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Dermatofibrosarcoma protuberans of the scalp: therapeutic challenges

Kanesen D, Zakaria Z, Ch'ng ES, Nandrajog P, Kandasamy R

ANZ J Surg, 2019 03;89(3):261-264.
PMID: 28513108 DOI: 10.1111/ans.14040
Matched MeSH terms: Scalp*
Fulltext Aggressive scalp and sternal lesion: A presentation of rare case of metastatic eccrine carcinoma

Rownose CS, Mohamad Saupi MS, Sharif SZ, Lah NASN

Ann Med Surg (Lond), 2021 May;65:102322.
PMID: 33996055 DOI: 10.1016/j.amsu.2021.102322

Introduction: Ductal Eccrine carcinoma (DEC) is a rare primary cutaneous tumor that exhibits both squamous and adnexal ductal differentiation. Due to its rarity in clinical practice we present as case of DEC and a literature review on the latest management of this rare disease.
Case presentation: We report a case 41 years old female presented with lesion on the scalp and sternal mass, increasing in size with itchiness and erythematous for 6 months duration. Further CECT scan of brain and neck shows features of malignant left frontal scalp lesion with poor plane with overlying skin and underlying skull bone and CECT of thorax shows a large, irregular heterogeneously enhancing mass with necrotic center noted at right hilar within superior segment of right lower lobe, encasing right middle and lower lobe bronchi. Wedge biopsy of scalp lesion showed an intradermal lesion extensively infiltrating by malignant gland accompanied by desmoplasia and the tumor cells are seen extending into the surgical margins suggestive of ductal eccrine carcinoma.Clinical Discussion:This case highlights the importance and challenges in achieving early diagnosis coupled with the scarcity of information on these leads to difficulty in managing this patient.
Conclusion: In managing Ductal Eccrine Carcinoma tumor, standard method of treatment for has not been established. However, wide surgical excision is the treatment of choice for localized lesions. Regarding prognosis, there is conflicting data published which we describe in this article.

Matched MeSH terms: Scalp
Association of autonomic nervous system and EEG scalp potential during playing 2D Grand Turismo 5

Subhani AR, Likun X, Saeed Malik A

Annu Int Conf IEEE Eng Med Biol Soc, 2012;2012:3420-3.
PMID: 23366661 DOI: 10.1109/EMBC.2012.6346700

Cerebral activation and autonomic nervous system have importance in studies such as mental stress. The aim of this study is to analyze variations in EEG scalp potential which may influence autonomic activation of heart while playing video games. Ten healthy participants were recruited in this study. Electroencephalogram (EEG) and electrocardiogram (ECG) signals were measured simultaneously during playing video game and rest conditions. Sympathetic and parasympathetic innervations of heart were evaluated from heart rate variability (HRV), derived from the ECG. Scalp potential was measured by the EEG. The results showed a significant upsurge in the value theta Fz/alpha Pz (p<0.001) while playing game. The results also showed tachycardia while playing video game as compared to rest condition (p<0.005). Normalized low frequency power and ratio of low frequency/high frequency power were significantly increased while playing video game and normalized high frequency power sank during video games. Results showed synchronized activity of cerebellum and sympathetic and parasympathetic innervation of heart.

Matched MeSH terms: Scalp/physiology*
Differential permethrin susceptibility of head lice sampled in the United States and Borneo

Pollack RJ, Kiszewski A, Armstrong P, Hahn C, Wolfe N, Rahman HA, et al.

Arch Pediatr Adolesc Med, 1999 Sep;153(9):969-73.
PMID: 10482215 DOI: 10.1001/archpedi.153.9.969

BACKGROUND: Pediculiasis is treated aggressively in the United States, mainly with permethrin- and pyrethrin-containing pediculicides. Increasingly frequent anecdotal reports of treatment failure suggest the emergence of insecticidal resistance by these lice.

OBJECTIVE: To confirm or refute the susceptibility of head lice sampled in the United States to permethrin.

DESIGN: Survey. Head lice were removed from children residing where pediculicides are readily available and where such products are essentially unknown. Their survival was compared following exposure to residues of graded doses of permethrin in an in vitro bioassay.

SETTING: School children from Massachusetts, Idaho, and Sabah (Malaysian Borneo).

SUBJECTS: In the United States, 75 children aged 5 to 8 years. In Sabah, 59 boys aged 6 to 13 years. Virtually all sampled US children had previously been treated with pediculicides containing pyrethrins or permethrin; none of the Sabahan children were so exposed.

MAIN OUTCOME MEASURE: Survival of head lice exposed to permethrin.

RESULTS: Permethrin did not affect head lice sampled from chronically infested US children who had previously been treated for pediculiasis. The slope of the dose-response regression line for these lice did not differ significantly from zero (P = .66). This pediculicide immobilized lice sampled in Sabah. Mortality correlated closely with permethrin concentration (P = .008).

CONCLUSIONS: Head lice in the United States are less susceptible to permethrin than are those in Sabah. The pyrethroid susceptibility of the general population of head lice in the United States, however, remains poorly defined. Accordingly, these relatively safe over-the-counter preparations may remain the pediculicides of choice for newly recognized louse infestations.

Matched MeSH terms: Scalp Dermatoses/drug therapy*
Risk factors associated with subaponeurotic haemorrhage in full-term infants exposed to vacuum extraction

Boo NY, Foong KW, Mahdy ZA, Yong SC, Jaafar R

BJOG, 2005 Nov;112(11):1516-21.
PMID: 16225572

To determine obstetric and neonatal risk factors associated with subaponeurotic haemorrhage (SAH) in infants exposed to vacuum extraction.

Matched MeSH terms: Scalp/injuries*
Fetal and maternal lactate increase during active second stage of labour

Nordström L, Achanna S, Naka K, Arulkumaran S

BJOG, 2001 Mar;108(3):263-8.
PMID: 11281466

To determine longitudinally fetal and maternal blood lactate concentrations during the second stage of labour.

Matched MeSH terms: Scalp
Fulltext Perioperative challenges in managing a patient with COVID-19 undergoing debridement for massive scalp myiasis

Lo SY, Teah MK, Ho YZ, Yeap TB

BMJ Case Rep, 2021 Feb 05;14(2).
PMID: 33547110 DOI: 10.1136/bcr-2020-241189

A young man presented to our centre needing an urgent debridement of his postcraniotomy wound due to massive myiasis during the COVID-19 pandemic in October 2020. Prior to the surgery, his nasopharyngeal swab real-time PCR test result was unknown. One day later, it returned as SARS-CoV-2 positive. All healthcare workers who were involved in the patient management avoided cross infection as they wore appropriate personal protective equipment. This article depicts the importance of adequate preparations when handling potentially infectious patients and the perioperative issues associated with it.

Matched MeSH terms: Scalp/surgery*
Correlation of Arsenic Levels in Smokeless Tobacco Products and Biological Samples of Oral Cancer Patients and Control Consumers

Arain SS, Kazi TG, Afridi HI, Talpur FN, Kazi AG, Brahman KD, et al.

Biol Trace Elem Res, 2015 Dec;168(2):287-95.
PMID: 25975948 DOI: 10.1007/s12011-015-0355-y

It has been extensively reported that chewing of smokeless tobacco (SLT) can lead to cancers of oral cavity. In present study, the relationship between arsenic (As) exposure via chewing/inhaling different SLT products in oral cancer patients have or/not consumed SLT products was studied. The As in different types of SLT products (gutkha, mainpuri, and snuff) and biological (scalp hair and blood) samples of different types of oral cancer patients and controls were analyzed. Both controls and oral cancer patients have same age group (ranged 30-60 years), socio-economic status, localities, and dietary habits. The concentrations of As in SLT products and biological samples were measured by electrothermal atomic absorption spectrophotometer after microwave-assisted acid digestion. The validity and accuracy of the methodology were checked by certified reference materials. The resulted data of present study indicates that the concentration of As was significantly higher in scalp hair and blood samples of oral cancer patients than those of controls (p<0.001). It was also observed that the values of As were two- to threefolds higher in biological samples of controls subjects, consuming SLT products as compared to those have none of these habits (p>0.01). The intake of As via consuming different SLT may have synergistic effects, in addition to other risk factors associated with oral cancer.

Matched MeSH terms: Scalp/drug effects
Neurofibromatosis Type 2 Presenting with Oculomotor Ophthalmoplegia and Distal Myopathy

Tevaraj JM, Li Min ET, Mohd Noor RA, Yaakub A, Wan Hitam WH

Case Rep Ophthalmol Med, 2016;2016:1701509.
PMID: 27738538

Neurofibromatosis type 2 usually presents with bilateral acoustic schwannomas. We highlight the rare presentation of neurofibromatosis initially involving third nerve. A 23-year-old Malay female presented with left eye drooping of the upper lid and limitation of upward movement for 8 years. It was associated with right-sided body weakness, change in voice, and hearing disturbance in the right ear for the past 2 years. On examination, there was mild ptosis and limitation of movement superiorly in the left eye. Both eyes had posterior subcapsular cataract. Fundoscopy showed generalised optic disc swelling in both eyes. She also had palsy of the right vocal cord, as well as the third and eighth nerve. There was wasting of the distal muscles of her right hand, with right-sided decreased muscle power. Pedunculated cutaneous lesions were noted over her body and scalp. MRI revealed bilateral acoustic and trigeminal schwannomas with multiple extra-axial lesions and intradural extramedullary nodules. Patient was diagnosed with neurofibromatosis type 2 and planned for craniotomy and tumour debulking, but she declined treatment. Neurofibromatosis type 2 may uncommonly present with isolated ophthalmoplegia, so a thorough physical examination and a high index of suspicion are required to avoid missing this condition.

Matched MeSH terms: Scalp
Fulltext Extensive Forehead Swelling Including the Periorbital Area in a Child: A Rare Manifestation of Acute Lymphoblastic Leukemia

Hanapi MS, Ghani SI, Sonny Teo KS, Wan-Embong WZ, Ariffin N, Wan Hitam WH

Cureus, 2018 Nov 03;10(11):e3539.
PMID: 30648072 DOI: 10.7759/cureus.3539

Acute lymphoblastic leukemia (ALL) manifestations in a child are varied. We report a unique and rare presentation of acute lymphoblastic leukemia in a child who presented with frontal swelling involving bilateral upper lids. A previously healthy one-year-old girl presented with progressively increasing frontal swelling of seven months duration. An examination revealed erythematous, firm, nontender forehead swelling that extended up to the medial part of bilateral upper eye lids. The extraocular muscle movement was normal. The anterior segment and fundus examination were also normal in both eyes. Other systemic examination revealed multiple leukemic cutis on the scalp. The cervical lymph nodes were also palpable with hepatosplenomegaly. A full blood picture (FBP) showed the presence of leucoerythroblastic blood film with 62% blast cells. Flow cytometry and bone marrow aspiration confirmed the diagnosis. Computed tomographic (CT) scan images revealed multiple well-defined hyperdense lesions at the subcutaneous skull with the largest lesion at the anterior glabella. Upon diagnosis, the patient was started on chemotherapy and the swelling resolved after one month post treatment. Extensive forehead swelling is a rare manifestation of acute lymphoblastic leukemia. A high index of suspicion aided with diagnostic investigations could help the doctors arrive at a correct diagnosis and treatment.

Matched MeSH terms: Scalp
Fulltext Potentially toxic elements in human scalp hair around China's largest polymetallic rare earth ore mining and smelting area

Dai L, Deng L, Wang W, Li Y, Wang L, Liang T, et al.

Environ Int, 2023 Feb;172:107775.
PMID: 36739854 DOI: 10.1016/j.envint.2023.107775

There is a growing concern about human health of residents living in areas where mining and smelting occur. In order to understand the exposure to the potentially toxic elements (PTEs), we here identify and examine the cadmium (Cd), chromium (Cr), copper (Cu), manganese (Mn), nickel (Ni), lead (Pb) and zinc (Zn) in scalp hair of residents living in the mining area (Bayan Obo, n = 76), smelting area (Baotou, n = 57) and a reference area (Hohhot, n = 61). In total, 194 hair samples were collected from the volunteers (men = 87, women = 107) aged 5-77 years old in the three areas. Comparing median PTEs levels between the young and adults, Ni levels were significantly higher in adults living in the smelting area while Cr was highest in adults from the mining area, no significant difference was found for any of the elements in the reference area. From the linear regression model, no significant relationship between PTEs concentration, log10(PTEs), and age was found. The concentrations of Ni, Cd, and Pb in hair were significantly lower in the reference area when compared to both mining and smelting areas. In addition, Cu was significantly higher in the mining area when compared to the smelting area. Factor analysis (FA) indicated that men and women from the smelting area (Baotou) and mining area (Bayan Obo), respectively, had different underlying communality of log10(PTEs), suggesting different sources of these PTEs. Multiple factor analysis quantilized the importance of gender and location when combined with PTEs levels in human hair. The results of this study indicate that people living in mining and/or smelting areas have significantly higher PTEs (Cu, Ni, Cd, and Pb) hair levels compared to reference areas, which may cause adverse health effects. Remediation should therefore be implemented to improve the health of local residents in the mining and smelting areas.

Matched MeSH terms: Scalp/chemistry
Sweating distribution and active sweat glands on the scalp of young males in hot-dry and hot-humid environments

Jung D, Kim YB, Lee JB, Muhamed AMC, Lee JY

Eur J Appl Physiol, 2018 Dec;118(12):2655-2667.
PMID: 30209544 DOI: 10.1007/s00421-018-3988-7

PURPOSE: We investigated the effects of humidity on regional sweating secretion and active sweat gland density on the scalp during passive heating in hot environments.
METHODS: Eight male subjects shaved their heads prior to expose to dry (30%RH; H30%) and humid (85%RH; H85%) conditions at an air temperature of 32 °C. Total sweat rate, local sweat rates (frontal, vertex, temporal, and occipital regions), active sweat glands on the scalp (2 frontal, 2 parietal, 2 temporal, 1 occipital, and 1 vertex), and rectal and skin temperatures were measured during leg immersion in 42 °C water for 60 min.
RESULTS: (1) Total sweat rates were greater for H30% (179.4 ± 35.6 g h-1) than for H85% (148.1 ± 27.2 g h-1) (P Scalp sweat secretion tended to be greater in the H85% than the H30%. (3) Head sweat rates were greater on the frontal than on the vertex for both humidity conditions (P scalp was greater for H85% (82 ± 13 glands cm-2) than for H30% (62 ± 17 glands cm-2) (P scalp region were significantly increased in the hot-humid condition compared to the hot-dry condition. Among the regions on the scalp surface, the vertex was the least sensitive to the change in humidity.

Matched MeSH terms: Scalp/physiology*
Fulltext Classification of Visual and Non-visual Learners Using Electroencephalographic Alpha and Gamma Activities

Jawed S, Amin HU, Malik AS, Faye I

Front Behav Neurosci, 2019;13:86.
PMID: 31133829 DOI: 10.3389/fnbeh.2019.00086

This study analyzes the learning styles of subjects based on their electroencephalo-graphy (EEG) signals. The goal is to identify how the EEG features of a visual learner differ from those of a non-visual learner. The idea is to measure the students' EEGs during the resting states (eyes open and eyes closed conditions) and when performing learning tasks. For this purpose, 34 healthy subjects are recruited. The subjects have no background knowledge of the animated learning content. The subjects are shown the animated learning content in a video format. The experiment consists of two sessions and each session comprises two parts: (1) Learning task: the subjects are shown the animated learning content for an 8-10 min duration. (2) Memory retrieval task The EEG signals are measured during the leaning task and memory retrieval task in two sessions. The retention time for the first session was 30 min, and 2 months for the second session. The analysis is performed for the EEG measured during the memory retrieval tasks. The study characterizes and differentiates the visual learners from the non-visual learners considering the extracted EEG features, such as the power spectral density (PSD), power spectral entropy (PSE), and discrete wavelet transform (DWT). The PSD and DWT features are analyzed. The EEG PSD and DWT features are computed for the recorded EEG in the alpha and gamma frequency bands over 128 scalp sites. The alpha and gamma frequency band for frontal, occipital, and parietal regions are analyzed as these regions are activated during learning. The extracted PSD and DWT features are then reduced to 8 and 15 optimum features using principal component analysis (PCA). The optimum features are then used as an input to the k-nearest neighbor (k-NN) classifier using the Mahalanobis distance metric, with 10-fold cross validation and support vector machine (SVM) classifier using linear kernel, with 10-fold cross validation. The classification results showed 97% and 94% accuracies rate for the first session and 96% and 93% accuracies for the second session in the alpha and gamma bands for the visual learners and non-visual learners, respectively, for k-NN classifier for PSD features and 68% and 100% accuracies rate for first session and 100% accuracies rate for second session for DWT features using k-NN classifier for the second session in the alpha and gamma band. For PSD features 97% and 96% accuracies rate for the first session, 100% and 95% accuracies rate for second session using SVM classifier and 79% and 82% accuracy for first session and 56% and 74% accuracy for second session for DWT features using SVM classifier. The results showed that the PSDs in the alpha and gamma bands represent distinct and stable EEG signatures for visual learners and non-visual learners during the retrieval of the learned contents.

Matched MeSH terms: Scalp
Fulltext Can Brain Waves Really Tell If a Product Will Be Purchased? Inferring Consumer Preferences From Single-Item Brain Potentials

Goto N, Lim XL, Shee D, Hatano A, Khong KW, Buratto LG, et al.

Front Integr Neurosci, 2019;13:19.
PMID: 31316357 DOI: 10.3389/fnint.2019.00019

Recent research has shown that event-related brain potentials (ERPs) recorded while participants view lists of different consumer goods can be modulated by their preferences toward these products. However, it remains largely unknown whether ERP activity specific to a single consumer item can be informative about whether or not this item will be preferred in a shopping context. In this study, we examined whether single-item ERPs could reliably predict consumer preferences toward specific consumer goods. We recorded scalp EEG from 40 participants while they were viewing pictures of consumer goods and we subsequently asked them to indicate their preferences for each of these items. Replicating previous results, we found that ERP activity averaged over the six most preferred products was significantly differentiated from ERP activity averaged across the six least preferred products for three ERP components: The N200, the late positive potential (LPP) and positive slow waves (PSW). We also found that using single-item ERPs to infer behavioral preferences about specific consumer goods led to an overall predictive accuracy of 71%, although this figure varied according to which ERPs were targeted. Later positivities such as the LPP and PSW yielded relatively higher predictive accuracy rates than the frontal N200. Our results suggest that ERPs related to single consumer items can be relatively accurate predictors of behavioral preferences depending on which type of ERP effects are chosen by the researcher, and ultimately on the level of prediction errors that users choose to tolerate.

Matched MeSH terms: Scalp
Fulltext The efficacy and tolerability of scalp cooling in preventing chemotherapy-induced alopecia in patients with breast cancer receiving anthracycline and taxane-based chemotherapy in an Asian setting

Saad M, Chong FLT, Bustam AZ, Ho GF, Malik RA, Ishak WZW, et al.

Indian J Cancer, 2019 1 4;55(2):157-161.
PMID: 30604728 DOI: 10.4103/ijc.IJC_581_17

BACKGROUND: Scalp cooling has been shown in several studies to be an effective method in preventing chemotherapy-induced alopecia (CIA). Data on the use of scalp cooling in Asian countries are limited, and evidence for its use and efficacy among our patients are not available.
OBJECTIVE: The aim of this study was to assess the effectiveness and tolerability of scalp cooling among breast cancer patients in our study population.
METHODS: Consecutive breast cancer patients receiving FE75C, FE100C, FE100C-D, docetaxel75 or docetaxel, and cyclophosphamide (TC) at our treatment center were recruited and allocated to the treatment (scalp cooling, DigniCapTM system) or control group in this prospective nonrandomized controlled study. The assessment of alopecia was carried out using the World Health Organization grading system and clinical photographs.
RESULTS: Seventy patients were recruited, but only 25 completed the study and were evaluable for analysis. Five of 12 patients (42%) in the scalp cooling group managed to preserve hair. Two of three patients who received FE75C and TC regimens had minimal hair loss. All patients treated with FE100C had severe hair loss. Half of all patients who received scalp cooling throughout chemotherapy rated the treatment as reasonably well tolerated. The most common reason for discontinuing scalp cooling was intolerance to its side effects.
CONCLUSION: Scalp cooling is potentially effective in reducing CIA caused by docetaxel, TC, and FE75C chemotherapy regimen. However, it was not well tolerated by our study population. The dropout rate was high, and this needs to be taken into consideration when pursuing further trials in a similar setting.

Matched MeSH terms: Scalp/blood supply*
Fulltext Infantile Myofibromatosis: A Case Report

Hasniah, A.L., Rohana, J., Boo, N.Y., Thambidorai, C.R., Isa, M.R.

International Medical Journal Malaysia, 2007;6(1):1-6.
MyJurnal

Case: A male infant was born at 36th week period of gestation with a birth weight of 1.99kg following an uneventful intrauterine period. At birth, he was noted to have multiple skin nodules. The largest nodule measuring 4.0 x 2.0 x 1.5 cm was at his pre-auricular area. It was initially fleshy and reddish in color. A few days later, it turned black and subsequently the black skin overlying the mass fell off, leaving a firm underlying mass with the appearance of a cauliflower. Other skin lesions, which were firm in consistency, were found on the medial aspect of his right supraorbital ridge, right mid-arm, right mid-thigh, plantar surface of his right big toe and his scalp. They were either skin-colored or reddish in colour, measuring between 1.0 and 2.0 cm in diameter. He also had hepatomegaly and splenomegaly palpable at 5 cm and 3 cm below the subcostal margins, respectively

Matched MeSH terms: Scalp
Fulltext Understanding the decision-delivery interval in cesarean births

Naseem, Rashid, Nalliah, Sivalingam

International e-Journal of Science, Medicine & Education, 2007;1(2):61-68.
MyJurnal

Avoiding the adverse neonatal effects of perinatal asphyxia has been one of the common indications for cesarean deliveries in current obstetric practice. Expeditious delivery is dependent on decision to perform cesarean delivery and time lines achieved. A decision-delivery interval of 30 minutes, a concept initiated by the American College of Obstetricians and Gynecologists has open to debate as controversy reins about neonatal outcome when this time interval is considered in isolation. Time lines alone are probably not the only criteria to be employed, and may contribute to errors in interpretation by professional regulatory bodies and the society at large. Procedures prior to decision making like trial of labour, fetal scalp sampling and readily available resources for instituting emergent cesarean delivery invariably need to be considered. Though decision to delivery time is an integral component of critical conduct intervals in the acutely compromised fetus, a more pragmatic approach needs to be taken considering potential and known logistical and obstetric factors in line with good obstetric practice.

Matched MeSH terms: Scalp
AFM analysis of collagen fibrils in expanded scalp tissue after anisotropic tissue expansion

Aziz J, Ahmad MF, Rahman MT, Yahya NA, Czernuszka J, Radzi Z

Int J Biol Macromol, 2018 Feb;107(Pt A):1030-1038.
PMID: 28939521 DOI: 10.1016/j.ijbiomac.2017.09.066

Successful use of tissue expanders depends on the quality of expanded tissue. This study evaluates the impact of anisotropic self-inflating tissue expander (SITE) on the biomechanics of skin. Two different SITE were implanted subcutaneously on sheep scalps; SITE that requires 30days for maximum expansion (Group A; n=5), and SITE that requires 21days for maximum expansion (Group B; n=5). Control animals (n=5) were maintained without SITE implantation. Young's Modulus, D-periodicity, overlap and gap region length, diameter, and height difference between overlap and gap regions on collagen fibrils were analyzed using atomic force microscopy. Histology showed no significant differences in dermal thickness between control and expanded skin of groups A and B. Furthermore, most parameters of expanded skin were similar to controls (p>0.05). However, the height difference between overlap and gap regions was significantly smaller in group B compared to both control and group A (p<0.01). Strong correlation was observed between Young's Modulus of overlap and gap regions of the control and group A, but not group B. Results suggest that a relatively slower SITE can be useful in reconstructive surgery to maintain the biomechanical properties of expanded skin.

Matched MeSH terms: Scalp/ultrastructure; Scalp/chemistry*
Fulltext A Study on Scalp Hair Health and Hair Care Practices among Malaysian Medical Students

Nayak BS, Ann CY, Azhar AB, Ling ECS, Yen WH, Aithal PA

Int J Trichology, 2017 Apr-Jun;9(2):58-62.
PMID: 28839388 DOI: 10.4103/ijt.ijt_76_16

INTRODUCTION: Scalp care is essential because it determines the health and condition of the hair and prevents the diseases of scalp and hair. The objectives of our study were to correlate race and hair types, to determine the awareness of hair care among Malaysian medical students, and to distinguish the factors that affect the health of hair and scalp.

METHODOLOGY: It was a cross-sectional study wherein validated questionnaires were given to 240 medical undergraduate students who belonged to three ethnic races of Malaysia, i.e., Chinese, Malay, and Malaysian Indians after their informed consent. The results were then analyzed using percentage statistics.

RESULTS: Chinese students had comparatively healthier scalp without dandruff. Most Chinese and Indians had silky type of hair while Malay had dry, rough hair. Chinese and Indians colored their hair and used various styling methods; while among the Malays, this percentage was very less. Regarding hair care practices, males used only shampoo and females used shampoo and conditioner for hair wash. Students also faced dietary and examination-related stress.

CONCLUSION: Results indicate that there exist morphological differences in hair among the studied population. Since most students color their hair and employ various hairstyling methods, they should be educated regarding best hair care practices to improve their scalp hair condition and health.

Matched MeSH terms: Scalp
Pattern of head injury in motorcycle fatalities

Ong BB, Krishnan R, Lee P

JUMMEC, 2000;5:33-35.

Head injury contributes to a significant proportion of motorcycle fatalities. The site and pattern of head injury in victims of fatal motorcycle crashes in 1995 were studied retrospectively. The site of impact on the head was determined based on the injuries on the scalp, pattern of skull fractures and injuries of the brain. Of 54 cases, 9 had massive crush injuries. Of the remaining 45 cases, the site of impact was as follows: frontal 21, lateral 14, posterior 4, vertex 1, chin 1 and unascertainable in 4 cases. The majority of injuries occurred on the front and lateral aspects of the skull. Motorcycle helmets are currently tested for impact energy attenuation and penetration test at the vertex. Helmet standards need to take into account site and nature of injury. KEYWORDS: Head injury, motorcycle fatalities, helmet standards.

Matched MeSH terms: Scalp

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