Stroke is becoming a major public health issue in our country due to the fact that there is an increasing life span of our population. Due to advancement of acute management of stroke, three out of four people will survive beyond the acute phase of stroke. Stroke care providers are still debating regarding the exact period of the terminology ‘longer-term stroke’; however many agreed that long-term of stroke refers to the period of one year and thereafter as this period is the determinant for longer-term survival. Management beyond the first year of stroke is complex, encompasses all aspects of patient’s life; physical, psychological and integration into community. Rehabilitation being the cornerstone of longer-term stroke management should now focused on more evidence-based approach as to be effective and relevant to the stroke patients.

Aim: To manufacture a clinical simulation apparatus for the undergraduates' endodontic radiography teaching Objectives: • To provide a model for teaching of parallax method using Kelly's forcep • To provide a model for undergraduates to practice radiographic localization employing parallax method. • To allow students to practice taking radiographs in a way that simulates the clinical situations with a good diagnostic quality Methods: Impressions of a dentate arch (maxillary and mandibullary) were used to form a stone cast. A section of the cast, in the area where the natural teeth were to be placed, is sectioned and removed. Three maxillary extracted teeth (canine, first and second premolar) were selected and mounted with acrylic resin at the sectioned area. The resin was cured in a light box. The arches were mounted in a phantom head with a placement of rubber cheek. The first premolar was isolated with rubber dam. The intraoral holder (Kelly's forcep) was attached to a robotic arm. The students were taught the correct angulations of the x-ray cone for the paralleling technique and parallax method using Kelly's forcep during root canal treatment. Results: All students managed to complete the exercise and were considered competent when they produced acceptable quality of radiographs. Conclusion: The model described was improvised from a model that has been used during the past 2 years for undergraduates' endodontic courses. It has been well accepted as it simulates the clinical situation more closely than was possible previously.

The aim of this study was to develop a new validated questionnaire to assess the health impact of divorce on women. A cross sectional study was undertaken in a district in Terengganu, using a newly developed self-administered Malay language questionnaire comprising of six domains and 82 items. The questionnaire was constructed based on the literature review and discussions with experts. Exploratory factor analysis was applied in construct validity and internal consistency was used for reliability analysis. A total of 51 respondents were involved in this study. All the consented divorcees were Malays. The mean (SD) age for the divorced women was 35.8 (10.00). Majority (82.4%) of them had secondary education. All the final three domains demonstrated Keiser-Meyer-Olkin (KMO) of more than 0.6, significant Bartlett’s test of Sphericity and Cronbach’s alpha of more than 0.80. The overall Cronbach’s alpha was excellent (0.920). The final questionnaire consisted of two domains. Factor loading for all items in each subdomains were satisfactory. The final functional somatic symptoms domain consisted of 6 subdomains and 19 items with factor loading from 0.402 to 0.914. For emotional instability domain, the final items were 13 items with factor loading from 0.548 to 0.878. The questionnaire was valid and reliable to be used for functional somatic symptoms and emotional instability domains. It is useful to assess the health impact and related intervention of divorced women. A confirmatory factor analysis may further confirm the final model.

The objectives of the research are to identify the noise sources and noise level exposure inside C130H aircraft’s hangar; to produce noise mapping; to identify hearing status of C130H aircraft maintenance crews (MC); and suggesting the noise control measure that can be applied. A field survey on noise level by using a digital sound level meter and producing noise mapping. A hearing testing among 63 MC was carried out in Institute of Aviation Medicine, Royal Malaysian Air Force (RMAF). Reviewing the literature and analyzing some control measures to be taken. Hearing test result shown 41.2% of the MC are having hearing impairment. The highest noise level at the central of the hangar is 92.2 dBA (day-time) and 94.2 dBA (night-time) when there is a C130H aircraft starting its engine at 50 meters from the central of the hangar, 95.3 dBA (day-time) and 97.3 dBA (night-time) when there is a C130H aircraft Engine Ground Run at 150 meters from the central of the hangar. Besides, Auxiliary Power Unit is producing the highest noise level which is 125.7 dBA (day-time) and 127.7 dBA (night-time). The application of Personal Protective Equipment (PPE) is the very likely control measure to be taken while engineering control is very costly but can be considered. Since noise is recognized as a hazard, hearing protection as PPE will not be the ultimate solution as a control measure. Hence, the Engineering Control must be identified and studied to be implemented as an ultimate solution to control the noise hazard in long term duration.
C130H aircraft ; maintenance crew ; noise exposure

The objective s of the research are t o identify the noise sources and noise level exposure inside C130H aircraft ’s hangar ; to produce nois e mapp ing ; to identify hearing status of C 130H aircraft maintenance crews (MC) ; and suggesting the noise control measure that can be applied. A field survey on noise level by using a digital s ound level m eter and producin g noise mapping . A h earing test ing among 63 MC was carried out in Institute of Aviation Me dicine , Royal Malaysian Air Force ( RMAF ) . Reviewing the literature and a nalyzing some control measure s to be taken. Hearing test result shown 41.2% of the MC are having hearing impairment. The highest noise level at the central of the hanga r is 92.2 dB A ( day - time) and 94.2 dBA (night - time) when there is a C130H aircraft starting its engine at 50 meter s from the centr al of the hanga r, 95.3 dBA (day - time) and 97.3 dBA (night - time) when there is a C130H a ircraft Engine Ground Run at 150 meter s fr om the centra l of the hanga r. Besides, Auxiliary Power Unit is producing the highest nois e level which is 125.7 dBA (day - time) and 127.7 dBA (night - time) . The application of Personal Protective Equipment (PPE) is the very likely control measure to be taken while engin eering control is ve ry costly but can be considered. Since noise is recognized as a hazard, hearing protection as PPE will not be the ultimate solution as a control measure. Hence, the Engineering Control must be identified and studied to be implemented as an ultimate solution to control the noise hazard in long term duration.

Blunt abdominal trauma can cause multiple internal injuries. However, these injuries are often difficult to accurately evaluate, particularly in the presence of more obvious external injuries. Computed tomography (CT) imaging is currently used to assess clinically stable patients with blunt abdominal trauma. CT can provide a rapid and accurate appraisal of the abdominal viscera, retroperitoneum and abdominal wall, as well as a limited assessment of the lower thoracic region and bony pelvis. This paper presents examples of various injuries in trauma patients depicted in abdominal CT images. We hope these images provide a resource for radiologists, surgeons and medical officers, as well as a learning tool for medical students.

Data on the prevalence of sexually transmitted diseases in the United Arab Emirates (UAE) is lacking and scarce. This study was carried out to determine the prevalence of both Treponema pallidum (causative agent of syphilis) and HIV infections among expatriates in Sharjah, UAE. The study group (N = 20,670) included expatriate workers of both sexes undergoing mandatory pre-employment testing between May and June 2014. Detection of specific antibodies to Treponema pallidum and HIV antigens and antibodies was conducted using commercially available kits. Of the 20,670 samples screened for syphilis, one hundred and five (0.51%) tested positive. Expatriates from India (30.5%), Pakistan (25.7%), and Bangladesh (15.2%) showed the highest infection rate with T. pallidum. Moreover, three age groups were most affected with syphilis and a significant correlation was noted between age and T. pallidum infections (x2 = 76.23; p = 0.001). Furthermore, an association was also observed between gender and infection with T. pallidum (x2 = 3.37; p = 0.04). Of the 20,670 samples screened for HIV, three samples (0.014%) tested positive for HIV antibodies and antigen. The results were consequently confirmed by western blot assay. The prevalence of infection with T. pallidum and HIV was determined for the first time among expatriates in Sharjah providing policymakers with data which could be used to develop appropriate prevention and control strategies.

Presence of air in the kidney can be problematic as the location of the air in different parts of the kidney greatly affects the subsequent management and outcome of the patient. We present here a case of a patient who had emphysematous pyelitis, in which CT scan was able to display presence of air only in the collecting system, thus differentiating this condition from the more fulminant emphysematous pyelonephritis. This leads to a more favourable prognosis and outcome to the patient.

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.

Kimura disease presents as benign lesion and is commonly present among the Asian population. It is a disease with a favourable prognosis and a peak age of onset in the third decade. It is a chronic inflammatory disorder of unknown etiology that involves the lymph nodes and subcutaneous tissues of the head and neck region. We report a case of a 15-year-old boy with multiple Kimura lymphadenopathies involving the left posterior auricular region as well as the anterior and posterior triangles of the neck.