Background: In Malaysia, occupational allergic contact dermatitis (ACD) is often under-reported. This case report describes a chemical engineer who developed possible ACD, likely due to workplace allergen exposure.Case presentation: He presented with a 4-month history of intensely itchy rashes on both hands, which improved during work breaks. A dermatological examination revealed lichenified, pruritic papules with well-defined borders on the palmar surfaces of both hands. A skin patch test identified reactions to five allergens, including ‘fragrance mix,’ ‘methyldibromo glutaronitrile,’ ‘clioquinol,’ ‘epoxy resin,’ and ‘textile dye mix.’ However, among these, only ‘bisphenol A diglycidyl ether,’ a component of ‘epoxy resin,’ was listed in the safety data sheet as a confirmed occupational exposure. In accordance with local regulations, this case was reported as ‘occupational dermatitis’ to the Department of Occupational Safety and Health. The patient was prescribed symptomatic topical treatments, including emollients and topical corticosteroids. Additionally, he was advised to switch to hypoallergenic products. On follow-up, his chronic inflammatory skin lesions showed improvement. Conclusions Thorough occupational history-taking and patch testing are essential for diagnosing ACD. Personalized health education and regular follow-ups, is crucial in monitoring lesion resolution and evaluating the effectiveness of preventive measures in workplace settings.

Background: In Malaysia, occupational allergic contact dermatitis (ACD) is often under-reported. This case report describes a chemical engineer who developed possible ACD, likely due to workplace allergen exposure.Case presentation: He presented with a 4-month history of intensely itchy rashes on both hands, which improved during work breaks. A dermatological examination revealed lichenified, pruritic papules with well-defined borders on the palmar surfaces of both hands. A skin patch test identified reactions to five allergens, including ‘fragrance mix,’ ‘methyldibromo glutaronitrile,’ ‘clioquinol,’ ‘epoxy resin,’ and ‘textile dye mix.’ However, among these, only ‘bisphenol A diglycidyl ether,’ a component of ‘epoxy resin,’ was listed in the safety data sheet as a confirmed occupational exposure. In accordance with local regulations, this case was reported as ‘occupational dermatitis’ to the Department of Occupational Safety and Health. The patient was prescribed symptomatic topical treatments, including emollients and topical corticosteroids. Additionally, he was advised to switch to hypoallergenic products. On follow-up, his chronic inflammatory skin lesions showed improvement. Conclusions Thorough occupational history-taking and patch testing are essential for diagnosing ACD. Personalized health education and regular follow-ups, is crucial in monitoring lesion resolution and evaluating the effectiveness of preventive measures in workplace settings.

Background: In Malaysia, occupational allergic contact dermatitis (ACD) is often under-reported. This case report describes a chemical engineer who developed possible ACD, likely due to workplace allergen exposure.Case presentation: He presented with a 4-month history of intensely itchy rashes on both hands, which improved during work breaks. A dermatological examination revealed lichenified, pruritic papules with well-defined borders on the palmar surfaces of both hands. A skin patch test identified reactions to five allergens, including ‘fragrance mix,’ ‘methyldibromo glutaronitrile,’ ‘clioquinol,’ ‘epoxy resin,’ and ‘textile dye mix.’ However, among these, only ‘bisphenol A diglycidyl ether,’ a component of ‘epoxy resin,’ was listed in the safety data sheet as a confirmed occupational exposure. In accordance with local regulations, this case was reported as ‘occupational dermatitis’ to the Department of Occupational Safety and Health. The patient was prescribed symptomatic topical treatments, including emollients and topical corticosteroids. Additionally, he was advised to switch to hypoallergenic products. On follow-up, his chronic inflammatory skin lesions showed improvement. Conclusions Thorough occupational history-taking and patch testing are essential for diagnosing ACD. Personalized health education and regular follow-ups, is crucial in monitoring lesion resolution and evaluating the effectiveness of preventive measures in workplace settings.

In light of the increasing use of online learning platforms in medical education, there is a critical need to assess the current state of online learning environments. Despite the global emphasis on digital education, limited studies have systematically explored how medical students perceive the effectiveness and quality of these environments, particularly in Pakistan. This study aims to fill this gap by evaluating medical students’ experiences with their institution’s online learning environments and identifying key strengths and challenges that impact learning outcomes. A mixed-method, sequential exploratory design was used, starting with a quantitative assessment followed by qualitative inquiry. Data from 253 medical students were collected via a survey, and 30 focus group interviews were conducted to provide deeper insights into the challenges students face in navigating the online learning environment. The findings revealed critical areas in need of improvement, including digital infrastructure, student engagement, and the accessibility of online resources. Qualitative data highlighted the need for more interactive and student-centred approaches to online education. By focusing on the status of online learning in medical education, this research provides valuable insights for educators and policymakers aiming to enhance the quality of digital learning environments. The study contributes to ongoing efforts to develop more effective, engaging, and responsive online learning strategies for medical students in Pakistan.
Education, Distance ; Education, Medical, Undergraduate ; Perception

A young gentleman presented with a closed fracture of the left radius and an open fracture of the left ulna complicated with segmental loss of the ulnar nerve measuring 1.5cm. After thorough debridement and stabilization of the bone injuries, the ulnar nerve gap was bridged with an autologous venous graft harvested off a tributary of the basilic vein that served as a nerve conduit. At 18 months post-surgery, sensori-motor function of the patient’s left ulnar nerve was nearly fully restored, indicative of successful reconstitution of the ulnar nerve using a basilic vein tributary vein graft.

Introduction: Social media has become a ubiquitous part of daily life. However, little is known about the influence of food-related social media content (FRSMC) on the eating habits of Malaysian undergraduates. This study explored FRSMC usage of undergraduates enrolled in a non-health program, its influence on eating habits, and how such social media content influences dietary behaviours. Method: This qualitative semi-structured interview study involved chemical engineering (CE) undergraduates at a university in Penang, Malaysia. The study was carried out from April 2021 to March 2022 during which ten participants were purposively selected. Based on precedent qualitative research sampling rule of thumb, this sample size of ten participants provided sufficient data saturation for an initial exploratory study. The interview sessions were recorded, transcribed, and thematically analyzed. Results: According to study findings, in terms of usage, food advertising and promotions; cooking tutorials and food and nutrition information are the most appealing types of FRSMC. With regards to eating habits, FRSMC can lead to healthy and unhealthy food choices. The study identified several perceived challenges, namely unrealistic and untrustworthy content, difficult and repetitive content, and algorithm-driven deviations from healthy diets. The effectiveness of FRSMC can be enhanced by creating trustworthy and engaging content. Conclusion: The study highlights that social media engagement can have both positive and negative impact on food choices among undergraduates. Some FRSMC are perceived to encourage and motivate undergraduates to adopt healthier dietary habits. Future research could involve a larger sample, representative of diverse socio-demographic groups in Malaysia.

Background: Coronavirus disease (COVID-19) induces inflammation, coagulopathy following platelet and monocyte activation, and fibrinolysis, resulting in elevated D-dimer levels.Activated platelets and monocytes produce microvesicles (MVs). We analyzed the differences in platelet and monocyte MV counts in mild, moderate, and severe COVID-19, as well as their correlation with D-dimer levels. Methods: In this cross-sectional study, blood specimens were collected from 90 COVID-19 patients and analyzed for D-dimers using SYSMEX CS-2500. Platelet MVs (PMVs; PMVCD42b+ and PMVCD41a+ ), monocyte MVs (MMVs; MMVCD14+ ), and phosphatidylserinebinding annexin V (PS, AnnV+ ) were analyzed using a BD FACSCalibur instrument. Results: PMV and MMV counts were significantly increased in COVID-19 patients. AnnV+ PMVCD42b+ and AnnV+ PMVCD41a+ cell counts were higher in patients with severe COVID-19 than in those with moderate clinical symptoms. The median (range) of AnnV+ PMVCD42b+ (MV/µL) in mild, moderate, and severe COVID-19 was 1,118.3 (328.1–1,910.5), 937.4 (311.4–2,909.5), and 1,298.8 (458.2–9,703.5), respectively (P = 0.009). The median (range) for AnnV+ PMVCD41a+ (MV/µL) in mild, moderate, and severe disease was 885.5 (346.3–1,682.7), 663.5 (233.8–2,081.5), and 1,146.3 (333.3–10,296.6), respectively (P = 0.007). D-dimer levels (ng/mL) weak correlated with AnnV+ PMVCD41a+(P = 0.047, r = 0.258). Conclusions PMV PMVCD42b+ and PMVCD41a+ counts were significantly increased in patients with severe clinical symptoms, and PMVCD41a+ counts correlated with D-dimer levels. Therefore, MV counts can be used as a potential biomarker of COVID-19 severity.

Background: Coronavirus disease (COVID-19) induces inflammation, coagulopathy following platelet and monocyte activation, and fibrinolysis, resulting in elevated D-dimer levels.Activated platelets and monocytes produce microvesicles (MVs). We analyzed the differences in platelet and monocyte MV counts in mild, moderate, and severe COVID-19, as well as their correlation with D-dimer levels. Methods: In this cross-sectional study, blood specimens were collected from 90 COVID-19 patients and analyzed for D-dimers using SYSMEX CS-2500. Platelet MVs (PMVs; PMVCD42b+ and PMVCD41a+ ), monocyte MVs (MMVs; MMVCD14+ ), and phosphatidylserinebinding annexin V (PS, AnnV+ ) were analyzed using a BD FACSCalibur instrument. Results: PMV and MMV counts were significantly increased in COVID-19 patients. AnnV+ PMVCD42b+ and AnnV+ PMVCD41a+ cell counts were higher in patients with severe COVID-19 than in those with moderate clinical symptoms. The median (range) of AnnV+ PMVCD42b+ (MV/µL) in mild, moderate, and severe COVID-19 was 1,118.3 (328.1–1,910.5), 937.4 (311.4–2,909.5), and 1,298.8 (458.2–9,703.5), respectively (P = 0.009). The median (range) for AnnV+ PMVCD41a+ (MV/µL) in mild, moderate, and severe disease was 885.5 (346.3–1,682.7), 663.5 (233.8–2,081.5), and 1,146.3 (333.3–10,296.6), respectively (P = 0.007). D-dimer levels (ng/mL) weak correlated with AnnV+ PMVCD41a+(P = 0.047, r = 0.258). Conclusions PMV PMVCD42b+ and PMVCD41a+ counts were significantly increased in patients with severe clinical symptoms, and PMVCD41a+ counts correlated with D-dimer levels. Therefore, MV counts can be used as a potential biomarker of COVID-19 severity.

Background: Coronavirus disease (COVID-19) induces inflammation, coagulopathy following platelet and monocyte activation, and fibrinolysis, resulting in elevated D-dimer levels.Activated platelets and monocytes produce microvesicles (MVs). We analyzed the differences in platelet and monocyte MV counts in mild, moderate, and severe COVID-19, as well as their correlation with D-dimer levels. Methods: In this cross-sectional study, blood specimens were collected from 90 COVID-19 patients and analyzed for D-dimers using SYSMEX CS-2500. Platelet MVs (PMVs; PMVCD42b+ and PMVCD41a+ ), monocyte MVs (MMVs; MMVCD14+ ), and phosphatidylserinebinding annexin V (PS, AnnV+ ) were analyzed using a BD FACSCalibur instrument. Results: PMV and MMV counts were significantly increased in COVID-19 patients. AnnV+ PMVCD42b+ and AnnV+ PMVCD41a+ cell counts were higher in patients with severe COVID-19 than in those with moderate clinical symptoms. The median (range) of AnnV+ PMVCD42b+ (MV/µL) in mild, moderate, and severe COVID-19 was 1,118.3 (328.1–1,910.5), 937.4 (311.4–2,909.5), and 1,298.8 (458.2–9,703.5), respectively (P = 0.009). The median (range) for AnnV+ PMVCD41a+ (MV/µL) in mild, moderate, and severe disease was 885.5 (346.3–1,682.7), 663.5 (233.8–2,081.5), and 1,146.3 (333.3–10,296.6), respectively (P = 0.007). D-dimer levels (ng/mL) weak correlated with AnnV+ PMVCD41a+(P = 0.047, r = 0.258). Conclusions PMV PMVCD42b+ and PMVCD41a+ counts were significantly increased in patients with severe clinical symptoms, and PMVCD41a+ counts correlated with D-dimer levels. Therefore, MV counts can be used as a potential biomarker of COVID-19 severity.

Background: Coronavirus disease (COVID-19) induces inflammation, coagulopathy following platelet and monocyte activation, and fibrinolysis, resulting in elevated D-dimer levels.Activated platelets and monocytes produce microvesicles (MVs). We analyzed the differences in platelet and monocyte MV counts in mild, moderate, and severe COVID-19, as well as their correlation with D-dimer levels. Methods: In this cross-sectional study, blood specimens were collected from 90 COVID-19 patients and analyzed for D-dimers using SYSMEX CS-2500. Platelet MVs (PMVs; PMVCD42b+ and PMVCD41a+ ), monocyte MVs (MMVs; MMVCD14+ ), and phosphatidylserinebinding annexin V (PS, AnnV+ ) were analyzed using a BD FACSCalibur instrument. Results: PMV and MMV counts were significantly increased in COVID-19 patients. AnnV+ PMVCD42b+ and AnnV+ PMVCD41a+ cell counts were higher in patients with severe COVID-19 than in those with moderate clinical symptoms. The median (range) of AnnV+ PMVCD42b+ (MV/µL) in mild, moderate, and severe COVID-19 was 1,118.3 (328.1–1,910.5), 937.4 (311.4–2,909.5), and 1,298.8 (458.2–9,703.5), respectively (P = 0.009). The median (range) for AnnV+ PMVCD41a+ (MV/µL) in mild, moderate, and severe disease was 885.5 (346.3–1,682.7), 663.5 (233.8–2,081.5), and 1,146.3 (333.3–10,296.6), respectively (P = 0.007). D-dimer levels (ng/mL) weak correlated with AnnV+ PMVCD41a+(P = 0.047, r = 0.258). Conclusions PMV PMVCD42b+ and PMVCD41a+ counts were significantly increased in patients with severe clinical symptoms, and PMVCD41a+ counts correlated with D-dimer levels. Therefore, MV counts can be used as a potential biomarker of COVID-19 severity.