Pusat Pengajian Sains Perubatan - Tesis
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- PublicationQuestionnaire translation, validation and relationship determinants of marital quality with clinical attributes of functional dyspepsia, irritable bowel syndrome and its overlap syndrome in Malay women(2024-09)Hamid, NurhazwaniFunctional Dyspepsia (FD), Irritable Bowel Syndrome (IBS), and FD-IBS overlap are common and bothersome disorders affecting people of diverse backgrounds, predominantly women. Research is limited in measurement tools available for marital quality, and the association of marital quality with psychological distress, symptom severity, and quality of life (QoL) of Malay women with FD, IBS, and FD-IBS overlap. Phase I, to develop valid measurement tools for marital quality in the Malay language. Secondly (Phase II), to compare mean differences, correlation between study variables, and to examine path relationships between marital quality with clinical attributes including psychological distress, symptom severity, and QoL among Malay women with FD, IBS, and FD-IBS overlap. Phases I and II were conducted using cross-sectional design and by convenience sampling. Phase I consisted of translation into the Malay language and validation of questionnaires including Revised Dyadic Adjustment Scale (RDAS), Relationship Dynamic Scale (RDS), Short Version Psychological Maltreatment of Women Inventory (PMWI-F), Multidimensional Pain Inventory (MPI), and Coping Strategies Questionnaire-Catastrophizing Scale (CSQ-CAT). All questionnaires were examined for content validity index (CVI), face validity index (FVI), exploratory factor analysis (EFA), and reliability (Cronbach’s alpha). For phase II, first, multivariate analysis of variance (MANOVA) would be used to determine mean differences between variables, second, correlation analysis of all variables and third, path analysis (PA) model to map inter-relationships between variables. All the newly translated Malay questionnaires were found to have CVIs and FVIs > 0.80. There were 150 participants (mean age 34.1 years old, standard deviation (SD)=9.5 years) and 513 participants (mean age 37.2 years old, SD=9.3 years) who have participated in phase I and II respectively. For phase I, all factor loadings were found satisfactory with EFA and the Cronbach’s alpha of RDAS-M, RDSM, PMWI-F-M, MPI-M, and CSQ-CAT-M was ranged between 0.7 and 0.9. For phase II, with MANOVA, the most significant mean differences were seen between groups of FD versus IBS, and FD versus FD-IBS overlap, and the marital quality most significantly affected included consensus, conflict management, negative responses, and solicitous responses. With Pearson correlation analysis, FD demonstrated the most significant correlations with all clinical attributes (r > 0.5). With PA of overall model, the fit indices for FD, IBS, and FD-IBS overlap were found to be acceptable. FD-IBS overlap had the most number of paths (n=30), followed by FD (n=26), and IBS the least (n=24). With PA, the most supported hypothesis for the domains marital quality and symptom severity was demonstrated with FD-IBS overlap. Whereas, for the domain psychological distress, the most supported hypothesis using PA was demonstrated for FD. First, the tools to measure marital quality have been translated into the Malay language, and are validated. Second, there is significant inter-relationships of marital quality with clinical attributes of FD, IBS, and FD-IBS overlap in the Malay women.
- PublicationElucidating the role of alpha-1-antitrypsin, IL-6, TNF-α, TAS and MDA in the pathogenesis of covid-19 positive cases(2025-01)Nazri, Nor Amirah MohammadThe study aimed to investigate the disparities in immune and oxidative stress responses in COVID-19 patients by analysing the levels of Alpha1-antitrypsin (A1AT) and its phenotype variants, as well as interleukin-6 (IL-6) and tumour necrosis factor (TNF-α), malondialdehyde (MDA), and total antioxidant status (TAS). This case-control study involved a total of 282 participants, including healthy controls, mild to moderate COVID-19 patients, and severe to critical COVID-19 patients, aged 18 to 80. COVID-19 blood samples were archived from the patients that hospitalized in Kelantan and Selangor between July 2021 and June 2023. During the same period, healthy control was recruited. The study found a significant difference in A1AT levels between control and severe COVID-19 patients (p<0.01), but not between control and mild to moderate patients (p=0.47) or between mild to moderate and severe to critical patients (p=0.33). IL-6 and TNF-alpha levels were significantly higher in COVID-19 patients than in controls (p<0.001), with no significant difference across different stages of COVID-19 disease. Additionally, TAS levels were reduced in patients with COVID-19 compared to those in the control group (p<0.001). Meanwhile, MDA levels significantly increased in COVID-19 patients compared to control patients (p<0.001). Both TAS and MDA showed no significant difference across the COVID-19 group. The analysis indicated that the PiMM phenotype emerged as the predominant phenotype among participants, regardless of their COVID-19 status or being part of the healthy control group. Additionally, this study identified some infrequently observed normal phenotypes, such as PiBM, PiCM, PiEM, and PiMX. Furthermore, participants did not exhibit variants associated with A1AT deficiency, notably PiS and PiZ. This research lays a foundational step toward understanding the genetic and biochemical underpinnings of COVID-19, paving the way for personalized medicine approaches in managing and treating this disease. Further studies are necessary to build on these findings, potentially leading to the development of targeted therapies and preventive strategies based on genetic predispositions and biochemical marker profiles.
- PublicationIsolation and characterization of bacteriophage against mdr klebsiella pneumoniae from hospital sewage(2024-12)Abusalah, Manal Abdel Haleem A.The prevalence of multidrug-resistant Klebsiella pneumoniae (MDR-KP) in healthcare settings has been increasing recently. Bacteriophages are a potential therapy against MDR bacteria and can be isolated from effluent water and other environmental sources. Additionally, bacteriophages are recognized as critical agents in the battle against MDR-KP infections. The high concentration of inorganic and organic compounds in hospital wastewater (HWW) provides a favourable environment for organisms, including phages, which supports the successful isolation of bacteriophages. Therefore, this study utilized wastewater samples collected from Hospital Pakar Universiti Sains Malaysia (HPUSM) and subjected them to a series of filtration and enrichment procedures to isolate phages that target MDR-KP. The isolated phages were subsequently characterized by their temperature stability, pH stability, chloroform stability, and host range. A high-resolution transmission electron microscope (HRTEM) was used to determine the morphology of the bacteriophages. The isolated phages exhibited a confined host range and showed high specificity for MDR-KP strains. Morphological analysis revealed that the phages belonged to the Siphoviridae and Podoviridae families. Furthermore, the phages demonstrated lytic activity under various undesirable conditions, including high pH, extreme temperature, and chloroform. These findings highlight the bacteriophages' potential as specific and effective biocontrol agents against MDR-KP infections, providing an opportunity for phage therapy in healthcare settings.
- PublicationThe effects of combined omega-3 and vitamin d supplementation on nutritional status, quality of life and inflammatory biomarkers among the breast cancer women in gaza strip, Palestine: a randomised controlled trial(2025-01)Almassri, Heba F. H.Breast cancer (BC) is a leading cause of cancer-related mortality worldwide, particularly among women. Early nutritional care is essential to prevent cancer cachexia, improve overall health, and enhance the quality of life (QoL) for BC patients. This study aimed to assess the impact of omega-3 fatty acids (ω3) and vitamin D3 (VitD) supplementation on nutritional status, QoL, blood biomarkers, and dietary intake in newly diagnosed BC women in Gaza, Palestine. In this 9-week randomized, controlled, open-labelled trial, 96 participants were recruited and randomly assigned to one of four groups: i) ω3 group, ii) VitD group, iii) ω3+VitD group, and iv) control group. The intervention groups received either two daily 300mg ω3 capsules and/or one weekly 50,000 IU VitD tablet. Outcome measures included patient-generated subjective global assessment (PG-SGA) scores, anthropometric measurements, dietary intake analysis via 24-hour recall, and QoL assessments using the EORTC QLQ-C30 and QLQ-BR23, serum albumin, serum tumour necrosis factor-alpha (TNF-α), serum high-sensitive C-reactive protein (hsCRP). Of the total 96 participants, 88 had completed at the end of study, achieving a 91.7% response rate. There was a significant increase in PG-SGA-derived nutritional risk scores (p<0.01), body weight, and body mass index (BMI) (both p<0.05) in the ω3+ VitD group compared to other groups. Furthermore, there was a significant rise in blood albumin levels (p< 0.05) compared to baseline in the ω3+ VitD group. Dietary nutrient intake analysis demonstrated substantial increases in daily energy and protein intake in both the ω3+VitD group and the ω3 group alone (both p<0.05) compared to the baseline. Significant differences in total global health status (p<0.01) among ω3+VitD group were observed compared to other groups, and women in the ω3+ VitD group reported significantly higher functional scores (all p<0.05), and lower scores for fatigue (p<0.01), nausea and vomiting, pain, and appetite loss (all p<0.05), compared to the baseline. Notably, the ω3+ VitD group showed a significant reduction in serum hsCRP and TNF-α (both p<0.05) from the baseline, and significant differences in TNF-α (p<0.05) and hsCRP (p< 0.001) were noted between groups at the trial's end. Overall, combined ω3 and VitD supplementation significantly improved nutritional status, QoL, and inflammatory markers among BC women who had undergoing an active treatment. These findings highlight the potential use of ω3 and VitD supplements as an effective adjuvant therapy in BC patient management, improving health outcomes and reducing inflammation, particularly in resource-limited settings. Hence, tailored nutritional guidelines and interventions are crucial for optimizing their nutritional care integration into the medical oncology care.
- PublicationMachine learning application in predicting anterior cruciate ligament injury among basketball players(2025-01)Longfei, GuoAnterior cruciate ligament (ACL) injury is among the most prevalent injuries in athletes, significantly impacting their competitive performance. Preventing ACL injury is challenging due to their multifactorial nature. Machine learning-based data mining techniques have shown significant potential in identifying risk factors associated with ACL injury. This study aimed to assess the predictive capability of these features using machine learning models. Data on athlete’s profile, physical function, specialized qualities, three-dimensional movement analysis, and simultaneous electromyography were prospectively collected from 104 male basketball players. A one-year follow-up was conducted to monitor ACL injury, identifying n=11 injured players. Four machine learning algorithms—Random Forest (RF), Support Vector Machine (SVM), eXtreme Gradient Boosting (XGBoost), and Logistic Regression (LR)—were developed to predict ACL injury. The optimal model was selected based on the mean area under the receiver operating characteristic curve (AUC-ROC) across 10 cross-validation runs and was used with Shapley Additive exPlanations to analyze the risk factors. The results show that AUC-ROC values varied slightly across repetitions and methods (0.66-0.80), the best classifier was RF. SHAP analysis identified key feature with the highest predictive value for ACL injury during specific sports motions. Emergency Stop phase: Increased knee flexion moment, posterior ground reaction forces, knee flexion angle, and overactivation of the lateral quadriceps and rectus femoris. Initial Acceleration phase: Elevated knee internal rotation torque and lateral stress on the lower limbs. Side-Cutting phase: Reduced tibial inclination and hip flexion angles, increased ankle inversion angle, ankle eversion moment, and excessive lateral thigh muscle activation. Furthermore, poor stability in the non-dominant leg, weak Squat Jump performance, training loads exceeding 15 hours per week, and prior injury history were significant ACL injury predictors. This study emphasizes the Machine Learning model's effectiveness in predicting ACL injury, highlighting biomechanical metrics, functional attributes, and historical feature as critical predictors for targeted prevention strategies.