OVERVIEW OF THE ANTENATAL DETECTION OF LYMPHATIC MALFORMATION, ITS ASSOCIATED GENETIC FACTORS, AND THE COMPLICATIONS Lymphatic malformation (LM) is a dysfunction of the lymphatic system that is associated with genetic diseases. The clinical manifestation is established, but the outcome concerning genetic abnormalities is still not well understood. This review reports the advancement of technology in detecting LM antenatally, its associated genetic factors, and the complications of LM. Articles which were mainly case reports published from 1983 to 2023 were obtained from the search in Ovid MEDLINE and Scopus using the keywords “gene*”, OR, “DNA”, OR “epigenetic*” AND “lymphatic malformation” OR “cystic hygroma”. The advancement of technology over the years has contributed to the various types of genetic investigations conducted on a foetus with LM, including fluorescence in situ hybridization and multiplex ligation-dependent probe amplification. Poor prognosis indicated by the presence of genetic or karyotype abnormality results in opted termination of pregnancy, intrauterine death, or death at early hours of life. The PTPNII, FOXC2, FOXF1, and SRY genes and various chromosome abnormalities are associated with LM. The complications of LM include bone deformity, cardiac and urinary anomalies, and the worst is foetal hydrops. This critical dysfunction warrants future research directions to identify risk factors or biomarkers to prevent future cases of pregnancy with LM.

COVID-19 is a highly contagious disease that caused a worldwide pandemic in 2020. Medical students are public advocates for COVID-19 vaccination to achieve herd immunity. Our objective is to ascertain the level of knowledge, attitude, and practice toward COVID-19 immunisation among medical students in Malaysia. The online study included four public universities in Peninsular Malaysia: Universiti Putra Malaysia, International Islamic University Malaysia, Universiti Sains Malaysia and Universiti Sains Islam Malaysia. Data collected include sociodemographic characteristics, history of COVID-19 infection, knowledge, attitude and practice towards COVID-19 immunisation. Analytical statistics were analysed with IBM Statistical Package Statistical Package for the Social Science (SPSS) v27.0 using Pearson chi-square or Fisher’s exact test (significant if p < 0.05). From the total of 427 respondents, 60.2% had good knowledge whereby clinical students 67.0% had a higher proportion of good knowledge as compared to preclinical students 53.5% (p = 0.004). Respondents in the age group of 21 to 24 years old (p < 0.001) and 25 to 29 years old (p = 0.016), and Indian ethnicity (p = 0.006) were more likely to have good knowledge. Respondents registered in Malaysia’s National COVID-19 vaccination program were considered as having a positive attitude (n = 264, 61.8%). A vaccination rate of 100% was observed. In conclusion, 60.2% of medical students had good knowledge, 61.8% had a positive attitude and 100% were vaccinated in these four public medical schools in Malaysia. Sociodemographic factors (age group and Indian ethnicity) have an association with only good knowledge but none with the level of attitude and practice towards COVID-19 immunisation.
COVID-19

Knowledge of renal vasculature anomalies is important during the preparation of renal and abdominal surgeries. In this case report, we described a rare finding of bilateral aberrant renal arteries, located at the superior pole of both kidneys, in a cadaver of an elderly Asian man during an anatomy practical session. The aberrant arteries branch from the abdominal aorta, slightly above the level of the normal renal arteries. Additionally, an accessory left renal vein was found to originate from the superior pole of the left kidney which later drains into the left renal vein. No accessory right renal vein was observed. The left renal vein was usually located anterior to the aorta, and bilateral testicular veins were noted to drain into common destinations.

The modiolus of the face manifests the interesting landmark for facial muscles attachment. The strong connective tissue fibres play an important role in the clinical setting, especially in the aesthetic and dental surgeries. In the fourth week of intrauterine life, the development of the modiolus evolves in accordance with the growth of muscles of facial expression. Microscopically, a white, tendinous structure with the thick irregular collagenous connective tissue of collagen fibres predominance appeared to be the modiolus. Modiolus is morphologically a fibromuscular muscle situated on the lateral border of the mouth. The formation of the nasolabial fold is important and a well-developed modiolus provide a toned face. Several works of literature forementioned the number of facial muscles attached to the modiolus but no definitive similarity are identified. This review summarizes the updated morphological features and applied anatomy of the facial modiolus with its muscle attachment.