Background: To study the effect of testosterone treatment on markers of inflammation in hypogonadal men with MS.Methods: 20 men with MS (IDF criteria) and LOH (total testosterone (TT) < 11 nmol/l) received 3 injections of testosterone undecanoate (Nebido) or placebo. Patients were divided into two groups according to TT levels 12 weeks after the third injection of Nebido/placebo: in group 1 (n = 13) TT was normalized to 15.75 [13.5-17.3] nmol/l and in group 2 (n = 7), TT was not normalized (8.3 [6.5-10.2] nmol/l). Interleukin-6 (IL-6), C-reactive protein (CRP) and tumor necrosis factor alpha (TNF alpha) were measured before and after 30 weeks. Statistical analysis was performed using Wilcoxon test.Results: In group 1, IL-6 decreased from 4.6 [3.0-3.8] to 3.8 [2.8-3.0] pg/ml (normal range (NR) < 4.1) (p = 0.04), TNF alpha decreased from 15.2 [12.3-15.3] to 12.2 [10.7-10.0] pg/ml (NR 0-8.21) (p = 0.005) and CRP decreased from 3.8 [1.4-4.1] to 1.9 [0.6-3.1] mg/L (NR 0-5) (p = 0.01). In group 2, there were no significant changes in IL-6, TNF alpha and CRP: IL-6 was 3.2 [2.8-3.2] and 3.2 [2.7-3.3] pg/ml (normal range (NR) < 4.1) (p = 1), TNF alpha was 13.2 [12.1-13.9] and 12.0 [11.5-12.1] pg/ml (NR 0-8.21) (p = 0.45) and CRP was 4.0 [0.6-6] and 4.9 [0.7-8.5] mg/L (NR 0-5) (p = 0.22) before and after 30 weeks of treatment, respectively.Conclusion: LOH correction in men with MS has beneficial effect on the process of chronic inflammation.17 Is sexual health the portal to men's health? -the experience of a primary men's health practice Background: The difference in health statistics between men and women is obvious in genderspecific medicine. Some of the reasons cited for this difference include men's attitude towards health and also a less than proactive approach of the medical community towards men's health. The Singapore Men's Health Clinic (SMHC) is a private community based men-only primary health care facility in practice since 2003. This study is to review the conditions that bring patients to the clinic and to examine the role the practice can play in men's health.Method: The presenting diagnoses of patients seen by the SMHC at locations where the clinic was first started and another after a move to new premises are reviewed. The case records of the first consecutive new patients seen in both locations for almost identical time periods (Location A: 17/11/03-17/06/04; Location B: 3/10/05-8/4/06) were retrieved. Relevant data are presented.Results: Fewer new patients were seen at B than at A (n = 140 vs. n = 482) although the hours of operation of the clinic were the same. The age distribution of patients was identical. Problems related to sexual health were the main diagnoses among patients at A and B (x 2 = 3.65) constituting 72.4% of all presenting

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The COVID-19 epidemic has had serious negative effects on children in terms of both their health and societal effects. However, owing to reports of a low vaccination rate, the objective of this study was to explore the factors associated with parents’ hesitation in getting their young children vaccinated. This is a cross-sectional study conducted in a tertiary hospital. All parents or legal guardians of paediatric patients with chronic illnesses aged 3 to 11 who visited the hospital during the study period filled out the online questionnaire. Two hundred and thirty-five outpatient clinic respondents and 77 ward respondents were asked to complete the questionnaire. Malays made up the majority (88.5%), followed by Chinese (6.7%) and Indians (4.8%). Ethnicity, information sources, children‘s age, knowledge score and vaccine perception were found to be significantly different across three degrees of acceptance – ‘Yes’, ‘No’ and ‘Not sure’. There was a significant correlation between ‘Yes’ and ‘No’ replies and parents‘ perceptions of immunisation hurdles. When compared to the Malays, the Chinese had substantially lower odds of responding with ‘Not sure’. Parents‘ acceptance of the vaccine was influenced by their awareness of COVID-19, the effectiveness of the vaccine, any side effects and doctors‘ recommendations. Parents were less concerned about vaccine side effects as their children aged. To infer, authorities should respond to public concerns and adverse events related to immunisation in a timely and transparent manner. To increase immunisation rates, it is important to inform the public that the advantages of receiving COVID-19 vaccination exceed its risks.

Inappropriate prescribing of antibiotics is one of the factors that lead to the development of antibiotic resistance. Therefore, understanding doctors’ practice, perception and knowledge is vital in targeting strategies to prevent antibiotic resistance. The aim of the study is to determine the practice, perception and knowledge of doctors on antibiotic use and resistance in Penang government hospitals. This is a cross sectional survey carried out in 6 Penang government hospitals from 9th January 2017 to 20th January 2017. A face-and-content validated questionnaire adapted from Abbo et al., was distributed to house officers (HO), medical officers (MO) and specialists/consultants (SC) and collected back within 5 working days. A total of 243 questionnaires were completed with a response rate of 60.45%. Majority of our respondents (91.6%) considered whether patient is critically ill and/or immunocompromised when selecting an antibiotic. Regardless of their position, doctors agreed that antibiotics are overused and antibiotic resistance is a significant problem nationally. However, MO tended to perceive antibiotic management programmes as an obstacle to good patient care. The mean knowledge score among respondents was 5.88 (1.92) out of 10. Adjusted analysis showed that SC have significantly higher mean knowledge score compared to HO and MO (p