Haemolytic disease of the foetus and newborn (HDFN) is caused by maternal red blood cells (RBC) alloimmunisation resulted from incompatibility of maternal and foetal RBCs. However, only a few HDFN attributed to anti-M were reported, varying from asymptomatic to severe anaemia with hydrops foetalis and even intrauterine death. A case of severe HDFN due to anti-M alloantibody from an alloimmunized grandmultiparous Malay woman with recurrent pregnancy loss is reported here. The newborn was delivered with severe and prolonged anaemia which required frequent RBC transfusions, intensive phototherapy and intravenous immunoglobulin administration. Although anti-M is rarely known to cause severe HDFN, a careful serological work-up and close assessment of foetal well-being is important, similar to the management of RhD HDFN. Alloimmunisation with anti-M type can lead to severe HDFN and even foetal loss.

BACKGROUND: A qualitative study providing an in-depth exploration of people's view and the increasing burden of overweight and obesity is required. This study aimed to explore the understanding of dieting and previous experiences on weight loss attempts among overweight and obese government employees in Kelantan, Malaysia, prior to recruitment into the intervention program. METHODS: Thirteen focus group discussions involving 129 participants from a weight-loss intervention program were conducted within the first 1 month of recruitment. These discussions were moderated by two trained researchers in the Malay language and assisted by an interview guide. They were audio-recorded and transcribed verbatim. A thematic analysis was performed, and codes and themes from each discussion were constructed. RESULTS: The participants understood dieting with various meanings, including skipping meals and removing rice from daily diets. They applied numerous methods to lose weight and achieved various outcomes. Health and appearance, social support, and compliance with current trends were the factors motivating these participants to lose weight. Their determination to lose weight was limited by lack of self-control and motivation, experiences of unpleasant effects, influence on weight, and environmental and health factors. CONCLUSION: Real-life weight loss experiences and perceptions provided relevant insights into current weight loss management strategies. Some of these issues and misunderstandings should be emphasized in weight loss strategies during health promotion.
Compliance ; Diet ; Focus Groups ; Health Promotion ; Malaysia ; Meals ; Motivation ; Obesity ; Overweight ; Qualitative Research ; Self-Control ; Weight Loss

Perioperative Patient Blood Management is part of the patient blood management (PBM) program specifically focused on surgical patients. Even though this concept had been introduced in 2010 by World Blood Organization (WHO), earlier studies in Europe had shown poor knowledge and practice among clinicians in this area. In Malaysia, PBM approach is still not comprehensive, and there was no published data to relate this problem with clinicians’ lack of knowledge and practice. Therefore, our main objective was to study the knowledge and practice of PBM among clinicians mainly involved in the perioperative field at Hospital Universiti Sains Malaysia (Hospital USM), Kelantan. A cross-sectional study was done from 1st December 2019 to 31st October 2020 using a structured and validated questionnaire containing 41 items. Logistic regression was used to evaluate the association between socio-demographic variables with knowledge level. A total of 252 participants were involved in this study. About 61.5% of the clinicians had a poor knowledge level. Poor knowledge level among clinicians was significantly associated with clinicians' age, primary field, previous knowledge about PBM, and PBM course attendance (p<0.05). The practice was at a moderate level. Overall, there were significant knowledge gaps and inadequate practice of PBM in perioperative patients among clinicians in Hospital USM. These results might guide the local clinical division to formulate more constructive and effective training strategies to strengthen the clinicians’ knowledge and practice of PBM in perioperative patients.
Knowledge