Introduction: Anaemia is common during pregnancy and can lead to miscarriage, intrauterine growth retardation, premature labour and antepartum haemorrhage. Anaemia in pregnancy is defined as a haemoglobin (Hb) level of <11 g/dL. Methods: This retrospective review included 407 antenatal mothers diagnosed with anaemia at 36±1 weeks of gestation at all 10 health clinics in Alor Gajah between January and December 2018. Results: According to the district annual returns, 2,407 antenatal mothers (36 weeks of gestation) were registered in the health clinics in Alor Gajah in 2018. Among them, the prevalence of anaemia was 18.6% (n=448). However, there were only 407 cards found. Most participants were Malays (89.4%), aged 20–40 years (93.6%) and married (96.3%). Almost all anaemia cases (96.5%) were mild (Hb level of 9–10.9 g/dL). Approximately 34.4% of the mothers were already anaemic at booking; 77.6% belonged to the B40 income group; and 31.6% had poor pregnancy spacing of <2 years. Iron deficiency anaemia was the most common type of anaemia (51.0%), followed by dilutional anaemia (34.0%), which did not normalise at 36 weeks of gestation. Anaemia was associated with lower educational (P<0.05) and Hb levels at booking (P<0.001). Conclusion Having normal maternal Hb levels in early pregnancy especially at booking is crucial, as it may reduce the possibility of anaemia during pregnancy. Early screening and supplementation of at-risk pregnancies may be applied as a preventive strategy. Suitable methods of iron treatment and investigation need further exploration.

Introduction: Coated archwires improve aesthetics during orthodontic treatment. However, little is known regarding their clinical benefit. This randomised controlled trial (RCT) compared the tooth alignment (TA), coating loss (CL), colour change (∆E*), and patient perception of coated archwires with their controls. Details of ∆E* and perception were reported in the second part of the articles. Methods: This RCT was done at three centres. Participants were randomised to receive one of four treatment interventions using 0.014” superelastic coated nickel-titanium archwires from Orthocare, RMO, G&H, and conventional uncoated 3M Unitek® archwires. These archwires were ligated during bonding and collected after eighth week and questionnaires were distributed to participants in the experimental groups only. After removal, TA and CL were measured using Little’s Irregularity Index and Autodesk® AutoCAD® software, respectively. At the time of this preliminary reporting, 84 participants had completed the trial. Two archwires fractured and were excluded. Therefore, 166 archwires (n = 166) were analysed. Results: Only non-extraction cases showed statistically significant differences in TA change between all groups (p = 0.005) and RMO showed significantly lowest mean of TA (1.5 mm). RMO and Orthocare showed significant TA change in the upper and lower arches (p = 0.037, 0.048). CL was found to be insignificant for both extraction and non-extraction cases (p >0.05). Comparison between upper and lower arches revealed no significant difference in TA and CL in all groups (p >0.05). Conclusion: From this preliminary analysis, Orthocare provides better TA in non-extraction cases despite highest percentage of coating loss.

Introduction: Electronic cigarettes (ECs) are new devices that have been accepted widely by both smokers and non-smokers. However, the evidence on EC used in Malaysia is scarce. The objective of thisstudy was to determine the prevalence of EC use and the socio-demographic and smoking characteristicsassociated with current EC use among Malaysian current and ex-smokers. Methods: This was a sub-analysis of data from a cross-sectional, national-population- based EC study conducted from May to June in 2016 in Malaysia. A detailed description of the sampling methods can be found in the National E-cigarette Survey (NECS) 2016 report. Briefly, data were obtained from 1396 individuals who had ever been smokers, i.e., 957 (68.6%) current smokers and 439 (31.4%) ex-smokers. Results: Current EC use was found predominantly among current smokers (8.0%) as compared with ex-smokers (4.3%). Among current smokers, the main reasons given for smoking ECs were wanting to try it (44.7%), followed by intention to quit tobacco smoking (15.8%) and to reduce tobacco smoking (10.5%). Using multiple logistic regression analysis, we found that among current smokers, current EC users were more likely to be younger, i.e., 18-44 years (aOR= 4.83, 95% CI= 1.97-11.86, p=0.001), urban residents (aOR= 1.89, 95% CI= 1.15-3.11, p=0.012), single/ divorced/ widowed (aOR= 2.11, 95% CI= 1.24-3.61, p=0.006) and students (aOR= 2.25, 95% CI= 1.01-5.01, p=0.048). Among exsmokers, only younger respondents (18-44 years old) was reported as being more likely to be current EC users (aOR= 3.81, 95% CI= 1.14-12.76, p=0.030). Conclusion: This study showed that currently using and ever having used ECs were more prevalent among current smokers. The reasons given for initiating EC use among current smokers were mainly wanting to try it, followed by intention to quit and to reduce tobacco smoking. Current EC use appears to be common among current smokers who are younger, urban residents, single/divorced/widowed and students. Therefore, EC cessation intervention strategies and policies should target these high-prevalence groups

Introduction: Electronic cigarettes (ECs) are new devices that have been accepted widely by both smokers and non-smokers. However, the evidence on EC used in Malaysia is scarce. The objective of thisstudy was to determine the prevalence of EC use and the socio-demographic and smoking characteristicsassociated with current EC use among Malaysian current and ex-smokers. Methods: This was a sub-analysis of data from a cross-sectional, national-population- based EC study conducted from May to June in 2016 in Malaysia. A detailed description of the sampling methods can be found in the National E-cigarette Survey (NECS) 2016 report. Briefly, data were obtained from 1396 individuals who had ever been smokers, i.e., 957 (68.6%) current smokers and 439 (31.4%) ex-smokers. Results: Current EC use was found predominantly among current smokers (8.0%) as compared with ex-smokers (4.3%). Among current smokers, the main reasons given for smoking ECs were wanting to try it (44.7%), followed by intention to quit tobacco smoking (15.8%) and to reduce tobacco smoking (10.5%). Using multiple logistic regression analysis, we found that among current smokers, current EC users were more likely to be younger, i.e., 18-44 years (aOR= 4.83, 95% CI= 1.97-11.86, p=0.001), urban residents (aOR= 1.89, 95% CI= 1.15-3.11, p=0.012), single/ divorced/ widowed (aOR= 2.11, 95% CI= 1.24-3.61, p=0.006) and students (aOR= 2.25, 95% CI= 1.01-5.01, p=0.048). Among exsmokers, only younger respondents (18-44 years old) was reported as being more likely to be current EC users (aOR= 3.81, 95% CI= 1.14-12.76, p=0.030). Conclusion: This study showed that currently using and ever having used ECs were more prevalent among current smokers. The reasons given for initiating EC use among current smokers were mainly wanting to try it, followed by intention to quit and to reduce tobacco smoking. Current EC use appears to be common among current smokers who are younger, urban residents, single/divorced/widowed and students. Therefore, EC cessation intervention strategies and policies should target these high-prevalence groups

Objective: To identify the phytochemical compounds from Annona muricata (A. muricata) and to determine their in vitro anti-proliferative activities against breast cancer cells, MCF7 and MDA-MB-231. Methods: A. muricata leaves were successively extracted by soxhlet method using n-hexane, ethyl acetate and methanol, and decocted with water. Each extract was analysed by gas chromatography mass spectrometry (GCMS) and characterized with Wiley and NIST library searches. Anti-proliferative activity of each extract was evaluated on MCF7 and MDA-MB-231 breast cancer cells using MTT assay. Results: The GCMS analysis of different solvent extracts of A. muricata leaves showed presence of different chemical groups of compounds such as steroids, terpenoids, phenolic compounds, sugars, sugars alcohol and others including vitamin E. Ethyl acetate leaves extract exhibited the lowest IC

A six-month-old baby with congenital patent ductus arteriosus (PDA), bilateral microtia and canal atresia was referred for hearing assessment. The audiology assessment revealed bilateral profound hearing loss, which is atypical for a case of pure canal atresia. Imaging was performed much earlier than usual and, as suspected, the patient also had bilateral severe inner ear anomaly. It is extremely rare for a person to have both external and inner ear anomaly because of the different embryological origin. The only suitable hearing rehabilitation option for this kind of patients is brainstem implant. However, the parents had opted for sign language as a form of communication. KEY WORDS: Microtia; canal atresia; cochleovestibular nerve aplasia; inner ear anomaly
Congenital Microtia

Parents or caregivers of children with learning disabilities have been shown to experience increases in stress and greater negative caregiving consequences than those with typically developing children. The current study sought to assess the perceived stress among Malay caregivers of children with learning disabilities in Kelantan. The Malay version of Perceived Stress Scale 10 items was administered to a sample of 40 caregivers of children with learning disabilities who were registered to five Pusat Pemulihan Dalam Komuniti (PDK) in Kelantan. Higher scores indicate higher levels of stress. The caregivers had mean age of 47.68 (SD = 9.18) years old, of whom 90% were fathers or mothers. Ninety percent of them were married, majority were unemployed or housewives and had secondary school education. The majority of children with learning disabilities were males and half of them were Down Syndrome children. The mean total Perceived Stress Scale score of the caregivers was 16.77 (SD = 5.74). There were no significant associations between total perceived stress score and any of the independent variables. The mean total perceived stress score showed that the perceived stress level was in the category of slightly higher than average and health concern level was high, while the average stress level was between score of 12 to 15. In conclusion, this result indicated that the caregivers had slightly higher levels of stress than the average score, and might increase susceptibility to stress-induced illness.
Stress ; Caregivers

Symptomatic bronchial artery aneurysm warrants urgent intervention. It has a known association with pulmonary infection caused by Staphylococcus aureus. We hereby report an elderly lady with a ruptured left superior bronchial artery mycotic aneurysm. She was in the early stages of treatment for a left lung abscess. She had multiple episodes of haemoptysis following which she underwent a left lower lobectomy. Presentation of lung abscess with a concurrent ruptured mycotic aneurysm warrants early surgical intervention and can be curative as seen in this case.
Staphylococcus aureus

Objective: To investigate some morphological and molecular characteristics of fungal parasites isolated from wild tropical bed bug, Cimex hemipterus. Methods: A series of culture methods were used to obtain fungal isolates from field-collected bed bugs. Characteristics of the isolates such as colony appearance, mycelial texture and pigmentation were studied to explore their morphology. Isolates were also subjected to a PCR-based genotyping test. Results: There were noticeable differences in morphological characteristics among the four isolates. Conidial areas of one isolate were dark green, whereas those of the remaining colonies were olive-green, black or dark brown. Conidia of the dark green isolate were globose, while those of olive-green, black and dark brown isolates were globose to subglobose, globose to spherical and globose to subglobose/finely roughened, respectively. These morphological specificities and the molecular analyses showed that the fungal internal transcribed spacer ribosomal region and β-tubulin gene sequences of the isolates shared clade with Trichoderma and Aspergillus sequences. Conclusions: Overall, the new discovery of common pathogens in agricultural field developed in live bed bugs storage tank may initiate the use of biological agents in later years.

PURPOSE: The level of the implant above the marginal bone and flap design have an effect on the bone resorption during the healing period. The aim of this study is to detect the relationship between the level of the implant at the implant placement and the bone level at the healing period in the mesial and distal side of implants placed with flapless (FL) and full-thickness flap (FT) methods. METHODS: Twenty-two nonsubmerged implants were placed with the FL and FT technique. Periapical radiographs were taken of the patient at implant placement, and at 6 and 12 weeks. By using computer software, bone level measurements were taken from the shoulder of the healing cap to the first bone implant contact in the mesial and distal side of the implant surface. RESULTS: At 6 weeks, the correlation between the crestal bone level at the implant placement and crestal bone level of the FT mesially was significant (Pearson correlation coefficient=0.675, P<0.023). At 12 weeks, in the FT mesially, the correlation was nonsignificant (Spearman correlation coefficient=0.297, P<0.346). At 6 weeks in the FT distally, the correlation was nonsignificant (Pearson correlation coefficient=0.512, P<0.107). At 12 weeks in the FT distally, the correlation was significant (Spearman correlation coefficient=0.730, P<0.011). At 6 weeks in the FL mesially, the correlation was nonsignificant (Spearman correlation coefficient=0.083, P<0.809). At 12 weeks in the FL mesially, the correlation was nonsignificant (Spearman correlation coefficient=0.062, P<0.856). At 6 weeks in the FL distally, the correlation was nonsignificant (Spearman correlation coefficient=0.197, P<0.562). At 12 weeks in the FL distally, the correlation was significant (Pearson correlation coefficient=0.692, P<0.018). CONCLUSIONS: A larger sample size is recommended to verify the conclusions in this preliminary study. The bone level during the healing period in the FT was more positively correlated with the implant level at implant placement than in the FL.
Bone Resorption ; Dental Implantation ; Humans ; Oral Surgical Procedures ; Software