A case of a large dentigerous cyst associated with canine tooth in the maxillary antrum is presented. This case is of interest because of its extensiveness and the presence of an ectopic tooth in the roof of the maxillary sinus. Theoretical aspects of canine impaction and cyst formation are reviewed. The management of a jaw cyst, in particular, the still popular Caldwell-Luc procedure is discussed.

The fourth industrial revolution is impacting the learning industry to become online learning, especially in Indonesia. Online learning provides benefits in that it can be cheaper, takes less time, can be self-paced, and provides an equal quality of education for students in rural areas. A total of 60 Indonesian college students on selected campus (age 20 ± 0,36 years old) who joined the Computer Simulation class in the third grade participated in this study. They are divided into two classes, an online class using Moodle software and a physical class, then observations are made. This study aims to obtain preliminary data to then research what human factors influence Indonesian people that constrain students from successful participation in online learning. The results show that there are three aspects of implementing online lectures in Indonesia: rules, usability and cognitive aspects. Besides, quality of place is an environmental factor that cannot be controlled.

Intrapulmonary bronchogenic cyst is a rare congenital lesion originating from abnormal budding of the embryonic foregut. It is less common than mediastinal bronchogenic cyst. We describe a case of intrapulmonary bronchogenic cyst and discuss the treatment of this condition.

Acute epiglottitis though relatively common in pediatric patients as compared to adults, present with almost similar clinical presentations. They include voice change, difficulty or painful swallowing and sometimes with upper airway obstruction. Physical finding of swollen epiglottis is difficult to be obtained owing to the danger of introducing laryngeal mirror into the oropharynx as to avoid contact spasm. The diagnostic thumb sign appearance on lateral neck radiograph is considered pathognomonic of epiglottitis. We report a case of an adult with clinical features and radiological finding of an acute epiglottitis, which did not resolve with antibiotic treatment. Subsequent imaging confirmed the presence of an abscess in the epiglottic mucosa.
Epiglottitis

School-based health programs implemented by the Malaysian Ministry of Education (MOE) through the National Physical Fitness Standard (SEGAK) assessments provided an important platform in health status monitoring among schoolchildren. However, to date, there is still no reliability study conducted on this method. Therefore, this study aimed to determine the reliability of the anthropometric data collected by physical education (PE) teachers in the SEGAK assessments. Anthropometry measurements of standard six school adolescents involved in the Health of Adolescents in Terengganu study were taken by trained researchers using a standardised protocol. The anthropometrics data were then compared with PE teachers’ measurements from the SEGAK assessments obtained from the specifically developed Health Monitoring System database. Reliability of the anthropometric measurements were analysed using Pearson’s correlation test, Intraclass Correlation Coefficients (ICC), Bland-Altman plot and Cohen’s Kappa statistics. Intraclass correlation coefficient between teacher-measured and researcher-measured values shows good correlation in weight (ICC = 0.93), height (ICC = 0.98) and BMI (ICC = 0.91). The Bland-Altman plot showed a relatively small difference in mean of weight, height, and BMI between teacher-measured and researcher-measured value. The mean difference between teacher-measured and researcher-measured value of weight, height, and BMI were 1.8kg, 0.1cm, and 0.8kg/m2 respectively. Overall, Cohen’s Kappa statistics showed substantial agreement (κ = 0.642) in BMI categorisation between the two measurements. Findings from reliability analysis conducted affirmed that anthropometrics assessments conducted by PE teachers in SEGAK assessments are reliable to be used for identification of body weight status among school children and adolescents particularly in Terengganu, Malaysia.

Background and Objectives: Despite much medical progress, stroke remains a leading cause of death and disability. The aim of our study was to analyze the frequency of various risk factors and determine predictors of in-hospital mortality among primary intracerebral hemorrhage (PICH) patients, thus providing insight in developing therapeutic strategies to improve the outcome. Methods: A prospective study conducted at a tertiary care hospital. Results: A total of 160 patients (108 male and 52 female) were evaluated. Their ages ranged from 25 to 85 years (mean age was 58.3 ± 11.4 years). Hypertension was the commonest risk factor (74.4%), followed by diabetes mellitus (18.8%) and cigarette smoking (36.3%). The commonest location of ICH was lobar (43.8%) followed by basal ganglia / internal capsule (28.1 %) and multilobar (13.1%). The overall in-hospital mortality was 32.5 %. About one third (32.7%) of the deaths occurred within fi rst 24 hours, this rose to 38.5% within fi rst 2 days and 84.6% within one week. The signifi cant independent predictors of acute in- hospital mortality were Glasgow Coma Scale (GCS) on admission, posterior fossa bleed (OR 11.01; 95% CI 3.21 to 37.81), hematoma volume >60ml (OR 4.72; 95% CI 1.34 to 16.64), mid line shift (OR 3.32; 95% CI 1.05 to 10.50) and intraventricular extension of haemorrhage (OR 5.69; 95% CI 2.24 to 14.47). Conclusion: Low GCS score, posterior fossa bleed, and large hematoma volume were main indicators of mortality following PICH in East coast of Peninsular Malaysia.

Multislice computed tomography (MSCT) is the imaging modality of choice in assessing clinically stable patients with blunt abdominal trauma. This study assessed the role of MSCT in the detection of intra abdominal injury caused by blunt trauma in our centre within a two-year-period (2008-2009). A total of 151 patients had MSCT abdomen for blunt abdominal trauma within this study period. Positive scan were seen in 126 patients (83.4%). Out of these positive scans, liver, spleen and renal injuries were seen in 42.1% (n=53), 34.9% (n=44) and 30.0% (n=34) of cases respectively. Laparotomies were performed in 45 patients. Out of these 45 laparotomies, 10 patients had surgically significant injuries that were missed on CT scan findings. The injuries were bowel perforation (n=4), serosal tear of bowel (n=1), mesenteric injuries with active haemorrhage (n=3), spleen injury (n=1) and liver injury (n=1).

Leptospirosis is a febrile zoonotic disease. Routine diagnosis of leptospirosis is based on the detection of specific antibodies with serological tests. The aim of our study was to determine the usefulness of immunochromatographic assay (ICA), ImmuneMed Leptospira IgM Duo Rapid test kit from Korea, in rapid screening of acute leptospirosis in emergency cases with limited expertise. A total of 197 serum samples (93 positive, 104 negative) were selected randomly. The test has good diagnostic sensitivity 73% and specificity 90%. With positive predictive value of 87% and negative predictive value of 79%, this reassures patients have higher chance of correct diagnosis. This ICA is acceptable for screening of leptospirosis but confirmation with microscopic agglutination test should follow.
Agglutination Tests ; Antibodies* ; Diagnosis ; Emergencies ; Humans* ; Immunochromatography ; Immunoglobulin M* ; Korea ; Leptospira* ; Leptospirosis ; Mass Screening ; Sensitivity and Specificity ; Serologic Tests ; Zoonoses

Worldwide prevalence of obesity among children and adolescents increased substantially over decades. Addressing potential risk factors of obesity among adolescents is very important for a successful intervention program in this population. The present study aimed to identify the sociodemographic determinants of obesity among school adolescents in Terengganu. A cross-sectional survey involving 3,798 school adolescents age 12 years old from 136 government primary schools in Kuala Terengganu and Besut districts were carried out from November 2014 to June 2015. For the purpose of this paper, the data for 2,842 school adolescents classified as either normal BMI (< +1SD) (n= 2,305) or obese (+2SD) (n= 537) based on WHO cut-off points were taken for analysis. Sociodemographic information on subjects and their parents were obtained from self-reported questionnaire. Anthropometric measurements were conducted by Physical Education teachers and uploaded into a specific developed database. The prevalence of obesity was relatively high in both genders in this study. Binary logistic regression analysis found gender, parental BMI, household income, household size and maternal working status were independently associated with obesity among school adolescents in this population. In the final model, being male, having working mother, and having obese parents were identified to be potential risk factors for obesity whilst having large household size lower the risk of obesity among these adolescents. Prevention programs are needed to increase awareness about the risk factors of obesity in adolescent and interventions should now focus on family member as well mainly the parents.
Sociodemographic ; obesity ; school adolescents ; Terengganu ; Malaysia

Doppler mode ultrasound is widely used in prenatal scanning and known to produce a higher acoustic output which later leads to higher heat energy conversion compared to other ultrasound modes. It has been reported that the use of Doppler imaging might increase the temperature of tissues, thus, when Doppler is used in combination with 2D ultrasound, the risks of bioeffects tend to increase more. It is also known that prolonged exposure to ultrasound during pregnancy can cause irreversible biological destructions to the fetus. Despite the benefits of using Doppler ultrasound, its potential adverse effects have received scant attention in the research literature. Therefore, this study aimed to examine a correlation between gestational stages (GS) and newborn rabbit’s body weight at different prenatal Doppler ultrasound exposure durations. Methods: Twelve pregnant New Zealand white rabbits (NZWR) were exposed once using three different Doppler ultrasound exposure durations (30, 60, 90 minutes exposure) at three different GSs (1st, 2nd, and 3rd GS). After delivery, the mean weights of the 62 newborns were statistically analysed. Results: Strong negative and positive correlation between newborn’s body weight at different GSs and Doppler ultrasound exposure durations with a significant result found in 60 minutes exposure (p = <0.01) and 90 minutes exposure (p = <0.01), respectively. Conclusion: It can be concluded that longer Doppler ultrasound exposure may lead to significant results onto the newborn rabbits’ body weight.