Pusat Pengajian Sains Perubatan - Dataset
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- PublicationComparing efficacy of tapering dose vs low dose oral steroid in chronic rhinosinusitis with nasal polyp(2022)Fauzi, Mohd Zul IzziBackground: Chronic rhinosinusitis with nasal polyp (CRSwNP) is one of the most common chronic inflammatory diseases of sinonasal mucosa. Oral corticosteroid (OCS) is considered a mainstay of treatment in the management of the disease. However, there is significant heterogeneity existed in OCS prescribing habits for this disease among the rhinologist. This study comes with the hypothesis that a low dose steroid can have a good outcome as compared to a tapering dose. Objective: To compare the efficacy between tapering dose and low dose oral steroid in patients with CRSwNP. Method: A balanced randomisation, two-armed, non-blinded interventional parallel-group study conducted involving 58 CRSwNP patients from Otorhinolaryngology clinic of Universiti Sains Malaysia Hospital. Patients were randomly assigned in a 1:1 ratio to receive either oral prednisolone tapering dose which the starting dose of 60mg/d, or low dose oral prednisolone of 25mg/d for 2weeks. Subjective parameter of quality of life questionnaire and total nasal symptoms score as well as objective parameter of endoscopic finding were measured before and after treatment. The adverse effects of both prescribtion were also recorded. Result: The mean value SNOTT-22 after 12 weeks post treatment is 27.61 (SD 8.17) for tapering dose and 27.75 (SD, 12.22) for low dose group.(p=0.58) The mean decrease in TNSS score for the tapering dose group after 6weeks and 12weeks were 2.18 and 2.39, respectively; meanwhile, the low dose group was 1.93 and 2.22 (p=0.072). The mean decrease in modified Lund-Kennedy score from baseline to 12weeks was 2.89units for the tapering dose group and 2.29units for the low dose group.(p=0.517) The nasal polyp grading mean value for 12weeks post-treatment was 2.50units(SD, 1.29) in the tapering dose group and 2.68units(SD, 1.41) in the low dose group.(p=0.66) Conclusion: This study indicates a significant improvement in terms of quality of life, total nasal symptoms score and endoscopic findings for both prescription groups. However, there are no significant improvement outcome differences between the two prescription dose.
- PublicationA study on anthropometric breast measurements in the malay population in Malaysian women(2014)Shahlini, S. UmayaalBreasts have many anatomic variations with respect to volume, width, length, projection, density, composition, shape, and placement on the chest wall. Anthropometric measurements, which involve measuring distances between a set of anatomical landmarks and a geometric volume formula is known to be the ideal and one of the most accurate method of determining breast volume. Our main objective in this study was to evaluate and measure breast anthropometric measurements in the Malay female population and obtain a baseline of normal parameters of the breast and nipple-areolar complex among them. We also aimed to compare the difference in breast volume between the right and left breast of individuals within the study population, to study the relationship between the breast volume and the height and weight of individuals and to evaluate the variation in breast volume in regards to Body Mass Index. The study included 100 healthy 17-30 year old single nulliparous Malay females in Malaysia with “aesthetically perfect” breasts with a BMI between 17 - 24.9 kg/m2. A total of 22 parameters were measured in standing position. The parameters measured were body weight, height, shoulder width, upper chest width and circumference, middle chest width and circumference, lower chest width and circumference, waist width, clavicle-nipple length, sternal notch-nipple length, nipple-nipple length, upper arm length, acromium to midhumeral point of nipple, medial mammary radius, lateral mammary radius, nipple-inframammary fold length, nipple diameter, areola diameter, nipple projection, and mammary projection. Breast volumes were also evaluated Normal parameters were successfully obtained. The mean breast volume of right and left breast was determined to be 536.59± 339.21 cc and 553.38 ± 368.12 cc. There was no significant correlation between height and breast volume but a positive correlation between breast volume and weight .With the positive correlation between BMI and breast volume using a linear model and linear regression a formula is derived to calculate the expected breast volume of an individual solely on the BMI. The mean distance from the supra-sternal notch to the nipple on the right side and left side is 18.76 ± 2.44 cm and 18.85 ± 2.34 cm. and the mean difference between the nipples is 18.22 ± 2.25 cm, forming an equilateral triangle. The standard mammary projection is 4cm± 1.3cm. This study will help in planning both aesthetic and reconstructive breast surgery and make it possible to compare the anthropometric breast values of young Malay Malaysian women with those of women in other countries.
- PublicationAnthropometry study of knee and correlation to the sizing of total knee arthroplasty in malay population(2022)Jiahour, LeongBackground: The accurate position and well fit total knee arthroplasty (TKA) implant that match with the resected bone are the important factors to give best outcome for TKA. Currently available TKA implant are based on the morphometry of the Caucasian knee. We believed there is discrepancy in matching current available TKA implant with Malay knees which lead to sub-optimal implant fitting and subsequently a poorer outcome. The objective of this study is to analyze the simulated resected distal femur and proximal tibia of Malay population and correlate to the current TKA implants by using CT scan image. Methodology: Radiological anthropometric measurement of 139 knees (44 males and 33 females) was measured from CT imaging record of all Malay patients who underwent CT lower limb in Hospital Universiti Sains Malaysia (HUSM) from January 2017 till December 2020. The data includes femoral anteroposterior (fAP), femoral mediolateral (fML), tibial anteroposterior (tAP), tibial mediolateral (tML) and condylar twist angle (CTA). The femoral and tibial aspect ratio was calculated and correlated to 2 currently used TKA implant systems in HUSM which are the Stryker and the Amplitude. Results: The mean fAP values were 52.3mm (SD 3.12) and 48.5mm (SD 2.50) for men and women, while the mean fML values were 72.7mm (SD 3.12) and 63.4mm (SD 3.12). The mean tAP values were 49.1mm (SD 2.60) and 43.9mm (SD 2.53) for men and women, while the mean tML values were 74.6mm (SD 3.64) and 65.3mm (SD 2.89). The mean CTA value were 5.2° (SD 1.94) and 4.6° (SD 2.21) for men and women. Both studied TKA implant had larger fML dimension than the resected femur for a given fAP dimension. Conclusion: The TKA implant evaluated in present study are not optimal for Malay knees which more profound in distal femur component for female. The TKA implants evaluated need to be adjusted to have a better match with Malay populations, especially femoral component. The result from this study can provide the fundamental data needed for TKA implant design that better fit to Malay Population
- PublicationInternet addiction among early adolescents during covid-19 pandemic in Kota Bharu, Kelantan, Malaysia(2022)Sangaran, Lena NandithaIntroduction The COVID-19 pandemic and school closures sparked a digital revolution in education, resulting in a surge in adolescent internet usage. Excessive internet usage may, unfortunately, be pathological and addicting. The study aimed to determine the prevalence of Internet addiction (IA) during the COVID-19 pandemic and identify its associated factors among early adolescents. Methodology: A cross-sectional online survey was conducted from February 2021 to April 2021 among adolescents in Kota Bharu, Kelantan, Malaysia. Participants completed the Malay Version Internet Addiction Test (MVIAT), Depression, Anxiety and Stress Scale- 21 (DASS-21), and sociodemographic information. Result: A total of 535 participants enrolled in the study. The prevalence of IA among the participants was 48.6%. Boys (AOR = 2.15, 95% CI = 1.30 – 3.57), internet usage at home (AOR = 6.17, 95% CI = 1.94 – 19.58), using internet to watch/download music (AOR=2.50, 95% CI = 1.52 – 4.12), social networking (AOR = 2.29, 95% CI = 1.19 – 4.40), inadequate parental/ guardian bonding (AOR = 2.19, 95% CI 1.31 – 3.65), depression (AOR = 2.03 , 95% CI = 1.07 – 3.85), anxiety (AOR = 2.79 , 95% CI = 1.64 – 4.76), and stress (AOR = 4.67, 95% CI = 2.00 – 10.91) were significantly associated with IA. Conclusion: IA was prevalent among adolescents in Malaysia during this pandemic, almost 50% of the adolescents in Malaysia have IA. Mental health, social networking, and parental relationship were significant factors for IA among adolescents during the COVID pandemic
- PublicationCost Effectiveness of Immediate Tracheostomy versus Early Tracheostomy in Decompressive Craniectomy Patients: A Retrospective Study.(2021)Hasan, Hezry AbuCost Effectiveness of Immediate Tracheostomy versus Early Tracheostomy in Decompressive Craniectomy Patients: A Retrospective Study Dr. Hezry bin Abu Hasan ’, Dr. Sofan bin Zenian ’, Dr. Regunath Kandasamy 2, Prof. Dato’ Dr. Syed Mohamed Aljunid Syed Junid 3'4. 1. Neurosurgical Unit, Hospital Queen Elizabeth, Kota Kinabalu, Sabah, Malaysia. 2. Department of Neurosurgery, Hospital Universiti Sains Malaysia (HUSM), Kubang Kerian, Kelantan, Malaysia. 3. Health Policy and Management Department, Faculty of Public Heal±, Kuwait University, Kuwait City, Kuwait. 4. International Center for Casemix and Clinical Coding (ITCC), National University of Malaysia, Kuala Lumpur, Malaysia. Traumatic Brain Injury (TBI) patients often present with refractory intracranial hypertension, necessitating a supratentorial decompressive craniectomy to relieve malignant intracranial pressure and prevent further neurological insult. However, due to the poor neurological condition of these patients, many are electively intubated and put on mechanical ventilation to protect tire airway and facilitate cerebral protective measures. Unfortunately, as a x result of poor and prolonged neurological recovery, many patients have to be put on tracheostomy in view of prolonged intubation. Prolonged mechanical ventilation also inefficiently utilizes the already limited mechanical ventilators and Intensive Care Unit (ICU) beds. In an attempt to maximize our limited hospital resources, we innovate a new method of tracheostomy timing strategy by performing the tracheostomy in the same setting as the supratentorial decompressive craniectomy (Immediate Tracheostomy) in patients who are anticipated to require prolonged mechanical ventilation. We attempt to answer ‘How early should Early Tracheostomy be done?’ by comparing the clinical and cost-saving benefit of the Immediate Tracheostomy strategy. A retrospective study on patients requiring a supratentorial decompressive craniectomy and tracheostomy done within 7 days of the cranial surgery from January 2013 to December 2019 in Hospital Queen Elizabeth was done. Patients receiving a tracheostomy in the same setting of their supratentorial decompressive craniectomy were assigned to the Immediate Tracheostomy (IT) group, whereas those who received a tracheostomy within 7 days of their cranial surgery was assigned to the Early Tracheostomy (ET) group. Normally distributed quantitative data was analyzed using the independent T-test, while non-normally distributed data was analyzed using the Mann-Whitney U-test. Qualitative variables were analyzed with a Chi-square test. Cost of treatment of each patient was obtained based on Malaysian costing database provided by Casemix System MY-DRG. Of 411 patients reviewed, a total of 63 patients were included in the study. 21 patients (33.3%) were allocated to the Immediate Tracheostomy (IT) group and 42 patients (66.7%) in the other. Patients in the Immediate Tracheostomy (IT) group had significantly lower total GCS scores (Median (IQR): 6 (3) versus 9 (4), p = 0.011), reduced duration of mechanical ventilation (Median (IQR): 72 hours (48) versus 120 hours (72), p = 0.001) and sedation (Median (IQR): 48 hours (24) versus 72 hours (54),/? = 0.001), and shorter ICU length of stay (Median (IQR): 72 hours (48) versus 144 hours (96), p = 0.001). Cost reduction with the Immediate Tracheostomy (IT) strategy was estimated to be RM 18,463.14 — RM 39,223 per patient. The diagnosis of severe TBI, total GCS score <6 on presentation, and the presence of Intraventricular Hemorrhage (IVH) on CT brain imaging were identified as possible indicators for patients who will benefit from the Immediate Tracheostomy (IT) strategy. The Immediate Tracheostomy strategy has shown evidence of increasing ICU bed turnover and reducing the cost of treatment. Patients presenting with a total GCS of < 6 and presence of IVH on CT Brain were seen to benefit from Immediate Tracheostomy. With the clinical and treatment cost benefits seen, the Immediate Tracheostomy (IT) strategy should be considered a viable option for the management of Traumatic Brain Injury patients undergoing supratentorial decompressive craniectomy.