Pusat Pengajian Sains Perubatan - Tesis
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- PublicationCurcumin as adjuvant treatment in patients with non-alcoholic fatty liver disease (NAFLD): A systematic review and meta-analysis(2022)Huang, Ngu MinObjective: The aim of this review is to determine the effect of curcumin on the liver ultrasonographic morphology, and the effectiveness of curcumin as adjuvant treatment for NAFLD. Methods: The Cohcrane library and PubMed were searched systematically to identify randomized controlled trials from 2000 to January 2021. The primary outcomes were NAFLD severity, liver steatosis resolution, liver scarring, liver enzymes, also lipid profiles. 16 RCTs with a total of 1028 participants were included in the meta-analysis. Results: Curcumin improved NAFLD severity (RR: 3.52, 95% CI 1.27 to 9.72; P = 0.02) and increased the liver steatosis resolution (RR 3.96, 95% CI 1.54 to 10.17; P = 0.004) based on the liver ultrasonographic finding. Curcumin supplementation reduced aspartate aminotransferase (MD -4.00, 95% CI -5.72 to -2.28; P < 0.001), alanine aminotransferase (MD -7.02, 95% CI -9.83 to -4.20; P < 0.001), total cholesterol (MD -11.86, 95% CI -19.25 to -4.46; P = 0.002) and BMI (MD: -0.41, 95% CI -0.75 to -0.07; P = 0.02). Conclusion: Curcumin supplementation has a favourable effect on liver ultrasonographic findings, reduced serum liver enzymes, total cholesterol, and BMI in participants with NAFLD. Therefore, promoting curcumin as adjuvant treatment on NAFLD patients might be justified.
- PublicationEvaluation of retinal nerve fibre layer thickness and choroidal thickness in parkinson disease patients(2022)Sheng, Ng KwangIntroduction Parkinson Disease (PD) is a neurodegenerative disorder characterised by specific motor features. Visual symptoms are also frequently involved. The human retina is considered part of the central nervous system in humans. Choroid is the ocular vascular layer that plays an important role in retina function. Anatomical changes in the retina and choroid may occur in patients diagnosed with neurodegenerative disorders such as PD. Retinal nerve fibre layer (RNFL) thickness and choroidal thickness (CT) could be additional useful parameters to diagnose PD. By conducting this study, we hope to highlight the potential of RNFL thickness and CT analysis as neurodegenerative biomarkers for PD. Objective To evaluate the RNFL thickness and CT in PD patients. Methodology A comparative cross-sectional, hospital-based study was conducted at Hospital Universiti Sains Malaysia. There were 39 PD patients and 39 normal controls recruited. These 2 groups were gender and age matched. Subjects that fulfilled the inclusion criteria underwent ocular examinations and optical coherence tomography (OCT) examinations in the right eye for peripapillary RNFL thickness and CT evaluation. Independent t-test, chi-square, ANCOVA, and Pearson’s correlation were used in the statistical analysis. Results There was statistically significant reduction of RNFL thickness in average (adjusted mean 88.87μm; 95% CI = 86.36, 91.38 vs 94.82μm; 95% CI = 92.32, 97.33; P = 0.001), superior (adjusted mean 110.08μm; 95% CI = 106.07, 114.09 vs 119.10μm; 95% CI = 115.09, 123.11; P = 0.002) and temporal (adjusted mean 63.77μm; 95% CI = 60.64, 66.90 vs 70.36μm; 95% CI = 67.23, 73.49; P = 0.004) in PD group compared to controls. There was significant reduction of central subfoveal CT (adjusted mean 271.13μm; 95% CI = 264.67, 277.60 vs 285.10μm; 95% CI = 278.63, 291.56; P = 0.003) in PD group compared to controls. There was significant weak negative correlation between the duration of PD with average RNFL thickness in PD patients (r = -0.354, P = 0.027). There was significant moderate negative correlation between the duration of PD with central subfoveal CT in PD patients (r = -0.493, P = 0.001), and weak negative correlation between the stage of PD with central subfoveal CT in PD patients (r = -0.380, P = 0.017). Conclusion The mean of average, superior and temporal RNFL thickness and CT was significantly lower in PD group than controls.
- PublicationEffect of visual rehabilitation on quality of life and depression among primary glaucoma patients(2022)Selvaraja, NanthiniINTRODUCTION Glaucoma is an irreversible optic neuropathy characterized by corresponding visual field defects. Increasing visual field damage from glaucoma affects patient’s daily living. Allocating time to physical, social, and cognitive activities has been widely attributed to a state of happiness in the elderly. The goal of visual rehabilitation is to maximize an individual’s functional vision. It may help individuals to gain greater control of their environment, which leads to greater self-confidence, lowered risk of depression and anxiety, and improved quality of life. OBJECTIVE To evaluate effect of visual rehabilitation on IOP, quality of life and depression among patients with primary glaucoma. METHODOLOGY A randomized single-blinded control trial was conducted involving primary glaucoma patients, mainly POAG and PACG patients between Dec 2020 and Dec 2021 at Hospital Universiti Sains Malaysia, Malaysia. Patients who fulfilled inclusion and exclusion criteria were randomized into group A and group B using sequentially numbered, opaque sealed envelopes (SNOSE). Patients in group A were assigned to attend rehabilitation sessions for 6 months. The patients in group B were advised to carry out their normal routine activities. At baseline and 6 months post recruitment, both groups were given GlauQol-36 and mGDS-14 questionnaire to read and answer. Descriptive Analysis and repeated measures ANOVA were performed using SPSS. RESULTS A total of 72 patients were recruited and randomized into two groups (n=36). However, only 67 patients completed the study (5 dropouts). The mean age of the recruited patients with primary glaucoma was 64.0±6.7 years old. There was no significant difference in all demographic data between groups A and B. There was a significantly higher mean IOP in Group A compared to Group B (p=0.003). For GlauQoL36, the total score for 6 months post intervention for group A was lower than group B but without statistically significant (p=0.309) based on RM ANOVA. Group A showed improvement in 6 months post intervention score in 4 domains (daily living, anxiety, treatment burden and confidence healthcare) but without significant difference based on paired T test. Group B showed improvement in 6 months post intervention score in 3 domains (daily living, anxiety and confidence heath care) but without significant difference. For mGDS-14, only one patient from group A scored more than 8 points (depressed) at baseline. The score remain the same at 6 month post intervention. The remaining patient’s mGDS14 questionnaire scoring was below 7 points. The mean mGDS-14 score at baseline was slightly higher in group B than in group A. There is no statistically significant difference (p=0.371) based on RM ANOVA. CONCLUSION In conclusion, visual rehabilitation based on the rehabilitation for patients with stroke may not be suitable for patients with glaucoma. However, there is potential benefit of visual rehabilitation to the QoL and reduction of depression among patients with glaucoma.
- PublicationOccupational stress level and its associated factors among malaysian plastic surgeons and plastic surgery medical officers(2022-11)Abuzarifa, NaimAim: This study was aimed to assess occupational stress level and its associated factors among Malaysian plastic surgeons and plastic surgery medical officers. Introduction: Plastic surgery is a medical specialty whose training covers the reconstructive area and aesthetics, although the glamour often referred to as its identity, is similar to that of surgeons in general, presenting stressful aspects such as dedication of time, personal responsibility, contact with human suffering, working many hours, accumulation of employment links, and unsatisfactory working conditions that can lead to stress and decrease the perception of quality of life. Several studies have found that physicians develop fatigue, which can lead to burnout syndrome and other serious conditions that can lead to the profession's abandonment and a decline in quality of life Methodology: A sample of 135 plastic surgeons and plastic surgery medical officers participated in this cross-sectional survey. All plastic surgeons and medical officers of plastic surgery working in public and private sectors at hospitals and medical centres were included in the study. Plastic surgeons and medical officers who were retired, unreachable and who refuse to consent for the participation were excluded. The socio-demographic, workplace, characteristics, and perceived stress scale were included in the questionnaire. From March to August 2022, the survey was circulated using a consecutive non-random sampling method to all plastic surgeons and plastic surgery medical officers in all regions of Malaysia. Results: Majority of the study participants were plastic surgeons (75.5%), the plastic surgery medical officers were 24.5%. The participants were predominantly males than females. Concerning the ethnicity majority of the plastic surgeons and plastic surgery medical officers were ethnic Malay. More than half of the plastic surgeons and plastic surgery medical officers were married. Majority of the plastic surgeon were having monthly income >10000 RM , while most of the plastic surgery medical officers were having <10000 RM per month. The perceived stress scale reported a moderate level of stress among plastic surgeons and plastic surgery medical officers. A statistically significant association is reported between age in years, monthly income, children, organization, working hours/week, on-calls/month, out-patients/week, and designation of the study participants with p value <0.05. Increased working hours per week (>50 hours) is significantly associated with higher stress level (p=0.007) among plastic surgeons and plastic surgery medical officers. Conclusion: In Malaysia, the plastic surgeons and plastic surgery medical officers reported relatively moderate levels of stress. They face a similar chance of experiencing occupational stress as plastic surgeons and plastic surgery medical officers do around the world. Their stress appears to be associated with long working hours.
- PublicationComparison of visibility and successful block between echoplex+® and stimuplex ultraline® 360° echogenic needle during ultrasound-guided supraclavicular brachial plexus block for upper limb surgery(2021)Ismet, SukiBackground: Needle visibility is an important factor for the success of ultrasound-guided supraclavicular brachial plexus block (USG SCBPB). This study aimed to compare the needle visibility, the duration of block performance and the success of block between two echogenic needles, Echoplex+ ® and Stimuplex® Ultraline 360°. Methods: A total of 70 patients, scheduled for upper limb surgery under USG-SCBPB, were randomised into 2 groups; Group E (n=35) was blocked using Echoplex+® needle and Group S (n=35) was blocked using ® Ultraline 3600 needle. The visibility of the needle, the duration of block performance and the success of block were recorded. Results: Needle visibility was comparable between both groups with a slightly higher percentage of good visibility in the Group S than the Group E [65.7 % vs 45.7 %; p=0.241]. The median of the duration of block performance [11.0 (IQR 6) vs. 10.0 (IQR 4); p=0.278] and the percentage of adequate block [88.6% vs 88.6%; p=0.565] were also comparable between the Group E and the Group S. Conclusions: Both echogenic needles, Echoplex+® and Stimuplex® Ultraline 360° were comparable in visibility, duration of block performance and the success of block during USG SCBPB.