Background: Work-related musculoskeletal disorders (WRMSDs) remain a major cause of occupational disability and productivity loss worldwide. Traditional statistical methods have identified numerous associated factors; however, they often struggle to capture complex non-linear relationships and interactions across multiple domains of risk. Machine learning (ML) offers an alternative analytical approach for modelling such multidimensional relationships. Methods: Following the PRISMA 2020 guidelines (PROSPERO: CRD420250605234), literature searches were conducted in Web of Science, Scopus, and PubMed for studies published between 2020 and 2025. Eligible studies applied ML methods to identify factors associated with WRMSDs using cross-sectional study designs. Included studies were appraised using the Joanna Briggs Institute Critical Appraisal Checklist for analytical cross-sectional studies. Results: Ten studies met the inclusion criteria, representing workers from healthcare, transport, manufacturing, and service sectors across Asia, Africa, and Europe. Frequently applied ML algorithms included random forest, support vector machine, and artificial neural networks, demonstrating strong internal discriminative performance (area under the receiver operating characteristic curve: 0.80–0.99), although the absence of external validation in several studies suggests a potential risk of overfitting. Commonly identified factors included age, sex, awkward posture, vibration exposure, prolonged working hours, stress, and burnout. Psychosocial factors, including post-traumatic stress disorder, job stress, and depression, were ranked among the most influential predictors within ML models. Conclusions ML models demonstrate strong capability in discriminating WRMSDs risk and identifying multidimensional risk factors compared with traditional statistical approaches. These models highlight complex interrelationships between ergonomic and psychosocial exposures. Future research should incorporate external validation, objective exposure measurements, and standardized ML reporting frameworks to enhance methodological transparency and generalizability.

Oropharyngeal Synovial Sarcoma: A Case Report Synovial sarcoma is a rare and aggressive type of sarcoma that develops from mesenchymal cells and accounts for around 8% to 10% of all cases of soft tissue sarcoma. The presence of synovial sarcoma in the head-and-neck region is characterised by aggressive behaviour and a generally unfavourable prognosis. Understanding the various manifestations of synovial sarcoma, particularly uncommon locations like the oropharynx, significantly improves patient outcomes by facilitating early diagnosis and prompt management. We report a case of a 57-year-old Malay woman who presented with a two-month history of sore throat and odynophagia, complicated with partial airway obstruction. She underwent endoscopic excision of the right oropharyngeal tumour via transoral approach, and the histopathological examination revealed monophasic synovial sarcoma. The surgical management, histopathological characteristics, and rarity of the disease are discussed.

Alveolar Soft Part Sarcoma as a Great Masquerader of Unilateral Sinonasal Tumour in Child: A Case Report Alveolar soft part sarcoma (ASPS) is a rare mesenchymal neoplasm that accounts for less than 1% of all sarcoma and the most common site of tumour is found in the soft tissue of the extremity. The incidence of ASPS in paediatric age group is rare. It is extremely uncommon for the tumour arising from the sinonasal within the head and neck region. Most of the reported cases were in the orbit and tongue. Localised ASPS carries a good prognosis after complete total resection. Diagnosing ASPS can be challenging as it can be a masquerader to other sinonasal soft tissue malignancy which required the laborious process of histopathological examination, immunohistochemistry, and ultrastructural examination to solve the complexity. We encountered an 11-year-old girl who presented with sudden onset of left nasal obstruction and on examination noted a unilateral vascular mass in the left nasal cavity turned out to be ASPS. She underwent left nasal tumour debulking via endoscopic approach under general anaesthesia. Post-operative, she recovered well with regular endoscopic surveillance and was referred to the oncology team for post-operative radiotherapy.

Adenosquamous carcinoma is a rare variant of squamous cell carcinoma of the nasal septum which is very aggressive and metastasise early with poor prognosis. We present a case of a gentleman who presented with left nasal septal swelling for 4 months. Examination showed a lesion at the left nasal septum extending to the dorsum of the nose and right upper lip region. Computed tomography scan of the paranasal sinuses and neck showed an enhancing lesion with ulceration at the left nasal septum, with regional metastasis to the neck. He underwent a subtotal rhinectomy, inferior maxillectomy, and bilateral modified radical neck dissection type III. Unfortunately, he succumbed to a cardiac arrest 5 days after surgery.

Benign paroxysmal positional vertigo (BPPV) is one of the most common vestibular disorder worldwide. Management of this pathology is not complicated and can be done in a short period of time with a proper diagnosis and treatment technique. There are several established methods for treatment of this disease includes Epley’s maneuver, Gans Canal Repositioning maneuver (Gans CRM) and others. This study reported a 38-year-old female presented with dizziness and vertigo, which is severely altered her daily activity, showed 90% improvement using the psychological effect assessment tool after three days of treatment with Gans CRM.

Lipoma is a benign, slow growing tumour composed of adipose tissue. In general, it is very unusual for lipoma to form in the head and neck region, let alone achieve a size of more than 10 cm with the involvement of deep neck spaces. We discussed a case of an extremely huge neck lipoma measuring 18 cm x 14 cm with extensive involvement of deep neck spaces, infratemporal fossa and pharynx, closely adherent to submandibular and parotid gland. The diagnostic and therapeutic challenges were discussed, in achieving a surgically complete excision and cosmetically acceptable outcome

Foodborne disease is among the primary illness that causes morbidity and mortality in the world. Several studies show that most students do not have adequate food safety knowledge to protect themselves against foodborne diseases. This study aimed to determine the food safety knowledge, behaviour, and beliefs among undergraduate students at a local university in Malaysia. This cross-sectional study involves 121 respondents from three health science-related faculties at the studied institution. The questionnaire was distributed via an online platform. This study used multiple-choiceformat questions for Food Safety Knowledge and a Likert type scale for Food Safety Behaviour and Belief question statements. Most of the respondents were female (78%). About 16% of the respondents have experience working / volunteering in food services, and half of them are involved in food handling during their services. This study recorded a moderate score in all sections (knowledge, behaviour, beliefs) with a total percentage score of 60.3%, 60.3%, and 66.1%, respectively. A strong but not significant correlation between food safety knowledge and beliefs (r = 0.69 p > 0.05) and between food safety knowledge and behaviour (r = 0.83 p > 0.05) were observed. This study is useful as a basis to develop a targeted food safety education program among undergraduate students. Students with high knowledge of food safety will increase food safety beliefs and behaviour, thus preventing them from getting any foodborne illness.

Histoplasmosis usually occurs in immunocompromised patients through the dissemination of the fungus from lungs to other organs but laryngeal involvement is rare. We report a 52-year-old male chronic smoker who presented with hoarseness for 3 months was initially investigated for laryngeal carcinoma. However biopsy showed granulomatous inflammation. He was treated with anti-tuberculosis treatment for 2 months but symptoms persisted and a repeat biopsy revealed laryngeal histoplasmosis. There were no sign and symptoms of pulmonary or systemic involvement. Treatment with intravenous amphotericin B and oral itraconazole lead to complete resolution of symptoms and signs. Monitoring and early revisiting the diagnosis are important when a patient’s symptoms do not improve with the treatment. Further investigation including a repeat biopsy of lesion is vital to establish the diagnosis and lead to appropriate management.

ABSTRACT Kimura disease (KD) is a rare chronic inflammatory disorder of unknown aetiology that primarily affects the head and neck region with lymph node involvement. Young to middle-aged adult Asian males are predominantly affected. The most common presentation is painless subcutaneous swelling in the head and neck region, while proptosis or orbital involvement is very rarely reported. KD shares some features with other inflammatory and neoplastic disorders, including lymphoma; thus, investigations to confirm the diagnosis should not be delayed. Systemic corticosteroids are commonly used to treat KD and show an excellent response; however, the optimal treatment is still uncertain, and KD has a high recurrence rate. We describe the case of a patient with KD who presented with proptosis and post-auricular swelling, which responded well to oral prednisolone treatment.
Kimura Disease ; Exophthalmos

When the first report of COVID-19 appeared in December 2019 from Wuhan, China, the world unknowingly perceived this as another flu-like illness. Many were surprised at the extreme steps that China had subsequently taken to seal Wuhan from the rest of the world. However, by February 2020, the SARS-CoV-2 virus, which causes COVID-19, had spread so quickly across the globe that the World Health Organization officially declared COVID-19 a pandemic. COVID-19 is not the first pandemic the world has seen, so what makes it so unique in Malaysia, is discussed to avoid a future coronacoma.