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- PublicationComparison of prophylaxis phenylephrine infusion and rescue bolus administration for maintaining blood pressure during spinal anaesthesia for caesarean delivery in obese women(2022)Background: Obesity and Caesarean section (CS) have been identified as independent risk factors for maternal morbidity and mortality. Regional anaesthesia should ideally be used for all Caesarean delivery unless contraindicated. However, maternal hypotension, a recognized complication of post-spinal anaesthesia, found more severe among obese mothers. Phenylephrine (PE) is a preferred choice of vasopressor in this setting as it results in better neonatal outcomes. This study investigates the effect of prophylactic PE infusion on the haemodynamics of obese parturients undergoing elective CS under spinal anesthesia. (SA) Methods: This was stratified balanced randomization, double blinded, parallel group study conducted in Hospital Universiti Sains Malaysia. A total of 74 parturients scheduled for elective CS under SA were randomized into two arms, Group A (n=37) received prophylactic PE infusion starting at 50 μg/min and adjusted according to the given algorithm or Group B (n=37) who received 100 μg phenylephrine bolus to treat post-spinal hypotension. The primary outcome measured included systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean artery pressure (MAP). The secondary outcomes were the total requirement of PE and neonatal Apgar scores. Results: Six patients were excluded from the analysis due to missing data. The result showed that SBP, DBP, and MAP were statistically significantly higher in the prophylactic infusion group compared with the therapeutic bolus group (p<0.05). The mean difference of SBP, DBP, and MAP between the two groups were significant. The mean requirement of PE was higher in the infusion group compared with the bolus group. Both groups have no difference in terms of neonatal Apgar score. Conclusion: Prophylactic PE infusion provides more excellent haemodynamic stability control than therapeutic PE boluses among obese parturients with BMI between 30 -40 kg/m2 undergoing CS under SA.
- PublicationPrevalence and outcome of infected tumour endoprosthesis in Hospital Universiti Sains Malaysia(2022)INTRODUCTION AND OBJECTIVE Endoprosthesis implantation is a viable option in the surgical management of malignant bone tumours; its modularity for joint and osseous defect reconstruction provides early good functional outcomes. However, with such significant operative intervention, it carries tremendous risk, and infection is one of the most dreaded complications. This study aims to determine the prevalence and outcome following treatment of infected endoprosthesis. METHODOLOGY This is a retrospective study in which all oncology patients that had undergone limb salvage surgery in the orthopaedic oncology unit, Hospital Universiti Sains Malaysia, from 2008-2018. A total of 69 patients were identified, and the prevalence and outcomes of patients complicated with endoprosthesis infection were determined. The diagnosis of infection is based on CDC criteria 2018. Patients' demographic data were collected, and statistical analysis was done using repeated measure analysis of variance (ANOVA) to determine the relationship between risk factors for infection. RESULTS A total of four out of 69 patients (5.8%) were found to be infected in this study. The four patients underwent staged surgery during the treatment period. There was no significant relationship between demographic or comorbidity and infection risk factors evaluated on multivariate analysis. However, the duration of surgery was found to be independently associated with an increased risk of infection (p=0.02). Of the three patients who underwent debridement and stages surgery and became infection free, only one required amputation due to unresolved infection. CONCLUSION The prevalence of infected endoprosthesis was considerably low, and the surgery duration was identified as a risk factor for infection.
- PublicationPoint of care procalcitonin for early detection of bacterial coinfection in patients with severe dengue in the intensive care unit: A prospective cohort study(2022)Background: Early detection of bacterial coinfection in severe dengue remains challenging. Point-of care (POC) Procalcitonin (PCT) may fulfil this role, but its performance has not been investigated. We therefore aimed to evaluate the performance of POC PCT for early detection of bacterial coinfection in patients with severe dengue admitted to the intensive care units (ICU). Methodology: In this dual-centre prospective cohort study, we analysed PCT level in severe dengue patients with and without bacterial coinfection upon their ICU admission. The diagnostic performance of PCT for the coinfection was determined through analysis of the receiver operating characteristics curve. Results: Fifty severe dengue patients were enrolled over a 1-year period. Fourteen (28.0%) of these patients had bacterial coinfection on ICU admission. PCT was significantly higher in patients with the coinfection than those without (36.2 [SD = 41.8] versus 3.6 [SD = 5.6] ng/mL, P = 0.012). The AUC of 0.768, ideal cut-off of >4.6 ng/mL, sensitivity of 64.3% and specificity of 83.3% revealed that PCT was a good marker for detecting bacterial coinfection in our severe dengue cohort. Conclusion: POC PCT provides early detection of bacterial coinfection with a good performance in severe dengue although further studies are warranted to validate these findings.
- PublicationEffects of vitamin c on the endothelium of rem sleep deprived animal model: a preliminary study(2019-12)REM sleep deprivation is associated with endothelial dysfunction, a key event in the initiation of the cardiovascular disease process. The functions of the endothelium impair when damage occurs to its structures. To date, the pathogenesis of endothelial dysfunction in REM sleep deprivation remains poorly understood. This study aimed to determine the relationship between REM sleep deprivation and endothelial damage. The role of antioxidant vitamin C was also evaluated. Sixteen (16) Sprague-Dawley (SD) male rats were divided equally into four groups: free moving control rats (FMC), REM sleep deprived rats for 72 hours (REMsd), sleep recovery for 72 hours after 72 hours of REM sleep deprivation (SR), and REM sleep deprived rats for 72 hours (REMsd) that pretreated with vitamin C (RVC). Rats were deprived from REM sleep using the inverted flowerpot technique. Vitamin C (1 OOmg/kg) was administered orally for 4 weeks before the adaptation period. There was a significant reduction of body weight gain despite a significant increase in food consumption in the REMsd during the experiment when compared to the adaptation period. The systolic blood pressure also increased significantly in the REMsd group as compared to other groups. Histologically, the endothelium of REMsd rat had a features of endothelial damage. The levels of malondialdehyde (MDA) in the aorta were significantly higher in REMsd group suggestive oflipid peroxidation. Whereas, the levels of superoxide dismutase (SOD) and total antioxidant capacity (TAC) were significantly lower in the REMsd group when compared to others. The changes following REM sleep deprivation revert with sleep recovery. In conclusion, the above findings provide convincing evidence that REM sleep deprivation induced oxidative stress that caused endothelial damage. Supplementation of vitamin C has beneficial effects in reducing the adverse effects following REM sleep deprivation.
- PublicationThe effectiveness of nutritional intervention towards poor weight gain among paediatrics in dietetic outpatient clinic, Hospital USM in 2016: a retrospective study(2019-06)This retrospective study was purposely conducted to assess the effectiveness of nutritional intervention towards poor weight gain among paediatrics in dietetic outpatient clinic, Hospital USM. Medical records and medical nutrition therapy cards were used to obtain the research data. Nutritional status indicators including weight, height and energy intake on first, second and third visits in year 2016 were collected to determine their differences respectively after receiving nutritional intervention, together with the sociodemographic characteristics, clinical data, dietary data and data on type of nutritional intervention received. The research study involved 75 subjects (50.7% female and 49.3% male) of age below 18 year old. Most of the subjects were 2 year old or below with total of 63(84.0%) subjects, female with total of 38(50.7%) subj ects, Malay with total of 72(96.0%) subjects, and with no knpwn medical illness with total of 49(65.4%) subjects. The mean (SO) of weight on second visit was 7.93(2.17) kg, significantly higher than that of first visit, which was 7.26 (2.09) kg at p
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- PublicationEffects of graphene oxide coating on the properties of polyurethane nanofiller nanocomposite foams(2022-08-22)In this study, carbon black (CB) and multiwalled carbon nanotube (MWCNT) were used as fillers for the preparation of the polyurethane (PU) nanocomposite foams. The CB and MWCNT loadings were in the range of (1, 2.5, 5, 7.5 phr). Further, graphene oxide (GO) coating was applied on the surface of the PU/CB and PU/MWCNT nanocomposite foams to increase the electrical conductivity which is determined by the surface resistance. The properties of the PU nanocomposite foams were characterised using foam density measurement, scanning electron microscopy (SEM), and surface resistance tests. The foam density of the PU was increased as a result of the increasing loading of CB or MWCNT. Furthermore, the PU/MWCNT nanocomposite foam has a higher density than the PU/CB nanocomposite foam at the same nanofiller loading. The microstructure analysis of the PU nanocomposite foams found that the average cell size is reduced as the filler loading increases. This indicates that the CB and MWCNT can act as cell nucleation sites to promote cell growth. The surface resistance of PU/MWCNT nanocomposite foam is lower than that of PU/CB nanocomposite foams at the same filler loading. Interestingly, the surface resistance of PU nanocomposite foams (formulation PU-MWCNT-5wt%) decreases from 5.8 x 1010 Ω to 1.7 x 108 Ω by the GO coating. This indicates that the GO coating is capable of increasing the electrical conductivity of the PU nanocomposite foam. Overall, the PU nanocomposite foam with dissipative behaviour was successfully produced using a combination of filler (dispersed in the PU matrix) and GO coating method.
- PublicationMapping temperature distribution during 3d printing process of post consumer high density polyethylene(2025-08-11)This study explores the use of 100 % post-consumer HDPE (PC-HDPE) compounded with 30 phr kaolin clay as filament for Fused Deposition Modeling (FDM). The aim of this project is to map real-time thermal distributions during FDM of PC-HDPE with 30 phr Kaolin filler (PC-HDPE/30) and identify nozzle size (0.4 and 0.6 mm), nozzle temperature (200, 220, 240, 260 °C) and bed temperature (60, 70, 80, 90 °C) that minimize shrinkage and warpage. Post-consumer HDPE flakes obtained from shredding of detergent bottles were cleaned, compounded with kaolin clay via a heated two-roll mill, and extruded into 1.75 mm filament. A Creality Ender-3 printer was equipped with an InfiRay T2S Plus thermal camera to map temperatures at the nozzle exit, bead, and build plate. A 4×4×2 full factorial design with three replicates was used to vary nozzle temperature, bed temperature, and nozzle size, shrinkage was calculated from CAD-to-printed volume differences, warpage was measured from average corner heights and all data were analyzed by ANOVA (α = 0.05) in Minitab 18. Based on data obtained and ANOVA analysis, the deposited temperature was highly sensitive to all main effects (P < 0.05). Shrinkage showed a significant interaction between nozzle and bed temperatures (P = 0.009), though neither factor alone was significant. Warpage was significantly influenced by nozzle temperature, bed temperature, and nozzle size (all P < 0.05), with a notable nozzle‑size × nozzle‑temperature interaction. A nozzle temperature of 220–240 °C, a bed temperature of 70–80 °C, and a 0.6 mm nozzle were recommended to minimize shrinkage and warpage.
- PublicationStructure-Function Relationship Between Natural Rubber Polymer And Proteins In The Latex Of Malaysian Hevea Clones(2025-10)Natural rubber obtained from the latex of hevea brasiliensis is of major importance to human civilisation. Proteomics analyses of h. Brasiliensis latex have revealed the major proteins responsible for the various biological pathways, such as rubber biosynthesis, defence against pathogens, stress tolerance, and wound healing. The characteristics of several of the hevea clones in malaysia remain undiscovered, especially in the aspect of their rubber molecular weight and latex protein differential abundance. A comprehensive proteomics and molecular weight distribution analysis was conducted on the latex of three hevea clones grown in malaysia: pb350, rrim3001 and rrim2025, according to their age groups of 5, 7 and 10 years old. The molecular weight of rubber from all samples shows a decreasing trend the older the plant grows older, ranging between 9.76×105 da to 29.26×105 da. The molecular weight distribution shows a unimodal distribution among all samples. A total of 619 unique proteins were identified from all samples, ranging from 127 to 286 proteins. Label-free quantification identified 50 differentially accumulated proteins amongst the different clones and age groups. Comparison analysis indicated that the molecular weight of the rubber is negatively correlated with the abundance level of the rubber biosynthesis-related proteins.
- PublicationA study on nutritional status, mealtime behavior and food refusal among autism spectrum disorder (asd) and typically developing (td) children aged 3 to 11 years old in USM Kubang Kerian, Kelantan(2017-05)A cross-sectional study was conducted to investigate the nutritional status, mealtime behaviors and food refusal among Autism Spectrum Disorder and Typically Developing children aged 3 to11 years old in Universiti Sains Malaysia Kubang Kerian, Kelantan (97 children). In this study, nutritional status was calculated and categorized based on CDC (2000). On the other hand, mealtime behaviors was determined using Brief Assessment of Mealtime Behavior in Children (BAMBIC). BAMBIC questionnaires consisted 3 factors which were Food Refusal, Disruptive Behaviors and Limited Variety. While food refusal among respondents was determined by using Food Preferences Inventory (FPI) based on 12 group which namely cereals and cereal products, meat and meat products, fish and seafood, eggs, legumes and legume products, milk and dairy products, vegetables, fruit, confectionery, beverages, spreads, seasonings and flavoring. Result showed that ASD children possessed higher in both underweight, overweight and obese as compared to TD children. In mealtime behaviors outcome, the food refusal and disruptive behavior factor were significantly different among ASD children compared to TD children. However, for limited variety factor, not significant mean differences was noted between ASD and TD children. The common food refusal that significantly different among ASD and TD children were cereal and cereal product (p <0.001), meat and product (p=0.039), bread spread (p=0.017) and confectionery cake (p=0.012). However, ASD and TD children do not show significant mean differences in refusing vegetables (p=0.239), fruits (p=0.089), fish and seafood (p=0.090), beverages (p=0.456)), milk and milk product (p=0.387) and flavoring and seasonings (p=0.925). In conclusion, children with ASD more likely to suffer underweight, overweight and obese issues as compared to TD children. This might be related to higher unhealthy food intake and less vegetables and fruits intake so leads some of them to overweight and obese. However, there were also a few of them might consuming less energy dense food and had higher mealtime behaviors problem so leads them to have lower BMI compared to TD children.
- PublicationDevelopment Of Pofa Based Geopolymer Concrete Activated With Wood Ash Lye Incorporating Timber Clinker Aggregate(2023-09)Cement manufacturing has led to excessive carbon dioxide (CO₂) emission into the atmosphere, which has contributed to global sustainability challenges. Moreover, huge amount of industrial waste like palm oil fuel ash (POFA), wood ash (WA), and timber clinker aggregate (TCA) landfilled in our environments coupled with the use of naturally occurring rocks for aggregate are also a negative factor for the global sustainability. Amidst these sustainability challenges of cement production, waste management, and the use of naturally occurring rocks emerges the technology of geopolymer concrete. The development of geopolymer concrete has gained recognition in recent years as innovative and alternative construction material. However, using aggressive chemicals like sodium hydroxide (NaOH) as alkaline activator and oven curing has limited it to laboratory research only. The current study strived to answer the research questions on the effectiveness of using WA lye as alkaline activator to replace NaOH and also the utilization of TCA as coarse aggregate in geopolymer concrete at the ambient temperature. The investigation began with the optimization of liquid binder (L/B) and alkali activator ratio (AAR) using varying L/B and AAR ratio. Then specimens with GGBS as a partial replacement of POFA from 0% to 40% were produced with the view to optimize the GGBS content. TCA was optimized by producing POFA: GGBS geopolymer concrete with 0% to 100% TCA at 20% increment as partial replacement of natural aggregate.