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- PublicationUltrasound assessment of diaphragm as a predictor tool of successful extubation in mechanically ventilated patients(2021)Background Weaning failure is defined as failure to pass a spontaneous breathing trial or the need for re-intubation within 48 hours following extubation. An estimated 20% of all mechanically ventilated patients will encounter a failed extubation scenario. The pathophysiology of weaning failure is multifactorial but a recent factor of interest described in current literature is that of diaphragm dysfunction. The purpose of this study is to determine the role of ultrasound assessment of diaphragm as a predictor tool of successful extubation in mechanically ventilated patients Methods This study was carried out in Hospital Queen Elizabeth, Sabah and Hospital Universiti Sains Malaysia, Kelantan. Seventy-five mechanically ventilated patients who were planned for extubation and met the inclusion criteria were enrolled into the study. Written consent was obtained from the next of kin. Bedside diaphragmatic ultrasound was carried out prior to extubation to assess diaphragm excursion and diaphragm thickness fraction. The diaphragm ultrasound was performed by the clinician who had no role in the management of the patients. Extubation was based on intensivist’s or anaesthetist’s decision who were blinded of the ultrasound results. The patients were followed up for 48 hours post extubation. Results There was a statistically significant difference in both the mean diaphragm excursion and the mean diaphragm thickness fraction between the successful extubation group and the failed extubation group. When the diaphragm thickness fraction increased by 1 %, the chance of successful extubation increased by 1.29 times. Conclusion Ultrasound assessment of diaphragm thickening fraction can be used as a predictor tool of successful extubation in mechanically ventilated patients.
- PublicationQuality of life after scoliosis surgery: The Hospital Sultanah Bahiyah experience(2021)Introduction Idiopathic scoliosis is a is a complex three-dimensional deformity of the spinal column. Adolescent idiopathic scoliosis (AIS) is the most common type affecting healthy young individuals. Psychological well-being of these young group of patients has been area of concern when managing these patients. Aim of this study is to assess quality of life in patient undergoing corrective surgery for AIS using the SRS-30 questionaire. Methodology A cross sectional study of all patients that underwent deformity correction surgery for AIS from January 2016 till December 2019 in Hospital Sultanah Bahiyah was done. Patient had to be followed up for at least 6 months. Only patient with idiopathic adolescent scoliosis were included. Radiographic measurements of the cobb angle preoperative and postoperatively were obtained from medical records of the patient. Patients were then contacted and given the SRS-30 questionnaire to be filled up. Results 24 patients were recruited in this study based on the inclusion and exclusion criteria . The median preoperative Cobb angle was 63.0 (19.90), while post operatively it was 18.0 (11.25) with a percentage of correction of 68.0 (17.5). The average total SRS score is 4.20(0.38). Using the Spearman’s Rho correlation analysis there was a significance and moderately positive correlation between the satisfaction with management domain scores and the percentage of Cobb’s Angle correction. However, the total scores despite having a positive correlation, were not statisitcally significant. Conclusion In this study, the average total SRS score was 4.2(0.38) indicating a favourable outcome in terms of quality of life in patient undergoing scoliosis surgery in Hospital Sultanah Bahiyah.
- PublicationA Novel Dynamic Evolutionary Model Integrating Discrete Hopfield Neural Networks With Satisfiability Problems And Its Applications In Image Encryption And Decryption(2025-06)This thesis proposes a series of innovative DHNN-SAT variants and their applications. To address the inefficiency of traditional DHNN-SAT networks in solving SAT problems with dynamic constraints, a Dynamically Evolving Discrete Hopfield-SAT Neural Network with a flexible and scalable architecture is specifically designed. To tackle challenges posed by varying network scales and logical complexities, an optimized network based on a Crow Search Algorithm-guided Fuzzy Clustering Hybrid Method is proposed.
- PublicationFoot care knowledge and practice Among type 2 diabetes mellitus patients In Hospital Universiti Sains Malaysia(2021)Introduction: Diabetic foot ulcer (DFU) is a chronic disease which causes significant mortality and morbidity to diabetic patients worldwide, especially complication like lower limb amputation. This study aims to determine the level of foot care knowledge and practice among type 2 diabetes mellitus (T2DM) patients and to determine relationship of foot care knowledge or practice with DFU. Materials and Methods: A cross sectional study was conducted in Hospital Universiti Sains Malaysia with subjects recruited from May 2019 to Jun 2020. They were recruited using convenient sampling method. Foot care knowledge and practice were obtained using a validated self-administered questionnaire. All patients were assessed for body mass index, monofilament testing for neuropathy and ankle brachial index for arterial insufficiency by single trained medical personnel. Results: Among 134 T2DM patients, 56 (42.8%) patients had DFU. The mean (SD) age of the study participants was 58.3 (9.9) years. A total of 113 (84.3%) T2DM patients had good foot care knowledge, and 85 (63.4%) T2DM patients had good practice. Majority of the T2DM patients with DFU had good foot care knowledge (87.5%), but poor practice (62.5%); while T2DM patients without DFU had good knowledge (82.1%) and good practise (82.1%). The Multiple Logistic Regression model showed that the foot care practice was an independent factor associated with DFU when age, peripheral diabetic neuropathy and BMI were adjusted, with estimated adjusted odds ratio 0.242 (95% CI: 0.077, 0.761). The foot care knowledge was not significantly associated with an increased risk of DFU when other confounders were adjusted (AOR: 1.347, 95% CI: 0.296, 6.741). Conclusion: Poor foot care practice was significantly associated with DFU. Apart from having foot care knowledge, adherence to education regarding foot hygiene, nail care and proper footwear is strongly recommended to prevent DFU and lower limb amputation. We suggest that the foot care practice adherence be evaluated and reinforced during every visit of T2DM patients to the health care facilities.
- PublicationEvaluation of health-related quality of life in children with vernal keratoconjunctivitis using quality of life in children with vernal keratoconjunctivitis questionnaire(2021)INTRODUCTION Vernal keratoconjunctivitis (VKC) is a recurrence, and chronic bilateral ocular allergic conjunctivitis mainly affected male prepuberty children. The signs and symptoms of VKC given a negative impact on well-being, lifestyle and limitation on psychosocial activities. There has been a lack of data on health-related quality of life (HRQoL) in children with VKC from Southeast Asia. OBJECTIVE To evaluate the mean total and subscales score of the QUICK questionnaire between the severity of VKC and in children with VKC and healthy groups. METHODOLOGY This study is a comparative cross-sectional study conducted in Hospital Selayang, Universiti Sains Malaysia between February 2019 and May 2020 involving children aged 8-15 years. The VKC participant's recruitment depends on the diagnosis of VKC, which was made based on the patient's clinical history, previous diagnosis, and objective examination. While in the control group, the participants were recruited from children with no existing ocular problems. RESULTS Two hundred forty children were recruited, including 120 children with VKC and 120 normal healthy children as control. There were statistically significant differences in all aspects of clinical data in the comparison between children with VKC and normal children (p<0.001) and within the children with VKC group (p<0.001). There was a statistical difference in mean total scores and all of the subscales between children with VKC and the control group (p<0.001) and between the children with mild, moderate and severe VKC(p<0.05). CONCLUSION The QUICK questionnaire is a good tool to assess the HRQoL among children with VKC. VKC disease negatively impacts HRQoL in children with VKC compared to normal children and in comparison within the severity of the VKC group. Understanding the psychosocial limitation and sign and symptoms of VKC that affected most HRQoL leads the physician to a holistic approach to managing the VKC patient.
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- ItemApplication of computational fluid dynamics in an outer channel of orbal biological system(2019-06)Orbal Biological System (OBS) is one of the modified oxidation ditches which claimed as the most energy efficient, safest and has the lowest maintenance. The OBS can be easily modified to meet wide assortment of influent conditions and effluent requirements. There are three channels in OBS, outer channel, middle channel and inner channel. The outer channel of OBS has the largest volume among the three channels, which is about 50% of the total volume of the system. It is crucial to study the operating system of the outer channel of OBS as it contribute to the highest energy consumption in the system. This is because in the wastewater treatment system nowadays, the quality standards of the effluent are not only the criteria to be focused on, but other aspects such as economic also are taken as considerations. Therefore, the study was conducted to understand the function and the effect of the number of aeration discs in the outer channel of the OBS. The Computational Fluid Dynamics (CFD) model is developed to have a better picture of the OBS. The simulation in CFD were used to study the behaviour of the influent in the outer channel of OBS and the velocity distribution for different operating conditions in the outer channel of OBS. The result of the CFD model were used to study the relationship between the velocity and the number of aeration discs being used. Based on the study, by turning off some shaft in the outer channel of OBS was contributing to less energy consumption. From the research, the average deviation for the CFD model is 23%, which need improvement in grid generation. The research provides a better understanding of model flow behaviour of a biological treatment system using the simulation tool. It can contribute to a better design of wastewater treatment process models in the future.
- ItemAntecedents And Outcome Of End User Grumbling In Enterprise Resource Planning Systems Pre-Implementation Phase: A Study Among The Manufacturing Firms In Bangladesh(Universiti Sains Malaysia, 2017-08)The success rate of enterprise resource planning (ERP) implementation is low around the world owing to its complex nature. The key focus of information system (IS) researchers has been to explore the ways to reduce threats to ERP implementation posed especially by user resistance. Although the reasons for user resistance have already been dealt with in previous studies, the understanding of how users assess a new ERP system in the pre-implementation phase and what prompts their decision to resist it is far from complete. The model proposed in the present study integrates status quo, technostress and absorptive capacity, thus throwing light on the end-user grumbling behaviour that precedes the implementation of a new ERP system. Data was collected via a survey questionnaire distributed to 221 respondents from five different manufacturing industries in Bangladesh which are currently in the process of installing the popular SAP ERP system. Results of this tested model indicate a significant impact of the constructs of status quo bias and technostress on end-user grumbling. Absorptive capacity of understanding and assimilating has no significant impact but absorptive capacity of applying has significant relationship with on user resistance. Additionally, end user grumbling has positive significant impact on symbolic adoption.This doctoral thesis also acknowledges the limitations of the study and suggests the new directions for future research.
- PublicationAssociation of laryngopharyngeal reflux (LPR) and central obesity(2021)Laryngopharyngeal reflux (LPR) is a common disease encountered in otolaryngology. The presentation differs from gastroesophageal reflux disease (GERD) despite sharing similar pathophysiology. There are various postulated risk factors to LPR amongst which is central obesity. The aim of this study is to establish central obesity as a risk factor in developing LPR. Methods This is a comparative cross-sectional study in which 180 patients who were 18 years old and above regardless of obesity status without confounding factors in causing laryngeal mucosal change such as smoking, malignancy, post nasal drip, treatment with proton pump inhibitors and pregnancy were enrolled. These patients were not diagnosed with LPR prior. No pH studies or empirical treatment with proton pump inhibitors were given before. Reflux symptom index (RSI) and reflux finding score (RFS) were used to screen for LPR sign and symptoms. Results 87 central-obese patients based on waist-to-hip ratio (0.9 and 0.85 for male and female respectively) and 93 non central-obese patients were recruited in this study. There was a significant higher value of both RSI and RFS in central-obese patients with significant positive correlation between these variables. Patients with central obesity might have a 2.6-fold higher probability of being diagnosed with LPR. Conclusion This study derived a linear correlation between central obesity and LPR based on the relatively simple and non-invasive RSI and RFS tool.
- ItemAnalysis of the expression of IBMR3 antigen in cells and tissues from rodents(2009)Monoclonal antibodies (Mab) and their fragments have been widely used for diagnostic and therapeutic purposes. IBMR3 hybridoma cells were produced in a previous study. The cell culture supernatant of the hybridoma cells was collected and stored at -20 °C freezer. The aim of this research is to investigate the expression profile of the IBMR3 antigens in different tissue of mouse, rat and cell lines HT29, 3T3 by using immunoblotting technique and immunohistochemical staining using the peroxidase technique. In this study the expression of IBMR3 antigen was evaluated in eighteen different organs taken from Balb/c mouse and Sprague Dawley rat, established cell lines, human colorectal HT29 cancer cell line and mouse fibroblast 3T3. Various mouse and rat tissues were snap- frozen and stored in liquid nitrogen. For immunoblotting six micron frozen sections of the various tissues were prepared and collected in Eppendorf tubes. The sections were then lysed in lysis buffer, and equal concentrations of lysates were run on 12% SDS-PAGE. The separated protein bands were transferred to PVDF/ polyvinylidene difluoride membrane for immunoblotting. Immunoblotting were subsequently subjected to densitometric analysis to get the value of molecular weight, peak height and raw volume of the protein band (Burnette, 1981). IBMR3Ag was expressed in mouse tissues with the highest MW (98.22) kDa and highest number (nine) of bands detected in muscle and the lowest MW in heart (75.00) kDa and liver (78.68) kDa with lowest number (2) of bands. In rat, more bands (eight) were detected in brain and kidney. While in spleen only four protein bands were detected. The highest MW was also indicated in brain (120.83 kDa), kidney (85.48 kDa) and 73.42 kDa in spleen. In both mouse and rat, highest expression of IBMR3 antigen was found in the lung and lowest in the brain. The immunohistochemical staining method was used in peroxidase technique for the investigation of the expression profile of the IBMR3 antigens in different frozen tissues from mouse and rat. The positive IBMR3 antigen were seen under light microscope as brown color, the results between weak, moderate and intense. Expressed IBMR3 antigens help to analyze the profile for molecular weight, peak height and raw volume. The different results in immunoblotting and immunohistochemistry staining gave positive expression for IBMR3 Ag in different part of the tissue sections, this shed more light on, whether the level of IBMR3 antigens are associated with pathological parameters. The results from this study suggest that the IBMR3 antigens were differentially expressed in mouse, rat tissue and cell lines. It was recommended that further research be conducted to identify and investigate the nature of the IBMR3 antigen and its potential role in tissue development.
- ItemThe effect of contemporary nursing care programme on Islamic work ethics and nursing caring behaviour in Southern Thailand(Pusat Pengajian Sains Kesihatan, Universiti Sains Malaysia, 2021-08)Issues related to quality of nursing care are still being debated in the literature while only a few studies were documented focusing on nursing caring behaviour in Southern Thailand. Non-caring behaviours were found to make the patients feel less confident and not empowered. This study aimed at examining the effect of the Contemporary Nursing Care Programme on nursing caring behaviour and work ethics. A quasi-experimental, pre-test and post-test design was implemented among 60 nurses who worked at Channae Hospital (experimental group, n=30) and Bachok Hospital (control group, n=30). The module of Contemporary Nursing Care Programme which was developed based on the human care conceptual model consisted of intention, utilizing professional knowledge skill, effective communication and respect domains. The experimental group received five sessions of Contemporary Nursing Care Programme and prior to that, both the experimental and control group received a pre-test while the post-test was conducted in the following week after completion of the programme. The Thai Nursing Caring Behaviour Scale (TNCBS) and Islamic Work Ethics (IWE) were used to measure nursing caring behaviour and work ethics and analysed using SPSS software. To further understand the two variables, a semi-structured interview was conducted among selected respondents (n=10). The results of paired t-tests showed nursing caring behaviour and work ethics were improved (p < .05) after the programme. Semi-structured interview which was analysed using thematic analysis revealed themes such as standard of care, role of nurses, and holistic care. The study found that the Contemporary Nursing Care Programme was useful in promoting caring behaviour and work ethics among nurses. Thus, the Contemporary Nursing Care Programme should gradually be implemented in the hospital setting particularly among new nurses. It is recommended that future research should implement a programme or training that embraces diverse culture and belief in order to achieve holistic care.