IIUM Medical Journal Malaysia (IMJM)
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Morphometric and Morphological Study of Mental Foramen in the Malaysian Population: Anatomy and Forensic Implications
Get PDFIntroduction: The mental foramen is present on either side of the body of the mandible bone. This foramen transmits mental vessels and nerves. In forensic anthropology, mental foramen may be important for differentiating sex, estimating age and identifying various races based on morphology. The main aim of the present study was to determine the position, shape and diameter of the mental foramen according to sex, age and race by postmortem computed tomography in the Malaysian population. Materials and Methods: A total of 79 dentulous patients (48 males, 31 females) from 3 age groups (18-30 years, 31– 50 years, 51-74 years) were selected for this study, and ten parameters were observed for each mandible. The parameters were divided into two morphological and eight morphometric parameters. The morphometric parameters were measured by using Osirix MD Software 3D Volume Rendering. Results: Results showed that mandibular body length and height were significantly greater in males than in females by independent t-test. (p< 0.05). However, the mandibular body height was found to decrease significantly with age in both sexes by one-way Anova. It was observed that the shape of mental foramen was 45.6% oval and 54.4% rounded. About 44.3% of them were in line with the longitudinal axis of the second premolar tooth. Conclusion: It was concluded that mental foramen may be used for identification purposes, particularly for sex, age and race determination
Validating a Lower Urine Output Criteria in Predicting Death in Critically Ill Patients
Get PDFIntroduction: Urine output provides a rapid estimate for kidney function, and its use has been incorporated in the diagnosis of acute kidney injury. However, not many studies had validated its use compared to the plasma creatinine. It has been showed that the ideal urine output threshold for prediction of death or the need for dialysis was 0.3 ml/kg/h. We aim to assess this threshold in our local ICU population. Methods: This was a secondary analysis of an observational study done in critically ill patients. Hourly urine output data was collected, and a moving average of 6-hourly urine output was calculated over the first 48 hours of ICU admission. AKIuo was defined if urine output ≤ 0.5 ml/kg/h, and UO0.3 was defined as urine output ≤ 0.3 ml/kg/h. Results: 143 patients were recruited into the study, of these, 87 (61%) had AKIuo, and 52 (36%) had UO0.3. The AUC of AKIuo in predicting death was 0.62 (0.51 to 0.72), and UO0.3 was 0.66 (0.55 to 0.77). There was lower survival in patients with AKIuo and UO0.3 compared to those without (p=0.01, and 0.001, respectively). However, only UO0.3 but not AKIuo independently predicted death (HR 2.44 (1.15 to 5.18). Conclusions: A threshold of 6 hourly urine output of 0.3 ml/kg/h but not 0.5 ml/kg/h independently predictive of death. This support previous finding of a lower threshold of urine output criteria for optimal prediction
Managing Subacute Subperiosteal Hematoma with High Intraocular Pressure: A Case Report
Get PDFSubperiosteal haematoma of the orbit is an uncommon complication of maxillofacial trauma, hence easily missed. It usually presents subacutely with proptosis and diplopia. In our case, the subperiosteal haematoma is complicated with high intraocular pressure, necessisating measures to reduce the intraocular pressure. Unresponsive to only medical treatment, surgical evacuation was carried out in this patient. Removal of the clot finally relieved the intraocular pressure and simultaneously improved the proptosis and the cumbersome diplopia
Clinical Resolution Of Periodontitis Among Diabetic Patients With Chronic Periodontitis CoMorbidity Under Medical-Dental Coordinated Care: A Preliminary Study In Kuantan
Get PDFIntroduction: Clinical resolution of periodontitis (CRP) of type-2 diabetic patients with chronic periodontitis (T2DM-PD) after receiving non-surgical periodontal treatment (NSPT) has been reported in the previous studies. This study aimed to evaluate CRP of T2DM-PD under medicaldental coordinated care (M-DCC). Materials and Methods: A 6-months follow-up quasi-experimental study was conducted among 20 subjects who received M-DCC in 2016. M-DCC included standard diabetic care provided by medical professional from 3 health clinics and NSPT provided by periodontal specialists from two periodontal specialist clinics. Target glycemic control achievement (TGCA) HbA1c 6.5% was assessed at baseline and 6 months after NSPT. Clinical resolution of PD was measured in terms of BPE, BOP %, CAL(mm), PPD(mm), PPD 4mm, PPD =4 mm and PPD 6mm at baseline, 3 and 6 months. Paired simple t test and ANOVA F test were applied to infer clinical resolution of periodontitis and its relation to TGCA. Results: Mean (SD) of average BPE at baseline, 3- and 6-months were 3.52(0.34), 3.12(0.33) and 3(0.45) with (p<0.05); average PPD(mm) were 3.33(0.5), 3.23(0.75) and 2.73(0.57) with (p<0.05); PPD(%) 4mm were 71.03(12.33), 82.77(9.9) and 85.85 (8.9) with (p<0.05); PPD(%) =4 mm were 27.94(11.9), 16.97(10.01) and 13.71(9.1) with (p<0.05) ; PPD(%) 6mm were 8.04(4.32), 2.66(2.3) and 1.87(2.32) with (p<0.05). Significant resolution of BPE, CAL(mm) and PPD(mm) was noticed among two subjects who has changed from uncontrolled TGCA to controlled TGCA. Conclusion(s): CRP and TGCA results have verified the effectiveness of M-DCC. A further clinical control trial with adequate sample size needs to confirm the results of the present study
Evaluation Of Knowledge And Attitude Towards Oral Health During Pregnancy And Common Practices Among Pregnant Women Residing In Pahang, Malaysia
Get PDFIntroduction: Oral health problem among pregnant woman has been shown to have possible association with preterm birth and low birth weight. Several studies found that pregnant women have limited knowledge of these adverse outcome. The aims of this study were to evaluate the knowledge, attitude and practices of pregnant women and to examine their practices in relation with their intraoral health status. Materials and Methods: This a cross-sectional study where pregnant women from government health clinics in Kuantan, Pahang completed a questionnaire to assess their knowledge, attitudes and practices towards oral health. A thorough dental examination was done to attain their oral health status. Results were analyzed by descriptive analysis, chi square test and multiple logistic regressions. Results: 296 pregnant women participated in this study. The mean age of the respondents was 28.7 years and the mean parity was two (2). Majority of them were Malay (91.9%) and had education below than higher secondary school (47.3%). Most respondents demonstrated poor knowledge (67%) and poor attitude (54%) about dental health in general.175 (59.1%) respondents do not know that gum disease are common in pregnancy and 235 (79.4%) of them are unaware of gum problems causing possible risk of adverse outcome in pregnancy. Half of them (53%) had good practice on oral health. Women with increase parity and are working were less likely to develop missing teeth. Good attitude towards dental health was found to be a protective factor for oral health disease. Conclusion(s): Most women were less knowledgeable and had poor attitude about oral and dental health. Gestation, employment and good attitude were significantly associated with good oral health outcome. Hence, targeted education should be promoted during pre-pregnancy in order to prevent possible adverse pregnancy outcome
Salivary Enzymological Profile Of Lactate Dehydrogenase (LDH), Tartrate Resistance Acid Phosphatase (TRAP), Alkaline Phosphatase (ALP) And Aspartate Aminotransferase (AST) During Orthodontic Treatment
Get PDFIntroduction: 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. Materials and Methods: A group of nineteen healthy subject (mean age 21.5 years) with Class II/1 malocclusion who required extraction of maxillary first premolar were recruited. Saliva samples were collected from these 19 patients that underwent canine traction using fixed appliances. Enzymes activities were measured before placement of fixed appliances (basal activity) followed with immediately before and weekly canine retraction for five weeks. The specific Lactate Dehydrogenase (LDH), Aspartate Aminotransferase (AST), Tartrate Resistance Acid Phosphatase (TRAP) and Alkaline Phosphatase (ALP) activities in saliva sample were analyzed using spectrophotometer (405nm). Result: No statistical significant (p> 0.05) difference was noted in LDH activity between basal activity and during canine retraction period. AST showed higher activity compared to basal activity from week 0 to week 1 with statistically significant increased (p<0.05) found in week 1. ALP showed significantly higher enzyme activity compared to basal activity from week 1 to 5, with the peak level at week 5. While TRAP showed significant increase in enzyme activity compared to basal activity only at week 2 after canine retraction. Conclusion(s): Orthodontic tooth movement can be monitored through the expression of AST, TRAP and ALP activity in saliva. Saliva LDH cannot be used as a biomarker in monitoring tooth movement
An Examination of Medical Imaging Literature in Malaysian Citation Index (MyCite)
Get PDFIntroduction: The Medical imaging service in Malaysia is expanding. The presence of imaging technologies needs to be supported by homegrown research to optimize their use. This study investigated the contribution of researches by Malaysian practitioners to the field of Medical imaging in the Malaysian Citation index (MyCite) database. Materials and method: Bibliometric and thematic analyses were performed on publications featured in the database from 2006 to 2016 using 13 keywords; radiology, radiography, medical imaging, radiation, x-ray, neuroimaging, nuclear imaging, magnetic resonance imaging, computed tomography scan, mammogram, ultrasound, fluoroscopy, and intravenous urogram. Results: A total of 268 articles were identified. The study reported the publications from Malaysians (54.1%) followed by non-Malaysians (41.8%) and collaboration between authors (4.1%). The researchers were mostly from university-based (67.4%) and hospital university-based (21.3%) compared to clinical-based (5.6%) researchers. For thematic analysis, the majority of the authors focused on certain topics such as clinical (42.9%) and modality (20.1%) with only a few on safety (12.3%), technical (9.7%), education (7.46%), professionalism (4.5%), quality (2.6%) and economy (0.4%) researches. Conclusion: The low number of publications related to Medical imaging do not reflect the real involvement of practitioners in research. Their research findings could have been indexed in other databases besides MyCite. However, the open access facility offered by MyCite should be optimized. The involvement of clinical-based practitioners can be enhanced in areas involving safety, technical, education, professionalism, quality and economy. Collaborative efforts by the practitioners could increase the number of publications and enhance homegrown research that will address local needs
Histological Evaluation of the Effect of Laser and Ultrasound on Bone Fracture Healing
Get PDFObjective: To study the effect of both laser and ultrasound radiation on bone fracture healing process. Materials and method: Nd:YAG laser (1064 nm wavelength, 135 mW power, 16 joules energy) and ultrasound (1 MHz frequency, 50 mW/cm2 power intensity) were used in this work. Fifteen mature, male, albino rats were divided into three groups and subjected to a partial fracture on the lateral aspect of femur by a sharp blade. The first group of these animals served as the control group. The second group was illuminated by the Nd:YAG laser for two minutes, the first dose was given immediately after surgical fracture induction, the other doses were given on days two, three, six and then one dose weekly for the next three weeks. The third group was treated with the addition of continuous wave ultrasound perpendicular to the laser treatment site in the second group. Results: The histological assessments at day 28 after the fracture of first group showed incomplete healing of the bone with disfiguration and disarrangement of Haversian system and the periosteum was not yet well developed. Treatment with laser in the second group showed irregularity and lack of Haversian system formation in bone healing. The laser and ultrasound treatment in the third group expressed a complete healing at the site of fracture with a complete layer of periosteum and a well arranged Haversian system. Conclusion: The combination of laser and ultrasound in therapy can enhance healing process of a fractured bone more than laser therapy alone, as ultrasound increases the depth of laser penetration in tissue
Phytochemical Analysis and In-Vitro Effects of Ethanolic Tamarindus Indica Seed Extract on Snake Venom
Get PDFIntroduction: Snakebite has been categorised as a ‘neglected tropical disease’ by WHO in 2009 and it affects mainly the poorer countries like Africa and Asia. The standard treatment for snake envenomation is the anti-snake venom medication which can be very expensive, not readily available and specific against a snake species. This study was conducted to screen the phytochemical compounds of Tamarindus indica seed extract (TSE) and its in-vitro effects on snake venom of three snake species; namely Daboia russelli, Naja kaouthia and Ophiophagus hannah. Materials and method: Ethanolic Soxhlet extract of TSE was used. Phytochemical screening analysing for saponins, alkaloids, flavanoids, anthraquinone derivatives, arthraquinone glycosides, phenolic compounds, tannins, terpenoids, sterol and volatile oils were carried out. In-vitro enzymatic inhibition study on venom enzymes namely phospholipase A2 (PLA2), proteinase and phosphomonoesterase (PME) were studied by measuring the absorbance using the spectrophotometer. There were two main groups; Group 1: venom only; and Group 2: venom with TSE. The mean triplicate determination of venom enzyme activity post-exposure to TSE from Group 2 was taken and analysed against 100% venom enzyme activity from Group 1. Results: Phytochemical screening showed that the TSE has (+++) phenolics and (+++) hydrolysable tannins. TSE significantly reduced all venom enzymatic activities i.e. PLA2, proteinase and PME from the three snake species at 925 nm, 280 nm and 400 nm, respectively. SDS-PAGE experiment showed the disruption of venom protein bands from all three snake species when venom was exposed to 4.76 µg TSE. Conclusion: Ethanolic TSE contains mainly phenolics and hydrolysable tannins which can reduce the snake venom enzymatic activities. This is possibly due to the formation of tannin-protein complex rendering the venom less potent