Osteosarcoma is a primary malignant neoplasm of the bone. Osteosarcoma of the jaws especially those of maxilla is rare. The diagnosis of osteosarcomas is diff icult and challenging. In this case report we highlight a rare case of osteosarcoma of the maxilla in a 29 year old male patient which was highly aggressive and was initially diagnosed as rhabdomyosarcoma. This case highlights the difficulty in diagnosing osteosarcoma merely from incisional biopsy specimens which may not be representative of the whole tumour. Limited clinical information at incisional biopsy also adds to the difficulty in arriving at the definitive diagnosis. We further discuss the treatment modalities followed in this case.

Langerhans Cell Histiocytosis (LCH) refers to a group of lesions presenting with a spectrum of clinical. features but sharing similar histology. These lesions are rare and treatment has been quite variable with current treatment protocol recommended being dependent on whether it is a unifocal or multi focal bone disease or a multi focal multisystem disease. However, the clinical presentations of LCH are variable and the decision to place into the appropriate clinical types may sometimes be masked by the non-discovery of all the lesions. In the oral maxillofacial area, the clinical features of these lesions may further pose a problem by nondescript manifestations as dental/periodontal/oral mucosal disorders. These oral findings may sometimes lead to inappropriate choice of treatment and delay in the diagnosis of all the lesions involved. This paper describes one such case where LCH manifest itself as a periodontal disease thus leading to delay in identifying all the sites involved and consequently a delay in id~ntifying the appropriate clinical type.

Objective: To explore the association between socialsupport and stress levels in preclinical and clinical dentalstudents in Malaysia. Method: A cross sectional surveyof dental undergraduate students was conducted at theFaculty of Dentistry, University of Malaya, UniversitiKebangsaan Malaysia and Universiti Sains Malaysia.Stress was measured using the Dental Environment Stress(DES) questionnaire. A DES-32 item was used to measurestress for the clinical students and DES-16 item for thepreclinical students. Four questions were used to measuresocial support. The total stress scores were standardizedfor comparison purposes. Results: A total of 357 (79.7%)preclinical and 417 (71.8%) clinical undergraduate dentalstudents responded to the questionnaires. The clinicalstudents experienced higher stress [mean standardizedDES score = 72.63, SD = 10.64] than preclinical students[mean standardized DES score = 70.19, SD=12.01]. Thetwo most stressful items reported by preclinical studentswere “fear of failing” and “examination and grades”.Among clinical students, the two most stressful items relatedto academic were “completing course requirement” and“fear of failing course” and items related to clinical sessionwere “fear of being barred due to the clinical schedule”and “patients late or absent”. Multiple regression analysesrevealed that low stress levels among preclinical studentswere significantly associated to a lot of contact withstudents of the same course. Conclusion: To some extent,social support does play a role in explaining differences inperceived stress, in particular among preclinical students.

Salacca zalacca (Gaertn.) Voss (family Arecaceae) is the snake fruit commonly known in Malay language as salak in Malaysia. This exotic fruit has diverse and potential pharmacological properties due to its high antioxidant content. It is often consumed due to its sweet taste. The abundant natural sugar and fibre along with minerals and vitamin makes it a nutritious fruit. Phytochemical investigation on this fruit has revealed the presence of flavonoids, phenolics, glycosides as well as some volatile and aromatic compounds, including gallic acid, quercetin, chlorogenic acid, epicatechin, proanthocyanidins, lycopene and β-carotene. Pharmacological studies on the fruit flesh and peel have shown some tremendous antioxidant, anti-inflammatory, anticancer and antidiabetic potential. This review provides the botanical information of Salacca zalacca as well as its scientific investigations involving the distinct pharmacological and phytochemical benefits. This could help in highlighting the lacking data and research gaps on this plant.

Staphylococcus aureus is a common bacterial pathogen known to cause various kinds of infections due to its repertoire of virulence factors. This study aimed to investigate the distribution of 19 types of virulence genes among clinical isolates of methicillin-susceptible S. aureus (MSSA) using the polymerase chain reaction. A total of 109 MSSA isolates, i.e., 63 hospital-associated (HA) and 46 community-associated (CA) were collected from Hospital Sultanah Nur Zahirah, the main tertiary hospital in Terengganu, Malaysia, from July 2016 to June 2017. The most frequent virulence genes detected were hla (78.9%, n=86) and hld (78.0%, n=85) encoding hemolysins, lukED (56.9%, n=62) encoding leukotoxin ED, followed by seb (26.6%, n=29) and sea (24.8%, n=27) encoding enterotoxins. Among 34 (31.2%) isolates carrying six or more virulence genes, only five were multidrug resistant (MDR) while the remaining isolates were susceptible. Significant associations were discovered between the hld gene with CA-MSSA (p=0.016) and the seo gene with HA-MSSA (p=0.023). However, there is no significant association between virulence genes among the different types of infection. The clinical MSSA isolates in Terengganu showed high prevalence and high diversity of virulence gene carriage.