Nor Azura Ahmad Tarmidzi, Wan Abdul Fattah Wan Ismail, Nik Salida Suhaila Nik Salleh, Mualimin Mochammad Sahid, Haslinda Ramli, Nalisha Mohamed Ramli, et al.
The position of facial bones contribute great impact to the shape of the face. Shape
of these underlying facial bones responsible for a person facial proportions, angles and contours.
Facial deformity can either be congenital or acquired. Functional impairment related to facial
deformity include chewing problems, breathing problems, speech impairments and
temporomandibular joint pathology. Orthognathic surgery is a procedure involving incision and
manipulation using instrument to align the jaws. Performing cosmetic surgery seems to change the
creation of Allah and the original law of changing Allah creation is prohibited. (Copied from article).
Tornwaldt's (Thornwaldt's) or nasopharyngeal cyst is an uncommon developmental
benign cyst located in the midline postero-superior wall of nasopharynx. Incidence reported in
general population is 0.06%. It occurred in the potential space due to outpouching of ectoderm into
the pharyngobasilar fascia at the site where notochord attached to pharyngeal ectoderm. (Copied from article).
Dental decays happened due to demineralization of dental minerals because of oral
acidic environment. The minerals that usually dissolved out from the enamel are calcium (Ca) and
phosphorus (P). To ensure more Ca and P absorbed via remineralization, high Ca and P content in
daily diet supply are required. In Malaysia, virgin coconut oil (VCO), coconut milk (CM) and coconut
water (CW) are a few of many major diet component of daily diet. The aim for this study is to
evaluate the Ca and P content of VCO, CM and CW. (Copied from article).
Delayed tooth eruption (DTE) is the emergence of a tooth into oral cavity that
deviates from norms established for different races, ethnics and sexes, which commonly caused
either by local or systemic conditions. (Copied from article).
MeSH terms: Mouth; Sexual Behavior; Tooth; Tooth Abnormalities; Tooth Eruption
Accurate and rapid diagnosis of tuberculous meningitis (TBM) is important for
early administration of treatment. In this study, we have evaluated the diagnostic value of
smear, culture, multiplex PCR and GeneXpert MTB/RIF to detect M. tuberculosis in
cerebrospinal fluid (CSF) samples from patients with suspected TBM registered in Queen
Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia. Of the 55 CSF samples collected, 12
(21.8%) samples were positive by multiplex PCR, 3 (5.4%) by GeneXpert MTB/RIF and only 1
(1.8%) by smear and culture. Multiplex PCR showed higher sensitivity to detect M. tuberculosis
in patients with suspected TBM and has the potential to be used as a diagnostic method.
Phacoemulsification (PEA) is currently the procedure of choice for most cataract extraction. However, intra-operative complications may require the procedure to be converted to extracapsular cataract extraction (ECCE). We have evaluated the indications for conversion and visual outcomes in cases converted from phacoemulsification to ECCE. A retrospective review was performed on 33 eyes in which phacoemulsification was initiated and then converted to ECCE. The main parameters evaluated were indications for conversion and visual outcomes at 3 months. Thirty-three cases out of 1448 operations were identified from January 2013 to February 2014.The incidence of PEA converted to ECCE was 2.2%. The indications for ECCE conversion were posterior capsular rupture (PCR) in twenty-two cases, combined capsulorhexis extension with PCR in three cases, capsulorhexis extension and zonular dialysis in two cases respectively. Combined zonular dialysis with PCR, corneal toxicity, Descemet’s tear and obscured edge of capsulorhexis had one case each. Twenty-six (78%) cases had gain in vision, one (3%) case had unchanged vision and six (18%) cases had worsening of vision. The incidence of complicated phacoemulsification surgery requiring intra-operative conversion to ECCE was low in our study (2.2%). Seventy-eight percent of cases achieved final VA of 6/12 or better. Therefore, early recognition of complications and timely intra-operative conversion of PEA to ECCE may result in good visual outcome.
The pathophysiology of systemic inflammatory response syndrome (SIRS) had been described to involve various strong oxidative reactions affecting the status and progress of the patients. Antioxidant therapy had been suggested in many studies involving SIRS management. The objective of this study was to compare the role of vitamin E Tocotrienol and vitamin E Tocopherol combined with vitamin C as antioxidant therapy in the management of critically ill patients diagnosed with SIRS, admitted to the intensive care unit and high dependency wards of Universiti Kebangsaan Malaysia Medical Centre (UKMMC). It was a single blind randomized clinical trial with a total of 72 patients in which 44.4% Malays, 34.7% Chinese, 19.4% Indians and 1.4% others with 59.7% males and 40.3% females were recruited. Patients in TRI E group received Tocotrienol with Vitamin C while TOCO group received Tocopherol with Vitamin C and a control group did not receive any antioxidant. The clinical parameters (heart rate, respiratory rate, systolic blood pressure) showed improvements with significant difference at the end of study (post-intervention) as compared to admission (pre-intervention).Whereas, the sepsis (temperature, PCT, CRP and WBC) and oxidative stress (8-OHdG/Creatinine) parameters showed improvements with significant difference at the end of study (post-intervention) as compared to admission (pre-intervention). The TRI E group showed obvious improvement in clinical, sepsis and oxidative stress parameters, as compared to TOCO and control groups. This study showed that Vitamin E Tocotrienol and Vitamin E Tocopherol in combination with Vitamin C demonstrated significant improvement in the clinical and laboratory parameters during the management of SIRS. Therefore, Vitamin E in combination with Vitamin C had therapeutic benefits in the treatment of critically ill patients with SIRS.
Surgical training worldwide has been reformed from
the since 19th century until the present era. It started as
a trade which eventually was transformed into a
profession that acquires skills and knowledge. The
apprenticeship model was introduced amongst the
Western surgeons as the standard approached for
surgical training. The surgery was learned through
direct observation without any formal and structured
education. William S Halstead had introduced the new
approach of training the surgeons in America
following his landmark lecture at Yale University in
1904 (1). His principle was based on direct the
German Surgical training which emphasized on basic
sciences in the curriculum and Sir William Ossler
concepts of bedside rounds. This has lead to the
development of Halsted principals of surgical training
which included intense and repetitive exposure in
managing surgical patients under the supervision of
skilled surgeons, acquiring the knowledge of scientific
basis of surgical diseases and as the surgical trainee
received enhanced responsibility and independence
with each advancing year (2). Since then, Halsted
principle of surgical training has become the
foundation of most established surgical training
worldwide. The principles have been expanded and
upgraded and since then six cores competencies have
been identified for the surgical residents to achieve
and master during the training course (3). There were
medical knowledge, patient care, interpersonal and
communication skills, professionalism, practice-based
learning and improvement and system based practice.
From the Malaysia perspective, surgical training was
done through the overseas Royal colleges after the
independence in 1957. The local programme started in
1982 through the initiative of local universities that
initially offered surgical training programme in
General surgery, Orthopedics and otorhinolaryngology
(4). Since then through the collaborations of Ministry
of Health and other professional bodies various
surgical training programme has been established to
provide training opportunities which will eventually
serving the nation. The subcommittee of the National
Conjoint Board for General Surgery was the
consultative body to oversee and manage the
implementation of the surgical training. Since the
establishment, the subcommittee was responsible in
streamlined the training curriculum for all the
universities that offered the course, centralized and
standardized the intake of the trainees, coordinating
the national exit examination and advising new
application for graduate training in general surgery.
The important milestone of the subcommittee was the
task given to develop the national surgical
postgraduate curriculum for the doctors who are
interested in becoming a surgeon in the country. The
curriculum is being developed to create a pathway for
surgical training from the internship until subspecialty
training. The development encompasses the
governance, the curriculum development, the training
process and learning outcome according to the latest
evidence based on post graduate training. The
programme should be the foundation in producing well
trained surgeons towards 2050 through TN50.
MeSH terms: Professionalism; Curriculum; Patient Care; Humans; Internship and Residency; Malaysia; Orthopedics; Otolaryngology; Training Support; Universities; Surgeons
Odontomas are the most common odontogenic hamartomas worldwide. Depending on
the level of organisation of the tissues inside, these can be differentiated into compound type
or complex type. As these are asymptomatic and do not cause any changes in the bone, they are
often diagnosed during the routine dental examination. Complex odontomas are commonly found
to occur in posterior mandible while compound odontomas are found in the anterior maxilla. A
nine-year-old female child reported for a routine dental check-up, when a missing left permanent
mandibular lateral incisor [32] was noticed. Further investigations revealed compound odontoma
and unerupted 32, which is an unusual location. Early detection of these tumours is essential to
avoid lengthy corrective treatments.
Temporomandibular joint dysfunction (TMD) is regarded as multifactorial in origin
and this may influence the diagnosis and treatment plan. Early detection of TMD with suitable
management may provide good response. This study was to relate demographic factors, signs and
symptoms, diagnosis, stage of detection and treatment modalities on review outcome. (Copied from article).
This study was to obtain baseline information and its associated factors on oral
cancer awareness, practice of risk habits and mouth self-examination (MSE) among selected highrisk
indigenous community in Sarawak. (Copied from article).
Orthodontic tooth movement is a complex process involving tooth and periodontal
tissue, which release enzymes and biomarkers. The aim of this study was to investigate enzymes
activities of salivary fluid during orthodontic treatment, (Copied from article).
Extracapsular spread (ECS) is one of the most important prognostic factors in oral
squamous cell carcinoma (OSCC). Gamma Glutamyl Hydrolase (GGH) is a lysosomal enzyme which is involved in folate homeostasis. It is overexpressed in several human malignancies but its role in
OSCC has never been reported. Carbonic Anhydrase 9 (CA9) is a transmembrane glycoprotein and is
related to hypoxia. High expression of CA9 has been associated with poor prognosis in several
tumours including OSCC. This study was aimed to investigate the expression of GGH and CA9 in
OSCC and their potential use as biomarkers to predict ECS. (Copied from article).
Conference abstract: First IIUM International Dental Conference 2017 [ABSTRACT ID: 73, Oral]
Introduction: Dental therapists are one of the main dental workforce in Malaysia and are exposed to various risk factors of MSD. However, studies on MSD among dental therapists are limited. The objectives of this study were to determine the prevalence, the sites affected, the symptom severity, the impact, the risk factors and the association between individual, biomechanical, physical and psychosocial risk factors with prevalence of MSD among dental therapists.
Materials and Methods: A survey was conducted using self-administered questionnaire which was distributed to all dental therapists in Perak, Terengganu and Kuala Lumpur in February 2017, from which a response rate of 89.2% was achieved.
Results: There was a high prevalence of MSD (87.5%) among the respondents. The MSD was found to be affecting mainly the back (69.7%), neck (66.7%), shoulders (58.7%) and wrists/hands (50.2%) while MSD of the elbow and lower extremities was found to more severe and often affect their daily work. Most of the respondents who reported MSD accommodated their own symptoms with analgesics or sought alternative treatment (20.1%). Majority reported that they often used vibratory instruments (76.1%), involved in biomechanical risk activities, and perceived that they have a high job demand and lack of authority to make decisions related to work. Age (OR: 3.58; 95% CI: 1.644, 7.773), number of extractions (OR: 4.69; 95% CI: 1.348, 16.327) as well as psychosocial factors (OR: 4.05; 95% CI: 1.547, 10.613) were significantly associated with prevalence of MSD.
Conclusion(s): Therefore, preventive measures should be implemented to reduce the burden of MSD.
KEYWORDS: musculoskeletal disorders, dental therapist, impact, symptom severity, risk factor
The aim of this study was to determine the incidence of torus palatinus and torus
mandibularis in Malaysians. The objectives are to evaluate the incidence of tori according to
ethnicity, to assess the incidence of tori according to gender and to determine the incidence of
torus palatinus vs torus mandibularis. (Copied from article).
Recurrent oral ulcer is a chronic inflammatory condition characterized by mucosa
ulceration, which was believed to have bacterial etiology. Streptococcus mutans is one of the
bacteria which have been implicated in this case; it is gram-positive bacteria that reside in the
biofilms on the tooth surfaces. The aim of this study was to evaluate Streptococcus mutans content
in saliva of recurrent oral ulcer patients and its role as a prognostic factor. (Copied from article).
Evidence suggests that several genes; including MYO1H, play an important role in the
etiology of Class III malocclusion. Single nucleotide polymorphism (SNP) in marker rs10850110 (locus
12q24.11) within MYO1H gene has been associated with the incidence of mandibular prognathism
(MP). MYO is a class 1 myosin that is responsible for the synthesis of Matrilin-1; an important
protein involved in the formation of cartilage's extracellular matrix, hence is implicated in the
formation of mandibular condyle cartilage. This study aimed to detect the presence of MYO1H
(rs10850110) SNP and to determine its genotype and allele distribution in MP patient in the local
population. (Copied from article).
Orthodontic fixed appliance is now considered as fashion accessory and a symbol of
wealth. Due to overwhelming demand, 'fake' and 'real' braces services have been offered through
social media by unqualified personnel using poor quality orthodontic brackets and cases of metal
toxicity from using these type of braces has been reported. (Copied from article).
MeSH terms: Dental Bonding; Braces; Income; Metals; Orthodontic Appliances; Orthodontic Brackets; Social Media
The growing demand for orthodontic braces among Malaysian community has led to
the development of "fake" and "real" braces. "Fake" braces refer to braces that are worn as costume
and are not bonded to teeth hence unable to produce movement of teeth. "Real" braces refer to
braces that are bonded to tooth structure and are able to produce tooth movement. The braces are
bonded by unqualified practitioners with no formal dental education and they provide braces
treatment in unlicensed premises such as hotel rooms or patients' own homes. (Copied from article).
Patient undergoes orthodontic treatment with fixed appliances have more plaque
retentive area compare to normal person. Therefore, this patient requires higher standard of oral
hygiene care. One of adjunctive cleaning device for oral hygiene care is water irrigator. There are
several types of water irrigator available in the market such as syringe type, electricity and battery
operated. However, the problem is the available water irrigators are expensive. (Copied from article).