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Fulltext Career Satisfaction of Malaysian Dentists With Expanded Roles at a Specialist Clinic

Malek AA, Radzi NAM, Musa MFC

Int Dent J, 2023 Aug;73(4):574-579.
PMID: 36513555 DOI: 10.1016/j.identj.2022.11.010

OBJECTIVES: Public dentists interested in postgraduate studies were required to complete clinical attachments at the Malaysian Ministry of Health (MOH) Dental Specialist Clinic (DSC). This cross-sectional quantitative study aimed to explore career satisfaction (CS) and barriers perceived by Malaysian dentists at Malaysia's MOH DSC.
METHODS: A total of 208 dentists from DSC nationwide completed an online questionnaire in June 2022. Demographic data and information on dentists' expanded roles were retrieved. Responses on dentists' satisfaction and perceived barriers were collected using a 5-point ordinal scale. Mann-Whitney U and Kruskal-Wallis tests were used to compare the mean rank differences for CS. Factors influencing CS were analysed using multiple logistic regression (MLR) (P < .05).
RESULTS: The mean age of the respondents was 32.68 ± 2.48 years. Almost half (49.0%) of the respondents were attached to a non-hospital-based clinic. The majority (72.0%) of them were permanently attached to the DSC. About half of the dentists (51.0%) strongly agreed that they received no financial incentives for their expanded role at the MOH DSC. Dentists attached at a non-hospital-based clinic (P = .046), working with more than 15 years of experience (P = .013), and having 12 to 18 months' duration of attachment (P = .014) were more satisfied. MLR analysis revealed that non-Malay respondents (odds ratio [OR], 1.54; P = .035) and those who applied for scholarships more than 3 times (OR, 1.85; P = .050) were more satisfied. In contrast, more than 19 months at the DSC decreased CS (OR, 0.44; P = .029).
CONCLUSIONS: Despite having a similar organisational structure, DSC dentists had different satisfaction levels. Dentists' ethnicity, duration of attachment, and frequency of applying for scholarships influenced their CS. Future career advancement plans in the MOH should consider these important influencing factors to ensure the delivery of quality health care from their personnel.
Effect on heavy metals concentration from vermiconversion of agro-waste mixed with landfill leachate

Azizi AB, Choy MY, Noor ZM, Noorlidah A

Waste Manag, 2015 Apr;38:431-5.
PMID: 25670166 DOI: 10.1016/j.wasman.2015.01.020

Spent Pleurotus sajor-caju compost mixed with livestock excreta, i.e. cow dung or goat manure, was contaminated with landfill leachate and vermiremediated in 75 days. Results showed an extreme decrease of heavy metals, i.e. Cd, Cr and Pb up to 99.81% removal as effect of vermiconversion process employing epigeic earthworms i.e. Lumbricus rubellus. In addition, there were increments of Cu and Zn from 15.01% to 85.63%, which was expected as non-accumulative in L. rubellus and secreted out as contained in vermicompost. This phenomenon is due to dual effects of heavy metal excretion period and mineralisation. Nonetheless, the increments were 50-fold below the limit set by EU and USA compost limits and the Malaysian Recommended Site Screening Levels for Contaminated Land (SSLs). Moreover, the vermicompost C:N ratio range is 20.65-22.93 and it can be an advantageous tool to revitalise insalubrious soil by acting as soil stabiliser or conditioner.
Vermiremoval of heavy metal in sewage sludge by utilising Lumbricus rubellus

Azizi AB, Lim MP, Noor ZM, Abdullah N

Ecotoxicol Environ Saf, 2013 Apr;90:13-20.
PMID: 23294636 DOI: 10.1016/j.ecoenv.2012.12.006

Experiments were conducted to remove heavy metals (Cr, Cd, Pb, Cu and Zn) from urban sewage sludge (SS) amended with spent mushroom compost (SMC) using worms, Lumbricus rubellus, for 105 days, after 21 days of pre-composting. Five combinations of SS/SMC treatments were prepared in triplicate along with a control for each treatment in microcosms. Analysis of the earthworms' multiplication and growth and laboratory analysis were conducted during the tenth and fifteenth week of vermicomposting. Our result showed that the final biomass of earthworms (mg) and final number of earthworms showed significant differences between treatments i.e. F=554.70, P=0.00 and F=729.10, P=0.00 respectively. The heavy metals Cr, Cd and Pb contained in vermicompost were lower than initial concentrations, with 90-98.7 percent removal on week ten. However, concentrations of Cu and Zn, that are considered as micronutrients, were higher than initial concentrations, but they were 10-200-fold lower than the EU and USA biosolid compost limits and Malaysian Recommended Site Screening Levels for Contaminated Land (SSLs). An increment of heavy metals were recorded in vermicompost for all treatments on week fifteen compared to week ten, while concentration of heavy metals in earthworms' tissue were lower compared to vermicompost. Hence, it is suggested that earthworms begin to discharge heavy metals into their surroundings and it was evident that the earthworms' heavy metals excretion period was within the interval of ten to fifteen weeks.
Fulltext Large fusiform posterior cerebral artery aneurysm (P2 segment): successful trapping and excision via subtemporal approach

Ramzisham ARM, Azizi AB, Zurin AAR

Med J Malaysia, 2004 Oct;59(4):530-2.
PMID: 15779587

A 62-year-old man presented with a 2-month history of right occipito-parietal headache and worsening ipsilateral ptosis. CT scan and cerebral angiography revealed a large fusiform aneurysm of the P2 segment of the right posterior cerebral artery (PCA). The aneurysm was successfully trapped and subsequently excised via sub temporal approach leaving no additional neurological deficits to our patient.
Unruptured anterior communicating artery aneurysm in a 2-year-old child

Syahrilfazli AJ, Nursharmizam MB, Azizi AB, Zurin AA

Pediatr Neurosurg, 2005 Sep-Oct;41(5):283-4.
PMID: 16195685
Intramedullary spinal cord abscess: The result of a missed congenital dermal sinus

Kanaheswari Y, Lai C, Raja Lope RJ, Azizi AB, Zulfiqar MA

J Paediatr Child Health, 2015 Feb;51(2):223-5.
PMID: 25099316 DOI: 10.1111/jpc.12707

Congenital dermal sinus (CDS) and occult spinal dysraphism are suspected when a cutaneous marker overlies the spine of a newborn. CDS can have the appearance of a simple dimple and occur within the gluteal cleft without any skin markers. CDS are the commonest cause of intramedullary spinal cord abscess.
Heterotopic neuroglial tissue presenting as oral cavity mass with intracranial extension

Marina MB, Zurin AR, Muhaizan WM, Primuharsa Putra SH, Azizi AB, Kenali MS

Int J Pediatr Otorhinolaryngol, 2005 Nov;69(11):1587-90.
PMID: 15935483

Heterotopic neuroglial tissue is a rare congenital lesion with predilection in head and neck region. We report a case of a newborn who presented with an oral cavity mass with intracranial extension and later respiratory distress that was successfully excised via transcranial and transcervical approach.
Fulltext Brain herniation in a neonate

Wong CY, Azizi AB, Shareena I, Rohana J, Boo NY, Isa MR

Singapore Med J, 2010 Oct;51(10):e166-8.
PMID: 21103805

Brain herniation is generally thought to be unlikely to occur in newborns due to the presence of the patent fontanelles and cranial sutures. A review of the literature published from 1993 to 2008 via MEDLINE search revealed no reports on neonatal brain herniation from intracranial tumour. We report a preterm Malay male infant born via elective Caesarean section for antenatally diagnosed intracerebral tumour, which subsequently developed herniation. Cerebral magnetic resonance imaging showed features that were compatible with a large complex intracranial tumour causing mass effect and gross hydrocephalus. Tumour excision was scheduled when the infant was two weeks old. Unfortunately, on the morning of the surgery, he developed signs of brain herniation and had profuse tumour haemorrhage during the attempted excision. Histopathological examination revealed an embryonal tumour, possibly an atypical rhabdoid/teratoid tumour. This case illustrates that intracranial tumours in newborns can herniate and should therefore be closely monitored.
The Prevalence and Distribution of Spina Bifida in a Single Major Referral Center in Malaysia

Sahmat A, Gunasekaran R, Mohd-Zin SW, Balachandran L, Thong MK, Engkasan JP, et al.

Front Pediatr, 2017;5:237.
PMID: 29170734 DOI: 10.3389/fped.2017.00237

Background: The aim of this study is to review the medical history of patients with spina bifida, encompassing both aperta and occulta types born between the years 2003 until 2016, spanning a 13-year time period. We assessed each patient and maternal parent information, details of the defects, and conditions associated with the primary defect. We also include information on patients' ambulation and education level (where available).
Methods: Data from the Department of Patient Information University of Malaya Medical Centre (UMMC), Malaysia was captured from spina bifida patients (ICD10: Q05 spina bifida). Data involved patients referred to UMMC between 2003 and 2016 and/or born in UMMC within that particular time frame. We filtered and extracted the information according to the data of clinical examination, medical review, and social history provided in the medical records.
Results: A total of 86 patient records with spina bifida were analyzed. Spina bifida prevalence rate in this study ranged from 1.87 to 8.9 per 1,000 live births depending on weightage. We note that ethnicity was a factor whereby the highest numbers of spina bifida were from Malays (n = 36, 41.86%), followed by equal numbers of Chinese and Indians (n = 24, 27.91%). The highest number of diagnoses reported was myelomeningocele type-spina bifida (n = 39, 45.35%). The most common site of the spina bifida lesion was located at the lumbar region irrespective of aperta or occulta types (n = 23, 26.74%). Data on other associated phenotypes of spina bifida such as hydrocephalus and encephalocele was also captured at 37.21% (n = 32) and 1.16% (n = 1), respectively. In terms of mobility, 32.84% (n = 22/67) of patients between the ages 4 and 16 years old were found to be mobile. As many as 36.07% of patients ranging from 5 to 16 years of age (n = 22/61) received formal education ranging from preschool to secondary school.
Conclusion: The prevalence of spina bifida in UMMC is as according to international statistics which is in the range of 0.5-10 per 1,000 live births. Majority of the reported cases were males, Malays, full term babies, and of the myelomeningocele phenotype located at the lumbar region.