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A successful antenatal myomectomy

Shafiee M, Nor Azlin M, Arifuddin D

Malays Fam Physician, 2012;7(2-3):42-5.
PMID: 25606256 MyJurnal

Complications that may occur while performing myomectomy in pregnancy can be prevented in a well-optimised surgery. Counselling and comprehensive peri-operative preparations are mandatory to minimise litigations and untoward events. Myomectomy in pregnancy remains a contentious issue. Degeneration of fibroid during pregnancy is common. However, conservative management suffices in majority of cases. In non-responsive conservative treatment, myomectomy may be an option. This article discusses our experience in treating a 38-year-old woman in her fourth pregnancy at 15 weeks gestation with symptomatic uterine fibroid. She had persistent abdominal pain since nine weeks gestation. She developed fever and acute abdomenat at 15 weeks and the uterus was larger than dates.Ultrasound scan confirmed single pregnancy with a large intramural fibroid showing degenerative changes. A myomectomy was performed as a preventive measure to prevent massive haemorrhage. Although performing myomectomy during pregnancy is considered controversial, complications can be minimised with properly-planned surgery.
Fulltext Effects of passive joint mobilization on patients with knee osteoarthritis

Nor Azlin M, Lyn SK

Sains Malaysiana, 2011;40(12):1461-1465.

A controlled, single blinded experimental study was conducted to determine the effects of passive joint mobilization on pain and stairs ascending-descending time in subjects with knee osteoarthritis (OA knee). A total of 22 subjects aged 40 and above with mild and moderate OA knee were assigned to either passive knee mobilization plus conventional physiotherapy (experimental group) or conventional physiotherapy alone (control group). Both groups received 2 therapy sessions per week, for 4 weeks. A blinded assessor measured pain with Visual analogue scale and stairs ascending-descending time with Aggregated Locomotor Function test, at baseline and at week 4. There was a significant reduction in pain among subjects in the experimental group (18.07 mm, t = 3.48, p = 0.01) compared to the control group (6.66 mm, t = 0.44, p = 0.67). Non-significant clinical difference was found in stairs ascending-descending time between the two groups (i.e. 6.25s in the experimental group versus 6.78 s in the control group, F(1,10) = 0.70, p = 0.42). No significant correlation was found between pain score and stairs ascending-descending time, r = 0.34, p = 0.16. The addition of passive joint mobilization to conventional physiotherapy reduced pain but not stairs ascending-descending time among subjects with knee osteoarthritis.
Fulltext Bertolotti's syndrome: A commonly missed cause of back pain in young patients

Manmohan S, Dzulkarnain A, Nor Azlin ZA, Fazir M

Malays Fam Physician, 2015;10(2):55-8.
PMID: 27099663

Bertolotti's syndrome must be considered as a differential diagnosis for lower back pain in young people. Treatment, whether conservative or operative, is still debatable. In this paper, we report a case of a 20-year-old girl presenting with lower back pain for 8 years. We administered injection with local anaesthetic and steroid injections within the pseudo-articulation; however, the pain was relieved for 3 weeks. Surgical excision of the pseudo-articulation successfully treated her back pain and the sciatica.
Fulltext A dilemma in management of intrauterine death in mother with major placenta previa

Rima Anggrena, D., Yulianty, A., Nor Azlin, M.I.

Journal of Surgical Academia, 2017;7(2):43-45.
MyJurnal

Placenta previa is a condition when the placental tissue extends over the internal cervical os. It is associated with
maternal and fetal morbidity and mortality. With intrauterine death, the mode of delivery will be more difficult to
decide. Here, we report a case of 30 years old G3P2 with placenta previa major diagnosed with intrauterine death at
29 weeks gestation who was managed conservatively and delivered vaginally with minimal complication. A good
patient selection and thorough counseling, patient with placenta previa major and intrauterine death still can be safely
delivered vaginally.
Fulltext Low-glycaemic index diet to improve dietary intake among women with gestational diabetes mellitus

Nor Azlin, M.I., Zalilah, M.S., Farhanah, A.S., Barakatun Nisak, M.Y.

Pertanika Journal of Science & Technology, 2017;25(107):31-42.
MyJurnal

This study examines the effect of a low glycaemic index (LGI) intervention to improve dietary intake among women with Gestational Diabetes Mellitus (GDM). Women with GDM were randomised to receive either a low GI intervention (LGI; n = 20) or standard nutrition therapy (SNT; n = 20) for a 4-week period. Food Frequency Questionnaire (FFQ) and Three-Day Diet Record assessed the dietary intake and food choices. Dietary intake and food choices of the participants were comparable at baseline. At the end of the study, energy, protein, fat and carbohydrate were reduced in both groups (p < 0.05). In the LGI group, fibre and calcium intake was higher compared with SNT group. More participants in
the LGI group consumed rice from the low GI varieties, the whole grain breads and the low GI biscuits (p<0.05) compared with participants in the SNT group. The diet GI reduced significantly in the LGI group (50 ± 9 units) compared with the SNT group (57 ± 6) (p < 0.05). Findings showed low GI dietary intervention improved the dietary intake of women with GDM.
Keywords: Carbohydrate, dietary intake, Gestational Diabetes Mellitus, low glycaemic index
Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Fulltext Effects of therapy-based virtual reality on walking endurance and quality of life of persons with knee osteoarthritis

Mohd Naqiuddin Johar, Nor Azlin Mohd Nordin, Normala Mesbah

Jurnal Sains Kesihatan Malaysia, 2019;17(2):113-120.
MyJurnal

Despite being becoming popular and heavily used in rehabilitation, the evidence on the effectiveness of Virtual reality-based therapy (VRBT) among persons with knee osteoarthritis (OA) remains limited. The aim of this study was to determine the effects of VRBT on walking endurance and quality of life of older persons with knee OA in comparison to conventional exercise therapy. This was a randomised controlled trial involving 44 participants (mean age and standard deviation = 66.32 ± 5.73 years) who received either a VRBT (experimental group, n = 22) or a conventional exercise therapy (control group, n = 22) for 45 minutes, twice per week for 12 weeks. The outcome of both therapies on walking endurance was measured using Six-Minute Walk Test (6 MWT), while quality of life was assessed using the Malay-version of Short Form-36 (SF-36). Analysis was done by ‘intention-to-treat’ approach, using Mixed Model ANOVA. A significant time-effect (p < 0.05), with large effect size between 0.43 and 0.54 were found for all outcomes following the therapies. An increase of 17% and 19% of 6 MWT scores were obtained in experimental and control group, respectively. Meanwhile, the scores for the physical and mental components of the SF-36 increased by 37.8% and 19.4% in the experimental group, and 45.7% and 20.6% in the control group. However, no significant group and interaction effects were found for all outcomes (p > 0.05). In conclusion, VRBT is comparable with conventional exercise therapy in improving walking endurance and quality of life of persons with knee OA, and can be used as a therapy option for this population.
Fulltext Schoolbag weight, its content, and incidence of back pain in different medium primary schools in Kuala Lumpur

Nor Azlin M. N., Asfarina, Z., Wan Chee, L.

Malaysian Journal of Medicine and Health Sciences, 2010;6(2):59-64.
MyJurnal

Introduction: Schoolbag weight across different types of school and schoolbag content has not been
studied in Malaysia. This cross sectional survey determines the weight of schoolbags, its content and
occurrence of back pain among primary school children in different medium primary school in Kuala
Lumpur. Methods: Students’ body weight, and schoolbags weight were measured using a calibrated
scale. Schoolbag content was examined, and weighed according to necessary learning materials
or unnecessary materials. Back pain in the past one week was assessed using a self-administered
questionnaire, adapted from previous studies. Results: A total of 358 students (167 male, 191 female)
were enrolled, of which 119 were from National School (NS), 122 from Chinese Medium School (CMS)
and 117 from Tamil Medium School (TMS). The mean schoolbag weight was 4.55±1.62kg for NS,
8.53±1.94kg for CMS and 6.06±2.09kg for TMS, which was 11.7%, 22.0% and 16.6% of body weight,
respectively. The mean weight of unnecessary schoolbag content was 0.64(0.91)kg for NS, 2.18(1.49)kg for CMS and 1.96(1.56) for TMS students. Back pain was detected in 87.0% NS students, 68.0% CMS students and 66.7% TMS students. Significant association was found between occurrence of back pain and types of school ( 2=16.64,p=0.00). Conclusions: Students from all the three mediums primary school, in particular Chinese medium school carry school bag heavier than that generally recommended, with unnecessary materials weigh up to 2kg. The occurrence of back pain is high and this is associated with the types of school.
Fulltext Extrapelvic Endometriosis: A report of two cases

Nor Azlin, M.I., Amelia, A.Z., Zainul Rashid, M.R.

International Medical Journal Malaysia, 2006;5(1):1-4.
MyJurnal

Extrapelvic endometriosis is fairly rare and may occur in numerous sites throughout the body. Unnecessary investigation may be performed before the diagnosis could be made. Here we present two cases where endometriotic nodules occurred on a caesarean section scar and in the vagina. Further management is discussed in the report.
Fulltext Hospital-based pulmonary rehabilitation program is more effective than home-based pulmonary rehabilitation in improving the quality of life of chronic obstructive pulmonary disease (COPD) patients. [Program rehabilitasi pulmonari di hospital lebih berkesan daripada program rehabilitasi pulmonari di rumah dalam meningkatkan kualiti hidup pesakit obstruksi pulmonari kronik (COPD)]

Ayiesah Ramli, Nor Azlin Mohd Nordin, Asfarina Zanudin, Wong, Judy

Jurnal Sains Kesihatan Malaysia, 2009;7(2):47-58.
MyJurnal

This study identified the effectiveness between home-based and hospital-based pulmonary rehabilitation program on the quality of life of chronic obstructive pulmonary disease (COPD) patients. Thirty five patients who met the inclusion criteria were referred by physicians and randomized to either hospital-based pulmonary rehabilitation (PRPH) or home-based pulmonary rehabilitation (PRPR). The PRPH program was scheduled twice a week for eight weeks at the Physiotherapy Department, Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Whilst, the PRPR group was required to attend sessions at the Physiotherapy Department twice to learn the exercise regimens before carrying out the exercises themselves at home. Subjects were asked to record activitites in a diary and a telephone call was made once every two weeks to ensure compliance towards the exercise regimens. The SF-36 questionnaire and Geriatric Depression Scale were outcome measures used in assessing status of patients prior to treatment and after intervention at the 8th week Seventeen (48.6%) subjects completed the PRPH and 15 (43%), the PRPR. Results indicated that in the PRPH group there were significant improvements in some of the domains of SF-36, i.e., role physical (p = 0.012) body pain (p = 0.040), general health (p = 0.008) and role emotional (p = 0.012). In the PRPR group, the Geriatric Depression Scale mean score was 1.8 ± 0.41 at baseline compared to 1.69 ± 0.48 following intervention (p > 0.05). Whilst, among the PRPH group, the mean was 1.87 ± 0.35 at baseline and 1.53 ± 0.52 after eight week (p < 0.05). In conclusion, hospital-based pulmonary rehabilitation is more effective than the home-based pulmonary rehabilitation in improving the quality of life and reducing depression among patients with COPD.
Keywords: Home Based Pulmonary Rehabilitation Program (PRPR); Hospital based Pulmonary Rehabilitation Program (PRPH); COPD; Quality of life (QOL).
Fulltext The function of median sensory nerve fibres and the relationship between its function with the duration of carpal tunnel syndrome and body mass index. [Kefungsian saraf sensori median dan hubungannya dengan tempoh carpal tunnel syndrome dan indeks jisim tubuh]

Nor Azura Azmi, Nor Azlin Mohd. Nordin, Nor Azila Noh

Jurnal Sains Kesihatan Malaysia, 2009;7(2):29-38.
MyJurnal

The study evaluated the function of median sensory nerve fibers, as well as determining the relationship between its function with the duration of Carpal Tunnel Syndrome (CTS) and body mass index (BMI) among CTS patients in Physiotherapy Unit, Universiti Kebangsaan Malaysia Hospital (HUKM). Thirty subjects (6 males and 24 females) with mean age 53.30 +/- 9.20 years and duration of the CTS 51.17 +/- 50.22 months participated in this study. The sensitivity of median sensory nerve was evaluated using Current Perception Threshold (CPT) Test with stimulation frequencies of 5 Hz, 250 Hz and 2000 Hz; which demonstrated the function of C, A-delta and A-beta nerve fiber respectively. Majority of the CTS patients had normal function in the 3 types of median sensory nerve fiber. Forty percents of the subjects had abnormality in the Aa function, 7% had abnormality of the A-beta function and 27% demonstrated abnormality in the C fiber function. Spearman Correlation Test showed no significant relationship between the function of median sensory nerve and the duration of CTS and body mass index (BMI) (p > 0.05). In conclusion, although majority of the patients demonstrated normal median sensory nerve function, abnormality of the A-beta, A-delta and C fibers sensitivity in some patients requires attention to prevent worsening of the nerve function thus avoiding related complications. Physiotherapists in HUKM may intensify the use of nerve stimulating modalities such as Transcutaneous Electrical Nerve Stimulation (TENS) to normalize the nerve functions of these patients.
Keywords: Carpal Tunnel Syndrome; Current perception threshold; Median sensory nerve sensitivity; Body mass index
Study site: Physiotherapy Unit, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Fulltext Feasibility and Effectiveness of Game-Based Circuit Exercise Therapy among Stroke Survivors: A Pilot Study in Kelantan, Malaysia

MOHD NAQIUDDIN JOHAR, NOR AZLIN MOHD NORDIN, YUSLIZA AZREEN

Buletin Sains Kesihatan, 2021;5(1):21-29.
MyJurnal

Circuit exercise therapy is being frequently used as a therapy option for stroke patients undergoing rehabilitation. However, the effectiveness of this therapy in improving post-stroke functionality remains limited. There is also a need to improvise the content of the existing circuit exercise therapy to further enhance the process of neuroplasticity towards the attainment of greater recovery. One strategy for this is to integrate the element of games into the exercise therapy to create a more enriched training environment during the exercise session. This study aimed to determine the feasibility and effectiveness of a game-based circuit exercise therapy among stroke survivors. This was a pilot experimental study involving 30 stroke patients at post-acute phase post-onset (mean age and standard deviation = 58.9 ± 6.6 years; mean Montreal Cognitive Assessment score = 23.4 ± 7.1) and conducted in a district of Kelantan, Malaysia. Simple random sampling method was used in recruiting the study participants. All participants undergone game-based circuit exercise therapy using a game board named “Checkercise” for 45 minutes, twice per week for 8 weeks. The feasibility of the therapy was measured in term of attrition rate, occurrence of adverse effects and feedbacks from the participants. While its effectiveness on post-stroke physical function were assessed with regards to improvement in functional stability and cardiovascular endurance, using Dynamic Gait Index (DGI) and 6-minute Walk Test, respectively. All data were analyzed using the paired samples t test, with the level of significance, p set at < 0.05. Study results shown low attrition rate, no apparent adverse effect, and positive feedbacks from the participants. Improvement in the participants’ mean score for DGI and 6-minute walk test by 7% and 23% respectively (p < 0.05), and medium effect size (Cohen’s d= 0.5 - 0.6) was obtained post-therapy. In conclusion, game-based circuit exercise therapy is feasible and beneficial for stroke survivors. The therapy can potentially be used as a therapy option for this population. A larger study is needed to confirm this study finding.
Fulltext Complete Recovery of Thoracic Myelopathy after Eleven Months of Paraplegia: A Case Report

Manmohan S, Nor Azlin ZA, Fazir M, Dzulkarnain A, Goh JH

Malays Orthop J, 2015 Mar;9(1):32-34.
PMID: 28435594 MyJurnal DOI: 10.5704/MOJ.1503.004

Instances of neurological recovery after early decompression of the spine in non-traumatic spinal cord compression are well documented. We present a patient with paraplegia of 11 months' duration due to atypical spinal tuberculosis who showed complete neurological recovery in three months.
Detection of foetal anomaly in advanced maternal age

Vijayaletchumi T, Shuhaila A, Abdul Manaf MR, Nor Azlin MI

Med J Malaysia, 2021 Nov;76(6):833-836.
PMID: 34806669

OBJECTIVE: The aim of this study was to assess the prevalence of foetal anomaly diagnosed during a detailed ultrasonography amongst patients of advanced maternal age (AMA) and to identify the related anomalies in these age groups.
METHOD: A retrospective observational study amongst AMA mothers was done in Universiti Kebangsaan Malaysia Medical Centre, a Malaysian teaching hospital. The data over a period of three years (January 2013 - December 2016) obtained from the Maternal Foetal Medicine clinic registry was analysed. AMA mothers with singleton pregnancy presenting for foetal structural anomaly scan was included. They were later subdivided into 2 groups (35-39 years and ≥ 40 years). The logistic regression analysis was used to analyse the association of the chromosomal anomalies and the age groups.
RESULTS: In all 486 patients were recruited and 84 patients were identified with foetal anomaly (17.3%). There was no significant difference in the prevalence of foetal anomalies or significant association with a specific structural foetal anomaly identified (p>0.05). However, the number of followups for these patients are significantly higher (p<0.001).
CONCLUSION: The prevalence of structural foetal anomalies identified in detailed ultrasonography was low in AMA mothers. Hence, referral criteria for detailed anomaly ultrasonography need to be re-looked.
Fulltext Serum soluble FMS-like tyrosine kinase 1 and placental growth factor concentration as predictors of preeclampsia in high risk pregnant women

Hanita O, Alia NN, Zaleha AM, Nor Azlin MI

Malays J Pathol, 2014 Apr;36(1):19-26.
PMID: 24763231 MyJurnal

Soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) contribute in the development of preeclampsia and are suggested as prediction markers in healthy pregnant women but limited data is available in women with major preeclampsia risk factors. This study aimed to determine the role of sFlt-1 and PlGF in predicting preeclampsia among high risk pregnant women. This was a prospective study and samples were collected for a period of ten months. Blood samples were obtained from 84 pregnant women who had at least one risk factor for preeclampsia at 25 to 28 weeks and at 29 to 36 weeks of gestation. SFlt-1 and PlGF concentrations were determined by immunoassay method. There were significantly higher median sFlt-1 and sFlt-1:PlGF ratio at gestational interval 25 to 28 weeks and sFlt-1:PlGF ratio at 29 to 36 weeks in high risk women who developed preeclampsia. Significant lower median serum PlGF levels at 25 to 28 weeks and 29 to 36 weeks were observed in this group of women. In conclusion, the concentrations of these markers were altered in high risk preeclamptic women, a similar pattern seen in low risk preeclamptic women. However the predictive value of these markers could not be established clearly.
Fulltext Direct medical cost of stroke: findings from a tertiary hospital in malaysia

Nor Azlin MN, Syed Aljunid SJ, Noor Azahz A, Amrizal MN, Saperi S

Med J Malaysia, 2012 Oct;67(5):473-7.
PMID: 23770861 MyJurnal

This study aimed to estimate cost of in-patient medical care due to stroke in a tertiary hospital in Malaysia. A retrospective analysis of stroke patients admitted to Universiti Kebangsaan Malaysia Medical Centre (UKMMC) between January 2005 and December 2008 were conducted. Cost evaluation was undertaken from the health provider's perspective using a top-down costing approach. Mean length of stay (LOS) was 6.4 ± 3.1 days and mean cost of care per patient per admission was MYR 3,696.40 ± 1,842.17 or 16% of per capita GDP of the country. Human resources made up the highest cost component (MYR 1,343.90, SD: 669.8 or 36% of the total cost), followed by medications (MYR 867.30, SD:432.40) and laboratory services (MYR 337.90, SD:168.40). LOS and cost of care varied across different stroke severity levels (p<0.01). A regression analysis shown significant influence of stroke severity on cost of care, with the most severe stroke consumed MYR 1,598.10 higher cost than the mild stroke (p<0.001). Cost of medical care during hospital admission due to stroke is substantial. Health promotion and primary prevention activities need to take priority to minimise stroke admission in future.
Fulltext Psychometric properties of quality of life questionnaires for patients with breast cancer-related lymphedema: A protocol for a systematic review

Meilani E, Zanudin A, Nordin NAM

Medicine (Baltimore), 2020 Dec 24;99(52):e23897.
PMID: 33350786 DOI: 10.1097/MD.0000000000023897

BACKGROUND: Breast-cancer related lymphedema (BCRL) is a common condition among breast cancer survivors that could impact the quality of life (QoL) of patients. Exploring the QoL of the patients with BCRL using valid and reliable QoL is crucial to capture the status of this important aspect hence appropriate intervention could be implement to patient. However, so far no scientific review is available, which reports the psychometric properties of the QoL questionnaires used in BCRL. The purpose of this systematic review is to comprehensively assess the psychometric properties of QoL questionnaires in patients with BCRL.
METHODS: We will perform comprehensive searches of published studies in electronic databases such as Medline (via Ovid), EBSCOhost, PubMed, Scopus, and Web of Science by using the following search terms: "quality of life"; "breast cancer"; "upper limb"; "lymphedema"; "questionnaire"; and "measurement properties." Only full-text articles in English language are included. Two reviewers will independently conduct the article selection, data extraction, and quality assessment. Any possible conflict between the 2 reviewers is going to be solved with the help of a third reviewer. The Consensus-based Standards for the Selection of Health Measurement Instrument (COSMIN) checklist and manual will be used to assess the selected study quality.
RESULTS: This review will provide an updated overview of available lymphedema-specific questionnaires used in BCRL population and then recommend the most valid and reliable QoL questionnaire for clinical and research use in patients with BCRL.
CONCLUSION: This review may help the clinician and researcher to find an updated overview of various questionnaires used to assess BCRL patients' QoL.
ETHICS AND DISSEMINATION: This review will use data from published studies. Therefore, ethical approval is not required prior to this review. The results of this review will be published in a peer-reviewed journal or presented at conferences.
STUDY REGISTRATION: OSF osf.io/8xwym.
Psychometric Evaluation of the Bahasa Malaysia Version of the Lymphedema Functioning, Disability, and Health Questionnaire for Upper Limb Lymphedema in Patients with Breast Cancer-Related Lymphedema

Meilani E, Zanudin A, Nordin NAM

Lymphat Res Biol, 2024 Apr 12.
PMID: 38608242 DOI: 10.1089/lrb.2023.0045

Background: Breast cancer-related lymphedema (BCRL) is the most prevalent comorbidity that occurs following breast cancer treatments and has negative impact on the patients' quality of life (QoL). The Lymphedema Functioning, Disability, and Health Questionnaire for Upper Limb Lymphedema (Lymph-ICF-UL) is a valid and reliable instrument in assessing the QoL of patients with BCRL. However, the Bahasa Malaysia (BM) version is not available yet. This study aimed to translate the Lymph-ICF-UL into BM and to evaluate its validity and reliability. Methods and Results: A forward-backward translation was performed based on Sousa's guideline, and then, the face, content, construct validity, internal consistency, and test-retest reliability were tested. Face validity was assessed by five patients, and content validity was evaluated by six experts. Then, construct validity and internal validity were assessed in 107 patients. Finally, test-retest reliability was analyzed in 21 patients. Two items were eliminated following suggestions from the patients and experts. All patients found the scoring system and items clear and relevant. The results showed sufficient content validity index and modified kappa statistics value. Confirmatory factor analysis showed acceptable fit indices. Cronbach's alpha values ranged from 0.67 to 0.95, intraclass correlation coefficient ranged from 0.88 to 0.99, standard error measurement was 2.29-6.15, and the Bland-Altman plot showed an agreement between two test occasions. Conclusion: These results suggested that the Lymph-ICF-UL BM has good validity and reliability in evaluating the QoL of patients with BCRL in Malaysia.
Fulltext Early second trimester hCG of maternal serum as predictor marker for pregnancy induced hypertension

Munirah, M., Khalidah, M.B., Dian Nasriana, N., Hanita, O., Nor Azlin, M.I.

Medicine & Health, 2018;13(1):143-152.
MyJurnal

Pregnancy induced hypertension (PIH) is commonly encountered in hypertensive disease in pregnancy (HDP) and important cause of feto-maternal morbidity and mortality. Abnormal changes of placenta development in PIH leads to abnormal elevation of second trimester maternal hCG level. Thus, it may have a role in prediction of PIH. The objective of this study was to evaluate the ability of serum hCG levels during early second trimester to predict PIH and obstetric outcome at later gestation. We conducted a cohort study which comprised 34 pregnant women varying from 14–20 weeks of gestation with serum hCG level taken at points of recruitment. Serum hCG was measured by a chemiluminescent immunoassay. Three (8.8%) pregnant women developed late onset PIH while the remainder were normotensive. The diagnostic performance of second trimester hCG in predicting PIH as assessed by receiver operator characteristic curve was poor (AUC = 0.398). Multiple of median (MoM) were used to improve the hCG performance and MoM of >2 MoM were considered as elevated hCG level. All pregnancies with PIH had 0.655). There was no significant association of hCG level and pregnancy outcome. In conclusion, estimation of second trimester hCG is a poor predictive marker for PIH. These findings are limited by the less number of hypertensive cases
Fulltext Outcomes of chair based exercise with progressive resistance training on physical performances among older adults: a preliminary study

Nor Afifi Razaob, Ain Efahera Ahmad Tajuddin, Nor Azlin Mohd Nordin, Nor Najwatul Akmal Ab Rahman

Jurnal Sains Kesihatan Malaysia, 2018;16(101):165-170.
MyJurnal

Enhancement of physical function had been shown in older adults who actively participate in physical activities, particularly in the form of aerobic training with addition of progressive resistance training (PRT). However, it is quite challenging and risky for most older adults to exercise in standing position without any support. Chair Based Exercise (CBE) is an alternative mode of exercise for older adult to facilitate exercise participation and increase safety. Its effect when combined with resistance training is unknown to date. Therefore, the aim of this study was to evaluate the outcome of CBE with PRT on physical performances among older adults. A total of 18 older adults (13 females (72%)) and 5 males (28%)), aged 60 to 83 years with mean age (SD) 72.67 (6.17) years completed the study. All subjects performed CBE with PRT intervention twice weekly for 8 weeks, with individually-tailored exercise progressions. Pre and post measurements of physical performance were performed using Six MinutesWalk Test (6MWT), Five Times Sit to Stand (FTSTS) and Hand Grip Strength (HGS) test. Significant improvement in 6MWT (p < .001), HGS Right hand (p = .043), HGS Left hand (p < .001), FTSTS (p < .001) was shown after the eight-week intervention. Adding PRT into seated exercises results in further improvement in physical performance of older adults. CBE-PRT may be recommended as an exercise routine for older adults living in the community.
Fulltext Does neurophobia exist among rehabilitation sciences students? a survey at Universiti Kebangsaan Malaysia

Nor Azlin Mohd Nordin, Nur Amirah Ishak, Nor Azura Azmi, Chai Siaw Chui, Fatimah Hani Hassan

Jurnal Sains Kesihatan Malaysia, 2018;16(101):203-209.
MyJurnal

Neurophobia, defined as ‘the fear of neural sciences and neurology’ is reported among medical students, which threatened their performance in neurology course. This phenomenon has not been studied among rehabilitation sciences students despite the significance of neurology as an area for rehabilitation. In this study we aim to assess the perceptions of neurology course and the possibility of neurophobia existence among rehabilitation sciences students of Universiti Kebangsaan Malaysia (UKM). We also aimed to identify learning methods which are regarded as useful among the students. A survey using self-administered questionnaires was conducted among 73 students from School of Rehabilitation Sciences of the university. Questions in the questionnaire were adapted from previous studies, in which neurophobia was indicated by poor knowledge and low confidence level in managing neurology course. Results showed that the percentage of participants who perceived having good knowledge of neurology was significantly higher than the percentage who claimed of having poor knowledge level (90.4% versus 9.6%, p < 0.01). Similarly, the percentage of participants who claimed having high confidence to handle neurology cases was higher than the percentage who expressed lack of confidence (79.2% versus 20.8%, p = 0.03). However, neurology course was perceived as difficult by majority of the participants (78.1%) when compared to other courses. Majority of the participants (97.3%) perceived clinical teaching as a useful method of learning rehabilitation science courses including neurology followed by problem-based learning (90.4%). While limited exposure to neurology cases was claimed as the main reason to why neurology is difficult. In conclusion, although neurology is perceived as a difficult course among rehabilitation sciences students, the students did not report lack of knowledge and confidence in the course. This implies that neurophobia does not exist among UKM rehabilitation students. Enhancement of learning methods may assist in reducing the level of difficulty of neurology course among the students.

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