Objective: To determine the degree of knowledge in the usage of pulse oximeter as a home assessment tool among the community in Malaysia. Methods: A cross-sectional survey was conducted in November 2021. The questionnaire assessed the knowledge in using pulse oximeters, user experience and opinions in using pulse oximeter as a home assessment tool during the pandemic. Results: A total of 504 respondents were included in the study, and the mean score in knowledge related to application of pulse oximetry was 73.00%, while the mean score in knowledge related to factors affecting pulse oximetry readings was only 38.51%. A total of 90.5% of the respondents recognised normal pulse rate and 88.5% knew the blood oxygen saturation levels of a healthy adult, while 69.4% recognised the definition of silent hypoxia. In addition, the majority of the respondents agreed that factors such as poor blood circulation (71.2%), excessive movements (69.8%), and hand position (60.7%) affected oximetry readings. However, 61.7%, 81.7%, 77.2% and 76.8% of the respondents could not identify nail polish, skin colour, skin thickness and tattoos as factors that may affect oximetry readings respectively. Conclusions: The respondents showed a satisfactory level of knowledge related to application of pulse oximetry, but a poor level of knowledge related to factors affecting pulse oximetry readings among the community in Malaysia. Continuous efforts in educating the community on the correct use of pulse oximeters are crucial for appropriate home assessment and avoiding unnecessary stress.

Objective: To evaluate antifungal and cytotoxic activities of four underutilised fruit species, i.e. Artocarpus altilis (breadfruit), Cynometra cauliflora (nam-nam), Mangifera pajang (M. pajang) (Bambangan) and Physalis minima (wild gooseberry). Methods: Extracts from the fresh flesh of Artocarpus altilis and Cynometra cauliflora, the flesh and kernel of M. pajang, and the whole fruit of Physalis minima were obtained by sequential extraction using hexane, chloroform, ethyl acetate, ethanol, methanol and distilled water. Each extract was assessed against six species of human fungal pathogens using a colourimetric broth microdilution method. The cytotoxicity was evaluated using African monkey kidney epithelial (Vero) cells. Results: All 30 extracts showed inhibitory activity against Cryptococcus neoformans. However, none of the extracts were active against Aspergillus fumigatus. The ethanol, methanol and water extracts from the kernel of M. pajang fruit showed the strongest activity against three species of Candida and Trichophyton interdigitale, with a minimum inhibitory concentration range of 0.001 - 0.630 mg/mL. The corresponding mean 50% cytotoxic concentrations for these three extracts were 358.7, 158.4 and 261.3 μg/mL, respectively against Vero cells. In contrast, the flesh of M. pajang fruit (hexane, chloroform and ethyl acetate extracts) showed statistically significant (P<0.001; ANOVA) strong toxicity against the cells, with 30.6, 13.5 and 22.2 μg/mL of mean values of 50% cytotoxic concentrations, respectively. Conclusions: The results suggest that the bioactivity of the kernel of M. pajang fruit is more selective towards fungi and thus is a potential source of new antifungal agents.

INTRODUCTIONThis study aims to evaluate the outcome and safety of the deep inferior epigastric perforator (DIEP) flap for breast reconstruction in a group of Southeast Asian women treated in our unit and to identify risk factors for breast reconstruction using the DIEP flap in this population.

MATERIALS AND METHODSThis is a prospective study on 50 consecutive DIEP flap breast reconstructions by a single surgeon in an academic institution between July 1999 and July 2006. Data on patient demographics, diagnosis, procedure type, adjuvant and neoadjuvant treatments, risk factors and complications were prospectively collected and registered in a clinical database. Outcome variables include total flap loss, partial flap loss, fat necrosis and minor complications related to the donor site or flap. Known risk factors are analysed to determine if they affect outcome in terms of complication rate in this group of patients.

RESULTSTotal flap loss, partial flap loss and fat necrosis complication rates were 6%, 4% and 10%, respectively. Flap complication rates were comparable to those quoted by previous studies done worldwide. Obesity (BMI >27) is a statistically significant factor associated with development of DIEP flap complications in our population.

CONCLUSIONBreast reconstruction with DIEP flap is a safe and reliable method when used in Southeast Asian women, offering optimal results with less donor -site morbidity. Obesity increases the incidence of flap complication in this group of patients.

Abdomen ; surgery ; Adult ; Asian Continental Ancestry Group ; Breast ; surgery ; Databases, Factual ; Female ; Humans ; Mammaplasty ; adverse effects ; methods ; Microsurgery ; Middle Aged ; Multivariate Analysis ; Obesity ; Postoperative Complications ; Prospective Studies ; Rectus Abdominis ; surgery ; Risk Factors ; Surgical Flaps ; adverse effects ; Treatment Outcome ; Young Adult