Case Report Open Access 15 Sinocutaneous fistula is a rare complication of chronic rhinosinusitis (CRS), most commonly involving the frontal sinus, with maxillary sinus involvement being uncommon and typically associated with trauma, surgery, or odontogenic infection. We report a rare case of a maxillary sinocutaneous fistula secondary to chronic maxillary rhinosinusitis in the absence of trauma, prior surgical intervention, fungal infection, or neoplasia. The condition resulted from longstanding inflammation with associated osteitis and cortical erosion of the maxillary sinus wall, leading to abnormal communication with the overlying facial skin. Diagnosis was established through clinical evaluation and contrast - enhanced computed tomography of the paranasal sinuses. Definitive management consisted of functional endoscopic sinus surgery with complete excision of the fistulous tract and primary multilayered closure. This case underscores the potential for chronic inflammatory sinonasal disease to cause rare bony complications and highlights the importance of considering CRS in the differential diagnosis of persistent facial cutaneous fistulae

Case Report Open Access 15 Sinocutaneous fistula is a rare complication of chronic rhinosinusitis (CRS), most commonly involving the frontal sinus, with maxillary sinus involvement being uncommon and typically associated with trauma, surgery, or odontogenic infection. We report a rare case of a maxillary sinocutaneous fistula secondary to chronic maxillary rhinosinusitis in the absence of trauma, prior surgical intervention, fungal infection, or neoplasia. The condition resulted from longstanding inflammation with associated osteitis and cortical erosion of the maxillary sinus wall, leading to abnormal communication with the overlying facial skin. Diagnosis was established through clinical evaluation and contrast - enhanced computed tomography of the paranasal sinuses. Definitive management consisted of functional endoscopic sinus surgery with complete excision of the fistulous tract and primary multilayered closure. This case underscores the potential for chronic inflammatory sinonasal disease to cause rare bony complications and highlights the importance of considering CRS in the differential diagnosis of persistent facial cutaneous fistulae

Introudction: Suboptimal care transition post-discharge may potentially increase subsequent healthcare system utilization. Transition of care is a service approach to support continuum of patient care after discharge. Objectives: This study aimed to compare the effect of pharmacist-assisted transition of care versus standard care models towards healthcare resource utilization among medical ward patients. Methods: A cluster randomized controlled study was conducted among medical ward patients in a Malaysian secondary hospital from July to December 2019. Intervention group received pharmacist-assisted discharge medication reconciliation, bedside discharge medication delivery with counselling and a timely post-discharge callback. Control group followed standard discharge process with medication collection at ambulatory pharmacy without post-discharge phone calls. Study endpoints included pharmacy first refill persistency, resolution on unintended discharge medication discrepancies and 30-days all-cause rehospitalization. Results: A total of 168 patients with 84 patients in each arm were recruited. Intervention resulted a higher pharmacy first refill persistency (70.2% versus 50.0%, p<0.05), indicating a lowering in subsequent unscheduled refill rate. Under intervention, consistent rate of resolution from discrepancies (100.0%, IQR 0 versus 100.0%, IQR 67; p<0.05) was demonstrated that corresponded to medication cost-savings of RM6.80 per prescription over control. Unplanned rehospitalization was not significantly different between groups (p>0.05) but towards a trend of 10% reduction after intervention. Conclusion Pharmacist-led transition care model demonstrated promising effect towards a reduction in healthcare resource use compared to standard care. Future studies for its standardization across institutions are warranted to facilitate service expansion.
Patient Transfer

Osteoporosis-related fractures have been recognized as a major health problem, particularly in the elderly with a high morbidity and mortality rate. The aims of the study were to identify knowledge and perception toward calcium intake among students at UiTM and to explore the differences between genders in dietary calcium intake. A cross sectional study was conducted through 336 students aged 18 to 34 years old. The participants were randomly chosen from the student’s enrolment list. A modified questionnaire was used to obtain the knowledge and perception of the participants. More than half of the participants have low knowledge regarding dietary calcium intake (58.6%), positive view towards the benefits of calcium intake and low perception towards the barrier of calcium intake. Chi square analysis showed a significant difference between male and female for knowledge (p=0.034) and barrier (p=0.002) for calcium intake. Intervention programs should be adopted to increase the knowledge among young adults to improve their health and prevent risk factors. So, health education specifically on calcium intake will be very useful to improve the knowledge and behavior of students.
Calcium ; Osteoporosis ; Knowledge ; Students ; Universities

A case of a large dentigerous cyst associated with canine tooth in the maxillary antrum is presented. This case is of interest because of its extensiveness and the presence of an ectopic tooth in the roof of the maxillary sinus. Theoretical aspects of canine impaction and cyst formation are reviewed. The management of a jaw cyst, in particular, the still popular Caldwell-Luc procedure is discussed.