The bleeding umbilicus: An uncommon presentation of endometriosis.

Dysmenorrhea is a common presentation in women of reproductive age in primary care. It can negatively affect the quality of life of a woman and restrict her daily activities. Endometriosis is the most common diagnosis for secondary dysmenorrhea. However, cutaneous endometriosis is an uncommon presentation of endometriosis. It requires a thorough history, physical examination and histological findings for definitive diagnosis. This paper reports an interesting case of a 47- year-old woman with primary cutaneous umbilical endometriosis and its management. Her final diagnosis was primary umbilical endometriosis with Stage 3 endometriosis based on the patient's history, clinical and surgical findings. The patient was discharged well on day three of operation and has been well since then with no signs of recurrence.

It is tuberculosis or melioidosis? A clinical diagnostic dilemma.

Pulmonary Tuberculosis (PTB) is an endemic disease in Malaysia and continues to cause great morbidity and mortality. However, the diagnosis and treatment may pose a challenge to the attending physician since other diseases such as melioidosis can mimic tuberculosis. Hence, the final diagnosis should be done thorough history of illness, physical examination, investigations, and interpretation of findings. We present here a case of a 27-year-old man who presented at our primary care clinic with underlying diabetes mellitus whose symptoms were suggestive of PTB, and who was treated with anti-tuberculosis but later his sputum grew culture Burkholderia pseudomallei.

Three case reports of infants with ankyloglossia affecting breastfeeding.

Ankyloglossia is a congenital anomaly which may reduce or restrict the tongue tip mobility. The restricted mobility is caused by an unusual short, thick lingual frenum. This condition may cause various problems in infants including breastfeeding in the new-borns. This case report describes 3 cases of ankyloglossia affecting breastfeeding and highlights the experiences of the mothers and their difficulties in breastfeeding babies with it. Comprehensive feeding examination was accomplished, the primary cause of feeding issues was identified, and frenotomy intervention was provided. Post frenotomy, infants were able to breastfeed easily and this was beneficial in continuation of breastfeeding and pain reduction in mothers.

Agreement between body weight perception and body weight status among late adolescents in Kuantan, Malaysia.

OBJECTIVES: Body weight perception may determine the practice of proper weight management. The objective of this study was to measure the agreement between body weight perception and actual body weight status and its associated factors among late adolescents in Kuantan, Malaysia. METHODS: A cross-sectional study was conducted from April to October 2018 among 479 adolescents aged 17-19 years old from seven institutions of higher learning in Kuantan. Body weight status was described as body mass index (BMI). Weight and height were measured, and BMI was calculated. Validated, self-administered Figure Rating Scale (FRS) questionnaires were used. Agreement between BMI and body weight perception was calculated using Kappa statistics. Logistic regression was employed to examine the association between body weight perception and sociodemographic variables. RESULTS: More than one-third (35.3%) of the respondents misjudged their own body weight. More than one third of the respondents (38.7%) who were underweight, misperceived themselves as having normal weight whilst 31.7% of obese respondents identified themselves as overweight. The agreement between body weight perception and body mass index was moderate (k0.46, p<0.01). CONCLUSION: Body weight perception was in moderate agreement with actual weight in late adolescents. Accurate body weight perception is an important factor in late adolescent's weight management behaviour. Hence, health education related to body weight management should be emphasized among this age group.

An infant with kwashiorkor: The forgotten disease.

Undernutrition remains a major public health concern, especially in developing countries. Despite being rich in resources, Malaysia is still home to children suffering from severe undernutrition. This paper presents the case of a 5-month-old boy with kwashiorkor stemming from improper weaning which was overlooked. This case highlights the importance of recognizing the early signs of kwashiorkor to allow for early referrals for proper management and prevent its possible complications.