We report a case 35-year-old lady who developed acute psychosis following administration of cefuroxime and metronidazole. Earliest mood changes occurred on the second day of antibiotics therapy. She developed hallucinations, delusions and bizarre behavior 1 day after the completion of the antibiotic therapy. All the relevant investigations including CT brain were normal. The psychosis resolved completely within 5 days of antipsychotic treatment.

Introduction: Methadone maintenance therapy (MMT) requires a client to take a daily dose of methadone to reduce cravings for opioid and suppress withdrawal syndrome. Non-retention in the MMT will seriously expose more risk rather than the benefits of the program. Hence, determining the factors associated with non-retention to the MMT is essential. Thus, the present study was conducted to determine the proportion of non-retention and its associated factors among clients receiving MMT in Kelantan, Malaysia. Methods: By using a retrospective record review analysis, the required information of the clients was obtained from fourteen MMT clinics in Kelantan, Malaysia. A total of 155 clients were selected in this study using systematic random sampling. Multiple logistic regression analysis was performed to determine the factors associated with non-retention among clients receiving MMT. Results: It was found that the proportion of non-retention to the MMT in Kelantan, Malaysia was 21.9%. Clients with advanced age, taking daily direct observed therapy, and no underlying HIV were the predictors of non-retention among clients receiving MMT in Kelantan, Malaysia. Conclusion: The findings highlight a relatively high proportion of non-retention among the MMT clients. There is a need for an integrated, culturally relevant approach towards tackling the factors associated with non-retention in the future to keep this program sustainable and effective.

Introduction: Treatment adherence with antiretroviral therapy (ART) and its related factors have hitherto been the subject of clinical concern. However, research focusing on the relationships between ART adherence and the presence of psychological distress and selected personality traits have yet to be concluded. Therefore, our study aimed to remedy this. Methods: A multicentre hospital-based cross-sectional study was conducted in northwest Peninsular Malaysia on HIV outpatients given ART from July 1st, 2018, till April 31st, 2020. Participants were recruited via purposive sampling. Data were collected through an interviewer-guided questionnaires: Hospital Anxiety and Depression Scale (HADS) and Zuckerman-Kuhlman personality test (ZKPQ-M-40-CC), and interviewer-guided Timeline Follow-back (TLFB) for the assessment of adherence to ART. Results: A total of 229 patients completed the study. Majority (n=220, 96.1%) were considered adherent to ART. Among those who were non-adherent, two (22.2%) had anxiety disorder and five (55.6%) had depressive disorder. There was no significant association between treatment adherence and the presence of anxiety nor depression. However, sociodemographic factors determined that age group (p=0.033) and marital status (p=0.044) were significantly associated with treatment adherence. Multivariate analysis determined that ‘Active’ personality trait increases the likelihood to better treatment adherence by 1.14 times (95% CI: 1.02, 1.28, p=0.018). Conclusion: We did not find any association between treatment adherence and the presence of anxiety or depression. However, higher scores in ‘Active’ personality trait increases the likelihood of better treatment adherence among adult HIV on ART.