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- PublicationPerceptions, problems faced and coping behaviour : a qualitative exploration among patients with breast cancer attending Hospital USM, Kubang Kerian, Kelantan(2018-07)Patients with breast cancer face many challenges which include coming to terms with the diagnosis, managing treatment regimens, dealing with the side effects of treatment, conducting self-care and rehabilitation. In addition, the underlying belief of the disease influenced their health seeking behaviours. Each individual may have different coping strategies in order to overcome her problem. The study aimed to explore perceptions, problems, and coping behaviours among patients with breast cancer, and to develop Self-study Health Education Module for patients with breast cancer. Patients were purposively recruited from the Outpatient Oncology Clinic, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia. Selected patients were interviewed in-depth until saturation were achieved. All interviews were tape-recorded and transcribed verbatim. Qualitative data were managed by Nvivo 10.0 software. Descriptive analysis was performed using SPSS version 22. A total of 34 patients took part in the study. Majority were married (85.3%), Malay (88.2%), age between 40 to 59 years old (70.6%), secondary school education (73.5%), housewife (61.8%), diagnosed with right breast cancer (52.9%) and with monthly income of less than RM 1500 (67.6%). The qualitative findings were divided into three sections which included patients’ perceptions regarding breast cancer, their problems and coping behaviours in patients with breast cancer. The themes raised from patients’ perceptions regarding breast cancer were cancer is viewed cancer as a death penalty; cancer treatment is terrifying and cancer as curable disease. The themes emerged regarding problems faced among patients with breast cancer were emotional, physical, and social relationship changes, economical restraint, and prioritise traditional over modern medicine. Three main themes emerged regarding coping behaviours were emotional-focused coping, spiritual-focused coping and problem-focused coping. Based on the study findings and literature search, a new Self-study Health Education Module was developed. Eleven experts viewed the module as good, very informative, helpful, suitable to implement and easy to understand. Mean scores of evaluations ranged from 3.5 (graphics are interesting) to 4.2 (module in line with objectives). Ten patients viewed the module as good, very interesting, clear, helpful, and easy to understand. Mean scores of evaluations ranged from 4.2 (pictures are interesting) to 4.8 (information are sufficient, beneficial). Health professional should also spend more time on counselling, conducting seminar and others activities to educate and improve awareness regarding breast cancer.
- PublicationClassification of glioma brain tumors in mr images using imagej-based radiomic analysis(2024-07)The aim of this study is to classify glioma brain tumor grades using ImageJ-based radiomic analysis. This study utilizes magnetic resonance imaging (MRI) with ImageJ (Fiji) software to perform radiomic analysis, providing a quantitative method to evaluate Glioma tumor without the use of Gadolinium based contrast agents (GBCAs). Gliomas can range from low grade gliomas (LGGs) (Grades I and II) to high grade gliomas (HGGs) (Grades III and IV) tumors. Accurate grading of tumor is vital in determination of the appropriate treatment. This is a retrospective study on 12 T2-weighted (T2W) images (n=12) of patients with pathologically diagnosed glioma of different grades retrieved at the Radiology Department, Hospital Universiti Sains Malaysia from Picture Archiving and Communications System (PACS). A single slice of T2W image is chosen for analysis and all of the images were analysed for its image quality. Then, a workflow and protocol for image processing were explored using ImageJ. The lesion and normal appearing white matter (NAWM) region of interest (ROI) were selected for histogram analysis, along with lesion to normal tissue ratio (LNR) calculations and standard deviation of lesion (SDL) analysis for the assessment of tumor heterogeneity and intensity. Additionally, color thresholding, lookup table (LUT) images with 3D plot surface images, and midline shift angle measurements were used to assess tumor characteristics such as the margin, edema, and mass effect. The result of this study shows no specific trend for the tumor intensity based on LNR findings; however the SDL of the tumor shows an increasing trend across the glioma grades, which proves the increasing heterogeneity as the glioma grades increase. The margin of the tumor can be depicted by entropy thresholding, the edema is depicted by LUT images. Finally, the mass effect is depicted by the measurement of midline shift angle where higher-grade tumor depicts further deviation from 180.0° and in 3D surface plot images. In conclusion, ImageJ-based radiomic analysis provides an accessible and simple method for classifying glioma brain tumors. This approach may potentially facilitate tumor grading without the use of GBCAs.
- PublicationPercentage depth dose (PDD) of 9 MEV electron beam in the medium with the presence of inhomogeneous tissue by using optically stimulated luminescence dosimeter (OSLD), EBT3 film and ionization chamber(2024-07)The human body has variations in tissue density such as high-density bone tissue and low-density lung tissue, which will impact the dose distribution in the medium. The study aims to evaluate the dosimetric accuracy of optically stimulated luminescence dosimeters (OSLD) and their ability to detect and measure dose perturbation by measuring the percentage depth dose (PDD) in the medium consisting of solid water, bone equivalent, and cork(lung) equivalent phantom. Three phantom setups of solid water phantom, solid water-bone phantom, and solid water-cork (lung) phantom were irradiated with a 9 MeV electron beam, and the PDD was measured using OSLD, EBT3 film, and ionization chamber. The PDD curve and electron range parameter obtained by OSLD was compared to other dosimeters and statistical test was conducted to determine the agreement between the PDD using the p-value. The results showed that PDD measured by OSLD was in good agreement with the ionization chamber and EBT3 film dosimetry in a homogenous solid water phantom setup. PDD in the inhomogeneous solid water-bone and solid water cork (lung) phantom setups measured by OSLD was also consistent with the EBT3 film and previous studies. No significant differences were observed between PDD measured by OSLD and the reference dosimetry, evidenced by p-value > 0.05 obtained from statistical tests. The overall results indicated the suitability of OSLD as a passive dosimeter in electron beam dosimetry in the medium with the presence of inhomogeneous tissue.
- PublicationEstablishment of local diagnostic reference level (LDRLS) for digital mobile radiography in neonate population(2024-08)Introduction: Radiology techniques such as chest AP, abdomen AP, and chestabdomen X-rays are frequently performed on neonates to address various clinical conditions. However, a comprehensive Diagnostic Reference Level (DRL) that considers the specific needs and categories of neonates is currently lacking. Developing such DRLs is crucial for optimising radiation doses and ensuring safe imaging practises tailored to the delicate physiology of neonates. Objectives: This study aims to evaluate the dose distribution (Air Kerma-Area Product, PKA in mGy.cm2) for chest, abdomen, and chest-abdomen AP studies for mobile digital X-ray units among neonates and establish the local diagnostic reference levels (LDRLs) for these studies specifically for neonates. Method: In this study, a retrospective survey of X-ray data was conducted on 694 neonate samples, aged 1 to 28 days, who underwent chest AP, abdomen AP, or chest-abdomen X-ray examinations between January 2022 and December 2023 at Hospital Universiti Sains Malaysia (HUSM) using a mobile Samsung GM85 unit. The dose distributions (PKA in mGy.cm2) were evaluated, and the local diagnostic reference levels were established for these selected studies. Results: The dose distribution (PKA in mGy.cm2) revealed the highest DRL (Q3) value in the abdomen AP (17.26 mGy.cm2) and the lowest in the chest AP (6.79 mGy.cm2). The reference range of PKA for the selected X-ray examinations are abdomen AP (1.98 – 140.98 mGy.cm2), chest-abdomen (2.62 – 132.66 mGy.cm2), and chest AP (0.97 – 24.50 mGy.cm2). Conclusion: The findings of this study reveal that KAP value proportionally increases with kV, mAs and FOV. The DRL for neonates varies depending on the area being scanned for each X-ray radiography examination. In summary, this study makes a significant contribution to enhancing radiation safety, patient care, and clinical decision-making in neonatal X-ray radiography. Generally, this study agrees with other conducted DRL studies.
- PublicationDevelopment and validation of IYCF-CCPQ to assess knowledge, attitude and practice (KAP) on infant and young child feeding and factors associated with the kap scores among child care providers in Kelantan(2019-01)Adequate nutrition is critical to child health. There is a need to identify the knowledge, attitude, and practice (KAP) on infant and young child feeding among child care providers. Pre-existing questionnaires are unsatisfactory due to a different target population, weak theory, and lack of confirmatory analysis. Our objectives were t o develop and validate a new questionnaire that will be use d to assess the KAP and its associated factors among child care provider s in Kota Bharu. This study consists of two phases which Phase 1 developed and validate a new questionnaire, meanwhile Phase 2 involved assessment of KAP and its associated factors. The questionnaire was developed based on literature review, experts’ opinion and theoretical framework. Response process was assessed via cognitive debriefing and pretesting. Psychometric validation was carried out among 200 child care providers outside Kota Bharu. Purposive sampling was applied. Item Response Theory and Exploratory Factor Analysis were used for internal structure validity . Internal consistency rel iability was conducted for all domains. For Phase 2, a cross-sectional study involved 150 child care providers in Kota Bharu. Multistage random sampling was applied. Level of KAP was determined and its associated factors were identified through multiple linear regression and chi-square analysis. As a result, the new questionnaire consists of 218 final items with 3 domains (99 items on knowledge, 77 items on attitude, and 42 items on practice) and named as ‘Borang Kaji Selidik Pemakanan Bayi dan Kanak-Kanak dalam kalangan Pengasuh’ or IYCF-CCPQ. IYCF-CCPQ had good psychometric properties. Internal consistency by marginal reliability ranging from 0.74 to 0.91 for domain knowledge. Reliability for domain attitude ranging from 0.89 to 0.90. Breastfeeding and formula feeding knowledge score (BFFKS) was 69.42 (SD 11.31), complementary feeding knowledge score (CFKS) was 76.99 (SD 9.31), breastfeeding and formula feeding attitude score (BFFAS) was 143.61 (SD 12.10); and complementary feeding attitude score (CFAS) was 176.69 (16.07). Exclusive breastfeeding experience (adjusted b=7.09; 95%CI 1.69,12.48; p=0.001) and number provider per centre (adjusted b=-0.41; 95%CI -0.77,-0.06; p=0.022) did had association with BFFKS. Being married had significant association with BFFKS (adjusted b=6.01; 95%CI 2.32,9.71; p<0.001), BFFAS (adjusted b=5.33; 95%CI 1.40,9.26; p=0.008) and CFAS (adjusted b=7.69; 95%CI 2.94,12.45; p=0.002). Increased total working hours per day (adjusted b=2.53; 95%CI 1.06,4.00; p<0.001) did have association with CFKS. Diploma or higher qualification did influence CFKS (adjusted b=3.13; 95%CI 0.08,6.19; p=0.046), BFFAS (adjusted b=5.33; 95%CI 21.40,9.26; p=0.008) and CFAS (adjusted b=10.74; 95%CI 5.69,15.79; p<0.001). Job scope less than five did influence CFKS (adjusted b=4.67; 95%CI 1.79,7.54; p=0.001), BFAS (adjusted b=3.94; 95%CI 0.29,7.58; p=0.036) and CFAS (adjusted b=8.24; 95%CI 3.53,12.94; p<0.001). Source information from health staff did influence CFKS (adjusted b=3.16; 95%CI 0.05,6.27; p=0.048). Meanwhile, pamphlet source had association with CFAS (adjusted b=5.89; 95%CI 0.79,11.00; p=0.025). There was a significant association of educational level (X2=8.12(3),p=0.044) and exclusive breastfeeding (p=0.041, fisher exact test) with the practice of handling express breastmilk. Meanwhile, hygenic practice did have association with educational level (p=0.048, fisher exact test). In conclusion, the IYCF-CCPQ is reliable and valid to be used to assess KAP among child care providers on infant young child feeding. Overall KAP was satisfactory and identified significant factors help in improving child care providers’ KAP in future.
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- PublicationElucidation Of The Molecular Mechanisms Of Orthosiphon Aristatus Extract In Non-Alcoholic Fatty Liver Disease(2023-07)Non-alcoholic fatty liver disease (NAFLD) is the most common form of liver disease, beginning with simple hepatic steatosis and potentially leading to hepatic inflammation, fibrosis, and cirrhosis. Despite extensive research on NAFLD, there is no approved standard therapy for it as of now. Natural agents could potentially serve as alternative or supportive therapeutic options. Orthosiphon aristatus (Blume) Miq, a traditional plant in Southeast Asia, holds promise due to its potential to mitigate obesity and hyperglycaemic conditions. A plethora of chemical constituents in the ethanolic extract of O. aristatus (EOA) have been identified in previous studies, underscoring its potent antioxidant properties and broad ethnopharmacological usage. This study evaluated the potential anti-NAFLD effects of the EOA using a variety of in vitro, in vivo, and in silico methods. This included feeding C57BL/6 mice a high-fat diet, inducing multilineage 3D spheroids of HepG2 and LX-2 cells using palmitic-oleic acid induced-NAFLD, and employing various bioinformatics tools, such as molecular docking, to identify the pharmacokinetic and pharmacodynamic properties of the bioactive compounds of the EOA. Our findings identified 20 bioactive compounds corresponding to 45 potential NAFLD-related targets. Mice fed with the standardized EOA (400 mg/kg) for eight weeks showed inhibited NAFLD progression. Significant reductions in liver enzymes such as alanine aminotransferase and aspartate transaminase, as well as serum levels of glucose, insulin, total cholesterol, triglycerides, and low-density lipoprotein were observed.
- PublicationApplication of hallimond tube for flotability study of magnetite(2022-10-01)This project focused on studying the effect of varied parameters on recovery of magnetite. For example, pH, conditioning time, collector dosage, flotation time and maleic acid as a collector are the parameters that been study for. The optimum parameter, which gave the maximum recovery on each variable was determined. The experiment was conducted in a Hallimond tube by using sample of having 96.81% of iron oxide. Oleic acid and maleic acid were employed as collector. Based on the results obtained, it showed that oleic acid is the efficient collector for flotation of magnetite. Magnetite float better on the alkaline phase with pH of 11. Other than that, for best conditioning time, it showed that 8 minutes is the ideal time for flotation of magnetite. For the collector dosage, the results showed that the best dosage of collector was 300 g/t with maximum recovery. Furthermore, the flotation time of 8 min gave the maximum recovery of magnetite. Different collector was used which is maleic acid to investigate the performance and it showed that maleic acid has less recovery compared to oleic acid with the recovery of 39.63%.
- PublicationComparison of fluorescent spot test against quantitative enzyme assay for detection of glucose-6-phosphate dehydrogenase deficiency(2022)Objectives: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common enzymopathy in the world. Some countries have practiced fluorescent spot test (FST) as a neonatal screening method since the 1980s. However, FST has its own limitations. Quantitative assays such as the careSTARTTM BioSensor1 have been demonstrated to be able to overcome some of these limitations. The objectives of this study are to compare the performance of FST with BioSensor1 in detecting G6PD deficiency in neonates and to verify the reference range of G6PD level for cord blood using BioSensor1. Methods: This study was a cross sectional study involving 455 neonates born in Hospital Universiti Sains Malaysia (Hospital USM), Kelantan, Malaysia beginning June 2020 until December 2020. Two millilitres of cord blood were taken in EDTA bottles to be analysed with BioSensor1 and dried cord blood spots on filter paper were sent for FST to determine the levels of G6PD. Demographics data and birth characteristics were taken from labour room records. Data was recorded and analysed using the Statistical Package for the Social Software (SPSS) version 27. P-value less than 0.05 were considered as significant. Results: The sensitivity of FST was 91% whilst its specificity was 97% at 30% cut-off G6PD activity level. In contrast, at 60% cut-off G6PD activity level, the sensitivity drastically decreased to 29% whilst the specificity was 100%. The overall prevalence of G6PD deficiency was 5.1% and 17.8% for FST and Biosensor1 respectively, demonstrating a drastic difference between the two tests (p < 0.001). The mean G6PD level for term neonates was 6.84 U/gHb whilst for preterm neonates was 6.63 U/gHb. Using independent T-Test, there was no significant difference in the mean G6PD levels between term and preterm neonates. There was also no significant association between different gestational age groups, maternal blood group and birthweight with mean G6PD level when tested using one way ANOVA test. Conclusions: FST has low sensitivity at 60% cut-off G6PD level. This cut-off level reflects intermediate G6PD activity, hence FST missed a significant proportion of G6PD intermediate individuals in our study. At the same time, the prevalence of G6PD deficiency significantly increased with the use of BioSensor1. Gestational age, birthweight and maternal blood group do not have significant association with G6PD level. In a budget constrained facility, it is recommended to use quantitative enzyme assay to screen female neonates and to use FST for male neonates especially in areas where G6PD deficiency is prevalent.
- PublicationCo2 Biofixation And Carbohydrate Biosynthesis By Locally Isolated Acidophilic Microalgae For Biobutanol Production Through Simultaneous Saccharification And Fermentation(2023-09)Butanol is a common chemical that used as an additive for automotive fuel. Among the production methods, the biobutanol synthesised through acetone-butanol-ethanol (ABE) fermentation process. The ABE fermentation using microalgae biomass that contains high carbohydrate with less lignin, which is suitable to be biobutanol feedstock. The potential of microalgae for biological CO2 biosequestration, making them value-added compared to other bioresources. In addition, the promising single-step saccharification and fermentation (SSF) process during ABE fermentation, has opened up a novel ground for advancement in economic biobutanol production. Based on this study, a total of two native acidophilic microalgae were successfully isolated and were identified as Coccomyxa dispar and Scenedesmus parvus strains. The C. dispar and S. parvus exhibited highest in terms of biomass productivity, carbohydrate productivity, and CO2 biofixation when cultivated under the elevated condition. Apart from that, the carbohydrate-related genes and proteins were also been investigated in this study. Based on the transcriptomic analysis, the results showed that a significant upregulated of carbohydrate-related genes such as AGB, SS, ISA, AGPase, ME, G6PD, Accc, RuBC, and CA that involved in C. dispar, while PGM, AGB, SS, AGPase, ME, DGAT, RuBC, and CA involved in S. parvus
- PublicationAlkaline treatment of 3D printed TI-AL-V alloy for bioactivity surface modification(2022-08-01)Ti6Al4V alloy has low bioactivity and surface treatment could improve its bioactivity. However, Ti6Al4V alloy manufactured by 3D printing has very fine microstructure compared to conventional manufacturing method.Thus, the aim of this work is to investigate the feasibility of modifying the surface of 3D printing Ti6Al4V alloy using NaOH alkaline treatment. . 3D printed Ti6Al4V alloy manufactured by 3D Gens Sdn Bhd in disc shape were soaked in 10M sodium hydroxide (NaOH) at 60ºC for 24hrs. Post heat treatment was applied to observe heating temperature affect upon the alkaline treated alloy at 200ºC, 400ºC, 600ºC and 800ºC. The X-Ray diffraction shows the presence of amorphous titanate layer after immersion in NaOH . The titanate was observed at 200ºC with the formation of rutile TiO2 after heat treatment at 800ºC. Morphology observation under Field Emission Scanning Electron Microscopy (FESEM) and elemental analysis indicate the deposition of titanate layer when heat treated with high temperature. The bioactivity of sample alkaline-heat treated at 200°C was investigated through immersion in Hank’s solution for 7 days trace 0.34wt% of Ca on alloy surfaces. The surface roughness of the sample after heat treatment was analysed using AFM where sample treated with 800ºC exhibit the highest surface roughness and alkali-heat treated at 200ºC has the lowest surface roughness. The wettability of the sample was tested by recording the contact angle of the sample with droplet of ultrasonic water where sample after alkaline treatment has the lowest value indicating it has the highest hydrophilic properties. The findings suggests that lower temperature after alkaline soaking is required to prevent phase transformation of sodium titanate layer during the post heat treatment so that high sodium titanate layer can form higher appetite layer on the surface alloy.
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