Colorectal carcinogenesis is a complex multistep process that includes changes in histomorphological appearance of the colonic mucosa and changes at molecular level. Aberrant crypt foci (ACF) was first described by Bird in 1987 on examination of methylene-blue-stained colonic mucosa of azoxymethane-treated mice under light microscopy. Since then ACF was considered as the earliest preneoplastic change that can be seen in the colonic mucosa. The aim of this study was to look at the histomorphology and distribution of ACF in colorectal carcinoma. 50 formalin-fixed archival colectomy specimens for colorectal carcinoma were examined under light microscopy after staining with 0.2% methylene blue. ACF was identified by larger and darker crypts with thickened epithelium, and often elevated from adjacent normal mucosa. ACF was found in 41 of 50 colectomy specimens examined. There were 328 ACF consisting of 36 (11.0%) ACF without hyperplasia or dysplasia, 263 (80.2%) ACF with hyperplasia and 29 (8.8%) ACF with dysplasia. Of these 29 ACF with dysplasia, 25 showed low grade dysplasia and four high grade dysplasia. The density of ACF was higher in the left colon, those older than 65 years of age and among males but these findings were statistically not significant. The crypt multiplicity of hyperplastic ACF (30.149, SD 28.395) was larger than dysplastic ACF (20.613, SD 40.128). The spectrum of histological changes observed probably represent the evolution of ACF in colorectal carcinogenesis.
Aberrant Crypt Foci/*pathology ; Adenocarcinoma/*pathology ; Colorectal Neoplasms/*pathology

Genitourinary tuberculosis in developing countries comprises approximately 15-20% of extrapulmonary cases of tuberculosis.1 Tuberculosis of the prostate is an uncommon clinical condition with less than 5% of genitourinary tuberculosis involving the prostate,2,3 and tuberculous prostatic abscesses are unusual presentation. The following case illustrated a case of prostatic tuberculosis abscess in an immune-compromised patient

This report details the case of a 12-year-old girl with a painful, progressive swelling of the medial portion of the clavicle with no history of trauma or other constitutional symptoms. All laboratory investigations were normal except for an elevated erythrocyte sedimentation rate (ESR). Initial plain radiographs showed a destructive lesion with magnetic resonance imaging showing features of malignancy. Biopsies revealed osteomyelitis, but with negative bacterial cultures and no evidence of malignancy. Treatment with antibiotics did not result in a favourable response. Over time, the swelling increased in size with episodic exacerbations of pain. Follow-up radiographs showed sclerosis and hyperostosis. After five years, this was recognized as non-bacterial chronic recurrent osteomyelitis of the clavicle.

The shoulder and axillary regions contain various complex anatomical structures in close proximity, many of which can give rise to neoplasms. Determining the origin and hence the exact diagnosis of advanced (diffuse) tumours in this region may become problematic. In view of the tumour morphology and the affected location in this case, we highlight the importance of Hodgkin lymphoma immunohistochemistry interpretation in a tumour which was initially suspected to be a soft tissue sarcoma.

Objectives: There is a lack of current published information on health and nutritional status of Orang Asli children. A study was conducted to assess breastfeeding practices, dietary intake and growth status of Orang Asli children in Sepang and Carey Island, Selangor.Methods: A total of 173 children(88 Temuan and 85 Mah Meri) from 137 households were measured for body weight and height. Information on breastfeeding practices and dietary intake was obtained from their mothers. Results:Most of the mothers (98.9%) breastfed their infants with a high proportion (86.8%) initiating breastfeeding within one hour after delivery.About 53% of the mothers reported discarding colostrum due to various reasons including the perception that colostrum in undesirable and can produce ill-health. Although many of these mothers (58.3%) discarded colostrum on their own initiative, about 25% of them reported that they were advised by health professionals. Among mothers who had stopped breastfeeding at the time of the study (n=48), the mean duration of breastfeeding was 12.1 ± 8.9 months. About 33% of the mothers stopped breastfeeding before their infants were 6 months old and only 31% breastfed their children for more than 1 year. The percentages of significantly underweight, stunted and wasted were 48.9%, 5.2.2% and 4.3% respectively for children aged 1-3 years, whereas among children aged 4-6 years old, 35.8%, 50.6% and 1.3% were underweight, stunted and wasted, respectively. A higher proportion of Mah Meri than Temuan children in both age groups were significantly underweight, stunted and wasted. Despite the adequate intake of energy and most nutrients,the Orang Asli children had insufficient mean number of servings for all food groups-grain and cereals, fruits, vegetables, meat and fish, and milk and dairy products. Conclusion: In this study, undernutrition is a major health and nutrition problem among the Orang Asli children. The problem could be due to many factors that include poor infant and child feeding practices. Concerted efforts by various government and non government agencies are essential to improve the health and nutrition of Orang Asli.

Acral melanoma has been reported to have distinctive clinical presentation and ethnic distribution compared to other histological types of malignant melanoma. Acral melanoma also exhibits distinctive focused gene amplifi cations, including cyclin D1 overexpression. We reviewed archived histological material of malignant melanoma in the Sarawak General Hospital from year 2004 to 2010. 43 tumours, comprising 28 acral melanoma and 15 non-acral melanoma, had suffi cient material to be included in the study. The majority (36%) of acral melanoma tumours occurred in the heel. The tumours were analyzed for cyclin D1 expression by immunohistochemistry. 68% of acral melanoma were cyclin D1 positive compared to a positivity of 33% in non-acral tumours. This difference was statistically signifi cant (p <0.05). This fi nding may improve the histological diagnosis of acral melanoma and detection of positive resection margins.

Objectives: This study aims to identify the relationship between dietary intakes of β-carotene with riskof oral cancer. Methods: A hospital-based, case-control study was conducted on 306 Malaysians whoseek treatment at participating centres/hospitals. Subjects selected from the Malaysian Oral Cancer Dataand Tissue Banking System (MOCDTBS) consisted of 153 cases and 153 controls that were matchedfor gender, age (±5 years) and ethnicity. Food consumption was measured using Food FrequencyQuestionnaire (FFQ). NutrieMart Version 2.0.0 software was used to estimate daily nutrient of eachsubject from the FFQ. Logistic Regression analysis was conducted to compute the odds ratio (OR) forintakes of β-carotene and oral cancer risk. Results: Intake of β-carotene was found to be not associatedwith risk of oral cancer (OR 0.83, 95%CI: 0.42-1.66, p>0.05). Conclusion: No significant associationwas found between dietary intakes of β-carotene with oral cancer risk in this study population.

Introduction: Awareness of the importance of dietary fibre (DF) in health among adolescents is seldom reported in Malaysia. This study aimed to compare the knowledge, attitude and practice (KAP) of DF intake between Malaysian rural and urban school-going adolescents. Pulau Pangkor in Perak and Damansara in Selangor were randomly selected as rural and urban schools, respectively. Methods: A total of 305 school adolescents with a mean age of 13.5±0.6 years were randomly selected from rural (72 Malay, 85 Chinese) and urban (86 Malay, 62 Chinese) schools completed socio-demographic, validated KAP on DF intake questionnaire, as well as a 24-hour dietary recall. Results: Adolescents from both areas have moderate knowledge (54.4±11.3%), positive attitude (78.7±13.1%) and good practice (65.8±19.9%) scores towards DF intake. Although rural adolescents had significantly (p=0.022) higher DF intake (7.8±3.5 g) compared to urban adolescents (6.9±3.5 g), their DF intake was still lower than the Malaysian recommendation of 20-30 g/day. The attitude of DF intake of rural (r=0.390) and urban (r=0.370) adolescents showed significant positive correlations with practice score of DF intake. While a significant correlation was found between the practice score and DF intake (r=0.191, p=0.017), no significant correlation was found between knowledge and attitude scores with DF intake. Conclusion: Public health authorities and schools should raise awareness on health benefit of consuming DF to promote an increase in DF consumption among school adoles

We reported a case of cauda equina myxopapillary ependymoma in a patient who presented with atypical history of progressive blurring of vision. Ophthalmology examination revealed relative afferent pupillary defect, binasal hemianopia and papilloedema. This case report serves as a reminder that the intraspinal tumour could be a cause of papilloedema, despite rare, should be considered in a hydrocephalus patient who presented with no intracranial pathology and minimal spinal symptoms.

Introduction: Adequate daily intake of fruits and vegetables is crucial for the prevention of chronic diseases. This study aimed to determine the effects of My Body is Fit and Fabulous at School (MyBFF@school) with nutrition education intervention (NEI) on the stages of change for fruit and vegetable intake among overweight and obese secondary school children based on the trans-theoretical model (TTM). Methods: This was a cluster randomised controlled trial involving 15 out of 415 eligible government secondary schools in central Peninsular Malaysia, which were randomly assigned into intervention (six schools; 579 school children) and control (nine schools; 462 school children). The intervention group was given NEI for 24 weeks, while the control group followed the existing school programme by the Ministry of Education. Results: There was no significant difference between the intervention and control groups for the stages of change, with majority at the maintenance stage after six months (intervention: 34.9%; control: 39.0%). The within group analysis showed a significant reduction after six months for those at the action stage (action and maintenance stage) from 68.0% to 60.4% in the intervention group and from 71.4% to 65.6% in the control group. However, there was a significant increase among those with adequate fruit and vegetable intake in the intervention group and no significant increase in the control group. Conclusion: MyBFF@school with NEI based on TTM provided acceptable changes in fruit and vegetable intake among overweight and obese secondary school children.