DRAF BUKU PROGRAM -2

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CONTENTS

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THE ORGANIZING COMMITTEE

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OPENING SPEECH

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PROGRAM

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PROGRAM

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NORSIMA NAZIFAH SIDEK

PLENARY PRESENTER

PLENARY TALK: RESEARCH IN HEALTH: THE VALUE, IMPORTANCE AND OVERSIGHT

Jawatan dan Gred : Pegawai Farmasi Gred UF 54

Gelaran Jawatan

iAlamat E-mel

: TimbalanPenyelaras (Penyelidikan),

CRC Hospital Sultanah Nur Zahirah,

Kuala Terengganu

: norsima@crc.moh.gov.my

No.Telefon(Pejabat) :09-6212121 ext 2159

No.Telefon (Bimbit) :0199573332

BIODATA

KELULUSAN AKADEMIK

1. Bachelor of Pharmacy Universiti Sains Malaysia (2005)

2. Part time Master of Science (Community Medicine ) (ongoing)

RINGKASAN PERKHIDMATAN

TARIKH

PERKARA

16.6.2005 Pelantikan pertama ke UF41

Pegawai Farmasi, Jabatan Farmasi Hospital Sultanah Nur Zahirah

09.03.2010 Kenaikan pangkat ke Gred UF44


16.6.2012 Kenaikan pangkat ke Gred U48/UF48


16.6.2016 Kenaikan pangkat ke Gred U52/UF52


16.6.2019

Kenaikan pangkat ke Gred U54/UF54

Pegawai Farmasi, CRC, Hospital Sultanah Nur Zahirah

hingga kini

SUMBANGAN

TAHUN

KEGIATAN

2017– Present

Speaker and facilitator for Introduction to Clinical Research Course

2017-2019 Invited lecturer for ILKKM post basic student (Basic Statistic course)

2017-2019 Speaker for Introduction of Clinical Research course

2019 Chair person for Concurrent Stream6 (National Stroke Registry) in

Malaysia Strok Conference

2019 Facilitor for Evidence Based Medicine Workshop

2011-2012 PHIS development team member

2011 Poster presentation at Asia Pacific Stroke Conference 2011, Colombo,

SriLanka

2011 Poster presentation at National Conference for Clinical Research 2011,

KualaLumpur.

2012 Poster presentation at Malaysia Society of Neuroscience Meeting 2012,

Putrajaya

2013 Poster presentation at World Congress of Neurology 2013, Vienna,Austria

2013 Oral Presentation At NHAMASM 2013,KualaLumpur

2017 Poster presentation at 11 th National Conference for Clinical Research

(NCCR) 2017

2018 OraL Presentation at AOMC-MSN Conference 2018

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PLENARY PRESENTER

CHE KU NOOR HANIZA BINTI CHE KU HITAM

PLENARY TALK: IMPORTANCE OF HEALTH STATISTIC

Date of birth : 02 December 1982

Office Number : 09-6212182

Email

: noor.h.cheku@gmail.com

PERSONAL INFORMATION

EDUCATIONAL BACKGROUND

1.Universiti Sultan Zainal Abidin (UniSZA), Kuala Terengganu(2015-2018) :

Doctor of Philosophy (Social Anthropology-Human and Environmental)

2.Universiti Malaysia Terengganu (UMT), Kuala Terengganu (2013-2014) :

Masterof Science (Social Studies-Human and Environmental)

3.Universiti Malaysia Sabah (UMS), Kota Kinabalu (2002-2005) :

Bachelor of Business with Honours (Entrepreneurship) Second Class Upper (CGPA3.11)

AWARD

1.Graduate On Time (GOT) Award 2018, Universiti Sultan Zainal Abidin (UniSZA),

KualaTerengganu.

2.Dean List Award 2004/2005, Universiti Malaysia Sabah (UMS), Kota Kinabalu.

Professional Course

1.Good Clinical Practice (GCP) 2023, (02 March 2023 ) Issue by National Committee for

Clinical Research Malaysia

1.Research Officer at Clinical Research Centre (CRC), Hospital Sultanah Nur Zahirah,

KualaTerengganu (Feb2022–Present)

DESIGNATIONS AND CAREERS

2.Research Committee in Ahli Jawatankuasa Teknikal (TWG) Jururawat Penyelidikan

Klinikal, Institut Penyelidikan Klinikal & Rangkaian Pusat Penyelidikan Klinikal (CRC)

(Feb 2023–Present)

3.Service Coordinator at Titan Oil & Gas Sdn Bhd, Subang Jaya (Jul 2019–Nov 2020)

and Kelantan Branch (Nov 2020–Aug 2021).

4.Research Assistant at Institut Darul Iman (IDAMAN), Universiti Sultan Zainal Abidin

(UniSZA) (01 Nov 2014 - 02 Feb 2019).

5.Research Assistant at Faculty of Business, Economic & Social Development,Universiti

Malaysia Terengganu (UMT) (01 Oct 2011–31 Mar 2014).

Principal Investigator

RESEARCH PUBLICATION AND CONFERENCES

1.NMRRID-23-00859-547 Nurses’ Occupational Stress, Job Satisfaction and Intent to

Leave: A Survey at Hospital Sultanah Nur Zahirah Terengganu (2023).

2.NMRRID-22-01356-WOU The Assessment Of Fear Towards COVID-19 And Its Effect

On Level Of Anxiety Among Healthcare Workers At Hospital Sultanah Nur Zahirah Terengganu:

On Online Survey (2022).

3.NMRRID-22-00838-D1G Modification Model of Post-Stroke Depression Among Post-

Stroke Out patients at Neurology Clinic Hospital Sultanah Nur Zahirah Terengganu (2022).

Co-Investigator

1.NMRRID-23-00877-DP1 Predicting The Successful Outcome in Acute Stroke Patients

Treated with Intravenous Thrombolysis (2022).

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PLENARY PRESENTER

FARINA ZULKERNAIN

PLENARY TALK BSKB: ACT 774: WAY FOWARD

Date of birth : May 6th 1964

PERSONAL INFORMATION

Current Position : Director (JUSA C) Allied Health Sciences Division,

Ministry of Health, Malaysia

PREVIOUS APPOINTMENTS (IF ANY)

Director Allied Health Sciences Division, Ministry of Health, Malaysia 11 Sept 2020 - present

Registrar, Malaysia Allied Health Professions Council

24 March 2022 - present

Senior Deputy Director (Khas C),Policy and Development Section,

Allied Health Sciences Division, Ministry of Health, Malaysia 4 Jan 2020 – 10 Sept 2020

Senior Deputy Director (Khas C), Regulatory & Practices Section,

Allied Health Sciences Division, Ministry of Health, Malaysia 2018 - 2019

Deputy Director (C54), Profession Development Unit

Allied Health Sciences Division, Ministry of Health, Malaysia 2009 - 2017

Nutritionist (C52), Pahang State Health Department, Malaysia 2008 - 2009

Nutritionist (C52), Selangor State Health Department, Malaysia 2005 - 2008

Nutritionist (C48), Sabah State Health Department, Malaysia 2002 - 2005

Nutritionist (C41), Malacca State Health Department, Malaysia 1997 - 2002

Nutritionist (C 41), Pahang State Health Department, Malaysia 1994 - 1997

Laboratory Technician,Hygiene Department, MAS Catering Services

Terminal 3, Subang Airport, Selangor 1992 - 1994

Research Assistant

National University of Malaysia, Bangi, Selangor 1992 - 1993

ACADEMIC /PROFESSIONAL QUALIFICATIONS

1.Bachelor of Science, Food Science and Nutrition (Hons.), National University of Malaysia (1992)

2. Diploma in Food Technology, MARA Institute of Technology, Shah Alam, Selangor (1986)

AWARDS & ACKNOWLEDGEMENTS

1. Certificate of Appreciation from Malaysia Qualifications Agency, Ministry of Higher Education (2021)

2. Certificate of Appreciation from Universiti Islam Antarabangsa Malaysia (IIUM), Pahang (2013)

3. Certificate of Appreciation from Universiti Sultan ZainalAbidin (UniZA), Terengganu (2013)

4. Excellent Service Award from Medical Programme, Ministry of Health, Malaysia (2009)

5. Excellent Service Award from Malacca State Health DepartmenT (2001)

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LIST OF PRESENTERS

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LIST OF PRESENTERS

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LIST OF PRESENTERS

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LIST OF PRESENTERS

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PRESENTATION PROGRAM

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ORAL RESEARCH ABSTRACT

The Relationship of Fruit Intake with CREB and BDNF Protein Levels Among

Adolescents in Terengganu

Siti Noor Syarma Mohd Sharif¹ ², Prof. Madya Ts Dr. Mohd Adzim Khalili Rohin², Dr. Norhayati Abd Hadi²

¹Pejabat Kesihatan Daerah Marang ²Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Terengganu

Darul Iman, Malaysia

R01

Introduction: Diet has a beneficial effect on neurogenesis and cognitive function

through a crucial role of CREB and BDNF protein levels. Increased fruit intake has been associated

with improved cognitive function. However, in Malaysia, most adolescents still haven't met

the recommended intake of fruits and far less is known on how their dietary of fruit intake can be

affected to their protein levels of CREB and BDNF.

Objectives: This study was conducted to determine the relationship of dietary fruit intake

with CREB and BDNF protein level among adolescents in Terengganu.

Methods: A cross sectional study was done on 352 students aged 14 and 16 years old

involving 11 secondary schools in Kuala Terengganu, Marang and Hulu Terengganu Districts. A

validated MyUM adolescent FFQ was used for fruit intake assessment. Blood sample to determine

the level of CREB and BDNF proteins.

Results: Serum level BDNF was correlated positively with fruit intake (r=0.62, p<0.001).

Papaya, watermelon, folate, thiamine and iron were the adjusted significant determinants for

BDNF. While banana, vitamin A and folate were found to be significant relationship with CREB.

Conclusions: The present study found a significant relationship between adolescent

CREB and BDNF protein levels with fruit consumption. Findings could potentially serve as preliminary

data for future studies on neuroprotective effects of fruits and thus, develop better intervention

strategies to increase fruit intake among adolescents and prevent cognitive impairment

in later life

R02

Keberkesanan Penggunaan Madu Sebagai Bahan Fiksatif Sel/Smear

Norli binti Ismail

Jabatan Patologi, Hospital Sultanah Nur Zahirah

Pengenalan: Ethanol merupakan bahan fiksasi bagi sel/pap smear di dalam makmal

Sitologi dan umum diketahui ia telah menjadi gold standard yang digunapakai berkurun lamanya.

Fiksatif yang baik merupakan aspek terpenting dalam mendiagnosis keputusan dengan lebih

tepat. 95% ethanol merupakan rutin fiksatif yang digunakan kerana terbukti ia dapat mengekalkan

morfologi sel dengan baik. Namun, alternatif baru iaitu menggunakan madu sebagai bahan

fiksatif dan telah dikaji mempunyai kebaikan setanding penggunaan ethanol.

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Objektif: Kajian terhadap madu ini telah dijalankan ke atas sampel buccal mucosa dan

ianya adalah bertujuan untuk mengkaji keberkesanan smear sitologi yang diawet dalam 20%

madu dan juga untuk membandingkan keberkesanan antara dua fiksatif dalam pencelupan.

Metodologi:. Ini merupakan kajian hirisan lintang bermula tahun 2015 sehingga 2016. Seramai

30 subjek telah dipilh dari golongan wanita dan kesemuanya adalah dari golongan pekerja dan

pelatih di Jabatan Patologi, HSNZ. Data dianalisis menggunakan Statistical Package For The

Social Science (SPSS 16) dengan kaedah non-parametric Chi Square.

Hasil Kajian: Hasil kajian mendapati tiada perbezaan signifikan antara kedua-dua fiksatif

di dalam pencelupan Papanicoulou. Nilai p> 0.05 menunjukkan hipotesis null tidak ditolak.

Kesimpulan: Dengan hasil kajian yang diperolehi, membuktikan bahawa madu mampu

menjadi bahan fiksatif yang baik setanding dengan penggunaan ethanol yang menjadi gold

standard di makmal Sitologi dalam mengekalkan keadaan asal morfologinya selain memberikan

kualiti pencelupan slaid yang memuaskan setanding penggunaan ethanol.

Correlation Between Coagulation Biomarkers, D-Dimer And Fibrinogen Levels With Demographic

Factors Among COVID-19 Patients in Terengganu

Kasmawati Abu Bakar¹,², Zariyantey Abdul Hamid¹, Azly Sumanty Ab. Ghani², Wan Zuhairah W.

Embong²

¹Biomedical Science Programme and Centre of Diagnostic, Universiti Kebangsaan Malaysia

²Pathology Department, Hospital Sultanah Nur Zahirah (HSNZ)

R03

Introduction: COVID-19 is well known as a global pandemic that causing substantial morbidity

and mortality. Development of COVID19-associated coagulopathies in COVID-19 patients

have been linked to a higher risk of coagulation dysfunction, particularly elevated fibrinogen and

D-Dimer levels. However, this condition remains unclearly reported in Malaysia, particularly in

Terengganu. Objectives: Thus, we investigated the COVID-19 patients’ sociodemographic profile

such as age, gender and race with levels of DDimer and fibrinogen and their relationship.

Method: A cross-sectional study from January to August 2021 was conducted, which involve

414 COVID-19 patients’ data from Laboratory Information System (LIS) and analyzed using descriptive

statistics and Chi-Square test.

Results: Results showed that higher positive COVID-19 cases were in males (n=213;

51.4%) compared to women (n=201; 48.6%) and more prominent in the age group of 15 to 64

years old (n=301; 72.7%), followed by age group of 65 years old and above (n=112; 27.1%) and

14 years old and below (n=1; 0.2%). Malay race is the most affected with 408 patients (98.6%)

and majority of patients showed high level of D-Dimer (n=327; 79.0%) along with normal level of

fibrinogen (n=278; 67.1%). Meanwhile, 26.0% of the patients showed high levels of both D-

Dimer and

fibrinogen.

Only 1.2% showed high D-Dimer with low fibrinogen levels, which indicate more incidences of

thrombosis than disseminated intravascular coagulation (DIC). Further analysis revealed only

age factor (p=0.012) showed positive and significant relationship with D-Dimer levels. As for fibrinogen

levels, both age (p=0.000) and gender (p=0.024) showed positive and significant rela-

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Conclusion: This study highlighted the abnormalities in D-Dimer and fibrinogen levels, well

correlated with age or/and gender factors among COVID-19 patients in Terengganu and highlighted

the importance of both biomarkers for better patient diagnosis, therapy and management.

Lead Equivalent Test For X-Ray Room In Terengganu Health Clinic

Malihah Yumni Mohd Razally¹, Azman Ibrahim², Nurhizwani Hilimi³, Muzammil Jalil4

Dr. Azuhar.Ripin5

¹Jabatan Kesihatan Negeri Terengganu, ²Agensi Nuklear Malaysia

R04

Introduction: Lead equivalent thickness measurement of a shielding material in diagnostic

radiology is very important to ensure that requirements for the purpose of radiation protection

of radiation workers,patients and the public. The Malaysian Ministry of Health (MOH) has established

that the irradiation room must have sufficient shielding thickness, for example for general

radiography must be at least 2.0 mm Pb.

Objective: To verify the lead equivalent thickness for general x-ray rooms at 10 health clinics

in Terengganu.

Methods: This paper presents a technique using americium-241 source and radiation survey

meter model fluke Biomedical Raysafe 452 to test and verify the integrity of the shielding

thickness in term of lead equivalent for x-ray room. Technical comparison of the attenuation of

gamma rays from Am-241 source through the walls of the x-ray room and pieces of lead were

used to assess the lead equivalent thickness of the walls.

Results: Results of lead equivalent thickness measurement of 10 x-ray rooms conducted

in 2022 were analysed for this presentation. Results showed that most of the positions tested are

comply to the MOH standard which is 2 mm Pb. equivalent. Whereas some specific positions

such as door frame,doorknob and doorslit for certain door, film hatch frame and electric sockets

were identified with potential to not met the require lead equivalent thickness hence may contribute

to higher radiation exposure to radiation workers and the public.

Conclusion: The renovation of x-ray room should be done to the positions that do not meet

the MOH requirement so that this can prevent from excessive radiation exposure to radiation

workers, patients and publics.However, the scattered radiation measured outside the X-ray

rooms during quality control annually does not exceed the permissible limits set by MOH which in

acceptable level.

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The Relationship between Parental Stress and Motor Performance of Their Child with

Learning Disabilities (LD)

Alwi Nazurah¹, Harun Dzalani² , Ahmad Mahadir³

¹ Physiotherapy Program, School of Rehabilitation Sciences, Faculty of Health Sciences, Universiti Kebangsaan

Malaysia, Kuala Lumpur, Malaysia ² Occupational Therapy Program, School of Rehabilitation

Sciences, Faculty of Health Sciences, UniversitiKebangsaan Malaysia ³ Unit of Health Psychology, Universiti

Kebangsaan Malaysia, Kuala Lumpur, Malaysia

R05

Introduction: The challenges and difficulties for parents of children born with LD are reported

in many studies. Numerous study reported that parents of children with LD experiencing

high parental stress compared to other parents. However the knowledge of the relationship between

the parental stress and motor performance of the child with LD is inadequate.

Objective: The main objective of this study was to investigate the relationship between

parental stress and motor performance of their child with LD.

Methods: A cross sectional study design was conducted at government and non- government

school in Kuala Lumpur. A total of 137 caregivers of individual with LD completed the Parenting

Stress Index-Short Form (PSI-SF) and a brief demographic questionnaire. Motor performances

of their children with LD were assessed using Movement Assessment Battery for Children-2

(MABC-2).The relationship between level of stress among caregivers and motor performance

of their child were determined using the Spearman’s Rho Correlation analysis.

Results: 115 (83%) of the caregivers had a high level of stress and 108 (85%) of the children

with LD having a significant movement difficulty. The parental stress of parents raising a

child with LD was negatively correlated to their child motor performance, rs (135) = - 0.236,

p=0.01.

Conclusions: An association between increased parenting stress and low motor performance

of the child with LD creates a need for additional family support. As the number of children

diagnosed with LD continues to rise, resources must be available to support parents of children

with LD and their families. Intervention specifically targeted to improve motor performance

of the child with LD may positively influence parental stress

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Comparison & Correlation Between Piriformis Thickness, Gluteal Thickness And

Strength In Low Back Pain Patients With And Without Piriformis Syndrome

Ida Kartini Othman¹,²

¹Centre of Physiotherapy, Faculty of Health Sciences, Universiti Teknologi MARA, ²Physiotherapy Unit,

Hospital Sultanah Nur Zahirah

Corresponding author: idakrtini@moh.gov.my

R06

Introduction: Piriformis Syndrome (PS) is a disorder presented as muscular spasm and

hypertrophy that is strongly associated with piriformis thickness. Patients with PS commonly related

with gluteal muscle strength overactivated or deactivated. Nevertheless, the comparison

between patients with PS or without PS on the piriformis muscle thickness and gluteal muscles

strength remains unclear.

Objective: This study aimed to investigate the comparison and correlation between the

thickness and strength between piriformis and gluteus muscles (maximus and medius) between

Low Back Pain (LBP) patients with and without PS.

Method: A total number of 91 participants, LBP + PS (n = 36), LBP - PS (n = 24) and

healthy (n = 31) were recruited in this study. Negative radiography, specific symptoms, and a

positive PS test were applied for PS diagnoses. The thickness and strengthof Piriformis and gluteus

muscles were measured by ultrasonography (USG) and surface electromyogram, respectively.

Result: The One-way ANOVA test demonstrated no significant difference in piriformis thickness

between LBP with PS and LBP without PS (p > 0.01). The LBP with non-PS demonstrated

the strongest gluteus maximus strength (72.59 ±27.12 μV) compared to the other two groups.

The gluteus medius strength was shown to be weaker in the LBP with PS (70.29 ±30.39 μV).

Whereas no significant difference (p>0.05) on the gluteus medius thickness between all the

groups. Meanwhile, in LBP with PS, Piriformis thickness was inversely correlated with gluteus

maximus strength (r = -0.4, p < 0.05).

Conclusion:

These findings may assist to elucidate the actions and functions of piriformis

and gluteus muscle in LBP with and without PS.

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The Effectiveness of Spinal Thrust Joint Manipulation in Clinical Setting:

A Systematic Review

Nor Haima Mariana Yaacob

Hospital Dungun

R07

Introduction: Spinal thrust manipulation is one of the manual interventions that can be

utilized in treating neck pain. Just like any other treatment, this maneuver is believed to exhibit

adverse effects. Therefore, this study aims to review the efficacy and adverse effects of spinal

thrust manipulation

Objectives: The objective of this study is to systematically review randomized controlled

trials (RCTs) that compares the effectiveness of spinal thrust manipulation and nonthrust

manipulation and determine the adverse effects following the treatment.

Methods: Following PRISMA guidelines for systematic review, a total of 365 articles

were retrieved from databases such as PubMED, PEDro, ScienceDirect, CENTRAL and

Google Scholar. One hundred and thirty-seven (137) articles were screened through their title

and abstract and further reviewed for their eligibility. One hundred and thirty-one (131) articles

were excluded and recorded with reasons. This review included six eligible articles, including

three RCT, two RCT pilot studies and one secondary analysis of RCT published since 2010

and fulfilled the inclusion criteria which included full text English publication, participants with

any types of neck pain aged 18 to 65 years old without red flags and human study. Four included

studies had a low risk of bias and two had some concern in terms of randomization process

and adherence of participants to intervention.

Results: Three of the included studies showed that spinal thrust manipulation was

more effective in reducing neck pain than non-thrust manipulation and the other studies yielded

otherwise. Factors that may contribute to the varying result could be the nature of pain, the performing

therapists, and the duration of follow up. The results have shown that spinal thrust manipulation

exhibited more on the mild and moderate adverse effects compared to major adverse

effects.

Conclusion: In conclusion, the efficacy of spinal TJM as compared to non TJM were

found to have no superiority than one another as the result manifested both interventions were

equally effective in reducing neck pain. Therefore, a more in-depth study about the efficacy and

adverse effects of spinal manipulation is required to obtain a more comprehensive result

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SARS-CoV-2 Genomic Surveillance Data Analysis: The changing trend of circulating

SARS-CoV-2 Variant of Concern (VOC) in Terengganu from June 2021 until December

2022

Anuar Mustaqim bin Musa¹, Nurul Adila binti Malek¹, Norazita binti Safie¹, Fatimah Haslina

binti Abdullah¹, Norlela binti Othman¹

¹Department of Pathology, Hospital Sultanah Nur Zahirah

R08

Introduction: Coronavirus disease 2019 (COVID-19) is an infectious disease caused by

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and a public health concern

worldwide causing a range of serious health problems. The better understanding in viral

mutations and variants is necessary for surveillance and disease management. Thus, the

whole genome sequencing (WGS) is a reliable approach to describe the virus epidemiology

and provide recent knowledge to emphasize those variants that can further compromise the

critical public health scenario.

Objectives: This study reported SARS-CoV-2 whole genome sequencing results from

June 2021 until December 2022 and to describe the changing trend of SARS-CoV variants

circulated in Terengganu.

Methods: A retrospective study using of SARS-CoV-2 whole genome sequencing (WGS)

surveillance data conducted by Ministry of Health and Terengganu Health State Department

from June 2021 until December 2022 as a part of national surveillance program. A total of 302

of SARS- CoV-2 positive samples with cycle threshold value of

Results: Of 302 samples, 104 were identified as the Delta variant of concern followed

by the Omicron variant. The Delta variant was the predominant variant circulating with the

original Delta variant, B.1.617.2 lineage being the most common, followed by AY.79 lineage

and AY.59, from June 2021 until November 2021. From December 2021 onward, the Omicron

variant BA.1 and BA.2 lineages outcompete the Delta variant to be the most prevalent SARS-

CoV-2 variant and sub lineages in Terengganu.

Conclusions: The changing trend of circulating SARS-CoV-2 variant and lineages were

identified. This report highlights genomic surveillance can significantly enhance the understanding

of SARS CoV-2 epidemiology, allowing the exploration of the real-time outbreak

management.

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Improvement of Lower Limb Strength After Physiotherapy Intervention Among Elderly

With Type 2 Diabetes

Siti Noorarita Binti Azhari

Physiotherapy Unit of Klinik Kesihatan Kuala Berang

R09

Introduction: Lower limb weakness is one of the physical deficit among elderly that can

lead to many unwanted event such as fall. There are many side effects of falls in older age such

as disabilities and may even result in morbidities. Elderly with type 2 diabetes have twice the

risk of fall than those without diabetes due to having to take multiple drugs for many years. Diabetic

patients also experienced lower limb muscle weakness due to diabetic neuropathy condition.

Objective: The objective of this study to determine the improvement of lower limb

strength using five times sit to stand test after physiotherapy intervention among elderlywith type

2 diabetes.

Method: This study was the combination of intervention and descriptive study. 124elderly

patients with Type 2 Diabetes were involved in this study, selected by purposive sampling.

This study was conducted at 7 Physiotherapy departments in primary care facilities in Terengganu

within 5 months duration. 5 times sit to stand was performed as outcome measure during

baseline and 2 months post physiotherapy session. The physiotherapy interventions performed

include lower limb strengthening exercise, balance training, core muscle strengthening exercise,

patient education for exercise and physical activities for diabetic patient and prescription of

home exercise programme.Data were analyzed using descriptive statistics.

Results: From 124 samples ofpatients 50(40%) patientswere male and 79(60%) were female.

Improvement can be seen in reduction of time to complete 5 times sit to stand among 88

(71%) diabetic patients after 2 month physiotherapy intervention.Out of 21 patients who using

walking aids, 16 (76%) of them has better lower limb strength.

Conclusion: Most elderly with type 2 Diabetes will experience lower limb weakness.Physiotherapy

interventions was found to be effectivein improvinglower limb’ strength,

which the improvement will help prevent risk of fall among elderly with Type 2 Diabetes.

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Abundance, Distribution and Bionomics of Main Malaria Vector in Terengganu:

A Cross-sectional Study

Nor Alina Mohd Alwi¹, Nur Hazirah Nodin1, Izzati Khalid2, Mohd Ridzuan Othman3, Siti Firdaus

Mohd Mokhdi4, Irda Idura Laili Nordin5, Mohd Khalil Jusoh1

¹Unit Entomologi & Pest, Jabatan Kesihatan Negeri Terengganu, ²Unit Entomologi & Pest, Pejabat

Kesihatan Daerah Kuala Nerus, 3Unit Entomologi & Pest, Pejabat Kesihatan Daerah Dungun,4Unit Entomologi

& Pest, Pejabat Kesihatan Daerah Besut,5Unit Entomologi & Pest, Pejabat Kesihatan Daerah Kuala

Terengganu

R10

Introduction: Malaria is a major vector-borne disease caused by Plasmodium and transmitted

via the bite of infected Anopheles mosquitoes.Anopheles lay their eggs in a variety of fresh or

brackish bodies of water, with different species having different preferences. Thespeciesof

Anopheles present in an area at a given time will influence the intensity of malaria transmission.

Understanding of the local distribution and abundance of those species will help facilitate the application

of suitable modes of malaria control and maximize the use of constrained resources.

Objectives: This study aimed to highlight the distribution of malaria cases and their vectors

throughout the state of Terengganu.

Methods: Anopheles mosquitoes were collected using human-landing catch (HLC) from the

location where malaria cases were reported. Cases of malaria from 2018 to 2022 in Terengganu

were analyzed. Anopheleswere identified by species using the keys of Reid and Sallum.

Results: 166 malaria cases were reported in Terengganu over 5 years. Young adults between

the ages of 30-39 year comprised 31% of the cases. Most infected individuals were involved

in agriculture-related occupation and self-employed 25% respectively. Plasmodium

knowlesi contributed to the highest number of cases all over the years. 21% of malaria case localities

that were assessed have vector findings. 250 out of 1892 (13.2%) mosquitoes captured

were malaria vectors. Anopheles maculatus(11.6%) was the predominant species followed by

Anopheles cracens (0.8%).

Conclusion: Anopheles maculatus and Anopheles cracens are still the main vectors of

malaria in Terengganu state where the habitat for these vectors is still in the forest area. Elimination

of malaria breeding sites and health education especially for people who have social activities

in the forest is very important to avoid the spread of malaria.

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The Effectiveness Of Educational Counseling Alone For Patient With Tinnitus

Wan Suhailah Wan Husain, Fatin Syakirah Harun, Dr Nik Khairani Nik Mohd Otorhinolaryngology

Department, Hospital Sultanah Nur Zahirah

R11

Introduction: Tinnitus is the perception of sounds in the absence of external auditory

stimulation. It is not a disease but a symptom associated with a number of health conditions,

such as noise-induced hearing loss, presbycusis, metabolic disorders, use of medication, ear

infections, somatosensory impairment and/or chronic co-morbidities.Perception of tinnitus is a

side effect of normal compensatory mechanisms in the brain. The source of tinnitus could not

be eliminated but it is possible to use naturally occurring mechanisms of brain plasticity to

achieve habituation of physiological reactions to the tinnitus. Previous study had found that

people with tinnitus were more socially withdrawn, reactive to stress, and less selfcontrolled.Patient

has to adjust their perception of internal noise, negative beliefs and consequences

that accompany with it.

Objective: This study aims to show the effectiveness of educational counseling only for

patients with tinnitus to reduce their annoyance level before proceed with further management.

Method: New patients were selected from patient attendance list to tinnitus clinic, ORL department

HSNZ between June 2021 to June 2022. A detailed history taking about tinnitus annoyancewere

taken. A questionnaire to evaluate their level of tinnitus annoyance were given topatients

during initial visit and during follow up after educational counseling.An educational counselingwas

given as an initial step of management before proceed with further management.

This counseling consists of education about ear, process of hearing, causes of hearing loss

and possible factors associated with tinnitus.

Results: Total 37 patients were referred to tinnitus clinic for tinnitus management during

June 2021 to June 2022. About 10 patients received educational counseling only for tinnitus

management. Average initial score was 39.4% after management the score was reduced to

20.9%. In average, patient showed reduction of tinnitus annoyance after receive educational

counseling only.

Conclusion: The findings from this study have showed that educational counselling is

a vital component of all tinnitus management options. It helps patients understand the cause of

their tinnitus, factors that could change their tinnitus loudness and steps to reduce awareness

to tinnitus perception. From there habituation to tinnitus perception could be occurred.

29


How Did Medical Socioeconomic Assistance Help Our Diabetes Patients? A Five Years

Retrospective Cohort Study in Hulu Terengganu District

Zawati Yusof1, Siti Noorarita Azhari¹, Nor Adila Abdul Aziz¹, Mohd Hafiz Yahya², Mohd Anuar

Abd Rahman³, Kasemani Embong³, Goh Soo Ning¹

¹Pejabat Kesihatan Daerah Hulu Terengganu, ²Hospital Hulu Terengganu,

³Jabatan Kesihatan Negeri Terengganu

R12

Introduction: Diabetes is one of the major health concerns worldwide. Socio-economic

status had been linked to metabolic control, a key determinant of diabetes-related complications.

The Medical Social Work Unit provides assistance to patients in need especially in the

form of medical equipment support to help improve their disease control.

Objectives: This study aimed to determine the HbA1c control before and after receiving

medical equipment support, i.e., glucometer

Methods: A retrospective cohort study was conducted from 1 January 2023 to 31 January

2023. By using purposive sampling method, this study included all patients in government

health clinicsin Hulu Terengganu Districtand who hadreferred to Medical Social Work Unit and

had received socioeconomic assistance (glucometer). Data was retrieved from patients’ record

cardsfrom year 2018 till 2022. Data was then entered, cleaned and analyzed by using Microsoft

Excel.

Results: A total of 31 samples had fulfilled our study’s inclusion criteria in five years period.

Most of the diabetic patients who had been referred to Medical Social Work Unit were females

(67.7%), had household income between RM300-RM1500, not working or housewife

(90.3%), had other underlying comorbid such as hypertension (61.3%), hyperlipidemia

(45.2%), stroke (3.2%), cataract (6.5%), retinopathy (3.2%), ischemic heart disease (3.2%) and

nephropathy (6.5%). The study samples’ mean age was 58 years old and mean BMI was 27.6.

Majority (18, 58.1%) had improved in HbA1clevel before and six months after received glucometer

support with mean reduction of 1.19% % of HbA1c level.

Conclusion: Glucometer support by Medical Social Work Unit is one of the contributing

factors to the reduction of HbA1c level in diabetic patients as they were able to do SMBG (selfmonitoring

blood glucose) at home. However, other factors such as increased patients’ awareness

and self-care via health education, compliance to treatment plan, social support were also

important factors that lead to the success of diabetic control.

30


Konflik Kerja Keluarga Terhadap Kepuasan Kerja Dalam Kalangan Kakitangan Ibu Pejabat

Jabatan Kesihatan Negeri Terengganu

Suraya Binti Sulong,Mohd Safie Bin Zakaria

Unit Psikologi & Kaunseling, Jabatan Kesihatan Negeri Terengganu

R13

Pengenalan: Konflik kerja keluarga merupakan satu konflik yang mendorong individu untuk

mengalami tekanan. Pertambahan beban, peranan dan peningkatan komitmen dalam pekerjaan

serta tanggungjawab keluarga yang berlaku disebabkan oleh perkembangan teknologi dan

ekonomi telah menyebabkan ketidakseimbangan peranan berlaku dan sekaligus mengakibatkan

tekanan kepada individu (Panatik & Badri, 2012).

Objektif: Kajian ini bertujuan mengenalpasti tahap konflik kerja keluarga dan kepuasan

kerja serta hubungan antara konflik kerja keluarga dan kepuasan kerja dalam kalangan kakitangan

kesihatan di Ibu Pejabat Jabatan Kesihatan Negeri Terengganu Metodologi: Alat ujian

Work Family Conflict Scale (Carlson dan Williams, 2020) telah digunakan bagi mengukur konflik

kerja keluarga manakala alat ujian Michigan Organizatinal Assessment Questionnaire (Cammann

et.all, 1979) digunakan bagi mengukur kepuasan kerja. Seramai 216 kakitangan Ibu Pejabat,

Jabatan Kesihatan Negeri Terengganu telah terlibat dalam kajian ini iaitu terdiri daripada 80

orang kakitangan lelaki dan136 kakitangan perempuan.

Hasil Kajian: Analisis diskriptif menunjukkan bahawa tahap konflik kerja keluarga secara

keseluruhan berada pada tahap rendah manakala kepuasan kerja secara keseluruhan berada

pada tahap sederhana. Bagi analisis korelasi spearman menunjukkan terdapat hubungan yang

signifikan diantara konflik kerja keluarga dan kepuasan kerja. Kesimpulan: Implikasi kajian ini

menunjukkan kepentingan kepada organisasi bagi menintikberatkan aspek kerja keluarga dalam

meningkatkan kepuasan dalam kalangan kakitangan.

Kesimpulan: Implikasi kajian ini menunjukkan kepentingan kepada organisasi bagi

menintikberatkan aspek kerja keluarga dalam meningkatkan kepuasan dalam kalangan kakitangan

31

32

ORAL CASE STUDY ABSTRACT

Converence Insufficiency and Eye-hand Coordination in Relation to Children Academic-

Learning Issues: A Case Report

Aziimah Awang Abd Rahman

Department of Ophthalmology, Kemaman Hospital

C01

Introduction: Fast learning trend in syllabus of Malaysia education system up to date

might invite troublesome in some parents and teachers that have child with some learning behavior

issues. Aim of this case report is to solve the Academic-Learning issues in Convergence

Insufficiency and Attention Deficit Disorder.

Case Presentation: Here is a case of a 9 year-old male Malay student with combination of

Convergence Insufficiency and mild ADD. Parents and teachers reported of his difficulty completing

work, avoidance, and inattention since his early age of 5-year old in pre school. This child initially

was diagnosed as Attention Deficit Disorder without Hyperactive. Later this year, he was

diagnosed to have CI in the age of 9 years old when he able give well subjective response in full

binocular vision (BV) assessment. He undergone weekly 3 in-office vision therapy (VT) sessions

and advised for daily home VT for 1 month. The result showed changes in his BV assessment.

Parents and teacher also reported a better Academic-Learning behavior at school and home after

VT sessions.

Conclusion: It is important not to neglect the full BV assessment in child with Academic

-Learning issue especially as soon as the child able to give good reliable subjective response.

_____________________________________________________________________________

Occupational Therapy Intervention Using Self Care Activities And Sensory Approach In

Autism Spectrum Disorder With Positive Results: A Case Study

Nurul Asma’ Mazelan

Occupational Therapy Department, Hospital Sultanah Nur Zahirah

C02

Introduction : Autism Spectrum Disorder (ASD) is a complex developmental condition that involves

persistent challenges in social interaction, speech and nonverbal communication and restricted

/ repetitive behavior. The effects of ASD and the severity of symptoms are different in

each person. It is usually first diagnosed in childhood with many of the most obvious signs presenting

around 2-3 years old but in some cases in toddlerhood when they stop acquiring or lose

previously gained skill.

33


Case Presentation : Mother was aware of her son, Boboy, being different from other children

at the age of 5 years. Since he is able to be in mainstream school, mother thought it will

fade away with time. Then mother noticed school had always been stressful for him and sought

professional help. He was referred for occupational therapy by a psychiatrist.He was an average

student and had no problem at school, but he had a hard time making friends since he was often

bullied and laughed at because of his awkward behaviour. He is also labelled as weird. He preferred

to be by himself because of these. Mother also described him as a messy boy because he

refused to comb his hair and was not able to perform other self care activities independently, including

bathing, dressing and grooming. Boboy underwent occupational therapy in HSNZ and also

at home with his mother, following a home program prescribed by his therapist. He had shown

good compliance and received good support from his mother. He had displayed a remarkable

progress after attending a total of 10 occupational therapy sessions.

Conclusion : Daily living activities have many therapeutic values which can be used as a

meaningful form of intervention. In this case, it offers the child a chance to participate in tasks

that matters the most to him based on the goals set by the child, the carer and the therapist as a

team earlier in the program. Children with Autism Spectrum Disorder will get an equal opportunity

to perform school activity with comprehensive support from carer, MDT and holistic approach

from therapist.

Nutrition Challenges in the Management of Children with Cornelia de lange Syndrome

(CdLS) :

A Case Study

Nabila Shahman¹ , Dr. Nurul Zahirah Zainal²

Department of Dietetic & Food Service Hospital Hulu Terengganu¹, Specialist Clinic Hospital Hulu Terengganu²

C03

Introduction: Cornelia de Lange Syndrome (CdLS) is a rare genetic condition that affects

growth and development that is present from birth. Feeding difficulties related to swallowing incoordination,

poor esophageal motility and gastroesophageal reflux (GER) occur in children with

CdLS and may result in not meeting weight gain expectation and life-threatening aspiration pneumonia.

Dietary intervention with optimization of feeding composition, frequency and volume may

help to obtain targeted weight and good nutritional outcome.

Case Presentation: A 7 years old boy diagnosed with Cornelia de Lange Syndrome

(CdLS) and Failure to thrive (FTT) was referred to Dietitian from KlinikPakar Hospital Hulu Terengganu

for weight static. During first visit to Dietitian, patient looked small for age and short stature

with body weight 3.8 kg and length 63.5 cm which fall below 3rd centile.

34


Patient on Ryles tube feeding every three hourly with caloric intake around 700 kcal/day and 15 g

protein/day with step 1 formula. Dietary intake was depend on availability of formula at home due

to economic status. Nutrition diagnosis was enteral nutrition (EN) composition inconsistent with

needs related to nutrition-related deficit knowledge concerning EN product as evidenced by inconsistent

with evidence based practice. Intervention with increasing strengh of current formula

used while maintaining tolerable volume was presribed, and complete and balance formula was

discussed along with help from multidisciplinary team as Medical Officer and Social Worker Officer

to start. Body weight show increment of 1.98 kg along 5 follow up visits to Dietitian at clinic

with average intake of 850 kcal/day and 24 g protein/day despite of struggling to achieve energy

requirement due to change of formulas, feeding volume toleration of 120cc and presence of reflux

.

Conclusion: Early nutritional intervention and regular reviews by Dietitian in CdLS patient

is essential to correct pre-existing nutritional deficiencies. Enteral formula selection and parental

education and guidance on feeding safety are critical components of managing a high-risk

reflux. The use of complete balance formula results in a favourable outcome.

Embracing the Future of Clinical Laboratory Technology: A HSNZ Experience

Nurul Izzati Mohd Annuar, Nik Muhammad Mahmood, Romel Shahfri Ahmad Tajuddin,

Rosemawati Arifin

Unit Patologi Kimia, Jabatan Patologi, Hospital Sultanah Nur Zahirah, Kuala Terengganu

nurul.izzati@moh.gov.my

C04

Introduction: Majority of medical decisions is influenced by clinical laboratory results

and it is very important to deliver the results in a timely manner for proper patient management.

Automation is considered one of the most important breakthroughs in the history of laboratory

diagnostics where it is effective in improving efficiency, standardization, quality and safety of laboratory

staffs. In this case, we have investigated the impact of total laboratory automation implementation

on the clinical laboratory workflow, efficiency and effectiveness.

Case presentation: Total lab automation system (TLA) was implemented in Unit Patologi

Kimia, HSNZ in 2018. Previously, manual steps and staffing are required to do repetitive procedure

such as centrifugation, de-capping, sample loading and storage. Adoption of TLA has

shown to significantly decrease the manual steps in the pre-analytical phase, thereby reducing

error and allowing staff to focus more on quality control and quality assurance. Other than that,

reduction in Routine Chemistry sample LTAT can be seen where pre-TLA, 48 minutes were required

starting from Pre-analytical step towards result verification while post-TLA the processing

time was down to 38.3 minutes. Besides, samples for routine chemistry and immunoassay testing

can be consolidated into single test tube. Anemia profile which consists of Iron, UIBC, TIBC

and Ferritin have shown significant reduction in cost of vacutainer usage as only single tube is

required. Pre-TLA, the identification of hemolysis, icterus or lipemia (HIL) interference has been

performed by visually inspecting for changes in the colour and clarity of serum by medical laboratory

staff.

35


Averages of 236, 970 routine biochemistry samples are visually inspected and this can lead to

inconsistency of reporting when performed manually. The visual inspection of HIL varies due to

factor such as work experiences, ability to differentiate color intensity and training opportunities.

Post TLA implementation, HIL indices are performed automatically by the system where better

quality and accurate results can be delivered to clinicians.

Conclusion: TLA significantly improved the laboratory performance by creating more

efficient and stable management of the workflow which impact the timeliness and quality of test

results, outlier rate, staff safety and clinician satisfaction

Post-Operative Nutritional Therapy for Patient with Achalasia: A Case Study

Lua Lee Yen, Noor Aziati Abdul Rahim

Department of Dietetics, Hospital Sultanah Nur Zahirah, Kuala Terengganu

C05

Introduction: Achalasia is a rare swallowing disorder with reported global prevalence

1.8 to 12.6 per 100,000 persons per year. It is characterized by the absence of esophageal peristalsis

and impaired relaxation of the lower esophageal sphincter in response to swallowing. It

occurs when nerves in the esophagus become damaged and causes paralyzed and dilated

overtime and eventually loses the ability to squeeze food down into the stomach. Achalasia can

lead to nutrition deficiency which can cause malnutrition and weight loss. Surgery treatment is

an option to relieve swallowing problems and prevent complication.

Case Presentation: Madam S, a 34-year-old malay female presented with achalasia during

her 3 rd pregnancy. She had previous history of elective lower segment caesarean section due

to achalasia and bilateral tubal ligation at 35-weeks period of amenorrhea in 2021. She was

seen by dietitian as outpatient for feeding optimization with oral nutritional supplement (ONS)

before going for laparoscopic Heller Cadiomyotomy in Jan 2022. Patient was electively admitted

for minimal invasive Mckeown esophagectomy in August 2022. Parenteral nutrition (PN) with

800 kcal/day was started on day 1 post operation day (POD). Nasogastric tube was inserted on

POD 4. Enteral feeding was started on POD 6 with 10ml/hr for 4 hourly feed and 2hourly rest by

using peptide-based formula and feeding was stepped up accordingly until POD12. PN was

then off by POD11. She was encouraged for oral feeding with standard polymeric ONS by

POD13. Finally, patient was discharged after POD 14 with liquid diet and was given a follow-up

after 2 weeks later. During the follow-up, her wounds were well-healed. She was allowed orally

with normal diet and continues her follow-up after another 3 months.

Conclusion: Optimizing nutrition therapy is often required to prevent malnutrition and

dehydration for patient with achalasia. Routine nutrition support team round with multidisciplinary

team approach is particularly important to devise nutritional care plan for this patient at a

timely basis.

36


C06

Outcome of Cycle Phonological Approach in Managing A Phonological Disorder Case:

A Case Report

Nur ‘Ain Mardhiyyah Mohd Khari, Najah Farahin Mustafa, Nur Arifah Azmi

Department of Otorhinolaringology, Hospital Sultanah Nur Zahirah

Introduction: Phonological disorder is one of functional speech sound disorders (SSD)

that commonly occur in pre-schoolers and school-age children. It refers to difficulty in organizing

the speech sounds into a system of sound patterns. Common complaints for children with SSD

including difficult to understand child’s speech and communication breakdown.Children normally

will get frustrated and sometimes lead to unpleasantbehaviours. Phonological disorder regarded

as significant problem and raise concern on child’s social communication in daily activities. Phonological

treatment are now varied. Thus, selecting intervention approach in which benefited the

child is one of the important things to be considered. Cycle Approach is one of the latest approaches

for the treatment of moderate to severe phonological disorders in which benefited child

with SSD. This study was implemented to a clinical experience to measure the speech outcome.

Case presentation: A 6 y/o malay girl with no known medical illness (NKMI) was referred

from ORL Clinic with concern of speech errors. Assessment on child’s speech and language was

then conducted and findings are revealed. Patient’s language skill was appropriate and speech

sound disorder is identified as phonological disorder with moderate severity. A lot of phonological

process was identified from child’s speech sample and speech intelligibility was rated as somewhat

intelligible. Cycle Approach was then selected in this case. 2 month of intervention period

was implemented and outcome were measured pre and post intervention focusing on elimination

of Phonological Process, count of Percentage Correct Consonant (PCC) and intelligibility rating.

After attending intensive therapy, a significant progress was seen in patient’s speech productions.

Conclusion: Understanding speech sound disorder is fundamental in treating child with

SSD. With the development of modern approaches,therapist has more opportunity to implement

new approach in clinical practice despite of traditional approach. Thus, it is good for therapist to

explore.

37


C07

NMRR ID: 01150

Semi Elemental Feeding with MCT Reduces Diarrhea Complications and Provide Adequate

Nutrition in Isolated Chylous Ascites (Paediatric) – A Case Report

Shaheeda Razali

Dietetic Department, Hospital Kemaman, Terengganu

Introduction: Chylous ascites (CA) is accumulation of lipid rich lymph in peritoneal cavity.

Patients most commonly present with abdominal distention, hydrocoele, chylothorax or peritonitis

and less common presentations such as diarrhea. Nutritional support is a used measure

in most of cases which involves a high protein and low-fat diet including medium chain triglycerides

(MCTs) to reduce chyle formation.

Case Presentation: A male Malay baby was born at 38 weeks POA with weight of 3.675

kg. Peritoneal tapping done at day 7 OL then he was diagnosed as isolated chylous ascites.

Feeding was started with term infant formula on day 2 OL and was changed to premature formula

due to weight keep reducing. Then he was referred to the dietitian for Portagen. However,

Activemax Hi Carb was introduced with additional of MCT oil due to Portagen was unavailable

but he developed episode of persistent diarrhea after 4th feeding but resolved after MCT oil

was witholded. Finally we introduced Peptamen Junior with strength gradually increased (0.77

kcal/ml up to 1.0 kcal/ml) on day 25 OL with no issues, weight increased to 5.14 kg prior to discharge.

He was readmitted on day 53 OL for Portagen however he was developed persistent

diarrhea. Feeding was changed back to Peptamen Junior with 1 kcal/ml and discharged at day

56 of life with no issues.This case illustrated how the formula containing peptide based protein

contributed to a reduction of gastrointestinal symptoms leading to improved tolerance of EN.

Changing to this formula was beneficial as gastrointestinal symptoms were significantly reduced,

feeding tolerance improved overall, and satisfactory weight gain was achieved.

Conclusion: Isolated chylous ascites with diarrhea developed in the very young child

successfully treated with semi elemental feeding with MCT which is an effective way of reducing

chyle production, reduces diarrhea complications and provide adequate nutrition

38

39

POSTER RESEARCH ABSTRACT

A Comparative Study on Sensory Processing Disorder Between Down Syndrome And

Typically Developing Children

Siti Nurhanis Mohd Razali

Unit Terapi Cara Kerja, Klinik Kesihatan Chendering, Kuala Terengganu.

siti.nurhanis@moh.gov.my

P01

Introduction: Sensory processing disorder (SPD) also known as sensory integration dysfunction

is a condition where multisensory integration is not adequately processed inorder to provide

appropriate responses to the demands of the environment. Child with Down syndrome is

commonly observe with sensory impairments and also can adversely affect learning and cognitive

functioning to the child. There are limited studies regarding the sensory processing challenges

and issues among children with Down syndrome that might be associated with the child’s developmental.

Objectives: The aim of this study is to compare sensory processing disorder between

children with Down syndrome and typically developing children. The specific objectives of this

study are to determine the level of sensory processing disorder of typically developing and Down

syndrome children also to compare any significant differences in sensory processing disorder between

them and to identify the differences of any components in the sensory processing disorder

and also to identify association between demographic characteristic with total score of Short

Sensory Profile.

Methods: A cross-sectional study with 66 parents of children with Down syndrome and typically

developing children were participated in this study. Sensory processing issues evaluated by

using Short Sensory Profile (SSP) in Malay version. Results: A significance differences was

found between Down syndrome and Typically Developing Children in level of sensory processing

disorder (p=0.001). This study also found that there were significance difference in each component

in Short Sensory Profile between these two groups of children (p=0.001) except in taste and

olfactory sensitivity component (p=0.052). Findings also identified association between children

age and total score of short sensory profile.

Conclusions: The results of this study suggest that sensory processing in children with

Down syndrome is different from that of typically developing children. This information may be

useful for occupational therapists to highlight and address sensory processing issues in children

with Down syndrome

40


Development of Allele Specific PCR For The Detection Of RS4859584 Within CXCL10 Gene

Using Rhamp Taqman Genotyping

Mazirah Mazlan, Mohd Nazif Samat @ Darawi

Department of Health Sciences, Faculty of Engineering and Life Sciences, Universiti Selangor (UNISEL)

P02

Introduction: Dengue infection becomes the most vector-borne viral disease of humansin

terms of morbidity and economic impact. Single nucleotide polymorphisms (SNPs) ofrs4859584

and rs8878 in CXCL10 were reported in previous studies significantlyassociated with vascular

permeability of dengue infection. Objective: The aim of this study is to develop an allele-specific

polymerase chain reaction (PCR) method for the detection of SNP rs4859584 within the CXCL10

gene ofthe human sample using rhampTaqman genotyping. Specifically, this study is to designa

PCR primer comprising the rhamptaqman probe for the detection of SNP rs4859584and to utilize

the develop rhamp SNP assay for differentiating the genotype of samplewhether is homozygous

C, heterozygous CG or homozygous G.

Methods: The study was conducted with the approval of the Research Ethics Committee

of Faculty of Engineering and Life Science (FELS), Universiti Selangor. Nine DNA sample that

was extracted from blood with a confirmed genotype were used in thisresearch. The DNA concentration

was measured at OD wavelength of 260nm and 280nm respectively using a Biophotometer.

Full components for rhAmp SNP Genotypingare rhAmp SNP Assay, rhAmp Genotyping

Master Mix, rhAmp Reporter mix and therhAmp Reporter Mix.

Result: rhamp SNP genotyping successfully detected genotype nine samples to targetSNP

rs4859584 within CXCL10. There are three samples that represent the genotypehomozygous

GG and gives the blue signal. Three samples are represent genotypeheterozygous C/G

gives the signal for the allele C and G in yellow codding. The lastthree samples are in red signal

are represented by genotypes homozygous C/C.

Conclusion: The hypothesis is accepted to use the rhamp SNP Genotyping to detectSNP

rs4859584 within the CXCL10 genes. This method can differentiate between all theGG, CC, and

CG genotypes, it also can be used to find the genetic polymorphism studyof the gene toward the

effects of the risk dengue infection in the future.

41


Fail Mesra Kanak-Kanak

Yusmiza binti Yusof, Amalina Naili Mohamad, Afnorashimah binti Mamat

Unit Rekod Perubatan, Hospital Setiu

P03

Pendahuluan: Jadual Pelupusan Rekod Perubatan telah dipinda pada tahun 2016 yang

membabitkan penyimpanan Rekod Pesakit Pediatrik. Tempoh pelupusan rekod pesakit Pediatrik

adalah berbeza daripada rekod lain, ia memerlukan tempoh penyimpanan sehingga pesakit

berumur 18 tahun sebelum dilupuskan. Unit Rekod Perubatan memberi fokus Rekod Pediatrik

berdasarkan lambakan rekod pesakit pediatrik yang sedang berlaku dan akan berlaku secara

langsung akan memberi impak kepada penyimpanan dan penyelenggaraan rekod terbabit.

Objektif: Pelaksanaan projek ini adalah di Unit Rekod Perubatan. Bermula dengan pengubahsuaian

fail pada 20 Februari 2017 dan kemudiannya disusuli dengan pengasingan,

penyusunan dan penyimpanan rekod pesakit pediatric pada awal tahun 2019. Sebanyak 11 unit

rak bertingkat digunakan bagi tujuan penyusunan rekod ini. Ia bagi menyediakan satu cara yang

boleh mempercepatkan proses carian fail pesakit pediatric dengan memudahkan pengesanan

fail terdahulu pesakit. Menyediakan cara pengasingan fail pesakit pediatric yang sistematik bagi

melupuskan fail pesakit pediatric dengan menyediakan cara jadual penyimpanan dan pelupusan

yang efektif.

Kaedah: Fail Mesra Kanak-Kanak dihasikan daripada ubahsuai fail pesakit biasa dengan

menggunakan warna OREN dan ruang bagi menulis nombor pengenalan ibu serta anak. Fail-fail

ini akan ditarik keluar dari rak penyimpanan utama ke rak penyimpanan khas apabila telah

cukup 7 tahun tempoh penyimpanan. Cadangan jadual pelupusan dan penyusunan fail dalam

tempoh 18 tahun disediakan bagi memudahkan pengurusan fail pada jangkamasa panjang yang

perlu dibuat penyelenggaraan pada masa kini.

Hasil: Pengurangan kos operasi dengan menjimatkan kos pengunaan fail, dimana dapat

mengelakkan duplikasi fail apabila terdapat kemasukkan pesakit pediatric menggunakan mykid

yang sebelum ini menggunakan nombor pengenalan ibu. Penjimatan masa mengesan rekod pesakit

pediatric dan mempercepatkan proses pengasingan rekod pesakit. Peningkatan tahap

produktiviti apabila cara sistematik ini diperkenalkan dengan memberikan ruang penyimpanan

rekod yang mencukupi apabila berlaku proses pelupusan rekod yang konsisten. Sekaligus dapat

meningkatkan kualiti kerja apabila memudahkan pengesanan fail terdahulu pesakit pediatrik.

Kesimpulan : Fail Mesra Kanak-Kanak merupakan salah satu cara bagi memudahkan pengurusan

fail pesakit pediatric daripada permulaan kemasukkan pesakit ke wad sehinggalah proses

pelupusan rekod tersebut.

42


Aedes Distribution and Meteorological Effect on Ovitrap Index in Kampung Bunga, Besut:

A Cross-sectional Study

Siti Firdaus Mohd Mokhdi¹, Dr.Hafizuddin Awang¹, Izzati Khalid², Mohd Ridzuan Othman³, Nor

Alina Mohd Alwi4, Nur Hazirah Nodin4, Irda Idura Laili Nordin5, Mohd Khalil Jusoh4

Unit Entomologi & Pest, Pejabat Kesihatan Daerah Besut, ²Unit Entomologi & Pest, Pejabat Kesihatan

Daerah Kuala Nerus, ³Pejabat Kesihatan Daerah Dungun, 4Unit Entomologi & Pest, Jabatan Kesihatan

Negeri Terengganu, 5Entomologi & Pest, Pejabat Kesihatan Daerah Kuala Terengganu

P04

Background: Ovitrap is a monitoring tool used to measure the presence and density of

Aedes species mosquitoes. The ovitrap index is track weekly for one year at the designated sentinel

site, Kg Bunga in the Besut district. The purpose of using ovitrap is to offer a different

breeding container and redirect Aedes mosquitoes from laying eggs in natural or man-made

containers. Objectives: The aimof this study is to assess the presence and abundance of Aedes

species and to evaluates the relation of meteorological factors like rainfall and environmental

temperature withovitrap index.

Methods: A total of60 containers were placed selected randomly both indoor and outdoor

premises. Ovitraps were collected and replaced weekly and will be taken back to the laboratoryfor

first (day 7) and second readings (day 11)for ovitrap index calculation. The Aedes larvae

were counted and identified by species under compound microscope. Data on temperature and

rainfall was obtained from the Besut Meteorological Department and analyzed using descriptive

and correlational analysis (SPSS).

Results: Aedes distribution showed that Aedes aegypti more prevalent than Aedes albopictus,

with 2,383 larvae of Aedes aegypti being recorded compared to 2,198 larvae of Aedes

albopictus. The data also revealed a significant correlation between the ovitrap index and temperature

(p0.05, p=0.6).

Conclusion: Aedes aegypti is the primary species present in the sentinel location. The

high population of this species highlights the need for control actions to be implemented according

to the guidelines by the Ministry of Health. The data show that temperature affects ovitrap

index.

43


P05

Penyiasatan Entomologi: Bekas Utama (Key Container) Pembiakan Aedes spp di Lokaliti

Kes Demam Denggi Negeri Terengganu: Kajian Hirisan Lintang

Izzati Khalid1, Dr. Effah LeiylenaYaacob1,Mohd Ridzuan Othman2, Nor Alina Mohd Alwi3, Nur Hazirah

Nodin3, Siti Firdaus Mohd Mokhdi4, Irda Idura Laili Nordin5, Mohd Khalil Jusoh3

1Unit Entomologi & Pest, Pejabat Kesihatan Daerah Kuala Nerus, 2Pejabat Kesihatan Daerah Dungun

Terengganu, 3Unit Entomologi & Pest, Jabatan Kesihatan Negeri Terengganu, 4Unit Entomologi & Pest,

Pejabat Kesihatan Daerah Besut,5Entomologi & Pest, Pejabat Kesihatan Daerah Kuala Terengganu

Latar belakang: Penghapusan tempat pembiakan Aedes masih lagi menjadi kaedah

yang utama bagi mengawal penularan kes demam denggi kerana ketiadaan ubat dan vaksin

yang sesuai buat masa kini. Analisa berkenaan bekas pembiakan yang utama memainkan

peranan penting dalam menentukan kaedah yang paling sesuai dan berkesan bagi kawalan

vektor. Objektif: Kajian ini dijalankan bagi mengenalpasti jenis bekas pembiakan Aedes spp

yang utama di Terengganu, sepsis Aedes yang ditemui dan perkaitan dengan jenis premis serta

melengkapkan aktiviti kawalan dan pencegahan sediaada di lokaliti kes denggi berdasarkan

konsep Pengurusan Vektor Secara Bersepadu (IVM).

Kaedah: Penyiasatan entomologi telah dijalankan di 105 lokaliti kes demam denggi di

semua daerah di Negeri Terengganu pada tahun 2022. Pemeriksaan larva telah dijalankan di

semua premis yang terletak dalam lingkungan 100 meter radius dari rumah kes. Bekas pembiakan

positif Aedes spp yang ditemui dikategorikan kepada jenis bekas, lokasi penemuan dan

sepsis larva. Analisa chi-sqare dilakukan bagi melihat perkaitan antara lokasi bekas pembiakan

Aedes yang ditemui (Indoor vs Outdoor) dengan jenis premis (taman perumahan vs kampung).

Keputusan: 90.4% lokaliti kes denggi yang dibuat Penyiasatan Entomologi didapati positif

Aedes. Daripada 8,126 bekas yang diperiksa, sebanyak 261(3.21%) bekas yang positif Aedes,

dengan Indoor (21.9%) dan Outdoor (78.1%). Peratusan, 85.1% positif Aedesalbopictus,

12.4% Aedesaegypti dan 2.5% campuran Aedes spp. Jenis bekas yang paling tinggi ditemui

dengan pembiakan Aedes adalah19.5% bekas plastik (>5 liter), 15.0% kanvas dan 14.0% bekas

minuman ternakan. Tiada hubungan yang signifikan antara pembiakan Aedes yang ditemui

dengan jenis premis, (P=0.387).

Kesimpulan: Bekas buatan manusia adalah habitat pembiakan utama bagi nyamuk Aedes

di lokaliti kes denggi, tidak mengira jenis premis. Oleh itu, kerjasama masyarakat ke arah

menghapuskan bekas buatan manusia, samaada di dalam atau di luar rumah adalah penting

untuk menjayakan program kawalan demam denggi.

44


Reference Interval Verification for Clinical Chemistry Parameters in Healthy Individual

Population of Hospital Kemaman

Fairuz Hashim, Dr Tengku Zaharah Tengku Ibrahim, Farahziela Abu, Dr Nur Shahidah Samsudin

Unit Patologi Kimia, Jabatan Patologi, Hospital Kemaman

Introduction: Reference intervals are essential for clinical laboratory test interpretation.The

reference interval for a given test is based on the results observed in 95% ofhealthy

population. Verification of an established reference interval is performed when a laboratory

adopts an established reference interval,either from a manufacturer or another laboratory using a

similar analytical system.

Objectives: This study focused on Hospital Kemaman healthy individual population as a

small number of reference individuals to verify thereference intervalsfor routine clinical chemistry

parameters which were established previously by manufacturer according to the European population.

Methods: A total of 80 healthy individuals consisting of male and female hospital staff

aged between 18 and 40 yearswere selected using the universal sampling method in January

2023. Venous blood was collected and measured for routine chemistry assays on Beckman

Coulter DXC700 analyser. Data partitioning was done according to the male and female populations.

All data were analysed for outliers using the Tukey method.Based on Clinical and Laboratory

Standards Institute (CLSI EP28A3C) guideline, if ≤10% of test results fall outside the reference

interval, the manufacturer’s claim is verified. If 15% -20% of test results fall outside the reference

interval, another set of reference specimens is obtained and analysed. Meanwhile, if

≥25% of the results fall outside the manufacturer’s range, the reference interval will be established

locally.

Results: Of the 28 reference intervals assessed, 27 passed the verification analysis with

>90% of the results fall within the manufacturer’s range. The male and female reference intervals

for albumin, alkaline phosphatase, ALT, amylase, AST, calcium, CK, creatinine, CRP, direct bilirubin,

phosphate, iron(male only), LDH, magnesium, total bilirubin, total protein, urea, uric acid,

and UIBC were verified and adopted for use.

Conclusion: Manufacturer reference intervals for most of the assays defined for Beckman

Coulter DXC700chemistry analyser were verified and can be implemented in Department of

Pathology, Hospital Kemaman to improve the quality of laboratory results produced, thereby improving

the quality of patient care.

P06

Automated Testingin Clinical Transfusion Laboratory Hospital Sultanah Nur Zahirah: Reducing

Testing and Transcription Errors

Noor Hamizah Mohd Hassan, Mohd Muhaimin Kambali

Transfusion Medicine Department, Hospital Sultanah Nur Zahirah, Kuala Terengganu

P07

Introduction: The implementation of automation for routine testing in clinical transfusion

laboratory (CTL) in Malaysia is still far behind compared to clinical chemistry laboratory, where

even relatively small laboratories use automated equipment extensively. Testing is one of the

critical control points in the transfusion process. Heavy workload increases risk of error especially

45


Results: Our laboratory received an average 45000 samples per year for pre-transfusion

testing. There were 18 testing and transcription errors reported in 2018 and 17 were reported in

2019 that was before the implementation of AT. These were 0.04% from the total number of

samples received in both years. While it was significantly reduced to 0% from July 2020 till June

2022 when the fully automated analyser and autoresult transmitted to BBIS was in place. We use

Biorad IH500 where the tests are performed by the analyser and the results are auto interpretedand

transmitted to BBIS once validated. This eliminates the process of manual result interpretation

and transcription into BBIS by our laboratory personnel.

Conclusion: Testing and transcription errors were eliminated through the implementation

of AT in our laboratory. Correct testing technique is necessary to provide a reliable result for

patients and guarantee the safe provision of blood components for transfusion. The automation

not only produces efficient and secure immunohaematological testing but enhancing the testing

capacity of our laboratory and improves patient safety.

Body Weight Perception and Weight Loss Practices among Police Officers in One of Primary

East Coast Centre Terengganu.

Amie Eryana Watiman, Saifullah Osman, Ramlah Ali, Kartini Abdul Karim

Department of Dietetics, Hospital Sultanah Nur Zahirah , Kuala Terengganu

P08

Introduction: Body image defined as self perception of weight, body shape or Body Mass

Index (BMI) might affect weight management. Self-body perceptions reflect an individual’s

awareness of body weight status in relation to their actual body weight. According to the World

Health Organization (WHO), a person with optimum health should maintain a body mass index

(BMI) of 18.5 to 24.9 kg/m2. Objectives: This study is to identify body weight perception among

PGA Battalion 9 staff and to determine the correct body weight perception among PGA Battalion

9 staff. We also aim to identify the weight loss methods to reduce weight among them.

Methods: This retrospective study on weight loss program was collaborated between Dietetic

Department and Pasukan Gerakan Am (PGA) Battalion 9, Kuala Terengganu. This program

has been held from 7 February 2018 until 16 Mac 2018. A self administered questionnaire

was used to assess sociodemgraphic data, body weight perception and weight loss method. All

raw data will be retrieved from Dietetic Department database. After reviewed, this data will be

analyzed using latest version of SPSS software.

Results: Among all the participants (61.7%) rated their current body weight as obesity,

29.4% rated as overweight where the rest rated as normal (8.8%), However, more than half

(55.9%) of participants perceived their weight correctly as per actual measured BMI. Exercise

(82.4%) is the most popular method chosen by the participant to reduce their weight following by

dieting as the second option. It was found that there is a reverse significant correlation between

age and score of body weight perception among the participants (r= -0.342, p < 0.05).

Conclusion: Most of the participants involved in this study knowstheir body weight perception

and action are done to reduce their weight. Therefore, body weight perception is an important

factor that influences the practice to reduce weight

46


Penilaian Risiko Terhadap Transmisi Mikrofilaria Dalam Vektor Filariasis di Kampung

Santong, Dungun: Kajian “Cross-sectional”

Mohd Ridzuan Othman1, Dr.Fathul Hakim Hamzah2, Dr. Ahmad Asri Ibrahim2, Jamalulai

Yahya1, Roslan Adam1, Mohd Syiharbudin W ahab1, Nor Alina Mohd Alwi3, Nur Hazirah

Nodin3, Izzati Khalid4, Siti Firdaus Mohd Mokhdi5, Irda Idura Laili Nordin6 Mohd Khalil Jusoh3

1Unit Entomologi & Pest,Pejabat Kesihatan Daerah Dungun, 2Pejabat Kesihatan Daerah Dungun,3Unit

Entomologi & Pest, Jabatan Kesihatan Negeri Terengganu,4Unit Entomologi & Pest, Pejabat Kesihatan

Daerah KualaN erus, 5Unit Entomologi & Pest, Pejabat Kesihatan Daerah Besut, 6Unit Entomologi &

Pest, Pejabat Kesihatan Daerah Kuala Terengganu

P09

Pengenalan : Filariasis adalah penyakit yang disebabkan oleh cacing filaria yang disebar

oleh pelbagai spesies nyamuk seperti Mansonia spp., Anopheles spp., Culex spp., dan Armigeres

spp.. Kampung Santong bagi Mukim Paka merupakan kawasan IU Merah yang seringkali

mencatatkan kes filariasis dan pada tahun 2021 terdapat 5 kes filariasis dilaporkan di Kampung

Santong, Dungun. Objektif: Kajian ini bertujuan untuk mengenalpasti kewujudan vektor

Filariasis dan mengesan kehadiran mikrofilaria di dalam badan nyamuk (vektor) melalui Ujian

Xenomonitoring serta menentukan potensi transmisi kes filariasis tempatan dilokaliti ini.

Kaedah: Tangkapan nyamuk dilakukan selama 6 jam dari pukul 18.00–01.00 dengan

kaedah “human landing catch” selama 3 hari berturut-turut. Bilangan nyamuk yang diperoleh

dikategorikan kepada spesies dan waktu kemuncak gigitan. Analisa statistik menggunakan

SPSS (Anova) dilakukan bagi melihat perbezaan signifikan antara spesis nyamuk dan mikrofilaria.

Keputusan: Kajian Penyiasatan Entomologi menunjukkan sampel yang diperoleh

sebanyak 18 spesis dengan spesis paling dominan (vektor) adalah Mansonia uniformis (132

ekor), Mansonia bonnae (123 ekor), Armigeres subalbatus (82 ekor), Mansoniadives (49 ekor),

Mansoniaannulata (37 ekor), dan Culex quinquefasciatus (25 ekor). Sebanyak 423 ekor nyamuk

iaitu vektor filariasis dihantar untuk ujian Xenomonitoring (PCR) dan didapati terdapat

sampel DNA Brugia malayi dalam nyamuk bagi spesis Mansoniauniformis. Analisa statistik

menunjukkan tiada hubungan signifikan antara spesies vektor nyamuk dengan mikrofilaria,

P=0.957 (P<0.05).

Kesimpulan: Terdapat kehadiran vector filariasis dan mikrofilaria dilokaliti ini serta

wujud transmisi jangkitan tempatan. Oleh itu, mobilasi penduduk di lokaliti ini ke arah penghapusan

tempat pembiakan vektor filarisis adalah penting kerana kawasan ini masih berpotensi

tinggi bagi penularan penyakit filarisis

47


Evaluation of Procedure Preparing Reconstituted Blood in HSNZ

Mohammad C.B., Mohd Muhaimin K.

Transfusion Medicine Department, Hospital Sultanah Nur Zahirah (HSNZ) Kuala Terengganu

P10

Introduction: Approximately 20-30 Exchange Transfusion (ET) procedure was performed

annually in Hospital Sultanah Nur Zahirah (HSNZ), Kuala Terengganu. In ABO Haemolytic Disease

of Fetus & Newborn (HDFN), the choice of blood are either Low Titre O Whole Blood

(LTOWB) or Reconstituted Blood (RB). There are three main issues in LTOWB which are no

consensus on the method of screening, no defined critical titre which will predict in vivo haemolysis

and high workload to search for LTOWB. Objective: To evaluate and validate the procedure

of preparing RB in HSNZ.

Methods: Fresh O red cells (less than 5 days) was selected from either Whole Blood,

Red Cells Concentrates or Red Cells in Additive Solution. The plasma was removed after light

spin method at 3500 rpm for 10 minutes at C. The amount of AB plasma need to be added

was based on schedule obtained from Corpus Christi Medical Center, US. The combination of

O red cells and AB plasma was then mixed properly before aliquoting for blood sample test.

Blood samples was taken for Full Blood Count, low plasma hband anti-A/B titre.A total of 60

samples of RB were prepared for this evaluation study. 100% of samples had Haematocrit within

desired range (0.45 to 0.55). Haemolysis of all samples were less than 0.8% of red cell mass.

No detectable anti-A/B was found in all samples.

Results: A total of 60 samples of RB were prepared for this evaluation study. 100% of

samples had Haematocrit within desired range (0.45 to 0.55). Haemolysis of all samples were

less than 0.8% of red cell mass. No detectable anti-A/B was found in all samples.

Conclusion: This finding shows that RB is better alternative as compared to LTOWB.

The disadvantage of RB is increasing donor exposure, however the risk can be mitigated by

careful selection of donor and using NAT tested blood. The procedure has been validated to be

used in HSNZ.

Kepelbagaian Spesis Anai-anai Infestasi Fasiliti Kesihatan Kerajaan di

Negeri Terengganu: A Cross Sectional Study

Nur Hazirah Nodin1, Nor Alina Mohd Alwi1, Izzati Khalid2, Mohd Ridzuan Othman3, Irda Idura

Laili Nordin4, Siti Firdaus Mohd Mokhdi5, Mohd Khalil Jusoh1

1 Unit Entomologi& Pest, JabatanKesihatan Negeri Terengganu 2 Unit Entomologi& Pest, Pejabat-

Kesihatan Daerah Kuala Nerus 3 Unit Entomologi& Pest, Pejabat Kesihatan Daerah Dungun 4 Unit Entomologi&

Pest, Pejabat Kesihatan Daerah Kuala Terengganu 5 Unit Entomologi& Pest, Pejabat

Kesihatan Daerah Besut

Pengenalan: Anai-anai adalah tergolong dalam Order Blattodea dan Suborder Isoptera.

Kepentingan anai-anai dalam ekosistem adalah sebagai agen penyubur tanah (garden termite).

Namun begitu, terdapat juga sepsis anai-anai yang boleh merosakkan hartabenda

(subterranean termite) seperti Coptotermesgestroi. Adalah penting bagi mengenalpasti sepsis

anai-anai dalam menentukan kawalan anai-anai samaada menggunakan pendekatan rawatan

umpan atau halangan.

48

P11


Objektif: Matlamat kajian ini adalah untuk mengumpul data awal mengenai infestasi anaianai

di bangunan fasiliti kesihatan kerajaan Negeri Terengganu serta kepelbagaian spesisnya.

Selain itu, untuk mengetahui struktur bangunan yang mempengaruhi kadar infestasi anai-anai.

Kaedah: Penilaian risiko entomologi terhadap infestasi anai-anai dijalankan di semua fasiliti

kesihatan kerajaan merangkumi Pejabat Kesihatan Daerah, Klinik Kesihatan dan Klinik Desa di

seluruh daerah Negeri Terengganu bagi tahun 2022. Fasiliti kesihatan yang terinfestasi direkodkan

jenis struktur bangunan dan sepsis anai-anai yang ditemui diambil sampel serta dibuat pengecaman

menggunakan kekunci dari USM dan FRIM. Analisa chi-square dilakukan bagi melihat

hubungkait antara jenis struktur bangunan (kayu/separa kayu dan batu) dengan sepsis anai-anai.

Keputusan: 27.78% fasiliti kesihatan di Negeri Terengganu telah terinfestasi dengan anaianai.

Daripada jumlah tersebut, pecahan sepsis anai-anai adalah Coptotermesgestroi (61.76%),

Macrotermesgilvus (14.71%), Globitermesglobulus (8.82%), Microcerotermespakistanicus

(7.35%), Drywood termite (4.41%), Odontotermes spp. (1.47%) dan Nasutitermes spp. (1.47%).

Terdapat hubungan yang signifikan antara serangan anai-anai dengan jenis struktur bangunan,

0.018 (P <0.05)

Kesimpulan: Spesis anai-anai yang utama menyerang fasiliti kesihatan di Negeri Terengganu

adalah sepsis Coptotermesgestroi iaitu sepsis pemakan kayu (subterranean termite). Infestasi

anai-anai mempengaruhi struktur bangunan dengan pemilihan utama adalah jeniskayu/separa

kayu. Olehitu, pencegahan awal seperti meracun tapak binaan sebelum membangunkan premis

adalah penting bagi mengatasi masalah anai-anai dan pembinaan bangunan dari struktur batu

dapat mengurangkan serangan anai-anai di masa akan datang

The Effectiveness of Space Spraying Activity Using Magnesium Oxide Slide at Dengue

Outbreak in Terengganu

Mohd Khalil bin Jusoh1, Nur Hazirah Nodin1, Siti Firdaus Mohd Mokhdi2, Irda Idura Laili Nordin3,

Mohd Ridzuan Othman4, Nor Alina Mohd Alwi1, Izzati Khalid5

1Unit Entomologi & Pest, Jabatan Kesihatan Negeri Terengganu, 2Unit Entomologi & Pest, Pejabat

Kesihatan Daerah Besut, 3Unit Entomologi & Pest, Pejabat Kesihatan Daerah Kuala Terengganu, 4Unit

Entomologi & Pest, Pejabat Kesihatan Daerah Dungun, 5Unit Entomologi & Pest, Pejabat Kesihatan Daerah

Kuala Nerus.

P12

Introduction: The characteristic of insecticidal droplets generated during space spraying

are important in ensuring optimal efficiency of mosquitoes control through this technique. The

droplets size that remains airborne can be measured using glass slides coated with magnesium

oxide (MgO). The optimum droplet size for space spraying against mosquitoes is 10-20 µm.

Objectives: The aimed of this study is to determine the space spraying activities in Terengganu

comply with the recommended droplet size.

Method: 15 pieces MgO slides were placed at selected houses according to distance from focus

point (less than 200 meter radius). 3 pieces of MgO slides per houses were placed one hour beforeand

collected 30 minutes to 1 hour after fogging activity. Measurement of droplets then was

examined under compound microscope. The calculation of volume median diameter (VMD) and

number median diameter (NMD) performed by computer program of Sofield & Kent (1984).

49


Result: The analysis found that mean NMD for Kuala Nerus, Kemaman and Hulu Terengganu

were achieved to recommended range of NMD which is 15.68 µm (Median=16.08, std

dev.=5.29), 18.62 µm (Median=20.29, std dev.=3.19) and 19.38 µm(Median=20.39, std

dev.=6.14) respectively. For Dungun (mean NMD =20.29 µm) and Marang (mean NMD = 20.44

µm) slightly higher than optimum droplet size. Besut recorded an average reading of 22.20 µm,

Setiu recorded an average of 22.51 µm while Kuala Terengganu recorded the highest average

reading of 28.25 µm.

Conclusion: Only 3 out of 8 districts show droplet size (NMD) comply with the recommended

droplet sizewhich is 10-20 µm. Otherdistrict needs to review or calibrate their machine

regularly so that it can produce the appropriate droplet size output and then make all activitiesefficient

and effectivein controlling the dengue outbreak.

Distribution Study of Thalassemia Carriers Among Teenagers in Terengganu

Nur Amira Binti Ahmad Naspu1 2, Sharifah Izwan Tuan Othman2, Dr Alawiyah Binti Awang1 1

Haematology Department Hospital Sultanah Nur Zahirah Kuala Terengganu, 2 Health Science Department

University Selangor

P13

Introduction: Thalassemia is a group of inheritance haematological disorder caused by a

defect in the synthesis of one or more haemoglobin chains as the globin chain may become defective

due to mutation or deletion and also due to excess production of other chains that result in

damage to the red cell membrane. The data of distribution is still lacking in Terengganu despite

the screening already done in Terengganu.

Objective: The aim of this study was to determine the distribution of alpha and betathalassemia

among teenagers in Terengganu based on screening programs to form four students

that had been carried out in secondary school. This screening was done as prevention for thalassemia

where it is one of the public health problems.

Method: The data was collected by using cross sectional study. The data was collected

by extracting the data from Laboratory Information Systems (LIS) and extracted to Microsoft Excel.

Medical record from the period of January to December2018 was selected.

Results: A total of 55.35% of the subjects were identified to have hypochromic microcytic

indices where hypochromic microcytic is one of the criteria of thalassemia. The carrier incidence

for common thalassemia was 48.03% (4.96% for beta-thalassemia, 21.67 % for Hb E and 21.4%

for alpha thalassemia trait).

Conclusion: The result of this study will serve as the baseline for further investigation of

thalassemia and provide better health services in the future.Thalassemia screening should be

incorporated as a routine part of the health care system in order to identify the asymptomatic carriers.

Delivery of screening tests should be complemented with the genetic counseling and treatment

options for transfusion-dependent children, premarital screening and pregnancy planning

among Malaysians. The awareness and continuous education about thalassemia need to be doneearly

so that thalassemia will no longer become a health burden to the country and become a

preventable disease

50


Effect of Nutrition Educational Programme (NEPro) on Knowledge, Attitude And Practice

of Healthy Eating Among Boarding School Students In Terengganu

Dr. Haymalatha Rajagam, Mohd Rashid bin Napis, Muntaz binti M.Kalandar, Nor Zuriani binti Zainal, Zarina

binti Aziz,Sharon Linus Lojikip, Nor Fadzila binti Jusoh, Zamilah Hasniah binti Ab Hamid, SalihahbintiBrahim

ppkprashid.11@gmail.com

P14

Introduction: This study was conducted to evaluate the potential attenuating effects of 3

sessions of Nutrition Educational Programme (NEPro) delivered at school setting, on healthy

eating knowledge, attitude, and practices among school children. A total of 200 school-going

children aged 16 years old, of any health status and body mass index grades, currently studying

and staying in Form Four of Boarding Schools in Terengganu.

Research Methodology: NEPro was a healthy eating program for school children. This study

was conducted for 4 weeks comprised of Nutrition Education Programme and interactive

games; consist of 3 sessions of 2-hour of nutrition and healthy eating education activities for the

intervention group and control group received the standard education nutrition materials only.

Knowledge, attitude and practice questionnaires were distributed to the school children preintervention

and post-intervention receiving the nutrition educational programme.

Results: The result obtained indicated that there was a significant difference in nutrition

knowledge score and healthy eating attitude score between the intervention and control group

after the NEPro intervention were implemented. The practice on healthy eating score were more

apparent compared to the nutrition knowledge and attitude. The satisfactory level of knowledge

for intervention group had increase from 68.3% (pre-test) to 75.0% (post-test). This study also

found that the satisfactory level of practices on healthy eating for intervention group had increase

from 44.2% (pre-test) to 75.0% (post-test) and the unsatisfactory level of practices on

healthy eating for intervention group had decrease from 55.8% (pretest) to 25.0% (post-test).

It show that the change in nutrition knowledge is concomitant with changes in dietary attitude

and behaviours in the intervention group. This finding indicates that nutrition knowledge is integral

to the achievement of healthful dietary behaviours and consequently in the improvement of

diet quality.

Conclusion: This study has shown that a well-planned nutrition educational programme

could improve nutrition knowledge and promote positive changes in attitudes and practices towards

good nutrition.

51


Neonatal Hearing Screening: Experience in HSNZ

Norsyuhada Samsudin, Wan Suhailah Wan Husain, Wan Hasyimah Wan Mamat, Dr Nik Khairani

Nik Mohd

Otorhinolaryngology Department, Hospital Sultanah Nur Zahirah

P15

Introduction: Congenital hearing loss is a hidden disabilit, it is among the highest congenital

abnormality worldwide. It was estimated 3 out of 1000 live baby born with significant hearing

loss. WHO resolution 1995, has recommended early detection of hearing loss in babies, toddlers

and children. Thus, permanent childhood hearing loss is associated with language, cognitive,

psychosocial and academic development deficits, affecting future employment, productivity

and income. Hospital Sultanah Nur Zahirah (HSNZ) has initiated neonatal hearing screening

since 2001. It covers only baby in special care nursery ward, done twice a week by trained staff

nurse. We could screen less than 10% live birth baby in HSNZ. After 20 years, neonatal hearing

screening in HSNZ has done a lot of improvement. In 2021, about 81% of baby born in HSNZ

has underwent hearing screening before discharge. From 13 965 babies underwent hearing

screening, we have detected about 36 babies with hearing loss either both ears or one ear. Objective:

To overview neonatal hearing screening program in HSNZ between 2017 and 2021.

Method: This is a retrospective report. All data were collected from yearly report of neonatal

hearing screening program in HSNZ. The data includes number of babies born live, number

of babies screened, number of babies failed hearing screening, number of babies return for diagnostic

hearing assessment, number of babies diagnosed with hearing loss and age of detection.

Results: According to yearly performance, NHS program in HSNZ has shownincrement

in numbers of babies screened. Hence it has detected more babies with congenital hearing loss,

improved quality of intervention and management to babies born with syndromic and baby born

from family with history of hearing loss.

Conclusion: Implementation of effective NHS program in hospital is a longterm process.

It requires understanding and awareness about the importance of early detection and intervention

of hearing loss among baby and children. It also requires cooperation from all levels in hospital

administration.

Comparison of Coagulation Factor VIII Content Between Blast Freezed FFP and Non Blast

Freezed

FFP HarunYusof¹, Mohd Muhaimin Kambali¹,

¹Transfusion Medicine Department, Hospital Sultanah Nur Zahirah

P16

Introduction: Many variables and factors can effect the fresh frozen plasma quality.We

investigated the effect of freezing technique and ABO blood groups on the quality of Fresh Frozen

Plasma (FFP) with respect to coagulation Factor VIII (FVIII) level. Objectives: The aim of this

study is to compare the factor viii content in blast freezed fresh frozen plasma and non-blast

freezed fresh frozen plasma. The factor VIII contents quality in FFP was analyze using the blast

freezer and conventional freezer in FFP processing with A, B and O blood group.

52


Methods: Sixty pints of whole blood each collected from the blood donation campaign

were processed for FFP preparation. The sample from the FFP preparation are collected and

count for baseline value of FVIII level.The FFP from blood group A,B and O were be split

equally to froze using blast freezer and conventional freezer (non blast freezed).Then the FVIII

level in FFP were analysed using single-stage clotting assay (Post FVIII level).

Results: The mean Post FVIII level in blast freezed FFP and non blast freezed FFP were

0.86 ± 0.29 IU/ml and 0.66 ± 0.19 IU/ml.The mean percentage recovery of FVIII level in blast

freezed FFP and non blast freezed FFP were 85.35% ± 9.65% and68.43% ± 13.31% respectively.

The FFP prepared using the blast freezer had the higher percent recovery of factor VIII

level than that Fresh Frozen Plasma prepared using conventional freezer (P

Conclusion: The mean baseline factor VIII level in blood group A and B(1.08 IU/ml) were

higher than that of factor VIII level in the blood group O Fresh Frozen Plasma (0.79 IU/ml).The

Factor VIII recovery in Fresh Frozen Plasma improves significantly with rapid freezing using

blast freezer.

Pendekatan Ekosistem Menggunakan MyMAT Dalam Mengurangkan Kes Demam Denggi

di Kuala Terengganu: a Cross Sectional Study

Irda Idura Laili Nordin1, Mohd Faqihuddin Abd Razak1, Azali,Md Rashid1, Dr. Fatimah Muda1,

Nor Alina Mohd Alwi2, Nur Hazirah Nodin2, Izzati Khalid3, Siti Firdaus Mohd Mokhdi4,

Mohd Ridzuan Othman5, Mohd Khalil Jusoh3

1Unit Entomologi & Pest, Pejabat Kesihatan Daerah Kuala Terengganu, 2Unit Entomologi & Pest, Jabatan

Kesihatan Negeri Terengganu, 3Unit Entomologi & Pest, Pejabat Kesihatan Daerah Kuala Nerus,

4Unit Entomologi & Pest, Pejabat Kesihatan Daerah Besut, 5Unit Entomologi & Pest, Pejabat

Kesihatan Daerah Dungun

Pengenalan: Aedes aegypti dan Aedes albopictus adalah vektor utama kepada penyebaran

penyakit bawaan vektor seperti Demam Denggi, Chikungunya, Demam Kuning dan Zika

di Malaysia. Pelbagai kaedah secara teori dan praktikal telah dijalankan untuk mengawal sebaran

virus yang disebabkan oleh Nyamuk Aedes. Satu kajian menggunakan perangkap nyamuk

yang dinamakan mymat (Malaysian Mosquito Autocidal Trap) dijalankan sebagai alat tambahan

dalam kawalan Demam Denggi khususnya di daerah Kuala Terengganu.

Objektif: Kajian ini adalah untuk mengenalpasti bahawa adakah mymat boleh

digunakan sebagai kaedah kawalan tambahan dalam mengawal kepadatan nyamuk Aedes

dan secara tidak langsung menurunkan risiko dari berlakunya sebaran virus Demam Denggi.

Kaedah: Kajian dijalankan bermula pada tahun 2020 hingga 2022 melibatkan dua lokaliti

wabak denggi. Sebanyak 120 bekas mymat dipasang dan pemantauan dijalankan secara

mingguan bermula minggu epid 01 hingga 52. Bilangan nyamuk Aedes yang terperangkap di

dalam mymat dikira dan data kejadian kes demam denggi yang didaftarkan di lokaliti kajian

direkodkan. Keputusan: Hasil kajian mendapati mymat berjaya memerangkap nyamuk Aedes

aegypti 2598 (38.3%) dan Aedes albopictus 2019 (29.7%).Manakala spesies nyamuk lain seperti

Culex quinquefasciatus 1379 (20.3%) dan serangga lain sebanyak 795 (11.7%). Analisa

kes demam denggi yang didaftarkan di lokaliti kajian menggunakan ujian chi-square menunjukkan

penurunan kes yang ketara pada tahun 2020 – 2022 (n=86) berbanding tahun 2016 –

2019 (n=192) dengan nilai p

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P17


Keputusan: Hasil kajian mendapati mymat berjaya memerangkap nyamuk Aedes aegypti

2598 (38.3%) dan Aedes albopictus 2019 (29.7%).Manakala spesies nyamuk lain seperti Culex

quinquefasciatus 1379 (20.3%) dan serangga lain sebanyak 795 (11.7%). Analisa kes demam

denggi yang didaftarkan di lokaliti kajian menggunakan ujian chi-square menunjukkan penurunan

kes yang ketara pada tahun 2020 – 2022 (n=86) berbanding tahun 2016 – 2019 (n=192) dengan

nilai p<0.00001.

Kesimpulan: Mymat berjaya memerangkap Nyamuk terutamanya dari genus Aedes aegypti

(38.3%) dan Aedes albopictus (29.7%). Ini secara tidak langsung dapat menurunkan densiti

nyamuk Aedes sekaligus mengurangkan risiko sebaran virus denggi dari berlaku.

Refractive Errors among School Children Seen in Optometry Clinic HSNZ after COVID-19

Lockdown in Kuala Terengganu, Malaysia

Mohd Fazuan Ahmat Nazri¹ , Mohd Afiru Sidid Omar² , Adawiyah Ismail³ , Rusmiza Amin4 , Shahidah

Ismail5 , Juliana Md Desa6 , Azlin Azira Ahmad7 , Sajidah Sulong8

Hospital Sultanah Nur Zahirah, Kuala Terengganu

P18

Introduction: The pandemic of SARS CoV2 virus has severely impacted the entire world

population. The lockdown imposed has created enormous challenges particularly on the health,

economic and social life of most individuals.

Objectives: This study aimed to investigate the refractive error among school children

seen in Optometry Clinic, HSNZ after national lockdown due to Covid19 and the distribution of

each type of refractive errors. Methods: General and clinical data were collected from Hospital

Information System (HIS) among Kuala Terengganu students, who were referred by SHT to Ophthalmology

Clinic, HSNZ, from 1 January 2022 to 31 December 2022. Myopia was defined as a

spherical equivalent of at least -0.50DS, hyperopia as a spherical equivalent of +2.00DS or more

and astigmatism as a cylinder magnitude of worse than or equal to 1.00DC. Children were considered

emmetropic if neither eye has myopia, hyperopia nor astigmatism. Data were analyzed

by using SPSS version 17.0. The Pearson’s correlation coefficient of the power of the right and

left was high (r = 0.768). Because of the similarity between the two laterality, only the right eye’s

results were presented.

Results: 374 electronics medical records (EMR) were selected from the Hospital Information

System. Sixty-two percent of children had vision less than 6/12. After received full treatment,

only 10% remained visual acuity less than 6/12 with the possibility of amblyopia and other

ocular diseases. This study showed refractive error was the majority cause of vision problem

(78%; n=399) and can be corrected by spectacles. Myopia was the most prevalent condition 42%

(n=215) compared to hyperopia 3% (n=17) and astigmatism 33% (n=167). The rates of emmetropia

was 22 % (n=111).

Conclusion: The unprecedented COVID-19 outbreak and the lockdown during the pandemic

have caused significant negative impacts on health and affected the refractive errors of primary

school students in Kuala Terengganu. These refractive errors should be corrected as first instance

to prevent further deterioration and other ocular diseases. Collective efforts must me

rolled out to control the number of refractive errors from increasing and prevent further adverse

health outcomes.

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A Preliminary Study of Post Mortem Interval (PMI) Estimation Using Vitreous Humour

Potassium In Postmortem Motor Vehicle Accident (MVA) Cases In Terengganu

Norzita, M., Mohd Mukhlee Shah, M. R., Mohammad Safwan Hakimi, B., Ahmad Faisol, H.,

Mohd Redzuan, M. N., Mohd Ariza, K., Nor Aziela, M., Zuraida, Md. Zainuri.

Introduction: Determination of postmortem interval (PMI) is very crucial and important

amongst forensic pathologist especially in cases where court hearing and trials were expected.

Many pathologists found it is very difficult and hard to determine the most accurate PMI given

the condition of the deceased and the surrounding as well as limited information gathered.

Many researchers have utilized vitreous humour potassium and other biochemical analytes to

determine the PMI but this method is not commonly practice in Malaysia thus it is the author’s

concern to adapt similar approached for local practice.

Objectives: The objectives of this study are to measure postmortem interval (PMI)

using vitreous humour sodium, potassium, chloride and urea. In addition, this calculated PMI

will be compared with known PMI obtained from the history of motor vehicle accident (MVA)

cases. Methods: In this study, 90 subjects from motor vehicle accident (MVA) postmortem cases

with known time of death were selected for the investigation of vitreous humour sodium, potassium,

chloride and urea. The results of these analytes were used to calculate the PMI using

previously published equations.The correlation between calculated PMI and known PMI were

measured to determine their significance.

Results: The Pearson correlation coefficient shows a significant correlation between

PMI and potassium level with p0.05. To some extent, no significant correlation was found between

the calculated PMI and the known PMI (p = 0.283).

Conclusion: It was discovered that there were weak correlation between PMI and potassium,

chloride and urea. This shows that its role in estimation of PMI is very limited. The

present study also did not observe any statistically significant of age and gender differences in

vitreous sodium, potassium, urea and chloride levels

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