Bungsu et al Brunei International Medical Journal 2025;21:82-87 Brunei International Medical Journal Brunei Colorectal Cancer Awareness and Risk Education for Screening (Bru-CARES) Community Project N BUNGSU1, AS HAJI MD ALI1, A HAJI GHAZALI1, S KONG1, MK ABU BAKAR1, NA GULZAR AHMAD1, S SUHAILI1, SK ONG1,2, P HASHMET1,3, VH CHONG1,2, K KOK1, E ERDAL1, H GHANI1*

Iron deficiency anemia is commonly encountered in clinical practice and the underlying etiology can be benign or pathological, depending on the gender and age of patients. Common causes include pre-menopausal menstrual and gastrointestinal blood loss. However, it is important to be aware of less common causes. Hereditary hemorrhagic telangiectasia, also known as Osler-Weber-Rendu syndrome is disorder of vascular malformations that can affect any site. Hereditary hemorrhagic telangiectasia often manifest with chronic blood loss resulting in iron deficiency anemia. Telangiectasias affecting the hands and oral cavity can be easily detected on careful examination but can be overlooked. Vascular malformations affecting other sites such liver, lungs and brain require radiological imaging. We report two cases of hereditary hemorrhagic telangiectasia and iron deficiency anemia secondary to recurrent epistaxis, one patient requiring only iron supplementation to maintain hemoglobin level and another requiring frequent transfusion.

Te djenkol bean (Archidendron pauciforum) is a native delicacy in Southeast Asia, though consumption can sometimes lead to djenkolism. Clinical features of djenkolism include acute abdominal pain, hematuria, urinary retention, and acute kidney injury (AKI). Te pain can be severe, which often leads to a misdiagnosis of acute abdomen. In this paper, we report the case of an Indonesian migrant with djenkolism. Due to the short history and severity of the abdominal pain, medical professionals suspected acute abdomen and proceeded with a negative exploratory laparotomy. However, djenkolism was suspected once relatives informed the professionals that the patient had consumed djenkol beans hours earlier. Te patient recovered through aggressive hydration and urine alkalinization with bicarbonate infusion. We highlight the importance of being aware of this rare cause of AKI, especially in Southeast Asia, in order to provide early diagnoses and prompt treatments.

Urinary tract infection (UTI) is one of the most common presentations in general practice and,in most instances, occurs in a single episode and is easily treated with a course of anti-microbialtherapy. In the case of recurrent urinary tract infections, it is important to consider evaluation forany underlying causes. We report the case of a 32 year old female who had recurrent UTIs; this wasa case of recurrent UTI secondary to xanthogranulomatous pyelonephritis from renal stones withresultant reno-colic fistula formation.

Biliary diseases during pregnancy are not uncommon and are frequently due to cholelithiasis. Choledochal cyst during pregnancy is rare. The management of biliary pathologies during pregnancy poses a challenge as the window of opportunity to carry out any interventions with minimal risk is small.