Pusat Pengajian Sains Perubatan - Tesis
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- PublicationEvaluation of medical students’ learning performances, engagement, and cognitive load in ospe-based anatomy practical session(2025)Lingxi, LiuBackground: Human anatomy education conventionally relies on cadaver dissection but faces challenges from limited teaching time, decreasing cadaver availability, and singlemethod limitations. This has driven exploration of innovative approaches that retain conventional strengths while addressing modern constraints. The integration of Objective Structured Practical Examination (OSPE) principles into practical sessions offered structured, interactive, provides immediate feedback, and enhances student engagement. Universiti Sains Malaysia's School of Medical Sciences transitioned from cadaveric dissection to multimodal teaching, implementing OSPE-based practical session since 2015. Objective: The purpose of this study is to investigate the impact of OSPE-based anatomy practical session on students' learning performances, engagement, and cognitive load. Methodology: This randomised control trial (RCT) study recruited 117 students (57 completed) who were randomly allocated 1:1 to either OSPE-based practical intervention or conventional teaching control groups via stratified randomization. The intervention involved a 1-hour lecture, 30-minute pre-practical assessment, and a 1 hour and 40 minutes practical session. The OSPE-based practical group engaged in anatomical identification tasks with peer/lecturer discussion, while controls used plastic models for senior lecturer debriefing and independent learning. Post-practical data included a 30- minute assessment, Burch Engagement survey, validated cognitive load scale, and online feedback. Data were analysed using SPSS 29.0 with descriptive statistics, independent/paired t-tests, and Mann-Whitney U tests as appropriate. Results: Both groups showed significant pre- to post-assessment improvements in psychomotor and cognitive scores. The OSPE-based practical group significantly enhanced cognitive performance compared to the conventional group, though no differences were found in psychomotor or overall scores. No significant between-group differences emerged in cognitive load or engagement domains. Student feedback indicated high satisfaction with the OSPE-based anatomy practical sessions. Conclusion: The OSPE-based approach demonstrated a modest advantage in enhancing cognitive performance, with comparable outcomes in psychomotor gains, cognitive load, and student engagement relative to conventional methods. While pre-intervention differences and high participation dropout may limit generalizability, within-group improvements and positive learner feedback affirm the pedagogical value of structured, scenario-based practical assessments in anatomy education.
- PublicationExploring new zolpidem binding site on ε-containing Gaba (A) receptor via computational methods(2025-05)Tze, Sherilyn Choo MingThe ε-containing GABA (A) receptors (GABAARs), a lesser-studied subtype within the GABAAR family, have gained attention due to their distinct pharmacological properties and potential involvement in brain injury. Zolpidem (ZPM), a widely used Z-drug, has been reported to induce paradoxical effects in brain-injured patients, although the molecular basis remains unclear. This study aimed to elucidate the structural and molecular mechanisms underlying this phenomenon through a comprehensive in silico approach. A homology model of the α1-β2-ε-α1-β2 GABAAR was successfully constructed and validated following energy minimization and equilibration using CHARMM-GUI and GROMACS. Molecular docking with AutoDock 4.2 assessed the binding affinities and interaction profiles of ZPM, flumazenil (FMZ), and methyl-6,7-dimethoxy-4-ethyl-β-carboline-2-carboxylate (DMCM) —representing positive, null, and negative allosteric modulators, respectively. ZPM exhibited the highest binding affinity at the α1+/ε− interface, followed by FMZ and DMCM. Structural analysis suggested that the γ2F77I and γ2A79S substitutions in the ε subunit may reduce ligand affinity, especially for bulkier ligands like FMZ and DMCM. Additionally, poor conservation of Loop F residues spanning γ2Glu182–Arg197 may influence modulatory efficacy of positive allosteric modulators (PAMs) like ZPM. Molecular dynamics simulations (100 ns) largely supported the pharmacological profiles of the ligands. Although ZPM showed limited activity at the α/ε site, the Monod-Wyman-Changeux allosteric model suggests that PAMs can enhance function in spontaneously active GABAARs with single GABA occupancy. This supports ZPM’s specific positive modulatory effects on ε-containing receptors and highlights their potential as therapeutic targets in brain injury.
- PublicationIn vitro evaluation of polyphenolic-rich fraction of cornsilk extract as anti-hyperglycaemic agent(2025-01)Joanne, KooDiabetes mellitus (DM) is a chronic metabolic disease that characterised by elevated blood glucose level due to insulin resistance or inadequate insulin production. The increased blood glucose concentration also known as hyperglycaemia which contributes to various diabetic complications such as diabetic cardiomyopathy and diabetic nephropathy. Metformin and acarbose are the well-known medical practical drugs used to treat and alleviate the diabetes-related complications. However, those antidiabetic drugs bring side effects to the diabetic patients during treatment. Hence, this study is aimed to investigate the polyphenolic-rich fraction (PRF) of cornsilk extract as a potential candidate in the study of type 2 diabetes mellitus (T2DM). The antiglycation effect and mechanism of PRF of cornsilk was evaluated using in vitro study. The cell viability and EC50 of PRF of cornsilk were determined using murine fibroblast (L929) cell line via MTT assay. The PRF of cornsilk showed statistically significantly protected and enhanced the L929 cell viability and proliferation under high glucose with p value of < 0.0001 and EC50 value of 3.84 x 10-12 mg/mL. Upon the MTT assay, the PRF of cornsilk was more effective than the metformin in protecting cells. Furthermore, the PRF of cornsilk depicted statistically significantly (IC50 = 8.38 mg/mL) inhibited the α-amylase enzyme using in vitro α-amylase inhibition assay. However, acarbose demonstrated more robust with a greater inhibition effect (IC50 = 6.95 mg/mL) than the PRF of cornsilk in the α-amylase inhibition assay. Lastly, the PRF of cornsilk showed statistically significantly reduced the advanced glycation end products (AGEs) level using BSA-glucose and -methylglyoxal antiglycation assays. The PRF of cornsilk showed stronger antiglycation activity than the metformin in these antiglycation assays. In short, the PRF of cornsilk is proved with its effective antiglycation property and showed to be a promising candidate to reduce diabetes-related complications by antiglycation pathway. However, more investigations have to carry out to gain further understanding on the antiglycation effect of the PRF of cornsilk
- PublicationMicrovascular Endothelial Function In Obesity; And The Effect Of Pharmacological Intervention With Orlistat And Sibutramine On Microvascular Endothelial Function And Selected Cardiovascular Risk Markers(2012)Al-Tahami, Belqes Abdullah MohammadObesity increases the risk of a variety of medical problems and cardiovascular diseases. Endothelial dysfunctionis one of the earliest vascular changes that occur in the pathogenesis.. Of cardiovascular diseases. This phd work is composed of three studies. The first study aimed to optimize a technique used to assess microvascular endothelial function, using laser doppler fluximetry (ldf) and the process of iontophoresis. Ldf measures skin perfusion, while iontophoresis is a non-invasive method of introducing charged substances across skin by means of a small electric current to evaluate both endotheliumdependent and endothelium independent vasodilatation. Firstly, the effect of sodium chloride used as a vehicle to dilute the iontophoresis drugs acetylcholine (ach) and sodium nitroprusside (snp) on non-specific vasodilatation was assessed. Secondly, to determine the number of electrical pulses needed to reach the maximum response during iontophoresis of ach and snp using low current strength. Thirdly, the reproducibility of different parameters during iontophoresis of ach and snp) were also determined. The initial iontophoresis protocol used consisted of 7 electrical pulses of2 minutes each separated by l minute current free interval.
- PublicationLaparoscopic cholecystectomy; intraoperative cholangiography versus no intraoperative cholangiography. a multi center randomized control trial(2019)Zainudin, Nur ZawaniIntroduction: Intraoperative cholangiography (IOC) is not something new in the world of laparoscopic cholecystectomy (LC). However it is still not a favorite method to be applied as a routine procedure in LC. Objectives: To determine the feasibility and safety of performing IOC during LC, to detect the incidence of undiagnosed pre-operative bile duct stone and to identify whether IOC can prevent bile duct injury. Method: Multi-center, double blinded randomize controlled trial done from 2016-2018. Total of 308 patients recruited and divided into 2 arms; with IOC and without IOC. Exclusion criteria includes in situ biliary stent placement, history of multiple laparotomies, performed. Out of 308 patients, 154 patients were assigned to IOC group and 154 patients were assigned to no IOC group. Results: There was a statistically significant difference of mean operation time between the group with IOC and no IOC (mean operation time for IOC group was 66.0 minutes (SD ±28.20) compared to no IOC group 55.6 minutes (SD±23.15), t statistics (df) = 306 (6.78), p-value <0.001). The successful rates for IOC was 98.1%. From 12 cases with presence of filling defects detected during IOC, 4 cases were confirmed CBD stones. Two were confirmed after conversion to CBDE and the other 2 cases were confirmed during ERCP performed. There was only 1 case of bile duct injury noted during IOC. No patients developed allergic reaction to contrast media and the post-operative complications were similar in both groups. Conclusion: IOC is a useful tool to delineate anatomy of bile duct during surgery. It also can easily been done by any surgeon with lots of practices and a proper guidance. Its use may be beneficial in selected cases.