Coping with dual sensory impairment or deafblindness can be a challenging task for an individual and for the caregiver. Currently limited information is available hence the objective of this study is to determine the profile and quality of life for children with dual sensory impairment or deafblindness. It is hoped that with this information, better rehabilitation programs can be designed for children with deafblindness in Malaysia. A purposive sampling was adopted. Children with dual sensory impairment were invited to participate in the study. Demographic and hearing loss information was extracted from the children’s medical records. Face to face interviews with parents were conducted using the SF-36 quality of life questionnaire. Vision assessment comprising visual acuity, refraction, cover test, external ocular examination and children’s behaviour observations was conducted. Four children were identified based on sample size calculation and fulfilled the dual sensory impairment criteria out of the 44 children screened. The mean age was 9.3 ± 2.9 years old. Majority of the children were of Indian ethnicity. The category of deafblindness was congenital deafblindness with rubella as the main cause. All the children were premature babies but had a normal birth weight. The hearing profile showed the majority of them had bilateral profound hearing loss with mean pure tone average ranging between 50 dBHL and 120 dBHL. The main type of hearing problem was sensorineural and the majority of children owned hearing aids. The visual profile of the deafblindness children revealed either light perception (LP) and categorised as blind or low to moderate myopia. A majority had esotropia. All the children used braille as a visual aids and children with residual vision used closed circuit television (CCTV). Tactile methods were the main means for communication and majority of the children used a white cane. Behaviour and external observation assessments concurred with the hearing and vision impairment manifested. Quality of life in these subjects was lower in 7 out of 8 SF-36 dimensions as compared to normative values. Congenital deafblindness is the main category found among the children in this study and they had profound vision and hearing losses. Tactile methods are the main means of communication for these children. Their quality of life was affected and introducing deafblindness rehabilitation, which includes a combination of hearing and low vision rehabilitation, will be able to assist them in coping with their daily activities.

Despite decades of intense research, malaria remains a deadly disease of the developing worlds. Drugresistance to limited available antimalarials, in part, has contributed to the persistence of this infectious disease. Likewise, the use of antimalarials such as artemisinin, though effective in global malaria control programs, is hampered by high cost and limited supply. Therefore, identification of an antimalarial drug that is easy to isolate and produce, inexpensive, and demonstrates little toxicity across a diverse population represents the ideal agent needed for global malaria control programs and eradication of this deadly disease. This review discusses several antimalarial compounds containing unique structural composition that have been isolated and characterized from plant sources. These compounds have exhibited promising antimalarial activities in vitro and in vivo. However, limitations such as toxicity, low bioavailability and/or poor solubility have probably restricted the scope of use for several plant products in humans. Nevertheless, plants provide novel leads, which can be developed into safe drugs by synthetic strategies as exemplified by artemether and quinoline class of antimalarials. Therefore, plant bioactive compounds described herein provide useful alternatives, which could be modulated to obtain antimalarials active against not only drug-sensitive, but also drug-resistant and multi-drug resistant strains of Plasmodium. In this direction, semi synthetic approaches to newer and modified antimalarials have provided useful insights into their applicability in antimalarial drug discovery.

This review is based on analysis of original research reports in one 2006 volume from each of three major epidemiology journals: The American Journal of Epidemiology, The International Journal of Epidemiology, and the European Journal of Epidemiology. A total of 149 research reports were included in the review. The pattern that emerged from the analysis was the tendency towards large epidemiological studies that utilise all available population-based data without resort to sampling. The tendency was to use data in existing data bases instead of field data collection. Developments in information technology enabled linkage between various data bases to extend the range of hypotheses that could be tested. The transition from sample epidemiology to population epidemiology had advantages and disadvantages. The main advantage was external validity (results of the study were applicable to the population). The main disadvantage was loss of internal validity that could be achieved in small studies with higher data quality and personal familiarity of the epidemiologist with the data. It is envisioned that in the future web-based data collection will be feasible. It will also be possible to use a wider range of data routinely collected online on citizens including credit card, shopping, and other financial transactions

Toxoplasmosis, caused by an intracellular protozoan parasite, Toxoplasma gondii, is widespread throughout the world. The disease is of major medical and veterinary importance, being a cause of congenital disease and abortion in humans and in domestic animals. In addition, it has gained importance recently due to toxoplasma encephalitis in AIDS patients. T.gondii was discovered 100 years ago. Its identification was rapidly followed by the recognition that it was a human pathogen. During the past 100 years, the spectrum of disease caused by this ubiquitous pathogen has expanded to include both congenital and acute infections as well as the recognition of diseases caused by this pathogen in the immune-compromised host. Recent data on behavioural changes in animals due to chronic toxoplasmosis is leading to research on the effect of this pathogen on the behaviour of human. Experimental studies on T.gondii have resulted in it becoming a model organism for studies on host pathogens interactions. Integration of clinical and experimental data on T.gondii should continue to lead to important insight into improvements in diagnosis for clinical management and vaccine development for control of toxoplasmosis.

Background: There was strong evidence from studies conducted in developed countries that second-hand smoke (SHS) exposure is detrimental to the birth weight of newborn. This study was conducted to determine the effect of exposure to SHS smoke during pregnancy on the weight of newborns. Methods: A retrospective cohort study was conducted. The exposed group consists of 209 postnatal women who experienced SHS exposure at home because of a husband or other housemate who smoked inside the house throughout the pregnancy. The non-exposed group included 211 women who did not experience SHS exposure at home or at work during pregnancy. We excluded non-Malay ethnicity, multiple births, and congenital defects. Results: There was a significant difference in the adjusted mean birth weight between exposed infants [2893.0 g (95% confidence interval (CI): 2781.3, 3004.7)] and not exposed infants to SHS [3046.1 g (95% CI 2929.5, 3162.6) (P < 0.001)] after controlling for significant maternal factors. There was a 12.9 g (95% CI: 7.01, 18.96) reduction in birth weight for a corresponding increase in the exposure to the smoke of one cigarette (P < 0.001). The incidence of low birth weight (LBW) was higher in exposed women, [10% (95% CI: 5.94, 14.06)] compared to non-exposed women [4.7% (95% CI: 1.85, 7.55)]. Conclusions: This study found a significant association between SHS exposure during pregnancy and decreased birth weight.

To report a rare case of left orbital rhabdomyosarcoma(RMS) presented with severe proptosis and fungating mass in an elderly patient.A 66 year Malay lady presented with severe proptosis and fungating mass in the left eye preceded by epistaxis for eight months. Biopsy showed histological features of alveolar RMS.

We conducted a multi-institutional case study to identify the issues associated with the adoption of information and communication technology (ICT) in five private care hospitals in the Kingdom of Saudi Arabia. We conducted interviews with 37 respondents primarily comprising IT professionals. We found that there were three determinants of behavioural intentions in this case study: organisation objectives, facilitating conditions and social influence where there are no effects of performance expectancy or effort expectancy. In all five cases, none of the moderators (age, gender, experience and voluntariness) in the original united theory of acceptance and use of technology model were considered critically important by IT professionals. In the present paper, all qualitative elements such as themes, patterns and overarching in the data were analysed to reach a conclusion. In addition, the various perspectives of using ICT are discussed.
Medical Informatics

Food is closely related with emotion. It often provides comfort and satisfaction. Some individuals choose to turn to food to curb their negative emotion, resulting in disturbances in eating patterns, such as overeating which lead to obesity and severely controlling food intake, which culminate in eating disorders like anorexia nervosa, bulimia nervosa and binge eating. These disorders are not related to the eating problems per se but often due to underlying or complicated by psychological factors, namely depression, anxiety, impulse control problems and personality. The roles of psychological factors in eating disorders and obesity should therefore not be downplayed. These disorders should be managed comprehensively involving multiple approaches, including not only biological but also psychological interventions provided by a professional team comprising endocrinologists, psychiatrists, dietitians, exercise physicians and surgeons.

We aimed to report the first case of anorexia nervosa in a young Malaysian Malay homosexual man with underlying borderline personality disorder and major depression. Patient and parents were interviewed. The Structured Clinical Interview for DSM IV was used to generate Axis-I diagnosis. The Hamilton Depressive Rating Scale was used to assess the severity of depression. His parents had marital discord. His father was overinvolved. Regarding anorexia nervosa, he had 163 cm height, 46kg weight and a body mass index (BMI) of 17 kg/m2 . His four limbs had multiple scratch marks. Laboratory test results showed anemia, leukocytosis and hypoalbuminemia. Family pathology, borderline personality disorder and homosexuality could be the risk factors of anorexia nervosa in this patient.

We aimed to report the first case of anorexia nervosa in a young Malaysian Malay homosexual man with underlying borderline personality disorder and major depression. Patient and parents were interviewed. The Structured Clinical Interview for DSM IV was used to generate Axis-I diagnosis. The Hamilton Depressive Rating Scale was used to assess the severity of depression. His parents had marital discord. His father was overinvolved. Regarding anorexia nervosa, he had 163 cm height, 46kg weight and a body mass index (BMI) of 17 kg/m2. His four limbs had multiple scratch marks. Laboratory test results showed anemia, leukocytosis and hypoalbuminemia. Family pathology, borderline personality disorder and homosexuality could be the risk factors of anorexia nervosa in this patient.