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Fulltext Modified Five-Flap Z-plasty for Surgical Correction of Webbed Neck Deformity in Turner Syndrome

Mohd Said MT, Halim AS, Mat Zain MA, Koh KL

Cureus, 2023 May;15(5):e39312.
PMID: 37346202 DOI: 10.7759/cureus.39312

Webbed neck deformity is a congenital anomaly that exists in several syndromes. Various techniques for surgically correcting the webbed neck deformity have been described in the literature, each comes with its own advantages and disadvantages. The aim of surgery is to achieve normal neck contour and symmetrical hairline, avoid excessive scarring over the anterior and lateral neck, and limit recurrence. In this report, we described our experience in managing a case of Turner syndrome with bilateral webbed neck deformity using the modified five-flap Z-plasty technique.
Fulltext Effectiveness of Pre-procedural Mouth Rinses in Reducing Aerosol Contamination During Periodontal Prophylaxis: A Systematic Review

Mohd-Said S, Mohd-Dom TN, Suhaimi N, Rani H, McGrath C

Front Med (Lausanne), 2021;8:600769.
PMID: 34179030 DOI: 10.3389/fmed.2021.600769

Background: Aerosol-producing dental procedures are of concern in the spread of infections, especially during the COVID-19 pandemic. Periodontal prophylaxis is the most common aerosol-producing procedure conducted in dental practice globally. During COVID-19, many national and international organizations advocated the use of pre-procedural mouth rinsing to prevent the spread of infections from aerosol-generating procedures in the dental setting; however, many questioned the scientific basis for such recommendations. Objective: This systematic review aimed to evaluate the effectiveness of pre-procedural rinsing when preforming periodontal prophylaxis in reducing aerosol contamination in the dental setting. Methods: A comprehensive standardized search strategy was employed, informed by a defined PICO question across four electronic databases. The review of the literature was conducted using the PRISMA framework. Agreement between assessors was determined throughout. Synthesis of study characteristics and key outcomes were conducted. Cochrane's risk-of-bias tool for randomized trials (RoB 2) was employed to assess the quality/bias among studies. Results: The initial search yielded 731 citations across the four databases; 95 potentially effective studies were identified, with 56 effective studies found. Thirty randomized control trial studies were identified, 21 with a focus on effectiveness of pre-procedural mouth rinsing, involving 984 participants (aged 18-70). Agreement between assessors was high (Kappa >0.80). Various pre-procedural mouth rinses were tested, most frequently chlorhexidine (CHX) in 18 studies. The concentrations, volume, and prescribed duration of rinsing varied among studies, hampering meta-analyses. Nonetheless, all studies identified significant reductions in bacterial contamination, as measured by colony forming units (cfu). The effectiveness of CHX over other agents was evident with more than half of the studies (7/15) reporting over a 70% reduction in bacterial contamination (cfu). There were concerns over the risk of bias in most studies (76.2%); 19.0% had a high risk of bias and 4.8% were of low risk of bias. Conclusion: There is substantial evidence to support pre-procedural mouth rinsing, such as with chlorohexidine, to effectively reduce aerosol contamination when performing periodontal prophylaxis compared to mouth rinsing with water or not rinsing.
Fulltext The Best Online Tools Based on Media Preference Reflected by Health Information Received on Social Media amongst Diabetic Patients in Hospital Canselor Tuanku Muhriz, Kuala Lumpur, Malaysia

Siti Zuhaida H, Chung HC, Mohd Said F, Tumingan K, Sahar Shah N, Hanim S, et al.

Malays J Med Sci, 2021 Jun;28(3):118-128.
PMID: 34285650 DOI: 10.21315/mjms2021.28.3.11

Background: Diabetes mellitus has become a major public health problem globally. Social media could be useful in assisting clinical practice and sharing health-related information to improve self-management and to promote a positive behavioural change. This study aims to develop a guide on the best online tools by determining the media preference reflected by health-related information received from social media amongst diabetic patients in Hospital Canselor Tuanku Muhriz (HCTM), Universiti Kebangsaan Malaysia, Kuala Lumpur.
Methods: This study was conducted cross-sectional on 174 respondents, who were selected by using a simple random sampling method. Socio-demographic data and the use of the internet and media for health-related information were obtained via questionnaires.
Results: The most preferred social media used for searching and sharing health-related information was WhatsApp (73.6%), followed by Facebook (67.8%), Instagram (18.4%) and Twitter (17.2%). The social media preference related to socio-demographic data of age was statistically significant (P < 0.002), which had a medium effect. Furthermore, the media preference was not significantly related to health-related information searched or shared on social media and the frequency of usage.
Conclusion: Indeed, the social media have been an essential media platform to enhance public awareness concerning public health. This calls for evolution to further enhance the use of social media amongst healthcare practitioners to emphasise health promotion and empower the patients to play an active role in their healthcare. This study provides a guideline for the medical researchers, practitioners or healthcare providers in choosing WhatsApp as an online medium to communicate with diabetic patients in the future, specifically in Malaysia.
Fulltext Synergistic enhancement in the microelectronic properties of poly-(dioctylfluorene) based Schottky devices by CdSe quantum dots

Muhammad F, Tahir M, Zeb M, Kalasad MN, Mohd Said S, Sarker MR, et al.

Sci Rep, 2020 Mar 16;10(1):4828.
PMID: 32179797 DOI: 10.1038/s41598-020-61602-1

This paper reports the potential application of cadmium selenide (CdSe) quantum dots (QDs) in improving the microelectronic characteristics of Schottky barrier diode (SBD) prepared from a semiconducting material poly-(9,9-dioctylfluorene) (F8). Two SBDs, Ag/F8/P3HT/ITO and Ag/F8-CdSe QDs/P3HT/ITO, are fabricated by spin coating a 10 wt% solution of F8 in chloroform and 10:1 wt% solution of F8:CdSe QDs, respectively, on a pre-deposited poly(3-hexylthiophene) (P3HT) on indium tin oxide (ITO) substrate. To study the electronic properties of the fabricated devices, current-voltage (I-V) measurements are carried out at 25 °C in dark conditions. The I-V curves of Ag/F8/P3HT/ITO and Ag/F8-CdSe QDs/P3HT/ITO SBDs demonstrate asymmetrical behavior with forward bias current rectification ratio (RR) of 7.42 ± 0.02 and 142 ± 0.02, respectively, at ± 3.5 V which confirm the formation of depletion region. Other key parameters which govern microelectronic properties of the fabricated devices such as charge carrier mobility (µ), barrier height (ϕb), series resistance (Rs) and quality factor (n) are extracted from their corresponding I-V characteristics. Norde's and Cheung functions are also applied to characterize the devices to study consistency in various parameters. Significant improvement is found in the values of Rs, n, and RR by 3, 1.7, and 19 times, respectively, for Ag/F8-CdSe QDs/P3HT/ITO SBD as compared to Ag/F8/P3HT/ITO. This enhancement is due to the incorporation of CdSe QDs having 3-dimensional quantum confinement and large surface-to-volume area. Poole-Frenkle and Richardson-Schottky conduction mechanisms are also discussed for both of the devices. Morphology, optical bandgap (1.88 ± 0.5 eV) and photoluminescence (PL) spectrum of CdSe QDs with a peak intensity at 556 nm are also reported and discussed.
Fulltext Development and evaluation of an integrated diabetes-periodontitis nutrition and health education module

Jamil NA, Chau SH, Abdul Razak NI, Shamsul Kamar II, Mohd-Said S, Rani H, et al.

BMC Med Educ, 2021 May 17;21(1):278.
PMID: 34001119 DOI: 10.1186/s12909-021-02721-9

BACKGROUND: A good understanding of the bi-directional relationship between diabetes and periodontitis is essential to ensure the successful management of both diseases. This study aimed to develop and evaluate an integrated diabetes-periodontitis nutrition and health education module.
METHODS: The module was developed as an iterative and review process by five experts in nutrition and dietetics, periodontics, and dental public health. It consisted of three phases: (i) needs assessment on module contents and characteristics, (ii) module development and (iii) module evaluation by experts. Twelve healthcare professionals aged between 30 and 53 years (average 13.5 years of working experience) validated the module contents and its comprehensibility using the Patient Education Materials Assessment Tool for printable materials (PEMAT-P) and audio-visual materials (PEMAT-A/V). Scores of 0 (disagree) or 1 (agree) were given for sets of understandability and actionability statements and presented as a total percentage.
RESULTS: Seventeen infographic-flip charts and 13 short-videos were developed in the Malay language and grouped into four topics: (i) Introduction to Diabetes and Periodontitis, (ii) Diabetes and Periodontitis Care, (iii) Lifestyle Modification, and (iv) Myths and Facts. Flip charts were rated between 76-100% for understandability and 80-100% for actionability, while videos rated between 90-100% for understandability and 100% for actionability, respectively.
CONCLUSION: Overall, the newly developed module ranked high median scores for understandability and actionability. This finding reflects positive acceptance of the integrated module among the various healthcare professionals involved in managing patients with diabetes and periodontitis.
Fulltext Amino Anthraquinone: Synthesis, Characterization, and Its Application as an Active Material in Environmental Sensors

Ali S, Tahir M, Mehboob N, Wahab F, J Langford S, Mohd Said S, et al.

Materials (Basel), 2020 Feb 21;13(4).
PMID: 32098037 DOI: 10.3390/ma13040960

This work reports synthesis, thin film characterizations, and study of an organic semiconductor 2-aminoanthraquinone (AAq) for humidity and temperature sensing applications. The morphological and phase studies of AAq thin films are carried out by scanning electron microscope (SEM), atomic force microscope (AFM), and X-ray diffraction (XRD) analysis. To study the sensing properties of AAq, a surface type Au/AAq/Au sensor is fabricated by thermally depositing a 60 nm layer of AAq at a pressure of ~10-5 mbar on a pre-patterned gold (Au) electrodes with inter-electrode gap of 45 µm. To measure sensing capability of the Au/AAq/Au device, the variations in its capacitance and resistance are studied as a function of humidity and temperature. The Au/AAq/Au device measures and exhibits a linear change in capacitance and resistance when relative humidity (%RH) and temperature are varied. The AAq is a hydrophobic material which makes it one of the best candidates to be used as an active material in humidity sensors; on the other hand, its high melting point (575 K) is another appealing property that enables it for its potential applications in temperature sensors.
Fulltext Treatment-seeking behavior among male civil servants in northeastern Malaysia: A mixed-methods study

Arumugam P, Tengku Ismail TA, Daud A, Musa KI, A Hamid NA, Ismail SB, et al.

Int J Environ Res Public Health, 2020 04 15;17(8).
PMID: 32326447 DOI: 10.3390/ijerph17082713

Background: Men's health in Malaysia is slowly gaining more attention, but minimal research has examined how Malaysian men behave and seek treatment. While few studies have investigated men's treatment-seeking behavior (TSB), those that have been conducted seem to be inconclusive and tend to yield contradictory findings.
Objectives: This paper aims to determine the proportion of inappropriate TSB and to explore in-depth treatment-seeking behavior among male civil servants in northeastern Malaysia.
Methods: This paper adopted a mixed-methods approach, specifically a concurrent parallel study design. A quantitative study using a self-administered questionnaire was performed to identify the proportion of appropriate and inappropriate TSB among male civil servants in northeastern Malaysia. Concurrently, a qualitative study was conducted involving six focus group discussion sessions, and the results of both parts were integrated to provide a detailed explanation of TSB among the participants.
Results: A total of 381 participants were involved in the quantitative study, yielding a response rate of 94.8%; 246 (64.6%) engaged in inappropriate TSB. Some of the reported morbidities among the participants were hypertension (26.5%) and diabetes mellitus (26.2%). From the qualitative study, a main theme related to TSB emerged with several sub-themes, which were health literacy, stage of seeking treatment, preference for alternative treatment, perceived threat of illness, self-treatment, and the influence of family members and others.
Conclusions: TSB among male civil servants in northeastern Malaysia is poor, and the factors contributing to it are multidimensional. This study has provided new valuable evidence on men's TSB in northeastern Malaysia. The findings can be used to facilitate and improve current policies and the implementation of men's health services throughout the country.
Fulltext Exploring the Feasibility of an Online Diabetes Wellness Programme among Periodontitis Patients with Type II Diabetes Mellitus during the COVID-19 Pandemic

Rusly NFS, Jamil NA, Mohd-Dom TN, Rani H, Mohd-Said S, Mohd-Norwir NA, et al.

Healthcare (Basel), 2022 Oct 26;10(11).
PMID: 36360470 DOI: 10.3390/healthcare10112129

There were massive interruptions, including patient visits for dietary advice and dental services, during the COVID-19 outbreak. This study assessed the feasibility of an online diabetes wellness programme among periodontitis patients with type II diabetes mellitus. Patients were grouped into the intervention group (IG) and control group (CG). At baseline and week 12, all patients answered online questionnaires on diabetes-related knowledge, physical activity, and oral impacts on daily performances (OIDP). Body weight and waist circumference were self-measured with guided instructions. Diet recalls were used to estimate dietary and added sugar intake. All patients received a weekly educational video, but the IG attended three e-consultation sessions with a dietitian (weeks 1, 3, and 8) and a dentist (week 8) via video call. A semi-structured interview was conducted to collate qualitative feedback among the IG participants at the end of the programme. A total of 24 periodontitis patients (14 IG and 10 CG) participated in this study. Among the IG patients, significant improvements in diabetes knowledge, body weight, BMI, calories, carbohydrates, fat, and added sugar intakes were observed at week 12. The CG patients only had a significant reduction in carbohydrate intake post intervention. No changes were reported in physical activity level and OIDP for both groups. Feedback received from the IG participants included convenience, practical, preferred approach during the pandemic, increased awareness and knowledge, and favourable lifestyle changes. This study demonstrates that an online diabetes wellness programme with healthcare professionals is feasible and can facilitate knowledge and lifestyle improvements that can be adapted during the crisis situation.
Fulltext From the Front or Back Door? Quantitative analysis of direct and indirect extractions of α-mangostin from mangosteen (Garcinia mangostana)

Eukun Sage E, Jailani N, Md Taib AZ, Mohd Noor N, Mohd Said MI, Abu Bakar M, et al.

PLoS One, 2018;13(10):e0205753.
PMID: 30321238 DOI: 10.1371/journal.pone.0205753

The pulp and pericarp of mangosteen (Garcinia mangostana) fruit are popular food, beverage and health products whereby 60% of the fruit consist of the pericarp. The major metabolite in the previously neglected or less economically significant part of the fruit, the pericarp, is the prenylated xanthone α-mangostin. This highly bioactive secondary metabolite is typically isolated using solvent extraction methods that involve large volumes of halogenated solvents either via direct or indirect extraction. In this study, we compared the quantities of α-mangostin extracted using three different extraction methods based on the environmentally friendly solvents methanol and ethyl acetate. The three solvent extractions methods used were direct extractions from methanol (DM) and ethyl acetate (DEA) as well as indirect extraction of ethyl acetate obtained via solvent partitioning from an initial methanol extract (IEA). Our results showed that direct extraction afforded similar and higher quantities of α-mangostin than indirect extraction (DM: 318 mg; DEA: 305 mg; IEA: 209 mg per 5 g total dried pericarp). Therefore, we suggest that the commonly used method of indirect solvent extraction using halogenated solvents for the isolation of α-mangostin is replaced by single solvent direct extraction using the environmentally friendly solvents methanol or ethyl acetate.
Fulltext Two-Dimensional Tungsten Disulfide-Based Ethylene Glycol Nanofluids: Stability, Thermal Conductivity, and Rheological Properties

Shah SNA, Shahabuddin S, Mohd Sabri MF, Mohd Salleh MF, Mohd Said S, Khedher KM, et al.

Nanomaterials (Basel), 2020 Jul 09;10(7).
PMID: 32659972 DOI: 10.3390/nano10071340

Developing stable nanofluids and improving their thermo-physical properties are highly important in heat transfer applications. In the present work, the stability, thermal conductivity, and rheological properties of tungsten disulphide (WS2) nanoparticles (NPs) with ethylene glycol (EG) were profoundly examined using a particle size analyzer, zeta-sizer, thermal property analyzer, rheometer, and pH measuring system. WS2 NPs were characterized by various techniques, such as XRD (X-Ray Diffraction), FTIR (Fourier Transform Infrared Spectroscopy), FESEM (Field emission scanning electron microscopy), and high-resolution transmission electron microscopy (HRTEM). The nanofluids were obtained with the two-step method by employing three volume concentrations (0.005%, 0.01%, and 0.02%) of WS2. The influence of different surfactants (Sodium dodecyl sulphate (SDS), Sodium dodecylbenzenesulfonate (SDBS), Cetyltrimethylammonium bromide (CTAB)) with various volume concentrations (0.05-2%) on the measured properties has also been evaluated. Pristine WS2/EG nanofluids exhibit low zeta potential values, i.e., -7.9 mV, -9.3 mV, and -5 mV, corresponding to 0.005%, 0.01%, and 0.02% nanofluid, respectively. However, the zeta potential surpassed the threshold (±30 mV) and the maximum values reached of -52 mV, -45 mV, and 42 mV for SDS, SDBS, and CTAB-containing nanofluids. This showed the successful adsorption of surfactants onto WS2, which was also observed through the increased agglomerate size of up to 1720 nm. Concurrently, particularly for 0.05% SDS with 0.005% WS2, thermal conductivity was enhanced by up to 4.5%, with a corresponding decrease in viscosity of up to 10.5% in a temperature range of (25-70 °C), as compared to EG. Conversely, the viscoelastic analysis has indicated considerable yield stress due to the presence of surfactants, while the pristine nanofluids exhibited enhanced fluidity over the entire tested deformation range. The shear flow behavior showed a transition from a non-Newtonian to a Newtonian fluid at a low shear rate of 10 s-1. Besides this, the temperature sweep analysis has shown a viscosity reduction in a range of temperatures (25-70 °C), with an indication of a critical temperature limit. However, owing to an anomalous reduction in the dynamic viscosity of up to 10.5% and an enhancement in the thermal conductivity of up to 6.9%, WS2/EG nanofluids could be considered as a potential candidate for heat transfer applications.
Fulltext Epiphytic Terrestrial Algae (Trebouxia sp.) as a Biomarker Using the Free-Air-Carbon Dioxide-Enrichment (FACE) System

Ismail A, Marzuki SD, Mohd Yusof NB, Buyong F, Mohd Said MN, Sigh HR, et al.

Biology (Basel), 2017 Mar 07;6(1).
PMID: 28272328 DOI: 10.3390/biology6010019

The increasing concentration of CO₂ in the atmosphere has caused significant environmental changes, particularly to the lower plants such as terrestrial algae and lichens that alter species composition, and therefore can contribute to changes in community landscape. A study to understand how increased CO₂ in the atmosphere will affect algal density with minimal adjustment on its natural ecosystem, and the suitability of the algae to be considered as a biomarker, has been conducted. The current work was conducted in the Free-Air-Carbon Dioxide-Enrichment (FACE) system located in Universiti Kebangsaan Malaysia, Bangi, Malaysia. CO₂ was injected through special valves located along the ring surrounding specimen trees where 10 × 10 cm quadrats were placed. A total of 16 quadrats were randomly placed on the bark of 16 trees located inside the FACE system. This system will allow data collection on the effect of increased CO₂ without interfering or changing other parameters of the surrounding environment such as the wind speed, wind direction, humidity, and temperature. The initial density Trebouxia sp. was pre-determined on 1 March 2015, and the final density was taken slightly over a year later, on 15 March 2016. The exposure period of 380 days shed some light in understanding the effect of CO₂ on these non-complex, short life cycle lower plants. The results from this research work showed that the density of algae is significantly higher after 380 days exposure to the CO₂-enriched environment, at 408.5 ± 38.5 × 10⁴ cells/cm², compared to the control site at 176.5 ± 6.9 × 10⁴ cells/cm² (independent t-test, p < 0.001). The distance between the trees and the injector valves is negatively correlated. Quadrats located in the center of the circular ring recorded lower algal density compared to the ones closer to the CO₂ injector. Quadrat 16, which was nearing the end of the CO₂ valve injector, showed an exceptionally high algal density-2-fold higher than the average density at 796 ± 38.5 × 10⁴ cells/cm². In contrast, Quadrat 9, which was located in the center of the ring (lower CO₂ concentration), recorded only 277 ± 38.5 × 10⁴ cells/cm², which further supports the previous claim. Based on the data obtained, this study provides useful data in understanding the positive effect of CO₂ on algal density, in a natural environment, and suggests the use of epiphytic terrestrial algae as a biomarker.
Fulltext Design and Develop Low-Cost Device on Monitoring Environmental Indoor Air Quality in Factory

Mohd Azrin Mohd Said, Shawn Felix Stephen, Nor Kamaliana Khamis, Abdullah Yassin, Ana Sakura Zainal Abidin, Rudiyanto Philman Jong, et al.

Journal of Engineering and Science Research, 2020;4(4):6-11.
MyJurnal

Environmental indoor air quality is one of the major concerns in occupational safety and health issues related to workers. Nowadays, the evolving of Internet of Things (IoT), the monitoring of the surrounding environmental desired parameters is more fascinating with the use of various sensors. Real time data now can be monitored with the Wi-Fi connection where the data being transfer across the network cloud with different platform service. This research focus is on the environmental monitoring for indoor air quality in terms of carbon monoxide (CO) in selected palm oil mill factory. This project aims to benefit the workers in a way where air quality is monitored. This low-cost device air quality monitoring (LCDAQM) used an ESPduino-32 to collect and process sensed data to the ThingSpeak platform service that can be monitored through web based or apps. The level of the carbon monoxide (CO) will light up the red LED when reach more than 50ppm which was set by OSHA. Result shows that level of CO in factory is unhealthy and need future engineering control action. The validation between LCDAQM and RS CO meter show the percentage error of 14.41%. Therefore, this study will help workers and factory to monitor and reduce the occupational safety and health (OSH) related problems to indoor air quality in factory.
Fulltext Oral health knowledge among healthcare professionals and their challenges in dealing with patients’ oral health problems

Dzulqarnain Ahmad Iskandar Shah, Nursabrina Roslan, Khairun ‘Izzah Zamansari, Tuan Nur Athirah Tuan Mohd Rahimi, Shahida Mohd-Said, Haslina Rani, et al.

Jurnal Sains Kesihatan Malaysia, 2020;18(2):39-47.
MyJurnal

The important role of non-dental healthcare professionals (HCPs) in promoting oral health is well-accepted and has received increased attention in recent years. However, greater efforts are needed to train them in ensuring better competency in delivering this role. The aim of the present study is to assess oral health and care knowledge among HCPs by further exploring possible challenges faced by them in managing oral health problems, particularly in regard to patients in a public primary healthcare clinic. In the case of the current research, a focus group discussion was carried out with ten HCPs who are directly involved with patients from different units within the health clinics. In particular, the questions developed for the focus group discussion were divided into two parts: (1) knowledge on oral health and its link to general health, and (2) issues and challenges faced by HCPs in handling patients with oral health problems in their daily routine. The session was recorded on a digital audio tape, the responses were then transcribed, followed by the grouping of the scripts which were then qualitatively analysed. The results revealed that majority of the participants appeared to have good knowledge of general and basic oral health; however, only very few of them were aware of the relationship between oral health problems with systemic conditions. Meanwhile, one of the main challenges faced by HCPs in handling patients with oral health problems is their limited knowledge of oral health problems. Specifically, the main challenges refer to the management of medically compromised patient requiring dental treatment as well as the difficulty in changing the mindset of patients regarding oral health issues, especially in terms of seeking dental treatment. In conclusion, it has been clearly observed that HCPs involved in the present study have good knowledge of general health and oral health but limited knowledge related to oral health to systemic health. Furthermore, they tend to face numerous challenges when dealing with patients, especially due to their limited knowledge of oral health facts and drug prescription for oral problems. Therefore, there is an urgent need of additional training for both HCPs and dental teams for the purpose of enabling both parties to provide coordinated and comprehensive service to patients with oral health problems at the primary healthcare clinics.
Keywords: Interprofessional collaboration; care coordination; multidisciplinary; oral health knowledge; healthcare professionals
Intra-specific hybridization: generator of genetic diversification and heterosis in Andrographis paniculata Nees. A bridge from extinction to survival

Valdiani A, Kadir MA, Saad MS, Talei D, Tan SG

Gene, 2012 Aug 15;505(1):23-36.
PMID: 22683537 DOI: 10.1016/j.gene.2012.05.056

Andrographis paniculata (AP) has been stated as a low-diverse, endangered and red-listed plant species. Self-pollinated mating system, being an introduced species and experiencing a bottleneck as well as over exploitation cause such a consequence. Inter and intra-specific hybridizations have been suggested as essential techniques for generating genetic diversity. To test the effect of intra-specific hybridization on diversification and heterosis of AP, seven accessions were outcrossed manually in all 21 possible combinations. Three types of markers including morphological, phytochemical and RAPD markers were employed to evaluate the mentioned hypothesis. The results revealed that hybridization acted as a powerful engine for diversification of AP as it caused heterotic expression of the studied traits, simultaneously. Initially, it seems that additive and non-additive gene effects both can be considered as the genetic basis of heterosis in AP for the investigated traits. Agronomic and morphological traits were differentiated from each other, while positive heterosis was recorded mainly for agronomic traits but not for the morphological traits. Intra-specific hybridization increased the genetic diversity in AP population. Nevertheless, a part of this variation could also be attributed to the negative heterosis. The current exploration demonstrated the first ever conducted manual intra-specific hybridization among AP accessions in a mass scale. However, the 17 RAPD primers produced a monomorph pattern, but perhaps increasing the number of markers can feature a new genetic profile in this plant.
Learning styles of Malaysian Generation 'Y' healthcare undergraduates

Nurumal MS, Salahuddin MA, Daud A, Shahadan SZ, Abdul-Mumin K, Shorey S

Enferm Clin, 2019 09;29 Suppl 2:471-475.
PMID: 31350157 DOI: 10.1016/j.enfcli.2019.04.070

OBJECTIVE: The learning styles of millennial students, also known as Generation 'Y', have been examined in the past to match the teaching style of an educator with the aim of improving behaviors, attitudes, and academic achievements. However, focus on Generation 'Y' healthcare undergraduates from a multi-cultural Asian society, is scarce and fragmented. Therefore, this research aims to identify the learning style preferences of Generation 'Y' undergraduates enrolled in varied healthcare programs at a Malaysian University.
METHOD: A quantitative cross-sectional study design was adopted. Honey and Mumford's Learning Style Questionnaire was used to explore the learning styles.
RESULTS: The reflector learning style was most preferred by the Malaysian healthcare undergraduates, and no significant difference was found between the learning styles of the clinical group and the semi-clinical group.
CONCLUSIONS: Educators should engage Malaysian healthcare undergraduates in a non-threatening environment - Association between learning style and sociodemographic warrants further investigation.
Mitigation of COVID-19 Risk Among Older Adults in Nursing Homes: A Public Survey

Lee WL, DeWitt D, Chui PL, Sahibudeen AKS, Nurumal MS, Chinna K, et al.

J Gerontol Nurs, 2021 Mar 01;47(3):23-28.
PMID: 33626161 DOI: 10.3928/00989134-20210209-04

The current study examines the public's perception on the mitigation of COVID-19 risk and knowledge of disease symptoms among older adults in nursing homes, with the intention to address gaps in knowledge using mobile technologies. An online survey questionnaire was completed by 611 adults residing in Malaysia. The four domains, derived from factor analysis, affirmed the supportive perception among the public (score range = 4.42 to 4.64/5.0). However, among the gaps identified were the perception toward hand sanitizing and susceptibility of older adults to COVID-19. Public knowledge on symptoms of COVID-19 was limited (e.g., 41.4% to 53.4% incorrect responses to anosmia, diarrhea, confusion). Multivariate analysis of variance found that males and participants with less education had significantly lower supportive perceptions (p < 0.05). With >86% of participants having access to internet communication technology, mobile interventions tailored to gender and educational level are recommended to promote long-term pandemic preparedness among stakeholders and the public. [Journal of Gerontological Nursing, 47(3), 23-28.].
Nurses' knowledge of health literacy, communication techniques, and barriers to the implementation of health literacy programs: A cross-sectional study

Nantsupawat A, Wichaikhum OA, Abhicharttibutra K, Kunaviktikul W, Nurumal MSB, Poghosyan L

Nurs Health Sci, 2020 Sep;22(3):577-585.
PMID: 32115835 DOI: 10.1111/nhs.12698

Nurses' health literacy knowledge and communication skills are essential for improving patients' health literacy. Yet, research on nurses' health literacy knowledge and perception is limited. The study aimed to evaluate nurses' health literacy knowledge, communication techniques, and barriers to the implementation of health literacy interventions. A cross-sectional study was used, and a total of 1697 nurses in 104 community hospitals in Thailand completed self-report measures. Approximately 55% of the participants had heard about the concept of health literacy; 9% had received formal training specific to interaction with patients with low health literacy. About 50% of the nurses were aware of their patients' low health literacy; therefore, they applied the recommended communication techniques for them. Delivery of effective health literacy training was hampered by a lack of assessment tools, health literacy training and specialists, educational materials, and health provider time. Hospital administrators, nurse managers, health leaders should develop strategies to create environments and resources supporting health literacy interventions.
Emergency department discharge instruction for mild traumatic brain injury: Evaluation on readability, understandability, actionability and content

Abdul Rahman N', Nurumal MS, Awang MS, Mohd Shah ANS

Australas Emerg Care, 2020 Dec;23(4):240-246.
PMID: 32713770 DOI: 10.1016/j.auec.2020.06.005

INTRODUCTION: Emergency departments (EDs) routinely provide discharge instructions due to a large number of patients with mild traumatic brain injury (mTBI) being discharged home directly from ED. This study aims to evaluate the quality of available mTBI discharge instructions provided by EDs of Malaysia government hospitals.
METHODS: All 132 EDs were requested for a copy of written discharge instruction given to the patients. The mTBI discharge instructions were evaluated using the Patient Education Materials Assessment-Printable Tool (PEMAT-P) for understandability and actionability. Readability was measured using an online readability tool of Malay text. The content was compared against the discharge instructions recommended by established guidelines.
RESULTS: 49 articles were eligible for the study. 26 of the articles met the criteria of understandability, and 3 met the criteria for actionability. The average readability level met the ability of average adult. Most of the discharge instructions focused on emergency symptoms, and none contained post-concussion features.
CONCLUSION: Majority of the discharge instructions provided were appropriate for average people to read but difficult to understand and act upon. Important information was neglected in most discharge instructions. Thus, revision and future development of mTBI discharge instruction should consider health literacy demand and cognitive ability to process such information.
A cross-sectional study on factors influencing attendance to eye screening

Isa RM, Saidi S, Salam A, Nurumal MS, Jamaludin TSS

Enferm Clin, 2021 04;31 Suppl 2:S321-S325.
PMID: 33849190 DOI: 10.1016/j.enfcli.2020.12.037

This study aimed to survey the factors influencing attendance to eye screening among Diabetes mellitus (DM) patients. This cross-sectional survey was carried out among 170 DM patients using self-administered questionnaires. Majority of participants, 45.9% (n=78) highlighted that lack of information regarding diabetes and not understanding the significance of eye screening are the barriers to eye screening. Whereas, 10.6% (n=18) reported lack of access to healthcare facilities, 6.5% (n=11) experienced time limitation and 2.9% (n=5) suffered financial issues. However, more than half of the participants (58.2%) have good knowledge related to diabetic eye complications. There was a significant difference between educational level with patients' attendance in yearly eye screening. Lack of information received by the patients on the importance of eye screening and communication issues seems to be prominent and becomes the reason for patients not attending eye screening.
Soft skill elements in structured clinical nursing assessment for undergraduate nursing students: A systematic review

Jamaludin TSS, Nurumal MS, Ahmad N, Muhammad SAN, Chan CM

Enferm Clin, 2021 04;31 Suppl 2:S58-S62.
PMID: 33849230 DOI: 10.1016/j.enfcli.2020.10.019

This systematic review aimed to appraise and synthesize the available evidence that examines the soft skill elements in clinical nursing assessment for undergraduate nursing students. This systematic review also is in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Relevant studies were identified based on the inclusion criteria with language filters but were limited to articles published from January 2000 to March 2019. Two reviewers independently conducted the quality assessment, data extraction, and analysis on all included studies. A total of 17 articles were included in this review. Studies showed that without developing adequate soft skill elements in the clinical skill assessment, students are graduating unprepared to be successful in the workplace. There is a need to consider and adopt soft skill elements in clinical skill assessment to improve the quality of nursing graduates and ultimately to create a positive impact on patient outcomes.

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