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- PublicationKnowledge and practice of preventive behaviour regarding kidney stone disease recurrence among patients in Hospital Pakar Universiti Sains Malaysia(2025-08)Kidney stone disease (KSD) is a recurrent condition that can lead to significant health problems and costs. Preventive behaviours, such as drinking enough water, dietary changes, and medical follow-up, are essential to reduce recurrence. This study aimed to determine the level of knowledge and practice of preventive behaviour among patients at Hospital Pakar Universiti Sains Malaysia (HPUSM). A total of 60 patients completed a self-administered questionnaire. Data were analysed using descriptive statistics and inferential tests with SPSS version 26.0. The mean knowledge score was 1.57 (SD = 0.50), with 56.7% of participants showing good knowledge. The mean practice score was 2.25 (SD = 0.628), with 55.0% showing moderate practice. Pearson’s correlation showed a weak and non-significant relationship between knowledge and practice (r = 0.132, p = 0.315). However, education level was significantly associated with both knowledge (p < 0.001) and practice (p = 0.005), while age and gender were not. In conclusion, while patients had moderate to good knowledge and practice, there was a gap in translating knowledge into consistent practice. Targeted education and support are needed to improve preventive behaviours and reduce KSD recurrence
- PublicationKnowledge and attitude towards HIV post exposure prophylaxis (PEP) among healthcare workers in Hospital Pakar Universiti Sains Malaysia(2025-08)This study aimed to assess the knowledge and attitude towards HIV post-exposure prophylaxis (PEP) among healthcare workers (HCWs) at Hospital Pakar Universiti Sains Malaysia (HPUSM). As HCWs are at risk of occupational exposure to HIV, especially through needle-stick injuries, understanding their awareness and perception of PEP is crucial. A cross-sectional study was conducted involving 167 participants, selected through stratified random sampling from seven inpatient wards. Data were collected using a structured questionnaire and analysed using descriptive statistics, Pearson correlation, and Chi-square tests. The results showed that while 80.2% of HCWs had a favourable attitude towards PEP, only 44.9% demonstrated good knowledge, with the majority 55.1% lacking adequate understanding. Although 76.6% had heard of PEP, only 9.6% had received formal training, and 71.3% had not encountered current PEP guidelines. A significant moderate positive correlation was found between knowledge and attitude (r² = 0.292, p = 0.001). Additionally, knowledge was significantly associated with factors such as educational level, profession, exposure to PEP information, and familiarity with guidelines. However, no socio-demographic characteristics were significantly associated with attitude. The findings highlight the need for improved training, clearer protocols, and greater institutional support to enhance PEP knowledge and readiness among healthcare workers
- PublicationKnowledge and practice on first aid of rice (rest, ice, compression, elevation) method among undergraduate nursing students in Universiti Sains Malaysia(2025-08)Musculoskeletal injuries, like sprains and strains, are common in both clinical and community settings. The RICE method (Rest, Ice, Compression, Elevation) is a widely used first aid approach to manage these injuries effectively. As future healthcare providers, nursing students need the knowledge and skills to use this method properly, emphasizing the importance of nursing education in early injury management. This study aimed to assess the level of knowledge and practice of the RICE method among undergraduate nursing students at Universiti Sains Malaysia (USM), and to explore the relationship between knowledge, practice, and selected socio-demographic factors. A cross-sectional study was carried out using a structured questionnaire, with 190 students taking part. Data were analysed using descriptive statistics, Pearson correlation, and Chi-Square tests with SPSS version 28.0. Most students (n = 118, 62.1%) had adequate knowledge of the RICE method, and 60.5% (n = 115) showed good practice. A significant positive correlation was found between knowledge and practice (r² = 0.337, p = 0.01). Among socio-demographic factors, only age showed a significant link with knowledge (χ² = 7.745, p = 0.021), while gender, education level, and prior exposure did not show significant associations
- PublicationMicrovascular Endothelial Function In Obesity; And The Effect Of Pharmacological Intervention With Orlistat And Sibutramine On Microvascular Endothelial Function And Selected Cardiovascular Risk Markers(2012)Obesity increases the risk of a variety of medical problems and cardiovascular diseases. Endothelial dysfunctionis one of the earliest vascular changes that occur in the pathogenesis.. Of cardiovascular diseases. This phd work is composed of three studies. The first study aimed to optimize a technique used to assess microvascular endothelial function, using laser doppler fluximetry (ldf) and the process of iontophoresis. Ldf measures skin perfusion, while iontophoresis is a non-invasive method of introducing charged substances across skin by means of a small electric current to evaluate both endotheliumdependent and endothelium independent vasodilatation. Firstly, the effect of sodium chloride used as a vehicle to dilute the iontophoresis drugs acetylcholine (ach) and sodium nitroprusside (snp) on non-specific vasodilatation was assessed. Secondly, to determine the number of electrical pulses needed to reach the maximum response during iontophoresis of ach and snp using low current strength. Thirdly, the reproducibility of different parameters during iontophoresis of ach and snp) were also determined. The initial iontophoresis protocol used consisted of 7 electrical pulses of2 minutes each separated by l minute current free interval.
- PublicationLaparoscopic cholecystectomy; intraoperative cholangiography versus no intraoperative cholangiography. a multi center randomized control trial(2019)Introduction: Intraoperative cholangiography (IOC) is not something new in the world of laparoscopic cholecystectomy (LC). However it is still not a favorite method to be applied as a routine procedure in LC. Objectives: To determine the feasibility and safety of performing IOC during LC, to detect the incidence of undiagnosed pre-operative bile duct stone and to identify whether IOC can prevent bile duct injury. Method: Multi-center, double blinded randomize controlled trial done from 2016-2018. Total of 308 patients recruited and divided into 2 arms; with IOC and without IOC. Exclusion criteria includes in situ biliary stent placement, history of multiple laparotomies, performed. Out of 308 patients, 154 patients were assigned to IOC group and 154 patients were assigned to no IOC group. Results: There was a statistically significant difference of mean operation time between the group with IOC and no IOC (mean operation time for IOC group was 66.0 minutes (SD ±28.20) compared to no IOC group 55.6 minutes (SD±23.15), t statistics (df) = 306 (6.78), p-value <0.001). The successful rates for IOC was 98.1%. From 12 cases with presence of filling defects detected during IOC, 4 cases were confirmed CBD stones. Two were confirmed after conversion to CBDE and the other 2 cases were confirmed during ERCP performed. There was only 1 case of bile duct injury noted during IOC. No patients developed allergic reaction to contrast media and the post-operative complications were similar in both groups. Conclusion: IOC is a useful tool to delineate anatomy of bile duct during surgery. It also can easily been done by any surgeon with lots of practices and a proper guidance. Its use may be beneficial in selected cases.
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- PublicationThe association between toxoplasma gondii infection and psychiatric disorders among psychiatric patients in hospital Universiti Sains Malaysia(2023-12)Toxoplasma infection, caused by the protozoon Toxoplasma gondii, is one of the most common parasitic zoonoses globally. This facultative heteroxenic, polyxenic organism has been identified as playing a role in the etiology of various psychiatric disorders. The present comparative cross-sectional study purposed to investigate the association between Toxoplasma infection and psychiatric disorders in patients at Hospital Universiti Sains Malaysia, Kelantan. Fifty-four psychiatric disorder patients from each category (schizophrenia, bipolar disorder, and depressive disorder) and 54 healthy individuals were analyzed by an enzyme-linked immunosorbent assay (ELISA) that detects anti-T. gondii immunoglobulin G (IgG). Subsequently, all IgG- positive plasma samples were analyzed for Toxoplasma-specific IgM. IgG avidity ELISA was tested for the positive samples of T. gondii IgM. The presence of the Toxoplasma B1 gene and ITS-1 region was determined in all extracted deoxyribonucleic acids (DNAs) from the whole blood using the polymerase chain reaction (PCR). The sociodemographic, clinical manifestations, and behavioural factors of the psychiatric patients and healthy individuals were assessed using a data collection form. Out of 54 patients with depressive disorder, 24/54 (44.4%) were IgG+/IgM-, and four (16.7%) were IgG+/IgM+. A high avidity index that described a past infection for more than 20 weeks was reported in half of the sample (50.0%) and the other half (50.0%) showed a contradicting result that indicated a possible recent infection within 20 weeks. Moreover, 30/54 (55.6%) patients with bipolar disorder were IgG+/IgM-, five (16.7%) were IgG+/IgM+, and four of them had high avidity index and one showed a low avidity index. Meanwhile, 29/54 (53.7%) patients with schizophrenia were IgG+/IgM-, 2 (6.9%) were IgG+/IgM+, one of them had a high avidity index, and one low avidity index. Out of 54 healthy individuals, 37.0% (20/54) were seropositive for T. gondii antibodies. In this study, no positive results were found for the presence of the Toxoplasma B1 gene and ITS-1 region. A Chi-Square and multiple logistic regression proved age (p=0.031), marital status (p=0.007), and employment (p=0.012) were significantly associated with Toxoplasma seropositivity rate in patients with psychiatric disorders. Close contact with cats/pets (p=0.033) and contact with soil (p=0.012) also were significantly associated with Toxoplasma seropositivity rate in the patients. In conclusion, the findings revealed varying seropositivity rates, indicating that individuals with psychiatric disorders such as schizophrenia, bipolar disorder, and depressive disorder may have experienced both past and potentially recent infections with T. gondii. However, additional research is needed to elucidate the causal relationships and underlying mechanisms. This is essential for the development of targeted interventions and preventive strategies, with the potential to enhance overall mental health outcomes for those affected.
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- PublicationEffect of ion exchange treatment on the properties of muscovite filled polymer composites(2009-05-01)The research reports the preparation and performance of particulate filled epoxy composites using casting method. A type of filler was used in this study which is muscovite. Surface treatment was carried out to muscovite particles in order to improve the interfacial and dispersion in epoxy matrix. The treated muscovite was characterized using X-Ray Diffraction (XRD) and Fourier Transmission Infra Red (FTIR), which indicate the particles have successfully treated. Mechanical properties were investigated in order to evaluate the effect of ion exchange treatment and filler loading on composites. It was found that the tensile strength and the tensile modulus increase over filler loading are investigated for untreated and treated muscovite composites. In term of tensile modulus, treated muscovite composite increase from 1996.5 ± 33 MPa (10wt% untreated muscovite) to 3188.5 ± 142.5 MPa (10wt% treated muscovite). It was observed that muscovite composites with ion exchange treatment give better performance in terms of thermal properties as compared with untreated muscovite composites. Furthermore, the coefficient of thermal expansion (CTE) has successfully reduced from 74.4 ppm/°C (neat epoxy) to 57.9 ppm/°C (10wt% treated muscovite) with targeted CTE value of around 20 -30 ppm/°C. The closer the CTE value of the substrate to chips is preferable in order to minimize the internal stress and fatigue cracking.
- PublicationValidation of the Malay version of affiliate stigma scale among caregivers of patients with mental illness in Hospital Universiti Sains Malaysia(2018-11)Background: Caregivers of a patient with mental illness are exposed to stigma. The internalization of this self-stigma among caregivers is known as affiliate stigma. Affiliate Stigma Scale was different compared to other tools used to measure the stigma among caregivers as it measures the internalization response related to the perceived stigma from surrounding. Nevertheless, there is lack of information on the psychometric properties of this tool used in the Malaysia context. The objective of this study was to validate the Malay version of Affiliate Stigma Scale. Methods: A cross-sectional study, involving 372 caregivers of a patient with mental illness, was conducted from May to December 2017, at psychiatry clinic hospital USM. ASS was first translated into Malay language using standard forward and backward translation procedures by a group of experts. Participants then completed the ASS-Malay (ASS-M). The data analyses involve assessment of construct validity by exploratory factor analysis, confirmatory factor analysis and construct reliability. Results: Our final model of ASS-Malay (ASS-M) consists of four factors with 21 items, as compared to original version with three factors with 22 items. Our finding showed the final model has good model fit based on RMSEA (0.065) and SRMR (0.055) and satisfactory composite reliability (Affective = 0.827, Cognitive = 0.857, Behaviour = 0.764, Self-Esteem = 0.861). Conclusion: The study showed that the four-factor model with 21 items of the Malay version of ASS has good psychometric properties. The scale is valid and reliable to measure affiliate stigma among caregivers of a patient with mental illness in Malaysia.
- PublicationTime to non-persistence of sodium-glucose co-transporter 2 inhibitors and its prognostic factors among patients with type 2 diabetes in Universiti Malaya Medical Centre(2024-08)Introduction: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have emerged as a new guideline-directed medical therapy (GDMT) for managing cardiovascular-kidney-metabolic (CKM) syndrome. Understanding the pattern of SGLT2i treatment persistence can help prevent unwarranted non-persistence of this GDMT and simultaneously, develop interventions to mitigate its negative consequences. This study aimed to evaluate the treatment persistence time on SGLT2i and to identify the prognostic factors for SGLT2i persistence time among adults with type 2 diabetes (T2D) at the Universiti Malaya Medical Centre, Kuala Lumpur, Malaysia. Methods: This was a retrospective cohort study involving adults aged 18 years and above with T2D who were initiated with SGLT2i between January 2016 and December 2021. The study outcome was time to SGLT2i non-persistence, defined as the time to first 90-day gap after the estimated end date of pharmacy supply. Kaplan-Meier estimate was used for median SGLT2i persistence time, life table analysis was used for obtaining persistence rates and Cox Proportional Hazard regression was used to identify the prognostic factors for the time to treatment persistence. Results: This study involved 602 adults with T2D, with the majority being male (52.0%). The mean age of patients was 60.1 years (standard deviation (SD) = 10.7). The median treatment persistence time was 40.5 months (95% confidence interval (CI): 34.6, 54.0). Treatment persistence rates reduced from 94.5% at 6 months to 78.0% at 1 year, and 62.7% at 2 years. Patients with baseline estimated glomerular filtration rate (eGFR) <60 ml/min/1.73m2 had an adjusted hazard ratio (AHR) of 1.57 (95% CI 1.20, 2.04; p = 0.001) for non-persistence of SGLT2i, compared to those with eGFR ≥60 ml/min/1.73m2. The use of DPP4i had an AHR of 0.75 (95% CI 0.57, 0.98; p = 0.042) for non-persistence of SGLT2i. Conclusions: Half of the patients discontinued SGLT2i within 3.5 years. Those with baseline eGFR <60 ml/min/1.73m2 and without concomitant DPP4i use were significantly associated with SGLT2i non-persistence. This study provides valuable insights into the time to SGLT2i non-persistence in adults with T2D and the underlying factors to facilitate more personalised diabetes management to optimise health outcomes.