CONTENTS
_____________________________________
From the HOD’s Desk
In Focus
⸎ Ivermectin I-TECH 2021
⸎ IMBCAMS Vaccine Trial
⸎ Age-Friendly City
⸎ Recombinant Covid
Fusion Protein Vaccine
⸎ Moral Distress Study
⸎ BID Mortality Profile
⸎ Patterns & Survival
Analysis of Pulmonary
Thromboembolic
⸎ Acceptance of COVID-19
Vaccine
Research Priority
Research Performance
Research Scope
2021– It’s a Wrap
2022– Looking Ahead
2
FROM THE HOD’S
DESK
NON COVID-19 RESEARCH
IN THE PANDEMIC
The COVID-19 pandemic resulted in a huge change in
clinical practice with much resources and manpower diverted
or allocated towards the diagnosis, management and
prevention of COVID-19. The care of non COVID-19 illnesses
were often sidelined or received scant attention except for
emergencies or malignancies. Similarly research, where
conducted was often COVID-19 focused.
2
4
6
8
9
9
10
10
11
12
20
28
41
43

NON COVID-19 RESEARCH IN THE PANDEMIC
3
FROM THE HOD’S DESK
Covid-19 Deaths by date of death from A summary of all cause mortality in the State of Perak
17 March 2020 until December 2021
Chart 1 Table 1
As can be seen Non COVID-19 mortality surpasses that of COVID-19. Understandably research has been
focused on this new disease entity as information is much needed to help us better understand and
combat this condition. Nevertheless research and advancement in the management of non COVID-19
diseases must resume and continue with earnest.
Dr. Philip Rajan Devesahayam
Head of Clinical Research Centre, Perak
Meeting with the Ipoh Mayor on dissemination of study findings
(Ipoh City is a member of WHO Global Network for Age-Friendly Cities and Communities)

4
IN FOCUS
A I-TECH 2021 — Ivermectin: The need for good science even amid a pandemic!
Ivermectin is an anti-parasitic medication commonly used in
humans and veterinary sectors. In Malaysia, only animal
grade ivermectin is approved for use by NPRA. In an in vitro
study by Caly, et al. 2020), ivermectin has shown to cause
~5000-fold reduction of SARS-CoV-2 virus within 48 hours.
This had led to multiple early studies on the use of
ivermectin in the treatment and prevention of COVID-19.
Due to the influence of misinformation in the social media,
many lay people resorted to self-medication with ivermectin,
leading to reported cases of hospitalization due to severe
adverse event, as well as late presentation to health facility
due to false assurance of ivermectin being a “miracle drug”
for COVID-19.
Clearly there was a need for robust evidence to ascertain the
efficacy of ivermectin in COVID-19. Thus, the Institute of
Clinical Research (ICR) and a group of frontline clinicians led
by Dr Steven Lim Chee Loon (Infectious disease specialist,
Hospital Raja Permaisuri Bainun), had initiated a clinical trial
named I-TECH study (Ivermectin Treatment Efficacy in
COVID-19 High Risk Patients). The clinical trial proposal was
reviewed and approved by Medical Research and Ethics
Committee (NMRR 21-155-58433) and registered under
Clinicaltrials.gov (NCT04920942). The use of Ivermectin for
this trial received a non-objection approval by National
Pharmaceutical Regulatory Agency (NPRA) for the clinical
trial.
► Assess the effectiveness of ivermectin in preventing progression of COVID-19 to severe disease among high risk
COVID-19 patients.
► Assess the efficacy of ivermectin in reducing mortality rate among high risk COVID-19 patients, and to compare difference
in resolution of symptoms, chest x-ray, laboratory investigations, ICU admission, mechanical ventilation and length of
hospital stay.
Source:
I-TECH Recruitment
Poster V 1.0
► Cont’d
CRCHospitalRajaPermaisuri Bainun,Ipoh
By Dr Song Li Herng

5
IN FOCUS
Hence with conclusion from the I-TECH study, MOH does not support the prescription of ivermectin in treatment on COVID-19
infection and discourage the publics to self-medication at home due to its adverse effect without close monitoring, and
potential late presentation of patients to health facility at late severe COVID-19 cases. The data will be incorporated into the
global clinical trials on ivermectin, while more data on ivermectin are on the way (Oxford Principle, ACTIV-6) to provide better
understanding on the use of ivermectin on COVID-19. Another clinical trial on prophylaxis of disease from post close contact
exposure of COVID-19 in Malaysia is in the planning phase and will be carried out in the near term future.
Acknowledgement: We thank Dr Steven Lim Chee Loon for his agreement and cooperation in publishing this article.
PI: Dr Steven Lim Chee Loon
Infectious disease specialist,
HRPB
Multi-center open labelled
Randomized trial (Phase III)
Study Sites:
Tertiary, District
Hospitals & PKRC’s
Study investigator
members
Subjects
sample size
Subjects under randomization arm will be receiving single
dose of 0.4mg/kg/day tablet Ivermectin for total 5 days
within facility monitoring; subjects under control arm will be
receiving a stand of care as per Malaysia guideline on
management of COVID-19. Both groups will be monitored
for any adverse events or deterioration from COVID-19
infection, with a day 5 follow up is schedule with clinical
finding recorded down, baseline blood test and chest X-ray
ordered. Subjects will be allowed home based on discharge
criteria set by Malaysia management guideline for COVID-
19, prior to discharge a follow up review will be carried out
by investigator team. Subject will be discharged from study
from day 28 if still need to be in hospital.
The main challenge faced by the investigators team was the
slow recruitment process at the period of time where more
severe cases were hospitalized in main tertiary facilities;
those mild to moderate high risk patients which fulfil the
inclusion criteria were relocated to low risk quarantine
centers and district cluster hospitals. The investigators
teams managed to overcome the recruitment issue by
expanding recruitment sites to cluster hospitals and low
risk quarantine centers (eg. MAEPS Serdang) and manage
the trial process and clinical data with integrity. The last
subject was recruited on 9th October 2021. I-TECH study
also found that there were slight increase adverse events
reported among treatment group specifically to diarrhea.

6
B IMBCAMS Covid-19 Vaccine Trial
In late 2020, Institute of Medical Biology Chinese Academy
of Medical Sciences (IMBCAMS) approached Malaysia to be
one of the countries to run the phase III COVID-19 vaccine
trial. In Perak, Hospital Raja Permaisuri Bainun (HRPB), Ipoh
and Hospital Taiping were invited to participate in this trial
along with other seven hospitals in Malaysia. In Ipoh, this
trial was led by Dr. Philip Rajan, Head of Otorhinolaryngolo-
gy Department and Clinical Research Centre. Meanwhile, in
Taiping was led by Dr. Cheah Wee Kooi, Head of Department
of Medicine and Clinical Research Centre. The trial was
started in February 2021. The trial received a good response
from the public, especially adults aged less than 60 years
old. Due to the trial protocol requirement, there was a need
to recruit volunteers aged 60 and above. There was less
response from the public aged 60 and above initially, but
with word of mouth from the existing volunteers, the team
managed to recruit the number of volunteers that were
required by the site.
The volunteers were required to attend five physical
follow-ups at the site and subsequently followed by virtual
follow-ups every fortnight for one year. The five physical
follow-ups aimed to monitor volunteers’ wellbeing after
receiving the study vaccine or placebo. During the
two-weekly follow-up, the volunteers were monitored for
any COVID-19 symptoms or any serious adverse reactions.
If the volunteers were suspected of COVID-19 infection as
stated in the protocol, the study team would arrange for a
COVID-19 swab test for the subject.
As time went by, the increasing number of COVID-19 cases in Malaysia caused uneasiness among the volunteers, study
team, ethics committee and IMBCAMS. This is because some of the volunteers are not protected by any vaccination as they
are in the placebo group. Given the worsening pandemic situation in Malaysia, an early analysis was conducted and showed
that the study vaccine was favorable and suggestive of having a certain level of protection. Hence, IMBCAMS amended the
study protocol to cross-over study design and added a booster in one of the groups (Figure 1). On top of that, IMBCAMS
incorporated an immunogenicity subgroup where volunteers were required to have additional six episodes of blood taking
for neutralizing antibody and IgG antibody testing.
Figure 1: Extended cross-over and booster trial
IN FOCUS
► Cont’d
By Dr Leong E Li

7
IN FOCUS
What was the design of the extended cross-
over and booster trial?
The extended cross-over and booster trial was initiated
in September 2021. The study team contacted every
subject who was still in the trial to explain the protocol
amendment. Volunteers were given the option to contin-
ue with the amended protocol or withdraw from the trial
without any penalty. Those who were keen to join the
extended cross-over and booster trial were given an
appointment to visit the site for screening and informed
consent process. Volunteers for the immunogenicity
group were chosen on a volunteer basis until the site's
quota was filled. Volunteers were required to attend five
physical follow-ups for both efficacy and immunogenicity
subgroup, to monitor volunteers’ wellbeing after the
study vaccine or placebo. Volunteers in the immunogen-
icity group were required to have added three visits for
blood taking. Regardless of efficacy or immunogenicity
group, volunteers would be followed-up via virtual
follow up to monitor for any COVID-19 symptoms. The
trial is aimed to complete in November 2022.
How did the Malaysian government conform to
the changes of the study design?
As the Malaysia government was enforcing the
requirement of vaccination status for normal social
activities, the Special Committee on Covid-19 Vaccine
Supply (JKJAV) was aware that this would affect the trial
volunteers as well. Taking into consideration the result
from early statistical analysis and protocol amendment,
JKJAV approved to provide digital certificates for all
volunteers who underwent the extended cross-over and
booster trial, and completed all four injections. Currently,
all the volunteers who have completed all four injections,
have received the digital certificate in MySejahtera.
What was the major setback faced during this
trial?
During end of the year 2021, the Ministry of Health
mandated that anyone who received CoronaVac as a
primary series vaccine to take a booster shot by
February 2022 in order to preserve their fully
vaccinated status in MySejahtera. Since the research
vaccination is an inactivated vaccine, the volunteers’
MySejahtera status may be affected. Furthermore, the
study team is concerned about the safety of volunteers
owing to the worsening global pandemic crisis caused
by Omicron. Given the circumstances, IMBCAMS decided
for early closure for all the sites in Malaysia and
proceeded for unblinding so that the volunteers could
get the COVID-19 booster vaccine as part of the
National COVID-19 Immunization Program (PICK).
The utmost priorities in any clinical trial are volunteers’
safety and scientific integrity of the trial. The study
protocol has been revised several times to adapt to the
dynamic pandemic environment. The challenging
environment has resulted in the final decision from
IMBCAMS for early closure for all the sites in Malaysia.
The global trial is still underway in various countries, and
we are hopeful for a positive outcome.
Source: Channel News Asia (05 June 2021)

8
C Age-friendly City Study— Is Ipoh an Age-friendly City?
The World Health Organisation has projected that the
proportion of older population globally will double from
11% in 2006 to 22% by 2050. Malaysia is not alone in
acing population ageing, where the population aged 60
years and above is accounted for 10.3% in year 2019. The
World Health Organisation introduced the “Age-friendly city”
and the Global Network of Age-Friendly Cities and
Communities (GNAFCC) to support older people in
communities, making cities more accessible for the aging
population. The 8 domains of age friendly city conceptual-
ized in the GNAFCC encompass aspects of (i) outdoor spaces
and buildings, (ii) transportation, (iii) housing, (iv) social
participation, (v) respect and social inclusion, (vi) civic
participation and employment, (vii) communication and
information, and (viii) community and health services.
Ipoh is ranked one of the nine best places to retire in the
world, in which 16.7% out of 739,700 people are more than
60 years of age. Riding on the bandwagon, we embarked on
a mixed-method study, consisting of both quantitative and
qualitative phase to evaluate the baseline perception of
elderly on the city’s age-friendliness in 2020. A quantitative
study was first conducted to determine the current
availability of various elements outlined under each GNAFCC
domain. We adapted the English version of the American
Association of Retired Persons Livable Communities – Great
Places for All Ages Survey Questionnaire. Participants were
conveniently sampled at public hospitals, health clinics, rec-
reational parks, and other public locations in the Ipoh City.
Due to the COVID-19 pandemic, the data collection was
resumed in the middle of 2021, and completed in October
of the same year.
We identified several perceived gaps of age-friendliness in
the eight domains. We presented the study findings to the
Mayor of Ipoh City in October 2021, where several
important gaps have been discussed and acknowledged.
A town hall meeting will be arranged with relevant
stakeholders in the Ipoh City Council to refine strategic
planning, by incorporating age-friendly element in the
10-year city development plan.
Based on the quantitative findings, in November 2021,
we conducted in-depth qualitative interviews to further
explain and interpret the quantitative findings. Given the
nature of pandemic that require physical distancing and
wearing a face mask, we conducted virtual interview
based on the participants’ preference and convenience.
The study population consist of older adults, caregivers
and key informants. Interviews were transcribed verbatim
and analysed through thematic analysis. The qualitative
phase of the study is expected to complete in the first
quarter of year of 2022.
We believed that this study can provide the essential
information for gerontology experts and decision-makers
in developing interventions and policies. As aged
population is on the rise, research on age-friendly cities is
gaining a foothold, closely related with older people’s
health, their physical, cognitive and emotional function,
and wellbeing. It is a noble goal to work on an age-
friendly city which is inclusive, safe, resilient and
sustainable, not only for the older people, but for
everyone.
IN FOCUS
By Mr Chang Chee Tao

9
IN FOCUS
LIVZON Mabpharm COVID-19 vaccine booster trial
CRCHospitalSeriManjung
A
Hospital Seri Manjung has been selected to conduct a COVID-19 vaccine booster trial, namely: A Global, Multi-Center,
Randomized, Double-Blind, Placebo-Controlled, Phase III Clinical Study to Evaluate the Efficacy, Safety and
Immunogenicity of Sequential Immunization of Recombinant SARS-CoV-2 Fusion Protein Vaccine (V-01) Against Covid-
19 in Healthy Adults aged 18 years and Older after the Vaccination of 2 Doses of Inactivated Vaccines, sponsored by
LIVZON Mabpharm Inc. The team of Hospital Seri Manjung was led by Dr. Lee Li Yuan as principal investigator.
► To evaluate the relative efficacy of
recombinant SARS-CoV-2 fusion protein
vaccine (V-01) as a booster to prevent
symptomatic infection and RT-PCR
positive COVID-19 compared with the
placebo control group.
► Adults aged 18 years and above
► Received second dose of 2-dose
regimen of inactivated vaccine i.e.
CoronaVac (Sinovac) or BBIBP-CorV
(Sinopharm), 3 to 6 months prior.
► History of previous COVID-19 infection
and any human coronavirus infection.
► RT-PCR confirmed COVID-19 infection
during screening period.
Hospital Seri Manjung team is actively looking for potential subjects with new recruitment strategy. The major
challenges faced during subject recruitment include: (i) free vaccination programme for COVID-19 vaccine booster has
been rolled out by government for all age groups, (ii) subjects booster dose vaccination status will not be updated in
MySejahtera, (iii) concern of being unprotected for 1 year period if being assigned to the placebo arm, (iv) individual
preference of certain COVID-19 brand, as well as (v) being unfamiliar with clinical trial.
► Volunteers are required to attend 2 study
visits, one week apart, followed by weekly
follow up contact for 1 year.
► During the first study visit, volunteers will
be randomly assigned to receive 1 dose
of either V-01 or placebo, upon comple-
tion of screening procedures.
Moral Distress among Healthcare Professionals B
► To evaluate the moral distress (MD)
among healthcare professionals (HCPs)
in Malaysia during the COVID-19
pandemic.
Overall, doctor had higher level of moral distress as compared to nurses, as well as in each of the following
departments, i.e. Medical Department, Pediatric Department and Intensive Care Unit amidst COVID-19 pandemic in
Malaysia. Doctor and nurses in Medical Department had higher level of MD as compared to their counterpart in
Pediatric Department and Intensive Care Unit. System-level root causes were ranked as the main root causes of moral
distress, for both doctors and nurses. Ensuring personal well-being or “self-care” were the most common solutions
given by the participants for dealing with moral distress during COVID-19 pandemic.
► Multi-center cross-sectional study
involving doctors and nurses working in
Medical wards, Pediatric wards or
Intensive Care Unit (ICU) of 10 Ministry
of Health hospitals.
► Self-administered online questionnaire was used as the study tool to capture demographic data and
moral distress among the doctors and nurses. A total of 492 subjects (141 doctors and 351 nurses)
answered the online questionnaire from January until July 2021.

10
This study aims to describe the mortality profile for BID cases
due to COVID-19 in Perak. This is a retrospective record review
study in which we retrospectively review all the mortality
reports of BID cases with laboratory confirmed Covid-19
infection between 1st January 2021 and 30th September
2021. The data on socio-demographic and clinical; as well as
status of vaccination, home surveillance order (HSO) and
COVID-19 assessment center (CAC) is currently being extracted
and transcribed into the study case report form (CRF).
IN FOCUS
Mortality Profile of Brought-in-dead (BID) cases due to COVID-19:
A Descriptive Study
C
Clinical and Computed Tomographical Patterns of Pulmonary Thromboembolic
Disease associated with COVID-19 Infection: A Tertiary Hospital Analysis
D
Source: MalayMail (03 July, 2021)
This study aims to study the clinical characteristics, computed
tomographical features of pulmonary thromboembolic disease
associated with COVID-19 infection. This is a retrospective
cohort study in which we retrospectively review all hospitalized
COVID-19 cases with suspected acute pulmonary
thromboembolic disease who had underwent CTPA
examinations between 1st April 2021 and 31st May 2021. The
clinical, laboratory and radiological data is currently being
collected by using electronic case report form (eCRF).
Source: Pulmonary Advisor
(31 July, 2018)
Survival Analysis of Pulmonary Thromboembolic Disease associated with COVID-19
Infection: A Comparison between Geriatric and Non-geriatric Populations
E
This study aims to explore the survival patterns among
hospitalized COVID-19 cases complicated with pulmonary
thromboembolic disease. This is a retrospective cohort study in
which we retrospectively review all hospitalized Covid-19 cases
complicated with pulmonary thromboembolic disease admitted
to HTAR between 1st April 2021 and 31st May 2021. The
clinical, laboratory and radiological data is currently being col-
lected by using electronic case report form (eCRF).
Source: American College of Cardiology
(22 April, 2020)

11
IN FOCUS
Factors Influencing the Potential Acceptance of a COVID-19 Vaccine
among Healthcare Workers in a District Hospital in Manjung, Perak
F
This study aimed to evaluate the potential acceptance of COVID-19 vaccine among HCWs in a district hospital in
Manjung, Perak. This was a single-centre cross-sectional study involving healthcare workers (HCWs) working in
the aforementioned hospital.
A self-administered online questionnaire was used as the
study tool to capture the socio-demographic
characteristics, acceptance of COVID-19 vaccine, its
associated factors and willingness to self-fund the
vaccine. A total of 901 subjects answered the online
questionnaire during a 2-week period from end of
December 2020 till early January 2021.
Among 901 subjects recruited, 74.8% self-considered
moderate to high risk of contracting COVID-19 infection.
Although 65.8% thought that COVID-19 vaccination
was important for self-protection but only 50.7% would
accept it.
Those not worried about fever post-vaccination, neutral towards unknown long-term side effect, neutral and not
worried about effectiveness of vaccine were more likely to accept COVID-19 vaccine. Subjects who would reject
vaccination despite declaration of bovine-free, reject India-manufactured vaccine, reject vaccination despite
recommendation by government or trusted healthcare professionals were associated with lower overall COVID-19
vaccine acceptance. Indifference towards vaccination despite declaration of porcine-free, duration of vaccine
effectiveness or escalation of cases were also associated with lower overall COVID-19 vaccine acceptance.
Online questionnaire
Socio-demographic
characteristics
Acceptance of
COVID-19 vaccine
Willingness to self-
fund the vaccine
Associated factors
of acceptance
Source: Bernama/File pic (18 Sep, 2020)

12
RESEARCH PRIORITY
Healthcare Priorities Highlighted in the Twelfth Malaysian Plan (RMK-12)
The Twelfth Malaysia Plan, 2021-2025, is transformational and injects
fundamental reforms that will truly strengthen the development trajectory
in the next five years to achieve the objective of a Prosperous, Inclusive,
Sustainable Malaysia based on the spirit of Keluarga Malaysia.
One of the 3 key themes of the Twelfth Plan is the “Strengthening of
security, wellbeing and inclusivity. In terms of wellbeing, this theme
focuses on efforts to improve healthcare in the country.
Healthcare service delivery will continue to be a focus in increasing the
health status of the rakyat. Endeavors to improve preparedness in battling
various diseases and the expansion of healthcare coverage will be
continued. One the game changers outlined in this theme includes:
The COVID-19 pandemic has tested the strength and response of healthcare delivery systems across the
world. Thus, revitalizing healthcare system is critical in order to ensure the rakyat have equal access to
healthcare services as well as be well-prepared in meeting future health crises.
► Cont’d
Revitalizing healthcare system in ensuring
a healthy and productive nation
On the social front, increasing health risks and demographic shifts pose
several challenges. The increase in the incidence of non-communicable
diseases (NCDs) and the need to manage the COVID-19 pandemic, including
the rollout of the National COVID-19 Immunisation Programme, has placed
intense pressure on the healthcare system. Malaysia has to prepare itself
holistically to meet the challenges posed by an aged society by 2030.

13
RESEARCH PRIORITY
Game Changer V in the Twelfth Malaysian Plan
( RMK-12 )
The COVID-19 pandemic has proven that it is critical to
have a robust healthcare sector and the need to embrace
the whole of nation approach in ensuring better
management of future outbreaks and health crises.
⸎ Lessons learnt from managing the pandemic will be
leveraged to revitalise and redesign the healthcare
services.
⸎ Resources and responsibilities will be consolidated and
healthcare services will be redesigned through
collaboration between public and private sectors as well
as CSOs.
⸎ In addition, a more sustainable health financing model
will be introduced and healthcare services will be
digitalised to accelerate delivery.
Revitalizing healthcare
system in ensuring
a healthy and
productive nation
► Cont’d

14
RESEARCH PRIORITY
Indicative areas for priority research in the health sector
during the process of development of the 12th Malaysia Plan
(2021-2025)
► Cont’d

15
RESEARCH PRIORITY
► Cont’d
Indicative areas for priority research in the health sector during the process of development of the 12th Malaysia Plan

RESEARCH PRIORITY
16 ► Cont’d

17
► Cont’d
RESEARCH PRIORITY

RESEARCH PRIORITY
18 ► Cont’d

19
RESEARCH PRIORITY

20
RESEARCH PERFORMANCE
Summary Report — Clinical Research Centre, Hospital Raja Permaisuri Bainun Ipoh
► Cont’d
Type of Research Service 2019 2020 2021
NMRR registration*
No. of research/Case studies/Clinical audit registered 135 228 108
No. of research/Case studies/Clinical audit projects with ethical approval 112 142 56
Research consultation No. of consultations (episodes) provided 627 638 352
Proposal review
No. of proposals reviewed by Hospital Research Review Committee
(HRRC)
130 106 32
Publication & presentation
submitted to CRC Ipoh
No. of application of publication in local/ international journals 11 26 24
No. of application of oral/poster presentation 39 5 5
Registry No. of patient registries supported 14 14 14
Training / Conference
No. of training workshops organised 25 18 7
No. of Ministry of Health staff trained 1590 719 449
No. of state conferences organised 1 1 1
Clinical Trial Involvement
(ISR/ IIR Hybrid)
No. of clinical trials supported by CRC staff 13 11 16
Research Projects and Output 2019 2020 2021
IIR projects
No. of research projects initiated by CRC and/ or in collaboration
with other institutions
30 39 38
Publications
No. of published articles in local/ international journals 12 16 21
No. of manuscripts pending publication 7 9 15
Research reports No. of research reports completed 5 8 17
Research presentation
No. of oral presentations 13 1 3
No. of poster presentations 14 8 7
Research awards No. of awards/ achievement received 8 5 5
Industry Sponsored Research (ISR) in CRM/CRC HRPB, Ipoh
Feasibility and Clinical Trials 2019 2020 2021
Feasibility No. of feasibility studies conducted 70 59 65
Clinical trials No. of on-going clinical trials 30 36 28
No. of upcoming clinical trials 8 8 7
*Data available only from Jan to Oct 2021.
A. Research services provided by CRC Hospital Raja Permaisuri Bainun
B. Investigator Initiated Research (IIR) in CRC Hospital Raja Permaisuri Bainun
C. Industry Sponsored Research (ISR) in CRC Hospital Raja Permaisuri Bainun

21
No. Details
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Malaysian Journal of Medical Sciences; 28(1):117–119. https://doi.org/10.21315/mjms2021.28.1.15
12 Chii-Chii Chew, Chee-Tao Chang, Xin-Jie Lim, Hasni-Adha Ibrahim, Hamiazwa Azmi, Nur-Ilyana Wahabi, Nur-Shuhaida Hamdan,
Nurul-Atiqah Nazan, Nur-Haliana Karim, Nurfarahdila-Ahmad Malawi, Ying-Ling Oon, Norshazila-Julia M.S & Amar-Singh HSS. 2021. The
quality of escalator signage for public safety in Malaysia: an observational study. Global Health Journal; ISSN 2414-6447.
https://doi.org/10.1016/j.glohj.2021.10.002.
13 Philip Rajan, Editorial. 2021. Challenges faced by Otorhinolaryngology (ORL) services, Malaysia, in the current pandemic. Medical Journal
of Malaysia; Aug; 76 (Supplement):1-2.
14 Purushotman Ramasamy, Vigneswaran Kumarasamy & Philip Rajan. 2021. Strategies in confronting the COVID-19 pandemic at a tertiary
public hospital for Otorhinolaryngology services. Medical Journal of Malaysia; Aug; 76 (Supplement): 35-8.
15 Gagandeep Singh Mann, Philip Rajan & Halimuddin Sawali. 2021. Otorhinolaryngology services at a district hospital in Sabah, Malaysia
during the COVID-19 Pandemic. Medical Journal of Malaysia; Aug; 76 (Supplement): 39-41.
16 Khairunnisak Misron, Tengku Mohamed Izam Tengku Kamalden, Lukmanul Hakim Misron, Philip Rajan & Siti Nor Fadhlina Misron. 2021.
Long-term maintenance costs incurred by the families of pediatric cochlear implant recipients in Malaysia. Cochlear
Implants International, doi: 10.1080/14670100.2021.1905975
► Cont’d

22
No. Details
17
Lee, S., Yeoh, Z.X., Sachlin, I.S., Gazali, N., Soelar, S.A., Foo, C.Y., Low, L.L., Alwi, S.S., Kamalden, T.F., Shanmuganathan, J., Zaid, M.,
Wong, C.Y., Chua, H.H., Yusuf, S., Muhamad, D., Devesahayam, P.R., Ker, H.B., Salahuddin, Z., Mustafa, M., Sawali, H., Lee, H.G., Din, S.,
Misnan, N.A., Amran, A.B., Ismail, M.N., Periasamy, C., Chow, T.S., Krishnan, E., Leong, C.L., Lim, L.P., Zaidan, N., Ibrahim, Z., Wahab, S.A.,
& Hashim, S.S. 2021. Self-Reported Symptom Study of COVID-19 Chemosensory Dysfunction in Malaysia. Scientific Reports.
doi :10.21203/rs.3.rs-696505/v1
18 Chee Tao Chang, Ju Ying Ang, Md Asiful Islam, Huan Keat Chan, Wee Kooi Cheah, Siew Hua Gan et al. 2021. Prevalence of Drug-Related
Problems and Complementary and Alternative Medicine Use in Malaysia: A Systematic Review and Meta-Analysis of 37,249 Older
Adults. MDPI Pharmaceuticals 14 (3), 187. doi: https://doi.org/10.3390/ph14030187.
19 Tan Pei Pei, Chee Tao Chang, Jernih Abdul Rahman & Sabariah Mohd Noor. 2021. Development and validation of a Malaysian blood
donor’s satisfaction (M-BDS) questionnaire. Malaysian Journal of Medical Sciences; 28 (3). 86-96.
20 Chang Chee Tao, Philip Rajan & Victor Hoe Chee Wai. 2021. Filtering Facepiece Respirators for Healthcare Workers Protection in the
Time of Covid-19 Pandemic. Malaysian Journal of Medical Sciences; 28 (3), 151-154.
https://doi.org/10.2135/mjms2021.28.3.14
21 Chee-tao Chang, Chii-chii Chew, Netia Jeganathan, Wai-keat Chung, Zuzainee Baharudin, Habsah Saad, Xiu-xing Kum, Siti Noor Ibrahim,
Sharifah Khalilah Ismail, Haema Shunmugurajoo, Sridalila Mohd Noor, & Amar-Singh HSS. 2021. The Ability of Nurses to Interpret
Neonatal Radiography at a Tertiary Hospital : An Interventional Study. Perak Medical Journal.
http://myjms.mohe.gov.my/index.php/pmj/article/view/6300/6326
No. Name
Award/
achievement
details
Event Details Study Title Photo
1
Chew
Chii Chii
Televised
Interview
Selamat Pagi
Malaysia
29 April 2021
“Apa Reaksi Rakyat
Malaysia”
Experiences of social stigma among
patients tested positive for COVID-19 and
their family members: A qualitative study
► Cont’d

23
No. Name
Award/
achievement
details
Event Details Study Title Photo
2
Leong
E Li
Best Poster
Winner
Annual Scientific
Meeting on Intensive
Care (ASMIC) by
Malaysian Society of
Intensive Care, 05 Sep
2021
The Needs And Experiences Of
Critically Ill Patients And Their Family
Members In Intensive Care Unit,
Hospital Raja Permaisuri Bainun,
Ipoh: A Qualitative Study
3
Lina
Hashim
Anugerah
Khidmat
Sokongan
Cemerlang
Anugerah
Penyelidikan Institut
Kesihatan Negara
(NIH) at NIH Setia
Alam, 26 Nov 2021
Khidmat Sokongan Cemerlang dalam
kategori Insitut Penyelidikan Klinikal
4
Escalator
info-
graphic
Program
Penerbitan
Buku Teks
Kurikulum
Standard
Sekolah
Rendah
(KSSR) 2022
Dewan Bahasa dan
Pustaka (DBP),
Kementerian
Pendidikan Malaysia
Gambar Infografik Tentang Tingkah
Laku Berbahaya Ketika Menggunakan
Eskalator Dalam Buku Teks Bahasa
Melayu Tahun 6 SJK Untuk Kegunaan
Tahun 2022
5
Dr.Philip
Rajan
Contribution
as a journal
editor
The Medical Journal of
Malaysia
The Medical Journal of Malaysia,
Aug 2021 Vol 176 Supp 4
(PP2121/01/2012)
(16 articles comprising of narrative
reviews, original articles,
commentaries and case reports in the
field of ORL services during COVID-19
Pandemic)

24
Summary Report — Clinical Research Centre, Hospital Seri Manjung
► Cont’d
IIR projects
13 19 21
Publications
NMRR registration*
Proposal review
(HRRC)
12 6 16
Publication &
presentation submitted
to CRC Ipoh
Registry No. of patient registries supported 1 1 1
No. of state conferences organised 1 0 1
A. Research services provided by CRC Hospital Seri Manjung
B. Investigator Initiated Research (IIR) in CRC Hospital Seri Manjung
No. of on-going clinical trials 8 9 10
Clinical trials
C. Industry Sponsored Research (ISR) in CRC Hospital Seri Manjung

25
No. Article Details
1
Singh RK, Chiew SC, Junus S, Krishnan SG, Wahid MA & Ng WH. 2021. Are Siblings of Children with Autism More Prone to
Behavioural and Psychological Problems as Compared to the General Population? Malaysian Journal of Psychiatry.
Nov 20 2020; 30(1).
2 Kamarozaman DM, Chiew SC, Low Qian Wen J, Pang YR, Bujang MA & Shafiei RM. 2021 Situation Analysis Of Fake Braces
Among Teenagers In Manjung District, Perak. Malaysian Dental Journal;1.
3 Tan TL, Chiew SC, Umabalan MB, Huey S, Khor B & Lee LY. 2021. Pseudomonas aeruginosa bacteraemia: A five-year analysis
of epidemiology, clinical profiles, and outcome in a Malaysian district hospital. Medical Journal of Malaysia. Sep 1;76(5):630
-636.
4 Tan TL, Tan-Loh J, Chiew SC, Lim KH, Ng WW, Akmal M, Khor SH & Lee LY. 2021. Risk factors and outcome of community
onset Pseudomonas aeruginosa bacteraemia in two Malaysian district specialist hospitals. Medical Journal of Malaysia.
2021 Nov; 76(6):820-827.
No. Name
Award/ achievement
details
Event Details Study Title
1
Dr Ngo
Ping Wen
(Co-author:
Dr. Ting
Siew Ying)
2nd
runner up
(Oral Presentation)
Perak Annual Medical
Research Conference 2021,
9th
Nov 2021
Factors related to prehospital delay in the
presentation of acute stroke and level of
awareness among stroke patients in a district
setting

26
Summary Report — Clinical Research Centre, Hospital Taiping
► Cont’d
IIR projects
13 19 21
Publications
NMRR registration*
Proposal review
(HRRC)
29 17 9
Publication &
presentation submitted
to CRC Ipoh
Registry No. of patient registries supported - - -
No. of state conferences organised - - 1
A. Research services provided by CRC Hospital Taiping
B. Investigator Initiated Research (IIR) in CRC Hospital Taiping
C. Industry Sponsored Research (ISR) in CRC Hospital Taiping
No. of on-going clinical trials 12 10 14
Clinical trials

27
No. Article Details
1
Lim JL, Ng EY, Lim SY, Tan AH, Abdul-Aziz Z, Ibrahim KA, Gopalai AA, Tay YW, Vijayanathan Y, Toh TS, Lim SK, Bee
PC, Puvanarajah SD, Viswanathan S, Looi I, Lim TT, Eow GB, Cheah WK, Tan EK & Ahmad-Annuar A. 2021.
Association study of MCCC1/LAMP3 and DGKQ variants with Parkinson's disease in patients of Malay ancestry.
Neurological Sciences. 42, 4203–4207. doi: 10.1007/s10072-021-05056-x.
2 Shu CC, Lim JW, Nor Ismaliza MI, Irene L & Cheah WK. 2021. SLC17A3 rs9379800 and Ischemic Stroke
Susceptibility at the Northern Region of Malaysia. Journal of Stroke & Cerebrovascular Diseases. 2021 Aug
10;105908. doi: https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.105908
3
K.W.Chua, S. Muthuvadivelu, R.A. Rani, S.C. Ong , N. Hussin & W. K. Cheah. 2021. Evaluation of the tolerability
and effectiveness of Tenecteplase in patients with ST-Segment-Elevation Myocardial Infarction in a Secondary
Hospital in Malaysia: A Retrospective Case Series. Current Therapeutic Research, Clinical and Experimental. 2021
Aug 21;95:100641. doi: 10.1016/j.curtheres.2021.100641
4
Chin M.L., Chan C.W.S. , Chong H.E. & Cheah W.K. 2021. Association of anemia with rehabilitation outcomes for
subacute geriatric rehabilitation patients in a secondary hospital in Malaysia. Aging Pathobiology and
Therapeutics 2021; 3(4). doi: 10.21203/rs.3.rs-384546/v1.
CRCHospitalTaiping

28
RESEARCH SCOPE
FUNDAMENTALS ON TYPE I AND II ERRORS
TYPE I ERROR TYPE II ERROR
Occurs when the effect of an intervention is deemed
significant when in fact there is no real difference or
effect due to the intervention
Occurs when the effect of an intervention is deemed
insignificant when in fact the intervention is effective
Caused by uncontrolled confounding influences,
and random variation
In statistical terms, this occurs when the null hypothesis is
incorrectly accepted and this causes a false-negative result
Probability of occurrence can be pre-defined and is
denoted as α or the significance level.
Conventional arbitrary value of P<0.05 is commonly used
Occurs when sample sizes are too small,
the true difference or effect is small and variability is large
If the null hypothesis is rejected, there should be a 5% chance
of a type I error.
As sample size of a study increases, the P-value will decrease
The probability of a type II error occurring can be calculated
or pre-defined and is denoted as β

29
RESEARCH SCOPE
1.1 – Login & Edit Details
(Basic Information, User Information, Institution Information)
& Set New Password
1. Go to the URL: https://nmrr.gov.my
2. Click Login and insert email & password
3. Click user profile located at top right of the landing page
4. Insert basic user information, institution information and upload necessary documents.
Save the information by clicking the save button in every section provided.
NATIONAL MEDICAL RESEARCH
REGISTRY (NMRR V2.0)
(INVESTIGATOR GUIDELINES)
CONTENT
1.1 - Login & Edit Details
1.2 - New Research Submission
1.3 - Edit Pending Submission/
Incomplete Submission/
Revision Required
23
24
30
► Cont’d

30
RESEARCH SCOPE
5. Insert current and new password to change the password (The password must contain one upper case and
one number).
Click the save button to confirm the new password.
1. Click on “create new submission” on the left side.
2. Insert information on the “New Submission Registration”. Basic information required are as follows:
 Submission type
 Research title
 Public title
 Research title abbreviation
 Protocol ID
 Research Scope
1.1 – Login & Edit Details (Cont’d)
► Cont’d
1.2 – New Research Submission

31
RESEARCH SCOPE
3. Once basic information is inserted, select one “Research Type”. it can be either:
⸎ Interventional
⸎ Observational
⸎ Qualitative Research
⸎ Mixed Method Research
⸎ Proof of Concept/
Theoretical Research
⸎ Applied Research
⸎ Registry/Biobanking/Clinical Database
⸎ Clinical Audit/Quality Assurance/
Quality Control
⸎ Systematic Review/Scoping Review/
Rapid Review/Meta-Analysis/ Metasynthesis
⸎ Special Write Up
4. Once Research Type is selected, click “Create New Submission”.
5. The General Information page will appear with a list of sections to be completed by the user.
Status of submission will appear as “Pending Submission” at the top part of the page.
To continue the submission, click on the edit button.
► Cont’d
1.2 – New Research Submission (Cont’d)

32
RESEARCH SCOPE
6. User is required to fill up all the necessary information required for the submission. Compulsory information is
being tagged with an asterisk *. Click on the section heading list on the right side of the pages to access
each section for the submission.
7. In each section, the user will need to fill up information according to each subsection available
(Note: Different “Research Type” would have different subsections to be filled) in the “Study Information”
section. Once information is inserted, click the save button located at the end of each subsection.
8. Each successful updates will have a notification at the bottom of each subsection.
► Cont’d

33
RESEARCH SCOPE
9. If there any information missing, user will have a command ask for the required information on every attempt
to save the subsection, for example,
10. When all subsection required has been filled up, user is required to refresh the pages. So that the icon
of the section listing will appear. Failure of the icon to appear indicates that there is some
information missing or unable to be saved.
11.In the “Purpose of Submission” section, to select the purpose of submission required for the submission.
Click the “save” button to capture the intended purposes. Purposes can be either:
 Registration
 Scientific Review &
Ethical Approval Submission
 Grant (MRG) Submission
 Publication & Presentation
Approval Submission
 Notification of Research
to Other Authority
► Cont’d

34
RESEARCH SCOPE
12. Once the subsection of Purpose of Submission
is saved, section required to upload documents
will be opened (depending on the purpose
selected); for example, if “Scientific Review
& Ethical Approval Submission” and “Grant
(MRG) Submission” has been selected & saved,
both submissions purpose section will appear in
the section list on the top right of the page.
► Cont’d
13. User will be able to upload necessary documents required for the submission by dragging the document
into the box or selecting the required file. Insert the version and version date of the documents (required by
the system).
14. Once the document has been uploaded, click save at the bottom of each subsection to finalise the document.

35
RESEARCH SCOPE
15. Once all required documents have been uploaded and input has been added, click at the end of the
section list “Confirmation of Submission”. User is required to tick the acknowledgement of confirmation and
then click the “submit” button to send the submission.
16.Once submission is successful, user will be brought to “My Submission” page and Status of the submission
will be shown as “Processing Submission by NMRR Secretariat”.
► Cont’d

36
RESEARCH SCOPE
A) For Pending Submission
1. Click My Submission at the left side of the
page.
► Cont’d
1.3 – Edit Pending Submissi on/I ncomplete Submissi on/ Revisi on Required
2. List of all the submission will be displayed. To edit a “Pending Submission” status, click on the edit (pencil
icon) under the action column of the particular submission or Research ID. User can delete the unwanted
submission by clicking on the delete (bin icon) – this will only be applicable for study with a “Pending
Submission” status.
3. Users will be brought to the “General
Information” pages. If there are no additional
changes on the General Information section, us-
ers can continue to edit the rest of the information
and upload the necessary documents following
the Main section list at the top right side of the
page.

37
RESEARCH SCOPE
A) For Pending Submission (cont’d)
4. User is required to tick the acknowledgement of confirmation at the “Confirmation of Submission” section
and then click the “submit” button to send the submission.
► Cont’d
B) For Incomplete Submission/ Revision Required
1. Click My Submission at the left side of the page.
2. List of all the submissions will be displayed. Submissions requiring revision by any secretariat will have the
status either as “incomplete submission / revision required” or “revision required” displayed on the status
column.

38
RESEARCH SCOPE
B) For Incomplete Submission/ Revision Required (Cont’d)
3. Firstly, click on the “Comment & Review” part (chat icon) to see all the query/ comments made by the
secretariat or reviewers.
► Cont’d
4. List of comments made by the secretariat or
reviewer will be displayed in the listing. It is
advisable for users to update the response in
after all the revision has been made in the data
submission & the document has been uploaded
(user can come back to the “Comment &
Review” later after the revision is made).
5. Click on the edit (pencil icon) under the action column of the particular submission or Research ID to edit
the data submission and to upload the revised document.

39
RESEARCH SCOPE
► Cont’d
7. User is advised to do the revision in reference to
the “Comment & Review”. Once user has edited
all the necessary revisions and uploaded all
revised documents (please make sure all the
updated information and documents is saved),
user is required to go back at the “Comment &
Review” page to insert the responses comment.
6. Users will be brought to the “General
Information” pages. If there are no additional
changes on the General Information section,
users can continue to edit the rest of the infor-
mation and upload the necessary documents
following the main section listing at the top right
side of the page. If revision involves the general
information, click update at the bottom of the
pages before proceeding to the rest of the
section (the same steps as per new submission.)

40
RESEARCH SCOPE
8. This should be followed by acknowledgement of confirmation. At this stage, please make sure that all
comments/queries in the “Comment & Review” has been answered first before clicking the “Submit” button.
Once this is done, user is unable to make any more changes to the information , document uploaded in the
data submission and the responses in the “Comment & Review”.

41
2021- IT’S A WRAP!
SUMMARY OF KEY EVENTS CONDUCTED BY
CRC HOSPITAL RAJA PERMAISURI BAINUN, IPOH

42
2021- IT’S A WRAP!
SUMMARY OF KEY EVENTS CONDUCTED BY
CRC HOSPITAL SERI MANJUNG
16 March 2021
Proposal Writing
Workshop
05-06 April 2021
27 April 2021
09 November 2021
Perak Research
Conference 2021
National Medical Research
Register (NMRR) Workshop
Introduction to
Clinical Research

43
2022 – LOOKING AHEAD!
CRC HOSPITAL RAJA PERMAISURI BAINUN IPOH
UPCOMING
EVENTS
JAN
DEC
NOV
OCT
SEP
AUG
JUN
MAY
JUN
APR

44
CRC HOSPITAL SERI MANJUNG
FEB
21
JUN
10
MAY
23-25
APR
25
MAR
07
MAR
28-30
JUL
18-19
AUG
15
Proposal Writing Workshop
Basic Statistics Workshop
Scientific Writing Workshop
Good Clinical Practice Workshop
Introduction to Clinical Research Workshop
NMRR Registration Workshop
Nursing Research Workshop
Pubmed Search Workshop
UPCOMING
EVENTS

45
CRC HOSPITALTAIPING
EVENTS
20th Jan
CRC - CME 1/2022
NMRR V2 Training
for Trainers
21st Apr
CRC - CME 2/2022
2nd Mac
Introduction to ISR
15th – 17th Mar
Proposal Writing
Workshop
15th - 16th Feb
Introduction to Clinical
Research (ICR) 1/2022
24th Feb
Pubmed
Workshop
25th Aug
Excel Analysis
Mini Roadshow to
PKD Hulu Perak
17th Nov
CRC - CME 6/2022
13th Oct
Endnote Application
18th - 19th Oct
Basic SPSS Workshop
15th Sep
CRC - CME 5/2022
20th - 21st Sep
Data Entry Workshop
17th - 18th May
NMRR Registration
Workshop
19th May
CRC - CME 3/2022
24th - 25th May
GCP Workshop
Mini Roadshow to
PKD LMS
12th - 13th Jul
Introduction to Clinical
Research (ICR) 2/2022
21st Jul
CRC - CME 4/2022
16th Jun
Google Form
Workshop
Intermediate SPSS
Workshop
Taiping Research Day
2022
JAN FEB
AUG SEP OCT NOV
MAY JUL
JUN
APR
MAR

CRC Hospital Raja Permaisuri Bainun
Level 4, Ambulatory Care Centre (ACC),
Hospital Raja Permaisuri Bainun,
Jalan Raja Ashman Shah,
30450 Ipoh, Perak Darul Ridzuan.
T: 05-208 5146
E: crcperak30990@gmail.com
Hospital Seri Manjung
32040 Seri Manjung,
Perak Darul Ridzuan.
T: 05-6896639 / 6882245
F: 05-6884013 / 6882245
1st Floor, CME Building,
Hospital Taiping, Jalan Stesen,
34000 Taiping,
Perak Darul Ridzuan.
T: 05-8204029
F: 05-8074517 / 05-8065187
CRC Hospital Raja Permaisuri Bainun
List of available staff
Dr. Philip Rajan a/l Devesahayam (HOD)
Dr. Sharon Linus Lojikip
Dr. Lim Xin Jie
Dr. Leong E Li
Dr. Billy Song Li Herng
Dr. Nur Sabrina Abdul Rahim
Dr. Muhammad Nuh Idy Razlan
Dr. Pandora Chow Lai Yeng
Dr. Devin Kumar Asoka Kumar
Chew Chii Chii
Chang Chee Tao
Premaa A/P Supramaniam
Lina Hashim
Hasni Adha Ibrahim
Personal MySTEP
Noorsyamimi Binti Mhd Akhir
Aisyah Ahmad Shadzili
Chin Ei Wei
Norhazlina Binti Ramlee
Gregory Domnic
Thian Zu Juin
Suniljeet Singh A/L Sukhdev Singh
Suria Junus
Choong Jing Wei
CRM
Ooi Siew Har
Revathe A/P Rajendran
Swarnaletchumi A/P Kanapathy
Nur Amirah Ramli
Ruth Merry A/P Paranjothi Yanok
Wan Ainor Syahdah Wan Hassan
Noorharjiana Surianti Mohd Saad
Dr Cheah Wee Kooi (HOD)
Dr Narwani Hussin
Dr Rosilawati Abdul Rani
Chan Wai Seong Christopher
Chua Kin Wei
Prema Muninathan
Sreevali Muthuvadivelu
CRM
Venoo Kuppusamy
Nur Fatin Raihanah
Siti Zubaidah Aripin
Siti Suraya Rozaidi
Dr. Nga Shih Hang (HOD)
Dr. Chang Meng Lee (Deputy)
Dr. Ting Siew Ying (MO)
Chiew Shoen Chuen (Pharmacist)
Norsarlizna Mat Sari
(Administrative Manager)
CRM
Azirah Osman
Lailye Zuraida Abu Bakar
© 2022 Clinical Research Centre Hospital Raja Permaisuri Bainun. All Rights Reserved.
CLINICAL RESEARCH CENTRE PERAK NETWORK
Research that matters to patients

4th Issue of CRC Perak Network Bulletin (2021)

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