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- PublicationChronic anterior pituitary dysfunction following traumatic head injury: Prospective study in Hospital Sultanah Aminah Johor Bahru(2020)Background and Objective Traumatic brain injury(TBI) is associated with increase morbidity, mortality and long term disability. Hypopituitarism following TBI is not rare and most patient had undiagnosed and untreated hypopituitarism. Association of post TBI hypopituitarism causing neurobehavioural and quality of life impairment. There are wide range of post-traumatic hypopituitarism (PTHP) has been reported ranging 10-58%. The aim of the study is to determine the incidence of the chronic anterior pituitary Deficiency in patients with traumatic brain injury. Subsequently determine the risk factor and the outcome of the patient with chronic anterior pituitary dysfunction. Methods This is the single centre prospective cross-sectional study where 105 traumatic head injury patients under Neurosurgical Department Hospital Sultanah Aminah, Johor Bahru follow up who fulfilled the inclusion criteria. The inclusion criteria were patient with traumatic head injury, age from 18 to 65-year-old and had history of trauma 3 month prior to enrolment. The exclusion criteria were traumatic brain injury patient in chronic vegetative state with low life expectancy, patient who diagnosed or taking hormonal replacement therapy prior to the trauma, pregnant woman and female patient with normal menses LH and FSH will not be taken. The primary investigator will do an interview with the patient and the patient will be asked question to complete questioner form (36 question). Subsequently, blood sampling will be done. Other demographic data will be required from the admission documents. Results A total 33 patients (31%) were noted to have anterior pituitary dysfunction. The mean age was 36.97 ± 12.96 years old with a median of 35 years old. Out of 33 patients, 27 (32.5%) were male and 6 patients were female (27.3%). Chronic anterior pituitary dysfunction also was seen in more patients with a severe traumatic head injury around 47.1%, a total of 23 patients sustained a severe head injury as compared to a moderate head injury (8 patients, 38.1%) and 2 sustained mild head injury (5.6%). The mean duration after the onset of trauma was 10.3 months ± 1.79 and the median was 11 months. Chronic anterior pituitary commonly found in the patient enrolled in the study at 11 and 12 months post-trauma. All patient with pituitary dysfunction had positive CT brain findings. Out of 33 patients, 22 had SAH at the basal cistern and 27 patients had a base of skull fracture. 52.1% of the patient underwent surgical intervention and 8 patients didn’t undergo any surgical intervention. Out of all 33 patients with chronic anterior pituitary dysfunction, 84.8% involved 1 axis and another 5 (15.2%) patients had 2 axes involved. Binary logistic regression analysis studies the relationship between each of the variables and showed that severity of the head injury (p < 0.001), prolonged duration of hospital stay (p=0.014), radiological findings of a base of skull fracture(p <0.001), and presence of SAH at basal cistern (p<0.001) was significantly associated with chronic anterior pituitary dysfunction There was a significant difference seen in SF36 marks, where the patient with anterior pituitary dysfunction has the lower SF-36 marks 56.3± 10.3.Conclusion The prevalence of hypopituitarism was estimated at 31%. Indicators of increased TBI severity, prolonged hospitalization and positive finding of radiological assessment ( presence of SAH and base of skull fracture). Post traumatic chronic anterior pituitary dysfunction also related with poor quality of life as showed by low SF36 marks.
- PublicationAssociation between types of mammographic breast density and histological subtypes of invasive breast carcinoma(2021)Background: Mammographic density is an established risk factor for breast cancer. It reflects the relative component of fat, epithelial tissue, and connective tissues that has a specific appearance due to different tissue attenuation on the mammogram. Women with dense breast have more epithelial and connective tissue and less fat tissue, and are at higher risk to get breast cancer. Histological subclassification of breast cancer can be divided into invasive carcinoma of no special type (NST) and special types (ST) which include lobular, tubular, cribiform, metaplastic, apocrine, mucinous, papillary, and many others. From various works of literature, the majority of ST breast carcinoma carries a better prognosis than NST. Thus, appropriate classification can allow accurate estimation of a patient’s prognostication and facilitate the identification of optimal treatment strategies. The purpose of this study is to evaluate the association between mammographic breast density and histological subtypes of invasive breast carcinoma. Methods: A cross-sectional study was conducted in Hospital Universiti Sains Malaysia (USM), Kota Bharu, Kelantan, Malaysia on 125 patients who had been diagnosed with breast carcinoma and had undergone mammogram prior to surgery. Breast density was determined using the Breast Imaging Reporting and Data System (BI-RADS) and Tabar classification. It was divided into dense (BI-RADS C and D, Tabar type I, IV, and V) and non-dense (BI-RADS A and B, Tabar II, and III) categories. Histological subtypes of breast carcinoma are categorized into invasive carcinoma of no-special type and special type breast carcinoma. The association between mammographic breast density and histological subtypes of breast carcinoma had been carried out using Pearson chi square test. Cohen’s kappa analysis was done to determine the agreement between BI-RADS and Tabar classification. Results: There is no significant association between mammographic breast density using BI-RADS and Tabar classification with histological subtype (p=0.833 and p=0.336 respectively). However, Cohen’s kappa analysis shows good agreement between BI-RADS and Tabar classification, with a Cohen’s kappa coefficient of 0.8 (p < 0.001) Conclusion: Our study shows no significant association between mammographic breast density and histological subtypes of invasive breast carcinoma. However, with limited literature, further research might be plausible to show the association between breast density and histopathological subtypes of breast carcinoma
- PublicationA study on acute chemical poisoning among patients in emergency department Hospital Tengku Ampuan Rahimah Klang and its complications(2020)Introduction Acute poisoning is one of the most common reasons of patient visits to the emergency department (ED). The sociodemographic and presentations vary from one region to another. This study purpose is to determine the sociodemographics, presentations and factors associated with complications in patients with acute chemical poisoning. Methodology This retrospective study involved all patients presented with acute chemical poisoning to the emergency department of a government hospital in Malaysia from January 2016 until December 2018. A total of 260 patients were included and their sociodemographic, clinical presentation, complications and outcomes were recorded. Multiple logistic regression analysis was used to determine factors associated with complications. Result From 260 patients, 168 (64.6%) patients had intentional poisoning while 92 (35.4%) patients accidentally exposed to different chemical substances. Majority were single (n=158,60.8%), male (n=152,58.5%), and Indian (n=149,57.3%). The most common agent involved was pesticide. Complication rate was 14.2% with mortality rate of 4.6%. Common complications included respiratory insufficiency (n=30,11.5%), altered consciousness (n=14, 5.4%) and renal failure (n=17, 6.5%). Factors significantly associated with complications were age (AOR 1.05, 95% CI 1.02 to 1.09, p=0.005), other race (AOR 30.35, 95% CI 2.77 to 332.94, p=0.005), Chinese (AOR 12.27, 95% CI 1.03 to 146.63, p=0.048), tachycardia (AOR 39.7, 95% CI 11.31 to 139.27, p=0.004), time of exposure from 0800-1600 (AOR 22.15, 95% CI 1.95 to 252.04, p=0.013) and latency time from presentation of 2 to 12 hours (AOR 3.43, 95% CI 1.28 to 9.21, p=0.015) Conclusion Acute chemical poisoning is common among single, male patients with intentional circumstance. Apart from that, other factors associated with complications were age, tachycardia, Chinese ethnicity and other races, time of exposure and latency time from presentation to ED
- PublicationMass hysteria among secondary school students in Kelantan: A phenomenological approach(2021)Despite rising incidences of hysteria especially among school students in Malaysia this phenomenon still puzzled and bring challenges to many parties. Due to scarcity of information and limited research in this occurrence this study will shed some light in exploring and interpreting this phenomenon and cultural factors that conceptualizes the hysteria expressions that are distinctive in our study setting. Qualitative interpretative phenomenological approach with face to face interviews were conducted among 20 Malay adolescence using the semi-structured in-depth interview guide. The participants were selected using purposive sampling. The mean age of participants were 14.3 years and all of them are Malay Muslim. 50% of participants were either youngest or eldest siblings and majority of the participants came from low socioeconomic household. The experience and interpretation of hysteria emerged as ‘Culture Stereotyping’, ‘Idiom of Distress’ and ‘Social Reinforcement Factors’. As the hysteria phenomenon is an intermeshed of deep-rooted cultural influence with the mental health issues, the management would need cultural competence and sensitivity apart from further psychological and emotional evaluation by the health professional
- PublicationClinical profiles and outcomes of renal scarring in children underwent dimercaptosuccinic acid renal scan in a tertiary Hospital(2021)Title Clinical Profiles and Outcomes of Renal scarring in Children Underwent Dimercaptosuccinic acid (DMSA) Renal scan in a Tertiary Hospital. Background: DMSA renal scan is universally applied to detect renal scarring. It is a known cause for hypertension and proteinuria and may progressed into chronic kidney disease (CKD). We reviewed the proportion of renal scarring and looking at their risk factors and its outcomes in all children that were referred for DMSA renal scan at tertiary centre hospital. Methodology: All records of children less than 18 years old that were referred for DMSA renal scan over ten years period were reviewed. Among children whose renal cortical defects were confirmed by DMSA scan, data of their risk factors and its outcome were collected manually. Results: Out of 92 children referred for DMSA renal scan, forty-eight of them were shown to have renal scarring of which more than 50% of them had underlying vesico-ureteric reflux (VUR). More than half had recurrent urinary tract infections (UTIs) of non-Escherichia coli organisms. The most common complication was CKD, of which majority were stage 3 with median duration of one year after detection of renal scarring. Six children (12.5%) developed hypertension with median age of 10.5 years and median duration of one year after diagnosis of renal scarring was demonstrated. Conclusion: DMSA renal scan is recommended to be performed in children with VUR to detect scarring as its long term complications such as hypertension and CKD have been demonstrated to occur as early as one year after diagnosis. Hence, early diagnosis and treatment of the underlying problem is crucial
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- ItemVolatility behavior patterns and information transmission mechanism : evidence from Malaysian futures markets(Universiti Sains Malaysia., 2005-10)This study employs bivariate ARMA(p,q)-EGARCH(p,q) model specifications model to investigate whether information between Malaysian futures and cash markets is transmitted through first moments or second moments or both. Using daily data, the study covers the period from January 2, 1990 until December 31, 2003. The study also investigates the effects of the Malaysian futures - cash market relationship in the light of international market interdependencies. More specifically, it looks at whether information from foreign futures markets of S&P SOO, HSIF and NSIF influence the futures-cash relationship and whether the effects come through price level or volatility or both. In addition, the study also looks at the volatility patterns of Malaysian futures markets in order to facilitate a better understanding of the volatility transmission process. Lastly, to determine whether this transmission of information process (be it within and across markets) is affected by structural changes, the sample period was sub -divided into pre-crisis, during-crisis and post-crisis periods. Results indicate that the volatility behavior patterns of FKLI and FCPO futures markets are highly persistent but mean-reverting. Volatility of these futures markets also reacted asymmetrically to its past innovations, where positive news caused higher volatility than negative news. Transmission of information between Malaysian futures and cash markets occurs at both returns and volatility level, where futures markets tend to dominate the cash market at both levels. Volatility transmission is not asymmetric when the interactions between the futures and cash markets are included. The error correction terms have significant predictive power on both the conditional mean and volatility of these futures markets. Findings show that domestic futures-cash relationship is being influenced by the information transmitted from foreign futures markets. As for the Malaysian stock index futures, S&P 500 futures is the information producer at return level, while HSIF futures is at volatility level. NSIF futures have no influence on the volatility of FKLI and its related cash markets
- ItemRekabentuk pencahayaan untuk pameran ayat al-quran di Muzium(2002-03)Understanding the meaning and terminology's of lighting is important towards the discussion of the artificial lighting design at exhibit area in museum. The purpose of this study is to gain information on how lights play the role in displaying museum artifact such as AI-Quran verses. To determine the application of lighting on artifact applicable with the types, position, color and brightness of light source. Level of illuminance on artifact which is classified under papers and manuscripts, is considered. Further more, on the impact of the acceptance of light and the light threat on artifact. The study involved the method of measuring light intensity and measuring temperature and relative humidity to support the illuminance level, temperature and humidity in display casing and surrounding environment. Elaboration from the result and analysis of measurement and the perception of visual impact from respondents' on artifact is obtained. Nonetheless, factors related such as environment factors and method of· displaying artifact will assist in produce of efficient lighting. Finally, few proposal and future studies have been proposed.
- ItemRemoval Of Zinc (Ii) Ions From Industrial Wastewater By Activated Carbon Synthesized From Mangrove (Rhizophora Mangle)(Universiti Sains Malaysia, 2022-07-01)Water pollution has become one of the major issues in Malaysia, due to the release of industrial wastewater containing heavy metals. A suitable adsorbent is required to overcome this problem. Activated carbon is one the common adsorbent used for adsorption processes. Commercially available activated carbon (CAC) is expensive because it is made from non-renewable resources and require advanced processing methods to be produced. In recent years, production for activated carbon from agricultural products has gained attention for its ability in enhancing adsorption processes. Therefore, this study focuses on the potential use of agricultural wastes that are abundantly available in Malaysia, which is mangrove wood, as the precursor for the preparation of inexpensive adsorbent that can be applied to eliminate Zn (II) ions from industrial wastewater. The preparation conditions of the char through microwave heating were made at various radiation power and time. The optimization of microwave radiation power and time was performed using Response Surface Methodology (RSM). The optimal activated carbon was obtained at 616 W and 4 mins under physical activation with CO2. Apart from that, the adsorption process using the mangrove-based activated carbon was investigated under several conditions. The adsorption of Zn (II) ions was performed in batch system. From the experimental data, the ideal KOH impregnation ratio was at 0.5 with 98.97% of activated carbon yield and zinc (II) ions removal of 84.44%. The surface properties and morphology and functional groups of the prepared adsorbents were examined using Scanning Electron Microscopy (SEM), Fourier Transform Infrared Spectroscopy (FT-IR) and CHNS Elemental Analyzer. The equilibrium phase during adsorption for all batch experiment was reached within 5 hours. The initial concentration of Zn (II) solutions was studied at different concentrations such as 10, 20, 30, 40 and 50 ppm. Whereas the varying temperatures selected for the experiment were 20, 40 and 60°C. The highest Zn (II) ions removal and adsorption capacity was reached at 10 ppm and 60°C with percentages of 82.70% and 20.4043 mg/g respectively. The Langmuir isotherm model exhibit the best fit for the adsorption carried out. The maximum adsorption capacity using Langmuir isotherm was 27.6243 mg/g. The experimental data was also well fitted with pseudo-second order kinetics with R2 value of 0.9999. Finally, the thermodynamics study proved that the adsorption process is naturally endothermic. The process is spontaneous and faster at higher temperature of 60°C.
- ItemKinetics And Optimization Studies Of Pressed Pericarp Fibers Pretreated With Organosolvent(Universiti Sains Malaysia, 2012-07)The existence of lignin in pressed pericarp fibres (PPF) could inhibit the cellulolytic microorganisms from reacting with cellulose which directly inhibits the cellulolytic enzyme activities. In order to increase the susceptibility of cellulose, PPF was treated with organic solvent under high pressure and temperature in a high pressurized reactor (HPR). Monohydric alcohols (propanol) showed better delignification and hydrolysis at 38.5% and 46.1%, respectively. Ethanol was chosen as pretreatment solvent for further screening of catalyst due to its wide availability and economical perspective. Results showed that ethanol catalysed by nitric acid gave the highest delignification (48.9%) and hydrolysis (96%) of PPF, an increase of 7.4-times from the untreated PPF (raw PPF). In this study, optimization of conditions for PPF pre-treatment was also carried out using one-factor-at-a-time method (OFAT) and a statistical tool. It was found that an optimal PPF pretreatment was achieved at 180oC, ethanol to water ratio of 0.65 aided with 0.8% (w/w) of nitric acid. For the response surface methodology (RSM) via central composite design (CCD), it was found that ethanol to water ratio 0.61 catalysed by 0.69 % (w/w) nitric acid at 183 oC with reaction time of 92 min was the best condition for delignification (55.2 %) and hydrolysis of PPF (90 %) as compared to the untreated condition. The irreversible simultaneous reaction rate model involving 3 species of lignin was proposed and modified, and found that it fitted well with the experimental data at co-efficient of determination (R2) 0.91. As for the cellulose retained and PPF hydrolysis, a conventional reaction rate model with slight modification and a basic enzymatic reaction mechanism were proposed, respectively.
- ItemConstruction of multigrid solver for 2D heat conduction problem(2017-06)This research describes the formulation and application of the multigrid method for the 2D heat conduction problem. A Multigrid method (MG) is essentially a matrix solver which is used with another computational method for solving partial differential equation (PDE) such as finite element method (FEM), boundary element method (BEM), finite different method (FDM) etc. The formulation between FEM and MG is used to test the performance of this combination through the solution. The solution involves partial differential equation (PDE) of Poisson equation of 2D heat conduction problem and the solutions solved by using Matlab. The Poisson equation was tested with various types of heat source and the error L2 norm and H1 norm were computed to validate and prove the convergence of the solution. The solution of FEM and FEM-MG were compared and FEM-MG contains two types of smoother Gauss-Siedel and Successive Over Relaxation (SOR). The result shows that the error of L2 and H1 norm in FEM-MG smaller compare to FEM with conventional linear system solver.