Institut Perubatan & Pergigian Termaju - Tesis

Browse

Recent Submissions

Now showing 1 - 5 of 343
  • Thumbnail Image
    Publication
    Motivation Factors And Potential Barriers For Blood Donation During Coronavirus (Covid-19) Pandemic In Kelantan, Malaysia
    (2023-11)
    Mohd Mahfdzuz, Samihah
    Introduction: The COVID-19 pandemic had both direct and indirect impacts on blood donation efforts worldwide. The number of blood donors is likely to decline as the number of everyday cases increases. This study aims to determine blood donors' socio demographic characteristics during COVID-19 and their association with motivation factors, and potential barriers to blood donation during the pandemic. Methods: This observational cross-sectional study was conducted among 350 blood donors in Kelantan using a self-administered questionnaire. Data was analysed using Statistical Package for the Social Sciences (SPSS) software. Logistic regression tests were used to determine the association between socio-demographic characteristics of blood donors with motivation factors and potential barriers. Results: Out of 350 participants, 54.9% were males, 46.9% were in 18-25 years old, 82.3% were Malays, 60.6% were single, 72.6% had high education levels, and 45.7% were regular donors. About 97.7% of the respondents donated blood due to altruism motivations while 53.2% of the respondents claimed they did not have enough time as their donation barrier. There was no association between socio-demographic characteristics of blood donors with motivation factors. Male respondents tend to have 1.82 times higher odds of having potential barriers for blood donation compared to female respondents (adjusted OR = 1.82, p = 0.020). Conclusion: Altruism is the main motivation factor for blood donation during COVID 19, while the main barrier for blood donation is lack of time. A well-planned, focused strategy is important in ensuring the efficacy of blood collection during pandemic.
  • Thumbnail Image
    Publication
    Outcome Following First Radioiodine Therapy For Remnant Ablation Of Low-risk Differentiated Thyroid Cancer At Institut Kanser Negara (Ikn)
    (2023-11)
    Anak Kindu , Anthony Louis
    Purpose: The role of remnant radioiodine ablation (RRA) in post-total thyroidectomy low-risk differentiated thyroid cancer (DTC) has been a debatable issue among experts over the decades. Giving that the risk of disease-specific death is less than 1% as well as only 2% - 3% risk of persistent or recurrent disease in low-risk DTC, the role of giving radioactive iodine therapy (RAIT) remains in the grey area. This study is to evaluate the outcome of RRA in low-risk DTC and to identify the possible affecting factors that may result in unsuccessful RRA in low-risk DTC. Methodology: A retrospective study of 212 patients with low-risk DTC treated with radioiodine-131 (I-131) with activities of 100 mCi and below from January 2017 to December 2020 at Nuclear Medicine Department, Institut Kanser Negara (IKN) with varying factors were identified to determine outcome following RRA in our centre. The outcome of a successful RRA was determined by negative diagnostic radioiodine-131 whole body scan (I-131 WBS) and endogenous thyrotrophin-stimulated serum thyroglobulin of (sTg) 1.0 ng/mL at two consecutive follow-up 6 to 12 months after RRA. sTg cut-off value was determined by using receiver operating characteristic (ROC) curve. The association of risk factors that may affect the successful RRA in low-risk DTC were determined using univariate and multiple logistic regression analysis.
  • Thumbnail Image
    Publication
    Study On Practice Of Massive Transfusion Protocol Activation In Hospital Universiti Sains Malaysia
    (2022-05)
    Wan Zulkipli, Nusaibah
    Introduction: Massive transfusion protocol (MTP) was designed to improve the outcome of patients at risk of mass ive haemorrhage. This study focused on the prevalence, indications, associated factors toward the indication of MTP cases and 24-hour mortality among who received MTP in Hospital USM. Methods: A retrospective cross-sectional study was performed on 110 patients for whom MTP was activated in Hospital USM. Data were extracted from the medical records and blood bank system (MyTransfus i). Simple and multiple logistic analysis was used for stati stical analysis, and a p-value of< 0.05 was considered significant. Results: A total of 273,087 patients were admitted to Hospital USM and 193 patients required MTP activation during the study period. The prevalence of MTP activation was only 0.07%. This study included 110 MTP cases which consisted of 62 (56.3%) trauma and 48 (43 .7%) non-trauma patients. The mean age of total patients were 40.0 years old, and maj ority were male (66.4%). The two most common MTP indications were motor vehicle accidents (n = 58) and gastrointestinal bleeding (n = 24). Female (adjusted OR= 20.08, 95% CI 5.76- 70.00, p <0.00 I) and presence of comorbidity (adjusted OR= 13.66, 95% CI 4.21 - 44.39, p<0.001) significantly associated with MTP indication. Meanwhile, no emergency procedure (adjusted OR= 12.77, 95% CI 4.22- 38.61, p <0.001) and noncompliance to MTP (adjusted OR = 4.30, 95% CI l.21 - 15.38, p = 0.024) were significantly associated with high mortality within 24-hour post MTP activation. Conclusion: The prevalence of MTP was low. Our result suggested that early emergency procedures to control the haemorrhage source should be done, and compliance towards MTP needs to be improved for better patient outcomes.
  • Thumbnail Image
    Publication
    In Silico Selection And Validation Of Dna Aptamer Against Progesterone Receptor Dna Binding Domain
    (2022)
    Tholasi Nadhan, Navien
    Progesterone receptor plays an important role in the progression of breast cancer. Currently, antibody-based Immunohistochemistry is used in pathological assessment of PR levels for the detection of breast cancer. The shortcomings associated with antibodies pave the path to use aptamers as the alternatives. Aptamers are single-stranded DNA or RNA oligonucleotides generated by SELEX that are capable of binding to their cognate target molecules with high affinity and specificity based on their unique structural folding capacity.The tediousness and rigor associated with certain steps of the conventional SELEX intensify the efforts to select DNA aptamers using in silico-docking approach. That said, we report an in silico selection and validation of DNA aptamer to the progesterone receptor DNA binding domain (PR DBD) using ssDNA sequences derived from human progesterone response elements (PREs).Firstly, a library of sixty-four different nearnative ssDNA analogs of the corresponding PRE sequences was designed and subjected to secondary and tertiary structural determination. After that, docking between the ssDNA tertiary structures with the PR DBD was carried out using PatchDock. The sequence with the highest docking score was chosen as the aptamer candidate and further validated by in vitro direct ELASA.Among the candidates, we selected the ssDNA sequence (PRDBDapt17; 5′- AGAACAGCGTGTTCT -3′), which showed the highest docking scores of 11334 as a promising PR DBD binding aptamer. In addition, the PRDBDapt17 detected recombinant PR DBD in direct ELASA with a limit of detection of 3.91 nM. The dissociation constant was estimated at 366.6 nM. Therefore, PRDBDapt17 is a potential aptamer that can be used in the diagnosis of breast cancer.
  • Thumbnail Image
    Publication
    Red Blood Cell Alloantibody Development Among Multi-transfused Patients In A Single Tertiary Centre
    (2023-11)
    Ismail, Hannah
    OBJECTIVES This research aimed to determine the prevalence, frequency, and specificity of RBC alloantibody and to evaluate the factors associated with its development among multi transfused patients in a single tertiary hospital. BACKGROUND Red blood cell (RBC) alloantibody development is one of the significant complications of blood transfusion, especially among multi-transfused patients. The risk depends on the frequency of exposure to the foreign RBC antigen, the antigen's immunogenicity, as well as the recipient's gender, age, underlying therapy or disease, and geographic ancestry. MATERIALS & METHODS This was a cross-sectional study involving retrospective data collection from 348 multi transfused patients who underwent pre-transfusion or immunohaematology testing from 1st January 2020 until 31st December 2021. Demographics and clinical characteristics were analysed using descriptive and multiple logistic analysis. RESULTS The prevalence of RBC alloantibody among 5,675 multi-transfused patients was 16.3%. Of the 348 multi-transfused patients studied, RBC alloantibodies were detected in 155 (44.5%) patients. Anti-E was the most common single alloantibody (39.6%), followed by anti-Mia (26.2%), as well as anti-M and anti-Lea (6.3% each). Multi-transfused patients with chronic kidney disease (p<0.001) and thalassaemia (p=0.032) were associated with a significantly higher risk for RBC alloantibody development. CONCLUSION Given the high prevalence of RBC alloantibody among multi-transfused patients, the provision of extended RBC antigen matched blood among these group of patients is essential to reduce the risk of transfusion induced alloimmunisation and subsequently haemolytic transfusion reaction or delayed serologic transfusion reaction.