The aim was to study the prevalence and sociodemographic features of odontogenic, non-odontogenic and salivary glands lesions among patients seen in Hospital Universiti Sains Malaysia. This information is essential to assist clinician in formulating reliable differential diagnosis of such lesion. Data on patient demographics, lesion location, tissue of origin and microscopic diagnosis were extracted from the Laboratory and Diagnosis record registries for biopsy specimen accessioned from year 2000 to 2012. This data was subsequently analyzed based on World Health Organization Classification of Head and Neck Tumours (2005). A total of 748 cases were included in the study. Out of the total number of cases, 367 cases were males and 377 cases were females. Ninety seven cases (13%) were of odontogenic origin, while 90 cases (12%) and 197 cases (26%) were of non-odontogenic and salivary gland origin respectively. Forty five percent of cases involved oral mucosal lesions. The most prevalent odontogenic lesion reported within the twelve years period was radicular cyst and ameloblastoma. Non-odontogenic bone lesion was rarely encountered with it making up less than two percent of total cases reported. Pleomorphic adenoma was the most prevalent benign salivary glands neoplasm reported within similar time period.
The objective of this survey was to evaluate the knowledge of final year dental and medical students of Universiti Sains Malaysia concerning epidemiology, aetiology, clinical aspects, prevention, early detection and treatment of oral cancer and oral potentially malignant disorders (OPMD). A pre-tested, self-administered questionnaire with 36 questions was used. Forty five dental students and 147 medical students participated in the study. Dental students were relatively better informed than their medical colleagues concerning most issues addressed in the questionnaire. Yet, in some areas of knowledge, the dental students did not differ significantly from their medical colleagues. Only a small proportion of both groups of students expressed confidence in their knowledge and skills in oral cancer prevention and detection. This study revealed areas of deficiency in the awareness of these students concerning oral cancer and OPMD. It points to a necessity to strengthen these aspects of medical and dental undergraduate curricula.
MeSH terms: Awareness; Curriculum; Malaysia; Mouth Neoplasms; Surveys and Questionnaires; Students, Dental; Students, Medical; Knowledge; Early Detection of Cancer
Rubinstein-Taybi syndrome is a multiple anomalies congenital disorder characterised by broad thumb and halluces, facial dysmorphism with mental and growth retardation. Oral features include small mouth, retro and micronagthic jaws, highly arched and narrow palate. Dental anomalies such as teeth with talon cusps and screwdriver shaped permanent incisors together with crowded teeth are common features in these patients. Although hyperdontia is said to be one of the features of this condition, nevertheless, presence of multiple supernumerary teeth has never been documented. This report highlighted a case of an eleven-year-old boy with Rubinstein-Taybi syndrome referred for unerupted permanent incisors who exhibited multiple supernumerary teeth radiographically.
Paediatric facial traumas are often accompanied by other intracranial and non-head injuries. Use of
Computed Tomography (CT) has increased diagnostic accuracy when compared to plain radiographs alone. Coexisting anomalies can sometimes be a chance finding from the imagings and this highlights the need of a formalreporting by a radiologist. We report a case of a traumatic unilateral condylar fracture with a coexisting life-threatening abnormality detected from careful assessment of the imagings.
In the present case, granuloma formation and loss of tooth vitality following the use of bone wax in third molar surgery in a 16 - year- old male patient were reported. Endodontic and surgical treatments were carried out on the patient. As foreign body granulomatous reaction to bone wax is not uncommon in the literature review, alternative haemostatic agents should be taken into consideration to avoid any potential complications and untoward effects of using bone wax for haemorrhage control in surgical procedures.
his study assesses inter-examiner reproducibility in recording various malocclusion parameters and Index of Orthodontic Treatment Need (IOTN) grade during patient examination by utilising the kappa statistic. Five previously calibrated orthodontists clinically examined 233 non-orthodontically treated schoolchildren aged 14-17 years for recording various malocclusion parameters. The examination was repeated twice, thirty days apart and precluded the use of study-models or radiographs. Although good inter-examiner reproducibility was observed in recording incisor class, IOTN dental health grade, type of posterior crossbite, and excellent for parameters with absolute criteria like
erupted supernumeraries, etc, substantial examiner variation resulted in only fair reproducibility for recording IOTN esthetic category, canine class, overbite category, traumatic overbite and upper centre-line shift of two millimetres or more from the facial midline. Reproducibility for detecting occlusal displacement in the presence of crossbite was poor, and kappa statistic was incalculable for recording openbite and number of upper incisors rotated 30° or more. Kappa was also incalculable for recording IOTN dental health subcategory due to the creation of asymmetric tables caused by rarely chosen subcategory options. Despite prior agreement between previously calibrated examiners on evaluation criteria, detection of certain malocclusion parameters during an epidemiological examination can prove to be challenging. Epidemiological studies that report on prevalence of malocclusion in the population should always report on the kappa reproducibility, especially if the study is carried out by multiple examiners.
MeSH terms: Orthodontists; Esthetics; Humans; Incisor; Malocclusion; Oral Health; Tooth Eruption; Reproducibility of Results; Prevalence; Epidemiologic Studies; Open Bite; Overbite; Index of Orthodontic Treatment Need
Some of the beneficial bio compatible properties of hydroxyapatite [Ca10(PO4)6(OH)2]; the major componentand an essential ingredient of normal bone and teeth, are that it is rapidly integrated into the human body and will bondto bone forming in distinguishable unions. But, before new materials are approved for medical use, mutagenesis systems to exclude cytotoxic, mutagenic or carcinogenic properties are applied worldwide. This study aimed to detectany chromosomal aberrations induced by the synthetic hydroxyapatite granules [Manufactured by Universiti Sains
Malaysia, (USM) Penang, Malaysia] in the bone marrow cells of mice. The mitotic indices of the groups treated with synthetic hydroxya patite granules did not show any significant difference as compared to the negative control group treated with distilled water. Also the groups of mice treated with synthetic hydroxyapatite granules and distilled waterdid not induce significant change in chromosome aberrations as compared to the positive control group treated with Mitomycin C. The mitotic indices and chromosomal analyses indicate that under the present test conditions, synthetichydroxya patite granules (manufactured by USM) are non cytotoxic and do not induce chromosome aberrations in the bone marrow cells of mice.
MeSH terms: Animals; Bone and Bones; Bone Marrow Cells; Carcinogens; Chromosome Aberrations; Humans; Malaysia; Mitotic Index; Mutagens; Mutagenesis; Mitomycin; Durapatite; Human Body; Chromosome Disorders; Control Groups; Mice
Orogastric lavage has been performed since 200 years ago for intoxicated patients. Due to the risk that outweighs benefits it has fallen out of favour for the last decade. A teenage girl presented to Emergency Department with history of ingestion of a bottle of pesticide within the time frame before gastric emptying. The girl was resuscitated, intubated and orogastric lavage was performed. Fifty cc of the toxic substance was siphoned and antidote of the toxin was administered. She was admitted to the Intensive Care Unit, subsequently recovered and discharge five days later. Definitive airway management, proper technique, correct selection of patients and adequate monitoring are paramount to the success of orogastric lavage.
The diagnosis of aortic dissection in a young adult in the absence of atherosclerosis or prior history of trauma is extremely rare. The presence of more than one arterial dissection site in such a patient is even more unheard of. We highlight a case of spontaneous multiple acute arterial dissections occurring in a 32-year-old male. Stanford B aortic dissection and a separate dissection extending from the bifurcation of the right common iliac artery to the right common femoral artery was noted on computed tomographic angiography (CTA). A small aneurysm of the right subclavian artery was also noted. A two-stage hybrid procedure involving a combination of open and endovascular surgery was employed. The rarity and lethality of this condition warrants a high index of suspicion for early diagnosis and prompt intervention.
This case report emphasizes the role of Assertive Community Treatment (ACT) in managing a family with four members suffering from mental illness, mainly schizophrenia. We report a case of middle-aged lady who was diagnosed with treatment resistant schizophrenia (TRS) living with two other family members with the same illness and their carer who developed major depression from shouldering the burden of caring for mentally ill family members. ACT, through its holistic approach, proved to have reduced hospitalizations and improve symptom control and quality of life in this family.
MeSH terms: Community Mental Health Services; Depressive Disorder, Major; Empathy; Family; Hospitalization; Humans; Middle Aged; Quality of Life; Schizophrenia; Caregivers; Mentally Ill Persons
Retinopathy of prematurity (ROP) is a disorder describing an immature vascularisation
of a developing retina in low birth weight preterm infants. This condition potentially
leads to blindness. ROP developed as a response of hypoxia of the eye due to
incomplete development of the retinal vessels. ROP is commonly reported as
bilateral disease,a small percentage of infants have asymmetrical changes. We
report a case of long-term outcome of a asymmetry ROP changes with peripheral
retinal ablation in a single eye. This particular case demonstrates the possible longterm
outcome of unilaterally treated ROP which could either be due to the severity
of the disease itself or the treatment she received. It is important to highlight the
possibility of unequal development of the eye in asymmetrical presentation of ROP.
Sepsis causes high mortality and morbidity. Static lactate concentration and early lactate clearance are cited to be a predictor for sepsis survival. This study examined the clinical utility of static lactate concentration and early lactate clearance within the first six hours of admission in Emergency Department (ED) to predict 28-day mortality rate in sepsis patients. Patients who presented with sepsis, severe sepsis or septic shock and admitted to ED of Universiti Kebangsaan Malaysia Medical Centre were recruited. Blood lactate concentrations were measured upon admission (H0), at 1st hour (H1) and 6th hour (H6), respectively. Either standard treatment of sepsis or early goal directed therapy was initiated according to sepsis severity. A follow-up report was conducted at 28 days via telephone call, e-mail or case notes. Patients were later classified into survivor and non-survivor as final outcome. Static lactate concentration appeared to be significantly higher for non-survivor as compared to the survival group at H0, H1 and H6 (p
The present study is to determine the level of depression, anxiety and stress among Universiti Kebangsaan Malaysia (UKM) clinical year medical students and their help seeking behaviour in relation to their psychological aspect. A cross-sectional study was conducted in UKM Medical Centre for three months duration. The study population was the third, fourth and fifth year medical students via proportional sampling. They were given questionnaires consisting of socio-demographic items, Depression, Anxiety and Stress Scale 21 – Bahasa Malaysia version BM-DASS21 and questions regarding help-seeking behaviors. Psychometric assessment (BMDASS21) estimated the level of depression, anxiety and stress among medical students. Help-seeking behavior questions assessed the use of medical facilities and other help-seeking sources. Regarding questions on the barriers towards seeking help from the primary health-care, three parts were evaluated: structural barriers, barriers towards perceptions on mental-health disorder and barriers towards use of primary health-care services. There were 380 medical students who were involved in this research. It was found that some students experienced depression (1.3%), anxiety (2.4%) and stress (2.4%). Majority of them preferred to seek help from friends (283; 74.5%) followed by parents (275; 72.4%). There was a significant association between students who were anxious and help seeking behaviour from formal sources: counselor (p=0.001) and religious personnel (p=0.03). Hence, it is essential to increase their awareness on psychological disorders and more efficient screening programme should be used to recognize medical students with possible emotional disorders.
Chronic obstructive pulmonary disease (COPD) patients are reported to have cardiovascular instability which leads to greater limitation for activities there by leads to poor quality of life. Physical training proved to be one of the moderators of these limitations. However, uncertainty prevails among the protocol and duration. The present study investigated the effect of physical training on blood pressure, heart rate and Rate pressure Product (RPP) among COPD patients. A total of thirty COPD patients aged between 40 to 55 years were recruited for the study based on the inclusion and exclusion criteria and were assigned in to experimental group (15 patients) and control group (15 patients). The mean difference of blood pressure, heart rate and RPP were analyzed using paired t-test. There was significant difference between the pre and post test values of all parameters between experimental and control group with p< 0.05. Diastolic blood pressure showed to be less significant compared to the systolic blood pressure. This showed that specifically designed physical improved the cardiovascular fitness among COPD patients.
MeSH terms: Blood Pressure; Heart Rate; Humans; Malaysia; Quality of Life; Exercise; Pulmonary Disease, Chronic Obstructive; Control Groups
Breast augmentation using silicone implant is a common and popular aesthetic procedure with a high safety profile. Infection of silicone breast implants is a rare clinical entity, with skin commensal organisms often implicated as causative pathogen. Surgical treatment often involves removal of the implant with salvage procedures limited to selected cases. This case highlights a delayed presentation of an infected silicone breast implant presenting as a chest wall abscess 15 years after initial surgery.
MeSH terms: Abscess; Esthetics; Silicones; Mammaplasty; Breast Implants; Thoracic Wall
Trophic ulcers have emerged as one of the major complications following diabetes mellitus (DM) and Hansen’s diseases (HD). In this case series, the study attempted total contact plaster boot using a readily available plaster of Paris to treat trophic ulcer for 10 subjects. A total of five subjects with DM and five subjects with HD were included based on the study criteria. Pre and post test measure of wound measurement size following total contact plaster boot were taken as an outcome measure. All ten subjects showed decrease in size of wound following fifteen days of treatment. No adverse effects were associated with this type of treatment. Subjects with trophic ulcer may benefit from the application of total contact plaster boot.
Cerebral palsy is a common cause of childhood disability. It has a great impact on parents and caregivers, especially when it reoccurs in the same family. Although familial cerebral palsy is relatively uncommon, cases have been reported among children from consanguineous, non-consanguineous marriages and multiple pregnancies suggesting a possible complex genetic mode of inheritance. Physicians need to be aware of the possibility of familial cerebral palsy for early detection and counseling. We describe a rare case of two male siblings from a non-consanguineous marriage affected by cerebral palsy.
The primary objective of the present study was to investigate the impact of sociodemographic factors on smoking and alcohol consumption among adults in Penang (Malaysia). A cross-sectional primary survey data with 398 respondents was used for analysis. The present study applied logistic regression models to examine the factors affecting the odds of smoking and alcohol consumption. The results showed that gender, ethnicity and education could significantly affect smoking. In particular, males (OR: 26.678) had a higher likelihood of smoking compared to the females, whereas Chinese (OR: 0.177), Indians/others (OR: 0.331) and individuals with tertiary education (OR: 0.258) had a lower likelihood of smoking than others. In terms of alcohol, gender, ethnicity and marital status were found to have a significant influence on the likelihood of alcohol consumption. Specifically, males (OR: 5.051), Chinese (OR: 37.796) and Indians/others (OR: 10.863) were more likely to consume alcohol than others, while married individuals (OR: 0.380) were less likely to consume alcohol than unmarried individuals. Based on the findings of the present study, numerous population-based intervention measures were suggested.
MeSH terms: Adult; Alcohol Drinking; Ethanol; Cross-Sectional Studies; Female; Humans; Malaysia; Male; Surveys and Questionnaires; Single Person; Smoking; Logistic Models; Marital Status
Sexual dysfunction is highly prevalent in gynaecological cancer patients. Most of the time, sexual dysfunction in gynaecological cancer is underdiagnosed as there is overlapping of symptoms with other psychological morbidities, interplaying of multiple risks, patients’ reluctance to complain or incompetence of health care provider to assess. Determining the risk factors of sexual dysfunction in cancer patients enables us to pay more attention to those who are vulnerable and to device strategies for early detection, prevention and treatment of sexual dysfunction in them. The main aim of the study was to determine the prevalence of sexual dysfunction and its risk factors in gynaecological cancer patients in Hospital Sultanah Bahiyah, Alor Star, Malaysia. Sexual function of eighty-three gynaecological cancer patients who were married were assessed with self-rated MVFSFI (Malay version Female Sexual Function Index). Self-rated WHOQOL-BREF (World Health Organization- Quality of Life- 26) which assessed the domains of quality of life was used while MINI (Mini International Neuropsychiatry Interview) was used for diagnosis of major depressive disorder. The prevalence of sexual dysfunction among the married gynaecological cancer patients was 65% (54/83). Sexual dysfunction was significantly associated with low education level (OR 3.055, CI 1.009-9.250), shorter duration of cancer (OR 0.966, CI 0.966- 0.998), ongoing chemotherapy (OR 3.045, CI 1.149-8.067), pain perception (OR 3.230, CI 1.257-8.303), absence of sexual intercourse for more than one month (OR 1.862) and three domains of quality of life such as physical health, psychological health and social relationship (OR 0.942, CI 0.908-0.978; OR 0.955, CI 0.916-0.995; OR 0.933, CI 0.894-0.973, respectively). However, sexual dysfunction was not associated with major depressive disorder (χ2 ² = 1.224, p = 0.268). The prevalence of sexual dysfunction in gynaecological cancer patients was comparable to other studies of similar population. Since, the risk factors of sexual dysfunction in gynaecological cancer patients are multidimensional, the process of assessment and management need to be holistic and patient-oriented.
MeSH terms: Attention; Coitus; Depressive Disorder, Major; Female; Health Personnel; Humans; Malaysia; Marriage; Mental Health; Morbidity; Neoplasms; Quality of Life; Risk Factors; Prevalence; Early Detection of Cancer; Neuropsychiatry; Pain Perception
Thalassaemia screening programme has been conducted in Malaysia since 2004. The aim of the programme was to reduce the burden of the disease by identifying thalassaemia carriers. However, the response towards the screening activities was unsatisfactory as there was lack of public awareness against the importance of thalassaemia screening. An alternative approach is to screen blood donors. The purpose of this study was to observe the prevalence of thalassaemia carriers among healthy blood donors. Seven hundred and thirty eight healthy blood donors were screened in Hospital Tengku Ampuan Rahimah, Klang from July to September 2010 using cation-exchange high performance liquid chromatography (HPLC). Cases with haemoglobin variants were further analyzed by gel electrophoresis at alkaline pH. Result shows that the blood donors consisted of 413 Malays (56%), 162 Indians (22%), 148 Chinese (20%) and 15 others (2%). There were 19 (2.6%) individuals with haemoglobin E trait, six (0.8%) with co-inheritance of haemoglobin E and αα- thalassaemia and five (0.7%) with β-thalassaemia trait. Haemoglobin Constant Spring and haemoglobin A2 prime were observed in two (0.3%); and Haemoglobin Lepore and alpha chain variant in one (0.2%). αα-thalassaemia and normal haemoglobin A2 β-thalassaemia could not be excluded in 190 cases (26%), as they required deoxyribonucleic acid (DNA) studies for identification. Thalassaemia screening in blood donors is more feasible and effective. Therefore, a wider scale population screening including blood donors could benefit the existing thalassaemia screening programme in Malaysia.