Background: Discrepancies between tooth sizes can cause orthodontic problems such as crowding and improper occlusion. By identifying these problems, better orthodontic treatment outcome can be achieved. The aim of this study is to identify anterior tooth size discrepancies among 4 different types of malocclusion i.e. Class I; Class II division 1 (II/1); Class II division 2 (II/2); and Class III. Methods: A retrospective study was carried out using 200 orthodontic study models where 50 study models were taken for each of the 4 malocclusion groups. The samples were selected using random sampling technique based on the orthodontic waiting list in the Orthodontic Department, Dental Faculty, UKM. All anterior teeth were measured by the same examiner at the largest mesio-distal dimension, using a digital caliper recorded up to 0.01 mm. Comparison between the 4 groups of malocclusion were made intra-arch using individual tooth size measurement and inter-arch using Anterior Bolton Index (ABI). Results: For the intra-arch assessment, Class II/1 had significantly the largest upper and lower anterior tooth size except for its upper canine and lower central incisor. Class III group had insignificantly the smallest mandibular anterior teeth compared to other malocclusion groups. For inter-arch assessment, Anterior Bolton Index (ABI) of all samples was 79.2 ± 3.94%. The highest ABI was noted in Class II / 2 of 80.3 ± 4.71%. However, no significant differences were found among the 4 malocclusion groups (p>0.05). Conclusion: Most of the anterior teeth in Class II division 1 were the largest of all. No significant difference in the inter-arch tooth size discrepancies were detected among all malocclusion groups.

Introduction: This cross-sectional study aims to determine the provision of foods according to NOVA classifications (an ultra-processed classification), to assess contribution of sodium and added sugar availability in each of NOVA food groups, and to evaluate nutritional status as well as to determine the relationship between sodium, added sugar availability of each NOVA foods groups and nutritional status among adults in Terengganu. Materials and methods: About 200 respondents aged between 18 and 59 years old from Kuala Nerus, Terengganu were recruited. Their dietary intake from two days of 24-hour dietary recall underwent NOVA classification and analyzed through Nutritionist Pro. All respondents had their blood pressure and fasting blood glucose taken. Spearman’s rank correlation was used to evaluate the relationship between sodium and added sugar each of NOVA food groups and the nutritional status. Results: The total energy intake of the respondents was 1818 kcal + 375.05 per day. The energy contribution of ultra-processed group was 24%. The sodium and added sugar contribution of ultra-processed group were 26% and 63%, respectively. The mean blood pressure and median of blood glucose were normal at 114/79 mmHg and 5.3 mmol/L, respectively. No significant correlation was found between sodium, added sugar availability of each NOVA food groups and nutritional status at p<0.05. Conclusion: Further studies involving vigorous research design need to be carried out in order to really understand the implication of ultra-processed food consumption towards the nutritional status of Malaysian population, as highlighted in the Malaysian Nutrition Research Priorities (2016-2020).

Stress modulates pain perception, resulting in either stress-induced analgesia or stress-induced hyperalgesia, as reported in both animal and human studies. The responses to stress include neural, endocrine, and behavioural changes, and built-in coping strategies are in place to address stressors. Peculiar to humans are additional factors that modulate pain that are experienced in times of stress, notably psychological factors that potentially influence the directionality of pain perception.

Pain is modulated by various factors, the most notable of which is emotions. Since love is an emotion, it can also modulate pain. The answer to the question of whether it enhances or reduces pain needs to be determined. A review was conducted of animal and human studies in which this enigmatic emotion and its interaction with pain was explored. Recent advances in neuroimaging have revealed similarities in brain activation relating to love and pain. At the simplest level, this interaction can be explained by the overlapping network structure in brain functional connectivity, although the explanation is considerably more complex. The effect of love can either result in increased or decreased pain perception. An explanation of the interaction between pain and love relates to the functional connectivity of the brain and to the psychological construct of the individual, as well as to his or her ability to engage resources relating to emotion regulation. In turn, this determines how a person relates to love and reacts to pain.

Congenital cholesteatoma (CC) is rare clinical condition and It is known as a pearly white mass medial to an intact tympanic membrane. In this case report, we describe a 6-year-old boy who presented with a one year history of left ear discomfort, reduced hearing, followed by ear discharge two months prior to admission. Otoscopic examination revealed a large attic perforation. Radiological investigation showed extensive cholesteatoma in the mastoid, mesotympanum and epitympanum with destruction of the ossicles including the stapes footplate. He underwent radical mastoidectomy in view of extensive cholesteatoma with tympanoplasty type V. In this case report, the classification, treatment and theories related to CC are discussed.

Pain, while salient, is highly subjective. A sensation perceived as painful by one person may be perceived as uncomfortable, not painful or even pleasant to others. Within the same person, pain may also be modulated according to its threat value and the context in which it is presented. Imaging techniques, such as functional magnetic resonance imaging and positron emission tomography, have identified a distributed network in the brain, the pain-relevant brain regions, that encode the sensory-discriminative aspect of pain, as well as its cognitive and affective/emotional factors. Current knowledge also implicates the prefrontal cortex as the modulatory area for pain, with its subdivisions forming the cortico-cortical pathway, an alternative pain modulatory pathway distinct from the descending modulatory pathway of pain. These findings from neuroimaging in human subjects have paved the way for the molecular mechanisms of pain modulation to be explored in animal studies.

Background: Stenotrophomonas maltophilia has emerged as an important nosocomial pathogen, capable of causing a wide spectrum of infections. Treatment is difficult because it is resistant to many antimicrobial agents, thus reducing the treatment options. The aims of this study were to describe the antimicrobial susceptibility patterns and synergistic effect of selected antimicrobial combinations against S. maltophilia isolates. Methods: This was a descriptive cross-sectional study undertaken in the Hospital Universiti Sains Malaysia from April 2011 to March 2012. S. maltophilia isolated from various clinical specimens were included in the study. Antimicrobial susceptibility testing was done using the epsilometer test (E-test) and interpreted according to the guidelines of the Clinical and Laboratory Standards Institute. In the synergy test, the isolates were tested against six different antimicrobial combinations. Results: In total, 84 S. maltophilia isolates were collected and analysed. According to the E-test, the antimicrobial susceptibility of trimethoprim-sulfamethoxazole (TMP-SMX), tigecycline, and ciprofloxacin was 100%, 91.1%, and 88.9% respectively. The antimicrobial combination of TMP-SMX and ceftazidime showed the highest synergistic effect. Conclusion: TMP-SMX remains the antimicrobial of choice to treat S. maltophilia infection. TMP-SMX and ceftazidime was the most effective combination in vitro.

Introduction: Osteoporosis is a major health problem worldwide. In Asia, few studies have measured knowledge, attitude and practices (KAP) of osteoporosis. This study aimed to determine the KAP of osteoporosis, including the main factors influencing attitude towards osteoporosis, and the relationship between osteoporosis knowledge, attitude, and practices among adults in Kuala Lumpur, Malaysia. Methods: A cross-sectional study via a self-administrated KAP questionnaire was carried out among 232 respondents aged 21 to 50 years in Kuala Lumpur. Random sampling was applied to select five districts in Kuala Lumpur, while convenient sampling was used for recruitment of apparently healthy subjects from community and institutional settings. The data were analysed using Mann-Whitney, Kruskal-Wallis, Chi-Square, Spearman Correlation and multiple logistic regression tests. Results: The findings indicate a moderate level of knowledge and attitude towards osteoporosis prevention with median scores of 51.6% and 68.6%, respectively. Osteoporosis knowledge varied significantly with gender, educational level and household income (p<0.05). Furthermore, attitude was significantly different in relation to educational level and household income. Based on the multiple logistic regression test, relatives and friends appeared to be the most significant factor influencing attitude (R=0.319, p<0.0001). Poor dietary and lifestyles practices were indicated, and a significant relationship was found between practice of weight-bearing activities and educational level (p<0.05). A significant correlation was found (ρ=0.348, p<0.0001) between knowledge and attitude, while no relationship was noted between knowledge and practice of weight-bearing activities or attitude and practice of weight-bearing activities. Conclusion: Knowledge played a significant role in affecting attitudes towards osteoporosis. However, understanding of osteoporosis is still at a moderate level. Friends and family were the most influential factor.

The potential of ketamine, an N-methyl D-aspartate (NMDA) receptor antagonist, in preventing central sensitization has led to numerous studies. Ketamine is increasingly used in the clinical setting to provide analgesia and prevent the development of central sensitization at subanaesthetic doses. However, few studies have looked into the potential of ketamine in combination with stress-induced analgesia. This study looks at the effects of swim stress, which is mediated by opioid receptor, on ketamine analgesia using formalin test. Morphine is used as the standard analgesic for comparison. Adult male Sprague-Dawley rats were assigned to 6 groups: 3 groups (stressed groups) were given saline 1ml/kg intraperitoneally (ip), morphine 10mg/kg ip or ketamine 5mg/kg ip and subjected to swim stress; 3 more groups (non-stressed groups) were given the same drugs without swim stress. Formalin test, which involved formalin injection as the pain stimulus and the pain score recorded over time, was performed on all rats ten minutes after cessation of swimming or 30 minutes after injection of drugs. Combination of swim stress and ketamine resulted in complete analgesia in the formalin test which was significantly different from ketamine alone (p<0.05) and saline with stress (p<0.01). There is no significant difference between ketamine stressed and morphine stressed. These results indicate that ketamine and swim stress act synergistically to produce profound analgesia in the formalin test. This suggests that in the clinical setting, under stressful situations such as operative stress, ketamine is capable of producing profound analgesia at a subanaesthetic dose.

MALAYSIAN ; Right ; Heart