Introduction: The disregard for hip flexion force when designing foot-operated equipment poses a potential threat to non-compliance with ergonomics principles, ultimately impacting occupational health. Nevertheless, there is a noticeable lack of studies focusing on the hip flexion strength of Malaysian adults in a standing position. This paper aimed to measure the maximum force of hip flexion strength and formulate a regression model for Malaysian young adults in a standing posture. Materials and methods: The experiment invited sixty Malaysian adults aged 20 to 26 years old. A digital force gauge (Mark-10, USA) was used to measure the hip flexion force. A regression model was developed to determine the influence of gender, body mass, body height, thigh length, and thigh circumference on the hip flexion force. Results: The results of this study found that the means of hip flexion force for the male and female participants were 192.8 N and 126.0 N, respectively. The regression model concluded that gender is the most significant factor influencing hip flexion force (p<0.01). The body mass, body height, thigh length, and thigh circumference positively correlate to hip flexion force. However, these correlations were not statistically significant (p>0.05). Conclusion: This study concluded that the relationship between anthropometric parameters and hip flexion force is not always straightforward and can be influenced by various factors. To gain a more comprehensive picture of hip flexion, it is essential to consider other potential factors such as muscle mass, neuromuscular control, and joint mechanics.

Introduction: Venepuncture procedure is painful and anxiety associated with venepuncture is common. There are many tools for assessing anxiety levels in an outpatient setting. Hence, this study is to compare the degree of agreement between State-Trait-Anxiety-Inventory (STAI) and Beck Anxiety Inventory (BAI) for measuring anxiety levels among adult patients before venepuncture procedure. Methods: A cross-sectional pilot study was conducted among patients while waiting for a venepuncture procedure in the Phlebotomy Unit, UiTMMC in April 2020. The Malay-validated version of the State-Trait-Anxiety-Inventory (STAI) and Beck Anxiety Inventory (BAI) were used to assess the anxiety level. Differences between sets of data were plotted as described by Bland-Altman to determine the agreement between these two assessment tools. Results: A total of 330 patients participated in the study with a mean age of 46.34 ± 14.34 years old and gender was equally distributed. The scores of state-anxiety (STAI-S), trait-anxiety (STAI-T) and BAI score were 30.04 ± 20.74; 29.51 ± 19.11; and 40.98 ± 20.45, respectively. The score of anxiety using BAI was higher compared to STAI-S (p<0.001) and STAI-T (p<0.001). The mean difference between the STAI-S and BAI was -10.94 (95%CI: -53.01, 26.87) and between the STAI-T and BAI was -11.47 (95%CI: -42.26, 19.32). However, very few patients’ scores outside the 95% LOA for both differences. Conclusion: The STAI and BAI are concordances in measuring anxiety levels among these patients. However, the anxiety score using BAI was higher than STAI. Thus, both assessment tools can be used in clinical practice in measuring anxiety in the out-patients setting.

Exoskeletons are wearable devices that can enhance human strength and are used in various fields, such as healthcare and the manufacturing industry. However, poorly designed exoskeletons can strain the muscles and cause injuries to users. The objectives of this review paper are to review the ergonomics factors that contribute to a harmonious user-exoskeleton interaction and to explore the current trends, challenges, and future directions for developing ergonomically designed exoskeletons. In this review, 102 relevant papers published from 2015 to 2023 were retrieved from Web of Science, Scopus, and Google Scholar. These papers were considered in the analysis for gathering relevant information on the topic. The authors identified six ergonomics factors, namely kinematic compatibility, contact pressure, postural control, metabolic cost, cognitive workload, as well as task demands and workplace conditions, that can influence the interaction between users and exoskeletons. By understanding and addressing these ergonomics factors during the design and development process, exoskeleton designers can enhance the user experience and adoption of the devices in daily living activities and industrial applications.

Aims: Psittacine birds such as parrots, macaws, cockatoos, lovebirds and parakeets, are widely reared as household pets or at aviary due to their attractive features. However, the status of virus-causing diseases of psittacine species in Malaysia is fairly under-documented. Therefore, this study was aimed to detect the presence of three common avian viruses that infect psittacine birds, i.e. beak and feather disease virus (BFDV), avian polyomavirus and avian papillomavirus. Methodology and results: Faecal samples from twelve asymptomatic captive psittacine birds of different species were collected from an undisclosed animal garden in Serdang, Selangor, Malaysia. Briefly, the sample was homogenised and resuspended with SM buffer with the ratio 1:1 (weight of sample/g: volume of SM buffer/mL) before centrifugation at 1,000 × g for 20 min. The supernatant was collected and filtered before subjected to genomic DNA extraction using a commercialised kit. Polymerase chain reaction (PCR) technique was used to screen the V1, VP1 and L1 genes of beak and feather disease virus (BFDV), avian polyomavirus and avian papillomavirus, respectively. Findings revealed that the samples were negative for BFDV and avian polyomavirus. However, positive results of 1.5 kbp PCR amplicon were detected for avian papillomavirus in four out of the 12 samples (33.33%), which was from the white-crested cockatoo, African grey parrot, yellow-collared macaw and Senegal parrot. Sequence analysis of the L1 gene from the Senegal parrot Poicephalus senegalus revealed 93% identity to a reference Psittacus erithacus timneh avian papillomavirus. Conclusion, significance and impact of study This study added to the limited prevalence data of three important avian viruses which infect captive psittacines in Seri Kembangan, Selangor, Malaysia. Avian papillomavirus, but not BFDV and avian polyomavirus, was detected in the collected captive psittacine birds. Therefore, a routine screening can be performed to monitor the health status of birds despite their asymptomatic manifestation, in order to prevent possible virus transmission.
Virus Diseases ; Birds

Introduction: Hyperphosphatemia is common among hemodialysis patients, often accompanies with unfavourable clinical outcomes. Several factors affect phosphate compliance among hemodialysis patients, with lack of such information at the local context. Thus, this cross-sectional study aimed to determine the associations of sociodemographic factors, knowledge on optimal control of serum phosphate, perceived social support from family, dietary phosphorus intake and phosphate compliance among hemodialysis patients. Methods: Structured questionnaire was used to obtain information on socioeconomic factors, knowledge, family social support and dietary phosphorus intakes of hemodialysis patients, with serum phosphate level was used as the surrogate marker for phosphate compliance. Results: A total of 76 patients (Mean age of 52 years old) were recruited. Hyperphosphatemia was prevalent with approximately 60% of the patients failed to achieve the target. Approximately 90% of the patients perceived low level of family social support. Young patients had significant higher serum phosphate compared to their older counterparts (r = -0.297, p =0.009). Serum phosphate was positively correlated with dietary intake of phosphorus, dialysis vintage (r = 0.301, p = 0.006) and comorbidity score (r = 0.325, p = 0.008) while negatively correlated with dialysis dose (r = -0.582, p = 0.002) and family social support (r = -0.263, p = 0.024). Conclusion: The promising role of dietary phosphorus intake in managing hyperphosphatemia deserves further attention. Innovative approaches are needed to promote self-adherence on serum phosphate especially the younger patients. It is imperative to promote family social support in the management of hyperphosphatemia among hemodialysis patients.

The purpose of this study is to determine the prevalence and causes of visually impairment among children below 4 years old in two public tertiary referral hospitals in Selangor, Malaysia. In this cross-sectional retrospective study, the case files of all children aged below 4 years from the ophthalmology clinics in two separate public hospitals in Selangor, Malaysia were analysed over a 5-year period. The definition of visual impairment was based on the World Health Organization (WHO) classification, i.e. moderate visual impairment: visual acuity <6/18 to 6/60 in the better eye; severe visual impairment: <6/60 to 3/60 in the better eye; and blindness: visual acuity <3/60 in the better eye. Prevalence of visual impairment was based on the presenting visual acuity and then differentiated according to the cause of visual impairment diagnosed. A total of 243 (17.38%) children from a total of 1,398 children were classified as visually impaired. Most of these children (n=119, 49.0%) exhibited moderate visual impairment, 26 (10.7%) had severe visual impairment, while 98 (40.3%) were blind. Refractive errors (n=60, 24.7%) were the most common cause of vision impairment, mostly myopes (n=28, 46.7 %). This was followed by strabismus (n=31, 12.8%) and retinopathy of prematurity (n=29, 11.9%). In conclusion, vision impairment was prevalent in children aged below 4 years old presenting to two ophthalmology clinics in a highly urbanised region in Malaysia. High refractive errors were the major cause of vision impairment seen. Our study highlights the need and utmost importance of an early intervention programme to be implemented for these children since the main cause of vision impairment found in this study is an easily treated problem.

The purpose of this study is to determine the prevalence and causes of visually impairment among children below 4 years old in two public tertiary referral hospitals in Selangor, Malaysia. In this cross-sectional retrospective study, the case files of all children aged below 4 years from the ophthalmology clinics in two separate public hospitals in Selangor, Malaysia were analysed over a 5-year period. The definition of visual impairment was based on the World Health Organization (WHO) classification, i.e. moderate visual impairment: visual acuity <6/18 to 6/60 in the better eye; severe visual impairment: <6/60 to 3/60 in the better eye; and blindness: visual acuity <3/60 in the better eye. Prevalence of visual impairment was based on the presenting visual acuity and then differentiated according to the cause of visual impairment diagnosed. A total of 243 (17.38%) children from a total of 1,398 children were classified as visually impaired. Most of these children (n=119, 49.0%) exhibited moderate visual impairment, 26 (10.7%) had severe visual impairment, while 98 (40.3%) were blind. Refractive errors (n=60, 24.7%) were the most common cause of vision impairment, mostly myopes (n=28, 46.7 %). This was followed by strabismus (n=31, 12.8%) and retinopathy of prematurity (n=29, 11.9%). In conclusion, vision impairment was prevalent in children aged below 4 years old presenting to two ophthalmology clinics in a highly urbanised region in Malaysia. High refractive errors were the major cause of vision impairment seen. Our study highlights the need and utmost importance of an early intervention programme to be implemented for these children since the main cause of vision impairment found in this study is an easily treated problem.
visual impairment ; prevalence ; children ; blindness

This paper investigate the effect of parents’ education background and family monthly income on the Intelligence Quotient (IQ) of students with special needs in Kelantan, Malaysia. This cross-sectional method study was employed multistage random sampling to obtain information drawn from 130 participants from 10 selected school in Kelantan, Malaysia. Questionnaire was used to obtain parents’ education background, family monthly income and demographic variables. Students IQ were assessed using Comprehensive Test for Non-Verbal Intelligence (CTONI 2nd Edition). Data analysis involve independent sample t-test, one-way between group ANOVA, Pearson’s correlation and multiple linear regression. From analysis of IQ score, 63.8% of the special needs students scored very poor IQ, 12.3% scored below average and only 1.5% score average IQ. Significant mean difference were revealed between age group (p = 0.002), parents’ education (p = 0.018) and family monthly income (p < 0.05) on special needs students IQ. Post-hoc tukey shows significance between parents who never went to school, went to secondary school (p = 0.037) and university/college (p = 0.021). In term of family monthly income, significance difference were found between family with low and high monthly income (p < 0.05). Family monthly income (r = 0.393, p < 0.01) showed positive moderate correlation on special needs students IQ. After being forwarded by multiple linear regression, it was found that family monthly income (B = 3.605, p < 0.05) and age group of special needs students (B = 0.879, p = 0.002) were significant predictor for IQ score and explained 22.5% of the variance (R2 = 0.225, F (5,124) = 83.94, p < 0.05. Overally, majority of special needs students in current study have very poor IQ score. Further explanation are discussed on the paper.

Introduction: Microbial keratitis (MK) is an important cause for corneal blindness and understanding its risk factors enable us to improve management and minimise its complications. Methods: In this retrospective case review, medical records of all patients treated for MK from 2006 to 2013 was analysed to know the socio-demography, preceding risk factors, clinical characteristics, causative organisms and final visual outcome. Results: A total of 174 patients (180 eyes) were included in this study. Identifiable ocular risk factors included contact lens (CL) usage (85, 47.2%), ocular trauma (50, 27.8%), ocular surface disease (21, 11.6%), steroid use (6, 3.3%) and immuno-compromy (19, 10.5%). Association factors for presenting uncorrected visual acuity (UCVA) were age group (p=0.013), size (p<0.001), location (p<0.001) and hypopyon (p<0.001). The predictors for final best spectacle-corrected visual acuity (BSCVA) were age group (p<0.001), nationality (p=0.020), occupation (p<0.001), CL use (p<0.001), ocular surface disease (p=0.048), size (p<0.001) and location (p<0.044), hospitalisation duration (p=0.002) and presenting UCVA (p<0.001). Conclusions: Contact lens was the most frequent predisposing risk factor for microbial keratitis, followed by ocular trauma. Understanding the association factors for presenting vision and predictors for final vision may help in the patients’ management and improve eventual outcome of microbial keratitis.

Background: Caregivers of children with learning disabilities have been shown to experience increased stress and greater negative caregiving consequences than those with typically developing children. There remains a lack of studies focusing on stress and coping mechanisms among caregivers of a wider age group and diagnosis of individuals with disabilities in Asian countries. The current study examines levels of perceived stress and associated child and caregiver factors among caregivers of children with learning disabilities in the Malaysian context. An additional aim was to determine whether caregiver coping styles may be predictors of perceived stress. Methods: The Malay version of the Perceived Stress Scale with 10 items and the Brief COPE Scale were administered to a sample of 190 Malay caregivers of children with learning disabilities registered with community-based rehabilitation centres in Kelantan, a state in Peninsular Malaysia. Multiple linear regression analysis was applied to determine the predictors of perceived stress. Results: The mean total perceived stress score of caregivers was 16.96 (SD = 4.66). The most frequently used coping styles found among caregivers included religion, acceptance and positive reframing, while substance use and behavioural disengagement were least frequently used. Higher perceived stress was significantly predicted among caregivers with fewer children, frequent use of instrumental support and behavioural disengagement coping, and lack of emotional support and religious coping. Conclusion: Findings indicate that the perceived stress levels among caregivers were significantly predicted by different coping styles. It is vital to help the caregivers improve their good coping styles in order to reduce their stress levels.