Purpose: The objective of this study was to determine the prevalence of poor visual acuity, colour blindness and visual field defect of new Malaysian drivers. Methods: A total of 3717 new drivers (50.2% males and 49.8% females) age 19±6 years, voluntarily participated in this study. Standard optometric apparatus such as LogMAR Charts, Ishihara plates and HandHeld Bernell Perimeter were used and standard procedures were applied. Results: The visual examination showed 6.7% (n=250) of subjects achieved less than 0.3 LogMAR with better eye whilst 2.2% (n=83) had failed the Ishihara Test (2.1% males and 0.1% females). Most of the affected drivers were deutranopia. Only 2094 subjects had their visual field using a mobile Handheld Bernell Perimeter. 1.72% (n=36) subjects have less than 120 degrees of peripheral field of vision. Conclusions: The visual status among new Malaysian drivers needs to be taken seriously to ensure safe driving. Other factors such as colour vision and visual field screening have to be considered seriously when evaluating the visual performance of a driver. Good visual performance is indispensible for safe driving

There was no difference in female sexual dysfunction amongst women with and without benign gynaecological disease.

Convergence insufficiency (CI) is a binocular anomaly associated with difficulty of the two eyes to converge during near vision. This study investigated the performance of binocular vision in subjects with CI. The performance of binocular vision that comprised of distant binocular visual acuity (VA), near binocular VA and stereoacuity of subjects with CI were compared with normals. Thirty subjects with CI of mean age 17.33 ±5.49 year-old and 30 normal subjects of mean age 18.77 ± 6.08 year-old with visual acuity of VA 6/6 or better, spherical refractive error of no more than ± 4.00 DS, astigmatism no more than 2.00 DC, non-strabismic and never had vision therapy, with good general and ocular health were recruited for the study. The monocular VA of the right eye, monocular VA of the left eye, binocular VA and stereoacuity of the two groups of subjects were measured and the data were compared. Results of the study showed significant differences in the distance binocular VA (t = 2.31, p < 0.05), near binocular VA (t = 0.89, p < 0.05) and stereoacuity (Z = -2.81, p < 0.01) between CI and normal subjects. The study concludes that subjects with CI experienced reduced performances distance binocular VA, near binocular VA and stereoacuity compared with normal subjects.

Purpose: A survey on new Malaysian drivers was conducted in Malaysia between year 2006-2009. The objective of this study was to look at the effectiveness of the present computerized visual screening tool and to compare it with the conventional testing method. Methods: A total of 3717 drivers aged 19±6 years, who had passed in the computerized visual screening, participated in this study. Results: 250 subjects achieved less than 0.3 LogMAR with their best eye and 83 subjects failed the Ishihara Test after retested using the conventional tool. Conclusion: These finding showed the computerized visual screening test failed to filter some subjects according to the standards set.

Oxidative stress has been associated with postmenopausal osteoporosis which pre-disposes to risk of fracture. Palm tocotrienol is a potent antioxidant and has the poten-tial to be used for treatment of post-menopausal osteoporosis. The aim of the study is to determine if palm tocotrienol supplementation could alleviate oxidative stress in ovariectomised rat model and improve its bone strength. The rats were divided into four groups: (i) sham-operated group (SHAM) (ii) ovariectomised-control group (OVX) (iii) ovariectomised and given 60mg/kg α-tocopherol by oral gavage (OVX + ATF) (iv) ovariectomised and given 60mg/kg palm tocotrienols by oral gavage (OVX + PTT). After eight weeks of treatment, blood samples were taken to measure oxidative status (MDA, SOD and GPX) while the femurs were biomechanically tested for strength and resistance to fracture. Ovariectomy was shown to induce oxidative stress as shown by the raised MDA levels and reduced GPX activity. Palm tocotrienols seemed to offer protection against the ovariectomy-induced oxidative stress as shown by the suppression of MDA levels and raised GPX and SOD activities in the OVX+PTT group. In comparison, α-tocopherol was only able to raise the SOD but not as high as palm tocotrienols. The biomechanical tests have shown that ovariectomy has not af-fected the bone strength significantly after eight weeks. Palm tocotrienols supplemen-tation for eight weeks was effective in preventing oxidative stress in a post-meno-pausal rat.

This is a review of research done in the area of substance abuse in Malaysia. There were 109 articles related to substance abuse found in a search through a database dedicated to indexing all original data relevant to medicine published in Malaysia between the years 2000-2013. Only 39 articles were reviewed, and case series, case report, reviews and reports were excluded. Research reviewed include the epidemiology of substance abuse, genetics, treatment and its relation to health behaviour, and health management. Studies have shown that more males than females use drugs. There was also a high prevalence of blood-bourne virus diseases and sexually transmitted diseases among drug users. Two studies showed some genetic polymorphism (Cyp 3a4 gene and FAAH Pro129Thr) among heroin and amphetamine users respectively that may contribute to drug dependence. Study on pharmacological treatment for substance abuse were limited to methadone and it was shown to improve the quality of life of heroin dependant patients. Alternative treatments such as acupunture and spiritual approach play a role in the management of substance abuse. Data also showed that treatment centres for substance abuse are lacking facilities for screening, assessment and treatment for medical illness related to substance use, e.g. Hepatitis C and tuberculosis. Studies on the effectiveness of current drug rehabilitation centres were inconclusive.

A 28-year-old G3P1+1 at 6 weeks period of amenorrhea with a previous Caesarean section presented with per vaginal bleeding. A cervical ectopic pregnancy was confirmed by a transvaginal scan. An intramuscular methotrexate was given followed by intracervical route due to poor decline of the serum βHCG. However, due to persistent increment of serum βHCG, an additional four doses of intramuscular methotrexate with folinic acid rescue were administered and she responded well to the regime. Unfortunately, following the last dose, she developed an episode of excessive per vaginal bleeding which required suction and curettage of the cervical canal. A Foley‘s catheter balloon was placed intracervically as a tamponade and the bleeding was successfully arrested.

Prisoners tend to be marginalized and deprived of the rights and privileges that others may enjoy, this make them susceptible to depression. Extensive research have been carried out on treatment of depression, however a review is essential to determine the evidence based complementary approach for examining depression among prisoners. Thus, the objective of this paper is to evaluate the effectiveness of the complementary approach to reduce depressive symptoms among adult prison inmates. Literature on the randomized control trial of complementary approach on depression published between 2012 and June 2017 was searched using various keywords. Literature resources were mainly from PubMed, EBSCOhost, Science Direct, and Wiley Online Library. The inclusion criteria were English full text, adult prison inmates with a diagnosis of depression, while the exclusion criteria include diagnostic instruments or other pharmacological trials. A total 158 studies were identified and after eliminating 21 duplicates, there were 137 articles to review. 22 studies have met the criteria for full-text review, however, some papers were excluded due to valid reasons, and only five studies were eligible for final review. Yoga, music therapy and cognitive bibliotherapy have showed potential to be used as complementary approaches for reducing depressive symptoms. However, the approach of ‘seeking safety’, which is a short-term behavioural intervention, was found to have an insignificant effect. Meanwhile, Beck Depression Inventory were most commonly used study instrument for measurement of outcome. Future research is needed to account for the varying modes of depression intervention which includes pharmacology trial or other study design.

This was a pilot study comparing the success between early versus late external cephalic version (ECV) involving primigravidae with singleton breech pregnancy. They were randomised into early (34–36 weeks) and late (37-40 weeks) ECV groups. A total of 44 women were initially randomised into 22 women for each group. The overall ECV success rate was acceptable in both groups although insignificantly higher in the late ECV group (55.6% versus 46.7%, p= 0.732.) Caesarean section in the early ECV group was higher (80% versus 72.2%). Early ECV group had women with higher BMI (29.5 versus 26.8 kg/m2, p=0.107), anterior placentation (60% versus 38.9%) and extended breech presentation (55.6% versus 44.4%; p= 0.296). In conclusion, early ECV in primigravidae showed no better success rate than late ECV. Maternal obesity, anterior placentation and extended breech presentation should alert to failure risk.

Postpartum depression is a depressive episode that can start at any point during the first year after childbirth. There are several tools that can be used for PPD screening. The need to define a predictive tool that is clinically useful and has acceptable sensitivity and sensitivity is important especially to be used in the primary care setting. This systematic review investigates the evidence of the sensitivity and specificity of screening tools used for PPD screening. The Standard for Reporting of Diagnostic Accuracies (STARD) guidelines were used to conduct the review as a basis for our methodology. PubMed, ScienceDirect and Springerlink databases between 2007 until 2017 were comprehensively searched EPDS and BDI instrument has sensitivity of more than 80% but findings for specificity was inconclusive. The heterogeneity across studies could be the result of methodological differences in validation of the instruments. In addition, these studies were conducted across continents and settings with different cultures, languages and resources. We have identified 5 different instruments used to screen for postpartum depression. The EPDS was the most validated instrument in the review and we found that EPDS and BDI have higher accuracy to screen postpartum depression because the sensitivity reported were more than 80%.