Management of traumatic dental injuries (TDI) in a young patient may range from simple to complex. In a situation where teeth are lost, a reliable and conservative treatment option is an implant-supported fixed dental prosthesis (i-FDP), as this treatment option negates the need to prepare sound abutment teeth as in the case of conventional fixed bridges. However, the placement of implants is usually prosthetically driven to allow for a 3D functional and aesthetic restoration. In the presence of severe skeletal Class III malocclusion, treatment may incorporate pre-surgical orthodontic treatment, followed by jaw surgery to correct the skeletal discrepancies and finally post-surgical orthodontic treatment before the rehabilitation with implants. A multidisciplinary treatment approach in a stepwise manner is required to address the patient’s overall treatment needs. This case report presents a joint prosthodontics, orthodontics and oral maxillofacial surgical management of a young adult male patient with a Skeletal Class III malocclusion who required rehabilitation of avulsed missing anterior teeth sustained from childhood TDI. The severity of the skeletal relationship required a Le Fort I maxillary advancement and a bilateral sagittal split osteotomy for the setback of the mandible in combination with orthodontics for correction of malocclusion and arch relationship prior to implant placement. Correction of the malocclusion and jaw deformity allowed the functional and aesthetic rehabilitation of the missing teeth using an i-FDP.

Background: A penile median raphe cyst is an uncommon congenital lesion that is formed due to failure of the median raphe to close completely during embryo development. The majority of the cysts are asymptomatic and often go unnoticed. Here, we report acute urinary retention as a very rare complication of a penile median raphe cyst. Case presentation: A 21-year-old single man presented with a sudden onset of acute urinary retention of one days’ duration. Urethral catheterization was done at the Emergency Department and this drained 800 ml of urine. On further questioning, he claimed that he had had a painless nodule at the glans penis since childhood. The swelling increased in size in the past week causing discomfort. He denied any history of genitalia trauma or recent sexual intercourse. On examination, there was a bluish lesion over the ventral aspect of the glans penis measuring about 3 x 2 cm. The lesion was later excised and histopathology revealed a median raphe cyst of the penis. Conclusion: A penile median raphe cyst is a rare lesion. Acute urinary retention caused by this lesion is very rare.

Background: Studies on the anthropometric, physical and physiological characteristics among Malaysian Paralympic powerlifters are limited. This study examined the sociodemographic, clinical information and anthropometric physical parameters of Paralympic powerlifters in Malaysia.Methods: A cross-sectional study was conducted during a Powerlifting Workshop and National Championship in 2016. A structured questionnaire was used to collect data on powerlifters’ sociodemographic, sports participation history and medical information. All participants underwent a structured physical medical examination and anthropometric assessments. Results: Fifty-two powerlifters participated in this study. Mean age of participants was 24.50±SD8.25 year. The majority of the participants were men (82.7%) and most had spinal cord injury (34.6%) or amputation of the lower limb (26.9%). Most of the powerlifters competed at district and state level championships and 42.3% had represented Malaysia at international competitions. Women powerlifters had a significantly higher amount of body fat compared to men (35.61% vs 19.80%; p=0.003). Male power-lifters had significantly longer arm and forearm length (30.10±IQR3.00 cm vs 23.00±IQR2.13 cm; p=0.020). A significantly positive relationship was found between age, experience, weight, BMI, LBM, arm circumferences (relaxed and tensed) and the powerlifter’s best lift. Age, experience, body weight, BMI, lean body mass, body fat, hip circumference and arm circumferences (relaxed and tensed) met the criteria for inclusion in a multivariate model. Years of experience and non-dominant arm circumference (tensed) were significant predictors of best lifts among powerlifters. Conclusion: In conclusion, assessment of anthropometric measures could be useful in monitoring athletes’ progress with training and have a role in the talent identification program for Paralympic powerlifters

Background: Penile augmentation using injection of a foreign body into penile skin was mainly performed by non-medical personnel. Majority of these patients end up with complication of an abnormal mass formation known as penile paraffinoma. Methods: We described three different surgical techniques for correction of penile paraffinoma based on our single-centre experience. Informed consents were obtained from patients whose photographs were taken during the operation step. Results: In general, three patients had simple excision biopsy with primary suturing, four patients underwent single stage excision of circumferential granuloma with bilateral scrotal skin flap reconstruction and one patient experienced dual stage procedure. Three of them were injected with paraffin, one with silicone and the remaining four were unable to identify the substance used. All patients successfully underwent the surgical procedure and four of them had minor postoperative surgical site infection and wound gapping. Conclusion: All patients recovered well and the mean International Index of Erectile Function (IIEF-5) score obtained was 24.25. In our experience, excision biopsy was adequate for focal mass and reconstructive surgery using bilateral scrotal flap was suitable for circumferential mass.

Pesticides and chemical fertilizers are widely used in agriculture to increase crop productivity among farmers.However, exposure to pesticides will give potential risk to human health. The aim of this study was to analyze thefrequency of micronucleus (MN) and binucleus (BNu) formation in buccal cells from farmers who were exposedto pesticides using the MN assay. Buccal swabs were collected from the farmers in Tanjung Karang (n = 32) andKelantan (n = 43) using wooden tongue depressor. A structured questionnaire was used to obtain demographic dataof the farmers. Cytogenetic analysis was carried out by Acridin Orange (AO) staining 0.0025% (w/v). The frequencyof MN and BNu as the biomarkers for cytogenetic damage was observed by using a fluorescence microscope.Comparison of frequency of MN and BNu is conducted in two areas namely Tanjung Karang, Selangor and Kelantanbecause of the agricultural activity and the type of pesticides used are different. Results showed that the frequencies of bothMN and BNu among farmers in Tanjung Karang were significantly higher (p < 0.05) compared to farmers in Kelantan.Meanwhile, for the socio-demographic factors (age, smoking status, working period), MN and BNu frequencies amongfarmers in Tanjung Karang were also significantly higher (p < 0.05) as compared to farmers in Kelantan. While in theaspect of pesticide exposure, the frequencies of MN and BNu showed no significant difference between the frequency ofpesticide spraying (p > 0.05) and the practices of PPE (Personal Protective Equipment) (p > 0.05). This may suggeststhat cytogenetic changes were not influenced by these factors. In addition, correlation study shows positive correlationbetween the frequency of MN with the pesticide exposure of farmers in Tanjung Karang (p > 0.05, r = 0.015) and Kelantan(p > 0.05, r = 0.0158). Besides, the frequency of BNu also has a positive correlation with the pesticide exposure amongfarmers in Tanjung Karang (p > 0.05, r = 0.036) and farmers in Kelantan (p > 0.05, r = 0.013). Hence, this present study demonstrated that exposure to pesticides increasedthe formation of MN and BNu among farmers and theprolonged use of pesticides may induce genotoxicity andDNA damage to human.

Objective To prove probable relations between serum E3 SUMO-protein ligase NSE2 (NSMCE2) concentration, peroxynitrite related to oxidative stress in nephrolithiasis patients. Methods A total of 60 patients with nephrolithiasis and 50 healthy volunteers were involved in this study. Colorimetric method was used to detect blood urea, creatinine, uric acid, protein, albumin, total antioxidant status, total oxidant status, peroxynitrite, nitric oxide and oxidative stress index. Glutathione, NSMCE2 and superoxide dismutase were measured by ELISA. Results A significant increase in level of peroxynitrite, total oxidant status, NSMCE2 and oxidative stress index in patients was observed, while total antioxidant status and glutathione were significantly decreased. Conclusions The study concluded that serum NSMCE2 significantly correlated with peroxynitrite and oxidative stress in patients with nephrolithiasis.

Background : Detecting the active state of systemic lupus erythematosus (SLE) is important but challenging. This study aimed to determine the diagnostic accuracy of serum endothelial cell adhesion molecules (ICAM-1 and VCAM-1) and anti-C1q antibody in discriminating between active and non-active SLE. Methods: Using SELENA-SLE disease activity index (SLEDAI), 95 SLE patients (45 active and 50 non-active) were assessed. A score above five was considered indicative of active SLE. The blood samples were tested for serum ICAM-1, VCAM-1 and anti-C1q antibody using enzyme-linked immunosorbent assay (ELISA). Results: The levels of serum VCAM-1 and anti-C1q antibody were significantly higher in active SLE patients. Both VCAM-1 and anti-C1q were able to discriminate between active and non-active SLE ( p -value < 0.001 and 0.005, respectively). From the receiver operating characteristic curves (ROCs) constructed, the optimal cut-off values for VCAM-1 and anti-C1q antibody in discriminating between active and non-active SLE were 30.5 ng/mL (69.0% sensitivity, 60.0% specificity, PPV 58.5%, NPV 66.7%) and 7.86 U/mL (75.6% sensitivity, 80% specificity, PPV 77.3%, NPV 78.4%), respectively. However, serum ICAM-1 level was unable to discriminate between the two groups ( p -value = 0.193). Conclusion: Anti-C1q antibody demonstrated the best diagnostic accuracy in discriminating between active and non-active SLE patients

OBJECTIVENephrolithiasis is one of the most common disorders of the urinary tract. The aim of this study was to examine a possible relationship between DNase I/II activity and E3 SUMO-protein ligase NSE2 in the sera of nephrolithiasis patients to evaluate the possibility of a new biomarker for evaluating kidney damage.

METHODSSixty nephrolithiasis patients and 50 control patients were enrolled in a case-control study. Their blood urea, creatinine, protein levels and DNase I/II activity levels were measured by spectrometry. Serum NSMCE2 levels were measured by ELISA. Blood was collected from patients of the government health clinics in Kuantan-Pahang and fulfilled the inclusion criteria.

RESULTSThe result indicated that mean levels of sera NSMCE2 have a significantly increase (P<0.01) in patients compared to control group. Compared with control subjects, activities and specific activities of serum DNase I and II were significantly elevated in nephrolithiasis patients (P$lt;0.01).

CONCLUSIONThis study suggests that an increase in serum concentrations of DNase I/II and E3 SUMO-protein ligase NSE2 level can be used as indicators for the diagnosis of kidney injury in patients with nephrolithiasis.

Adult ; Blood Proteins ; analysis ; Case-Control Studies ; Creatinine ; blood ; Deoxyribonuclease I ; blood ; Endodeoxyribonucleases ; blood ; Hemoglobins ; analysis ; Humans ; Ligases ; blood ; Malaysia ; Middle Aged ; Nephrolithiasis ; blood ; enzymology ; Urea ; blood

Objective: To verify possible associations between adenosine aminohydrolase (ADA) and AMP-aminohydrolase (AMPDA) to E3 SUMO-protein ligase NSE2 (NSMCE2) in patients with renal stones. And to isolate, purify and characterize ADA in patients with renal stones and healthy group. Methods: A total of 60 renal stones patients and 50 control were enrolled in a case- control study. The blood urea, creatinine, uric acid, protein, albumin, ADA and AMPDA were measured by colorimetric tests. The serum NSMCE2 was measured by ELISA. Results: Serum ADA, AMPDA and specific activity of enzymes showed significant decrease (P < 0.05) in patients with renal stones compared to control group, mean levels of sera NSMCE2 and uric acid had a significant increase (P < 0.01 and P < 0.05, respectively) in patients compared to control group. Conclusions: The present study suggests that ADA, AMP deaminase and NSMCE2 can be used as a indicator to monitor the DNA damage and inflammation disorders in the patients with kidney stones.

Objective: To verify possible relations between 5'-nucleotidase, xanthine oxidase to E3 small ubiquitin-like modifier-protein ligase non structural maintenance of chromosomes elements 2 in sera patients with kidney stones and to evaluate the possibility of a new biomarker for the evaluation of kidney damage. Methods: A sixty patients with known kidney stones who appeared the government health clinics in Kuantan-Pahang and fifty apparently healthy were taken as control group. The 5'- nucleotidase, xanthine oxidase and other biochemical parameters were measured by colorimetric tests. The serum NSMCE2 were measured by enzyme linked immunosorbent assay. Results: The mean serum xanthine oxidase [(39.98 ± 19.70) IU/L] and ecto-5'-nucleotidase activity (40.03 ± 9.53 IU/L) were significantly higher than the controls' levels of (18.04 ± 6.26) and (16.06 ± 4.61) IU/L respectively. There were 85.00% and 83.33%, of patients with kidney stones who had abnormal ecto-5'-nucleotidase activity and uric acid respectively while xanthine oxidase activity was less sensitive 58.33%. Conclusions: The present study suggests that the increase in serumof xanthine oxidase,ecto- 5'-nucleotidase activities E3 small ubiquitin-like modifier-protein ligase NSE2 concentration can be used as biomarkers for diagnosis of kidney damage in patients with kidney stone, also in developments of change DNA damage and inflammation disorders in these patients.