Introduction: Hepatocellular carcinoma (HCC) is the most common primary malignant liver tumour, which commonly occurs in those with underlying chronic liver problems mainly cirrhoric liver with viral hepatitis (HBV and HCV) as the most common aetiological agent. HCC could also arise from non-chronic liver, which include non-B non-C (NBNC) hepatitis, which is different in pathogenesis, epidemiology and prognosis. This disease entity would include the commonly benign fatty liver leading to non-alcoholic steatohepatitis (NASH) and HCC as sequale. Methods: We present a case of non-B non-C HCC arising from a fatty liver in a non-alcoholic patient. Literature search was done with special emphasis on this disease. Conclusion: The incidence of NBNC HCC demonstrates an increasing trend, making it an important entity to be recognised early. A good understanding of this incidence would make it possible to predict the outcome, especially as the prognosis of non-B non-C HCC is fairly good if the HCC is found at an early stage

Visual Functions are affected by the aging process and without appropriate intervention eventually will results in diminishing visual acuity. As the situation proceeds difficulty to perform daily life activities ensureand will impact on the quality of life especially in the elderly. The objective of this study was to determine the effect of visual impairment towards daily activities and quality of life among elderly. Measurements that were conducted included visual acuity at distance using the LogMAR Chart to determine the level of visual impairment, quality of life test using the Low Vision Quality of Life (LVQOL) questionnaire and ability to cope with the activities of daily life was measured using the Barthel Index (BI). It was found that visual function progressively worsens with age, as did the BI which declined as visual function worsened. The LVQOL score reduced significantly with worsening visual ability. Thirty five percent of the elderly in this study required some form of optometric and low vision intervention. In conclusion, the deterioration in the functions among elderly can reduce the ability to cope with the daily life activities. Other than that, uncorrected visual acuity will cause reduction in the quality of life among the elderlies

Cognitive Impairment is common in late life and may be due to the normal process of ageing, or associated with physical or mental disorder which contributes to a decrease in quality of life, neuropsychiatric symptoms, increased disability and increased healthcare cost. The aim of this study is to determine the prevalence of cognitive impairment among the elderly members in NACSCOM in Day Care Centres within the Klang Valley and its associated socio-demographic factors such as age, gender and educational level. This cross-sectional study was conducted on 101 members of NACSCOM in Day Care Centres of Damansara,Subang Jaya and Setapak using assisted questionnaires as the research tool. The questionnaire comprising of a total of 10 questions based on Elderly Cognitive Assessment Questionnaires (ECAQ), consisted of three parts, memory, orientation and recall. One correctly answered question earned the respondent one mark. The total score for ECAQ is 10 where respondents with scores of 5 and below were identified as having cognitive impairment. Data collected was analyzed using Chi-square test (SPSS version 18). The prevalence of cognitive impairment among the elderly members of NACSCOM in Day Care Centres within the Klang Valley was 4.0%. This study also showed that there was no statistically significant association between cognitive impairment and sociodemographic factors such as age, gender and education. Prevalence of cognitive impairment among the members of NACSCOM in Day Care Centres within the Klang Valley was found to be low. This could be attributed to the fact that members actively participated in activities organized by NACSCOM. The study also did not find any statistically significant association between cognitive impairment and age, gender and education.

A rare case of primary squamous cell carcinoma of the thyroid is reported herein. A 64-year-old Malay lady presented with a gradually enlarging thyroid nodule for the past 6 months and underwent total thyroidectomy. Histopathology revealed a squamous cell carcinoma of the thyroid with complete resection. Possible primary tumour elsewhere was excluded. Postoperative irradiation was given and patient is still alive after 2 years of follow-up.
Desiccated thyroid ; Carcinoma, Squamous Cell ; Primary ; Case Report ; Histopathology

Breast cancer is the most common cancer among Malaysian women. This study aimed to determine the reproductive for premenopausal breast cancer risk in Kuala Lumpur, Malaysia. A case-control study was conducted in 216 histopathologically confirmed cases of premenopausal breast cancer and 216 community-based controls that were matched by age within a 5-year period and ethnicity. The results of this study showed that premenopausal breast cancer risks were strongly related to parity, number of live births and family history of breast cancer. Premenopausal women with these known reproductive and family history risk factors should take extra measures to undergo appropriate screening method for early detection of breast cancer

The long agonistic protocol for controlled ovarian hyperstimulation (COH) is effective and used most often, thus is considered the gold standard. Therefore any new regimen has to be compared in its results with those obtained with the long protocol. This report compares the efficacy of GnRH agonist and antagonist in a retrospective study of IVF/ICSI carried out in a tertiary teaching hospital from 2003 to 2006. Only the first COH cycle followed by IVF-ICSI from 200 couples (agonist = 120 and antagonist = 80) were analysed. The end points studied included the number of oocytes recovered, number of mature (MII) oocytes, fertilization, cleavage, morphology based embryo quality, pregnancy rate, quantity and cost of gonadotrophin. The average age of female subjects was 35.1 +/- 4.7 years with 50% being 35 years and above. Major infertility factors were tubal blockage, male factor and endometriosis altogether comprising 68%. GnRH agonist and antagonist cycle parameters were comparable except lesser amount of gonadotrophin was used with lower resultant costs (both p < 0.0005) in antagonistic regime. Antagonist regime produce somewhat more good quality embryos (p = 0.065), an insignificant difference. A clinical pregnancy rate per embryo transfer of 16.3% in agonist and 20.6% in antagonist regime was achieved respectively. In conclusion, GnRH antagonist protocol produced a COH response, embryonic development and pregnancy rates on par to GnRH agonist regime. Moreover GnRH antagonist protocol required a shorter stimulation period plus fewer complications. Hence GnRH antagonist regime provided means for a friendlier, convenient and cost effective protocol for patients.
Gonadorelin ; Protocols documentation ; Pregnancy ; Encounter due to In vitro fertilization ; Sperm Injections, Intracytoplasmic

Introduction: Knowledge, compliance, and attitudes toward the standard precaution guidelines are crucial to avoid contamination not only on patients but also on healthcare providers. Little is known regarding Malaysian nursing students’ knowledge, compliance, and attitudes toward standard precaution guidelines. The purpose of this study was to look into Malaysian nursing students’ knowledge, compliance, and attitudes towards standard precaution guidelines. Methods: This cross-sectional study was conducted among 337 Diploma nursing students who were chosen by simple random sampling. A self-invented questionnaire based on the CDC recommendations was administered to the participants and their responses were recorded. With a Cronbach’s alpha coefficient of 0.96, the instrument is reliable. The STROBE cross-sectional design process guideline was used as the study design. Results: Majority of the nursing students have adequate knowledge (n=222, 65.9%), adequate compliance (n=229, 68%) and good attitudes (n=171, 50.7%) with the standard precaution. The findings suggest an association between gender (p=0.005) and year of educational level (p=0.001) with the level of knowledge. There was also an association between the level of knowledge with the level of compliance (p=0.029) and the level of attitude (p=0.002) with standard precautions among the nursing students. Conclusion: Even though nearly two-thirds of the participants appeared to have adequate knowledge and compliance, only half of them have good attitudes with the standard precautions. This study indicates that although the students had adequate knowledge and compliance, measures are needed to foster compatible attitudes towards the standard precautions among the nursing students.