Introduction: Body weight of children is affected by many factors including food habits which are influenced by their parents. Studies in the West have shown that parents tend to control child feeding in response to their child’s weight status. The aim of this study was to assess Malaysian parental concerns about child weight and the control they exert on child feeding. Methods: This crosssectional study was conducted on parents and their children aged 9 to 12 years from a primary school in Kuala Lumpur. The weight status of the children was classified according to the body mass index-for-age growth chart. Parental concerns about child weight and control in child feeding was assessed using the adapted Malay version of Child Feeding Questionnaire. Results: A total of 204 parents participated in this study. The study found that being a female served as a protective factor against becoming overweight (OR:0.28, CI:0.13-0.62). Parents with overweight children were significantly older (OR:1.08, CI:1.01-1.15), concerned about their child’s weight (OR:2.77, CI:1.49-5.12) and controlled their child’s feeding by restricting food intake(OR:2.70, CI:1.30-5.60). They were less likely to pressure their children to eat (OR:0.32, CI:0.19-0.56). Parents from the low income group were more likely to have underweight children (OR: 4.15, CI:1.28-13.47). Conclusion: There was significant difference in level of parental concern across differing child weight status. Parents with overweight children were likely to be more concerned about their child’s weight, tending to control their feeding. In contrast, parents with underweight children did not exert control on their feeding.

Rail maintenance routines are necessary to enable the all rail operations to achieve its aim in maintaining a safe and efficient operation. The maintenance tasks expose the workers to vibration and noise, as they handle specialized machineries and heavy self-propelled vehicles. Exposure of noise above the permissible exposure limit and over the daily allowable duration may cause noise-induce hearing loss (NIHL). Investigation on the type of task that has high noise level exposure on the maintenance workers was conducted to justify the needs to further detailed of this study. This paper will describe the task analysis on maintenance workers and to identify possible tasks with exposure to high level of noise. It scopes down to grinding crew of the maintenance department of light rail transit. Methods used were real-time sound measurement using a sound level meter, observation and interviews. Then, data were analysed to understand the situation of exposure of noise during rail maintenance. An ergonomic risk assessment was also conducted by adoption of the latest guideline on Ergonomic Risk Assessment (ERA) at Workplace Guidelines recommended by Department of Occupational Safety and Health (DOSH), Malaysia. A hierarchical task analysis (HTA) was generated on the task of the maintenance worker, focusing on rail grinding crew. The newly generated HTA had allowed better understanding about the nature of work and the task conducted by a rail grinder during the work shifts. Tasks involving high noise level was identified. Data recorded shows that the noise level for the blowing activity was relatively high and exceeded the permissible exposure limit of 90dBA. The exposure level was currently controlled by practicing the usage of hearing protection equipment (HPE) and by controlling exposure time in accordance to recommendations of the Factory and Machinery Act (FMA). Thus, it had confirmed that maintenance workers were exposed to high noise levels when performing their daily task. Further studies are needed to investigate the relationship between the duration of exposure and noise-induce hearing loss (NIHL) with consideration of the lifestyles of the maintenance workers.

Pedestrians’ fatality trend in road crashes has been improving in recent years though it remains third in rank behind motorcyclists and car occupants. Based on the statistics, young pedestrians were the most affected group and the commonest injury regions were head and legs. Pedestrian crashes occurred primarily in rural areas and straight roads and at low light environment, and often involve cars and motorcycles. In addition to existing issues of careless and illegal crossing practices, there are potential new hazards face by pedestrian, which are mobile electronic device use and electric vehicle, especially when crossing roads. Road safety programs and interventions shall consider these new issues.
pedestrian safety ; pedestrian distraction ; Malaysia

BACKGROUND: A variety of island flaps can be based on the superficial temporal artery with variable tissue composition. They can be used for defect reconstruction, cavity resurfacing, facial hair restoration, or contracture release. METHODS: Seventy-two patients underwent facial reconstruction using a superficial temporal artery island flap from October 2010 to October 2014. The defects had various etiologies, including trauma, burns, tumors, exposed hardware, and congenital causes. We classified the patients by indication into 5 groups: cavity resurfacing, contracture release, facial hair restoration, skin coverage, and combined. The demographic data of the patients, defect characteristics, operative procedures, postoperative results, and complications were retrospectively documented. The follow-up period ranged from 24 to 54 months. RESULTS: A total of 24 females and 48 males were included in this study. The mean age of the patients was 33.7±15.6 years. The flaps were used for contracture release in 13 cases, cavity resurfacing in 10 cases, skin coverage in 17 cases, facial hair restoration in 19 cases, and combined defects in 13 cases. No major complications were reported. Conclusion: Based on our experiences with the use of superficial temporal artery island flaps, we have developed a detailed approach for the optimal management of patients with composite facial defects. The aim of this article is to provide the reader with a systematic algorithm to use for such patients.
Burns ; Contracture ; Female ; Follow-Up Studies ; Hair ; Humans ; Male ; Reconstructive Surgical Procedures ; Retrospective Studies ; Skin ; Surgical Flaps ; Surgical Procedures, Operative ; Temporal Arteries*

INTRODUCTIONAn investigation was carried out to determine the morphological characteristics of fibroblasts in two portions of the vocal fold (VF) mucosa, the macula flava (MF) and Reinke's space (RS), of three different age groups: newborns, adults and geriatrics.

METHODSNormal human VF obtained from autopsy cases were included in this study: four from mature newborns; four from middle-aged adults; and four from geriatric cases. Fibroblasts in RS and MF were investigated by transmission electron microscopy.

RESULTSThe fibroblasts of the MF in both adults and newborns tended to be stellate in shape, with a small nucleus/cytoplasm (N/C) ratio and a well-developed rough endoplasmic reticulum (rER) and Golgi apparatus (GA). Most of the fibroblasts present in RS were oval in newborns and spindle-shaped in adults, with a large N/C ratio and less developed rER and GA. The majority of fibroblasts of the geriatric MF were stellate in shape; while in geriatric RS, the majority of fibroblasts were spindle-shaped with an N/C ratio of 0.5 to 2.0 as in the case of adults. However, the development of rER and GA was less marked in geriatrics than in adults.

CONCLUSIONHistological changes of fibroblasts in the VF mucosa are one of the important causes of the change in voice quality with ageing. Furthermore, geriatric changes in the vocal ligament can be attributed to the activities and the presence of ageing processes in fibroblasts of geriatric VF mucosa.

Adult ; Age Factors ; Aged ; Cell Nucleus ; ultrastructure ; Cytoplasm ; ultrastructure ; Endoplasmic Reticulum ; ultrastructure ; Female ; Fibroblasts ; ultrastructure ; Golgi Apparatus ; ultrastructure ; Humans ; Infant, Newborn ; Laryngeal Mucosa ; ultrastructure ; Male ; Microscopy, Electron, Transmission ; methods ; Vocal Cords ; ultrastructure

Objective: To investigate the antioxidant, antibacterial, and chemical ingredients of Ardisia elliptica (A. elliptica) methanolic extracts. Methods: The plant was extracted using methanol. Antibacterial and antioxidant activ-ities were evaluated. Results: The results showed that both fruit and leaf extract of A. elliptica have significant antibacterial activities against Gram-positive and Gram-negative bacteria. Fruit extracts showed higher content of phenolic (71 ± 0.03 GAE/mg extract dry weight), in com-parison to the leaf extracts (37 ± 0.05 GAE/mg extract dry weight). Flavonoid content, and Fe2+chelating activity of fruit extracts were higher than leaf extract. The percentage radical inhibition of fruit extract is found to be higher (70%) than that of leaf extract (60%). LCMS results indicated that the major compounds in the fruit extract were Gingerol, Aspidin, Kampherol, and Stercuresin, while the leaf extract contained Gingerol, Aspidin, Triangularin, and Salicyl acyl glucuronide. Furthermore, the results of GCMS indicated that fruit extract contained these major compounds:Vitamin E Tocopherol, 5-hepylresornicol, 2-Nonylmalonic acid, 5-pentadecylresornicol, and Stigmasta-7-22-dien-3-ol. However, leaf extract of A. elliptica contained these major compounds: Alpha Amyrenol, 4,4, 6, 6a, 6b, 8, 8a, 9,10, 11,12,12a, 14, 14a, 14b octadehydro-2H-picen-3-one, and Lonasterol, 4-t-Butyl-2-[4-nitrophenyl] phenol. Conclusions: The results provide evidence that fruit and leaf of A. elliptica extracts might indeed be used as a potential source of effective natural antimicrobial and anti-oxidant agents in pharmaceutical and food industries.

We report a case of a healthy 78 -year- old indonesian man who presented with chronic weight loss, poor appetite and lethargy. CT abdomen showed bilateral adrenal masses. EUS – guided FNA was performed on the left adrenal gland. Histopathology report was Histoplasma Capsulatum. He recovered well with antifungal treatment without any complication. In this case, we found that the role of EUS – guided FNA was not only limited to diagnosis but also helped in the prognosis of the disease since the method was able to assess the general anatomy of the adrenal gland better than other imaging modalities due to its close proximity and direct visualization.

We report a case of a healthy 78-year-old indonesian man who presented with chronic weight loss, poor appetite and lethargy. CT abdomen showed bilateral adrenal masses. EUS-guided FNA was performed on the left adrenal gland. Histopathology report was Histoplasma Capsulatum. He recovered well with antifungal treatment without any complication. In this case, we found that the role of EUS -guided FNA was not only limited to diagnosis but also helped in the prognosis of the disease since the method was able to assess the general anatomy of the adrenal gland better than other imaging modalities due to its close proximity and direct visualization.

Background: and Purpose Repetitive transcranial magnetic stimulation (rTMS) of the cerebellar hemisphere represents a new option in treating essential tremor (ET) patients. We aimed to determine the efficacy of cerebellar rTMS in treating ET using different protocols regarding the number of sessions, exposure duration, and follow-up duration. Methods: A randomized sham-controlled trial was conducted, in which 45 recruit patients were randomly allocated to 2 groups. The first (active group) comprised 23 patients who were exposed to 12 sessions of active rTMS with 900 pulses of 1-Hz rTMS at 90% of the resting motor threshold daily on each side of the cerebellar hemispheres over 4 weeks. The second group (sham group) comprised 22 patients who were exposed to 12 sessions of sham rTMS. Both groups were reassessed at baseline and after 1 day, 1 month, 2 months, and 3 months using the Fahn-Tolosa-Marin tremor-rating scale (FTM). Results: Demographic characteristics did no differ between the two groups. There were significant reductions both in FTM subscores A and B and in the FTM total score in the active-rTMS group during the period of assessment and after 3 months (p=0.031 and 0.011, respectively).However, subscore C did not change significantly from baseline when assessed at 2 and 3 months (p=0.073 and 0.236, respectively). Furthermore, the global assessment score was significantly higher in the active-rTMS group (p>0.001). Conclusions Low-frequency rTMS over the cerebellar cortex for 1 month showed relative safety and long-lasting efficacy in patients with ET. Further large-sample clinical trials are needed that include different sites of stimulation and longer follow-ups.