A literature review of 16 papers on occupational injury research in Malaysia published during a 13-year period from 2000-2013 was carried out. The objective of this review and article selection was based on relevance to the research theme and mention of areas for future research. Most of the publications have focused on descriptive epidemiology, management practices, worker’s knowledge, attitude, training, and rehabilitation services. The transportation, agriculture and construction sectors were found to be the most hazardous sectors and would benefit the most from Occupational Safety & Health (OSH) research and interventions. There is a strong need to develop a national injury surveillance system and also a mechanism to ensure adherence to the Occupational Safety & Health Act(OSHA) 1994. Detailed description and identification of risk factors for occupational injury in the environment, including machinery and equipment used was generally lacking. Future research on occupational injury should focus on surveillance to determine the magnitude of occupational injuries, determination of risk factors, identifying costeffective interventions (such as enforcement of OSHA regulations), and assessment of rehabilitation services. Relevant government agencies, universities, corporate sector and occupational safety organizations need to play a proactive role in identifying priority areas and research capacity building. Funding for occupational injury should be commensurate with the magnitude of the problem.
Occupational Injuries ; Accidents, Occupational

Academic Medical Centers ; organization & administration ; Biomedical Research ; organization & administration ; Education, Medical ; organization & administration ; Faculty, Medical ; Humans ; Singapore

Ectopic lingual thyroid is a rare developmental anomaly. It is caused by aberrant embryogenesis during the thyroid descent to the neck. It may remain asymptomatic or present with dysphagia, hemoptysis, dyspnoea or dysphonia. Clinically, it presents as a mass lesion on the base of the tongue. The most important diagnostic tool for an ectopic lingual thyroid is the 99mTc radionuclide scan, but imaging modalities such as computed tomography scan and magnetic resonance imaging may also help to assess its location and extent and to rule out the presence of normal thyroid tissue in the thyroid bed. The management of an ectopic thyroid remains controversial. No treatment is required for asymptomatic patients in the euthyroid state. Patients with hypothyroidism should be treated with thyroid hormone substitution therapy. Malignant transformation is an indication for complete surgical resection. Ablative radioiodine therapy can be considered for older patients and those who are unfit for surgery. In complicated cases, surgical resection is recommended through the transoral, transhyoid or lateral pharyngectomy approach. We report a case of ectopic lingual thyroid in a 35-year-old man who presented with nasal twang and hemoptysis.

Aging ; Alzheimer Disease ; diagnosis ; epidemiology ; prevention & control ; Humans ; Incidence ; Leisure Activities ; Psychological Tests

Bile ; analysis ; Calcium Carbonate ; metabolism ; Gallbladder Diseases ; diagnosis ; metabolism ; Humans ; Hydrogen-Ion Concentration ; Male ; Middle Aged

Documented advance care planning (ACP) discussions with patients enable doctors to have continuity and collaboration across all settings as patients move from one setting to another. These shared decision-making discussions generally consist of 3 steps: giving information; assisting patients to understand the options in the context of their situations; and helping these patients make informed decisions based on their individual preferences. Primary care physicians should take advantage of their position as healthcare providers to continue the care of the patient and the relationship they have with the patient by initiating ACP discussions. The National Medical Ethics Committees recommendation in 2010 is that such discussions should be started as part of routine care in primary care and outpatient settings before individuals become acutely unwell. Important barriers that need to be overcome are negative encounters with different personalities who can present themselves as difficult - the angry patient, the anxious patient, the patient in collusion, and the patient in denial. In this paper are some guiding principles on how to carry out ACP discussions with such patients. There is also a need for doctors to recognise that as caregivers, they may be exhibiting blocking behaviours to ACP discussions that patients are trying to initiate. These should be avoided.

Hepatic resection, the only treatment that offers long term survival for patients with Hepatocellular carcinoma (HCC), have shown significant improvement in results over the past decades. The aim of the study was to compare the survival between patients receiving and not receiving surgery. A retrospective cohort study measured the survival of newly diagnosed cases of HCC patients who underwent treatment in Selayang Hospital from 1 January 2003 till 31 December 2006. Survival time was measured from the date of diagnosis until the subjects died or until the end of study period (31 December 2007). Overall survival was significantly longer in surgery group in comparison with non-surgery group with a median survival of 43 and 20 months, respectively (p<0.001). The following factors were noted to have improved survival duration with surgical resection; Child Pugh Class B patients, tumor size less or more than 4cm and number of nodules less than 3. Subgroup analysis showed improved survival duration with surgical resection among patients with Child Pugh Class B with tumor size less than 4cm or with nodule less than 3 and patients who had less than 3 nodules, even with tumor size of less or more than 4cm. Multivariate Cox Re-gression showed surgical intervention significantly improved survival time for overall patients (Adjusted HR: 1.5) while non-surgery improved survival in patients with tumor size less than 4cm (Adjusted HR: 0.4). Surgical resection significantly improved the survival duration in overall patients while non-surgical procedure improved survival if the tumor size was less than 4cm.

Primary ; Excision ; Cheek ; Malignant Neoplasms

Large ; Cysts ; Case Report