Introduction: Melioidosis is endemic in Malaysia but prevalence data is limited. Methodology: In this cross-sectional study, sera suspected for melioidosis were received from local hospitals from year 2013 to 2014. These data were grouped into different age groups with more focus in children aged <15 years old. Results: Children <15 years old were more exposed to Burkholderia pseudomallei [Adjusted Odds ratio (AOR)=4.71, 95% Confidence Interval (CI): 4.04, 5.50) compared to the other age groups. Females, instead of males, had a slightly higher risk for melioidosis. There were more seropositive cases against melioidosis in eastern coast states (Kelantan, Terengganu, Pahang) and Sarawak. Sabah natives and nonMalaysians had higher risk of exposure to B. pseudomallei. Conclusion: Age group and region were independent risk factors for exposure against B. pseudomallei. Paediatric melioidosis is of concern and a marker against intensity of exposure.

This is a retrospective descriptive study of the chest imaging findings of 118 patients with confirmed A(H1N1) in a tertiary referral centre. About 42% of the patients had positive initial chest radiographic (CXR) findings. The common findings were bi-basal air-space opacities and perihilar reticular and alveolar infiltrates. In select cases, high-resolution computed tomography (CT) imaging showed ground-glass change with some widespread reticular changes and atelectasis.

This study was conducted to investigate the effect of lentils on serum glucose and serum lipid levels in diabetic rats. Forty adult male Sprague-Dawley rats, 12 weeks of age weighing 220-290g, were used. Diabetes was induced by streptozotocin at a level of 35 mg/kg intra-peritoneally. The animals were randomly divided into five groups, eight animals each: a casein diet (control), raw whole lentil (RWL), cooked whole lentil (CWL), raw dehulled lentil (RDL) and cooked dehulled lentil (CDL). Animals were fed with experimental diets for six weeks, sacrificed and blood samples were taken. Serum glucose level of the CDL group (387.9 ± 53.3 mg/dl) was significantly lower (P<0.05) than that of the control, RDL and RWL groups (529.0 ± 11.7, 538.6 ± 45.0, 542.1 ± 32.2 mg/dl respectively). In addition, HDL concentration of CWL group (66.3 ± 1.9 mg/dl) was significantly higher (P<0.01) than that of the control, RWL and RDL groups (54.9 ± 3.5, 50.8 ± 4.2, 54.0 ± 3.4 mg/dl respectively). However, there was no significant difference in serum glucose and serum HDL between the CDL and CWL groups. No significant differences (p>0.05) were detected in triglycerides, total cholesterol and LDL cholesterol among the experimental groups. It is concluded that cooked lentils rather than raw lentils was more effective in lowering blood glucose and improving HDL cholesterol in diabetic rats. There was no difference between whole and dehulled lentils with regard to effects on blood glucose and HDL cholesterol levels.

This study aimedto evaluate the coronal microleakage of different thickness of different restorative materials (glass ionomer cement (GIC, GC Gold Label 2), composite restoration (SDR, Dentsply Sirona) and (Filtek Z350 XT, 3M ESPE)) used as final restoration in endodontically treated teeth. 72 sound maxillary incisors were used. Following instrumentation, all canals were obturated with gutta-percha (Dentsply Maillefer) and Roth sealer (Roth International Ltd). After 2mm of gutta-percha removal below cemento-enamel junction, the crown was cut until length of 6mm from the gutta-percha to the incisal edge was achieved. The teeth were divided into four experimental groups (n=18) and access restorations were placed in different thickness combinations. Group 1 (G1): 2mm SDR + 4mm Filtek; Group 2 (G2): 4mm SDR + 2mm Filtek; Group 3 (G3): 2mm GIC + 2mm SDR + 2mm Filtek; Group 4 G4): 6mm SDR. All samples were thermocycled (500 thermal cycles between 5o and 55oC and dwell time of 30s), coated with nail varnish leaving 1mm margin around the filling material, immersed in 2% Rhodamine B solution and sectioned longitudinally. The dye penetration was observed under a stereomicroscope (Olympus SZX7) with 1.25x magnification. The data were analysed using Kolmogorov-Smirnov test, ANOVA test and post-hoc Tukey’s HSD test.There was significant difference of microleakage among all groups. G1 showed least microleakage but with no significant difference between G1 and G3 (p=0.513) and G1 and G4 (p=0.477). G2 showed significant microleakage compared to G1, G3 and G4 (p<0.05). In conclusion, sandwich technique between SDR and Filtek reduces microleakage in which the combination of 2mm SDR with 4mm Filtek in G1 had the least microleakage but with additional 2mm of GIC in G3 further reduces the microleakage.

Objectives: There are a number of validated questionnaires available for the screening of Post-Traumatic Stress Disorder (PTSD), and the PTSD Checklist for Civilians is one of them. However, none was translated into the Malay Language and validated for use in the Malaysian population. The aim of this study is to translate and validate the Malay PTSD Checklist for Civilians (MPCL-C). Methods: The PCL-C was translated into the Malay Language and back-translated. The reliability and validity of the MPCL-C were then determined by administering them to those who presented at the emergency department for motor vehicle accident at least one month before. Results: The MPCL-C has good face and content validity. In terms of reliability, it is also good, with Chronbach’s alpha values of 0.90, 0.77, 0.75 and 0.74 for the full scale, re-experiencing, avoidance and arousal domains respectively. Conclusions: The MPCL-C is a valid and reliable instrument to screen for PTSD in motor vehicle accident victims for the studied population.

Pneumocephalus or collection of air in the intracranial cavity can occur after trauma or surgery. However, delayed pneumocephalus occurring months after the initial injury is not common. We would like to report a case of spontaneous traumatic pneumoencephalocele presenting with transient recurrent hemiparesis 14 months after the initial trauma.
month ; Deferred ; Wounds and Injuries ; Injury inflicted to the body by an external force ; Surgical aspects

The burden of head and neck squamous cell carcinoma (HNSCC) is increasing globally with 600,000new cases being reported annually. A great proportion of these are oral squamous cell carcinomas (OSCCs) which are preceded by oral potentially malignant disorders (OPMDs). The aim of our study was to assess the prevalence of OPMDs among adult Malaysian dental patients with and without risk habits. The objectives of this study were i) to determine the prevalence of OPMDs among dental patients who were tobacco smokers ii) to determine the prevalence of OPMDs among dental patients who were alcohol users iii) to determine the prevalence of OPMDs among dental patients without any risk habits iv) to determine the awareness on oral cancer among dental patients with and without risk habits. Materials and methods: This was a cross sectional observational study, carried out at Faculty of Dentistry, University of Malaya. A conventional oral examination was conducted by two investigators who were trained and calibrated prior to the survey. Participants were administered a questionnaire that was pre-tested in a previous study. 83 subjects were recruited into the study. Leukoplakia was the only OPMD detected in our study with a prevalence of 10.8%. All patients diagnosed with leukoplakia were males (P < 0.05). A significant association between the prevalence of OPMDs and risk habits was found. There was a general lack of awareness among smokers regarding alcohol as an aetiological agent for oral cancer. A significant proportion of subjects who smoked were unaware of early signs of oral cancer.

BACKGROUND/OBJECTIVES: Metabolic syndrome (MetS) is a set of interrelated metabolic risk factors that increase the risk of cardiovascular morbidity and mortality. Studies regarding the specificity and sensitivity of serum levels of leptin and uric acid as predictors of MetS are limited. The aim of this study was to evaluate the serum levels of leptin and uric acid in terms of their specificity and sensitivity as predictors of MetS in the studied Jordanian group. SUBJECTS/METHODS: In this cross sectional study, 630 adult subjects (308 men and 322 women) were recruited from the King Hussein Medical Center (Amman, Jordan). The diagnosis of MetS was made according to the 2005 International Diabetes Federation criteria. Receiver operating characteristic curves were used to determine the efficacy of serum levels of leptin and uric acid as predictors of MetS in the studied Jordanian group. RESULTS: Study results showed that for identification of subjects with MetS risk, area under the curve (AUC) for leptin was 0.721 and 0.683 in men and women, respectively. Serum uric acid levels in men showed no significant association with any MetS risk factors and no significant AUC, while uric acid AUC was 0.706 in women. CONCLUSION: Serum leptin levels can be useful biomarkers for evaluation of the risk of MetS independent of baseline obesity in both men and women. On the other hand, serum uric acid levels predicted the risk of MetS only in women.
Adult* ; Area Under Curve ; Biomarkers ; Diagnosis ; Female ; Hand ; Humans ; Leptin* ; Male ; Mortality ; Obesity ; Risk Factors ; ROC Curve ; Sensitivity and Specificity ; Uric Acid*

The Third National Health and Morbidity Survey (NHMS III) was conducted in 2006 on a nationally representative sample of population in Malaysia. Over 21,000 children aged 0-17.9 years were measured for body weight and stature according to the protocol of the World Health Organization. This article describes the nutritional status of children aged 0-59.9 months. Mean z score for weightfor-age (WAZ), height-for-age (HAZ) and BMI-for-age were compared with the z-scores tables of the WHO standards. The overall prevalence of underweight and stunting of the children were 12.9% and 17.2% respectively. These levels included 2.4% severe underweight and 6.0% severe stunting. In terms of z scores, the age group of 0–5.9 months showed the best nutritional status with mean WAZ of -0.33 (95%CI: -0.52, 0.15) and -0.40 (-0.57, 0.24) for boys and girls respectively, while mean HAZ was 0.64 (0.38, 0.89) for boys and 0.76 (0.54, 0.98) for girls. Mean HAZ and WAZ status was least satisfactory after about 6 months, suggesting a faltering in growth rate at an age that coincides with dependence on complementary feeding. Prevalence of overweight based on BMI-for-age for the sexes combined was 6.4%, while that based on WAZ was 3.4%. The NHMS III results indicate that Malaysian children have better nutritional status compared to children under 5 years in neighbouring countries. In order to meet the targets set in the National Plan of Nutrition (2006-2015), more effective intervention programmes are needed to accelerate the reduction of underweight and stunting, and to arrest the rise of overweight in young children.

Background: and Purpose Abnormal excitability of the central nervous system, both spinal and supraspinal, has previously been described as a pathophysiological plastic mechanism for chronic pain syndromes. Primary fibromyalgia (FM) as one extreme of this spectrum of diseases. This case-control study aimed to determine the changes in the spinal excitability by investigating the Hoffman reflex (H-reflex) in patients with FM. Methods: Thirty-eight patients with FM and 30 healthy controls participated in this case-control study. We measured the H-reflex bilaterally in the upper limbs (flexor carpi radialis) and the lower limbs (gastrocnemius and soleus). Moreover, pain-related variables were measured, including pain severity (using a visual analogue scale), pain duration, Widespread Pain Index, and the score on the Symptom Severity Scale. Various psychiatric comorbidities and qualityof-life parameters were measured for each patient, including scores on the Hamilton Depression Rating Scale, Taylor’s Manifest Anxiety Scale, and the Revised Fibromyalgia Impact Questionnaire. Results: A significant increase in the ratio of the maximum baseline-to-peak amplitudes of H and M waves (Hmax/Mmax) but not in the H-wave minimum latency was found in patients with FM compared with healthy controls. There were no significant correlations between this ratio in both muscles and the various pain-related measures, psychiatric comorbidity, and quality of life in patients with FM. Patients with FM suffered more depression and anxiety than did the controls. Conclusions We found increased spinal excitability in patients with FM, which was not confined to the site of maximum pain. This information may help in the diagnosis of FM and supports the hypothesis of central sensitization.