In order to prepare Malaysia to be nuclear ready, the Malaysian 1 MW TRIGA MARK II research
reactor (RTP) located at the Malaysian Nuclear Agency was premeditated with the aim to effectually
actualize the multitude areas of basic nuclear research, labor training and education. To meet the
modern safety standards, analyses of a strong interaction between the thermal-hydraulic system
behavior and the space-dependent neutron kinetics are needed as mere thermal-hydraulics codes are
said to be incapable to succeed the present safety standards. This could be achieved through the
coupling of neutronic and thermal-hydraulic codes of the reactor. Previous studies had shown that the
coupled codes are able to successfully be employed for the correlation between thermal-hydraulic
analysis and neutron kinetics at transient and steady state. In this study, the coupling was achieved
through MCNP and TRIGLAV codes for neutronic and thermal-hydraulic respectively. Core-15 of
RTP was modeled for both of the codes; hence calculating the criticality, analysis of power and
neutron flux distribution. The consistency and accuracy of the developed Core-15 MCNP model was
established by comparing calculations to the experimental results and TRIGLAV code. The criticality
predictions for both codes are in very good agreement with the experimental results. The core reached
its criticality after 66 fuels. The highest hot rod power peaking factor was found to be 1.28. The
results are conservative and can be applied to show the reliability of MCNP and TRIGLAV codes.
One of the major component in neutron radiography is a collimator that is used to collimate the neutron in parallel beam with less gamma ray contamination and high thermal neutron flux. The collimator consists of seven components and the interest component is an aperture as it is used to prevent the thermal neutron from entering the beam except through the center hole. In this study, the collimator design was taken from radial beam port at NR facilities at ANM with the collimation ratio is 46.4. In order to increase the collimation ratio, optimization of the aperture component has been done on four different material and 1-5 cm diameter parameters. The optimization of apertures shows that the cadmium with 1 cm diameter yields the thermal neutron flux at the collimator inlet and outlet with 1.78 x103 n cm-2 s-1 and 5.90 x102 n cm-2 s-1 while the gamma ray contamination was 10.7 μSv hr-1. The optimization succeed to produce high L/D ratio however the thermal flux was low and the gamma contamination was higher that original design but satisfied the ICRP 74 condition for radiation worker.
There is a growing interest from, newcomer countries to utilise nuclear energy for electricity
generation. The International Atomic. Energy Agency (IAEA) has developed two methodologies,
namely, the IAEA Milestone Approach and the International Project on Innovative Nuclear Reactors
and Fuel Cycles (INPRO) Methodology to help its Member States in assessing the viability of nuclear
power programme (NPP) and nuclear energy system. This paper highlights important features of both
methodologies in supporting deployment of nuclear power programme for a newcomer country. In
summary, the IAEA Milestone Approach focuses for near term while the INPRO Methodology focuses
for long term assessment to support the deployment of first NPP in newcomer countries. Depending
on newcomer country's priority and resources, both methodologies can be performed either separately
or in-parallel.
This study focused, on the activity concentration and radiation hazard assessment of radionuclide in
bricks. The activity concentrations per unit of mass in the studied bricks ranged from 59.82 to 236.65
Bqkg'1 for Ra-226, from 66.29 to 185-4 Bqkg'1 for Th-232, and from 283.50 to 1599.67 Bqkg'1for K-fO.
In terms of radiation hazard assessment, granite bricks exceeded the allowance limit stated by Nuclear
Energy Agency -Organisation for Economic Co-operation & Development (NEA-OECD) in radiumequilibrium
activity (Req), External Hazard Index (Hex), Internal Hazard Index (Hin) and
Representative Level Index (Iw). Thus, this has proof that the naturally occurring radionuclide
materials present in the brick have a potential in effecting the dwellers health.
Structural and dielectric properties of barium strontium, titanate (Ba(ÿ)SrxTiO$) ceramics with x—
0.25, 0.5 and 0.75 were investigated. The Ba(i-xjSrxTiOs ceramics were synthesised by solid state
reaction method. Microstructure, surface morphology and dielectric properties of the synthesised
ceramics were examined using XRD, SEM and Impedance Spectroscopy respectively. XRD results
revealed that all samples contained BaTiOg as primary phase with tetragonal perovskite crystal
structure. The crystallite size slightly increased with the increasing of Sr contents. SEM micrographs
showed that the microstructure become denser when Sr contents increased. Impedance spectroscopy
showed dielectric constant for all samples were decreased with increasing temperature up to 200°C.
Introduction: Degenerative disorder involving the acromioclavicular
joint (ACJ) is quite common especially in the elderly.
One of the surgical modalities of treatment of this disorder is the
Mumford Procedure. Arthroscopic approach is preferred due to
its reduced morbidity and faster post-operative recovery. One
method utilizes the anteromedial and Neviaser portals, which
allow direct and better visualization of the ACJ from the
subacromial space. However, the dangers that may arise from
incision and insertion of instruments through these portals are
not fully understood. This cadaveric study was carried out to
investigate the dangers that can arise from utilization of these
portals and which structures are at risk during this procedure.
Methods: Arthroscopic Mumford procedures were performed
on 5 cadaver shoulders by a single surgeon utilizing the
anteromedial and Neviaser portals. After marking each portals
with methylene blue, dissection of nearby structures were
carried out immediately after each procedure was completed.
Important structures (subclavian artery as well as brachial plexus
and its branches) were identified and the nearest measurements
were made from each portal edges to these structures. Results:
The anteromedial portal was noted to be closest to the
suprascapular nerve (SSN) at 2.91 cm, while the Neviaser portal
was noted to be closest also to the SSN at 1.60 cm. The
suprascapular nerve was the structure most at risk during the
Mumford procedure. The anteromedial portal was noted to be
the most risky portal to utilize compared to the Neviaser portal.
Conclusion: Extra precaution needs to be given to the
anteromedial portal while performing an arthroscopic distal
clavicle resection in view of the risk of injuring the
suprascapular nerve of the affected limb.
The needs of intensive care patient’s family
members are often neglected. Many healthcare practitioners do
not realize that meeting the family needs in the intensive care
settings actually may improve outcome for their patients and
enable the family members to cope and deal with the patient’s
hospitalization period effectively. With this in mind, the present
study aimed to address the needs of Malaysian family members
of intensive care unit patients. Methods: This cross-sectional
survey was conducted among family members of Intensive Care
Unit of Hospital Universiti Sains Malaysia, Malaysia. A total of
60 family members were recruited using a convenience sampling
manner. A Malay validated Critical Care Family Needs
Inventory was used to identify the family needs among the
respondents. Descriptive statistics as well as mean comparison
analyses were employed to achieve the study. Results: The
findings showed that family members ranked Assurance items as
the most important needs. In terms of subscales scores,
Assurance and Information evidenced higher mean scores
compared to other dimensions. All the family need dimensions
had positive and significant associations with one another. The
highest correlation was noted among Comfort – Support pair,
r(58) = 0.73, p < 0.001. No significant differences in the mean
values found across gender, history of admission and types of
relationships. In contrast, significant mean difference was
observed across level of education. Conclusion: Identifying the
needs of family members in the intensive care unit is imperative
as it raises awareness and contributes knowledge in terms of
family needs to healthcare providers, policy makers, medical
social workers and general public.
Hip fractures cases are common in elderly population. After a hip fracture, around 80% of patients were unable to carry out at least one independent activity of daily living (ADL). This review attempted to provide an evidence-based literature on ADL of elderly hip fracture patients. A computerised literature search using Medline (OVID) and Scopus databases were conducted to identify relevant studies on ADL of elderly hip fracture patients that was assessed with Katz ADL score. Only articles that fulfilled the inclusion criteria were included in this review. Initial search identified 314 potentially relevant articles but after careful screening, only 5 full-text articles were selected for the present review. Three studies showed an increase dependent level of the patients’ ADL after hip fractures. Two studies showed not more than half of the patients were unable to regain their pre-fracture ADL level after one year of hip fracture incidence. Feeding/eating showed the highest independent activity while bathing was the lowest independent activity among patients. In conclusion, elderly hip fracture patients have declined ADL with the risk that they may never regain their pre-fracture ADL level.
MeSH terms: Activities of Daily Living; Aged; Hip Fractures; Humans; Pelvic Bones; Risk; Incidence
Cerebral Venous Thrombosis in patients with Evan’s Syndrome of autoimmune hemolytic anemia is rare. The
common neurological symptoms are headaches, vision loss, dyslexia without agraphia, motor aphasia,
unilateral upper limb weakness and papilloedema. We present a case report of a lady with a known case of
Evan’s Syndrome whom presented with severe anemia and unilateral right sided hemiparesis with right facial
weakness. Plain and Contrast enhanced CT brain showed bilateral high parietal white matter edema with
venous thrombosis in the right transverse and superior sagittal venous sinuses. At the time of the diagnosis,
she was in hematological remission.
Anticipation of complications is of paramount importance for a surgeon. Incisional hernia is a well-known
complication for abdominal surgeries. Risk factors such as increasing age, obesity, male gender are well
known. Intestinal obstruction, strangulation and perforation are imminent complications of this type of
hernia if they become incarcerated. Common contents of a ventral incisional hernia are small bowel, large
bowel and omentum. Even though Meckel’s diverticulum is a common gastrointestinal anomaly, it is rarely
found to be the content of a hernial sac. A hernia sac containing Meckel’s diverticulum is also known as
Littre’s hernia. Only a few cases have been reported in the literature. Thus here we present a case of
perforated Meckel’s diverticulum that was entrapped in the ventral incisional hernia.
Eventration of the diaphragm is caused by weakened musculature of the diaphragm. This can occur in one or
both hemidiaphragms. Symptoms may be minimal and it is usually detected incidentally on chest radiograph
which would show an elevation of the diaphragm. We report and discuss a case of eventration of right
diaphragm in a patient presented with a lobulated lung mass on chest radiograph.
Aberrant right subclavian artery is a rare cause of dysphagia. This is a congenital anomaly with the right
subclavian artery originating from the dorsal part of the aortic arch and coursing through the mediastinum
between the esophagus and the vertebral column. We report a case of a patient with chronic dysphagia
caused by this condition. We further discuss the case with regards to its clinical features and options of
management.
Background: Peer assessment has been shown to complement both formative and summative evaluations in education and used in some medical programmes. The study was aimed to find correlation between group work peer assessment score and final examination mark among four batches of International Islamic University Malaysia (IIUM) first year MBBS students.
Method: A set of four questions was constructed and tested to assess students’ overall role in their group research project. The difference in distribution according to years was tested by using one-way ANOVA or Kruskal-Wallis, depending on the data distribution. Pearson correlation coefficient test was done to test the linear association between peer score and final examination mark. Partial correlation test was used to adjust the correlation for four academic years.
Results: From the analysed data of 502 students, there was moderate, significant positive correlation (0.366) between peer assessment score and the final examination mark (P < 0.001). Adjustment to the academic years resulted in correlation coefficient of 0.371.
Conclusion: The results provide an important insight on the influence of peers’ perception in predicting the medical student academic performance.
Introduction: Gastrointestinal stromal tumour (GIST) is relatively rare. The clinical behaviour of GIST ranges
from benign to frank sarcoma. The diagnosis is established through histopathological examination and
immunohistochemistry profile. In Malaysia, the number of publications related to GIST is relatively rare. This
study was therefore conducted to examine the demographic, histopathological and immunohistochemical
features of GIST cases diagnosed in the Department of Pathology, Hospital Tengku Ampuan Afzan, Kuantan,
Pahang from 2009 until 2014. Methods: Past histopathological records were reviewed. Demographic and
histopathological and immunohistochemical data of patients diagnosed were collected. Results: There were
28 cases (14 males and 14 females) diagnosed as GIST. Mean age was 56.4 years, and the majority were
above 40 years of age (85.7%). Stomach was the most common location (42.9%), followed by small intestine
(28.6%). In 23 cases (82%), the tumours exhibited spindle cell morphology, while epithelioid cell and mixed
cell types were seen in 3 cases (11%) and 2 cases (7%), respectively. Five cases were categorised as very low
risk to low risk behaviour, while 18 cases were intermediate to high. None of the histological parameters
analysed which include tumour morphology, necrosis, haemorrhage, nuclear atypia and mean number of
mitoses showed significance difference between the different risk behaviour groups. Positivity with KIT
(CD117), considered to be the defining immunohistochemistry feature, was negative in 2 cases. Conclusion:
Although this study is a retrospective study, the findings contribute to the knowledge on GISTS in Malaysia.
Future research related to GISTs in Malaysia should focus on molecular analyses for KIT and PDGFRA
mutations for diagnostic confirmation especially in KIT-negative cases and also for the purpose of
therapeutic response correlations.
Introduction: The Eating Disorder Examination Questionnaire (EDE-Q) has been widely used as a tool to
detect eating disorders. We aimed to identify the EDE-Q normative data among secondary school students in
Kuala Lumpur, Malaysia. Methods: This is a cross-sectional study involving four secondary schools in an
urban area. The respondents of secondary school students were selected using stratified sampling. Results:
There were 298 teenagers 12 to 17 years of age who participated in the study. The EDE-Q mean scores ±
standard deviation was 1.27 ± 1.08 for the total score (Global Score), 0.78 ± 0.95 for Restraint Domain, 1.02
± 1.03 for Eating Concern, 1.76 ± 1.55 for Shape Concern and 1.54 ± 1.43 for Weight Concern. Conclusion:
Mean values obtained from this study were relatively lower when compared to western populations. Shape
Concern and Weight Concern had higher scores compared to the other domains. These values are useful for
EDE-Q interpretation in Malaysia.
MeSH terms: Adolescent; Feeding and Eating Disorders; Body Weight; Cross-Sectional Studies; Eating; Humans; Malaysia; Surveys and Questionnaires; Students
Introduction: The Medical Faculty of Universiti Sains Islam Malaysia (USIM) aims to produce good Muslim
doctors (GMD) who are able to practise medicine that is integrated with Islamic values. Islamic courses and
Medical Ethics are integrated into the curriculum in its effort to provide adequate Islamic knowledge and
nurturing professionalism as a process of personal and professional development (PPD) within the framework
of Islamic teaching. The objective of the study was to evaluate the perception of graduates and students of
characteristics of a GMD. Method: A self-administered questionnaire was distributed to the participants. The
respondents were asked to rate their level of agreement or disagreement on the statements that represent
the characteristics of a GMD. Statistical analysis of the data was carried out using SPSS version 18.0. The
mean, median and inter quartile ranges of the characteristics were determined and differences between the
groups were analysed using Mann-Whitney U test. Results: Results showed significant difference between
gender for the item “Conscious of professional ethics” (p=0.021). Significant differences were seen in the
median scores between the graduates and the final year students in four out of six items for personal
characteristic. Conclusion: Islamic input in the medical curriculum and the teaching of professionalism has
an impact on graduate perception of characteristics of a GMD. Further improvement in the teaching of
professionalism among undergraduates is necessary in order to promote greater impact on the understanding
and internalization of characteristics of a GMD. The Islamic input in the medical curriculum can thus be
regarded as the blueprint for PPD of medical undergraduates to become a GMD.
MeSH terms: Professionalism; Curriculum; Ethics, Medical; Ethics, Professional; Faculty, Medical; Humans; Islam; Malaysia; Physicians; Surveys and Questionnaires; Students
Introduction: H. pylori BabA is an outer membrane protein that mediates bacterial adherence to the gastric
epithelium, triggers several pathways during the course of infection, and thus contributes to the disease
development. Considering the variability in the presence of BabA coding gene (babA2) among H. pylori
clinical strains, the aim of this study was to assess the relationship between the genotype status of H. pylori
babA2 and the severity of clinical and histopathological outcomes. Methods: Gastric mucosal biopsy
specimens were collected from 30 CLO test-positive patients, 16 with gastritis and 14 with peptic ulcer
disease. Polymerase chain reaction was carried out to detect the presence of H. pylori-specific glmM gene
and BabA coding gene (babA2). Histopathological examination was performed to evaluate the severity of H.
pylori-associated gastric disease according to the Updated Sydney Classification System. Results: The glmM
and babA2 genes were present in 100% and 86.7% of the tested H. pylori strains, respectively. Although
higher degrees of inflammatory activity and H. pylori density were noted in babA2-positive biopsy
specimens, there was no statistically significant association between babA2 genotype status and the severity
of gastric disease. Conclusion: The babA2 genotype status of H. pylori may not be considered as a sole
marker for determining the infection outcomes.
Introduction: Transsexuals face discriminations and rejections from the Malaysian society. The number of
studies done on understanding the phenomenology, experiences, and problems faced by transsexuals is still
few in Malaysia. This research aims to document their psycho-social and spiritual backgrounds and the
relevant experiences, and to explore their perceptions and needs as male-to-female transsexuals in the
context of Persatuan Insaf Pahang, Malaysia. Materials and Methods: A qualitative research was carried out
in July and August 2015 among eight male-to-female transsexual adults in Kuantan, Pahang. Snowball
sampling was used. Participants who gave consent were interviewed in two focus groups. Data obtained was
transcribed and used as the primary data source. Results: Subjects in this study reported confusions over
their gender identity since childhood. They struggled against conflicts regarding their transsexuality in
adolescence, and eventually many quit their studies. As adults, they were discriminated against in
employment and religious settings. They provided positive feedbacks on religious authorities who could
understand problems unique to transsexuals and empathise with the transsexual community. Conclusion: The
psycho-sexual phenomenology is the same in transsexuals all over the world. Misunderstanding and
discrimination from the society remain heavy towards this community. Transsexuals should learn to adapt to
meeting expectations from the society as well, so they could be accepted in public. They will need religious
guidance and spiritual support for better quality of life. Dedicated efforts are still needed in training
professionals in the educational, medical, and religious fields to attend to the specific needs of transsexuals
in this country.
MeSH terms: Adolescent; Adult; Employment; Female; Gender Identity; Humans; Informed Consent; Learning; Malaysia; Male; Quality of Life; Sexual Behavior; Transsexualism; Information Storage and Retrieval; Focus Groups; Qualitative Research
Smoking is an issue that has spread around the world throughout the years. The majority of smokers have the intention to quit smoking, but due to some factors, it may prevent their intention. Research and interventions have been done in many countries to decrease the smoking prevalence. This cross-sectional study aimed to find out the associations of knowledge, attitude and practice (KAP) towards smoking and to identify the factors associated with knowledge and attitude towards smoking, in priority to sociodemographic factors among the International Islamic University Malaysia Kuantan (IIUMK) communities, including between students and workers. One hundred fifteen respondents of students and workers from IIUMK were investigated with a self-administered questionnaire starting from 10-01-2014 to 10-02-2014. The data were analysed using SPSS software.Respondents had good knowledge and practice, and moderate attitude towards smoking. There was weak positive correlation between knowledge with attitude (r=+0.193, p=0.038) and practice (r=+0.206, p=0.028), also moderate correlation between attitude and practice towards smoking (r=+0.626, p<0.001). There was no factor found to be associated with knowledge, but significant association was found between attitude towards smoking with gender (p<0.001), education level (p=0.016) and smoking status (p<0.001). Although, the mean values of KAP levels were higher for workers, but it was not statistically significant as compared to the students. These study findings suggested that the main obligation are more for students to improve their KAP level towards smoking as they are fresh generation who will educate and lead the upcoming generation of Malaysia.
KEYWORDS: Health Knowledge, Attitudes, Practice, Smoking, Students, Workers.
Background: The resultant dysphonia and aspiration in unilateral vocal cord palsy can be overcome with
medialisation thyroplasty. With this background, we aim to determine the aetiology of the unilateral vocal
cord palsy and effectiveness of the phonosurgical procedure with Gore-Tex as a sole treatment. Methods:
Within a seven year period, 37 Gore-Tex medialisation thyroplasty were performed for unilateral vocal cord
palsy at our institution and medical records were retrospectively reviewed. Results: There were 18
males and 19 females with mean age of 48.7 years (range 19–81 years). The predominant aetiology was
thyroidectomy (43.2%) with benign thyroid disease predominates (n=13) over thyroid malignancy (n=3). Voice
outcome was evaluated subjectively using visual analogue scoring system, results indicating that Gore-Tex
medialisation thyroplasty was effective in addressing dysphonia in 62.5% (n=15) patients. However it alone
cannot address aspiration seen in those with high vagal nerve lesion. Airway compromise occurred in two
cases postoperatively (5.4%) presenting as acute stridor. Conclusion: In unilateral vocal cord palsy, Gore-Tex
medialisation thyroplasty can effectively improve the resultant dysphonia and often accompanying aspiration
which would otherwise be disabling for the patients.