A 4-year-old boy complained of dryness of lips for a 3-month duration. The dryness progressed to becoming scaly and painful, and lesions extended beyond the lip area. The condition was associated with peri-oral itchiness. The boy was observed to be licking his lips subconsciously a few times per minute. The lesions started with a habitual licking of the lips. There was no history of allergies or any recent intake of a new drug. There was also no history of atopy in the patient or his family

Hibernoma is a slow growing, rare benign tumour, which derived from brown adipose tissue. This tumour is usually found in the area where foetal fat persists such as back, axilla, retro peritoneum and thorax. Hibernoma rarely occurs in the retro pharynx. We report a case of retropharyngeal hibernoma in a 44-year-old male. He presented with obstructive symptoms for six months and a retropharyngeal mass upon examination. His CT scan findings showed a mass in the prevertebral region from level of C2 until C5 causing narrowing of upper aero digestive tract. Histopathological examination reported as hibernoma.
Lipoma

OBJECTIVE: Electrophysiological studies, which are mostly focused on afferent pathway, have proven that auditory processing deficits exist in patients with schizophrenia. Nevertheless, reports on the suppressive effect of efferent auditory pathway on cochlear outer hair cells among schizophrenia patients are limited. The present, case-control, study examined the contralateral suppression of transient evoked otoacoustic emissions (TEOAEs) in patients with schizophrenia. METHODS: Participants were twenty-three healthy controls and sixteen schizophrenia patients with normal hearing, middle ear and cochlear outer hair cells function. Absolute non-linear and linear TEOAEs were measured in both ears by delivering clicks stimuli at 80 dB SPL and 60 dB SPL respectively. Subsequently, contralateral suppression was determined by subtracting the absolute TEOAEs response obtained at 60 dBpe SPL during the absence and presence of contralateral white noise delivered at 65 dB HL. No attention tasks were conducted during measurements. RESULTS: We found no significant difference in absolute TEOAEs responses at 80 dB SPL, in either diagnosis or ear groups (p>0.05). However, the overall contralateral suppression was significantly larger in schizophrenia patients (p<0.05). Specifically, patients with schizophrenia demonstrated significantly increased right ear contralateral suppression compared to healthy control (p<0.05). CONCLUSION: The present findings suggest increased inhibitory effect of efferent auditory pathway especially on the right cochlear outer hair cells. Further studies to investigate increased suppressive effects are crucial to expand the current understanding of auditory hallucination mechanisms in schizophrenia patients.
Afferent Pathways ; Auditory Pathways ; Case-Control Studies ; Diagnosis ; Ear ; Ear, Middle ; Efferent Pathways ; Hair ; Hallucinations ; Hearing ; Humans ; Noise ; Schizophrenia*

OBJECTIVE: The present, case-control, study investigates binaural hearing performance in schizophrenia patients towards sentences presented in quiet and noise. METHODS: Participants were twenty-one healthy controls and sixteen schizophrenia patients with normal peripheral auditory functions. The binaural hearing was examined in four listening conditions by using the Malay version of hearing in noise test. The syntactically and semantically correct sentences were presented via headphones to the randomly selected subjects. In each condition, the adaptively obtained reception thresholds for speech (RTS) were used to determine RTS noise composite and spatial release from masking. RESULTS: Schizophrenia patients demonstrated significantly higher mean RTS value relative to healthy controls (p=0.018). The large effect size found in three listening conditions, i.e., in quiet (d=1.07), noise right (d=0.88) and noise composite (d=0.90) indicates statistically significant difference between the groups. However, noise front and noise left conditions show medium (d=0.61) and small (d=0.50) effect size respectively. No statistical difference between groups was noted in regards to spatial release from masking on right (p=0.305) and left (p=0.970) ear. CONCLUSION: The present findings suggest an abnormal unilateral auditory processing in central auditory pathway in schizophrenia patients. Future studies to explore the role of binaural and spatial auditory processing were recommended.
Auditory Pathways ; Case-Control Studies ; Ear ; Hearing* ; Humans ; Masks ; Noise* ; Schizophrenia*

Objectives This study aims to detect MRSA nasal carriers among medical staff and patients in Dermatology ward Hospital Kuala Lumpur by using two methods, the conventional blood sheep agar (BSA) and the novel BBL CHROMagar MRSA (C-MRSA). It also aims to compare the BSA medium with the C-MRSA medium in terms of specificity, sensitivity and time to detection to MRSA. Method A single centre, prospective study where 100 nasal swab samples were taken from medical staff and inpatients, then plated on to both BSA and C-MRSA. After 24 hours incubation, the plates were examined for presence of bacterial colonies, then incubated for another 24 hours if no colonies were present. All colonies on C-MRSA and BSA were subjected to coagulase and susceptibility testing for confirmation of MRSA. MRSA strains produce mauve colonies on CMRSA from hydrolysis of the chromogenic substance, thus C-MRSA uses colour as a diagnostic tool. Results Mauve colonies were present on nine C-MRSA plates in the first 24 hours which were all confirmed to be MRSA. Another nine CMRSA plates isolated bluish colonies which were not MRSA. There were colonies on 96 BSA plates, nine of which were MRSA. C-MRSA medium has 100% sensitivity and specificity in detecting MRSA. Both culture media had similar detection rates of MRSA from nasal swabs, however C-MRSA allows for earlier detection of MRSA within 24 hours compared to BSA which takes 48 hours. 2.2% of ward staff and 15.7% of inpatients were found to be MRSA carriers. Conclusion CHROMagar MRSA allows for more rapid identification of MRSA carriers within 24 hours compared to the conventional BSA which takes 48 hours. This allows earlier action to be taken to reduce the spread of MRSA infection.

A study was conducted to determine the level of mothers' perception on children with cleft deformity and its associated factors This was a cross sectional study involving 110 mothers with children attending the Plastic And Reconstructive Surgery Clinic. Data was gathered from a face to face interview based on a questionnaire that assesses the level of perception and its associated factors. The level of perception was evaluated from a scoring method and divided into four domains namely psychosocial, care management, treatment and education. The level of perception was high in all four domains ranged from 62% for treatment and 80% for education. Factors that were significantly associated with the level of perception were ethnicity, religion, type of cleft deformity and level of information. Information regarding cleft deformity must be tailored toward mothers’ personal characteristics and type of cleft deformity to improve mothers' perception on this problem.

Sleep quality can vary in relation to one’s general well-being and in the elderly, it is often affected by the presence of medical or psychological conditions. This study aims to determine the frequency of different components of sleep quality in the elderly, and their relationships with psychosocial and medical attributes. A cross-sectional study was conducted on 123 attendees aged 60 years and above at Pusat Perubatan Primer Universiti Kebangsaan Malaysia. Sleep quality and psychological distress were assessed using the validated Malay versions of Pittsburgh sleep quality index (PSQI) and Hamilton anxiety depression scale (HADS) respectively. Information on medical comorbidities and medications were obtained from the participants, their doctors and medical notes. Almost half of the patients experienced poor sleep quality (47.2%) which was significantly associated with older mean age (69.5 ±4.55). There was no statistical significance between sleep quality and other sociodemographic characteristics (gender, ethnicity and living arrangement). Most patients described their sleep quality as subjectively generally “fairly good” (69.1%) despite PSQI scores indicating poor sleep quality. A majority of the patients (59.3%) were on follow-up for 3 or more medical illnesses, with heart disease as the only medical comorbidity significantly associated with poor sleep quality. Most of them also complained of only “mild difficulty” with their sleep. Among the 7 sleep components of PSQI, “sleep disturbance” was the most frequent experience. Most experienced mild sleep disturbance (87.8%) and usage of hypnotic agents was low (6.5%). Only 23.6% of patients had significant psychological distress (HADS scores ≥ 8), with positive correlation with sleep quality.
Sleep ; Polysomnography

This article discusses on the natural compounds from the ant plant (Myrmecodia species, family: Rubiaceae). The ethyl acetate (EtOAc) extract from the tuber of M. platytyrea was fractionated by using medium pressure liquid chromatography, giving eight fractions (F1-F8). Those fractions were evaluated using the 2, 2-diphenyl-1-picrylhydrazyl (DPPH) assay. Fraction F5 was recorded as potent (EC50 = 21.57 ± 1.40 µg/mL). Then, it was purified by using column chromatography (CC) (mobile phase = chloroform: EtOAc). From the CC, ten fractions (F5F1-F5F10) were obtained and compound (1) was isolated from F5F3 via preparative thin layer chromatography (TLC). After spraying with anisaldehyde-sulphuric reagent, compound (1) gave a green TLC spot (Rf = 0.65, 100% CHCl3 , multiple development). The 1 H-Nuclear Magnetic Resonance (NMR) spectroscopy (500 MHz, CDCl3 ) was performed to determine the chemical framework of (1). This compound was identified as morindolide, having an iridoid structure. Meanwhile, the mass spectra for compounds (2) and (3) were analysed. The data presented the molecular ion at m/z 375 [M-H]- and 255, suggesting the formulation of 2-(2-methylbutyryl)phloroglucinol glucoside and a flavanone, respectively. From the literature, compound (1) was firstly isolated from a Chinese natural medicine, the dried root of Morinda officinalis (family: Rubiaceae). The flavonoids are also included as the biologically active compounds from Myrmecodia. In short, this is the first occurrence of morindolide from the ant plant.
Flavonoids

Anxiety and depression were known to bring detrimental outcome in patients with ischemic heart disease (IHD). Notwithstanding their high prevalence and catastrophic impact, anxiety and depression were unrecognized and untreated. The aim of this study was to determine the prevalence of anxiety and depression among IHD patients and the association of this condition with clinical and selected demographic factors. This was a cross-sectional study on 100 IHD patients admitted to medical ward in UKMMC. Patients diagnosed to have IHD were randomly assessed using Hospital Anxiety and Depression Scale (HADS) and Perceived Social Support (PSS) Questionnaire. Socio-demographic data were obtained by direct interview. Fifteen percent of IHD patients in this sample were noted to have anxiety, fourteen percent noted to have depression while thirty two percent was noted to have both anxiety and depression. Patients’ age group and the duration of illness were found to have significant association with anxiety. Socio-demographic data were obtained by direct interview. Fifteen percent of IHD patients in this sample were noted to have anxiety, fourteen percent noted to have depression while thirty two percent was noted to have both anxiety and depression. Patients’ age group and the duration of illness were found to have significant association wit¬h anxiety. The other clinical and selected demographic factors such as gender, race, marital status, education level, occupation, co-existing medical illness and social support were not found to be significantly associated with anxiety or depression among the IHD patients. In conclusion, proper assessment of anxiety and depression in IHD patients, with special attention to patients’ age and duration of illness should be carried out routinely to help avert detrimental consequences.​

Diabetes in pregnancy is associated with risks to the woman and her developing fetus. Management of the condition at the primary care level includes pre-conception care, screening, diagnosis, as well as antenatal and postpartum care. A multidisciplinary approach is essential in ensuring its holistic management.