Displaying publications 21 - 40 of 167 in total

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  1. Ilic D, Nordin RB, Glasziou P, Tilson JK, Villanueva E
    BMC Med Educ, 2015;15:39.
    PMID: 25884717 DOI: 10.1186/s12909-015-0321-6
    BACKGROUND: Few studies have been performed to inform how best to teach evidence-based medicine (EBM) to medical trainees. Current evidence can only conclude that any form of teaching increases EBM competency, but cannot distinguish which form of teaching is most effective at increasing student competency in EBM. This study compared the effectiveness of a blended learning (BL) versus didactic learning (DL) approach of teaching EBM to medical students with respect to competency, self-efficacy, attitudes and behaviour toward EBM.
    METHODS: A mixed methods study consisting of a randomised controlled trial (RCT) and qualitative case study was performed with medical students undertaking their first clinical year of training in EBM. Students were randomly assigned to receive EBM teaching via either a BL approach or the incumbent DL approach. Competency in EBM was assessed using the Berlin questionnaire and the 'Assessing Competency in EBM' (ACE) tool. Students' self-efficacy, attitudes and behaviour was also assessed. A series of focus groups was also performed to contextualise the quantitative results.
    RESULTS: A total of 147 students completed the RCT, and a further 29 students participated in six focus group discussions. Students who received the BL approach to teaching EBM had significantly higher scores in 5 out of 6 behaviour domains, 3 out of 4 attitude domains and 10 out of 14 self-efficacy domains. Competency in EBM did not differ significantly between students receiving the BL approach versus those receiving the DL approach [Mean Difference (MD)=-0.68, (95% CI-1.71, 0.34), p=0.19]. No significant difference was observed between sites (p=0.89) or by student type (p=0.58). Focus group discussions suggested a strong student preference for teaching using a BL approach, which integrates lectures, online learning and small group activities.
    CONCLUSIONS: BL is no more effective than DL at increasing medical students' knowledge and skills in EBM, but was significantly more effective at increasing student attitudes toward EBM and self-reported use of EBM in clinical practice. Given the various learning styles preferred by students, a multifaceted approach (incorporating BL) may be best suited when teaching EBM to medical students. Further research on the cost-effectiveness of EBM teaching modalities is required.
    Matched MeSH terms: Statistics, Nonparametric
  2. Tan JM, Parolia A, Pau AK
    BMC Oral Health, 2013;13:52.
    PMID: 24098931 DOI: 10.1186/1472-6831-13-52
    This study compared the effectiveness of a Specially Designed Paste Carrier technique with the Syringe-Spreader technique and the Syringe-Lentulo spiral technique in the intracanal placement of calcium hydroxide.
    Matched MeSH terms: Statistics, Nonparametric
  3. Jeevaratnam K, Nadarajah VD, Judson JP, Nalliah S, Abdullah MF
    PMID: 20920154 DOI: 10.1186/1471-2393-10-58
    Hypertensive disorders in pregnancy contributes to about 12% of maternal deaths in Malaysia and similarly worldwide. Early detection and adequate management are preventable strategies. Biochemical markers of abnormal angiogenesis would be more specific in early detection than routine blood pressure and proteinuria measurements. The aim of this study was to estimate maternal plasma PlGF and sFlt-1 levels in pregnant women with gestational hypertension at three intervals of pregnancy and correlate these biomarker levels with placental morphometry.
    Matched MeSH terms: Statistics, Nonparametric
  4. Yip WK, Abdullah MA, Yusoff SM, Seow HF
    Clin Exp Immunol, 2009 Mar;155(3):412-22.
    PMID: 19220831 DOI: 10.1111/j.1365-2249.2008.03793.x
    The pathological significance of the mechanisms of tumour immune-evasion and/or immunosuppression, such as loss of T cell signalling and increase in regulatory T cells (T(regs)), has not been well established in the nasopharyngeal carcinoma (NPC) microenvironment. To evaluate the T(reg) immunophenotypes in tumour-infiltrating lymphocytes (TILs), we performed a double-enzymatic immunostaining for detection of forkhead box P3 (FoxP3) and other markers including CD4, CD8, and CD25 on 64 NPC and 36 non-malignant nasopharyngeal (NP) paraffin-embedded tissues. Expression of CD3 zeta and CD3 epsilon was also determined. The prevalence of CD4(+)FoxP3(+) cells in CD4(+) T cells and the ratio of FoxP3(+)/CD8(+) were increased significantly in NPC compared with those in NP tissues (P < 0.001 and P = 0.025 respectively). Moreover, the ratio of FoxP3(+)/CD25(+)FoxP3(-) in NPC was significantly lower than that in NP tissues (P = 0.005), suggesting an imbalance favouring activated phenotype of T cells in NPC. A significant negative correlation between the abundance of FoxP3(+) and CD25(+)FoxP3(-) cells (P < 0.001) was also identified. When histological types of NPC were considered, a lower ratio of FoxP3(+)/CD25(+)FoxP3(-) was found in non-keratinizing and undifferentiated carcinomas. Increased CD4(+)FoxP3(+)/CD4(+) proportion and FoxP3(+)/CD8(+) ratio were associated with keratinizing squamous cell carcinoma. A reduced expression of CD3 zeta in TILs was found in 20.6% of the NPC tissues but none of the NP tissues. These data provide evidence for the imbalances of T(reg) and effector T cell phenotypes and down-regulation of signal-transducing molecules in TILs, supporting their role in suppression of immune response and immune evasion of NPC.
    Matched MeSH terms: Statistics, Nonparametric
  5. Tan PC, Aziz AZ, Ismail IS, Omar SZ
    Clin Biochem, 2012 Oct;45(15):1192-6.
    PMID: 22659058 DOI: 10.1016/j.clinbiochem.2012.05.025
    OBJECTIVES: To evaluate gamma-glutamyltransferase (GGT), alanine transaminases (ALT) and aspartate transaminases (AST) levels and prevalent gestational diabetes mellitus (GDM).
    DESIGN AND METHODS: Random plasma glucose, GGT, ALT and AST and the 50-g glucose challenge test were done on antenatal women followed by diagnostic 3-point 75-g oral glucose tolerance test within two weeks. GDM was diagnosed by ADA (2011) criteria.
    RESULTS: The GDM rate was 12.2% (319/2610). Mean GGT level was higher in GDM women, 18 ± 12 vs. 16 ± 11 IU/L; P=0.03. The risk for GDM was higher for women in the highest GGT quartile band compared to the lowest: RR 1.35 95%CI 1.0-1.8; P=0.04. However, after adjustment for confounders, GGT was no longer associated with GDM. There was no correlation between ALT and AST levels and GDM.
    CONCLUSIONS: Liver transaminases do not predict GDM in contrast to type 2 diabetes.
    Matched MeSH terms: Statistics, Nonparametric
  6. Liem LK, Choong LH, Woo KT
    Clin Biochem, 2002 May;35(3):181-7.
    PMID: 12074825
    OBJECTIVE: Dihydropyrimidine dehydrogenase (DPD) catalyzes the degradation of thymine, uracil, and the chemotherapeutic drug 5-Fluorouracil. In general reverse-phase high pressure liquid chromatography is the standard method for separating 5-[2-(14)C]Fluorouracil and 5-[2-(14)C]Fluoro-5,6-dihydrouracil. However, the use of 100% aqueous solution (as HPLC mobile phase) may collapse the C-18 bonded phase and result in a retention time shift. The aim of this study is to develop a rapid, reproducible, sensitive method for screening partial DPD deficiency in healthy volunteers.

    DESIGN AND METHODS: The activity of DPD was measured using 5-[2- (14)C]Fluorouracil (5-[2-(14)C]FUra) followed by separation of substrate and product 5-[2-(14)C]FUraH(2) with a 15 x 4.6 mm I.D., 5 microm particle size (d(p)) porous graphitic carbon (PGC) column (Hypercarb(R)) and HPLC with online detection of the radioactivity. This was standardized using the protein concentration of the cytosol (NanoOrange(R) Protein Quantitation).

    RESULTS: Complete baseline separation of 5-[2-(14)C]Fluorouracil (5-[2-(14)C]FUra) and 5-[2-(14)C]Fluoro-5,6-dihydrouracil (5-[2-(14)C]FUraH(2)) was achieved using a porous graphitic carbon (PGC) column. The detection limit for 5-[2-(14)C]FUraH(2) was 0.4 pmol.

    CONCLUSIONS: By using linear gradient separation (0.1% Trifluoroacetic acid [TFA] in water to 100% Methanol) protocols in concert with PGC columns (Hypercarb(R)), we have demonstrated that a PGC column has a distinct advantage over C-18 reverse phase columns in terms of column stability (pH 1-14). This method provides an improvement on the specific assay for DPD enzyme activity. It is rapid, reproducible and sensitive and can be used for routine screening for healthy and cancer patients for partial and profound DPD deficiency before treatment with 5- FUra.

    Matched MeSH terms: Statistics, Nonparametric
  7. Siar CH, Toh CG, Ali TB, Seiz D, Ong ST
    Clin Oral Implants Res, 2012 Apr;23(4):438-46.
    PMID: 21435011 DOI: 10.1111/j.1600-0501.2010.02145.x
    A stable oral mucosa is crucial for long-term survival and biofunctionality of implants. Most of this evidence is derived from clinical and animal studies based solely on implant-supported prosthesis. Much less is known about the dimensions and relationships of this soft tissue complex investing tooth-implant-supported bridgework (TISB). The aim here was to obtain experimental evidence on the dimensional characteristics of oral mucosa around TISB with two different abutment designs.
    Matched MeSH terms: Statistics, Nonparametric
  8. Ugusman A, Zakaria Z, Hui CK, Nordin NA
    Clinics (Sao Paulo), 2010 Jul;65(7):709-14.
    PMID: 20668629 DOI: 10.1590/S1807-59322010000700010
    Nitric oxide produced by endothelial nitric oxide synthase (eNOS) possesses multiple anti-atherosclerotic properties. Hence, enhanced expression of eNOS and increased Nitric oxide levels may protect against the development of atherosclerosis. Piper sarmentosum is a tropical plant with antioxidant and anti-inflammatory activities. This study aimed to investigate the effects of Piper sarmentosum on the eNOS and Nitric oxide pathway in cultured human umbilical vein endothelial cells (HUVECs).
    Matched MeSH terms: Statistics, Nonparametric
  9. Chin KY, Soelaiman IN, Mohamed IN, Ngah WZ
    Clinics (Sao Paulo), 2012 Aug;67(8):911-6.
    PMID: 22948459
    OBJECTIVES: Variations in sex hormones and the calcium balance can influence bone health in men. The present study aimed to examine the relationship between the calcaneal speed of sound and biochemical determinants of bone mass, such as sex hormones, parathyroid hormones and serum calcium.

    METHODS: Data from 549 subjects from the Malaysian Aging Male Study, which included Malay and Chinese men aged 20 years and older residing in the Klang Valley, were used for analysis. The subjects' calcaneal speed of sound was measured, and their blood was collected for biochemical analysis. Two sets of multiple regression models were generated for the total/bioavailable testosterone and estradiol to avoid multicollinearity.

    RESULTS: The multiple regression results revealed that bioavailable testosterone and serum total calcium were significant predictors of the calcaneal speed of sound in the adjusted model. After adjustment for ethnicity and body mass index, only bioavailable testosterone remained significant; the total serum calcium was marginally insignificant. In a separate model, the total testosterone and sex hormone-binding globulin were significant predictors, whereas the total serum calcium was marginally insignificant. After adjustment for ethnicity and body mass index (BMI), the significance persisted for total testosterone and SHBG. After further adjustment for age, none of the serum biochemical determinants was a significant predictor of the calcaneal speed of sound.

    CONCLUSION: There is a significant age-dependent relationship between the calcaneal speed of sound and total testosterone, bioavailable testosterone and sex hormone-binding globulin in Chinese and Malay men in Malaysia. The relationship between total serum calcium and calcaneal speed of sound is ethnicity-dependent.

    Matched MeSH terms: Statistics, Nonparametric
  10. Cheng KP, Roslani AC, Sehha N, Kueh JH, Law CW, Chong HY, et al.
    Colorectal Dis, 2012 Jun;14(6):e346-51.
    PMID: 22568647 DOI: 10.1111/j.1463-1318.2012.02943.x
    Surgical site infection (SSI) remains a common postoperative morbidity, particularly in colorectal resections, and poses a significant financial burden to the healthcare system. The omission of mechanical bowel preparation, as is performed in enhanced recovery after surgery programmes, appears to further increase the incidence. Various wound protection methods have been devised to reduce the incidence of SSIs. However, there are few randomized controlled trials assessing their efficacy. The aim of this study is to investigate whether ALEXIS wound retractors with reinforced O-rings are superior to conventional wound protection methods in preventing SSIs in colorectal resections.
    Matched MeSH terms: Statistics, Nonparametric
  11. Erni Noor, Al-Bayaty, Fouad Hussain, Muhammad Qadri Bin Mohd Shukri, Mohamad Syahir Bin Zulkiflee
    Compendium of Oral Science, 2019;6(1):15-25.
    MyJurnal
    Objective: To evaluate the root debridement skill in periodontology pre-clinical module among dental students and to estimate the effectiveness of conducting periodontology pre-clinical module before entering clinical module. Materials and Method: : A total of 47 pre-clinical dental students (Year 2) were included in this study. Single rooted extracted teeth were collected, mounted on acrylic resin and set into the level of 1/3 of the root length. Each of them were instructed to prepare a mounted teeth and to perform root debridement procedure on the labial surface of the tooth only within 10 minutes using Gracey curette #5/6. The similar samples were distributed back to the same students (which were already in clinical year (year 4) to repeat the same procedure on the lingual surface of the same tooth. Root surface roughness was evaluated by using scanning electron microscope (SEM) and profilometer for both labial and lingual surfaces. Statistical analysis was done using Mann-Whitney U test and T-test. Significance level of p ≤ 0.05 was assumed for all analysis. Results: SEM photomicrographs of root surfaces with magnifications of 100x and 800x revealed that there were incomplete removal of the dental calculus in both surfaces and significant roughness root surfaces noted. Conclusion: : No significant differences noted between the students’ root debridement skill in the pre-clinical and also clinical year. Objectives of the current module were fulfilled but in order to meet the highest standard, current module need to be improved in the future.
    Matched MeSH terms: Statistics, Nonparametric
  12. Chan LF, Maniam T, Shamsul AS
    Crisis, 2011;32(5):283-7.
    PMID: 21940256 DOI: 10.1027/0227-5910/a000088
    Depressed inpatients constitute a high-risk population for suicide attempts.
    Matched MeSH terms: Statistics, Nonparametric
  13. Abubakar U, Muhammad HT, Sulaiman SAS, Ramatillah DL, Amir O
    Curr Pharm Teach Learn, 2020 03;12(3):265-273.
    PMID: 32273061 DOI: 10.1016/j.cptl.2019.12.002
    BACKGROUND AND PURPOSE: Training pharmacy students in infectious diseases (ID) is important to enable them to participate in antibiotic stewardship programs. This study evaluated knowledge and self-confidence regarding antibiotic resistance, appropriate antibiotic therapy, and antibiotic stewardship among final year pharmacy undergraduate students.

    METHODS: A cross-sectional electronic survey was conducted at universities in Indonesia, Malaysia, and Pakistan. A 59-item survey was administered between October 2017 and December 2017.

    FINDINGS: The survey was completed by 211 students (response rate 77.8%). The mean knowledge score for antibiotic resistance, appropriate antibiotic therapy, and antibiotic stewardship was 5.6 ± 1.5, 4.7 ± 1.8 (maximum scores 10.0) and 3.1 ± 1.4 (maximum score 5.0), respectively. Significant variations were noted among the schools. There was poor awareness about the consequences of antibiotic resistance and cases with no need for an antibiotic. The knowledge of antibiotic resistance was higher among male respondents (6.1 vs. 5.4) and those who had attended antibiotic resistance (5.7 vs. 5.2) and antibiotic therapy (5.8 vs. 4.9) courses (p 

    Matched MeSH terms: Statistics, Nonparametric
  14. Goh CF, Ong ET
    Curr Pharm Teach Learn, 2019 06;11(6):621-629.
    PMID: 31213319 DOI: 10.1016/j.cptl.2019.02.025
    BACKGROUND AND PURPOSE: The flipped classroom has not been fully exploited to improve tertiary education in Malaysia. A transformation in pharmacy education using flipped classrooms will be pivotal to resolve poor academic performance in certain courses. This study aimed to investigate the effectiveness of the flipped classroom in improving student learning and academic performance in a course with a historically low pass rate.

    EDUCATIONAL ACTIVITY AND SETTING: A quasi-experimental pre- and posttest control group design was employed. The experimental group experienced the flipped classroom for selected topics while the control group learned in a traditional classroom. Analysis of covariance was utilized to compare the performance on the final exam using the grade point of a pre-requisite course as the covariate. Students' perceptions of their experience in the flipped classroom were gauged through a web-based survey.

    FINDINGS: Student performance on the final exam was significantly higher in the flipped classroom group. The lowest-scoring students benefitted the most in terms of academic performance. More than two-thirds of students responded positively to the use of the flipped classroom and felt more confident while participating in classes and tests.

    SUMMARY: The flipped classroom is academically beneficial in a challenging course with a historically low pass rate; it was also effective in stimulating learning interest. The current study identified that for the flipped classroom to be successful, the role of educators, the feasibility of the approach, and the acceptance of students were important.

    Matched MeSH terms: Statistics, Nonparametric
  15. Thong YL, Messer HH, Siar CH, Saw LH
    Dent Traumatol, 2001 Dec;17(6):254-9.
    PMID: 11766092
    Intracanal medicaments are recommended for use in replanted teeth to inhibit inflammatory root resorption. This study compared the effect of calcium hydroxide (Pulpdent) and a corticosteroid-antibiotic paste (Ledermix) on periodontal healing and root resorption following replantation. Incisors of eight Macaca fascicularis monkeys were extracted, stored dry for 15 min and replanted. After 11 days, root canals in two adjacent maxillary incisors were treated with one medicament and contralateral incisors with the other medicament, or left as untreated controls. Animals were sacrificed 8 weeks later and the teeth prepared for histomorphometric evaluation of periodontal ligament inflammation and root resorption. Periodontal ligament inflammation and inflammatory root resorption were markedly inhibited by both calcium hydroxide and corticosteroid-antibiotic relative to untreated controls. Replacement resorption was lowest in the corticosteroid-antibiotic group, and significantly (P<0.05) more normal periodontal ligament was present in this group (79.6%) than in calcium hydroxide and control groups (64.6% and 62.7%, respectively). Treatment with the corticosteroid-antibiotic inhibited inflammatory resorption and was slightly more effective than calcium hydroxide in producing a periodontal healing response.
    Matched MeSH terms: Statistics, Nonparametric
  16. Chiam CW, Chan YF, Loong SK, Yong SS, Hooi PS, Sam IC
    Diagn Microbiol Infect Dis, 2013 Oct;77(2):133-7.
    PMID: 23886793 DOI: 10.1016/j.diagmicrobio.2013.06.018
    Quantitative real-time polymerase chain reaction (qRT-PCR) is useful for diagnosis and studying virus replication. We developed positive- and negative-strand qRT-PCR assays to detect nsP3 of chikungunya virus (CHIKV), a positive-strand RNA alphavirus that causes epidemic fever, rash, and arthritis. The positive- and negative-strand qRT-PCR assays had limits of quantification of 1 and 3 log10 RNA copies/reaction, respectively. Compared to a published E1 diagnostic assay using 30 laboratory-confirmed clinical samples, the positive-strand nsP3 qRT-PCR assay had higher R(2) and efficiency and detected more positive samples. Peak viral load of 12.9 log(10) RNA copies/mL was reached on day 2 of illness, and RNA was detectable up to day 9, even in the presence of anti-CHIKV IgM. There was no correlation between viral load and persistent arthralgia. The positive-strand nsP3 assay is suitable for diagnosis, while the negative-strand nsP3 assay, which uses tagged primers to increase specificity, is useful for study of active viral replication kinetics.
    Matched MeSH terms: Statistics, Nonparametric
  17. Chew CS, Cherry CL, Kamarulzaman A, Yien TH, Aghafar Z, Price P
    Dis Markers, 2011;31(5):303-9.
    PMID: 22048272 DOI: 10.3233/DMA-2011-0844
    Chemokines influence the migration of leukocytes to secondary lymphoid tissue and sites of inflammation. In HIV patients, they are implicated in inflammatory complications of antiretroviral therapy (ART), notably Immune Reconstitution Disease (IRD) and Sensory Neuropathy (SN). However most chemokines have not been monitored as patients begin ART or correlated with IRD and SN.
    Matched MeSH terms: Statistics, Nonparametric
  18. Hussain A, Ibrahim MI
    East Mediterr Health J, 2012 Jun;18(6):635-40.
    PMID: 22888622
    Community pharmacies are valued for their potential role in the management of common ailments. This cross-sectional study aimed to document the management of diarrhoea by community pharmacies in 3 cities in Pakistan. Visits were performed to 371 randomly selected pharmacies to request advice for a simulated paediatric case of diarrhoea. The pharmacy's management was scored on a checklist including history taking and provision of advice and information. Customers were served by a salesperson in 97.3% of visits and by a pharmacist in only 2.2%. Medication was dispensed in 77.1% of visits. Of the medications dispensed, 58.7% were antiamoebics, 14.0% antibiotics and 18.9% antidiarrhoeals; only 8.4% were oral rehydration salts. None of the regimens matched with a standard prescription. The dosage regimen was explained to the customer in only 52.6% of cases. Drug safety, unqualified personnel, lack of history taking, inappropriate treatment and lack of counselling are concerns to be addressed.
    Matched MeSH terms: Statistics, Nonparametric
  19. Phan K, Kim KW, Hashim JH
    Environ Res, 2014 Nov;135:37-41.
    PMID: 25262072 DOI: 10.1016/j.envres.2014.07.031
    We investigated relationship of arsenicosis symptoms with total blood arsenic (BAs) and serum albumin (SAlb) of residents in the Mekong River basin of Cambodia. We found that arsenicosis patients had significantly higher BAs and lower SAlb than asymptomatic villagers (Mann-Whitney U test, p<0.01). Arsenicosis symptoms were found to be 76.4% (1.764 times) more likely to develop among individuals having an SAlb≤44.3gL(-1) than among those who had an SAlb>44.3gL(-1) (OR=1.764, 95% CI=0.999-3.114) and 117.6% (2.176 times) as likely to occur among those with BAs>5.73µgL(-1) than for those having BAs≤5.73µgL(-1) (OR=2.176, 95% CI=1.223-3.872). Furthermore, a significant negative correlation was also found between BAs and SAlb (rs (199)=-0.354, p<0.0001). As such, this study suggests that people with low SAlb and/or high BAs are likely to rapidly develop arsenicosis symptoms.
    Matched MeSH terms: Statistics, Nonparametric
  20. Lua PL, Neni WS
    Epilepsy Behav, 2011 Jul;21(3):248-54.
    PMID: 21576038 DOI: 10.1016/j.yebeh.2011.03.039
    The influence of awareness, knowledge, and attitudes (AKA) on the health-related quality of life (HRQoL) of patients with epilepsy has not been widely established. The aims of this preliminary study were to (1) assess general AKA and HRQoL levels, (2) correlate AKA and HRQoL levels, and (3) compare the HRQoL of patients with epilepsy with different AKA levels. A cross-sectional sample of outpatients with epilepsy were recruited from the Neurology Clinic, Hospital Sultanah Nur Zahirah, Kuala Terengganu, Malaysia. Data analysis was carried out using the Statistical Package for Social Sciences Version 15 employing descriptive and nonparametric statistics. On written consent, included patients completed the Malay AKA Epilepsy and the Malay Quality of Life in Epilepsy-30 (MQOLIE-30) instruments. Across all patients, both AKA levels (median: 80.0, range: 0-170) and overall HRQoL (median 51.5; range 15-97) were moderate. Awareness was significantly correlated only with Seizure Worry (r(s)=+0.29, p<0.05), whereas Knowledge was not significantly linked to any domain. However, Attitudes was significantly correlated with all domains (r(s)=+0.35 to +0.47, p<0.01) except Medication Effects and Seizure Worry. Patients with good AKA levels (Total Score ≥ median) experienced significantly better Overall Quality of Life and Cognitive Functioning (p<0.05). Findings showed that AKA may play an important role in influencing patients' HRQoL, suggesting that epilepsy treatment efforts should also focus on enhancing AKA through epilepsy awareness to improve health outcomes.

    Study site: Neurology Clinic, Hospital Sultanah Nur Zahirah
    Matched MeSH terms: Statistics, Nonparametric
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