An 18-year-old woman presented to the clinic with painless bleeding of her gums upon brushing her teeth. The bleeding stopped spontaneously, and there was no other bleeding tendency. On further questioning, the patient had irregular menses and was taking the oral contraceptive pills (OCP) Diane-35ED® to regulate her menses. She had been on this medication for four months. She was not on any other medication and had no chronic illness.

A 62-year-old man presented with severe bilateral ocular surface chemical injury and history of failed penetrating keratoplasty of right eye in 1996. Visual acuity was hand movement in right eye and light perception in left eye. Staged procedures of limbal stem cells allograft followed by penetrating keratoplasty have been done and resulted in good ocular surface restoration and rehabilitation of vision in right eye.

A healthy, six-year-old girl presented to the clinic with a three-day history of swelling on the foor of her mouth (Figure 1). Te swelling was painless and was not associated with discharge or bleeding inside her mouth. She also denied any fever, signifcant loss of weight or appetite, halitosis, dysphagia, and odynophagia. Tere was no other neck or chest swelling. On physical examination, her face and neck appeared normal and symmetrical. Cervical and submandibular lymph nodes were not palpable. However, there was an ill-defned, rounded, bluish swelling approximately 2 cm in diameter on the left foor of the mouth lateral to the frenulum. Te swelling was soft with a smooth surface but non-tender upon palpation. Tere was no bleeding or discharge noted in the oral cavity. Other oral structures appeared normal despite multiple caries on her deciduous teeth.

A 63-year-old male presented with sudden diminution of vision, eye discomfort, redness and watering in his left eye. He had undergone glaucoma valve filtering surgery for refractive secondary glaucoma one week back. He also had a history of failed augmented trabeculectomy one year earlier in the same eye. Ocular examination showed best corrected visual acuity(BCVA) of 6/18 and there was a bleb leak, shallow anterior chamber and intraocular pression(IOP) of 6mmHg. Successful sealing of bleb leak was performed using fibrin glue resulted in deepening of anterior chamber with IOP of 13mmHg. This case demonstrates that, fibrin glue is an effective method for management of early filtering bleb leak.

The aim of the Fourth Millennium Developmental Goal is to reduce mortality among children less than 5 years by two thirds between 1990 and 2015. Efforts are more focus on improving children’s health. The aim of this study was to describe the trend of stillbirth and neonatal deaths in University Kebangsaan Malaysia Medical Centre from 2004 to 2010. A retrospective cross-sectional study was conducted using hospital data on perinatal mortality and monthly census delivery statistics. There were 45,277 deliveries with 526 stillbirths and neonatal deaths. More than half of the stillborn cases were classified as normally formed macerated stillbirth and prematurity was common in neonatal deaths. The trend of SB and NND was found fluctuating in this study. However, by using proportionate test comparing rate, there was a transient significant decline of stillbirth but not neonatal deaths rates between 2004 and 2006. On the other hand, the neonatal deaths rate showed significant increment from 2006 to 2008. When both mortality rates were compared using proportionate test, from the start of the study, year 2004 with end of the study, year 2010, there was no significant decline noted. Trends of stillbirth and neonatal death rates in University Kebangsaan Malaysia Medical Centre within 7 years study period did not show the expected outcome as in Millennium Developmental Goal of two thirds reduction.
Stillbirth ; Infant Mortality

Background: Non-specific low back pain is one of the most common physical ailments affecting millions of people worldwide. This condition constitutes a significant public health problem and was listed as a prevalent health complaint in most societies. Even though there are many anecdotal claims for reflexology in the treatment of various conditions such as a migraine, arthritis and multiple sclerosis, but very little clinical evidence exist for reflexology on the management of low back pain per se.Objectives: This study aim to evaluate the effects of foot reflexology therapy as an adjunctive treatment to the Malaysian low back pain standard care in relieving pain and promoting health-related quality of life among people with non-specific low back pain. Methods and analysis: This is parallel randomized controlled trial with pre and post-treatment study design. The study setting for the intervention located at Penawar Reflexology Center, Kuala Terengganu, Malaysia. Total of 100 people with non-specific low back pain will be allocated into one of two groups, using a randomization computer program of Research Randomizer. The control group will receive low back pain standard care, while the intervention group will receive standard care plus eight sessions of foot reflexology therapy. The pain intensity and health-related quality of life scores will be measured using visual analog scale and Euro-quality of life scale respectively in both groups.Measurements: Outcome measures will be undertaken at pre-intervention (week 1), post-intervention (week 6) and follow-up (week 10).Conclusion: This will be the first trial to compare the foot reflexology therapy with control group among people who medically diagnosed with non-specific low back pain in Malaysia. The result of this study will contribute to better management of this population especially for Malaysia healthcare setting.Trial registration: The study was approved by the Human Research Ethics Committee of University Sultan Zainal Abidin (UHREC/2016/2/011). The study protocol was registered at ClinicalTrials.gov, with the ID number of NCT02887430

Myxoid liposarcoma is the major subtype of liposarcoma and commonly presents in the extremities, particularly in the thigh. We introduce an unusual case of a myxoid liposarcoma presenting as a large perineal swelling occupying the para-rectal and para-anal spaces in a 49-yearold male patient. The diagnosis, management, and prognosis of myxoid liposarcoma are discussed. A literature review is performed for myxoid liposarcoma.

This paper analyses the construct validity and reliability of a new developed questionnaire measuring the effects of the occupational safety practice and supervisory enforcement on the safety and health reporting among the oil palm labours. The exploratory factor analysis (EFA) was conducted to determine the underlying dimensions between variables and refine the proposed theory. The EFA was performed using the statistical analysis software SPSS. The questionnaire for all constructs was designed by adopting and customizing questionnaires from previous studies and reviewed by the language, content and statistical experts before it was administered on 100 oil palm Federal Land Development Authority (FELDA) labours. All of the variables passed the Bartlett’s Test of Sphericity (p-value < 0.05) and the measure of sampling adequacy using Kaiser-Meyer-Olkin (KMO > 0.60). The Cronbach’s Alpha value for the occupational safety practices for Organizational Safety Support (OSS), Safety Knowledge and Emergency Trainings (SKET), Compliance to Safety and Health Regulations (CSHR), and the Safety Procedures and Risk Management (SPRM) components were 0.957, 0.957, 0.940 and 0.936 respectively. The Cronbach’s Alpha for the supervisory enforcement construct was 0.930, while the value for safety reporting was 0.976 for component 1 and 0.936 for component 2. The validity and reliability of the questionnaires to assess the effect of occupational safety practice and the supervisory enforcement on the safety and health reporting among the Malaysian oil palm labours is confirmed.

Neurophobia, defined as ‘the fear of neural sciences and neurology’ is reported among medical students, which threatenedtheir performance in neurology course. This phenomenon has not been studied among rehabilitation sciences studentsdespite the significance of neurology as an area for rehabilitation. In this study we aim to assess the perceptions of neurologycourse and the possibility of neurophobia existence among rehabilitation sciences students of Universiti KebangsaanMalaysia (UKM). We also aimed to identify learning methods which are regarded as useful among the students. A surveyusing self-administered questionnaires was conducted among 73 students from School of Rehabilitation Sciences of theuniversity. Questions in the questionnaire were adapted from previous studies, in which neurophobia was indicated by poorknowledge and low confidence level in managing neurology course. Results showed that the percentage of participantswho perceived having good knowledge of neurology was significantly higher than the percentage who claimed of havingpoor knowledge level (90.4% versus 9.6%, p < 0.01). Similarly, the percentage of participants who claimed having highconfidence to handle neurology cases was higher than the percentage who expressed lack of confidence (79.2% versus20.8%, p = 0.03). However, neurology course was perceived as difficult by majority of the participants (78.1%) whencompared to other courses. Majority of the participants (97.3%) perceived clinical teaching as a useful method of learningrehabilitation science courses including neurology followed by problem-based learning (90.4%). While limited exposureto neurology cases was claimed as the main reason to why neurology is difficult. In conclusion, although neurology isperceived as a difficult course among rehabilitation sciences students, the students did not report lack of knowledge andconfidence in the course. This implies that neurophobia does not exist among UKM rehabilitation students. Enhancementof learning methods may assist in reducing the level of difficulty of neurology course among the students.

Among the main reasons for re-emergence of vaccine preventable diseases were missed or incomplete immunization schedule. The supplementary immunization activity (SIA) is an important intervention done to provide complete immunization coverage among those children. Better outcome came along with good knowledge and perception on the program. Thus, this study aims to assess the level of knowledge and perception of the mothers towards SIA program. A cross-sectional study was conducted among mothers with children ≤ 15 years old in Cheras, Kuala Lumpur. Data was collected by interview using the guided questionnaire consists of four sections to assess the socio demographic, socio economic, knowledge and perception regarding SIA. The questionnaire was validated for internal consistency with Cronbach’s alpha 0.461 for knowledge and 0.729 for perception. A total of 105 respondents with the median age of 33 years (IQR: 28-38) with majority of them are Malays (82.9%), Muslim (83.8%), married (97.1%) and (57.1%) with 1- 2 child in the family. Half of them were from low income family (46.7%) and had secondary education level (54.3%) and were housewives (47.6%). One third of the respondents (33%) never heard about SIA before. Overall had poor knowledge (82.9%) and perception (95.2%) towards SIA. There is a significant association between the level of knowledge on SIA with household income (χ^2=7.746, p=0.019) and occupation (χ^2=6.457, p<0.05). However, there was no significant association between the socio demographic and socio-economic factors and perception towards SIA. In conclusion, the knowledge and perception among mothers on SIA are still poor. More intensive health educations may be useful to be incorporated within the program implementation to increase the community understanding and perception towards SIA in the future.