Purpose: An ideal cleansing regime to prepare a clean colon is important for yielding best results during colonoscopy. Many centers practice strict dietary modifications - ie, skipping more than one solid meal 1 or 2 days before the procedure with the consumption of a bowel cleansing agent. No formal studies have been performed to determine how long a patient should withhold solid meals during bowel preparation prior to an outpatient colonoscopy. Materials and methods: A randomized prospective controlled trial was carried out with patients who underwent elective colonoscopy at a tertiary general hospital in Malaysia for 7 months' duration. Patients were randomized into one of two groups. Group A patients abstained from a solid diet for 24 hours (the last solid meal was breakfast the day before the colonoscopy). Group B patients abstained from a solid diet 14 hours prior to the colonoscopy (the last solid meal was dinner the day before the colonoscopy). We standardized the time for the oral intake of sodium phosphosoda in both groups. The Boston Bowel Preparation Scale was used to grade the cleanliness between the two groups and a score > 2 was taken as clean bowel preparation. Results: A total of 178 patients (each arm had 89 patients) were recruited for this study. Group A showed a mean bowel cleanliness score of 3. Group B showed a mean bowel cleanliness score of 2.5. However, there was a significant difference in bowel cleanliness between the groups (P <= 0.05). Conclusion: Abstinence of solid food for either 24 hours or 14 hours prior to the colonoscopy both produced clean bowel preparation scores. Patients who can afford to skip more meals should stop solid food intake at 24 hours prior to colonoscopy. However, for patients who are not able to fast for long, they should be allowed to take solid food up to 14 hours prior to the procedure, thus reducing the need to over-starve them.

Introduction: Use of minimally invasive techniques for gastrostomy insertion in children is well documented. Laparoscopic placement is fast becoming the method of choice. However, it is important to note that there are still many centers in developing and under-developed countries in which laparoscopic or endoscopic facilities are not readily available. Methods: Here, we describe a less than 2 cm, single-incision open gastrostomy technique successfully performed on seven infants and one child who were all malnourished. A nasogastric tube was inserted to assist the technique. Results: All patients had a wound measuring less than 2 cm. Mean operating time was 30 minutes. Gastrostomy tube feeding was established after 6 hours post-surgery. No complications occurred in any of the patients. Conclusions: This technique is an excellent minimally invasive approach. It is simple, safe, and feasible.

The Malaysian legal education evolves in the recent years due to the interest of the stakeholders in the legal industry. Among the vibrant development in the Malaysian legal education is the assimilation of Shariah education in legal education. Up to date, only International Islamic University Malaysia (IIUM) and Islamic Science University of Malaysia (USIM) offer Shariah education and legal education with an objective of enabling the graduates to practice in both fields in Malaysia. This is an added value for the graduates which contributes positively to the Malaysian need of graduates having both qualities of Shariah and Law. The challenge in providing such education is unique. Not only must the institution ensure adequate and appropriate curriculum structure, it must also provide capable educators in both fields and fulfill other requirements. This paper adopts qualitative study involving interviews of experts, collection and analyses of data from the universities, Malaysian Qualification Agency (MQA) and Ministry of Higher Education of Malaysia. It also involves doctrinal analysis of the corpus of knowledge on Shariah and law education. The outcome of the paper shows the need of legal and Shariah education in Malaysia and describes the running of the programmes offered by this nature.