IIUM Medical Journal Malaysia (IMJM)
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Orthodontic Management Of An Erupted Mesiodens: A Case Report
Get PDFIntroduction: Hyperdontia is the condition of having supernumerary tooth, or teeth, which appear in addition to the regular number of teeth. It is a developmental anomaly and has been argued to arise from multiple aetiologies. It may remain embedded in the alveolar bone or can erupt into the oral cavity. Mesiodens is a supernumerary tooth located in the anterior maxilla, placed palatally or in between the maxillary central incisors. It may be single or paired, erupted or impacted and at times even inverted. Aesthetic or functional problems are two main issues associated with mesiodens.This case report demonstrates the orthodontic management of a case of a nonsyndromic male patient with conical type supernumerary tooth at the maxillary anterior region with a Class I malocclusion complicated by palatally erupted upper right lateral tooth with Bolton discrepancy. Good aesthetic and functional result achieved at the end of treatment
Knowledge, Attitude, and Practice of Self-Wound Management among Patients with Diabetic Foot Ulcer (Dfu) in Pahang
Get PDFIntroduction: A survey in 2011 reported that the prevalence of diabetes in Malaysia is 20.8% (2.8 million people) and 88% have uncontrolleddiabetes. Diabetic foot ulcer (DFU) is one of the common diabetes complications in Malaysia that leads to other devastated situation including infection, amputation and death. In Pahang, 95% of the patients have uncontrolled diabetes and 50% of them suffered from DFU. Self-wound management is an important element in reducing the risk of further complications of DFU. However, little is known on the patients' understanding of diabetes and their practice of selfwound management. This study aimed to understand the knowledge, attitude and practice of self-wound management among patients with diabetic ulcer in Pahang. Materials and method: A quantitative, cross-sectional study was conducted in a tertiary hospital in Pahang involving 100 participants. Participants were recruited using purposive sampling from April 2017 until May 2017. Participants' knowledge, attitude and practice of self-wound management were measured using self-administered questionnaires. Additionally, the data on socio-demographic was gathered. The data was computed into SPSS and analyzed using descriptive and inferential statistics. Results: Out of 100 participants, 95% of them had good knowledge on diabetes and DFU, 84% had a positive attitude towards self-wound management and 56% perceived good practices of self-wound management. However, a chi-square test between knowledge on diabetes and DFU and practice of self-wound management found no significant interaction (p > 0.05). Meanwhile, there was a significant interaction between attitude and practice of self-wound management (p < 0.05). Conclusion: Good knowledge on diabetes and DFU do not determine the patients’ practice of self-wound management. However, positive attitude towards self-wound management would contribute to the practice and willingness of the patients to selfmanage their foot ulcer wound at home
Perception of Diabetes Control Among Patients with Poor Glycated Hemoglobin
Get PDFIntroduction: Despite advances in the management of diabetes, the rate of control of diabetes in the population remains modest. Perception of diabetes control is a key to patient empowerment. The aim of this study was to describe the perception of diabetes control among patient with poorly controlled diabetes. Materials and method: A cross sectional study was done involving 276 patients with type 2 diabetes mellitus in the out-patient settings. After obtaining an informed consent, the socio-demography and medical history of each patient was recorded. Their most recent available blood investigations were documented. Patients were then asked on their perception of diabetes control whether it was excellent, moderate or poor. Analyses were descriptive and exploratory. Results: The median age of subjects was 56.0 (48.0,62.0) years old, with a median duration of diabetes of 8 (4,13) years. The median HbA1C was 9.5 (8.3,11.4)% with a fasting blood sugar of 9.7 (7.1,13.8) mmol/L. Despite having poor HbA1C, 28.4% of patients perceived that their diabetes control was excellent; 58.9% perceived moderate and only 12.7% accurately perceived poor control. The reverse relationship between perception of disease and education may indicate that other factors such as effective communication might need to be considered. The absence of association between perception and duration of diabetes may suggest that information given to patient over the years had poor impact on their understanding of disease control. Conclusion: This study demonstrated that there was presence of discordance between perception of diabetes control and HbA1C. Identifying the discordance between perception of diabetes control and HbA1C should be the first step in delivering a personalized diabetes education for patient
Preliminary in Vivo Evaluation of Bone Healing in Critical Size Bone Defects Implanted with an Injectable Calcium Phosphate Bone Cement (Osteopaste)
Get PDFIntroduction: A novel injectable calcium phosphate bone cement (osteopaste) has been developed. Its potential application in orthopaedics as a filler of bone defects has been studied. The biomaterial was composed of tetra-calcium phosphate (TTCP) and tricalcium phosphate (TCP) powder. The aim of the present study was to evaluate the healing process of osteopaste in rabbit tibia. Materials and method: The implantation procedure was carried out on thirty-nine of New Zealand white rabbits. The in vivo bone formation was investigated by either implanting the Osteopaste, Jectos or MIIG – X3 into a critical size defect (CSD) model in the proximal tibial metaphysis. CSD without treatment served as negative control. After 1 day, 6 and 12 weeks, the rabbits were euthanized, the bone were harvested and subjected for analysis. Results: Radiological images and histological sections revealed integration of implants with bone tissue with no signs of graft rejection. There was direct contact between osteopaste material and host bone. The new bone was seen bridging the defect. Conclusion: The result showed that Osteopaste could be a new promising biomaterial for bone repair and has a potential in bone tissue engineering
Sepsis Mortality Score Using Multi-Marker Approach for the Prediction of Mortality in Septic Critically Ill Patients
Get PDFIntroduction: Clinical scoring methods such as the Sequential Organ Failure Assessment (SOFA) score are frequently used to predict outcome in sepsis, with limited capacity. Further tools for risk assessment of septic critically ill patients would thus be useful. Our purpose was to derive a scoring method i.e. Sepsis Mortality Score using multimarker approach for the prediction of 30-day mortality in septic critically ill patients, and compare its performance to the SOFA score. Materials and method: This prospective study included 159 septic patients admitted to an intensive care unit (ICU). Leukocytes count, procalcitonin (PCT), interleukin-6 (IL-6), paraoxonase (PON) and arylesterase (ARE) were assayed from blood draws obtained on ICU presentation. Logistic regression was used to identify an optimal combination of these biomarkers to create the Sepsis Mortality Score, which was the predicted probability of 30-day mortality. Results: The 30-day mortality rate was 28.9%. In the logistic regression model, leukocytes count, PCT, IL-6 and ARE remained as independent biomarkers. The areas under curve (AUC) of the Sepsis Mortality Score derived from these biomarkers was 0.814 (95% confidence interval (CI) 0.736-0.892), better than the SOFA score (AUC 0.767 (95% CI 0.677-0.857). Addition of Sepsis Mortality Score on SOFA score showed an even better prediction of 30-day mortality (AUC 0.845 (95% CI 0.772-0.919)). Conclusion: Multi-marker approach using leukocytes count, PCT, IL-6 and ARE, combined with the SOFA score, might provide a valuable tool for risk assessment of septic critically ill patients
The Cytotoxicity Effect of Spermidine -Sulphur Analogues Type 1 (Ssa-1) And Type 2 (Ssa-2) against Human Lung Adenocarcinoma Cells (A549), Human Colorectal Adenocarcinoma Cells (Hct-8), and Human Breast Adenocarcinoma Cells (Mcf-7)
Get PDFIntroduction: Over accumulation of polyamines is one of the causes of cancer because polyamines could promote the cancer cells growth. Due to the lack of specificity and increased reports of side effects in the current cancer treatment, one of the strategies to overcome the challenges is by utilizing polyamines as vectors of known cytotoxic compounds to target the cancer cells. Therefore, this study was aimed to investigate the cytotoxicity effect of Spermidine Sulphur Analogues Type 1 and Type 2 (SSA-1 and SSA-2) against human lung adenocarcinoma cells (A549), human colorectal adenocarcinoma cells (HCT-8) and human breast adenocarcinoma cell (MCF-7). Materials and method: The cytotoxicity studies of SSA-1 and SSA-2 against in vitro cells: A549, HCT-8, and MCF-7 were carried out by using MTT assay and the IC50 in each cell was determined. Results: SSA-1 exhibited cytotoxicity effect in all selected cell lines with IC50 between 2.0 mM to 5.3 mM. While SSA-2 also exhibited cytotoxicity effect in all cell lines with IC50 between 0.8 mM to 5.0 mM. Conclusion: SSA-1 and SSA-2 were cytotoxic against A549, HCT-8, and MCF-7. However, the cytotoxic effect was not potent against these cell lines as a higher concentration of compounds was needed to inhibit the cells growth. Hence, it is suggested that further study on the cytotoxicity effect of SSA-1 and SSA-2 in other cell lines should be conducted and the formulation of the analogues based on sulphur should be amended by conjugating it with selected metal
Awareness and Involvement of the Arts, Commerce and Science College Teachers in Students’ Mental Health and Behavioural Problems: A Cross-sectional Study from Sangli District (MH), India
Get PDFBackground: Teachers play an important role in reducing adolescent health problems. However, the involvement of teachers in adolescent health is not well understood. This current study was conducted to address this. Methods: A cross-sectional study was conducted among teachers of randomly selected arts, commerce and science colleges in Sangli, (Maharashtra) India. The data was collected by cluster random sampling. The study period was from November 2014 to April 2015. The study tool was self-administered questionnaire. Due ethical considerations, consents were taken. Analysis was done using Microsoft Excel 2003 and IBM SPSS version 22. Results: Out of 319 study participants; 246 (77.1%) participants had good awareness regarding adolescent health problems, 254 (79.6%) participants had good attitude towards reproductive health. Forty-three (13.5%), 22 (6.9%) and 15 (4.7%) participants had good practices regarding behavioural problems, psychological problems and substance abuse respectively. Practices about behavioural problems and substance abuse were associated with adolescent health training. In bi-variate analysis, age was a significant predictor for all the three practices. Conclusion: Most teachers had good attitude and awareness; but poor knowledge and practices regarding adolescent issues. All teachers should undergo training regarding adolescent health; with periodic refresher courses or lectures. Anonymous feedback from students should be sought to keep vigilance over efforts of the teachers
A Prospective Study On Response To Treatment Of Patients With Temporomandibular Disorder: A Clinical Study
Get PDFIntroduction: Temporomandibular joint dysfunction (TMD) is regarded as multifactorial in origin and this may influence the diagnosis and treatment plan. Early detection of TMD with suitable management may provide good response. This study was to relate demographic factors, signs and symptoms, diagnosis, stage of detection and treatment modalities on review outcome. Materials and Methods: 71 TMD patients were selected from Oral Medicine and Oral Pathology clinics. Patients’ details were recorded. Staging of patients was done based on guidelines by American Society of Temporomandibular Joint Surgeons (ASTMJS). Treatment modalities including selftherapy, occlusal splint and medication proposed to patients were based on their signs and symptoms. Prosthetic rehabilitation was indicated for free-end extension ridge. Treatment outcomes measure recommended by International Association of Oral and Maxillofacial Surgeons (IAOMS) was used during review visit. Results: Female showed higher incidence of TMD compared to male, with ratio of 2.5:1. 46(64.79%) patients were detected at early stage. Patients in their twenties [54(76.06%)] had the highest occurrence of TMD. Treatment modalities were correlated with signs and symptoms (p= 0.046), stage of detection (p= 0.030), and diagnosis (p= 0.023). Multiple regression displayed significant association on improvement of patients’ condition after treatment, mediated by stage of detection (r = - 0.216). 30(42.25%) patients detected at early stage had improvement of (on) signs and symptoms. Conclusion(s): Demographic factors contributed to incidence of TMD. Treatment plans were related to patients' condition, diagnosis and stage of detection. Early detection of TMD with proper management/s influenced patients’ condition
Antibiotic Susceptibility Study Of Metal-Gentamicin Complexes Against Staphylococcus Aureus Biofilms
Get PDFIntroduction: Dental plaque is a structurally and functionally organized biofilm. Modern molecular biological techniques have identified about 1000 different bacterial species in the dental biofilm, twice as many as can be cultured. Inherent resistance of biofilm bacteria to conventional antibiotics is alarming. It induces antibiotic resistance to an order of three or more in magnitude greater than those displayed by planktonic bacteria. Staphylococcus aureus is the most dominant bacterial species isolated from the saliva and dental plaques. One of the reasons for its pathogenicity is its ability to form biofilms. In this study, the resistance of S. aureus biofilms against a eries of metal-antibiotics, an alternative to the conventional antibiotics, was investigated. Materials and Methods: A series of metal-antibiotic complexes derived from gentamicin was synthesized to give metal-gentamicin complexes. The metal contents of all the compounds were determined using Atomic Absorption Spectroscopy (AAS). Antibiotic susceptibility testing of the gentamicin-antibiotic complexes against several strains of S. aureus biofilms was conducted using broth microdilution assay. Results: The results showed that S. aureus is susceptible against Co(II) and Fe(II) gentamicin complexes; all were tested at 0.25 to 1 mmol concentrations. Conclusion(s): Co(II) and Fe(II)-gentamicin complexes demonstrated antimicrobial activity
Bilateral Transposition Of Maxillary Canines And First Premolars : Orthodontic Management. A Case Report
Get PDFIntroduction: Transposition is a rare dental anomaly in positional interchange between two adjacent teeth. Studies indicated that tooth transpositions are more frequent unilateral than bilateral (12:1). It is a very rare phenomenon when the anomaly is bilateral and affects same teeth on both sides. The case of a 17 year old girl, with class I incisor relationship on class 1 skeletal base with bilateral transposition of maxillary canines-first premolars, severe crowding and posterior crossbite, is presented. This case report demonstrates the orthodontic management of bilateral transposition of maxillary canines-first premolars and by the end of treatment, the transpositions were maintained while achieving a good functional and aesthetic result