Chronic Myeloid Leukaemia (CML) is a disease characterised by a distinctive marker that is the Philadelphia Chromosome and an ability to transform into blast phase, which confers a poor prognosis. The median survival was reported to be between three to six months in correlation to blast phase. Extramedullary involvement with CML to sites such as pleural, meningeal and bones have been reported. We report a case of 41-year-old man who was diagnosed with CML in blast phase and presented with ascites. Ultrasound of abdomen showed coarse echotexture of liver suggestive leukaemic infiltration to the liver. The liver profile was severely deranged and associated with coagulopathy. Flow cytometry analysis of the peritoneal fluid revealed presence of myeloblasts consistent with CML in blast crisis with leukaemic ascites. Bone marrow biopsy also confirmed disease transformation. He received standard induction chemotherapy for acute myeloid leukaemia with dose modifications based on liver enzymes performance. Our case highlights an unusual presentation of CML in blast crisis with leukaemic ascites and the challenges in managing cytotoxic treatments due to the liver infiltration.
Leukemia, Myeloid, Acute

Ergonomics and design have made the greatest relation in producing an artifact or creating a workplace. A computer table is widely used in classrooms in universities. However, the problems of the current computer table have been detected through the results of RULA analysis. In this project, a survey of the questionnaire was done and the anthropometric data have also been collected. The dimensions of the current computer table are then collected and the deficiencies of the current computer table have been focused on RULA analysis. A new structural design of the computer table has been designed, in order to meet the requirements of ergonomics. A product of the new design of ergonomics computer table is made and has been focused on RULA analysis to define the improvement between both tables. The paper showed a comparison between the current computer table and the new ergonomics computer table were analyzed. The improvement of the new ergonomics computer table was identified and reduced the injuries and disorders. A further investigation on better working posture when using a computer table is required, while further improvement for the product design of a new ergonomics computer table is needed, as well as the application of the ergonomics design aspect in our life.

This paper reviews various papers since the year 2000 until 2016 regarding visual technology in human anthropometrystudy, and discusses three major points; (1) the methods and objectives of the research, (2) the subjects of theexperiments and (3) body parts involved in the anthropometrical measurements. Measurement using visualtechnology is claimed to be more accurate in obtaining anthropometrical data compared to the conventional methodusing manual tools. However, commercial visual technology system can be very costly. Based on the reviewedstudies, a significant amount of research has adopted various visual processing methods to predict the human’s bodymeasurement. All of the studies utilized the applications of enhanced technologies that are able to reduce time andhuman errors that normally occur during traditional hand-operated measurement. Usually, in order to prove thattheir result is promising, the studies compared their results with the results gained from manual measurement. Thefinding from this review is a preliminary step towards developing a camera-based system in anthropometrymeasurement for the use in automotive ergonomics design.

Introduction: Immunosuppressive state due to haematological malignancies and chemotherapy may cause disruption to wound healing despite optimum conventional treatment and standard wound dressing. Non-healing wounds are predisposed to infection whereas chemotherapy dose reductions or interruptions are associated with poor survival. Background: Mononuclear cells contain progenitor cells including haematopoietic and mesenchymal stem cells, endothelial progenitor cells and fibroblasts which facilitate wound healing through cytokines, growth factor secretions, cell-cell interactions and provision of extracellular matrix scaffolding. Clinical applications of autologous mononuclear cells therapy in wound healing in non-malignant patients with critical limb ischaemia have been reported with remarkable outcome. Methods: We report three patients with haematological malignancies undergoing chemotherapy, who received autologous mononuclear cells implantation to treat non-healing wound after optimum conventional wound care. The sources of mononuclear cells (MNC) were from bone marrow (BM), peripheral blood (PB) and mobilised PB cells (mPB-MNC) using granulocyte colony stimulating factor (G-CSF). The cells were directly implanted into wound and below epidermis. Wound sizes and adverse effects from implantation were assessed at regular intervals. Results: All patients achieved wound healing within three months following autologous mononuclear cells implantation. No implantation adverse effects were observed. Conclusions: Autologous mononuclear cells therapy is a feasible alternative to conventional wound care to promote complete healing in non-healing wounds compounded by morbid factors such as haematological malignancies, chemotherapy, diabetes mellitus (DM), infections and prolonged immobility.

Introduction: Diabetic foot infection is often associated with high morbidity, disability and poor quality of life. This study focuses on the demography, the number of repetitive surgery and length of stay in hospital of patients with diabetic foot infection. Method: This is a retrospective observational study. Patients who were admitted to the Orthopaedic ward of Hospital Segamat (HS), Johor, Malaysia from January 2016 to December 2018 and required surgical intervention were included in the study. Data was collected from the computer system of HS and medical notes of patients. Results: 35.6% of the total orthopaedic emergency surgeries performed were for patients with diabetic foot infection, 25% of the surgical procedures performed were major amputations of lower limb and 40% of the patients with diabetic foot infection required more than one surgical operation. Discussion: The demographics of the patients is consistent with the demographics of Malaysia where majority of them are Malays followed by Chinese, Indians and others. Despite being only 10% of total admission to the department, this group of patients contributed to 35.6% of the total emergency surgeries performed. The amputation rate in the centre is comparable to the other local studies. The average length of stay in hospital was found to be shorter compared to overseas due to different rehabilitation protocols.

Pulmonary hydatid cyst (PHC) in pregnancy is a very rare pathology. We report here a case of ruptured PHC during pregnancy in a 26-year old Syrian (refugee) woman who presented with complaints of productive cough with metallic taste and dyspnoea. PHC was suspected due to her clinical and radiological findings. Interestingly, the sputum examination confirmed the diagnosis as numerous protoscoleces were present. Serology for Echinococcus infection revealed positive at high titre. Early diagnosis and prompt treatment by providing care improves the patient outcome. Parasitological examination of the respiratory specimen in suspected ruptured PHC is desirable as a valuable detection tool.

Objective To summarize the precise association between pulmonary tuberculosis (PTB) and P2x7 A1513C gene polymorphism. Methods PubMed and Google Scholar web-databases were searched for the studies reporting the association of P2x7 A1513C polymorphism and PTB risk. A meta-analysis was performed for the selected case–control studies and pooled odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated for all the genetic models. Results Eleven studies comprising 2 678 controls and 2 113 PTB cases were included in this meta-analysis. We observed overall no significant risk in all the five genetic models. When stratified population by the ethnicity, Caucasian population failed to show any risk of PTB in all the genetics models. In Asian ethnicity, variant allele (C vs. A: P = 0.001; OR = 1.375, 95% CI = 1.159–1.632) and heterozygous genotype (AC vs. AA: P = 0.001; OR = 1.570, 95% CI = 1.269–1.944) demonstrated significant increased risk of PTB. Likewise, recessive genetic model (CC + AC vs. AA: P = 0.001; OR = 1.540, 95% CI = 1.255–1.890) also demonstrated increased risk of PTB in Asians. Conclusions Our meta-analysis did not suggest the association of P2x7 A1513C polymorphism with PTB risk in overall or separately in Caucasian population. However, it plays a significant risk factor for predisposing PTB in Asians. Future larger sample and expression studies are needed to validate this association.

Introduction: Commuting accidents (CAs) caused significant detrimental impacts on the Fire and Rescue Department of Malaysia (FRDM). Therefore, this study aims to identify factors of CA by mainly focusing on environmental factors Methodology: The qualitative data was obtained from FRDM accident investigation reports from five states (Kedah, Selangor, Kuala Lumpur, Negeri Sembilan and Johor) between 2017-2021. The data were analysed using content analysis. Results: Four environmental factors that contribute to CA were identified. The factors were environmental conditions (rainfall, strong wind, light glare, and insufficient lighting), time (twilight and night time), road physical conditions (hilly road, curvy, steep, and narrow road, weak manhole cover, soft ground, wet and slippery road), and road environment (traffic congestion and sudden animal crossing) Conclusion These findings provide environment-related hazards input for risk assessment and management of CA in FRDM, as well as valuable information for future research. Therefore, it has the potential to improve road safety for firefighters, the general public, and animals