Introduction: This study aims to determine the prognostic factors and survival outcomes of patients that underwent this surgery. Method: A retrospective review of 43 patients who underwent exenteration for periocular malignancies over a 14-year period was carried out. Patient demographics, tumour histology, treatment details, surgical margins’ status and post-operative survival were recorded. The survival outcome examined was the overall survival (OS) rate. Cox regression and Kaplan-Meier analysis were used to evaluate post-exenteration survival. Results: In total, 20 females and 23 males with a median age of 62 ± 17.3 years were identified. The most common indication for exenteration was basal cell carcinoma (20.9%), followed by squamous cell carcinoma (18.6%), adenocystic carcinoma (14%), malignant melanoma (14%) and sebaceous gland carcinoma (11.6%). The independent predictors for worse OS on multivariate analysis were Chinese ethnicity (adjusted hazard ratio [aHR] 4.95, p =0.017), sebaceous gland carcinoma (aHR 57.61 p=0.006), adenocystic carcinoma (aHR 45.87, p=0.008), clear surgical margins (aHR 5.41, p=0.025), receiving only chemotherapy (aHR 169.13, p=0.004), and receiving both adjuvant chemotherapy and radiotherapy (aHR 41.51, p=0.010). Conclusion: We recommend targeted public health initiatives for Chinese patients due to their increased mortality risk from peri-ocular malignancies. In addition, we advise comprehensive adjuvant therapy for all patients regardless of whether a clear surgical margin is achieved. Basal cell carcinoma and adenocystic carcinoma may also benefit from genetic research. We advocate more training for ophthalmologists to identify periocular malignancies earlier for better treatment options and increased chances of survival.

Introduction: Ageing is commonly linked with physical inactivity. This review was performed to identify the factors associated with participation in physical activity among older adults in Malaysia. Methods: A systematic review was conducted using five databases; Pubmed, Sagepub, Scopus, Cochrane Library and Science Direct. Observational and intervention studies published between January 2010 and December 2020 were included, with Malaysian older adults aged 55 years and older being the main subject. Results: A total of 9 articles were included in the review. Analysis was guided by the Social Ecological Model for Health Promotion. The review had successfully identified gender, age, education level, health reasons, ethnicity and attitude as intrapersonal factors, social support (friend) and marital status as interpersonal factors, and locality as well as availability of facilities as environmental factors. Conclusions: Physical activity participation among Malaysian older adults were mainly determined by intrapersonal factors, particularly gender, health condition and educational level.

Aims: Melon Manis Terengganu, MMT is one of the economically important fruits in Terengganu, which contains numerous nutritional values and bioactive compounds that benefit human health. The major problem is MMT has been affected by Fusarium sp., which is the common fungus in the Cucurbitaceae family resulting in Fusarium wilt disease and lowering melon production. It may also affect the antioxidant value of MMT; however, limited study has been conducted on this issue. Hence, the objective of this study was to determine the non-enzymatic as well as enzymatic activities in response to Fusarium sp. (S2 and S4) infection. Methodology and results: In this study, MMT leaves were incubated in culture filtrate (CF) obtained from Murashige and Skoog (MS) liquid medium. The antioxidative responses were assayed at 0, 1, 3, 5, 7 and 9 days of treatment. In response to Fusarium infection, the ascorbic acid, α-tocopherol and carotenoid content were significantly stimulated at the early stages of the experiment and slowly reduced afterward. This current study also demonstrated that the CAT-specific activities were initially induced in S2 CF-treated leaves. Similar APX and gPOD specific activity patterns were observed in both S2 and S4 CFs treatments. The APX and gPOD-specific activities were induced at the later stages of infection in S4 CF-treated leaves. Conclusion, significance and impact of study: The results revealed that enzymatic and non-enzymatic antioxidants worked together to fight against stress caused by the fungal infection, with the activation of the plant defense system.

Pengenalan: Soal selidik sebagai alat untuk mengukur faktor sosiobudaya berkaitan COVID-19 masih belum digunakan secara meluas oleh kebanyakan penyelidik. Di Malaysia, tiada soal selidik yang dibina dan disahkan untuk tujuan tersebut. Oleh itu, tujuan kajian ini adalah untuk membina dan mengesahkan soal selidik sebagai alat ujian yang baru bagi mengukur faktor sosiobudaya berkaitan COVID-19 dalam kalangan Orang Asli di Malaysia. Metodologi: Kajian rintis ini melibatkan 30 orang penduduk Orang Asli di Pos Lenjang, Kuala Lipis, Pahang. Indeks Kesahan Kandungan (CVI) digunakan untuk menguji kesahan kandungan soal selidik, manakala kesahan konstruk dan kebolehpercayaan konsistensi dalaman soal selidik ditentukan menggunakan Exploratory factor analysis (EFA) dan Cronbach’s Alpha. Hasil Kajian: Satu set soal selidik terdiri daripada empat konstruk telah dibina iaitu kepercayaan, amalan perubatan tradisional, adat dan budaya tradisional, dan sokongan sosial. Sebanyak 16 item telah dikekalkan di dalam EFA dengan nilai Cronbach’s Alpha setiap konstruk adalah 0.617, 0.778, 0.773 dan 0.779. Rumusan Soal selidik yang telah dibina ini berjaya divalidasi dan boleh digunakan untuk mengukur faktor sosiobudaya berkaitan COVID-19 dalam kalangan Orang Asli. Walau bagaimanapun, penambahbaikan masih perlu dilakukan dari masa ke semasa untuk memastikan soal selidik ini relevan terutamanya jika ia digunakan ke atas populasi atau dari negara yang berbeza dari Malaysia, dengan mengambil kira juga penyakit yang berbeza.

Introduction: Workplace safety culture (WSC) is crucial in providing a safe working environment. Workers need to be reminded regularly of its importance, and therefore effectively, work safety intervention programs need to be identified to be used for this purpose. The main objective is to identify workplace intervention programs to improve WSC among office workers. The specific goals are to determine the types of intervention (knowledge-based, attitudinal, and practices-based interventions), the theories used, and the effectiveness. Methods: Databases such as ProQuest, CINAHL, Medline, and ScienceDirect were used to perform literature searches with the keywords [“safety culture training” OR “safety culture education” OR “safety culture promotion”] AND [“office workers” OR “civil servant” OR “white-collar workers” OR “administrative officers” OR “clerical officer”]. The inclusion criteria set for the search process included research articles, publication between January 1, 2015, and September 10, 2020, which were research articles within five years and eight months of publication to the time of data extraction of this study. Availability of full-text articles, articles published in English, and only articles among office workers. Results: This review includes seven articles and the techniques used for these studies were knowledge, attitude, and practices towards WSC. Conclusion: As the number and scope of intervention of studies on WSC seem scarce, the nature of jobs nowadays and in the future seems to be more office-based; consequently, more of these studies are recommended among office workers.

Introduction: Globally, commuting accident risks are always neglected in an organisation. There is a need to assess the impact of commuting accidents based on sociodemographic, human, vehicle, road, and environmental factors and to find suitable and effective mitigation strategies to alleviate the associated undesirable outcomes. Methods: This research was designed to develop a mobile application to assess commuting accident risk levels using artificial intelligence principles, as we are now in the 21st-century technology era. A total of 216 respondents from private and government industries participated in this study. Besides, to prove the developed application’s effectiveness, the study evaluated the effectiveness of the identified risk factor in determining the level of commuting risks predicted by respondents with the risk level calculated by the mobile application. Results: A major contribution of this paper is the effectiveness and accuracy of a mobile application known as CommuRisk. The app was developed using Android Studio and natively uses Java. There was a significant difference between with and without mobile applications in determining the level of commuting risks, and the effectiveness was proven with a (p-value = 0.001) at a 95% confidence interval with large sample size. Conclusion: Thus, this paper proved the effectiveness and accuracy of a mobile application in calculating risk levels exposed by commuters compared to risk levels predicted by commuters.

Introduction: Workplace accidents have been a persistent problem in Malaysia’s manufacturing industry, particularly for small and medium-sized enterprises (SMEs). Employee behavior has been identified as a significant contributing factor to these accidents, and research has suggested that improving safety knowledge and attitudes can enhance safety behavior. Despite this, there have been no empirical intervention studies in Malaysia to investigate the effectiveness of safety intervention programs aimed at improving SME worker safety behavior. Therefore, this study aimed to assess the efficacy of the Occupational Hazard Self-Evaluation Module (OHSEM) intervention in enhancing safety knowledge, attitudes, and behavior (KAB) among SME workers in the manufacturing sector. Methods: A quasi-experimental design with control group was utilized to evaluate the effectiveness of the OHSEM intervention. The intervention was implemented over a 12-week period on production workers in the experimental group, while the control group received no intervention. A self-administered questionnaire was distributed to 88 production workers in both groups before and after the intervention to measure the improvement of safety KAB. Descriptive analysis and an independent t-test were used to analyse the data. Results: The post-test results showed that safety KAB for the control group was moderate (mean = 2.11), while the mean score in the experimental group was high (m=4.17). Furthermore, the t-test result revealed a significant difference in safety KAB mean scores between the experimental and control groups. Conclusion: This study provides empirical evidence on the effectiveness of the OHSEM intervention in enhancing safety KAB in SMEs in the Malaysian SME (manufacturing) sector.

Introduction: To investigate the use of a tubular retractor to provide access to the craniovertebral junction (CVJ) sparing the soft palate with the aim of reducing complications associated with traditional transoral approach but yet allowing adequate decompression of the CVJ. Materials and methods: Twelve consecutive patients with severe myelopathy (JOA-score less than 11) from ventral CVJ compression were operated between 2014-2020 using a tubular retractor assisted transoral decompression. Results: All patients improved neurologically statistically (p=0.02). There were no posterior pharynx wound infections or rhinolalia. There was one case with incomplete removal of the lateral wall of odontoid and one incidental durotomy. Conclusions: A Tubular retractor provides adequate access for decompression of the ventral compression of CVJ. As the tubular retractor pushed away the uvula, soft palate and pillars of the tonsils as it docked on the posterior pharyngeal wall, the traditional complications associated with traditional transoral procedures is completely avoided.

Introduction: Musculoskeletal disorders (MSDs) was found to be high among nurses especially those working in the hospital. One of the risk factors of MSDs is psychosocial factors apart from physical and ergonomic factors. However, limited study was found specifically looking at this association among nurses working at tertiary university hospital especially in Malaysia. Hence, the objective of this study is to assess the association between organizational psychosocial risk factors with MSDs among nurses working at tertiary university hospital. Methods: A cross-sectional study was conducted with a total of 550 respondents among nurses in University Malaya Medical Centre working from all nursing working department. Samples was selected using Stratified Random Sampling based on nursing working location ratio. A multiple logistic regression was conducted to determine the association between organizational psychosocial factors with MSDs among study population. Results: Multiple logistic regression revealed that supervisors support was associated with MSDs (AOR 0.309, 95%CI 0.133-0.716) even after controlled with confounders such as age, number of children, income, history of musculoskeletal disease, employment grade, total employment duration, work schedule type and selected ergonomic factors. On the other hand, other psychosocial factors which includes decision latitude, psychological job demand, co-worker support, and job insecurity were found not be significant. Conclusion The findings highlighted the relationships between organizational psychosocial factors and MSDs among nurses at tertiary university hospital specifically the role of supervisor support as a protective factor against MSDs among this working population. Hence, hospital top management should incorporate this element as one of the components in their program to reduce MSDs among nurses in the hospital.
Musculoskeletal Diseases

Systemic lupus erythematosus (SLE) is a connective tissue disease of unknown etiology that predominantly affects women of childbearing age. We report a case of male systemic lupus erythematous with antinuclear antibodies and typical clinical presentations of multiple skin lesions, polyarticular joint pain, fatigue, anorexia, and hair loss. Full evaluations were used to establish a diagnosis of SLE. The lower prevalence of SLE among males and antinuclear antibody-negative patients poses a great challenge for diagnosis. Therefore, as primary care doctors, we need to have a high suspicion of systemic lupus erythematous even in male and antinuclear antibody-negative patients. Thus, early treatment may help patients improve their quality of life.