1.Ergonomic risk assessment of manual handling tools by oil palm collectors and loaders
Nur Syazwani MN ; Baba MD ; Mohd Nizam AR ; Ezrin Hani S
Malaysian Journal of Public Health Medicine 2016;16(Supplement 2):56-60
Oil palm workers are exposed to ergonomics problems in their routine works. Although many technological advances
have been developed, a large number of workers are still using manual handling tools in their daily work. A study
was done to identify and solve the problems or issues of material handling effect on oil palm collectors and loaders
during their daily work activities. A cross sectional study was done in an oil palm plantation in Negeri Sembilan,
Malaysia. Twenty five workers were selected randomly to participate in this study. Musculoskeletal symptoms were
recorded using Modified Nordic Questionnaires and awkward postures of the workers were assessed using Rapid
Entire Body Assessment (REBA). Result showed that 61% of workers were exposed to high risk level and 39% to very
high risk level of working posture problems. In conclusion, majority of oil palm collectors and loaders need to correct
their working posture as soon as possible. The manual handling activities need to be improved with respect to
correct procedure for health and safety concerns.
2.Improvement of Urgent Tests Laboratory Turnaround Time Through Laboratory Lean Management
Salbiah Isa ; Rohayu Hami ; Hanita Hashim ; Mohd Nizam S. ; Harani MS. ; Sairi S. ; Mohd Jamsani Mat Salleh
Malaysian Journal of Medicine and Health Sciences 2020;16(Supp 2, May):15-21
Introduction: Laboratory turnaround time (LTAT) is considered a reliable indicator of the quality and efficiency of a laboratory’s service. LTAT achievement, particularly of urgent tests, remains unsatisfactory and challenging in many clinical laboratories especially in tertiary health care centres with high workload and restricted resources. The unresolved issue of unsatisfactory urgent renal profile (RP) LTAT below the standard performance goal prompted our interest to improve laboratory’s handling of urgent test request. We thus implemented the Lean principle in the management of urgent test requests using urgent RP as the test model. Methods: The implementation of laboratory Lean involved 4 steps process; (1) Development of burning platform for change (2) Identification of waste (3) Planning and implementation of control measures (4) Measuring, monitoring, and sustaining the improvement. Urgent RP LTAT and the percentage of the request met the time requirement determined based on the data extracted from laboratory information system (LIS) before and after the implementation of Lean was compared to assess the effectiveness. Results: Urgent RP LTAT after the implementation of Lean was reduced i.e 35 min (before) vs 31 min (after), with the percentage of LTAT met the time requirement was significantly increased above the set target i.e 82.8% (before) to 93.5% (after) with P-value = 0.001. Conclusion: Implementation of innovation using Lean management has significantly improved urgent RP LTAT achievement, thus optimised urgent test management in our Chemical Pathology laboratory. Lean is a strongly recommended strategy to improve urgent test LTAT especially in laboratories with restricted resources.
3.Clinical Characteristics and Outcomes in Children With Severe Multisystem Inflammatory Syndrome in Children in Malaysia: A Nationwide Cohort Study
Hing Cheong Kok1 ; Dinesh Nair1 , ; Ee Vien Low2 ; Mohd Nizam Mat Bah3 ; David Chun-Ern Ng4 ; Anis Siham Zainal Abidin5,6 ; Fu Lung Khiu7 ; Huong Nai Law7 ; Heng Kiat Pung6 ; Ke Juin Wong1 ; Kwee Ching See8 ; Putri Nor Baiti Mohamad Radzi8 ; Kwai Cheng Chan9 ; Lina Lim10 ; Deenish Muniandy11 ; Nik Khairulddin Nik Yusoff12 ; Lydia Toon Muhammad Nasrun Toon3 ; Emieliyuza Yusnita Alias3 ; Pheik Sian Choong13 ; Muhammad Syarhan Nor Hadid14 ; Haema Shunmugarajoo15 ; Prakash Rao Rama Rao16 ; Siew Moy Fong1
Malaysian Journal of Medicine and Health Sciences 2025;21(No. 1):18-26
Introduction: Early identification of patients at risk for severe multisystem inflammatory syndrome in children (MIS-C)
is essential for favourable clinical outcomes. This study aims to identify the clinical characteristics, factors and outcomes associated with severe MIS-C. Materials and methods: In this retrospective cohort study involving 14 major
hospitals in Malaysia, children <15 years who met the United States Centres for Disease Control and Prevention
case definition for MIS-C were included. Severe MIS-C was defined as children who required inotropic support,
ventilatory support (invasive or non-invasive ventilation), or left ventricular ejection fraction of <55%. The factors
investigated for severe MIS-C were demographic characteristics, the presence of comorbidities, clinical characteristics, and laboratory measures. Multivariable logistic regression was used to compute the adjusted odds ratio (aORs)
of factors associated with severe MIS-C. Results: Among the 155 patients, 91 (58.7%) presented with severe MIS-C.
Severe MIS-C was more likely in patients aged ≥5 years old (aOR 2.13, 95% confidence interval [CI] 1.08-4.21), with
dehydration (aOR 3.80, 95% CI 1.53-9.45), lethargy (aOR 2.02, 95% CI 0.97-4.18), tachycardia (aOR 8.33, 95% CI
3.27-21.22), albumin <30g/L (aOR 3.36, 95% CI 1.58-7.13), creatine kinase >200U/L (aOR 3.68, 95% CI 1.57-8.64),
D-dimer >3.0µg/mL (aOR 2.11, 95% CI 1.08-4.13), ferritin >500ng/mL (aOR 3.77, 95% CI 1.88-7.55), prothrombin
time >12.7 seconds (aOR 3.22, 95% CI 1.61-6.43), and urea >6mmol/L (aOR 5.09, 95% CI 2.04-12.71). Conclusion:
Identification of these associated factors of severity in MIS-C could aid in early recognition and prompt escalation of
care, leading to better outcomes.