Pusat Pengajian Sains Perubatan - Tesis

Browse

Now showing 1 - 5 of 2497

Review of the pregnancy outcome of mother with advanced maternal age in Hospital Sultanah Aminah, Johor Bahru from 2017-2018
(2022)
Ping, Tan Yi
Objective: To investigate the association between advanced maternal age and adverse pregnancy outcomes. Study method: A cross-sectional study comparing 239 advanced maternal age mother (≥35 years old) and a control group of 239 pregnant mothers aged 20–34, delivering at Hospital Sultanah Aminah in Johor from 2017 through 2018. Each of these groups was further analysed depending on parity (nulliparity and multiparity). Demographic background and pregnancy outcomes were compared between the groups. Result: The mean age of study group and Controls was 37.48 ± 2.226 years and 28.21 ± 3.610 years, respectively. Advanced maternal age was associated with higher parity and pre-existing medical illness. Advanced maternal age was significantly associated with higher incidence of anaemia. Those nulliparity mother with advanced maternal age had increased risk of exposure to lower Apgar scores (≤4 at 1 minute) by 14.75 compared to Controls. There were no significant differences between the two age groups in the incidences of other adverse obstetric outcomes and perinatal outcomes. Conclusion: We observed that maternal anaemia was associated with advanced maternal age and a low Apgar score at 1 minute is an independent risk factor for advanced maternal age nulliparity. Otherwise, this study demonstrated that the the reproduction beyond the age of 35 years is not associated with any significant maternal, delivery and perinatal complications. Overall, the study showed that the outcome of pregnancy with advanced maternal age is comparable to the control group
Evaluation on knowledge and practice of target intraocular pressure in the management of glaucoma patients among ophthalmologists and medical officers
(2022)
Jin, Diana Toh Shi
Purpose This study aimed to assess the knowledge and practice of intraocular pressure (IOP) target use among ophthalmologists and medical officers in Malaysia based on the Malaysian Clinical Practice Guidelines for the treatment of glaucoma patients. Methodology A two-phase study was conducted from 1 January 2020 to 31 December 2021 among 279 subjects (139 ophthalmologists and 140 medical officers) working in ophthalmology clinics/hospitals in Malaysia. The first phase consisted of the development and validation of a questionnaire to assess knowledge and practice of IOP target use. This questionnaire was then used in the second phase. The second phase involved a cross-sectional study using an online questionnaire. The mean total scores of knowledge and practice of IOP target use were compared between ophthalmologists and medical officers using a t-test. Results A total of 323 ophthalmologists and medical officers were invited to participate, but only 279 (139 ophthalmologists and 140 medical officers) subjects responded to the questionnaire (86.4%). The mean experience in ophthalmology services was 7.42 (5.51) years. A total of 225 respondents (80.6%) used the use of IOP targets. There was a significant difference in the practice of using IOP targets between ophthalmologists (125, 89.9%) and medical officers (100, 71.4%) (p<0.001). The mean total knowledge score among the specialists (21.03 [95% CI: 20.52, 21.54]) was significantly better than that of medical officers (20.24 [95% CI: 19.78, 20.69]) p=0.022. There was a significant association between the average score of knowledge and practice in setting IOP targets (p=0.002). There was no significant association between the number of glaucoma patients treated with IOP knowledge (p=0.376) and practice (0.083) of using IOP targets. Lack of understanding (27.8%) and confusion in choosing the IOP target setting method (35.2%) were the main reasons for those who did not practice IOP target setting. The most popular IOP setting method was the percentage of IOP reduction from the original IOP. Conclusion There are differences in knowledge and practice of using IOP targets among ophthalmologists and medical officers in Malaysia. Intervention programs should be designed to improve the understanding and practice of IOP target setting in Malaysia
Evaluation of stress response and anxiety scores of paediatric patients sedated with intranasal dexmedetomidine vs placebo: A randomized control trial
(2022)
Rajasingam, Dhivya
Background: Dexmedetomidine’s (DEX) favourable properties that include analgesia, sedation, and maintenance of cardiovascular stability renders it an ideal drug for paediatric patients. It provides a safer option with less concern for postoperative sedation and hangover effect. Furthermore, intranasal dexmedetomidine is tolerable and easily administered to paediatric patients. Methods: This was a prospective randomized controlled trial. A total of 60 paediatric patients who underwent elective surgery were included in the study and randomly assigned to receive either intranasal DEX (n = 30) or intranasal 0.9% normal saline (NS, n= 30). Primary outcomes measured the baseline serum cortisol level and serum cortisol postinduction of anaesthesia. Secondary outcomes included Modified Yale Preoperative Anxiety Scale scores, Sedation Behavior Scores (SBSs) and haemodynamic stability. Results: Both NS and DEX groups showed a significant increase in serum cortisol levels when compared with the baseline. Pairwise comparisons between the groups showed no significant difference in serum cortisol levels (95%CI 1.73(-57.28, 60.75); p = 0.95). Both NS and DEX groups showed significant improvement for SBS post sedation administration. There was a significant increase in post-induction of anaesthesia heart rate level in the NS group (95%CI – 10.23(-15.57, -4.90) p = 0.00); however, it was not significant in the DEX group (95% CI – 7.17(-15.405, 1.07); p = 0.09) Conclusion: At a dose of 1 mcg/kg, intranasal DEX provides a satisfactory level of anaesthesia for paediatric patients; however, it does not reduce the stress response to induction of anaesthesia
Evaluation of immunophenotypic expressions of plasma cells in plasma cell myeloma patients and its association with prognostic factors and clinical stages
(2021)
Chi, Ling Pei
Introduction: Neoplastic plasma cell expresses aberrant markers which differ from normal plasma cell was postulated to carry prognostic significance. This study aimed to determine the proportion of immunophenotypic expression of plasma cells in plasma cell myeloma patients at diagnosis and to study the association between these markers with clinical and laboratory parameters. Methods: A retrospective study was carried out from June 2016 till June 2019 by collecting the flow cytometry results (CD38/CD138/CD19/CD45/CD56/CD117 and cytoplasmic kappa and light chains expression) from newly diagnosed plasma cell myeloma, PCM cases in both Hospital Kuala Lumpur and Hospital USM. Clinical data and laboratory results retrieved from medical record were analyzed statistically using SPSS26.0. Results: All 78 cases of flow cytometry results in newly diagnosed PCM had more than one aberrant antigen expression with 100% expression rate for both CD38 and CD138 while CD19/CD45/CD56/CD117 in 28.2%, 23.1%, 83.3% and 25.6% respectively. The majority were expressed kappa light chain restriction, 60.3%. A significant association was demonstrated between CD19 markers with serum creatinine (p=0.036). However, there was no significant association between expression of other immunophenotypic markers with its associated factors. Conclusion: Immunophenotyping by multiparametric flow cytometryisausefultoolfordistinguishingneoplasticplasmacellsfromnormalplasma cell where aberrant antigens were present in most of thePCM withaheterogenous immunophenotypic profile of PCM were defined in our population as compared to others. Moreover, there was a significant association demonstrated between CD19 with serum creatinine. However, this result should be confirmed with a bigger sample size.
Evaluation of haemoglobin level and platelet count in neonates with and without retinopathy of prematurity
(2021)
Di, Lim Zi
Aim: Haemoglobin and platelet have been postulated to play a role in the development of retinopathy of prematurity (ROP). This study aimed to compare weekly mean haemoglobin level and platelet count between ROP and non-ROP infants in the first six weeks of life. Method: Ninety-three premature infants with birth weight less than 1.5 kg and gestational age less than 32 weeks were recruited in Hospital Universiti Sains Malaysia from 2017 to 2019. Each ROP case was individually matched (1: 2) to two non-ROP cases. Weekly mean haemoglobin level, weekly mean platelet count, and other related risk factors were documented. Result: Thirty-one infants with ROP and 62 infants with non-ROP were recruited. Of those with ROP, 8 had stage 1 ROP, 6 had stage 2 ROP, 16 had stage 3 ROP. The mean birth weight and gestational age of the ROP group was 962.2 g and 27.6 weeks while the non-ROP group was 1056.9 g and 28.5 weeks respectively. We found significant differences in the weekly mean platelet counts between ROP and non-ROP infants from week two to week six of life (p=0.003). A significant difference was also found when comparing weekly mean haemoglobin level at week one of life (p=0.003). However, no significant difference was found in the weekly mean platelet count (p=0.489) and weekly mean haemoglobin level (p=0.292) after adjusting to covariates. Conclusion: There is no significant difference in mean haemoglobin level and platelet count in the first six weeks of life between ROP and non-ROP infants after adjusting to confounding factors like sepsis, bronchopulmonary dysplasia and blood transfusion.

Browse

Recent Submissions