Introduction: To determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) nasal carriage and detection of S. aureus leukotoxins among medical students of Universiti Teknologi MARA. Methods: Both sides of the anterior nares of 136 volunteers, comprising 68 preclinical and 68 clinical medical students, were swabbed and immediately cultured onto mannitol salt agar for growth of S. aureus. Standard microbiological techniques were conducted to identify and confirm the S. aureus colonies and susceptibility test against oxacillin were conducted by using Kirby-Bauer method to determine their resistance to methicillin. Polymerase chain reaction was performed for detection of leukotoxins, i.e., Panton-Valentine Leukocidin (PVL) and -haemolysin genes. Results: Nineteen students (14%) consisting of 10 preclinical (14.7%) and 9 clinical (13.2%) were nasal carriers of S. aureus. However, none of the S. aureus isolates were MRSA. No PVL gene was detected but eight of them were positive for -haemolysin gene. Conclusion: There were no MRSA nasal carriers among the medical students, but a low prevalence of S. aureus nasal carriers was detected. These carriers do not pose as high risk because none of the strains of S. aureus possess both the -haemolysin toxin and the PVL toxin that are associated with tissue necrosis.
Introduction: Although urinary incontinence is commonly associated with increasing parity, there is however a lack of published data on urinary incontinence among primiparous women. This study aims to determine its prevalence among primiparous women at 6-8 weeks postpartum, its risk factors and effects to their quality of life. Methods: This is a crosssectional study involving primiparous women at 6-8 weeks postpartum. Women in their third trimester were recruited using convenience sampling. Data were obtained using a study proforma, and International Consultation on Incontinence Questionnaire – Short Form (ICIQSF) over a face-to-face interview. The same questionnaire with additional enquiries on delivery was completed over a telephone interview at 6-8 week postpartum. Data were analysed using chi-square and simple logistic regression tests contained in the Statistical Package for Social Science version 20.0. Results: Three hundred and six women participated in this study. The prevalence of urinary incontinence in the third trimester of pregnancy was 34.3% (95%CI: 29.0, 39.7) and dropped to 5.2% (95% CI: 2.7, 7.7) at 6-8 weeks postpartum. Childhood enuresis and postpartum body mass index were the two factors that showed significant association with postpartum urinary incontinence. Urinary incontinence in 95 (31%) women had resolved by 6-8 weeks postpartum, whereas 10 (3.3%) women still had persistent symptom. A small proportion of women (2.0%) developed urinary incontinence in the postpartum period. Majority of women with urinary incontinence did not feel it significantly affected their quality of life. The ICIQ- SF mean score was 6.13 (range 2- 12). Conclusions: Postpartum urinary incontinence is rather uncommon among primiparous women and does not seem to affect their quality of life. Childhood enuresis and postpartum BMI were risk factors associated with postpartum urinary incontinence.
The low back is usually associated with the lumbar spine which supports the entire weight of the upper body and significantly, is vital to the body mobility. Injury to the surrounding soft tissues can cause mild to debilitating symptoms due to muscle strain and ligament sprain. The causes of injury to the lower back are probably due to sudden twisting movement, poor posture position at work and manual handling of heavy objects or with twisting or bending movements while lifting. An Ergonomic Risk Assessment was carried out on a dental laboratory worker who complained of unresolved low back ache after a year on treatment and follow up at the outpatient department of a health clinic. From the various investigative methods used, it was found that the worker in question was placed in a situation that will over time encourage her to develop musculoskeletal disease. Our recommendations for change include immediate awareness and training in ergonomic principles of work and to report all cases so that appropriate action can be taken, reassess the workstation and environment of work, job enrichment, and creating a conducive environment for work. Once the changes have been implemented, a review will be necessary in three months time.
This is a conceptual paper to study the factors that affect the
safety practitioner’s perception towards safety and health risk assessment,
namely HIRARC at oil palm plantation. Retrospective safety and health data
were obtained and analysed. Factors identified were both confusions on
hazard description and interpretation of risk assessment matrix. This paper
will examine those factors and make recommendations for future research in
Malaysia.
In order to have an effective preventive measures to reduce accidents
at the workplace, organisations need to take a robust step to increase safety
participation in Occupational Safety and Health Management System (OSHMS).
Accidents will affect employees' morale for work and employers will bear the
consequence of the direct and indirect recovery cost. Specifically, accidents will
cost big company’s good reputation. This study intends to examine the
relationship of organizational safety factors (management safety commitment,
safety training, extrinsic reward, intrinsic reward, employee involvement, safety
communication and safety advice) towards safety participation in OSHMS using
the resource-based view (RBV) and knowledge-based view (KBV) theories. A
total of 100 responses were analysed from the Malaysian manufacturing firms
with OHSAS 18001 or MS 1722 certifications. Data were analysed using
the Smart Partial Least Square (SmartPLS). It is found that safety training and
employee involvement have direct relationship towards safety participation in
OSHMS. Specifically, the safety advice showed a significant moderating effect on
the relationship between management safety commitment and safety
participation in OSHMS. The findings of this study are useful to both OSH
practitioners and organisation who wish to understand and apply safety capital
towards safety participation in OSHMS with specific reference to the role of
safety advice played by safety professionals.
Recent fire accidents in schools have given rise to the safety
issues. Training on fire safety is very important to help improve the safety aspect
in schools while perceptions of fire safety training among school teachers are
crucial in order to identify methods to prevent accidents from recurring. This
study was conducted in order to analyze the perceptions of school teachers
towards fire safety training in schools. Survey questionnaires were distributed
among 400 school teachers from 111 schools randomly selected from ten District
Education Offices (DEO) in Kelantan. The results were analyzed using
Statistical Package for the Social Sciences (SPSS). They were based on 32% and
68% male and female respondents respectively. Descriptive analysis shows that
most of the school teachers agreed with the need for fire safety training to be
conducted in schools. This study suggests that school teachers require fire safety
training in order for them to help improve fire safety in schools. Thus, teachers
will be able to teach their students on the importance of fire safety, how to
prevent fire and actions to be taken if an emergency happens in schools. It is
hoped that the number of fire accidents in schools can be reduced with the school
communities’ commitment towards safety.
Poor IAQ would lead to the occurrence of Sick Building Syndrome
(SBS) and other symptoms. This study aimed to investigate the IAQ and the symptoms
of SBS among the office workers in the two selected buildings (old and new). A
comparative cross sectional study was conducted among 90 office workers from an
old building (26 years of age) and a new building (5 years of age). The SBS symptoms
were assessed utilising the questionnaires adopted from Industry Code of Practice
(ICOP) 2010 while IAQ parameters were monitored using the Handheld 3016 IAQ
Particle Counter and Multi-Function Ventilation Meter. All the parameters studied
were below the standard limit as set by the Department of Occupational Safety and
Health (DOSH) and the United States of America’s Environmental Protection Agency
(US EPA) except for air velocity in the old building which was lower than the
acceptable standard range. The levels of PM10 and total particulate matter (TPM) in
the old building was significantly higher as compared to the new building (PM10: Z=
-2.495, p = 0.013 and TPM: Z = -2.873, p = 0.014). The SBS prevalence was 51.1%
among respondents at the new building while 64.4% for old building. However, the
difference was not statistically significant (p > 0.05). There was a significant
association of drowsiness among respondents between old and new building (2=
4.050, p = 0.044). Therefore, in order to ensure a good IAQ, regular maintenance of
ventilation and control measures should be conducted.
The purpose of this study is to assess the preferred temperature
(Tpref) of human participants exposed to air-conditioned temperature variations in
climate chamber experiments. Findings were later compared with an earlier Tpref
experiment by de Dear et. al. (1991). Twenty nine healthy college-age participants
underwent thirty minutes of preconditioned session before casting their thermal
preference and thermal sensation votes every 10 minutes for the remaining 150
minutes of the experiment. These affective votes were correlated against average of
ambient air temperature and participant's body temperature taken 30 minutes
before the experiment ends. The mean Tpref was 25.1°C (± 1.2), mean skin
temperature of 33.7°C (± 0.6) and mean body temperature of 36.3°C (±0.3). It can
be concluded that Tpref gathered in the preferred temperature experiment shows
significant difference in participants’ temperature preference which was 0.6 °C
cooler than earlier experiment suggesting change in how indoor ambient
temperature is preferred. In addition, mean skin temperature and gender did not
influence participants’ Tpref.
The global demand for palm oil is growing, thus prompting an
increase in the global production. Such increasing demand for palm oil is due to
palm oil’s relatively cheap price and versatile advantage both in edible and nonedible
applications. Being world second largest producers, Malaysia’s palm oil
industry is growing in complexity and successively to succeed on the global level by
accounts for about 30% of the world production of palm oil in 2015/16. But,
reliability and safety issues are still problematic areas that need to be addressed by
all parties in this industry e.g. millings, refineries and oleochemicals. Although there
are laws and guidelines that provide protection for reliability, safety and health such
as OSHA 1994, OHSAS 18001 and MS 1722, palm oil industry is relatively lacking
behind in process safety as several catastrophic accidents occurred were believed
caused by process safety failures. Therefore, process safety management in palm oil
industry must be enhanced to standard similar to other industries such as chemical
process and oil and gas industries, so that it can prevent major hazard accidents
which can result in fatality, asset damage and environmental impact. This papers
investigates the needs of process safety management in palm oil industry and
proposes a generic process safety management framework which may be useful for
palm oil industry. From the study, it can be concluded that proactive actions are
certainly required to overcome process safety issue in palm oil industry as several
catastrophic accidents occurred were believed caused by process failures.
This study aims to assess the level of Knowledge, Attitude and
Practices (KAP) on Musculoskeletal Disorders (MSDs) from employer perspectives
in Malaysia industries. A developed KAP questionnaires were distributed and
returned by 39 employers. Most employer show good scores to majority of items in
Knowledge and Attitude sections. However, good practices are still lacking as the
scores are quite low for half of the items. Kruskal-Wallis test for independent sample
was used to test the relationship between gender and KAP scores. It was found out
that gender is linked with few items in Knowledge and Attitude section (r < 0.05)
while no indication of relationship with Practice scores. As the number of reported
MSDs cases are increasing in Malaysia, hence understanding of KAP factors are
crucial in order to tackle the problem.
MeSH terms: Attitude; Malaysia; Musculoskeletal Diseases; Surveys and Questionnaires; Knowledge
Stress reduces the performance and productivity of employees.
One of the most important stressors originate from organizational factors,
which are decision latitude, psychological demand, social support and job
insecurity. This creates four kinds of jobs: passive, active, low strain and high
strain. The objective of the study is to determine the association between
organizational factors with occupational stress and cortisol level among
lecturers in University Selangor. This cross-sectional study used a purposive
sampling, which involved 45 lecturers from various faculties. The instrument
used in this study was Job Content Questionnaire (JCQ) which is a
Psychosocial Job Assessment Instrument designed by Karasek et al., (1998).
The questionnaire has been translated to Malay version by Edimansyah et al.,
(2006). 10ml of blood sample was collected from each respondent by certified
phlebotomist. Results from the statistical analysis showed that majority of the
respondents were female (75.6%), aged below forty years old (82.2%), married
(77.8%) and hold a master degree (68.9%). Most of the respondents were
found having low decision latitude 35(77.5%). Majority of the respondents
were also found in passive group 13(28.9%) which were having low
psychological job demand and low decision latitude, while others are in low
strain 11(24.4%), high strain 11(24.4%) and active group 10(22.2%)
respectively. There was a significant association between two organizational
factors with occupational stress level, which are decision latitude and
psychological job demand (p0.05). As a
conclusion, two out of four organizational factors, which are decision latitude
and psychological job demand showed a significant association with
occupational stress levels. Cortisol as one of stress biomarkers may not be
significant due to small sample size.
MeSH terms: Cross-Sectional Studies; Female; Hydrocortisone; Malaysia; Marriage; Occupations; Surveys and Questionnaires; Social Support; Universities; Biomarkers; Sample Size
Safety behaviour is important in preventing industrial accident.
Safety leadership attribute by the supervisors is one of the determinants of safety
behaviour among the employees. This study aimed to determine the influence of
employer’s safety leadership towards worker’s safety behaviour within Small and
Medium Enterprises (SME)-Manufacturing in Negeri Sembilan. Three independent
variables representing safety leadership namely safety motivation, safety concern
and safety policy were selected whilst safety compliance and safety participation
were the dimensions used to measure safety behaviour. Self-administered
questionnaire were distributed and answered by 210 employees of Negeri
Sembilan’s SME-Manufacturing. The results revealed that safety concern and safety
policy had significantly influenced safety compliance. Whilst, safety motivation and
safety concern determined the workers’ safety participation. No significant influence
found by safety motivation towards safety compliance as well as safety policy
towards safety participation. Safety concern was the important component of safety
leadership as it consistently explained the variance in all dimensions of safety
behaviour.
This study aims to determine the awareness level of safety
management and safety behavior among SMEs workers. Safety management as a
subsystem in the overall management of the organization. It is designed to control
hazards that can affect the safety and health of workers. Small and Medium Enterprise
(SMEs) in Malaysia continue to face many challenges both traditionally and new.
80% to 90% of occupational accidents occurred involving worker of SMEs industry.
A self-administered questionnaire was distributed to the involved small medium
industries. Questionnaires form that consist of three sections, namely socio
demographic, safety management and safety behavior. This study was conducted at
selected SMEs located in Klang Valley. 226 workers responded. In order to interpret
the level of awareness among the respondents, a 3-level scale (High: 3.68 – 5.00,
Moderate: 2.34 – 3.67, Low: 1.00 – 2.33) based on the mean score was used suggested
by Ashari & Mahmood. The findings show that the highest level of awareness was
safety behavior while the lowest awareness level was safety promotion policy
respectively. Findings also showed that, there were moderate correlation between
safety management and safety behavior. Understanding the concept of the OSH
management system will help us to understand the application of OSH management
system in Malaysia. OSH Management very important to prevent accident, ill health
& injury at workplace towards development of safety culture.
Pesticides are commonly used for pest control in oil palm
plantations. The knowledge, attitude and practices (KAP) while handling pesticides
may potentially result in adverse health effects among the estate workers. The aim of
this study is to determine the KAP of pesticides used and the capacity of selfreporting
health conditions among workers in palm oil plantations. A crosssectional
study was conducted to investigate the KAP and its self-reporting health
symptoms by using questionnaires and face-to-face interviews to 120 male estate
workers who use pesticides in their daily work routine in the oil palm plantation. At
least 85.8% of respondents had a good knowledge of pesticide used, 46.7% of them
indicated neutral level of attitude on the pesticides’ usage, and 68.3% of them
demonstrated a good practice while handling mixture of pesticides. Overall, there is
a significant association between the practices of pesticide usage with the selfreporting
health symptoms, such as dizziness, excessive vision, cough,
nausea/vomiting, redness of skin, difficulty in breathing, skin rashes, blurred vision,
excessive sweating and hand tremor. More than half of the estate workers indicated
a moderate to good knowledge, attitude and practices level of pesticide handling in
oil palm plantations. This study suggests that the self-reporting symptoms are real
and not over-reporting by workers. The increase in KAP of pesticides usage among
these workers have highlighted the necessity to improve the traditional field training
method of safe handling of pesticide to a sustainable field practical-based learning.
The latter training approach is to engage theory into practice.
Identification of causative organisms of clinically suspected microbial keratitis is very important so that appropriate targeted antimicrobial treatment can be offered to patients. The current routine method of corneal scraping specimens on to multiple agar culture plates for microbiological study is not really providing encouraging result. Our trial of modified technique of using BACTEC broth for three clinically suspected microbial keratitis cases worked 100% to identify the causative organisms in cases of microbial keratitis.
Keywords: culture media, cornea, keratitis
Sleeve gastrectomy has gained popularity over the years and is commonly performed laparoscopically through multiple small incisions. The arrival of single incision laparoscopic surgery has been a game changer, allowing for sleeve gastrectomy to be performed through a cosmetically more appeasing scar with improved patient
satisfaction. In this article, we describe the history, technical challenges, proposed solutions to some of the hurdles faced during single-incision laparoscopic bariatric surgery and highlight our method of performing single incision laparoscopic sleeve gastrectomy purely through a single access device.
Keywords: bariatric, cosmetic, laparoscopy, obesity, sleeve gastrectomy
Ligasi arteri sphenopalatine merupakan satu terapi pembedahan untuk masalah
hidung berdarah. Prosedur ini memerlukan pengetahuan yang luas mengenai
variasi anatomi hidung. Walaubagaimanapun, petanda yang biasanya dipercayai
seperti crista ethmoidalis mungkin tidak dijumpai atau tiada langsung. Variasi
tersebut adalah penting dan boleh menentukan keberkesanan prosedur ini.
Kami memaparkan satu kes variasi foramen dan arteri sphenopalatine yang tiada
crista ethmoidalis. Foramen sphenopalatine dijumpai di bahagian atas meatus
superior melepasi lamella concha superior di bahagian horizontalnya. Hanya satu
cabang arteri yang ditemui keluar daripada foramen sphenopalatine. Foramen
sphenopalatine diukur daripada bahagian depan hidung. Ia berukuran 69 mm dari
“nasal sill” dan 54 mm dari limen nasi.
Leptospirosis is an emerging infectious disease with worldwide distribution. Its symptoms may mimic a number of other infections such as dengue, malaria, hepatitis and typhoid fever, particularly in tropical countries where these diseases are endemic. Similarly, dengue is an important infectious disease that poses as a public health emergency due to its rapid epidemic spread across the world. Here, we report a fatal case of dengue fever in a patient who was also serologically positive for leptospirosis. Co-infection of both dengue and leptospirosis can lead to an illness with overlapping symptoms and therefore present a clinical diagnostic dilemma to the treating physician. Hence, a high index of suspicion among clinicians is required, especially in high endemic areas. The optimal usage of antigen-based rapid diagnostic tests is essential to aid the clinicians to make timely and accurate diagnosis as well as to start appropriate treatment regimes.
Keywords: co-infection, communicable diseases, dengue, leptospirosis
Altered mental status in the setting of polytrauma poses a challenge to the emergency team managing the patient. The tendency to miss positive findings in these circumstances increases several folds due to multiple factors such as depressed mental status/intoxication, presence of distracting injuries and concurrent life-threatening injuries that require more urgent attention. In view of this, NEXUS (National Emergency X-Radiography Utilization Study) criteria of clearing the cervical spine was adopted and used worldwide. Consensus on clearance of the other parts of spine is still lacking. This case reports highlights the findings in a 18-yrs-old male who presented with altered mental status, facial pain and abrasion, following a motor vehicle accident. Facial bone fracture was diagnosed and he was discharged. Three days later, he came with severe epigastric pain. Tenderness on palpation was noted at the spine and Computed Tomography (CT) scan was done. Multiple thoracic vertebra fractures were seen. As a conclusion, thorough primary and secondary survey should be done in patients who have regained full consciousness prior to discharge in order to avoid overlooking other serious injuries.
Keywords: altered, CT scan, fracture, mental status, thoracic vertebra
This report stresses on the occurrence of a rare adverse reaction to clozapine, i.e. allergic cutaneous and visceral angioedema, in a patient with treatment resistant schizophrenia (TRS). We report the case of a schizophrenic patient who was resistant to treatment and developed an allergic reaction involving her skin and gastro-intestinal system upon the commencement of clozapine. She was then treated with a combination pharmacotherapy which left some residual symptoms. The manifestation of allergic reactions to clozapine and its management strategies are discussed in the paper. There is a pressing need to develop a new psychotropic which is on par with clozapine.
Keywords: allergy, angioedema, clozapine, schizophrenia
MeSH terms: Angioedema; Clozapine; Female; Humans; Malaysia; Schizophrenia; Young Adult; Drug-Related Side Effects and Adverse Reactions*