This study aims to determine the job satisfaction (JS) level among professional driving instructors (PDIs) in the driver training and licensing system in Malaysia. Specifically, it looks at the influence of income level and remuneration scheme on PDI’s satisfaction. The average income of PDI is relatively low with three remuneration schemes: fixed income; fixed income plus commission; and commission only. The study adopted the cross-sectional survey using the 20-item Minnesota Job Satisfaction Questionnaire (MSQ) (short-form) with end-specified 10-point scale. Analysis of the data revealed that PDIs with higher income are more satisfied with their job, t (179) = -3.248, p = 0.001. Similarly, three level One-way ANOVA of JS scores with three remuneration schemes revealed a significant difference of JS across these schemes, F (2,178) = 3.51, p ≤ 0.032. Researchers’ further exploration found a significant interaction between these two variables (income level vs. remuneration scheme), F (5,175) = 4.88, p = 0.001. In general, PDIs with higher income are more satisfied with their job only if they received it as a fixed income (regardless of having commission or not). This insightful finding can be a basis for relevant stakeholders in understanding the influence of income and remuneration scheme towards JS among PDIs in Malaysia.
Job satisfaction ; professional driving instructor ; driver training ; driver licensing ; Malaysia

Massive haemoptysis can occur in lung abscess. Massive haemoptysis itself may be life threatening due to asphyxiation or respiratory failure secondary to acute large airway obstruction by blood clots. Prompt removal of the obstructing blood clots save life. We describe a case of lung abscess causing massive haemoptysis resulting in acute airway obstruction which required rigid bronchoscopy to remove the huge blood clot. (JUMMEC2010; 13(2): 107-110)
Bronchoscopy

This study evaluates the cytotoxic and mutagenic effect of synthetic hydroxyapatite granules (source: School of Material and Mineral Resources Engineering, Universiti Sains Malaysia) in the bone marrow cells of mice. Mice are exposed to synthetic hydroxyapatite granules, the bone marrow cells are collected and observed for chromosome aberrations. No chromosome aberrations were noticed in the animals exposed to distilled water (negative control) and to the test substance, synthetic hydroxyapatite granules (treatment) groups. Chromosome aberrations were observed in the animals exposed to Mitomycin C (positive control group). There was no indication of cytotoxicity due to synthetic hydroxyapatite granules in the animals as revealed by the mitotic index. Hence, synthetic hydroxyapatite granules are considered non-mutagenic under the prevailing test conditions.
Bone Marrow Cells/*drug effects ; Bone Substitutes/*toxicity ; *Chromosome Aberrations ; Durapatite/*toxicity ; *Mutagenicity Tests

The present study is aimed at finding the mutagenicity and cytotoxicity of dense form of synthetic hydroxyapatite (Source: School of Materials and Mineral Resources Engineering, Universiti Sains Malaysia) in the blood of sheep. The biomaterial was implanted in the tibia of Malin, an indigenous sheep breed of Malaysia. Blood was collected from the sheep before implantation of the biomaterial, cultured and a karyological study was made. Six weeks after implantation, blood was collected from the same animal, cultured and screened for chromosome aberrations. The mitotic indices and karyological analysis indicated that the implantation of synthetic hydroxyapatite (dense form) did not produce any cytotoxicity or chromosome aberrations in the blood of sheep.
Biocompatible Materials/*toxicity ; Bone Substitutes/*toxicity ; Bone and Bones/pathology ; Cell Survival/drug effects ; *Chromosome Aberrations ; Hydroxyapatites/*toxicity ; Karyotyping ; *Mutagenicity Tests ; *Prostheses and Implants ; Sheep

Abdominal obesity (AO) is an independent risk factor for cardiovascular disease, hypertension and diabetes mellitus in adults. There is a lack of data on the magnitude and socio-demographic profile of AO among Malaysian adults at the national level. In the Third National Health and Morbidity Survey (NHMS III) conducted in 2006, AO of adults aged 18 years and above was determined based on the waist circumference as part of the nutritional status assessment. This article reports the prevalence of AO in relation to socio-economic factors and demographic characteristics of adult subjects. Out of a total of 33,465 eligible individuals 18 years and above, waist circumference was measured in 32,900 (98.3%) individuals. The prevalence of AO was assessed using the cut-off points recommended by World Health Organization. The mean waist circumference in men and women was 84.0cm [95% confidence interval (95% CI): 83.8, 84.3] and 80.3cm (95% CI: 80.1, 80.6) respectively. The national prevalence of AO was 17.4% (95% CI: 16.9, 17.9). The identified risks of AO were women (OR: 4.2, 95% CI: 3.8, 4.6), aged 50-59 years (OR: 5.6, 95% CI: 4.0, 7.7), Indians (OR: 3.0, 95% CI:2.4, 3.8), housewives (OR: 1.4, 95% CI: 1.1, 1.7), subjects with primary education (OR: 1.3, 95% CI: 1.1, 1.5) and ever married (OR: 1.4, 95% CI: 1.2, 1.6). Being the largest population-based study on AO among Malaysians, these findings have important public health implications. There is an urgent need to revise public health policies and programmes aimed at prevention of abdominal obesity especially in the groups at risk.

Osteomyelitis is a chronic infection of bones. Eradication of bone infection is usually with antibiotics and debridement, but it is slow and the infection can recur even after many years. It is now established that osteomyelitis is due to biofilm and a better understanding of the process is required. We review the development of biofilm and apply it to osteomyelitis management. The planktonic microbes' response to adverse conditions is the formation of biofilm. Bacterial infections in planktonic forms cause infections that can be controlled with antibiotics and immunisation, however the same microbe when its phenotype becomes biofilm is more resilient. The understanding of how planktonic bacteria convert to biofilm is one of the aims set out for this article.

Locked pubic symphysis is a rare form of pelvic injury that usually occurs after a lateral compression injury to the pelvis, where the intact pubis is trapped behind the contralateral pubis. To the best of our knowledge, there were 25 similar cases reported in the English literature since it was first described in 1952. We present a case of locked pubic symphysis with a left iliac wing fracture and a left femur shaft fracture requiring open reduction and internal fixation. We also reviewed previous reported cases of locked pubic symphysis and analysed the pattern of presentation and guide to management of such injuries. We propose a classification system for grading overlapping pubic symphysis that will provide a better guide to the management of such injuries

Objectives: To facilitate clinical and translational research, imaging and non-imaging clinical data from multiple disparate systems must be aggregated for analysis. Study participant records from various sources are linked together and to patient records when possible to address research questions while ensuring patient privacy. This paper presents a novel tool that pseudonymizes participant identifiers (PIDs) using a researcher-driven automated process that takes advantage of application-programming interface (API) and the Perl Open-Source Digital Imaging and Communications in Medicine Archive (POSDA) to further de-identify PIDs. The tool, on-demand cohort and API participant identifier pseudonymization (O-CAPP), employs a pseudonymization method based on the type of incoming research data. Methods: For images, pseudonymization of PIDs is done using API calls that receive PIDs present in Digital Imaging and Communications in Medicine (DICOM) headers and returns the pseudonymized identifiers. For non-imaging clinical research data, PIDs provided by study principal investigators (PIs) are pseudonymized using a nightly automated process. The pseudonymized PIDs (P-PIDs) along with other protected health information is further de-identified using POSDA. Results: A sample of 250 PIDs pseudonymized by O-CAPP were selected and successfully validated. Of those, 125 PIDs that were pseudonymized by the nightly automated process were validated by multiple clinical trial investigators (CTIs). For the other 125, CTIs validated radiologic image pseudonymization by API request based on the provided PID and P-PID mappings. Conclusions We developed a novel approach of an ondemand pseudonymization process that will aide researchers in obtaining a comprehensive and holistic view of study participant data without compromising patient privacy.

Introduction: Reverse total shoulder arthroplasty provides a surgical alternative to standard total shoulder arthroplasty for the treatment of cuff tear arthropathy, arthritis and fracture sequelae. This study aimed to assess the short-term outcomes following reverse total shoulder arthroplasty for patients in a large public hospital in Malaysia. Materials and Methods: We identified and performed five primary reverse total shoulder arthroplasties between 1 May 2019 and 1 June 2020. All patients were contactable and available for analysis. Assessment of functional outcomes was performed using the Constant-Murley score, the patient satisfaction score (PSS), and imaging studies. The mean follow-up from operation to the time of reporting was 9.6 months (range, 3 to 14 months) Results: The median age for our patients was 58 years (±11.91). The most common indication for surgery was posttraumatic arthritis, followed by rotator cuff arthropathy and osteoarthritis. The mean Constant score improved from 9.0 pre-operatively to 52.3 post-operatively at a mean of 9.6 months. The majority of the patients were satisfied with the surgery as the post-operative range of motion, especially anterior elevation and abduction, improved in four of our patients and there were no short-term complications, for example, of infection or revisions, reported at the last followup. Conclusion: This study has shown that reverse total shoulder arthroplasty can yield good short-term outcomes for the treatment of complex shoulder problems in addition to cuff tear arthropathy. It should be considered a treatment for rotator cuff tears, severe arthritis and ≥ 3 parts proximal humeral fractures.

We report the outcome following arthroscopic ACL reconstruction combined with a Modified LeMaire procedure in a patient who underwent multiple surgeries following an open ipsilateral femoral fracture and an above knee amputation of the contralateral limb at the time of initial trauma. This case highlights the importance of achieving ligamental stability in the contra-lateral limb in aiding proper rehabilitation following amputation and the potential pitfalls of retrograde femoral nailing.