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Aims: Owing to the continuous debate and dilemma regarding the appropriate approach for managing fibroids with pregnancy, this review aims to synthesize, analyze and build up evidence from the published studies, especially the recent ones, about the changing trends in the last decade regarding the management of uterine fibroids with pregnancy and the feasibility as well as safety of cesarean myomectomy in comparison to the traditional conservative approach of deferring removal of the fibroids 3--6 months post-partum. Materials and methods: This is a review of the literature, and all the co-authors searched for, gathered, and filtered the most recent publications on the subject through PubMed, Medline, Google search, and others. Findings: The prevalence of fibroids with pregnancy ranges between 0.1 and 3.9% however, the true rate may be higher than this presently reported incidence. Discussion: An increasing trend in diagnosing fibroids with pregnancy is currently clearly obvious, mainly due to the concept of delaying child-bearing as well as the steady increase in the rate of cesarean delivery which leads to more incidental findings of asymptomatic fibroids. Conclusions: Uterine fibroids in pregnancy represent a dilemma in both diagnosis and treatment. Ultrasonography remains the main diagnostic modality for fibroids during pregnancy despite its reduced sensitivity and specificity during pregnancy. Treatment of fibroids with pregnancy continues to be a matter of debate and controversy, where traditionally myomectomy used to be deferred until after delivery and maybe after puerperium. At present both caesarean myomectomy and also, myomectomy during pregnancy have places in modern obstetrics. Statement of significance: • The problem regarding the association of fibroids with pregnancy arises mainly from the challenges in both the diagnosis, where ultrasonography has a reduced sensitivity and specificity during pregnancy, as well as the controversy and debate in the treatment strategies of the condition. • The traditional known practice of managing fibroids in association with pregnancy, is to postpone the removal of fibroids until postnatal and even after puerperium to allow a time for uterine involution and shrinkage of the fibroid hence, minimizing the operative time and the associated blood loss with the potential risks of spontaneous miscarriage, placental dysfunction, fetal malpresentations and preterm birth especially with submucous and intramural fibroids. • This article highlighted the newly introduced interventions in the context of the management of fibroids with pregnancy including, techniques to prevent preterm delivery and achieve term birth in case of treatment delay until post-delivery, or the implementation of cesarean myomectomy as well as myomectomy during pregnancy. [ABSTRACT FROM AUTHOR]

Objective: This literature review was designed to highlight the most up-to-date and evidence-based interventions, whenever available, regarding diagnostic imaging modalities and management strategies for patients, with the placenta accreta spectrum. Materials and Methods: A comprehensive review of the literature was conducted using database searches in Science Direct, Google Scholar, and PubMed to locate the most up-to-date information, related to this topic. Results: The placenta accreta spectrum has an unclear etiology, with cesarean delivery and placenta previa being the most implicated factors. Conclusion: There is a growing global consensus that the two main risk factors for placenta accreta are placenta previa and prior cesarean delivery. Up-to-date, grayscale sonography combined with Doppler interrogation is thought to be the best first-line assistance, for the identification of abnormal placental invasion. Cesarean hysterectomy, with placenta left in situ, is the classical surgical treatment. [ABSTRACT FROM AUTHOR]

Impetigo herpetiformis (IH) is a pregnancy-specific dermatosis that is currently considered a form of generalised pustular psoriasis and mainly occurs in late pregnancy during the third trimester. IH presents as erythematous patches and pustules and might have systemic involvement. The disease may be associated with severe maternal, fetal, and neonatal complications. IH treatment is very challenging, however, various therapeutic options are available and effective for disease treatment. [ABSTRACT FROM AUTHOR]

Objectives: In this study, we aimed to determine the prevalence and risk factors of alcohol use among a cohort of population in Sabah. Design: This is a prospective, cohort study involving rural community residents. Setting: Rural community resident at Bingkor, Keningau, Sabah. Participants: 363 individuals aged 13 years old and above. Intervention: Community‐based participatory research to determine the prevalence and risk factors associated with alcohol use. Main outcome measures: Measurement of alcohol use using Alcohol Use Disorders Identification Test (AUDIT) and assessment of psychiatric morbidity using Mini International Neuropsychiatric Interview (MINI) questionnaires. Results: Most alcohol drinkers aged between 36‐45 years old, followed by 26‐35 years old and 46‐55 years old. Interestingly, there are almost similar female to male ratio. Most were Kadazan‐Dusun ethnic, non‐Muslims, and married. Although only less than a third of the participants received tertiary education, the majority were working. Based on the findings, being a male, non‐Muslim and having an obsessive‐compulsive disorder (OCD) (current) posed a significantly higher risk of alcohol consumption. Conclusion: A worryingly high prevalence of hazardous alcohol consumption among the locals is reported. There is a need for population‐wide intervention towards preventive measures based on the identified risk factors for hazardous alcohol use. [ABSTRACT FROM AUTHOR]

Nutritional knowledge, attitudes and practice (KAP) may guide healthy meal choices. Here, nutritional KAP was compared across school students in Sabah based on locality and gender. A cross-sectional survey of students aged 15–19 years was conducted using multistage sampling. Nutritional KAP was measured via questionnaire. Anthropometric measures of weight and height were taken in person to calculate body mass index (BMI). Among the 994 participants, 80% were urban and 60% were female (mean age 16.5 ± 0.6 yr). Most were of Kadazan-Dusun (23%) ethnicity. Measured height for age Z score (HAZ) and BMI for age Z score (BAZ) differed between urban and rural students (−1.2 ± 0.8 versus −1.5 ± 0.7 for HAZ; p < 0.001; 0.2 ± 1.4 versus −0.1 ± 1.3; p = 0.02, respectively). No difference in nutritional knowledge was found, although urban students prioritized having a healthy/balanced diet (59.55% versus 48.50%, p = 0.03) and ate daily breakfast (57.4% versus 10.2%, p < 0.001) compared to rural. Females scored higher on nutritional knowledge than males (18.9 ± 2.8 vs. 18.1 ± 3.4, respectively, p = 0.0001), yet males selected more healthy/balanced foods (63.3% versus 53.3%, p = 0.041). The gap remains between nutritional KAP and translating this to healthy eating among adolescents, related to locality and gender. [ABSTRACT FROM AUTHOR]

Obesity has been proven to have adverse effects on fertility and is one of the predisposing factors for delay in pregnancy even with the use of assisted reproductive technique. There are many pathways in which obesity can affect fertility such as anovulation, poor implantation and low-quality oocyte. We report a case of a 40-year-old lady with primary infertility for six years with underlying polycystic ovary syndrome (PCOS) and BMI 45.7 whom was successfully conceived twice following bariatric surgery procedure in which reduction of 70% of her BMI prior to bariatric surgery lead to her spontaneous conception without fertility intervention and successful live birth. Obese PCOS needs multidisciplinary approaches which include weight loss program such as dietary advice, exercise intervention as part of preliminary treatment prior to ovulation induction and counselling. Bariatric surgery has been a mainstay treatment in patients with morbid obesity and those with BMI more than 35 associated with obesity related problems such as joint pain, hypertension or diabetes mellitus. Bariatric surgery such as laparoscopic sleeve gastrectomy should be considered more often in contrast to lifestyle modification for morbidly obese lady with PCOS and infertility prior to the use of standard ovulation induction regime for treating infertility. • We report a case of a 40-year-old lady with primary infertility for six years with underlying polycystic ovary syndrome (PCOS) and BMI 45.7 whom was successfully conceived twice following bariatric surgery procedure. • Bariatric surgery in morbidly obese lady helps to achieve reduction of 70% of her BMI and lead to her spontaneous conception without fertility intervention and successful live birth. • Obese PCOS needs multidisciplinary approaches which include weight loss programme such as dietary advice, exercise intervention as preliminary treatment prior to ovulation induction and counselling. • Bariatric surgery such as laparoscopic sleeve gastrectomy should be considered more often in contrast to lifestyle modification for morbidly obese lady with PCOS and infertility prior to the use of her standard ovulation induction regime for treating her infertility. [ABSTRACT FROM AUTHOR]

Background: Dengue fever infection has become a major public health concern in Malaysia with frequent epidemics occurring in urban areas. In Sabah, Dengue fever is among the 5 most reported communicable diseases and the district of Kota Kinabalu is among the top 3 districts with the highest number of dengue cases with 563 cases recorded in 2016. Aims and Methodolgy: This study aimed to determine the factors contributing or associated with dengue fever occurrence in Kota Kinabalu. A cross- sectional study was conducted among the primary health care clinic attendees in Kota Kinabalu. Data was collected via a set of structured questionnaires focusing on socio-demographic characteristic of participants, environmental characteristic of households, history of previous exposure to dengue fever, knowledge towards dengue fever and its vector, awareness on dengue fever and mosquito control and dengue fever prevention practices. Results and Recommendations: Among the 350 individual's that participated in the interview, 53 were dengue fever cases. Subsequently, the prevalence of Dengue fever cases among the study population was calculated with prevalence in percentage concluded as 15.1%. Further analysis revealed that factors such as aged group by years, number of household occupants, staying at dengue outbreak areas, self - reported history of recent mosquito bites, indoor and outdoor storage of open water containers, installed house window screens, knowledge on dengue fever and its vector, practices of wearing protective clothing outdoor and usage of mosquito repellent ointment or creams showed significant association with dengue fever outcomes. However, further studies would need to be conducted to determine if these factors possess a higher threat or risk for dengue fever. [ABSTRACT FROM AUTHOR]