Displaying publications 101 - 120 of 137 in total

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  1. Fulltext Termination of pregnancy for a Muslim rape victim and dilemma in Malaysian setting: a case report
    Umi Adzlin, S., Azizul, A., Uma, V., Nor’Izam, A.
    Malaysian Journal of Psychiatry, 2012;21(2):0-0.
    MyJurnal
    This case report highlights on the dilemma in making a decision for termination of pregnancy (TOP) for a muslim rape victim in Malaysian setting. We report a case of 17 year-old student at 7 weeks of pregnancy after being gang-raped, who, together with her parents, had requested for a TOP. Psychiatric assessment showed that the patient suffered from a major depressive disorder and post-traumatic stress disorder which justified termination of pregnancy on a psychological and clinical basis. However the available Malaysian Islamic fatwa had caused some uncertainties on the final decision making. This case demonstrated on the needs to understand the relevant issues beyond clinical judgment in relation to TOP in our setting which encompasses the legal provision, ethical obligation as well as the needs for a clear religious understanding and stand to support the medical decision.
    Matched MeSH terms: Uncertainty
  2. Fulltext Music therapy and hospitalized children: three case studies
    Lim, Kar Gee, Ee, Chin Loh
    Malaysian Journal of Paediatrics and Child Health, 2017;23(1):0-0.
    MyJurnal
    Music therapy is rarely available within the medical services in Malaysia. Hospitalized children experience a great deal of stress, anxiety, and pain due to unfamiliar environment, separation from the family, a variety of medical procedures and treatments, and the uncertainties of the illnesses. Music is often used to cope with both physical and psychological distress clinically because of its pervasiveness and familiarity. The purpose of this article is to elaborate the effectiveness of music therapy in addressing both physical and psychosocial needs of hospitalized children. The three case studies demonstrated how a variety of music therapy interventions are used to facilitate individualized goals and to improve the quality of life.
    Matched MeSH terms: Uncertainty
  3. Fulltext Community pharmacists' perceptions towards online health information in Kuala Lumpur, Malaysia
    Ong SW, Hassali MA, Saleem F
    Pharm Pract (Granada), 2018 06 27;16(2):1166.
    PMID: 30023025 DOI: 10.18549/PharmPract.2018.02.1166
    Objective: The current study was carried out to assess community pharmacists' perceptions towards online health information, to examine the type of information seek from Internet and to identify the barriers when they retrieved online health information.

    Methods: The study was designed as a cross-sectional questionnaire-based survey whereby all (300) community pharmacists practicing in Federal Territory of Kuala Lumpur, Malaysia were targeted for data collection. A 35-itemed questionnaire was posted out along with a stamped addressed envelope, invitation letter and support letter. Responses were also accepted via online response. Both descriptive and inferential statistics were used for data analysis. All statistical analysis was performed using SPSS v. 20.0.

    Results: A total of 67 responses were received with a response rate of 22.3%. The top three frequently health information searched by respondents were medicine information, general healthcare information and disease-related information. High number of respondents agreed that Internet had too much health information to scan through. Gender (p=0.018) showed significant association with visiting established health websites. Meanwhile, statistical significant was observed between age and searching medicine information (p=0.037), undertaking online continuing professional development (p=0.023), as well as searching clinical guidelines (p=0.047). Respondents' education level showed significant association with uncertainty about the reliability of online health information (p=0.023) and unsure about filtering the information (p=0.007).

    Conclusions: Majority of the respondents expressed positive perception with the use of Internet for health information. The findings of the current study showed the widely use of Internet for health information among community pharmacists. Hence, this study provides opportunity for future works to further examine community pharmacist's retrieval and appraisal skills for online health information, as well as application of this information into their daily pharmacy practice.

    Matched MeSH terms: Uncertainty
  4. Industrial radiotracer application in flow rate measurement and flowmeter calibration using 99mTc and 198Au nanoparticles radioisotope
    Mohd Yunos MAS, Hussain SA, Sipaun SM
    Appl Radiat Isot, 2019 Jan;143:24-28.
    PMID: 30368049 DOI: 10.1016/j.apradiso.2018.10.008
    The flow rate or fluid velocity measurement is important to maintain fluid flow quality performance in the systems. This study focuses on determination of volumetric flow rate measurement and to calibrate the conventional flowmeter using industrial radiotracer approach in quadrilateral gas-liquid bubble column reactor. In this work, two different radioisotopes which emit γ-ray have been chosen as radioactive tracer which is 99mTc produced from 99Mo/99mTc radioisotope generator and 198Au nanoparticle form neutron activation at research nuclear reactor TRIGA Mark II. Both radioisotopes representing liquid and solid tracer purposely designed for tracing liquid flow. The peak to peak radiotracer method known as pulse velocity method was applied to determine the volumetric flow rate. The radiation signals were monitored using 4 unit NaI scintillation detectors located at 4 different points nearby the inlet and outlet of the quadrilateral bubble column reactor process stream. The water volume inside the bubble column reactor was fixed at 0.04 m3 and liquid flow rates in this reactor were specified on installed flowmeter at different reference value which is 4 lpm, 8 lpm, and 12 lpm, respectively. The experimental result shows very good linearity and repeatability by following the theoretical equations with less uncertainty in volumetric flow rate measurement. The obtained results also validated the effectiveness of the proposed method for the installed flowmeter calibration efficiency.
    Matched MeSH terms: Uncertainty
  5. Fulltext Overview of safety and efficacy of non-viral gene transfer in cartilage tissue engineering from the worldview of Islam
    Noorhidayah Md Nazir, Munirah Sha’ban
    International Medical Journal Malaysia, 2018;17(101):115-123.
    MyJurnal
    This paper examines the safety and efficacy of non-viral gene transfer in cartilage tissue engineering (TE) from the worldview of Islam. The first clinical trial treating adenosine deaminase deficient patients conducted in 1990 has triggered the development of gene transfer technology. The potential of gene transfer is further explored in TE field with the hope that it could prosper the regenerative medicine application. However, ethical issues become important when it comes to application of new treatment modalities, primarily in gene transfer because of genetic modification influences the basis of life - the DNA. Besides ethical issue, the application of gene transfer in treating diseases also attract views from religious context. The questions on the techniques to administer the gene in human, social acceptance of genetically modified cell and adverse effects from it are still debatable and unresolved. Apart from that dilemma, both safety and efficacy issues are raised due to the scientific uncertainty and social perception of the technology. Despite countless number of encouraging findings and recommendations by the proponents of
    the technology, gene transfer is currently available only in the research setting. The established guidelines are used to complement and provide the necessary foundations in discussing the aspects involved in the incorporation of gene transfer with cartilage TE. Relevant Islamic input are identified and aligned to those particular guidelines. It is hoped that the integration of Islamic inputs in the existing guidelines could suggest the safest approach in treating cartilage degenerative disease through gene transfer and TE.
    Matched MeSH terms: Uncertainty
  6. Characterization of MOSkin detector for in vivo dose verification during Cobalt-60 high dose-rate intracavitary brachytherapy
    Jamalludin Z, Jong WL, Abdul Malik R, Rosenfeld A, Ung NM
    Phys Med, 2019 Feb;58:1-7.
    PMID: 30824140 DOI: 10.1016/j.ejmp.2019.01.010
    In vivo dosimetry in high dose-rate (HDR) intracavitary brachytherapy (ICBT) is important for assessing the true dose received by surrounding organs at risk during treatment. It also serves as part of the treatment delivery quality assurance and verification program with the use of a suitable dosimeter. Such a dosimeter should be characterized under brachytherapy conditions before clinical application to ensure the accuracy of in vivo measurement. In this study, a MOSFET-based detector, MOSkin, was calibrated and characterized under HDR Cobalt-60 (Co-60) brachytherapy source. MOSkin possessed the major advantages of having small physical and dosimetric sizes of 4.8 × 10-6 mm3 with the ability to provide real-time measurements. Using solid water and polymethyl methacrylate (PMMA) phantom, the detectors' reproducibility, linearity, angular and distance dependency was tested for its suitability as an in vivo detector. Correction factors to account for differences in depth measurements were determined. The MOSkin detector showed a reliable response when tested under Co-60 brachytherapy range of doses with an excellent linearity of R2 = 0.9997 and acceptable reproducibility. A phantom verification study was also conducted to verify the differences between MOSkin responses and treatment planning (TPS) calculated doses. By taking into account several correction factors, deviations ranging between 0.01 and 0.4 Gy were found between MOSkin measured and TPS doses at measurement distance of 20-55 mm. The use of MOSkin as the dosimeter of choice for in vivo dosimetry under Co-60 brachytherapy condition is feasible.
    Matched MeSH terms: Uncertainty
  7. Using GWAS top hits to inform priors in Bayesian fine-mapping association studies
    Walters K, Cox A, Yaacob H
    Genet Epidemiol, 2019 Sep;43(6):675-689.
    PMID: 31286571 DOI: 10.1002/gepi.22212
    The default causal single-nucleotide polymorphism (SNP) effect size prior in Bayesian fine-mapping studies is usually the Normal distribution. This choice is often based on computational convenience, rather than evidence that it is the most suitable prior distribution. The choice of prior is important because previous studies have shown considerable sensitivity of causal SNP Bayes factors to the form of the prior. In some well-studied diseases there are now considerable numbers of genome-wide association study (GWAS) top hits along with estimates of the number of yet-to-be-discovered causal SNPs. We show how the effect sizes of the top hits and estimates of the number of yet-to-be-discovered causal SNPs can be used to choose between the Laplace and Normal priors, to estimate the prior parameters and to quantify the uncertainty in this estimation. The methodology can readily be applied to other priors. We show that the top hits available from breast cancer GWAS provide overwhelming support for the Laplace over the Normal prior, which has important consequences for variant prioritisation. This work in this paper enables practitioners to derive more objective priors than are currently being used and could lead to prioritisation of different variants.
    Matched MeSH terms: Uncertainty
  8. Fulltext Norm-dist Monte-Carlo integrative method for the improvement of fuzzy analytic hierarchy process
    Wicaksono FD, Arshad YB, Sihombing H
    Heliyon, 2020 Apr;6(4):e03607.
    PMID: 32346625 DOI: 10.1016/j.heliyon.2020.e03607
    This paper presents the novel approach of the Norm-dist Monte-Carlo fuzzy analytic hierarchy process (NMCFAHP) to incorporate probabilistic and epistemic uncertainty due to human's judgment vagueness in multi-criteria decision analysis. Normal distribution is applied as the most appropriate distribution model to approximate the probability distribution function of the criteria and alternatives within Monte-Carlo simulation. To test the applicability of the proposed NMCFAHP, the case study of non-destructive test (NDT) technology selection is performed in the Petroleum Company in Borneo, Indonesia. When compared with the conventional triangular fuzzy-AHP, the proposed NMCFAHP method reduces the standard error of mean values by 90.4-99.8% at the final evaluation scores. This means that the proposed NMCFAHP significantly involves fewer errors when dealing with fuzzy uncertainty and stochastic randomness. The proposed NMCFAHP delivers reliable performance to overcome probabilistic uncertainty and epistemic vagueness in the group decision making process.
    Matched MeSH terms: Uncertainty
  9. Making friends in the rainforest: "negrito" adaptation to risk and uncertainty
    Lye TP
    Hum Biol, 2013 Feb-Jun;85(1-3):417-44.
    PMID: 24297236 DOI: 10.3378/027.085.0320
    The so-called negritos adapt not just to a tropical forest environment but also to an environment characterized by perturbations and fluctuations. As with other hunter-gatherers in the region and, indeed, throughout the world, they use both social and ecological methods to enhance their chances of survival in this changing environment: socially, they have developed networks of trading and marriage partners; ecologically, they maintain patches of key resources that are available for future harvesting. As evidenced in the case of the Batek (Orang Asli), patterns of forest structure and composition are sometimes direct outcomes of intentional resource concentration and enrichment strategies. While little of the above is controversial anthropologically, what has drawn some debate is the nature of the relationship with partner societies. Conventional wisdom posits relations of inequality between foragers and "others": foragers and farmers are often construed as hierarchical dyads where foragers supply products or labor to farmers in exchange for agricultural harvests and other trade goods. This kind of adaptation appears to be one of divergent specialization. However, there are cases, such as in the relationship between Batek and Semaq Beri, where both societies follow a roughly similar mode of adaptation, and specialization has not materialized. In sum, while not denying that hierarchy and inequality exist, I suggest that they have to be contextualized within a larger strand of relationships that includes both hierarchy and egality. Further, such relationships are part of the general portfolio of risk reduction strategies, following which access to widely scattered environmental resources, and passage from one location to another, is enhanced not by competing with and displacing neighbors but by maintaining a flexible regime of friendly exchange partners.
    Matched MeSH terms: Uncertainty
  10. Fulltext Land snails of Leptopoma Pfeiffer, 1847 in Sabah, Northern Borneo (Caenogastropoda: Cyclophoridae): an analysis of molecular phylogeny and geographical variations in shell form
    Phung CC, Heng PS, Liew TS
    PeerJ, 2017;5:e3981.
    PMID: 29104827 DOI: 10.7717/peerj.3981
    Leptopoma is a species rich genus with approximately 100 species documented. Species-level identification in this group has been based on shell morphology and colouration, as well as some anatomical features based on small sample sizes. However, the implications of the inter- and intra-species variations in shell form to the taxonomy of Leptopoma species and the congruency of its current shell based taxonomy with its molecular phylogeny are still unclear. There are four Leptopoma species found in Sabah, Borneo, and their taxonomy status remains uncertain due to substantial variation in shell forms. This study focuses on the phylogenetic relationships and geographical variation in shell form of three Leptopoma species from Sabah. The phylogenetic relationship of these species was first estimated by performing Maximum Likelihood and Bayesian analysis based on mitochondrial genes (16S rDNA and COI) and nuclear gene (ITS-1). Then, a total of six quantitative shell characters (i.e., shell height, shell width, aperture height, aperture width, shell spire height, and ratio of shell height to width) and three qualitative shell characters (i.e., shell colour patterns, spiral ridges, and dark apertural band) of the specimens were mapped across the phylogenetic tree and tested for phylogenetic signals. Data on shell characters of Leptopoma sericatum and Leptopoma pellucidum from two different locations (i.e., Balambangan Island and Kinabatangan) where both species occurred sympatrically were then obtained to examine the geographical variations in shell form. The molecular phylogenetic analyses suggested that each of the three Leptopoma species was monophyletic and indicated congruence with only one of the shell characters (i.e., shell spiral ridges) in the current morphological-based classification. Although the geographical variation analyses suggested some of the shell characters indicating inter-species differences between the two Leptopoma species, these also pointed to intra-species differences between populations from different locations. This study on Leptopoma species is based on small sample size and the findings appear only applicable to Leptopoma species in Sabah. Nevertheless, we anticipate this study to be a starting point for more detailed investigations to include the other still little-known (ca. 100) Leptopoma species and highlights a need to assess variations in shell characters before they could be used in species classification.
    Matched MeSH terms: Uncertainty
  11. Generalized Likelihood Uncertainty Estimation (GLUE) methodology for optimization of extraction in natural products
    Maulidiani, Rudiyanto, Abas F, Ismail IS, Lajis NH
    Food Chem, 2018 Jun 01;250:37-45.
    PMID: 29412925 DOI: 10.1016/j.foodchem.2018.01.023
    Optimization process is an important aspect in the natural product extractions. Herein, an alternative approach is proposed for the optimization in extraction, namely, the Generalized Likelihood Uncertainty Estimation (GLUE). The approach combines the Latin hypercube sampling, the feasible range of independent variables, the Monte Carlo simulation, and the threshold criteria of response variables. The GLUE method is tested in three different techniques including the ultrasound, the microwave, and the supercritical CO2 assisted extractions utilizing the data from previously published reports. The study found that this method can: provide more information on the combined effects of the independent variables on the response variables in the dotty plots; deal with unlimited number of independent and response variables; consider combined multiple threshold criteria, which is subjective depending on the target of the investigation for response variables; and provide a range of values with their distribution for the optimization.
    Matched MeSH terms: Uncertainty
  12. Fulltext Theory-Based Failure Modes and Effect Analysis for Medication Errors
    Jafarzadeh Ghoushchi S, Dorosti S, Ab Rahman MN, Khakifirooz M, Fathi M
    J Healthc Eng, 2021;2021:5533208.
    PMID: 33868619 DOI: 10.1155/2021/5533208
    Medication Errors (MEs) are still significant challenges, especially in nonautomated health systems. Qualitative studies are mostly used to identify the parameters involved in MEs. Failing to provide accurate information in expert-based decisions can provoke unrealistic results and inappropriate corrective actions eventually. However, mostly, some levels of uncertainty accompany the decisions in real practice. This study tries to present a hybrid decision-making approach to assigning different weights to risk factors and considering the uncertainty in the ranking process in the Failure Modes and Effect Analysis (FMEA) technique. Initially, significant MEs are identified by three groups of qualified experts (doctors, nurses, and pharmacists). Afterward, for assigning weights to the risk factors, Z-number couples with the Stepwise Weight Assessment Ratio Analysis (SWARA) method, named Z-SWARA, to add reliability concept in the decision-making process. Finally, the identified MEs are ranked through the developed Weighted Aggregated Sum Product Assessment (WASPAS) method, namely, Z-WASPAS. To demonstrate the applicability of the proposed approach, the ranking results compare with typical methods, such as fuzzy-WASPAS and FMEA. The findings of the present study highlight improper medication administration as the main failure mode, which can result in a fatality or patient injury. Moreover, the utilization of multiple-criteria decision-making methods in combination with Z-number can be a useful tool in the healthcare management field since it can address the problems by considering reliability and uncertainty simultaneously.
    Matched MeSH terms: Uncertainty
  13. Fulltext Pyogenic granuloma-like lesion in children: Should we wait?
    Chooi LK, Saad AZM, Durairajanayagam S
    Indian J Plast Surg, 2017 6 16;50(1):104-106.
    PMID: 28615821 DOI: 10.4103/ijps.IJPS_25_17
    Malignant melanoma is a potentially lethal cutaneous malignancy. Melanoma in paediatrics is rare as compared to adult melanoma. The clinicopathological characteristics of paediatric melanoma are different from adult melanoma, and the presence of melanoma mimics which occurs frequently in children (Spitz naevi) resulted in diagnosis uncertainty. We reported a 9-year-old girl who presented with a slow-growing, pyogenic granuloma-like lesion which was diagnosed with melanoma. It is important to have a high index of suspicion in paediatric skin lesion that would usually be deemed benign. Early tissue biopsy in a suspicious lesion prevents delayed diagnosis and treatment.
    Matched MeSH terms: Uncertainty
  14. Fulltext Investigation of graphene-on-metal substrates for SPR-based sensor using finite-difference time domain
    Said FA, Menon PS, Rajendran V, Shaari S, Majlis BY
    IET Nanobiotechnol, 2017 Dec;11(8):981-986.
    PMID: 29155398 DOI: 10.1049/iet-nbt.2017.0051
    In this study, the authors investigated the effects of a single layer graphene as a coating layer on top of metal thin films such as silver, gold, aluminum and copper using finite-difference time domain method. To enhance the resolution of surface plasmon resonance (SPR) sensor, it is necessary to increase the SPR reflectivity and decrease the full-width-half maximum (FWHM) of the SPR curve so that there is minimum uncertainty in the determination of the resonance dip. Numerical data was verified with analytical and experimental data where all the data were in good agreement with resonance angle differing in <10% due to noise present in components such as humidity and temperature. In further analysis, reflectivity and FWHM were compared among four types of metal with various thin film thicknesses where graphene was applied on top of the metal layers, and data was compared against pure conventional metal thin films. A 60 nm-thick Au thin film results in higher performance with reflectivity of 92.4% and FWHM of 0.88° whereas single layer graphene-on-60 nm-thick Au gave reflectivity of 91.7% and FWHM of 1.32°. However, a graphene-on-40 nm-thick Ag also gave good performance with narrower FWHM of 0.88° and reflection spectra of 89.2%.
    Matched MeSH terms: Uncertainty
  15. Systematic Review and Meta-Analysis on the Impact of Hexaminolevulinate- Versus White-Light Guided Transurethral Bladder Tumor Resection on Progression in Non-Muscle Invasive Bladder Cancer
    Gakis G, Fahmy O
    Bladder Cancer, 2016 Jul 27;2(3):293-300.
    PMID: 27500197
    Introduction: Although there is evidence that hexaminolevulinate (HAL)-based transurethral bladder tumor resection (TURBT) improves the detection of Ta-T1 non-muscle-invasive bladder cancer (NMIBC) as well as carcinoma in situ there is uncertainty about its beneficial effects on progression. Material and Methods: A systematic literature search was conducted according to the PRISMA statement to identify studies reporting on HAL- vs. white-light (WL-) based TUR-BT in non-muscle invasive bladder cancer between 2000 and 2016. A two-stage selection process was utilized to determine eligible studies. Of a total of 294 studies, 5 (4 randomized and one retrospective) were considered for final analysis. The primary objective was the rate of progression. Results: The median follow-up for patients treated with HAL- and WL-TURBT was 27.6 (1-55.1) and 28.9 (1-53) months, respectively. Of a total of 1301 patients, 644 underwent HAL- and 657 WL-based TURBT. Progression was reported in 44 of 644 patients (6.8%) with HAL- and 70 of 657 patients (10.7%) with WL-TURBT, respectively (median odds ratio: 1.64, 1.10-2.45 for HAL vs. WL; p = 0.01). Data on progression-free survival was reported in a single study with a trend towards improved survival for patients treated with HAL-TURBT (p = 0.05). Conclusions: In this meta-analysis the rate of progression was significantly lower in patients treated with HAL- vs. WL-based TURBT. These results support the initiation of randomized trials on HAL with progression as primary endpoint.
    Matched MeSH terms: Uncertainty
  16. Scientists, speak up! Source impacts trust in health advice across five countries
    Zarzeczna N, Hanel PHP, Rutjens BT, Bono SA, Chen YH, Haddock G
    J Exp Psychol Appl, 2024 Sep;30(3):430-441.
    PMID: 37902696 DOI: 10.1037/xap0000500
    We examined how different types of communication influence people's responses to health advice. We tested whether presenting COVID-19 prevention advice (e.g., washing hands/distancing) as either originating from a government or scientific source would affect people's trust in and intentions to comply with the advice. We also manipulated uncertainty in communicating the advice effectiveness. To achieve this, we conducted an experiment using large samples of participants (N = 4,561) from the United Kingdom, the United States, Canada, Malaysia, and Taiwan. Across countries, participants found messages more trustworthy when the purported source was science rather than the government. This effect was moderated by political orientation in all countries except for Canada, while religiosity moderated the source effect in the United States. Although source did not directly affect intentions to act upon the advice, we found an indirect effect via trust, such that a more trusted source (i.e., science) was predictive of higher intentions to comply. However, the uncertainty manipulation was not effective. Together, our findings suggest that despite prominence of science skepticism in public discourse, people trust scientists more than governments when it comes to practical health advice. It is therefore beneficial to communicate health messages by stressing their scientific bases. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
    Matched MeSH terms: Uncertainty
  17. Fulltext Present status and future concerns of expanded newborn screening in malaysia: sustainability, challenges and perspectives
    Leong YH, Gan CY, Tan MA, Majid MI
    Malays J Med Sci, 2014 Mar;21(2):63-7.
    PMID: 24876809 MyJurnal
    Newborn screening (NBS) program is an important tool for the early diagnosis and preventive treatment of life-long impairments. NBS is one of the strategies recommended by the World Health Organization to promote the primary prevention of congenital anomalies and the health of children with these conditions. However, NBS initiation and implementation in developing countries, especially South-East Asian and North African regions, are slow and challenging. Expanded NBS is not mandatory and has not yet been incorporated into the public healthcare system in our country. Limited funding, manpower shortages, inadequate support services, low public awareness, and uncertain commitment from healthcare practitioners are the main challenges in establishing this program at the national level. Involvement and support from policy makers are very important to the success of the program and the benefit of the entire population.
    Matched MeSH terms: Uncertainty
  18. Fulltext Wernicke's Encephalopthy Associated with Hyperemesis Gravidarum - A Case Report
    Sulaiman W, Othman A, Mohamad M, Salleh HR, Mushahar L
    Malays J Med Sci, 2002 Jul;9(2):43-6.
    PMID: 22844223 MyJurnal
    Two cases of Wernicke's encephalopathy due to hyperemesis gravidarum are described. The first patient presented with bilateral papilloedema, altered sensorium and the second with bilateral retinal haemorrhages, ophthalmoplegia and nystagmus. Both patients were diagnosed with Wernicke's encephalopathy on clinical ground since there were no laboratory facilities to measure red cell transketolase and thiamine pyrophosphate levels. This is a rare but treatable complication of hyperemesis gravidarum (HG) and due to lack of diagnostic tools, there is often diagnostic uncertainty, delay in commencing appropriate treatment, as well as irreversible damage to the upper brain stem and death.
    Matched MeSH terms: Uncertainty
  19. Fulltext Functional status and health-related quality of life in patients with primary intracranial tumour
    Ooi AL, Mazlina M
    Med J Malaysia, 2013 Dec;68(6):448-52.
    PMID: 24632911 MyJurnal
    This study aimed to evaluate the functional status and HRQoL in patients with primary intracranial tumours in Malaysia. Karnofsky Performance Scale (KPS) and Modified Barthel Index (MBI) were used to assess the functional status whereas EORTC core Quality of Life Questionnaire (QLQ-C30) and Brain Cancer Module (BN-20) questionnaires were used to assess the HRQoL. Thirty-eight patients with primary intracranial tumours admitted for surgery in University Malaya Medical Center were recruited. These assessments were administered before surgery (baseline) and six months after surgery (follow-up). All patients received some form of rehabilitation interventions after surgery. The global HRQoL and functional status of these patients showed improvement at six months after surgery. Emotional Functioning score showed the greatest improvement among the functional domains (63 vs 86, p=0.003). Reduction in symptom burden such as fatigue, nausea, vomiting, pain and headache were also noted at follow-up together with less future uncertainty (p<0.05). Pearson correlation revealed statistically significant positive correlation between functional status and HRQoL at baseline and follow-up, in particular, global health status (r=0.50 and r=0.67), physical functioning (r=0.53 and r=0.90) and role functioning (r=0.34 and r=0.77). Thus, from the correlation found, improving a patient's function and independence level throughout all stages of care, even before any surgical intervention is offered would improve the HRQoL concurrently.
    Matched MeSH terms: Uncertainty
  20. Risk assessment for the daily intake of polycyclic aromatic hydrocarbons from the ingestion of cockle (Anadara granosa) and exposure to contaminated water and sediments along the west coast of Peninsular Malaysia
    Mirsadeghi SA, Zakari MP, Yap CK, Shahbazi A
    J Environ Sci (China), 2011;23(2):336-45.
    PMID: 21517010
    The concentration of carcinogenic polycyclic aromatic hydrocarbons (c-PAHs) present in the sediment and water of Peninsular Malaysia as well as in the cockle Anadara granosa was investigated. Samples were extracted and analysed with gas chromatography-mass spectrometry. The concentrations of total carcinogenic polycyclic aromatic hydrocarbons (t-PAHs) were measured between 0.80 +/- 0.04 to 162.96 +/- 14.74 ng/g wet weight (ww) in sediment, between 21.85 +/- 2.18 to 76.2 +/- 10.82 ng/L in water samples and between 3.34 +/- 0.77 to 46.85 +/- 5.50 ng/g ww in the cockle tissue. The risk assessment of probable human carcinogens in the Group B2 PAHs was calculated and assessed in accordance with the standards of the United States Environmental Protection Agency (US EPA). Case I in the toxicity assessment analysed the cancer risk to consumers of Malaysian blood cockle. Case II assessed the risk of cancer from exposure to PAHs from multiple pathways. The average cancer risk of case I and case II were found to be classifiable as unsafe according to the US EPA standard. The cancer risk due to c-PAHs acquired by the ingestion of blood cockle was (8.82 +/- 0.54) x 10-6 to (2.67 +/- 0.06) x 10(-2), higher than the US EPA risk management criterion. The non-cancer risks associated with multiple pathways in Kuala Gula, Kuala Juru and Kuala Perlis were higher than the U.S. EPA safe level, but the non-cancer risk for eating blood cockle was below the level of U.S. EPA concern.
    Matched MeSH terms: Uncertainty
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