Displaying publications 1 - 20 of 25 in total

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  1. Muhamad Z, Ramli A, Amat S
    Sultan Qaboos Univ Med J, 2015 May;15(2):e266-74.
    PMID: 26052461
    OBJECTIVES: The aim of this study was to determine the content validity, internal consistency, test-retest reliability and inter-rater reliability of the Clinical Competency Evaluation Instrument (CCEVI) in assessing the clinical performance of physiotherapy students.
    METHODS: This study was carried out between June and September 2013 at University Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia. A panel of 10 experts were identified to establish content validity by evaluating and rating each of the items used in the CCEVI with regards to their relevance in measuring students' clinical competency. A total of 50 UKM undergraduate physiotherapy students were assessed throughout their clinical placement to determine the construct validity of these items. The instrument's reliability was determined through a cross-sectional study involving a clinical performance assessment of 14 final-year undergraduate physiotherapy students.
    RESULTS: The content validity index of the entire CCEVI was 0.91, while the proportion of agreement on the content validity indices ranged from 0.83-1.00. The CCEVI construct validity was established with factor loading of ≥0.6, while internal consistency (Cronbach's alpha) overall was 0.97. Test-retest reliability of the CCEVI was confirmed with a Pearson's correlation range of 0.91-0.97 and an intraclass coefficient correlation range of 0.95-0.98. Inter-rater reliability of the CCEVI domains ranged from 0.59 to 0.97 on initial and subsequent assessments.
    CONCLUSION: This pilot study confirmed the content validity of the CCEVI. It showed high internal consistency, thereby providing evidence that the CCEVI has moderate to excellent inter-rater reliability. However, additional refinement in the wording of the CCEVI items, particularly in the domains of safety and documentation, is recommended to further improve the validity and reliability of the instrument.
    KEYWORDS: Clinical Competence; Malaysia; Physiotherapy Speciality; Validity and Reliability
  2. Ariff MAM, Ros MIAC, Yahaya NHM
    Sultan Qaboos Univ Med J, 2018 Feb;18(1):e97-e99.
    PMID: 29666689 DOI: 10.18295/squmj.2018.18.01.016
    Pes anserine bursitis (PAB) is an inflammation of the bursa located between the medial aspect of the tibia and the hamstring muscles. It is common in patients with degenerative or inflammatory knee arthritis, usually has a self-limiting course and tends to respond well to conservative treatment. However, painful PAB directly following total knee replacement surgery is rare. We report two such cases who were diagnosed via ultrasonography at the Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia, in 2015. Both patients were treated locally with triamcinolone acetonide under ultrasound guidance and responded well to treatment.
  3. Hoe HG, Zaki FM, Rashid AHA
    Sultan Qaboos Univ Med J, 2018 Feb;18(1):e93-e96.
    PMID: 29666688 DOI: 10.18295/squmj.2018.18.01.015
    Synovial haemangiomas are rare benign vascular proliferations arising in synovium-lined surfaces. While the knee is by far the joint most commonly involved, this condition can also occur in the elbow. We report an eight-year-old boy who presented to the National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia, in 2016 with a left elbow swelling of one year's duration. Magnetic resonance imaging showed a lobulated intra-articular mass with intermediate signal intensity on T1-weighted imaging and low signal punctate and linear structures within the hyperintense mass on T2-weighted imaging. In addition, there was heterogeneous yet avid contrast enhancement on post-gadolinium contrast images. The mass had juxta-articular extension and bony erosion to the coronoid process and the head of the radius. Synovial haemangiomas present a diagnostic dilemma. This report highlights certain imaging characteristics to distinguish this entity from other differential diagnoses.
  4. Iqhbal M, Noor JM, Karim NA, Ismail I, Sanib H, Mokhtar MA, et al.
    Sultan Qaboos Univ Med J, 2018 May;18(2):e219-e222.
    PMID: 30210855 DOI: 10.18295/squmj.2018.18.02.017
    The use of ultrasonography in acute and critical care medicine is becoming increasingly common. However, use of an airway ultrasound as an adjunct to determine the type of intervention needed and assess complications is not common practice. We report a 56-year-old male who presented to the Emergency Department of the Sungai Buloh Hospital, Selangor, Malaysia, in 2015 with hoarseness, stridor and impending respiratory failure. A point-of-care ultrasound performed to assess the neck and vocal cords indicated a heterogeneous echogenic mass in the larynx, thus ruling out a cricothyroidotomy. The patient was therefore referred for an emergency tracheostomy. This case highlights the importance of point-of-care airway ultrasonography in the assessment of patients with stridor. This imaging technique not only helps to detect the cause of the stridor, but also to determine the feasibility of a cricothyroidotomy in emergency cases.
  5. Hamid ZA, Tan HY, Chow PW, Harto KAW, Chan CY, Mohamed J
    Sultan Qaboos Univ Med J, 2018 May;18(2):e130-e136.
    PMID: 30210840 DOI: 10.18295/squmj.2018.18.02.002
    Objectives: The ex vivo maintenance of haematopoietic stem/progenitor cells (HSPCs) is crucial to ensure a sufficient supply of functional cells for research or therapeutic applications. However, when exposed to reactive oxygen species (ROS) in a normoxic microenvironment, HSPCs exhibit genomic instability which may diminish their quantity and quality. This study aimed to investigate the role of N-acetylcysteine (NAC) supplementation on the oxidative stress levels, genotoxicity and lineage commitment potential of murine haematopoietic stem/progenitor cells (HSPCs).

    Methods: This study was carried out at the Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia, between June 2016 and July 2017. Bone marrow cells were isolated from nine mice and cultured in a growth medium. Various concentrations of NAC between 0.125-2 μM were added to the culture for 48 hours; these cells were then compared to non-supplemented cells harvested from the remaining three mice as the control group. A trypan blue exclusion test was performed to determine cell viability, while intracellular ROS levels and genotoxicity were determined by hydroethidine staining and comet assay, respectively. The lineage commitment potential of erythroid, myeloid and pre-B-lymphoid progenitor cells was evaluated via colony-forming cell assay.

    Results: NAC supplementation at 0.25, 0.5 and 2 μM significantly increased cell viability (P <0.050), while intracellular ROS levels significantly decreased at 0.25 and 0.5 μM (P <0.050). Moreover, DNA damage was significantly reduced at all NAC concentrations (P <0.050). Finally, the potential lineage commitment of the cells was not significantly affected by NAC supplementation (P >0.050).

    Conclusion: The findings of this study indicate that NAC supplementation may potentially overcome the therapeutic limitations of ex vivo-maintained HSPCs.

  6. Khan MJ, Chelliah S, Haron MS, Ahmed S
    Sultan Qaboos Univ Med J, 2017 Feb;17(1):e11-e17.
    PMID: 28417022 DOI: 10.18295/squmj.2016.17.01.003
    Travel motivations, perceived risks and travel constraints, along with the attributes and characteristics of medical tourism destinations, are important issues in medical tourism. Although the importance of these factors is already known, a comprehensive theoretical model of the decision-making process of medical tourists has yet to be established, analysing the intricate relationships between the different variables involved. This article examines a large body of literature on both medical and conventional tourism in order to propose a comprehensive theoretical framework of medical tourism decision-making. Many facets of this complex phenomenon require further empirical investigation.
  7. Jawi ZM, Deros BM, Rashid AAA, Isa MHM, Awang A
    Sultan Qaboos Univ Med J, 2017 Aug;17(3):e277-e285.
    PMID: 29062549 DOI: 10.18295/squmj.2017.17.03.004
    This review article aimed to analyse existing literature regarding the roles and performance of professional driving instructors (PDIs) in novice driver education (DE). A systematic classification scheme was adopted to analyse identified articles to determine the study context of PDIs in novice DE, the competency level of PDIs in relation to experienced and learner drivers and the contributions of PDIs to the novice driver learning process. A total of 14 original research articles were identified, with no systematic reviews or meta-analyses available. Overall, all of the articles were found to be inadequate in providing an in-depth understanding of the roles and performance of PDIs in novice DE. There is an urgent need to improve current understanding of the roles of PDIs in novice DE and to work towards an internationally recognised PDI management approach.
  8. Tan HH, Tan SK, Shunmugan R, Zakaria R, Zahari Z
    Sultan Qaboos Univ Med J, 2017 Nov;17(4):e455-e459.
    PMID: 29372089 DOI: 10.18295/squmj.2017.17.04.013
    Persistent urogenital sinus (PUGS) is a rare anomaly whereby the urinary and genital tracts fail to separate during embryonic development. We report a three-year-old female child who was referred to the Sabah Women & Children Hospital, Sabah, Malaysia, in 2016 with a pelvic mass. She had been born prematurely at 36 gestational weeks via spontaneous vaginal delivery in 2013 and initially misdiagnosed with neurogenic bladder dysfunction. The external genitalia appeared normal and an initial sonogram and repeat micturating cystourethrograms did not indicate any urogenital anomalies. She therefore underwent clean intermittent catheterisation. Three years later, the diagnosis was corrected following the investigation of a persistent cystic mass posterior to the bladder. At this time, a clinical examination of the perineum showed a single opening into the introitus. Magnetic resonance imaging of the pelvis revealed gross hydrocolpos and a genitogram confirmed a diagnosis of PUGS, for which the patient underwent surgical separation of the urinary and genital tracts.
  9. Lee CY, Osman SS, Noor HM, Isa NSA
    Sultan Qaboos Univ Med J, 2018 Nov;18(4):e541-e544.
    PMID: 30988978 DOI: 10.18295/squmj.2018.18.04.020
    A congenital pulmonary airway malformation (CPAM) is a rare cystic anomaly that may occur during development of the fetal airways. The vast majority of CPAMs are detected in neonates; as such, it is unusual for diagnosis to occur in adulthood. We report a 21-year-old male patient who presented to the emergency department of the Hospital Ampang, Kuala Lumpur, Malaysia, in 2015 with chest pain, breathlessness and tachypnoea. Based on an initial chest X-ray, the patient was misdiagnosed with pneumothorax and underwent urgent chest tube insertion; however, his condition deteriorated over the course of the next three days. Further imaging was suggestive of infected bullae or an undiagnosed CPAM. The patient therefore underwent video-assisted thoracoscopic surgery, during which a large infected bulla was resected. A diagnosis of an infected CPAM was confirmed by histopathological examination. Following the surgery, the patient recovered quickly and no bullae remnants were found at a one-month follow-up.
  10. Yap FB
    Sultan Qaboos Univ Med J, 2018 Nov;18(4):e520-e523.
    PMID: 30988973 DOI: 10.18295/squmj.2018.18.04.015
    Objectives: This study aimed to investigate the off-label use of a combination calcipotriol plus betamethasone dipropionate (CBD) gel in the treatment of moderate-to-severe scalp seborrhoeic dermatitis (SSD).

    Methods: This retrospective study involved 32 patients with SSD who were prescribed CBD gel at the Subang Jaya Medical Centre, Selangor, Malaysia, between January 2016 and December 2017. The Physician Global Assessment Scale was used to assess disease severity. Itching/discomfort was evaluated using a visual analogue scale.

    Results: The mean age was 35.8 ± 6.9 years. Severe disease was seen in 53.1%. Complete clearance was recorded in 15.6%, 40.6% and 59.4% of patients at weeks two, six and 10, respectively. By week 10, 87.5% had achieved marked improvement. Both mean itching and discomfort scores significantly improved at weeks two, six and 10 (P <0.001). Better outcomes were significantly associated with disease duration and itching intensity and discomfort at presentation (P <0.050).

    Conclusion: CBD gel should be considered as an option for SSD cases not adequately controlled by prior conventional treatment.

  11. Mohamed NF, Ghazali SR, Yaacob NA, Rahim AAA, Maskon O
    Sultan Qaboos Univ Med J, 2018 Nov;18(4):e494-e500.
    PMID: 30988969 DOI: 10.18295/squmj.2018.18.04.011
    Objectives: Heart failure (HF) is a common clinical syndrome with an enormous impact on prognosis and lifestyle. Accordingly, rehabilitation measures need to be patient-specific and consider various sociocultural factors so as to improve the patient's quality of life (QOL). This study aimed to develop and validate a HF-specific QOL (HFQOL) questionnaire within a multicultural setting.

    Methods: This study took place at the National Heart Institute and Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia, between March 2013 and March 2014. A self-administered 75-item HFQOL questionnaire was designed and administrated to 164 multi-ethnic Malaysian HF patients. Exploratory factor analysis was performed to assess the instrument's construct validity. Cronbach's alpha coefficients were used to determine internal consistency.

    Results: A total of 33 out of 75 items were retained in the final tool. The HFQOL questionnaire had three common factors-psychological, physical-social and spiritual wellbeing-resulting in a cumulative percentage of total variance of 44.3%. The factor loading ranges were 0.450-0.718 for psychological wellbeing (12 items), 0.394-0.740 for physical-social wellbeing (14 items) and 0.449-0.727 for spiritual wellbeing (seven items). The overall Cronbach's alpha coefficient of the questionnaire was 0.82, with coefficients of 0.86, 0.88 and 0.79 for the psychological, physical-social and spiritual wellbeing subdomains, respectively.

    Conclusion: The HFQOL questionnaire was found to be a valid and reliable measure of QOL among Malaysian HF patients from various ethnic groups. Such tools may facilitate cardiac care management planning among multi-ethnic patients with HF.

  12. Tan SK, Sanmugam A, Danaee M, Ramanujam TM, Nallusamy MA, Zahari Z, et al.
    Sultan Qaboos Univ Med J, 2019 Nov;19(4):e352-e358.
    PMID: 31897319 DOI: 10.18295/squmj.2019.19.04.011
    Objectives: Transition of care (TOC) from paediatric to adult care is still at an early stage in Malaysia. This study aimed to explore current practices and perspectives regarding TOC among paediatric surgeons in Malaysia.

    Methods: This study was carried out between June and December 2017. All 48 paediatric surgeons currently working in Malaysia were invited to participate in a questionnaire-based survey to assess demographic characteristics and practices and perspectives regarding TOC.

    Results: A total of 38 paediatric surgeons participated in the survey (response rate: 79.2%). Overall, 97.4% did not have an organised TOC model in their institution, with most (65.8%) caring for paediatric patients with complex surgical conditions until adulthood. Although the majority (86.8%) felt that care should be transitioned to adult surgeons with appropriate credentials, most surgeons (84.2%) nevertheless preferred to be involved in the management of adolescent patients after transition. However, there was no consensus regarding the most suitable age to begin the transition. Years of experience as a paediatric surgeon and place of practice did not affect overall TOC practice scores (P >0.050 each). The presence of adult comorbidities was considered the most common reason to initiate TOC (81.6%), while the lack of TOC guidelines was perceived to be the greatest barrier (84.2%).

    Conclusion: This study provides a better understanding of TOC from the point of view of paediatric surgeons in Malaysia. However, further studies involving other stakeholders (i.e. patients and adult surgeons) are needed to help formulate a suitable and successful TOC model in this setting.

  13. Nurumal MS, Diyono NQH, Che Hasan MK
    Sultan Qaboos Univ Med J, 2020 Nov;20(4):e374-e379.
    PMID: 33414944 DOI: 10.18295/squmj.2020.20.04.015
    Objectives: Self-efficacy is an important factor in determining the ability of students to execute tasks or skills needed in the implementation of interprofessional learning (IPL). This study aimed to identify levels of self-efficacy with regards to IPL skills among undergraduate healthcare students and to investigate differences according to gender, programme of study and year of study.

    Methods: This descriptive cross-sectional study was conducted between January and March 2018 at the International Islamic University Malaysia, Kuantan, Malaysia. The Self-Efficacy for Interprofessional Experiential Learning scale was used to evaluate the self-efficacy of 336 students from five faculties including nursing, medicine, dentistry, pharmacy and allied health sciences.

    Results: Significant differences in self-efficacy scores for the interprofessional interaction subscale were identified according to programme of study, with pharmacy students scoring significantly lower than allied health students (mean score: 54.1 ± 10.4 versus 57.4 ± 10.1; P = 0.014). In addition, there was a significant difference in self-efficacy scores for the interprofessional interaction subscale according to year of study, with first-year students scoring significantly lower compared to fifth-year students (mean score: 52.8 ± 10.4 versus 59.9 ± 11.9; P = 0.018). No statistically significant differences in self-efficacy scores were identified with regards to gender or for the interprofessional team evaluation and feedback subscale.

    Conclusion: These findings may contribute to the effective implementation of IPL education in healthcare faculties. Acknowledging the influence of self-efficacy on the execution of IPL skills is crucial to ensure healthcare students are able to adequately prepare for future interprofessional collaboration in real clinical settings.

  14. Mohamed J, Nazratun Nafizah AH, Zariyantey AH, Budin SB
    Sultan Qaboos Univ Med J, 2016 May;16(2):e132-41.
    PMID: 27226903 DOI: 10.18295/squmj.2016.16.02.002
    Diabetes mellitus is a non-communicable disease that occurs in both developed and developing countries. This metabolic disease affects all systems in the body, including the liver. Hyperglycaemia, mainly caused by insulin resistance, affects the metabolism of lipids, carbohydrates and proteins and can lead to non-alcoholic fatty liver disease, which can further progress to non-alcoholic steatohepatitis, cirrhosis and, finally, hepatocellular carcinomas. The underlying mechanism of diabetes that contributes to liver damage is the combination of increased oxidative stress and an aberrant inflammatory response; this activates the transcription of pro-apoptotic genes and damages hepatocytes. Significant involvement of pro-inflammatory cytokines-including interleukin (IL)-1β, IL-6 and tumour necrosis factor-α-exacerbates the accumulation of oxidative damage products in the liver, such as malondialdehyde, fluorescent pigments and conjugated dienes. This review summarises the biochemical, histological and macromolecular changes that contribute to oxidative liver damage among diabetic individuals.
  15. Ismail S, Shamsuddin K, Latiff KA, Saad HA, Majid LA, Othman FM
    Sultan Qaboos Univ Med J, 2015 Feb;15(1):e98-e104.
    PMID: 25685394
    OBJECTIVES: This study aimed to examine the effectiveness of an Islamic voluntary fasting intervention to control post-Ramadan weight gain.

    METHODS: This study was conducted between July and November 2011. Two weight loss intervention programmes were developed and implemented among groups of overweight or obese Malay women living in the Malaysian cities of Putrajaya and Seremban: a standard programme promoting control of food intake according to national dietary guidelines (group B) and a faith-based programme promoting voluntary fasting in addition to the standard programme (group A). Participants' dietary practices (i.e., voluntary fasting practices, frequency of fruit/vegetable consumption per week and quantity of carbohydrates/protein consumed per day), body mass index (BMI), blood pressure, fasting blood high-density lipoprotein cholesterol (HDL-C) and total cholesterol (TC):HDL-C ratio were assessed before Ramadan and three months post-Ramadan.

    RESULTS: Voluntary fasting practices increased only in group A (P <0.01). Additionally, the quantity of protein/carbohydrates consumed per day, mean diastolic pressure and TC:HDL-C ratio decreased only in group A (P <0.01, 0.05, 0.02 and <0.01, respectively). Frequency of fruit/vegetable consumption per week, as well as HDL-C levels, increased only in group A (P = 0.03 and <0.01, respectively). Although changes in BMI between the groups was not significant (P = 0.08), BMI decrease among participants in group A was significant (P <0.01).

    CONCLUSION: Control of post-Ramadan weight gain was more evident in the faith-based intervention group. Healthcare providers should consider faith-based interventions to encourage weight loss during Ramadan and to prevent post-Ramadan weight gain among patients.

  16. Adam D, Ramli A, Shahar S
    Sultan Qaboos Univ Med J, 2016 Feb;16(1):e47-53.
    PMID: 26909213 DOI: 10.18295/squmj.2016.16.01.009
    Cognitive impairment is a common problem among the elderly and is believed to be a precursor to dementia. This study aimed to explore the effectiveness of a combined dance and relaxation intervention as compared to relaxation alone in reducing anxiety and depression levels and improving quality of life (QOL) and cognitive function among the cognitively impaired elderly.
  17. Kamal I, Chelliah KK, Mustafa N
    Sultan Qaboos Univ Med J, 2015 May;15(2):e292-6.
    PMID: 26052465
    The aim of this research was to examine the average glandular dose (AGD) of radiation among different breast compositions of glandular and adipose tissue with auto-modes of exposure factor selection in digital breast tomosynthesis.
  18. Hanafiah M, Yahya A, Zuhdi Z, Yaacob Y
    Sultan Qaboos Univ Med J, 2014 Nov;14(4):e578-81.
    PMID: 25364566
    An undifferentiated embryonal sarcoma of the liver is a rare malignant tumour. We highlight the diagnostic dilemma and differential diagnosis of a case involving a large cystic liver lesion in a young adult. A 20-year-old man presented with a large liver lesion to the Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia, in February 2012. The initial clinico-radiological presentations were suggestive of a liver abscess. A total tumour resection was performed and the final histopathological results of the resected specimen indicated an undifferentiated embryonal sarcoma of the liver. The ultrasound and computed tomographic images of the tumour were reviewed and found to be contradictory in appearance, as the tumour seemed predominantly solid in the ultrasound image and predominantly cystic in the computed tomographic image. Familiarisation with the imaging appearance of this tumour and a high index of suspicion is therefore crucial in making a successful diagnosis.
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