Waterborne diseases (WBDs) have continued to be a major health threat to people living in many underdeveloped countries due to absence of basic infrastructure, especially water and health care facilities. In this study we report the findings of an investigation into waterborne diseases amongst the riverine communities in Anambra State, South Eastern Nigeria. A survey of 1200 heads of household using a questionnaire and 600 hospital records were reviewed. A major concern of the study was to identify socio-economic and cultural factors that drive the epidemiology of such diseases. Findings revealed significant differences in the prevalence of waterborne diseases within and between the communities, implicating education levels of the head of household, occupation, and source of water used. The study recommends the provision of community health education through trained community health workers and provision of functional and accessible health care services as a primary means of combating water borne diseases.

Mental disorders cause a substantial amount of the burden of disease. Although they are less frequent in rural areas, their provision of care is disproportionately lower. Reimbursement claims in the federal state of Mecklenburg-West Pomerania of the years 2006/2007 serve as the basis for the descriptive distribution of subgroups on the total number of mental disorders and their outpatient care. Of all claims, 35.3% were allotted to neurotic, stress-related and somatoform disorders, 24.2% to affective disorders and 12.5% to substance use disorders. Claims for reimbursement were made for 44.7% by general practitioners, 15.1% by neurologists and psychiatrists, 12.6% by gynaecologists, and 8.1% by internists. Psychotherapists claimed 3.1%. These results cause considerations regarding the establishment of psychotherapeutic and neurological / psychiatric practices as well as the significance of mental disorders in the training of general practitioners.

Phonophobia and hyperacusis are two separate but closely related symptoms that are often mistakenly used in clinical practice as the same entity. Here we present a case report to highlight the distinguishing features of both and discuss the steps of management in these conditions. It is vital for the attending doctors to recognise hyperacusis and phonophobia as different entities to manage them successfully.

Background: Synovial sarcoma (SS) is a rare cancer and accounts for 5-10% of adult soft tissue sarcomas. Making an accurate diagnosis is difficult due to the overlapping histological features of SS with other types of sarcomas and the non-specific immunohistochemistry profile findings. Molecular testing is thus considered necessary to confirm the diagnosis since more than 90% of SS cases carry the transcript of t(X;18)(p11.2;q11.2). The purpose of this study is to diagnose SS at molecular level by testing for t(X;18) fusion-transcript expression through One-step reverse transcriptase real-time Polymerase Chain Reaction (PCR). Method: Formalin-fixed paraffin-embedded tissue blocks of 23 cases of soft tissue sarcomas, which included 5 and 8 cases reported as SS as the primary diagnosis and differential diagnosis respectively, were retrieved from the Department of Pathology, Tengku Ampuan Afzan Hospital, Kuantan, Pahang. RNA was purified from the tissue block sections and then subjected to One-step reverse transcriptase real-time PCR using sequence specific hydrolysis probes for simultaneous detection of either SYT-SSX1 or SYT-SSX2 fusion transcript. Results: Of the 23 cases, 4 cases were found to be positive for SYT-SSX fusion transcript in which 2 were diagnosed as SS whereas in the 2 other cases, SS was the differential diagnosis. Three cases were excluded due to failure of both amplification assays SYT-SSX and control β-2-microglobulin. The remaining 16 cases were negative for the fusion transcript. Conclusion: This study has shown that the application of One-Step reverse transcriptase real time PCR for the detection SYT-SSX transcript is feasible as an aid in confirming the diagnosis of synovial sarcoma.

Phaeohyphomycosis is a rare subcutaneous mycosis induced by dematiaceous fungi. Clinically, it is characterized by persistent hyperkeratotic nodules that respond poorly to treatment. A 48-year-old male presented with verrucous tumors and plaques on the trunk and extremities of twelve years duration. Histopathologic studies were consistent with a deep fungal infection, and culture studies identified the causative organism to be Veronea botryosa. The patient underwent surgical excision of some tumors and was given full courses of oral antifungals which did not lead to complete clinical cure. Twelve years after his last follow up, he presented with an increase in number and size of tumors,as well as pallor and weight loss. Histopathology of several skin tumors demonstrated fungal organisms and typical features of phaeohyphomycosis, and significantly, squamous cell carcinoma was present.

Human ; Male ; Middle Aged ; Antifungal Agents ; Carcinoma, Squamous Cell ; Dermatomycoses ; Fungi ; Pallor ; Phaeohyphomycosis ; Skin Neoplasms ; Weight Loss

Aesthetic or cosmetic dentistry is one of the main areas of dental practice. Increasing demands of patients for aesthetics has resulted in the development of several techniques for restoring the anterior teeth. Composite resin restorations have become an integral part of contemporary restorative dentistry and can be called “star of minimal invasion” due to its conservative concepts. The direct composite veneering allows restoring the tooth in a natural way and preservation of sound tooth structure when compared to indirect restorations. Before placement of direct composite veneers, a proper diagnosis, available treatment options, cost of treatment, patient’s expectations and duration of treatment should be taken into consideration. This article presents three case reports of aesthetic rehabilitation of anterior teeth using direct composite with satisfactory outcome that mimic the natural dentition.

Introduction: Increased prevalence of dengue fever had led to increase stress in providing optimal care for patients. This has been identified as a potential factor that may lead to negative health effects on medical doctors. This study was designed to review the prevalence and associated factors of burnout syndrome (including depression, anxiety, and stress level) among clinicians in the setting of increasing cases of dengue in Malaysia. Methods: A cross-sectional, multi-centre study was carried out among doctors in contact with patients with dengue infection from four major hospitals in Malaysia in 2015 using Maslach Burnout Inventory and DASS-21 questionnaire. Results: A total of 313 respondents were included in this study with 15.9% of the respondents experiencing high burnout syndrome. Long working hours, depression, anxiety, and stress were significantly associated with high degree of burnout syndrome (p<0.05). However, number of dengue cases reviewed was not significantly associated with the degree of burnout syndrome. Depression and stress were among factors identified as the predictors for burnout syndrome. Conclusion: High degree of burnout syndrome among clinicians with significant correlations with symptoms of depression and stress will require early identification to enable early measures to resolve, as well as prevent it. Future studies with more hospitals involvement should be conducted to establish the relationship between the degree of burnout syndrome and prevalence of dengue infection.

It is aging fast in Korea like other Asian countries. Social care systems, human resources, and appropriate senior products for elderly people are important factors to keep the society ealthy and productive. In this paper, we introduce the current status of senior products and standards in Korea including the Korea Senior Product Association (KSPA); present general status of the senior industry in Korea,long-term care insurance program for the elderly as well as welfare items; discuss problems and importance of standardization in the senior industry, the scope of senior products, and the current status of standardization.

Chronic Urinary Retention (CUR) can be either asymptomatic or associated with lower urinary tract symptoms. There has been no report of case of CUR presented with unilateral scrotal swelling. In the present report, a 69-year-old man came with an abdominal distension and left scrotal swelling. He was initially diagnosed with ascites secondary to a possible malignancy. A diagnosis was established after a computed tomography (CT) scan was done that revealed a giant bladder distension with volume of 10.1 litres. The left scrotal swelling was resolved after catheterization was carried out. There was a possibility that the patient had inferior vena cava obstruction secondary to the huge bladder

Marked improvement in the management of thalassaemia has not been matched by progress in psychosocial rehabilitation as thalassaemia continues to pose challenges to patients and their family members. Few studies have been carried out in Malaysia to look at such issues. This study is therefore to explore the concerns, beliefs and feelings about thalassaemia. It was conducted in the year 2009 over 7 months on “focus groups”, in patients aged 8-22 years and parents attending Paediatric Clinic of Tengku Ampuan Afzan Hospital, Kuantan, Pahang. Results showed that concerns and adverse impact were related to lower grades in education, poor self-image, less chance of employment, marriage, financial burden and social integration. Compliance to subcutaneous iron chelator was poor. There were various concerns related to blood transfusion therapy. It is evident that thalassaemia greatly affects the psychosocial dimensions and a more structured long term psychosocial support is needed to improve quality of life of patients.