Both premature ejaculation(PE) and erectile dysfunction(ED) are prevalent sexual health disorders that have been inadequately investigated in Malaysia, a multiethnic and conservative nation.The objective of the study was to study the relationship between PE and ED, and other common mental health issues, i.e. anxiety and depression in Malaysian urban population. Methods: The diagnosis for PE was established by clinical diagnosis using DSM-5 and ISSM definition criteria for PE, whereas a diagnosis of ED was established by the International Index of Erectile Function (IIEF) questionnaire. Anxiety and depression levels were detected from the Hospital Anxiety and Depression Scale (HADS). Results: Based on DSM-V and ISSM clinical diagnosis for PE, the prevalence of PE was found to be 25%. Erectile dysfunction (p = 0.035, OR = 3.315, 95% CI 1.088, 10.103) and severe anxiety (p = 0.020, OR = 7.656, 95% CI 1.383, 42.396) significantly predicted presence of PE. Conclusion: There was a strong association between PE and ED and between PE and anxiety. Routine examination for PE in male patients should address the issue and the management of both ED and anxiety among PE patients, especially in an urban Malaysian clinical and medical care setting.

Objective: Bradycardia due to the combination of amisulpride and fluvoxamine is not commonly known in the literature. Methods: We report a case of asymptomatic sinus bradycardia that occurred when amisulpride and fluvoxamine were given concurrently and resolved after cessation of both these two medications. The Naranjo scale for Adverse Drug Reaction was used to determine the likelihood of medications’ in causing bradycardia. Other possible causes were also assessed and ruled out through medical consultations. Results: This case strongly suggests that the bradycardia occurred due to the combined effect of these medications’ independent risk in causing this potentially harmful cardiac event. Conclusion: Therefore, it is important to monitor for bradycardia whenever both these medications are prescribed even at therapeutic dosages.

Objective: Several cases of suicide attempt by charcoal burning producing CO have been reported in Malaysia. This case report highlights a case of delayed delayed neuropsychiatry sequelae (DNS) in CO poisoning. Method: We report a young Chinese homemaker who presented with DNS who was detained in a Malaysian forensic psychiatric ward. Results: After approximately two weeks of admission, in a familicide attempt, she had started to exhibit subtle changes in her behaviour, including social withdrawal, impaired memory, and there was lack of emotional distress. Conclusion: We report an interesting DNS as one of the two forms of chronic sequelae of CO poisoning, whereas the other type of neuropsychiatric sequelae is the persistently progressive type.