Purpose: Disc displacement can cause resorption of the head of the condyle and affect its volume. This study analysed the volume of normal condyles and those with disc displacement with reduction (DDR) in cone-beam computed tomography (CBCT) scans from the Indonesian population. Materials and Methods: This study analysed 56 condyles (26 normal and 30 with DDR) from patients who visited the Oral and Maxillofacial Radiology Unit after being referred from the Prosthodontics Unit at Dental Hospital Universitas Padjadjaran from December 2020 to February 2021. Samples were divided into 2 groups (normal and DDR left and right-side condyles) based on the DC/TMD Axis 1 form through the clinical examination results. Both sample groups were exposed to CBCT radiation. The CBCT imaging results in the Digital Imaging and Communications in Medicine format were exported to the open-source ITK-SNAP format to determine condyle volume. Volumetric data from the cortical and trabecular areas of the right or left side condyles were arranged by sex. The independent t-test was used to determine the significance of differences with IBM SPSS version 21.0. Intra- and inter-observer reliability and validity were tested before determining the volume of the condyles. Results: Normal condyles and DDR condyles showed significant differences in volume (P<0.05). Significant differences were also seen in cortical (P=0.0007) and trabecular (P=0.0045) volumes. There was a significant difference in condylar volume based on sex. Conclusion The normal condyle volume was significantly different from the DDR condyle volume in both sexes.

Purpose: Spatial perception is an essential skill for professional dentists. The objective of this study was to observe the spatial ability, as well as anatomy module grades, of dental students at a dental education center in Indonesia and relate these to gender and cohort. Methods: A cross-sectional study was carried out where dental students in years (cohorts) 1, 2, 4–6 were invited to take the Revised Purdue Spatial Visualization Test (PSVT-R) and the redrawn Vandenberg and Kuse Mental Rotation Test (MRT) in order to assess spatial ability. In addition, the 1st- and 2nd-year dental students carried out gross anatomy assessments. Spatial ability test results were compared using an independent t-test to detect gender differences, one-way analysis of variance to inspect cohort differences, and correlation relative to anatomy module scores. Results: A total of 326 dental students voluntarily participated. Statistically significant gender differences were found in both spatial ability tests in the overall sample (PSVT-R: p<0.001; MRT: p=0.001). When the 1st- and 2nd-year dental students were pooled, significant gender differences were detected, in which males scored higher than females in both spatial ability tests (PSVT-R: p<0.001; MRT: p=0.003). In anatomy, however, females scored higher than the males (p=0.005). In addition, there were weak to moderate, but significant correlations between spatial ability tests and anatomy scores. Conclusion This study indicated that spatial ability may not be the only factor predicting the academic performance of dental students. However, dental students with low spatial ability scores may need supplementary educational techniques when learning specific spatial tasks.

Extramedullary hematopoiesis (EMH) is a rare cause of adrenal mass. We present a 44-year-old woman who has thalassaemia intermedia, referred to Endocrinology clinic for huge adrenal mass. Along with a paraspinal lesion discovered in this patient, the leading diagnosis was EMH. The patient was treated with hypertransfusion and hydroxyurea, which led to a reduction in the size of the right adrenal mass and paraspinal mass. This case highlights the challenges in managing this rare condition. Although EMH is a rare cause of adrenal mass, the diagnosis must be considered in any patient with a history of a congenital hemolytic disorder, to avoid unnecessary surgical procedures.
Hematopoiesis, Extramedullary

ABSTRACT Salmon skin extract contains high proline and hydroxyproline, and has been suggested as a potential topical agent for traumatic oral ulcer healing. The aim of this study was to evaluate the effect of salmon skin extract as traumatic oral ulcer healing. A total of 32 Wistar rats (200 g to 250 g) were distributed into four groups. Group 1 served as the control group (no treatment), Group 2 was topically treated with salmon skin extract agent 4%, Group 3 was topically treated with salmon skin extract agent 5%, and Group 4 was topically treated with salmon skin extract agent 6%. Traumatic ulcers at lip mucosa were performed in all rats and 0.1 ml salmon skin extract was applied on the ulcer twice daily for seven days. The animals were euthanised on the last day of treatment. Biopsy specimens were taken from the lip mucosa in all rats for epithelial thickness evaluation and the study for number of fibroblasts by histological analysis. Significant increase in epithelial thickness and the number of fibroblasts (p > 0.05) was observed in salmon skin extract treatment groups as compared to the control group. Salmon skin extract 6% treatment group had the highest epithelial thickness and the number of fibroblasts amongst the study groups. Salmon skin extract promises an innovative topical application treatment for traumatic oral ulcer healing. Salmon skin extract 6% was the most effective concentration for traumatic oral ulcer healing.
Epithelial Cells ; Fibroblasts ; Oral Ulcer--therapy

The aim of this study is to investigate the volumetric measurements of the maxillary sinus among Indonesian population through computed tomography (CT) scan semi-automated segmentation. This project collected 802 retrospective head CT scan archives from Department of Radiology, Hasan Sadikin Hospital, Bandung, Indonesia between 2019–2020. Patients with craniofacial anomalies/pathology fracture in proximity of the maxillary sinuses, and mediocre image quality were excluded from this study resulting only 97 CT scan archives (194 maxillary sinuses; 52 males; 45 females; age range 0–25 years old). Three-dimensional craniofacial structures were reconstructed and volumetric measurements of the maxillary sinus were computed through semi-automated segmentation using ITK-SNAP. This study recorded the initial phase of maxillary sinus pneumatization during infancy. The maxillary sinus developed until reaching the maximum of average maxillary sinus volume at 13,278.73 mm 3 in 16 to 20 years old group in which afterwards fell to 12,325.21 mm 3 . There was no difference found between right and left maxillary sinus volume. This study revealed that the pneumatization of maxillary sinus begin during infancy and climb until reaching the second decade of life, in which after that slowly decrease. Moreover, no difference between right and left maxillary sinus volume was detected. The volumetric dimension of maxillary sinus presented in this study may serve as the basis knowledge surgical intervention of maxillary sinus and its related structures.

Introduction: Stichopus hermanii (SH), which contains various antioxidant agents, tends to protect oxidative stress caused by chronic cigarette smoking (CCS). This study, therefore, aims to investigate the protective effect of SH supplementation against CCS-induced oxidative stress in rat salivary glands. Methods: A total of 30 male Wistar rats, which were equally divided into the control (C), cigarette smoke (CS), and treatment (T) groups, were used to carry out this research. In T group, 17 mg/kg BW of SH was administered for 90 days. Their salivary glands were removed for oxidative stress marker analyses ie malondialdehyde (MDA) level, total antioxidant status (TAS), superoxide dismutase (SOD) and catalase (CAT) activity, with the data analyzed using one-way ANOVA and Tukey’s multiple comparison test to obtain a p-value of less than 0.05, which were considered statistically significant. Results: The results showed that in the CS group oxidative stress occurred which was characterized by significantly increased MDA levels, reduced TAS, SOD and CAT activity. While the T group significantly decreased MDA levels, enhanced TAS, SOD and CAT activity. Conclusion: In conclusion, SH supplementation tends to prevent oxidative stress produced by CCS in rat salivary glands.

Introduction: Association studies between single nucleotide polymorphisms (SNPs) and type 2 diabetes mellitus (T2DM) have been abundant. However, there are limited reports on copy number variations (CNVs) of beta-defensins (DEFB) gene in relation to T2DM. In this study, DEFB copy numbers were quantified in T2DM with nephropathy, T2DM without nephropathy and non-diabetic control groups to investigate its influence in chronic inflammation in Malaysian individuals. Methods: DEFB copy number in Malaysian individuals were quantified by using paralogue ratio tests (PRT) which allow direct quantification of gene copy number by using PRT107A and HSPD21 PRT primers. The copy number generated was then validated from insertion/deletion ratio measurement 5DEL (rs5889219) and two microsatellite analyses (EPEV-1 and EPEV-3). Results: DEFB copy number was found extending from 2 to 8 copies in the non-diabetic group (n=146), while in T2DM group (n=392), copy numbers were more extensive, ranging between 1 and 12 copies; with 1, 10 and 12 copies detected in T2DM with nephropathy group (n=202). Statistically, there is no significant difference in DEFB copy number between T2DM and the non-diabetic group (p=0.209) as well as between diabetic nephropathy and without nephropathy of the T2DM group (p=0.522). However, significant white blood cell (WBC) count was found between T2DM groups with and without diabetic nephropathy (p=0.000). Conclusion: Extreme DEFB copy numbers in T2DM with nephropathy group suggest future studies with bigger sample size are necessary to elucidate the true impact of CNVs of DEFB gene in promoting early onset of nephropathy in T2DM.

Introduction: Prediabetes, typically defined as blood glucose levels above normal but below diabetes thresholds, denotes a risk state that confers a high chance of developing diabetes. Asians, particularly the Southeast Asian population, may have a higher genetic predisposition to diabetes and increased exposure to environmental and social risk factors. Malaysia alone was home to 3.4 million people with diabetes in 2017; the figure is estimated to reach 6.1 million by 2045. Developing strategies for early interventions to treat prediabetes and preventing the development of overt diabetes and subsequent cardiovascular and microvascular complications are therefore important. Methods: An expert panel comprising regional experts was convened in Kuala Lumpur, for a one-day meeting, to develop a document on prediabetes management in Malaysia. The expert panel comprised renowned subject-matter experts and specialists in diabetes and endocrinology, primary-care physicians, as well as academicians with relevant expertise. Results: Fifteen key clinical statements were proposed. The expert panel reached agreements on several important issues related to the management of prediabetes providing recommendations on the screening, diagnosis, lifestyle and pharmacological management of prediabetes. The expert panel also proposed changes in forthcoming clinical practice guidelines and suggested that the government should advocate early screening, detection, and intensive management of prediabetes. Conclusion: This document provides a comprehensive approach to the management of prediabetes in Malaysia in their daily activities and offer help in improving government policies and the decision-making process.

Background: Preconception care is a set of interventions that aim to identify and modify biomedical, behavioral, and social risks to a woman’s health or pregnancy outcome through prevention and management. These interventions emphasize factors that must be addressed before conception or early in pregnancy in order to have maximal impact. Preconception health care is a key intervention in improving maternal and neonatal health care. Identification of specific needs of population-at-risk remains crucial in developing quality preconception health care programs in the Philippines. Objectives: This paper: 1) described the preconception health status of women of reproductive age in selected communities in Lipa City Batangas; 2) identified the perceived preconception needs of women of reproductive age in selected communities; 3) determined the significant challenges to the provision of appropriate preconception health care; and 4) provided recommendations to address the gaps and challenges. Methods: A total of 4,357 women of reproductive age were interviewed using a preconception checklist tool previously developed by researchers from Peking University (China), American University of Beirut (Lebanon), and University of the Philippines Manila (Philippines). Eleven Focus Group Discussions (FGDs) on various aspects of preconception health care were conducted among women of reproductive age from communities and workplaces (industries/factories, government offices, schools, entertainment centers, health centers). Thematic analyses of the data from the FGDs were performed. Recommendations for overcoming identified challenges to quality services were presented. Results: There are salient gaps in preconception health care, particularly in micronutrient intake, immunization status, family planning and infectious diseases screening in both urban and rural communities. The study also showed major gaps in medical and educational services, particularly for adolescents. Conclusion Health and social challenges in the preconception health care delivery system for women of reproductive age in Lipa City Batangas were identified, including the prioritization of at-risk groups and development of strategies to address preconception health care gaps in both urban and rural settings. The alarming increasing rate of teenage pregnancy must be given highest priority with integration of safe and healthy pregnancy in the curriculum. The development of programs for men and women recognizes that parenthood is a partnership. To guarantee a successful program on preconception health care services, government must utilize an inter-sectoral and interdisciplinary approach with the participation of various stakeholders and sectors, both government and private. The engagement of women of reproductive age in planning provides a dynamic feedback for the relevance of the planned programs.
Delivery of Health Care

Diabetes in pregnancy is associated with risks to the woman and her developing fetus. Management of the condition at the primary care level includes pre-conception care, screening, diagnosis, as well as antenatal and postpartum care. A multidisciplinary approach is essential in ensuring its holistic management.