Pusat Pengajian Sains Perubatan - Tesis
Browse
Recent Submissions
- PublicationKnowledge attitude and practice (KAP) of nurses towards covid-19 and associated factors in Hospital Universiti Sains Malaysia (HUSM)(2022)Thirugnanam, SivapriyaIntroduction. Knowledge, attitude and practice (KAP) of nurses towards COVID-19 is vital because of their interaction with potentially infected COVID-19 patients. Objective of the study is to evaluate KAP among the inpatient and outpatient nurses in Hospital Universiti Sains Malaysia (HUSM) and determine any associating factors (variables) such as age, year of practice, ranking and the department they are working. Methods. A cross-sectional study was conducted among nurses (n=243) in (HUSM) between October 1, 2020 and December 31, 2020 . The participants were recruited using both convenience and snowball sampling methods. The self-administered questionnaire consisted of four sections – sociodemographic (associated factors), knowledge, attitude, and practice on COVID-19 among the nurses. Data were analysed using Statistical Package for Social Science (SPSS) version 22 (IBM Inc, Chicago, IL, USA). Logistic regression analysis was conducted to determine the best model of predictors of KAP scores among nurses. Results. The overall mean percentage of knowledge, attitude and practice were 89.7%, 97% and 90.1%, respectively. Based on the total KAP score there was no significant differences in knowledge (p = 0.689), attitude (p = 0.628) and practice (p = 0.084) between inpatient and outpatient department nurses. Using simple logistic regression (p > 0.05), there is no co-relation between KAP and the variables among outpatient and inpatient nurses in HUSM. Conclusions. Despite COVID-19 is an ongoing and expanding disease, at the early stage in 2020, this study has shown overall good knowledge, attitude, and practice among the nurses in HUSM. However, continues seminars and awareness should be conducted in HUSM according to the latest guidelines by WHO and Malaysian Ministry of Health (MOH).
- PublicationModulation of tamoxifen effects on era-positive and era-negative breast cancer cells by tualang honey(2014-10)Said @Fauzi, Agustine NengsihTamoxifen (TAM) is an anti-estrogen drug commonly used for treatment of hormone receptor-positive breast cancer. However, the side effects and cancer cell resistance to TAM limits its clinical efficacy. Therefore, many studies have been conducted to focus on the combination treatment of TAM with new agents or compounds to achieve the treatment objective with minimal side effects. For these reasons and based on the increasing reports of its medicinal use, Tua/ang honey (TH) was selected in this study. The current study aimed to evaluate the role of TH in modulating TAM effects and its death signalling pathways in human breast cancer cells, MCF-7 (ERa-positive) and MDA-MB-231 (ERa-negative) as well as in nonmalignant breast epithelial cells, MCF lOA. Initially, all cells were treated with TH to determine its cytotoxic effects and to identify the type of cell death mechanism. For further analyses, the cells were treated with TH, TAM and the combination of TH+ TAM for determination of apoptotic activity, alteration in mitochondrial membrane potential ('I'm), caspase activation and cell cycle regulation. The effects of TH, TAM and TH+TAM in MCF-7 and MDA-MB-231 cells were also determined at the gene and protein levels by PCR Array system and Western blotting, respectively. The results showed that TH was cytotoxic and induced apoptosis of MCF-7 and MDA-MB-231 cells but not MCFI OA cells. TH modulates TAM activities by promoting late apoptosis and differentially affects TAM-induced cell cycle arrest in MCF-7 and MDA-MB-231 cells. PCR Array data showed remarkable up- and down-regulation of several apoptotic genes in MCF-7 cells including p53 ( ~ 1300-fold), GADD45A ( ~ 120-fold), L TBR ( ~ 790-fold) and BCL-2 ( ~-180-fold), but not in MDA-MB-231 cells. The induction of F ADD, p53 and p21 protein expression in MCF-7 cells showed that TH-induced apoptotic activities are mediated by death receptor and p53-dependent p21 signalling pathways. Increased expression of p21 without elevated level of p53 in MDA-MB-231 cells suggests that the TH induced-apoptotic activity is p53-independent. The ability of TH to modulate TAM apoptotic activities in ERa-positive (MCF-7) and ERa-negative (MDA-MB-231) cells indicates the potential of TH as anticancer agent/adjuvant in breast cancer treatment.
- PublicationStudy on ABO/RHD blood group and red blood cell immunization among chronic liver disease patients in Hospital Universiti Sains Malaysia(2022)Abdullah, Siti Zaleha S.Background: ABO and Rhesus (Rh) blood groups showed some association with various diseases. However, whether ABO and Rh blood group is associated with chronic liver disease (CLD) remains unknown. Furthermore, CLD patients commonly complicated with anemia require blood transfusion support which puts them at risk for red blood cell (RBC) alloimmunization. Variations in the frequency of RBC alloimmunization have been noted among different patient populations. Thus, this study aimed to determine the association of ABO/RhD blood grouping with CLD, the rate of RBC immunization, and their associated risk factors among CLD patients in our center. Materials and Methods: This is a case-control study involving 441 patients with CLD treated at Hospital Universiti Sains Malaysia and subjected to pre-transfusion testing from April 2012 until April 2022. Clinical and laboratory data were retrieved from the blood bank information system and patient’s record and were statistically analyzed using multiple logistic regression. P < 0.05 is considered significant. Results: A total of 441 patients were included in our study. The majority of patients were elderly, with a mean age of 57.9 (SD 12.1) years old, male (65.1%), and Malay (92.1%). The most common causes of CLD in our center were viral hepatitis (62.1%) and metabolic liver disease (25.4%). The frequency of O and B blood groups was almost equally distributed among CLD patients, at 31.5% and 31.3%, respectively. The non-O blood group was significantly associated with an increased risk of CLD (adjusted OR = 1.65, P=0.027). Twenty-four and two CLD patients were reported to have RBC alloantibodies and autoantibodies with a prevalence of 5.4% and 0.5%, respectively. Most patients developed a single alloantibody (83.3%) and belonged to the Rh blood group, which were anti-E (35.7%) and anti-c (14.3%), followed by anti-Mia (17.9%) in the MNS blood group. There was no significant factor associated with RBC alloimmunization among CLD patients identified. Conclusion: The non-O blood group was significantly associated with an increased risk of CLD. Although the prevalence of RBC alloimmunization among CLD patients was low, the vast majority developed clinically significant RBC alloantibodies, mostly from the Rh blood group. Therefore, all CLD patients requiring blood transfusion are recommended for Rh phenotyping and supplied with phenotype-matched Rh to prevent Rh alloimmunization.
- PublicationThe development of problem solvingbased lifestyle module and its random capillary blood glucose and perception in practising healthy lifestyle among diabetes high-risk group in Kelantan(2023-03)Mahmud, MuniraBackground: Diabetes high-risk groups are at intermediate stage in developing type 2 diabetes mellitus (T2DM) but are still reversible. A structured lifestyle education that empowers self-care in lifestyle modifications must be tailored to high-risk groups. Objectives: To develop a problem-solving-based lifestyle education and determine its effect on diabetes risk score (FINDRISC), capillary blood glucose (CBG), and perception practising five healthy lifestyle tasks using MySTAR among diabetes high-risk population in Kelantan. Module satisfaction was assessed among the intervention group participants at post-intervention. Methods: There are two phases of this study. Phase one is the development of the module and phase two is a quasi-experimental study. Based on the literature review and expert discussions, problem-solving based lifestyle education module was developed. Materials include narrated lectures, self-care and simulated counselling videos. Twelve experts evaluated the content validity index (CVI) and 20 community members assessed face validity index (FVI). The intervention group was from the community in Bachok, while the control group was in from Tumpat, who rece ived usual health education from their clinic. The FINDRISC diabetes risk score CBG ' and perceived confidence in practising MyST AR tasks were collected pre-and post-8 weeks intervention among 80 diabetes high-risk participants. Module satisfaction questionnaire was given to the intervention group post-intervention. Diabetes risk score was compared using RM ANOV A, while CBG and MyST AR tasks were compared using RM ANCOV A between groups overtime. For each analysis, intention-to-treat (ITT) and per-protocol (PP) analysis were performed. Results: The problem-solving-based lifestyle module was named STOP & SLIMS module, consisting of 17 narrative educational videos, four self-care videos, and twoweekly healthy eating and active lifestyle challenges. Three subcomponents of the module; introduction of prediabetes, healthy eating, and active lifestyle, showed high CVI (90.4%, 88.1 %, and 90.2% respectively) and high FYI, ranging from 0 .88 to 1.0. Out of 80 participants, 31 participants in the intervention group and 33 in the control group completed the study. There was no significant difference in FINDRJSC diabetes risk score between the groups after 8 weeks of intervention. CBG was not significantly different in ITT but significant in PP analysis between the group. In the comparison of groups, the intervention group showed a significantly higher score of perceived confidence to practice MyST AR tasks with adjusted mean difference [95% Confidence Interval (CI)] by doing moderate-intensity exercise 150 minutes per week [15.25 (3.45, 27.05)] and regular physical activity at least three times per week [18.00 (8 . 14, 27.85)]. Meanwhile, at post-intervention, there were significant differences in mean scores of perceived practising "Suku Suku Separuh" [15.00 (1.82, 28.17)], avoid consume sweet food and beverages [19.15 (8.20, 30.09)], moderateintensity exercise 150 minutes per week [31.41 (18.44, 44.39)] and regular physical activity at least three times per week [28.44 (15.35, 41.53)] between the groups. The intervention group also had high mean satisfaction score for the module ranging from 4.3 to 4.7. Conclusion: The STOP & SLIMS module has the potential to be delivered, particularly to diabetes high-risk groups in order to improve their healthy lifestyle practising, particularly healthy eating and active lifestyle.
- PublicationDevelopment and evaluation of a hybrid tobacco cessation curriculum (HTCC programme) for Malaysian medical students(2018-12)Nyo, Kay KhineDoctors should be knowledgeable in tobacco cessation, should have positive attitudes towards tobacco cessation, and should be confident and competent in tobacco cessation counselling skills. Studies identified lack of tobacco cessation education and formal training in worldwide medical schools including Malaysia. A community trial of the hybrid approach of web-based tobacco cessation (TC) curriculum intervention was conducted among 204 third year medical students from two private medical universities of Northern Malaysia. from 2012 to 2013. They were assigned into the intervention group ( l 04) and control group ( I 00) from a different medical university. Universal sampling method was applied. The objectives of the study were to compare pre-intervention and post-intervention mean scores of within each group and between groups. WTCC program comprised of 9 interactive web-based modules and face-to-face practical sessions. Ethical approval and informed consent were obtained. A validated self-administered questionnaire was administered. Statistical analysis was done by Generalised Estimated Equations (GEE) by SPSS version 19.There were statistical significant improvements between before and 6 months after the intervention of the intervention group in total general knowledge scores in TC and TCC (MD +6.68, 95%CI 2.85-10.51), p<0.001),specific knowledge scores in TC and TCC interventions (5A's and 5R's brief clinical interventions and motivational interviewing) (MD +2.10, 95%Cl l.20-3. I 0, p<0.001), tobacco legislation and enforcement (MD + 1.68, 95%CI 0.85-2.50, p<0.001), positive attitudes towards role of doctors in TC (MD +3.20, 95%CI 1.16- 9.94, p<0.001), self-efficacy scores in basic clinical skills of TCC (MD +4.64, 95%CI 0.59-8.70, p<0.05), acquired training scores in TCC (MD +3.0l,95%CI 2.43- 3.60, p<0.001). There were statistical significant differences between groups in terms of specific knowledge on TC and TCC interventions (p<0.001), knowledge on tobacco legislation and enforcement (p<0.001) and perceived barriers of doctors in TC (p<0.05) positive attitudes towards TC (p<0.001), positive attitudes towards role of doctors in TC (p<0.001) and self-competency in communication skills of TCC (p<0.05). The hybrid delivery of a comprehensive, interactive, web-based tobacco cessation curriculum (WTCC) for third year medical students was effective in improving knowledge, positive attitudes, self-efficacy in basic counselling skills and self-competency in communication skills of TCC. Hence, it should be adopted and integrated in undergraduate medical school curricula in Malaysia.