The attitudes shown by community towards the mentally ill patient can have implications for recovery. To gather robust evidence regarding community attitudes towards people with mental illness, a data collection is required. A cross sectional study was carried out to examine the community attitudes towards the mentally ill patients and its associated factors in Tampoi Town, Johor among 347 respondents. This study was conducted from June 2012 to June 2013. Community Attitudes towards the Mentally Ill questionnaire was used to examine public attitudes towards the mentally ill patients. Another questionnaire was used to determine media influence and history or experience with the mentally ill patients was administered by a researcher. The community in this town had a positive attitude towards the mentally ill patients. Benevolence attitude which represent the positive attitude has the highest mean score [37.13 (4.18)]. Social Restrictiveness attitude which represent the negative attitude has the lowest mean score [25.42 (4.82)]. Results indicated that race, educational level and previous experience with the mentally ill patients had a significant association with community attitudes towards the mentally ill patients. Meanwhile, age, gender, religion, occupation, income and media have no association with community attitudes towards the mentally ill patients. These results are expected to help the related parties in conducting various comprehensive and holistic programs or campaign. Specifically, medical social worker should be more sensitive to the public attitude toward the mentally ill patients so that they could recognize the contributing factors on negative attitudes and prevent them.

Objectives This study aims to detect MRSA nasal carriers among medical staff and patients in Dermatology ward Hospital Kuala Lumpur by using two methods, the conventional blood sheep agar (BSA) and the novel BBL CHROMagar MRSA (C-MRSA). It also aims to compare the BSA medium with the C-MRSA medium in terms of specificity, sensitivity and time to detection to MRSA. Method A single centre, prospective study where 100 nasal swab samples were taken from medical staff and inpatients, then plated on to both BSA and C-MRSA. After 24 hours incubation, the plates were examined for presence of bacterial colonies, then incubated for another 24 hours if no colonies were present. All colonies on C-MRSA and BSA were subjected to coagulase and susceptibility testing for confirmation of MRSA. MRSA strains produce mauve colonies on CMRSA from hydrolysis of the chromogenic substance, thus C-MRSA uses colour as a diagnostic tool. Results Mauve colonies were present on nine C-MRSA plates in the first 24 hours which were all confirmed to be MRSA. Another nine CMRSA plates isolated bluish colonies which were not MRSA. There were colonies on 96 BSA plates, nine of which were MRSA. C-MRSA medium has 100% sensitivity and specificity in detecting MRSA. Both culture media had similar detection rates of MRSA from nasal swabs, however C-MRSA allows for earlier detection of MRSA within 24 hours compared to BSA which takes 48 hours. 2.2% of ward staff and 15.7% of inpatients were found to be MRSA carriers. Conclusion CHROMagar MRSA allows for more rapid identification of MRSA carriers within 24 hours compared to the conventional BSA which takes 48 hours. This allows earlier action to be taken to reduce the spread of MRSA infection.

MicroRNAs (miRNAs) are mostly located at cancer-associated genomic regions or in fragile sites, suggesting their important role in the pathogenesis of human cancers. Multiple myeloma (MM) is a cancer of plasma cells, the third most common cancer of the blood after lymphoma and leukaemia. There are several published reports on miRNAs in MM, however most used bone marrow rather than peripheral blood samples. The aim of this study is to characterise miRNA expression in normal and MM patients using peripheral blood samples as it is less invasive and is readily available from patients. Blood samples from 35 MM patients were analysed using the microarray method. We identified up-regulation of 36 miRNAs (57%) and down-regulation of 27 miRNAs (43%). We also identified the CCND2, HMGA2 and IGF1R genes were among the highly predictive target genes (P(CT) > 0.80) for most of the deregulated miRNAs. These genes are known to play important roles in MM as well as other cancers. Five miRNAs (let-7c, miR-16, miR- 449, miR-181a and miR-181b) were found to exhibit similar expression patterns (p < 0.05) in peripheral blood when compared to data obtained by using bone marrow aspirates from MM patients in other studies. In conclusion, our study has demonstrated that miRNAs are also present and differentially expressed in the peripheral blood of MM patients compared to controls and may potentially serve as candidate tumour biomarkers in MM. In particular, let-7c and miR-16 have been shown to be significantly expressed in the bone marrow.

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common enzyme deficiency worldwide including Malaysia. Screening of cord blood for partial G6PD deficiency is important as they are also prone to develop acute haemolysis. In this study, we determined the prevalence of partial G6PD deficient in paediatric population aged 1 month-12 years and normal term female neonates using OSMMR-D kit with haemoglobin (Hb) normalization and compare it with florescence spot test (FST). A total of 236 children, aged between between 1 month-12 years and 614 normal term female neonates were recruited for this study. Determination of normal means for G6PD activity and; cut-off points for partial and severe deficiency were determined according to WHO Working Group (1989). Determination of prevalence for partial deficiency for both groups (female patient) was done using this enzyme assay kit and findings were compared with FST. In this study, 15.7% (18/115) female children were classified as partial G6PD deficient by quantitative enzyme method (G6PD activity: 4.23-5.26U/gHb). However, FST only detected 0.9% (1/115) with minimal G6PD activity. The prevalence of partial G6PD deficiency in female neonate group was 3.42% (21/614) by enzyme assay versus 0.49% (3/614) by FST. This study concluded that our routine screening method using FST was unable to diagnose female heterozygotes. We recommend using this quantitative enzyme assay method by OSMMR-D kit since it was more sensitive in detecting G6PD deficiency in female neonates compared to FST.
Glucosephosphate Dehydrogenase Deficiency

Primary retroperitoneal cavernous hemangioma is a very rare benign neoplasm. A retroperitoneal hemangioma may be detected accidentally or be symptomatic due to local compression on adjacent structures. We reported on the diagnosis and treatment of a patient with PRCH with a subtle clinical presentation and atypical findings on computed tomography imaging. The patient presented with right hypochondriac discomfort for one month duration. Computed tomography of the abdomen revealed a huge mass arising from right lobe of liver which was compressing the surrounding structures. Intraoperatively there was a huge cystic like mass arising from the retroperitoneum which had clear margin with the adjacent structures. The tumour was successfully excised with an intact capsule and histopathological examination revealed a cavernous hemangioma.
cystic ; hemangioma ; neoplasm ; retroperitoneal

Objective: To assess the public health risk to Singapore posed by the emergence of artemisinin-resistant (ART-R) malaria in the Greater Mekong Subregion (GMS). Methods: We assessed the likelihood of importation of drug-resistant malaria into Singapore and the impact on public health of its subsequent secondary spread in Singapore. Literature on the epidemiology and contextual factors associated with ART-R malaria was reviewed. The epidemiology of malaria cases in Singapore was analysed. The vulnerability and receptivity of Singapore were examined, including the connectivity with countries reporting ART-R malaria, as well as the preparedness of Singaporean health authorities. Sources of information include international journals, World Health Organization guidelines, data from the Singapore Ministry of Health and National Public Health Laboratory of the National Centre for Infectious Diseases, and the International Air Transport Association. Results: The importation of ART-R malaria into Singapore is possible given the close proximity and significant travel volume between Singapore and the GMS countries reporting artemisinin resistance. Singapore’s vulnerability is further enhanced by the presence of foreign workers from neighbouring endemic countries. Nonetheless, the overall likelihood of such an event is low based on the rarity and decreasing trend of imported malaria incidence. With the presence of Anopheles vectors in Singapore, imported cases of drug-resistant malaria could cause secondary transmission. Nevertheless, the risk of sustained spread is likely to be mitigated by the comprehensive surveillance and control system in place for both infected vectors and human cases. Discussion This risk assessment highlights the need for a continued high degree of vigilance of ART-R malaria locally and globally to minimize the risk and public health impact of drug-resistant malaria in Singapore.