Treating tuberculosis (TB) remains a public health challenge in many developing countries. Treatment success rate in Malaysia is on declining pattern from 78% in 2000 to 48% in 2006. This study will determine factors associated with unsuccessful treatment among pulmonary TB patients. A retrospective cohort study was conducted on notified and treated pulmonary TB cases in Kota Bharu district Kelantan between January 2006 and December 2007. To identify the associated factors, univariate comparison and multiple logistic regressions were performed. Among the 765 patients identified, 472 (61.7%) cases fulfilled the criteria and were analyzed. There were 316 males and 156 females and their mean (SD) age was 45 (17.9) years. In univariable analysis, age, gender, educational level, employment status, family incomes as well as co-existence of extra-pulmonary TB, smoking, co-morbid disease (diabetes mellitus), HIV status, sputum cultures, chest X-ray findings and duration of delay for diagnosis were all found to have significant relationship with unsuccessful pulmonary TB treatment outcome. After adjusted for the confounders, the significant predictors for unsuccessful tuberculosis treatment were age (Adj. OR 1.09; 95% CI: 1.03-1.15), HIV positive (Adj. OR 23.04; 95% CI: 3.01-176.22) and advanced chest X-ray findings (Adj. OR 6.51; 95% CI: 1.50-28.23). A large proportion of unsuccessfully treated cases could be identified at entry by screening for age, chest X-rays and HIV status and specially targeted measures could be taken. The use of directly observed treatment short-course (DOTS) should be given more focus and priority among this high risk group of patients.

Objectives: Traditionally, scoliosis surgery is aimed at attaining a fused, balanced and painless spine. With improvement in surgical and instrumentation techniques, spine surgeons strive to achieve higher degree of Cobb’s angle and rib hump correction with the idea of greater patient satisfaction. The aim of this study was to determine the patients’ satisfaction using SRS-22 questionnaire and their correlations with the radiographic changes. Materials and methods: A prospective study was conducted in a tertiary referral centre using the Scoliosis Research Society-22 (SRS-22) questionnaire during the patients’ annual follow up, between February to April 2014. Thirtyseven patients who met the inclusion criteria were enrolled. Results: The mean pre-operative Cobb’s angles were 57.8o ± 12.7o and mean post-operative angle of 20.0o ± 10.4o, resulting in average correction of 65.9 ± 14.4%. Mean preoperative rib hump was 61.1 ± 15.4 mm with mean postoperative rib hump of 15.8 ± 17.8 mm, resulting in average reduction of 77.7 ± 23.7%. Mean of post-operative total SRS score was 4.1 ± 0.5. Using Spearman rank correlation, the percentage of Cobb’s angle correction versus the SRS-22 score showed correlation of 0.17 (P=0.33) while the percentage of rib hump reduction versus SRS-22 score showed a correlation of 0.11 (P=0.53). Conclusion: In this study, the average total SRS-22 score was 4.1 ± 0.5 (range, 3.1-4.9) post-operatively indicating very high satisfaction rate overall. Despite attempts at greater curve correction and rib hump reduction, there is no direct correlation between patient satisfaction and radiographic parameters.
Scoliosis ; Spinal Diseases

This clinical audit is aimed to provide an insight into the performance of dental technicians in renderingfixed prosthodontics services at Faculty of Dentistry, University of Malaya. A retrospective audit wascarried out between 1st of November 2014 and 31st January 2015 using data derived from records andmonthly returns of the technicians, which are kept at the ceramic laboratory. Retrospective data oncases of diagnostic wax-ups, full metal crowns, metal ceramic crowns, all ceramic crowns and bridgesthat were sent to ceramic laboratory for fabrication from 1st of September 2013 to 31st of August 2014was systematically extracted from the record and tabulated categorically in SPSS version 22.0. Theturnaround time in workings day for diagnostic wax-ups and the prostheses was calculated by deductingexit date from entry date. Subsequently, the turnaround time and the complexity of cases were categorizedaccordingly. The association of turnaround time and the complexity of the cases was analysed usingFisher Exact test with p value < 0.05. Within this time frame, a total of 102 cases of diagnostic waxups,36 cases of crown and 18 cases of bridges were fabricated. 57.8% of diagnostic wax-ups werecompleted within 3 days. 100% of 1 unit crown were completed within 7 days and 94.4% of bridges werecompleted within 14 days. There was a significant association of turnaround time and the complexity ofthe cases for diagnostic wax-ups and crowns with p value <0.05. The standard for turnaround time isbeing met by the ceramic laboratory at Faculty of Dentistry, University of Malaya. However, due to theexcessive workload, the overall output of all the measured procedures remains low.