Introduction: Soil-transmitted helminth (STH) infections by Ascaris lumbricoides, Trichuris trichiura and hookworms still persist in rural and urban areas of developing communities. Recent studies in Malaysia focused on Orang Asli communities and none in the hospital settings. This study aimed to investigate the prevalence and associated risk factors for STH among children admitted to Paediatric ward of the Hospital Tengku Ampuan Afzan (HTAA). Materials and Methods: This study was conducted among 135 (78 males, 57 females) patients in HTAA from December 2017 to May 2018. Faecal samples were examined using wet smear, Kato-Katz, Harada-Mori and sedimentation techniques. Demographic data and hygiene practice information were collected using a pre-tested questionnaire. Results: The overall prevalence of STH was 5.9% (A.lumbricoides 5.2%, T.trichiura 0.7%, and hookworms 0.7%). Prevalence among males was 3.8% and females 8.8%. Majority (95.6%) were Malays. Chi square analysis showed that factors significantly associated with STH infections are household monthly income (p<0.05), education level of mother (p<0.05) and father (p<0.05), the source of drinking water (p<0.05), the method of garbage disposal (p<0.05). Logistic regression analysis confirmed garbage disposal via burning as a risk factor of STH infections (p= 0.021, OR=23.8, 95% CI=1.6- 350.06). Conclusion: This study shows that the prevalence of STH infections is low in children probably due to the effective implementation of control programs and good hygiene practice. Differences in individual lifestyles and the humid weather condition are probable reasons for sporadic infection to still exist.

Indexation status matters for scholarly journal prestige and trust. The performance of Malaysian medical journals at the international level is gauged through the global citation databases, and at the national level through MyCite, a national citation indexing system. The performance indicators include journals publication productivity, the citations they garner, and their scores on other bibliometric indices such as journal impact factor (IF), and h-index. There is a growing consciousness amongst journal editorials to improve quality and increase chances of getting indexed inMyCite. Althoughitisnow possible to gauge journal performance withinMalaysia,throughMyCite, the government and public are concerned about journal performance in international databases. Knowing the performance of journals in MyCite will help the editors and publishers to improve the quality and visibility of Malaysian journals and strategise to bring their journal to the international level of indexation.

AVM in the mandible is rare. It may present with recurrent episodes of unexplained gingival haemorrhage, bony swelling, tooth mobility or facial asymmetry. We reported our experience in managing a case of a 15 year old Malay girl who presented with a life threatening bleeding from her mandible.
Mandible ; Hemorrhage ; Arteriovenous Malformations ; experience ; Tooth Mobility

A study on heavy metals accumulation and human health risk assessment in the consumption of two tropical freshwater eel species (A. bengalensis bengalensis) from the Sungai Perak at Kuala Kangsar, Perak and (A. bicolor bicolor) from the Air Hitam irrigation canal, Kampung Kuala Sanglang, Kedah was carried out. Specimens were examined and analyzed for Pb and Cd concentrations using ICP-MS while the total Hg concentration was measured using a direct mercury analyzer (MA-3000). The range for the total concentrations (µg/g wet wt.) in A. bicolor bicolor were 0.01-0.4 (Cd), 0.03-0.77 (Pb) and 0.36-0.94 (Hg) while for A. bengalensis bengalensis, they were 0.76-1.23 (Cd), 0.01-0.10 (Pb) and 0.27-1.5 (Hg). A. bengalensis bengalensis (Sungai Perak) showed a significant strong relationship between Hg/Pb (r = .771, P < 0.05) and A. bicolor bicolor (Air Hitam irrigation canal) with Cd/Pb (r = -.895, P < 0.05) in muscle tissues and the results indicated Hg and Pb were introduced from point and non-point sources, therefore it is of concern. Interspatial comparison with the findings of previous local and international studies showed both species of freshwater eels accumulated Hg to high levels, exceeding the safe limits stipulated in the Malaysian Food Act of 1984, Food Regulations (1985) and USEPA (1997). However, the Target Hazard Quotient (THQ) and Hazard Index (HI) indicated that both freshwater eel spp. from the studied sites are safe to consume as there is no risk posed from consumption based on the health risk assessment results as Pb, Cd and Hg concentrations were under the permissible limits of nutrient intake.

Introduction: Depression and anxiety are common complications associated with traumatic brain injury (TBI) patients but screening tools which are validated to assess these complications in the TBI population are scarce. This study investigated the validity of the Malay version of Hospital Anxiety and Depression Scale (HADS) to screen for depression and anxiety among Malaysian TBI patients. Materials and Methods: This cross -sectional study recruited 101 TBI patients in which they were administered the Malay version of HADS and the Structured Clinical Interview for Diagnostic and Statistical Manual for Mental Disorder 4th Edition (DSM-IV) for Axis I Disorders (SCID-I) (as comparison tool). Internal consistency (Cronbach’s α) and concurrent validity (using receiver operating characteristics) of the Malay version of HADS were evaluated. Results: The total Malay version of HADS score and its anxiety subscale exhibited good internal consistency of 0.80 and 0.78 respectively, but the internal consistency of its depressive subscale was low at 0.57. The depressive subscale of the Malay version of HADS exhibited high area under the curve (AUC) of 0.86, specificity of 82%, sensitivity of 76% and negative predictive value of 91% but its positive predictive value was 58%, at cut-off point of 8/9. While the anxiety subscale also demonstrated high AUC of 0.88, specificity of 71%, sensitivity of 93% and negative predictive value of 98% its positive predictive value was only 34%. Conclusion: The Malay version of HADS is a valid screening tool for depression and anxiety among Malaysian TBI population.

Objective: To investigate the efficacy of pomegranate (Punica granatum) peel extract as an alternative treatment on the white laboratory mice against giardiasis.
Methods: Experimental animals were divided into five groups, including Group A:control (infected untreated), Group B: infected and fed with pectin 7 days before infection, Group C: infected and fed with pectin starting from 7th day of infection, Group D:infected and fed with pomegranate peel extract 7 days before infection, and Group E: infected and fed with pomegranate peel extract starting from 7th day of infection.
Results: Results from this study revealed that the prevention rate in the experimental groups reached approximately 50%by the 10th day of using pomegranate peel extract. Moreover, stool cyst counts of groups showed a significant reduction in the shedding of cysts approximately 75.6%by day 20 post-infection. ELISA test showed a reduction in Giardia antigen in the stools of the experimental groups which received pomegranate peel extract. The cure rate of these groups was approximately 97.4% by 28th day of infection.
Conclusions: Our present findings indicated that the pomegranate peel extract proved to be valuable in prevention and treatment of Giardia lamblia infection. Further studies are required to determine the effective dose of pomegranate peel extract against Giardia lamblia infection.

Introduction: Traditional medicine which includes Islamic faith healing centre is still an important place to seek treatment whether for psychiatric reasons or others. This study aims to determine the prevalence of psychiatric illness among attenders of an Islamic spiritual healing centre and to understand patients’ illness attribution and their religiosity. Methods: A cross-sectional study was done with a systematic random sampling to obtain the prevalence of psychiatric illness which was diagnosed using Malay version of Mini International Neuropsychiatric Interview (M.I.N.I). Religiosity was measured using Hatta Islamic Religiosity Scale 1996 (HIRS96) and illness perception using Brief Illness Perception Questionnaire (BIPQ). Results: The prevalence of psychiatric illness among the attenders was 53.5%. Depressive disorder were more prevalent (41.5%) followed by anxiety disorder (28.3%), bipolar disorder (16.8%) and psychotic disorders (5.9%). More than half (58.8%) of attenders attributed their illness to supernatural causes but there were no significant difference between those with psychiatric illness and those without in terms of their attribution to supernatural causes, p=0.197.Generally, the patients had a higher religiosity score. Conclusion : This high prevalence shows a need for collaboration with the spiritual healing practitioners to improve delivery of treatment to patient and this would be a more holistic approach.

Pilomatrixoma is a benign tumour that originates from the matrix of the hair root. This rare tumour is usually managed by the dermatologists. The commonest location of this tumour is in the head and neck region; hence, it can be encountered by any doctors with interest in this area. When presented in the neck, this hard tumour may pose a diagnostic challenge. A case report of pilomatrixoma misdiagnosed as a metastatic neck disease from fine-needle aspiration cytology is presented. The mistake in the diagnosis has led to a more aggressive and high morbidity surgery than necessary. It is important that head and neck doctors be aware of this condition and includes it in the differential diagnosis of hard masses presenting in the neck.

This is a retrospective study to determine the distribution site, associated fracture and causes of mandibular fractures at HUSM, over a 5 year period, from 1st January 2002 – 31st December 2006. Records of patients who had mandibular fracture were reviewed. Data of age, sex, site of fracture, causes and associated fracture were recorded and analyzed using SPSS version 15.0. There were 113 (84.3%) males and 21 (15.7%) females. The mean age for male was 84.3% and female was 15.7%. The fracture occurs mostly at the age of 11-20 years (45.5%), followed by 21-30 years (30.6%). Motor vehicle accidents (MVA) were the commonest causes of mandibular fracture (92.5%), followed by fight and assault (3.7%), industrial accidents (3.0%), fall (0.7%). There were no cases recorded due to sport injury. The commonest site of mandibular fracture occurs at angle and para-symphysis (23%), followed by body (20.1%), symphysis (16.7%), condyle (15.5%) and ramus (1.7%). The most common associated fractures were head injury (23.5%), followed by clavicle fracture (17.2%) and fracture of radius (10.7%). Mandibular fracture was common in males with the mean age 24.63 years and mostly due to MVA. Angle and para-symphysis is the commonest site of mandibular fracture with most of the patient suffered from concomitant head injury.