Sarcoidosis typically affects young adults with bilateral hilar lympadenopathy, lung parenchymal disease and/or skin lesion. Childhood sarcoidosis is relatively a rare entity. Concurrent ocular and renal involvements are extremely uncommon especially in childhood sarcoidosis. We presented a case of an Asian teenager with bilateral recurrent anterior uveitis and features of renal failure due to childhood sarcoidosis. He showed remarkable clinical improvements after combination of oral corticosteroids and methotrexate. His final visual outcome was satisfactory following augmented trabeculectomy in both eyes due to intractable glaucoma. It is essential to make a prompt diagnosis and initiate proper management to avoid ocular mobidity in this unusual presentation.

·A 27-year-old man was stung by a bee presented with severe pain in the right eye. It was associated with reduced vision and swelling of the eyelids. A retained stinger was identified at the center of the cornea, surrounded by dense corneal oedema and numerous folds in the Descemet's membrane. The sting was removed completely. He subsequently developed persistent corneal oedema and heterochromia iridis. He was treated with intensive topical steroids. He underwent penetrating keratoplasty five months after the injury. His visual acuity was satisfactory one year after the surgery. Corneal oedema is an uncommon complication of bee sting injuries. It can be persistent and results in severe visual impairment. An early penetrating keratoplasty offers a good visual outcome after bee sting injury.

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a rare inherited cardiomyopathy characterised by right ventricular dysfunction, ventricular arrhythmias and increased risk of sudden cardiac death. Due to the replacement of myocardium with fibro-fatty and fibrous tissue, patients with ARVC are prone to develop ventricular tachycardia. Histologically, it is often reported as the ‘triangle of dysplasia’ involving the inflow tract, outflow tract and apex of the right ventricle.2 We describe a 20-years-old patient who collapsed during a futsal match and was subsequently diagnosed to have ARVC with a right ventricular thrombus from cardiac magnetic resonance imaging.

Objective: In this present study, we aim to evaluate the accuracy of the HbA1c relative to fasting plasma glucose (FPG) in the diagnosis of diabetes and pre-diabetes among The Malaysian Cohort (TMC) participants. Methodology: FPG and HbA1c were taken from 40,667 eligible TMC participants that have no previous history of diabetes, aged between 35-70 years and were recruited from 2006 – 2012. Participants were classified as normal, diabetes and pre-diabetes based on the 2006 World Health Organization (WHO) criteria. Statistical analyses were performed using ANOVA and Chi-square test, while Pearson correlation and Cohen’s kappa were used to examine the concordance rate between FPG and HbA1c. Results: The study samples consisted of 16,224 men and 24,443 women. The prevalence of diabetes among the participants was 5.7% and 7.5% according to the FPG and HbA1c level, respectively. Based on FPG, 10.6% of the participants had pre-diabetes but this increased to 14.2% based on HbA1c (r=0.86; P<0.001). HbA1c had a sensitivity of 58.20 (95% CI: 56.43, 59.96) and a specificity of 98.59 (95% CI: 98.46, 98.70). Conclusion A higher prevalence of pre-diabetes and diabetes was observed when using HbA1c as a diagnosis tool, suggesting that it could possibly be more useful for early detection. However, given that HbA1c may also have lower sensitivity and higher false positive rate, several diagnostic criteria should be used to diagnose diabetes accurately.
Diabetes Mellitus, Type 2 ; Diagnosis