Major Depressive Disorder (MDD) is substantially higher in people seeking Methadone Maintenance Therapy (MMT) as compared to the normal population. Erectile Dysfunction (ED) is one of the side effects of Methadone Maintenance Therapy (MMT) which is rarely explored as it is regarded as a sensitive topic. This study aims to determine the prevalence of MDD and its association with ED among MMT clients. A cross-sectional study was conducted involving 160 subjects who attended the Methadone outpatient clinic. The clients were given Patient Health Questionnaire-9 to screen for depressive symptoms and MINI International Neuropsychiatric Interview to diagnose MDD. ED was diagnosed using the 5-item International Index of Erectile Function. The results showed the prevalence of depression in clients on MMT was 30.6% and the prevalence of ED was 72.5%. On multivariate analyses, there were significant associations between ED with depression (P<0.05). Smoking also was found to be contributed to depression. Sociodemographic factors, comorbid medical illnesses, and illicit substance use were found to have no associations with depression. Therefore, given the prevalence of MDD and ED in MMT clients was high, routine assessment of depressive symptoms and sexual function in clients on methadone should be done to minimize their negative impact on the clients

Background: COVID-19 was first detected in Malaysia on 25 January 2020. Multiple clusters were detected in Petaling District, with the first locally transmitted case reported on 8 February. Descriptive analyses of the epidemiology of the COVID-19 outbreak in Petaling are presented, from the first case to the end of the first wave. Methods: All laboratory-confirmed COVID-19 cases reported to the Petaling District Health Office between 1 February and 26 June 2020 were analysed. Socio-demographic characteristics, symptoms, date of onset, date of exposure, travel history and history of comorbidities were obtained by phone interviews using one of two investigation forms. The descriptive analysis was conducted according to time, place and person. Results: There were 437 COVID-19 cases, for an incidence rate of 24/100 000 population. Ten (2.3%) deaths and 427 recovered cases were recorded. Of the 437 cases, 35.5% remained asymptomatic and 64.5% were symptomatic. Common symptoms included fever (43.8%), cough (31.6%) and sore throat (16.2%); 67.3% had no comorbidities, 62.5% reported close contact with a confirmed case, and 76.7% were local infections. Transmission occurred in four main groups: religious gatherings (20.4%), corporations (15.1%), health facilities (10.3%) and a wholesale wet market (6.4%). In 31.9% of confirmed cases, an epidemiological link to an asymptomatic case was found. Conclusion: Transmission of the disease by asymptomatic cases should be emphasized to ensure continuous wearing of face masks, hand hygiene and social distancing. Further research should be conducted to better understand the transmission of SARS-CoV-2 from asymptomatic cases.

Homocystineimia is an Inborn Errors of Metabolism (IEM) which can occur due to accumulation of homocysteine. Homocysteine is one of the sulfur-containing amino acid with thiol group that is formed by demethylation of methionine. Deficiency of enzymes involves in homocysteine metabolism can give rise to seven types of homocystinemia subject to total homocysteine level. Therefore reference ranges are needed to differentiate between normal and abnormal population as well as the type of homocystineimia depending on the enzymes defect in the pathway. Hence, homocysteine reference ranges in children for the Malaysian population were postulated. 3 mL of blood was collected from 86 normal individuals (52 boys and 34 girls) and then subsequently processed and analysed using High Performance Liquid Chromatogrphy – Ion Exchange Chromatography (HPLC-IEC). The calculated mean total homocysteine for the population was 8.1 ± 3.89 µM (95% confidence interval, l 7.3-8.9 µM). Reference range was 2.5 – 16.2 µM with lower and upper cut-off were 1.0 µM dan 21.0 µM, respectively. The newly developed reference range of total homocysteine for Malaysian children is able to reduce false negative cases in the laboratory.