A survey was carried out using a medical examination format that was prepared by the Malaysian Medical Association. The findings of the survey show that of the 266 cases surveyed, 64 drivers (24% of cases surveyed) are either totally unfit to drive or temporarily unfit to drive heavy goods and passenger vehicles. This is clear indication that the current format that is being used by the Road Transport Department is inadequate and needs to be reviewed. It must also be stressed that all the above 64 drivers have been certified fit using the existing Road Transport Department format and are currently driving in our highways and roads. Heavy vehicle goods and passenger vehicle drivers if not properly examined and medically certified are not only be endangering their own lives but also that of others. It is therefore recommended that based on the data available from this survey, the Road Transport Department should seriously consider adopting the medical examination format that was formalised by the Malaysian Medical Association and used in this survey.
The aim of this research is to study how the physical changes in the maxillofacial trauma patients affect them psychologically in patients of different ages, sexes, races, socioeconomic backgrounds, types and severity of injury. The study was conducted by doing a questionnaire survey, which was divided into physical and psychological components. In the physical component, the questions were mainly related to the physical injuries to the patient, which could be visualized clinically and functionally. The psychological component consisted of analyzing the impact of the maxillofacial trauma to the psychological profile. Twenty patients of both sexes and ages, ranged from 15 to 62 years old were interviewed. The main cause of trauma was from motor vehicle accidents. This study appears to show that maxillofacial trauma may have a psychological impact on patients.
Currently, the generated brake lining waste dust, which contains asbestos as its major component, is disposed of into a secure landfill without any additional treatment. As an alternative to this, solidification/stabilization (S/S) disposal of the dust was investigated using Portland cement alone and Portland cement mixed with activated carbon (AC), as the binders. Toxicity Characteristics Leaching Procedure (TCLP) results on the solidified matrix showed that cement was able to immobilize the heavy metals, Ba, Zn, Cr, Pb, Cu and Fe, to within the limits set by the US EPA for TCLP. Addition of AC to the cement reduced the leaching of heavy metals by an additional 4-24% compared to cement alone. The pH of the TCLP leachate extracted from virgin cement, and from dust treated with cement with or without AC was found to increase to 10.9-12.5 as opposed to an initial value of 4.93 for the TCLP extract for the untreated dust. Results of ANS 16.1 (modified) leach protocol revealed that Ba in cement-treated samples showed the highest leach rate, followed by Zn, Pb, Cr, Cu and Fe. The leach rate of heavy metals decreased with progress in time. Cement mixed with AC exhibited similar leach characteristics, however, the leach rate was lower. The linear relationship between the cumulative fraction leached (CFL) and the square root of leaching time in all cement-based samples indicate that a diffusional process is the controlling transport mechanism for the leaching of the heavy metals. The obtained Leachability Indices (L(i)) of 7.6-9.1 and 8.3-9.5 for cement and cement with AC, respectively, were low but exceeded the guidance value of 6, which clearly indicates that all the heavy metals studied are retained well within solid matrices. Cement-based S/S hardening times increased from 30 to 96 h as the dust content increased from 40 to 70 wt.%. The resulting solid matrices exhibited a compressive strength ranging from 1 to 12 MPa, which was well above the specified limit of 414 kPa for such matrices. An economic analysis indicates that the disposal costs for the dust in the only available secure landfill would increase by 40.3% if one were to go for the cement S/S option. Addition of AC to the cement would escalate this by an additional 43.8%. Although the S/S of brake lining dust using cement effectively immobilized the heavy metals of concern, cost considerations may hinder the commercial adaptation of this technique for waste disposal unless new regulatory demands are implemented.
We do not know how medical doctors perceive the risk of cancer as a cause of death. Medical doctors provide advice and information on health risks to the general public. How they perceive these risks influences the way they behave towards these risks and the way they will communicate these risks. We would like to ascertain how medical students perceive cancer as a health risk. This will hehv us determine misperceptions among medical students that need to be addressed before they practice medicine. A cross-sectional study was conducted among
all UPM medical students (2000-2001) using sefadministered questionnaires. A total of 339 (88.3%) students responded to the questionnaires. The internal consistency of items was good (Cronbach Alpha >0,7). Cancer was perceived as the 3rd leading risk of death after motor vehicle accidents (I") and heart diseases/cardiovascular disorders (2"d ). The breast was perceived as the organ with the highest risk of developing cancer. Smoking was perceived to be the leading risk factor for developing cancer. There is a dpjference in risk perception of diseases, cancer target organs and cancer risk factors based on gender and ethnicity. There was moderate to fair correlation ( r = 0.41-0.57) between perception of risks of death, cancer target organs and risks factors of cancer (p
In developing countries, motorcycle use has grown in popularity in the past decades. Commensurate with this growth is the increase in death and casualties among motorcyclists in these countries. One of the strategic programs to minimize this problem is to reduce motorcyclists exposure by shifting them into safer modes of transport. This study aims to explore the differences in the characteristics of bus and motorcycle users. It identifies the factors contributing to their choice of transport mode and estimates the probability that motorcyclists might change their travel mode to a safer alternative; namely, bus travel.
A methodology was developed for diagnosing industrial work, which includes questionnaire, observation, measurements, data collection and statistical analysis. A survey was conducted to investigate the relationship between job satisfaction and factors that affect work design in 2 automotives manufacturing companies in Malaysia. A basic work design model was proposed. The aim of this model was to determine the factors that influence employees' perception towards their work. A set of multiple-choice questionnaires was developed and data was collected by interviewing employees at a production plant. The survey focused on job and environmental factors. The results supported the proposed model and showed that job and environmental factors were significantly related to job satisfaction. They highlighted the significant influence of age, work experience and marital status on job satisfaction. Further, environmental factors, especially the surroundings, context dependence and the building's function, also had a significant impact on job satisfaction.
To determine the risk factors associated with complain of low back pain. A cross sectional study was done from June 2004 until August 2005. Seven hundred and sixty commercial vehicle drivers from 11 bus companies in central, northern and eastern regions in Malaysia participated in this study. Modified Nordic questionnaire was used to determine the prevalence of low back pain; Maestro human vibration meter was used to measure the personal R.M.S values of lateral, anterior-posterior and vertical axes. Modified Owas was used to assess the awkward posture of the driver torso namely, bending forward movement, leaning, sitting straight and twisting. Profile of Mood States (POMS) was used to evaluate the mood states of bus drivers with complain of low back pain. A high prevalence of low back pain (60.4%) among Malaysian commercial vehicle drivers was found. Logistic regression analysis controlling for age, income, education level and non occupational activities revealed that the following factors were related to low back pain: Tension-anxiety [1.080, 95% CI 1.041-1.121], depression dejection [1.047, 95% CI 1.023-1.072], anger-hostility [1.053, 95% CI 1.027-1.081], fatigue [1.132, 95% CI 1.089-1.177] and confusion [1.114, 95% CI 1.061-1.169] of POMS, length of employment [1.001, 95% CI 1.0-1.003], steering wheel adjustment [1.521, 95% CI 1.101-2.101], perception of exposing to vibration [1.943, 95% CI 1.389-2.719]. In conclusion, combinations of risks lead to high increase of low back pain complain among Malaysian bus drivers.
Soft-tissue injuries with or without facial bone involvement are the most common presentation following maxillofacial trauma. The objective of this study was to look at the distribution, pattern and type of soft-tissue injury in relation to aetiology. Records of patients over a period of 5 years (1998-2002), who sustained maxillofacial injuries and were treated at Kajang Hospital, a secondary referral hospital, were reviewed. Out of 313 patients with maxillofacial injuries, 295 patients sustained soft-tissue injuries. Males (79%) between 21 and 30 years old (34%) were the majority of patients. Road-traffic accident was the main cause of soft-tissue injuries (75%) with motorcycle accident being the most frequent (40%). The upper lips (23%) and the lower lips (18%) were the most common extraoral site involved, while the labial mucosa and sulcular areas, both accounting for 21%, were the most common intraoral sites. Stringent road-traffic regulations should be practiced in developing countries, as morbidity arising from road-traffic accidents poses a national economic and social problem.
We present two cases of direct traumatic carotico-cavernous fistula following motor vehicle accident. Their main symptoms include loss of vision, progressive proptosis and recurrent epistaxis. Angiogram confirmed presence of carotico-cavernous fistula in both cases. One was successfully treated by open surgery and the other by embolization with Guglielmi detachable coils (GDC). In both cases, proptosis and epistaxis resolved completely.
How people perceive risk influences their behaviour towards these risks. We do not know how workers perceive risk of dying from activities or technology. This study was conducted among 198 workers of a security company in Malaysia. The workers were asked to score on a Likert scale of 1 to 5 the perceived risk of death of Malaysians from activities and technology. The highest perceived risks of death were, in order of ranking, motorcycles, motor vehicles, handguns, alcoholic beverages and smoking. The difference in perception and reality is discussed.
A disposable screen-printed e-tongue based on sensor array and pattern recognition that is suitable for the assessment of water quality in fish tanks is described. The characteristics of sensors fabricated using two kinds of sensing materials, namely (i) lipids (referred to as Type 1), and (ii) alternative electroactive materials comprising liquid ion-exchangers and macrocyclic compounds (Type 2) were evaluated for their performance stability, sensitivity and reproducibility. The Type 2 e-tongue was found to have better sensing performance in terms of sensitivity and reproducibility and was thus used for application studies. By using a pattern recognition tool i.e. principal component analysis (PCA), the e-tongue was able to discriminate the changes in the water quality in tilapia and catfish tanks monitored over eight days. E-tongues coupled with partial least squares (PLS) was used for the quantitative analysis of nitrate and ammonium ions in catfish tank water and good agreement were found with the ion-chromatography method (relative error, ±1.04- 4.10 %).
A retrospective cross-sectional study of injury patients who attended the Accident and Emergency Unit was conducted at the University of Malaya Medical Centre. Demographic data with regards to age, sex, race, occupation and the relevant data such as type of accident, type of injury sustained and also severity seen during the month of January 2005 were selected retrospectively from medical record. The objectives were to review road traffic accidents and their severity of injuries among the patients. There were two hundred and forty-three (197 males and 46 females) patients involved: 60% Malays, 16% Chinese, 21% Indians and 3% other ethnic groups. Peak accidents occurred among the 21 to 30 years age group. Among the type of accidents, 65.8% involved motorbike riders, 10.3% car drivers, 8.6% pillion riders, 7.8% car passengers, 5.8% pedestrians and 1.6% were bicycle rider injuries. About 57.6% sustained minor injuries and 42.4% major injuries. There was no significant association between outcome of road traffic accidents and sex, age group and race. However, there was a significant association between type of accidents and severity of injuries (p = 0.014). Males sustained more major injuries and motorbike accidents were the highest among road injuries. Therefore, further prevention and control with emphasis on behavioural changes, education and law enforcement may reduce the number of road traffic accidents in the future.
A teenager college student was fatally injured by burst tyre air pressure while waiting on a public bus stand to catch a bus to reach her college at Kuala Lumpur. She accidentally came near the wheel while boarding when tube and tyre got burst .The air pressure had blown the girl in the air and she subsequently fell on a rough surface. The iron-locking rim of the wheel acted as a missile and hit the girl. She died on her way to the hospital. A medico-legal autopsy was performed which showed extensive injuries in the cranial and chest cavity. Head had large scalp laceration with diffuse separation and gaping from in the vault region; skull bones were fractured. Chest cavity had extensive rib fractures, lacerated lungs and haemo-thorax while externally there was no obvious injury. It requires intensive care management and screening of the victims. Tyre-blast injuries are not so common. This case exposes the hazard due to burst tyre.
Chemical composition of fine (PM2.5) aerosol samples collected for the 5 years period (2001- 2005) using Gent Stacked filter unit sampler at Klang Valley (3 o 10 ’ 30 ’’ N, 101 o 43 ’ 24 ’’ E) were analysed using Neutron Activation Analysis (NAA) and Proton Induced X-ray Emission (PIXE). Results of the study show that the major component of the fine aerosol was black carbon and sulfur with the mass concentration ranged from 4.4 - 6.7µg m -3 and 1.2 - 1.9µg m -3 , respectively. The total fine aerosol mass concentration were in the ranged of 25 - 31µg m -3 with the reconstructed mass was about 50% as relative to the gravimetric mass. Statistical method, factor analysis with varimax approach has been applied to the aerosol composition data for the fingerprint identification. The analysis produces five identified fingerprint represent soil, industry, motor vehicles/biomass burning and Pb and Zn sources. There is also an unidentified source that could be related to unknown industrial activities.
This is a retrospective study to determine the distribution site, associated fracture and causes of mandibular fractures at HUSM, over a 5 year period, from 1st January 2002 - 31st December 2006. Records of patients who had mandibular fracture were reviewed. Data of age, sex, site of fracture, causes and associated fracture were recorded and analyzed using SPSS version 15.0. There were 113 (84.3%) males and 21 (15.7%) females. The mean age for male was 84.3% and female was 15.7%. The fracture occurs mostly at the age of 11-20 years (45.5%), followed by 21-30 years (30.6%). Motor vehicle accidents (MVA) were the commonest causes of mandibular fracture (92.5%), followed by fight and assault (3.7%), industrial accidents (3.0%), fall (0.7%). There were no cases recorded due to sport injury. The commonest site of mandibular fracture occurs at angle and para-symphysis (23%), followed by body (20.1%), symphysis (16.7%), condyle (15.5%) and ramus (1.7%). The most common associated fractures were head injury (23.5%), followed by clavicle fracture (17.2%) and fracture of radius (10.7%). Mandibular fracture was common in males with the mean age 24.63 years and mostly due to MVA. Angle and para-symphysis is the commonest site of mandibular fracture with most of the patient suffered from concomitant head injury.
The use of environmental planning tools for optimum solid waste landfill siting taking into account all environmental implications was carried out by applying Life Cycle Analysis (LCA) to enhance the research information obtained from initial analysis using Geographical Information Systems (GIS). The objective of this study is to identify the most eco-friendly landfill site by conducting a LCA analysis upon 5 potential GIS generated sites which incorporated eleven important criteria related to the social, environmental, and economical factors. The LCA analysis utilized the daily distance covered by collection trucks among the 5 selected landfill sites to generate inventory data on total energy usage for each landfill sites. The planning and selection of the potential sites were facilitated after conducting environmental impact analysis upon the inventory data which showed the least environmental impact.
An atlanto-occipital dislocation is a rare airbag-induced injury in trauma patients. We report a case of an atlanto-occipital dislocation in a 6-year-old patient who was an unrestrained passenger in the front seat of a vehicle involved in a low-speed motor vehicle accident. This case illustrates the fatal threat of airbag deployment to the child passenger travelling in the vehicle front seat even in a low-speed collision, and supports the recommendation that children under 12 years of age travelling in vehicles with dual airbag systems should be seated in the back.
Obstructive sleep apnea (OSA) has been identified as one of the significant risk factors for motor vehicle crashes (MVCs). In the interest of public safety, this study was conducted to determine the prevalence of OSA and its associated factors among express bus drivers in Malaysia. Identifying factors or conditions related with OSA is very important because they can be used as indicators to subject a person to a confirmatory diagnosis using polysomnography testing.
A 20- year-old female student was involved in a motor vehicle accident. She sustained a severe friction injury to the left knee that resulted in considerable soft tissue and bone loss. There was also damage to the knee extensor mechanism, tibialis anterior muscle, femoral trochlea, the anterior half of the tibial plateau extending distally to the proximal tibia and skin. However, there was no crushing of the limb or resultant neurovascular deficit but cancellous bone and the remainder of the joint were exposed. Repeated surgical debridement was performed and was followed by covering of the soft tissue using a latissimus dorsi free flap and skin grafts. The bony defect was reconstituted with antibiotic bone cement to prevent flap adherence and shrinkage, enhance stability and prevent fracture. The cement was later removed at the time of arthrodesis at which time an ipsilateral double barrel vascularised fibular graft supplemented with autogenously cancellous bone and a ring fixator was used. Computer tomography confirmed union at three months post procedure. The fixator was then removed and a tibialis posterior transfer was performed.