Dental prosthesis ingestion in adults is uncommon, and delayed presentation may complicate diagnosis and management. We report a 39 -year-old woman with epilepsy who accidentally ingested a broken dental prosthesis during sleep. She initially presented with a foreign body sensation and underwent laryngoscopy and oesophagogastroduodenoscopy 24 hours after ingestion and these were unremarkable with no foreign body identified. Four days later, she developed dyspnoea, chest pain, and sepsis. Clinical and radiological assessments revealed a massive left pleural effusion, pneumomediastinum, and contrast leakage from the distal oesophagus, consistent with an oesophageal perforation. The patient was referred urgently for surgical intervention and was successfully treated. This case illustrates the diagnostic challenges of radiolucent dental prostheses and the potential for mucosal injury that may not be immediately evident, which can lead to delayed diagnosis or misdiagnosis resulting in severe complications. Awareness and early recognition, appropriate imaging with computed tomography or contrast studies, and high clinical suspicion are critical, particularly in neurologically compromised patients. Prompt diagnosis and intervention are essential to prevent serious complications such as mediastinitis, sepsis, and respiratory failure

Dental prosthesis ingestion in adults is uncommon, and delayed presentation may complicate diagnosis and management. We report a 39 -year-old woman with epilepsy who accidentally ingested a broken dental prosthesis during sleep. She initially presented with a foreign body sensation and underwent laryngoscopy and oesophagogastroduodenoscopy 24 hours after ingestion and these were unremarkable with no foreign body identified. Four days later, she developed dyspnoea, chest pain, and sepsis. Clinical and radiological assessments revealed a massive left pleural effusion, pneumomediastinum, and contrast leakage from the distal oesophagus, consistent with an oesophageal perforation. The patient was referred urgently for surgical intervention and was successfully treated. This case illustrates the diagnostic challenges of radiolucent dental prostheses and the potential for mucosal injury that may not be immediately evident, which can lead to delayed diagnosis or misdiagnosis resulting in severe complications. Awareness and early recognition, appropriate imaging with computed tomography or contrast studies, and high clinical suspicion are critical, particularly in neurologically compromised patients. Prompt diagnosis and intervention are essential to prevent serious complications such as mediastinitis, sepsis, and respiratory failure

Dental prosthesis ingestion in adults is uncommon, and delayed presentation may complicate diagnosis and management. We report a 39 -year-old woman with epilepsy who accidentally ingested a broken dental prosthesis during sleep. She initially presented with a foreign body sensation and underwent laryngoscopy and oesophagogastroduodenoscopy 24 hours after ingestion and these were unremarkable with no foreign body identified. Four days later, she developed dyspnoea, chest pain, and sepsis. Clinical and radiological assessments revealed a massive left pleural effusion, pneumomediastinum, and contrast leakage from the distal oesophagus, consistent with an oesophageal perforation. The patient was referred urgently for surgical intervention and was successfully treated. This case illustrates the diagnostic challenges of radiolucent dental prostheses and the potential for mucosal injury that may not be immediately evident, which can lead to delayed diagnosis or misdiagnosis resulting in severe complications. Awareness and early recognition, appropriate imaging with computed tomography or contrast studies, and high clinical suspicion are critical, particularly in neurologically compromised patients. Prompt diagnosis and intervention are essential to prevent serious complications such as mediastinitis, sepsis, and respiratory failure

Dental prosthesis ingestion in adults is uncommon, and delayed presentation may complicate diagnosis and management. We report a 39 -year-old woman with epilepsy who accidentally ingested a broken dental prosthesis during sleep. She initially presented with a foreign body sensation and underwent laryngoscopy and oesophagogastroduodenoscopy 24 hours after ingestion and these were unremarkable with no foreign body identified. Four days later, she developed dyspnoea, chest pain, and sepsis. Clinical and radiological assessments revealed a massive left pleural effusion, pneumomediastinum, and contrast leakage from the distal oesophagus, consistent with an oesophageal perforation. The patient was referred urgently for surgical intervention and was successfully treated. This case illustrates the diagnostic challenges of radiolucent dental prostheses and the potential for mucosal injury that may not be immediately evident, which can lead to delayed diagnosis or misdiagnosis resulting in severe complications. Awareness and early recognition, appropriate imaging with computed tomography or contrast studies, and high clinical suspicion are critical, particularly in neurologically compromised patients. Prompt diagnosis and intervention are essential to prevent serious complications such as mediastinitis, sepsis, and respiratory failure

Flood disaster is the commonest natural disaster with huge impact on healthcare services in Malaysia. TheFloodDMQ-BM©questionnairewasdeveloped as a tool to assess the knowledge, attitude, and practice of healthcare providers regarding patient management during a flood disaster. We aimto further validate the FloodDMQ-BM©questionnaire by using Confirmatory Factor Analysis (CFA) and Item Response Theory (IRT).Thiscross-sectional studyinvolved doctors, nurses and paramedics workingin the Emergency Department of Hospital Universiti Sains Malaysia, Hospital Raja Perempuan Zainab II and Hospital Kuala Krai. Respondents were required to complete the FloodDMQ-BM©questionnaire. The responseswereanalysed by using CFA and IRT to establish its validity and reliability. A total of 215respondents participatedin this study. CFA analysiswith Maximum Likelihood Robust as the estimation method, on the attitude and practice components resulted in good factor loadings (>0.5) in nearly all items and excellent modelfit indices values (CFI = 0.96-0.98, TLI = 0.95-0.96, SRMR = 0.04-0.05, RMSEA = 0.07).Meanwhile, IRT analysis on the knowledge section showed a good two-way marginal fit based on S-X2, and a good model fit with RMSEA of 0.08. Based on the 2PL model by using the IRT assessment of the knowledge section, one item in the knowledge section (K3) was removed (chi-squared residual >4) resulting in improved model fit. The included items had well-standardized loadings (>0.3) and marginal reliability of 0. 651.Ourresults confirmed that the FloodDMQ-BM©questionnaire displayed valid and reliable psychometric properties.