This article describes the psychological assessment and management for trauma survivors. An appropriate assessment is essential to ensure that psychotherapy, behavioural treatment and support networks are sufficient for the trauma survivor’s long-term needs or until the individual is capable of functioning normally. In line with the mission of the American Psychological Association (APA) Division 56 (Trauma Psychology), this article suggests practical guidelines for psychologists, counselors and social health workers. Issues discussed include definition of trauma, post-incident symptoms and trauma recovery. Among the types of trauma examined were cancer, sudden death, sexual abuse and AIDS. A working model to initiate assessment was presented together with projected treatment modalities. Additionally, this article also incorporates knowledge on professional and public education about dissociation, trauma and trauma related disorders besides strengthening knowledge about trauma, dissociation and disorders related to chronic trauma. This article also supports communication and cooperation among clinicians and other professionals in the field of dissociation and trauma as well as stimulating national and international research projects. Different individuals react differently to a similar event. A person may experience trauma as a reaction to the event while another person may not. Not all individuals who experience a potentially traumatic event will be psychologically traumatised.
Keywords: Psychological assessment; trauma recovery; trauma survivors
“Following the child’s lead” and “collaborative consultation with parents” are solidly grounded in the best practice of
early language intervention. However, the success of these two practices are based on assumptions that they are valued by
families and that they can be feasibly implemented by the attending speech-language pathologist (SLP). Such assumptions
can be unjustified in cultures that value the use of “adult-guided instructions” over following the child’s lead and when
the work setting of the SLP does not readily accommodate those practices. This article takes the form of a position paper.
Through review of the literature, the paper (1) identifies the research-cultural practice gap in early language intervention
in Malaysia; (2) positions the two research-informed practices – following the child’s lead and collaborative consultation
with parents, on the continuum of intrusiveness in early language intervention; and (3) proposes the techniques of Milieu
Teaching as an approach to bridge the research-cultural practice gap in Malaysia.
MeSH terms: Adult; Child; Cooperative Behavior; Family; Humans; Language; Malaysia; Parents; Referral and Consultation; Speech; Early Intervention (Education)
The aim of this review was to systematically explore the underlying musculoskeletal biomechanical mechanisms of carrying and to describe its potential relationship with low back pain. This literature review was carried out using AMED, CINAHL, Compendex and MEDLINE electronic databases. Articles published from 2004 to 2012 were selected for consideration. Articles were considered if at least one measurement of kinetics, kinematics or other related musculoskeletal parameters related to biomechanics were included within the study. After combining the main keywords, 677 papers were identified. However, only 10 studies met all the inclusion criteria. Age, body mass index, gender and level of physical activity were identified as the factors that may influence the biomechanics of carrying activity. Carrying a loaded backpack was reported leading to posterior pelvic tilt, reduced lumbar lordosis, but increased cervical lordosis, thoracic kyphosis and trunk forward lean. Furthermore, while carrying bilaterally, lumbo-pelvic coordination was also reported to be more in-phase, as well as reduced coordination variability in transverse plane. Future studies investigating the biomechanics of a standardized carrying activity for clinical test are recommended.
MeSH terms: Biomechanical Phenomena; Humans; Kinetics; Motor Activity; Body Mass Index; Review; Low Back Pain
Obesity is a growing epidemic due to an accelerated phase of industrialization and urbanization with the overfed people
now outnumbered the underfed. It is the major public health problem with a lot of research interest as it is associated
with many complicated chronic disorders such as type-2 diabetes, cardiovascular diseases (CVD) and cancers. A global
estimation of 2.8 million deaths per year is due to obesity and there are tremendous on-going efforts to identify hosts
and environmental factors that infl uence the cause and pathogenesis of obesity. Concerted efforts from different research
groups had successfully shown that obese subjects have altered composition of gut microbiota and transplantation of this
microbiota infl uences body weight in the germ-free recipient mice. The advancement of technology had made possible
the study of gut microbiota which was unculturable for better understanding of their impact to human health. Rapid
deep sequencing of DNA at reasonable cost through various options of platforms followed by data analysis using robust
bioinformatic tools are an important way of analysing the gut microbiome. Here we review the role of gut microbiota
which modulates host’s metabolic functions and gene expression, facilitating the extraction and storage of energy from the
ingested dietary substances and leading to body-weight gain. We will discuss on the different techniques used, focusing
on the high-defi nition technologies for the determination of the composition, function and ecology of gut microbiota. This
allows the appropriate selection of platform which becomes the key for success of subsequent research.
Alpinia conchigera (lengkuas kecil) merupakan sejenis tumbuhan herba yang sering digunakan sebagai rawatan alternatif
dalam bidang perubatan tradisional. Kajian ini dijalankan untuk menilai kesan sitotoksik, genotoksik serta mod kematian
sel yang disebabkan oleh ekstrak heksana A. conchigera ke atas sel hepar Chang. Asai MTT selama 24 jam telah dijalankan
untuk mengenal pasti peratus viabiliti sel hepar Chang setelah dirawat dengan ekstrak heksana A. conchigera. Keputusan
menunjukkan terdapat penurunan viabiliti sel secara signifi kan (p < 0.05) dengan nilai IC50 (8.6 μg/ml) berbanding kawalan
negatif. Berdasarkan nilai IC50 ini, pewarnaan AO/PI dilakukan untuk menentukan mod kematian sel hepar Chang iaitu sama
ada secara apoptosis atau nekrosis. Didapati bahawa terdapat perbezaan secara signifi kan (p < 0.05) bagi mod kematian
sel hepar Chang secara apoptosis berbanding kawalan negatif. Dalam kajian ini, penentuan tahap kerosakan DNA sel
hepar Chang turut dilakukan dengan menggunakan asai komet beralkali dengan nilai IC10 dan IC25 yang diperoleh daripada
asai MTT (4 μg/ml dan 6 μg/ml) masing-masing. Setelah sel hepar Chang dirawat dengan ekstrak heksana A. conchigera
selama 2 jam, didapati terdapat perbezaan secara signifi kan (p < 0.05) bagi peratus kerosakan DNA bagi kumpulan rawatan
berbanding kawalan negatif. Kesimpulannya, ekstrak heksana A. conchigera memberi kesan sitotoksik dan genotoksik
terhadap sel hepar Chang serta menyebabkan kematian sel secara apoptosis.
Ocular abnormalities have apparent effects on brain activation. However, neuroimaging data about the ocular characteristics of healthy participants are still lacking to be compared with data for patients with ocular pathology. The objective of this multiple participants’ functional magnetic resonance imaging (fMRI) studies was to investigate the brain activation characteristics of healthy participants when they view stimuli of various shapes, pattern and size. During the fMRI scans, the participants view the growing ring, rotating wedge, flipping hour glass/bow tie, quadrant arc and full checker board stimuli. All stimuli have elements of black-and-white checkerboard pattern. Statistical parametric mapping (SPM) was used in generating brain activation via fixed-effects (FFX) and conjunction analyses. The stimuli of various shapes, pattern and size produce different brain activation with more activation concentrated in the left hemisphere. These results are supported by the conjunction analysis which indicated that the left pre-central, post-central, superior temporal and occipital gyrus as well as the left cingulate cortices were involved when the participants viewed each given stimulus. Differential activation analysis showed activation with high specificity in the occipital region due to the stimuli of various shapes, pattern and size. The activation in the right middle temporal gyrus was found to be significantly higher in response to moving stimuli as compared to stationary stimuli. This confi rms the involvement of the right middle temporal gyrus in the observation of movements. The black-and-white checkerboard stimuli of various shapes, pattern and size, stationary and moving was found to 1) activate visual as well as other cortices in temporal and parietal lobes, 2) cause asymmetry in brain function and 3) exhibit functional integration characteristics in several brain areas.
Keywords: fMRI; SPM; visual stimulus; occipital gyrus; middle temporal gyrus
MeSH terms: Magnetic Resonance Imaging; Biological Processes; Physiological Processes
Ujian teks bacaan Bahasa Melayu telah dibangunkan untuk menilai prestasi membaca kanak-kanak sekolah rendah.
Seramai 120 pelajar Tahap 1 (purata umur 8.5 ± 0.5 tahun) dan Tahap 2 (purata umur 10.5 ± 0.5 tahun) berpenglihatan
normal telah dipilih secara rawak. Subjek diminta membaca lima teks bacaan secara rawak dengan kuat. Masa selesai
membaca setiap teks bacaan diukur dan sebarang kesalahan menyebut perkataan direkodkan. Purata kelajuan membaca
dan kadar membaca diukur sebagai perkataan per minit (ppm). Kelajuan membaca Tahap 1 adalah 88.81 ± 1.95 {ralat
piawai (RP)} ppm dan kadar membaca pula adalah 87.20 ± 1.98 (RP) ppm. Bagi Tahap 2, kelajuan membaca adalah
108.12 ± 1.66 (RP) ppm manakala kadar membaca adalah 107.22 ± 1.67 (RP) ppm. Kelajuan dan kadar membaca di
antara subjek bagi setiap teks bacaan menunjukkan tiada perbezaan yang signifi kan (p > 0.05) dengan nilai p bagi
kedua-duanya adalah 0.91 manakala bagi tahap 2 pula nilai p adalah 0.57. Perbandingan di antara teks bacaan juga
menunjukkan tiada perbezaan yang signifi kan (p > 0.05). Semua teks bacaan adalah homogen secara statistik maka teks
bacaan yang dibangunkan boleh dipilih secara rawak semasa ujian dan tidak akan memberi kesan kepada penilaian
prestasi membaca di kalangan kanak-kanak sekolah rendah.
The fi rst part of this study was about measurement of dosimetric parameters for small photon beams to be used as input
data for treatment planning computer system (TPS) and to verify the dose calculated by TPS in Stereotactic Radiosurgery
(SRS) procedure. The beam data required were percentage depth dose (PDD), off-axis ratio (OAR) and scattering factor.
Small beams of 5 mm to 45 mm diameter from a circular cone collimator in SRS were used for beam data measurements.
Measurements were made using pinpoint ionisation chamber (0.016cc). In the second part of this study, we reported
the important of carrying out quality assurance (QA) procedures before SRS treatment which were found to infl uence the
accuracy of dose delivery. These QA procedures consisted of measurements on the accuracy in target localization and
treatment room laser alignment. The calculated TPS dose for treatment was verifi ed using pinpoint ionisation chamber
and thermoluminescent detector (TLD) 100H. The deviation mean between measured and calculated dose was -3.28%.
The measured dose obtained from pinpoint ionisation chamber is in good agreement with the calculated dose from TPS
with deviation mean of 2.17%. In conclusion, pinpoint ionisation chamber gives a better accuracy in dose calculation
compared to TLD 100H. The results are acceptable as recommended by International Commission on Radiation Units
and Measurements (ICRU) Report No. 50 (1994) that dose delivered to the target volume must be within ± 5% error.
Diabetes mellitus (DM) is a metabolic disease which is characterized by hyperglycemia. There is either disturbance in insulin secretion or defective insulin action or even a combination of both. Usually, there are few confounding factors like genetic, obesity, sedentary life style, atherosclerosis, and even faulty dietary habits which lead or aggravate DM. Usually, the individual does not care and often the complications resulting from hyperglycaemia are fatal. Complications in DM involve the cardiovascular, musculoskeletal, endocrine, renal and neurological systems in the body. Treatment of diabetic complications is not only costly but it is also a burden on the affected families. The present review discusses the challenges faced in DM with special concern on diet and food habits. Knowledge of proper food consumption may also help an individual combat complication in DM and reduce the mortality and morbidity.
Keywords: Diabetes mellitus; complications; food; habits; mortality; morbidity
MeSH terms: Diabetes Mellitus, Type 1; Diet; Insulin
Many studies have shown that probiotic strains added to a number of probiotic products are not compatible to that of
claimed. It is thus of note to validate probiotic strains added to probiotic products. In this study, three probiotic drinks,
A, B and C, were cultured on MRS agar and the number of bacterial colonies was enumerated. The bacterial counts
recovered from A (9.3 ± 6.9 log CFU/ml) and C (9.0 ± 6.9 log CFU/ml) were signifi cantly higher than B (5.2 ± 3.5 log
CFU/ml) and achieved the minimal amount recommended for probiotic bacteria. All of the isolates appeared as gram
positive rods microscopically and were proven to be catalase negative. However, there were only A1, A2, B4 and C1 that
were highly tolerant to the gastrointestinal pH 3 to 6. The four isolates produced and secreted antimicrobial substances
which inhibited the growth of Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus). C1 showed the greatest
growth inhibition by forming 17.50-mm and 17.85-mm inhibition zones against E. coli and S. aureus, respectively. The
16s rDNA sequencing and phylogenetic analysis were performed to further identify the twelve isolates. The twelve isolates
were found to be Lactobacillus (L.), particularly L. casei and L. paracasei. However, the bacteria isolated from drink B
were incompatible to the labelled ones. In conclusion, probiotic drinks are possible to contain different bacterial counts
and probiotic strains from the labelled ones. These differences might affect health benefi ts rendered by probiotic strains
to consumers.
Bawang merah merupakan tumbuhan yang mengandungi pelbagai khasiat dan telah dijadikan sebagai makanan dan
ubatan sejak dahulu lagi oleh pelbagai kaum dan bangsa. Kajian ini dilakukan bagi mengenal pasti khasiat bawang
merah terhadap tubuh manusia dari perspektif sarjana-sarjana perubatan Islam dan kajian-kajian saintifi k. Data-data
literatur telah dikumpulkan dari empat buah buku perubatan Islam dan 14 artikel daripada pelbagai jurnal berkaitan.
Data terkumpul dianalisis menggunakan Nvivo10.0 bagi membentuk kategori bersesuaian seterusnya menghasilkan
dapatan kajian. Hasil kajian menunjukkan terdapat sekurang-kurangnya 17 khasiat bawang merah yang merangkumi
enam khasiat dari perspektif sarjana perubatan Islam seperti merawat penyakit mata sentiasa berair, merawat masalah
dalam telinga, merawat jangkitan dari gigitan anjing, meneutralkan racun, merangsang syahwat dan merawat penyakit
akibat air tercemar. Manakala 11 manfaat lagi dikenal pasti daripada kajian-kajian saintifi k seperti ia merupakan agen
antiplatelet, agen anti-pembentukan lemak, agen antioksidan, agen antitrombotik, agen antikarsinogen, agen antidepresen/
antimurung, agen antiinfl amasi, agen antiasma, agen antibiotik, menurunkan tahap hiperglisemia dan mengurangkan
risiko penyakit aterosklerosis. Justeru kajian ini mencadangkan agar bawang merah diketengahkan sebagai salah satu
rawatan organik serta alternatif kepada rawatan konvensional sedia ada.
Identifi cation of unknown suspect through bite marks has always been challenging. Narrowing list of suspects through sex and race markers is always recommend but rarely utilized due to limited publication in this area. Thus, this preliminary research was aimed to study the difference of bite mark made on dental wax between sex and race. A sample size of 40 UKM undergraduates comprising of Malay (male = 10, female = 10) and Chinese (male = 10, female = 10) were used in this study. Bite mark of subject was obtained through dental wax, digitally scanned and analyzed using Image-J software. Parameters measured were anterior teeth size, intercanine width and anterior teeth relative rotation. Result indicated that mandible left canine tooth size had signifi cant sexual dimorphism (p < 0.05) in differentiating sex. The means for male and female measured were 4.63 ± 1.05 mm and 5.35 ± 0.87 mm respectively. In addition to the result, tooth size of maxillary left canine and mandible left lateral incisor were signifi cantly different (p < 0.05) between races. Means for mandible left canine Malay and Chinese were 5.27 ± 1.01 mm and 4.50 ± 1.22 mm respectively. Furthermore, left lateral incisor mandible had means of 5.15 ± 0.87 mm and 4.60 ± 0.74 mm for Malay and Chinese respectively. Unfortunately, there were no signifi cant differences for intercanine width and anterior teeth relative rotation between the two major races in Malaysia. In conclusion, this research has demonstrated the possibility of using tooth size of mandible left canine, maxillary left canine and mandible left lateral discriminate sex and race.
Managing a patient with a huge intraoral mass is always challenging. Manipulation or even a simple biopsy of the mass may lead to hemorrhage and further compromise the airway. An examination under anesthesia is not without risk. The method of securing the airway itself may become an issue if the mass is fully occupying the airway before intubation. Usually a tracheostomy is indicated. We share a gentleman presented with a huge intraoral mass occupying the oropharynx, which initially necessitates tracheostomy. We utilized the ultrasonic scalpel-assisted instrument to biopsy by debulking the tumour, thus avoiding the tracheostomy while waiting for the definitive treatment.
Dermoid cysts are anatomic embryonic abnormalities that are rarely seen in the oral cavity. Histologically, they are further classified as epidermoid, dermoid or teratoid. We report a case in which an 18- year-old girl who developed an epidermoid cyst presenting as a large sublingual swelling occupying the entire floor of the mouth causing snoring and speech difficulty. We emphasized on the clinical steps in achieving an accurate diagnosis, possible differential diagnosis, necessary imaging techniques and management of epidermoid cyst.
The practice of quack dentistry worldwide is a challenge to the profession of dentistry as it undermines the trust of the general public and places the patients at unnecessary risks through their illegal practices. Although the ratio of patients to dentists is rapidly decreasing in Malaysia due to the increased output of qualified dentists from both local and foreign institutions, quack dentistry is still practiced in many areas. This report intends to highlight a popular treatment prescribed by these quack dentists which is removable partial dentures that is fixed to the adjacent teeth by cold cure acrylic. We also aim to discuss the design of the denture and the means employed to remove this ’fixed partial denture’. It is hoped that this case report will highlight the prevalence of the practice of quack dentistry especially in geographical area of this case report and allow the authorities to devise means to stop this illegal practice.
Congenital epulis is a fairly rare soft tissue tumour occurring exclusively on the alveolar ridge of newborns. The exact origin of congenital epulis is still debatable. The objective of the study is to determine the clinicopathological features and immunohistochemical findings of congenital epulis. A retrospective study was carried out to determine the clinicopathological features of congenital epulis, diagnosed histologically in the main oral histopathology laboratory in Malaysia from 1967 to 2014. Immunostaining using vimentin, muscle specific actin, smooth muscle antigen, desmin, S100, CD34, CD68 and CD1a was carried out. Twelve cases of congenital epulis were reviewed. All of the patients were females and the presentation age ranged from 2 to 90 days. The patients comprised of 6 Malays, 3 Chinese, 2 Indians and 1 Orang Asli. Most of the cases (n=7) involved the maxillary ridge and presented as pedunculated well-defined lumps (n=8). Excisional biopsy was performed in all cases. Via immunohistochemistry, vimentin expression was observed in all cases; but negative for CD34, muscle specific actin, smooth muscle antigen, and desmin. CD1a and S100 positivity was seen in five cases. The interstitial cells were highlighted by CD68. Although congenital epulis has been first described 130 years ago, the exact nature of its histogenesis remains a mystery.
This study aimed to assess the nutritional status (BMI), oral health behaviour, sugar consumption and the associated factors with dental caries among a group of 7 to 11 years old children in Kuala Lumpur, Malaysia. Three hundred and twelve students were recruited from February to July 2013. Information gathered were their socio-demographic characteristics, body mass index, sugar consumption, oral-health behaviour, oral hygiene index and decay-missing-filled teeth (dmft) index. Anthropometry measurements and sugar intake was measured using verified tools. Meanwhile, dmft was examined using the World Health Organization (WHO) criteria. 53.7% of the children were of the normal body weight with mean sugar consumption of 31.81±4.24 g/day. Prevalence of dental caries was reported at 44.6% (95% CI: 42.2, 53.3) with a mean (SD) dmft of 1.27(1.84). No association was found between dental caries and weight status distribution. Most children tend to brush their teeth 2 times or more in a day (75%), however, they spent lesser time in tooth brushing (5.4%) and do not practice flossing (78%). Regression analysis showed that age (p
MeSH terms: Body Weight; Carbohydrates; Child; Dental Caries; Humans; Malaysia; Nutritional Status; Oral Hygiene Index; Regression Analysis; Students; Toothbrushing; Health Behavior; Body Mass Index; Prevalence; Tooth Loss; Ideal Body Weight
Dental caries is the main oral health problem in hearing-impaired (HI) children and remains the most neglected need. The present study aimed to determine caries prevalence and treatment needs in HI children and the association with salivary parameters. A cross-sectional study was conducted on 63 HI children aged between 7-14 years who attended a special school for the deaf. Clinical oral examination was done and salivary parameters (resting flow rate and resting pH) were measured. Caries experience was charted using the index of decay-filled teeth (dft) and Decay-Missing-Filled Teeth (DMFT) for primary and permanent dentition respectively. Data were analysed using SPSS version 12.0. The mean age was 11.5 (SD 2.39) years and 53.8% were female. Dental caries prevalence was 88.0% (95% Cl: 73.0, 100.0) in primary dentition and 85.0% (95% Cl: 73.0, 96.0) in permanent dentition. The mean dft was 6.1 (SD 4.14) and the mean DMFT was 4.9 (SD 3.28). The mean resting flow rate was 0.14 (SD 0.08) ml/min while mean pH was 6.8 (SD 0.79). Both pit and fissure sealants and restorations were the highest (83.1%) treatment needs. Only 3.1% of the children did not require any treatment. There were no significant association between both salivary flow rate and salivary pH with caries experience in the primary (p=0.342, p=0.610 respectively) and permanent (p= 0.99, p=0.70 respectively) teeth. In conclusion, children with HI have high caries prevalence and unmet need for dental treatments. Salivary pH and resting flow rate of the children were not associated with their caries experience.
Prevalence of dysphagia is one of the important epidemiological data which will contribute to the proper planning and support the setting up of a swallowing rehabilitation clinic at this hospital. The present study aimed to determine the prevalence of dysphagia in patients with head and neck cancer (HNC) at Hospital Universiti Sains Malaysia (Hospital USM) from 2001-2010. In this institutional retrospective study, a total of 66 records were obtained comprising of 86.4% Malay patients, 9.1% Chinese, 1.5% Indians, and 3% other ethnic groups. These data were taken from the database of HNC patients seen at the dental clinic, Hospital USM between 2001 and 2010. Difficulty swallowing, frequent coughing during meal, choking, diet modification, and non-oral nutritional support were identified as signs and symptoms associated with dysphagia. Results showed that 59.1% of patients have had dysphagia before, during, or after the treatment of HNC. Data from the present study would be instrumental in increasing awareness among clinicians involved in patient care and it may help in planning the outline of management of dysphagia. Furthermore, it is anticipated to have implications for further research in swallowing and dysphagia.
Study site: Dental clinics, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
Chronic periodontitis (CP) is an inflammatory disease of the supporting tissues of the teeth caused by specific microorganism. Hypertension is one of the major causes of cardiovascular disease whereas periodontitis has recently drawn increasing attention because of its potential relationship with cardiovascular disease. The objectives of this study were to determine the prevalence of the hypertension in CP patients as well as to evaluate the association between hypertension and severity of CP. One hundred and eighty five records of CP patients treated in Dental Clinic, Universiti Sains Malaysia Hospital (USM Hospital), Kelantan from 2010 until 2013 were retrieved and reviewed. The diagnosis of periodontal disease and the presence of hypertension were recorded. The severity of chronic periodontitis was classified into mild, moderate and severe according to the clinical attachment loss. The data was obtained and analyzed using SPSS version 20.0. Majority of the subjects were from Malay ethnic group (94.4%) at the age range between 41 and 61 years (67.8%). In conclusion, the prevalence of hypertension in chronic periodontitis patients was 12.2%. There was no significant association between hypertension and severity of CP (p=0.229).