Body posture is one of the most important parts when lifting an object as it can causes injury if the wrong technique and body posture were used. A worker will injure their low back if a bad posture is not in consideration. A good body posture is recommended among workers to reduce the chance of injury while lifting and improve their postural safety. The main objectives of this study are to observe the body posture of the worker during lifting and study the comparison of using lower back support when lifting. It also investigates the muscle activity of the worker during heavy lifting using EMG and simulates the worker's movement using CATIA Software for Rapid Upper Limb Assessment (RULA) results. The selected grocery was chosen in Kota Samarahan, Sarawak with 7 male respondents are identified to undergo this study. The results show that the worker with lower back support tends to show raw EMG signal with lower muscle activity compared to without using lower back support. Thus, using belt support can reduce muscle activity by up to 67.4% compare to not wearing back support. Raw EMG signals also show 3010 amplitude (mV) muscle activity if postural safety of the workers improved by following the NIOSH lifting Recommendations.
Responding to demands for transformed networking practices requires new forms of knowledge. Given their scale and complexity, networking problems can no longer be solved by way of extending intermediaries. Recent research on alternative approaches has focused on the understanding network structures formed by interactions between heterogeneous actors. Rather than linear extensions, network theory highlights cliques structure as a major determinant of performance derives largely from the frequent finding that managers that are embedded with influential connections are at increased likelihood of becoming influential themselves thus opening rooms for new knowledge and innovative technology and practices. It is suggested that the strong and consistent cliques are at least partially responsible to managing network complexity. This paper contributes to our understanding of such facilitation by investigating the networks in which managers exchange information. We report findings based on the study of managers in a maritime industry. Network surveys identified who the managers contacted for inputs and who they had talked to about the information by 6 months earlier. Snow-balling interviews collected farmer statements about their most valuable contacts and these statements have been analysed. The network analysis shows that managers with densely tied and occupationally homogeneous contacts grew their networks more than did managers with contacts that are loosely tied and diverse. The network analysis reveals an important principle: managers’s value knowledge delivered by persons of homogenous connections rather distance ones. It is argued that social network analysis is an appropriate method for studying influence development use in the context of networked organizations.
Introduction: Cardiovascular disease (CVD) is the principal cause of admission and death in the Malaysian government hospitals. Method: The pattern of cardiac related mortality (CRM) cases in Hospital Serdang, Selangor was reviewed to determine the specific trends in ethnicity, age, gender and type of CRM. Data was drawn from the death registry records in Forensic Department of Hospital Serdang from January 2006 to December 2008. This preliminary project was carried out to assess the number of CRM cases and their characteristics to feed the decision to sensibly embark on another project related to atherosclerosis. Results: Out of 573 CRM cases, 84.5% were Malaysians out of which the majority were Malays (45.9%), fol- lowed by Chinese (30.2%), and Indians (22.1%). The majority were men (78.4%) with a mean age of death at 51.83 ± 14.10 (95% CI 50.52-53.14) years as compared to women (21.6%) with a mean age of death at 57.42 ± 16.92 (95% CI 54.41-60.43) years. Declining mortality trend was observed only in men. The 46-60 years old age group had the highest percentage of mortality and continually increase by year. Ischaemic heart disease (IHD) was the most common CRM type (69.1% in 2006, 66.2% in 2007, and 71.9% in 2008). Conclusion: We observed inconsistent trends of CRM in Hospital Serdang in terms of ethnicity, age, gender and type of CRM cases presented. Nevertheless, these findings do not necessarily represent the overall trends of CRM in Malaysia.
Introduction: Iron deficiency anaemia (IDA) is the most common cause of anaemia. The diagnosis of IDA, however, remains a challenge and is a problem worldwide. Serum iron study is commonly used for IDA diagnosis but there are some limitations. This study was conducted to evaluate reticulocyte-haemoglobin equivalent (Ret-He) as a screening tool for IDA diagnosis in adults. Method: This is a comparative case control study conducted in Hospital Tengku Ampuan Afzan, Kuantan consisting of adult patients with iron deficiency anaemia and a healthy control group. Hae- matological parameters (Hb, RBC count, MCV, MCH, RDW) inclusive of Ret-He and serum iron parameters (serum iron, transferrin saturation and serum ferritin) were measured. Correlation between Ret-He with other haematological and serum iron parameters were analysed. Results: There were 103 IDA adult patients with majority of them being female (85.4%) with median age of 36 years old. Malay ethnicity (79.6%) contributed to the larger proportion of adult IDA patients. The Ret-He value for patient and control groups were 16.50 ± 4.90 pg and 34.80 ± 1.97 pg, re- spectively. Ret-He was 89.32% sensitive and 100% specific with 100% positive predictive value (PPV) and 73.11% negative predictive value (NPV) when compared to transferrin saturation. There was significant correlation between Hb, MCH, MCV, RDW and serum iron, transferrin saturation and serum ferritin parameters with Ret-He. Conclusion: Ret-He together with a complete blood count, may serve as an alternative to the serum iron parameters for screening of IDA in adults.
Introduction: Iron deficiency anaemia (IDA) is the most common cause of anaemia worldwide. Determination of body iron status is necessary to diagnose IDA. This can be measured using a biochemistry assessment of the serum/ plasma. Plasma/serum iron quantitation is also important in diagnosing iron overload disorders. However, iron studies are limited due to high cost and lack of access to biochemical analysers. Therefore, a cost- and technical-ef- fective method is needed to measure human plasma iron concentration. Plasma iron is mainly transferrin-bound and an acidic plasmic condition is necessary to release the iron. This study investigated various candidate acid salts to achieve the acidic condition needed for plasma iron release. Method: Ten powdered or crystallised acid salts were studied for their water solubility as well as their pH reduction capability in revised simulated body fluid (r-SBF) and commercially available human plasma without any change in colour or form. Results: Six acid salts studied were discontinued from further investigation because they were insoluble in water. Another two candidates were unsuitable as they precipitated in r-SBF and human plasma. Maleic acid formed a jelly-like texture after a certain amount of time in human plasma. Only citric acid met all the criteria of a suitable acid salt to be investigated further as part of the reagent for a spontaneous plasma iron measurement. Conclusion: Citric acid, which is a colourless and odourless acid salt, was selected to lower the human plasma pH to an acidic condition for transferrin-bound iron release.
Pediatric ocular trauma; though the number is small, can lead to a devastating lifetime impact due to its risk of ambly- opia (if it occurs before the age of seven) and also loss of vision. We are reporting a case of a young 12-year-old-boy who was struck unintentionally by an arrow to the eye by another friend during sports activity. The arrow pierced the right eyebrow just below the orbital roof then perforated the globe from the superior orbit pointing downwards piercing the floor of the orbit fracturing the maxillary roof. Emergency scleral repair was done; however, there was no useful vision left. Arrow injury to the eye is a rare occurrence but leads to severe consequences given its high velocity and projectile in nature. The incidence is low and highly avoidable if precautionary measures are taken.
Superior vena cava (SVC) syndrome can be fatal if not discovered early. Most SVC syndrome presentations are relat- ed to malignancies; lung cancer in particular. The presentations may vary, depending on severity of SVC obstruction. We report a case of mild SVC syndrome of a 70-year-old gentleman who presented with a one-month history of in- termittent plethora and facial puffiness. Computed tomography scan of the chest revealed superior mediastinal mass which may represent matted lymph nodes obstructing SVC with bilateral pleural and pericardial effusion. Biopsy of the mass was done, and non-small cell lung carcinoma was diagnosed. Clinical presentation, differential diagnoses and issues relating to SVC syndrome were discussed with the emphasis on early recognition of mild symptoms and prompt management.
Streptoccoccus plurianimalium is a rare pathogen that has recently made a crossover from its common host, animals to humans. As reports start to emerge from this pathogen, it has come to light that it can cause clinically significant infections in a broad spectrum of systems. However, the mode of transmission of this pathogen has not yet been fully established. We report here a case of Streptoccoccus plurianimalium peritonitis in a patient undergoing continuous ambulatory peritoneal dialysis in our centre. To the best of our knowledge, this is the first case report of a Streptoc- coccus plurianimalium peritonitis in an end-stage kidney disease patient.
As urban centres pursue localisation of the Sustainable Development Goals (SDGs), rapidly growing cities in low-and middle-income countries (LMICs), many of which are located in the Asia-Pacific region, are experiencing competing demands for limited resources. The protection and enhancement of Urban Green Spaces (UGS) is a practical, low- cost opportunity to produce multiple benefits across the SDGs, ranging from improving the health and wellbeing of city dwellers and reducing inequalities to protecting local flora and fauna and attracting economic investments for future generations. In developing a city-wide strategy for UGS that aligns with the New Urban Agenda, it is important to consider the coordination of efforts from multiple sectors through participatory decision-making mechanisms that engage the civil society and address the needs of the most vulnerable population groups regarding mobility (such as children, elderly, women and people with disabilities) to ensure no one is left behind.
Abnormal malignant growth of breast cells often occurs among women after menopause. But, recently, breast cancer (BC) is increasing in trend among young women, mainly in Asian countries. Breast cancer in young women (BCYW) usually presented with higher grades, advanced stage, and aggressive subtype. The survival of BCYW is poor with a more progressive and higher chance of recurrence and metastasis. Treatment for BCYW usually is more intensive and extensive, which causes more side effects that potentially lead to psychosocial issues. This article review highlights the unique and complex issues of BCYW in Malaysia and around the world.
Stroke care service in Malaysia is suboptimal despite the fact that it is one of the commonest cause of death. This is due to several limitations, including lack of resources and funding for the stroke care establishment and the man- agement itself. Alternatively, other regions have come up with numerous ways to combat the difficulties in order to provide better stroke care services. We have identified the overwhelming benefits of creating stroke care units, thrombolysis services, and endovascular thrombectomy. For this reason, we designed a Regional Emergency Stroke Quick Response Network (RESQ) based on the needs of the current situation in Malaysia. With a standardised RESQ training, we hope to achieve close-knitted cooperation in between the emergency medical services, emergency de- partment team and the RESQ, which subsequently will create an ideal improvised stroke care units.
Proton therapy is an advanced type of radiotherapy and the use of charged particle proton instead of high energy X-rays to treat cancer has been increasing in recent years, as it offers superior dose distribution and more effectively spares healthy tissues compared to conventional radiotherapy. Proton therapy has potential clinical advantages for some types of tumours that are difficult to treat by conventional radiotherapy, it also has the added benefits of no exit dose beyond tumour. Many countries that established cancer treatment facilities in the last decade chose proton therapy because of its lower capital cost and higher cost-effectiveness compared to carbon ions therapy. This review first describes the physical characteristics of proton beam for radiotherapy, followed by potential clinical benefits of proton beam therapy in Malaysia. The paper also discusses the challenges of implementing the first proton centre in Malaysia.
Cosmos caudatus Kunth is an edible plant commonly known for its beneficial medicinal effects on human health and traditionally used to treat various health conditions, including diabetes. This review summarizes the current state of knowledge about this plant, to provide some basic information about this herb that reflects its antidiabetic potential through multiple mechanisms. Currently, available evidence suggests that C. caudatus possess some pharmaco- logical effects, including anti-inflammatory, antimicrobial, the formation of healthy bone and regulation of blood pressure and glucose levels. The review summarized the antidiabetic activity and its significant phytoconstituents in
C. caudatus
A majority of hypertensive patients will end up suffering uncontrolled hypertension, which is partly due to poor medication adherence. This paper aimed to review a range of interventions that could improve anti-hypertensive medication adherence. Literature search was conducted using PubMed, Scopus, Medline, and Science Direct da- tabases, with publication dates confined to between October 2009 and October 2019. Eventually, only 11 studies were used for this study. It was found that interventions that are based on or include patient education, patient in- terviews, patient reminders, self-management and behavioural modifications have the potential to improve patients’ adherence to anti-hypertensive therapy. Most successful interventions involve patient reminder, self-management and behavioural intervention.
The American College of Obstetricians and Gynaecologists (ACOG), US Department of Health and Human Services (HHS), and American College of Sports Medicine (ACSM) recommend that all pregnancies with medical clearance should engage in moderate-intensity physical activity (PA) at least 150 minutes per week. However, most of them are physically inactive. Thus, this article aims to identify predictors of physical inactivity among antenatal women. Four databases were used to search relevant articles using PICO strategy systematically. The screening began with examining titles, abstracts, and keywords, followed by scrutinizing and assessing full articles. Finally, a total of five studies were included for the data extraction, and the predictors are sociodemographic (trimesters, parity, marital status, and pre-pregnancy PA status), socioeconomic (household income), lifestyle (smoking and eating unhealthy diet) and health-related factors (multiple pregnancies, received fertility treatment, being unwell, musculoskeletal pain, symptom of early pregnancy and uterine contraction). All these predictors provide crucial information for the success of future physical activity intervention.
Introduction: The aim of the study was to compare the changes in the skeletal and dentoalveolar structures in Malay patients with Class II Division 1 malocclusion treated by prefabricated re-mouldable customizable functional appli- ance (T4FTM) and Twin Block (TB) appliance. Methods: A randomised clinical trial was carried out with samples ran- domly assigned to active (TB appliance) and experimental (T4FTM appliance) groups. Pre- and post-treatment lateral cephalometric radiographs were taken for each subject and the overjet was clinically measured at the same intervals. 20 angular and linear measurements were chosen and measured separately. Results: Independent t test was used to compare the changes between the two groups. A significant difference between the groups was seen with overjet at 2.14 mm (p < 0.01), Sv_Pog distance at 1.83mm (p < 0.05), Sv_ii distance at 2.55 mm (p < 0.001), horizontal distance from the upper to the lower incisor tip at 1.81 mm which was statistically significant (p < 0.05). The other variables SNB and ANB angles too showed a significant difference. However, all the favourable changes were noted in the TB group. Conclusion: T4FTM appliance could be an effective appliance for the management of British Standard Institute's Class II Division 1 malocclusion on Class II skeletal pattern. However, the TB group differed significantly and had a more favourable correction in terms of the sagittal skeletal and dentoalveolar discrepancy.
Introduction: Bauxite ore contain various heavy metals especially aluminum, if exposed excessively is detrimental to the respiratory system. Objective: This study aimed at determining the PM10 and its Al, As, Cd, Cr, Ni and Pb con- tent and assessing the inhalation health risk assessment (HRA) among the community. Method: This cross-sectional study was conducted in Kuantan on 162 randomly selected respondents in three residential areas; Felda Bukit Goh (FBG), Jalan Besar Bukit Goh (JBBG) and Kuantan Port Consortium Flat (KPCF). Questionnaires were used to obtain the background information and health symptoms. PM10 with its heavy metals were subsampled for 24 hours using air
sampling pumps in 42 randomly sub-sampled households from the 3 areas. Results: PM10 exceeded 150 µg/m and
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the Al, Cd, As, Cr, Ni and Pb levels exceeded the standard limit. The hazard quotient (HQ) of Cd in JBBG (4.13), Cr in FBG (74.06), JBBG (84.41), KPCF (76.87) and Ni in FBG (60.53), JBBG (66.95) and KPCF (58.81) exceeded the HQ
value of 1. The lifetime cancer risk (LCR) exceeded the level of 0.0000001 for Cr in FBG (0.0252), JBBG (0.0288) and KPCF (0.0262), as well as for Ni in the FBG (0.000184), JBBG (0.000204), and KPCF (0.000179) areas. Conclusion: The PM10 levels exceeded the USEPA guidelines while Al, Cd, As, Cr, Ni and Pb exceeded the ATSDR limit. The Cd, Cr and Ni posed non-carcinogenic and carcinogenic health risks. Therefore, health risks from the PM10, Cd, Cr and Ni exposures were found in this study.
Introduction: Public transit is a sustainable transport mode that can improve the health and well-being of urban population. Following the development of mass rapid transits (MRT) in Greater Kuala Lumpur, this study aims to em- pirically test the behavioral framework behind the intention to use rail transport among private motor vehicle users. Methods: Data was obtained through a cross sectional travel survey (N=509) conducted on the catchment popula- tion of an upcoming MRT line in Greater Kuala Lumpur. The factors in the hypothesized framework were service quality, environmental health concerns, attitude and the intention to use. The data was modeled using the Maximum Likelihood (ML) estimation in structural equations. Results: The validated model indicated that service quality and environmental health concerns significantly affected respondents' intention to use rail transport, mediated by attitude. Reliability, convenience and comfort were the most valued service qualities, while environmental concerns were more valued than health concerns. There were significant moderation by age, income, and having children below 18 years old on the framework. Higher age groups valued more on service quality, while attitude had larger determin- ing effects on the higher income groups. Besides, the lower direct effect of service quality on attitude among higher income groups implied possibility of other affective factors for the subgroup. Conclusion: This study demonstrated the importance of service quality, attitude, and environmental health concerns in encouraging rail transport usage among private motor vehicle users. Certain subpopulations may be targeted for promotion strategies to improve rail transport use in the city.
Introduction: Prevention of osteoporotic fracture requires identification of individuals at high risk. Bone mineral
density(BMD) is commonly used to estimate fracture probability despite inadequate predictive discrimination ability.
Sphingosine-1-phosphate(S1P), a new marker of bone metabolism and bone turnover markers(BTM) such as procollagen-type-1 amino-terminal propeptide(P1NP) and C-terminal telopeptide of type I collagen(CTX) may complement
current assessment. The study determined P1NP, CTX and S1P levels and their correlation with BMD, 25-hydroxyvitamin D (25(OH)D) and parathyroid hormone(PTH) in selected subjects. Method: A cross-sectional study involving
Malaysian Chinese men and women aged 50-90 years old from Puchong and Kajang, Selangor. Each subject had
BMD determined by dual-energy x-ray absorptiometry and blood samples taken for 25(OH)D, PTH, P1NP, CTX and
S1P. Results: A total of 131 subjects [45(34.4%) males and 86(65.6%) post-menopausal women] with median age
of 65(IQR=17) were recruited. P1NP and CTX were significantly higher in post-menopausal women (P1NP=61.71
ng/ml, CTX=0.489 ng/ml) compared to men (P1NP=46.94 ng/ml, CTX=0.381 ng/ml). P1NP and CTX differed significantly according to BMD categories with values highest in osteoporosis. S1P between men (2.12±0.75 µmol/L) and
post-menopausal women (1.96±0.68 µmol/L) did not differ significantly and did not differ according to BMD categories. S1P did not correlate with BMD, P1NP, CTX and 25(OH)D. P1NP and CTX negatively correlated with BMD
at all measured sites but not 25(OH)D. Conclusion: CTX and P1NP, but not S1P negatively correlated with BMD.
CTX and P1NP were highest in those with osteoporosis. In this group of Malaysian Chinese subjects, CTX and P1NP
rather than S1P reflects bone health.
Introduction: Immune reconstitution inflammatory syndrome (IRIS) is paradoxical clinical deterioration experienced
by some HIV-infected patients in response to antiretroviral therapy (ART). There is still limited published data on
IRIS from this region including Malaysia. This study aimed to determine IRIS prevalence, clinical manifestations
and possible predictors among HIV-infected patients in an infectious disease centre in Peninsular Malaysia.
Method: This retrospective study was conducted in Hospital Sungai Buloh involving secondary data of 256
HIV-infected patients who were initiated on ART in the year 2017. Medical record of each patient was reviewed
for up to 12 months following ART initiation to identify IRIS diagnosis which was made by the treating physician.
Relevant clinical and laboratory information were retrieved from hospital electronic database. Results: IRIS has
occurred in 17.6% of patients. Infections by Mycobacterium tuberculosis (53.3%), Pneumocystis jirovecii (11.1%)
and Talaromyces marneffei (6.6%) were the commonest three aetiologies of IRIS. Subacute lupus erythematosus was
the only non-infectious IRIS identified. Baseline HIV viral load, CD4+ T-cell count and haemoglobin level between
IRIS and non-IRIS patients were significantly different. Risk of developing IRIS was increased seven times in patients
with CD4+ T-cell count < 100 cells/µL and four times in patients with HIV RNA viral load > 5.5 log10 copies/ml prior
to ART initiation. Conclusion: Mycobacterium tuberculosis infections were the highest IRIS manifestation. Although
rare, non-infectious IRIS does occur and should be part of the differential diagnosis. Patients with positive predictors
should be appropriately monitored for possible IRIS development once initiated on ART.