As Malaysia races towards a developed nation status, children are increasingly being ferried daily in vehicles almost exclusively as the majority of the population are able to afford private transportations. This paper reviews the current safety concerns for children whilst going in vehicles on Malaysian roads and the steps undertaken to address the need to enhance children’s safety whilst going in these vehicles and suggest possible remedial action to counter the possible lack of awareness for children’s safety whilst in these vehicles. This paper focuses on children on motorcycles and private vehicles (cars, vans and multi-purpose vehicle (MPV)) and excludes other form of transport (buses, lorries) as this paper tries to put forth measures that can be undertaken by the children’s parents and guardian to better enhance the safety of their children. A search was undertaken of all the major database of articles. Articles related to children’s safety systems, children related injuries, children related accident data, available laws and legislation were reviewed to present the need for greater awareness of children’s safety while going in vehicles in Malaysia. There are currently already safety legislations, measures, steps and equipments in place in ensuring the safety of children whilst going in vehicles on Malaysian roads. However, enforcement of laws in developing countries are not easy and we have to start at the root of the problem which is the parents and adults who ferry these children in vehicles. There is a pressing need to educate parents and adults alike on the urgent undertaking of child safety whilst in vehicles. Engineering countermeasures and intervention are probably needed to protect these vulnerable users. For vehicles, a device capable of providing some sort of protection to the child whilst riding pillion should be designed and developed. A legislation mandating the use of child seats whilst ensuring the child seats are affordable to the masses.
Children ; safety ; vehicles ; Malaysia ; awareness ; protection

Discomfort due to riding a motorcycle is an issue that need to be addressed as it has long-term effects of musculoskeletal disorders on motorcyclists especially among occupational motorcyclist. Thus, this study was conducted to analyse the rating of muscle discomfort and correlation with the risk factors among traffic police riders. A cross-sectional study was carried out among 137 male traffic police riders (high-powered motorcycle) with the age between 20 to 39 years old. The 100-mm visual analogue scale questionnaire included ratings of perceived discomfort scales for 20 specific body regions was used in the study. The results indicate that the lower back (left and right) were the highest mean of discomfort which were 56.6 mm and 55.9 mm respectively. This followed with right (48.5±36.2 mm) and left (48.4±30.3 mm) upper back, and right hand (47.0±33.0 mm). The mean of overall discomfort ratings for all regions were more than 20 mm. Besides, there is a strong positive significant correlation between duration of ridings (hours) and overall discomfort ratings (p<0.01, r=0.785) and moderate positive correlation between year of traffic police motorcycle riding experience and overall discomfort ratings (p<0.01, r=0.410). As a conclusion, cumulative riding hours, riding experience and no support of the back area of the body in motorcycle seat, are the most concern in this study as this are the contributing factors to the muscle discomfort among traffic police riders while riding high-powered motorcycle. Thus, this study suggested an additional feature is needed in current motorcycle design in order to enhance comforts of traffic police riders. Also, it will improve the condition of traffic police riders’ discomfort and indirectly also improve their work and health performance as well as productivity.

Introduction: Alleviating pain and anxiety of patients during procedures is an essential skill for an Emergency Physician (EP). Several sedatives and dissociative agents are used for PSA (Procedural Sedation and Analgesia). In this study, we aimed to compare two drugs that is, ketamine and fentanyl for procedural sedation in adults with isolated limb injuries in the Emergency Department (ED). Materials and methods: In this prospective, randomised controlled interventional trial, patients aged between 18 to 65 years with isolated extremity injury requiring PSA in the ED were recruited. A total of 200 subjects were included in the study and randomly allocated to either the fentanyl (n=100) or the ketamine (n=100) group. Patients were blinded to the intervention and subsequently premedicated with Midazolam. Following this, they received either ketamine or fentanyl based on the group they were allocated to. Vital signs, including but not limited to the level of sedation, were measured at predetermined time intervals. A Modified Aldrete Score of >8 was used as a criterion for disposition from the ED. Data were collected in a predesigned proforma. We aimed to compare the effectiveness as well as ascertain the safety profile of the two drugs for PSA in the ED. Results: There was no significant difference between the two groups when age, gender, mechanism of injury and comorbidities were compared. We found that there was no statistically significant difference between the two groups when blood pressure, respiratory rate and depth of sedation were compared. In both groups, there was a significant decrease in pain on the Numerical Rating Scale (NRS) following drug administration from 8 to 3 (p<0.001). Patients in the fentanyl group had an increased incidence of transient oxygen desaturation (p<0.001). Vomiting was more common in the ketamine group (p<0.001). Conclusion: PSA is a safe and efficacious procedure for patients undergoing painful procedures in ED. Patients in both the groups maintained hemodynamic stability throughout the procedure. From our study, we were able to conclude that both ketamine and fentanyl are similar in efficacy for PSA in the ED for adults with isolated limb injuries. In addition, no significant cardiovascular adverse events were noted in either group in our study.