Pusat Pengajian Sains Perubatan - Monograf

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Prevalens Effusi Telinga Tengah Di Kalangan Kanak-kanak Tadika Di Kota Bharu
(1999)
Mohamad Hamzah
Reent Topics Of Pharmacology In Oriental Medicine ; Detoxification Of Morphine Addiction In The Mouse Narcotic Dependence Model Using Extracts From Psidium Guajava Leaves
(1999)
The chance discovery of"the effects of opium on the body and mind in early history of man has led to the continuous search for opiate-like compounds that bring cures for our ailments, impart a feeling of well-being and elimini~e pain,· anxiety an_d discomfort. Unfortunately, many of these drl:lgs produce a powerful, seemingly endless, psychological s~ate of discomfort which overwhelms the individual and induces -an~. urgent need for relief or satisfaction. This opioid-induce~-satisfaction leads invariably to m~rked tolerance and serious physical dependence which develop rather rapidly with repeated doses of ri~iates like morphine or heroin.
Polymerase Chain Reaction Of Dried Blood Spots To Detect Parasite DNA In Individuals With Lymphatic Filariasis
(1999)
Sabudin, Mazula
Lymphatic filariasis caused by Brugia malayi has traditionally been detected in the blood of infected individuals by microscopy. Screening for blood-stage microfilaria (mf) by microscopy is labour intensive with user fatigue and poor specimen handling responsible for false negative results. Recently a method to detect the DNA from circulating microfilaria using the polymerase chain reaction (PCR) has been described (Lizotte et a/., 1994 ). However, the specimen collection method described \Yas unsuitable for routine screening in · field situations. The aim of the study reported here was to adapt the PCR method to a simple blood spot sampling and DNA extraction method suitable for remote areas without compromising the sensitivity of PCR. Blood spots were collected from individuals in Kelantan and Terengganu to optimise the technique. A one tube DNA extraction method was developed and coupled to a nested PCR assay that was field tested on an endemic community in Sabah. There was 100°/o sensitivity when comparing PCR to microscopy but only 70% sensitivity when comparing microscopy to PCR. The increased sensitiyity of PCR coupled with simple sample collection and DNA extraction provides a valuable ~ltern~tive to microscopy for detecting B. ma/ayi positive individuals in endem1c reg1ons of the world. ·
A comparative study of intra venous patient-controlled analgesia morphine and tramadol in patients undergoing major operation
(2004)
Kamalrujan Hassan, Shamsul
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.
Faktor penyebab kemasukan semula ke hospital universiti sains malaysia (HUSM) dalam kalangan pesakit dengan penyakit chronic obstructive pulmonary disease (COPD).
(2006)
Azmi, Barkhis
The readmission to the hospital is a serious problem for the health care system. It is an important indication of the quality and effectiveness of health care services. It is also the factor which causes increase in the cost of the health care services. Literature review shows that Chronic Obstructive Pulmonary Disease (COPD) is one of the diseases which has high readmission rates. The objective of this study is to identify the causative factor of hospital readmission among COPD patients. The identification of the factor can help to determine the action needed to reduce the number of COPD patients who have been readmitted. Reduction in the number of patients who have been readmitted will also reduce the burden of this phenomenon to the hospital and the individual who is involved. A descriptive study about the causative factor of the hospital readmission among COPD patients has been done in medical ward HUSM from 15th of December 2005 to 1 th of January 2006. There are 30 patients who have been chosen by using the convenience sampling to join this study. There are 19 male patients and I 1 female patients who have been diagnosed to have COPD and readmitted during this study. This study found that older patients especially those aged 65 years and above, male, with low education level and work as farmers are the demography factors which cause the readmission of these patients into the hospital. This study also found that patient's knowledge about the disease and treatment and the patient's inhaler administration technique shows significant association to the readmission rates with the p value for each of them is 0.000 and 0.021 respectively. While patient's compliance to the medication do not shows significant association to the readmission rates. The readmission of COPD patient which results from the exacerbation or complication of the disease are the problems which needs an attention as it has negative effect to the health institution, family and the patients themselves. Therefore, the finding of this study can be applied in the discharge plan for COPD patient in order to reduce the readmission rates and furthermore to increase the effectiveness of health care services and the patient's quality of life.
Parents knowledge on premature baby care in hospital university science malaysia (HUSM).
(2006)
Desa, Fatimah
Premature babies are those born before 37 weeks of gestation. Parents of premature babies need to have basic knowledge in caring for these babies as their life are at high risk . This study is to study the knowledge level in premature baby care in parents whose children are receiving treatment at HUSM. This study is done to study the knowledge level and socioeconomic factor influencing parents in care of premature baby at HUSM. This is a cross-sectional study toward 60 respondents who have premature babies and receiving treatment at HUSM. This study using questionnaire and the data was analyzed using 'Statistical Package For Social Science' (SPSS) version 12.0. From this study, the knowledge of respondents in the care of the premature baby was acceptable. Overall, the knowledge of respondents was 90% regarding feeding, 81.1% immunization, 62% bonding, 61% regarding birth premature babies, 56.5% healthcare, and 56% physical development. The result showed that the majority respondents have knowledge due to previous experience of caring for these babies during hospitalization and also from nurses and doctors treating the baby. Generally, most premature baby grow normally and their development is also normal but they need special care while they are growing. Nurses, have to be prepared in providing information and knowledge to parents who have premature babies so that they can apply the knowledge in caring for their premature baby. When the parents have enough knowledge regarding care of premature baby the caring process can be done in a proper and satisfactory manner.
Determination of paracetamol and caffeine in dosage forms by high performance liquid chromatography with photo diode array detection.
(2006)
Ismail, Ismazarni
A simple, accurate, and reproducible high performance liquid chromatographic method for the separation and simultaneous determination of paracetamol and caffeine in dosage forms is described. The HPLC system consisted of Water Alliance Series 2475 with photo diode array detection. The separations were c.arried out at room temperature on a C-8 (5 J.lffi, 250 x 4.6 mm i.d) Luna 5~ C-8 (2) Phenomenax Prodigy} analytical column. A mixture of 0.01 M KH2P04, methanol, acetonitrile, and isopropyl alcohol was used as mobile phase at a flow rate of 0.5 mllmin. Mobile phase solvents were degassed for 30 min. using ultrasonic bath and filtered through a 0.45 J.lm Milipore filter. The wavelength was in range of 210 to 400 nm. The validation validation linearity (r = 0.9998, 0.996 respectively for caffeine and paracetamol). The calculations of the concentration of paracetamol and caffeine were based on peak areas using calibration plots. The retention time of the separation of the mixture of caffeine and paracetamol were recorded as 11.695 min and 9.684 min respectively. This method is successfully applied to the analysis of commercial pharmaceutical preparations, yielding better resolution, sensitivity, and ease of operation as compared to the existing methods.
The Patient Compliance regarding of Eye-Care Information after Cataract Operation.
(2006)
Ahmad, Che Hasmah
A long term observation study has been done by observing the level of patient compliance concerning eye-care after cataract surgery and the right technique of eye drop instillation among patients that perform cataract surgery at HUSM, Kelantan. Level of compliance is the main factors that determine effectiveness of visual treatment after cataract surgery. This is important in order to avoid any complications that can cause permanent blindness. To evaluate patient's compliance to eye-care and right technique of installation of eye drop among patients that has performed cataract surgery and the influencing factors. There were 51 patients that underwent cataract surgery were attended first session of appointment after cataract surgery from December 2005 to January 2006 at Ophthalmology Clinic, HUSM, were interviewed by using research question. All of them had given eye-care information for post cataract operation and instruction of instillation of eye drop before discharge. Data were collected and analyzed by using descriptive test, Independent Samples Test and ANOVA for mean score, where the reading P<0.05 is considered significant. Result of the study showing the level of compliance of patient to eye-care after cataract surgery are high, including the aspects of hygienic, safety, diet, avoidance of vibration and pressure. Significant factors are age, race, educational level and work. Else, 13 out of 51 samples chose to instill eye drop independently and 38 samples chose to be dependent, the significant factor for the right technique of instillation of eye drop is age. From the results, although it shows the level of compliance and the instillation techniques of eye drop higher, but it should be increased by observing the group of patients having problems and the influencing factors. Thus, efforts to overcome the factors must be observed by all the health members that parties in order to achieve the success of the treatment.
Maternal anxiety during universal newborn hearing screening at Hospital Universiti Sains Malaysia.
(2009)
Kamaruddin, Noor Rafidah
The purpose of this study was to investigate the maternal anxiety during Universal Newborn Hearing Screening (UNHS) at Hospital Universiti Sains Malaysia (HUSM). A sample of 50 mothers who had given birth at HUSM was surveyed using a set of questionnaire. The instruments were based upon demographic profile, knowledge about hearing screening and Beck Anxiety Inventory (BAI). BAI is a set of questionnaire used to assess the level of maternal anxiety. The data was coded and analyzed using Wilcoxon signed Rank Test of SPSS version 11.5. The findings indicated that majority of the mothers were having mild anxiety during the first screening and before they undergone the second screening. The result also showed that there was significant difference of maternal anxiety level between the first screenings and before the second screening. There was also significant difference in the level of maternal anxiety between mothers whose babies failed the first screening and passed the second screening. Even though both results showed that there was a significant reduction in the level of maternal anxiety, but some of them are still in anxiety state. Therefore, actions need to be taken to improve the failure rate in UNHS.
A study to determine association of pattern of calcifications in ct scan and staging of retinoblastoma in Hospital University Science Malaysia.
(2011)
Goon, Rozita
A study to determine the association between pattern of calcification in CT scan and staging of retinoblastoma in Hospital University Science Malaysia(HUSM). Retinoblastoma is one of the most common intraocular malignancy in children under 15 years old. About 80% of cases occurs in patients under 3 years old. The incidence varies form countries to countries. In United States of America, it occurs in 1 of every 15000 live birth. Most incidence of retinoblastoma is unilateral, bilateral involvement is seen in approximately 30% of cases and it is detected earlier. Physical and radiological examination helps in diagnosing retinoblastoma. CT scan of the orbit is one of the important tools in diagnosing retinoblastoma. Intraocular calcification can be detected in about 80% of the CT scan of orbit. Many researches have been performed since 1980s to determine association between intraocular calcification in retinoblastoma with prognosis and size of the tumour. The aim of study is to determine the association between intraocular retinoblastoma in CT scan and staging in Hospital Universiti Sains Malaysia (HUSM). To determine frequency of intraocular calcification in retinoblastoma and association between the pattern of calcification with histopathological examination, clinical data and staging. This was a retrospective descriptive study. The age of patients were ranged from 0 to 7 years old. 23 patients with 24 involved eyes were included in this study during the study period from January 2003 until July 2010. All patients had undergone pretreatment CT scan of the orbit and enucleation. The CT scans were performed using GE Lightspeed Plus with contiguous 1.25mm orbital slice in axial projection. A repeated examination was done after intravenous injection of contrast medium Omnipaque (300 mg iodine/ ml). From these, coronal images were reformatted through the orbits and oblique sagittal images were reformatted through the optic nerves. Characteristic of calcification on CT scan images which were presence of calcification, size, site and Hounsfield Unit of calcification were recorded. CT scan images were reviewed via GE Centricity PACS- IW (Intregrated web) version 3.71. Histological findings which were presence of calcification, size, site of tumour and optic nerve involvement were recorded. History of presenting illness, family history, demographic data and clinical classification were sought form medical record and recorded. Association between characteristic of calcification and histological findings, clinical data and staging were determined. There was 95% intraocular CT calcification seen in retinoblastoma in this study. There was significant association between presence of calcification on CT and presence of calcification on HPE(p=0.042). There was also significant association between presence of HPE calcification and CT calcification site(p=0.016). Significant association noted between CT calcification size and strabismus(p=0.035). Although presence of calcification on CT scan was used as a criteria to diagnosed retinoblastoma especially in children younger than 3 years old, there is no significant association between patterns of the calcification with staging in retinoblastoma.
Perinatal, maternal and antenatal associated factors for autism: a case control study.
(2011)
Abdullah, Mohammad Nasir
Autism disorders are a group of neurodevelopmental disorders which characterized into three main domains which are social interaction impairment, communication delay and repetitive or stereotypic behavior. Many studies had suggested that the risk factors for autism derive from three big factors namely environmental factors, genetic predisposition and vaccine induced. The aim of this study was to investigate the perinatal, maternal and antenatal associated factors on autistic disorder children at Hospital Pulau Pinang and Hospital Bukit Mertajam, Pulau Pinang. A case control study involving 312 cases and control was conducted using data retrieved from hospital records at Pulau Pinang hospital and Bukit Mertajam hospital from 2001 to 2008. The departments involved were Psychiatric, Obstetrics and Gynecology and Record and Management Department. All cases which met the inclusion and exclusion criteria were included in the study. Univariable and multivariable logistic regression were used to explore the prenatal/perinatal risk factors associated with autistic disorder children. There were seven risk factors contributed most to autistic disorder determination. The factors were maternal age [Adjusted OR: 1.41; 95% CI: (1.27, 1.57)], maternal smoking reported at first antenatal visit [Adjusted OR: 13.61; 95% CI: (1.87, 99.35)], birth asphyxia [Adjusted OR: 0.35; 95% CI: (0.11, 1.08)], psychiatric history [Adjusted OR: 54.94; 95% CI: (12.07, 250.04)], multiple gestation [Adjusted OR: 4.81; 95% CI: (1.86, 12.45)], parity for more than 4 [Adjusted OR: 0.11; 95% CI: (0.03, 0.47)], parity between 0 and 1 [Adjusted OR: 0.19; 95% CI: (0.07,0.55)], Chinese race compared to the Malay race [Adjusted OR: 10.11; 95% CI: (3.61, 28.30)] and Indian race compared to the Malay race [Adjusted OR: 5.14; 95% CI: (1.38, 19.16)]. The results suggested that autistic disorders were associated with perinatal, maternal and antenatal factors such as delivery, pregnancy and maternal characteristics.
Effects of resistance training on selected healthrelated fitness variables among female students of Universiti Sains Malaysia, Health Campus
(2012)
Rigar, Carl Sherman
The purpose of this study was to examine the effects of resistance training among female students of Universiti Sains Malaysia, Health Campus on selected health-related fitness variables including body composition, muscular strength, muscular endurance and flexibility. A total of twenty healthy female students of Universiti Sains Malaysia, Health Campus (20.3 ± 0.7 years old) were involved in this study. All subjects underwent pre-test where their anthropometrical measurements, body composition, muscular strength, muscular endurance and flexibility were measured. They were randomly assigned into control group (n=10) and exercise group (n=10). The control group resumed with their normal physical activity while the exercise group underwent resistance training programme which comprised of ten resistance exercises per session, thrice a week. After six weeks, all the subjects underwent post-test to measure their anthropometrical measurements, body composition, muscular strength, muscular endurance and flexibility. The findings revealed no significant difference (p > 0.05) in above measurements between the two groups. Although there were no significant differences, a trend of improvement could be observed in body composition and back and leg strength among exercise subjects after six weeks of resistance training. The results show that resistance training does bring benefits on health-related fitness among female students and it should be made a part of regular exercise apart from aerobic exercise to improve health-related fitness.
Proliferation effects of human fetal osteoblast cell line (hFOB 1.19) treated with Quercus Infectoria galls extract
(2013)
Rozelan, Dalila
The Quercus infectoria (QI) galls are traditionally reported to have great medicinal value such as astringent effect, anti-pyretic, anti-diabetic, anti-tremorine, anti-inflammatory, antibacterial, anti-viral and anti-oxidant activity. Those activities were postulated due to the presence of polyphenols which are proven to have an anabolic effect on the bone metabolism by modulating the proliferation, differentiation and mineralization of osteoblasts. Furthermore, Ql galls also contain mineral compositions such as calcium, phosphorus, magnesium, iron, zinc, oxygen, potassium, aluminium, carbon, manganese, nickel and silica, which are important for bone metabolism. The present study was undertaken to evaluate the effect of Ql galls extract on proliferation, bone formation markers such as alkaline phosphatase (ALP) and osteocalcin level, and morphology of hFOB 1.19 cells. The cells were cultured in Dulbecco's modified eagle medium F12 supplemented with 10% fetal bovine serum and 1% penicillin/streptomycin, and then were treated with QI galls extract at various concentrations ranging from 0.1 to 99.0 J.lg/rnl for 72 hours. The proliferation activity of hFOB 1.19 treated with QI galls extract was measured by MIT assay with median effective concentration (EC50) 10.30 J.lg/ml. This concentration was more effective compared to positive control drug, pamidronate which exert the ECso at 16.09 J.lg/ml. In addition, the functional activity such as ALP and osteocalcin levels, were measured by enzyme-linked immunosorbent assay (ELISA) method at day 1, 3, 7, 10 and 14. The ALP activity for hFOB 1.19 treated with QI galls extract were increased in time dependent manner. The ALP highest activity in the QI galls extracts treated cells recorded as 38.79 UIL. This trend were also observed in hFOB 1.19 treated with pamidronate. However, the cells treated with QI galls extract exerted higher ALP activity compared to cells treated with pamidronate (28.03 U/L). Meanwhile, osteocalcin level for hFOB 1.19 treated with QI galls extract also were increased in time dependent manner. The highest osteocalcin level in Ql galls extract treated cells was 2.18 ng/ml. However, the osteocalcin level in hFOB 1.19 treated with pamidronate peaked at day 10 (1.54 ng/ml) and the level decreased afterward. Overall, the cells treated with QI galls extract still exerted higher osteocalcin level compared to cells treated with pamidronate. The morphology of hFOB 1.19 was observed by using inverted microscope from day I until day I4. The QI galls extract treated cells showed an increment in the cell number (percentage of raise in cell no. on day 1 = 81.48% and day 14 = 96.18%). More interestingly, cells treated with Ql galls extract remain uniformly elongated and overconfluent. Inversely, cells treated with pamidronate observed as rounded and less density (percentage of raise in cell no. on day I = 76.I9 % and day I4 = 92.19 % ). In conclusion, the result of functional activity and morphological changes of the cells were consistent and the effect of QI galls extract on proliferation of osteoblasts was much better than pamidronate. Thus, these suggest that QI galls extract might be a potent anabolic agent that able to enhance the proliferation, differentiation and mineralization of the osteoblast cells.
A randomized trial on haemodynamic changes during intubation using airtraqr and macintosh laryngoscope
(2013)
Chen, Chua Chen
Sympathetic response is associated with laryngoscopy and intubation. Such response can be hazardous to patients with poor physiological reserve. Many research and development were done to look for the best way of obtunding this response. New laryngoscopes like Airtraq® laryngoscope were designed to improve the process of intubation and thus reduces sympathetic response secondary to laryngoscopy and intubation. To compare the sympathetic response and immediate complication of endotracheal intubation using Airtraq® and Macintosh laryngoscope, which are then analyzed to determine if the newer Airtraq® laryngoscope is an inferior, equal or superior alternative to the mainstay Macintosh laryngoscope. This is an experimental, prospective, stratified, single blind randomized study. 142 patients who had fulfilled the inclusion and exclusion criteria were allocated into Airtraq® and Macintosh group according to age group, 18-29, 30-39, 40-49 and 50-59. sBP, dBP, MAP and HR of patients at baseline, during intubation, 1, 2, 3, 4, and 5 minutes post-intubation were collected and compared. Complications associated with laryngoscopy and intubation were observed in this study too. Statistical analysis using mean (SD) and ANOVA test were performed on the data obtained. Data was compared in general, age group below 40 years old and age group above 40 years old. In general, there was significant difference within group for both Airtraq® and Macintosh groups for sBP, dBP, MAP (p < 0.001). However, there was no significant different between and within-between group for sBP, dBP, MAP and HR. Pressure response was significant different within and between groups for age group more than 40 years old (p 0.05) and the changes were more than 20.0% from the baseline in Airtraq® group. No significant different in HR between 2 groups and the changes were less than 20.0% in all age groups. Airtraq® laryngoscope causes less sympathetic stimulation during laryngoscopy and intubation. It is suitable to use in elder patients and those which exaggerated sympathetic response during laryngoscopy can be hazardous.
The effect of light resistance training using dumbbells and ankle-wrist weights on modifiable cardiovascular disease risk factors.
(2013)
Yaacob, Najib Majdi
Cardiovascular diseases which account for the majority of the population disease burden are closely linked to unhealthy lifestyles. One of the global strategies to reduce the burden is by promoting physical activity which includes both aerobic activity and resistance training. Resistance training is an important component of physical activity which has a great potential for improvement of overall health. This study aimed to determine and compare the effect of light resistance training using either dumbbells or ankle-wrist weights on body composition, blood pressure, health related physical fitness and biochemical parameters among overweight and obese adults in Kelantan. One hundred and thirty eight overweight and obese adults, aged 18-60 years were randomized to two groups; dumbbell group (n=69) and ankle-wrist weight group (n=69). Participants in dumbbell group performed group exercises three times per week using a pair of one kilogram dumbbells. The exercise consisted of a one sets of 12 movements, 12 repetitions for each movements which lasted for 20 minutes. Participants in ankle-wrist weight groups were given a pair of 500 gm ankle and a pair of 500 gm wrist weights to be used during activities of daily living for at least 20 minutes, three days per week. For both groups, resistances training for the first three months were closely monitored for adherence and the last three months were not directly monitored. Eighty nine participants completed this sixth month study. At third month, both groups showed significant reduction from baseline in waist circumference (WC) (dumbbell group: mean difference: 4.26, 95% CI: 2.10, 6.42; p<0.001; ankle-wrist weight group: mean difference: 3.31, 95% CI: 2.07, 4.55; p<0.001), waist to hip ratio (WHR) (dumbbell group: mean difference: 0.022,95% CI: 0.003, 0.041; p—0.016; ankle-wrist weight group: mean difference: 0.011, 95% CI: 0.001, 0.022; p—0.035) body fat percentage (dumbbell group: mean difference: 1.14, 95% CI: 0.60, 1.68; p<0.001; ankle-wrist weight group: mean difference: 1.20, 95% CI: 0.72, 1.69; p<0.001) and significant increase in skeletal muscle percentage (dumbbell group: mean difference: -0.66, 95% CI: -1.06, -0.27; p<0.001; ankle-wrist weight group: mean difference: -0.82, 95% CI: -1.13, -0.51; p<0.001), cardiorespiratory fitness (dumbbell group: mean difference: 17.23, 95% CI: 14.63, 19.83; p<0.001; anklewrist weight group: mean difference: 15.57, 95% CI: 13.18, 17.96; p<0.001), muscular endurance (Push up test: dumbbell group: mean difference: -5.78, 95% CI: -7.04, -4.51; p<0.001; ankle-wrist weight group: mean difference: -5.41, 95% CI: - 6.48, -4.34; p<0.001; Sit up test: dumbbell group: mean difference: -8.33, 95% CI: - 10.18, -6.47; p<0.001; ankle-wrist weight group: mean difference: -8.96, 95% CI: - 10.46, -7.46; p<0.001), muscular strength (Handgrip strength: dumbbell group: mean difference: -6.30, 95% CI: -8.77, -3.83; p<0.001; ankle-wrist weight group: mean difference: -4.16, 95% CI: -5.51, -2.82; p<0.001; Leg strength: dumbbell group: mean difference: -16.43, 95% CI: -19.84, -13.02; p<0.001; ankle-wrist weight group: mean difference: -21.49, 95% CI: -25.89, -17.09; p<0.001) and flexibility (dumbbell group: mean difference: -5.40, 95% CI: -6.63, -4.17; p<0.001; ankle-wrist weight group: mean difference: -1.67, 95% CI: -2.40, -0.95; p<0.001). Participants in dumbbell group showed significant reduction in total cholesterol (mean difference: 0.30, 95% CI: 0.03, 0.57; p=0.033), low density lipoprotein cholesterol (LDL-C) (mean difference: 0.36, 95% CI: 0.09, 0.63; p=0.004) and non-high density lipoprotein cholesterol (mean difference: 0.39, 95% CI: 0.12, 0.66; p=0.002) while participants in ankle-wrist weight group showed significant increase in high density lipoprotein cholesterol (HDL-C) (mean difference: -0.14, 95% CI: -0.25, -0.02; p=0.014) at the end of the third month. At the end of sixth month, significant reduction from baseline in WC and WHR, and significant increase in cardiorespiratory fitness, muscular strength, muscular endurance and flexibility were maintained with addition of significant reduction of systolic blood pressure (SBP) for both groups (dumbbell group: mean difference: 5.60, 95% CI: 1.24, 9.96; p=0.006; ankle-wrist weight group: mean difference: 5.27, 95% CI: 0.99, 9.54; p=0.008) and significant increase in HDL-C were maintained for ankle-wrist weight group. After adjustment of age only improvement of WC, SBP, cardiorespiratory fitness, muscular strength, muscular endurance and flexibility were still significant. Effect of six months light resistance training between using dumbbells and ankle-wrist weights were similar with exception of leg strength which was better in ankle-wrist weight group (at month 3: 62.38 vs. 68.43; at month 6: 58.38 vs. 70.96; p<0.001) and flexibility was better for dumbbell group (at month 3: 36.70 vs. 32.59; at month 6: 37.83 vs. 33.35; p<0.001). Resistance exercise using either dumbbells or ankle-wrist weight produce significant improvement in certain components of body composition, blood pressure, health related physical fitness and biochemical parameters. Light resistance training should be considered to be an integral component of healthy lifestyle promotion programs aiming to reduce cardiovascular risk and to improve overall health.
Percutaneous balloon angioplasty in central venous stenosis and occlusion in haemodialysis vascular access: comparison of the outcome.
(2013)
Wahed, Haniza
Central venous occlusive disease is currently increasing in trend, in view of improved health care and lifestyle changes. Central venous occlusive disease requires treatment, especially in hemodialysis patient. Venous hypertension in this disease interfere the hemodialysis access and eventually leading to its dysfunction and access termination. Interventional radiology has emerged in endovascular treatment, playing its important role in treatment of central venous occlusive disease. Surgical intervention has been less favourable in the management of central venous occlusive disease, indirectly reduces the health care burden. The current practice of central venous occlusive disease is an endovascular approach as a frontline. However there is no proper protocol in managing the disease. In this study, success rate in venous stenosis and venous occlusion were compared and the association of degree of stenosis and length of occlusion with success rate has been studied. Hopefully it will help in predicting the patient which is suitable for endovascular management or surgery and contributing in developing a proper management protocol in the future. This is a cross sectional retrospective study of percutaneous angioplasty in the treatment of central venous stenosis and occlusion in Hospital Pulau Pinang for period 21 months from May 2011 to February 2013. The patient’s notes were traced and data were collected on the success rate, complication rate, presence and location of stenosis, degree of stenosis and length of occlusion. Venograms were reviewed in all cases to assess lesion characteristics, pre procedure and post procedure results. Descriptive analysis was used to analyze the demographic data. 71 patients were included into this study of which 42 (59.2%) males and 29 (40.8%) females. Their age ranged from 17 to 86 years old. 21 (29.6%) were Malay, 39 (54.9%) Chinese and 11 (15.5%) are Indian. From total 71 patients, 28 (39.4%) cases are were venous stenosis and 43 (60.6%) cases were venous occlusions. 25 out of 28 cases of venous stenosis were successfully treated with success rate of 89.3%. 19 out of 43 cases of venous occlusion were successfully treated with success rate of 44.2%. There is association between the success rate of procedure and degree of stenosis and length of occlusion. The success rate of percutaneous angioplasty in central venous stenosis is higher (89.3%) compare to total venous occlusion (44.2%) among haemodialysis patient. The degree of stenosis and length of occlusion is significantly associated with the success rate of percutaneous balloon angioplasty.
Screening of laryngopharyngeal reflux disease in patients with gastroesophageal reflux disease symptoms in Hospital Universiti Sains.
(2013)
Apparau, Hema
Laryngopharyngeal reflux (LPR) has been recognized as an extraesophageal manifestation of gastro esophageal reflux disease (GERD). However, many questions still exist as how to diagnose this disease accurately and to identify patients with silent reflux. This study was conducted to determine the prevalence of LPR in patients with GERD symptoms in Hospital Universiti Sains Malaysia, Kubang Kerian. This is a cross sectional study involving 115 patients presenting to Gastroenterology clinic and Outpatient clinic in HUSM from December 2011 to June 2012. Participants were required to answer the Symptomatic GERD questionnaire and Reflux Symptom Index questionnaire. This was followed by laryngeal examination and documentation of Reflux Finding Score. The prevalence of LPR in patients with symptomatic GERD was 33.04%. The commonest symptom in RSI was ‘heartbum, chest pain, indigestion or stomach acid coming up’. The most commonest sign seen in RFS is ‘erythema’. There was significant correlation between RSI and RFS. LPR is present in patients with symptoms of GERD. RSI and RFS play an important role to identify patients with LPR and aid the clinician to deliver the appropriate treatment to them.
Evaluation of entamoeba histolytica acetyl co-a synthetase recombinant protein (rehacs) for serodiagnosis of acute amoebic liver abscess in humans.
(2015-05)
Sith, Nur Shafiqa Md
Amoebic liver abscess (ALA) caused by Entamoeba histolytica is the most common and potentially fatal extra-intestinal manifestation of amoebiasis. At Hospital Universiti Sains Malaysia (HUSM), diagnosis of ALA includes detection of antibodies using a commercial kit based on crude soluble antigens (CSA) of E. histolytica. CSA consist of a cocktail of E. histolytica proteins that are not well-defined in terms of the characteristics of the proteins and their masses. This study was done to evaluate the diagnostic potential of a well-defined recombinant protein of E. histolytica acetyl-Co-A synthetase (rEhACS) using serum samples from patients warded in HUSM who were diagnosed with ALA based on clinical symptoms, ultrasound imaging, and positive serology with commercial indirect haemagglutination kit, llfA (Cellognost® Amebiasis Kit, Dade Behring Marburg GmbH, Germany). The rEhACS was expressed in E. coli BL21 AI and purified using Ni-NTA resin column under optimized parameters. Presence of the purified rEhACS protein was ascertained based on observation of the prominently expressed -77 kDa on SDS-PAGE gel stained with Coomassie brilliant blue. The specificity and sensitivity of the purified protein were evaluated via enzymelinked immunosorbent assay (ELISA) using 30 ALA-positive serum samples and 30 ALA-negative serum samples with llfA seronegative obtained from patients infected with pathogens other than E. histo/ytica. The sensitivity and specificity for rEhACS/total anti-human IgG-ELISA were 500/o and 96.67% respectively. Meanwhile, for rEhACS/anti-human IgG4-ELISA were 36.67% and 96.67% respectively. In conclusion, this study demonstrated that rEhACS was highly specific for serodiagnosis of ALA. Interestingly, 50% (IgG-ELISA) or 36.6% (lgG4-ELISA) ofthe positive serum samples were _probably obtained from patients with acute ALA. Future studies should focus on identifying new acute ALA cases based on rEhACS antigen followed by performing a battery of ALA examinations such as ultrasonography and molecular detection ofbiopsied liver abscess samples to confirm the infection.
Understanding platelet thrombogenicity cascade of the biocompatible chitosanderivates In von willebrand disease
(2016)
Saad, Arman Zaharil Mat
Introduction: Chitosan extracted from the shells of arthropods have becoming one of the most promising local hemostatic agents because it is of particular interest as it functions independently on platelets and normal clotting mechanisms. Objectives: This work verified the underlying mechanisms of chitosan-induced platelet thrombogenicity cascades and comprises experimental tests such as degradation ability; coagulation analysis and the investigations of hemostatic mediators: von Willebrand Factor (vWF), Factor 8 (FVIII), Thromboxane A2 (TXA2), P2Yl2, glycoprotein IlbIIIa (GpIIbIIIa), Transforming Growth Factor- Beta 1 (TGF-~1) and Platelet Derived Growth Factor-AB (PDGF-AB) in normal donors and von Willebrand disease (vWD) patients in vitro. Materials and Methods: Comparative studies have been conducted to measure the hemostatic capacity of biodegradable: 7% N,O-Carboxymethylchitosan (NO-CMC) (with 0.45 mL collagen), 8% NOCMC, Oligo-chitosan (0-C) and 0-C 53. Lyostypt, the topical hemostatic agent was used as a positive control. This study was conducted using scanning electron microscope, enzyme-linked immunosorbent assay, westergren, coagulation analyzer, western blotting and flow cytometry techniques. Fourteen vWD and normal subjects were recruited in this study with provided informed written consent. Results and Discussions: 0-C type of chitosans are able to enzymatically degrade, 1 possess better porosity and the scaffold pores are sufficient to allow nutrients and cells to enter and by encouraging platelet activities to accelerate hemostasis and wound healing process. 0-Cs exert a combined effect on thrombogenesis by causing platelets to adhere, activate, aggregate and forms insoluble fibrin network to strengthen platelet plug formation by elevating the studied mediators.O-C was capable to induce the expression levels of vWF, FVIII and TXA2 receptor signals. This signaling pathway assists the platelet aggregation. Also, GpIIbIIIa and P2Y 12 analysis showed that 0-C group of chitosan are capable of activating platelets by providing a good surface for blood hemostatic mediators and signals to facilitate thrombin generation. 0-C-activated platelets lead to the release of growth factors, mainly TGF-~1 and PDGF-AB. Therefore, this exhibited that greater expression level of 0-C group of chitosan assists in mediating wound healing process. Conclusion: Tested chitosan-stimulated-mediators potentially initiate the platelet actions and expedite the hemostasis processes in vitro. Based on the outcome of this research, the 0-C and 0-C 53 stimulated hemostasis process and worked better and equal to the commercially available lyostypt in normal donors or subjects and vWD patients in vitro.
Determination of the heavy metals contamination from batik factory effluents to its surrounding
(2016)
Muslim, Noor Zuhartini Md
Batik industries may produce a large amount of effluents with a high concentration of pollutants such as heavy metals. Heavy metals are environmentally stable, non-biodegradable, and toxic to living beings. Heavy metals tend to accumulate in soils, plants and eventually cause chronic and adverse effects on human health. In this study, the levels of heavy metals in effluent, soil and plant around batik factories were determined using atomic absorption spectrophotometer (AAS). Effluent, soil and plant samples were collected from three batik factories in Kota Bharu , Kelantan. Cadmium (Cd), lead (Pb), zinc (Zn), copper (Cu), chromium (Cr), and iron (Fe) were chosen as representative metal elements. The results indicated that high concentration of heavy.

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