We report a case of a 16 years old girl who presented sequentially with primary amenorrhoea, hypertension and hypokalaemia. Eight years later, she was finally diagnosed with 17alpha-hydroxylase deficiency congenital adrenal hyperplasia. Previous antihypertensive medications were stopped. Hydrocortisone alone successfully maintained normotension and normokalaemia.
Adrenal Hyperplasia, Congenital/*diagnosis ; Adrenal Hyperplasia, Congenital/*etiology ; Diagnosis, Differential ; Hypertension/etiology ; Hypogonadism/etiology ; Hypokalemia/etiology ; Steroid Hydroxylases/*deficiency

Agriculture sector accounts significant numbers of injuries and fatalities in the workplace particularly related to pesticide management. Among three main pathways of pesticide exposure, dermal contact is the most common route, which exposure usually occurs during pesticide mixing/loading, application, harvesting and other farming activities. This review aims to present and discuss several vital components of pesticide dermal exposure among agriculture workers, as well as pesticide application in agriculture sector in Malaysia involving different commodity agriculture sub-sectors. Pesticide exposure was discussed from perspective of three pesticide management activities (i.e. preparation, application and cleaning) that contribute to the risk of exposure through three routes (i.e. emission, deposition, transfer). Moreover, this paper also discussed pesticide dermal exposure risk assessment methods which can be defined into exposure assessment and effect assessment. The exposure rate was affected by various factors such as application equipment, application rate and duration, type of pesticide formulation, pesticide management stage, usage of personal protective equipment, training and aptitude of the applicator as well as environmental factors (i.e. temperature, humidity, wind speed and direction). The factors mention earlier have been used to explain the exposure distribution over different parts of the body and support the fact that pesticide type was not a major factor in total exposure.
Pesticide ; dermal exposure ; exposure risk ; distribution

Discomfort due to riding a motorcycle is an issue that need to be addressed as it has long-term effects of musculoskeletal disorders on motorcyclists especially among occupational motorcyclist. Thus, this study was conducted to analyse the rating of muscle discomfort and correlation with the risk factors among traffic police riders. A cross-sectional study was carried out among 137 male traffic police riders (high-powered motorcycle) with the age between 20 to 39 years old. The 100-mm visual analogue scale questionnaire included ratings of perceived discomfort scales for 20 specific body regions was used in the study. The results indicate that the lower back (left and right) were the highest mean of discomfort which were 56.6 mm and 55.9 mm respectively. This followed with right (48.5±36.2 mm) and left (48.4±30.3 mm) upper back, and right hand (47.0±33.0 mm). The mean of overall discomfort ratings for all regions were more than 20 mm. Besides, there is a strong positive significant correlation between duration of ridings (hours) and overall discomfort ratings (p<0.01, r=0.785) and moderate positive correlation between year of traffic police motorcycle riding experience and overall discomfort ratings (p<0.01, r=0.410). As a conclusion, cumulative riding hours, riding experience and no support of the back area of the body in motorcycle seat, are the most concern in this study as this are the contributing factors to the muscle discomfort among traffic police riders while riding high-powered motorcycle. Thus, this study suggested an additional feature is needed in current motorcycle design in order to enhance comforts of traffic police riders. Also, it will improve the condition of traffic police riders’ discomfort and indirectly also improve their work and health performance as well as productivity.

INTRODUCTION: Hypertension is a key modifiable risk factor for myocardial infarction and stroke, yet medication adherence remains low. The ongoing COVID-19 pandemic has further complicated the management of chronic diseases like hypertension. This study aimed to explore the correlation between the patient-doctor relationship and medication adherence among hypertensive Filipinos aged 40-65 years in the Greater Manila Area during the pandemic. METHODS: A cross-sectional study was conducted involving 131 hypertensive Filipino participants. Data were collected through an online survey, assessing participant demographic and medical profiles, medication adherence using the Hill-Bone Compliance Scale (HBCS), and the patient-doctor relationship using the Physician-Doctor Relationship Questionnaire-9 (PDRQ-9). RESULTS: Approximately half of the participants demonstrated good adherence to hypertension medication. A weak but significant positive correlation was found between overall medication adherence and the patient-doctor relationship. The duration of anti-hypertensive drug intake also showed a weak positive correlation with medication adherence. Factors such as comorbidities and type of consultation did not significantly impact medication adherence. CONCLUSION This study emphasizes the significance of the patient-doctor relationship in medication adherence among hypertensive Filipinos during the COVID-19 pandemic. Enhancing communication and trust between patients and physicians can potentially improve medication adherence and overall disease management.
COVID-19 ; hypertension ; medication adherence ; perception ; anti-hypertensive agents ; cross- sectional