IIUM Medical Journal Malaysia (IMJM)
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Environmental and Occupational Health Impact of Bauxite Mining in Malaysia: A Review
Get PDFIn the perspective of recent bauxite mining in Malaysia, this review aims to identify the potential environmental and health impacts on miners and surrounding communities. The environmental issues of bauxite mining include, air, water and soil pollution due to bauxite dust; leaching of bauxite into water sources resulting in reduced soil fertility as well as affecting agricultural food products and aquatic life. Bauxite occupational exposure affects the health of miners, and has negative consequences on the health of surrounding communities, such as increased respiratory symptoms, contamination of drinking water, other potential health risks from ingestion of bauxite and heavy metals, including noise-induced hearing loss and mental stress. This review discusses the processes of bauxite mining, its constituents and residual trace elements, and their impact on the environment and health of exposed workers and communities. It also explores the Malaysian legal requirements and standards of occupational exposure to bauxite
Concomitant Anomalous Branching of Facial Nerve and Double Parotid Duct: A Case Report
Get PDFThe facial nerve divides within the parotid gland into upper temporozygomatic and lower cervicofacial branches. The two branches further subdivide and emerge from the parotid gland as five main branches. We observed a rare anomalous branching pattern of the facial nerve along with double parotid duct on the right side of a 50-year-old male cadaver. The two parotid ducts emerged at the level of the anterior border of parotid gland then united to form one single duct thereby opened into the oral cavity. The first duct (D1) emerged from the upper one third of the anterior border of the parotid gland and traversed horizontally for 9 mm to join the second duct. Knowledge of anomalous branching pattern of facial nerve and double parotid ducts may be beneficial for maxillofacial surgeons
An Investigation Into The Synergistic Relationship Between Lactoferrin And Azithromycin With Particular Reference To Periodontopathic Bacteria
Get PDFIntroduction: The development of treatment strategies for periodontitis that maximise the effectiveness of antibiotics is highly desirable. Azithromycin is proving to be an effective antibiotic for treatment of refractory periodontitis which works by binding to the outer membrane of Gramnegative bacteria and subsequently inhibits protein synthesis. Lactoferrin is a membrane-active host antimicrobial protein and so the objective of this study was to determine whether the effect of azithromycin (AZM) against example periodontopathogens (Porphyromonas gingivalis and Tannerella forsythia) could be potentiated by lactoferrin. Materials and Methods: Two strains of P. gingivalis and T. forsythia were exposed to lactoferrin (LF; up to 10 mg/ml) and AZM (up to 5 g/ml) for 0 -72 h. The MICs for AZM were established using E-Test strips and by agar diffusion. Susceptibility to LF and LF + AZM was evaluated using diffusion assays, with and without iron depletion. Results: The range of MIC values of AZM for P. gingivalis strains and T. forsythia was 0.16 - 0.63 µg/ml and 0.50 - 0.63 µg/ml, respectively. However, no inhibition was observed with iron saturated lactoferrin at any concentration or under iron depletion conditions nor was any effect observed on the AZM MIC by its presence. Conclusion(s): P. gingivalis and T. forsythia were inhibited by AZM but were not affected by LF and there was no synergism between AZM and LF
Natal Tooth With Riga Fede Disease: A Case Report
Get PDFIntroduction: Natal tooth and neonatal tooth is a rare occurrence but can have a significant impact on lactation. A 45-day-old baby girl was referred for problem with breastfeeding. Her mother complained of painful nipple during nursing for the past two weeks. Physical examination of the mother's breast and nipple revealed normal findings. Examination of the baby's oral cavity revealed a natal tooth over the mandibular anterior region, small in size, whitish opaque in colour and exhibiting grade 1mobility. There was a whitish ulcer over the ventral aspect of the tongue. A diagnosis of natal tooth in association with Riga Fede disease was made. The baby underwent tooth extraction under topical anesthesia. Subsequently, breastfeeding was able to be continued without any problem. Hence, extraction of natal tooth should be individualized and properly assessed
Standard Versus Real Versus Fake Braces: An Elemental Composition Analysis
Get PDFIntroduction: 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. Materials and Methods: This study was conducted to explore the elemental analysis of several types of 'fake', 'real' and standard braces. The metal composition of 9 upper right central incisor brackets were measured using high pressure environmental scanning electron microscope equipped with an energy dispersive X-ray spectrometer (ESEM/EDX). The quantitative analysis of the percentage of weight concentration of the elements were calculated. Results: The elemental analysis using ANOVA revealed that there was no statistically difference metal weight composition between 'fake', 'real' and standard braces. All brackets were manufactured from different types of alloys. Nonetheless, no toxic elements such as plumbum or mercury were detected in the composition of 'fake' and 'real' braces. Conclusion(s): In conclusion, the metal compositions of 'fake' and 'real' braces were not statistically different from conventional brackets and no pernicious elements were detected
Epigenetic Changes of Drd2 Gene in Pathogenesis of Schizophrenia
Get PDFIntroduction: The dopamine hypothesis has earlier dominated the theories for the development of schizophrenia based on the early pharmacologic evidence. The antipsychotic drugs, among others, is thought to interfere with the function of the dopamine D2 receptor (DRD2) resulting in clinical improvement. Accumulating evidence suggest the role of epigenetic mechanisms in the pathophysiology of schizophrenia. Despite this, specific evidence linking the DRD2 DNA methylation with schizophrenia is insufficient mainly due to the poor accessibility and limited brain samples. Of late, new data has suggested the global impact of DNA methylation in the development of schizophrenia, thus methylation in the peripheral blood could infer changes in the brain. The aim of this study was to assess the DRD2 DNA methylation in the peripheral blood of schizophrenia. Materials and method: The case control study consisted of 138 schizophrenia patients and 132 healthy controls. The genomic DNA from the peripheral blood was bisulfite converted. The DRD2 DNA methylation level was quantitatively measured by using the MethyLight Taqman® assay and normalized with the ALU reference control to give the percentage methylation ratio. The demographic data was calculated using descriptive statistics while parametric variables were compared using independent samples t-test or analysis of covariance. Results: There was a significant hypomethylation of DRD2 in schizophrenia compared to the control group (p=0.001). The hypomethylation was also significant in males (p=0.007) and females (p=0.036) patients. Conclusion: This study supports the possible role of DNA methylation of DRD2 gene could contribute to the pathogenesis of schizophrenia
Estimates of Glomerular Filtration Rate by the Chronic Kidney Disease Epidemiology Collaboration Equations Best Correlates with Kinetic Estimates of Glomerular Filtration Rates in the Critically Ill
Get PDFIntroduction: Kinetic estimate of GFR (keGFR) is a more accurate estimate of GFR in the acute settings with rapidly changing kidney functions. It takes into account the changes of creatinine over time, creatinine production rate, and the volume of distribution, however needs serial measurement of creatinine. We evaluated which methods of the conventional eGFR measurement best correlates with keGFR. This could assist clinicians in using a simpler method of calculation and is useful in the absence of serial plasma creatinine. Materials and method: This is a secondary analysis of prospective observational study. Inclusion criteria includes age more than 18 years old, and exclusion criteria includes ICU admission of less than 48 hours, post elective surgery, and ICU readmission. Plasma creatinine were measured daily for five days, and eGFR were calculated using the Cockcroft-Gault, MDRD, CKD-EPI and keGFR equations. Results: One hundred and forty three patients were analysed, of which 78(54.5%) had AKI. keGFR strongly correlated with eGFRCKD-EPI at all time points (all r≥0.90, p<0.0001). The correlation persisted in both AKI and No AKI patients. keGFR only correlated well with eGFRMDRD and eGFRCG in AKI patients but less in patients without AKI. Bland Altman analysis showed that eGFRMDRD had the least bias, but eGFRCKD-EPI had the greatest precision. Conclusion: The new equation, keGFR strongly correlated with the eGFR by the CKD-EPI equation regardless of the time points and AKI status, and had the greatest precision. In the absence of serial plasma creatinine measurement, eGFR can accurately be estimated by the CKD-EPI equation compared to others
The Value of Aqueous Assessment in Diagnosing Dry Eye
Get PDFIntroduction: The clinical evaluation of the three layers of tear film is still poorly described. The purpose of this study is to evaluate the value of aqueous assessment in diagnosing dry eye. Materials and method: Schirmer test with anaesthesia (STA) and tear meniscus height (TMH) measurement were conducted on non-dry eye (NDE) and dry eye (DE) subjects in this cross-sectional study. The NDE and DE subjects were classified using two types of classification; classification 1 and classification 2. Results: 321 subjects with 642 eyes were recruited in the study. STA was significantly correlated with TMH (r = 0.24, p < 0.001) in all 642 eyes. The comparison between nondry and dry eye subjects in STA and TMH were not significantly different (p > 0.05) if the Classification 1 was used to define dry eye. In Classification 2, there were significantly different between NDE (12.5 ± 8.2 mm) and DE (3.4 ± 0.8 mm) subjects in STA (p < 0.001). Similar trend was also depicted in TMH based on the definition of dry eye stated in Classification 2 (NDE = 0.45 ± 0.20 mm, DE = 0.39 ± 0.14 mm; p < 0.05). Conclusion: The value of STA and TMH were lower significantly in dry eye subjects. However, the significant outcomes were only demonstrated if the clinical signs of dryness were used in the definition of dry eye
Traumatic Brain Injury Patterns on Ct Scan: A Comparison of Motorcyclist Versus Passenger Vehicle Patients Involved in Road Traffic Accidents
Get PDFIntroduction: Traumatic brain injury following road traffic accidents is a common cause of morbidity and mortality in Malaysia. We aim to determine the differences of traumatic brain injury patterns based on CT findings among motorcyclist versus passenger vehicle patients involved in road traffic accidents. Materials and method: This retrospective study was conducted in Hospital Tengku Ampuan Afzan (HTAA), Kuantan, Pahang. A total of 100 CT scan brains of patients who were involved in road traffic accidents were retrieved and reviewed, 50 of them were motorcyclists and the other 50 were passenger vehicles. Results: Fifty percent of the motorcyclists had an abnormal CT brain finding while only 24% of the passenger vehicle showed abnormal finding. Among motorcyclist, skull fracture was the most common finding (30%) followed by subdural hemorrhage (28%). Among passenger vehicle, the most common finding was subdural hemorrhage (10%) followed by subarachnoid hemorrhage, intraparenchymal haemorrhage and skull fracture (8% each). The motorcyclist had significantly higher rate of subdural haemorrhage, extradural haemorrhage, intraparenchymal contusion and skull fracture compared to passenger vehicle patients with p value of 0.02, 0.03, 0.007 and 0.005 respectively. Conclusion: The occurrence of traumatic brain injury was significantly higher among the motorcyclist compared to passenger vehicle patients involved in road traffic accidents. The findings of this study highlighted the need for taking further measures to increase safety among the motorcyclists
Analysis Of MYO1H Single Nucleotide Polymorphism In Class III Malocclusion With Mandibular Prognathism: A Preliminary Study
Get PDFIntroduction: 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. Materials and Methods: The sample comprises of 31 patients; 14 patients from class I malocclusion (control samples) and 17 patients from class III malocclusion (MP). Cephalometric measurements were performed prior to saliva samples collection. The DNA was amplified using the specific primers for the marker rs10850110 and the genotyping was done by sequencing. Chi-square test was used to determine the over-representation of marker allele (p<0.05). Results: Presence of MYO1H SNP (rs10850110) was detected in local population analysed and the distribution of its genotype and allele could be observed. There were significant differences between allele (p=0.000) and genotype (p=0.000) frequency within control (Class I) and Class III malocclusion. Conclusion(s): Our findings are in agreement with previous studies suggesting positive influence of MYO1H (rs10850110) SNP in the incidence of MP. Further studies should be developed in order to understand the exact role and mechanism of MYO1H in different classes of malocclusions