Urinary lead concentration in chronic kidney disease patients at nephrology clinic in Sabah

Presently, scientific knowledge on the association between urinary lead concentration and renal profile is limited, especially on the characteristic of urinary lead that could aggravate existing kidney disease. This study aims to determine the concentration of urinary lead with serum creatinine and blood urea nitrogen in chronic kidney disease patients and to identify the influences of confounding factors and the blood pressure on the chronic kidney disease patients. Graphite Furnace Atomic Absorption Spectrometer was used to determine the urinary lead concentration. The differences and correlation of urinary lead with serum creatinine, blood urea nitrogen and diastolic blood pressure between the chronic kidney disease patients and control groups were assessed using Mann Whitney U and Spearman correlation tests. Our findings indicated a significantly higher urinary lead concentration in the chronic kidney disease group compared to the control group (p-=0.002). Nevertheless, there is a weak relationship between urinary lead with serum creatinine, blood urea nitrogen and diastolic blood pressure in the chronic kidney disease group (r values: -0.123, 0.101, and 0.127). In addition, sociodemographic factors did not influence the concentration of urinary lead (p>0.05). The urinary lead concentration in the chronic kidney disease group is not substantial, thus the evidence of urinary lead accumulation in chronic kidney disease group who have yet to start renal replacement therapy is inconclusive

Lower back pain and its association with whole-body vibration and manual materials handling among commercial drivers in Sabah

A cross-sectional study was undertaken to determine the prevalence of lower back pain (LBP) and its association with whole-body vibration (WBV) and manual materials handling (MMH). We studied 110 commercial vehicle drivers using a self-administered questionnaire and the VI-400Pro human vibration monitor. Prevalence of LBP was 66.4%. The percentage of drivers who had frequent manual handling of heavy loads was 45.5% and those who handled heavy loads in awkward postures accounted for 86.4%. Daily vibration A(8) averaged on the z axis was 0.25 (0.06) m·s−2 and at vector sum was 0.29 (0.07) m·s−2. Daily vibration exposures on the z axis, frequent manual handling of heavy loads and awkward posture during MMH were significantly associated with LBP. Drivers who are exposed to WBV and frequently handle heavy loads manually and with awkward postures probably have more LBP than drivers who are exposed to only one of these risk factors

Blood Lead Concentration and Working Memory Ability on Malay Primary School Children in Urban and Rural Area, Malacca

The most lead concentrations in the environment come from human activities such as burning fossil fuels, mining and manufacturing. Once lead enters into environment, it does not break down, but lead compounds were changed by sunlight, air and water. The main target for lead toxicity is nervous system. A child’s mental and physical growth can be affected even at low levels of exposure. Objective of this study was to determine the relationship between blood lead concentration and working memory ability among primary school children in urban and rural area, Melaka. The final number of 111 respondents participates in this study which represents 37 from urban area and 74 from rural area. The biological indicator for lead exposure was blood sample. WMI consist of Digit Span as a subtest which comprise of Digit Span Forward (auditory short-term memory) and Digit Span Backward (auditory working memory). The mean of blood lead concentration for urban children was 8.51±3.61µg/dL and rural children were 6.86±4.63µg/dL. There was significant difference of blood lead concentration between urban and rural children (t=2.061, p=0.042). Result showed the mean of WMI score for urban children was 82.03±12.55 and rural children the mean score of WMI was 87.30±13.88. There was significant different of WMI score between urban and rural children (t=-2.012, p=0.048). Result showed there was significant inversely correlation of WMI score with blood lead concentration among urban (r=-0.417, p=0.010) and rural (r=-0.369, p=0.001) children, and there was no association of socio-economic variables with WMI score. This study had made the conclusions; there was significant difference of blood lead concentration among urban and rural children. Urban children state high concentration rather than rural children. There was a significant difference of working memory ability among urban and rural children. Urban children showed lower score compared to rural children. There was inversely significant correlation between blood lead concentration and working memory ability among primary school children in urban and rural area, Melaka

Hearing impairment and contributing factors among fertilizer factory workers

INTRODUCTION: Hearing impairment remains the main occupational health problem in the manufacturing industry, and its contributing factors have not been well controlled. METHODS: Unmatched case control and comparative studies were carried out among fertilizer factory workers in Sarawak with the aim of determining contributing factors for hearing impairment. Respondents consisted of 49 cases that were diagnosed from 2005 to 2008 with 98 controls from the same work places. Chi-square test and Mann-Whitney test were used in a univariate analysis to determine the association between hearing impairment and the contributing risks being studied. RESULTS: The results of the univariate analysis showed that hearing impairment was significantly (p<0.05) associated with older age, lower education level, high smoking dose, high occupational daily noise dose, longer duration of service, infrequent used of hearing protection device (HPD), and low perception of sound on HPD usage. Multivariate logistic regression of hearing impairment after controlling for age found the following five variables: occupational daily noise dose ≥50% (OR 3.48, 95% CI 1.36-8.89), ≥15 years of services (OR 2.92, 95% CI 1.16-7.33), infrequent use of HPD (OR 2.79, 95% CI 1.15-6.77), low perception of sound on HPD (POR 2.77, 95% CI 1.09-6.97), and smoking more than 20 packs per year (OR 4.71, 95% CI 1.13-19.68). DISCUSSION: In conclusion, high occupational noise exposure level, longer duration of service, low perception of sound on HPD, infrequent used of HPD, and smoking more than 20 packs per year were the contributing factors to hearing impairment, and appropriate intervention measures should be proposed and taken into considerations

Factors associated with uncontrolled hypertension among hypertensive patients reported from different primary health clinics in Tuaran, Sabah, Malaysia: a cross sectional study

Objective: Hypertension is a major global issue and in an increasing trend. A disproportional balance between blood pressure controls among treated hypertensive patients is a challenge in public health as uncontrolled hypertension is the main contributor to cardiovascular, cerebrovascular and kidney diseases. Aims of the study are to determine the prevalence of uncontrolled hypertension and associated factors among hypertensive patients attending hypertension clinic at primary health clinics in Tuaran district. Justification of this study is uncontrolled hypertension causing high morbidity and mortality including premature death. Material and Methods: Study included 460 participants; is a cross-sectional study among hypertensive patient registered at three primary health clinics in Tuaran district, Sabah. Data were collected using structured modified questionnaires and analyzed using SPSS version 24.0. Results: Prevalence of uncontrolled hypertension was 45.9%. The study found that male gender (OR 2.1, 95% CI: 1.442, 3.061), high BMI status (OR 1.975, 95% CI: 1.305, 2.990), presence of diabetes mellitus (OR 3.436, 95% CI: 2.104, 5.613) and lower medication adherence (OR 1.834, 95% CI: 1.256, 2.678) were significantly associated with uncontrolled hypertension with p <0.05. Conclusion: The prevalence of uncontrolled hypertension in this study population was high with nearly half of the study population had uncontrolled hypertension. Combination of associated factors such as obesity, diabetes mellitus and lower hypertensive medication compliance had a higher impact on uncontrolled hypertension among the study group. This study further needed to address an attitudinal change, extra guidance, coaching and empowerment in the treatment of hypertensio

Assessment of Ergonomic Risk Level and Working Performance of Pre-Cast Construction Workers in Sabah

A cross-sectional study was conducted on 116 male pre-cast construction workers in Sipitang, Sabah to evaluate the association between Ergonomic Risk Level exposure and their working performances for 6 months (June to November 2014). Initially, a structured interview using a modified-Standardized Nordic Questionnaire was conducted on each study subject to determine the prevalence of Musculoskeletal Disorders (MSDs). The results showed that 93 out of 116 subjects (80.17%) complained of experiencing ache, pain or body discomfort during and after work with high percentage of MSDs prevalence affecting the wrist (78.5%), shoulder (73.1%), and lower leg (71.0%) regions of the body. Pictures and videos of workers performing their routine tasks were analyzed using Rapid Entire Body Assessment (REBA) tool to generate individual Ergonomic Risk Level classification. The results showed that all subjects were exposed to Medium (56.90%), High (29.31%) and Very High (13.79%) level of Ergonomic Risk. Pearson Correlation and One-way ANOVA test was conducted to determine the association between Ergonomic Risk Level and the subjects’ individual working performances. The results indicated that there was a significant negative association between Ergonomic Risk Level and the workers' performances in terms of tendency to work overtime (p<.001, r=-.55) and the frequency of taking unpaid leaves (p=.038, r=.56). In conclusion, continuous exposure to significant Ergonomic Risk Level among the pre-cast construction workers has triggered the development of MSDs which eventually affected their working performances

The North Borneo Iranun’s Community’s Ethnomedicine Knowledge on Marsh Clam (Geloina expansa)

Hamdan DDM, Shah JMD, Gumpulan F, Foo J, Lukman KA. 2020. The North Borneo Iranun's Community's Ethnomedicine Knowledge on Marsh Clam (Geloina expansa). Biodiversitas 21: 30-38. North Borneo is rich with natural resources that have boundless potentials for pharmaceutical product discovery that can lead to socioeconomic development in rural areas as suppliers. Even though rich with cultural heritage and comprises of hundred sub-ethnic groups, detail documentation of ethnomedicinal knowledge in North Borneo from different ethnic groups is still limited and could disappear in no time. The ethnomedicinal knowledge of marsh clam (Geloina expansa) use in the Iranun community (respondents no.=28) living in Kampung Rampayan Ulu, Kota Belud in North Borneo were investigated and the concentration of iron, zinc and copper in different parts of marsh clam tissues were determined. In postnatal care of the Iranun community, many believe that marsh clam soup help boost nursing mother milk supply. Marsh clam is rich with micronutrients of iron followed by zinc and copper. The mantle organ has a higher iron concentration than other tissues. The traditional knowledge to heal blood clotting and bruises is topical application of marsh clam mantle organs onto the wound areas. Although participants have ethnomedicinal knowledge on marsh clam, they have poor knowledge of the nutritional benefits of this clam. Lifelong learning of the benefit of marsh clam is necessary from local health care

Factors Associated with Diabetic Retinopathy among type 2 Diabetes Mellitus (T2DM) patients in Sabah Primary Health Clinics, Sabah Malaysia

Introduction: T2DM is a chronic progressing disease that often complicates with macrovascular and microvascular complications. Diabetic retinopathy is the leading cause of blindness in the world. 422 million adults suffer DM, lead to 2.6% of global blindness and 1.5 million deaths. In Malaysia, DM increases to 15.2% from 2011 survey and prevalence of diabetic retinopathy was 36.8%. Limited study about retinopathy in Sabah and Malaysia. The objectives are to determine the prevalence of diabetic retinopathy and major associated risk factors among T2DM patients in primary health clinic, Sabah. Methods: A cross sectional study design. Secondary data review on Sabah T2DM patients profiles that were registered in National Diabetes Registry from the year 2008 to 2015. The study was conducted from 5thMay-23rd May 2016. N=22,435 of T2DM patients from 46 primary government health clinics in Sabah. Respondents defined as T2DM patients who were managed at primary health clinic and entered in National Diabetes Registry. It is updated on new occurrence of complications, comorbidities, loss of follow up and death. Diagnosis by qualified medical doctor. T1DM, IGT, GDM were excluded. Diabetic retinopathy is a disturbance in visual acuity of a diabetic patients and pathological changes seen by fundoscamera. Results: The mean age is 61 years old and at the range of 50-69 years old. 59% are female. Chinese has the highest proportion with 22.9%. More than three quarter has hypertension, dyslipidaemia and has BMI>25.0, with mean of 27.5. The highest complications is retinopathy with 18.5%, followed by nephropathy 6.6%, IHD 1.8%, and <1% of CVA, amputation and foot ulcer. Out of 11 variables, there are 7 significant variables associated with diabetic retinopathy. There are duration of diabetes aOR 1.06(95%CI 1.05-1.07), older age of patients aOR 1.01(95%CI 1.00-1.02), hypertension aOR 1.6(95%CI 1.4-1.9), dyslipidaemia aOR 1.3(95%CI 1.2-1.4), higher than normal level HBA1c aOR 1.3(95%CI 1.1-1.4), nephropathy aOR 2.5(95%CI 2.1-2.9) and diabetic foot ulcer aOR 3.0(95%CI 2.0-4.8). Conclusion: Prevalence of diabetic retinopathy among T2DM patients in primary health clinic Sabah is 18.5%. Duration of diabetes, older age of patients, hypertension, dyslipidaemia, higher than normal level HBA1c, nephropathy and diabetic foot ulcer are the associated factors for diabetic retinopathy. The importance of clinical audit on diabetic eye screening and HBA1c monitoring among patients has to be strengthened in primary health clinics, especially patients nearing the pensioner age. Optimisation and control of blood pressure and lipid level could help to reduce the risk of developing diabetic retinopathy

Electrical safety in a hospital setting: A narrative review

Electrical hazard is a significant threat in hospitals that require sustainable assessment and improvement. Workplace assessment and medical surveillance systems are often overlooked, and employees fail to comply with the necessary measures that have been instructed at the workplace. The incidents are attributed to a lack of knowledge regarding occupational safety and health and a lack of awareness regarding electrical hazards importance. The consequences of neglecting these assessments may result in health deterioration and low work quality and may also cause disability and impairment. This review describes occupational safety and health perspective about electrical hazards in hospital settings. Further preventive measures were recommended to outline practical and feasible steps resulting in a safer and healthier working environment