Objective: To investigate phenolics, fatty acids composition and biological activities of various extracts and fractions of Malaysian Aaptos aaptos. Methods: Fatty acid methyl ester was analyzed by gas chromatography-flame ionization detector. Antioxidant activity was determined using 2,2-diphenyl-picrylhydrazyl radical scavenging assay and total phenolics content by Folin-Ciocalteu procedure. Vero cells viability was evaluated using methyl thiazole tetrazolium and the inactivation of herpes simplex virus type 1 by neutral red uptake assay. p-Hydroxybenzamide isolated by column chromatography was characterized by utilizing nuclear magnetic resonance spectroscopy and electron impact mass spectrometry. Results:The chloroform, ethyl acetate and methanol extracts of Aaptos aaptos produced higher portions of straight-chain saturated fatty acid, while hexane extract mainly consisted of unsaturated fatty acid. The five majors of fatty acid methyl ester were identified as behenic acid, cis-10-heptadecenoic acid and cis-10-pentadecenoic acids, palmitic acid and tricosanoic acid. In addition, among all organic extracts, chloroform extract inactivated herpes simplex virus type 1 while exhibited weak cytotoxic activity against normal Vero cells and also exhibited strong cytotoxic activity on HL-60, MCF-7, K562, CEM-SS and WEHI-3B cells. A phenolic compound, p-hydroxybenzamide was also isolated from the sponge. Conclusions: Aaptos aaptos could be a source to derive the potential antiviral and anticancer agents. However, further studies are needed to determine the mechanism involved in the process.

We report a 55-year old lady with the presentation of stridor and type II respiratory failure requiringtracheal intubation. She had right Horner’s syndrome associated with pleural effusion. Her chest radiographrevealed right upper zone lobulated opacities and therefore right Pancoast tumor was the initial diagnosis.However, her CECT thorax revealed a huge right subclavian artery pseudoaneurysm with severe trachealcompression. This rare condition imposed a significant diagnostic as well as therapeutic challenge. Vascularsurgery is the definitive treatment but it is associated with high risks. The exact role of rigid bronchoscopyfor airway stenting is unknown due to limited evidence available. Indeed, this form of central airwayobstruction may benefit from temporary tracheal stenting whilst the surgical repair of the lesion is planned.It may facilitate early weaning and allows less complicated airway control.

Among the main reasons for re-emergence of vaccine preventable diseases were missed or incomplete immunization schedule. The supplementary immunization activity (SIA) is an important intervention done to provide complete immunization coverage among those children. Better outcome came along with good knowledge and perception on the program. Thus, this study aims to assess the level of knowledge and perception of the mothers towards SIA program. A cross-sectional study was conducted among mothers with children ≤ 15 years old in Cheras, Kuala Lumpur. Data was collected by interview using the guided questionnaire consists of four sections to assess the socio demographic, socio economic, knowledge and perception regarding SIA. The questionnaire was validated for internal consistency with Cronbach’s alpha 0.461 for knowledge and 0.729 for perception. A total of 105 respondents with the median age of 33 years (IQR: 28-38) with majority of them are Malays (82.9%), Muslim (83.8%), married (97.1%) and (57.1%) with 1- 2 child in the family. Half of them were from low income family (46.7%) and had secondary education level (54.3%) and were housewives (47.6%). One third of the respondents (33%) never heard about SIA before. Overall had poor knowledge (82.9%) and perception (95.2%) towards SIA. There is a significant association between the level of knowledge on SIA with household income (χ^2=7.746, p=0.019) and occupation (χ^2=6.457, p<0.05). However, there was no significant association between the socio demographic and socio-economic factors and perception towards SIA. In conclusion, the knowledge and perception among mothers on SIA are still poor. More intensive health educations may be useful to be incorporated within the program implementation to increase the community understanding and perception towards SIA in the future.

Madam S, who diagnosed to have stage IV lung adenocarcinoma with exon 21 L858R point mutation (T3N2M1a) was admitted for massive pericardial effusion in April 2016. She was ECOG 4 on admission. Her ECOG improved to 1 after pericardial tapping and initiation of free sample erlotinib 100 mg daily. Repeated CT thorax post treatment showed the disease was partial responded. Due to financial constraints, she had never bought any EGFR-TKI. She was given a free sample of erlotinib intermittently for total of 12 months followed by intermittent afatinib supply for 2 years. Due to this limited supply, she took half doses of afatinib by cutting a 40 mg tablet once every few days to sustain the continuation of cancer treatment. No major side effects were observed and she remained ECOG 0 with good weight gain. Up to her last clinic visit in September 2021, her PFS was more than 5 years. Intermittent doses of EGFR-TKI may prolong PFS in patients with advanced EGFRm+ NSCLC who has limited treatment options.

Objective: To investigate phenolics, fatty acids composition and biological activities of various extracts and fractions of Malaysian Aaptos aaptos. Methods: Fatty acid methyl ester was analyzed by gas chromatography-flame ionization detector. Antioxidant activity was determined using 2,2-diphenyl-picrylhydrazyl radical scavenging assay and total phenolics content by Folin-Ciocalteu procedure. Vero cells viability was evaluated using methyl thiazole tetrazolium and the inactivation of herpes simplex virus type 1 by neutral red uptake assay. p-Hydroxybenzamide isolated by column chromatography was characterized by utilizing nuclear magnetic resonance spectroscopy and electron impact mass spectrometry. Results: The chloroform, ethyl acetate and methanol extracts of Aaptos aaptos produced higher portions of straight-chain saturated fatty acid, while hexane extract mainly consisted of unsaturated fatty acid. The five majors of fatty acid methyl ester were identified as behenic acid, cis-10-heptadecenoic acid and cis-10-pentadecenoic acids, palmitic acid and tricosanoic acid. In addition, among all organic extracts, chloroform extract inactivated herpes simplex virus type 1 while exhibited weak cytotoxic activity against normal Vero cells and also exhibited strong cytotoxic activity on HL-60, MCF-7, K562, CEM-SS and WEHI-3B cells. A phenolic compound, p-hydroxybenzamide was also isolated from the sponge. Conclusions: Aaptos aaptos could be a source to derive the potential antiviral and anticancer agents. However, further studies are needed to determine the mechanism involved in the process.

Introduction: Sexually transmitted Infections (STIs) are major public health concerns reaching an all-time high, globally. In Malaysia data on the prevalence of STIs remains scarce which limits the understanding of STI transmission dynamics and the role of interventions in the control of STIs. The aim of this study is to determine the epidemiology characteristics of STIs mainly from Malaysian private healthcare institutions. Method: A two years (2016 and 2017) retrospective review was conducted on 160 multiplex RT-PCR STI reports from KPJ hospitals, Malaysia. Results: There were 65 (40.6 %) patients positive STIs [male: 21/65 (32.3 %); female: 44/65 (67.7 %)]. The STIs was prevalent among young adults (56/65; 86.2 %) from the central region (46/65; 70.8 %). Females had 1.7 times greater risk to develop STI (20 per 100) and two times higher chance to have multiple STIs (10 per 100) in comparison to male. The single STIs was caused mainly by U. parvum (N=17). In males, U. urealyticum (N=3) and C. trachomatis (N=3) were prevalent, while U. parvum (N=15) was prevalent in females. There were 19 dual infections of STIs which were commonly caused by U. parvum and M. hominis (N=5). There were seven STIs cases caused by three pathogens concurrently including U. urealyticum, U. parvum and C. trachomatis (N=2) and U. urealyticum, M. genitalium and C. trachomatis (N=2). Females from urban communities have higher risk in comparison to males for developing multiple STIs. Conclusion: This study provides an imperative platform for temporal trends of STIs in Malaysia which reflects the health status of certain populations that warrant immediate public health interventions.

Introduction: A stroke can have devastating consequences and may reduce the Quality of Life (QoL) of stroke survivors. Specific QoL measurement is therefore needed to appreciate and quantify the impact of this condition. The objective of the study is to culturally adapt, translate and validate the Bahasa Melayu, Mandarin and Tamil versions of the Stroke Impact Scale (SIS) 3.0 for its application in clinical practice and stroke research in Malaysia. Methods: A total of nine translators translated the SIS 3.0 and five professional experts carried out the linguistic validation of the SIS 3.0 in accordance with the Mapi Research Institute’s linguistic validation guideline. The steps for linguistic validation included forward translation, synthesis, backward translation, clinicians’ review, and cognitive debriefing. Ten to thirteen healthcare practitioners rated the translated versions of SIS 3.0 using the Content Validity Index (CVI) and Content Validity Ratio (CVR). Results: During the translation processes, concerns were expressed about various grammatical and semantic issues, such as the appropriateness of some phrases used for the Malaysian demographic. The Scale-CVI average was 0.91 and 0.95 for relevance and clarity respectively which indicated excellent content validity. The CVR values ranged from 0.40 to 1.00. Conclusion: The Bahasa Melayu, Mandarin and Tamil versions of SIS 3.0 was well developed. The translated versions of SIS 3.0 could be adopted in clinical, community and educational settings. Nevertheless, further in-depth psychometric testing including construct validity and reliability on a larger sample among the multi-ethic Malaysians stroke survivors is advised.