Therapeutic Diet for Xerostomia in Head and Neck Cancer Patients: A Narrative Review Xerostomia significantly disrupts nutritional status, increases oral complications, and reduces quality of life in head and neck cancer (HNC) patients. This systematic review aimed to determine the best dietary interventions for the management of xerostomia in HNC patients by examining available therapies and their effects. A search of PubMed, Web of Science, and Scopus was conducted for randomised controlled trials, interventional, and observational studies published between December 2000 and December 2021. English articles involving adult HNC patients undergoing or having completed anti-cancer therapy were included. Non-HNC xerostomia causes and abstracts were excluded. Risk of bias was assessed using the Cochrane and Joanna Briggs Institute (JBI) tools. Fifteen studies were included out of 533 articles. Acidic candy, ginger extract, chewing gum, vitamin C/E supplements, and thyme honey were identified as helpful in reducing xerostomia. Dietary counselling and awareness of diet modifications improved symptoms, nutrition, and quality of life. Acidic candy was particularly effective in stimulating salivary flow but may cause dental enamel erosion, and timing precautions were necessary for thyroid patients’ post-radioactive ablation. Hydration techniques were commonly adopted by patients for symptom alleviation. Dietary modifications show promise in managing xerostomia in HNC patients, although further large-scale, randomised trials are needed to confirm these findings and explore new interventions.

Debilitating and often misdiagnosed cardiac autonomic neuropathy affects people with diabetes. Damage to the biggest sympathetic trunk ganglion of autonomic nerve fibers that innervate the heart and blood vessels, the superior cervical ganglion (SCG), is the cause of aberrant heart rate and vascular dynamics in people with diabetic cardiac autonomic neuropathy (DCAN). Mediating host immunological responses to microbial infection and cellular damage, inflammasomes are a class of cytosolic protein complexes that include NLRP3. This review compiled the findings of experimental investigations on DCAN and discussed their connection to the NLRP3 inflammasome’s involvement. SCG P2X7 receptor expression can be boosted by inflammation brought on by hyperglycemia, leading to nerve injury. Unfortunately, there is a lack of research on DCAN-related inflammation in animal models, especially in inflammasome. Currently, only IncRNAUC.360+ shRNA and Schisandrin B, prove to alleviate the pathogenesis. Therefore, more research into the causes and potential remedies for DCAN is necessary.

This case report presents a groundbreaking discovery of a hitherto undocumented ligament connecting the lingula lobe of the left lung to the diaphragm. The study involved a routine dissection of an adult Asian cadaver during a respiratory module practical session. The cord-like structure, approximately 7 cm in length and 2 cm in diameter, showed ligamentous features and was firmly attached to the upper surface of the left diaphragm without any vascular connections. This finding holds potential clinical significance, particularly during anatomical resections of the lung, as the ligament may need to be freed in surgeries such as lingulectomy, left upper lobectomy, or left lower lobectomy. However, the ligament’s relevance differs from the well-known inferior pulmonary ligament, which aids in accessing crucial lymph nodes during left lower lobectomy. The absence of vascular structures suggests a lack of mediastinal lymph nodes associated with this newly identified ligament. Further research is warranted to fully understand its clinical implications.

Embryology is a critical subdiscipline in medical education, focusing on human body organ development and providing a foundation for understanding developmental anatomy. However, traditional teaching methods using static 2D graphics in textbooks may hinder students’ comprehension of the complex 3D embryonic growth processes. To address this, multimedia approaches, such as animations, videos, and interactive tools, have been explored for effective embryology education. This scoping review identifies five key elements of successful multimedia teaching in embryology: multimodal integrated instructional content, cognitive load-reduction strategies, cognitive engagement and physical interactivity, learner-controlled multimedia instruction, and development of tacit knowledge. These strategies promote active learning, enhance students’ understanding, and foster critical thinking skills. Future research should focus on evaluating the impact of multimedia approaches on students’ engagement, attitudes, and competency development. Embracing multimedia in embryology education can improve medical students’ clinical understanding and support effective medical practice.

NAVIGATING POST-TONSILLECTOMY WATERS IN AUTISM: A TALE OF COMPLICATIONS AND TRIUMPH Adenotonsillectomy (AT) is a common surgery performed in the field of otolaryngology. The most prevalent problems following AT are haemorrhage and breathing obstruction, although many individuals do not experience any subsequent difficulties. We would like to present a case of a child with autism spectrum disorder (ASD) who developed dysphagia and subsequent detrimental complications, including dehydration, after undergoing AT. This condition requires a multidisciplinary strategy to address the problem and provide special care and treatment for ASD children. By employing an all-encompassing strategy, the child demonstrated notable progress in her symptoms and was released after recuperation, with laboratory results returning to normal.

Oral squamous cell carcinoma (OSCC) is the commonest malignant tumour affecting the oral cavity with a poor 5-year disease free survival. We present an octogenarian with a recurrent oral cavity squamous cell carcinoma, treated with salvage mandibulectomy without bony reconstruction. No immediate or intermediate perioperative complications were documented. Subsequent monthly surveillance clinical examination, endoscopy and computed tomography at six months post-operative showed no evidence of residual tumour. Geriatric syndrome, perioperative risk and oncologic stratification are three main cornerstones in evaluating feasibility of oncologic surgery in an elderly patient. A multidisciplinary approach allowed surgical extirpation of OSCC with a good outcome

Introduction: In Malaysia, the undiagnosed diabetes prevalence has increased. Socio-demographic characteristics and nutritional status play a crucial role in prediabetes development. Hence, this cross-sectional study aimed to identify the socio-demographic characteristics and nutritional status of adults at risk of T2DM in Kuala Nerus, Terengganu. Methods: A total of 30 participants at risk of T2DM aged 18 to 59 years old were recruited from Kuala Nerus using a convenience sampling method. Information on socio-demographic, anthropometric, fasting plasma glucose (FPG) level, clinical profile, Finnish Type 2 Diabetes Risk Assessment Tool (FINDRISC) score, dietary intake, and physical activity level were obtained. Results: The participants (mean age: 36.1 ± 8.7 years) were mostly female (76.7%), Malay (96.7%), married (43.3%), had a tertiary degree (60.0%), and were working (83.3%) with a monthly salary of less than RM 1000. Half of the participants were from the obese class I category. Their FPG level was 5.6 ± 0.5 mmol/L and half of them were classified as having optimal blood pressure. Also, they had a mean FINDRISC score of 6.3 ± 1.8. The participants consumed 2073 ± 247 kcal/day, which was comprised of 50.8% carbohydrate, 16.1% protein, and 33.1% fat. Most of them (63.3%) were minimally active. Conclusion: The participants had moderate T2DM risk with normal FPG level, blood pressure, and heart rate. They had excessive energy and fat intake with insufficient dietary fibre intake. It is vital to examine the socio-demographic characteristics and nutritional status, which can provide important information for planning future cost-effective T2DM preventive strategies.

Introduction: Musical-based education has been linked with improved students’ academic performance and mental wellbeing. This study aimed to evaluate a musical-based anatomy learning module using the combination of music, choreographed movements and 3D anatomy illustrations on muscles of the hand. Methods: A 5-minute duration video on muscles of the hand was developed through series of discussions with expert panels to incorporate the three stated components, emphasizing on the use of catchy music and simple terms to assist memorization skills. A single arm quasi-experimental pilot study was conducted with pre- and post-intervention measurement of knowledge, perception, stress and happy index related to learning anatomy. A total of 157 medical students were recruited and exposed to a total of 20 minutes video duration over three days. The effectiveness of the intervention was investigated using paired t-test and was interpreted based on the pre- and post-measured exposure mean differences. Results: The newly developed musical-based anatomy learning module had effectively improved knowledge and happy index related to learning anatomy, with significant mean differences were observed on the total mean scores for knowledge (MD= 2.707, p< 0.001) and happy index (MD=3.256, p< 0.001), as well as significant reduction of the mean scores for the negative items for perceptions and stress. Conclusion: The improved knowledge and happy index related to learning anatomy reflecting the positive impact of music used in combination choreographed movements and 3D illustrations to strengthen memorizing skills of medical students as well as instilling positive mood.

Introduction: Globally, commuting accident risks are always neglected in an organisation. There is a need to assess the impact of commuting accidents based on sociodemographic, human, vehicle, road, and environmental factors and to find suitable and effective mitigation strategies to alleviate the associated undesirable outcomes. Methods: This research was designed to develop a mobile application to assess commuting accident risk levels using artificial intelligence principles, as we are now in the 21st-century technology era. A total of 216 respondents from private and government industries participated in this study. Besides, to prove the developed application’s effectiveness, the study evaluated the effectiveness of the identified risk factor in determining the level of commuting risks predicted by respondents with the risk level calculated by the mobile application. Results: A major contribution of this paper is the effectiveness and accuracy of a mobile application known as CommuRisk. The app was developed using Android Studio and natively uses Java. There was a significant difference between with and without mobile applications in determining the level of commuting risks, and the effectiveness was proven with a (p-value = 0.001) at a 95% confidence interval with large sample size. Conclusion: Thus, this paper proved the effectiveness and accuracy of a mobile application in calculating risk levels exposed by commuters compared to risk levels predicted by commuters.

Introduction: The unprecedented COVID-19 pandemic has led to unavoidable new norms, including increasing demands for online learning. In view of the potential constraints to virtually learn anatomy among medical students, this study was conducted to identify the level of exposure towards online anatomy learning as well as the perceived constraints among medical students in a public university in Malaysia. Methods: A cross sectional study utilizing online survey was conducted during the movement control order (MCO) enforcement in Malaysia between March and October 2020 among all consented medical students at a public university in the Klang Valley area. The data was collected using a validated self-administered questionnaire which was distributed using Google Form application. Results: A total of 281 medical students consented and completed the online survey, with 94.3% students had low level of exposure towards online anatomy learning. Year of study and accessibility towards computing facilities and internet connection were significantly associated with online anatomy learning, with the non-clinical students are 19.9 (aOR= 19.888, B=2.990, 95%CI: 2.484-159.220) times more likely to have higher exposure towards online anatomy learning respectively. Conclusion: A very high proportion of medical students having low exposure towards online anatomy learning was observed in this study, which was predicted among the clinical students. Strengthening the utilization of online learning should be seriously considered in parallel with the new norms and the many uncertainties with COVID-19 pandemic, to ensure continuity of effective and quality learning.