There is a mushrooming interest in the anti-carcinogenic property of vitamin D. However, many researches reported a conflicting result in the association of vitamin D levels to certain types of cancer. This study was designed to assess the association between vitamin D and vitamin D receptor (VDR) expression with breast cancer. This case-control study, carried out at Hospital Universiti Sains Malaysia, Kelantan, involved 69 newly diagnosed breast cancer patients and 73 healthy volunteers. Serum 25(OH)D was taken and compared between 2 groups. VDR expression in patients’ breast tissue samples was determined by immunohistochemical staining method using anti-VDR antibody. 85.5% of breast cancer patients and 97.3% of healthy control were vitamin D insufficient with a mean (SD) of 13.36 (6.96) ng/mL and 13.05 (3.71) ng/mL, respectively, and the difference was not statistically significant. VDR expression showed cytoplasmic positivity in 75.4% of breast cancer tissue, followed by both cytoplasmic and nuclear positivity in 21.5% and complete absence in 3%. There was no significant association between VDR expression and hormone receptor status. In conclusion, there was a high prevalence of vitamin D deficiency among breast cancer and healthy volunteers in our study. There was no significant association between breast cancer and vitamin D. The VDR expression in breast cancer cells showed high cytoplasmic localization.

Insulin resistance increases the risk of developing diabetes, and the degree of resistance influences the glycemic control of patients with diabetes. Numerous researchers have focused on improving insulin sensitivity in order to prevent diabetes-related complications and other chronic diseases. Several studies have also linked vitamin D levels to insulin secretion and resistance, given that both vitamin D and its receptor complex play important roles in regulating pancreatic β-cells. It has been suggested that vitamin D supplementation improves vitamin D levels, but further research is needed to confirm this as neither insulin function nor glycemic control improves when vitamin D levels increase. Magnesium is a cofactor for many enzymes. Although the role of magnesium in the management of diabetes has long been evaluated, it has not yet been determined whether magnesium supplements improve insulin function. However, several researchers have found that patients with good glycemic control have high magnesium levels. Magnesium is closely related to vitamin D and is necessary for the transport and activation of vitamin D in humans. Combined supplementation with vitamin D and magnesium improves glycemic control in patients with diabetes.

Thyroglobulin (Tg) is a precursor for thyroid hormone, specifically synthesized by thyroid follicular cells upon stimulation by the thyroid stimulating hormone (TSH). Damage to the thyroid cells caused by benign or malignant thyroid diseases cause the release of Tg into circulation. Differentiated thyroid cancer (DTC) is the most common endocrine malignancy, which has an excellent prognosis if detected and treated early. This review describes the clinical and laboratory aspects of Tg and AntiTg measurement in the management of DTC. The serum Tg measurement has been used in the pre- and post-operative management of DTC. The clinical significance of Tg and the role its low level can play in the diagnosis and monitoring of DTC as well as in the prediction of its recurrence must be understood. DTC may lead to the production of a different Tg with novel immunogenic cancer epitopes that can induce TgAb synthesis. The preoperative TgAb level has shown a high predictive value for DTC, while postoperative serum TgAb can be used for the detection of disease persistence and recurrence. Despite the importance of TgAb level in DTC management, the presence of TgAb interferes with the analysis of Tg measurement, thus limiting its clinical utility. There is no established value regarding at which level TgAb interferes with Tg measurement. Available methods in measuring Tg and TgAb should emphasize the lower and upper limits of their detection, especially for postoperative monitoring and early disease recurrence detection. The accurate measurement of serum Tg and TgAb is pertinent to the follow-up of DTC patients, and any suspicious results must be interpreted in accordance with clinical findings in view of a present possible assay interference.

Coronavirus disease 2019 (COVID-19) is a global pandemic. Clinical studies have shown that there was an association between COVID-19 and cardiovascular disease. The virus can directly induce myocardial injury, arrhythmia, acute coronary syndrome, and venous thromboembolism. In Malaysia, students will come back to University soon. The screening techniques framework is required to reduce the pandemic Covid-19 transmission among the students. In this manuscript, we present a new screening technique framework which is consists of temperature and heart rate measurements, movement tracking and risk assessment. Students will be given a questionnaire to stratify their risk into high, medium, and low risk. The temperature will be measured by using an infrared thermometer. The heart rate will be monitored only in those in high and lowrisk categories by using a smart bracelet. The students’ movement will be tracked by using a Wi-Fi based location technique. To avoid any privacy concerns, the location data will be extracted only if the student shared the location with the confirmed COVID-19 case. Lastly, the risk assessment is required in reporting if the infection occurs among students.

The haematology laboratory at Hospital Universiti Sains Malaysia implements sample acceptance and rejection according to the rejection criteria following guidelines by ISO 15189. This study aims to evaluate causes and types of samples rejection and we also introduce an initiative to reduce sample rejection. A 2- month retrospective study was conducted by obtaining and evaluating data from samples sent to the haematology laboratory from June and July 2022. The laboratory received a total of 32,726 samples, out of which 1,084 (3.31%) were rejected. Rejection rates were 3.19% and 3.43% consecutively for June and July 2022. The leading cause of sample rejection was clotted samples (36.6%), followed by duplicate requests (22.9%), and insufficient amounts (16.9%). High sample rejection rates were recorded from the paediatric surgical ward, medical high-dependency unit, and otorhinolaryngology ward. The lowest rejection rate was from the outpatient clinic. The overall sample rejection rate was 3%. Therefore, a few mitigation strategies need to be employed to improve the acceptance rate.

Background: Glycosylated hemoglobin (HbA1c) serves as a crucial biomarker for the diagnosis and monitoring of diabetes. It can be measured via different methods. Interference during analysis can potentially arise from various factors, including rare occurrences such as hyperleukocytosis. Case presentation: Here, we present the case of a 54-year-old male patient with a 20-year history of type 2 diabetes mellitus who complained of prolonged lethargy, epigastric discomfort, and constitutional symptoms of malignancy. Further investigation revealed a diagnosis of T-cell prolymphocytic leukemia accompanied by hyperleukocytosis, indicated by a white cell count of 574.60 x 109/L with predominant lymphocytes. Chemotherapy and tumor lysis syndrome prophylaxis were initiated. During diabetic monitoring, analysis of HbA1c using capillary electrophoresis revealed an absent HbA1c peak; this has not previously been observed. To address this finding, the sample underwent repeated saline washing and centrifugation. Subsequent analysis demonstrated an improvement, with a well-fractionated HbA1c peak present at 8.7% (71 mmol/mol). Various factors can interfere with HbA1c analysis. Drug and hemoglobin variant interference was ruled out following the recovery of the peak post saline washing. The accelerated migration speed of the sample caused by interfering substances in the plasma was postulated to result in a profile shift, leading to the non-recognition of HbA1c fractions. Conclusion: By implementing the important step of washing out interfering molecules, the shift was eliminated, allowing for a true HbA1c level measurement. The appearance of an HbA1c peak post saline wash suggests the presence of endogenous substances that interfere with the assay's analytical method.

Ornithine transcarbamylase (OTC) deficiency (OTCD), the most common urea cycle disorder, is an X-linked genetic disorder due to complete or partial lack of the OTC enzyme. Its clinical presentation depends on the degree of enzyme deficiency and ranges from an acute neonatal metabolic crisis with a high mortality rate through to an asymptomatic adult. We present a case of a newborn baby boy who presented with poor feeding, vomiting, lethargy, and respiratory distress. Laboratory investigations revealed severe hyperammonaemia, hyperglutaminaemia, hyperalaninaemia, absence of citrulline, and marked orotic aciduria. Family screening confirmed the presence of an OTC disease-causing mutation in his mother. It was a heterozygous mutation, c.316G>A. p. Gly106Arg in exon 4.