Browse publications by year: 2016

Fulltext Noise monitoring case study: liquefied petroleum gas terminal

Deros, B.M., Daruis, D.D.I., Rozia, H.M.N.

Malaysian Journal of Public Health Medicine, 2016;16(10):0-0.
MyJurnal

The main objective of the study is to determine the noise level emitted by the machinery and equipment used at a Liquefied Petroleum Gas in Melaka, Malaysia. The study also aims to determine the exposure level of noise to the employees. The machinery and equipment noise level was measured using a calibrated sound level meter. Noise level of each source was measured by pointing the sound level meter microphone at normal working distance to the source. Personal noise exposure was conducted at the shoulder of the personnel and as close as possible to the personnel’s ear. From a total of 154 noise sources points identified at three work areas surveyed, 122 points were above Action Level of 85 dBA of which 57 points had exceeded the Permissible Exposure Limit of 90 dBA. For the personal exposure monitoring, ten out of fourteen had exceeded the Action Level of 85 dBA for those working for 8 hours and 82 dBA for those working for twelve hours and one of them had exceeded the Permissible Exposure Limit of 87 dBA for those working for twelve hours. The monitored personnel have exceeded the Maximum Level and the Peak Level limit of 115 dBA and 140 dB respectively. From the study, it is concluded that further noise monitoring is needed especially when there are changes to the work process and equipment used. Also the requirement to notify the selected workers on the personal noise exposure result, actions to reduce noise level at the workplace through engineering control methods and administrative controls.
Fulltext Sitting anthropometrics groupings of school children from grades 1 to 5

Hanani Yuhaniz, Asnawi Seraila, Suhaimi Muhammed, Abdul Hamid Saleh

Malaysian Journal of Public Health Medicine, 2016;16(10):0-0.
MyJurnal

This study on anthropometrics of Primary School children from grade 1 to 5 in Peninsular Malaysia involves 2310 students aged seven to eleven years old. The objectives were to analyze the differentiation of anthropometrics between children of grades 1 to 5 and grouping them to suitable levels in which they are appropriate to propose chair dimensions. A multi-stage sampling method was used, and rural and urban areas were also included in providing anthropometric database that represents the whole Peninsular Malaysia population. There were six dimensions measured in this study, which are sitting shoulder, sitting subscapular height, sitting elbow height, hip width, buttock-popliteal length and popliteal height. All the measurements were chosen to represent dimensions needed to construct ergonomic school chair. From the results, ANOVA showed p-values of

MeSH terms: Analysis of Variance; Buttocks; Child; Elbow; Humans; Malaysia; Nerve Tissue Proteins; Schools; Shoulder; Students; RNA-Binding Proteins
Fulltext Steady state visual evoked potential based BCI as control method for exoskeleton: a review

Norhafizan Ahmad, Raja Ariffin Raja Ghazilla, Muhammad Zikril Hakim Md Azizi

Malaysian Journal of Public Health Medicine, 2016;16(10):0-0.
MyJurnal

Brain Computer Interfaces (BCI) provide a vast possibility in enabling the brain to communicate directly with the computer, hence providing an alternative in controlling the machines without much effort. In fields of rehabilitations robotics, the applications of an exoskeletons in assisting a spinal cord injured (SCI) patients were growing. Steady state visually evoked potentials (SSVEP) based BCIs that utilizes the human visual reactions to the constant flickered stimulus quickly showed its potentials among the BCIs used in rehabilitations devices because of its advantages such as a higher immunity to noises and artefacts and also its robustness compared to other BCIs. Rehabilitation exoskeletons demands an approach that are more user friendly and the aspects of control scheme and mechanical parts that are more focused on assisting the patients in rehabilitations and providing a SCI patients an alternatives to explore their surroundings in a more intuitive ways. This paper highlights the current development trends in SSVEP based BCIs for rehabilitation exoskeletons and proposed the potential research scopes in the future that can improve the effectiveness, and its potential applications in rehabilitations.

MeSH terms: Biological Phenomena; Brain; Computers; Evoked Potentials, Visual; Humans; Noise; Robotics; Spinal Cord; Artifacts; Brain-Computer Interfaces
Prevalence of falls among community-dwelling elderly and its associated factors: A cross-sectional study in Perak, Malaysia

Yeong UY, Tan SY, Yap JF, Choo WY

Malays Fam Physician, 2016;11(1):7-14.
PMID: 28461842 MyJurnal

INTRODUCTION: Fall is a major cause of injuries and can increase the risk of early mortality among elderly. The objective of this study was to determine the prevalence of falls among community-dwelling elderly in rural Malaysia and its associated factors.
METHODS: Data were obtained from a cross-sectional survey in five randomly selected districts in the state of Perak, Malaysia. A total of 250 households were randomly selected. A total of 811 individuals aged 60 years or more were recruited and interviewed using a structured questionnaire. Information about socio-demographic, history of falls in the past 1 year, medical history, drug history and physical activity level were enquired.
RESULTS: The prevalence of falls in the past 1 year among community-dwelling elderly was reported to be 4.07%. Indigenous elderly (Adjusted odd ratio, AOR = 6.06, 95% CI = 1.10-33.55, p = 0.039) and living alone (AOR = 2.60, 95% CI = 1.04-6.50, p = 0.042) were shown to be factors associated with falls. Physical activity level, number of co-morbidities and number of medications used were not associated with falls.
CONCLUSION: Elderly of indigenous ethnicity and living alone are the main factors associated with falls in this population. Indigenous people may be at higher risk, which warrant further investigation with a larger sample to improve the precision of estimates.
Fulltext Fever and rash in an 11-month-old girl

Jamani NA, Puteri Shanaz JK

Malays Fam Physician, 2016;11(1):15-17.
PMID: 28461843
MeSH terms: Exanthema Subitum*; Female; Humans; Infant; Malaysia
Fulltext Multiple concurrent primary extramammary Paget's disease

Leelavathi M, Norazirah MN, Nur Amirah AP

Malays Fam Physician, 2016;11(1):18-21.
PMID: 28461844

Extramammary Paget's disease (EMPD) is a rare malignant disorder of the skin, which was described in as early as the nineteenth century. EMPD usually occurs as a single lesion in the apocrine sweat gland-bearing skin with abundant hair follicles. Here, we present an elderly man who suffered from a non-resolving chronic genital pruritus for 8 months. Initially, he was managed for recurrent fungal infection and eczema. Later, a diagnosis of the rare condition multiple primary EMPD was made based on the histopathology findings and appropriate treatment was given.

MeSH terms: Aged; Eczema; Genitalia; Humans; Male; Mycoses; Paget Disease, Extramammary; Pruritus; Skin; Sweat Glands; Hair Follicle; Rare Diseases
Fulltext Pneumoperitoneum or Chilaiditi's sign

Teoh SW, Mimi O, Poonggothai SP, Liew SM, Kumar G

Malays Fam Physician, 2016;11(1):22-24.
PMID: 28461845

Chilaiditi's sign describes the incidental radiographic finding of the bowel positioned between the right diaphragm and the liver. This is often misdiagnosed as pneumoperitoneum or free air under the diaphragm, which may lead to unnecessary investigations or surgical procedures. Here, we report two incidental chest radiograph findings of air under the diaphragm in patients who were being screened for pulmonary tuberculosis. This case series highlights the importance of awareness of the diagnosis of Chilaiditi's sign to avoid unnecessary hospital referrals.

MeSH terms: Abdomen; Diaphragm; Humans; Injections, Intraperitoneal; Intestines; Liver; Pneumoperitoneum; Referral and Consultation; Tuberculosis, Pulmonary
Fulltext Isolated unilateral sixth cranial nerve palsy: A rare presentation of dengue fever

Mazliha M, Boo YL, Chin PW

Malays Fam Physician, 2016;11(1):25-26.
PMID: 28461846 MyJurnal

Dengue fever is a common mosquito-borne viral infection endemic in tropical and subtropical countries. Neurological manifestations in dengue infection are relatively uncommon, and include encephalitis, encephalopathy, neuromuscular disorders and neuro-ocular disorders. Cranial mononeuropathy is a rare manifestation of dengue infection. A 40-year-old man was diagnosed with isolated, unilateral sixth cranial nerve palsy complicating dengue infection. The patient was managed accordingly, and full ocular recovery was observed. This was the first reported case of isolated sixth cranial nerve palsy associated with dengue fever in Malaysia. It is important for clinicians to consider dengue as a differential diagnosis in patients presenting with fever and sixth cranial nerve palsy.

MeSH terms: Adult; Dengue; Diagnosis, Differential; Encephalitis; Eye; Humans; Malaysia; Male; Culicidae; Mononeuropathies; Abducens Nerve Diseases
Fulltext Immune reconstitution inflammatory syndrome in a HIV-infected patient with disseminated tuberculosis

Koh KC, Pak JW

Malays Fam Physician, 2016;11(1):27-30.
PMID: 28461847 MyJurnal

Immune reconstitution inflammatory syndrome (IRIS) is the paradoxical worsening of pre-existing infectious processes after commencement of anti-retroviral therapy (ART) in HIV-infected patients. Its manifestations are dependent on the underlying opportunistic infections. We report a case of an HIV-infected patient with disseminated tuberculosis, who responded to anti-tuberculosis therapy but suffered from paradoxical worsening after commencement of ART.

MeSH terms: Antitubercular Agents; Humans; Opportunistic Infections; Tuberculosis, Miliary; HIV Infections; Immune Reconstitution Inflammatory Syndrome
Fulltext An elderly with a 'bony' smile

Mohamad I, Nadarajah S

Malays Fam Physician, 2016;11(1):31-32.
PMID: 28461848
Fulltext A teenager with mucoid discharge from the neck

Mohamad I

Malays Fam Physician, 2016;11(1):33-34.
PMID: 28461849
Fulltext Implementing standard setting into the Conjoint MAFP/FRACGP Part 1 examination - Process and issues

Chan SC, Mohd Amin S, Lee TW

Malays Fam Physician, 2016;11(2-3):2-8.
PMID: 28461851

BACKGROUND: The College of General Practitioners of Malaysia and the Royal Australian College of General Practitioners held the first Conjoint Member of the College of General Practitioners (MCGP)/Fellow of Royal Australian College of General Practitioners (FRACGP) examination in 1982, later renamed the Conjoint MAFP/FRACGP examinations. The examination assesses competency for safe independent general practice and as family medicine specialists in Malaysia. Therefore, a defensible standard set pass mark is imperative to separate the competent from the incompetent.

OBJECTIVE: This paper discusses the process and issues encountered in implementing standard setting to the Conjoint Part 1 examination.

DISCUSSION: Critical to success in standard setting were judges' understanding of the process of the modified Angoff method, defining the borderline candidate's characteristics and the composition of judges. These were overcome by repeated hands-on training, provision of detailed guidelines and careful selection of judges. In December 2013, 16 judges successfully standard set the Part 1 Conjoint examinations, with high inter-rater reliability: Cronbach's alpha coefficient 0.926 (Applied Knowledge Test), 0.921 (Key Feature Problems).

MeSH terms: Australia; Family Practice; Fellowships and Scholarships; Malaysia; Physical Examination; Physicians, Family; Specialization; Reproducibility of Results; General Practitioners; General Practice
Fulltext Management of neonatal jaundice in primary care

Wan A, Mat Daud S, Teh SH, Choo YM, Kutty FM

Malays Fam Physician, 2016;11(2-3):16-19.
PMID: 28461853

The Clinical Practice Guidelines on Management of Neonatal Jaundice 2003 was updated by a multidisciplinary development group and approved by the Ministry of Health Malaysia in 2014. A systematic review of 13 clinical questions was conducted using evidence retrieved mainly from Medline and Cochrane databases. Critical appraisal was done using the Critical Appraisal Skills Programme checklist. Recommendations were formulated based on the accepted 103 evidences and tailored to local setting as stated below. Neonatal jaundice (NNJ) is a common condition seen in primary care. Multiple risk factors contribute to severe NNJ, which if untreated can lead to adverse neurological outcomes. Visual assessment, transcutaneous bilirubinometer (TcB) and total serum bilirubin (TSB) are the methods used for the detection of NNJ. Phototherapy remains the mainstay of the treatment. Babies with severe NNJ should be followed-up to detect and manage sequelae. Strategies to prevent severe NNJ include health education, identification of risk factors, proper assessment and early referral.

MeSH terms: Bilirubin; Health Education; Humans; Infant, Newborn; Jaundice, Neonatal; Malaysia; Phototherapy; Primary Health Care; Referral and Consultation; Risk Factors; MEDLINE; Checklist
Fulltext Congenital cholesteatoma: Different clinical presentation in two cases

Abdul Jalil S, Md Daud MK

Malays Fam Physician, 2016;11(2-3):30-32.
PMID: 28461856

INTRODUCTION: Congenital cholesteatoma (CC) of the middle ear is a rare entity that may be undiagnosed for years. The lesion can grow undetected until it produces symptoms such as reduced hearing or otalgia.

METHOD: Case report.

RESULTS: We report two cases of young ladies with CC who presented with different otological symptoms. The first case complained of recurrent unilateral ear pain while the second case presented with unilateral reduced hearing. Examination of both cases revealed a whitish mass seen behind an intact tympanic membrane. Both cases underwent surgery and histopathological examinations; findings were consistent with cholesteatoma.

CONCLUSION: There are varieties of clinical presentations of CC and the diagnosis is based on clinical findings.

MeSH terms: Cholesteatoma; Ear, Middle; Earache; Tympanic Membrane; Hearing Loss
Fulltext Leech in the Nose - an unusual cause of epistaxis

Zainuddin N, Nair P, Razali F

Malays Fam Physician, 2016;11(2-3):33-34.
PMID: 28461857

Leech is an uncommon nasal foreign body, which can cause epistaxis. It is an aquatic segmental worm living in fresh water most commonly in tropical areas. Once it is attached in the nose, it will secrete an anticoagulant enzyme named hirudin, and that will result in continuous bleeding more than from a normal wound even after it is removed. We present a case of a live leech in the nose that caused unilateral epistaxis in a patient with a recent history of jungle trekking.

MeSH terms: Animals; Anticoagulants; Epistaxis; Foreign Bodies; Fresh Water; Hirudins; Humans; Leeches; Nose
Fulltext Head and neck tuberculosis: The great mimic

Mohamad I, Nik Hassan N, Nik Othman NA

Malays Fam Physician, 2016;11(2-3):38.
PMID: 28461859
Fulltext Rash in a foreign worker

Nurjahan MI, Tevaraj P

Malays Fam Physician, 2016;11(2-3):39-41.
PMID: 28461860

Hookworm-related cutaneous larva migrans (HrCLM) is a zoonosis which is endemic in many sub-tropic and tropical countries including Malaysia. We report a case of a 40-year old plantation worker who presented with a pruritic rash on his abdomen. It is important for clinicians to diagnose and treat HrCLM promptly as this condition results in considerable morbidity when treatment is delayed.

MeSH terms: Adult; Larva Migrans*; Malaysia; Male
Fulltext Knowledge, attitude, and practice of parents regarding antibiotic usage in treating children's upper respiratory tract infection at primary health clinic in Kuala Lumpur, Malaysia: Pilot Study

Koh CT, Ghazi HF, Ahmad MI, Abdul Samad N, Lai KEY, Ismail NF, et al.

Health Serv Res Manag Epidemiol, 2016 May 5;3:2333392816643720.
PMID: 28462275 DOI: 10.1177/2333392816643720

OBJECTIVES: To assess the knowledge, attitude, and practice of parents regarding antibiotic usage for treating upper respiratory tract infection (URTI) among children.
METHODS: A cross-sectional study was conducted among 320 randomly selected parents attending a primary health clinic using self-administered questionnaires.
RESULTS: About two-thirds (69.1%) of the parents had poor knowledge level. Only 25.2% and 21.6% of the parents could correctly identify amoxicillin and penicillin as the treatment of children's URTI. However, about two-thirds (67.5%) of the parents were aware of the antibiotic resistance caused by overuse of antibiotics. A significant association was noted between the father's and mother's educational level and family income with the knowledge level. Only mother's educational level depicted a significant association with the attitude.
CONCLUSION: The knowledge of parents regarding antibiotic usage for URTI was poor. More numbers of health promotions and educational campaigns are required to help parents understand about antibiotic usage.
Study site: Primary care clinic, Bandar Tasik Selatan, Kuala Lumpur, Malaysia

MeSH terms: Ambulatory Care Facilities; Anti-Bacterial Agents*; Child; Cross-Sectional Studies; Humans; Health Knowledge, Attitudes, Practice; Malaysia; Parents; Respiratory Tract Infections*
Fulltext Suitability of driving simulators as a tool to study driving fatigue due to vibration and environment: a review

Faizul Rizal Ismail, Mohd Zaki Nuawi, Schramm, Dieter, Nor Kamaliana Khamis

Malaysian Journal of Public Health Medicine, 2016;16(10):0-0.
MyJurnal

Fatigue due to driving is an important aspect in maintaining drivers’ performance and safety. There are many studies linking fatigue to reduction in performance and increase in accident risk. There are also some signs linking road and vehicle vibrations to fatigue, but this not been thoroughly investigated. Experiments have been made to detect and quantify levels of driving fatigue in human, usually involving driving over long distance of highway or normal roads. However, these methods are quite time consuming, high cost, hard to control and also potentially high risk. With the development of better display, computing power and motion technologies, driving simulators are becoming more and more realistic each year. With this insight, it is proposed that these driving simulators can be used as a tool to study human fatigue, where they can counter the above shortcomings significantly. This paper will review different methods conducted in past published works to investigate the viability and validity of using driving simulators as a tool for studying vibration matters and its effects on human fatigue. In this paper, there were twenty past studies have been reviewed in term of its simulator design and its study design. The selection is based on these keywords; simulator, fatigue, vibration, human and driver and all papers were filtered from 1990s to current year.
Fulltext Tibialis anterior muscle contraction on driver’s knee angle posture less than 101º for foot pressing and releasing an automotive pedal

Yusoff, A.R., Deros, B.M., Daruis, D.D.I., Joseph, H.L.

Malaysian Journal of Public Health Medicine, 2016;16(10):0-0.
MyJurnal

Proper driving requires a proper posture to bring comfort to drivers. A problem that commonly exists in driving is incorrect driving posture which can cause discomfort to the driver, especially when interacting with automotive pedals. Research on contraction of tibialis anterior (TA) muscle on driver's posture based on the knee angle less than 101º in a position of pressing and releasing a pedal was conducted to investigate and overcome this problem. This is a field experiment study and surface electromyography (sEMG) is used in collecting data on the TA muscle. The procedure of collecting data on the TA muscle before and after experiments follows the Surface ElectroMyoGraphy for the Non-Invasive Assessment of Muscles (SENIAM) recommendations. The result of the experiment shows that there is a strong negative relationship between driver's postures in nature based on the angle of the knee with TA muscle contractions, where the Pearson correlation coefficient (r) is - .993. While the temporal analysis measurements based on Maximum Voluntary Isometric Contraction (MVIC) 60% in a position of releasing a pedal exceeding rms μV 39.38, are 39.71 and 40.25 respectively. On the other hand, MVIC 2% rms μV values: 1.19 and 1.2 are obtained in the position of pressing the pedal. The knee angle with TA muscle contractions is significant [F (1, 10) = 660, p

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