Introduction: SABINA III assessed short-acting β2-agonist (SABA) prescription patterns and their association with asthma-related outcomes globally. Herein, we examined SABA prescription and clinical outcomes in the Malaysian cohort of SABINA III. Methods: In this observational, cross-sectional study, patients (12 years) were recruited between July and December 2019 from 15 primary and specialty care centres in Malaysia. Prescribed asthma treatments and severe exacerbation history within 12 months prior and asthma symptom control during the study visit were evaluated. Associations of SABA prescription with asthma control and severe exacerbation were analysed using multivariable regression models. Results: Seven hundred thirty-one patients (primary care, n=265 [36.3%]; specialty care, n=466 [63.7%]) were evaluated. e prevalence of SABA over-prescription (3 SABA prescriptions/year) was 47.4% (primary care, 47.1%; specialty care, 47.6%), 51.8% and 44.5% among all patients and patients with mild and moderate-to-severe asthma, respectively. Altogether 9.0% (n=66) purchased SABA without a prescription; among them, 43.9% (n=29) purchased 3 inhalers. e mean (standard deviation) number of severe asthma exacerbations was 1.38 (2.76), and 19.7% (n=144) and 25.7% (n=188) had uncontrolled and partly controlled symptoms, respectively. Prescriptions of 3 SABA inhalers (vs 1–2) were associated with lower odds of at least partly controlled asthma (odds ratio=0.42; 95% condence interval [CI]=0.27–0.67) and higher odds of having severe exacerbation(s) (odds ratio=2.04; 95% CI=1.44–2.89). Conclusion: e prevalence of SABA over-prescription in Malaysia is high, regardless of the prescriber type, emphasising the need for healthcare providers and policymakers to adopt latest evidence-based recommendations to address this public health concern.

Traumatic Posterior Hip Dislocation in a Child: When is an Anterior Open Reduction Indicated? A Case Report Traumatic hip dislocations in children are uncommon, occurring in about 5% of all dislocations in children. Neglected hip dislocations are rarer and pose a serious threat to the normal development of the hip with complications of avascular necrosis and unstable gait. Open reduction is usually required, but the most appropriate surgical approach has not been clearly defined. We reported a child with a traumatic posterior hip dislocation who was successfully treated through an anterior approach after a previously failed posterior open reduction. An anterior open reduction of the hip following a previous failed posterior open reduction is a safe procedure and avoids the likelihood of an iatrogenic injury to the sciatic nerve. Pre-operative imaging with a CT scan or MRI is required in neglected cases to visualise intra-articular bone fragments, which can prevent a concentric reduction.

Introduction: The purpose of this study is to identify the incidence of clavicle fractures in newborn associated with fetal, maternal and process of deliveries in Kuantan General Hospital from June 2012 until January 2014. This study is to determine epidemiological data of clavicle fractures, maternal and baby risk factors associated with clavicle fractures of newborn and its’ outcome. Methods: This is a prospective study. 13 patients were identified to fulfill the inclusion criteria of the study. The data of sociodemographic, associated fetal and maternal risk factors and the outcomes were recorded using proforma. The statistical data analysis was done using SPSS 12.0. Results: Out of 20,257 live births at our centre during the study period, 13 infants were diagnosed to have clavicle fractures, giving an incidence of 0.64 per 1000 live births. There were 5 (38.5%) left, 7 (53.8%) right and one (7.7%) bilateral fracture. All fractures located at the mid shaft of the clavicle and none have associated brachial plexus injuries. All infants were delivered through vaginal delivery (61.5%); five through assisted delivery (instrumental); 2 (15.4%) forcep and 3 (23.1%) vacuum. Two of the babies developed shoulder dystocia. The average birth weight was 3371 grams (SD 0.269) and mean gestational age was 38.7 weeks (SD 1.16). Five of the mothers (38.5%) were primigravida and eight (61.5%) were multigravida in which,7 (53.8%)were healthy without other co-morbidty, 5 (38.5%) having gestational diabetis and one (7.7%) hypertension. The average maternal weight was 62.0 kg and height 1.58 metres with average BMI of 24.16 (3.29SD). All eventually had a complete recovery at 6 weeks with clinical and radiological evident of fracture union. Conclusions: In conclusion, all patients with clavicle fractures were found following vaginal delivery. There were no associations between neonatal clavicle fractures with maternal or baby risk factors. All fractures healed without any complications.