Background: Leptospirosis cases are typically rodent-sourced. Domestic animals like cattle and dogs are also known to be carriers of Leptospira but are rarely implicated in human cases. Case Presentation: In this case, a parasitology researcher who dissected dogs presented with atypical leptospirosis which had high possibility to be canine-sourced. Conclusion: Leptospirosis must be suspected in febrile patients with canine bodily fluid exposure.

Introduction: Tropical herbs are used as a medicine long before the introduction of modern medicine, especially by traditional healers. However, its’ scientific benefits are not widely investigated. There is a belief that the use of traditional herbs potentially causing health deterioration due to its unknown mechanism of actions and interactions, and the nature of its unregulated processing as a health supplement. Parkia speciosa (local: petai) and Pithecellobium jiringa (local: jering) are two tropical herbs from the Leguminosae family that are widely used raw as salads with many perceived health benefits and harms. We reviewed both species, looking into scientific pieces of evidence supporting the belief. Methods: The databases of MEDLINE, PubMed, EBSCOhost, and Google Scholars were systematically searched for both in vitro and in vivo effects of both species with no language restriction. Data were extracted using standardised fashioned. Results: P speciosa has pharmacological properties including antioxidant and anti-inflammation. It has shown to have antibacterial properties and glucose-lowering activity. P jiringa contains known antioxidant metabolites such as flavonoids, phenolics and terpenoids. It also contains antiangiogenic properties with potential use in retinopathy, cancer, and Rheumatoid arthritis. However, both herbs have potentially harmful effects which include liver injuries. Large consumption of P jiringa leads to acute kidney injury. Conclusion: Consumption of both P speciosa and P jiringa has medicinal properties as well as health harm. If taken as a supplement, rigorous clinical trials are needed to delineate benefit vs harm effect of both herbs.

Malaysia is categorized as an intermediate tuberculosis (TB) burden country by World Health Organisation. This cause great challenge as an occupational hazard for healthcare providers (HCPs) in Malaysia, as they received two- to three-fold greater risk of contracting TB than the general population. This cross-sectional questionnaire study aimed to assess HCPs' knowledge, attitude, practice, and stigma (KAPS) towards TB in Hospital Sultan Haji Ahmad Shah, Temerloh. A pilot-tested questionnaire was designed based on the WHO recommendation for KAPS study in TB. A survey was carried out between September 2018 and February 2019. Data were analyzed using SPSS version 25.The majority of respondents have moderate knowledge (75%) and practice (93%) on tuberculosis whilst scored lower on attitude (49%). Average self-perceived stigma was observed (67%) with higher sympathy (73%). Overall knowledge and practice on tuberculosis among HCPs in HOSHAS was good with some misconceptions about disease transmission. However, more works needed to improve the attitude and stigma towards TB, as it may affect health services delivery towards TB patients.

Staphylococcus aureus is part of the normal human flora that can commonly be found on the skin and mucous membranes of the nasal area. However, in immunosuppressed patients such as those with kidney failures, colonization can potentially lead to infection. There is a concern of increasing antibiotic resistance in S. aureus. This study aimed to determine the prevalence of S. aureus nasal colonization and its antimicrobial susceptibility among haemodialysis-dependent populations. Methods: A cross-sectional study at the Nephrology Unit, Hospital Canselori Tuanku Mukhriz (HCTM) was conducted among haemodialysis-dependent patients between February 2017 to February 2018. Nasal swabs were obtained and cultured on mannitol salt agar. S. aureus isolates were identified by gram staining, tube coagulase and Deoxyribonuclease (DNase). Cefoxitin disc (30 µg) were used to identified the presence of MRSA (methicillin-resistance S. aureus). The S. aureus colonies were further tested against six antibiotics using Kirby Bauer disc diffusion. Result: A total of 134 patients were recruited. S. aureus isolates were detected from 27 patients (20.1%). All S. aureus were phenotypically identified as methicillin-sensitive S. aureus (MSSA) based on the cefoxitin disc. Teicoplanin and linezolid were the most effective with 100% susceptibility. S. aureus exhibited a high resistance rate towards erythromycin (29.6%). No MRSA was isolated in this study. Conclusion: This study highlighted the high prevalence of S. aureus nasal colonization in haemodialysis patients. Teicoplanin and linezolid were found to be the most effective antibiotics against isolated S. aureus.

Introduction: Neuromodulation devices have emerged as an alternative treatment for drug-resistant epilepsy syndrome, especially for temporal lobe epilepsy (TLE). Transcranial direct current stimulation (tDCS) is one of neuromodulation techniques that shown promising results in refractory epilepsy. We aim to evaluate clinical efficacy of tDCS used in refractory TLE in clinical trial setting. Methods: Six-stages Arksey and O'Malley's methodology framework were used to guide this scoping review. PubMed, SCOPUS, and Cochrane Library were searched for clinical trials involving tDCS in refractory TLE. We also examined the tDCS protocol used, clinical efficacy and its side effects. Results: Five studies met the inclusion criteria. Three studies were randomized crossover studies, and the other two were randomized placebo-controlled double-blind study and pilot randomized control trial. A total of 85 subjects were involved with mean seizure frequency of 2.6 per week. TDCS protocols involved were 1 and 2 mA of direct current with varying frequency and duration. All studies showed improved seizure control in TDCS arm with minimal to zero side effects. Conclusion: TDCS appears as a safe and better option. Despite the benefit seen among refractory TLE, future prospective studies should focus on standardization of tDCS application as well as a more homogenous patient selection.