An Unusual Presentation of Neurotized Congenital Giant Melanocytic Nevus and Type 1 Neurofibromatosis: A Diagnostic Challenge

@#Among the three subtypes of neurofibromatosis are type 1 and 2 neurofibromatosis and schwannomatosis, von Recklinghausen disease also known as type 1 neurofibromatosis has an autosomal dominant inheritance. It is the commonest form as and presents with numerous café-au-lait macules and neurofibromas. Giant congenital melanocytic nevus (CGMN) on the other hand is characterized by a melanocytic proliferation that present at birth. CGMN develops due to a defective embryonic pigment cell (melanocyte) precursors development and are often present at birth. Giant congenital melanocytic nevus (CGMN) and type 1 neurofibromatosis may occur together rarely. Clinicians should be aware of the rare presentation of both CGMN and type 1 neurofibromatosis in a patient.

Knowledge, attitude, practice and perception on sunscreen and skin cancer among doctors and pharmacists

@#Introduction: Excessive ultraviolet light (UV) can cause premature skin aging and potentially skin cancer. Currently there is a lack of awareness among health care professionals and the public on sun protection. The objectives of this study were to determine knowledge on sunscreen and skin cancer among health care professionals, to evaluate the knowledge, attitude, practice and perception of doctors and pharmacists toward the usage of sunscreen as protection against UV radiation. Materials And Methods: This is a cross-sectional study conducted among doctors and pharmacists in Hospital Sultanah Nora Ismail, Batu Pahat, Johor, Malaysia. Questionnaires were used in this study. Results: A total of 384 participants completed the questionnaires. The participants consisted of 323 doctors (84.1%) and 61 pharmacists (15.9%). The age group of the participants ranged between 25 till 55 years old. Ninety doctors (27.9%) and thirty-one pharmacists (51.0%) reported used sunscreen daily (p<0.001). This finding showed that there was a deficit in the practice of sun protection. Pharmacists scored a higher knowledge score of median 12 (IQR=3.0) while the doctors scored 11 (IQR=2.0). This study showed a significant association between ethnicity and skin cancer knowledge (p<0.05). Conclusion: This study demonstrated a lack of knowledge of sunscreen and skin cancer prevention among health care practitioners. This finding supports better medical education program on this topic.

Characteristics of Sexually Transmitted Infections in Genito-Urinary Medicine Clinic, Sarawak General Hospital between 2018 and 2020

Background@#Sexually transmitted infections (STIs) are common worldwide. This study aims to determine the patterns of STIs among attendees in the Genito-Urinary Medicine (GUM) clinic of Sarawak General Hospital (SGH).@*Methods@#This is a retrospective study. Medical records of new cases referred to GUM clinic, SGH between the year 2018 and 2020 were reviewed. Demography data, diagnosis, and clinical characteristics of STIs were reviewed and analysed using SPSS software.@*Results@#There was a total of 225 patients with newly diagnosed STIs. Their mean age was 30.9 years old. There were 124 (55.1%) males and 101 (44.9%) females. Nearly half (46.7%) of the patients were Malay, followed by Sarawak indigenous groups (33.3%), and Chinese (18.7%). Most patients (n=119, 52.9%) were single at the time of diagnosis. Three quarters (73.3%) of the patients were heterosexual, while 47 (20.9%) patients were homosexual or bisexual, and missing data in the remaining 5.8%. Anogenital wart was the commonest STI (49.8%), followed by syphilis (n=91, 40.4%), genital herpes (n=24,10.7%) and gonorrhoea (n= 15, 6.7%). The commonest symptoms were genital growth (n= 107, 47.6%), followed by pelvic discharge (n=22, 9.8%).@*Conclusion@#The most common STIs in our study are anogenital warts, syphilis, genital herpes and gonorrhea. Effective national sexuality education in Malaysia is paramount in reducing premarital sex and STIs. Human Papillomavirus (HPV) vaccines are effective to reduce genital warts and HPV related malignancies.

Dilemma in the management of methanol poisoning at a district hospital in Malaysia

@#There are increasing reports of methanol poisoning (MP) incidence worldwide. In Malaysia, the largest first methanol poisoning was reported in Selangor in 2013 with a total of 41 patients and cluster of cases been reported from the country since then. Often MP involved adulterated alcohol containing more than the legal permissible concentration of methanol. Methanol is rapidly absorbed and metabolised into formic acid which causes variable symptoms of the central nervous system such as blindness, seizure, coma and gastrointestinal disturbances. Mortality could reach up to 83% as reported using the coma state, pH and pCO2 level in the worst-case scenario.