Fingers, unit of measurement ; Homologous Grafts ; Tendons ; Leprosy ; Claw

Hour

Introduction: Tooth restoration is a common, routine procedure among dentists but still has its own difficulties especially for posterior teeth. As it is a straightforward procedure, some dentists are not aware of the difficulties that may contribute in reducing the longevity of the filling. The aim of the study is to determine the difficulties encountered during and after placement of restorative materials in deep cavities. Materials and methods: Standardized questionnaires were divided randomly among general private dental practitioners in Kuala Lumpur. Chi-square test was used to determine any significant factors associated with difficulties of material placement. Results: This study showed that the most frequent difficulties encountered among practitioners were to obtain good moisture control (39.0%). No significant association was found between obtaining good moisture control and year of clinical experience (p= 0.286) and also place of graduation with the manipulation of the materials (p= 0.542). Conclusion: Dental practitioners claimed that it was difficult to obtain good moisture control in placement of posterior restoration. Thus, it is an obligation of dental practitioners to practice proper isolation and good manipulation of materials on posterior restoration.

Osteoma is the most common benign tumour of the nose and paranasal sinuses. However, involvement of the sphenoid sinus by osteoma is rare. Most of the time, patients with paranasal sinus osteoma are asymptomatic. However, symptoms may present, depending on the location and extension of the tumour. We report a case of a patient with sphenoethmoidal osteoma found incidentally on imaging, with evidence of impingement onto the optic nerve at the optic canal. However, the patient was asymptomatic. He was surgically treated using the endoscopic transnasal approach.
Osteoma ; Sphenoid Sinus

Various tests to help in the clinical diagnosis of distal biceps tendon ruptures have been described. In our experience these tests are painful in the acute setting. We suggest a simple alternative test wherein the biceps muscle belly is held by the examiner and translated medially and laterally. This is done with the forearm flexed to 90 degrees. It is first performed with the biceps relaxed and subsequently performed with the forearm flexed against resistance. In the relaxed forearm the biceps easily translates over 50% of its width. When placed under tension (by flexing against resistance) this translation is significantly reduced. In cases of complete distal biceps tendon rupture, the biceps still translates, even under resisted flexion of the forearm. This simple test is less painful than other described tests, is easy to perform, and aids in clinical diagnosis of distal biceps tendon ruptures.
Diagnosis ; Forearm ; Physical Examination ; Rupture* ; Tendon Injuries ; Tendons*

Medical ethics is a system of moral principles that apply values and judgments to the practice of medicine. As a scholarly discipline, medical ethics encompasses its practical application in clinical settings as well as work on its history, philosophy, theology, and sociology. The medical profession has long subscribed to a body of ethical statements developed primarily for the benefit of the patient. A physician must recognize responsibility to patients first and foremost, as well as to society, to other health professionals, and to self. This paper presents some information regarding medical ethics, including the values and principles of ethical conduct. Later the requirements of consent form is presented to guide the researchers before conducting a study.
Ethics, Medical ; Ethics

Teachers face one of the highest demands of any professional group to use their voices at work. Thus, they are at higher risk of developing voice disorder than the general population. The consequences of voice disorder may have impact on teacher’s social and professional life as well as their mental, physical and emotional state and their ability to communicate. Objectives of this study are to determine the prevalence of voice disorder and the relationship between voice disorder with associated risk factors such as teaching activities and lifestyle factors among primary school teachers in Bintulu, Sarawak. A cross sectional study was conducted based on random sample of 4 primary schools in Bintulu, Sarawak between January-March 2014. A total of 100 full-time primary school teachers were invited to participate in the study. Data were collected through a self-administered questionnaire addressing the prevalence of voice disorder and potential risk factors. Descriptive analysis and chi-square test was used to measure the relationship between voice disorder and associated risk factors. The response rate for this study was 78% (78/100). The study found that the prevalence of voice disorder among primary school teachers in Bintulu, Sarawak was 13%. Chi-square test results revealed that factors significantly associated with voice disorder (p<0.05) were smoking (p=0.012), consuming alcohol beverages (p=0.012) for lifestyle factors while teaching session (p=0.049) for teaching activities. A low prevalence of voice disorder exists among primary school teachers in Bintulu, Sarawak. Smoking, consuming alcohol beverages and teaching session has proven to be significantly associated causing voice disorder among them.

Aims: Streptococcus pneumoniae is the most common bacterial respiratory pathogen that can lead to invasive diseases such as pneumonia, bacteremia, and meningitis. The interaction of S. pneumoniae with host respiratory epithelial cells is crucial in the colonization of human respiratory tract and involve in the virulence. The aim of the study is to investigate the adherence of S. pneumoniae and the effect of serotypic variation on neuraminidase genes (NanA and NanB) after interaction of A549 human lung epithelial cells with S. pneumoniae serotypes. Methodology and results: Six different serotypes of S. pneumoniae were used (1, 3, 5, 19F, 23F, and 14). A549 human lung epithelial cells were inoculated with pneumococcal strains of different serotype for 3 hours. The number of adherent bacteria was determined by serial dilution followed by spread plate technique on tryptic soy agar supplemented with 5% sheep blood. Bacterial RNA was harvested from the infected A549 cells. The differential expression level of neuraminidases was observed by quantitative real-time PCR (qRT-PCR). Based on bacterial adherence assay, serotype 14 showed highest adherence, meanwhile, serotype 23F showed lowest adherence. This suggests that serotype 14 has a better affinity to adhere to A549 cells as compared to serotype 23F. Higher NanA gene expression was observed in serotype 5, 23F and 19F, while lower expression in serotype 14. In contrast, NanB gene shows low-level expression in serotype 23F and 19F, while higher expression in serotype 14. This postulates that NanA and NanB gene may have different functions in the pathogenesis of S. pneumoniae. Conclusion, significance and impact of study: Our finding on differential expression of neuraminidase gene of S. pneumoniae of various serotypes on A549 cells might give a better understanding of host pathogen interaction between bacteria serotypes and host cell.

Doctor-patient communication skills are important in family medicine and can be taught and learned. This paper summarizes the salient contents and main methods of the teaching and learning of doctor-patient communication, especially those applicable to the discipline.
Patients ; Communication ; Family Practice ; Educational process of instructing ; Primary Health Care

seconds ; therapeutic aspects ; Chronic Disease ; Back