Introduction: Acne is a common skin disease with a high psychosocial burden, affecting mostly adolescents and youth worldwide. Management of acne is often challenged by cutaneous side effects that leads to therapeutic intolerance, poor compliance and impaired efficacy. Materials and Methods: This was a single-centre, evaluatorblinded, split-face, randomised study investigating the effects of thermal spring water (TSW) in improving efficacy and tolerability of standard acne therapy. Total of 31 participants with mild-to-moderate acne were recruited and subjected to TSW spray one side of the face 4 times daily for 6 weeks in addition to standard therapy. The other side received standard therapy only. Results: Six (19.4%) males and 25 (80.6%) female with mean age 25.1±6.13 participated, 15 (48.4%) had mild acne while 16 (51.6%) had moderate acne. Seven (22.6%) were on oral antibiotics, 25 (80.6%) used adapalene, 6 (19.4%) tretinoin and 21 (67.7%) benzoyl peroxide. Skin hydration improved and better on spring water treated side with mean difference12.41±30.31, p = 0.04 at the forehead, 39.52±65.14, p < 0.01 at the cheek and 42.172±71.71, p < 0.01 at the jaw at week 6. Participants also report significant reduction in dryness at the treated side at week 6, mean difference 0.93±0.10, p < 0.001. TEWL, sebum and pH were comparable on both sides with no significant differences. Tolerability towards standard therapy improved as early week 2 with reduction of stinging following application of topical therapy (mean difference 0.62±1.43, p = 0.03), increase in skin feeling good (-1.79±1.70, p < 0.001) and skin suppleness (0.62±1.43, p < 0.001). These improvements were significantly maintained till week 6. Cardiff acne disability index significantly improved at week 6 (p<0.001) despite no significant changes in Comprehensive Acne Severity Scale score before and after treatment.

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.

Introduction: Zika virus infection is caused by flavivirus virus and spread by Aedes mosquitoes. Since first reported in 1947, it spread to various countries especially in the equatorial region including Malaysia. The infection is non-fatal to an adult. However, the major risk of its infection is towards unborn baby when the mother is infected. The vertical transmission to the foetus possess various risks include the teratogenic effect that may lead to elective abortion. Thus, the objectives of this review are to discover about Zika virus and its effect on pregnant women and to evaluate Islamic perspective about elective abortion of Zika virus-infected women. Methods: This review was done through reviewing evidence from the journals, books and reports. The data were reviewed thematically according to the objectives. Results: Studies shown that Zika virus may cause miscarriage, preterm birth, microcephaly and other malformation known as Congenital Zika syndrome. This leads to a demand for elective abortion which raised Islamic ethical issue if it is permissible. In Islam, abortion is extremely prohibited once the foetus reached 120-day of conception unless it causes harm to the mother’s life. But, if the foetus age is less than 120-day, abortion is permissible when the pregnancy affects the mother’s health. Abortion due to foetal microcephaly and congenital malformation is prohibited. Conclusion: Effort must be taken to prevent the spread of Zika virus to reduce the need for an elective abortion through an education Muslim community regarding elective abortion.

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.