Introduction: Acne vulgaris is a chronic inflammatory dermatosis caused by Propionibacterium acnes. Clinicians are constantly attempting to discover the best antibiotic regimes in treating acne vulgaris. This study compares two regimens in terms of efficacy, tolerability, compliance and recurrence rate to make recommendation on which is the best regime. Methods: An open-labelled prospective randomized investigator-blinded interventional study was carried on moderate acne vulgaris patients. Patients were assigned to treatment arm at enrolment followed by follow-up and maintenance visits. Demographic data were collected at enrolment and questionnaire enquiring acne condition, general health and quality of life impairment were filled at every visit followed by blinded dermatologist assessment. Antibiotic tablets were provided based on assigned arm until follow-up 3. Results: 26 mild acne vulgaris patients aged 17 to 29 years were recruited. Physician assessment based on GAGS and photo assessment analysis showed an overall significant change (p<0.05) with decreasing trend indicating that the treatment is statistically effective. However, no significant differences (p>0.05) were found between regimens. Similarly, patient self-perceived assessment and CADI assessment also showed overall significant changes (p<0.05) with increasing trend indicating improvement in acne condition but no significant differences (p<0.05) between regimens. Conclusion: Neither regimen were significantly more efficacious than another. In view of cost, oral azithromycin 500mg daily for consecutive 4 days monthly is suggested as a better option.

Introduction: In Malaysia, herbal medicines are used for variety of reasons including health promotion and home remedies during pregnancy and postpartum with Manjakani (Quercus infectoria) as one of the most commonly consumed herbs. Herbal medicines consumption had been linked to heavy metals contamination and transfer from mother to infant and may affect infant’s growth and development. This study aims to (i) determine Manjakani consumption among postpartum mothers, (ii) quantify its heavy metals level, namely lead, cadmium, arsenic and chromium, and (iii) determine health risk associated with its consumption. Methods: A cross-sectional study involving 106 postpartum mothers was carried out in Kuala Lumpur. Six samples of Manjakani were sampled and extracted using microwave digester and analysed using Inductively coupled plasma mass spectrometry (ICP-MS). Non-carcinogenic health risks for herbal medicine consumption were calculated using Hazard Quotient (HQ). Results: Manjakani was consumed by 16% of mothers (n=17). Highest level of the metals was shown by chromium with mean concentration of 4210 ± 1910 ug/kg, followed by lead (170.8 ± 193.2), arsenic (39.3 ± 27.1) and cadmium (7.7 ± 0.76). There were no significant non-carcinogenic health risks with lead, arsenic, chromium and cadmium contamination (HQ < 1). Conclusion: Manjakani is consumed by mothers during confinement period. Heavy metals were quantified in Manjakani although no significant association was observed with socio-demographic characteristics and birth outcomes.

Introduction: Consumption of Chinese Herbal Medicine (CHMs) have escalated globally. They are preferred treatment for minor diseases or disorders. In Malaysia, CHMs are common home remedies during pregnancy and postpartum. Angelica sinensis (Danggui) is a staple CHMs during postpartum for purpose of nourishing blood and resolving stasis. Concerns are raised over possible heavy metals toxicity. Objective: This study aims to (i) determine Danggui consumption among postpartum mothers, (ii) quantify its heavy metals level, namely Lead (Pb), Cadmium (Cd), Arsenic (As) and Chromium (Cr) and (iii) determine health risks of Danggui consumption among mothers. Methods: A cross-sectional study involving 112 postpartum mothers was carried out in Kuala Lumpur. Danggui samples were collected from nine districts in Kuala Lumpur (Segambut, Seputeh, Cheras, Kepong, Bandar Tun Razak, Titiwangsa, Setiawangsa, Batu and Lembah Pantai). Heavy metals were extracted using microwave digester and analysed using Inductively coupled plasma mass spectrometry (ICPMS). Hazard Quotient (HQ) was used to determine non-carcinogenic health risks for herbal medicine consumption. Results: Danggui was consumed by 19.6% of mothers (n=22). Among them, incidence of jaundice was 63.6% and need for phototherapy was 40.9%. Heavy metals contaminations were found in the decreasing order of Cr > As > Pb > Cd with median (interquartile) of 3996.3 (2805.6) μg/ kg, 128.3 (56.7), 98.6 (99.1) and 37.0 (35.0) respectively. No non-carcinogenic health risks were found for all four metals. Conclusion: Alarming concentrations of heavy metals were quantified in Danggui warranting for further investigation to safeguard health of postpartum mothers.