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- 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.
- PublicationKnowledge and practice of preconception care among women in kampung orang asli Ulu Kampar Gopeng Perak(2025-08)Preconception care is an important preventive approach to improve maternal and child health. However, the awareness and practice of preconception care remain limited among the Orang Asli community in Malaysia. This study aims to determine the level of knowledge and practice of preconception care among women in Kampung Orang Asli Ulu Kampar, Gopeng, Perak, and to examine the association between them. A cross-sectional study was conducted involving 119 Orang Asli women aged 18 years and above. Data were collected using a validated self-administered questionnaire and analysed using SPSS Version 28.0, employing descriptive and inferential statistics. The result revealed that 63% of respondents had good knowledge of preconception care, while 79.8% demonstrated good preconception care practices. However, there was no significant association between knowledge and practice (p=0.139). In conclusion, the majority of women practised good preconception care, knowledge gaps remain, particularly in areas such as nutrition and birth spacing. Strengthening health education, improving culturally sensitive outreach services, and conducting further qualitative research are recommended to enhance preconception care in Orang Asli communities.
- PublicationKnowledge, attitude and practice towards 5 moments for hand hygiene among undergraduate nursing students at Univerisiti Sains Malaysia(2025-08)Hand hygiene is essential in healthcare to prevent infections, yet compliance among nursing students remains a challenge. This cross-sectional study assessed knowledge, attitude, and practice towards Five Moments for Hand Hygiene among undergraduate nursing students at Universiti Sains Malaysia. A total of 141 participants were recruited via convenience sampling, and data were collected using a self-administered validated questionnaire. Results showed that 95.7% of students had good hand hygiene practice, while most had moderate knowledge (72.3%) and attitude (58.9%). Weak, non-significant positive correlations were found between knowledge, attitude, and practice (knowledge-attitude: r = 0.137, p = 0.105; knowledge-practice: r = 0.129, p = 0.127; attitude-practice: r = 0.134, p = 0.111). Furthermore, no significant differences in practice were observed based on gender (χ² = 1.681, p = 0.219), education level (χ² = 0.187, p = 1.000), and year of study (χ² = 2.741, p = 0.506). These findings emphasize the need for ongoing education, regular hand hygiene campaigns, accessible placement of hand rubs and sinks, continuous supervision and practical training to maintain and enhance hand hygiene compliance.
- PublicationThe relationship between parental knowledge of human papillomavirus (HPV) infection and their attitudes and intentions towards vaccinating their sons with hpv vaccine in secondary schools in Gombak, Selangor(2025-08)Human papillomavirus (HPV) is a significant public health concern globally, affecting both men and women and contributing to various types of cancers. Despite the availability of HPV vaccines in Malaysia, immunisation efforts predominantly target adolescent girls, leaving boys unprotected and contributing to gender disparities in HPV prevention. This cross-sectional study investigated the relationship between parental knowledge of HPV infection and attitudes toward vaccinating their adolescent sons in secondary schools in Gombak, Selangor. A total of 315 parents participated in the study through self-administered questionnaires adapted from validated scales (GK23 and HABS). The results revealed that only 28.87% of parents demonstrated good knowledge of HPV infection, while 38.7% had poor knowledge. Parental attitudes varied, with concerns noted regarding vaccine safety, lack of communication on sexual health, and misinformation. Statistically significant associations were found between higher parental knowledge and more positive attitudes toward HPV vaccination, as well as between positive attitudes and willingness to vaccinate. The findings underscore the urgent need for inclusive public health policies, targeted educational interventions, and gender-neutral HPV vaccination strategies to enhance vaccine uptake and reduce HPV-related disease burden among Malaysian males.
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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.