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INTRODUCTION: Risks of breast cancer occurring among female transgender using hormonal therapy is emerging. However, most transgenders are also engaged in breast implant procedures resembling female sexual characteristics and satisfaction without realizing the risk of cancer development. Thus, breast cancer risk assessment of female transgenders in Malaysia should be evaluated further. This study aims to develop and validate an assessment tool in the Malay language version to measure breast cancer awareness among female transgenders in Malaysia. MATERIALS AND METHODS: A crosssectional study with a purposive sampling method was conducted among 300 respondents in districts in the states of Pahang, Kedah, and Kelantan. The minimum number of respondents required was 300 persons based on the Nunnally method, with an item ratio of 1:10. All the subjects were given questionnaires on sociodemographic data and breast cancer-related items, consisting of five domains; knowledge of symptoms and clinical features, breast cancer risk factors, breast screening programmes, barriers in seeking medical help, and lastly, the confidence, skills and behaviour concerning breast selfexamination. Each domain consisted of five to seven items. All the responses were recorded as 'Yes,' 'No,' or 'Not Sure'. Reliability was determined using Cronbach's alpha for internal consistency, while construct validity was assessed using exploratory factor analysis. RESULTS: The reliability of the 28 items for Malay Version of Breast Cancer Awareness scale by Cronbach Alpha was 0.864, suggesting that the constructs were reliable and acceptable. In addition, the construct validity was assessed using exploratory factor analysis highlights five meaningful domain. DISCUSSION AND CONCLUSION: This Malay language breast cancer awareness scale is a convenient self-assessment method, inexpensive and understandable which highlights common issues faced by male-to-female transgender with targeted domains. This scale is valid and reliable by achievable internal consistency value of 0.864. [ABSTRACT FROM AUTHOR]

Introduction: Fistula-in-ano is a benign anorectal disease which always poses a big dilemma to the surgeons because of their significant recurrent rate following surgery. Materials and Methods: A cross-sectional study involving 42 patients undergoing core out fistulectomy in the Hospital Tengku Ampuan Afzan, Kuantan, Pahang, Malaysia were included in this study. Demographic data of patients were assessed. Endoanal ultrasound (EAUS) was done prior to the surgery to determine types of fistula and classified using Park's classification. Follow up was made post-operatively at 4th week, 2nd month, 3rd month, 4th month, 5th month and 6th month to look for the duration of healing or recurrence. Results: 5 out of 42 patients were lost to follow up leaving 37 patients available for the analysis. Mean age of the patient was 38.4 (13.8) years old. Transphincteric and intersphincteric type of fistula accounted for 54.5% and 40.1%, respectively. 62.2% (n=23) of patients achieved primary healing after the procedure. The mean for healing duration was 3.7 (3.1) months. Recurrence of the disease was seen only in 37.8% (n=14) of the patients. Conclusions: Even though we managed to achieve significant success rate cumulatively, recurrence of fistula still impose a significant challenge toward patient's management. Therefore, further prospective study with a bigger sample size is recommended to look into this method to reduce recurrence of fistula. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study is to identify the incidence of clavicle fractures in newborn associated with fetal, maternal and process of deliveries in Kuantan General Hospital from June 2012 until January 2014. This study is to determine epidemiological data of clavicle fractures, maternal and baby risk factors associated with clavicle fractures of newborn and its' outcome. Methods: This is a prospective study. 13 patients were identified to fulfill the inclusion criteria of the study. The data of sociodemographic, associated fetal and maternal risk factors and the outcomes were recorded using proforma. The statistical data analysis was done using SPSS 12.0. Results: Out of 20,257 live births at our centre during the study period, 13 infants were diagnosed to have clavicle fractures, giving an incidence of 0.64 per 1000 live births. There were 5 (38.5%) left, 7 (53.8%) right and one (7.7%) bilateral fracture. All fractures located at the mid shaft of the clavicle and none have associated brachial plexus injuries. All infants were delivered through vaginal delivery (61.5%); five through assisted delivery (instrumental); 2 (15.4%) forcep and 3 (23.1%) vacuum. Two of the babies developed shoulder dystocia. The average birth weight was 3371 grams (SD 0.269) and mean gestational age was 38.7 weeks (SD 1.16). Five of the mothers (38.5%) were primigravida and eight (61.5%) were multigravida in which,7 (53.8%)were healthy without other co-morbidty, 5 (38.5%) having gestational diabetis and one (7.7%) hypertension. The average maternal weight was 62.0 kg and height 1.58 metres with average BMI of 24.16 (3.29SD). All eventually had a complete recovery at 6 weeks with clinical and radiological evident of fracture union. Conclusions: In conclusion, all patients with clavicle fractures were found following vaginal delivery. There were no associations between neonatal clavicle fractures with maternal or baby risk factors. All fractures healed without any complications. [ABSTRACT FROM AUTHOR]