Institut Perubatan & Pergigian Termaju - Tesis

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Identification And Validation Of Hub Genes Involved In Atp-Induced Cell Death In The Pathogenesis Of Inflammatory Bowel Disease
(2025-02)
Zhang, Haolong
Extracellular adenosine triphosphate (eatp) plays a critical role in inflammatory bowel disease (ibd) as a key regulator of cell death processes. The p2x7 receptor, found on intestinal epithelial cells, is frequently implicated in cell death mechanisms involving eatp. However, the specific mechanisms of eatp-induced cell death and their connection to ibd remain unclear. Therefore, the primary objective of this study is to integrate data collection, bioinformatics analysis, and experimental validation to identify and confirm hub genes involved in eatp-induced cell death in the context of ibd. This approach combines computational and laboratory methods to produce reliable and high-confidence results. Not only does this approach enhance understanding of the molecular pathways involved in atp-induced cell death, but it also offers potential therapeutic targets for managing ibd. The experiment begins with data collection, focusing on acquiring relevant datasets and gene sets from public databases and scientific literature. For transcriptomic data, keywords such as "ibd" and "transcriptome" were used to search the geo database (gene expression omnibus, specify abbreviation).
Therapeutic Effects Of Human Pericardial Fluid Cells In Doxorubicin-Induced Heart Failure Rat Model Via Intrapericardial Injection
(2025-03)
Xu, Yaping
Heart failure (hf) is the leading cause of mortality worldwide. Cell therapy has emerged as an alternative strategy for treating hf. This study aimed to isolate and characterize human pericardial fluid-derived cells (hpfcs) and investigate the cell engraftment, therapeutic effects, and mechanisms of action after intrapericardially administered into a doxorubicin-induced hf rat model. Hpfcs were isolated from the pericardial fluid of five hf patients who underwent heart transplantation and cultured. The cultured hpfcs showed the expression of stem cell markers nanog+/sca-1+ (94.0% ± 1.8%), c-kit+/nanog+ (30% ± 4.0%), c-kit+/sca-1+ (16.6% ± 4.4%), and cd90+/cd105+ (76.8% ± 15.5%) at passage 3. Additionally, hemopoietic markers cd45+cd90+ (35.1% ± 19.7%) and cd34+cd73+ (13.9% ± 6.9%) were also expressed. These hpfcs were also able to differentiate into adipocytes (70.6% ± 1.2%), osteoblasts (29.3% ± 3.3%), and cardiomyocytes (81% ± 1.6%) in vitro. Doxorubicin (dox) was used to induce hf in rats for 6 weeks (2.0 mg/ml). Hf characteristics were confirmed at week 4 by examining the changes in cardiac function, fibrosis, and the expression of inflammatory cytokines and angiogenic factors prior to administering hpfcs (2.5 × 105 cells/heart) intrapericardially at passage 2. The same parameters were re-assessed for changes after 1 and 4 weeks of cell administration
The Effectiveness Of Acceptance And Commitment Therapy （Act）On Disease Acceptance And Quality Of Life Among Breast Cancer Patients
(2025-03)
Song, Wenjun
Breast cancer is associated with various psychological and psychosocial challenges for patients, yet there is a limited number of randomized controlled trials (rcts) examining its impact. This study aimed to address this gap by evaluating the effects of acceptance and commitment therapy (act) in two study phases. Phase i employed a cross-sectional design involving 346 cancer patients in malaysia, focused on adapting and validating the malay version of the illness cognition questionnaire (icq-m) and the multidimensional scale of perceived social support (mspss-m). Data were collected through self-administered questionnaires, with analyses performed for internal consistency, convergent validity, discriminant validity, construct validity, and concurrent validity. In phase ii, 80 breast cancer patients were enrolled in a two-arm randomized controlled trial (rct) with a parallel group design. The study assessed the effects of act on disease acceptance, quality of life (qol), social support, and psychological flexibility at three-time points, i.E., baseline, post-intervention, and 12-week follow-up.
Knowledge Regarding Informed Consent For Blood Transfusion Among Patients In Hospital Melaka And Its Associated Factors.
(2021-05)
Senin @ Nordin, Mohd Hilmi
Background: To perform blood transfusion, a physician is required to obtain informed consent from the patient. However, previous studies have shown a poor transfer of knowledge from the doctor to the patient regarding blood transfusion, with conflicting information as recollected by patients from informed consent discussions. This study aims to evaluate knowledge on informed consent for blood transfusion among patients. Methods: A cross-sectional study was performed from October 2019 to May 2020 at Hospital Melaka. The instrument used in this study was a structured, validated questionnaire written in the Malaysian language. Respondents aged 18 and above, who had given their consent for blood transfusion within three days, were recruited using purposive sampling. Logistic regression was used to investigate potential predictors for good knowledge. Results: Data analysis was performed on 239 sets of returned questionnaires, which showed that 85.8% of the respondents had good knowledge. Additionally, 94.1% of them were aware that informed consent is mandatory before the blood transfusion procedure. The lowest percentage of correct responses (43.9%) was regarding the timing of the informed consent. Respondents with a history of undergoing transfusion more than once (AOR = 2.18; 95% CI = 1.02, 4.65; p = 0.04), and practising Buddhism as a religion (AOR = 0.36; 95% CI = 0.15–0.86; p = 0.02) showed significant associations with knowledge. Conclusion: The respondents in this study were relatively knowledgeable of informed consent for blood transfusion. However, further analysis revealed the deficiency of knowledge among the respondents in several aspects of this topic. The findings can aid Malaysian health authority to plan for interventions that would improve knowledge of informed consent on blood transfusion among patients and the public.
Value Of Baseline Post-transplant Mag3 Renal Scintigraphy In The Evaluation Of Graft Function
(2021-11)
Yeen, Boey Ching
Objective. Accurate assessment of graft function in the post-transplant period is crucial as it influences patient management and graft prognostication. However, traditionally used modalities such as serum creatinine, urine output and ultrasonography are hampered by various drawbacks. This study sought to determine whether baseline DRS performed within 72 hours post-transplant could accurately depict graft function. This study chose the occurrence of delayed graft function (DGF), which is defined as the requirement for dialysis within the first week post-transplant, as the primary clinical end-point of graft function. Graft function at 1- and 3-months post-transplant were used as secondary endpoints. Subjects and Methods. This retrospective study enrolled all renal transplant recipients who underwent baseline DRS using MAG3 within 72 hours post-transplant between 2017 and 2019 in Hospital Kuala Lumpur. Two qualitative parameters, renogram grade and tubular injury severity score (TISS) and a quantitative parameter, R20:3, were evaluated. Three other experienced observers independently analysed a random selection of scans to assess interobserver agreement. Clinical data was scrutinised to determine whether patients developed DGF, their corresponding risk factors and graft function at 1- and 3-months. Results. A total of 120 patients underwent DRS within 72 hours. Three patients were excluded due to loss of scan data and primary graft dysfunction. The remaining 117 patients were enrolled. The overall incidence of DGF was 16.2%, with a significantly higher incidence amongst cadaveric graft recipients (53.6%) compared to living graft recipients (4.5%). Renogram grade ≥ 2, TISS ≥ 4 and R20:3 > 1.31 significantly predicted DGF, p<0.05 with high AUC for R20:3 of 0.97. The cut-off value for R20:3 was 1.31 with a sensitivity of 94.7% and specificity of 92.8% for the prediction of DGF. Grafts with parameters above the cut-offs showed significantly worse GFR at 1- and 3- months post-transplant. Both renogram grade and R20:3 showed excellent interobserver correlation. After adjustment for various donor and recipient factors, longer cold ischaemic times significantly contributed to DGF. Conclusion. Baseline DRS was able to depict early graft function and prognosticate grafts at 1- and 3-months post-transplant. Renogram grade and R20:3, which exhibit excellent interobserver correlation, should be included in the reporting of post-transplant DRS. Due to the greater incidence of impaired graft function in cadaveric graft recipients, routine baseline DRS could provide added value in this population.

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