Symmetrical peripheral gangrene (SPG) is a rare, debilitating disease that deserves more widespread concern among the medical fraternities. The objective of this review is to outline the etiology, pathology findings, and management practices of SPG. About 18%–40% mortality rate was reported, and survivors have high frequency of multiple limb amputations. SPG is the hallmark of disseminated intravascular coagulation (DIC). The main pathogenesis theory, to date, is microthrombosis associated with disturbed procoagulant–anticoagulant balance. The treatment of SPG is largely anecdotal and theoretically involves heparin-based anticoagulation and substitution of natural anticoagulants. Early recognition, prompt management of DIC, and underlying conditions may halt the progression of the disease. The multicenter randomized controlled trial should be set up to formulate the proper treatment guidelines.

Objective: The objective of this study was to examine the relationship between performance barriers and competency, and implementation of an expanded public health role for community pharmacists. , Methods: A validated questionnaire was utilized for this study whereby 3 variables of the study (performance barriers, competency and public health role) were measured using a 5-point Likert scale. Three hundred questionnaires were distributed to target respondents of registered community pharmacies in 5 states (Johor, Negeri Sembilan, Selangor, Perak and Penang) in Malaysia. The data were analysed utilizing the principles of structural equation modelling.Results: There were 191 completed and usable responses received, which represented a 66.7% response rate. This study showed perceived competency had a direct relationship with delivering a general public health role. A perceived lack of competency was shown to be a barrier to fulfilling a public health role. However, other factors, such as design of premises, IT infrastructure and pay, were not viewed as barriers to carrying out a public health role. Conclusion:Perceived competency is an obstacle for community pharmacists to undertake a public health role in Malaysia. Adequate training programs in pharmaceutical public health have to be put in place to address this concern and this should therefore be a priority.

Objective: The aim of this study was to explore the influence of physical activity and media viewing on the occurrence of childhood obesity in Malaysia.Methods: A 42-item validated questionnaire in the Malay and English language, containing Likert scale close-ended questions was used to explore the degree of physical activity practiced by families as well as trends on media viewing restrictions among parents in 5 selected states of Peninsular Malaysia. A total of 1200 self-administered questionnaires were sent out to schools in rural and urban areas of the respective 5 states and body mass index (BMI) for children was measured using the WHO 2007 reference standards. A total of 802 completed and usable questionnaires were obtained yielding a response rate of 66.6%. Chi-square and descriptive statistics were used to analyze the results.Results: The findings revealed that while children may have agreed limits on media viewing (television/computer/video games), as the child’s BMI increased the rate of agreed limits decreased. However, the enforcement of these limits was not consistent. Interestingly, 70% of the parents who did not enforce restrictions on media viewing were also obese themselves. In terms of physical activity, this was far lower among obese and severe obese children and family activities involving physical activity was scarce with a rate of 25%.Conclusion: The study affirms the fact that Malaysia needs to promote engagement in physical activity as a national policy and shows that the importance of enforcing media viewing restrictions should be highlighted to the community at large.

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