrain sources in different form of meal, such as compact rice with nice palatability and match well with any side dish, while contributing beneficial nutrients compared to white rice. Compact brown rice able to be produced from three different varieties of brown rice. When compared compact brown rice to compact white rice, compact brown rice contributes to higher protein ranged between 7.00 - 8.63%, higher fat in form of unsaturated fats (1.98 - 2. 69%), higher minerals (0.63 - 0.84%) and has low carbohydrate ( 10.44 - I 0.83%) meanwhile compact brown rice only contribute 1.55 - 1.56%, 0.33 - 0.34%, 0.28 - 0.38% and 17.56 - 17.93% of protein, fat, total ash and carbohydrate percentages respectively. However, due to practical error and cooking method, compact brown rice has lower total dietary fibre content which is ranged between 7.10 - 9.46 g/l00g while compact white rice contributes between 7.43 - 11 .30 g/l00g. Texture profile analyses and sensory evaluation are also conducted to assess palatability level of compact brown rice. Compact brown rice from three different rice varieties are not able to fonn a uniformly structured compact rice due to its property of less stickiness which cause less ability to stick with other grains therefore lead to unsolid structure. Among the brown rice varieties, long grain brown rice has the nearest hardness, adhesiveness, cohesiveness and gumminess compared to commercial compact rice with the values of 418.60g VS 687.34g, -153.31 VS -162.85, l.94 VS 2.20 and 812.55kg VS 1513.27kg respectively. Based on sensory attributes, when compared to commercial compact rice, specialty brown rice shows insignificant difference in term of aroma, texture, taste and appearance attributes. Even though long grain brown rice is more similar to commercial compact rice in term of textural properties, specialty brown rice is more preferred as it might be influenced by its palatability and appearance. Hence, specialty variety is the most suitable brown rice for development of compact rice, as it also well-accepted when served with popular side dishes such as serunding, /ontong and rendang. Further study is needed which centred on different treatment of cooking method while preserving beneficial nutrients and has nice palatability.
- PublicationNutritional status and its relationship with the quality of life in cancer patients(2018-06)Background: In patients with cancer, poor nutritional status is related with poor outcomes and altered quality of life. For that, the aim of this study was to identify relationship between nutritional status with quality of life in cancer patients at Hospital Universiti Sains Malaysia. Methods: The respondents had been selected as sample using purposive sampling and interviews method had been used to obtain the information such as socio-demographic data, cancer types, weight and height. For quality of life, European Organization of Research and Treatment of Cancer Quality of Life questionnaire (EORTC QLQ-C30) was used to assess quality of life and it were self-answered questions. Results: There were a total 90 of participants and 54.4% of participants had normal weight followed by obese (16.7%), underweight (15.6%) and overweight (13.3%). In this study, population's global quality of health score is 58.06 ± 18.84 and the mean score of patients in BMI categories of overweight were the highest (69.44 ± 15.21) followed by normal weight (56.80 ± 21.16), underweight (56.55 ± 13.94) and obese (54.44 ± 15.06) and for gender it was 58.89 ± 17.95 in the females and 56.39 ± 20.72 in the males. It also had been found that there is no statistically difference of mean score of quality of life in each dimension with BMI except for dimension of pain, tested using ANNOY A with (p= 0.032). Conclusion: Normal weight patients were common in a representative population of cancer patients at HUSM. HUSM population's quality of health score is slightly less than the EORTC reference value global score. This result had proved that there was worsening of overall quality of life of cancer patients in this population and in comparison with was higher in the females than males. Overall quality of life had demonstrated that overweight had a greater quality of life and obese was in the lowest other than others.
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- ItemPengetahuan Dan Tingkah Laku Pengguna Dadah Secara Suntikan (IDU) Yang Mengikut Program Pertukaran Jarum Dan Alat Suntikan (NSEP) Di Pulau Pinang(Universiti Sains Malaysia, 2017-07)Kajian kualitatif ini dijalankan bagi meningkatkan tahap kualiti dan keberkesanan penyampaian perkhidmatan dalam Program Pertukaran Jarum dan Alat Suntikan (NSEP) kepada pengguna dadah secara suntikan (IDU). Objektif kajian ini meliputi: (1) mengenal pasti ciri-ciri sosiodemografi IDU yang terlibat dalam NSEP; (2) meneroka pengetahuan IDU yang terlibat dalam NSEP berkaitan HIV/AIDS, HCV, VCT dan NSEP; (3) meneroka bentuk tingkah laku IDU yang terlibat dalam NSEP berkaitan dengan tingkah laku suntikan dan tingkah laku hubungan seks; (4) menganalisis halangan dan cabaran IDU dalam mengamalkan tingkah laku pengurangan risiko; dan (5) mencadangkan strategi atau peranan yang boleh dipraktikkan oleh pekerja sosial dalam meningkatkan lagi keberkesanan NSEP ke arah pembentukan tingkah laku pengurangan risiko dalam kalangan IDU. Kajian ini telah dijalankankan di Pulau Pinang dengan melibatkan seramai 20 orang responden. Kaedah temu bual mendalam berlandaskan panduan temu bual separa berstruktur telah digunakan dalam proses pengumpulan data. Penemuan kajian mendapati dalam konteks pengetahuan bahawa: (1) IDU mempunyai pengetahuan mengenai HIV/AIDS yang baik; (2) IDU tidak mempunyai pengetahuan mengenai HCV yang baik; (3) IDU mempunyai pengetahuan mengenai VCT yang baik; dan (4) IDU mempunyai pengetahuan yang baik mengenai NSEP. Dalam konteks tingkah laku menyuntik dadah dan hubungan seks pula, didapati bahawa: (1) tingkah laku penggunaan jarum dan picagari adalah secara amalan pengurangan risiko; (2) tingkah laku menggunakan pad alkohol adalah secara amalan pengurangan risiko; (3) penggunaan kapas adalah secara amalan pengurangan risiko; (4) tidak menggunakan tourniquet secara amalan pengurangan risiko; (5) mengamalkan pemilihan urat berbanding arteri; (6) mengamalkan penukaran kawasan anggota badan bagi tujuan menyuntik dadah; (7) tidak mengamalkan penyimpanan jarum dan alat suntikan yang telah digunakan di tempat yang selamat; dan (8) IDU tidak aktif dalam tingkah laku hubungan seks.
- PublicationFabrication and characterization of electrospinning biodegradable fabric layer for face mask application(2022-08-19)The increased use of 3-ply facemasks has raised concerns about the pollution they cause to the environment. The non-biodegradability of current 3-ply facemasks is highlighted because it is difficult to manage the waste and much more pollution is created when facemasks are discarded. Several studies have been conducted in order to improve the filtration layer on a consistent basis by using biodegradable polymers as an alternative. The present study aimed to fabricate polylactic acid (PLA), poly (butylene adipate-co terephthalate) (PBAT) and PLA/PBAT fibre mat layers. The effect of different needle sizes on the properties and morphology of PLA and PBAT fibre mats was identified by using the Scanning Electron Microscope (SEM) tabletop, ImageJ and Universal Tensile Machine (UTS). In addition, the effect of single and binary solvents was investigated to produce PLA/PBAT fibre mat layer. Results showed that small size needles produced small-diameter fibres. The best needles to use for the fabrication of the PLA and PBAT fibre mats are 25G and 23G, respectively based on the fibre diameter and tensile properties. A 25G needle produced the smallest diameter and compact fibre mat. However, a 21G needle produced a PLA fibre mat with the highest tensile strength and Young’s modulus. On the other hand, a 25G needle is the best needle size to produce a PBAT fibre mat with good tensile properties. Binary solvents using DCM and DMF produced continuous and thinner fibres and showed higher tensile properties compared to the single solvent system.
- ItemCrash recovery support for variable strength t-way test generation strategy(2016-06-01)Often, the biggest challenge in software testing relates to the fact that it is not feasible to test for all the input parameters exhaustively owing to constraints in costs, resources and time. Considering these factors, software testers must appropriately sample the test cases in order to best utilize the resources at hand. Within the context of Combinatorial Testing, testers often resort to t-way test generation strategy (where t indicates the strength of interaction). Empirical evidence in the literature indicated that t-way test generation strategy has managed to minimize the test cases significantly whilst maintaining the fault detection capability of the testing process. Much useful progress has been achieved as far as the development of t-way test generation strategy is concerned. Nevertheless, some issues remain especially in the context of addressing ever increasing complexity and size of software (i.e. lines of code) resulting into high number of interaction among input parameters. Firstly, the test generation can be painstakingly long, interruption is expensive as the whole generation process needs to be restarted from scratch. Time and efforts will also be wasted. Secondly, existing strategies commit too early on selection of the best value of input parameters when sampling of the test cases. For this reason, these strategies were less sufficient in terms of generating optimal test suite size. Here, to enhance the t-way testing capability, there is also a need to consider variable-strength strategy. This approach is often favored because of the compromise in terms of test suite size as the strategy focuses testing where it has the most potential value which usually is associated with a risk analysis and priority. In order to address these issues, this research develops a variable-strength (VS) interaction t-way test generation strategy, called Test Suite Generator with Crash Recovery support (TSGCR). Unlike existing strategies, TSGCR adopts Multilevel Greedy algorithm, which delays choosing the best value until it satisfies certain rules. To provide a reliable operation, TSGCR also permits crash recovery support integrated as part of the strategy itself. As the test generation can potentially be long lasting processes (i.e. due to large selection of input parameters and values), TSGCR tolerates involuntary transaction failures (e.g. such as power failure or system errors) or voluntary execution suspension (e.g. to give ways for other computations) enabling restoration of state and data to the last consistent state. To evaluate the competitiveness of TSGCR, the test generator is tested with uniform and mixed input parameters and the performance (in terms of the generated test suite size) is compared with existing variable strength t-way test generation strategies using well-known standard benchmark configurations (based on six sets of experiments). Benchmarking results showed that for VS interaction configurations for uniform input parameters, TSGCR is able to get seven Δ with 0 value, i.e. similar value to the best solution obtained by other strategies, seven Δ with +ve values, i.e. able to get the best solution; from fourteen out of forty four experimental results. While for VS interaction configurations for mixed input parameters, TSGCR is able to get twenty seven Δ with 0 value, eight Δ with +ve values; from thirty five out of forty one experimental results. Hence, the results demonstrated that TSGCR produces competitive results as far as the size of the test suite is concerned against most existing strategies.
- ItemKaedah Kepimpinan Dan Perancangan Strategik Dalam Pengurusan Kualiti Di Institusi Pembangunan Berteraskan Islam Brunei Darussalam(Universiti Sains Malaysia, 2017-03)Tesis ini bertujuan mengkaji kaedah kepimpinan dan perancangan strategik dalam pengurusan kualiti di institusi pembangunan berteraskan Islam (IPBI). Sekalipun pengurusan kualiti lazim dilihat lebih dominan pada masa kini, namun terdapat pengkaji sudah mula menilai pengurusan kualiti dari perspektif Islam. Ini merupakan satu perkembangan yang baik bertujuan membina pengurusan kualiti yang berteraskan Islam sepenuhnya. Penelitian terhadapnya memerlukan evolusi secara perlahan-lahan. Oleh sebab itu, kajian ini hanya melihat sebahagian aspek utama dalam pengurusan kualiti iaitu kaedah kepimpinan dan perancangan strategik sahaja. Memandangkan IPBI di Malaysia secara dominannya masih terikat dengan konsep pengurusan kualiti lazim, maka ada keperluan untuk mengkaji negara lain yang cuba melaksanakan pengurusan secara Islam. Negara tersebut ialah Negara Brunei Darussalam (NBD). NBD telah memperkenalkan konsep dan falsafah yang Islamik untuk negaranya seperti Melayu Islam Beraja (MIB) dan Negara Zikir. Konsep dan falsafah ini memperlihatkan bahawa NBD berusaha membangunkan aspek politik, ekonomi dan sosial menggunakan pendekatan Islam. Pembangunan NBD juga mengambil berat tentang aspek pengurusan kualiti. Maka timbul persoalan, apakah kaedah pengurusan kualiti yang dijalankan oleh IPBI di NBD ini? Bagaimanakah kaedah kepimpinan dan perancangan strategik yang dilaksanakan oleh IPBI di NBD? Untuk tujuan kajian ini, terdapat tiga objektif. Pertama, mengenal pasti kaedah pengurusan kualiti khususnya kaedah kepimpinan dan perancangan strategik yang dilaksanakan di IPBI terpilih NBD; kedua, menganalisis kaedah kepimpinan dan perancangan strategik dalam pengurusan kualiti di IPBI terpilih NBD; dan ketiga, merumuskan kaedah kepimpinan dan perancangan strategik di IPBI terpilih NBD.
- ItemNanostructured materials as catalysts for the production of gasoline from used palm oil and crude palm oil:(2007)The objective of this research was to develop an efficient cracking catalyst with good hydrothermal stability, reusability, low deactivation rate and minimum side products with high selectivity towards gasoline fraction yield. In this research, the catalytic process for the production of gasoline from crude palm oil (CPO) and used palm oil (UPO) was studied at atmospheric pressure, temperature of 723 K, weight hourly space velocity (WHSV) of 2.5 h-1 and crude/used palm oil to catalyst ratio of 8 in a fixed bed micro-reactor. Six different types of composite catalysts namely; HZSM-5/alumina (CZA), HBeta/ silica-alumina (CBS), Al-MCM-41/alumina (CMA), Al-MCM-41/silica-alumina (CMS), Al-SBA-15/alumina (CSA) and Al-SBA-15/silica-alumina (CSS) were synthesized and tested as cracking catalysts. The composite CZA and CBS were characterized for their surface area, adsorption-desorption isotherm, pore size distribution, crystallinity, acidity and surface morphology. The composites CMA, CSA, CMS and CSS were characterized for their crystallinity, acidity and surface morphology. HZSM-5 gave 98.5 wt% UPO conversion with 45.2 wt% yield of gasoline fraction and 25.9 wt% gaseous products. Composite CZA35 gave 97 wt% UPO conversion, 47 wt% yield of gasoline fraction and 19.7 wt% gaseous products as compared to HZSM-5. The alumina coating increased the average pore size (APS) of the mesopores and reduced the acidity of composite catalyst. Steam treated HZSM-5 and CZA35 showed comparable activity as the fresh catalysts. St-ZSM5 gave 93.5 wt% UPO conversion with 46 wt% yield of gasoline fraction and UPO conversion was 92.3 wt% with 46.3 wt% yield of gasoline fraction over St-CZA35. The reduction in the surface area of St-CZA35 was lower as compared to St-ZSM5. The aromatics (BTX) present in the organic liquid product (OLP) were reduced from 33.9 wt% obtained with fresh CZA35 to 17.9 wt% over St-CZA35. Composite CBS25 gave comparable gasoline fraction yield with 62.9 wt% CPO conversion as compared to 74.5 wt% CPO conversion over H-Beta. Its activity was improved after steam treatment with increase in CPO conversion to 74.7 wt% with gasoline fraction yield of 31.8 wt%. H-Beta activity dropped after steam treatment with drop in conversion from 74.5 wt% to 65.5 wt% and gasoline fraction yield from 26 wt% to 23.8 wt%. The coating of silica-alumina helped to increase the cracking activity and hydrothermal stability of the composite due to change in the surface morphology. The coating of alumina improved Al-MCM-41 hydrothermal stability. St-CMA25 gave 62 wt% CPO conversion with 19.7 wt% gasoline fraction yield, higher than that obtained over St-AlMCM-41 (60.5 wt% conversion with 13.1 wt% gasoline fraction yield). The composites CSA, CMS and CSS gave low cracking activity due to changes in the surface morphology as observed from SEM analysis. Comparing the performances of all synthesized composites, CZA35 was found to be best cracking catalyst. The deactivation of catalysts was studied by obtaining time on stream data with palm oil to catalyst ratio in the range of 8 to 16. Composites with alumina, CZA and CMA showed lower deactivation as compared to HZSM-5 and Al-MCM-41 catalysts. The deactivation data were fitted using suitable activity model and deactivation parameters were obtained.