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- PublicationComparative study of clinical outcomes of vascularised versus non-vascularised fibular graft reconstruction after wide resection of giant cell tumour of distal radius(2021)Introduction Giant cell tumour (GCT) of distal radius is a benign tumour but can be locally aggressive. The tumour can be devastating to the bone which may result in severe deformity. For Campanacci grade III and some grade II usually treated by wide local excision followed by reconstruction using either autologous vascularised or non-vascularised fibular graft and both were reported with good results. We would like to compare the clinical outcomes of these two groups of treatment. Materials and methods This is a multicentre cross sectional study involving Hospital Universiti Sains Malaysia (HUSM) and University Malaya Medical Centre (UMMC). Patients who diagnosed with distal radius GCT and underwent wide resection followed by reconstruction with either autologous vascularised fibular graft (VFG) or non-vascularised fibular graft (NVFG) between year 2000 and 2019 in respective centres with minimum 1 year of follow up were included. Indications for VFG are Campanacci grade III, extensive soft tissue involvement, large tumour and fracture deformity. A total of 21 patients (7 VFG and 14 NVFG) fulfilled the criteria with a median age of 27 years were called for assessment using musculoskeletal tumour society (MSTS) score. Among the 21 patients, 9 males (5 VFG, 4 NVFG) and 12 females (2 VFG, 10 NVFG). Bony union was determined by plain radiograph with bridging callus at least three cortices in two views. Non-parametric Mann-Whitney U test were used for statistical analysis using SPSS version 24. Results The Overall MSTS score of NVFG was 80%, better than VFG 73.3% but statistically was not significant with the p-value of 0.60. In comparison of each component in MSTS scoring found to be no significant difference in pain (p = 0.48), function (p = 0.94), emotional (p = 0.50), hand positioning (p = 0.61), manual dexterity (p = 0.93) and lifting ability (p = 0.89). Median difference of union rate for VFG was 30 weeks (IQR = 31) while NVFG was 22.8 weeks (IQR = 23). There was no significant difference in union rate (p = 0.52) between these two groups of patients. However, two patients from NVFG group were reported non-union whereas all patients in VFG group achieved union. No serious morbidity reported at donor site from both groups. Conclusion Generally, VFG patients have larger tumour, hence more complicated surgeries. However clinical outcomes are generally similar compared to NVFG. VFG has slightly higher complication rates but they are considered minor whereas NVFG has serious complications such as non-union and graft resorption which required revision surgery. This is a retrospective study with limited sample size. Prospective study with larger sample size is justified to further prove these results
- PublicationReview of the pregnancy outcome of mother with advanced maternal age in Hospital Sultanah Aminah, Johor Bahru from 2017-2018(2022)Objective: To investigate the association between advanced maternal age and adverse pregnancy outcomes. Study method: A cross-sectional study comparing 239 advanced maternal age mother (≥35 years old) and a control group of 239 pregnant mothers aged 20–34, delivering at Hospital Sultanah Aminah in Johor from 2017 through 2018. Each of these groups was further analysed depending on parity (nulliparity and multiparity). Demographic background and pregnancy outcomes were compared between the groups. Result: The mean age of study group and Controls was 37.48 ± 2.226 years and 28.21 ± 3.610 years, respectively. Advanced maternal age was associated with higher parity and pre-existing medical illness. Advanced maternal age was significantly associated with higher incidence of anaemia. Those nulliparity mother with advanced maternal age had increased risk of exposure to lower Apgar scores (≤4 at 1 minute) by 14.75 compared to Controls. There were no significant differences between the two age groups in the incidences of other adverse obstetric outcomes and perinatal outcomes. Conclusion: We observed that maternal anaemia was associated with advanced maternal age and a low Apgar score at 1 minute is an independent risk factor for advanced maternal age nulliparity. Otherwise, this study demonstrated that the the reproduction beyond the age of 35 years is not associated with any significant maternal, delivery and perinatal complications. Overall, the study showed that the outcome of pregnancy with advanced maternal age is comparable to the control group
- PublicationEvaluation on knowledge and practice of target intraocular pressure in the management of glaucoma patients among ophthalmologists and medical officers(2022)Purpose This study aimed to assess the knowledge and practice of intraocular pressure (IOP) target use among ophthalmologists and medical officers in Malaysia based on the Malaysian Clinical Practice Guidelines for the treatment of glaucoma patients. Methodology A two-phase study was conducted from 1 January 2020 to 31 December 2021 among 279 subjects (139 ophthalmologists and 140 medical officers) working in ophthalmology clinics/hospitals in Malaysia. The first phase consisted of the development and validation of a questionnaire to assess knowledge and practice of IOP target use. This questionnaire was then used in the second phase. The second phase involved a cross-sectional study using an online questionnaire. The mean total scores of knowledge and practice of IOP target use were compared between ophthalmologists and medical officers using a t-test. Results A total of 323 ophthalmologists and medical officers were invited to participate, but only 279 (139 ophthalmologists and 140 medical officers) subjects responded to the questionnaire (86.4%). The mean experience in ophthalmology services was 7.42 (5.51) years. A total of 225 respondents (80.6%) used the use of IOP targets. There was a significant difference in the practice of using IOP targets between ophthalmologists (125, 89.9%) and medical officers (100, 71.4%) (p<0.001). The mean total knowledge score among the specialists (21.03 [95% CI: 20.52, 21.54]) was significantly better than that of medical officers (20.24 [95% CI: 19.78, 20.69]) p=0.022. There was a significant association between the average score of knowledge and practice in setting IOP targets (p=0.002). There was no significant association between the number of glaucoma patients treated with IOP knowledge (p=0.376) and practice (0.083) of using IOP targets. Lack of understanding (27.8%) and confusion in choosing the IOP target setting method (35.2%) were the main reasons for those who did not practice IOP target setting. The most popular IOP setting method was the percentage of IOP reduction from the original IOP. Conclusion There are differences in knowledge and practice of using IOP targets among ophthalmologists and medical officers in Malaysia. Intervention programs should be designed to improve the understanding and practice of IOP target setting in Malaysia
- PublicationEvaluation of stress response and anxiety scores of paediatric patients sedated with intranasal dexmedetomidine vs placebo: A randomized control trial(2022)Background: Dexmedetomidine’s (DEX) favourable properties that include analgesia, sedation, and maintenance of cardiovascular stability renders it an ideal drug for paediatric patients. It provides a safer option with less concern for postoperative sedation and hangover effect. Furthermore, intranasal dexmedetomidine is tolerable and easily administered to paediatric patients. Methods: This was a prospective randomized controlled trial. A total of 60 paediatric patients who underwent elective surgery were included in the study and randomly assigned to receive either intranasal DEX (n = 30) or intranasal 0.9% normal saline (NS, n= 30). Primary outcomes measured the baseline serum cortisol level and serum cortisol postinduction of anaesthesia. Secondary outcomes included Modified Yale Preoperative Anxiety Scale scores, Sedation Behavior Scores (SBSs) and haemodynamic stability. Results: Both NS and DEX groups showed a significant increase in serum cortisol levels when compared with the baseline. Pairwise comparisons between the groups showed no significant difference in serum cortisol levels (95%CI 1.73(-57.28, 60.75); p = 0.95). Both NS and DEX groups showed significant improvement for SBS post sedation administration. There was a significant increase in post-induction of anaesthesia heart rate level in the NS group (95%CI – 10.23(-15.57, -4.90) p = 0.00); however, it was not significant in the DEX group (95% CI – 7.17(-15.405, 1.07); p = 0.09) Conclusion: At a dose of 1 mcg/kg, intranasal DEX provides a satisfactory level of anaesthesia for paediatric patients; however, it does not reduce the stress response to induction of anaesthesia
- PublicationMotivation Factors And Potential Barriers For Blood Donation During Coronavirus (Covid-19) Pandemic In Kelantan, Malaysia(2023-11)Introduction: The COVID-19 pandemic had both direct and indirect impacts on blood donation efforts worldwide. The number of blood donors is likely to decline as the number of everyday cases increases. This study aims to determine blood donors' socio demographic characteristics during COVID-19 and their association with motivation factors, and potential barriers to blood donation during the pandemic. Methods: This observational cross-sectional study was conducted among 350 blood donors in Kelantan using a self-administered questionnaire. Data was analysed using Statistical Package for the Social Sciences (SPSS) software. Logistic regression tests were used to determine the association between socio-demographic characteristics of blood donors with motivation factors and potential barriers. Results: Out of 350 participants, 54.9% were males, 46.9% were in 18-25 years old, 82.3% were Malays, 60.6% were single, 72.6% had high education levels, and 45.7% were regular donors. About 97.7% of the respondents donated blood due to altruism motivations while 53.2% of the respondents claimed they did not have enough time as their donation barrier. There was no association between socio-demographic characteristics of blood donors with motivation factors. Male respondents tend to have 1.82 times higher odds of having potential barriers for blood donation compared to female respondents (adjusted OR = 1.82, p = 0.020). Conclusion: Altruism is the main motivation factor for blood donation during COVID 19, while the main barrier for blood donation is lack of time. A well-planned, focused strategy is important in ensuring the efficacy of blood collection during pandemic.
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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.