Ab, 2. Umi Kalsom Ali, three. Marlyn Mohammad, four. Ezura Madiana Md. Monoto, 5. M.M. Rahman, 1-3,five: Division of Medical Microbiology Immunology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras 56000 Kuala Lumpur, Malaysia. 4: Division of Household Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras 56000 Kuala Lumpur, Malaysia. Correspondence: Asrul Abdul Wahab, Division of Healthcare Microbiology Immunology, Faculty of Medicine, The National University of Malaysia, Cheras 56000 Kuala Lumpur, Malaysia. E-mail: asrulwahab@hotmailthe infection inside the pregnant woman are crucial so that you can avoid adverse outcome. CASE 1: Mrs. ZNA, a 29-year-old Malay housewife, Gravida four Para 2+1, came for antenatal booking in the principal care MFAP4 Protein medchemexpress clinic, complaining of polyuria, polydipsia and lethargy for the past a single week. Dating ultrasound revealed 11 weeks fetus. She was diagnosed with gestational diabetes mellitus (GDM) with fasting blood glucose of 11.0 mmol/L and subsequently referred right here for additional management. She also complained of itchiness at the genital area connected with whitish vaginal discharge whereby the higher vaginal swab specimen for microbiology culture revealed presence of candida infection. She was subsequently treated appropriately. Routine blood investigations such as hepatitis B, human immunodeficiency virus (HIV) and Carboxylesterase 1, Human (HEK293, His) syphilis serology tests were carried out. The serology tests for hepatitis B and HIV had been adverse. However, the fast plasma reagin (RPR) was reactive at 1:16 titration. The diagnosis of syphilis was confirmed by a positive Syphilis IgG result. On additional history, she admitted for the treatment of syphilis throughout her preceding pregnancy in 2010 at yet another hospital. She was offered 3 doses of intramuscular penicillin. Prior syphilis record showed the RPR titre was 1:8 but no subsequent follow-up.Pak J Med Sci 2015 Vol. 31 No. 1 pjms.pk Received for Publication: Revision Received: Edited by Reviewer: Accepted for Publication:June 26, 2014 July 9, 2014 September 22, 2014 September 29,Asrul Abdul Wahab et al.The diagnosis of syphilis re-infection was made and she was treated with 2.4 million units of penicillin weekly for three doses. Her other health-related complications have been managed accordingly. She was discharged in the ward after the blood sugar level was optimized and continued her comply with up in the clinic. Her husband was counselled for syphilis screening but refused. Consequently, she completed the treatment for syphilis. The second and third trimester ultrasounds revealed no abnormalities. Repeated RPR at 33 weeks of gestation was non-reactive. She delivered a baby boy at 38 weeks of gestation through LSCS with birth weight of four.0 kg. No clinical indicators of congenital syphilis noted. Speedy Plasma Reagin (RPR) result for the baby was nonreactive. She was discharged after 3 days in the ward. Post-natal follow up was scheduled for them but she requested to be noticed in another hospital at her hometown. CASE 2: Mrs. TPS is often a 21-year-old Chinese housewife, Gravida 1 Para 0, at 31 weeks gestation was admitted for the ward for premature contraction. She gave a 3-days history of reduced fetal movement. Antenatally, she attended antenatal check up in a different hospital. She was mildly anaemic with haemoglobin of 10.eight g/dL and was treated with oral haematinics. Otherwise it was uneventful. She recently moved to Kuala Lumpur, therefore had never attended antenatal stick to up in this hospital. Both her and her h.