Introduction: Pituitary apoplexy is a rare, life-threatening endocrine emergency caused by acute hemorrhage or infarction of the pituitary, often in the setting of a pre-existing adenoma (2–12%). While classically presenting with sudden headache, visual loss, and altered consciousness, it can occasionally mimic an acute stroke. Occurrence after coronary procedures is exceptionally rare, particularly when accompanied by cerebral infarction. We report a middle-aged male who developed an acute stroke following percutaneous coronary intervention (PCI) and subsequently had panhypopituitarism secondary to pituitary apoplexy. Case: A 50-year-old male, with underlying diabetes mellitus, hypertension, dyslipidemia, and chronic kidney disease stage G3A, initially admitted to a private centre for PCI, however, complicated with acute left-sided weakness, headache, and reduced consciousness 2 days postprocedure. He had a history of progressive left visual loss for 3 months. Examination revealed Glasgow Coma Scale E2V4M4, blood pressure 118/82 mmHg, left-sided power 4/5, and temporal pallor of the left optic disc. His blood sugar was 15.5 mmol/L. Urgent computer tomography scan of the brain demonstrated a right basal ganglia infarct with sellar mass measuring 15 × 15 × 20 mm extending into the suprasellar cistern with mass effect. Magnetic resonance imaging confirmed multifocal acute and chronic infarcts with an acute pituitary hemorrhage compressing the optic chiasm. Biochemistry showed mild acute kidney injury (urea 11.7 mmol/L, creatinine 119 µmol/L) without electrolyte imbalance, thrombocytopenia, or anemia. Hormonal studies revealed partial hypopituitarism with normal thyroid function, secondary adrenal insufficiency (serum morning cortisol 40 nmol/L), and central hypogonadism (serum testosterone 2.2 nmol/L). Hydrocortisone was initiated inpatient, followed later by testosterone replacement and antiplatelet therapy during follow-up. Conclusion This case illustrates pituitary apoplexy with an atypical presentation: acute neurological deficits following invasive cardiovascular procedures. It underscores the importance of multidisciplinary management involving endocrinologists, cardiologists, neurologists, and neurosurgeons to optimize outcomes. Early recognition, prompt neuroimaging, and timely treatment are vital to prevent irreversible neurological and endocrine complications.
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Sufficient intake of macronutrients and micronutrients are essential for child growth. Many children with autism spectrum disorder (ASD) however are reported to be picky eaters which may lead to malnourishment. As diet and behaviour are importantly interconnected, this study aims to determine the level of knowledge on nutrition among parents and special educators of children with ASD. A cross-sectional study was conducted at a National Autism Centre in Kuala Lumpur, Malaysia from May to August 2018. A 37-item questionnaire was self-administered to the respondents who attended series of training of trainers’ sessions. The data was the collected and analysed descriptively. A total of 209 respondents participated with 153 parents and 56 special educators of children with ASD. Only 37.9% of the parents agreed that their children’s diet contain balanced nutrition. Majority of the parents and special educators had the perception that sugar, junk food and gluten are bad for the children but they were still given due to the accessibility and convenience. The low level of knowledge among parents and special educators about the nutrition of children with ASD indicates that a measure should be taken to increase the awareness and to overcome the malnutrition among ASD children.

The application of artificial intelligence (AI) is on the rise in the healthcare industry. However, the study on the physicians’ perspectives is still lacking. The study aimed to examine physicians’ attitudes, expectations, and concerns regarding the application of AI in medicine. A cross-sectional study was conducted in October 2019 among physicians in a tertiary teaching hospital in Malaysia. The survey used a validated questionnaire from the literature, which covered: (1) socio-demographic profile; (2) attitude towards the application of AI; (3) expected application in medicine; and (4) possible risks of using AI. Comparison of the mean score between the groups using a t-test or one-way analysis of variance (ANOVA). A total of 112 physicians participated in the study: 64.3% from the clinical departments; 35.7% from the non-clinical specialties. The physicians from non-clinical departments had significantly higher mean attitude score (mean = 14.94 ± 3.12) compared to the clinical (person-oriented) departments (mean = 14.13 ± 3.10) and clinical (technique-oriented) departments (mean = 13.06 ± 2.88) (p = 0.033). The tech-savvy participants had a significantly higher mean attitude score (mean = 14.72 ± 3.55) than the non–tech-savvy participants (mean = 13.21 ± 2.46) (p = 0.01). There are differences in the expectations among the respondents and some concerns exist especially on the legal aspect of AI application in medicine. Proper training and orientation should precede its implementation and must be appropriate to the physicians’ needs for its utilization and sustainability.

Background: Stenotrophomonas maltophilia has emerged as an important nosocomial pathogen, capable of causing a wide spectrum of infections. Treatment is difficult because it is resistant to many antimicrobial agents, thus reducing the treatment options. The aims of this study were to describe the antimicrobial susceptibility patterns and synergistic effect of selected antimicrobial combinations against S. maltophilia isolates. Methods: This was a descriptive cross-sectional study undertaken in the Hospital Universiti Sains Malaysia from April 2011 to March 2012. S. maltophilia isolated from various clinical specimens were included in the study. Antimicrobial susceptibility testing was done using the epsilometer test (E-test) and interpreted according to the guidelines of the Clinical and Laboratory Standards Institute. In the synergy test, the isolates were tested against six different antimicrobial combinations. Results: In total, 84 S. maltophilia isolates were collected and analysed. According to the E-test, the antimicrobial susceptibility of trimethoprim-sulfamethoxazole (TMP-SMX), tigecycline, and ciprofloxacin was 100%, 91.1%, and 88.9% respectively. The antimicrobial combination of TMP-SMX and ceftazidime showed the highest synergistic effect. Conclusion: TMP-SMX remains the antimicrobial of choice to treat S. maltophilia infection. TMP-SMX and ceftazidime was the most effective combination in vitro.