Colorectal cancer (CRC) is one of the most common gastrointestinal cancers in the world. In Malaysia, it is the third most common cancer for both men and women. Curative surgical resection with en bloc removal of the regional lymph nodes remains the mainstay of treatment with 5-year survival rate of 70%-90% for local disease. 1 Nonetheless, about 1 in 3 curatively treated CRC patient will suffer from local recurrence or metastasis . 2 Among the usual sites of recurrence are liver, lungs, local and/or regional intraabdominal and retroperitoneal lymph nodes. 3 We report a rare case of colon cancer recurrence to the left kidney after curative surgery and adjuvant therapy, which mimicked left renal cell carcinoma.

Purple urine bag syndrome (PUBS), as the name implies produces purplish discoloration of the urine. It is commonly observed among elderly women with constipation, and individuals with long term catheter in the setting of urinary tract infection (UTI). From the literature research, there were no publications on PUBS in Malaysia; however we believe that it is underreported. We present a unique case of this rare condition occurring in a 68-year-old man, a nursing home resident on long term urinary catheter. The urine cleared after hydration, antibiotic therapy and replacement of the catheter.
Urinary Tract Infections

Introduction: This multiple-subject fMRI study continue to further investigate brain activation within and effective connectivity between the significantly (p<0.001) activated primary motor area (M1), supplementary motor area (SMA) with the inclusion of BA44 during unimanual (UNIright and UNIleft) and bimanual (BIM) self-paced tapping of hand fingers. Methods: The activation extent (spatial and height) and effective connectivity were analysed using statistical parametric mapping (SPM), dynamic causal modeling (DCM) and the novel method of Bayesian model selection (BMS) for group studies. Results: Group results for UNIright and UNIleft showed contra-lateral and ipsi-lateral involvement of M1 and SMA. The results for BIM showed bilateral activation in M1, SMA and BA44. A larger activation area but with lower percentage of signal change (PSC) are observed in the left M1 due to the control on UNIright as compared to the right M1 due to the control on UNIleft. This is discussed as due to the influence of the tapping rate effects that is greater than what would be produced by the average effects of the dominant and sub-dominant hand. However, the higher PSC observed in the right M1 is due to a higher control demand used by the brain in coordinating the tapping of the sub-dominant hand fingers. Connectivity analysis indicated M1 as the intrinsic input for UNIright and UNIleft while for BIM, the inputs were both M1s. During unilateral finger tapping, the contra-lateral M1 acts as the input center which in turn triggers the propagation of signal unidirectionally to other regions of interest. The results obtained for BIM (BIMleft and BIMright) however yield a model with less number of significant connection. M1-M1 connection is unidirectional for UNIleft and UNIright originating from contra-lateral M1, and is inhibited during BIM. Conclusion: By taking into consideration the presence of outliers that could have arisen in any subject under study, BMS for group study has successfully chosen a model that has the best balance between accuracy (fit) and complexity.

This study investigated the functional specialisation characteristics of brain in multiple right-hand dominant subjects pertaining to the activation of the cerebral motor cortices evoked by unilateral finger tapping, especially in primary motor (M1) and supplementary motor (SMA) areas. This multiple-subject study used unilateral (UNIright and UNIleft) selfpaced tapping of hand fingers to activate the M1 and SMA. Brain activation characteristics were analysed using statistical parametric mapping (SPM). Activation for UNIright and UNIleft showed the involvement of contralateral and ipsilateral M1 and SMA. A larger activation area but with a lower percentage of signal change (PSC) were observed in the left M1 due to the control on UNIright (4164 voxels at α = 0.001, PSC = 1.650) as compared to the right M1 due to the control on UNIleft (2012 voxels at α = 0.001, PSC = 2.377). This is due to the influence of the tapping rate effects which is greater than what could be produced by the average effects of the dominant and sub-dominant hands. The significantly higher PSC value observed in the right M1 (p < 0.05) is due to a higher control demand used by the brain in coordinating the tapping of the sub-dominant fingers. The findings obtained from this study showed strong evidence of the existence of brain functional specialisation and could be used as baseline references in determining the most probable motor pathways in a sample of subjects.

Biocompatibility and growth of osteoblast on bone scaffolds play an important role towards their therapeutic application. The presence of oxidative stress generated by bone scaffolds highly influences osteoblast growth and its functional performance. In this study in-vitro interaction of developed Alginate/Cockle Shell powder nanobiocomposite bone scaffold on osteoblast with regards to cytotoxicity and oxidative stress are evaluated. Cytotoxicity studies using MTT assays revealed a significant increase in viability of cultured osteoblast in the presences of the scaffold extracts. The growth of osteoblast on the scaffold were not deterred with the presence of any major oxidative stress factors as determined through oxidative stress profile studies using SOD, GSH and ROS assays. The nanobiocomposite scaffold evaluated in this study shows promising use in regards to facilitating osteoblast proliferation, growth and viability.

Calcium carbonate (CaCO3 ) plays a crucial role in influencing the growth of osteoblast. This study was conducted to compare the performance of alginate/cockle shell powder nanobiocomposite (nCP) bone scaffold developed from naturally occurring CaCO3 with alginate/calcium carbonate (CC) bone scaffold developed using synthetic CaCO3. The study compares the performance of the scaffold in supporting the growth of osteoblast through in vitro evaluations as well as initial biocompatibility observations through in vivo methods. Both scaffolds were developed using the mixture of 40% alginate solution with either 60% of nano cockle shell powder or synthetic CaCO3 to obtain a three dimensional scaffold structure. In vitro evaluation on calcium release and ALP enzyme activity was conducted on both scaffolds seeded with osteoblast on day’s three, five and seven using commercial kits. In vivo observations using histological methods were further conducted by implanting osteoblast seeded scaffold subcutaneously at the dorsum of 8 albino mice for 21 days. Findings from in vitro studies showed a significant increase (p < 0.05) in the release of calcium and ALP enzyme activity in nCP scaffolds on day seven compared to days three and five of CC scaffold. Histological observations using H&E and von Kossa staining showed infiltration and proliferation of osteoblast on both scaffolds as well as early stage bone tissue formation. Formation of new blood vessels within the scaffolds was also observed in nCP scaffold. Both the developed scaffolds were noted to support osteoblast growth and new tissue formation with better potentials displayed by nCP scaffolds comparatively. This study shows that naturally occurring CaCO3 obtained from cockle shells in the form of nano powder has good potentials to be used as a biomaterial for bone tissue engineering applications.

The objective of this cross -sectional study is to determine the prevalence and pattern of herbal medicines use during pregnancy among women in Tumpat district, Kelantan. A total of 210 mothers were interviewed using a structured questionnaire. There were 108 mothers (51.4%) who used at least one type of herbal medicines during pregnancy. The most common herbal medicines used (63.9%) was coconut oil which was ingested during the third trimester of pregnancy only. The most common indication was (89.8%) to facilitate labour. The majority of users (79.6%) used herbal medicines during the third trimester of pregnancy only. Many of them (81.5%) believed that herbal medicines were effective to solve their health problems and fulfilled the indications for use. The older generation like parents and in laws (63.9%) were the most common persons who suggested using herbal medicines. The majority of them used the herbs only once (56.5%) and one type (87.0%) throughout the pregnancy. Further research focusing on local commonly used herbal medicines is to be carried out to evaluate the safety and efficacy of the herbs.

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.

This study was conducted to determine the prevalence of candidiasis among women of 20 to 59 years of age at Sarawak General Hospital by examining the conventional Pap smear. The prevalence of this infection was studied among the five main ethnic groups comprising of Iban, Chinese, Malay, Bidayuh and Orang Ulu. Microscopic screening of 300 conventional Pap smears which had been processed and stained with the Papanicolaou staining method was conducted. Based on the information provided in the Pap smear screening form, the clinical manifestations were observed which may provide some indications on the type of infection. The details of the clinical manifestations were very important because in an infection or inflammation, Pap smears would usually demonstrate the cyto-morphological changes of the epithelial cells. The age factor among the different ethnics also plays important role in the assessment of the infection frequency. Candida sp. was detected in 12.7% of the specimens. The infection occurred in all ethnic groups as well as in all age groups. All cases presented with clinical signs and symptoms. The results of this study revealed the importance of undergoing Pap smear screening for candidiasis detection besides screening for the early detection of cervical cancer

This study was conducted to determine the prevalence of bacterial vaginosis among women of age 20 to 59 years at Sarawak General Hospital by examining the conventional Pap smear. The prevalence of this infection was studied among the five main ethnic groups comprising the Iban, Chinese, Malay, Bidayuh and Orang Ulu. Microscopic screening of 300 conventional Pap smears which had been processed and stained with the Papanicolaou staining method was conducted. Based on the information provided in the Pap smear screening form, the clinical manifestations were observed which may provide some indications on the type of infection. The details of the clinical manifestations were very important because in an infection or inflammation, Pap smears would usually demonstrate changes on the cyto-morphology of the epithelial cells. The age factor among the different ethnics also played important role in the assessment of the infection frequency. Bacterial vaginosis was detected in 79.7% (239/300) of cases. The infection occurred in all ethnic groups and the infections were more frequently seen among the 20 to 39 years age group. Majority of the cases (93.9%) presented with clinical signs and symptoms. The results of this study revealed the importance of undergoing a Pap smear screening for bacterial vaginosis detection besides screening for the early detection of cervical cancer