Telecommuting refers to the work option that enables telecommuters to work outside of the office. It
allows telecommuters to have a direct contact with those inside and outside of the organization by
using information and communication technologies. Despite the continuous effort by Malaysia’s
government, the implementation and occurrence of telecommuting practice in Malaysia had not gained
full support from many local companies. Consequently, the Malaysian workforce has suffered from
low-level performance and poor productivity due to the lack of flexibility in task accomplishment.
Therefore, the main objective of this study is to investigate whether the impacts of telecommuting
engagement (i.e. job autonomy, work-family balance, work productivity, and level of occupational
stress) lead to employee’s performance. This research aims to identify the most dominant impact of
telecommuting engagement that leads to the employee performance. The study has adopted a
correlational research and cross-sectional survey research design to explore the relationship between
variables. There were 229 respondents who practice telecommuting work arrangement. They were
chosen from 11 oil and gas companies located in Kuantan, Pahang. The findings of the study had
revealed that all of the telecommuting impacts which consists of the job autonomy, work-family
balance, work productivity and level of occupational stress have a significant relationship with the
employee performance at r = .923, p < 0.05, r = .734, p < 0.05, r = .817, p < 0.05, and r = .408, p < 005
respectively. Job autonomy was found the most dominant impact of telecommuting engagement that
leads to the employee performance with r = .923, p < 0.05. The positive experiences and knowledge
possessed by the telecommuters in the oil and gas industry helped to increase the level of motivation
and maintain the good mental and physical state of employees. The exercise of the proper balance
between the personal and professional life could guarantee the high employees’ performance among
the telecommuters. Hence, it is suggested for the government to promote and develop more appropriate
policies regarding telecommuting practice in Malaysia. The purpose is to enhance the level of
acceptance towards the work arrangement among the local society. Moreover, the active approaches by
the government can stimulate the implementation of telecommuting in this country as people will have
more proper guidelines to assist the work practices. Telecommuting work arrangement helps to achieve
excellent performance in an organization.
MeSH terms: Oil and Gas Industry; Work Performance; Cross-Sectional Studies; Government; Humans; Longitudinal Studies; Malaysia; Motivation; Surveys and Questionnaires; Stress, Psychological; Exercise
Mature cystic teratoma is the commonest ovarian germ cell tumour which accounts for 70% of all benign ovarian neoplasms in the reproductive age groups. Being a pluripotent germ cell tumour, mature cystic teratoma has at least two out of three mature embryonic germ cell components: ectoderm, mesoderm and endoderm. The presence of multiple cystic spaces within the tumour wall, also known as pneumatosis cystoides-like appearance is rarely described but a characteristic feature in cystic teratoma of the ovary. Currently, there is little information concerning the mechanism of its formation. Herein, we described an unusual case of ovarian mature cystic teratoma in a 31-year-old pregnant female with multiple sieve-like areas resembling pneumatosis cystoides of the intestine. Macroscopic and histological examination of the ovary revealed features diagnostic of mature cystic teratoma. Intriguingly, multiple cystic spaces of variable sizes were found within the cyst wall histologically. They were lined partially or completely by foamy histiocytes and foreign body type multinucleated giant cells, exhibiting strong CD68 immunoreactivity. Vascular endothelial markers (CD31 and CD34) and epithelial marker (cytokeratin AE1/AE3) were negative. A diagnosis of mature cystic teratoma with pneumatosis cystoides-like feature was rendered. The patient was discharged well with no signs and symptoms of early labour. The etiopathogenesis of this intriguing histological feature is briefly discussed in this article.
Few cases of chalazia secondary to bortezomib are reported in literature. However, it is not a recognized ocular adverse effect. We hereby report a case of recurrent chalazia secondary to bortezomib. A 40-year-old male with light chain myeloma on ten weeks of chemotherapy with bortezomib was treated for left eye inflamed chalazion with bilateral meibominitis. Severe chalazia persisted despite treatment, which necessitated cessation of chemotherapy. The patient’s condition improved on oral doxycycline and chemotherapy was recommenced but his chalazia recurred, necessitating incision and curretage. His chalazia responded to oral azithromycin without further cessation of chemotherapy. Bortezomib’s association with chalazia has been characterized as a possible adverse drug reaction according to the World Health organization classification, and its recognization as an established adverse reaction to will allow earlier identification and appropriate co-management of the patient.
MeSH terms: Bortezomib; Adult; Doxycycline; Eye; Humans; Iatrogenic Disease; Male; Multiple Myeloma; Neoplasm Recurrence, Local; World Health Organization; Chalazion; Azithromycin; Drug-Related Side Effects and Adverse Reactions
Idiopathic hypereosinophilic syndrome (HES) is an uncommon disorder which usually presents with prolonged and significant primary eosinophilia with end-organ dysfunction. Damaging proteins released by the eosinophilic granules are responsible for the tissues and organ system damage. Here we report two cases of idiopathic HES. Both the patients were young lady presented with high grade fever and concomitant symptoms. Laboratory findings showed leucocytosis with predominant neutrophilia and marked eosinophilia. A diagnosis of idiopathic HES was made after excluding secondary causes of eosinophilia. However, the first patient was complicated with multiple venous thrombosis and intravenous heparin was started which was later changed to subcutaneous low molecular weight heparin (LMWH). The patient developed pleural effusion and consolidation. Intravenous Tazoscin, tablet Prednisolone and tablet Hydroxyurea was started and the patient responded well. Despite treatment, two weeks later, suddenly the patient collapsed and unfortunately succumbed. On the other hand, the second patient was complicated with fever, thrombocytopenia, haemolytic anaemia, acute renal failure and neurological deficit which were part and parcel of thrombotic thrombocytopenic purpura (TTP). Plasma exchange was commenced and patient’s condition had slowly improved. Nevertheless, the hypoxia which she sustained during the multiple episodes of fits had resulted in permanent brain injury and thus requiring a tracheostomy for prolonged ventilatory support. Currently, there is no cure for HES. The main aim of treatment is to minimise the tissue damage caused by the hypereosinophilia. Early diagnosis and intervention are therefore crucial in preventing the spread of the disease and the end-organ damage.
Trauma is thought to complicate 1 in 12 pregnancies. The management of trauma during pregnancy requires special consideration because pregnancy alters maternal physiology and the foetus is a potential collateral victim. The approach of these cases in the setting of the Emergency Department should not only be diagnostic for any foetal injuries but also prognostic for any future undue outcome. Antenatal traumatic brain injury is a rare but real complication of maternal blunt force trauma. Our case involves a 22-year-old primigravida who suffered a motor vehicle accident and on initial assessment revealed normal foetal assessment but subsequently after premature labour revealed a new born with traumatic brain injury. Early ultrasonographic evaluation and observational period with continuous electronic foetal monitoring may improve the detection and emergent treatment in these cases.
Electrocardiographic abnormalities can be associated with acute pancreatitis. However, data regarding the actual causative factor still remains elusive. Many previous cases were reported on non-specific ST and T wave abnormalities concurrent with acute pancreatitis but rarely with an increasing trend of cardiac markers. We describe the case of a 70-year-old female who presented with one such conundrum. Our patient had typical presentation of acute pancreatitis but had dynamic ECG changes with markedly increased cardiac markers. Subsequently after initiation of treatment for acute pancreatitis and observation for the course of several days, the ECG returned to the baseline as pre admission. This substantiates the fact that acute pancreatitis can mimic both biochemical and electrical manifestation of an acute coronary syndrome. Thus, Emergency Physicians should consider acute pancreatitis as a possible diagnosis in patients who present with abnormal electrocardiograms.
Warfarin is an anticoagulant that is commonly used as thrombo-prophylaxis in patients at risk of thrombo-embolic events. However, the use of warfarin is known to cause hemorrhage due to its anticoagulation effect. Although the common sites of hemorrhage are gastrointestinal and genitourinary tract, it can also occur in the least expected location. We report a rare case of spinal cord compression secondary to intraspinal epidural hematoma as a result of overwarfarinization in a patient who had undergone liver transplant. The patient underwent emergency decompression laminectomy of spinal cord and hematoma evacuation after the reversal of overwarfarinization to normal levels.
Case of co-existence of twin pregnancy of complete hydatidiform molar with viable intrauterine pregnancy is extremely rare with low incidence of 1 case for 20,000 – 100,000. It is associated with high risk of spontaneous abortion, preterm delivery, intrauterine death, bleeding, pre-eclampsia, and persistence trophoblastic disease (PTD). It may associate with biochemical derangement that may induce symptomatic manifestation to the mother. There are few cases reported in Asia population with significant clinical dilemma and management to the maternal and foetus. Here, we report a case of a young woman with previous bad obstetric history who presented with antepartum per-vaginal bleeding and was noted to have a twin pregnancy with complete hydatidiform molar and viable foetus. It was complicated with markedly elevated human chorionic gonadotropin (hCG) and hyperthyroidism. Postpartumly, her hCG level was persistently high and her condition progressed into gestational trophoblastic neoplasm.
It is rare for anterior chamber migration of an Ozurdex® implant from vitreous cavity, but it is seen more frequently in aphakic eyes or in pseudophakic cases with zonular dehiscense. We describe a case of a middle-aged gentleman who had persistent diabetic macular oedema not responding to anti-VEGF (vascular endothelium growth factor), who was treated with intravitreal Ozurdex® in his post vitrectomized eye and developed anterior migration of the implant to the anterior chamber. Anterior dislocation of an intravitreal implant of dexamethasone can be managed by repositioning it to the vitreous cavity or removing it through a corneal limbal incision. Ozurdex® is a friable implant, especially after a few weeks of implantation. Therefore, removal of the implant by grasping or aspiration may lead to its fracture or dispersion of the implant material. This is a report of a simple,fast and effective technique to remove a migrated Ozurdex® from the anterior chamber using a modified silicone tip.
Ludwig angina is a fulminant condition that is potentially lethal. If left unrecognized or untreated, this condition carries a mortality rate of up to 50%. We illustrate a case of 43-year-old male who presented with signs and symptoms of Ludwig angina over a period of two days. The patient had history of tooth extraction prior to the onset of symptoms. Despite typical clinical presentation, Ludwig angina was not considered during the first visit to medical. Ludwig angina is a clinical diagnosis that requires high index of suspicion. Delay in the diagnosis increase the risk of airway obstruction due to its rapidly spreading oedema of the upper airway.
Presented herein is a case of one different morphological anomaly of pronator quadratus (PQ) muscle. Here, the shape of PQ was not similar to the normal morphology of the muscle. The PQ muscle appeared to be in distinct triangular-shaped instead of quadrangular-shaped. In addition, this triangular-shaped was found in two sites i.e. proximal and distal. Significantly, the PQ muscle consisted of two fleshy red fibres and white aponeurosis. Proximally placed portion had a wide base and a narrower apex. The larger base was attached to the ulna and formed of fleshy red fibres which converged laterally to be continuous with aponeurosis ending on the radius. In contrast, the distal triangular portion had the fleshy fibres attached to the radius and converged medially to be continuous with aponeurotic portions on the ulna. Each portion were referred as pronator triangularis proximalis and pronator triangularis distalis. These variations might affect atypically in cases of forearm pronation. Information of these variations is important in hand surgeries and provide an additional knowledge on the relationship between morphology of PQ muscle and the limitation or the strength in the action of it.
Ocular tuberculosis is an ocular infection caused by Mycobacterium tuberculosis (TB). About 5-10% of ocular inflammation cases are caused by ocular TB. Spectrum of ocular TB is diverse, affecting any part of the adnexa, different layers and structures of the globe, orbital contents, optic nerve to the orbital apex posteriorly. It can be associated with or without systemic manifestation. Posterior uveitis is the most common presentation of ocular tuberculosis. Subretinal haemorrhage secondary to choroidal neovascularization (CNV) is a rare complication in ocular tuberculosis. We report a rare case of secondary choroidal neovascularization in a 9-year-old boy with bilateral eye choroidal tuberculoma with underlying miliary tuberculosis. He was treated with intravitreal ranibizumab and intravitreal recombinant-tissue plasminogen activator (r-TPA) injection. The CNV resolved, however, vision was poor due to atrophic fovea.
Proximal stability consists of core and hip stability play a significant role in supporting the body weight in stationary and in motion. Thus, proximal stability could contribute to knee osteoarthritis (OA). Therefore, this study was carried out to determine the core stability and hip stability of knee OA patients. A total of thirty-two women aged between 45 to 60 years had volunteered to participate in this study, comprised of 16 knee OA patients and 16 normal. Hip stability was assessed using hip crossover test and core stability was assessed using core muscle endurance, core muscle strength and core muscle flexibility. Data of hip stability, core muscle strength and flexibility were analyzed using chi-square; and core muscle endurance data were analyzed using independent sample t-test. Compared to normal subjects, knee OA patients have poor hip stability [Hip Crossover Test (λ=0.500, p=0.033)] and core stability. Core stability was assessed based on core muscle strength [abdominal muscles (χ=12.157, p
Gait and balance disorder are among the most common causes of falls in elderly and often lead to injury, disability and loss of independence. However, there might be a discrepancy between elderly’s perception of their own walking ability, balance, risk of fall with doctor’s evaluation. The aim of this study was to compare perception of the elderly’s walking ability, balance and risk of fall with clinical assessment. This cross sectional study was done in a Primary Care Clinic which involved elderly > 60 years using systematic random sampling. Participants completed a self-administered questionnaire comprising of sociodemographic data and question assessing their perception of ability of walking, balance and risk of fall. Actual clinical assessment was done using Tinetti Performance Oriented Mobility Assessment. Most of the participants perceived they had good walking (84.4%) and balance ability (77%). A small proportion (11.5%) agreed that they are at risk of fall. There was a good agreement in walking ability (k: 0.702, p:
MeSH terms: Accidental Falls; Aged; Cross-Sectional Studies; Gait; Humans; Primary Health Care; Surveys and Questionnaires; Range of Motion, Articular; Walking; Orientation, Spatial
While socio-demographic, physical and other factors are associated with neck pain, there is scanty literature about how these factors are associated with disability in adults suffering from this condition. We aimed to determine the socio-demographic and physical (strength and range of motions) related factors of disability in adults with non-specific chronic neck pain. A total of 34 adults with neck pain, with mean age 55 (10.80) years from a physiotherapy clinic in a teaching hospital participated in this study. Socio-demographic details such as body mass index (BMI), current employment status, hours of exercise done a week were obtained. Severity of pain was evaluated using the Numerical Rating Scale (NRS). Disability level was assessed using Neck Disability Index. Cervical range of motion was measured using the Cervical Range of Motion device. A hand dynamometer was used to measure the dominant hand grip muscle strength. The data was analyzed using descriptive and stepwise linear regression analysis. More than half the participants were females, above 50 years, in the overweight group (BMI>25 kg/m2), currently unemployed and had severe neck pain (NRS >7). Handgrip strength was the only factor found to be significantly (p
MeSH terms: Adult; Demography; Employment; Female; Hospitals, Teaching; Humans; Middle Aged; Regression Analysis; Body Mass Index; Range of Motion, Articular; Hand Strength; Neck Pain; Physical Therapy Modalities; Overweight; Muscle Strength
Pain is one of commonest presentations at Emergency Department (ED). Previous studies showed inadequate pain control in ED. However, few have addressed specific, practical methods of improving the timeliness and frequency of pain control in emergency setting. This study was a randomized controlled trial in a simulated environment of an actual functioning ED using a timer device to remind care personnel to assess pain and provide analgesia at set intervals versus a “standard therapy” group without visual/audio aids. The mean documentation performance scores between timer and control groups were 94.45% + 5.85 vs 72.22% + 17.57 (p
The AIDS epidemic in Southeast Asia has led to a marked rise in the incidence of talaromycosis (penicilliosis) marneffei. The aim of this cross-sectional study was to determine the clinico-epidemiological features and outcome predictors of talaromycosis in Malaysia. We identified Talaromycosis marneffei cases from cultures of sterile specimens from 191 human immunodeficiency virus (HIV)- infected patients. Talaromycosis increased from 20-25 (2010-2011) to 45-50 cases per year (2012-2014). Talaromycosis was the HIV-presenting illness in 117 (61.3%) patients. The incidence of talaromycosis as HIV-presenting illness showed an increasing trend from 10.7 (2010) to 26.4 (2014) cases per 1000 new HIV patients. The patients were between 19 and 74 of age (mean 37.2+9.4 years) and the male to female ratio was 7.7:1. Malay (73, 38.2%) and Chinese (70, 36.3%) were the most prevalent ethnic groups. Common clinical manifestations included loss of weight (85.9%), fever (84.8%) and cough (67%), while skin lesions were only present in 42.9% cases. Common concurrent infections were oral candidiasis (79.6%), tuberculosis (36.1%) and hepatitis C infection (20.9%). Most patients (93.7%) were anaemic with mean haemoglobin level of 9.9+2.3 g/dL, 39% had impaired liver function, and 18.8% were neutropaenic. Median CD4 cell count was 16 cells/L. Most patients (70.4%) received intravenous amphotericin B followed by itraconazole. At 8-month follow up, 148 (81.8%) patients were alive while 33 (18.2%) had died. Intravenous drug abuse, concurrent toxoplasma encephalitis and concurrent Pneumocystis jiroveci pneumonia independently predicted death outcome in both univariate and multivariate logistic regression analyses.
Lecturers are expected to cope with stress in their workplace in order to continue to be productive. The demand to fulfill targets will increase the incidence of occupational stress. The aim of the study was to determine the factors associated with occupational stress among state university lecturers in Bandung, Indonesia. The study was carried out on 354 state university lecturers in Bandung, who came to the research location during May 2017. It was conducted by means of a diagnostic survey with the use of the Self Reporting Questionnaire (SRQ), Spiritual Wellness Inventory-R (SWI-R), Social Readjustment Rating Scale (SRRS), Miller Smith lifestyle assessment inventory, and Occupational Stress Scale (OSC). A total of 330 respondents became our study subjects with response rate of 92.94%. A correlation bivariate was applied to analyse the correlation of external and internal factors with occupational stress. The statistical analysis was conducted by means of SPSS Statistics 18.0 with p≤0.05. From 330 lecturers, there were 153 (46.4%) males and 177 (53.6%) females. The marital status included 257 (77.9%) married, 27 (8.2%) single, while 46 (13.9%) did not answer. The results proved the existence of a correlation between life, stress event, life style, mental emotional disorders, with occupational stress. The spirituality factors contributed to occupational stress were selfworth, control, and connectedness. Lecturer had to cope with occupational stress. There are some factors, which could influence occupational stress among lecturers.
MeSH terms: Female; Indonesia; Life Style; Male; Surveys and Questionnaires; Universities; Incidence; Workplace; Marital Status; Spirituality; Self Report
Chair based exercise (CBE) is an exercise alternative for older adults in ensuring safety during exercise. Its evidence of effectiveness is currently limited to frail older adults or those with acute medical conditions or terminal illnesses. Given higher exercise difficulty level, CBE could benefit healthier older adults and can be an exercise option for this population. This study was designed to evaluate the outcome of a CBE on physical performance and quality of life in community-dwelling older women in Malaysia. A total of 18 older women (mean age 66.78 + 4.60 years) completed CBE at twice-per-week for eight weeks. Exercise outcomes were measured using six minutes’ walk test (6MWT), five times sit to stand test (FTSTS) and hand-held dynamometer for physical endurance, functional lower limb strength and grip strength, respectively. A Malay version of the World Health Organization quality of life scale (WHOQOL-BREFMalay) was used to measure the health status and QOL of the participants. All data were analysed with the use of inferential statistics, with significance level set at p
MeSH terms: Aged; Female; Health Status; Humans; Malaysia; Middle Aged; Physical Endurance; Quality of Life; World Health Organization; Exercise; Frail Elderly; Hand Strength; Physical Therapy Modalities; Lower Extremity; Independent Living; Walk Test
Diabetes requires dedicated self-management to be able to achieve good control and outcome as this is a lifelong condition. The internet offers an amazing wealth of health information which may influence diabetes self-management. The aim of this study was to determine the prevalence of online health information seeking among people with diabetes and its associated factors. About 380 participants answered the online health information seeking questionnaire developed from literature search and expert panel review. Diabetes Self-Management was assessed using the Diabetes Self-Management Questionnaire (DSMQ). The prevalence of online health information seeking among people with diabetes was 38.4%. Common information sought included diabetes treatment (82.9%) lifestyle modification (77.4%) and diabetes prevention (67.3%). A large majority (93.1%) felt that the online information on diabetes was useful. Doctors and printed reading materials were the most common sources of information for diabetes (94.2% & 65.3%). Lower median age (59 years, IQR = 11), having a family member with diabetes, (COR = 1.188) tertiary education (COR = 6.037) and those who are employed (COR = 3.880) have higher odds of seeking online diabetes related health information. However, there was no significant association between online health information seeking and diabetes self-management. Prevalence of online health information seeking among people with diabetes was at an acceptable level. However, it was not associated with optimal diabetic self-management. Doctors and printed information remain as popular sources of information and hence should be maintained.
Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
MeSH terms: Adult; Age Factors; China/ethnology; Cross-Sectional Studies; Diabetes Mellitus; Female; Hospitals, University; Humans; India/ethnology; Life Style; Malaysia; Malaysia/ethnology; Male; Surveys and Questionnaires; Self Care; Health Behavior; Prevalence; Internet; Information Seeking Behavior