Severe hyponatraemia is defined as a sodium level of less than 120 mEq/L, and it is frequently accompanied by neurological symptoms like coma, convulsions, respiratory arrest, and death. Clinical cardiac toxicity from hyponatremia, such as bradyarrhythmia, is extremely rare. In this article, we present a case of acute severe hyponatraemia that induced unstable bradyarrhythmia and led to refractory bradycardia, which did not improve despite receiving treatment in accordance with the standard Advanced Cardiovascular Life Support protocol. The patient’s bradyarrhythmia has completely resolved with the administration of 3% hypertonic saline, which restored her sodium levels. Due to the possibility that severe hyponatremia may contribute to the aetiology of cardiac malfunction, this case raises awareness about the significance of closely monitoring electrocardiograms and telemetry in patients with severe hyponatremia.

Tinospora crispa (L.) is a medicinal plant traditionally used to treat various ailments including diabetes. The stem has been widely studied for its antidiabetic properties, however the antidiabetic potential of its leaves has not been explored. This study investigates the antidiabetic properties of methanolic T. crispa stem and leaves extracts on alloxan-induced diabetic rats. The stems and leaves were extracted using Soxhlet extraction with methanol as solvent. Crude extracts were administered at 500 mg/kg body weight (BW) (high dose) and 250 mg/kg BW (low dose) via oral route to alloxan induced diabetic rats. T. crispa stem and leaves extracts was found to significantly reduce blood glucose following a twelve-week treatment period. The highest mean difference in blood glucose level was exhibited by animals in the high dose treated stem and low dose leaf extracts. Both extracts showed approximately 75% percentage recovery from hyperglycaemia. The highest regenerative capacity was observed in animals treated with the low dose leaf extract.

Abstract Introduction: This study is part the Investigator Initiated Research (IIR) project under the mental health suicide and para suicide cluster. Self-harm is an important predictor of suicide and leaves a significant long-lasting psychological effect. Despite the increasing prevalence of rate of self-harm, very little research had been done in Asian countries. The objective of this study is to determine the prevalence of self-harm in selected hospitals, demographic profiles and factors associated with development of self-harm. Methods: This is a multi-centred cross sectional study. Six months of data collection was performed between the 1st November 2013 and 30th April 2014. All cases that were identified to have carried out Self-Harm were interviewed using The World Health Organization (WHO) SUPRE-MISS Questionnaire Annexe 1 which had been adapted to the Malaysian culture by the research committee members. Results: A total of 99 samples were obtained for this study. They mostly came from low socioeconomic background. Majority of the patients were females, and this was consistent with studies worldwide. Poisoning by pesticides was the most frequent method of choice and about 30% of the patients had previous attempts. Conclusion: Sociodemographic factors play a significant role in self-harm. It is important to know the sociodemographic profile to identify which group of people are at risk and intervention can be focused.

This review aims to present an overview of current research findings on the possible relationship between phonologicalawareness and visual-spatial skills among individuals with dyslexia. Narrative review of the relevant articles wereobtained through computerized searches of databases such as PubMed, PubMed Central (PMC) and Google Scholarwhich included articles from SAGE, Taylor & Francis and Massachusetts Institute of Technology (MIT) Press from theyear 2000 to 2014. The key words were explored, both exclusively and in combination with each other, so as to provide abetter understanding of the relationship between them among individuals with dyslexia. Although it is evident that thereis a phonological deficit in individuals with dyslexia, however, it is inconclusive with regards to the visual-spatial deficitand strength. There is a consensus on the nature of phonological awareness skill deficits but not on the visual spatialabilities in dyslexia. In fact, the relationship between phonological awareness and visual spatial abilities in dyslexia isdependent on the area of visual ability measured.

Children with Specific Learning Disorder (SLD) faces challenges in academic areas and are often negatively labelled. The learning problems in SLD children were mainly due to poor phonological skill but not much was known about the contribution of visuospatial difficulties. Therefore, this study aims to determine the relationship between phonological awareness skills and global visual-spatial abilities among Malay speaking children with SLD, and to compare children with SLD and typical readers on intellectual functioning, phonological awareness and global visual-spatial ability. An equal number of typical readers (n = 36) and children with SLD were recruited. Data were coded and analysed using Kendall’s Tau-b, independent samples t-test and Mann-Whitney U test. Results showed phonological skills have strong negative correlation with global visual-spatial ability (r = .55). The typical readers have significantly higher IQ and better phonological skills and better global visual-spatial skills as compared to the group with SLD. However, there is no conclusive evidence due to specificity of more than one area measured by the assessment tools. Nevertheless, it provides a direction for future research to look into global visual-spatial aspects of SLD to aid in educational instruction in the future, in addition to the long-standing phonology deficit theory.
Specific Learning Disorders ; dyslexia ; phonological awareness, global visual-spatial ability, intellectual functioning

OBJECTIVES: This study aimed to evaluate the chemical and biological properties of fast-set white mineral trioxide aggregate (FS WMTA), which was WMTA combined with calcium chloride dihydrate (CaCl₂·2H₂O), compared to that of WMTA. MATERIALS AND METHODS: Surface morphology, elemental, and phase analysis were examined using scanning electron microscope (SEM), energy dispersive X-ray microanalysis (EDX), and X-ray diffraction (XRD), respectively. The cytotoxicity and cell attachment properties were evaluated on human periodontal ligament fibroblasts (HPLFs) using methyl-thiazol-diphenyltetrazolium (MTT) assay and under SEM after 24 and 72 hours, respectively. RESULTS: Results showed that the addition of CaCl₂·2H₂O to WMTA affected the surface morphology and chemical composition. Although FS WMTA exhibited a non-cytotoxic profile, the cell viability values of this combination were lesser than WMTA, and the difference was significant in 7 out of 10 concentrations at the 2 time intervals (p < 0.05). HPLFs adhered over the surface of WMTA and at the interface, after 24 hours of incubation. After 72 hours, there were increased numbers of HPLFs with prominent cytoplasmic processes. Similar findings were observed with FS WMTA, but the cells were not as confluent as with WMTA. CONCLUSIONS: The addition of CaCl₂·2H₂O to WMTA affected its chemical properties. The favorable biological profile of FS WMTA towards HPLFs may have a potential impact on its clinical application for repair of perforation defects.
Calcium Chloride* ; Calcium* ; Cell Survival ; Cytoplasm ; Electron Probe Microanalysis ; Fibroblasts ; Humans ; Miners* ; Periodontal Ligament ; X-Ray Diffraction

The aim of the current study is to review the medicinal properties of the plants found in Brunei Darussalam namely Litsea elliptica, Dillenia suffruticosa, Dillenia excelsa, Aidia racemosa, Vitex pinnata and Senna alata. The known phytochemical constituents of these plants and their ability to bring about a range of biological activities are included in this review. These plants have been used traditionally for a multitude of diseases and illnesses. There is a lot of untapped potential in these medicinal plants which could cure multiple diseases.

The aim of the current study is to review the medicinal properties of the plants found in Brunei Darussalam namely Litsea elliptica, Dillenia suffruticosa, Dillenia excelsa, Aidia racemosa, Vitex pinnata and Senna alata. The known phytochemical constituents of these plants and their ability to bring about a range of biological activities are included in this review. These plants have been used traditionally for a multitude of diseases and illnesses. There is a lot of untapped potential in these medicinal plants which could cure multiple diseases.

Objective: The family caregiver has a pivotal role in the management of HIV/AIDS patients and their well-being is consequently crucial as it could impact negatively on the quality of caregiving. This preliminary qualitative investigation intended to explore and describe the challenges and experiences of HIV/AIDS family caregivers in Terengganu, Malaysia. Methods: A convenient sample of family caregivers of HIV/AIDS patients who were aware of the diagnosis was enrolled. Recruitment was conducted in Hospital Sultanah Nur Zahirah, Kuala Terengganu, Malaysia and semi-structured interviews were used. Results: Results were transcribed into verbatim before being subjected to analysis. Twelve Muslim caregivers consented participation (age range = 18.0 - 81.0; female = 75.0%, mother/wife = 50.0%; married = 83.3%; ≤ primary school = 50.0%; and self-employed = 66.7%). The four major themes that emerged were challenges of caregiving, financial issues, stigma and discrimination, and support for caregivers. Additionally, caregivers did mention several positive aspects of their caregiving role including satisfaction from helping family member and improved family relationships. Conclusion: A variety of life aspects were negatively affected by caring for HIV patients, thus requiring a multidisciplinary approach to address such issues.
HIV ; Caregivers ; Islam ; Life Change Events ; Patients ; Malaysia

The current Ebola outbreak, which is the first to affect West African countries, has been declared to have met the conditions for a Public Health Emergency of International Concern (PHEIC) by the World Health Organization (WHO). Thus, the Ministry of Health (MOH) of Malaysia has taken steps to strengthen and enhanced the five core components of preparedness and response to mitigate the outbreak. The National Crisis Preparedness and Response Centre (CPRC) commands, controls and coordinates the preparedness and response plans for disasters, outbreaks, crises and emergencies (DOCE) related to health in a centralised way. Through standardised case definition and mandatory notification of Ebola by public and private practitioners, surveillance of Ebola is made possible. Government hospitals and laboratories have been identified to manage and diagnose Ebola virus infections, and medical staff members have been trained to handle an Ebola outbreak, with emphasis on strict infection prevention and control practices. Monitoring of the points of entry, focusing on travellers and students visiting or coming from West African countries is made possible by interagency collaborations. To alleviate the public’s anxiety, effective risk communications are being delivered through various channels. With experience in past outbreak control, the MOH’s preparedness and response plans are in place to abate an Ebola outbreak.