“Two Stones on One Bird”: A Case Report on Severe Biphasic Anaphylaxis Masquerading as Life-Threatening Acute Asth

BACKGROUND: Anaphylaxis often misdiagnosed and treated as acute asthma, especially when it has a predominant respiratory symptom, and there are no obvious precipitants or previous allergic history. This morbid outcome is preventable if the level of suspicion for anaphylaxis is high among healthcare provider when treating a patient who is not responding to the standard management of acute asthma. A proportion of anaphylactic patient shows a biphasic reaction which potentially fatal when it is under-anticipated and prematurely discharge without adequate observation period after the recovery of the initial episode. CASE REPORT: Here, we present a case of a young man who has childhood asthma with the last attack more than 10years ago presented with symptoms suggestive of acute exacerbation of bronchial asthma. As the symptoms failed to improve after standard asthma management, anaphylaxis was suspected, and he was given intramuscular adrenaline 0.5 mg which leads to symptom improvement. However, he developed another attack shortly after improvement while under observation. CONCLUSION: The objective of this case report is to emphasis the importance of keeping anaphylaxis in mind whenever a patient has treatment-refractory asthma, and also the anticipation of biphasic reaction that warrants adequate observation period especially those who are likely to have developed it

Effects of Machiavellianism on Ingratiation in Organizational Settings

Abstract: Influential behaviour has generally been shaped by personality. In organizational research, Machiavellianism has commonly been defined as the need to develop and defend one’s power and success. It is the utilisation of power to incite other people to act or believe in conformity with one’s own principle and a personality disposition that involves manipulative and deceptive intent. Whereas, ingratiation is an influence tactic to obtain favour from somebody by purposeful efforts. It is depicted as subordinates’ improper efforts within an organisation to enhance their interpersonal allure in the eyes of their superior. In other words, the subordinates are attempting to obtain the superior's approval with the aim of attaining favourable perquisites such as promotions and raises. Thus, such influence tactic is more often than not, a reflection of a personality trait found in Machiavellianism. On this premise, this paper elucidates the relationship between Machiavellianism and ingratiatory behaviours of subordinates in organisations. Key words: Machiavellianism; Ingratiation; Employees; Influence; Management Résumé: Les comportements influents ont généralement été façonnés par la personnalité. Dans les recherches organisationnelles, le machiavélisme a souvent été défini comme la nécessité de développer et de défendre le pouvoir et succès de quelqu’un. L'utilisation du pouvoir peut inciter d'autres personnes à agir ou à croire en conformité avec son propre principe et une disposition de personnalité qui implique l'intention manipulatrice et trompeuse. Alors que, la complaisance est une tactique d’influence pour obtenir la faveur de quelqu'un par des efforts constructifs. Elles sont considérées comme des efforts incorrects des subordonnés au sein d'une organisation pour améliorer leur allure interpersonnelles aux yeux de leur supérieur. En d'autres termes, les subordonnés tentent d'obtenir l'approbation du supérieur dans le but d'atteindre les avantages indirects favorables telles que la promotion et l’augmentation de salaire. Ainsi, ce genre de tactique d’influence est souvent un reflet d'un trait de personnalité trouvé dans le machiavélisme. Sur ce prémisse, ce document met en lumière la relation entre le machiavélisme et les comportements de complaisance des subordonnés dans les organisations. Mots clés: Machiavélisme; Complaisance; Employés; Influence; Gestio

Upward influence strategies: relationship with academics' career advancement

Often times, in academia world, academics report to superiors who are not from similar backgrounds and do not share the same standards, points of view or needs. Hence, to be effective, any particular academic staff must understand that upward power is partly based on the ability and willingness to use influence tactics. The aim of this paper is to provide an in-depth analysis of the relationship between upward influence strategies and employees’ career success. All three dimensions of upward influence strategies i.e. soft, hard and rational tactics have different effects towards career progression due to the nature of the tactics. The paper argues that career advancement, assuming that all other factors are equal, is a very subjective matter which lies upon three main influencing factors of ingratiation, assertiveness and reasoning

Ingratiation and the use of power in Malaysian secondary schools

It is presumed that an ingratiating subordinate would acquire more rewards from a leader. When the leader is receptive to influence, subordinates would attempt to impress him/her by presenting themselves to be competent. This holds true for any type of organizations. The objective of this paper is to analyze principals’ exertion of power in Malaysian secondary schools and teachers’ ingratiatory strategy. This paper argues that generally, principals’ leadership in schools can be considered as authoritarian and that therefore, teachers are prone to employing ingratiation tactic in order to obtain the principal’s approval and receive favorable outcomes

Knowledge and perception of integrity among Penang civil servants

The integrity of the civil servants needs to be greatly improved in order to turn Malaysian Vision 2020 into a reality. This objective of this research was to determine the level of awareness, knowledge and understanding on noble values particularly integrity among selected civil servants in selected State Government agencies in Pulau Pinang, Malaysia. The respondents were selected based on a purposive sampling technique. The research used a quantitative approach where self-administered structured questions were distributed. Descriptive and inference analysis were carried out to meet the research objectives outlined. The research findings showed that there were civil servants groups who were unclear and uncertain about the meaning of integrity in public sector. Those with shorter length of services were found to be less knowledgeable on the rule and procedure which led to them being unsure about integrity. Length of service was found to be inversely related to the perception on the knowledge of integrity, corruption and quality of service delivery. In this research, respondents might or might have not disclosed the actual truth when answering questions. Most heads of departments might have not wanted to disclose actual work realities of their offices. They, in particular, did not want to wash their dirty linen in public. For that reason, future research may improve on such limitation

Contribution Of Informal Street Vendors to Local Government Revenue During Post-Covid 19 Pandemic

This paper discusses the contribution of informal street vendors to local government revenue generation during the COVID-19 pandemic. Informal street vendors usually develop businesses to sell something and earn an income. They not only generate their income but also generate revenue for the local government. The main objective of local governments is to maintain and improve their efficiency. Therefore, this study aims to understand how informal street vendors contribute to the revenue of Kubang Pasu municipal in the short term, especially after the COVID-19 pandemic. The study covers 50 street vendors in Kubang Pasu. The results of the study show that there are only two (2) independent variables that affect the dependent variable. First, the relationship between affordable licenses and Kubang Pasu Municipal’s revenue shows a positive (0.301) and significant (0.019) relationship at a 0.050 level of significance, which means that the more affordable licenses issued, the higher the Kubang Pasu municipal revenue. Second, the relationship between the current post-pandemic business situation and Kubang Pasu municipal’s revenue shows a positive (0.541) and significant (0.058) relationship at the 0.10 level of significance, which means that the more accessible the business situation is in the post-pandemic period, the higher Kubang Pasu Municipal’s revenue will be. The newly developed revenue source will secure local government revenues in the long term and avoid budget deficits. Kubang Pasu Municipal needs to create new revenue sources, as they are still among the local governments with low revenue sources compared to local governments in other states

The perception of integrity of three public agencies in Kuala Terengganu

Malaysia in its effort to become a fully developed nation by 2020 has undertaken a monumental task in instilling noble values into its society including its civil sector. The integrity of the civil servants needs to be greatly improved in order to turn this vision into a reality. This project attempted to examine the level of awareness, knowledge and understanding on noble values particularly integrity among selected civil servants in selected State Government agencies in Terenganu, Malaysia. The respondents were selected based on a purposive sampling technique. The research used a quantitative approach where self-administered structured questions were distributed. Descriptive and inference analysis were carried out to meet the research objectives outlined. The research findings showed that there were civil servants groups who were unclear and uncertain about the meaning of integrity in public sector. Those with shorter length of services were found to be less knowledgeable on the rule and procedure which led to them being unsure about integrity. Length of service was found to be inversely related to the perception on the knowledge of integrity, corruption and quality of service delivery. For that reason, future research should identify the causes that will lead to enhancement of perception of integrity

Motivation Model for Employee Retention: Applicability to HRM Practices in Malaysian SME Sector

In the Vision 2020, Malaysian government aims at achieving a developed nation status by the year 2020. To realize the vision, the country needed the support and motivation from all Malaysians. Hence, human resource management (HRM) plays an important role for the said vision since it is a significant capital in the operation of an organization. For Malaysian entrepreneurial firms, it is crucial to retain their employees in order to achieve their ultimate goal i.e. maximizing profits. Such small, growthoriented firms are considered vulnerable to lose even one key employee because it may aggravate extensive consequences and, at the extreme, may imperil exertions to attain organizational objectives. Employee retention becomes a vital human capital objective for entrepreneurial companies which are seeking to grow and capture market share. Motivation is essential in leading the employees towards achieving organizational goals besides fostering the organizational commitment. Such organizational attachment and motivation has implications for whether an employee will opt for remaining with the organization or not. With HRM, the human resource (HR) model would regard humans as being inspired by an intricate collection of interconnected aspects, such as recognition, interpersonal relation, and desire for meaningful work. HR managers must endeavour to redesign the job to be more varied and decentralized in order to encourage sovereignty among employees. Therefore, motivation model is relevant to be employed in HRM practices for employee retention. This paper is primarily based on literature review. Extensive literature study is used to identify relevant information and references. This paper intends to elucidate one particular issue with regards to Malaysian SMEs which is employee retention and in more specifically, this study will aim to produce a model for employee retention conjoining it with organizational strategies, organizational culture and benefits factors. To attain this aim, the two-factor, or motivation-hygiene theory (Herzberg, 1968) was taken as the basic foundation.Key words: Motivation-hygiene; Vital human capital; Sovereignity; JEL Codes: C11, J1

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries(1,2). However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world(3) and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health(4,5). However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular riskchanged from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.Peer reviewe