Pusat Pengajian Sains Perubatan - Tesis
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- PublicationCharacterization of acoustic parameters of resonant /m/ and /n/ sounds for the development of objective indicators of resonant voice therapy(2025-10)Razak, Siti Sufiah AbdulResonant voice therapy (RVT) is an evidence-based intervention for voice disorders, often initiated with nasal sounds such as /m/ and /n/. Resonant voice (RV) is usually verified through auditory and tactile feedback under a speech-language therapist’s (SLT) guidance, but these perceptual methods are limited outside clinical settings. The present study aimed to identify objective acoustic parameters that could indicate RV and support tangible feedback tools for self-guided practice. Ninety participants (45 females, 45 males) contributed data for /m/, and 83 (41 females, 42 males) for /n/. After RV training, each provided three 6-second recordings of RV and typical voice (TV). The middle 3 seconds were analyzed in Praat to extract fundamental frequency (F0), formants (F1–F4), F0 standard deviation (F0SD), perturbation measures, cepstral peak prominence (CPPFull, CPPVoice), harmonic-to-noise ratio (HNR), and mean intensity. Significant differences (p < 0.05, medium effect size) were found in APQ3 and DDA for females, as well as in mean intensity for males. Mean intensity consistently distinguished RV from TV, with significantly higher values in RV. Compared to the /n/ sound, the /m/ sound presented with lower value perturbation measures and F0SD and higher value for CPP and HNR, though not significant. Formant analyses revealed significant F2 and F3 differences in males, while female results were less consistent. These findings demonstrate the potential of acoustic parameters to differentiate RV from TV. Consistent patterns across multiple measures, some statistically supported, highlight their promise as objective indicators and their utility in developing tangible feedback tools to enhance RVT practice
- PublicationAntiviral activities of tualang honey against chikungunya virus-infected human fibroblast-like synoviocytes (HFLS)(2025-11)Mohamad, Nur AliahChikungunya is a mosquito-borne viral disease caused by chikungunya virus (CHIKV), primarily transmitted to humans by Aedes aegypti and Aedes albopictus mosquitoes. The illness is characterised by fever, polyarthralgia, myalgia, rash and headache. In chronic chikungunya, arthralgia can persist for months or even years. Although a vaccine called IXCHIQ exists, it is not widely used and current treatment options focus on symptom relief. This study aimed to investigate the in vitro antiviral activity of Tualang honey against CHIKV infection in human fibroblast-like synoviocytes (HFLS) cells. The potential anti-CHIKV activity of different concentrations of Tualang honey at various incubation periods was evaluated through pre-treatment and post-treatment assays. Additionally, the modes of action were further investigated using virucidal, anti-adsorption, and anti-entry assays. The maximum non-toxic dose (MNTD) of honey in HFLS cells was found to be 50 mg/mL although for subsequent antiviral assays ≤ 20 mg/mL concentrations were used. The viral inhibitory effect was evaluated using plaque assays to measure viral titres and quantitative Reverse Transcription Polymerase Chain Reaction (qRT-PCR) to quantify RNA copy numbers. Tualang honey exhibited minimal to excellent prophylactic activity during the pre-treatment assay, reducing viral titres by 29.21% to 94.87% and RNA copy numbers by 12.90% to 69.80%. Significant inhibition (p < 0.05) of CHIKV viral titres was observed following pre-treatment with 10 and 15 mg/mL for 6 and 12 hours before infection, respectively. Interestingly, the anti-CHIKV effects of Tualang honey in HFLS cells were more prominent during pre-treatment compared to post-treatment. Post-treatment with Tualang honey resulted in minimal to strong inhibition, reducing CHIKV viral titres by 6.67% to 72.46% and RNA copy numbers by 10.87% to 29.21%. The greatest inhibition was observed following post-treatment with 15 mg/mL concentration at 4 hour post infection (hpi), although these effects were not statistically significant. Notably, Tualang honey exhibited a virucidal effect, with up to an 80.50% reduction in CHIKV viral titres. Significant virucidal activity (p < 0.05) was observed when 15 and 20 mg/mL of honey were incubated with 2 X 10³ pfu of CHIKV. Furthermore, Tualang honey demonstrated both anti-adsorption and anti-entry effects, with the latter being more pronounced, reducing viral titres by up to 90.45% compared to 66.89% for anti-adsorption. In conclusion, this study demonstrates that Tualang honey possesses anti-CHIKV activities and exerts its effects through broad modes of action. Further research is required to confirm its clinical applicability and fully elucidate its mechanisms of action
- PublicationParental perceptions and awareness of adolescent cyberbullying in Selangor: a mixed method study(2024-12)Ghazali, Sarah AqilahBackground: The widespread use of the internet among adolescents has increased the prevalence of cyberbullying, posing serious risks to their mental and social well-being. Parental understanding of this issue in Malaysia remains underexplored. Objective: This study assesses parents’ perceptions and awareness of cyberbullying, identifies related factors, and explores parents’ experiences in managing cyberbullying incidents in Selangor. Methodology: Using a sequential explanatory mixed-methods design, Phase 1 involved a cross-sectional study using the KEPS-I questionnaire, which was administered to 522 parents of adolescents, selected from eight national secondary schools through a multistage sampling method, and analysed using linear regression to determine factors related to parental perceptions and awareness of cyberbullying. The interphase involved identifying parents whose children had experienced cyberbullying based on Phase 1 findings. Phase 2, designed as a phenomenological study, included in-depth interviews with 12 parents, selected through purposive sampling from Phase 1 respondents and additional respondents recruited via advertisements to achieve data saturation. Thematic analysis was used to explore parents’ lived experiences and insights. Results: The mean (SD) score for overall parental perceptions and awareness was 3.96 (0.44). The highest mean (SD) score was observed in the preventive measures domain, 4.40 (0.47), while the lowest mean (SD) score was in the internet and social media knowledge domain, 3.61 (0.66). Parents’ age (adjusted b = -0.475 95% CI: -0.704, -0.246, p-value < 0.001), ethnicity (adjusted b = -3.035, 95% CI: -5.893, -0.177, p-value = 0.037), and daily use of the internet and social media (adjusted b = 5.670, 95% CI: 0.244, 11.115, p-value = 0.041) were related to their perceptions and awareness of cyberbullying. Four themes emerged: parental responses to cyberbullying, parental self-efficacy in managing cyberbullying, challenges in addressing cyberbullying and strengthening child safety and support against cyberbullying. Conclusion: The study underscores the need for targeted educational initiatives and support systems to empower parents in managing cyberbullying effectively. Findings contribute to policy recommendations aimed at enhancing parental awareness and preventive strategies.
- PublicationTime series modelling and forecasting commuting accident and association with meteorological parameters in Johor Bahru and Kuala Lumpur, Malaysia (2015-2019)(2024-12)Hanafi, Nur SujaihahIntroduction: In tropical countries such as Malaysia, rainfall and temperature serve as primary meteorological parameters that potentially increase the risk of road traffic accidents (RTAs). The working population in major cities is particularly vulnerable, especially during commuting hours, resulting in a surge of commuting accidents. However, research evidence utilizing objective measures, such as time series data, to model the association between meteorological factors and commuting accidents or even the RTAs in general, particularly within the Malaysian context are substantially limited. Therefore, this study aims to model the association between rainfall and temperature with commuting accidents and forecast their future occurrence. Methods: This study employed retrospective secondary data on RTAs, rainfall, and temperature from Kuala Lumpur and Johor Bahru from 1 January 2015 to 31 December 2019. In the first phase, the outcome variable was the number of RTAs among the working population. A quasi-Poisson regression model was utilized to investigate the influence of different temporal factors on the outcome variable. Its association with temperature and rainfall was then examined using a combination of Hurdle Negative Binomial (HNB) regression and Distributed lag non-linear models (DLNM). The second phase focused on the number of commuting accidents as an outcome variable, defined as RTAs involving the working population during commuting hours (7:00 am to 8:00 pm). A combined approach using time-stratified case-crossover design and DLNM was implemented to investigate the association between temperature and rainfall with commuting accidents and subsequently, an ARIMA model was employed to forecast their future incidence. Results: In phase one, 11,877 and 8833 workers were involved in 11,531 and 8632 RTAs over five years in Kuala Lumpur and Johor Bahru, respectively. The majority of workers were male (> 75%) and aged 15-44 years (> 70%). The time of day, divided into two time zones, was significantly associated with RTAs among workers. The incidence risk ratio (IRR) was highest during T3 (12:00 pm - 5:59 pm) compared to T1 (12:00 am – 5:59 am) and during PEAK 2 (4:30 pm-7:30 pm) compared to OTHER (12:00 am – 7:29 am, 7:31 pm – 11:59 pm) in both cities. In Kuala Lumpur, workers had higher RTA risk during weekdays compared to weekend (IRR of 1.18, 95% CI: 1.10, 1.27). Weeks comprising of three or more school holiday showed a reduced RTA risk in both cities (Kuala Lumpur: IRR 0.78, 95% CI: 0.69-0.88; Johor Bahru: IRR 0.83, 95% CI: 0.72-0.95). Lower temperatures significantly affected RTA occurrence, peaking at 22°C in Kuala Lumpur (OR 1.46, 95% CI 1.10-1.94) and 26°C in Johor Bahru (OR 1.36, 95% CI 1.04-1.78). The strongest lag effect of extremely low temperature (23°C) was at lag 0, and for extremely high temperature, it was delayed up to 16 hours in Kuala Lumpur (36°C) and 24 hours for Johor Bahru (34°C). Rainfall intensity increased RTA odds, with the most pronounced effects at lag 9-hour and 12-hour in Kuala Lumpur and Johor Bahru, respectively. In phase two, 8941 and 6548 commuting accidents were recorded in Kuala Lumpur and Johor Bahru from 1 January 2015 to 31 December 2019. Kuala Lumpur showed a significant inverse linear association between daily maximum temperature and commuting accidents, with the highest odds at 28°C (OR 1.76, 95% CI 1.14-2.72), while Johor Bahru had a non-significant positive association, peaking at 35°C (OR 1.21, 95% CI 0.63-2.32). No significant association between rainfall and commuting accidents was observed in both cities. The best forecasting model for Kuala Lumpur was a regression with ARIMA (1,1,1) error, with a weekly daily minimum temperature utilized as regressor. In Johor Bahru, ARIMA (1,1,1) was identified as the best fitted model. Both models indicated no substantial changes in the projected trajectory of weekly commuting accidents during 2020. Conclusion: The study findings elucidate the association between temperature, rainfall, and their lag effect with RTAs among the working population, and subsequently on commuting accidents, underscoring the significance of incorporating meteorological parameters in public health policy related to occupational safety and health, urban planning, and road safety. These insights can also inform targeted intervention and enhance the preparedness of urban workers for extreme weather events resulting from climate change.
- PublicationHousehold air pollution and childhood bronchial asthma new onset risk in Kota Bharu Kelantan: the determinants and modelling(2024-12)Ibrahim, Muhammad NaimBackground: Rapid urbanisation and industrialisation have led to increasing environmental pollution, heightening children's vulnerability to bronchial asthma (BA). Environmental factors, including rising household product consumption and poorly regulated outdoor pollution, play a key role in this trend. Despite the growing risk, locally focused studies on household-related contributors to childhood BA remain limited. Therefore, this study aims to elucidate the relationship between household air pollution and the risk of childhood BA onset in Kota Bharu, Kelantan. It includes the development, validation, and reliability analysis of the HAPBAC-Checklist, as well as identifying the determinants of childhood BA onset and modelling them. Methodology: The study was conducted through two phases, from March 2023 to April 2024. The first phase involved the development and validation of the HAPBAC-Checklist, which included four stages: 1) the development of the checklist 2) content validation 3) face validation and 4) reliability analysis (kappa agreement analysis). Then, the second phase employed a case-control study involving 194 children; 97 newly diagnosed BA cases and 97 controls, in Kota Bharu, Kelantan. Data were collected using the HAPBAC-Checklist and air quality measurements. Descriptive analysis and logistic regression identified factors linked to childhood BA new onset, which were then used to develop accurate predictive models. Results: The final validated HAPBAC-Checklist consists of five domains (sociodemographic, family history of atopy, child’s medical history, household attributes, and outdoor attributes) with 59 items. The I-CVI scores indicated good relevancy (value ranged from 0.83 to 1.00), and the S-CVI value was satisfactory (value of 0.94). The I-FVI (at least 0.83) and the S-FVI (value of 0.96) indicating the checklist was easily understood. The kappa analysis for reliability testing for five domains combined was 0.88 (95% CI: 0.81, 0.95; p<0.001). A case-control study found that case group had a higher proportion of indoor smoking, indoor pets, new wooden furniture, and other household attributes. As for outdoor, the case group had a higher proportion vehicle near their homes, use outdoor wood stoves, and live closer to pollution sources such as major roads and garbage burning. Air quality measurements indicated higher pollutant levels among households in the case group. Multiple logistic regression revealed the significant determinants were younger age (AdjOR: 0.67, 95% CI: 0.50, 0.89; p=0.007), mother with history of atopy (AdjOR: 5.18, 95% CI: 1.54, 17.38; p=0.009), and sibling with history of atopy (AdjOR: 4.88, 95% CI: 1.51, 15.78; p=0.008); Household attributes: indoor smoking (AdjOR: 5.64, 95% CI: 1.95, 16.29; p=0.001), indoor pets (AdjOR: 3.65, 95% CI: 1.21, 11.04; p=0.022), recent home painting (AdjOR: 9.25, 95% CI: 1.56, 54.91; p=0.014), poorly ventilated kitchens (AdjOR: 12.28, 95% CI: 2.80, 53.87; p=0.001), frequent frying (AdjOR: 14.15, 95% CI: 3.01, 66.48; p=0.001), wood stove use indoor (AdjOR: 17.84, 95% CI: 1.29, 247.20; p=0.032) and fragrance indoor (AdjOR: 7.54, 95% CI: 2.23, 25.51; p=0.001); Outdoor attributes: proximity to main roads (AdjOR: 0.99, 95% CI: 0.98, 0.99; p=0.001) and nearby livestock or outdoor pets (AdjOR: 5.62, 95% CI: 1.82, 17.38; p=0.003); and air quality measurement: elevated levels of indoor PM10 (AdjOR: 1.03, 95% CI: 1.02, 1.05; p<0.001) and Aspergillus spores (AdjOR: 1.08, 95% CI: 1.01, 1.16; p=0.048). The predictive model developed from these 14 determinants showed an excellent fit (ROC curve = 0.947; 95% CI: 0.92, 0.97), effectively predicting childhood BA onset. Conclusion: The HAPBAC-Checklist is a novel tool specifically tailored to address locally identified household and outdoor factors influencing BA. The widespread determinants underscore the urgent need to prevent childhood BA. This study recommends policies promoting healthier living environments, incentives for safer practices, stricter regulation of household products, and health advocacy on key risk factors.