Three primary schools with three different food service managements in Kuala Selangor were selected for this study. Food samples served for five school days were taken and analyzed for calories, protein, fat and carbohydrate. It was observed that most of the food served was rice-based such as nasi lemak, chicken rice, noodles and traditional cakes. The amount of calories and protein per serving ranged from 77-274 kcal and 0.9-3.6 g respectively. Food served under the Supplementary School Feeding Programme contained higher calories than those sold by these school canteens. However, the amounts of protein and calories were still short of the expected amounts recommended by the Ministry of Education, which according to menu should provide at least 10 g protein and 290-390 kcal. The percentage contributions of energy from protein in foods served at school canteens were also lower than the recommended.
Supernumerarypremolars have been reported to occur in 0.29% of the general populationand to represent about 9.1% of all supernumerary teeth. Most of the supernumerary teeth reported in the literature were detected by radiographsas most of them were unerupted or impacted.Asearch of the literature revealed not many cases of fully erupted and well aligned supernumerary premolars being reported. A case of a unilateral transposed supernumery premolarthat had erupted into alignment is presented here. The remarkable featureof this case is that the supernumery premolar is transposed between the first and second permanent maxillary molars. The etiology of supernumeraryteeth is also reviewed.
A case of mucosal burn during the placement of fissure sealant on the first permanent molars of a 9-year-old Malay boy is presented. The erythematous lesion with accompanying burning sensation appeared a few minutes after the etching liquid, containing 37% by weight phosphoric acid, had accidentally come into contact with the buccal mucosa on the right side of the angle of the mouth. The mucosa showed complete healing after one week. The use of rubber dam for tooth isolation while doing fissure sealant is essential to avoid accidental contact of potentially caustic chemicals, such as the phosphoric acid etchant, with the oral mucosa as it can result in mucosal burns.
Severe gingival recession caused by dehiscence usually present a challenging task to the clinician as any mucogingival surgery without bony regeneration will not 'prevent the condition from recurring. The procedures of guided tissue regeneration ( GTR ) which allow regeneration of the lost periodontium may offer some solution to the condition. This paper reports on the use of a non-resorbable GTR membrane to treat an isolated lower incisor gingival recession associated with dehiscence.
Fixed-removable appliance is frequently used to extrude a tooth but the idea of incorporating an acrylic capping or stop has not been documented in the literature. This article reports on a case treated with this new approach and describes the technique used.
The current standard of managing facial bone fractures is the use of rigid internal fixation. This method provides good stabilization and repair for mid-face fractures such as the zygomatico-orbitalfracture. Nowadays, for the young and old, patients want not only rapid bone healing, but also good facial aesthetics after surgical treatment following maxillofacial trauma. Therefore, osteosynthesis of fractures and inconspicuous post-operative scars are considered essential. The lower eyelid approach or modified blepharoplasty provides rapid access to the infraorbital rim as well as the orbital floor, while the lateral eyebrow incision gives direct access for fixation at the fronto-zygomatic suture. Combining the Gillies' approach and a single form of rigid internal fixation, good cosmetic results and function can be achieved. Cases using the micro-plate-system for thin infraorbital bones and the miniplate- system for thicker facial bones involving zygomatico-orbital fractures are described.
In recent years, dental evidence has played an important role in the positive identification of unknown deceased victims of catastrophies. To improve further dental identification techniques, there is an urgent need to adopt a national policy on denture marking as a compulsory procedure in the fabrication of dentures. The favoured scheme of marking which provides the most information for the identity of the denture wearer is proposed here.
The canine teeth of the mature ferret have closed apices. They are easily accessible for operating purposes and are sufficiently large, allowing conventional cavity preparation techniques to be prepared using ordinary dental instruments. Handling of the ferret is relatively easy since it becomes quite tame after a period of time. The body weight in male is greater and the teeth larger than those of the female. The cost of purchase and maintenance of the ferret is also inexpensive. For all these reasons, the ferret male is animal of choice in dental experiments.
MeSH terms: Animals; Body Weight; Cuspid; Dental Caries; Dental Cavity Preparation; Dental Instruments; Female; Ferrets; Male
The Combined Cleft Clinic at the University Hospital, Kuala Lumpur was organised in 1992. The team consists of Plastic Surgeon, Orthodontists, Speech therapist, Ear, Nose and Throat Surgeon, Audiologist, medical officers and the nurses. We attend the clinic on a regular basis. Specialists from other medical and dental disciplines as well as the members of the Cleft Lip and Palate Association of Malaysia (CLAPAM) do occasionally participate in this set-up.The team members formulate treatment plans for each cleft patient, monitor the patient's growth and development and manage the patient at different stages according to the individual needs. To date, the idea of team approach and an establishment of a centre towards management of cleft patients seem to be the most ideal as the patients are benefiting total treatment and care from various specialists from only one place. The experience of University Hospital as a centre for cleft patients is discussed.
Side effects such as abrasion of the dental hard tissue have been frequently observed following the extensive use of mechanical cleansing. As promising antiseptics like chlorhexidine produces extrinsic dental staining on long term usage, there has been increasing interest and research generated towards chemically based stain removing agents. This invitro studyexamined whether some commercial oral hygiene products could inhibit chlorhexidine derived stain independent of any mechanical cleansing action. Perspex blocks were soaked in triplicate in chlorhexidine solution for 2 minutesand stain inhibition by these products was determined by further soaking the blocks in productl water slurries for 2 minutes and finally in tea solution for I hourly periods. The optical density (OD) of each specimen was determined at each hourly interval by spectrophotometry at 395 nm and the mean values obtained. At the end of the study, most of the products inhibited stain compared to water control and there was a variation in the stain inhibitingefficacyof the products. It is thus concluded that oral hygiene products like dentifricesand mouthrinses can inhibit chlorhexidine derived extrinsic dental stain to a variable degree through a chemical action by contained ingredients.
The effect of filler content and storage conditions such as drying, storing in water and thermal cycling on linear dimensional changes were investigated and evaluated. The dimensional accuracy studies were performed using a specific designed mould and a coordinate measuring machine. The findings gave support to the view that tiller content is an important factor influencing the physical and mechanical properties of the composite inlay material. The higher tiller content gave less polymerization shrinkage. The greatest linear shrinkage recorded was 0.79 %. The average linear shrinkage (in air, water and thermal cycling) for 79 % filler Prisma AP.H was 0.33 %, for 65 % tiller Prisma AP.H was 0.35 % and for 50 % filler Prisma AP.H was 0.42 %. Generally, dimensional changes was greatest when stored dry. This was followed by materials which were thermal cycled. The least dimensional change recorded was when the materials were stored in water.
In Malaysia the School Dental Service (SDS) provides comprehensive dental treatment with the aim of rendering the child dentally fit before leaving primary school at 12 years. Hence the purpose of this study was to investigate I) the prevalence and treatment needs of traumatised permanent incisors and 2) to assess their relationship to the degree of incisor overjet amongst 12-13 year-old schoolchildren. The sample comprised of 1519 schoolchildren attending 20 secondary government and government-aided schools in Klang district. There were 772 boys and 747 girls. The sampling procedure involved a multistage, clustered and stratified random sampling. The prevalence of traumatic injuries in permanent incisors was 2.6% which confirmed the results of a previous local study. Boys suffered more trauma than girls with a ratio of about 1.5:I. A majority (77.5% ) of the children had one tooth affected. The most commonly affected teeth were the upper central incisors (91.8%) followed by the lower central incisors (4.1%). A high percentage (57.5%) of children with traumatised anterior teeth had increased overjet (>3mm). Almost all cases (93.9%) required two or more surface fillings. However the majority of affected children (56%) were satisfied with their appearance. It is concluded that traumatic dental injuries should be incorporated as part of the treatment plan for the SDS and appropriately managed soon after occurrence or not later than 12 years after which they leave the SDS. Future epidemiological studies should also give due emphasis to the relative importance of traumatised teeth in children.
The diagnosis of oral cancer have been variously reported as being due to delay by clinicians, patients or both. The purpose of this study was to evaluate the referral pattern of 65 patients eventually diagnosed as having oral squamous cell carcinoma. The results showed that 50% of the patients delayed seeking professional help for more than 3 months after being aware of the lesion. The majority of the patients consulted medical practitioners as the first source of help. The mean clinicians' and patients' delay were 10.3 weeks and 28.9 weeks respectively. Dental practitioners showed a tendency to refer on more advanced lesions compared to the medical practitioners. The findings raise the concern that lack of patients' awareness, misdiagnosis by clinicians and late detection by dental practitioners prevail thus calling for urgent measures towards early detection of the disease.
MeSH terms: Carcinoma, Squamous Cell; Dentists; Diagnostic Errors; Humans; Mouth Neoplasms; Referral and Consultation; Early Detection of Cancer
Molecular characterization of a total of 54 isolates of Salmonella typhi from Santiago, Chile, was performed by pulsed-field gel electrophoresis (PFGE) after digestion of chromosomal DNA with three restriction endonucleases: XbaI (5'-TCTAGA-3'), AvrII (5'-CCTAGG-3'), and SpeI (5'-ACTAGT-3'). Thirteen of the 54 isolates were obtained from environmental sources (sewage and river water), and the rest were isolates from clinical cases of typhoid fever. Considerable genetic diversity was detected among the human isolates obtained in 1994, as evidenced by the presence of 14 to 19 different PFGE patterns among 20 human isolates, with F (coefficient of similarity) values ranging from 0.69 to 1.0 (XbaI), 0.61 to 1.0 (AvrII), and 0.70 to 1.0 (SpeI). A total of eight phage types were detected among these 20 isolates, with 50% possessing the E1 or 46 phage type. There was no correlation between PFGE pattern and phage types. Similar diversity was seen among 21 isolates obtained in 1983, with 17 to 19 PFGE patterns detected and F values of 0.56 to 1.0 (XbaI), 0.55 to 1.0 (AvrII), and 0.67 to 1.0 (SpeI). Comparison of these two groups of human isolates obtained 11 years apart indicated that certain molecular types of S. typhi are shared and are able to persist for considerable periods. A similar degree of genetic diversity was also detected among the environmental isolates of S. typhi, for which 10 to 12 different PFGE patterns were detected among the 13 isolates analyzed, with F values ranging from 0.56 to 1.0 (XbaI), 0.52 to 1.0 (AvrII), and 0.69 to 1.0 (SpeI). Certain molecular types present among the environmental isolates of S. typhi were also found among the human isolates from the same time period, providing evidence for the epidemiological link between environmental reservoirs and human infection.
The organism designated the SF agent was originally isolated in Japan in 1962 from Stellantchasmus falcatus metacercaria parasitic on gray mullet fish. The SF agent resembles members of the genus Ehrlichia morphologically and exhibits weak antigenic cross-reactivity with Ehrlichia sennetsu. This organism causes mild clinical signs in dogs, but severe splenomegaly and lymphadenopathy in mice. This suggests that the SF agent may be similar to either Neorickettsia helminthoeca, an intracellular parasite of a fluke and the cause of salmon poisoning disease in dogs, or E. sennetsu, the causative agent of human sennetsu ehrlichiosis in Japan and Malaysia. In order to determine the phylogenetic relationship between the SF agent and other ehrlichial species, the 16S rRNA gene was amplified by the PCR and sequenced. The SF agent sequence was most closely related to the sequences of Ehrlichia risticii (level of sequence similarity, 99.1%), the causative agent of Potomac horse fever, and E. sennetsu (level of sequence similarity, 98.7%). The next most similar sequence was that of N. helminthoeca, but the level of sequence similarity was only 93.7%. E. sennetsu, E. risticii, the SF agent, and N. helminthoeca formed a distinct cluster that was separated from all other ehrlichial species. As determined by immunofluorescence labeling, antiserum against the SF agent cross-reacted strongly with E. sennetsu, E. risticii, and N. helminthoeca. When three genetically distinct ehrlichial isolates obtained from horses with Potomac horse fever were compared with the SF agent, we found that the SF agent was most closely related to Ohio isolate 081, followed by IllinoisT (T = type strain) and a Kentucky isolate. We observed strong antigenic cross-reactivities and similarities in Western blot (immunoblot) reaction profiles when we compared the SF agent, E. risticii, and E. sennetsu; however, weaker antigenic cross-reactivity was observed when the SF agent and N. helminthoeca were compared. Our results indicate that the SF agent is antigenically more closely related to E. risticii and E. sennetsu than to N. helminthoeca. The biological and antigenic characteristics and the 16S rRNA sequence data suggest that the SF agent is a new species that belongs to the genus Ehrlichia.
Three peak flow meters (PFM), Wright's, Miniwright's II (MPFM), and Pocket, were evaluated in 50 children in a pediatric outpatient clinic. It was found that there was close agreement between the Pocket and the MPFM as shown by an intraclass correlation (rho) of 0.95. Less agreement was noted between the MPFM and the Pocket, respectively, with the Wright's. It was also noted that the coefficient of correlation (r) was not a suitable test for agreement in this study. Both the Pocket and the MPFM also read higher than the Wright's. We conclude that children should be monitored using the same type of peak flow meter.
Study site: Pediatric clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Two types of palm oil and sal fat based cocoa butter equivalents, namely fCBE (produced by using co-fractionation method) and mCBE (produced by using conventional method) were prepared. Results showed that the fCBE had triglyceride composition and solidification characteristics closer to the Malaysian cocoa butter than the mCBE produced at the same yield percentage. Increasing acetone washing time had little effect on the fCBE if compared to the effect of increasing palm olein to sal fat blend ratio. Co-fractionation technique increase the compatibility between CBE component triglycerides. Thus, more palm oil can be incorporated in the preparation and the process can be carried out at not low temperature as compared to the conventional method.
Palm oil (PO ; iodin value = 52), palm stearin (POs1; i.v. = 32 and POs2; i.v. = 40) and palm kernel oil (PKO; i.v. = 17) were blended in ternary systems. The blends were then studied for their physical properties such as melting point (m.p.), solid fat content (SFC), and cooling curve. Results showed that palm stearin increased the blends melting point while palm kernel oil reduced it. To produce table margarine with melting point (m.p.) below 40 degrees C, the POs1 should be added at level of < or = 16%, while POs2 at level of < or = 20%. At 10 degrees C, eutectic interaction occur between PO and PKO which reach their maximum at about 60:40 blending ratio. Within the eutectic region, to maintain the SFC at 10 degrees C to be < or = 50%, POs1 may be added at level of < or = 7%, while POs2 at level of < or = 12%. The addition of palm stearin increased the blends solidification Tmin and Tmax values, while PKO reduced them. Blends which contained high amount of palm stearin showed melting point and cooling curves quite similar to that of pastry margarine.
A method for determining shell in palm kernel cake (PKC) is described. This simple and rapid method requires little pretreatment compared with the method currently used in PKC trade, in which the sample undergoes defatting, acid and alkali digestion, and washing, before a chloroform-alcohol solution is used to separate the shells. In the proposed method, only defatting the sample is required. The shells are separated by the density difference between the shell and PKC in a potassium iodide solution. Recoveries of at least 93% were obtained, and the correlation coefficient between the actual shell content and the determined shell content was 0.999, with gradients of 0.97 and 0.98 for fine and coarse shell, respectively.