An 18-year-old woman presented to the clinic with painless bleeding of her gums upon brushing her teeth. The bleeding stopped spontaneously, and there was no other bleeding tendency. On further questioning, the patient had irregular menses and was taking the oral contraceptive pills (OCP) Diane-35ED® to regulate her menses. She had been on this medication for four months. She was not on any other medication and had no chronic illness.

A healthy, six-year-old girl presented to the clinic with a three-day history of swelling on the foor of her mouth (Figure 1). Te swelling was painless and was not associated with discharge or bleeding inside her mouth. She also denied any fever, signifcant loss of weight or appetite, halitosis, dysphagia, and odynophagia. Tere was no other neck or chest swelling. On physical examination, her face and neck appeared normal and symmetrical. Cervical and submandibular lymph nodes were not palpable. However, there was an ill-defned, rounded, bluish swelling approximately 2 cm in diameter on the left foor of the mouth lateral to the frenulum. Te swelling was soft with a smooth surface but non-tender upon palpation. Tere was no bleeding or discharge noted in the oral cavity. Other oral structures appeared normal despite multiple caries on her deciduous teeth.

In primary care, chest X-rays are commonly performed to assess patients presenting with a prolonged cough. However, the extent to which the flms are accurately interpreted depends on the skill of the doctors. Doctors with insufcient experience may miss an exact diagnosis when evaluating a flm, especially in patients with nonspecifc symptoms, such as in the case discussed in this paper. Tis case involved a persistent dry cough with an underlying diagnosis that would have been missed if the fndings of the chest X-ray had not been properly analyzed.

Introduction: In most Asian countries, stroke is one of themajor causes of mortality. A stroke event is life-changing forstroke survivors, which results in either mortality ordisability. Therefore, this study comprehensively focuses onprevalence, risk factors, and secondary prevention forstroke recurrence identified in South, East, and SoutheastAsian countries. Methods: This scoping review uses themethodological framework of Arksey and O’Malley. Acomprehensive search of academic journals (English) onthis topic published from 2007 to 2017 was conducted. Atotal of 22 studies were selected from 585 studies screenedfrom the electronic databases.Results: First-year stroke recurrence rates are in the rangeof 2.2% to 25.4%. Besides that, modifiable risk factors aresignificantly associated with pathophysiological factors(hypertension, ankle-brachial pressure index, atherogenicdyslipidaemia, diabetes mellitus, metabolic syndrome, andatrial fibrillation) and lifestyle factors (obesity, smoking,physical inactivity, and high salt intake). Furthermore, age,previous history of cerebrovascular events, and strokesubtype are also significant influence risk factors forrecurrence. A strategic secondary prevention method forrecurrent stroke is health education along with managingrisk factors through a combination of appropriate lifestyleintervention and pharmacological therapy.Conclusion: To prevent recurrent stroke, health interventionshould be geared towards changing lifestyle to embody ahealthier approach to life. This is of great importance topublic health and stroke survivors’ quality of life.

Healthcare providers are responsible for performing medical check-ups, analyse and interpret patient's laboratory results. It is common for an initially asymptomatic patient to receive abnormal results including liver enzymes such as alkaline phosphatase (ALP). The concern in these patients is the cut-off value for mildly elevated levels that requires intervention. This paper reports a case of liver malignancy in a 32-year-old man who presented with a mild elevation of ALP level less than five times the upper limit of normal. The patient had no clinical symptoms. Early ultrasound liver assessment showed dilated common bile duct, which led to an urgent CT scan of the liver that revealed supportive features of fibrolamellar carcinoma. The patient was managed successfully with early partial hepatectomy that has saved him from morbidity and mortality of liver malignancy. Indeed, liver malignancy can be detected early in a health clinic from a further assessment of trivial elevation of ALP.

Introduction: Women with uncontrolled diabetes may conceive but will result in poor pregnancy outcomes. This study aimed to assess the level of knowledge and attitude and determine factors associated with attitude towards preconception care. Method: A cross-sectional study was conducted in various government health clinics from all districts in Terengganu by using multistage random sampling. A self-administered questionnaire was applied to assess the level of knowledge and attitude towards preconception care. Multiple logistic regressions were applied to determine factors associated with attitude towards preconception care. Results: A total of 422 respondents were involved. The prevalence of respondents with unsatisfactory knowledge and attitude were 41.7% and 84.1%, respectively. Knowledge was not significantly associated with attitude. Respondents who used contraception had a better attitude (Adj. OR: 0.44, 95% CI:0.23,0.84). Low household income was associated (Adj. OR: 2.40, 95% CI:1.10,5.26) with an unsatisfactory attitude towards preconception care. Conclusion: Attitude towards preconception care amongst diabetic women who were attending primary care clinics was unsatisfactory. A structured and focused preconception educational programme care is necessary, especially amongst low-income women.