The pandemic of obesity is of great concern as its associated co-morbidities are devastating; causing lifelong burden to individual’s health and is economically costly to a country. Factors that lead to obesity are a combination of environmental and genetic factors. The Pro-opiomelanocortin (POMC) gene resides in chromosome 2p23.3, and its protein is composed of 241 amino acids which is responsible for the production of polyhormones that regulate appetite and food intake. The study aimed to investigate the prevalence of the RsaI single nucleotide polymorphism (SNP) site in the 5’-untranslated region (UTR) of POMC and its possible association with obesity among 302 multi-ethnic Malaysian subjects (142 obese, 160 non-obese; 120 males, 182 females) from the Kampar Health Clinic. Subjects were recruited by convenience sampling with informed consent and socio-demographic data as well as anthropometric measurements were taken. Subjects were genotyped by polymerase chain reaction - restriction fragment length polymorphism (PCR-RFLP) analysis using DNA extracted from blood. The distribution of the RsaI genotypes was significantly different among the different ethnicities, but the mutated RsaI (- / -) genotype was rare as it only occurred in 8.9% of the subjects. With the frequency of the RsaI (-) allele of 0.31, it was associated with the percentage of skeletal muscles (p<0.05), but not with obesity, gender, ethnicity and related anthropometric measurements. In conclusion, the 5’-UTR RsaI SNP in POMC may not be associated with obesity in the Kampar Health Clinic cohort; however, it could lead to the down-regulation of skeletal muscle build-up of up to 0.71%.

We present a case of an 8-year-old girl with a high grade osteogenic sarcoma of the proximal humerus treated with wide resection and vascularized proximal humerus treated with wide resection and vascularized proximal fibular epiphyseal transfer. At 5 years after reconstruction, the patient is tumor free and had a Musculoskeletal Tumor Score of 26/30 or 86.7%. The functional outcomes in terms of shoulder range of motion and pain were good. Complications include transient peroneal nerve palsy and mild valgus instability of the knee.

Human ; Female ; Child ; Shoulder ; Peroneal Nerve ; Range Of Motion, Articular ; Fibula ; Humerus ; Knee Joint ; Pain ; Osteosarcoma

Sacrococcygeal teratoma is a rare tumor, it occurs once in every 40,000 live births. Most of the reported cases appear in female infant (M:F=1:4). They deserve clinical attention because they are potentially malignant and are curable if diagnosed and treated early. The patients may have associated congenital anomalies. This patient has spina bifida cystica in lower sacrum. Brief review of related literature is included in the report.
Female ; Humans ; Infant ; Infant, Newborn* ; Live Birth ; Sacrum ; Spina Bifida Cystica* ; Spinal Dysraphism* ; Teratoma*

Introduction: Fragility fractures, which occur after a lowtrauma injury, increases with advancing age. Such fracture doubles the life-time risk of sustaining another fracture. This risk is highest in the immediate 18 months after the index fracture. However, most patients do not receive the appropriate risk assessment and intervention to reduce this risk. A coordinated model of care termed Fracture Liaison Service (FLS) has been reported to address this treatment gap. Materials and methods: This scoping review aims to explore the potential role and delivery of FLS services in Malaysia. Scientific and non-scientific sources relevant to FLS were identified from electronic bibliographic databases, specialist journals and relevant websites. Findings were categorised into themes and presented narratively. Results: FLS services remain concentrated in the Klang Valley. Even within FLS services, many do not have extensive coverage to risk assess all fracture patients. These services are multidisciplinary in nature where there are links between different departments, such as orthopaedics, osteoporosis expertise, bone densitometry, rehabilitation, falls services and primary care. FLS was able to increase the number of people undergoing fracture risk assessment and treatment. The importance of FLS was highlighted by local experts and stakeholders. Its implementation and delivery are supported by a number of national guidelines. Conclusion: FLS is central to our national efforts to reduce the impending fragility fracture crisis in the coming years. Continued effort is needed to increase coverage within FLS services and across the country. Training, awareness of the problem, research, and policy change will support this endeavour.

BACKGROUND: Angiotensin converting enzyme inhibitors (ACEIs) or Angiotensin II type 1 receptor blockers (ARBs) are compelling indication drugs for hypertensive patients with diabetes mellitus. But prescription rate in 2005 year study of Pohang . Gyeongju area was only 30.8%. Therefore, a study on the change of prescription rate in the same area after 3 years was done. METHODS: During three months from January 2008, 152 hypertensive patients with diabetes mellitus on their prescribed antihypertensive medications by 9 family physicians in visiting order were analyzed. After the analysis, the infl uencing factors for such prescriptions were ascertained by directly visiting each physicians who prescribed them. RESULTS: A regimen of 16 antihypertensive agents were prescribed by these family physicians. Prescription count of ACEIs or ARBs was 101 cases (66.4%). ACEIs single therapy was 19 cases (12.5%), ACEIs combination therapy was 7 cases (4.6%), ARBs single therapy was 31 cases (20.4%) and ARBs combination therapy was 44 cases (28.9%). The ACEIs or ARBs which were selected by physicians that followed "compelling indication" was 5 (55.6%), "excellent reduce pressure effect" was 3 (33.3%) and "public relations of new medicine" was 1 (11.1%). CONCLUSION: In prescribing antihypertensive agents for patients with diabetes mellitus, selection of ACEIs or ARBs was increased from 30.8% to 66.4%. Education of recommended standard by participating in such study and developing of excellent new medicines may increase such change.
Angiotensin II Type 1 Receptor Blockers ; Angiotensin-Converting Enzyme Inhibitors ; Antihypertensive Agents ; Diabetes Mellitus ; Humans ; Hypertension ; Physicians, Family ; Prescriptions ; Primary Health Care

By 2050, it is predicted that six million hip fractures will occur each year of which the majority will happen in Asia. Malaysia is not spared from this predicted rise and its rate of increase will be one of the highest in this region. Much of this is driven by our unprecedented growth in the number of older people. Characteristics of individuals with hip fractures in Malaysia mirror what has been reported in other countries. They will be older multimorbid people who were already at risk of falls and fractures. Outcomes were poor with at least a quarter do not survive beyond 12 months and in those that do survive have limitation in their mobility and activities of daily living. Reviewing how these fractures are managed and incorporating new models of care, such as orthogeriatric care, could address these poor outcomes. Experts have warned of the devastating impact of hip fracture in Malaysia and that prompt action is urgently required. Despite that, there remains no national agenda to highlight the need to improve musculoskeletal health in the country

Humans ; Adolescent ; Pandemics ; Substance-Related Disorders/epidemiology* ; Smoking ; Ethanol ; Republic of Korea/epidemiology* ; Alcohol Drinking/epidemiology*