Helminthiasis is a common parasitic condition particularly among children in rural areas in developing countries where poor hygiene standard is practiced. The study aimed to determine the prevalence of helminthiasis among Indian preschoolers in urban areas in Penang and its associated factors. A total of 194 urban Indian preschoolers aged 4 to 6 years old were selected randomly from 11 kindergartens in the state of Penang for this cross sectional study. Data collection was carried out in 2 phases. First, microscopic stool examinations were done to examine the presence of helminths. Second, self administered questionnaires which inquired about human, environment and socioeconomic factors were completed by the parents/guardians. The overall prevalence of helminthiasis was 7.2% and the most frequently encountered infective agent was Ascaris lumbricoides (57.1%) and followed by the tapeworms (42.86%). The logistic regression indicated that habitual thumb sucking (AOR= 5.6. 95%CI: 1.73-18.39) and families owning domestic pets (AOR= 3.2; 95%CI: 1.03-10.14) were the significant contributing factors to helminthiasis among the Indian pre-schoolers in urban Penang. Although the prevalence of helminth infection among the urban Indian preschoolers is lower than rural area, it is still a public health concern. Children habitual thumb sucking and rearing domestic pets at home were the significant contributing factors in helminthiasis. Prevention strategy should focus on health education and promotion among adults and children, awareness on domestic animal hygiene and maintaining good environmental sanitation. Multi agency collaboration is clearly essential, especially between state health, education and veterinary departments in curbing this disease.

Damage Control Resuscitation and Surgery is the concept of controlled hypotension, haemostatic resuscitation and abbreviated surgical procedures following severe trauma; the practice of which has resulted in improved mortality and morbidity. We describe a rare case of thoraco-abdominal impalement successfully managed based on the concept of Damage Control Resuscitation.
Hypotension

Introduction: The objectives of this study were to analyse, compare and contrast the demographic, clinical and pathological data of odontogenic tumours seen at a regional oral pathology centre in the Northern part of Peninsular Malaysia with other international data as an aid to clinicians in diagnosing odontogenic tumours. Materials and Methods: This was a descriptive, retrospective study of odontogenic tumours diagnosed from January 2007 to December 2014 at this centre. The odontogenic tumours were classified using the 2005 World Health Organization classification system. Results: Among 2,733 biopsy specimens, 173 cases were diagnosed as odontogenic tumours (6.3%), of which 171 (98.8%) are benign and 2 (1.2%) are malignant. The most frequently encountered tumour was ameloblastoma (n=96, 55.5%), followed by keratocystic odontogenic tumour (KCOT) (n=38, 22.0%) and odontomas (n=16, 9.2%). Malignant tumours accounted for 1.2% of the tumours. Most ameloblastomas and KCOTs affected the mandible preferentially. The mean age was 33.5 (± 17.8) years and 64.7% of patients were in the age group of 10 to 39. Odontogenic tumours were slightly more common in males, with a male to female ratio of 1.4:1. Conclusion: The findings of this study are similar to the other studies in Asia in which the most common tumour encountered is the ameloblastoma, followed by KCOT. The most common signs and symptoms are pain and swelling, while paraesthesia and root resorption are less frequently reported. Such clinical and radiographic features should alert the clinician of a possible odontogenic tumour and though rare, malignant tumours should also be included in the differential diagnoses.
Odontogenic tumour

The study was conducted to create specific formulae for stature estimation of adult male population in Malaysia based on measurements of femur, tibia and fibula lengths using radiographic method. A number of thirty two Malaysians from hospitals involved as subjects in this study. The subjects were Malays (14), Chinese (8) and Indians (10) from 25-45 years old. The standing height of the subject was recorded before femur, tibia and fibula were scanned with an x-ray machine. The bones length was measured on the x-ray film in centimetres (cm) and analysed using Statistical Package for Social Sciences (SPSS) version 19.0 for Windows. The results showed a significant relationship (p < 0.05) between stature and measurements of length of femur, tibia and fibula. Stature of Malays and Indians were significant (p < 0.05)with measurements of length of femur, tibia and fibula but insignificant in Chinese. Simple Linear Regression Analysis was used to derive regression equation for single bone and Multiple Linear Regression Analysis was used to derive regression equation for combination of femur, tibia and fibula. Six formulae for stature estimation of adult male population in Malaysia were derived. The formulae consist of three formulae for single bone, a formulae for combination bones with unknown race, a formulae for combination bones of Malays population and a formulae for combination bones of Indians population. Formulae for combination bones had the highest correlation coefficient compared to the formula using a single bone. Standard error was found to be high in all the formulae due to small sample size. Extension for this study is essential to provide Malaysia with accurate formulae.

The aim of this study was to develop formulae for stature and sex estimation using foot length and foot width. A total of 150 subjects ranging in age from 20 to 30 years were recruited from Universiti Kebangsaan Malaysia Kampus Kuala Lumpur (UKMKKL). The subjects were Malays (45 males and 45 females) and Chinese (30 males and 30 females). Stature, foot length and foot width were measured using anthropometric instruments in millimetres. Statistical analysis indicated that bilateral variation of various lengths was insignificant for all the foot measurements (Foot length/FL: t(298) = -0.235, p = 0.815; Foot width/FW: t(298) = 0.932, p = 0.352). Sex differences were found to be highly significant for all the measurements (Stature/S: t(148) = 12.550, p < 0.05; FL:t(148) = 11.692, p < 0.05; FW:t(148) = 8.321, p < 0.05). Stature was highly significant in Chinese rather than Malay (t(148) = -3.103, p < 0.05) but no significant differences were found in all the foot measurements (FL: t(148) = 0.002, p = 0.999; FW:t(148) = 1.362, p = 0.175). The highest correlation was found between stature and foot length in all groups. Linear and Multiple Regression Analysis were used to develop formulae for stature estimation. However, the latter was found to be more accurate as the correlation coefficient was highest in the combination of foot length and foot width in all the formulae (S = 585.298+(4.898xFL)-(1.453xFW), F(2,149 = 149.324, p < 0.01, R2 = 0.670). Formulae for sex estimation were obtained by using the Classification Tree Analysis. Result had indicated that sex estimation formulae can help to determine the sex with 86.3-87.5% accuracy in females and 85.2-85.7% accuracy in males by using foot length while the accuracy is 68.4-76.8% in females and 77.8-81.0% in males by using foot width.

Introduction: Stature estimation is population dependent, and population-specific regression equations should be generated for accurate anthropological assessments. Nevertheless, stature estimation data was inaccessible and limited in some of the South-East Asian countries. The systematic review was conducted to analyse the regression equations of stature estimations developed in South-East Asian region. Materials and Methods: A systematic literature search was performed through SCOPUS database and Google Scholar from January till March 2018. All published articles which developed stature estimation from different types of bone, methods and type of statures (i.e. living stature, forensic stature and cadaveric stature) were included in this study. Risks of biases were also assessed. Population studies with no regression equations were excluded from the study. Results: Seven studies that met the inclusion criteria were identified. In the South-East Asia region, regression equations for stature estimation were developed in Thailand and Malaysia. In these studies, bone measurements were done either by radiography, direct bone measurement, or palpation on body surface for anatomical bony prominence. All of these studies used various parts of bones for stature estimation. Conclusion: The most widely used regression equations for stature estimation in SouthEast Asian population were from the Thailand population. Further research is recommended to develop regression equations for other South-East Asian countries.
Stature estimation

BACKGROUND: Prolonged standing has been hypothesized as a vital contributor to discomfort and muscle fatigue in the workplace. The objective of this study was to develop a decision support system that could provide systematic analysis and solutions to minimize the discomfort and muscle fatigue associated with prolonged standing. METHODS: The integration of object-oriented programming and a Model Oriented Simultaneous Engineering System were used to design the architecture of the decision support system. RESULTS: Validation of the decision support system was carried out in two manufacturing companies. The validation process showed that the decision support system produced reliable results. CONCLUSION: The decision support system is a reliable advisory tool for providing analysis and solutions to problems related to the discomfort and muscle fatigue associated with prolonged standing. Further testing of the decision support system is suggested before it is used commercially.
Fatigue ; Human Engineering ; Muscle Fatigue

Congenital malformations (CM) comprise a wide range of abnormalities of body structure or function that are present at birth and are of prenatal origin. It has contributed to a significant proportion of infant morbidity and mortality. The aims of this study were to determine the extent and investigate the relationship between CM and its associated demographic variables. Data was extracted from Ministry of Health (MOH) database compiled from the reports on Stillbirth & Under 5 Mortality from year 2013 to 2014. Out of 9,827 child death, 2,840 (28.9%) were classified under CM as defined under ICD-10 classification. Majority of those with CMs died at neonatal stage (62.7%) and among mothers aged between 20 to 35 years old (67.3%). The mean age of mothers among CM children was 30.8±6.5 years old. Approximately 5.8%, 6.7% and 3.3 % of total CM were neural tube defects, heart defects and hydrops fetalis respectively. The prevalence of CM in males was 15% higher than females. The difference were evident between CM and age of death of children under 5 years old (p<0.001) as well as between CM and maternal age groups (p<0.001). CM is responsible for 28.9% of total causes of child death with higher occurrence of malformation in males. A significantly higher risk of CMs among mother aged between 20 to 35 years old was observed. This emphasises the importance of raising awareness and the need to strengthen appropriate response for surveillance and prevention program of common CM in Malaysia.

Background: Hypersensitivity pneumonitis (HP) is an increasingly recognized form of diffuse parenchymal lung disease. Krebs von den Lungen-6 (KL-6) is now classified as a human MUC1 mucin protein, and regenerating type II pneumocytes are the primary cellular source of KL-6/MUC1 in the affected lungs of patients with interstitial lung diseases (ILD). Serum KL-6/MUC1 levels have been demonstrated to be useful for the evaluation of various ILD. To determine the role of circulating KL-6 in evaluating the disease activity and management of HP. Methods: An observational cross-sectional study was conducted on 51 patients with HP and 20 healthy controls. Serum KL-6 levels were measured in both groups. Patients were further assessed based on chest high-resolution computed tomography (HRCT), pulmonary function test, 6-minute walk test, echocardiography, bronchioalveolar lavage, and/or transbronchial biopsy. Patients were divided into the fibrotic and non-fibrotic groups according to the HRCT findings. Results: The median serum KL-6 levels were significantly higher in HP patients as compared to the control group. The median serum KL-6 levels were found to be higher in the non-fibrotic HP group (1,900 IU/mL) as compared to the fibrotic group (1,200 IU/mL). There was a significant inverse correlation between serum KL-6 serum level and the dose of steroids as well as the duration of steroid therapy. Conclusion The presence of higher KL-6 levels in the non-fibrotic HP group implies its enhanced production by regenerating pneumocytes in response to alveolar injury. The significant association between serum KL-6 levels and the dose and the duration of steroid therapy emphasizes the significant role of steroids in the stabilization of the disease.