This study assessed the level of public awareness pertaining to risk factors,symptoms, treatment and source of information in relation to stroke and transient ischaemic attack. Stroke risk profile of the respondents was correlated with their level of knowledge. Using a validated pre-tested questionnaire, 112 respondents were recruited during two separate community events. Respondents completed the questionnaire and underwent health screening. The data were analysed using SPSS version 20. Overall knowledge was poor. Only 35% of the respondents had satisfactory knowledge of the warning signs (p= 0.94) and 29% had satisfactory knowledge on the risk factors (p=0.46). When analysed according to risk groups, 26%, 30% and 41% of respondents had satisfactory awareness in the low, intermediate and high risk group, respectively. None of the respondents knew about the availability of treatment of acute stroke in the emergency department or the importance of rehabilitation as part of stroke management. Public awareness on stroke risk factors, symptoms and management is poor.
Stroke

Colour stability of the material is an essential factor that contributes to the selection of a flexible denture material. Staining effects on the denture may result in unattractive appearance, the dissatisfaction of the wearer, and limited usage period of the denture. This study aims to identify the colour stability of the Valplast flexible denture material using three types of beverages. Methods: A total of 32 disc-shaped flexible resin materials (20 +/- 0.1 mm in diameter and thickness 3 +/- 0.1 mm) were prepared based on the manufacturer instructions. The samples were randomly divided into 4 groups of immersion: distilled water (control), coffee solution, tea solution and red wine. The samples were left in the specified immersion solution for up to 60 days. Colour changes were measured after 1, 3, 7, 14, 21, 30, 45 and 60 days of immersion. Results: The samples immersed in coffee solution changed from S1 to S2, whereas samples in tea solution changed from S1 to S3. Additionally, samples in red wine changed from S1 to S4, as observed using the Valplast colour tone guide. The highest reflection measured using spectroscopy was 65.146 at 385.19 nm of the control samples, whereas the lowest reflection was 1.974 at the wavelength of 385.97 nm on the samples immersed in the red wine. Conclusion: The most significant difference can be observed in the red wine group, followed by samples in tea and coffee solutions. Moreover, increasing the immersion period causes increasing staining effect of the denture.
Craniofacial and Biomaterial Sciences Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, 13200, Bertam, Penang, Malaysia 2 Institut Latihan Kementerian Kesihatan Malaysia (Pergigian), No.3 Jalan Sepoy Lines, 10450 Georgetown, Penang, Malaysia 3 Division of Research and Networking, Advanced Medical and Dental Institute, Universiti Sains Malaysia, 13200, Bertam, Penang, Malaysia 4 School of Physics, Universiti Sains Malaysia, 11800 Minden, Penang, Malaysia

Branchial apparatus anomalies usually manifest in teenage or early adult life. Infection complicates second branchial pouch anomalies usually presented as a neck lump or discharging sinus. It is the most common form of anomalies compared to another branchial pouch aberrant. However, it is extremely rare to find a complete branchial fistula with both internal and external openings. Misdiagnosis usually occurs leading to inappropriate and suboptimal treatment. Here, we report of a case of complete second branchial pouch fistula and discuss the clinical presentation and surgical management of such lesion.

Introduction: The lack of evidence that proves the benefit of traditional and complementary medicines (T&CM) in treating chronic medical conditions does not deter its usage among patients worldwide. Prevalence of usage among post-stroke patients in Malaysia especially is unknown. This study aims to determine the prevalence, practice and perception of T&CM use among stroke survivors attending an outpatient rehabilitation program in a teaching hospital. Methods: A cross-sectional study was conducted among 104 post stroke patients attending an outpatient rehabilitation program. A structured self-administered questionnaire was used to collect data on sociodemographic and clinical profile of patients, as well as types of therapy used and perception on T&CM usage. Descriptive analysis was done, and bivariate analysis was used to determine associations between categorical data. Results: Mean age of patients was 62 years (SD 12.2), 54% were Chinese and 75% of the patients had ischaemic stroke. Mean age of T&CM users was younger compared to nonT&CM users (61 years vs. 66 years, p=0.04). Two-thirds (66%) of patients admitted to concurrent T&CM usage while attending conventional post stroke rehabilitation. Acupuncture (40.4%), massage (40.4%) and traditional Chinese medicine (11.5%) were the most common T&CM used. Positive perception was recorded in terms of ability of T&CM usage to relieve post stroke symptoms (68%), and it was safe to use because it was made from ‘natural sources'. Negative perception recorded: T&CM caused significant adverse effects (57.6%) and was not safe to be used in combination with other conventional medicines (62.5%). Conclusions: Concurrent T&CM usage among post-stroke patients attending structured outpatient rehabilitation program is widely practised especially acupuncture, massage and traditional Chinese medici
Complementary Therapies, Stroke

Aged ; Female ; Humans ; Lingual Thyroid ; complications ; drug therapy ; physiopathology ; Oral Hemorrhage ; diagnosis ; etiology ; physiopathology

The important role of non-dental healthcare professionals (HCPs) in promoting oral health is well-accepted and has received increased attention in recent years. However, greater efforts are needed to train them in ensuring better competency in delivering this role. The aim of the present study is to assess oral health and care knowledge among HCPs by further exploring possible challenges faced by them in managing oral health problems, particularly in regard to patients in a public primary healthcare clinic. In the case of the current research, a focus group discussion was carried out with ten HCPs who are directly involved with patients from different units within the health clinics. In particular, the questions developed for the focus group discussion were divided into two parts: (1) knowledge on oral health and its link to general health, and (2) issues and challenges faced by HCPs in handling patients with oral health problems in their daily routine. The session was recorded on a digital audio tape, the responses were then transcribed, followed by the grouping of the scripts which were then qualitatively analysed. The results revealed that majority of the participants appeared to have good knowledge of general and basic oral health; however, only very few of them were aware of the relationship between oral health problems with systemic conditions. Meanwhile, one of the main challenges faced by HCPs in handling patients with oral health problems is their limited knowledge of oral health problems. Specifically, the main challenges refer to the management of medically compromised patient requiring dental treatment as well as the difficulty in changing the mindset of patients regarding oral health issues, especially in terms of seeking dental treatment. In conclusion, it has been clearly observed that HCPs involved in the present study have good knowledge of general health and oral health but limited knowledge related to oral health to systemic health. Furthermore, they tend to face numerous challenges when dealing with patients, especially due to their limited knowledge of oral health facts and drug prescription for oral problems. Therefore, there is an urgent need of additional training for both HCPs and dental teams for the purpose of enabling both parties to provide coordinated and comprehensive service to patients with oral health problems at the primary healthcare clinics.

Introduction: Venepuncture procedure is painful and anxiety associated with venepuncture is common. There are many tools for assessing anxiety levels in an outpatient setting. Hence, this study is to compare the degree of agreement between State-Trait-Anxiety-Inventory (STAI) and Beck Anxiety Inventory (BAI) for measuring anxiety levels among adult patients before venepuncture procedure. Methods: A cross-sectional pilot study was conducted among patients while waiting for a venepuncture procedure in the Phlebotomy Unit, UiTMMC in April 2020. The Malay-validated version of the State-Trait-Anxiety-Inventory (STAI) and Beck Anxiety Inventory (BAI) were used to assess the anxiety level. Differences between sets of data were plotted as described by Bland-Altman to determine the agreement between these two assessment tools. Results: A total of 330 patients participated in the study with a mean age of 46.34 ± 14.34 years old and gender was equally distributed. The scores of state-anxiety (STAI-S), trait-anxiety (STAI-T) and BAI score were 30.04 ± 20.74; 29.51 ± 19.11; and 40.98 ± 20.45, respectively. The score of anxiety using BAI was higher compared to STAI-S (p<0.001) and STAI-T (p<0.001). The mean difference between the STAI-S and BAI was -10.94 (95%CI: -53.01, 26.87) and between the STAI-T and BAI was -11.47 (95%CI: -42.26, 19.32). However, very few patients’ scores outside the 95% LOA for both differences. Conclusion: The STAI and BAI are concordances in measuring anxiety levels among these patients. However, the anxiety score using BAI was higher than STAI. Thus, both assessment tools can be used in clinical practice in measuring anxiety in the out-patients setting.

A 78-year-old post-stroke man with multiple comorbidities who was activity of daily living-dependent developed aspiration pneumonia associated with nasogastric tube (NGT) blockage. He presented with malnutrition and risk of sarcopenia with hypoalbuminaemia, small calf circumference (CC), low body mass index and small mid upper arm circumference. He showed symptoms of moderate-to-severe vascular dementia with behavioural psychological stress disorder, resulting in carer stress. Psychoeducation among the carers and referral to a neuro-psychiatrist were ensued after outpatient-based team meeting discussion. Herein, we highlight the importance of screening for sarcopenia and nutritional status in post-stroke patients with the use of the CC and serum albumin level as well as the involvement of a multidisciplinary team in the primary care setting to improve patient outcomes. Percutaneous endoscopic gastrostomy tubes are more suitable than NGTs for post-stroke patients who require enteral feeding to improve the nutritional status.
Stroke ; Sarcopenia ; Enteral Nutrition

Pilomatrixoma is an uncommon benign tumour arising from the matrix and inner sheath of a normal hair follicle as well as hair cortex. It is usually presented as a superficial, solitary, firm mass which is asymptomatic and slowly growing. It accounts for about 0.2% of all routine skin specimens and may poses a diagnostic challenge as it may resemble other common benign lesions found in the head and neck region. We report a case of a 33-year old men presented to us with a pilomatrixoma of the right cheek, surgical management and histological findings.