Pusat Pengajian Sains Kesihatan - Monograf

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Provision of enteral feeding adequacy and reason for underfeeding in intensive care unit patients in HUSM
(2018-06)
Shokor, Mohamad Safwan Abd
Patient who admitted in the ICU require optimal amount of nutrition therapy for a better clinical outcome. The objectives of this study was to investigate the prevalence of enteral nutrition (EN) feeding adequacy, mean differences between feeding adequacy and biochemical indicator among patient and to identify the causes of under feeding. A cross sectional study was carried out at Trauma ICU, Medical ICU and 2 Delima, Hospital USM. Adult patients (2: 18 years old) who were, expected to stay for at least 24 hours in ICU and received enteral feeding during admission were included. Eligible patient was followed in ICU ward for maximum of 7 days or until death or discharge from ICU. A total of 55 patient were involved. Mean age 50.4 ± 17.2 years and mean BMI 25.7 ±6.9 kg/m2 (overweight). Among 55 patients, 34 (61.8%)did not received the recommended nutrition requirement (2: 80 of calculated energy and protein requirement). Changes in total protein , albumin and haemoglobin for 7 days between underfed and adequately fed were not statistically significant except for albumin for the first day of EN feeding. The most frequent reason for the feeding interruption were respiratory procedure (38%), operating room procedure (12%) and high GRV (> 500ml) (11 %). EN feeding was inadequate among critically ill patient as evidenced by majority (61.8%) of critically ill patient not receiving the recommended energy and protein. The causes feeding interruption should be improved via standard clinical protocol to avoid nutrition deterioration among critically ill patient.
Nutritional composition and textural properties of ready-to-eat compact rice developed from selected brown rice available in Malaysia
(2018-06)
Hairudin, Noor Sy Afinaz
Rice is a staple food for nearly two-thirds of world population. However, brown rice is less preferred compared to white rice due to its sensory and textural attributes, in addition to lack of availability. Therefore, this study is one of the alternative to increase the availability of wholegrain sources in different form of meal, such as compact rice with nice palatability and match well with any side dish, while contributing beneficial nutrients compared to white rice. Compact brown rice able to be produced from three different varieties of brown rice. When compared compact brown rice to compact white rice, compact brown rice contributes to higher protein ranged between 7.00 - 8.63%, higher fat in form of unsaturated fats (1.98 - 2. 69%), higher minerals (0.63 - 0.84%) and has low carbohydrate ( 10.44 - I 0.83%) meanwhile compact brown rice only contribute 1.55 - 1.56%, 0.33 - 0.34%, 0.28 - 0.38% and 17.56 - 17.93% of protein, fat, total ash and carbohydrate percentages respectively. However, due to practical error and cooking method, compact brown rice has lower total dietary fibre content which is ranged between 7.10 - 9.46 g/l00g while compact white rice contributes between 7.43 - 11 .30 g/l00g. Texture profile analyses and sensory evaluation are also conducted to assess palatability level of compact brown rice. Compact brown rice from three different rice varieties are not able to fonn a uniformly structured compact rice due to its property of less stickiness which cause less ability to stick with other grains therefore lead to unsolid structure. Among the brown rice varieties, long grain brown rice has the nearest hardness, adhesiveness, cohesiveness and gumminess compared to commercial compact rice with the values of 418.60g VS 687.34g, -153.31 VS -162.85, l.94 VS 2.20 and 812.55kg VS 1513.27kg respectively. Based on sensory attributes, when compared to commercial compact rice, specialty brown rice shows insignificant difference in term of aroma, texture, taste and appearance attributes. Even though long grain brown rice is more similar to commercial compact rice in term of textural properties, specialty brown rice is more preferred as it might be influenced by its palatability and appearance. Hence, specialty variety is the most suitable brown rice for development of compact rice, as it also well-accepted when served with popular side dishes such as serunding, /ontong and rendang. Further study is needed which centred on different treatment of cooking method while preserving beneficial nutrients and has nice palatability.
Nutritional status and its relationship with the quality of life in cancer patients
(2018-06)
Rozuki, Nurul Izzatie Mohd
Background: In patients with cancer, poor nutritional status is related with poor outcomes and altered quality of life. For that, the aim of this study was to identify relationship between nutritional status with quality of life in cancer patients at Hospital Universiti Sains Malaysia. Methods: The respondents had been selected as sample using purposive sampling and interviews method had been used to obtain the information such as socio-demographic data, cancer types, weight and height. For quality of life, European Organization of Research and Treatment of Cancer Quality of Life questionnaire (EORTC QLQ-C30) was used to assess quality of life and it were self-answered questions. Results: There were a total 90 of participants and 54.4% of participants had normal weight followed by obese (16.7%), underweight (15.6%) and overweight (13.3%). In this study, population's global quality of health score is 58.06 ± 18.84 and the mean score of patients in BMI categories of overweight were the highest (69.44 ± 15.21) followed by normal weight (56.80 ± 21.16), underweight (56.55 ± 13.94) and obese (54.44 ± 15.06) and for gender it was 58.89 ± 17.95 in the females and 56.39 ± 20.72 in the males. It also had been found that there is no statistically difference of mean score of quality of life in each dimension with BMI except for dimension of pain, tested using ANNOY A with (p= 0.032). Conclusion: Normal weight patients were common in a representative population of cancer patients at HUSM. HUSM population's quality of health score is slightly less than the EORTC reference value global score. This result had proved that there was worsening of overall quality of life of cancer patients in this population and in comparison with was higher in the females than males. Overall quality of life had demonstrated that overweight had a greater quality of life and obese was in the lowest other than others.
Feeding tolerance in enteral nutrition via bolus and continous feeding mode in critically ill ventilated patient.
(2018-06)
Basri, Nur Zhafirah
The term critically ill patients are characterized with the presence of hyper catabolism that cause by physiological and psychosocial stressors that associated with critical illness. Enteral nutrition is the alternative to provide sufficient energy required by critically ill patient as it contains complete balanced nutrients which include macronutrients and micronutrients in form that easy to digest. The aim for this study is to measure the feeding tolerance compared between bolus versus continuous feeding modes. The rate of feeding tolerance was measured by comparing the aspiration rate, and gastrointestinal (GI) complication. A total of 48 respondent was involved in this study. Study respondents who fulfilled the inclusion criteria were selected through convenience sampling technique. A social demographic data and health condition was collected from medical folder. All the data in this study was collected from medical folders that available in ward selected. This study found that there is no association between feeding mode and aspiration rate (/?= 0.563). There is also no association between feeding modes and diarrhea incidence (/?=0.838). The association between mode of feeding and vomiting is not found (p=0.663).
Molecular identification of curvularia species and the characteristics of their infections
(2018-12)
Kassim, Nur Shahira
The incidence of fungal infection has dramatically increased in recent years. Early diagnosis and rapid intervention is a critical element to determine the effective treatment in fungal infection. The laboratory diagnosis of the Curvularia infection in Hospital USM currently depends on the conventional methods of microscopic and culture which is timeconsuming, and the sensitivity is not known. In this study, molecular identification of Curvularia species was done using Internal Transcribed Spacer - Polymerase Chain Reaction (ITS-PCR) and sequencing. The characteristics of Curvularia infections in Hospital USM were also described. A total of 19 Curvularia spp. were isolated from all specimen from the year 2001 to 2018. ITS sequencing was able to identify 11 (57.8%) C. lunata, three Curvularia geniculata, two C. brachyspora, and one C. crepinii. Males were noted to be more affected than females. More than 50% of the patients belonged to age group of 40 years and above. Curvularia spp. were isolated mainly from corneal scraping (74%, n=14). Other specimens included blood, bronchoalveolar lavage and tissue. Most of the patients presented with comeal ulcers. A total of 16 patients (84%) received antifungal therapy and majority of the patients (79%) had clinical cure.

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