Displaying publications 1 - 20 of 54 in total

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  1. Zainal Abidin SS, Kew TY, Azman M, Mat Baki M
    BMJ Case Rep, 2020 Dec 22;13(12).
    PMID: 33370978 DOI: 10.1136/bcr-2020-237129
    A 57-year-old male chronic smoker with underlying diabetes mellitus presented with dysphonia associated with cough, dysphagia and reduced effort tolerance of 3 months' duration. Videoendoscope finding revealed bilateral polypoidal and erythematous true and false vocal fold with small glottic airway. The patient was initially treated as having tuberculous laryngitis and started on antituberculous drug. However, no improvement was observed. CT of the neck showed erosion of thyroid cartilage, which points to laryngeal carcinoma as a differential diagnosis. However, the erosion was more diffuse and appeared systemic in origin. The diagnosis of laryngeal perichondritis was made when the histopathological examination revealed features of inflammation, and the tracheal aspirate isolated Pseudomonas aeruginosa The patient made a good recovery following treatment with oral ciprofloxacin.
  2. Za'im NAN, Azman M
    Malays Fam Physician, 2021 Nov 30;16(3):119-122.
    PMID: 34938403 DOI: 10.51866/cr1163
    Hoarseness accounts for 1% of all consultations in primary care. Suspicion of malignancy should be considered in individuals with risk factors presenting with unexplained hoarseness lasting more than two weeks. A significant number of patients with laryngeal cancer present at an advanced stage due to lack of awareness regarding vocal health. It is important to educate both the public and primary care health providers concerning laryngeal cancer. We present the case of an 81-year- old male smoker who presented to us with a six-month history of progressive hoarseness. He was initially treated in two primary and one secondary care centres, where a diagnosis of laryngeal cancer was not considered. Careful assessment in our centre managed to determine a diagnosis of T3N0M0 glottic carcinoma. We will discuss this alarming triad of progressive hoarseness in a male smoker to help primary care physicians streamline their thoughts and identify red flags in a hoarse patient.
  3. Za'im NAN, Al-Dhief FT, Azman M, Alsemawi MRM, Abdul Latiff NMA, Mat Baki M
    J Otolaryngol Head Neck Surg, 2023 Sep 20;52(1):62.
    PMID: 37730624 DOI: 10.1186/s40463-023-00661-6
    BACKGROUND: A multidimensional voice quality assessment is recommended for all patients with dysphonia, which requires a patient visit to the otolaryngology clinic. The aim of this study was to determine the accuracy of an online artificial intelligence classifier, the Online Sequential Extreme Learning Machine (OSELM), in detecting voice pathology. In this study, a Malaysian Voice Pathology Database (MVPD), which is the first Malaysian voice database, was created and tested.

    METHODS: The study included 382 participants (252 normal voices and 130 dysphonic voices) in the proposed database MVPD. Complete data were obtained for both groups, including voice samples, laryngostroboscopy videos, and acoustic analysis. The diagnoses of patients with dysphonia were obtained. Each voice sample was anonymized using a code that was specific to each individual and stored in the MVPD. These voice samples were used to train and test the proposed OSELM algorithm. The performance of OSELM was evaluated and compared with other classifiers in terms of the accuracy, sensitivity, and specificity of detecting and differentiating dysphonic voices.

    RESULTS: The accuracy, sensitivity, and specificity of OSELM in detecting normal and dysphonic voices were 90%, 98%, and 73%, respectively. The classifier differentiated between structural and non-structural vocal fold pathology with accuracy, sensitivity, and specificity of 84%, 89%, and 88%, respectively, while it differentiated between malignant and benign lesions with an accuracy, sensitivity, and specificity of 92%, 100%, and 58%, respectively. Compared to other classifiers, OSELM showed superior accuracy and sensitivity in detecting dysphonic voices, differentiating structural versus non-structural vocal fold pathology, and between malignant and benign voice pathology.

    CONCLUSION: The OSELM algorithm exhibited the highest accuracy and sensitivity compared to other classifiers in detecting voice pathology, classifying between malignant and benign lesions, and differentiating between structural and non-structural vocal pathology. Hence, it is a promising artificial intelligence that supports an online application to be used as a screening tool to encourage people to seek medical consultation early for a definitive diagnosis of voice pathology.

  4. Xiao Hong C, Abd Wahab S, Azman M
    BMJ Case Rep, 2020 Oct 27;13(10).
    PMID: 33109696 DOI: 10.1136/bcr-2020-236484
    Penetrating foreign body in the head and neck can be catastrophic from injury to the constellation of vascular and neural structures in the neck. Early recognition and prompt surgical intervention is imperative to save lives. Herein, we present an unusual case of iatrogenic foreign body-a coiled guidewire embedded in the deep neck space. The complications, radiological investigation and multidisciplinary surgical management are further discussed.
  5. Wan-Chiew N, Baki MM, Fauzi MB, Lokanathan Y, Azman M
    Polymers (Basel), 2021 Aug 06;13(16).
    PMID: 34451158 DOI: 10.3390/polym13162619
    Vocal fold injection is a preferred treatment in glottic insufficiency because it is relatively quick and cost-saving. However, researchers have yet to discover the ideal biomaterial with properties suitable for human vocal fold application. The current systematic review employing PRISMA guidelines summarizes and discusses the available evidence related to outcome measures used to characterize novel biomaterials in the development phase. The literature search of related articles published within January 2010 to March 2021 was conducted using Scopus, Web of Science (WoS), Google Scholar and PubMed databases. The search identified 6240 potentially relevant records, which were screened and appraised to include 15 relevant articles based on the inclusion and exclusion criteria. The current study highlights that the characterization methods were inconsistent throughout the different studies. While rheologic outcome measures (viscosity, elasticity and shear) were most widely utilized, there appear to be no target or reference values. Outcome measures such as cellular response and biodegradation should be prioritized as they could mitigate the clinical drawbacks of currently available biomaterials. The review suggests future studies to prioritize characterization of the viscoelasticity (to improve voice outcomes), inflammatory response (to reduce side effects) and biodegradation (to improve longevity) profiles of newly developed biomaterials.
  6. Wan Ahmad Kammal WS, Azman M, Salleh AA, Md Pauzi SH, Abd Shukor N
    Malays J Pathol, 2020 Aug;42(2):283-286.
    PMID: 32860383
    Oncocytic carcinoma of the salivary gland is an uncommon tumour in the head and neck region. Owing to its rarity, identifying the histopathological features of a malignant tumour can be difficult and challenging. We report a case of a 70-year-old man who presented with a left facial weakness for six months in a background history of left parotid swelling over the past 10 years. Clinical examination revealed a 3x3cm left parotid mass and grade 4 facial nerve palsy. Fine needle aspiration of the mass showed scattered cohesive, monolayered sheets of uniform oncocytic cells. Subsequently, a left total parotidectomy and selective neck dissection were performed. Histological examination showed sheets of small oncocytes with minimal nuclear atypia. Evidence of nerve entrapment, capsular invasion and perivascular permeation were identified in focal areas. Thus, a final diagnosis of oncocytic carcinoma was rendered.
  7. Suriani MJ, Ilyas RA, Zuhri MYM, Khalina A, Sultan MTH, Sapuan SM, et al.
    Polymers (Basel), 2021 Oct 13;13(20).
    PMID: 34685272 DOI: 10.3390/polym13203514
    Increasing scientific interest has occurred concerning the utilization of natural fiber-enhanced hybrid composites that incorporate one or more types of natural enhancement. Annual natural fiber production is estimated to be 1,783,965 × 103 tons/year. Extensive studies have been conducted in the domains of natural/synthetic as well as natural/natural hybrid composites. As synthetic fibers have better rigidity and strength than natural fibers, natural/synthetic hybrid composites have superior qualities via hybridization compared to natural composites in fibers. In general, natural fiber compounds have lower characteristics, limiting the use of natural composites reinforced by fiber. Significant effort was spent in enhancing the mechanical characteristics of this group of materials to increase their strengths and applications, especially via the hybridization process, by manipulating the characteristics of fiber-reinforced composite materials. Current studies concentrate on enhancing the understanding of natural fiber-matrix adhesion, enhancing processing methods, and natural fiber compatibility. The optimal and resilient conceptions have also been addressed due to the inherently more significant variabilities. Moreover, much research has tackled natural fiber reinforced hybrid composite costs. In addition, this review article aims to offer a review of the variables that lead to the mechanical and structural failure of natural fiber reinforced polymer composites, as well as an overview of the details and costings of the composites.
  8. Sharil A, Nawaz A, Nor Azman M, Zulmi W, Faisham W
    Malays Orthop J, 2013 Mar;7(1):30-5.
    PMID: 25722804 MyJurnal DOI: 10.5704/MOJ.1303.013
    We evaluated functional outcomes for patients who underwent surgery for resection and endoprosthesis replacement for primary tumours around the knee. We used the Musculoskeletal Tumour Society Scoring System (MSTS) for functional evaluations to compare differences between distal femur (DF) and proximal tibia (PT) placements. The study sample included 34 cases of distal femur and 20 cases of proximal tibia endoprosthesis replacement. Primary tumours were classified as follows: 33 osteosarcoma, 20 stage III giant cell tumour (GCT) and one case of mesenchymal chondrosarcoma. The mean MSTS score for both DF and PT endoprosthesis together was 21.13 (70.43%), and The MSTS scores for DF was 21.94 (73.13%) and PT was 19.75 (65.83%) Infection developed in 7 cases and 5 of which were PT endoprosthesis cases. Three deep infections required early, two-stage revision and resulted in poor MSTS scores. We conclude that endoprosthesis replacement for primary bone tumours had early good to excellent functional outcome. There were no differences in functional outcomes when comparing distal femur endoprostheses with proximal tibia endoprostheses.

    KEY WORDS: functional outcome, bone tumour, knee, and endoprosthesis.

  9. Sairin ME, Mat Baki M, Manap RA, Puteh SEW, Azman M, Mohamed AS
    Auris Nasus Larynx, 2020 Oct;47(5):842-848.
    PMID: 32273190 DOI: 10.1016/j.anl.2020.03.004
    OBJECTIVE: This study investigated the reliability of body plethysmography in comparison to spirometry in objectively measuring upper airway functions.

    METHODS: The study population consisted of 53 participants, 23 patients with BVFI after endolaryngeal laser posterior cordectomy and 30 healthy volunteers. All of them had body plethysmography (airway resistance, Raw), spirometry (ratio of forced expiratory flow at 50% to forced inspiratory flow at 50%, FEF50/FIF50 and peak inspiratory flow, PIF), 6 min-walking-test (6MWT) and Medical Research Council (MRC) dyspnea scale measurements. The tests were repeated and reliability was evaluated using intraclass correlation (ICC) and Spearman correlation.

    RESULTS: The reliability of Raw was high with ICC of 0.92, comparable to the spirometry measurements: FEF50/FIF50(ICC = 0.72) and PIF (ICC = 0.97). The mean of Raw was significantly higher in patient group. A strong significant correlation between Raw and MRC dyspnea scale (r = 0.79; p<0.05) and a moderate negative correlation between Raw and 6MWT (r = 0.4; p<0.05) was demonstrated.

    CONCLUSION: Body plethysmography (Raw) is a reliable tool in objective measurement of upper airway resistance that reflects the patient's perception of breathlessness. A larger number of participants are necessary to confirm this finding.

  10. Rajendran T, Azman M
    Cureus, 2023 Apr;15(4):e38293.
    PMID: 37255907 DOI: 10.7759/cureus.38293
    Subglottic hemangiomas are rare in adulthood. The presence of the lesion in the subglottic region makes it even more unusual. Moreover, these lesions do not have a typical course and involution changes as seen in the infantile forms. An elderly female initially came with a brief history of dyspnea and symptoms of upper respiratory tract infection. The patient also complained of a change of voice and noisy breathing, with a recent history of intubation following COVID-19 pneumonia and late-onset bronchial asthma. Flexible nasopharyngolaryngoscopy showed a mass below the vocal folds, which was seen to arise from the posterior subglottic region. The patient eventually underwent endoscopic excision of the lesion under general anesthesia and recovered well. Symptoms of hoarseness and stridor, along with a history of intubation, should raise a high index of suspicion for laryngeal diseases. A delay in the diagnosis of an obstructing lesion in the subglottis occurs in the presence of a confounding lung infection and overlap of clinical features with those of bronchial asthma. Surgical excision is required not only to alleviate obstructive symptoms but also to rule out malignancy.
  11. Qualickuz Zanan NH, Azman M, Zainuddin K, Wan Puteh SE, Mohamed AS, Mat Baki M
    Acta Otorhinolaryngol Ital, 2021 Aug;41(4):348-355.
    PMID: 34533538 DOI: 10.14639/0392-100X-N1202
    Objective: This study aimed to describe the sound frequency of snoring in relation to the site of upper airway vibration among snorers.

    Methods: 383 snores from 40 participants who complained of snoring were digitally recorded during natural and induced sleep using a level III polysomnography monitor with a built-in microphone. During drug-induced sleep endoscopy (DISE), the real-time site of upper airway obstruction was assessed, and the sound frequency of snoring was recorded synchronously.

    Results: The mean peak of snoring frequency for unilevel palatal, oropharynx and epiglottis obstruction were 522.5, 482.4 and 300.0 Hz, respectively. Most participants showed multilevel obstruction at the palate and oropharynx, in which the mean for bi-peak snoring frequency were 402.90 Hz and 1086.96 Hz, respectively. Severity of OSA was significantly associated with multilevel obstruction.

    Conclusions: There was a significant association between the snoring sound frequency and site of unilevel obstruction. Palatal or oropharyngeal obstruction produced sound at mid-frequency range, while the epiglottis produced a low frequency range. Multilevel obstruction documented a bi-peak snoring frequency.

  12. Ong FM, Husna Nik Hassan NF, Azman M, Sani A, Mat Baki M
    J Voice, 2019 Jul;33(4):581.e17-581.e23.
    PMID: 29793874 DOI: 10.1016/j.jvoice.2018.01.015
    OBJECTIVES: This study aimed to determine the validity and reliability of Bahasa Malaysia version of Voice Handicap Index-10 (mVHI-10).

    MATERIALS AND METHODS: This cross-sectional study was carried out in the Otorhinolaryngology, Head and Neck Surgery Department of Universiti Kebangsaan Malaysia Medical Centre (UKMMC) from June 2015 to May 2016. The mVHI-10 was produced following a rigorous forward and backward translation. One hundred participants, including 50 healthy volunteers (17 male, 33 female) and 50 patients with voice disorders (26 male, 24 female), were recruited to complete the mVHI-10 before flexible laryngoscopic examinations and acoustic analysis. The mVHI-10 was repeated in 2 weeks via telephone interview or clinic visit. Its reliability and validity were assessed using interclass correlation.

    RESULTS: The test-retest reliability for total mVHI-10 and each item score was high, with the Cronbach alpha of >0.90. The total mVHI-10 score and domain scores were significantly higher (P 

  13. Ng WC, Lokanathan Y, Baki MM, Fauzi MB, Zainuddin AA, Azman M
    Biomedicines, 2022 Nov 30;10(12).
    PMID: 36551838 DOI: 10.3390/biomedicines10123082
    Glottic insufficiency is widespread in the elderly population and occurs as a result of secondary damage or systemic disease. Tissue engineering is a viable treatment for glottic insufficiency since it aims to restore damaged nerve tissue and revitalize aging muscle. After injection into the biological system, injectable biomaterial delivers cost- and time-effectiveness while acting as a protective shield for cells and biomolecules. This article focuses on injectable biomaterials that transport cells and biomolecules in regenerated tissue, particularly adipose, muscle, and nerve tissue. We propose Wharton's Jelly mesenchymal stem cells (WJMSCs), induced pluripotent stem cells (IP-SCs), basic fibroblast growth factor (bFGF), vascular endothelial growth factor (VEGF), hepatocyte growth factor (HGF), insulin growth factor-1 (IGF-1) and extracellular vesicle (EV) as potential cells and macromolecules to be included into biomaterials, with some particular testing to support them as a promising translational medicine for vocal fold regeneration.
  14. Ng WC, Lokanathan Y, Fauzi MB, Baki MM, Zainuddin AA, Phang SJ, et al.
    Sci Rep, 2023 Mar 29;13(1):5128.
    PMID: 36991038 DOI: 10.1038/s41598-023-32080-y
    Glottic insufficiency is one of the voice disorders affecting all demographics. Due to the incomplete closure of the vocal fold, there is a risk of aspiration and ineffective phonation. Current treatments for glottic insufficiency include nerve repair, reinnervation, implantation and injection laryngoplasty. Injection laryngoplasty is favored among these techniques due to its cost-effectiveness and efficiency. However, research into developing an effective injectable for the treatment of glottic insufficiency is currently lacking. Therefore, this study aims to develop an injectable gelatin (G) hydrogel crosslinked with either 1-ethyl-3-(3-dimethylaminpropyl)carbodiimide hydrochloride) (EDC) or genipin (gn). The gelation time, biodegradability and swelling ratio of hydrogels with varying concentrations of gelatin (6-10% G) and genipin (0.1-0.5% gn) were investigated. Some selected formulations were proceeded with rheology, pore size, chemical analysis and in vitro cellular activity of Wharton's Jelly Mesenchymal Stem Cells (WJMSCs), to determine the safety application of the selected hydrogels, for future cell delivery prospect. 6G 0.4gn and 8G 0.4gn were the only hydrogel groups capable of achieving complete gelation within 20 min, exhibiting an elastic modulus between 2 and 10 kPa and a pore size between 100 and 400 μm. Moreover, these hydrogels were biodegradable and biocompatible with WJMSCs, as > 70% viability were observed after 7 days of in vitro culture. Our results suggested 6G 0.4gn and 8G 0.4gn hydrogels as potential cell encapsulation injectates. In light of these findings, future research should focus on characterizing their encapsulation efficiency and exploring the possibility of using these hydrogels as a drug delivery system for vocal fold treatment.
  15. Ng BW, Azhar AA, Azman MH, Sukri MS, Arvinder-Singh HS, Abdul Wahid AM
    Med J Malaysia, 2020 07;75(4):391-395.
    PMID: 32724000
    INTRODUCTION: Nurses play a vital role in the care and prevention of ulcers in patients with diabetic foot. Patient education, prevention of ulcers and rehabilitation are some of the vital aspects that nurses provide on a daily basis. Thus, good knowledge and attitude of nurses towards diabetic foot ulcers and its care will ensure better patient care.

    OBJECTIVES: The aim is to study the level of knowledge and attitude of nurses towards diabetic foot ulcers and its care in Hospital Segamat, Malaysia.

    METHODS: A validated questionnaire was used between February 2019 to May 2019 covering area such as demography, predisposing factors of ulcer formation, characteristics of ulcers, complications of ulcers, and attitude towards diabetic foot care.

    RESULTS: A total of 101 nurses took part and 57% of the participants scored poorly in the knowledge section of the questionnaire. In all 72% had scored poorly when asked regarding complications of diabetic foot ulcers; 49.5% of the nurses had positive attitude towards diabetic foot care; and 79.3% thought that care for diabetic foot ulcer is timeconsuming. Majority of them think that their colleagues are the main source of information. All demographic variables were deemed to be confounders with the knowledge and attitude of nurses towards diabetic foot ulcers and its care.

    CONCLUSIONS: Nurses in this centre had poor knowledge towards diabetic foot ulcers and its care. None of the variable studied were correlated with the level know knowledge. Good or poor knowledge of nurses does not correspond equally to good or poor attitude towards diabetic foot ulcers care. More frequent formal training of diabetic foot care would be needed to ensure better knowledge.
  16. Nasir ZM, Azman M, Baki MM, Mohamed AS, Kew TY, Zaki FM
    Surg Radiol Anat, 2021 Aug;43(8):1225-1233.
    PMID: 33388863 DOI: 10.1007/s00276-020-02639-9
    PURPOSE: This study aims to determine laryngeal dimension in relation to all three transcutaneous injection laryngoplasty (TIL) approaches (thyrohyoid, transthyroid and cricothyroid) using three-dimensionally reconstructed Computed Tomography (CT) scan and compare the measurements between sex, age group and ethnicity.

    METHODS: CT scans of the neck of two hundred patients were analysed by two groups of raters. For thyrohyoid approach, mean distance from the superior border of the thyroid cartilage to the laryngeal cavity (THd) and mean angle from the superior border of the thyroid cartilage to mid-true cords (THa) were measured. For transthyroid approach, mean distance from mid-thyroid cartilage to mid-true cords (TTd) and Hounsfield unit (HU) at mid-thyroid cartilage (TTc) were measured. For cricothyroid approach, mean distance from the inferior border of the thyroid cartilage to the laryngeal cavity (CTd) and mean angle from the inferior border of the thyroid cartilage to mid-true cords (CTa) were measured.

    RESULTS: There were statistically significant differences between males and females for all measurements except for CTa (p  0.05). There was a significant fair positive correlation between age and TTc (p = 0.0002). For all measurements obtained, there were moderate to excellent inter-group consistency and intra-rater reliability.

    CONCLUSION: This study demonstrated a significant sex dimorphism that may influence the three TIL approaches except for needle angulation in the cricothyroid approach. The knowledge of laryngeal dimension is important to increase success in TIL procedure.

  17. Muslim NN, Salim B, Kalimuthu S, Gopalan S, Azman M
    Cureus, 2023 Jun;15(6):e40491.
    PMID: 37461758 DOI: 10.7759/cureus.40491
    Vocal cord nodules are benign laryngeal lesions seen in professional voice users. They are usually bilateral and are thought to occur due to submucosal edema and hemorrhage, with resultant fibrosis. False cord occurrences are very rare; hence we report a unique case of unilateral right false cord nodule. A healthy 16-year-old female student presented with persistent hoarseness for two years without any history of voice abuse, trauma, infection, or endotracheal intubation. Endoscopic examination showed a mass occupying the right false cord. Subsequent direct laryngoscopy revealed a friable mass on the right false cord without any true cord involvement. Complete excision was done. Post-operatively her symptoms completely resolved, and flexible endoscopic examination seven months post-op showed no recurrence. Histopathological examination revealed fragments of fibro collagenous tissue covered by benign respiratory epithelium, favoring the diagnosis of a benign nodule. False cord benign lesions are rare. In a symptomatic case, endolaryngeal microsurgery gives a good outcome.
  18. Musa MSH, Yeoh ZX, Azman M
    Cureus, 2024 Jan;16(1):e52918.
    PMID: 38406054 DOI: 10.7759/cureus.52918
    Foreign body (FB) inhalation in the pediatric population is a common emergency referral in otolaryngology practice. Mismanagement can lead to significant morbidity or even mortality. Anesthesiologists conventionally use the Cook® airway exchange catheter (CAEC) during endotracheal tube exchange in the intensive care unit, but its usage as an oxygen conduit is beneficial in other airway procedures. A healthy two-year-old boy was brought to casualty for allegedly choking on a boneless chicken meat bolus during mealtime. The initial presentation showed that the child was comfortable with soft audible stridor without signs of respiratory distress. Bedside video laryngoscopy revealed a whitish FB in the proximity of the vocal cord. The patient was subjected to emergency direct laryngoscopy and bronchoscopy to retrieve the FB. Under general anesthesia, the true nature of FB was revealed, which was an embedded chicken bone into the laryngeal ventricle, causing a significant reduction of the rima glottis opening. CAEC was used to maintain oxygenation during the complex extraction process, and the child was discharged without any morbidity. Eyewitness history is an essential component in diagnosing FB inhalation in the pediatric population. Despite that, identifying potential difficulty is important to provide backup, especially in the case of unexpected events during managing airway emergencies.
  19. Mohd Shakri N, Mat Baki M, Mohamed AS, Azman M
    J Voice, 2023 Sep;37(5):803.e11-803.e21.
    PMID: 34176683 DOI: 10.1016/j.jvoice.2021.04.020
    BACKGROUND: Communication adjustment from patients' perspective is paramount to ensure optimization of voice rehabilitation post laryngectomy. Very few specific self-rating tools exist with the Self-Evaluation of Communication Experiences after Laryngectomy (SECEL) having the most evidence regarding validity, reliability and clinical utility.

    OBJECTIVES: This study aimed to translate and validate a Bahasa Malaysia version of SECEL (mSECEL) using a validated framework of transcultural adaptation.

    METHODS: This cross-sectional study was conducted in the Otorhinolaryngology, Department of Universiti Kebangsaan Malaysia Medical Centre from February 2019 to May 2020. The mSECEL was produced following a rigorous forward and backward translation. Eighty-three laryngectomees (78 male, five female) using various methods of alaryngeal communication (47 voice prosthesis, 29 electrolarynx, three esophageal speech and four pen and paper), completed the mSECEL and mVHI-10 before head and neck and flexible laryngoscopic examinations. The mSECEL was repeated in 2 weeks via telephone interview or clinic visit. Its reliability was assessed using intraclass correlation. The Pearson product-moment correlation test was used to analyze correlation between the mSECEL and mVHI-10.

    RESULTS: The mSECEL questionnaire showed strong internal consistency with the Cronbach alpha of >0.90 for total score, Environmental and Attitude subscale. The test-retest reliability for total mSECEL score was high with the intraclass correlation of 0.97. There was a highly significant positive correlation between the mSECEL total score and mVHI-10 (P < 0.001). Items in the General subscale showed poorer internal consistency with Cronbach alpha ranging 0.55-0.46 and poor correlation with mVHI-10.

    CONCLUSIONS: The Bahasa Malaysia version of the SECEL measure is a valid and reliable instrument to evaluate communication perception after laryngectomy. Future studies should consider subscale validation and further abbreviation of its items to make this measure clinically relevant.

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