Displaying publications 1 - 20 of 22 in total

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  1. Ibrahim AH, Harun MS
    J Bioeth Inq, 2024 Feb 26.
    PMID: 38407763 DOI: 10.1007/s11673-024-10345-z
    Rapid developments in science and technology have resulted in novel discoveries, leading to new questions particularly related to human values and ethics. Every discovery and technology has positive and negative implications and affects human lives either directly or indirectly, involving all walks of life. Bioethical discourse in Malaysia must consider the multiracial and multireligious background of Malaysia and especially the Islamic view as the majority of Malaysians are Muslims and Islam is the religion of the federation. This article discusses several selected bioethical issues in Malaysia by studying the application of maṣlaḥah (the public good) and mafsadah (evil and harms) in Malaysian Islamic rulings (fatwas). This article uses the critical interpretation approach, as this is an ethical, interpretive, textual, and contextual analysis. In a situation when there is a conflict between maṣlaḥah and avoidance of mafsadah, it is preferred to attempt to address both needs. However, if maṣlaḥah and avoidance of mafsadah are mutually exclusive, the decision to choose must be made by weighing (tarjīḥ) and choosing the one which is superior. The maṣlaḥah and mafsadah concepts play vital and significant roles in bioethical discourse to realize human essential interests, namely faith, life, lineage, intellect, and property, thus achieving maqāṣid al-sharī'ah (the ultimate goal of sharia). This concept helps in guiding bioethical discussions, especially in determining the priority between achieving benefits and avoiding harms. The application of this concept will also assist Malaysian authorities in formulating appropriate rulings, especially bioethical issues related to Malaysian Muslims' lives.
  2. Muhamad A, Syihab AH, Ibrahim AH
    Sci Eng Ethics, 2020 Apr;26(2):1053-1066.
    PMID: 32048138 DOI: 10.1007/s11948-020-00192-7
    Environmental sustainability is one of the contemporary discourses that has abundant values embedded in the Quran and Sunnah teachings. Islam gives great emphasis on environment as it is preserved and protected under the Maqasid al-Shariah (Objectives of the Islamic Law). The general outlook of Quranic paradigm on utilizing natural environment is based on prohibition of aggression and misuse. It is likewise founded on the construction and sustainable use. Thus, this article attempts to elaborate key concepts of the Quran and Sunnah teachings that reveal imperative values for environmental sustainability. Research method employs in this paper is an analytical study of Quranic verses with special highlights of tafsir bi al-ma'thur (explanation based upon traditions), tafsir bi al-ra'yi (explanation based on reasoning), and historical narrative. In short, this paper brings to light the relevance of classical and contemporary works of Quran and Sunnah studies that have meticulous values for shaping the better world of human-nature's interaction.
  3. Kassim NK, Hanafi MH, Ibrahim AH, Hasnan N
    Malays Orthop J, 2021 Mar;15(1):135-137.
    PMID: 33880162 DOI: 10.5704/MOJ.2103.022
    The optimisation of blood pressure management is critical in managing hypotensive episodes in patients with spinal cord injury. Improper handling of this preventable factor will negatively impact the patient recovery prognosis. A 42-year-old man was admitted for a complete spinal cord injury after fell from height. He developed subacute neurological deterioration unrelated to the mechanical instability but due to multiple episodes of hypotension occurring one month after the initial injury. After proper management of blood pressure, his deterioration was halted and no further progression. Spinal cord haemodynamics play an important role in mediating the onset of subacute post-traumatic ascending myelopathy. Better education and awareness on Subacute Post-traumatic Ascending Myelopathy (SPAM) especially to the junior healthcare providers are important to hinder this rare but avoidable condition.
  4. Ibrahim AH, Rahman NNA, Saifuddeen SM, Baharuddin M
    Sci Eng Ethics, 2019 02;25(1):129-142.
    PMID: 29071572 DOI: 10.1007/s11948-017-9980-5
    Tri-parent baby technology is an assisted reproductive treatment which aims to minimize or eliminate maternal inheritance of mutated mitochondrial DNA (mtDNA). The technology became popular following the move by the United Kingdom in granting license to a group of researchers from the Newcastle Fertility Centre, Newcastle University to conduct research on the symptoms of defective mtDNA. This technology differs from other assisted reproductive technology because it involves the use of gamete components retrieved from three different individuals. Indirectly, it affects the preservation of lineage which is important from an Islamic point of view. This paper aims to analyze and discuss the implications of the tri-parent technology on preservation of lineage from the perspective of Maqasid al-Shari'ah based the Islamic bioethics. The analysis shows that there are a few violations of the preservation of lineage, hence the tri-parent baby technology should not be permitted.
  5. Ibrahim AH, Rahman NNA, Saifuddeen SM
    Sci Eng Ethics, 2018 10;24(5):1493-1502.
    PMID: 28895055 DOI: 10.1007/s11948-017-9963-6
    Rapid development in the area of assisted reproductive technology (ART), has benefited mankind by addressing reproductive problems. However, the emergence of new technologies and techniques raises various issues and discussions among physicians and the masses, especially on issues related to bioethics. Apart from solutions provided using conventional bioethics framework, solutions can also be derived via a complementary framework of bioethics based on the Higher Objectives of the Divine Law (Maqasid al-Shariah) in tackling these problems. This approach in the Islamic World has been applied and localised in the Malaysian context. Thus, this paper highlights a conceptual theoretical framework for solving current bioethical issues, with a special focus on ART in the Malaysian context, and compares this theory with conventional theories of bioethics.
  6. Ibrahim AH, Rahman NNA, Saifuddeen SM
    J Bioeth Inq, 2023 Sep;20(3):485-495.
    PMID: 37440155 DOI: 10.1007/s11673-023-10279-y
    Mitochondrial replacement technology (MRT) is an emerging and complex bioethical issue. This treatment aims to eliminate maternal inherited mitochondrial DNA (mtDNA) disorders. For Muslims, its introduction affects every aspect of human life, especially the five essential interests of human beings-namely, religion, life, lineage, intellect, and property. Thus, this technology must be assessed using a comprehensive and holistic approach addressing these human essential interests. Consequently, this article analyses and assesses tri-parent baby technology from the perspective of Maqasidic bioethics-that is, Islamic bioethics based on the framework of Maqasid al-Shariah. Using this analysis, this article suggests that tri-parent baby technology should not be permitted for Muslims due to the existence of third-party cell gametes which lead to lineage mixing and due to the uncertain safety of the therapy itself and because the major aim of the technology is to fulfil the affected couples interest to conceive their own genetically healthy child, not to treat and cure mtDNA disorders sufferers.
  7. Ibrahim AH, Rahman NNA, Saifuddeen SM, Baharuddin M
    J Bioeth Inq, 2019 Sep;16(3):333-345.
    PMID: 30715660 DOI: 10.1007/s11673-019-09902-8
    Maqasid al-Shariah based Islamic bioethics is an Islamic bioethics concept which uses the objectives of the Shariah (maqasid al-Shariah) as its approach in analysing and assessing bioethical issues. Analysis based on maqasid al-Shariah based Islamic bioethics will examine any bioethical issues from three main aspects namely intention, method, and output or final goal of the studied issues. Then, the evaluation will be analysed from human interest hierarchy, inclusivity, and degree of certainty. The Islamic bioethics concept is a manifestation of dynamic Islamic jurisprudence which can overcome new complex and complicated bioethical issues such as tri-parent baby technology issues. Therefore, this article will introduce and explain the concept of maqasid al-Shariah based Islamic bioethics and outline a general guidance of maqasid al-Shariah based Islamic bioethics to determine a maqṣad (objective) based on standards of human good or well-being (maslahah) and harm (mafsadah).
  8. Dahham SS, Al-Rawi SS, Ibrahim AH, Abdul Majid AS, Abdul Majid AMS
    Saudi J Biol Sci, 2018 Dec;25(8):1524-1534.
    PMID: 30591773 DOI: 10.1016/j.sjbs.2016.01.031
    Desert truffles are seasonal and important edible fungi that grow wild in many countries around the world. Truffles are natural food sources that have significant compositions. In this work, the antioxidant, chemical composition, anticancer, and antiangiogenesis properties of the Terfezia claveryi truffle were investigated. Solvent extractions of the T. claveryi were evaluated for antioxidant activities using (DPPH, FRAP and ABTS methods). The extracts cytotoxicity on the cancer cell lines (HT29, MCF-7, PC3 and U-87 MG) was determined by MTT assay, while the anti-angiogenic efficacy was tested using ex-vivo assay. All extracts showed moderate anticancer activities against all cancer cells (p 
  9. Ong YP, Ho LN, Ong SA, Banjuraizah J, Ibrahim AH, Lee SL, et al.
    Chemosphere, 2019 Mar;219:277-285.
    PMID: 30543963 DOI: 10.1016/j.chemosphere.2018.12.004
    Photocatalytic fuel cell (PFC) is considered as a sustainable green technology which could degrade organic pollutant and generate electricity simultaneously. A synergistic double-sided ZnO/BaTiO3 loaded carbon plate heterojunction photoanode was fabricated in different ratios by using simple ultrasonication and mixed-annealed method. The double-sided design of photoanode allowed the lights irradiated at both sides of the photoanode. The ferroelectricity fabricated photoanode was applied in a membraneless PFC with platinum-loaded carbon as the cathode. Results revealed that the photoanode with 1:1 ratio of BaTiO3 and ZnO exhibited a superior photocatalytic activity among all the photoanodes prepared in this study. The heterojunction of this photoanode was able to achieve up to a removal efficiency of 93.67% with a maximum power density of 0.5284 μW cm-2 in 10 mg L-1 of Reactive Red 120 (RR120) without any supporting electrolyte. This photoanode was able to maintain at high performance after recycling 3 times. Overloading of ZnO above 50% on BaTiO3 could lead to deterioration of the performance of PFC due to the charge defects and light trapping ability. The interactions, interesting polarizations of the photocatalysts and proposed mechanism of the n-n type heterojunction in the photoanode of ZnO/BaTiO3 was also discussed.
  10. Ong YP, Ho LN, Ong SA, Banjuraizah J, Ibrahim AH, Thor SH, et al.
    Chemosphere, 2021 Jan;263:128212.
    PMID: 33297171 DOI: 10.1016/j.chemosphere.2020.128212
    A unidirectional flow solar photocatalytic fuel cell (PFC) was successfully developed for the first time to offer alternative for electricity generation and simultaneous wastewater treatment. This study was focused on the synthesis of α-, δ- and β-MnO2 by wet chemical hydrothermal method for application as the cathodic catalyst in PFC. The crystallographic evolution was performed by varying the ratios of KMnO4 to MnSO4. The mechanism of the PFC with the MnO2/C as cathode was also discussed. Results showed that the catalytic activity of MnO2/C cathode was mainly predominated by their crystallographic structures which included Mn-O bond strength and tunnel size, following order of α- > δ- > β-MnO2/C. Interestingly, it was discovered that the specific surface areas (SBET) of different crystal phases did not give an impact on the PFC performance. However, the Pmax could be significantly influenced by the micropore surface area (Smicro) in the comparison among α-MnO2. Furthermore, the morphological transformation carried out by altering the hydrothermal duration demonstrated that the nanowire α-M3(24 h)/C with 1:1 ratio of KMnO4 and MnSO4 yielded excellent PFC performance with a Pmax of 2.8680 μW cm-2 and the lowest Rint of 700 Ω.
  11. Wan Yusoff WR, Hanafi MH, Ibrahim AH, Kassim NK, Suhaimi A
    J Taibah Univ Med Sci, 2021 Apr;16(2):288-291.
    PMID: 33897336 DOI: 10.1016/j.jtumed.2020.12.003
    Alien hand syndrome (AHS) is a rare post-stroke complication. Although the occurrence of AHS after stroke is rare, it can have a disabling impact on the lifestyle and career of the patients post stroke. It is difficult to distinguish AHS from the non-dominant hemispheric infarction with symptoms of hemianopia and left hemineglect, as patients with AHS can also have neglect as well as behaviour symptoms if the frontal lobe is involved. We report the case of a 62-year-old gentleman who was admitted to the rehabilitation ward and was treated for neglect and apraxia following right middle cerebral artery stroke. After further re-evaluation, the patient was diagnosed with AHS. Functionally, he improved and the symptoms disappeared four months after the stroke. In this case report, we highlight the features of AHS and provide a unique management approach.
  12. Nordin N, Ho LN, Ong SA, Ibrahim AH, Lee SL, Ong YP
    Chemosphere, 2019 Jan;214:614-622.
    PMID: 30292044 DOI: 10.1016/j.chemosphere.2018.09.144
    The hybrid system of photocatalytic fuel cell - peroxi-coagulation (PFC-PC) is a sustainable and green technology to degrade organic pollutants and generate electricity simultaneously. In this study, three different types of photocatalysts: TiO2, ZnO and α-Fe2O3 were immobilized respectively on carbon cloth (CC), and applied as photoanodes in the photocatalytic fuel cell of this hybrid system. Photocatalytic fuel cell was employed to drive a peroxi-coagulation process by generating the external voltage accompanying with degrading organic pollutants under UV light irradiation. The degradation efficiency of Amaranth dye and power output in the hybrid system of PFC-PC were evaluated by applying different photoanode materials fabricated in this study. In addition, the effect of light on the photocurrent of three different photoanode materials was investigated. In the absence of light, the reduction of photocurrent percentage was found to be 69.7%, 17.3% and 93.2% in TiO2/CC, ZnO/CC and α-Fe2O3/CC photoanodes, respectively. A maximum power density (1.17 mWcm-2) and degradation of dye (93.8%) at PFC reactor were achieved by using ZnO/CC as photoanode. However, the different photoanode materials at PFC showed insignificant difference in dye degradation trend in the PC reactor. Meanwhile, the degradation trend of Amaranth at PFC reactor was influenced by the recombination rate, electron mobility and band gap energy of photocatalyst among different photoanode materials.
  13. Nordin N, Ho LN, Ong SA, Ibrahim AH, Abdul Rani AL, Lee SL, et al.
    Chemosphere, 2020 Apr;244:125459.
    PMID: 31790991 DOI: 10.1016/j.chemosphere.2019.125459
    The hybrid electrochemical system of photocatalytic fuel cell - peroxi-coagulation (PFC-PC) is a combined technology of advanced oxidation process (AOP) which involve the hydroxyl radical formation for simultaneous degradation of organic pollutant and electricity generation. The p-nitrosodimethylaniline (RNO) spin trapping technique was applied by analyzing the RNO bleaching performance to detect the OH at the PFC and PC reactors. The presence of UV light showed higher RNO bleaching rate at the PFC reactor (11.7%) with maximum power density (Pmax = 3.14 mW cm-2). Results revealed that the optimum of maximum power density was observed at iron plate size of 30 cm2. UV light became a limiting factor in the PFC system as a power source in the PFC-PC system. Meanwhile, iron plate plays an important role to supply the soluble Fe2+ ions by oxidation process and become a suitable catalyst for in-situ production of H2O2 and OH through the PC process to degrade the organic molecules.
  14. Arifin N, Hasbollah HR, Hanafi MH, Ibrahim AH, Rahman WAWA, Aziz RC
    Malays J Med Sci, 2017 Oct;24(5):106-111.
    PMID: 29386978 MyJurnal DOI: 10.21315/mjms2017.24.5.12
    The incidence of lower limb amputation is high across the globe and continues to be a major threat to morbidity and mortality. Consequently, the provision of high quality and effective prosthetics services have been known as an essential component for a successful rehabilitation outcome. In Malaysia, amputation prevalence has been increasing in which several main components of service delivering aspects (such as service intervention, prosthetic personnel) should be anticipated to accommodate for the increasing demand. This article highlights the hurdles experienced in providing prosthetic services in Malaysia from multiple aspects such as financial burden to acquire the prosthesis and lack of expertise to produce quality prosthesis. This paramount issues consequently justify for the urgency to carry out national level survey on the current statistics of lower limb amputation and to ascertain the available workforce to provide a quality prosthetics services. Only with accurate and current information from the national survey, strategies and policies aimed at enhancing the outcome from prosthetics services can be achieved.
  15. Ibrahim AH, Li H, Al-Rawi SS, Majid ASA, Al-Habib OA, Xia X, et al.
    Am J Transl Res, 2017;9(11):4936-4944.
    PMID: 29218091
    OBJECTIVE: The process of wound healing involves activation of keratinocytes, fibroblasts, endothelial cells, etc. Angiogenesis is crucial during the process of wound healing. Virgin coconut oil is widely utilized in South Asia for various purposes including food, medicinal and industrial applications. This study aimed to evaluate the potency of fermented virgin coconut oil (FVCO) in angiogenesis and wound healing via both in vitro and in vivo assays.

    METHODS: Human umbilical vein endothelial (HUVEC), fibroblast (CCD-18) and retinal ganglion (RGC-5) cells were cultured in medium containing different concentrations of FVCO. The proliferation, migration and morphological changes of cells were determined. The angiogenic effect of FVCO was evaluated by rat aortic assay. The therapeutic effect of FVCO on wound healing was further assessed in a wound excision model in Sprague Dawley rats. The expression of phospho-VEGFR2 (vascular endothelial growth factor receptor 2) in HUVECs was detected by Western blot.

    RESULTS: FVCO (6 and 12 µg/mL) significantly improved the proliferation of HUVEC, CCD-18 and RGC-5 cells (P < 0.05 or 0.01). FVCO (25 µg/mL) markedly increased the migration ability of CCD-18 and RGC-5 cells (P < 0.05). FVCO did not affect cell morphology as indicated by fluorescein diacetate (FDA), rhodamine 123 and Hoechst staining. FVCO (25, 50 and 100 µg/mL) significantly stimulated the ex vivo blood vessel formation as compared with negative control (P < 0.05). Rats in FVCO group had significantly smaller wound size, higher wound healing percentage, and shorter wound closure time when compared with control group since day 8 (P < 0.05), suggesting that oral FVCO administration notably promoted the wound healing process. FVCO treatment (6 and 12 µg/mL) significantly enhanced the phospho-VEGFR2 expression in HUVECs (P = 0.006 and 0.000, respectively).

    CONCLUSION: Our study confirms a high angiogenic and wound healing potency of FVCO that might be mediated by the regulation of VEGF signing pathway.

  16. Nordin N, Ho LN, Ong SA, Ibrahim AH, Wong YS, Lee SL, et al.
    Environ Sci Pollut Res Int, 2017 Oct;24(29):23331-23340.
    PMID: 28840563 DOI: 10.1007/s11356-017-9964-7
    A novel sustainable hybrid system of photocatalytic fuel cell (PFC) and Fenton process is an alternative wastewater treatment technology for energy-saving and efficient treatment of organic pollutants. The electrons generated from PFC photoanode are used to produce H2O2 in the Fenton reactor and react with the in situ generation of Fe2+ from sacrificial iron for hydroxyl radical formation. In this study, the effect of different initial Amaranth dye concentrations on degradation and electricity generation were investigated. ZnO/Zn photoanode was prepared by anodizing method and characterized by X-ray diffraction (XRD) and scanning electron microscope (SEM). Results revealed that the maximum power density (9.53 mW/m2) and current density (0.0178 mA/m2) were achieved at 10 mg/L of Amaranth. The correlation between dye degradation, voltage output, and kinetic photocatalytic degradation were also investigated and discussed.
  17. Abdulrahman MD, Zakariya AM, Hama HA, Hamad SW, Al-Rawi SS, Bradosty SW, et al.
    Adv Pharmacol Pharm Sci, 2022;2022:4495688.
    PMID: 35677711 DOI: 10.1155/2022/4495688
    Medicinal plants are the primary raw materials used in the production of medicinal products all over the world. As a result, more study on plants with therapeutic potential is required. The tropical tree Ziziphus spina belongs to the Rhamnaceae family. Biological reports and traditional applications including management of diabetes and treatment of malaria, digestive issues, typhoid, liver complaints, weakness, skin infections, urinary disorders, obesity, diarrhoea, and sleeplessness have all been treated with different parts of Z. spina all over the globe. The plant is identified as a rich source of diverse chemical compounds. This study is a comprehensive yet detailed review of Z. spina based on major findings from around the world regarding ethnopharmacology, biological evaluation, and chemical composition. Scopus, Web of Science, BioMed Central, ScienceDirect, PubMed, Springer Link, and Google Scholar were searched to find published articles. From the 186 research articles reviewed, we revealed the leaf extract to be significant against free radicals, microbes, parasites, inflammation-related cases, obesity, and cancer. Chemically, polyphenols/flavonoids were the most reported compounds with a composition of 66 compounds out of the total 193 compounds reported from different parts of the plant. However, the safety and efficacy of Z. spina have not been wholly assessed in humans, and further well-designed clinical trials are needed to corroborate preclinical findings. The mechanism of action of the leaf extract should be examined. The standard dose and safety of the leaf should be established.
  18. Ong YP, Ho LN, Ong SA, Ibrahim AH, Banjuraizah J, Thor SH, et al.
    Environ Sci Pollut Res Int, 2022 Nov;29(54):81368-81382.
    PMID: 35729394 DOI: 10.1007/s11356-022-21413-5
    To enhance dye removal and energy recovery efficiencies in single-pair electrode photocatalytic fuel cell (PFC-AC), dual cathodes PFC (PFC-ACC) and dual photoanodes PFC (PFC-AAC) were established. Results revealed that PFC-AAC yielded the highest decolorization rate (1.44 h-1) due to the promotion of active species such as superoxide radical (•O2-) and hydroxyl radical (•OH) when the number of photoanode was doubled. The results from scavenging test and UV-Vis spectrophotometry disclosed that •OH was the primary active species in dye degradation of PFC. Additionally, PFC-AAC also exhibited the highest power output (17.99 μW) but the experimental power output was much lower than the theoretical power output (28.24 μW) due to the strong competition of electron donors of doubled photoanodes to electron acceptors at the single cathode and its high internal resistance. Besides, it was found that the increments of dye volume and initial dye concentration decreased the decolorization rate but increased the power output due to the higher amount of sacrificial agents presented in PFC. Based on the abovementioned findings and the respective dye intermediate products identified from gas chromatography-mass spectrometry (GC-MS), the possible degradation pathway of RR120 was scrutinized and proposed.
  19. Hashim NM, Che Daud AZ, Ibrahim AH, Ab Majid MH, Mohd Ghazali MN, Abdul Razak MM, et al.
    Prosthet Orthot Int, 2024 Jan 01;48(1):89-99.
    PMID: 37639558 DOI: 10.1097/PXR.0000000000000270
    BACKGROUND: An excellent validated and reliable instrument is paramount in holistically evaluating the prosthetic and orthotic (P&O) service, encompassing functional outcomes, health-related quality of life (HRQoL), and patient satisfaction with devices and service.

    OBJECTIVE: To perform a translation and cross-cultural adaptation of 3 modules of the Orthotics and Prosthetics Users' Survey (OPUS): (1) lower-extremity functional status (LEFS), (2) client satisfaction with device and services (CSDS), and (3) HRQoL in Malay language, and analyze its psychometric properties.

    STUDY DESIGN: Translation and validation study.

    METHODS: This translation process consisted of 4 phases: (1) a forward-backward translation, (2) content and face validity by utilizing content and face validity indices, (3) pilot testing and psychometric analysis using exploratory factor analysis, and (4) test-retest reliability.

    RESULTS: One item from OPUS Health Quality of Life Index-Malay pilot version, 5 items from OPUS LEFS-Malay pilot version, and 4 items of OPUS Satisfaction with Device and Services-Malay pilot version were deleted because of poor factor loading of <0.6. The final version of Modified OPUS HRQoL-M, Modified OPUS LEFS-M, and Modified OPUS CSDS-M consisted of 22 items, 15 items, and 17 items, respectively. The final versions of all 3 Modified OPUS Malay version possess good internal consistency of 0.854, 0.927, and 0.98, and intraclass correlation of 0.773, 0.871, and 0.821, respectively .

    CONCLUSION: Modified OPUS HRQoL-M, Modified OPUS LEFS-M, and Modified OPUS CSDS-M are valid and reliable instruments to be adopted into the local Malaysia population.

  20. Hanafi MH, Kassim NK, Ibrahim AH, Adnan MM, Ahmad WMAW, Idris Z, et al.
    Malays J Med Sci, 2018 Mar;25(2):116-125.
    PMID: 30918461 MyJurnal DOI: 10.21315/mjms2018.25.2.12
    Background: Stroke is one of the leading causes of mortality and morbidity in Malaysia. Repetitive transcranial magnetic stimulation (rTMS) is one of the new non-invasive modality to enhance the motor recovery in stroke patients.

    Objectives: This pilot study compared the motor evoked potential (MEP) changes using different settings of rTMS in the post-ischemic stroke patient. The goal of the study is to identify effect sizes for a further trial and evaluate safety aspects.

    Methods: Eight post-stroke patients with upper limb hemiparesis for at least six months duration were studied in a tertiary hospital in Northeast Malaysia. Quasi experimental design was applied and the participants were randomised into two groups using software generated random numbers. One of the two settings: i) inhibitory setting, or ii) facilitatory setting have been applied randomly during the first meeting. The motor evoked potential (MEP) were recorded before and after application of the rTMS setting. A week later, a similar procedure will be repeated but using different setting than the first intervention. Each patient will serve as their own control. Repeated measures ANOVA test was applied to determine the effect sizes for both intervention through the options of partial eta-squared (η2p).

    Result: The study observed large effect sizes (η2p > 0.14) for both rTMS settings in the lesion and non-lesion sides. For safety aspects, no minor or major side effects associated with the rTMS was reported by the participants.

    Conclusions: The partial eta square of MEP value for both rTMS settings (fascilitatory and inhibitory) in both lesion and non-lesion sides represents large effect sizes. We recommend further trial to increase number of sample in order to study the effectiveness of both settings in ischemic stroke patient. Our preliminary data showed both settings may improve the MEP of the upper extremity in the ischemic stroke patient. No significant improvement noted when comparing both settings.

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