Ascorbic acid (vitamin C) is an essential micronutrient that the human's body cannot synthesize endogenously. Scurvy, a disease of ascorbic acid deficiency, can manifest in a myriad of presentations. Due to its rarity in the modern world, scurvy is considered as a disease of the past. We present a paediatric case of scurvy with musculoskeletal manifestations as a result of picky eating behavior.We report a previously healthy nine-year-old boy who presented with unexplained progressive bilateral lower limb generalized weakness and pain for two months. All initial biochemical and radiological investigations were unremarkable. Upon further history taking, he had severe picky eating behavior which raised the suspicion of scurvy. The diagnosis was confirmed with a serum ascorbic acid test. After ascorbic acid supplementation, his symptoms resolved immediately. Further food behavioral modification counselling to his family members helped to change his diet in a lasting way. As a result, he had no recurrence of symptoms. This case highlights the importance of having a high index of suspicion for an uncommon disease and emphasizes the need for a detailed dietary history upon patient's presentation.

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Introduction: Having children with congenital anomalies, particularly congenital talipes equinovarus (CTEV) may impact the psychological wellbeing of the parents. This study is to assess the psychological impact of CTEV, the related factors, and the coping strategies used by the parents in Hospital Tengku Ampuan Afzan (HTAA), Kuantan, Pahang. Materials and method: A cross-sectional study involving 43 parents with CTEV child was conducted from 18 July till 27 August 2016 at Hospital Tengku Ampuan Afzan. Selfadministered Malay version of Depression Anxiety and Stress Scale 21 items (DASS-21)1 is used to measure the psychological wellbeing of the parents and the Malay version of Brief COPE is used to measure coping strategies. Data were analysed using frequencies, percentages and Chi-square χ2 test. Results: There were 43 respondents, majority were Malay (90.7%), female (86%), and married (97.7%). Average age was 30.3 years old. 70% of the respondents were having a positional CTEV child and 30% have structural CTEV. Overall, prevalence of depression, anxiety, and stress among parents were very low. Only 9.3% experience depression, 11.6% experience anxiety, and only 2.3% was reported to be stress. The psychological wellbeing of the parents was not related with the parental age, gender, marital status, education level, and monthly income. The most common coping strategy used is religion, acceptance and positive reinterpretation. Conclusion: Only a few parents with structural and positional CTEV reported symptoms of depression, anxiety, and stress and most of them use positive coping strategies such as religion, problem focused and dysfunctional focused.

Coronoid fractures are challenging to manage and rarely isolated. It’s always associated with three instability patterns of the elbow, which is the terrible triads, varus posteromedial rotatory instability and transolecranon fracture- dislocation. We have performed an open reduction and reconstruction of the coronoid process using autologous tricortical iliac bone graft for one patient after persistent elbow dislocation in malunited type III coronoid fracture. The main goal of management of coronoid fracture with elbow dislocation is to maintain the joint stability and acceptable elbow functions. Through understanding the pattern of injuries, proper investigation and approach could improve the outcome of surgery. We believe that reconstructing coronoid process using tricortical iliac bone graft provides acceptable stable elbow joint and good functional flexion arc of motion.

Introduction: Use of mobile apps as a pedagogical tool in the medical education has gained popularity as mobile apps have great potentials in perpetuating clinical knowledge and skills. To leverage mobile technology in medical education, we designed a hybrid mobile app based on our undergraduate orthopaedic curriculum. Materials and Methods: The frontend was created using hybrid mobile framework to target both iOS and Android platforms. The backend is powered by Firebase (Google Inc.) to manage authentication and social messaging. The content consisted of basic orthopaedic skills, trauma and resuscitation skills, Islamic input in orthopaedic and information cheatsheets. Results: OrthoBoard is being used by IIUM medical undergraduates as an ancillary source of learning, particularly useful as quick references and visual guides for enhancing orthopaedic knowledge and performing clinical procedures. The social messaging capability built into the app serves as a platform for discussion and exchange of information. This is the first medical app, to our knowledge, that integrates orthopaedic clinical knowledge and practice as well as Islamic input in orthopaedics into teaching and learning with the integration of social messaging as a platform for enhancement of knowledge and practice. Conclusion: Use of mobile apps as pedagogical tool in the medical education will undoubtedly increase in the future. As students and teachers embrace mobile technology in and outside the classroom, better user-centric and subject-specific apps will be required to fulfil the needs. For medical educators, developing mobile apps will possibly be one of the future armamentarium in the delivery of knowledge and skills.