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.

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.

Management of complicated massive infective endocarditis (IE) in patients who are contraindicated for surgical valve replacement has long been a dilemma for many clinicians. Studies have shown that massive IE patients who were treated conservatively generally result in poorer prognosis. We report two cases of massive native valve infective endocarditis with severe mitral valve regurgitation and septic emboli that has been successfully treated conservatively. Interestingly, despite having a large vegetation and multiple septic emboli complications, none of these two cases had any positive culture or serology. Managing culture negative IE without surgical intervention pose an even greater challenge to the choice and duration of antibiotics with further long-term plans. We hope to share these case series to aid in the management dilemma of similar cases in the future.

Proper understanding the ‘Instructions to authors’ for a particular journal is the key towards successful submission of a manuscript which will lead to it being published. Common errors that are frequently made by authors in their submission to the Malaysia Journal of Malaysia (MJM) that lead to rejection of their submission or requiring major revisions or minor revisions are listed and discussed in this article. Outright rejection prior to even a peer review process may be made for an article due to: it is poorly written or when there is suspicion on the authenticity of the submission, which contains elements that are suspected to be plagiarised, it is a duplicate submission or not in the format required by the MJM. The editor in charge of the issue makes a recommendation to the Editor in Chief for the final decision.

AIM:To compare the pattern electroretinogram (PERG) and pattern visual evoked potential (PVEP) between obstructive sleep apnoea (OSA) patients and controls.METHODS: This was a prospective cross-sectional study involving 40 OSA patients and 31 control subjects in Hospital Universiti Sains Malaysia.Patients with a confirmed diagnosis of OSA who had no ocular pathology were randomly selected to participate in the study.The apnoea-hypopnoea index (AHI) was obtained from their records and used for stratification of OSA severity.Electrophysiological tests (PVEP and PERG) were performed on each patient by a trained technician in the electrophysiology laboratory of the Department of Ophthalmology, USM.The results obtained were recorded as median values.Data analysis was done using IBM Statistics Version 21.0.RESULTS: Among OSA patients, we observed a significant reduction of the PERG amplitude P50 (P<0.001) and the PVEP amplitude P100 (P<0.001) compared to the control group.OSA patients also had a significant increase in PVEP time to peak P100 (P=0.003) and time to peak N75 (P=0.004).However, no significant differences were detected in PERG time to peak between OSA patients and controls.There were likewise no significant differences in PVEP or PERG between OSA patients with different disease severity.CONCLUSION: OSA patients have significant abnormalities in PVEP amplitude and time to peak, as well as PERG amplitude.This may reflect subclinical optic nerve dysfunction in OSA.Further research is needed to determine the association between the severity of OSA and the degree of optic nerve dysfunction.

Dichloromethane and methanolic extracts of each plant were tested for their antiplasmodial activity on chloroquineresistant strain of Plasmodium falciparum (FCB strain), based on lactate dehydrogenase activity. Cytotoxicity was assessed with the MTT test on MRC-5 human diploid embryonic lung cells. Most extracts of ten selected plants used in Malay traditional medicine in Malaysia had activity in vitro. This supports continued investigations of traditional medicine in the search for new antimalarial agent. The compounds responsible for the observed antiplasmodial effects are under investigation.

An entomological study was conducted in Tanjung Sepat, Selangor, Malaysia in May until September 2007 revealing five species of butterflies (all from family Nymphalidae) were attracted to pig carcasses placed in an oil palm plantation. Euploea mulciber (Cramer 1777), Hypolimnas bolina (Linnaeus 1758), Elymnias hypermnestra (Linnaeus 1763), Mycalesis mineus (Linnaeus 1758) and Ypthima baldus (Fabricius 1775) came to the carcasses at different stages of decomposition. From this study, we know that nymphalid butterflies are attracted to carcasses but their roles are most probably unimportant in post-mortem estimation.

Chrysomya megacephala (Fabricius) and Chrysomya rufifacies (Macquart) are two important species of blow flies that could be utilised as indicators to estimate the Post Mortem Interval (PMI) of corpses in forensic science. Determination of PMI of corpses is based on the larva size and its development stages. Development studies of eggs, larvae and pupae of Ch. megacephala and Ch. rufifacies at 27ºC, 30ºC and 33ºC were carried out using an insect growth chamber. Data from these studies were used to construct growth curves and Accumulated Degree Hours (ADH) for both species. Ch. megacephala needs 9.15 days to complete one life cycle at 27ºC, 8.54 days at 30ºC and 6.76 days at 33ºC. Development for Ch. rufifacies is slower than Ch. megacephala and takes 9.92 day at 27ºC, 9.13 days at 30ºC and 7.44 days at 33ºC. Eggs of the two species hatch faster at 33ºC compared to the two other temperatures. Low value of ADH shows shorter life cycle of that particular species. This study’s findings are useful in estimating PMI of the corpses found under various environmental temperatures.

Nasopharyngeal carcinoma (NPC) is a non-lymphomatous, squamous cell carcinoma that occurs in the epithelial lining of the nasopharynx, an area that shows varying degrees of differentiation. Although relatively rare worldwide, NPC has substantial incidence and mortality in populations in Southeast Asia and in people with Southern Chinese ancestry. In Malaysia, NPC is a leading cancer type. In the clinic, NPC presents on a very wide spectrum. Therefore, a high degree of suspicion on the part of the clinician and an increased awareness by the patient is essential for the recognition of an early lesion. Early detection of the cancer is important as it affects the patient’s prognosis and the mode of treatment. Managing patients with NPC is very challenging as patients usually present late when the cancer is already in an advanced stage. Here, we review the challenges in the management of NPC.

To determine the outcome of laser-assisted uvulopalatoplasty for the management of patients with snoring in Universiti Sains Malaysia Hospital (HUSM). A retrospective review of patients who underwent LAUP with or without tonsillectomy or adenoidectomy under general anaesthesia between December 2003 to December 2006. Data was obtained from admission and follow-up records in the otorhinolaryngology clinic of USM Hospital (HUSM). A total of nineteen patients underwent procedure for the treatment of snoring. Majority of these patients presented with symptoms of loud snoring and daytime somnolence. The main operations performed were LAUP with or without tonsillectomy or adenoidectomy. The justification for LAUP were overhanging and excessive uvula or soft palate, whereas for adenotonsillectomy were the hypertrophied adenoids and tonsils. On follow-up, most of the patients claimed improvement of snoring within the first 2 months post-operation. However, majority of them defaulted follow-up after that. One patient (AHI preoperatively was mild) was reviewed up to 8 months with no snoring. One patient (AHI was severe preoperatively and normal post operatively) remained in our follow-up was satisfied with the operation. Two patients continued to experience snoring post LAUP despite trial of non-surgical methods. The outcome of LAUP in our patients showed variable results. This showed that patient selection is very important to achieve good result in LAUP. Long-term follow-up is also essential to document the success for LAUP.