Introduction: The ability to proliferate progressively is a crucial characteristic of cancer cells. A number of natural products including prophetic food were demonstrated to have an anti-proliferative effect on cancer cells. Trigona honey has received much attention for its anti-microbial and anti-oxidant properties. The anti-proliferative effect of this honey on cancer cells however, is yet to be discovered. Objective: The aim of this study is to investigate the anti-proliferative effect of Trigona honey on MCF-7 cells. Materials & Methods: MCF-7 cells were cultured in basal medium DMEM-F12, containing 10% fetal bovine serum, 1% antibiotic antimycotic and 1% glutamax. Upon 80% confluence in 96 well plate, used media were replaced with basal media enriched with different concentrations (v/v) of Trigona itama honey; 0, 0.049, 0.195, 0.78, 3.125, 12.5 and 25. Proliferation of MCF-7 cells after 24 and 72 hours were measured by WST assay. Higher absorbance reading denotes higher proliferation rate. Results: MCF-7 cells treated with Trigona honey-enriched media showed consistent reduction in cell proliferation after 24 and 72 hours. Discussion & Conclusion: These preliminary findings show a promising effect of Trigona honey as an anti-cancer agent through its anti-proliferative effect.

Introduction: Triploidy is one of the commonest chromosomal aberrations in first trimester spontaneous miscarriages. We describe a case of Triploidy Syndrome diagnosed in the second trimester. Case report: A 32-year-old lady in her second pregnancy at 15 weeks gestation was noted to have oligohydramnios and a fetus that was small for gestational age. Detailed ultrasound showed a male fetus with several abnormalities which include micrognathia, frontal bossing, bilateral mild ventriculomegaly, clawed hands, bilateral talipes, constricted chest, small stomach and a small bladder. At 19 weeks an intrauterine death was confirmed. At autopsy the fetus was macerated and the parameters corresponded to a 16-week-old gestation. Additional features noted were hypertelorism, microphthalmia, malformed low set ears, small mouth, short nasion and micropenis. The limbs abnormalities include bilateral syndactyly of third and fourth fingers, syndactyly of third and fourth digits of right foot, rocker bottom feet and bilateral talipes equinovarus. There was hypoplasia of the right lower limb with thinning at the middle anterior part of the thigh. On internal examination there were hypoplastic alobar lungs, stenosed ductus arteriosus, pulmonary trunk hypoplasia and adrenal hypoplasia. The placenta showed no evidence of hydatidiform mole. Fetal DNA analysis following amniocentesis revealed a Triploidy Syndrome containing XXY chromosome. Discussion & conclusion: Triplody can be classified into diandric or digynic types. The former reflects extra haploid set of chromosomes of paternal origin and associated with partial hydatidiform mole. The digynic type represents extra haploid set of maternal origin and is more likely to live into second trimester which was demonstrated in our case.

Introduction: Chronic histiocytic intervillositis (CHI) is a rare placental lesion strongly associated with recurrent miscarriages and fetal losses. It requires histopathological diagnosis and can only be made after delivery of the products of conception (POC). We describe a case of CHI in a 41-yearold lady with a 16-year history of thirteen recurrent consecutive first trimester miscarriages. Case report: The patient is a 41-year-old lady who suffered first trimester miscarriages in all her thirteen pregnancies. The relevant clinical investigations revealed neither significant nor helpful findings in determining the cause of recurrent miscarriages. Histological findings in each except one of the submitted conceptual tissue showed similar features of histiocytic aggregates primarily within the intervillous spaces, a characteristic description of CHI. One of the samples showed degenerative changes. Discussion: Practicing pathologists are not familiar with the histological features of CHI and this may be a potential pitfall in routine examination of POCs. Recognising this entity allows for accurate diagnosis and hence better management. The aetiology remains unclear, although an immunopathological basis are being explored.

Children daycare centres have nowadays become a necessity due to the guardians’ job constraint in this modern globalization era. Increasing demand of daycare centres showed ramiϑication on unintentional injuries at the childcare settings. The incidence is becoming more common and this may lead to a lawsuit for negligence. Failure to provide proper ϑirst aid response is one of the issues faced by the caregivers. To the best of our knowledge, this is the ϑirst study investigating the effects of ϑirst aid training and certiϑication on knowledge, attitude and conϑidence (KAC) among childcare providers in Negeri Sembilan, Malaysia. A self-administered questionnaire was given to 54 Negeri Sembilan childcare providers before and after they received a comprehensive module on the ϑirst aid training. The training comprised of three major components; basic life support, trauma injuries and non-trauma injuries. Throughout the training, participants were given a series of lectures, hands-on practicals and small group discussion on speciϑied topics from the module. Overall results showed a signiϑicant increase in knowledge, attitude and conϑidence (p<0.001) after the respondents’ had received the FAT4CP© training. The ϑirst aid training provided to the childcare providers was found effective and had successfully improved their knowledge by 12.5% and their conϑidence to perform ϑirst aid increased by 20.0%. They are now more prepared and efϑicient at handling any emergency situations at childcare centres. Our results suggested that FAT4CP© training programme was able to increase knowledge, attitude and conϑidence of childcare providers in Negeri Sembilan to handle emergency cases. Therefore, the programme is suggested to be implemented at all childcare centres in order to improve and sustain the providers’ abilities in handling emergency situations.

Introduction: Maternal Floor Infarction (MFI) is an uncommon pathological entity characterised by the presence of massive and diffuse perivillous fibrinoid material in the maternal surface of the placenta. It was first described in the 1960s. MFI has clear associations with intrauterine fetal demise, IUGR and recurrent pregnancy losses. We would like to share two cases of MFI, which had similar clinical presentations. Case reports: Case 1: A 31-year-old lady who is in her sixth pregnancy and at 32 weeks of gestation. She has a history of three intrauterine fetal deaths and two live births. Her recent pregnancy was complicated with IUGR, oligohydramnious and absence of end diastolic flow on Doppler. Case 2: A 34-year-old lady who is in her third pregnancy and at 35 weeks of gestation. Similarly she had IUGR and oligohydramnios. In both cases, the babies were delivered alive by caesarean sections. Tissue examination of both placentas showed extensive fibrin deposition on the decidual floor, extending up into the intervillous spaces with encasement of the villi amounting to MFI. Discussion and Conclusion: Although MFI is uncommon, it has significant perinatal morbidity and mortality with the risk of recurrence. In general, practicing pathologists are unfamiliar with MFI which is macroscopically and microscopically different from ischaemic infarcts. The etiology of MFI is unknown, but evidence support an alloimmune or autoimmune mechanism. Awareness of this old entity and recognizing them on placenta tissue sections would aid in management of future pregnancies and in the adequate follow up of the surviving infants

Intrauterine infection has emerged to be the main and frequent cause of premature delivery and foetal demise. Microorganisms gain entry into the amniotic cavity via ascending route, haematogenous dissemination, retrograde seeding from peritoneal cavity and accidental introduction during invasive procedures. This is a case of foetal loss in utero from a twin pregnancy due to intrauterine sepsis diagnosed through placenta examination. Both maternal and foetal evidences of inflammatory response were demonstrated in the placenta on histology. Microscopically, there were acute chorioamnionitis and villitis as well as abundant gram positive cocci in the foetal blood within placental villous capillaries. The presence of intravascular bacterial organism provides evidence for a conclusive diagnosis of intrauterine sepsis, particularly where the placenta or foetal blood microbiological cultures results are not available or equivocal. More attention should therefore be given when sampling, as pathological evidences of underlying foetal compromise or death could be provided by well-represented placental tissue samples.

Introduction: Placental teratoma is an extremely rare benign non trophoblastic tumor of the placenta. It consists of various mature tissues derived from germ cell layers. We report a case of placental teratoma which was an unexpected finding during a normal per vagina delivery. Case report: The patient was a 35-year-old lady at full term gestation presented to the hospital with signs of labour. She had spontaneous vaginal delivery and her baby was well. However, following the delivery of the placenta she passed out an oval mass measuring approximately 7.5 cm in largest diameter with skin-like appearance of the outer surface. The cut surface of the mass appeared heterogenous with solid and cystic areas. On histology the cystic areas were lined by skin with an underlying adnexal tissue. The components of the solid areas were bony, cartilagenous and adipose tissues as well as brain, blood vessels and glands. No immature component was noted. The placenta tissue was unremarkable. Discussion and conclusion: The differential diagnosis is fetus acardius amorphus which is due to blighted fetus or failed twin associated with multiple pregnancy. On the contrary, placental teratoma is almost always associated with a normal pregnancy outcome and fetal development. Whether it is a true neoplasm or an extreme form of fetus acardius, the issue of origin remains unsolved. Obstetricians and pathologists should be made aware of this entity. In understanding the molecular insights of their histogenesis, further studies are required