Megaselia scalaris (Loew) (Diptera: Phoridae) is a cosmopolitan scuttle fly of medical and forensic importance. This species is generally small, humpbacked and is a prominent decomposer of corpses indoors. Taxonomically, adult sexes can be distinguished based on the characteristics of the terminal segments of the abdomen. In this report, the terminalia of adult male and female M. scalaris were examined using scanning electron microscope (SEM). The terminal segment of an adult female is less complex compared to male, consisting of an ovipositor and cerci. In male, the hypopygium consists of epandrium, hypandrium, anal tube and penis complex. A pair of long and feathered setae was attached to the tip of the anal tube and tapered. The application of SEM to identify this species isuseful and can be expanded to other species in this fly group.
Microscopy, Electron, Scanning

Introduction: The annual incidence of intracranial aneurysm in Malaysia is estimated to be 1.1–1.7 per 100,000 population based on a study done conducted in 1988. Since then, little epidemiological research has been conducted in Malaysia, and the real incidence is therefore probably unreported despite advancements in the diagnosis and treatment of this disorder. Intracranial aneurysm may be treated by microsurgical clipping or embolisation depending on its location and the surgeon’s preference. This study aims to report the characteristics and outcomes of patients with a clipped anterior circulation aneurysm in Hospital Sungai Buloh. Methods: We retrospectively collected the data of patients with anterior circulation aneurysms who underwent clipping from 1 January 2013 until 30 June 2014 in Hospital Sungai Buloh. Results: The mean age of the patients was 48.9 years old, and 56.7% of the study population were male and 63.3% were Malay. There were almost equal numbers of patients with (46.7%) and without (53.3%) co-morbidities such as hypertension and ischaemic heart disease. Half of the study population fell under Fisher grade 3 (50.0%), whereas 46.7% were Fisher grade 4. With respect to the Navarro score, 20% of patients scored 10, 16.7% scored 5 or 7, 13.3% scored 11, 10% scored 9, 6.7% scored 1 and 3.3% scored 2, 3 or 8. Most of the patients fell under grade I (33.3%) of the World Federation of Neurological Societies grading (WFNS), and the fewest number of patients were grade III (3.3%). Most (56.7%) patients had an intracranial aneurysm located at the anterior communicating artery (ACOM), followed by the anterior cerebral artery (ACA) and the middle cerebral artery (MCA) (16.7% each), the posterior communicating artery (PCOM) (6.7%) and, finally, the internal carotid artery (ICA) (3.3%). Neurological outcomes at three and six months were assessed using the Modified Rankin Scale (mRS). At three months follow-up, the majority of the participants (33.3%) scored 0 or 6, whereas at six months follow-up, the majority scored 0 (43.3%). Conclusion: The main characteristics of patients in Hospital Sungai Buloh were that they were in their 40s and mostly Malays without any known comorbidities. Although the majority of patients had high Fisher grades, their outcomes post intervention were promising. However,as data collected from Hospital Sungai Buloh may not be representative of the whole country, a larger-scale data collection is necessary to create our own database and to identify the risks factors that are exclusive to our country, if present.

This was a prospective observational study done to evaluate the role of a repeat head CT in patients with mild traumatic brain injury. The aim was to evaluate wether the repeat head CT were useful in providing information that leads to any neurosurgical intervention. 279 adult patients with a mild head injury (GCS 13-15) were enrolled, and these comprised of patients with an initial traumatic intracranial haemorrhage not warranting any surgical intervention. All patients were subjected to a repeat head CT within 48 hours of admission and these showed no change or improvements of the brain lesion in 217 patients (79.2%) and worsening in 62 patients (20.8%). In thirty-one patients, surgical intervention was done following the repeat head CT. All of these patients had a clinical deterioration prior to the repeat head CT. Even if a repeat head CT had not been ordered on these patients, they would have had a repeat head CT due to deteriorating neurological status. When the 62 patients with a worsening repeat head CT were compared with the 217 patients with an improved or unchanged repeat head CT, they were found to have older age, lower GCS on admission, presenting symptoms of headache, higher incidence of multiple traumatic intracranial pathology and lower haemoglobin level on admission. On stepwise multiple logistic regression analysis, three factors were found to independently predict a worse repeat head CT (Table IV). This includes age of 65 years or older, GCS score of less than 15 and multiple traumatic intracranial lesion on initial head CT. As a conclusion, we recommend that, in patients with a MTBI and a normal neurological examination, a repeat cranial CT is not indicated, as it resulted in no change in management or neurosurgical intervention. Close monitoring is warranted in a subset of patients with risk factors for a worsening repeat head CT.

Determination of races in the analysis of hair on scalp is one of the challenges faced in forensic analysis to identify victims, suspects and crime scene. This study aimed to determine the differences among the two main races in Malaysia which included Malay and Chinese, through the examination of the characteristics of hair. These includes general features of the hair, patterns of cuticle, colors, cortex pigment distribution and characteristics of medulla - types, thickness and medulla index. This study was carried out by using a light microscope and consisted of five steps, which were sample preparation, examination of common features of hair, preparation and examination of cuticle scales matrix, cortex and medulla. Result showed that most of the Malay have dark brown pigments while Chinese have pigments of light brown color. We also noted that thickness of medulla can also be used to differentiate between Malay and Chinese where average values for Malay and Chinese are 7.59 ± 1.45 μm and 9.12 ± 1.85 μm, respectively. The average values of medulla index for Malay and Chinese were noticeably different at 0.17 ± 0.02 μm and 0.18 ± 0.02 μm, respectively. However, textures, thickness of hair, patterns of cuticle scales, and types of medulla do not show any significant difference between Malay and Chinese. In conclusion, this study has shown that pigment colors, thickness of medulla and medulla index are important characteristics that can be used to determine race

A study on the isolation and identification of bacterial flora from hot spring was carried out using water from Bentong hot spring in Pahang. In general most of the bacteria identified from the hot springs were from Bacillus sp. This was due to its ability to adapt to high temperature mainly by forming endospore. The objective of this study was to identify bacteria other than Bacillus that were able to survive in hot springs. Three hot spring pools were identified (A,B and C) with temperatures ranging from 36°C to 52°C and pH values between 7.88-8.65. This study has succesfully isolated two species of Gram positive cocci and three species of Gram negative bacilli. The two Gram positives were Streptococcus sp. and Staphylococcus sp. The three species of Gram negative rods were unidentified and were denoted as X, XI and XII.

CNS malignant astrocytoma has a descending frequency of occurrence according to site; moving from intracranial to cervical-medullary, thoracic, lumbar and extremely rare in the conus medullaris. IMSC glioblastoma are rare and de novo conus medullaris GBM is an extreme rarity. The duration of symptoms is short and the neurological & clinical deterioration are rapid. Despite aggressive treatment via surgery and radiotherapy IMSC & conus GBM still carry a grim and fatal prognosis. This is a strong motivation for developing new treatment strategy. New treatment modality like Temozolomide & gene therapy is currently in under studyand long term result is under study and review.

Post mortem changes are important in estimating post mortem interval (PMI). This project’s aim was to study the effect of burial and type of clothing on rate of decomposition, which can contribute to estimating PMI for victims. 12 rabbits (Oryctolagus cuniculus) carcasses were separated into 3 groups: no clothing, light clothing and heavy clothing. Control subjects were placed on the ground surface while test subjects were buried at 30 cm depth graves. Soil samples prior and after decomposition were collected for soil pH and moisture analysis. Post mortem change was assessed using a Total Body Score system. The head, neck and limb regions were found to decay faster than the body trunk region. Mummifi cation occurred on body parts that were exposed directly to the atmosphere while adipocere formed on some buried subjects. Burial delayed decomposition due to lower insect activity and lower soil temperature. The soil layer also blocked the accessibility of majority of the arthropods, causing further delay in decomposition. Clothing enhanced decay for bodies on ground surface because it provided protection for maggots and retained moisture on tissues. However, clothing delayed decomposition in buried bodies because it physically separated the bodies from soil and arthropods. Higher sun exposure and repetitive exhumation showed acceleration of decomposition. The decomposition process increased soil pH and moisture percentage values. Soil pH initially increased until pH 8.0-8.4 followed by a slight decrease while soil moisture percentage changed inconsistently. Burial was signifi cant in affecting post mortem change, F(1,11)=12.991, p<0.05 while type of clothing was not signifi cant, F(2,9)=0.022, p=0.978 and combination of both type of clothing and burial factors were also not signifi cant, F(2,3)=0.429, p=0.686. For validation, an accuracy of 83.33% was achieved based on soil pH and soil moisture percentage analysis.

This case report discusses the rare association of cerebral abscess related to conjunctivitis in an otherwise healthy child. A 6 year old boy presented with conjunctivitis was treated with topical antibiotics and resolved after a week. Conjunctival swab cultures grew MRSA. A month later he developed status epileptics and CT scans revealed a large cerebral abscess. He was treated with intravenous antibiotics which covered for MRSA, along with an incision and drainage for the cerebral abscess. Pus cultures grew MRSA. The patient recovered well with no disturbance in visual acuity or visual field. On post-operative follow ups, he had no other neurological deficit apart from a slight limp.

A 59-year-old female farmer presented with left painful swollen eye for 1 week after being stung by a rice black bug ( Scotinophara sp. ). It was associated with acute progressive blurring of vision. On examination of the left eye, there was a marked periorbital swelling with proptosis and complete ptosis. The extraocular movements were restricted in all the directions. The cornea was hazy with large epithelial defect. Fundoscopy showed combined features of both central retinal vein and artery occlusions with swollen optic disc and ischaemia of the macular area. CT scan and MRI of orbit and brain showed evidence of orbital soft tissue inflammation. Patient was diagnosed with left orbital cellulitis, keratouveitis and central retinal vein and artery occlusions. The periorbital swelling and proptosis were improved after treatment with systemic and topical antibiotics. However, the vision remained no perception of light(NPL)and limitation of ocular movements persisted. The potential ophthalmic insults by Scotinophara sp. Can be severe and permanent. Awareness of the debilitating insults by Scotinophara sp. To human eye should be instilled timely especially in its prone areas.

AIM:To report unusual presentation and good outcome of neuromyelitis optica(NMO) in a child.METHODS:Case Report.RESULTS: An 8-year-old girl presented with 5-day history of sudden bilateral visual deterioration followed by left lower limb weakness. Visual acuity was perception to light in both eyes. Funduscopy revealed bilateral hyperaemic swollen optic discs. MRI of brain and spine revealed enhancing white matter lesions in the right frontal lobe and spinal cord at C5 level. She was diagnosed NMO and treated with intravenous methylprednisolone and tapering doses of oral prednisolone as maintenance therapy.Symptoms gradually improved 1 month after treatment. However, she presented with similar presentation 1 week after stopping oral prednisolone. MRI of brain and spine were reviewed and showed enhancing lesion in the right frontal lobe and longitudinal segment of spinal cord from C3 to C5 level. She was promptly given intravenous methylprednisolone for 5 days followed by prolonged tapering of oral prednisolone over 6 months period. After 2 months, she was able to walk and attend activities of school. Visual acuity was improved to 6/10 in both eyes and neurological examination was normal. There was no recurrence during the next year. Final visual acuity was 6/7.5 in the the right eye and 6/10 in the left eye.CONCLUSION: The diagnosis of NMO should be kept in mind although it is unusual presentation in child presented with bilateral visual loss and unilateral lower limb weakness. Early diagnosis and treatments would yield good outcome to the patient.