PURPOSE: This study aimed to analyze the relationship between self-perceived dental esthetics and the selected esthetic mathematical proportions. MATERIALS AND METHODS: Descriptive cross-sectional study was conducted among 48 dental students who fit into the inclusion criteria. The subjects rated their self-perceived dental esthetics based on the given Likert scale. Standardized portrait photographs of each subject were taken and the mesiodistal measurements of the maxillary anterior teeth were measured using a graphic editing software. The golden proportion, golden percentage and RED proportion in maxillary anterior teeth were then calculated. RESULTS: Most subjects were pleased with the size, form, and color of their maxillary anterior teeth. Only 2.1% of the maxillary canines and 10.4% of the left maxillary lateral incisors complied with the golden proportion. The maxillary lateral incisors demonstrated its occurrence to golden percentage. For the RED proportion, 29.2% of the left maxillary teeth and 16.7% of the contralateral teeth complied with the proportion. Self-perceived dental esthetics and the occurrence these mathematical proportions have no association. CONCLUSION Within the limitations of the study, it can be concluded that most subjects were satisfied with their self-perceived dental esthetics. Only a small percentage of the subjects having their natural dentition coincide with the golden proportion, golden percentage and RED proportion with a higher percentage occurring on the RED proportion. Hence, the mathematical proportions do not represent the naturally occurring dentition. These mathematical proportions can serve as a guide and the perceived teeth width can be customized accordingly.

PURPOSE: This study aimed to analyze the relationship between self-perceived dental esthetics and the selected esthetic mathematical proportions. MATERIALS AND METHODS: Descriptive cross-sectional study was conducted among 48 dental students who fit into the inclusion criteria. The subjects rated their self-perceived dental esthetics based on the given Likert scale. Standardized portrait photographs of each subject were taken and the mesiodistal measurements of the maxillary anterior teeth were measured using a graphic editing software. The golden proportion, golden percentage and RED proportion in maxillary anterior teeth were then calculated. RESULTS: Most subjects were pleased with the size, form, and color of their maxillary anterior teeth. Only 2.1% of the maxillary canines and 10.4% of the left maxillary lateral incisors complied with the golden proportion. The maxillary lateral incisors demonstrated its occurrence to golden percentage. For the RED proportion, 29.2% of the left maxillary teeth and 16.7% of the contralateral teeth complied with the proportion. Self-perceived dental esthetics and the occurrence these mathematical proportions have no association. CONCLUSION Within the limitations of the study, it can be concluded that most subjects were satisfied with their self-perceived dental esthetics. Only a small percentage of the subjects having their natural dentition coincide with the golden proportion, golden percentage and RED proportion with a higher percentage occurring on the RED proportion. Hence, the mathematical proportions do not represent the naturally occurring dentition. These mathematical proportions can serve as a guide and the perceived teeth width can be customized accordingly.

PURPOSE: This study aimed to analyze the relationship between self-perceived dental esthetics and the selected esthetic mathematical proportions. MATERIALS AND METHODS: Descriptive cross-sectional study was conducted among 48 dental students who fit into the inclusion criteria. The subjects rated their self-perceived dental esthetics based on the given Likert scale. Standardized portrait photographs of each subject were taken and the mesiodistal measurements of the maxillary anterior teeth were measured using a graphic editing software. The golden proportion, golden percentage and RED proportion in maxillary anterior teeth were then calculated. RESULTS: Most subjects were pleased with the size, form, and color of their maxillary anterior teeth. Only 2.1% of the maxillary canines and 10.4% of the left maxillary lateral incisors complied with the golden proportion. The maxillary lateral incisors demonstrated its occurrence to golden percentage. For the RED proportion, 29.2% of the left maxillary teeth and 16.7% of the contralateral teeth complied with the proportion. Self-perceived dental esthetics and the occurrence these mathematical proportions have no association. CONCLUSION Within the limitations of the study, it can be concluded that most subjects were satisfied with their self-perceived dental esthetics. Only a small percentage of the subjects having their natural dentition coincide with the golden proportion, golden percentage and RED proportion with a higher percentage occurring on the RED proportion. Hence, the mathematical proportions do not represent the naturally occurring dentition. These mathematical proportions can serve as a guide and the perceived teeth width can be customized accordingly.

PURPOSE: This study aimed to analyze the relationship between self-perceived dental esthetics and the selected esthetic mathematical proportions. MATERIALS AND METHODS: Descriptive cross-sectional study was conducted among 48 dental students who fit into the inclusion criteria. The subjects rated their self-perceived dental esthetics based on the given Likert scale. Standardized portrait photographs of each subject were taken and the mesiodistal measurements of the maxillary anterior teeth were measured using a graphic editing software. The golden proportion, golden percentage and RED proportion in maxillary anterior teeth were then calculated. RESULTS: Most subjects were pleased with the size, form, and color of their maxillary anterior teeth. Only 2.1% of the maxillary canines and 10.4% of the left maxillary lateral incisors complied with the golden proportion. The maxillary lateral incisors demonstrated its occurrence to golden percentage. For the RED proportion, 29.2% of the left maxillary teeth and 16.7% of the contralateral teeth complied with the proportion. Self-perceived dental esthetics and the occurrence these mathematical proportions have no association. CONCLUSION Within the limitations of the study, it can be concluded that most subjects were satisfied with their self-perceived dental esthetics. Only a small percentage of the subjects having their natural dentition coincide with the golden proportion, golden percentage and RED proportion with a higher percentage occurring on the RED proportion. Hence, the mathematical proportions do not represent the naturally occurring dentition. These mathematical proportions can serve as a guide and the perceived teeth width can be customized accordingly.

PURPOSE: This study aimed to analyze the relationship between self-perceived dental esthetics and the selected esthetic mathematical proportions. MATERIALS AND METHODS: Descriptive cross-sectional study was conducted among 48 dental students who fit into the inclusion criteria. The subjects rated their self-perceived dental esthetics based on the given Likert scale. Standardized portrait photographs of each subject were taken and the mesiodistal measurements of the maxillary anterior teeth were measured using a graphic editing software. The golden proportion, golden percentage and RED proportion in maxillary anterior teeth were then calculated. RESULTS: Most subjects were pleased with the size, form, and color of their maxillary anterior teeth. Only 2.1% of the maxillary canines and 10.4% of the left maxillary lateral incisors complied with the golden proportion. The maxillary lateral incisors demonstrated its occurrence to golden percentage. For the RED proportion, 29.2% of the left maxillary teeth and 16.7% of the contralateral teeth complied with the proportion. Self-perceived dental esthetics and the occurrence these mathematical proportions have no association. CONCLUSION Within the limitations of the study, it can be concluded that most subjects were satisfied with their self-perceived dental esthetics. Only a small percentage of the subjects having their natural dentition coincide with the golden proportion, golden percentage and RED proportion with a higher percentage occurring on the RED proportion. Hence, the mathematical proportions do not represent the naturally occurring dentition. These mathematical proportions can serve as a guide and the perceived teeth width can be customized accordingly.

Pregnancy after undergoing major gastrointestinal surgeries like the Whipple’s procedure (pancreaticoduodenectomy) for pancreatic neoplasm is rare. This case report describes a 24-year-old woman who conceived and delivered a healthy baby after undergoing a Whipple’s procedure 5 months earlier for a pancreatic tumor. Her pregnancy was managed by a multidisciplinary team, and she delivered at 37 weeks of gestation through cesarean section without any complications. This case highlights the potential for successful pregnancy following a Whipple’s procedure, with proper counseling, coordinated care, and close monitoring during pregnancy.
Pancreatic Neoplasms ; Pancreaticoduodenectomy ; Pregnancy

People with type 2 diabetes mellitus have increased risk of chronic kidney disease and atherosclerotic cardiovascular disease. Improved care delivery and implementation of guideline-directed medical therapy have contributed to the declining incidence of atherosclerotic cardiovascular disease in high-income countries. By contrast, the global incidence of chronic kidney disease and associated mortality is either plateaued or increased, leading to escalating direct and indirect medical costs. Given limited resources, better risk stratification approaches to identify people at risk of rapid progression to end-stage kidney disease can reduce therapeutic inertia, facilitate timely interventions and identify the need for early nephrologist referral. Among people with chronic kidney disease G3a and beyond, the kidney failure risk equations (KFRE) have been externally validated and outperformed other risk prediction models. The KFRE can also guide the timing of preparation for kidney replacement therapy with improved healthcare resources planning and may prevent multiple complications and premature mortality among people with chronic kidney disease with and without type 2 diabetes mellitus. The present review summarizes the evidence of KFRE to date and call for future research to validate and evaluate its impact on cardiovascular and mortality outcomes, as well as healthcare resource utilization in multiethnic populations and different healthcare settings.

Introduction: Burnout is a growing trend among medical students worldwide. The aim of this study was to determine the prevalence and factors associated with burnout among medical students at a public university in Malaysia. Methods: A cross-sectional study was conducted among 1st through 5th year medical students at a public university using a simple random sampling method in recruiting participants. In this study, The Maslach Burnout Inventory-General Survey for Student (MBI-SS) was used and burnout is defined as severely emotionally exhausted and severely depersonalised. Results: A total of 328 medical students were recruited with a with response rate of 88.6%. The burnout prevalence was 10.1%. Based on multivariate logistic regression, presence of smartphone addiction with adjusted (odds ratio (OR) 7.37, 95% confidence interval (CI) = 1.67, 32.49), course choice not based on personal interest or due to family pressure (OR 2.72, 95% CI = 1.08, 6.85) and the presence of family relationship problems (OR = 3.58, 95% CI = 1.27, 10.04) are more likely to be associated with burnout among the medical students. Conclusion: Our study has shown that every tenth medical students suffers from burnout. Medical students who are addicted to smartphone, have chosen medical course against individual interest or because of family pressure and have family relationship problems are at risk of getting burnout. Intervention is required to address this issue for the future well-being of medical students.

Objectives: The aim of these Clinical Practice Guidelines is to provide evidence-based recommendations to assist healthcare providers in the screening, diagnosis and management of patients with postmenopausal osteoporosis (OP). Methods: A list of key clinical questions on the assessment, diagnosis and treatment of OP was formulated. A literature search using the PubMed, Medline, Cochrane Databases of Systematic Reviews, and OVID electronic databases identified all relevant articles on OP based on the key clinical questions, from 2014 onwards, to update from the 2015 edition. The articles were graded using the SIGN50 format. For each statement, studies with the highest level of evidence were used to frame the recommendation. Results: This article summarizes the diagnostic and treatment pathways for postmenopausal OP. Risk stratification of patients with OP encompasses clinical risk factors, bone mineral density measurements and FRAX risk estimates. Non-pharmacological measures including adequate calcium and vitamin D, regular exercise and falls prevention are recommended. Pharmacological measures depend on patients’ fracture risk status. Very high-risk individuals are recommended for treatment with an anabolic agent, if available, followed by an anti-resorptive agent. Alternatively, parenteral anti-resorptive agents can be used. High-risk individuals should be treated with anti-resorptive agents. In low-risk individuals, menopausal hormone replacement or selective estrogen receptor modulators can be used, if indicated. Patients should be assessed regularly to monitor treatment response and treatment adjusted, as appropriate. Conclusions The pathways for the management of postmenopausal OP in Malaysia have been updated. Incorporation of fracture risk stratification can guide appropriate treatment.

Gestational trophoblastic diseases are histologically different types of tumors originating from the placenta with an incidence of 0.2–5.8/1000 pregnancies. Ectopic pregnancy is the implantation of the fertilized ovum outside the uterine cavity, and a 0.64% incidence is reported. Ectopic cornual pregnancy and molar pregnancy are rare cases, and a combination of these two rare entities occurring simultaneously is even rare and very few cases have been reported in the literature. A cornual pregnancy refers to the implantation and development of a gestational sac in one of the upper and lateral portions of the uterus, whereas an interstitial pregnancy is a gestational sac that implants within the proximal, intramural portion of the fallopian tube that is enveloped by the myometrium. We present one of the rare combinations of molar pregnancy and cornual/interstitial ectopic pregnancy in a 30‑year‑old G3 P1 who presented with a triad of amenorrhea, vaginal bleeding, and abdominal pain. Laparotomy was done in view of an ultrasound which was suggestive of a well‑defined complex thick‑walled lesion of size 3.2 × 3.3 with a gestational sac and no cardiac activity in the right fallopian tube/adnexa suggesting tubal ectopic pregnancy. Beta‑human chorionic gonadotropin (β‑hCG) levels were done and noted to be as high as 9998 mIU/mL. Intraoperatively, a cornual ectopic pregnancy was found with no hemoperitoneum which was excised. Histopathology showed chorionic villi with variable size and hydropic change, myxoid stromal changes, and cistern formation with polar trophoblastic proliferation, based on which a diagnosis of molar pregnancy was made. Although ultrasonography and higher than usual serum β‑hCG levels are diagnostic of uterine molar pregnancy, they do not yield a proper diagnosis in ectopic molar pregnancy, hence, making it difficult to distinguish between an early ectopic molar pregnancy from a nontrophoblastic tubal pregnancy. The final diagnosis is usually made only after histopathology. A high degree of clinical suspicion of cornual pregnancy followed by histopathological examination of the products of conception is the standard for arriving at an appropriate diagnosis. Serial serum β‑hCG level follow‑up is recommended to rule out its malignant potential.
Pregnancy, Cornual ; Pregnancy, Ectopic ; Hydatidiform Mole