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Green solution for oil spills: A review on the role of surface-active ionic liquids

Nazar M, Ahmad A, Hussain SMS, Sulaimon AA, Moniruzzaman M

Adv Colloid Interface Sci, 2025 Feb;336:103362.
PMID: 39626337 DOI: 10.1016/j.cis.2024.103362

Oil spills have long-lasting and harmful impacts on the environment, particularly on aquatic ecosystems. This review provides a comprehensive overview of conventional methods for oil spill removal, highlighting both their advantages and limitations. Traditional methods for addressing oil spills, including physical, thermal, biological and chemical techniques, often prove insufficient, with chemical dispersants being the most popular approach. However, the concern about the toxicity and low biodegradability of these dispersants have led researchers to explore more effective and ecologically benign alternatives. Recently, surface-active ionic liquids (SAILs) have gained interest due to their amphiphilic nature, green and biodegradable characteristics, and excellent performance under various temperature and salinity conditions. In this review, the molecular composition of SAILs, with a specific emphasis on the roles of their head groups, alkyl chains, and counter anions, has been discussed. Additionally, the aggregation behavior of SAILs, their ability to reduce interfacial tension (IFT), and their potential to form stable emulsions, which are important for effective oil dispersion, has been also discussed in the paper. This review also examines key environmental factors such as temperature and salinity that influence the efficacy of oil dispersion using SAILs. The study investigates the possibilities of SAILs as an environmentally friendly substitute for conventional dispersants, while also discussing the challenges and possible future paths for the industry. However, the long-term environmental effects of SAILs and their degradation products are still uncertain, underscoring the necessity of future research. Insights into the optimization of SAIL formulations, their environmental impact, and the feasibility of large-scale application are also discussed, offering a forward-looking perspective on the development of next-generation oil spill remediation technologies.
Fulltext Phosphoric acid based geopolymer foam-activated carbon composite for methylene blue adsorption: isotherm, kinetics, thermodynamics, and machine learning studies

Khan MI, Sufian S, Hassan F, Shamsuddin R, Farooq M

RSC Adv, 2025 Jan 16;15(3):1989-2010.
PMID: 39845118 DOI: 10.1039/d4ra05782a

In this study, a binary composite adsorbent based on activated carbon and phosphoric acid geopolymer foam (ACP) was prepared by combining phosphoric acid geopolymer (PAGP) with activated carbon (AC) and applied for the removal of methylene blue (MB). Activated carbon was thoroughly mixed with a mixture of fly ash and metakaolin in varying ratios, followed by phosphoric acid activation and thermal curing. The ACP adsorbent was characterized using scanning electron microscope (SEM), Fourier transform infrared (FTIR) spectrophotometer, X-ray diffractometer (XRD), surface area analyser (SAP), and thermogravimetric analyser (TGA). Batch analysis was performed to examine the effects of various adsorption parameters including pH (2, 4, 6, 7, 8, and 10), adsorbent dosage (0.06-0.2 g), MB concentration (50-250 mg L-1), contact duration (up to 240 minutes), and temperature (25-55 °C). The ACP with 70% PAGP and 30% AC was found to be the most suitable adsorbent as it maintained its structure and exhibited better MB adsorption. The ACP had a surface area of 47.36 m2 g-1 and a pore size of 5.6 nm and was found to be amorphous in nature. The adsorption equilibrium reached in 240 minutes at pH 7, indicating an efficient adsorption process. The adsorption increased with the initial dye concentration and decreased with the increase in temperature. The ideal parameters for adsorption of MB using ACP include 0.2 g of adsorbent, 25 °C, pH 10, and 240 minutes. The adsorption data fitted well with the Langmuir isotherm, pseudo-second-order (PSO) kinetics model, and three-step intraparticle diffusion (IPD) model. The adsorption capacity calculated using the Langmuir isotherm was 204.8 mg g-1 with an R 2 = 0.989. Thermodynamics parameters showed that the adsorption process was exothermic, energetically favourable, and associated with a decrease in entropy. According to the FTIR findings, pH effect, Langmuir isotherm, PSO kinetics, IPD model, and thermodynamics factors, chemisorption is identified as the predominant process. Different machine learning models, i.e., gaussian process regression (GPR), support vector regression (SVR and SVR-rbf), random forest regression (RFR), decision tree regression (DTR) and artificial neural network (ANN), were trained and tested using adsorption capacity and % removal data. The ANN model (random search) demonstrated better performance compared to other models, achieving an R 2 value of 0.873 for adsorption capacity and 0.799 for % removal on test data.
Fulltext Study protocol for a randomized control trial investigating the effectiveness of a multifaceted mHealth approach on adherence to antihypertensive treatment among patients in Pakistan

Arshed M, Mahmud AB, Umer MF, Mashhadi F, Kawish AB

Pak J Med Sci, 2025 Jan;41(1):22-28.
PMID: 39867791 DOI: 10.12669/pjms.41.1.9272

BACKGROUND & OBJECTIVES: Poor medication adherence is an essential contributor to Pakistan's high prevalence of uncontrolled hypertension. This study will be aimed to assess the efficacy of a one-of-a-kind developed intervention in improving medication adherence and treatment outcomes in hypertension patients.
METHODS: Twleve months duration long randomized controlled trial from January to December 2021 will be carried out at Shaikh Zayed Medical Complex (SZMC), Lahore. A total of 440 patients aged 18 years and older diagnosed with hypertension in the last month with non- adherence to antihypertensive therapy <80% of pills used in the last 30 days and have access to a smartphone will be randomized into either the intervention group (n=220) or the control group (n=220). For the intervention arm, a comprehensive intervention, the "Multi-Aid-Package," consisting of seven items: written, voice, and graphics messages, animated video, educational material, and a 24/7 help service, has been designed. Standard care will be provided to the control group. The primary outcome will be improved adherence to antihypertensive medication, while the secondary outcome will be an alteration in systolic blood pressure (SBP). The analysis will be intention to treat.
CONCLUSION: According to this study, if the multifunctional Multi-Aid-Package proves to be a useful mobile health tool for improving hypertension patients' medication adherence, it will also significantly affect systolic blood pressure. In Pakistan and other comparable low- and middle-income countries LMICs, the Multi-Aid-Package ought to be taken into consideration as a means of enhancing adherence to medications among hypertension patients.
Monster of the Night: Identifying Pakistani Gender-Based, Religious, and Cultural Influences on Sleep Paralysis Among University Students

Khan FF, Haq MSU, Ashfaq A, Saud M, Ibrahim A

Cult Med Psychiatry, 2025 Jan 25.
PMID: 39856384 DOI: 10.1007/s11013-024-09892-2

The present study has explored the folk knowledge about the phenomenon of sleep paralysis in Pakistani society. The research aimed to gain a nuanced glimpse focusing on three major factors, culture, religion, and gender, that influence the lived experiences of those who face sleep paralysis. In this qualitative research, to have a holistic perception of indigenous knowledge about it, we selected both male and female participants who have experienced sleep paralysis. The findings indicate that there is an influence of Pakistani culture and religion regarding the experiences of the people with sleep paralysis, and gender is linked with the folklore on creatures that were linked to fairy tales and Islamic teachings. The study also revealed that Pakistani ethnic diversity has created a pool of versatility for identifying different experiences regarding sleep paralysis. These experiences were not just a part of the medical situation but portrayed the multicultural facets that are embedded in the individuals throughout their lives. Lastly, the study suggests that there is a complexity within the interactions between culture, religion, and gender on sleep paralysis. This needs to be further investigated to create culturally appropriate therapies that may have a favorable effect on both physical and mental health outcomes.
Effects of logging and recovery process on avian richness and diversity in hill dipterocarp tropical rainforest-Malaysia

Husin MZ, Rajpar MN

J Environ Biol, 2015 Jan;36 Spec No:121-7.
PMID: 26591891

The effects of logging and recovery process on avian richness and diversity was compared in recently logged and thirty year post-harvested hill dipterocarp tropical rainforest, using mist-netting method. Atotal of 803 bird individuals representing 86 bird species and 29 families (i.e., 37.90% from recently logged forest and 62.10% from thirty year post-harvested forest) were captured from October 2010 to September, 2012. Twenty one bird species were commonly captured from both types of forests, 37 bird species were caught only in thirty year post-harvested forest and 28 bird species were caught only from recently logged forest. Arachnothera longirostra--Little Spiderhunter, Malacopteron magnum--Rufous-crowned Babbler, Alophoixus phaeocephalus -Yellow-bellied Bulbul and Meiglyptes tukki--Buff-necked Woodpecker were the most abundant four bird species in the thirty year post-harvested forest. On the contrary, seven bird species, i.e., Trichastoma rostratum - White-chested Babbler, Lacedo pulchella - Banded Kingfisher, Picus miniaceus--Banded Woodpecker, Enicurus ruficapillus - Chestnut-naped Forktail, Anthreptes simplex--Plain Sunbird, Muscicapella hodgsoni--Pygmy Blue Flycatcher and Otus rufescens--Reddish Scope Owl were considered as the rarest (i.e., each represented only 0.12%). Likewise, A. longirostra, Pycnonotus eythropthalmos - Spectacled Bulbul, P. simplex--Cream-vented Bulbul and Merops viridis--Blue-throated Bee-eater were the most dominant and Copsychus malabaricus--White-rumped Shama Eurylaimus javanicus--Banded Broadbill /xos malaccensis - Streaked Bulbul and Harpactes diardii--Diard's Trogon (each 0.12%) were the rarest bird species in recently logged forest. CAP analysis indicated that avian species in thirty year post-harvested forest were more diverse and evenly distributed than recently logged forest. However, recently logged forest was rich in bird species than thirty year post- harvested forest. The results revealed that logging and retrieval process affect bird species richness and diversity. However, bird species may respond differently from habitat to habitat, i.e., forest logging causes disturbance of some avian species while recovery process may replace the loss of vegetation and harbour a wide array of avian species richness and diversity.
Fulltext Multilayer stock forecasting model using fuzzy time series

Javedani Sadaei H, Lee MH

ScientificWorldJournal, 2014;2014:610594.
PMID: 24605058 DOI: 10.1155/2014/610594

After reviewing the vast body of literature on using FTS in stock market forecasting, certain deficiencies are distinguished in the hybridization of findings. In addition, the lack of constructive systematic framework, which can be helpful to indicate direction of growth in entire FTS forecasting systems, is outstanding. In this study, we propose a multilayer model for stock market forecasting including five logical significant layers. Every single layer has its detailed concern to assist forecast development by reconciling certain problems exclusively. To verify the model, a set of huge data containing Taiwan Stock Index (TAIEX), National Association of Securities Dealers Automated Quotations (NASDAQ), Dow Jones Industrial Average (DJI), and S&P 500 have been chosen as experimental datasets. The results indicate that the proposed methodology has the potential to be accepted as a framework for model development in stock market forecasts using FTS.
Laccase enzymes: purification, structure to catalysis and tailoring

Moin SF, Omar MN

Protein Pept Lett, 2014;21(8):707-13.
PMID: 23855667

Laccases belong to the multicopper binding protein family that catalysis the reduction of oxygen molecule to produce water. These enzymes are glycosylated proteins and have been isolated and purified from fungi, bacteria, plant, insects and lichens. The variety of commercial and industrial application of laccases has attracted much attention towards the research addressing different aspects of the protein characterization, production and fit for purpose molecule. Here we briefly discuss the purification, catalytic mechanism in light of available understanding of structure-function relationship and the tailoring side of the protein, which has been the subject of recent research. Purification strategy of laccases is a method of choice and is facilitated by increased production of the enzyme. The structure-function relationship has given insights to unfold the catalytic mechanism. Site directed mutagenesis and other modification at C-terminal end or surrounding environment of copper centres have shown promising results to fit for purpose aspect, with a lot remains to be explored in glycosylation status and its alteration.
Fulltext Increasing the efficiency of detecting active tuberculosis cases in intermediate and high-burden tuberculosis countries: A way forward

Atif M, Sulaiman SA

J Basic Clin Pharm, 2012 Sep;3(4):330-1.
PMID: 24826045 DOI: 10.4103/0976-0105.105333
Fulltext Impact of pharmacist recruitment on ADR reporting: Malaysian experience

Hadi MA, Ming LC

South Med Rev, 2011 Dec;4(2):102-3.
PMID: 23093890 DOI: 10.5655/smr.v4i2.1009
Relative radiological risks derived from different TENORM wastes in Malaysia

Ismail B, Teng IL, Muhammad Samudi Y

Radiat Prot Dosimetry, 2011 Nov;147(4):600-7.
PMID: 21266370 DOI: 10.1093/rpd/ncq577

In Malaysia technologically enhanced naturally occurring radioactive materials (TENORM) wastes are mainly the product of the oil and gas industry and mineral processing. Among these TENORM wastes are tin tailing, tin slag, gypsum and oil sludge. Mineral processing and oil and gas industries produce large volume of TENORM wastes that has become a radiological concern to the authorities. A study was carried out to assess the radiological risk related to workers working at these disposal sites and landfills as well as to the members of the public should these areas be developed for future land use. Radiological risk was assessed based on the magnitude of radiation hazard, effective dose rates and excess cancer risks. Effective dose rates and excess cancer risks were estimated using RESRAD 6.4 computer code. All data on the activity concentrations of NORM in wastes and sludges used in this study were obtained from the Atomic Energy Licensing Board, Malaysia, and they were collected over a period of between 5 and 10 y. Results obtained showed that there was a wide range in the total activity concentrations (TAC) of nuclides in the TENORM wastes. With the exception of tin slag and tin tailing-based TENORM wastes, all other TENORM wastes have TAC values comparable to that of Malaysia's soil. Occupational Effective Dose Rates estimated in all landfill areas were lower than the 20 mSv y(-1) permissible dose limit. The average Excess Cancer Risk Coefficient was estimated to be 2.77×10(-3) risk per mSv. The effective dose rates for residents living on gypsum and oil sludge-based TENORM wastes landfills were estimated to be lower than the permissible dose limit for members of the public, and was also comparable to that of the average Malaysia's ordinary soils. The average excess cancer risk coefficient was estimated to be 3.19×10(-3) risk per mSv. Results obtained suggest that gypsum and oil sludge-based TENORM wastes should be exempted from any radiological regulatory control and should be considered radiologically safe for future land use.
Regularized logistic regression with adjusted adaptive elastic net for gene selection in high dimensional cancer classification

Algamal ZY, Lee MH

Comput Biol Med, 2015 Dec 1;67:136-45.
PMID: 26520484 DOI: 10.1016/j.compbiomed.2015.10.008

Cancer classification and gene selection in high-dimensional data have been popular research topics in genetics and molecular biology. Recently, adaptive regularized logistic regression using the elastic net regularization, which is called the adaptive elastic net, has been successfully applied in high-dimensional cancer classification to tackle both estimating the gene coefficients and performing gene selection simultaneously. The adaptive elastic net originally used elastic net estimates as the initial weight, however, using this weight may not be preferable for certain reasons: First, the elastic net estimator is biased in selecting genes. Second, it does not perform well when the pairwise correlations between variables are not high. Adjusted adaptive regularized logistic regression (AAElastic) is proposed to address these issues and encourage grouping effects simultaneously. The real data results indicate that AAElastic is significantly consistent in selecting genes compared to the other three competitor regularization methods. Additionally, the classification performance of AAElastic is comparable to the adaptive elastic net and better than other regularization methods. Thus, we can conclude that AAElastic is a reliable adaptive regularized logistic regression method in the field of high-dimensional cancer classification.
Patient satisfaction constructs

Rahman MS, Osmangani AM

Int J Health Care Qual Assur, 2015;28(8):841-54.
PMID: 26440486 DOI: 10.1108/IJHCQA-05-2015-0056

The purpose of this paper is to examine the five-factor structure of patients' satisfaction constructs toward private healthcare service providers.
Fulltext Recurrent vomiting in a woman due to miscarriage: think out of the box

Khalid S, Aris MS

BMJ Case Rep, 2016 Mar 30;2016.
PMID: 27030452 DOI: 10.1136/bcr-2015-213165

A 25-year-old gravida 2 para 1 with 12-week amenorrhoea presented a second time for recurrent vomiting in pregnancy. She was diagnosed to have a missed miscarriage following absent fetal heart seen in an early scan. She opted for conservative management. However, on the third presentation, her vomiting continued. Repeated transvaginal ultrasound scan showed a fetus with a crown rump length of 19 mm, which is equivalent to 8 weeks and 4 days, with absence of fetal heart pulsation. Thyroid function tests and β human chorionic gonadotropin were then requested. Results showed that the patient's serum β human chorionic gonadotropin level was markedly raised to 147,000. A molar pregnancy was suspected. Her thyroid function tests came back normal. Suction curettage was performed and histopathology confirmed a partial molar pregnancy. On follow-up, the β human chorionic gonadotropin level was normal by 7 weeks after the curettage.
Challenges to health workers and their opinions about parents' refusal of oral polio vaccination in the Khyber Pakhtoon Khawa (KPK) province, Pakistan

Khan TM, Sahibzada MU

Vaccine, 2016 Apr 19;34(18):2074-81.
PMID: 26993330 DOI: 10.1016/j.vaccine.2016.03.008

A qualitative study design was adapted to explore the challenges faced by health workers (HWs) during the polio health campaign. In addition, HWs' opinions about the factors causing parents to refuse oral polio vaccination (OPV) were also explored. Four focus group discussions (FGDs) were held (from 1st January 2015-31st March 2015) with the HWs who participated in the OPV campaigns in the polio red zones of Khyber Pakhtoon Khawa (KPK) province of Pakistan, namely Kohat (FG 1), Domel and Bannu (FG 2), Hangoo (FG 3), and Peshawar (FG 4). A total of N=42 HWs (10-11 in each FG) agreed to participate in this study. Overall, HWs disclosed that public attitude and harsh behaviour towards the HWs and security threats are the two main challenges they face. Common issues hindering parents' willingness to vaccinate their children against OPV are: OPV is seen as haram and not permitted in Islam, it is said to contain the blood of pigs (Khinzir) and monkeys, and parents are afraid that it is done to induce sterility among their children. HWs also shared that parents have a strong belief in the conspiracies that are associated with OPV, i.e. the USA and CIA, are spying on us and our government is helping them to achieve their agenda. Furthermore, HWs revealed that frequent visits may further strengthen parents' perceptions and make them more resistant to OPV. The common side effects of OPV reported by parents were mainly gastro-intestinal problems and in some cases mild to moderate fever with some respiratory symptoms. There is a great need to improve the logistics and facilities for HWs assisting in vaccination programmes. Furthermore, it is necessary to improve education, so people understand the basic concept of revaccination and booster doses, thereby assisting in creating a basic understanding of vaccinations, which may trigger changes in attitudes and make people believe in the benefits of OPV rather than following the conspiracies that lead them to refuse it.
Recent advances in exploiting ionic liquids for biomolecules: Solubility, stability and applications

Sivapragasam M, Moniruzzaman M, Goto M

Biotechnol J, 2016 Jun 17.
PMID: 27312484 DOI: 10.1002/biot.201500603

The technological utility of biomolecules (e.g. proteins, enzymes and DNA) can be significantly enhanced by combining them with ionic liquids (ILs) - potentially attractive "green" and "designer" solvents - rather than using in conventional organic solvents or water. In recent years, ILs have been used as solvents, cosolvents, and reagents for biocatalysis, biotransformation, protein preservation and stabilization, DNA solubilization and stabilization, and other biomolecule-based applications. Using ILs can dramatically enhance the structural and chemical stability of proteins, DNA, and enzymes. This article reviews the recent technological developments of ILs in protein-, enzyme-, and DNA-based applications. We discuss the different routes to increase biomolecule stability and activity in ILs, and the design of biomolecule-friendly ILs that can dissolve biomolecules with minimum alteration to their structure. This information will be helpful to design IL-based processes in biotechnology and the biological sciences that can serve as novel and selective processes for enzymatic reactions, protein and DNA stability, and other biomolecule-based applications.
Fulltext Field accumulation risks of heavy metals in soil and vegetable crop irrigated with sewage water in western region of Saudi Arabia

Balkhair KS, Ashraf MA

Saudi J Biol Sci, 2016 Jan;23(1):S32-44.
PMID: 26858563 DOI: 10.1016/j.sjbs.2015.09.023

Wastewater irrigated fields can cause potential contamination with heavy metals to soil and groundwater, thus pose a threat to human beings . The current study was designed to investigate the potential human health risks associated with the consumption of okra vegetable crop contaminated with toxic heavy metals. The crop was grown on a soil irrigated with treated wastewater in the western region of Saudi Arabia during 2010 and 2011. The monitored heavy metals included Cd, Cr, Cu, Pb and Zn for their bioaccumulation factors to provide baseline data regarding environmental safety and the suitability of sewage irrigation in the future. The pollution load index (PLI), enrichment factor (EF) and contamination factor (CF) of these metals were calculated. The pollution load index of the studied soils indicated their level of metal contamination. The concentrations of Ni, Pb, Cd and Cr in the edible portions were above the safe limit in 90%, 28%, 83% and 63% of the samples, respectively. The heavy metals in the edible portions were as follows: Cr > Zn > Ni > Cd > Mn > Pb > Cu > Fe. The Health Risk Index (HRI) was >1 indicating a potential health risk. The EF values designated an enhanced bio-contamination compared to other reports from Saudi Arabia and other countries around the world. The results indicated a potential pathway of human exposure to slow poisoning by heavy metals due to the indirect utilization of vegetables grown on heavy metal-contaminated soil that was irrigated by contaminated water sources. The okra tested was not safe for human use, especially for direct consumption by human beings. The irrigation source was identified as the source of the soil pollution in this study.
Slow release coating remedy for nitrogen loss from conventional urea: a review

Naz MY, Sulaiman SA

J Control Release, 2016 Mar 10;225:109-20.
PMID: 26809006 DOI: 10.1016/j.jconrel.2016.01.037

Developing countries are consuming major part of the global urea production with an anticipated nitrogen use efficiency of 20 to 35%. The release of excess nitrogen in the soil is not only detrimental to the environment but also lessens the efficiency of the conventional urea. The urea performance can be enhanced by encapsulating it with slow release coating materials and synchronizing the nutrients' release with the plant up-taking. However, the present cost of most of the coated fertilizers is considerably higher than the conventional fertilizers. The high cost factor prevents their widespread use in mainstream agriculture. This paper documents a review of literature related to the global urea market, issues pertaining to the conventional urea use, natural and synthetic materials for slow release urea and fluidized bed spray coating process. The aim of the current review is to develop technical understanding of the conventional and non-conventional coating materials and associated spray coating mechanism for slow release urea production. The study also investigated the potential of starch as the coating material in relation to the coatings tested previously for controlled release fertilizers.
Travel itinerary uncertainty and the pre-travel consultation--a pilot study

Flaherty G, Md Nor MN

J Travel Med, 2016 Jan;23(1).
PMID: 26782127 DOI: 10.1093/jtm/tav010

Risk assessment relies on the accuracy of the information provided by the traveller. A questionnaire was administered to 83 consecutive travellers attending a travel medicine clinic. The majority of travellers was uncertain about destinations within countries, transportation or type of accommodation. Most travellers were uncertain if they would be visiting malaria regions. The degree of uncertainty about itinerary potentially impacts on the ability of the travel medicine specialist to perform an adequate risk assessment, select appropriate vaccinations and prescribe malaria prophylaxis. This study reveals high levels of traveller uncertainty about their itinerary which may potentially reduce the effectiveness of their pre-travel consultation.
Fulltext Single Cell Electrical Characterization Techniques

Mansor MA, Ahmad MR

Int J Mol Sci, 2015;16(6):12686-712.
PMID: 26053399 DOI: 10.3390/ijms160612686

Electrical properties of living cells have been proven to play significant roles in understanding of various biological activities including disease progression both at the cellular and molecular levels. Since two decades ago, many researchers have developed tools to analyze the cell's electrical states especially in single cell analysis (SCA). In depth analysis and more fully described activities of cell differentiation and cancer can only be accomplished with single cell analysis. This growing interest was supported by the emergence of various microfluidic techniques to fulfill high precisions screening, reduced equipment cost and low analysis time for characterization of the single cell's electrical properties, as compared to classical bulky technique. This paper presents a historical review of single cell electrical properties analysis development from classical techniques to recent advances in microfluidic techniques. Technical details of the different microfluidic techniques are highlighted, and the advantages and limitations of various microfluidic devices are discussed.
True Median Cleft Lip-15 Years of Review and Prevalence

Hamzan MI, Sulaiman WAW

Cleft Palate Craniofac J, 2020 08;57(8):1051-1054.
PMID: 32476501 DOI: 10.1177/1055665620926346

OBJECTIVES: The author presents 4 cases and attempts to analyze the prevalence of true median cleft lip (MCL) in one center. Embryology, associated anomalies, and surgical treatment are discussed.
DESIGN: A retrospective descriptive study.
SETTING: Hospital Universiti Sains Malaysia.
PARTICIPANTS: All patients with congenital facial cleft deformities from 2005 to 2019 were retrieved from the Plastic Surgery OR Registry. All characteristics in interest were individually tabulated and evaluated. Four cases were reviewed and discussed.
OUTCOME: Prevalence of true MCL.
RESULTS: Out of the 494 patients included in the study, only 4 (0.81%) were affected with a median cleft, and the prevalence of true median cleft was hence determined to be 3 (0.61%) among the cleft population.
CONCLUSION: The prevalence of the true MCL is rare which makes it hard to categorize these clefts, and the surgical protocol needs to be established for the definitive treatment.

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