The purpose of this study was to determine the level of ergonomic knowledge and safety among contractor of a selected construction site located in Georgetown, Penang. The study also tried to identify the restrictions in imple- menting ergonomic and safety programs in the workplace. Prior to the study, a field investigation were conducted by the researcher and the researcher found out that workers are practicing poor body posture in the site and thus decided to conduct this study. Data were collected primarily from a questionnaire and the data were analyzed using Mann-Whitney test due to the small sample size which only involved 35 respondents. Results from the study shows respondents have high in ergonomic knowledge (p=0.962,>0.05). Several factors restricting the implementation of ergonomic programs are “lack of management support” and “lack of information and training”.
Cases of penile siliconoma are unusual and less commonly present to medical practitioners. The siliconoma is a subsequence of injecting high viscous solution into the penis; commonly sillicone with the aim to enhance its size and performance. This case will look at a patient who developed penile siliconoma after a dubious penile implant injection gone wrong. It will also look at what surgical options are available to the unfortunate patients to ease their suffering. Physician should have a high index of suspicion on the use of such substances to enhance sexual perfor- mances in patients presenting with atypical penile swelling.
Introduction: A cross-sectioned study was carried out on 1016 drug addicts from Johor state to better understand their profile.
Method: A structured questionnaire prepared in three languages was used to collect the data which was analyzed using the Statistical Package for Social Sciences.
Result & Discussion: The overall mean age of the respondents was 33.8 (95% CI= 33.3 - 34.4) years and ranged from 16 to 61 years. ANOVA post hoc multiple comparison tests showed that there was a significant difference in the mean age between Malays and Chinese (p<0.05). The majority of the respondents were Malay (79.6%) and had secondary education (72.1%) or primary education (21.7%). The majority (79%) was either semi-skilled or unskilled. More than 70% had mores than five siblings. About 36% of the respondents had past a history of discipline problem at school. The majority (99.6%) of the drugs addicts had smoked before and more than 90% were currently smoking. More than 80% had consumed alcoholic beverages. The majority did not use condom when they had sex. Only 24% stated that they did use a needle or syringe that had previously been used by someone else. Less than 4% had either bleached or boiled the needle or syringe that had previously been used by someone else. About 17% were tested positive for HIV. The mean age at which the respondents first started injecting drugs was 21.5 (95% CI= 20.7 - 22.2) years. ANOVA post hoc multiple comparison tests showed that there was no significant difference in the mean age of the different ethnic groups at which the respondents first started injecting drugs. The majority (84.2%) of the drug addicts started injecting drugs between 10 and 20 years of age. Friends introduced 80% of the drug addicts to drugs. The common reasons given for first taking drugs was " I was curious about the feeling of taking drugs (43.6%), "my friends asked me to try" (23.4%), "to release tension" (15.6%) and 5% stated "to try for fun", and 3% that they were "depressed". The majority (64.2%) of the drug addicts spend RM 500 or more per month on drugs and more than 10% of them spend as much as RM 1000 or more per month.
Conclusion: These results indicate an urgent need for a more comprehensive prevention program involving family, schools, commmunities and the media and aimed at reducing drug abuse. Keywords: Profile, drug addicts, Malaysia
Introduction: Most research has primarily focused on the influence of patients' beliefs on medication adherence in non-aboriginal populations. This study compared medication beliefs among aboriginal and non-aboriginal patients with hypertension and/or diabetes mellitus, predictors of medication beliefs, and their impact on medication adher- ence. Methods: A prospective cohort study was conducted using the Beliefs about Medicines Questionnaire-Specific on a randomly selected sample of 38 patients for each group. Medication adherence was measured by pill counts and prescription refill history. Results: Over half of the aboriginal and non-aboriginal patients believed that the med- ications are necessary for their health. In particular, aboriginal patients had higher necessity score (mean 21.32, SD 2.90) than non-aboriginal patients (mean 19.45, SD 3.68, p
Introduction: Despite advancement of treatment modalities, Tuberculosis (TB) treatment interruption rate has glob- ally accelerating, calling for greater framework shifting towards psychosocial intervention. Similarly, Selangor state had reported the perturbing TB treatment interruption rate, which was figured persistently above 10% in the interval year of 2014 to 2018, thus signifies an empirical assessment on Information-Motivation-Behavioural skills (IMB) determinants of TB intensive phase treatment. This study aims to determine the time to intensive phase TB treatment interruption and its prognostic factors among newly diagnosed pulmonary Tuberculosis (PTB) smear positive patients in urban district Selangor. Methods: A multi-centric prospective cohort study will recruit 695 newly diagnosed PTB smear positive patients at treatment centres in urban districts, Selangor. This study will utilize validated self-admin- istered questionnaire and standardised data collection form (PROFORMA). At baseline, we will elicit information on IMB models constructs, additionally on socio-demographics, health service factors and clinical characteristics. Meanwhile, four points follow up will be executed to retrieve information on treatment status and time varying effects of body weight, treatment side effects, symptoms improvement and internalised stigma. Finally, survival analysis will be computed to identify the time to intensive phase treatment interruption and its prognostic factors. Conclusion: This study will enlighten IMB model determinants of intensive phase treatment interruption, hence to endeavour psychosocial elements in designing time relevant public health strategies in TB case management.
The transwell migration assay is commonly used for assessing cell migration. It involves the enumeration of cells that
have migrated across a pore-containing membrane. We describe a randomised approach to quantifying migrated
cells and compare it to a conventional full cell count. We used ATP as a chemoattractant and automatic cell quantification performed on all fields (Full count; FC) or 10 randomly selected fields (Randomised count; RC). The two
methods were compared by evaluating standard deviations (SD), coefficient of variation (CV) and using the Bland-Altman analysis. The dispersion of data is higher with the RC approach (3.77-6.66% CV for control; 3.89-4.48% CV
for ATP-treated wells) compared to FC (0.27-0.46% CV for control; 0.05-0.09% CV for ATP-treated wells), but are
acceptable considering that the number of migrated cells are in the thousands. Both methods verified that an ATP
migration assay for BV2 microglia was established, demonstrating that the RC approach is reliable and comparable
to a full count.
Pneumonia is a common lung infection. Common bacterial cause of this serious lung infection includes Streptococcus pneumoniae, Haemophilus influenzae and Mycoplasma pneumoniae. Haemophilus parahaemolyticus pneumonia is an uncommon cause of bacterial pneumonia, occurring mainly as an opportunistic pathogen in immunocompromised patients as in this case, diabetes mellitus. Therefore, this case report will look at a case of 49-year-old man who was diagnosed with this uncommon pathogen which was successfully eradicated with antibiotics. This case report will look at a case of 49 years old who was diagnosed with this uncommon pathogen which was successfully eradicated with antibiotics.
Introduction: Artemether and lumefantrine was registered as Riamet in Switzerland in 1999 and is commonly used in Keningau Hospital for managing uncomplicated malaria. Riamet works at the food vacoule of the malarial parasite, where they interfere with the conversion of heme into haemozoin. Case description: We report a case of Riamet induced prolonged corrected QT interval (QTc) in a 37 year old gentleman admitted for severe malaria (hypotension) with normal QTc of 420msc on presentation. Upon starting Riamet, he developed bradycardia and ECG showed sinus bradycardia with prolonged QTc of 551msec and no arrythmias. Echocardiography showed no structural heart abnormalities. All electrolytes were within normal range. He was monitored in cardiac care unit with decision to complete 6 doses of Riamet. Patient was started on Dopamine infusion which maintained his blood pressure and heart rate within normal range. 5 days post Riamet completion, his heart rate improved and dopamine infusion was tapered off and QTc normalized to 407msc. Discussion: The most common mechanism of drugs causing QT inter-val prolongation is by blocking the human ether-à-go-go related gene (hERG) potassium channel. Blockage of the hEGR channel lengthens ventricular re-polarization and duration of ventricular action potential which is reflected in ECG as prolonged QT interval. In the in-vitro whole cell patch clamp study, lumefantrine and its metabolite desbu-tyl-lumefantrine showed a concentration-dependent inhibition of the hERG current. The period of QTc prolongation was 3.5 to 4 days after the last dose of the standard 6 dose regimen. Conclusion: Riamet induced prolonged QTc is a very rare complication. A baseline electrocardiography is therefore imminent for every patient prior to initiation of this medication to avoid cardiac arrythmias.
Introduction: Tuberculosis (TB) of the elbow joint is uncommon. Prompt diagnosis and treatment are important to prevent joint destruction and preserve function. We present a case of TB synovitis of the elbow joint in a patient with active rheumatoid arthritis (RA). Case description: A 56-year-old woman with a known seropositive RA on metho-trexate and Leflunomide was seen in the outpatient rheumatology clinic as part of her monthly follow-up. She com-plained of persistent bilateral elbow pain and swelling, despite optimisation of her disease-modifying antirheumatic drugs (DMARD) and steroid therapy. The suspicion for another diagnosis for her elbow symptoms stems from the persistent pain and swelling amidst increased titration of methotrexate and prednisolone dosages. Ultrasound scan of her elbows revealed bilateral complex olecranon bursitis with active synovitis. The left elbow aspiration yielded cloudy yellowish synovial fluid and the sample was sent for fluid culture, acid-fast bacilli (AFB) stain, and GeneXpert. No AFB was seen but the GeneXpert test confirmed the presence of Mycobacterium Tuberculosis. Thus, a diagnosis of TB synovitis of the left elbow was made, and she was promptly started on anti-tubercular therapy (ATT) consisting of Rifampicin, Isoniazid, Ethambutol and Pyrazinamide with the aim to complete 9 months of ATT. Conclusion: The diagnosis of tuberculous synovitis is challenging. In the absence of constitutional or respiratory symptoms, joint TB is usually low on the initial differential diagnosis in patients presenting with joint pain and swelling. The diagnosis is made even more difficult in patients with concomitant rheumatoid arthritis. This case demonstrates the importance of a high index of suspicion for TB, particularly when evaluating patients in high TB prevalence area with an underlying immunosuppressive state.
Sarcoidosis is characterized by formation of inflammatory granulomas affecting all over the body, with pulmonary predilection (1). Neurosarcoidosis is a rare but potentially dangerous manifestation of sarcoidosis. We report a case of disseminated sarcoidosis presenting with a neurological diagnostic dilemma. Worsening mediastinal lymphade- nopathy, together formation of lung and liver nodules making a sarcoidosis diagnosis favourable. Histology from these lesions showed non-caseating granulomatous inflammation. She was treated as a rare case of disseminated sarcoidosis. To date, there is no specific or clear guideline on the management of disseminated sarcoidosis.
A 2-year-old girl who was under genetic follow up for developmental delay and dysmorphism was accidentally found to have bilateral optic disc swelling during screening examination. She showed response to optokinetic drum examination and the anterior segment examination was unremarkable. Optic disc swellings were seen in both eyes. Lumbar puncture shows high opening pressure of 50 cm H2O with unremarkable CSF analysis. MRI of brain was done and showed features in keeping with mild cerebral atrophy, with no evidence of hydrocephalus or space oc- cupying lesion. She was diagnosed with idiopathic intracranial hypertension and oral acetazolamide 125mg bd was commenced. However, papilloedema persist despite medical therapy. Ventriculoperitonel shunt was inserted to re- duce the csf pressure. This case report highlights the importance of considering idiopathic intracranial hypertension as a cause of optic disc swelling in pre-pubertal children because delay in diagnosis and treatment may permanently affect visual function especially in children.
The incidence of neurenteric cyst (NC) is rare amongst spine tumors. It is most often asymptomatic but may present
with sensory and motor symptoms. When associated with thoracic vertebra fusion it is not reported before, this complicates the placement of pedicle screw during posterior instrumentation. Herein, we report a case of thoracic spinal
neurenteric cyst in a 40-year-old man that presents with chronic back pain, left lower limb weakness and numbness.
Elective excision of NC over T6-T7 with laminectomy and multilevel posterior instrumentation was successfully
performed with significant improvement of the symptoms. Neurenteric cyst is a rare spinal cord lesion which may
cause permanent neurological sequalae. Complete surgical excision with spine fixation in this case provides good
long-term outcome.
Leech infestation in otolaryngology is sporadically seen in
remote area of tropical countries, but the cases are usually not
scientifically reported. We are reporting an unusual case of a
land leech removal from external auditory canal (EAC).
Introduction:Gliosarcoma is a rare malignant brain tumor. The clinical presentation is acute with rapid progression of symptoms. Commonly affecting the elderly, it is rare to happen in youngsters. Case description: A 28-year-old radiographer presented to us with two episodes of unprovoked seizure. He denied any medical illnesses, or trauma, fall, motor vehicle accident and fever prior to these attacks. The computed tomography (CT) of brain was normal. He was managed as epilepsy and remained symptom-free for 3 years until the unprovoked seizure recurred. Another CT of brain performed and revealed a right parietal intracranial mass. This finding was supported by magnetic reso-nance imaging scan. The histologic examination showed a biphasic pattern of glial with predominant sarcomatous component giving a diagnosis of gliosarcoma of the brain. He had completed six cycles of adjuvant chemotherapy and was asymptomatic during clinic follow up with no tumor recurrence. Conclusion: Individuals with high risk of radiation exposure particularly radiographer as in our case requires a special attention when it comes to the diagnosis of malignancy. Despite of indolent clinical presentations, a close monitoring is needed to avoid mismanagement and subsequent morbidities.
Parotid tumours represent one of many groups of tumours in the field of
Otorhinolaryngology. However, a local demographical evaluation of parotid tumours and its annual incidences has never been undertaken. This study intends to review local demography in relation to incidence of parotid tumour seen in Otorhinolaryngology (ORL) clinic, Hospital Tuanku Ja’afar Seremban, Negeri Sembilan from the year 2007 till 2012. Methods: A retrospective demographical study on parotid cases seen in ORL clinic, Hospital Tuanku Ja’afar Seremban between 2007 till 2012 involving 56 cases. Data that was collected include patient details, facial nerve involvement on presentation, type of surgery performed, site of tumour, facial nerve injury post operation and final histopathological diagnosis. Results: An average of 10 cases per year was noted from 2007 to 2012. Male to female ratio was found to be 1.4:1. Age range of sample population were 9 to 79 years old with a mean age of 47 at time of diagnosis. Superficial lobe was found to be the most common tumour site (63%). Majority of cases consists of benign tumours in 51 out of 56 cases with Warthin’s tumour and Pleomorphic Adenoma being the most common histopathological finding. Post operative facial nerve injury were noted in 17 cases in which 13 cases were temporary while 4 others were permanent.
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.
Introduction: One of the biggest global health threats of the 21st century is climate change It is so catastrophic that the climate action has been given a platform as it is the 13th goal of the 17 United Nations Sustainable developmen-tal goals (SDG). This review seeks to understand the factors causing climate change, followed by understanding the impact it has on individual and population health. We also identify the strategies to control and prevent further cli-mate change. Methods: Reviews of local and international articles from the past ten years was conducted. The focus of the review was the causes, health effects as well as strategies. Data base used was Pro Quest. Results: This re-view identified that the main contributor to climate change are man-made activities such as fossil fuels combustion, livestock farming, and deforestation. This change in climate has many repercussions from mass migrations, increase communicable diseases as well as an increase in extreme weather events and natural disasters. All this eventually leads to the deterioration of individual and population health. Strengthening adaptivity to climate-related hazard, climate change integration into national policies, education, awareness-raising, impact reduction and early warning are actions that are present in Malaysia to manage this crisis. Conclusion: Climate change is occurring globally, and its presence can no longer be denied. Actions have been put forth, but only when its importance and impact is taken seriously will the positive changes be sustainable.
Prisoner tend to be marginalized and deprived that it burdens them with psychological trauma, predominantly depression. This review will identify the determinants of depression among adult inmates. Literatures published from 2012 to March 2017 were searched from various databases. Inclusion criteria were English full text, adults with a diagnosis of depression while exclusion criteria were diagnostic instruments, clinical or drug trials. The review adhered to Preferred Reporting Items for Systematic Review and Meta-Analyses: The PRISMA Statement reporting. A total of 168 studies were identified although only 14 studies were eligible for final review. Factors associated with inmates’ depression range from the potentially modifiable to non-modifiable. Recognized modifiable factors were psychological, family support, and environment while non-modifiable were biological, demographic, individual, and social. Determinants identified should be addressed in formulation of better targeting therapy, in terms of both prevention and treatment of depression among inmates.
Introduction: Malaysia has been nominated among the top four well-established healthcare system in the world. However, with the status of a developing country, there are still lacking in offering healthcare services and aware-ness among poverty. The objective of this review is to look into the factors hindering healthcare coverage in poverty. Methods: These literature reviews were carried out by using the electronic databases included, Google Scholars, Medline, PUBMED and EBSCOhost. Results: In current economic status, poverty status needs to be revised as the cost of living has markedly increased especially in the urban. Many factors affect the health status, which include the issues in term of rising health expenditure, demography-geography and imbalance workload distribution. Less expo-sure to health and wellness and geographical-demographic profile are the main reasons for the lack of self-awareness in assessing health services. Various actions had been taken by the stakeholders to improve health statuses such as telehealth, referral system and integration between agencies. Suggestion to improve the existing plan with the atten-tion given especially in the rural area which composed of multi-ethnicity and demography-geographical distribution. In Islam, Prophet Muhammad PBUH promotes health through his eating habits, physical activities include prayer and sports, proper sleep habit and through fasting. Conclusion: Poor and lack of awareness of healthcare services and health ownership have been the main reason for low health-seeking in poverty. Factors such as rising health expenditure, demography-geography factors and lack of facilities provided and unbalance workload distribution in the public-private sector contribute to the issue of concern.