The controversial usage of antiseptic in treating wound infections had become a huge issue over the years due to its minimal effectiveness and high toxicity level that are harmful to humans. Hence, numerous studies had been carried out to determine other possible approaches including herbal remedies. The alarming situation had led us to study on Piper sarmentosum and its antimicrobial activity against selected pathogens. In present study, methanol extract of Piper sarmentosum leaves were prepared to investigate the presence of phytochemical compounds. The in vitro antimicrobial activity of crude methanolic extract was evaluated using disc diffusion and microdilution broth methods. The study demonstrated the antimicrobial activity of leaves extract against Staphylococcus aureus (7 mm) and Escherichia coli (6.5 mm). However, no zone of inhibition was observed against Pseudomonas aeruginosa. Meanwhile, the MIC values for Staphylococcus aureus was 6.25 mg/mL whilst Escherichia coli was 12.5 mg/mL. In addition, the phytochemical screening results revealed that the extract contained glycosides, flavonoids, terpenoids, alkaloids, and phenolics. In conclusion, methanolic extract of Piper sarmentosum leaves has the potential as a new, effective alternative towards current drugs that are available for skin-associated infection. The findings from this study are crucial in providing latest information of the plant’s additional values that can be incorporated as a baseline for current and future studies as well as in investigating other possible plants that are beneficial for health purposes, particularly for combating skin-associated infection.

A 59-year-old woman presented with a two-week history of spontaneous gum bleeding and easy bruising. Her full blood count on admission showed pancytopenia with haemoglobin of 96 gm/L, total white cell count of 1.6 x 109/L (absolute neutrophil count of 0.26 x 109/L) and platelet count of 17.0 x 109/L. Peripheral blood film showed a few abnormal hypergranular promyelocytes present. Five days later she developed the above signs. What is the diagnosis? Answer: refer to page 72

(Refer to page 51) Answer: Spontaneous bilateral periorbital haematoma associated with acute promyelocytic leukemia In this patient, the spontaneous bilateral periorbital haematoma could be due to severe thrombocytopenia. However the presence of abnormal promyelocytes in the peripheral blood smear (Panel, darkly stained cells are promyelocytes) is suggestive of acute promyelocytic leukemia (APL) which should be confirmed with a bone marrow biopsy, cytogenetic study for t(15;17) and molecular study for PML-RARa oncogene fusion.

Failure in achieving abstinence in methamphetamine dependence population is a common scenario. The use of methamphetamine in pregnancy however, was not so often brought to attention. This report highlights the challenges and issues encountered in the management of a pregnant lady with the problem of methamphetamine dependence, who presented with psychosis. Among the areas outlined were issues in commencing treatment for methamphetamine psychosis, presence of psychosocial conditions that impeded total abstinence and the risks of methamphetamine use during pregnancy.
Methamphetamine ; Pregnancy Women

Binge eating (BE) behaviour is associated with obesity and eating disorders. This cross-sectional study investigates BE behaviour and its relationship with nutrition-related factors among university students. A total of 170 (69% females) university students in Malaysia aged 19 to 24 years participated in this study. BE behaviour was assessed with the use of Binge Eating Scale (BES) questionnaire. Socio-demographic background and nutritional status (anthropometric measurements, body mass index (BMI) and dietary intake) were also measured. BE behaviour reported by 10% percent of the participants. BE behaviour was associated with increased energy intake, elevated BMI and sex (Adjusted R2 = 0.116, p < 0.001). Differences in sex-specific factors in predicting the risk of BE behaviour were evident. In male participants, an increased in energy intake, elevated BMI and had a higher waist circumference associated with the risk of BE behaviour (Adjusted R2 = 0.411, p < 0.001). In female participants, only a higher waist circumference associated with BE behaviour (Adjusted R2 = 0.028, p < 0.05). The finding suggests that understanding sex-specific factors are necessary to prevent BE. These are the potential targets for tailored eating behaviour intervention among university students.

Objective: To reveal the prevalence of gastrointestinal nematodiasis, Trichostrogylus, Haemonchus, Strongyloides and Trichuris and coccidiosis, mainly Eimeria in kids, yearlings and adult goats. Methods: A total of 287 goat faecal specimens were randomly collected from three farms in Kuala Terengganu, Setiu and Besut. Results: Prevalence of coccidiosis (89.2%) was significantly higher (P < 0.05) than gastrointestinal nematodiasis (52.3%). Gastrointestinal nematodes (GINs) were found in 37.0% kids, 63.5% yearlings and 53.3% adults. Identification of GINs revealed the predominance of Strongyloides (45.6%) followed by Trichostrogylus (12.9%), Hae-monchus (11.8%) and Trichuris (8.7%) in all groups whereby the adult goats recorded the highest infections of Trichostrogylus (20.5%), Haemonchus (10.6%), Strongyloides (51.5%) in all groups. The age-specific intensity for Eimeria was in following order:kids (92.6%), adults (86.6%) and yearlings (51.5%) and the difference was not significant (P > 0.05). The concurrent infections between GINs and Eimeria were 67.94% in all groups. Polyparasitisms of Trichostrongylus (17.4%), Haemonchus (15.15%) and Strongyloides (40.4%) with Eimeria had infected most adult goats. Dual infections of Trichostrongylus with Eimeria and Trichuris with Eimeria were significantly higher in adults than yearlings and kids (P<0.05). Conclusions: GINs and Eimeria were widely distributed in the goats leading to higher risk of morbidity and mortality.

trends ; Drug Addiction

·AIM: To present a case of Coats' disease in adult and to illustrate the retinal findings.·METHODS: A case report.·RESULTS: A 63 years old Malay man, a known case of diabetes mellitus, presented with one year history of painless and progressive reduced vision in the right eye. Right eye visual acuity was counting finger 2 feet while left eye best corrected visual acuity was 6/12. Right fundus showed presence of extensive subretinal exudates at the temporal part of the posterior pole involving the macular area and nasal to the optic disc. It was associated with multiple areas of abnormal blood vessels temporal to the macula with attenuated vessels. Fundus fluorescein angiography(FFA) showed presence of telangiectatic vessels at the area of subretinal exudates and leakage of fluorescein from the telangiectatic vessels. The left eye was normal. Based on clinical and FFA findings, he was diagnosed to have adult Coats' disease. The right eye was treated with argon laser photocoagulation. Six months post laser, his visual acuity remained at 6/120 and there was minimal regression of the disease seen in the retina. ·CONCLUSION: The clinical and angiographic findings are important in diagnosing retinal telangiectasia. Treatment by laser photocoagulation in area of leakages may be beneficial in preventing visual loss.

Quality of transitional care affects healthcare spending and service use. Poor transitional care is associated with adverse effects such as medication error and risk of unnecessary readmission. The objective of this study is to evaluate patients’ perception of quality of transitional care from a public tertiary hospital to a public health clinic in Negeri Sembilan. A cross-sectional study was conducted involving 307 respondents from the public health clinic following discharge from the hospital from July to September 2018.Patient’s perception of quality of transitional care was measured using the Care Transitional Measure (CTM 15®) questionnaire. The response rate for this study was 90.6%. The mean CTM-15® score was 73.1 (±13.03) out of a scale of 1 to 100. The mean scores for the various domains were: Critical understanding was 73.3 (±14.33), Preferences important was 71.9 (±14.99), Management preparation was 74.0 (±14.53), and Care plan 73.3 (±14.75). Multiple linear regression showed that age was a significant independent predictor for the CTM-15® scores where elderly patients had poorer scores than young adults (adjusted R2=0.104, p<0.001).In conclusion, the perceived quality of transitional care between the public general hospital and health clinic was good but decreased with patient’s age. This could be due to complexity of the patient’s problems upon discharge.

The medical manufacturing industry is currently one of the sectors with great potential growth in Malaysia, which offers numerous job opportunities to local and foreign workers. The growing proportion of workers in this industry means that a large number of workers are potentially exposed to ergonomic risk factors at the workplace, which may consequently affect their health. Thus, this study was carried out is to investigate the ergonomic risk factors and the prevalence of musculoskeletal disorders among male workers in a medical manufacturing company in northern Malaysia. Eight industrial workers (n = 8) were recruited from two Plastic Technology (PT) departments to participate in this study. Observations were made by recording the participants performing two tasks (manual lifting of containers and bags of chemicals) using a video camera at the PT1 and PT3 departments. The participants’ personal information and their job-related characteristics were first collected using a demographic questionnaire. Next, the Cornell Musculoskeletal and Hand Discomfort Questionnaire (CMDQ) was used to evaluate the prevalence of musculoskeletal disorders among workers while Manual Handling Assessment Charts (MAC) were used to assess the most common risk factors during the lifting operations. The results showed that the highest prevalence of musculoskeletal disorders among the male workers at the medical manufacturing company was at the lower back (83.17%), upper back (4.38%), right shoulder (3.49%), and left shoulder (3.49%). Based on the results of the MAC, 100% of the participants were at high risk of injury from postures in the vertical lift zones, torso twisting, and sideways bending. In addition, 87.5 and 62.5% of the participants were at high risk of injury based on their hand distance from the lower back and grip on the load, respectively. The results of this study can serve as a guideline to implement interventional ergonomics programmes at the workplace and improve the musculoskeletal health of workers in the medical manufacturing industry in Malaysia.