Pusat Pengajian Sains Perubatan - Tesis

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Female sexual dysfunction following gynaecologic cancer treatment in Hospital Tengku Ampuan Afzan
(2023)
Ahmad, Tuan Norhanani Tuan
OBJECTIVE: Sexual dysfunction is highly prevalent in gynaecological cancer patients. Determining the risk factors of sexual dysfunction in cancer patients enables us to pay more attention to those who are vulnerable and to device strategies for early detection, prevention and treatment of sexual dysfunction in them. The main aim of the study was to determine the prevalence of sexual dysfunction and its associated factors in gynaecological cancer patients in Hospital Tengku Ampuan Afzan, Kuantan, Pahang. STUDY METHOD: This cross sectional study involved gynaeoncology patients in Hospital Tengku Ampuan Afzan who fit the inclusion criteria for this study. They will be evaluated by using Malay Version of Female Sexual Function Index (MVFSFI). It is 19 item questionnaire that assess sexual functioning in women in 6 separate domains. Data were analysed using univariate analyses and logistic regression analysis to look for prevalence and factor associated with Female Sexual Dysfunction. RESULT: Sexual dysfunction in gyaneoncology patients following treatment is 63.2% FSD is most observed in patient with cervical cancer (83%). Age and education level have significant association with having sexual dysfunction problems. Women of a year older has 1.325 odds ratio to have sexual dysfunction problems (95% CI: 1.201, 1.461, p-value <0.001). Women who did not pursue tertiary education has 1.884 odds ratio of having sexual dysfunction problems compare to those who complete until tertiary education (95% CI: 1.054, 3.364, p-value 0.032). Patients who underwent surgery and chemotherapy has 0.343 times the odds and patients who only underwent surgery as treatment has 0.123 times the odds of having FSD when compared to those who received CCRT as treatment. CONCLUSION: Sexual dysfunction is one of the common side effects following gynaecological cancer treatment and this study shows the prevalence is high and there are other associated factors that also involved.
Evaluation of anatomical and functional outcome of epiretinal membrane surgery in patients with idiopathic epiretinal membrane
(2023)
Thamotaran, Tinesh
Objective: To evaluate anatomical and functional outcomes of an idiopathic epi-retinal membrane (ERM) between observation group and intervention group at 6-month post-operative. Design: Prospective Cohort study. Participants: Patients who met the clinical diagnosis of idiopathic ERM in the age frame of 18-80 years; patients with reduced visual acuity (VA), with best corrected VA of 0.2 LogMar or worse, with symptoms of significant metamorphopsia, who visited our center from June 2021 to June 2022. Methods: All idiopathic ERM patients who fulfilled the inclusion criteria were selected. The data recorded included the year of ERM diagnosis, duration of symptoms, age at diagnosis, gender, ethnicity, and presence of other ocular pathologies. VA, lens status, ERM configuration, and central subfield mean thickness (CST), ellipsoid zone integrity (EZ), and disorganized retinal inner layer (DRIL) in spectral domain-optical coherence tomography (SD-OCT) were recorded for all patients at diagnosis and 6 months after diagnosis in observation group and at diagnosis and 6 months post-surgery for intervention group. Patients received information on the symptoms associated with ERM, treatment options, and disease progression, then made informed consent of the treatment plan. Main Outcome Measures: VA, CST, EZ and DRIL at diagnosis and 6 months Result: Sixty subjects (30 observation and 30 interventional arms) were recruited for this study. The mean age in the observation and interventional groups was 64.10 + 7.4 years and 62.70 + 8.44 years, respectively. The mean at diagnosis CST was 357.13 + 59.57 μm and 410.03 + 89.06 μm in the observation group and intervention group respectively. The mean difference and 95% confidence interval in post-op CST were - 69.67 (-99.17, -40.17) with significant differences among groups in post-op CST (p<0.001). There was a significant association of EZ integrity between groups (p<0.001), 95% CI of mean difference: (-0.13, -0.01). Meanwhile, there is no significant association of DRIL between both groups (p=0.23), with 95% CI of mean difference (-0.13, -0.01). Furthermore, the mean VA after 6 months and VA Change between observation and intervention groups are significantly different (p<0.001), with 95% CI of mean difference (-0.85, -0.28) and (-0.68, -0.27) respectively. Finally, there is a significant association between the duration of ERM, preoperative VA, intact EZ and CST with post-operation VA outcome at 6 months post-intervention (p<0.05). Conclusion ERM surgery has shown positive outcomes on anatomical and functional aspects. SD-OCT biomarkers, such as CST and EZ have significant association with post-operative visual outcome. It is evident that a longer duration of ERM does have a minimal impact on the outcome.
Development and validation of the Malay version of the perception and awareness of cyberbullying questionnaire among the Malaysian parents and caregivers
(2023)
Kumaran, Thenmoli Chandira
Background: Cyberbullying is becoming a common and alarming issue among children and adolescents. This situation must be given attention as the victims are repeatedly threatened, harassed, humiliated, embarrassed, or likewise targeted by the perpetrator. This can be done on the basis includes developing awareness among the parents and caregivers. However, so far, there is no validated questionnaire available in the Malay language to assess the perception and awareness of cyberbullying among parents and caregivers in Malaysia. Therefore, there is a need to develop and validate a questionnaire in the Malay language to measure their Perceptions and Awareness of Cyberbullying. Objective: This study is to develop a questionnaire in the Malay language to assess the Perceptions and Awareness of Cyberbullying among parents in Malaysia and to determine its validity and reliability. Method: A cross-sectional study involving 270 participants from 20 to 60 years old was conducted from December 2020 to November 2022 via an online questionnaire form. A Malay Version of The Perceptions and Awareness of Cyberbullying Questionnaire among parents was developed through three phases namely item development, scale development and scale evaluation. It was named as soal selidik Kesedaran dan Persepsi buli siber dalam kalangan ibu bapa (KEPS - I). The Content and Face Validation Index were done to ensure KEPS - I has good face and content validity. The finalized version of KEPS - I was harmonized and pre-tested on 30 participants. Study participants then completed the socio-demographic questionnaire and KEPS-I questionnaire. Data were analyzed using SPSS version 26 for construct validity by performing exploratory factor analysis (EFA), construct reliability, and test-retest reliability. Result: In this study, the initial scale was developed with six factors and 48 items. While the final model of KEPS-I comprises five factors with 34 items after undergoing the EFA. A final question (Question 34) is an open-answer question that was incorporated as the last question. The findings revealed acceptable factor loading, which is more than 0.4, overall Cronbach's alpha is good (0.894 - 0.939), yet poor test-retest reliability (ICC = 0.293). Conclusion: The study revealed that KEPS - I with five factors and 34 items has good psychometric properties. The scale is valid and reliable to measure the Perceptions and Awareness of Cyberbully among parents in Malaysia, although it showed poor stability.
Comparison of diagnostic quality and radiation dose between test bolus and bolus tracking protocols for computed tomography pulmonary angiography (CTPA) among pregnant women in two tertiary centres
(2023)
Kean, Tan Seu
Background: Computed Tomography Pulmonary Angiography (CTPA) among pregnant women is often non-diagnostic and may need the repetition of CTPA. This study aims to compare the test bolus and the bolus tracking protocols for CTPA among pregnant women by analysing the mean contrast enhancement of the pulmonary artery, diagnostic quality and radiation dosage, as well as the outcome of repeated CTPA among pregnant women due to initial non-diagnostic CTPA. Methods: This retrospective study from two tertiary centres included pregnant women who underwent CTPA using test bolus and bolus tracking protocols. CTPA quality, mean pulmonary artery enhancement and dose length product (DLP) were collected and compared between both protocols. The frequency and outcome of CTPA repetition due to suboptimal quality were analysed. Results: A total of 69 patients were selected from both groups, 34 from test bolus protocol and 35 from bolus tracking protocol. Test bolus protocol yields similar contrast enhancement with slightly higher percentage of CTPA with diagnostic quality than bolus tracking protocol; but not statistically significant. However, bolus tracking protocol had significantly better acceptable CTPA quality than the test bolus protocol. Test bolus protocol had significantly lower mean DLP, 220 mGy.cm ± 69, than bolus tracking protocol, 323 mGy.cm ± 34, p-value <0.001. Half of the repeated CTPA did not show significantly better CTPA quality on repetition. Conclusion: No significant difference between test bolus and bolus tracking protocol in CTPA among pregnant women, but the bolus tracking protocol had better overall CTPA quality with higher radiation dose. Repetition of CTPA studies for poor CTPA quality may not always benefit. Hence, we advise weighing the risk and benefits of study repetition.
Relationship between site of facial nerve injury and electroneuronography : a retrospective study
(2023)
Rajoo, Tamil Selvi
Objective: To evaluate the clinical outcome of patients with temporal bone fracture (TBF) and traumatic facial nerve injury. The aim was to determine the association between site of facial nerve injury and electroneuronography(ENOG). Study design: This a retrospective study (observational) which done between 1st January 2010 to 31st January 2020. Setting: Tertiary university hospital Patients : 82 patients who had TBF and traumatic facial nerve injury who treated in our hospital. The data on demography of patients, clinical findings, Pure Tone Audiometry, House Brackmann (HB), ENOG and High Resolution Computer Tomography (HRCT) Temporal result were collected and analysed. Results: The mean age of who patients involved in trauma were 27.5 years old. Motor Vehicle Accidents (MVA) constituted 92.7% of cause of trauma. Mostly involving unhelmet motorcyclist (83.3%). Delayed facial paralysis was found in 87.8% cases. The HB grade IV was recorded highest (50%). The conductive hearing loss was most observed. The Longitudinal TBF had highest prevalence (60.5%). Based on new classification of TBF, majority were otic capsule sparing (84.4%). The tympanic segment (28%) commonly injured followed by first genu (24.4%). There was no significant difference between the percentage denervation (ENOG) and the facial canal sites fracture (p value<0.075). Conclusion: There is no association between sites of facial nerve injury and ENOG. The selection of patients for surgery should not solely rely on HRCT but also clinical grading (time of onset) and serial ENOG monitoring.

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