Project Location: National Heart Institute
Supervisor: Dr Ahmad Farouk
Co-Supervisor: Prof Rusli Nordin
Associate Supervisor: Dato Dr Jeswant Dillon (IJN)

Synopsis:
Hyperhidrosis is due to the hyperactive autonomic stimulation of the sweat glands in response to stress. Primary hyperhidrosis is a common yet psychologically disabling condition and there is no known effective medical therapy and the response is usually transient. Thoracoscopic sympathectomy was first described in 1942 by Hughes, and remained rare until the introduction of video-endoscopic techniques in the 1980s. Since then it has become the preferred method of treatment for primary hyperhidrosis of the palms, axillae, and face and more recently for facial blushing. Compensatory sweating is the most common side effect, and is believed to be due to a thermoregulatory mechanism. The reported frequencies vary considerably, with conflicting views as to its severity and predisposition. The aim of this study is to evaluate the efficacy of this procedure, to provide long-term follow-up data and to investigate the occurrence, severity and underlying factors to compensatory sweating in one institution. This project will therefore describe our experience at the National Heart Institute (IJN) in managing hyperhidrosis via Endoscopic Thoracic Sympathectomy (ETS) focusing on its effectiveness, recurrence of hyperhidrosis and incidence of compensatory sweating.

Project Location: National Heart Institute
Supervisor: Dr Ahmad Farouk
Co-Supervisor: Prof Rusli Nordin
Associate Supervisor: Dr Siti Noraida, Dato Dr Jeswant Dillon (IJN)

Synopsis:
Primary and secondary hyperhidrosis differ in etiology and characteristics. Secondary hyperhidrosis is generalized excessive sweating caused by another medical condition, such as infection, menopause, cancer, hyperthyroidism, or neurologic disorders. These patients experience sweating over large areas of their body and the symptoms can be present while patients are sleeping. Primary hyperhidrosis, on the other hand, affects otherwise healthy individuals and is characterized by more focal symptoms that do not occur during sleep. Primary hyperhidrosis is not caused by another medical condition, nor is it a side effect of medications. Thoracoscopic sympathectomy has been shown to be an effective means to prevent excessive sweating, with a success rate of more than 95%. And compensatory sweating is a common side effect in which sweating is increased in previously non-problematic areas, most commonly, the torso and back. The frequency of compensatory sweating is estimated between 67% and 89% and varies greatly in severity. While studies have proven the fact that Endoscopic Thoracoscopic Sympathectomy (ETS) is highly successful in eliminating palmar and axillary hyperhidrosis, there is a high incidence of compensatory sweating.  

The aim of this study is specifically to look into the Quality of Life of patients after ETS and comparing to that before surgery. And whether the occurrence of compensatory sweating would diminish the Quality of Life of patients.

Project Location: Monash University Malaysia
Supervisor: Dr Kyi Kyi Tha
Co-Supervisor: Dr Lee Chooi Yeng
Associate Supervisor: Assoc Prof Arkendu Sen

Synopsis:
Pharmacology is a subject that has generally been perceived as ‘dry’ as the information delivered is mostly factual. But understanding of how the drugs act is pivotal before one could correctly apply the theory that was learned into practice, ie. pharmacotherapy.

The ultimate aim of this research project is to make the learning of pharmacology and diseases management ‘fun’ and ‘lively’. An online, interactive learning module that allows active learning of drugs used in the treatment of GI diseases, and their use in diseases management will be developed. The module will incorporate namely, interactive case studies, videos or animation, and quizzes that should reinforce information taught in the lectures. The module focuses on the pharmacotherapeutic management of selected gastrointestinal (GI) diseases.

In this project, we will test and evaluate the teaching and learning tools that are used in the module through qualitative and quantitative studies. Importantly, only via these studies that the module would present materials that students find most useful and relevant in enhancing their learning of the subject matter. The hypothesis is that a student-centred e-learning module will further enhance the understanding of GI pharmacotherapy and complement what has been presented in the lectures.

Project Location: Brain Research Institute Monash Sunway (BRIMS), Monash University Malaysia
Supervisor: Dr Takayoshi Ubuka
Co-Supervisor: Prof Ishwar Parhar

Synopsis:
Autism spectrum disorder (ASD) is a neurodevelopmental disorder, characterized by impaired social interaction, verbal and non-verbal communication, and restricted and repetitive behavior. 1-2 % of children are diagnosed with ASD in recent years. It is known that some endocrine disrupting chemicals (EDC), such as bisphenol A (BPA), can interfere with the neurodevelopmental process. We hypothesize that ASD is caused by some EDC exposure during the neurodevelopmental period. In this project, we will examine the effect of BPA on the neurodevelopmental process by immunohistochemistry. Three-chamber test and open field test will be performed to quantify sociality and restricted (repetitive) behavior, respectively.

Project Location: Brain Research Institute Monash Sunway (BRIMS), Monash University Malaysia
Supervisor: Dr Tomoko Soga
Co-Supervisor: Prof Ishwar Parhar

Synopsis:
Social problems such as bullying, victimisation, abuse and neglect are extreme social phenomenon, which are mainly triggered by certain types of social stressors. Social stress is one of the important factors responsible for the precipitation of depression in humans. However, the mechanism through which social stress leads to depression remains unclear. Serotonin is a key neurotransmitter, and an imbalance in serotonin levels influence mood that leads to depression. It has been shown that socially stressed animals display serotonergic dysfunction in the brain. However, it is unknown which brain areas are affected by serotonergic dysfunction under socially stressed condition. This project aims to identify brain areas that are affected by serotonin in socially stressed animal model (adult male tilapia fish) by morphological and molecular biology approaches.

Project Location: Brain Research Institute Monash Sunway (BRIMS), Monash University Malaysia
Supervisor: Prof Ishwar Parhar
Co-Supervisor: Dr Satoshi Ogawa

Synopsis:
Environmental and social stresses have deleterious effects on reproductive function in vertebrates. Global climate change, human disturbance and endocrine disruption from pollutants are increasingly likely to pose additional stresses that could have a major impact on human society.

In the last decade, the emergence of several hypothalamic neuropeptides, such as kisspeptin and gonadotropin-inhibitory hormone (GnIH) have led to a significant revision of our understanding as to how reproduction is controlled by the brain. Kisspeptin acts as the accelerator, whereas GnIH acts as the restraint. In recent years, these hypothalamic neuropeptides have been also identified as important regulators of social stress including fear and anxiety. However, their neuroendocrine roles in stress response are not well known. In this project, we will investigate the role of two key hypothalamic reproductive neuropeptides, kisspeptin and GnIH in stress response.

Project Location: Brain Research Institute Monash Sunway (BRIMS), Monash University Malaysia
Supervisor: Dr Shogo Moriya
Co-Supervisor: Prof Ishwar Parhar

Synopsis:
Parkinson’s disease (PD) is a common neurodegenerative disorder that results in motor impairment. Currently, there is no effective treatment for PD because no drug target is currently available. PD is caused by death of neurons (= neurodegeneration) in human brain that produce dopamine, a neurotransmitter that helps regulate movement and emotional responses. However, the actual cause of neurodegeneration of dopaminergic neurons remains unknown. One major risk factor of PD is ageing. Recently, we have identified novel age-related genes that are expressed in brain regions containing dopaminergic neurons. In this project, the potential involvement of these age-related genes in relation to the dopamine system will be investigated by molecular biology techniques using zebrafish.

Project Location: Brain Research Institute Monash Sunway (BRIMS), Monash University Malaysia
Supervisor: Dr Satoshi Ogawa
Co-Supervisor: Prof Ishwar Parhar

Synopsis:
Drug abuse and addiction remain great challenges to public health agendas in the world. A better understanding of the neurocircuits affected by drug abuse lead to a better understanding of addiction and to more effective strategies for the prevention and treatment of substance-use disorders. G protein-coupled receptors (GPCRs) are involved in drug addictions. "Orphan" GPCRs, those with unknown functions, are considered potential targets for new drugs and many are the subject of active drug-design research. This project aims to examine the potential role of orphan GPCRs in drug addiction by molecular biology and imaging techniques using zebrafish model.

Project Location: Monash University Malaysia
Supervisor: Dr Kyi Kyi Tha
Co-Supervisor: Dr Amreeta Dhanoa
Associate Supervisor: Assoc Prof Lakshmi Selvaratnam

Synopsis:
Dengue viral infection is a major public health problem worldwide especially in the tropical and subtropical countries including Malaysia. Fifty to a hundred million of the world population are suffering from dengue infection every year and Malaysia has reported 53,823 cases with 158 deaths as of June 2015 (WHO, 2015). Interestingly, recent trends show that young adults are found to be more susceptible to dengue (Chew, Rahman and Salleh, 2012; Ahmad Nizal et.al, 2012). Currently, there is neither definitive nor effective treatment for this potentially fatal infection. Complementary and alternative medicine (CAM) is a popular well-known adjunct to the treatment of various diseases including infections. Recently, various CAM practices and products such as Carica papaya (Subenthrian et.al, 2013), Phyllanthus species (Suresh, 2015), etc. show promising effects on prevention and treatment of dengue.

However, there have been limited studies regarding the perception of usage of CAM for dengue viral infection. Therefore, this pilot study aims to investigate the awareness, perception and attitude towards usage of CAM amongst medical students and general medical practitioners (GPs) in Malaysia. We hypothesise that medical students and GPs are aware of CAM use for dengue infection, however, perceptions, attitudes and knowledge may vary. GPs may also have concerns on their patients’ usage of CAM.

Project Location: Monash University Malaysia
Supervisor: Dr Rakesh Naidu
Co-Supervisor: Prof Iekhsan Othman
Associate Supervisor: Dr Muhamad Rusdi Ahmad Rusmuli

Synopsis:
B. candidus and B. fasciatus are two highly venomous elapid snakes in Malaysia with medical importance. Venoms from these kraits species contain myriads of bioactive molecules and toxins with potential therapeutic application. Potential anticancer activities have been described from the venom of other snake species including, cobras and vipers. However, little is known about the anticancer potentials of the Malaysian kraits.

The present study aimed to investigate the anticancer activity of the Malaysian kraits venom on human colon cancer cells and to identify venom protein(s) with potential anticancer action. Cytotoxic studies will be conducted on human colon cancer cells via colorimetric MTT assay and the venom proteins will be identified with a combination of proteomic approach; FPLC, HPLC and mass spectrometry. It is hypothesized that the Malaysian krait venom will have anticancer activities on the human colon cancer cells.

Project Location: Monash University Malaysia & Seaco Segamat
Supervisor: Dr Devi Mohan
Co-Supervisor: Dr Blossom Stephan (Newcastle UK)
Associate Supervisor: Prof Daniel Reidpath

Synopsis:
MCI is considered to be an intermediate state between normal cognitive ageing and dementia associated with an increased risk of future dementia. When diagnosed in clinical settings, individuals with MCI have an annual dementia progression rate of approximately 10%. In population-based studies progression rates are generally found to be lower than those reported in clinical samples (4.9% per year). This raises questions regarding the utility of MCI in population-based samples. Further, to date, no study has undertaken a detailed investigate of MCI in the Malaysia population. Determining how best to identify individuals at high risk of dementia in Malaysia will have important implications for treatment, public health surveillance and education. The aim of the project is to undertake a detailed investigation of the state of Mild Cognitive Impairment (MCI), including prevalence and risk factors among elderly using, data from the Southeast Asia Community Observatory (SEACO) Elderly Cohort Feasibility Study.

Research Questions The project will address two questions: (1) What is the population prevalence of MCI among elderly in SEACO; and, (2) What are the risk factors (e.g., health, social, demographic) associated with a MCI diagnosis?

Project Location: Johor Bahru
Supervisor: Dr Vanassa A/P Ratnasingam
Co-Supervisor: Assoc Prof Sivakumar A/L Thurairajasingam

Synopsis:
MSM1 and Transgender population is at a higher risk of STI2 in particular HIV.

Aims of study to assess:

1) Behavioural and biological factors that influence risk of transmission of HIV and other STI

2) Mental health issues, substance use and other risk behaviours

3) Contributing social and cultural factors 

Methods & Techniques:

Cross sectional survey on MSM & Transgender population at Intan Life Zone Johor Bahru (drop in center).

Harm Reduction Case Workers (trained by project Supervisors) will complete the questionnaires through interviews with clients.

Survey questionnaires:

-  behaviour & biological factors (self-developed survey)

-  substance abuse (ASSIST)

-  riskbehaviours (HIV Risk Taking Behaviour Scale HRBS)

-  mental health assessment (General Health Questionnaire GHQ-12)

-  social and cultural factors (self-developed survey)

-  knowledge towards HIV prevention (HIV Knowledge Questionnaire HIV-KQ-18)

Candidates Expectations:

-  Designing self-developed survey questionnaire with the supervisors suitable in context to the local population

-  Training of the Harm Reduction Case Workers in administration of the questionnaires

-  Collating and analyzing the data

Small group education talks to promote health education, screening and safe sex among clients

Project Location: Johor Bahru
Supervisor: Dr Vanassa A/P Ratnasingam
Co-Supervisor: Assoc Prof Sivakumar A/L Thurairajasingam

Synopsis:
MSM (men having sex with men) and Transgender population is at a higher risk of sexually transmitted infections in particular HIV. These groups of people are shunned by society, discriminated, marginalised and stigmatized; hence for them to access health screening is limited.

In Malaysia same –sex, sexual acts is an offence under Malaysian Penal Code 377 and the Shaariah Law. The estimated population of MSM in Malaysia is about 173000 and Transgender 10000-200001. In 2014, IBSS (Integrated Bio-behavioural Surveillance) by the Ministry of Health Malaysia found the HIV prevalence in MSM was reported at 8.9% and the prevalence of those who tested in the past 12 months and knew their results was 40.9%2.

Project Location: Johor Bahru
Supervisor: Dr Nevein Philip
Co-Supervisor: Dr Amutha Ramadas

Synopsis:
Multiple sclerosis (MS) and Neuromyelitis optica (NMO) are chronic demyelinating disease of the central nervous system with unknown etiology(1). Scientists believe that certain environmental and infectious factors trigger the disease in genetically predisposed persons. Many infectious factors are being investigated to determine any association with the development of MS and NMO, including multiple viruses and bacteria, it was found that Epstein-Barr virus is most consistently linked to the development of MS and NMO (2).

Helicobacter pylori is a gram-negative bacterium that causes peptic ulcers and gastric cancer was found to be associated with the development and progression of multiple neurological diseases (3). However evidenceon its relationship with MS and NMO is contradicting.

Project Location: Johor Bahru
Supervisor: Dr Nevein Philip
Co-Supervisor: Dr Amutha Ramadas

Synopsis:
Multiple Sclerosis and Neuromyelitis optica are relatively uncommon diseases in Malaysia being an equator country it is of low prevalence, ( 1-2/100,000).  lack of sun exposure and Vit D deficiency are risk factor for MS in western countries , however  no data about these risk factors for MS and NMO in Malaysia.

Researchers found that vitamin D has an extensive immunemodulatory effect, blocks the production of pro-inflammatory cytokines by microglia and plays an important role in neuronal function as well as moderating demyelination and potentiate remyelination of the nervous system . Despite its location, However, there is a lack of evidence linking dietary vitamin D, plasma 25 hydroxyvitamin D (25 (OH)D) level and MS, NMO and NMO spectrum disorders (NMOSD) among Malaysian population. Identification of the presence of vitamin D deficiency as a risk factor for MS, NMO and NMOSD in Malaysia assist clinicians to initiate relevant strategies in prevention and management of these diseases.

Project Location: Johor Bahru
Supervisor: Assoc Prof Sivakumar A/L Thurairajasingam
Co-Supervisor: Assoc Prof Jeyarajah A/L M Selvadurai
Associate Supervisor: Dr Abdul Kadir Abu Bakar Haslina Mohd Yusof

Synopsis:
In smoking research, modulating smoking cue reactivity has been one productive target behavior for brain stimulation. Anodal tDCS of the DLPFC (neuronal depolarization) increases activation and reduces cravings in response to these cues. The finding that noninvasive stimulation modifies cue-induced cravings has profound implications for understanding the processes underlying addiction and relapse.

AIMS OF STUDY:
- To determine whether Transcranial Direct Current Stimulation (tDCS) can reduce cigarette smoking and constitute a treatment of tobacco addiction.

Primary Outcome Measures:
- Change from baseline in the number of cigarettes consumed at the end of the week of tDCS

Secondary Outcome Measures:
- Change from baseline in the number of cigarettes consumed 1 month after tDCS

METHODS & TECHNIQUES
- Randomized, Parallel Assignment, Double Blind stimulation on individuals with strong dependence on nicotine, comparing between “Active tDCS” and “Sham tDCS”

Sample size: 40 subjects (20 in each arm)
Intervention
1. Sham tDCS
    • Delivered by the stimulator 2mA for 40s & brief current pulses until the end of stimulation
    • 20 minutes per session, 2 sessions per day, Total 10 sessions
2. Active tDCS
    • Anodal tDCS applied over the right DLPFC 2mA
    • 20minutes per session, 2 session per day, total 10 sessions

Project Location: Klinik Tanglin, Bangsar
Supervisor: Dr Amutha Ramadas
Co-Supervisor: Prof Rusli Nordin

Synopsis:
Poor metabolic control results in irreversible tissue damage and this accounts for 3.2 million deaths per annum (1). Type 2 Diabetes Mellitus (T2DM) accounts for a huge burden of morbidity and mortality through micro­ and macrovascular complications (2,3). Long term damages include damage and dysfunction of the cardiovascular system, eyes and nerves. Local evidence has shown a lower quality of life (QOL) of patients with non­ communicable diseases (NCD) in general and T2DM in particular, though the assessment of QOL itself varies according to studies (4). In addition to this, the psychological make­up of the patients with T2DM has been found to have an impact on their self-management behaviour, medication adherence, complications and QOL play a central role in self-management behaviours (5,6). Given the rise in prevalence of diabetes and its related co­morbidities in Malaysia, a comprehensive study that quantifies all these aspects in a sample of patients of T2DM is required to give us a greater understand of this complex relationship.

This study aims to investigate the relationship between diabetes complications and severity, medication adherence, psychosocial well­being and QOL of patients with T2DM.

Project Location: Johor Bahru
Supervisor: Dr Amutha Ramadas
Co-Supervisor: Dr Nevein Philip

Synopsis:
Multiple sclerosis (MS) is chronic inflammatory demyelinating and disabling disorder of the central nervous system affecting mainly young adults (1). In recent years, comorbidities have been shown to be associated with increased hospitalisation (2), diseases progression (3), decreased quality of life (4) and increased mortality (5) in people with MS. Although there is a growing interest in comorbidities linked to MS, the information about metabolic comorbidities in patients with multiple sclerosis (MS) is scarce. In addition, despite overall evidence suggesting an increased risk in people with MS, limited and inconsistent data exist on the risk factors of MetS in this group (6).  The available evidence sggest future research in this areas, if physicians are to advise people with MS adequately in avoiding metabolic comorbidities. Besides, investigation into this subject matter in Malaysia is still at its infancy.
Study aims:
1. To determine the prevalence of MetS and its component in people with MS.
2. To determine the association between the following modifiable risk factors and MetS in people with MS:
    • BMI
    • Physical inactivity
    • Dietary behaviour
    • Alcohol and smoking

Project Location: Johor Bahru
Supervisor: Dr Ahmad Munir Qureshi
Co-Supervisor: Prof Rusli Nordin
Associate Supervisor: Dr Amutha Ramadas

Synopsis:
Adolescence is developmental phase which leads to independent living, maintaining connections to family, peers, and community.  This transition could be most turbulent life period (Encyclopedia of Mental Health  2016).
Demography, home life, school performance, romance, peer pressure, teacher interaction, finance and emerging adult responsibility were correlated to stress. Adolescent stress been linked with physical disease [Mandler, G. 1984], and psychiatric issues such as depression, suicidal intentions and committing suicide [Grant et al 2004, Johnson et al 2002].
In past several questionnaires were used to measure Malaysian adolescent stress, except Adult Stress Questionnaire (ASQ) [Byrne & Mazanov 2002], studies were conducted in other states,  and showed prevalence range of 18% to 48%. With this variability we are not sure about exact prevalence of adolescent stress in Johor, and are curious to find it out.

Study Aims:
To investigate prevalence and sources of adolescent stress.

Hypothesis:
Prevalence of adolescent stress among students of SMK Dato Jaafar, is same as other Malaysian states.

Independent factors such as, demography, home life, school performance, romance, peer pressure, teacher interaction, finance and emerging adult responsibility lead to adolescent stress.

Project Location: Johor Bahru
Supervisor: Assoc Prof Nerminathan Veerasingam
Co-Supervisor: Dr J Ravichandran

Synopsis:
Pregnancy is a state of increased nutritional requirements including micro-nutrients, hence making a woman susceptible to deficiencies. In the recent years, there has been a surge witnessed in the publications exploring the effects of Vitamin D deficiency on pregnancy that is employed through its role in glucose homeostasis, immune function and cellular growth.  Vitamin D is now considered a hormone for its non-classical effects as its receptors are found in all cells.   Among the outcomes of note include pre-eclampsia, gestational diabetes, prematurity and small for gestational age (SGA) infants, pre-maturity as well as increased caesarean section rates. It is also well recognised that Ca+ absorption is manyfold during pregnancy largely due to the classical effects of Vitamin D. It would be interesting to find out the change levels due to pregnancy causing the deficiency and hence the non-classical effects. Less than a handful of published data suggest 60% of pregnant Malaysian women are deficient in Vitamin D in the 2nd trimester. 

This study will aim to see the effects of the Vitamin D deficiency in the 2nd trimester and its outcome on pregnancy with regards to gestational diabetes and small for gestational age (SGA) in Malaysia.

Project Location: Johor Bahru
Supervisor: Assoc Prof Nerminathan Veerasingam
Co-Supervisor: Dr J Ravichandran

Synopsis:
Pregnancy is a state of increased nutritional requirements including micro-nutrients, hence making a woman susceptible to deficiencies. In the recent years, there has been a surge witnessed in the publications exploring the effects of Vitamin D deficiency on pregnancy that is employed through its role in glucose homeostasis, immune function and cellular growth.  Vitamin D is now considered a hormone for its non-classical effects as its receptors are found in all the cells. It would be interesting to find out the change in levels of the hormone due to pregnancy causing deficiency and hence the non-classical effects. Less than a handful of published data suggest 60% of pregnant Malaysian women have vitamin D deficiency in the 2nd trimester.

It has been well known for a long time that Vitamin D levels are dependent on sunlight exposure, ethnicity, and skin pigmentation. There is now evidence from the United States that vitamin D absorption and metabolism are determined by the genetic makeup of a person. Malaysia has a unique population mix of Malay, Chinese and Indian ethnicities. The differences in culture, dietary habits, levels of exposure to sunlight and most importantly skin pigmentation have a major impact on the levels of vitamin D synthesized by the skin on exposure to sunlight. This study will aim to determine the relationship of vitamin D deficiency with ethnic differences, age and skin pigmentation in Malaysia.

Project Location: Monash University Malaysia
Supervisor: Assoc Prof Anil Gandhi
Co-Supervisor: Dr Sarojah
Associate Supervisor: Mdm Tuan Nur

Synopsis:
Breast cancer remains pertinent with high a morbidity even with much improved mortality rates. This cross-sectional study aims to review medical records of patients under the care of Hospital Sultanah Aminah and Hospital Sultan Ismail with a targeted sample size of 3000 patients with regards to patients’ risk factors, protective factors and their tumor presentation and method of detection. This aims to establish screening habits of our women and to determine stage at presentation and if there are any different risk factors. There has been a very limited number of studies in Malaysia, especially one that is of this size.

Project Location: Johor Bahru
Supervisor: Assoc Prof Anil Gandhi
Co-Supervisor: Mdm Tuan Nur

Synopsis:
Surgical site infections (SSIs) which has been proposed as an indicator of a hospital or surgical units’ performance remains a significant contributor to post-operative morbidity and mortality worldwide. A prospective study investigating the rates of surgical site infections among general surgical patients in Hospital Sultanah Aminah and their risk factors for it. This would involve daily review of the surgical site.

The main focus would be to determine if emergency surgeries carry a higher incidence of SSI than elective surgeries and if those could be explained by the seniority of the surgeon.

Project Location: Johor Bahru
Supervisor: Assoc Prof Anil Gandhi
Co-Supervisor: Dr Peter Evans

Synopsis:
Laparoscopic surgery is increasingly being utilized and it is important that students are exposed to its basic principles as early as their undergraduate days. This study aims to provide the evidence for such a change by establishing an increasing popularity for laparoscopic versus open surgery by retrospective analysis of operation theatre records. Secondarily, is to determine the level of expected skill and knowledge of surgeons towards the basic skills of a houseman in assisting laparoscopic surgery and hence to devise a suitable introductory course for undergraduate students.

Project Location: Monash University Malaysia at Sunway & CSJB
Supervisor: Assoc Prof Anil Gandhi
Co-Supervisor: Dr Ahmad Munir Qureshi

Synopsis:
Different medical schools have adopted a variety of learning/teaching styles depending upon their resources and curriculum that has resulted in many interesting learning options for students. Hence, this study, which will be questionnaire based aims to determine the students’ opinion on their preferred learning method, styles and preferences in students across the two Monash campuses to identify which learning style works best among our students. This study also aims to compare changing learning habits among students in their pre-clinical to their penultimate years.

Project Location: Johor Bahru
Supervisor: Dr Ahmad Farouk
Co-Supervisor: Prof Rusli Nordin
Associate Supervisor: Dr Siti Noraida

Synopsis:
Background: Recent years have seen an ongoing trend of vaccine hesitancy in this country. This attitude was largely attributed to the anti-vaccine movement, though many other determinants have never been examined conclusively. Surprisingly, despite the compelling evidence of the value of vaccines in preventing diseases and disabilities and in saving the lives of millions of children every year, vaccine hesitancy has become a growing focus of attention and concern. This attitude has resulted in cases of diseases that were mentioned in textbooks only such as diphtheria and pertussis, to be diagnosed currently in this country. WHO has defined vaccine hesitancy as a delay in acceptance or refusal of vaccination despite availability of vaccination services. Given that vaccine hesitancy is specific to sub-groups within populations, and is rarely population-wide, it is important to first understand who is hesitant about vaccination, what their concerns are and in which geographic, socio-cultural or political context that may have contributed to the hesitancy.

Aims: The study aims to assess parental knowledge, attitude and practice (KAP) towards the Ministry of Health (MOH) free vaccination programme and factors predicting vaccine hesitancy (uptake) of the free vaccines. The study will also assess and compare the KAP and predictive factors of vaccine hesitancy (uptake) of other specific sub-groups such as Homeopaths, Health-care Providers (Nurses and Paramedics) and general Medical Practitioners.

Hypotheses:
1. There is a high prevalence of false belief, negative attitude, and vaccine hesitancy related to the MOH free vaccination programme.
2. Socio-demographic factors, false belief, and negative attitude are strong predictors of vaccine hesitancy among parents, homeopaths, healthcare providers, and general medical practitioners.

Project Location: Johor Bahru
Supervisor: Assoc Prof Anil Gandhi
Co-Supervisor: Prof Rusli Nordin

Synopsis:
Students at Monash as well as medical schools around the world are exposed to a variety of clinical cases via a patient and paper based PBLs. However, recent literature review mentions about  video PBLs which may prove to be more effective as it allows greater visualization of patient’s signs and symptoms and it trains students to recognize disease pattern from essentially ‘raw’ data, not given a verbal label by an expert writing the case. This study starts by converting several paper PBL cases into video PBLs and to conduct a pilot study with Year 3 students, gathering their feedback on its usefulness.

Project Location: Johor Bahru
Supervisor: Assoc Prof Nerminathan Veerasingam
Co-Supervisor: Dr J Ravichandran

Synopsis:
Pregnancy is a state of increased nutritional requirements including micro-nutrients, hence making a woman susceptible to deficiencies. In the recent years, there has been a surge witnessed in the publications exploring the effects of Vitamin D deficiency on pregnancy that is employed through its role in glucose homeostasis, immune function and cellular growth. Less than a handful of published data suggest 60% of pregnant Malaysian women are deficient in Vitamin D in the 2nd trimester. It would be interesting to find out the change levels due to pregnancy causing the deficiency.
Many prior studies have suggested that the vitamin D levels in pregnant women tend to be lower than that of non-pregnant women, presumably due to increased nutritional needs during the gestational period. In pregnant women, maternal 1,25(OH)2D requirements surge up to 4 to 5 times the usual amounts needed. This is a maternal physiology response in order to sustain the increased transfer of calcium across the placenta for fetal skeletal growth. Several theories such as haemodilution and reduced exposure to sun have been put forward to explain the deficient levels of vitamin D during pregnancy. However, it is obvious that these hypotheses do not fully account for the widespread prevalence of vitamin D deficiency among pregnant women. The definite explanation for this decline in vitamin D levels would be the increased demand for calcium needed in fetal bone formation.

The current known mechanism of vitamin D transfer across the placenta is that vitamin D dissociates from its binding protein before traversing over via simple diffusion. One might assume that less amounts of 25(OH)D  would diffuse across the placenta due to the property of vitamin D3-binding protein possessing greater affinity for 25(OH)D as compared to 1,25(OH)2D. This however, does not happen and the reverse is true due to the action of placental 24-hydroxylase. This enzyme prevents 1,25(OH)2D from crossing the placenta by converting 1,25(OH)2D to an inactive form of vitamin D, known as 24,25-dihydroxyvitamin D3. A less proven and controversial hypothesis suggests the occurrence of 1,25(OH)2D synthesis in the decidual and placental tissue. This postulation however needs to be explored more in-depth. Based on the reasons stated above, we are thus comparing vitamin D levels in cord blood with that of maternal serum levels during labour to better comprehend this matter.

This study will aim to study the differences in vitamin D levels of pregnant women in labour and how they correlate to levels in cord blood as well as to study how these levels vary in a non-pregnant population in Malaysia.

Project Location: Segamat
Supervisor: Assoc Prof Naganathan A/L Kathiresan Pillai
Co-Supervisor: Assoc Prof Dr Amudha Kadirvelu
Associate Supervisor: Prof Parasakthi A/P Navaratnam

Synopsis:
In 2010, a distinct outbreak of malaria was documented in the Segamat Health District. This occurred in the presence of endemic dengue infections and co- infections were a possibility.

This is a retrospective observational study through review of case notes of patients diagnosed with malaria/malaria-dengue coinfections during the outbreak. A data collection sheet will be used and data analysis will be carried out to determine risk factors, rates of co-infections, plasmodium species, diagnostic challenges and factors influencing disease severity and clinical outcomes.

Project Location: DEMC
Supervisor: Assoc Prof Dr Amudha Kadirvelu
Co-Supervisor: Dr Siti Noraida   
Associate Supervisor: Assoc Prof Sunil Gurtu

Synopsis:
Effective postoperative pain control is an essential component of care of the surgical patient. A majority of surgical patients suffer from moderate to severe pain despite all the available analgesic drugs and modern devices. Adequate pain management continues to be a major challenge in the management of surgical patients. This project aims to: (a) assess the quality of post-operative pain management in the surgical wards and (b) explore patients’ experience of pain and satisfaction with post-operative pain control.
Consecutive, eligible hospitalized patients aged over 18 years and within 24 and 72 hours of surgery will be invited to participate in this prospective cross-sectional study. American Pain Society Patient Outcome Questionnaire (APSPOQ) will be used to collect information related to experience of pain and satisfaction with post-operative pain control from consenting participants. Pain Management Index (PMI) will be used to determine the adequacy of post-operative pain management. Data will be analysed using the Statistical Package for Social Sciences (SPSS).

Project Location: Hospital Kajang
Supervisor: Assoc Prof Sivalal A/L Sadasivan
Co-Supervisor: Assoc Prof Dr Amudha Kadirvelu
Associate Supervisor: Prof Parasakthi A/P Navaratnam

Synopsis:
Leptospirosis is an acute arthropod zoonotic infection that is major cause of morbidity and mortality worldwide. Infections are sporadic but there are often major outbreaks. It is caused by the leptospirosis spirochete which can only be seen with dark field microscopy. The common factors responsible for the re-emergence of the disease are reservoir and carrier hosts, flooding, improper drainage, animal-human interface, and human host risk factors.
The objective of this research project is to identify the reasons for the recent outbreak of Leptospirosis, identify weakness/shortfalls in existing control measures, and postulate remedial measures.

Project Location: Sungai Long Medical Centre, PJ
Supervisor: Assoc Prof Sivalal A/L Sadasivan
Co-Supervisor: Assoc Prof Dr Amudha Kadirvelu
Associate Supervisor: Dr Sree Kumar (Cardiologist)

Synopsis:
This study plans to explore the use EECP therapy (a non-invasive treatment for patients with CHD) in Malaysia. A literature review of EECP therapy will also be carried out.
EECP therapy is typically provided in 35, one-hour treatment sessions over a period of approximately seven weeks. While lying on a treatment table, compressive cuffs are firmly wrapped around the patient's calves, thighs and buttocks. These cuffs inflate in a distal to proximal sequence in early diastole, and deflate simultaneously in late diastole just prior to the onset of systole, specifically timed to the patient's ECG to optimize therapeutic benefit.
A neurohormonal response is triggered inducing production of growth and vasodilatation factors, which together with the increased pressure gradient, promotes growth of new arteries, while dilating and normalizing the function of existing blood vessels. The collaterals bypass stenoses and increase blood flow to ischemic areas of the heart, leading to improved clinical outcomes.
However, despite safety, effectiveness and sustained benefit being scientifically validated through RCT and registry data with about 190 papers since 1992, use of this technology is not widespread.

Project Location: Johor Bahru
Supervisor: Assoc Prof Suneet Sood
Co-Supervisor: Ghislaine L Lewis (School of Arts)

Synopsis:
Ethicists disagree in the resolution of ethical dilemmas because the elements of ethics (e.g. non-maleficence, beneficence, autonomy) have never been ranked. We need a hierarchy. Principle 2 should apply to a dilemma provided it has no conflict with principle 1, and so on. We plan to try to create this hierarchy. Dilemmas will be extracted from literature, and submitted for resolution (n=200) to academics, who will also complete a questionnaire Analysis of the questionnaires and of 100 of these resolutions will help rank the elements of ethics. This hierarchy will be validated by applying it to the remaining 100 resolutions.

Project Location: Monash University Malaysia at Sunway or Johor Bahru
Supervisor: Assoc Prof Suneet Sood
Co-Supervisor: Prof Rusli Nordin
Associate Supervisor: Assoc Prof Mini Sood

Synopsis:
Motivation is a major factor determining a student’s academic achievement. Educators constantly search for novel methods to motivate medical students. However, since there is no method of measuring motivation, it is impossible for educators to know whether their methods are working. Thus we need an instrument that will reliably measure motivation. No such instrument is currently available.
This project aims to develop and validate a questionnaire to measure motivation to learn among medical students. The steps of the project will include literature search, development of first draft, testing, modification, finalizing, administration to students, and validation.

Project Location: General Hospital KL
Supervisor: Assoc Prof Suneet Sood
Co-Supervisor: Dr Nevein Philip Botross Henien

Synopsis:
Appendicitis is probably linked to altered gut microflora. The link is unprovable, since microflora studies are expensive, and we cannot justify the expense. A proven association definitely exists between appendicitis and at least one immune disorder—ulcerative colitis. Therefore appendicitis should also link with other immune diseases. We plan to explore its link with neuromyelitis optica, by measuring the prevalence of appendectomy among a population of adult neuromyelitis optica patients. Data (both retrospective and prospective) will be collected from outpatient departments at Hospital Kuala Lumpur. We need about 150 asthma subjects and 150 controls.

Project Location: Monash University Malaysia
Supervisor: Dr Lau Wee Ming
Co-Supervisor: Dr Kyi Kyi Tha
Associate Supervisor:

Synopsis:
Screen usage has been on the rise since the coming of the internet in the 1980s. Connectivity is easily accessible due to the availability of WiFi hotspots and users are able to purchase increasingly cheaper and portable electronic devices. The Clinical Research Centre Perak reported kids’ screen usage as a worrying situation due to the adverse effects. A recent literature review by Hale and Guan (2015) indicated that ‘screen time is adversely associated with sleep outcomes.’  In view of these two findings, it would be appropriate to study the trend of screen usage amongst students in higher learning; as almost every student owns a portable electronic device. They are plugged on throughout the day. This pilot study aims to explore the use of screen time amongst students in a tertiary education centre and how this affects their sleep, ‘time-out’ and learning.  We hypothesise that all students spent significant amount of time on their screens at the expense of their sleep, ‘time-out’ and learning.
This project involves design of a survey questionnaire to explore the health and screen usage amongst tertiary institution students.

Project Location: Monash University Malaysia at Sunway & CSJB, HSA
Supervisor: Dr Nevein Philip Botross Henien
Co-Supervisor: Dr Arkendu Sen
Associate Supervisor: Choon (Senior Consultant)

Synopsis:
Background: With the increase in both breadth and depth of medical curriculum, as well as in the huge increase in the number of medical schools in Malaysia there has been a concern that many medical graduates may not have equitable exposure to clinical dermatology which in most cases depends upon the exposure and Dermatology case loads in their respective teaching hospitals. Competencies of medical graduates in being able to translate their often scant clinical Dermatology exposure during such MBBS training to their workplace diagnosis during houseman ship and general practice is a challenge especially in absence of expert Dermatology guidance during their houseman ship rotations in remote hospitals. Aims:This pilot research aims to design, develop and evaluate an interactive e-learning Clinical Dermatology Repository using high resolution skin pathology imaging. Importance of the study: Such Digital repository, as continuous professional development, may be used as a ready reference for diagnosis and management of common skin conditions in the Malaysian context by House officers and General practitioners in their day to day practice.

Project Location: Medical Precinct, KK Kelana Jaya, TMC & Tun Hussein Onn Eye Hospital
Supervisor: Dr Priyia Pusparajah
Co-Supervisor: Dato’ Dr Khalid Bin Abdul Kadir

Synopsis:
AGE products are of great interest in the pathogenesis of diabetic vascular complications including diabetic retinopathy and diabetic nephropathy. Of particular interest, AGE levels have been shown to predict microvascular complications independently of HbA1c, and have been postulated to be the biochemical reason underpinning the so-called ‘glucose memory’ phenomenon. Identifying markers of eye and kidney damage in their early stages, or better still identifying patients at risk of developing these conditions would aid with early intervention and prevention of debilitating disease. We believe plasma AGE levels have the potential to do this.

We have preliminary data on AGE levels in a spectrum of diabetic patients mainly without any vascular complications and now aim to recruit about 90 patients with kidney disease and retinopathy. Their medical history will be obtained as well as previous blood investigation reports; we would examine them for retinopathy and check the urine for microalbumuria. Their plasma AGE levels would be measured and we would analyse the data for  correlation between the plasma AGE with varying stages of diabetic retinopathy and nephropathy.

Project Location: Monash University Malaysia
Supervisor: Assoc Prof Quek Kia Fatt
Co-Supervisor: Dr Amutha Ramadas

Synopsis:
Male sexual dysfunction is a common health problem affecting men of all ages worldwide, but is more common with increasing age. Treatment can often help men suffering from sexual dysfunction. There are many treatments available but the efficacy/effectiveness remains varies from one another.

Physicians have noted that a number of factors which serve as barriers in addressing sexual health with their patients including physician’s self-perceived inadequate knowledge and training, patient’s embarrassment, physicians own discomfort feelings with the topic etc.

Medical school can play vital role by promoting appropriate and effective management of sexual functioning problems.  Currently, there is a significant gap of knowledge in medical education in general with regards to sexual health components.

The proposed study is to determine the knowledge of medical students on the types of the male sexual disorders; treatment availability for Male Sexual Dysfunction and the impact of sexual dysfunction on self-esteem, quality of life, marital  etc

Project Location: KKM, CSJB & Monash University Malaysia
Supervisor: Assoc Prof Ngim Chin Fang
Co-Supervisor: Prof Rusli Nordin
Associate Supervisor: Dr Amutha Ramadas

Synopsis:
Thalassaemia major is an autosomal recessive condition where patients require lifelong expensive and burdensome treatment. It posed a public health problem in Malaysia where 5% of the population are carriers and more than 6000 patients are registered. An estimated RM3million per patient will be spent on the first 3 decades of their lives.

Thalasaemia major can be prevented by avoiding marriage between carriers, avoiding pregnancies where both couples are carriers, pre-implantation genetic diagnosis and selective termination of pregnancies following prenatal diagnosis. Malaysian public health strategies have focussed on voluntary screening and avoidance of marriage among carriers.

The success of thalassaemia prevention in Malaysia will depends on the populations’ awareness of the condition, their carrier status and acceptance of the preventive measures. Our study aims to assess the public’s KAP with regards to thalassaemia and suggest steps to improve these aspects.

Aim:
1)    Assess the public’s knowledge, attitudes and practice (KAP) with regards to thalassaemia and its preventive measures.
2)    Explore the socio-demographic factors affecting the KAP.

Hypothesis
1)    KAP about thalassaemia prevention is unsatisfactory in our community.
2)    Socio-demographic factors are important determinants of the KAP in Malaysia.

Project Location: HAS
Supervisor: Dr Mini Sood
Co-Supervisor: Dr Nisha
Associate Supervisor: Dr J Ravichandran

Synopsis:
Episiotomy is commonly used surgical procedure in developing countries to assist births. The rate of episiotomy reported in 2005 was around 60-100 % in Taiwan, Nepal and South Africa, while in Malaysia it was about 69%.(Birth 2005:32:219-223) The current guidelines favour the approach of a selective episiotomy (Nice guidelinesCG55London (UK):National Institute for health and clinical excellence; Sept 2007:1-65) There are few studies available on the knowledge level   of episiotomy, of the people involved in deciding when   to give it. The current study was designed to assess the knowledge and gaps amongst the house officers and midwives regarding episiotomy, in a tertiary hospital in Malaysia.
Aim of the study:
To assess the knowledge of the housemen and midwives on episiotomy.
Hypothesis- There are gaps in the knowledge of episiotomy amongst the housemen and midwives, in deciding which patients need an episiotomy

Project Location: HSA
Supervisor: Assoc Prof Ngim Chin Fang
Co-Supervisor: Assoc Prof Quek Kia Fatt

Synopsis:
Intussusception remains as one of the common paediatric surgical conditions requiring urgent attention. Left untreated, complications such as intestinal obstruction, perforation and peritonitis may develop and it is almost always fatal.  The abdominal ultrasound is both an accurate diagnostic test with non-surgical reduction using modalities such as air and hydrostatic reduction being the mainstay of treatment for non-severe cases.

The success of reduction of intussusception is dependent on several factors which may include the duration of symptoms and radiological findings. There are very few studies published with regards to paediatricintussusception amongst Malaysia children and research in this area will aid in future decision makings among local clinicians.

Aim:
1) To study the clinical presentations, laboratory parameters and radiological findings of intussusception amongst Malaysian children.
2) To study the factors associated with a favourable outcome in a Malaysian tertiary centre

Project Location: Monash University Malaysia
Supervisor: Assoc Prof Arkendu Sen
Co-Supervisor: Assoc Prof Lakshmi Selvaratnam

Synopsis:
The new frontiers of Medical education involves Augmented reality applications. Augmented reality allows a user to view and interact with a digital image while at the same time seeing and experience of the actual specimens simultaneously. At JCSMHS, we are developing interactive three dimension (3D) Augmented reality objects of actual cadaveric specimens that allows medical students with a virtual “feel” and give the same learning and visualisation experience as a real one.

Aim:
This pilot research aims to evaluate the impact of the newly developed cally relevant labelled 3D AR anatomy and pathology objects for medical learning.